A Case of Resistant SUNCT that Gave Response to Steroid Treatment

Directory of Open Access Journals (Sweden)

Hakan Levent Gül

2014-03-01

Full Text Available Conjunctival injection and tearing with unilateral short lasting neuralgiform headache syndrome is called as SUNCT. Even though these headaches are reported seldomly, the prevalence is possibly higher than known. It is of importance to recognize these uncommon disorder, since its management differs from common primary headaches. Until today, it was reported to be treated with different types of drugs. We here reported a 30 years old male patient with normal neurological examination, blood examination and neuroimaging. Our patient gave no response to indomethacin, gabapentine and carbamazepine treatments. This case is an example of SUNCT case treated with steroid

Direct versus indirect revascularization procedures for moyamoya disease: a comparative effectiveness study.

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Macyszyn, Luke; Attiah, Mark; Ma, Tracy S; Ali, Zarina; Faught, Ryan; Hossain, Alisha; Man, Karen; Patel, Hiren; Sobota, Rosanna; Zager, Eric L; Stein, Sherman C

2017-05-01

OBJECTIVE Moyamoya disease (MMD) is a chronic cerebrovascular disease that can lead to devastating neurological outcomes. Surgical intervention is the definitive treatment, with direct, indirect, and combined revascularization procedures currently employed by surgeons. The optimal surgical approach, however, remains unclear. In this decision analysis, the authors compared the effectiveness of revascularization procedures in both adult and pediatric patients with MMD. METHODS A comprehensive literature search was performed for studies of MMD. Using complication and success rates from the literature, the authors constructed a decision analysis model for treatment using a direct and indirect revascularization technique. Utility values for the various outcomes and complications were extracted from the literature examining preferences in similar clinical conditions. Sensitivity analysis was performed. RESULTS A structured literature search yielded 33 studies involving 4197 cases. Cases were divided into adult and pediatric populations. These were further subdivided into 3 different treatment groups: indirect, direct, and combined revascularization procedures. In the pediatric population at 5- and 10-year follow-up, there was no significant difference between indirect and combination procedures, but both were superior to direct revascularization. In adults at 4-year follow-up, indirect was superior to direct revascularization. CONCLUSIONS In the absence of factors that dictate a specific approach, the present decision analysis suggests that direct revascularization procedures are inferior in terms of quality-adjusted life years in both adults at 4 years and children at 5 and 10 years postoperatively, respectively. These findings were statistically significant (p indirect and combination procedures may offer optimal results at long-term follow-up.

The Kjeldahl method as a primary reference procedure for total protein in certified reference materials used in clinical chemistry. II. Selection of direct Kjeldahl analysis and its preliminary performance parameters.

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Vinklárková, Bára; Chromý, Vratislav; Šprongl, Luděk; Bittová, Miroslava; Rikanová, Milena; Ohnútková, Ivana; Žaludová, Lenka

2015-01-01

To select a Kjeldahl procedure suitable for the determination of total protein in reference materials used in laboratory medicine, we reviewed in our previous article Kjeldahl methods adopted by clinical chemistry and found an indirect two-step analysis by total Kjeldahl nitrogen corrected for its nonprotein nitrogen and a direct analysis made on isolated protein precipitates. In this article, we compare both procedures on various reference materials. An indirect Kjeldahl method gave falsely lower results than a direct analysis. Preliminary performance parameters qualify the direct Kjeldahl analysis as a suitable primary reference procedure for the certification of total protein in reference laboratories.

The step complexity measure for emergency operating procedures - comparing with simulation data

International Nuclear Information System (INIS)

Park, Jinkyun; Jung, Wondea; Kim, Jaewhan; Ha, Jaejoo; Shin, Yunghwa

2001-01-01

In complex systems, such as nuclear power plants (NPPs) or airplane control systems, human errors play a major role in many accidents. Therefore, to prevent occurrences of accidents or to ensure system safety, extensive effort has been made to identify significant factors that cause human errors. According to related studies, written manuals or operating procedures are revealed as one of the most important factors, and complexity or understandability of a procedure is pointed out as one of the major reasons that make procedure-related human errors. Many qualitative checklists are suggested to evaluate emergency operating procedures (EOPs) of NPPs. However, since qualitative evaluations using checklists have some drawbacks, a quantitative measure that can quantify the complexity of EOPs is imperative to compensate for them. In order to quantify the complexity of EOPs, Park et al. suggested the step complexity (SC) measure to quantify the complexity of a step included in EOPs. In this paper, to ensure the appropriateness of the SC measure, SC scores are compared with averaged step performance time data obtained from emergency training records. The total number of available records is 36, and training scenarios are the loss of coolant accident and the excess steam dump event. The number of scenario is 18 each. From these emergency training records, step performance time data for 39 steps are retrieved, and they are compared with estimated SC scores of them. In addition, several questions that are needed to clarify the appropriateness of the SC measure are also discussed. As a result, it was observed that estimated SC scores and step performance time data have a statistically meaningful correlation. Thus, it can be concluded that the SC measure can quantify the complexity of steps included in EOPs

Comparative analysis of lockout programs and procedures applied to industrial machines

Energy Technology Data Exchange (ETDEWEB)

Chinniah, Y.; Champoux, M.; Burlet-Vienney, D.; Daigle, R. [Institut de recherche Robert-Sauve en sante et en securite du travail, Montreal, PQ (Canada)

2008-09-15

In 2005, approximately 20 workers in Quebec were killed by dangerous machines. Approximately 13,000 accidents in the province were linked to the use of machines. The resulting cost associated with these accidents was estimated to be $70 million to the Quebec Occupational Health and Safety Commission (CSST) in compensation and salary replacement. According to article 185 of the Quebec Occupational Health and Safety Regulation (RSST), workers intervening in hazardous zones of machines and processes during maintenance, repairs, and unjamming activities must apply lockout procedures. Lockout is defined as the placement of a lock or tag on an energy-isolating device in accordance with an established procedure, indicating that the energy-isolating device is not to be operated until removal of the lock or tag in accordance with an established procedure. This report presented a comparative analysis of lockout programs and procedures applied to industrial machines. The study attempted to answer several questions regarding the concept of lockout and its definition in the literature; the differences between legal lockout requirements among provinces and countries; different standards on lockout; the contents of lockout programs as described by different documents; and the compliance of lockout programs in a sample of industries in Quebec in terms of Canadian standard on lockout, the CSA Z460-05 (2005). The report discussed the research objectives, methodology, and results of the study. It was concluded that the concept of lockout has different meanings or definitions in the literature, especially in regulations. However, definitions of lockout which are found in standards have certain similarities. 50 refs., 52 tabs., 2 appendices.

A comparative assessment of alternative waste management procedures for selected reprocessing wastes

International Nuclear Information System (INIS)

Hickford, G.E.; Plews, M.J.

1983-07-01

This report, which has been prepared by Associated Nuclear Services for the Department of the Environment, presents the results of a study and comparative assessment of management procedures for low and intermediate level solid waste streams arising from current and future fuel reprocessing operations on the Sellafield site. The characteristics and origins of the wastes under study are discussed and a reference waste inventory is presented, based on published information. Waste management strategy in the UK and its implications for waste conditioning, packaging and disposal are discussed. Wastes currently arising which are not suitable for Drigg burial or sea dumping are stored in an untreated form. Work is in hand to provide additional and improved disposal facilities which will accommodate all the waste streams under study. For each waste stream viable procedures are identified for further assessment. The procedures comprise a series of on-site operations-recovery from storage, pre-treatment, treatment, encapsulation, and packaging, prior to storage or disposal of the conditioned waste form. Assessments and comparisons of each procedure for each waste are presented. These address various process, operational, economic, radiological and general safety factors. The results are presented in a series of tables with supporting text. For the majority of wastes direct encapsulation with minimal treatment appears to be a viable procedure. Occupational exposure and general safety are not identified as significant factors governing the choice of procedures. The conditioned wastes meet the general requirements for safe handling during storage and transportation. The less active wastes suitable for disposal by currently available routes meet the appropriate disposal criteria. It is not possible to consider in detail the suitability for disposal of the more active wastes for which disposal facilities are not yet available. (Author)

How does the workload and work activities of procedural GPs compare to non-procedural GPs?

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Russell, Deborah J; McGrail, Matthew R

2017-08-01

To investigate patterns of Australian GP procedural activity and associations with: geographical remoteness and population size hours worked in hospitals and in total; and availability for on-call DESIGN AND PARTICIPANTS: National annual panel survey (Medicine in Australia: Balancing Employment and Life) of Australian GPs, 2011-2013. Self-reported geographical work location, hours worked in different settings, and on-call availability per usual week, were analysed against GP procedural activity in anaesthetics, obstetrics, surgery or emergency medicine. Analysis of 9301 survey responses from 4638 individual GPs revealed significantly increased odds of GP procedural activity in anaesthetics, obstetrics or emergency medicine as geographical remoteness increased and community population size decreased, albeit with plateauing of the effect-size from medium-sized (population 5000-15 000) rural communities. After adjusting for confounders, procedural GPs work more hospital and more total hours each week than non-procedural GPs. In 2011 this equated to GPs practising anaesthetics, obstetrics, surgery, and emergency medicine providing 8% (95%CI 0, 16), 13% (95%CI 8, 19), 8% (95%CI 2, 15) and 18% (95%CI 13, 23) more total hours each week, respectively. The extra hours are attributable to longer hours worked in hospital settings, with no reduction in private consultation hours. Procedural GPs also carry a significantly higher burden of on-call. The longer working hours and higher on-call demands experienced by rural and remote procedural GPs demand improved solutions, such as changes to service delivery models, so that long-term procedural GP careers are increasingly attractive to current and aspiring rural GPs. © 2016 National Rural Health Alliance Inc.

Measurement of vesicoureteral reflux with intravenous 99mTc-DTPA compared to radiographic cystography

International Nuclear Information System (INIS)

Hedman, J.K.; Kempi, V.; Voss, H.

1978-01-01

The results of a /sup 99m/Tc-DTPA study of vesicoureteral reflux in 51 children with recurrent urinary tract infections were compared with those of radiographic micturition cystourethrography. Reflux, shown by either of the two methods, was regarded as an indication of the disorder. Neither method was regarded as a standard reference method. Agreement between the two methods was obtained in 90 of 102 renal units, i.e., ureter and/or renal pelvis (88 percent). Statistical analysis performed on the remaining 12 cases showed that the two procedures usually gave similar results

Postoperative pain in complex ophthalmic surgical procedures: comparing practice with guidelines.

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Lesin, Mladen; Sundov, Zeljka Duplancic; Jukic, Marko; Puljak, Livia

2014-06-01

To analyze the management of postoperative pain after complex ophthalmic surgery and to compare it to the guidelines. A retrospective study. University Hospital Split, Croatia. Patients (N = 447) who underwent complex ophthalmic surgical procedures from 2008 to 2012. The following data were extracted from patient medical records: age, gender, type and dosage of premedication, preoperative patient's physical status, type of procedure, duration of procedure-surgical and anesthesia time, type and dosage of anesthesia, the type and dosage of postoperative analgesia for each postoperative day. None of the patients had information about pain intensity in their records. There were 90% patients who did not receive any medication the night before surgery, 54% did not receive any premedication immediately before surgery, 19% did not receive any pain medication after the surgery in the operating room and 46% of patients did not receive any analgesics after being released to the ophthalmology department. Among those who received analgesia after surgery, 98% received only one dose of an analgesic, and 93% of patients received analgesia only on the day of the surgery. Furthermore, patients were returned to the department immediately after surgery, without intensive monitoring. During the analyzed five years there were no educational session organized by anesthesiologist to the ophthalmic surgeons. Postoperative pain management and perioperative care of patients undergoing major ophthalmic surgery indicates lack of attention towards pain intensity and postoperative analgesia. Appropriate interventions should be employed to improve postoperative pain management, to facilitate patient recovery. Wiley Periodicals, Inc.

Comparing the 810nm diode laser with conventional surgery in orthodontic soft tissue procedures.

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Ize-Iyamu, I N; Saheeb, B D; Edetanlen, B E

2013-09-01

To compare the use of the 810nm diode laser with conventional surgery in the management of soft tissue mucogingival problems associated with orthodontic treatment. Orthodontic patients requiring different soft tissue surgical procedures were randomly assigned to receive conventional surgery or soft tissue diode laser, (wavelength 810 nm). Parameters documented include the type of anaesthesia used, intra and post operative pain, bleeding, the use of scalpel and sutures. The chi-squared test was used to test for significance at 95% confidence level. Probability values (p-values) less than 0.05 were regarded as significant. Only 2(16.7%) of the procedures carried out with the soft tissue laser required infiltration anaesthesia compared to 10 (90.9%) with conventional surgery and this was significant (Pdiode laser (Pdiode laser. No sutures were used in all soft tissue cases managed with the diode laser and this was significant (Plaser compared with conventional surgery. Orthodontic patients treated with the diode laser required less infiltration anaesthesia, had reduced bleeding during and after surgery, rapid postoperative haemostasis, elimination of the need for sutures and an improved postoperative comfort and healing.

One of the many visiting theoreticians, R P Feynman, who gave lectures at CERN during the year

CERN Multimedia

CERN PhotoLab

1970-01-01

Visiting CERN in January was R P Feynman, who has recently been working on strong interaction theory. On 8 January, he packed the lecture theatre, as usual, when he gave a talk on inelastic hadron collisions and is here caught in a typically graphic pose.

The Ross procedure offers excellent survival compared with mechanical aortic valve replacement in a real-world setting.

Science.gov (United States)

Andreas, Martin; Wiedemann, Dominik; Seebacher, Gernot; Rath, Claus; Aref, Tandis; Rosenhek, Raphael; Heinze, Georg; Eigenbauer, Ernst; Simon, Paul; Ruetzler, Kurt; Hiesmayr, Joerg-Michael; Moritz, Anton; Laufer, Guenther; Kocher, Alfred

2014-09-01

The ideal prosthesis for young patients requiring aortic valve replacement has not been defined to date. Although the Ross procedure provides excellent survival, its application is still limited. We compared the long-term survival after the Ross procedure with mechanical aortic valve replacement. All consecutive Ross procedures and mechanical aortic valve replacements performed between 1991 and 2008 at a single centre were analysed. Only adult patients between 18 and 50 years of age were included in the study. Survival and valve-related complications were evaluated. Furthermore, survival was compared with the age- and sex-matched Austrian population. A total of 159 Ross patients and 173 mechanical valve patients were included. The cumulative survival for the Ross procedure was significantly better, with survival rates of 96, 94 and 93% at 5, 10 and 15 years, respectively, in comparison to 90, 84 and 75% (P Ross group but was significantly reduced in the mechanical valve group. In a real-world setting, the Ross procedure is associated with a long-term survival benefit in young adults in comparison to mechanical aortic valve replacement. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Comparing imaging procedures: techniques and examples. Gastroenterology

International Nuclear Information System (INIS)

Malmud, L.S.

1982-01-01

The distinct advantages of nuclear medicine procedures, in comparison to radiography, contrast studies, computerized tomography and ultrasound, are emphasized. Scintigraphic methods offer quantitative data regarding function which competing imaging modalities are unable to provide, and make them the studies of choice in the evaluation of gastrointestinal physiology and functional abnormalities

A Comparison of Math Cover, Copy, Compare Intervention Procedures for Children with Autism Spectrum Disorder.

Science.gov (United States)

Morton, Reeva C; Gadke, Daniel L

2018-03-01

Cover, Copy, Compare (CCC) and Copy, Cover, Compare (MCCC) procedures are effective interventions for improving math fluency. However, there is a gap in literature exploring the use of these interventions for children with autism spectrum disorders (ASD). The purpose of the current study was to compare the use of CCC and MCCC for children with ASD using a multi-component single-case experimental design. The results showed no notable difference between the interventions. Implications and limitations, particularly surrounding experimental control, are discussed in detail.

The influence of a new fabrication procedure on the catalytic activity of ruthenium-selenium catalysts

International Nuclear Information System (INIS)

Cheng, H.; Yuan, W.; Scott, K.

2006-01-01

A new procedure has been introduced to enhance catalytic activity of ruthenium-selenium electro-catalysts for oxygen reduction, in which materials are treated under hydrogen atmosphere at elevated temperatures. The characterisation using scanning electron microscopy, energy dispersive spectroscopy or energy dispersive X-ray spectroscopy exhibited that the treatment at 400 deg. C made catalysts denser while their porous nature remained, led to a good degree of crystallinity and an optimum Se:Ru ratio. The half cell test confirms feasibility of the new procedure; the catalyst treated at 400 deg. C gave the highest reduction current (55.9 mA cm -2 at -0.4 V) and a low methanol oxidation effect coefficient (3.8%). The direct methanol fuel cell with the RuSe 400 deg. C cathode catalyst (2 mg RuSe cm -2 ) generated a power density of 33.8 mW cm -2 using 2 M methanol and 2 bar oxygen at 90 deg. C. The new procedure produced the catalysts with low decay rates. The best sample was compared to the Pt and to the reported ruthenium-selenium catalyst. Possible reasons for the observations are discussed

The minimal ice water caloric test compared with established vestibular caloric test procedures.

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Schmäl, Frank; Lübben, Björn; Weiberg, Kerstin; Stoll, Wolfgang

2005-01-01

Caloric testing of the vestibular labyrinth is usually performed by classical caloric test procedures (CCTP) using water warmed to 30 degrees C and 44 degrees C. Ice water irrigation (4 degrees C) is usually not performed, although it might be useful as a bedside test. To verify the validity of the Minimal Ice Water Caloric Test (MIWCT), comparative video-oculographic investigations were performed in 22 healthy subjects using ice water (0.5 ml, 1.0 ml, 2 ml), CCTP, and cold air (27 degrees C). Frequency, amplitude, slow phase velocity (SPV), the onset, and the duration of nystagmus were documented. After addition of three ice cubes, the temperature of conventional tap water (16 degrees C) fell within 13 min to 4 degrees C. In pessimum position the subjects demonstrated no nystagmus response. Compared to CCTP, MIWCT was associated with a significantly later onset of nystagmus and a significant prolongation of the nystagmus reaction. In contrast to air stimulation (27 degrees C), a significant Spearman's correlation was noted between MIWCT (1 and 2 ml) and established CCTP in respect of essential nystagmus parameters (frequency, amplitude and SPV). Furthermore, MIWCT (0.5 and 1 ml) showed a higher sensitivity and specificity with regard to the detection of canal paresis based on Jongkees' formula compared to stimulation with air 27 degrees C. Thus, MIWCT appears to be a suitable procedure for bedside investigation of vestibular function outside the vestibular laboratory, e.g. in a hospital ward, where bedridden patients with vertigo occasionally require vestibular testing.

Compensation for Real Properties Acquired for Roads in Different Procedures - Comparative Analysis

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Barańska Anna

2017-12-01

Full Text Available Real properties acquired for the so-called public purpose, such as road investments, generate a one-off financial indemnity in the form of compensation paid to the expropriated owner. Due to the different possible modes of expropriation (pursuant to the Real Estate Management Act or the Special Road Act, the amount of the compensation due may be determined in different ways, which entails a variety of results. The article compares the compensation levels determined in two possible procedures: basing on the predominant use of the adjacent areas or on data from the transactions of real properties intended for public roads.

Is Office-Based Surgery Safe? Comparing Outcomes of 183,914 Aesthetic Surgical Procedures Across Different Types of Accredited Facilities.

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Gupta, Varun; Parikh, Rikesh; Nguyen, Lyly; Afshari, Ashkan; Shack, R Bruce; Grotting, James C; Higdon, K Kye

2017-02-01

There has been a dramatic rise in office-based surgery. However, due to wide variations in regulatory standards, the safety of office-based aesthetic surgery has been questioned. This study compares complication rates of cosmetic surgery performed at office-based surgical suites (OBSS) to ambulatory surgery centers (ASCs) and hospitals. A prospective cohort of patients undergoing cosmetic surgery between 2008 and 2013 were identified from the CosmetAssure database (Birmingham, AL). Patients were grouped by type of accredited facility where the surgery was performed: OBSS, ASC, or hospital. The primary outcome was the incidence of major complication(s) requiring emergency room visit, hospital admission, or reoperation within 30 days postoperatively. Potential risk factors including age, gender, body mass index (BMI), smoking, diabetes, type of procedure, and combined procedures were reviewed. Of the 129,007 patients (183,914 procedures) in the dataset, the majority underwent the procedure at ASCs (57.4%), followed by hospitals (26.7%) and OBSS (15.9%). Patients operated in OBSS were less likely to undergo combined procedures (30.3%) compared to ASCs (31.8%) and hospitals (35.3%, P procedures. Plastic surgeons should continue to triage their patients carefully based on other significant comorbidities that were not measured in this present study. LEVEL OF EVIDENCE 3. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

Comparative study on cleanup procedures for the determination of organophosphorus pesticides in vegetables

International Nuclear Information System (INIS)

Alvin, Chai Lian Kuet; Lau, Seng

2008-01-01

A study was carried out to compare the cleanup procedures for the determination of organophosphorus pesticides in vegetables. Eleven organophosphorus pesticides were extracted with acetone and methylene chloride. Extracts were cleanup by solid-phase extraction (SPE) mixed-mode column using quaternary amine and aminopropyl (SAX/ NH 2 ) or octadecyl (C 18 ) sorbents. The pesticides were determined by gas chromatography with flame photometric detector. The recovery results obtained from the SPE SAX/ NH 2 and C 18 cleanups in carrot, cucumber and green mustard samples were in the range of 71.0 % to 115 %. Lower recoveries were obtained for polar pesticides, methamidophos and dimethoate. These results were compared to the method currently used in the laboratory which does not include any cleanup. (author)

Graduate and undergraduate students’ reaction to the teaching procedures used in semipresential classes

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Henry Maia Peixoto

2013-12-01

Full Text Available The objective of this study was to investigate the reactions of undergraduate and graduate students to the teaching procedures used in semipresential classes. This exploratory study was performed with a quantitative approach at a public university, with undergraduate and graduate students who had completed semipresential classes on health promotion education. Among the 19 evaluated teaching procedures, 15 (78.9% did not show any statistically significant differences between the two academic levels. The means and medians for most variables, for both undergraduate (78.9% and graduate (89.5% students, were above 7 in a scale ranging between 0 (awful and 10 (excellent. Therefore, it is concluded that both groups showed similar reactions to the teaching procedures and gave satisfactory opinions in this regard. Understanding these aspects can support designing class disciplines that use teaching procedures that are adequate to university students. Descriptors: Education, Distance; Education, Higher; Learning; Educational Measurement.

Comparative studies of imaging procedures: What is the contribution of CT?

International Nuclear Information System (INIS)

Witte, G.; Buecheler, E.

1990-01-01

Within the field of diagnostic imaging, CT and MR are competing procedures, each of which has particular advantages in specific diagnostic situations. Knowledge of these advantages is helpful in deciding upon a diagnostic procedure. We evaluate the indications for CT according to area of examination. (orig.) [de

Comparison of digestion procedures used for the determination of boron in biological tissues by ICP-AES [inductively-coupled, plasma-atomic emission spectroscopy

International Nuclear Information System (INIS)

Bauer, W.F.; Miller, D.L.; Steele, S.M.

1988-01-01

A study was designed to identify the most accurate and reliable procedures for the digestion of biological tissues prior to the determination of boron by inductively-coupled, plasma-atomic emission spectroscopy (ICP-AES). The four procedures used in this study were an acid bomb digestion and digestions performed in test tubes using perchloric acid and hydrogen peroxide, nitric acid and hydrogen peroxide, and nitric acid alone. Digestions using nitric acid and hydrogen peroxide and nitric acid alone were performed in a manner analogous to the perchloric acid/hydrogen peroxide procedure. The tissues used in the study were from dogs that had been administered a boron compound (Na 2 B 12 H 11 SH) and included two brain tissues, a liver and a tongue. These tissues were selected in order to eliminate results that may be due to surface spiking only. None of the test tube procedures were successful in completely dissolving the samples, as was evidenced by residual color and a coagulated precipitate. The amount of precipitate was much larger for the brain tissues in all cases. The acid bomb digestion and the perchloric acid/hydrogen peroxide procedures gave comparable boron concentrations for all of the tissues in this study. 2 refs., 1 tab

Emergency Physician Awareness of Prehospital Procedures and Medications

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Rachel Waldron

2014-07-01

Full Text Available Introduction: Maintaining patient safety during transition from prehospital to emergency department (ED care depends on effective handoff communication between providers. We sought to determine emergency physicians’ (EP knowledge of the care provided by paramedics in terms of both procedures and medications, and whether the use of a verbal report improved physician accuracy. Methods: We conducted a 2-phase observational survey of a convenience sample of EPs in an urban, academic ED. In this large ED paramedics have no direct contact with physicians for non-critical patients, giving their report instead to the triage nurse. In Phase 1, paramedics gave verbal report to the triage nurse only. In Phase 2, a research assistant (RA stationed in triage listened to this report and then repeated it back verbatim to the EPs caring for the patient. The RA then queried the EPs 90 minutes later regarding their patients’ prehospital procedures and medications. We compared the accuracy of these 2 reporting methods. Results: There were 163 surveys completed in Phase 1 and 116 in Phase 2. The oral report had no effect on EP awareness that the patient had been brought in by ambulance (86% in Phase 1 and 85% in Phase 2. The oral report did improve EP awareness of prehospital procedures, from 16% in Phase 1 to 45% in Phase 2, OR=4.28 (2.5-7.5. EPs were able to correctly identify all oral medications in 18% of Phase 1 cases and 47% of Phase 2 cases, and all IV medications in 42% of Phase 1 cases and 50% of Phase 2 cases. The verbal report led to a mild improvement in physician awareness of oral medications given, OR=4.0 (1.09-14.5, and no improvement in physician awareness of IV medications given, OR=1.33 (0.15-11.35. Using a composite score of procedures plus oral plus IV medications, physicians had all three categories correct in 15% of Phase 1 and 39% of Phase 2 cases (p<0.0001. Conclusion: EPs in our ED were unaware of many prehospital procedures and

Prenatal diagnostic procedures used in pregnancies with congenital malformations in 14 regions of Europe.

Science.gov (United States)

Garne, Ester; Loane, Maria; de Vigan, Catherine; Scarano, Gioacchino; de Walle, Hermien; Gillerot, Yves; Stoll, Claude; Addor, Marie-Claude; Stone, David; Gener, Blanca; Feijoo, Maria; Mosquera-Tenreiro, Carmen; Gatt, Miriam; Queisser-Luft, Annette; Baena, Neus; Dolk, Helen

2004-11-01

To investigate outcomes of ultrasound investigations (US) and invasive diagnostic procedures in cases of congenital malformations (CM), and to compare the use of invasive prenatal test techniques (amniocentesis (AC) versus chorionic villus sampling (CVS)) among European populations. Analysis of data from population-based registries of CM. 25 400 cases of CM recorded by 14 EUROCAT registries covering a total population of 1,013,352 births 1995-99. US were performed in 91% of cases, and positively detected CM in 35% of cases. AC was performed in 24% of the cases and CVS in 3% of cases. Thirty-eight percent of invasive tests gave positive results. Fifty-two percent of cases with maternal age > or = 35 years had an invasive test performed compared to 20% of cases with younger mothers. Considerable variation was found between registries in the uptake rate of invasive tests in cases with older maternal age and on the use of invasive tests with only four regions employing CVS techniques in at least a third of the cases having invasive tests. For chromosomal anomalies US gave positive results in 46% of cases with maternal age or = 35 years with US performed. Prenatal US was performed in 91% of all pregnancies with CM but the test was only positive in a third of the cases. There was large regional variation in the uptake rate of invasive tests with maternal age of 35 years or more. For every CVS carried out there were nine AC tests. US is an important tool in the prenatal diagnosis of chromosomal anomalies in Europe. Copyright 2004 John Wiley & Sons, Ltd.

Childbirth care: the oral history of women who gave birth from the 1940s to 1980s

OpenAIRE

Leister,Nathalie; Riesco,Maria Luiza Gonzalez

2013-01-01

This study's objective was to gain a greater understanding of the changes that took place in the childbirth care model from the experience of women who gave birth in the State of Sao Paulo, Brazil from the 1940s to the 1980s. This is a descriptive study conducted with 20 women using the Thematic Oral History method. Data were collected through unstructured interviews. The theme extracted from the interviews was "The experience of childbirth". The results indicate a time and generational demar...

New non-cognitive procedures for medical applicant selection: a qualitative analysis in one school.

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Katz, Sara; Vinker, Shlomo

2014-11-07

Recent data have called into question the reliability and predictive validity of standard admission procedures to medical schools. Eliciting non-cognitive attributes of medical school applicants using qualitative tools and methods has thus become a major challenge. 299 applicants aged 18-25 formed the research group. A set of six research tools was developed in addition to the two existing ones. These included: a portfolio task, an intuitive task, a cognitive task, a personal task, an open self-efficacy questionnaire and field-notes. The criteria-based methodology design used constant comparative analysis and grounded theory techniques to produce a personal attributes profile per participant, scored on a 5-point scale holistic rubric. Qualitative validity of data gathering was checked by comparing the profiles elicited from the existing interview against the profiles elicited from the other tools, and by comparing two profiles of each of the applicants who handed in two portfolio tasks. Qualitative validity of data analysis was checked by comparing researcher results with those of an external rater (n =10). Differences between aggregated profile groups were checked by the Npar Wilcoxon Signed Ranks Test and by Spearman Rank Order Correlation Test. All subjects gave written informed consent to their participation. Privacy was protected by using code numbers. A concept map of 12 personal attributes emerged, the core constructs of which were motivation, sociability and cognition. A personal profile was elicited. Inter-rater agreement was 83.3%. Differences between groups by aggregated profiles were found significant (p < .05, p < .01, p < .001).A random sample of sixth year students (n = 12) underwent the same admission procedure as the research group. Rank order was different; and arrogance was a new construct elicited in the sixth year group. This study suggests a broadening of the methodology for selecting medical school applicants. This methodology

A COMPARATIVE STUDY OF PEDIATRIC CARDIAC CATHETERIZATION PROCEDURE UNDER GENERAL ANESTHESIA WITH OR WITHOUT FEMORAL NERVE BLOCK

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Jigisha

2016-02-01

Full Text Available OBJECTIVE Anesthetic management for interventional cardiac procedures/cardiac catheterization in pediatric patients is challenging. Cardiac anomalies vary from simple to complex congenital cardiac anomalies, shunts may be present at multiple levels and patients may be profoundly cyanotic, may be with ventricular dysfunction. They usually require sedation and analgesia to maintain steady stable state. In adults, such type of procedures can be well managed with local anesthesia. METHODS Fifty patients were included in the study. They were randomly divided into two groups- Group A (n=25 patients received femoral N. block along with IV sedation and analgesia while group B (n=25 patients received only IV sedation and analgesia. Both groups were compared for hemodynamics, pain score and requirement of IV anesthetic agents and any complications if come up. RESULTS Group A patients required IV ketamine 3.24mg/kg (±0.31SD as compared to 5.58mg/kg (±1.6SD in group B, which suggests significantly reduced requirement of IV anesthetic agents in group where femoral nerve block has been given. Hemodynamic parameters remained stable and comparable (no statistically significant variation Pain score was less in group A patients than group B. CONCLUSION It has been observed that Group A patients required less dosages of IV anesthetic agents, with stable hemodynamics and less pain score and sedation score as compared to group B patients.

A Comparative Analysis of the Procedure Employed in Item ...

African Journals Online (AJOL)

Zimbabwe Journal of Educational Research ... and psychological scales designed to measure constructs in education and social sciences were purposively selected for the study based on accessibility and availability of validation information. The instruments used for the study were scaling procedures used in 27 published ...

A robust procedure for comparing multiple means under heteroscedasticity in unbalanced designs.

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Esther Herberich

2010-03-01

Full Text Available Investigating differences between means of more than two groups or experimental conditions is a routine research question addressed in biology. In order to assess differences statistically, multiple comparison procedures are applied. The most prominent procedures of this type, the Dunnett and Tukey-Kramer test, control the probability of reporting at least one false positive result when the data are normally distributed and when the sample sizes and variances do not differ between groups. All three assumptions are non-realistic in biological research and any violation leads to an increased number of reported false positive results. Based on a general statistical framework for simultaneous inference and robust covariance estimators we propose a new statistical multiple comparison procedure for assessing multiple means. In contrast to the Dunnett or Tukey-Kramer tests, no assumptions regarding the distribution, sample sizes or variance homogeneity are necessary. The performance of the new procedure is assessed by means of its familywise error rate and power under different distributions. The practical merits are demonstrated by a reanalysis of fatty acid phenotypes of the bacterium Bacillus simplex from the "Evolution Canyons" I and II in Israel. The simulation results show that even under severely varying variances, the procedure controls the number of false positive findings very well. Thus, the here presented procedure works well under biologically realistic scenarios of unbalanced group sizes, non-normality and heteroscedasticity.

Comparing adaptive procedures for estimating the psychometric function for an auditory gap detection task.

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Shen, Yi

2013-05-01

A subject's sensitivity to a stimulus variation can be studied by estimating the psychometric function. Generally speaking, three parameters of the psychometric function are of interest: the performance threshold, the slope of the function, and the rate at which attention lapses occur. In the present study, three psychophysical procedures were used to estimate the three-parameter psychometric function for an auditory gap detection task. These were an up-down staircase (up-down) procedure, an entropy-based Bayesian (entropy) procedure, and an updated maximum-likelihood (UML) procedure. Data collected from four young, normal-hearing listeners showed that while all three procedures provided similar estimates of the threshold parameter, the up-down procedure performed slightly better in estimating the slope and lapse rate for 200 trials of data collection. When the lapse rate was increased by mixing in random responses for the three adaptive procedures, the larger lapse rate was especially detrimental to the efficiency of the up-down procedure, and the UML procedure provided better estimates of the threshold and slope than did the other two procedures.

Diagnosing alcoholism in high-risk drinking drivers: comparing different diagnostic procedures with estimated prevalence of hazardous alcohol use

NARCIS (Netherlands)

Korzec, A.; Bär, M.; Koeter, M. W.; de Kieviet, W.

2001-01-01

In several European countries, drivers under influence (DUI), suspected of an alcohol use disorder (AUD, 'alcoholism') are referred for diagnostic examination. The accuracy of diagnostic procedures used in diagnosing AUD in the DUI population is unknown. The aim of this study was to compare three

Safety and efficacy of rivaroxaban compared with warfarin in patients undergoing peripheral arterial procedures.

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Talukdar, Anjan; Wang, S Keisin; Czosnowski, Lauren; Mokraoui, Nassim; Gupta, Alok; Fajardo, Andres; Dalsing, Michael; Motaganahalli, Raghu

2017-10-01

Rivaroxaban is a United States Food and Drug Administration-approved oral anticoagulant for venous thromboembolic disease; however, there is no information regarding the safety and its efficacy to support its use in patients after open or endovascular arterial interventions. We report the safety and efficacy of rivaroxaban vs warfarin in patients undergoing peripheral arterial interventions. This single-institution retrospective study analyzed all sequential patients from December 2012 to August 2014 (21 months) who were prescribed rivaroxaban or warfarin after a peripheral arterial procedure. Our study population was then compared using American College of Chest Physicians guidelines with patients then stratified as low, medium, or high risk for bleeding complications. Statistical analyses were performed using the Student t-test and χ 2 test to compare demographics, readmissions because of bleeding, and the need for secondary interventions. Logistic regression models were used for analysis of variables associated with bleeding complications and secondary interventions. The Fisher exact test was used for power analysis. There were 44 patients in the rivaroxaban group and 50 patients in the warfarin group. Differences between demographics and risk factors for bleeding between groups or reintervention rate were not statistically significant (P = .297). However, subgroup evaluation of the safety profile suggests that patients who were aged ≤65 years and on warfarin had an overall higher incidence of major bleeding (P = .020). Patients who were aged >65 years, undergoing open operation, had a significant risk for reintervention (P = .047) when they received rivaroxaban. Real-world experience using rivaroxaban and warfarin in patients after peripheral arterial procedures suggests a comparable safety and efficacy profile. Subgroup analysis of those requiring an open operation demonstrated a decreased bleeding risk when rivaroxaban was used (in those aged <65�

Are minimally invasive procedures harder to acquire than conventional surgical procedures?

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Hiemstra, Ellen; Kolkman, Wendela; le Cessie, Saskia; Jansen, Frank Willem

2011-01-01

It is frequently suggested that minimally invasive surgery (MIS) is harder to acquire than conventional surgery. To test this hypothesis, residents' learning curves of both surgical skills are compared. Residents had to be assessed using a general global rating scale of the OSATS (Objective Structured Assessment of Technical Skills) for every procedure they performed as primary surgeon during a 3-month clinical rotation in gynecological surgery. Nine postgraduate-year-4 residents collected a total of 319 OSATS during the 2 years and 3 months investigation period. These assessments concerned 129 MIS (laparoscopic and hysteroscopic) and 190 conventional (open abdominal and vaginal) procedures. Learning curves (in this study defined as OSATS score plotted against procedure-specific caseload) for MIS and conventional surgery were compared using a linear mixed model. The MIS curve revealed to be steeper than the conventional curve (1.77 vs. 0.75 OSATS points per assessed procedure; 95% CI 1.19-2.35 vs. 0.15-1.35, p < 0.01). Basic MIS procedures do not seem harder to acquire during residency than conventional surgical procedures. This may have resulted from the incorporation of structured MIS training programs in residency. Hopefully, this will lead to a more successful implementation of the advanced MIS procedures. Copyright © 2010 S. Karger AG, Basel.

Simplified procedures for fast reactor fuel cycle and sensitivity analysis

International Nuclear Information System (INIS)

Badruzzaman, A.

1979-01-01

The Continuous Slowing Down-Integral Transport Theory has been extended to perform criticality calculations in a Fast Reactor Core-blanket system achieving excellent prediction of the spectrum and the eigenvalue. The integral transport parameters did not need recalculation with source iteration and were found to be relatively constant with exposure. Fuel cycle parameters were accurately predicted when these were not varied, thus reducing a principal potential penalty of the Intergal Transport approach where considerable effort may be required to calculate transport parameters in more complicated geometries. The small variation of the spectrum in the central core region, and its weak dependence on exposure for both this region, the core blanket interface and blanket region led to the extension and development of inexpensive simplified procedures to complement exact methods. These procedures gave accurate predictions of the key fuel cycle parameters such as cost and their sensitivity to variation in spectrum-averaged and multigroup cross sections. They also predicted the implications of design variation on these parameters very well. The accuracy of these procedures and their use in analyzing a wide variety of sensitivities demonstrate the potential utility of survey calculations in Fast Reactor analysis and fuel management

A comparative study of trabeculectomy and the new clear-cornea filtering procedure, intrastromal diathermal keratostomy (IDK)

DEFF Research Database (Denmark)

Bach-Holm, Daniella; Storr-Paulsen, Allan; Norregaard, Jens Christian

2012-01-01

Hg in the IDK group. The number of medications pre- and postoperatively in the trabeculectomy group was 3.1 and 0.5 versus 3.2 and 1.3 in the IDK group. Forty-four (59%) of the eyes in the trabeculectomy group met the complete success criteria compared with 5 (20%) in the IDK group (p......Purpose: For the first time to compare the 1-year success rates of trabeculectomy and the new clear-cornea filtering procedure, intrastromal diathermal keratostomy (IDK). Methods: Prospective clinical observational study including 99 consecutively operated eyes (69 patients) with well......-established primary open-angle glaucoma referred for filtering operation. We compared the change in intraocular pressure (IOP), number of anti-glaucomatous medication, complications and reoperations after 1 year. Seventy-four eyes were operated with trabeculectomy, and 25 with IDK. Complete success was defined as IOP...

Postpartum Care Services and Birth Features of The Women Who Gave Birth in Burdur in 2009

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Binali Catak

2011-10-01

Full Text Available AIM: In the study, it is aimed to evaluate postpartum care services and the delivery characteristics of the women who gave birth in Burdur in 2009. MATERIAL AND METHODS: In the study, the data is used about \\\\\\"Birth and Postpartum Care\\\\\\" of the research \\\\\\" Birth, Postpartum Care Services, and Nutritional Status of Children of the women who are giving birth in Burdur in 2009 \\\\\\". The population of the planned cross-sectional study are women who gave birth in Burdur in 2009. For the determination of the population, a list of women who gave birth in 2009 were used which was requested from family physicians. The reported number of women was 2318. The sample size representing the population to be reached was calculated as 1179. The data were collected using face-to-face interviews and were analyzed using SPSS package program. RESULTS: The mean age of the women was 27.1 (± 5.5 with an average size of households 4.3 (± 1.2. 22.1% of the women live with large families and 64.4% live in the village. 8.0% of the women were relatives with their husbands, 52.8% have arranged marriage and 1.3% have no official marriage. 1 in every 4 women is housewive, 1.8% have no formal education, 76.4% have no available social and 7.1% have no available health insurance. The average number of pregnancies of women is 2.1 (± 1.2 and number of children is 1.8 (± 0.8. Spontaneous abortion, induced abortion, stillbirth and death rate of children under 5 years of age are respectively 16.4%, 6.6%, 2.7%, 3.4%. 99.8% of the women have given birth in hospital, % 67.3 had medical supervision, 62.8% had cesarean birth. The average days of hospital stay after birth is 1.9 (± 3.1. 4.8% of the women after being discharged from the hospital have not received Postpartum Care (DSB. Of the women who have received DSB service, 2.2% had taken this service at home by family physician / family health stuff, 33.9% by obstetrician in practice. 92.2% of the women 1 time, 15

Cost-effectiveness analysis comparing the essure tubal sterilization procedure and laparoscopic tubal sterilization.

