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Sample records for patient set-up accuracy

  1. Impact of the frequency of online verifications on the patient set-up accuracy and set-up margins

    Directory of Open Access Journals (Sweden)

    Mohamed Adel

    2011-08-01

    Full Text Available Abstract Purpose The purpose of the study was to evaluate the patient set-up error of different anatomical sites, to estimate the effect of different frequencies of online verifications on the patient set-up accuracy, and to calculate margins to accommodate for the patient set-up error (ICRU set-up margin, SM. Methods and materials Alignment data of 148 patients treated with inversed planned intensity modulated radiotherapy (IMRT or three-dimensional conformal radiotherapy (3D-CRT of the head and neck (n = 31, chest (n = 72, abdomen (n = 15, and pelvis (n = 30 were evaluated. The patient set-up accuracy was assessed using orthogonal megavoltage electronic portal images of 2328 fractions of 173 planning target volumes (PTV. In 25 patients, two PTVs were analyzed where the PTVs were located in different anatomical sites and treated in two different radiotherapy courses. The patient set-up error and the corresponding SM were retrospectively determined assuming no online verification, online verification once a week and online verification every other day. Results The SM could be effectively reduced with increasing frequency of online verifications. However, a significant frequency of relevant set-up errors remained even after online verification every other day. For example, residual set-up errors larger than 5 mm were observed on average in 18% to 27% of all fractions of patients treated in the chest, abdomen and pelvis, and in 10% of fractions of patients treated in the head and neck after online verification every other day. Conclusion In patients where high set-up accuracy is desired, daily online verification is highly recommended.

  2. Impact of the frequency of online verifications on the patient set-up accuracy and set-up margins

    International Nuclear Information System (INIS)

    Rudat, Volker; Hammoud, Mohamed; Pillay, Yogin; Alaradi, Abdul Aziz; Mohamed, Adel; Altuwaijri, Saleh

    2011-01-01

    The purpose of the study was to evaluate the patient set-up error of different anatomical sites, to estimate the effect of different frequencies of online verifications on the patient set-up accuracy, and to calculate margins to accommodate for the patient set-up error (ICRU set-up margin, SM). Alignment data of 148 patients treated with inversed planned intensity modulated radiotherapy (IMRT) or three-dimensional conformal radiotherapy (3D-CRT) of the head and neck (n = 31), chest (n = 72), abdomen (n = 15), and pelvis (n = 30) were evaluated. The patient set-up accuracy was assessed using orthogonal megavoltage electronic portal images of 2328 fractions of 173 planning target volumes (PTV). In 25 patients, two PTVs were analyzed where the PTVs were located in different anatomical sites and treated in two different radiotherapy courses. The patient set-up error and the corresponding SM were retrospectively determined assuming no online verification, online verification once a week and online verification every other day. The SM could be effectively reduced with increasing frequency of online verifications. However, a significant frequency of relevant set-up errors remained even after online verification every other day. For example, residual set-up errors larger than 5 mm were observed on average in 18% to 27% of all fractions of patients treated in the chest, abdomen and pelvis, and in 10% of fractions of patients treated in the head and neck after online verification every other day. In patients where high set-up accuracy is desired, daily online verification is highly recommended

  3. Extracranial stereotactic radiation therapy: set-up accuracy of patients treated for liver metastases

    International Nuclear Information System (INIS)

    Herfarth, K.K.; Debus, J.; Lohr, F.; Bahner, M.L.; Fritz, P.; Hoess, A.; Schlegel, W. Ph.D.; Wannenmacher, M.F.

    2000-01-01

    Purpose: Patients with liver metastases might benefit from high-dose conformal radiation therapy. A high accuracy of repositioning and a reduction of target movement are necessary for such an approach. The set-up accuracy of patients with liver metastases treated with stereotactic single dose radiation was evaluated. Methods and Materials: Twenty-four patients with liver metastases were treated with single dose radiation therapy on 26 occasions using a self-developed stereotactic frame. Liver movement was reduced by abdominal pressure. The effectiveness was evaluated under fluoroscopy. CT scans were performed on the planning day and directly before treatment. Representative reference marks were chosen and the coordinates were calculated. In addition, the target displacement was quantitatively evaluated after treatment. Results: Diaphragmal movement was reduced to median 7 mm (range: 3-13 mm). The final set-up accuracy of the body was limited to all of median 1.8 mm in latero-lateral direction (range: 0.3-5.0 mm) and 2.0 mm in anterior-posterior direction (0.8-3.8 mm). Deviations of the body in cranio-caudal direction were always less than the thickness of one CT slice (<5 mm). However, a repositioning was necessary in 16 occasions. The final target shift was median 1.6 mm (0.2-7.0 mm) in latero-lateral and 2.3 mm in anterior-posterior direction (0.0-6.3 mm). The median shift in cranio-caudal direction was 4.4 mm (0.0-10.0 mm). Conclusions: In patients with liver metastases, a high set-up accuracy of the body and the target can be achieved. This allows a high-dose focal radiotherapy of these lesions. However, a control CT scan should be performed directly before therapy to confirm set-up accuracy and possibly prompt necessary corrections

  4. Cone beam CT evaluation of patient set-up accuracy as a QA tool

    DEFF Research Database (Denmark)

    Nielsen, Morten; Bertelsen, Anders; Westberg, Jonas

    2009-01-01

    Purpose. To quantify by means of cone beam CT the random and systematic uncertainty involved in radiotherapy, and to determine if this information can be used for e.g. technical quality assurance, evaluation of patient immobilization and determination of margins for the treatment planning. Patients...... and lateral directions). In the CC direction, the margin has to be 5 mm for the Thorax patients. The total uncertainty on the patient position grows during the treatment course, especially in the CC direction for patients receiving thoracical irradiation. This may stem from problems in the immobilization...... and methods. Eighty four cancer patients have been cone beam CT scanned at treatment sessions 1, 2, 3, 10 and 20. Translational and rotational errors are analyzed. Results and conclusions. For the first three treatment sessions the mean translational error in the AP direction is 1 mm; this indicates a small...

  5. Accuracy in tangential breast treatment set-up

    International Nuclear Information System (INIS)

    Tienhoven, G. van; Lanson, J.H.; Crabeels, D.; Heukelom, S.; Mijnheer, B.J.

    1991-01-01

    To test accuracy and reproducibility of tangential breast treatment set-up used in The Netherlands Cancer Institute, a portal imaging study was performed in 12 patients treated for early stage breast cancer. With an on-line electronic portal imaging device (EPID) images were obtained of each patient in several fractions and compared with simulator films and with each other. In 5 patients multiple images (on the average 7) per fraction were obtained to evaluate set-up variations due to respiratory movement. The central lung distance (CLD) and other set-up parameters varied within 1 fraction about 1mm (1SD). The average variation of these parameters between various fractions was about 2 mm (1SD). The differences between simulator and treatment set-up over all patients and all fractions was on the average 2-3mm for the central beam edge to skin distance and CLD. It can be concluded that the tangential breast treatment set-up is very stable and reproducible and that respiration does not have a significant influence on treatment volume. EPID appears to be an adequate tool for studies of treatment set-up accuracy like this. (author). 35 refs.; 2 figs.; 3 tabs

  6. Feasibility of geometrical verification of patient set-up using body contours and computed tomography data

    International Nuclear Information System (INIS)

    Ploeger, Lennert S.; Betgen, Anja; Gilhuijs, Kenneth G.A.; Herk, Marcel van

    2003-01-01

    Background and purpose: Body contours can potentially be used for patient set-up verification in external-beam radiotherapy and might enable more accurate set-up of patients prior to irradiation. The aim of this study is to test the feasibility of patient set-up verification using a body contour scanner. Material and methods: Body contour scans of 33 lung cancer and 21 head-and-neck cancer patients were acquired on a simulator. We assume that this dataset is representative for the patient set-up on an accelerator. Shortly before acquisition of the body contour scan, a pair of orthogonal simulator images was taken as a reference. Both the body contour scan and the simulator images were matched in 3D to the planning computed tomography scan. Movement of skin with respect to bone was quantified based on an analysis of variance method. Results: Set-up errors determined with body-contours agreed reasonably well with those determined with simulator images. For the lung cancer patients, the average set-up errors (mm)±1 standard deviation (SD) for the left-right, cranio-caudal and anterior-posterior directions were 1.2±2.9, -0.8±5.0 and -2.3±3.1 using body contours, compared to -0.8±3.2, -1.0±4.1 and -1.2±2.4 using simulator images. For the head-and-neck cancer patients, the set-up errors were 0.5±1.8, 0.5±2.7 and -2.2±1.8 using body contours compared to -0.4±1.2, 0.1±2.1, -0.1±1.8 using simulator images. The SD of the set-up errors obtained from analysis of the body contours were not significantly different from those obtained from analysis of the simulator images. Movement of the skin with respect to bone (1 SD) was estimated at 2.3 mm for lung cancer patients and 1.7 mm for head-and-neck cancer patients. Conclusion: Measurement of patient set-up using a body-contouring device is possible. The accuracy, however, is limited by the movement of the skin with respect to the bone. In situations where the error in the patient set-up is relatively large, it is

  7. Comparison of prostate set-up accuracy and margins with off-line bony anatomy corrections and online implanted fiducial-based corrections.

    Science.gov (United States)

    Greer, P B; Dahl, K; Ebert, M A; Wratten, C; White, M; Denham, J W

    2008-10-01

    The aim of the study was to determine prostate set-up accuracy and set-up margins with off-line bony anatomy-based imaging protocols, compared with online implanted fiducial marker-based imaging with daily corrections. Eleven patients were treated with implanted prostate fiducial markers and online set-up corrections. Pretreatment orthogonal electronic portal images were acquired to determine couch shifts and verification images were acquired during treatment to measure residual set-up error. The prostate set-up errors that would result from skin marker set-up, off-line bony anatomy-based protocols and online fiducial marker-based corrections were determined. Set-up margins were calculated for each set-up technique using the percentage of encompassed isocentres and a margin recipe. The prostate systematic set-up errors in the medial-lateral, superior-inferior and anterior-posterior directions for skin marker set-up were 2.2, 3.6 and 4.5 mm (1 standard deviation). For our bony anatomy-based off-line protocol the prostate systematic set-up errors were 1.6, 2.5 and 4.4 mm. For the online fiducial based set-up the results were 0.5, 1.4 and 1.4 mm. A prostate systematic error of 10.2 mm was uncorrected by the off-line bone protocol in one patient. Set-up margins calculated to encompass 98% of prostate set-up shifts were 11-14 mm with bone off-line set-up and 4-7 mm with online fiducial markers. Margins from the van Herk margin recipe were generally 1-2 mm smaller. Bony anatomy-based set-up protocols improve the group prostate set-up error compared with skin marks; however, large prostate systematic errors can remain undetected or systematic errors increased for individual patients. The margin required for set-up errors was found to be 10-15 mm unless implanted fiducial markers are available for treatment guidance.

  8. Comparison of prostate set-up accuracy and margins with off-line bony anatomy corrections and online implanted fiducial-based corrections

    International Nuclear Information System (INIS)

    Greer, P. B.; Dahl, K.; Ebert, M. A.; Wratten, C.; White, M.; Denham, K. W.

    2008-01-01

    Full text: The aim of the study was to determine prostate set-up accuracy and set-up margins with off-line bony anatomy-based imaging protocols, compared with online implanted fiducial marker-based imaging with daily corrections. Eleven patients were treated with implanted prostate fiducial markers and online set-up corrections. Pretreatment orthogonal electronic portal images were acquired to determine couch shifts and verification images were acquired during treatment to measure residual set-up error. The prostate set-up errors that would result from skin marker set-up, off-line bony anatomy-based protocols and online fiducial marker-based corrections were determined. Set-up margins were calculated for each set-up technique using the percentage of encompassed isocentres land a margin recipe. The prostate systematic set-up errors in the medial-lateral, superior-inferior and anterior-I posterior directions for skin marker set-up were 2.2, 3.6 and 4.5 mm (1 standard deviation). For our bony anatomy-I based off-line protocol the prostate systematic set-up errors were 1.6, 2.5 and 4.4 mm. For the online fiducial based set-up the results were 0.5, 1.4 and 1.4 mm. A prostate systematic error of 10.2 mm was uncorrected by the off-line bone protocol in one patient. Set-up margins calculated to encompass 98% of prostate set-up shifts were 111-14 mm with bone off-line set-up and 4-7 mm with online fiducial markers. Margins from the van Herk margin I recipe were generally 1-2 mm smaller. Bony anatomy-based set-up protocols improve the group prostate set-up error compared with skin marks; however, large prostate systematic errors can remain undetected or systematic (errors increased for individual patients. The margin required for set-up errors was found to be 10-15 mm unless I implanted fiducial markers are available for treatment guidance.

  9. Assessment of Set-up Accuracy in Tangential Breast Treatment Using Electronic Portal Imaging Device

    International Nuclear Information System (INIS)

    Lee, Byung Koo; Kang, Soo Man

    2012-01-01

    The aim of this study was to investigate the setup accuracy for tangential breast treatment patients using electronic portal image and 2-D reconstruction image Twenty two patients undergoing tangential breast treatment. To explore the setup accuracy, distances between chosen landmarks were taken as reference parameters. The difference between measured reference parameters on simulation films and electronic portal images (EPIs) was calculated as the setup error. A total of 22 simulation films and 110 EPIs were evaluated. In the tangential fields, the calculated reference parameters were the central lung distance (CLD), central soft-tissue distance (CSTD), and above lung distance (ALD), below lung distance (BLD). In the medial tangential field, the average difference values for these parameters were 1.0, -6.4, -2.1 and 2.0, respectively; and the values were 1.5, 2.3, 4.1 and 1.1, respectively. In the lateral tangential field, the average difference values for these parameters were -1.5, -4.3, -2.7 and -1.3, respectively; and the values were 3.3, 2.1, 2.9 and 2.5, respectively. CLD, CSTD, ALD and BLD in the tangential fields are easily identifiable and are helpful for detecting setup errors using EPIs in patients undergoing tangential breast radiotherapy treatment.

  10. Assessment of Set-up Accuracy in Tangential Breast Treatment Using Electronic Portal Imaging Device

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    Lee, Byung Koo [Dept. of Radiation Oncology, Korea University Anam Hospital, Seoul (Korea, Republic of); Kang, Soo Man [Dept. of Radiation Oncology, Korea University Gospel Hospital, Seoul (Korea, Republic of)

    2012-09-15

    The aim of this study was to investigate the setup accuracy for tangential breast treatment patients using electronic portal image and 2-D reconstruction image Twenty two patients undergoing tangential breast treatment. To explore the setup accuracy, distances between chosen landmarks were taken as reference parameters. The difference between measured reference parameters on simulation films and electronic portal images (EPIs) was calculated as the setup error. A total of 22 simulation films and 110 EPIs were evaluated. In the tangential fields, the calculated reference parameters were the central lung distance (CLD), central soft-tissue distance (CSTD), and above lung distance (ALD), below lung distance (BLD). In the medial tangential field, the average difference values for these parameters were 1.0, -6.4, -2.1 and 2.0, respectively; and the values were 1.5, 2.3, 4.1 and 1.1, respectively. In the lateral tangential field, the average difference values for these parameters were -1.5, -4.3, -2.7 and -1.3, respectively; and the values were 3.3, 2.1, 2.9 and 2.5, respectively. CLD, CSTD, ALD and BLD in the tangential fields are easily identifiable and are helpful for detecting setup errors using EPIs in patients undergoing tangential breast radiotherapy treatment.

  11. Evaluation of rotational set-up errors in patients with thoracic neoplasms

    International Nuclear Information System (INIS)

    Wang Yanyang; Fu Xiaolong; Xia Bing; Fan Min; Yang Huanjun; Ren Jun; Xu Zhiyong; Jiang Guoliang

    2010-01-01

    Objective: To assess the rotational set-up errors in patients with thoracic neoplasms. Methods: 224 kilovoltage cone-beam computed tomography (KVCBCT) scans from 20 thoracic tumor patients were evaluated retrospectively. All these patients were involved in the research of 'Evaluation of the residual set-up error for online kilovoltage cone-beam CT guided thoracic tumor radiation'. Rotational set-up errors, including pitch, roll and yaw, were calculated by 'aligning the KVCBCT with the planning CT, using the semi-automatic alignment method. Results: The average rotational set-up errors were -0.28 degree ±1.52 degree, 0.21 degree ± 0.91 degree and 0.27 degree ± 0.78 degree in the left-fight, superior-inferior and anterior-posterior axis, respectively. The maximal rotational errors of pitch, roll and yaw were 3.5 degree, 2.7 degree and 2.2 degree, respectively. After correction for translational set-up errors, no statistically significant changes in rotational error were observed. Conclusions: The rotational set-up errors in patients with thoracic neoplasms were all small in magnitude. Rotational errors may not change after the correction for translational set-up errors alone, which should be evaluated in a larger sample future. (authors)

  12. Application of video imaging for improvement of patient set-up

    International Nuclear Information System (INIS)

    Ploeger, Lennert S.; Frenay, Michel; Betgen, Anja; Bois, Josien A. de; Gilhuijs, Kenneth G.A.; Herk, Marcel van

    2003-01-01

    Background and purpose: For radiotherapy of prostate cancer, the patient is usually positioned in the left-right (LR) direction by aligning a single marker on the skin with the projection of a room laser. The aim of this study is to investigate the feasibility of a room-mounted video camera in combination with previously acquired CT data to improve patient set-up along the LR axis. Material and methods: The camera was mounted in the treatment room at the caudal side of the patient. For 22 patients with prostate cancer 127 video and portal images were acquired. The set-up error determined by video imaging was found by matching video images with rendered CT images using various techniques. This set-up error was retrospectively compared with the set-up error derived from portal images. It was investigated whether the number of corrections based on portal imaging would decrease if the information obtained from the video images had been used prior to irradiation. Movement of the skin with respect to bone was quantified using an analysis of variance method. Results: The measurement of the set-up error was most accurate for a technique where outlines and groins on the left and right side of the patient were delineated and aligned individually to the corresponding features extracted from the rendered CT image. The standard deviations (SD) of the systematic and random components of the set-up errors derived from the portal images in the LR direction were 1.5 and 2.1 mm, respectively. When the set-up of the patients was retrospectively adjusted based on the video images, the SD of the systematic and random errors decreased to 1.1 and 1.3 mm, respectively. From retrospective analysis, a reduction of the number of set-up corrections (from nine to six corrections) is expected when the set-up would have been adjusted using the video images. The SD of the magnitude of motion of the skin of the patient with respect to the bony anatomy was estimated to be 1.1 mm. Conclusion: Video

  13. Patient set-up verification by infrared optical localization and body surface sensing in breast radiation therapy

    International Nuclear Information System (INIS)

    Spadea, Maria Francesca; Baroni, Guido; Riboldi, Marco; Orecchia, Roberto; Pedotti, Antonio; Tagaste, Barbara; Garibaldi, Cristina

    2006-01-01

    Background and purpose: The aim of the study was to investigate the clinical application of a technique for patient set-up verification in breast cancer radiotherapy, based on the 3D localization of a hybrid configuration of surface control points. Materials and methods: An infrared optical tracker provided the 3D position of two passive markers and 10 laser spots placed around and within the irradiation field on nine patients. A fast iterative constrained minimization procedure was applied to detect and compensate patient set-up errors, through the control points registration with reference data coming from treatment plan (markers reference position, CT-based surface model). Results: The application of the corrective spatial transformation estimated by the registration procedure led to significant improvement of patient set-up. Median value of 3D errors affecting three additional verification markers within the irradiation field decreased from 5.7 to 3.5 mm. Errors variability (25-75%) decreased from 3.2 to 2.1 mm. Laser spots registration on the reference surface model was documented to contribute substantially to set-up errors compensation. Conclusions: Patient set-up verification through a hybrid set of control points and constrained surface minimization algorithm was confirmed to be feasible in clinical practice and to provide valuable information for the improvement of the quality of patient set-up, with minimal requirement of operator-dependant procedures. The technique combines conveniently the advantages of passive markers based methods and surface registration techniques, by featuring immediate and robust estimation of the set-up accuracy from a redundant dataset

  14. A method for patient set-up guidance in radiotherapy using augmented reality

    International Nuclear Information System (INIS)

    Talbot, J.; Meyer, J.; Watts, R.; Grasset, R.

    2009-01-01

    Full text: A system for patient set-up in external beam radiotherapy was developed using Augmented Reality (AR). Live images of the linac treatment couch and patient were obtained with video cameras and displayed on a nearby monitor. A 3D model of the patient's external contour was obtained from planning CT data, and AR tracking software was used to superimpose the model onto the video images in the correct position for treatment. Throughout set-up and treatment, the user can view the monitor and visually confirm that the patient is positioned correctly. To ensure that the virtual contour was displayed in the correct position, a process was devised to register the coordinates of the linac with the camera images. A cube with AR tracking markers attached to its faces was constructed for alignment with the isocentre using room lasers or cone-beam CT. The performance of the system was investigated in a clinical environment by using it to position an anthropomorphic phantom without the aid of additional set-up methods. The positioning errors were determined by means of CBCT and image registration. The translational set-up errors were found to be less than 2.4 mm and the rotational errors less than 0.3 0 . This proof-of-principle study has demonstrated the feasibility of using AR for patient position and pose guidance.

  15. A managed clinical network for cardiac services: set-up, operation and impact on patient care.

    Science.gov (United States)

    Stc Hamilton, Karen E; Sullivan, Frank M; Donnan, Peter T; Taylor, Rex; Ikenwilo, Divine; Scott, Anthony; Baker, Chris; Wyke, Sally

    2005-01-01

    To investigate the set up and operation of a Managed Clinical Network for cardiac services and assess its impact on patient care. This single case study used process evaluation with observational before and after comparison of indicators of quality of care and costs. The study was conducted in Dumfries and Galloway, Scotland and used a three-level framework. Process evaluation of the network set-up and operation through a documentary review of minutes; guidelines and protocols; transcripts of fourteen semi-structured interviews with health service personnel including senior managers, general practitioners, nurses, cardiologists and members of the public. Outcome evaluation of the impact of the network through interrupted time series analysis of clinical data of 202 patients aged less than 76 years admitted to hospital with a confirmed myocardial infarction one-year pre and one-year post, the establishment of the network. The main outcome measures were differences between indicators of quality of care targeted by network protocols. Economic evaluation of the transaction costs of the set-up and operation of the network and the resource costs of the clinical care of the 202 myocardial infarction patients from the time of hospital admission to 6 months post discharge through interrupted time series analysis. The outcome measure was different in National Health Service resource use. Despite early difficulties, the network was successful in bringing together clinicians, patients and managers to redesign services, exhibiting most features of good network management. The role of the energetic lead clinician was crucial, but the network took time to develop and 'bed down'. Its primary "modus operand" was the development of a myocardial infarction pathway and associated protocols. Of sixteen clinical care indicators, two improved significantly following the launch of the network and nine showed improvements, which were not statistically significant. There was no difference

  16. A managed clinical network for cardiac services: set-up, operation and impact on patient care

    Directory of Open Access Journals (Sweden)

    Karen E. Hamilton

    2005-09-01

    Full Text Available Purpose: To investigate the set up and operation of a Managed Clinical Network for cardiac services and assess its impact on patient care. Methods: This single case study used process evaluation with observational before and after comparison of indicators of quality of care and costs. The study was conducted in Dumfries and Galloway, Scotland and used a three-level framework. Process evaluation of the network set-up and operation through a documentary review of minutes; guidelines and protocols; transcripts of fourteen semi-structured interviews with health service personnel including senior managers, general practitioners, nurses, cardiologists and members of the public. Outcome evaluation of the impact of the network through interrupted time series analysis of clinical data of 202 patients aged less than 76 years admitted to hospital with a confirmed myocardial infarction one-year pre and one-year post, the establishment of the network. The main outcome measures were differences between indicators of quality of care targeted by network protocols. Economic evaluation of the transaction costs of the set-up and operation of the network and the resource costs of the clinical care of the 202 myocardial infarction patients from the time of hospital admission to 6 months post discharge through interrupted time series analysis. The outcome measure was different in National Health Service resource use. Results: Despite early difficulties, the network was successful in bringing together clinicians, patients and managers to redesign services, exhibiting most features of good network management. The role of the energetic lead clinician was crucial, but the network took time to develop and ‘bed down’. Its primary “modus operand” was the development of a myocardial infarction pathway and associated protocols. Of sixteen clinical care indicators, two improved significantly following the launch of the network and nine showed improvements, which were

  17. Calculation errors of Set-up in patients with tumor location of prostate. Exploratory study; Calculo de errores de Set-up en pacientes con localizacion tumoral de prostata. Estudio exploratorio

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    Donis Gil, S.; Robayna Duque, B. E.; Jimenez Sosa, A.; Hernandez Armas, O.; Gonzalez Martin, A. E.; Hernandez Armas, J.

    2013-07-01

    The calculation of SM is done from errors in positioning (set-up). These errors are calculated from movements in 3D of the patient. This paper is an exploratory study of 20 patients with tumor location of prostate in which errors of set-up for two protocols of work are evaluated. (Author)

  18. Evaluation of set-up deviations during the irradiation of patients suffering from breast cancer treated with two different techniques

    International Nuclear Information System (INIS)

    KukoIowicz, Pawel Franciszek; Debrowski, Andrzej; Gut, Piotr; Chmielewski, Leszek; Wieczorek, Andrzej; Kedzierawski, Piotr

    2005-01-01

    Purpose: To compare reproducibility of set-up for two different treatment techniques for external irradiation of the breast. Methods and materials: In total, the analysis comprised 56 pairs of portal and simulator films for 14 consecutive patients treated following breast conserving therapy and 98 pairs of portal and simulator films for 20 consecutive patients treated after mastectomy. For the first group the tangential field technique (TF technique) was used, for the second the inverse hockey stick technique (IHS technique). Evaluation of the treatment reproducibility was performed in terms of systematic and random error calculated for the whole groups, comparison of set-up accuracy by means of comparison of cumulative distribution of the length of the displacement vector. Results: In the IHS and TF techniques for medial and lateral fields, displacement larger than 5 mm occurred in 28.3, 15.8 and 25.4%, respectively. For the IHS technique, the systematic errors for lateral and cranial-caudal direction were 1.9 and 1.7 mm, respectively (1 SD), the random errors for lateral and cranial-caudal direction were 2.0 and 2.5 mm. For the TF technique, the systematic errors for ventral-dorsal and cranial-caudal direction were 2.6 and 1.3 mm for medial field and 3.7 and 0.7 mm for lateral fields, respectively, the random errors for lateral and cranial-caudal direction were 2.2 and 1.0 mm for medial field and 2.9 and 1.1 for lateral field, respectively. Rotations were negligible in the IHS technique. For the TF technique the systematic and random components amounted to about 2.0 degrees (1 SD). Conclusions: Both the inverse hockey stick and standard tangential techniques showed good reproducibility of patients' set-up with respect to cranial-caudal direction. For the TF technique, the accuracy should be improved for the medial field with respect to the ventral-dorsal direction

  19. Set-up error in supine-positioned patients immobilized with two different modalities during conformal radiotherapy of prostate cancer

    International Nuclear Information System (INIS)

    Fiorino, C.; Cattaneo, G.M.; Calandrino, R.; Reni, M.; Bolognesi, A.; Bonini, A.

    1998-01-01

    Background: Conformal radiotherapy requires reduced margins around the clinical target volume (CTV) with respect to traditional radiotherapy techniques. Therefore, high set-up accuracy and reproducibility are mandatory. Purpose: To investigate the effectiveness of two different immobilization techniques during conformal radiotherapy of prostate cancer with small fields. Materials and methods: 52 patients with prostate cancer were treated by conformal three- or four-field techniques with radical or adjuvant intent between November 1996 and March 1998. In total, 539 portal images were collected on a weekly basis for at least the first 4 weeks of the treatment on lateral and anterior 18 MV X-ray fields. The average number of sessions monitored per patient was 5.7 (range 4-10). All patients were immobilized with an alpha-cradle system; 25 of them were immobilized at the pelvis level (group A) and the remaining 27 patients were immobilized in the legs (group B). The shifts with respect to the simulation condition were assessed by measuring the distances between the same bony landmarks and the field edges. The global distributions of cranio-caudal (CC), posterior-anterior (PA) and left-right (LR) shifts were considered; for each patient random and systematic error components were assessed by following the procedure suggested by Bijhold et al. (Bijhold J, Lebesque JV, Hart AAM, Vijlbrief RE. Maximising set-up accuracy using portal images as applied to a conformal boost technique for prostatic cancer. Radiother. Oncol. 1992;24:261-271). For each patient the average isocentre (3D) shift was assessed as the quadratic sum of the average shifts in the three directions. Results 5 mm equal to 4.4% with respect to the 21.6% of group A (P<0.0001). This value was also better than the corresponding value found in a previously investigated group of 21 non-immobilized patients (Italia C, Fiorino C, Ciocca M, et al. Quality control by portal film analysis of the conformal radiotherapy

  20. SU-F-I-03: Correction of Intra-Fractional Set-Up Errors and Target Coverage Based On Cone-Beam Computed Tomography for Cervical Cancer Patients

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    Zhang, JY [Cancer Hospital of Shantou University Medical College, Shantou, Guangdong (China); Hong, DL [The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong (China)

    2016-06-15

    Purpose: The purpose of this study is to investigate the patient set-up error and interfraction target coverage in cervical cancer using image-guided adaptive radiotherapy (IGART) with cone-beam computed tomography (CBCT). Methods: Twenty cervical cancer patients undergoing intensity modulated radiotherapy (IMRT) were randomly selected. All patients were matched to the isocenter using laser with the skin markers. Three dimensional CBCT projections were acquired by the Varian Truebeam treatment system. Set-up errors were evaluated by radiation oncologists, after CBCT correction. The clinical target volume (CTV) was delineated on each CBCT, and the planning target volume (PTV) coverage of each CBCT-CTVs was analyzed. Results: A total of 152 CBCT scans were acquired from twenty cervical cancer patients, the mean set-up errors in the longitudinal, vertical, and lateral direction were 3.57, 2.74 and 2.5mm respectively, without CBCT corrections. After corrections, these were decreased to 1.83, 1.44 and 0.97mm. For the target coverage, CBCT-CTV coverage without CBCT correction was 94% (143/152), and 98% (149/152) with correction. Conclusion: Use of CBCT verfication to measure patient setup errors could be applied to improve the treatment accuracy. In addition, the set-up error corrections significantly improve the CTV coverage for cervical cancer patients.

  1. Contrast-Enhanced Proton Radiography for Patient Set-up by Using X-Ray CT Prior Knowledge

    Energy Technology Data Exchange (ETDEWEB)

    Spadea, Maria Francesca, E-mail: mfspadea@unicz.it [Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro (Italy); Fassi, Aurora [Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano (Italy); Zaffino, Paolo [Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro (Italy); Riboldi, Marco; Baroni, Guido [Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano (Italy); Bioengineering Unit—CNAO Foundation, Pavia (Italy); Depauw, Nicolas [Department of Radiation Oncology, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts (United States); Centre for Medical Radiation Physics, University of Wollongong, Wollongong (Australia); Seco, Joao [Department of Radiation Oncology, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts (United States)

    2014-11-01

    Purpose: To obtain a contrasted image of the tumor region during the setup for proton therapy in lung patients, by using proton radiography and x-ray computed tomography (CT) prior knowledge. Methods and Materials: Six lung cancer patients' CT scans were preprocessed by masking out the gross tumor volume (GTV), and digitally reconstructed radiographs along the planned beam's eye view (BEV) were generated, for a total of 27 projections. Proton radiographies (PR) were also computed for the same BEV through Monte Carlo simulations. The digitally reconstructed radiograph was subtracted from the corresponding proton image, resulting in a contrast-enhanced proton radiography (CEPR). Michelson contrast analysis was performed both on PR and CEPR. The tumor region was then automatically segmented on CEPR and compared to the ground truth (GT) provided by physicians in terms of Dice coefficient, accuracy, precision, sensitivity, and specificity. Results: Contrast on CEPR was, on average, 4 times better than on PR. For 10 lateral projections (±45° off of 90° or 270°), although it was not possible to distinguish the tumor region in the PR, CEPR offers excellent GTV visibility. The median ± quartile values of Dice, precision, and accuracy indexes were 0.86 ± 0.03, 0.86 ± 0.06, and 0.88 ± 0.02, respectively, thus confirming the reliability of the method in highlighting tumor boundaries. Sensitivity and specificity analysis demonstrated that there is no systematic over- or underestimation of the tumor region. Identification of the tumor boundaries using CEPR resulted in a more accurate and precise definition of GTV compared to that obtained from pretreatment CT. Conclusions: In most proton centers, the current clinical protocol is to align the patient using kV imaging with bony anatomy as a reference. We demonstrated that CEPR can significantly improve tumor visualization, allowing better patient set-up and permitting image guided proton therapy (IGPT)

  2. Fast evaluation of patient set-up during radiotherapy by aligning features in portal and simulator images

    International Nuclear Information System (INIS)

    Bijhold, J.; Herk, M. van; Vijlbrief, R.; Lebesque, J.V.

    1991-01-01

    A new fast method is presented for the quantification of patient set-up errors during radiotherapy with external photon beams. The set-up errors are described as deviations in relative position and orientation of specified anatomical structures relative to specified field shaping devices. These deviations are determined from parameters of the image transformations that make their features in a portal image align with the corresponding features in a simulator image. Knowledge of some set-up parameters during treatment simulation is required. The method does not require accurate knowledge about the position of the portal imaging device as long as the positions of some of the field shaping devices are verified independently during treatment. By applying this method, deviations in a pelvic phantom set-up can be measured with a precision of 2 mm within 1 minute. Theoretical considerations and experiments have shown that the method is not applicable when there are out-of-plane rotations larger than 2 degrees or translations larger than 1 cm. Inter-observer variability proved to be a source of large systematic errors, which could be reduced by offering a precise protocol for the feature alignment. (author)

  3. High dose three-dimensional conformal boost (3DCB) using an orthogonal diagnostic X-ray set-up for patients with gynecological malignancy: a new application of real-time tumor-tracking system

    International Nuclear Information System (INIS)

    Yamamoto, Ritsu; Yonesaka, Akio; Nishioka, Seiko; Watari, Hidemichi; Hashimoto, Takayuki; Uchida, Daichi; Taguchi, Hiroshi; Nishioka, Takeshi; Miyasaka, Kazuo; Sakuragi, Noriaki; Shirato, Hiroki

    2004-01-01

    The feasibility and accuracy of high dose three-dimensional conformal boost (3DCB) using three internal fiducial markers and a two-orthogonal X-ray set-up of the real-time tumor-tracking system on patients with gynecological malignancy were investigated in 10 patients. The standard deviation of the distribution of systematic deviations (Σ) was reduced from 3.8, 4.6, and 4.9 mm in the manual set-up to 2.3, 2.3 and 2.7 mm in the set-up using the internal markers. The average standard deviation of the distribution of random deviations (σ) was reduced from 3.7, 5.0, and 4.5 mm in the manual set-up to 3.3, 3.0, and 4.2 mm in the marker set-up. The appropriate PTV margin was estimated to be 10.2, 12.8, and 12.9 mm in the manual set-up and 6.9, 6.7, and 8.3 mm in the gold marker set-up, respectively, using the formula 2Σ+0.7σ. Set-up of the patients with three markers and two fluoroscopy is useful to reduce PTV margin and perform 3DCB

  4. Effectiveness of couch height-based patient set-up and an off-line correction protocol in prostate cancer radiotherapy

    International Nuclear Information System (INIS)

    Lin, Emile N.J.Th. van; Nijenhuis, Edwin; Huizenga, Henk; Vight, Lisette van der; Visser, Andries

    2001-01-01

    Purpose: To investigate set-up improvement caused by applying a couch height-based patient set-up method in combination with a technologist-driven off-line correction protocol in nonimmobilized radiotherapy of prostate patients. Methods and Materials: A three-dimensional shrinking action level correction protocol is applied in two consecutive patient cohorts with different set-up methods: the traditional 'laser set-up' group (n=43) and the 'couch height set-up' group (n=112). For all directions, left-right, ventro-dorsal, and cranio-caudal, random and systematic set-up deviations were measured. Results: The couch height set-up method improves the patient positioning compared to the laser set-up method. Without application of the correction protocol, both systematic and random errors reduced to 2.2-2.4 mm (1 SD) and 1.7-2.2 mm (1 SD), respectively. By using the correction protocol, systematic errors reduced further to 1.3-1.6 mm (1 SD). One-dimensional deviations were within 5 mm for >90% of the measured fractions. The required number of corrections per patient in the off-line correction protocol was reduced significantly during the course of treatment from 1.1 to 0.6 by the couch height set-up method. The treatment time was not prolonged by application of the correction protocol. Conclusions: The couch height set-up method improves the set-up significantly, especially in the ventro-dorsal direction. Combination of this set-up method with an off-line correction strategy, executed by technologists, reduces the number of set-up corrections required

  5. Quality assurance of a system for improved target localization and patient set-up that combines real-time infrared tracking and stereoscopic X-ray imaging.

    Science.gov (United States)

    Verellen, Dirk; Soete, Guy; Linthout, Nadine; Van Acker, Swana; De Roover, Patsy; Vinh-Hung, Vincent; Van de Steene, Jan; Storme, Guy

    2003-04-01

    The aim of this study is to investigate the positional accuracy of a prototype X-ray imaging tool in combination with a real-time infrared tracking device allowing automated patient set-up in three dimensions. A prototype X-ray imaging tool has been integrated with a commercially released real-time infrared tracking device. The system, consisting of two X-ray tubes mounted to the ceiling and a centrally located amorphous silicon detector has been developed for automated patient positioning from outside the treatment room prior to treatment. Two major functions are supported: (a) automated fusion of the actual treatment images with digitally reconstructed radiographs (DRRs) representing the desired position; (b) matching of implanted radio opaque markers. Measurements of known translational (up to 30.0mm) and rotational (up to 4.0 degrees ) set-up errors in three dimensions as well as hidden target tests have been performed on anthropomorphic phantoms. The system's accuracy can be represented with the mean three-dimensional displacement vector, which yielded 0.6mm (with an overall SD of 0.9mm) for the fusion of DRRs and X-ray images. Average deviations between known translational errors and calculations varied from -0.3 to 0.6mm with a standard deviation in the range of 0.6-1.2mm. The marker matching algorithm yielded a three-dimensional uncertainty of 0.3mm (overall SD: 0.4mm), with averages ranging from 0.0 to 0.3mm and a standard deviation in the range between 0.3 and 0.4mm. The stereoscopic X-ray imaging device integrated with the real-time infrared tracking device represents a positioning tool allowing for the geometrical accuracy that is required for conformal radiation therapy of abdominal and pelvic lesions, within an acceptable time-frame.

  6. Leadership set-up

    DEFF Research Database (Denmark)

    Thude, Bettina Ravnborg; Stenager, Egon; von Plessen, Christian

    2018-01-01

    . Findings: The study found that the leadership set-up did not have any clear influence on interdisciplinary cooperation, as all wards had a high degree of interdisciplinary cooperation independent of which leadership set-up they had. Instead, the authors found a relation between leadership set-up and leader...... could influence legitimacy. Originality/value: The study shows that leadership set-up is not the predominant factor that creates interdisciplinary cooperation; but rather, leader legitimacy also should be considered. Additionally, the study shows that leader legitimacy can be difficult to establish...... and that it cannot be taken for granted. This is something chief executive officers should bear in mind when they plan and implement new leadership structures. Therefore, it would also be useful to look more closely at how to achieve legitimacy in cases where the leader is from a different profession to the staff....

  7. Set-up errors in patients undergoing image guided radiation treatment. Relationship to body mass index and weight loss

    DEFF Research Database (Denmark)

    Johansen, Jørgen; Bertelsen, Anders; Hansen, Christian Rønn

    2008-01-01

    by the relative weight change over time. Results: The SD of the translational and rotational random set-up errors during the first three sessions for H&N were 0.9 mm (Left-Right), 1.1mm (Anterior-Posterior), 0.7 mm (Cranio-Caudal) and 0.7 degrees (LR-axis), 0.5 degrees (AP-axis), and 0.7 degrees (CC......-axis). The equivalent data for lung cancer patients were 1.1 mm (LR), 1.1mm (AP), 1.5 mm (CC) and 0.5 degrees (LR-axis), 0.6 degrees (AP-axis), and 0.4 degrees (CC-axis). The median BMI for H&N and lung was 25.8 (17.6-39.7) and 23.7 (17.4-38.8), respectively. The median weekly weight change for H&N was -0.3% (-2.0 to 1...... (H&N) and 20 lung cancer patients were investigated. Patients were positioned using customized immobilization devices consisting of vacuum cushions and thermoplastic shells. Treatment was given on an Elekta Synergy accelerator. Cone-beam acquisitions were obtained according to a standardized Action...

  8. Role of Papanicolaou Smear in the Diagnosis of Pathologic Flora in Asymptomatic Patients in Rural Health Care Set-Up

    Directory of Open Access Journals (Sweden)

    Siona Sabu

    2017-10-01

    Full Text Available Introduction: The infections of female genital tract, especially the cervix are asymptomatic in presentation and pose a diagnostic challenge. Vaginal infections can lead to cytoplasmic and nuclear abnormalities in the epithelial cells. Additionally, these infections could augur an inflammatory response of varying nature. The most common flora include Candida albicans, Gardnerella vaginalis, Trichomonas vaginalis, Human Papilloma Virus (HPV, Human Herpes Virus (HHV and Actinomyces sp. Aim: This study seeks to measure the role of Papanicolaou smear in detection of pathologic flora: Candida albicans, Gardnerella vaginalis, Trichomonas vaginalis, HPV, HHV and Actinomyces; in a rural health care set up amongst women in the reproductive and menopausal age group. Materials and Methods: A retrospective study of cervical smears by Papanicolaou method, over a 14 month period was carried out in a tertiary care centre including a total number of 150 patients. Results: Of the total of 150 samples examined, Candida species was the most frequently detected (8.7% followed by Trichomonas vaginalis (5.3% and Gardnerella vaginalis species (4.7%. HPV-induced changes were noted in a mere 2% of cases. Actinomyces species was noted in less than 1% of cases. Conclusion: The Papanicolaou test for examining cervical smear has definite uses in detecting vaginal microorganisms. Apart from detection of the usual pathogenic flora, the test has utility in defining the degree of inflammation and additional reparative changes.

  9. A randomized controlled trial comparing customized versus standard headrests for head and neck radiotherapy immobilization in terms of set-up errors, patient comfort and staff satisfaction (ICORG 08-09)

    International Nuclear Information System (INIS)

    Howlin, C.; O'Shea, E.; Dunne, M.; Mullaney, L.; McGarry, M.; Clayton-Lea, A.; Finn, M.; Carter, P.; Garret, B.; Thirion, P.

    2015-01-01

    Purpose: To recommend a specific headrest, customized or standard, for head and neck radiotherapy patients in our institution based primarily on an evaluation of set-up accuracy, taking into account a comparison of patient comfort, staff and patient satisfaction, and resource implications. Methods and materials: Between 2008 and 2009, 40 head and neck patients were randomized to either a standard (Arm A, n = 21) or customized (Arm B, n = 19) headrest, and immobilized with a customized thermoplastic mask. Set-up accuracy was assessed using electronic portal images (EPI). Random and systematic set-up errors for each arm were determined from 668 EPIs, which were analyzed by one Radiation Therapist. Patient comfort was assessed using a visual analogue scale (VAS) and staff satisfaction was measured using an in-house questionnaire. Resource implications were also evaluated. Results: The difference in set-up errors between arms was not significant in any direction. However, in this study the standard headrest (SH) arm performed well, with set-up errors comparative to customized headrests (CHs) in previous studies. CHs require regular monitoring and 47% were re-vacuumed making them more resource intensive. Patient comfort and staff satisfaction were comparable in both arms. Conclusion: The SH provided similar treatment accuracy and patient comfort compared with the CH. The large number of CHs that needed to be re-vacuumed undermines their reliability for radiotherapy schedules that extend beyond 34 days from the initial CT scan. Accordingly the CH was more resource intensive without improving the accuracy of positioning, thus the standard headrest is recommended for continued use at our institution

  10. Automation and robotization of the set-up and treatment for patients treated for a brain and base of the skull tumor

    International Nuclear Information System (INIS)

    Noel, G.; Ferrand, R.; Feuvret, L.; Meyroneinc, S.; Mazeron, J.J.; Boisserie, G.; Mazeron, J.J.

    2003-01-01

    Progresses of the three-dimensional imageries and of the software of planning systems makes that the radiotherapy of the tumours of brain and the base of skull is increasingly precise. The set-up of the patients and the positioning of the beams are key acts whose realization can become extremely tiresome if the requirement of precision increases. This precision very often rests still on the visual comparison of digital images. In the near future, the development of the automated systems controlled by robots should allow a noticeable improvement of the precision, safety and speed of the patient set-up. (author)

  11. Epidemiological study of clinical characteristics of patients with PCOS attending infertility clinic and awareness of PCOS in a rural set up

    OpenAIRE

    Shubhada Jajoo; Riju Angik

    2013-01-01

    Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age group. It is a common diagnosis in women presenting with infertility. All the dimensions of PCOS have not been completely explored. In this study we studied the clinical features of PCOS and comparing with non-PCOS infertility patients and simultaneously studied the prevalence of PCOS in infertility patients and its awareness in a rural set up. Methods: It is a prospect...

  12. SU-E-T-258: Development of a New Patient Set-Up Monitoring System Using Force Sensing Resistor (FSR) Sensor for the Radiation Therapy

    International Nuclear Information System (INIS)

    Cho, M; Kim, T; Kang, S; Kim, D; Kim, K; Shin, D; Suh, T

    2015-01-01

    Purpose: The purpose of this work is to develop a new patient set-up monitoring system using force sensing resistor (FSR) sensors that can confirm pressure of contact surface and evaluate its feasibility. Methods: In this study, we focused on develop the patient set-up monitoring system to compensate for the limitation of existing optical based monitoring system, so the developed system can inform motion in the radiation therapy. The set-up monitoring system was designed consisting of sensor units (FSR sensor), signal conditioning devices (USB cable/interface electronics), a control PC, and a developed analysis software. The sensor unit was made by attaching FSR sensor and dispersing pressure sponge to prevent error which is caused by concentrating specific point. Measured signal from the FSR sensor was sampled to arduino mega 2560 microcontroller, transferred to control PC by using serial communication. The measured data went through normalization process. The normalized data was displayed through the developed graphic user interface (GUI) software. The software was designed to display a single sensor unit intensity (maximum 16 sensors) and display 2D pressure distribution (using 16 sensors) according to the purpose. Results: Changes of pressure value according to motion was confirmed by the developed set-up monitoring system. Very small movement such as little physical change in appearance can be confirmed using a single unit and using 2D pressure distribution. Also, the set-up monitoring system can observe in real time. Conclusion: In this study, we developed the new set-up monitoring system using FSR sensor. Especially, we expect that the new set-up monitoring system is suitable for motion monitoring of blind area that is hard to confirm existing optical system and compensate existing optical based monitoring system. As a further study, an integrated system will be constructed through correlation of existing optical monitoring system. This work was supported by

  13. SU-E-T-258: Development of a New Patient Set-Up Monitoring System Using Force Sensing Resistor (FSR) Sensor for the Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Cho, M; Kim, T; Kang, S; Kim, D; Kim, K; Shin, D; Suh, T [The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)

    2015-06-15

    Purpose: The purpose of this work is to develop a new patient set-up monitoring system using force sensing resistor (FSR) sensors that can confirm pressure of contact surface and evaluate its feasibility. Methods: In this study, we focused on develop the patient set-up monitoring system to compensate for the limitation of existing optical based monitoring system, so the developed system can inform motion in the radiation therapy. The set-up monitoring system was designed consisting of sensor units (FSR sensor), signal conditioning devices (USB cable/interface electronics), a control PC, and a developed analysis software. The sensor unit was made by attaching FSR sensor and dispersing pressure sponge to prevent error which is caused by concentrating specific point. Measured signal from the FSR sensor was sampled to arduino mega 2560 microcontroller, transferred to control PC by using serial communication. The measured data went through normalization process. The normalized data was displayed through the developed graphic user interface (GUI) software. The software was designed to display a single sensor unit intensity (maximum 16 sensors) and display 2D pressure distribution (using 16 sensors) according to the purpose. Results: Changes of pressure value according to motion was confirmed by the developed set-up monitoring system. Very small movement such as little physical change in appearance can be confirmed using a single unit and using 2D pressure distribution. Also, the set-up monitoring system can observe in real time. Conclusion: In this study, we developed the new set-up monitoring system using FSR sensor. Especially, we expect that the new set-up monitoring system is suitable for motion monitoring of blind area that is hard to confirm existing optical system and compensate existing optical based monitoring system. As a further study, an integrated system will be constructed through correlation of existing optical monitoring system. This work was supported by

  14. Development of an imaging system for patient set-up monitoring during radiotherapeutic treatment with high energy photons

    International Nuclear Information System (INIS)

    Herk, M. van.

    1985-01-01

    A prototype image detector has been designed and built for patient moniorting during radiotherapy treatment with high energy photon beams. A matrix of DC operated ionisation chambers was used to detect the transmitted radiation through a patient. The detector was developed in order to replace the current method, in which film radiography is used. Various detector configurations have been tested, and some results will be presented. Image enhancement was achieved by computer processing of the data. Theoretical possibilities of the detector system have been studied. (Auth.)

  15. SU-E-CAMPUS-T-01: Analysis of the Precision of Patient Set-Up, and Fidelity of the Delivered Dose Distribution in Proton Therapy of Ocular Tumors

    International Nuclear Information System (INIS)

    Trofimov, A; Carpenter, K; Shih, HA

    2014-01-01

    Purpose: To quantify daily set-up variations in fractionated proton therapy of ocular melanomas, and to assess the effect on the fidelity of delivered distribution to the plan. Methods: In a typical five-fraction course, daily set-up is achieved by matching the position of fiducial markers in orthogonal radiographs to the images generated by treatment planning program. A patient maintains the required gaze direction voluntarily, without the aid of fixation devices. Confirmation radiographs are acquired to assess intrafractional changes. For this study, daily radiographs were analyzed to determine the daily iso-center position and apparent gaze direction, which were then transferred to the planning system to calculate the dose delivered in individual fractions, and accumulated dose for the entire course. Dose-volume metrics were compared between the planned and accumulated distributions for the tumor and organs at risk, for representative cases that varied by location within the ocular globe. Results: The analysis of the first set of cases (3 posterior, 3 transequatorial and 4 anterior tumors) revealed varying dose deviation patterns, depending on the tumor location. For anterior and posterior tumors, the largest dose increases were observed in the lens and ciliary body, while for the equatorial tumors, macula, optic nerve and disk, were most often affected. The iso-center position error was below 1.3 mm (95%-confidence interval), and the standard deviation of daily polar and azimuthal gaze set-up were 1.5 and 3 degrees, respectively. Conclusion: We quantified interfractional and intrafractional set-up variation, and estimated their effect on the delivered dose for representative cases. Current safety margins are sufficient to maintain the target coverage, however, the dose delivered to critical structures often deviates from the plan. The ongoing analysis will further explore the patterns of dose deviation, and may help to identify particular treatment scenarios

  16. SU-E-CAMPUS-T-01: Analysis of the Precision of Patient Set-Up, and Fidelity of the Delivered Dose Distribution in Proton Therapy of Ocular Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Trofimov, A; Carpenter, K; Shih, HA [Massachusetts General Hospital, Boston, MA (United States)

    2014-06-15

    Purpose: To quantify daily set-up variations in fractionated proton therapy of ocular melanomas, and to assess the effect on the fidelity of delivered distribution to the plan. Methods: In a typical five-fraction course, daily set-up is achieved by matching the position of fiducial markers in orthogonal radiographs to the images generated by treatment planning program. A patient maintains the required gaze direction voluntarily, without the aid of fixation devices. Confirmation radiographs are acquired to assess intrafractional changes. For this study, daily radiographs were analyzed to determine the daily iso-center position and apparent gaze direction, which were then transferred to the planning system to calculate the dose delivered in individual fractions, and accumulated dose for the entire course. Dose-volume metrics were compared between the planned and accumulated distributions for the tumor and organs at risk, for representative cases that varied by location within the ocular globe. Results: The analysis of the first set of cases (3 posterior, 3 transequatorial and 4 anterior tumors) revealed varying dose deviation patterns, depending on the tumor location. For anterior and posterior tumors, the largest dose increases were observed in the lens and ciliary body, while for the equatorial tumors, macula, optic nerve and disk, were most often affected. The iso-center position error was below 1.3 mm (95%-confidence interval), and the standard deviation of daily polar and azimuthal gaze set-up were 1.5 and 3 degrees, respectively. Conclusion: We quantified interfractional and intrafractional set-up variation, and estimated their effect on the delivered dose for representative cases. Current safety margins are sufficient to maintain the target coverage, however, the dose delivered to critical structures often deviates from the plan. The ongoing analysis will further explore the patterns of dose deviation, and may help to identify particular treatment scenarios

  17. The application of a low-cost 3D depth camera for patient set-up and respiratory motion management in radiotherapy

    Science.gov (United States)

    Tahavori, Fatemeh

    Respiratory motion induces uncertainty in External Beam Radiotherapy (EBRT), which can result in sub-optimal dose delivery to the target tissue and unwanted dose to normal tissue. The conventional approach to managing patient respiratory motion for EBRT within the area of abdominal-thoracic cancer is through the use of internal radiological imaging methods (e.g. Megavoltage imaging or Cone-Beam Computed Tomography) or via surrogate estimates of tumour position using external markers placed on the patient chest. This latter method uses tracking with video-based techniques, and relies on an assumed correlation or mathematical model, between the external surrogate signal and the internal target position. The marker's trajectory can be used in both respiratory gating techniques and real-time tracking methods. Internal radiological imaging methods bring with them limited temporal resolution, and additional radiation burden, which can be addressed by external marker-based methods that carry no such issues. Moreover, by including multiple external markers and placing them closer to the internal target organs, the effciency of correlation algorithms can be increased. However, the quality of such external monitoring methods is underpinned by the performance of the associated correlation model. Therefore, several new approaches to correlation modelling have been developed as part of this thesis and compared using publicly-available datasets. Highly competitive results have been obtained when compared against state-of-the-art methods. Marker-based methods also have the disadvantages of requiring manual set-up time for marker placement and patient positioning and potential issues with reproducibility of marker placement. This motivates the investigation of non-contact marker-free methods for use in EBRT, which is the main topic of this thesis. The Microsoft Kinect is used as an example of a low-cost consumer grade 3D depth camera for capturing and analysing external

  18. Setting up virtual private network

    International Nuclear Information System (INIS)

    Huang Hongmei; Zhang Chengjun

    2003-01-01

    Setting up virtual private network for business enterprise provides a low cost network foundation, increases enterprise's network function and enlarges its private scope. The text introduces virtual private network's principal, privileges and protocols that use in virtual private network. At last, this paper introduces several setting up virtual private network's technologies which based on LAN

  19. Setting up virtual private network

    International Nuclear Information System (INIS)

    Huang Hongmei; Zhang Chengjun

    2003-01-01

    Setting up virtual private network for business enterprise provides a low cost network foundation, increases enterprise network function and enlarges its private scope. This text introduces virtual private network principal, privileges and protocols applied in virtual private network. At last, this paper introduces several setting up virtual private network technologies which is based on LAN

  20. A comparative study of set up variations and bowel volumes in supine versus prone positions of patients treated with external beam radiation for carcinoma rectum.

    Science.gov (United States)

    Rajeev, K R; Menon, Smrithy S; Beena, K; Holla, Raghavendra; Kumar, R Rajaneesh; Dinesh, M

    2014-01-01

    A prospective study was undertaken to evaluate the influence of patient positioning on the set up variations to determine the planning target volume (PTV) margins and to evaluate the clinical relevance volume assessment of the small bowel (SB) within the irradiated volume. During the period of months from December 2011 to April 2012, a computed tomography (CT) scan was done either in supine position or in prone position using a belly board (BB) for 20 consecutive patients. All the patients had histologically proven rectal cancer and received either post- or pre-operative pelvic irradiation. Using a three-dimensional planning system, the dose-volume histogram for SB was defined in each axial CT slice. Total dose was 46-50 Gy (2 Gy/fraction), delivered using the 4-field box technique. The set up variation of the study group was assessed from the data received from the electronic portal imaging device in the linear accelerator. The shift along X, Y, and Z directions were noted. Both systematic and random errors were calculated and using both these values the PTV margin was calculated. The systematic errors of patients treated in the supine position were 0.87 (X-mm), 0.66 (Y-mm), 1.6 (Z-mm) and in the prone position were 1.3 (X-mm), 0.59 (Y-mm), 1.17 (Z-mm). The random errors of patients treated in the supine positions were 1.81 (X-mm), 1.73 (Y-mm), 1.83 (Z-mm) and in prone position were 2.02 (X-mm), 1.21 (Y-mm), 3.05 (Z-mm). The calculated PTV margins in the supine position were 3.45 (X-mm), 2.87 (Y-mm), 5.31 (Z-mm) and in the prone position were 4.91 (X-mm), 2.32 (Y-mm), 5.08 (Z-mm). The mean volume of the peritoneal cavity was 648.65 cm 3 in the prone position and 1197.37 cm 3 in the supine position. The prone position using BB device was more effective in reducing irradiated SB volume in rectal cancer patients. There were no significant variations in the daily set up for patients treated in both supine and prone positions.

  1. An adaptive control algorithm for optimization of intensity modulated radiotherapy considering uncertainties in beam profiles, patient set-up and internal organ motion

    International Nuclear Information System (INIS)

    Loef, Johan; Lind, Bengt K.; Brahme, Anders

    1998-01-01

    A new general beam optimization algorithm for inverse treatment planning is presented. It utilizes a new formulation of the probability to achieve complication-free tumour control. The new formulation explicitly describes the dependence of the treatment outcome on the incident fluence distribution, the patient geometry, the radiobiological properties of the patient and the fractionation schedule. In order to account for both measured and non-measured positioning uncertainties, the algorithm is based on a combination of dynamic and stochastic optimization techniques. Because of the difficulty in measuring all aspects of the intra- and interfractional variations in the patient geometry, such as internal organ displacements and deformations, these uncertainties are primarily accounted for in the treatment planning process by intensity modulation using stochastic optimization. The information about the deviations from the nominal fluence profiles and the nominal position of the patient relative to the beam that is obtained by portal imaging during treatment delivery, is used in a feedback loop to automatically adjust the profiles and the location of the patient for all subsequent treatments. Based on the treatment delivered in previous fractions, the algorithm furnishes optimal corrections for the remaining dose delivery both with regard to the fluence profile and its position relative to the patient. By dynamically refining the beam configuration from fraction to fraction, the algorithm generates an optimal sequence of treatments that very effectively reduces the influence of systematic and random set-up uncertainties to minimize and almost eliminate their overall effect on the treatment. Computer simulations have shown that the present algorithm leads to a significant increase in the probability of uncomplicated tumour control compared with the simple classical approach of adding fixed set-up margins to the internal target volume. (author)

  2. [Comparison of set-up control for head and neck patients between radiation oncologist and therapists with the aim of partial delegation].

    Science.gov (United States)

    Garcia-Ramirez, M; Maugey, S; Burgaud, L; Carpentey, F; Parezys, E; Carricaburu, M

    2014-11-01

    The aim of this prospective study was to evaluate daily set-up by a radiation oncologist and by radiation therapists using on-board imaging of patients with head and neck cancer in order to calculate margin to PTV (planning target volume) and intent partial delegation of positioning images control. The files of 11 patients with head and neck cancer treated on a Synergy™ (Elekta™) accelerator with on-board imaging system were evaluated. Daily kV-kV images were double-blind reviewed by radiation therapists (7 participants) and by one radiation oncologist. The radiation oncologist's measures were used for margin calculation from CTV to PTV. The difference of measures and the concordance of decisions between radiation therapists and the radiation oncologist were calculated. The 325 measures made by the radiation oncologist resulted in a margin of 5mm to be applied to the CTV in each direction. Nine hundred seventy-seven measures were made by the radiation oncologist and radiation therapists with a difference of 3mm or less in 98.46%. The concordance of decision for a 4mm difference or less to the isocenter was 96.7%. This study confirms the 5mm PTV margin mostly used in ORL. The small gap between the radiation oncologist's and therapists' measures allows a partial delegation of positioning images control. Copyright © 2014 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  3. Setting up crowd science projects.

    Science.gov (United States)

    Scheliga, Kaja; Friesike, Sascha; Puschmann, Cornelius; Fecher, Benedikt

    2016-11-29

    Crowd science is scientific research that is conducted with the participation of volunteers who are not professional scientists. Thanks to the Internet and online platforms, project initiators can draw on a potentially large number of volunteers. This crowd can be involved to support data-rich or labour-intensive projects that would otherwise be unfeasible. So far, research on crowd science has mainly focused on analysing individual crowd science projects. In our research, we focus on the perspective of project initiators and explore how crowd science projects are set up. Based on multiple case study research, we discuss the objectives of crowd science projects and the strategies of their initiators for accessing volunteers. We also categorise the tasks allocated to volunteers and reflect on the issue of quality assurance as well as feedback mechanisms. With this article, we contribute to a better understanding of how crowd science projects are set up and how volunteers can contribute to science. We suggest that our findings are of practical relevance for initiators of crowd science projects, for science communication as well as for informed science policy making. © The Author(s) 2016.

  4. Electronic portal image assisted reduction of systematic set-up errors in head and neck irradiation

    International Nuclear Information System (INIS)

    Boer, Hans C.J. de; Soernsen de Koste, John R. van; Creutzberg, Carien L.; Visser, Andries G.; Levendag, Peter C.; Heijmen, Ben J.M.

    2001-01-01

    Purpose: To quantify systematic and random patient set-up errors in head and neck irradiation and to investigate the impact of an off-line correction protocol on the systematic errors. Material and methods: Electronic portal images were obtained for 31 patients treated for primary supra-glottic larynx carcinoma who were immobilised using a polyvinyl chloride cast. The observed patient set-up errors were input to the shrinking action level (SAL) off-line decision protocol and appropriate set-up corrections were applied. To assess the impact of the protocol, the positioning accuracy without application of set-up corrections was reconstructed. Results: The set-up errors obtained without set-up corrections (1 standard deviation (SD)=1.5-2 mm for random and systematic errors) were comparable to those reported in other studies on similar fixation devices. On an average, six fractions per patient were imaged and the set-up of half the patients was changed due to the decision protocol. Most changes were detected during weekly check measurements, not during the first days of treatment. The application of the SAL protocol reduced the width of the distribution of systematic errors to 1 mm (1 SD), as expected from simulations. A retrospective analysis showed that this accuracy should be attainable with only two measurements per patient using a different off-line correction protocol, which does not apply action levels. Conclusions: Off-line verification protocols can be particularly effective in head and neck patients due to the smallness of the random set-up errors. The excellent set-up reproducibility that can be achieved with such protocols enables accurate dose delivery in conformal treatments

  5. SU-F-P-18: Development of the Technical Training System for Patient Set-Up Considering Rotational Correction in the Virtual Environment Using Three-Dimensional Computer Graphic Engine

    International Nuclear Information System (INIS)

    Imura, K; Fujibuchi, T; Hirata, H; Kaneko, K; Hamada, E

    2016-01-01

    Purpose: Patient set-up skills in radiotherapy treatment room have a great influence on treatment effect for image guided radiotherapy. In this study, we have developed the training system for improving practical set-up skills considering rotational correction in the virtual environment away from the pressure of actual treatment room by using three-dimensional computer graphic (3DCG) engine. Methods: The treatment room for external beam radiotherapy was reproduced in the virtual environment by using 3DCG engine (Unity). The viewpoints to perform patient set-up in the virtual treatment room were arranged in both sides of the virtual operable treatment couch to assume actual performance by two clinical staffs. The position errors to mechanical isocenter considering alignment between skin marker and laser on the virtual patient model were displayed by utilizing numerical values expressed in SI units and the directions of arrow marks. The rotational errors calculated with a point on the virtual body axis as the center of each rotation axis for the virtual environment were corrected by adjusting rotational position of the body phantom wound the belt with gyroscope preparing on table in a real space. These rotational errors were evaluated by describing vector outer product operations and trigonometric functions in the script for patient set-up technique. Results: The viewpoints in the virtual environment allowed individual user to visually recognize the position discrepancy to mechanical isocenter until eliminating the positional errors of several millimeters. The rotational errors between the two points calculated with the center point could be efficiently corrected to display the minimum technique mathematically by utilizing the script. Conclusion: By utilizing the script to correct the rotational errors as well as accurate positional recognition for patient set-up technique, the training system developed for improving patient set-up skills enabled individual user to

  6. SU-F-P-18: Development of the Technical Training System for Patient Set-Up Considering Rotational Correction in the Virtual Environment Using Three-Dimensional Computer Graphic Engine

    Energy Technology Data Exchange (ETDEWEB)

    Imura, K [Division of Quantum Radiation Science, Department of Health Science, Graduate School of Medical Science, Kyushu University, Fukuoka (Japan); Fujibuchi, T; Hirata, H [Department of Health Science, Graduate School of Medical Science, Kyushu University, Fukuoka (Japan); Kaneko, K [Innovation Center for Educational Resource, Kyushu University, Fukuoka (Japan); Hamada, E [Cancer Treatment Center, Tobata Kyoritsu Hospital, Kitakyushu (Japan)

    2016-06-15

    Purpose: Patient set-up skills in radiotherapy treatment room have a great influence on treatment effect for image guided radiotherapy. In this study, we have developed the training system for improving practical set-up skills considering rotational correction in the virtual environment away from the pressure of actual treatment room by using three-dimensional computer graphic (3DCG) engine. Methods: The treatment room for external beam radiotherapy was reproduced in the virtual environment by using 3DCG engine (Unity). The viewpoints to perform patient set-up in the virtual treatment room were arranged in both sides of the virtual operable treatment couch to assume actual performance by two clinical staffs. The position errors to mechanical isocenter considering alignment between skin marker and laser on the virtual patient model were displayed by utilizing numerical values expressed in SI units and the directions of arrow marks. The rotational errors calculated with a point on the virtual body axis as the center of each rotation axis for the virtual environment were corrected by adjusting rotational position of the body phantom wound the belt with gyroscope preparing on table in a real space. These rotational errors were evaluated by describing vector outer product operations and trigonometric functions in the script for patient set-up technique. Results: The viewpoints in the virtual environment allowed individual user to visually recognize the position discrepancy to mechanical isocenter until eliminating the positional errors of several millimeters. The rotational errors between the two points calculated with the center point could be efficiently corrected to display the minimum technique mathematically by utilizing the script. Conclusion: By utilizing the script to correct the rotational errors as well as accurate positional recognition for patient set-up technique, the training system developed for improving patient set-up skills enabled individual user to

  7. Impact of patient-specific factors, irradiated left ventricular volume, and treatment set-up errors on the development of myocardial perfusion defects after radiation therapy for left-sided breast cancer

    International Nuclear Information System (INIS)

    Evans, Elizabeth S.; Prosnitz, Robert G.; Yu Xiaoli; Zhou Sumin; Hollis, Donna R.; Wong, Terence Z.; Light, Kim L.; Hardenbergh, Patricia H.; Blazing, Michael A.; Marks, Lawrence B.

    2006-01-01

    Purpose: The aim of this study was to assess the impact of patient-specific factors, left ventricle (LV) volume, and treatment set-up errors on the rate of perfusion defects 6 to 60 months post-radiation therapy (RT) in patients receiving tangential RT for left-sided breast cancer. Methods and Materials: Between 1998 and 2005, a total of 153 patients were enrolled onto an institutional review board-approved prospective study and had pre- and serial post-RT (6-60 months) cardiac perfusion scans to assess for perfusion defects. Of the patients, 108 had normal pre-RT perfusion scans and available follow-up data. The impact of patient-specific factors on the rate of perfusion defects was assessed at various time points using univariate and multivariate analysis. The impact of set-up errors on the rate of perfusion defects was also analyzed using a one-tailed Fisher's Exact test. Results: Consistent with our prior results, the volume of LV in the RT field was the most significant predictor of perfusion defects on both univariate (p = 0.0005 to 0.0058) and multivariate analysis (p = 0.0026 to 0.0029). Body mass index (BMI) was the only significant patient-specific factor on both univariate (p = 0.0005 to 0.022) and multivariate analysis (p = 0.0091 to 0.05). In patients with very small volumes of LV in the planned RT fields, the rate of perfusion defects was significantly higher when the fields set-up 'too deep' (83% vs. 30%, p = 0.059). The frequency of deep set-up errors was significantly higher among patients with BMI ≥25 kg/m 2 compared with patients of normal weight (47% vs. 28%, p = 0.068). Conclusions: BMI ≥25 kg/m 2 may be a significant risk factor for cardiac toxicity after RT for left-sided breast cancer, possibly because of more frequent deep set-up errors resulting in the inclusion of additional heart in the RT fields. Further study is necessary to better understand the impact of patient-specific factors and set-up errors on the development of RT

  8. An experimental set-up to test heatmoisture exchangers

    NARCIS (Netherlands)

    N. Ünal (N.); J.C. Pompe (Jan); W.P. Holland (Wim); I. Gultuna; P.E.M. Huygen; K. Jabaaij (K.); C. Ince (Can); B. Saygin (B.); H.A. Bruining (Hajo)

    1995-01-01

    textabstractObjectives: The purpose of this study was to build an experimental set-up to assess continuously the humidification, heating and resistance properties of heat-moisture exchangers (HMEs) under clinical conditions. Design: The experimental set-up consists of a patient model, measurement

  9. How to set up a psychodermatology clinic.

    Science.gov (United States)

    Aguilar-Duran, S; Ahmed, A; Taylor, R; Bewley, A

    2014-07-01

    Psychodermatology is a recognized subspecialty, but lack of awareness among dermatologists and limitation of resources make the management of these patients challenging. Clinicians are often unsure about the practicalities of setting up a psychodermatology service. There is confusion about which model is best suited to which service, and about the development of a psychodermatology multidisciplinary team. To identify the necessary steps in setting up a psychodermatology clinic. The study was based on the experience of a UK-based psychodermatology unit and the recently published standards by the UK Psychodermatology Working Party. The type of service provision will depend on the type of patients seen in the unit. The core team will be composed of a psychodermatologist and a psychologist. Access to a psychiatrist is essential if patients present with primary psychiatric conditions or primary cutaneous conditions with suicidal or other psychiatric risks. Adequate training of the healthcare staff is advised. The premises and time allocation should be adequate, and this translates into higher tariffs. Using business care tariffs for people with mental health conditions might be more appropriate, as the consultations are longer and involve more members of staff; however, the overall cost remains lower than if these patients were seen in a general dermatology service or in the community. Psychodermatology services are globally limited, and yet the demand for psychodermatology care is high. There is evidence that dedicated psychodermatology services are cost-effective. Healthcare professionals need to be aware of the steps necessary to establish and maintain psychodermatology services. © 2014 British Association of Dermatologists.

  10. Difference in the Set-up Margin between 2D Conventional and 3D CT Based Planning in Patients with Early Breast Cancer

    International Nuclear Information System (INIS)

    Jo, Sun Mi; Chun, Mi Sun; Kim, Mi Hwa; Oh, Young Taek; Noh, O Kyu; Kang, Seung Hee

    2010-01-01

    Simulation using computed tomography (CT) is now widely available for radiation treatment planning for breast cancer. It is an important tool to help define the tumor target and normal tissue based on anatomical features of an individual patient. In Korea, most patients have small sized breasts and the purpose of this study was to review the margin of treatment field between conventional two-dimensional (2D) planning and CT based three-dimensional (3D) planning in patients with small breasts. Twenty-five consecutive patients with early breast cancer undergoing breast conservation therapy were selected. All patients underwent 3D CT based planning with a conventional breast tangential field design. In 2D planning, the treatment field margins were determined by palpation of the breast parenchyma (In general, the superior: base of the clavicle, medial: midline, lateral: mid - axillary line, and inferior margin: 2 m below the inflamammary fold). In 3D planning, the clinical target volume (CTV) ought to comprise all glandular breast tissue, and the PTV was obtained by adding a 3D margin of 1 cm around the CTV except in the skin direction. The difference in the treatment field margin and equivalent field size between 2D and 3D planning were evaluated. The association between radiation field margins and factors such as body mass index, menopause status, and bra size was determined. Lung volume and heart volume were examined on the basis of the prescribed breast radiation dose and 3D dose distribution. The margins of the treatment field were smaller in the 3D planning except for two patients. The superior margin was especially variable (average, 2.5 cm; range, -2.5 to 4.5 cm; SD, 1.85). The margin of these targets did not vary equally across BMI class, menopause status, or bra size. The average irradiated lung volume was significantly lower for 3D planning. The average irradiated heart volume did not decrease significantly. The use of 3D CT based planning reduced the

  11. Difference in the Set-up Margin between 2D Conventional and 3D CT Based Planning in Patients with Early Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jo, Sun Mi; Chun, Mi Sun; Kim, Mi Hwa; Oh, Young Taek; Noh, O Kyu [Ajou University School of Medicine, Seoul (Korea, Republic of); Kang, Seung Hee [Inje University, Ilsan Paik Hospital, Ilsan (Korea, Republic of)

    2010-11-15

    Simulation using computed tomography (CT) is now widely available for radiation treatment planning for breast cancer. It is an important tool to help define the tumor target and normal tissue based on anatomical features of an individual patient. In Korea, most patients have small sized breasts and the purpose of this study was to review the margin of treatment field between conventional two-dimensional (2D) planning and CT based three-dimensional (3D) planning in patients with small breasts. Twenty-five consecutive patients with early breast cancer undergoing breast conservation therapy were selected. All patients underwent 3D CT based planning with a conventional breast tangential field design. In 2D planning, the treatment field margins were determined by palpation of the breast parenchyma (In general, the superior: base of the clavicle, medial: midline, lateral: mid - axillary line, and inferior margin: 2 m below the inflamammary fold). In 3D planning, the clinical target volume (CTV) ought to comprise all glandular breast tissue, and the PTV was obtained by adding a 3D margin of 1 cm around the CTV except in the skin direction. The difference in the treatment field margin and equivalent field size between 2D and 3D planning were evaluated. The association between radiation field margins and factors such as body mass index, menopause status, and bra size was determined. Lung volume and heart volume were examined on the basis of the prescribed breast radiation dose and 3D dose distribution. The margins of the treatment field were smaller in the 3D planning except for two patients. The superior margin was especially variable (average, 2.5 cm; range, -2.5 to 4.5 cm; SD, 1.85). The margin of these targets did not vary equally across BMI class, menopause status, or bra size. The average irradiated lung volume was significantly lower for 3D planning. The average irradiated heart volume did not decrease significantly. The use of 3D CT based planning reduced the

  12. Set-up for differential manometers testing

    International Nuclear Information System (INIS)

    Ratushnyj, M.I.; Galkin, Yu.V.; Nechaj, A.G.

