SPIRIT advance care planning intervention in early stage dementias: An NIH stage I behavioral intervention development trial.

Science.gov (United States)

Song, Mi-Kyung; Ward, Sandra E; Hepburn, Kenneth; Paul, Sudeshna; Shah, Raj C; Morhardt, Darby J

2018-06-02

People in the early stages of Alzheimer's disease and related dementias (ADRD) are encouraged to engage in advance care planning (ACP) while they are still competent to appoint a surrogate decision maker and meaningfully participate in ACP discussions with the surrogate. In this NIH Stage I behavioral intervention development trial, we will adapt and test an efficacious ACP intervention, SPIRIT (Sharing Patient's Illness Representation to Increase Trust), with people with mild dementia and their surrogates to promote open, honest discussions while such discussions about end-of-life care are possible. We will first adapt SPIRIT (in person) to target people with mild dementia and their surrogates through a process of modification-pretesting-refinement using stakeholders (persons with mild dementia, family caregivers, and clinicians) and experts, including adapting the delivery mode to interactive web-based videoconference format (SPIRIT-remote). Then in a 3-group RCT with 120 patient-surrogate dyads, we will evaluate the feasibility and acceptability of SPIRIT in-person and SPIRIT remote, and preliminary efficacy of SPIRIT compared to usual care on preparedness outcomes for end-of-life decision making (dyad congruence on goals of care, patient decisional conflict, and surrogate decision-making confidence) shortly after the intervention. This Stage I research of SPIRIT will generate valuable insights regarding how to improve ACP for people with mild dementia who will progress to an advanced stage of the disease in the foreseeable future. ClinicalTrials.gov NCT03311711, Registered 10/12/2017. Copyright © 2018. Published by Elsevier Inc.

Planning Costs in Certain Stage of the Life Cycle of Investment Activity of Construction Organization

OpenAIRE

Iakymchuk Iryna M.

2017-01-01

The article discusses the issues related to planning costs in certain stages of the life-cycle of investment activity of construction organization. It has been specified that cost management based on the life-cycle model of the investment project, which is being implemented by a construction organization, allows for a consistent improvement in the efficiency of the innovation process on the basis of a clear planning, as well as cost forecasting. This approach allows for the long-term effectiv...

Radiation Therapy Planning for Early-Stage Hodgkin Lymphoma: Experience of the International Lymphoma Radiation Oncology Group

International Nuclear Information System (INIS)

Maraldo, Maja V.; Dabaja, Bouthaina S.; Filippi, Andrea R.; Illidge, Tim; Tsang, Richard; Ricardi, Umberto; Petersen, Peter M.; Schut, Deborah A.; Garcia, John; Headley, Jayne; Parent, Amy; Guibord, Benoit; Ragona, Riccardo; Specht, Lena

2015-01-01

Purpose: Early-stage Hodgkin lymphoma (HL) is a rare disease, and the location of lymphoma varies considerably between patients. Here, we evaluate the variability of radiation therapy (RT) plans among 5 International Lymphoma Radiation Oncology Group (ILROG) centers with regard to beam arrangements, planning parameters, and estimated doses to the critical organs at risk (OARs). Methods: Ten patients with stage I-II classic HL with masses of different sizes and locations were selected. On the basis of the clinical information, 5 ILROG centers were asked to create RT plans to a prescribed dose of 30.6 Gy. A postchemotherapy computed tomography scan with precontoured clinical target volume (CTV) and OARs was provided for each patient. The treatment technique and planning methods were chosen according to each center's best practice in 2013. Results: Seven patients had mediastinal disease, 2 had axillary disease, and 1 had disease in the neck only. The median age at diagnosis was 34 years (range, 21-74 years), and 5 patients were male. Of the resulting 50 treatment plans, 15 were planned with volumetric modulated arc therapy (1-4 arcs), 16 with intensity modulated RT (3-9 fields), and 19 with 3-dimensional conformal RT (2-4 fields). The variations in CTV-to-planning target volume margins (5-15 mm), maximum tolerated dose (31.4-40 Gy), and plan conformity (conformity index 0-3.6) were significant. However, estimated doses to OARs were comparable between centers for each patient. Conclusions: RT planning for HL is challenging because of the heterogeneity in size and location of disease and, additionally, to the variation in choice of treatment techniques and field arrangements. Adopting ILROG guidelines and implementing universal dose objectives could further standardize treatment techniques and contribute to lowering the dose to the surrounding OARs

Automated Volumetric Modulated Arc Therapy Treatment Planning for Stage III Lung Cancer: How Does It Compare With Intensity-Modulated Radio Therapy?

Energy Technology Data Exchange (ETDEWEB)

Quan, Enzhuo M. [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chang, Joe Y.; Liao Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Xia Tingyi [Department of Radiation Oncology, Beijing 301 Hospital, Beijing (China); Yuan Zhiyong [Department of Radiation Oncology, Tianjin Medical University Cancer Hospital and Institute, Tianjin (China); Liu Hui [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, Zhongshan University Hospital, Guangzhou (China); Li, Xiaoqiang; Wages, Cody A.; Mohan, Radhe [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zhang Xiaodong, E-mail: xizhang@mdanderson.org [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

2012-09-01

Purpose: To compare the quality of volumetric modulated arc therapy (VMAT) or intensity-modulated radiation therapy (IMRT) plans generated by an automated inverse planning system with that of dosimetrist-generated IMRT treatment plans for patients with stage III lung cancer. Methods and Materials: Two groups of 8 patients with stage III lung cancer were randomly selected. For group 1, the dosimetrists spent their best effort in designing IMRT plans to compete with the automated inverse planning system (mdaccAutoPlan); for group 2, the dosimetrists were not in competition and spent their regular effort. Five experienced radiation oncologists independently blind-reviewed and ranked the three plans for each patient: a rank of 1 was the best and 3 was the worst. Dosimetric measures were also performed to quantitatively evaluate the three types of plans. Results: Blind rankings from different oncologists were generally consistent. For group 1, the auto-VMAT, auto-IMRT, and manual IMRT plans received average ranks of 1.6, 2.13, and 2.18, respectively. The auto-VMAT plans in group 1 had 10% higher planning tumor volume (PTV) conformality and 24% lower esophagus V70 (the volume receiving 70 Gy or more) than the manual IMRT plans; they also resulted in more than 20% higher complication-free tumor control probability (P+) than either type of IMRT plans. The auto- and manual IMRT plans in this group yielded generally comparable dosimetric measures. For group 2, the auto-VMAT, auto-IMRT, and manual IMRT plans received average ranks of 1.55, 1.75, and 2.75, respectively. Compared to the manual IMRT plans in this group, the auto-VMAT plans and auto-IMRT plans showed, respectively, 17% and 14% higher PTV dose conformality, 8% and 17% lower mean lung dose, 17% and 26% lower mean heart dose, and 36% and 23% higher P+. Conclusions: mdaccAutoPlan is capable of generating high-quality VMAT and IMRT treatment plans for stage III lung cancer. Manual IMRT plans could achieve quality

Automated Volumetric Modulated Arc Therapy Treatment Planning for Stage III Lung Cancer: How Does It Compare With Intensity-Modulated Radio Therapy?

International Nuclear Information System (INIS)

Quan, Enzhuo M.; Chang, Joe Y.; Liao Zhongxing; Xia Tingyi; Yuan Zhiyong; Liu Hui; Li, Xiaoqiang; Wages, Cody A.; Mohan, Radhe; Zhang Xiaodong

2012-01-01

Purpose: To compare the quality of volumetric modulated arc therapy (VMAT) or intensity-modulated radiation therapy (IMRT) plans generated by an automated inverse planning system with that of dosimetrist-generated IMRT treatment plans for patients with stage III lung cancer. Methods and Materials: Two groups of 8 patients with stage III lung cancer were randomly selected. For group 1, the dosimetrists spent their best effort in designing IMRT plans to compete with the automated inverse planning system (mdaccAutoPlan); for group 2, the dosimetrists were not in competition and spent their regular effort. Five experienced radiation oncologists independently blind-reviewed and ranked the three plans for each patient: a rank of 1 was the best and 3 was the worst. Dosimetric measures were also performed to quantitatively evaluate the three types of plans. Results: Blind rankings from different oncologists were generally consistent. For group 1, the auto-VMAT, auto-IMRT, and manual IMRT plans received average ranks of 1.6, 2.13, and 2.18, respectively. The auto-VMAT plans in group 1 had 10% higher planning tumor volume (PTV) conformality and 24% lower esophagus V70 (the volume receiving 70 Gy or more) than the manual IMRT plans; they also resulted in more than 20% higher complication-free tumor control probability (P+) than either type of IMRT plans. The auto- and manual IMRT plans in this group yielded generally comparable dosimetric measures. For group 2, the auto-VMAT, auto-IMRT, and manual IMRT plans received average ranks of 1.55, 1.75, and 2.75, respectively. Compared to the manual IMRT plans in this group, the auto-VMAT plans and auto-IMRT plans showed, respectively, 17% and 14% higher PTV dose conformality, 8% and 17% lower mean lung dose, 17% and 26% lower mean heart dose, and 36% and 23% higher P+. Conclusions: mdaccAutoPlan is capable of generating high-quality VMAT and IMRT treatment plans for stage III lung cancer. Manual IMRT plans could achieve quality

Stormwater Pollution Prevention Plan TA-60 Roads and Grounds Facility and Associated Sigma Mesa Staging Area

Energy Technology Data Exchange (ETDEWEB)

Sandoval, Leonard Frank [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-02-01

This Stormwater Pollution Prevention Plan (SWPPP) is applicable to operations at the Technical Area -60 (TA-60) Roads and Grounds Facility and Associated Sigma Mesa Staging Area off Eniwetok Drive, in Los Alamos County, New Mexico.

Planning Costs in Certain Stage of the Life Cycle of Investment Activity of Construction Organization

Directory of Open Access Journals (Sweden)

Iakymchuk Iryna M.

2017-09-01

Full Text Available The article discusses the issues related to planning costs in certain stages of the life-cycle of investment activity of construction organization. It has been specified that cost management based on the life-cycle model of the investment project, which is being implemented by a construction organization, allows for a consistent improvement in the efficiency of the innovation process on the basis of a clear planning, as well as cost forecasting. This approach allows for the long-term effectiveness of innovation project by providing cost-management services at all stages of investment project, identifying opportunities for reducing them, thereby contributing to sustainable development of construction organization over time. It has been concluded that the more specific the program of activities of construction organization, the more accurate the process of identification of costs becomes, the more efficient is the management of costs, targeted at saving resources, reducing the self cost of construction works.

An unit cost adjusting heuristic algorithm for the integrated planning and scheduling of a two-stage supply chain

Directory of Open Access Journals (Sweden)

Jianhua Wang

2014-10-01

Full Text Available Purpose: The stable relationship of one-supplier-one-customer is replaced by a dynamic relationship of multi-supplier-multi-customer in current market gradually, and efficient scheduling techniques are important tools of the dynamic supply chain relationship establishing process. This paper studies the optimization of the integrated planning and scheduling problem of a two-stage supply chain with multiple manufacturers and multiple retailers to obtain a minimum supply chain operating cost, whose manufacturers have different production capacities, holding and producing cost rates, transportation costs to retailers.Design/methodology/approach: As a complex task allocation and scheduling problem, this paper sets up an INLP model for it and designs a Unit Cost Adjusting (UCA heuristic algorithm that adjust the suppliers’ supplying quantity according to their unit costs step by step to solve the model.Findings: Relying on the contrasting analysis between the UCA and the Lingo solvers for optimizing many numerical experiments, results show that the INLP model and the UCA algorithm can obtain its near optimal solution of the two-stage supply chain’s planning and scheduling problem within very short CPU time.Research limitations/implications: The proposed UCA heuristic can easily help managers to optimizing the two-stage supply chain scheduling problems which doesn’t include the delivery time and batch of orders. For two-stage supply chains are the most common form of actual commercial relationships, so to make some modification and study on the UCA heuristic should be able to optimize the integrated planning and scheduling problems of a supply chain with more reality constraints.Originality/value: This research proposes an innovative UCA heuristic for optimizing the integrated planning and scheduling problem of two-stage supply chains with the constraints of suppliers’ production capacity and the orders’ delivering time, and has a great

SU-F-T-356: DosimetricComparison of VMAT Vs Step and Shoot IMRT Plans for Stage III Lung CancerPatients with Mediastinal Involvement

Energy Technology Data Exchange (ETDEWEB)

Pearson, D; Bogue, J [University of Toledo, Toledo, OH (United States)

2016-06-15

Purpose: For Stage III lung cancers that entail treatment of some or all of the mediastinum, anterior-posterior focused Step and Shoot IMRT (SS-IMRT) and VMAT plans have been clinically used to deliver the prescribed dose while working to minimize lung dose and avoid other critical structures. A comparison between the two planning methods was completed to see which treatment method is superior and minimizes dose to healthy lung tissue. Methods: Ten patients who were recently treated with SS-IMRT or VMAT plans for Stage III lung cancer with mediastinal involvement were selected. All patients received a simulation CT for treatment planning, as well as a 4D CT and PET/CT fusion for target delineation. Plans were prescribed 6250 cGy in 25 fractions and normalized such that 100% of the prescription dose covered 95% of the PTV. Clinically approved SS-IMRT or VMAT plans were then copied and planned using the alternative modality with identical optimization criteria. SS-IMRT plans utilized seven to nine beams distributed around the patient while the VMAT plans consisted of two full 360 degree arcs. Plans were compared for the lung volume receiving 20 Gy (V20). Results: Both SS-IMRT and VMAT can be used to achieve clinical treatment plans for patients with Stage III Lung cancer with targets encompassing the mediastinum. VMAT plans produced an average V20 of 23.0+/−8.3% and SS-IMRT produced an average of 24.2+/−10.0%. Conclusion: Results indicate that either method can achieve comparable dose distributions, however, VMAT can allow the optimizer to distribute dose over paths of minimal lung tissue and reduce the V20. Therefore, creating a VMAT with constraints identical to an SS-IMRT plan could help to reduce the V20 in clinical treatment plans.

SU-F-T-356: DosimetricComparison of VMAT Vs Step and Shoot IMRT Plans for Stage III Lung CancerPatients with Mediastinal Involvement

International Nuclear Information System (INIS)

Pearson, D; Bogue, J

2016-01-01

Purpose: For Stage III lung cancers that entail treatment of some or all of the mediastinum, anterior-posterior focused Step and Shoot IMRT (SS-IMRT) and VMAT plans have been clinically used to deliver the prescribed dose while working to minimize lung dose and avoid other critical structures. A comparison between the two planning methods was completed to see which treatment method is superior and minimizes dose to healthy lung tissue. Methods: Ten patients who were recently treated with SS-IMRT or VMAT plans for Stage III lung cancer with mediastinal involvement were selected. All patients received a simulation CT for treatment planning, as well as a 4D CT and PET/CT fusion for target delineation. Plans were prescribed 6250 cGy in 25 fractions and normalized such that 100% of the prescription dose covered 95% of the PTV. Clinically approved SS-IMRT or VMAT plans were then copied and planned using the alternative modality with identical optimization criteria. SS-IMRT plans utilized seven to nine beams distributed around the patient while the VMAT plans consisted of two full 360 degree arcs. Plans were compared for the lung volume receiving 20 Gy (V20). Results: Both SS-IMRT and VMAT can be used to achieve clinical treatment plans for patients with Stage III Lung cancer with targets encompassing the mediastinum. VMAT plans produced an average V20 of 23.0+/−8.3% and SS-IMRT produced an average of 24.2+/−10.0%. Conclusion: Results indicate that either method can achieve comparable dose distributions, however, VMAT can allow the optimizer to distribute dose over paths of minimal lung tissue and reduce the V20. Therefore, creating a VMAT with constraints identical to an SS-IMRT plan could help to reduce the V20 in clinical treatment plans.

Optimizing the Steel Plate Storage Yard Crane Scheduling Problem Using a Two Stage Planning/Scheduling Approach

DEFF Research Database (Denmark)

Hansen, Anders Dohn; Clausen, Jens

This paper presents the Steel Plate Storage Yard Crane Scheduling Problem. The task is to generate a schedule for two gantry cranes sharing tracks. The schedule must comply with a number of constraints and at the same time be cost efficient. We propose some ideas for a two stage planning...

A two-stage optimal planning and design method for combined cooling, heat and power microgrid system

International Nuclear Information System (INIS)

Guo, Li; Liu, Wenjian; Cai, Jiejin; Hong, Bowen; Wang, Chengshan

2013-01-01

Highlights: • A two-stage optimal method is presented for CCHP microgrid system. • Economic and environmental performance are considered as assessment indicators. • Application case demonstrates its good economic and environmental performance. - Abstract: In this paper, a two-stage optimal planning and design method for combined cooling, heat and power (CCHP) microgrid system was presented. The optimal objective was to simultaneously minimize the total net present cost and carbon dioxide emission in life circle. On the first stage, multi-objective genetic algorithm based on non-dominated sorting genetic algorithm-II (NSGA-II) was applied to solve the optimal design problem including the optimization of equipment type and capacity. On the second stage, mixed-integer linear programming (MILP) algorithm was used to solve the optimal dispatch problem. The approach was applied to a typical CCHP microgrid system in a hospital as a case study, and the effectiveness of the proposed method was verified

Personal and socio-psychological characteristics of women of reproductive age, operated on for symptomatic endometriod desease, at the stage of pregnancy planning

Directory of Open Access Journals (Sweden)

T. P. Chuieva-Pavlovska

2017-10-01

Full Text Available Endometrioid disease occurs in every tenth woman of reproductive age and often leads not only to physical discomfort, but also frustrates them psychosocially, reduces professional, psychosocial and reproductive adaptation in general. The aim: to reveal the personal and psychosocial characteristics of women at the stage of pregnancy planning, operated on for symptomatic endometriosis, in connection with the task of optimizing the management and improvement of pregnancy outcomes. Material and methods. Under observation, there were 123 women operated on for symptomatic endometriosis, 125 somatically and gynecologically conditionally healthy fertile women. All the women were going to plan a pregnancy. The diagnosis of endometriosis in all cases was identified histologically. The psychosocial and personal characteristics of these women at the stage of pregnancy planning were studied. Conclusions.  The peculiarities of the personal and psychosocial characteristics of women at the stage of pregnancy planning, operated on for symptomatic endometriosis, are unfavorable child-parent relations, destructive relationships with their own mother, complicated course of pregnancy in the mother, high personal anxiety, impaired sex and age identification in women, inadequate (infantile, disadaptive forms of responding to stressful situations, emotional instability.

Effect of stage development of mining operations on maximization the net present value in long-term planning of open pits

OpenAIRE

Kržanović, Daniel; Rajković, Radmilo; Mikić, Miomir; Ljubojev, Milenko

2014-01-01

Long-term planning in the mining industry has one main goal: maximizing the value that is realized by excavation and processing of mineral resources. When designing the open pits, determining the stages of development the mining operations, (eng. Pushback) is one of the important factors in the process of long-term production planning. Using the different scientific methods and mathematical algorithms underlying the operation of modern software for strategic planning of production, it is poss...

The economics of planning electricity transmission to accommodate renewables: Using two-stage optimisation to evaluate flexibility and the cost of disregarding uncertainty

International Nuclear Information System (INIS)

Weijde, Adriaan Hendrik van der; Hobbs, Benjamin F.

2012-01-01

Aggressive development of renewable electricity sources will require significant expansions in transmission infrastructure. We present a stochastic two-stage optimisation model that captures the multistage nature of transmission planning under uncertainty and use it to evaluate interregional grid reinforcements in Great Britain (GB). In our model, a proactive transmission planner makes investment decisions in two time periods, each time followed by a market response. Uncertainty is represented by economic, technology, and regulatory scenarios, and first-stage investments must be made before it is known which scenario will occur. The model allows us to identify expected cost-minimising first-stage investments, as well as estimate the value of information, the cost of ignoring uncertainty, and the value of flexibility. Our results show that ignoring risk in planning transmission for renewables has quantifiable economic consequences, and that considering uncertainty can yield decisions that have lower expected costs than traditional deterministic planning methods. In the GB case, the value of information and cost of disregarding uncertainty in transmission planning were of the same order of magnitude (approximately £100 M, in present worth terms). Further, the best plan under a risk-neutral decision criterion can differ from the best under risk-aversion. Finally, a traditional sensitivity analysis-based robustness analysis also yields different results than the stochastic model, although the former's expected cost is not much higher.

A Decade of Comparative Dose Planning Studies for Early-Stage Hodgkin Lymphoma: What Can We Learn?

Energy Technology Data Exchange (ETDEWEB)

Maraldo, Maja V., E-mail: dra.maraldo@gmail.com [Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Specht, Lena [Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Department of Hematology, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark)

2014-12-01

During the past 4 decades, the treatment of Hodgkin lymphoma has changed dramatically, and combined modality treatment is now considered the standard of care for patients with early-stage disease. However, the risk of late effects has led to concerns regarding the use of radiation therapy, especially in young patients with a long life expectancy. In this study, we review the current evidence for modern radiation therapy planning and delivery techniques in the treatment of early-stage Hodgkin lymphoma with a focus on a reduced delivered dose, a reduced irradiated volume, and a more conformal dose distribution. Although studies are difficult to compare because of differences in field technique, prescribed dose, target volumes, patient population, and reported dosimetric and plan evaluation parameters, modern radiation therapy significantly reduces exposure to normal tissues and thereby the estimated risk of late effects. However, there is no such thing as a single best modern delivery technique when multiple organs at risk are considered simultaneously because of the heterogeneity in patient anatomy and disease location, and the choice of radiation therapy technique should be made individually for each patient.

An inexact two-stage stochastic energy systems planning model for managing greenhouse gas emission at a municipal level

International Nuclear Information System (INIS)

Lin, Q.G.; Huang, G.H.

2010-01-01

Energy management systems are highly complicated with greenhouse-gas emission reduction issues and a variety of social, economic, political, environmental and technical factors. To address such complexities, municipal energy systems planning models are desired as they can take account of these factors and their interactions within municipal energy management systems. This research is to develop an interval-parameter two-stage stochastic municipal energy systems planning model (ITS-MEM) for supporting decisions of energy systems planning and GHG (greenhouse gases) emission management at a municipal level. ITS-MEM is then applied to a case study. The results indicated that the developed model was capable of supporting municipal energy systems planning and environmental management under uncertainty. Solutions of ITS-MEM would provide an effective linkage between the pre-regulated environmental policies (GHG-emission reduction targets) and the associated economic implications (GHG-emission credit trading).

MRI or CT for pretreatment staging and radiotherapy planning for radiochemotherapy in distal rectal cancer. Radiologists point

International Nuclear Information System (INIS)

Vloka, M.; Kirkova, G.

2013-01-01

Full text: Introduction: In the recent years, the therapeutic approach to rectal cancer changed dramatically. Implementation of a common mesorectal excision and preoperative radiotherapy has become a standard procedure. Noninvasive imaging methods have become basic and leading methods in the process of pre-therapy staging and rectal cancer radiotherapy planning. What you will learn : Following the recommendations of the 2013 ESGAR EURECCA 2012 we will present: a comparative data about the place and role of MRI and CT in the algorithm for low rectal carcinoma staging ; a standard MRI protocol for low rectum carcinoma staging as well as the questions concerning the image interpretation that the radiologist needs to answer. Discussion : Based on the European rules and consensus in the standard protocols implementation of in conducting MRI in rectal cancer, we have the opportunity for preoperative staging of the tumor and hence for proper treatment. The high spatial and tissue resolution of MRI allows carcinoma’s visualization at the depth infiltration of the wall of rectum, distance from mesorectal fascia, involvement of anorectal sphincter, pelvic floor and adjacent bodies, involvement of the venous plexus and the metastatic pararectal lymph nodes presence. Additional performed lung, abdomen and pelvis CT (MDCT) has limited chance for tumor staging, but it serves for distant metastases detection. Conclusion: MRI is the main method for T and N staging and re-staging of low carcinoma of the rectum. MDCT is used for determination of the N stages of the disease

Stages of Change or Changes of Stage? Predicting Transitions in Transtheoretical Model Stages in Relation to Healthy Food Choice

Science.gov (United States)

Armitage, Christopher J.; Sheeran, Paschal; Conner, Mark; Arden, Madelynne A.

2004-01-01

Relatively little research has examined factors that account for transitions between transtheoretical model (TTM) stages of change. The present study (N=787) used sociodemographic, TTM, and theory of planned behavior (TPB) variables, as well as theory-driven interventions to predict changes in stage. Longitudinal analyses revealed that…

A planning comparison of 7 irradiation options allowed in RTOG 1005 for early-stage breast cancer

Energy Technology Data Exchange (ETDEWEB)

Chen, Guang-Pei, E-mail: gpchen@mcw.edu [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Liu, Feng [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); White, Julia [Department of Radiation Oncology, The Ohio State University, Columbus, OH (United States); Vicini, Frank A. [Michigan Healthcare Professionals/21st Century Oncology, Farmington Hills, MI (United States); Freedman, Gary M. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Arthur, Douglas W. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA (United States); Li, X. Allen [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States)

2015-04-01

This study compared the 7 treatment plan options in achieving the dose-volume criteria required by the Radiation Therapy Oncology Group (RTOG) 1005 protocol. Dosimetry plans were generated for 15 representative patients with early-stage breast cancer (ESBC) based on the protocol-required dose-volume criteria for each of the following 7 treatment options: 3D conformal radiotherapy (3DCRT), whole-breast irradiation (WBI) plus 3DCRT lumpectomy boost, 3DCRT WBI plus electron boost, 3DCRT WBI plus intensity-modulated radiation therapy (IMRT) boost, IMRT WBI plus 3DCRT boost, IMRT WBI plus electron boost, IMRT WBI plus IMRT boost, and simultaneous integrated boost (SIB) with IMRT. A variety of dose-volume parameters, including target dose conformity and uniformity and normal tissue sparing, were compared for these plans. For the patients studied, all plans met the required acceptable dose-volume criteria, with most of them meeting the ideal criteria. When averaged over patients, most dose-volume goals for all plan options can be achieved with a positive gap of at least a few tenths of standard deviations. The plans for all 7 options are generally comparable. The dose-volume goals required by the protocol can in general be easily achieved. IMRT WBI provides better whole-breast dose uniformity than 3DCRT WBI does, but it causes no significant difference for the dose conformity. All plan options are comparable for lumpectomy dose uniformity and conformity. Patient anatomy is always an important factor when whole-breast dose uniformity and conformity and lumpectomy dose conformity are considered.

Wind turbines and transmission systems for offshore wind projects in planning stage

Energy Technology Data Exchange (ETDEWEB)

Madariaga, Ander; Martin, Jose Luis; Martinez de Alegria, Inigo; Zamora, Inmaculada [University of the Basque Country (UPV/EHU), Bilbao (Spain). Engineering Faculty; Ceballos, Salvador [Parque Tecnologico de Bizkaia, Derio (Spain). Tecnalia Research and Innovation

2012-07-01

This paper reviews the current situation of the offshore wind turbines (OWTs) and the transmission systems (TSs) for offshore wind projects in the planning stage. Bearing in mind that offshore wind projects can last between seven and ten years from the first environmental studies to the commissioning, research engineers from companies and academia consider the solutions already available, but also to the new proposals expected to be ready in time for the project under consideration. Regarding the wind energy conversion systems (WECSs) installed in the OWTs, their main characteristics are reviewed considering turbines in the 4.1 to 10.0 MW range. Regarding the TSs, the current situation of point-to-point HVAC and HVDC links is presented, as well as some ideas related to future DC grids currently under study. (orig.)

Planning benchmark study for SBRT of early stage NSCLC. Results of the DEGRO Working Group Stereotactic Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Moustakis, Christos [University Muenster, Department of Radiation Oncology, Muenster (Germany); German CyberKnife Center, Soest (Germany); Blanck, Oliver [UKSH Universitaetsklinikum Schleswig Holstein, Department of Radiation Oncology, Kiel (Germany); Saphir Radiosurgery Center, Guestrow and Frankfurt, Frankfurt (Germany); Ebrahimi Tazehmahalleh, Fatemeh [University Muenster, Department of Radiation Oncology, Muenster (Germany); City Hospital Dessau, Dessau (Germany); Chan, Mark ka heng [UKSH Universitaetsklinikum Schleswig Holstein, Department of Radiation Oncology, Kiel (Germany); Ernst, Iris; Haverkamp, Uwe; Eich, Hans Theodor [University Muenster, Department of Radiation Oncology, Muenster (Germany); German CyberKnife Center, Soest (Germany); Krieger, Thomas [University of Wuerzburg, Department of Radiation Oncology, Wuerzburg (Germany); Duma, Marciana-Nona; Oechsner, Markus [Technical University of Munich, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Ganswindt, Ute; Heinz, Christian [Ludwig-Maximilians-University, Department of Radiation Oncology, Munich (Germany); Alheit, Horst; Blank, Hilbert [Radiationtherapy Distler, Bautzen (Germany); Nestle, Ursula; Wiehle, Rolf [University Medical Center Freiburg, Department of Radiation Oncology, Freiburg (Germany); Kornhuber, Christine; Ostheimer, Christian [University Halle, Department of Radiation Oncology, Halle (Germany); Petersen, Cordula [University Hospital Hamburg-Eppendorf, Hamburg (Germany); Pollul, Gerhard [University Mainz, Department of Radiation Oncology, Mainz (Germany); Baus, Wolfgang; Altenstein, Georg [University Hospital of Cologne, Cologne (Germany); Beckers, Eric; Jurianz, Katrin [Gamma Knife Center Krefeld, Krefeld (Germany); Sterzing, Florian [University Hospital Heidelberg, Heidelberg (Germany); Kretschmer, Matthias [Radiologische Allianz Hamburg, Hamburg (Germany); Seegenschmiedt, Heinrich; Maass, Torsten [Radiationtherapy and Cyberknife Center Hamburg, Hamburg (Germany); Droege, Stefan [Lung Clinic Hemer, Hemer (Germany); Wolf, Ulrich [University Leipzig, Department of Radiation Oncology, Leipzig (Germany); Schoeffler, Juergen [Radiationtherapy Department Boeblingen, Boeblingen (Germany); Guckenberger, Matthias [University Zurich, Department of Radiation Oncology, Zurich (Switzerland)

2017-10-15

The aim was to evaluate stereotactic body radiation therapy (SBRT) treatment planning variability for early stage nonsmall cell lung cancer (NSCLC) with respect to the published guidelines of the Stereotactic Radiotherapy Working Group of the German Society for Radiation Oncology (DEGRO). Planning computed tomography (CT) scan and the structure sets (planning target volume, PTV; organs at risk, OARs) of 3 patients with early stage NSCLC were sent to 22 radiotherapy departments with SBRT experience: each department was asked to prepare a treatment plan according to the DEGRO guidelines. The prescription dose was 3 fractions of 15 Gy to the 65% isodose. In all, 87 plans were generated: 36 used intensity-modulated arc therapy (IMAT), 21 used three-dimensional conformal radiation therapy (3DCRT), 6 used static field intensity-modulated radiation therapy (SF-IMRT), 9 used helical radiotherapy and 15 used robotic radiosurgery. PTV dose coverage and simultaneously kept OARs doses were within the clinical limits published in the DEGRO guidelines. However, mean PTV dose (mean 58.0 Gy, range 52.8-66.4 Gy) and dose conformity indices (mean 0.75, range 0.60-1.00) varied between institutions and techniques (p ≤ 0.02). OARs doses varied substantially between institutions, but appeared to be technique independent (p = 0.21). All studied treatment techniques are well suited for SBRT of early stage NSCLC according to the DEGRO guidelines. Homogenization of SBRT practice in Germany is possible through the guidelines; however, detailed treatment plan characteristics varied between techniques and institutions and further homogenization is warranted in future studies and recommendations. Optimized treatment planning should always follow the ALARA (as low as reasonably achievable) principle. (orig.) [German] Ziel war die Untersuchung der Variabilitaet der Bestrahlungsplanung der stereotaktischen Strahlentherapie (SBRT) fuer das nicht-kleinzellige Bronchialkarzinom (NSCLC) im

Theory of Economic Development (Secondary Stage)

OpenAIRE

Mashkoor, Aasim; Ahmed, Ovais

2015-01-01

This is a secondary stage of theory of economic development. This research study is covering the secondary phase of development which rules the tactical plans of the main strategy. In this stage, the social and economical demands varies from country to country and we have developed the theory according to the Pakistani economic conditions. It requires great a lot of technical and strategic analysis to chose the accurate plans accordingly.

Master-slave control with trajectory planning and Bouc-Wen model for tracking control of piezo-driven stage

Science.gov (United States)

Lu, Xiaojun; Liu, Changli; Chen, Lei

2018-04-01

In this paper, a redundant Piezo-driven stage having 3RRR compliant mechanism is introduced, we propose the master-slave control with trajectory planning (MSCTP) strategy and Bouc-Wen model to improve its micro-motion tracking performance. The advantage of the proposed controller lies in that its implementation only requires a simple control strategy without the complexity of modeling to avoid the master PEA's tracking error. The dynamic model of slave PEA system with Bouc-Wen hysteresis is established and identified via particle swarm optimization (PSO) approach. The Piezo-driven stage with operating period T=1s and 2s is implemented to track a prescribed circle. The simulation results show that MSCTP with Bouc-Wen model reduces the trajectory tracking errors to the range of the accuracy of our available measurement.

Prevention and control of proliferative vitreoretinopathy: primary retinal detachment surgery using silicone oil as a planned two-stage procedure in high-risk cases.

Science.gov (United States)

Alexander, P; Prasad, R; Ang, A; Poulson, A V; Scott, J D; Snead, M P

2008-06-01

For rhegmatogenous retinal detachment, reattachment with a single procedure is associated with better visual outcomes. In the past, silicone oil has been used mostly as a last resort following failed primary surgery. This study evaluates a novel approach to patients at high risk of primary failure, using silicone tamponade as the primary stage of a planned two-stage procedure. We report a series of 140 eyes that underwent primary surgery for rhegmatogenous retinal detachment. Patients at higher risk of surgical failure (eg giant retinal tear, inability to posture, poor view, uncertainty of location of primary break, primary proliferative vitreoretinopathy (PVR), multiple tears with rolled posterior edges, retinoschisis/detachment, staphyloma with macular hole) were managed by a planned staged procedure using primary silicone oil tamponade. This was followed by silicone removal at a later date. Fifty-four eyes underwent scleral buckling alone, with primary success in 52/54 (96%). Fifty-three eyes underwent vitrectomy and gas, achieving primary success in 50/53 (94%). Thirty-three eyes were classified high risk and managed with primary silicone. Silicone was safely removed in 22/25. In eight eyes, silicone was retained without attempt at removal. In total, primary retinal reattachment was achieved in 128 of 140 eyes (91.4%). Of these, 124 (97%) did not require long-term tamponade. Only four eyes (2.9%) developed PVR. A planned two-stage approach to highrisk cases of retinal detachment using primary silicone oil tamponade followed by silicone removal can achieve a high primary reattachment rate with less than 3% incidence of PVR.

Incremental clinical value of a dedicated RT planning FDG PET-CT over staging PET-CT in non-small cell lung cancer

International Nuclear Information System (INIS)

Lin, P.; Som, S.; Vinod, S.; Lin, M.; Shon, I. H.

2009-01-01

Full text:Objectives: To evaluate whether FDG-PET performed for radiotherapy planning can detect disease progression, compared with staging PET. Methods: Thirteen patients underwent a planning PET-CT for curative RT ( R T-PET ) within eight weeks of a staging PET-CT for newly diagnosed NSCLC between 10/2007 and 1/2009. All studies were acquired on a Philips GXL PET-CT using the same protocols, except RT-PET is acquired on a RT flat bed. The images were interpreted by consensus readings of two physicians: location/number, visual grading (0-4:3> liver, 4>brain), max transverse diameter ( M ax D ) (tumour margin is delineated by a SUV threshold of 2.5) and max SUV of each lesion. Progressive disease (PD) is defined as >10% increase in max D. Results: RT-PET detected PD (primary or nodal) or new metastases in 8 pts (61%) (mean interval:30.2±14 days, range:7-54 days). For primary tumour, RT-PET detected PD in 5

Strategies for automatic online treatment plan reoptimization using clinical treatment planning system: A planning parameters study

International Nuclear Information System (INIS)

Li, Taoran; Wu, Qiuwen; Zhang, You; Vergalasova, Irina; Lee, W. Robert; Yin, Fang-Fang; Wu, Q. Jackie

2013-01-01

Purpose: Adaptive radiation therapy for prostate cancer using online reoptimization provides an improved control of interfractional anatomy variations. However, the clinical implementation of online reoptimization is currently limited by the low efficiency of current strategies and the difficulties associated with integration into the current treatment planning system. This study investigates the strategies for performing fast (∼2 min) automatic online reoptimization with a clinical fluence-map-based treatment planning system; and explores the performance with different input parameters settings: dose-volume histogram (DVH) objective settings, starting stage, and iteration number (in the context of real time planning).Methods: Simulated treatments of 10 patients were reoptimized daily for the first week of treatment (5 fractions) using 12 different combinations of optimization strategies. Options for objective settings included guideline-based RTOG objectives, patient-specific objectives based on anatomy on the planning CT, and daily-CBCT anatomy-based objectives adapted from planning CT objectives. Options for starting stages involved starting reoptimization with and without the original plan's fluence map. Options for iteration numbers were 50 and 100. The adapted plans were then analyzed by statistical modeling, and compared both in terms of dosimetry and delivery efficiency.Results: All online reoptimized plans were finished within ∼2 min with excellent coverage and conformity to the daily target. The three input parameters, i.e., DVH objectives, starting stage, and iteration number, contributed to the outcome of optimization nearly independently. Patient-specific objectives generally provided better OAR sparing compared to guideline-based objectives. The benefit in high-dose sparing from incorporating daily anatomy into objective settings was positively correlated with the relative change in OAR volumes from planning CT to daily CBCT. The use of the

Study of the Model of Activating Contingency Plans within Disruptive Incidents by Stages%突发事件下分阶段启动应急预案模型研究

Institute of Scientific and Technical Information of China (English)

于辉; 江智慧

2011-01-01

经前期处置下,研究管理者面对突发事件应该何时启动前期处置方案和应急预案的问题.在完全没有突发事件持续时阎信息的条件下,利用局内决策理论与方法构建了企业何时启动前期处置方案和应急预案的分阶段启动模型,并利用"竞争比"说明该方案的有效性.在此基础上,进一步通过数值分析表明分阶段启动应急预案的重要意义.%The increased number of natural disasters has disrupted social and economic progress. Minimizing the impact of these disasters can bring stability to society. Emergency response systems have played an important role in achieving this goal. Since the "SARS" crisis in the year 2003, China has begun to focus on building emergency response systems. A national contingency plan system was established in 2004 according to the "Classification" rule. China initially formed a main emergency plan system,constituted by national overall emergency response plans, specific contingency plans, department emergency plans, local emergency plans, and contingency plans for enterprises with large-scale activities.Existing literature has focused on the importance of contingency plans, the assessment of contingency plans, and approaches to improving emergency preparedness. Few studies have addressed problems associated with the activation of contingency plans when the public administration is disrupted by natural disasters. This paper investigates how managers activate contingency plans at the predisposal stage and potential problems that may arise from disruption by natural disasters at this stage. Case studies are conducted and our analysis results show that activating contingency plans at the pre-disposition stage is effective at dealing with public crises caused by natural disasters. A mathematical model is constructed to provide information on when to activate contingency plans in different phases.Decision theories and methods are used to help propose an

A two-stage planning and control model toward Economically Adapted Power Distribution Systems using analytical hierarchy processes and fuzzy optimization

Energy Technology Data Exchange (ETDEWEB)

Schweickardt, Gustavo [Instituto de Economia Energetica, Fundacion Bariloche, Centro Atomico Bariloche - Pabellon 7, Av. Bustillo km 9500, 8400 Bariloche (Argentina); Miranda, Vladimiro [INESC Porto, Instituto de Engenharia de Sistemas e Computadores do Porto and FEUP, Faculdade de Engenharia da Universidade do Porto, R. Dr. Roberto Frias, 378, 4200-465 Porto (Portugal)

2009-07-15

This work presents a model to evaluate the Distribution System Dynamic De-adaptation respecting its planning for a given period of Tariff Control. The starting point for modeling is brought about by the results from a multi-criteria method based on Fuzzy Dynamic Programming and on Analytic Hierarchy Processes applied in a mid/short-term horizon (stage 1). Then, the decision-making activities using the Hierarchy Analytical Processes will allow defining, for a Control of System De-adaptation (stage 2), a Vector to evaluate the System Dynamic Adaptation. It is directly associated to an eventual series of inbalances that take place during its evolution. (author)

Ensuring the Process of Realisation of Financial Planning of Banking Activity

OpenAIRE

Kirkach Svitlana M.

2014-01-01

The article studies theoretical aspects of the process of realisation of financial planning of the bank's activity and identifies and justifies its six main stages: 1) goal formation stage; 2) preparation stage; 3) assessment; 4) financial plan approval; 5) financial plan execution, and 6) stage of the financial plan monitoring, control and adjustment. The above sequence of stages of the process of realisation of financial planning of the bank's activity allows a trustworthy assessment of the...

Social Cognitive and Planned Behavior Variables Associated with Stages of Change for Physical Activity in Spinal Cord Injury: A Multivariate Analysis

Science.gov (United States)

Keegan, John; Ditchman, Nicole; Dutta, Alo; Chiu, Chung-Yi; Muller, Veronica; Chan, Fong; Kundu, Madan

2016-01-01

Purpose: To apply the constructs of social cognitive theory (SCT) and the theory of planned behavior (TPB) to understand the stages of change (SOC) for physical activities among individuals with a spinal cord injury (SCI). Method: Ex post facto design using multivariate analysis of variance (MANOVA). The participants were 144 individuals with SCI…

Incremental clinical value of a dedicated RT planning FDG PET-CT over staging PET-CT in non-small cell lung cancer

International Nuclear Information System (INIS)

Lin, P.; Som, S.; Vinod, S.; Lin, M.; Shon, I. H.

2009-01-01

Full text:Objectives: To evaluate whether FDG-PET performed for radiotherapy planning can detect disease progression, compared with staging PET. Methods: Thirteen patients underwent a planning PET-CT for curative RT ( R T-PET ) within eight weeks of a staging PET-CT for newly diagnosed NSCLC between 10/2007 and 1/2009. All studies were acquired on a Philips GXL PET-CT using the same protocols, except RT-PET is acquired on a RT flat bed. The images were interpreted by consensus readings of two physicians: location/number, visual grading (0-4:3> liver, 4>brain), max transverse diameter ( M ax D ) (tumour margin is delineated by a SUV threshold of 2.5) and max SUV of each lesion. Progressive disease (PD) is defined as >10% increase in max D. Results: RT-PET detected PD (primary or nodal) or new metastases in 8 pts (61%) (mean interval:30.2±14 days, range:7-54 days). For primary tumour, RT-PET detected PD in 5 pts (range: 12-32% increase in max D and 12-39% increase in SUV) and RT-CT detected PD in 3 pts (11-21% increase in max D, paired t test: p = 0.19). Stage-PET detected 28 mediastinal/hilar nodal sites. RT-PET detected PD in 11 of these lesions in 4 pts (31%) and CT detected similar progression in 8 lesions in 2 pts. RT-PET detected 10 new lesions in 3 pts (23%) resulting in upstaging to N3 in 2 pts (supraclavicular and hilar nodes) and M1 in 1 pt (bone). Conclusion: A dedicated RT PET-CT has the potential to detect disease progression and impact on RT planning in a large number of patients.

Stormwater Pollution Prevention Plan - TA-60 Roads and Grounds Facility and Associated Sigma Mesa Staging Area

Energy Technology Data Exchange (ETDEWEB)

Sandoval, Leonard Frank [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2018-01-31

This Storm Water Pollution Prevention Plan (SWPPP) was developed in accordance with the provisions of the Clean Water Act (33 U.S.C. §§1251 et seq., as amended), and the Multi-Sector General Permit for Storm Water Discharges Associated with Industrial Activity (U.S. EPA, June 2015) issued by the U.S. Environmental Protection Agency (EPA) for the National Pollutant Discharge Elimination System (NPDES) and using the industry specific permit requirements for Sector P-Land Transportation and Warehousing as a guide. This SWPPP applies to discharges of stormwater from the operational areas of the TA-60 Roads and Grounds and Associated Sigma Mesa Staging Area at Los Alamos National Laboratory. Los Alamos National Laboratory (also referred to as LANL or the “Laboratory”) is owned by the Department of Energy (DOE), and is operated by Los Alamos National Security, LLC (LANS). Throughout this document, the term “facility” refers to the TA-60 Roads and Grounds and Associated Sigma Mesa Staging Area. The current permit expires at midnight on June 4, 2020.

Research planning in the energy sector

International Nuclear Information System (INIS)

Graenicher, H.

1977-06-01

The author considers research planning split into four separate aspects: the character of the research situation; the function of planning stages; the type of research target; and the limit of the application of research planning by planning stages. He then considers the specific problem of energy research and discusses the question of what the state is to do and how to do it with particular attention to the Swiss situation. (G.T.H)

Barriers to Advance Care Planning in End-Stage Renal Disease: Who is to Blame, and What Can be Done?

Science.gov (United States)

Kelley, Alan Taylor; Turner, Jeffrey; Doolittle, Benjamin

2018-07-01

Patients with end-stage renal disease experience significant mortality and morbidity, including cognitive decline. Advance care planning has been emphasized as a responsibility and priority of physicians caring for patients with chronic kidney disease in order to align with patient values before decision-making capacity is lost and to avoid suffering. This emphasis has proven ineffective, as illustrated in the case of a patient treated in our hospital. Is this ineffectiveness a consequence of failure in the courtroom or the clinic? Through our own experience we affirm what has been written before: that legal precedent favors intensive treatment in virtually all cases without 'clear and convincing evidence' of a patient's previously declared wishes to the contrary. Equally clear is that more than 20 years of support in the clinical literature suggesting advance care planning early in the course of disease can address challenges in the legal system for those lacking capacity. However, many physicians fail to recognize the need for advance care planning in a timely manner and lack the necessary training to provide it. The need for more training and new tools to recognize opportunities for advance care planning in daily practice remains unmet.

Marketing planning by learning: "Plearning" approach

Directory of Open Access Journals (Sweden)

Ilić Milovan M.

2006-01-01

Full Text Available This work emphasizes that the final outcome of planning is not only the benefit of having the ready plan but showing that the very process of planning through which a business goes through, is important. Here we consider the process of learning in order to get a complete picture of current and future business processes. Three stages of learning are included. The first stage describes the current position of the business; the second stage describes the position of the business in the future and the last stage shows how the business will achieve these objectives. The focus of planning should be deciding on internal communication which form the basis for gaining the competitive advantage. One of the ways for carrying out this analysis is creating the matrix based on gaining competitive advantage through using resources.

Two-stage stochastic programming model for the regional-scale electricity planning under demand uncertainty

International Nuclear Information System (INIS)

Huang, Yun-Hsun; Wu, Jung-Hua; Hsu, Yu-Ju

2016-01-01

Traditional electricity supply planning models regard the electricity demand as a deterministic parameter and require the total power output to satisfy the aggregate electricity demand. But in today's world, the electric system planners are facing tremendously complex environments full of uncertainties, where electricity demand is a key source of uncertainty. In addition, electricity demand patterns are considerably different for different regions. This paper developed a multi-region optimization model based on two-stage stochastic programming framework to incorporate the demand uncertainty. Furthermore, the decision tree method and Monte Carlo simulation approach are integrated into the model to simplify electricity demands in the form of nodes and determine the values and probabilities. The proposed model was successfully applied to a real case study (i.e. Taiwan's electricity sector) to show its applicability. Detail simulation results were presented and compared with those generated by a deterministic model. Finally, the long-term electricity development roadmap at a regional level could be provided on the basis of our simulation results. - Highlights: • A multi-region, two-stage stochastic programming model has been developed. • The decision tree and Monte Carlo simulation are integrated into the framework. • Taiwan's electricity sector is used to illustrate the applicability of the model. • The results under deterministic and stochastic cases are shown for comparison. • Optimal portfolios of regional generation technologies can be identified.

MR staging accuracy for endometrial cancer based on the new FIGO stage

International Nuclear Information System (INIS)

Shin, Kyung Eun; Park, Byung Kwan; Kim, Chan Kyo; Bae, Duk Soo; Song, Sang Yong; Kim, Bohyun

2011-01-01

Background: Magnetic resonance imaging (MRI) has been frequently used to determine a preoperative treatment plan for gynecologic cancers. However, the MR accuracy for staging an endometrial cancer is not satisfactory based on the old FIGO staging system. Purpose: To evaluate MR accuracy for staging endometrial cancer using the new FIGO staging system. Material and Methods: Between January 2005 and May 2009, 199 women underwent surgery due to endometrial cancer. In each patient, an endometrial cancer was staged using MR findings based on the old FIGO staging system and then repeated according to the new FIGO staging system for comparison. Histopathologic findings were used as a standard of reference. Results: The accuracy of MRI in the staging of endometrial carcinoma stage I, II, III, and IV using the old FIGO staging system were 80% (159/199), 89% (178/199), 90% (179/199), and 99% (198/199), respectively, compared to 87% (174/199), 97% (193/199), 90% (179/199), and 99% (198/199), respectively, when using the new FIGO staging criteria. The overall MR accuracy of the old and new staging systems were 51% (101/199) and 81% (161/199), respectively. Conclusion: MRI has become a more useful tool in the preoperative staging of endometrial cancers using the new FIGO staging system compared to the old one with increased accuracy

Impact of [18F]fluorodeoxyglucose PET-CT staging on treatment planning in radiotherapy incorporating elective nodal irradiation for non-small-cell lung cancer: a prospective study.

Science.gov (United States)

Kolodziejczyk, Milena; Kepka, Lucyna; Dziuk, Miroslaw; Zawadzka, Anna; Szalus, Norbert; Gizewska, Agnieszka; Bujko, Krzysztof

2011-07-15

To evaluate prospectively how positron emission tomography (PET) information changes treatment plans for non-small-cell lung cancer (NSCLC) patients receiving or not receiving elective nodal irradiation (ENI). One hundred consecutive patients referred for curative radiotherapy were included in the study. Treatment plans were carried out with CT data sets only. For stage III patients, mediastinal ENI was planned. Then, patients underwent PET-CT for diagnostic/planning purposes. PET/CT was fused with the CT data for final planning. New targets were delineated. For stage III patients with minimal N disease (N0-N1, single N2), the ENI was omitted in the new plans. Patients were treated according to the PET-based volumes and plans. The gross tumor volume (GTV)/planning tumor volume (PTV) and doses for critical structures were compared for both data sets. The doses for areas of potential geographical misses derived with the CT data set alone were compared in patients with and without initially planned ENI. In the 75 patients for whom the decision about curative radiotherapy was maintained after PET/CT, there would have been 20 cases (27%) with potential geographical misses by using the CT data set alone. Among them, 13 patients would receive ENI; of those patients, only 2 patients had the PET-based PTV covered by 90% isodose by using the plans based on CT alone, and the mean of the minimum dose within the missed GTV was 55% of the prescribed dose, while for 7 patients without ENI, it was 10% (p = 0.006). The lung, heart, and esophageal doses were significantly lower for plans with ENI omission than for plans with ENI use based on CT alone. PET/CT should be incorporated in the planning of radiotherapy for NSCLC, even in the setting of ENI. However, if PET/CT is unavailable, ENI may to some extent compensate for an inadequate dose coverage resulting from diagnostic uncertainties. Copyright © 2011 Elsevier Inc. All rights reserved.

Impact of [18F]Fluorodeoxyglucose PET-CT Staging on Treatment Planning in Radiotherapy Incorporating Elective Nodal Irradiation for Non-Small-Cell Lung Cancer: A Prospective Study

International Nuclear Information System (INIS)

Kolodziejczyk, Milena; Kepka, Lucyna; Dziuk, Miroslaw; Zawadzka, Anna; Szalus, Norbert; Gizewska, Agnieszka; Bujko, Krzysztof

2011-01-01

Purpose: To evaluate prospectively how positron emission tomography (PET) information changes treatment plans for non-small-cell lung cancer (NSCLC) patients receiving or not receiving elective nodal irradiation (ENI). Methods and Materials: One hundred consecutive patients referred for curative radiotherapy were included in the study. Treatment plans were carried out with CT data sets only. For stage III patients, mediastinal ENI was planned. Then, patients underwent PET-CT for diagnostic/planning purposes. PET/CT was fused with the CT data for final planning. New targets were delineated. For stage III patients with minimal N disease (N0-N1, single N2), the ENI was omitted in the new plans. Patients were treated according to the PET-based volumes and plans. The gross tumor volume (GTV)/planning tumor volume (PTV) and doses for critical structures were compared for both data sets. The doses for areas of potential geographical misses derived with the CT data set alone were compared in patients with and without initially planned ENI. Results: In the 75 patients for whom the decision about curative radiotherapy was maintained after PET/CT, there would have been 20 cases (27%) with potential geographical misses by using the CT data set alone. Among them, 13 patients would receive ENI; of those patients, only 2 patients had the PET-based PTV covered by 90% isodose by using the plans based on CT alone, and the mean of the minimum dose within the missed GTV was 55% of the prescribed dose, while for 7 patients without ENI, it was 10% (p = 0.006). The lung, heart, and esophageal doses were significantly lower for plans with ENI omission than for plans with ENI use based on CT alone. Conclusions: PET/CT should be incorporated in the planning of radiotherapy for NSCLC, even in the setting of ENI. However, if PET/CT is unavailable, ENI may to some extent compensate for an inadequate dose coverage resulting from diagnostic uncertainties.

The third stage of hospital long-range planning: the marketing approach.

Science.gov (United States)

Rynne, T J

1980-01-01

Today most hospital administrators are convinced they should implement long-range planning. The marketing approach to long-range planning is an effective strategy that is consumer oriented. It starts the planning process with the consumer, letting the consumer's needs and wants guide the organization's planning.

Ensuring the Process of Realisation of Financial Planning of Banking Activity

Directory of Open Access Journals (Sweden)

Kirkach Svitlana M.

2014-03-01

Full Text Available The article studies theoretical aspects of the process of realisation of financial planning of the bank’s activity and identifies and justifies its six main stages: 1 goal formation stage; 2 preparation stage; 3 assessment; 4 financial plan approval; 5 financial plan execution, and 6 stage of the financial plan monitoring, control and adjustment. The above sequence of stages of the process of realisation of financial planning of the bank’s activity allows a trustworthy assessment of the bank’s activity environment, formation of specific goals and tasks of the bank’s activity, and also to determine the ways of their achievement, and so on. The result of the process of realisation of financial planning of the bank’s activity is the bank’s financial plan, which is proposed to divide into four sub-sections: plan of the bank’s assets and liabilities; plan of the bank’s receipts and expenditures; plan of the bank’s cash flows; and plan of forecast values of basic financial indicators of the bank’s activity.

Staging of lung cancer.