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Thiel, John A; Carson, George D

2008-07-01

To analyze the financial implications of establishing a hysteroscopic sterilization program using the Essure micro-insert tubal sterilization system in an ambulatory clinic. A retrospective cohort study (Canadian Task Force classification Type II-2), in an ambulatory women's health clinic in a tertiary hospital, of 108 women undergoing Essure coil insertion between 2005 and 2006, and 104 women undergoing laparoscopic tubal sterilization for permanent sterilization between 2001 and 2004. The Essure procedures used a 4 mm single channel operative hysteroscope and conscious sedation (fentanyl and midazolam); the laparoscopic tubal sterilizations were completed under general anaesthesia with a 7 mm laparoscope and either bipolar cautery or Filshie clips. Costs associated with the procedure, follow-up, and management of any complications (including nursing, hospital charges, equipment, and disposables) were tabulated. The Essure coils were successfully placed on the first attempt in 103 of 108 women (95%). Three patients required a second attempt to complete placement and two patients required laparoscopic tubal sterilization after an unsuccessful Essure. All 104 laparoscopic tubals were completed on the first attempt with no complications reported. The total cost for the 108 Essure procedures, including follow-up evaluation, was $138,996 or $1287 per case. The total cost associated with the 104 laparoscopic tubal sterilization procedures was $148,227 or $1398 per case. The incremental cost-effectiveness ratio was $111. The Essure procedure in an ambulatory setting resulted in a statistically significant cost saving of $111 per sterilization procedure. Carrying out the Essure procedure in an ambulatory setting frees space in the operating room for other types of cases, improving access to care for more patients.

The effect of trainee involvement on procedure and list times: A statistical analysis with discussion of current issues affecting orthopaedic training in UK.

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Wilson, T; Sahu, A; Johnson, D S; Turner, P G

2010-02-01

Training surgeons adds time to the duration of procedures and operation lists. This is not accounted for in the finance received to perform the operation by the hospital in the Payment by Results (PbR) system. To find out: 1. The effect on the duration of a procedure and the number of procedures performed on the list when a trainee is involved. 2. The percentage of orthopaedic cases with trainee involvement. 3. The effect of European working time directive (EWTD) on the trainee involvement in cases from theatre data in 2008 versus logbook data from 2004 - 2008. Data was taken from two different sources. Firstly, the Operating Room Information System (ORMIS) and patient operation notes. The second source was a consultant's logbook comprising 227 primary total knee replacements performed between 2004 and 2008. The data produced trends suggesting trainees took longer to perform procedures than consultants. In orthopaedic operations, 92% of cases had trainees present and of these 17% of cases were performed by trainees in 2008. Before the implementation of the EWTD, trainees performed more procedures when compared with current logbook data (38% versus 17% cases). Time taken by a trainee to perform the procedure under direct consultant supervision was significantly higher in comparison to procedures performed by a consultant alone (P = < 0.0001). Analysing the ORMIS and logbook data gave similar conclusions. Hospitals should be given financial recognition for training. In this debate, we should remain focused on the provision of quality training for the next generation of surgeons.

Long-term clinical outcomes with the retropubic tension-free vaginal tape (TVT) procedure compared to Burch colposuspension for correcting stress urinary incontinence (SUI).

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Holdø, Bjørn; Verelst, Margareta; Svenningsen, Rune; Milsom, Ian; Skjeldestad, Finn Egil

2017-11-01

The retropubic tension-free vaginal tape (TVT) procedure replaced Burch colposuspension as the primary surgical method for stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) in women in our department in 1998. In this study we compared the short-term and long-term clinical outcomes of these surgical procedures. Using a case series design, we compared the last 5 years of the Burch procedure (n = 127, 1994-1999) with the first 5 years of the retropubic TVT procedure (n = 180, 1998-2002). Information from the medical records was transferred to a case report form comprising data on perioperative and long-term complications as well as recurrence of UI, defined as bothersome UI or UI in need of repeat surgery. Other endpoints were rates of perioperative and late complications and the rates of prolapse surgery after primary surgery. The data were analyzed with the chi-squared and t tests and survival analysis using SPSS. The cumulative recurrence rate of SUI in women with preoperative SUI was significantly higher after the Burch procedure, but no difference was observed in women with MUI. There were no significant differences in rates of perioperative and late complications. At 12 years there was a significant increase in rates of repeat surgery for incontinence and prolapse in women after the Burch procedure. The long-term efficacy of TVT surgery was superior to that of Burch colposuspension in women with SUI. In addition, the rate of late prolapse surgery was significantly higher after the Burch procedure.

Measuring variability of procedure progression in proceduralized scenarios

International Nuclear Information System (INIS)

Kim, Yochan; Park, Jinkyun; Jung, Wondea

2012-01-01

Highlights: ► The VPP measure was developed to quantify how differently operators follow the procedures. ► Sources that cause variability of ways to follow a given procedure were identified. ► The VPP values for the scenarios are positively related to the scenario performance time. ► The VPP measure is meaningful for explaining characteristics of several PSFs. -- Abstract: Various performance shaping factors (PSFs) have been presented to explain the contributors to unsafe acts in a human failure event or predict a human error probability of new human performance. However, because most of these parameters of an HRA depend on the subjective knowledge and experience of HRA analyzers, the results of an HRA insufficiently provide unbiased standards to explain human performance variations or compare collected data with other data from different analyzers. To secure the validity of the HRA results, we propose a quantitative measure, which represents the variability of procedure progression (VPP) in proceduralized scenarios. A VPP measure shows how differently the operators follow the steps of the procedures. This paper introduces the sources of the VPP measure and relevance to PSFs. The assessment method of the VPP measure is also proposed, and the application examples are shown with a comparison of the performance time. Although more empirical studies should be conducted to reveal the relationship between the VPP measure and other PSFs, it is believed that the VPP measure provides evidence to quantitatively evaluate human performance variations and to cross-culturally compare the collected data.

Characterization and comparative investigation of thermally insulating layers for the turbine and engine construction

International Nuclear Information System (INIS)

Steffens, H.D.; Fischer, U.

1987-01-01

The aim of the research project was to subject commercially produced thermal insulation layer systems, the use of which seems promising for engine and turbine construction, to standardized characterisation, testing and comparison. Suitable methods and procedures for this had to be developed, in order to be able to derive instructions for optimisation guidelines for the production of improved thermal insulation systems from the results of investigations. In the context of the research project, a computer-controlled thermal shock test rig was first developed, designed and built. This test rig was designed so that important test conditions, such as the heating and cooling speed could be varied reproducibly over wide ranges. Methods and procedures were worked out, which permit a comparative qualitative and quantitative characterisation of layers of thermal insulation. From metallographic investigations, the layer build-up, layer structure, porosity and crack morphology of the layers in the delivered state and after testing could be assessed and compared. X-ray fine structure investigations gave information on the type and quantity of the phases occurring in the ceramic layers. The results of thermal shock tests which were done at different temperature intervals depending on the substrate, could be correlated with the build-up of layers and supplied information on damage mechanisms and the course of failure. (orig.) With 57 figs., 16 tabs., 89 refs [de

Health and environmental impacts of electricity generation systems: procedures for comparative assessments

International Nuclear Information System (INIS)

Demin, V.F.

2002-01-01

The IAEA technical report involving description of the Manual for procedure of comparison risk assessment (CRA) and external cost (ECA) of environmental and public health effect from nuclear energetics and other power generation is treated. CRA and ECA results depend on national and regional social-economic, geographic, medical and demographic, and other features. When using CRA and ECA procedures developed in concrete countries their adaptation is necessary for conditions of other countries [ru

A comparative examination of sample treatment procedures for ICAP-AES analysis of biological tissue

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De Boer, J. L. M.; Maessen, F. J. M. J.

The objective of this study was to contribute to the evaluation of existing sample preparation procedures for ICAP-AES analysis of biological material. Performance characteristics were established of current digestion procedures comprising extraction, solubilization, pressure digestion, and wet and dry ashing methods. Apart from accuracy and precision, a number of criteria of special interest for the analytical practice was applied. As a test sample served SRM bovine liver. In this material six elements were simultaneously determined. Results showed that every procedure has its defects and advantages. Hence, unambiguous recommendation of standard digestion procedures can be made only when taking into account the specific analytical problem.

Sentinel node biopsy (SNB) in malignant melanoma as same day procedure vs delayed procedure

DEFF Research Database (Denmark)

Rødgaard, Jes Christian; Kramer, Stine; Stolle, Lars B

2013-01-01

The aim of this study was to compare a delayed sentinel node biopsy (dSNB) procedure with a same-day procedure (sSNB) in malignant melanoma. In March 2012, Aarhus University Hospital went from the dSNB to the sSNB procedure defined by lymphoscintigraphy (LS) and sentinel node biopsy (SNB) perform......, essential to keep the morbidity and economic costs low, while keeping the quality of the procedure high....

Comparative analysis of diagnostic accuracy of different brain biopsy procedures.

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Jain, Deepali; Sharma, Mehar Chand; Sarkar, Chitra; Gupta, Deepak; Singh, Manmohan; Mahapatra, A K

2006-12-01

Image-guided procedures such as computed tomography (CT) guided, neuronavigator-guided and ultrasound-guided methods can assist neurosurgeons in localizing the intraparenchymal lesion of the brain. However, despite improvements in the imaging techniques, an accurate diagnosis of intrinsic lesion requires tissue sampling and histological verification. The present study was carried out to examine the reliability of the diagnoses made on tumor sample obtained via different stereotactic and ultrasound-guided brain biopsy procedures. A retrospective analysis was conducted of all brain biopsies (frame-based and frameless stereotactic and ultrasound-guided) performed in a single tertiary care neurosciences center between 1995 and 2005. The overall diagnostic accuracy achieved on histopathology and correlation with type of biopsy technique was evaluated. A total of 130 cases were included, which consisted of 82 males and 48 females. Age ranged from 4 to 75 years (mean age 39.5 years). Twenty per cent (27 patients) were in the pediatric age group, while 12% (16 patients) were >or= 60-years of age. A definitive histological diagnosis was established in 109 cases (diagnostic yield 80.2%), which encompassed 101 neoplastic and eight nonneoplastic lesions. Frame-based, frameless stereotactic and ultrasound-guided biopsies were done in 95, 15 and 20 patients respectively. Although the numbers of cases were small there was trend for better yield with frameless image-guided stereotactic biopsy and maximum diagnostic yield was obtained i.e, 87% (13/15) in comparison to conventional frame-based CT-guided stereotactic biopsy and ultrasound-guided biopsy. Overall, a trend of higher diagnostic yield was seen in cases with frameless image-guided stereotactic biopsy. Thus, this small series confirms that frameless neuronavigator-guided stereotactic procedures represent the lesion sufficiently in order to make histopathologic diagnosis.

Co-Creation Learning Procedures: Comparing Interactive Language Lessons for Deaf and Hearing Students.

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Hosono, Naotsune; Inoue, Hiromitsu; Tomita, Yutaka

2017-01-01

This paper discusses co-creation learning procedures of second language lessons for deaf students, and sign language lessons by a deaf lecturer. The analyses focus on the learning procedure and resulting assessment, considering the disability. Through questionnaires ICT-based co-creative learning technologies are effective and efficient and promote spontaneous learning motivation goals.

Is the Whipple procedure harmful for long-term outcome in treatment of chronic pancreatitis? 15-years follow-up comparing the outcome after pylorus-preserving pancreatoduodenectomy and Frey procedure in chronic pancreatitis.

Science.gov (United States)

Bachmann, Kai; Tomkoetter, Lena; Kutup, Asad; Erbes, Johannes; Vashist, Yogesh; Mann, Oliver; Bockhorn, Maximilian; Izbicki, Jakob R

2013-11-01

The aim of this study was to report on 15-year long-term results of a randomized controlled trial comparing extended drainage procedure (Frey) and classical resectional procedure [pylorus-preserving pancreatoduodenectomy (PD)] in patients with chronic pancreatitis. Chronic pancreatitis is a common inflammatory disease with a prevalence of 10 to 30 cases per 100,000 inhabitants. It is characterized by the progressive conversion of pancreatic parenchyma to fibrous tissue. Different surgical procedures are used in treatment of persistent pain. Sixty-four patients suffering from chronic pancreatitis with inflammatory mass in the pancreatic head were randomly assigned in 2 treatment groups (PD, n = 32) and (Frey, n = 32). The perioperative course of the randomized controlled trial and the 7 years follow-up have been previously published. All participating patients were contacted with a standardized, validated questionnaire (EORTC QLQ C30) to evaluate the long-term survival, quality-of-life pain, and exocrine and endocrine function. In the 15-year long-term follow-up, the pain control was good and comparable between both groups, but the quality of life was better after Frey procedure in regard of the physical status [PD: 100 (0-100) vs PD: 60 (0-100) (P = 0.011)]. No significant differences in terms of the Pain Score were detected between both groups [PD: 7 (0-100) vs Frey 4 (0-100) P = 0.258]. Seven patients after Frey OP and 6 patients after PD were free of pain. Analyzing the postoperative overall survival, a higher long-term mortality was found after PD (53%) than that found after Frey procedure (30%) resulting in a longer mean survival (14.5 ± 0.8 vs 11.3 ± 0.8 years; P = 0.037). No correlation between endocrine or exocrine pancreatic function and pain was found, whereas continuous alcohol consumption was associated with poorer outcome regarding quality of life (P treatment of chronic pancreatitis.

Location of the levator veli palatini insertion following levator retropositioning, palatal pushback, and pharyngeal flap procedures.

Science.gov (United States)

Mulliken, J B; Giargiana, F A; Claybaugh, G J; Hoopes, J E

1975-07-01

A long-term cineradiographic follow-up study of twenty patients with velo-pharyngeal incompetence fails to demonstrate predictable retrodisplacement of the levator insertion following combined levator retropositioning, pushback, and pharyngeal flap procedures. Simple levator retropositioning gave posterior displacement in the two patients evaluated. Patients with normal or posterior levator insertions pre-operatively all demonstrated post-operative anterior displacement following pharyngeal flap procedures, either alone or in combination with pushback. Anterior levator displacement may be the result of scar contraction or division of the levator sling (during insetting of a pharyngeal flap). Pre-operative and post-operative speech evaluation demonstrated substantial improvement in all except 3 patients; 2 of the poor speech results were patients with demonstrated levator retrodisplacement on post-operative cineradiography.

Randomized, Split-Face/Décolleté Comparative Trial of Procedure Enhancement System for Fractional non-Ablative Laser Resurfacing Treatment.

Science.gov (United States)

Robinson, Deanne Mraz; Frulla, Ashton P

2017-07-01

INTRODUCTION: A topical proprietary procedural enhancement system (PES) containing a combination of active ingredients including a tripeptide and hexapeptide (TriHex Technology™, Alastin Procedure Enhancement Invasive System, ALASTIN Skincare™, Inc., Carlsbad, CA) has been used successfully to aid in healing and improve symptomatology following resurfacing procedures. METHODS: PES (Gentle Cleanser, Regenerating Skin Nectar with TriHex Technology™, Ultra Nourishing Moisturizer with TriHex Technology™, Soothe + Protect Recovery Balm, Broad Spectrum 30+ Sunscreen) was compared to a basic regimen (Aquaphor™, Cerave™ cleanser, Vanicream™, Alastin Broad Spectrum 30+ Sunscreen) in a split face/ décolleté trial following fractional non-ablative thulium-doped resurfacing treatment to the face or décolleté. The skin was pre-conditioned and treated during and after the procedure using the two regimens. RESULTS: A blinded investigator rated the PES statistically superior to the basic regimen on healing post-laser treatment on day 4 based on lentigines, texture, and Global Skin Quality. Subjects also reported 'better looking and feeling' skin on the PES side. CONCLUSION: PES appears to improve healing post-non ablative thulium-doped resurfacing treatment to the face/décolleté in comparison with standard of care. J Drugs Dermatol. 2017;16(7):707-710..

Long-term follow-up of a randomized clinical trial comparing Beger with pylorus-preserving Whipple procedure for chronic pancreatitis.

Science.gov (United States)

Müller, M W; Friess, H; Martin, D J; Hinz, U; Dahmen, R; Büchler, M W

2008-03-01

Duodenum-preserving pancreatic head resection according to Beger and the pylorus-preserving Whipple (ppWhipple) procedure were compared in patients with chronic pancreatitis (CP) in a randomized clinical trial. Perioperative data and short-term outcome have been reported previously. The present study evaluated long-term follow-up. Forty patients were enrolled originally, 20 in each group. Long-term follow-up included mortality, morbidity, pain status, occupational rehabilitation, quality of life (QoL), and endocrine and exocrine function at median follow-up of 7 and 14 years. One patient who had a ppWhipple procedure was lost to follow-up. There were five late deaths in each group. No differences were noted in pain status and exocrine pancreatic function. Loss of appetite was significantly worse in the ppWhipple group at 14 years' follow-up, but there were no other differences in QoL parameters examined. After 14 years, diabetes mellitus was present in seven of 15 patients who had the Beger procedure and 11 of 14 patients after ppWhipple resection (P = 0.128). After long-term follow-up of up to 14 years early advantages of the Beger procedure were no longer present. 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Automatic segmentation of rotational x-ray images for anatomic intra-procedural surface generation in atrial fibrillation ablation procedures.

Science.gov (United States)

Manzke, Robert; Meyer, Carsten; Ecabert, Olivier; Peters, Jochen; Noordhoek, Niels J; Thiagalingam, Aravinda; Reddy, Vivek Y; Chan, Raymond C; Weese, Jürgen

2010-02-01

Since the introduction of 3-D rotational X-ray imaging, protocols for 3-D rotational coronary artery imaging have become widely available in routine clinical practice. Intra-procedural cardiac imaging in a computed tomography (CT)-like fashion has been particularly compelling due to the reduction of clinical overhead and ability to characterize anatomy at the time of intervention. We previously introduced a clinically feasible approach for imaging the left atrium and pulmonary veins (LAPVs) with short contrast bolus injections and scan times of approximately 4 -10 s. The resulting data have sufficient image quality for intra-procedural use during electro-anatomic mapping (EAM) and interventional guidance in atrial fibrillation (AF) ablation procedures. In this paper, we present a novel technique to intra-procedural surface generation which integrates fully-automated segmentation of the LAPVs for guidance in AF ablation interventions. Contrast-enhanced rotational X-ray angiography (3-D RA) acquisitions in combination with filtered-back-projection-based reconstruction allows for volumetric interrogation of LAPV anatomy in near-real-time. An automatic model-based segmentation algorithm allows for fast and accurate LAPV mesh generation despite the challenges posed by image quality; relative to pre-procedural cardiac CT/MR, 3-D RA images suffer from more artifacts and reduced signal-to-noise. We validate our integrated method by comparing 1) automatic and manual segmentations of intra-procedural 3-D RA data, 2) automatic segmentations of intra-procedural 3-D RA and pre-procedural CT/MR data, and 3) intra-procedural EAM point cloud data with automatic segmentations of 3-D RA and CT/MR data. Our validation results for automatically segmented intra-procedural 3-D RA data show average segmentation errors of 1) approximately 1.3 mm compared with manual 3-D RA segmentations 2) approximately 2.3 mm compared with automatic segmentation of pre-procedural CT/MR data and 3

A randomized clinical trial comparing cervical dysplasia treatment with cryotherapy vs loop electrosurgical excision procedure in HIV-seropositive women from Johannesburg, South Africa.

Science.gov (United States)

Smith, Jennifer S; Sanusi, Busola; Swarts, Avril; Faesen, Mark; Levin, Simon; Goeieman, Bridgette; Ramotshela, Sibongile; Rakhombe, Ntombiyenkosi; Williamson, Anna L; Michelow, Pam; Omar, Tanvier; Hudgens, Michael G; Firnhaber, Cynthia

2017-08-01

Mortality associated with cervical cancer is a public health concern for women, particularly in HIV-seropositive women in resource-limited countries. HIV-seropositive women are at a higher risk of high-grade cervical precancer, which can eventually progress to invasive carcinoma as compared to HIV-seronegative women. It is imperative to identify effective treatment methods for high-grade cervical precursors among HIV-seropositive women. Randomized controlled trial data are needed comparing cryotherapy vs loop electrosurgical excision procedure treatment efficacy in HIV-seropositive women. Our primary aim was to compare the difference in the efficacy of loop electrosurgical excision procedure vs cryotherapy for the treatment of high-grade cervical intraepithelial neoplasia (grade ≥2) among HIV-seropositive women by conducting a randomized clinical trial. HIV-seropositive women (n = 166) aged 18-65 years with histology-proven cervical intraepithelial neoplasia grade ≥2 were randomized (1:1) to cryotherapy or loop electrosurgical excision procedure treatment at a government hospital in Johannesburg. Treatment efficacy was compared using 6- and 12-month cumulative incidence posttreatment of: (1) cervical intraepithelial neoplasia grade ≥2; (2) secondary endpoints of histologic cervical intraepithelial neoplasia grade ≥3 and grade ≥1; and (3) high-grade and low-grade cervical cytology. The study was registered (ClinicalTrials.govNCT01723956). From January 2010 through August 2014, 166 participants were randomized (86 loop electrosurgical excision procedure; 80 cryotherapy). Cumulative cervical intraepithelial neoplasia grade ≥2 incidence was higher for cryotherapy (24.3%; 95% confidence interval, 16.1-35.8) than loop electrosurgical excision procedure at 6 months (10.8%; 95% confidence interval, 5.7-19.8) (P = .02), although by 12 months, the difference was not significant (27.2%; 95% confidence interval, 18.5-38.9 vs 18.5%; 95% confidence interval, 11

Endoscopic versus stereotactic procedure for pineal tumour biopsies: Comparative review of the literature and learning from a 25-year experience.

Science.gov (United States)

Balossier, A; Blond, S; Touzet, G; Lefranc, M; de Saint-Denis, T; Maurage, C-A; Reyns, N

2015-01-01

Pineal tumours account for 1% to 4% of brain tumours in adults and for around 10% in children. Except in a few cases where germ cell markers are elevated, accurate histological samples are mandatory to initiate the treatment. Open surgery still has a high morbidity and is often needless. Biopsies can either be obtained by endoscopic or stereotactic procedures. Following an extensive review of the literature (PubMed 1970-2013; keywords pineal tumour, biopsy; English and French), 33 studies were analysed and relevant data compared regarding the type of procedure, diagnosis rate, cerebrospinal fluid diversion type and rate, perioperative mortality, morbidity. Endoscopic and stereotactic biopsies showed a diagnosis rate of 81.1% (20%-100%) and 93.7% (82%-100%), respectively. Endoscopic biopsies involved 21.0% of minor and 2.0% of major complications whereas stereotactic biopsies involved 6.4% of minor and 1.6% of major complications. The most frequently reported complication was haemorrhage for both endoscopic and stereotactic procedures, accounting for 4.8% and 4.3%, respectively. Mortality rate was low for both endoscopic and stereotactic procedures, equal to 0.4% and 1.3%, respectively. Local experience of stereotactic biopsies was also reported and corroborated the previous data. The difference between both procedures is not statistically significant (p>0.05) across large series (≥20patients). Nevertheless, tissue diagnosis appears less accurate with endoscopic procedures than with stereotactic procedures (81.1% versus 93.7%, weighted mean across all series). In our opinion, the neuroendoscopic approach is the best tool for managing hydrocephalus, whereas stereotactic biopsies remain the best way to obtain a tissue diagnosis with accuracy and low morbidity. Copyright © 2014. Published by Elsevier Masson SAS.

Quality of life comparing dor and toupet after heller myotomy for achalasia.

Science.gov (United States)

Tomasko, Jonathan M; Augustin, Toms; Tran, Tung T; Haluck, Randy S; Rogers, Ann M; Lyn-Sue, Jerome R

2014-01-01

Laparoscopic Heller cardiomyotomy (LHC) is standard therapy for achalasia. Traditionally, an antireflux procedure has accompanied the myotomy. This study was undertaken to compare quality-of-life outcomes between patients undergoing myotomy with Toupet versus Dor fundoplication. In addition, we investigated overall patient satisfaction after LHC in the treatment of achalasia. One hundred thirty-five patients who underwent LHC over a 13-year period were identified for inclusion. Symptoms queried included dysphagia, heartburn, and bloating using the Gastroesophageal Reflux Disease-Health-Related Quality of Life Scale and a second published scale for the assessment of gastroesophageal reflux disease and dysphagia symptoms. The patients' overall satisfaction after surgery was also rated. Data were compared on the basis of type of fundoplication. Symptom scores were analyzed using chi-square tests and Fisher's exact tests. Sixty-three patients completed the survey (47%). There were no perioperative deaths or reoperations. The mean length of stay was 2.8 days. The mean operative time for LHC with Toupet fundoplication was 137.3±30.91 minutes and for LHC with Dor fundoplication was 111.5±32.44 minutes (P=.006). There was no difference with respect to the incidence or severity of postoperative heartburn, dysphagia, or bloating. Overall satisfaction with Toupet fundoplication was 87.5% and with Dor fundoplication was 93.8% (P>.999). LHC with either Toupet or Dor fundoplication gave excellent patient satisfaction. Postoperative symptoms of heartburn and dysphagia were equivalent when comparing LHC with either antireflux procedure. Dor and Toupet fundoplication were found to have equivalent outcomes in the short term. We prefer Dor to Toupet fundoplication because of its decreased need for extensive dissection and better mucosal protection.

Continuous Descent Approach (CDA) compared to regular descent procedures : Less annoying?

NARCIS (Netherlands)

White, K.; Arntzen, M.; Bronkhorst, A.; Meeter, M.

2014-01-01

Annoyance reactions to different types of landing procedures were addressed in a controlled laboratory setting using a Virtual Community Noise Simulator (VCNS) with a head mounted display.Participants, standing on a virtual countryside road, experienced four types of descentflyovers by an A330

Policies and procedures in the workplace: how health care organizations compare.

Science.gov (United States)

Loo, R

1993-01-01

Many organizations are implementing programs and services to manage the human and economic costs of stress. A mail survey was conducted of 500 randomly selected Canadian organizations having at least 500 employees. The survey tapped four major areas: organizational policies and procedures for managing stress; programs and services offered; perceived benefits and constraints for the organization; and projected future directions in this area. Analyses of returns from 210 organizations-43 health and 167 non-health-revealed various findings. For example, over half of health care organizations have policies and procedures as opposed to less than half of non-health care organizations. Also, health care organizations place greater emphasis on smoking cessation, weight control programs and on stress management training. Although some Canadian organizations are addressing stress, much more could and should be done, especially by organizations that do not yet recognize the impact of stress on employees and their work performance.

Comparative analysis of diagnostic accuracy of different brain biopsy procedures

OpenAIRE

Jain Deepali; Sharma Mehar; Sarkar Chitra; Gupta Deepak; Singh Manmohan; Mahapatra A

2006-01-01

Background: Image-guided procedures such as computed tomography (CT) guided, neuronavigator-guided and ultrasound-guided methods can assist neurosurgeons in localizing the intraparenchymal lesion of the brain. However, despite improvements in the imaging techniques, an accurate diagnosis of intrinsic lesion requires tissue sampling and histological verification. Aims: The present study was carried out to examine the reliability of the diagnoses made on tumor sample obtained via different s...

Plants Africa gave to the World

Directory of Open Access Journals (Sweden)

G. Kunkel

1983-11-01

Full Text Available Although the flora of Africa is rather poor in plant species when compared to the floras of Tropical America or South-east Asia, this vast continent is the home of a wide range of plants useful to Man. Many of these have become famous in cultivation around the world. Coffee now provides an important source of income for certain countries, and the Yams yield one of the world’s staple foods. The Oil Palm and Cola trees are widely cultivated in Africa itself and elsewhere. African Mahoganies and Ironwoods are much sought after timber trees of excellent quality. Numerous grasses and pulses are well-known for their food value, and some of the native Cucurbitaceae are appreciated additions to our vegetable diet. African plants have also made their contribution to horticulture, ranging from world-famous trees such as the African or Gabon Tulip tree and many of the South African species of Proteaceae to the multitude of East and South African succulents. The present paper provides a survey of the most important of these useful plants and will emphasize the need of further research for forestry and agricultural as well as horticultural purposes, especially as far as some still little-known but potentially important plants species are concerned.

Comparative evaluation of the US Environmental Protection Agency's and the Oak Ridge Institute for Science and Education's environmental survey and site assessment program field sampling procedures

International Nuclear Information System (INIS)

Vitkus, T.J.; Bright, T.L.; Roberts, S.A.

1997-10-01

At the request of the U.S. Nuclear Regulatory Commission's (NRC's) Headquarters Office, the Environmental Survey and Site Assessment Program (ESSAP) of the Oak Ridge Institute for Science and Education (ORISE) compared the documented procedures that the U.S. Environmental Protection Agency (EPA) and ESSAP use for collecting environmental samples. The project objectives were to review both organizations' procedures applicable to collecting various sample matrices, compare the procedures for similarities and differences, and then to evaluate the reason for any identified procedural differences and their potential impact on ESSAP's sample data quality. The procedures reviewed included those for sampling surface and subsurface soil, surface and groundwater, vegetation, air, and removable surface contamination. ESSAP obtained copies of relevant EPA documents and reviewed and prepared a tabulated summary of each applicable procedure. The methods for collecting and handling each type of sample were evaluated for differences, and where these were identified, the significance and effect of the differences on analytical quality were determined. The results of the comparison showed that, overall, the procedures and methods that EPA and ESSAP use for sample collection are very similar. The number of minor differences noted were the result of restrictions or procedures necessary to ensure sample integrity and prevent the introduction of interfering compounds when samples are to be analyzed for chemical parameters. For most radio nuclide analyses, these additional procedures are not necessary. Another item noted was EPA's inclusion of steps that reduce the potential for sample cross-contamination by preparing (dressing) a location prior to collecting a sample or removing a portion of a sample prior to containerization

Critical Emergency Medicine Procedural Skills: A Comparative Study of Methods for Teaching and Assessment.

Science.gov (United States)

Chapman, Dane M.; And Others

Three critical procedural skills in emergency medicine were evaluated using three assessment modalities--written, computer, and animal model. The effects of computer practice and previous procedure experience on skill competence were also examined in an experimental sequential assessment design. Subjects were six medical students, six residents,…

To evaluate and compare the efficacy of combined sucrose and non-nutritive sucking for analgesia in newborns undergoing minor painful procedure: a randomized controlled trial.

Science.gov (United States)

Thakkar, P; Arora, K; Goyal, K; Das, R R; Javadekar, B; Aiyer, S; Panigrahi, S K

2016-01-01

The objective of this study was to evaluate and compare the efficacy of combined sucrose and non-nutritive sucking (NNS) for analgesia in newborn infants undergoing heel-stick procedures. This randomized control trial was conducted in the neonatal intensive care unit of a tertiary care hospital over a period of 1 year. One hundred and eighty full-term neonates with birth weight >2200 g and age >24 h were randomized to one of four interventions administered 2 min before the procedure: 2 ml of 30% sucrose (group I, n=45) or NNS (group II, n=45) or both (group III, n=45) or none (group IV, n=45). Primary outcome was composite score based on Premature Infant Pain Profile (PIPP) score. Baseline variables were comparable among the groups. Median (interquartile range) PIPP score was 3 (2 to 4) in group III as compared with 7 (6.5 to 8) in group I, 9 (7 to 11) in group II and 13 (10.5 to 15) in group IV. Group III had significant decrease in the median PIPP score compared with other groups (P=0.000). Median PIPP score also decreased significantly with any intervention as compared with no intervention (P=0.000). Sucrose and/or NNS are effective in providing analgesia in full-term neonates undergoing heel-stick procedures, with the combined intervention being more effective compared with any single intervention.

A new 99mTc-red blood cell labeling procedure for cardiac blood pool imaging: Clinical results

International Nuclear Information System (INIS)

Kelbaek, H.; Buelow, K.; Aldershvile, J.; Moegelyang, J.; Nielsen, S.L.; Copenhagen Univ.

1989-01-01

The first clinical results of a new 99m Tc-red blood cell labeling procedure avoiding cell centrifugation are presented. One ml heparinized blood samples were incubated with small amounts of a stannous kit. By titration studies, ideal quantities of sodium hypochlorite for oxidation of extracellular tin and of EDTA as stabilizer of the label were found. The Cl - concentration and pH of the labeled blood were acceptable, and EDTA increased labeling yield and stability determined in vitro by a few percent. The new procedure gave a slightly higher labeling yield than a current technique using centrifugation of cells. Labeling efficiency expressed as cell bound/total activity was 96.6%±1.3% in healthy subjects and 95.5%±2.2% in cardiac patients and remained high for 2 h after reinjection. The biological halflife of labeled cells following the new procedure was 11-12 h rendering it suitable for serial determinations of radionuclide cardiography. (orig.)

COMPARATIVE ANALYSIS OF OXALIC ACID PRODUCED FROM RICE HUSK AND PADDY

OpenAIRE

P.I. Oghome; K.O.Amanze; C.I.O.Kamalu; A.C Nkwocha; S.O.Opebiyi

2012-01-01

In this research work, comparative analysis of Oxalic acid produced from Rice husk and Paddy was carried out in order to ascertain which waste sample produced a better yield. Nitric acid oxidation of carbohydrates was the method adopted in the production. The variable ratios of HNO3:H2SO4 used were 80:20, 70:30, 60:40, and 50:50. The variable ratio of 60:40 gave the maximum yield and at a maximum temperature of 75oC. Rice husk sample gave a percentage yield of 53.2, 64.4, 81.0, and 53.3 at te...

Comparative clinical evaluation of transcutaneous electrical nerve stimulator over conventional local anesthesia in children seeking dental procedures: A clinical study

Directory of Open Access Journals (Sweden)

M Varadharaja

2014-01-01

Full Text Available Aim: The aim of this study to evaluate the effectiveness of pain control by employing transcutaneous electrical nerve stimulator (TENS over conventional injectable local anesthesia for children requiring restorative procedures under rubber dam. Materials and Methods: The study design considered was the split mouth design, in experiment (right side, dental procedures under rubber dam was performed under TENS and in control (left side, dental procedures under rubber dam was performed under conventional injectable local anesthetic (LA. The level of comfort and discomfort experienced during TENS and conventional LA was determined using visual analog scale (VAS and heart rate. Result: Increase in mean heart rate associated with TENS (0.78% was significantly less compared to increase in heart rate with administration of conventional local anesthesia (11.78%. In VAS, the mean values for pain indicate that minimum pain was felt with TENS, which was closely followed by LA. Conclusion: TENS can offer many safer and psychological advantages and is a valuable alternative to conventional LA for children.

Non-conventional procedure of polarimetry data inversion in conditions of comparable Faraday and Cotton-Mouton effects

International Nuclear Information System (INIS)

Kravtsov, Yu.A.; Chrzanowski, J.; Mazon, D.

2011-01-01

A new procedure for inverting plasma polarimetry data is proposed in this paper. The procedure is based on the fit between a two parameter knowledge-based plasma model, which is using both magnetic and Thompson scattering data, and the polarimetric measurements. In turn the polarimetry system is assumed to measure two angular parameters of polarization: its azimuthal and ellipticity angles. The inversion procedure under consideration is based on the angular variables technique (AVT), describing evolution of the angular parameters of polarization ellipse in weakly anisotropic plasma. Generally inversion procedure can be applied both for weak and significant Faraday and Cotton-Mouton effects. For weak polarimetric effects inversion procedure shows the results of traditional polarimetry.

Distraction arthroplasty compared to other cartilage preservation procedures in patients with post-traumatic arthritis: a systematic review.

Science.gov (United States)

Rivera, Jessica C; Beachler, Jason A

2018-01-23

Post-traumatic arthritis (PTA) is characterized by the deterioration of articular cartilage temporally associated with an articular injury. With a paucity of literature comparing joint preservation techniques, we performed a systematic review of the literature intending to describe and summarize the results of ankle distraction arthroplasty as it compares with studies on tibio-talar microfracture, allograft, and autograft for ankle joint preservation in the post-traumatic population under 50 years of age. Research databases were searched and abstracts screened for relevance on our topic of interest. Abstracts meeting screening criteria with high interobserver reliability underwent full-manuscript review and coding for pertinent citation, study level, treatment, and outcome variables. Outcome variables for patient-reported pain scales, validated outcome measurement tools, radiographic progression, reoperation/re-treatment rates, and complication rates were recorded. Out of 105 unique citations, 10 publications were included. The distraction arthroplasty studies had 36 out of 181 patients requiring reoperation for complications (19.9%), while other joint-preserving procedures studies had 40 out of 177 patients requiring reoperations for complications (22.6%). Clinical outcome scores at mean follow-up time ranging from 2 to 10 years between studies were similar. Reported results for a variety of cartilage preservation procedures, including distraction arthroplasty, are satisfactory and reoperation rates for complication are similar. Limitations in available data and underlying study quality affect synthesis of the results therein. While distraction arthroplasty is an option for cartilage preservation in patients with PTA of the ankle, the technique is highly specialized which may affect the external validity. III.

An improved ashing procedure for biologic sample

Energy Technology Data Exchange (ETDEWEB)

Zongmei, Wu [Zhejiang Province Enviromental Radiation Monitoring Centre (China)

1992-07-01

The classical ashing procedure in muffle was modified for biologic samples. In the modified procedure the door of muffle was open in the duration of ashing process, the ashing was accelerated and the ashing product quality was comparable to that the classical procedure. The modified procedure is suitable for ashing biologic samples in large batches.

An improved ashing procedure for biologic sample

International Nuclear Information System (INIS)

Wu Zongmei

1992-01-01

The classical ashing procedure in muffle was modified for biologic samples. In the modified procedure the door of muffle was open in the duration of ashing process, the ashing was accelerated and the ashing product quality was comparable to that the classical procedure. The modified procedure is suitable for ashing biologic samples in large batches

A fast, easy circumcision procedure combining a CO2 laser and cyanoacrylate adhesive: a non-randomized comparative trial

Directory of Open Access Journals (Sweden)

Tahsin Gorgulu

2016-02-01

Full Text Available ABSTRACT Background Circumcision is performed as a routine operation in many countries, more commonly for religious and cultural reasons than for indicated conditions, such as phimosis and balanitis. There are many techniques available, and recently electrocautery and both Nd:YAG and CO2 lasers, instead of blades, have been used for skin and mucosal incisions. However, the infection risk in circumcisions performed using a CO2 laser was 10% higher. There are also reports of sutureless procedures using cyanoacrylate, but these have higher risks of hematoma and hemorrhage. We combined a CO2 laser and cyanoacrylate to shorten the operation time and to decrease bleeding complications. Materials and Methods : Circumcisions were performed under general anesthesia with CO2 laser and cyanoacrylate combination in 75 6–9-year-old boys between May 2013 and August 2014 only for religious reasons. As a control, we compared them retrospectively with 75 age-matched patients who were circumcised using the conventional guillotine method in our clinic. Results No hematomas, bleeding, or wound infections were observed. One wound dehiscence (1.33% occurred during the early postoperative period and healed without any additional procedures. The median operating time was 7 (range 6–9 minutes. The conventional guillotine group comprised one hematoma (1.3%, two wound dehiscences (2.6%, and two hemorrhages (2.6%, and the median operating time was 22 (range 20–26 minutes. The difference in surgical time was significant (p<0.001, with no significant difference in the rate of complications between the two groups. Conclusion The combined CO2 laser and cyanoacrylate procedure not only decreased the operating time markedly, but also eliminated the disadvantages associated with each individual procedure alone.

Two-stage dental implants inserted in a one-stage procedure : a prospective comparative clinical study

NARCIS (Netherlands)

Heijdenrijk, Kees

2002-01-01

The results of this study indicate that dental implants designed for a submerged implantation procedure can be used in a single-stage procedure and may be as predictable as one-stage implants. Although one-stage implant systems and two-stage.

Procedures for the selection of stopping power ratios for electron beams: Comparison of IAEA TRS procedures and of DIN procedures with Monte Carlo results

International Nuclear Information System (INIS)

Roos, M.; Christ, G.

2000-01-01

In the International Code of Practice IAEA TRS-381 the stopping power ratios water/air are selected according to the half-value depth and the depth of measurement. In the German Standard DIN 6800-2 a different procedure is recommended, which, in addition, takes the practical electron range into account; the stopping power data for monoenergetic beams from IAEA TRS-381 are used. Both procedures are compared with recent Monte Carlo calculations carried out for various beams of clinical accelerators. It is found that the DIN procedure shows a slightly better agreement. In addition, the stopping power ratios in IAEA TRS-381 are compared with those in DIN 6800-2 for the reference conditions of the beams from the PTB linac; the maximum deviation is not larger than 0.6%. (author)

Direct methylation procedure for converting fatty amides to fatty acid methyl esters in feed and digesta samples.

Science.gov (United States)

Jenkins, T C; Thies, E J; Mosley, E E

2001-05-01

Two direct methylation procedures often used for the analysis of total fatty acids in biological samples were evaluated for their application to samples containing fatty amides. Methylation of 5 mg of oleamide (cis-9-octadecenamide) in a one-step (methanolic HCl for 2 h at 70 degrees C) or a two-step (sodium methoxide for 10 min at 50 degrees C followed by methanolic HCl for 10 min at 80 degrees C) procedure gave 59 and 16% conversions of oleamide to oleic acid, respectively. Oleic acid recovery from oleamide was increased to 100% when the incubation in methanolic HCl was lengthened to 16 h and increased to 103% when the incubation in methoxide was modified to 24 h at 100 degrees C. However, conversion of oleamide to oleic acid in an animal feed sample was incomplete for the modified (24 h) two-step procedure but complete for the modified (16 h) one-step procedure. Unsaturated fatty amides in feed and digesta samples can be converted to fatty acid methyl esters by incubation in methanolic HCl if the time of exposure to the acid catalyst is extended from 2 to 16 h.

On comparative inquiry

DEFF Research Database (Denmark)

Moutsios, Stavros

of self‐reflexivity and self-questioning in the Greek polis gave also rise to the genuine interest in the institutions of the cultural ‘other’. Impartiality in the study of the others’ institutions started in Greece and it was closely associated with the signification that physis (nature) should......The paper explores the origins of comparative studies, which as it argues are located in Ancient Greece. Greece is not only the place where the school was born, but it is also there where the interest in and inquiry of the institutions of other societies, including education, emerged. The rise...... to know better their own society through comparison. Cross-cultural examination in this regard informed further the Greeks’ self-reflexivity. By going through a set of historical sources and contemporary literature, the paper will elaborate on the emergence of cross-cultural and comparative inquiry...