    1985-01-01

    Set-up characteristic for controlling and testing metrological characteristics of TPP and NPP differential manometers with extreme pressure drop upto 250 kPa is briefly described. The set-up provides with automatic and manual assignment of values of gauge air pressure with errors of 0.1 and 0.25% correspondingly. The set-up is supplied with standard equipment to measure output signals. Set-up supply is carried out by a one-phase alternating current circuit with 220 V. Air supply is carried out by O.4-0.6 MPa. pressure of a pneumatic system. Application of the set-up increases operating efficiency 5 times while checking and turning differential manometers

  13. Galvanic cells: setting up the Daniell cell.

    OpenAIRE

    Milla González, Miguel

    2008-01-01

    With the reagents (0.05M copper nitrate solution, 0.05M zinc nitrate solution) and material (glassware, potentiometer, electric wire) availabe in the laboratory, the user must set up the Daniell cell. Different configurations can be possible if the half cells are filled with either electrolyte solution. The cell connections to the measuring device can also be changed. In all instances, an explanation of the set up cell is obtained as well as of the measured potential difference.

  14. Essential Requirements to Setting up an Aesthetic Practice

    OpenAIRE

    Sachdev, Mukta; Britto, Gillian R

    2014-01-01

    Aesthetic dermatology is becoming a vital and popular branch of medicine. This article aims to guide dermatologists to set up a professional and ethical aesthetic practice. Dermatologists should have an integrated practice of clinical dermatology, dermatosurgery and cosmetic dermatology. Ethical practice is the gold standard for any medical field, especially with dermatologists, who should avoid doing unnecessary procedures. Proper patient counselling and addressing the patients′ concerns is ...

  15. Seminar on setting up your own business

    CERN Multimedia

    DSU Department

    2008-01-01

    Organised by the French-Swiss Foundation for Research and Technology (FFRST), in partnership with CERN, and open to all CERN personnel: Friday 7 March 2008, from 9.00 a.m. to 4.00 p.m. in the Globe of Science and Innovation Are you interested in setting up your own business? Have you already taken any steps in that direction? Do you wish to develop a business plan based on your own professional expertise? If so, you are cordially invited to take part in this seminar, at which you will have the opportunity to: hear first-hand accounts from former members of the CERN personnel who have become entrepreneurs and talk about their experience and needs in terms of financial support, find out about the possibilities for obtaining support at the national level (in Switzerland and France) through presentations of the CTI Start-up and OSEO programmes, have discussions with the relevant Swiss and French regional authorities responsible for supporting start-ups in innovative technolog...

  16. Seminar on setting up your own business

    CERN Multimedia

    DSU Department

    2008-01-01

    Organised by the French-Swiss Foundation for Research and Technology (FFRST), in partnership with CERN, and open to all CERN personnel: Friday 7 March 2008, from 9.00 a.m. to 4.00 p.m. in the Globe of Science and Innovation Are you interested in setting up your own business? Have you already taken any steps in that direction? Do you wish to develop a business plan based on your own professional expertise? If so, then you are cordially invited to take part in this seminar at which you will have the opportunity to: hear first-hand accounts from former members of the CERN personnel who have become entrepreneurs and talk about their experience and needs in terms of financial support, find out about the possibilities of obtaining support at national level (in Switzerland and France) through presentations of the CTI Start-up and OSEO programmes, have discussions with the relevant Swiss and French regional authorities responsible for supporting start-ups in innovative technologies...

  17. Set-up of light nuclei multidetector

    International Nuclear Information System (INIS)

    Drouet, A.

    1985-01-01

    In order to study mechanisms of reactions produced by heavy ions in the GANIL energy range (15-100 MeV/A), a multidetector capable to detect large multiplicities for particles and light nuclei is necessary. The multidetector set up covers the 3-30 0 angular range and consists of 96 counters (NE102 plastic scintillator sheet, 2mm thick). The apparatus must identify the nuclear charge of the detected particles. Using the apparatus at GANIL leaded to carry out data processing tools in conversationnal mode and to write on experimental area programs performing and monitoring data acquisition. A test carried out with a 44 MeV/A argon beam showed that the apparatus was working properly: the identification in nuclear charge between Z=1 (proton) and Z=7 (nitrogen) is good. Results of the test allow to draw light production curves in the NE102 plastic scintillator for the following ions: 1 H, 4 He, 7 Li, 9 Be, 11 B, 12 C, 14 N, in the 13 to 44 MeV/A energy range [fr

  18. Windows VPN Set Up | High-Performance Computing | NREL

    Science.gov (United States)

    Windows VPN Set Up Windows VPN Set Up To set up Windows for HPC VPN, here are the steps: Download your version of Windows. Note: We only support the the Endian Connect software when connecting to the a VPN connection to the HPC systems. Windows Version Connect App Windows 10

  19. An experimental set-up to test heat-moisture exchangers

    NARCIS (Netherlands)

    Unal, N.; Pompe, J. C.; Holland, W. P.; Gültuna, I.; Huygen, P. E.; Jabaaij, K.; Ince, C.; Saygin, B.; Bruining, H. A.

    1995-01-01

    The purpose of this study was to build an experimental set-up to assess continuously the humidification, heating and resistance properties of heat-moisture exchangers (HMEs) under clinical conditions. The experimental set-up consists of a patient model, measurement systems and a ventilator. Surgical

  20. Influence of Daily Set-Up Errors on Dose Distribution During Pelvis Radiotherapy

    International Nuclear Information System (INIS)

    Kasabasic, M.; Ivkovic, A.; Faj, D.; Rajevac, V.; Sobat, H.; Jurkovic, S.

    2011-01-01

    An external beam radiotherapy (EBRT) using megavoltage beam of linear accelerator is usually the treatment of choice for the cancer patients. The goal of EBRT is to deliver the prescribed dose to the target volume, with as low as possible dose to the surrounding healthy tissue. A large number of procedures and different professions involved in radiotherapy process, uncertainty of equipment and daily patient set-up errors can cause a difference between the planned and delivered dose. We investigated a part of this difference caused by daily patient set-up errors. Daily set-up errors for 35 patients were measured. These set-up errors were simulated on 5 patients, using 3D treatment planning software XiO (CMS Inc., St. Louis, MO). The differences in dose distributions between the planned and shifted ''geometry'' were investigated. Additionally, an influence of the error on treatment plan selection was checked by analyzing the change in dose volume histograms, planning target volume conformity index (CI P TV) and homogeneity index (HI). Simulations showed that patient daily set-up errors can cause significant differences between the planned and actual dose distributions. Moreover, for some patients those errors could influence the choice of treatment plan since CI P TV fell under 97 %. Surprisingly, HI was not as sensitive as CI P TV on set-up errors. The results showed the need for minimizing daily set-up errors by quality assurance programme. (author)

  1. Standard guidelines for setting up a dermatosurgery theatre

    Directory of Open Access Journals (Sweden)

    Rajendran S

    2009-08-01

    Full Text Available Introduction, definition, rationale and scope: Dermatologists in India are now increasingly performing surgical and cosmetic procedures in their practice. This calls for minimum standards at the national level with the main focus of patient safety and hence the guidelines for setting up a dermatosurgical theatre. Facility: The dermatosurgery theatre can be created in either physician′s clinic, or a hospital depending on the procedure to be performed. The dermatosurgery theatre requires careful planning with regards to - location, dimension, shell design, lighting, electrical requirements, operation table, chair, trolley, surgical instruments, sterilization of devices, asepsis and advanced life support. Apart from physical considerations, other considerations including theatre etiquettes, consent for surgery, safety of dermatosurgeon, theatre staff and lastly biomedical waste management should be looked into. These issues are discussed in detail in the recommendations.

  2. Set-Up and Punchline as Figure and Ground

    DEFF Research Database (Denmark)

    Keisalo, Marianna Päivikki

    the two that cannot be resolved by appeal to either set-up or punchline, but traps thought between them in an ‘epistemological problem’ as comedian Louis CK put it. For comedians, set-ups and punchlines are basic tools, practical and concrete ways to create and organize material. They are also familiar...

  3. French scientists offered time to set up companies

    CERN Document Server

    Butler, D

    1999-01-01

    The French minister of national education, research and technology announced that French researchers working for public research institutes and universities are to be offered up to six years sabbatical leave to set up their own companies (11 para)

  4. Challenges in setting up quality control in diagnostic radiology ...

    African Journals Online (AJOL)

    Journal Home > Vol 24, No 4 (2015) >. Log in or ... Quality control (QC) on diagnostic radiology equipment form part of the fundamental requirements for the ... Inadequate cooperation by facilities management, lack of QC equipment and insufficient staff form the major challenges in setting up QC in the facilities under study.

  5. View of the WA10 set-up

    CERN Multimedia

    CERN PhotoLab

    1977-01-01

    The WA10 experiment by the Geneva-Lausanne Collaboration was set-up in the H5 beam (unseparated, up to 50 GeV/c) to study K+-p --> K0pi+-p and other reactions of similar topology, and the energy dependence of resonance production.

  6. A Magnetic Set-Up to Help Teach Newton's Laws

    Science.gov (United States)

    Panijpan, Bhinyo; Sujarittham, Thanida; Arayathanitkul, Kwan; Tanamatayarat, Jintawat; Nopparatjamjomras, Suchai

    2009-01-01

    A set-up comprising a magnetic disc, a solenoid and a mechanical balance was used to teach first-year physics students Newton's third law with the help of a free body diagram. The image of a floating magnet immobilized by the solenoid's repulsive force should help dispel a common misconception of students as regards the first law: that stationary…

  7. Automotive RF immunity test set-up analysis

    NARCIS (Netherlands)

    Coenen, M.J.; Pues, H.; Bousquet, T.; Gillon, R.; Gielen, G.; Baric, A.

    2011-01-01

    Though the automotive RF emission and RF immunity requirements are highly justifiable, the application of those requirements in an non-intended manner leads to false conclusions and unnecessary redesigns for the electronics involved. When the test results become too dependent upon the test set-up

  8. Market and Impact Study Setting Up MMX Discount Store

    OpenAIRE

    Sabina Irimie; Andreea Ionică; Virginia Băleanu; Cristina Osvath

    2008-01-01

    The paper is focused on the following elements of the impact study’s content: social and economic features of the area and the social, economic and commercial impact. Currently we witness the materialisation of the research’s results by setting up such a store MMX DISCOUNT in the town of Vulcan from the Jiu Valley

  9. Radiotherapy for breast cancer: respiratory and set-up uncertainties

    International Nuclear Information System (INIS)

    Saliou, M.G.; Giraud, P.; Simon, L.; Fournier-Bidoz, N.; Fourquet, A.; Dendale, R.; Rosenwald, J.C.; Cosset, J.M.

    2005-01-01

    Adjuvant Radiotherapy has been shown to significantly reduce locoregional recurrence but this advantage is associated with increased cardiovascular and pulmonary morbidities. All uncertainties inherent to conformal radiation therapy must be identified in order to increase the precision of treatment; misestimation of these uncertainties increases the potential risk of geometrical misses with, as a consequence, under-dosage of the tumor and/or overdosage of healthy tissues. Geometric uncertainties due to respiratory movements or set-up errors are well known. Two strategies have been proposed to limit their effect: quantification of these uncertainties, which are then taken into account in the final calculation of safety margins and/or reduction of respiratory and set-up uncertainties by an efficient immobilization or gating systems. Measured on portal films with two tangential fields. CLD (central lung distance), defined as the distance between the deep field edge and the interior chest wall at the central axis, seems to be the best predictor of set-up uncertainties. Using CLD, estimated mean set-up errors from the literature are 3.8 and 3.2 mm for the systematic and random errors respectively. These depend partly on the type of immobilization device and could be reduced by the use of portal imaging systems. Furthermore, breast is mobile during respiration with motion amplitude as high as 0.8 to 10 mm in the anteroposterior direction. Respiratory gating techniques, currently on evaluation, have the potential to reduce effect of these movements. Each radiotherapy department should perform its own assessments and determine the geometric uncertainties with respect of the equipment used and its particular treatment practices. This paper is a review of the main geometric uncertainties in breast treatment, due to respiration and set-up, and solutions proposed to limit their impact. (author)

  10. Splendidly blended: a machine learning set up for CDU control

    Science.gov (United States)

    Utzny, Clemens

    2017-06-01

    As the concepts of machine learning and artificial intelligence continue to grow in importance in the context of internet related applications it is still in its infancy when it comes to process control within the semiconductor industry. Especially the branch of mask manufacturing presents a challenge to the concepts of machine learning since the business process intrinsically induces pronounced product variability on the background of small plate numbers. In this paper we present the architectural set up of a machine learning algorithm which successfully deals with the demands and pitfalls of mask manufacturing. A detailed motivation of this basic set up followed by an analysis of its statistical properties is given. The machine learning set up for mask manufacturing involves two learning steps: an initial step which identifies and classifies the basic global CD patterns of a process. These results form the basis for the extraction of an optimized training set via balanced sampling. A second learning step uses this training set to obtain the local as well as global CD relationships induced by the manufacturing process. Using two production motivated examples we show how this approach is flexible and powerful enough to deal with the exacting demands of mask manufacturing. In one example we show how dedicated covariates can be used in conjunction with increased spatial resolution of the CD map model in order to deal with pathological CD effects at the mask boundary. The other example shows how the model set up enables strategies for dealing tool specific CD signature differences. In this case the balanced sampling enables a process control scheme which allows usage of the full tool park within the specified tight tolerance budget. Overall, this paper shows that the current rapid developments off the machine learning algorithms can be successfully used within the context of semiconductor manufacturing.

  11. Setting up and managing a remote maintenance operation for fusion

    International Nuclear Information System (INIS)

    Haist, Bernhard

    2008-01-01

    Trying to set up and manage a remote maintenance operation for a thermonuclear fusion reactor is a complex undertaking. There are many problems and challenges which need addressing. This paper tries to guide the reader through this process by composing a list of generic problems and by analysing possible solutions. The first challenge before setting up a remote maintenance operation for a fusion reactor is the systematic analysis of all the remote handling requirements. Based upon this the remote handling concept, including facility layout and equipment, can be defined. The following aspects have to be considered and incorporated into the remote handling concept: - Remote handling task development. - Remote handling task logistics and resource management. - Command, control and human-machine interface system. - Viewing and camera systems. - Virtual reality and Augmented Reality software. - Automatic path planning and collision avoidance. - Remote transfer of heavy loads. - Maintainability of RH equipment. - Reliability, redundant systems and safety. - Rationalisation and modularity in both hardware and software. - Recovery from failure modes. - Condition monitoring and fault detection/prediction. - Ability to deal with unforeseen problems. Oxford Technologies Ltd. has a proven track record in setting up and running the Remote Handling group at the JET Joint Undertaking in Culham, UK. Based on the unique experience gained at JET, Oxford Technologies Ltd. also developed the current design and remote handling concept of the ITER Hot Cell during a study in 2004. Examples of both the JET remote handling experience and the ITER Hot Cell design and layout are given throughout this paper

  12. Setting up and managing a remote maintenance operation for fusion

    International Nuclear Information System (INIS)

    Haist, B.

    2007-01-01

    Trying to set up and manage a remote maintenance operation for a thermonuclear fusion reactor is a complex undertaking. There are many problems and challenges which need addressing. This paper tries to guide the reader through this process by composing a list of generic problems and by analysing possible solutions. The first challenge before setting up a remote maintenance operation for a fusion reactor is the systematic analysis of all the remote handling requirements. Based upon this the remote handling concept, including facility layout and equipment, can be defined. The following aspects have to be considered and incorporated into the remote handling concept: - Remote handling task development - Remote handling task logistics and resource management - Command, control and human-machine interface system - Viewing and camera systems - Virtual Reality and Augmented Reality software - Automatic path planning and collision avoidance - Remote transfer of heavy loads - Maintainability of RH Equipment - Reliability, redundant systems and safety - Rationalisation and modularity in both hardware and software - Recovery from failure modes - Condition monitoring and fault detection/prediction - Ability to deal with unforeseen problems Oxford Technologies Ltd has a proven track record in setting up and running the Remote Handling group at the JET Joint Undertaking in Culham, UK. Based on the unique experience gained at JET, Oxford Technologies Ltd also developed the current design and remote handling concept of the ITER Hot Cell during a study in 2004. Examples of both the JET Remote Handling experience and the ITER Hot Cell design and layout are given throughout this paper. (orig.)

  13. Setting up and managing a remote maintenance operation for fusion

    Energy Technology Data Exchange (ETDEWEB)

    Haist, Bernhard [Oxford Technologies Ltd., 7 Nuffield Way, Abingdon, Oxon OX14 1RJ (United Kingdom)], E-mail: Bernhard.Haist@oxfordtechnologies.co.uk

    2008-12-15

    Trying to set up and manage a remote maintenance operation for a thermonuclear fusion reactor is a complex undertaking. There are many problems and challenges which need addressing. This paper tries to guide the reader through this process by composing a list of generic problems and by analysing possible solutions. The first challenge before setting up a remote maintenance operation for a fusion reactor is the systematic analysis of all the remote handling requirements. Based upon this the remote handling concept, including facility layout and equipment, can be defined. The following aspects have to be considered and incorporated into the remote handling concept: - Remote handling task development. - Remote handling task logistics and resource management. - Command, control and human-machine interface system. - Viewing and camera systems. - Virtual reality and Augmented Reality software. - Automatic path planning and collision avoidance. - Remote transfer of heavy loads. - Maintainability of RH equipment. - Reliability, redundant systems and safety. - Rationalisation and modularity in both hardware and software. - Recovery from failure modes. - Condition monitoring and fault detection/prediction. - Ability to deal with unforeseen problems. Oxford Technologies Ltd. has a proven track record in setting up and running the Remote Handling group at the JET Joint Undertaking in Culham, UK. Based on the unique experience gained at JET, Oxford Technologies Ltd. also developed the current design and remote handling concept of the ITER Hot Cell during a study in 2004. Examples of both the JET remote handling experience and the ITER Hot Cell design and layout are given throughout this paper.

  14. Set-up for pulse radiolysis of agressive substances

    International Nuclear Information System (INIS)

    Kozlowska-Milner, E.; Broszkiewicz, R.; Stanikowski, J.

    1975-01-01

    A set-up for the pulse radiolysis of aggressive substances with a relatively low consumption of the liquid, tested for anhydrous HNO 3 , has been described. The samples have been irradiated with single pulses of 10 MeV electrons at the linear accelerator type LAE 13-9. The absorption spectra of the irradiated samples (within a range of 300-800 nm) were provided by a xenon lamp. The variations of the voltage from the photomultiplier, coupled with an oscilloscope, were registered with the aid of a Polaroid camera. (T.G.)

  15. Setting up and performance of a laser enhanced ionisation spectrometer

    International Nuclear Information System (INIS)

    Chandola, L.C.; Khanna, P.P.; Razvi, M.A.N.

    1990-01-01

    A laser enhanced ionisation (LEI) spectrometer has been successfuly set up around an excimer laser pumped dye laser. The performance of the spectrometer has been tested by analysing sodium in water solutions. A straight line working curve has been obtained in the concentration range of 1-1000 ng/ml of Na. The effect of parameters like laser power, ion collector electrode voltage and the load resistance on LEI signals has been investigated. The spectrometer is useful not only for analytical purposes but also for laser spectroscopic studies of species formed in flames, study of phenomenon of combustion etc. (author). 1 tab ., 10 figs., 5 refs

  16. ALBERTA - HEC test beam set-up in June 1999

    CERN Multimedia

    Vinter, M.

    1999-01-01

    Photo1 - HEC 2 (rear) being set up in the "clean" room. Photo2 - HEC 2 (rear) being craned onto rotating C. Photo3 - HEC 2 (rear) being rotated. Photo4 - A now well rotated HEC 2 (rear) is being craned off the C. Photo5 - HEC 2 (rear) installed in the cryostat. Photo6 - Part of the basic frame (the frame that sits in the very bottom of the cryostat). Photo7 - Part of the basic frame (one of the two frames which the 3 calorimeter modules sit on). Photo8 - The marriage frame.

  17. A HPMT based set-up to characterize scintillating crystals

    International Nuclear Information System (INIS)

    D'Ambrosio, C.; Ercoli, C.; Jaaskelainen, S.; Lecoeur, G.; Leutz, H.; Loos, R.; Piedigrossi, D.; Puertolas, D.; Rosso, E.; Schomaker, R.

    1999-01-01

    We have developed a fully automatic measurement set-up, capable of measuring light yields arising from scintillating crystals in a linear range of about four orders of magnitude. The photodetector is a hybrid photomultiplier tube specially developed to optimize linear range and photon detection. Crystal and photodetector are temperature controlled by a closed water circuit, as this is essential when measuring low light yield scintillating crystals with a marked temperature dependence of their light yield. Gamma sources can be placed either on top or on the side of the crystal. In this latter case, the source can be automatically moved by a computer-controlled step motor to provide a uniformity profile of the light yield along the crystal. Tagged and not-tagged operation modes are possible. The whole set-up is computer-controlled in an effort to provide fast and reliable measurements, to characterize many crystals per day. This is important for the quality control of the lead tungstate crystals that will be applied in the electromagnetic calorimeter of the CMS-detector at the LHC at CERN. (author)

  18. A HPMT based set-up to characterize scintillating crystals

    Energy Technology Data Exchange (ETDEWEB)

    D' Ambrosio, C.; Ercoli, C.; Jaaskelainen, S.; Lecoeur, G.; Leutz, H.; Loos, R.; Piedigrossi, D.; Puertolas, D.; Rosso, E.; Schomaker, R

    1999-09-21

    We have developed a fully automatic measurement set-up, capable of measuring light yields arising from scintillating crystals in a linear range of about four orders of magnitude. The photodetector is a hybrid photomultiplier tube specially developed to optimize linear range and photon detection. Crystal and photodetector are temperature controlled by a closed water circuit, as this is essential when measuring low light yield scintillating crystals with a marked temperature dependence of their light yield. Gamma sources can be placed either on top or on the side of the crystal. In this latter case, the source can be automatically moved by a computer-controlled step motor to provide a uniformity profile of the light yield along the crystal. Tagged and not-tagged operation modes are possible. The whole set-up is computer-controlled in an effort to provide fast and reliable measurements, to characterize many crystals per day. This is important for the quality control of the lead tungstate crystals that will be applied in the electromagnetic calorimeter of the CMS-detector at the LHC at CERN. (author)

  19. Set-up errors analyses in IMRT treatments for nasopharyngeal carcinoma to evaluate time trends, PTV and PRV margins

    Energy Technology Data Exchange (ETDEWEB)

    Mongioj, Valeria (Dept. of Medical Physics, Fondazione IRCCS Istituto Nazionale Tumori, Milan (Italy)), e-mail: valeria.mongioj@istitutotumori.mi.it; Orlandi, Ester (Dept. of Radiotherapy, Fondazione IRCCS Istituto Nazionale Tumori, Milan (Italy)); Palazzi, Mauro (Dept. of Radiotherapy, A.O. Niguarda Ca' Granda, Milan (Italy)) (and others)

    2011-01-15

    Introduction. The aims of this study were to analyze the systematic and random interfractional set-up errors during Intensity Modulated Radiation Therapy (IMRT) in 20 consecutive nasopharyngeal carcinoma (NPC) patients by means of Electronic Portal Images Device (EPID), to define appropriate Planning Target Volume (PTV) and Planning Risk Volume (PRV) margins, as well as to investigate set-up displacement trend as a function of time during fractionated RT course. Material and methods. Before EPID clinical implementation, an anthropomorphic phantom was shifted intentionally 5 mm to all directions and the EPIs were compared with the digitally reconstructed radiographs (DRRs) to test the system's capability to recognize displacements observed in clinical studies. Then, 578 clinical images were analyzed with a mean of 29 images for each patient. Results. Phantom data showed that the system was able to correct shifts with an accuracy of 1 mm. As regards clinical data, the estimated population systematic errors were 1.3 mm for left-right (L-R), 1 mm for superior-inferior (S-I) and 1.1 mm for anterior-posterior (A-P) directions, respectively. Population random errors were 1.3 mm, 1.5 mm and 1.3 mm for L-R, S-I and A-P directions, respectively. PTV margin was at least 3.4, 3 and 3.2 mm for L-R, S-I and A-P direction, respectively. PRV margins for brainstem and spinal cord were 2.3, 2 and 2.1 mm and 3.8, 3.5 and 3.2 mm for L-R, A-P and S-I directions, respectively. Set-up error displacements showed no significant changes as the therapy progressed (p>0.05), although displacements >3 mm were found more frequently when severe weight loss or tumor nodal shrinkage occurred. Discussion. These results enable us to choose margins that guarantee with sufficient accuracy the coverage of PTVs and organs at risk sparing. Collected data confirmed the need for a strict check of patient position reproducibility in case of anatomical changes

  20. MCNPX proton transport simulations for a therapy set-up

    International Nuclear Information System (INIS)

    Herault, J.; Iborra, N.; Chauvel, P.; Serrano, B.

    2005-01-01

    Patients with ocular melanoma have been treated since June 1991 at the medical cyclotron of the Centre Antoine Lacassagne (CAL). Positions and sizes of the ocular nozzle elements were initially defined based on experimental work, taking as a pattern functional existing facilities. Nowadays Monte Carlo (MC) calculation offers a tool to refine this geometry by adjusting size and place of beam modelling devices. Moreover, the MC tool is a useful way to calculate the dose and to evaluate the impact of secondary particles in the field of radiotherapy or radiation protection. Both LINAC and cyclotron producing X-rays, electrons, protons and neutrons are available in CAL, which suggests choosing MCNPX for its particle versatility. As a first step, the existing installation was input in MCNPX to check its aptitude to reproduce experimentally measured depth-dose profile, lateral profile. Relative comparisons of percentage depth-dose and lateral profiles, performed between measured data and simulations, show an agreement of the order of 2% in dose and 0.1 mm in range accuracy. These comparisons carried out with and without beam-modifying device, yield results compatible to the required precision in ocular melanoma treatments, as long as adequate choices are made on MCNPX input decks for physics card. (authors)

  1. How patients can improve the accuracy of their medical records.

    Science.gov (United States)

    Dullabh, Prashila M; Sondheimer, Norman K; Katsh, Ethan; Evans, Michael A

    2014-01-01

    Assess (1) if patients can improve their medical records' accuracy if effectively engaged using a networked Personal Health Record; (2) workflow efficiency and reliability for receiving and processing patient feedback; and (3) patient feedback's impact on medical record accuracy. Improving medical record' accuracy and associated challenges have been documented extensively. Providing patients with useful access to their records through information technology gives them new opportunities to improve their records' accuracy and completeness. A new approach supporting online contributions to their medication lists by patients of Geisinger Health Systems, an online patient-engagement advocate, revealed this can be done successfully. In late 2011, Geisinger launched an online process for patients to provide electronic feedback on their medication lists' accuracy before a doctor visit. Patient feedback was routed to a Geisinger pharmacist, who reviewed it and followed up with the patient before changing the medication list shared by the patient and the clinicians. The evaluation employed mixed methods and consisted of patient focus groups (users, nonusers, and partial users of the feedback form), semi structured interviews with providers and pharmacists, user observations with patients, and quantitative analysis of patient feedback data and pharmacists' medication reconciliation logs. (1) Patients were eager to provide feedback on their medications and saw numerous advantages. Thirty percent of patient feedback forms (457 of 1,500) were completed and submitted to Geisinger. Patients requested changes to the shared medication lists in 89 percent of cases (369 of 414 forms). These included frequency-or dosage changes to existing prescriptions and requests for new medications (prescriptions and over-the counter). (2) Patients provided useful and accurate online feedback. In a subsample of 107 forms, pharmacists responded positively to 68 percent of patient requests for

  2. Report on the set-up of a holographic interferometer

    International Nuclear Information System (INIS)

    Koster, J.N.

    1977-10-01

    Holographic interferometry is well suited for visualizing temperature, density, pressure and concentration fields in transparent fluids. The holographic real-time interferometer allows a continuous observation of stationary and instationary flow processes. After the explanation of the measuring technique, the problems arising during the interferometer set-up as well as the necessary adjusting operations are described. For heat transfer problems new possibilities for the application of holographic interferometry are revealed. Convection in boxes, temperature fields around heated or cooled bodies, concentration and diffusion processes in two phase-flows, mixtures and solutions as well as melting and freezing processes may be investigated. On the basis of particular examples some applications are presented. (orig.) [de

  3. The new cold neutron tomography set-up at SINQ

    CERN Document Server

    Baechler, S; Cauwels, P; Dierick, M; Jolie, J; Materna, T; Mondelaers, W

    2002-01-01

    A new cold neutron tomography set-up is operational at the neutron spallation source SINQ of the Paul Scherrer Institute (PSI) in Villigen, Switzerland. The detection system is based on a sup 6 LiF/ZnS:Ag conversion screen and a CCD camera. Several tests have been carried out to characterize the quality of the tomography system, such as homogeneity, reproducibility, L/D-ratio and spatial resolution. The high flux and the good efficiency of the detector lead to very short exposure times. Thus, a typical set of tomography scans can be performed in only 20 min. Then, 3D computed tomography objects were calculated using the filtered back-projection reconstruction method. Initial results of various samples show that cold neutron tomography can be a useful tool for industry, geology and dentistry. Furthermore, suitable applications can be found in the field of archaeology.

  4. CACTUS - a multidetector set-up at the Oslo Cyclotron

    International Nuclear Information System (INIS)

    Guttormsen, M.; Bjerke, B.; Messelt, S.; Olsen, E.A.; Ramsoey, T.; Rekstad, J.; Tveter, T.S.; Wikne, J.C.; Kownacki, J.

    1989-06-01

    The design and construction of the multidetector system CACTUS is discussed, and its operation in the context of the Oslo Cyclotron is described. The multidetector system has been initiated to meet the requirements at the Oslo Cyclotron Laboratory in the experimental work on nuclear structure at high intrinsic excitation energy. The laboratory has developed a promising technique based on measuring γ-decay after single nucleon transfer reactions with the use of pγ coincidences. However, a proper interpretation of the experimental results has often been difficult due to low counting rates. One of the most important aims for the new experimental set-up has been to obtain pγ as well as pγγ coincidence spectra with high statistics. The CACTUS detector system which is mounted on the 90 o beam line of the cyclotron, consists of 28 NaI and 2 Ge detectors in combination with 8 Si particle telescopes

  5. Analysis method set up to check against adulterated export honey

    International Nuclear Information System (INIS)

    Lyon, G.L.

    2001-01-01

    Over the past few years, North America has experienced occasional problems with the adulteration of honey, mainly by additions of other, cheaper sugar to increase bulk and lower production costs. The main addition was usually high fructose corn syrup, which had a similar chemical composition to that of honey. As a consequence of this type of adulteration, a method for its detection was developed using isotope ratio mass spectroscopy (IRMS). This was later refined to be more sensitive and is now specified as an Official Test. The Institute of Geological and Nuclear Sciences has now set up the analysis method to the international criteria at the Rafter Stable Isotope Laboratory in Lower Hutt. 2 refs

  6. An unconventional set-up for fluxless brazing of aluminium

    CERN Document Server

    Loos, Robert

    1999-01-01

    In order to successfully braze aluminium alloy assemblies without the use of oxide-removing fluxes, an evironment with very low contaminant level is mandatory. This is mostly achieved by using a vacuum furnace. Brazing under inert gas of sufficient purity is also possible. The method reported upon here makes use of a stainless steel bag which can enter a traditional air furnace. The bag is evacuated, giving a well distributed mechanical pressure on the parts to join. The intrinsic handicap of poor vacuum is compensated by regular inert gas flushing, even at high temperatures. The set-up works rather well, and the idea is believed to yield a valuable strategic and economic option, for the realization of special equipment as well as for prototyping work. We intend to use the principle for the CMS Preshower cooling screens.

  7. Setting up of a PIXE facility at FOTIA at BARC

    International Nuclear Information System (INIS)

    Joseph, Daisy; Saxena, A.

    2005-01-01

    PIXE-(Proton Induced X-ray Emission) -an ideal technique for material characterization has been set up at the Folded Tandem Ion Accelerator (FOTIA) at BARC, Trombay. A separate beam line at 45 deg port in which a dedicated PIXE chamber has been installed is being used for PIXE studies. PIXE studies on gold standards were carried out using protons of energy 3.3 MeV. Caritage values of gold standards were obtained which agree well with the certified values. Single element standard solutions (100 μg/ml) for low-Z elements such as Cr, Mn, Fe, Co, Cu and Zn were analyzed by PIXE. Well resolved α and β components of the x-rays were seen with detection limits in the range of 0.8-4 μg/g. (author)

  8. Localization of Manufacturing Capabilities in Setting Up Nuclear Power Plants

    International Nuclear Information System (INIS)

    Chadda, Sushil Kumar

    2011-01-01

    Nuclear renaissance is now imminent and is inevitable in view of rapidly increasing global warming concerns. A steep shift towards environmentally benign sources of energy remains an unavoidable choice as continents are warming up pushing seas into human habitation and disturbing global ecology. Accordingly, Indian government in its integrated energy policy document has planned for raising nuclear power capacity to generate 63 GWe by 2030. This envisages estimated investments of US$22 billion in the next 15 to 20 years. Setting up of nuclear energy generation capacity, however, remains a painstakingly slow process primarily due to complex, multidisciplinary efforts required to crank up a reactor. A robust supply chain remains key to expediting this process. In the light of this, it is critically important to ensure supply-chain for materials and components and putting in place cost effective project management to complete the projects on time and within the budgets. In this context, the participation of industries and their preparedness to meet the challenges are necessary. This would also require investments towards up gradation of manufacturing technology, training of manpower and mobilization of resources at the construction site. The industry would also need to enhance detailing and design engineering capabilities for the plants. It is only when such capabilities have been brought up that the possibilities of time-bound setting up of nuclear plants can be realized. In this paper, various issues with regard to project cost, regulatory and licensing, technology and gestation period etc for new build plants relevant to manufacturing industry are discussed. The plans for enhancing manufacturing capabilities for the critical path items of the project schedule with viable business, ensuring returns to stakeholders and financing and investment cycle are brought out. The various steps and initiatives being taken by Bharat Forge Ltd, the flagship company of Kalyani

  9. Magnetic spectrometer of the DEUTERON-2 set-up

    International Nuclear Information System (INIS)

    Ajvazyan, R.V.; Alanakyan, K.V.; Amaryan, M.J.

    1989-01-01

    A magnetic spectrometer of the two-arm DEUTERON-2 set-up of the Erevan Physical Institute is described. It is shown that the rejection factor for electrons and pions is 10 -2 - 10 -3 . The positively charged particles in the momentum range up to 1.5 GeV/c are identified by momentum and time-of-flight measurements. The main characteristics of the spectrometer are: momentum and angular acceptance δp/p = 46%, Δθ = 4 deg, solid angle ΔΩ = 2.75 msr, momentum resolution δp/p = 1.5%, angular resolutions δθ = 0.6 deg, δφ = 2 deg. The intervals of measured momentum and the polar scattering anlge are 0.5-3 GeV/c and 10-30 deg, 68-90 deg respectively. 7 refs.; 11 figs

  10. Portal imaging to assess set-up errors, tumor motion and tumor shrinkage during conformal radiotherapy of non-small cell lung cancer

    International Nuclear Information System (INIS)

    Erridge, Sara C.; Seppenwoolde, Yvette; Muller, Sara H.; Herk, Marcel van; Jaeger, Katrien de; Belderbos, Jose S.A.; Boersma, Liesbeth J.; Lebesque, Joos V.

    2003-01-01

    Purpose: To investigate patient set-up, tumor movement and shrinkage during 3D conformal radiotherapy for non-small cell lung cancer. Materials and methods: In 97 patients, electronic portal images (EPIs) were acquired and corrected for set-up using an off-line correction protocol based on a shrinking action level. For 25 selected patients, the orthogonal EPIs (taken at random points in the breathing cycle) throughout the 6-7 week course of treatment were assessed to establish the tumor position in each image using both an overlay and a delineation technique. The range of movement in each direction was calculated. The position of the tumor in the digitally reconstructed radiograph (DRR) was compared to the average position of the lesion in the EPIs. In addition, tumor shrinkage was assessed. Results: The mean overall set-up errors after correction were 0, 0.6 and 0.2 mm in the x (left-right), y (cranial-caudal) and z (anterior-posterior) directions, respectively. After correction, the standard deviations (SDs) of systematic errors were 1.4, 1.5 and 1.3 mm and the SDs of random errors were 2.9, 3.1 and 2.0 mm in the x-, y- and z-directions, respectively. Without correction, 41% of patients had a set-up error of more than 5 mm vector length, but with the set-up correction protocol this percentage was reduced to 1%. The mean amplitude of tumor motion was 7.3 (SD 2.7), 12.5 (SD 7.3) and 9.4 mm (SD 5.2) in the x-, y- and z-directions, respectively. Tumor motion was greatest in the y-direction and in particular for lower lobe tumors. In 40% of the patients, the projected area of the tumor regressed by more than 20% during treatment in at least one projection. In 16 patients it was possible to define the position of the center of the tumor in the DRR. There was a mean difference of 6 mm vector length between the tumor position in the DRR and the average position in the portal images. Conclusions: The application of the correction protocol resulted in a significant

  11. Accuracy and Consistency of Respiratory Gating in Abdominal Cancer Patients

    International Nuclear Information System (INIS)

    Ge, Jiajia; Santanam, Lakshmi; Yang, Deshan; Parikh, Parag J.

    2013-01-01

    Purpose: To evaluate respiratory gating accuracy and intrafractional consistency for abdominal cancer patients treated with respiratory gated treatment on a regular linear accelerator system. Methods and Materials: Twelve abdominal patients implanted with fiducials were treated with amplitude-based respiratory-gated radiation therapy. On the basis of daily orthogonal fluoroscopy, the operator readjusted the couch position and gating window such that the fiducial was within a setup margin (fiducial-planning target volume [f-PTV]) when RPM indicated “beam-ON.” Fifty-five pre- and post-treatment fluoroscopic movie pairs with synchronized respiratory gating signal were recorded. Fiducial motion traces were extracted from the fluoroscopic movies using a template matching algorithm and correlated with f-PTV by registering the digitally reconstructed radiographs with the fluoroscopic movies. Treatment was determined to be “accurate” if 50% of the fiducial area stayed within f-PTV while beam-ON. For movie pairs that lost gating accuracy, a MATLAB program was used to assess whether the gating window was optimized, the external-internal correlation (EIC) changed, or the patient moved between movies. A series of safety margins from 0.5 mm to 3 mm was added to f-PTV for reassessing gating accuracy. Results: A decrease in gating accuracy was observed in 44% of movie pairs from daily fluoroscopic movies of 12 abdominal patients. Three main causes for inaccurate gating were identified as change of global EIC over time (∼43%), suboptimal gating setup (∼37%), and imperfect EIC within movie (∼13%). Conclusions: Inconsistent respiratory gating accuracy may occur within 1 treatment session even with a daily adjusted gating window. To improve or maintain gating accuracy during treatment, we suggest using at least a 2.5-mm safety margin to account for gating and setup uncertainties

  12. Setting up of a cerebral visual impairment clinic for children: Challenges and future developments.

    Science.gov (United States)

    Philip, Swetha Sara

    2017-01-01

    The aim of this study is to describe the setting up of a cerebral visual impairment (CVI) clinic in a tertiary care hospital in South India and to describe the spectrum of cases seen. The CVI clinic, set up in February 2011, receives interdisciplinary input from a core team involving a pediatrician, neurologist, psychiatrist, occupational therapist, pediatric ophthalmologist, and an optometrist. All children, children (45%) had moderate CP. Forty percent of CVI was due to birth asphyxia, but about 20% did not have any known cause for CVI. Seventy percent of patients, who came back for follow-up, were carrying out the habilitation strategies suggested. Average attendance of over 300 new patients a year suggests a definite need for CVI clinics in the country. These children need specialized care to handle their complex needs. Although difficult to coordinate, an interdisciplinary team including the support groups and voluntary organizations is needed to facilitate the successful implementation of such specialized service.

  13. Setting-up a small observatory from concept to construction

    CERN Document Server

    Arditti, David

    2008-01-01

    Every amateur astronomer who is considering a purpose-built observatory will find this book absolutely invaluable during both the planning and the construction stages. Drawing on David Arditti’s practical experience and that of many other amateur astronomers, it gives invaluable help in making all the important decisions. To begin with, Setting up a Small Observatory addresses what you really need from an observatory, whether to build or buy, what designs you should consider, and where you should site it. Uniquely, it also considers the aesthetics of an amateur observatory: how to make it fit in with your home, garden, and yard, even disguising it as a more common garden building if necessary. There’s also a wealth of practical details for constructing and equipping your small observatory – everything from satisfying local planning laws and building codes through to making sure that your completed observatory is well-equipped, convenient, and comfortable to use. Whether you are considering a simple low-...

  14. Secondary electron images obtained with a standard PEEM set up

    International Nuclear Information System (INIS)

    Benka, O.; Zeppenfeld, P.

    2004-01-01

    Secondary electron images excited by 3 to 4.3 keV electrons are obtained with a standard photoelectron electron emission microscope (PEEM) set up equipped with an imaging energy filter (IEF). The electron gun was mounted on a standard PEEM entrance flange at an angle of 25 o with respect to the sample surface. A low extraction voltage of 500 V was used to minimize the deflection of the electron beam by the PEEM extraction electrode. The secondary electron images are compared to photoelectron images excited by a standard 4.9 eV UV lamp. In the case of a Cu pattern on a Si substrate it is found that the lateral resolution without the IEF is about the same for electron and photon excitation but that the relative electron emission intensities are very different. The use of the IEF-reduces the lateral resolution. Images for secondary electron energies between eV 1 and eV 2 were obtained by setting the IEF to -V 1 and -V 2 ∼ -(V 1 + 5V) potentials and taking the difference of both images. Images up to 100 eV electron energies were recorded. The lateral resolution is in the range of μm. The material contrast obtained in these difference images are discussed in terms of a secondary electron and photoelectron emission model and secondary electron energy spectra measured with a LEED-Auger spectrometer. (author)

  15. Set up for simultaneous water desalination and power generation

    International Nuclear Information System (INIS)

    Hasan, S.W.; Mookhi, M.B.; Sadiq, M.A.; Hasan, Z.; Zaidi, S.I.; Shah, W.A.

    2010-01-01

    Instead of following the conventional fuel oriented power generation methods and dissipating its heat into environment, we evaporate saline water into steam and use its energy to generate power. Using this scheme would make sea water usable in power generation which at the moment is only being used for cooling purposes in the power plants. The steam used for generating electricity is eventually collected, condensed and used for potable purposes. The proposed scheme may be seen as Steam Power Generation with additional feature of desalination. We set up an experimental test bed in order to calculate the electric power available using this scheme. To ensure safety for human consumption, we also perform chemical tests on the desalinated water to see whether it is fit to be used for drinking and agricultural purposes. Our conclusions are based on actual experiments and laboratory tests; procedures outlined here may be used at larger scale for more in-depth analyses. We also highlight future extensions and modifications in this work. (author)

  16. IAEA Sets Up Team to Drive Nuclear Safety Action Plan

    International Nuclear Information System (INIS)

    2011-01-01

    Full text: The International Atomic Energy Agency is setting up a Nuclear Safety Action Team to oversee prompt implementation of the IAEA Action Plan on Nuclear Safety and ensure proper coordination among all stakeholders. The 12-point Action Plan, drawn up in the wake of the Fukushima Daiichi accident, was approved by the Agency's Board of Governors on 13 September and endorsed by all 151 Member States at its General Conference last week. The team will work within the Agency's Department of Nuclear Safety and Security, headed by Deputy Director General Denis Flory, and will coordinate closely with the Director General's Office for Policy. ''The Action Plan requires immediate follow-up,'' Director General Yukiya Amano said. ''This compact, dedicated team will assist Deputy Director General Flory in implementing the measures agreed in the Action Plan.'' Gustavo Caruso, Head of the Regulatory Activities Section in the IAEA's Division of Installation Safety, has been designated as the team's Special Coordinator for the implementation of the Action Plan. The IAEA has already started implementing its responsibilities under the Action Plan, including development of an IAEA methodology for stress tests for nuclear power plants. The methodology will be ready in October. (IAEA)

  17. SET UP OF THE NEW AUTOMATIC HYDROMETEOROLOGICAL NETWORK IN HUNGARY

    Directory of Open Access Journals (Sweden)

    J. NAGy

    2013-03-01

    Full Text Available The Hungarian Meteorological Service (OMSZ and General Directorate of Water Management (OVF in Hungary run conventional precipitation measurement networks consisting of at least 1000 stations. OMSZ automated its synoptic and climatological network in 90’s and now more than 100 automatic stations give data every 1-10 minutes via GPRS channel. In 2007 the experts from both institutions determined the requirements of a common network. The predecessor in title of OVF is general Directorate for Water and Environment gave a project proposal in 2008 for establishment of a new hydrometeorological network based on common aims for meteorology and hydrology. The new hydrometeorological network was set up in 2012 financed by KEOP project. This network has got 141 weighing precipitation gauges, 118 temperature - humidity sensors and 25 soil moisture and soil temperature instruments. Near by Tisza-Lake two wind sensors have been installed. The network is operated by OMSZ and OVF together. OVF and its institutions maintain the stations itself and support the electricity. OMSZ operates data collection and transmission, maintaines and calibrates the sensors. Using precipitation data of enhanced network the radar precipitation field quality may be more precise, which are input of run-off model. Thereby the time allowance may be increased in flood-control events. Based on soil moisture and temperature water balance in soil may be modelled and forecast can be produced in different conditions. It is very important task in drought and inland water conditions. Considering OMSZ investment project in which new Doppler dual polarisation radar and 14 disdrometers will be installed, the precipitation estimation may be improved since 2015.

  18. Cyclotron produced radionuclides: Guidelines for setting up a facility

    International Nuclear Information System (INIS)

    2009-01-01

    Establishment of a cyclotron based radionuclide and radiopharmaceutical production facility is a major undertaking regardless of the scope and size of the facility. Regulatory demands of radiation protection and pharmaceutical manufacturing only add to the need for meticulous attention to a large number of factors in overall planning and successful implementation. Also, a significant commitment of resources, not just during the onset of the project, but also for sustained continuity further adds to the already difficult decision making process. In this publication, all these issues have been addressed and discussed conceptually for the benefit of planners and stakeholders of a new facility. The need for a clear vision and realistic scope of the programme has been repeatedly emphasized throughout this book as this aspect of project planning is absolutely vital for defining and achieving the mission and objectives of the facility. The most critical aspects in conceptualization, planning and subsequent implementation have been discussed in detail and are highlighted below as necessary actions: - Performing a feasibility study which balances wishful thinking with project viability; - Forming a task force composed of the stakeholders to evaluate strategically the various aspects of project planning to ultimately recommend the scope and objectives of the facility, and also to formulate the project plan; - Assessing the financial aspects of the project, including the set-up and operating costs of the facility through the development of business models and cost-benefit analyses; - Designing a facility and layout that encompasses the scope of the project and also takes into consideration the regulatory requirements; - Ensuring the availability of appropriately qualified and trained staff, critical for efficient and high quality operation of the facility; - Applying GMP regulations for the production of radiopharmaceutical products which are consistently safe for human use

  19. Surface imaging, portal imaging, and skin marker set-up vs. CBCT for radiotherapy of the thorax and pelvis

    International Nuclear Information System (INIS)

    Pallotta, Stefania; Bucciolini, Marta; Vanzi, Eleonora; Marrazzo, Livia; Simontacchi, Gabriele; Paiar, Fabiola; Ceroti, Marco; Livi, Lorenzo

    2015-01-01

    The aim of this study was to compare surface imaging, portal imaging, and skin marker set-up in radiotherapy of thoracic and pelvic regions, using cone beam computed tomography (CBCT) data as the gold standard. Twenty patients were included in this study. CBCT, surface acquisition (SA), and two orthogonal portal images (PI) were acquired during the first four treatment sessions. Patient set-up corrections, obtained by registering the planning CT with CBCT, were used as the gold standard. Registration results of the PI and SA were evaluated and compared with those obtained with CBCT. The advantage derived from using SA or PI verification systems over a skin marker set-up was also quantified. A statistically significant difference between PI and SA (in favour of PI) was observed in seven patients undergoing treatment of the pelvic region and in two patients undergoing treatment of the thoracic region. The use of SA or PI, compared with a skin marker set-up, improved patient positioning in 50% and 57 % of the thoracic fractions, respectively. For pelvic fractions, the use of PI was beneficial in 73 % of the cases, while the use of SA was beneficial in only 45 %. Patient positioning worsened with SA, particularly along longitudinal and vertical directions. PI yielded more accurate registration results than SA for both pelvic and thoracic fractions. Compared with the skin marker set-up, PI performances were superior to SA for pelvic fractions while comparable results were obtained for thoracic fractions. (orig.) [de

  20. Accuracy of robotic patient positioners used in ion beam therapy

    International Nuclear Information System (INIS)

    Nairz, Olaf; Winter, Marcus; Heeg, Peter; Jäkel, Oliver

    2013-01-01

    In this study we investigate the accuracy of industrial six axes robots employed for patient positioning at the Heidelberg Ion Beam Therapy Center. In total 1018 patient setups were monitored with a laser tracker and subsequently analyzed. The measurements were performed in the two rooms with a fixed horizontal beam line. Both, the 3d translational errors and the rotational errors around the three table axes were determined. For the first room the 3d error was smaller than 0.72 mm in 95 percent of all setups. The standard deviation of the rotational errors was at most 0.026° for all axes. For the second room Siemens implemented an improved approach strategy to the final couch positions. The 95 percent quantile of the 3d error could in this room be reduced to 0.53 mm; the standard deviation of the rotational errors was also at most 0.026°. Robots are very flexible tools for patient positioning in six degrees of freedom. This study proved that the robots are able to achieve clinically acceptable accuracy in real patient setups, too

  1. Digital versus conventional implant impressions for edentulous patients: accuracy outcomes.

    Science.gov (United States)

    Papaspyridakos, Panos; Gallucci, German O; Chen, Chun-Jung; Hanssen, Stijn; Naert, Ignace; Vandenberghe, Bart

    2016-04-01

    To compare the accuracy of digital and conventional impression techniques for completely edentulous patients and to determine the effect of different variables on the accuracy outcomes. A stone cast of an edentulous mandible with five implants was fabricated to serve as master cast (control) for both implant- and abutment-level impressions. Digital impressions (n = 10) were taken with an intraoral optical scanner (TRIOS, 3shape, Denmark) after connecting polymer scan bodies. For the conventional polyether impressions of the master cast, a splinted and a non-splinted technique were used for implant-level and abutment-level impressions (4 cast groups, n = 10 each). Master casts and conventional impression casts were digitized with an extraoral high-resolution scanner (IScan D103i, Imetric, Courgenay, Switzerland) to obtain digital volumes. Standard tessellation language (STL) datasets from the five groups of digital and conventional impressions were superimposed with the STL dataset from the master cast to assess the 3D (global) deviations. To compare the master cast with digital and conventional impressions at the implant level, analysis of variance (ANOVA) and Scheffe's post hoc test was used, while Wilcoxon's rank-sum test was used for testing the difference between abutment-level conventional impressions. Significant 3D deviations (P impressions (P > 0.001). Digital implant impressions are as accurate as conventional implant impressions. The splinted, implant-level impression technique is more accurate than the non-splinted one for completely edentulous patients, whereas there was no difference in the accuracy at the abutment level. The implant angulation up to 15° did not affect the accuracy of implant impressions. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Diagnostic accuracy of procalcitonin in critically ill immunocompromised patients

    Directory of Open Access Journals (Sweden)

    Legriel Stéphane

    2011-08-01

    Full Text Available Abstract Background Recognizing infection is crucial in immunocompromised patients with organ dysfunction. Our objective was to assess the diagnostic accuracy of procalcitonin (PCT in critically ill immunocompromised patients. Methods This prospective, observational study included patients with suspected sepsis. Patients were classified into one of three diagnostic groups: no infection, bacterial sepsis, and nonbacterial sepsis. Results We included 119 patients with a median age of 54 years (interquartile range [IQR], 42-68 years. The general severity (SAPSII and organ dysfunction (LOD scores on day 1 were 45 (35-62.7 and 4 (2-6, respectively, and overall hospital mortality was 32.8%. Causes of immunodepression were hematological disorders (64 patients, 53.8%, HIV infection (31 patients, 26%, and solid cancers (26 patients, 21.8%. Bacterial sepsis was diagnosed in 58 patients and nonbacterial infections in nine patients (7.6%; 52 patients (43.7% had no infection. PCT concentrations on the first ICU day were higher in the group with bacterial sepsis (4.42 [1.60-22.14] vs. 0.26 [0.09-1.26] ng/ml in patients without bacterial infection, P 0.5 ng/ml had 100% sensitivity but only 63% specificity for diagnosing bacterial sepsis. The area under the receiver operating characteristic (ROC curve was 0.851 (0.78-0.92. In multivariate analyses, PCT concentrations > 0.5 ng/ml on day 1 independently predicted bacterial sepsis (odds ratio, 8.6; 95% confidence interval, 2.53-29.3; P = 0.0006. PCT concentrations were not significantly correlated with hospital mortality. Conclusion Despite limited specificity in critically ill immunocompromised patients, PCT concentrations may help to rule out bacterial infection.

  3. Diagnostic accuracy of procalcitonin in critically ill immunocompromised patients.

    Science.gov (United States)

    Bele, Nicolas; Darmon, Michael; Coquet, Isaline; Feugeas, Jean-Paul; Legriel, Stéphane; Adaoui, Nadir; Schlemmer, Benoît; Azoulay, Elie

    2011-08-24

    Recognizing infection is crucial in immunocompromised patients with organ dysfunction. Our objective was to assess the diagnostic accuracy of procalcitonin (PCT) in critically ill immunocompromised patients. This prospective, observational study included patients with suspected sepsis. Patients were classified into one of three diagnostic groups: no infection, bacterial sepsis, and nonbacterial sepsis. We included 119 patients with a median age of 54 years (interquartile range [IQR], 42-68 years). The general severity (SAPSII) and organ dysfunction (LOD) scores on day 1 were 45 (35-62.7) and 4 (2-6), respectively, and overall hospital mortality was 32.8%. Causes of immunodepression were hematological disorders (64 patients, 53.8%), HIV infection (31 patients, 26%), and solid cancers (26 patients, 21.8%). Bacterial sepsis was diagnosed in 58 patients and nonbacterial infections in nine patients (7.6%); 52 patients (43.7%) had no infection. PCT concentrations on the first ICU day were higher in the group with bacterial sepsis (4.42 [1.60-22.14] vs. 0.26 [0.09-1.26] ng/ml in patients without bacterial infection, P 0.5 ng/ml had 100% sensitivity but only 63% specificity for diagnosing bacterial sepsis. The area under the receiver operating characteristic (ROC) curve was 0.851 (0.78-0.92). In multivariate analyses, PCT concentrations > 0.5 ng/ml on day 1 independently predicted bacterial sepsis (odds ratio, 8.6; 95% confidence interval, 2.53-29.3; P = 0.0006). PCT concentrations were not significantly correlated with hospital mortality. Despite limited specificity in critically ill immunocompromised patients, PCT concentrations may help to rule out bacterial infection.

  4. Anaesthesia in Congenital Facial Anomalies in a Rural Set up of a Developing Country

    Directory of Open Access Journals (Sweden)

    Debasish Saha

    2015-01-01

    Full Text Available Background: India has an estimated backlog of 1000000 cleft patients. A total of 35000 new cleft patients are born each year. With the capacity to operate on approximately 50000 patients each year only 15000 patients from the national backlog can be operated upon each year if capability is not augmented. Objectives: To reach the population at large we meticulously planned an out-reach programme and operated on patients even in rural set ups with lack of modern facilities. We operated on patients at sub divisional centres, where apparatus for providing sevoflurane was not available. Institutional Ethical clearance was taken before conduction of the study. Patients who required prolonged surgery were taken to the tertiary centre. Working ventilators were also not available at peripheral centres. Materials and Methods: This interventional study was carried in a time span of four years on nineteen hundred and nine patients, after taking approval from the Institutional Ethical Committee. Patients were screened and some were operated at rural centers and others at a tertiary care centre. Patients who could not afford to come to the tertiary care centre were operated at different rural centers. Informed consent was taken. Results: There were 1909 patients with Congenital Facial Anomalies (CFA over four years period out of which 918 patients were of either unilateral or bilateral cleft lip. They were successfully operated at rural health centers with limited facilities. This could reduce the total load of surgeries for CFA at tertiary care hospital ensuring safe surgeries for all with CFA for all age groups and both genders.No mortality was recorded and post operative complications consisted of nausea and vomiting, three had delayed recovery and one had laryngospasm. Conclusion: Outreach programmes can increase the efficacy of Smile Train Project and effective screening of patients before surgery can result in fruitful outcomes even in a rural set up

  5. Cone beam CT-based set-up strategies with and without rotational correction for stereotactic body radiation therapy in the liver.

    Science.gov (United States)

    Bertholet, Jenny; Worm, Esben; Høyer, Morten; Poulsen, Per

    2017-06-01

    Accurate patient positioning is crucial in stereotactic body radiation therapy (SBRT) due to a high dose regimen. Cone-beam computed tomography (CBCT) is often used for patient positioning based on radio-opaque markers. We compared six CBCT-based set-up strategies with or without rotational correction. Twenty-nine patients with three implanted markers received 3-6 fraction liver SBRT. The markers were delineated on the mid-ventilation phase of a 4D-planning-CT. One pretreatment CBCT was acquired per fraction. Set-up strategy 1 used only translational correction based on manual marker match between the CBCT and planning CT. Set-up strategy 2 used automatic 6 degrees-of-freedom registration of the vertebrae closest to the target. The 3D marker trajectories were also extracted from the projections and the mean position of each marker was calculated and used for set-up strategies 3-6. Translational correction only was used for strategy 3. Translational and rotational corrections were used for strategies 4-6 with the rotation being either vertebrae based (strategy 4), or marker based and constrained to ±3° (strategy 5) or unconstrained (strategy 6). The resulting set-up error was calculated as the 3D root-mean-square set-up error of the three markers. The set-up error of the spinal cord was calculated for all strategies. The bony anatomy set-up (2) had the largest set-up error (5.8 mm). The marker-based set-up with unconstrained rotations (6) had the smallest set-up error (0.8 mm) but the largest spinal cord set-up error (12.1 mm). The marker-based set-up with translational correction only (3) or with bony anatomy rotational correction (4) had equivalent set-up error (1.3 mm) but rotational correction reduced the spinal cord set-up error from 4.1 mm to 3.5 mm. Marker-based set-up was substantially better than bony-anatomy set-up. Rotational correction may improve the set-up, but further investigations are required to determine the optimal correction

  6. Developing and setting up of a nuclear medicine information management system

    International Nuclear Information System (INIS)

    Baghel, N.S.; Asopa, R.; Nayak, U.N.; Rajan, M.G.R.; Subhalakshmi, P.V.; Shailaja, A.; Rajashekharrao, B.; Karunanidhi, Y.R.

    2010-01-01

    Full text: With the advent and progress of information technology in the present decade, high-performance networks are being installed in hospitals to implement an effective and reliable Hospital Information Management Systems (HIMS). The Radiation Medicine Centre (RMC), is one of the earliest and largest nuclear medicine centres in India and several thousand patients undergo diagnostic as well as therapeutic procedures with different radiopharmaceuticals. The evolution towards a fully digital department of nuclear medicine is driven by expectations of not only improved patient management but also a well-defined workflow along with prompt and quality patient services. The aim was to develop and set up a practical and utility based Nuclear Medicine Information Management System (NMIMS) for various functional procedures at RMC. A customised NMIMS is developed with M/s ECIL using ASP.NET and SQL server technology facilitated by an IBM x3650 M3 Server, 18 thin-clients/desktop PCs and Windows 2008 server operating system and MS-SQL 2005 server software. The various modules have been developed to meet the requirements of different activities pertaining to patient appointment and scheduling, clinical assessment, radiopharmacy procedures, imaging and non-imaging studies and protocols, in-vitro laboratory tests, in-patient and out-patient treatment procedures, radiation protection and regulatory aspects and other routine operational procedures associated with patient management at RMC. The menus are developed as per scheduled workflow (SWF) in the department. The various aspects of SWF have been designed to ensure smooth, easy and trouble free patient management. Presently, the NMIMS has been developed excluding imaging data and we are in the process of setting up Picture Archiving Communication System (PACS) integrated to the existing database system, which will archive and facilitate imaging data in DICOM format in order to make a paperless department. The developed NMIMS

  7. Set-up for steam generator tube bundle washing after explosion expanding the tubes

    International Nuclear Information System (INIS)

    Osipov, S.I.; Kal'nin, A.Ya.; Mazanenko, M.F.

    1985-01-01

    Set-up for steam generator tube bundle washing after the explosion expanding of tubes is described. Washing is accomplished by distillate. Steam is added to distillate for heating, and compersed air for preventing hydraulic shock. The set-up is equiped by control equipment. Set-up performances are presented. Time for one steam generator washing constitutes 8-12 h. High economic efficiency is realized due to the set-up introduction

  8. Installing and Setting Up Git Software Tool on Windows | High-Performance

    Science.gov (United States)

    Computing | NREL Git Software Tool on Windows Installing and Setting Up Git Software Tool on Windows Learn how to set up the Git software tool on Windows for use with the Peregrine system. Git is this doc, we'll show you how to get git installed on Windows 7, and how to get things set up on NREL's

  9. Accuracy of acoustic respiration rate monitoring in pediatric patients.

    Science.gov (United States)

    Patino, Mario; Redford, Daniel T; Quigley, Thomas W; Mahmoud, Mohamed; Kurth, C Dean; Szmuk, Peter

    2013-12-01

    Rainbow acoustic monitoring (RRa) utilizes acoustic technology to continuously and noninvasively determine respiratory rate from an adhesive sensor located on the neck. We sought to validate the accuracy of RRa, by comparing it to capnography, impedance pneumography, and to a reference method of counting breaths in postsurgical children. Continuous respiration rate data were recorded from RRa and capnography. In a subset of patients, intermittent respiration rate from thoracic impedance pneumography was also recorded. The reference method, counted respiratory rate by the retrospective analysis of the RRa, and capnographic waveforms while listening to recorded breath sounds were used to compare respiration rate of both capnography and RRa. Bias, precision, and limits of agreement of RRa compared with capnography and RRa and capnography compared with the reference method were calculated. Tolerance and reliability to the acoustic sensor and nasal cannula were also assessed. Thirty-nine of 40 patients (97.5%) demonstrated good tolerance of the acoustic sensor, whereas 25 of 40 patients (62.5%) demonstrated good tolerance of the nasal cannula. Intermittent thoracic impedance produced erroneous respiratory rates (>50 b·min(-1) from the other methods) on 47% of occasions. The bias ± SD and limits of agreement were -0.30 ± 3.5 b·min(-1) and -7.3 to 6.6 b·min(-1) for RRa compared with capnography; -0.1 ± 2.5 b·min(-1) and -5.0 to 5.0 b·min(-1) for RRa compared with the reference method; and 0.2 ± 3.4 b·min(-1) and -6.8 to 6.7 b·min(-1) for capnography compared with the reference method. When compared to nasal capnography, RRa showed good agreement and similar accuracy and precision but was better tolerated in postsurgical pediatric patients. © 2013 John Wiley & Sons Ltd.

  10. Evaluation of errors set-up and setting margins calculation in treatments 3-D conformal radiotherapy; Evaluacion de errores de set-up y calculo de margenes de configuracion en tratamientos de radioterapia CONFORMADA 3-D

    Energy Technology Data Exchange (ETDEWEB)

    Donis, S.; Robayna, B.; Gonzalez, A.; Hernandez Armas, J.

    2011-07-01

    The use of IGRT techniques provide knowledge of the mistakes made in the positioning of a patient, to population studies and estimate the margins for each population.In this paper we evaluate the errors of set-up in 3 different locations and from these margins are calculated configuration (SM).

  11. Set-up errors in radiotherapy for oesophageal cancers - Is electronic portal imaging or conebeam more accurate?

    International Nuclear Information System (INIS)

    Hawkins, Maria A.; Aitken, Alexandra; Hansen, Vibeke N.; McNair, Helen A.; Tait, Diana M.

    2011-01-01

    Purpose: To compare kV computed tomography (CBCT) with electronic portal imaging (EPI) and evaluate set-up variations in the anterior-posterior (AP), right-left (LR) and cranio-caudal (CC) directions and rotational variations: pitch, roll, and yaw, for oesophageal cancer patients treated with radical radiotherapy. Methods and materials: Twenty patients with locally advanced oesophageal cancer treated with chemoradiation were consented for this prospective ethics approved protocol. Patients were positioned using skin marks/tattoos, kV-CBCT scans (XVI) and EPI's were performed prior to treatment and registered to the planning CT scans and digitally reconstructed radiographs, respectively. XVI data was used to adjust patient setups before treatment delivery. A total of 122 EPI pairs and 207 CBCT scans were analysed. The systematic and random errors were calculated. Results: The systematic and random errors (mm) for XVI were 1.3, 1.7, 1.4 and 2.6, 3.9, 2.0 in RL, CC and AP direction, respectively, with EPI of similar magnitude. There was no correlation between the 2 modalities of imaging as 31.7% of all image pairs were discordant >3 mm and 12.5% >5 mm. XVI identified rotations >3 o in 44 images. Conclusions: EPI results in different position correction for verification of radiotherapy in oesophageal malignancies when compared with CBCT. CBCT verification offers adequate 3D volumetric image quality to improve the accuracy of treatment delivery for oesophageal malignancies in radiotherapy and should be used for image guidance.

  12. Evaluation of RSA set-up from a clinical biplane fluoroscopy system for 3D joint kinematic analysis.

    Science.gov (United States)

    Bonanzinga, Tommaso; Signorelli, Cecilia; Bontempi, Marco; Russo, Alessandro; Zaffagnini, Stefano; Marcacci, Maurilio; Bragonzoni, Laura

    2016-01-01

    dinamic roentgen stereophotogrammetric analysis (RSA), a technique currently based only on customized radiographic equipment, has been shown to be a very accurate method for detecting three-dimensional (3D) joint motion. The aim of the present work was to evaluate the applicability of an innovative RSA set-up for in vivo knee kinematic analysis, using a biplane fluoroscopic image system. To this end, the Authors describe the set-up as well as a possible protocol for clinical knee joint evaluation. The accuracy of the kinematic measurements is assessed. the Authors evaluated the accuracy of 3D kinematic analysis of the knee in a new RSA set-up, based on a commercial biplane fluoroscopy system integrated into the clinical environment. The study was organized in three main phases: an in vitro test under static conditions, an in vitro test under dynamic conditions reproducing a flexion-extension range of motion (ROM), and an in vivo analysis of the flexion-extension ROM. For each test, the following were calculated, as an indication of the tracking accuracy: mean, minimum, maximum values and standard deviation of the error of rigid body fitting. in terms of rigid body fitting, in vivo test errors were found to be 0.10±0.05 mm. Phantom tests in static and kinematic conditions showed precision levels, for translations and rotations, of below 0.1 mm/0.2° and below 0.5 mm/0.3° respectively for all directions. the results of this study suggest that kinematic RSA can be successfully performed using a standard clinical biplane fluoroscopy system for the acquisition of slow movements of the lower limb. a kinematic RSA set-up using a clinical biplane fluoroscopy system is potentially applicable and provides a useful method for obtaining better characterization of joint biomechanics.

  13. SETTING UP OF A HOMECARE SYSTEM FOR HIGH COST NEBULISERS IN A PAEDIATRIC CYSTIC FIBROSIS CENTRE.

    Science.gov (United States)

    Chorro-Mari, Veronica; Christiansen, Nanna

    2016-09-01

    Due to national changes to the commissioning process of high cost nebulisers (HCN) for Cystic Fibrosis (CF) patients, CF centres have to repatriate the prescribing of the HCN to the tertiary care centres.1 The following nebulisers will no longer be prescribed by primary care: Cayston® (Aztreonam); Colomycin®, Pomixin®, Clobreathe® (Colistimethate); Pulmozyme® (Dornase alfa); Tobi®, Tobi Podhaler ®, Bramitob® (Tobramycin).This abstract explains how the Royal London Hospital (RLH) Paediatric Pharmacy recruited over 100 paediatric (CF) patients smoothly within a period of 4 months and set up a homecare system to avoid patients and families having to travel large distances to obtain their medication. A number of homecare companies were evaluated initially. Parameters looked at were reports of customer satisfaction, delivery cost, turn-around time once the prescription was received and availability of same day delivery service.In order to capture existing patients we met with CF Specialist Nurses to establish the total number of patients on HCN, what nebulised treatment they were on and their respective doses. We prioritised patients that had known problems with GP prescribing and anybody newly starting on HCN.To communicate the change to parents, a letter was sent to all parents explaining the changeover to homecare delivery and tertiary prescribing. In addition a section in the parent bulletin was dedicated to the topic as well. Following this we contacted parents via phone and in clinic to request consent and explain the process.Up to 10 patients were contacted weekly (average of 7); the consent form and registration form were then faxed to the Homecare company for patient registration. In parallel to this prescriptions were requested for the patients that had been set up in the previous week, ensuring that prescribing was spread out over time to avoid having peak times for repeat prescriptions.In addition to the letter to parents GP surgeries were also

  14. Intensity modulated radiation therapy for oropharyngeal cancer: the sensitivity of plan objectives and constraints to set-up uncertainty

    International Nuclear Information System (INIS)

    Ploquin, Nicolas; Song, William; Lau, Harold; Dunscombe, Peter

    2005-01-01

    The goal of this study was to assess the impact of set-up uncertainty on compliance with the objectives and constraints of an intensity modulated radiation therapy protocol for early stage cancer of the oropharynx. As the convolution approach to the quantitative study of set-up uncertainties cannot accommodate either surface contours or internal inhomogeneities, both of which are highly relevant to sites in the head and neck, we have employed the more resource intensive direct simulation method. The impact of both systematic (variable from 0 to 6 mm) and random (fixed at 2 mm) set-up uncertainties on compliance with the criteria of the RTOG H-0022 protocol has been examined for eight geometrically complex structures: CTV66 (gross tumour volume and palpable lymph nodes suspicious for metastases), CTV54 (lymph node groups or surgical neck levels at risk of subclinical metastases), glottic larynx, spinal cord, brainstem, mandible and left and right parotids. In a probability-based approach, both dose-volume histograms and equivalent uniform doses were used to describe the dose distributions achieved by plans for two patients, in the presence of set-up uncertainty. The equivalent uniform dose is defined to be that dose which, when delivered uniformly to the organ of interest, will lead to the same response as the non-uniform dose under consideration. For systematic set-up uncertainties greater than 2 mm and 5 mm respectively, coverage of the CTV66 and CTV54 could be significantly compromised. Directional sensitivity was observed in both cases. Most organs at risk (except the glottic larynx which did not comply under static conditions) continued to meet the dose constraints up to 4 mm systematic uncertainty for both plans. The exception was the contra lateral parotid gland, which this protocol is specifically designed to protect. Sensitivity to systematic set-up uncertainty of 2 mm was observed for this organ at risk in both clinical plans

  15. Residual rotational set-up errors after daily cone-beam CT image guided radiotherapy of locally advanced cervical cancer

    International Nuclear Information System (INIS)

    Laursen, Louise Vagner; Elstrøm, Ulrik Vindelev; Vestergaard, Anne; Muren, Ludvig P.; Petersen, Jørgen Baltzer; Lindegaard, Jacob Christian; Grau, Cai; Tanderup, Kari

    2012-01-01

    Purpose: Due to the often quite extended treatment fields in cervical cancer radiotherapy, uncorrected rotational set-up errors result in a potential risk of target miss. This study reports on the residual rotational set-up error after using daily cone beam computed tomography (CBCT) to position cervical cancer patients for radiotherapy treatment. Methods and materials: Twenty-five patients with locally advanced cervical cancer had daily CBCT scans (650 CBCTs in total) prior to treatment delivery. We retrospectively analyzed the translational shifts made in the clinic prior to each treatment fraction as well as the residual rotational errors remaining after translational correction. Results: The CBCT-guided couch movement resulted in a mean translational 3D vector correction of 7.4 mm. Residual rotational error resulted in a target shift exceeding 5 mm in 57 of the 650 treatment fractions. Three patients alone accounted for 30 of these fractions. Nine patients had no shifts exceeding 5 mm and 13 patients had 5 or less treatment fractions with such shifts. Conclusion: Twenty-two of the 25 patients have none or few treatment fractions with target shifts larger than 5 mm due to residual rotational error. However, three patients display a significant number of shifts suggesting a more systematic set-up error.