Science.gov (United States)

de Groot, Patricia M; Carter, Brett W; Betancourt Cuellar, Sonia L; Erasmus, Jeremy J

2015-06-01

Primary lung cancer is the leading cause of cancer mortality in the world. Thorough clinical staging of patients with lung cancer is important, because therapeutic options and management are to a considerable degree dependent on stage at presentation. Radiologic imaging is an essential component of clinical staging, including chest radiography in some cases, computed tomography, MRI, and PET. Multiplanar imaging modalities allow assessment of features that are important for surgical, oncologic, and radiation therapy planning, including size of the primary tumor, location and relationship to normal anatomic structures in the thorax, and existence of nodal and/or metastatic disease. Copyright © 2015 Elsevier Inc. All rights reserved.

A three-stage short-term electric power planning procedure for a generation company in a liberalized market

International Nuclear Information System (INIS)

Nabona, Narcis; Pages, Adela

2007-01-01

In liberalized electricity markets, generation companies bid their hourly generation in order to maximize their profit. The optimization of the generation bids over a short-term weekly period must take into account the action of the competing generation companies and the market-price formation rules and must be coordinated with long-term planning results. This paper presents a three stage optimization process with a data analysis and parameter calculation, a linearized unit commitment, and a nonlinear generation scheduling refinement. Although the procedure has been developed from the experience with the Spanish power market, with minor adaptations it is also applicable to any generation company participating in a competitive market system. (author)

A treatment planning comparison between modulated tri-cobalt-60 teletherapy and linear accelerator–based stereotactic body radiotherapy for central early-stage non−small cell lung cancer

Energy Technology Data Exchange (ETDEWEB)

Merna, Catherine; Rwigema, Jean-Claude M.; Cao, Minsong; Wang, Pin-Chieh; Kishan, Amar U.; Michailian, Argin; Lamb, James; Sheng, Ke; Agazaryan, Nzhde; Low, Daniel A.; Kupelian, Patrick; Steinberg, Michael L.; Lee, Percy, E-mail: percylee@mednet.ucla.edu

2016-04-01

We evaluated the feasibility of planning stereotactic body radiotherapy (SBRT) for large central early-stage non−small cell lung cancer with a tri-cobalt-60 (tri-{sup 60}Co) system equipped with real-time magnetic resonance imaging (MRI) guidance, as compared to linear accelerator (LINAC)–based SBRT. In all, 20 patients with large central early-stage non−small cell lung cancer who were treated between 2010 and 2015 with LINAC-based SBRT were replanned using a tri-{sup 60}Co system for a prescription dose of 50 Gy in 4 fractions. Doses to organs at risk were evaluated based on established MD Anderson constraints for central lung SBRT. R{sub 100} values were calculated as the total tissue volume receiving 100% of the dose (V{sub 100}) divided by the planning target volume and compared to assess dose conformity. Dosimetric comparisons between LINAC-based and tri-{sup 60}Co SBRT plans were performed using Student's t-test and Wilcoxon Ranks test. Blinded reviews by radiation oncologists were performed to assess the suitability of both plans for clinical delivery. The mean planning target volume was 48.3 cc (range: 12.1 to 139.4 cc). Of the tri-{sup 60}Co SBRT plans, a mean 97.4% of dosimetric parameters per patient met MD Anderson dose constraints, whereas a mean 98.8% of dosimetric parameters per patient were met with LINAC-based SBRT planning (p = 0.056). R{sub 100} values were similar between both plans (1.20 vs 1.21, p = 0.79). Upon blinded review by 4 radiation oncologists, an average of 90% of the tri-{sup 60}Co SBRT plans were considered acceptable for clinical delivery compared with 100% of the corresponding LINAC-based SBRT plans (p = 0.17). SBRT planning using the tri-{sup 60}Co system with built-in MRI is feasible and achieves clinically acceptable plans for most central lung patients, with similar target dose conformity and organ at risk dosimetry. The added benefit of real-time MRI-guided therapy may further optimize tumor targeting while

A treatment planning comparison between modulated tri-cobalt-60 teletherapy and linear accelerator-based stereotactic body radiotherapy for central early-stage non-small cell lung cancer.

Science.gov (United States)

Merna, Catherine; Rwigema, Jean-Claude M; Cao, Minsong; Wang, Pin-Chieh; Kishan, Amar U; Michailian, Argin; Lamb, James; Sheng, Ke; Agazaryan, Nzhde; Low, Daniel A; Kupelian, Patrick; Steinberg, Michael L; Lee, Percy

2016-01-01

We evaluated the feasibility of planning stereotactic body radiotherapy (SBRT) for large central early-stage non-small cell lung cancer with a tri-cobalt-60 (tri-(60)Co) system equipped with real-time magnetic resonance imaging (MRI) guidance, as compared to linear accelerator (LINAC)-based SBRT. In all, 20 patients with large central early-stage non-small cell lung cancer who were treated between 2010 and 2015 with LINAC-based SBRT were replanned using a tri-(60)Co system for a prescription dose of 50Gy in 4 fractions. Doses to organs at risk were evaluated based on established MD Anderson constraints for central lung SBRT. R100 values were calculated as the total tissue volume receiving 100% of the dose (V100) divided by the planning target volume and compared to assess dose conformity. Dosimetric comparisons between LINAC-based and tri-(60)Co SBRT plans were performed using Student׳s t-test and Wilcoxon Ranks test. Blinded reviews by radiation oncologists were performed to assess the suitability of both plans for clinical delivery. The mean planning target volume was 48.3cc (range: 12.1 to 139.4cc). Of the tri-(60)Co SBRT plans, a mean 97.4% of dosimetric parameters per patient met MD Anderson dose constraints, whereas a mean 98.8% of dosimetric parameters per patient were met with LINAC-based SBRT planning (p = 0.056). R100 values were similar between both plans (1.20 vs 1.21, p = 0.79). Upon blinded review by 4 radiation oncologists, an average of 90% of the tri-(60)Co SBRT plans were considered acceptable for clinical delivery compared with 100% of the corresponding LINAC-based SBRT plans (p = 0.17). SBRT planning using the tri-(60)Co system with built-in MRI is feasible and achieves clinically acceptable plans for most central lung patients, with similar target dose conformity and organ at risk dosimetry. The added benefit of real-time MRI-guided therapy may further optimize tumor targeting while improving normal tissue sparing, which warrants further

Sport event marketing plan

Directory of Open Access Journals (Sweden)

Gašović Milan

2007-01-01

Full Text Available A marketing plan details how an event organization will compete in the marketplace in terms of its service offerings, promotions and evaluation. During the first stage of the marketing plan process, a number of its consumers (current, former and prospective and competitors. Marketing objectives are developed and implemented using an action plan. The marketing plan objectives are evaluated using an objective-discrepancy approach to determine the extent to which they were attained.

Commissioning plans for SSC linac

International Nuclear Information System (INIS)

Hurd, J.W.; Aprile, R.L.; Chang, C.R.; Crist, C.E.; Cutler, R.I.; Funk, L.W.; Guy, F.W.; Leifeste, G.T.; Raparia, D.; Saadatmand, K.; Sethi, R.C.; Swenson, D.A.; Tooker, J.; Yao, C.G.

1992-01-01

Presented are the general description of the SSC linac and the plans for commissioning. Sections of the linac are installed, tested, and beam commissioned in a serial approach. A specialized set of diagnostics is used to characterize the beam through each section. In addition to the standard diagnostic set, plans call for the use of a bunch shape monitor and x-ray spectrometer. Streak camera and digital imaging diagnostics will be developed. The commissioning plan is folded into the general linac project schedule to show the relation between delivery, staging, installation, conditioning, and actual commissioning with beam. These plans form the basis for coordination between the various organizations responsible for different elements of the linac including the technical components, infrastructure, and temporary staging and operation facilities. (Author) 2 figs., 17 refs

External plans for radiological emergency; Plan de emergencia radiologica externo

Energy Technology Data Exchange (ETDEWEB)

Suarez, G; Vizuet G, J; Benitez S, J A [Instituto Nacional de Investigaciones Nucleares, A.P. 18-1027, 11801 Mexico D.F. (Mexico)

1999-07-01

Since 1989, the National Institute of Nuclear Research in Mexico shares in the task of Food and Water Control corresponding to the FT-86 task force of External Plans for Radiological Emergency (PERE), in charge of the Veracruz Health Services. In the PERE preparation stage previous actions are necessary developed for the preparation and updating of this plan and the task organization with the purpose to maintaining standing and operable in any time and circumstance, the capability to response in the face of an emergency. This stage englobes activities which must be realized before to carry out the Plan as they are the specialized training of personnel which participates and the execution of exercises and simulacrums. Until 1998, training and exercises for this task had been realized under diverse possible sceneries but in conditions that simulated the presence of radioactive material. For this reason, it should be emphasized the training realized during the days 6th, 7th, 8th July, 1999, in the emergency planning zone of the Plan, which to carry out using radioactive material. The National Institute of Nuclear Research had in charge of the training. This work describes all the activities for the realization of this training. (Author)

Evaluating the role of collaborative planning in BC's Parks and Protected Areas Management Planning process

OpenAIRE

Ronmark, Tracy

2005-01-01

BC's protected areas system has recently doubled in size as a result of land use planning across the province. Managing protected areas to meet many goals requires thoughtful planning that involves stakeholder participation and dispute resolution through the plan development and implementation stages. This research identifies the best practices for planning and evaluates protected areas management planning processes based on those criteria. Evaluative criteria were developed from a literature...

Scenario Based Network Infrastructure Planning

DEFF Research Database (Denmark)

Knudsen, Thomas Phillip; Pedersen, Jens Myrup; Madsen, Ole Brun

2005-01-01

The paper presents a method for IT infrastructure planning that take into account very long term developments in usages. The method creates a scenario for a final, time independent stage in the planning process. The method abstracts relevant modelling factors from available information...

Setting planned leadtimes in customer-order-driven assembly systems

NARCIS (Netherlands)

Atan, Z.; Kok, de A.G.; Dellaert, N.P.; Janssen, F.B.S.L.P.; Boxel, van R.

2016-01-01

We study an assembly system with a number of parallel multistage processes feeding a multistage final assembly process. Each stage has a stochastic throughput time. We assume that the system is controlled by planned leadtimes at each stage. From these planned leadtimes the start and due times of all

Assessment of Growth Using Mandibular Canine Calcification Stages and Its Correlation with Modified MP3 Stages.

Science.gov (United States)

Nayak, Reshma; Nayak, Us Krishna; Hegde, Gautam

2010-01-01

Orthodontic diagnosis and treatment planning for growing children must involve growth prediction, especially in the treatment of skeletal problems. Studies have shown that a strong association exists between skeletal maturity and dental calcification stages. The present study was therefore taken up to provide a simple and practical method for assessing skeletal maturity using a dental periapical film and standard dental X-ray machine, to compare the developmental stages of the mandibular canine with that of developmental stages of modified MP3 and to find out if any correlation exists, to determine if the developmental stages of the mandibular canine alone can be used as a reliable indicator for assessment of skeletal maturity. A total of 160 periapical radiographs (80 males and 80 females), of the mandibular right canine and the MP3 region was taken and assessed according to the Dermirjian's stages of dental calcification and the modified MP3 stages. The correlation between the developmental stages of MP3 and the mandibular right canine in male and female groups, is of high statistical significance (p = 0.001). The correlation coefficient between MP3 stages and developmental stages of mandibular canine and chronological age in male and females was found to be not significant. The correlation between the mandibular canine calcification stages and MP3 stages was found to be significant. The developmental stages of the mandibular canine could be used very reliably as a sole indicator for assessment of skeletal maturity.

STAGES : a system for generating strategic alternatives for forest management

NARCIS (Netherlands)

Bos, J.

1994-01-01

Strategic planning is important in forest management. However, it has never been described clearly in literature. In this study a framework for strategic planning was developed and based on this a STrategic Alternatives Generating System (STAGES) to support decision making in strategic

Ethical, legal and social issues in the context of the planning stages of the Southern African Human Genome Programme.

Science.gov (United States)

de Vries, Jantina; Slabbert, Melodie; Pepper, Michael S

2012-03-01

As the focus on the origin of modern man appears to be moving from eastern to southern Africa, it is recognised that indigenous populations in southern Africa may be the most genetically diverse on the planet and hence a valuable resource for human genetic diversity studies. In order to build regional capacity for the generation, analysis and application of genomic data, the Southern African Human Genome Programme was recently launched with the aid of seed funding from the national Department of Science and Technology in South Africa. The purpose of the article is to investigate pertinent ethical, legal and social issues that have emerged during the planning stages of the Southern African Human Genome Programme. A careful consideration of key issues such as public perception of genomic research, issues relating to genetic and genomic discrimination and stigmatisation, informed consent, privacy and data protection, and the concept of genomic sovereignty, is of paramount importance in the early stages of the Programme. This article will also consider the present legal framework governing genomic research in South Africa and will conclude with proposals regarding such a framework for the future.

The rationale and technique of staged-volume arteriovenous malformation radiosurgery

International Nuclear Information System (INIS)

Pollock, Bruce E.; Kline, Robert W.; Stafford, Scott L.; Foote, Robert L.; Schomberg, Paula J.

2000-01-01

Purpose: Stereotactic radiosurgery is an effective management strategy for properly selected arteriovenous malformation (AVM) patients. However, the risk of postradiosurgical radiation-related injury generally limits this procedure to patients with AVMs of an average diameter of 3 cm or less. Radiosurgery of large AVMs in a planned staged fashion was undertaken to limit the radiation exposure to the surrounding normal brain. Methods and Materials: Between April 1997 and December 1999, 10 patients with a median AVM volume of 17.4 cm 3 (range, 7.4-53.3 cm 3 ) underwent staged-volume radiosurgery (23 procedures). At the first radiosurgical procedure, the total volume of the AVM is estimated and a dose plan calculated that covers 10 cm 3 -15 cm 3 , or one-half the nidus volume if the AVM is critically located (brainstem, thalamus, or basal ganglia). At 6-month intervals thereafter, radiosurgery was repeated to different portions of the AVM with the previous dose plan(s) being re-created utilizing intracranial landmarks to minimize radiation overlap. Radiosurgical procedures were continued until the entire malformation has been irradiated. Results: The radiation dosimetry of staged-volume AVM radiosurgery was compared to hypothetical single-session procedures for the 10 patients. Staged-volume radiosurgery decreased the 12-Gy volume by an average of 11.1% (range, 4.9-21%) (p < 0.001). The non-AVM 12-Gy volume was reduced by an average of 27.2% (range, 12.5-51.3%) (p < 0.001). Discussion: Staged-volume radiosurgery of large AVMs results in less radiation exposure to the adjacent brain. Further follow-up is needed to determine whether this technique provides a high rate of AVM obliteration while maintaining an acceptable rate of radiation-related complications

LANDSCAPE PLANNING IN UKRAINE: THE FIRST LANDSCAPE-PLANNING PROGRAM

Directory of Open Access Journals (Sweden)

Leonid Rudenko

2013-01-01

Full Text Available The paper presents the results of the first, in Ukraine; project on landscape planning widely accepted in European countries. Under the project implemented in 2010–2013, a landscape-planning program has been developed for the Cherkassy oblast. This is the first document of this kind in Ukraine. The program is mainly based on the experience of the German and Russian schools of landscape planning and on research and assessment conducted by the authors, which allowed identifying approaches to landscape planning, principles of the national policy, and characteristics and potential of environmentally friendly planning in Ukraine. The paper discusses the main phases of the work on the development of the landscape program for the oblast. It also identifies the main stages and key concepts and principles of landscape planning. The paper presents the results of integrated research on the identification and classification of conflicts in land use and the integral concept of the developmental goals for the oblast. The results can be the foundation for adopting management decisions and development of action plans for the lower hierarchal branches.

Sectoral Plan 'Deep Geological Disposal', Stage 2. Proposed site areas for the surface facilities of the deep geological repositories as well as for their access infrastructure. General report

International Nuclear Information System (INIS)

2011-12-01

In line with the provisions of the nuclear energy legislation, the sites for deep geological disposal of Swiss radioactive waste are selected in a three-stage Sectoral Plan process (Sectoral Plan for Deep Geological Disposal). The disposal sites are specified in Stage 3 of the selection process with the granting of a general licence in accordance with the Nuclear Energy Act. The first stage of the process was completed on 30 th November 2011, with the decision of the Federal Council to incorporate the six geological siting regions proposed by the National Cooperative for the Disposal of Radioactive Waste (NAGRA) into the Sectoral Plan for Deep Geological Disposal, for further evaluation in Stage 2. The decision also specifies the planning perimeters within which the surface facilities and shaft locations for the repositories will be constructed. In the second stage of the process, at least two geological siting regions each will be specified for the repository for low- and intermediate-level waste (L/ILW) and for the high-level waste (HLW) repository and these will undergo detailed geological investigation in Stage 3. For each of these potential siting regions, at least one location for the surface facility and a corridor for the access infrastructure will also be specified. NAGRA is responsible, at the beginning of Stage 2, for submitting proposals for potential locations for the surface facilities and their access infrastructure to the Federal Office of Energy (SFOE); these are then considered by the regional participation bodies in the siting regions. The present report and its annexes volume document these proposals. In Stage 2, under the lead of the SFOE, socio-economic-ecological studies will also be carried out to investigate the impact of a repository project on the environment, economy and society. The present reports also contain the input data to be provided by NAGRA for the generic (site-independent) part of these impact studies. A meaningful discussion

Diagnostic imaging in the staging of gynecologic cancers

International Nuclear Information System (INIS)

Forstner, R.; Graf, A.

1999-01-01

The prognosis in patients with gynecologic cancers depends not only on the stage but also on a wide spectrum of other findings. Cross-sectional imaging modalities, including sonography, CT and MRI, have increasingly been used for optimal treatment planning in gynecologic cancers. Their staging criteria are based on the well-established FIGO staging system. CT and MRI compete with sonography, which plays a pivotal role in the valuation of the female pelvis. This paper reviews the role of sonography, CT and MRI in the staging of gynecologic malignancies. It puts the emphasis on MRI, which has been established as imaging modality of choice in the preoperative evaluation of cervical and endometrial cancer, and which seems slightly superior to CT in the staging of ovarian cancer. (orig.) [de

THE COMMUNITY PLANNING PROCESS. KANSAS STATE UNIVERSITY SHORT COURSE SERIES ON COMMUNITY PLANNING AND DEVELOPMENT, 6.

Science.gov (United States)

WEISENBURGER, RAY B.

PART OF A KANSAS STATE UNIVERSITY SERIES ON COMMUNITY PLANNING AND DEVELOPMENT, THIS MONOGRAPH DISCUSSES THE STAGES IN THE PREPARATION AND IMPLEMENTATION OF COMPREHENSIVE URBAN SCHEMES. FIRST OF ALL, SOCIAL ACCEPTANCE, ECONOMIC, FEASIBILITY, POLITICAL RESPONSIBILITY, AND ENVIRONMENTAL SATISFACTION ARE VITAL TO SUCCESSFUL PLANNING. ORGANIZATION FOR…

Integrating design and production planning with knowledge-based inspection planning system

International Nuclear Information System (INIS)

Abbasi, Ghaleb Y.; Ketan, Hussein S.; Adil, Mazen B.

2005-01-01

In this paper an intelligent environment to integrate design and inspection earlier to the design stage. A hybrid knowledge-based approach integrating computer-aided design (CAD) and computer-aided inspection planning (CAIP) was developed, thereafter called computer-aided design and inspection planning (CADIP). CADIP was adopted for automated dimensional inspection planning. Critical functional features were screened based on certain attributes for part features for inspection planning application. Testing the model resulted in minimizing the number of probing vectors associated with the most important features in the inspected prismatic part, significant reduction in inspection costs and release of human labor. In totality, this tends to increase customer satisfaction as a final goal of the developed system. (author)

The Middle School Learner: Instructional Planning for a Transitional Stage

Science.gov (United States)

Brown, James

1978-01-01

Examines Piaget's concrete and formal operational stages of intellectual development in relation to the middle school learner. Presents teaching strategies requiring the learner to use concrete and formal operational forms of thought in dealing with a social studies unit about Quebec. (Author/JK)

Sectoral Plan 'Deep Geological Disposal', Stage 2. Proposed site areas for the surface facilities of the deep geological repositories as well as for their access infrastructure. Annexes

International Nuclear Information System (INIS)

2011-12-01

In line with the provisions of the nuclear energy legislation, the sites for deep geological disposal of Swiss radioactive waste are selected in a three-stage Sectoral Plan process (Sectoral Plan for Deep Geological Disposal). The disposal sites are specified in Stage 3 of the selection process with the granting of a general licence in accordance with the Nuclear Energy Act. The first stage of the process was completed on 30 th November 2011, with the decision of the Federal Council to incorporate the six geological siting regions proposed by the National Cooperative for the Disposal of Radioactive Waste (NAGRA) into the Sectoral Plan for Deep Geological Disposal, for further evaluation in Stage 2. The decision also specifies the planning perimeters within which the surface facilities and shaft locations for the repositories will be constructed. In the second stage of the process, at least two geological siting regions each will be specified for the repository for low- and intermediate-level waste (L/ILW) and for the high-level waste (HLW) repository and these will undergo detailed geological investigation in Stage 3. For each of these potential siting regions, at least one location for the surface facility and a corridor for the access infrastructure will also be specified. NAGRA is responsible, at the beginning of Stage 2, for submitting proposals for potential locations for the surface facilities and their access infrastructure to the Federal Office of Energy (SFOE); these are then considered by the regional participation bodies in the siting regions. The general report and the present annexes volume document these proposals. In Stage 2, under the lead of the SFOE, socio-economic-ecological studies will also be carried out to investigate the impact of a repository project on the environment, economy and society. The present reports also contain the input data to be provided by NAGRA for the generic (site-independent) part of these impact studies. A meaningful

ORGANIZATIONAL AND METHODIC SUPPORT TO COMMERCIAL BANK STRATEGIC PLANNING

Directory of Open Access Journals (Sweden)

N. G. Korostyliov

2011-01-01

Full Text Available Organizational and methodic support to bank activity strategic planning comprises making prospects for main bank finance activity indices, their correction and examination as well as control over their dynamics. There are specific features of organization of bank strategic planning at present stage of development of Russian economics. Main stages of this process and principles on which this study should be based are discussed. Banking environment information level should be taken into account, feasibility testing of organizational planning systems having to be undertaken in practice.

MDOT implementation plan for GPS technology in planning, design, and construction delivery

Science.gov (United States)

2010-09-13

Global Positioning System (GPS) technology offers advantages to transportation agencies in the planning, design and construction stages of project delivery. This research study will develop a guide for Mississippi Department of Transportation (MDOT) ...

SSCL computer planning

International Nuclear Information System (INIS)

Price, L.E.

1990-01-01

The SSC Laboratory is in the process of planning the acquisition of a substantial computing system to support the design of detectors. Advice has been sought from users and computer experts in several stages. This paper discuss this process

Early stage fuel cell funding

International Nuclear Information System (INIS)

Bergeron, C.

2004-01-01

'Full text:' Early stage venture funding requires an in depth understanding of both current and future markets as well as the key technical hurdles that need to be overcome for new technology to commercialize into successful products for mass markets. As the leading fuel cell and hydrogen investor, Chrysalix continuously reviews global trends and new technologies, evaluates them with industry leaders worldwide and tries to match them up with the best possible management teams when selecting its early stage investments. Chrysalix Energy Limited Partnership is an early-stage venture capital firm focusing on fuel cell and related fueling technology companies and is a private equity joint venture between Ballard Power Systems, BASF Venture Capital, The BOC Group, The Boeing Company, Duke Energy, Mitsubishi Corporation and Shell Hydrogen. Operating independently, Chrysalix offers a unique value proposition to its clients throughout the business planning, start-up and operations phases of development. Chrysalix provides early-stage funding to new companies as well as management assistance, technological knowledge, organized networking with industry players and experience in the management of intellectual property. (author)

Social Foundation of Scenario Planning

DEFF Research Database (Denmark)

Rowland, Nicholas James; Spaniol, Matthew Jon

2017-01-01

In this article, the authors establish that models of scenario planning typically involve a series of phases, stages, or steps that imply a sequenced (i.e., linear or chronological) process. Recursive models, in contrast, allow phases to repeat, thus, incorporating iteration. The authors acknowle......In this article, the authors establish that models of scenario planning typically involve a series of phases, stages, or steps that imply a sequenced (i.e., linear or chronological) process. Recursive models, in contrast, allow phases to repeat, thus, incorporating iteration. The authors...... from science and technology studies (STS) on knowledge production, the authors explain transition from one phase to the next and iteration between and within phases based on social negotiation. To this end, the authors examine the interplay between the “scenario development” phase and the “scenario use......” phase of a planning process with a non-governmental organization in Denmark. The upshot for facilitators is practical insight into how transition between phases and phase iteration in scenario planning can be identified, leveraged, and, thus, managed. The upshot for scholars is a related insight...

Multi-staged robotic stereotactic radiosurgery for large cerebral arteriovenous malformations

International Nuclear Information System (INIS)

Ding, Chuxiong; Solberg, Timothy D.; Hrycushko, Brian; Medin, Paul; Whitworth, Louis; Timmerman, Robert D.

2013-01-01

Purpose: To investigate a multi-staged robotic stereotactic radiosurgery (SRS) delivery technique for the treatment of large cerebral arteriovenous malformations (AVMs). The treatment planning process and strategies to optimize both individual and composite dosimetry are discussed. Methods: Eleven patients with large (30.7 ± 19.2 cm 3 ) AVMs were selected for this study. A fiducial system was designed for fusion of targets between planar angiograms and simulation CT scans. AVMs were contoured based on single contrast CT, MRI and orthogonal angiogram images. AVMs were divided into 3–8 sub-target volumes (3–7 cm 3 ) for sequential treatment at 1–4 week intervals to a prescription dose of 16–20 Gy. Forward and inversely developed treatment plans were optimized for 95% coverage of the total AVM volume by dose summation from each sub-volume, while minimizing dose to surrounding tissues. Dose-volume analysis was used to evaluate the PTV coverage, dose conformality (CI), and R 50 and V 12Gy parameters. Results: The treatment workflow was commissioned and able to localize within 1 mm. Inverse optimization outperformed forward planning for most patients for each index considered. Dose conformality was shown comparable to staged Gamma Knife treatments. Conclusion: The CyberKnife system is shown to be a practical delivery platform for multi-staged treatments of large AVMs using forward or inverse planning techniques

[Professor WANG Linpeng's experience of acupuncture for migraine based on different stages and types].

Science.gov (United States)

Wang, Shaosong

2016-07-12

By using the methods of experience summary and case report, professor WANG Linpeng 's clinical experience of acupuncture for migraine was summarized.Professor WANG proposed the different acupuncture plans should be established according to the active stage and remission stage of migraine; in the active stage acupuncture should be applied at gallbladder meridian with penetration needling technique to reinforce the stimulation intensity; in the remission stage the aim was to regulate zang-fu and back- shu points should be emphasized.In addition, attention should be paid on acupuncture technique and preventive treatment.For menstruation-type and psychological disorder-type migraine, different acupuncture plans should be adopted and regulating meridian and spirit was essential in the treatment.

Impact of MRI in the management and staging of cancer of the uterine cervix

Energy Technology Data Exchange (ETDEWEB)

Stenstedt, Kristina (Centre of Surgical Gastroenterology, Karolinska Univ. Hospital and Karolinska Inst., Stockholm (Sweden)); Hellstroem, Ann-Cathrin (Dept. of Gynecological Oncology, Radiumhemmet, Karolinska Univ. Hospital and Karolinska Inst., Stockholm (Sweden)); Fridsten, Susanne; Blomqvist, Lennart (Dept. of Diagnostic Radiology Karolinska Univ. Hospital and Karolinska Inst., Stockholm (Sweden))

2011-04-15

Background. Cervical carcinoma is the only gynecological tumor still being staged mainly by clinical examination and only a limited use of diagnostic radiology. Cross sectional imaging is increasingly used as an aid in the staging procedure. We wanted to assess the impact of magnetic resonance imaging (MRI) in addition to the clinical staging of patients with carcinoma of the uterine cervix. Material and methods. A retrospective single-centre analysis of 183 women referred to a tertiary referral centre for gynecological tumors (<= 65 years old) with cervical cancer diagnosed between January 1, 2003 and December 31, 2006 who have undergone an MRI investigation before start of treatment. Patient records were retrospectively reviewed and any change of the planned treatment after the MRI examination was noted. Results. In patients with cervical carcinoma FIGO stage Ia2-IIa treated surgically, the treatment plan was altered due to MRI results in 10/125 patients. In the smaller group of patients with clinically more advanced disease receiving radio-chemotherapy, the treatment plan was altered in 12/58 patients. Reasons for changing the treatment plan after MRI were findings indicating a higher (n = 8) or lower (n = 5) local tumor stage, findings of para aortic nodal disease (n = 4) or difficulty to clinically examine the patient due to obesity (n = 2). MRI was also an aid in deciding whether or not to offer fertility preserving treatment in three cases. Conclusion. The use of MRI affects treatment planning in patients with cancer of the uterine cervix. The impact is more obvious in more advanced stages of disease and in patients who are difficult to examine clinically due to, for example body constitution. The result of MRI is also an aid in deciding whether or not a fertility preserving operation is feasible

Impact of MRI in the management and staging of cancer of the uterine cervix

International Nuclear Information System (INIS)

Stenstedt, Kristina; Hellstroem, Ann-Cathrin; Fridsten, Susanne; Blomqvist, Lennart

2011-01-01

Background. Cervical carcinoma is the only gynecological tumor still being staged mainly by clinical examination and only a limited use of diagnostic radiology. Cross sectional imaging is increasingly used as an aid in the staging procedure. We wanted to assess the impact of magnetic resonance imaging (MRI) in addition to the clinical staging of patients with carcinoma of the uterine cervix. Material and methods. A retrospective single-centre analysis of 183 women referred to a tertiary referral centre for gynecological tumors (≤ 65 years old) with cervical cancer diagnosed between January 1, 2003 and December 31, 2006 who have undergone an MRI investigation before start of treatment. Patient records were retrospectively reviewed and any change of the planned treatment after the MRI examination was noted. Results. In patients with cervical carcinoma FIGO stage Ia2-IIa treated surgically, the treatment plan was altered due to MRI results in 10/125 patients. In the smaller group of patients with clinically more advanced disease receiving radio-chemotherapy, the treatment plan was altered in 12/58 patients. Reasons for changing the treatment plan after MRI were findings indicating a higher (n = 8) or lower (n = 5) local tumor stage, findings of para aortic nodal disease (n = 4) or difficulty to clinically examine the patient due to obesity (n = 2). MRI was also an aid in deciding whether or not to offer fertility preserving treatment in three cases. Conclusion. The use of MRI affects treatment planning in patients with cancer of the uterine cervix. The impact is more obvious in more advanced stages of disease and in patients who are difficult to examine clinically due to, for example body constitution. The result of MRI is also an aid in deciding whether or not a fertility preserving operation is feasible

A Predictive Model of Multi-Stage Production Planning for Fixed Time Orders

Directory of Open Access Journals (Sweden)

Kozłowski Edward

2014-09-01

Full Text Available The traditional production planning model based upon a deterministic approach is well described in the literature. Due to the uncertain nature of manufacturing processes, such model can however incorrectly represent actual situations on the shop floor. This study develops a mathematical modeling framework for generating production plans in a multistage manufacturing process. The devised model takes into account the stochastic model for predicting the occurrence of faulty products. The aim of the control model is to determine the number of products which should be manufactured in each planning period to minimize both manufacturing costs and potential financial penalties for failing to fulfill the order completely.

An Enrollment Marketing Plan for Institutions of Higher Learning: An Update.

Science.gov (United States)

Bingham, Frank G., Jr.

1996-01-01

A college marketing model consisting of several strategies and contingency plans for decision-making under difficult conditions is outlined. The plan provides for orderly transition from one marketing stage to the next logical stage, allowing some control over both internal and external environments, and providing insight into the delicate…

Strategic and tactiocal planning for managing national park resources

Science.gov (United States)

Daniel L. Schmoldt; David L. Peterson

2001-01-01

Each National Park Service unit in the United States produces a resource management plan (RMP) every four years or less. These plans constitute a strategic agenda for a park. Later, tactical plans commit budgets and personnel to specific projects over the planning horizon. Yet, neither planning stage incorporates much quantitative and analytical rigor and is devoid of...

Assessing Behavioral Stages From Social Media Data.

Science.gov (United States)

Liu, Jason; Weitzman, Elissa R; Chunara, Rumi

2017-01-01

Important work rooted in psychological theory posits that health behavior change occurs through a series of discrete stages. Our work builds on the field of social computing by identifying how social media data can be used to resolve behavior stages at high resolution (e.g. hourly/daily) for key population subgroups and times. In essence this approach opens new opportunities to advance psychological theories and better understand how our health is shaped based on the real, dynamic, and rapid actions we make every day. To do so, we bring together domain knowledge and machine learning methods to form a hierarchical classification of Twitter data that resolves different stages of behavior. We identify and examine temporal patterns of the identified stages, with alcohol as a use case (planning or looking to drink, currently drinking, and reflecting on drinking). Known seasonal trends are compared with findings from our methods. We discuss the potential health policy implications of detecting high frequency behavior stages.

MR imaging for staging of cervical carcinoma: Update

Energy Technology Data Exchange (ETDEWEB)

Yoon, Seong Kuk; Kim, Dong Won [Dong A University Hospital, Busan(Korea, Republic of)

2017-08-15

Uterine cervical cancer is globally the third most common cancer among women, and shows high mortality with invasive cervical carcinoma. Early detection of the disease, its correct staging, and treatment are therefore of great importance. The staging system updated in 2009 by the International Federation of Gynecology and Obstetrics (FIGO), is commonly used for planning the treatment. However, there are significant inaccuracies in the FIGO staging system. Accurate tumor staging is very important to decide the treatment strategy. Although not included in the staging system, magnetic resonance (MR) imaging is a valuable tool for local staging of the disease, and is useful in assessing the spread of the tumor and metastatic lymph nodes, thereby becoming a more accurate substitute for clinical staging of cervical carcinoma. In addition, it is capable of assessing the disease response to surgery or chemoradiation. This review briefly describes the role of MR imaging and the basic MR scanning protocol in evaluating cervical carcinoma. The MR findings with staging, and MR evaluation of treatment response, are further addressed.

Novel approaches of chemoradiotherapy in unresectable stage IIIA and stage IIIB non-small cell lung cancer.

Science.gov (United States)

Stinchcombe, Thomas E; Bogart, Jeffrey A

2012-01-01

Approximately one third of patients with non-small cell lung cancer have unresectable stage IIIA or stage IIIB disease, and appropriate patients are candidates for chemoradiotherapy with curative intent. The optimal treatment paradigm is currently undefined. Concurrent chemoradiotherapy, compared with sequential chemotherapy and thoracic radiation therapy (TRT), results in superior overall survival outcomes as a result of better locoregional control. Recent trials have revealed efficacy for newer chemotherapy combinations similar to that of older chemotherapy combinations with concurrent TRT and a lower rate of some toxicities. Ongoing phase III trials will determine the roles of cisplatin and pemetrexed concurrent with TRT in patients with nonsquamous histology, cetuximab, and the L-BLP25 vaccine. It is unlikely that bevacizumab will have a role in stage III disease because of its toxicity. Erlotinib, gefitinib, and crizotinib have not been evaluated in stage III patients selected based on molecular characteristics. The preliminary results of a phase III trial that compared conventionally fractionated standard-dose TRT (60 Gy) with high-dose TRT (74 Gy) revealed an inferior survival outcome among patients assigned to the high-dose arm. Hyperfractionation was investigated previously with promising results, but adoption has been limited because of logistical considerations. More recent trials have investigated hypofractionated TRT in chemoradiotherapy. Advances in tumor targeting and radiation treatment planning have made this approach more feasible and reduced the risk for normal tissue toxicity. Adaptive radiotherapy uses changes in tumor volume to adjust the TRT treatment plan during therapy, and trials using this strategy are ongoing. Ongoing trials with proton therapy will provide initial efficacy and safety data.

SU-E-T-151: Breathing Synchronized Delivery (BSD) Planning for RapicArc Treatment

International Nuclear Information System (INIS)

Lu, W; Chen, M; Jiang, S

2015-01-01

Purpose: To propose a workflow for breathing synchronized delivery (BSD) planning for RapicArc treatment. Methods: The workflow includes three stages: screening/simulation, planning, and delivery. In the screening/simulation stage, a 4D CT with the corresponding breathing pattern is acquired for each of the selected patients, who are able to follow their own breathing pattern. In the planning stage, one breathing phase is chosen as the reference, and contours are delineated on the reference image. Deformation maps to other phases are performed along with contour propagation. Based on the control points of the initial 3D plan for the reference phase and the respiration trace, the correlation with respiration phases, the leaf sequence and gantry angles is determined. The beamlet matrices are calculated with the corresponding breathing phase and deformed to the reference phase. Using the 4D dose evaluation tool and the original 3D plan DVHs criteria, the leaf sequence is further optimized to meet the planning objectives and the machine constraints. In the delivery stage, the patients are instructed to follow the programmed breathing patterns of their own, and all other parts are the same as the conventional Rapid-Arc delivery. Results: Our plan analysis is based on comparison of the 3D plan with a static target (SD), 3D plan with motion delivery (MD), and the BSD plan. Cyclic motion of range 0 cm to 3 cm was simulated for phantoms and lung CT. The gain of the BSD plan over MD is significant and concordant for both simulation and lung 4DCT, indicating the benefits of 4D planning. Conclusion: Our study shows that the BSD plan can approach the SD plan quality. However, such BSD scheme relies on the patient being able to follow the same breathing curve that is used in the planning stage during radiation delivery. Funded by Varian Medical Systems

The experience gained at various stages of the Atucha nuclear power plant project

International Nuclear Information System (INIS)

Cosentino, J.O.

1977-01-01

The paper describes the experience gained in Argentina at the successive stages of planning, feasibility study, decision-making, awarding of contracts, construction and operation of the first nuclear power plant in Latin America. In particular, the operating experience accumulated so far is summarized together with the requirements for preparing operating tables for the plant. The role of the Atucha plant is also described in connection with the second plant under construction and the third in the planning stage [es

Stage measurement at gaging stations

Science.gov (United States)

Sauer, Vernon B.; Turnipseed, D. Phil

2010-01-01

Stream and reservoir stage are critical parameters in the computation of stream discharge and reservoir volume, respectively. In addition, a record of stream stage is useful in the design of structures that may be affected by stream elevation, as well as for the planning for various uses of flood plains. This report describes equipment and methodology for the observation, sensing, and recording of stage in streams and reservoirs. Although the U.S. Geological Survey (USGS) still uses the traditional, basic stilling-well float system as a predominant gaging station, modern electronic stage sensors and water-level recorders are now commonly used. Bubble gages coupled with nonsubmersible pressure transducers eliminate the need for stilling wells. Submersible pressure transducers have become common in use for the measurement of stage in both rivers and lakes. Furthermore, noncontact methods, such as radar, acoustic, and laser methods of sensing water levels, are being developed and tested, and in the case of radar, are commonly used for the measurement of stage. This report describes commonly used gaging-station structures, as well as the design and operation of gaging stations. Almost all of the equipment and instruments described in this report will meet the accuracy standard set by the USGS Office of Surface Water (OSW) for the measurement of stage for most applications, which is ±0.01 foot (ft) or 0.2 percent of the effective stage. Several telemetry systems are used to transmit stage data from the gaging station to the office, although satellite telemetry has become the standard. These telemetry systems provide near real-time stage data, as well as other information that alerts the hydrographer to extreme or abnormal events, and instrument malfunctions.

External plans for radiological emergency

International Nuclear Information System (INIS)

Suarez, G.; Vizuet G, J.; Benitez S, J.A.

1999-01-01

Since 1989, the National Institute of Nuclear Research in Mexico shares in the task of Food and Water Control corresponding to the FT-86 task force of External Plans for Radiological Emergency (PERE), in charge of the Veracruz Health Services. In the PERE preparation stage previous actions are necessary developed for the preparation and updating of this plan and the task organization with the purpose to maintaining standing and operable in any time and circumstance, the capability to response in the face of an emergency. This stage englobes activities which must be realized before to carry out the Plan as they are the specialized training of personnel which participates and the execution of exercises and simulacrums. Until 1998, training and exercises for this task had been realized under diverse possible sceneries but in conditions that simulated the presence of radioactive material. For this reason, it should be emphasized the training realized during the days 6th, 7th, 8th July, 1999, in the emergency planning zone of the Plan, which to carry out using radioactive material. The National Institute of Nuclear Research had in charge of the training. This work describes all the activities for the realization of this training. (Author)

A new system for assessment of growth using mandibular canine calcification stages and its correlation with modified MP3 stages.

Science.gov (United States)

Hegde, Gautham; Hegde, Nanditha; Kumar, Anil; Keshavaraj

2014-07-01

Orthodontic diagnosis and treatment planning for growing children must involve growth prediction, especially in the treatment of skeletal problems. Studies have shown that a strong association exists between skeletal maturity and dental calcification stages. The present study was therefore taken up to provide a simple and practical method for assessing skeletal maturity using a dental periapical film and standard dental X-ray machine, to compare the developmental stages of the mandibular canine with that of developmental stages of modified MP3 and to find out if any correlation exists, to determine if the developmental stages of the mandibular canine alone can be used as a reliable indicator for assessment of skeletal maturity. A total of 160 periapical radiographs, of the mandibular right canine and the MP3 region was taken and assessed according to the Dermirjian's stages of dental calcification and the modified MP3 stages. The correlation coefficient between MP3 stages and developmental stages of mandibular canine was found to be significant in both male and female groups. When the canine calcification stages were compared with the MP3 stages it was found that with the exception of the D stage of canine calcification the remaining stages showed a very high correlation with the modified MP3 stages. The correlation between the mandibular canine calcification stages, and the MP3 stages was found to be significant. The canine calcification could be used as a sole indicator for assessment of skeletal maturity.

TFM classification and staging of oral submucous fibrosis: A new proposal.

Science.gov (United States)

Arakeri, Gururaj; Thomas, Deepak; Aljabab, Abdulsalam S; Hunasgi, Santosh; Rai, Kirthi Kumar; Hale, Beverley; Fonseca, Felipe Paiva; Gomez, Ricardo Santiago; Rahimi, Siavash; Merkx, Matthias A W; Brennan, Peter A

2018-04-01

We have evaluated the rationale of existing grading and staging schemes of oral submucous fibrosis (OSMF) based on how they are categorized. A novel classification and staging scheme is proposed. A total of 300 OSMF patients were evaluated for agreement between functional, clinical, and histopathological staging. Bilateral biopsies were assessed in 25 patients to evaluate for any differences in histopathological staging of OSMF in the same mouth. Extent of clinician agreement for categorized staging data was evaluated using Cohen's weighted kappa analysis. Cross-tabulation was performed on categorical grading data to understand the intercorrelation, and the unweighted kappa analysis was used to assess the bilateral grade agreement. Probabilities of less than 0.05 were considered significant. Data were analyzed using SPSS Statistics (version 25.0, IBM, USA). A low agreement was found between all the stages depicting the independent nature of trismus, clinical features, and histopathological components (K = 0.312, 0.167, 0.152) in OSMF. Following analysis, a three-component classification scheme (TFM classification) was developed that describes the severity of each independently, grouping them using a novel three-tier staging scheme as a guide to the treatment plan. The proposed classification and staging could be useful for effective communication, categorization, and for recording data and prognosis, and for guiding treatment plans. Furthermore, the classification considers OSMF malignant transformation in detail. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

TMI-2 containment decontamination plans

International Nuclear Information System (INIS)

McDougall, F.

1980-01-01

Because of other priorities such as reentry, purging, and recovery, containment decontamination is only in the preliminary planning stages. This paper summarizes the study with emphasis on the remote decontamination techniques

History of Planning Structure Development in Irkutsk

Science.gov (United States)

Kulakov, A. I.; Ree, A. U.

2017-11-01

The development of Irkutsk was spontaneous; the first streets represented a rather complex system of streets, dead ends, lanes. Throughout the history of the city, several general plans and development projects have been implemented (but not completely). Unlike other large Siberian cities (Novosibirsk, Krasnoyarsk), Irkutsk managed to preserve its historical appearance, architecture and initial planning. During its history the city has passed five stages of the planning structure development. The first stage of the city’s history coincides with the formation of the Russian settlements network in Eastern Siberia from the middle of the 17th to the end of the 18th centuries. Like many other Siberian cities, Irkutsk began its evolution from a fortified stockaded town. By the end of the 17th century a trading quarter appeared outside its walls. Currently, the city is developing and growing, so, a relevant issue of the further development direction of the Irkutsk planning structure naturally arises.

A new system for assessment of growth using mandibular canine calcification stages and its correlation with modified MP3 stages

Directory of Open Access Journals (Sweden)

Gautham Hegde

2014-01-01

Full Text Available Objective: Orthodontic diagnosis and treatment planning for growing children must involve growth prediction, especially in the treatment of skeletal problems. Studies have shown that a strong association exists between skeletal maturity and dental calcification stages. The present study was therefore taken up to provide a simple and practical method for assessing skeletal maturity using a dental periapical film and standard dental X-ray machine, to compare the developmental stages of the mandibular canine with that of developmental stages of modified MP3 and to find out if any correlation exists, to determine if the developmental stages of the mandibular canine alone can be used as a reliable indicator for assessment of skeletal maturity. Materials and Methods: A total of 160 periapical radiographs, of the mandibular right canine and the MP3 region was taken and assessed according to the Dermirjian′s stages of dental calcification and the modified MP3 stages. Results and Discussion: The correlation coefficient between MP3 stages and developmental stages of mandibular canine was found to be significant in both male and female groups. When the canine calcification stages were compared with the MP3 stages it was found that with the exception of the D stage of canine calcification the remaining stages showed a very high correlation with the modified MP3 stages. Conclusion: The correlation between the mandibular canine calcification stages, and the MP3 stages was found to be significant. The canine calcification could be used as a sole indicator for assessment of skeletal maturity.

Marketing Plan sebagai Upaya Pencapaian Strategi Pemasaran Perusahaan Jangka Panjang

OpenAIRE

Triastity, Rahayu

2011-01-01

Marketing plan is an important element in a company business plan. Marketing plan is conducted annually focused on implementation of decision dealing with marketing variable mix that is product, price, distribution, and promotion. Marketing plan must be monitored regularly especially in the beginning stage, as part of business plan. Marketing plan provides data for the company about neighborhood description, tactics and specific objectives that will be achieved. Marketing plan also describes ...

The Quota-Based Compensation Plan in Fashion Retailing Industry under Asymmetric Information

Directory of Open Access Journals (Sweden)

Mingzhu Yu

2014-01-01

Full Text Available We study a compensation plan problem in the fashion retailing industry, which involves a risk-neutral fashion retailer and a risk-neutral salesperson, in a two-stage game framework with asymmetric information. In the first stage, the fashion retailer provides a menu of compensation plans to the salesperson who decides which plan to sign based on his superior market demand information. Confronted with the asymmetric demand information, the fashion retailer could observe market information from the salesperson's response by designing a menu of compensation plans rather than a single one to the salesperson. In the second stage, the fashion retailer then makes production decision and the salesperson determines his selling effort. We consider both adverse selection and moral hazard. We adopt the quota-based plan to derive the fashion retailer’s optimal compensation plan design and the salesperson's best response. We emphasize the impact of the quota level on the system outcomes. The results reveal that a higher quota level is disadvantageous to the fashion retailer but advantageous to the salespersons.

18F-FDG PET/CT for initial staging in breast cancer patients. Is there a relevant impact on treatment planning compared to conventional staging modalities?

International Nuclear Information System (INIS)

Krammer, J.; Schnitzer, A.; Kaiser, C.G.; Buesing, K.A.; Schoenberg, S.O.; Wasser, K.; Sperk, E.; Brade, J.; Wasgindt, S.; Suetterlin, M.; Sutton, E.J.

2015-01-01

To evaluate the impact of whole-body 18 F-FDG PET/CT on initial staging of breast cancer in comparison to conventional staging modalities. This study included 102 breast cancer patients, 101 patients were eligible for evaluation. Preoperative whole-body staging with PET/CT was performed in patients with clinical stage ≥ T2 tumours or positive local lymph nodes (n = 91). Postoperative PET/CT was performed in patients without these criteria but positive sentinel lymph node biopsy (n = 10). All patients underwent PET/CT and a conventional staging algorithm, which included bone scan, chest X-ray and abdominal ultrasound. PET/CT findings were compared to conventional staging and the impact on therapeutic management was evaluated. PET/CT led to an upgrade of the N or M stage in overall 19 patients (19 %) and newly identified manifestation of breast cancer in two patients (2 %). PET/CT findings caused a change in treatment of 11 patients (11 %). This is within the range of recent studies, all applying conventional inclusion criteria based on the initial T and N status. PET/CT has a relevant impact on initial staging and treatment of breast cancer when compared to conventional modalities. Further studies should assess inclusion criteria beyond the conventional T and N status, e.g. tumour grading and receptor status. (orig.)

Space Transportation System Cargo projects: inertial stage/spacecraft integration plan. Volume 1: Management plan

Science.gov (United States)

1981-01-01

The Kennedy Space Center (KSC) Management System for the Inertial Upper Stage (IUS) - spacecraft processing from KSC arrival through launch is described. The roles and responsibilities of the agencies and test team organizations involved in IUS-S/C processing at KSC for non-Department of Defense missions are described. Working relationships are defined with respect to documentation preparation, coordination and approval, schedule development and maintenance, test conduct and control, configuration management, quality control and safety. The policy regarding the use of spacecraft contractor test procedures, IUS contractor detailed operating procedures and KSC operations and maintenance instructions is defined. Review and approval requirements for each documentation system are described.

Planning of the BN-350 reactor decommissioning

International Nuclear Information System (INIS)

Klepikov, A.Kh.; Tazhibayeva, I.L.; Zhantikin, T.M.; Baldov, A.N.; Nazarenko, P.I.; Koltyshev, S.M.; Wells, P.B.

2002-01-01

The experimental and commercial BN-350 NPP equipped with a fast neutron sodium cooled reactor is located in Kazakhstan near the Aktau city on the Caspian Sea coast. It was commissioned in 1973 and intended for weapon-grade plutonium production and as stream supply to a water desalination facility and the turbines of the Mangyshlak Atomic Energy Complex. Taking into account technical, financial and political issues, the Government of Kazakhstan enacted the Decree no. 456 'On Decommissioning of the Reactor BN-350 in the Aktau City of the Mangystau Region'. Because the decision on reactor decommissioning was adopted before the end of scheduled operation (2003), the plan to decommission the BN-350 reactor has not yet been developed. To determine the activities required for ensuring reactor safety and in preparation for decommission in the period prior, the development and ensuring approval by the Republic of Kazakhstan Government of the decommissioning plan, a 'Plan of Priority Actions for BN-350 Reactor Decommissioning' was developed and approved. Actions provided for in the plan include the following: Development of BN-350 Reactor Decommissioning Plan; Accident prevention during the period of transition; Unloading nuclear fuel from reactor and draining the coolant from the heat exchange circuits. Decommission is defined as a complex of administrative and technical actions taken to allow the removal of some or all of regulatory controls over a nuclear facility. These actions involve decontamination, dismantling and removal of radioactive materials, waste, components and structures. They are carried out to achieve a progressive and systematic reduction in radiological hazards and are undertaken on the basis of planning and assessment in order to ensure safety decommissioning operations. In accordance with the decision of Kazakhstan Government, three basic stages for BN-350 reactor decommissioning are envisaged: First stage - Placement of BN-350 into long-term storage

MDOT implementation plan for global positioning systems (GPS) technology in planning, design, and construction delivery.

Science.gov (United States)

2010-09-13

Global Positioning System (GPS) technology offers advantages to transportation agencies in the planning, design and construction stages of project delivery. This research study will develop a guide for Mississippi Department of Transportation (MDOT) ...

A comparison of different three-dimensional treatment planning techniques for localized radiotherapy of prostate cancer

International Nuclear Information System (INIS)

Koswig, S.; Dinges, S.; Buchali, A.; Boehmer, D.; Salk, J.; Rosenthal, P.; Harder, C.; Schlenger, L.; Budach, V.

1999-01-01

Purpose: Four different three-dimensional planning techniques for localized radiotherapy of prostate cancer were compared with regard to dose homogeneity within the target volume and dose to organs at risk, dependent upon tumor stage. Patients and Methods: Six patients with stage T1, 7 patients with stage T2 and 4 patients with stage T3 were included in this study. Four different 3D treatment plans (rotation, 4-field, 5-field and 6-field technique) were calculated for each patient. Dose was calculated with the reference point at the isocenter (100%). The planning target volume was encompassed within the 95% isodose surface. All the techniques used different shaped portal for each beam. Dose volume histograms were created and compared for the planning target volume and the organs at risk (33%, 50%, 66% volume level) in all techniques. Results: The 4 different three-dimensional planning techniques revealed no differences concerning dose homogeneity within the planning target volume. The dose volume distribution at organs at risk show differences between the calculated techniques. In our study the best protection for bladder and rectum in stage T1 and T2 was achieved by the 6-field technique. A significant difference was achieved between 6-field and 4-field technique only in the 50% volume of the bladder (p=0.034), between the 6-field and rotation technique (all volume levels) and between 5-field and rotation technique (all volume levels). In stage T1, T2 6-field and 4-field technique in 50% (p-0.033) and 66% (p=0.011) of the rectum volume. In stage T3 a significant difference was not observed between the 4 techniques. The best protection of head of the femur was achieved by the rotation technique. Conclusion: In the localized radiotherapy of prostate cancer in stage T1 or T2 the best protection for bladder and rectum was achieved by a 3D-planned conformal 6-field technique. If the seminal vesicles have been included in the target volume and in the case of large

Planning and Preparation for CD-ROM Implementation: The Citadel Library.

Science.gov (United States)

Maynard, J. Edmund

Management guidelines for library planning and a strategic planning program profile based on the literature were used in the planning process for implementing access to databases on CD-ROM at the Daniel Library of the Citadel, Military College of South Carolina. According to this model, the planning process would consist of five stages: (1)…

Contraceptive social marketing: a continuous cycle of planning, testing and evaluating.

Science.gov (United States)

1985-01-01

This article outlines the contraceptive marketing process used by the Social Marketing for Change (SOMARC) project. The 1st stage of the process involves analysis of the market, the consumer, and the social marketing organization's capabilities. In the 2nd stage, planning, data collected in the analysis stage are used to define objectives, segment target markets, and devise strategies for each element in the marketing mix. In the 3rd stage, all the elements in the marketing mix are developed and tested (e.g. product concepts, pricing, packaging, communication messages) and refined on the basis of test results. In stage 4, the action plan is implemented and marketing progress and institutional performance are monitored. Stage 5 includes an assessment of in-market effectiveness in terms of responses from consumers, retailers, and health professionals. The last stage feeds back to the 1st. All the reviewed data are recycled into analysis to begin again the continuous process of refinement and improvement.

Planning for design quality

International Nuclear Information System (INIS)

Marguglio, B.W.