Calculation procedure for formulating lauric and palmitic fat blends based on the grouping of triacylglycerol melting points

Directory of Open Access Journals (Sweden)

B. P. Nusantoro

2018-01-01

Full Text Available A calculation procedure for formulating lauric and palmitic fat blends has been developed based on grouping TAG melting points. This procedure offered more flexibility in choosing the initial fats and oils and eventually gave deeper insight into the existing chemical compositions and better prediction on the physicochemical properties and microstructure of the fat blends. The amount of high, medium and low melting TAGs could be adjusted using the given calculation procedure to obtain the desired functional properties in the fat blends. Solid fat contents and melting behavior of formulated fat blends showed particular patterns with respect to ratio adjustments of the melting TAG groups. These outcomes also suggested that both TAG species and their quantity had a significant influence on the crystallization behavior of the fat blends. Palmitic fat blends, in general, were found to exhibit higher SFC values than those of Lauric fat blends. Instead of the similarity in crystal microstructure, lauric fat blends were stabilized at β polymorph while palmitic fat blends were stabilized at β’ polymorph.

Calculation procedure for formulating lauric and palmitic fat blends based on the grouping of triacylglycerol melting points

International Nuclear Information System (INIS)

Nusantoro, B.P.; Yanty, N.A.M.; Van de Walle, D.; Hidayat, C.; Danthine, S.; Dewettinck, K.

2017-01-01

A calculation procedure for formulating lauric and palmitic fat blends has been developed based on grouping TAG melting points. This procedure offered more flexibility in choosing the initial fats and oils and eventually gave deeper insight into the existing chemical compositions and better prediction on the physicochemical properties and microstructure of the fat blends. The amount of high, medium and low melting TAGs could be adjusted using the given calculation procedure to obtain the desired functional properties in the fat blends. Solid fat contents and melting behavior of formulated fat blends showed particular patterns with respect to ratio adjustments of the melting TAG groups. These outcomes also suggested that both TAG species and their quantity had a significant influence on the crystallization behavior of the fat blends. Palmitic fat blends, in general, were found to exhibit higher SFC values than those of Lauric fat blends. Instead of the similarity in crystal microstructure, lauric fat blends were stabilized at β polymorph while palmitic fat blends were stabilized at β’ polymorph. [es

Use of CR-39 foils for personnel neutron dosimetry: improved electrochemical etching chambers and procedures

International Nuclear Information System (INIS)

Hankins, D.E.; Homann, S.G.; Westermark, J.

1986-01-01

The electrochemical etching procedures for the new dosimetry system that uses foils of CR-39 plastic has been improved. During 1985, the etching chambers were modified to correct several problems and the changes to the etching procedures were studied, which gave a more uniform track density and size. The currently recommended etch parameters are given. A new generation of CR-39 material from the manufacturer proved to have a considerably lower background track density and a higher sensitivity; the new foils are also more uniform in thickness, which eliminates the need to numerically compensate for thickness variations. The energy dependence of the CR-39 using monoenergetic neutrons from accelerators at Battelle Northwest Laboratories and at Los Alamos National Laboratory was determined. Some variation was found in the energy dependence, but it is believed this was caused by changes in the etching procedures and by uncertainties in the fluences of the neutrons from the accelerators. A means by which the counting of CR-39 tracks may be automated is suggested; this would be very useful in adapting the CR-39 dosimetry system to large-scale use

Can a Drill Guide Improve the Coracoid Graft Placement During the Latarjet Procedure? A Prospective Comparative Study With the Freehand Technique.

Science.gov (United States)

Barth, Johannes; Boutsiadis, Achilleas; Neyton, Lionel; Lafosse, Laurent; Walch, Gilles

2017-10-01

One of the factors that can affect the success of the Latarjet procedure is accurate coracoid graft (CG) placement. The use of a guide can improve placement of the CG and screw positioning in the sagittal and axial planes as compared with the classic open ("freehand") technique. Cohort study; Level of evidence, 2. A total of 49 patients who underwent a Latarjet procedure for the treatment of recurrent anterior shoulder instability were prospectively included; the procedure was performed with the freehand technique in 22 patients (group 1) and with use of a parallel drill guide during screw placement in 27 patients (group 2). All patients underwent a postoperative computed tomography scan with the same established protocol. The scans were used to evaluate and compare the position of the CG in the sagittal and axial planes, the direction of the screws (α angle), and overall contact of the graft with the anterior surface of the glenoid after the 2 surgical techniques. The CG was placed >60% below the native glenoid equator in 23 patients (85.2%) in group 2, compared with 14 patients (63.6%) in group 1 ( P = .004). In the axial plane, the position of the CG in group 2 patients was more accurate (85.2% and 88.9% flush) at the inferior and middle quartiles of the glenoid surface ( P = .012 and .009), respectively. Moreover, with the freehand technique (group 1), the graft was in a more lateral position in the inferior and middle quartiles ( P = .012 and .009, respectively). No differences were found between groups 1 and 2 regarding the mean α angle of the superior (9° ± 4.14° vs 11° ± 6.3°, P = .232) and inferior (9.5° ± 6° vs 10° ± 7.5°, P = .629) screws. However, the mean contact angle (angle between the posterior coracoid and the anterior glenoid surface) with the freehand technique (3.8° ± 6.8°) was better than that of the guide (8.55° ± 8°) ( P = .05). Compared with the classic freehand operative technique, the parallel drill guide can ensure

Exploration of freely available web-interfaces for comparative homology modelling of microbial proteins.

Science.gov (United States)

Nema, Vijay; Pal, Sudhir Kumar

2013-01-01

This study was conducted to find the best suited freely available software for modelling of proteins by taking a few sample proteins. The proteins used were small to big in size with available crystal structures for the purpose of benchmarking. Key players like Phyre2, Swiss-Model, CPHmodels-3.0, Homer, (PS)2, (PS)(2)-V(2), Modweb were used for the comparison and model generation. Benchmarking process was done for four proteins, Icl, InhA, and KatG of Mycobacterium tuberculosis and RpoB of Thermus Thermophilus to get the most suited software. Parameters compared during analysis gave relatively better values for Phyre2 and Swiss-Model. This comparative study gave the information that Phyre2 and Swiss-Model make good models of small and large proteins as compared to other screened software. Other software was also good but is often not very efficient in providing full-length and properly folded structure.

Cost-effectiveness of procedures for treatment of ostium secundum atrial septal defects occlusion comparing conventional surgery and septal percutaneous implant.

Science.gov (United States)

da Costa, Márcia Gisele Santos; Santos, Marisa da Silva; Sarti, Flávia Mori; Simões e Senna, Kátia Marie; Tura, Bernardo Rangel; Correia, Marcelo Goulart; Goulart, Marcelo Correia

2014-01-01

The study performs a cost-effectiveness analysis of procedures for atrial septal defects occlusion, comparing conventional surgery to septal percutaneous implant. A model of analytical decision was structured with symmetric branches to estimate cost-effectiveness ratio between the procedures. The decision tree model was based on evidences gathered through meta-analysis of literature, and validated by a panel of specialists. The lower number of surgical procedures performed for atrial septal defects occlusion at each branch was considered as the effectiveness outcome. Direct medical costs and probabilities for each event were inserted in the model using data available from Brazilian public sector database system and information extracted from the literature review, using micro-costing technique. Sensitivity analysis included price variations of percutaneous implant. The results obtained from the decision model demonstrated that the percutaneous implant was more cost effective in cost-effectiveness analysis at a cost of US$8,936.34 with a reduction in the probability of surgery occurrence in 93% of the cases. Probability of atrial septal communication occlusion and cost of the implant are the determinant factors of cost-effectiveness ratio. The proposal of a decision model seeks to fill a void in the academic literature. The decision model proposed includes the outcomes that present major impact in relation to the overall costs of the procedure. The atrial septal defects occlusion using percutaneous implant reduces the physical and psychological distress to the patients in relation to the conventional surgery, which represent intangible costs in the context of economic evaluation.

Cost-effectiveness of procedures for treatment of ostium secundum atrial septal defects occlusion comparing conventional surgery and septal percutaneous implant.

Directory of Open Access Journals (Sweden)

Márcia Gisele Santos da Costa

Full Text Available OBJECTIVES: The study performs a cost-effectiveness analysis of procedures for atrial septal defects occlusion, comparing conventional surgery to septal percutaneous implant. METHODS: A model of analytical decision was structured with symmetric branches to estimate cost-effectiveness ratio between the procedures. The decision tree model was based on evidences gathered through meta-analysis of literature, and validated by a panel of specialists. The lower number of surgical procedures performed for atrial septal defects occlusion at each branch was considered as the effectiveness outcome. Direct medical costs and probabilities for each event were inserted in the model using data available from Brazilian public sector database system and information extracted from the literature review, using micro-costing technique. Sensitivity analysis included price variations of percutaneous implant. RESULTS: The results obtained from the decision model demonstrated that the percutaneous implant was more cost effective in cost-effectiveness analysis at a cost of US$8,936.34 with a reduction in the probability of surgery occurrence in 93% of the cases. Probability of atrial septal communication occlusion and cost of the implant are the determinant factors of cost-effectiveness ratio. CONCLUSIONS: The proposal of a decision model seeks to fill a void in the academic literature. The decision model proposed includes the outcomes that present major impact in relation to the overall costs of the procedure. The atrial septal defects occlusion using percutaneous implant reduces the physical and psychological distress to the patients in relation to the conventional surgery, which represent intangible costs in the context of economic evaluation.

Payment Procedures for Electronic Government Services

OpenAIRE

Pousttchi, Key; Wiedemann, Dietmar Georg

2005-01-01

In this paper, we analyse payment procedures for their suitability for electronic government. We provide an overview of the payment procedures currently available on the market, compare the situation in electronic government with the situation in electronic commerce and analyze what we can transfer. Based on functional requirements we propose a scheme that allows public agencies to examine the appropriateness of any given payment procedure for electronic government.

Nuclear Waste Fund cash management procedures

International Nuclear Information System (INIS)

1988-04-01

The Nuclear Waste Policy Act if 1982 (NWPA) provided for the Office of Radioactive Waste Management (OCRWM) to adopt financial and accounting methods comparable to those used by private industry, including borrowing and investing authority. This document describes the procedures OCRWM follows to meet its borrowing and investing authority under the NWPA. These procedures are a supplement to, and are, therefore, not intended to supersede, existing Departmental policies and procedures

Etiology of Readmissions Following Orthopaedic Procedures and Medical Admissions. A Comparative Analysis.

Science.gov (United States)

Maslow, Jed; Hutzler, Lorraine; Slover, James; Bosco, Joseph

2015-12-01

The Federal Government, the largest payer of health care, considers readmission within 30 days of discharge an indicator of quality of care. Many studies have focused on causes for and strategies to reduce readmissions following medical admissions. However, few studies have focused on the differences between them. We believe that the causes for readmission following orthopaedic surgery are markedly different than those following medical admissions, and therefore, the strategies developed to reduce medical readmissions will not be as effective in reducing readmissions after elective orthopaedic surgery. All unplanned 30-day readmissions following an index hospitalization for an elective orthopaedic procedure (primary and revision total joint arthroplasty and spine procedure) or for one of the three publicly reported medical conditions (AMI, HF, and pneumonia, which accounted for 11% of readmissions) were identified at our institution from 2010 through 2012. A total of 268 patients and 390 medical patients were identified as having an unplanned 30-day readmission. We reviewed a prospectively collected data base to determine the reason for readmission in each encounter. A total of 233 (86.9%) orthopaedic patients were readmitted for surgical complications, most commonly for a wound infection (56.0%) or wound complication (11.6%). Following an index admission of HF or AMI, the primary reason for readmission was a disease of the circulatory system (55.9% and 57.4%, respectively). Following an index admission for pneumonia, the primary reason for readmission was a disease of the respiratory system (34.5%). The causes of readmissions following orthopaedic surgery and medical admissions are different. Patients undergoing orthopaedic procedures are readmitted for surgical complications, frequently unrelated to aftercare, and medicine patients are readmitted for reasons related to the index diagnosis. Interventions designed to reduce orthopaedic readmissions must focus on

Bifurcation Culprit Lesions in ST-segment Elevation Myocardial Infarction: Procedural Success and 5-year Outcome Compared With Nonbifurcation Lesions.

Science.gov (United States)

Salinas, Pablo; Mejía-Rentería, Hernán; Herrera-Nogueira, Raúl; Jiménez-Quevedo, Pilar; Nombela-Franco, Luis; Núñez-Gil, Iván Javier; Gonzalo, Nieves; Del Trigo, María; Pérez-Vizcayno, María José; Quirós, Alicia; Escaned, Javier; Macaya, Carlos; Fernández-Ortiz, Antonio

2017-08-09

We assessed short- and long-term outcomes of primary angioplasty in ST-segment elevation myocardial infarction by comparing bifurcation culprit lesions (BCL) with non-BCL. Observational study with a propensity score matched control group. Among 2746 consecutive ST-segment elevation myocardial infarction patients, we found 274 (10%) patients with BCL. The primary outcome was a composite endpoint including all-cause death, myocardial infarction, coronary artery bypass grafting or target vessel revascularization, assessed at 30-days and 5-years. Baseline characteristics showed no differences after propensity matching (1:1). In the BCL group, the most frequent strategy was provisional stenting of the main branch (84%). Compared with the non-BCL group, the procedures were technically more complex in the BCL group in terms of need for balloon dilatation (71% BCL vs 59% non-BCL; P = .003), longer procedural time (70 ± 29minutes BCL vs 62.8 ± 28.9minutes non-BCL; P = .004) and contrast use (256.2 ± 87.9mL BCL vs 221.1 ± 82.3mL non-BCL; P < .001). Main branch angiographic success was similar (93.4% BCL vs 93.8% non-BCL; P = .86). Thirty-day all-cause mortality was similar between groups: 4.7% BCL vs 5.1% non-BCL; P = .84. At the 5-year follow-up, there were no differences in all-cause death (12% BCL vs 13% non-BCL; P = .95) or the combined event (22% BCL vs 21% non-BCL; P = .43). Primary angioplasty of a BCL was technically more complex; however, main branch angiographic success was similar, and there were no differences in long-term prognosis compared with non-BCL patients. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Muscle lesion comparing of imaging procedures (sonography and MRT) -experimental and clinical study

International Nuclear Information System (INIS)

Mellerowicz, H.; Lubasch, A.; Dulce, M.; Wagner, S.; Paul, B.

1993-01-01

Muscle injuries in sports are more common now. Diagnosis and follow up of muscle injuries is nowadays achieved by sonography and MRT. In order to assess the two imagine procedures, a direct test for comparison of sonography and MRT was performed in an experimental study: A standardised disconnection of m. triceps surae in rats was either sutured and glued or not treated. Clinical studies were performed in 26 patients suffering from muscle trauma. Sonography was proved to be a reliable procedure especially in follow up control until full weight bearing and should be used first. Negative or doubtfull findings require further investigation by MRT. Especially contrast medium (Gd-DTPA) assisted examinations enables a long term follow up and may even show small (muscle strain) and deep lying injuries. (orig.) [de

FFTF fuel pin design procedure verification for transient operation

International Nuclear Information System (INIS)

Baars, R.E.

1975-05-01

The FFTF design procedures for evaluating fuel pin transient performance are briefly reviewed, and data where available are compared with design procedure predictions. Specifically, burst conditions derived from Fuel Cladding Transient Tester (FCTT) tests and from ANL loss-of-flow tests are compared with burst pressures computed using the design procedure upon which the cladding integrity limit was based. Failure times are predicted using the design procedure for evaluation of rapid reactivity insertion accidents, for five unterminated TREAT experiments in which well characterized fuel failures were deliberately incurred. (U.S.)

Clinical Outcomes of Root Reimplantation and Bentall Procedure: Propensity Score Matching Analysis.

Science.gov (United States)

Lee, Heemoon; Cho, Yang Hyun; Sung, Kiick; Kim, Wook Sung; Park, Kay-Hyun; Jeong, Dong Seop; Park, Pyo Won; Lee, Young Tak

2018-03-26

This study aimed to evaluate the clinical outcomes of aortic root replacement(ARR) surgery:Root reimplantation as valve-sparing root replacement(VSR) and the Bentall procedure. We retrospectively reviewed 216 patients who underwent ARR between 1995 and 2013 at Samsung Medical Center. Patients were divided into two groups, depending on the procedure they underwent: Bentall(n=134) and VSR(n=82). The mean follow-up duration was 100.9±56.4 months. There were 2 early deaths in the Bentall group and none in the VSR group(p=0.53). Early morbidities were not different between the groups. Overall mortality was significantly lower in the VSR group (HR=0.12,p=0.04). Despite the higher reoperation rate in the VSR group(p=0.03), major adverse valve-related events(MAVRE) did not differ between the groups(p=0.28). Bleeding events were significantly higher in the Bentall group during follow-up(10 in Bentall group, 0 in VSR group, p=0.04). here were 6 thromboembolic events only in the Bentall group(p=0.11). We performed a propensity score matching analysis comparing the groups(134 Bentall vs 43 VSR). Matched analysis gave similar results, i.e. HR=0.17 and p=0.10 for overall mortality and HR=1.01 and p=0.99 for MAVRE. Although there was marginal significance in the propensity matched analysis, it is plausible to anticipate a survival benefit with VSR during long-term follow-up. Despite a higher reoperation for aortic valves, VSR can be a viable option in patients who decline life-long anticoagulation, especially the young or the patients in whom anticoagulation is contraindicated. Copyright © 2018. Published by Elsevier Inc.

22 CFR 92.37 - Authentication procedure.

Science.gov (United States)

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Authentication procedure. 92.37 Section 92.37... Notarial Acts § 92.37 Authentication procedure. (a) The consular officer must compare the foreign official...) Where the State law requires the consular officer's certificate of authentication to show that the...

Comparison of sample preparation procedures on metal(loid) fractionation patterns in lichens.

Science.gov (United States)

Kroukamp, E M; Godeto, T W; Forbes, P B C

2017-08-13

The effects of different sample preparation strategies and storage on metal(loid) fractionation trends in plant material is largely underresearched. In this study, a bulk sample of lichen Parmotrema austrosinense (Zahlbr.) Hale was analysed for its total extractable metal(loid) content by ICP-MS, and was determined to be adequately homogenous (sample were prepared utilising a range of sample preservation techniques and subjected to a modified sequential extraction procedure or to total metal extraction. Both experiments were repeated after 1-month storage at 4 °C. Cryogenic freezing gave the best reproducibility for total extractable elemental concentrations between months, indicating this to be the most suitable method of sample preparation in such studies. The combined extraction efficiencies were >82% for As, Cu, Mn, Pb, Sr and Zn but poor for other elements, where sample preparation strategies 'no sample preparation' and 'dried in a desiccator' had the best extraction recoveries. Cryogenic freezing procedures had a significantly (p sample cleaning and preservation when species fractionation patterns are of interest. This study also shows that the assumption that species stability can be ensured through cryopreservation and freeze drying techniques needs to be revisited.

Surgeon-patient communication during awake procedures.

Science.gov (United States)

Smith, Claire S; Guyton, Kristina; Pariser, Joseph J; Siegler, Mark; Schindler, Nancy; Langerman, Alexander

2017-06-01

Surgeons are increasingly performing procedures on awake patients. Communication during such procedures is complex and underexplored in the literature. Surgeons were recruited from the faculty of 2 hospitals to participate in an interview regarding their approaches to communication during awake procedures. Three researchers used the constant comparative method to transcribe, code, and review interviews until saturation was reached. Twenty-three surgeons described the advantages and disadvantages of awake procedures, their communication with the awake patient, their interactions with staff and with trainees, the environment of awake procedures, and how communication in this context is taught and learned. Surgeons recognized communication during awake procedures as important and reported varied strategies for ensuring patient comfort in this context. However, they also acknowledged challenges with multiparty communication during awake procedures, especially in balancing commitments to teaching with their duty to comfort the patient. Copyright © 2016 Elsevier Inc. All rights reserved.

Do Ethical Judgments Depend on the Type of Response Scale? Comparing Acceptability versus Unacceptability Judgments in the Case of Life-Ending Procedures

Directory of Open Access Journals (Sweden)

Etienne Mullet

2010-01-01

Full Text Available Using Functional Measurement (Anderson, 2008, Frileux, Lelièvre, Muñoz Sastre, Mullet, and Sorum (2003 examined the joint impact of several key factors on lay people's judgments of the acceptability of physicians' interventions to end patients' lives. The level of acceptability was high, and the information integration rule that best described the participants' judgments was Acceptability = Patient's Request + Patient's Age + Residual Suffering + Incurability. Critics suggested, however, that acceptability was high because the ethical problem was framed in terms of acceptability (Murphy, 2007. Presenting participants with acceptability scales may have caused the life-ending procedure to be represented in participants' mind as basically "acceptable". By contrast, presenting participants with unacceptability scales might cause the procedure to be represented as basically "unacceptable". In the present study, therefore, we directly compared lay people's judgments of the acceptability of life-ending procedures under two opposite conditions - an acceptability condition, and an unacceptability condition. The life-ending procedure did not appear as more acceptable to participants responding in terms of acceptability than to those responding in terms of unacceptability. In addition, the impacts of the factors describing the end-of-life situations were not affected by the type of judgment scale that was used. Functional Measurement seems to be resistant to goal-framing effects; the findings that have been observed using acceptability scales can be considered as robust.

Comparative study of deterioration procedure in chemical-leavened steamed bread dough under frozen storage and freeze/thaw condition.

Science.gov (United States)

Wang, Pei; Yang, Runqiang; Gu, Zhenxin; Xu, Xueming; Jin, Zhengyu

2017-08-15

Successive freeze/thaw (FT) cycle was a widely used empirical approach to shorten the experimental period since it could accelerate frozen dough deterioration compared with frozen storage (FS). In order to compare the effect of FS and FT cycle on deterioration procedure of chemical-leavened steamed bread dough, kinetic studies of bread quality indices were performed and the relationships between bread quality and dough components were further established. Results showed that degradation of steamed bread loaf volume and firmness followed first-order kinetics during FS and zero-order kinetics during FT, respectively. Glutenin macropolymers (GMP) depolymerization and dough weight loss occurred steadily throughout FS and FT. Significant enhancement of damaged starch and crystallinity were observed at the later FS period and FT cycle. Multiple regression study led to the conclusion that dough weight loss contributed the most to the reduced bread loaf volume under FS whereas GMP depolymerization dominated under FT condition. Copyright © 2017 Elsevier Ltd. All rights reserved.

Estimating the Standard Error of the Judging in a modified-Angoff Standards Setting Procedure

Directory of Open Access Journals (Sweden)

Robert G. MacCann

2004-03-01

Full Text Available For a modified Angoff standards setting procedure, two methods of calculating the standard error of the..judging were compared. The Central Limit Theorem (CLT method is easy to calculate and uses readily..available data. It estimates the variance of mean cut scores as a function of the variance of cut scores within..a judging group, based on the independent judgements at Stage 1 of the process. Its theoretical drawback is..that it is unable to take account of the effects of collaboration among the judges at Stages 2 and 3. The..second method, an application of equipercentile (EQP equating, relies on the selection of very large stable..candidatures and the standardisation of the raw score distributions to remove effects associated with test..difficulty. The standard error estimates were then empirically obtained from the mean cut score variation..observed over a five year period. For practical purposes, the two methods gave reasonable agreement, with..the CLT method working well for the top band, the band that attracts most public attention. For some..bands in English and Mathematics, the CLT standard error was smaller than the EQP estimate, suggesting..the CLT method be used with caution as an approximate guide only.

Comparison of transition-matrix sampling procedures

DEFF Research Database (Denmark)

Yevick, D.; Reimer, M.; Tromborg, Bjarne

2009-01-01

We compare the accuracy of the multicanonical procedure with that of transition-matrix models of static and dynamic communication system properties incorporating different acceptance rules. We find that for appropriate ranges of the underlying numerical parameters, algorithmically simple yet high...... accurate procedures can be employed in place of the standard multicanonical sampling algorithm....

Do single-use medical devices containing biopolymers reduce the environmental impacts of surgical procedures compared with their plastic equivalents?

Science.gov (United States)

Unger, Scott R; Hottle, Troy A; Hobbs, Shakira R; Thiel, Cassandra L; Campion, Nicole; Bilec, Melissa M; Landis, Amy E

2017-01-01

Background While petroleum-based plastics are extensively used in health care, recent developments in biopolymer manufacturing have created new opportunities for increased integration of biopolymers into medical products, devices and services. This study compared the environmental impacts of single-use disposable devices with increased biopolymer content versus typically manufactured devices in hysterectomy. Methods A comparative life cycle assessment of single-use disposable medical products containing plastic(s) versus the same single-use medical devices with biopolymers substituted for plastic(s) at Magee-Women's Hospital (Magee) in Pittsburgh, PA and the products used in four types of hysterectomies that contained plastics potentially suitable for biopolymer substitution. Magee is a 360-bed teaching hospital, which performs approximately 1400 hysterectomies annually. Results There are life cycle environmental impact tradeoffs when substituting biopolymers for petroplastics in procedures such as hysterectomies. The substitution of biopolymers for petroleum-based plastics increased smog-related impacts by approximately 900% for laparoscopic and robotic hysterectomies, and increased ozone depletion-related impacts by approximately 125% for laparoscopic and robotic hysterectomies. Conversely, biopolymers reduced life cycle human health impacts, acidification and cumulative energy demand for the four hysterectomy procedures. The integration of biopolymers into medical products is correlated with reductions in carcinogenic impacts, non-carcinogenic impacts and respiratory effects. However, the significant agricultural inputs associated with manufacturing biopolymers exacerbate environmental impacts of products and devices made using biopolymers. Conclusions The integration of biopolymers into medical products is correlated with reductions in carcinogenic impacts, non-carcinogenic impacts and respiratory effects; however, the significant agricultural inputs associated

Evaluation of spray and point inoculation methods for the phenotyping of Puccinia striiformis on wheat

DEFF Research Database (Denmark)

Sørensen, Chris Khadgi; Thach, Tine; Hovmøller, Mogens Støvring

2016-01-01

flexible application procedure for spray inoculation and it gave highly reproducible results for virulence phenotyping. Six point inoculation methods were compared to find the most suitable for assessment of pathogen aggressiveness. The use of Novec 7100 and dry dilution with Lycopodium spores gave...... for the assessment of quantitative epidemiological parameters. New protocols for spray and point inoculation of P. striiformis on wheat are presented, along with the prospect for applying these in rust research and resistance breeding activities....

Deterministic effects of interventional radiology procedures

International Nuclear Information System (INIS)

Shope, Thomas B.

1997-01-01

The purpose of this paper is to describe deterministic radiation injuries reported to the Food and Drug Administration (FDA) that resulted from therapeutic, interventional procedures performed under fluoroscopic guidance, and to investigate the procedure or equipment-related factors that may have contributed to the injury. Reports submitted to the FDA under both mandatory and voluntary reporting requirements which described radiation-induced skin injuries from fluoroscopy were investigated. Serious skin injuries, including moist desquamation and tissues necrosis, have occurred since 1992. These injuries have resulted from a variety of interventional procedures which have required extended periods of fluoroscopy compared to typical diagnostic procedures. Facilities conducting therapeutic interventional procedures need to be aware of the potential for patient radiation injury and take appropriate steps to limit the potential for injury. (author)

Comparative analysis of environmental DNA extraction and purification methods from different humic acid rich soils

CSIR Research Space (South Africa)

Lakay, FM

2007-01-01

Full Text Available Three different soil DNA isolation and four purification strategies were compared on different soil samples with variable rates of success. Bead beating extraction gave significantly higher DNA yields than microwave-based and liquid nitrogen...

Comparative efficiency of final endodontic cleansing procedures in removing a radioactive albumin from root canal systems

International Nuclear Information System (INIS)

Cecic, P.A.; Peters, D.D.; Grower, M.F.

1984-01-01

Fifty-six teeth were initially instrumented, with the use of seven irrigants or irrigant combinations, and filled with radioactive albumin. The study then showed the relative ability of three final endodontic procedures (copious reirrigation with saline solution, drying with paper points, and reassuring patency of the canal with the final instrument) to remove the albumin. Even after copious irrigation, each additional procedure removed statistically significant amounts of albumin. Alternating an organic solvent and an inorganic solvent did appear to leave the canal system in the optimal condition for final cleansing procedures. The study then correlated the relative efficiency of irrigation alone versus instrumentation plus irrigation in removing the remaining albumin from the canal systems. Reinstrumentation plus copious irrigation removed significantly more albumin than copious irrigation alone

Comparative evaluation of the effectiveness of electronic dental anesthesia with 2% lignocaine in various minor pediatric dental procedures: A clinical study

Directory of Open Access Journals (Sweden)

Abhishek Dhindsa

2011-01-01

Full Text Available One of the most distressing aspects of dentistry for pediatric patients is the fear and anxiety caused by the dental environment, particularly the dental injection. The application and induction of local anesthetics has always been a difficult task, and this demands an alternative method that is convenient and effective. Electronic dental anesthesia, based on the principal of transcutaneous electric nerve stimulation (TENS, promises to be a viable mode of pain control during various pediatric clinical procedures. Therefore, the aim of the present study was to evaluate the effectiveness of TENS and to compare its efficacy with 2% lignocaine during various minor pediatric dental procedures. Pain, comfort and effectiveness of both the anesthetics were evaluated using various scales and no significant difference was observed between 2% lignocaine and TENS in the various pain scales, while TENS was perceived to be significantly effective in comfort and efficacy as judged by the operator and quite comfortable as judged by the patient himself/herself.

Estimation of staff lens doses during interventional procedures. Comparing cardiology, neuroradiology and interventional radiology

International Nuclear Information System (INIS)

Vano, E.; Sanchez, R.M.; Fernandez, J.M.

2015-01-01

The purpose of this article is to estimate lens doses using over apron active personal dosemeters in interventional catheterisation laboratories (cardiology IC, neuroradiology IN and radiology IR) and to investigate correlations between occupational lens doses and patient doses. Active electronic personal dosemeters placed over the lead apron were used on a sample of 204 IC procedures, 274 IN and 220 IR (all performed at the same university hospital). Patient dose values (kerma area product) were also recorded to evaluate correlations with occupational doses. Operators used the ceiling-suspended screen in most cases. The median and third quartile values of equivalent dose Hp(10) per procedure measured over the apron for IC, IN and IR resulted, respectively, in 21/67, 19/44 and 24/54 μSv. Patient dose values (median/third quartile) were 75/128, 83/176 and 61/159 Gy cm 2 , respectively. The median ratios for dosemeters worn over the apron by operators ( protected by the ceiling-suspended screen) and patient doses were 0.36; 0.21 and 0.46 μSv Gy -1 cm -2 , respectively. With the conservative approach used (lens doses estimated from the over apron chest dosemeter) we came to the conclusion that more than 800 procedures y -1 and per operator were necessary to reach the new lens dose limit for the three interventional specialties. (authors)

A comparative study on assessment procedures and metric properties of two scoring systems of the Coma Recovery Scale-Revised items: standard and modified scores.

Science.gov (United States)

Sattin, Davide; Lovaglio, Piergiorgio; Brenna, Greta; Covelli, Venusia; Rossi Sebastiano, Davide; Duran, Dunja; Minati, Ludovico; Giovannetti, Ambra Mara; Rosazza, Cristina; Bersano, Anna; Nigri, Anna; Ferraro, Stefania; Leonardi, Matilde

2017-09-01

The study compared the metric characteristics (discriminant capacity and factorial structure) of two different methods for scoring the items of the Coma Recovery Scale-Revised and it analysed scale scores collected using the standard assessment procedure and a new proposed method. Cross sectional design/methodological study. Inpatient, neurological unit. A total of 153 patients with disorders of consciousness were consecutively enrolled between 2011 and 2013. All patients were assessed with the Coma Recovery Scale-Revised using standard (rater 1) and inverted (rater 2) procedures. Coma Recovery Scale-Revised score, number of cognitive and reflex behaviours and diagnosis. Regarding patient assessment, rater 1 using standard and rater 2 using inverted procedures obtained the same best scores for each subscale of the Coma Recovery Scale-Revised for all patients, so no clinical (and statistical) difference was found between the two procedures. In 11 patients (7.7%), rater 2 noted that some Coma Recovery Scale-Revised codified behavioural responses were not found during assessment, although higher response categories were present. A total of 51 (36%) patients presented the same Coma Recovery Scale-Revised scores of 7 or 8 using a standard score, whereas no overlap was found using the modified score. Unidimensionality was confirmed for both score systems. The Coma Recovery Scale Modified Score showed a higher discriminant capacity than the standard score and a monofactorial structure was also supported. The inverted assessment procedure could be a useful evaluation method for the assessment of patients with disorder of consciousness diagnosis.

Is the frozen elephant trunk procedure superior to the conventional elephant trunk procedure for completion of the second stage?

Science.gov (United States)

Rustum, Saad; Beckmann, Erik; Wilhelmi, Mathias; Krueger, Heike; Kaufeld, Tim; Umminger, Julia; Haverich, Axel; Martens, Andreas; Shrestha, Malakh

2017-10-01

Our goal was to compare the results and outcomes of second-stage completion in patients who had previously undergone the elephant trunk (ET) or the frozen elephant trunk (FET) procedure for the treatment of complex aortic arch and descending aortic disease. Between August 2001 and December 2014, 53 patients [mean age 61 ± 13 years, 64% (n = 34) male] underwent a second-stage completion procedure. Of these patients, 32% (n = 17) had a previous ET procedure and 68% (n = 36) a previous FET procedure as a first-stage procedure. The median times to the second-stage procedure were 7 (0-78) months in the ET group and 8 (0-66) months in the FET group. The second-stage procedure included thoracic endovascular aortic repair in 53% (n = 28) of patients and open surgical repair in 47% (n = 25). More endovascular interventions were performed in FET patients (61%, n = 22) than in the ET group (35%, n = 6, P = 0.117). The in-hospital mortality rate was significantly lower in the FET (8%, n = 3) group compared with the ET group (29%, n = 5, P = 0.045). The median follow-up time after the second-stage operation for the entire cohort was 4.6 (0.4-10.4) years. The 5-year survival rate was 76% in the ET patients versus 89% in the FET patients (log-rank: P = 0.11). We observed a significantly lower in-hospital mortality rate in the FET group compared to the ET group. This result might be explained by the higher rate of endovascular completion in the FET group. We assume that the FET procedure offers the benefit of a more ideal landing zone, thus facilitating endovascular completion. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Comparative study on various attenuation theories usually used for aseismatic design of reactor facilities

International Nuclear Information System (INIS)

Muto, Kiyoshi; Kobayashi, Toshio.

1977-01-01

In the vibration analysis for the aseismatic design of reactor facilities, various attenuation theories have been used case by case. In this study, three attenuation theories of internal viscosity type, strain energy type and kinetic energy type were applied to the vibration analysis for a BWR type reactor building, and the respective results were compared. The three theories are explained briefly. Different damping factors were taken for the RC building, steel internal equipments and ground. The reactor building for a BWR of Mark 1 type was studied, and the mathematic vibration model involving those for the building, shield wall, primary containment vessel, gamma shield wall, reactor pressure vessel and foundation is shown. Natural frequency analysis, frequency response analysis and earthquake response analysis were carried out. Regarding the response of the building, the internal viscosity type and the strain energy type gave almost same values, but the kinetic energy type gave the value 1.2 times as large as the former values. In the response of the building, the first mode element is predominant, and the damping factors to the first mode caused these results. Regarding the maximum response acceleration and floor response spectra of internal equipments, the strain energy type and the kinetic energy type gave similar results, and the internal viscosity type gave smaller values. (Kako, I.)

A comparative study of Averrhoabilimbi extraction method

Science.gov (United States)

Zulhaimi, H. I.; Rosli, I. R.; Kasim, K. F.; Akmal, H. Muhammad; Nuradibah, M. A.; Sam, S. T.

2017-09-01

In recent year, bioactive compound in plant has become a limelight in the food and pharmaceutical market, leading to research interest to implement effective technologies for extracting bioactive substance. Therefore, this study is focusing on extraction of Averrhoabilimbi by different extraction technique namely, maceration and ultrasound-assisted extraction. Fewplant partsof Averrhoabilimbiweretaken as extraction samples which are fruits, leaves and twig. Different solvents such as methanol, ethanol and distilled water were utilized in the process. Fruit extractsresult in highest extraction yield compared to other plant parts. Ethanol and distilled water have significant role compared to methanol in all parts and both extraction technique. The result also shows that ultrasound-assisted extraction gave comparable result with maceration. Besides, the shorter period on extraction process gives useful in term of implementation to industries.

Comparative Detection of Alkaline Protease Production in Exiguobacterium acetylicum

International Nuclear Information System (INIS)

Gomaa, O.M.; EI Shafey, H.M.

2009-01-01

Alkaline protease is one of the most important enzymes in industry, medicine, and research. In the present work, a comparative detection for alkaline protease activity was established for instant detection of enzyme activity. Eight different alkalophilic bacterial isolates were compared based on the clear zone they produced on skim milk agar. One strain gave an absolute clear zone in 16 hours and was used for alkaline protease detection. The result of Phenotypic identification using Biology Microlog 3 identified the isolate as Exiguobacterium acetylicum. The isolate under study showed slightly different characteristics from a known Exiguobacterium acetylicum strain. The isolate tolerated alkaline conditions up to ph 11, while good growth was evident at ph 7, the maximum alkaline protease activity was observed at ph 9 which reached up to 109.01 U/ml. The alkaline activity assay using alkaline protease enzyme assay were coordinating with those obtained by conductivity; there was a relevant decrease in conductivity at the maximum increase in enzyme activity, which proved the cell membrane conductivity has a close relation to alkaline protease production. This isolate has tolerated gamma radiation, the increase in dose (up to 4 Gy) gave wider clear zones in terms of diameter and this was relevant to the conductivity measurements

Estimation of staff lens doses during interventional procedures. Comparing cardiology, neuroradiology and interventional radiology.

Science.gov (United States)

Vano, E; Sanchez, R M; Fernandez, J M

2015-07-01

The purpose of this article is to estimate lens doses using over apron active personal dosemeters in interventional catheterisation laboratories (cardiology IC, neuroradiology IN and radiology IR) and to investigate correlations between occupational lens doses and patient doses. Active electronic personal dosemeters placed over the lead apron were used on a sample of 204 IC procedures, 274 IN and 220 IR (all performed at the same university hospital). Patient dose values (kerma area product) were also recorded to evaluate correlations with occupational doses. Operators used the ceiling-suspended screen in most cases. The median and third quartile values of equivalent dose Hp(10) per procedure measured over the apron for IC, IN and IR resulted, respectively, in 21/67, 19/44 and 24/54 µSv. Patient dose values (median/third quartile) were 75/128, 83/176 and 61/159 Gy cm(2), respectively. The median ratios for dosemeters worn over the apron by operators (protected by the ceiling-suspended screen) and patient doses were 0.36; 0.21 and 0.46 µSv Gy(-1) cm(-2), respectively. With the conservative approach used (lens doses estimated from the over apron chest dosemeter) we came to the conclusion that more than 800 procedures y(-1) and per operator were necessary to reach the new lens dose limit for the three interventional specialties. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The impact of a medical procedure service on patient safety, procedure quality and resident training opportunities.

Science.gov (United States)

Tukey, Melissa H; Wiener, Renda Soylemez

2014-03-01

At some academic hospitals, medical procedure services are being developed to provide supervision for residents performing bedside procedures in hopes of improving patient safety and resident education. There is limited knowledge of the impact of such services on procedural complication rates and resident procedural training opportunities. To determine the impact of a medical procedure service (MPS) on patient safety and resident procedural training opportunities. Retrospective cohort analysis comparing characteristics and outcomes of procedures performed by the MPS versus the primary medical service. Consecutive adults admitted to internal medicine services at a large academic hospital who underwent a bedside medical procedure (central venous catheterization, thoracentesis, paracentesis, lumbar puncture) between 1 July 2010 and 31 December 2011. The primary outcome was a composite rate of major complications. Secondary outcomes included resident participation in bedside procedures and use of "best practice" safety process measures. We evaluated 1,707 bedside procedures (548 by the MPS, 1,159 by the primary services). There were no differences in the composite rate of major complications (1.6 % vs. 1.9 %, p = 0.71) or resident participation in bedside procedures (57.0 % vs. 54.3 %, p = 0.31) between the MPS and the primary services. Procedures performed by the MPS were more likely to be successfully completed (95.8 % vs. 92.8 %, p = 0.02) and to use best practice safety process measures, including use of ultrasound guidance when appropriate (96.8 % vs. 90.0 %, p = 0.0004), avoidance of femoral venous catheterization (89.5 vs. 82.7 %, p = 0.02) and involvement of attending physicians (99.3 % vs. 57.0 %, p < 0.0001). Although use of a MPS did not significantly affect the rate of major complications or resident opportunities for training in bedside procedures, it was associated with increased use of best practice safety process measures.

Comparison of detection procedures of Mycoplasma hyopneumoniae, Mycoplasma hyosynoviae, and Mycoplasma hyorhinis in lungs, tonsils, and synovial fluid of slaughtered pigs and their distributions in Thailand.

Science.gov (United States)

Makhanon, Metta; Tummaruk, Padet; Thongkamkoon, Pacharee; Thanawongnuwech, Roongroje; Prapasarakul, Nuvee

2012-02-01

The aim of this study was to investigate whether direct PCR (DP) gave similar results to culture prior to PCR (CPP) for detecting mycoplasmas in different types of pig tissues. A total of 724 samples obtained from lungs, tonsils, or synovial fluids from 270 slaughtered pigs were used. The history of clinical signs, lung score, and the presence of joint lesions were recorded during sample collection. The rates of detection of Mycoplasma hyopneumoniae, Mycoplasma hyosynoviae, and Mycoplasma hyorhinis using both procedures were evaluated. The overall prevalences of M. hyopneumoniae, M. hyosynoviae, and M. hyorhinis were 40.3%, 12.3%, and 64.6%, respectively, and the detection rate depended on the sample type and the procedure used. With lung tissue, DP gave a higher detection rate for M. hyopneumoniae (77.4%) than CPP (38.5%). M. hyorhinis was detected by CPP at 15.6% and 18.1% and by DP at 31.5% and 5.2%, respectively. The positive rate derived from tonsil from CPP was closed to that of DP. Using synovial fluid could not yield any positive M. hyorhinis from CPP whereas 37.2% was positive from DP. In contrast, using sample tissue from lung and tonsil by CPP could show much higher positive number than that of DP. There was a significant relationship between joint lesion and M. hyorhinis detection by DP (P hyopneumoniae and M. hyorhinis detection by DP and CPP, respectively. Tonsil was likely the community of persistent M. hyosynoviae and M. hyorhinis with highly detection by CPP. Synovial fluid was apparently unsuitable for mycoplasmal culture. The accuracy of mycoplasmal detection may depend upon the type of sample relevant to the detection procedure used.