  16. Setting up a parathyroid multidisciplinary team meeting: one year's experience, outcomes and learning points.

    Science.gov (United States)

    Hancox, S H; Sinnott, J D; Kirkland, P; Lipscomb, D; Owens, E; Howlett, D C

    2018-03-01

    A parathyroid multidisciplinary team meeting was set up at East Sussex Healthcare Trust, from November 2014 to November 2015, in order to improve and streamline services for patients with parathyroid pathology. Data were collected on all new referrals for hyperparathyroidism, and on the outcomes for each patient discussed at the meeting, including the number of operations and management outcomes. A survey was sent out to the members of the multidisciplinary team meeting to determine their perception of its effectiveness. Seventy-nine new referrals were discussed throughout the year; 43 per cent were recommended for surgery, 41 per cent had a trial of conservative or medical management before re-discussion, and 16 per cent required further imaging. Ninety-two per cent of patients underwent an ultrasound, single-photon emission computed tomography/computed tomography or nuclear medicine (sestamibi) scan prior to the meeting. All ultrasound scans were performed by a consultant radiologist. The multidisciplinary team meeting has been successful, with perceived benefits for patients, improved imaging evaluation and efficiency of referral pathways, leading to more appropriate patient management.

  17. Computational fluid dynamics simulation of indoor climate in low energy buildings: Computational set up

    Directory of Open Access Journals (Sweden)

    Risberg Daniel

    2017-01-01

    Full Text Available In this paper CFD was used for simulation of the indoor climate in a part of a low energy building. The focus of the work was on investigating the computational set up, such as grid size and boundary conditions in order to solve the indoor climate problems in an accurate way. Future work is to model a complete building, with reasonable calculation time and accuracy. A limited number of grid elements and knowledge of boundary settings are therefore essential. An accurate grid edge size of around 0.1 m was enough to predict the climate according to a grid independency study. Different turbulence models were compared with only small differences in the indoor air velocities and temperatures. The models show that radiation between building surfaces has a large impact on the temperature field inside the building, with the largest differences at the floor level. Simplifying the simulations by modelling the radiator as a surface in the outer wall of the room is appropriate for the calculations. The overall indoor climate is finally compared between three different cases for the outdoor air temperature. The results show a good indoor climate for a low energy building all around the year.

  18. Setting up and Running a School Library. Information Collection and Exchange Publication No. ED204

    Science.gov (United States)

    Baird, Nicola

    2012-01-01

    This book explains how teachers can set up and run a successful school library. In it you will find advice and information on how to: (1) set up a small library and build bookshelves; (2) select books for your library; (3) make a written record of your school's books, pamphlets and other library stock such as newspapers, magazines, audio tapes and…

  19. Realization of an automatic set up to measure electrical characteristic of solid state detectors

    International Nuclear Information System (INIS)

    Manfredotti, C.; Crosetto, D.; Gabutti, A.; Gervino, G.; Varesio, R.

    1986-01-01

    An automatic set-up is described to study electrical properties of silicon detectors for nuclear research. Particularly, I-V characteristics from silicon junction prototype detectors and amorphous samples to test the data acquisition system, are presented. This set-up joins a low cost to good versatility that makes it very useful in wide application ranges in silicon detector electrical characterization

  20. VITEX 2016 : Evaluation of learning objectives and exercise set-up

    NARCIS (Netherlands)

    Rijk, R. van; Stubbé-Alberts, H.E.

    2016-01-01

    To strengthen awareness of the need for cooperation, between public and private partners, and between countries, a new exercise set-up was developed. The VITEX exercise set-up is a table top exercise that aims to bring relevant networks together, and supports cooperation and collaboration between

  1. Accuracy of pedicle screw placement in patients with Marfan syndrome.

    Science.gov (United States)

    Qiao, Jun; Zhu, Feng; Xu, Leilei; Liu, Zhen; Sun, Xu; Qian, Bangping; Jiang, Qing; Zhu, Zezhang; Qiu, Yong

    2017-03-21

    There is no study concerning safety and accuracy of pedicle screw placement in Marfan syndrome. The objective of this study is to investigate accuracy and safety of pedicle screw placement in scoliosis associated with Marfan syndrome. CT scanning was performed to analyze accuracy of pedicle screw placement. Pedicle perforations were classified as medial, lateral or anterior and categorized to four grades: ≤ 2 mm as Grade 1, 2.1-4.0 mm as Grade 2, 4.1-6.0 mm as Grade 3, ≥6.1 mm as Grade 4. Fully contained screws or with medial wall perforation ≤ 2 mm or with lateral wall perforation ≤ 6 mm and without injury of visceral organs were considered acceptable, otherwise were unacceptable. 976 pedicle screws were placed, 713 screws (73.1%) were fully contained within the cortical boundaries of the pedicle. 924 (94.7%) screws were considered as acceptable, and 52 (5.3%) as unacceptable. The perforation rate was higher using free-hand technique than O-arm navigation technique (30.8% VS. 11.4%, P Marfan syndrome is accuracy and safe. O-arm navigation was an effective modality to ensure the safety and accuracy of screw placement. Special attention should be paid when screws were placed at the lumber spine and the concave side of spine deformity to avoid the higher rate of complications.

  2. Computed tomographic simulation of craniospinal fields in pediatric patients: improved treatment accuracy and patient comfort.

    Science.gov (United States)

    Mah, K; Danjoux, C E; Manship, S; Makhani, N; Cardoso, M; Sixel, K E

    1998-07-15

    To reduce the time required for planning and simulating craniospinal fields through the use of a computed tomography (CT) simulator and virtual simulation, and to improve the accuracy of field and shielding placement. A CT simulation planning technique was developed. Localization of critical anatomic features such as the eyes, cribriform plate region, and caudal extent of the thecal sac are enhanced by this technique. Over a 2-month period, nine consecutive pediatric patients were simulated and planned for craniospinal irradiation. Four patients underwent both conventional simulation and CT simulation. Five were planned using CT simulation only. The accuracy of CT simulation was assessed by comparing digitally reconstructed radiographs (DRRs) to portal films for all patients and to conventional simulation films as well in the first four patients. Time spent by patients in the CT simulation suite was 20 min on average and 40 min maximally for those who were noncompliant. Image acquisition time was absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with portal and/or simulation films to within 5 mm in five of the eight cases. Discrepancies of > or =5 mm in the positioning of the inferior border of the cranial fields in the first three patients were due to a systematic error in CT scan acquisition and marker contouring which was corrected by modifying the technique after the fourth patient. In one patient, the facial shield had to be moved 0.75 cm inferiorly owing to an error in shield construction. Our analysis showed that CT simulation of craniospinal fields was accurate. It resulted in a significant reduction in the time the patient must be immobilized during the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall, it has improved staff efficiency and resource utilization.

  3. Computed tomographic simulation of craniospinal fields in pediatric patients: improved treatment accuracy and patient comfort

    International Nuclear Information System (INIS)

    Mah, Katherine; Danjoux, Cyril E.; Manship, Sharan; Makhani, Nadiya; Cardoso, Marlene; Sixel, Katharina E.

    1998-01-01

    Purpose: To reduce the time required for planning and simulating craniospinal fields through the use of a computed tomography (CT) simulator and virtual simulation, and to improve the accuracy of field and shielding placement. Methods and Materials: A CT simulation planning technique was developed. Localization of critical anatomic features such as the eyes, cribriform plate region, and caudal extent of the thecal sac are enhanced by this technique. Over a 2-month period, nine consecutive pediatric patients were simulated and planned for craniospinal irradiation. Four patients underwent both conventional simulation and CT simulation. Five were planned using CT simulation only. The accuracy of CT simulation was assessed by comparing digitally reconstructed radiographs (DRRs) to portal films for all patients and to conventional simulation films as well in the first four patients. Results: Time spent by patients in the CT simulation suite was 20 min on average and 40 min maximally for those who were noncompliant. Image acquisition time was <10 min in all cases. In the absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with portal and/or simulation films to within 5 mm in five of the eight cases. Discrepancies of ≥5 mm in the positioning of the inferior border of the cranial fields in the first three patients were due to a systematic error in CT scan acquisition and marker contouring which was corrected by modifying the technique after the fourth patient. In one patient, the facial shield had to be moved 0.75 cm inferiorly owing to an error in shield construction. Conclusions: Our analysis showed that CT simulation of craniospinal fields was accurate. It resulted in a significant reduction in the time the patient must be immobilized during the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall

  4. Diagnostic accuracy of fine needle aspiration cytology in patients ...

    African Journals Online (AJOL)

    Objective: To estimate the sensitivity and specificity of FNAC in detecting malignancy for thyroid disease using histopathology ... thyroid carcinoma being the most predominant type and colloid goiter was the most predominant benign thyroid disease. The sensitivity ..... tic accuracy of fine needle aspiration cytology in thyroid.

  5. Precision assessment of model-based RSA for a total knee prosthesis in a biplanar set-up.

    Science.gov (United States)

    Trozzi, C; Kaptein, B L; Garling, E H; Shelyakova, T; Russo, A; Bragonzoni, L; Martelli, S

    2008-10-01

    Model-based Roentgen Stereophotogrammetric Analysis (RSA) was recently developed for the measurement of prosthesis micromotion. Its main advantage is that markers do not need to be attached to the implants as traditional marker-based RSA requires. Model-based RSA has only been tested in uniplanar radiographic set-ups. A biplanar set-up would theoretically facilitate the pose estimation algorithm, since radiographic projections would show more different shape features of the implants than in uniplanar images. We tested the precision of model-based RSA and compared it with that of the traditional marker-based method in a biplanar set-up. Micromotions of both tibial and femoral components were measured with both the techniques from double examinations of patients participating in a clinical study. The results showed that in the biplanar set-up model-based RSA presents a homogeneous distribution of precision for all the translation directions, but an inhomogeneous error for rotations, especially internal-external rotation presented higher errors than rotations about the transverse and sagittal axes. Model-based RSA was less precise than the marker-based method, although the differences were not significant for the translations and rotations of the tibial component, with the exception of the internal-external rotations. For both prosthesis components the precisions of model-based RSA were below 0.2 mm for all the translations, and below 0.3 degrees for rotations about transverse and sagittal axes. These values are still acceptable for clinical studies aimed at evaluating total knee prosthesis micromotion. In a biplanar set-up model-based RSA is a valid alternative to traditional marker-based RSA where marking of the prosthesis is an enormous disadvantage.

  6. PENURUNAN WAKTU SET-UP UNTUK PENINGKATAN EFEKTIFITAS PADA PT. X

    Directory of Open Access Journals (Sweden)

    Hendri Hendri

    2015-06-01

    Full Text Available PT. X bergerak dalam industri manufuktur yang memproduksi komponen otomotif yang  salah satu prosesnya adalah pembuatan bearing. Saat ini, persaingan dalam dunia bisnis semakin ketat. Situasi ini membuat organisasi untuk memperbaiki diri dengan penurunan waktu set-up supaya dapat menghilangkan pemborosan sehingga peningkatan efektifitas dapat dicapai. Untuk melakukan penurunan waktu set-up dalam penelitian ini menggunakan metode Single Minute Exchange of Dies (SMED. SMED adalah salah satu metoda improvement dari Lean Manufacturing yang digunakan untuk mempercepat waktu yang dibutuhkan untuk melakukan setup pergantian dari memproduksi satu jenis produk ke model produk lainnya. Penelitian ini bertujuan untuk mengetahui waktu Set up, serta mengetahui cara memperbaiki dan menurunkan waktu set up. Setelah dilakukan penelitian diketahui total waktu set up atau change over serta dilakukan perbaikan pada tiga titik yakni memindakan enam aktivitas internal menjadi aktivitas eksernal yang aktivitasnya dipersingkat, mengganti cara kerja setting/pengencangan baut dari cara manual ke alat bantu pengencangan dengan bantuan tekanan udara (pneumatic, dan mengganti cara kerja setting/penyetelan manual menjadi penyetelan dengan mengunakan block gauge. Secara keseluruhan terjadi penurunan waktu set up yang signifikan. Dengan demikian terjadi peningkatan efektifitas dengan menghilangkan pemborosan waktu set up sehinga terjadi peningkatan jumlah produksi per jam.

  7. An experimental set-up to measure Light Yield of Scintillating Fibres

    CERN Document Server

    Alfieri, C; Joram, C; Kenzie, M W

    2015-01-01

    In the context of the LHCb SciFi Tracker project, an experimental set up was designed and built to provide reliable and reproducible measurements of the light yield of scintillating fibres. This document describes the principle and technical realisation of the set-up. A few examples illustrate the operation and data analysis. In the first implementation of the set-up a photomultiplier tube with bialkali photocathode was used for the reading of the light from the fibres under test. In order to measure also green emitting fibres, the photomultiplier was replaced in January 2016 by a SiPM with higher sensitivity and larger spectral coverage1.

  8. The Impact of use of Double Set-up on Infection Rates in Revision Total Knee Replacement and Limb Salvage Procedures

    Directory of Open Access Journals (Sweden)

    Jennifer Waterman

    2015-03-01

    Full Text Available A retrospective analysis was performed to determine the impact of utilizing a double set-up procedure on reducing infection rates revision total knee and limb salvage procedures in patients with known joint infection.  Eighteen cases fit selection criteria.  The recurrence rate of infection was 5.5% which is less than reported recent literature review.   This suggests the use of a double set-up in combination with other infection reducing protocols may help further reduce recurrent infection.  Keywords: double set-up, infection, revision total knee arthroplasty, limb-salvage

  9. Determination and evaluation of intra fractional and set-up changes during radiotherapy to the cervical carcinoma using cone beam computed tomography

    International Nuclear Information System (INIS)

    Pathak, Pankaj; Kumar, Rajesh; Birbiya, Narendra; Mishra, Praveen Kumar; Singh, Manisha; Mishra, Pankaj Kumar

    2017-01-01

    To confirm the accuracy of the location of the Fudicial markings in relation to the actual isocentre of the irradiated volume due to Intra-fractional and Set-Up changes in Cancer Cervix with the help of Cone Beam computed Tomography (CBCT)

  10. Special problems of setting up nuclear medicine in a developing country

    International Nuclear Information System (INIS)

    Ganatra, R.D.

    1992-01-01

    There are some special problems in setting up nuclear medicine in a developing country. They can be briefly described in the form of the following general rules. 1) Impossible triangle. For the practice of nuclear medicine, three things are needed: Instrument, Radiopharmaceutical and a Patient. In a developing country, these three become three sides of an impossible triangle. When the radiopharmaceutical is available, the instrument may not be working; when the instrument is functioning, the radiopharmaceutical may not have been obtained from the foreign supplier; and when both are there, the patient might no longer be in the hospital. Three sides of this triangle never join to become a congruent whole. 2) Reverse square law. Further away one is from the source of supply of instruments and radiopharmaceuticals, the problems multiply by the square of this distance. 3) Future of nuclear medicine is tied to the electrical supply available in a developing country. These problems related to power supply are described in the Chapter on maintenance of instruments

  11. Special problems of setting up nuclear medicine in a developing country

    Energy Technology Data Exchange (ETDEWEB)

    Ganatra, R D

    1993-12-31

    There are some special problems in setting up nuclear medicine in a developing country. They can be briefly described in the form of the following general rules. 1) Impossible triangle. For the practice of nuclear medicine, three things are needed: Instrument, Radiopharmaceutical and a Patient. In a developing country, these three become three sides of an impossible triangle. When the radiopharmaceutical is available, the instrument may not be working; when the instrument is functioning, the radiopharmaceutical may not have been obtained from the foreign supplier; and when both are there, the patient might no longer be in the hospital. Three sides of this triangle never join to become a congruent whole. 2) Reverse square law. Further away one is from the source of supply of instruments and radiopharmaceuticals, the problems multiply by the square of this distance. 3) Future of nuclear medicine is tied to the electrical supply available in a developing country. These problems related to power supply are described in the Chapter on maintenance of instruments

  12. Mapping Suitable Sites for Setting up Wind Farms: A Case Study of ...

    African Journals Online (AJOL)

    Mapping Suitable Sites for Setting up Wind Farms: A Case Study of Nyanga District. ... Ethiopian Journal of Environmental Studies and Management ... sources and continuous power shortages make wind energy a very attractive alternative to ...

  13. An evaluation system of the setting up of predictive maintenance programmes

    International Nuclear Information System (INIS)

    Carnero, MaCarmen

    2006-01-01

    Predictive Maintenance can provide an increase in safety, quality and availability in industrial plants. However, the setting up of a Predictive Maintenance Programme is a strategic decision that until now has lacked analysis of questions related to its setting up, management and control. In this paper, an evaluation system is proposed that carries out the decision making in relation to the feasibility of the setting up. The evaluation system uses a combination of tools belonging to operational research such as: Analytic Hierarchy Process, decision rules and Bayesian tools. This system is a help tool available to the managers of Predictive Maintenance Programmes which can both increase the number of Predictive Maintenance Programmes set up and avoid the failure of these programmes. The Evaluation System has been tested in a petrochemical plant and in a food industry

  14. Positioning accuracy for lung stereotactic body radiotherapy patients determined by on-treatment cone-beam CT imaging

    Science.gov (United States)

    Richmond, N D; Pilling, K E; Peedell, C; Shakespeare, D; Walker, C P

    2012-01-01

    Stereotactic body radiotherapy for early stage non-small cell lung cancer is an emerging treatment option in the UK. Since relatively few high-dose ablative fractions are delivered to a small target volume, the consequences of a geometric miss are potentially severe. This paper presents the results of treatment delivery set-up data collected using Elekta Synergy (Elekta, Crawley, UK) cone-beam CT imaging for 17 patients immobilised using the Bodyfix system (Medical Intelligence, Schwabmuenchen, Germany). Images were acquired on the linear accelerator at initial patient treatment set-up, following any position correction adjustments, and post-treatment. These were matched to the localisation CT scan using the Elekta XVI software. In total, 71 fractions were analysed for patient set-up errors. The mean vector error at initial set-up was calculated as 5.3±2.7 mm, which was significantly reduced to 1.4±0.7 mm following image guided correction. Post-treatment the corresponding value was 2.1±1.2 mm. The use of the Bodyfix abdominal compression plate on 5 patients to reduce the range of tumour excursion during respiration produced mean longitudinal set-up corrections of −4.4±4.5 mm compared with −0.7±2.6 mm without compression for the remaining 12 patients. The use of abdominal compression led to a greater variation in set-up errors and a shift in the mean value. PMID:22665927

  15. Characterization of n-heptane as a single component Diesel surrogate fuel. EHPC test set-up implementation

    Energy Technology Data Exchange (ETDEWEB)

    Meijer, M.

    2010-06-15

    The availability of accurately measured fuel properties, during an injection event under engine relevant conditions is critical within the surrogate fuel approach. There is a need to perform in-house measurements in order to validate developed and new models. A well defined and accurately measured data-set will facilitate on-going work for sophisticated engine related in-cylinder combustion modeling. In this work pure n-heptane fuel is used as a single component surrogate fuel and is studied in a high-pressure constant volume optical test set-up. N-heptane is often used as a single component surrogate diesel fuel since it has a comparable Cetane number as European diesel. Detailed chemical-kinetic mechanisms for low-, intermediate-, and high-temperature n-heptane oxidation are available and several models exist that have sufficiently reduced dimensionality (number of species and reactions) to enable their use in CFD (Computational Fluid Mechanics) simulations. This report discusses the route and implementation to perform such an accurate and relevant n-heptane measurement series. The aim is to combine the efforts of earlier presented EHPC (Eindhoven High Pressure Cell) related work and new approaches, into the proposed surrogate fuel measurement series. The following aspects, related to the applied constant volume combustion chamber set-up, are studied and implemented: Extending the operating ranges towards relevant engine conditions; Study the accuracy and sensitivities of the different measurement steps; Implementing different optical diagnostic principles; and Implement a standardized and robust post processing routine. The different optical diagnostic principles used in this work are: high-speed Schlieren, Mie scattering and beginnings are made to implement a simultaneous LII LIF (Laser Induced Incandescence - Laser Induced Fluorescence) set-up using a new ICCD (Intensified Charge Coupled Device) camera with dual imaging feature. Combining the different

  16. HUG sets up an emergency operations centre on the CERN site

    CERN Multimedia

    Antonella Del Rosso

    2015-01-01

    Discussions between CERN and the Hôpitaux universitaires de Genève (HUG), under the aegis of the Swiss authorities, have resulted in the setting-up of an emergency operations centre on the CERN site. This will be the operations base for an emergency doctor, a medical emergency vehicle and a driver. Located on the Swiss part of the Meyrin site, close to Building 57, it will be inaugurated on 20 May.   SMUR team based at CERN. CERN’s medical staff and fire-fighters dispense first aid but in medical emergencies they are obliged to call on outside services to treat and transfer patients to hospital. In the Canton of Geneva, this service is provided by HUG via the 144 emergency line. But HUG is based on the eastern side of Geneva, a long way from CERN, and response times can be substantial. In order to improve the safety of the growing number of people on the site, CERN asked Switzerland, as one of its Host States, to help it reduce the medical emergency response t...

  17. Cone beam CT with zonal filters for simultaneous dose reduction, improved target contrast and automated set-up in radiotherapy

    International Nuclear Information System (INIS)

    Moore, C J; Marchant, T E; Amer, A M

    2006-01-01

    Cone beam CT (CBCT) using a zonal filter is introduced. The aims are reduced concomitant imaging dose to the patient, simultaneous control of body scatter for improved image quality in the tumour target zone and preserved set-up detail for radiotherapy. Aluminium transmission diaphragms added to the CBCT x-ray tube of the Elekta Synergy TM linear accelerator produced an unattenuated beam for a central 'target zone' and a partially attenuated beam for an outer 'set-up zone'. Imaging doses and contrast noise ratios (CNR) were measured in a test phantom for transmission diaphragms 12 and 24 mm thick, for 5 and 10 cm long target zones. The effect on automatic registration of zonal CBCT to conventional CT was assessed relative to full-field and lead-collimated images of an anthropomorphic phantom. Doses along the axis of rotation were reduced by up to 50% in both target and set-up zones, and weighted dose (two thirds surface dose plus one third central dose) was reduced by 10-20% for a 10 cm long target zone. CNR increased by up to 15% in zonally filtered CBCT images compared to full-field images. Automatic image registration remained as robust as that with full-field images and was superior to CBCT coned down using lead-collimation. Zonal CBCT significantly reduces imaging dose and is expected to benefit radiotherapy through improved target contrast, required to assess target coverage, and wide-field edge detail, needed for robust automatic measurement of patient set-up error

  18. Evaluation of different set-up error corrections on dose-volume metrics in prostate IMRT using CBCT images

    International Nuclear Information System (INIS)

    Hirose, Yoshinori; Tomita, Tsuneyuki; Kitsuda, Kenji; Notogawa, Takuya; Miki, Katsuhito; Nakamura, Mitsuhiro; Nakamura, Kiyonao; Ishigaki, Takashi

    2014-01-01

    We investigated the effect of different set-up error corrections on dose-volume metrics in intensity-modulated radiotherapy (IMRT) for prostate cancer under different planning target volume (PTV) margin settings using cone-beam computed tomography (CBCT) images. A total of 30 consecutive patients who underwent IMRT for prostate cancer were retrospectively analysed, and 7-14 CBCT datasets were acquired per patient. Interfractional variations in dose-volume metrics were evaluated under six different set-up error corrections, including tattoo, bony anatomy, and four different target matching groups. Set-up errors were incorporated into planning the isocenter position, and dose distributions were recalculated on CBCT images. These processes were repeated under two different PTV margin settings. In the on-line bony anatomy matching groups, systematic error (Σ) was 0.3 mm, 1.4 mm, and 0.3 mm in the left-right, anterior-posterior (AP), and superior-inferior directions, respectively. Σ in three successive off-line target matchings was finally comparable with that in the on-line bony anatomy matching in the AP direction. Although doses to the rectum and bladder wall were reduced for a small PTV margin, averaged reductions in the volume receiving 100% of the prescription dose from planning were within 2.5% under all PTV margin settings for all correction groups, with the exception of the tattoo set-up error correction only (≥ 5.0%). Analysis of variance showed no significant difference between on-line bony anatomy matching and target matching. While variations between the planned and delivered doses were smallest when target matching was applied, the use of bony anatomy matching still ensured the planned doses. (author)

  19. Ultrasound Accuracy in Diagnosing Appendicitis in Obese Pediatric Patients.

    Science.gov (United States)

    Love, Bryan E; Camelo, Monica; Nouri, Sarvenaz; Kriger, Diego; Ludi, Daniel; Nguyen, Henry

    2017-10-01

    The use of ultrasound to diagnose appendicitis in pediatric patients has been growing with the improvement of ultrasound technology and operator skills, but its utility in the increasingly obese pediatric population has not been thoroughly investigated. A retrospective review of all pediatric (≤18 years old) patients with appendicitis who were admitted at a single hospital from 2014 to 2016 was conducted. Patients were stratified into body mass index (BMI) percentile categories based on the centers for disease control guidelines. Comparisons were then made. There were 231 patients with an average BMI percentile of 72.6; 99 (42.9%) who had an ultrasound, of which 54 (54.5%) were positive for acute appendicitis, whereas 43 (43.4%) were nondiagnostic. In patients who had a nondiagnostic ultrasound, 37 had a CT demonstrating acute appendicitis. These were compared with 123 patients who had CT alone demonstrating acute appendicitis. The CT-only group was older (12 vs 9, P appendicitis.

  20. Assessment of three-dimensional set-up errors in conventional head and neck radiotherapy using electronic portal imaging device

    International Nuclear Information System (INIS)

    Gupta, Tejpal; Chopra, Supriya; Kadam, Avinash; Agarwal, Jai Prakash; Devi, P Reena; Ghosh-Laskar, Sarbani; Dinshaw, Ketayun Ardeshir

    2007-01-01

    Set-up errors are an inherent part of radiation treatment process. Coverage of target volume is a direct function of set-up margins, which should be optimized to prevent inadvertent irradiation of adjacent normal tissues. The aim of this study was to evaluate three-dimensional (3D) set-up errors and propose optimum margins for target volume coverage in head and neck radiotherapy. The dataset consisted of 93 pairs of orthogonal simulator and corresponding portal images on which 558 point positions were measured to calculate translational displacement in 25 patients undergoing conventional head and neck radiotherapy with antero-lateral wedge pair technique. Mean displacements, population systematic (Σ) and random (σ) errors and 3D vector of displacement was calculated. Set-up margins were calculated using published margin recipes. The mean displacement in antero-posterior (AP), medio-lateral (ML) and supero-inferior (SI) direction was -0.25 mm (-6.50 to +7.70 mm), -0.48 mm (-5.50 to +7.80 mm) and +0.45 mm (-7.30 to +7.40 mm) respectively. Ninety three percent of the displacements were within 5 mm in all three cardinal directions. Population systematic (Σ) and random errors (σ) were 0.96, 0.98 and 1.20 mm and 1.94, 1.97 and 2.48 mm in AP, ML and SI direction respectively. The mean 3D vector of displacement was 3.84 cm. Using van Herk's formula, the clinical target volume to planning target volume margins were 3.76, 3.83 and 4.74 mm in AP, ML and SI direction respectively. The present study report compares well with published set-up error data relevant to head and neck radiotherapy practice. The set-up margins were <5 mm in all directions. Caution is warranted against adopting generic margin recipes as different margin generating recipes lead to a different probability of target volume coverage

  1. Chart review of electroconvulsive therapy practice from a tertiary care geriatric mental health set up

    Directory of Open Access Journals (Sweden)

    Akanksha Sonal

    2017-01-01

    Full Text Available Introduction: Electroconvulsive therapy (ECT is frequently used treatment procedure, and is utilized more often for severe, treatment-resistant, or refractory psychiatric disorders. However, published data on the use of ECT is limited, more so for special population like older adults. Aim: The aim of the study was to explore the clinical, demographic, and diagnostic profiles of older adults, and the parameters of ECT treatment, in a tertiary care Geriatric Mental Health set up. Materials and Methods: Approval to review the case notes was obtained from the Institutional Ethical Committee. The individuals were aged 60 years and above and had received ECT between January 2014 and May 2017. The relevant details pertaining to the aims of the study were recorded in a spreadsheet. Results: Twenty-five courses (absolute number = 191 of ECT were given to 21 patients (mean age = 67.44 ± 9.8 years with mean of 7.64 ± 3.6 ECT per patient. Majority of the patients belonged to age group 60–69 years, and were male (81%. Depression was the most common diagnosis for giving ECT (43% in these individuals, and poor response to pharmacological treatment (81% was the most common indication. The mean duration of the seizure elicited was 28.8 ± 13.2 s, and a therapeutic response was seen in 86% of cases. No major complications were noted during ECT treatment. Conclusion: When used judiciously and with trained staff, ECT is an effective and relatively safe mode of treatment even in older adults.

  2. Setting up home-based palliative care in countries with limited resources: a model from Sarawak, Malaysia.

    Science.gov (United States)

    Devi, B C R; Tang, T S; Corbex, M

    2008-12-01

    The provision of palliative care (PC) and opioids is difficult to ensure in remote areas in low- and middle-income countries. We describe here the set up of a home-care program in Sarawak (the Malaysian part of the Borneo Island), where half the population lives in villages that are difficult to access. The establishment of this program, initiated in 1994 by the Department of Radiotherapy of Sarawak General Hospital, consisted of training, empowering nurses, simplifying referral, facilitating access to medication, and increasing awareness among public and health professionals about PC. The program has been sustainable and cost efficient, serving 936 patients in 2006. The total morphine usage in the program increased from 1400 g in 2006. The results show that pain medication can be provided even in remote areas with effective organization and empowerment of nurses, who were the most important determinants for the set up of this program. Education of family was also a key aspect. The authors believe that the experience gained in Sarawak may help other regions with low or middle resources in the set up of their PC program especially for their remote rural population.

  3. An optimised set-up for total reflection particle induced X-ray emission

    International Nuclear Information System (INIS)

    Kan, J.A. van; Vis, R.D.

    1997-01-01

    MeV proton beams at small angles of incidence (0-35 mrad) are used to analyse trace elements on flat surfaces such as Si wafers or quartz substrates. In these experiments, the particle induced X-ray emission (PIXE) signal is used in a new optimized set-up. This set-up is constructed in such a way that the X-ray detector can reach very large solid angles, larger than 1 sr. Use of these large detector solid angles, combined with the reduction of bremsstrahlung background, affords limits of detection (LOD) of the order of 10 10 at cm -2 using total reflection particle induced X-ray emission (TPIXE). The LODs from earlier TPIXE measurements in a non-optimized set-up are used to estimate LODs in the new TPIXE set-up. Si wafers with low surface concentrations of V, Ni, Cu and Ag are used as standards to calibrate the LODs found with this set-up. The metal concentrations are determined by total reflection X-ray fluorescence (TXRF). The TPIXE measurements are compared with TXRF measurements on the same wafers. (Author)

  4. Practical performance for CT simulator set up and commissioning for 3d radiotherapy

    International Nuclear Information System (INIS)

    Wang, Y.; Rinks, A.; Zealey, W.

    2004-01-01

    horizontal directions with the slice thickness less than the diameter of ball-bearing size, and the orientation and distance are measured over the slice images and DRR images. Electron Density Calibration 1. Tube Voltage kV- the electron density depends on the voltage setting (kV). Calibrations are carried out for different kV settings and separate electron density tables are generated. 2. Tube Current mA - experimental results show that change of HU's is not significant, but low mA scans produce higher Standard Deviation and noise. 3. Scan speed- made no noticeable differences if scan setup is unchanged (e.g. kV or collimation) 4. Collimation - experimental results show that the same slice thickness with different collimation, e.g. 1x5 or 5x1 in the reconstructed image, will cause electron density values to vary. It is suggested that the slice thickness in different collimation settings should be calibrated separately. 5. Sample Area - the readings taken from close to the phantom surface can be different compared with the readings taken from a deeper position in the phantom due to different scanning scatter effects. Calibration tables for the body and head-neck were performed separately. For a new CT installation the scanning isocentre is determined first before setting up the couch and external lasers. This routine assists the engineer during installation and commissioning to ensure the CT scanner meets specifications required for a therapy scanner. The electron density should be calibrated for each kV used. Collimation also affects electron density values. Separate tables for different volumes such as body and head and neck may be warranted. Copyright (2004) Australasian College of Physical Scientists and Engineers in Medicine

  5. Mathematical model of the electronuclear set-up on the beam of the JINR synchrotron

    International Nuclear Information System (INIS)

    Barashenkov, V.S.; Kumawat, H.; Lobanova, V.A.; Kumar, V.

    2003-01-01

    On the base of the Monte Carlo code CASCADE, developed at JINR, a mathematical model of the deep-subcritical set-up with uranium blanket used in experiments underway at JINR using a 0.6-4 GeV proton beam, is created. The neutron spectra, yields and energies of generated particles are calculated and compared for several modifications of the set-up. The influence of paraffin and graphite moderators on the characteristics of particles escaping lead target is studied. The modelled set-up can be considered as a first step to experiments with the designed at JINR U-Pu ADS SAD with heat power of several tens of kW

  6. Trace element analysis in an optimized set-up for total reflection PIXE (TPIXE)

    International Nuclear Information System (INIS)

    Van Kan, J.A.; Vis, R.D.

    1996-01-01

    A newly constructed chamber for measuring with MeV proton beams at small incidence angles (0 to 35 mrad) is used to analyse trace elements on flat surfaces such as Si wafers, quartz substrates and perspex. This set-up is constructed in such a way that the X-ray detector can reach very large solid angles, larger than 1 sr. Using these large solid angles in combination with the reduction of bremsstrahlungs background, lower limits of detection (LOD) using TPIXE can be obtained as compared with PIXE in the conventional geometry. Standard solutions are used to determine the LODs obtainable with TPIXE in the optimized set-up. These solutions contain traces of As and Sr with concentrations down to 20 ppb in an insulin solution. The limits of detection found are compared with earlier ones obtained with TPIXE in a non optimized set-up and with TXRF results. (author)

  7. Mathematical Model of the Electronuclear Set-Up on the Beam of the JINR Synchrotron

    CERN Document Server

    Barashenkov, V S; Kumawat, H; Lobanova, V A

    2004-01-01

    On the base of the Monte Carlo code CASCADE, developed at JINR, a mathematical model of the deep-subcritical set-up with uranium blanket used in experiments underway at JINR using a 0.6-4 GeV proton beam, is created. The neutron spectra, yields and energies of generated particles are calculated and compared for several modifications of the set-up. The influence of paraffin and graphite moderators on the characteristics of particles escaping lead target is studied. The modelled set-up can be considered as a first step to experiments with the designed at JINR U-Pu ADS SAD with heat power of several tens of kW.

  8. Implementation of random set-up errors in Monte Carlo calculated dynamic IMRT treatment plans

    International Nuclear Information System (INIS)

    Stapleton, S; Zavgorodni, S; Popescu, I A; Beckham, W A

    2005-01-01

    The fluence-convolution method for incorporating random set-up errors (RSE) into the Monte Carlo treatment planning dose calculations was previously proposed by Beckham et al, and it was validated for open field radiotherapy treatments. This study confirms the applicability of the fluence-convolution method for dynamic intensity modulated radiotherapy (IMRT) dose calculations and evaluates the impact of set-up uncertainties on a clinical IMRT dose distribution. BEAMnrc and DOSXYZnrc codes were used for Monte Carlo calculations. A sliding window IMRT delivery was simulated using a dynamic multi-leaf collimator (DMLC) transport model developed by Keall et al. The dose distributions were benchmarked for dynamic IMRT fields using extended dose range (EDR) film, accumulating the dose from 16 subsequent fractions shifted randomly. Agreement of calculated and measured relative dose values was well within statistical uncertainty. A clinical seven field sliding window IMRT head and neck treatment was then simulated and the effects of random set-up errors (standard deviation of 2 mm) were evaluated. The dose-volume histograms calculated in the PTV with and without corrections for RSE showed only small differences indicating a reduction of the volume of high dose region due to set-up errors. As well, it showed that adequate coverage of the PTV was maintained when RSE was incorporated. Slice-by-slice comparison of the dose distributions revealed differences of up to 5.6%. The incorporation of set-up errors altered the position of the hot spot in the plan. This work demonstrated validity of implementation of the fluence-convolution method to dynamic IMRT Monte Carlo dose calculations. It also showed that accounting for the set-up errors could be essential for correct identification of the value and position of the hot spot

  9. Implementation of random set-up errors in Monte Carlo calculated dynamic IMRT treatment plans

    Science.gov (United States)

    Stapleton, S.; Zavgorodni, S.; Popescu, I. A.; Beckham, W. A.

    2005-02-01

    The fluence-convolution method for incorporating random set-up errors (RSE) into the Monte Carlo treatment planning dose calculations was previously proposed by Beckham et al, and it was validated for open field radiotherapy treatments. This study confirms the applicability of the fluence-convolution method for dynamic intensity modulated radiotherapy (IMRT) dose calculations and evaluates the impact of set-up uncertainties on a clinical IMRT dose distribution. BEAMnrc and DOSXYZnrc codes were used for Monte Carlo calculations. A sliding window IMRT delivery was simulated using a dynamic multi-leaf collimator (DMLC) transport model developed by Keall et al. The dose distributions were benchmarked for dynamic IMRT fields using extended dose range (EDR) film, accumulating the dose from 16 subsequent fractions shifted randomly. Agreement of calculated and measured relative dose values was well within statistical uncertainty. A clinical seven field sliding window IMRT head and neck treatment was then simulated and the effects of random set-up errors (standard deviation of 2 mm) were evaluated. The dose-volume histograms calculated in the PTV with and without corrections for RSE showed only small differences indicating a reduction of the volume of high dose region due to set-up errors. As well, it showed that adequate coverage of the PTV was maintained when RSE was incorporated. Slice-by-slice comparison of the dose distributions revealed differences of up to 5.6%. The incorporation of set-up errors altered the position of the hot spot in the plan. This work demonstrated validity of implementation of the fluence-convolution method to dynamic IMRT Monte Carlo dose calculations. It also showed that accounting for the set-up errors could be essential for correct identification of the value and position of the hot spot.

  10. Special set-up and treatment techniques for the radiotherapy of pediatric malignancies

    International Nuclear Information System (INIS)

    Martinez, A.; Donaldson, S.S.; Bagshaw, M.A.

    1977-01-01

    The prevention of serious and long term complications of treatment have become as important a consideration in the therapy of children with malignant disease as the goal of tumor control. This balance requires meticulous treatment planning and attention to the treatment preparation and immobilization techniques when radiotherapy is administered to children. Accurate localization of tumor volume and daily reproducibility is essential for delivering precise irradiation. Four special set-up and treatment techniques which have a specific usefulness in radiotherapy for pediatric malignancies are defined and illustrated with the aid of clinical cases. They include the three point set-up, the split beam technique, the isocentric technique, and the strinking field technique

  11. Accuracy of the initial diagnosis among patients with an acutely altered mental status

    OpenAIRE

    Sporer, KA; Solares, M; Edward, JD; Wang, W; Alan, HBW; Robert, MR

    2013-01-01

    Objectives: The objectives of this prospective observational study were to: (1) determine the accuracy of physician diagnosis in patients with an acutely altered mental status (AMS) within the first 20 min of emergency department (ED) presentation; and (2) access if physician confidence in early diagnosis correlates with accuracy of diagnosis. Methods: A prospective observational convenience study was conducted of 112 adult patients who presented to an urban county ED with AMS (Glasgow Coma S...

  12. Analysis of patient setup accuracy using electronic portal imaging device

    International Nuclear Information System (INIS)

    Onogi, Yuzo; Aoki, Yukimasa; Nakagawa, Keiichi

    1996-01-01

    Radiation therapy is performed in many fractions, and accurate patient setup is very important. This is more significant nowadays because treatment planning and radiation therapy are more precisely performed. Electronic portal imaging devices and automatic image comparison algorithms let us analyze setup deviations quantitatively. With such in mind we developed a simple image comparison algorithm. Using 2459 electronic verification images (335 ports, 123 treatment sites) generated during the past three years at our institute, we evaluated the results of the algorithm, and analyzed setup deviations according to the area irradiated, use of a fixing device (shell), and arm position. Calculated setup deviation was verified visually and their fitness was classified into good, fair, bad, and incomplete. The result was 40%, 14%, 22%, 24% respectively. Using calculated deviations classified as good (994 images), we analyzed setup deviations. Overall setup deviations described in 1 SD along axes x, y, z, was 1.9 mm, 2.5 mm, 1.7 mm respectively. We classified these deviations into systematic and random components, and found that random error was predominant in our institute. The setup deviations along axis y (cranio-caudal direction) showed larger distribution when treatment was performed with the shell. Deviations along y (cranio-caudal) and z (anterior-posterior) had larger distribution when treatment occurred with the patient's arm elevated. There was a significant time-trend error, whose deviations become greater with time. Within all evaluated ports, 30% showed a time-trend error. Using an electronic portal imaging device and automatic image comparison algorithm, we are able to analyze setup deviations more precisely and improve setup method based on objective criteria. (author)

  13. An experimental set-up for carbon isotopic analysis of atmospheric ...

    Indian Academy of Sciences (India)

    We present here, an experimental set-up developed for the first time in India for the ... The internal reproducibility (precision) for the δ13C ... interaction of CO2 and water, and reproduce iso- ..... enhanced emission of anthropogenic CO2, varia-.

  14. Setting up Schizosaccharomyces pombe crosses/matings

    DEFF Research Database (Denmark)

    Ekwall, Karl; Thon, Genevieve

    2017-01-01

    Here we provide methods for setting up standard crosses with Schizosaccharomyces pombe strains. All strain genotypes and pedigrees should be recorded in a laboratory strain book. Matings between two haploid strains of interest are induced on solid medium poor in nitrogen. Usually, sporulation agar...

  15. The possibility to use 'energy plus transmutation' set-up for neutron ...

    Indian Academy of Sciences (India)

    Neutron field was measured in different places of this set- up using different .... to see that the proton integral was around 1013 protons for all experiments. The shape of the .... The lines are drawn to guide the eyes, only statistical errors are ...

  16. Technologies for the Fast Set-Up of Automated Assembly Processes

    DEFF Research Database (Denmark)

    Krüger, Norbert; Ude, Ales; Petersen, Henrik Gordon

    2014-01-01

    of so called few-of-a-kind production. Therefore, most production of this kind is done manually and thus often performed in low-wage countries. In the IntellAct project, we have developed a set of methods which facilitate the set-up of a complex automatic assembly process, and here we present our work...

  17. Controlling Mechatronic Set-up Using Real-time Linux and CTC ++

    NARCIS (Netherlands)

    Broenink, Johannes F.; Jovanovic, D.S.; Hilderink, G.H.; van Amerongen, J.; Jonker, B.; Regtien, P.; Stramigioli, S.

    2002-01-01

    The development of control software for mechatronic systems is presented by means of a case study: a 2 DOF mechanical rotational set-up usable as a camera-positioning device. The control software is generated using the code generation facility of 20-SIM, thus guaranteeing the generated code being

  18. 12 November 1991-Ministerial Order setting up a Commission for assessing information in the nuclear field

    International Nuclear Information System (INIS)

    1991-01-01

    The Commission sets up by this Order must ensure that the public is kept informed on the technical, health, ecological, economic and financial aspects of nuclear energy, and advises the Secretary of State for Energy on the conditions for informing the public and proposes methods for disseminating such information. (NEA)

  19. The Use of Instructional and Motivational Self-Talk in Setting up a Physical Education Lesson

    Science.gov (United States)

    Zourbanos, Nikos

    2013-01-01

    The main purpose of this article is to provide guidelines to physical educators for setting up a self-talk program during their lesson. The article briefly presents definitions of self-talk and research findings in sport and physical education to highlight the important benefits of positive self-talk in enhancing task performance. It also provides…

  20. Automotive RF immunity test set-up analysis : why test results can't compare

    NARCIS (Netherlands)

    Coenen, Mart; Pues, H.; Bousquet, T.

    2011-01-01

    Though the automotive RF emission and RF immunity requirements are highly justifiable, the application of those requirements in an non-intended manner leads to false conclusions and unnecessary redesigns for the electronics involved. When the test results become too dependent upon the test set-up

  1. The pattern of trauma in private general medical practice set-up Port ...

    African Journals Online (AJOL)

    BACKGROUND: Private general medical practice establishments appear to be treating a significant number of trauma cases including more serious ones. Aim: To find out the extent of such treatment of trauma and what has made this possible. METHODS: All trauma cases treated in a private general medical practice set up ...

  2. Anhui Tongling Invests 1 Billion Yuan to Set up “Copper Industry Fund”

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    <正>On September 12, the signing ceremony for "Anhui Copper Industry Fund" set up by Anhui Tongling Development & Investment Group Co., Ltd. and Shanghai V. Stone Investment Management Co., Ltd. was held in Tongling. The fund is 1 billion yuan.

  3. Setting up a randomized clinical trial in the UK: approvals and process.

    Science.gov (United States)

    Greene, Louise Eleanor; Bearn, David R

    2013-06-01

    Randomized clinical trials are considered the 'gold standard' in primary research for healthcare interventions. However, they can be expensive and time-consuming to set up and require many approvals to be in place before they can begin. This paper outlines how to determine what approvals are required for a trial, the background of each approval and the process for obtaining them.

  4. Experimental Study of Drag Resistance using a Laboratory Scale Rotary Set-Up

    DEFF Research Database (Denmark)

    Erik Weinell, Claus; Olsen, Kenneth N.; Christoffersen, Martin W.

    2003-01-01

    This work covers an experimental study of the drag resistance of different painted surfaces and simulated large-scale irregularities, viz. dry spraying, weld seams, barnacle fouling and paint remains. A laboratory scale rotary set-up was used to determine the drag resistance, and the surface...

  5. Setting up a child eye care centre: the Mercy Eye Hospital, Abak ...

    African Journals Online (AJOL)

    Aim: To document and share our experience in setting up a Child Eye Care Centre within a rural mission eye hospital and document subsequent development of services. Method: The location of the project was Mercy Eye Hospital (MEH) Abak, Akwa Ibom State in the South South zone of Nigeria). Consent to commence ...

  6. Order of 27 February 1985 setting up a Nuclear Engineering Terminology Commission

    International Nuclear Information System (INIS)

    1985-01-01

    The Commission set up by this Order will draw up an inventory of the gaps in French nuclear engineering vocabulary, taking into account users' needs; it will also propose and revise the necessary terms in the light of present knowledge and contribute to collection and harmonisation of terminological and neological data. (NEA) [fr

  7. Worms Eat My Garbage. How To Set Up and Maintain a Worm Composting System. First Edition.

    Science.gov (United States)

    Appelhof, Mary

    This book is a resource for parents and teachers who want to teach about recycling and composting by setting up and maintaining a worm composting system. It is designed to be a detailed yet simple manual of vermicomposting. The manual covers the basics of vermicomposting and answers such questions as where to store a composting container, what…

  8. Rank the Voltage across Light Bulbs … Then Set up the Live Experiment

    Science.gov (United States)

    Jacobs, Greg C.

    2018-01-01

    The Tasks Inspired by Physics Education Research (TIPERS) workbooks pose questions in styles quite different from the end-of-chapter problems that those of us of a certain age were assigned back in the days before Netscape. My own spin on TIPERS is not just to do them on paper, but to have students set up the situations in the laboratory to…

  9. 'When measurements mean action' decision models for portal image review to eliminate systematic set-up errors

    International Nuclear Information System (INIS)

    Wratten, C.R.; Denham, J.W.; O; Brien, P.; Hamilton, C.S.; Kron, T.; London Regional Cancer Centre, London, Ontario

    2004-01-01

    The aim of the present paper is to evaluate how the use of decision models in the review of portal images can eliminate systematic set-up errors during conformal therapy. Sixteen patients undergoing four-field irradiation of prostate cancer have had daily portal images obtained during the first two treatment weeks and weekly thereafter. The magnitude of random and systematic variations has been calculated by comparison of the portal image with the reference simulator images using the two-dimensional decision model embodied in the Hotelling's evaluation process (HEP). Random day-to-day set-up variation was small in this group of patients. Systematic errors were, however, common. In 15 of 16 patients, one or more errors of >2 mm were diagnosed at some stage during treatment. Sixteen of the 23 errors were between 2 and 4 mm. Although there were examples of oversensitivity of the HEP in three cases, and one instance of undersensitivity, the HEP proved highly sensitive to the small (2-4 mm) systematic errors that must be eliminated during high precision radiotherapy. The HEP has proven valuable in diagnosing very small ( 4 mm) systematic errors using one-dimensional decision models, HEP can eliminate the majority of systematic errors during the first 2 treatment weeks. Copyright (2004) Blackwell Science Pty Ltd

  10. How to address patients' defences: a pilot study of the accuracy of defence interpretations and alliance.

    Science.gov (United States)

    Junod, Olivier; de Roten, Yves; Martinez, Elena; Drapeau, Martin; Despland, Jean-Nicolas

    2005-12-01

    This pilot study examined the accuracy of therapist defence interpretations (TAD) in high-alliance patients (N = 7) and low-alliance patients (N = 8). TAD accuracy was assessed in the two subgroups by comparing for each case the patient's most frequent defensive level with the most frequent defensive level addressed by the therapist when making defence interpretations. Results show that in high-alliance patient-therapist dyads, the therapists tend to address accurate or higher (more mature) defensive level than patients most frequent level. On the other hand, the therapists address lower (more immature) defensive level in low-alliance dyads. These results are discussed along with possible ways to better assess TAD accuracy.

  11. Surface imaging, portal imaging, and skin marker set-up vs. CBCT for radiotherapy of the thorax and pelvis

    Energy Technology Data Exchange (ETDEWEB)

    Pallotta, Stefania; Bucciolini, Marta [Universita degli Studi di Firenze, Dipartimento di Scienze Biomediche Sperimentali e Cliniche, Florence (Italy); AOU Careggi, Sezione di Fisica Medica, Florence (Italy); Vanzi, Eleonora; Marrazzo, Livia [AOU Careggi, Sezione di Fisica Medica, Florence (Italy); Simontacchi, Gabriele; Paiar, Fabiola [AOU Careggi, Sezione di Radioterapia, Florence (Italy); Ceroti, Marco [ISPO, U.O. Epidemiologia Molecolare e Nutrizionale, Florence (Italy); Livi, Lorenzo [Universita degli Studi di Firenze, Dipartimento di Scienze Biomediche Sperimentali e Cliniche, Florence (Italy); AOU Careggi, Sezione di Radioterapia, Florence (Italy)

    2015-09-15

    The aim of this study was to compare surface imaging, portal imaging, and skin marker set-up in radiotherapy of thoracic and pelvic regions, using cone beam computed tomography (CBCT) data as the gold standard. Twenty patients were included in this study. CBCT, surface acquisition (SA), and two orthogonal portal images (PI) were acquired during the first four treatment sessions. Patient set-up corrections, obtained by registering the planning CT with CBCT, were used as the gold standard. Registration results of the PI and SA were evaluated and compared with those obtained with CBCT. The advantage derived from using SA or PI verification systems over a skin marker set-up was also quantified. A statistically significant difference between PI and SA (in favour of PI) was observed in seven patients undergoing treatment of the pelvic region and in two patients undergoing treatment of the thoracic region. The use of SA or PI, compared with a skin marker set-up, improved patient positioning in 50% and 57 % of the thoracic fractions, respectively. For pelvic fractions, the use of PI was beneficial in 73 % of the cases, while the use of SA was beneficial in only 45 %. Patient positioning worsened with SA, particularly along longitudinal and vertical directions. PI yielded more accurate registration results than SA for both pelvic and thoracic fractions. Compared with the skin marker set-up, PI performances were superior to SA for pelvic fractions while comparable results were obtained for thoracic fractions. (orig.) [German] Ziel dieser Studie ist der Vergleich der Patientenpositionierung mittels der 3-D/4-D-Erfassung der Patientenoberflaeche durch ein Abtastsystem, kV/MV-Verifikationsaufnahmen mit Hochenergiebildsystemen und Markierungen auf der Haut bei Bestrahlungen im Thorax- bzw. Beckenbereich. Als Goldstandard zum Vergleich dienten CBCT(''cone beam computed tomography'')-Aufnahmen. Die Studie basiert auf Untersuchungen an 20 Patienten. Es wurden

  12. Diagnostic accuracy and treatment management of depression in elderly primary care patients.

    NARCIS (Netherlands)

    Volkers, A.C.; Nuyen, J.; Verhaak, P.F.M.; Schellevis, F.G.

    2003-01-01

    Background: The negative impact of major depression on the risk of somatic diseases, mortality and social functioning is prominent in elderly patients. Aim: We investigated how accurately general practitioners (GPs) diagnose depression in old age and if diagnostic accuracy is related to patient and

  13. A simple and convenient set-up for high-temperature Brillouin light scattering

    International Nuclear Information System (INIS)

    Guerette, Michael; Huang Liping

    2012-01-01

    An emulated platelet geometry (or reflection-induced platelet geometry) is employed to collect photons scattered from both longitudinal and transverse acoustic waves travelling within a bulk transparent sample sitting on a reflective Pt plate. Temperature of the sample was controlled with a Linkam TS1500 optical furnace (maximum temperature of 1500 °C). This simple and convenient set-up allows a full determination of elastic constants of transparent materials in situ as a function of temperature from Brillouin light scattering. Structural information can be gained at the same time by guiding the scattered light into a Raman spectrometer using a flipping mirror or a beam splitter. We will demonstrate the applications of this set-up in transparent inorganic glasses, but it can be easily extended to any other transparent materials, either crystalline or amorphous in nature. (paper)

  14. Development of a grinding-specific performance test set-up

    DEFF Research Database (Denmark)

    Olesen, C. G.; Larsen, B. H.; Andresen, E. L.

    2015-01-01

    The aim of this study was to develop a performance test set-up for America's Cup grinders. The test set-up had to mimic the on-boat grinding activity and be capable of collecting data for analysis and evaluation of grinding performance. This study included a literature-based analysis of grinding...... demands and a test protocol developed to accommodate the necessary physiological loads. This study resulted in a test protocol consisting of 10 intervals of 20 revolutions each interspersed with active resting periods of 50 s. The 20 revolutions are a combination of both forward and backward grinding...... and an exponentially rising resistance. A custom-made grinding ergometer was developed with computer-controlled resistance and capable of collecting data during the test. The data collected can be used to find measures of grinding performance such as peak power, time to complete and the decline in repeated grinding...

  15. Development of a grinding-specific performance test set-up.

    Science.gov (United States)

    Olesen, C G; Larsen, B H; Andresen, E L; de Zee, M

    2015-01-01

    The aim of this study was to develop a performance test set-up for America's Cup grinders. The test set-up had to mimic the on-boat grinding activity and be capable of collecting data for analysis and evaluation of grinding performance. This study included a literature-based analysis of grinding demands and a test protocol developed to accommodate the necessary physiological loads. This study resulted in a test protocol consisting of 10 intervals of 20 revolutions each interspersed with active resting periods of 50 s. The 20 revolutions are a combination of both forward and backward grinding and an exponentially rising resistance. A custom-made grinding ergometer was developed with computer-controlled resistance and capable of collecting data during the test. The data collected can be used to find measures of grinding performance such as peak power, time to complete and the decline in repeated grinding performance.

  16. Practical guidelines for setting up neurosurgery skills training cadaver laboratory in India.

    Science.gov (United States)

    Suri, Ashish; Roy, Tara Sankar; Lalwani, Sanjeev; Deo, Rama Chandra; Tripathi, Manjul; Dhingra, Renu; Bhardwaj, Daya Nand; Sharma, Bhawani Shankar

    2014-01-01

    Though the necessity of cadaver dissection is felt by the medical fraternity, and described as early as 600 BC, in India, there are no practical guidelines available in the world literature for setting up a basic cadaver dissection laboratory for neurosurgery skills training. Hands-on dissection practice on microscopic and endoscopic procedures is essential in technologically demanding modern neurosurgery training where ethical issues, cost constraints, medico-legal pitfalls, and resident duty time restrictions have resulted in lesser opportunities to learn. Collaboration of anatomy, forensic medicine, and neurosurgery is essential for development of a workflow of cadaver procurement, preservation, storage, dissection, and disposal along with setting up the guidelines for ethical and legal concerns.

  17. Act No. 15 of 22 April 1980 setting up the Nuclear Safety Council

    International Nuclear Information System (INIS)

    1980-01-01

    The Spanish authorities are in the process or reorganising the public nuclear sector in order to separate the promotional and research aspects of the uses of nuclear energy for peaceful purposes from the regulation and control of such activities. To this effect this Act sets up a Nuclear Safety Council which takes over part of the duties and the personnel of the Junta de Energia Nuclear provided for by the Act of 29th April 1964 on Nuclear Energy. The new Nuclear Safety Council is a body which is independent of the State central administration and has legal personality as well as its own financial resources required to carry out its duties. The latter comprise, inter alia, proposing to the Government the regulations required in matters of nuclear safety and radiation protection; this includes the setting-up of standards and criteria for the selection of nuclear installation sites, in consultation with the local competent bodies. (NEA) [fr

  18. Investigation on Superior Performance by Fractional Controller for Cart-Servo Laboratory Set-Up

    Directory of Open Access Journals (Sweden)

    Ameya Anil Kesarkar

    2014-01-01

    Full Text Available In this paper, an investigation is made on the superiority of fractional PID controller (PI^alpha D^beta over conventional PID for the cart-servo laboratory set-up. The designed controllers are optimum in the sense of Integral Absolute Error (IAE and Integral Square Error (ISE. The paper contributes in three aspects: 1 Acquiring nonlinear mathematical model for the cart-servo laboratory set-up, 2 Designing fractional and integer order PID for minimizing IAE, ISE, 3 Analyzing the performance of designed controllers for simulated plant model as well as real plant. The results show a significantly superior performance by PI^alpha D^beta as compared to the conventional PID controller.

  19. X-ray fluorescence (XRF) set-up with a low power X-ray tube

    International Nuclear Information System (INIS)

    Gupta, Sheenu; Deep, Kanan; Jain, Lalita; Ansari, M.A.; Mittal, Vijay Kumar; Mittal, Raj

    2010-01-01

    The X-ray fluorescence set-up with a 100 W X-ray tube comprises a computer controlled system developed for remote operation and monitoring of tube and an adjustable stable 3D arrangement to procure variable excitation energies with low scattered background. The system was tested at different filament currents/anode voltages. The MDL of the set-up at 0.05-1.00 mA/4-12 kV is found ∼(1-100) ppm for K and L excitations and ∼(200-700) ppm for M excitations of elements and improves with filament current and anode voltage. Moreover, L measurements for Sm and Eu at five K X-ray energies of elements(Z=29-40) and analytical determination in some synthetic samples were undertaken.

  20. Stereo particle image velocimetry set up for measurements in the wake of scaled wind turbines

    Science.gov (United States)

    Campanardi, Gabriele; Grassi, Donato; Zanotti, Alex; Nanos, Emmanouil M.; Campagnolo, Filippo; Croce, Alessandro; Bottasso, Carlo L.

    2017-08-01

    Stereo particle image velocimetry measurements were carried out in the boundary layer test section of Politecnico di Milano large wind tunnel to survey the wake of a scaled wind turbine model designed and developed by Technische Universität München. The stereo PIV instrumentation was set up to survey the three velocity components on cross-flow planes at different longitudinal locations. The area of investigation covered the entire extent of the wind turbines wake that was scanned by the use of two separate traversing systems for both the laser and the cameras. Such instrumentation set up enabled to gain rapidly high quality results suitable to characterise the behaviour of the flow field in the wake of the scaled wind turbine. This would be very useful for the evaluation of the performance of wind farm control methodologies based on wake redirection and for the validation of CFD tools.

  1. ECONOMIC EVALUATION OF A BREEDING PROGRAMME FOR SETTING UP TWO HIGH PERFORMANCES BEE LINES

    OpenAIRE

    POPESCU, A.; RADOI, C.

    2003-01-01

    This study aimed to evaluate costs, incomes and financial results related to the creation of two Apis Mellifica Carpatica lines, based on a specific Breeding Programme within a closed population. The two beelines have been carefully selected for the bee populations living in two areas of Romania: North Moldavia and South Muntenia. A new selection technology is set up in order to produce high performance queen bees, well adapted to the environmental conditions mainly to picking. Genetic gain w...

  2. Integration of micro milling highspeed spindle on a microEDM-milling machine set-up

    DEFF Research Database (Denmark)

    De Grave, Arnaud; Hansen, Hans Nørgaard; Andolfatto, Loic

    2009-01-01

    In order to cope with repositioning errors and to combine the fast removal rate of micro milling with the precision and small feature size achievable with micro EDM milling, a hybrid micro-milling and micro-EDM milling centre was built and tested. The aim was to build an affordable set-up, easy...... by micro milling. Examples of test parts are shown and used as an experimental validation....

  3. Set up of a method for the adjustment of resonance parameters on integral experiments

    International Nuclear Information System (INIS)

    Blaise, P.

    1996-01-01

    Resonance parameters for actinides play a significant role in the neutronic characteristics of all reactor types. All the major integral parameters strongly depend on the nuclear data of the isotopes in the resonance-energy regions.The author sets up a method for the adjustment of resonance parameters taking into account the self-shielding effects and restricting the cross section deconvolution problem to a limited energy region. (N.T.)

  4. Coincidence set-up with a high duty-cycle, high energy electron accelerator

    International Nuclear Information System (INIS)

    Leconte, P.

    1981-01-01

    Important studies are now undertaken to develop continuous wave electron accelerators with energy ranging from 1 to 4 Gev. So very important effort must be now put on the development of the experimental set-up matching the performances expected from the electron beam. Major steps in the understanding of the nuclear systems will come from more and more exclusive experiments where well defined mechanisms will be selected

  5. LS1 Report: A brand new set-up for ASACUSA-CUSP

    CERN Multimedia

    Antonella Del Rosso

    2014-01-01

    ASACUSA is running for the first time with a totally new set-up. Three new vital instruments have been designed, produced and installed during LS1 in addition to several other major modifications. The collaboration is now ready to perform the first high-precision measurement of the hyperfine structure of antihydrogen – a study that aims at comparing the inner properties of matter and antimatter.   The ASACUSA set-up. The ASACUSA-CUSP collaboration comprises about 30 scientists from various institutes in Europe and Japan. Because of the Japanese contribution, the experiment is often known by its Japanese pronunciation, the experiment’s logo is in Japanese, and the logbook uses Japanese time! This year, for the first time, the experiment is running with a completely new set-up, which now includes a new superconducting double cusp magnet, a new tracking detector and a new final antihydrogen detector. “The magnet is the heart of the ASACUSA experiment,” expl...

  6. Over-relaxation phenomena during the set-up of RFP plasmas

    International Nuclear Information System (INIS)

    Nordlund, P.; Mazur, S.

    1995-03-01

    Experiments on the Extrap T1 reversed field pinch have shown that the formation of the RFP configuration is quite sensitive to the relative programming of the toroidal field and ohmic heating circuits. In this paper, new measurements of the evolution of the current density profile and of the spectral structure of the fluctuations during the set-up phase of RFP plasmas in the T1 experiment are presented. These measurements improve the understanding of the role of different spectral components in the dynamics of RFP formation. Under unfavourable (slow) set-up conditions, comparatively high energy is accumulated in m = 1 internal kinks prior to reversal of the edge toroidal fields. At reversal, nonlinearly driven m = 0 modes trigger a rapid broadening of the m = 1 spectrum. This behaviour is associated with a violent suppression of the current density in the core leading to an over-relaxation of the discharge involving a hollowing of the parallel current density profile. The over-relaxation phenomenon increases the volt-second consumption and plasma/wall interaction during RFP set-up, and degrades the flat-top discharge performance. 15 refs, 5 figs, 1 tab

  7. Over-relaxation phenomena during the set-up of RFP plasmas

    Energy Technology Data Exchange (ETDEWEB)

    Nordlund, P.; Mazur, S.

    1995-03-01

    Experiments on the Extrap T1 reversed field pinch have shown that the formation of the RFP configuration is quite sensitive to the relative programming of the toroidal field and ohmic heating circuits. In this paper, new measurements of the evolution of the current density profile and of the spectral structure of the fluctuations during the set-up phase of RFP plasmas in the T1 experiment are presented. These measurements improve the understanding of the role of different spectral components in the dynamics of RFP formation. Under unfavourable (slow) set-up conditions, comparatively high energy is accumulated in m = 1 internal kinks prior to reversal of the edge toroidal fields. At reversal, nonlinearly driven m = 0 modes trigger a rapid broadening of the m = 1 spectrum. This behaviour is associated with a violent suppression of the current density in the core leading to an over-relaxation of the discharge involving a hollowing of the parallel current density profile. The over-relaxation phenomenon increases the volt-second consumption and plasma/wall interaction during RFP set-up, and degrades the flat-top discharge performance. 15 refs, 5 figs, 1 tab.

  8. Single ion hit detection set-up for the Zagreb ion microprobe

    Science.gov (United States)

    Smith, R. W.; Karlušić, M.; Jakšić, M.

    2012-04-01

    Irradiation of materials by heavy ions accelerated in MV tandem accelerators may lead to the production of latent ion tracks in many insulators and semiconductors. If irradiation is performed in a high resolution microprobe facility, ion tracks can be ordered by submicrometer positioning precision. However, full control of the ion track positioning can only be achieved by a reliable ion hit detection system that should provide a trigger signal irrespectively of the type and thickness of the material being irradiated. The most useful process that can be utilised for this purpose is emission of secondary electrons from the sample surface that follows the ion impact. The status report of the set-up presented here is based on the use of a channel electron multiplier (CEM) detector mounted on an interchangable sample holder that is inserted into the chamber in a close geometry along with the sample to be irradiated. The set-up has been tested at the Zagreb ion microprobe for different ions and energies, as well as different geometrical arrangements. For energies of heavy ions below 1 MeV/amu, results show that efficient (100%) control of ion impact can be achieved only for ions heavier than silicon. The successful use of the set-up is demonstrated by production of ordered single ion tracks in a polycarbonate film and by monitoring fluence during ion microbeam patterning of Foturan glass.

  9. Using a Robust Design Approach to Optimize Chair Set-up in Wheelchair Sport

    Directory of Open Access Journals (Sweden)

    David S. Haydon

    2018-02-01

    Full Text Available Optimisation of wheelchairs for court sports is currently a difficult and time-consuming process due to the broad range of impairments across athletes, difficulties in monitoring on-court performance, and the trade-off set-up that parameters have on key performance variables. A robust design approach to this problem can potentially reduce the amount of testing required, and therefore allow for individual on-court assessments. This study used orthogonal design with four set-up factors (seat height, depth, and angle, as well as tyre pressure at three levels (current, decreased, and increased for three elite wheelchair rugby players. Each player performed two maximal effort sprints from a stationary position in nine different set-ups, with this allowing for detailed analysis of each factor and level. Whilst statistical significance is difficult to obtain due to the small sample size, meaningful difference results aligning with previous research findings were identified and provide support for the use of this approach.

  10. Broadband short pulse measurement by autocorrelation with a sum-frequency generation set-up

    International Nuclear Information System (INIS)

    Glotin, F.; Jaroszynski, D.; Marcouille, O.

    1995-01-01

    Previous spectral and laser pulse length measurements carried out on the CLIO FEL at wavelength λ=8.5 μm suggested that very short light pulses could be generated, about 500 fs wide (FWHM). For these measurements a Michelson interferometer with a Te crystal, as a non-linear detector, was used as a second order autocorrelation device. More recent measurements in similar conditions have confirmed that the laser pulses observed are indeed single: they are not followed by other pulses distant by the slippage length Nλ. As the single micropulse length is likely to depend on the slippage, more measurements at different wavelengths would be useful. This is not directly possible with our actual interferometer set-up, based on a phase-matched non-linear crystal. However, we can use the broadband non-linear medium provided by one of our users' experiments: Sum-Frequency Generation over surfaces. With such autocorrelation set-up, interference fringes are no more visible, but this is largely compensated by the frequency range provided. First tests at 8 μm have already been performed to validate the technic, leading to results similar to those obtained with our previous Michelson set-up

  11. Development of high pressure rinsing set up for 650 MHz, 5- cell superconducting RF cavity cleaning

    International Nuclear Information System (INIS)

    Suhane, S.K.; Chauhan, S.K.; Bose, A.; Kokil, S.V.; Rajput, D.S.; Oraon, B.; Md Hussain; Sahu, A.; Raghavendra, S.; Joshi, S.C.

    2015-01-01

    High pressure rinsing (HPR) is an ultra-cleanliness process for the surface preparation of high field superconducting RF cavities. Any dust particle or chemical residue on the interior of cavity causes field emission. Jets of high pressure (80-100 bar) ultra pure water dislodge surface contaminants that normally resist removal with conventional rinsing procedures, leading to substantial reduction in field emission and better cavity performance. For cleaning of 650 MHz, 5-cell SRF cavities, a high pressure rinsing set up has been developed at RRCAT. The HPR tool has a rotating wand coaxial with the vertically mounted SRF cavity that is moving up and down. Fan style spray nozzles are attached to the end of the rotating wand and the water jets emerging from spray nozzles scan the entire internal surface of the cavity. The set-up was installed in a specially built clean area meeting cleanliness class 100 standards. The ultrapure water with resistivity 2 ≥ 18 MΩ-cm required for rinsing is obtained from a dedicated water purification system installed for this purpose. The paper describes the salient design and constructional details of the high pressure rinsing set up. Characterization of water jet parameters based on the momentum transfer between the water jet and a load cell is also presented. (author)

  12. Robotic-based carbon ion therapy and patient positioning in 6 degrees of freedom: setup accuracy of two standard immobilization devices used in carbon ion therapy and IMRT.

    Science.gov (United States)

    Jensen, Alexandra D; Winter, Marcus; Kuhn, Sabine P; Debus, Jürgen; Nairz, Olaf; Münter, Marc W

    2012-03-29

    To investigate repositioning accuracy in particle radiotherapy in 6 degrees of freedom (DOF) and intensity-modulated radiotherapy (IMRT, 3 DOF) for two immobilization devices (Scotchcast masks vs thermoplastic head masks) currently in use at our institution for fractionated radiation therapy in head and neck cancer patients. Position verifications in patients treated with carbon ion therapy and IMRT for head and neck malignancies were evaluated. Most patients received combined treatment regimen (IMRT plus carbon ion boost), immobilization was achieved with either Scotchcast or thermoplastic head masks. Position corrections in robotic-based carbon ion therapy allowing 6 DOF were compared to IMRT allowing corrections in 3 DOF for two standard immobilization devices. In total, 838 set-up controls of 38 patients were analyzed. Robotic-based position correction including correction of rotations was well tolerated and without discomfort. Standard deviations of translational components were between 0.5 and 0.8 mm for Scotchcast and 0.7 and 1.3 mm for thermoplastic masks in 6 DOF and 1.2-1.4 mm and 1.0-1.1 mm in 3 DOF respectively. Mean overall displacement vectors were between 2.1 mm (Scotchcast) and 2.9 mm (thermoplastic masks) in 6 DOF and 3.9-3.0 mm in 3 DOF respectively. Displacement vectors were lower when correction in 6 DOF was allowed as opposed to 3 DOF only, which was maintained at the traditional action level of >3 mm for position correction in the pre-on-board imaging era. Setup accuracy for both systems was within the expected range. Smaller shifts were required when 6 DOF were available for correction as opposed to 3 DOF. Where highest possible positioning accuracy is required, frequent image guidance is mandatory to achieve best possible plan delivery and maintenance of sharp gradients and optimal normal tissue sparing inherent in carbon ion therapy.

  13. Accuracy of rockall score for in hospital re bleeding among cirrhotic patients with variceal bleed

    International Nuclear Information System (INIS)

    Asgher, S.; Saleem, M.K.

    2015-01-01

    To assess the diagnostic accuracy of Roc kall scoring system for predicting in-hospital re-ble- eding in cirrhotic patients presenting with variceal bleed. Material and Methods: This descriptive case series study was conducted at Department of Medicine Combined Military Hospital Lahore from December 2013 to May 2014. We included patients with liver cirrhosis who presented with upper GI bleeding and showed varices as the cause of bleeding on endoscopy. Clinical and endoscopic features were noted to calculate Rockall score. Patients with score < 2 and > 8 were included. After treating with appropriate pharmacological and endoscopic therapy, patients were followed for re-bleeding for 10 days. Diagnostic accuracy was assessed by calculating sensitivity, specificity, positive and negative predictive values using 2 x 2 tables. Results: In the study, 175 patients were included. Mean age was 51.5 ± 1.22 years. Male to female ratio was 1.5 to 1.0 out of 175 patients, 157 patients (89.7%) were of low risk group (score = 2) while 18 patients (10.3%) were in high risk group (score > 8). In low risk group, re-bleeding occurred only in 2 patients (1.2%) while in high risk group, re-bleeding occurred in 14 patients (78%). Rockall score was found to have good diagnostic accuracy with sensitivity of 87.5%, specificity of 97.48%, positive predictive value of 77.8% and negative predictive value of 98.7%. Conclusion: In cases of variceal bleed, frequency of re-bleed is less in patients who are in low risk category with lower Rockall score and high in high risk patients with higher rockall score. The Rockall score has a good diagnostic accuracy in prediction of re-bleed in variceal bleeding. (author)

  14. Minimum standard guidelines of care on requirements for setting up a laser room

    Directory of Open Access Journals (Sweden)

    Dhepe Niteen

    2009-08-01

    Full Text Available Introduction, definition, rationale and scope: Lasers are now becoming an integral part of dermatological practice in India, with more and more dermatologists starting laser dermatology practice. Lasers, when are used with care, by properly trained operators, in carefully designed environment, can deliver a range of useful aesthetic and dermatologic treatments. Facility: Laser treatment is an office procedure, hence it does not require hospital set-up. The laser room facility requires careful planning keeping in mind safety of both patient and operator, convenience of operating, and optimum handling of costly equipments. The facility should be designed to handle procedures under local anesthesia and sedation. Facilities, staff and equipment to handle any emergencies should be available. Location: A room in existing dermatology clinic can be adequately converted to a laser room. Dimensions of laser room, its door and patient′s table should be such that it should facilitate easy movement of patient, machine trolley, operator and assistant in case of routine procedures and in emergency. Physician Qualification: Any dermatologist with MD or diploma in dermatology can do laser procedures, provided he/ she has acquired necessary skills by virtue of training, observing a competent dermatologist. Such training may be obtained during post graduation or later in specified workshops or courses under a competent dermatologist or at centre which routinely performs such procedures. Electricity and uninterrupted power supply: Laser equipments should be connected to stabilizer or UPS circuits only. Preferably an on line UPS as recommended by the laser company should be installed. Earthing of the equipment is essential to avoid damage to the equipment and electrical shocks to the operator. Sufficient power back up to complete the procedure if power is off midway, is essential. Air-conditioning: Laser machines should be operated in low ambient temperature, with

  15. ECONOMIC EVALUATION OF A BREEDING PROGRAMME FOR SETTING UP TWO HIGH PERFORMANCES BEE LINES

    Directory of Open Access Journals (Sweden)

    A POPESCU

    2003-10-01

    Full Text Available This study aimed to evaluate costs, incomes and financial results related to the creation of two Apis Mellifica Carpatica lines, based on a specific Breeding Programme within a closed population. The two beelines have been carefully selected for the bee populations living in two areas of Romania: North Moldavia and South Muntenia. A new selection technology is set up in order to produce high performance queen bees, well adapted to the environmental conditions mainly to picking. Genetic gain will be get by selling the mated selected queens belonging to the two lines to various beekeepers interested to obtain more and high quality bee products.