1977-01-01

In the nuclear industry and in other high technology industries in which the Government serves as either a customer or a regulator, it is almost always required that the contractor prepare a Quality Program Plan sometimes also referred to as a Quality Program Index. Often, the Quality Program Plan is included as part of the contractor's proposal in response to the Government's or a prime contractor's Request for Proposal. At this stage, the Quality Program Plan serves to demonstrate to the prospective customer the availability of the various quality systems. It provides the customer with a commitment as to the use of these quality systems, thus giving greater assurance that the customer's overall quality and design requirements can be met. The Quality Program Plan is contributing to the salability of the proposal. 1 ref

LSC (X) Logistics Planning Support, Task 1 Requirements Definition

National Research Council Canada - National Science Library

Scalzo, John

2004-01-01

.... During the early stage after vessel delivery, there is a requirement to manage this plan through a transition period until the designated support manager is under contract and/or provided with the resources to execute the plan.

Internal quality control: planning and implementation strategies.

Science.gov (United States)

Westgard, James O

2003-11-01

The first essential in setting up internal quality control (IQC) of a test procedure in the clinical laboratory is to select the proper IQC procedure to implement, i.e. choosing the statistical criteria or control rules, and the number of control measurements, according to the quality required for the test and the observed performance of the method. Then the right IQC procedure must be properly implemented. This review focuses on strategies for planning and implementing IQC procedures in order to improve the quality of the IQC. A quantitative planning process is described that can be implemented with graphical tools such as power function or critical-error graphs and charts of operating specifications. Finally, a total QC strategy is formulated to minimize cost and maximize quality. A general strategy for IQC implementation is recommended that employs a three-stage design in which the first stage provides high error detection, the second stage low false rejection and the third stage prescribes the length of the analytical run, making use of an algorithm involving the average of normal patients' data.

MARKETING PLANNING AS KEY FACTOR OF ENTERPRISE STRUCTURE COMPETITIVENESS

Directory of Open Access Journals (Sweden)

E. V. Omelchenko

2012-01-01

Full Text Available Market planning in businesses dealing both with goods and services plays an important coordinating role, since it helps an enterprise to attain its inner consent, to determine development directions, to stimulate inner cooperation, to coordinate distribution of its resources and to formulate ways to solve tasks on the basis of which the company intends to reach its marketing aims. Specified in the article are market planning stages to be followed by a company engaged in the sphere of design services, compliance with the stages making it easier to develop the final marketing plan, to create new advantages both to stand competition at the chosen market and even to take leading positions there.

SU-F-T-377: Monte Carlo Re-Evaluation of Volumetric-Modulated Arc Plans of Advanced Stage Nasopharygeal Cancers Optimized with Convolution-Superposition Algorithm

Energy Technology Data Exchange (ETDEWEB)

Lee, K; Leung, R; Law, G; Wong, M; Lee, V; Tung, S; Cheung, S; Chan, M [Tuen Mun Hospital, Hong Kong (Hong Kong)

2016-06-15

Background: Commercial treatment planning system Pinnacle3 (Philips, Fitchburg, WI, USA) employs a convolution-superposition algorithm for volumetric-modulated arc radiotherapy (VMAT) optimization and dose calculation. Study of Monte Carlo (MC) dose recalculation of VMAT plans for advanced-stage nasopharyngeal cancers (NPC) is currently limited. Methods: Twenty-nine VMAT prescribed 70Gy, 60Gy, and 54Gy to the planning target volumes (PTVs) were included. These clinical plans achieved with a CS dose engine on Pinnacle3 v9.0 were recalculated by the Monaco TPS v5.0 (Elekta, Maryland Heights, MO, USA) with a XVMC-based MC dose engine. The MC virtual source model was built using the same measurement beam dataset as for the Pinnacle beam model. All MC recalculation were based on absorbed dose to medium in medium (Dm,m). Differences in dose constraint parameters per our institution protocol (Supplementary Table 1) were analyzed. Results: Only differences in maximum dose to left brachial plexus, left temporal lobe and PTV54Gy were found to be statistically insignificant (p> 0.05). Dosimetric differences of other tumor targets and normal organs are found in supplementary Table 1. Generally, doses outside the PTV in the normal organs are lower with MC than with CS. This is also true in the PTV54-70Gy doses but higher dose in the nasal cavity near the bone interfaces is consistently predicted by MC, possibly due to the increased backscattering of short-range scattered photons and the secondary electrons that is not properly modeled by the CS. The straight shoulders of the PTV dose volume histograms (DVH) initially resulted from the CS optimization are merely preserved after MC recalculation. Conclusion: Significant dosimetric differences in VMAT NPC plans were observed between CS and MC calculations. Adjustments of the planning dose constraints to incorporate the physics differences from conventional CS algorithm should be made when VMAT optimization is carried out directly

Kaizen planning, implementing and controlling

CERN Document Server

García-Alcaraz, Jorge Luis; Maldonado-Macías, Aidé Aracely

2017-01-01

This book reports a literature review on kaizen, its industrial applications, critical success factors, benefits gained, journals that publish about it, main authors (research groups) and universities. Kaizen is treated in this book in three stages: planning, implementation and control. The authors provide a questionnaire designed with activities in every stage, highlighting the benefits gained in each stage. The study has been applied to more than 400 managers and leaders in continuous improvement in Mexican maquiladoras. A univariate analysis is provided to the activities in every stage. Moreover, structural equation models associating those activities with the benefits gained are presented for a statistical validation. Such a relationship between activities and benefits helps managers to identify the most important factor affecting their benefits and financial income.

The evolutionary origin of the vertebrate body plan: the problem of head segmentation.

Science.gov (United States)

Onai, Takayuki; Irie, Naoki; Kuratani, Shigeru

2014-01-01

The basic body plan of vertebrates, as typified by the complex head structure, evolved from the last common ancestor approximately 530 Mya. In this review, we present a brief overview of historical discussions to disentangle the various concepts and arguments regarding the evolutionary development of the vertebrate body plan. We then explain the historical transition of the arguments about the vertebrate body plan from merely epistemological comparative morphology to comparative embryology as a scientific treatment on this topic. Finally, we review the current progress of molecular evidence regarding the basic vertebrate body plan, focusing on the link between the basic vertebrate body plan and the evolutionarily conserved developmental stages (phylotypic stages).

The United Kingdom's School Asset Management Plans.

Science.gov (United States)

Jones, Alan

1999-01-01

Examines the U.K.'s Asset Management Plans (AMPs) designed to help Local Education Authorities (LEAs) identify and address the most important priorities in their school capital programs, and to help in their longer term planning and management of the school estate. Discusses AMP objectives, the stages of developing an AMP, and how the Department…

Scenario tree airline fleet planning for demand uncertainty

NARCIS (Netherlands)

Repko, M.G.J.; Lopes dos Santos, Bruno F.

2017-01-01

This paper proposes an innovative multi-period modeling approach to solve the airline fleet planning problem under demand uncertainty. The problem is modeled using a scenario tree approach. The tree is composed of nodes, which represent points of decision in multiple time stages of the planning

Operative planning of functional sessions for multisatellite observation and communication systems

Science.gov (United States)

Darnopykh, Valeriy V.; Malyshev, Veniamin V.

2012-04-01

An important control aspect of modern satellite observation and communication systems is the control of the functional processes. Functional sessions proceed under conditions of restricted technical ability, large amounts or information to be processed by the on-board equipment, practice inequality of the received information, intentions of system management and operators, interests of customers and other factors. A large number of spacecrafts (SC) in orbital constellation is one of the most important factors affecting the functional process also. Besides that some modern projects of satellite systems are multifunctional that is mixed operations of observation and communication. Therefore the functioning of SC on-board equipment must be accurately co-ordinate. That is why the problem of operative planning the functioning of these systems, while directly affecting the efficiency of the system, is very complex and actual at present. A methodical approach and software package for operative planning of functional processes for satellite observation and communication systems, including multifunctional projects, are considered in the paper. The base scheme of this approach consists of four main stages: stage 1—modeling of SC orbital kinematics and dynamics; stage 2—modeling of system functional processes with all kind of restrictions and criterion function values; stage 3—solving an optimization tasks by numerical applicable algorithms and constructing the optimal (or accuracy) plans; stage 4—repeated plan optimization (different variants) and analyzing. Such scheme is the result of authors practical research which have been realized during last 15 years by the operative planning as for any kinds of single SC as for satellite systems with different structure of orbital constellation. The research helps to unify the procedure of operative planning, to formulate basic principles and approaches for its solving, to develop special software package. The main aspects

Esophageal motion characteristics in thoracic esophageal cancer: Impact of clinical stage T4 versus stages T1-T3

Directory of Open Access Journals (Sweden)

Yuta Kobayashi, MS

2016-10-01

Conclusions: The EM and the ITV margins in cT4 were significantly smaller than those in cT1-T3. The NM and the ITV margins of abdominal LNs were much larger than those of cervicothoracic LNs and the esophagus. In clinical radiation therapy planning for esophageal cancer, we should take cT stage into consideration.

Political Ideonomy of Rostow’s Stages of Economic Growth Theory

Directory of Open Access Journals (Sweden)

M. Mozafarinia

2016-05-01

Full Text Available The conditions of success and reasons for failure of development strategies and plans, are among the most important “development studies” issues. This has been explained in different ways: for example, there is a strong relationship between the efficiency of development strategies and plans and development theories. Based on paradigmatic-implicative theory, which explains the relationship between development theories and political thought and considers the development theory as one of the practical implications of political thought, a condition for the success of development strategies and development plans can be found to be rooted in the political thought foundation. Therefore, in the present article we explore the political thought supporting Rostow’s Stages of Economic Growth theory, as one of the oldest and most important development theories which in the 1960s resulted in understanding development as “growth”. We use qualitative content analysis method to show that the political foundation of Rostow’s Stages of Economic Growth theory is based on the principle of “the most utility for the most people” in accordance with Bentham’s utilitarian political thought.

Staging laparoscopy improves treatment decision-making for advanced gastric cancer.

Science.gov (United States)

Hu, Yan-Feng; Deng, Zhen-Wei; Liu, Hao; Mou, Ting-Yu; Chen, Tao; Lu, Xin; Wang, Da; Yu, Jiang; Li, Guo-Xin

2016-02-07

To evaluate the clinical value of staging laparoscopy in treatment decision-making for advanced gastric cancer (GC). Clinical data of 582 patients with advanced GC were retrospectively analyzed. All patients underwent staging laparoscopy. The strength of agreement between computed tomography (CT) stage, endoscopic ultrasound (EUS) stage, laparoscopic stage, and final stage were determined by weighted Kappa statistic (Kw). The number of patients with treatment decision-changes was counted. A χ(2) test was used to analyze the correlation between peritoneal metastasis or positive cytology and clinical characteristics. Among the 582 patients, the distributions of pathological T classifications were T2/3 (153, 26.3%), T4a (262, 45.0%), and T4b (167, 28.7%). Treatment plans for 211 (36.3%) patients were changed after staging laparoscopy was performed. Two (10.5%) of 19 patients in M1 regained the opportunity for potential radical resection by staging laparoscopy. Unnecessary laparotomy was avoided in 71 (12.2%) patients. The strength of agreement between preoperative T stage and final T stage was in almost perfect agreement (Kw = 0.838; 95% confidence interval (CI): 0.803-0.872; P advanced GC and decrease unnecessary exploratory laparotomy.

Integrated Care Planning for Cancer Patients: A Scoping Review

Directory of Open Access Journals (Sweden)

Anum Irfan Khan

2017-11-01

Full Text Available Introduction: There has been a growing emphasis on the use of integrated care plans to deliver cancer care. However little is known about how integrated care plans for cancer patients are developed including featured core activities, facilitators for uptake and indicators for assessing impact. Methods: Given limited consensus around what constitutes an integrated care plan for cancer patients, a scoping review was conducted to explore the components of integrated care plans and contextual factors that influence design and uptake. Results: Five types of integrated care plans based on the stage of cancer care: surgical, systemic, survivorship, palliative and comprehensive (involving a transition between stages are described in current literature. Breast, esophageal and colorectal cancers were common disease sites. Multi-disciplinary teams, patient needs assessment and transitional planning emerged as key features. Provider buy-in and training alongside informational technology support served as important facilitators for plan uptake. Provider-level measurement was considerably less robust compared to patient and system-level indicators. Conclusions: Similarities in design features, components and facilitators across the various types of integrated care plans indicates opportunities to leverage shared features and enable a management lens that spans the trajectory of a patient’s journey rather than a phase-specific silo approach to care.

The role of family planning communications--an agent of reinforcement or change.

Science.gov (United States)

Chen, E C

1981-12-01

Results are presented of a multiple classification analysis of responses to a 1972 KAP survey in Taiwan of 2013 married women aged 18-34 designed to determine whether family planning communication is primarily a reinforcement agent or a change agent. 2 types of independent variables, social demographic variables including age, number of children, residence, education, employment status, and duration of marriage; and social climate variables including ever receiving family planning information from mass media and ever discussing family planning with others, were used. KAP levels, the dependent variables, were measured by 2 variables each: awareness of effective methods and awareness of government supply of contraceptives for knowledge, wish for additional children and approve of 2-child family for attitude, and never use contraception and neither want children nor use contraception for practice. Social demographic and attitudinal variables were found to be the critical ones, while social climate and knowledge variables had only negligible effects on various stages of family planning adoption, indicating that family planning communications functioned primarily as a reinforcement agent. The effects of social demographic variables were prominent in all stages of contraceptive adoption. Examination of effects of individual variables on various stages of family planning adoption still supported the argument that family planning communications played a reinforcement role. Family planning communications functioned well in diffusing family planning knowledge and accessibility, but social demographic variables and desire for additional children were the most decisive influences on use of contraception.

Towards individualised radiotherapy for Stage I seminoma

International Nuclear Information System (INIS)

Martin, Jarad M.; Joon, Daryl Lim; Ng, Nicole; Grace, Michael; Gelderen, David van; Lawlor, Marita; Wada, Morikatsu; Joon, Michael Lim; Quong, George; Khoo, Vincent

2005-01-01

Background and purpose: Adjuvant radiotherapy is currently standard treatment of Stage I seminoma (SOS). The use of computerised tomogram (CT) planning is compared with traditional planning for greater treatment individualisation. Material and methods: Two plans were generated for each of 10 patients: one using traditional rectangular para-aortic fields, and one using conformal fields. The primary target volume compared was the dosimetric coverage of the inferior vena cava and aorta. Results: The dosimetric analysis of traditional plans showed that they provided reasonable dosimetric coverage of the CTV. However, if 1 cm is used for uncertainty based on nodal coverage then the periphery of the PTV could be significantly under-dosed. The CT based plan delivered improved dosimetry to the vessel PTV compared with the traditional field (CT D95=24.7 Gy, traditional D95=23.6 Gy, P=0.002). CT-based plans were significantly wider than traditional plans (CT=11.8 cm, traditional=9 cm, P=0.002). The CT plan tended to irradiate relatively small volumes of the kidneys to higher doses. Conclusions: Traditional para-aortic fields may deliver suboptimal dosimetry to an anatomically defined PTV. Our CT-based fields tend to be wider than traditional fields, and provide improved dosimetry to vessels based target volumes. Given that traditional fields are often delivering significantly less than the prescribed dose to the target volume, and that marginal relapses cause a high proportion of treatment failure, there is a suggestion that CT-based plans may avoid underdosage and geographical miss sometimes seen with traditional plans

Marketing plan and campaign for Riosol Oy

OpenAIRE

Toivonen, Kim

2016-01-01

The aim of this thesis was to create an efficient marketing plan and a working marketing campaign for the case company. The aspects of the marketing plan and campaign were adjusted to fit the company size, field of business and aims of the case company. To get a better view on the aspects of the marketing plan and campaign, theoretical frameworks are inspected, such as marketing mix, company stages and SWOT-analysis. This thesis consists of theoretical framework as well as practical implem...

Planning of emergency medical treatment in nuclear power plant

International Nuclear Information System (INIS)

Kusama, Tomoko

1989-01-01

Medical staffs and health physicists have shown deep concerning at the emergency plans of nuclear power plants after the TMI nuclear accident. The most important and basic countermeasure for accidents was preparing appropriate and concrete organization and plans for treatment. We have planed emergency medical treatment for radiation workers in a nuclear power plant institute. The emergency medical treatment at institute consisted of two stages, that is on-site emergency treatment at facility medical service. In first step of planning in each stage, we selected and treatment at facility medical service. In first step of planning in each stage, we selected and analyzed all possible accidents in the institute and discussed on practical treatments for some possible accidents. The manuals of concrete procedure of emergency treatment for some accidents were prepared following discussion and facilities and equipment for medical treatment and decontamination were provided. All workers in the institute had periodical training and drilling of on-site emergency treatment and mastered technique of first aid. Decontamination and operation rooms were provided in the facillity medical service. The main functions at the facility medical service have been carried out by industrial nurses. Industrial nurses have been in close co-operation with radiation safety officers and medical doctors in regional hospital. (author)

Strategic planning and security analysis

International Nuclear Information System (INIS)

DePasquale, S.

1991-01-01

Nuclear security master planning is a deliberative process, founded on the premise that the broad scope of security must be analyzed before any meaningful determinations may be reached on an individual security aspect. This paper examines the analytical process required in developing a Security Master Plan. It defines a four stage process concluding with the selection of security measures encompassing physical security, policy and procedure considerations and guard force deployment. The final product orchestrates each security measure in a complementary and supportive configuration

Strategy Scriptions: On sociomaterial devices staging strategy formulation European Management Journal

DEFF Research Database (Denmark)

Friis, Ole Uhrskov

2014-01-01

is making strategic choices, then chose a strategy and then making and action plan. Most project groups worked as expected, one group constituting a rare exception, as staging and the mobilisation of devices lead to unanticipated events, triggering extraordinary management activity. Our study shows......Strategy formulation can be viewed as an entanglement of social and material elements, developing sociomaterial strategy devices. Devices contribute to arranging and staging occasions of strategy formulation. The article investigates which arenas are staged for strategy formulation, which types...... of devices is purposely mobilised by management. and consultants. First, one central device, based on a balanced scorecard, is staging the managers as active strategists in a more traditional strategy workshop, with the employees as distanced spectators. Second, the employees are staged in an open space...

Study on optimization of normal plant outage work plan for nuclear power plants

International Nuclear Information System (INIS)

Aoki, Takayuki; Kodama, Noriko; Takase, Kentaro; Miya, Kenzo

2011-01-01

This paper discusses maintenance optimization in maintenance implementation stage following maintenance planning stage in nuclear power plants and proposes a methodology to get an optimum maintenance work plan. As a result of consideration, the followings were obtained. (1) The quantitative evaluation methodology for optimizing maintenance work plan in nuclear power plants was developed. (2) Utilizing the above methodology, a simulation analysis of maintenance work planning for BWR's PLR and RHR systems in a normal plant outage was performed. Maintenance cost calculation in several cases was carried out on the condition of smoothening man loading over the plant outage schedule as much as possible. (3) As a result of the simulation, the economical work plans having a flat man loading over the plant outage schedule were obtained. (author)

Financial planning for young households

DEFF Research Database (Denmark)

Pedersen, Anne Marie Boiden; Weissensteiner, Alex; Poulsen, Rolf

2013-01-01

We analyze the financial planning problems of young households whose main decisions are how to finance the purchase of a house (liabilities) and how to allocate investments in pension savings schemes (assets). The problems are solved using a multi-stage stochastic programming model where...

Noise and intercept point calculation for modern radio receiver planning

DEFF Research Database (Denmark)

Iversen, Christian Rye; Kolding, T. E.

2001-01-01

The paper presents analytical expressions for determining noise and intercept points for cascaded radio receiver stages. The theory allows for active receiver stages with frequency selectivity and flexible impedance levels. This makes the method highly usable for planning of modem receivers where...

SVC Planning in Large–scale Power Systems via a Hybrid Optimization Method

DEFF Research Database (Denmark)

Yang, Guang ya; Majumder, Rajat; Xu, Zhao

2009-01-01

The research on allocation of FACTS devices has attracted quite a lot interests from various aspects. In this paper, a hybrid model is proposed to optimise the number, location as well as the parameter settings of static Var compensator (SVC) deployed in large–scale power systems. The model...... utilises the result of vulnerability assessment for determining the candidate locations. A hybrid optimisation method including two stages is proposed to find out the optimal solution of SVC in large– scale planning problem. In the first stage, a conventional genetic algorithm (GA) is exploited to generate...... a candidate solution pool. Then in the second stage, the candidates are presented to a linear planning model to investigate the system optimal loadability, hence the optimal solution for SVC planning can be achieved. The method is presented to IEEE 300–bus system....

Spent nuclear fuel project integrated schedule plan

International Nuclear Information System (INIS)

Squires, K.G.

1995-01-01

The Spent Nuclear Fuel Integrated Schedule Plan establishes the organizational responsibilities, rules for developing, maintain and status of the SNF integrated schedule, and an implementation plan for the integrated schedule. The mission of the SNFP on the Hanford site is to provide safe, economic, environmentally sound management of Hanford SNF in a manner which stages it to final disposition. This particularly involves K Basin fuel

Spent nuclear fuel project integrated schedule plan

Energy Technology Data Exchange (ETDEWEB)

Squires, K.G.

1995-03-06

The Spent Nuclear Fuel Integrated Schedule Plan establishes the organizational responsibilities, rules for developing, maintain and status of the SNF integrated schedule, and an implementation plan for the integrated schedule. The mission of the SNFP on the Hanford site is to provide safe, economic, environmentally sound management of Hanford SNF in a manner which stages it to final disposition. This particularly involves K Basin fuel.

The use of biologically related model (Eclipse for the intensity-modulated radiation therapy planning of nasopharyngeal carcinomas.

Directory of Open Access Journals (Sweden)

Monica W K Kan

Full Text Available Intensity-modulated radiation therapy (IMRT is the most common treatment technique for nasopharyngeal carcinoma (NPC. Physical quantities such as dose/dose-volume parameters are used conventionally for IMRT optimization. The use of biological related models has been proposed and can be a new trend. This work was to assess the performance of the biologically based IMRT optimization model installed in a popular commercial treatment planning system (Eclipse as compared to its dose/dose volume optimization model when employed in the clinical environment for NPC cases.Ten patients of early stage NPC and ten of advanced stage NPC were selected for this study. IMRT plans optimized using biological related approach (BBTP were compared to their corresponding plans optimized using the dose/dose volume based approach (DVTP. Plan evaluation was performed using both biological indices and physical dose indices such as tumor control probability (TCP, normal tissue complication probability (NTCP, target coverage, conformity, dose homogeneity and doses to organs at risk. The comparison results of the more complex advanced stage cases were reported separately from those of the simpler early stage cases.The target coverage and conformity were comparable between the two approaches, with BBTP plans producing more hot spots. For the primary targets, BBTP plans produced comparable TCP for the early stage cases and higher TCP for the advanced stage cases. BBTP plans reduced the volume of parotid glands receiving doses of above 40 Gy compared to DVTP plans. The NTCP of parotid glands produced by BBTP were 8.0 ± 5.8 and 7.9 ± 8.7 for early and advanced stage cases, respectively, while those of DVTP were 21.3 ± 8.3 and 24.4 ± 12.8, respectively. There were no significant differences in the NTCP values between the two approaches for the serial organs.Our results showed that the BBTP approach could be a potential alternative approach to the DVTP approach for NPC.

Flood action plans

International Nuclear Information System (INIS)

Slopek, R.J.

1995-01-01

Safe operating procedures developed by TransAlta Utilities for dealing with flooding, resulting from upstream dam failures or extreme rainfalls, were presented. Several operating curves developed by Monenco AGRA were described, among them the No Overtopping Curve (NOC), the Safe Filling Curve (SFC), the No Spill Curve (NSC) and the Guaranteed Fill Curve (GFC). The concept of an operational comfort zone was developed and defined. A flood action plan for all operating staff was created as a guide in case of a flooding incident. Staging of a flood action plan workshop was described. Dam break scenarios pertinent to the Bow River were developed for subsequent incorporation into a Flood Action Plan Manual. Evaluation of the technical presentations made during workshops were found them to have been effective in providing operating staff with a better understanding of the procedures that they would perform in an emergency. 8 figs

Second molar calcification stages to evaluate skeletal maturation: A cross-sectional radiographic study

Directory of Open Access Journals (Sweden)

U H Vijayashree

2014-01-01

Conclusion: A highly positive correlation exists between DI of mandibular second molars and CVMI. Stage F of Demirjian index, with the root length equal to or greater than the crown height corresponds to stage 3 of CVMI indicating the start of peak in mandibular growth which would be appropriate time to plan for functional appliances. Therefore, mandibular second molar calcification stages are reliable skeletal maturity indicator, which can be used to predict the growth status in determining the optimal treatment timing.

Relative Efficiencies of a Three-Stage Versus a Two-Stage Sample Design For a New NLS Cohort Study. 22U-884-38.

Science.gov (United States)

Folsom, R. E.; Weber, J. H.

Two sampling designs were compared for the planned 1978 national longitudinal survey of high school seniors with respect to statistical efficiency and cost. The 1972 survey used a stratified two-stage sample of high schools and seniors within schools. In order to minimize interviewer travel costs, an alternate sampling design was proposed,…

Planning and design considerations in karst terrain

Science.gov (United States)

Fischer, J. A.; Greene, R. W.; Ottoson, R. S.; Graham, T. C.

1988-10-01

This article discusses the various steps that the authors feel are necessary to the successful progression of an engineered project sited in karst terrain. The procedures require a multidisciplined approach with liaison and cooperation among the various parties to the project. Initially, the prospective owner must have sufficient understanding of the potential engineering problems to incorporate the engineering geologist into the early stages of any planned acquisition. The first step in an investigation should include a review of the available geologic information, aerial photo interpretation, consultation with the State Geological Survey, and a geologic reconnaissance of the prospective site and surrounding area. A go-no-go decision as to purchase can often been made at an early time. Although, in some instances, more study is needed for a particularly intriguing property. The second stage should consider the various planning alternatives that are feasible based upon the limited available information. At this stage planning/purchase decisions can be made as to purchasing options, value of the property, design constraints, and the possible economic penalties that could be associated with the potential site construction. Various planning and construction alternatives should be considered in this phase of the work. The third stage should include a site investigation program of moderate size, consisting of test pits and/or exploratory borings. The borings should be drilled using water as the drilling fluid, with an experienced crew and qualified technical inspection. The authors find the use of geophysical techniques can be extremely misleading unless used in conjunction with exploratory drilling. Successful evaluations using geophysical procedures occur only under ideal conditions. The geotechnical viability of the plan and preliminary design should be investigated in the fourth phase. Additionally, the physical parameters required for the design of structures

Psychiatry in primary care using the three-stage assessment

African Journals Online (AJOL)

terms of the patient's readiness to change his/her behaviour and then use an agenda-setting technique to decide which risk factor to .... and occasionally uses cannabis. She is not using any family planning (besides ... require a long-term relationship with their primary care physician,. Table 1. The three-stage assessment.

Development of the Decommissioning Planning System for the WWR-M Reactor

Energy Technology Data Exchange (ETDEWEB)

Lobach, Y. [Institute for Nuclear Research, Kiev (Ukraine)

2013-08-15

Kiev's research reactor WWR-M is in operation for more than 50 years and its continued operation is planned. At the same time the development of a decommissioning plan is a mandatory requirement of the national legislation and it must be performed at the operational stage of nuclear installation as early as possible. Recently, the Decommissioning Programme for the WWR-M reactor has been developed. The programme covers the whole decommissioning process and represents the main guiding document during the whole decommissioning period, which determines and substantiates the principal technical and organizational activities on the preparation and implementation of the reactor decommissioning, the consequence of the decommissioning stages, the sequence of planned works and measures as well as the necessary conditions and infrastructure for the provision and safe implementation. The programme contains the basic directions of further decommissioning planning aimed on the timely preparation for the reactor decommissioning. This paper describes the status of the WWR-M reactor decommissioning planning attained by the middle of 2011. (author)

The strategies, experiences and future challenges of the information component in the Indonesian Family Planning Programme.

Science.gov (United States)

Suyono, H

1988-12-01

In 1957, the Indonesian Planned Parenthood Federation was established. In 1970, the National Family Planning Board (BKKBN) was created. The current contraceptive prevalence rate is 45-50%. The family planning program began with a health-oriented approach. To promote acceptance, religious leaders were asked to provide legitimacy to the program. Through their efforts, it became possible to include all the means and medication used for family planning services within the program. In developing an IEC strategy to encourage couples to accept family planning, 3 main factors were studied: 1) the types of innovations that were to be introduced, 2) the characteristics of the Indonesian community, and 3) the need for an IEC strategy to convey the programs messages the community and make the community itself the agent of the innovation being introduced. The elements of the strategy were introduced stage by stage to avoid unnecessary debate. Another strategic step was the introduction of family planning using a community approach. A 3rd strategic step was a shift from couples as family planning acceptors to the introduction of the norm of a small, happy, and prosperous family. The 1st stage, expansion of program coverage, 1) promoted the need for and desirability of family planning to make the small and happy family the norm and 2) supplied contraceptives and information about contraceptives throughout Indonesia. The 2nd stage, the program maintenance approach, included 1) an increase in the frequency of visits to villages by mobile family planning teams, 2) the integration of family planning activities with other health-related activities, and 3) giving people a wider choice of methods and helping them to choose the most suitable method for them. The 3rd stage made family planning a community activity, integrated within the economic and social fabric of community life. The general strategy of the IEC program is to make the various target groups full family planning

A production planning model considering uncertain demand using two-stage stochastic programming in a fresh vegetable supply chain context.

Science.gov (United States)

Mateo, Jordi; Pla, Lluis M; Solsona, Francesc; Pagès, Adela

2016-01-01

Production planning models are achieving more interest for being used in the primary sector of the economy. The proposed model relies on the formulation of a location model representing a set of farms susceptible of being selected by a grocery shop brand to supply local fresh products under seasonal contracts. The main aim is to minimize overall procurement costs and meet future demand. This kind of problem is rather common in fresh vegetable supply chains where producers are located in proximity either to processing plants or retailers. The proposed two-stage stochastic model determines which suppliers should be selected for production contracts to ensure high quality products and minimal time from farm-to-table. Moreover, Lagrangian relaxation and parallel computing algorithms are proposed to solve these instances efficiently in a reasonable computational time. The results obtained show computational gains from our algorithmic proposals in front of the usage of plain CPLEX solver. Furthermore, the results ensure the competitive advantages of using the proposed model by purchase managers in the fresh vegetables industry.

Pre-defined and optional staging for the deployment of enterprise systems: a case study and a framework

Science.gov (United States)

Lichtenstein, Yossi; Cucuy, Shy; Fink, Lior

2017-03-01

The effective deployment of enterprise systems has been a major challenge for many organisations. Customising the new system, changing business processes, and integrating multiple information sources are all difficult tasks. As such, they are typically done in carefully planned stages in a process known as phased implementation. Using ideas from Option Theory, this article critiques aspects of phased implementation. One customer relationship management (CRM) project and its phased implementation are described in detail and ten other enterprise system deployments are summarised as a basis for the observation that almost all deployment stages are pre-defined operational steps rather than decision points. However, Option Theory suggests that optional stages, to be used only when risk materialises, should be integral parts of project plans. Although such optional stages are often more valuable than pre-defined stages, the evidence presented in this article shows that they are only rarely utilised. Therefore, a simple framework is presented; it first identifies risks related to the deployment of enterprise systems, then identifies optional stages that can mitigate these risks, and finally compares the costs and benefits of both pre-defined and optional stages.

Migration plans and hours of work in Malaysia.

Science.gov (United States)

Gillin, E D; Sumner, D A

1985-01-01

"This article describes characteristics of prospective migrants in the Malaysian Family Life Survey and investigates how planning to move affects hours of work. [The authors] use ideas about intertemporal substitution...to discuss the response to temporary and permanent wage expectations on the part of potential migrants. [An] econometric section presents reduced-form estimates for wage rates and planned migration equations and two-stage least squares estimates for hours of work. Men currently planning a move were found to work fewer hours. Those originally planning only a temporary stay at their current location work more hours." excerpt

An inexact mixed risk-aversion two-stage stochastic programming model for water resources management under uncertainty.

Science.gov (United States)

Li, W; Wang, B; Xie, Y L; Huang, G H; Liu, L

2015-02-01

Uncertainties exist in the water resources system, while traditional two-stage stochastic programming is risk-neutral and compares the random variables (e.g., total benefit) to identify the best decisions. To deal with the risk issues, a risk-aversion inexact two-stage stochastic programming model is developed for water resources management under uncertainty. The model was a hybrid methodology of interval-parameter programming, conditional value-at-risk measure, and a general two-stage stochastic programming framework. The method extends on the traditional two-stage stochastic programming method by enabling uncertainties presented as probability density functions and discrete intervals to be effectively incorporated within the optimization framework. It could not only provide information on the benefits of the allocation plan to the decision makers but also measure the extreme expected loss on the second-stage penalty cost. The developed model was applied to a hypothetical case of water resources management. Results showed that that could help managers generate feasible and balanced risk-aversion allocation plans, and analyze the trade-offs between system stability and economy.

Intervention-engagement and its role in the effectiveness of stage-matched interventions promoting physical exercise.

Science.gov (United States)

Richert, Jana; Lippke, Sonia; Ziegelmann, Jochen P

2011-01-01

Intervention-engagement has received little attention in sports medicine as well as research and promotion of physical exercise. The construct is important, however, in the understanding of why interventions work. This study aimed at shedding more light on the interplay of engagement and the subsequent effectiveness of physical exercise interventions. A three-stage model differentiating among nonintenders, intenders, and actors informed the intervention design in this study. In an Internet-based randomized controlled trial (RCT) with two measurement points, N = 326 participants received a stage-matched, stage-mismatched, or control treatment. Assessed variables were goal setting, planning, behavior, and intervention-engagement. It was found that regarding goal setting, nonintenders in the stage-matched intervention and those who engaged highly in the stage-matched intervention improved significantly over time. Regarding planning, intenders in the matched condition as well as all actors increased their levels over time. Regarding behavior, nonintenders and intenders having engaged highly in the intervention improved more than those having engaged little. In order to help nonintenders progress on their way toward goal behavior, it is necessary that they engage highly in a stage-matched intervention. Implications for exercise promotion are that interventions should also aim at increasing participants' intervention-engagement.

Strategic School Planning in Jordan

Science.gov (United States)

Al-Zboon, Mohammad Saleem; Hasan, Manal Subhi

2012-01-01

The study aimed to measuring the applying degree of the strategic school planning stages at the Governmental high schools from the educational supervisors and principals perspective in the directorates related to Amman city, the study society was formed of the educational supervisors and principals working at Educational directorates related to…

A Novel Surgical Template Design in Staged Dental Implant Rehabilitations

Directory of Open Access Journals (Sweden)

Michael Patras

2012-05-01

Full Text Available Background: The philosophy of a gradual transition to an implant retained prosthesis in cases of full-mouth or extensive rehabilitation usually involves a staged treatment concept. In this therapeutic approach, the placement of implants may sometimes be divided into phases. During a subsequent surgical phase of treatment, the pre-existing implants can serve as anchors for the surgical template. Those modified surgical templates help in the precise transferring of restorative information into the surgical field and guide the optimal three-dimensional implant positioning. Methods: This article highlights the rationale of implant-retained surgical templates and illustrates them through the presentation of two clinical cases. The templates are duplicates of the provisional restorations and are secured to the existing implants through the utilization of implant mounts. Results: This template design in such staged procedures provided stability in the surgical field and enhanced the accuracy in implant positioning based upon the planned restoration, thus ensuring predictable treatment outcomes.Conclusions: Successful rehabilitation lies in the correct sequence of surgical and prosthetic procedures. Whenever a staged approach of implant placement is planned, the clinician can effectively use the initially placed implants as anchors for the surgical template during the second phase of implant surgery.

Prostate intensity-modulated radiotherapy planning in seven mouse clicks: Development of a class solution for cancer.

Science.gov (United States)

Wood, Maree; Fonseca, Amara; Sampson, David; Kovendy, Andrew; Westhuyzen, Justin; Shakespeare, Thomas; Turnbull, Kirsty

2016-01-01

The aim of the retrospective study was to develop a planning class solution for prostate intensity-modulated radiotherapy (IMRT) that achieved target and organs-at-risk (OAR) doses within acceptable departmental protocol criteria using the Monaco treatment planning system (Elekta-CMS Software, MO, USA). Advances in radiation therapy technology have led to a re-evaluation of work practices. Class solutions have the potential to produce highly conformal plans in a time-efficient manner. Using data from intermediate and high risk prostate cancer patients, a stepwise quality improvement model was employed. Stage 1 involved the development of a broadly based treatment template developed across 10 patients. Stage 2 involved template refinement and clinical audit ( n  = 20); Stage 3, template review ( n  = 50) and Stage 4 an assessment of a revised template against the actual treatment plan involving 72 patients. The computer algorithm that comprised the Stage 4 template met clinical treatment criteria for 82% of patients. Minor template changes were required for a further 13% of patients. Major changes were required in 4%; one patient could not be assessed. The average calculation time was 13 min and involved seven mouse clicks by the planner. Thus, the new template met treatment criteria or required only minor changes in 95% of prostate patients; this is an encouraging result suggesting improvements in planning efficiency and consistency. It is feasible to develop a class solution for prostate IMRT using a stepwise quality improvement model which delivers clinically acceptable plans in the great majority of prostate cases.

Planning and design of a knowledge based system for green manufacturing management

Science.gov (United States)

Kamal Mohd Nawawi, Mohd; Mohd Zuki Nik Mohamed, Nik; Shariff Adli Aminuddin, Adam

2013-12-01

This paper presents a conceptual design approach to the development of a hybrid Knowledge Based (KB) system for Green Manufacturing Management (GMM) at the planning and design stages. The research concentrates on the GMM by using a hybrid KB system, which is a blend of KB system and Gauging Absences of Pre-requisites (GAP). The hybrid KB/GAP system identifies all potentials elements of green manufacturing management issues throughout the development of this system. The KB system used in the planning and design stages analyses the gap between the existing and the benchmark organizations for an effective implementation through the GAP analysis technique. The proposed KBGMM model at the design stage explores two components, namely Competitive Priority and Lean Environment modules. Through the simulated results, the KBGMM System has identified, for each modules and sub-module, the problem categories in a prioritized manner. The System finalized all the Bad Points (BP) that need to be improved to achieve benchmark implementation of GMM at the design stage. The System provides valuable decision making information for the planning and design a GMM in term of business organization.

Planning and design of a knowledge based system for green manufacturing management

International Nuclear Information System (INIS)

Nawawi, Mohd Kamal Mohd; Mohamed, Nik Mohd Zuki Nik; Aminuddin, Adam Shariff Adli

2013-01-01

This paper presents a conceptual design approach to the development of a hybrid Knowledge Based (KB) system for Green Manufacturing Management (GMM) at the planning and design stages. The research concentrates on the GMM by using a hybrid KB system, which is a blend of KB system and Gauging Absences of Pre-requisites (GAP). The hybrid KB/GAP system identifies all potentials elements of green manufacturing management issues throughout the development of this system. The KB system used in the planning and design stages analyses the gap between the existing and the benchmark organizations for an effective implementation through the GAP analysis technique. The proposed KBGMM model at the design stage explores two components, namely Competitive Priority and Lean Environment modules. Through the simulated results, the KBGMM System has identified, for each modules and sub-module, the problem categories in a prioritized manner. The System finalized all the Bad Points (BP) that need to be improved to achieve benchmark implementation of GMM at the design stage. The System provides valuable decision making information for the planning and design a GMM in term of business organization

[Planning by service organisation priorities. The process of preparing strategic service-organisation plans].

Science.gov (United States)

Sampietro-Colom, Laura; Costa, Dolors; Busqué, Anna; Lacasa, Carme

2008-12-01

Strategic planning designs the general setting and the strategic principles of a healthcare system, as well as the general guidelines that govern the development of a health system. Strategic service-organisation plans deal with translating healthcare policies into service policies and respond, principally, to the need for services; these give rise to problems that require a solution. They are developed in line with advances in scientific knowledge, the implementation and current characteristics of the healthcare services and the evolution in the competences of professional teams. There are five stages for their development: identification of health/service requirements; prioritisation of needs in health/services; definition of and agreement on service organisation models (care model and service portfolio); the preparation of and agreement on territorial action plans; introduction and evaluation. A conceptual framework is presented along with practical applications carried out in Catalonia.

Groundwater protection management program plan

International Nuclear Information System (INIS)

1992-06-01

US Department of Energy (DOE) Order 5400.1 requires the establishment of a groundwater protection management program to ensure compliance with DOE requirements and applicable Federal, state, and local laws and regulations. The Uranium Mill Tailings Remedial Action (UMTRA) Project Office has prepared a ''Groundwater Protection Management Program Plan'' (groundwater protection plan) of sufficient scope and detail to reflect the program's significance and address the seven activities required in DOE Order 5400.1, Chapter 3, for special program planning. The groundwater protection plan highlights the methods designed to preserve, protect, and monitor groundwater resources at UMTRA Project processing and disposal sites. The plan includes an overview of the remedial action status at the 24 designated processing sites and identifies project technical guidance documents and site-specific documents for the UMTRA groundwater protection management program. In addition, the groundwater protection plan addresses the general information required to develop a water resources protection strategy at the permanent disposal sites. Finally, the plan describes ongoing activities that are in various stages of development at UMTRA sites (long-term care at disposal sites and groundwater restoration at processing sites). This plan will be reviewed annually and updated every 3 years in accordance with DOE Order 5400.1

Planning competitiveness on the energy sector

International Nuclear Information System (INIS)

Hennicke, P.

1991-01-01

The book reviews the concept of least cost planning which can be applied in all stages of energy management. It is a system-analytical concept of planning, cost optimisation, and application of investment alternatives in energy supply and energy conversion. In particular, the authors discuss inhowfar the positive results achieved in the USA with cost saving programmes based on least-cost planning can be applied to the situation of the Federal Republic of Germany. It is shown that least-cost planning could make a key contribution to operations scheduling of public utilities, in the establishment and implementation of local and regional energy concepts, and especially in the theory and practice of state supervision of the energy sector. The 14 contributions can be found as separate records in this database. (orig./HP) With 31 figs [de

40 CFR 51.152 - Contingency plans.

Science.gov (United States)

2010-07-01

... FOR PREPARATION, ADOPTION, AND SUBMITTAL OF IMPLEMENTATION PLANS Prevention of Air Pollution Emergency... emission control actions to be taken at each episode stage. (Examples of emission control actions are set...: (1) Prompt acquisition of forecasts of atmospheric stagnation conditions and of updates of such...

WE-F-BRB-02: Setting the Stage for Incorporation of Toxicity Measures in Treatment Plan Assessments

International Nuclear Information System (INIS)

Mayo, C.

2015-01-01

Advancements in informatics in radiotherapy are opening up opportunities to improve our ability to assess treatment plans. Models on individualizing patient dose constraints from prior patient data and shape relationships have been extensively researched and are now making their way into commercial products. New developments in knowledge based treatment planning involve understanding the impact of the radiation dosimetry on the patient. Akin to radiobiology models that have driven intensity modulated radiotherapy optimization, toxicity and outcome predictions based on treatment plans and prior patient experiences may be the next step in knowledge based planning. In order to realize these predictions, it is necessary to understand how the clinical information can be captured, structured and organized with ontologies and databases designed for recall. Large databases containing radiation dosimetry and outcomes present the opportunity to evaluate treatment plans against predictions of toxicity and disease response. Such evaluations can be based on dose volume histogram or even the full 3-dimensional dose distribution and its relation to the critical anatomy. This session will provide an understanding of ontologies and standard terminologies used to capture clinical knowledge into structured databases; How data can be organized and accessed to utilize the knowledge in planning; and examples of research and clinical efforts to incorporate that clinical knowledge into planning for improved care for our patients. Learning Objectives: Understand the role of standard terminologies, ontologies and data organization in oncology Understand methods to capture clinical toxicity and outcomes in a clinical setting Understand opportunities to learn from clinical data and its application to treatment planning Todd McNutt receives funding from Philips, Elekta and Toshiba for some of the work presented

78 FR 61329 - Revision of the Land Management Plan for the Nantahala and Pisgah National Forests

Science.gov (United States)

2013-10-03

.... Individuals who use telecommunication devices for the deaf (TDD) may call the Federal Information Relay.... More information on the planning process can also be found on the Nantahala and Pisgah Plan Revision... Forest Planning Rule (36 CFR Part 219), the planning process encompases three-stages: Assessment, plan...

Economic Analysis in the System of Financial Planning of Forestry Enterprises

Directory of Open Access Journals (Sweden)

Ievdokymov Viktor V.

2017-12-01

Full Text Available The aim of the article is to develop organizational and methodological provisions of economic analysis of forestry enterprises’ financial plans as a result of financial planning. The importance of financial planning as a basis for developing managerial decisions regarding the financial potential is substantiated. The characteristic of the development stages and the importance of financial potential in countries of the world is given. The stages of forecasting as the basis of enterprises’ financial plans are considered. The composition of the subsystems, methods and functions of financial planning highlighted in the scientific literature is investigated. The place of economic analysis in financial planning and in the system of financial planning of an enterprise’s economic activity is determined. There identified the directions of information disclosure in a financial plan: formation of financial results, budget settlements, cash flow, capital investments, ratio analysis, financial status, breakdown of individual items. The prospect for further research is to determine the order of applying the analytical procedures for each of these directions of economic analysis to justify the application of the analytical procedures for assessing financial potential on the basis of financial plans of forestry enterprises. This will allow to create information space for managing the financial potential of a forestry enterprise to achieve its tactical and strategic goals.

Planning and Managing Drupal Projects

CERN Document Server

Nordin, Dani

2011-01-01

If you're a solo website designer or part of a small team itching to build interesting projects with Drupal, this concise guide will get you started. Drupal's learning curve has thrown off many experienced designers, particularly the way it handles design challenges. This book shows you the lifecycle of a typical Drupal project, with emphasis on the early stages of site planning. Learn how to efficiently estimate and set up your own project, so you can focus on ways to make your vision a reality, rather than let project management details constantly distract you. Plan and estimate your projec

Research Planning and Evaluation Project

International Nuclear Information System (INIS)

Song, Seunghyun; Kim, Doyang; Ryu, Byunghoon; Lim, Chaeyoung; Song, Leeyoung; Lee, Youngchul; Han, Changsun; Kim, Hackchoon

2011-12-01

- To activate R and D through a systematic and impartial evaluation by using information on efficient distribution of research resource, setting project priorities, and measuring achievement against goals produced after research on planning and evaluation system for the government-funded project for KAERI was conducted. - Nuclear R and D project is the representative national R and D project which has been implemented in Korea. For the sustainable development of nuclear energy which supplies about 40% of total electricity generation and the enhancement of it innovative ability in the future, a systematic and efficient strategy in the planning stage is required

Planning for implementation in a volunteer process

International Nuclear Information System (INIS)

Tweed, Cherry

2014-01-01

The framework for implementing geological disposal of the UK's higher activity radioactive wastes is laid out in the Managing Radioactive Waste Safely (MRWS) White Paper published by the UK Government in June 2008. The process to site a facility is to be staged and based on voluntarism and partnership with local communities. This process is in its early stages and this paper outlines the work being undertaken by the Nuclear Decommissioning Authority's Radioactive Waste Management Directorate (NDA-RWMD), the implementing body for geological disposal in the UK, to plan, along with others, how to deal with the waste and get it safely underground. It describes how the work programme has been developed, how the safety is demonstrated, how to provide packaging advice and develop the organisation. The processes used to build confidence in these plans are also presented

The role and importance of the strategic planning in bank marketing

Directory of Open Access Journals (Sweden)

Gheorghe PISTOL

2010-06-01

Full Text Available The paper aims to highlight the strategic planning role and place in bank marketing, define the concepts of strategic planning and marketing planning and the tactical planning, marketing plan and marketing program. In this context, the author emphasize the strategic marketing planning process and its implementation stages (defining the specific mission, environmental analysis, formulation of objectives, strategies, action plans and programs, implementation, testing, overhaul and performance evaluation. Also, are reviewed organizational and decision levels specific for the strategic planning, higher organizational level, strategic unit level and operational level and the criteria considered in formulating objectives: acceptability, flexibility, motivating character, clarity, feasibility and compatibility.

Non-nuclear radiological emergencies. Special plan for radiological risk of the Valencian Community

International Nuclear Information System (INIS)

Rodríguez Rodrigo, I.; Piles Alepuz, I.; Peiró Juan, J.; Calvet Rodríguez, D.

2015-01-01

After the publication of the Radiological Hazard Basic Directive, Generalitat (the regional government in Valencian Community) initiated the edition of the pertinent Special Plan, with the objective to assemble the response of all the Security and Emergency Agencies, including the Armed Forces, in a radiological emergency affecting the territory of the Valencian Community, under a single hierarchy command. Being approved and homologated the Radiological Hazard Special Plan, Generalitat has undertaken the implementation process planned to finish in June 2015. Following the same process as other Plans, implementation is organized in a first informative stage, followed of a formative and training stage, and finishing with an activation exercise of the Plan. At the end of the process, is expected that every Agency will know their functions, the structure and organization in which the intervention takes place, the resources needed, and adapt their protocols to the Plan requirements. From the beginning, it has been essential working together with the Nuclear Safety Council, as is established in the agreement signed in order to collaborate in Planning, Preparedness and Response in Radiological Emergencies. [es

Unvented Drum Handling Plan

International Nuclear Information System (INIS)

MCDONALD, K.M.

2000-01-01

This drum-handling plan proposes a method to deal with unvented transuranic drums encountered during retrieval of drums. Finding unvented drums during retrieval activities was expected, as identified in the Transuranic (TRU) Phase I Retrieval Plan (HNF-4781). However, significant numbers of unvented drums were not expected until excavation of buried drums began. This plan represents accelerated planning for management of unvented drums. A plan is proposed that manages unvented drums differently based on three categories. The first category of drums is any that visually appear to be pressurized. These will be vented immediately, using either the Hanford Fire Department Hazardous Materials (Haz. Mat.) team, if such are encountered before the facilities' capabilities are established, or using internal capabilities, once established. To date, no drums have been retrieved that showed signs of pressurization. The second category consists of drums that contain a minimal amount of Pu isotopes. This minimal amount is typically less than 1 gram of Pu, but may be waste-stream dependent. Drums in this category are assayed to determine if they are low-level waste (LLW). LLW drums are typically disposed of without venting. Any unvented drums that assay as TRU will be staged for a future venting campaign, using appropriate safety precautions in their handling. The third category of drums is those for which records show larger amounts of Pu isotopes (typically greater than or equal to 1 gram of Pu). These are assumed to be TRU and are not assayed at this point, but are staged for a future venting campaign. Any of these drums that do not have a visible venting device will be staged awaiting venting, and will be managed under appropriate controls, including covering the drums to protect from direct solar exposure, minimizing of container movement, and placement of a barrier to restrict vehicle access. There are a number of equipment options available to perform the venting. The

SNF project engineering process improvement plan

International Nuclear Information System (INIS)

KELMENSON, R.L.

1999-01-01

This Engineering Process Improvement Plan documents the activities and plans to be taken by the SNF Project (the Project) to support its engineering process and to produce a consolidated set of engineering procedures that are fully compliant with the requirements of HNF-PRO-1819 (1819). These requirements are imposed on all engineering activities performed for the Project and apply to all life-cycle stages of the Project's systems, structures and components (SSCs). This Plan describes the steps that will be taken by the Project during the transition period to ensure that new procedures are effectively integrated into the Project's work process as these procedures are issued. The consolidated procedures will be issued and implemented by September 30, 1999

HVDC-System-Interaction Assessment through Line-Flow Change-Distribution Factor and Transient-Stability Analysis at Planning Stage

Directory of Open Access Journals (Sweden)

Sungchul Hwang

2016-12-01

Full Text Available Many of the recent projects for new transmission line have considered the high-voltage direct current (HVDC system, owing to the many advantages of the direct current (DC system. The most noteworthy advantage is that a cable can serve as a substitute for the overhead transmission line in residential areas; therefore, the HVDC system application is increasing, and as the number of DC systems in the power system increases, the interaction assessment regarding the HVDC system gains importance. An index named multi-infeed interaction factor (MIIF is commonly used to estimate the interaction between power converters; however, the HVDC system is composed of two converters and a transmission line. The MIIF represents the interaction between the rectifiers and inverters, but not for the whole system. In this work, a method to assess the interaction of the whole system was therefore studied. To decide on the location of the new HVDC transmission system at the planning stage, in consideration of the interaction of the existing DC system, the line flow change distribution factor, according to the HVDC-transmission capacity change, was examined. Also, a power system transient -stability analysis was performed with different HVDC system locations, depending on the distribution factor. The simulation results indicate that when the factor is higher, two HVDC systems have a stronger interaction and are less stable in the transient state.

FINANCIAL AUDIT -RISKS IDENTIFIED IN THE AUDIT PLANNING STAGE

Directory of Open Access Journals (Sweden)

Stelian Selisteanu

2015-09-01

Full Text Available The general objective of the audit activity is to currently present, under all significant aspects, a financial situation and to state an opinion according to which all economic operations are indeed correct and pursuant the law. As any activity that involves the human factor, the audit activity is subject to the influence of certain risks, risks that emerge, firstly, from an organizational level of the audited entity. In audit, risk is a very important influence element, whose ignorance can generate major implications in achieving the final goal to create an evidences database on which a pertinent and objective opinion can be founded, concerning the audited financial situations. In this context, one of the main objectives, that takes place during the planning phase of the audit, is represented by assessing risks to which the audited activity is subjected to, evaluation that helps the determining the work volume implied by the audit.

A Case Study: Optimal Stage Gauge NetworkUsing Multi Objective Genetic Algorithm

Science.gov (United States)

Joo, H. J.; Han, D.; Jung, J.; Kim, H. S.

2017-12-01

Recently, the possibility of occurrence of localized strong heavy rainfall due to climate change is increasing and flood damage is also increasing trend in Korea. Therefore we need more precise hydrologic analysis for preparing alternatives or measures for flood reduction by considering climate conditions which we have difficulty in the prediction. To do this, obtaining reliable hydrologic data, for an example, stage data, is very important. However, the existing stage gauge stations are scattered around the country, making it difficult to maintain them in a stable manner, and subsequently hard to acquire the hydrologic data that could be used for reflecting the localized hydrologic characteristics. In order to overcome such restrictions, this paper not only aims to establish a plan to acquire the water stage data in a constant and proper manner by using limited manpower and costs, but also establishes the fundamental technology for acquiring the water level observation data or the stage data. For that, this paper identifies the current status of the stage gauge stations installed in the Chung-Ju dam in Han river, Korea and extract the factors related to the division and characteristics of basins. Then, the obtained factors are used to develop the representative unit hydrograph that shows the characteristics of flow. After that, the data are converted into the probability density function and the stations at individual basins are selected by using the entropy theory. In last step, we establish the optimized stage gauge network by the location of the stage station and grade using the Multi Objective Genetic Algorithm(MOGA) technique that takes into account for the combinations of the number of the stations. It is expected that this paper can help establish an optimal observational network of stage guages as it can be applied usefully not only for protecting against floods in a stable manner, but also for acquiring the hydrologic data in an efficient manner. Keywords

Relation between the organizational lifecycle and planning: a study of accounting service companies from the state of Santa Catarina

Directory of Open Access Journals (Sweden)

Dinorá Baldo de Faveri

2014-11-01

Full Text Available The study aims to identify the relation between the different stages of the organizational lifecycle and the planning process of accounting service companies in the State of Santa Catarina. This descriptive research with a quantitative approach was undertaken through a survey in a convenience sample of 116 companies. Therefore, the model by Miller and Friesen (1984 was used to identify the lifecycle stages and the instrument by Frezatti, Relvas, Nascimento, Junqueira and Souza (2010 to measure the usage level of the planning artifacts. The planning was analyzed in its three modalities: Strategic Planning, Budget and Budgetary Control. To analyze the data, discriminant and correlation analyses were used. The study results showed that the accounting service companies are classified in distinct stages of the organizational lifecycle, predominantly birth and rejuvenation. Only half of the companies analyzed use the budget, even when managed by people with a background in the area who know the importance of this instrument. In addition, a negative correlation was observed between the stages of birth and decline and the use of the planning artifacts and a positive correlation between the stages of growth, maturity and rejuvenation, in line with the results by Miller and Friesen (1984.