Patient's Perceptions Regarding Orthodontic Needs and Satisfactory Level with the Procedure.

Science.gov (United States)

Farishta, Saibel

2015-09-01

In order to keep the patients satisfied with Orthodontic treatment and to address the growing concern among new orthodontic patients, this study was undertaken to evaluate patient's perceptions of their orthodontic treatment needs and the satisfactory level with the procedure. This cross-sectional study was conducted among a sample of 362 patients who had received orthodontic treatment. Questionnaires included information factors that encouraged them to take orthodontic treatment, painful experience of orthodontic therapy, and also to know the effectiveness of the treatment. Student's t-test and ANOVA test were used to analyze results at P = 0.05. Most of the participants faced problems due to their dentition (60.2%), followed by mastication 23.6%. It was found that most of the study subjects were motivated by orthodontist to receive the treatment (29.7%). When the participants were asked about the complications faced by them during the procedure and the most common answer was a longer duration of the treatment (23.3%). Pain was also a common factor faced by the participants (15.9%). Significant results were seen according to gender and age. The study concluded that problems in the dentition were the main factor to seek orthodontic treatment and most of the subjects were convinced by the specialist to undergo orthodontic therapy. Many problems faced during the treatment, but still majority gave a positive response to the treatment.

Applying computer-based procedures in nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

Oliveira, Mauro V. de; Carvalho, Paulo V.R. de; Santos, Isaac J.A.L. dos; Grecco, Claudio H.S. [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Div. de Instrumentacao e Confiabilidade Humana], e-mail: mvitor@ien.gov.br, e-mail: paulov@ien.gov.br, e-mail: luquetti@ien.gov.br, e-mail: grecco@ien.gov.br; Bruno, Diego S. [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Escola Politecnica. Curso de Engenharia de Controle e Automacao], e-mail: diegosalomonebruno@gmail.com

2009-07-01

Plant operation procedures are used to guide operators in coping with normal, abnormal or emergency situations in a process control system. Historically, the plant procedures have been paper-based (PBP), with the digitalisation trend in these complex systems computer-based procedures (CBPs) are being developed to support procedure use. This work shows briefly the research on CBPs at the Human-System Interface Laboratory (LABIHS). The emergency operation procedure EOP-0 of the LABIHS NPP simulator was implemented in the ImPRO CBP system. The ImPRO system was chosen for test because it is available for download in the Internet. A preliminary operation test using the implemented procedure in the CBP system was realized and the results were compared to the operation through PBP use. (author)

Quality of harvested autologous platelets compared with stored donor platelets for use after cardiopulmonary bypass procedures.

Science.gov (United States)

Crowther, M; Ford, I; Jeffrey, R R; Urbaniak, S J; Greaves, M

2000-10-01

Platelet dysfunction has a major contribution in bleeding after cardiopulmonary bypass (CPB) and transfusion of platelets is frequently used to secure haemostasis. Allogeneic platelets prepared for transfusion are functionally impaired. Autologous platelets harvested preoperatively require a shorter storage time before transfusion and their use also avoids the risks associated with transfusion of allogeneic blood products. For the first time, we have compared the functional quality of autologous platelets with allogeneic platelets prepared by two methods, immediately before infusion. Platelet activation was assessed by P-selectin expression and fibrinogen binding using flow cytometry. We also monitored the effects of CPB surgery and re-infusion of autologous platelets on platelet function. Autologous platelet-rich plasma (PRP) contained a significantly lower (P platelets compared with allogeneic platelet preparations, and also contained a significantly higher (P platelets. Allogeneic platelets prepared by donor apheresis were more activated and less responsive than those produced by centrifugation of whole blood. In patients' blood, the percentage of platelets expressing P-selectin or binding fibrinogen increased significantly after CPB (P platelets responsive to in vitro agonists was decreased (P platelet activation during the procedure. The percentage of activated platelets decreased (statistically not significant) after re-infusion of autologous PRP. P-selectin expression had returned to pre-CPB levels 24 h post-operatively. Autologous platelet preparations display minimal activation, but remain responsive. Conservation of platelet function may contribute to the potential clinical benefits of autologous transfusion in cardiopulmonary bypass.

Trends in Medicare Reimbursement for Orthopedic Procedures: 2000 to 2016.

Science.gov (United States)

Eltorai, Adam E M; Durand, Wesley M; Haglin, Jack M; Rubin, Lee E; Weiss, Arnold-Peter C; Daniels, Alan H

2018-03-01

Understanding trends in reimbursement is critical to the financial sustainability of orthopedic practices. Little research has examined physician fee trends over time for orthopedic procedures. This study evaluated trends in Medicare reimbursements for orthopedic surgical procedures. The Medicare Physician Fee Schedule was examined for Current Procedural Terminology code values for the most common orthopedic and nonorthopedic procedures between 2000 and 2016. Prices were adjusted for inflation to 2016-dollar values. To assess mean growth rate for each procedure and subspecialty, compound annual growth rates were calculated. Year-to-year dollar amount changes were calculated for each procedure and subspecialty. Reimbursement trends for individual procedures and across subspecialties were compared. Between 2000 and 2016, annual reimbursements decreased for all orthopedic procedures examined except removal of orthopedic implant. The orthopedic procedures with the greatest mean annual decreases in reimbursement were shoulder arthroscopy/decompression, total knee replacement, and total hip replacement. The orthopedic procedures with the least annual reimbursement decreases were carpal tunnel release and repair of ankle fracture. Rate of Medicare procedure reimbursement change varied between subspecialties. Trauma had the smallest decrease in annual change compared with spine, sports, and hand. Annual reimbursement decreased at a significantly greater rate for adult reconstruction procedures than for any of the other subspecialties. These findings indicate that reimbursement for procedures has steadily decreased, with the most rapid decrease seen in adult reconstruction. [Orthopedics. 2018; 41(2):95-102.]. Copyright 2018, SLACK Incorporated.

Pre-procedural antibiotics for endoscopic urological procedures: Initial experience in individuals with spinal cord injury and asymptomatic bacteriuria.

Science.gov (United States)

Chong, Julio T; Klausner, Adam P; Petrossian, Albert; Byrne, Michael D; Moore, Jewel R; Goetz, Lance L; Gater, David R; Grob, B Mayer

2015-03-01

The objective of this study was to compare the safety, efficacy, quality-of-life impact, and costs of a single dose or a longer course of pre-procedural antibiotics prior to elective endoscopic urological procedures in individuals with spinal cord injury and disorders (SCI/D) and asymptomatic bacteriuria. A prospective observational study. Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA. Sixty persons with SCI/D and asymptomatic bacteriuria scheduled to undergo elective endoscopic urological procedures. A single pre-procedural dose of antibiotics vs. a 3-5-day course of pre-procedural antibiotics. Objective and subjective measures of health, costs, and quality of life. There were no significant differences in vital signs, leukocytosis, adverse events, and overall satisfaction in individuals who received short-course vs. long-course antibiotics. There was a significant decrease in antibiotic cost (33.1 ± 47.6 vs. 3.6 ± 6.1 US$, P = 0.01) for individuals in the short-course group. In addition, there was greater pre-procedural anxiety (18 vs. 0%, P antibiotics. SCI/D individuals with asymptomatic bacteriuria may be able to safely undergo most endoscopic urological procedures with a single dose of pre-procedural antibiotics. However, further research is required and even appropriate pre-procedural antibiotics may not prevent severe infections.

Student Non-Academic Discipline Procedures at Canadian Universities.

Science.gov (United States)

Williams, Tom; Schiralli, Martin

1993-01-01

Surveyed nonacademic disciplinary procedures in 50 Canadian universities through interviews and examination of written policies and procedures. Compared and contrasted such aspects as (1) authority for adjudicating and resolving cases; (2) scope of review mechanisms (just students or entire university community); (3) appeal process; (4) nature of…

HYPNOSIS FOR ACUTE PROCEDURAL PAIN: A Critical Review

Science.gov (United States)

Kendrick, Cassie; Sliwinski, Jim; Yu, Yimin; Johnson, Aimee; Fisher, William; Kekecs, Zoltán; Elkins, Gary

2015-01-01

Clinical evidence for the effectiveness of hypnosis in the treatment of acute, procedural pain was critically evaluated based on reports from randomized controlled clinical trials (RCTs). Results from the 29 RCTs meeting inclusion criteria suggest that hypnosis decreases pain compared to standard care and attention control groups and that it is at least as effective as comparable adjunct psychological or behavioral therapies. In addition, applying hypnosis in multiple sessions prior to the day of the procedure produced the highest percentage of significant results. Hypnosis was most effective in minor surgical procedures. However, interpretations are limited by considerable risk of bias. Further studies using minimally effective control conditions and systematic control of intervention dose and timing are required to strengthen conclusions. PMID:26599994

Hypnosis for Acute Procedural Pain: A Critical Review.

Science.gov (United States)

Kendrick, Cassie; Sliwinski, Jim; Yu, Yimin; Johnson, Aimee; Fisher, William; Kekecs, Zoltán; Elkins, Gary

2016-01-01

Clinical evidence for the effectiveness of hypnosis in the treatment of acute procedural pain was critically evaluated based on reports from randomized controlled clinical trials (RCTs). Results from the 29 RCTs meeting inclusion criteria suggest that hypnosis decreases pain compared to standard care and attention control groups and that it is at least as effective as comparable adjunct psychological or behavioral therapies. In addition, applying hypnosis in multiple sessions prior to the day of the procedure produced the highest percentage of significant results. Hypnosis was most effective in minor surgical procedures. However, interpretations are limited by considerable risk of bias. Further studies using minimally effective control conditions and systematic control of intervention dose and timing are required to strengthen conclusions.

Procedures for health risk assessment in Europe

NARCIS (Netherlands)

Seeley, M.R.; Tonner-Navarro, L.E.; Beck, B.D.; Deskin, R.; Feron, V.J.; Johanson, G.; Bolt, H.M.

2001-01-01

This report compares cancer classification systems, health risk assessment approaches, and procedures used for establishing occupational exposure limits (OELs), in various European countries and scientific organizations. The objectives were to highlight and compare key aspects of these processes and

Administrative Procedure Act and mass procedures (illustrated by the nuclear licensing procedure)

International Nuclear Information System (INIS)

Naumann, R.

1977-01-01

The report deals with the administrative procedure law of 25.5.76 of the Fed. Government, esp. with its meaning for the administrative procedures for the permission for nuclear power plants, as fas ar so-called mass procedures are concerned. (UN) [de

Comparative effect of tube drain on post operative inflammatory complications of impacted mandibular third molar surgery College Hospital, Ibadan, Nigeria.

Science.gov (United States)

Obimakinde, O S; Fasola, A O; Arotiba, J T; Okoje, V N; Obiechina, A E

2010-09-01

Swelling, pain and trismus are acute reversible inflammatory complications of impacted mandibular third molar (M3) surgery. They contribute to the deterioration of quality of life and loss of several useful working hours. This study aimed to investigate whether the use of a surgical drain following M3 surgery can minimise these inflammatory complications. Eighty consecutive patients who gave consent were enrolled into the study. Patients were assigned into two groups (drain and no drain) by systematic sampling method which was modified to ensure matching of patients by age, sex and spatial relationship of the impacted mandibular third molar. The patients in the drain group (n=40) had a Foley's catheter drain inserted into the wound after the surgical procedure while the patients in the no drain group (n=40) had their wound closed without the use of drain. All patients had primary wound closure with 3.0 black silk sutures after the procedure. Demographic data, cheek dimension and maximal mouth opening were recorded before the procedure. Pain, swelling and trismus were evaluated in the two groups at 24 hours, 48 hours and 7th day after surgery. Post operative swelling and visual analogue scale score for pain were comparatively lesser in the drain group patients. The maximal interincisal distance was also more in the drain group patients. The findings from this study indicated that there is a significant benefit of using a surgical drain in minimising postoperative oedema, pain and trismus following surgical removal of impacted mandibular third molar.

A comparative evaluation of V and V procedures for conventional software and expert systems

International Nuclear Information System (INIS)

Saglietti, F.

1992-01-01

This paper presents some initial considerations on the particular features of artificial intelligence differing from conventional programs and rendering the V and V procedures more simple under certain points of view, but more complex with respect to others. On the basis of the characteristics identified, some existing testing strategies are presented and analyzed; an additional adequacy criterion is suggested in order to increase error detectability. The aim of this work is to extend the existing (though so far still incomplete) testing theories for conventional programs, such as to allow their application also to artificial intelligent systems. The ultimate goal of the present investigations is thus represented by a unified problem representation permitting to define adequate V and V procedures by adapting them to the specific software category considered. In particular, special criteria for Al testing should be included to the usual coverage requirements in order to capture also those faults, which seem to be typical for the expert reasoning

The Comparing Options for Management: Patient-centered Results for Uterine Fibroids (COMPARE-UF) Registry: Rationale and Design.

Science.gov (United States)

Stewart, Elizabeth A; Lytle, Barbara L; Thomas, Laine; Wegienka, Ganesa R; Jacoby, Vanessa; Diamond, Michael P; Nicholson, Wanda K; Anchan, Raymond M; Venable, Sateria; Wallace, Kedra; Marsh, Erica E; Maxwell, George L; Borah, Bijan J; Catherino, William H; Myers, Evan R

2018-05-08

To design and establish a uterine fibroid (UF) registry based in the United States (US) to provide comparative effectiveness data regarding UF treatment. We report here the design and initial recruitment for the Comparing Options for Management: Patient-centered Results for Uterine Fibroids (COMPARE-UF) registry (Clinicaltrials.gov, NCT02260752), funded by the Agency for Healthcare Research and Quality (AHRQ) in collaboration with the-Patient-Centered Outcomes Research Institute (PCORI). COMPARE-UF is designed to help answer critical questions about treatment options for women with symptomatic UF. Women undergoing a procedure for UF (hysterectomy, myomectomy [abdominal, hysteroscopic, vaginal and laparoscopic/robotic], endometrial ablation, radiofrequency fibroid ablation, uterine artery embolization, magnetic resonance guided focused ultrasound or progestin-releasing intrauterine device insertion) at one of the COMPARE-UF sites are invited to participate in a prospective registry with three years follow-up for post-procedural outcomes. Enrolled participants provide annual follow-up through an online portal or through traditional phone contact. A central data abstraction center provides information obtained from imaging, operative or procedural notes and pathology reports. Women with uterine fibroids and other stakeholders are a key part of the COMPARE-UF registry and participate at all points from study design to dissemination of results. We built a network of nine clinical sites across the US with expertise in the care of women with UF to capture geographic, racial, ethnic and procedural diversity. Of the initial 2031 women enrolled in COMPARE-UF, 42% are self-identified as Black or African-American and 40% are age 40 years or younger with 16% of participants under age 35. Women undergoing myomectomy comprise the largest treatment group at 46% of all procedures with laparoscopic or robotic myomectomy comprising the largest subset of myomectomies at 19% of all

Comparative approaches from empirical to mechanistic simulation modelling in Land Evaluation studies

Science.gov (United States)

Manna, P.; Basile, A.; Bonfante, A.; Terribile, F.

2009-04-01

The Land Evaluation (LE) comprise the evaluation procedures to asses the attitudes of the land to a generic or specific use (e.g. biomass production). From local to regional and national scale the approach to the land use planning should requires a deep knowledge of the processes that drive the functioning of the soil-plant-atmosphere system. According to the classical approaches the assessment of attitudes is the result of a qualitative comparison between the land/soil physical properties and the land use requirements. These approaches have a quick and inexpensive applicability; however, they are based on empirical and qualitative models with a basic knowledge structure specifically built for a specific landscape and for the specific object of the evaluation (e.g. crop). The outcome from this situation is the huge difficulties in the spatial extrapolation of the LE results and the rigidity of the system. Modern techniques instead, rely on the application of mechanistic and quantitative simulation modelling that allow a dynamic characterisation of the interrelated physical and chemical processes taking place in the soil landscape. Moreover, the insertion of physical based rules in the LE procedure may make it less difficult in terms of both extending spatially the results and changing the object (e.g. crop species, nitrate dynamics, etc.) of the evaluation. On the other side these modern approaches require high quality and quantity of input data that cause a significant increase in costs. In this scenario nowadays the LE expert is asked to choose the best LE methodology considering costs, complexity of the procedure and benefits in handling a specific land evaluation. In this work we performed a forage maize land suitability study by comparing 9 different methods having increasing complexity and costs. The study area, of about 2000 ha, is located in North Italy in the Lodi plain (Po valley). The range of the 9 employed methods ranged from standard LE approaches to

Face-off: A new identification procedure for child eyewitnesses.

Science.gov (United States)

Price, Heather L; Fitzgerald, Ryan J

2016-09-01

In 2 experiments, we introduce a new "face-off" procedure for child eyewitness identifications. The new procedure, which is premised on reducing the stimulus set size, was compared with the showup and simultaneous procedures in Experiment 1 and with modified versions of the simultaneous and elimination procedures in Experiment 2. Several benefits of the face-off procedure were observed: it was significantly more diagnostic than the showup procedure; it led to significantly more correct rejections of target-absent lineups than the simultaneous procedures in both experiments, and it led to greater information gain than the modified elimination and simultaneous procedures. The face-off procedure led to consistently more conservative responding than the simultaneous procedures in both experiments. Given the commonly cited concern that children are too lenient in their decision criteria for identification tasks, the face-off procedure may offer a concrete technique to reduce children's high choosing rates. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Martius procedure revisited for urethrovaginal fistula

Directory of Open Access Journals (Sweden)

N P Rangnekar

2000-01-01

Full Text Available Background: Urethrovaginal fistula is a dreadful com-plication of obstetric trauma due to prolonged labour or obstetric intervention commonly seen in developing coun-tries. Due to prolonged ischaemic changes, the fistula is resistant to healing. The strategic location of the fistula leads to postoperative impairment of continence mecha-nism. Anatomical repair was previously the commonest mode of surgical management, but was associated with a miserable cumulative cure rate ranging from 16-60%. Hence we tried to study the efficacy of Martius procedure in the management of urethrovaginal fistula. Material and Methods: We studied the outcome of 12 urethrovaginal fistulae, all caused by obstetric trauma, treated surgically with Martius procedure in 8 and with anatomical repair in 4, retrospectively. 9 patients had re-current fistulae while I patient had multiple fistulae. Pa-tients were followed up for the period ranging from 6 months to 4′/2 years for fistula healing, continence and postoperative complications like dvspareunia. Results: Cumulative cure rate ofMartius procedure was 87.5% with no postoperative stress incontinence, while fistula healing rate of anatomical repair was only 25% (I patient out of 4 which was also complicated by Intrin-sic Sphincter Deficiency (ISD. In case of recurrent fistu-lae the success rate of anatomical repair was 0% compared to 83.33% with Martius procedure. Conclusions: Martius procedure has shown much bet-ter overall cure rate compared to anatomical repair be-cause - a it provides better reinforcement to urethral suture line, b it provides better blood supply and lymph drainage to the ischaemic fistulous area, c provides sur-face for epithelialization and, d helps to maintain conti-nence. Hence we recommend Martius procedure as a surgical modality for the treatment of urethrovaginal fis-tula.

A cost and time analysis of laryngology procedures in the endoscopy suite versus the operating room.

Science.gov (United States)

Hillel, Alexander T; Ochsner, Matthew C; Johns, Michael M; Klein, Adam M

2016-06-01

To assess the costs, charges, reimbursement, and efficiency of performing awake laryngology procedures in an endoscopy suite (ES) compared with like procedures performed in the operating room (OR). Retrospective review of billing records. Cost, charges, and reimbursements for the hospital, surgeon, and anesthesiologist were compared between ES injection laryngoplasty and laser excision procedures and matched case controls in the OR. Time spent in 1) the preoperative unit, 2) the operating or endoscopy suite, and 3) recovery unit were compared between OR and ES procedures. Hospital expenses were significantly less for ES procedures when compared to OR procedures. Reimbursement was similar for ES and OR injection laryngoplasty, though greater for OR laser excisions. Net balance (reimbursement-expenses) was greater for ES procedures. A predictive model of payer costs over a 3-year period showed similar costs for ES and OR laser procedures and reduced costs for ES compared to OR injection laryngoplasty. Times spent preoperatively and the procedure were significantly less for ES procedures. For individual laryngology procedures, the ES reduces time and costs compared to the OR, increasing otolaryngologist and hospital efficiency. This reveals cost and time savings of ES injection laryngoplasty, which occurs at a similar frequency as OR injection laryngoplasty. Given the increased frequency for ES laser procedures, total costs are similar for ES and OR laser excision of papilloma, which usually require repeated procedures. When regulated office space is unavailable, endoscopy rooms represent an alternative setting for unsedated laryngology procedures. NA Laryngoscope, 126:1385-1389, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

A comparative study of some aspects of radiation protection and dosimetry procedures. Pt. 1 and 2

International Nuclear Information System (INIS)

Drexler, G.; Goeksu, H.Y.; Johns, T.F.

1987-10-01

A study has been made of the procedures used in the Member States of the European Communities for dealing with certain practical and administrative aspects of radiation protection of occupationally exposed persons, and especially of the methods and procedures used in personnel dosimetry. It was found that the different states have adopted quite different methods for dealing with some of these problems, the method chosen seeming to depend on the size of the country and the extent and timing of its involvement with nuclear power developments; but although the different countries have adopted different methods of control, as far as we can judge they have all been reasonably effective in achieving adequate control of occupational exposures. Nevertheless, there are still issues that each country could probably learn and perhaps improve its own procedure by making a more careful study of the way in which other countries deal with these problems. Therefore the study was extended to cover the USA and Japan in order to facilitate such comparisons and improvements. (orig.)

Configural and component processing in simultaneous and sequential lineup procedures.

Science.gov (United States)

Flowe, Heather D; Smith, Harriet M J; Karoğlu, Nilda; Onwuegbusi, Tochukwu O; Rai, Lovedeep

2016-01-01

Configural processing supports accurate face recognition, yet it has never been examined within the context of criminal identification lineups. We tested, using the inversion paradigm, the role of configural processing in lineups. Recent research has found that face discrimination accuracy in lineups is better in a simultaneous compared to a sequential lineup procedure. Therefore, we compared configural processing in simultaneous and sequential lineups to examine whether there are differences. We had participants view a crime video, and then they attempted to identify the perpetrator from a simultaneous or sequential lineup. The test faces were presented either upright or inverted, as previous research has shown that inverting test faces disrupts configural processing. The size of the inversion effect for faces was the same across lineup procedures, indicating that configural processing underlies face recognition in both procedures. Discrimination accuracy was comparable across lineup procedures in both the upright and inversion condition. Theoretical implications of the results are discussed.

Emergency procedures

International Nuclear Information System (INIS)

Abd Nasir Ibrahim; Azali Muhammad; Ab Razak Hamzah; Abd Aziz Mohamed; Mohammad Pauzi Ismail

2004-01-01

The following subjects are discussed - Emergency Procedures: emergency equipment, emergency procedures; emergency procedure involving X-Ray equipment; emergency procedure involving radioactive sources

Development of a diagnosis- and procedure-based risk model for 30-day outcome after pediatric cardiac surgery.

Science.gov (United States)

Crowe, Sonya; Brown, Kate L; Pagel, Christina; Muthialu, Nagarajan; Cunningham, David; Gibbs, John; Bull, Catherine; Franklin, Rodney; Utley, Martin; Tsang, Victor T

2013-05-01

The study objective was to develop a risk model incorporating diagnostic information to adjust for case-mix severity during routine monitoring of outcomes for pediatric cardiac surgery. Data from the Central Cardiac Audit Database for all pediatric cardiac surgery procedures performed in the United Kingdom between 2000 and 2010 were included: 70% for model development and 30% for validation. Units of analysis were 30-day episodes after the first surgical procedure. We used logistic regression for 30-day mortality. Risk factors considered included procedural information based on Central Cardiac Audit Database "specific procedures," diagnostic information defined by 24 "primary" cardiac diagnoses and "univentricular" status, and other patient characteristics. Of the 27,140 30-day episodes in the development set, 25,613 were survivals, 834 were deaths, and 693 were of unknown status (mortality, 3.2%). The risk model includes procedure, cardiac diagnosis, univentricular status, age band (neonate, infant, child), continuous age, continuous weight, presence of non-Down syndrome comorbidity, bypass, and year of operation 2007 or later (because of decreasing mortality). A risk score was calculated for 95% of cases in the validation set (weight missing in 5%). The model discriminated well; the C-index for validation set was 0.77 (0.81 for post-2007 data). Removal of all but procedural information gave a reduced C-index of 0.72. The model performed well across the spectrum of predicted risk, but there was evidence of underestimation of mortality risk in neonates undergoing operation from 2007. The risk model performs well. Diagnostic information added useful discriminatory power. A future application is risk adjustment during routine monitoring of outcomes in the United Kingdom to assist quality assurance. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Measurement of patient radiation doses in certain urography procedures

International Nuclear Information System (INIS)

Sulieman, A.; Barakat, H.; Zailae, A.; Abuderman, A.; Theodorou, K.

2015-01-01

Patients are exposed to significant radiation doses during diagnostic and interventional urological procedures. This study aimed to measure patient entrance surface air kerma (ESAK) and to estimate the effective dose during intravenous urography (IVU), extracorporeal shock-wave lithotripsy (ESWL), and ascending urethrogram (ASU) procedures. ESAK was measured in patients using calibrated thermo luminance dosimeters, GR200A). Effective doses (E) were calculated using the National Radiological Protection Board (NRPB) software. A total of 179 procedures were investigated. 27.9 % of the patients underwent IVU procedures, 27.9 % underwent ESWL procedures and 44.2 % underwent ASU procedures. The mean ESAK was 2.1, 4.18 and 4.9 mGy for IVU, ESWL, and ASU procedures, respectively. Differences in patient ESAK for the same procedure were observed. The mean ESAK values were comparable with those in previous studies. (authors)

[Meta-analysis of randomized controlled trials comparing procedure for prolapse and hemorrhoids with Milligan-Morgan hemorrhoidectomy in the treatment of prolapsed hemorrhoids].

Science.gov (United States)

He, Ping; Chen, Hongliang

2015-12-01

To compare the safety and efficacy of procedure for prolapse and hemorrhoids (PPH) with Milligan-Morgan hemorrhoidectomy (MMH) in the treatment of prolapsed hemorrhoids. All the randomized controlled trials (RCT) comparing PPH with MMH in the treatment of prolapsed hemorrhoids published between January 1998 and January 2015 were retrieved from PubMed, Embase, Cochrane Library, CBM, CNKI, Wangfang, VIP databases. Hand search was applied in Chinese Journal of Gastrointestinal Surgery, Chinese Journal of Coloproctology and Journal of Colorectal and Anal Surgery from the library of Chengdu University of Traditional Chinese Medicine. Associated reference documents in enrolled trials were reviewed. The methodological quality of enrolled trials was evaluated according to the Cochrane handbook for systematic reviews of interventions. Meta-analysis was performed using RevMan 5.3 software. Sixteen RCTs recruiting 1411 patients were identified. Among them, 702 patients underwent PPH, and other 709 patients MMH. Meta-analysis showed that as compared to MMH, PPH had shorter operating time(WMD=-12.34, 95% CI:-17.87 to -6.80, P=0.000], shorter hospital stay (WMD=-1.48, 95% CI: -1.81 to -1.14, P=0.000) and shorter time to recover normal activity (WMD=-14.11, 95% CI: -24.51 to -3.70, P=0.008). Patients in PPH group experienced less pain at postoperative 24 h, postoperative 1 week and the first postoperative bowel movement (all P0.05). Satisfaction degree of patients in PPH group was better than that in MMH group (OR=2.36, 95% CI:1.36 to 4.07, P=0.002). Procedure for prolapse and hemorrhoids offers some short-term benefits over Milligan-Morgan hemorrhoidectomy, but is associated with a higher rate of recurrent disease.

Procedural and Logic Programming: A Comparison.

Science.gov (United States)

Watkins, Will; And Others

1988-01-01

Examines the similarities and fundamental differences between procedural programing and logic programing by comparing LogoWriter and PROLOG. Suggests that PROLOG may be a good first programing language for students to learn. (MVL)

Highly Specific Estrone Sulfate Antibody Production Using Hapten-Bovine Serum Albumin Conjugate And Modified Tailoring

International Nuclear Information System (INIS)

ELBANNA, I.M.; GAMAL, M.H.; SALEM, A.

2009-01-01

Estrone-3-sulfate represents an important estrogenic metabolite indicative to uterine function during early pregnancy and post-partum in animals. Exploiting preparation of less expensive estrone-3-sulfate bovine serum albumin (BSA) conjugate was persuaded for raising antiserum in rabbits. The use of estrone rabbit gamma globulin conjugate as a tollerogenic agent was used to investigate the effect on specificity of the harvested antiserum. Five male New Zealand rabbits were used. After immunization procedure, blood samples were collected and individual bleedings were evaluated for titre and specificity using estrone-3-sulfate- 3 H as a tracer. The tollerogenic pre-immunization procedure gave more specific antiserum than the conventional immunization method. Nevertheless, the titre was lower in tollerogenic than conventional method (1/3500 and 1/4900 as working final dilution, respectively). It is concluded that preparation of E1 -3-sulfate oxime-BSA gave more suitable yield with less expense as compared with previous studies. Pre-immunization injection of tollerogen gave more specific antiserum while the lower titre could be improved after further booster immunization.

Peroral endoscopic myotomy: An emerging minimally invasive procedure for achalasia

Science.gov (United States)

Vigneswaran, Yalini; Ujiki, Michael B

2015-01-01

Peroral endoscopic myotomy (POEM) is an emerging minimally invasive procedure for the treatment of achalasia. Due to the improvements in endoscopic technology and techniques, this procedure allows for submucosal tunneling to safely endoscopically create a myotomy across the hypertensive lower esophageal sphincter. In the hands of skilled operators and experienced centers, the most common complications of this procedure are related to insufflation and accumulation of gas in the chest and abdominal cavities with relatively low risks of devastating complications such as perforation or delayed bleeding. Several centers worldwide have demonstrated the feasibility of this procedure in not only early achalasia but also other indications such as redo myotomy, sigmoid esophagus and spastic esophagus. Short-term outcomes have showed great clinical efficacy comparable to laparoscopic Heller myotomy (LHM). Concerns related to postoperative gastroesophageal reflux remain, however several groups have demonstrated comparable clinical and objective measures of reflux to LHM. Although long-term outcomes are necessary to better understand durability of the procedure, POEM appears to be a promising new procedure. PMID:26468336

Automated Kick Control Procedure for an Influx in Managed Pressure Drilling Operations

Directory of Open Access Journals (Sweden)

Jing Zhou

2016-01-01

Full Text Available Within drilling of oil and gas wells, the Managed Pressure Drilling (MPD method with active control of wellbore pressure during drilling has partly evolved from conventional well control procedures. However, for MPD operations the instrumentation is typically more extensive compared to conventional drilling. Despite this, any influx of formation fluids (commonly known as a kick during MPD operations is typically handled by conventional well control methods, at least if the kick is estimated to be larger than a threshold value. Conventional well control procedures rely on manual control of the blow out preventer, pumps, and choke valves and do not capitalize on the benefits from the instrumentation level associated with MPD. This paper investigates two alternative well control procedures specially adapted to backpressure MPD: the dynamic shut-in (DSI procedure and the automatic kick control (AKC procedure. Both methods capitalize on improvements in Pressure While Drilling (PWD technology. A commercially available PWD tool buffers high-resolution pressure measurements, which can be used in an automated well control procedure. By using backpressure MPD, the choke valve opening is tuned automatically using a feedback-feedforward control method. The two procedures are evaluated using a high fidelity well flow model and cases from a North Sea drilling operation are simulated. The results show that using AKC procedure reduces the time needed to establish control of the well compared to DSI procedure. It also indicates that the AKC procedure reduces the total kick size compared to the DSI procedure, and thereby reduces the risk of lost circulation.

Automated measurement of serum thyroxine with the ''AIRA II,'' as compared with competitive protein binding and radioimmunoassay

International Nuclear Information System (INIS)

Reese, M.G.; Johnson, L.V.R.

1978-01-01

Two conventional serum thyroxine assays, run in separate laboratories, one by competitive protein binding and one by radioimmunoassay, were used to evaluate the automated ARIA II (Becton Dickinson Immunodiagnostics) serum thyroxine assay. Competitive protein binding as compared to ARIA II with 111 clinical serum samples gave a slope of 1.04 and a correlation coefficient of 0.94. The radioimmunoassay comparison to ARIA II with 53 clinical serum samples gave a slope of 1.05 and a correlation coefficient of 0.92. The ARIA II inter-assay coefficient of variation for 10 replicates of low, medium, and high thyroxine serum samples was 6.2, 6.0, and 2.9%, respectively, with an inter-assay coefficient of variation among 15 different assays of 15.5, 10.1, and 7.9%. The automated ARIA II, with a 2.2-min cycle per sample, gives results that compare well with those by manual methodology

The price of surgery: markup of operative procedures in the United States.

Science.gov (United States)

Gani, Faiz; Makary, Martin A; Pawlik, Timothy M

2017-02-01

Despite cost containment efforts, the price for surgery is not subject to any regulations. We sought to characterize and compare variability in pricing for commonly performed major surgical procedures across the United States. Medicare claims corresponding to eight major surgical procedures (aortic aneurysm repair, aortic valvuloplasty, carotid endartectomy, coronary artery bypass grafting, esophagectomy, pancreatectomy, liver resection, and colectomy) were identified using the Medicare Provider Utilization and Payment Data Physician and Other Supplier Public Use File for 2013. For each procedure, total charges, Medicare-allowable costs, and total payments were recorded. A procedure-specific markup ratio (MR; ratio of total charges to Medicare-allowable costs) was calculated and compared between procedures and across states. Variation in MR was compared using a coefficient of variation (CoV). Among all providers, the median MR was 3.5 (interquartile range: 3.1-4.0). MR was noted to vary by procedure; ranging from 3.0 following colectomy to 6.0 following carotid endartectomy (P < 0.001). MR also varied for the same procedure; varying the least after liver resection (CoV = 0.24), while coronary artery bypass grafting pricing demonstrated the greatest variation in MR (CoV = 0.53). Compared with the national average, MR varied by 36% between states ranging from 1.8 to 13.0. Variation in MR was also noted within the same state varying by 15% within the state of Arkansas (CoV = 0.15) compared with 51% within the state of Wisconsin (CoV = 0.51). Significant variation was noted for the price of surgery by procedure as well as between and within different geographical regions. Greater scrutiny and transparency in the price of surgery is required to promote cost containment. Copyright © 2016 Elsevier Inc. All rights reserved.

Dosimetric evaluation of mammary tomosynthesis procedures

International Nuclear Information System (INIS)

Silva, Rayre Janaína Vieira; Perini, Ana Paula; Santos, William de Souza; Vedovato, Uly P.; Neves, Lucio Pereira

2017-01-01

This work presents the results of the research on the evaluation of radiation doses usually applied in mammary procedures, using the Monte Carlo method. A virtual environment was created, to mimic the procedures room, including the room, its components, patient and source. The spectrum was obtained from the literature. The percentage of energy deposited compared to energy deposited in the breast was determined, and the scattered radiation was absorbed in specific areas. The regions of the head and neck were the most affected by scattered radiation. (author)

State Token Petri Net modeling method for formal verification of computerized procedure including operator's interruptions of procedure execution flow

International Nuclear Information System (INIS)

Kim, Yun Goo; Seong, Poong Hyun

2012-01-01

The Computerized Procedure System (CPS) is one of the primary operating support systems in the digital Main Control Room. The CPS displays procedure on the computer screen in the form of a flow chart, and displays plant operating information along with procedure instructions. It also supports operator decision making by providing a system decision. A procedure flow should be correct and reliable, as an error would lead to operator misjudgement and inadequate control. In this paper we present a modeling for the CPS that enables formal verification based on Petri nets. The proposed State Token Petri Nets (STPN) also support modeling of a procedure flow that has various interruptions by the operator, according to the plant condition. STPN modeling is compared with Coloured Petri net when they are applied to Emergency Operating Computerized Procedure. A converting program for Computerized Procedure (CP) to STPN has been also developed. The formal verification and validation methods of CP with STPN increase the safety of a nuclear power plant and provide digital quality assurance means that are needed when the role and function of the CPS is increasing.

Acute Procedural Pain in Children

DEFF Research Database (Denmark)

Kristensen, Helle Nygård; Lundbye-Christensen, Søren; Haslund-Thomsen, Helle

2018-01-01

INTRODUCTION: Hospitalized children often describe needle-related procedures as the worst pain possible and such procedures may be emotionally traumatic. The use of hospital clowns related to painful medical procedures in children may offer pain relief, but this has not been systematically...... evaluated. The objective of this study was to assess the effect of a therapeutic clown in comparison to standard care on the experience of pain for children receiving venipuncture. METHODS: A sample of 116 children aged 4-15 years consecutively admitted to the hospital was allocated to either......: Without the clown present, the mean pain score (2.7±2.8) was not significantly different between the two age groups. Children aged 7-15 years had lower pain scores when the clown was present compared to the control group (P=0.025). Children aged 4-6 years had higher pain scores with the clown present...

Newmark's Procedures in Persian Translation of Golding's Lord of the Flies

Directory of Open Access Journals (Sweden)

Habibollah Mashhady

2015-03-01

Full Text Available Numerous frameworks and procedures have been proposed for translation. In this regard, the Newmark’s proposed procedures have been widely discussed in translation studies. Yet, few studies have ever applied his procedures simultaneously for describing and assessing translations. This paper is an attempt to compare the translation procedures used in two Persian translations of Golding's Lord of the Flies by Rafiee and Mansoori based on Newmark's translation procedures. The main question is if the translator’s procedures can be described and assessed by Newmark’s framework or not. To do so, first, some chapters of the English novel were randomly selected, and then, they were compared with their corresponding parts in the Persian translations. Then, comparisons were classified and analyzed in terms of transliteration, shift, synonymy, modulation, addition, omission, as well as mistranslation to find out which procedures were used more by the two translators, and to show the extent of the mistranslated items in the two translations. The results showed that Newmark’s procedures are nearly comprehensive and worked well for translating and assessing the translation of a literary work.

Comparative evaluation of stress levels before, during, and after periodontal surgical procedures with and without nitrous oxide-oxygen inhalation sedation

Directory of Open Access Journals (Sweden)

Gurkirat Sandhu

2017-01-01

Full Text Available Context: Periodontal surgical procedures produce varying degree of stress in all patients. Nitrous oxide-oxygen inhalation sedation is very effective for adult patients with mild-to-moderate anxiety due to dental procedures and needle phobia. Aim: The present study was designed to perform periodontal surgical procedures under nitrous oxide-oxygen inhalation sedation and assess whether this technique actually reduces stress physiologically, in comparison to local anesthesia alone (LA during lengthy periodontal surgical procedures. Settings and Design: This was a randomized, split-mouth, cross-over study. Materials and Methods: A total of 16 patients were selected for this randomized, split-mouth, cross-over study. One surgical session (SS was performed under local anesthesia aided by nitrous oxide-oxygen inhalation sedation, and the other SS was performed on the contralateral quadrant under LA. For each session, blood samples to measure and evaluate serum cortisol levels were obtained, and vital parameters including blood pressure, heart rate, respiratory rate, and arterial blood oxygen saturation were monitored before, during, and after periodontal surgical procedures. Statistical Analysis Used: Paired t-test and repeated measure ANOVA. Results: The findings of the present study revealed a statistically significant decrease in serum cortisol levels, blood pressure and pulse rate and a statistically significant increase in respiratory rate and arterial blood oxygen saturation during periodontal surgical procedures under nitrous oxide inhalation sedation. Conclusion: Nitrous oxide-oxygen inhalation sedation for periodontal surgical procedures is capable of reducing stress physiologically, in comparison to LA during lengthy periodontal surgical procedures.

En gave til skolernes litteraturundervisning

DEFF Research Database (Denmark)

Larsen, Peter Stein

2015-01-01

Mens Caspar Erics debutdigtsamling, " 7/ 11", fra sidste år var præget af en stil, hvor der i en hæsblæsende strøm blev refereret til Facebook, You-Tube, iPhone, mp3, Macbook, Twitter og Netflix, frem for at man fik noget at vide om, hvad der rørte sig i ... ......Mens Caspar Erics debutdigtsamling, " 7/ 11", fra sidste år var præget af en stil, hvor der i en hæsblæsende strøm blev refereret til Facebook, You-Tube, iPhone, mp3, Macbook, Twitter og Netflix, frem for at man fik noget at vide om, hvad der rørte sig i ... ...

Geomagnetism gave me my bearings

Indian Academy of Sciences (India)

Lawrence

days at the University of Delhi, but also had the opportunity to attend summer ... versity in the United States, I worked on a problem in condensed- matter physics. ... diately after my Ph.D. made me open to the idea of taking up research in an ...

Comparative anthelmintic activity investigation of selected ethno-medicinal weeds

Science.gov (United States)

Pueblos, Kirstin Rhys S.; Bajalla, Mark; Pacheco, Dixie; Ganot, Sheila; Paig, Daisy; Tapales, Radyn; Lagare, Jeanne; Quimque, Mark Tristan J.