  16. A user-friendly technical set-up for infrared photography of forensic findings.

    Science.gov (United States)

    Rost, Thomas; Kalberer, Nicole; Scheurer, Eva

    2017-09-01

    Infrared photography is interesting for a use in forensic science and forensic medicine since it reveals findings that normally are almost invisible to the human eye. Originally, infrared photography has been made possible by the placement of an infrared light transmission filter screwed in front of the camera objective lens. However, this set-up is associated with many drawbacks such as the loss of the autofocus function, the need of an external infrared source, and long exposure times which make the use of a tripod necessary. These limitations prevented up to now the routine application of infrared photography in forensics. In this study the use of a professional modification inside the digital camera body was evaluated regarding camera handling and image quality. This permanent modification consisted of the replacement of the in-built infrared blocking filter by an infrared transmission filter of 700nm and 830nm, respectively. The application of this camera set-up for the photo-documentation of forensically relevant post-mortem findings was investigated in examples of trace evidence such as gunshot residues on the skin, in external findings, e.g. hematomas, as well as in an exemplary internal finding, i.e., Wischnewski spots in a putrefied stomach. The application of scattered light created by indirect flashlight yielded a more uniform illumination of the object, and the use of the 700nm filter resulted in better pictures than the 830nm filter. Compared to pictures taken under visible light, infrared photographs generally yielded better contrast. This allowed for discerning more details and revealed findings which were not visible otherwise, such as imprints on a fabric and tattoos in mummified skin. The permanent modification of a digital camera by building in a 700nm infrared transmission filter resulted in a user-friendly and efficient set-up which qualified for the use in daily forensic routine. Main advantages were a clear picture in the viewfinder, an auto

  17. Initial verification of an induction heating set-up for injection molding

    DEFF Research Database (Denmark)

    Menotti, Stefano; Hansen, Hans Nørgaard; Bissacco, Giuliano

    2013-01-01

    Molding of thin and long parts by injection molding leads to special requirements for the mold in order to ensure proper filling and acceptable cycle time. This paper investigates the applicability of embedded induction heating for the improvement of the filling of thin long parts. The object...... selected for the investigation is a thin spiral. For the complete molding of the component, elevated mold temperatures are required. For this propose a new injection molding set-up was developed, which allows rapid heating of the cavity wall by an induction heating system. The temperature was measured...

  18. Royal Order of 12 December 1975 setting up a National Energy Committee

    International Nuclear Information System (INIS)

    1978-01-01

    The National Energy Committee was set up by Royal Order of 12 December 1975. Its duties are to advise on the general objectives of energy policy and its implementation. It supervises execution of the policy and makes recommendations on matters within its competence. The Committee is chaired by the Minister for Economic Affairs and Energy and is composed of representatives of the Government, trade unions, undertakings, consumers, gas and electricity committees, oil and coal industries and a delegate of the Planning Department. This Order repeals the Order of 17 July 1957 creating an Energy Advisory Council. (NEA) [fr

  19. Experimental set-up for advanced aeroelastic tests on sectional models

    Czech Academy of Sciences Publication Activity Database

    Král, Radomil; Pospíšil, Stanislav; Náprstek, Jiří

    2016-01-01

    Roč. 40, č. 1 (2016), s. 3-13 ISSN 0732-8818 R&D Projects: GA ČR GA103/09/0094; GA AV ČR IAA200710902; GA MŠk(CZ) ED1.1.00/02.0060 Institutional support: RVO:68378297 Keywords : bridge aeroelasticity * wind tunnel * experimental set-up * non- linear response Subject RIV: JM - Building Engineering Impact factor: 0.932, year: 2016 http://link.springer.com/article/10.1007%2Fs40799-015-0004-6

  20. 29 July 1991-Royal Order setting up a Higher Institute for Emergency Planning

    International Nuclear Information System (INIS)

    1991-01-01

    This Institute was set up in accordance with national legislation on protection against major industrial risks and Directive 89/618 Euratom on informing the general public about health protection measures to be applied and steps to be taken in the event of a radiological emergency. The Institute's duties include: organizing training for emergency planning and assistance; promoting the exchange of ideas on emergency planning between the authorities and operators of installations which could generate major risks, including nuclear installations; and disseminating adequate and regularly updated information to persons involved in emergency assistance on the risks they incur and the protection measures to be taken. (NEA)

  1. Application of activation methods on the Dubna experimental transmutation set-ups.

    Science.gov (United States)

    Stoulos, S; Fragopoulou, M; Adloff, J C; Debeauvais, M; Brandt, R; Westmeier, W; Krivopustov, M; Sosnin, A; Papastefanou, C; Zamani, M; Manolopoulou, M

    2003-02-01

    High spallation neutron fluxes were produced by irradiating massive heavy targets with proton beams in the GeV range. The experiments were performed at the Dubna High Energy Laboratory using the nuclotron accelerator. Two different experimental set-ups were used to produce neutron spectra convenient for transmutation of radioactive waste by (n,x) reactions. By a theoretical analysis neutron spectra can be reproduced from activation measurements. Thermal-epithermal and fast-super-fast neutron fluxes were estimated using the 197Au, 238U (n,gamma) and (n,2n) reactions, respectively. Depleted uranium transmutation rates were also studied in both experiments.

  2. Setting-up of a direct reading emission spectrometer and its adaptation for plutonium handling

    International Nuclear Information System (INIS)

    Page, A.G.; Godbole, S.V.; Kulkarni, M.J.; Porwal, N.K.; Thulasidas, S.K.; Sastry, M.D.; Srinivasan, P.S.

    1986-01-01

    A Jarrell-Ash 750 AtomComp 1100 series direct reading emission spectrometer was set up and its performance features were checked with regard to analysis of uranium-based samples using d.c. arc/inductively coupled argon plasma excitation techniques. The instrument has been subsequently modified to enable handling of plutonium-based samples. The modifications include building up of a specially designed glove-box around the excitation sources and consequent changes in the electro-mechanical controls associated with them. The modified system was extensively used for the trace metal assay of FBTR fuel sample. (author)

  3. Setting up Information Literacy Workshops in School Libraries: Imperatives, Principles and Methods

    Directory of Open Access Journals (Sweden)

    Reza Mokhtarpour

    2010-09-01

    Full Text Available While many professional literature have talked at length about the importance of dealing with information literacy in school libraries in ICT dominated era, but few have dealt with the nature and mode of implementation nor offered a road map. The strategy emphasized in this paper is to hold information literacy sessions through effective workshops. While explaining the reasons behind such workshops being essential in enhancing information literacy skills, the most important principles and stages for setting up of such workshops are offered in a step-by-step manner.

  4. Feasibility for the setting up of a multipurpose food irradiation facility in Senegal

    International Nuclear Information System (INIS)

    Diop, Y.; Marchioni, E.; Hasswlmann, C.; Ba, D.; Kuntz, F.

    2002-01-01

    The setting up of a cobalt-60 (activity 500 kCi) irradiation facility in the highest populated region of Senegal (Dakar district) to treat a wide range of foodstuffs for local consumption (millet/sorghum, rice, maize, cowpeas, potatoes, onions, mangoes, citrus fruits and dried fishes) is considered as profitable for a private investor or a Senegalese food producer (or trader), provided the tonnage of foodstuffs treated is adequate, more than 22,000 t·kGy, i.e. a total tonnage above 77,000 t, taking into account the irradiation doses used for the various foodstuffs. (author)

  5. Dr Google: The readability and accuracy of patient education websites for Graves' disease treatment.

    Science.gov (United States)

    Purdy, Amanda C; Idriss, Almoatazbellah; Ahern, Susan; Lin, Elizabeth; Elfenbein, Dawn M

    2017-11-01

    National guidelines emphasize the importance of incorporating patient preferences into the recommendations for the treatment of Graves' disease. Many patients use the Internet to obtain health information, and search results can affect their treatment decisions. This study compares the readability and accuracy of patient-oriented online resources for the treatment of Graves' disease by website affiliation and treatment modality. A systematic Internet search was used to identify the top websites discussing the treatment of Graves' disease. Readability was measured using 5 standardized tests. Accuracy was assessed by a blinded, expert panel, which scored the accuracy of sites on a scale of 1 to 5. Mean readability and accuracy scores were compared among website affiliations and treatment modalities. We identified 13 unique websites, including 2 academic, 2 government, 5 nonprofit, and 4 private sites. There was a difference in both readability (mean 13.2, range 9.1-15.7, P = .003) and accuracy (mean 4.04, range 2.75-4.50, P = .019) based on website affiliation. Government sites (mean readability 11.1) were easier to read than academic (14.3, P < .01), nonprofit (13.9, P < .01), and private sites (13.5, P < .05). Academic sites (mean accuracy 4.50) were more accurate than private sites (3.56, P < .05). Online patient resources for the treatment of Graves' disease are written at an inappropriately high reading level. Academic sites contain both the most accurate and the most difficult to read information. Private sites represented the majority of our top results but contained the least accurate information. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Diagnostic accuracy of high-definition CT coronary angiography in high-risk patients

    International Nuclear Information System (INIS)

    Iyengar, S.S.; Morgan-Hughes, G.; Ukoumunne, O.; Clayton, B.; Davies, E.J.; Nikolaou, V.; Hyde, C.J.; Shore, A.C.; Roobottom, C.A.

    2016-01-01

    Aim: To assess the diagnostic accuracy of computed tomography coronary angiography (CTCA) using a combination of high-definition CT (HD-CTCA) and high level of reader experience, with invasive coronary angiography (ICA) as the reference standard, in high-risk patients for the investigation of coronary artery disease (CAD). Materials and methods: Three hundred high-risk patients underwent HD-CTCA and ICA. Independent experts evaluated the images for the presence of significant CAD, defined primarily as the presence of moderate (≥50%) stenosis and secondarily as the presence of severe (≥70%) stenosis in at least one coronary segment, in a blinded fashion. HD-CTCA was compared to ICA as the reference standard. Results: No patients were excluded. Two hundred and six patients (69%) had moderate and 178 (59%) had severe stenosis in at least one vessel at ICA. The sensitivity, specificity, positive predictive value, and negative predictive value were 97.1%, 97.9%, 99% and 93.9% for moderate stenosis, and 98.9%, 93.4%, 95.7% and 98.3%, for severe stenosis, on a per-patient basis. Conclusion: The combination of HD-CTCA and experienced readers applied to a high-risk population, results in high diagnostic accuracy comparable to ICA. Modern generation CT systems in experienced hands might be considered for an expanded role. - Highlights: • Diagnostic accuracy of High-Definition CT Angiography (HD-CTCA) has been assessed. • Invasive Coronary angiography (ICA) is the reference standard. • Diagnostic accuracy of HD-CTCA is comparable to ICA. • Diagnostic accuracy is not affected by coronary calcium or stents. • HD-CTCA provides a non-invasive alternative in high-risk patients.

  7. Subjective evaluation of the accuracy of video imaging prediction following orthognathic surgery in Chinese patients

    NARCIS (Netherlands)

    Chew, Ming Tak; Koh, Chay Hui; Sandham, John; Wong, Hwee Bee

    Purpose: The aims of this retrospective study were to assess the subjective accuracy of predictions generated by a computer imaging software in Chinese patients who had undergone orthognathic surgery and to determine the influence of initial dysgnathia and complexity of the surgical procedure on

  8. Accuracy of three automated 25-hydroxyvitamin D assays in hemodialysis patients

    NARCIS (Netherlands)

    Depreter, B.; Heijboer, A.C.; Langlois, M.R.

    2013-01-01

    Introduction: We evaluated the accuracy of three automated assays for 25(OH)D measurement in comparison to ID-XLC-MS/MS in hemodialysis patients, considering the importance of their vitamin D status and reported discrepant results obtained with automated assays. Methods: All three assays were

  9. Diagnostic accuracy of computed tomography using lower doses of radiation for patients with Crohn's disease.

    LENUS (Irish Health Repository)

    Craig, Orla

    2012-08-01

    Magnetic resonance and ultrasonography have increasing roles in the initial diagnosis of Crohn\\'s disease, but computed tomography (CT) with positive oral contrast agents is most frequently used to identify those with acute extramural complications. However, CT involves exposure of patients to radiation. We prospectively compared the diagnostic accuracy of low-dose CT (at a dose comparable to that used to obtain an abdominal radiograph) with conventional-dose CT in patients with active Crohn\\'s disease.

  10. Monitoring electro-magnetic field in urban areas: new set-ups and results

    International Nuclear Information System (INIS)

    Lubritto, C.; Petraglia, A.; Paribello, G.; Formosi, R.; Rosa, M. de; Vetromile, C.; Palmieri, A.; D'Onofrio, A.; Di Bella, G.; Giannini, V.

    2006-01-01

    In this paper two different set-ups for continuous monitoring of electromagnetic levels are presented: the first one (Continuous Time E.M.F. Monitoring System) is based upon a network of fixed stations, allowing a detailed field monitoring as function of the time; the second one (Mobile Measurements Units) resorts to portable stations mounted on standard bicycles, allowing a positional screening in limited time intervals. For both set-ups a particular attention has been paid to the data management, by means of tools like web geographic information systems (Web-Gis). Moreover the V.I.C.R.E.M./E.L.F. software has been used for a predictive analysis of the electromagnetic field levels along with the geo referenced data coming from the field measurements. Starting from these results it has been realized that there is a need for an efficient and correct action of monitoring and information/formation in this domain, where dis-information or bad information is very often spread in the population, in particular in a field where the process of the appreciation and assessment of risk does not necessarily make use of a rationale, technically-informed procedure, but the judgement is rather based on a personal feeling, which may derive from a limited, unstructured set of information, using a set of qualitative attributes rather than a quantity. (N.C.)

  11. Test set up description and performances for HAWAII-2RG detector characterization at ESTEC

    Science.gov (United States)

    Crouzet, P.-E.; ter Haar, J.; de Wit, F.; Beaufort, T.; Butler, B.; Smit, H.; van der Luijt, C.; Martin, D.

    2012-07-01

    In the frame work of the European Space Agency's Cosmic Vision program, the Euclid mission has the objective to map the geometry of the Dark Universe. Galaxies and clusters of galaxies will be observed in the visible and near-infrared wavelengths by an imaging and spectroscopic channel. For the Near Infrared Spectrometer instrument (NISP), the state-of-the-art HAWAII-2RG detectors will be used, associated with the SIDECAR ASIC readout electronic which will perform the image frame acquisitions. To characterize and validate the performance of these detectors, a test bench has been designed, tested and validated. This publication describes the pre-tests performed to build the set up dedicated to dark current measurements and tests requiring reasonably uniform light levels (such as for conversion gain measurements). Successful cryogenic and vacuum tests on commercial LEDs and photodiodes are shown. An optimized feed through in stainless steel with a V-groove to pot the flex cable connecting the SIDECAR ASIC to the room temperature board (JADE2) has been designed and tested. The test set up for quantum efficiency measurements consisting of a lamp, a monochromator, an integrating sphere and set of cold filters, and which is currently under construction will ensure a uniform illumination across the detector with variations lower than 2%. A dedicated spot projector for intra-pixel measurements has been designed and built to reach a spot diameter of 5 μm at 920nm with 2nm of bandwidth [1].

  12. Sensor set-up for wireless measurement of automotive rim and wheel parameters in laboratory conditions

    Science.gov (United States)

    Borecki, M.; Prus, P.; Korwin-Pawlowski, M. L.; Rychlik, A.; Kozubel, W.

    2017-08-01

    Modern rims and wheels are tested at the design and production stages. Tests can be performed in laboratory conditions and on the ride. In the laboratory, complex and costly equipment is used, as for example wheel balancers and impact testers. Modern wheel balancers are equipped with electronic and electro-mechanical units that enable touch-less measurement of dimensions, including precision measurement of radial and lateral wheel run-out, automatic positioning and application of the counterweights, and vehicle wheel set monitoring - tread wear, drift angles and run-out unbalance. Those tests are performed by on-wheel axis measurements with laser distance meters. The impact tester enables dropping of weights from a defined height onto a wheel. Test criteria are the loss of pressure of the tire and generation of cracks in the wheel without direct impact of the falling weights. In the present paper, a set up composed of three accelerometers, a temperature sensor and a pressure sensor is examined as the base of a wheel tester. The sensor set-up configuration, on-line diagnostic and signal transmission are discussed.

  13. Contribution to the development of the multidetector AMPHORA. Design of the electronic set up

    International Nuclear Information System (INIS)

    Stassi, P.

    1989-01-01

    The multidetector AMPHORA has been designed and built to be used to detect and identify all the particles produced in intermediate energy heavy ion reactions. This installation consist of 140 detectors built with CsI(TI) + NE102A and CsI(TI) + NE213 scintillators, covering nearly 81% of the solid angle around the target. These detectors can identify light charged particles, intermediate mass fragments and neutrons. The electronic set up associated is compact and requires little manual adjustment. It is built with special CAMAC modules which have the folowing functions: A 4 channel constant fraction discriminator and gate generator, a 16 channel charge to digital converter (12 bits), a 8 channel time to digital converter (12 bits), a 16 channel pile-up detector and a fast decision module. This thesis contains a detailed explanation of the principle and operation of the set up. It also contains a part which describes the way to connect all the modules of the electronic configuration for AMPHORA [fr

  14. Monitoring electro-magnetic field in urban areas: new set-ups and results

    Energy Technology Data Exchange (ETDEWEB)

    Lubritto, C.; Petraglia, A.; Paribello, G.; Formosi, R.; Rosa, M. de; Vetromile, C.; Palmieri, A.; D' Onofrio, A. [Seconda Universita di Napoli, Dipt. di Scienze Ambientali, Caserta (Italy); Di Bella, G.; Giannini, V. [Vector Group, Roma (Italy)

    2006-07-01

    In this paper two different set-ups for continuous monitoring of electromagnetic levels are presented: the first one (Continuous Time E.M.F. Monitoring System) is based upon a network of fixed stations, allowing a detailed field monitoring as function of the time; the second one (Mobile Measurements Units) resorts to portable stations mounted on standard bicycles, allowing a positional screening in limited time intervals. For both set-ups a particular attention has been paid to the data management, by means of tools like web geographic information systems (Web-Gis). Moreover the V.I.C.R.E.M./E.L.F. software has been used for a predictive analysis of the electromagnetic field levels along with the geo referenced data coming from the field measurements. Starting from these results it has been realized that there is a need for an efficient and correct action of monitoring and information/formation in this domain, where dis-information or bad information is very often spread in the population, in particular in a field where the process of the appreciation and assessment of risk does not necessarily make use of a rationale, technically-informed procedure, but the judgement is rather based on a personal feeling, which may derive from a limited, unstructured set of information, using a set of qualitative attributes rather than a quantity. (N.C.)

  15. Set Up of an Automatic Water Quality Sampling System in Irrigation Agriculture

    Directory of Open Access Journals (Sweden)

    Emanuel Heinz

    2013-12-01

    Full Text Available We have developed a high-resolution automatic sampling system for continuous in situ measurements of stable water isotopic composition and nitrogen solutes along with hydrological information. The system facilitates concurrent monitoring of a large number of water and nutrient fluxes (ground, surface, irrigation and rain water in irrigated agriculture. For this purpose we couple an automatic sampling system with a Wavelength-Scanned Cavity Ring Down Spectrometry System (WS-CRDS for stable water isotope analysis (δ2H and δ18O, a reagentless hyperspectral UV photometer (ProPS for monitoring nitrate content and various water level sensors for hydrometric information. The automatic sampling system consists of different sampling stations equipped with pumps, a switch cabinet for valve and pump control and a computer operating the system. The complete system is operated via internet-based control software, allowing supervision from nearly anywhere. The system is currently set up at the International Rice Research Institute (Los Baños, The Philippines in a diversified rice growing system to continuously monitor water and nutrient fluxes. Here we present the system’s technical set-up and provide initial proof-of-concept with results for the isotopic composition of different water sources and nitrate values from the 2012 dry season.

  16. Set-up and Test Procedure for Suction Installation and Uninstallation of Bucket Foundation

    DEFF Research Database (Denmark)

    Koteras, Aleksandra Katarzyna

    This technical report describes the set-up and the test procedures for installation and uninstallation of medium-scale model of bucket foundation that can be performed in the geotechnical part of laboratory in Aalborg University. The installation of bucket foundation can be tested with the use of......) and loading frame used for those tests have been already used for axially static and cyclic loading of piles (Thomassen, 2015a) and for axially static and cyclic loading of bucket foundation (Vaitkunaite et al., 2015).......This technical report describes the set-up and the test procedures for installation and uninstallation of medium-scale model of bucket foundation that can be performed in the geotechnical part of laboratory in Aalborg University. The installation of bucket foundation can be tested with the use...... of suction under the bucket lid or by applying additional force through the hydraulic piston, forcing the bucket to penetrate into the soil. Tests for uninstallation are performed also with the use of water pressure, as a reverse process to the suction installation. Both installation and uninstallation tests...

  17. CHALLENGES IN SETTING UP QUALITY CONTROL IN DIAGNOSTIC RADIOLOGY FACILITIES IN NIGERIA.

    Science.gov (United States)

    Inyang, S O; Egbe, N O; Ekpo, E

    2015-01-01

    The Nigerian Nuclear Regulatory Authority (NNRA) was established to regulate and control the use of radioactive and radiation emitting sources in Nigeria. Quality control (QC) on diagnostic radiology equipment form part of the fundamental requirements for the authorization of diagnostic radiology facilities in the Country. Some quality control tests (output, exposure linearity and reproducibility) were measured on the x-ray machines in the facilities that took part in the study. Questionnaire was developed to evaluate the frequencies at which QC tests were conducted in the facilities and the challenges in setting up QC. Results show great variation in the values of the QC parameters measured. Inadequate cooperation by facilities management, lack of QC equipment and insufficient staff form the major challenges in setting up QC in the facilities under study. The responses on the frequencies at which QC tests should be conducted did not correspond to the recommended standards; indicating that personnel were not familiar with QC implementation and may require further training on QC.

  18. Ebola 2014: Setting up a port health screening programme at an international train station.

    Science.gov (United States)

    Cleary, Vivien; Wynne-Evans, Edward; Freed, James; Fleet, Katie; Thorn, Simone; Turbitt, Deborah

    2017-12-01

    An outbreak of Ebola virus disease (EVD) began in Guinea in December 2013 and was declared a Public Health Emergency of International Concern by the World Health Organization in August 2014. In October, the UK government tasked Public Health England (PHE) to set up EVD screening at key ports. The key aim of port-of-entry screening was to identify passengers coming from areas with high risk of EVD, and give them advice to raise their awareness of symptoms and what actions to take. Direct flights from Sierra Leone, Guinea or Liberia had all been cancelled, so intelligence on passenger numbers and routes was used to identify the most commonly used routes from the affected countries into the UK. One of these was St Pancras International train station. Screening had never previously been implemented at a UK train station so had to be set up from scratch. Key to the success of this was excellent multi-agency working between PHE, the UK Border Force, Eurostar, Network Rail and the Cabinet Office. This paper gives an overview of the activation of EVD screening at St Pancras International and the subsequent decommissioning.

  19. Diagnosis and outcome of birth asphyxia in resource constrained health care set up

    International Nuclear Information System (INIS)

    Zaman, S.; Shah, S.A.; Mehmood, S.; Shahzad, S.; Munir, M.; Mushtaq, A.

    2017-01-01

    Objective: To determine morbidity and mortality of neonates with low APGAR score in a resource constrained health care set up. Study Design: Prospective descriptive study. Place and Duration of Study: The study was carried out in combined military hospital Attock, from Jan 2013 to Jan 2015. Material and Methods: All term neonates with 37 completed weeks of gestation and APGAR score less than 7 were included in the study. APGAR score was calculated by an attending pediatrician, gynecologist or trained female nurse at 0 and 5 minutes. In Neonatal Intensive Care Unit [NICU] the babies were daily examined by pediatrician. Outcome was documented in term of morbidity i.e. fits and mortality i.e. death of babies. Results: Total number of neonates included in the study were 85 of which 55 (65%) were males and 30 (35%) were females. Of the total neonates 65 (76%) were discharged in satisfactory conditions and 20 (24%) expired during stay in the hospital. The mean APGAR score of newborns was 4.98 +- 0.98 at 5 minutes. During stay in hospital 46 (54%) were diagnosed to have hypoxic ischemic encephalopathy 2 (HIE2), those diagnosed with HIE3 were 5 (6%) and the rest 14 (16%) with HIE1. Conclusion: Low APGAR score is an important cause of admission to NICU. Low APGAR score was found associated with increased risk of fits in neonates and one of the most important cause of mortality in our set up. (author)

  20. Research of vibration resistance of non-rigid shafts turning with various technological set-ups

    Directory of Open Access Journals (Sweden)

    Vasilevykh Sergey L.

    2017-01-01

    Full Text Available The article considers the definition of the stability range of a dynamic system for turning non-rigid shafts with different technological set-ups: standard and developed ones; they are improved as a result of this research. The topicality of the study is due to the fact that processing such parts is associated with significant difficulties caused by deformation of the workpiece under the cutting force as well as occurrence of vibration of the part during processing, they are so intense and in practice they force to significantly reduce the cutting regime, recur to multiple-pass operation, lead to premature deterioration of the cutter, as a result, reduce the productivity of machining shafts on metal-cutting machines. In this connection, the purpose of the present research is to determine the boundaries of the stability regions with intensive turning of non-rigid shafts. In the article the basic theoretical principles of construction of a mathematical system focused on the process of non-free cutting of a dynamic machine are justified. By means of the developed mathematical model interrelations are established and legitimacies of influence of various technological set-ups on stability of the dynamic system of the machine-tool-device-tool-blank are revealed. The conducted researches allow to more objectively represent difficult processes that occur in a closed dynamic system of a machine.

  1. Diagnostic accuracy of surgeons and trainees in assessment of patients with acute abdominal pain.

    Science.gov (United States)

    2016-09-01

    Diagnostic accuracy in the assessment of patients with acute abdominal pain in the emergency ward is not adequate. It has been argued that this is because the investigations are carried out predominantly by a trainee. Resource utilization could be lowered if surgeons had a higher initial diagnostic accuracy. Patients with acute abdominal pain were included in a prospective cohort study. A surgical trainee and a surgeon made independent assessments in the emergency department, recording the clinical diagnosis and proposed diagnostic investigations. A reference standard diagnosis was established by an expert panel, and the proportion of correct diagnoses was calculated. Diagnostic accuracy was expressed in terms of sensitivity, specificity, positive predictive value and negative predictive value. Interobserver agreement for the diagnosis and elements of history-taking and physical examination were expressed by means of Cohen's κ. Certainty of diagnosis was recorded using a visual analogue scale. A trainee and a surgeon independently assessed 126 patients. Trainees made a correct diagnosis in 44·4 per cent of patients and surgeons in 42·9 per cent (P = 0·839). Surgeons, however, recorded a higher level of diagnostic certainty. Diagnostic accuracy was comparable in distinguishing urgent from non-urgent diagnoses, and for the most common diseases. Interobserver agreement for the clinical diagnosis varied from fair to moderate (κ = 0·28-0·57). The diagnostic accuracy of the initial clinical assessment is not improved when a surgeon rather than a surgical trainee assesses a patient with abdominal pain in the emergency department. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

  2. Setting up a hydrological model based on global data for the Ayeyarwady basin in Myanmar

    Science.gov (United States)

    ten Velden, Corine; Sloff, Kees; Nauta, Tjitte

    2017-04-01

    The use of global datasets in local hydrological modelling can be of great value. It opens up the possibility to include data for areas where local data is not or only sparsely available. In hydrological modelling the existence of both static physical data such as elevation and land use, and dynamic meteorological data such as precipitation and temperature, is essential for setting up a hydrological model, but often such data is difficult to obtain at the local level. For the Ayeyarwady catchment in Myanmar a distributed hydrological model (Wflow: https://github.com/openstreams/wflow) was set up with only global datasets, as part of a water resources study. Myanmar is an emerging economy, which has only recently become more receptive to foreign influences. It has a very limited hydrometeorological measurement network, with large spatial and temporal gaps, and data that are of uncertain quality and difficult to obtain. The hydrological model was thus set up based on resampled versions of the SRTM digital elevation model, the GlobCover land cover dataset and the HWSD soil dataset. Three global meteorological datasets were assessed and compared for use in the hydrological model: TRMM, WFDEI and MSWEP. The meteorological datasets were assessed based on their conformity with several precipitation station measurements, and the overall model performance was assessed by calculating the NSE and RVE based on discharge measurements of several gauging stations. The model was run for the period 1979-2012 on a daily time step, and the results show an acceptable applicability of the used global datasets in the hydrological model. The WFDEI forcing dataset gave the best results, with a NSE of 0.55 at the outlet of the model and a RVE of 8.5%, calculated over the calibration period 2006-2012. As a general trend the modelled discharge at the upstream stations tends to be underestimated, and at the downstream stations slightly overestimated. The quality of the discharge measurements

  3. Balancing dose and image registration accuracy for cone beam tomosynthesis (CBTS) for breast patient setup

    International Nuclear Information System (INIS)

    Winey, B. A.; Zygmanski, P.; Cormack, R. A.; Lyatskaya, Y.

    2010-01-01

    Purpose: To balance dose reduction and image registration accuracy in breast setup imaging. In particular, the authors demonstrate the relationship between scan angle and dose delivery for cone beam tomosynthesis (CBTS) when employed for setup verification of breast cancer patients with surgical clips. Methods: The dose measurements were performed in a female torso phantom for varying scan angles of CBTS. Setup accuracy was measured using three registration methods: Clip centroid localization accuracy and the accuracy of two semiautomatic registration algorithms. The dose to the organs outside of the ipsilateral breast and registration accuracy information were compared to determine the optimal scan angle for CBTS for breast patient setup verification. Isocenter positions at the center of the patient and at the breast-chest wall interface were considered. Results: Image registration accuracy was within 1 mm for the CBTS scan angles θ above 20 deg. for some scenarios and as large as 80 deg. for the worst case, depending on the imaged breast and registration algorithm. Registration accuracy was highest based on clip centroid localization. For left and right breast imaging with the isocenter at the chest wall, the dose to the contralateral side of the patient was very low (<0.5 cGy) for all scan angles considered. For central isocenter location, the optimal scan angles were 30 deg. - 50 deg. for the left breast imaging and 40 deg. - 50 deg. for the right breast imaging, with the difference due to the geometric asymmetry of the current clinical imaging system. Conclusions: The optimal scan angles for CBTS imaging were found to be between 10 deg. and 50 deg., depending on the isocenter location and ipsilateral breast. Use of the isocenter at the breast-chest wall locations always resulted in greater accuracy of image registration (<1 mm) at smaller angles (10 deg. - 20 deg.) and at lower doses (<0.1 cGy) to the contralateral organs. For chest wall isocenters, doses

  4. Diagnostic accuracy of dual energy CT angiography in patients with diabetes mellitus

    International Nuclear Information System (INIS)

    Schabel, C.; Bongers, M.N.; Syha, R.; Ketelsen, D.; Homann, G.; Notohamiprodjo, M.; Nikolaou, K.; Bamberg, F.; Thomas, C.

    2015-01-01

    Peripheral arterial disease (PAD) represents a major and highly prevalent complication in patients with diabetes mellitus. The diagnostic, non-invasive work-up by computed tomography angiography (CTA) is limited in the presence of extensive calcification. The aim of the study was to determine the diagnostic accuracy of dual energy CTA (DE-CTA) for the detection and characterization of PAD in patients with diabetes mellitus. In this study 30 diabetic patients with suspected or known PAD were retrospectively included in the analysis. All subjects underwent DE-CTA (Somatom Definition Flash, Siemens Healthcare, Erlangen, Germany) prior to invasive angiography, which served as the reference standard. Blinded analysis included assessment of the presence and degree of peripheral stenosis on curved multiplanar reformatting (MPR) and maximum intensity projections (MIP). Conventional measures of diagnostic accuracy were derived. Among the 30 subjects included in the analysis (83 % male, mean age 70.0 ± 10.5 years, 83 % diabetes type 2), the prevalence of critical stenosis in 331 evaluated vessel segments was high (30 %). Dual energy CT identified critical stenoses with a high sensitivity and good specificity using curved MPR (100 % and 93.1 %, respectively) and MIP images (99 % and 91.8 %, respectively). In stratified analysis, the diagnostic accuracy was higher for stenosis pertaining to the pelvic and thigh vessels as compared with the lower extremities (curved MPR accuracy 97.1 % vs. 99.2 vs. 90.9 %; respectively, p < 0.001). The use of DE-CTA allows reliable detection and characterization of peripheral arterial stenosis in patients with diabetes mellitus with higher accuracy in vessels in the pelvic and thigh regions compared with the vessels in the lower legs. (orig.) [de

  5. PENERAPAN METODE TUTOR SEBAYA UNTUK MENINGKATKAN KETERAMPILANPREPARE DANTABLE SET UP DALAM MATA KULIAH TATA HIDANG

    Directory of Open Access Journals (Sweden)

    Wahyuningsih Wahyuningsih

    2011-02-01

    Full Text Available This learning teching research was intended to improve the learning outcomes of the students practicing in the subject of prepare and table set up, the main subject of Tata Hidang I (Servicing Arragements I. The subject for this research consisted of 18 S1 students of the learning group number 02 for the study Program for PKK, concentrating on Tata Boga, Departement of Service & Production Technology, the Technical Faculty of Semarang State University for the academic period of 2009-2010. This research was conducted in the gasal semester of the academic year of 2009-2010. The needed data were collected by means of tests and obsevation on the learning outcomes of the students practicing in the sub-subject of Prepare and Table Set up. The data collection used grading sheets for practices in Tata Hidang as its instrument. The data were then analized using the method of descriptive presentation. This was a classroom-action research planned in three cycles. The second and third cycles were implemented based on reflections on the first cycle and on improvements that should be reached. Every cycle consisted of two face to face encounters and of 4 activities: (1planning, (2 implementations, (3 observations, (4 reflections. The results of this research showed that the use of peeer tutorials for the learning-teching pocesses had positive effects both on the students and the lecturers that it might improve the quality of lecturing for the Tata Hidang I. The grades obtained by the students from practicing in the sub-subject of prepare and table set up increased from the lowest grade C (46.7% BC and B (60% and AB (26.6 %, and AB (26.6%.. Trough the three cycles, the number of BC grade decreased from 66% to only 20%. Based on the results of this research, it is recommended that peer tutorial for the subject of Tata Hidang I and Servicing in Food & Beverage should be continued in order that the educational serveices provided to the practicing students might be

  6. Analysis of Regional Timelines To Set Up a Global Phase III Clinical Trial in Breast Cancer: the Adjuvant Lapatinib and/or Trastuzumab Treatment Optimization Experience

    OpenAIRE

    Metzger-Filho, Otto; Azambuja, Evandro de; Bradbury, Ian; Saini, Kamal S.; Bines, Jose; Simon, Sergio D. [UNIFESP; Van Dooren, Veerle; Aktan, Gursel; Pritchard, Kathleen I.; Wolff, Antonio C.; Smith, Ian; Jackisch, Christian; Lang, Istvan; Untch, Michael; Boyle, Frances

    2013-01-01

    Purpose. This study measured the time taken for setting up the different facets of Adjuvant Lapatinib and/or Trastuzumab Treatment Optimization (ALTTO), an international phase III study being conducted in 44 participating countries.Methods. Time to regulatory authority (RA) approval, time to ethics committee/institutional review board (EC/IRB) approval, time from study approval by EC/IRB to first randomized patient, and time from first to last randomized patient were prospectively collected i...

  7. In vivo dosimetry of high-dose fractionated irradiation in an experimental set-up with rats

    Energy Technology Data Exchange (ETDEWEB)

    Fortan, L; Van Hecke, H; Van Duyse, B; De Neve, W; De Meerleer, B [Ghent Rijksuniversiteit (Belgium). Kliniek voor Radiotherapie en Kerngeneeskunde; Pattyn, P; Van Renthergem, K [Ghent University (Belgium). Dept. of Surgery

    1995-12-01

    The feasibility to irradiate a limited section of a rat abdomen with well-defined edges was assessed. Because of the relative small volume involved, in vivo dosimetry with TLDs was necessary in providing us information about the accuracy of the irradiation method. Three to five days prior to the start of the radiotherapy treatment, two plastic strips - each containing a TLD-dosimeter (Harshaw TLD10 LiF rods, 1 mm dia x 6 mm) sealed in polyethylene tubing, and a lead bean - were implanted in the rat abdomen. The plastic strips made a closed loop around the bowel, through the mesenterium, and were fixed with a single stitch on the inner abdominal wall. One loop was made in the hepatic area; another was made in the lower abdomen, around the rectosigmoid. Conscious animals were irradiated using a purpose-build plexi-holder, with rear legs immobilised to avoid longitudinal movements. The implanted lead beans enabled us to simulate the rat prior to each radiation session. This way, the radiation field could be set up individually for each rat, in such way that the rectosigmoid area received full dose and the hepatic area received no irradiation dose at all. Irradiation was carried out, using 5 MV photons of a linear accelerator. Fifteen animals per group were irradiated according a conventional (2.0 Gy / fraction; 5 fractions / week) or a hyperfractionated (1.6 Gy / fraction; 2 daily fractions; 5 days / week) schedule, with different total doses. Prior to implantation, TLDs were individually calibrated and checked for stability. After removal from the abdomen . TLDs were tested again for accuracy. TLDs with an unacceptable read-out curve were rejected (about 2 to 4 TLDs per group of 15). The obtained accumulated doses - as determined by TLD read-outs-were comparable to the theoretical doses, indicating that fractionated radiation of small fields, with well defined mark off, in rats is feasible.

  8. In vivo dosimetry of high-dose fractionated irradiation in an experimental set-up with rats

    International Nuclear Information System (INIS)

    Fortan, L.; Van Hecke, H.; Van Duyse, B.; De Neve, W.; De Meerleer, B.; Pattyn, P.; Van Renthergem, K.

    1995-01-01

    The feasibility to irradiate a limited section of a rat abdomen with well-defined edges was assessed. Because of the relative small volume involved, in vivo dosimetry with TLDs was necessary in providing us information about the accuracy of the irradiation method. Three to five days prior to the start of the radiotherapy treatment, two plastic strips - each containing a TLD-dosimeter (Harshaw TLD10 LiF rods, 1 mm dia x 6 mm) sealed in polyethylene tubing, and a lead bean - were implanted in the rat abdomen. The plastic strips made a closed loop around the bowel, through the mesenterium, and were fixed with a single stitch on the inner abdominal wall. One loop was made in the hepatic area; another was made in the lower abdomen, around the rectosigmoid. Conscious animals were irradiated using a purpose-build plexi-holder, with rear legs immobilised to avoid longitudinal movements. The implanted lead beans enabled us to simulate the rat prior to each radiation session. This way, the radiation field could be set up individually for each rat, in such way that the rectosigmoid area received full dose and the hepatic area received no irradiation dose at all. Irradiation was carried out, using 5 MV photons of a linear accelerator. Fifteen animals per group were irradiated according a conventional (2.0 Gy / fraction; 5 fractions / week) or a hyperfractionated (1.6 Gy / fraction; 2 daily fractions; 5 days / week) schedule, with different total doses. Prior to implantation, TLDs were individually calibrated and checked for stability. After removal from the abdomen . TLDs were tested again for accuracy. TLDs with an unacceptable read-out curve were rejected (about 2 to 4 TLDs per group of 15). The obtained accumulated doses - as determined by TLD read-outs-were comparable to the theoretical doses, indicating that fractionated radiation of small fields, with well defined mark off, in rats is feasible

  9. Setting up decommissioning funds for nuclear facilities - a competence problem for EURATOM

    International Nuclear Information System (INIS)

    Danwitz, Th. von

    2003-01-01

    The nuclear package presented by the European Commission in the autumn of 2002 has added considerable practical significance to the problem of the vertical limits of competence between the Community and its member states within the framework of the Euratom Treaty. The question most important to Germany is the authority of the European Atomic Energy Community to oblige its member states to set up funds for financing the decommissioning of nuclear facilities. As the Euratom Treaty contains no explicit competences of Euratom for regulations of this type, the article examines the content and range of Art. 30 ff. of the Euratom Treaty, the unwritten authority resulting from factual connections and the nature of the problems involved, looks at the importance of international agreements as far as legal competences are implied, and deals with a possible competence based on the right to amend the Treaty under Art. 203, Euratom Treaty. (orig.) [de

  10. A new X-ray absorption experimental set-up dedicated to DeNOx catalysis

    International Nuclear Information System (INIS)

    Revel, R.; Bazin, D.; Seigneurin, A.; Barthe, P.; Dubuisson, J.M.; Decamps, T.; Sonneville, H.; Poher, J.J.; Maire, F.; Lefrancois, P.

    1999-01-01

    In this paper, we present a complete in situ X-ray absorption reaction cell that simulates DeNO x experimental conditions. In this device, the sample is placed at high temperature under the flow of a complex mixture of reactive gases (NO, C 3 H 6 , O 2 , N 2 ). Particular attention has been paid to the material and design of the sample holders in order to avoid preferential gas circulation and thus ensure a true diffusion of the reactive gases on the catalyst. Moreover, precise control of the gas flow is maintained by means of mass flow controllers, and the safety of the set-up is assured by CO, CO 2 and NO detectors directly relayed to an electronic device, which is itself linked to the various mass flow controllers. Finally, the possibilities of this device are illustrated through the in situ XANES study of a Cu-ZSM-5 catalytic system

  11. Specific heat measurement set-up for quench condensed thin superconducting films.

    Science.gov (United States)

    Poran, Shachaf; Molina-Ruiz, Manel; Gérardin, Anne; Frydman, Aviad; Bourgeois, Olivier

    2014-05-01

    We present a set-up designed for the measurement of specific heat of very thin or ultra-thin quench condensed superconducting films. In an ultra-high vacuum chamber, materials of interest can be thermally evaporated directly on a silicon membrane regulated in temperature from 1.4 K to 10 K. On this membrane, a heater and a thermometer are lithographically fabricated, allowing the measurement of heat capacity of the quench condensed layers. This apparatus permits the simultaneous thermal and electrical characterization of successively deposited layers in situ without exposing the deposited materials to room temperature or atmospheric conditions, both being irreversibly harmful to the samples. This system can be used to study specific heat signatures of phase transitions through the superconductor to insulator transition of quench condensed films.

  12. Setting up your own business. Facing the future as an entrepreneur.

    Science.gov (United States)

    Brent, N J

    1990-01-01

    Other areas of setting up and running a business also are important to explore, especially if the business plans to use employees. You will become an employer, and you must be familiar with rules and regulations that include areas such as the employee's right to a safe workplace, worker's compensation laws, unemployment compensation laws and tax liabilities, antidiscrimination laws, and wage and tax laws. If independent contractors are going to be used, you must recognize that well-developed contracts are a necessity. If you are going to market a new product, consult with an attorney whose practice concentrates in trademark and patent law before the product is shared with others. Being well informed about the proposed business venture, not only before its establishment but as it develops and grows, can help you be in the best position to have a successful business.

  13. FTIR free-jet set-up for the high resolution spectroscopic investigation of condensable species

    Science.gov (United States)

    Georges, R.; Bonnamy, A.; Benidar, A.; Decroi, M.; Boissoles, J.

    2002-05-01

    An existing experimental set-up combining Fourier transform infrared (FTIR) spectroscopy and free-jet cooling has been modified significantly to allow high resolution studies of the spectrum of monomer species which are liquid under standard conditions. Evaporation of the liquid samples is controlled by a condenser apparatus which is described. A supersonic planar expansion issuing from a narrow aperture is preferred for its very high cooling rate. Such an expansion, probed with a pitot tube, has a zone of limited temperature gradient close to the nozzle exit. The continuum isentropic model appears well suited to describing the thermodynamic properties of the flow up to a high number of nozzle diameters downstream. High resolution spectra of benzene and methanol have been recorded in the 3 µm wavelength range, and their analysis demonstrates a well defined rotational temperature in the 20-25 K range.

  14. Setting up and running an advanced light microscopy and imaging facility.

    Science.gov (United States)

    Sánchez, Carlos; Muñoz, Ma Ángeles; Villalba, Maite; Labrador, Verónica; Díez-Guerra, F Javier

    2011-07-01

    During the last twenty years, interest in light microscopy and imaging techniques has grown in various fields, such as molecular and cellular biology, developmental biology, and neurobiology. In addition, the number of scientific articles and journals using these techniques is rapidly increasing. Nowadays, most research institutions require sophisticated microscopy systems to cover their investigation demands. In general, such instruments are too expensive and complex to be purchased and managed by a single laboratory or research group, so they have to be shared with other groups and supervised by specialized personnel. This is the reason why microscopy and imaging facilities are becoming so important at research institutions nowadays. In this unit, we have gathered and presented a number of issues and considerations from our own experience that we hope will be helpful when planning or setting up a new facility.

  15. Setting Up Simulations of Failure Scenarios for a Crab Cavity in the Nominal LHC

    CERN Document Server

    Yee, B

    2010-01-01

    The crab cavity (CC) represents a possible solution for the problem of the reduction of the luminosity due to a crossing angle. The CC apply a transversal kick on the beam particles that varies with the longitudinal position along the bunch in order to produce an effective head-head collision and to increase the geometry luminosity. For that reason the BE-ABP group at CERN has been performing studies for the implementation of the CC in the LHC. Because machine protection is a critical element of LHC operation, it is essential to study the failure scenarios of the superconducting crab cavity and the possible resulting damage impact and well as to find possible mitigation measures. For this purpose we set up simulation tools to model CC failures in the nominal LHC.

  16. Three axis vector magnet set-up for cryogenic scanning probe microscopy

    International Nuclear Information System (INIS)

    Galvis, J. A.; Herrera, E.; Buendía, A.; Guillamón, I.; Vieira, S.; Suderow, H.; Azpeitia, J.; Luccas, R. F.; Munuera, C.; García-Hernandez, M.

    2015-01-01

    We describe a three axis vector magnet system for cryogenic scanning probe microscopy measurements. We discuss the magnet support system and the power supply, consisting of a compact three way 100 A current source. We obtain tilted magnetic fields in all directions with maximum value of 5T along z-axis and of 1.2T for XY-plane magnetic fields. We describe a scanning tunneling microscopy-spectroscopy (STM-STS) set-up, operating in a dilution refrigerator, which includes a new high voltage ultralow noise piezodrive electronics and discuss the noise level due to vibrations. STM images and STS maps show atomic resolution and the tilted vortex lattice at 150 mK in the superconductor β-Bi 2 Pd. We observe a strongly elongated hexagonal lattice, which corresponds to the projection of the tilted hexagonal vortex lattice on the surface. We also discuss Magnetic Force Microscopy images in a variable temperature insert

  17. Friction degradation and set-up effects in hard clays offshore Congo and Angola

    International Nuclear Information System (INIS)

    Colliat, J.L.; Vergobbi, P.; Puech, A.

    1993-01-01

    Piles driven into stiff to hard clays encountered offshore Congo and Angola clearly show both clay-type effects which are (1) friction degradation, with very low driving resistances during continuous driving, and (2) set-up after driving interruptions. Both phenomena were studied by back-analysis of driving records, including results of pile driving monitoring. It allowed one to deduce the friction distribution along the piles during driving; show how the shaft friction at any depth reduces as the pile is driven further into the ground; and show that the shaft friction after driving delays can be close to the estimated static friction capacity of the piles. The SRD calculation method proposed by the authors takes the friction degradation effect into account, leading to improved pile drivability predictions. Four case histories are presented to illustrate the results obtained

  18. Neutron polarizing set-up of the Sofia IRT research reactor

    International Nuclear Information System (INIS)

    Krezhov, K.; Mikhajlova, V.; Okorokov, A.

    1990-01-01

    Neutron polarizing set-up of one of the horizontal beam tubes of the IRT-200 research reactor of the Bulgarian Institute of Nuclear Research and Nuclear Energy is presented. Neutron mirrors are extensively used in an effort to compensate the moderate reactor beam intensity by the high reflected intensity and wide-band transmittance of the mirror neutron guides. Time-to-flight technique using a slotted neutron absorbing chopper with a horizontal rotation axis has been applied to obtain the exit neutron spectra. Beam polarization and flipping ratios have been determined. Cadmium ratio in the polarized beam has been found almost 10 4 and the average polarization has been measured to be higher than 96%. 3 figs, 3 refs

  19. Three axis vector magnet set-up for cryogenic scanning probe microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Galvis, J. A. [Laboratorio de Bajas Temperaturas, Departamento de Física de la Materia Condensada, Instituto de Ciencia de Materiales Nicolás Cabrera, Condensed Matter Physics Center (IFIMAC), Facultad de Ciencias Universidad Autónoma de Madrid, 28049 Madrid (Spain); Departamento de Ciencias Naturales Facultad de Ingeniería Universidad Central, Bogotá (Colombia); Herrera, E.; Buendía, A. [Laboratorio de Bajas Temperaturas, Departamento de Física de la Materia Condensada, Instituto de Ciencia de Materiales Nicolás Cabrera, Condensed Matter Physics Center (IFIMAC), Facultad de Ciencias Universidad Autónoma de Madrid, 28049 Madrid (Spain); Guillamón, I.; Vieira, S.; Suderow, H. [Laboratorio de Bajas Temperaturas, Departamento de Física de la Materia Condensada, Instituto de Ciencia de Materiales Nicolás Cabrera, Condensed Matter Physics Center (IFIMAC), Facultad de Ciencias Universidad Autónoma de Madrid, 28049 Madrid (Spain); Unidad Asociada de Bajas Temperaturas y Altos Campos Magnéticos, UAM, CSIC, Cantoblanco, E-28049 Madrid (Spain); Azpeitia, J.; Luccas, R. F.; Munuera, C.; García-Hernandez, M. [Unidad Asociada de Bajas Temperaturas y Altos Campos Magnéticos, UAM, CSIC, Cantoblanco, E-28049 Madrid (Spain); Instituto de Ciencia de Materiales de Madrid, Consejo Superior de Investigaciones Científicas (ICMM-CSIC), Sor Juana Inés de la Cruz 3, 28049 Madrid (Spain); and others

    2015-01-15

    We describe a three axis vector magnet system for cryogenic scanning probe microscopy measurements. We discuss the magnet support system and the power supply, consisting of a compact three way 100 A current source. We obtain tilted magnetic fields in all directions with maximum value of 5T along z-axis and of 1.2T for XY-plane magnetic fields. We describe a scanning tunneling microscopy-spectroscopy (STM-STS) set-up, operating in a dilution refrigerator, which includes a new high voltage ultralow noise piezodrive electronics and discuss the noise level due to vibrations. STM images and STS maps show atomic resolution and the tilted vortex lattice at 150 mK in the superconductor β-Bi{sub 2}Pd. We observe a strongly elongated hexagonal lattice, which corresponds to the projection of the tilted hexagonal vortex lattice on the surface. We also discuss Magnetic Force Microscopy images in a variable temperature insert.

  20. Setting up a new CZO in the Ganga basin: instrumentation, stakeholder engagement and preliminary observations

    Science.gov (United States)

    Gupta, S.; Tripathi, S.; Sinha, R.; Karumanchi, S. H.; Paul, D.; Tripathi, S. N.; Sen, I. S.; Dash, S. K.

    2017-12-01

    The Ganga plains represent the abode of more than 400 million people and a region of severe anthropogenic disturbance to natural processes. Changing agricultural practices, inefficient use of water, contamination of groundwater systems, and decrease in soil fertility are some of the issues that have affected the long-term resilience of hydrological processes. The quantification of these processes demands a network of hydro-meteorological instrumentation, low-cost sensors, continuous engagement of stakeholders and real time data transmission at a fine interval. We have therefore set up a Critical Zone Observatory (CZO) in a small watershed (35km2) that forms an intensively managed rural landscape consisting of 92% of agricultural land in the Pandu River Basin (a small tributary of the Ganga River). Apart from setting up a hydro-meteorological observatory, the major science questions we want to address relate to development of water balance model, understanding the soil-water interaction and estimation of nutrient fluxes in the watershed. This observatory currently has various types of sensors that are divided into three categories: (a) spatially not dense but temporally fine data, (b) spatially dense but temporally not fine data and(c) spatially dense and temporally fine data. The first category represent high-cost sensors namely automatic weather stations that are deployed at two locations and provide data at 15-minute interval. The second category includes portable soil moisture, discharge and groundwater level at weekly/ biweekly interval. The third category comprises low-cost sensors including automatic surface and groundwater level sensors installed on open wells to monitor the continuous fluctuation of water level at every 15 minutes. In addition to involving the local communities in data collection (e.g. manual rainfall measurement, water and soil sampling), this CZO also aims to provide relevant information to them for improving their sustainability. The

  1. Development of Data Acquisition Set-up for Steady-state Experiments

    Science.gov (United States)

    Srivastava, Amit K.; Gupta, Arnab D.; Sunil, S.; Khan, Ziauddin

    2017-04-01

    For short duration experiments, generally digitized data is transferred for processing and storage after the experiment whereas in case of steady-state experiment the data is acquired, processed, displayed and stored continuously in pipelined manner. This requires acquiring data through special techniques for storage and on-the-go viewing data to display the current data trends for various physical parameters. A small data acquisition set-up is developed for continuously acquiring signals from various physical parameters at different sampling rate for long duration experiment. This includes the hardware set-up for signal digitization, Field Programmable Gate Arrays (FPGA) based timing system for clock synchronization and event/trigger distribution, time slicing of data streams for storage of data chunks to enable viewing of data during acquisition and channel profile display through down sampling etc. In order to store a long data stream of indefinite/long time duration, the data stream is divided into data slices/chunks of user defined time duration. Data chunks avoid the problem of non-access of server data until the channel data file is closed at the end of the long duration experiment. A graphical user interface has been developed in Lab VIEW application development environment for configuring the data acquisition hardware and storing data chunks on local machine as well as at remote data server through Python for further data access. The data plotting and analysis utilities have been developed with Python software, which provides tools for further data processing. This paper describes the development and implementation of data acquisition for steady-state experiment.

  2. Setting up and functioning of an Emergency Medicine Department: Lessons learned from a preliminary study

    Directory of Open Access Journals (Sweden)

    K Asish

    2016-01-01

    Full Text Available Background and Aims: Tertiary care teaching hospitals remain referral centres for victims of trauma and mass casualty. Often specialists from various disciplines manage these crowded casualty areas. These age old casualty areas are being replaced, throughout the country by Emergency Medicine Departments (EMDs, presumed to be better planned to confront a crisis. We aimed to gather basic data contributive in setting up of an EMD at a tertiary care teaching hospital from the lessons learned from functioning existent systems. Methods: This is primarily a questionnaire-based descriptive study at tertiary care referral centres across the country, which was purposively selected.The study models included one from a hospital without designated EMD and the other four from hospitals with established EMDs. Direct observation and focus group meetings with experienced informants at these hospitals contributed to the data. In the absence of a validated hospital preparedness assessment scale, comparison was done with regard to quantitative, qualitative and corroborative parameters using descriptive analysis. Results: The EMDs at best practice models were headed by specialist in Emergency Medicine assisted by organised staff, had protocols for managing mass casualty incident (MCI, separate trauma teams, ergonomic use of infrastructure and public education programmes. In this regard, these hospitals seemed well organised to manage MCIs and disasters. Conclusion: The observation may provide a preliminary data useful in setting up an EMD. In the absence of published Indian literature, this may facilitate further research in this direction. Anaesthesiologists, presently an approved Faculty in Emergency Medicine training can provide creative input with regard to its initial organisation and functioning, thus widening our horizons in a country where there is a severe dearth of trained emergency physicians.

  3. The potential impact of the tension of the pelvic muscles on set-up errors in radiotherapy for pelvic malignancies

    International Nuclear Information System (INIS)

    Bujko, Krzysztof; Czuchraniuk, Piotr; Zolciak, Agnieszka; Kukolowicz, Pawel; Kepka, Lucyna; Bielik, Agnieszka

    2004-01-01

    The purpose of the study reported here was to evaluate the potential impact of the tension of pelvic muscles on set-up errors. Twenty-nine consecutive patients with rectal cancer were included. The treatment simulation of the lateral beam in prone position was performed twice-with relaxed and next with maximally tense pelvic muscles. During the second simulation, the couch was moved so as to align the centre of the beam with the actual position of the skin mark tattooed during the first simulation. The bony landmarks on both images of corresponding lateral fields were matched. The beam's centre displacement and the rotation were measured using the beam image taken in relaxed position as a reference. The absolute values were used in calculation of the mean. For the anterior-posterior direction, the mean value of displacements was 15.3 mm, standard deviation (SD) 6.9 mm and the maximal value 37 mm. For the cranial-caudal direction, the mean value was 4.4 mm, SD 4 mm and the maximal value 17 mm. The mean rotation of the pelvis was 5.3 degrees, SD 2.4 degrees and maximal rotation 11 degrees. The majority of displacements were in the posterior (86%) and caudal (55%) directions. The majority of rotations were clockwise (76%). It was shown that pelvic muscle tension was the reason for anal verge displacements and mispositionings of the shielding block. This results in set-up inaccuracy, especially in the anterior-posterior direction, shielding block mispositioning and anal verge displacement

  4. How To Set Up Your Own Small Business. Service Company Case Study. Manufacturing Firm Case Study. Retail Store Case Study.

    Science.gov (United States)

    Fallek, Max

    This collection of case studies is intended for use in a course in setting up a small business. The first, a case study of the process of setting up a service company, covers analyzing the pros and cons of starting one's own business, assessing the competition and local market, and selecting a site for and financing the business. The principal…

  5. Scratch to state-of-the-art: setting up a new robotic facility in a developing country.

    Science.gov (United States)

    Bora, G S; Mavuduru, R S; Devana, S K; Singh, S K; Mandal, A K

    2018-03-01

    The potential challenges encountered for setting up a robotic assisted surgical facility in developing country like India are many. We describe the initial hurdles and troubleshooting in establishing a facility of such kind. This experience might help to decrease initial hiccups in setting up such an innovative technology at other institutes.

  6. Accuracy and precision of four common peripheral temperature measurement methods in intensive care patients.

    Science.gov (United States)

    Asadian, Simin; Khatony, Alireza; Moradi, Gholamreza; Abdi, Alireza; Rezaei, Mansour

    2016-01-01

    An accurate determination of body temperature in critically ill patients is a fundamental requirement for initiating the proper process of diagnosis, and also therapeutic actions; therefore, the aim of the study was to assess the accuracy and precision of four noninvasive peripheral methods of temperature measurement compared to the central nasopharyngeal measurement. In this observational prospective study, 237 patients were recruited from the intensive care unit of Imam Ali Hospital of Kermanshah. The patients' body temperatures were measured by four peripheral methods; oral, axillary, tympanic, and forehead along with a standard central nasopharyngeal measurement. After data collection, the results were analyzed by paired t-test, kappa coefficient, receiver operating characteristic curve, and using Statistical Package for the Social Sciences, version 19, software. There was a significant meaningful correlation between all the peripheral methods when compared with the central measurement (Ptemperatures of right and left tympanic membranes and the standard central nasopharyngeal measurement (88%). Paired t-test demonstrated an acceptable precision with forehead (P=0.132), left (P=0.18) and right (P=0.318) tympanic membranes, oral (P=1.00), and axillary (P=1.00) methods. Sensitivity and specificity of both the left and right tympanic membranes were more than for other methods. The tympanic and forehead methods had the highest and lowest accuracy for measuring body temperature, respectively. It is recommended to use the tympanic method (right and left) for assessing a patient's body temperature in the intensive care units because of high accuracy and acceptable precision.

  7. A compact and stable eddy covariance set-up for methane measurements using off-axis integrated cavity output spectroscopy

    Directory of Open Access Journals (Sweden)

    D. M. D. Hendriks

    2008-01-01

    Full Text Available A Fast Methane Analyzer (FMA is assessed for its applicability in a closed path eddy covariance field set-up in a peat meadow. The FMA uses off-axis integrated cavity output spectroscopy combined with a highly specific narrow band laser for the detection of CH4 and strongly reflective mirrors to obtain a laser path length of 2–20×103 m. Statistical testing and a calibration experiment showed high precision (7.8×10−3 ppb and accuracy (<0.30% of the instrument, while no drift was observed. The instrument response time was determined to be 0.10 s. In the field set-up, the FMA is attached to a scroll pump and combined with a 3-axis ultrasonic anemometer and an open path infrared gas analyzer for measurements of carbon dioxide and water vapour. The power-spectra and co-spectra of the instruments were satisfactory for 10 Hz sampling rates.

    Due to erroneous measurements, spikes and periods of low turbulence the data series consisted for 26% of gaps. Observed CH4 fluxes consisted mainly of emission, showed a diurnal cycle, but were rather variable over. The average CH4 emission was 29.7 nmol m−2 s−1, while the typical maximum CH4 emission was approximately 80.0 nmol m−2 s−1 and the typical minimum flux was approximately 0.0 nmol m−2 s−1. The correspondence of the measurements with flux chamber measurements in the footprint was good and the observed CH4 emission rates were comparable with eddy covariance CH4 measurements in other peat areas.

    Additionally, three measurement techniques with lower sampling frequencies were simulated, which might give the possibility to measure CH4 fluxes without an external pump and save energy. Disjunct eddy covariance appeared to be the most reliable substitute for 10 Hz eddy covariance, while relaxed eddy accumulation gave

  8. Assessing the Accuracy and Readability of Online Health Information for Patients With Pancreatic Cancer.

    Science.gov (United States)

    Storino, Alessandra; Castillo-Angeles, Manuel; Watkins, Ammara A; Vargas, Christina; Mancias, Joseph D; Bullock, Andrea; Demirjian, Aram; Moser, A James; Kent, Tara S

    2016-09-01

    The degree to which patients are empowered by written educational materials depends on the text's readability level and the accuracy of the information provided. The association of a website's affiliation or focus on treatment modality with its readability and accuracy has yet to be thoroughly elucidated. To compare the readability and accuracy of patient-oriented online resources for pancreatic cancer by treatment modality and website affiliation. An online search of 50 websites discussing 5 pancreatic cancer treatment modalities (alternative therapy, chemotherapy, clinical trials, radiation therapy, and surgery) was conducted. The website's affiliation was identified. Readability was measured by 9 standardized tests, and accuracy was assessed by an expert panel. Nine standardized tests were used to compute the median readability level of each website. The median readability scores were compared among treatment modality and affiliation categories. Accuracy was determined by an expert panel consisting of 2 medical specialists and 2 surgical specialists. The 4 raters independently evaluated all websites belonging to the 5 treatment modalities (a score of 1 indicates that readability and accuracy based on the focus of the treatment modality and the website's affiliation. Websites discussing surgery (with a median readability level of 13.7 and an interquartile range [IQR] of 11.9-15.6) were easier to read than those discussing radiotherapy (median readability level, 15.2 [IQR, 13.0-17.0]) (P = .003) and clinical trials (median readability level, 15.2 [IQR, 12.8-17.0]) (P = .002). Websites of nonprofit organizations (median readability level, 12.9 [IQR, 11.2-15.0]) were easier to read than media (median readability level, 16.0 [IQR, 13.4-17.0]) (P readability level, 14.8 [IQR, 12.9-17.0]) (P readability level, 14.0 [IQR, 12.1-16.1]) were easier to read than media websites (P = .001). Among treatment modalities, alternative therapy websites exhibited the

  9. Accuracy of nursing diagnosis "readiness for enhanced hope" in patients with chronic kidney disease.

    Science.gov (United States)

    Silva, Renan Alves; Melo, Geórgia Alcântara Alencar; Caetano, Joselany Áfio; Lopes, Marcos Venícios Oliveira; Butcher, Howard Karl; Silva, Viviane Martins da

    2017-07-06

    To analyse the accuracy of the nursing diagnosis readiness for enhanced hope in patients with chronic kidney disease. This is a cross-sectional study with 62 patients in the haemodialysis clinic conducted from August to November 2015. The Hearth Hope Scale was used to create definitions of the defining characteristics of the North American Nursing Diagnosis Association International. We analysed the measures of sensitivity, specificity, predictive value, likelihood ratio, and odds ratio of the defining characteristics of the diagnosis. Of the characteristics, 82.22% presented the diagnosis. The defining characteristics "Expresses the desire to enhance congruency of expectations with desires" and "Expresses the desire to enhance problem solving to meet goals" increased the chance of having the diagnosis by eleven and five, respectively. The characteristics, "Expresses desire to enhance congruency of expectations with desires" and "Expresses desire to enhance problem solving to meet goals" had good accuracy measures.

  10. Digital dental surface registration with laser scanner for orthodontics set-up planning

    Science.gov (United States)

    Alcaniz-Raya, Mariano L.; Albalat, Salvador E.; Grau Colomer, Vincente; Monserrat, Carlos A.

    1997-05-01

    We present an optical measuring system based on laser structured light suitable for its diary use in orthodontics clinics that fit four main requirements: (1) to avoid use of stone models, (2) to automatically discriminate geometric points belonging to teeth and gum, (3) to automatically calculate diagnostic parameters used by orthodontists, (4) to make use of low cost and easy to use technology for future commercial use. Proposed technique is based in the use of hydrocolloids mould used by orthodontists for stone model obtention. These mould of the inside of patient's mouth are composed of very fluent materials like alginate or hydrocolloids that reveal fine details of dental anatomy. Alginate mould are both very easy to obtain and very low costly. Once captured, alginate moulds are digitized by mean of a newly developed and patented 3D dental scanner. Developed scanner is based in the optical triangulation method based in the projection of a laser line on the alginate mould surface. Line deformation gives uncalibrated shape information. Relative linear movements of the mould with respect to the sensor head gives more sections thus obtaining a full 3D uncalibrated dentition model. Developed device makes use of redundant CCD in the sensor head and servocontrolled linear axis for mould movement. Last step is calibration to get a real and precise X, Y, Z image. All the process is done automatically. The scanner has been specially adapted for 3D dental anatomy capturing in order to fulfill specific requirements such as: scanning time, accuracy, security and correct acquisition of 'hidden points' in alginate mould. Measurement realized on phantoms with known geometry quite similar to dental anatomy present errors less than 0,1 mm. Scanning of global dental anatomy is 2 minutes, and generation of 3D graphics of dental cast takes approximately 30 seconds in a Pentium-based PC.

  11. Diagnostic accuracy of dual-energy computed tomography in patients with gout: A meta-analysis.

    Science.gov (United States)

    Lee, Young Ho; Song, Gwan Gyu

    2017-08-01

    This study aimed to evaluate the diagnostic performance of dual-energy computed tomography (DECT) for patients with gout. We searched the Medline, Embase, and Cochrane Library databases, and performed a meta-analysis on the diagnostic accuracy of DECT in patients with gout. A total of eight studies including 510 patients with gout and 268 controls (patients with non-gout inflammatory arthritis) were available for the meta-analysis. The pooled sensitivity and specificity of DECT were 84.7% (95% confidence interval [CI]: 81.3-87.7) and 93.7% (93.0-96.3), respectively. The positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 9.882 (6.122-15.95), 0.163 (0.097-0.272), and 78.10 (31.14-195.84), respectively. The area under the curve of DECT was 0.956 and the Q * index was 0.889, indicating a high diagnostic accuracy. Some between-study heterogeneity was found in the meta-analyses. However, there was no evidence of a threshold effect (Spearman correlation coefficient = 0.419; p = 0.035). In addition, meta-regression showed that the sample size, study design, and diagnostic criteria were not sources of heterogeneity, and subgroup meta-analyses did not change the overall diagnostic accuracy. Our meta-analysis of published studies demonstrates that DECT has a high diagnostic accuracy and plays an important role in the diagnosis of gout. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Effects of accuracy constraints on reach-to-grasp movements in cerebellar patients.

    Science.gov (United States)

    Rand, M K; Shimansky, Y; Stelmach, G E; Bracha, V; Bloedel, J R

    2000-11-01

    Reach-to-grasp movements of patients with pathology restricted to the cerebellum were compared with those of normal controls. Two types of paradigms with different accuracy constraints were used to examine whether cerebellar impairment disrupts the stereotypic relationship between arm transport and grip aperture and whether the variability of this relationship is altered when greater accuracy is required. The movements were made to either a vertical dowel or to a cross bar of a small cross. All subjects were asked to reach for either target at a fast but comfortable speed, grasp the object between the index finger and thumb, and lift it a short distance off the table. In terms of the relationship between arm transport and grip aperture, the control subjects showed a high consistency in grip aperture and wrist velocity profiles from trial to trial for movements to both the dowel and the cross. The relationship between the maximum velocity of the wrist and the time at which grip aperture was maximal during the reach was highly consistent throughout the experiment. In contrast, the time of maximum grip aperture and maximum wrist velocity of the cerebellar patients was quite variable from trial to trial, and the relationship of these measurements also varied considerably. These abnormalities were present regardless of the accuracy requirement. In addition, the cerebellar patients required a significantly longer time to grasp and lift the objects than the control subjects. Furthermore, the patients exhibited a greater grip aperture during reach than the controls. These data indicate that the cerebellum contributes substantially to the coordination of movements required to perform reach-to-grasp movements. Specifically, the cerebellum is critical for executing this behavior with a consistent, well-timed relationship between the transport and grasp components. This contribution is apparent even when accuracy demands are minimal.

  13. Diagnostic accuracy of the defining characteristics of the excessive fluid volume diagnosis in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Maria Isabel da Conceição Dias Fernandes

    2015-12-01

    Full Text Available Objective: to evaluate the accuracy of the defining characteristics of the excess fluid volume nursing diagnosis of NANDA International, in patients undergoing hemodialysis. Method: this was a study of diagnostic accuracy, with a cross-sectional design, performed in two stages. The first, involving 100 patients from a dialysis clinic and a university hospital in northeastern Brazil, investigated the presence and absence of the defining characteristics of excess fluid volume. In the second step, these characteristics were evaluated by diagnostic nurses, who judged the presence or absence of the diagnosis. To analyze the measures of accuracy, sensitivity, specificity, and positive and negative predictive values were calculated. Approval was given by the Research Ethics Committee under authorization No. 148.428. Results: the most sensitive indicator was edema and most specific were pulmonary congestion, adventitious breath sounds and restlessness. Conclusion: the more accurate defining characteristics, considered valid for the diagnostic inference of excess fluid volume in patients undergoing hemodialysis were edema, pulmonary congestion, adventitious breath sounds and restlessness. Thus, in the presence of these, the nurse may safely assume the presence of the diagnosis studied.

  14. 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.

  15. Do technical parameters affect the diagnostic accuracy of virtual bronchoscopy in patients with suspected airways stenosis?

    International Nuclear Information System (INIS)

    Jones, Catherine M.; Athanasiou, Thanos; Nair, Sujit; Aziz, Omer; Purkayastha, Sanjay; Konstantinos, Vlachos; Paraskeva, Paraskevas; Casula, Roberto; Glenville, Brian; Darzi, Ara

    2005-01-01

    Purpose: Virtual bronchoscopy has gained popularity over the past decade as an alternative investigation to conventional bronchoscopy in the diagnosis, grading and monitoring of airway disease. The effect of technical parameters on diagnostic outcome from virtual bronchoscopy has not been determined. This meta-analysis aims to estimate accuracy of virtual compared to conventional bronchoscopy in patients with suspected airway stenosis, and evaluate the influence of technical parameters. Materials and methods: A MEDLINE search was used to identify relevant published studies. The primary endpoint was the 'correct diagnosis' of stenotic lesions on virtual compared to conventional bronchoscopy. Secondary endpoints included the effects of the technical parameters (pitch, collimation, reconstruction interval, rendering method, and scanner type), and date of publication on the diagnostic accuracy of virtual bronchoscopy. Results: Thirteen studies containing 454 patients were identified. Meta-analysis showed good overall diagnostic performance with 85% calculated pooled sensitivity (95% CI 77-91%), 87% specificity (95% CI 81-92%) and area under the curve (AUC) of 0.947. Subgroups included collimation of 3 mm or more (AUC 0.948), pitch of 1 (AUC 0.955), surface rendering technique (AUC 0.935), and reconstruction interval of more than 1.25 mm (AUC 0.914). There was no significant difference in accuracy accounting for publication date, scanner type or any of the above variables. Weighted regression analysis confirmed none of these variables could significantly account for study heterogeneity. Conclusion: Virtual bronchoscopy performs well in the investigation of patients with suspected airway stenosis. Overall sensitivity and specificity and diagnostic odds ratio for diagnosis of airway stenosis were high. The effects of pitch, collimation, reconstruction interval, rendering technique, scanner type, and publication date on diagnostic accuracy were not significant

  16. New large solar photocatalytic plant: set-up and preliminary results.

    Science.gov (United States)

    Malato, S; Blanco, J; Vidal, A; Fernández, P; Cáceres, J; Trincado, P; Oliveira, J C; Vincent, M

    2002-04-01

    A European industrial consortium called SOLARDETOX has been created as the result of an EC-DGXII BRITE-EURAM-III-financed project on solar photocatalytic detoxification of water. The project objective was to develop a simple, efficient and commercially competitive water-treatment technology, based on compound parabolic collectors (CPCs) solar collectors and TiO2 photocatalysis, to make possible easy design and installation. The design, set-up and preliminary results of the main project deliverable, the first European industrial solar detoxification treatment plant, is presented. This plant has been designed for the batch treatment of 2 m3 of water with a 100 m2 collector-aperture area and aqueous aerated suspensions of polycrystalline TiO2 irradiated by sunlight. Fully automatic control reduces operation and maintenance manpower. Plant behaviour has been compared (using dichloroacetic acid and cyanide at 50 mg l(-1) initial concentration as model compounds) with the small CPC pilot plants installed at the Plataforma Solar de Almería several years ago. The first results with high-content cyanide (1 g l(-1)) waste water are presented and plant treatment capacity is calculated.