Planning a regional palliative care services network.

Science.gov (United States)

Zalot, G N

1989-03-01

Table 1 summarizes the role of task force members and staff for each of the main tasks of the process of planning. The number of meetings required for each stage of the process is estimated in the last column. Planning for a regional palliative care services network is a process involving "hard" and "soft" elements. Hard elements involve the organizational structure, task force meetings, information/statistical data bases and the discrete tasks summarized in Table 1. These elements are well known, if nokt always well organized in practice. It is the "softer" elements that usually mean the difference between a dull bureaucratic exercise and a creative exchange of ideas and concepts with a vision for the future. Not to be underestimated is the critical role of group development in this process. The Task Force, supported by professional staff expertise and judgment, hopes to achieve a level of group development termed "synergy," that is, where the group outperforms (in terms of quality and quantity of work) its best individual member. Not a small feat, but critical to a successful planning exercise! Any regional planning implies a commitment to change. After all, new services will be added, some phased out, others revised, and others enhanced, resulting in changes in roles and responsibilities of providers. Change should not be greeted with disdain but viewed as a natural part of the environment in which we plan and provide services. A major advantage to the process of planning is that the level of support for change is already mobilized through the various stages of the process highlighted.(ABSTRACT TRUNCATED AT 250 WORDS)

SU-E-T-480: Radiobiological Dose Comparison of Single Fraction SRS, Multi-Fraction SRT and Multi-Stage SRS of Large Target Volumes Using the Linear-Quadratic Formula

International Nuclear Information System (INIS)

Ding, C; Hrycushko, B; Jiang, S; Meyer, J; Timmerman, R

2014-01-01

Purpose: To compare the radiobiological effect on large tumors and surrounding normal tissues from single fraction SRS, multi-fractionated SRT, and multi-staged SRS treatment. Methods: An anthropomorphic head phantom with a centrally located large volume target (18.2 cm 3 ) was scanned using a 16 slice large bore CT simulator. Scans were imported to the Multiplan treatment planning system where a total prescription dose of 20Gy was used for a single, three staged and three fractionated treatment. Cyber Knife treatment plans were inversely optimized for the target volume to achieve at least 95% coverage of the prescription dose. For the multistage plan, the target was segmented into three subtargets having similar volume and shape. Staged plans for individual subtargets were generated based on a planning technique where the beam MUs of the original plan on the total target volume are changed by weighting the MUs based on projected beam lengths within each subtarget. Dose matrices for each plan were export in DICOM format and used to calculate equivalent dose distributions in 2Gy fractions using an alpha beta ratio of 10 for the target and 3 for normal tissue. Results: Singe fraction SRS, multi-stage plan and multi-fractionated SRT plans had an average 2Gy dose equivalent to the target of 62.89Gy, 37.91Gy and 33.68Gy, respectively. The normal tissue within 12Gy physical dose region had an average 2Gy dose equivalent of 29.55Gy, 16.08Gy and 13.93Gy, respectively. Conclusion: The single fraction SRS plan had the largest predicted biological effect for the target and the surrounding normal tissue. The multi-stage treatment provided for a more potent biologically effect on target compared to the multi-fraction SRT treatments with less biological normal tissue than single-fraction SRS treatment

Actor coalitions and implementation in strategic delta planning: Opening the Haringvliet sluices in the Netherlands

Science.gov (United States)

Vermoolen, Myrthe; Hermans, Leon

2016-04-01

The sustained development of urbanizing deltas is influenced by natural and societal processes. These processes are characterized by their long time span, in which conflicting interests of different stakeholders have to be reconciled. Reaching consent between actors is a challenge itself, but maintaining this consent throughout different stages of strategic planning - from advocacy and agenda setting to implementation - over these long periods of time is even more difficult. The implementation stage still includes many different actors involved, some of which are different than the ones who agreed before, due to both the long run of the strategic delta planning, and to a shift of tasks and responsibilities. Thus, implementation of strategic plans often features delays, deviations of agreed plans and unintended outcomes. A key question therefore is how coalition dynamics in (pre-)planning stages influence and are influenced by the coalition dynamics during implementation. The different stages in strategic planning are often studied from either a plan formulation or an implementation perspective, but the connection between the two proves an important bottleneck for strategic planning in deltas. For instance, many building with nature solutions are still in their pilot-phase, and their upscaling can profit from lessons concerning past implementation efforts. The proposed contribution will use the case of the management of the Dutch Haringvliet sluices and the decision ('Kierbesluit') in 2000 to put these sluices ajar, to study the link between the different strategic delta planning stages and the role of the formation and change of actor coalitions herein. With the completion of the Haringvliet dam with outlet sluices in 1970, the Haringvliet estuary of the rivers Rhine and Meuse was closed off from the sea, creating a fresh water lake. This was done to make the Dutch Southwest delta safe from flooding, and had positive effects for agricultural water supply and

Monitor of spatial plans. Feasibility study

International Nuclear Information System (INIS)

Bollen, M.J.S.; Ritsema van Eck, J.; Farjon, J.M.J.

2008-01-01

The national government needs assessments of consequences of building projects in relation to spatial policy objectives such as the prevention of urban sprawl or the development of landscape qualities. Normally the effects of spatial policies appear after several years. Spatial plans can possibly indicate these effects earlier. To allow policies to be adapted to unwanted developments, the assessments should be available in the early planning stages of these building projects. The Dutch Minister of VROM has asked the Netherlands Environmental Assessment Agency to investigate the feasibility of a monitoring system based on building plans. As building projects take a long period from conception until realization, a monitoring system for these projects should include all plans for the next ten to fifteen years with an indication of the chance that these plans are realized. The existing databases in the Netherlands provide sufficient information to assess consequences of plans for those objectives that are directly related to the urbanization pattern. However, an improvement of these databases is necessary, amongst other things by coordination of these databases [nl

Uterine cervical cancer. Preoperative staging with magnetic resonance imaging; Zervixkarzinom. Praeoperatives Staging mittels Magnetresonanztomographie

Energy Technology Data Exchange (ETDEWEB)

Collettini, F.; Hamm, B. [Charite-Universitaetsmedizin Berlin, Campus Charite Mitte, Klinik fuer Radiologie, Berlin (Germany)

2011-07-15

The treatment of uterine cervical carcinoma is largely dependent on the tumor stage. Despite significant inaccuracies in the clinical examination, uterine cervical cancer remains the only gynecological form of cancer still largely staged according to clinical findings. Although imaging is still not included in the staging the recently published revised FIGO (Federation International de Gynecologie et d'Obstetrique) system encourages the use of modern cross-sectional imaging (magnetic resonance imaging MRI and computed tomography CT). Due to its high soft tissue contrast MRI allows excellent non-invasive assessment of the cervix with direct tumor delineation as well as assessment of the prognosis based on morphological factors. Studies in the literature report an accuracy of 93% for MRI in the preoperative assessment of tumor size and in the differentiation of operable from advanced cervical cancer. Therefore MRI is considered to be the optimal modality for diagnostic evaluation starting from FIGO stage IB1, for radiation therapy planning, and for exclusion of recurrence in follow-up. In this paper we give an overview of the role of magnetic resonance imaging in preoperative staging of uterine cervical cancer. (orig.) [German] Die Therapieplanung beim Zervixkarzinom ist weitgehend von der Stadieneinteilung nach FIGO (Federation International de Gynecologie et d'Obstetrique) abhaengig, die trotz erheblicher Ungenauigkeiten bei der klinischen Stadieneinteilung weiterhin aufgrund klinischer Untersuchungsbefunde erfolgt. Obwohl bildgebende Verfahren nach wie vor fuer die Stadieneinteilung nicht vorgesehen sind, wird im kuerzlich erschienen revidierten Stagingsystem der FIGO zum ersten Mal die Verwendung moderner Schnittbilddiagnostik (MRT und CT) befuerwortet. Die MRT ermoeglicht dank ihres hohen Weichteilkontrasts ein ausgezeichnetes nichtinvasives Staging des Zervixkarzinoms mit direkter Tumordarstellung sowie einer Prognoseabschaetzung anhand

A Resiliency Action Plan for the National Renewable Energy Laboratory: May 23, 2014 -- June 5, 2015

Energy Technology Data Exchange (ETDEWEB)

Vogel, J [Abt Environmental Research, Boulder, CO (United States); Wagner, C. [Abt Environmental Research, Boulder, CO (United States); Renfrow, S. [Abt Environmental Research, Boulder, CO (United States)

2015-09-03

The second stage in a two-stage project called the National Renewable Energy Laboratory (NREL) Climate Change Resiliency and Preparedness (CCRP) project is summarized in this resiliency action plan. This CCRP pilot project was funded by the U.S. Department of Energy's Sustainability Performance Office and launched in winter 2014. The resiliency action plan begins where the previous stage of the project -- the vulnerability assessment -- ended. This report discusses resiliency options to reduce the risk of the highest risk vulnerabilities that were identified in the NREL vulnerability assessment.

Staging Investigations in Breast Cancer: Collective Opinion of UK Breast Surgeons

Directory of Open Access Journals (Sweden)

N. Chand

2013-01-01

Full Text Available Introduction. Certain clinicopathological factors are associated with a higher likelihood of distant metastases in primary breast cancer. However, there remains inconsistency in which patients undergo formal staging for distant metastasis and the most appropriate investigation(s. Aims. To identify UK surgeon preferences and practice with regard to staging investigations for distant metastases. Methods. A survey was disseminated to members of the Association of Breast Surgery by e-mail regarding surgeon/breast unit demographics, use of staging investigations, and local policy on pre/postoperative staging investigations. Several patient scenarios were also presented. Results. 123 of 474 (25.9% recipients completed the survey. Investigations routinely employed for patients diagnosed with early breast cancer included serological/haematological tests (72% respondents, axillary ultrasound (67%, liver ultrasound (2%, chest radiograph (36%, and computed tomography (CT (1%. Three areas contributed to decisions to undertake staging by CT scan: tumour size, axillary nodal status, and plan for chemotherapy. There was widespread variation as to criteria for CT staging based on tumour size and nodal status, as well as the choice of staging investigation for the clinical scenarios presented. Conclusions. There remains variation in the use of staging investigations for distant disease in early breastcancer despite available guidelines.

New procedures. Comprehensive staging of lung cancer by MRI

International Nuclear Information System (INIS)

Hintze, C.; Dinkel, J.; Biederer, J.; Heussel, C.P.; Puderbach, M.

2010-01-01

Lung cancer staging according to the TNM system is based on morphological assessment of the primary cancer, lymph nodes and metastases. All aspects of this important oncological classification are measurable with MRI. Pulmonary nodules can be detected at the clinically relevant size of 4-5 mm in diameter. The extent of mediastinal, hilar and supraclavicular lymph node affection can be assessed at the same time. The predominant metastatic spread to the adrenal glands and spine can be detected in coronal orientation during dedicated MRI of the lungs. Search focused whole body MRI completes the staging. Various additional MR imaging techniques provide further functional and clinically relevant information during a single examination. In the oncological context the most important techniques are imaging of perfusion and tumor motion. Functional MRI of the lungs complements the pure staging and improves surgical approaches and radiotherapy planning. (orig.) [de

Effect of Radiotherapy Planning Complexity on Survival of Elderly Patients With Unresected Localized Lung Cancer

International Nuclear Information System (INIS)

Park, Chang H.; Bonomi, Marcelo; Cesaretti, Jamie; Neugut, Alfred I.; Wisnivesky, Juan P.

2011-01-01

Purpose: To evaluate whether complex radiotherapy (RT) planning was associated with improved outcomes in a cohort of elderly patients with unresected Stage I-II non-small-cell lung cancer (NSCLC). Methods and Materials: Using the Surveillance, Epidemiology, and End Results registry linked to Medicare claims, we identified 1998 patients aged >65 years with histologically confirmed, unresected stage I-II NSCLC. Patients were classified into an intermediate or complex RT planning group using Medicare physician codes. To address potential selection bias, we used propensity score modeling. Survival of patients who received intermediate and complex simulation was compared using Cox regression models adjusting for propensity scores and in a stratified and matched analysis according to propensity scores. Results: Overall, 25% of patients received complex RT planning. Complex RT planning was associated with better overall (hazard ratio 0.84; 95% confidence interval, 0.75-0.95) and lung cancer-specific (hazard ratio 0.81; 95% confidence interval, 0.71-0.93) survival after controlling for propensity scores. Similarly, stratified and matched analyses showed better overall and lung cancer-specific survival of patients treated with complex RT planning. Conclusions: The use of complex RT planning is associated with improved survival among elderly patients with unresected Stage I-II NSCLC. These findings should be validated in prospective randomized controlled trials.

Spatial Distribution and Sampling Plans for Grapevine Plant Canopy-Inhabiting Scaphoideus titanus (Hemiptera: Cicadellidae) Nymphs.

Science.gov (United States)

Rigamonti, Ivo E; Brambilla, Carla; Colleoni, Emanuele; Jermini, Mauro; Trivellone, Valeria; Baumgärtner, Johann

2016-04-01

The paper deals with the study of the spatial distribution and the design of sampling plans for estimating nymph densities of the grape leafhopper Scaphoideus titanus Ball in vine plant canopies. In a reference vineyard sampled for model parameterization, leaf samples were repeatedly taken according to a multistage, stratified, random sampling procedure, and data were subjected to an ANOVA. There were no significant differences in density neither among the strata within the vineyard nor between the two strata with basal and apical leaves. The significant differences between densities on trunk and productive shoots led to the adoption of two-stage (leaves and plants) and three-stage (leaves, shoots, and plants) sampling plans for trunk shoots- and productive shoots-inhabiting individuals, respectively. The mean crowding to mean relationship used to analyze the nymphs spatial distribution revealed aggregated distributions. In both the enumerative and the sequential enumerative sampling plans, the number of leaves of trunk shoots, and of leaves and shoots of productive shoots, was kept constant while the number of plants varied. In additional vineyards data were collected and used to test the applicability of the distribution model and the sampling plans. The tests confirmed the applicability 1) of the mean crowding to mean regression model on the plant and leaf stages for representing trunk shoot-inhabiting distributions, and on the plant, shoot, and leaf stages for productive shoot-inhabiting nymphs, 2) of the enumerative sampling plan, and 3) of the sequential enumerative sampling plan. In general, sequential enumerative sampling was more cost efficient than enumerative sampling.

A case study of strategic planning IFB

Directory of Open Access Journals (Sweden)

Pedro Henrique Rodrigues de Camargo Dias

2018-03-01

Full Text Available The purpose of this article is to identify and characterize the initial stage of the IFB strategic planning, based on the perception of top management and planning team. The case study adopts a qualitative approach supported by bibliographic research techniques, to build a theoretical foundation, allied to the semistructure interview for later, application of the content analysis. As a result, we can identify that the institution opted to first define the strategic references, based on the construction of the mission, vision and values, and later, analysis of the organizational diagnosis, based on the Balanced Scorecard methodology. It was verified that the tool of strategic planning and its use are points that need to be better understood by the managers and technical planning team. The predominant characteristics of strategic planning are composed of a programmatic tool for projecting medium and long term goals and actions, of legal compliance, as it integrates and operationalizes the Institutional Development Plan (PDI.

SCENARIO PLANNING AS LEARNING

Directory of Open Access Journals (Sweden)

Antonio Lourenço Junior

2010-10-01

Full Text Available Scenario Planning has been increasingly used, from its introduction to the decision process as effective tools to test decisions, and improve performance in a dynamic environment (Chermack, 2005. The purpose of this article is to demonstrate the potential of an experimental Scenario Planning Model to mobilize, encourage and add more content to the organization’s decision making process – mainly with respect to Strategic Plans of two governmental institutions, a pharmaceutical company and a technology education foundation.  This study describes the application stages of a hybrid scenario-planning model – herein referred to as Planning as Learning – via action-research, showing the scenarios resulting from the experiment and describes the main results of an assessment of such practice. In order to do that, two well-established Scenario Planning models (Prospective school and Shell’s model were analyzed. They were used as a reference for the proposition and application of an experimental model in the two study objects. A questionnaire was used to assess the technique impact. It was possible to obtain high levels of reliability. In-depth interviews were also conducted with the participants. At the end, the results confirmed the model efficiency as a basis for decision making in the competitive environment in which the two institutions are inserted, also to encourage the learning process as a group, as observed throughout the work.

Multi-stage volcanic island flank collapses with coeval explosive caldera-forming eruptions.

Science.gov (United States)

Hunt, James E; Cassidy, Michael; Talling, Peter J

2018-01-18

Volcanic flank collapses and explosive eruptions are among the largest and most destructive processes on Earth. Events at Mount St. Helens in May 1980 demonstrated how a relatively small (300 km 3 ), but can also occur in complex multiple stages. Here, we show that multistage retrogressive landslides on Tenerife triggered explosive caldera-forming eruptions, including the Diego Hernandez, Guajara and Ucanca caldera eruptions. Geochemical analyses were performed on volcanic glasses recovered from marine sedimentary deposits, called turbidites, associated with each individual stage of each multistage landslide. These analyses indicate only the lattermost stages of subaerial flank failure contain materials originating from respective coeval explosive eruption, suggesting that initial more voluminous submarine stages of multi-stage flank collapse induce these aforementioned explosive eruption. Furthermore, there are extended time lags identified between the individual stages of multi-stage collapse, and thus an extended time lag between the initial submarine stages of failure and the onset of subsequent explosive eruption. This time lag succeeding landslide-generated static decompression has implications for the response of magmatic systems to un-roofing and poses a significant implication for ocean island volcanism and civil emergency planning.

ALARA and planning of interventions

Energy Technology Data Exchange (ETDEWEB)

Rocaboy, A. [Electricite de France, Avoine (France)

1995-03-01

The implementation of ALARA programs implies integration of radiation protection criterion at all stages of outage management. Within the framework of its ALARA policy, Electricide de France (EDF) has given an incentive to all of its nuclear power plants to develop {open_quotes}good practices{close_quotes} in this domain, and to exchange their experience by the way of a national feed back file. Among the developments in the field of outage organization, some plants have focused on the planning stage of activities because of its influence on the radiological conditions of interventions and on the good succession of tasks within the radiological controlled areas. This paper presents the experience of Chinon nuclear power plant. At Chinon, we are pursuing this goal through careful outage planning. We want the ALARA program during outages to be part of the overall maintenance task planning. This planning includes the provision of the availability of every safety-related component, and of the variations of water levels in hthereactor and steam generators to take advantage of the shield created by the water. We have developed a computerized data base with the exact position of all the components in the reactor building in order to avoid unnecessary interactions between different tasks performed in the same room. A common language between Operation and Maintenance had been established over the past years, using {open_quotes}Milestones and Corridors{close_quotes}. A real time dose rate counting system enables the Radiation Protection (RP) Department to do an accurate and efficient follow up during the outage for all the {open_quotes}ALARA{close_quotes} maintenance tasks.

Family life clinics for Gulf state: Bahrain FPA helps bring a family planning breakthrough.

Science.gov (United States)

1979-01-01

Family life clinics which will provide family planning services alongside maternal and child health services and general counseling are opening in health centers throughout Bahrain and in the main hospital at Manama. Bahrain, a small island in the Arabian Gulf, formed its first Family Planning Association (FPA) just 4 years ago; and this new initiative is seen as a direct result of cooperation between FPA and the government. To spread family planning awareness and services particularly to the poorer section of the population, Bahrain's FPA developed in various stages. Stage 1, in 1975, was to attract and educate volunteers and channel their interest into special committees dealing with programs; public relations; child welfare; legal and medical affairs; research; and conferences and education. Stage 2 came with the need to coordinate the work and set up a 2-person staff and an office. Stage 3 developed with the first field campaign. Door-to-door visiting was tried but was not popular with volunteers or residents. Approaching the population through community clubs and institutions was tried with much success. The new family life clinics are the latest stage of a fruitful cooperation between FPA and the Ministry of Labor and Social Affairs. In addition to the new family life clinics, an active effort to improve family planning awareness has continued using national seminars and mass media. Fund-raising is under way for a mobile,clinic which will provide health services and methods of contraception, to which there is still substantial resistance, to many on the island who have no exposure to the mass media. Wide acceptance of the need for family planning for the sake of mothers, the family, and the child is growing in Bahrain.

Healthcare Strategic Planning as Part of National and Regional Development in the Israeli Galilee: A Case Study of the Planning Process.

Science.gov (United States)

Peled, Ronit; Schenirer, Jerry

2009-10-01

This article describes a systematic process of geographic and strategic planning for healthcare services as a part of a regional development plan in the Israeli Galilee. The planning process consisted of three stages: (a) assessment of needs, demand and existing resources; (b) prioritisation of initiatives; and (c) scheduling of theoretical priorities. For many years the region has suffered from inequities and inequalities regarding the availability and accessibility of a regional healthcare system, resulting in high mortality and morbidity rates and low quality of life. The aim of the healthcare strategic plan was to suggest initiatives and actions to be taken in order to improve healthcare provision and the health and wellbeing of local residents.

New procedures. Comprehensive staging of lung cancer by MRI; Neue Verfahren. Umfassendes Staging des Lungenkarzinoms mit der MRT

Energy Technology Data Exchange (ETDEWEB)

Hintze, C. [Universitaetsklinikum Schleswig-Holstein, Campus Kiel, Klinik fuer Diagnostische Radiologie, Kiel (Germany); Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abteilung Radiologie (E010), Heidelberg (Germany); Dinkel, J. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abteilung Radiologie (E010), Heidelberg (Germany); Biederer, J. [Universitaetsklinikum Schleswig-Holstein, Campus Kiel, Klinik fuer Diagnostische Radiologie, Kiel (Germany); Heussel, C.P. [Thoraxklinik Heidelberg, Abteilung Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Puderbach, M. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abteilung Radiologie (E010), Heidelberg (Germany); Thoraxklinik Heidelberg, Abteilung Diagnostische und Interventionelle Radiologie, Heidelberg (Germany)

2010-08-15

Lung cancer staging according to the TNM system is based on morphological assessment of the primary cancer, lymph nodes and metastases. All aspects of this important oncological classification are measurable with MRI. Pulmonary nodules can be detected at the clinically relevant size of 4-5 mm in diameter. The extent of mediastinal, hilar and supraclavicular lymph node affection can be assessed at the same time. The predominant metastatic spread to the adrenal glands and spine can be detected in coronal orientation during dedicated MRI of the lungs. Search focused whole body MRI completes the staging. Various additional MR imaging techniques provide further functional and clinically relevant information during a single examination. In the oncological context the most important techniques are imaging of perfusion and tumor motion. Functional MRI of the lungs complements the pure staging and improves surgical approaches and radiotherapy planning. (orig.) [German] Das Staging des Lungenkarzinoms nach dem TNM-System basiert auf der morphologischen Einschaetzung des Primarius, der Lymphknoten und Metastasen. Alle Aspekte dieser onkologisch wichtigen Beurteilung lassen sich mit der MRT erfassen. Pulmonale Rundherde sind ab der klinisch relevanten Groesse von 4-5 mm Durchmesser sicher erkennbar. Die Groesse der mediastinalen, hilaeren und supraklavikulaeren Lymphknoten kann in einem Untersuchungsgang bestimmt werden. In der koronaren Schichtfuehrung der dedizierten MRT der Lunge werden die Bereiche der bevorzugten Metastasierung in Nebennieren und weite Teile der Wirbelsaeule miterfasst. Durch eine gezielte Ganzkoerper-MRT als Suchmethode wird der letzte Teil des Stagings erfuellt. Die MRT bietet vielfaeltige Moeglichkeiten, zusaetzliche funktionelle, klinisch relevante Informationen innerhalb einer Untersuchung zu erheben. Im onkologischen Kontext sind die Perfusionsbildgebung der Lunge und die Bewegungsabschaetzung der Tumoren am bedeutendsten. Die funktionelle MRT der

VOYAGE PLANNING

Directory of Open Access Journals (Sweden)

Kazimierz SKÓRA

2016-09-01

Full Text Available A sea voyage can be divided into three parts with varying degrees of risk: - from the berth at the port of departure to the pilot disembarkation point - from the pilot disembarkation to another pilot embarkation point near the port of call/destination - from the pilot embarkation point to the berth Results of statistical research into ship accidents at sea point to an increased number of incidents and accidents, including groundings, especially in restricted areas. Such areas are often narrow and have limited depths, while their short straight sections require frequent course alterations, often in varying hydrometeorological conditions. Due to all these factors, the voyage has to be carefully planned and all watchkeeping officers have to be well prepared to conduct the ship safely. The article presents the objectives, scope, legal basis and stages in the process of voyage planning. The compliance with the outlined principles will reduce the level of risk in maritime transport.

Planning and participation

International Nuclear Information System (INIS)

Rucht, D.

1982-01-01

This study is trying to give a vast survey of the political and administrative system. It is to demonstrate the relations between its secular development trends, the necessity and the limits of political planning under the present conditions and, finally, the increasing demands for participation as expressed especially by citizens' initiatives. These stages, however, are certainly not presented in a smooth manner. Yet the author claims to have kept a certain continuity and inner logic of presentation and argumentation. (orig./DG) [de

Project of Particular intervention plan of the Belleville-sur-Loire NPP. Special provisions of the ORSEC plan

International Nuclear Information System (INIS)

2015-01-01

The Particular intervention plan (PPI in French) is an emergency plan which foresees the measures and means to be implemented to address the potential risks of the presence and operation of a nuclear facility. This plan is implemented and developed by the Prefect in case of nuclear accident (or incident leading to a potential accident), the impact of which extending beyond the facility perimeter. It represents a special section of the organisation plan for civil protection response (ORSEC plan). The PPI foresees the necessary measures and means for crisis management during the first hours following the accident and is triggered by the Department Prefect according to the information provided by the facility operator. Its aim is to protect the populations leaving within 10 km of the facility against a potential radiological hazard. The PPI describes: the facility, the intervention area, the protection measures for the population, the conditions of emergency plan triggering, the crisis organisation, the action forms of the different services, and the post-accident stage. This document is the project of Particular intervention plan for the Belleville-sur-Loire Nuclear Power Plant (Cher, France)

Accounting for uncertainty in evaluating water quality impacts of urban development plan

International Nuclear Information System (INIS)

Zhou Jiquan; Liu Yi; Chen Jining

2010-01-01

The implementation of urban development plans causes land use change, which can have significant environmental impacts. In light of this, environmental concerns should be considered sufficiently at an early stage of the planning process. However, uncertainties existing in urban development plans hamper the application of strategic environmental assessment, which is applied to evaluate the environmental impacts of policies, plans and programs. This study develops an integrated assessment method based on accounting uncertainty of environmental impacts. And the proposed method consists of four main steps: (1) designing scenarios of economic scale and industrial structure, (2) sampling for possible land use layouts, (3) evaluating each sample's environmental impact, and (4) identifying environmentally sensitive industries. In doing so, uncertainties of environmental impacts can be accounted. Then environmental risk, overall environmental pressure and potential extreme environmental impact of urban development plans can be analyzed, and environmentally sensitive factors can be identified, especially under considerations of uncertainties. It can help decision-makers enhance environmental consideration and take measures in the early stage of decision-making.

Cost calculations at early stages of nuclear research facilities in the nordic countries

International Nuclear Information System (INIS)

Iversen, Klaus; Salmenhaara, Seppo; Backe, Steinar; Cato, Anna; Lindskog, Staffan; Callander, Clas; Efraimsson, Henrik; Andersson, Inga; Sjoeblom, Rolf

2007-01-01

The Nordic countries Denmark, Norway and Sweden, and to some extent also Finland, had very large nuclear research and development programs for a few decades starting in the nineteen fifties. Today, only some of the facilities are in use. Some have been decommissioned and dismantled while others are at various stages of planning for shutdown. The perspective ranges from imminent to several decades. It eventually became realized that considerable planning for the future decommissioning is warranted and that an integral part of this planning is financial, including how financial funds should be acquired, used and allocated over time. This necessitates that accurate and reliable cost estimates be obtained at all stages. However, this is associated with fundamental difficulties and treacherous complexities, especially for the early ones. Eventually, Denmark and Norway decided not to build any nuclear power plants while Finland and Sweden did. This is reflected in the financing where the latter countries have established systems with special funds in which money is being collected now to cover the future costs for the decommissioning of the research facilities. Nonetheless, the needs for planning for the decommissioning of nuclear research facilities are very similar. However, they differ considerably from those of nuclear power reactors, especially with regard to cost calculations. It has become apparent in the course of work that summation types of cost estimation methodologies give rise to large systematic errors if applied at early stages, in which case comparison based assessments are less biased and may be more reliable. Therefore, in order to achieve the required quality of the cost calculations, it is necessary that data and experience from authentic cases be utilized in models for cost calculations. It also implies that this calculation process should include a well adopted learning process. Thus, a Nordic co-operation has been established for the exchange and

A preventive maintenance model with a two-level inspection policy based on a three-stage failure process

International Nuclear Information System (INIS)

Wang, Wenbin; Zhao, Fei; Peng, Rui

2014-01-01

Inspection is always an important preventive maintenance (PM) activity and can have different depths and cover all or part of plant systems. This paper introduces a two-level inspection policy model for a single component plant system based on a three-stage failure process. Such a failure process divides the system′s life into three stages: good, minor defective and severe defective stages. The first level of inspection, the minor inspection, can only identify the minor defective stage with a certain probability, but can always reveal the severe defective stage. The major inspection can however identify both defective stages perfectly. Once the system is found to be in the minor defective stage, a shortened inspection interval is adopted. If however the system is found to be in the severe defective stage, we may delay the maintenance action if the time to the next planned PM window is less than a threshold level, but otherwise, replace immediately. This corresponds to the well adopted maintenance policy in practice such as periodic inspections with planned PMs. A numerical example is presented to demonstrate the proposed model by comparing with other models. - Highlights: • The system′s deterioration goes through a three-stage process, namely, normal, minor defective and severe defective. • Two levels of inspections are proposed, e.g., minor and major inspections. • Once the minor defective stage is found, instead of taking a maintenance action, a shortened inspection interval is recommended. • When the severe defective stage is found, we delay the maintenance according to the threshold to the next PM. • The decision variables are the inspection intervals and the threshold to PM

Procurement planning in oil refining industries considering blending operations

DEFF Research Database (Denmark)

Oddsdottir, Thordis Anna; Grunow, Martin; Akkerman, Renzo

2013-01-01

This paper addresses procurement planning in oil refining, which has until now only had limited attention in the literature. We introduce a mixed integer nonlinear programming (MINLP) model and develop a novel two-stage solution approach, which aims at computational efficiency while addressing...... parameters than in previous literature. The developed approach is tested using historical data from Statoil A/S as well as through a comprehensive numerical analysis. The approach generates a feasible procurement plan within acceptable computation time, is able to quickly adjust an existing plan to take...

Personality Traits and Training Initiation Process: Intention, Planning, and Action Initiation.

Science.gov (United States)

Laguna, Mariola; Purc, Ewelina

2016-01-01

The article aims at investigating the role of personality traits in relation to training initiation. Training initiation is conceptualized as a goal realization process, and explained using goal theories. There are three stages of the process analyzed: intention to undertake training, plan formulation, and actual training undertaking. Two studies tested the relationships between five personality traits, defined according to the five factor model, and the stages of the goal realization process. In Study 1, which explains training intention and training plans' formulation, 155 employees participated. In Study 2, which was time-lagged with two measurement points, and which explains intention, plans, and training actions undertaken, the data from 176 employees was collected at 3 month intervals. The results of these studies show that personality traits, mainly openness to experience, predict the training initiation process to some degree: intention, plans, and actual action initiation. The findings allow us to provide recommendations for practitioners responsible for human resource development. The assessment of openness to experience in employees helps predict their motivation to participate in training activities. To increase training motivation it is vital to strengthen intentions to undertake training, and to encourage training action planning.

78 FR 41782 - Nez Perce-Clearwater National Forests; Idaho; Notice To Proceed With Forest Plan Revision

Science.gov (United States)

2013-07-11

... pursuant to the 2012 Forest Planning Rule. This process will ultimately result in a Forest Land Management... Planning Rule) which implements the NFMA. Forest Plans describe the strategic direction for management of... is the first phase of the planning process. Only informal public input is required at this stage (36...

MRI and endosonography in preoperative staging of advanced rectal carcinomas after hypothermoradiochemotherapy

International Nuclear Information System (INIS)

Schroeder, R.J.; Pegios, W.; Huenerbein, M.; Vogl, T.J.; Hidajat, N.; Gellermann, J.; Wust, P.; Rau, B.; Schlag, P.; Felix, R.

1997-01-01

Purpose: Comparison of diagnostic accuracy of staging of endorectal sonography (ES) and body coil MRI after preoperative hyperthermoradiochemotherapy in patients with advanced rectal cancer. Methods: Prospective analysis of MRI and ES in 30 patients after hyperthermoradiochemotherapy and correlation with histopathological patterns. Results: T-staging by MRI was correct in 47% and by ES in 53% of the cases. Despite similar accuracy of staging in T 0 - and T 1 -tumours, we found different accuracies concerning T 2 -tumour staging about 63% versus 73% (MRI/ES), concerning perirectal infiltration 70% for both techniques, concerning invasion of adjacent organs 90% versus 87%, and concerning lymph node metastases without respect to the N-stage 63% versus 63%. Conclusion: Both imaging modalities provide useful information for operation planning despite limited accuracy after hyperthermoradiochemotherapy. The body coil MRI does not seem to be severely inferior to ES in posttherapeutic staging, despite better contour line imaging by ES. With respect to the determination of invasion of other organs, MRI seems to be more useful. (orig.) [de

Organizational Life Cycle and the Growth of Information Technology Stage Theory

Directory of Open Access Journals (Sweden)

Jamshid Nazemi

2012-10-01

Full Text Available : Organizations have the different patterns of behaviors on management practice and the use of systems during their life cycle and due to rapid growth of information technology, the application of appropriate technologies is becoming an essential part of business, as well. The adaptation of appropriate management systems on different stages of organizational life period will affect on sustainability of the firms and success to move to next stage and alignment and collaboration schema of IS/IT and business requirement affects on management effectiveness at every stage. This research investigated the significance of relationship between management behavior and IS/IT usage and the generic approach selected by companies. The results showed that organizations have chosen different approach during their life cycle and as they faced with unique challenges on each stage, a common practice on using information technology and applications became part of organizational life cycle. A generic model for information technology usage on organization life cycle was also developed that will assist organizations to select and develop IS/IT plans which addresses the requirements for each stage of life cycle.

Vitrification development plan for US Department of Energy mixed wastes

International Nuclear Information System (INIS)

Peters, R.; Lucerna, J.; Plodinec, M.J.

1993-10-01

This document is a general plan for conducting vitrification development for application to mixed wastes owned by the US Department of Energy. The emphasis is a description and discussion of the data needs to proceed through various stages of development. These stages are (1) screening at a waste site to determine which streams should be vitrified, (2) waste characterization and analysis, (3) waste form development and treatability studies, (4) process engineering development, (5) flowsheet and technical specifications for treatment processes, and (6) integrated pilot-scale demonstration. Appendices provide sample test plans for various stages of the vitrification development process. This plan is directed at thermal treatments which produce waste glass. However, the study is still applicable to the broader realm of thermal treatment since it deals with issues such as off-gas characterization and waste characterization that are not necessarily specific to vitrification. The purpose is to provide those exploring or considering vitrification with information concerning the kinds of data that are needed, the way the data are obtained, and the way the data are used. This will provide guidance to those who need to prioritize data needs to fit schedules and budgets. Knowledge of data needs also permits managers and planners to estimate resource requirements for vitrification development

Skin-Sparing Radiation Using Intensity-Modulated Radiotherapy After Conservative Surgery in Early-Stage Breast Cancer: A Planning Study

International Nuclear Information System (INIS)

Saibishkumar, Elantholi P.; MacKenzie, Marc A.; Severin, Diane; Mihai, Alina; Hanson, John M.Sc.; Daly, Helene; Fallone, Gino; Parliament, Matthew B.; Abdulkarim, Bassam S.

2008-01-01

Purpose: To evaluate the feasibility of skin-sparing by configuring it as an organ-at-risk (OAR) while delivering whole-breast intensity-modulated radiotherapy (IMRT) in early breast cancer. Methods and Materials: Archival computed tomography scan images of 14 left-sided early-breast tumor patients who had undergone lumpectomy were selected for this study. Skin was contoured as a 4- to 5-mm strip extending from the patient outline to anterior margin of the breast planning target volume (PTV). Two IMRT plans were generated by the helical tomotherapy approach to deliver 50 Gy in 25 fractions to the breast alone: one with skin dose constraints (skin-sparing plan) and the other without (non-skin-sparing plan). Comparison of the plans was done using a two-sided paired Student t test. Results: The mean skin dose and volume of skin receiving 50 Gy were significantly less with the skin-sparing plan compared with non-skin-sparing plan (42.3 Gy vs. 47.7 Gy and 12.2% vs. 57.8% respectively; p < 0.001). The reduction in skin dose was confirmed by TLD measurements in anthropomorphic phantom using the same plans. Dose-volume analyses for other OARs were similar in both plans. Conclusions: By configuring the skin as an OAR, it is possible to achieve skin dose reduction while delivering whole-breast IMRT without compromising dose profiles to PTV and OARs

Dosimetric accuracy and clinical quality of Acuros XB and AAA dose calculation algorithm for stereotactic and conventional lung volumetric modulated arc therapy plans

International Nuclear Information System (INIS)

Kroon, Petra S; Hol, Sandra; Essers, Marion

2013-01-01

The main aim of the current study was to assess the dosimetric accuracy and clinical quality of volumetric modulated arc therapy (VMAT) plans for stereotactic (stage I) and conventional (stage III) lung cancer treatments planned with Eclipse version 10.0 Anisotropic Analytical Algorithm (AAA) and Acuros XB (AXB) algorithm. The dosimetric impact of using AAA instead of AXB, and grid size 2.5 mm instead of 1.0 mm for VMAT treatment plans was evaluated. The clinical plan quality of AXB VMAT was assessed using 45 stage I and 73 stage III patients, and was compared with published results, planned with VMAT and hybrid-VMAT techniques. The dosimetric impact on near-minimum PTV dose (D 98% ) using AAA instead of AXB was large (underdose up to 12.3%) for stage I and very small (underdose up to 0.8%) for stage III lung treatments. There were no significant differences for dose volume histogram (DVH) values between grid sizes. The calculation time was significantly higher for AXB grid size 1.0 than 2.5 mm (p < 0.01). The clinical quality of the VMAT plans was at least comparable with clinical qualities given in literature of lung treatment plans with VMAT and hybrid-VMAT techniques. The average mean lung dose (MLD), lung V 20Gy and V 5Gy in this study were respectively 3.6 Gy, 4.1% and 15.7% for 45 stage I patients and 12.4 Gy, 19.3% and 46.6% for 73 stage III lung patients. The average contra-lateral lung dose V 5Gy-cont was 35.6% for stage III patients. For stereotactic and conventional lung treatments, VMAT calculated with AXB grid size 2.5 mm resulted in accurate dose calculations. No hybrid technique was needed to obtain the dose constraints. AXB is recommended instead of AAA for avoiding serious overestimation of the minimum target doses compared to the actual delivered dose

Production planning in the Combinado Lácteo Santiago

Directory of Open Access Journals (Sweden)

Edith Carmen Fajardo-Alcolea

2017-12-01

Full Text Available A planning, programming and control of the production procedure is designed in this paper to consider all the technical and organizational aspects that are involved in planning, using the balance and normative method, and a variant of the General Algorithm for the Calculation of the Capacities. This procedure is supported by an innovative computer application designed to assist students, technicians and specialists in the planning stages. The procedure is applied in the company “Combinado Lácteo de Santiago de Cuba” to plan the production in 2016. As a result, an innovation of an organizational type is obtained that allows the Production Master Plan, disaggregated in the different time horizons, consider the real capacity of the plants. For its evaluation it was compared to the production plan prepared by the company and the actual production data of the first quarter of the year to determine the existing differences.

Stressed-deformed state of mountain rocks in elastic stage and between elasticity

Directory of Open Access Journals (Sweden)

Samedov A.M.

2017-12-01

Full Text Available The problems of the stress-strain state of rocks in the elastic stage and beyond the elastic limits, and the ways of schematizing the tension and compression diagrams were reviewed in the article. To simplify calculations outside the elastic range, the tension (compression diagrams are usually schematized, i.e. are replaced by curved smooth lines having a fairly simple mathematical expression and at the same time well coinciding with the experimentally obtained diagrams. When diagram is to be schematized, it is necessary to take a constant temperature of superheated water steam if a rock test is planned in a relaxed form. Note that when the diagram is schematizing, the difference between the limits of proportionality and fluidity is erased. This allows the limit of proportionality to be considered the limit of fluidity. Schematicization can be carried out in the area where the tensile strength (compression is planned to be destroyed with the established weakening of rocks by exposure to water steam or chemical reagents. Samples of rocks in natural form were tested and weakened by means of superheated water steam (220 °C and more and chemical reagents for tension and compression. The data are obtained, the diagrams of deformation are constructed and schematized in the elastic stage and beyond the elastic limit. Based on the schematic diagrams of deformation, the components of stress and strain were composed in the elastic stage and beyond the elastic limit. It is established in the publication that rocks under compression and stretching deform, both within the elastic stage, and beyond the limits of elasticity. This could be seen when the samples, both in natural and in weakened state, with superheated water steam (more than 220 °C or chemical reagents were tested. In their natural form, they are mainly deformed within the elastic stage and are destroyed as a brittle material, and in a weakened form they can deform beyond the elastic stage and

An Examination of the Volitional Stages in Consumer Decisions to Avoid Sweatshop Clothing

OpenAIRE

Shaw, D; Bekin, C; Shiu, E; Hassan, L; Hogg, G; Wilson, E

2006-01-01

While much research in ethical consumption has focused on contexts such as food, this research explores ethical consumer decision-making in the context of intention to avoid sweatshop clothing where consumer concern has increased but response from the market remains limited. This research seeks to deepen the theory of planned behaviour with respect to the volitional stages underlying behaviour. The findings of the research support a modified theory of planned behaviour model and also reveal v...

Positron Emission Tomography/Computed Tomography in the Staging and Treatment of Anal Cancer

Energy Technology Data Exchange (ETDEWEB)

Sveistrup, Joen, E-mail: joensveistrup@hotmail.com [Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); Loft, Annika [PET and Cyclotron Unit, Department of Clinical Physiology and Nuclear Medicine, Centre of Diagnostic Investigations, Rigshospitalet, Copenhagen (Denmark); Berthelsen, Anne Kiil [Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); PET and Cyclotron Unit, Department of Clinical Physiology and Nuclear Medicine, Centre of Diagnostic Investigations, Rigshospitalet, Copenhagen (Denmark); Henriksen, Birthe Merete; Nielsen, Michael Bachmann [Department of Radiology, Section of Ultrasound X4123, Rigshospitalet, Copenhagen (Denmark); Engelholm, Svend Aage [Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark)

2012-05-01

Purpose: This study was intended to determine the role of PET/CT in the staging of anal cancer as a supplement to three-dimensional transanal ultrasound (TAUS) and inguinal ultrasound (US). The impact of the PET/CT on the initial stage and treatment plan proposed by TAUS/US was assessed. Methods and Materials: Ninety-five (95) patients referred to our clinic between July 1, 2005, and December 31, 2009, were retrospectively reviewed. All patients had biopsy-proven primary squamous cell cancer of the anal canal. There were 65 females (68%) and 30 males (32%), and the median age was 58 years (range, 35-88 years). Six (6%) of the patients were HIV positive. All patients were staged with TAUS/US and PET/CT. Results: Twenty-eight (28) patients were diagnosed with suspicious perirectal node metastases. TAUS visualized 24 of these, whereas PET/CT detected 15. Suspicious inguinal nodes were visualized on either US or PET/CT in 41 patients. Seventeen (17) of these had confirmed malignant disease on biopsy, and 15 had confirmed benign disease. All 17 patients (100%) with malignant inguinal nodes were diagnosed by PET/CT, whereas US identified 16 (94%). Ten patients were diagnosed with suspicious inguinal nodes on PET/CT that had not been seen on US. One of these was malignant, three were benign, and six were not biopsied. PET/CT diagnosed eight metastatic sites, whereas TAUS/US diagnosed three. PET/CT discovered three of the five synchronous cancers seen in this study. PET/CT upstaged the disease in 14% of the cases and changed the treatment plan proposed by TAUS/US in 17%. Conclusion: PET/CT has great potential influence on the staging and treatment of anal cancer. TAUS is important in the staging of the primary tumor and N1-stage, whereas PET/CT seems necessary for the N2/3-stage, the M-stage and synchronous cancers.

Early stage cervical cancer of the uterine

International Nuclear Information System (INIS)

Kaneyasu, Yuuko; Fujiwara, Hisaya

2011-01-01

This paper describes the present state of radiotherapy (RT) of early stage cervical cancer involving the history, outcomes of clinical trials, procedure for each stage, irradiation methods, concurrent chemo-RT (CCRT), late adverse events, and QOL after RT. It has a history of >100 years from the brachytherapy with radium, but is not yet completely established even now. There are many RT trials hitherto. Retrospectively, no significant difference is seen in outcomes of radical RT and surgery: 80-90% efficacy for stage I and 60-80% for II in the former, respectively, and 80-96% and 65-80%, in the latter. Between RT and surgery, there is a report of randomized comparative study in Italy. In Japan, reported are comparative outcomes based on patients' choice for therapy, retrospective studies including authors' one, prospective multi-institutional cooperative trials by Japanese Radiation Oncology Study Group, and Treatment Guidelines for Cervical Cancer (2007). RT procedure depends on the stage defined by FIGO (International Federation of Gynecology and Obstetrics) and at stages I-II, intracavitary RT is major with optimal dose 29 Gy/5 fractions for I, and 23/4 Gy with external total pelvic radiation 50 Gy for II. In external radiation, the planning target volume includes the whole pelvic field with 1.8-2 Gy/5 weeks and optionally, the extended field when metastasis suspicious. Intracavitary RT with application device in the uterine is of significance for the cancer as 50% complete cure even in stage III is reported. CCRT brings about good prognosis, which is shown in a Japanese trial to compare postoperative RT alone and CCRT with CDDP and 5-FU. The late adverse events are seen mainly in the large bowel and studies of QOL, an important factor for choice of treatment, are now in progress. (T.T.)

Australia-wide comparison of intensity modulated radiation therapy prostate plans

International Nuclear Information System (INIS)

Skala, M.; Holloway, L.; Bailey, M.; Kneebone, A.

2005-01-01

The aim of this study was to investigate the ability of Australian centres to produce high-dose intensity modulated radiation therapy (IMRT) prostate plans, and to compare the planning parameters and resultant dose distributions. Five Australian radiation therapy departments were invited to participate. Each centre received an identical 5 mm-slice CT data set complete with contours of the prostate, seminal vesicles, rectum, bladder, femoral heads and body outline. The planning team was asked to produce the best plan possible, using published Memorial Sloan-Kettering Cancer Centre prescription and dose constraints. Three centres submitted plans for evaluation. All plans covered the planning target volume adequately; however, only one plan met all the critical organ dose constraints. Although the planning parameters, beam arrangements and planning systems were different for each centre, the resulting plans were similar. In Australia, IMRT for prostate cancer is in the early stages of implementation, with routine use limited to a few centres. Copyright (2005) Blackwell Science Pty Ltd

Chronic infections in hip arthroplasties: comparing risk of reinfection following one-stage and two-stage revision: a systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Lange J

2012-03-01

Full Text Available Jeppe Lange1,2, Anders Troelsen3, Reimar W Thomsen4, Kjeld Søballe1,51Lundbeck Foundation Centre for Fast-Track Hip and Knee Surgery, Aarhus C, 2Center for Planned Surgery, Silkeborg Regional Hospital, Silkeborg, 3Department of Orthopaedics, Hvidovre Hospital, Hvidovre, 4Department of Clinical Epidemiology, Aarhus University Hospital, Aalborg, 5Department of Orthopaedics, Aarhus University Hospital, Aarhus C, DenmarkBackground: Two-stage revision is regarded by many as the best treatment of chronic infection in hip arthroplasties. Some international reports, however, have advocated one-stage revision. No systematic review or meta-analysis has ever compared the risk of reinfection following one-stage and two-stage revisions for chronic infection in hip arthroplasties.Methods: The review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Relevant studies were identified using PubMed and Embase. We assessed studies that included patients with a chronic infection of a hip arthroplasty treated with either one-stage or two-stage revision and with available data on occurrence of reinfections. We performed a meta-analysis estimating absolute risk of reinfection using a random-effects model.Results: We identified 36 studies eligible for inclusion. None were randomized controlled trials or comparative studies. The patients in these studies had received either one-stage revision (n = 375 or two-stage revision (n = 929. Reinfection occurred with an estimated absolute risk of 13.1% (95% confidence interval: 10.0%–17.1% in the one-stage cohort and 10.4% (95% confidence interval: 8.5%–12.7% in the two-stage cohort. The methodological quality of most included studies was considered low, with insufficient data to evaluate confounding factors.Conclusions: Our results may indicate three additional reinfections per 100 reimplanted patients when performing a one-stage versus two-stage revision. However, the

Multi-hazard evacuation route and shelter planning for buildings.

Science.gov (United States)

2014-06-01

A bi-level, two-stage, binary stochastic program with equilibrium constraints, and three variants, are presented that : support the planning and design of shelters and exits, along with hallway fortification strategies and associated : evacuation pat...

Preliminary work for stage 2 decommissioning of B16 pile chimney

International Nuclear Information System (INIS)

Wright, E.M.; Mathews, R.F.

1991-01-01

Planning of the second stage of decommissioning of the two pile chimneys at Sellafield started while work was underway on the first stage, which involved removal of the sections above the filters. The second stage requires the removal of all radio-active parts and the dismantling of the filter and diffuser sections, and has to be completed by 1997. The planning involved studying the many possible options and their effects on both radiological and industrial safety. This decommissioning project employs a high proportion of civil engineering and construction techniques, which are then developed to eliminate the hazards from radioactive dusts, and to minimise the effect of radiation on operatives working on the project. Much of this equipment is modified forms of standard construction equipment and includes cutting equipment and remotely operated vehicles. The initial phases of the work involve: provision of a waste packaging and access building; provision of temporary ventilation systems to control the dust generated by the work, cutting of 3 m square access doorway through the 1.5 m thick reinforced concrete wall of the chimney; provision of Remotely Operated Vehicle (ROV) to act as a tool carrier for lining stripping work; removal of the thermal lining from the floor and lower walls of the chimney, and installation of precast concrete walls which separate the pile reactor core from the chimney flue. (author)

Transformation of a virtual action plan into a motor plan in the premotor cortex.

Science.gov (United States)

Nakayama, Yoshihisa; Yamagata, Tomoko; Tanji, Jun; Hoshi, Eiji

2008-10-08

Before preparing to initiate a forthcoming motion, we often acquire information about the future action without specifying actual motor parameters. The information for planning an action at this conceptual level can be provided with verbal commands or nonverbal signals even before the associated motor targets are visible. Under these conditions, the information signifying a virtual action plan must be transformed to information that can be used for constructing a motor plan to initiate specific movements. To determine whether the premotor cortex is involved in this process, we examined neuronal activity in the dorsal premotor cortex (PMd) of monkeys performing a behavioral task designed to isolate the behavioral stages of the acquisition of information for a future action and the construction of a motor plan. We trained the animals to receive a symbolic instruction (color and shape of an instruction cue) to determine whether to select the right or left of targets to reach, despite the physical absence of targets. Subsequently, two targets appeared on a screen at different locations. The animals then determined the correct target (left or right) based on the previous instruction and prepared to initiate a reaching movement to an actual target. The experimental design dissociated the selection of the right/left at an abstract level (action plan) from the physical motor plan. Here, we show that activity of individual PMd neurons initially reflects a virtual action plan transcending motor specifics, before these neurons contribute to a transformation process that leads to activity encoding a motor plan.

Fuels planning: science synthesis and integration; social issues fact sheet 10: Stages of collaboration

Science.gov (United States)

Christine Esposito

2006-01-01

Collaboration is a powerful tool for improving both the management of wildland fire and the overall health of forests and other elements of fire-dependent ecosystems. This fact sheet discusses seven stages that are typical of most collaborations.Other publications in this...

Optimization process planning using hybrid genetic algorithm and intelligent search for job shop machining.

Science.gov (United States)

Salehi, Mojtaba; Bahreininejad, Ardeshir

2011-08-01

Optimization of process planning is considered as the key technology for computer-aided process planning which is a rather complex and difficult procedure. A good process plan of a part is built up based on two elements: (1) the optimized sequence of the operations of the part; and (2) the optimized selection of the machine, cutting tool and Tool Access Direction (TAD) for each operation. In the present work, the process planning is divided into preliminary planning, and secondary/detailed planning. In the preliminary stage, based on the analysis of order and clustering constraints as a compulsive constraint aggregation in operation sequencing and using an intelligent searching strategy, the feasible sequences are generated. Then, in the detailed planning stage, using the genetic algorithm which prunes the initial feasible sequences, the optimized operation sequence and the optimized selection of the machine, cutting tool and TAD for each operation based on optimization constraints as an additive constraint aggregation are obtained. The main contribution of this work is the optimization of sequence of the operations of the part, and optimization of machine selection, cutting tool and TAD for each operation using the intelligent search and genetic algorithm simultaneously.

A Two-stage Improvement Method for Robot Based 3D Surface Scanning

Science.gov (United States)

He, F. B.; Liang, Y. D.; Wang, R. F.; Lin, Y. S.

2018-03-01

As known that the surface of unknown object was difficult to measure or recognize precisely, hence the 3D laser scanning technology was introduced and used properly in surface reconstruction. Usually, the surface scanning speed was slower and the scanning quality would be better, while the speed was faster and the quality would be worse. In this case, the paper presented a new two-stage scanning method in order to pursuit the quality of surface scanning in a faster speed. The first stage was rough scanning to get general point cloud data of object’s surface, and then the second stage was specific scanning to repair missing regions which were determined by chord length discrete method. Meanwhile, a system containing a robotic manipulator and a handy scanner was also developed to implement the two-stage scanning method, and relevant paths were planned according to minimum enclosing ball and regional coverage theories.