2017-01-01

Helminth infections are one of the seriously neglected potent diseases in many parts of the world. The problems of parasitic helminthes becoming resistant to currently available anthelmintic drugs pose a challenge for the search - relying on natural products - for new and better anthelmintics. In this paper, four abundant Philippine weeds: Chrysopogon aciculatus Trin. Cyperus brevifolius Rottb., Ruellia tuberosa Linn. and Saccharum spontaneum Linn. were investigated for their anthelmintic activities to establish basis of their folkloric claim. The hexane-soluble and chloroform-soluble extracts were obtained through sequential solvent partitioning of the crude ethanolic extract of the air-dried aerial part of each plant sample. Meanwhile, the decoction was obtained from fresh aerial part of the plant samples. All extracts were then subjected to in vitro anthelmintic screening at different concentration as per method of Ghosh, et al. against African nightcrawler earthworms (Eudrillus euginiae) in which the activity of the extracts was determined by correlation with time. The anthelmintic bioassay results revealed a dose-dependent toxicity relationship. It indicated relatively low anthelmintic activities of the decoction of the four plant samples as compared to their corresponding crude ethanol extracts. Among the crude ethanol extracts, C. brevifolius (CBE) gave fastest time to bring about paralysis and death to the test organisms at all concentrations tested. For the hexane extracts, R. tuberosa (RTH) gave better activity among other plant samples. Lastly, among the chloroform-soluble extracts, both that of C. brevifolius (CBC) and R. tuberosa (RTC) comparably showed strongest anthelmintic activities at all tested concentrations, thus, exhibited best anthelmintic activity that is remarkably comparable to the positive control, Mebendazole at the highest concentration tested. In fact, CBC and RTC showed highest anthelmintic potential compared to all extracts tested in

The application of cat swarm optimisation algorithm in classifying small loan performance

Science.gov (United States)

Kencana, Eka N.; Kiswanti, Nyoman; Sari, Kartika

2017-10-01

It is common for banking system to analyse the feasibility of credit application before its approval. Although this process has been carefully done, there is no warranty that all credits will be repaid smoothly. This study aimed to know the accuracy of Cat Swarm Optimisation (CSO) algorithm in classifying small loans’ performance that is approved by Bank Rakyat Indonesia (BRI), one of several public banks in Indonesia. Data collected from 200 lenders were used in this work. The data matrix consists of 9 independent variables that represent profile of the credit, and one categorical dependent variable reflects credit’s performance. Prior to the analyses, data was divided into two data subset with equal size. Ordinal logistic regression (OLR) procedure is applied for the first subset and gave 3 out of 9 independent variables i.e. the amount of credit, credit’s period, and income per month of lender proved significantly affect credit performance. By using significantly estimated parameters from OLR procedure as the initial values for observations at the second subset, CSO procedure started. This procedure gave 76 percent of classification accuracy of credit performance, slightly better compared to 64 percent resulted from OLR procedure.

Still special? Harvesting procedures for industrial hemp

Directory of Open Access Journals (Sweden)

Hans-Jörg Gusovius

2016-01-01

Full Text Available A multitude of different harvesting procedures is available after the re-approval of hemp growing in Germany about 20 years ago. Established, but as well recent machine developments enable the supply of raw materials for further processing or as food and feed materials. The necessary specialization level results in high but, compared to other established crops, not exceeding procedural costs. In this study, harvesting procedures and technologies are analyzed that are currently used under Northern European cultivation conditions. However, technological enhancements are still needed in order to improve the competitiveness of fibre hemp in the crop rotation as well as of hemp-based semi-finished and finished products.

Washback to Learning Outcomes: A Comparative Study of IELTS Preparation and University Pre-Sessional Language Courses

Science.gov (United States)

Green, Anthony

2007-01-01

This study investigated whether dedicated test preparation classes gave learners an advantage in improving their writing test scores. Score gains following instruction on a measure of academic writing skills--the International English Language Testing System (IELTS) academic writing test--were compared across language courses of three types; all…

In silico models for predicting ready biodegradability under REACH: a comparative study.

Science.gov (United States)

Pizzo, Fabiola; Lombardo, Anna; Manganaro, Alberto; Benfenati, Emilio

2013-10-01

REACH (Registration Evaluation Authorization and restriction of Chemicals) legislation is a new European law which aims to raise the human protection level and environmental health. Under REACH all chemicals manufactured or imported for more than one ton per year must be evaluated for their ready biodegradability. Ready biodegradability is also used as a screening test for persistent, bioaccumulative and toxic (PBT) substances. REACH encourages the use of non-testing methods such as QSAR (quantitative structure-activity relationship) models in order to save money and time and to reduce the number of animals used for scientific purposes. Some QSAR models are available for predicting ready biodegradability. We used a dataset of 722 compounds to test four models: VEGA, TOPKAT, BIOWIN 5 and 6 and START and compared their performance on the basis of the following parameters: accuracy, sensitivity, specificity and Matthew's correlation coefficient (MCC). Performance was analyzed from different points of view. The first calculation was done on the whole dataset and VEGA and TOPKAT gave the best accuracy (88% and 87% respectively). Then we considered the compounds inside and outside the training set: BIOWIN 6 and 5 gave the best results for accuracy (81%) outside training set. Another analysis examined the applicability domain (AD). VEGA had the highest value for compounds inside the AD for all the parameters taken into account. Finally, compounds outside the training set and in the AD of the models were considered to assess predictive ability. VEGA gave the best accuracy results (99%) for this group of chemicals. Generally, START model gave poor results. Since BIOWIN, TOPKAT and VEGA models performed well, they may be used to predict ready biodegradability. Copyright © 2013 Elsevier B.V. All rights reserved.

On Procedural Freedom of Choice

NARCIS (Netherlands)

Arlegi, R.; Dimitrov, D.A.

2004-01-01

Numerous works in the last decade have analyzed the question of how to compare opportunity sets as a way to measure and evaluate individual freedom of choice.This paper defends that, in many contexts, external procedural aspects that are associated to an opportunity set should be taken into account

Radioimmunoassay and chemical ionization/mass spectrometry compared for plasma cortisol determination

International Nuclear Information System (INIS)

Lindberg, C.; Johnson, S.; Hedner, P.; Gustafsson, A.

1982-01-01

A method is described for determination of cortisol in plasma and urine, based on chemical ionization/mass spectrometry with deuterium-labeled cortisol as the internal standard. The within-run precision (CV) was 2.5-5.7%, the between-run precision 4.6%. Results by this method were compared with those by a radioimmunological method (RIANEN Cortisol, New England Nuclear) for 395 plasma samples. The latter method gave significantly higher (approx. 25%) cortisol values

Patients exposure assessment for radiographic procedures in diagnostic radiology

International Nuclear Information System (INIS)

Arandjic, D.; Ciraj-Bjelac, O.; Stankovic, K.; Lazarevic, Dj.; Ciraj-Bjelac, O.)

2007-01-01

In this work the results of dose assessment for the most frequent radiographic procedures in diagnostic radiology are shown. Entrance surface doses were assessed for 7 radiographic procedures. Three hospitals, six x-ray units in total, were enrolled in investigation. Patient doses were estimated based on results of x-ray tube output measurements. Finally, doses were compared with Diagnostic reference level. Higher dose values were observed for chest examinations. In comparison with results from other countries, doses from this procedure in Serbia are significantly higher. Estimated doses for other procedures were well below Diagnostic reference levels [sr

Gastric antral vascular ectasia and its clinical correlates in patients with early diffuse systemic sclerosis in the SCOT trial.

Science.gov (United States)

Hung, Emily W; Mayes, Maureen D; Sharif, Roozbeh; Assassi, Shervin; Machicao, Victor I; Hosing, Chitra; St Clair, E William; Furst, Daniel E; Khanna, Dinesh; Forman, Stephen; Mineishi, Shin; Phillips, Kristine; Seibold, James R; Bredeson, Christopher; Csuka, Mary Ellen; Nash, Richard A; Wener, Mark H; Simms, Robert; Ballen, Karen; Leclercq, Sharon; Storek, Jan; Goldmuntz, Ellen; Welch, Beverly; Keyes-Elstein, Lynette; Castina, Sharon; Crofford, Leslie J; Mcsweeney, Peter; Sullivan, Keith M

2013-04-01

To describe the prevalence and clinical correlates of endoscopic gastric antral vascular ectasia (GAVE; "watermelon stomach") in early diffuse systemic sclerosis (SSc). Subjects with early, diffuse SSc and evidence of specific internal organ involvement were considered for the Scleroderma: Cyclophosphamide Or Transplant (SCOT) trial. In the screening procedures, all patients underwent upper gastrointestinal endoscopy. Patients were then categorized into those with or without endoscopic evidence of GAVE. Demographic data, clinical disease characteristics, and autoantibody data were compared using Pearson chi-square or Student t tests. Twenty-three of 103 (22.3%) individuals were found to have GAVE on endoscopy. Although not statistically significant, anti-topoisomerase I (anti-Scl70) was detected less frequently among those with GAVE (18.8% vs 44.7%; p = 0.071). Similarly, anti-RNP antibodies (anti-U1 RNP) showed a trend to a negative association with GAVE (0 vs 18.4%; p = 0.066). There was no association between anti-RNA polymerase III and GAVE. Patients with GAVE had significantly more erythema or vascular ectasias in other parts of the stomach (26.1% vs 5.0%; p = 0.003). Endoscopic GAVE was present on screening in almost one-fourth of these highly selected patients with early and severe diffuse SSc. While anti-Scl70 and anti-U1 RNP trended toward a negative association with GAVE, there was no correlation between anti-RNA Pol III and GAVE. Patients with GAVE had a higher frequency of other gastric vascular ectasias outside the antrum, suggesting that GAVE may represent part of the spectrum of the vasculopathy in SSc.

Increasing spelling achievement: an analysis of treatment procedures utilizing an alternating treatments design.

OpenAIRE

Ollendick, T H; Matson, J L; Esveldt-Dawson, K; Shapiro, E S

1980-01-01

Two studies which examine the effectiveness of spelling remediation procedures are reported. In both studies, an alternating treatment design was employed. In the first study, positive practice overcorrection plus positive reinforcement was compared to positive practice alone and a no-remediation control condition. In the second study, positive practice plus positive reinforcement was compared to a traditional corrective procedure plus positive reinforcement and a traditional procedure when u...

Realistic Vascular Replicator for TAVR Procedures.

Science.gov (United States)

Rotman, Oren M; Kovarovic, Brandon; Sadasivan, Chander; Gruberg, Luis; Lieber, Baruch B; Bluestein, Danny

2018-04-13

Transcatheter aortic valve replacement (TAVR) is an over-the-wire procedure for treatment of severe aortic stenosis (AS). TAVR valves are conventionally tested using simplified left heart simulators (LHS). While those provide baseline performance reliably, their aortic root geometries are far from the anatomical in situ configuration, often overestimating the valves' performance. We report on a novel benchtop patient-specific arterial replicator designed for testing TAVR and training interventional cardiologists in the procedure. The Replicator is an accurate model of the human upper body vasculature for training physicians in percutaneous interventions. It comprises of fully-automated Windkessel mechanism to recreate physiological flow conditions. Calcified aortic valve models were fabricated and incorporated into the Replicator, then tested for performing TAVR procedure by an experienced cardiologist using the Inovare valve. EOA, pressures, and angiograms were monitored pre- and post-TAVR. A St. Jude mechanical valve was tested as a reference that is less affected by the AS anatomy. Results in the Replicator of both valves were compared to the performance in a commercial ISO-compliant LHS. The AS anatomy in the Replicator resulted in a significant decrease of the TAVR valve performance relative to the simplified LHS, with EOA and transvalvular pressures comparable to clinical data. Minor change was seen in the mechanical valve performance. The Replicator showed to be an effective platform for TAVR testing. Unlike a simplified geometric anatomy LHS, it conservatively provides clinically-relevant outcomes and complement it. The Replicator can be most valuable for testing new valves under challenging patient anatomies, physicians training, and procedural planning.

Randomized Controlled Trial Comparing Open Versus Laparoscopic Placement of a Peritoneal Dialysis Catheter and Outcomes: The CAPD I Trial.

Science.gov (United States)

van Laanen, Jorinde H H; Cornelis, Tom; Mees, Barend M; Litjens, Elisabeth J; van Loon, Magda M; Tordoir, Jan H M; Peppelenbosch, Arnoud G

2018-01-01

To determine the best operation technique, open versus laparoscopic, for insertion of a peritoneal dialysis (PD) catheter with regard to clinical success. Clinical success was defined as an adequate function of the catheter 2 - 4 weeks after insertion. All patients with end-stage renal disease who were suitable for PD and gave informed consent were randomized for either open surgery or laparoscopic surgery. A previous laparotomy was not considered an exclusion criterion. Laparoscopic placement had the advantage of pre-peritoneal tunneling, the possibility for adhesiolysis, and placement of the catheter under direct vision. Catheter fixation techniques, omentopexy, or other adjunct procedures were not performed. Other measured parameters were in-hospital morbidity and mortality and post-operative infections. Between 2010 and 2016, 95 patients were randomized to this study protocol. After exclusion of 5 patients for various reasons, 44 patients received an open procedure and 46 patients a laparoscopic procedure. Gender, age, body mass index (BMI), hypertension, current hemodialysis, severe heart failure, and previous an abdominal operation were not significantly different between the groups. However, in the open surgery group, fewer patients had a previous median laparotomy compared with the laparoscopic group (6 vs 16 patients; p = 0.027). There was no statistically significant difference in mean operation time (36 ± 24 vs 38 ± 15 minutes) and hospital stay (2.1 ± 2.7 vs 3.1 ± 7.3 days) between the groups. In the open surgery group 77% of the patients had an adequate functioning catheter 2 - 4 weeks after insertion compared with 70% of patients in the laparoscopic group ( p = not significant [NS]). In the open surgery group there was 1 post-operative death (2%) compared with none in the laparoscopic group ( p = NS). The morbidity in both groups was low and not significantly different. In the open surgery group, 2 patients had an exit-site infection and 1 patient

Procedure for statistical analysis of one-parameter discrepant experimental data

International Nuclear Information System (INIS)

Badikov, Sergey A.; Chechev, Valery P.

2012-01-01

A new, Mandel–Paule-type procedure for statistical processing of one-parameter discrepant experimental data is described. The procedure enables one to estimate a contribution of unrecognized experimental errors into the total experimental uncertainty as well as to include it in analysis. A definition of discrepant experimental data for an arbitrary number of measurements is introduced as an accompanying result. In the case of negligible unrecognized experimental errors, the procedure simply reduces to the calculation of the weighted average and its internal uncertainty. The procedure was applied to the statistical analysis of half-life experimental data; Mean half-lives for 20 actinides were calculated and results were compared to the ENSDF and DDEP evaluations. On the whole, the calculated half-lives are consistent with the ENSDF and DDEP evaluations. However, the uncertainties calculated in this work essentially exceed the ENSDF and DDEP evaluations for discrepant experimental data. This effect can be explained by adequately taking into account unrecognized experimental errors. - Highlights: ► A new statistical procedure for processing one-parametric discrepant experimental data has been presented. ► Procedure estimates a contribution of unrecognized errors in the total experimental uncertainty. ► Procedure was applied for processing half-life discrepant experimental data. ► Results of the calculations are compared to the ENSDF and DDEP evaluations.

Comparative Test Case Specification

DEFF Research Database (Denmark)

Kalyanova, Olena; Heiselberg, Per

This document includes the specification on the IEA task of evaluation building energy simulation computer programs for the Double Skin Facades (DSF) constructions. There are two approaches involved into this procedure, one is the comparative approach and another is the empirical one. In the comp....... In the comparative approach the outcomes of different software tools are compared, while in the empirical approach the modelling results are compared with the results of experimental test cases. The comparative test cases include: ventilation, shading and geometry....

Portal monitor evaluation and test procedure

International Nuclear Information System (INIS)

Johnson, L.O.; Gupta, V.P.; Stevenson, R.L.; Rich, B.L.

1983-10-01

The purpose was to develop techniques and procedures to allow users to measure performance and sensitivity of portal monitors. Additionally, a methodology was developed to assist users in optimizing monitor performance. The two monitors tested utilized thin-window gas-flow proportional counters sensitive to beta and gamma radiation. Various tests were performed: a) background count rate and the statistical variability, b) detector efficiency at different distances, c) moving source sensitivity for various size sources and speeds, and d) false alarm rates at different background levels. A model was developed for the moving source measurements to compare the experimental data with measured results, and to test whether it is possible to adequately model the behavior of a portal monitor's response to a moving source. The model results were compared with the actual test results. A procedure for testing portal monitors is also given. 1 reference, 9 figures, 8 tables

Aqueous CO2 vs. aqueous extraction of soils as a preparative procedure for acute toxicity testing

International Nuclear Information System (INIS)

Yates, G.W.; Burks, S.L.

1994-01-01

This study was to determine if contaminated soils extracted with supercritical CO 2 (SFE) would yield different results from soils extracted with an aqueous media. Soil samples from an abandoned oil refinery were subjected to aqueous and SFE extraction. Uncontaminated control sites were compared with contaminated sites. Each extract was analyzed for 48 hour acute Ceriodaphnia LC50s and Microtox reg-sign EC50s. Comparisons were then made between the aqueous extracts and the SFE extracts. An additional study was made with HPLC chromatographs of the SFE contaminated site extracts to determine if there was a correlation between LC50 results and peak area of different sections of the chromatograph. The 48 hour Ceriodaphnia LC50 of one contaminated site showed a significant increase in toxicity with the supercritical extract compared to the aqueous extract. All contaminated sites gave toxic responses with the supercritical procedure. The Microtox reg-sign assay showed a toxic response with 2 of the 3 contaminated sites for both aqueous and SFE extracts. Results indicate that the Ceriodaphnia assays were more sensitive than Microtox reg-sign to contaminants found in the refinery soil. SFE controls did not show adverse effects with the Ceriodaphnia, but did have a slight effect with Microtox reg-sign. The best correlation (r 2 > 0.90) between the Ceriodaphnia LC50s and the peak areas of the chromatographs was obtained for sections with an estimated log K ow of 1 to 5. SFE extraction provided a fast, efficient and inexpensive method of collecting and testing moderately non-polar to strongly non-polar organic contaminants from contaminated soils

Two Procedures for Relaxation as Self-Control in the Treatment of Communication Apprehension

Science.gov (United States)

Deffenbacher, Jerry L.; Payne, Dennis M.

1977-01-01

An in vivo procedure for relaxation as self-control and a procedure for self-control modification of desensitization were compared to a no-treatment control. Results showed modified desensitization, compared to the control, significantly decreased communication anxiety and fear of negative evaluation and significantly increased assertiveness.…

Radioimmunoassay and liquid-chromatographic analysis for free cortisol in urine compared with isotope dilution-mass spectrometry

International Nuclear Information System (INIS)

Lantto, O.

1982-01-01

Three different routine methods for analysis for urinary cortisol with those by a highly specific reference method based on isotope dilution-mass spectrometry (I) were compared. A ''high-performance'' liquid-chromatographic method (II) gave the most comparable results (regression coefficient 0.86, intercept 9 nmol/L). For some urines much lower values were obtained by I than by II. Two radioimmunoassay (III) methods, one involving direct assay and one involving extraction, gave less-accurate results (regression coefficients of 1.87 and 1.52 and intercepts of 86 and 12 nmol/L, respectively), although values obtained by III and by I correlated well (r = 0.95-0.99), indicating a relation between the free cortisol and the compounds interfering in III. The apparent accuracy for the extraction method was improved by using as calibration standards urine samples previously assayed by I (regression coefficient 0.90, intercept 6 nmol/L). All four methods investigated showed a statistically significant sex-related difference in 24-h urinary cortisol excretion; evidently such a finding should be a prerequisite in any such method proposed for routine use

Application of computerized procedure system for AP1000

International Nuclear Information System (INIS)

Wen Fang

2012-01-01

With the tendency of digitalisation in instrumentation and control system of nuclear power plants, AP1000, as well as other advanced PWRs, is provided with the technical basis for the application of CPS (computerized procedure system). This paper makes a brief introduction on CPS construction and function. CPS, as an advanced procedure system, does not only have the function of electronic indication for operation procedures, but also have the ability to monitor plant data, process the data and then present the status of the procedure steps to the reactor operator. In addition, advantages of CPS compared with paper-based procedures and comparison with digital operating system of one M310 plus advanced nuclear power plant are described. Moreover, based on current situation, this paper offers several suggestions on CPS localization for Sanmen AP1000 nuclear power project. Besides, the last part of this paper discusses problems we might meet during the process of CPS localization. (author)

AGREED-UPON PROCEDURES, PROCEDURES FOR AUDITING EUROPEAN GRANTS

Directory of Open Access Journals (Sweden)

Daniel Petru VARTEIU

2016-12-01

The audit of EU-funded projects is an audit based on agreed-upon procedures, which are established by the Managing Authority or the Intermediate Body. Agreed-upon procedures can be defined as engagements made in accordance with ISRS 4400, applicable to agreed-upon procedures, where the auditor undertakes to carry out the agreed-upon procedures and issue a report on factual findings. The report provided by the auditor does not express any assurance. It allows users to form their own opinions about the conformity of the expenses with the project budget as well as the eligibility of the expenses.

Thyroid Radiation Dose to Patients from Diagnostic Radiology Procedures over Eight Decades: 1930-2010.

Science.gov (United States)

Chang, Lienard A; Miller, Donald L; Lee, Choonsik; Melo, Dunstana R; Villoing, Daphnée; Drozdovitch, Vladimir; Thierry-Chef, Isabelle; Winters, Sarah J; Labrake, Michael; Myers, Charles F; Lim, Hyeyeun; Kitahara, Cari M; Linet, Martha S; Simon, Steven L

2017-12-01

This study summarizes and compares estimates of radiation absorbed dose to the thyroid gland for typical patients who underwent diagnostic radiology examinations in the years from 1930 to 2010. The authors estimated the thyroid dose for common examinations, including radiography, mammography, dental radiography, fluoroscopy, nuclear medicine, and computed tomography (CT). For the most part, a clear downward trend in thyroid dose over time for each procedure was observed. Historically, the highest thyroid doses came from the nuclear medicine thyroid scans in the 1960s (630 mGy), full-mouth series dental radiography (390 mGy) in the early years of the use of x rays in dentistry (1930s), and the barium swallow (esophagram) fluoroscopic exam also in the 1930s (140 mGy). Thyroid uptake nuclear medicine examinations and pancreatic scans also gave relatively high doses to the thyroid (64 mGy and 21 mGy, respectively, in the 1960s). In the 21st century, the highest thyroid doses still result from nuclear medicine thyroid scans (130 mGy), but high thyroid doses are also associated with chest/abdomen/pelvis CT scans (18 and 19 mGy for males and females, respectively). Thyroid doses from CT scans did not exhibit the same downward trend as observed for other examinations. The largest thyroid doses from conventional radiography came from cervical spine and skull examinations. Thyroid doses from mammography (which began in the 1960s) were generally a fraction of 1 mGy. The highest average doses to the thyroid from mammography were about 0.42 mGy, with modestly larger doses associated with imaging of breasts with large compressed thicknesses. Thyroid doses from dental radiographic procedures have decreased markedly throughout the decades, from an average of 390 mGy for a full-mouth series in the 1930s to an average of 0.31 mGy today. Upper GI series fluoroscopy examinations resulted in up to two orders of magnitude lower thyroid doses than the barium swallow. There are

Brachytherapy for prostate cancer: Comparative characteristics of procedures

Directory of Open Access Journals (Sweden)

S. V. Kanaev

2015-01-01

Full Text Available The introduction of interstitial radiation sources is the «youngest» of the radical method of treatment of patients with prostate cancer (PC. The high level of efficiency comparable to prostatectomy at a significantly lower rate of complications causes rapid growth of clinical use of brachytherapy (BT. Depending on the radiation source and the mode of administration into the prostate gland are two types BT – high-dose rate (temporary (HDR-BT and low-dose rate (permanent (LDR-BT brachytherapy. At the heart of these two methods are based on a single principle of direct effect of the quantum gamma radiation on the area of interest. However, the differences between the characteristics of isotopes used and technical aspects of the techniques cause the difference in performance and complication rates for expression HDR-BT and LDR-BT.

Ruthenium oxide/carbon composites with microporous or mesoporous carbon as support and prepared by two procedures. A comparative study as supercapacitor electrodes

International Nuclear Information System (INIS)

Pico, F.; Morales, E.; Fernandez, J.A.; Centeno, T.A.; Ibanez, J.; Rojas, R.M.; Amarilla, J.M.; Rojo, J.M.

2009-01-01

Composites are prepared by deposition of nanoparticles of RuO 2 .xH 2 O (1-4 nm) on two carbons: microporous carbon (1.3 nm of average micropore size) and mesoporous carbon (11 nm of average mesopore size). Two-preparation procedures are used: (i) procedure A consisting of repetitive impregnations of the carbons with RuCl 3 .0.5H 2 O solutions, and (ii) procedure B based on impregnation of the carbons with Ru(acac) 3 vapour. The procedure B leads to supported RuO 2 .xH 2 O particles that appear more crystalline than those obtained by the procedure A. Specific capacitance and specific surface area of the composites are discussed as functions of the RuO 2 content, and different dependences for the composites derived from the two carbons are found. Mesoporous carbon is better support than microporous carbon. Procedure A leads to supported RuO 2 .xH 2 O particles with higher specific capacitance than the particles deposited by procedure B

Ruthenium oxide/carbon composites with microporous or mesoporous carbon as support and prepared by two procedures. A comparative study as supercapacitor electrodes

Energy Technology Data Exchange (ETDEWEB)

Pico, F. [Instituto de Ciencia de Materiales de Madrid (ICMM), Consejo Superior de Investigaciones Cientificas (CSIC), Sor Juana Ines de la Cruz 3, Cantoblanco, E-28049-Madrid (Spain); Morales, E. [Instituto de Ciencia y Tecnologia de Polimeros (ICTP), CSIC, Juan de la Cierva 3, E-28006-Madrid (Spain); Fernandez, J.A.; Centeno, T.A. [Instituto Nacional del Carbon (INCAR), CSIC, Francisco Pintado Fe 26, E-33011-Oviedo (Spain); Ibanez, J. [Centro Nacional de Investigaciones Metalurgicas (CENIM), CSIC, Avda. Gregorio del Amo 8, E-28040-Madrid (Spain); Rojas, R.M.; Amarilla, J.M. [Instituto de Ciencia de Materiales de Madrid (ICMM), Consejo Superior de Investigaciones Cientificas (CSIC), Sor Juana Ines de la Cruz 3, Cantoblanco, E-28049-Madrid (Spain); Rojo, J.M. [Instituto de Ciencia de Materiales de Madrid (ICMM), Consejo Superior de Investigaciones Cientificas (CSIC), Sor Juana Ines de la Cruz 3, Cantoblanco, E-28049-Madrid (Spain)], E-mail: jmrojo@icmm.csic.es

2009-03-01

Composites are prepared by deposition of nanoparticles of RuO{sub 2}.xH{sub 2}O (1-4 nm) on two carbons: microporous carbon (1.3 nm of average micropore size) and mesoporous carbon (11 nm of average mesopore size). Two-preparation procedures are used: (i) procedure A consisting of repetitive impregnations of the carbons with RuCl{sub 3}.0.5H{sub 2}O solutions, and (ii) procedure B based on impregnation of the carbons with Ru(acac){sub 3} vapour. The procedure B leads to supported RuO{sub 2}.xH{sub 2}O particles that appear more crystalline than those obtained by the procedure A. Specific capacitance and specific surface area of the composites are discussed as functions of the RuO{sub 2} content, and different dependences for the composites derived from the two carbons are found. Mesoporous carbon is better support than microporous carbon. Procedure A leads to supported RuO{sub 2}.xH{sub 2}O particles with higher specific capacitance than the particles deposited by procedure B.

Robotic pancreas drainage procedure for chronic pancreatitis: robotic lateral pancreaticojejunostomy (Puestow procedure).

Science.gov (United States)

Khan, Adeel S; Siddiqui, Imran; Vrochides, Dionisios; Martinie, John B

2018-01-01

Lateral pancreaticojejunostomy (LPJ), also known as the Puestow procedure, is a complex surgical procedure reserved for patients with refractory chronic pancreatitis (CP) and a dilated pancreatic duct. Traditionally, this operation is performed through an open incision, however, recent advancements in minimally invasive techniques have made it possible to perform the surgery using laparoscopic and robotic techniques with comparable safety. Though we do not have enough data yet to prove superiority of one over the other, the robotic approach appears to have an advantage over the laparoscopic technique in better visualization through 3-dimensional (3D) imaging and availability of wristed instruments for more precise actions, which may translate into superior outcomes. This paper is a description of our technique for robotic LPJ in patients with refractory CP. Important principles of patient selection, preoperative workup, surgical technique and post-operative management are discussed. A short video with a case presentation and highlights of the important steps of the surgery is included.

Comparing Social Stories™ to Cool versus Not Cool

Science.gov (United States)

Leaf, Justin B.; Mitchell, Erin; Townley-Cochran, Donna; McEachin, John; Taubman, Mitchell; Leaf, Ronald

2016-01-01

In this study we compared the cool versus not cool procedure to Social Stories™ for teaching various social behaviors to one individual diagnosed with autism spectrum disorder. The researchers randomly assigned three social skills to the cool versus not cool procedure and three social skills to the Social Stories™ procedure. Naturalistic probes…

Occupational radiation doses during interventional procedures

International Nuclear Information System (INIS)

Nuraeni, N; Hiswara, E; Kartikasari, D; Waris, A; Haryanto, F

2016-01-01

Digital subtraction angiography (DSA) is a type of fluoroscopy technique used in interventional radiology to clearly visualize blood vessels in a bony or dense soft tissue environment. The use of DSA procedures has been increased quite significantly in the Radiology departments in various cities in Indonesia. Various reports showed that both patients and medical staff received a noticeable radiation dose during the course of this procedure. A study had been carried out to measure these doses among interventionalist, nurse and radiographer. The results show that the interventionalist and the nurse, who stood quite close to the X-ray beams compared with the radiographer, received radiation higher than the others. The results also showed that the radiation dose received by medical staff were var depending upon the duration and their position against the X-ray beams. Compared tothe dose limits, however, the radiation dose received by all these three medical staff were still lower than the limits. (paper)

Procedure for Measuring and Reporting Commercial Building Energy Performance

Energy Technology Data Exchange (ETDEWEB)

Barley, D.; Deru, M.; Pless, S.; Torcellini, P.

2005-10-01

This procedure is intended to provide a standard method for measuring and characterizing the energy performance of commercial buildings. The procedure determines the energy consumption, electrical energy demand, and on-site energy production in existing commercial buildings of all types. The performance metrics determined here may be compared against benchmarks to evaluate performance and verify that performance targets have been achieved.

Quantization Procedures

International Nuclear Information System (INIS)

Cabrera, J. A.; Martin, R.

1976-01-01

We present in this work a review of the conventional quantization procedure, the proposed by I.E. Segal and a new quantization procedure similar to this one for use in non linear problems. We apply this quantization procedures to different potentials and we obtain the appropriate equations of motion. It is shown that for the linear case the three procedures exposed are equivalent but for the non linear cases we obtain different equations of motion and different energy spectra. (Author) 16 refs

Office-based procedures for diagnosis and treatment of esophageal pathology.

Science.gov (United States)

Wellenstein, David J; Schutte, Henrieke W; Marres, Henri A M; Honings, Jimmie; Belafsky, Peter C; Postma, Gregory N; Takes, Robert P; van den Broek, Guido B

2017-09-01

Diagnostic and therapeutic office-based procedures under topical anesthesia are emerging in the daily practice of laryngologists and head and neck surgeons. Since the introduction of the transnasal esophagoscope, office-based procedures for the esophagus are increasingly performed. We conducted a systematic review of literature on office-based procedures under topical anesthesia for the esophagus. Transnasal esophagoscopy is an extensively investigated office-based procedure. This procedure shows better patient tolerability and equivalent accuracy compared to conventional transoral esophagoscopy, as well as time and cost savings. Secondary tracheoesophageal puncture, esophageal dilatation, esophageal sphincter injection, and foreign body removal are less investigated, but show promising results. With the introduction of the transnasal esophagoscope, an increasing number of diagnostic and therapeutic office-based procedures for the esophagus are possible, with multiple advantages. Further investigation must prove the clinical feasibility and effectiveness of the therapeutic office-based procedures. © 2017 Wiley Periodicals, Inc.

Comparison of VFA titration procedures used for monitoring the biogas process.

Science.gov (United States)

Lützhøft, Hans-Christian Holten; Boe, Kanokwan; Fang, Cheng; Angelidaki, Irini

2014-05-01

Titrimetric determination of volatile fatty acids (VFAs) contents is a common way to monitor a biogas process. However, digested manure from co-digestion biogas plants has a complex matrix with high concentrations of interfering components, resulting in varying results when using different titration procedures. Currently, no standardized procedure is used and it is therefore difficult to compare the performance among plants. The aim of this study was to evaluate four titration procedures (for determination of VFA-levels of digested manure samples) and compare results with gas chromatographic (GC) analysis. Two of the procedures are commonly used in biogas plants and two are discussed in literature. The results showed that the optimal titration results were obtained when 40 mL of four times diluted digested manure was gently stirred (200 rpm). Results from samples with different VFA concentrations (1-11 g/L) showed linear correlation between titration results and GC measurements. However, determination of VFA by titration generally overestimated the VFA contents compared with GC measurements when samples had low VFA concentrations, i.e. around 1 g/L. The accuracy of titration increased when samples had high VFA concentrations, i.e. around 5 g/L. It was further found that the studied ionisable interfering components had lowest effect on titration when the sample had high VFA concentration. In contrast, bicarbonate, phosphate and lactate had significant effect on titration accuracy at low VFA concentration. An extended 5-point titration procedure with pH correction was best to handle interferences from bicarbonate, phosphate and lactate at low VFA concentrations. Contrary, the simplest titration procedure with only two pH end-points showed the highest accuracy among all titration procedures at high VFA concentrations. All in all, if the composition of the digested manure sample is not known, the procedure with only two pH end-points should be the procedure of

Radioimmunoassay procedure using a stabilized complex

International Nuclear Information System (INIS)

Sultanian, I.V.; Irani, J.H.

1978-01-01

An improved radioimmunoassay procedure involves the use of a stabilized complex of labelled antigen and antibody which has an extended shelf life as compared to the same complex absent the stabilizers. Since the time needed to incubate the mixture of labelled antigen and antibody is eliminated, the time for completing the assay is considerably shortened and simplified. The components for carrying out the procedure are packaged in a kit basically including standard antigen for generation of a standard curve, a stabilized labelled antigen-antibody complex and reference serum, if used. A plurality of stabilizers are used in the complex to provide a shelf life of six weeks or more. 10 claims

Efficiency of performing pulmonary procedures in a shared endoscopy unit: procedure time, turnaround time, delays, and procedure waiting time.

Science.gov (United States)

Verma, Akash; Lee, Mui Yok; Wang, Chunhong; Hussein, Nurmalah B M; Selvi, Kalai; Tee, Augustine

2014-04-01

The purpose of this study was to assess the efficiency of performing pulmonary procedures in the endoscopy unit in a large teaching hospital. A prospective study from May 20 to July 19, 2013, was designed. The main outcome measures were procedure delays and their reasons, duration of procedural steps starting from patient's arrival to endoscopy unit, turnaround time, total case durations, and procedure wait time. A total of 65 procedures were observed. The most common procedure was BAL (61%) followed by TBLB (31%). Overall procedures for 35 (53.8%) of 65 patients were delayed by ≥ 30 minutes, 21/35 (60%) because of "spillover" of the gastrointestinal and surgical cases into the time block of pulmonary procedure. Time elapsed between end of pulmonary procedure and start of the next procedure was ≥ 30 minutes in 8/51 (16%) of cases. In 18/51 (35%) patients there was no next case in the room after completion of the pulmonary procedure. The average idle time of the room after the end of pulmonary procedure and start of next case or end of shift at 5:00 PM if no next case was 58 ± 53 minutes. In 17/51 (33%) patients the room's idle time was >60 minutes. A total of 52.3% of patients had the wait time >2 days and 11% had it ≥ 6 days, reason in 15/21 (71%) being unavailability of the slot. Most pulmonary procedures were delayed due to spillover of the gastrointestinal and surgical cases into the block time allocated to pulmonary procedures. The most common reason for difficulty encountered in scheduling the pulmonary procedure was slot unavailability. This caused increased procedure waiting time. The strategies to reduce procedure delays and turnaround times, along with improved scheduling methods, may have a favorable impact on the volume of procedures performed in the unit thereby optimizing the existing resources.

Procedural-support music therapy in the healthcare setting: a cost-effectiveness analysis.

Science.gov (United States)

DeLoach Walworth, Darcy

2005-08-01

This comparative analysis examined the cost-effectiveness of music therapy as a procedural support in the pediatric healthcare setting. Many healthcare organizations are actively attempting to reduce the amount of sedation for pediatric patients undergoing various procedures. Patients receiving music therapy-assisted computerized tomography scans ( n = 57), echocardiograms ( n = 92), and other procedures ( n = 17) were included in the analysis. Results of music therapy-assisted procedures indicate successful elimination of patient sedation, reduction in procedural times, and decrease in the number of staff members present for procedures. Implications for nurses and music therapists in the healthcare setting are discussed.

Endovascular thrombectomy and post-procedural headache.

Science.gov (United States)

Khan, Sabrina; Amin, Faisal Mohammad; Holtmannspötter, Markus; Hansen, Klaus; Florescu, Anna Maria; Fakhril-Din, Zainab; Petersen, Julie Falkenberg; Ghanizada, Hashmat; Ayata, Cenk; Gaist, David; Ashina, Messoud

2017-12-01

We investigated the prevalence of post-procedural headache in patients who have undergone thrombectomy for ischemic stroke, and correlated history of migraine with risk of peri-procedural complications. A total of 314 patients underwent thrombectomy at the Danish National Hospital from January 2012 to December 2014. Eligible subjects were phone-interviewed using a purpose-developed semi-structured questionnaire according to the International Classification of Headache Disorders 3, beta version criteria. Among 96 eligible subjects, there was a significant decrease in migraine (p = 0.022) within the first 3 months after EVT compared to 1 year before treatment, which was further evident at interview time (on average 1.6 years after EVT, p = 0.013). A minority of patients experienced headaches for the first time within 3 months of their EVT (migraine 2, TTH 9), which persisted at interview time for subjects with migraine. Out of 12 subjects with peri-procedural complications, 2 had a history of migraine with aura. Thrombectomy leads to a significant decrease in previously known migraine, and new onset of headache in a small subset of patients. A history of migraine does not appear to predispose to peri-procedural complications.

Impact of operator fatigue on endoscopy performance: implications for procedure scheduling.

LENUS (Irish Health Repository)

Harewood, Gavin C

2009-08-01

With increasing volumes of endoscopic procedures, endoscopists\\' workload has had to increase to meet this escalating demand. The aim of this study was to characterize the impact of endoscopist fatigue on quality of endoscopy performance by comparing outcomes based on chronological procedure order.

Comparative evaluation of frictional characteristics of coated low friction ligatures - Super Slick Ties™ with conventional uncoated ligatures

Directory of Open Access Journals (Sweden)

Deepu Leander

2011-01-01

Conclusions: SST produced lower levels of friction (11% for all archwire materials when compared to conventional uncoated ligatures (Dispense-A-Stix and both conventional uncoated ligatures and coated ligatures gave a rank order of coefficient of kinetic friction (μkf among archwires, with stainless steel archwires exhibiting the least and TMA TM showing the highest.

Patient doses from fluoroscopically guided cardiac procedures in pediatrics

International Nuclear Information System (INIS)

Martinez, L C; Vano, E; Gutierrez, F; Rodriguez, C; Gilarranz, R; Manzanas, M J

2007-01-01

Infants and children are a higher risk population for radiation cancer induction compared to adults. Although some values on pediatric patient doses for cardiac procedures have been reported, data to determine reference levels are scarce, especially when compared to those available for adults in diagnostic and therapeutic procedures. The aim of this study is to make a new contribution to the scarce published data in pediatric cardiac procedures and help in the determination of future dose reference levels. This paper presents a set of patient dose values, in terms of air kerma area product (KAP) and entrance surface air kerma (ESAK), measured in a pediatric cardiac catheterization laboratory equipped with a biplane x-ray system with dynamic flat panel detectors. Cardiologists were properly trained in radiation protection. The study includes 137 patients aged between 10 days and 16 years who underwent diagnostic catheterizations or therapeutic procedures. Demographic data and technical details of the procedures were also gathered. The x-ray system was submitted to a quality control programme, including the calibration of the transmission ionization chamber. The age distribution of the patients was 47 for 2 respectively for the four age bands. These KAP values increase by a factor of 8 when moving through the four age bands. The probability of a fatal cancer per fluoroscopically guided cardiac procedure is about 0.07%. Median values of ESAK for the four age bands were 46, 50, 56 and 163 mGy, which lie far below the threshold for deterministic effects on the skin. These dose values are lower than those published in previous papers

Office-Based Procedures for the Diagnosis and Treatment of Laryngeal Pathology.

Science.gov (United States)

Wellenstein, David J; Schutte, Henrieke W; Takes, Robert P; Honings, Jimmie; Marres, Henri A M; Burns, James A; van den Broek, Guido B

2017-09-18

Since the development of distal chip endoscopes with a working channel, diagnostic and therapeutic possibilities in the outpatient clinic in the management of laryngeal pathology have increased. Which of these office-based procedures are currently available, and their clinical indications and possible advantages, remains unclear. Review of literature on office-based procedures in laryngology and head and neck oncology. Flexible endoscopic biopsy (FEB), vocal cord injection, and laser surgery are well-established office-based procedures that can be performed under topical anesthesia. These procedures demonstrate good patient tolerability and multiple advantages. Office-based procedures under topical anesthesia are currently an established method in the management of laryngeal pathology. These procedures offer medical and economic advantages compared with operating room-performed procedures. Furthermore, office-based procedures enhance the speed and timing of the diagnostic and therapeutic process. Copyright © 2017 The Voice Foundation. All rights reserved.

Patient doses in interventional cardiology procedures

International Nuclear Information System (INIS)

Domienik, J.; Papierz, S.; Jankowski, J.; Peruga, J.Z.