  17. Secondary electron images obtained with a standard photoelectron emission microscope set-up

    International Nuclear Information System (INIS)

    Benka, Oswald; Zeppenfeld, Peter

    2005-01-01

    The first results of secondary electron images excited by 3-4.3 keV electrons are presented. The images are obtained with a standard FOCUS-PEEM set-up equipped with an imaging energy filter (IEF). The electron gun was mounted on a standard PEEM entrance flange at an angle of 25 deg. with respect to the sample surface. A low extraction voltage of 500 V was used to minimize the deflection of the electron beam by the PEEM extraction electrode. The secondary electron images are compared to photoelectron images excited by a standard 4.9 eV UV lamp. In the case of a Cu pattern on a Si substrate it is found that the lateral resolution without the IEF is about the same for electron and photon excitation but that the relative electron emission intensities are very different. The use of the IEF reduces the lateral resolution. Images for secondary electron energies between eV 1 and eV 2 were obtained by setting the IEF to -V 1 and -V 2 ∼-(V 1 +5V) potentials and taking the difference of both images. Images up to 100 eV electron energies were recorded. The material contrast obtained in these difference images is discussed in terms of a secondary electron and photoelectron emission model and secondary electron energy spectra measured with a LEED-Auger spectrometer

  18. Set up and application of an underwater Α-ray spectrometer for radioactivity measurements

    Directory of Open Access Journals (Sweden)

    C. TSABARIS

    2005-06-01

    Full Text Available The set up and control of an underwater measuring instrument for radioactivity pollution in the marine environment is described. The detection system is based on a NaI scintillator (RADAM III with modifications for use in the marine environment with on-line measurements. The system is simple, has low power consumption and is stable for long-term monitoring (10 months. Before its deployment, the sensor was calibrated in the laboratory in a tank full of water to reproduce the marine environment. The calibrations were performed, by detecting the 661keV and 1461 keV gamma rays of known activity liquid sources 137 Cs and 40 K, respectively. The measured spectra in the laboratory were compared with spectra from a similar detector as acquired in the field. The analysis of the parallel measurement gave satisfactory agreement for the concentration of the potassium (40 K, as calculated from the salinity in the seawater, thus enabling the system for quantitative measurement of the seawater radioactivity.

  19. The new dedicated PIXE set-up at the National Environmental Research Institute, Denmark

    International Nuclear Information System (INIS)

    Kemp, Ka ring re; Waahlin, Peter

    1999-01-01

    The Niels Bohr Institute in Copenhagen was in the beginning of the 70'es one of the early places for PIXE. Contributions were made to the theoretical interpretation of the PIXE spectra as well as the practical application. The home-made 4 MV van de Graaff accelerator at the Niels Bohr Institute was an excellent tool for PIXE. The accelerator, which was used for many years, has now found its place on a museum after more than 40 years of active service. A dedicated PIXE set-up has now been established at the National Environmental Research Institute using a new 1.7 MV Tandem Pelletron (5SDH) from NEC. The main application is elemental analysis of outdoor aerosols. The main work is unsophisticated macro analyses, which do not push the equipment to its limits. This enables automated analysis of about 10,000 samples per year using very limited manpower resources. The research focuses on the contribution from various source types to the atmosphere over Europe, the North Atlantic and Greenland. Source compositions and their temporal variations are studied

  20. Set-up and methods for SiPM Photo-Detection Efficiency measurements

    International Nuclear Information System (INIS)

    Zappalà, G.; Acerbi, F.; Ferri, A.; Gola, A.; Paternoster, G.; Zorzi, N.; Piemonte, C.

    2016-01-01

    In this work, a compact set-up and three different methods to measure the Photo-Detection Efficiency (PDE) of Silicon Photomultipliers (SiPMs) and Single-Photon Avalanche Diodes (SPADs) are presented. The methods, based on either continuous or pulsed light illumination, are discussed in detail and compared in terms of measurement precision and time. For the SiPM, these methods have the feature of minimizing the effect of both the primary and correlated noise on the PDE estimation. The PDE of SiPMs (produced at FBK, Trento, Italy) was measured in a range from UV to NIR, obtaining similar results with all the methods. Furthermore, the advantages of measuring, when possible, the PDE of SPADs (of the same technology and with the same layout of a single SiPM cell) instead of larger devices are also discussed and a direct comparison between measurement results is shown. Using a SPAD, it is possible to reduce the measurement complexity and uncertainty since the correlated noise sources are reduced with respect to the SiPM case.

  1. A new instrumental set-up for polarized neutron scattering experiments

    International Nuclear Information System (INIS)

    Schmidt, Wolfgang; Ohl, Michael

    2005-01-01

    Neutron scattering with polarization analysis is a powerful tool to determine magnetic structures and excitations. A common setup is to mount the sample at the center of a Helmholtz-type coil which can provide a magnetic field of any direction at the sample position and also a guide field along the neutron flight paths around the sample. Recent experiments showed quite a high demand for measurements at low momentum transfers. For the corresponding low scattering angles air scattering gives rise to a very large background. For this reason we have extended the standard setup to a combination of a large vacuum tank surrounded by electrical coils. The vacuum tank eliminates the air scattering and we can use the polarization analysis down to the lowest accessible momentum transfers. The coils themselves also show some new features: In contrary to the classic (symmetric) coil distribution we use an asymmetric setup which gives the advantage of a larger scattering window. Due to a more sophisticated current distribution this modified coil arrangement needs not to be rotated for different scattering conditions. The whole set-up will soon be available at IN12, a cold neutrons three-axis spectrometer operated by FZ Juelich in collaboration with CEA Grenoble as a CRG-B instrument at the Institut Laue Langevin in Grenoble

  2. TEST BEAM COORDINATION: The 2004 Test Beam Calorimetry set-up in H8

    CERN Multimedia

    Aleksa, M; Di Girolamo, B; Ferrari, C; Giugni, D; Santoni, C; Wingerter, I

    A new table has been designed, built and finally mounted to position the LAr cryostat in front of the Tilecal modules. The new table has been connected to the existing Tilecal table to be able to move the full set-up along eta values between 0 and 1.2. The table has been conceived by D. Giugni (INFN Milano and now CERN PH) and modeled by G. Braga (INFN Milano) in spring-summer 2003. The realization of the table has been done by an Italian firm (MatecImpianti, Fenegrò, Como) under the supervision of S. Coelli (INFN Milano) starting August 2003. Figure 1 shows the table assembled at the firm (left). Figure 1: The Tilecal-LAr table: in Fenegro (left) and at CERN (right). In November 2003 the table has been delivered to CERN and put in temporary storage to be assembled after the preparation of the Tilecal zone. In February 2004 two technicians from the firm and the team of technician coordinated by C. Ferrari (CERN AB/ATB), assembled, tested and commissioned the table under the supervision of S. Coelli...

  3. Mortality Predicted Accuracy for Hepatocellular Carcinoma Patients with Hepatic Resection Using Artificial Neural Network

    Directory of Open Access Journals (Sweden)

    Herng-Chia Chiu

    2013-01-01

    Full Text Available The aim of this present study is firstly to compare significant predictors of mortality for hepatocellular carcinoma (HCC patients undergoing resection between artificial neural network (ANN and logistic regression (LR models and secondly to evaluate the predictive accuracy of ANN and LR in different survival year estimation models. We constructed a prognostic model for 434 patients with 21 potential input variables by Cox regression model. Model performance was measured by numbers of significant predictors and predictive accuracy. The results indicated that ANN had double to triple numbers of significant predictors at 1-, 3-, and 5-year survival models as compared with LR models. Scores of accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC of 1-, 3-, and 5-year survival estimation models using ANN were superior to those of LR in all the training sets and most of the validation sets. The study demonstrated that ANN not only had a great number of predictors of mortality variables but also provided accurate prediction, as compared with conventional methods. It is suggested that physicians consider using data mining methods as supplemental tools for clinical decision-making and prognostic evaluation.

  4. Mortality Predicted Accuracy for Hepatocellular Carcinoma Patients with Hepatic Resection Using Artificial Neural Network

    Science.gov (United States)

    Chiu, Herng-Chia; Ho, Te-Wei; Lee, King-Teh; Chen, Hong-Yaw; Ho, Wen-Hsien

    2013-01-01

    The aim of this present study is firstly to compare significant predictors of mortality for hepatocellular carcinoma (HCC) patients undergoing resection between artificial neural network (ANN) and logistic regression (LR) models and secondly to evaluate the predictive accuracy of ANN and LR in different survival year estimation models. We constructed a prognostic model for 434 patients with 21 potential input variables by Cox regression model. Model performance was measured by numbers of significant predictors and predictive accuracy. The results indicated that ANN had double to triple numbers of significant predictors at 1-, 3-, and 5-year survival models as compared with LR models. Scores of accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) of 1-, 3-, and 5-year survival estimation models using ANN were superior to those of LR in all the training sets and most of the validation sets. The study demonstrated that ANN not only had a great number of predictors of mortality variables but also provided accurate prediction, as compared with conventional methods. It is suggested that physicians consider using data mining methods as supplemental tools for clinical decision-making and prognostic evaluation. PMID:23737707

  5. Diagnostic Accuracy of Tests for Polyuria in Lithium-Treated Patients.

    Science.gov (United States)

    Kinahan, James Conor; NiChorcorain, Aoife; Cunningham, Sean; Freyne, Aideen; Cooney, Colm; Barry, Siobhan; Kelly, Brendan D

    2015-08-01

    In lithium-treated patients, polyuria increases the risk of dehydration and lithium toxicity. If detected early, it is reversible. Despite its prevalence and associated morbidity in clinical practice, it remains underrecognized and therefore undertreated. The 24-hour urine collection is limited by its convenience and practicality. This study explores the diagnostic accuracy of alternative tests such as questionnaires on subjective polyuria, polydipsia, nocturia (dichotomous and ordinal responses), early morning urine sample osmolality (EMUO), and fluid intake record (FIR). This is a cross-sectional study of 179 lithium-treated patients attending a general adult and an old age psychiatry service. Participants completed the tests after completing an accurate 24-hour urine collection. The diagnostic accuracy of the individual tests was explored using the appropriate statistical techniques. Seventy-nine participants completed all of the tests. Polydipsia severity, EMUO, and FIR significantly differentiated the participants with polyuria (area under the receiver operating characteristic curve of 0.646, 0.760, and 0.846, respectively). Of the tests investigated, the FIR made the largest significant change in the probability that a patient experiences polyuria (3500 mL/24 hours; interval likelihood ratio, 14). Symptomatic questioning, EMUO, and an FIR could be used in clinical practice to inform the prescriber of the probability that a lithium-treated patient is experiencing polyuria.

  6. Diagnostic accuracy of three different MRI protocols in patients with inflammatory bowel disease

    International Nuclear Information System (INIS)

    Jesuratnam-Nielsen, Kayalvily; Løgager, Vibeke Berg; Munkholm, Pia; Thomsen, Henrik S

    2015-01-01

    Magnetic resonance imaging (MRI) is used for workup and control of inflammatory bowel disease (IBD); however, disagreement remains as to how the MRI should be performed. To compare prospectively the diagnostic accuracy of MRI with neither oral nor intravenous contrast medium (plain MRI), magnetic resonance follow-through (MRFT) and MR enteroclysis (MRE) using MRE as the reference standard in patients with inflammatory bowel disease. Plain MRI and MRE were carried out in addition to MRFT. All patients underwent both plain MR and MRFT on the same day and MRE within seven days. For the evaluation, the bowel was divided into nine segments. One radiologist, blinded to clinical findings, evaluated bowel wall thickness, diffusion weighted imaging (DWI), mural hyperenhancement, and other inflammatory changes in each bowel segment. Twenty patients (6 men, 14 women; median age, 43.5 years; age range, 26–76 years) underwent all three examinations; 10 with Crohn’s disease (CD), three with ulcerative colitis (UC), and seven with IBD unclassified (IBD-U). Sensitivity, specificity, and accuracy were in the range of 0–75%, 81–96%, and 75–95% for wall thickening, and 0–37%, 59–89%, and 50–86% for DWI in plain MRI, respectively. Sensitivity, specificity, and accuracy were in the range of 0–50%, 96–100%, and 90–100% for wall thickening, 0–50%, 84–97%, and 82–95% for DWI, and 0–71%, 94–100%, and 85–100% for mural hyperenhancement in MRFT, respectively. The use of oral and intravenous contrast agent improves detection of bowel lesions resulting in MRFT remaining the superior choice over plain MRI for diagnostic workup in patients with IBD

  7. Diagnostic Accuracy of Nonmydriatic Fundus Photography for the Detection of Glaucoma in Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Francisco J. Muñoz-Negrete

    2015-01-01

    Full Text Available Purpose. To determine the diagnostic accuracy for glaucoma of a set of criteria with nonmydriatic monoscopic fundus photography (NMFP in diabetics. Methods. Diabetics recruited from a screening program for diabetic retinopathy and diabetic glaucoma patients recruited from our glaucoma unit were included. Any patient with evidence of diabetic retinopathy was excluded. Diabetic patients had to have no visual field defects to be included as controls. Glaucoma patients had to have a glaucomatous field defect in at least one eye to be included. One NMFP was taken per eye for all subjects. These photographs were evaluated by two masked glaucoma specialists for the presence of the following: bilateral cup to disc (C/D ratio ≥0.6, notching or thinning of the neuroretinal rim, disc hemorrhages, and asymmetry in the C/D ratio between both eyes ≥0.2. This evaluation led to a dichotomous classification: if any of the above criteria was present, the patient was classified as glaucoma. If none were present, the patient was classified as normal. Results. 72 control subjects and 72 glaucoma patients were included. Evaluation of NMFP had a sensitivity of 79.17% and a specificity of 80.56% for specialist 1 and a sensitivity of 72.22% and a specificity of 88.88% for specialist 2 for the detection of glaucoma. The overall accuracy was 79.83% and 80.55%, respectively. Discussion. NMFP evaluation by a glaucoma specialist may be useful for the detection of glaucoma in diabetics.

  8. Decree No. 89-85 of 8 February 1989 setting up a Council on Technological Risk Prevention

    International Nuclear Information System (INIS)

    1989-01-01

    The Council set up by this Decree contributes to the assessment of collective risks arising from industrial activities, in particular nuclear activities, through its opinions, recommendations, studies, and proposes the relevant preventive actions to the Government. (NEA) [fr

  9. Set up of analytical methods for evaluation of specifications of recombinant Hepatitis-B vaccine

    Directory of Open Access Journals (Sweden)

    Daram M

    2009-06-01

    Full Text Available "nBackground: Hepatitis B vaccination has been included in routine immunization of all individuals according to WHO recommendations since 1991. Despite successful coverage, 3-5% of recipients fail to mount a desirable protection level of Ab. Vaccine failure results from: emergence of mutation, immune failure of individuals, decrease in vaccine potency, and etc. The quality of Hepatitis B vaccine should be evaluated by a reliable method. "n"nMethods: The amount of vaccine antigen was measured through the in vitro assay of Hepatitis B vaccines which consists of multiple dilutions of the reference material and samples. The preparations were evaluated by Elisa to determine the amount of HBsAg. The data were analyzed by parallel-line analysis software. The in vivo assay was performed by inoculating multiple doses of the reference and sample preparations in Balb/c mice. A control group was also inoculated with vaccine matrix. Four weeks later, the mice sera were evaluated to determine the presence of antibodies against Hepatitis B by Elisa method. The data were analyzed by Probit analysis software. "n"nResults: Both methods were set up in our laboratory by which different batches of Hepatitis B vaccine were evaluated. It was observed that In vivo and In vitro methods provide comparable results. Therefore we can use the in vitro method for routine testing of HB vaccine quality control. "n"nConclusion: In vitro method can be used in place of In vivo method because of its time and cost-effectiveness. Moreover, since no animals are used in in vitro method, it complies well with the 3R concept (Reduction, Refinement, and Replacement of animal testing and the current tendency to use alternative method.

  10. The importance of site selection for setting up a wind turbine

    Energy Technology Data Exchange (ETDEWEB)

    Raghunandan, A.; Gowda, G.; Pandian, A. [MS RAMAIAH Institute of Technology, Bangalore (India); Ramanan, G. [RV College of Engineering, Bangalore (India)

    2012-07-01

    A wind energy system transforms the kinetic energy of the wind into mechanical or electrical energy that can be harnessed for practical use. Building a wind turbine is far more than simply a matter of finding a field or mountaintop where the wind is blowing and plopping one down. A great deal of attention should be given to finding the proper site for a wind turbine. The main factor one should consider is the average speed of the wind over an extended time. Estimation of the wind power potential for a site is the most important requirement for selecting a site for the installation of a wind turbine. Also wind turbines should be sited well above trees, buildings, and other obstacles else, the result will be poor energy production and increased wear and tear on the turbine. One way to get rid of this is to place the wind turbine on a tall tower. When selecting a place for setting up a wind turbine, engineers consider factors such as wind hazards, characteristics of the land that affect wind speed, and the effects of one turbine on nearby turbines in wind farms. The other factors that are important for selecting a site for installation of wind turbines are Hill effect, Roughness, or the amount of friction that Earth's surface exerts on wind, Tunnel effect, Turbulence, Variations in wind speed, Wind obstacles and Wind shear. This paper will emphasis on the necessary inspections which are to be done on the site before installing a Wind Turbine. (Author)

  11. Investigations in quantum games using EPR-type set-ups

    Science.gov (United States)

    Iqbal, Azhar

    2006-04-01

    Research in quantum games has flourished during recent years. However, it seems that opinion remains divided about their true quantum character and content. For example, one argument says that quantum games are nothing but 'disguised' classical games and that to quantize a game is equivalent to replacing the original game by a different classical game. The present thesis contributes towards the ongoing debate about quantum nature of quantum games by developing two approaches addressing the related issues. Both approaches take Einstein-Podolsky-Rosen (EPR)-type experiments as the underlying physical set-ups to play two-player quantum games. In the first approach, the players' strategies are unit vectors in their respective planes, with the knowledge of coordinate axes being shared between them. Players perform measurements in an EPR-type setting and their payoffs are defined as functions of the correlations, i.e. without reference to classical or quantum mechanics. Classical bimatrix games are reproduced if the input states are classical and perfectly anti-correlated, as for a classical correlation game. However, for a quantum correlation game, with an entangled singlet state as input, qualitatively different solutions are obtained. The second approach uses the result that when the predictions of a Local Hidden Variable (LHV) model are made to violate the Bell inequalities the result is that some probability measures assume negative values. With the requirement that classical games result when the predictions of a LHV model do not violate the Bell inequalities, our analysis looks at the impact which the emergence of negative probabilities has on the solutions of two-player games which are physically implemented using the EPR-type experiments.

  12. The second Dutch national survey on radon in dwellings. Set-up of the project

    International Nuclear Information System (INIS)

    Hiemstra, Y.; Stoop, P.; Lembrechts, J.

    1997-03-01

    In 1994 the Dutch Ministry of Housing, Spatial Planning and the Environment (VROM) commissioned RIVM to carry out a national survey on radon in dwellings, the set-up of which is described in this report. The goals of the survey were: (a) to determine the average and the range of the radon (222Rn) concentration in Dutch dwellings built since the previous survey in 1984, and (b) to quantify the relative contribution of radon from the building materials and from the soil to the indoor radon level in dwellings built in the course of the last decade. These data will be used for the selection of possible countermeasures and as a reference for evaluating the effectiveness of final regulations on radon. Two separate random samples from the Dutch housing stock were taken to answer these questions. A sample of about 1000 dwellings built between 1985 and 1993 in 52 municipalities was taken to answer the first question. The composition of the sample differs from the Dutch housing stock for a number of characteristics, the most obvious of which is the over-representation of single-family and private homes. A sample of about 450 single-family dwellings built in 14 municipalities on different soil types was taken to answer the second question. Two groups of municipalities were distinguished because of geographic differences in building practices: those where town houses predominate and those with mainly detached and semi-detached houses. Information on radon and its sources was collected through placement of alpha track detectors, installation of so-called PFT sources and passive samplers for air infiltration measurement, collection of soil samples and completion of a questionnaire on building and ventilation characteristics. The results of the study are dealt with in RIVM report no. 610058006. 8 figs., 9 tabs., 31 refs. 4 appendices

  13. Concept and set-up of an IR-gas sensor construction kit

    Science.gov (United States)

    Sieber, Ingo; Perner, Gernot; Gengenbach, Ulrich

    2015-10-01

    The paper presents an approach to a cost-efficient modularly built non-dispersive optical IR-gas sensor (NDIR) based on a construction kit. The modularity of the approach offers several advantages: First of all it allows for an adaptation of the performance of the gas sensor to individual specifications by choosing the suitable modular components. The sensitivity of the sensor e.g. can be altered by selecting a source which emits a favorable wavelength spectrum with respect to the absorption spectrum of the gas to be measured or by tuning the measuring distance (ray path inside the medium to be measured). Furthermore the developed approach is very well suited to be used in teaching. Together with students a construction kit on basis of an optical free space system was developed and partly implemented to be further used as a teaching and training aid for bachelor and master students at our institute. The components of the construction kit are interchangeable and freely fixable on a base plate. The components are classified into five groups: sources, reflectors, detectors, gas feed, and analysis cell. Source, detector, and the positions of the components are fundamental to experiment and test different configurations and beam paths. The reflectors are implemented by an aluminum coated adhesive foil, mounted onto a support structure fabricated by additive manufacturing. This approach allows derivation of the reflecting surface geometry from the optical design tool and generating the 3D-printing files by applying related design rules. The rapid fabrication process and the adjustment of the modules on the base plate allow rapid, almost LEGO®-like, experimental assessment of design ideas. Subject of this paper is modeling, design, and optimization of the reflective optical components, as well as of the optical subsystem. The realization of a sample set-up used as a teaching aid and the optical measurement of the beam path in comparison to the simulation results are

  14. Improving beam set-up using an online beam optics tool

    International Nuclear Information System (INIS)

    Richter, S.; Barth, W.; Franczak, B.; Scheeler, U.; Wilms, D.

    2004-01-01

    The GSI accelerator facility [1] consists of the Universal Linear Accelerator (Unilac), the heavy ion synchrotron SIS, and the Experimental Storage Ring (ESR). Two Unilac injectors with three ion source terminals provide ion species from the lightest such as hydrogen up to uranium. The High Current Injector (HSI) for low charge state ion beams provides mostly high intense but short pulses, whereas the High Charge State Injector (HLI) supplies long pulses with a high duty factor of up to 27%. Before entering the Alvarez section of the Unilac the ion beam from the HSI is stripped in a supersonic gas jet. Up to three different ion species can be accelerated for up to five experiments in a time-sharing mode. Frequent changes of beam energy and intensity during a single beam time period may result in time consuming set-up and tuning especially of the beam transport lines. To shorten these changeover times an online optics tool (MIRKO EXPERT) had been developed. Based on online emittance measurements at well-defined locations the beam envelopes are calculated using the actual magnet settings. With this input improved calculated magnet settings can be directly sent to the magnet power supplies. The program reads profile grid measurements, such that an atomized beam alignment is established and that steering times are minimized. Experiences on this tool will be reported. At the Unilac a special focus is put on high current operation with short but intense beam pulses. Limitations like missing non-destructive beam diagnostics, insufficient longitudinal beam diagnostics, insufficient longitudinal beam matching, and influence of the hard edged model for magnetic fields will be discussed. Special attention will be put on the limits due to high current effects with bunched beams. (author)

  15. Optimally setting up directed searches for continuous gravitational waves in Advanced LIGO O1 data

    Science.gov (United States)

    Ming, Jing; Papa, Maria Alessandra; Krishnan, Badri; Prix, Reinhard; Beer, Christian; Zhu, Sylvia J.; Eggenstein, Heinz-Bernd; Bock, Oliver; Machenschalk, Bernd

    2018-02-01

    In this paper we design a search for continuous gravitational waves from three supernova remnants: Vela Jr., Cassiopeia A (Cas A) and G347.3. These systems might harbor rapidly rotating neutron stars emitting quasiperiodic gravitational radiation detectable by the advanced LIGO detectors. Our search is designed to use the volunteer computing project Einstein@Home for a few months and assumes the sensitivity and duty cycles of the advanced LIGO detectors during their first science run. For all three supernova remnants, the sky positions of their central compact objects are well known but the frequency and spin-down rates of the neutron stars are unknown which makes the searches computationally limited. In a previous paper we have proposed a general framework for deciding on what target we should spend computational resources and in what proportion, what frequency and spin-down ranges we should search for every target, and with what search setup. Here we further expand this framework and apply it to design a search directed at detecting continuous gravitational wave signals from the most promising three supernova remnants identified as such in the previous work. Our optimization procedure yields broad frequency and spin-down searches for all three objects, at an unprecedented level of sensitivity: The smallest detectable gravitational wave strain h0 for Cas A is expected to be 2 times smaller than the most sensitive upper limits published to date, and our proposed search, which was set up and ran on the volunteer computing project Einstein@Home, covers a much larger frequency range.

  16. Electromagnetic impact by microcellular base stations: analysis and guidelines for a correct setting up

    International Nuclear Information System (INIS)

    Licitra, G.; Reggiani, M.; Silvi, A.M.; Zari, A.; Ricci, A.

    2002-01-01

    During the last few years the development of mobile communications has required ever increasing number of base stations for both existing mobile operators and new ones. More and more users ask for a higher quality services so new technological solutions have been studied and applied to assure effective coverage for given geographical areas, as in squares or narrow streets, characterized by a very high traffic demand or where coverage by usual macro cells is very difficult. On the other side, modern societies of developed countries ask for a better and better quality of life and appropriate government policies. Several studies of national and international scientific organizations have been performed and are still in progress to establish any possible adverse effects on human health of non-ionizing radiation exposure. So, many governments, forced by public opinion pressure, have produced specific standards in agreement with scientific organization guidelines and prudent avoidance politics too. Nowadays, designing their networks, mobile operators have to respect requirements contained in these standards. So a hierarchical cellular system have been recently proposed to comply more easily with both coverage requirements and lower exposure limits. This new coverage strategy of geographical areas requires the presence of microcells beside the usual macro cells. In this paper the study of the distribution of the electromagnetic field levels produced by microcellular base stations characterized by different features and configurations is presented, in order to define a few guidelines for the correct setting up of antennas in compliance with current standard requirements. This is obtained comparing results of theoretical modeling, based on the radio electrical characteristics of each sources, and measurements data. Results achieved by measurements performed on a preliminary sample of microcells have been presented in this work

  17. A quality control study of the accuracy of patient positioning in irradiation of pelvic fields

    International Nuclear Information System (INIS)

    Creutzberg, Carien L.; Althof, Vincent G.M.; Hoog, Marjan de; Visser, Andries G.; Huizenga, Henk; Wijnmaalen, Arendjan; Levendag, Peter C.

    1996-01-01

    Purpose: Determining and improving the accuracy of patient positioning in pelvic fields. Methods and Materials: Small pelvic fields were studied in 16 patients treated for urological cancers using a three-field isocentric technique. Large pelvic fields were studied in 17 gynecological cancer patients treated with anterior and posterior (AP-PA) parallel opposed fields. Quantitative analysis of 645 megavolt images and comparison to 82 simulation images were carried out. Results: Small pelvic fields: for the position of the patient in the field, standard deviations of the difference between simulation (SIM) and treatment (MV) images were 3.4 mm in the lateral direction, 5.3 mm in the cranio-caudal direction, and 4.8 mm in the ventro-dorsal direction. Alterations in the positioning technique were made and tested. Large pelvic fields: differences between simulation and treatment images for the position of the patient in the field were 4 mm [1 standard deviation (SD)] in the lateral direction and 6.5 mm in the cranio-caudal direction. A systematic shift of the treatment field in the cranial direction had occurred in the majority of patients. A positioning technique using laser lines and marking of the caudal field border was shown to be more accurate. Conclusion: Studies of positioning accuracy in routine irradiation techniques are needed to obtain data for definition of the margins for each treatment site at each institution. Random variations should be kept at a minimum by monitoring and improving positioning techniques. Treatment verification by megavolt imaging or film should be used to detect and correct systematic variations early in the treatment series

  18. Accuracy of the Timed Up and Go test for predicting sarcopenia in elderly hospitalized patients.

    Science.gov (United States)

    Martinez, Bruno Prata; Gomes, Isabela Barboza; Oliveira, Carolina Santana de; Ramos, Isis Resende; Rocha, Mônica Diniz Marques; Forgiarini Júnior, Luiz Alberto; Camelier, Fernanda Warken Rosa; Camelier, Aquiles Assunção

    2015-05-01

    The ability of the Timed Up and Go test to predict sarcopenia has not been evaluated previously. The objective of this study was to evaluate the accuracy of the Timed Up and Go test for predicting sarcopenia in elderly hospitalized patients. This cross-sectional study analyzed 68 elderly patients (≥60 years of age) in a private hospital in the city of Salvador-BA, Brazil, between the 1st and 5th day of hospitalization. The predictive variable was the Timed Up and Go test score, and the outcome of interest was the presence of sarcopenia (reduced muscle mass associated with a reduction in handgrip strength and/or weak physical performance in a 6-m gait-speed test). After the descriptive data analyses, the sensitivity, specificity and accuracy of a test using the predictive variable to predict the presence of sarcopenia were calculated. In total, 68 elderly individuals, with a mean age 70.4±7.7 years, were evaluated. The subjects had a Charlson Comorbidity Index score of 5.35±1.97. Most (64.7%) of the subjects had a clinical admission profile; the main reasons for hospitalization were cardiovascular disorders (22.1%), pneumonia (19.1%) and abdominal disorders (10.2%). The frequency of sarcopenia in the sample was 22.1%, and the mean length of time spent performing the Timed Up and Go test was 10.02±5.38 s. A time longer than or equal to a cutoff of 10.85 s on the Timed Up and Go test predicted sarcopenia with a sensitivity of 67% and a specificity of 88.7%. The accuracy of this cutoff for the Timed Up and Go test was good (0.80; IC=0.66-0.94; p=0.002). The Timed Up and Go test was shown to be a predictor of sarcopenia in elderly hospitalized patients.

  19. Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea.

    Science.gov (United States)

    Kim, Sehun; Park, Jin Joo; Lee, Seung-Ah; Cho, Youngjin; Yoon, Yeonyee E; Oh, Il-Young; Yoon, Chang-Hwan; Suh, Jung-Won; Cho, Young-Seok; Youn, Tae-Jin; Cho, Goo-Yeong; Chae, In-Ho; Lee, Hae-Young; Shin, Jinho; Park, Sungha; Choi, Dong-Ju

    2018-01-01

    Currently, office blood pressure (OBP) is the most widely used method of measuring blood pressure (BP) in daily clinical practice. However, data on the diagnostic accuracy of OBP in reference to ambulatory blood pressure (ABP) are scarce in Korea. In retrospective and prospective cohorts, manual OBP and ABP measurements were compared among ambulatory hypertensive patients. Hypertension was defined as systolic OBP ≥ 140 mmHg and/or diastolic OBP ≥ 90 mmHg, and systolic ABP ≥ 130 mmHg and/or diastolic ABP ≥ 80 mmHg. In the retrospective cohort (n = 903), the mean OBP1 (before ABP measurement) was higher than ABP in both systolic (138 ± 17 mmHg vs. 123 ± 13 mmHg, p ABP ( r 2 = 0.038, p ABP, which is the reference method for measuring BP, was 43.9%. The prospective cohort (n = 57) showed similar results. In a subgroup analysis, male patients had higher false negative results (masked or under-treated hypertension) than did female patients (26.1% vs. 17.8%, p = 0.003), whereas female patients had a higher false positive rate (white-coat or over-treated hypertension) than did male patients (28.7% vs. 15.2%, p ABP. Men and women have different patterns of discordance. These findings indicate that management of hypertensive patients with manual OBP measurements may be suboptimal and encourages the use of ABP in ambulatory hypertensive patients.

  20. Setting Up Decision-Making Tools toward a Quality-Oriented Participatory Maize Breeding Program

    Science.gov (United States)

    Alves, Mara L.; Brites, Cláudia; Paulo, Manuel; Carbas, Bruna; Belo, Maria; Mendes-Moreira, Pedro M. R.; Brites, Carla; Bronze, Maria do Rosário; Gunjača, Jerko; Šatović, Zlatko; Vaz Patto, Maria C.

    2017-01-01

    Previous studies have reported promising differences in the quality of kernels from farmers' maize populations collected in a Portuguese region known to produce maize-based bread. However, several limitations have been identified in the previous characterizations of those populations, such as a limited set of quality traits accessed and a missing accurate agronomic performance evaluation. The objectives of this study were to perform a more detailed quality characterization of Portuguese farmers' maize populations; to estimate their agronomic performance in a broader range of environments; and to integrate quality, agronomic, and molecular data in the setting up of decision-making tools for the establishment of a quality-oriented participatory maize breeding program. Sixteen farmers' maize populations, together with 10 other maize populations chosen for comparison purposes, were multiplied in a common-garden experiment for quality evaluation. Flour obtained from each population was used to study kernel composition (protein, fat, fiber), flour's pasting behavior, and bioactive compound levels (carotenoids, tocopherols, phenolic compounds). These maize populations were evaluated for grain yield and ear weight in nine locations across Portugal; the populations' adaptability and stability were evaluated using additive main effects and multiplication interaction (AMMI) model analysis. The phenotypic characterization of each population was complemented with a molecular characterization, in which 30 individuals per population were genotyped with 20 microsatellites. Almost all farmers' populations were clustered into the same quality-group characterized by high levels of protein and fiber, low levels of carotenoids, volatile aldehydes, α- and δ-tocopherols, and breakdown viscosity. Within this quality-group, variability on particular quality traits (color and some bioactive compounds) could still be found. Regarding the agronomic performance, farmers' maize populations

  1. Setting Up Decision-Making Tools toward a Quality-Oriented Participatory Maize Breeding Program

    Directory of Open Access Journals (Sweden)

    Mara L. Alves

    2017-12-01

    Full Text Available Previous studies have reported promising differences in the quality of kernels from farmers' maize populations collected in a Portuguese region known to produce maize-based bread. However, several limitations have been identified in the previous characterizations of those populations, such as a limited set of quality traits accessed and a missing accurate agronomic performance evaluation. The objectives of this study were to perform a more detailed quality characterization of Portuguese farmers' maize populations; to estimate their agronomic performance in a broader range of environments; and to integrate quality, agronomic, and molecular data in the setting up of decision-making tools for the establishment of a quality-oriented participatory maize breeding program. Sixteen farmers' maize populations, together with 10 other maize populations chosen for comparison purposes, were multiplied in a common-garden experiment for quality evaluation. Flour obtained from each population was used to study kernel composition (protein, fat, fiber, flour's pasting behavior, and bioactive compound levels (carotenoids, tocopherols, phenolic compounds. These maize populations were evaluated for grain yield and ear weight in nine locations across Portugal; the populations' adaptability and stability were evaluated using additive main effects and multiplication interaction (AMMI model analysis. The phenotypic characterization of each population was complemented with a molecular characterization, in which 30 individuals per population were genotyped with 20 microsatellites. Almost all farmers' populations were clustered into the same quality-group characterized by high levels of protein and fiber, low levels of carotenoids, volatile aldehydes, α- and δ-tocopherols, and breakdown viscosity. Within this quality-group, variability on particular quality traits (color and some bioactive compounds could still be found. Regarding the agronomic performance, farmers

  2. The experience of a nationwide Community of Practice to set up Regional Prevention Plans in Italy.

    Science.gov (United States)

    Giusti, Angela; Perra, Alberto; Lombardo, Flavia

    2017-07-27

    In 2010, the Italian Ministry of Health decided to start the planning process to elaborate the National Plan of Prevention 2010-2012 jointly with the 21 Regions. The National Institute of Health was responsible for supporting regional planners (RPs) by an original participatory approach of a web-based Community of Practice (CoP) to set up their own Regional Plans of Prevention. In this paper, we summarise the theoretical framework adopted, the main phases characterising the lifecycle of the nationwide CoP, the evaluation approach adopted and its findings. Following the CoP theoretical framework from Wenger, an initial group of RPs were trained on Project Cycle Management as a planning method and thereafter they started interacting on a web-based Moodle platform for 8 months. The CoP evaluation mainly took into account aspects of 'immediate value', such as members interactions within the website, and several quantitative and qualitative tools were used to monitor changes over time. Data were retrieved from Moodle statistics or directly from the RPs by the means of a Knowledge, Attitude and Practice survey, a reaction survey, SWOT analysis and focus groups. The level of individual RPs knowledge increased after the initial course from 55.7% to 75%, attitudes and competence perception about the planning process method also showed an overall favourable change. During the CoP life span, the number of members increased from the original 98 RPs to include up to 600 new members on the basis of spontaneous demand. From April 2010 to January 2011, the 'vital signs' of the CoP were monitored, including RP logins (13,450 total logins and 3744 unique logins), views (27,522) and posts (1606) distributed in 326 forum discussion threads. Data and information retrieved from quantitative and qualitative evaluation approaches proved to be useful for the management and follow-up of the CoP. The CoP experience was successful as 19 out of 20 Regions submitted their Regional Preventive

  3. Accuracy of chest radiography versus chest computed tomography in hemodynamically stable patients with blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Chardoli Mojtaba

    2013-12-01

    Full Text Available 【Abstract】 Objective: Thoracic injuries are respon- sible for 25% of deaths of blunt traumas. Chest X-ray (CXR is the first diagnostic method in patients with blunt trauma. The aim of this study was to detect the accuracy of CXR versus chest computed tomograpgy (CT in hemodynami- cally stable patients with blunt chest trauma. Methods: Study was conducted at the emergency department of Sina Hospital from March 2011 to March 2012. Hemodynamically stable patients with at least 16 years of age who had blunt chest trauma were included. All patients underwent the same diagnostic protocol which consisted of physical examination, CXR and CT scan respectively. Results: Two hundreds patients (84% male and 16% female were included with a mean age of (37.9±13.7 years. Chin J Traumatol 2013;16(6:351-354 Rib fracture was the most common finding of CXR (12.5% and CT scan (25.5%. The sensitivity of CXR for hemothorax, thoracolumbar vertebra fractures and rib fractures were 20%, 49% and 49%, respectively. Pneumothorax, foreign body, emphysema, pulmonary contusion, liver hematoma and ster- num fracture were not diagnosed with CXR alone. Conclusion: Applying CT scan as the first-line diag- nostic modality in hemodynamically stable patients with blunt chest trauma can detect pathologies which may change management and outcome. Key words: Radiography; Thoracic injuries; Tomography, X-ray computed

  4. Microcirculation and its relation to continuous subcutaneous glucose sensor accuracy in cardiac surgery patients in the intensive care unit

    NARCIS (Netherlands)

    Siegelaar, Sarah E.; Barwari, Temo; Hermanides, Jeroen; van der Voort, Peter H. J.; Hoekstra, Joost B. L.; DeVries, J. Hans

    2013-01-01

    Continuous glucose monitoring could be helpful for glucose regulation in critically ill patients; however, its accuracy is uncertain and might be influenced by microcirculation. We investigated the microcirculation and its relation to the accuracy of 2 continuous glucose monitoring devices in

  5. Diagnostic Accuracy of Ultrasonography in the Initial Evaluation of Patients with Penetrating Chest Trauma

    Directory of Open Access Journals (Sweden)

    Farhad Heydari

    2014-03-01

    Full Text Available Introduction: Traumatic chest injuries (TCI are one of the most common causes of referring to the emergency departments, with high mortality and disability. This study was designed to evaluate the diagnostic accuracy of ultrasonography versus chest X ray (CXR in detection of hemo-pneumothorax for patients suffering penetrating TCI. Methods: The present cross-sectional study was performed to evaluate the diagnostic accuracy of ultrasonography in penetrating TCI victims referred to the emergency department of Shahid Kashani and Alzahra hospitals of Isfahan, Iran, from July 2012 to June 2013. Bedside ultrasonography and plain CXR was done on arrival and three hours after admission. The results of ultrasonography and radiography were separately evaluated by an emergency medicine specialist and a radiologist, who were blind to the aims of the study. Then, sensitivity, specificity, positive predictive value (PPV, negative predictive value (NPV, and kappa coefficient was considered to evaluate the accuracy of ultrasonography. Results: In this research 64 patients with penetrating chest trauma were assessed (98.4% male. The mean age of them was 25.6±8.5 years (rang: 13-65. The plain radiography revealed the eight (12.5 % cases of pneumothorax and one (1.6% hemothorax. The findings of primary ultrasonography also showed the same number of hemo-pneumothorax. Sensitivity and specificity of primary ultrasound in diagnosis of pneumothorax were 100% (95% Cl: 60.7- 100 and 100.0% (95% Cl, 92.0% to 100.0% and in detection of hemothorax were 100% (95% Cl: 50.5-100 and 100% (95% Cl: 92.8-100, respectively. Sensitivity and specificity of ultrasound in the third hour were 100% (95% Cl: 31.3-100 and 100% (95% Cl: 91.4-100, respectively. Conclusion: Findings of the present study have shown that ultrasonography has an acceptable diagnostic accuracy in the initial assessment of patients with penetrating chest trauma. However, because of its dependency on operator

  6. Accuracy of pre-contrast imaging in abdominal magnetic resonance imaging of pediatric oncology patients

    International Nuclear Information System (INIS)

    Mohd Zaki, Faizah; Moineddin, Rahim; Grant, Ronald; Chavhan, Govind B.

    2016-01-01

    Safety concerns are increasingly raised regarding the use of gadolinium-based contrast media for MR imaging. To determine the accuracy of pre-contrast abdominal MR imaging for lesion detection and characterization in pediatric oncology patients. We included 120 children (37 boys and 83 girls; mean age 8.94 years) referred by oncology services. Twenty-five had MRI for the first time and 95 were follow-up scans. Two authors independently reviewed pre-contrast MR images to note the following information about the lesions: location, number, solid vs. cystic and likely nature. Pre- and post-contrast imaging reviewed together served as the reference standard. The overall sensitivity was 88% for the first reader and 90% for the second; specificity was 94% and 91%; positive predictive value was 96% and 94%; negative predictive value was 82% and 84%; accuracy of pre-contrast imaging for lesion detection as compared to the reference standard was 90% for both readers. The difference between mean number of lesions detected on pre-contrast imaging and reference standard was not significant for either reader (reader 1, P = 0.072; reader 2, P = 0.071). There was substantial agreement (kappa values of 0.76 and 0.72 for readers 1 and 2) between pre-contrast imaging and reference standard for determining solid vs. cystic lesion and likely nature of the lesion. The addition of post-contrast imaging increased confidence of both readers significantly (P < 0.0001), but the interobserver agreement for the change in confidence was poor (kappa 0.12). Pre-contrast abdominal MR imaging has high accuracy in lesion detection in pediatric oncology patients and shows substantial agreement with the reference standard for characterization of lesions. Gadolinium-based contrast media administration cannot be completely eliminated but can be avoided in many cases, with the decision made on a case-by-case basis, taking into consideration location and type of tumor. (orig.)

  7. Accuracy and precision of four common peripheral temperature measurement methods in intensive care patients

    Directory of Open Access Journals (Sweden)

    Asadian S

    2016-09-01

    Full Text Available Simin Asadian,1 Alireza Khatony,1 Gholamreza Moradi,2 Alireza Abdi,1 Mansour Rezaei,3 1Nursing and Midwifery School, Kermanshah University of Medical Sciences, 2Department of Anesthesiology, 3Biostatistics & Epidemiology Department, Kermanshah University of Medical Sciences, Kermanshah, Iran Introduction: An accurate determination of body temperature in critically ill patients is a fundamental requirement for initiating the proper process of diagnosis, and also therapeutic actions; therefore, the aim of the study was to assess the accuracy and precision of four noninvasive peripheral methods of temperature measurement compared to the central nasopharyngeal measurement. Methods: In this observational prospective study, 237 patients were recruited from the intensive care unit of Imam Ali Hospital of Kermanshah. The patients’ body temperatures were measured by four peripheral methods; oral, axillary, tympanic, and forehead along with a standard central nasopharyngeal measurement. After data collection, the results were analyzed by paired t-test, kappa coefficient, receiver operating characteristic curve, and using Statistical Package for the Social Sciences, version 19, software. Results: There was a significant meaningful correlation between all the peripheral methods when compared with the central measurement (P<0.001. Kappa coefficients showed good agreement between the temperatures of right and left tympanic membranes and the standard central nasopharyngeal measurement (88%. Paired t-test demonstrated an acceptable precision with forehead (P=0.132, left (P=0.18 and right (P=0.318 tympanic membranes, oral (P=1.00, and axillary (P=1.00 methods. Sensitivity and specificity of both the left and right tympanic membranes were more than for other methods. Conclusion: The tympanic and forehead methods had the highest and lowest accuracy for measuring body temperature, respectively. It is recommended to use the tympanic method (right and left for

  8. Accuracy of pre-contrast imaging in abdominal magnetic resonance imaging of pediatric oncology patients

    Energy Technology Data Exchange (ETDEWEB)

    Mohd Zaki, Faizah [University of Toronto, Department of Diagnostic Imaging, The Hospital for Sick Children and Medical Imaging, Toronto, ON (Canada); Universiti Kebangsaan Malaysia Medical Center, Department of Radiology, Kuala Lumpur (Malaysia); Moineddin, Rahim [University of Toronto, Department of Family and Community Medicine, Toronto, ON (Canada); Grant, Ronald [University of Toronto, Department of Hematology and Oncology, The Hospital for Sick Children and Medical Imaging, Toronto, ON (Canada); Chavhan, Govind B. [University of Toronto, Department of Diagnostic Imaging, The Hospital for Sick Children and Medical Imaging, Toronto, ON (Canada)

    2016-11-15

    Safety concerns are increasingly raised regarding the use of gadolinium-based contrast media for MR imaging. To determine the accuracy of pre-contrast abdominal MR imaging for lesion detection and characterization in pediatric oncology patients. We included 120 children (37 boys and 83 girls; mean age 8.94 years) referred by oncology services. Twenty-five had MRI for the first time and 95 were follow-up scans. Two authors independently reviewed pre-contrast MR images to note the following information about the lesions: location, number, solid vs. cystic and likely nature. Pre- and post-contrast imaging reviewed together served as the reference standard. The overall sensitivity was 88% for the first reader and 90% for the second; specificity was 94% and 91%; positive predictive value was 96% and 94%; negative predictive value was 82% and 84%; accuracy of pre-contrast imaging for lesion detection as compared to the reference standard was 90% for both readers. The difference between mean number of lesions detected on pre-contrast imaging and reference standard was not significant for either reader (reader 1, P = 0.072; reader 2, P = 0.071). There was substantial agreement (kappa values of 0.76 and 0.72 for readers 1 and 2) between pre-contrast imaging and reference standard for determining solid vs. cystic lesion and likely nature of the lesion. The addition of post-contrast imaging increased confidence of both readers significantly (P < 0.0001), but the interobserver agreement for the change in confidence was poor (kappa 0.12). Pre-contrast abdominal MR imaging has high accuracy in lesion detection in pediatric oncology patients and shows substantial agreement with the reference standard for characterization of lesions. Gadolinium-based contrast media administration cannot be completely eliminated but can be avoided in many cases, with the decision made on a case-by-case basis, taking into consideration location and type of tumor. (orig.)

  9. Accuracy of Platelet Counting by Optical and Impedance Methods in Patients with Thrombocytopaenia and Microcytosis

    Directory of Open Access Journals (Sweden)

    Mohamed-Rachid Boulassel

    2015-11-01

    Full Text Available Objectives: Obtaining accurate platelet counts in microcytic blood samples is challenging, even with the most reliable automated haematology analysers. The CELL-DYN™ Sapphire (Abbott Laboratories, Chicago, Illinois, USA analyser uses both optical density and electronic impedance methods for platelet counting. This study aimed to evaluate the accuracy of optical density and electrical impedance methods in determining true platelet counts in thrombocytopaenic samples with microcytosis as defined by low mean corpuscular volume (MCV of red blood cells. Additionally, the impact of microcytosis on platelet count accuracy was evaluated. Methods: This study was carried out between February and December 2014 at the Haematology Laboratory of the Sultan Qaboos University Hospital in Muscat, Oman. Blood samples were collected and analysed from 189 patients with thrombocytopaenia and MCV values of <76 femtolitres. Platelet counts were tested using both optical and impedance methods. Stained peripheral blood films for each sample were then reviewed as a reference method to confirm platelet counts. Results: The platelet counts estimated by the impedance method were on average 30% higher than those estimated by the optical method (P <0.001. The estimated intraclass correlation coefficient was 0.52 (95% confidence interval: 0.41–0.62, indicating moderate reliability between the methods. The degree of agreement between methods ranged from -85.5 to 24.3 with an estimated bias of -30, suggesting that these methods generate different platelet results. Conclusion: The impedance method significantly overestimated platelet counts in microcytic and thrombocytopaenic blood samples. Further attention is therefore needed to improve the accuracy of platelet counts, particularly for patients with conditions associated with microcytosis.

  10. Diagnostic accuracy of a step-up imaging strategy in pediatric patients with blunt abdominal trauma

    International Nuclear Information System (INIS)

    Schuppen, J. van; Olthof, D.C.; Wilde, J.C.H.; Beenen, L.F.M.; Rijn, R.R. van; Goslings, J.C.

    2014-01-01

    Introduction: Blunt abdominal trauma (BAT) is an important but often unrecognized cause of death in children. Imaging plays a vital role in the early detection of abdominal trauma. The exact role of imaging in the management of BAT in children is still under research. The aim of this study was to assess diagnostic accuracy of a step-up imaging strategy, where the decision to observe or to perform an intervention depends on the vital parameters of the patient, in combination with the presence or absence of free fluid at Focused Assessment with Sonography for Trauma (FAST) and the findings on CT (performed selectively), for pediatric patients presenting to the ED with a blunt abdominal trauma. Methods: Consecutive patients aged ≤16 years admitted between January 2008 and December 2012 to a Dutch level 1 trauma centre were included in this retrospective study. Sensitivity, negative predictive value (NPV) and the negative likelihood ratio (LR−) of the imaging strategy were calculated. Results: The cohort consisted of 122 patients; 66 (54%) patients were discharged home after primary survey, 51 (41%) patients were admitted and observed, 3 (2%) patients underwent transarterial embolization and 2 (2%) patients underwent surgery. Treatment failed in 1 patient, initially selected for observation. The sensitivity of the imaging strategy was 0.833 (0.446–0.990). The NPV and LR− were 0.991 (0.963–1.000) and 0.167 (0.028–0.997), respectively. Conclusion: The step-up imaging strategy that is applied in our academic level 1 trauma centre has a high sensitivity and a high negative predictive value. No clinically relevant injuries were missed without doing unnecessary harm, e.g. radiation or an intervention

  11. Investigating the recording and accuracy of fluid balance monitoring in critically ill patients

    Directory of Open Access Journals (Sweden)

    Annette Diacon

    2014-11-01

    Full Text Available Background. The accurate assessment of fluid balance data collected during physical assessment as well as during monitoring and record-keeping forms an essential part of the baseline patient information that guides medical and nursing interventions aimed at achieving physiological stability in patients. An informal audit of 24-hour fluid balance records in a local intensive care unit (ICU showed that seven out of ten fluid balance calculations were incorrect.Objective. To identify and describe current clinical nursing practice in fluid balance monitoring and measurement accuracy in ICUs, conducted as part of a broader study in partial fulfilment of a Master of Nursing degree.Methods. A quantitative approach utilising a descriptive, exploratory study design was applied. An audit of 103 ICU records was conducted to establish the current practices and accuracy in recording of fluid balance monitoring. Data were collected using a purpose-designed tool based on relevant literature and practice experience. Results. Of the original recorded fluid balance calculations, 79% deviated by more than 50 mL from the audited calculations. Further­more, a significant relationship was shown between inaccurate fluid balance calculation and administration of diuretics (p=0.01. Conclusion. The majority of fluid balance records were incorrectly calculated.

  12. Set-up of proportional counter L2 for 14C measurements with improved precision

    International Nuclear Information System (INIS)

    Goslar, T.; Pazdur, A.; Pazdur, M.F.; Walanus, A.; Zastawny, A.

    1990-01-01

    Radiocarbon dating with improved precision denotes determination of conventional radiocarbon dates with accuracy equal to ca ± 25 yr. The paper presents some fundamental data concerning construction and design of the proportional counter L2, the results of calibration of the counter, including detailed information on changes of the background counting rate. The counter L2 enables dating of samples up to 50 000 yr. For samples younger than 3000 yr the error of dating is equal to ca ± 25 yr. 4 figs., 1 tab., 9 refs. (author)

  13. Accuracy of the all patient refined diagnosis related groups classification system in congenital heart surgery.

    Science.gov (United States)

    Parnell, Aimee S; Shults, Justine; Gaynor, J William; Leonard, Mary B; Dai, Dingwei; Feudtner, Chris

    2014-02-01

    Administrative data are increasingly used to evaluate clinical outcomes and quality of care in pediatric congenital heart surgery (CHS) programs. Several published analyses of large pediatric administrative data sets have relied on the All Patient Refined Diagnosis Related Groups (APR-DRG, version 24) diagnostic classification system. The accuracy of this classification system for patients undergoing CHS is unclear. We performed a retrospective cohort study of all 14,098 patients 0 to 5 years of age undergoing any of six selected congenital heart operations, ranging in complexity from isolated closure of a ventricular septal defect to single-ventricle palliation, at 40 tertiary-care pediatric centers in the Pediatric Health Information Systems database between 2007 and 2010. Assigned APR-DRGs (cardiac versus noncardiac) were compared using χ2 or Fisher's exact tests between those patients admitted during the first day of life versus later and between those receiving extracorporeal membrane oxygenation support versus those not. Recursive partitioning was used to assess the greatest determinants of APR-DRG type in the model. Every patient admitted on day 1 of life was assigned to a noncardiac APR-DRG (pDRG (pDRG experienced a significantly increased mortality (pDRG coding has systematic misclassifications, which may result in inaccurate reporting of CHS case volumes and mortality. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Patient and professional accuracy of recalled treatment decisions in out-patient consultations

    DEFF Research Database (Denmark)

    Skinner, T. C.; Barnard, K.; Cradock, S.

    2007-01-01

    Aims: To test the assumption that professional recall of consultation decisions is valid and more accurate than patient recall of consultation decisions. Methods: One hundred and thirty-four consultations between diabetes specialist nurses and diabetes specialist dietitians in an adult out-patien...

  15. Evaluating Speed Enforcement Field Set-Ups Used by Regional Police in Belgium: An Analysis of Speed Outcome Indicators

    Directory of Open Access Journals (Sweden)

    Brenda Wilmots

    2016-12-01

    Full Text Available In this paper the results from a field experiment (conducted in 2012 are presented, in which 3 regional police units in the Flemish region of Belgium each tested a particular combination of a speed control (with mobile radar in an anonymous car with communicative signage. The goal of this paper was to scientifically evaluate frequently used field set-ups. The following set-ups were tested in one week: (1 police unit 1: speed control with and without a static feedback sign placed after the control; (2 police unit 2: speed control with and without a digital feedback sign placed after the control; (3 police unit 3: speed display followed by a second speed display further along the road section. During certain time frames, speed control took place in between both signs. All tested field set-ups generated significant reductions in the speed level. Studying the effect of the different variations for each set-up reveals that the effect of the speed control is generally larger in combination with the signage alongside the road. After the period during which the police activities took place, speed levels again reached their initial level. Based on the before–after analysis, only in police area 2 was a small ‘time halo-effect’ found. To generalize results from this pilot study, repetition of tested set-ups in the field is recommended as well as testing on a larger scale.

  16. A fast-response production-inventory model for deteriorating seasonal products with learning in set-ups

    Directory of Open Access Journals (Sweden)

    Ibraheem Abdul

    2011-10-01

    Full Text Available The classical production-inventory model assumes that both demand and set-up costs are constant. However, in real manufacturing environment, managers usually embark on continuous improvement programmes that often lead to more effective use of tools and machineries and consequently reduction in set-up costs. In fact, constant emphasis on reduction of set-up costs is usually cited as one of the factors responsible for the efficiency of Japanese manufacturing methods. On the other hand, the demand for seasonal product is often characterized by a mixture of time-dependent patterns over the entire season. This paper investigates the effect of learning-based reduction in set-up costs on the optimal schedules and costs of a production-inventory system for deteriorating seasonal products. The demand pattern is a general three-phase ramp-type demand function that represents the various phases of demand commonly observed in many seasonal products in the market. A two-parameter Weibull-distribution function is used for the deterioration of items in order to make the model more generalized and realistic. The study further presents two different multi-period production strategies that can ensure a fast-response to customers’ demand and compare them with the usual single period strategy. The Numerical example and sensitivity analysis shows that learning-based reduction in set-up costs leads to higher production frequency and shorter production runs which are vital aspects of the just-in-time (JIT philosophy.

  17. [Three types of brand name loyalty strategies set up by drug manufacturers].

    Science.gov (United States)

    PréMont, Marie-Claude; Gagnon, Marc-André

    2014-11-01

    The recent restructuring of the pharmaceutical industry has led to three new types of promotional strategies to build patient loyalty to brand name drugs: loyalty through rebates, patient support, and compassion programs. Loyalty through rebates seeks to keep patients on a brand name drug and prevent their switch to the generic equivalent. Loyalty through patient support provides aftersales services to help and support patients (by phone or home visits) in order to improve adherence to their treatments. Finally, compassion programs offer patients access to drugs still awaiting regulatory approval or reimbursement by insurers. When and if the approval process is successful, the manufacturer puts an end to the compassion program and benefits from a significant cohort of patients already taking a very expensive drug for which reimbursement is assured. The impact of these programs on public policies and patients' rights raises numerous concerns, among which the direct access to patients and their health information by drug manufacturers and upward pressure on costs for drug insurance plans.

  18. A conceptual design of the set-up for solid state spectroscopy with free electron laser and insertion device radiation

    CERN Document Server

    Makhov, V N

    2001-01-01

    The set-up for complex solid state spectroscopy with the use of enhanced properties of radiation from insertion devices and free electron lasers is proposed. Very high flux and pulsed properties of radiation from insertion devices and free electron lasers offer the possibility for the use of such powerful techniques as electron paramagnetic resonance (EPR) and optically detected magnetic resonance (ODMR) for the studies of excited states of electronic excitations or defects in solids. The power density of radiation can become high enough for one more method of exited-state spectroscopy: transient optical absorption spectroscopy. The set-up is supposed to combine the EPR/ODMR spectrometer, i.e. cryostat supplied with superconducting magnet and microwave system, and the optical channels for excitation (by radiation from insertion devices or free electron laser) and detection of luminescence (i.e. primary and secondary monochromators). The set-up can be used both for 'conventional' spectroscopy of solids (reflec...

  19. A Full-size High Temperature Superconducting Coil Employed in a Wind Turbine Generator Set-up

    DEFF Research Database (Denmark)

    Song, Xiaowei (Andy); Mijatovic, Nenad; Kellers, Jürgen

    2016-01-01

    A full-size stationary experimental set-up, which is a pole pair segment of a 2 MW high temperature superconducting (HTS) wind turbine generator, has been built and tested under the HTS-GEN project in Denmark. The performance of the HTS coil is crucial to the set-up, and further to the development...... is tested in LN2 first, and then tested in the set-up so that the magnetic environment in a real generator is reflected. The experimental results are reported, followed by a finite element simulation and a discussion on the deviation of the results. The tested and estimated Ic in LN2 are 148 A and 143 A...

  20. High-resolution CT of nontuberculous mycobacterium infection in adult CF patients: diagnostic accuracy

    International Nuclear Information System (INIS)

    McEvoy, Sinead; Lavelle, Lisa; Kilcoyne, Aoife; McCarthy, Colin; Dodd, Jonathan D.; DeJong, Pim A.; Loeve, Martine; Tiddens, Harm A.W.M.; McKone, Edward; Gallagher, Charles G.

    2012-01-01

    To determine the diagnostic accuracy of high-resolution computed tomography (HRCT) for the detection of nontuberculous mycobacterium infection (NTM) in adult cystic fibrosis (CF) patients. Twenty-seven CF patients with sputum-culture-proven NTM (NTM+) underwent HRCT. An age, gender and spirometrically matched group of 27 CF patients without NTM (NTM-) was included as controls. Images were randomly and blindly analysed by two readers in consensus and scored using a modified Bhalla scoring system. Significant differences were seen between NTM (+) and NTM (-) patients in the severity of the bronchiectasis subscore [45 % (1.8/4) vs. 35 % (1.4/4), P = 0.029], collapse/consolidation subscore [33 % (1.3/3) vs. 15 % (0.6/3)], tree-in-bud/centrilobular nodules subscore [43 % (1.7/3) vs. 25 % (1.0/3), P = 0.002] and the total CT score [56 % (18.4/33) vs. 46 % (15.2/33), P = 0.002]. Binary logistic regression revealed BMI, peribronchial thickening, collapse/consolidation and tree-in-bud/centrilobular nodules to be predictors of NTM status (R 2 = 0.43). Receiver-operator curve analysis of the regression model showed an area under the curve of 0.89, P < 0.0001. In adults with CF, seven or more bronchopulmonary segments showing tree-in-bud/centrilobular nodules on HRCT is highly suggestive of NTM colonisation. (orig.)

  1. High-resolution CT of nontuberculous mycobacterium infection in adult CF patients: diagnostic accuracy

    Energy Technology Data Exchange (ETDEWEB)

    McEvoy, Sinead; Lavelle, Lisa; Kilcoyne, Aoife; McCarthy, Colin; Dodd, Jonathan D. [St. Vincent' s University Hospital, Department of Radiology, Dublin (Ireland); DeJong, Pim A. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Loeve, Martine; Tiddens, Harm A.W.M. [Erasmus MC-Sophia Children' s Hospital, Department of Radiology, Department of Pediatric Pulmonology and Allergology, Rotterdam (Netherlands); McKone, Edward; Gallagher, Charles G. [St. Vincent' s University Hospital, Department of Respiratory Medicine and National Referral Centre for Adult Cystic Fibrosis, Dublin (Ireland)

    2012-12-15

    To determine the diagnostic accuracy of high-resolution computed tomography (HRCT) for the detection of nontuberculous mycobacterium infection (NTM) in adult cystic fibrosis (CF) patients. Twenty-seven CF patients with sputum-culture-proven NTM (NTM+) underwent HRCT. An age, gender and spirometrically matched group of 27 CF patients without NTM (NTM-) was included as controls. Images were randomly and blindly analysed by two readers in consensus and scored using a modified Bhalla scoring system. Significant differences were seen between NTM (+) and NTM (-) patients in the severity of the bronchiectasis subscore [45 % (1.8/4) vs. 35 % (1.4/4), P = 0.029], collapse/consolidation subscore [33 % (1.3/3) vs. 15 % (0.6/3)], tree-in-bud/centrilobular nodules subscore [43 % (1.7/3) vs. 25 % (1.0/3), P = 0.002] and the total CT score [56 % (18.4/33) vs. 46 % (15.2/33), P = 0.002]. Binary logistic regression revealed BMI, peribronchial thickening, collapse/consolidation and tree-in-bud/centrilobular nodules to be predictors of NTM status (R{sup 2} = 0.43). Receiver-operator curve analysis of the regression model showed an area under the curve of 0.89, P < 0.0001. In adults with CF, seven or more bronchopulmonary segments showing tree-in-bud/centrilobular nodules on HRCT is highly suggestive of NTM colonisation. (orig.)

  2. Experimental Set-up and Full-scale measurements in the ‘Cube'

    DEFF Research Database (Denmark)

    Kalyanova, Olena; Heiselberg, Per

    The Cube' is an outdoor test facility located at the main campus of Aalborg University. It has been built in the fall of 2005 with the purpose of detailed investigations of the DSF performance, development of the empirical test cases for validation and further improvements of various building...... of any power supplied to the experimental zone in order to maintain the necessary thermal conditions. An accuracy of these measurements is justified by the quality of the facility construction: ‘the Cube' is very well insulated and tight....... simulation software for the modelling of buildings with double skin facades in the frame of IEA ECBCS ANNEX 43/SHC Task 34, Subtask EDouble Skin Facade. The test facility is designed to be flexible for a choice of the DSF operational modes, natural or mechanical flow conditions, different types of shading...

  3. Accuracy of the Timed Up and Go test for predicting sarcopenia in elderly hospitalized patients

    Directory of Open Access Journals (Sweden)

    Bruno Prata Martinez

    2015-05-01

    Full Text Available OBJECTIVES: The ability of the Timed Up and Go test to predict sarcopenia has not been evaluated previously. The objective of this study was to evaluate the accuracy of the Timed Up and Go test for predicting sarcopenia in elderly hospitalized patients. METHODS: This cross-sectional study analyzed 68 elderly patients (≥60 years of age in a private hospital in the city of Salvador-BA, Brazil, between the 1st and 5th day of hospitalization. The predictive variable was the Timed Up and Go test score, and the outcome of interest was the presence of sarcopenia (reduced muscle mass associated with a reduction in handgrip strength and/or weak physical performance in a 6-m gait-speed test. After the descriptive data analyses, the sensitivity, specificity and accuracy of a test using the predictive variable to predict the presence of sarcopenia were calculated. RESULTS: In total, 68 elderly individuals, with a mean age 70.4±7.7 years, were evaluated. The subjects had a Charlson Comorbidity Index score of 5.35±1.97. Most (64.7% of the subjects had a clinical admission profile; the main reasons for hospitalization were cardiovascular disorders (22.1%, pneumonia (19.1% and abdominal disorders (10.2%. The frequency of sarcopenia in the sample was 22.1%, and the mean length of time spent performing the Timed Up and Go test was 10.02±5.38 s. A time longer than or equal to a cutoff of 10.85 s on the Timed Up and Go test predicted sarcopenia with a sensitivity of 67% and a specificity of 88.7%. The accuracy of this cutoff for the Timed Up and Go test was good (0.80; IC=0.66-0.94; p=0.002. CONCLUSION: The Timed Up and Go test was shown to be a predictor of sarcopenia in elderly hospitalized patients.

  4. Accuracy of multidetector-row CT in diagnosing lymph node metastasis in patients with gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Takuro; Kurokawa, Yukinori; Takiguchi, Shuji; Miyazaki, Yasuhiro; Takahashi, Tsuyoshi; Yamasaki, Makoto; Miyata, Hiroshi; Nakajima, Kiyokazu; Mori, Masaki; Doki, Yuichiro [Osaka University, Graduate School of Medicine, Department of Gastroenterological Surgery, Suita, Osaka (Japan)

    2014-08-06

    The purpose of this study was to determine the optimal cut-off value of lymph node size for diagnosing metastasis in gastric cancer with multidetector-row computed tomography (MDCT) after categorizing perigastric lymph nodes into three regions. The study included 90 gastric cancer patients who underwent gastrectomy. The long-axis diameter (LAD) and short-axis diameter (SAD) of all visualized lymph nodes were measured with transverse MDCT images. The locations of lymph nodes were categorized into three regions: lesser curvature, greater curvature, and suprapancreatic. The diagnostic value of lymph node metastasis was assessed with receiver operating characteristic (ROC) analysis. The area under the curve was larger for SAD than LAD in all groups. The optimal cut-off values of SAD were determined as follows: overall, 9 mm; differentiated type, 9 mm; undifferentiated type, 8 mm; lesser curvature region, 7 mm; greater curvature region, 6 mm; and suprapancreatic region, 9 mm. The diagnostic accuracies for lymph node metastasis using individual cut-off values were 71.1 % based on histological type and 76.6 % based on region of lymph node location. The diagnostic accuracy of lymph node metastasis in gastric cancer was improved by using individual cut-off values for each lymph node region. (orig.)

  5. PCA3 and PCA3-Based Nomograms Improve Diagnostic Accuracy in Patients Undergoing First Prostate Biopsy

    Directory of Open Access Journals (Sweden)

    Virginie Vlaeminck-Guillem

    2013-08-01

    Full Text Available While now recognized as an aid to predict repeat prostate biopsy outcome, the urinary PCA3 (prostate cancer gene 3 test has also been recently advocated to predict initial biopsy results. The objective is to evaluate the performance of the PCA3 test in predicting results of initial prostate biopsies and to determine whether its incorporation into specific nomograms reinforces its diagnostic value. A prospective study included 601 consecutive patients addressed for initial prostate biopsy. The PCA3 test was performed before ≥12-core initial prostate biopsy, along with standard risk factor assessment. Diagnostic performance of the PCA3 test was evaluated. The three available nomograms (Hansen’s and Chun’s nomograms, as well as the updated Prostate Cancer Prevention Trial risk calculator; PCPT were applied to the cohort, and their predictive accuracies were assessed in terms of biopsy outcome: the presence of any prostate cancer (PCa and high-grade prostate cancer (HGPCa. The PCA3 score provided significant predictive accuracy. While the PCPT risk calculator appeared less accurate; both Chun’s and Hansen’s nomograms provided good calibration and high net benefit on decision curve analyses. When applying nomogram-derived PCa probability thresholds ≤30%, ≤6% of HGPCa would have been missed, while avoiding up to 48% of unnecessary biopsies. The urinary PCA3 test and PCA3-incorporating nomograms can be considered as reliable tools to aid in the initial biopsy decision.

  6. Diagnostic accuracy and patient acceptance of MRI in children with suspected appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Thieme, Mai E.; Valdehueza, Zaldy D.; Wiarda, Bart M. [Medical Centre Alkmaar, Department of Radiology, Alkmaar (Netherlands); Leeuwenburgh, Marjolein M.N. [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam (Netherlands); Academic Medical Centre Amsterdam, Department of Surgery, Amsterdam (Netherlands); Bouman, Donald E. [Medical Spectrum Twente, Department of Radiology, Enschede (Netherlands); Bruin, Ivar G.J.M. de; Schreurs, W.H.; Houdijk, Alexander P.J. [Medical Centre Alkmaar, Department of Surgery, Alkmaar (Netherlands); Stoker, Jaap [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam (Netherlands)

    2014-03-15

    To compare magnetic resonance imaging (MRI) and ultrasound in children with suspected appendicitis. In a single-centre diagnostic accuracy study, children with suspected appendicitis were prospectively identified at the emergency department. All underwent abdominal ultrasound and MRI within 2 h, with the reader blinded to other imaging findings. An expert panel established the final diagnosis after 3 months. We evaluated the diagnostic accuracy of three imaging strategies: ultrasound only, conditional MRI after negative or inconclusive ultrasound, and MRI only. Significance between sensitivity and specificity was calculated using McNemar's test statistic. Between April and December 2009 we included 104 consecutive children (47 male, mean age 12). According to the expert panel, 58 patients had appendicitis. The sensitivity of MRI only and conditional MRI was 100 % (95 % confidence interval 92-100), that of ultrasound was significantly lower (76 %; 63-85, P < 0.001). Specificity was comparable among the three investigated strategies; ultrasound only 89 % (77-95), conditional MRI 80 % (67-89), MRI only 89 % (77-95) (P values 0.13, 0.13 and 1.00). In children with suspected appendicitis, strategies with MRI (MRI only, conditional MRI) had a higher sensitivity for appendicitis compared with a strategy with ultrasound only, while specificity was comparable. (orig.)

  7. The Influence of Natural Frequency of the Experimental Set-up on the Friction Coefficient of Stainless Steel-304

    OpenAIRE

    M. A. Chowdhury; Md. M. Helali

    2010-01-01

    The present paper investigates experimentally the effect of natural frequency of the experimental set-up on friction property of stainless steel-304. To do so, a pin-on-disc apparatus having facility of vibrating the test samples at different directions, amplitudes and frequencies was designed and fabricated. The natural frequency of the set-up was varied by adding dead loads of the setup from 0 kg to 50 kg. At each added load the friction coefficient has been measured. Results show that both...

  8. Test of a cryogenic set-up for a 10 meter long liquid nitrogen cooled superconducting power cable

    DEFF Research Database (Denmark)

    Træholt, Chresten; Rasmussen, Carsten; Kühle (fratrådt), Anders Van Der Aa

    2000-01-01

    High temperature superconducting power cables may be cooled by a forced flow of sub-cooled liquid nitrogen. One way to do this is to circulate the liquid nitrogen (LN2) by means of a mechanical pump through the core of the cable and through a sub-cooler.Besides the cooling station, the cryogenics...... cable. We report on our experimental set-up for testing a 10 meter long high temperature superconducting cable with a critical current of 3.2 kA at 77K. The set-up consists of a custom designed cable end termination, current lead, coolant feed-through, liquid nitrogen closed loop circulation system...

  9. Diagnostic accuracy of dual-source CT coronary angiography in patients with atrial fibrillation: Meta analysis

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Gang, E-mail: cjr.sungang@vip.163.com [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Li, Min [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Jiang, Zhi-wei [Department of Health Statistics, School of Public Health, Fourth Military Medical University, No. 169, Changle West Road, Xi’an, Shaanxi 710032 (China); Xu, Lin [Department of Medical Cardiology, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Peng, Zhao-hui; Ding, Juan; Li, Li [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Jin, Zhi-tao [Department of Cardiology, General Hospital of the Second Artillery, Beijing 100088 (China)

    2013-10-01

    Rationale and objective: To synthesize the available data to underscore the diagnostic accuracy of dual-source CT (DSCT) coronary angiography in patients with atrial fibrillation (AF). Materials and methods: We searched in the electronic databases of PubMed for all published studies that examined patients with AF using DSCT. We used an exact binomial rendition of the bivariate mixed-effects regression model to synthesize the diagnostic data. Results: The positive and negative likelihood ratios (LRs) at the patient level were 6.0 (CI, 3.6–10.1) and 0.03(CI, 0.004–0.2), respectively. The negative predictive values higher than 90% were available for a CAD prevalence <78%. The pooled vessel- and segment-level estimates showed higher positive and negative LRs than the patient-level estimates (15.3 [CI, 9.8–23.9] and 0.1 [CI, 0.07–0.3]; 25.1 [CI, 10.8–58.5] and 0.2 [CI, 0.2–0.3], respectively). No statistically significant heterogeneity between studies and publication bias were found at the patient level estimate. A sensitivity analysis showed that no study influenced the pooled results larger than 0.02. Conclusions: Cardiac angiography with DSCT can be applied as an imaging test for ruling out CAD in patient with AF. However, DSCT angiography may be not an effective tool for risk stratification for the high negative LR at the artery and segment levels.