Limited cognitive benefits in Stage +2 postmenopausal women after 6 weeks of treatment with Ginkgo biloba.

Science.gov (United States)

Elsabagh, Sarah; Hartley, David E; File, Sandra E

2005-03-01

Gingko biloba has cognitive benefits both in populations suffering from dementia and after acute treatment in healthy volunteers, with some evidence indicating that those with poorer cognitive performance show greater benefit. We have previously found that 1 week of treatment with ginkgo improved attention, memory and mental flexibility in post-menopausal women, but the evidence for any beneficial effects of longer treatment is less well-established. The present study aimed to determine whether cognitive benefits, similar to those previously found after 1 week of treatment, would persist after 6 weeks of treatment, and whether those with poorer cognitive performance would benefit more. In a placebo-controlled, double-blind study, postmenopausal women (aged 51-67 years) were randomly allocated to receive a standardized extract of ginkgo (LI 1370, Lichtwer Pharma, Marlow, UK) (one capsule/day of 120 mg, n = 45) or matching placebo (n = 42) for 6 weeks. According to an established reproductive staging system, subjects were divided into those in the early (Stage +1; mean age 55 years) and late (Stage +2: mean age 61 years) stages of menopause. At baseline and after 6 weeks of treatment, subjects completed tests of mental flexibility, planning, memory and sustained attention, and ratings of mood, sleepiness, bodily and menopausal symptoms. The only significant effects of ginkgo were in the test of mental flexibility, in which there were significant menopausal stage-ginkgo interactions. This was because subjects in Stage +2 required fewer trials to complete the task and made fewer errors after ginkgo treatment, whereas those in Stage +1 showed no benefits. Subjects in Stage +2 had poorer performance at baseline compared to those in Stage +1 both in this task and the test of planning ability. The beneficial effects of ginkgo were limited to the test of mental flexibility and to those with poorer performance.

Problems of heat sources modeling on stage of isolated power systems expansion planning

International Nuclear Information System (INIS)

Malenkov, A.V.; Reshetnikova, L.N.; Sergeev, Yu.A.

1998-01-01

It is necessary to use computer codes for evaluation of possible applications and role of nuclear district heating plants in the local self-balancing power and heating systems, which are to be located in the remote isolated and hardly accessible regions in the Far North of Russia. Key factors in determining system configurations and its performances are: (1) interdependency of electricity, heat and fuel supply; (2) long distance between energy consumer centres (from several tens up to some hundred kilometers); and (3) difficulty in export and import of the electricity, especially the fuel in and from neighbouring and remote regions. The problem to challenge is to work out an optimum expansion plan of the local electricity and heat supply system. The ENPEP (ENergy and Power Evaluation Program) software package, which was developed by IAEA together with the USA Argonne National Laboratory, was chosen for this purpose. The Chaun-Bilibino power system (CBPS), an isolated power system in far North-East region of Russia, was selected as the first case of the ENPEP study. ENPEP allows a complex approach in the system expansion optimization planning in the time frame of planning period of up to 30 years. The key ENPEP module, ELECTRIC, considers electricity as the only product. The cogeneration part (heat production) must be considered outside the ELECTRIC model and then the results to be transfer ed to ELECTRIC. The ENPEP study on the Chaun-Bilibino isolated power system has shown that the modelling of the heat supply sources in ENPEP is not a trivial problem. It is very important and difficult to correctly represent specific features of cogeneration process at the same time. (author)

Recovery from a chemical weapons accident or incident: A concept paper on planning

Energy Technology Data Exchange (ETDEWEB)

Herzenberg, C.L.; Haffenden, R.; Lerner, K.; Meleski, S.A.; Tanzman, E.A. [Argonne National Lab., IL (United States); Lewis, L.M. [US Dept. of Agriculture (United States); Hemphill, R.C. [Niagara Mohawk Power Corporation (United States); Adams, J.D. [US Environmental Protection Agency (United States)

1994-04-01

Emergency planning for an unintended release of chemical agent from the nation`s chemical weapons stockpile should include preparation for. the period following implementation of immediate emergency response. That period -- the recovery, reentry, and restoration stage -- is the subject of this report. The report provides an overview of the role of recovery, reentry, and restoration planning in the Chemical Stockpile Emergency Preparedness Program (CSEPP), describes the transition from immediate emergency response to restoration, and analyzes the legal framework that would govern restoration activities. Social, economic, and administrative issues, as well as technical ones, need to be considered in the planning effort. Because of possible jurisdictional conflicts, appropriate federal, state, and local agencies need to be included in a coordinated planning process. Advance consideration should be given to the pertinent federal and state statutes and regulations. On the federal level, the principal statutes and regulations to be considered are those associated with the Comprehensive Environmental Response, Compensation, and Liability Act; the Resource Conservation and Recovery Act; and the National Environmental Policy Act. This report recommends that extensive preaccident planning be undertaken for the recovery, reentry, and restoration stage and outlines several key issues that should be considered in that planning. The need for interagency cooperation and coordination at all levels of the planning process is emphasized.

Efficacy of transvaginal contrast-enhanced MRI in the early staging of cervical carcinoma

International Nuclear Information System (INIS)

Akata, Deniz; Kerimoglu, Ulku; Hazirolan, Tuncay; Karcaaltincaba, Musturay; Oezmen, Mustafa N.; Akhan, Okan; Koese, Faruk

2005-01-01

The objective of this study was to evaluate the efficacy of transvaginal contrast for local staging of cervical carcinoma. Fifty patients diagnosed with cervical carcinoma prospectively underwent magnetic resonance (MR) imaging before and after vaginal opacification (VO) with a mixture of 25 ml saline and 25 ml barium. T2-weighted (T2W) TSE images in axial and sagittal planes were compared before and after vaginal opacification. Dynamic T1W images in sagittal and fat-suppressed T1W images in transverse planes were also evaluated after intravenous contrast administration. Involvement of vaginal wall, lumen, and fornices; parametrium; rectum; and bladder were noted. Changes in local tumor staging and in treatment planning were also assessed after vaginal opacification. MR results were later compared with surgical pathological findings. Twenty-eight patients who went through surgical staging were included in the study. VO did not change any of the MR interpretations in 14 patients (50%). Correct staging was achieved with T2W TSE images with and without VO (in sagittal and transverse planes) in 78.5% and 50% of the patients, respectively. VO correctly lowered staging in seven and increased it in three patients compared with sagittal standard T2W images. Treatment planning was also changed in four (14%) of these patients. When overall accuracy of MR staging to indicate the appropriate treatment was evaluated, patients would have received the proper treatment in 90% and 79% of the cases when only T2W sagittal images with and without VO were evaluated, respectively. Dynamic gradient-echo images in sagittal planes and postcontrast T1W images in transverse planes evaluated with T2W series after VO, accomplished correct staging in 23 (82%) of the patients. MRI staging in early cervical cancer may be difficult and overestimated, especially if the tumor is slightly extended into the proximal vagina. Use of vaginal contrast medium is an easy, well-tolerated, and effective

Are stage IV vestibular schwannomas preoperatively different from other stages?

Science.gov (United States)

Tringali, Stéphane; Dubreuil, Christian; Zaouche, Sandra; Ferber-Viart, Chantal

2008-01-01

The aim of this study was to focus on the clinical and paraclinical symptoms of patients suffering from Stage IV vestibular schwannomas (VSs). In this prospective study, we included 734 patients who have VS and candidates for operation. Patients were classified as having Stage I, II, III, or IV tumors according to Tos criteria as evaluated by magnetic resonance imaging. PREOPERATIVE CLINICAL EVALUATION: We recorded the occurrence of complaints (%) and duration (yr) of hearing loss, tinnitus, and balance disorder. Preoperative paraclinical evaluation included pure-tone (PTA) and speech audiometry, auditory brainstem response (ABR) patterns, and vestibular deficit at videonystamography (VNG). Continuous variables were compared between Stage IV and other stages using analysis of variance. Qualitative variables expressed as a percentage of presence were compared between Stage IV and other stages using percentage comparison. Quantitative Parameters. Patients with Stage IV VS were significantly younger as compared with patients with other stages. Stage IV hearing loss was greater compared with other stages at 250 and 500 Hz but smaller at 2,000 and 8,000 Hz. We found no difference in the loss of PTA between Stage IV and the other stages. Speech discriminancy score was smaller in Stage IV. The durations of hearing loss, tinnitus, and balance disorders were similar whatever the tumor stage. Auditory brainstem response patterns showed no difference in Wave III latency between Stage IV VS and other stages, whereas Wave V latency and V-I interval were higher in Stage IV. Both ABR threshold and VNG caloric deficit were higher in Stage IV VS compared with other stages. Qualitative Parameters. The percentage of patients with Stage IV was lower than that with Stages II and III. The percentage of men and women was similar in all stages. The occurrence of hearing loss was similar in all stages, whereas that of tinnitus was lower in Stage IV compared with Stages I and II. In

Mine planning and scheduling at Ranger Uranium Mine - environmental requirements and economics

International Nuclear Information System (INIS)

Bath, L.J.

1984-01-01

Ranger Uranium Mines operates an open cut located in the Northern Territory. Strict environmental controls govern all operations and the water management requirements have the greatest impact on mine planning. The two main goals of planning are to provide mill feed and to mine sufficient suitable quality waste rock for ongoing construction of the tailings dam. Early planning concentrated on staged development of the pit to provide access to as much ore as possible for a given amount of development. All waste was considered to be suitable construction material. Grade control of crusher feed was the main problem in planning, as wide variations occur in ore grade over relatively short distances. Water management for the site operates a 'no release' system for contaminated waters. Design storage has proven inadequate, and the open cut has been used as the extra storage. As construction of future stages of the tailings dam requires non-mineralised rock materials which meet specific quality criteria, the mine has had to re-examine long term planning and pit development strategies. This has entailed the collection of much data not required under normal mining conditions, such as the assaying of waste drill core. The overall impact on mine planning of the environmental regulations has been to alter the philosophy of earlier planning, making it necessary to create a new strategy for pit development with the accent on exposing waste

Psychosocial Well-Being Associated With Activity of Daily Living Stages Among Community-Dwelling Older Adults

Directory of Open Access Journals (Sweden)

Ling Na PhD

2017-03-01

Full Text Available Objectives: Activity of daily living (ADL stages demonstrated ordered associations with risk of chronic conditions, hospitalization, nursing home use, and mortality among community-living elderly. This article explores the association of stages with psychosocial well-being. We hypothesized that higher ADL stages (greater ADL limitation are associated with more restricted social networks, less perceived social support, greater social isolation, and poorer mental health. Methods: Cross-sectional data from the National Social Life, Health, and Aging Project ( N = 3,002 were analyzed in regression models and latent factor models. Results: Although ADL stages had a nearly monotonic relationship with most mental health measures (e.g., Center for Epidemiologic Studies Depression Scale [CES-D], only the complete limitation stage (Stage IV showed significant disadvantage in the majority of social network measures. Discussion: The study may aid clinicians and policy makers to better understand the social and mental health needs of older adults at different ADL stages and provide well-planned social and mental health care.

Opening stages of the marathon at the Maltings

International Nuclear Information System (INIS)

Anon.

1983-01-01

In this report on the opening stages of the public inquiry into plans to build a new nuclear power station at Sizewell in Suffolk based on the pressurised water reactor system, the opening address of Lord Silsoe QC and the evidence of J. Baker, R. Mathews and J. Wright, all appearing for the CEGB, are summarized. Arguments examined included, economy, siting, safety, diversification of fuel supplies, and the question of using renewable energy sources for alternative power generation. (U.K.)

Treatment planning with intensity modulated particle therapy for multiple targets in stage IV non-small cell lung cancer

Science.gov (United States)

Anderle, Kristjan; Stroom, Joep; Vieira, Sandra; Pimentel, Nuno; Greco, Carlo; Durante, Marco; Graeff, Christian

2018-01-01

Intensity modulated particle therapy (IMPT) can produce highly conformal plans, but is limited in advanced lung cancer patients with multiple lesions due to motion and planning complexity. A 4D IMPT optimization including all motion states was expanded to include multiple targets, where each target (isocenter) is designated to specific field(s). Furthermore, to achieve stereotactic treatment planning objectives, target and OAR weights plus objective doses were automatically iteratively adapted. Finally, 4D doses were calculated for different motion scenarios. The results from our algorithm were compared to clinical stereotactic body radiation treatment (SBRT) plans. The study included eight patients with 24 lesions in total. Intended dose regimen for SBRT was 24 Gy in one fraction, but lower fractionated doses had to be delivered in three cases due to OAR constraints or failed plan quality assurance. The resulting IMPT treatment plans had no significant difference in target coverage compared to SBRT treatment plans. Average maximum point dose and dose to specific volume in OARs were on average 65% and 22% smaller with IMPT. IMPT could also deliver 24 Gy in one fraction in a patient where SBRT was limited due to the OAR vicinity. The developed algorithm shows the potential of IMPT in treatment of multiple moving targets in a complex geometry.

Mobilization plan for the Y-12 9409-5 tank storage facility RCRA closure plan. Final report. Revision 1

International Nuclear Information System (INIS)

1993-11-01

This mobilization plan identifies the activities and equipment necessary to begin the field sampling for the Oak Ridge Y-12 9409-5 Diked Tank Storage Facility (DTSF) Resource Conservation and Recovery Act (RCRA) closure. Elements of the plan outline the necessary components of each mobilization task and identify whether SAIC or the Martin Marietta Energy Systems, Inc. Y-12 Environmental Restoration Division will be responsible for task coordination. Field work will be conducted in two phases: mobilization phase and soil sampling phase. Training and medical monitoring, access, permits and passes, decontamination/staging area, equipment, and management are covered in this document

Final Work Plan: Targeted Investigation at York, Nebraska

Energy Technology Data Exchange (ETDEWEB)

LaFreniere, Lorraine M. [Argonne National Lab. (ANL), Argonne, IL (United States)

2016-08-01

The targeted investigation at York will be implemented in phases, so that data collected and interpretations developed at each stage of the program can be evaluated to guide subsequent phases most effectively. Section 2 of this Work Plan presents a brief overview of the York site, its geologic and hydrologic setting, and the previous CCC/USDA investigations. Section 3, outlines the proposed technical program for the targeted investigation, and Section 4 describes the investigative methods to be employed. A community relations plan is in Section 5, and Section 6 includes health and safety information. In addition to this site-specific Work Plan, the Master Work Plan (Argonne 2002) developed by Argonne for CCC/USDA investigations in Nebraska should be consulted for complete details of the methods and procedures to be used at York.

Outage planning in Japan

International Nuclear Information System (INIS)

Nedderman, John.

1997-01-01

Nuclear plant operators in Japan are constrained to keep refuelling and maintenance outages to a minimum by the regulation limiting operating cycles to no longer than 13 months. Outage planning by two contrasting operators is described. Hokkaido Electric, which operates only one plant, Tomari, with two PWRs, plans to reduce outage time from the present 65 days in two stages. Detailed review of previous outage schedules has shown that a reduction to 59 days should be achievable by careful planning without any fundamental changes. The second reduction to 49 days will require such measures as relaxing water purity standards, rescheduling fuel unloading and loading shifts and speeding up eddy current testing of primary equipment by using steam generator nozzle dams. Kansai Electric, operating 11 PWRs at three plants, has scope for reducing outages at all of its units using a range of measures. Steam generator replacement in the seven oldest reactors, completed in July 1997, is by far the most significant of these and is expected to save 64 days repair time in a previous average outage time of 131 days. (UK)

Realisation of functions of planning and organisation in the system of management of transaction expenses

Directory of Open Access Journals (Sweden)

Krush Peter V.

2014-01-01

Full Text Available The goal of the article lies in building a functional model of management of transaction expenses of an enterprise with specification of stages of realisation of planning functions in an organisation. In the result of the study the article marks out functions of management of transaction expenses, which ensure transformation of incoming (financial resources into outgoing ones (optimised transaction expenses. The article identifies stages of realisation of “Planning transaction expenses” and “Organisation of management of transaction expenses” functions. It characterises in detail responsibilities of enterprise subdivisions that deal with management of transaction expenses. It establishes that the original element of the planning function is the budget of transaction expenses for a planning period and organisation – job descriptions of employees with detailed description of their duties and authorities, rights and obligations. The prospect of further scientific developments is study of stages of realisation of such management functions as “Motivation of personnel on rational use of funds and management of transaction expenses”, “Control over the state of management of transaction expenses” and “Regulation of the process of management of transaction expenses” of enterprises.

CARTOGRAPHICAL-GEOINFORMATICAL SECURITY OF TERRITORIAL PLANNING IN THE RUSSIAN FEDERATION

Directory of Open Access Journals (Sweden)

A. N. Panin

2017-01-01

Full Text Available The adoption of the town planning code of the Russian Federation in 2004, started the modern stage of spatial planning in Russia at all administrative-territorial levels. Despite the fact that it was more than 12 years ago, the system of preparation documents of territorial planning and zoning has continued the path of improvement [Chistobaev, 2013]. Quite significant aspects of these documents preparation is related to the cartographic unit. Over the period there has been a qualitative shift in the preparation of the documents that is connected first of all with an increasing role of geographic information systems, and strengthening synchronization of documents of various administrative and territorial rank, including due to transition to a unified cartographic basis [Skaterschikov, 2007].It is important to note that in the post-Soviet period, actually work on the documents of spatial planning in the country has conducted. Thus, the first stage after a significant break was characterized by misunderstandings on the part of authorities of “customer” role and significance of this document on the one hand, and the other, was associated with the shortage of specialists, which was simply not enough for large-scale operation in the country. These problems led to what in fact was complete absence of current methods and requirements for the formation of the documents. So the preparation of the graphic part was limited at best, issuing paper copies and receiving electronic copies of maps as raster images.The second stage is characterized by a number of positive trends – first, the town planning code of the Russian Federation has undergone significant changes and second, there has been put into effect additional normative legal acts, guidelines governing the preparation of the documents related to the software shells, and meeting the needs of the Federal Service for State Registration, Cadastre and Cartography of the Russian Federation. Since the

America's Next Great Ship: Space Launch System Core Stage Transitioning from Design to Manufacturing

Science.gov (United States)

Birkenstock, Benjamin; Kauer, Roy

2014-01-01

The Space Launch System (SLS) Program is essential to achieving the Nation's and NASA's goal of human exploration and scientific investigation of the solar system. As a multi-element program with emphasis on safety, affordability, and sustainability, SLS is becoming America's next great ship of exploration. The SLS Core Stage includes avionics, main propulsion system, pressure vessels, thrust vector control, and structures. Boeing manufactures and assembles the SLS core stage at the Michoud Assembly Facility (MAF) in New Orleans, LA, a historical production center for Saturn V and Space Shuttle programs. As the transition from design to manufacturing progresses, the importance of a well-executed manufacturing, assembly, and operation (MA&O) plan is crucial to meeting performance objectives. Boeing employs classic techniques such as critical path analysis and facility requirements definition as well as innovative approaches such as Constraint Based Scheduling (CBS) and Cirtical Chain Project Management (CCPM) theory to provide a comprehensive suite of project management tools to manage the health of the baseline plan on both a macro (overall project) and micro level (factory areas). These tools coordinate data from multiple business systems and provide a robust network to support Material & Capacity Requirements Planning (MRP/CRP) and priorities. Coupled with these tools and a highly skilled workforce, Boeing is orchestrating the parallel buildup of five major sub assemblies throughout the factory. Boeing and NASA are transforming MAF to host state of the art processes, equipment and tooling, the most prominent of which is the Vertical Assembly Center (VAC), the largest weld tool in the world. In concert, a global supply chain is delivering a range of structural elements and component parts necessary to enable an on-time delivery of the integrated Core Stage. SLS is on plan to launch humanity into the next phase of space exploration.

INTEGRATED APPROACH TO GENERATION OF PRECEDENCE RELATIONS AND PRECEDENCE GRAPHS FOR ASSEMBLY SEQUENCE PLANNING

Institute of Scientific and Technical Information of China (English)

无

2002-01-01

An integrated approach to generation of precedence relations and precedence graphs for assembly sequence planning is presented, which contains more assembly flexibility. The approach involves two stages. Based on the assembly model, the components in the assembly can be divided into partially constrained components and completely constrained components in the first stage, and then geometric precedence relation for every component is generated automatically. According to the result of the first stage, the second stage determines and constructs all precedence graphs. The algorithms of these two stages proposed are verified by two assembly examples.

Chemotherapy Toxicity On Quality of Life in Older Patients With Stage I, Stage II, Stage III, or Stage IV Ovarian Epithelial, Primary Peritoneal Cavity, or Fallopian Tube Cancer

Science.gov (United States)

2017-05-03

Stage I Ovarian Cancer; Stage IA Fallopian Tube Cancer; Stage IB Fallopian Tube Cancer; Stage IC Fallopian Tube Cancer; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIB Fallopian Tube Cancer; Stage IIC Fallopian Tube Cancer; Stage III Ovarian Cancer; Stage III Primary Peritoneal Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIC Fallopian Tube Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

Oil spill response planning on the Columbia river estuary

International Nuclear Information System (INIS)

Christopherson, S.K.; Slyman, P.M.

1993-01-01

The Columbia River Estuary lies along the Washington-Oregon state boundary on the west coast of the United States. The entire area is environmentally very sensitive with numerous large, shallow bays, exposed mud flats, wetland areas, and central channels having maximum currents of three to four knots. These features make the area very difficult to protect from an oil spill. Spill response is further complicated because of the many different state, federal, and local jurisdictions with mandated responsibilities in oil spill response and environmental protection. Under the leadership of the US Coast Guard Marine Safety Office in Portland, Oregon, a steering group was established to guide the development of a response plan for the Columbia River Estuary. A concerted effort was made to include representatives from response organizations, natural resource agencies, and resource users from federal, state, and local governments, and commercial sectors in the planning process. The first draft of an operational response plan was completed the summer of 1992 through a combination of technical workshops, field trips, and small working groups meeting with local communities. The Columbia River Estuary Response Plan prioritizes areas to protect; identifies specific response strategies for protecting these areas; and outlines the Iogistics needed to implement these strategies, including equipment needs, the location of staging areas, and the identification of pre-designed command posts. The local spill response cooperative and oil transportation industry are using the plan to coordinate the purchase of response equipment and the staging of this equipment at numerous locations along the river. The key to success is ensuring that all the groups responding to an event participate in the planning process together. This process has worked well and will serve as a model for response planning for other areas along the Columbia River and coastal areas of Washington and Oregon

Planning of activities in the Laguna Verde Central planning at 12 weeks

International Nuclear Information System (INIS)

Chimalpopoca, C.

2007-01-01

The universe of works that are carried out in a nuclear facility to maintain effective the structures, systems and components require of a continuous analysis, in the order of the maintenance frequencies that can be of the preventive, predictive or corrective type. Each component is associated to reserve parts, readiness of systems, in fulfillment to the operation technical specifications, to the environment of the one work; each component requires of a planning level, where it is distinguished with clarity when they are executed, in the operation stage, stop or recharge. This work has as end to show like the activities are planned during the operation, using planning methods to twelve weeks, where the reach of the task is conceptualized, operative requirements, of reserve parts, of the work environment analysis, of those radiological conditions, of the authorizations for their execution, the same execution and the evaluation post work like a technique to maintain in continuous improvement the tasks of the maintenance of the Units of the Power station. A motor valve to be worked in its internals requires access to the work point, it requires bill of the system, electric disconnection, maneuvers to disassemble actuators and retirement of thermal isolation if it applies, reserve parts of the caps joints, control mechanisms, personal, tools, radiological control. The success of the continuous operation of a power station is in the planning quality, the attention of each one of the details to assure that the components, structures and components stay effective to make their function when they are demanded. The planning task requires of experience and knowledge of each some of the components, the task of planning of activities and its execution is multidisciplinary This work has that purpose, to show the planning tools in the Laguna Verde Nuclear Power station, under the concept of twelve weeks. (Author)

A Planning Model for the Development of Programs for Abused and Neglected Children in Rural Areas.

Science.gov (United States)

Chamberlain, William A.

Described are planning steps involved in developing programs for abused and neglected children in rural areas. Among barriers cited are economic factors and resistance to social planning. Emphasized is the need for congruence among local and regional agencies and organizations. Analyzed are six planning stages: entry, in which consultants gain…

Finding the K best synthesis plans.

Science.gov (United States)

Fagerberg, Rolf; Flamm, Christoph; Kianian, Rojin; Merkle, Daniel; Stadler, Peter F

2018-04-05

In synthesis planning, the goal is to synthesize a target molecule from available starting materials, possibly optimizing costs such as price or environmental impact of the process. Current algorithmic approaches to synthesis planning are usually based on selecting a bond set and finding a single good plan among those induced by it. We demonstrate that synthesis planning can be phrased as a combinatorial optimization problem on hypergraphs by modeling individual synthesis plans as directed hyperpaths embedded in a hypergraph of reactions (HoR) representing the chemistry of interest. As a consequence, a polynomial time algorithm to find the K shortest hyperpaths can be used to compute the K best synthesis plans for a given target molecule. Having K good plans to choose from has many benefits: it makes the synthesis planning process much more robust when in later stages adding further chemical detail, it allows one to combine several notions of cost, and it provides a way to deal with imprecise yield estimates. A bond set gives rise to a HoR in a natural way. However, our modeling is not restricted to bond set based approaches-any set of known reactions and starting materials can be used to define a HoR. We also discuss classical quality measures for synthesis plans, such as overall yield and convergency, and demonstrate that convergency has a built-in inconsistency which could render its use in synthesis planning questionable. Decalin is used as an illustrative example of the use and implications of our results.

Sustainability and Business Planning

OpenAIRE

Joy Davidson

2017-01-01

This session will consider the longer term sustainability of ROM services and provide an introduction to Business Model Canvas (BMC) as a tool to help develop a longer term business plan. Working in institutional groups, each group will work together to develop a BMC for their institution. This will be revisited at several stages over the life of the project and updated accordingly. By the end of this session, participants will: •be able to flesh out a Business Model C...

Strategic cycling: shaking complacency in healthcare strategic planning.

Science.gov (United States)

Begun, J; Heatwole, K B

1999-01-01

As the conditions affecting business and healthcare organizations in the United States have become more turbulent and uncertain, strategic planning has decreased in popularity. Strategic planning is criticized for stiffling creative responses to the new marketplace and for fostering compartmentalized organizations, adherence to outmoded strategies, tunnel vision in strategy formulation, and overemphasis on planning to the detriment of implementation. However, effective strategic planning can be a force for mobilizing all the constituents of an organization, creating discipline in pursuit of a goal, broadening an organization's perspective, improving communication among disciplines, and motivating the organization's workforce. It is worthwhile for healthcare organizations to preserve these benefits of strategic planning at the same time recognizing the many sources of turbulence and uncertainty in the healthcare environment. A model of "strategic cycling" is presented to address the perceived shortcomings of traditional strategic planning in a dynamic environment. The cycling model facilitates continuous assessment of the organization's mission/values/vision and primary strategies based on feedback from benchmark analysis, shareholder impact, and progress in strategy implementation. Multiple scenarios and contingency plans are developed in recognition of the uncertain future. The model represents a compromise between abandoning strategic planning and the traditional, linear model of planning based on progress through predetermined stages to a masterpiece plan.

ENSI's view on NTB-10-01 'Evaluation of the geological documents for the provisional safety assessment in SGT Stage 2' - Sectoral Plan 'Deep Geological Disposal'

International Nuclear Information System (INIS)

2011-03-01

As a preliminary action ahead of Stage 2 in the Sectoral Plan 'Deep Geological Disposal' ('Sachplan Geologische Tiefenlager': SGT) the bodies in charge of the management of the radioactive wastes have to determine, together with the Swiss Federal Nuclear Safety Inspectorate (ENSI), which complementary investigations are needed for the provisional safety assessment of the foreseen repositories. In particular, comparisons between the different sites must be possible. If some doubts remain, new investigations have to be conducted. In SGT Stage 1 the National Cooperative for the Disposal of Radioactive Waste (NAGRA) stated that a time period of 100'000 years shall be considered for the storage of low- and intermediate-level radioactive wastes (SMA) and of 1 million years for the storage of high-level wastes (HAA). In SGT Stage 2, considerations about possible modifications of the biosphere during the considered time periods for SMA as well as for HAA have to be included. In what regards the host rock, ENSI declares that the dataset describing the Opalinus clay is sufficient for the site-specific safety analyses. What regards the Wellenberg site for a SMA repository, ENSI has earlier analysed the license request of the NAGRA. For the Mergel formations of the Helveticum, NAGRA conducted a complete safety analysis. ENSI considers the knowledge acquired for these rock types as sufficient for the technical safety comparisons in SGT Stage 2. The knowledge of the rock 'Brauner Dogger' is correct but some more information about the lithostratigraphy and the biostratigraphy is requested. The understanding of the effect of the rock density reduction on the hydraulic conductibility of Opalinus clay and Mergel formations is accurate enough for the comparisons in SGT Stage 2. For the 'Brauner Dogger', comparable data are missing, but the proposed thickness of 300 m of the host rock offers a sufficient protection against density reduction effects. Concerning the behaviour of the

The planning of training process in triathlon

Directory of Open Access Journals (Sweden)

Volodymyr Vodlozerov

2016-04-01

Full Text Available Purpose: is the working out of base variant of training process as the base for planning of individual training of triathlete. Material & Methods: studying and generalization of special literature of basis training process for endurance in cyclic kinds of sports, the analysis of training of famous triathletes to competitions. Results: mane stages of training process formation in triathlon and features of distribution of sportsman’s training load in depending on period of training were considered. Conclusions: comprehensive planning of training process in different kinds of triathlon is lying down in basis of improving of competition form of triathlete.

Detectors plans for LS1

International Nuclear Information System (INIS)

Nessi, M.

2012-01-01

All experiments plan an effective usage of the LS1 shutdown period. After three years of running they will go through a consolidation phase, mostly to fix problems that have emerged over time, like single points of failure in the infrastructure, failures of low-voltage power supplies and optical links. Upgrades of some detector components will start, mainly related to the beam pipe, the innermost tracker elements and the trigger system. Detector components, which had to be staged for cost reasons in 2003, will then enter into the detector setup. The goal is to be fully ready for the new energy regime at nominal luminosity. This article reviews the planned maintenance and modification works for ATLAS, CMS, LHCb and ALICE experiments. (author)

Landfill gas: planning and regulation

International Nuclear Information System (INIS)

Nealon, T.

1991-01-01

There is no legislation in the UK that relates directly to landfill gas. However, various pieces of legislation do exist which control all aspects of landfill and therefore, indirectly, landfill gas. This legislation includes Planning Acts, The Control of Pollution Act, Health and Safety at Work Acts, and Public Health Acts, and affects landfill gas throughout the life of the site - from planning stage to long after the last load has been deposited and restoration has been carried out. Responsibility for ensuring compliance with these various Acts lies with a variety of Authorities, including Plannning Authorities, Waste Disposal Authorities, and Environmental Health Authorities. Responsibility for actual compliance with the Acts lies with the operator, for active sites, and the landowner in the case of closed sites. (author)

Factor analysis for imperfect maintenance planning at nuclear power plants by cognitive task analysis

International Nuclear Information System (INIS)

Takagawa, Kenichi; Iida, Hiroyasu

2011-01-01

Imperfect maintenance planning was frequently identified in domestic nuclear power plants. To prevent such an event, we analyzed causal factors in maintenance planning stages and showed the directionality of countermeasures in this study. There is a pragmatic limit in finding the causal factors from the items based on report descriptions. Therefore, the idea of the systemic accident model, which is used to monitor the performance variability in normal circumstances, is taken as a new concept instead of investigating negative factors. As an actual method for analyzing usual activities, cognitive task analysis (CTA) was applied. Persons who experienced various maintenance activities at one electric power company were interviewed about sources related to decision making during maintenance planning, and then usual factors affecting planning were extracted as performance variability factors. The tendency of domestic events was analyzed using the classification item of those factors, and the directionality of countermeasures was shown. The following are critical for preventing imperfect maintenance planning: the persons in charge should fully understand the situation of the equipment for which they are responsible in the work planning and maintenance evaluation stages, and they should definitely understand, for example, the maintenance bases of that equipment. (author)

Upgrading the JET pellet injector with a two-stage light gas gun prototype and future planning

International Nuclear Information System (INIS)

Kupschus, P.; Sonnenberg, K.; Bailey, W.; Gadeberg, M.; Hardaker, J.; Hedley, L.; Helm, J.; Flory, D.; McCarthy, P.; Nowak, A.; Twynam, P.; Szabo, T.; Watson, M.

1989-01-01

For about two years the Joint European TORUS (JET) has been using a multi-pellet injector jointly built by JET and the Oak Ridge National Laboratory (ORNL). This was and is jointly operated by a JET - US Pellet Team within the Pellet Agreement between JET and the US Department of Energy (US DOE) under the wider umbrella of the EURATOM - US DOE Agreement on collaborative Fusion Research. This injector is composed of the ORNL Launcher, employing three independently firing repetitive (up to 5 s -1 ) pneumatic guns for pellet speeds of up to 1.5 kms -1 , and a JET launcher-torus interface (Pellet Interface) which provides all required services to the launcher and its immediate control system. In particular, it provides the differential pumping to match the high pressures of the gun system to the vacuum pressure and flow requirements of the plasma boundary. The Pellet Interface, in its design from its conception about four years ago, was intended to be equipped with a JET built pellet launcher system employing also high-speed guns at a later date once the ORNL Launcher will have been removed as it is not compatible with the JET requirements for the Active Phase (tritium and remote handling compatibility). As a first step - to learn about the possible plasma physics benefits as well as to gain technical experience concerning the application of advanced gun technology, a JET two-stage light gas gun prototype has been developed and is now being installed in parallel with the ORNL Launcher. This paper reports on the JET pellet injector development program, its motivation and its results to date. It describes briefly the presently operated pellet injector, continues to outline the design of the prototype in more detail and finally sketches the plans for the near future. 8 refs., 11 figs., 1 tab

Implementation of a Web-Based Collaborative Process Planning System

Science.gov (United States)

Wang, Huifen; Liu, Tingting; Qiao, Li; Huang, Shuangxi

Under the networked manufacturing environment, all phases of product manufacturing involving design, process planning, machining and assembling may be accomplished collaboratively by different enterprises, even different manufacturing stages of the same part may be finished collaboratively by different enterprises. Based on the self-developed networked manufacturing platform eCWS(e-Cooperative Work System), a multi-agent-based system framework for collaborative process planning is proposed. In accordance with requirements of collaborative process planning, share resources provided by cooperative enterprises in the course of collaboration are classified into seven classes. Then a reconfigurable and extendable resource object model is built. Decision-making strategy is also studied in this paper. Finally a collaborative process planning system e-CAPP is developed and applied. It provides strong support for distributed designers to collaboratively plan and optimize product process though network.

Environmental screening tools for assessment of infrastructure plans based on biodiversity preservation and global warming (PEIT, Spain)

International Nuclear Information System (INIS)

Garcia-Montero, Luis G.; Lopez, Elena; Monzon, Andres; Otero Pastor, Isabel

2010-01-01

Most Strategic Environmental Assessment (SEA) research has been concerned with SEA as a procedure, and there have been relatively few developments and tests of analytical methodologies. The first stage of the SEA is the 'screening', which is the process whereby a decision is taken on whether or not SEA is required for a particular programme or plan. The effectiveness of screening and SEA procedures will depend on how well the assessment fits into the planning from the early stages of the decision-making process. However, it is difficult to prepare the environmental screening for an infrastructure plan involving a whole country. To be useful, such methodologies must be fast and simple. We have developed two screening tools which would make it possible to estimate promptly the overall impact an infrastructure plan might have on biodiversity and global warming for a whole country, in order to generate planning alternatives, and to determine whether or not SEA is required for a particular infrastructure plan.

Survival Advantage Associated with Decrease in Stage at Detection from Stage IIIC to Stage IIIA Epithelial Ovarian Cancer

Science.gov (United States)

Lefringhouse, Jason; Pavlik, Edward; Miller, Rachel; DeSimone, Christopher; Ueland, Frederick; Kryscio, Richard; van Nagell, J. R.

2014-01-01

Objective. The aim of this study was to document the survival advantage of lowering stage at detection from Stage IIIC to Stage IIIA epithelial ovarian cancer. Methods. Treatment outcomes and survival were evaluated in patients with Stage IIIA and Stage IIIC epithelial ovarian cancer treated from 2000 to 2009 at the University of Kentucky Markey Cancer Center (UKMCC) and SEER institutions. Results. Cytoreduction to no visible disease (P < 0.0001) and complete response to platinum-based chemotherapy (P < 0.025) occurred more frequently in Stage IIIA than in Stage IIIC cases. Time to progression was shorter in patients with Stage IIIC ovarian cancer (17 ± 1 months) than in those with Stage II1A disease (36 ± 8 months). Five-year overall survival (OS) improved from 41% in Stage IIIC patients to 60% in Stage IIIA patients treated at UKMCC and from 37% to 56% in patients treated at SEER institutions for a survival advantage of 19% in both data sets. 53% of Stage IIIA and 14% of Stage IIIC patients had NED at last followup. Conclusions. Decreasing stage at detection from Stage IIIC to stage IIIA epithelial ovarian cancer is associated with a 5-year survival advantage of nearly 20% in patients treated by surgical tumor cytoreduction and platinum-based chemotherapy. PMID:25254047

Stuart oil shale project stage two: executive summary: draft environmental impact statement

International Nuclear Information System (INIS)

1999-09-01

The project is an oil shale open pit mine and processing operation that is currently being commissioned 15 km north of Gladstone, Queensland, Australia, and is owned as a joint venture by Southern Pacific Petroleum N.L., Central Pacific Minerals N.L, and Suncor Energy Inc., a leading Canadian company that is an integrated energy company. The results of a comprehensive investigation are included of the potential environmental impacts of the project, and which are described in the Draft Environmental Impact Statement (EIS). In stage two, there is included the existing mine expansion as well as the construction of an additional process plant based around a larger commercial scale ATP oil shale processing plant. The new stage two operation will be developed next to and integral with services and infrastructure provided for stage one. Described are: the assessment process, regulatory framework and the project area, the needs for an alternative to the project, the proposal itself, the existing natural, social and economic impacts, and the environmental impacts as well as plans for their mitigation. In appendices there are included a draft environmental management overview strategy and an environmental management plan. The elements covered in the report by section are: background, need for the project, the proponent, legislation and approvals, project description, environmental issues and impact management

Engineering Technical Review Planning Briefing

Science.gov (United States)

Gardner, Terrie

2012-01-01

The general topics covered in the engineering technical planning briefing are 1) overviews of NASA, Marshall Space Flight Center (MSFC), and Engineering, 2) the NASA Systems Engineering(SE) Engine and its implementation , 3) the NASA Project Life Cycle, 4) MSFC Technical Management Branch Services in relation to the SE Engine and the Project Life Cycle , 5) Technical Reviews, 6) NASA Human Factor Design Guidance , and 7) the MSFC Human Factors Team. The engineering technical review portion of the presentation is the primary focus of the overall presentation and will address the definition of a design review, execution guidance, the essential stages of a technical review, and the overall review planning life cycle. Examples of a technical review plan content, review approaches, review schedules, and the review process will be provided and discussed. The human factors portion of the presentation will focus on the NASA guidance for human factors. Human factors definition, categories, design guidance, and human factor specialist roles will be addressed. In addition, the NASA Systems Engineering Engine description, definition, and application will be reviewed as background leading into the NASA Project Life Cycle Overview and technical review planning discussion.

Planned Parenthood works with Korean government.

Science.gov (United States)

Yang, J M

1968-01-01

In early 1961 special representatives of the International Planned Parenthood Federation (IPPF) organized the Planned Parenthood Federation of Korea (PPFK). The leaders, mostly young university professors, physicians, and government officials well recognized in the fields of public health gynecology/obstetrics, pediatrics, nursing, sociology, social work, and economics, shared an interest in improving the national economy, the national welfare, countermeasures against the population crisis, and the urgent need for family planning services in Korea. The leadership of General Park Chung-hee led to adoption of a national policy in support of family planning at an early stage in November 1961. Since 1961, the government budget for family planning has doubled every year. The PPFK was asked to play a major role in planning, administration, training, information, and education of the national program until the government established the new section of Maternal and Child Health in the Ministry of Health and Social Affairs in 1963. The role of the PPFK has never diminished. The training of family planning personnel at various levels is still carried out entirely by the PPFK. The PPFK operates mobile vans to provide educational activities, IUD insertions, and male sterilization services to people in villages without doctors. The PPFK operates pilot projects to test new methods either in clinics or in the field. The PPFK exists to supplement and cooperate with the government in family planning. With its flexibility, the PPFK team of experts stands ready to provide quick and positive services without red tape.

Short-term hydropower production planning by stochastic programming

DEFF Research Database (Denmark)

Fleten, Stein-Erik; Kristoffersen, Trine

2008-01-01

-term production planning a matter of spatial distribution among the reservoirs of the plant. Day-ahead market prices and reservoir inflows are, however, uncertain beyond the current operation day and water must be allocated among the reservoirs in order to strike a balance between current profits and expected......Within the framework of multi-stage mixed-integer linear stochastic programming we develop a short-term production plan for a price-taking hydropower plant operating under uncertainty. Current production must comply with the day-ahead commitments of the previous day which makes short...

Planning and management support for NPP personnel SAT-based training programmes

International Nuclear Information System (INIS)

Ziakova, M.

1998-01-01

This paper deals with planning and management support for NPP personnel SAT based training programmes based on IAEA TC Project SLR/0/003 on upgrading NPP personnel training, with the aim of upgrading NPP safety and reliability of NPP operation and maintenance. The costs needed include both Slovak and IAEA sources. Five stages of the Project are defined: planning; organizing; motivating; implementation; control, review and accountability

Radiotherapy facilities: Master planning and concept design considerations

Energy Technology Data Exchange (ETDEWEB)

NONE

2014-08-15

This publication provides guidelines on how to plan a radiotherapy facility in terms of the strategic master planning process including the legal, technical and infrastructure requirements. It outlines a risk assessment methodology, a typical project work plan and describes the professional expertise required for the implementation of such a project. Generic templates for a block design are suggested, which include possibilities for future expansion. These templates can be overlaid onto the designated site such that the most efficient workflow between the main functional areas can be ensured. A sample checklist is attached to act as a guideline for project management and to indicate the critical stages in the process where technical expert assistance may be needed. The publication is aimed at professionals and administrators involved in infrastructure development, planning and facility management, as well as engineers, building contractors and radiotherapy professionals.

Radiotherapy facilities: Master planning and concept design considerations

International Nuclear Information System (INIS)

2014-01-01

This publication provides guidelines on how to plan a radiotherapy facility in terms of the strategic master planning process including the legal, technical and infrastructure requirements. It outlines a risk assessment methodology, a typical project work plan and describes the professional expertise required for the implementation of such a project. Generic templates for a block design are suggested, which include possibilities for future expansion. These templates can be overlaid onto the designated site such that the most efficient workflow between the main functional areas can be ensured. A sample checklist is attached to act as a guideline for project management and to indicate the critical stages in the process where technical expert assistance may be needed. The publication is aimed at professionals and administrators involved in infrastructure development, planning and facility management, as well as engineers, building contractors and radiotherapy professionals

Sample size reassessment for a two-stage design controlling the false discovery rate.

Science.gov (United States)

Zehetmayer, Sonja; Graf, Alexandra C; Posch, Martin

2015-11-01

Sample size calculations for gene expression microarray and NGS-RNA-Seq experiments are challenging because the overall power depends on unknown quantities as the proportion of true null hypotheses and the distribution of the effect sizes under the alternative. We propose a two-stage design with an adaptive interim analysis where these quantities are estimated from the interim data. The second stage sample size is chosen based on these estimates to achieve a specific overall power. The proposed procedure controls the power in all considered scenarios except for very low first stage sample sizes. The false discovery rate (FDR) is controlled despite of the data dependent choice of sample size. The two-stage design can be a useful tool to determine the sample size of high-dimensional studies if in the planning phase there is high uncertainty regarding the expected effect sizes and variability.

One-stage and two-stage penile buccal mucosa urethroplasty

Directory of Open Access Journals (Sweden)

G. Barbagli

2016-03-01

Full Text Available The paper provides the reader with the detailed description of current techniques of one-stage and two-stage penile buccal mucosa urethroplasty. The paper provides the reader with the preoperative patient evaluation paying attention to the use of diagnostic tools. The one-stage penile urethroplasty using buccal mucosa graft with the application of glue is preliminary showed and discussed. Two-stage penile urethroplasty is then reported. A detailed description of first-stage urethroplasty according Johanson technique is reported. A second-stage urethroplasty using buccal mucosa graft and glue is presented. Finally postoperative course and follow-up are addressed.

Implementation of imaging of the national protocol for quality control in planning systems

International Nuclear Information System (INIS)

Caudepon Moreno, F.; Martin-Viera cueto, J. A.; Bodineau gil, C.; Benitez Villegas, E. M.; Casado Villalon, F. J.; Moreno Sainz, C.

2011-01-01

Quality control of the planning system (SP) plays a key role in quality assurance schemes that include all stages of the radiotherapy process.In this work we focus on the evidence detailing the ''Protocol for quality control in therapy planning systems with ionizing radiation of the SEFM in ''anatomical data acquisition (DA).

Statistical inference for extended or shortened phase II studies based on Simon's two-stage designs.

Science.gov (United States)

Zhao, Junjun; Yu, Menggang; Feng, Xi-Ping

2015-06-07

Simon's two-stage designs are popular choices for conducting phase II clinical trials, especially in the oncology trials to reduce the number of patients placed on ineffective experimental therapies. Recently Koyama and Chen (2008) discussed how to conduct proper inference for such studies because they found that inference procedures used with Simon's designs almost always ignore the actual sampling plan used. In particular, they proposed an inference method for studies when the actual second stage sample sizes differ from planned ones. We consider an alternative inference method based on likelihood ratio. In particular, we order permissible sample paths under Simon's two-stage designs using their corresponding conditional likelihood. In this way, we can calculate p-values using the common definition: the probability of obtaining a test statistic value at least as extreme as that observed under the null hypothesis. In addition to providing inference for a couple of scenarios where Koyama and Chen's method can be difficult to apply, the resulting estimate based on our method appears to have certain advantage in terms of inference properties in many numerical simulations. It generally led to smaller biases and narrower confidence intervals while maintaining similar coverages. We also illustrated the two methods in a real data setting. Inference procedures used with Simon's designs almost always ignore the actual sampling plan. Reported P-values, point estimates and confidence intervals for the response rate are not usually adjusted for the design's adaptiveness. Proper statistical inference procedures should be used.

Personal Financial Literacy and Financial Planning in Klang Valley, Malaysia

OpenAIRE

Hoe, Siew Yee

2008-01-01

The financial planning industry in Malaysia is still very much at its inception stage. Currently, regulators- Bank Negara Malaysia and Securities Commission of Malaysia have started to regulate the industry by imposing requirements for whoever wanted to venture into the financial planning profession. The title of ‘Financial Planner’ is now highly legalized by the authorities. Empirical studies have been done by overseas scholars and found that the lack of personal financial literacy has been ...

Positron Emission Tomography/Computed Tomography-Guided Intensity-Modulated Radiotherapy for Limited-Stage Small-Cell Lung Cancer

International Nuclear Information System (INIS)

Shirvani, Shervin M.; Komaki, Ritsuko; Heymach, John V.; Fossella, Frank V.; Chang, Joe Y.

2012-01-01

Purpose: Omitting elective nodal irradiation from planning target volumes does not compromise outcomes in patients with non–small-cell lung cancer, but whether the same is true for those with limited-stage small-cell lung cancer (LS-SCLC) is unknown. Therefore, in the present study, we sought to determine the clinical outcomes and the frequency of elective nodal failure in patients with LS-SCLC staged using positron emission tomography/computed tomography and treated with involved-field intensity-modulated radiotherapy. Methods and Materials: Between 2005 and 2008, 60 patients with LS-SCLC at our institution underwent disease staging using positron emission tomography/computed tomography before treatment using an intensity-modulated radiotherapy plan in which elective nodal irradiation was intentionally omitted from the planning target volume (mode and median dose, 45 Gy in 30 fractions; range, 40.5 Gy in 27 fractions to 63.8 Gy in 35 fractions). In most cases, concurrent platinum-based chemotherapy was administered. We retrospectively reviewed the clinical outcomes to determine the overall survival, relapse-free survival, and failure patterns. Elective nodal failure was defined as recurrence in initially uninvolved hilar, mediastinal, or supraclavicular nodes. Survival was assessed using the Kaplan-Meier method. Results: The median age of the study patients at diagnosis was 63 years (range, 39–86). The median follow-up duration was 21 months (range, 4–58) in all patients and 26 months (range, 4–58) in the survivors. The 2-year actuarial overall survival and relapse-free survival rate were 58% and 43%, respectively. Of the 30 patients with recurrence, 23 had metastatic disease and 7 had locoregional failure. We observed only one isolated elective nodal failure. Conclusions: To our knowledge, this is the first study to examine the outcomes in patients with LS-SCLC staged with positron emission tomography/computed tomography and treated with definitive

Positron Emission Tomography/Computed Tomography-Guided Intensity-Modulated Radiotherapy for Limited-Stage Small-Cell Lung Cancer

Energy Technology Data Exchange (ETDEWEB)

Shirvani, Shervin M.; Komaki, Ritsuko [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Heymach, John V.; Fossella, Frank V. [Department of Thoracic/Head and Neck Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Chang, Joe Y., E-mail: jychang@mdanderson.org [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)

2012-01-01

Purpose: Omitting elective nodal irradiation from planning target volumes does not compromise outcomes in patients with non-small-cell lung cancer, but whether the same is true for those with limited-stage small-cell lung cancer (LS-SCLC) is unknown. Therefore, in the present study, we sought to determine the clinical outcomes and the frequency of elective nodal failure in patients with LS-SCLC staged using positron emission tomography/computed tomography and treated with involved-field intensity-modulated radiotherapy. Methods and Materials: Between 2005 and 2008, 60 patients with LS-SCLC at our institution underwent disease staging using positron emission tomography/computed tomography before treatment using an intensity-modulated radiotherapy plan in which elective nodal irradiation was intentionally omitted from the planning target volume (mode and median dose, 45 Gy in 30 fractions; range, 40.5 Gy in 27 fractions to 63.8 Gy in 35 fractions). In most cases, concurrent platinum-based chemotherapy was administered. We retrospectively reviewed the clinical outcomes to determine the overall survival, relapse-free survival, and failure patterns. Elective nodal failure was defined as recurrence in initially uninvolved hilar, mediastinal, or supraclavicular nodes. Survival was assessed using the Kaplan-Meier method. Results: The median age of the study patients at diagnosis was 63 years (range, 39-86). The median follow-up duration was 21 months (range, 4-58) in all patients and 26 months (range, 4-58) in the survivors. The 2-year actuarial overall survival and relapse-free survival rate were 58% and 43%, respectively. Of the 30 patients with recurrence, 23 had metastatic disease and 7 had locoregional failure. We observed only one isolated elective nodal failure. Conclusions: To our knowledge, this is the first study to examine the outcomes in patients with LS-SCLC staged with positron emission tomography/computed tomography and treated with definitive intensity

Particular intervention plan of Cherbourg's military harbour

International Nuclear Information System (INIS)

2014-01-01

The Particular intervention plan (PPI in French) is an emergency plan which foresees the measures and means to be implemented to address the potential risks of the presence and operation of a nuclear facility. This plan is implemented and developed by the Prefect in case of nuclear accident (or incident leading to a potential accident), the impact of which extending beyond the facility perimeter. It represents a special section of the organisation plan for civil protection response (ORSEC plan). The PPI foresees the necessary measures and means for crisis management during the first hours following the accident and is triggered by the Department Prefect according to the information provided by the facility operator. Its aim is to protect the populations leaving within 10 km of the facility against a potential radiological hazard. The PPI describes: the facility, the intervention area, the protection measures for the population, the conditions of emergency plan triggering, the crisis organisation, the action forms of the different services, and the post-accident stage. This document is the public version of the Particular intervention plan of the military harbour of Cherbourg (Manche, France) which hosts several nuclear facilities devoted to the construction and dismantling of nuclear submarines (without weapons)

Team table: a framework and tool for continuous factory planning

Science.gov (United States)

Sihn, Wilfried; Bischoff, Juergen; von Briel, Ralf; Josten, Marcus

2000-10-01

Growing market turbulences and shorter product life cycles require a continuous adaptation of factory structures resulting in a continuous factory planning process. Therefore a new framework is developed which focuses on configuration and data management process integration. This enable an online system performance evaluation based on continuous availability of current data. The use of this framework is especially helpful and will guarantee high cost and time savings, when used in the early stages of the planning, called the concept or rough planning phase. The new framework is supported by a planning round table as a tool for team-based configuration processes integrating the knowledge of all persons involved in planning processes. A case study conducted at a German company shows the advantages which can be achieved by implementing the new framework and methods.

Comparison of CT-based 3D treatment planning with simulator planning of pelvic irradiation of primary cervical carcinoma

International Nuclear Information System (INIS)

Knocke, T.H.; Pokrajac, B.; Fellner, C.; Poetter, R.

1999-01-01

In a prospective study on 20 subsequent patients with primary cervical carcinoma in Stages I to III simulator planning of a 4-field box-technique was performed. After defining the planning target volume (PTV) in the 3D planning system the field configuration of the simulator planning was transmitted. The resulting plan was compared to a second one based on the defined PTV and evaluated regarding a possible geographical miss and encompassment of the PTV by the treated volume (ICRU). Volumes of open and shaped portals were calculated for both techniques. Planning by simulation resulted in 1 geographical miss and in 10 more cases the encompassment of the PTV by the treated volume was inadequate. For a PTV of mean 1 729 cm 3 the mean volume defined by simulation was 3 120 cm 3 for the open portals and 2 702 cm 3 for the shaped portals. The volume reduction by blocks was 13,4% (mean). With CT-based 3D treatment planning the volume of the open portals was 3,3% (mean) enlarged to 3 224 cm 3 . The resulting mean volume of the shaped portals was 2 458 ccm. The reduction compared to the open portals was 23,8% (mean). The treated volumes were 244 cm 3 or 9% (mean) smaller compared to simulator planning. The 'treated volume/planning target volume ratio' was decreased from 1.59 to 1.42. (orig.) [de

Novel clinical staging for patients with end-stage gastrointestinal carcinoma.

Science.gov (United States)

Yasuda, Naokuni; Nakashima, Osamu; Ohnaka, Toru; Kamisaka, Koji; Tsunoda, Akira; Kusano, Mitsuo

2006-01-01

We created a new clinical staging system for end-stage gastrointestinal (GI) carcinoma to clarify the therapeutic goals for these patients. Data were obtained from a retrospective review of medical charts. Based on daily clinical observation of 144 patients with end-stage GI carcinoma, we classified the terminal stages as A, B, C, and D. The mean durations of terminal stages A, B, C, and D were 19, 16.6, 6.6, and 1.8 days, respectively, in patients with end-stage gastric cancer and 28.5, 9.1, 5.4, and 1.9 days, respectively, in patients with colorectal cancer. Moreover, 88.0% of patients with gastric carcinoma and 82.6% of patients with colorectal carcinoma passed through terminal stages A, B, C, and D sequentially. The patients in terminal stage B experienced temporary relief of symptoms, but those in terminal stage C did not (P terminal stages can easily be judged by clinical observation and may be an effective new tool with which to manage patients with end-stage GI carcinoma and their families.