2008-01-01

In most countries of European Union legislation requires the determination of the total skin dose to patient resulting from interventional procedures to assess the risk of deterministic effect. To this end, various dose indicators like dose area product (DAP), cumulative dose (CD) and entrance dose at the patient plane (EFD) are used in clinical practice. The study aims at relating those dose indicators with doses ascribe to the most irradiated areas of the patient skin usually expressed in terms of local maximal skin dose (MSD). For the study the local MSD and related to their areas are investigated and compared for coronary angiography CA and intervention (PCI). Two methods implying radiographic films Kodak EDR2 and matrixes of thermoluminescent dosimeters (TLDs) are applied for direct measurements of dose distribution for selected procedures. Both methods are compared. Additionally, for patient dosimetry the following data: MSD, CD, EFD, fluoroscopy time (FT), number of acquired images, total DAP, fluoro-DAP and record-DAP were collected for randomly selected procedure. The statistical quantities like: median, 3 rd quartile, mean and standard deviation for all dosimetric parameters are determined. Preliminary study showed that the values of data collected for coronary procedures are in the ranges 0,7 - 27,3 min for fluoroscopy time, 50 - 350 Gy cm 2 for total DAP, 300 - 2000 mGy for CD, 140 - 2000 mGy for EFD and 100 - 1500 mGy for local maximal skin dose. For interventions the ranges are, accordingly 3,0 - 43,6 min , 25 - 450 Gy cm 2 , 270 - 6600 mGy, 80 - 2600 mGy and 80 - 1500 mGy. As a result of the study the correlations between dose indicators and local MSD are analyzed. The concentration of dose on irradiated films are going to be investigated in some detail as well. (author)

[Robot assisted Frykman-Goldberg procedure. Case report].

Science.gov (United States)

Zubieta-O'Farrill, Gregorio; Ramírez-Ramírez, Moisés; Villanueva-Sáenz, Eduardo

2017-12-01

Rectal prolapse is defined as the protrusion of the rectal wall through the anal canal; with a prevalence of less than 0.5%. The most frequent symptoms include pain, incomplete defecation sensation with blood and mucus, fecal incontinence and/or constipation. The surgical approach can be perineal or abdominal with the tendency for minimal invasion. Robot-assisted procedures are a novel option that offer technique advantages over open or laparoscopic approaches. 67 year-old female, who presented with rectal prolapse, posterior to an episode of constipation, that required manual reduction, associated with transanal hemorrhage during defecation and occasional fecal incontinence. A RMI defecography was performed that reported complete rectal and uterine prolapse, and cystocele. A robotic assisted Frykman-Goldberg procedure wass performed. There are more than 100 surgical procedures for rectal prolapse treatment. We report the first robot assisted procedure in Mexico. Robotic assisted surgery has the same safety rate as laparoscopic surgery, with the advantages of better instrument mobility, no human hand tremor, better vision, and access to complicated and narrow areas. Robotic surgery as the surgical treatment is a feasible, safe and effective option, there is no difference in recurrence and function compared with laparoscopy. It facilitates the technique, improves nerve preservation and bleeding. Further clinical, prospective and randomized studies to compare the different minimal invasive approaches, their functional and long term results for this pathology are needed. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

Licensing procedures in Brazil and in the Federal Republic of Germany

International Nuclear Information System (INIS)

Costa Lima, W.A. da.

1974-01-01

The procedures for the licensing of nuclear power plants in Brazil and in the Federal Republic of Germany are described. The juridical situation, the administrative praxis and comparative aspects are discussed. Suggestions are made for the improvement of licensing procedures in both countries. (I.C.R.) [pt

On generalized fixed sequence procedures for controlling the FWER.

Science.gov (United States)

Qiu, Zhiying; Guo, Wenge; Lynch, Gavin

2015-12-30

Testing a sequence of pre-ordered hypotheses to decide which of these can be rejected or accepted while controlling the familywise error rate (FWER) is of importance in many scientific studies such as clinical trials. In this paper, we first introduce a generalized fixed sequence procedure whose critical values are defined by using a function of the numbers of rejections and acceptances, and which allows follow-up hypotheses to be tested even if some earlier hypotheses are not rejected. We then construct the least favorable configuration for this generalized fixed sequence procedure and present a sufficient condition for the FWER control under arbitrary dependence. Based on the condition, we develop three new generalized fixed sequence procedures controlling the FWER under arbitrary dependence. We also prove that each generalized fixed sequence procedure can be described as a specific closed testing procedure. Through simulation studies and a clinical trial example, we compare the power performance of these proposed procedures with those of the existing FWER controlling procedures. Finally, when the pairwise joint distributions of the true null p-values are known, we further improve these procedures by incorporating pairwise correlation information while maintaining the control of the FWER. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Abdominoplasty: Risk Factors, Complication Rates, and Safety of Combined Procedures.

Science.gov (United States)

Winocour, Julian; Gupta, Varun; Ramirez, J Roberto; Shack, R Bruce; Grotting, James C; Higdon, K Kye

2015-11-01

Among aesthetic surgery procedures, abdominoplasty is associated with a higher complication rate, but previous studies are limited by small sample sizes or single-institution experience. A cohort of patients who underwent abdominoplasty between 2008 and 2013 was identified from the CosmetAssure database. Major complications were recorded. Univariate and multivariate analysis was performed evaluating risk factors, including age, smoking, body mass index, sex, diabetes, type of surgical facility, and combined procedures. The authors identified 25,478 abdominoplasties from 183,914 procedures in the database. Of these, 8,975 patients had abdominoplasty alone and 16,503 underwent additional procedures. The number of complications recorded was 1,012 (4.0 percent overall rate versus 1.4 percent in other aesthetic surgery procedures). Of these, 31.5 percent were hematomas, 27.2 percent were infections and 20.2 percent were suspected or confirmed venous thromboembolism. On multivariate analysis, significant risk factors (p procedures (1.5), and procedure performance in a hospital or surgical center versus office-based surgical suite (1.6). Combined procedures increased the risk of complication (abdominoplasty alone, 3.1 percent; with liposuction, 3.8 percent; breast procedure, 4.3 percent; liposuction and breast procedure, 4.6 percent; body-contouring procedure, 6.8 percent; liposuction and body-contouring procedure, 10.4 percent). Abdominoplasty is associated with a higher complication rate compared with other aesthetic procedures. Combined procedures can significantly increase complication rates and should be considered carefully in higher risk patients. Risk, II.

Chemometrics Optimized Extraction Procedures, Phytosynergistic Blending and in vitro Screening of Natural Enzyme Inhibitors Amongst Leaves of Tulsi, Banyan and Jamun.

Science.gov (United States)

De, Baishakhi; Bhandari, Koushik; Singla, Rajeev K; Katakam, Prakash; Samanta, Tanmoy; Kushwaha, Dilip Kumar; Gundamaraju, Rohit; Mitra, Analava

2015-10-01

Tulsi, Banyan, and Jamun are popular Indian medicinal plants with notable hypoglycemic potentials. Now the work reports chemo-profiling of the three species with in-vitro screening approach for natural enzyme inhibitors (NEIs) against enzymes pathogenic for type 2 diabetes. Further along with the chemometrics optimized extraction process technology, phyto-synergistic studies of the composite polyherbal blends have also been reported. Chemometrically optimized extraction procedures, ratios of polyherbal composites to achieve phyto-synergistic actions, and in-vitro screening of NEIs amongst leaves of Tulsi, Banyan, and Jamun. The extraction process parameters of the leaves of three plant species (Ficus benghalensis, Syzigium cumini and Ocimum sanctum) were optimized by rotatable central composite design of chemometrics so as to get maximal yield of bio-actives. Phyto-blends of three species were prepared so as to achieve synergistic antidiabetic and antioxidant potentials and the ratios were optimized by chemometrics. Next, for in vitro screening of natural enzyme inhibitors the individual leaf extracts as well as composite blends were subjected to assay procedures to see their inhibitory potentials against the enzymes pathogenic in type 2 diabetes. The antioxidant potentials were also estimated by DPPH radical scavenging, ABTS, FRAP and Dot Blot assay. Considering response surface methodology studies and from the solutions obtained using desirability function, it was found that hydro-ethanolic or methanolic solvent ratio of 52.46 ± 1.6 and at a temperature of 20.17 ± 0.6 gave an optimum yield of polyphenols with minimal chlorophyll leaching. The species also showed the presence of glycosides, alkaloids, and saponins. Composites in the ratios of 1:1:1 and 1:1:2 gave synergistic effects in terms of polyphenol yield and anti-oxidant potentials. All composites (1:1:1, 1:2:1, 2:1:1, 1:1:2) showed synergistic anti-oxidant actions. Inhibitory activities against the

Ultrastructural Changes and Corneal Wound Healing After SMILE and PRK Procedures.

Science.gov (United States)

Wei, Shengsheng; Wang, Yan; Wu, Di; Zu, PeiPei; Zhang, Hui; Su, Xiaolian

2016-10-01

To compare keratocyte activation, cellular morphologic changes and wound healing after SMILE and PRK procedures using transmission electron microscope (TEM). In this study, 22 New Zealand white rabbits (10- to 15-week old) were used. The right eyes of all animals underwent SMILE procedure and the left eyes underwent PRK procedure. Cornea samples taken 1 day and 1 week postoperatively were examined using TEM. Using TEM 1 day after SMILE procedure, the organization of collagen fibers seemed to have been preserved without thermal alterations. Keratocyte activation was observed in the anterior stroma. Disrupted collagen arrangement and debris of cells are visible in the area of damage, and some phagocytic cells and a large number of secondary lysosomes are visible in those cells. At the perimeter zone of the interface, many coenocytes and collagen fragments could be found within the phagocytic cell. One week after SMILE procedure, potential lacuna could be discerned. A large part of the interface of the lenticule extracted had an appearance of clearly being adhered to some mucus secretions. One day after PRK procedure, an irregular epithelial surface was visible using TEM. Keratocytes had been activated and the rough endoplasmic reticulum in those cells had expanded. One week after PRK procedure, the epithelial surface still was irregular and keratinization of the epithelium was still visible in some areas. Corneal endothelium cells were mildly damaged and some vacuoles within the cytoplasm could be discerned. In the anterior stroma, some unhealthy activated keratocytes could still be observed. New collagen fibrils were found present near the activated keratocytes. Using TEM, keratocyte activation could still be observed after SMILE compared to after PRK procedure. Fewer cellular ultrastructural changes were seen after SMILE procedure. Unlike in PRK procedure, no damaged epithelium and endothelium were found after SMILE.

Computerized procedures system

Science.gov (United States)

Lipner, Melvin H.; Mundy, Roger A.; Franusich, Michael D.

2010-10-12

An online data driven computerized procedures system that guides an operator through a complex process facility's operating procedures. The system monitors plant data, processes the data and then, based upon this processing, presents the status of the current procedure step and/or substep to the operator. The system supports multiple users and a single procedure definition supports several interface formats that can be tailored to the individual user. Layered security controls access privileges and revisions are version controlled. The procedures run on a server that is platform independent of the user workstations that the server interfaces with and the user interface supports diverse procedural views.

Quantitative determination of 14C(-)-epicatechin and 14C-rutin on the Uncaria plant by a two-step heterogeneous thin-layer chromatographic-liquid scintillation counting procedure

International Nuclear Information System (INIS)

Das, N.P.; Law, K.H.

1987-01-01

A simple, rapid, precise and relatively inexpensive thin-layer chromatographic method coupled to heterogeneous liquid scintillation counting procedure was used for the quantitation of radioactivity of biologically synthesized ( 14 C) flavonoids and other phenolic plant constituents. The two flavonoids, namely ( 14 C) rutin and ( 14 C) (-) -epicatechin, extracted from the plant Uncaria elliptica Roxb were separated on plastic thin-layer plates coated with silica gel using the two solvent systems : acetonitrile-acetic acid-water (8.5:0.5:1.5) and ethyl acetate-acetic acid-water (3:1:3). The respective spots on the plates that corresponded to the two flavonoids were cut out and eluted with 3 ml aliquots of methanol followed by direct addition of scintillation flour. This method gave 99 +- 2 per cent of the total count indicating the excellent elution procedure. The results were reproducible and showed linearity over the range of 0 - 35000 dpm. The elution efficiency by several other organic solvents were also investigated. (author). 19 refs., 4 tables

Additional radiation dose to population due to X-ray diagnostic procedures

International Nuclear Information System (INIS)

Chougule, A.

2006-01-01

Full text of publication follows: Discovery of X rays has revolutionised the medical diagnosis but the fact that the diagnostic radiological procedures contribute about 80 to 90 % of the radiation dose to population as compared to other man made radiation sources cannot be ignored especially when X ray diagnostic facilities are being made available to larger section of the society. The estimated frequency of radiological procedures in India is 12,000 procedures/ year/100,000 population, though it is quite less as compared to developed countries, its increasing day by day. As part of the project, a radiation protection survey of X ray installations and patient radiation dose measurement during various radiological procedures was undertaken. 193 X ray installations were surveyed and the radiation doses received by the patient during various radiological procedure was measured. For measurement of radiation doses, CaSO 4 : Dy thermoluminescence (T.L.) discs of size 13.3 mm diameter and 0.8 mm thickness were used. Pre annealed T.L. discs were fixed by adhesive tape on the patient skin at the center of entrance beam before the exposure. After exposure the T.L. discs were estimated f or entrance skin dose during that particular projection/ examination. 10,000 measurements at different centers during various radiological procedures were done. It was found that chest radiography accounts for 37 % of all radiological procedures and further it was observed that 70 % of the chest X rays were normal with out any pathology indicating scope for curtailing the unwarranted radiological procedures. The special investigations like barium swallow, barium meal and fallow through accounts for about 1.5 % of the total radiological procedures. The entrance skin dose [E.S.D.] during chest radiography was 0.3 + 0.1 mGy where as during K.U.B. and cervical spine radiography it was 6.2 + 1.1 mGy and 5.1 + 0.9 mGy respectively. The details of frequency of various radiological procedures and the

Reducing neonatal pain during routine heel lance procedures.

Science.gov (United States)

Morrow, Carla; Hidinger, Andrea; Wilkinson-Faulk, Debbie

2010-01-01

To measure the difference in pain scores for newborns who were held and swaddled while undergoing routine heel lance procedures compared to newborns who were lying on their backs and not swaddled during heel lance. Additionally, we sought to compare the total amount of time it took to collect the specimens in each group. A total of 42 neonates recruited from a large tertiary hospital were enrolled in a randomized controlled trial. Infants in the experimental group (n = 22) were swaddled and held in an upright position during routine heel lance procedures while neonates in the control group (n = 20) remained in a standard care position. Pain was measured with the Neonatal Inventory Pain Scale (NIPS) at two points in time for each group (just before the heel lance procedure and at the completion of the heel lance). Total collection time was measured using a stopwatch accurate to 1/100th of a second. Specimen quality was measured based on the number of rejected specimens for each group. Descriptive statistics and t tests were used to analyze the data. The mean NIPS score for neonates who were swaddled and held during the procedure (experimental group) was significantly lower (M = 1.3, SD = .9) than the score for infants in the standard position (control group) (M = 2.7, SD = 1.3), t (40) = -4.48, p lance procedures offers nurses a nonpharmacologic method of neonatal pain reduction for heel sticks. This technique can be easily implemented on any unit independent of facility protocols. Furthermore, the technique is not associated with any cost or policy development, making it more likely that nurses can use it in practice.

Five-year follow-up of a prospective non-randomised study comparing duodenum-preserving pancreatic head resection with classic Whipple procedure in the treatment of chronic pancreatitis.

Science.gov (United States)

Möbius, C; Max, D; Uhlmann, D; Gumpp, K; Behrbohm, J; Horvath, K; Hauss, J; Witzigmann, H

2007-05-01

Three prospective randomised studies were conducted to compare pancreatoduodenectomy (PD) with duodenum-preserving pancreatic head resection (DPPHR) in patients suffering from chronic pancreatitis (cP). In these three series, the superiority of the duodenum-preserving technique with regard to quality of life (QOL) and pain relief has been demonstrated. Long-term follow-up investigations have not been published so far. The present paper reports on a 5-year follow-up study of a prospective, non-randomised trial comparing classic Whipple procedure (PD) with Beger DPPHR. Seventy patients were initially enrolled in this study. Fifty-one patients were left for the present long-term outcome analysis (PD, n = 24; DPPHR, n = 27). The follow-up included the following parameters: QOL, pain intensity, endocrine and exocrine function, and body mass index (BMI). The median follow-up was 63.5 (range 56-67) months. Two patients in the DPPHR group and none in the PD group underwent a re-operation. The QOL scores of the relevant symptom scales (nausea, pain, diarrhoea) and functional parameters (physical status, working ability, global QOL) were significantly better in the DPPHR group than in the PD group. Pain intensity as self-assessed by the patients was less pronounced in the DPPHR group (P Whipple procedure in terms of QOL and pain intensity as self-assessed by the patients.

Inside-out: comparing internally generated and externally generated basic emotions.

Science.gov (United States)

Salas, Christian E; Radovic, Darinka; Turnbull, Oliver H

2012-06-01

A considerable number of mood induction (MI) procedures have been developed to elicit emotion in normal and clinical populations. Although external procedures (e.g., film clips, pictures) are widely used, a number of experiments elicit emotion by using self-generated procedures (e.g., recalling an emotional personal episode). However, no study has directly compared the effectiveness of two types of internal versus external MI across multiple discrete emotions. In the present experiment, 40 undergraduate students watched film clips (external procedure) and recalled personal events (internal procedure) inducing 4 basic emotions (fear, anger, joy, sadness) and later completed a self-report questionnaire. Remarkably, both internal and external procedures elicited target emotions selectively, compared with nontarget emotions. When contrasting the intensity of target emotions, both techniques showed no significant differences, with the exception of Joy, which was more intensely elicited by the internal procedure. Importantly, when considering the overall level of intensity, it was always greater in the internal procedure, for each stimulus. A more detailed investigation of the data suggest that recalling personal events (a type of internal procedure) generates more negative and mixed blends of emotions, which might account for the overall higher intensity of the internal mood induction.

Comparative evaluation of two radioenzymatic procedures designed to determine noradrenaline in the plasma (COMT assay and PNMT assay)

International Nuclear Information System (INIS)

Barth, A.

1984-01-01

A comparative evaluation of two radioenzymatic procedures to determine the concentration of noradrenaline in the plasma - with linearity, sensitivity, specifity and accuracy serving as test criteria - led to the following results: In view of a probability of error in the order of 2% both methods were judged to show a satisfactory sensitivity. The specific of the COMT assay, by contrast with that of the PNMT assay, was found to be wanting, as the noradrenaline measurements in the presence of other biogenic amines were biassed in such a way that the values determined were higher than the actual concentrations. During antihypertensive treatment even minimal changes in the noradrenaline concentration can be ascertained on a quantitative basis. If suitable hardware is available, the COMT assay permits up to 25 single determinations to be carried out per day, while the number of double determinations is restricted to 7 per day. One advantage, however, lies in the fact that several catecholamines in the plasma can be detected simultaneously, if required. In cases where the noradrenaline concentration alone is to be determined for clinical purposes, preference should be given to the PNMT assay, as both tests showed equal linearity and sensitivity. (TRV) [de

Comparing de novo assemblers for 454 transcriptome data.

Science.gov (United States)

Kumar, Sujai; Blaxter, Mark L

2010-10-16

Roche 454 pyrosequencing has become a method of choice for generating transcriptome data from non-model organisms. Once the tens to hundreds of thousands of short (250-450 base) reads have been produced, it is important to correctly assemble these to estimate the sequence of all the transcripts. Most transcriptome assembly projects use only one program for assembling 454 pyrosequencing reads, but there is no evidence that the programs used to date are optimal. We have carried out a systematic comparison of five assemblers (CAP3, MIRA, Newbler, SeqMan and CLC) to establish best practices for transcriptome assemblies, using a new dataset from the parasitic nematode Litomosoides sigmodontis. Although no single assembler performed best on all our criteria, Newbler 2.5 gave longer contigs, better alignments to some reference sequences, and was fast and easy to use. SeqMan assemblies performed best on the criterion of recapitulating known transcripts, and had more novel sequence than the other assemblers, but generated an excess of small, redundant contigs. The remaining assemblers all performed almost as well, with the exception of Newbler 2.3 (the version currently used by most assembly projects), which generated assemblies that had significantly lower total length. As different assemblers use different underlying algorithms to generate contigs, we also explored merging of assemblies and found that the merged datasets not only aligned better to reference sequences than individual assemblies, but were also more consistent in the number and size of contigs. Transcriptome assemblies are smaller than genome assemblies and thus should be more computationally tractable, but are often harder because individual contigs can have highly variable read coverage. Comparing single assemblers, Newbler 2.5 performed best on our trial data set, but other assemblers were closely comparable. Combining differently optimal assemblies from different programs however gave a more credible

Evaluation of safeguards procedures: a summary of a methodology

International Nuclear Information System (INIS)

Salisbury, J.D.; Savage, J.W.

1979-01-01

A methodology for the evaluation of safeguards procedures is described. As presently conceptualized, the methodology will consist of the following steps: (1) expansion of the general protection requirements that are contained in the NRC regulations into more detailed but still generic requirements for use at the working level; (2) development of techniques and formats for using the working-level requirements in an evaluation; (3) development of a technique for converting specific facility protection procedures into a format that will allow comparison with the working-level requirements; (4) development of an evaluation technique for comparing the facility protection procedures to determine if they meet the protection requirements

Calculation of piping loads due to filling procedures

International Nuclear Information System (INIS)

Swidersky, Harald; Thiele, Thomas

2012-01-01

Filling procedures in piping systems are usually not load cases that are studied by fluid dynamic and structure dynamic analyses with respect to the integrity of pipes and supports. Although, their frequency is higher than that of postulated accidental transients, therefore they have to be considered for fatigue analyses. The piping and support loads due to filling procedures are caused by the density differences if the transported fluids, for instance in flows with the transport of gas bubbles. The impact duration of the momentum forces is defined by the flow velocity and the length of discontinuities in the piping segments. Filling procedures end very often with a shock pressure, caused by the impact and decelerating of the fluid front at smaller cross sections. The suitability of the thermally hydraulics program RELAP/MOD3.3 for the calculation of realistic loads from filling procedures was studied, the results compared with experimental data. It is shown that dependent on the discretization level the loads are partial significantly underestimated.

Comparison of hand hygiene procedures for removing Bacillus cereus spores.

Science.gov (United States)

Sasahara, Teppei; Hayashi, Shunji; Hosoda, Kouichi; Morisawa, Yuji; Hirai, Yoshikazu

2014-01-01

Bacillus cereus is a spore-forming bacterium. B. cereus occasionally causes nosocomial infections, in which hand contamination with the spores plays an important role. Therefore, hand hygiene is the most important practice for controlling nosocomial B. cereus infections. This study aimed to determine the appropriate hand hygiene procedure for removing B. cereus spores. Thirty volunteers' hands were experimentally contaminated with B. cereus spores, after which they performed 6 different hand hygiene procedures. We compared the efficacy of the procedures in removing the spores from hands. The alcohol-based hand-rubbing procedures scarcely removed them. The soap washing procedures reduced the number of spores by more than 2 log10. Extending the washing time increased the spore-removing efficacy of the washing procedures. There was no significant difference in efficacy between the use of plain soap and antiseptic soap. Handwashing with soap is appropriate for removing B. cereus spores from hands. Alcohol-based hand-rubbing is not effective.

A Randomized Controlled Trial to Compare e-Feedback Versus "Standard" Face-to-Face Verbal Feedback to Improve the Acquisition of Procedural Skill.

Science.gov (United States)

Al-Jundi, Wissam; Elsharif, Mohamed; Anderson, Melanie; Chan, Phillip; Beard, Jonathan; Nawaz, Shah

Constructive feedback plays an important role in learning during surgical training. Standard feedback is usually given verbally following direct observation of the procedure by a trained assessor. However, such feedback requires the physical presence of expert faculty members who are usually busy and time-constrained by clinical commitments. We aim to evaluate electronic feedback (e-feedback) after video observation of surgical suturing in comparison with standard face-to-face verbal feedback. A prospective, blinded, randomized controlled trial comparing e-feedback with standard verbal feedback was carried out in February 2015 using a validated pro formas for assessment. The study participants were 38 undergraduate medical students from the University of Sheffield, UK. They were recorded on video performing the procedural skill, completed a self-evaluation form, and received e-feedback on the same day (group 1); observed directly by an assessor, invited to provide verbal self-reflection, and then received standard verbal feedback (group 2). In both groups, the feedback was provided after performing the procedure. The participants returned 2 days later and performed the same skill again. Poststudy questionnaire was used to assess the acceptability of each feedback among the participants. Overall, 19 students in group 1 and 18 students in group 2 completed the study. Although there was a significant improvement in the overall mean score on the second performance of the task for all participants (first performance mean 11.59, second performance mean 15.95; p ≤ 0.0001), there was no difference in the overall mean improvement score between group 1 and group 2 (4.74 and 3.94, respectively; p = 0.49). The mean overall scores for the e-feedback group at baseline recorded by 2 independent investigators showed good agreement (mean overall scores of 12.84 and 11.89; Cronbach α = 0.86). Poststudy questionnaire demonstrated that both e-feedback and standard verbal feedback

Randomized Comparative Study of the U- and H-Type Approaches of the TVT-Secur Procedure for the Treatment of Female Stress Urinary Incontinence: One-Year Follow-Up

Science.gov (United States)

Kim, Jung Jun; Lee, Young-Suk

2010-01-01

Purpose We compared outcomes of the U- and H-type approaches of the tension-free vaginal tape (TVT)-Secur procedure for the treatment of female stress urinary incontinence (SUI). Materials and Methods From March 2007 to July 2008, 115 women with SUI underwent TVT-Secur by a single surgeon. Patients were randomly assigned to either the U- or the H-type approach. After 12 months, postoperative changes in the Sandvik questionnaire, incontinence quality of life questionnaire (I-QoL), Bristol female lower urinary tract symptoms-scored form (BFLUTS-SF), and postoperative patient satisfaction were evaluated. Cure was regarded as no leakage on the Sandvik questionnaire. Complications were also evaluated. Results Of 115 women, 53 were treated with the U approach, and 62 women were treated with the H approach. At 12 months, 88.7% of those treated with the U approach and 87.1% of those treated with the H approach were cured (p=0.796). The I-QoL and filling, incontinence, sexual function, and QoL sum (BFLUTS-SF) scores were improved with both approaches, and there were no significant differences in the degree of improvement between approaches. Approximately 83.7% and 82.9% of the women treated with the U and H approaches, respectively, were satisfied with the outcome (p=0.858). There were 3 cases of intra-operative vaginal wall perforation in the H-type group. Immediate postoperative retention was observed in 2 women in the U-type group and 1 woman in the H-type group. One woman in the U-type group underwent tape releasing and cutting procedures for persistent large post-void residuals. Conclusions The U- and the H-type approaches of the TVT-Secur procedure provided comparable effectiveness for the treatment of female SUI. PMID:20428427

Comparing Treatment and Control Groups on Multiple Outcomes: Robust Procedures for Testing a Directional Alternative Hypothesis

Science.gov (United States)

Lix, Lisa M.; Deering, Kathleen N.; Fouladi, Rachel T.; Manivong, Phongsack

2009-01-01

This study considers the problem of testing the difference between treatment and control groups on m [greater than or equal to] 2 measures when it is assumed a priori that the treatment group will perform better than the control group on all measures. Two procedures are investigated that do not rest on the assumptions of covariance homogeneity or…

The computerised procedure system COPMA and its user interface

International Nuclear Information System (INIS)

Krogsaeter, M.; Larsen, J.; Nilsen, S.; Oewre, F.

1990-01-01

At the OECD Halden Reactor Project, the COPMA system has been developed in order to investigate whether procedures can be executed more safety and efficiently if they are computerised, i.e. if the operator uses a CRT-based system instead of written manuals. Procedures are entered in a procedure data base using PED, a procedure editor. Each procedure is given a textual as well as a graphical representation. For the textual representation, the language PROLA is used, a language which has been designed for simple procedure specification. The COPMA online system lets the operator execute procedures that are stored in the procedure data base. The operator interface is a screen divided into non-overlapping windows each serving a different purpose. All commands to the system are given by moving a mouse device around and clicking buttons on top of the mouse. A procedure consists of steps, each step containing a number of instructions. The operator works on one activity at a time, an activity to be seen as a procedure instance. A graph shows the overall procedure (or activity) structure in a window and activity execution is traced in the graph. Another windows shows the instructions of the step currently being executed. The operator steps through the activity by selecting whether and how to execute the listed instructions. COPMA can maintain the status of several activities in parallel, so that the operator can easily switch between different activities. COPMA is linked to a PWR nuclear simulator over Ethernet using the TCP/IP protocol. This gives a number of advantages as compared to conventional written procedures, especially the fact that COPMA can help collect data from the procedure data base automatically

Computer assisted procedure maintenance

International Nuclear Information System (INIS)

Bisio, R.; Hulsund, J. E.; Nilsen, S.

2004-04-01

The maintenance of operating procedures in a NPP is a tedious and complicated task. Through the whole life cycle of the procedures they will be dynamic, 'living' documents. Several aspects of the procedure must be considered in a revision process. Pertinent details and attributes of the procedure must be checked. An organizational structure must be created and responsibilities allotted for drafting, revising, reviewing and publishing procedures. Available powerful computer technology provides solutions within document management and computerisation of procedures. These solutions can also support the maintenance of procedures. Not all parts of the procedure life cycle are equally amenable to computerized support. This report looks at the procedure life cycle in todays NPPs and discusses the possibilities associated with introduction of computer technology to assist the maintenance of procedures. (Author)

[A comparative study between two procedures of TVT retropubic mid-urethral sling placement for treatment of female stress urinary incontinence].

Science.gov (United States)

Sergent, F; Gay-Crosier, G; Resch, B; Pons, J-C; Marpeau, L

2014-03-01

To evaluate complications and functional outcomes at 1 year and more of a modified Tension-free Vaginal Tape (TVT) technique from that of classic TVT. Retrospective study comparing the two techniques. For the modified TVT technique, a peri-urethrovesical hydrodissection was performed. An 18-gauge hollow needle, in which a thread was introduced, was used as an ancillary for the placement of the sling. The sling was secured to the thread and then positioned with it. Bladder filling objectified perforations. An absorbable suture around the sling allowed its descent if necessary. One hundred and eighteen procedures were performed (54 classic TVT and 64 modified TVT). For the standard TVT and the modified TVT, the vesico-urethral perforation rates were respectively 7.4% and 1.5% (PTVT versus 88.2% and 90% for the modified TVT (NS). The dissatisfaction rate was lower for the modified TVT (PTVT, it is possible to reduce its complications while maintaining its efficacy. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Equating Multidimensional Tests under a Random Groups Design: A Comparison of Various Equating Procedures

Science.gov (United States)

Lee, Eunjung

2013-01-01

The purpose of this research was to compare the equating performance of various equating procedures for the multidimensional tests. To examine the various equating procedures, simulated data sets were used that were generated based on a multidimensional item response theory (MIRT) framework. Various equating procedures were examined, including…

Comparison of pancuronium and vecuronium for fetal neuromuscular blockade during invasive procedures.

Science.gov (United States)

Watson, W J; Atchison, S R; Harlass, F E

1996-01-01

Neuromuscular blocking agents, used to arrest fetal motion for invasive intrauterine procedures, may cause temporary fetal heart rate changes. After 21 invasive procedures using either pancuronium bromide or vecuronium bromide, post-procedure fetal heart rate tracings were retrospectively compared. Pancuronium was associated with an increased fetal heart rate and decreased beat-to-beat variability for 2.5 hours after its use, whereas vecuronium caused no fetal heart rate changes. Vecuronium bromide offers advantages over pancuronium, because the decreased effect on the fetal heart allows better assessment of fetal well-being immediately following invasive intrauterine procedures.

Human factoring administrative procedures

International Nuclear Information System (INIS)

Grider, D.A.; Sturdivant, M.H.

1991-01-01

In nonnuclear business, administrative procedures bring to mind such mundane topics as filing correspondence and scheduling vacation time. In the nuclear industry, on the other hand, administrative procedures play a vital role in assuring the safe operation of a facility. For some time now, industry focus has been on improving technical procedures. Significant efforts are under way to produce technical procedure requires that a validated technical, regulatory, and administrative basis be developed and that the technical process be established for each procedure. Producing usable technical procedures requires that procedure presentation be engineered to the same human factors principles used in control room design. The vital safety role of administrative procedures requires that they be just as sound, just a rigorously formulated, and documented as technical procedures. Procedure programs at the Tennessee Valley Authority and at Boston Edison's Pilgrim Station demonstrate that human factors engineering techniques can be applied effectively to technical procedures. With a few modifications, those same techniques can be used to produce more effective administrative procedures. Efforts are under way at the US Department of Energy Nuclear Weapons Complex and at some utilities (Boston Edison, for instance) to apply human factors engineering to administrative procedures: The techniques being adapted include the following

Comparison of Three English-to-Dutch Machine Translations of SNOMED CT Procedures

NARCIS (Netherlands)

Cornet, Ronald; Hill, Carly; de Keizer, Nicolette

2017-01-01

Dutch interface terminologies are needed to use SNOMED CT in the Netherlands. Machine translation may support in their creation. The aim of our study is to compare different machine translations of procedures in SNOMED CT. Procedures were translated using Google Translate, Matecat, and Thot. Google

The medical practice of euthanasia in Belgium and The Netherlands: legal notification, control and evaluation procedures

NARCIS (Netherlands)

Smets, T.; Bilsen, J.J.; Cohen, J.; Rurup, M.L.; Keyser, E.; Deliens, L.H.J.

2009-01-01

OBJECTIVES: To describe and compare current legal procedures for notifying, controlling and evaluating (NCE-procedures) euthanasia in Belgium and the Netherlands, and to discuss the implications for a safe and controllable euthanasia practice. METHODS: We systematically studied and compared official

They gave their names to science

National Research Council Canada - National Science Library

Halacy, D. S

1967-01-01

...: Ernst Mach and his number, Gergor Mendel and his laws, Christian Johann Doppler and his effect, Hans Geiger and his radiation counter, Nicholas Sadi Carnot and thermodynamics, Gustave, Gaspard de...

Comparative-historical method in Slavic linguistics and Alexander Vostokov’s philological intuitions

Directory of Open Access Journals (Sweden)

Melkov Andrey Sergeevich

2015-04-01

Full Text Available The article is devoted to the estimation of Alexander Vostokov’s (1781-1864 contribution to the formation and development of the Slavic philology as a scientific discipline. In the foundation of the research there is the analyses of Vostokov’s work “Judgement about the Slavic language”, which has become the result of the scientist’s study the oldest Russian manuscript “Ostromir Gospels”. Vostokov devised a new method for the Slavic philology, which is used to call comparative-historical in modern science. The scientist gave the beginning of Old Church Slavonic and Old Russian written monuments scientific researching. Thanks to Vostokov’s discoveries, there has been formed the basis of Russian comparative-historical linguistics.

Patient doses from fluoroscopically guided cardiac procedures in pediatrics

Science.gov (United States)

Martinez, L. C.; Vano, E.; Gutierrez, F.; Rodriguez, C.; Gilarranz, R.; Manzanas, M. J.

2007-08-01

Infants and children are a higher risk population for radiation cancer induction compared to adults. Although some values on pediatric patient doses for cardiac procedures have been reported, data to determine reference levels are scarce, especially when compared to those available for adults in diagnostic and therapeutic procedures. The aim of this study is to make a new contribution to the scarce published data in pediatric cardiac procedures and help in the determination of future dose reference levels. This paper presents a set of patient dose values, in terms of air kerma area product (KAP) and entrance surface air kerma (ESAK), measured in a pediatric cardiac catheterization laboratory equipped with a biplane x-ray system with dynamic flat panel detectors. Cardiologists were properly trained in radiation protection. The study includes 137 patients aged between 10 days and 16 years who underwent diagnostic catheterizations or therapeutic procedures. Demographic data and technical details of the procedures were also gathered. The x-ray system was submitted to a quality control programme, including the calibration of the transmission ionization chamber. The age distribution of the patients was 47 for <1 year; 52 for 1-<5 years; 25 for 5-<10 years and 13 for 10-<16 years. Median values of KAP were 1.9, 2.9, 4.5 and 15.4 Gy cm2 respectively for the four age bands. These KAP values increase by a factor of 8 when moving through the four age bands. The probability of a fatal cancer per fluoroscopically guided cardiac procedure is about 0.07%. Median values of ESAK for the four age bands were 46, 50, 56 and 163 mGy, which lie far below the threshold for deterministic effects on the skin. These dose values are lower than those published in previous papers.

Spline-procedures

International Nuclear Information System (INIS)

Schmidt, R.

1976-12-01

This report contains a short introduction to spline functions as well as a complete description of the spline procedures presently available in the HMI-library. These include polynomial splines (using either B-splines or one-sided basis representations) and natural splines, as well as their application to interpolation, quasiinterpolation, L 2 -, and Tchebycheff approximation. Special procedures are included for the case of cubic splines. Complete test examples with input and output are provided for each of the procedures. (orig.) [de

Double- vs. single-balloon enteroscopy: single center experience with emphasis on procedural performance.

Science.gov (United States)

Lenz, Philipp; Roggel, Moritz; Domagk, Dirk

2013-09-01

This study aims to compare double- (DBE) and single-balloon enteroscopy (SBE) in small bowel disorders with respect to procedural performance and clinical impact. This retrospective analysis at a tertial referral center included 1,052 DBEs and 515 SBEs performed in 904 patients over 7 years. Procedural and patients' characteristics were precisely analyzed. Significantly more patients with anemia and gastrointestinal bleeding were investigated by DBE (P recent years of enteroscopy (2008-2011), no difference in small bowel visualization could be observed. The anal insertion depths and complete enteroscopy rates (CER) were comparable. Procedure times were significantly shorter within the SBE procedure (oral: 50 vs. 40 min; anal: 55 vs. 46 min, P Diagnostic yield was significantly higher in the SBE, compared to the DBE group (61.7 vs. 48.2 %; P diagnostic tools and proved to be indispensable in the daily gastroenterological practice. The lower insertion depths, but higher diagnostic yield, of SBE may reflect the more focused selection of patients scheduled for small bowel diagnostics in recent years.

[Multimodal distraction to relieve pain in children undergoing acute medical procedures].

Science.gov (United States)

Miller, Kate; Rodger, Sylvia; Bucolo, Sam; Wang, Xue-Qing; Kimble, Roy M

2009-10-01

Non-pharmacological approaches to pain management have been used by therapists for decades to reduce the anxiety and pain experienced by children during burn care procedures. With a greater understanding of pain and the principles behind what causes a child to be distracted, combined with access to state of the art technology, we have developed an easy to use, hand held multimodal distraction device (MMD). MMD is an interactive device that prepares the child for a procedure and uses developmentally appropriate distraction stories and games during the procedures to alleviate anxiety and pain. This paper summarizes the results of three randomized control trials. The trials aimed to understand the effectiveness of MMD as a distraction and preparation tool in reducing anxiety and pain in children undergoing burns and non-burns medical procedures compared to pure pharmacological approaches Standard Distraction (SD) and off the shelf video games (VG). Three separate prospective randomized control trials involving 182 children having 354 dressing changes were conducted in the burns and orthopedic departments at Royal Children's Hospital, Brisbane, Australia, to address the above aims. Pain and anxiety scores were completed for the child, caregiver and nursing staff according to the Modified Faces, Legs, Activity, Cry and Consolability Scale, Faces Pain Scale-Revised, Visual Analogue Scale and Wong-Baker Faces Pain Rating Scale. Procedural length was recorded. MMD as a preparation and distraction tool were shown to have a significant impact on child, parent and nursing staff reported anxiety and pain during procedures compared to standard care and video games (P positive effect on clinical time and was shown to sustain its impact on pain and time with further dressing changes. MMD is more effective in reducing the pain and anxiety experienced by children in acute medical procedures as compared with SD and VG. MMD is continuing to be trialed and is continuing to show

The characteristics of the Westinghouse accident procedures and the main differences with SOP

International Nuclear Information System (INIS)

Hu Yan; Gan Peijiang; Sun Chen

2014-01-01

In this note, the Westinghouse operation file system is summarized. The structures of procedures, design methods, implementation logics of the Westinghouse accident procedures are discussed. And compared with the SOP principles, the main differences are clarified. (authors)

A Comparative Evaluation of Procedural Level Generators in the Mario AI Framework

DEFF Research Database (Denmark)

Horn, Britton; Dahlskog, Steve; Shaker, Noor

dierent from another in terms of its output. To remedy this, we have conducted a large-scale comparative evaluation of level generators for the Mario AI Benchmark, a research-friendly clone of the classic platform game Super Mario Bros. In all, we compare the output of seven dierent level generators from...

Time Savings and Surgery Task Load Reduction in Open Intraperitoneal Onlay Mesh Fixation Procedure

Science.gov (United States)

Roy, Sanjoy; Hammond, Jeffrey; Panish, Jessica; Shnoda, Pullen; Savidge, Sandy; Wilson, Mark

2015-01-01

Background. This study assessed the reduction in surgeon stress associated with savings in procedure time for mechanical fixation of an intraperitoneal onlay mesh (IPOM) compared to a traditional suture fixation in open ventral hernia repair. Study Design. Nine general surgeons performed 36 open IPOM fixation procedures in porcine model. Each surgeon conducted two mechanical (using ETHICON SECURESTRAPTM Open) and two suture fixation procedures. Fixation time was measured using a stopwatch, and related surgeon stress was assessed using the validated SURG-TLX questionnaire. T-tests were used to compare between-group differences, and a two-sided 95% confidence interval for the difference in stress levels was established using nonparametric methodology. Results. The mechanical fixation group demonstrated an 89.1% mean reduction in fixation time, as compared to the suture group (p Open demonstrated a significant reduction in fixation time and surgeon stress, which may translate into improved operating efficiency, improved performance, improved surgeon quality of life, and reduced overall costs of the procedure. PMID:26240834

Changes in surgical procedures for acromioclavicular joint dislocation over the past 30 years.