  10. Prevalence of Posttraumatic Growth Hormone Deficiency Is Highly Dependent on the Diagnostic Set-up

    DEFF Research Database (Denmark)

    Klose, Marianne Christina; Stochholm, Kirstine; Janukonyté, Jourgita

    2014-01-01

    CONTEXT: Recent international guidelines suggest pituitary screening in patients with moderate and severe traumatic brain injury (TBI). Predominantly isolated GH deficiency (GHD) was reported in the literature, raising the question of potential methodological bias. OBJECTIVE: Our objective was to...

  11. Roll and pitch set-up errors during volumetric modulated arc delivery: can adapting gantry and collimator angles compensate?

    Science.gov (United States)

    Hoffmans-Holtzer, Nienke A; Hoffmans, Daan; Dahele, Max; Slotman, Ben J; Verbakel, Wilko F A R

    2015-03-01

    The purpose of this work was to investigate whether adapting gantry and collimator angles can compensate for roll and pitch setup errors during volumetric modulated arc therapy (VMAT) delivery. Previously delivered clinical plans for locally advanced head-and-neck (H&N) cancer (n = 5), localized prostate cancer (n = 2), and whole brain with simultaneous integrated boost to 5 metastases (WB + 5M, n = 1) were used for this study. Known rigid rotations were introduced in the planning CT scans. To compensate for these, in-house software was used to adapt gantry and collimator angles in the plan. Doses to planning target volumes (PTV) and critical organs at risk (OAR) were calculated with and without compensation and compared with the original clinical plan. Measurements in the sagittal plane in a polystyrene phantom using radiochromic film were compared by gamma (γ) evaluation for 2 H&N cancer patients. For H&N plans, the introduction of 2°-roll and 3°-pitch rotations reduced mean PTV coverage from 98.7 to 96.3%. This improved to 98.1% with gantry and collimator compensation. For prostate plans respective figures were 98.4, 97.5, and 98.4%. For WB + 5M, compensation worked less well, especially for smaller volumes and volumes farther from the isocenter. Mean comparative γ evaluation (3%, 1 mm) between original and pitched plans resulted in 86% γ plan restored the mean comparison to 96% γ < 1. Preliminary data suggest that adapting gantry and collimator angles is a promising way to correct roll and pitch set-up errors of < 3° during VMAT for H&N and prostate cancer.

  12. SU-C-204-06: Surface Imaging for the Set-Up of Proton Post-Mastectomy Chestwall Irradiation: Gated Images Vs Non Gated Images

    International Nuclear Information System (INIS)

    Batin, E; Depauw, N; MacDonald, S; Lu, H

    2015-01-01

    Purpose: Historically, the set-up for proton post-mastectomy chestwall irradiation at our institution started with positioning the patient using tattoos and lasers. One or more rounds of orthogonal X-rays at gantry 0° and beamline X-ray at treatment gantry angle were then taken to finalize the set-up position. As chestwall targets are shallow and superficial, surface imaging is a promising tool for set-up and needs to be investigated Methods: The orthogonal imaging was entirely replaced by AlignRT™ (ART) images. The beamline X-Ray image is kept as a confirmation, based primarily on three opaque markers placed on skin surface instead of bony anatomy. In the first phase of the process, ART gated images were used to set-up the patient and the same specific point of the breathing curve was used every day. The moves (translations and rotations) computed for each point of the breathing curve during the first five fractions were analyzed for ten patients. During a second phase of the study, ART gated images were replaced by ART non-gated images combined with real-time monitoring. In both cases, ART images were acquired just before treatment to access the patient position compare to the non-gated CT. Results: The average difference between the maximum move and the minimum move depending on the chosen breathing curve point was less than 1.7 mm for all translations and less than 0.7° for all rotations. The average position discrepancy over the course of treatment obtained by ART non gated images combined to real-time monitoring taken before treatment to the planning CT were smaller than the average position discrepancy obtained using ART gated images. The X-Ray validation images show similar results with both ART imaging process. Conclusion: The use of ART non gated images combined with real time imaging allows positioning post-mastectomy chestwall patients in less than 3 mm / 1°

  13. SU-C-204-06: Surface Imaging for the Set-Up of Proton Post-Mastectomy Chestwall Irradiation: Gated Images Vs Non Gated Images

    Energy Technology Data Exchange (ETDEWEB)

    Batin, E; Depauw, N; MacDonald, S; Lu, H [Massachusetts General Hospital, Boston, MA (United States)

    2015-06-15

    Purpose: Historically, the set-up for proton post-mastectomy chestwall irradiation at our institution started with positioning the patient using tattoos and lasers. One or more rounds of orthogonal X-rays at gantry 0° and beamline X-ray at treatment gantry angle were then taken to finalize the set-up position. As chestwall targets are shallow and superficial, surface imaging is a promising tool for set-up and needs to be investigated Methods: The orthogonal imaging was entirely replaced by AlignRT™ (ART) images. The beamline X-Ray image is kept as a confirmation, based primarily on three opaque markers placed on skin surface instead of bony anatomy. In the first phase of the process, ART gated images were used to set-up the patient and the same specific point of the breathing curve was used every day. The moves (translations and rotations) computed for each point of the breathing curve during the first five fractions were analyzed for ten patients. During a second phase of the study, ART gated images were replaced by ART non-gated images combined with real-time monitoring. In both cases, ART images were acquired just before treatment to access the patient position compare to the non-gated CT. Results: The average difference between the maximum move and the minimum move depending on the chosen breathing curve point was less than 1.7 mm for all translations and less than 0.7° for all rotations. The average position discrepancy over the course of treatment obtained by ART non gated images combined to real-time monitoring taken before treatment to the planning CT were smaller than the average position discrepancy obtained using ART gated images. The X-Ray validation images show similar results with both ART imaging process. Conclusion: The use of ART non gated images combined with real time imaging allows positioning post-mastectomy chestwall patients in less than 3 mm / 1°.

  14. Set-up improvement in head and neck radiotherapy using a 3D off-line EPID-based correction protocol and a customised head and neck support

    International Nuclear Information System (INIS)

    Lin, Emile N.J. Th. van; Vight, Lisette van der; Huizenga, Henk; Kaanders, Johannes H.A.M.; Visser, Andries G.

    2003-01-01

    Purpose: First, to investigate the set-up improvement resulting from the introduction of a customised head and neck (HN) support system in combination with a technologist-driven off-line correction protocol in HN radiotherapy. Second, to define margins for planning target volume definition, accounting for systematic and random set-up uncertainties. Methods and materials: In 63 patients 498 treatment fractions were evaluated to develop and implement a 3D shrinking action level correction protocol. In the comparative study two different HN-supports were compared: a flexible 'standard HN-support' and a 'customised HN-support'. For all three directions (x, y and z) random and systematic set-up deviations (1 S.D.) were measured. Results: The customised HN-support improves the patient positioning compared to the standard HN-support. The 1D systematic errors in the x, y and z directions were reduced from 2.2-2.3 mm to 1.2-2.0 mm (1 S.D.). The 1D random errors for the y and z directions were reduced from 1.6 and 1.6 mm to 1.1 and 1.0 mm (1 S.D.). The correction protocol reduced the 1D systematic errors further to 0.8-1.1 mm (1 S.D.) and all deviations in any direction were within 5 mm. Treatment time per measured fraction was increased from 10 to 13 min. The total time required per patient, for the complete correction procedure, was approximately 40 min. Conclusions: Portal imaging is a powerful tool in the evaluation of the department specific patient positioning procedures. The introduction of a comfortable customised HN-support, in combination with an electronic portal imaging device-based correction protocol, executed by technologists, led to an improvement of overall patient set-up. As a result, application of proposed recipes for CTV-PTV margins indicates that these can be reduced to 3-4 mm

  15. A clinical study of vitiligo in a rural set up of Gujarat

    Directory of Open Access Journals (Sweden)

    Rita V Vora

    2014-01-01

    Full Text Available Introduction: Vitiligo is an acquired depigmentary condition caused by inactivation or destruction of melanocytes in epidermis and hair follicle. Worldwide incidence of 1% has been reported; similar to various dermatological clinics in India. Widespread prejudice, ignorance, taboos, lack of scientific appraisal, and confusion of vitiligo with leprosy makes it an immense psychological stress. Aim: To know the clinical profile of vitiligo patient with associated cofactors. Materials and Methods: Total 1,010 patients of vitiligo attended in outpatient department at Shree Krishna Hospital (SKH and Matar camp, Gujarat over 1 year period from August 2011 to July 2012 were included in this study. Detail history and clinical examination of patients were done. Results: Out of 1,010 patients 57.3% were females and 42.7 % were males. Most cases developed vitiligo by 2 nd decade of life. Progressive course was found in 60.9 % of patients. Vitiligo vulgaris (57.8% was most common morphological type. Most common site of onset (41.5% and involvement (75.7% was lower limb. Family history was present in 20.4%. Conclusions: Vitiligo constitutes important dermatological disease especially in India. The data suggest that local epidemiological behavior of vitiligo need not be the same across different regions. Vitiligo differs substantially in various clinical aspects.

  16. Order of 24 April 1970 on the setting up of ionizing radiation electric generators for medical purposes

    International Nuclear Information System (INIS)

    1970-01-01

    This Order prescribes that the setting up of electric generators emitting ionizing radiations with an energy higher than 500 KeV used for medical purposes are subject to licensing and provides a model applications form to this effect. (NEA) [fr

  17. Amendment of the Order of 2 November 1976 setting up an Institute for Protection and Nuclear Safety (29 October 1981)

    International Nuclear Information System (INIS)

    1981-01-01

    The Institute for Protection and Nuclear Safety was set up within the Atomic Energy Commission by an Order of 2 November 1976 now amended by this new Order, which specifies that, in connection with nuclear safety, the Institute provides direct technical support to the Central Service for the Safety of Nuclear Installations. (NEA) [fr

  18. Recent developments in comprehensive two-dimensional gas chromatography (GC X GC) I. Introduction and instrumental set-up

    NARCIS (Netherlands)

    Adahchour, M.; Beens, J.; Vreuls, R.J.J.; Brinkman, U.A.T.

    2006-01-01

    We review the literature on comprehensive two-dimensional gas chromatography (GC × GC), emphasizing developments in the period 2003-2005. The review opens with a general introduction, the principles of the technique and the set-up of GC × GC systems. It also discusses theoretical aspects, trends in

  19. From simple vegetation surveys to management of biodiversity data. Problems in setting up a database for alpine flora

    Directory of Open Access Journals (Sweden)

    SPIEGELBERGER, Thomas

    2011-03-01

    Full Text Available This study discusses the establishment of the FlorEM database for alpine flora which intends to become a reference on plant diversity. The difficulties in setting up the database, its advantages and limitations are all presented here.

  20. Set up for Success: An Examination of the Ronald E. McNair Postbaccalaureate Achievement Program's Mentoring Component

    Science.gov (United States)

    Wyre, Dwuena Cene

    2011-01-01

    Often, individuals are set up to fail. However, effective mentoring can set individuals up to succeed. This nonexperimental cross-sectional, predictive study examines the Ronald E. McNair Postbaccalaureate Achievement Program's mentoring component. Specific focus is placed on faculty mentor competency and its impact on McNair student intent to…

  1. Accuracy of Triple Diagnostic Test in Patients with Thyroid Nodule at Dr. Cipto Mangunkusumo General Hospital

    Directory of Open Access Journals (Sweden)

    Diani Kartini

    2017-04-01

    Full Text Available The aim of the study is to evaluate the accuracy of triple diagnostic test on thyroid nodules. The data from patients’ medical records who came to Cipto Mangunkusumo General Hospital for the first time or for evaluation of thyroid nodule and patients who underwent thyroidectomy during 2010 to 2011. Clinical examination was scored by McGill Thyroid Nodule Score. ROC procedure was performed to obtain clinical cut-off scores of diagnosis of malignant. Ultrasonography (USG result was considered malignant for TIRADS 4, 5, and 6. If clinical, USG and histopathology examinations of triple diagnostic give positive results, it will be classified as concordant malignant whereas if all those three show benign results, the classification is benign. Thyroid carcinoma was found in 134 out of 161 patients with thyroid nodule. There were 84 patients with concordant results for all three elements of the triple test. Out of 84 patients with concordant triple diagnostic results, there were 53 malignant cases (32.9% and 31 benign cases (19.3%. Main histopathological findings among patients with thyroid carcinoma was papillary (90.3%, follicular (3%, medullary (0.7%, and anaplastic (6%. The sensitivity and specificity of triple diagnostic was 77% and 94%, with positive predictive value of 98%, negative predictive value of 51,6% and accuracy of 80.9%. Combination of clinical findings, USG, and FNAB gave malignant probability of 92%, better than combination of clinical findings and USG (81.6% or clinical findings and FNAB (87%. Triple diagnostic cannot be used as an ideal test to replace frozen section examination in managing thyroid nodule. However, in cases with concordant results of each triple diagnostic’s element, the positive predictive value (98% and malignant probability (92% is high. Keywords: thyroid nodule, triple diagnostic, accuracy.   Akurasi Metode Triple Diagnostic pada Pasien Nodul Tiroid  di RSUPN Dr. Cipto Mangunkusumo   Abstrak Tujuan

  2. Accuracy of prehospital triage protocols in selecting severely injured patients: A systematic review.

    Science.gov (United States)

    van Rein, Eveline A J; Houwert, R Marijn; Gunning, Amy C; Lichtveld, Rob A; Leenen, Luke P H; van Heijl, Mark

    2017-08-01

    Prehospital trauma triage ensures proper transport of patients at risk of severe injury to hospitals with an appropriate corresponding level of trauma care. Incorrect triage results in undertriage and overtriage. The American College of Surgeons Committee on Trauma recommends an undertriage rate below 5% and an overtriage rate below 50% for prehospital trauma triage protocols. To find the most accurate prehospital trauma triage protocol, a clear overview of all currently available protocols and corresponding outcomes is necessary. The aim of this systematic review was to evaluate the current literature on all available prehospital trauma triage protocols and determine accuracy of protocol-based triage quality in terms of sensitivity and specificity. A search of Pubmed, Embase, and Cochrane Library databases was performed to identify all studies describing prehospital trauma triage protocols before November 2016. The search terms included "trauma," "trauma center," or "trauma system" combined with "triage," "undertriage," or "overtriage." All studies describing protocol-based triage quality were reviewed. To assess the quality of these type of studies, a new critical appraisal tool was developed. In this review, 21 articles were included with numbers of patients ranging from 130 to over 1 million. Significant predictors for severe injury were: vital signs, suspicion of certain anatomic injuries, mechanism of injury, and age. Sensitivity ranged from 10% to 100%; specificity from 9% to 100%. Nearly all protocols had a low sensitivity, thereby failing to identify severely injured patients. Additionally, the critical appraisal showed poor quality of the majority of included studies. This systematic review shows that nearly all protocols are incapable of identifying severely injured patients. Future studies of high methodological quality should be performed to improve prehospital trauma triage protocols. Systematic review, level III.

  3. Gene network inherent in genomic big data improves the accuracy of prognostic prediction for cancer patients.

    Science.gov (United States)

    Kim, Yun Hak; Jeong, Dae Cheon; Pak, Kyoungjune; Goh, Tae Sik; Lee, Chi-Seung; Han, Myoung-Eun; Kim, Ji-Young; Liangwen, Liu; Kim, Chi Dae; Jang, Jeon Yeob; Cha, Wonjae; Oh, Sae-Ock

    2017-09-29

    Accurate prediction of prognosis is critical for therapeutic decisions regarding cancer patients. Many previously developed prognostic scoring systems have limitations in reflecting recent progress in the field of cancer biology such as microarray, next-generation sequencing, and signaling pathways. To develop a new prognostic scoring system for cancer patients, we used mRNA expression and clinical data in various independent breast cancer cohorts (n=1214) from the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) and Gene Expression Omnibus (GEO). A new prognostic score that reflects gene network inherent in genomic big data was calculated using Network-Regularized high-dimensional Cox-regression (Net-score). We compared its discriminatory power with those of two previously used statistical methods: stepwise variable selection via univariate Cox regression (Uni-score) and Cox regression via Elastic net (Enet-score). The Net scoring system showed better discriminatory power in prediction of disease-specific survival (DSS) than other statistical methods (p=0 in METABRIC training cohort, p=0.000331, 4.58e-06 in two METABRIC validation cohorts) when accuracy was examined by log-rank test. Notably, comparison of C-index and AUC values in receiver operating characteristic analysis at 5 years showed fewer differences between training and validation cohorts with the Net scoring system than other statistical methods, suggesting minimal overfitting. The Net-based scoring system also successfully predicted prognosis in various independent GEO cohorts with high discriminatory power. In conclusion, the Net-based scoring system showed better discriminative power than previous statistical methods in prognostic prediction for breast cancer patients. This new system will mark a new era in prognosis prediction for cancer patients.

  4. Accuracy of the Distress Thermometer for home care patients with palliative care needs in Germany.

    Science.gov (United States)

    Wüller, Johannes; Küttner, Stefanie; Foldenauer, Ann Christina; Rolke, Roman; Pastrana, Tania

    2017-06-01

    Our aim was to examine the accuracy of the German version of the Distress Thermometer (DT) compared with the Hospital Anxiety and Depression Scale (HADS) in patients with palliative care needs living at home. Ours was a 15-month cross-sectional study beginning in September of 2013 in Germany with consecutive patients cared for by a palliative home care service. The survey was implemented during the initial visit by a home care team. Patients were excluded if they were under 18 years of age, mentally or physically unable to complete the assessment questionnaires as judged by their healthcare worker, or unable to understand the German language. During the first encounter, the DT and HADS were applied, and sociodemographic and medical data were collected. A total of 89 persons completed both the HADS and DT questionnaires (response rate = 59.7%; mean age = 67 years; female = 55.1%; married = 65.2%; living home with relatives = 73.0%; oncological condition = 92.1%; Karnofsky Performance Scale [KPS] score: 0-40 = 30.3%, 50-70 = 57.3%, >80 = 6.7%). The mean DT score was 6.3 (±2.3), with 84.3% of participants scoring above the DT cutoff (≥4). The mean HADStotal score was 17.9 (±7.8), where 64% of participants had a total HADS score (HADStotal) ≥15, 51.7% reported anxiety (HADSanxiety ≥ 8), and 73% reported depression (HADSdepression ≥ 8). Using the HADS as a gold standard, a DT cutoff score ≥5 was optimal for identifying severe distress in patients with palliative care needs, with a sensitivity of 93.0%, a specificity of 34.4%, a positive predictive value (PPV) of 73.3%, and likelihood ratios LR+ = 1.42 (home with palliative care needs in order to offer adequate support.

  5. Trending and accuracy of noninvasive hemoglobin monitoring in pediatric perioperative patients.

    Science.gov (United States)

    Patino, Mario; Schultz, Lindsay; Hossain, Monir; Moeller, Jennifer; Mahmoud, Mohamed; Gunter, Joel; Kurth, C Dean

    2014-10-01

    Rainbow Pulse CO-Oximetry technology (Masimo Corporation, Irvine, CA) provides continuous and noninvasive measurement of arterial hemoglobin concentration (SpHb). We assessed the trending and accuracy of SpHb by this innovative monitoring compared with Hb concentration obtained with conventional laboratory techniques (Hb) in children undergoing surgical procedures with potential for substantial blood loss. Hb concentrations were recorded from Pulse CO-Oximetry and a conventional hematology analyzer. Regression analysis and 4-quadrant plot were used to evaluate the trending for changes in SpHb and Hb measurements (ΔSpHb and ΔHb). Bias, precision, and limits of agreement of SpHb and of in vivo adjusted SpHb (SpHb - first bias to HB) compared with Hb were calculated. One hundred fifty-eight SpHb-Hb data pairs and 105 delta pairs (ΔSpHb and ΔHb) from 46 patients aged 2 months to 17 years with Hb ranging from 16.7 to 7.9 g/dL were collected. To evaluate trending, the delta pairs (ΔSpHb and ΔHb) were plotted, which revealed a positive correlation (ΔSpHb = 0.022 + 0.76ΔHb) with correlation coefficient r = 0.76, 95% CI [confidence interval] = 0.57-0.86. The bias and precision of SpHb to Hb and in vivo adjusted SpHb were 0.4 ± 1.3 g/dL and 0.1 ± 1.2 g/dL, respectively; the limits of agreement were -2.0 to 3.2 g/dL before in vivo adjustment and -2.4 to 2.2 g/dL after in vivo adjustment (P value = 0.04). The mean percent bias (from the reference Hb concentration) decreased from 4.1% ± 11.9% to 0.7% ± 11.3% (P value = 0.01). No drift in bias over time was observed during the study procedure. Of patient demographic and physiological factors tested for correlation with the SpHb, only perfusion index at sensor site showed a weak correlation. The accuracy of SpHb in children with normal Hb and mild anemia is similar to that previously reported in adults and is independent of patient demographic and physiological states except for a weak correlation with perfusion index

  6. Diagnostic accuracy of the original 30-item and shortened versions of the Geriatric Depression Scale in nursing home patients

    NARCIS (Netherlands)

    Jongenelis, K; Eisses, AMH; Gerritsen, DL; Beekman, ATF; Kluiter, H; Ribbe, MW

    Objective To determine the diagnostic accuracy of the 30-item and shortened versions of the Geriatric Depression Scale (GDS) in diagnosing depression in older nursing home patients. Method Three hundred and thirty-three older nursing home patients participated in a prospective cross-sectional study

  7. Diagnostic accuracy of the original 30-item and shortened versions of the Geriatric Depression Scale in nursing home patients

    NARCIS (Netherlands)

    Jongenelis, K; Eisses, AMH; Gerritsen, DL; Beekman, ATF; Kluiter, H; Ribbe, MW

    2005-01-01

    Objective To determine the diagnostic accuracy of the 30-item and shortened versions of the Geriatric Depression Scale (GDS) in diagnosing depression in older nursing home patients. Method Three hundred and thirty-three older nursing home patients participated in a prospective cross-sectional study

  8. Evaluation of the frequency and accuracy of gonad shield placement in patients undergoing pelvic radiography

    Energy Technology Data Exchange (ETDEWEB)

    Karami, V.; Zabihzadeh, Mansour; Sarikhani, S. [Ahvaz Jundishapur University of Medical Sciences, Ahvaz (Iran, Islamic Republic of)

    2016-11-01

    Gonad shielding has been advocated to reduce radiation exposure in patients undergoing pelvic radiography. The aim of this study is to evaluate the frequency and accuracy of gonad shield placement in patients undergoing pelvic radiography. A retrospective study was performed on 1230 anteroposterior (AP) pelvic radiographs of 939 children under 16 years old. All the radiographs were reviewed to determine the frequency of gonad shielding and to evaluate whether gonad shields were correctly positioned when they are used. The gonad shield was present in 82 radiographs (30 girls and 52 boys) and was completely disregarded in 1148 radiographs. From 82 images which shield was present, the gonad shields adequately positioned in 28 radiographs (3 girls and 25 boys) and in the remaining 54 radiographs, the shield did not adequately protected the gonads due to incorrect placement of the shield. The inaccuracy placement and absence of gonad shields were more common in girls than boys (P-value < 0.05). More care should be taken to correctly positioning of the gonad shields in boys and its usage should be encouraged. However, the practice of ovarian shielding is not an effective way to reduce radiation exposure in girls undergoing pelvis radiography. (author)

  9. Evaluation of the frequency and accuracy of gonad shield placement in patients undergoing pelvic radiography

    International Nuclear Information System (INIS)

    Karami, V.; Zabihzadeh, Mansour; Sarikhani, S.

    2016-01-01

    Gonad shielding has been advocated to reduce radiation exposure in patients undergoing pelvic radiography. The aim of this study is to evaluate the frequency and accuracy of gonad shield placement in patients undergoing pelvic radiography. A retrospective study was performed on 1230 anteroposterior (AP) pelvic radiographs of 939 children under 16 years old. All the radiographs were reviewed to determine the frequency of gonad shielding and to evaluate whether gonad shields were correctly positioned when they are used. The gonad shield was present in 82 radiographs (30 girls and 52 boys) and was completely disregarded in 1148 radiographs. From 82 images which shield was present, the gonad shields adequately positioned in 28 radiographs (3 girls and 25 boys) and in the remaining 54 radiographs, the shield did not adequately protected the gonads due to incorrect placement of the shield. The inaccuracy placement and absence of gonad shields were more common in girls than boys (P-value < 0.05). More care should be taken to correctly positioning of the gonad shields in boys and its usage should be encouraged. However, the practice of ovarian shielding is not an effective way to reduce radiation exposure in girls undergoing pelvis radiography. (author)

  10. Accuracy of Implant Placement Utilizing Customized Patient Instrumentation in Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    William D. Bugbee

    2013-01-01

    Full Text Available Customized patient instrumentation (CPI combines preoperative planning with customized cutting jigs to position and align implants during total knee arthroplasty (TKA. We compared postoperative implant alignment of patients undergoing surgery with CPI to traditional TKA instrumentation for accuracy of implant placement. Twenty-five consecutive TKAs using CPI were analyzed. Preoperative CT scans of the lower extremities were segmented using a computer program. Limb alignment and mechanical axis were computed. Virtual implantation of computer-aided design models was done. Postoperative coronal and sagittal view radiographs were obtained. Using 3D image-matching software, relative positions of femoral and tibial implants were determined. Twenty-five TKAs implanted using traditional instrumentation were also analyzed. For CPI, difference in alignment from the preoperative plan was calculated. In the CPI group, the mean absolute difference between the planned and actual femoral placements was 0.67° in the coronal plane and 1.2° in the sagittal plane. For tibial alignment, the mean absolute difference was 0.9° in the coronal plane and 1.3° in the sagittal plane. For traditional instrumentation, difference from ideal placement for the femur was 1.5° in the coronal plane and 2.3° in the sagittal plane. For the tibia, the difference was 1.8° in the coronal plane. CPI achieved accurate implant positioning and was superior to traditional TKA instrumentation.

  11. Suspected hypoglycaemia in out patient practice: accuracy of dried blood spot analysis.

    Science.gov (United States)

    Parker, D R; Bargiota, A; Cowan, F J; Corrall, R J

    1997-12-01

    The assay of dried blood spots on filter paper to determine blood glucose concentration has been used to detect hypoglycaemia in out patients. We assessed the accuracy of this approach in assaying blood glucose concentrations in the hypoglycaemic range. Volunteers were rendered hypoglycaemic by intravenous infusion of insulin. The glucose concentration in simultaneously taken blood samples was measured either fresh or after drying on filter paper. Twenty-four healthy young volunteers and 9 patients with insulin-dependent diabetes were studied. Plasma glucose concentrations were measured using a standard auto analyser glucose oxidase method. Whole blood taken simultaneously was placed on prepared filter paper and allowed to dry; glucose concentration was then measured using a well-established technique. A correction factor was applied to convert the glucose concentration of plasma to that of whole blood. The relationship between glucose concentrations measured by the two methods was determined by regression coefficient. In the unequivocally hypoglycaemic range (plasma dried blood spot glucose concentrations significantly correlated with standard plasma glucose concentrations (r = 0.81; P dried blood spot method had a sensitivity of 91%. In the range designated probable hypoglycaemia (plasma dried blood spot method was 100% in both ranges. Measurement of glucose concentrations in dried blood spots is specific and sensitive in the hypoglycaemic range. The present study indicates that hypoglycaemia may be excluded or confirmed respectively when levels in excess of 3.7 or below 2.8 mmol/l are found in uncorrected dried blood spot analysis.

  12. Points in the set-up of tests for fMRI. Toward the delineation of language-competent areas in clinical practice

    International Nuclear Information System (INIS)

    Takashima, Hisaharu; Ejima, Mitsuhiro; Takeyama, Mamoru; Yamaguchi, Masami; Sato, Yoshino

    2001-01-01

    This hospital has performed fMRI of language-competent areas of the brain to identify the language-dominant hemisphere and obtain the configuration of the focus in the language-dominant side of the brain. Until now, signals have been detected in only two of fifteen patients who were diagnosed by language tests of a last-syllable word chain. In the present experiment, we tried to have subjects select the type of test. The result was that changes in signals were detected in eight of ten patients. Although the set-up of tests for fMRI is said to hold significant value, clear-cut studies to back this up have rarely been seen. Because clinical medicine treats patients who have difficulty in communication or suffer from aphasia, it is important to take into consideration individual variations and to set up a test suitable for, or achievable by, these individuals. The present method enabled us to avoid failure in examination caused by unsuccessful tests. (author)

  13. Points in the set-up of tests for fMRI. Toward the delineation of language-competent areas in clinical practice

    Energy Technology Data Exchange (ETDEWEB)

    Takashima, Hisaharu; Ejima, Mitsuhiro; Takeyama, Mamoru; Yamaguchi, Masami; Sato, Yoshino [Tokyo Women' s Medical Coll. (Japan). Hospital

    2001-06-01

    This hospital has performed fMRI of language-competent areas of the brain to identify the language-dominant hemisphere and obtain the configuration of the focus in the language-dominant side of the brain. Until now, signals have been detected in only two of fifteen patients who were diagnosed by language tests of a last-syllable word chain. In the present experiment, we tried to have subjects select the type of test. The result was that changes in signals were detected in eight of ten patients. Although the set-up of tests for fMRI is said to hold significant value, clear-cut studies to back this up have rarely been seen. Because clinical medicine treats patients who have difficulty in communication or suffer from aphasia, it is important to take into consideration individual variations and to set up a test suitable for, or achievable by, these individuals. The present method enabled us to avoid failure in examination caused by unsuccessful tests. (author)

  14. Reproduction of set-up of the fields in x-ray radiotherapy

    International Nuclear Information System (INIS)

    Izawa, Kazuo; Hata, Kiyoshi; Sasaki, Junichi; Matsugi, Shunpei; Takeshita, Masanori; Okamoto, Hideaki; Nakajima, Tadashi

    1985-01-01

    We measured the reproducibility of the field in radiotherapy by lineacgram and carried out the measurement of the following sites such as the larynx, pharynx, whole brain and the whole pelvis. The measurement points are 5 in the head and neck, and 7 in pelvis. The data of this study were obtained from 536 film sheets for 62 patients during May 1983 to September 1983 period. We used the XTL-5 localization film and Kyokko GF intensifying screen. The reproducibility error was decided with the use of the average and standard deviations. The following results were obtained: 1) The site that has the minimal error is larynx with 4.8 mm; the maximal error is whole brain with 11.2 mm; and the whole pelvis with 6 mm. 2) The fixing device is always needed at the head and neck site. 3) Using the fixing device, it was comfirmed that the reproducibility error of the field is due to arrangement of place rather than the patients movement during the treatment time. We further aim, to reduce the scattering shown by the standard deviation than the one by the average value. (author)

  15. Automatic radiation dose monitoring for CT of trauma patients with different protocols: feasibility and accuracy

    International Nuclear Information System (INIS)

    Higashigaito, K.; Becker, A.S.; Sprengel, K.; Simmen, H.-P.; Wanner, G.; Alkadhi, H.

    2016-01-01

    Aim: To demonstrate the feasibility and accuracy of automatic radiation dose monitoring software for computed tomography (CT) of trauma patients in a clinical setting over time, and to evaluate the potential of radiation dose reduction using iterative reconstruction (IR). Materials and methods: In a time period of 18 months, data from 378 consecutive thoraco-abdominal CT examinations of trauma patients were extracted using automatic radiation dose monitoring software, and patients were split into three cohorts: cohort 1, 64-section CT with filtered back projection, 200 mAs tube current–time product; cohort 2, 128-section CT with IR and identical imaging protocol; cohort 3, 128-section CT with IR, 150 mAs tube current–time product. Radiation dose parameters from the software were compared with the individual patient protocols. Image noise was measured and image quality was semi-quantitatively determined. Results: Automatic extraction of radiation dose metrics was feasible and accurate in all (100%) patients. All CT examinations were of diagnostic quality. There were no differences between cohorts 1 and 2 regarding volume CT dose index (CTDI_v_o_l; p=0.62), dose–length product (DLP), and effective dose (ED, both p=0.95), while noise was significantly lower (chest and abdomen, both −38%, p<0.017). Compared to cohort 1, CTDI_v_o_l, DLP, and ED in cohort 3 were significantly lower (all −25%, p<0.017), similar to the noise in the chest (–32%) and abdomen (–27%, both p<0.017). Compared to cohort 2, CTDI_v_o_l (–28%), DLP, and ED (both –26%) in cohort 3 was significantly lower (all, p<0.017), while noise in the chest (+9%) and abdomen (+18%) was significantly higher (all, p<0.017). Conclusion: Automatic radiation dose monitoring software is feasible and accurate, and can be implemented in a clinical setting for evaluating the effects of lowering radiation doses of CT protocols over time. - Highlights: • Automatic dose monitoring software can be

  16. Diagnostic Accuracy of Ultrasonography and Radiography in Initial Evaluation of Chest Trauma Patients.

    Science.gov (United States)

    Vafaei, Ali; Hatamabadi, Hamid Reza; Heidary, Kamran; Alimohammadi, Hosein; Tarbiyat, Mohammad

    2016-01-01

    Application of chest radiography for all multiple trauma patients is associated with a significant increase in total costs, exposure to radiation, and overcrowding of the emergency department. Ultrasound has been introduced as an alternative diagnostic tool in this regard. The aim of the present study is to compare the diagnostic accuracy of chest ultrasonography and radiography in detection of traumatic intrathoracic injuries. In the present prospective cross-sectional study, patients with traumatic intrathoracic injuries, who were referred to the emergency department from December 2013 to December 2014, were assessed. The patients underwent bedside ultrasound, radiographic and computed tomography (CT) scan examinations based on ATLS recommendations. Screening performance characteristics of ultrasonography and radiography were compared using SPSS 21.0. Chest CT scan was considered as gold standard. 152 chest trauma patients with a mean age of 31.4 ± 13.8 years (range: 4 ‒ 67), were enrolled (77.6% male). Chest CT scan showed pulmonary contusion in 48 (31.6%) patients, hemothorax in 29 (19.1%), and pneumothorax in 55 (36.2%) cases. Area under the ROC curve of ultrasonography in detection of pneumothorax, hemothorax, and pulmonary contusion were 0.91 (95% CI: 0.86‒0.96), 0.86 (95% CI: 0.78‒0.94), and 0.80 (95% CI: 0.736‒0.88), respectively. Area under the ROC curve of radiography was 0.80 (95% CI: 0.736‒0.87) for detection of pneumothorax, 0.77 (95% CI: 0.68‒0.86) for hemothorax, and 0.58 (95% CI: 0.5‒0.67) for pulmonary contusion. Comparison of areas under the ROC curve declared the significant superiority of ultrasonography in detection of pneumothorax (p = 0.02) and pulmonary contusion (p < 0.001). However, the diagnostic value of the two tests was equal in detection of hemothorax (p = 0.08). The results of the present study showed that ultrasonography is preferable to radiography in the initial evaluation of patients with traumatic injuries to the

  17. Diagnostic Accuracy of Ultrasonography and Radiography in Initial Evaluation of Chest Trauma Patients

    Directory of Open Access Journals (Sweden)

    Ali Vafaei

    2016-01-01

    Full Text Available Introduction: Application of chest radiography for all multiple trauma patients is associated with a significant increase in total costs, exposure to radiation, and overcrowding of the emergency department. Ultrasound has been introduced as an alternative diagnostic tool in this regard. The aim of the present study is to compare the diagnostic accuracy of chest ultrasonography and radiography in detection of traumatic intrathoracic injuries. Methods: In the present prospective cross-sectional study, patients with traumatic intrathoracic injuries, who were referred to the emergency department from December 2013 to December 2014, were assessed. The patients underwent bedside ultrasound, radiographic and computed tomography (CT scan examinations based on ATLS recommendations. Screening performance characteristics of ultrasonography and radiography were compared using SPSS 21.0. Chest CT scan was considered as gold standard. Results: 152 chest trauma patients with a mean age of 31.4 ± 13.8 years (range: 4 ‒ 67, were enrolled (77.6% male. Chest CT scan showed pulmonary contusion in 48 (31.6% patients, hemothorax in 29 (19.1%, and pneumothorax in 55 (36.2% cases. Area under the ROC curve of ultrasonography in detection of pneumothorax, hemothorax, and pulmonary contusion were 0.91 (95% CI: 0.86‒0.96, 0.86 (95% CI: 0.78‒0.94, and 0.80 (95% CI: 0.736‒0.88, respectively. Area under the ROC curve of radiography was 0.80 (95% CI: 0.736‒0.87 for detection of pneumothorax, 0.77 (95% CI: 0.68‒0.86 for hemothorax, and 0.58 (95% CI: 0.5‒0.67 for pulmonary contusion. Comparison of areas under the ROC curve declared the significant superiority of ultrasonography in detection of pneumothorax (p = 0.02 and pulmonary contusion (p < 0.001. However, the diagnostic value of the two tests was equal in detection of hemothorax (p = 0.08. Conclusion: The results of the present study showed that ultrasonography is preferable to radiography in the initial

  18. Setting up a mobile dental practice within your present office structure.

    Science.gov (United States)

    Morreale, James P; Dimitry, Susan; Morreale, Mark; Fattore, Isabella

    2005-02-01

    Different service models have emerged in Canada and the United States to address the issue of senior citizens' lack of access to comprehensive dental care. Over the past decade, one such model, the use of mobile dental service units, has emerged as a practical strategy. This article describes a mobile unit, operated as an adjunct to the general practitioner's office and relying mainly on existing office resources, both human and capital, to deliver services at long-term care institutions. The essential components of a profitable geriatric mobile unit are described, including education, equipment, marketing research and development, and human resource management. Issues related to patient consent and operating expenditures are also discussed. Data from one practitioner's mobile dental unit, in Hamilton, Ontario, are presented to demonstrate the feasibility and profitability of this approach.

  19. A Fully Immersive Set-Up for Remote Interaction and Neurorehabilitation Based on Virtual Body Ownership

    Science.gov (United States)

    Perez-Marcos, Daniel; Solazzi, Massimiliano; Steptoe, William; Oyekoya, Oyewole; Frisoli, Antonio; Weyrich, Tim; Steed, Anthony; Tecchia, Franco; Slater, Mel; Sanchez-Vives, Maria V.

    2012-01-01

    Although telerehabilitation systems represent one of the most technologically appealing clinical solutions for the immediate future, they still present limitations that prevent their standardization. Here we propose an integrated approach that includes three key and novel factors: (a) fully immersive virtual environments, including virtual body representation and ownership; (b) multimodal interaction with remote people and virtual objects including haptic interaction; and (c) a physical representation of the patient at the hospital through embodiment agents (e.g., as a physical robot). The importance of secure and rapid communication between the nodes is also stressed and an example implemented solution is described. Finally, we discuss the proposed approach with reference to the existing literature and systems. PMID:22787454

  20. Does risk-adjusted payment influence primary care providers’ decision on where to set up practices?

    DEFF Research Database (Denmark)

    Anell, Anders; Dackehag, Margareta; Dietrichson, Jens

    2018-01-01

    Background: Providing equal access to healthcare is an important objective in most health care systems. It is especially pertinent in systems like the Swedish primary care market, where private providers are free to establish themselves in any part of the country. To improve equity in access...... to care, 15 out 21 county councils in Sweden have implemented risk-adjusted capitation based on the Care Need Index, which increases capitation to primary care centers with a large share of patients with unfavorable socioeconomic and demographic characteristics. Our aim is to estimate the effects of using...... Index values. Results: Risk-adjusted capitation significantly increases the number of private primary care centers in areas with relatively high Care Need Index values. The adjustment results in a changed distribution of private centers within county councils; the total number of private centers does...

  1. Role of ultrasonography in the evaluation of children with acute abdomen in the emergency set-up

    Directory of Open Access Journals (Sweden)

    Aviral

    2005-01-01

    Full Text Available Background: Acute abdomen in children has been aptly described as Pandora′s box. Unlike computerized tomography (CT scan, ultrasonography (USG has no radiation hazard and the present study analyses the diagnostic yield of the USG in acute abdomen in children. Materials and Methods: Between September 2001 to October 2003, 75 patients with acute abdomen underwent clinical examination, routine biochemical tests, erect X-ray abdomen, USG and CT scan. Laparotomy and histological examination established final diagnosis. Results: The accuracy of correct diagnosis was 60%, 66.6%, 64%, 98.7% with clinical examination alone, USG alone, clinical examination combined with conventional radiography, and clinical evaluation combined with conventional radiography and USG respectively. USG helped to prevent unnecessary laparotomy in 16.3% of patients. Conclusions: USG is good investigative modality in the management of acute abdomen in children.

  2. Commissioning of a proton gantry equipped with dual x-ray imagers and a robotic patient positioner, and evaluation of the accuracy of single-beam image registration for this system

    International Nuclear Information System (INIS)

    Wang, Ning; Ghebremedhin, Abiel; Patyal, Baldev

    2015-01-01

    Purpose: To check the accuracy of a gantry equipped with dual x-ray imagers and a robotic patient positioner for proton radiotherapy, and to evaluate the accuracy and feasibility of single-beam registration using the robotic positioner. Methods: One of the proton treatment rooms at their institution was upgraded to include a robotic patient positioner (couch) with 6 degrees of freedom and dual orthogonal kilovoltage x-ray imaging panels. The wander of the proton beam central axis, the wander of the beamline, and the orthogonal image panel crosswires from the gantry isocenter were measured for different gantry angles. The couch movement accuracy and couch wander from the gantry isocenter were measured for couch loadings of 50–300 lb with couch rotations from 0° to ±90°. The combined accuracy of the gantry, couch, and imagers was checked using a custom-made 30 × 30 × 30 cm 3 Styrofoam phantom with beekleys embedded in it. A treatment in this room can be set up and registered at a setup field location, then moved precisely to any other treatment location without requiring additional image registration. The accuracy of the single-beam registration strategy was checked for treatments containing multiple beams with different combinations of gantry angles, couch yaws, and beam locations. Results: The proton beam central axis wander from the gantry isocenter was within 0.5 mm with gantry rotations in both clockwise (CW) and counterclockwise (CCW) directions. The maximum wander of the beamline and orthogonal imager crosswire centers from the gantry isocenter were within 0.5 and 0.8 mm, respectively, with the gantry rotations in CW and CCW directions. Vertical and horizontal couch wanders from the gantry isocenter were within 0.4 and 1.3 mm, respectively, for couch yaw from 0° to ±90°. For a treatment with multiple beams with different gantry angles, couch yaws, and beam locations, the measured displacements of treatment beam locations from the one based on the

  3. A Proposed Methodology to Assess the Accuracy of 3D Scanners and Casts and Monitor Tooth Wear Progression in Patients.

    Science.gov (United States)

    Ahmed, Khaled E; Whitters, John; Ju, Xiangyang; Pierce, S Gareth; MacLeod, Charles N; Murray, Colin A

    2016-01-01

    The aim of this study was to detail and assess the capability of a novel methodology to 3D-quantify tooth wear progression in a patient over a period of 12 months. A calibrated stainless steel model was used to identify the accuracy of the scanning system by assessing the accuracy and precision of the contact scanner and the dimensional accuracy and stability of casts fabricated from three different types of impression materials. Thereafter, the overall accuracy of the 3D scanning system (scanner and casts) was ascertained. Clinically, polyether impressions were made of the patient's dentition at the initial examination and at the 12-month review, then poured in type IV dental stone to assess the tooth wear. The anterior teeth on the resultant casts were scanned, and images were analyzed using 3D matching software to detect dimensional variations between the patient's impressions. The accuracy of the 3D scanning system was established to be 33 μm. 3D clinical analysis demonstrated localized wear on the incisal and palatal surfaces of the patient's maxillary central incisors. The identified wear extended to a depth of 500 μm with a distribution of 4% to 7% of affected tooth surfaces. The newly developed 3D scanning methodology was found to be capable of assessing and accounting for the various factors affecting tooth wear scanning. Initial clinical evaluation of the methodology demonstrates successful monitoring of tooth wear progression. However, further clinical assessment is needed.

  4. Microsurgery simulation training system and set up: An essential system to complement every training programme.

    Science.gov (United States)

    Masud, Dhalia; Haram, Nadine; Moustaki, Margarita; Chow, Whitney; Saour, Samer; Mohanna, Pari Naz

    2017-07-01

    Microsurgical techniques are essential in plastic surgery; however, inconsistent training practices, acquiring these skills can be difficult. To address this, we designed a standardised laboratory-based microsurgical training programme, which allows trainees to develop their dexterity, visuospatial ability, operative flow and judgement as separate components. Thirty trainees completed an initial microsurgical anastomosis on a chicken femoral artery, assessed using the structured assessment of microsurgical skills (SAMS) method. The study group (n = 18) then completed a 3-month training programme, while the control group (n = 19) did not. A final anastomosis was completed by all trainees (n = 30). The study group had a significant improvement in the microsurgical technique, assessed using the SAMS score, when the initial and final scores were compared (Mean: 24 SAMS initial versus 49 SAMS final) (p group had a significantly lower rate of improvement (Mean: 23 SAMS initial versus 25 SAMS final). There was a significant difference between the final SAMS score of the study group and that of senior surgeons (Mean: 49 study final SAMS versus 58 senior SAMS). This validated programme is a safe, cost-effective and flexible method of allowing trainees to develop microsurgical skills in a non-pressurized environment. In addition, the objectified skills allow trainers to assess the trainees' level of proficiency before operating on patients. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Setting up an IAPT site: the Ealing Mental Health & Well-Being Service.

    Science.gov (United States)

    Ruprah-Shah, Baljeet

    2009-01-01

    IAPT will succeed or fail on the extent to which it enables partnerships. For years I have been working to integrate mental health services in Ealing. Improving Access to Psychological Therapies (IAPT) offers the best chance I have ever known to achieve this, and to make a coordinated impact on the health of the people of Ealing. IAPT is an exciting opportunity for us in Ealing and we have grabbed it with both hands. We are incorporating it into our beliefs, values and passion to produce a service that will reflect our vision for holistic primary care services. A service which is financially sound. A service which does not believe that there is one answer to everyone's mild to moderate mental health problems. A service which recognises that working in silos is detrimental to our patients' health. A service which is constantly striving to improve relationships with our partners. A service which is mindful about the people we see, and the staff who see them.

  6. Set up and operation for medical radiation exposure quality control system of health promotion center

    International Nuclear Information System (INIS)

    Kim, Jung Su; Kim, Jung Min; Jung, Hae Kyoung

    2016-01-01

    In this study, standard model of medical radiation dosage quality control system will be suggested and the useful of this system in clinical field will be reviewed. Radiation dosage information of modalities are gathered from digital imaging and communications in medicine(DICOM) standard data(such as DICOM dose SR and DICOM header) and stored in database. One CT scan, two digital radiography modalities and two mammography modalities in one health promotion center in Seoul are used to derive clinical data for one month. After 1 months research with 703 CT scans, the study shows CT 357.9 mGy·cm in abdomen and pelvic CT, 572.4 mGy·cm in brain without CT, 55.9 mGy·cm in calcium score/heart CT, screening CT at 54 mGy·cm in chest screening CT(low dose screening CT scan), 284.99 mGy·cm in C-spine CT and 341.85 mGy·cm in L-spine CT as health promotion center reference level of each exam. And with 1955 digital radiography cases, it shows 274.0 mGy·cm"2 and for mammography 6.09 mGy is shown based on 536 cases. The use of medical radiation shall comply with the principles of justification and optimization. This quality management of medical radiation exposure must be performed in order to follow the principle. And the procedure to reduce the radiation exposure of patients and staff can be achieved through this. The results of this study can be applied as a useful tool to perform the quality control of medical radiation exposure

  7. Set up and operation for medical radiation exposure quality control system of health promotion center

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Su; Kim, Jung Min [Korea University,Seoul (Korea, Republic of); Jung, Hae Kyoung [Dept. of Diagnostic Radiology, CHA Bundang Medical Center, CHA University, Sungnam (Korea, Republic of)

    2016-03-15

    In this study, standard model of medical radiation dosage quality control system will be suggested and the useful of this system in clinical field will be reviewed. Radiation dosage information of modalities are gathered from digital imaging and communications in medicine(DICOM) standard data(such as DICOM dose SR and DICOM header) and stored in database. One CT scan, two digital radiography modalities and two mammography modalities in one health promotion center in Seoul are used to derive clinical data for one month. After 1 months research with 703 CT scans, the study shows CT 357.9 mGy·cm in abdomen and pelvic CT, 572.4 mGy·cm in brain without CT, 55.9 mGy·cm in calcium score/heart CT, screening CT at 54 mGy·cm in chest screening CT(low dose screening CT scan), 284.99 mGy·cm in C-spine CT and 341.85 mGy·cm in L-spine CT as health promotion center reference level of each exam. And with 1955 digital radiography cases, it shows 274.0 mGy·cm{sup 2} and for mammography 6.09 mGy is shown based on 536 cases. The use of medical radiation shall comply with the principles of justification and optimization. This quality management of medical radiation exposure must be performed in order to follow the principle. And the procedure to reduce the radiation exposure of patients and staff can be achieved through this. The results of this study can be applied as a useful tool to perform the quality control of medical radiation exposure.

  8. Research on mechanical and sensoric set-up for high strain rate testing of high performance fibers

    Science.gov (United States)

    Unger, R.; Schegner, P.; Nocke, A.; Cherif, C.

    2017-10-01

    Within this research project, the tensile behavior of high performance fibers, such as carbon fibers, is investigated under high velocity loads. This contribution (paper) focuses on the clamp set-up of two testing machines. Based on a kinematic model, weight optimized clamps are designed and evaluated. By analyzing the complex dynamic behavior of conventional high velocity testing machines, it has been shown that the impact typically exhibits an elastic characteristic. This leads to barely predictable breaking speeds and will not work at higher speeds when acceleration force exceeds material specifications. Therefore, a plastic impact behavior has to be achieved, even at lower testing speeds. This type of impact behavior at lower speeds can be realized by means of some minor test set-up adaptions.

  9. The Influence of Natural Frequency of the Experimental Set-up on the Friction Coefficient of Stainless Steel-304

    Directory of Open Access Journals (Sweden)

    M. A. Chowdhury

    2010-03-01

    Full Text Available The present paper investigates experimentally the effect of natural frequency of the experimental set-up on friction property of stainless steel-304. To do so, a pin-on-disc apparatus having facility of vibrating the test samples at different directions, amplitudes and frequencies was designed and fabricated. The natural frequency of the set-up was varied by adding dead loads of the setup from 0 kg to 50 kg. At each added load the friction coefficient has been measured. Results show that both the natural frequency and friction coefficient decrease with the increase of added loads. It has been also observed that the coefficient of friction increases with the increase of natural frequency of the experimental setup. The experimental results are also compared with those available in literature and simple physical explanations are provided.

  10. Setting up a control and certification system for organic farming in developing countries: the case of Algeria

    OpenAIRE

    ZIANE, Mrs Djamila

    2002-01-01

    The main objective of this work is to define the steps and the procedures to set up an effective control and certification system for Algeria, that is compatible with local peculiarities and realities and which complies with the International Regulations. The aim of this initiative is to offer a cost-efficient and credible inspection and certification for organic products to farmers, processors and traders. Doing so, the access to export and domestic markets should be facilitated. Furthermore...

  11. The method to set up file-6 in neutron data library of light nuclei below 20 MeV

    International Nuclear Information System (INIS)

    Zhang Jingshang; Han Yinlu

    2001-01-01

    So far there is no file-6 (double differential cross section data, DDX) of the light nuclei in the main evaluated neutron nuclear data libraries in the world. Therefore, locating a proper description on the double differential cross section of all kinds of outgoing particles from neutron induced light nucleus reaction below 20 MeV is necessary. The motivation for this work is to introduce a way to set up file-6 in the neutron data library

  12. Setting up the photoluminescence laboratory at ISOLDE & Perturbed Angular Correlation spectroscopy for BIO physics experiments using radioactive ions

    CERN Document Server

    Savva, Giannis

    2016-01-01

    The proposed project I was assigned was to set up the photoluminescence (PL) laboratory at ISOLDE, under the supervision of Karl Johnston. My first week at CERN coincided with the run of a BIO physics experiment using radioactive Hg(II) ions in which I also participated under the supervision of Stavroula Pallada. This gave me the opportunity to work in two projects during my stay at CERN and in the present report I describe briefly my contribution to them.

  13. Portal Hypertension in Patients with Liver Cirrhosis: Diagnostic Accuracy of Spleen Stiffness.

    Science.gov (United States)

    Takuma, Yoshitaka; Nouso, Kazuhiro; Morimoto, Youichi; Tomokuni, Junko; Sahara, Akiko; Takabatake, Hiroyuki; Matsueda, Kazuhiro; Yamamoto, Hiroshi

    2016-05-01

    To evaluate the accuracy of spleen stiffness (SS) and liver stiffness (LS) measured by using acoustic radiation force impulse imaging in the diagnosis of portal hypertension in patients with liver cirrhosis, with the hepatic venous pressure gradient (HVPG) as a reference standard. Institutional review board approval and informed consent were obtained for this prospective single-center study. From February 2012 to August 2013, 60 patients with liver cirrhosis (mean age, 70.8 years; age range, 34-88 years; 34 men, 26 women) with HVPG, LS, and SS measurements and gastrointestinal endoscopy and laboratory data were included if they met the following criteria: no recent episodes of gastrointestinal bleeding, no history of splenectomy, no history of partial splenic embolization, no history of β-blocker therapy, and absence of portal thrombosis. The efficacy of the parameters for the evaluation of portal hypertension was analyzed by using the Spearman rank-order correlation coefficient and receiver operating characteristic (ROC) curve analysis. The correlation coefficient between SS and HVPG (r = 0.876) was significantly better than that between LS and HVPG (r = 0.609, P portal hypertension (HVPG ≥ 10 mm Hg), severe portal hypertension (HVPG ≥ 12 mm Hg), esophageal varices (EVs), and high-risk EVs were significantly higher (0.943, 0.963, 0.937, and 0.955, respectively) than those of LS, spleen diameter, platelet count, and platelet count to spleen diameter ratio (P portal hypertension, severe portal hypertension, EVs, and high-risk EVs (negative likelihood ratios, 0.051, 0.056, 0.054, and 0.074, respectively). SS is reliable and has better diagnostic performance than LS for identifying portal hypertension in liver cirrhosis. (©) RSNA, 2015 Online supplemental material is available for this article.

  14. SimTCM: A human patient simulator with application to diagnostic accuracy studies of Chinese medicine.

    Science.gov (United States)

    Ferreira, Arthur de Sá; Pacheco, Antonio Guilherme

    2015-01-01

    The aim of this work is to develop and implement the SimTCM, an advanced computational model that incorporates relevant aspects from traditional Chinese medicine (TCM) theory as well as advanced statistical and epidemiological techniques for simulation and analysis of human patients. SimTCM presents five major attributes for simulation: representation of true and false profiles for any single pattern; variable count of manifestations for each manifestation profile; empirical distributions of patterns and manifestations in a disease-specific population; incorporation of uncertainty in clinical data; and the combination of the four examinations. The proposed model is strengthened by following international standards for reporting diagnostic accuracy studies, and incorporates these standards in its treatment of study population, sample size calculation, data collection of manifestation profiles, exclusion criteria and missing data handling, reference standards, randomization and blinding, and test reproducibility. Simulations using data from patients diagnosed with hypertension and post-stroke sensory-motor impairments yielded no significant differences between expected and simulated frequencies of patterns (P=0.22 or higher). Time for convergence of simulations varied from 9.90 s (9.80, 10.27) to 28.31 s (26.33, 29.52). The ratio iteration profile necessary for convergence varied between 1:1 and 5:1. This model is directly connected to forthcoming models in a large project to design and implement the SuiteTCM: ProntTCM, SciTCM, DiagTCM, StudentTCM, ResearchTCM, HerbsTCM, AcuTCM, and DataTCM. It is expected that the continuity of the SuiteTCM project enhances the evidence-based practice of Chinese medicine. The software is freely available for download at: http://suitetcm.unisuam.edu.br.

  15. Synthesis and characterisation of polymeric nanofibers poly (vinyl alcohol) and poly (vinyl alcohol)/silica using indigenous electrospinning set up

    Energy Technology Data Exchange (ETDEWEB)

    Sasipriya, K.; Suriyaprabha, R.; Prabu, P.; Rajendran, V., E-mail: veerajendran@gmail.com [Centre for Nanoscience and Technology, K. S. Rangasamy College of Technology, Tamil Nadu (India)

    2013-11-01

    Indigenous design and fabrication horizontal of electrospinning set up was developed to facilitate with double drum conveyor belt system to make ease in harvesting nanofibers rapidly. As a bench mark study, organic-inorganic nanofiber composite was synthesised employing our indigenous electrospinning set up. The aqueous solution of poly (vinyl alcohol) and poly (vinyl alcohol)/silica sol were employed to produce nanofiber mats in order to vary the experimental parameters such as voltage, solvent effect and the effect of catalyst. The synthesised pure electro spun poly (vinyl alcohol) and poly (vinyl alcohol)/silica sol fibers were characterized by Scanning electron microscopy (SEM), Atomic force microscopy (AFM) and Fourier transform infra red spectroscopy (FTIR). According to the results, the fine polymeric nanofibers were achieved in the size range of 100-500 nm for pure poly (vinyl alcohol) fiber and 100-700 nm for polyvinyl alcohol/silica and the constitution of silica in rendering better fiber mats with this double drum set up. (author)

  16. Synthesis and characterisation of polymeric nanofibers poly (vinyl alcohol) and poly (vinyl alcohol)/silica using indigenous electrospinning set up

    International Nuclear Information System (INIS)

    Sasipriya, K.; Suriyaprabha, R.; Prabu, P.; Rajendran, V.

    2013-01-01

    Indigenous design and fabrication horizontal of electrospinning set up was developed to facilitate with double drum conveyor belt system to make ease in harvesting nanofibers rapidly. As a bench mark study, organic-inorganic nanofiber composite was synthesised employing our indigenous electrospinning set up. The aqueous solution of poly (vinyl alcohol) and poly (vinyl alcohol)/silica sol were employed to produce nanofiber mats in order to vary the experimental parameters such as voltage, solvent effect and the effect of catalyst. The synthesised pure electro spun poly (vinyl alcohol) and poly (vinyl alcohol)/silica sol fibers were characterized by Scanning electron microscopy (SEM), Atomic force microscopy (AFM) and Fourier transform infra red spectroscopy (FTIR). According to the results, the fine polymeric nanofibers were achieved in the size range of 100-500 nm for pure poly (vinyl alcohol) fiber and 100-700 nm for polyvinyl alcohol/silica and the constitution of silica in rendering better fiber mats with this double drum set up. (author)

  17. Synthesis and characterisation of polymeric nanofibers poly (vinyl alcohol and poly (vinyl alcohol/silica using indigenous electrospinning set up

    Directory of Open Access Journals (Sweden)

    K. Sasipriya

    2013-01-01

    Full Text Available Indigenous design and fabrication horizontal of electrospinning set up was developed to facilitate with double drum conveyor belt system to make ease in harvesting nanofibers rapidly. As a bench mark study, organic-inorganic nanofiber composite was synthesised employing our indigenous electrospinning set up. The aqueous solution of poly (vinyl alcohol and poly (vinyl alcohol/silica sol were employed to produce nanofiber mats in order to vary the experimental parameters such as voltage, solvent effect and the effect of catalyst. The synthesised pure electro spun poly (vinyl alcohol and poly (vinyl alcohol/silica sol fibers were characterized by Scanning electron microscopy (SEM, Atomic force microscopy (AFM and Fourier transform infra red spectroscopy (FTIR. According to the results, the fine polymeric nanofibers were achieved in the size range of 100-500 nm for pure poly (vinyl alcohol fiber and 100-700 nm for polyvinyl alcohol/silica and the constitution of silica in rendering better fiber mats with this double drum set up.

  18. Accuracy of CT-guided biopsies in 158 patients with thoracic spinal lesions

    International Nuclear Information System (INIS)

    Hao, D.J.; He, B.R.; Liu, T.J.; Zhao, Q.P.; Sun, H.H.; Jiang, Y.H.

    2011-01-01

    Background. Inconsistent accuracies of CT-guided thoracic spinal biopsies have been reported in previous studies. Purpose. To determine the accuracy of CT-guided thoracic spinal biopsy, to compare the results with those previously reported, and to determine if there are any factors that influence the accuracy of CT-guided thoracic spinal biopsy. Material and Methods. In total, 158 consecutive CT-guided percutaneous thoracic spine procedures (performed at the Dept. of Spinal Surgery, Xian Red Cross Hospital between April 2000 and July 2010) were reviewed. The 158 lesions were categorized by location and radiographic features. Pathological and clinical follow-up were used to determine accuracy. Results. The diagnostic accuracy of CT-guided thoracic spinal biopsy was 90.5% overall. Biopsy of metastatic bone disease (98.2%) was significantly more accurate than biopsies of primary tumors (80.9%) and of hematological malignancies (47.0%) (P < 0.05 and P < 0.005, respectively). The diagnostic accuracy of CT-guided thoracic spinal biopsy was significantly higher for the lower thoracic spine (97.6%) than for the middle (90.0%) or upper thoracic spine (80.4%) (P < 0.05 and P < 0.025, respectively). The diagnostic accuracy was significantly higher for lytic lesions (96.4%) than for sclerotic lesions (81.3%) (P < 0.010). The accuracy of biopsies performed using the transpedicular approach (91.0%) was not significantly different from that of biopsies performed using posterolateral approaches (91.5%) (0.25 < P < 0.5). Conclusion. Percutaneous CT-guided thoracic spinal biopsy is a viable alternative to open surgical biopsy. The diagnostic accuracy was not affected by any of the variables except for lesion level, histology, and radiographic features

  19. Accuracy of CT-guided biopsies in 158 patients with thoracic spinal lesions

    Energy Technology Data Exchange (ETDEWEB)

    Hao, D.J.; He, B.R.; Liu, T.J.; Zhao, Q.P. (Dept. of Spinal Surgery, Xian Red Cross Hospital, Xian Shaanxi (China)), email: zqpddn1@gmail.com; Sun, H.H. (Dept. of Orthopaedic, Tangdu Hospital, Fourth Military Medical Univ., Xian Shaanxi (China)); Jiang, Y.H. (Dept. of Radiology, Xian Red Cross Hospital, Xian Shaanxi (China))

    2011-11-15

    Background. Inconsistent accuracies of CT-guided thoracic spinal biopsies have been reported in previous studies. Purpose. To determine the accuracy of CT-guided thoracic spinal biopsy, to compare the results with those previously reported, and to determine if there are any factors that influence the accuracy of CT-guided thoracic spinal biopsy. Material and Methods. In total, 158 consecutive CT-guided percutaneous thoracic spine procedures (performed at the Dept. of Spinal Surgery, Xian Red Cross Hospital between April 2000 and July 2010) were reviewed. The 158 lesions were categorized by location and radiographic features. Pathological and clinical follow-up were used to determine accuracy. Results. The diagnostic accuracy of CT-guided thoracic spinal biopsy was 90.5% overall. Biopsy of metastatic bone disease (98.2%) was significantly more accurate than biopsies of primary tumors (80.9%) and of hematological malignancies (47.0%) (P < 0.05 and P < 0.005, respectively). The diagnostic accuracy of CT-guided thoracic spinal biopsy was significantly higher for the lower thoracic spine (97.6%) than for the middle (90.0%) or upper thoracic spine (80.4%) (P < 0.05 and P < 0.025, respectively). The diagnostic accuracy was significantly higher for lytic lesions (96.4%) than for sclerotic lesions (81.3%) (P < 0.010). The accuracy of biopsies performed using the transpedicular approach (91.0%) was not significantly different from that of biopsies performed using posterolateral approaches (91.5%) (0.25 < P < 0.5). Conclusion. Percutaneous CT-guided thoracic spinal biopsy is a viable alternative to open surgical biopsy. The diagnostic accuracy was not affected by any of the variables except for lesion level, histology, and radiographic features

  20. Accuracy of sentinel lymph node biopsy for the assessment of auxiliary status in patients with early (T1) breast carcinoma

    International Nuclear Information System (INIS)

    Gurleyik, G.; Sekmen, U.; Saglam, A.; Aker, F.

    2005-01-01

    Objective: To determine the accuracy of SLN biopsy for the assessment of auxiliary status, and prognostic markers leading to lymphatic metastasis in patients with early (T1) breast cancer. Design: Cross-sectional study. Place and Duration of Study: Department of Surgery, Teaching and Research Hospital. Between January 2000 and August 2004. Patients and Methods: SLN mapping by blue dye method was performed on 39 patients with T1 breast carcinoma. SLNs, level 1 and 2 auxiliary nodes were dissected and excised. The size, pathologic features of the primary tumor, SLNs and other auxiliary nodes, and hormone receptors were evaluated by histopathologic examination. The rate of SLNs and non SLNs involvement, and demographic, clinical and pathologic risk factors leading to nodal metastasis were established. The diagnostic accuracy of SLN for auxiliary status was calculated. Results: SLNs were identified in 37 (95%) patients. The axilla had metastasis in 11 (28%) patients. Malignant cells involved SLNs in 8 patients. Non-SLNs had metastasis in 3 patients without SLN involvement. The sensitivity, specificity and accuracy of SLN biopsy for predicting auxiliary status was calculated as 73%, 100% and 92% respectively. Four of 5 patients T1c tumors (p=0.14) and lymphovascular invasion (p=0.0004). Conclusion: SLN biopsy with high diagnostic accuracy may prevent unnecessary disection of the axilla in the majority of patients with early (T1) breast carcinoma. Some risk factors as pre-menopausal status, absence of hormone receptors, and presence of lymphovascular invasion must be taken into account as important determinant of non-SLNs metastasis. (author)

  1. Accuracy of diagnostic ultrasound in patients with suspected subacromial disorders: a systematic review and meta-analysis.

    NARCIS (Netherlands)

    Ottenheijm, R.P.; Jansen, M.J.; Staal, J.B.; Bruel, A. van den; Weijers, R.E.; Bie, R.A. de; Dinant, G.J.

    2010-01-01

    OBJECTIVE: To determine the diagnostic accuracy of ultrasound for detecting subacromial disorders in patients presenting in primary and secondary care settings. DATA SOURCES: Medline and Embase were searched on June 9, 2010. In addition, the reference list of 1 systematic review and all included

  2. Impact of the diagnostic process on the accuracy of source identification and time to antibiotics in septic emergency department patients.

    Science.gov (United States)

    Uittenbogaard, Annemieke J M; de Deckere, Ernie R J T; Sandel, Maro H; Vis, Alice; Houser, Christine M; de Groot, Bas

    2014-06-01

    Timely administration of effective antibiotics is important in sepsis management. Source-targeted antibiotics are believed to be most effective, but source identification could cause time delays. First, to describe the accuracy/time delays of a diagnostic work-up and the association with time to antibiotics in septic emergency department (ED) patients. Second, to assess the fraction in which source-targeted antibiotics could have been administered solely on the basis of patient history and physical examination. Secondary analysis of the prospective observational study on septic ED patients was carried out. The time to test result availability was associated with time to antibiotics. The accuracy of the suspected source of infection in the ED was assessed. For patients with pneumosepsis, urosepsis, and abdominal sepsis, combinations of signs and symptoms were assessed to achieve a maximal positive predictive value for the sepsis source, identifying a subset of patients in whom source-targeted antibiotics could be administered without waiting for diagnostic test results. The time to antibiotics increased by 18 (95% confidence interval: 12-24) min/h delay in test result availability (n=323). In 38-79% of patients, antibiotics were administered after additional tests, whereas the ED diagnosis was correct in 68-85% of patients. The maximal positive predictive value of signs and symptoms was 0.87 for patients with pneumosepsis and urosepsis and 0.75 for those with abdominal sepsis. Use of signs and symptoms would have led to correct ED diagnosis in 33% of patients. Diagnostic tests are associated with delayed administration of antibiotics to septic ED patients while increasing the diagnostic accuracy to only 68-85%. In one-third of septic ED patients, the choice of antibiotics could have been accurately determined solely on the basis of patient history and physical examination.

  3. Diagnostic test accuracy of nutritional tools used to identify undernutrition in patients with colorectal cancer: a systematic review.

    Science.gov (United States)

    Håkonsen, Sasja Jul; Pedersen, Preben Ulrich; Bath-Hextall, Fiona; Kirkpatrick, Pamela

    2015-05-15

    Effective nutritional screening, nutritional care planning and nutritional support are essential in all settings, and there is no doubt that a health service seeking to increase safety and clinical effectiveness must take nutritional care seriously. Screening and early detection of malnutrition is crucial in identifying patients at nutritional risk. There is a high prevalence of malnutrition in hospitalized patients undergoing treatment for colorectal cancer. To synthesize the best available evidence regarding the diagnostic test accuracy of nutritional tools (sensitivity and specificity) used to identify malnutrition (specifically undernutrition) in patients with colorectal cancer (such as the Malnutrition Screening Tool and Nutritional Risk Index) compared to reference tests (such as the Subjective Global Assessment or Patient Generated Subjective Global Assessment). Patients with colorectal cancer requiring either (or all) surgery, chemotherapy and/or radiotherapy in secondary care. Focus of the review: The diagnostic test accuracy of validated assessment tools/instruments (such as the Malnutrition Screening Tool and Nutritional Risk Index) in the diagnosis of malnutrition (specifically under-nutrition) in patients with colorectal cancer, relative to reference tests (Subjective Global Assessment or Patient Generated Subjective Global Assessment). Types of studies: Diagnostic test accuracy studies regardless of study design. Studies published in English, German, Danish, Swedish and Norwegian were considered for inclusion in this review. Databases were searched from their inception to April 2014. Methodological quality was determined using the Quality Assessment of Diagnostic Accuracy Studies checklist. Data was collected using the data extraction form: the Standards for Reporting Studies of Diagnostic Accuracy checklist for the reporting of studies of diagnostic accuracy. The accuracy of diagnostic tests is presented in terms of sensitivity, specificity, positive

  4. Accuracy and congruence of patient and physician weight-related discussions: from Project CHAT (Communicating Health: Analyzing Talk)

    Science.gov (United States)

    Bodner, Michael E.; Dolor, Rowena J.; Óstbye, Truls; Lyna, Pauline; Alexander, Stewart C.; Tulsky, James A.; Pollak, Kathryn I.

    2014-01-01

    Objective Primary care providers should counsel overweight patients to lose weight. Rates of self-reported weight-related counseling vary, perhaps due to self-report bias. We assessed accuracy and congruence of weight-related discussions among patients, physicians, and audio-recorded encounters. Methods We audio recorded encounters between physicians (n=40) and their overweight/obese patients (n=461) at five community-based practices. We coded weight-related content and surveyed patients and physicians immediately after the visit. Generalized linear mixed models assessed factors associated with accuracy. Results Overall, accuracy was moderate: patient (67%), physician (70%), and congruence (62%). When encounters contained weight-related content were analyzed, patients (98%) and physicians (97%) were highly accurate and congruent (95%) but when weight was not discussed patients and physicians were more inaccurate and incongruent (patient 36%; physician 44%; 28% congruence). Physicians less comfortable discussing weight were more likely to misreport that weight was discussed [OR = 4.5 (95% CI=1.88–10.75, p<0.001)]. White physicians with African-American patients were more likely to report accurately no discussion about weight than White physicians with White patients OR=0.30 (95% CI=0.13–0.69, p<0.01). Conclusion Physician and patient self-report of weight-related discussions were highly accurate and congruent when audio-recordings indicated weight was discussed, but not when recordings indicated no weight discussions. Physician overestimation of weight discussions when weight is not discussed constitutes missed opportunities for health interventions. PMID:24390888

  5. The Semi-opened Infrastructure Model (SopIM): A Frame to Set Up an Organizational Learning Process

    Science.gov (United States)

    Grundstein, Michel

    In this paper, we introduce the "Semi-opened Infrastructure Model (SopIM)" implemented to deploy Artificial Intelligence and Knowledge-based Systems within a large industrial company. This model illustrates what could be two of the operating elements of the Model for General Knowledge Management within the Enterprise (MGKME) that are essential to set up the organizational learning process that leads people to appropriate and use concepts, methods and tools of an innovative technology: the "Ad hoc Infrastructures" element, and the "Organizational Learning Processes" element.

  6. Decree N0 81-978 of 29 October 1981 setting up a Higher Council for Nuclear Safety

    International Nuclear Information System (INIS)

    1981-01-01

    This Decree amends the Decree of 13 March 1973 setting up a High Council for Nuclear Safety and a Central Service for the Safety of Nuclear Installations. The High Council, which is attached to the Ministry of industry, is competent to advise on all questions involving the safety of nuclear installations. Henceforth, the National Assembly, the Senate and the regional or general Councils concerned may request the Minister to submit for consideration by the High Council all important matters within its competence. (NEA) [fr

  7. Fiber optic based OSL set up for online and offline measurements of dose due to ionizing radiation

    International Nuclear Information System (INIS)

    Rawat, N.S.; Kulkarni, M.S.; Upadhyay, B.N.; Srikanth, G.; Bindra, K.S.; Oak, S.M.