Plans for environmental restoration of uranium mining and milling sites in Bulgaria

International Nuclear Information System (INIS)

Nedyalkov, K.

1997-01-01

In 1992, uranium mining and milling industry in Bulgaria was closed down by Decree No. 163 of the Council of Ministers of the Republic of Bulgaria which defined the procedure for development of liquidation plans, their approval and the procedure for funding from the national budget. The 1994 Decree No. 56 of the Council of Ministers assigned the organization of the liquidation and rehabilitation activities to the Committee of Energy (later, in 1996, transformed to the Ministry of Energy and Energy Resources). An Interdepartmental Board of Experts including representatives of all concerned ministries and agencies was established to coordinate the above activities and to approve work plans. The main stages of liquidation of the uranium industry and its after-effects were defined as follows: (1) environmental status (maintenance of a minimized service mode in order to preserve the state of the site- environment system); (2) technical liquidation; (3) technical recultivation; (4) biological recultivation; (5) purification of contaminated waters; and (6) monitoring. In 1992 and 1993, preparation for the above activities was carried out by development of detailed preliminary studies and work plans for the first stage - the stage of technical liquidation. Their implementation was launched by evacuation of mining and drilling machinery, haulage and processing of finished products etc. (author)

A stage is a stage is a stage: a direct comparison of two scoring systems.

Science.gov (United States)

Dawson, Theo L

2003-09-01

L. Kohlberg (1969) argued that his moral stages captured a developmental sequence specific to the moral domain. To explore that contention, the author compared stage assignments obtained with the Standard Issue Scoring System (A. Colby & L. Kohlberg, 1987a, 1987b) and those obtained with a generalized content-independent stage-scoring system called the Hierarchical Complexity Scoring System (T. L. Dawson, 2002a), on 637 moral judgment interviews (participants' ages ranged from 5 to 86 years). The correlation between stage scores produced with the 2 systems was .88. Although standard issue scoring and hierarchical complexity scoring often awarded different scores up to Kohlberg's Moral Stage 2/3, from his Moral Stage 3 onward, scores awarded with the two systems predominantly agreed. The author explores the implications for developmental research.

Transportation Business Plan: strategy options document

International Nuclear Information System (INIS)

1984-10-01

This document provides the framework for development of a business plan for establishing and operating the transportation system necessary to support a repository. Section I contains introductory material and defines the plan in terms of policy basis, purpose, and scope of business activities. Section II discusses the evolving strategy that will direct the Department's business actions and describes various strategy options that are under consideration. Also discussed in Section II is a process for the systematic development and acquisition of the transportation system. This process is based on a phased development approach with business activities divided into four stages: system definition; engineering development and certification; cask fleet procurement and carrier negotiations; and transportation operations. 8 figures, 2 tables

Decommissioning plans and program in the Federal Republic of Germany

International Nuclear Information System (INIS)

Loschhorn, U.

1988-01-01

Seven reactors of different types are currently being decommissioned or plans are being drawn up to do so. The Niederaichbach reactor will be completely dismantled (stage 3) and returned to a green field site within five years. Other reactors will be decommissioned to stage 2. The progress on these projects is summarized. Research and development of decommissioning techniques and tools for decontamination concrete blasting, pipe cutting, remotely controlled manipulators and melting of steel scrap, are described. (author)

Steep Dose-Response Relationship for Stage I Non-Small-Cell Lung Cancer Using Hypofractionated High-Dose Irradiation by Real-Time Tumor-Tracking Radiotherapy

International Nuclear Information System (INIS)

Onimaru, Rikiya; Fujino, Masaharu; Yamazaki, Koichi; Onodera, Yuya; Taguchi, Hiroshi; Katoh, Norio; Hommura, Fumihiro; Oizumi, Satoshi; Nishimura, Masaharu; Shirato, Hiroki

2008-01-01

Purpose: To investigate the clinical outcomes of patients with pathologically proven, peripherally located, Stage I non-small-cell lung cancer who had undergone stereotactic body radiotherapy using real-time tumor tracking radiotherapy during the developmental period. Methods and Materials: A total of 41 patients (25 with Stage T1 and 16 with Stage T2) were admitted to the study between February 2000 and June 2005. A 5-mm planning target volume margin was added to the clinical target volume determined with computed tomography at the end of the expiratory phase. The gating window ranged from ±2 to 3 mm. The dose fractionation schedule was 40 or 48 Gy in four fractions within 1 week. The dose was prescribed at the center of the planning target volume, giving more than an 80% dose at the planning target volume periphery. Results: For 28 patients treated with 48 Gy in four fractions, the overall actuarial survival rate at 3 years was 82% for those with Stage IA and 32% for those with Stage IB. For patients treated with 40 Gy in four fractions within 1 week, the overall actuarial survival rate at 3 years was 50% for those with Stage IA and 0% for those with Stage IB. A significant difference was found in local control between those with Stage IB who received 40 Gy vs. 48 Gy (p = 0.0015) but not in those with Stage IA (p = 0.5811). No serious radiation morbidity was observed with either dose schedule. Conclusion: The results of our study have shown that 48 Gy in four fractions within 1 week is a safe and effective treatment for peripherally located, Stage IA non-small-cell lung cancer. A steep dose-response curve between 40 and 48 Gy using a daily dose of 12 Gy delivered within 1 week was identified for Stage IB non-small-cell lung cancer in stereotactic body radiotherapy using real-time tumor tracking radiotherapy

The planning of decommissioning activities within nuclear facilities - Generating a Baseline Decommissioning Plan

International Nuclear Information System (INIS)

Meek, N.C.; Ingram, S.; Page, J.

2003-01-01

BNFL Environmental Services has developed planning tools to meet the emerging need for nuclear liabilities management and decommissioning engineering both in the UK and globally. It can provide a comprehensive baseline planning service primarily aimed at nuclear power stations and nuclear plant. The paper develops the following issues: Decommissioning planning; The baseline decommissioning plan;The process; Work package; Compiling the information; Deliverables summary; Customer Benefits; - Planning tool for nuclear liability life-cycle management; - Robust and reliable plans based upon 'real' experience; - Advanced financial planning; - Ascertaining risk; - Strategy and business planning. The following Deliverables are mentioned:1. Site Work Breakdown Structure; 2. Development of site implementation strategy from the high level decommissioning strategy; 3. An end point definition for the site; 4. Buildings, operational systems and plant surveys; 5. A schedule of condition for the site; 6. Development of technical approach for decommissioning for each work package; 7. Cost estimate to WBS level 5 for each work package; 8. Estimate of decommissioning waste arisings for each work package; 9. Preparation of complete decommissioning programme in planning software to suit client; 10. Risk modelling of work package and overall project levels; 11. Roll up of costs into an overall cost model; 12. Cash flow, waste profiling and resource profiling against the decommissioning programme; 13. Preparation and issue of Final Report. Finally The BDP process is represented by a flowchart listing the following stages: [Power Station project assigned] → [Review project and conduct Characterisation review of power station] → [Identify work packages] → [Set up WBS to level 3] → [Assign work packages] → [Update WBS to level 4] →[Develop cost model] → [Develop logic network] → [Develop risk management procedure] ] → [Develop project strategy document]→ [Work package

105-F and DR Phase 1 Sampling and Analysis Plan

International Nuclear Information System (INIS)

Curry, L.R.

1998-06-01

This SAP presents the rationale and strategy for characterization of specific rooms within the 105-F and 105-DR reactor buildings. Figures 1-1 and 1-2 identify the rooms that are the subject of this SAP. These rooms are to be decontaminated and demolished as an initial step (Phase 1 ) in the Interim Safe Storage process for these reactors. Section 1.0 presents the background and sites history for the reactor buildings and summarizes the data quality objective process, which provides the logical basis for this SAP. Preliminary surveys indicate that little radiochemical contamination is present. Section 2.0 presents the quality assurance project plan, which includes a project management structure, sampling methods and quality control, and oversight of the sampling process. Section 2.2.1 summarizes the sampling methods, reflecting the radiological and chemical sampling designs presented in Tables 1-17 and 1-18. Section 3.0 presents the Field Sampling Plan for Phase 1. The sampling design is broken into two stages. Stage 1 will verify the list of radioactive constituents of concern and generate the isotopic distribution. The objectives of Stage 2 are to estimate the radionuclide inventories of room debris, quantify chemical contamination, and survey room contents for potential salvage or recycle. Table 3-1 presents the sampling activities to be performed in Stage 1. Tables 1-17 and 1-18 identify samples to be collected in Stage 2. Stage 2 will consist primarily of survey data collection, with fixed laboratory samples to be collected in areas showing visible stains. Quality control sampling requirements are presented in Table 3-2

Carotid-Sparing Intensity-Modulated Radiotherapy for Early-Stage Squamous Cell Carcinoma of the True Vocal Cord

International Nuclear Information System (INIS)

Chera, Bhishamjit S.; Amdur, Robert J.; Morris, Christopher G.; Mendenhall, William M.

2010-01-01

Purpose: To compare radiation doses to carotid arteries among various radiotherapy techniques for treatment of early-stage squamous cell carcinoma (SCC) of the true vocal cords. Methods and Materials: Five patients were simulated using computed tomography (CT). Clinical and planning target volumes (PTV) were created for bilateral and unilateral stage T1 vocal cord cancers. Planning risk volumes for the carotid arteries and spinal cord were delineated. For each patient, three treatment plans were designed for bilateral and unilateral target volumes: opposed laterals (LATS), three-dimensional conformal radiotherapy (3DCRT), and intensity-modulated radiotherapy (IMRT), for a total of 30 plans. More than 95% of the PTV received the prescription dose (63Gy at 2.25 Gy per treatment). Results: Carotid dose was lowest with IMRT. With a bilateral vocal cord target, the median carotid dose was 10Gy with IMRT vs. 25 Gy with 3DCRT and 38 Gy with LATS (p < 0.05); with a unilateral target, the median carotid dose was 4 Gy with IMRT vs. 19 Gy with 3DCRT and 39 Gy with LATS (p < 0.05). The dosimetric tradeoff with IMRT is a small area of high dose in the PTV. The worst heterogeneity results were at a maximum point dose of 80 Gy (127%) in a unilateral target that was close to the carotid. Conclusions: There is no question that IMRT can reduce the dose to the carotid arteries in patients with early-stage vocal cord cancer. The question is whether the potential advantage of reducing the carotid dose outweighs the risk of tumor recurrence due to contouring errors and organ motion and the risk of complications from dose heterogeneity.

Enterprise Architecture Planning in developing A planning Information System: a Case Study of Semarang State University

Directory of Open Access Journals (Sweden)

Budiman Kholiq

2018-01-01

Full Text Available This research has applied an integrated design and development of planning information system, which is been designed using Enterprise Architecture Planning. Frequent discrepancy between planning and realization of the budget that has been made, resulted in ineffective planning, is one of the reason for doing this research. The design using EAP aims to keep development aligned and in line with the strategic direction of the organization. In the practice, EAP is carried out in several stages of the planning initiation, identification and definition of business functions, proceeded with architectural design and EA implementation plan that has been built. In addition to the design of the Enterprise Architecture, this research carried out the implementation, and was tested by several methods of black box and white box. Black box testing method is used to test the fundamental aspects of the software, tested by two kinds of testing, first is using User Acceptance Testing and the second is using software functionality testing. White box testing method is used to test the effectiveness of the code in the software, tested using unit testing. Tests conducted using white box and black box on the integrated planning information system, is declared successful. Success in the software testing can not be ascertained if the software built has not shown any distinction from prior circumstance to the development of this integrated planning information system. For ensuring the success of this system implementation, the authors test consistency between the planning of data and the realization of prior-use of the information system, until after-use information system. This consistency test is done by reducing the time data of the planning and realization time. From the tabulated data, the planning information system that has been built reduces the difference between the planning time and the realization time, in which indicates that the planning information system

Enterprise Architecture Planning in developing A planning Information System: a Case Study of Semarang State University

Science.gov (United States)

Budiman, Kholiq; Prahasto, Toni; Kusumawardhani, Amie

2018-02-01

This research has applied an integrated design and development of planning information system, which is been designed using Enterprise Architecture Planning. Frequent discrepancy between planning and realization of the budget that has been made, resulted in ineffective planning, is one of the reason for doing this research. The design using EAP aims to keep development aligned and in line with the strategic direction of the organization. In the practice, EAP is carried out in several stages of the planning initiation, identification and definition of business functions, proceeded with architectural design and EA implementation plan that has been built. In addition to the design of the Enterprise Architecture, this research carried out the implementation, and was tested by several methods of black box and white box. Black box testing method is used to test the fundamental aspects of the software, tested by two kinds of testing, first is using User Acceptance Testing and the second is using software functionality testing. White box testing method is used to test the effectiveness of the code in the software, tested using unit testing. Tests conducted using white box and black box on the integrated planning information system, is declared successful. Success in the software testing can not be ascertained if the software built has not shown any distinction from prior circumstance to the development of this integrated planning information system. For ensuring the success of this system implementation, the authors test consistency between the planning of data and the realization of prior-use of the information system, until after-use information system. This consistency test is done by reducing the time data of the planning and realization time. From the tabulated data, the planning information system that has been built reduces the difference between the planning time and the realization time, in which indicates that the planning information system can motivate the

Development of Lesson Plans and Student Worksheets Based Socio-Scientific Issues on Pollution Environmental Topic

Science.gov (United States)

Rahayu, S.; Meyliana, M.; Arlingga, A.; Reny, R.; Siahaan, P.; Hernani, H.

2017-09-01

The aim of this study is to develop lesson plans and student worksheets based socio-scientific issues on pollution environmental topic for seventh-grade junior high school students. Environmental pollution topic split into several subtopics namely air pollution, water pollution and soil pollution. The composing of lesson plans were developed based on socio-scientific issues with five stages, namely (1) Motivate; (2) Challenge; (3) Collect scientific evidence; (4) Analyse the evidence; (5) Build knowledge and make connections; and (6) Use evidence. While student worksheets contain articles on socio-scientific issues, practice, and there are a few questions to determine students’ reasoning. The method that is used in this research is research and development (R & D method). Development model used in this study is a model of Plomp that consists of four stages, namely: (1) Initial Research; (2) Design; (3) Realization or Construction; (4) Testing, evaluation and revision; (5) Implementation, while the research was limited to the fourth stage. Lesson plans and student worksheets based on socio-scientific issues was validated through an expert validation. The result showed that lesson plans and student worksheets based socio-scientific issues on pollution theme have a very decent and be able to apply in science classroom.

SU-F-T-358: Is Auto-Planning Useful for Volumetric-Modulated Arc Therapy Planning in Rectal Cancer Radiotherapy?

International Nuclear Information System (INIS)

Li, K; Chang, X; Wang, J; Hu, P; Hu, W

2016-01-01

Purpose: To evaluate whether Auto-Planning based volumetric-modulated radiotherapy (auto-VMAT) can reduce manual interaction time during treatment planning and improve plan quality for rectal cancer radiotherapy. Methods: Ten rectal cancer patients (stage II and III) after radical resection using Dixon surgery were enrolled. All patients were treated with VMAT technique. The manual VMAT plans (man-VMAT) were designed in the Pinnacle treatment planning system (Version 9.10) following the standard treatment planning procedure developed in our department. Clinical plans were manually designed by our experienced dosimetrists. Additionally, an auto-VMAT plan was created for each patient using Auto-Planning module. However, manual interaction was still applied to meet the clinical requirements. The treatment planning time and plan quality surrogated by the DVH parameters were compared between manual and automated plans. Results: The total planning time and manual interaction time were 50.38 and 4.47 min for the auto-VMAT and 36.81 and 16.94 min for the man-VMAT (t=60.14,−23.86; p=0.000, 0.000). In terms of plan quality, both plans meet the clinical requirements. The PTV homogeneity index (HI) and conformity index (CI) were 0.054 and 0.822 for the auto-VMAT and 0.059 and 0.815 for the man-VMAT (t=−1.72, 0.36;p=0.119,0.730).Compared to the man-VMAT, the auto-VMAT showed reduction of 11.9% and 0.7% in V40 and V50 of the bladder, respectively.The V30 and D mean were reduced by 14.0% and 5.1Gy in the left femur and 12.2% and 3.8Gy in the right femur. Conclusion: The Auto-Planning based VMAT plans not only shows similar or superior plan quality to the manual ones in the rectal cancer radiotherapy, but also improve the planning efficiency significantly. However, manual interactions are still required to achieve a clinically acceptable plan based on our experiences.

SU-F-T-358: Is Auto-Planning Useful for Volumetric-Modulated Arc Therapy Planning in Rectal Cancer Radiotherapy?

Energy Technology Data Exchange (ETDEWEB)

Li, K; Chang, X; Wang, J; Hu, P; Hu, W [Fudan University Shanghai Cancer Center, Shanghai, Shanghai (China)

2016-06-15

Purpose: To evaluate whether Auto-Planning based volumetric-modulated radiotherapy (auto-VMAT) can reduce manual interaction time during treatment planning and improve plan quality for rectal cancer radiotherapy. Methods: Ten rectal cancer patients (stage II and III) after radical resection using Dixon surgery were enrolled. All patients were treated with VMAT technique. The manual VMAT plans (man-VMAT) were designed in the Pinnacle treatment planning system (Version 9.10) following the standard treatment planning procedure developed in our department. Clinical plans were manually designed by our experienced dosimetrists. Additionally, an auto-VMAT plan was created for each patient using Auto-Planning module. However, manual interaction was still applied to meet the clinical requirements. The treatment planning time and plan quality surrogated by the DVH parameters were compared between manual and automated plans. Results: The total planning time and manual interaction time were 50.38 and 4.47 min for the auto-VMAT and 36.81 and 16.94 min for the man-VMAT (t=60.14,−23.86; p=0.000, 0.000). In terms of plan quality, both plans meet the clinical requirements. The PTV homogeneity index (HI) and conformity index (CI) were 0.054 and 0.822 for the auto-VMAT and 0.059 and 0.815 for the man-VMAT (t=−1.72, 0.36;p=0.119,0.730).Compared to the man-VMAT, the auto-VMAT showed reduction of 11.9% and 0.7% in V40 and V50 of the bladder, respectively.The V30 and D mean were reduced by 14.0% and 5.1Gy in the left femur and 12.2% and 3.8Gy in the right femur. Conclusion: The Auto-Planning based VMAT plans not only shows similar or superior plan quality to the manual ones in the rectal cancer radiotherapy, but also improve the planning efficiency significantly. However, manual interactions are still required to achieve a clinically acceptable plan based on our experiences.

Strategy and Portfolio Management Aspects of Integrated Business Planning

Directory of Open Access Journals (Sweden)

Peter Jurečka

2013-03-01

Full Text Available With ongoing globalization and thereof derived growing competitiveness on most markets, companies are under constant pressure to increase the effectiveness and efficiencies of their operations. This article focuses on one of the core business management processes – on planning, namely on Sales and Operations Planning (S&OP and its latest development stage represented by the concept of Integrated Business Planning (IBP. It aims to extend the traditional concept of S&OP for selected topics from business strategy and portfolio management, which structured inclusion into planning represent one of key factors distinguishing IBP from conventional S&OP. Implementation of IBP, which constitutes significant step towards operational excellence, is applicable for almost all business and thus can be used broadly as effective tool for facing the challenges of economic and financial crisis.

Invasive cervical carcinoma (Stages IB-IIB)

International Nuclear Information System (INIS)

Sironi, S.; Zanello, A.; Rodighiero, M.G.; Vanzulli, A.; Del Maschio, A.; Taccagni, G.L.; Belloni, C.

1991-01-01

In the patients with invasive cervical carcinoma, the accurate assessment of parametrial invasion greatly affects the therapeutic choice between surgery and radiation therapy. As a matter of fact, surgery is usually performed only in the patients with carcinoma confined to the cervix, whereas those with parametrial involvement, or more advanced stages, are treated with radiation therapy. This prospective study was aimed at investigating the comparative adequecy of CT and MR imaging in assessing parametrial status in the patients with invasive cervical cancer. Twenty-one consecutive patients, with histologic diagnosis of cervical carcinoma, were investigated. All of them were clinically considered as having invasive cervical cancer (FIGO stage IB-IIB) and subsequently underwent surgery. In all cases, detailed histology of the parametrium was obtained. Pathological data were compared with CT and MR findings in all cases. As for assessing parametrial involvement by cancer, CT had 62% accuracy, 63% sensitivity, and 60% specificity, versus MR imaging 81% accuracy, 69% sensitivity, and 80% specificify. Therefore, MR imaging appears to be superior to CT in assessing the parametrial status of patients with invasive cervical carcinoma; the method yields valuable information for treatment planning

A Three-Stage Birandom Program for Unit Commitment with Wind Power Uncertainty

Directory of Open Access Journals (Sweden)

Na Zhang

2014-01-01

Full Text Available The integration of large-scale wind power adds a significant uncertainty to power system planning and operating. The wind forecast error is decreased with the forecast horizon, particularly when it is from one day to several hours ahead. Integrating intraday unit commitment (UC adjustment process based on updated ultra-short term wind forecast information is one way to improve the dispatching results. A novel three-stage UC decision method, in which the day-ahead UC decisions are determined in the first stage, the intraday UC adjustment decisions of subfast start units are determined in the second stage, and the UC decisions of fast-start units and dispatching decisions are determined in the third stage is presented. Accordingly, a three-stage birandom UC model is presented, in which the intraday hours-ahead forecasted wind power is formulated as a birandom variable, and the intraday UC adjustment event is formulated as a birandom event. The equilibrium chance constraint is employed to ensure the reliability requirement. A birandom simulation based hybrid genetic algorithm is designed to solve the proposed model. Some computational results indicate that the proposed model provides UC decisions with lower expected total costs.

Particular intervention plan of the Civaux Nuclear Power Plant. Public version. Special provision of the organisation plan for civil protection response

International Nuclear Information System (INIS)

2016-04-01

The Particular intervention plan (PPI in French) is an emergency plan which foresees the measures and means to be implemented to address the potential risks of the presence and operation of a nuclear facility. This plan is implemented and developed by the Prefect in case of nuclear accident (or incident leading to a potential accident), the impact of which extending beyond the facility perimeter. It represents a special section of the organisation plan for civil protection response (ORSEC plan). The PPI foresees the necessary measures and means for crisis management during the first hours following the accident and is triggered by the Department Prefect according to the information provided by the facility operator. Its aim is to protect the populations leaving within 10 km of the facility against a potential radiological hazard. The PPI describes: the facility, the intervention area, the protection measures for the population, the conditions of emergency plan triggering, the crisis organisation, the action forms of the different services, and the post-accident stage. This document is the public version of the Particular intervention plan of the Civaux nuclear power plant (Vienne, France)

Technical Report: Optimizing the Slab Yard Planning and Crane Scheduling Problem using a Two-Stage Approach

DEFF Research Database (Denmark)

Hansen, Anders Dohn; Clausen, Jens

2008-01-01

In this paper, we present The Slab Yard Planning and Crane Scheduling Problem. The problem has its origin in steel production facilities with a large throughput. A slab yard is used as a buffer for slabs that are needed in the upcoming production. Slabs are transported by cranes and the problem...... considered here, is concerned with the generation of schedules for these. The problem is decomposed and modeled in two parts, namely a planning problem and a scheduling problem. In the planning problem a set of crane operations is created to take the yard from its current state to a desired goal state...... schedule for the cranes is generated, where each operation is assigned to a crane and is given a specific time of initiation. For both models, a thorough description of the modeling details is given along with a specification of objective criteria. Variants of the models are presented as well. Preliminary...

Squamous cell carcinomas of the soft palate treated with radiation therapy alone or followed by planned neck dissection

International Nuclear Information System (INIS)

Erkal, Haldun S.; Serin, Meltem; Amdur, Robert J.; Villaret, Douglas B.; Stringer, Scott P.; Mendenhall, William M.

2001-01-01

Purpose: The present study presents the experience at the University of Florida with treatment of unselected patients with carcinomas of the soft palate with radiation therapy (RT) alone or followed by planned neck dissection. Methods and Materials: One hundred seven patients treated with curative intent with RT alone or followed by neck dissection from 1965 to 1996 were included in the study. All patients had follow-up for at least 2 years. No patients were lost to follow-up. Results: Local control rates at 5 years were 86% for T1, 91% for T2, 67% for T3, and 36% for T4 carcinomas. T-stage and overall treatment time significantly affected local control in multivariate analysis. Nodal control rates at 5 years were 86% for N0, 76% for N1, 61% for N2, and 67% for N3 carcinomas. Overall treatment time and planned neck dissection significantly affected nodal control in multivariate analysis. Ultimate local-regional control rates at 5 years were 90% for Stage I, 92% for Stage II, 84% for Stage III, and 60% for Stage IV disease. Overall treatment time and planned neck dissection significantly affected ultimate local-regional control in multivariate analysis. The overall survival rate at 5 years was 42% for all patients. Overall stage, overall treatment time, and planned neck dissection significantly affected overall survival in multivariate analysis. The cause-specific survival rate at 5 years was 70% for all patients. Overall treatment time and planned neck dissection significantly affected cause-specific survival in multivariate analysis. Three patients sustained severe postoperative complications and 3 patients sustained severe late complications. Sixteen patients had synchronous and 14 patients had metachronous carcinomas of the head and neck mucosal sites. Conclusion: For limited carcinomas of the soft palate, RT (alone or followed by planned neck dissection) results in relatively high local-regional control and survival rates. For advanced carcinomas of the soft

Using Integer Programming for Airport Service Planning in Staff Scheduling

Directory of Open Access Journals (Sweden)

W.H. Ip

2010-09-01

Full Text Available Reliability and safety in flight is extremely necessary and that depend on the adoption of proper maintenance system. Therefore, it is essential for aircraft maintenance companies to perform the manpower scheduling efficiently. One of the objectives of this paper is to provide an Integer Programming approach to determine the optimal solutions to aircraft maintenance planning and scheduling and hence the planning and scheduling processes can become more efficient and effective. Another objective is to develop a set of computational schedules for maintenance manpower to cover all scheduled flights. In this paper, a sequential methodology consisting of 3 stages is proposed. They are initial maintenance demand schedule, the maintenance pairing and the maintenance group(s assignment. Since scheduling would split up into different stages, different mathematical techniques have been adopted to cater for their own problem characteristics. Microsoft Excel would be used. Results from the first stage and second stage would be inputted into integer programming model using Microsoft Excel Solver to find the optimal solution. Also, Microsoft Excel VBA is used for devising a scheduling system in order to reduce the manual process and provide a user friendly interface. For the results, all can be obtained optimal solution and the computation time is reasonable and acceptable. Besides, the comparison of the peak time and non-peak time is discussed.

Mingle with Teachers in Physics on Stage

CERN Multimedia

2000-01-01

'Physics on Stage' is an international festival where 450 physics educators from 22 European countries will gather at CERN from 6 to 10 November to show how fascinating and entertaining physics can be. In a week-long event innovative methods of teaching physics and demonstrations of the fun that lies in physics will be presented in a fair, in spectacular performances, and presentations. The performances of Physics on Stage will be held in the Amphitheatre but unfortunately the seats will be all taken by the delegates. However, a live transmission will be organised so CERN staff can watch the event on screen in the following locations: For Monday 6 November in the LHC Amphitheatre all day. For Tuesday 7 November in the LHC Amphitheatre and the SL Amphitheatre. For Wednesday 8 November in the LHC and PS Amphitheatres. For Thursday 9 November in the LHC and SL and after 12.00 in the PS Amphitheatre too. Because of the event the main restaurant will be closed on Thursday 9 November after 14.00. So plan you...

(18)F-FDG PET-CT simulation for non-small-cell lung cancer: effect in patients already staged by PET-CT.

Science.gov (United States)

Hanna, Gerard G; McAleese, Jonathan; Carson, Kathryn J; Stewart, David P; Cosgrove, Vivian P; Eakin, Ruth L; Zatari, Ashraf; Lynch, Tom; Jarritt, Peter H; Young, V A Linda; O'Sullivan, Joe M; Hounsell, Alan R

2010-05-01

Positron emission tomography (PET), in addition to computed tomography (CT), has an effect in target volume definition for radical radiotherapy (RT) for non-small-cell lung cancer (NSCLC). In previously PET-CT staged patients with NSCLC, we assessed the effect of using an additional planning PET-CT scan for gross tumor volume (GTV) definition. A total of 28 patients with Stage IA-IIIB NSCLC were enrolled. All patients had undergone staging PET-CT to ensure suitability for radical RT. Of the 28 patients, 14 received induction chemotherapy. In place of a RT planning CT scan, patients underwent scanning on a PET-CT scanner. In a virtual planning study, four oncologists independently delineated the GTV on the CT scan alone and then on the PET-CT scan. Intraobserver and interobserver variability were assessed using the concordance index (CI), and the results were compared using the Wilcoxon signed ranks test. PET-CT improved the CI between observers when defining the GTV using the PET-CT images compared with using CT alone for matched cases (median CI, 0.57 for CT and 0.64 for PET-CT, p = .032). The median of the mean percentage of volume change from GTV(CT) to GTV(FUSED) was -5.21% for the induction chemotherapy group and 18.88% for the RT-alone group. Using the Mann-Whitney U test, this was significantly different (p = .001). PET-CT RT planning scan, in addition to a staging PET-CT scan, reduces interobserver variability in GTV definition for NSCLC. The GTV size with PET-CT compared with CT in the RT-alone group increased and was reduced in the induction chemotherapy group.

18F-FDG PET-CT Simulation for Non-Small-Cell Lung Cancer: Effect in Patients Already Staged by PET-CT

International Nuclear Information System (INIS)

Hanna, Gerard G.; McAleese, Jonathan; Carson, Kathryn J.; Stewart, David P.; Cosgrove, Vivian P.; Eakin, Ruth L.; Zatari, Ashraf; Lynch, Tom; Jarritt, Peter H.; Young, V.A. Linda D.C.R.; O'Sullivan, Joe M.

2010-01-01

Purpose: Positron emission tomography (PET), in addition to computed tomography (CT), has an effect in target volume definition for radical radiotherapy (RT) for non-small-cell lung cancer (NSCLC). In previously PET-CT staged patients with NSCLC, we assessed the effect of using an additional planning PET-CT scan for gross tumor volume (GTV) definition. Methods and Materials: A total of 28 patients with Stage IA-IIIB NSCLC were enrolled. All patients had undergone staging PET-CT to ensure suitability for radical RT. Of the 28 patients, 14 received induction chemotherapy. In place of a RT planning CT scan, patients underwent scanning on a PET-CT scanner. In a virtual planning study, four oncologists independently delineated the GTV on the CT scan alone and then on the PET-CT scan. Intraobserver and interobserver variability were assessed using the concordance index (CI), and the results were compared using the Wilcoxon signed ranks test. Results: PET-CT improved the CI between observers when defining the GTV using the PET-CT images compared with using CT alone for matched cases (median CI, 0.57 for CT and 0.64 for PET-CT, p = .032). The median of the mean percentage of volume change from GTV CT to GTV FUSED was -5.21% for the induction chemotherapy group and 18.88% for the RT-alone group. Using the Mann-Whitney U test, this was significantly different (p = .001). Conclusion: PET-CT RT planning scan, in addition to a staging PET-CT scan, reduces interobserver variability in GTV definition for NSCLC. The GTV size with PET-CT compared with CT in the RT-alone group increased and was reduced in the induction chemotherapy group.

Worksheet of Exogenous Variables that Impact the Success of Validation Stage of Product Delivery of a Project

Directory of Open Access Journals (Sweden)

Altino José Mentzingen de Moraes

2015-02-01

Full Text Available In the theory presented by PMBoK© - Project Management Book of Knowledge the Project Management [1] features - among others - the Disciplines of Scope and Quality. The Discipline of Scope, to become effective, must provide the execution of a hypothetical step (not defined in its text but perceived by the present author of this paper that can be termed as Planning Stage of Project Result. The Discipline of Quality, to become effective, must provide the execution of an also hypothetical step (also not defined in its text but also perceived by the same present author of this paper that can be termed as Validation Stage of Product Delivery.In the theory presented by PMBoK© - Project Management Book of Knowledge the Project Management [1] features - among others - the Disciplines of Scope and Quality. The Discipline of Scope, to become effective, must provide the execution of a hypothetical step (not defined in its text but perceived by the present author of this paper that can be termed as Planning Stage of Project Result. The Discipline of Quality, to become effective, must provide the execution of an also hypothetical step (also not defined in its text but also perceived by the same present author of this paper that can be termed as Validation Stage of Product Delivery.In the theory presented by PMBoK© - Project Management Book of Knowledge the Project Management [1] features - among others - the Disciplines of Scope and Quality. The Discipline of Scope, to become effective, must provide the execution of a hypothetical step (not defined in its text but perceived by the present author of this paper that can be termed as Planning Stage of Project Result. The Discipline of Quality, to become effective, must provide the execution of an also hypothetical step (also not defined in its text but also perceived by the same present author of this paper that can be termed as Validation Stage of Product Delivery. The importance of both Stages is crucial to

HOW DO YOUNG PEOPLE SELECT INFORMATION TO PLAN A TRIP

Directory of Open Access Journals (Sweden)

Oana ŢUGULEA

2013-12-01

Full Text Available The purpose of the research is to reveal the young tourists preferences in the process of planning a trip. Sources of information used, the utility of Internet/travel agencies in planning travel trip activities, preferred means of transportation and types of accommodation are investigated. As research methods, there used both qualitative and quantitative methods: focus group and survey. Internet is more used by young tourists in planning trips than travel agencies are. Internet is considered more useful in the documentation stage and when buying airline tickets. Young tourists are more influenced by friends when planning a trip. Young tourists prefer cars and planes as means of transportation for a trip and hotels and guesthouses as accommodation when traveling.

Predicted Rates of Secondary Malignancies From Proton Versus Photon Radiation Therapy for Stage I Seminoma

Energy Technology Data Exchange (ETDEWEB)

Simone, Charles B., E-mail: csimone@alumni.upenn.edu [Department of Radiation Oncology, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania (United States); Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Kramer, Kevin [Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland (United States); O' Meara, William P. [Division of Radiation Oncology, National Naval Medical Center, Bethesda, Maryland (United States); Bekelman, Justin E. [Department of Radiation Oncology, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania (United States); Belard, Arnaud [Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland (United States); McDonough, James [Department of Radiation Oncology, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania (United States); O' Connell, John [Radiation Oncology Service, Walter Reed Army Medical Center, Washington, DC (United States)

2012-01-01

Purpose: Photon radiotherapy has been the standard adjuvant treatment for stage I seminoma. Single-dose carboplatin therapy and observation have emerged as alternative options due to concerns for acute toxicities and secondary malignancies from radiation. In this institutional review board-approved study, we compared photon and proton radiotherapy for stage I seminoma and the predicted rates of excess secondary malignancies for both treatment modalities. Methods and Material: Computed tomography images from 10 consecutive patients with stage I seminoma were used to quantify dosimetric differences between photon and proton therapies. Structures reported to be at increased risk for secondary malignancies and in-field critical structures were contoured. Reported models of organ-specific radiation-induced cancer incidence rates based on organ equivalent dose were used to determine the excess absolute risk of secondary malignancies. Calculated values were compared with tumor registry reports of excess secondary malignancies among testicular cancer survivors. Results: Photon and proton plans provided comparable target volume coverage. Proton plans delivered significantly lower mean doses to all examined normal tissues, except for the kidneys. The greatest absolute reduction in mean dose was observed for the stomach (119 cGy for proton plans vs. 768 cGy for photon plans; p < 0.0001). Significantly more excess secondary cancers per 10,000 patients/year were predicted for photon radiation than for proton radiation to the stomach (4.11; 95% confidence interval [CI], 3.22-5.01), large bowel (0.81; 95% CI, 0.39-1.01), and bladder (0.03; 95% CI, 0.01-0.58), while no difference was demonstrated for radiation to the pancreas (0.02; 95% CI, -0.01-0.06). Conclusions: For patients with stage I seminoma, proton radiation therapy reduced the predicted secondary cancer risk compared with photon therapy. We predict a reduction of one additional secondary cancer for every 50 patients

Preserving Functional Lung Using Perfusion Imaging and Intensity-Modulated Radiation Therapy for Advanced-Stage Non-Small Cell Lung Cancer

International Nuclear Information System (INIS)

Shioyama, Yoshiyuki; Jang, Si Young; Liu, H. Helen; Guerrero, Thomas; Wang, Xuanmin; Gayed, Isis W.; Erwin, William D.; Liao, Zhongxing; Chang, Joe Y.; Jeter, Melenda; Yaremko, Brian P.; Borghero, Yerko O.; Cox, James D.; Komaki, Ritsuko; Mohan, Radhe

2007-01-01

Purpose: To assess quantitatively the impact of incorporating functional lung imaging into intensity-modulated radiation therapy planning for locally advanced non-small cell lung cancer (NSCLC). Methods and Materials: Sixteen patients with advanced-stage NSCLC who underwent radiotherapy were included in this study. Before radiotherapy, each patient underwent lung perfusion imaging with single-photon-emission computed tomography and X-ray computed tomography (SPECT-CT). The SPECT-CT was registered with simulation CT and was used to segment the 50- and 90-percentile hyperperfusion lung (F50 lung and F90 lung). Two IMRT plans were designed and compared in each patient: an anatomic plan using simulation CT alone and a functional plan using SPECT-CT in addition to the simulation CT. Dosimetric parameters of the two types of plans were compared in terms of tumor coverage and avoidance of normal tissues. Results: In incorporating perfusion information in IMRT planning, the median reductions in the mean doses to the F50 and F90 lung in the functional plan were 2.2 and 4.2 Gy, respectively, compared with those in the anatomic plans. The median reductions in the percentage of volume irradiated with >5 Gy, >10 Gy, and >20 Gy in the functional plans were 7.1%, 6.0%, and 5.1%, respectively, for F50 lung, and 11.7%, 12.0%, and 6.8%, respectively, for F90 lung. A greater degree of sparing of the functional lung was achieved for patients with large perfusion defects compared with those with relatively uniform perfusion distribution. Conclusion: Function-guided IMRT planning appears to be effective in preserving functional lung in locally advanced-stage NSCLC patients

Stage design

International Nuclear Information System (INIS)

Shacter, J.

1975-01-01

A method is described of cycling gases through a plurality of diffusion stages comprising the steps of admitting the diffused gases from a first diffusion stage into an axial compressor, simultaneously admitting the undiffused gases from a second diffusion stage into an intermediate pressure zone of said compressor corresponding in pressure to the pressure of said undiffused gases, and then admitting the resulting compressed mixture of diffused and undiffused gases into a third diffusion stage

THE EVALUATION SYSTEM OF DESIGN SOLUTIONS FOR RESIDENTIAL PROPERTY ON THE PRE-INVESTMENT STAGE THROUGH NEURAL NETWORK TECHNOLOGY

Directory of Open Access Journals (Sweden)

G. D. Kostsikava

2016-01-01

Full Text Available Ever since the Soviet Union design solutions were evaluated according to different criteria and indicators. At the present stage of evaluation systems of design solutions stands systemengineering doctrine is allocated. It is complemented by the theory of efficiency and financial sustainability investment project in view of the general market concept. Also great attention is paid to the virtual object modeling. It is urgent to include the behavior prediction of an investment construction project model at each stage of its life cycle. The high cost of all phases of this life cycle makes it necessary to calculate the feasibility of the investment. Very urgent to do it as accurately as possible and before we start of design works on the stage of the investment plan evaluation. Belarus has legislated pre-investment stage of construction project development. To evaluate the design solution at this stage is necessary to develop an investment justification, a project management plan and a business plan. They will evaluate and will compare several options for future objects by the complex. This requires not only time, but considerable financial costs. In order to optimize the process to develop an evaluation system design solutions based on existing projects. It allows the customer (investor choose design solutions to build the object without developing of pre-design documentations for several options. This system it is advisable to try out the example of apartment house building with the assistance of the national fund of project documentation and objects-analogues data bank. The developed evaluation system of design solutions for residential real estate objects in the pre-investment stage is supposed to use the theory of neural networks and neyroprogramming. This system bases on the input parameters projects. The hidden layer neurons are trained to choose suitable projects of apartment houses with their classification. The projects will be classified

Novel Techniques with the Aid of a Staged CBCT Guided Surgical Protocol

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Evdokia Chasioti

2015-01-01

Full Text Available The case report will present some novel techniques for using a “staged” protocol utilizing strategic periodontally involved teeth as transitional abutments in combination with CBCT guided implant surgery. Staging the case prevented premature loading of the grafted sites during the healing phase. A CBCT following a tenting screw guided bone regeneration procedure ensured adequate bone to place an implant fixture. Proper assessment of the CBCT allowed the surgeon to do an osteotome internal sinus lift in an optimum location. The depth of the bone needed for the osteotome sinus floor elevation was planned. The staged appliance allowed these sinus-augmented sites to heal for an extended period of time compared to implants, which were uncovered and loaded at an earlier time frame. The staged protocol and CBCT analysis enabled the immediate implants to be placed in proper alignment to the adjacent fixture. After teeth were extracted, the osseointegrated implants were converted to abutments for the transitional appliance. Finally, the staged protocol allowed for soft tissue enhancement in the implant and pontic areas prior to final insertion of the prosthesis.

Smart city planning and development shortcomings

Directory of Open Access Journals (Sweden)

Margarita Angelidou

2017-04-01

Full Text Available This paper explores smart city planning and development shortcomings. In particular, it investigates eleven cases of smart city strategies and the shortcomings that were observed during their planning and implementation stages. The cases include: Barcelona Smart City, PlanlT Valley, Stockholm Smart City, Cyberjaya, King Abdullah Economic City, Masdar City, Skolkovo, Songdo International Business District, Chicago Smart City, Rio de Janeiro Smart City, and Konza Technology City. The paper proceeds with the synthesis of the findings and their critical appraisal. Shortcomings are classified into economic and budget shortages, bureaucratic and organizational challenges, challenges in the development and layout of digital services, poor physical planning, struggle to attract investment and support the development of new businesses, low performance in attracting and engaging users, and stakeholder resistance. In turn, the shortcomings are clustered in two distinct groups and analyzed in terms of causes and effects. The paper closes with mitigation propositions, accounting for past experience and novel approaches to this end.

Public information plan. Version 2

International Nuclear Information System (INIS)

1993-01-01

The Public Information Plan is intended to be used in conjunction with the U.S. Department of Energy (DOE) Uranium Mill Tailings Remedial Action (UMTRA) Project Public Participation Plan. The Public Participation Pion describes the DOE procedure for involving the public in the decision-making process related to the UMTRA Project during the stages at which public participation is required and solicited. This Public Information Plan describes the department's procedure for communicating with the public about project policies, plans, and activities. Together, these complementary plans describe the DOE public affairs program for the UMTRA Project. This project was authorized by Congress in the Uranium Mill Tailings Radiation Control Act (UMTRCA) of 1978, (Public Law (PL) 95-6041), as amended. The Act provides for a cooperative effort with affected states and Indian tribes for the cleanup of designated abandoned or inactive uranium mill tailings sites, which are located in 10 states, 9 of them west of the Mississippi River. The public has a right to know about proposed government actions and to be heard in the planning of activities that influence their lives. The UMTRA Project is unclassified and the DOE provides accurate information about policy and project activities to interested stakeholders, including the news media, in a timely way. The DOE encourages states and local governments, as well as individuals, to join actively in the decision-making process. This is intended to ensure that the resulting decisions are made with full knowledge of the public's views and that these decisions address the public's concerns to the extent possible within the law. The DOE, through the implementation of the Public Information Plan, keeps the public informed on matters such as health concerns, environmental issues, remedial action construction plans, project costs, and specific site activities

[Application of endosseous screw implants. Indications and planning].

Science.gov (United States)

Pajarola, G F; Sailer, H F

1991-01-01

To achieve long term positive results for endosseous dental implants, three points have to be considered: the osséointegration, the correct indication and the suprastructural planification designed for the spécific type of implant. If the surgery part is done by a different practitioner as the prosthetic part, tight coworking for planning is necessary and the responsibility in each step has to be cleared in advance. The planification in implant cases is divided into three stages: clearing of contraindications, choice of the suprastructure, and the surgery planning. Aids for exact localisation of the implants are presented.

The costs of the environmental administration in the planning of the electric sector in Colombia - methodological aspects

International Nuclear Information System (INIS)

Jurado Montano, Jose Lino

2001-01-01

The environmental costs came forth in the planning of the Colombian electrical sector by early 90's. The costs of environmental programs for generation projects were calculated, considering constraints and assumptions, some of them are still valid. The necessity to know the environmental costs of generation and transmission projects in preliminary stages of planning, as complement to indicative expansion plans, allowed the development of a model that assesses in advance the impacts and defines the costs of their environmental measures in future stages of construction and operation. The model uses geo-referenced basic information but sufficient to determine multiple impact and cost indicators. This model was developed with the active participation of representative agents of the electrical sector and will support UPME in valuation of expansion plans and it can supply preliminary costs to potential project investors in this sector

Optimising the Slab Yard Planning and Crane Scheduling Problem using a two-stage heuristic

DEFF Research Database (Denmark)

Hansen, Anders Dohn; Clausen, Jens

2010-01-01

In this paper, we present the Slab Yard Planning and Crane Scheduling Problem. The problem has its origin in steel production facilities with a large throughput. A slab yard is used as a buffer for slabs that are needed in the upcoming production. Slabs are transported by cranes and the problem...

SU-E-T-808: Volumetric Modulated Arc Radiotherapy Vs. Intensity-Modulated Radiotherapy for Early-Stage Nasopharyngeal Carcinoma: A Dosimetric Study

Energy Technology Data Exchange (ETDEWEB)

Lu, J-Y; Huang, B-T; Zhang, W-Z [Cancer Hospital of Shantou University Medical College, Shantou, Guangdong (China)

2015-06-15

Purpose: To compare volumetric modulated arc radiotherapy (VMAT) technique with fixed-gantry intensity-modulated radiotherapy (IMRT) technique for early-stage nasopharyngeal carcinoma. Methods: CT datasets of ten patients with early-stage nasopharyngeal carcinoma were included. Dual-arc VMAT and nine-field IMRT plans were generated for each case, and were then compared in terms of planning-target-volume (PTV) coverage, conformity index (CI) and homogeneity index (HI), as well as organ-at-risk (OAR) sparing, planning time, monitor units (MUs) and delivery time. Results: Compared with the IMRT plans, the VMAT plans provided comparable HI and CI of PTVnx (PTV of primary tumor of nasopharynx), superior CI and inferior HI of PTVnd (PTV of lymph nodes), as well as superior CI and comparable HI of PTV60 (high-risk PTV). The VMAT plans provided better sparing of the spinal cord, oral cavity and normal tissue, but inferior sparing of the brainstem planning OAR volume (PRV), larynx and parotids, as well as comparable sparing of the spinal cord PRV, brainstem, lenses, optic nerves, optic chiasm. Moreover, the average planning time (181.6 ± 36.0 min) for the VMAT plans was 171% more than that of the IMRT plans (68.1 ± 7.6 min). The MUs of the VMAT plans (609 ± 43) were 70% lower than those of the IMRT plans (2071 ± 262), while the average delivery time (2.2 ± 0.1 min) was 66% less than that of the IMRT plans (6.6 ± 0.4 min). Conclusion: Compared with the IMRT technique, the VMAT technique can achieve similar or slightly superior target dose distribution, with no significant advantages on OAR sparing, and it can achieve significant reductions of MUs and delivery time.

SU-E-T-808: Volumetric Modulated Arc Radiotherapy Vs. Intensity-Modulated Radiotherapy for Early-Stage Nasopharyngeal Carcinoma: A Dosimetric Study

International Nuclear Information System (INIS)

Lu, J-Y; Huang, B-T; Zhang, W-Z

2015-01-01

Purpose: To compare volumetric modulated arc radiotherapy (VMAT) technique with fixed-gantry intensity-modulated radiotherapy (IMRT) technique for early-stage nasopharyngeal carcinoma. Methods: CT datasets of ten patients with early-stage nasopharyngeal carcinoma were included. Dual-arc VMAT and nine-field IMRT plans were generated for each case, and were then compared in terms of planning-target-volume (PTV) coverage, conformity index (CI) and homogeneity index (HI), as well as organ-at-risk (OAR) sparing, planning time, monitor units (MUs) and delivery time. Results: Compared with the IMRT plans, the VMAT plans provided comparable HI and CI of PTVnx (PTV of primary tumor of nasopharynx), superior CI and inferior HI of PTVnd (PTV of lymph nodes), as well as superior CI and comparable HI of PTV60 (high-risk PTV). The VMAT plans provided better sparing of the spinal cord, oral cavity and normal tissue, but inferior sparing of the brainstem planning OAR volume (PRV), larynx and parotids, as well as comparable sparing of the spinal cord PRV, brainstem, lenses, optic nerves, optic chiasm. Moreover, the average planning time (181.6 ± 36.0 min) for the VMAT plans was 171% more than that of the IMRT plans (68.1 ± 7.6 min). The MUs of the VMAT plans (609 ± 43) were 70% lower than those of the IMRT plans (2071 ± 262), while the average delivery time (2.2 ± 0.1 min) was 66% less than that of the IMRT plans (6.6 ± 0.4 min). Conclusion: Compared with the IMRT technique, the VMAT technique can achieve similar or slightly superior target dose distribution, with no significant advantages on OAR sparing, and it can achieve significant reductions of MUs and delivery time

Computer-assisted preoperative simulation for positioning and fixation of plate in 2-stage procedure combining maxillary advancement by distraction technique and mandibular setback surgery.

Science.gov (United States)

Suenaga, Hideyuki; Taniguchi, Asako; Yonenaga, Kazumichi; Hoshi, Kazuto; Takato, Tsuyoshi

2016-01-01

Computer-assisted preoperative simulation surgery is employed to plan and interact with the 3D images during the orthognathic procedure. It is useful for positioning and fixation of maxilla by a plate. We report a case of maxillary retrusion by a bilateral cleft lip and palate, in which a 2-stage orthognathic procedure (maxillary advancement by distraction technique and mandibular setback surgery) was performed following a computer-assisted preoperative simulation planning to achieve the positioning and fixation of the plate. A high accuracy was achieved in the present case. A 21-year-old male patient presented to our department with a complaint of maxillary retrusion following bilateral cleft lip and palate. Computer-assisted preoperative simulation with 2-stage orthognathic procedure using distraction technique and mandibular setback surgery was planned. The preoperative planning of the procedure resulted in good aesthetic outcomes. The error of the maxillary position was less than 1mm. The implementation of the computer-assisted preoperative simulation for the positioning and fixation of plate in 2-stage orthognathic procedure using distraction technique and mandibular setback surgery yielded good results. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

System Planning With The Hanford Waste Operations Simulator

International Nuclear Information System (INIS)

Crawford, T.W.; Certa, P.J.; Wells, M.N.

2010-01-01

At the U. S. Department of Energy's Hanford Site in southeastern Washington State, 216 million liters (57 million gallons) of nuclear waste is currently stored in aging underground tanks, threatening the Columbia River. The River Protection Project (RPP), a fully integrated system of waste storage, retrieval, treatment, and disposal facilities, is in varying stages of design, construction, operation, and future planning. These facilities face many overlapping technical, regulatory, and financial hurdles to achieve site cleanup and closure. Program execution is ongoing, but completion is currently expected to take approximately 40 more years. Strategic planning for the treatment of Hanford tank waste is by nature a multi-faceted, complex and iterative process. To help manage the planning, a report referred to as the RPP System Plan is prepared to provide a basis for aligning the program scope with the cost and schedule, from upper-tier contracts to individual facility operating plans. The Hanford Tank Waste Operations Simulator (HTWOS), a dynamic flowsheet simulation and mass balance computer model, is used to simulate the current planned RPP mission, evaluate the impacts of changes to the mission, and assist in planning near-term facility operations. Development of additional modeling tools, including an operations research model and a cost model, will further improve long-term planning confidence. The most recent RPP System Plan, Revision 4, was published in September 2009.

A neo-strategic planning approach to enhance local tobacco control programs.

Science.gov (United States)

Douglas, Malinda R; Carter, Sara Sally R; Wilson, Andrew P; Chan, Andie

2015-01-01

Research in tobacco control demonstrating best practices is widely disseminated; however, application at the local level is often difficult. Translating research into practice requires a concerted effort to develop an understanding of the evidence and how it can be applied within diverse contexts. A strategic planning infrastructure was developed to support the translation of evidence-based interventions into community practice. This paper highlights the strategic process of turning "know-what" into "know-how" to facilitate the strategic planning and implementation of tobacco control best practices at the local level. The purpose, people, process, and product strategies of knowledge management and translation provided a framework for the strategic planning infrastructure. The knowledge translation concepts of audience, motivations, and mechanisms were synergized in the neo-strategic planning component design. The participants were 20 community coalitions funded to implement local tobacco control programs. From 2004 to 2011, the strategic planners facilitated a cyclical process to translate research into practice using a trio of integrated tools, skill-building workshops on strategic planning, and grantee-driven technical assistance and consultation. In the short term, the usefulness of the strategic planning components to the programs was measured. The intermediate outcome was the successful movement of the community programs from the planning stage to the implementation stage. The achievement of community-level changes in planned tobacco control efforts was the overall outcome measure for the success of the local coalitions. Seventeen of 20 communities that began the planning process implemented strategic plans. All 17 of the programs implemented evidence-based practices, resulting in numerous tobacco-free policies, increased cessation, and increased support from the media and community. Bridging the gap between research and practice can enhance the practicality

The Third Competition on Knowledge Engineering for Planning and Scheduling

OpenAIRE

Bartak, Roman; Fratini, Simone; McCluskey, Lee

2010-01-01

We report on the staging of the third competition on knowledge engineering for AI planning and scheduling systems, held during ICAPS-09 at Thessaloniki, Greece in September 2009. We give an overview of how the competition has developed since its first run in 2005, and its relationship with the AI planning field. This run of the competition focused on translators that when input with some formal description in an application-area-specific language, output solver-ready domain models. Despite a ...

Application of Cervical Vertebral Maturation Stages Index in Orthodontics

Directory of Open Access Journals (Sweden)

Z.Dalili

2005-02-01

Full Text Available Evaluation of skeletal age and determination of growth status had important and special roie in orthodontic treatment planning (such as functional orthopedic treatment and orthognatic surgery and also in stability of it. There were several biologic indicators for the detection of the peak in mandibular growth. Due to the limitations of biological indicators application, idea of new indicators was seemed importantly. Cervical vertebral maturation (CVM method is one of them. At first the detection of the peak in mandibular growth was based on the analysis of the second through sixth cervical vertebrae in six developmental stages. But a few improvements of the original CVM analysis were still needed. In this method, the peak in mandibular growth was determined based on the analysis of the second through fourth cervical vertebrae in five developmental stages. This method is easy, applicable and more valid than hand-wrist analysis method.