Science.gov (United States)

Takase, Katsumi; Yamamoto, Kengo

2013-10-01

Generally, surgical treatment is recommended for Rockwood type 5 traumatic acromioclavicular joint dislocations. Since 1980, the authors have performed the modified Dewar procedure, the modified Cadenat procedure, and anatomical reconstruction of the coracoclavicular ligaments for this injury. The goal of this study was to determine the ideal surgical procedure for acromioclavicular joint dislocations by comparing these 3 procedures. The modified Dewar procedure was performed on 55 patients (Dewar group), the modified Cadenat procedure was performed on 73 patients (Cadenat group), and anatomical reconstruction of the coracoclavicular ligaments was performed on 11 patients (reconstruction group). According to the UCLA scoring system, therapeutic results averaged 27.3 points in the Dewar group, 28.2 in the Cadenat group, and 28.4 in the reconstruction group. The incidence of residual subluxation or dislocation in the acromioclavicular joint was evaluated at final radiographic follow-up. Subluxation occurred in 21 patients in the Dewar group, 18 in the Cadenat group, and 3 in the reconstruction group. Dislocation occurred in 3 patients in the Dewar group. Osteoarthritic changes in the acromioclavicular joint occurred in 20 patients in the Dewar group, 9 in the Cadenat group, and 1 in the reconstruction group. The modified Cadenat procedure can provide satisfactory therapeutic results and avoid postoperative failure or loss of reduction compared with the modified Dewar procedure. However, the modified Cadenat procedure does not anatomically restore the coracoclavicular ligaments. Anatomic restoration of both coracoclavicular ligaments can best restore acromioclavicular joint function. Copyright 2013, SLACK Incorporated.

Nordic Cancer Registries - an overview of their procedures and data comparability.

Science.gov (United States)

Pukkala, Eero; Engholm, Gerda; Højsgaard Schmidt, Lise Kristine; Storm, Hans; Khan, Staffan; Lambe, Mats; Pettersson, David; Ólafsdóttir, Elínborg; Tryggvadóttir, Laufey; Hakanen, Tiina; Malila, Nea; Virtanen, Anni; Johannesen, Tom Børge; Larønningen, Siri; Ursin, Giske

2018-04-01

The Nordic Cancer Registries are among the oldest population-based registries in the world, with more than 60 years of complete coverage of what is now a combined population of 26 million. However, despite being the source of a substantial number of studies, there is no published paper comparing the different registries. Therefore, we did a systematic review to identify similarities and dissimilarities of the Nordic Cancer Registries, which could possibly explain some of the differences in cancer incidence rates across these countries. We describe and compare here the core characteristics of each of the Nordic Cancer Registries: (i) data sources; (ii) registered disease entities and deviations from IARC multiple cancer coding rules; (iii) variables and related coding systems. Major changes over time are described and discussed. All Nordic Cancer Registries represent a high quality standard in terms of completeness and accuracy of the registered data. Even though the information in the Nordic Cancer Registries in general can be considered more similar than any other collection of data from five different countries, there are numerous differences in registration routines, classification systems and inclusion of some tumors. These differences are important to be aware of when comparing time trends in the Nordic countries.

Procedural Media Representation

OpenAIRE

Henrysson, Anders

2002-01-01

We present a concept for using procedural techniques to represent media. Procedural methods allow us to represent digital media (2D images, 3D environments etc.) with very little information and to render it photo realistically. Since not all kind of content can be created procedurally, traditional media representations (bitmaps, polygons etc.) must be used as well. We have adopted an object-based media representation where an object can be represented either with a procedure or with its trad...

Endovascular abdominal aortic aneurysm repair (EVAR) procedures: counterbalancing the benefits with the costs.

Science.gov (United States)

Paraskevas, Kosmas I; Bessias, Nikolaos; Giannoukas, Athanasios D; Mikhailidis, Dimitri P

2010-05-01

Endovascular abdominal aortic aneurysm (AAA) repair (EVAR) is associated with lower 30-day mortality rates compared with open repair. Despite that, there are no significant differences in mortality rates between the two procedures at 2 years. On the other hand, EVAR is associated with considerably higher costs compared with open repair. The lack of significant long-term differences between the two procedures together with the substantially higher cost of EVAR may question the appropriateness of EVAR as an alternative to open surgical repair in patients fit for surgery. With several thousands of AAA procedures performed worldwide, the employment of EVAR for the management of all AAAs irrespective of the patient's surgical risk may hold implications for several national health economies. The lower perioperative mortality and morbidity rates associated with EVAR should thus be counterbalanced against the considerable costs of these procedures.

Thermal fatigue in mixing tees: A step by step simplified procedure

International Nuclear Information System (INIS)

Faidy, Claude

2003-01-01

Following the CIVAUX 1 incident of a leak on RHR system, EDF has developed a step by step procedure to screen and analyse similar locations: mixing tees with long duration at high ΔT between the 2 fluids. The paper present the procedure, the background of the methodology and few R and D work that support this procedure. The procedure is based on: screening criteria on maximum DT and minimum duration. screening criteria without any duration consideration, only DT and material. a simplified and conservative estimation of a usage factor. a detailed analysis of usage factor and crack growth rate, based on specific data collection of operating transients. Around that procedure EDF launched an R and D program on fatigue curves and fatigue reduction factors for high cycle fatigue. The procedure is compared with field experience and recent R and D fatigue tests. (author)

Minimally invasive surgical procedures for the treatment of lumbar disc herniation

Directory of Open Access Journals (Sweden)

Raspe, Heiner

2005-11-01

Full Text Available Introduction: In up to 30% of patients undergoing lumbar disc surgery for herniated or protruded discs outcomes are judged unfavourable. Over the last decades this problem has stimulated the development of a number of minimally-invasive operative procedures. The aim is to relieve pressure from compromised nerve roots by mechanically removing, dissolving or evaporating disc material while leaving bony structures and surrounding tissues as intact as possible. In Germany, there is hardly any utilisation data for these new procedures – data files from the statutory health insurances demonstrate that about 5% of all lumbar disc surgeries are performed using minimally-invasive techniques. Their real proportion is thought to be much higher because many procedures are offered by private hospitals and surgeries and are paid by private health insurers or patients themselves. So far no comprehensive assessment comparing efficacy, safety, effectiveness and cost-effectiveness of minimally-invasive lumbar disc surgery to standard procedures (microdiscectomy, open discectomy which could serve as a basis for coverage decisions, has been published in Germany. Objective: Against this background the aim of the following assessment is: * Based on published scientific literature assess safety, efficacy and effectiveness of minimally-invasive lumbar disc surgery compared to standard procedures. * To identify and critically appraise studies comparing costs and cost-effectiveness of minimally-invasive procedures to that of standard procedures. * If necessary identify research and evaluation needs and point out regulative needs within the German health care system. The assessment focusses on procedures that are used in elective lumbar disc surgery as alternative treatment options to microdiscectomy or open discectomy. Chemonucleolysis, percutaneous manual discectomy, automated percutaneous lumbar discectomy, laserdiscectomy and endoscopic procedures accessing the disc

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

International Nuclear Information System (INIS)

Rieger, B.

2015-01-01

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

Comparing solar energy alternatives

Energy Technology Data Exchange (ETDEWEB)

White, J R

1984-01-01

The paper outlines a computational procedure for comparing the merits of alternative processes to convert solar radiation to heat, electrical power, or chemical energy. The procedure uses the ratio of equipment investment to useful work as an index. Comparisons with conversion counterparts based on conventional fuels are also facilitated by examining this index. The procedure is illustrated by comparisons of (1) photovoltaic converters of differing efficiencies; (2) photovoltaic converters with and without focusing concentrators; (3) photovoltaic conversion plus electrolysis vs photocatalysis for the production of hydrogen; (4) photovoltaic conversion plus plasma arcs vs photocatalysis for nitrogen fixation. Estimates for conventionally-fuelled processes are included for comparison. The reasons why solar-based concepts fare poorly in such comparisons are traced to the low energy density of solar radiation and its low stream time factor resulting from the limited number of daylight hours available and clouds obscuring the sun.

Comparing solar energy alternatives

Energy Technology Data Exchange (ETDEWEB)

White, J R

1984-01-01

This paper outlines a computational procedure for comparing the merits of alternative processes to convert solar radiation to heat, electrical power, or chemical energy. The procedure uses the ratio of equipment investment to useful work as an index. Comparisons with conversion counterparts based on conventional fuels are also facilitated by examining this index. The procedure is illustrated by comparisons of (1) photovoltaic converters of differing efficiencies; (2) photovoltaic converters with and without focusing concentrators; (3) photovoltaic conversion plus electrolysis vs photocatalysis for the production of hydrogen; (4) photovoltaic conversion plus plasma arcs vs photocatalysis for nitrogen fixation. Estimates for conventionally-fuelled processes are included for comparison. The reasons why solar-based concepts fare poorly in such comparisons are traced to the low energy density of solar radiation and its low stream time factor resulting from the limited number of daylight hours available and clouds obscuring the sun. 11 references.

Comparing international and South African work-based assessment ...

African Journals Online (AJOL)

Comparing international and South African work-based assessment of medical interns' practice. ... in the finding that most studies in SA have dealt with the assessment of core procedural skills related to acute clinical care, while the assessment of non-clinical competencies and non-procedural skills was poorly addressed.

A comparison of vowel normalization procedures for language variation research

Science.gov (United States)

Adank, Patti; Smits, Roel; van Hout, Roeland

2004-11-01

An evaluation of vowel normalization procedures for the purpose of studying language variation is presented. The procedures were compared on how effectively they (a) preserve phonemic information, (b) preserve information about the talker's regional background (or sociolinguistic information), and (c) minimize anatomical/physiological variation in acoustic representations of vowels. Recordings were made for 80 female talkers and 80 male talkers of Dutch. These talkers were stratified according to their gender and regional background. The normalization procedures were applied to measurements of the fundamental frequency and the first three formant frequencies for a large set of vowel tokens. The normalization procedures were evaluated through statistical pattern analysis. The results show that normalization procedures that use information across multiple vowels (``vowel-extrinsic'' information) to normalize a single vowel token performed better than those that include only information contained in the vowel token itself (``vowel-intrinsic'' information). Furthermore, the results show that normalization procedures that operate on individual formants performed better than those that use information across multiple formants (e.g., ``formant-extrinsic'' F2-F1). .

Surgical specialty procedures in rural surgery practices: implications for rural surgery training.

Science.gov (United States)

Sticca, Robert P; Mullin, Brady C; Harris, Joel D; Hosford, Clint C

2012-12-01

Specialty procedures constitute one eighth of rural surgery practice. Currently, general surgeons intending to practice in rural hospitals may not get adequate training for specialty procedures, which they will be expected to perform. Better definition of these procedures will help guide rural surgery training. Current Procedural Terminology codes for all surgical procedures for 81% of North Dakota and South Dakota rural surgeons were entered into the Dakota Database for Rural Surgery. Specialty procedures were analyzed and compared with the Surgical Council on Resident Education curriculum to determine whether general surgery training is adequate preparation for rural surgery practice. The Dakota Database for Rural Surgery included 46,052 procedures, of which 5,666 (12.3%) were specialty procedures. Highest volume specialty categories included vascular, obstetrics and gynecology, orthopedics, cardiothoracic, urology, and otolaryngology. Common procedures in cardiothoracic and vascular surgery are taught in general surgical residency, while common procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology are usually not taught in general surgery training. Optimal training for rural surgery practice should include experience in specialty procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology. Copyright © 2012 Elsevier Inc. All rights reserved.

Mutagenic treatments towards increasing the frequency of day-neutral mutations and standardization of procedures for tissue culture, in potato

International Nuclear Information System (INIS)

Upadhya, M.D.; Chandra, R.; Abraham, M.J.

1976-01-01

Various chemical mutagens and gamma radiation have been used on single dormant eyes and true seeds with a view to finding effective mutagenic treatment for the induction of day-length neutral mutants in potato using an effective screening technique for the isolation of day-length neutral mutants. Sodium meta bisulphite (SMS) was found to be an efficient mutagen in inducing mutations for this trait in true seeds although the same concentrations, when used for treating the single tuber eyes proved lethal. Pre-soaking the seeds for 24 hrs prior to treatment with 0.0025M SMS gave highest frequency of the mutants followed by 48 hrs presoaking, indicating a sensitive stage during the cell cycle in true seeds. Other mutagen treatments gave different frequencies of mutations. The highest frequency of day-length neutral mutants was observed when seeds irradiated with 40 Kr of gamma radiation were treated with 0.05M hydrazinium dichloride solution. Screening procedures have also been standardised with the development of synethetic media for the isolation of biochemical mutants at the true seed level. Initial efforts have yielded mutants resistant to LD 100 doses of ethionine. Another aspect of the study was to develop a proper potato callus culture technique. A medium has been developed to produce and maintain callus from potato leaf strips. Efforts on the regeneration of shoot and roots from callus, have so far lead to differentiation of callus to form roots. The ultimate aim of these studies is to develop plantlets from single cell which would form the units of mutation induction and isolation. (author)

A Review of Clinical Data for Currently Approved Hysteroscopic Sterilization Procedures

Science.gov (United States)

Basinski, Cindy M

2010-01-01

Two hysteroscopic permanent sterilization procedures are approved for use in the United States: Essure® Permanent Birth Control System (Conceptus Incorporated, Mountain View, CA) and Adiana® Permanent Contraception (Hologic, Inc., Bedford, MA). This review compares the clinical trial data for these procedures. A notable difference is the resultant clinical pregnancy risk. The clinical trials for the Essure procedure have reported no pregnancies in 643 relying women in the 9 years since initiation of the studies. The clinical trial for the Adiana procedure has reported 12 pregnancies in 570 relying women in nearly 5 years of collected data. Other clinical outcome parameters concerning Essure and Adiana are examined in this review. PMID:21364861

Features of Somatic and Reproductive Status of Women, who Gave Birth to a Child with Congenital Malformations, and Their Identifiсation Using «Case — Control» Method According to Data of Lviv Regional Clinical Perinatal Center in 2007–2009

Directory of Open Access Journals (Sweden)

Zborovska N.V. Zborovska N.V.

2012-04-01

While comparing a range of reproductive anamnesis indices there was noticed a higher percentage of dead children, stillbirths, anemia in pregnancy, gestosis in the first half of pregnancy, gestosis in the second half of pregnancy, abnormal labors in mothers who gave birth to a child with congenital malformations than in women of control group. According to ultrasound diagnosis congenital abnormalities in pregnancy were detected in 31.6 % of cases. There were diagnosed 4 cases of Arnold — Chiari syndrome (spina bifida and internal hydrocephalus; and 3 cases of each: hydrocephalus, gastroschisis, small intestinal atresia, and 2 cases of each: congenital malformations, hypoplastic left heart syndrome, Down’s syndrome, congenital diaphragmatic hernia, omphalocele, congenital rectal atresia, and 1 case of each: spina bifida, congenital absence of forearm and hand, left ventricular rabdomioma, encephalocele.

Cerebral Embolic Protection During Transcatheter Aortic Valve Replacement Significantly Reduces Death and Stroke Compared With Unprotected Procedures.

Science.gov (United States)

Seeger, Julia; Gonska, Birgid; Otto, Markus; Rottbauer, Wolfgang; Wöhrle, Jochen

2017-11-27

The aim of this study was to evaluate the impact of cerebral embolic protection on stroke-free survival in patients undergoing transcatheter aortic valve replacement (TAVR). Imaging data on cerebral embolic protection devices have demonstrated a significant reduction in number and volume of cerebral lesions. A total of 802 consecutive patients were enrolled. The Sentinel cerebral embolic protection device (Claret Medical Inc., Santa Rosa, California) was used in 34.9% (n = 280) of consecutive patients. In 65.1% (n = 522) of patients TAVR was performed in the identical setting except without cerebral embolic protection. Neurological follow-up was done within 7 days post-procedure. The primary endpoint was a composite of all-cause mortality or all-stroke according to Valve Academic Research Consortium-2 criteria within 7 days. Propensity score matching was performed to account for possible confounders. Both filters of the device were successfully positioned in 280 of 305 (91.8%) consecutive patients. With use of cerebral embolic protection rate of disabling and nondisabling stroke was significantly reduced from 4.6% to 1.4% (p = 0.03; odds ratio: 0.29, 95% confidence interval: 0.10 to 0.93) in the propensity-matched population (n = 560). The primary endpoint occurred significantly less frequently, with 2.1% (n = 6 of 280) in the protected group compared with 6.8% (n = 19 of 280) in the control group (p = 0.01; odds ratio: 0.30; 95% confidence interval: 0.12 to 0.77). In multivariable analysis Society of Thoracic Surgeons score for mortality (p = 0.02) and TAVR without protection (p = 0.02) were independent predictors for the primary endpoint. In patients undergoing TAVR use of a cerebral embolic protection device demonstrated a significant higher rate of stroke-free survival compared with unprotected TAVR. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Effect of different light-curing devices and aging procedures on composite knoop microhardness

Directory of Open Access Journals (Sweden)

Fernanda Regina Voltarelli

2009-12-01

Full Text Available The aim of this study was to evaluate the effect of light-curing devices (Halogen/HAL, Light Emitting Diodes/LED, Argon Laser/LAS and Plasma Arc/PAC and aging procedures (Mechanical Cycling/MC, Thermal Cycling/TC, Storage/S, MC+TC and MC+TC+S on the micro-hardness of bottom/B and top/T surfaces of 2-mm-high composite resin cylinders. The Knoop microhardness test (25 g, 20 s on both B and T was performed before and after each aging procedure. For B and T, before aging procedures, PAC showed reduced polymerization effectiveness when compared with HAL. In the T, after TC, PAC and LAS had also showed reduced polymerization effectiveness when compared to HAL and LED. For all light-curing devices, MC+TC+S and S affected the Knoop microhardness values. In the B, no difference could be observed among the aging procedures for PAC. From all light-curing units, PAC may have rendered composites of reduced quality and the storage aging procedures were the most harmful to the polymer hardness.

Legitimization Arguments for Procedural Reforms: a semio-linguistic analysis of statement of reasons from the Civil Procedure Code of 1939 and of the draft bill of the New Civil Procedure Code of 2010.

Directory of Open Access Journals (Sweden)

Matheus Guarino Sant’Anna Lima de Almeida

2016-08-01

Full Text Available This research aims to analyze the arguments of legitimization that were used in the reform of Brazilian procedural legal codes, by comparing the texts of the statement of reasons of the Civil Procedure Code of 1939 and the draft bill of the New Civil Procedure Code. We consider these codes as milestones: the Civil Procedure Code of 1939 was the first one with a national scope; the draft bill of the New Civil Procedure Code was the first one produced during a democratic period. Our goal is to search for similarities and contrasts between the legitimization arguments used in each historical and political period, by asking if they were only arguments to bestow legitimacy to such reforms. We decided to use the methodological tools of sociolinguistic analysis of speech developed by Patrick Charaudeau in his analyses of political speech in order to elucidate how the uses of language and elements of meaning in the speech construction provide justification for the concept of procedure, in both 1939 and 2010. As a result, we conclude that the process of drafting the CPC of 1939 and the New CPC, even if they are very distant in terms of political and historical contexts, they are also very close in their rhetorical construction and their attempt to find justification and adherence. On balance, some of the differences depend on the vocabulary used when the codes were developed, their justification and the need for change. 

An integrated computer-based procedure for teamwork in digital nuclear power plants.

Science.gov (United States)

Gao, Qin; Yu, Wenzhu; Jiang, Xiang; Song, Fei; Pan, Jiajie; Li, Zhizhong

2015-01-01

Computer-based procedures (CBPs) are expected to improve operator performance in nuclear power plants (NPPs), but they may reduce the openness of interaction between team members and harm teamwork consequently. To support teamwork in the main control room of an NPP, this study proposed a team-level integrated CBP that presents team members' operation status and execution histories to one another. Through a laboratory experiment, we compared the new integrated design and the existing individual CBP design. Sixty participants, randomly divided into twenty teams of three people each, were assigned to the two conditions to perform simulated emergency operating procedures. The results showed that compared with the existing CBP design, the integrated CBP reduced the effort of team communication and improved team transparency. The results suggest that this novel design is effective to optim team process, but its impact on the behavioural outcomes may be moderated by more factors, such as task duration. The study proposed and evaluated a team-level integrated computer-based procedure, which present team members' operation status and execution history to one another. The experimental results show that compared with the traditional procedure design, the integrated design reduces the effort of team communication and improves team transparency.

Procedure generation and verification

International Nuclear Information System (INIS)

Sheely, W.F.

1986-01-01

The Department of Energy has used Artificial Intelligence of ''AI'' concepts to develop two powerful new computer-based techniques to enhance safety in nuclear applications. The Procedure Generation System, and the Procedure Verification System, can be adapted to other commercial applications, such as a manufacturing plant. The Procedure Generation System can create a procedure to deal with the off-normal condition. The operator can then take correct actions on the system in minimal time. The Verification System evaluates the logic of the Procedure Generator's conclusions. This evaluation uses logic techniques totally independent of the Procedure Generator. The rapid, accurate generation and verification of corrective procedures can greatly reduce the human error, possible in a complex (stressful/high stress) situation

Comparison of argon plasma coagulation in management of upper gastrointestinal angiodysplasia and gastric antral vascular ectasia hemorrhage.

Science.gov (United States)

Chiu, Yi-Chun; Lu, Lung-Sheng; Wu, Keng-Liang; Tam, William; Hu, Ming-Luen; Tai, Wei-Chen; Chiu, King-Wah; Chuah, Seng-Kee

2012-06-09

Vascular ectasias, including gastric antral vascular ectasia (GAVE) and angiodysplasia, are increasingly recognized as important sources of gastrointestinal bleeding. This study investigated and compared the efficacies and outcomes of treatment of upper gastrointestinal (UGI) angiodysplasia and GAVE hemorrhage by endoscopic argon plasma coagulation (APC). From January 2006 to December 2009, 46 patients diagnosed with upper GI bleeding caused by angiodysplasia or GAVE at a tertiary hospital were recruited into this study. They included 26 males and 20 females with an average age of 65.6 years (range, 45-90 years). All patients underwent APC for hemostasis during an endoscopic procedure. Parameters such as underlying co-morbidities, number of endoscopic treatment sessions, recurrent bleeding, and clinical outcomes during follow-up were analyzed. The 46 patients with UGI vascular ectasia hemorrhage included 27 patients with angiodysplasia and 19 with GAVE. The patients with angiodysplasia were older than those with GAVE (71.6 ± 10.2 years versus 61.8 ± 11.9 years, P = 0.005). More GAVE patients than angiodysplasia patients had co-existing liver cirrhosis (63.2% versus 25.9%, P = 0.012). The patients with GAVE had a higher rate of recurrent bleeding (78.9% versus 7.4%, P bleeding. Further multivariate analysis revealed that GAVE was the only independent risk factor for recurrent bleeding after APC treatment (OR = 0.027, P bleeding. The efficacy of APC treatment is greater for angiodysplasia than for vascular ectasia bleeding. GAVE patients have a higher recurrent bleeding rate and may require multiple treatment sessions for sustained hemostasis.

Parametric Sensitivity Tests- European PEM Fuel Cell Stack Test Procedures

DEFF Research Database (Denmark)

Araya, Samuel Simon; Andreasen, Søren Juhl; Kær, Søren Knudsen

2014-01-01

performed based on test procedures proposed by a European project, Stack-Test. The sensitivity of a Nafion-based low temperature PEMFC stack’s performance to parametric changes was the main objective of the tests. Four crucial parameters for fuel cell operation were chosen; relative humidity, temperature......As fuel cells are increasingly commercialized for various applications, harmonized and industry-relevant test procedures are necessary to benchmark tests and to ensure comparability of stack performance results from different parties. This paper reports the results of parametric sensitivity tests......, pressure, and stoichiometry at varying current density. Furthermore, procedures for polarization curve recording were also tested both in ascending and descending current directions....

Modified Distal Urethral Polypropylene Sling (Canal Transobturator Tape Procedure: Efficacy for Persistent Stress Urinary Incontinence After a Conventional Midurethral Sling Procedure

Directory of Open Access Journals (Sweden)

Chang Hee Kim

2013-03-01

Full Text Available Purpose: Despite reports of persistent stress urinary incontinence (SUI in patients after the midurethral sling (MUS procedure, there is no widely accepted definition or cause of the condition. In many cases, the mesh implanted in the previous MUS procedure has been found to have migrated proximally. The aim of this study was to evaluate the efficacy of the modified distal urethral polypropylene sling, or canal transobturator tape (TOT, procedure for persistent SUI after a conventional MUS procedure on the assumption that persistent SUI after MUS is due to the location of the sling. Methods: From January 2008 to April 2012, 31 female patients who underwent the canal TOT procedure presented with incontinence or lower urinary tract symptoms (LUTS were included in this study. We identified patients who had been operated on by use of the conventional MUS procedure at other medical facilities, whose Valsalva leak pressure point was less than 120 cm-H2O by urodynamic study, and who were also diagnosed with persistent SUI. If vaginal or urethral mesh exposure was concomitant with persistent SUI, the mesh was removed completely or in part. Surgical procedures for canal TOT were identical to the original TOT procedures, except in the number and location of the vaginal incisions. Incontinence Impact Questionnaire-Short Form (IIQ-7 and Urogenital Distress Inventory-Short Form (UDI-6 scores were assessed preoperatively and at 3 months postoperatively. Results: There were no intraoperative or postoperative complications. Twenty-eight patients (90.3% showed improvement in incontinence or other LUTS. Postoperative scores of the IIQ-7 (0.65±0.48 and UDI-6 (3.48±2.28 were significantly improved compared with preoperative scores (1.26±0.58 and 7.52±4.30, respectively; P<0.05. Conclusions: Improper sling location is one of the major causes of persistent SUI after the conventional MUS procedure. Our results demonstrate that canal TOT may be an alternative

Aesthetic Surgical Procedures in Men: Major Complications and Associated Risk Factors.

Science.gov (United States)

Kaoutzanis, Christodoulos; Winocour, Julian; Yeslev, Max; Gupta, Varun; Asokan, Ishan; Roostaeian, Jason; Grotting, James C; Higdon, K Kye

2018-03-14

The number of men undergoing cosmetic surgery is increasing in North America. To determine the incidence and risk factors of major complications in males undergoing cosmetic surgery, compare the complication profiles between men and women, and identify specific procedures that are associated with higher risk of complications in males. A prospective cohort of patients undergoing cosmetic surgery between 2008 and 2013 was identified from the CosmetAssure database. Gender specific procedures were excluded. Primary outcome was occurrence of a major complication in males requiring emergency room visit, hospital admission, or reoperation within 30 days of the index operation. Univariate and multivariate analysis evaluated potential risk factors for major complications including age, body mass index (BMI), smoking, diabetes, type of surgical facility, type of procedure, and combined procedures. Of the 129,007 patients, 54,927 underwent gender nonspecific procedures, of which 5801 (10.6%) were males. Women showed a higher mean age (46.4 ± 14.1 vs 45.2 ± 16.7 years, P procedures (RR 3.47), and combined procedures (RR 2.56). Aesthetic surgery in men is safe with low major complication rates. Modifiable predictors of complications included BMI and combined procedures.

three-in-one procedure versus percutaneous spinal fixation alone

African Journals Online (AJOL)

Results: All patients showed progressive decrease of NRS pain and ODI scores compared with preoperative ... Patients maintained on rehabilitation medicine for at least ..... the 3-in-1 procedure; however, the results obtained in the current.

On the decennium of penal order procedure in Serbia

Directory of Open Access Journals (Sweden)

Brkić Snežana

2011-01-01

Full Text Available In this paper, the author defines the notion and explains the penal order procedure and its general characteristics. It is one of the special simplified criminal proceedings, which has got special basis and special structure. This procedural form is ultimately aimed at the rationalization of the criminal procedure. It is achieved by avoiding the main hearing in the trial proceeding. The author presents the evolution of the penal order in Serbia from 2001 to 2011. He points to some legal innovations in this field during that decennium. He compares old and new legal provisions about penal order and finds some differences. There is a constant tendency to expanding the area of criminal offences which can be judged in this procedural form. New legal provisions are, in general, better than previous. However, the practice has shown that application of penal order is too small. The previous practice does not live up to expectations of theory and legislator.

Planning and consultation procedures for low-level radioactive waste disposal: a comparative analysis of overseas experience

International Nuclear Information System (INIS)

Kemp, R.

1989-03-01

The results are presented of a study the purpose of which was to learn from experience in countries other than the UK, of planning and public consultation procedures associated with the establishment of low-level radioactive waste (LLW) disposal sites. Information on LLW developments in the United States, Canada, France, Holland, Switzerland, Sweden, and West Germany was sought. Particular regard was given to the efficacy of public consultation and negotiation procedures; the key aspects bearing on the public acceptability of LLW proposals; and the form and effect of any compensation mechanisms in operation. The main findings include: (i) Public acceptability of radioactive waste proposals depends upon a combination of basic understanding, trust, consultation and negotiation. (ii) There is no overall correct approach. (iii) The greatest success overseas appears to be linked to some combination of the following elements: authority and clarity in the exposition of radioactive waste management policy; the early involvement of local authority organisations in site selection; careful attention to the potential contribution of authoritative independent advisory groups; the development and nurturing of local liaison committees to establish good communications at the local level; careful consideration of means of devolving some power to local authority level for safety reassurance; and the development of an incremental, openly negotiated approach to compensation. (author)

Results of clinical application of the modified maze procedure as concomitant surgery

Science.gov (United States)

Bakker, Robbert C.; Akin, Sakir; Rizopoulos, Dimitris; Kik, Charles; Takkenberg, Johanna J.M.; Bogers, Ad J.J.C.

2013-01-01

OBJECTIVES Atrial fibrillation is the most common cardiac arrhythmia and is associated with significant morbidity and mortality. The classic cut-and-sew maze procedure is successful in 85–95% of patients. However, the technical complexity has prompted modifications of the maze procedure. The objective of this study was to retrospectively evaluate the clinical safety and efficacy of the maze treatment performed at our institution. METHODS From March 2001 until February 2009, 169 patients underwent a modified maze procedure for atrial fibrillation at the Erasmus MC, Rotterdam. Patient characteristics, surgical procedure and follow-up data were obtained by reviewing the medical charts and consulting with the referring physicians. The efficacy of the procedure as measured by AF recurrence was analysed with a repeated measurements model. The quality of life of the patients was assessed with the SF-36 (a short-form health survey with 36 questions) questionnaire and compared with that of the general Dutch population. RESULTS Of the 169 patients who underwent a modified maze procedure, 163 had their maze procedure as a concomitant procedure. The 30-day mortality rate was 4.7% (n = 8). The rate of post-procedural AF recurrence varied significantly over time (P < 0.0001). Decreased left ventricular function, increased age and higher preoperative creatinine levels were predictors of AF recurrence. Quality of life, as measured with the SF-36 questionnaire, was comparable with that of the Dutch population for all health domains. CONCLUSIONS Concomitant maze is a relatively safe treatment that eliminates atrial fibrillation in the majority of patients, although the probability of recurrent AF increases with the passage of time. Decreased left ventricular function, increased age and higher preoperative creatinine levels are associated with an increased risk of AF recurrence. PMID:23103720

Procedures for Selecting Items for Computerized Adaptive Tests.

Science.gov (United States)

Kingsbury, G. Gage; Zara, Anthony R.

1989-01-01

Several classical approaches and alternative approaches to item selection for computerized adaptive testing (CAT) are reviewed and compared. The study also describes procedures for constrained CAT that may be added to classical item selection approaches to allow them to be used for applied testing. (TJH)

Skin-to-skin care for procedural pain in neonates.

Science.gov (United States)

Johnston, Celeste; Campbell-Yeo, Marsha; Fernandes, Ananda; Inglis, Darlene; Streiner, David; Zee, Rebekah

2014-01-23

Skin-to-skin care (SSC), otherwise known as Kangaroo Care (KC) due to its similarity with marsupial behaviour of ventral maternal-infant contact, is one non-pharmacological intervention for pain control in infants. The primary objectives were to determine the effect of SSC alone on pain from medical or nursing procedures in neonates undergoing painful procedures compared to no intervention, sucrose or other analgesics, or additions to simple SSC such as rocking; and the effects of the amount of SSC (duration in minutes) and the method of administration (who provided the SSC, positioning of caregiver and neonate pair).The secondary objectives were to determine the incidence of untoward effects of SSC and to compare the SSC effect in different postmenstrual age subgroups of infants. The standard methods of the Cochrane Neonatal Collaborative Review Group were used. Databases searched in August 2011: Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library); Evidence-Based Medicine Reviews; MEDLINE (1950 onwards); PubMed (1975 onwards); EMBASE (1974 onwards); CINAHL (1982 onwards); Web of Science (1980 onwards); LILACS database (1982 onwards); SCIELO database (1982 onwards); PsycInfo (1980 onwards); AMED (1985 onwards); Dissertation-Abstracts International (1980 onwards). Searches were conducted throughout September 2012. Studies with randomisation or quasi-randomisation, double or single-blinded, involving term infants (> 37 completed weeks postmenstrual age (PMA)) to a maximum of 44 weeks PMA and preterm infants (lance as the painful procedure, one study combined venepuncture and heel stick (n = 50), two used intramuscular injection, and one used 'vaccination' (n = 80). The studies that were included were generally strong and free from bias.Eleven studies (n = 1363) compared SSC alone to a no-treatment control. Although 11 studies measured heart rate during painful procedures, data from only four studies (n = 121) could be combined to give a

Comparative study of the mutant prevention concentrations of moxifloxacin, levofloxacin, and gemifloxacin against pneumococci.

Science.gov (United States)

Credito, Kim; Kosowska-Shick, Klaudia; McGhee, Pamela; Pankuch, Glenn A; Appelbaum, Peter C

2010-02-01

We tested the propensity of three quinolones to select for resistant Streptococcus pneumoniae mutants by determining the mutant prevention concentration (MPC) against 100 clinical strains, some of which harbored mutations in type II topoisomerases. Compared with levofloxacin and gemifloxacin, moxifloxacin had the lowest number of strains with MPCs above the susceptibility breakpoint (P<0.001), thus representing a lower selective pressure for proliferation of resistant mutants. Only moxifloxacin gave a 50% MPC (MPC50) value (1 microg/ml) within the susceptible range.

Sequence-specific procedural learning deficits in children with specific language impairment.

Science.gov (United States)

Hsu, Hsinjen Julie; Bishop, Dorothy V M

2014-05-01

This study tested the procedural deficit hypothesis of specific language impairment (SLI) by comparing children's performance in two motor procedural learning tasks and an implicit verbal sequence learning task. Participants were 7- to 11-year-old children with SLI (n = 48), typically developing age-matched children (n = 20) and younger typically developing children matched for receptive grammar (n = 28). In a serial reaction time task, the children with SLI performed at the same level as the grammar-matched children, but poorer than age-matched controls in learning motor sequences. When tested with a motor procedural learning task that did not involve learning sequential relationships between discrete elements (i.e. pursuit rotor), the children with SLI performed comparably with age-matched children and better than younger grammar-matched controls. In addition, poor implicit learning of word sequences in a verbal memory task (the Hebb effect) was found in the children with SLI. Together, these findings suggest that SLI might be characterized by deficits in learning sequence-specific information, rather than generally weak procedural learning. © 2014 The Authors. Developmental Science Published by John Wiley & Sons Ltd.

More than just tapping: index finger-tapping measures procedural learning in schizophrenia.

Science.gov (United States)

Da Silva, Felipe N; Irani, Farzin; Richard, Jan; Brensinger, Colleen M; Bilker, Warren B; Gur, Raquel E; Gur, Ruben C

2012-05-01

Finger-tapping has been widely studied using behavioral and neuroimaging paradigms. Evidence supports the use of finger-tapping as an endophenotype in schizophrenia, but its relationship with motor procedural learning remains unexplored. To our knowledge, this study presents the first use of index finger-tapping to study procedural learning in individuals with schizophrenia or schizoaffective disorder (SCZ/SZA) as compared to healthy controls. A computerized index finger-tapping test was administered to 1169 SCZ/SZA patients (62% male, 88% right-handed), and 689 healthy controls (40% male, 93% right-handed). Number of taps per trial and learning slopes across trials for the dominant and non-dominant hands were examined for motor speed and procedural learning, respectively. Both healthy controls and SCZ/SZA patients demonstrated procedural learning for their dominant hand but not for their non-dominant hand. In addition, patients showed a greater capacity for procedural learning even though they demonstrated more variability in procedural learning compared to healthy controls. Left-handers of both groups performed better than right-handers and had less variability in mean number of taps between non-dominant and dominant hands. Males also had less variability in mean tap count between dominant and non-dominant hands than females. As expected, patients had a lower mean number of taps than healthy controls, males outperformed females and dominant-hand trials had more mean taps than non-dominant hand trials in both groups. The index finger-tapping test can measure both motor speed and procedural learning, and motor procedural learning may be intact in SCZ/SZA patients. Copyright © 2012 Elsevier B.V. All rights reserved.

Plastic freezer bags: a cost-effective method to protect extraction sites in laparoscopic colorectal procedures?

Science.gov (United States)

Huynh, Hai P; Musselman, Reilly P; Trottier, Daniel C; Soto, Claudia M; Poulin, Eric C; Mamazza, Joseph; Boushey, Robin P; Auer, Rebecca C; Moloo, Husein

2013-10-01

To review surgical-site infection (SSI) and retrieval-site tumor recurrence rates in laparoscopic colorectal procedures when using a plastic freezer bag as a wound protector. Laparoscopic colorectal procedures where a plastic freezer bag used as a wound protector at the extraction site were reviewed between 1991 and 2008 from a prospectively collected database. χ test was used to compare SSI and tumor recurrence rates between groups. Costing data were obtained from the operating room supplies department. A total of 936 cases with 51 (5.45%) surgical-site infections were identified. SSI rates did not differ when comparing groups based on demographic factors, diagnosis, or location of procedure. Retrieval-site tumor recurrence rate was 0.21% (1/474). Cost of plastic freezer bags including sterilization ranged from $0.25 to $3. Plastic freezer bags as wound protectors in laparoscopic colorectal procedures are cost effective and have SSI and retrieval-site tumor recurrence rates that compare favorably to published data.

Play vs. Procedures

DEFF Research Database (Denmark)

Hammar, Emil

Through the theories of play by Gadamer (2004) and Henricks (2006), I will show how the relationship between play and game can be understood as dialectic and disruptive, thus challenging understandings of how the procedures of games determine player activity and vice versa. As such, I posit some...... analytical consequences for understandings of digital games as procedurally fixed (Boghost, 2006; Flannagan, 2009; Bathwaite & Sharp, 2010). That is, if digital games are argued to be procedurally fixed and if play is an appropriative and dialectic activity, then it could be argued that the latter affects...... and alters the former, and vice versa. Consequently, if the appointed procedures of a game are no longer fixed and rigid in their conveyance of meaning, qua the appropriative and dissolving nature of play, then understandings of games as conveying a fixed meaning through their procedures are inadequate...

Endovascular thrombectomy and post-procedural headache

DEFF Research Database (Denmark)

Khan, Sabrina; Amin, Faisal Mohammad; Holtmannspötter, Markus

2017-01-01

BACKGROUND: We investigated the prevalence of post-procedural headache in patients who have undergone thrombectomy for ischemic stroke, and correlated history of migraine with risk of peri-procedural complications. A total of 314 patients underwent thrombectomy at the Danish National Hospital from...... January 2012 to December 2014. Eligible subjects were phone-interviewed using a purpose-developed semi-structured questionnaire according to the International Classification of Headache Disorders 3, beta version criteria. FINDINGS: Among 96 eligible subjects, there was a significant decrease in migraine...... (p = 0.022) within the first 3 months after EVT compared to 1 year before treatment, which was further evident at interview time (on average 1.6 years after EVT, p = 0.013). A minority of patients experienced headaches for the first time within 3 months of their EVT (migraine 2, TTH 9), which...

Comparison of criminal procedure and inspection

International Nuclear Information System (INIS)

Hyung, Sang Cheol

2009-01-01

While a criminal investigation and international inspection are similar in the purpose of identifying any possible violator, there are also differences between them. Especially in the case of a criminal procedure, the defendants are presumed to be innocent until he or she is convicted, but states must make efforts to prove their nuclear transparency. Let's compare both of them to find out the reason why these different points have happened

Measuring Vocational Preferences: Ranking versus Categorical Rating Procedures.

Science.gov (United States)

Carifio, James

1978-01-01

Describes a study to compare the relative validities of ranking v categorical rating procedures for obtaining student vocational preference data in exploratory program assignment situations. Students indicated their vocational program preferences from career clusters, and the frequency of wrong assignments made by each method was analyzed. (MF)

Matched-pair analyses of resting and dynamic morphology between Monarc and TVT-O procedures by ultrasound.

Science.gov (United States)

Yang, Jenn-Ming; Yang, Shwu-Huey; Huang, Wen-Chen; Tzeng, Chii-Ruey

2013-07-01

To determine morphologic differences between Monarc and TVT-O procedures in axial and coronal planes by three- and four-dimensional (3D and 4D) ultrasound. Retrospective chart audits and ultrasound analyses were conducted on 128 women who had undergone either Monarc or TVT-O procedures for urodynamic stress incontinence. Thirty matched pairs of the two successful procedures were randomly selected and compared. Matched variables were age, parity, body mass index, cesarean status, menopausal status, and primary surgeries. Six-month postoperative 3D and 4D ultrasound results obtained at rest, on straining, and during coughing in these 60 women were analyzed. Assessed ultrasound parameters included the axial tape urethral distance (aTUD), axial central urethral echolucent area (aUCEA), axial tape angle (aTA), and coronal tape angle (cTA), all of which were measured at three equidistant points along the tapes. Paired t-tests were used to compare differences in ultrasound parameters between women after the two procedures and a P value TVT-O procedures. There were no significant differences in other resting ultrasound parameters between these two procedures. Additionally, after both procedures women had comparable straining and coughing ultrasound manifestations as well as respective dynamic changes. Despite flatter resting tape angulations in women following Monarc procedures, both Monarc and TVT-O tapes had equivalent dynamic patterns and changes assessed by 4D ultrasound. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Communities in the nuclear licensing procedure according to Atomic Energy Act, Article 7

International Nuclear Information System (INIS)

Wald, A.