    2016-01-01

    An optic-fiber dosimetry system based on optically stimulated luminescence (OSL) and radio-luminescence (RL) from Al_2O_3 : C single-crystal (detector) was designed and developed. The set up is intended to measure dose and dose rates at various radiological installations. The Al_2O_3:C single crystal (from Landaeur Inc. USA) was coupled to a fiber optic delivery system and OSL from the detector is stimulated via the optical fiber cable using light from a Nd:YAG laser. OSL and RL signals are later used to predict cumulative dose and dose rates using "6"0Co gamma source. (author)

  8. MARKETING STRATEGY FOR SETTING UP AN OWN COFFEE SHOP IN CHINA : Using Starbucks as a case study

    OpenAIRE

    Wei , ChiJiao

    2016-01-01

    The thesis aimed to find out a suitable marketing strategy and making a marketing plan for setting up an own coffee shop in Shanghai, China. Coffee was one of the most popular drinks in the world and coffee has been accepted by more and more Chinese people. Coffee industry was well-received choice for the entrepreneurs to start up their own business in China. Marketing strategy played an important role in the intense market competition. A successful marketing strategy could help the coffee co...

  9. Decree no 76-845 of 1 September 1976 setting up a Council for external nuclear policy

    International Nuclear Information System (INIS)

    1976-01-01

    This Decree has set up a Council for External Nuclear Policy, chaired by the President of the Republic, and includes the Prime Minister, the Ministers for Economy and Finance (these duties are presently discharged by the Prime Minister), Defence, Industry, Trade and Crafts, External Trade, and the Administrator-General of the Commissariat a l'Energie Atomique, as well as the Minister of Foreign Affairs. The duty of this Council is to define the various aspects of external nuclear policy, in particular, regarding the export of technology, equipment and sensitive nuclear products. (NEA) [fr

  10. Decree No. 77-1233 of 10 November 1977 setting up a Council for information on nuclear electricity generation

    International Nuclear Information System (INIS)

    1977-01-01

    This Decree sets up a Council for information on nuclear electricity generation directly under the authority of and appointed by the Prime Minister. It has 18 members who include, inter alia, mayors of the communes concerned by nuclear power plant siting, representatives of nature and environmental protection associations, science academicians and economics, energy and communications experts. The Council's purpose is to ensure that the public has access to infomation on nuclear electricity generation from the technical, health, ecological, economic and financial viewpoints. It advises the Government on the public's conditions of access to information and proposes methods for its dissemination. (NEA) [fr

  11. First results with the experimental set-up at a Bugey reactor: neutrino oscillations, search of axions

    International Nuclear Information System (INIS)

    Hoummada, A.

    1982-07-01

    This work presents an experimental set-up at the Bugey PWR reactor to put into evidence neutrino oscillations. The first part describes a neutrino detector specially designed for the investigation of neutrino oscillations at two distances (13.50 m and 19 m) under the core of the reactor. Preliminary analysis are presented. The second part reports a search for axions, using the neutrino detector well-shielded volume. Created in competition with electro magnetic transitions, axion should be produced in abondance in the reactor core. This experiment excludes the existence of the axion of the standard model [fr

  12. SU-E-I-58: Experiences in Setting Up An Online Fluoroscopy Tracking System in a Large Healthcare System

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, R; Wunderle, K; Lingenfelter, M [The Cleveland Clinic, Cleveland, OH (United States)

    2015-06-15

    Purpose: Transitioning from a paper based to an online system for tracking fluoroscopic case information required by state regulation and to conform to NCRP patient dose tracking suggestions. Methods: State regulations require documentation of operator, equipment, and some metric of tube output for fluoroscopy exams. This information was previously collected in paper logs, which was cumbersome and inefficient for the large number of fluoroscopic units across multiple locations within the system. The “tech notes” feature within Siemens’ Syngo workflow RIS was utilized to create an entry form for technologists to input case information, which was sent to a third party vendor for archiving and display though an online web based portal. Results: Over 55k cases were logged in the first year of implementation, with approximately 6,500 cases per month once fully online. A system was built for area managers to oversee and correct data, which has increased the accuracy of inputted values. A high-dose report was built to automatically send notifications when patients exceed trigger levels. In addition to meeting regulatory requirements, the new system allows for larger scale QC in fluoroscopic cases by allowing comparison of data from specific procedures, locations, equipment, and operators so that instances that fall outside of reference levels can be identified for further evaluation. The system has also drastically improved identification of operators without documented equipment specific training. Conclusion: The transition to online fluoroscopy logs has improved efficiency in meeting state regulatory requirements as well as allowed for identification of particular procedures, equipment, and operators in need of additional attention in order to optimize patient and personnel doses, while high dose alerts improve patient care and follow up. Future efforts are focused on incorporating case information from outside of radiology, as well as on automating processes for

  13. SU-E-I-58: Experiences in Setting Up An Online Fluoroscopy Tracking System in a Large Healthcare System

    International Nuclear Information System (INIS)

    Fisher, R; Wunderle, K; Lingenfelter, M

    2015-01-01

    Purpose: Transitioning from a paper based to an online system for tracking fluoroscopic case information required by state regulation and to conform to NCRP patient dose tracking suggestions. Methods: State regulations require documentation of operator, equipment, and some metric of tube output for fluoroscopy exams. This information was previously collected in paper logs, which was cumbersome and inefficient for the large number of fluoroscopic units across multiple locations within the system. The “tech notes” feature within Siemens’ Syngo workflow RIS was utilized to create an entry form for technologists to input case information, which was sent to a third party vendor for archiving and display though an online web based portal. Results: Over 55k cases were logged in the first year of implementation, with approximately 6,500 cases per month once fully online. A system was built for area managers to oversee and correct data, which has increased the accuracy of inputted values. A high-dose report was built to automatically send notifications when patients exceed trigger levels. In addition to meeting regulatory requirements, the new system allows for larger scale QC in fluoroscopic cases by allowing comparison of data from specific procedures, locations, equipment, and operators so that instances that fall outside of reference levels can be identified for further evaluation. The system has also drastically improved identification of operators without documented equipment specific training. Conclusion: The transition to online fluoroscopy logs has improved efficiency in meeting state regulatory requirements as well as allowed for identification of particular procedures, equipment, and operators in need of additional attention in order to optimize patient and personnel doses, while high dose alerts improve patient care and follow up. Future efforts are focused on incorporating case information from outside of radiology, as well as on automating processes for

  14. Comparison of the accuracy of three algorithms in predicting accessory pathways among adult Wolff-Parkinson-White syndrome patients.

    Science.gov (United States)

    Maden, Orhan; Balci, Kevser Gülcihan; Selcuk, Mehmet Timur; Balci, Mustafa Mücahit; Açar, Burak; Unal, Sefa; Kara, Meryem; Selcuk, Hatice

    2015-12-01

    The aim of this study was to investigate the accuracy of three algorithms in predicting accessory pathway locations in adult patients with Wolff-Parkinson-White syndrome in Turkish population. A total of 207 adult patients with Wolff-Parkinson-White syndrome were retrospectively analyzed. The most preexcited 12-lead electrocardiogram in sinus rhythm was used for analysis. Two investigators blinded to the patient data used three algorithms for prediction of accessory pathway location. Among all locations, 48.5% were left-sided, 44% were right-sided, and 7.5% were located in the midseptum or anteroseptum. When only exact locations were accepted as match, predictive accuracy for Chiang was 71.5%, 72.4% for d'Avila, and 71.5% for Arruda. The percentage of predictive accuracy of all algorithms did not differ between the algorithms (p = 1.000; p = 0.875; p = 0.885, respectively). The best algorithm for prediction of right-sided, left-sided, and anteroseptal and midseptal accessory pathways was Arruda (p algorithms were similar in predicting accessory pathway location and the predicted accuracy was lower than previously reported by their authors. However, according to the accessory pathway site, the algorithm designed by Arruda et al. showed better predictions than the other algorithms and using this algorithm may provide advantages before a planned ablation.

  15. Accuracy of a commercial optical 3D surface imaging system for realignment of patients for radiotherapy of the thorax

    International Nuclear Information System (INIS)

    Schoeffel, Philipp J; Harms, Wolfgang; Sroka-Perez, Gabriele; Schlegel, Wolfgang; Karger, Christian P

    2007-01-01

    Accurate and reproducible patient setup is a prerequisite to fractionated radiotherapy. To evaluate the applicability and technical performance of a commercial 3D surface imaging system for repositioning of breast cancer patients, measurements were performed in a rigid anthropomorphic phantom as well as in healthy volunteers. The camera system records a respiration-gated surface model of the imaged object, which may be registered to a previously recorded reference model. A transformation is provided, which may be applied to the treatment couch to correct the setup of the patient. The system showed a high stability and detected pre-defined shifts of phantoms and healthy volunteers with an accuracy of 0.40 ± 0.26 mm and 1.02 ± 0.51 mm, respectively (spatial deviation between pre-defined shift and suggested correction). The accuracy of the suggested rotational correction around the vertical axis was always better than 0.3 0 in phantom measurements and 0.8 0 in volunteers, respectively. Comparison of the suggested setup correction with that detected by a second and independently operated marker-based optical system provided consistent results. The results demonstrate that the camera system provides highly accurate setup corrections in a phantom and healthy volunteers. The most efficient use of the system for improving the setup accuracy in breast cancer patients has to be investigated in routine patient treatments

  16. Diagnostic accuracy of full-body linear X-ray scanning in multiple trauma patients in comparison to computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Joeres, A.P.W.; Heverhagen, J.T.; Bonel, H. [Inselspital - University Hospital Bern (Switzerland). Univ. Inst. of Diagnostic, Interventional and Pediatric Radiology; Exadaktylos, A. [Inselspital - University Hospital Bern (Switzerland). Dept. of Emergency Medicine; Klink, T. [Inselspital - University Hospital Bern (Switzerland). Univ. Inst. of Diagnostic, Interventional and Pediatric Radiology; Wuerzburg Univ. (Germany). Inst. of Diagnostic and Interventional Radiology

    2016-02-15

    The purpose of this study was to evaluate the diagnostic accuracy of full-body linear X-ray scanning (LS) in multiple trauma patients in comparison to 128-multislice computed tomography (MSCT). 106 multiple trauma patients (female: 33; male: 73) were retrospectively included in this study. All patients underwent LS of the whole body, including extremities, and MSCT covering the neck, thorax, abdomen, and pelvis. The diagnostic accuracy of LS for the detection of fractures of the truncal skeleton and pneumothoraces was evaluated in comparison to MSCT by two observers in consensus. Extremity fractures detected by LS were documented. The overall sensitivity of LS was 49.2%, the specificity was 93.3%, the positive predictive value was 91%, and the negative predictive value was 57.5%. The overall sensitivity for vertebral fractures was 16.7%, and the specificity was 100%. The sensitivity was 48.7% and the specificity 98.2% for all other fractures. Pneumothoraces were detected in 12 patients by CT, but not by LS.40 extremity fractures were detected by LS, of which 4 fractures were dislocated, and 2 were fully covered by MSCT. The diagnostic accuracy of LS is limited in the evaluation of acute trauma of the truncal skeleton. LS allows fast whole-body X-ray imaging, and may be valuable for detecting extremity fractures in trauma patients in addition to MSCT.

  17. Diagnostic accuracy and prognostic impact of restaging by magnetic resonance imaging after preoperative chemoradiotherapy in patients with rectal cancer

    International Nuclear Information System (INIS)

    Huh, Jung Wook; Kim, Hee Cheol; Lee, Soon Jin; Yun, Seong Hyeon; Lee, Woo Yong; Park, Yoon Ah; Cho, Yong Beom; Chun, Ho-Kyung

    2014-01-01

    Background: The prognostic role of restaging rectal magnetic resonance imaging (MRI) in patients with preoperative CRT has not been established. The goal of this study was to evaluate the diagnostic accuracy and prognostic role of radiological staging by rectal MRI after preoperative chemoradiation (CRT) in patients with rectal cancer. Methods: A total of 231 consecutive patients with rectal cancer who underwent preoperative CRT and radical resection from January 2008 to December 2009 were prospectively enrolled. The diagnostic accuracy and prognostic significance of post-CRT radiological staging by MRI was evaluated. Results: The sensitivity, specificity, positive predictive value, and negative predictive value of radiological diagnosis of good responders (ypTNM stage 0–I) were 32%, 90%, 65%, and 69%, respectively. The overall accuracy of MRI restating for good responders was 68%. The 5-year disease-free survival rates of patients with radiological and pathological TNM stage 0, stage I, and stage II–III were 100%, 94%, and 76%, respectively (P = 0.037), and 97%, 87%, and 73%, respectively (P = 0.007). On multivariate analysis, post-CRT radiological staging by MRI was an independent prognostic factor for disease-free survival. Conclusion: Radiological staging by MRI after preoperative CRT may be an independent predictor of survival in patients with rectal cancer

  18. SU-E-T-91: Accuracy of Dose Calculation Algorithms for Patients Undergoing Stereotactic Ablative Radiotherapy

    International Nuclear Information System (INIS)

    Tajaldeen, A; Ramachandran, P; Geso, M

    2015-01-01

    Purpose: The purpose of this study was to investigate and quantify the variation in dose distributions in small field lung cancer radiotherapy using seven different dose calculation algorithms. Methods: The study was performed in 21 lung cancer patients who underwent Stereotactic Ablative Body Radiotherapy (SABR). Two different methods (i) Same dose coverage to the target volume (named as same dose method) (ii) Same monitor units in all algorithms (named as same monitor units) were used for studying the performance of seven different dose calculation algorithms in XiO and Eclipse treatment planning systems. The seven dose calculation algorithms include Superposition, Fast superposition, Fast Fourier Transform ( FFT) Convolution, Clarkson, Anisotropic Analytic Algorithm (AAA), Acurous XB and pencil beam (PB) algorithms. Prior to this, a phantom study was performed to assess the accuracy of these algorithms. Superposition algorithm was used as a reference algorithm in this study. The treatment plans were compared using different dosimetric parameters including conformity, heterogeneity and dose fall off index. In addition to this, the dose to critical structures like lungs, heart, oesophagus and spinal cord were also studied. Statistical analysis was performed using Prism software. Results: The mean±stdev with conformity index for Superposition, Fast superposition, Clarkson and FFT convolution algorithms were 1.29±0.13, 1.31±0.16, 2.2±0.7 and 2.17±0.59 respectively whereas for AAA, pencil beam and Acurous XB were 1.4±0.27, 1.66±0.27 and 1.35±0.24 respectively. Conclusion: Our study showed significant variations among the seven different algorithms. Superposition and AcurosXB algorithms showed similar values for most of the dosimetric parameters. Clarkson, FFT convolution and pencil beam algorithms showed large differences as compared to superposition algorithms. Based on our study, we recommend Superposition and AcurosXB algorithms as the first choice of

  19. SU-E-T-91: Accuracy of Dose Calculation Algorithms for Patients Undergoing Stereotactic Ablative Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Tajaldeen, A [RMIT university, Docklands, Vic (Australia); Ramachandran, P [Peter MacCallum Cancer Centre, Bendigo (Australia); Geso, M [RMIT University, Bundoora, Melbourne (Australia)

    2015-06-15

    Purpose: The purpose of this study was to investigate and quantify the variation in dose distributions in small field lung cancer radiotherapy using seven different dose calculation algorithms. Methods: The study was performed in 21 lung cancer patients who underwent Stereotactic Ablative Body Radiotherapy (SABR). Two different methods (i) Same dose coverage to the target volume (named as same dose method) (ii) Same monitor units in all algorithms (named as same monitor units) were used for studying the performance of seven different dose calculation algorithms in XiO and Eclipse treatment planning systems. The seven dose calculation algorithms include Superposition, Fast superposition, Fast Fourier Transform ( FFT) Convolution, Clarkson, Anisotropic Analytic Algorithm (AAA), Acurous XB and pencil beam (PB) algorithms. Prior to this, a phantom study was performed to assess the accuracy of these algorithms. Superposition algorithm was used as a reference algorithm in this study. The treatment plans were compared using different dosimetric parameters including conformity, heterogeneity and dose fall off index. In addition to this, the dose to critical structures like lungs, heart, oesophagus and spinal cord were also studied. Statistical analysis was performed using Prism software. Results: The mean±stdev with conformity index for Superposition, Fast superposition, Clarkson and FFT convolution algorithms were 1.29±0.13, 1.31±0.16, 2.2±0.7 and 2.17±0.59 respectively whereas for AAA, pencil beam and Acurous XB were 1.4±0.27, 1.66±0.27 and 1.35±0.24 respectively. Conclusion: Our study showed significant variations among the seven different algorithms. Superposition and AcurosXB algorithms showed similar values for most of the dosimetric parameters. Clarkson, FFT convolution and pencil beam algorithms showed large differences as compared to superposition algorithms. Based on our study, we recommend Superposition and AcurosXB algorithms as the first choice of

  20. Technical note: An experimental set-up to measure latent and sensible heat fluxes from (artificial plant leaves

    Directory of Open Access Journals (Sweden)

    S. J. Schymanski

    2017-07-01

    Full Text Available Leaf transpiration and energy exchange are coupled processes that operate at small scales yet exert a significant influence on the terrestrial hydrological cycle and climate. Surprisingly, experimental capabilities required to quantify the energy–transpiration coupling at the leaf scale are lacking, challenging our ability to test basic questions of importance for resolving large-scale processes. The present study describes an experimental set-up for the simultaneous observation of transpiration rates and all leaf energy balance components under controlled conditions, using an insulated closed loop miniature wind tunnel and artificial leaves with pre-defined and constant diffusive conductance for water vapour. A range of tests documents the above capabilities of the experimental set-up and points to potential improvements. The tests reveal a conceptual flaw in the assumption that leaf temperature can be characterized by a single value, suggesting that even for thin, planar leaves, a temperature gradient between the irradiated and shaded or transpiring and non-transpiring leaf side can lead to bias when using observed leaf temperatures and fluxes to deduce effective conductances to sensible heat or water vapour transfer. However, comparison of experimental results with an explicit leaf energy balance model revealed only minor effects on simulated leaf energy exchange rates by the neglect of cross-sectional leaf temperature gradients, lending experimental support to our current understanding of leaf gas and energy exchange processes.

  1. Setting-up a cost recovery system for the largest wastewater treatment plant in South-East Asia.

    Science.gov (United States)

    Lønholdt, J; Elberg Jørgensen, P; O'Hearn, D

    2005-01-01

    A tariff system has been set up for the largest wastewater treatment plant in South-East Asia, the Samut Prakarn Wastewater Treatment Plant south of Bangkok, which is currently under completion. Fully functional the plant will have a design capacity for 500,000 m3 per day and will service a combined residential and industrial area with approximately 600,000 residents and 2,300 factories. The tariff system, which includes a tariff model, is based on water consumption and BOD load. As background for setting the tariffs a comprehensive monitoring system including an industrial permitting system has been developed. The paper presents the background and rationale for setting up the system as well as the objective, scope and content of the tariff system and the industrial permit system. Further, the feasibility of introducing cost recovery systems, which is widely accepted in developing economies on the conceptual level and to some extent implemented at the legal and regulatory level, but has yet to be implemented at large, is discussed.

  2. The urban boundary-layer field campaign in marseille (ubl/clu-escompte): set-up and first results

    Science.gov (United States)

    Mestayer, P.G.; Durand, P.; Augustin, P.; Bastin, S.; Bonnefond, J.-M.; Benech, B.; Campistron, B.; Coppalle, A.; Delbarre, H.; Dousset, B.; Drobinski, P.; Druilhet, A.; Frejafon, E.; Grimmond, C.S.B.; Groleau, D.; Irvine, M.; Kergomard, C.; Kermadi, S.; Lagouarde, J.-P.; Lemonsu, A.; Lohou, F.; Long, N.; Masson, V.; Moppert, C.; Noilhan, J.; Offerle, B.; Oke, T.R.; Pigeon, G.; Puygrenier, V.; Roberts, S.; Rosant, J.-M.; Sanid, F.; Salmond, J.; Talbaut, M.; Voogt, J.

    The UBL/CLU (urban boundary layer/couche limite urbaine) observation and modelling campaign is a side-project of the regional photochemistry campaign ESCOMPTE. UBL/CLU focuses on the dynamics and thermodynamics of the urban boundary layer of Marseille, on the Mediterranean coast of France. The objective of UBL/CLU is to document the four-dimensional structure of the urban boundary layer and its relation to the heat and moisture exchanges between the urban canopy and the atmosphere during periods of low wind conditions, from June 4 to July 16, 2001. The project took advantage of the comprehensive observational set-up of the ESCOMPTE campaign over the Berre-Marseille area, especially the ground-based remote sensing, airborne measurements, and the intensive documentation of the regional meteorology. Additional instrumentation was installed as part of UBL/CLU. Analysis objectives focus on (i) validation of several energy balance computational schemes such as LUMPS, TEB and SM2-U, (ii) ground truth and urban canopy signatures suitable for the estimation of urban albedos and aerodynamic surface temperatures from satellite data, (iii) high resolution mapping of urban land cover, land-use and aerodynamic parameters used in UBL models, and (iv) testing the ability of high resolution atmospheric models to simulate the structure of the UBL during land and sea breezes, and the related transport and diffusion of pollutants over different districts of the city. This paper presents initial results from such analyses and details of the overall experimental set-up.

  3. Accuracy of advanced cancer patients' life expectancy estimates: The role of race and source of life expectancy information.

    Science.gov (United States)

    Trevino, Kelly M; Zhang, Baohui; Shen, Megan J; Prigerson, Holly G

    2016-06-15

    The objective of this study was to examine the source of advanced cancer patients' information about their prognosis and determine whether this source of information could explain racial disparities in the accuracy of patients' life expectancy estimates (LEEs). Coping With Cancer was a prospective, longitudinal, multisite study of terminally ill cancer patients followed until death. In structured interviews, patients reported their LEEs and the sources of these estimates (ie, medical providers, personal beliefs, religious beliefs, and other). The accuracy of LEEs was calculated through a comparison of patients' self-reported LEEs with their actual survival. The sample for this analysis included 229 patients: 31 black patients and 198 white patients. Only 39.30% of the patients estimated their life expectancy within 12 months of their actual survival. Black patients were more likely to have an inaccurate LEE than white patients. A minority of the sample (18.3%) reported that a medical provider was the source of their LEEs; none of the black patients (0%) based their LEEs on a medical provider. Black race remained a significant predictor of an inaccurate LEE, even after the analysis had been controlled for sociodemographic characteristics and the source of LEEs. The majority of advanced cancer patients have an inaccurate understanding of their life expectancy. Black patients with advanced cancer are more likely to have an inaccurate LEE than white patients. Medical providers are not the source of information for LEEs for most advanced cancer patients and especially for black patients. The source of LEEs does not explain racial differences in LEE accuracy. Additional research into the mechanisms underlying racial differences in prognostic understanding is needed. Cancer 2016;122:1905-12. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons

  4. Quantitative modeling of the accuracy in registering preoperative patient-specific anatomic models into left atrial cardiac ablation procedures

    Energy Technology Data Exchange (ETDEWEB)

    Rettmann, Maryam E., E-mail: rettmann.maryam@mayo.edu; Holmes, David R.; Camp, Jon J.; Cameron, Bruce M.; Robb, Richard A. [Biomedical Imaging Resource, Mayo Clinic College of Medicine, Rochester, Minnesota 55905 (United States); Kwartowitz, David M. [Department of Bioengineering, Clemson University, Clemson, South Carolina 29634 (United States); Gunawan, Mia [Department of Biochemistry and Molecular and Cellular Biology, Georgetown University, Washington D.C. 20057 (United States); Johnson, Susan B.; Packer, Douglas L. [Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905 (United States); Dalegrave, Charles [Clinical Cardiac Electrophysiology, Cardiology Division Hospital Sao Paulo, Federal University of Sao Paulo, 04024-002 Brazil (Brazil); Kolasa, Mark W. [David Grant Medical Center, Fairfield, California 94535 (United States)

    2014-02-15

    Purpose: In cardiac ablation therapy, accurate anatomic guidance is necessary to create effective tissue lesions for elimination of left atrial fibrillation. While fluoroscopy, ultrasound, and electroanatomic maps are important guidance tools, they lack information regarding detailed patient anatomy which can be obtained from high resolution imaging techniques. For this reason, there has been significant effort in incorporating detailed, patient-specific models generated from preoperative imaging datasets into the procedure. Both clinical and animal studies have investigated registration and targeting accuracy when using preoperative models; however, the effect of various error sources on registration accuracy has not been quantitatively evaluated. Methods: Data from phantom, canine, and patient studies are used to model and evaluate registration accuracy. In the phantom studies, data are collected using a magnetically tracked catheter on a static phantom model. Monte Carlo simulation studies were run to evaluate both baseline errors as well as the effect of different sources of error that would be present in a dynamicin vivo setting. Error is simulated by varying the variance parameters on the landmark fiducial, physical target, and surface point locations in the phantom simulation studies. In vivo validation studies were undertaken in six canines in which metal clips were placed in the left atrium to serve as ground truth points. A small clinical evaluation was completed in three patients. Landmark-based and combined landmark and surface-based registration algorithms were evaluated in all studies. In the phantom and canine studies, both target registration error and point-to-surface error are used to assess accuracy. In the patient studies, no ground truth is available and registration accuracy is quantified using point-to-surface error only. Results: The phantom simulation studies demonstrated that combined landmark and surface-based registration improved

  5. Diagnostic accuracy of exercise thallium-201 single-photon emission computed tomography in patients with left bundle branch block

    International Nuclear Information System (INIS)

    Larcos, G.; Gibbons, R.J.; Brown, M.L.

    1991-01-01

    Recent reports have proposed that abnormal apical or anterior wall perfusion with exercise thallium-201 imaging may increase diagnostic accuracy for disease of the left anterior descending artery in patients with left bundle branch block (LBBB). To evaluate these suggestions, 83 patients with LBBB who underwent thallium-201 single-photon emission computed tomography and coronary angiography within an interval of 3 months were retrospectively reviewed. There were 59 men and 24 women aged 33 to 84 years (mean 65). Myocardial perfusion to the apex, anterior wall and anterior septum were scored qualitatively by consensus of 2 experienced observers and by quantitative analysis in comparison with a normal data base. The sensitivity, specificity and accuracy of perfusion defects in these segments were then expressed according to angiographic findings. Significant stenosis of vessels within the left anterior descending artery territory was present in 38 patients. By receiver-operator characteristic analysis, a fixed or reversible defect within the apex by the qualitative method was the best criterion for coronary artery disease. However, although highly sensitive (79 and 85% by the qualitative and quantitative methods, respectively), an apical defect was neither specific (38 and 16%, respectively), nor accurate (57 and 46%, respectively). Perfusion abnormalities in the anterior wall and septum were also of limited diagnostic accuracy. Thus, modified interpretative criteria in patients with LBBB are not clinically useful in the assessment of left anterior descending artery disease

  6. Statistical models for quantifying diagnostic accuracy with multiple lesions per patient

    NARCIS (Netherlands)

    Zwinderman, Aeilko H.; Glas, Afina S.; Bossuyt, Patrick M.; Florie, Jasper; Bipat, Shandra; Stoker, Jaap

    2008-01-01

    We propose random-effects models to summarize and quantify the accuracy of the diagnosis of multiple lesions on a single image without assuming independence between lesions. The number of false-positive lesions was assumed to be distributed as a Poisson mixture, and the proportion of true-positive

  7. Pretreatment axillary ultrasonography and core biopsy in patients with suspected breast cancer: Diagnostic accuracy and impact on management

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Ortega, Maria Jose, E-mail: rserranogan@telefonica.net [Breast Imaging Center, Radiology Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Alvarez Benito, Marina, E-mail: marinaalvarezbenito@telefonica.net [Breast Imaging Center, Radiology Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Fuentes Vahamonde, Elena, E-mail: elena.fuentes.sspa@juntadeandalucia.es [Pathology Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Rioja Torres, Pilar, E-mail: priojat@yahoo.es [Clinical Management Unit, Department of General and Digestive Surgery, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Benitez Velasco, Ana, E-mail: abvelazco@yahoo.es [Nuclear Medicine Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Martinez Paredes, Maria, E-mail: mariaparedes@uco.es [Radiology and Physical Medicine Area, University of Cordoba Medical School, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain)

    2011-07-15

    Preoperative diagnosis of axillary metastases in breast cancer patients enables treatment planning. We aimed to evaluate the diagnostic accuracy of axillary ultrasonography and percutaneous biopsy, both alone and in combination, in detecting axillary metastases in patients with breast cancer and to assess the impact of these techniques on the patients' management. Materials and methods: Retrospective study of consecutive patients with suspected breast cancer examined between October 2006 and December 2008. The diagnosis of a primary tumor was histologically confirmed in all patients. All patients underwent axillary ultrasonography and percutaneous core biopsy (14G) of suspicious lymph nodes. We evaluated the morphological characteristics of the lymph nodes by ultrasonography. We calculated the diagnostic accuracy of ultrasonography and of core biopsy, and assessed the impact of these techniques on patients' treatment. Results: We evaluated 675 axillary regions and performed 291 core biopsies of axillary lymph nodes in 662 patients. In 650 patients, breast cancer was histologically confirmed and in 12 patients malignant tumors in other locations were confirmed. The sensitivity and specificity of axillary ultrasonography were 63.2% and 88.7%, respectively. The absence of a fatty hilum within the lymph node was the ultrasonographic finding with the highest positive predictive value for malignancy (93.1%). The sensitivity and specificity of axillary core biopsy were 69.1% and 100%, respectively. Sentinel lymph node biopsy was avoided in 33% of initial candidates and immediate breast reconstruction was undertaken in 35.1% of the patients with mastectomy and negative axillary core biopsy. Conclusions: Ultrasonography and axillary core biopsy enable adequate pretreatment staging in patients with breast cancer and has a positive impact on their management.

  8. Accuracy and outcome of rapid ultrasound in shock and hypotension (RUSH) in Egyptian polytrauma patients.

    Science.gov (United States)

    Elbaih, Adel Hamed; Housseini, Ahmed Mohamed; Khalifa, Mohamed E M

    2018-03-26

    "Polytrauma" patients are of a higher risk of complications and death than the summation of expected mortality and morbidity of their individual injuries. The ideal goal in trauma resuscitation care is to identify and treat all injuries. With clinical and technological advanced imaging available for diagnosis and treatment of traumatic patients, point of care-rapid ultrasound in shock and hypotension (RUSH) significantly affects modern trauma services and patient outcomes. This study aims to evaluate the accuracy of RUSH and patient outcomes by early detection of the causes of unstable polytrauma. This cross-sectional, prospective study included 100 unstable polytrauma patients admitted in Suez Canal University Hospital. Clinical exam, RUSH and pan-computed tomography (pan-CT) were conducted. The result of CT was taken as the standard. Patients were managed according to the advanced trauma life support (ATLS) guidelines and treated of life threatening conditions if present. Patients were followed up for 28 days for a short outcome. The most diagnostic causes of unstability in polytrauma patients by RUSH are hypovolemic shock (64%), followed by obstructive shock (14%), distributive shock (12%) and cardiogenic shock (10%) respectively. RUSH had 94.2% sensitivity in the diagnosis of unstable polytrauma patients; the accuracy of RUSH in shock patients was 95.2%. RUSH is accurate in the diagnosis of unstable polytrauma patients; and 4% of patients were diagnosed during follow-up after admission by RUSH and pan-CT. Copyright © 2018 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  9. 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.

  10. Awareness assessment of harmful effects of mercury in a health care set-up in India: A survey-based study.

    Science.gov (United States)

    Halder, Nabanita; Peshin, Sharda Shah; Pandey, Ravindra Mohan; Gupta, Yogendra Kumar

    2015-12-01

    Mercury, one of the most toxic heavy metals, is ubiquitous in environment. The adverse health impact of mercury on living organisms is well known. The health care facilities are one of the important sources of mercury release into the atmosphere as mercury items are extensively used in hospitals. To assess the awareness about mercury toxicity and the knowledge of proper handling and disposal of mercury-containing items in health care set-up, a questionnaire-based survey was carried out amongst doctors (n = 835), nurses (n = 610) and technicians (n = 393) in government hospitals, corporate hospitals and primary health care centres in the Indian states of Delhi, Uttar Pradesh and Haryana. The study was conducted using a tool-containing pretested structured multiple-choice questionnaire. Analysis of the results using STATA 11.1 software highlighted that overall awareness was more in corporate sector. However, percentage range of knowledge of respondents irrespective of health care sector was only between 20 and 40%. Despite the commitment of various hospitals to be mercury free, mercury containing-thermometer/sphygmomanometer are still preferred by health professionals. The likely reasons are availability, affordability, accuracy and convenience in use. There is an urgent need for source reduction, recycling and waste minimization. Emphasis must be laid on mercury alternative products, education and training of health personnel and public at large, about correct handling and proper clean up of spills. © The Author(s) 2013.

  11. Accuracy assessment of pharmacogenetically predictive warfarin dosing algorithms in patients of an academic medical center anticoagulation clinic.

    Science.gov (United States)

    Shaw, Paul B; Donovan, Jennifer L; Tran, Maichi T; Lemon, Stephenie C; Burgwinkle, Pamela; Gore, Joel

    2010-08-01

    The objectives of this retrospective cohort study are to evaluate the accuracy of pharmacogenetic warfarin dosing algorithms in predicting therapeutic dose and to determine if this degree of accuracy warrants the routine use of genotyping to prospectively dose patients newly started on warfarin. Seventy-one patients of an outpatient anticoagulation clinic at an academic medical center who were age 18 years or older on a stable, therapeutic warfarin dose with international normalized ratio (INR) goal between 2.0 and 3.0, and cytochrome P450 isoenzyme 2C9 (CYP2C9) and vitamin K epoxide reductase complex subunit 1 (VKORC1) genotypes available between January 1, 2007 and September 30, 2008 were included. Six pharmacogenetic warfarin dosing algorithms were identified from the medical literature. Additionally, a 5 mg fixed dose approach was evaluated. Three algorithms, Zhu et al. (Clin Chem 53:1199-1205, 2007), Gage et al. (J Clin Ther 84:326-331, 2008), and International Warfarin Pharmacogenetic Consortium (IWPC) (N Engl J Med 360:753-764, 2009) were similar in the primary accuracy endpoints with mean absolute error (MAE) ranging from 1.7 to 1.8 mg/day and coefficient of determination R (2) from 0.61 to 0.66. However, the Zhu et al. algorithm severely over-predicted dose (defined as >or=2x or >or=2 mg/day more than actual dose) in twice as many (14 vs. 7%) patients as Gage et al. 2008 and IWPC 2009. In conclusion, the algorithms published by Gage et al. 2008 and the IWPC 2009 were the two most accurate pharmacogenetically based equations available in the medical literature in predicting therapeutic warfarin dose in our study population. However, the degree of accuracy demonstrated does not support the routine use of genotyping to prospectively dose all patients newly started on warfarin.

  12. Diagnostic accuracy of ultrasound in upper and lower extremity long bone fractures of emergency department trauma patients.

    Science.gov (United States)

    Frouzan, Arash; Masoumi, Kambiz; Delirroyfard, Ali; Mazdaie, Behnaz; Bagherzadegan, Elnaz

    2017-08-01

    Long bone fractures are common injuries caused by trauma. Some studies have demonstrated that ultrasound has a high sensitivity and specificity in the diagnosis of upper and lower extremity long bone fractures. The aim of this study was to determine the accuracy of ultrasound compared with plain radiography in diagnosis of upper and lower extremity long bone fractures in traumatic patients. This cross-sectional study assessed 100 patients admitted to the emergency department of Imam Khomeini Hospital, Ahvaz, Iran with trauma to the upper and lower extremities, from September 2014 through October 2015. In all patients, first ultrasound and then standard plain radiography for the upper and lower limb was performed. Data were analyzed by SPSS version 21 to determine the specificity and sensitivity. The mean age of patients with upper and lower limb trauma were 31.43±12.32 years and 29.63±5.89 years, respectively. Radius fracture was the most frequent compared to other fractures (27%). Sensitivity, specificity, positive predicted value, and negative predicted value of ultrasound compared with plain radiography in the diagnosis of upper extremity long bones were 95.3%, 87.7%, 87.2% and 96.2%, respectively, and the highest accuracy was observed in left arm fractures (100%). Tibia and fibula fractures were the most frequent types compared to other fractures (89.2%). Sensitivity, specificity, PPV and NPV of ultrasound compared with plain radiography in the diagnosis of upper extremity long bone fractures were 98.6%, 83%, 65.4% and 87.1%, respectively, and the highest accuracy was observed in men, lower ages and femoral fractures. The results of this study showed that ultrasound compared with plain radiography has a high accuracy in the diagnosis of upper and lower extremity long bone fractures.

  13. Experimental set-up for testing alignments and measurement stability of a metrology system in Silicon Carbide for GAIA

    NARCIS (Netherlands)

    Veggel, van A.A.; Wielders, A.A.; Brug, van H.; Rosielle, P.C.J.N.; Nijmeijer, H.; Hatheway, A.E.

    2005-01-01

    The GAIA satellite will make a 3-D map of our Galaxy with measurement accuracy of 10 microarcseconds using two astrometric telescopes. The angle between the lines-of-sight of the two telescopes will be monitored using the Basic Angle Monitoring system with 1 microarcsecond accuracy. This system will

  14. Diagnostic accuracy and tolerability of contrast enhanced CT colonoscopy in symptomatic patients with increased risk for colorectal cancer

    International Nuclear Information System (INIS)

    Ozsunar, Yelda; Coskun, Guelten; Delibas, Naciye; Uz, Burcin; Yuekselen, Vahit

    2009-01-01

    Objective: We compared the accuracy and tolerability of intravenous contrast enhanced spiral computed tomography colonography (CTC) and optical colonoscopy (OC) for the detection of colorectal neoplasia in symptomatic patients for colorectal neoplasia. Methods: A prospective study was performed in 48 patients with symptomatic patients with increased risk for colorectal cancer. Spiral CTC was performed in supine and prone positions after colonic cleansing. The axial, 2D MPR and virtual endoluminal views were analyzed. Results of spiral CTC were compared with OC which was done within 15 days. The psychometric tolerance test was asked to be performed for both CTC and colonoscopy after the procedure. Results: Ten lesions in 9 of 48 patients were found in CTC and confirmed with OC. Two masses and eight polyps, consisted of 1 tubulovillous, 1 tubular, 2 villous adenoma, 4 adenomatous polyp, 4 adenocarcinoma, were identified. Lesion prevalence was 21%. Sensitivity, specificity, accuracy, positive and negative predictive values were found 100%, 87%, 89%, 67% and 100%, respectively. Psychometric tolerance test showed that CTC significantly more comfortable comparing with OC (p = 0.00). CTC was the preferred method in 37% while OC was preferred in 6% of patients. In both techniques, the most unpleasant part was bowel cleansing. Conclusion: Contrast enhanced CTC is a highly accurate method in detecting colorectal lesions. Since the technique was found to be more comfortable and less time consuming compare to OE, it may be preferable in management of symptomatic patients with increased risk for colorectal cancer.

  15. The Accuracy Of Fuzzy Sugeno Method With Antropometry On Determination Natural Patient Status

    Science.gov (United States)

    Syahputra, Dinur; Tulus; Sawaluddin

    2017-12-01

    Anthropometry is one of the processes that can be used to assess nutritional status. In general anthropometry is defined as body size in terms of nutrition, then anthropometry is reviewed from various age levels and nutritional levels. Nutritional status is a description of the balance between nutritional intake with the needs of the body individually. Fuzzy logic is a logic that has a vagueness between right and wrong or between 0 and 1. Sugeno method is used because in the process of calculating nutritional status so far is still done by anthropometry. Currently information technology is growing in any aspect, one of them in the aspect of calculation with data taken from anthropometry. In this case the calculation can use the Fuzzy Sugeno Method, in order to know the great accuracy obtained. Then the results obtained using fuzzy sugeno integrated with anthropometry has an accuracy of 81.48%.

  16. Setting-up of the Laser Induced Fluorescence diagnostic. Measurements of Cr density in a neon glow discharge

    International Nuclear Information System (INIS)

    Tafalla, D.; Cal, E. de la; Tabares, F. L.

    1994-01-01

    A plasma diagnostic based on the Laser Induced Fluorescence (LIF) technique has been set up in the Fusion Division at the CIEMAT. In a preliminary experiment, the density of sputtered chromium atoms produced in a neon glow discharge was measured. Firstly, the laser beam was characterized by calibration of its wavelength, bandwidth and energy profile and Rayleigh scattering in N2 was used for the optical system calibration. An absolute density of Cr atoms of n ∼ 5x10 cm was obtained in discharges at 100 mA and pressure of 15 mTorr and a linear dependence of the LIF signal us. current was found. These values are in agreement with those expected from the tabulated sputtering yields and the thermalization and diffusion of the sputtered atoms into the Ne plasma. (Author) 19 refs

  17. Setting-up of the Laser Induced Fluorescence diagnostic. Measurements of Cr density in a neon glow discharge

    International Nuclear Information System (INIS)

    Tafalla, D.; Cal, E. de la; Tabares, F.L.

    1994-01-01

    A plasma diagnostic based on the Laser Induced Fluorescence (LIF) technique has been set up in the Fusion Division at the CIEMAT. In a preliminary experiment, The density of sputtered chromium atoms produced in a neon glow discharge was measured. Firstly, the laser beam was characterized by calibration of its wavelength bandwidth and energy profile and Rayleigh scattering in N 2 was used for the optical system calibration. An absolute density of Cr atoms of n= 5x10''9 cm''-3 was obtained in discharges at 100 mA and pressure of 15 mTorr and a linear dependence of the LIF signal US. current was found. These values are in agreement with those expected from the tabulated sputtering yields and the thermalization and diffusion of the sputtered atoms into the Ne plasma

  18. Beam patterns in an optical parametric oscillator set-up employing walk-off compensating beta barium borate crystals

    Science.gov (United States)

    Kaucikas, M.; Warren, M.; Michailovas, A.; Antanavicius, R.; van Thor, J. J.

    2013-02-01

    This paper describes the investigation of an optical parametric oscillator (OPO) set-up based on two beta barium borate (BBO) crystals, where the interplay between the crystal orientations, cut angles and air dispersion substantially influenced the OPO performance, and especially the angular spectrum of the output beam. Theory suggests that if two BBO crystals are used in this type of design, they should be of different cuts. This paper aims to provide an experimental manifestation of this fact. Furthermore, it has been shown that air dispersion produces similar effects and should be taken into account. An x-ray crystallographic indexing of the crystals was performed as an independent test of the above conclusions.

  19. Beam patterns in an optical parametric oscillator set-up employing walk-off compensating beta barium borate crystals

    International Nuclear Information System (INIS)

    Kaucikas, M; Warren, M; Van Thor, J J; Michailovas, A; Antanavicius, R

    2013-01-01

    This paper describes the investigation of an optical parametric oscillator (OPO) set-up based on two beta barium borate (BBO) crystals, where the interplay between the crystal orientations, cut angles and air dispersion substantially influenced the OPO performance, and especially the angular spectrum of the output beam. Theory suggests that if two BBO crystals are used in this type of design, they should be of different cuts. This paper aims to provide an experimental manifestation of this fact. Furthermore, it has been shown that air dispersion produces similar effects and should be taken into account. An x-ray crystallographic indexing of the crystals was performed as an independent test of the above conclusions. (paper)

  20. Production and characterization of protonated molecular clusters containing a given number of water molecules with the DIAM set-up

    International Nuclear Information System (INIS)

    Bruny, G.

    2010-01-01

    nano-scale characterization of irradiation in bio-molecular systems requires observation of novel features which are now achievable with the recent technical progress. This work is a central part in the development of DIAM which is a new experimental set-up devoted to irradiation of bio-molecular clusters at the Institut de Physique Nucleaire de Lyon. The development of the cluster source and of a double focusing mass spectrometer leads to the production of intense beams of mass selected protonated molecular clusters. Combined with this mass selected cluster beams an innovative detection technique is demonstrated in collision induced dissociation experiments. The results contribute to the knowledge of the stability and the structure of the small protonated water clusters and mixed clusters of water and pyridine. (author)

  1. Setting up of Nuclide GRAF-3S spark source mass spectrometer for the analysis of high purity materials

    International Nuclear Information System (INIS)

    Mahalingam, T.R.; Murugaiyan, P.; Soni, K.S.; Venkateswarlu, Ch.

    1975-01-01

    A spark source mass spectrometer model GRAF-35 manufactured by the Nuclide Corporation, U.S.A., was set up for analysis of nuclear-grade and high purity materials. The main difficulty with its successful operation was to achieve and maintain the required level of vacuum i.e. less than 2X10 -8 torr in the magnetic analyser region. With 100 1/s ion pump, the required vacuum could be achieved, but the spectrometer required periodical baking which minimises the life of the instrument. The pumping system was replaced by Ultek Boostivac pump - a combination of ion pump (150 1/s) and a titanium sublimation pump (1000 1/sec speed for condensable vapours) which eliminated baking as the necessary level of vacuum could be easily achieved whenever required. Results of the analysis of zone-refined indium and uranium for trace impurities are given. (M.G.B.)

  2. Experimental set-up for electrical resistivity measurements at low temperature in amorphous and crystalline metallic samples

    International Nuclear Information System (INIS)

    Rodriquez Fernandez, J.M.; Lopez Sanchez, R.J.; Gomez-Sal, J.C.

    1986-01-01

    The experimental set-up to measure the thermal variation of the electrical resistivity between 10.5 K and 300 K, has been developed. A four probe A.C. method with a synchronous-detection (lock'in) technique were the idoneous for our proposes. We have designed a new type of pressure sample-holder adopted to the CS-202 type cryostat. The measurements performed on samples already known have allowed us to determine the sensitivity of our experiments, which is Δ ρ/ρ=2x10 -4 . The measurements performed in the new Y 3 Rh 2 Si 2 compound which at 10 K has no magnetic ordering, are also presented. (author)

  3. Challenges in interprofessional collaboration: experiences of care providers and policymakers in a newly set-up Dutch assault centre.

    Science.gov (United States)

    Zijlstra, Elza; Lo Fo Wong, Sylvie; Teerling, Anne; Hutschemaekers, Giel; Lagro-Janssen, Antoine

    2018-03-01

    Sexual and family violence are problems that affect many women and men, and the negative health consequences of violence are numerous. As adequate acute interprofessional care can prevent negative health consequences and improve forensic medical examination, a Centre for Sexual and Family Violence was set up. We aimed to improve our understanding of the challenges in interprofessional collaboration in a newly set-up centre for sexual and family violence. We conducted a qualitative study with semi-structured interviews about the experiences with interprofessional collaboration of 16 stakeholders involved in the Centre for Sexual and Family Violence Nijmegen. Participants were selected by purposive sampling. Participants found that the interprofessional collaboration had improved communication and competences. However, there were challenges too. Firstly, the interprofessional collaboration had brought parties closer together, but the collaboration also forced professionals to strongly define their boundaries. Mutual trust and understanding needed to be built up. Secondly, a balance had to be struck between pursuing the shared vision - which was to improve quality of care for victims - and giving space to organizations' and professionals' own interest. Thirdly, care for victims of sexual and family violence could be demanding on healthcare providers in an emotional sense, which might jeopardize professional's initial motivation for joining the Centre for Sexual and Family Violence Nijmegen. The interprofessional collaboration in an assault centre improves quality of care for victims, but there are also challenges. The tasks of an assault centre are to create opportunities to discuss professional roles and professional interests, to build up good interpersonal relations in which trust and understanding can grow, to formulate a strong and shared victim-centred vision and to support care providers with training, feedback and supervision. © 2017 Nordic College of Caring

  4. Reconstruction of gene regulatory modules from RNA silencing of IFN-α modulators: experimental set-up and inference method.

    Science.gov (United States)

    Grassi, Angela; Di Camillo, Barbara; Ciccarese, Francesco; Agnusdei, Valentina; Zanovello, Paola; Amadori, Alberto; Finesso, Lorenzo; Indraccolo, Stefano; Toffolo, Gianna Maria

    2016-03-12

    Inference of gene regulation from expression data may help to unravel regulatory mechanisms involved in complex diseases or in the action of specific drugs. A challenging task for many researchers working in the field of systems biology is to build up an experiment with a limited budget and produce a dataset suitable to reconstruct putative regulatory modules worth of biological validation. Here, we focus on small-scale gene expression screens and we introduce a novel experimental set-up and a customized method of analysis to make inference on regulatory modules starting from genetic perturbation data, e.g. knockdown and overexpression data. To illustrate the utility of our strategy, it was applied to produce and analyze a dataset of quantitative real-time RT-PCR data, in which interferon-α (IFN-α) transcriptional response in endothelial cells is investigated by RNA silencing of two candidate IFN-α modulators, STAT1 and IFIH1. A putative regulatory module was reconstructed by our method, revealing an intriguing feed-forward loop, in which STAT1 regulates IFIH1 and they both negatively regulate IFNAR1. STAT1 regulation on IFNAR1 was object of experimental validation at the protein level. Detailed description of the experimental set-up and of the analysis procedure is reported, with the intent to be of inspiration for other scientists who want to realize similar experiments to reconstruct gene regulatory modules starting from perturbations of possible regulators. Application of our approach to the study of IFN-α transcriptional response modulators in endothelial cells has led to many interesting novel findings and new biological hypotheses worth of validation.

  5. Comparison of different statistical methods for estimation of extreme sea levels with wave set-up contribution

    Science.gov (United States)

    Kergadallan, Xavier; Bernardara, Pietro; Benoit, Michel; Andreewsky, Marc; Weiss, Jérôme

    2013-04-01

    Estimating the probability of occurrence of extreme sea levels is a central issue for the protection of the coast. Return periods of sea level with wave set-up contribution are estimated here in one site : Cherbourg in France in the English Channel. The methodology follows two steps : the first one is computation of joint probability of simultaneous wave height and still sea level, the second one is interpretation of that joint probabilities to assess a sea level for a given return period. Two different approaches were evaluated to compute joint probability of simultaneous wave height and still sea level : the first one is multivariate extreme values distributions of logistic type in which all components of the variables become large simultaneously, the second one is conditional approach for multivariate extreme values in which only one component of the variables have to be large. Two different methods were applied to estimate sea level with wave set-up contribution for a given return period : Monte-Carlo simulation in which estimation is more accurate but needs higher calculation time and classical ocean engineering design contours of type inverse-FORM in which the method is simpler and allows more complex estimation of wave setup part (wave propagation to the coast for example). We compare results from the two different approaches with the two different methods. To be able to use both Monte-Carlo simulation and design contours methods, wave setup is estimated with an simple empirical formula. We show advantages of the conditional approach compared to the multivariate extreme values approach when extreme sea-level occurs when either surge or wave height is large. We discuss the validity of the ocean engineering design contours method which is an alternative when computation of sea levels is too complex to use Monte-Carlo simulation method.

  6. Implementation of the European multicentre database of healthy controls for [(123)I]FP-CIT SPECT increases diagnostic accuracy in patients with clinically uncertain parkinsonian syndromes

    DEFF Research Database (Denmark)

    Albert, Nathalie L; Unterrainer, Marcus; Diemling, Markus

    2016-01-01

    PURPOSE: Even though [(123)I]FP-CIT SPECT provides high accuracy in detecting nigrostriatal cell loss in neurodegenerative parkinsonian syndromes (PS), some patients with an inconclusive diagnosis remain. We investigated whether the diagnostic accuracy in patients with clinically uncertain PS wit...

  7. The setting up and running of a cross-county out-of-hours gastrointestinal bleed service: a possible blueprint for the future.

    Science.gov (United States)

    Shokouhi, Bahman N; Khan, Mohammad; Carter, Martyn J; Khan, Nasser Q; Mills, Philip; Morris, Danielle; Rowlands, David E; Samsheer, Kote; Sargeant, Ian R; McIntyre, Peter B; Greenfield, Simon M

    2013-07-01

    Acute upper gastrointestinal bleeding (AUGIB) results in 25 000 hospital admissions annually. Patients admitted at weekends with AUGIB have increased mortality, and guidelines advise out-of-hours endoscopy. We present retrospective data from our service involving the interhospital transfer of patients. We pooled resources of two neighbouring general hospitals, just north of London. Emergency endoscopy is performed at the start of the list followed by elective endoscopy in the endoscopy unit on Saturday and Sunday mornings. From Friday evening to Sunday morning, patients admitted to Queen Elizabeth II Hospital (QEII) are medically stabilised and transferred to Lister Hospital by ambulance. 240 endoscopies were performed out of hours from December 2007 to March 2011. Of these, 54 patients were transferred: nine had emergency endoscopy at QEII as they were medically unstable; eight of the patients transferred required therapeutic intervention for active bleeding. The mean pre-endoscopy Rockall score of those transferred was 2.5. We examined the records of 51 of the 54 patients transferred. There were three deaths within 30 days after endoscopy not associated with the transfer process. 19 (37%) patients had reduced hospitalisation after having their endoscopy at the weekend. The introduction of the out-of-hours endoscopy service in our trust has had multiple benefits, including patients consistently receiving timely emergency endoscopy, significantly reduced disruption to emergency operating theatres, and participation of endoscopy nurses ensures a better and safer experience for patients, and better endoscopy decontamination. We suggest our model is safe and feasible for other small units wishing to set up their own out-of-hours endoscopy service to adopt.

  8. A randomised trial of Supine versus Prone breast radiotherapy (SuPr study): Comparing set-up errors and respiratory motion

    International Nuclear Information System (INIS)

    Kirby, Anna M.; Evans, Philip M.; Helyer, Sarah J.; Donovan, Ellen M.; Convery, Helen M.; Yarnold, John R.

    2011-01-01

    Purpose: To test a prone position against the international-standard supine position in women undergoing whole-breast-radiotherapy (WBRT) after wide-local-excision (WLE) of early breast cancer (BC) in terms of feasibility, set-up errors, and respiratory motion. Methods: Following WLE of BC with insertion of tumour-bed clips, patients underwent 4D-CT for WBRT-planning in supine and prone positions (the latter using an in-house-designed platform). Patients were randomised to undergo WBRT fractions 1-7 in one position, switching to the alternate position for fractions 8-15 (40 Gy/15-fractions total). Cone-beam CT-images (CBCT) were acquired prior to fractions 1, 4, 7, 8, 11 and 14. CBCT data were matched to planning-CT data using (i) chest-wall and (ii) clips. Systematic and random errors were calculated. Maximal displacement of chest-wall and clips with respiration was measured on 4D-CT. Clinical- to planning-target-volume (CTV-PTV) margins were calculated. Patient-comfort-scores and treatment-times were evaluated. Results: Twenty-five patients were randomized. 192/192 (100%) planned supine fractions and 173/192 (90%) prone fractions were completed. 3D population systematic errors were 1.3-1.9 mm (supine) and 3.1-4.3 mm (prone) (p = 0.02) and random errors 2.6-3.2 mm (supine) and 3.8-5.4 mm (prone) (p = 0.02). Prone positioning reduced chest-wall and clip motion (0.5 ± 0.2 mm (prone) versus 2.7 ± 0.5 mm (supine) (p < 0.001)) with respiration. Calculated CTV-PTV margins were greater for prone (12-16 mm) than for supine treatment (10 mm). Patient-comfort-scores and treatment times were comparable (p = 0.06). Conclusions: Set-up errors were greater using our prone technique than for our standard supine technique, resulting in the need for larger CTV-PTV margins in the prone position. Further work is required to optimize the prone treatment-platform and technique before it can become a standard treatment option at our institution.

  9. TU-CD-304-09: Feasibility Study for Thermoplastic Mask Set Up Monitoring Using Force Sensing Resistor (FSR) Sensor

    International Nuclear Information System (INIS)

    Kim, T; Cho, M; Kang, S; Kim, D; Kim, K; Shin, D; Suh, T; Kim, S

    2015-01-01

    Purpose: To improve the setup accuracy of thermoplastic mask, we developed a new monitoring method based on force sensing technology and evaluated its feasibility. Methods: The thermoplastic mask setup monitoring system consists of a force sensing resistor sensor unit, a signal transport device, a control PC and an in-house software. The system is designed to monitor pressure variation between the mask and patient in real time. It also provides a warning to the user when there is a possibility of movement. A preliminary study was performed to evaluate the reliability of the sensor unit and developed monitoring system with a head phantom. Then, a simulation study with volunteers was conducted to evaluate the feasibility of the monitoring system. Note that the sensor unit can have multiple end-sensors and every end-sensor was confirmed to be within 2% reliability in pressure reading through a screening test. Results: To evaluate the reproducibility of the proposed monitoring system in practice, we simulated a mask setup with the head phantom. FRS sensors were attached on the face of the head phantom and pressure was monitored. For 3 repeated mask setups on the phantom, the variation of the pressure was less than 3% (only 1% larger than 2% potential uncertainty confirmed in the screening test). In the volunteer study, we intended to verify that the system could detect patient movements within the mask. Thus, volunteers were asked to turn their head or lift their chin. The system was able to detect movements effectively, confirming the clinical feasibility of the monitoring system developed. Conclusion: Through the proposed setup monitoring method, it is possible to monitor patient motion inside a mask in real time, which has never been possible with most commonly used systems using non-radiographic technology such as infrared camera system and surface imaging system. This work was supported by the Radiation Technology R&D program (No. 2013M2A2A7043498) and the Mid

  10. TU-CD-304-09: Feasibility Study for Thermoplastic Mask Set Up Monitoring Using Force Sensing Resistor (FSR) Sensor

    Energy Technology Data Exchange (ETDEWEB)

    Kim, T; Cho, M; Kang, S; Kim, D; Kim, K; Shin, D; Suh, T [The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of); Kim, S [Virginia Commonwealth University, Richmond, VA (United States)

    2015-06-15

    Purpose: To improve the setup accuracy of thermoplastic mask, we developed a new monitoring method based on force sensing technology and evaluated its feasibility. Methods: The thermoplastic mask setup monitoring system consists of a force sensing resistor sensor unit, a signal transport device, a control PC and an in-house software. The system is designed to monitor pressure variation between the mask and patient in real time. It also provides a warning to the user when there is a possibility of movement. A preliminary study was performed to evaluate the reliability of the sensor unit and developed monitoring system with a head phantom. Then, a simulation study with volunteers was conducted to evaluate the feasibility of the monitoring system. Note that the sensor unit can have multiple end-sensors and every end-sensor was confirmed to be within 2% reliability in pressure reading through a screening test. Results: To evaluate the reproducibility of the proposed monitoring system in practice, we simulated a mask setup with the head phantom. FRS sensors were attached on the face of the head phantom and pressure was monitored. For 3 repeated mask setups on the phantom, the variation of the pressure was less than 3% (only 1% larger than 2% potential uncertainty confirmed in the screening test). In the volunteer study, we intended to verify that the system could detect patient movements within the mask. Thus, volunteers were asked to turn their head or lift their chin. The system was able to detect movements effectively, confirming the clinical feasibility of the monitoring system developed. Conclusion: Through the proposed setup monitoring method, it is possible to monitor patient motion inside a mask in real time, which has never been possible with most commonly used systems using non-radiographic technology such as infrared camera system and surface imaging system. This work was supported by the Radiation Technology R&D program (No. 2013M2A2A7043498) and the Mid

  11. The accuracy of fine-needle aspiration cytology for diagnosis of parotid gland masses: a clinicopathological study of 114 patients

    Directory of Open Access Journals (Sweden)

    Jens Kristjan GUDMUNDSSON

    Full Text Available ABSTRACT Objective Fine-needle aspiration cytology is a valuable method for preoperative assessment of head and neck tumors. However, its accuracy in detection of salivary gland masses is controversial compared with other methods. The aim of this work was to evaluate the effectiveness and accuracy of fine-needle aspiration cytology (FNAC in the diagnosis of parotid gland masses. Material and Methods Over a 10-year period, 126 parotid gland masses were resected. Retrospective chart reviews of 114 patients were performed. The results of FNAC and final histological diagnosis were compared and the accuracy of FNAC was determined. Results Final histological evaluation revealed 11 malignant tumors and 103 benign lesions. Pleomorphic adenoma was the most common neoplasm (63%, followed by Warthin’s tumor (17.5%. The sensitivity of FNAC in detecting malignant tumors was 73% and the specificity was 97%. Positive predictive value (PPV was 73% and negative predictive value (NPV was 97%. The overall accuracy of FNAC in detecting parotid masses was 95%. False-negative diagnosis was found in mucoepidermoid carcinoma, acinic cell carcinoma, and epithelial-myoepithelial carcinoma whereas there was false-positive diagnosis in cases of pleomorphic adenoma and normal parotid gland tissue. Conclusion FNAC is a reliable minimally invasive diagnostic method with a high sensitivity in diagnosis of lesions in parotid glands. The sensitivity of detection of malignant tumors in parotid glands was low due to the biopsy technique used, and depended on tumor location. Postoperative complications decreased after superficial parotidectomy.

  12. Accuracy of imaging methods for detection of bone tissue invasion in patients with oral squamous cell carcinoma

    Science.gov (United States)

    Uribe, S; Rojas, LA; Rosas, CF

    2013-01-01

    The objective of this review is to evaluate the diagnostic accuracy of imaging methods for detection of mandibular bone tissue invasion by squamous cell carcinoma (SCC). A systematic review was carried out of studies in MEDLINE, SciELO and ScienceDirect, published between 1960 and 2012, in English, Spanish or German, which compared detection of mandibular bone tissue invasion via different imaging tests against a histopathology reference standard. Sensitivity and specificity data were extracted from each study. The outcome measure was diagnostic accuracy. We found 338 articles, of which 5 fulfilled the inclusion criteria. Tests included were: CT (four articles), MRI (four articles), panoramic radiography (one article), positron emission tomography (PET)/CT (one article) and cone beam CT (CBCT) (one article). The quality of articles was low to moderate and the evidence showed that all tests have a high diagnostic accuracy for detection of mandibular bone tissue invasion by SCC, with sensitivity values of 94% (MRI), 91% (CBCT), 83% (CT) and 55% (panoramic radiography), and specificity values of 100% (CT, MRI, CBCT), 97% (PET/CT) and 91.7% (panoramic radiography). Available evidence is scarce and of only low to moderate quality. However, it is consistently shown that current imaging methods give a moderate to high diagnostic accuracy for the detection of mandibular bone tissue invasion by SCC. Recommendations are given for improving the quality of future reports, in particular provision of a detailed description of the patients' conditions, the imaging instrument and both imaging and histopathological invasion criteria. PMID:23420854

  13. Square-wave anodic-stripping voltammetric determination of Cd, Pb and Cu in wine: Set-up and optimization of sample pre-treatment and instrumental parameters

    International Nuclear Information System (INIS)

    Illuminati, Silvia; Annibaldi, Anna; Truzzi, Cristina; Finale, Carolina; Scarponi, Giuseppe

    2013-01-01

    For the first time, square-wave anodic-stripping voltammetry (SWASV) was set up and optimized for the determination of Cd, Pb and Cu in white wine after UV photo-oxidative digestion of the sample. The best procedure for the sample pre-treatment consisted in a 6-h UV irradiation of diluted, acidified wine, with the addition of ultrapure H 2 O 2 (three sequential additions during the irradiation). Due to metal concentration differences, separate measurements were carried out for Cd (deposition potential −950 mV vs. Ag/AgCl/3 M KCl deposition time 15 min) and simultaneously for Pb and Cu (E d −750 mV, t d 30 s). The optimum set-up of the main instrumental parameters, evaluated also in terms of the signal-to-noise ratio, were as follows: E SW 20 mV, f 100 Hz, ΔE step 8 mV, t step 100 ms, t wait 60 ms, t delay 2 ms, t meas 3 ms. The electrochemical behaviour was reversible bielectronic for Cd and Pb, and kinetically controlled monoelectronic for Cu. Good accuracy was found both when the recovery procedure was used and when the results were compared with data obtained by differential pulse anodic stripping voltammetry. The linearity of the response was verified up to ∼4 μg L −1 for Cd and Pb and ∼15 μg L −1 for Cu. The detection limits for t d = 5 min in the 10 times diluted, UV digested sample were (ng L −1 ): Cd 7.0, Pb 1.2 and Cu 6.6, which are well below currently applied methods. Application to a Verdicchio dei Castelli di Jesi white wine revealed concentration levels of Cd ∼0.2, Pb ∼10, Cu ∼30 μg L −1 with repeatabilities of (±RSD%) Cd ±6%, Pb ±5%, Cu ±10%

  14. Evaluation of Pictorial Dietary Assessment Tool for Hospitalized Patients with Diabetes: Cost, Accuracy, and User Satisfaction Analysis

    Directory of Open Access Journals (Sweden)

    Dwi Budiningsari

    2017-12-01

    Full Text Available Although nutritional screening and dietary monitoring in clinical settings are important, studies on related user satisfaction and cost benefit are still lacking. This study aimed to: (1 elucidate the cost of implementing a newly developed dietary monitoring tool, the Pictorial Dietary Assessment Tool (PDAT; and (2 investigate the accuracy of estimation and satisfaction of healthcare staff after the use of the PDAT. A cross-over intervention study was conducted among 132 hospitalized patients with diabetes. Cost and time for the implementation of PDAT in comparison to modified Comstock was estimated using the activity-based costing approach. Accuracy was expressed as the percentages of energy and protein obtained by both methods, which were within 15% and 30%, respectively, of those obtained by the food weighing. Satisfaction of healthcare staff was measured using a standardized questionnaire. Time to complete the food intake recording of patients using PDAT (2.31 ± 0.70 min was shorter than when modified Comstock (3.53 ± 1.27 min was used (p < 0.001. Overall cost per patient was slightly higher for PDAT (United States Dollar 0.27 ± 0.02 than for modified Comstock (USD 0.26 ± 0.04 (p < 0.05. The accuracy of energy intake estimated by modified Comstock was 10% lower than that of PDAT. There was poorer accuracy of protein intake estimated by modified Comstock (<40% compared to that estimated by the PDAT (>71% (p < 0.05. Mean user satisfaction of healthcare staff was significantly higher for PDAT than that for modified Comstock (p < 0.05. PDAT requires a shorter time to be completed and was rated better than modified Comstock.

  15. Accuracy and Coverage of Diagnosis and Procedural Coding of Severely Injured Patients in the Finnish Hospital Discharge Register: Comparison to Patient Files and the Helsinki Trauma Registry.

    Science.gov (United States)

    Heinänen, M; Brinck, T; Handolin, L; Mattila, V M; Söderlund, T

    2017-09-01

    The Finnish Hospital Discharge Register data are frequently used for research purposes. The Finnish Hospital Discharge Register has shown excellent validity in single injuries or disease groups, but no studies have assessed patients with multiple trauma diagnoses. We aimed to evaluate the accuracy and coverage of the Finnish Hospital Discharge Register but at the same time validate the data of the trauma registry of the Helsinki University Hospital's Trauma Unit. We assessed the accuracy and coverage of the Finnish Hospital Discharge Register data by comparing them to the original patient files and trauma registry files from the trauma registry of the Helsinki University Hospital's Trauma Unit. We identified a baseline cohort of patients with severe thorax injury from the trauma registry of the Helsinki University Hospital's Trauma Unit of 2013 (sample of 107 patients). We hypothesized that the Finnish Hospital Discharge Register would lack valuable information about these patients. Using patient files, we identified 965 trauma diagnoses in these 107 patients. From the Finnish Hospital Discharge Register, we identified 632 (65.5%) diagnoses and from the trauma registry of the Helsinki University Hospital's Trauma Unit, 924 (95.8%) diagnoses. A total of 170 (17.6%) trauma diagnoses were missing from the Finnish Hospital Discharge Register data and 41 (4.2%) from the trauma registry of the Helsinki University Hospital's Trauma Unit data. The coverage and accuracy of diagnoses in the Finnish Hospital Discharge Register were 65.5% (95% confidence interval: 62.5%-68.5%) and 73.8% (95% confidence interval: 70.4%-77.2%), respectively, and for the trauma registry of the Helsinki University Hospital's Trauma Unit, 95.8% (95% confidence interval: 94.5%-97.0%) and 97.6% (95% confidence interval: 96.7%-98.6%), respectively. According to patient records, these patients were subjects in 249 operations. We identified 40 (16.1%) missing operation codes from the Finnish Hospital

  16. Caregivers' attentional bias to pain : does it affect caregiver accuracy in detecting patient pain behaviors?

    NARCIS (Netherlands)

    Mohammadi, Somayyeh; Dehghani, Mohsen; Khatibi, Ali; Sanderman, Robbert; Hagedoorn, Mariet

    Attentional bias to pain among family caregivers of patients with pain may enhance the detection of pain behaviors in patients. However, both relatively high and low levels of attentional bias may increase disagreement between patients and caregivers in reporting pain behaviors. This study aims to

  17. Diagnostic accuracy of 18F-FDG PET/CT for detection of suspected recurrence in patients with oesophageal carcinoma

    International Nuclear Information System (INIS)

    Sharma, Punit; Jain, Sachin; Karunanithi, Sellam; Malhotra, Arun; Bal, Chandrasekhar; Kumar, Rakesh; Pal, Sujoy; Julka, Pramod Kumar; Thulkar, Sanjay

    2014-01-01

    To evaluate the role of 18 F-FDG PET/CT in the detection of recurrence in patients with oesophageal carcinoma, suspected clinically or following conventional investigations. This was a retrospective study. Data from 180 patients (age 56.3 ± 10.4 years; 126 men, 54 women) with histopathologically proven oesophageal carcinoma (squamous cell 115, adenocarcinoma 59, neuroendocrine carcinoma 4, small cell 1, poorly differentiated 1) who had undergone 227 18 F-FDG PET/CT studies for suspected recurrence were analysed. Recurrence was suspected clinically or following conventional investigations. PET/CT images were revaluated by two nuclear medicine physicians in consensus. Findings were grouped into local, nodal and distant recurrence. Results were compared to those from contrast-enhanced (CE) CT when available (109 patients). Clinical/imaging follow-up (minimum 6 months) with histopathology (when available) was taken as the reference standard. Of the 227 18 F-FDG PET/CT studies,166 were positive and 61 were negative for recurrent disease. PET/CT showed local recurrence in 134, nodal recurrence in 115 and distant recurrence in 47, with more than one site of recurrence in 34. The PET/CT findings were true-positive in 153 studies, true-negative in 54, false-positive in 13 and false-negative in 7. The sensitivity of 18 F-FDG PET/CT was 96 %, the specificity was 81 %, the positive and negative predictive values were 92 % and 89 %, respectively, and the accuracy was 91 %. PET/CT showed similar accuracy in patients with squamous cell carcinoma and in those with adenocarcinoma (P = 0.181). 18 F-FDG PET/CT was more specific than CECT (67 % vs. 21 %; P 18 F-FDG PET/CT shows high accuracy in the detection of suspected recurrence in patients with oesophageal carcinoma. It is more specific than and is superior to CECT in the detection of nodal recurrence. (orig.)

  18. How 3D patient-specific instruments improve accuracy of pelvic bone tumour resection in a cadaveric study.

    Science.gov (United States)

    Sallent, A; Vicente, M; Reverté, M M; Lopez, A; Rodríguez-Baeza, A; Pérez-Domínguez, M; Velez, R

    2017-10-01

    To assess the accuracy of patient-specific instruments (PSIs) versus standard manual technique and the precision of computer-assisted planning and PSI-guided osteotomies in pelvic tumour resection. CT scans were obtained from five female cadaveric pelvises. Five osteotomies were designed using Mimics software: sacroiliac, biplanar supra-acetabular, two parallel iliopubic and ischial. For cases of the left hemipelvis, PSIs were designed to guide standard oscillating saw osteotomies and later manufactured using 3D printing. Osteotomies were performed using the standard manual technique in cases of the right hemipelvis. Post-resection CT scans were quantitatively analysed. Student's t -test and Mann-Whitney U test were used. Compared with the manual technique, PSI-guided osteotomies improved accuracy by a mean 9.6 mm (p 5 mm and 27% (n = 8) were > 10 mm. In the PSI cases, deviations were 10% (n = 3) and 0 % (n = 0), respectively. For angular deviation from pre-operative plans, we observed a mean improvement of 7.06° (p Cite this article : A. Sallent, M. Vicente, M. M. Reverté, A. Lopez, A. Rodríguez-Baeza, M. Pérez-Domínguez, R. Velez. How 3D patient-specific instruments improve accuracy of pelvic bone tumour resection in a cadaveric study. Bone Joint Res 2017;6:577-583. DOI: 10.1302/2046-3758.610.BJR-2017-0094.R1. © 2017 Sallent et al.

  19. Detection of actinides and rare earths in natural matrices with the AGLAE new, high sensitivity detection set-up

    Science.gov (United States)

    Zucchiatti, Alessandro; Alonso, Ursula; Lemasson, Quentin; Missana, Tiziana; Moignard, Brice; Pacheco, Claire; Pichon, Laurent; Camarena de la Mora, Sandra

    2014-08-01

    A series of granite samples (Grimsel and Äspö) enriched by sorption with natU (10-3 M, 10-4 M, 10-5 M in solution) and La (10-3 M, 10-4 M in solution) has been scanned by PIXE over a surface of 1920 × 1920 mm2 together with non-enriched Grimsel and Äspö granites and a glass standard. An assessment of minimum detection limits, MDL's, for several elements has been performed with the use of standard materials. Due to mapping and the high sensitivity of the new AGLAE detection system, U levels around 30 ppm can be detected from the whole PIXE spectrum (one low energy detector and four summed filtered detectors) while U reach grains, inhomogeneously distributed over the surface can be clearly identified through the multi elemental maps and analyzed separately. Even the nominally enriched samples have La levels below the MDL, probably because precipitation of the element (and not adsorption) mostly took place, and precipitates were eliminated after surface cleaning carried out before PIXE analyses. A multi detector system that implies a PIXE detection solid angle much wider than in any other similar set-up (a factor of 2-5); a higher events selectivity, given by the possibility of filtering individually up to 4 PIXE detectors; a double RBS detector, the new Ion Beam Induced Luminescence (IBIL) spectrometry and gamma spectrometry. Full mapping capability in air, assisted by a powerful event by event reconstruction software. These features allow lower Minimum Detection Limits (MDL) which are highly beneficial to the analysis of cultural heritage objects, meaning generally a reduction of irradiation time. Paintings will then be studied without any damage to the pigments that have color change tendencies which is a major drawback of the previous system. Alternatively they could allow an increase in information collected at equal time, particularly considering the detector's fast response and therefore the potential for high beam currents when sample damage can be

  20. Use the Bar Code System to Improve Accuracy of the Patient and Sample Identification.

    Science.gov (United States)

    Chuang, Shu-Hsia; Yeh, Huy-Pzu; Chi, Kun-Hung; Ku, Hsueh-Chen

    2018-01-01

    In time and correct sample collection were highly related to patient's safety. The sample error rate was 11.1%, because misbranded patient information and wrong sample containers during January to April, 2016. We developed a barcode system of "Specimens Identify System" through process of reengineering of TRM, used bar code scanners, add sample container instructions, and mobile APP. Conclusion, the bar code systems improved the patient safety and created green environment.