Staging Mobilities

DEFF Research Database (Denmark)

Jensen, Ole B.

and lived as people are “staging themselves” (from below). Staging mobilities is a dynamic process between “being staged” (for example, being stopped at traffic lights) and the “mobile staging” of interacting individuals (negotiating a passage on the pavement). Staging Mobilities is about the fact...

Robust Optimization Model for Production Planning Problem under Uncertainty

Directory of Open Access Journals (Sweden)

Pembe GÜÇLÜ

2017-01-01

Full Text Available Conditions of businesses change very quickly. To take into account the uncertainty engendered by changes has become almost a rule while planning. Robust optimization techniques that are methods of handling uncertainty ensure to produce less sensitive results to changing conditions. Production planning, is to decide from which product, when and how much will be produced, with a most basic definition. Modeling and solution of the Production planning problems changes depending on structure of the production processes, parameters and variables. In this paper, it is aimed to generate and apply scenario based robust optimization model for capacitated two-stage multi-product production planning problem under parameter and demand uncertainty. With this purpose, production planning problem of a textile company that operate in İzmir has been modeled and solved, then deterministic scenarios’ and robust method’s results have been compared. Robust method has provided a production plan that has higher cost but, will result close to feasible and optimal for most of the different scenarios in the future.

The Influence Of Planning Decisions Regarding Land Evaluation Based On A Selected Local Real Estate Market

Directory of Open Access Journals (Sweden)

Foryś Iwona

2015-12-01

Full Text Available The article analyzes the influence of planning decisions on changes taking place on the local real estate market. Three stages of the planning process are studied in particular, i.e.: the passing of the study of conditions and directions of spatial development, the Commune Council Resolution on initiating the formulation of a local spatial development plan, and finally the Resolution on accepting the local plan, as well as the effects of these activities on the land value in a given real estate market in Stargard Szczeciński, in the West-Pomeranian (Zachodniopomorskie Province of Poland. The object of the research is to identify the indicated relationships on a given real estate market, on which respective spatial planning stages can be distinguished, as well as the strength and course of the analyzed relationships. The study will verify the research hypothesis regarding the strength and directions of the effects of planning decisions as the direct and indirect reasons behind price changes on the real estate market. The analysis uses data from the Price Register and the District Starosty Values, along with statistical and public information data and the authors' own studies.

Association between vascular supply, stage and tumour size of juvenile nasopharyngeal angiofibroma.

Science.gov (United States)

Mehan, Raghav; Rupa, V; Lukka, Vijay Kumar; Ahmed, Munawar; Moses, Vinu; Shyam Kumar, N K

2016-12-01

Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular tumour seen in adolescent males. To study the vascular pattern of these tumours, we retrospectively reviewed the records of patients with JNA who underwent preoperative angiography. Most (82.2 %) of the 45 patients assessed were Radkowski stage III with a mean size of 5.29 cm. There was a significant association between tumour stage and size (p = 0.029). Ten different vessels were seen to supply these tumours. All tumours had primary supply from the distal third of the ipsilateral internal maxillary artery (IMA). Accessory vessel supply was chiefly from the Vidian branch of internal carotid artery (ICA) (55.6 %). Stage III tumours were supplied by a greater number of feeding vessels than earlier stage tumours (p < 0.01). Larger tumours were more likely to have ICA supply (p = 0.04). Bilateral supply was seen in 48.7 %. However, there was no predominance of bilateral over ipsilateral IMA supply even in advanced stage tumours. One patient in our series was found to have a caroticocavernous fistula. Residual or recurrent tumours were characterized by new vasculature (100 %) and greater accessory supply from the ipsilateral ICA (85.7 %). Our study highlights the fact that surgical planning cannot be dependent on staging alone and should include preoperative assessment of tumour vasculature by angiography.

Nevada National Security Site Integrated Groundwater Sampling Plan, Revision 1

Energy Technology Data Exchange (ETDEWEB)

Farnham, Irene

2018-03-01

The purpose is to provide a comprehensive, integrated approach for collecting and analyzing groundwater samples to meet the needs and objectives of the DOE/EM Nevada Program’s UGTA Activity. Implementation of this Plan will provide high-quality data required by the UGTA Activity for ensuring public protection in an efficient and cost-effective manner. The Plan is designed to ensure compliance with the UGTA Quality Assurance Plan (QAP) (NNSA/NFO, 2015); Federal Facility Agreement and Consent Order (FFACO) (1996, as amended); and DOE Order 458.1, Radiation Protection of the Public and the Environment (DOE, 2013). The Plan’s scope comprises sample collection and analysis requirements relevant to assessing both the extent of groundwater contamination from underground nuclear testing and impact of testing on water quality in downgradient communities. This Plan identifies locations to be sampled by CAU and location type, sampling frequencies, sample collection methodologies, and the constituents to be analyzed. In addition, the Plan defines data collection criteria such as well purging, detection levels, and accuracy requirements/recommendations; identifies reporting and data management requirements; and provides a process to ensure coordination between NNSS groundwater sampling programs for sampling analytes of interest to UGTA. Information used in the Plan development—including the rationale for selection of wells, sampling frequency, and the analytical suite—is discussed under separate cover (N-I, 2014) and is not reproduced herein. This Plan does not address compliance for those wells involved in a permitted activity. Sampling and analysis requirements associated with these wells are described in their respective permits and are discussed in NNSS environmental reports (see Section 5.2). In addition, sampling for UGTA CAUs that are in the Closure Report (CR) stage are not included in this Plan. Sampling requirements for these CAUs are described in the CR

Trading stages

DEFF Research Database (Denmark)

Steiner, Uli; Tuljapurkar, Shripad; Coulson, Tim

2012-01-01

Interest in stage-and age structured models has recently increased because they can describe quantitative traits such as size that are left out of age-only demography. Available methods for the analysis of effects of vital rates on lifespan in stage-structured models have not been widely applied ...... examples. Much of our approach relies on trading of time and mortality risk in one stage for time and risk in others. Our approach contributes to the new framework of the study of age- and stage-structured biodemography....

Applying a particle filtering technique for canola crop growth stage estimation in Canada

Science.gov (United States)

Sinha, Abhijit; Tan, Weikai; Li, Yifeng; McNairn, Heather; Jiao, Xianfeng; Hosseini, Mehdi

2017-10-01

Accurate crop growth stage estimation is important in precision agriculture as it facilitates improved crop management, pest and disease mitigation and resource planning. Earth observation imagery, specifically Synthetic Aperture Radar (SAR) data, can provide field level growth estimates while covering regional scales. In this paper, RADARSAT-2 quad polarization and TerraSAR-X dual polarization SAR data and ground truth growth stage data are used to model the influence of canola growth stages on SAR imagery extracted parameters. The details of the growth stage modeling work are provided, including a) the development of a new crop growth stage indicator that is continuous and suitable as the state variable in the dynamic estimation procedure; b) a selection procedure for SAR polarimetric parameters that is sensitive to both linear and nonlinear dependency between variables; and c) procedures for compensation of SAR polarimetric parameters for different beam modes. The data was collected over three crop growth seasons in Manitoba, Canada, and the growth model provides the foundation of a novel dynamic filtering framework for real-time estimation of canola growth stages using the multi-sensor and multi-mode SAR data. A description of the dynamic filtering framework that uses particle filter as the estimator is also provided in this paper.

Shenzhen International Low Carbon City in Development: Practice of Low Carbon Planning Technology Strategy Based on Dynamic Demands

Institute of Scientific and Technical Information of China (English)

Yu; Han; Li; Caige

2016-01-01

Targeted at the dynamic demands in the rapid urban construction, the planning technology strategy of the Shenzhen International Low Carbon City studies the fl exible index model based on carbon emission evaluation, and adopts rolling development and micro-circulation construction mode to achieve quick returns with small investment. Meanwhile, it also evaluates the application of low carbon technology and gives feedback in time, so as to constantly optimize and complete the low carbon city planning. In detail, it involves industrial planning, ecological restoration, transport planning, energy resource planning, architectural design, etc., for which appropriate approaches are selected according to the principle of rolling development of unit cells and based on different requirements of different stages. The quick-response and fl exible technology system can help the low carbon city to choose an appropriate technology strategy in line with its own characteristics in the start-up stage and rapid development, thus realizing the sustainable leap-forward development and providing reference for other similar regions.

Shenzhen International Low Carbon City in Development: Practice of Low Carbon Planning Technology Strategy Based on Dynamic Demands

Institute of Scientific and Technical Information of China (English)

Yu Han; Li Caige

2016-01-01

Targeted at the dynamic demands in the rapid urban construction,the planning technology strategy of the Shenzhen International Low Carbon City studies the flexible index model based on carbon emission evaluation,and adopts rolling development and micro-circulation construction mode to achieve quick returns with small investment.Meanwhile,it also evaluates the application of low carbon technology and gives feedback in time,so as to constantly optimize and complete the low carbon city planning.In detail,it involves industrial planning,ecological restoration,transport planning,energy resource planning,architectural design,etc.,for which appropriate approaches are selected according to the principle of rolling development of unit cells and based on different requirements of different stages.The quick-response and flexible technology system can help the low carbon city to choose an appropriate technology strategy in line with its own characteristics in the start-up stage and rapid development,thus realizing the sustainable leap-forward development and providing reference for other similar regions.

Particular intervention plan of The Bugey Nuclear Power Plant

International Nuclear Information System (INIS)

2014-01-01

The Particular intervention plan (PPI in French) is an emergency plan which foresees the measures and means to be implemented to address the potential risks of the presence and operation of a nuclear facility. This plan is implemented and developed by the Prefect in case of nuclear accident (or incident leading to a potential accident), the impact of which extending beyond the facility perimeter. It represents a special section of the organisation plan for civil protection response (ORSEC plan). The PPI foresees the necessary measures and means for crisis management during the first hours following the accident and is triggered by the Department Prefect according to the information provided by the facility operator. Its aim is to protect the populations leaving within 10 km of the facility against a potential radiological hazard. The PPI describes: the facility, the intervention area, the protection measures for the population, the conditions of emergency plan triggering, the crisis organisation, the action forms of the different services, and the post-accident stage. This document is the public version of the Particular intervention plan of the Bugey NPP (Ain, France)

Particular intervention plan of the Flamanville Nuclear Power Plant

International Nuclear Information System (INIS)

2008-01-01

The Particular intervention plan (PPI in French) is an emergency plan which foresees the measures and means to be implemented to address the potential risks of the presence and operation of a nuclear facility. This plan is implemented and developed by the Prefect in case of nuclear accident (or incident leading to a potential accident), the impact of which extending beyond the facility perimeter. It represents a special section of the organisation plan for civil protection response (ORSEC plan). The PPI foresees the necessary measures and means for crisis management during the first hours following the accident and is triggered by the Department Prefect according to the information provided by the facility operator. Its aim is to protect the populations leaving within 10 km of the facility against a potential radiological hazard. The PPI describes: the facility, the intervention area, the protection measures for the population, the conditions of emergency plan triggering, the crisis organisation, the action forms of the different services, and the post-accident stage. This document is the public version of the Particular intervention plan of the Flamanville NPP (Manche, France)

Understanding public sexual harassment : lesson plans and session guidance, key Stages 3 & 4.

OpenAIRE

Vera-Gray, F.; Bullough, J.

2017-01-01

These lesson plans have been written by Dr. Fiona Vera-Gray at Durham University and Jayne Bullough from Rape Crisis South London (RASASC). They were created through a partnership project with Doll’s Eye Theatre, Purple Drum, RASASC, Dr. Maria Garner, and Dr. Fiona Vera-Gray. Lessons on public sexual harassment were drawn from the work of Dr. Vera-Gray at Durham University. The project was made possible by Durham Law School’s Impact Acceleration Grant from the Economics and ...

Model of unplanned smoking initiation of children and adolescents: an integrated stage model of smoking behavior.

Science.gov (United States)

Kremers, S P J; Mudde, A N; De Vries, H

2004-05-01

Two lines of psychological research have attempted to spell out the stages of adolescent smoking initiation. The first has focused on behavioral stages of smoking initiation, while the second line emphasized motivational stages. A large international sample of European adolescents (N = 10,170, mean age = 13.3 years) was followed longitudinally. Self-reported motivational and behavioral stages of smoking initiation were integrated, leading to the development of the Model of Unplanned Smoking Initiation of Children and Adolescents (MUSICA). The MUSICA postulates that youngsters experiment with smoking while they are in an unmotivated state as regards their plans for smoking regularly in the future. More than 95% of the total population resided in one of the seven stages distinguished by MUSICA. The probability of starting to smoke regularly during the 12 months follow-up period increased with advanced stage assignment at baseline. Unique social cognitive predictors of stage progression from the various stages were identified, but effect sizes of predictors of transitions were small. The integration of motivational and behavioral dimensions improves our understanding of the process of smoking initiation. In contrast to current theories of smoking initiation, adolescent uptake of smoking behavior was found to be an unplanned action.

Ballistic Missile Defense: New Plans, Old Challenges

Directory of Open Access Journals (Sweden)

Elizabeth Zolotukhina

2010-01-01

Full Text Available On September 17, 2009—the 70th anniversary of the Soviet invasion of Poland in 1939 that marked the beginning of World War II—the Obama Administration announced its intention to shelve plans for the U.S. Ballistic Missile Defense (BMD that had been developed under former President George W. Bush. Pointing to a new intelligence assessment, President Obama argued that his predecessor's plan to deploy an X-band radar station outside of Prague, Czech Republic, and 10 two-stage interceptor missiles in Poland would not adequately protect America and its European allies from the Iranian threat and reiterated his opposition to utilizing unproven technology in any European BMD architecture.

MRI-based N-staging in esophageal cancer

International Nuclear Information System (INIS)

Krupski, G.; Lorenzen, J.; Nicolas, V.; Adam, G.; Gawad, K.; Izbicki, J.R.

2002-01-01

Purpose: For planning the therapeutic strategies and estimating the prognosis in esophageal cancer, N-staging is very important. To date, MRI still is of minor importance as imaging modality of the mediastinum despite promising developments in the past, like ECG-gating or 'averaging' sequences, e.g. LOTA (Long-term averaging), which facilitate mediastinal and thoracic MR-imaging. In a prospective approach, the value of MRI based N-staging was examined with respect to LOTA-sequences. Material and Methods: Within from weeks prior to esophagectomy, standardized MRI of the esophagus was performed in 15 patients (10 squamous-cell-carcinomas and 5 adenocarcinomas) using a 1.5 T whole body scanner. Imaging quality was classified based on depiction of aortic wall or tracheal wall layers. Criteria for malignant infiltration were a diameter of more than 15 mm or a round appearance of a lymph node together with GD-DTPA enhancement. All data were blinded and separately read by two radiologists. The data of the study were compared with those from the pathological workup of the resected specimen. Results: MRI had a sensitivity of 100% and a specificity of 78% for lymph node metastases. Due to incomplete depiction of the celiac trunk (M1), nodal metastasis in a non-enlarged node was missed. Conclusion: With modern MRI, N-staging is almost as accurate as the gold standard endoscopic ultrasound and should particularly be used in patients not suited for an endoscopic ultrasound examination. (orig.) [de

Analysis of chlorophyll fluorescence reveals stage specific patterns of chloroplast-containing cells during Arabidopsis embryogenesis

Directory of Open Access Journals (Sweden)

RICARDO I TEJOS

2010-01-01

Full Text Available The basic body plan of a plant is established early in embryogenesis when cells differentiate, giving rise to the apical and basal regions of the embryo. Using chlorophyll fluorescence as a marker for chloroplasts, we have detected specific patterns of chloroplast-containing cells at specific stages of embryogenesis. Non-randomly distributed chloroplast-containing cells are seen as early as the globular stage of embryogenesis in Arabidopsis. In the heart stage of embryogenesis, chloroplast containing cells are detected in epidermal cells as well as a central region of the heart stage embryo, forming a triangular septum of chloroplast-containing cells that divides the embryo into three equal sectors. Torpedo stage embryos have chloroplast-containing epidermal cells and a central band of chloroplast-containing cells in the cortex layer, just below the shoot apical meristem. In the walking-stick stage of embryogenesis, chloroplasts are present in the epidermal, cortex and endodermal cells. The chloroplasts appear reduced or absent from the provascular and columella cells of walking-stick stage embryos. These results suggest that there is a tight regulation of plastid differentiation during embryogenesis that generates specific patterns of chloroplast-containing cells in specific cell layers at specific stages of embryogenesis.

Hazardous Waste Code Determination for First/Second-Stage Sludge Waste Stream (IDCs 001, 002, 800)

International Nuclear Information System (INIS)

Arbon, R.E.

2001-01-01

This document, Hazardous Waste Code Determination for the First/Second-Stage Sludge Waste Stream, summarizes the efforts performed at the Idaho National Engineering and Environmental Laboratory (INEEL) to make a hazardous waste code determination on Item Description Codes (IDCs) 001, 002, and 800 drums. This characterization effort included a thorough review of acceptable knowledge (AK), physical characterization, waste form sampling, chemical analyses, and headspace gas data. This effort included an assessment of pre-Waste Analysis Plan (WAP) solidified sampling and analysis data (referred to as preliminary data). Seventy-five First/Second-Stage Sludge Drums, provided in Table 1-1, have been subjected to core sampling and analysis using the requirements defined in the Quality Assurance Program Plan (QAPP). Based on WAP defined statistical reduction, of preliminary data, a sample size of five was calculated. That is, five additional drums should be core sampled and analyzed. A total of seven drums were sampled, analyzed, and validated in compliance with the WAP criteria. The pre-WAP data (taken under the QAPP) correlated very well with the WAP compliant drum data. As a result, no additional sampling is required. Based upon the information summarized in this document, an accurate hazardous waste determination has been made for the First/Second-Stage Sludge Waste Stream

Early-Stage Chunking of Finger Tapping Sequences by Persons Who Stutter and Fluent Speakers

Science.gov (United States)

Smits-Bandstra, Sarah; De Nil, Luc F.

2013-01-01

This research note explored the hypothesis that chunking differences underlie the slow finger-tap sequencing performance reported in the literature for persons who stutter (PWS) relative to fluent speakers (PNS). Early-stage chunking was defined as an immediate and spontaneous tendency to organize a long sequence into pauses, for motor planning,…

Analysis of Development Plans from Communications Perspective

Directory of Open Access Journals (Sweden)

Zohreh Shahghasemi

2016-12-01

Full Text Available The movement towards the goals of "Vision plan 1404" needs the perception of the requirements to prepare plans for achieving the favorite objectives of development. With the advent of the information age, the rules of development policy-making strongly have changed in the world and also unique opportunities areprovided by variables of communications for countries that have been in early stages of development. Based on this, considering the communications in macro-level and in the political, social, economic and cultural development plans is important and necessary. This requires a review and pathology of previous plans and evaluation of their strengths and weaknesses for preparing of more comprehensive future plans. Themain question of this study is: what is the approach of development plans to communications section after Islamic revolution?  Which aspects of communications are considered, and what aspects are ignored?  This study analyzes five development plans after the revolution, by using of qualitative content analysis. Results show that in all five-year plans the focus was on hardware and quantitative dimensions of communication development and media, but qualitative and content aspects, such as the right to universal access to information, freedom to obtain and disseminate information within the constitution, freedom of speech and press, a move towards the information society and knowledge-based, also other dimensions of communications such as human, traditional and social communication has been less considered. In the fourth development plan that is "knowledge" – centered, new fields of communications has been studied comprehensively in comparison to other plans. According to these approaches and new scientific and experimental perspectives, this paper suggests further engagement in communications necessity for development policy-making.

Spatial and stage-structured population model of the American crocodile for comparison of comprehensive Everglades Restoration Plan (CERP) alternatives

Science.gov (United States)

Green, Timothy W.; Slone, Daniel H.; Swain, Eric D.; Cherkiss, Michael S.; Lohmann, Melinda; Mazzotti, Frank J.; Rice, Kenneth G.

2010-01-01

As part of the U.S. Geological Survey Priority Ecosystems Science (PES) initiative to provide the ecological science required during Everglades restoration, we have integrated current regional hydrologic models with American crocodile (Crocodylus acutus) research and monitoring data to create a model that assesses the potential impact of Comprehensive Everglades Restoration Plan (CERP) efforts on the American crocodile. A list of indicators was created by the Restoration Coordination and Verification (RECOVER) component of CERP to help determine the success of interim restoration goals. The American crocodile was established as an indicator of the ecological condition of mangrove estuaries due to its reliance upon estuarine environments characterized by low salinity and adequate freshwater inflow. To gain a better understanding of the potential impact of CERP restoration efforts on the American crocodile, a spatially explicit crocodile population model has been created that has the ability to simulate the response of crocodiles to various management strategies for the South Florida ecosystem. The crocodile model uses output from the Tides and Inflows in the Mangroves of the Everglades (TIME) model, an application of the Flow and Transport in a Linked Overland/Aquifer Density Dependent System (FTLOADDS) simulator. TIME has the capability to link to the South Florida Water Management Model (SFWMM), which is the primary regional tool used to assess CERP restoration scenarios. A crocodile habitat suitability index and spatial parameter maps that reflect salinity, water depth, habitat, and nesting locations are used as driving functions to construct crocodile finite rate of increase maps under different management scenarios. Local stage-structured models are integrated with a spatial landscape grid to display crocodile movement behavior in response to changing environmental conditions. Restoration efforts are expected to affect salinity levels throughout the habitat of

System of optimization computations of five year plans in the coal industry. [USSR

Energy Technology Data Exchange (ETDEWEB)

Goyzman, E I; Korenev, V G

1980-01-01

A system of optimization computations of five year plans is set forth which was developed over a number of years at the Central Scientific Research Institute of Economics and Scientific-Technical Information of the Coal Industry. Basic principles of design and methodological approaches are given which were used in development of the systemas well as levels of administration and information links between them. The report analyzes the characteristics of problems of planning which arise at different stages of formation of the five year plans and discusses possibilities of taking into account these characteristics in optimized models. Economic formulations of problems of optimization of five year plans are given as applied to two levels of administration: at the branch level and at the level of production associations. Economic-mathematical models of optimization of five year plans are developed for each of the levels and their characteristic features described. The primary methodological principles, on the basis of which optimization models were developed are examined. An economic-mathematical model with continuous variables was developed for the branch level of planning. Volumes of recovery according to a group of shafts in the stage of normal operation (stable group) of each production enterprise are adopted as model variables. A system of limitations which includes limitations on volumes and distinguishable resources is formulated. The minimum of operating expenses, minimum of capital investments and maximum of recovery volumes for the planned period can be used as the optimization criteria. An economic-mathematical model which uses integral variable was developed for the production association level.

Planning a Stigmatized Nonvisible Illness Disclosure: Applying the Disclosure Decision-Making Model

Science.gov (United States)

Choi, Soe Yoon; Venetis, Maria K.; Greene, Kathryn; Magsamen-Conrad, Kate; Checton, Maria G.; Banerjee, Smita C.

2016-01-01

This study applied the disclosure decision-making model (DD-MM) to explore how individuals plan to disclose nonvisible illness (Study 1), compared to planning to disclose personal information (Study 2). Study 1 showed that perceived stigma from the illness negatively predicted disclosure efficacy; closeness predicted anticipated response (i.e., provision of support) although it did not influence disclosure efficacy; disclosure efficacy led to reduced planning, with planning leading to scheduling. Study 2 demonstrated that when information was considered to be intimate, it negatively influenced disclosure efficacy. Unlike the model with stigma (Study 1), closeness positively predicted both anticipated response and disclosure efficacy. The rest of the hypothesized relationships showed a similar pattern to Study 1: disclosure efficacy reduced planning, which then positively influenced scheduling. Implications of understanding stages of planning for stigmatized information are discussed. PMID:27662447

The strategic marketing planning – General Framework for Customer Segmentation

Directory of Open Access Journals (Sweden)

Alina Elena OPRESCU

2014-03-01

Full Text Available Any approach that involves the use of strategic resources of an organisation requires a responsible approach, a behaviour that enables it to properly integrate itself into the dynamic of the business environment. This articles addresses in a synthetic manner, the issues of specific integration efforts for customers’ segmentation in the strategic marketing planning. The essential activity for any organisation wishing to optimise its response to the market, the customer segmentation will fully benefit from the framework provided by the strategic marketing planning. Being a sequential process, it not only allows time optimisation of the entire marketing activity but it also leads to accuracy of the strategic planning and its stages.

Potential for Revitalisation of the Diaphragm for Family Planning in ...

African Journals Online (AJOL)

AJRH Managing Editor

diaphragm, into the existing family planning method mix in Uganda. A total of 26 ... expand women's options for contraceptive protection. ... several countries, and the product was approved in ..... younger clients and may not adequately market ... different stages of their life cycle. .... maternal mortality ratio in Uganda: priority.

Geological considerations and constraints in planning and executing horizontal well prospects : two case studies from the Saudi Arabia

Energy Technology Data Exchange (ETDEWEB)

Nwabor, D. [Schlumberger Oilfield Services (Saudi Arabia); Al-Fawwaz, A.; Hassani, S. [Saudi Aramco, Dhahran (Saudi Arabia)

2006-07-01

This paper discussed the challenges facing horizontal well drilling with particular reference to the limited success rates of 2 wells that were initially planned and drilled geometrically according to integrated geological and seismic data. The limited success was due partly to drilling to target without considering the key subsurface risks and uncertainties at the execution stages of the wells. Two case studies from these fields were presented in an effort to highlight important geological issues that must be considered when planning and executing horizontal wells. While the wells were being drilled, geological decisions were taken based on seismic data, geological modelling and assessing offset well log responses. The continuous use of real-time data during well drilling contributed to the achievement of the wells' objectives. This approach eliminated all the initial assumptions from seismic data. During the planning stages, many target surfaces such as faults, horizons and unconformities were created from a 3 dimensional grid. Each well was geologically steered in the execution stages by comparing what was seen while drilling with what was initially proposed at the planning stages. As drilling progressed, geological issues such as structural, stratigraphic, reservoir fluid contact and surveying uncertainties were considered. In most instances, the geological objectives of the studied wells were met, thereby improving production, increasing net pay and return on investment. It was concluded that the experience from this work can be applied to oilfields anywhere in the world.

Comparisons of single-stage and two-stage approaches to genomic selection.

Science.gov (United States)

Schulz-Streeck, Torben; Ogutu, Joseph O; Piepho, Hans-Peter

2013-01-01

Genomic selection (GS) is a method for predicting breeding values of plants or animals using many molecular markers that is commonly implemented in two stages. In plant breeding the first stage usually involves computation of adjusted means for genotypes which are then used to predict genomic breeding values in the second stage. We compared two classical stage-wise approaches, which either ignore or approximate correlations among the means by a diagonal matrix, and a new method, to a single-stage analysis for GS using ridge regression best linear unbiased prediction (RR-BLUP). The new stage-wise method rotates (orthogonalizes) the adjusted means from the first stage before submitting them to the second stage. This makes the errors approximately independently and identically normally distributed, which is a prerequisite for many procedures that are potentially useful for GS such as machine learning methods (e.g. boosting) and regularized regression methods (e.g. lasso). This is illustrated in this paper using componentwise boosting. The componentwise boosting method minimizes squared error loss using least squares and iteratively and automatically selects markers that are most predictive of genomic breeding values. Results are compared with those of RR-BLUP using fivefold cross-validation. The new stage-wise approach with rotated means was slightly more similar to the single-stage analysis than the classical two-stage approaches based on non-rotated means for two unbalanced datasets. This suggests that rotation is a worthwhile pre-processing step in GS for the two-stage approaches for unbalanced datasets. Moreover, the predictive accuracy of stage-wise RR-BLUP was higher (5.0-6.1%) than that of componentwise boosting.

Global floor planning approach for VLSI design

International Nuclear Information System (INIS)

LaPotin, D.P.

1986-01-01

Within a hierarchical design environment, initial decisions regarding the partitioning and choice of module attributes greatly impact the quality of the resulting IC in terms of area and electrical performance. This dissertation presents a global floor-planning approach which allows designers to quickly explore layout issues during the initial stages of the IC design process. In contrast to previous efforts, which address the floor-planning problem from a strict module placement point of view, this approach considers floor-planning from an area planning point of view. The approach is based upon a combined min-cut and slicing paradigm, which ensures routability. To provide flexibility, modules may be specified as having a number of possible dimensions and orientations, and I/O pads as well as layout constraints are considered. A slicing-tree representation is employed, upon which a sequence of traversal operations are applied in order to obtain an area efficient layout. An in-place partitioning technique, which provides an improvement over previous min-cut and slicing-based efforts, is discussed. Global routing and module I/O pin assignment are provided for floor-plan evaluation purposes. A computer program, called Mason, has been developed which efficiently implements the approach and provides an interactive environment for designers to perform floor-planning. Performance of this program is illustrated via several industrial examples

Optimal dimensioning of low-energy district heating networks with operational planning

DEFF Research Database (Denmark)

Tol, Hakan; Svendsen, Svend

2012-01-01

in design stage resulted in satisfaction of heat demand of the house in low temperature operation. In this paper the operational planning of the low-energy DH systems was investigated to reduce the dimensions of the distribution network with consideration given both to current high-heat and future low......-heat demand situations. The operational planning was based on boosting (increasing) the supply temperature at peak-demand situations which occur rarely over a year period. Hence optimal pipe dimensions of low-energy DH systems were investigated based on the dynamic response of in-house heating systems...... of operational planning in comparison to DH network dimensioned according to high heat demand situation....

Nuclear Cryogenic Propulsion Stage Affordable Development Strategy

Science.gov (United States)

Doughty, Glen E.; Gerrish, H. P.; Kenny, R. J.

2014-01-01

The development of nuclear power for space use in nuclear thermal propulsion (NTP) systems will involve significant expenditures of funds and require major technology development efforts. The development effort must be economically viable yet sufficient to validate the systems designed. Efforts are underway within the National Aeronautics and Space Administration's (NASA) Nuclear Cryogenic Propulsion Stage Project (NCPS) to study what a viable program would entail. The study will produce an integrated schedule, cost estimate and technology development plan. This will include the evaluation of various options for test facilities, types of testing and use of the engine, components, and technology developed. A "Human Rating" approach will also be developed and factored into the schedule, budget and technology development approach.

CURRENT STATUS AND RECLAMATION PLAN OF FORMER URANIUM MINING AND MILLING FACILITIES AT NINGYO-TOGE IN JAPAN

International Nuclear Information System (INIS)

Sato, Kazuhiko; Tokizawa, Takayuki

2003-01-01

The Japan Nuclear Cycle Development Institute (JNC) conducted research and development projects on uranium exploration in Japan from 1956 to 1987. Several mine facilities, such as waste rock yards and a mill tailing pond, were retained around Ningyo-toge after the projects ended. Although there is no legal issue in the mine in accordance with related law and agreements at present, JNC has a notion that it is important to reduce the burden of waste management on future generations. Thus, the Ningyo-toge Environmental Engineering Center of JNC proposed a reclamation plan for these facilities with fundamental policy, an example of safety analysis and timetables. The plan has mainly three phases: Phase I is the planning stage, and this paper corresponds to this: Phase II is the stage to perform various tests for safety analysis and site designing: Phase III is the stage to accomplish measures. Preliminarily safety analyses suggested that our supposed cover designs for both waste rock and m ill tailing are enough to keep dose limit of 1mSv/y at site boundaries. The plan is primarily based on the Japanese Mine Safety Law, also refers to ICRP recommendations, IAEA reports, measures implemented overseas, etc. because this is the first case in Japan. For the accomplishment of this plan, it is important to establish a close relationship with local communities and governments, and to maintain a policy of open-to-public

Planning contract and networks of home services

Directory of Open Access Journals (Sweden)

José Eudoro Narváez Viteri

2010-06-01

Full Text Available This article highlights the worrying increase in public investment in infrastructure works due to deficiencies at the stage of study and design, particularly in public utility services networks. Some cities lack real technical drawings and updated underground networks, especially in the former. Hence, no reliable information is difficult to require contractors, consultants about study designs appropriate public service networks in evident contradiction with the principle of contractual planning.

Tactical supply chain planning for a forest biomass power plant under supply uncertainty

International Nuclear Information System (INIS)

Shabani, Nazanin; Sowlati, Taraneh; Ouhimmou, Mustapha; Rönnqvist, Mikael

2014-01-01

Uncertainty in biomass supply is a critical issue that needs to be considered in the production planning of bioenergy plants. Incorporating uncertainty in supply chain planning models provides improved and stable solutions. In this paper, we first reformulate a previously developed non-linear programming model for optimization of a forest biomass power plant supply chain into a linear programming model. The developed model is a multi-period tactical-level production planning problem and considers the supply and storage of forest biomass as well as the production of electricity. It has a one-year planning horizon with monthly time steps. Next, in order to incorporate uncertainty in monthly available biomass into the planning, we develop a two-stage stochastic programming model. Finally, to balance the risk and profit, we propose a bi-objective model. The results show that uncertainty in availability of biomass has an additional cost of $0.4 million for the power plant. Using the proposed stochastic optimization model could reduce this cost by half. - Highlights: • Developed a two-stage stochastic optimization model to consider supply uncertainty. • Maximized the profit of a forest biomass power plant value chain. • Minimized two risk measures, variability index and downside risk, to manage risks. • Stochastic optimization model provided feasible solution for all scenarios. • Results showed a trade-off between profit and risk management

Positron Emission Tomography/Computed Tomography in the Staging and Treatment of Anal Cancer

DEFF Research Database (Denmark)

Sveistrup, Joen; Loft, Annika; Berthelsen, Anne Kiil

2012-01-01

PURPOSE: This study was intended to determine the role of PET/CT in the staging of anal cancer as a supplement to three-dimensional transanal ultrasound (TAUS) and inguinal ultrasound (US). The impact of the PET/CT on the initial stage and treatment plan proposed by TAUS/US was assessed. METHODS......-88 years). Six (6%) of the patients were HIV positive. All patients were staged with TAUS/US and PET/CT. RESULTS: Twenty-eight (28) patients were diagnosed with suspicious perirectal node metastases. TAUS visualized 24 of these, whereas PET/CT detected 15. Suspicious inguinal nodes were visualized...... on either US or PET/CT in 41 patients. Seventeen (17) of these had confirmed malignant disease on biopsy, and 15 had confirmed benign disease. All 17 patients (100%) with malignant inguinal nodes were diagnosed by PET/CT, whereas US identified 16 (94%). Ten patients were diagnosed with suspicious inguinal...

Radiotherapy Facilities: Master Planning and Concept Design Considerations (Russian Edition)

International Nuclear Information System (INIS)

2015-01-01

This publication provides guidelines on how to plan a radiotherapy facility in terms of the strategic master planning process including the legal, technical and infrastructure requirements. It outlines a risk assessment methodology and a typical project work plan, and describes the professional expertise required for the implementation of such a project. Generic templates for a block design are suggested, which include possibilities for future expansion. These templates can be overlaid onto the designated site such that the most efficient workflow between the main functional areas can be ensured. A sample checklist is attached to act as a guideline for project management and to indicate the critical stages in the process where technical expert assistance may be needed. The publication is aimed at professionals and administrators involved in infrastructure development, planning and facility management, as well as engineers, building contractors and radiotherapy professionals

Core competency model for the family planning public health nurse.

Science.gov (United States)

Hewitt, Caroline M; Roye, Carol; Gebbie, Kristine M

2014-01-01

A core competency model for family planning public health nurses has been developed, using a three stage Delphi Method with an expert panel of 40 family planning senior administrators, community/public health nursing faculty and seasoned family planning public health nurses. The initial survey was developed from the 2011 Title X Family Planning program priorities. The 32-item survey was distributed electronically via SurveyMonkey(®). Panelist attrition was low, and participation robust resulting in the final 28-item model, suggesting that the Delphi Method was a successful technique through which to achieve consensus. Competencies with at least 75% consensus were included in the model and those competencies were primarily related to education/counseling and administration of medications and contraceptives. The competencies identified have implications for education/training, certification and workplace performance. © 2014 Wiley Periodicals, Inc.

A robotized six degree of freedom stage for optical microscopy

Science.gov (United States)

Avramov, M. Z.; Ivanov, I.; Pavlov, V.; Zaharieva, K.

2013-04-01

This work represents an investigation of the possibility to use a hexapod system for optical microscopy investigation and measurements. An appropriate hexapod stage has been developed. The stage has been calibrated and used for several different optical microscopy applications. The construction of the stage is based on the classic Stewart platform and thus represents a parallel robot with 6 degree of freedom. Appropriate software is controlling the transformation of the 3 position coordinates of the moving plate and the 3 Euler angles in position velocities and accelerations of the plate motion. An embedded microcontroller is implementing the motion plan and the PID controller regulating the kinematics. By difference to the available in the market hexapods the proposed solution is with lower precision but is significantly cheaper and simple to maintain. The repeatability obtained with current implementation is 0,05 mm and 0,001 rad. A specialized DSP based video processing engine is used for both feedback computation and application specific image processing in real-time. To verify the concept some applications has been developed for specific tasks and has been used for specific measurements.

Radiotherapy Treatment Planning for Testicular Seminoma

International Nuclear Information System (INIS)

Wilder, Richard B.; Buyyounouski, Mark K.; Efstathiou, Jason A.; Beard, Clair J.

2012-01-01

Virtually all patients with Stage I testicular seminoma are cured regardless of postorchiectomy management. For patients treated with adjuvant radiotherapy, late toxicity is a major concern. However, toxicity may be limited by radiotherapy techniques that minimize radiation exposure of healthy normal tissues. This article is an evidence-based review that provides radiotherapy treatment planning recommendations for testicular seminoma. The minority of Stage I patients who choose adjuvant treatment over surveillance may be considered for (1) para-aortic irradiation to 20 Gy in 10 fractions, or (2) carboplatin chemotherapy consisting of area under the curve, AUC = 7 × 1−2 cycles. Two-dimensional radiotherapy based on bony anatomy is a simple and effective treatment for Stage IIA or IIB testicular seminoma. Centers with expertise in vascular and nodal anatomy may consider use of anteroposterior–posteroanterior fields based on three-dimensional conformal radiotherapy instead. For modified dog-leg fields delivering 20 Gy in 10 fractions, clinical studies support placement of the inferior border at the top of the acetabulum. Clinical and nodal mapping studies support placement of the superior border of all radiotherapy fields at the top of the T12 vertebral body. For Stage IIA and IIB patients, an anteroposterior–posteroanterior boost is then delivered to the adenopathy with a 2-cm margin to the block edge. The boost dose consists of 10 Gy in 5 fractions for Stage IIA and 16 Gy in 8 fractions for Stage IIB. Alternatively, bleomycin, etoposide, and cisplatin chemotherapy for 3 cycles or etoposide and cisplatin chemotherapy for 4 cycles may be delivered to Stage IIA or IIB patients (e.g., if they have a horseshoe kidney, inflammatory bowel disease, or a history of radiotherapy).

Radiotherapy Treatment Planning for Testicular Seminoma

Energy Technology Data Exchange (ETDEWEB)

Wilder, Richard B., E-mail: richardbwilder@yahoo.com [Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL (United States); Buyyounouski, Mark K. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Efstathiou, Jason A. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Beard, Clair J. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States)

2012-07-15

Virtually all patients with Stage I testicular seminoma are cured regardless of postorchiectomy management. For patients treated with adjuvant radiotherapy, late toxicity is a major concern. However, toxicity may be limited by radiotherapy techniques that minimize radiation exposure of healthy normal tissues. This article is an evidence-based review that provides radiotherapy treatment planning recommendations for testicular seminoma. The minority of Stage I patients who choose adjuvant treatment over surveillance may be considered for (1) para-aortic irradiation to 20 Gy in 10 fractions, or (2) carboplatin chemotherapy consisting of area under the curve, AUC = 7 Multiplication-Sign 1-2 cycles. Two-dimensional radiotherapy based on bony anatomy is a simple and effective treatment for Stage IIA or IIB testicular seminoma. Centers with expertise in vascular and nodal anatomy may consider use of anteroposterior-posteroanterior fields based on three-dimensional conformal radiotherapy instead. For modified dog-leg fields delivering 20 Gy in 10 fractions, clinical studies support placement of the inferior border at the top of the acetabulum. Clinical and nodal mapping studies support placement of the superior border of all radiotherapy fields at the top of the T12 vertebral body. For Stage IIA and IIB patients, an anteroposterior-posteroanterior boost is then delivered to the adenopathy with a 2-cm margin to the block edge. The boost dose consists of 10 Gy in 5 fractions for Stage IIA and 16 Gy in 8 fractions for Stage IIB. Alternatively, bleomycin, etoposide, and cisplatin chemotherapy for 3 cycles or etoposide and cisplatin chemotherapy for 4 cycles may be delivered to Stage IIA or IIB patients (e.g., if they have a horseshoe kidney, inflammatory bowel disease, or a history of radiotherapy).

Clinical Impact of Education Provision on Determining Advance Care Planning Decisions among End Stage Renal Disease Patients Receiving Regular Hemodialysis in University Malaya Medical Centre.

Science.gov (United States)

Hing Wong, Albert; Chin, Loh Ee; Ping, Tan Li; Peng, Ng Kok; Kun, Lim Soo

2016-01-01

Advance care planning (ACP) is a process of shared decision-making about future health-care plans between patients, health care providers, and family members, should patients becomes incapable of participating in medical treatment decisions. ACP discussions enhance patient's autonomy, focus on patient's values and treatment preferences, and promote patient-centered care. ACP is integrated as part of clinical practice in Singapore and the United States. To assess the clinical impact of education provision on determining ACP decisions among end-stage renal disease patients on regular hemodialysis at University Malaya Medical Centre (UMMC). To study the knowledge and attitude of patients toward ACP and end-of-life issues. Fifty-six patients were recruited from UMMC. About 43 questions pretest survey adapted from Lyon's ACP survey and Moss's cardiopulmonary resuscitation (CPR) attitude survey was given to patients to answer. An educational brochure is then introduced to these patients, and a posttest survey carried out after that. The results were analyzed using SPSS version 22.0. Opinion on ACP, including CPR decisions, showed an upward trend on the importance percentage after the educational brochure exposure, but this was statistically not significant. Seventy-five percent of participants had never heard of ACP before, and only 3.6% had actually prepared a written advanced directive. The ACP educational brochure clinically impacts patients' preferences and decisions toward end-of-life care; however, this is statistically not significant. Majority of patients have poor knowledge on ACP. This study lays the foundation for execution of future larger scale clinical trials, and ultimately, the incorporation of ACP into clinical practice in Malaysia.

Experiences and lessons learned for planning and supply of micronutrient powders interventions

Science.gov (United States)

Schauer, Claudia; Sunley, Nigel; Nyhus Dhillon, Christina; Roca, Claudia; Tapia, Gustavo; Mathema, Pragya; Walton, Shelley; Situma, Ruth; Zlotkin, Stanley; DW Klemm, Rolf

2017-01-01

Abstract Realistic planning for a nutrition intervention is a critical component of implementation, yet effective approaches have been poorly documented. Under the auspices of “The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,” 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powders (MNP) interventions for young children. This paper focuses on programmatic experiences in the planning stages of an MNP intervention, encompassing assessment, enabling environment and adaptation, as well as considerations for supply. Methods included a review of published and grey literature, key informant interviews, and deliberations throughout the consultation process. We found that assessments helped justify adopting an MNP intervention, but these assessments were often limited by their narrow scope and inadequate data. Establishing coordinating bodies and integrating MNP into existing policies and programmes have helped foster an enabling environment and support programme stability. Formative research and pilots have been used to adapt MNP interventions to specific contexts, but they have been insufficient to inform scale‐up. In terms of supply, most countries have opted to procure MNP through international suppliers, but this still requires understanding and navigating the local regulatory environment at the earliest stages of an intervention. Overall, these findings indicate that although some key planning and supply activities are generally undertaken, improvements are needed to plan for effective scale‐up. Much still needs to be learned on MNP planning, and we propose a set of research questions that require further investigation. PMID:28960875

[Preoperative imaging/operation planning for liver surgery].

Science.gov (United States)

Schoening, W N; Denecke, T; Neumann, U P

2015-12-01

The currently established standard for planning liver surgery is multistage contrast media-enhanced multidetector computed tomography (CM-CT), which as a rule enables an appropriate resection planning, e.g. a precise identification and localization of primary and secondary liver tumors as well as the anatomical relation to extrahepatic and/or intrahepatic vascular and biliary structures. Furthermore, CM-CT enables the measurement of tumor volume, total liver volume and residual liver volume after resection. Under the condition of normal liver function a residual liver volume of 25 % is nowadays considered sufficient and safe. Recent studies in patients with liver metastases of colorectal cancer showed a clear staging advantage of contrast media-enhanced magnetic resonance imaging (CM-MRI) versus CM-CT. In addition, most recent data showed that the use of liver-specific MRI contrast media further increases the sensitivity and specificity of detection of liver metastases. This imaging technology seems to lead closer to the ideal "one stop shopping" diagnostic tool in preoperative planning of liver resection.

Application of Science-Based Restoration Planning to a Desert River System

Science.gov (United States)

Laub, Brian G.; Jimenez, Justin; Budy, Phaedra

2015-06-01

Persistence of many desert river species is threatened by a suite of impacts linked to water infrastructure projects that provide human water security where water is scarce. Many desert rivers have undergone regime shifts from spatially and temporally dynamic ecosystems to more stable systems dominated by homogenous physical habitat. Restoration of desert river systems could aid in biodiversity conservation, but poses formidable challenges due to multiple threats and the infeasibility of recovery to pre-development conditions. The challenges faced in restoring desert rivers can be addressed by incorporating scientific recommendations into restoration planning efforts at multiple stages, as demonstrated here through an example restoration project. In particular, use of a watershed-scale planning process can identify data gaps and irreversible constraints, which aid in developing achievable restoration goals and objectives. Site-prioritization focuses limited the resources for restoration on areas with the greatest potential to improve populations of target organisms. Investment in research to understand causes of degradation, coupled with adoption of a guiding vision is critical for identifying feasible restoration actions that can enhance river processes. Setting monitoring as a project goal, developing hypotheses for expected outcomes, and implementing restoration as an experimental design will facilitate adaptive management and learning from project implementation. Involvement of scientists and managers during all planning stages is critical for developing process-based restoration actions and an implementation plan to maximize learning. The planning process developed here provides a roadmap for use of scientific recommendations in future efforts to recover dynamic processes in imperiled riverine ecosystems.

Application of science-based restoration planning to a desert river system

Science.gov (United States)

Laub, Brian G.; Jimenez, Justin; Budy, Phaedra

2015-01-01

Persistence of many desert river species is threatened by a suite of impacts linked to water infrastructure projects that provide human water security where water is scarce. Many desert rivers have undergone regime shifts from spatially and temporally dynamic ecosystems to more stable systems dominated by homogenous physical habitat. Restoration of desert river systems could aid in biodiversity conservation, but poses formidable challenges due to multiple threats and the infeasibility of recovery to pre-development conditions. The challenges faced in restoring desert rivers can be addressed by incorporating scientific recommendations into restoration planning efforts at multiple stages, as demonstrated here through an example restoration project. In particular, use of a watershed-scale planning process can identify data gaps and irreversible constraints, which aid in developing achievable restoration goals and objectives. Site-prioritization focuses limited the resources for restoration on areas with the greatest potential to improve populations of target organisms. Investment in research to understand causes of degradation, coupled with adoption of a guiding vision is critical for identifying feasible restoration actions that can enhance river processes. Setting monitoring as a project goal, developing hypotheses for expected outcomes, and implementing restoration as an experimental design will facilitate adaptive management and learning from project implementation. Involvement of scientists and managers during all planning stages is critical for developing process-based restoration actions and an implementation plan to maximize learning. The planning process developed here provides a roadmap for use of scientific recommendations in future efforts to recover dynamic processes in imperiled riverine ecosystems.

Organizational downsizing: a review of literature for planning and research.

Science.gov (United States)

Davis, Jullet A; Savage, Grant; Stewart, R Thomas

2003-01-01

The use of downsizing as management's strategic response to environmental and institutional changes is prevalent in all U.S. industries, including healthcare. The popular and research literature is inundated with reports on companies undergoing various stages of restructuring, which often include one or more staff reductions. This article provides a review of downsizing literature published from 1985 to 2002. Although the findings and conclusions of these articles are generally inconsistent, the prevailing opinion is that for downsizing to be successful, effective planning must occur long before, during, and after downsizing. Additionally, a downsizing plan should be included in the strategic management plan of all organizations, regardless of whether they plan to downsize or not. By including such a plan, the organization will be better prepared to begin the staff-reduction process should it be forced to do so in response to environmental changes. Finally, providing ample support and protection for staff is key to the organization's recovery and growth. The lessons provided in this literature review should assist healthcare managers in deciding how to plan and structure potential staff reductions.

On Planning and Managing the Preservation of Historical Buildings

Directory of Open Access Journals (Sweden)

Č. Jarský

2003-01-01

Full Text Available The process of preserving and reconstructing historical buildings poses several specific questions and raises problems which must be solved in the planning and management stage of the building process - from questions of architectural and art-historical significance, via the future purpose of use of the building, links to the surrounding buildings, environmental questions, questions of cost, time analysis, and quality assurance problems. Many of these problems can be solved with the help of a computer model of the course of the rehabilitation and reconstruction of the building created by a construction technology network diagram. The CONTEC integrated project planning, management and quality control system based on these diagrams has been used for bidding, planning and managing the reconstruction process of several significant historical buildings in Prague and other cities.

The enactment stage of end-of-life decision-making for children.

Science.gov (United States)

Sullivan, Jane Elizabeth; Gillam, Lynn Heather; Monagle, Paul Terence

2018-01-11

Typically pediatric end-of-life decision-making studies have examined the decision-making process, factors, and doctors' and parents' roles. Less attention has focussed on what happens after an end-of-life decision is made; that is, decision enactment and its outcome. This study explored the views and experiences of bereaved parents in end-of-life decision-making for their child. Findings reported relate to parents' experiences of acting on their decision. It is argued that this is one significant stage of the decision-making process. A qualitative methodology was used. Semi-structured interviews were conducted with bereaved parents, who had discussed end-of-life decisions for their child who had a life-limiting condition and who had died. Data were thematically analysed. Twenty-five bereaved parents participated. Findings indicate that, despite differences in context, including the child's condition and age, end-of-life decision-making did not end when an end-of-life decision was made. Enacting the decision was the next stage in a process. Time intervals between stages and enactment pathways varied, but the enactment was always distinguishable as a separate stage. Decision enactment involved making further decisions - parents needed to discern the appropriate time to implement their decision to withdraw or withhold life-sustaining medical treatment. Unexpected events, including other people's actions, impacted on parents enacting their decision in the way they had planned. Several parents had to re-implement decisions when their child recovered from serious health issues without medical intervention. Significance of results A novel, critical finding was that parents experienced end-of-life decision-making as a sequence of interconnected stages, the final stage being enactment. The enactment stage involved further decision-making. End-of-life decision-making is better understood as a process rather than a discrete once-off event. The enactment stage has particular

Mizunami Underground Research Laboratory project. A project on research stage of investigating prediction from ground surface. Project report at fiscal year of 2000 to 2004

International Nuclear Information System (INIS)

2000-04-01

This was a detailed plan after fiscal year 2000 on the first stage of the Research stage at investigating prediction from ground surface' in three researches carried out at the Mizunami Underground Research Laboratory (MIU) according to the 'Basic plan on research of underground science at MIU', based on progress of investigation and research before fiscal year 1999. This project contains following three items as its general targets; establishment of general investigating techniques for geological environment, collection of informations on deep underground environment, and development on foundation of engineering technology at super-deep underground. And, targets at investigating prediction stage from ground surface contain acquisition of geological environment data through investigations from ground surface to predict changes of the environment accompanied with underground geological environment and construction of experimental tunnel, to determine evaluating method on prediction results, and to determine plannings of an investigating stage accompanied with excavation of the tunnel by carrying out detail design of the tunnel. Here were introduced about results and problems on the investigation of the first phase, the integration of investigating results, and the investigation and researches on geology/geological structure, hydrology and geochemistry of groundwater, mechanical properties of rocks, and the mass transfer. (G.K.)

Systems principles of planning the net cost of oil and gas extraction

Energy Technology Data Exchange (ETDEWEB)

Ryazanova, N I

1979-01-01

The automated system of calculation of ASPC ''oil extraction'' is developed in order to improve the existing system of planning of the oil extracting sector. The most complete expression of the systems construction of the plan is found in the section ''net cost and profit.'' Unity of the production process advances definite requirements for construction of the plan for net cost of oil and gas extraction as the model of this unified process. According to these requirements, the plan for net cost must be developed on the basis of interrelationship of the indicators of the plan for net cost within the section and with indicators of other sections of the plan, methodological unity and continuity of the methods of planning net cost by elements of outlays, articles of calculation and technical-economic factors, methodological continuity of regimes and stages of planning, as well as based on methodological continuity of the control levels. The listed requirements are principles for systems planning of the net cost of oil and gas extraction. These principles guarantee improvement in planning of net cost of oil and gas extraction according to the requirements made for the national economic planning.

Sleep Stage Transition Dynamics Reveal Specific Stage 2 Vulnerability in Insomnia.

Science.gov (United States)

Wei, Yishul; Colombo, Michele A; Ramautar, Jennifer R; Blanken, Tessa F; van der Werf, Ysbrand D; Spiegelhalder, Kai; Feige, Bernd; Riemann, Dieter; Van Someren, Eus J W

2017-09-01

Objective sleep impairments in insomnia disorder (ID) are insufficiently understood. The present study evaluated whether whole-night sleep stage dynamics derived from polysomnography (PSG) differ between people with ID and matched controls and whether sleep stage dynamic features discriminate them better than conventional sleep parameters. Eighty-eight participants aged 21-70 years, including 46 with ID and 42 age- and sex-matched controls without sleep complaints, were recruited through www.sleepregistry.nl and completed two nights of laboratory PSG. Data of 100 people with ID and 100 age- and sex-matched controls from a previously reported study were used to validate the generalizability of findings. The second night was used to obtain, in addition to conventional sleep parameters, probabilities of transitions between stages and bout duration distributions of each stage. Group differences were evaluated with nonparametric tests. People with ID showed higher empirical probabilities to transition from stage N2 to the lighter sleep stage N1 or wakefulness and a faster decaying stage N2 bout survival function. The increased transition probability from stage N2 to stage N1 discriminated people with ID better than any of their deviations in conventional sleep parameters, including less total sleep time, less sleep efficiency, more stage N1, and more wake after sleep onset. Moreover, adding this transition probability significantly improved the discriminating power of a multiple logistic regression model based on conventional sleep parameters. Quantification of sleep stage dynamics revealed a particular vulnerability of stage N2 in insomnia. The feature characterizes insomnia better than-and independently of-any conventional sleep parameter. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Internet plan and planning

Directory of Open Access Journals (Sweden)

Kahriman Emina

2008-01-01

Full Text Available Paper discuss specific features of internet plan as well as planning as management process in general in the contemporary environment. No need to stress out that marketing plan and marketing planning is core activity in approaching to market. At the same time, there are a lot specific c request in preparing marketing plan comparing to business planning due to marketing plan is an essential part. The importance of internet plan and planning rely on specific features of the internet network but as a part of general corporate as well as marketing strategy.