  1. To compare the accuracy of Prayer's sign and Mallampatti test in predicting difficult intubation in Diabetic patients

    International Nuclear Information System (INIS)

    Baig, M. M. A.; Khan, F. H.

    2014-01-01

    Objective: To determine the accuracy of Prayer's sign and Mallampatti test in predicting difficult endotracheal intubation in diabetic patients. Methods: The cross-sectional study was performed at Aga Khan University Hospital, Karachi, over a period from January 2009 to April 2010, and comprised 357 patients who required endotracheal intubation for elective surgical procedures. Prayer's sign and Mallampatti tests were performed for the assessment of airway by trained observers. Ease or difficulty of laryngoscopy after the patient was fully anaesthetised with standard technique were observed and laryngoscopic view of first attempt was rated according to Cormack-Lehan grade of intubation. SPSS 15 was used for statistical analysis. Results: Of the 357 patients, 125(35%) were classified as difficult to intubate. Prayer's sign showed significantly lower accuracy, positive and negative predictive values than Mallampatti test. The sensitivity of Prayer's sign was lower 29.6 (95% Confidence Interval, 21.9-38.5) than Mallampatti test 79.3 (95% confidence interval, 70.8-85.7) while specificity of both the tests was not found to be significantly different. Conclusion: Prayer's sign is not acceptable as a single best bedside test for prediction of difficult intubation. (author)

  2. Accuracy of patient's turnover time prediction using RFID technology in an academic ambulatory surgery center.

    Science.gov (United States)

    Marchand-Maillet, Florence; Debes, Claire; Garnier, Fanny; Dufeu, Nicolas; Sciard, Didier; Beaussier, Marc

    2015-02-01

    Patients flow in outpatient surgical unit is a major issue with regards to resource utilization, overall case load and patient satisfaction. An electronic Radio Frequency Identification Device (RFID) was used to document the overall time spent by the patients between their admission and discharge from the unit. The objective of this study was to evaluate how a RFID-based data collection system could provide an accurate prediction of the actual time for the patient to be discharged from the ambulatory surgical unit after surgery. This is an observational prospective evaluation carried out in an academic ambulatory surgery center (ASC). Data on length of stay at each step of the patient care, from admission to discharge, were recorded by a RFID device and analyzed according to the type of surgical procedure, the surgeon and the anesthetic technique. Based on these initial data (n = 1520), patients were scheduled in a sequential manner according to the expected duration of the previous case. The primary endpoint was the difference between actual and predicted time of discharge from the unit. A total of 414 consecutive patients were prospectively evaluated. One hundred seventy four patients (42%) were discharged at the predicted time ± 30 min. Only 24% were discharged behind predicted schedule. Using an automatic record of patient's length of stay would allow an accurate prediction of the discharge time according to the type of surgery, the surgeon and the anesthetic procedure.

  3. Do tumor size or patient age influence the accuracy of sentinel lymph node (Sn) detection in breast cancer?

    International Nuclear Information System (INIS)

    Cortes, M.; Fernandez, A.; Benito, E.; Azpeitia, D.; Ricart, Y.; Escobedo, A.; Martin-Comin, J.

    2002-01-01

    Full text: The aim was to analyze the influence of the age of the patient and tumor size on the accuracy to identify SN in patients with breast cancer. The whole population are 250 patients with breast cancer. In 236 data on size and age were available. Mean age was 53.6 years, range 28-87 years. Patients were classified 1) depending an age: 40 60 years: 73 p and 2) depending on tumor size (mm): 30: 46 p. Examination protocol: All patients received a peritumoral injection of 111 MBq (3mCi) of 99mTc-HSA-nanocolloid in 1 - 3 ml. 2 h later 300 seconds anterior and lateral thoracic scans were obtained. A 57-Co flood phantom was positioned back to the patient to outline the anatomical contour and help to localize SN. SN was marked on the skin with permanent ink. Intraoperative SN localization was performed using a gamma probe. Histopathologic analysis of SN was done with haematoxylin/eosin, immunohistochemistry and PCR. Histopathology of the SN was compared to the histopathology of all the other lymph nodes drawn out by the surgeon. SN were identified by lymphoscintigraphy in 227 cases of 250 (91 %). 221 of them (97 %) were localized in axyla. In 210 of 221 SN could be localized and drawn out at surgery. The no detection and false negative rate were much higher in patients aged > 60 (29 and 33 %) and in tumors > 30 mm (32 and 19 %) than in patients 60 y and tumors > 30 mm (46 %) and the highest false negative rate appears in patients >60 and tumors > 30 mm (33 %) 1) No FN were found in patients with tumor size <10 mm. 2) No FN were found in patients aged under 40 years. 3) FN rate seems to be higher in older patients. 4) The age of patients and the size of tumor seem to influence an the SN detection rates. (author)

  4. Accuracy and precision of patient positioning for pelvic MR-only radiation therapy using digitally reconstructed radiographs

    Science.gov (United States)

    Kemppainen, R.; Vaara, T.; Joensuu, T.; Kiljunen, T.

    2018-03-01

    Background and Purpose. Magnetic resonance imaging (MRI) has in recent years emerged as an imaging modality to drive precise contouring of targets and organs at risk in external beam radiation therapy. Moreover, recent advances in MRI enable treatment of cancer without computed tomography (CT) simulation. A commercially available MR-only solution, MRCAT, offers a single-modality approach that provides density information for dose calculation and generation of positioning reference images. We evaluated the accuracy of patient positioning based on MRCAT digitally reconstructed radiographs (DRRs) by comparing to standard CT based workflow. Materials and Methods. Twenty consecutive prostate cancer patients being treated with external beam radiation therapy were included in the study. DRRs were generated for each patient based on the planning CT and MRCAT. The accuracy assessment was performed by manually registering the DRR images to planar kV setup images using bony landmarks. A Bayesian linear mixed effects model was used to separate systematic and random components (inter- and intra-observer variation) in the assessment. In addition, method agreement was assessed using a Bland-Altman analysis. Results. The systematic difference between MRCAT and CT based patient positioning, averaged over the study population, were found to be (mean [95% CI])  -0.49 [-0.85 to  -0.13] mm, 0.11 [-0.33 to  +0.57] mm and  -0.05 [-0.23 to  +0.36] mm in vertical, longitudinal and lateral directions, respectively. The increases in total random uncertainty were estimated to be below 0.5 mm for all directions, when using MR-only workflow instead of CT. Conclusions. The MRCAT pseudo-CT method provides clinically acceptable accuracy and precision for patient positioning for pelvic radiation therapy based on planar DRR images. Furthermore, due to the reduction of geometric uncertainty, compared to dual-modality workflow, the approach is likely to improve the total

  5. Fluvio geomorphic set-up of Noctis Fossae in Noctis Labyrinthus of Syria-Planum Provenance, Mars

    Science.gov (United States)

    Chavan, A. A.; Bhandari, S.

    2017-12-01

    The modern era of planetary exploration has revealed fluvial or fluvial like landforms on the extraterrestrial surfaces of planets and moons of our solar system. This has posed as interesting challenges for advancing our fundamental understanding of fluvial processes and their associated landforms on the planetary surfaces especially on Mars. It has been recognized through earlier studies that the channels and valleys are extensively dissected on Mars. The Valleys are low lying, elongate troughs surrounded by elevated topography. Moreover, valley networks on Mars are the most noticeable features attesting that different geological processes and possibly climatic conditions prevailed in the past and played a vital role in formulating the Martian topography. Channel incisions which are a domino effect both tectonic and surface runoff and groundwater sapping. The components of surface runoff have been deciphered with the help of morphometric exercises. Further, the geomorphological studies of these landforms are critical in understanding the regional tectonics. The present work is an assessment of Fluvio geomorphic set-up of Noctis Fossae in Noctis Labyrinthus of Syria-Planum Provenance, Mars. This study focuses on the fluvio geomorphology of the southern highlands (00 to 400S to 850-1200W) to determine how these features were formed, which process formed these valleys and includes the probable causes resulting into the development of the topography. Keywords: Noctis Fossae; Noctis Labyrinthus; Syria Planum; Mars

  6. A simplified edge illumination set-up for quantitative phase contrast mammography with synchrotron radiation at clinical doses

    International Nuclear Information System (INIS)

    Longo, Mariaconcetta; Rigon, Luigi; Lopez, Frances C M; Longo, Renata; Chen, Rongchang; Dreossi, Diego; Zanconati, Fabrizio

    2015-01-01

    This work presents the first study of x-ray phase contrast imaging based on a simple implementation of the edge illumination method (EIXPCi) in the field of mammography with synchrotron radiation. A simplified EIXPCi set-up was utilized to study a possible application in mammography at clinical doses. Moreover, through a novel algorithm capable of separating and quantifying absorption and phase perturbations of images acquired in EIXPCi modality, it is possible to extract quantitative information on breast images, allowing an accurate tissue identification. The study was carried out at the SYRMEP beamline of Elettra synchrotron radiation facility (Trieste, Italy), where a mastectomy specimen was investigated with the EIXPCi technique. The sample was exposed at three different energies suitable for mammography with synchrotron radiation in order to test the validity of the novel algorithm in extracting values of linear attenuation coefficients integrated over the sample thickness. It is demonstrated that the quantitative data are in good agreement with the theoretical values of linear attenuation coefficients calculated on the hypothesis of the breast with a given composition. The results are promising and encourage the current efforts to apply the method in mammography with synchrotron radiation. (note)

  7. Set-up and first operation of a plasma oven for treatment of low level radioactive wastes

    Directory of Open Access Journals (Sweden)

    Nachtrodt Frederik

    2014-01-01

    Full Text Available An experimental device for plasma treatment of low and intermediate level radioactive waste was built and tested in several design variations. The laboratory device is designed with the intention to study the general effects and difficulties in a plasma incineration set-up for the further future development of a larger scale pilot plant. The key part of the device consists of a novel microwave plasma torch driven by 200 W electric power, and operating at atmospheric pressure. It is a specific design characteristic of the torch that a high peak temperature can be reached with a low power input compared to other plasma torches. Experiments have been carried out to analyze the effect of the plasma on materials typical for operational low-level wastes. In some preliminary cold tests the behavior of stable volatile species e. g., caesium was investigated by TXRF measurements of material collected from the oven walls and the filtered off-gas. The results help in improving and scaling up the existing design and in understanding the effects for a pilot plant, especially for the off-gas collection and treatment.

  8. The alpha-particle irradiator set up at the ISS for radiobiological studies on targeted and non-targeted effects

    International Nuclear Information System (INIS)

    Esposito, G.; Antonelli, F.; Belli, M.; Campa, A.; Simone, G.; Sorrentino, E.; Tabocchini, M.A.

    2008-01-01

    In this paper we describe the alpha-particle irradiator that has been set up at the Istituto Superiore di Sanita (ISS) for controlled exposure of cultured mammalian cells. It can be equipped with two different sources, namely 2'4'4'Cm and 2'4'1'Am, allowing irradiation at different dose-rates (typically 1-100 mGy/min). The irradiator has dimensions small enough to be inserted into a standard cell culture incubator to perform irradiation of cultured cells in physiological conditions. The dose uniformity is such that the variations in the irradiation area are less than ± 12% of the average dose value on different irradiation areas up to ∼ 25 cm'2. Moreover, in the framework of the FP6 Euratom Integrated Project Non-targeted effects of ionizing radiation (NOTE), Petri dishes were realized for housing permeable membrane insert(s) to be used in co-culture experiments. Aluminium shields were also realized for half shield irradiation experiments. The alpha-particle irradiator of the ISS has been successfully used for studying DNA damage, namely double strand breaks (DSB, as measured by the γ-H2AX assay), in directly hit and in bystander primary human fibroblasts [it

  9. An experimental set-up to study carbon, water, and nitrate uptake rates by hydroponically grown plants.

    Science.gov (United States)

    Andriolo, J L; Le Bot, J; Gary, C; Sappe, G; Orlando, P; Brunel, B; Sarrouy, C

    1996-01-01

    The experimental system described allows concomitant hourly measurements of CO2, H2O, and NO3 uptake rates by plants grown hydroponically in a greenhouse. Plants are enclosed in an airtight chamber through which air flows at a controlled speed. Carbon dioxide exchange and transpiration rates are determined from respective differences of concentrations of CO2 and water vapor of the air at the system inlet and outlet. This set-up is based on the "open-system" principle with improvements made on existing systems. For instance, propeller anemometers are used to monitor air flow rates in the chamber. From their signal it is possible to continuously adjust air speed to changing environmental conditions and plant activity. The air temperature inside the system therefore never rises above that outside. Water and NO3 uptake rates are calculated at time intervals from changes in the volume and the NO3 concentration of the nutrient solution in contact with the roots. The precise measurement of the volume of solution is achieved using a balance which has a higher precision than any liquid level sensors. Nitrate concentration is determined in the laboratory from aliquots of solution sampled at time intervals. A number of test runs are reported which validate the measurements and confirm undisturbed conditions within the system. Results of typical diurnal changes in CO2, H2O, and NO3 uptake rates by fruiting tomato plants are also presented.

  10. Design and setting up of a system for remote monitoring and control on auxiliary machines in electric vehicles

    Directory of Open Access Journals (Sweden)

    Dimitrov Vasil

    2017-01-01

    Full Text Available Systems for remote monitoring and control of the proper operation, energy consumption, and efficiency of the controlled objects are very often used in different spheres of industry, in the electricity distribution network, etc. Various types of intelligent energy meters, PLCs and other control devices are involved in such systems. Proper operation of the auxiliary machines in electric vehicles is of great importance and implementation of a system for their remote monitoring and control is useful and ensures reliability and increased efficiency. A system has been designed and built using contemporary devices. An asynchronous motor is controlled by a soft starter and opportunities for remote monitoring (by an intelligent energy meter and control (by a PLC and Touch panel have been provided. Soft starters are widely used in industry for control on asynchronous drives when speed regulation is not a mandatory requirement. They are cheaper than inverters and frequency converters and allow for temporal reduction of the torque and current surge during start-up, as well as smooth deceleration. Therefore they can also be used in electric vehicles to control auxiliary machines (pumps, fans, air coolers, compressors, etc.. The present paper presents a methodology for their design and setting up.

  11. [Multiple sclerosis epidemiological situation update: pertinence and set-up of a population based registry of new cases in Catalonia].

    Science.gov (United States)

    Otero, S; Batlle, J; Bonaventura, I; Brieva, Ll; Bufill, E; Cano, A; Carmona, O; Escartín, A; Marco, M; Moral, E; Munteis, E; Nos, C; Pericot, I; Perkal, H; Ramió-Torrentà, Ll; Ramo-Tello, C; Saiz, A; Sastre-Garriga, J; Tintoré, M; Vaqué, J; Montalban, X

    2010-05-16

    The first epidemiological studies on multiple sclerosis (MS) around the world pictured a north to south latitudinal gradient that led to the first genetic and environmental pathogenic hypothesis. MS incidence seems to be increasing during the past 20 years based on recent data from prospective studies performed in Europe, America and Asia. This phenomenon could be explained by a better case ascertainment as well as a change in causal factors. The few prospective studies in our area together with the increase in the disease in other regions, justifies an epidemiological MS project in order to describe the incidence and temporal trends of MS. A prospective multicenter MS registry has been established according to the actual requirements of an epidemiological surveillance system. Case definition is based on the fulfillment of the McDonald diagnostic criteria. The registry setting is the geographical area of Cataluna (northeastern Spain), using a wide network of hospitals specialized in MS management. Recent epidemiological studies have described an increase in MS incidence. In order to contrast this finding in our area, we consider appropriate to set up a population based registry.

  12. Social and cultural resources for the setting up and functioning of family enterprises in a small Bulgarian town

    Directory of Open Access Journals (Sweden)

    Petrova Ivanka

    2015-01-01

    Full Text Available As a field of culture, the family enterprise shows that in the current European societies the economic operation does not proceed only from a purely rational point of view and that notwithstanding the common speaking of globalization, the local may be a prerequisite for successful economic development. My objective has been to show, proceeding from an example from a small Bulgarian town, that the family enterprise is a field of culture in which the observed phenomena are strongly influenced by the social inclusion of the enterprise and by its tie-up with the context of the urban environment. I shall investigate in what way local social and cultural resources are intensively used in the process of setting up and functioning of a family enterprise from the sphere of hoteldom and tourism in the town of Belogradchik. I intend to study whether these resources are conducive to the economic prosperity of the firm. Another research objective is to establish the manner of identification of the enterprise with the town, with the region and the local culture by way of the services provided (tourist and restaurant. I shall look for an answer to the question of how the enterprise’ working realm fits in the concrete cultural, historical and social context of the town.

  13. The upgraded external-beam PIXE/PIGE set-up at LABEC for very fast measurements on aerosol samples

    Energy Technology Data Exchange (ETDEWEB)

    Lucarelli, F., E-mail: lucarelli@fi.infn.it; Calzolai, G.; Chiari, M.; Giannoni, M.; Mochi, D.; Nava, S.; Carraresi, L.

    2014-01-01

    At the 3 MV Tandetron accelerator of the LABEC laboratory of INFN in Florence, an external beam facility is fully dedicated to measurements of elemental composition of atmospheric aerosol. The experimental set-up hitherto used for this kind of applications has been upgraded with the replacement of a traditional Si(Li) detector for the detection of medium–high Z elements with a silicon drift detector (SDD) with a big active area (80 mm{sup 2}) and 450 μm thickness, with the aim of obtaining better minimum detection limits (MDL) and reduce measuring times. The Upilex extraction window has been replaced by a more resistant one (Si{sub 3}N{sub 4}). A comparison between the old Si(Li) and the new SDD for aerosol samples collected on different substrata like Teflon, Kapton and Nuclepore evidenced the better performances of the SDD. It allows obtaining better results (higher counting statistics, lower MDLs) even in shorter measuring times, thus allowing very fast analysis of both daily and hourly samples.

  14. Dual-energy CTA in patients with symptomatic peripheral arterial occlusive disease. Study of diagnostic accuracy and impeding factors

    Energy Technology Data Exchange (ETDEWEB)

    Klink, Thorsten [Wuerzburg Univ. (Germany). Inst. of Diagnostic and Interventional Radiology; Bern Univ. (Switzerland). Univ. Inst. of Diagnostic, Interventional, and Pediatric Radiology; Wilhelm, Theresa; Roth, Christine [Univ. Hospital Giessen and Marburg, Marburg (Germany). Dept. of Diagnostic and Interventional Radiology; Heverhagen, Johannes T. [Bern Univ. (Switzerland). Univ. Inst. of Diagnostic, Interventional, and Pediatric Radiology

    2017-05-15

    The purpose of this study was to assess the diagnostic performance of dual-energy CT angiography (DE-CTA) in patients with symptomatic peripheral artery occlusive disease (PAOD) and to identify factors that impede its diagnostic accuracy. Dual-source DE-CTA scans of the lower extremities of 94 patients were retrospectively compared to the diagnostic reference standard, digital subtraction angiography (DSA). Two independent observers assessed PAOD incidence, image quality, artifacts, and diagnostic accuracy of DE-CTA in 1014 arterial segments on axial, combined 80/140 kVp reconstructions and on 3 D maximum intensity projections (MIP) after automated bone and plaque removal. The impact of calcifications, image quality, and image artifacts on the diagnostic accuracy was evaluated using Fisher's exact test. Furthermore, interobserver agreement was analyzed. Two observers achieved sensitivities of 98.0% and 93.9%, respectively, and specificities of 75.0% and 66.7%, respectively, for detecting stenoses of >50% of the lower extremity arteries. Calcifications impeded specificity, e.g. from 81.2% to 46.2% for reader 1 (p<0.001). Specificity increased with higher image quality, e.g. from 70.0% to 76.4% for reader 1 (p<0.001). Artifacts decreased the specificity of reader 2 (p<0.001). The overall interobserver agreement ranged between moderate and substantial for stenosis detection and calcified plaques. Conclusion DE-CTA is accurate in the detection of arterial stenoses of >50% in symptomatic PAOD patients. Calcified atherosclerotic plaques, image quality, and artifacts may impede specificity.

  15. Effect of eliminating administrative radiographs on patient exposure and accuracy of provisional treatment plans

    International Nuclear Information System (INIS)

    Kantor, M.L.; Slome, B.A.

    1987-01-01

    Published reports and recommendations suggest that radiographs are often ordered because of administrative policies during the screening and selection of patients for dental school clinics. This study examined the prescription of radiographs for two groups of patients: those who were radiographically examined according to an administrative policy and those whose radiographic needs were determined by a clinical examination. The provisional treatment needs assessment based on the screening examination was compared to the final treatment plan based on a complete diagnostic workup for both groups of patients to assess the effect of a change in school policy. Clinicians ordered half the number of panoramic radiographs as would have been ordered by administrative policy. There was no significant difference in the agreement between the provisional and final treatment plans under the two policies. These results suggest that dental schools can comply with federal recommendations against administrative radiographs without compromising patient selection

  16. Accuracy of CT-guided joint aspiration in patients with suspected infection status post-total hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Tomas, Xavier; Garcia-Diez, Ana Isabel; Pomes, Jaime [Universidad de Barcelona, Department of Radiology, Hospital Clinic, Barcelona (Spain); Bori, Guillem; Garcia, Sebastian; Gallart, Xavier; Martinez, Juan Carlos; Riba, Josep [Universidad de Barcelona, Department of Orthopaedics, Hospital Clinic, Barcelona (Spain); Soriano, Alex; Mensa, Josep [Universidad de Barcelona, Department of Infectious Diseases, Hospital Clinic, Barcelona (Spain); Rios, Jose [Statistical Unit de Suport a la Estadistica I Metodologia IDIBAPS, Barcelona (Spain); Almela, Manel [Universidad de Barcelona, Department of Microbiology, Hospital Clinic, Barcelona (Spain)

    2011-01-15

    To determine the accuracy of guided computed tomography aspiration in the detection of septic hip prosthesis before surgery. Sixty-three patients (35 women and 28 men; age range, 29-86 years; mean age, 71 years) with clinically suspected septic hip prosthesis were prospectively studied with independent review board (IRB) approval. Volume and microbiological cultures of aspirated fluid and several computed tomography imaging findings such as periprosthetic fluid collections, prosthetic acetabular malposition, and heterotopic ossification were analyzed. All patients underwent revision surgery and infection was finally diagnosed in 33 patients. Statistical comparative analysis was performed comparing computed tomography aspiration and surgical findings (95% CI; level of significance at P = 0.05 two-sided) with 70% sensitivity, 100% specificity, 84% accuracy, 100% positive predictive value, and 75% negative predictive value. Using Fisher's exact test, the presence of periprosthetic fluid collections (P = 0.001), prosthetic acetabular malposition (P = 0.025) and aspirated fluid volume (P = 0.009) were significantly higher in infected than in non-infected prostheses, whereas heterotopic ossification was not (P = 0.429). Computed tomography aspiration is accurate to preoperatively diagnose septic hip prosthesis on the basis of volume and bacterial cultures of aspirated joint fluid. Furthermore, imaging findings such as periprosthetic fluid collections and prosthetic acetabular malposition strongly suggest infected prosthesis. (orig.)

  17. Accuracy of CT-guided joint aspiration in patients with suspected infection status post-total hip arthroplasty

    International Nuclear Information System (INIS)

    Tomas, Xavier; Garcia-Diez, Ana Isabel; Pomes, Jaime; Bori, Guillem; Garcia, Sebastian; Gallart, Xavier; Martinez, Juan Carlos; Riba, Josep; Soriano, Alex; Mensa, Josep; Rios, Jose; Almela, Manel

    2011-01-01

    To determine the accuracy of guided computed tomography aspiration in the detection of septic hip prosthesis before surgery. Sixty-three patients (35 women and 28 men; age range, 29-86 years; mean age, 71 years) with clinically suspected septic hip prosthesis were prospectively studied with independent review board (IRB) approval. Volume and microbiological cultures of aspirated fluid and several computed tomography imaging findings such as periprosthetic fluid collections, prosthetic acetabular malposition, and heterotopic ossification were analyzed. All patients underwent revision surgery and infection was finally diagnosed in 33 patients. Statistical comparative analysis was performed comparing computed tomography aspiration and surgical findings (95% CI; level of significance at P = 0.05 two-sided) with 70% sensitivity, 100% specificity, 84% accuracy, 100% positive predictive value, and 75% negative predictive value. Using Fisher's exact test, the presence of periprosthetic fluid collections (P = 0.001), prosthetic acetabular malposition (P = 0.025) and aspirated fluid volume (P = 0.009) were significantly higher in infected than in non-infected prostheses, whereas heterotopic ossification was not (P = 0.429). Computed tomography aspiration is accurate to preoperatively diagnose septic hip prosthesis on the basis of volume and bacterial cultures of aspirated joint fluid. Furthermore, imaging findings such as periprosthetic fluid collections and prosthetic acetabular malposition strongly suggest infected prosthesis. (orig.)

  18. Skin markings in external radiotherapy by temporary tattooing with henna: Improvement of accuracy and increased patient comfort

    International Nuclear Information System (INIS)

    Wurstbauer, Karl; Sedlmayer, Felix; Kogelnik, H. Dieter

    2001-01-01

    Purpose: To guarantee invariable skin markings in patients undergoing a course of external radiotherapy, especially using conformal techniques. Cutaneous markings with henna also increase patient comfort, because washing and showering are allowed. Methods and Materials: Henna, a completely natural product, is a skin colorant with a history of 5,000 years. It is applied to the skin in the form of a paste. While drying, henna stains the superficial skin layers for several weeks, and the marked area can be exposed to water arbitrarily. In case of fading of the stain before the end of radiotherapy, the marking procedure can be repeated. From November 1998 until March 2000, we performed skin markings with henna in 158 patients with different tumor sites. The majority of patients received conformal radiotherapy techniques. All patients have been evaluated concerning durability of the markings, the required number of marking procedures per treatment course, and possible related side effects. Results: The median durability of henna staining is 23 days (range 12-48 days). On average, two marking procedures (range 1-4) are necessary for a patient treated with curative intent. Although washing and showering are freely permitted, no adverse cutaneous side effects (e.g., erythema, allergic reactions) have been observed. Conclusions: Skin marking by temporary tattooing with henna increases the accuracy of external radiotherapy. It yields stable and invariable markings for the entire course of radiotherapy and also increases the comfort of patients

  19. The accuracy of ultrasonography for the evaluation of portal hypertension in patients with cirrhosis: A systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Gaeun; Cho, Youn Zoo; Baik, Soon Koo [College of Nursing, Research Institute for Nursing Science, Keimyung Univercity, Daegu (Korea, Republic of); Kim, Moon Young; Hong, Won Ki; Kwon, Sang Ok [Dept. of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of)

    2015-04-15

    Studies have presented conflicting results regarding the accuracy of ultrasonography (US) for diagnosing portal hypertension (PH). We sought to identify evidence in the literature regarding the accuracy of US for assessing PH in patients with liver cirrhosis. We conducted a systematic review by searching databases, including MEDLINE, EMBASE, and the Cochrane Library, for relevant studies. A total of 14 studies met our inclusion criteria. The US indices were obtained in the portal vein (n = 9), hepatic artery (n = 6), hepatic vein (HV) (n = 4) and other vessels. Using hepatic venous pressure gradient (HVPG) as the reference, the sensitivity (Se) and specificity (Sp) of the portal venous indices were 69-88% and 67-75%, respectively. The correlation coefficients between HVPG and the portal venous indices were approximately 0.296-0.8. No studies assess the Se and Sp of the hepatic arterial indices. The correlation between HVPG and the hepatic arterial indices ranged from 0.01 to 0.83. The Se and Sp of the hepatic venous indices were 75.9-77.8% and 81.8-100%, respectively. In particular, the Se and Sp of HV arrival time for clinically significant PH were 92.7% and 86.7%, respectively. A statistically significant correlation between HVPG and the hepatic venous indices was observed (0.545-0.649). Some US indices, such as HV, exhibited an increased accuracy for diagnosing PH. These indices may be useful in clinical practice for the detection of significant PH.

  20. The accuracy of ultrasonography for the evaluation of portal hypertension in patients with cirrhosis: A systematic review

    International Nuclear Information System (INIS)

    Kim, Gaeun; Cho, Youn Zoo; Baik, Soon Koo; Kim, Moon Young; Hong, Won Ki; Kwon, Sang Ok

    2015-01-01

    Studies have presented conflicting results regarding the accuracy of ultrasonography (US) for diagnosing portal hypertension (PH). We sought to identify evidence in the literature regarding the accuracy of US for assessing PH in patients with liver cirrhosis. We conducted a systematic review by searching databases, including MEDLINE, EMBASE, and the Cochrane Library, for relevant studies. A total of 14 studies met our inclusion criteria. The US indices were obtained in the portal vein (n = 9), hepatic artery (n = 6), hepatic vein (HV) (n = 4) and other vessels. Using hepatic venous pressure gradient (HVPG) as the reference, the sensitivity (Se) and specificity (Sp) of the portal venous indices were 69-88% and 67-75%, respectively. The correlation coefficients between HVPG and the portal venous indices were approximately 0.296-0.8. No studies assess the Se and Sp of the hepatic arterial indices. The correlation between HVPG and the hepatic arterial indices ranged from 0.01 to 0.83. The Se and Sp of the hepatic venous indices were 75.9-77.8% and 81.8-100%, respectively. In particular, the Se and Sp of HV arrival time for clinically significant PH were 92.7% and 86.7%, respectively. A statistically significant correlation between HVPG and the hepatic venous indices was observed (0.545-0.649). Some US indices, such as HV, exhibited an increased accuracy for diagnosing PH. These indices may be useful in clinical practice for the detection of significant PH.

  1. Accuracy of shock index versus ABC score to predict need for massive transfusion in trauma patients.

    Science.gov (United States)

    Schroll, Rebecca; Swift, David; Tatum, Danielle; Couch, Stuart; Heaney, Jiselle B; Llado-Farrulla, Monica; Zucker, Shana; Gill, Frances; Brown, Griffin; Buffin, Nicholas; Duchesne, Juan

    2018-01-01

    Various scoring systems have been developed to predict need for massive transfusion in traumatically injured patients. Assessments of Blood Consumption (ABC) score and Shock Index (SI) have been shown to be reliable predictors for Massive Transfusion Protocol (MTP) activation. However, no study has directly compared these two scoring systems to determine which is a better predictor for MTP activation. The primary objective was to determine whether ABC or SI better predicted the need for MTP in adult trauma patients with severe hemorrhage. This was a retrospective cohort study which included all injured patients who were trauma activations between January 1, 2009 and December 31, 2013 at an urban Level I trauma center. Patients ABC and SI were calculated for each patient. MTP was defined as need for >10 units PRBC transfusion within 24h of emergency department arrival. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) were used to evaluate scoring systems' ability to predict effective MTP utilization. A total of 645 patients had complete data for analysis. Shock Index ≥1 had sensitivity of 67.7% (95% CI 49.5%-82.6%) and specificity of 81.3% (95% CI 78.0%-84.3%) for predicting MTP, and ABC score ≥2 had sensitivity of 47.0% (95% CI 29.8%-64.9%) and specificity of 89.8% (95% CI 87.2%-92.1%). AUROC analyses showed SI to be the strongest predictor followed by ABC score with AUROC values of 0.83 and 0.74, respectively. SI had a significantly greater sensitivity (P=0.035), but a significantly weaker specificity (PABC score. ABC score and Shock Index can both be used to predict need for massive transfusion in trauma patients, however SI is more sensitive and requires less technical skill than ABC score. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. The usefulness and scientific accuracy of private sector Arabic language patient drug information leaflets.

    Science.gov (United States)

    Sukkari, Sana R; Al Humaidan, Abdullah S; Sasich, Larry D

    2012-07-01

    Inadequate access to useful scientifically accurate patient information is a major cause of the inappropriate use of drugs resulting in serious personal injury and related costs to the health care system. The definition of useful scientifically accurate patient information for prescription drugs was accepted by the US Secretary of the Department of Health and Human Services in 1996 as that derived from or consistent with the US FDA approved professional product label for a drug. Previous quality content studies found that English language patient drug information leaflets distributed by US pharmacies failed to meet minimum criteria defining useful and scientifically accurate information. Evaluation forms containing the explicit elements that define useful scientifically accurate information for three drugs with known serious adverse drug reactions were created based on the current US FDA approved professional product labels. The Arabic language patient drug information leaflets for celecoxib, paroxetine, and lamotrigine were obtained locally and evaluated using a methodology similar to that used in previous quality content patient drug information studies in the US. The Arabic leaflets failed to meet the definition of useful scientifically accurate information. The celecoxib leaflet contained 30% of the required information and the paroxetine and lamotrigine leaflets contained 24% and 20%, respectively. There are several limitations to this study. The Arabic leaflets from only one commercial North American vendor were evaluated and the evaluation included a limited number of drugs. A larger study is necessary to be able to generalize these results. The study results are consistent with those of previous quality content studies of commercially available English patient drug information leaflets. The results have important implications for patients as access to a reliable source of drug information may prevent harm or limit the suffering from serious adverse drug

  3. Non-contact test set-up for aeroelasticity in a rotating turbomachine combining a novel acoustic excitation system with tip-timing

    International Nuclear Information System (INIS)

    Freund, O; Seume, J R; Montgomery, M; Mittelbach, M

    2014-01-01

    Due to trends in aero-design, aeroelasticity becomes increasingly important in modern turbomachines. Design requirements of turbomachines lead to the development of high aspect ratio blades and blade integral disc designs (blisks), which are especially prone to complex modes of vibration. Therefore, experimental investigations yielding high quality data are required for improving the understanding of aeroelastic effects in turbomachines. One possibility to achieve high quality data is to excite and measure blade vibrations in turbomachines. The major requirement for blade excitation and blade vibration measurements is to minimize interference with the aeroelastic effects to be investigated. Thus in this paper, a non-contact—and thus low interference—experimental set-up for exciting and measuring blade vibrations is proposed and shown to work. A novel acoustic system excites rotor blade vibrations, which are measured with an optical tip-timing system. By performing measurements in an axial compressor, the potential of the acoustic excitation method for investigating aeroelastic effects is explored. The basic principle of this method is described and proven through the analysis of blade responses at different acoustic excitation frequencies and at different rotational speeds. To verify the accuracy of the tip-timing system, amplitudes measured by tip-timing are compared with strain gage measurements. They are found to agree well. Two approaches to vary the nodal diameter (ND) of the excited vibration mode by controlling the acoustic excitation are presented. By combining the different excitable acoustic modes with a phase-lag control, each ND of the investigated 30 blade rotor can be excited individually. This feature of the present acoustic excitation system is of great benefit to aeroelastic investigations and represents one of the main advantages over other excitation methods proposed in the past. In future studies, the acoustic excitation method will be used

  4. Development of a phantom to evaluate the positioning accuracy of patient immobilization systems using thermoplastic mask and polyurethane cradle.

    Science.gov (United States)

    Inata, Hiroki; Semba, Takatoshi; Itoh, Yoshihiro; Kuribayashi, Yuta; Murayama, Suetoshi; Nishizaki, Osamu; Araki, Fujio

    2012-07-01

    The purpose of this study was to develop a new phantom to evaluate the positioning accuracy of patient immobilization systems. The phantom was made of papers formed into a human shape, paper clay, and filling rigid polyester. Acrylonitrile butadiene styrene (ABS) pipes were inserted at anterior-posterior (A-P) and right-left (R-L) directions in the phantom to give static load by pulling ropes through the pipes. First, the positioning precision of the phantom utilizing a target locating system (TLS) was evaluated by moving the phantom on a couch along inferior-superior (I-S), A-P, and R-L directions in a range from -5 mm to +5 mm. The phantom's positions detected with the TLS were compared with values measured by a vernier caliper. Second, the phantom movements in a tensile test were chosen from patient movements determined from 15 patients treated for intracranial lesions and immobilized with a thermoplastic mask and polyurethane cradle. The phantom movement was given by minimum or maximum values of patient movements in each direction. Finally, the relationship between phantom movements and the static load in the tensile test was characterized from measurements using the new phantom and the TLS. The differences in all positions between the vernier caliper measurement and the TLS detected values were within 0.2 mm with frequencies of 100%, 95%, and 90% in I-S, A-P, and R-L directions, respectively. The phantom movements according to patient movements in clinical application in I-S, A-P, and R-L directions were within 0.58 mm, 0.94 mm, and 0.93 mm from the mean value plus standard deviation, respectively. The regression lines between the phantom movements and static load were given by y = 0.359x, y = 0.241x, and y = 0.451x in I-S, A-P, and R-L directions, respectively, where x is the phantom movement (mm) and y is the static load (kgf). The relationship between the phantom movements and static load may represent the performance of inhibiting patient movements, so the

  5. Accuracy of near-patient vs. inbuilt spirometry for monitoring tidal volumes in an in-vitro paediatric lung model.

    Science.gov (United States)

    Morgenroth, S; Thomas, J; Cannizzaro, V; Weiss, M; Schmidt, A R

    2018-03-01

    Spirometric monitoring provides precise measurement and delivery of tidal volumes within a narrow range, which is essential for lung-protective strategies that aim to reduce morbidity and mortality in mechanically-ventilated patients. Conventional anaesthesia ventilators include inbuilt spirometry to monitor inspiratory and expiratory tidal volumes. The GE Aisys CS 2 anaesthesia ventilator allows additional near-patient spirometry via a sensor interposed between the proximal end of the tracheal tube and the respiratory tubing. Near-patient and inbuilt spirometry of two different GE Aisys CS 2 anaesthesia ventilators were compared in an in-vitro study. Assessments were made of accuracy and variability in inspiratory and expiratory tidal volume measurements during ventilation of six simulated paediatric lung models using the ASL 5000 test lung. A total of 9240 breaths were recorded and analysed. Differences between inspiratory tidal volumes measured with near-patient and inbuilt spirometry were most significant in the newborn setting (p tidal volume measurements with near-patient spirometry were consistently more accurate than with inbuilt spirometry for all lung models (p tidal volumes decreased with increasing tidal volumes, and was smaller with near-patient than with inbuilt spirometry. The variability in measured tidal volumes was higher during expiration, especially with inbuilt spirometry. In conclusion, the present in-vitro study shows that measurements with near-patient spirometry are more accurate and less variable than with inbuilt spirometry. Differences between measurement methods were most significant in the smallest patients. We therefore recommend near-patient spirometry, especially for neonatal and paediatric patients. © 2018 The Association of Anaesthetists of Great Britain and Ireland.

  6. The accuracy of PiCCO® in measuring cardiac output in patients under therapeutic hypothermia: Comparison with transthoracic echocardiography.

    Science.gov (United States)

    Souto Moura, T; Aguiar Rosa, S; Germano, N; Cavaco, R; Sequeira, T; Alves, M; Papoila, A L; Bento, L

    2018-03-01

    Invasive cardiac monitoring using thermodilution methods such as PiCCO® is widely used in critically ill patients and provides a wide range of hemodynamic variables, including cardiac output (CO). However, in post-cardiac arrest patients subjected to therapeutic hypothermia, the low body temperature possibly could interfere with the technique. Transthoracic Doppler echocardiography (ECHO) has long proved its accuracy in estimating CO, and is not influenced by temperature changes. To assess the accuracy of PiCCO® in measuring CO in patients under therapeutic hypothermia, compared with ECHO. Thirty paired COECHO/COPiCCO measurements were analyzed in 15 patients subjected to hypothermia after cardiac arrest. Eighteen paired measurements were obtained at under 36°C and 12 at ≥36°C. A value of 0.5l/min was considered the maximum accepted difference between the COECHO and COPiCCO values. Under conditions of normothermia (≥36°C), the mean difference between COECHO and COPiCCO was 0.030 l/min, with limits of agreement (-0.22, 0.28) - all of the measurements differing by less than 0.5 l/min. In situations of hypothermia (<36°C), the mean difference in CO measurements was -0.426 l/min, with limits of agreement (-1.60, 0.75), and only 44% (8/18) of the paired measurements fell within the interval (-0.5, 0.5). The calculated temperature cut-off point maximizing specificity was 35.95°C: above this temperature, specificity was 100%, with a false-positive rate of 0%. The results clearly show clinically relevant discordance between COECHO and COPiCCO at temperatures of <36°C, demonstrating the inaccuracy of PiCCO® for cardiac output measurements in hypothermic patients. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  7. Accuracy of Dolphin visual treatment objective (VTO prediction software on class III patients treated with maxillary advancement and mandibular setback

    Directory of Open Access Journals (Sweden)

    Robert J. Peterman

    2016-06-01

    Full Text Available Abstract Background Dolphin® visual treatment objective (VTO prediction software is routinely utilized by orthodontists during the treatment planning of orthognathic cases to help predict post-surgical soft tissue changes. Although surgical soft tissue prediction is considered to be a vital tool, its accuracy is not well understood in tow-jaw surgical procedures. The objective of this study was to quantify the accuracy of Dolphin Imaging’s VTO soft tissue prediction software on class III patients treated with maxillary advancement and mandibular setback and to validate the efficacy of the software in such complex cases. Methods This retrospective study analyzed the records of 14 patients treated with comprehensive orthodontics in conjunction with two-jaw orthognathic surgery. Pre- and post-treatment radiographs were traced and superimposed to determine the actual skeletal movements achieved in surgery. This information was then used to simulate surgery in the software and generate a final soft tissue patient profile prediction. Prediction images were then compared to the actual post-treatment profile photos to determine differences. Results Dolphin Imaging’s software was determined to be accurate within an error range of +/− 2 mm in the X-axis at most landmarks. The lower lip predictions were most inaccurate. Conclusions Clinically, the observed error suggests that the VTO may be used for demonstration and communication with a patient or consulting practitioner. However, Dolphin should not be useful for precise treatment planning of surgical movements. This program should be used with caution to prevent unrealistic patient expectations and dissatisfaction.

  8. Relocatable fixation systems in intracranial stereotactic radiotherapy. Accuracy of serial CT scans and patient acceptance in a randomized design.

    Science.gov (United States)

    Theelen, A; Martens, J; Bosmans, G; Houben, R; Jager, J J; Rutten, I; Lambin, P; Minken, A W; Baumert, B G

    2012-01-01

    The goal was to provide a quantitative evaluation of the accuracy of three different fixation systems for stereotactic radiotherapy and to evaluate patients' acceptance for all fixations. A total of 16 consecutive patients with brain tumours undergoing fractionated stereotactic radiotherapy (SCRT) were enrolled after informed consent (Clinical trials.gov: NCT00181350). Fixation systems evaluated were the BrainLAB® mask, with and without custom made bite-block (fixations S and A) and a homemade neck support with bite-block (fixation B) based on the BrainLAB® frame. The sequence of measurements was evaluated in a randomized manner with a cross-over design and patients' acceptance by a questionnaire. The mean three-dimensional (3D) displacement and standard deviations were 1.16 ± 0.68 mm for fixation S, 1.92 ± 1.28 and 1.70 ± 0.83 mm for fixations A and B, respectively. There was a significant improvement of the overall alignment (3D vector) when using the standard fixation instead of fixation A or B in the craniocaudal direction (p = 0.037). Rotational deviations were significantly less for the standard fixation S in relation to fixations A (p = 0.005) and B (p = 0.03). EPI imaging with off-line correction further improved reproducibility. Five out of 8 patients preferred the neck support with the bite-block. The mask fixation system in conjunction with a bite-block is the most accurate fixation for SCRT reducing craniocaudal and rotational movements. Patients favoured the more comfortable but less accurate neck support. To optimize the accuracy of SCRT, additional regular portal imaging is warranted.

  9. Relocatable fixation systems in intracranial stereotactic radiotherapy. Accuracy of serial CT scans and patient acceptance in a randomized design

    International Nuclear Information System (INIS)

    Theelen, A.; Martens, J.; Bosmans, G.; Houben, R.; Jager, J.J.; Rutten, I.; Lambin, P.; Baumert, B.G.; Minken, A.W.; Radiotherapeutic Inst. RISO, Deventer

    2012-01-01

    The goal was to provide a quantitative evaluation of the accuracy of three different fixation systems for stereotactic radiotherapy and to evaluate patients' acceptance for all fixations. Methods A total of 16 consecutive patients with brain tumours undergoing fractionated stereotactic radiotherapy (SCRT) were enrolled after informed consent (Clinical trials.gov: NCT00181350). Fixation systems evaluated were the BrainLAB registered mask, with and without custom made bite-block (fixations S and A) and a homemade neck support with bite-block (fixation B) based on the BrainLAB registered frame. The sequence of measurements was evaluated in a randomized manner with a cross-over design and patients' acceptance by a questionnaire. Results The mean three-dimensional (3D) displacement and standard deviations were 1.16 ± 0.68 mm for fixation S, 1.92 ± 1.28 and 1.70 ± 0.83 mm for fixations A and B, respectively. There was a significant improvement of the overall alignment (3D vector) when using the standard fixation instead of fixation A or B in the craniocaudal direction (p = 0.037). Rotational deviations were significantly less for the standard fixation S in relation to fixations A (p = 0.005) and B (p = 0.03). EPI imaging with off-line correction further improved reproducibility. Five out of 8 patients preferred the neck support with the bite-block. Conclusion The mask fixation system in conjunction with a bite-block is the most accurate fixation for SCRT reducing craniocaudal and rotational movements. Patients favoured the more comfortable but less accurate neck support. To optimize the accuracy of SCRT, additional regular portal imaging is warranted. (orig.)

  10. Clinical diagnostic accuracy of acute colonic diverticulitis in patients admitted with acute abdominal pain, a receiver operating characteristic curve analysis.

    Science.gov (United States)

    Jamal Talabani, A; Endreseth, B H; Lydersen, S; Edna, T-H

    2017-01-01

    The study investigated the capability of clinical findings, temperature, C-reactive protein (CRP), and white blood cell (WBC) count to discern patients with acute colonic diverticulitis from all other patients admitted with acute abdominal pain. The probability of acute diverticulitis was assessed by the examining doctor, using a scale from 0 (zero probability) to 10 (100 % probability). Receiver operating characteristic (ROC) curves were used to assess the clinical diagnostic accuracy of acute colonic diverticulitis in patients admitted with acute abdominal pain. Of 833 patients admitted with acute abdominal pain, 95 had acute colonic diverticulitis. ROC curve analysis gave an area under the ROC curve (AUC) of 0.95 (CI 0.92 to 0.97) for ages patients. Separate analysis showed an AUC = 0.83 (CI 0.80 to 0.86) of CRP alone. White blood cell count and temperature were almost useless to discriminate acute colonic diverticulitis from other types of acute abdominal pain, AUC = 0.59 (CI 0.53 to 0.65) for white blood cell count and AUC = 0.57 (0.50 to 0.63) for temperature, respectively. This prospective study demonstrates that standard clinical evaluation by non-specialist doctors based on history, physical examination, and initial blood tests on admission provides a high degree of diagnostic precision in patients with acute colonic diverticulitis.

  11. Beta, gamma contamination analysis of thermo luminescence dosimeter cassettes using Geiger Muller counting set up and gamma spectrometry techniques

    International Nuclear Information System (INIS)

    Prasad, S.K.; Sudheer, T.S.; Sahoo, L.; Vinayagam, Bhakti; Kamble, Mahesh; Khuspe, R.R.; Anilkumar, Rekha; Verma, K.K.

    2009-01-01

    Β-γ contamination cheek up of TLD cassettes were carried out and the isotopes found were 137 Cs, 106 Ru, 60 Co, 64 Cu, 144 Ce and 95 Nb with activity per square cm varying from 0.05-4.70 Bq/cm 2 with median value 1.3. The assessed dose in TLD was in the range of 2.10 mSv to 22.05 mSv for beta, 0.05 mSv to 5.25 mSv for gamma. The beta doses have median value of 6.19 mSv. This contamination may be due to active water contamination on TLD's of personnel working for irradiated fuel handling or work in fuel rod (under water) storage area. This gives a method to estimate skin exposure of personnel due to skin contamination during work. Chances of getting TLD's contaminated due to various reasons were studied. Contamination was found maximum inside the cassette box having area 16 cm 2 . In case of plastic pouch of TLD disc contamination was detected in three cases. Contamination level on TLD cassettes using GM counter was found in the range of 0.30-3.6 Bq/cm 2 for cassettes. By opening the window of the surveymeter contamination and field of these cassettes in closed condition were found to increase by 20% due to the measurement of beta dose. With the same condition contamination of TLD cassette in open condition was found five times more. This is due to the a-contamination which is five times more than a contamination, The most prominent isotope 137 Cs in common chemical forms are soluble in water and if inhaled or ingested are rapidly and completely absorbed in the lungs and across the gastrointestinal tract. Thus a skin contamination of most prominent isotope 137 Cs can lead to intake in addition to skin dose. Fading studies of contamination of TLD cassettes were carried out. It was found negligible after counting with GM counting set up after a period of 3 months. But one of the TLD cassettes was showing an 80% reduction of contamination after 3 months with GM counting set up, the contaminants being 141 Ce, 103 Ru and 95 Nb. The gamma peaks in the external exposure

  12. The upgraded external-beam PIXE/PIGE set-up at LABEC for very fast measurements on aerosol samples

    Energy Technology Data Exchange (ETDEWEB)

    Lucarelli, F.; Calzolai, G.; Chiari, M.; Mochi, D.; Nava, S. [Department of Physics, University of Florence and INFN, Florence (Italy)

    2013-07-01

    Full text: Particle Induced X-ray Emission (PIXE)technique has been widely used since its birth for the study of the aerosol composition, and for a long time it has been the dominating technique for its elemental analysis. However now it has to compete with other techniques, like Induced Coupled Plasma and detection by Atomic Emission Spectroscopy (ICP-AES) or Mass Spectrometry (ICP-MS) or Synchrotron Radiation XRF (SR-XRF). To remain competitive, a proper experimental set-up is important to fully exploit PIXE capabilities. At LABEC, an external beam line is fully dedicated to PIXE-PIGE measurements of atmospheric aerosols [1]. Recently SDD (Silicon Drift Detectors) have been introduced for X-ray detection thanks to their better resolution with respect to Si(Li) detectors and the possibility of managing high counting rates (up to 50 kHz at 0.5 μsec shaping time). This implies, in turn, the possibility of using very high beam currents thus drastically reducing the measurement time. However their use for a complete characterization of X-rays was limited by the small thickness and surface areas available. Now SDD with a thickness of 500 μm and 80 mm{sup 2} area have been introduced in the market. We have therefore replaced the Si(Li) detector used so far for the detection of medium-high Z elements with such a SDD. A comparison of the two detectors has been carried out; PIXE minimum detection limits (MDLs) at different proton beam energies have been studied to find out the best energy for PIXE measurements on aerosol samples collected on different substrata, namely Teflon, Kapton, Nuclepore and Kimfol, used for daily or hourly sampling or for cascade impactors. In particular in the case of Teflon filters, the production of γ-rays by F in the Teflon filter limits the current which may be used and the Compton γ-ray background worsens the MDLs. Due to the lower thickness of the SDD detector with respect to a typical Si(Li) detector, these problems are reduced

  13. Uncertainties in surface mass and energy flux estimates due to different eddy covariance sensors and technical set-up

    Science.gov (United States)

    Arriga, Nicola; Fratini, Gerardo; Forgione, Antonio; Tomassucci, Michele; Papale, Dario

    2010-05-01

    Eddy covariance is a well established and widely used methodology for the measurement of turbulent fluxes of mass and energy in the atmospheric boundary layer, in particular to estimate CO2/H2O and heat exchange above ecologically relevant surfaces (Aubinet 2000, Baldocchi 2003). Despite its long term application and theoretical studies, many issues are still open about the effect of different experimental set-up on final flux estimates. Open issues are the evaluation of the performances of different kind of sensors (e.g. open path vs closed path infra-red gas analysers, vertical vs horizontal mounting ultrasonic anemometers), the quantification of the impact of corresponding physical corrections to be applied to get robust flux estimates taking in account all processes concurring to the measurement (e.g. the so-called WPL term, signal attenuation due to air sampling system for closed path analyser, relative position of analyser and anemometer) and the differences between several data transmission protocols used (analogue, digital RS-232, SDM). A field experiment was designed to study these issues using several instruments among those most used within the Fluxnet community and to compare their performances under conditions supposed to be critical: rainy and cold weather conditions for open-path analysers (Burba 2008), water transport and absorption at high air relative humidity conditions for closed-path systems (Ibrom, 2007), frequency sampling limits and recorded data robustness due to different transmission protocols (RS232, SDM, USB, Ethernet) and finally the effect of the displacement between anemometer and analyser using at least two identical analysers placed at different horizontal and vertical distances from the anemometer. Aim of this experiment is to quantify the effect of several technical solutions on the final estimates of fluxes measured at a point in the space and if they represent a significant source of uncertainty for mass and energy cycle

  14. The wasted energy: A metric to set up appropriate targets in our path towards fully renewable energy systems

    International Nuclear Information System (INIS)

    Vinagre Díaz, Juan José; Wilby, Mark Richard; Rodríguez González, Ana Belén

    2015-01-01

    By 2020 Europe has to increase its energy efficiency and share of renewables in 20%. However, even accomplishing these challenging objectives Europe will be effectively wasting energy as we demonstrate in this paper. In our way towards a fully renewable scenario, we need at least to stop wasting energy in order to guarantee the energy supply needed for growth and comfort. We waste energy when we employ more primary energy than the final energy we ultimately use and this excess cannot be reutilized. In this paper we propose the WE (wasted energy) as a novel metric to measure the performance of energy systems and set up appropriate targets. The WE incorporates information about energy efficiency and renewable sources. Unlike European legislation, the WE considers them in an integrated way. This approach will help Member States to exploit their intrinsic capabilities and design their optimum strategy to reach their objectives. Using the information in Eurostat, we calculate the WE of Member States in EU-28 and their evolution. We also analyze illustrative examples to highlight strategies to reduce the WE, study the connection between economic development and WE, and provide a tool to diagnose the potential of improvement of an energy system. - Highlights: • Even achieving the 2020 objectives, Europe will still be wasting energy. • We need to reduce wasted energy in our way towards 100% renewable energy systems. • The WE (wasted energy) integrates efficiency and renewable in a single target. • We provide the empirical WE of Member States in EU-28 and their evolution. • Finally we highlight best practices of real energy systems.

  15. Setting up a safe deep repository for long-lived HLW and ILW in Russia: Current state of the works

    International Nuclear Information System (INIS)

    Polyakov, Yu.D.; Porsov, A.Yu.; Beigul, V.P.; Palenov, M.V.

    2014-01-01

    The concept of RW disposal in Russia in accordance with the Federal Law 'On Radioactive Waste Management and Amendments to Specific Legal Acts of the Russian Federation' No. 190-FL dated 11 July 2011, is oriented at the ultimate disposal of waste, without an intent for their subsequent retrieval. The law 190-FL has it as follows: - A radioactive waste repository is a radioactive waste storage facility intended for disposal of the radioactive wastes without an intent for their subsequent retrieval. - Disposal of solid long-lived high-level waste and solid long-lived intermediate-level waste is carried out in deep repositories for radioactive waste. - Import into the Russian Federation of radioactive waste for the purpose of its storage, processing and disposal, except for spent sealed sources of ionising radiation originating from the Russian Federation, is prohibited. For safe final disposal of long-lived HLW and ILW, it is planned to construct a deep repository for radioactive waste (DRRW) in a low-pervious monolith rock massif in the Krasnoyarsk region in the production territory of the Mining and Chemical Combine (FSUE 'Gorno-khimicheskiy kombinat'). According to the IAEA recommendations and in line with the international experience in feasibility studies for setting up of HLW and SNF underground disposal facilities, the first mandatory step is the construction of an underground research laboratory. An underground laboratory serves the following purposes: - itemised research into the characteristics of enclosing rock mass, with verification of massive material suitability for safe disposal of long-lived HLW and ILW; - research into and verification of the isolating properties of an engineering barrier system; - development of engineering solutions and transportation and process flow schemes for construction and running of a future RW ultimate isolation facility. (authors)

  16. Diarrhea is a Major killer of Children with Severe Acute Malnutrition Admitted to Inpatient Set-up in Lusaka, Zambia

    Directory of Open Access Journals (Sweden)

    Mwambazi Mwate

    2011-10-01

    Full Text Available Abstract Introduction Mortality of children with Severe Acute Malnutrition (SAM in inpatient set-ups in sub-Saharan Africa still remains unacceptably high. We investigated the prevalence and effect of diarrhea and HIV infection on inpatient treatment outcome of children with complicated SAM receiving treatment in inpatient units. Method A cohort of 430 children aged 6-59 months old with complicated SAM admitted to Zambia University Teaching Hospital's stabilization centre from August to December 2009 were followed. Data on nutritional status, socio-demographic factors, and admission medical conditions were collected up on enrollment. T-test and chi-square tests were used to compare difference in mean or percentage values. Logistic regression was used to assess risk of mortality by admission characteristics. Results Majority, 55.3% (238/430 were boys. The median age of the cohort was 17 months (inter-quartile range, IQR 12-22. Among the children, 68.9% (295/428 had edema at admission. The majority of the children, 67.3% (261/388, presented with diarrhea; 38.9% (162/420 tested HIV positive; and 40.5% (174/430 of the children died. The median Length of stay of the cohort was 9 days (IQR, 5-14 days; 30.6% (53/173 of the death occurred within 48 hours of admission. Children with diarrhea on admission had two and half times higher odds of mortality than those without diarrhea; Adjusted OR = 2.5 (95% CI 1.50-4.09, P Conclusion Diarrhea is a major cause of complication in children with severe acute malnutrition. Under the current standard management approach, diarrhea in children with SAM was found to increase their odds of death substantially irrespective of other factors.

  17. A knowledge brokerage approach for assessing the impacts of the setting up young farmers policy measure in Greece

    International Nuclear Information System (INIS)

    Bournaris, Th.; Moulogianni, Ch.; Arampatzis, S.; Kiomourtzi, F.; Wascher, D.M.; Manos, B.

    2016-01-01

    This study explores Knowledge Brokerage (KB) aspects of an ex-post Impact Assessment (IA) for the Rural Development Programme (RDP) measure of setting up young farmers, under the Common Agricultural Policy (CAP), at the regional level in Northern Greece. The measure supports the entry of young farmers in agriculture by moving land from older to younger farmers. The aim of the study was to test a set of KB tools for improving the interaction between researchers and policy makers. Our analysis mainly focused on a suite of IA Support Modules to guide practitioners, and on a technical tool kit, a web-based contextualisation platform, to support the IA of the specific test case. Offering a structured approach towards IA, both the Support Modules and LIAISE-KIT allow framing the context, organisation, scheduling and method selection in the light of KB objectives. The evaluation of how IA Support Modules influence the Science Policy Interface (SPI), in the case of the ex-post assessment, demonstrated the high relevance of KB activities for facilitating the interaction between researchers and regional policy makers. The assessment bridges the gap between knowledge producers developing scientific output to be applied in a specific context, and knowledge users, who want clear messages regarding the policy challenges they face. Other conclusions include the need for specific guidelines and training for knowledge users, especially with regard to the use of tools. According to our findings, a consequent application of KB activities is a crucial pre-condition for successfully implementing IAs in future RDP measures.

  18. A knowledge brokerage approach for assessing the impacts of the setting up young farmers policy measure in Greece

    Energy Technology Data Exchange (ETDEWEB)

    Bournaris, Th.; Moulogianni, Ch.; Arampatzis, S.; Kiomourtzi, F. [Aristotle University of Thessaloniki (Greece); Wascher, D.M. [Alterra Wageningen UR (Netherlands); Manos, B., E-mail: manosb@agro.auth.gr [Aristotle University of Thessaloniki (Greece)

    2016-02-15

    This study explores Knowledge Brokerage (KB) aspects of an ex-post Impact Assessment (IA) for the Rural Development Programme (RDP) measure of setting up young farmers, under the Common Agricultural Policy (CAP), at the regional level in Northern Greece. The measure supports the entry of young farmers in agriculture by moving land from older to younger farmers. The aim of the study was to test a set of KB tools for improving the interaction between researchers and policy makers. Our analysis mainly focused on a suite of IA Support Modules to guide practitioners, and on a technical tool kit, a web-based contextualisation platform, to support the IA of the specific test case. Offering a structured approach towards IA, both the Support Modules and LIAISE-KIT allow framing the context, organisation, scheduling and method selection in the light of KB objectives. The evaluation of how IA Support Modules influence the Science Policy Interface (SPI), in the case of the ex-post assessment, demonstrated the high relevance of KB activities for facilitating the interaction between researchers and regional policy makers. The assessment bridges the gap between knowledge producers developing scientific output to be applied in a specific context, and knowledge users, who want clear messages regarding the policy challenges they face. Other conclusions include the need for specific guidelines and training for knowledge users, especially with regard to the use of tools. According to our findings, a consequent application of KB activities is a crucial pre-condition for successfully implementing IAs in future RDP measures.

  19. Sensitivity testing of the model set-up used for calculation of photochemical ozone creation potentials (POCP) under European conditions

    Energy Technology Data Exchange (ETDEWEB)

    Altenstedt, J.; Pleijel, K.

    1998-02-01

    Photochemical Ozone Creation Potentials (POCP) is a method to rank VOC, relative to other VOC, according to their ability to produce ground level ozone. To obtain POCP values valid under European conditions, a critical analysis of the POCP concept has been performed using the IVL photochemical trajectory model. The critical analysis has concentrated on three VOC (ethene, n-butane and o-xylene) and has analysed the effect on their POCP values when different model parameters were varied. The three species were chosen because of their different degradation mechanisms in the atmosphere and thus their different abilities to produce ozone. The model parameters which have been tested include background emissions, initial concentrations, dry deposition velocities, the features of the added point source and meteorological parameters. The critical analysis shows that the background emissions of NO{sub x} and VOC have a critical impact on the POCP values. The hour of the day for the point source emission also shows a large influence on the POCP values. Other model parameters which have been studied have not shown such large influence on the POCP values. Based on the critical analysis a model set-up for calculation of POCP is defined. The variations in POCP values due to changes in the background emissions of NO{sub x} and VOC are so large that they can not be disregarded in the calculation of POCP. It is recommended to calculate POCP ranges based on the extremes in POCP values instead of calculating site specific POCP values. Four individual emission scenarios which produced the extremes in POCP values in the analysis have been selected for future calculation of POCP ranges. The scenarios are constructed based on the emissions in Europe and the resulting POCP ranges are thus intended to be applicable within Europe 67 refs, 61 figs, 16 tabs

  20. Limets 2: a hot-cell test set-up for Liquid Metal Embrittlement (LME) studies in liquid lead alloys

    International Nuclear Information System (INIS)

    Van den Bosch, J.; Bosch, R.W.; Al Mazouzi, A.

    2008-01-01

    Full text of publication follows. In the nuclear energy sector one of the main candidate designs for the accelerator driven system (ADS) uses liquid lead or lead bismuth eutectic both as a coolant and as spallation target. In the fusion community liquid lead lithium eutectic is considered as a possible coolant for the blanket and as a tritium source. Therefore the candidate materials for such structural components should not only comply with the operating conditions but in addition need to guarantee chemical and physical integrity when coming into contact with the lead alloys. The latter phenomena can be manifested in terms of erosion/corrosion. and/or of the so called liquid metal embrittlement (LME). Thus the susceptibility to LME of the structural materials under consideration to be used in such applications should be investigated in contact with the various lead alloys. LME, if occurring in any solid metal/liquid meta] couple, is likely to increase with irradiation hardening as localised stresses and crack initiations can promote it. To investigate the mechanical response of irradiated materials in contact with a liquid metal under representative conditions, a dedicated testing facility has recently been developed and built at our centre. It consists of an instrumented hot cell. equipped with a testing machine that allows mechanical testing of active materials in contact with active liquid lead lithium and liquid lead bismuth under well controlled chemistry conditions. The specificity of the installation is to handle highly activated and contaminated samples. Also a dedicated dismantling set-up has been developed that allows to retrieve the samples from the irradiation rig without any supplementary damage. In this presentation we will focus on the technical design of this new installation, its special features that have been developed to allow testing in a hot environment and the modifications and actions that have been taken to allow testing in liquid lead

  1. Assessing the sleeping habits of patients in a sleep disorder centre: a review of sleep diary accuracy

    Science.gov (United States)

    Lawrence, Geoffrey

    2018-01-01

    Background Excessive daytime sleepiness (EDS) is a complaint common to many aspects of medicine. There are primary and secondary causes for EDS, with secondary causes including a large number of common conditions. Primary causes, such as narcolepsy, are much rarer. When assessing for primary hypersomnia, restricted or fragmented sleep must be ruled out. This process involves assessment of sleeping habits using a sleep diary and/or actigraphy. Clinicians are suspicious of the accuracy with which patients use the former. This review aims to evaluate the accuracy of a sleep diary study against the ‘objective gold standard’ actigraphy report. Methods Data from 35 patients at a Sleep Disorder Centre who underwent both a sleep diary and actigraphy study for suspected primary hypersomnia in 2016 was collected. Mean values of four variables were calculated: ‘time of lights out’, ‘time to fall asleep’, ‘time of waking’ and ‘sleep time’. The ‘similarity’ was assessed. This was a term defined in three different ways: if sleep diary values are accurate to within 20, 30 and 60 min respectively. Percentage ‘similarity’, mean time differences and standard deviations (SDs) were calculated for each variable. A paired t-test was also performed to assess the significance of the time differences between the two modalities. Results Least accurate was ‘sleep time’, with 14.7%, 23.5% and 58.8% of patients within 20, 30 and 60 min of the actigraphy respectively. Mean time difference for this variable was 66 min (versus 33, 15 and 22). ‘Time to fall asleep’ was most accurate, with 76.5%, 82.4% and 100% ‘similarity’ respectively. Conclusions The clinically acceptable accuracy has no universal definition, so clinicians must use experience and reasoning to determine this level to interpret this data. The review suggests that some variables are entered with high accuracy, and the diary is low cost and adds subjective information that cannot be gathered

  2. Accuracy of bedside glucose measurement from three glucometers in critically ill patients.

    NARCIS (Netherlands)

    Hoedemaekers, C.W.E.; Klein Gunnewiek, J.M.T.; Prinsen, M.A.; Willems, J.L.; Hoeven, J.G. van der

    2008-01-01

    OBJECTIVE: Implementation of strict glucose control in most intensive care units has resulted in increased use of point-of-care glucose devices in the intensive care unit. The aim of this study was to determine the reliability of point-of-care testing glucose meters among critically ill patients

  3. Accuracy of WISC-III and WAIS-IV short forms in patients with neurological disorders

    NARCIS (Netherlands)

    van Ool, Jans S.; Hurks, Petra P.M.; Snoeijen-Schouwenaars, Francesca M.; Tan, In Y.; Schelhaas, Helenius J.; Klinkenberg, Sylvia; Aldenkamp, Albert P.; Hendriksen, Jos G.M.

    2018-01-01

    The assessment of intellectual abilities is intensive, time-consuming, and might be considered burdensome for patients. We examined psychometric qualities of short forms (SFs) of the Wechsler Intelligence Scales for Children (WISC-third edition) and for adults (WAIS-fourth edition), in children (n =

  4. Analysis of regional timelines to set up a global phase III clinical trial in breast cancer: the adjuvant lapatinib and/or trastuzumab treatment optimization experience.

    Science.gov (United States)

    Metzger-Filho, Otto; de Azambuja, Evandro; Bradbury, Ian; Saini, Kamal S; Bines, José; Simon, Sergio D; Dooren, Veerle Van; Aktan, Gursel; Pritchard, Kathleen I; Wolff, Antonio C; Smith, Ian; Jackisch, Christian; Lang, Istvan; Untch, Michael; Boyle, Frances; Xu, Binghe; Baselga, Jose; Perez, Edith A; Piccart-Gebhart, Martine

    2013-01-01

    This study measured the time taken for setting up the different facets of adjuvant lapatinib and/or trastuzumab treatment optimization (ALTTO), an nternational phase III study being conducted in 44 participating countries. Time to regulatory authority (RA) approval, time to ethics committee/institutional review board (EC/IRB) approval, time from study approval by EC/IRB to first randomized patient, and time from first to last randomized patient were prospectively collected in the ALTTO study. Analyses were conducted by grouping countries into either geographic regions or economic classes as per the World Bank's criteria. South America had a significantly longer time to RA approval (median: 236 days, range: 21-257 days) than Europe (median: 52 days, range: 0-151 days), North America (median: 26 days, range: 22-30 days), and Asia-Pacific (median: 62 days, range: 37-75 days). Upper-middle economies had longer times to RA approval (median: 123 days, range: 21-257 days) than high-income (median: 47 days, range: 0-112 days) and lower-middle income economies (median: 57 days, range: 37-62 days). No significant difference was observed for time to EC/IRB approval across the studied regions (median: 59 days, range 0-174 days). Overall, the median time from EC/IRB approval to first recruited patient was 169 days (range: 26-412 days). This study highlights the long time intervals required to activate a global phase III trial. Collaborative research groups, pharmaceutical industry sponsors, and regulatory authorities should analyze the current system and enter into dialogue for optimizing local policies. This would enable faster access of patients to innovative therapies and enhance the efficiency of clinical research.

  5. Accuracy of CT enterography and magnetic resonance enterography imaging to detect lesions preoperatively in patients undergoing surgery for Crohn's disease.

    Science.gov (United States)

    Seastedt, Kenneth P; Trencheva, Koiana; Michelassi, Fabrizio; Alsaleh, Doaa; Milsom, Jeffrey W; Sonoda, Toyooki; Lee, Sang W; Nandakumar, Govind

    2014-12-01

    CT enterography and magnetic resonance enterography have emerged as first-line imaging technologies for the evaluation of the gastrointestinal tract in Crohn's disease. The purpose of this work was to evaluate the accuracy of these imaging modalities to identify Crohn's disease lesions preoperatively. This was a retrospective chart review. The study was conducted at a single institution. Seventy-six patients with Crohn's disease with preoperative CT enterography and/or magnetic resonance enterography were included in the study. The number of stenoses, fistulas, and abscesses on CT enterography and/or magnetic resonance enterography before surgery were compared with operative findings. Forty patients (53%) were women, 46 (60%) underwent surgery for recurrent Crohn's disease, and 46 (57%) had previous abdominal surgery. Thirty-six (47%) had a preoperative CT enterography and 43 (57%) had a preoperative magnetic resonance enterography. CT enterography sensitivity was 75% for stenosis and 50% for fistula. MRE sensitivity was 68% for stenosis and 60% for fistula. The negative predictive values of CT enterography and magnetic resonance enterography for stenosis were very low (54% and 65%) and were 85% and 81% for fistula. CT enterography had 76% accuracy for stenosis and 79% for fistula; magnetic resonance enterography had 78% accuracy for stenosis and 85% for fistula. Both were accurate for abscess. False-negative rates for CT enterography were 50% for fistula and 25% for stenosis. False-negative rates for magnetic resonance enterography were 40% for fistula and 32% for stenosis. Unexpected intraoperative findings led to modification of the planned surgical procedure in 20 patients (26%). This study was limited by its small sample size, its retrospective nature, and that some studies were performed at outside institutions. CT enterography and magnetic resonance enterography in patients with Crohn's disease were accurate for the identification of abscesses but not for

  6. Diagnostic accuracy of point shear wave elastography in the detection of portal hypertension in pediatric patients.

    Science.gov (United States)

    Burak Özkan, M; Bilgici, M C; Eren, E; Caltepe, G

    2018-03-01

    The purpose of this study was to determine the usefulness of point shear wave elastography (p-SWE) of the liver and spleen for the detection of portal hypertension in pediatric patients. The study consisted of 38 healthy children and 56 pediatric patients with biopsy-proven liver disease who underwent splenic and liver p-SWE. The diagnostic performance of p-SWE in detecting clinically significant portal hypertension was assessed using receiver operating characteristic (ROC) curves. Reliable measurements of splenic and liver stiffness with p-SWE were obtained in 76/94 (81%) and 80/94 patients (85%), respectively. The splenic stiffness was highest in the portal hypertension group (Pportal hypertension was lower for splenic p-SWE than for liver p-SWE (0.906 vs. 0.746; P=0.0239). The cut-off value of splenic p-SWE for portal hypertension was 3.14m/s, with a specificity of 98.59% and a sensitivity of 68.18%. The cut-off value of liver p-SWE for portal hypertension was 2.09m/s, with a specificity of 80.28% and a sensitivity of 77.27%. In pediatric patients, p-SWE is a reliable method for detecting portal hypertension. However, splenic p-SWE is less accurate than liver p-SWE for the diagnosis of portal hypertension. Copyright © 2017 Editions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  7. Accuracy of circulating histones in predicting persistent organ failure and mortality in patients with acute pancreatitis.

    Science.gov (United States)

    Liu, T; Huang, W; Szatmary, P; Abrams, S T; Alhamdi, Y; Lin, Z; Greenhalf, W; Wang, G; Sutton, R; Toh, C H

    2017-08-01

    Early prediction of acute pancreatitis severity remains a challenge. Circulating levels of histones are raised early in mouse models and correlate with disease severity. It was hypothesized that circulating histones predict persistent organ failure in patients with acute pancreatitis. Consecutive patients with acute pancreatitis fulfilling inclusion criteria admitted to Royal Liverpool University Hospital were enrolled prospectively between June 2010 and March 2014. Blood samples were obtained within 48 h of abdominal pain onset and relevant clinical data during the hospital stay were collected. Healthy volunteers were enrolled as controls. The primary endpoint was occurrence of persistent organ failure. The predictive values of circulating histones, clinical scores and other biomarkers were determined. Among 236 patients with acute pancreatitis, there were 156 (66·1 per cent), 57 (24·2 per cent) and 23 (9·7 per cent) with mild, moderate and severe dise