Particular intervention plan of the Cruas-Meysse Nuclear Power Plant

International Nuclear Information System (INIS)

2013-01-01

The Particular intervention plan (PPI in French) is an emergency plan which foresees the measures and means to be implemented to address the potential risks of the presence and operation of a nuclear facility. This plan is implemented and developed by the Prefect in case of nuclear accident (or incident leading to a potential accident), the impact of which extending beyond the facility perimeter. It represents a special section of the organisation plan for civil protection response (ORSEC plan). The PPI foresees the necessary measures and means for crisis management during the first hours following the accident and is triggered by the Department Prefect according to the information provided by the facility operator. Its aim is to protect the populations leaving within 10 km of the facility against a potential radiological hazard. The PPI describes: the facility, the intervention area, the protection measures for the population, the conditions of emergency plan triggering, the crisis organisation, the action forms of the different services, and the post-accident stage. This document is the public version of the Particular intervention plan of the Cruas-Meysse NPP (Ardeche, France)

Concentration and the second stage of labor: outcomes associated with the interactive metronome.

Science.gov (United States)

McGowan, Meghan L; Lin, Alexander; Ou-Yang, Robin; Zei, Markus; Grobman, William

2012-11-01

To analyze the association between concentration, as measured by the Interactive Metronome, and a prolonged second stage of labor in nulliparous patients. From September 2008 to November 2009, nulliparous women at ≥34 weeks' gestation who were planning to use an epidural were asked to perform a 1-minute Interactive Metronome clapping test. Scores and demographic information were recorded. Data were then abstracted regarding each patient's labor course. The main outcome measure was the frequency of the second stage of labor exceeding 2 hours. Only patients with epidural anesthesia who completed the second stage of labor and did not require operative delivery performed for fetal indications prior to 2 full hours of pushing were included. Of the patients whose Interactive Metronome test scores were in the last quartile, which we associated with poor concentration, 52.9% (18/34) had a second stage of labor exceeding 2 hours compared with only 31.7% (33/104) of patients whose scores placed them in the first three quartiles (p = 0.026). Nulliparous patients with poor concentration scores, as measured by the Interactive Metronome, were more likely to push greater than 2 hours in the second stage of labor. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Second stage gasifier in staged gasification and integrated process

Science.gov (United States)

Liu, Guohai; Vimalchand, Pannalal; Peng, Wan Wang

2015-10-06

A second stage gasification unit in a staged gasification integrated process flow scheme and operating methods are disclosed to gasify a wide range of low reactivity fuels. The inclusion of second stage gasification unit operating at high temperatures closer to ash fusion temperatures in the bed provides sufficient flexibility in unit configurations, operating conditions and methods to achieve an overall carbon conversion of over 95% for low reactivity materials such as bituminous and anthracite coals, petroleum residues and coke. The second stage gasification unit includes a stationary fluidized bed gasifier operating with a sufficiently turbulent bed of predefined inert bed material with lean char carbon content. The second stage gasifier fluidized bed is operated at relatively high temperatures up to 1400.degree. C. Steam and oxidant mixture can be injected to further increase the freeboard region operating temperature in the range of approximately from 50 to 100.degree. C. above the bed temperature.

Second-stage transsphenoidal approach (TSA) for highly vascular pituicytomas in children.

Science.gov (United States)

Kim, Young Gyu; Park, Young Seok

2015-06-01

A pituicytoma in the sellar area is extremely rare in children and, due to its highly vascularized nature, can be difficult to address using the transsphenoid approach (TSA) to surgery. Here, we report a rare case of a pituicytoma that was completely removed from a child through a staged operation using the TSA. A 13-year-old girl was admitted with a 1-year history of visual disturbance and amenorrhea. Visual field examination showed left total blindness and right temporal hemianopsia. Laboratory results revealed hormonal levels all within normal ranges. Brain magnetic resonance imaging (MRI) showed a homogeneous, highly enhancing sellar and suprasellar mass, typically suggestive of a pituitary adenoma. TSA surgery revealed the tumor had a rubbery-firm consistency, hypervascularity, and profuse bleeding. We removed the tumor partially and planned a second-stage operation. Gross total removal is the treatment of choice for this type of tumor. Attempted resection of these presumed adenomas or meningiomas using the TSA often results in unexpectedly heavy intraoperative bleeding due to the high vascularity of this rare tumor, making surgery challenging, especially in children where the tumor is within a relatively narrow corridor. While pituicytomas are a rare differential diagnosis for sellar or parasellar tumors in children, total removal by second-stage TSA surgery is indicated in the case of profuse bleeding or uncertainty of biopsy. Following first-stage TSA surgery and pathologic confirmation of pituicytoma, the strategy is typically gross total removal during second-stage TSA surgery. Although very rare in children, a pituicytoma should be included in the differential diagnosis of a mass in the sellar area if the tumor is highly enhancing or very vascular. Second-stage TSA surgery is another strategy when the pathology is not clear during the first-stage TSA surgery.

Predictors of Safety and Efficacy of 2-Stage Hepatectomy for Bilateral Colorectal Liver Metastases

Science.gov (United States)

Passot, Guillaume; Chun, Yun Shin; Kopetz, Scott E; Zorzi, Daria; Brudvik, Kristoffer Watten; Kim, Bradford J; Conrad, Claudius; Aloia, Thomas A; Vauthey, Jean-Nicolas

2016-01-01

Background In patients with bilateral colorectal liver metastases (CLM) not resectable in one operation, 2-stage hepatectomy is the standard surgical approach. The objective of this study was to determine factors associated with safety and efficacy of 2-stage hepatectomy. Study Design The study included all 109 patients for whom two-stage hepatectomy for CLM was planned during 2003-2014. RAS mutation status and other clinicopathologic factors were evaluated for association with major complications and survival using multivariate analysis. Results Two-stage hepatectomy was completed in 89 of 109 patients (82%). Reasons for dropout after first stage were disease progression (n=12), insufficient liver growth (n=5), and complications after first stage or portal vein embolization (n=3). More than six cycles of preoperative chemotherapy were associated with failure to proceed to second stage (p=0.009). Rates of major complications (26% vs. 6%; p<0.001) and 90-day mortality (7% vs. 0%; p=0.006) were higher after second stage. The cumulative rate of major complications was 15% (n=29). Factors independently associated with major complications were rectal primary tumor, metachronous CLM, and more than one lesion resected at first stage. At median follow-up of 29.5 months, 3-year (68% vs. 6%; p<0.001) and 5-year overall survival rates (49% vs. 0%; p<0.001) were better after two-stage hepatectomy completion than noncompletion. Factors independently associated with poor overall survival were rectal primary tumor (p=0.044), more than five CLM (p=0.043), need for chemotherapy after first stage (p=0.046), and RAS mutation (p<0.001). Conclusions RAS mutation independently predicts the oncologic efficacy of two-stage hepatectomy and may help guide patient selection for this aggressive surgical strategy. PMID:26968325

Dynamics of general and specially trained of women-weightlifters at the stage of specialized basic training

Directory of Open Access Journals (Sweden)

Viktor Slobodyanuk

2015-04-01

Full Text Available Purpose: to determine the dynamics of the general and special training of women-weightlifters different groups weight categories for annual macrocycle at the stage of specialized basic training. Materials and Methods: indexes long jump, running 30 meters, push-ups, jumps on how Abalakova index and wrist strength athletes different schools of Ukraine. Results: found dynamic indicators of general and special training of women-weightlifters different groups weight categories at the stage of basic training six specialized schools in Ukraine. Conclusions: the results of the study provide an opportunity to consider certain indicators in planning differentiated training programs to improve the training process athletes for women-weightlifters at the stage of specialized basic training different groups weight categories in the annual macrocycle.

A common control signal and a ballistic stage can explain the control of coordinated eye-hand movements.

Science.gov (United States)

Gopal, Atul; Murthy, Aditya

2016-06-01

Voluntary control has been extensively studied in the context of eye and hand movements made in isolation, yet little is known about the nature of control during eye-hand coordination. We probed this with a redirect task. Here subjects had to make reaching/pointing movements accompanied by coordinated eye movements but had to change their plans when the target occasionally changed its position during some trials. Using a race model framework, we found that separate effector-specific mechanisms may be recruited to control eye and hand movements when executed in isolation but when the same effectors are coordinated a unitary mechanism to control coordinated eye-hand movements is employed. Specifically, we found that performance curves were distinct for the eye and hand when these movements were executed in isolation but were comparable when they were executed together. Second, the time to switch motor plans, called the target step reaction time, was different in the eye-alone and hand-alone conditions but was similar in the coordinated condition under assumption of a ballistic stage of ∼40 ms, on average. Interestingly, the existence of this ballistic stage could predict the extent of eye-hand dissociations seen in individual subjects. Finally, when subjects were explicitly instructed to control specifically a single effector (eye or hand), redirecting one effector had a strong effect on the performance of the other effector. Taken together, these results suggest that a common control signal and a ballistic stage are recruited when coordinated eye-hand movement plans require alteration. Copyright © 2016 the American Physiological Society.

Improvement Plans of Fermilab’s Proton Accelerator Complex

Science.gov (United States)

Shiltsev, Vladimir

2017-09-01

The flagship of Fermilab’s long term research program is the Deep Underground Neutrino Experiment (DUNE), located Sanford Underground Research Facility (SURF) in Lead, South Dakota, which will study neutrino oscillations with a baseline of 1300 km. The neutrinos will be produced in the Long Baseline Neutrino Facility (LBNF), a proposed new beam line from Fermilab’s Main Injector. The physics goals of the DUNE require a proton beam with a power of some 2.4 MW at 120 GeV, which is roughly four times the current maximum power. Here I discuss current performance of the Fermilab proton accelerator complex, our plans for construction of the SRF proton linac as key part of the Proton Improvement Plan-II (PIP-II), outline the main challenges toward multi-MW beam power operation of the Fermilab accelerator complex and the staged plan to achieve the required performance over the next 15 years.

Modification of staging and treatment of head and neck cancer by FDG-PET/CT prior to radiotherapy

International Nuclear Information System (INIS)

Abramyuk, A.; University Hospital Dresden; Appold, S.; Zoephel, K.; Baumann, M.; University Hospital Dresden; Abolmaali, N.; University Hospital Dresden

2013-01-01

Background and purpose: Reliable tumor staging is a fundamental pre-requisite for efficient tumor therapy and further prognosis. The aim of this study was to compare head and neck cancer (HNC) staging before and after FDG-PET/CT, evaluating the stage modifications for radiotherapy (RT) planning. Patients and methods: A total of 102 patients with untreated primary HNC, who underwent conventional staging and staging including FDG-PET/CT before RT, were enrolled in this retrospective study. Blinded pre-FDG-PET/CT and post-FDG-PET/CT staging data were compared. The impact on patient management was tested by comparing the intention before and after FDG-PET/CT. Results: Significant modifications of T, N, and M stage as well as clinical stage were detected after inclusion of FDG-PET/CT data (p = 0.002, 0.0006, 0.001, 0.03, respectively). Overall, the implementation of FDG-PET/CT led to modification of RT intention decision in 14 patients. Conclusions: FDG-PET/CT demonstrates essential influence on tumor staging in HNC patients scheduled for irradiation. Implementation of FDG-PET/CT in imaging protocol improves selection of candidates for curative and palliative RT and allows further optimization of treatment management and therapy intention. (orig.)

Quantitative analysis of tumor shrinkage due to chemotherapy and its implication for radiation treatment planning in limited-stage small-cell lung cancer

International Nuclear Information System (INIS)

Xia, Bing; Wang, Jia-Zhou; Liu, Qi; Cheng, Jing-Yi; Zhu, Zheng-Fei; Fu, Xiao-Long

2013-01-01

The optimal timing of chemoradiotherapy in limited-stage small-cell lung cancer (LS-SCLC) hasn’t been established, although evidence from studies supported that patients can benefit from early radiation therapy. The purpose of this study was to quantify tumor shrinkage in response to induction chemotherapy (IC), evaluate the impact of tumor shrinkage on radiation dosimetric parameters and determine its implication for the timing of radiation therapy for patients with LS-SCLC. Twenty patients with LS-SCLC who were treated with IC followed by concomitant radiation therapy were investigated retrospectively. Ten patients received 1 cycle of IC, and 10 patients received 2 cycles of IC. Pre-IC CT imaging was coregistered with a simulation CT, and virtual radiation plans were created for pre- and post-IC thoracic disease in each case. The changes in the gross target volume (GTV), planning target volume (PTV) and dosimetric factors associated with the lungs, esophagus and heart were analyzed. The mean GTV and PTV for all of the patients decreased by 60.9% and 40.2%, respectively, which resulted in a significant reduction in the radiation exposure to the lungs, esophagus and heart. Changes in the PTV and radiation exposure of normal tissue were not significantly affected by the number of chemotherapy cycles delivered, although patients who received 2 cycles of IC had a greater decrease in GTV than those who received only 1 cycle of IC (69.6% vs. 52.1%, p = 0.273). Our data showed that targeting the tumor post-IC may reduce the radiation dose to normal tissue in patients with LS-SCLC. However, the benefit to the normal tissue was not increased by an additional cycle of IC. These findings suggest that the first cycle of chemotherapy is very important for tumor shrinkage and that initiating thoracic radiation therapy at the second cycle of chemotherapy may be a reasonable strategy for timing of radiation therapy in LS-SCLC treatment

Improving operational effectiveness of tactical master plans for emergency and elective patients under stochastic demand and capacitated resources

NARCIS (Netherlands)

Adan, I.J.B.F.; Bekkers, J.A.; Dellaert, N.P.; Jeunet, J.; Vissers, J.M.H.

2009-01-01

This paper develops a two-stage planning procedure for master planning of elective and emergency patients while allocating at best the available hospital resources. Four types of resources are considered: operating theatre, beds in the medium and in the intensive care units, and nursing hours in the

Improving operational effectiveness of tactical master plans for emergency and elective patients under stochastic demand and capacitated resources

NARCIS (Netherlands)

Adan, I.J.B.F.; Bekkers, J.A.; Dellaert, N.P.; Jeunet, J.; Vissers, Jan

2011-01-01

This paper develops a two-stage planning procedure for master planning of elective and emergency patients while allocating at best the available hospital resources. Four types of resources are considered: operating theatre, beds in the medium and in the intensive care units, and nursing hours in the

Prostate cancer staging

Science.gov (United States)

... this page: //medlineplus.gov/ency/patientinstructions/000397.htm Prostate cancer staging To use the sharing features on this ... trials you may be able to join How Prostate Cancer Staging is Done Initial staging is based on ...

Comparative effectiveness of one-stage versus two-stage basilic vein transposition arteriovenous fistulas.

Science.gov (United States)

Ghaffarian, Amir A; Griffin, Claire L; Kraiss, Larry W; Sarfati, Mark R; Brooke, Benjamin S

2018-02-01

Basilic vein transposition (BVT) fistulas may be performed as either a one-stage or two-stage operation, although there is debate as to which technique is superior. This study was designed to evaluate the comparative clinical efficacy and cost-effectiveness of one-stage vs two-stage BVT. We identified all patients at a single large academic hospital who had undergone creation of either a one-stage or two-stage BVT between January 2007 and January 2015. Data evaluated included patient demographics, comorbidities, medication use, reasons for abandonment, and interventions performed to maintain patency. Costs were derived from the literature, and effectiveness was expressed in quality-adjusted life-years (QALYs). We analyzed primary and secondary functional patency outcomes as well as survival during follow-up between one-stage and two-stage BVT procedures using multivariate Cox proportional hazards models and Kaplan-Meier analysis with log-rank tests. The incremental cost-effectiveness ratio was used to determine cost savings. We identified 131 patients in whom 57 (44%) one-stage BVT and 74 (56%) two-stage BVT fistulas were created among 8 different vascular surgeons during the study period that each performed both procedures. There was no significant difference in the mean age, male gender, white race, diabetes, coronary disease, or medication profile among patients undergoing one- vs two-stage BVT. After fistula transposition, the median follow-up time was 8.3 months (interquartile range, 3-21 months). Primary patency rates of one-stage BVT were 56% at 12-month follow-up, whereas primary patency rates of two-stage BVT were 72% at 12-month follow-up. Patients undergoing two-stage BVT also had significantly higher rates of secondary functional patency at 12 months (57% for one-stage BVT vs 80% for two-stage BVT) and 24 months (44% for one-stage BVT vs 73% for two-stage BVT) of follow-up (P < .001 using log-rank test). However, there was no significant difference

Recommendations for the use of PET and PET-CT for radiotherapy planning in research projects.

Science.gov (United States)

Somer, E J; Pike, L C; Marsden, P K

2012-08-01

With the increasing use of positron emission tomography (PET) for disease staging, follow-up and therapy monitoring in a number of oncological indications there is growing interest in the use of PET and PET-CT for radiation treatment planning. In order to create a strong clinical evidence base for this, it is important to ensure that research data are clinically relevant and of a high quality. Therefore the National Cancer Research Institute PET Research Network make these recommendations to assist investigators in the development of radiotherapy clinical trials involving the use of PET and PET-CT. These recommendations provide an overview of the current literature in this rapidly evolving field, including standards for PET in clinical trials, disease staging, volume delineation, intensity modulated radiotherapy and PET-augmented planning techniques, and are targeted at a general audience. We conclude with specific recommendations for the use of PET in radiotherapy planning in research projects.

Computer Based Assessment of Cervical Vertebral Maturation Stages Using Digital Lateral Cephalograms.

Science.gov (United States)

Dzemidzic, Vildana; Sokic, Emir; Tiro, Alisa; Nakas, Enita

2015-12-01

This study was aimed to investigate the reliability of a computer application for assessment of the stages of cervical vertebra maturation in order to determine the stage of skeletal maturity. For this study, digital lateral cephalograms of 99 subjects (52 females and 47 males) were examined. The following selection criteria were used during the sample composition: age between 9 and 16 years, absence of anomalies of the vertebrae, good general health, no history of trauma at the cervical region. Subjects with lateral cephalograms of low quality were excluded from the study. For the purpose of this study a computer application Cephalometar HF V1 was developed. This application was used to mark the contours of the second, third and fourth cervical vertebrae on the digital lateral cephalograms, which enabled a computer to determine the stage of cervical vertebral maturation. The assessment of the stages of cervical vertebral maturation was carried out by an experienced orthodontist. The assessment was conducted according to the principles of the method proposed by authors Hassel and Farman. The degree of the agreement between the computer application and the researcher was analyzed using by statistical Cohen Kappa test. The results of this study showed the agreement between the computer assessment and the researcher assessment of the cervical vertebral maturation stages, where the value of the Cohen Kappa coefficient was 0.985. The computer application Cephalometar HF V1 proved to be a reliable method for assessing the stages of cervical vertebral maturation. This program could help the orthodontists to identify the stage of cervical vertebral maturation when planning the orthodontic treatment for the patients with skeletal disharmonies.

The national plan of radioactive materials and wastes management. 2010-2012 edition

International Nuclear Information System (INIS)

2010-01-01

This short presentation, given by the nuclear safety authority (ASN) at the meeting of January 26, 2010 of the high committee for the nuclear safety transparency and information (HCTISN), describes the different stages of the elaboration of the new edition of the French national plan of radioactive materials and wastes management (PNGMDR). The plan comprises 3 parts: the principles and objectives of the radioactive materials and wastes management, the status of existing procedures and of procedures still under development by the end of 2009, the improvements made. The topics concern: the interim storage, the long-term management and the global consistency of the plan. (J.S.)

To evaluate disparity between clinical and pathological tumor-node-metastasis staging in oral cavity squamous cell carcinoma patients and its impact on overall survival: An institutional study.

Science.gov (United States)

Gupta, Karan; Panda, Naresh K; Bakshi, Jaimanti; Das, Ashim

2015-01-01

Accurate clinical staging is important for patient counseling, treatment planning, prognostication, and rational design of clinical trials. In head and neck squamous cell carcinoma, discrepancy between clinical and pathological staging has been reported. To evaluate any disparity between clinical and pathological tumor-node-metastasis (TNM) staging in oral cavity squamous cell carcinoma (OCSCC) patients and any impact of the same on survival. Retrospective chart review from year 2007 to 2013, at a tertiary care center. All survival analyses were performed using SPSS for Windows version 15 (Chicago, IL, USA). Disease-free survival curves were generated using Kaplan-Meier algorithm. One hundred and twenty-seven patients with OCSCC were analyzed. Seventy-nine (62.2%) were males and 48 (37.8%) females with a mean age at presentation 43.6 years (29-79 years). The highest congruence between clinical and pathological T-staging seen for clinical stage T1 and T4 at 76.9% and 73.4% with pathological T-stage. Similarly, the highest congruence between clinical and pathological N-stage seen for clinical N0 and N3 at 86.4% and 91.7% with pathological N-stage. Of clinically early stage patients, 67.5% remained early stage, and 32.5% were upstaged to advanced stage following pathological analysis. Of the clinically advanced stage patients, 75% remained advanced, and 25% were pathologically downstaged. This staging discrepancy did not significantly alter the survival. Some disparity exists in clinical and pathological TNM staging of OCSCC, which could affect treatment planning and survival of patients. Hence, more unified and even system of staging for the disease is required for proper decision-making.

The influence of magnetic field strength in ionization stage on ion transport between two stages of a double stage Hall thruster

International Nuclear Information System (INIS)

Yu Daren; Song Maojiang; Li Hong; Liu Hui; Han Ke

2012-01-01

It is futile for a double stage Hall thruster to design a special ionization stage if the ionized ions cannot enter the acceleration stage. Based on this viewpoint, the ion transport under different magnetic field strengths in the ionization stage is investigated, and the physical mechanisms affecting the ion transport are analyzed in this paper. With a combined experimental and particle-in-cell simulation study, it is found that the ion transport between two stages is chiefly affected by the potential well, the potential barrier, and the potential drop at the bottom of potential well. With the increase of magnetic field strength in the ionization stage, there is larger plasma density caused by larger potential well. Furthermore, the potential barrier near the intermediate electrode declines first and then rises up while the potential drop at the bottom of potential well rises up first and then declines as the magnetic field strength increases in the ionization stage. Consequently, both the ion current entering the acceleration stage and the total ion current ejected from the thruster rise up first and then decline as the magnetic field strength increases in the ionization stage. Therefore, there is an optimal magnetic field strength in the ionization stage to guide the ion transport between two stages.

Participatory soil and water conservation planning using a financial analysis tool in the west usambara highlands of tanzania

NARCIS (Netherlands)

Tenge, A.J.M.; Okoba, B.O.; Sterk, G.

2007-01-01

Despite decades of soil and water conservation (SWC) efforts in Tanzania, the adoption of the recommended SWC measures by farmers is minimal. In the past, SWC plans did not incorporate farmers' knowledge, and the economics of SWC was not given much attention at the planning stage. This research

Association of Aldosterone and Cortisol with Cardiovascular Risk Factors in Prehypertension Stage

Directory of Open Access Journals (Sweden)

Sadiqa Badar Syed

2012-01-01

Full Text Available Background. The Pakistani population has higher incidence of cardiovascular (CV diseases at younger ages, due to undiagnosed, uncontrolled hypertension (HTN. A variety of associated HTN stressors is also reported. The study plans to understand the variables associated with initiation of HTN in this population. Objective. To find plasma aldosterone and cortisol relationship with some CV risk factors (obesity, dyslipidemia, hyperglycemia, sodium and potassium in different stages of HTN particularly prehypertension. Subjects and Methods. The study conducted on 276 subjects (25–60 years, classified into prehypertensive (=55, HTN stage-1 (=70 and II (=76 according to 7th JNC report and compared with normotensive controls (=75. The anthropometric profiles (height, weight, waist circumference, Body Mass index and BP recorded. Serum cortisol, aldosterone, total cholesterol, Low density lipoproteins, blood glucose, Na+ and K+, using standard laboratory techniques, were determined in fasting blood samples. Results. Subjects were mostly overweight and obese (80%, 90%, and 76% in pre-HTN, stage-I and II versus 69% in controls. The aldosterone level (ng/dl was in higher normal range (9.17–12.41 and significantly correlated to BMI (0.587 in controls, and to TC (0.726 and LDL (0.620 in pre-HTN stage-I. The cortisol level was positively correlated (25. Conclusion. Pre-HTN stage among Pakistani population with successive increase in various risk factors of HTN in relation to aldosterone and cortisol has been identified. Interaction of the risk factors with endogenous levels of these hormones may initiate stages of HTN.

Significant clinical impact and prognostic stratification provided by FDG-PET in the staging of oesophageal cancer

International Nuclear Information System (INIS)

Duong, Cuong P.; Demitriou, Helen; Thompson, Anne; Williams, David; Thomas, Robert J.S.; Weih, LeAnn; Hicks, Rodney J.

2006-01-01

To evaluate the clinical impact of FDG-PET in staging oesophageal cancer and whether this information improves prognostic stratification. Impact was based on comparison of a prospectively recorded pre-PET plan with post-PET treatment in 68 consecutive patients undergoing primary staging. Survival was analysed using the Kaplan-Meier product limit method and the Cox proportional hazards regression model. FDG-PET findings impacted on the management of 27/68 patients (40%): in 12 therapy was changed from curative to palliative and in three from palliative to curative, while in 12 other patients there was a change in the treatment modality or delivery but not in the treatment intent. The median survival was 21 months, with post-PET stage and treatment intent both strongly associated with survival (p<0.001). Conventional stage was not able to clearly stratify this population. The use of FDG-PET for primary staging of oesophageal cancer changed the clinical management of more than one-third of patients and provided superior prognostic stratification compared with conventional investigations. (orig.)

Optics of two-stage photovoltaic concentrators with dielectric second stages

Science.gov (United States)

Ning, Xiaohui; O'Gallagher, Joseph; Winston, Roland

1987-04-01

Two-stage photovoltaic concentrators with Fresnel lenses as primaries and dielectric totally internally reflecting nonimaging concentrators as secondaries are discussed. The general design principles of such two-stage systems are given. Their optical properties are studied and analyzed in detail using computer ray trace procedures. It is found that the two-stage concentrator offers not only a higher concentration or increased acceptance angle, but also a more uniform flux distribution on the photovoltaic cell than the point focusing Fresnel lens alone. Experimental measurements with a two-stage prototype module are presented and compared to the analytical predictions.

Optics of two-stage photovoltaic concentrators with dielectric second stages.

Science.gov (United States)

Ning, X; O'Gallagher, J; Winston, R

1987-04-01

Two-stage photovoltaic concentrators with Fresnel lenses as primaries and dielectric totally internally reflecting nonimaging concentrators as secondaries are discussed. The general design principles of such two-stage systems are given. Their optical properties are studied and analyzed in detail using computer ray trace procedures. It is found that the two-stage concentrator offers not only a higher concentration or increased acceptance angle, but also a more uniform flux distribution on the photovoltaic cell than the point focusing Fresnel lens alone. Experimental measurements with a two-stage prototype module are presented and compared to the analytical predictions.

Multiple stage railgun

International Nuclear Information System (INIS)

Aaland, K.; Hawke, R.S.; Scudder, J.K.

1982-01-01

A multiple stage magnetic railgun accelerator for accelerating a projectile by movement of a plasma arc along the rails. The railgun is divided into a plurality of successive rail stages which are sequentially energized by separate energy sources as the projectile moves through the bore of the railgun. Propagation of energy from an energized rail stage back towards the breech end of the railgun can be prevented by connection of the energy sources to the rails through isolation diodes. Propagation of energy from an energized rail stage back towards the breech end of the railgun can also be prevented by dividing the rails into electrically isolated rail sections. In such case means are used to extinguish the arc at the end of each energized stage and a fuse or laser device is used to initiate a new plasma arc in the next energized rail stage

The protection motivation theory within the stages of the transtheoretical model - stage-specific interplay of variables and prediction of exercise stage transitions.

Science.gov (United States)

Lippke, Sonia; Plotnikoff, Ronald C

2009-05-01

Two different theories of health behaviour have been chosen with the aim of theory integration: a continuous theory (protection motivation theory, PMT) and a stage model (transtheoretical model, TTM). This is the first study to test whether the stages of the TTM moderate the interrelation of PMT-variables and the mediation of motivation, as well as PMT-variables' interactions in predicting stage transitions. Hypotheses were tested regarding (1) mean patterns, stage pair-comparisons and nonlinear trends using ANOVAs; (2) prediction-patterns for the different stage groups employing multi-group structural equation modelling (MSEM) and nested model analyses; and (3) stage transitions using binary logistic regression analyses. Adults (N=1,602) were assessed over a 6 month period on their physical activity stages, PMT-variables and subsequent behaviour. (1) Particular mean differences and nonlinear trends in all test variables were found. (2) The PMT adequately fitted the five stage groups. The MSEM revealed that covariances within threat appraisal and coping appraisal were invariant and all other constrains were stage-specific, i.e. stage was a moderator. Except for self-efficacy, motivation fully mediated the relationship between the social-cognitive variables and behaviour. (3) Predicting stage transitions with the PMT-variables underscored the importance of self-efficacy. Only when threat appraisal and coping appraisal were high, stage movement was more likely in the preparation stage. Results emphasize stage-specific differences of the PMT mechanisms, and hence, support the stage construct. The findings may guide further theory building and research integrating different theoretical approaches.

Lighting and cooling energy consumption in an open-plan office using solar film coating

International Nuclear Information System (INIS)

Li, Danny H.W.; Lam, Tony N.T.; Wong, S.L.; Tsang, Ernest K.W.

2008-01-01

In subtropical Hong Kong, solar heat gain via glazing contributes to a significant proportion of the building envelope cooling load. The principal fenestration design includes eliminating direct sunlight and reducing cooling requirements. Daylighting is an effective approach to allow a flexible building facade design strategy, and to enhance an energy-efficient and green building development. This paper studies the lighting and cooling energy performances for a fully air-conditioned open-plan office when solar control films together with daylight-linked lighting controls are being used. Measurements were undertaken at two stages including the electricity expenditures for the office using photoelectric dimming controls only (first stage) and together with the solar control film coatings on the windows (second stage). Electric lighting and cooling energy consumption, transmitted daylight illuminance and solar radiation were systematically recorded and analysed. The measured data were also used for conducting and validating the building energy simulations. The findings showed that the solar film coatings coupled with lighting dimming controls cut down 21.2% electric lighting and 6.9% cooling energy consumption for the open-plan office

US/Canada wheat and barley crop calender exploratory experiment implementation plan

Science.gov (United States)

1980-01-01

A plan is detailed for a supplemental experiment to evaluate several crop growth stage models and crop starter models. The objective of this experiment is to provide timely information to aid in understanding crop calendars and to provide data that will allow a selection between current crop calendar models.

Planning magnetic resonance imaging for prostate cancer intensity-modulated radiation therapy: Impact on target volumes, radiotherapy dose and androgen deprivation administration.

Science.gov (United States)

Horsley, Patrick J; Aherne, Noel J; Edwards, Grace V; Benjamin, Linus C; Wilcox, Shea W; McLachlan, Craig S; Assareh, Hassan; Welshman, Richard; McKay, Michael J; Shakespeare, Thomas P

2015-03-01

Magnetic resonance imaging (MRI) scans are increasingly utilized for radiotherapy planning to contour the primary tumors of patients undergoing intensity-modulated radiation therapy (IMRT). These scans may also demonstrate cancer extent and may affect the treatment plan. We assessed the impact of planning MRI detection of extracapsular extension, seminal vesicle invasion, or adjacent organ invasion on the staging, target volume delineation, doses, and hormonal therapy of patients with prostate cancer undergoing IMRT. The records of 509 consecutive patients with planning MRI scans being treated with IMRT for prostate cancer between January 2010 and July 2012 were retrospectively reviewed. Tumor staging and treatment plans before and after MRI were compared. Of the 509 patients, 103 (20%) were upstaged and 44 (9%) were migrated to a higher risk category as a result of findings at MRI. In 94 of 509 patients (18%), the MRI findings altered management. Ninety-four of 509 patients (18%) had a change to their clinical target volume (CTV) or treatment technique, and in 41 of 509 patients (8%) the duration of hormone therapy was changed because of MRI findings. The use of radiotherapy planning MRI altered CTV design, dose and/or duration of androgen deprivation in 18% of patients in this large, single institution series of men planned for dose-escalated prostate IMRT. This has substantial implications for radiotherapy target volumes and doses, as well as duration of androgen deprivation. Further research is required to investigate whether newer MRI techniques can simultaneously fulfill staging and radiotherapy contouring roles. © 2014 Wiley Publishing Asia Pty Ltd.

Design considerations for single-stage and two-stage pneumatic pellet injectors

International Nuclear Information System (INIS)

Gouge, M.J.; Combs, S.K.; Fisher, P.W.; Milora, S.L.

1988-09-01

Performance of single-stage pneumatic pellet injectors is compared with several models for one-dimensional, compressible fluid flow. Agreement is quite good for models that reflect actual breech chamber geometry and incorporate nonideal effects such as gas friction. Several methods of improving the performance of single-stage pneumatic pellet injectors in the near term are outlined. The design and performance of two-stage pneumatic pellet injectors are discussed, and initial data from the two-stage pneumatic pellet injector test facility at Oak Ridge National Laboratory are presented. Finally, a concept for a repeating two-stage pneumatic pellet injector is described. 27 refs., 8 figs., 3 tabs

Stages of Agricultural Land Consolidation in Ukraine with Consideration for International Best Practices

Directory of Open Access Journals (Sweden)

Popov Andriy S.

2017-03-01

Full Text Available The aim of the article is to develop recommendations on defining stages of consolidation of agricultural land in Ukraine on the basis of the best international practices. The analysis, systematization and generalization of scientific works of domestic and foreign scientists made it possible to determine a possible order of land consolidation in Ukraine and provide a detailed description of each stage. As a result of the research, the following main stages of land consolidation were proposed: the initiation, inventory, planning, implementation and final one. Each of these stages is considered consistently with justification of its expediency, the list of necessary measures and land management documentation, presentation of practical examples from different countries of the world. It is determined that each stage of the land consolidation procedure should be conducted in compliance with the principle of openness, which ensures the involvement of the maximum number of landowners/land users and protection of their interests, creates a positive attitude of the society towards land consolidation. A structural and logical model of the procedure for consolidating agricultural land, which clearly reflects the stages and activities of its implementation, is drawn up. There presented recommendations on the need to introduce new land management documentation for land consolidation with a detailed description of their essence. The relevance of further studies of the procedure for the agricultural land consolidation is in bringing a flexible, simple, cost-effective and short-term approach to its implementation.

Influence of temporal and spatial factors on abundance and richness of fish early stages in shallow tropical estuaries

NARCIS (Netherlands)

Arévalo-Frías, W.; Mendoza-Carranza, M.

2015-01-01

Accurate determination of abundance and richness of fish early stages in estuarine zones is critical to support management and protection plans; it is therefore necessary to consider all influential factors. Habitat diversity, seasonality, moon phase and diel variations, and their interactions are

Assessment of capabilities in persons with advanced stage of dementia: Validation of The Montessori Assessment System (MAS).

Science.gov (United States)

Erkes, Jérôme; Camp, Cameron J; Raffard, Stéphane; Gély-Nargeot And, Marie-Christine; Bayard, Sophie

2017-01-01

This study evaluated the validity and reliability of the Montessori Assessment System. The Montessori Assessment System assesses preserved abilities in persons with moderate to severe dementia. In this respect, this instrument provides crucial information for the development of effective person-centered care plans. A total of 196 persons with a diagnosis of dementia in the moderate to severe stages of dementia were recruited in 10 long-term care facilities in France. All participants completed the Montessori Assessment System, the Clinical Dementia Rating Scale and/or the Mini Mental State Examination and the Severe Impairment Battery-short form. The internal consistency and temporal stability of the Montessori Assessment System were high. Additionally, good construct and divergent validity were demonstrated. Factor analysis showed a one-factor structure. The Montessori Assessment System demonstrated satisfactory psychometric properties while being a useful instrument to assess capabilities in persons with advanced stages of dementia and hence to develop person-centered plans of care.

Participatory planning intercultural: Reflections for social work

Directory of Open Access Journals (Sweden)

Esperanza Gómez Hernández

2012-01-01

Full Text Available Since the nineties, participatory planning has emerged as a linking strategy for various social, political, economic and cultural sectors that assessed it as a potential for building consensus in the making of local processes forsocial improvement. Similarly, it was legitimized as a setting for practice for professionals trained in the social sciences, mainly Social Work. This article, from a geopolitical and geo-cultural perspective, presents contextual elements that determined the configuration of participatory planning in Latin America. These elements shall be staged in order to redefine diversity and the intercultural perspective that has been linked to this mobilizing strategy, against the institutionalized discourse of development and for the emergence of crisis and ruptures with this social paradigm from other practices and worldviews of life in the territories.

A time consistent risk averse three-stage stochastic mixed integer optimization model for power generation capacity expansion

International Nuclear Information System (INIS)

Pisciella, P.; Vespucci, M.T.; Bertocchi, M.; Zigrino, S.

2016-01-01

We propose a multi-stage stochastic optimization model for the generation capacity expansion problem of a price-taker power producer. Uncertainties regarding the evolution of electricity prices and fuel costs play a major role in long term investment decisions, therefore the objective function represents a trade-off between expected profit and risk. The Conditional Value at Risk is the risk measure used and is defined by a nested formulation that guarantees time consistency in the multi-stage model. The proposed model allows one to determine a long term expansion plan which takes into account uncertainty, while the LCoE approach, currently used by decision makers, only allows one to determine which technology should be chosen for the next power plant to be built. A sensitivity analysis is performed with respect to the risk weighting factor and budget amount. - Highlights: • We propose a time consistent risk averse multi-stage model for capacity expansion. • We introduce a case study with uncertainty on electricity prices and fuel costs. • Increased budget moves the investment from gas towards renewables and then coal. • Increased risk aversion moves the investment from coal towards renewables. • Time inconsistency leads to a profit gap between planned and implemented policies.

A New Two-Stage Approach to Short Term Electrical Load Forecasting

Directory of Open Access Journals (Sweden)

Dragan Tasić

2013-04-01

Full Text Available In the deregulated energy market, the accuracy of load forecasting has a significant effect on the planning and operational decision making of utility companies. Electric load is a random non-stationary process influenced by a number of factors which make it difficult to model. To achieve better forecasting accuracy, a wide variety of models have been proposed. These models are based on different mathematical methods and offer different features. This paper presents a new two-stage approach for short-term electrical load forecasting based on least-squares support vector machines. With the aim of improving forecasting accuracy, one more feature was added to the model feature set, the next day average load demand. As this feature is unknown for one day ahead, in the first stage, forecasting of the next day average load demand is done and then used in the model in the second stage for next day hourly load forecasting. The effectiveness of the presented model is shown on the real data of the ISO New England electricity market. The obtained results confirm the validity advantage of the proposed approach.

Stages in planning and construction of the Muelheim-Kaerlich nuclear power station

International Nuclear Information System (INIS)

Pracht, F.

1975-01-01

On October 23, 1972, RWE gave a letter of intent and on January 9, 1973 an order for the construction of a nuclear power plant on a turn-key basis to the consortium of BBC, BBR and Hochtief. The power plant in question was the Muelheim-Kaerlich nuclear power station with a pressurized-water reactor of a gross efficiency of 1,295 MWe. After considerable delay of the project, the first building permit was issued to the builder-owner on January 15, 1975, and the constructional work on the building site started immediately afterwards. As the planning and constructional work has so far been carried out according to schedule and the consortium intends to keep the effects of the belated license as small as possible, the start-off of the plant will probably be in summer 1979 if the constructional work is not interrupted. (orig./AK) [de

Using a concept map as a tool for strategic planning: The Healthy Brain Initiative.

Science.gov (United States)

Anderson, Lynda A; Day, Kristine L; Vandenberg, Anna E

2011-09-01

Concept mapping is a tool to assist in strategic planning that allows planners to work through a sequence of phases to produce a conceptual framework. Although several studies describe how concept mapping is applied to various public health problems, the flexibility of the methods used in each phase of the process is often overlooked. If practitioners were more aware of the flexibility, more public health endeavors could benefit from using concept mapping as a tool for strategic planning. The objective of this article is to describe how the 6 concept-mapping phases originally outlined by William Trochim guided our strategic planning process and how we adjusted the specific methods in the first 2 phases to meet the specialized needs and requirements to create The Healthy Brain Initiative: A National Public Health Road Map to Maintaining Cognitive Health. In the first stage (phases 1 and 2 of concept mapping), we formed a steering committee, convened 4 work groups over a period of 3 months, and generated an initial set of 42 action items grounded in science. In the second stage (phases 3 and 4), we engaged stakeholders in sorting and rating the action items and constructed a series of concept maps. In the third and final stage (phases 5 and 6), we examined and refined the action items and generated a final concept map consisting of 44 action items. We then selected the top 10 action items, and in 2007, we published The Healthy Brain Initiative: A National Public Health Road Map to Maintaining Cognitive Health, which represents the strategic plan for The Healthy Brain Initiative.

Legal protection against outline operating plans under mining law; Rechtsschutz gegen Rahmenbetriebsplaene im Bergrecht

Energy Technology Data Exchange (ETDEWEB)

Schmitz, Holger; Mausch, Marlen [Rechtsanwaltskanzlei Noerr LLP, Berlin (Germany)

2011-03-15

In the outline planning for a mining project the question of to what extent the interests of potentially affected surface owners must be taken into account at this early stage of project planning regularly arises. In this contribution the authors explain after a brief introduction to the subject the current jurisdiction of the Federal Administrative Court in respect of the corresponding legal requirements on the outline operating plants, the legal effects of the approval of an outline operating plan and the right of the surface owners to contest the operating plan approval. In addition the permissibility of the initial treatment of owner interests in subsequent special operating plans is described. It is evident that the binding effect of the outline operating plans on the one hand and the transfer of owner interests to special operating plans on the other conflict to a certain extent. (orig.)

Modified allocation capacitated planning model in blood supply chain management

Science.gov (United States)

Mansur, A.; Vanany, I.; Arvitrida, N. I.

2018-04-01

Blood supply chain management (BSCM) is a complex process management that involves many cooperating stakeholders. BSCM involves four echelon processes, which are blood collection or procurement, production, inventory, and distribution. This research develops an optimization model of blood distribution planning. The efficiency of decentralization and centralization policies in a blood distribution chain are compared, by optimizing the amount of blood delivered from a blood center to a blood bank. This model is developed based on allocation problem of capacitated planning model. At the first stage, the capacity and the cost of transportation are considered to create an initial capacitated planning model. Then, the inventory holding and shortage costs are added to the model. These additional parameters of inventory costs lead the model to be more realistic and accurate.

Addendum to ''Test Plan: Small-Scale Seal Performance Tests (SSSPT)''

International Nuclear Information System (INIS)

Finley, R.E.

1992-01-01

This document describes activities that are intended to update the data base of fluid flow measurements made on expansive salt concrete (ESC) seals as part of the Small-Scale Seal Performance Tests (SSSPT). The original plans for the SSSPT experiments are described by Stormont (1985a and 1985b). These seals have previously been tested with brine and gas during the early stages (less than 450 days) after emplacement. The purpose of this Test Plan Addendum is to detail the activities necessary to, update the gas and brine measurements previously performed on the SSSPT Series A and Series B seals and to identify the key personnel responsible for implementing these activities. This addendum describes a limited undertaking and does NOT change the scope of the original test plan

[Optimization of radiotherapy planning for non-small cell lung cancer (NSCLC) using 18FDG-PET].

Science.gov (United States)

Schmidt, S; Nestle, U; Walter, K; Licht, N; Ukena, D; Schnabel, K; Kirsch, C M

2002-10-01

In recent years, FDG-PET examinations have become more important for problems in oncology, especially in staging of bronchogenic carcinoma. In the retrospective study presented here, the influence of PET on the planning of radiotherapy for patients with non-small-cell lung cancer (NSCLC) was investigated. The study involved 39 patients with NSCLC who had been examined by PET for staging. They received radiotherapy on the basis of the anterior/posterior portals including the primary tumour and the mediastinum planned according to CT- and bronchoscopic findings. The results of the PET examination were not considered in initial radiotherapy planning. The portals were retrospectively redefined on the basis of FDG uptake considering the size and localization of the primary tumour; and FDG activities outside the mediastinal part of the portals. In 15 out of 39 patients, the CT/PET-planned portals differed from the CT-planned ones. In most causes (n = 12) the CT/PET field was smaller than the CT field. The median geometric field size of the portals was 179 cm2, after redefinition using PET 166 cm2. In 20 patients with disturbed ventilation caused by the tumour (atelectasis, dystelectosis), a correction of the portal was suggested significantly more frequently than in the other patients (p = 0.03). Our results demonstrate the synergism of topographical (CT) and metabolic (FDG-PET) information, which could be helpful in planning radiotherapy of bronchial carcinoma, especially for patients with disturbed ventilation.

Career planning and development for nurses: the time has come.

Science.gov (United States)

Donner, G J; Wheeler, M M

2001-06-01

Developments in how the nursing profession is perceived by nurses and by society, along with unparalleled changes in health care systems, have created an environment in which individual nurses must take control of their careers and futures. Educators, employers and professional organizations also have a key role to play in fostering the career planning and development of nurses, usually the largest employee group in most health care organizations. This article provides an overview of what career planning and development is and why it is important for nurses. A career planning and development model is described that provides nurses with a focused strategy to take greater responsibility for engaging in the ongoing planning process that is crucial throughout the major stages of their career. Finally, educators, employers and professional organizations are challenged to collaborate with individual nurses on career-development activities that will enable nurses to continue to provide high-quality care in ever-changing health care systems.

Surgery or radiation therapy for Stage I and IIA carcinoma of the cervix

International Nuclear Information System (INIS)

Brady, L.W.

1979-01-01

The choice of treatment in carcinoma of the cervix is best decided after careful individual appraisal has been carried out. For best results, a long-term view must be agreed upon initially and careful followup by the same team is obligatory. At present, surgery, radiation therapy, and a combination of these two modalities have been employed successfully to manage carcinoma of the cervix. To a great extent, the facilities, the experience, and the interest of the personnel involved influence the type of therapy that will be employed. Generally speaking, the choice of treatment is determined primarily by the stage of the disease process. Radical surgery in the management of patients with Stage I and Stage II-A carcinoma of the cervix must be planned to include within the en bloc dissection the uterus, tubes, ovaries, and regional lymph node drainage from those organs. Therefore, a radical lymphadnectomy is an integral and important part of the overall management program when radical surgery is performed. In most institutions, radiation therapy is used most frequently to treat carcinoma of the cervix in Stages I and II-A. The data from various institutions indicate significant survival potential from radiation therapy treatment programs that are appropriately devised. In Stages I and II-A the complications are minimal in character (primarily proctitis and cystitis); generally, they involve a potential incidence of about six percent

Turbine stage model

International Nuclear Information System (INIS)

Kazantsev, A.A.

2009-01-01

A model of turbine stage for calculations of NPP turbine department dynamics in real time was developed. The simulation results were compared with manufacturer calculations for NPP low-speed and fast turbines. The comparison results have shown that the model is valid for real time simulation of all modes of turbines operation. The model allows calculating turbine stage parameters with 1% accuracy. It was shown that the developed turbine stage model meets the accuracy requirements if the data of turbine blades setting angles for all turbine stages are available [ru

Integrated Strategic Planning of Global Production Networks and Financial Hedging under Uncertain Demands and Exchange Rates

Directory of Open Access Journals (Sweden)

Achim Koberstein

2013-11-01

Full Text Available In this paper, we present a multi-stage stochastic programming model that integrates financial hedging decisions into the planning of strategic production networks under uncertain exchange rates and product demands. This model considers the expenses of production plants and the revenues of markets in different currency areas. Financial portfolio planning decisions for two types of financial instruments, forward contracts and options, are represented explicitly by multi-period decision variables and a multi-stage scenario tree. Using an illustrative example, we analyze the impact of exchange-rate and demand volatility, the level of investment expenses and interest rate spreads on capacity location and dimensioning decisions. In particular, we show that, in the illustrative example, the exchange-rate uncertainty cannot be completely eliminated by financial hedging in the presence of demand uncertainty. In this situation, we find that the integrated model can result in better strategic planning decisions for a risk-averse decision maker compared to traditional modeling approaches.

Twin Birth Study: 2-year neurodevelopmental follow-up of the randomized trial of planned cesarean or planned vaginal delivery for twin pregnancy.

Science.gov (United States)

Asztalos, Elizabeth V; Hannah, Mary E; Hutton, Eileen K; Willan, Andrew R; Allen, Alexander C; Armson, B Anthony; Gafni, Amiram; Joseph, K S; Ohlsson, Arne; Ross, Susan; Sanchez, J Johanna; Mangoff, Kathryn; Barrett, Jon F R

2016-03-01

The Twin Birth Study randomized women with uncomplicated pregnancies, between 32(0/7)-38(6/7) weeks' gestation where the first twin was in cephalic presentation, to a policy of either a planned cesarean or planned vaginal delivery. The primary analysis showed that planned cesarean delivery did not increase or decrease the risk of fetal/neonatal death or serious neonatal morbidity as compared with planned vaginal delivery. This study presents the secondary outcome of death or neurodevelopmental delay at 2 years of age. A total of 4603 children from the initial cohort of 5565 fetuses/infants (83%) contributed to the outcome of death or neurodevelopmental delay. Surviving children were screened using the Ages and Stages Questionnaire with abnormal scores validated by a clinical neurodevelopmental assessment. The effect of planned cesarean vs planned vaginal delivery on death or neurodevelopmental delay was quantified using a logistic model to control for stratification variables and using generalized estimating equations to account for the nonindependence of twin births. Baseline maternal, pregnancy, and infant characteristics were similar. Mean age at assessment was 26 months. There was no significant difference in the outcome of death or neurodevelopmental delay: 5.99% in the planned cesarean vs 5.83% in the planned vaginal delivery group (odds ratio, 1.04; 95% confidence interval, 0.77-1.41; P = .79). A policy of planned cesarean delivery provides no benefit to children at 2 years of age compared with a policy of planned vaginal delivery in uncomplicated twin pregnancies between 32(0/7)-38(6/7)weeks' gestation where the first twin is in cephalic presentation. Copyright © 2016 Elsevier Inc. All rights reserved.

Study on role structure in social planning systems

International Nuclear Information System (INIS)

Kimata, Noboru

1984-01-01

New proposals are attended with a new set of role-expectation. If we lack attention to this aspect of any proposal, we face a serious difficulty in its implementation stage. The system called as Public Hearring shows us this fact. In this paper, introducing ABC model of communication by Westley and Maclean, we try to describe a set of role-expectation for particitants in social planning systems. And also introducing analytical concepts of role enactment process, we reveal two important problems for any proposal as a subsystem of social planning systems: (i) importance of role negotiation process for role-consensus, and (ii) necessity of supporting systems for role-adaptation. Especially for role-adaptation to Channel-Roles, we indicate the potential of VISMS as its supporting system. (author)

To evaluate disparity between clinical and pathological tumor-node-metastasis staging in oral cavity squamous cell carcinoma patients and its impact on overall survival: An institutional study

Directory of Open Access Journals (Sweden)

Karan Gupta

2015-01-01

Full Text Available Background: Accurate clinical staging is important for patient counseling, treatment planning, prognostication, and rational design of clinical trials. In head and neck squamous cell carcinoma, discrepancy between clinical and pathological staging has been reported. Objective: To evaluate any disparity between clinical and pathological tumor-node-metastasis (TNM staging in oral cavity squamous cell carcinoma (OCSCC patients and any impact of the same on survival. Materials and Methods: Retrospective chart review from year 2007 to 2013, at a tertiary care center. Statistical Analysis: All survival analyses were performed using SPSS for Windows version 15 (Chicago, IL, USA. Disease-free survival curves were generated using Kaplan-Meier algorithm. Results: One hundred and twenty-seven patients with OCSCC were analyzed. Seventy-nine (62.2% were males and 48 (37.8% females with a mean age at presentation 43.6 years (29-79 years. The highest congruence between clinical and pathological T-staging seen for clinical stage T1 and T4 at 76.9% and 73.4% with pathological T-stage. Similarly, the highest congruence between clinical and pathological N-stage seen for clinical N0 and N3 at 86.4% and 91.7% with pathological N-stage. Of clinically early stage patients, 67.5% remained early stage, and 32.5% were upstaged to advanced stage following pathological analysis. Of the clinically advanced stage patients, 75% remained advanced, and 25% were pathologically downstaged. This staging discrepancy did not significantly alter the survival. Conclusion: Some disparity exists in clinical and pathological TNM staging of OCSCC, which could affect treatment planning and survival of patients. Hence, more unified and even system of staging for the disease is required for proper decision-making.

The planning of transmission grids. Conditions of the energy policy turnaround; Die Planung der Uebertragungsnetze. Bedingung der Energiewende.

Energy Technology Data Exchange (ETDEWEB)

Witt, Siegfried de; Durinke, Peter; Kause, Harriet [DE WITT Rechtsanwaltsgesellschaft mbH, Berlin (Germany)

2012-07-01

The book reports on planning processes for the power transmission grid. The design and implementation of a high-voltage line of the transmission system consists of four stages (Part I): (a) National planning of requirements; (b) Planning procedures or federal sector planning; (c) Planning approval procedure; (d) Expropriation proceedings. Part II of this book describes the planning according to the Energy Economy Law (EnWG) and Electricity Grid Expansion Act (EnLAG). The Part III of the book under consideration describes the procedures to be taken out by the NABEG (Act for the Acceleration of Network Expansion) from the scope of paragraph 15 ROG (Regional Planning Act) and paragraph 43 EnWG.

A simplified staging system based on the radiological findings in different stages of ochronotic spondyloarthropathy

International Nuclear Information System (INIS)

Jebaraj, Isaac; Chacko, Binita Riya; Chiramel, George Koshy; Matthai, Thomas; Parameswaran, Apurve

2013-01-01

This study describes a group of 26 patients with ochronotic spondyloarthropathy who were on regular treatment and follow-up at a tertiary level hospital and proposes a simplified staging system for ochronotic spondyloarthropathy based on radiographic findings seen in the thoracolumbar spine. This proposed classification makes it easy to identify the stage of the disease and start the appropriate management at an early stage. Four progressive stages are described: an inflammatory stage (stage 1), the stage of early discal calcification (stage 2), the stage of fibrous ankylosis (stage 3), and the stage of bony ankylosis (stage 4). To our knowledge, this is the largest reported series of radiological description of spinal ochronosis, and emphasizes the contribution of the spine radiograph in the diagnosis and staging of the disease

A simplified staging system based on the radiological findings in different stages of ochronotic spondyloarthropathy

Directory of Open Access Journals (Sweden)

Isaac Jebaraj

2013-01-01

Full Text Available This study describes a group of 26 patients with ochronotic spondyloarthropathy who were on regular treatment and follow-up at a tertiary level hospital and proposes a simplified staging system for ochronotic spondyloarthropathy based on radiographic findings seen in the thoracolumbar spine. This proposed classification makes it easy to identify the stage of the disease and start the appropriate management at an early stage. Four progressive stages are described: an inflammatory stage (stage 1, the stage of early discal calcification (stage 2, the stage of fibrous ankylosis (stage 3, and the stage of bony ankylosis (stage 4. To our knowledge, this is the largest reported series of radiological description of spinal ochronosis, and emphasizes the contribution of the spine radiograph in the diagnosis and staging of the disease.