1978-01-01

The legal positions to be taken by communities in administrative procedures as well as in administrative proceedings in court are pointed out. It is discussed to what extent a community can plead the rights of its inhabitants. The nuclear licensing procedure is investigated more closely and compared with other licensing procedures. The legal position of the communities is discussed with special regard to the right of complaint. (HSCH) 891 HP/HSCH 892 MKO [de

Time Savings and Surgery Task Load Reduction in Open Intraperitoneal Onlay Mesh Fixation Procedure

Directory of Open Access Journals (Sweden)

Sanjoy Roy

2015-01-01

Full Text Available Background. This study assessed the reduction in surgeon stress associated with savings in procedure time for mechanical fixation of an intraperitoneal onlay mesh (IPOM compared to a traditional suture fixation in open ventral hernia repair. Study Design. Nine general surgeons performed 36 open IPOM fixation procedures in porcine model. Each surgeon conducted two mechanical (using ETHICON SECURESTRAPTM Open and two suture fixation procedures. Fixation time was measured using a stopwatch, and related surgeon stress was assessed using the validated SURG-TLX questionnaire. T-tests were used to compare between-group differences, and a two-sided 95% confidence interval for the difference in stress levels was established using nonparametric methodology. Results. The mechanical fixation group demonstrated an 89.1% mean reduction in fixation time, as compared to the suture group (p<0.00001. Surgeon stress scores measured using SURG-TLX were 55.5% lower in the mechanical compared to the suture fixation group (p<0.001. Scores in five of the six sources of stress were significantly lower for mechanical fixation. Conclusions. Mechanical fixation with ETHICON SECURESTRAPTM Open demonstrated a significant reduction in fixation time and surgeon stress, which may translate into improved operating efficiency, improved performance, improved surgeon quality of life, and reduced overall costs of the procedure.

Weber, Durkheim, and the comparative method.

Science.gov (United States)

Kapsis, R E

1977-10-01

This essay compares and contrasts the means by which Durkheim and Weber dealt with methodological issues peculiar to the comparative study of societies, what Smelser has called "the problem of sociocultural variability and complexity." More specifically, it examines how Weber and Durkheim chose appropriate comparative units for their empirical studies. The approaches that Weber and Durkheim brought to theproblem of cross-cultural comparison have critical implications for more current procedures used in the comparative study of contemporary and historical societies.

Simple and Effective Procedure for Immobilization of Oxidases onto ...

African Journals Online (AJOL)

Received 25 June 2003; revised 7 September 2003; accepted 20 January 2004. ... permselective membrane layer prior to enzyme immobilization gave promising result with .... monitored by using litmus paper (Macherey-Nagel, Dueren, ..... a Plasma concentration for healthy adult ranges from 4 to 15 mg L–1 [ref. 31].

Randomized comparison of operator radiation exposure comparing transradial and transfemoral approach for percutaneous coronary procedures: rationale and design of the minimizing adverse haemorrhagic events by TRansradial access site and systemic implementation of angioX - RAdiation Dose study (RAD-MATRIX).

Science.gov (United States)

Sciahbasi, Alessandro; Calabrò, Paolo; Sarandrea, Alessandro; Rigattieri, Stefano; Tomassini, Francesco; Sardella, Gennaro; Zavalloni, Dennis; Cortese, Bernardo; Limbruno, Ugo; Tebaldi, Matteo; Gagnor, Andrea; Rubartelli, Paolo; Zingarelli, Antonio; Valgimigli, Marco

2014-06-01

Radiation absorbed by interventional cardiologists is a frequently under-evaluated important issue. Aim is to compare radiation dose absorbed by interventional cardiologists during percutaneous coronary procedures for acute coronary syndromes comparing transradial and transfemoral access. The randomized multicentre MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX) trial has been designed to compare the clinical outcome of patients with acute coronary syndromes treated invasively according to the access site (transfemoral vs. transradial) and to the anticoagulant therapy (bivalirudin vs. heparin). Selected experienced interventional cardiologists involved in this study have been equipped with dedicated thermoluminescent dosimeters to evaluate the radiation dose absorbed during transfemoral or right transradial or left transradial access. For each access we evaluate the radiation dose absorbed at wrist, at thorax and at eye level. Consequently the operator is equipped with three sets (transfemoral, right transradial or left transradial access) of three different dosimeters (wrist, thorax and eye dosimeter). Primary end-point of the study is the procedural radiation dose absorbed by operators at thorax. An important secondary end-point is the procedural radiation dose absorbed by operators comparing the right or left radial approach. Patient randomization is performed according to the MATRIX protocol for the femoral or radial approach. A further randomization for the radial approach is performed to compare right and left transradial access. The RAD-MATRIX study will probably consent to clarify the radiation issue for interventional cardiologist comparing transradial and transfemoral access in the setting of acute coronary syndromes. Copyright © 2014 Elsevier Inc. All rights reserved.

Improvement of ethanol-tolerance of haploid Saccharomyces diastaticus

International Nuclear Information System (INIS)

Song, S.H.; Kim, K.; Lee, M.W.

1994-01-01

Several mutation procedures have been compared to obtain an ethanol-tolerant Saccharomyces diastaticus strain secreting glucoamylase. These procedures include spontaneous mutation, EMS treatment, UV irradiation, and combination of EMS treatment and UV irradiation. All these methods were followed by adaptation of the yeast cells to gradually higher ethanol concentration. Among these procedures, the combined method of EMS treatment and UV irradiation gave the promising result, i.e. the ethanol tolerance of the yeast increased from 11.5%(v/v) to 14.0%(v/v). Respiratory deficient petite mutants of industrial and ethanol-tolerant yeast strains have been isolated and hybridized with haploid S. diastaticus strains. The resulting hybrids showed increased ethanol tolerance and starch-fermentability

Differing Procedures for Recording Mortality Statistics in Scandinavia

DEFF Research Database (Denmark)

Tøllefsen, Ingvild M.; Hem, Erlend; Ekeberg, Øivind

2017-01-01

Background: There may be various reasons for differences in suicide rates between countries and over time within a country. One reason can be different registration practices. Aims: The purpose of this study was to describe and compare the present procedures for mortality and suicide registration...... in the three Scandinavian countries and to illustrate potential sources of error in the registration of suicide. Method: Information about registration practices and classification procedures was obtained from the cause of death registers in Norway, Sweden, and Denmark. In addition, we received information...... and in postmortem examinations exist in Scandinavian countries. These differences might influence the suicide statistics in Scandinavia....

Glycemic potency of muffins made with wheat, rice, corn, oat and barley flours: a comparative study between in vivo and in vitro.

Science.gov (United States)

Soong, Yean Yean; Quek, Rina Yu Chin; Henry, Christiani Jeyakumar

2015-12-01

Muffins made with wheat flour are a popular snack consumed in western and emerging countries. This study aimed to examine the content of amylose, glycemic response (GR) and glycemic index (GI) of muffins baked with refined wheat and rice flours, as well as wholegrain corn, oat and barley flours. This study adopted a randomized, controlled, crossover, non-blind design. Twelve healthy participants consumed wheat, rice, corn, oat and barley muffins once and the reference glucose solution three times in a random order on non-consecutive day. Capillary blood samples were taken every 15 min in the first 60 min and every 30 min for the remaining 60 min for blood glucose analysis. The Megazyme amylose/amylopectin assay procedure was employed to measure amylose content. The GR elicited from the consumption of wheat, rice and corn muffins was comparable between these samples but significantly greater when compared with oat and barley muffins. Consumption of wholegrain muffins, apart from corn muffin, blunted postprandial GR when compared with muffins baked with refined cereal flours. Muffins baked with wheat, rice, corn, oat and barley flours gave rise to GI values of 74, 79, 74, 53 and 55, respectively. The content of amylose was significantly higher in corn, oat and barley muffins than wheat and rice muffins. The greater content of amylose and fibre may play a part in the reduced glycemic potency of oat and barley muffins. Wheat flour can be substituted with oat and barley flours for healthier muffins and other bakery products.

Validation of radiation dose estimations in VRdose: comparing estimated radiation doses with observed radiation doses

International Nuclear Information System (INIS)

Nystad, Espen; Sebok, Angelia; Meyer, Geir

2004-04-01

The Halden Virtual Reality Centre has developed work-planning software that predicts the radiation exposure of workers in contaminated areas. To validate the accuracy of the predicted radiation dosages, it is necessary to compare predicted doses to actual dosages. During an experimental study conducted at the Halden Boiling Water Reactor (HBWR) hall, the radiation exposure was measured for all participants throughout the test session, ref. HWR-681 [3]. Data from this experimental study have also been used to model tasks in the work-planning software and gather data for predicted radiation exposure. Two different methods were used to predict radiation dosages; one method used all radiation data from all the floor levels in the HBWR (all-data method). The other used only data from the floor level where the task was conducted (isolated data method). The study showed that the all-data method gave predictions that were on average 2.3 times higher than the actual radiation dosages. The isolated-data method gave predictions on average 0.9 times the actual dosages. (Author)

A Comparison of Error-Correction Procedures on Skill Acquisition during Discrete-Trial Instruction

Science.gov (United States)

Carroll, Regina A.; Joachim, Brad T.; St. Peter, Claire C.; Robinson, Nicole

2015-01-01

Previous research supports the use of a variety of error-correction procedures to facilitate skill acquisition during discrete-trial instruction. We used an adapted alternating treatments design to compare the effects of 4 commonly used error-correction procedures on skill acquisition for 2 children with attention deficit hyperactivity disorder…

Fingertip replantation using the subdermal pocket procedure.

Science.gov (United States)

Lin, Tsan-Shiun; Jeng, Seng-Feng; Chiang, Yuan-Cheng

2004-01-01

of follow-up monitoring. Compared with other methods, the subdermal pocket procedure has the advantages of exact subdermal/subdermal contact, a shorter pocketing period, and more feasible observation. The method can offer an alternative salvage procedure for fingertip amputations with no suitable vessels available for microsurgical replantation.

Declarative and procedural learning in children and adolescents with posterior fossa tumours

Directory of Open Access Journals (Sweden)

Casares Encarnación

2006-03-01

Full Text Available Abstract Background This quasi-experimental study was designed to assess two important learning types – procedural and declarative – in children and adolescents affected by posterior fossa tumours (astrocytoma vs. medulloblastoma, given that memory has an important impact on the child's academic achievement and personal development. Methods We had three groups: two clinical (eighteen subjects and one control (twelve subjects. The learning types in these groups were assessed by two experimental tasks evaluating procedural-implicit and declarative memory. A Serial Reaction-Time Task was used to measure procedural sequence learning, and the Spanish version 1 of the California Verbal Learning Test-Children's Version- CVLT- 2 to measure declarative-explicit learning. The learning capacity was assessed considering only the blocks that represent learning, and were compared with MANOVA in clinical and normal subjects. The Raven, simple reaction-time, finger-tapping test, and grooved pegboard tests were used to assess the overall functioning of subjects. The results were compared with those from a control group of the same age, and with Spanish norm-referenced tools where available Results The results indicate the absence of procedural-implicit learning in both clinical groups, whereas declarative-explicit learning is maintained in both groups. Conclusion The clinical groups showed a conservation of declarative learning and a clear impairment of procedural learning. The results support the role of the cerebellum in the early phase of procedural learning.

Determination of efficacy of nuclear medicine procedures

International Nuclear Information System (INIS)

Saenger, E.L.; Buncher, C.R.; Specker, B.; McDevitt, R.A.

1984-01-01

Nuclear medicine, a high technology field, is evaluated as to its usefulness. This paper describes the SNM study of 2023 patients comparing two methods evaluating efficacy for lung scanning (LS). Only the referring physicians determined the probabilities of the most important (MI) and most likely (ML) diagnoses and management before and after lung scanning. A logistic regression model was developed for probability of a signout diagnosis of PE. Equal patient groups tested the validity of the regression equations for the probability of PE as MI or ML. The models developed on Group I (G-I) and used on Group II (G-II) gave similar results. This shows that LS classifies PE and NOT PE categories where PE was considered both MI and ML. Entropy minimax pattern detection (EMPD) attempts prediction of signout diagnosis and management from prior patient attributes. In 2023 cases, attributes alone could not eliminate the use of LS for all patients. Comparing the two methods, the predictive values, sensitivity and specificity of each method are similar. EMPD predicts on a relatively small percent (40% before LS, 71% post LS) while the logistic equation predicts on 100% of the cases. An advantage of EMPD is that it does not require estimates of prior probability. However, LR, uses this estimate, thus incorporating intuitive knowledge not evaluated by EMPD. These methods are unique in showing that LS can direct the referring physician toward or away from anticoagulant therapy based on findings of the lung scan

Rapid in vitro labeling procedures for two-dimensional gel fingerprinting

International Nuclear Information System (INIS)

Lee, Y.F.; Fowlks, E.R.

1982-01-01

Improvements of existing in vitro procedures for labeling RNA radioactively, and modifications of the two-dimensional polyacrylamide gel electrophoresis system for making RNA fingerprints are described. These improvements are (a) inactivation of phosphatase with nitric acid at pH 2.0 eliminated the phenol-cholorform extraction step during 5'-end labeling with polynucleotide kinase and [γ- 32 P]ATP; (b) ZnSO 4 inactivation of R Nase T 1 results in a highly efficient procedure for 3'-end labeling with T4 ligase and [5'- 32 P]pCp; and (c) a rapid 4-min procedure for variable quantity range of 125 I and RNA results in a qualitative and quantitative sample for high-molecular weight RNA fingerprinting. Thus, these in vitro procedures become rapid and reproducible when combined with two-dimensional gel electrophoresis which eliminates simultaneously labeled impurities. Each labeling procedure is compared, using tobacco mosaic virus, Brome mosaic virus, and polio RNA. A series of Ap-rich oligonucleotides was discovered in the inner genome of Brome mosaic Virus RNA-3

Working, declarative and procedural memory in specific language impairment

Science.gov (United States)

Lum, Jarrad A.G.; Conti-Ramsden, Gina; Page, Debra; Ullman, Michael T.

2012-01-01

According to the Procedural Deficit Hypothesis (PDH), abnormalities of brain structures underlying procedural memory largely explain the language deficits in children with specific language impairment (SLI). These abnormalities are posited to result in core deficits of procedural memory, which in turn explain the grammar problems in the disorder. The abnormalities are also likely to lead to problems with other, non-procedural functions, such as working memory, that rely at least partly on the affected brain structures. In contrast, declarative memory is expected to remain largely intact, and should play an important compensatory role for grammar. These claims were tested by examining measures of working, declarative and procedural memory in 51 children with SLI and 51 matched typically-developing (TD) children (mean age 10). Working memory was assessed with the Working Memory Test Battery for Children, declarative memory with the Children’s Memory Scale, and procedural memory with a visuo-spatial Serial Reaction Time task. As compared to the TD children, the children with SLI were impaired at procedural memory, even when holding working memory constant. In contrast, they were spared at declarative memory for visual information, and at declarative memory in the verbal domain after controlling for working memory and language. Visuo-spatial short-term memory was intact, whereas verbal working memory was impaired, even when language deficits were held constant. Correlation analyses showed neither visuo-spatial nor verbal working memory was associated with either lexical or grammatical abilities in either the SLI or TD children. Declarative memory correlated with lexical abilities in both groups of children. Finally, grammatical abilities were associated with procedural memory in the TD children, but with declarative memory in the children with SLI. These findings replicate and extend previous studies of working, declarative and procedural memory in SLI. Overall, we

Nitrous oxide provides safe and effective analgesia for minor paediatric procedures - a systematic review

DEFF Research Database (Denmark)

Pedersen, Rie S; Bayat, Allan; Steen, Nick Phaff

2013-01-01

Pain and distress during minor hospital-related procedures is a familiar problem in many children. Inadequate relief of children's procedural pain and distress not only affects the experience of the children and their parents, but also adversely impacts procedural success. We aimed to review the ...... the safety and efficacy of nitrous oxide during brief, but painful paediatric procedures and to compare nitrous oxide with some of the commonly used pharmacological and non-pharmacological treatments for relieving anxiety and mild to moderate pain in Denmark....

A case-control study to compare the outcome of women treated by two minimally invasive procedures-ultraminilaparotomy myomectomy and laparoscopic myomectomy

Directory of Open Access Journals (Sweden)

Kuo-Chang Wen

2018-04-01

Full Text Available Objective: Ultraminilaparotomy myomectomy (UMLT-M with less 4 cm transverse skin incision and conventional 3-port wound laparoscopic myomectomy (LM approaches were proposed as alternative minimally invasive procedures in the management of women with symptomatic uterine myomas but few studies have compared the outcomes of both procedures. Materials and methods: Between January 2002 and December 2003, 71 patients undergoing UMLT-M were compared with those 71 women undergoing LM. The last data collection for all patients was done on 31 December 2016. The parameters for comparison included the characteristics of the uterine myomas, surgical parameters, morbidities, and outcomes. Surgical parameters included the operative time (minutes, estimated blood loss (milliliters, time for removal of drainage, percentage of blood transfusion and co-morbidities. Results: Mean operative time in the LM group was significantly longer than that in the UMLT-M group (208.7 ± 65.9 vs. 98.0 ± 28.2 min, p < 0.001. Intra-operative blood loss was significantly higher in the LM group than that in the UMLT-M group (210.9 ± 184.5 vs. 111.7 ± 108.4 ml, p < 0.001. However, more patients had postoperative fever in the UMLT-M group (39.4% vs. 8.5%, p < 0.001. The recurrence rate of myoma at 5-year follow-up was significantly different between two groups (35.2% of UMLT-M vs. 57.7% of LM, p = 0.007, but there was no difference when follow-up time was over ten years. The location of the myoma recurrence was different between two groups with higher recurrence rates in the fundal and lateral sides of uterus in the UMLT-M group and in the anterior wall of uterus in the LM group. However, the overall symptom control, the need of repeated myoma-related surgery and subsequent pregnancy outcome of both groups seemed to be similar in both groups. Conclusions: More operative time and more blood loss reflected that LM demanded skills, experience and equipment

Procedural sedation analgesia

OpenAIRE

Sheta, Saad A

2010-01-01

The number of noninvasive and minimally invasive procedures performed outside of the operating room has grown exponentially over the last several decades. Sedation, analgesia, or both may be needed for many of these interventional or diagnostic procedures. Individualized care is important when determining if a patient requires procedural sedation analgesia (PSA). The patient might need an anti-anxiety drug, pain medicine, immobilization, simple reassurance, or a combination of these interve...

Comparing de novo assemblers for 454 transcriptome data

Directory of Open Access Journals (Sweden)

Blaxter Mark L

2010-10-01

Full Text Available Abstract Background Roche 454 pyrosequencing has become a method of choice for generating transcriptome data from non-model organisms. Once the tens to hundreds of thousands of short (250-450 base reads have been produced, it is important to correctly assemble these to estimate the sequence of all the transcripts. Most transcriptome assembly projects use only one program for assembling 454 pyrosequencing reads, but there is no evidence that the programs used to date are optimal. We have carried out a systematic comparison of five assemblers (CAP3, MIRA, Newbler, SeqMan and CLC to establish best practices for transcriptome assemblies, using a new dataset from the parasitic nematode Litomosoides sigmodontis. Results Although no single assembler performed best on all our criteria, Newbler 2.5 gave longer contigs, better alignments to some reference sequences, and was fast and easy to use. SeqMan assemblies performed best on the criterion of recapitulating known transcripts, and had more novel sequence than the other assemblers, but generated an excess of small, redundant contigs. The remaining assemblers all performed almost as well, with the exception of Newbler 2.3 (the version currently used by most assembly projects, which generated assemblies that had significantly lower total length. As different assemblers use different underlying algorithms to generate contigs, we also explored merging of assemblies and found that the merged datasets not only aligned better to reference sequences than individual assemblies, but were also more consistent in the number and size of contigs. Conclusions Transcriptome assemblies are smaller than genome assemblies and thus should be more computationally tractable, but are often harder because individual contigs can have highly variable read coverage. Comparing single assemblers, Newbler 2.5 performed best on our trial data set, but other assemblers were closely comparable. Combining differently optimal assemblies

Assessment of Patients Radiation Dose During Interventional Radiological Procedure in PPUKM

International Nuclear Information System (INIS)

Mohd Khalid Matori; Husaini Salleh; Muhammad Jamal Muhammad Isa

2014-01-01

Interventional Radiology (IR) is a relatively new subspecialty of radiology. It is subspecialty where minimally invasive procedures are performed under radiological guidance using X-ray. This procedure can deliver high radiation doses compared with other radiological method due to long screening time. Because of these it is important to determine radiation doses received by patients undergoing IR procedures. It is to ensure that the dose is within the range deemed to be saved. A total of 128 patients undergoing IR procedures in PPUKM between 2012 and 2013 were study retrospectively. Dose area product (DAP) meter were used to measure the integral dose for the whole procedures. Mean kerma-area products for abdomen, head, pelvis, and thorax were 243.1, 107.3, 39.05 and 45.7 Gycm 2 , respectively. This study may provide the useful information which can be use to establish baseline patient dose data for dose optimizing study and carried out a recommendation on effective method of patient dose reduction during IR procedures. A more detail results of this study are presented in this paper. (author)

Avoiding Psychological Pitfalls in Aesthetic Medical Procedures.

Science.gov (United States)

Wang, Qiuyu; Cao, Chuan; Guo, Rui; Li, Xiaoge; Lu, Lele; Wang, Wenping; Li, Shirong

2016-12-01

To assess the prevalence of body dysmorphic disorder (BDD) in an aesthetic surgery setting in the region of Southwest China, and to ascertain the differences in terms of body images between patients in the aesthetic setting and general Chinese population. This study tracked patient satisfaction with their body image changes while undergoing aesthetic medical procedures to identify whether the condition of patients who were presenting with BDD symptoms or their psychological symptoms could be improved by enhancing their appearance. Additionally, this study explored whether there was improvement in quality of life (QoL) and self-esteem after aesthetic medical procedures. A total of 106 female patients who were undergoing aesthetic medical procedures for the first time (plastic surgery, n = 26; minimally invasive aesthetic treatment, n = 42; and aesthetic dermatological treatment, n = 38) were classified as having body dysmorphic disorder symptoms or not having body dysmorphic disorder symptoms, based on the body dysmorphic disorder examination (BDDE), which was administered preoperatively. These patients were followed up for 1 month after the aesthetic procedures. The multidimensional body self-relations questionnaire-appearance scales (MBSRQ-AS) and rosenberg self-esteem scale (RSE-S) were used to assess patients' preoccupation with appearance and self-esteem pre-procedure and 1 month post-procedure. Additionally, 100 female healthy control participants were recruited as a comparative group into this study and they were also assessed using BDDE, MBSRQ-AS, and RSE-S. A total of 14.2 % of 106 aesthetic patients and 1 % of 100 healthy controls were diagnosed with BDD to varying extents. BDDE scores were 72.83 (SD ± 30.7) and 68.18 (SD ± 31.82), respectively, before and after the procedure for the aesthetic patient group and 43.44 (SD ± 15.65) for the healthy control group (F = 34.28; p aesthetic patients (pre-procedure) and female adult norms from

Patient radiation exposure in right versus left trans-radial approach for coronary procedures

Energy Technology Data Exchange (ETDEWEB)

Rigattieri, Stefano; Di Russo, Cristian; Cera, Maria; Fedele, Silvio; Sciahbasi, Alessandro [Interventional Cardiology Unit, Sandro Pertini Hospital, Rome (Italy); Pugliese, Francesco Rocco [Emergency Department Sandro Pertini Hospital, Rome (Italy)

2015-01-15

Objectives: The aim of this study was to compare radiation exposure, assessed by dose-area product (DAP), in right trans-radial approach (RR) versus left trans-radial approach (LR) for coronary procedures. Background: In LR the catheter course is more similar to trans-femoral approach, thus allowing an easier negotiation of coronary ostia which, in turn, might translate into reduced fluoroscopy time (FT) and radiation exposure as compared to RR. Methods: We retrospectively selected diagnostic and interventional procedures (PCI) performed by RR or LR at our center from May 2009 to May 2014. We only included in the analysis the procedures in which DAP values were available. Results: We analyzed 1464 procedures, 1175 of which performed by RR (80.3%) and 289 by LR (19.7%). Median DAP values were significantly higher in RR as compared to LR for diagnostic and interventional procedures (4482 vs. 3540 cGy.cm{sup 2} and 11523 vs. 10086 cGy.cm{sup 2}, respectively; p < 0.05). No significant differences were observed in FT and in contrast volume (CV). In the propensity-matched cohort, consisting of 269 procedures for each group, no significant differences between LR and RR were observed in median DAP values for both diagnostic and interventional procedures (3990 vs. 3542 cGy.cm{sup 2} and 9964 vs. 10216 cGy.cm{sup 2}, respectively; p = ns); FT and CV were also similar. At multiple linear regression analysis laterality of trans-radial approach was not associated with DAP. Conclusions: In an experienced trans-radial center LR is not associated with a reduction in radiation exposure, FT or CV as compared to RR. - Highlights: • Right trans-radial approach is by far more commonly used than left trans-radial approach. • Left trans-radial approach has the advantage of an easier catheter manipulation, more similar to trans-femoral approach. • This could reduce fluoroscopy time and radiation exposure. • We conducted a retrospective study to investigate patient radiation

New Procedure to Develop Lumped Kinetic Models for Heavy Fuel Oil Combustion

KAUST Repository

Han, Yunqing

2016-09-20

A new procedure to develop accurate lumped kinetic models for complex fuels is proposed, and applied to the experimental data of the heavy fuel oil measured by thermogravimetry. The new procedure is based on the pseudocomponents representing different reaction stages, which are determined by a systematic optimization process to ensure that the separation of different reaction stages with highest accuracy. The procedure is implemented and the model prediction was compared against that from a conventional method, yielding a significantly improved agreement with the experimental data. © 2016 American Chemical Society.

HASL procedures manual

International Nuclear Information System (INIS)

Harley, J.H.

1977-08-01

Additions and corrections to the following sections of the HASL Procedures Manual are provided: General, Sampling, Field Measurements; General Analytical Chemistry, Chemical Procedures, Data Section, and Specifications

Adopting wedge hepatic venography with CO2 during transjugular intrahepatic portosystemic shunt procedures

International Nuclear Information System (INIS)

Zhang Linpeng; Chen Songtao; Shi Xiulan

2012-01-01

Objective: To renovate angiography in identifying portal vein anatomy during transjugular intrahepatic portosystemic shunt (TIPS) procedures, saving the time of TIPS procedures, decreasing the risk of the complications of the post-procedure. Methods: The difference between the Wedge hepatic venography with Carbon Dioxide in 6 cases and Inferior Mesenteric artery angiography in 7 cases during TIPS procedures were compared in the identification of portal vein anatomy. The quality of images, their effects on the procedures, the complications and the recovery post-procedure were evaluated. Results: Using CO 2 , the portal veins were opacified in all 6 cases. TIPS procedures succeeded in all cases except 1 case because of poor coagulation function. Using Inferior Mesenteric artery angiography, the portal veins were opacified in all 7 cases. TIPS procedure succeeded in all cases except 1 case because of chronic portal occlusion. Puncture-site hematoma occurred in 1 case after TIPS procedure. Conclusion: Wedge hepatic venography with Carbon Dioxide is superior, safer and more convenient than Inferior Mesenteric Artery angiography in identifying portal vein anatomy during TIPS. (authors)

Transversal of Procedure Elements in a Computerized Procedure System

Energy Technology Data Exchange (ETDEWEB)

Jung, Yeonsub [KHNP Central Research Institute, Daejeon (Korea, Republic of)

2014-05-15

APR1400 MCR(Main Control Room) has introduced CPS(Computerized Procedure System). APR400 CPS is framed with overview pane, step detail pane, and monitoring pane. The overview shows the step in one dimensional array. Diagram in the step detail pane is called as flowlogic diagram. The flowlogic diagram has advantage of being intuitive and not being segmented so that the interfaces are easy to follow and understand. While developing CPS software or training operators these interfaces, however, there is still areas to refine behaviors of flowlogic diagram. If flowlogic diagram has contingency instructions, it is sometime difficult to interpret it properly. Therefore this paper is trying to explain behavior of flowlogic diagram in view of procedure elements. Procedure execution can be called as transversal of steps and instructions in flowlogic diagram. Both hierarchy of procedures elements and flowlogic diagram provides useful framework to test transversal with completeness. Navigation button behaviors are interpreted in view of flowlogic diagram. The framework and flowlogic diagram can be further applied to improve CPS user interfaces.

The Effect of an Orthopaedic Surgical Procedure in the National Basketball Association.

Science.gov (United States)

Minhas, Shobhit V; Kester, Benjamin S; Larkin, Kevin E; Hsu, Wellington K

2016-04-01

Professional basketball players have a high incidence of injuries requiring surgical intervention. However, no studies in the current literature have compared postoperative performance outcomes among common injuries to determine high- and low-risk procedures to these athletes' careers. To compare return-to-play (RTP) rates and performance-based outcomes after different orthopaedic procedures in National Basketball Association (NBA) players and to determine which surgeries are associated with the worst postoperative change in performance. Cohort study; Level of evidence, 3. Athletes in the NBA undergoing anterior cruciate ligament reconstruction, Achilles tendon repair, lumbar discectomy, microfracture, meniscus surgery, hand/wrist or foot fracture fixation, and shoulder stabilization were identified through team injury reports and archives on public record. The RTP rate, games played per season, and player efficiency rating (PER) were determined before and after surgery. Statistical analysis was used to compare the change between pre- and postsurgical performance among the different injuries. A total of 348 players were included. The RTP rates were highest in patients with hand/wrist fractures (98.1%; mean age, 27.0 years) and lowest for those with Achilles tears (70.8%; mean age, 28.4 years) (P = .005). Age ≥30 years (odds ratio [OR], 3.85; 95% CI, 1.24-11.91) and body mass index ≥27 kg/m(2) (OR, 3.46; 95% CI, 1.05-11.40) were predictors of not returning to play. Players undergoing Achilles tendon repair and arthroscopic knee surgery had a significantly greater decline in postoperative performance outcomes at the 1- and 3-year time points and had shorter career lengths compared with the other procedures. NBA players undergoing Achilles tendon rupture repair or arthroscopic knee surgery had significantly worse performance postoperatively compared with other orthopaedic procedures. © 2016 The Author(s).

Usefulness of perineal ultrasonography after tension-free vaginal tape procedure for stress urinary incontinence

International Nuclear Information System (INIS)

Yoon, Seong Kuk

2005-01-01

To evaluate the usefulness of perineal ultrasonography after a tension-free vaginal tape (TVT) procedure in women with stress urinary incontinence. Thirty-four patients with stress urinary incontinence who underwent the TVT procedure were included in this study. We compared the perineal ultrasonography findings before and after the procedure. The mean age was 49 years (rang: 32-75 years) and the mean follow-up time was 9.5 days (range: 5-19 days). We obtained the entire sagittal image of the bladder neck, urethra, urethrovesical junction and symphysis pubis. The posterior urethrovesical angle (PUVA) and descent of the bladder neck at rest and during stress, and the diameter of proximal urethra at rest were all evaluated. We compared these ultrasonographic changes before and after the procedure. Before the TVT procedure, the PUVA was 134.7 ± 5.9 .deg. at rest and 146.8 ± 8.5 .deg. during stress, and the difference between PUVA at rest and during stress was 12.2 ± 7.3 .deg. . After the TVT procedure, the PUVA significantly decreased to 125.6 ± 7.5 .deg. at rest and 132.5 ± 8.3 .deg. during stress, and the difference also significantly decreased to 7.0 ± 5.0 .deg. (ρ < 0.01). Before the procedure, the descent of the bladder neck was 17 ± 7.0 mm, while the descent significantly decreased to 7.7 ± 4.1 mm after the procedure (ρ < 0.01). Before the procedure, the diameter of the proximal urethra was 5.6 ± 1.4 mm at rest, but the diameter was 5.5 ± 1.1 mm, without significant change, after the procedure. Follow-up perineal ultrasonography after the TVT procedure may be useful for evaluating changes including the PUVA, descent and appearance of the bladder neck

Usefulness of perineal ultrasonography after tension-free vaginal tape procedure for stress urinary incontinence

Energy Technology Data Exchange (ETDEWEB)

Yoon, Seong Kuk [Donga University College of Medicine, Busan (Korea, Republic of)

2005-07-15

To evaluate the usefulness of perineal ultrasonography after a tension-free vaginal tape (TVT) procedure in women with stress urinary incontinence. Thirty-four patients with stress urinary incontinence who underwent the TVT procedure were included in this study. We compared the perineal ultrasonography findings before and after the procedure. The mean age was 49 years (rang: 32-75 years) and the mean follow-up time was 9.5 days (range: 5-19 days). We obtained the entire sagittal image of the bladder neck, urethra, urethrovesical junction and symphysis pubis. The posterior urethrovesical angle (PUVA) and descent of the bladder neck at rest and during stress, and the diameter of proximal urethra at rest were all evaluated. We compared these ultrasonographic changes before and after the procedure. Before the TVT procedure, the PUVA was 134.7 {+-} 5.9 .deg. at rest and 146.8 {+-} 8.5 .deg. during stress, and the difference between PUVA at rest and during stress was 12.2 {+-} 7.3 .deg. . After the TVT procedure, the PUVA significantly decreased to 125.6 {+-} 7.5 .deg. at rest and 132.5 {+-} 8.3 .deg. during stress, and the difference also significantly decreased to 7.0 {+-} 5.0 .deg. ({rho} < 0.01). Before the procedure, the descent of the bladder neck was 17 {+-} 7.0 mm, while the descent significantly decreased to 7.7 {+-} 4.1 mm after the procedure ({rho} < 0.01). Before the procedure, the diameter of the proximal urethra was 5.6 {+-} 1.4 mm at rest, but the diameter was 5.5 {+-} 1.1 mm, without significant change, after the procedure. Follow-up perineal ultrasonography after the TVT procedure may be useful for evaluating changes including the PUVA, descent and appearance of the bladder neck.

Pollutant Assessments Group procedures manual: Volume 2, Technical procedures

Energy Technology Data Exchange (ETDEWEB)

1992-03-01

This is volume 2 of the manuals that describes the technical procedures currently in use by the Pollution Assessments Group. This manual incorporates new developments in hazardous waste assessment technology and administrative policy. Descriptions of the equipment, procedures and operations of such things as radiation detection, soil sampling, radionuclide monitoring, and equipment decontamination are included in this manual. (MB)

Usefulness of ultrasonography in follow-up evaluation after Ilizarov procedure : comparison with plain radiography

Energy Technology Data Exchange (ETDEWEB)

Lee, Jong Hoon; Jee, Sung Woo; Lee, Ho Won; Lee, Sung Moon; Kim, Jung Sik; Kim, Hong; Song, Kwang Soon; Woo, Sung Ku [Keimyung University, Taegu (Korea, Republic of). School of Medicine; Cho, Kil Ho [Yeungnam Univ., Taegu (Korea, Republic of). School of Medicine

1998-06-01

The purpose of this study is to compare the usefulness of ultrasonography in follow up evaluation after the Ilizarov procedure with that of plain radiography. We analyzed ultrasound findings in twelve patients who had undergone the Ilizarov procedure, and retrospectively compared the results with the findings of plain radiography. The procedure was performed due to post-traumatic limb deformity or non-union (nine of twelve patients), congenital pseudoarthrosis (one case), sequelae of poliomyelitis (one case), and short stature (one case). The patients` mean age was 29 years; eleven of twelve were male. Ten of twelve procedures were performed on the tibia and two on the femur. After 7-10 days, distraction was initiated at a rate of 0.25 mm four times a day. Ultrasonography was performed with a 5-10 MHz linear or convex transducer; new bone formation was defined as dotted or linear echogenic foci within a hypoechoic distraction gap. Initial ultrasonographic examination was performed 2-4 weeks after distraction, and the results were compared with those of plain radiography. Color doppler imaging was performed in three cases. After the Ilizarov bone lengthening procedure, ultrasound appears to be useful for follow-up examination. New bone formation, as well as complications, can be detected earlier; it can indicate whether ultrasound-guided interventional procedure is required, and if combined with color doppler study, is able to detect the periosteal blood supply. Further evaluation of the clinical significance of preserved periosteal blood supply seems however, to be needed. (author). 18 refs., 4 figs.

Usefulness of ultrasonography in follow-up evaluation after Ilizarov procedure : comparison with plain radiography

International Nuclear Information System (INIS)

Lee, Jong Hoon; Jee, Sung Woo; Lee, Ho Won; Lee, Sung Moon; Kim, Jung Sik; Kim, Hong; Song, Kwang Soon; Woo, Sung Ku; Cho, Kil Ho

1998-01-01

The purpose of this study is to compare the usefulness of ultrasonography in follow up evaluation after the Ilizarov procedure with that of plain radiography. We analyzed ultrasound findings in twelve patients who had undergone the Ilizarov procedure, and retrospectively compared the results with the findings of plain radiography. The procedure was performed due to post-traumatic limb deformity or non-union (nine of twelve patients), congenital pseudoarthrosis (one case), sequelae of poliomyelitis (one case), and short stature (one case). The patients' mean age was 29 years; eleven of twelve were male. Ten of twelve procedures were performed on the tibia and two on the femur. After 7-10 days, distraction was initiated at a rate of 0.25 mm four times a day. Ultrasonography was performed with a 5-10 MHz linear or convex transducer; new bone formation was defined as dotted or linear echogenic foci within a hypoechoic distraction gap. Initial ultrasonographic examination was performed 2-4 weeks after distraction, and the results were compared with those of plain radiography. Color doppler imaging was performed in three cases. After the Ilizarov bone lengthening procedure, ultrasound appears to be useful for follow-up examination. New bone formation, as well as complications, can be detected earlier; it can indicate whether ultrasound-guided interventional procedure is required, and if combined with color doppler study, is able to detect the periosteal blood supply. Further evaluation of the clinical significance of preserved periosteal blood supply seems however, to be needed. (author). 18 refs., 4 figs

Skin-to-skin care for procedural pain in neonates.

Science.gov (United States)

Johnston, Celeste; Campbell-Yeo, Marsha; Disher, Timothy; Benoit, Britney; Fernandes, Ananda; Streiner, David; Inglis, Darlene; Zee, Rebekah

2017-02-16

Skin-to-skin care (SSC), often referred to as 'kangaroo care' (KC) due to its similarity with marsupial behaviour of ventral maternal-infant contact, is one non-pharmacological intervention for pain control in infants. The primary objectives were to determine the effect of SSC alone on pain from medical or nursing procedures in neonates compared to no intervention, sucrose or other analgesics, or additions to simple SSC such as rocking; and to determine the effects of the amount of SSC (duration in minutes), method of administration (e.g. who provided the SSC) of SSC in reducing pain from medical or nursing procedures in neonatesThe secondary objectives were to determine the safety of SSC care for relieving procedural pain in infants; and to compare the SSC effect in different postmenstrual age subgroups of infants. For this update, we used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1); MEDLINE via PubMed (1966 to 25 February 2016); Embase (1980 to 25 February 2016); and CINAHL (1982 to 25 February 2016). We also searched clinical trials' databases, conference proceedings, and the reference lists of retrieved articles for randomized controlled trials and quasi-randomized trials. Studies with randomisation or quasi-randomisation, double- or single-blinded, involving term infants (≥ 37 completed weeks' postmenstrual age (PMA) to a maximum of 44 weeks' PMA and preterm infants (care, and duration of SSC. Twenty-five studies (n = 2001 infants) were included. Nineteen studies (n = 1065) used heel lance as the painful procedure, one study combined venepuncture and heel stick (n = 50), three used intramuscular injection (n = 776), one used 'vaccination' (n = 60), and one used tape removal (n = 50). The studies were generally strong and had low or uncertain risk of bias. Blinding of the intervention was not possible, making them subject to high risk, depending on the

EML procedures manual

International Nuclear Information System (INIS)

Volchok, H.L.; de Planque, G.

1982-01-01

This manual contains the procedures that are used currently by the Environmental Measurements Laboratory of the US Department of Energy. In addition a number of analytical methods from other laboratories have been included. These were tested for reliability at the Battelle, Pacific Northwest Laboratory under contract with the Division of Biomedical and Environmental Research of the AEC. These methods are clearly distinguished. The manual is prepared in loose leaf form to facilitate revision of the procedures and inclusion of additional procedures or data sheets. Anyone receiving the manual through EML should receive this additional material automatically. The contents are as follows: (1) general; (2) sampling; (3) field measurements; (4) general analytical chemistry; (5) chemical procedures; (6) data section; (7) specifications

Randomized comparison of operator radiation exposure comparing transradial and transfemoral approach for percutaneous coronary procedures: rationale and design of the minimizing adverse haemorrhagic events by TRansradial access site and systemic implementation of angioX – RAdiation Dose study (RAD-MATRIX)

International Nuclear Information System (INIS)

Sciahbasi, Alessandro; Calabrò, Paolo; Sarandrea, Alessandro; Rigattieri, Stefano; Tomassini, Francesco; Sardella, Gennaro; Zavalloni, Dennis; Cortese, Bernardo; Limbruno, Ugo; Tebaldi, Matteo; Gagnor, Andrea; Rubartelli, Paolo; Zingarelli, Antonio; Valgimigli, Marco

2014-01-01

Background: Radiation absorbed by interventional cardiologists is a frequently under-evaluated important issue. Aim is to compare radiation dose absorbed by interventional cardiologists during percutaneous coronary procedures for acute coronary syndromes comparing transradial and transfemoral access. Methods: The randomized multicentre MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX) trial has been designed to compare the clinical outcome of patients with acute coronary syndromes treated invasively according to the access site (transfemoral vs. transradial) and to the anticoagulant therapy (bivalirudin vs. heparin). Selected experienced interventional cardiologists involved in this study have been equipped with dedicated thermoluminescent dosimeters to evaluate the radiation dose absorbed during transfemoral or right transradial or left transradial access. For each access we evaluate the radiation dose absorbed at wrist, at thorax and at eye level. Consequently the operator is equipped with three sets (transfemoral, right transradial or left transradial access) of three different dosimeters (wrist, thorax and eye dosimeter). Primary end-point of the study is the procedural radiation dose absorbed by operators at thorax. An important secondary end-point is the procedural radiation dose absorbed by operators comparing the right or left radial approach. Patient randomization is performed according to the MATRIX protocol for the femoral or radial approach. A further randomization for the radial approach is performed to compare right and left transradial access. Conclusions: The RAD-MATRIX study will probably consent to clarify the radiation issue for interventional cardiologist comparing transradial and transfemoral access in the setting of acute coronary syndromes

Randomized comparison of operator radiation exposure comparing transradial and transfemoral approach for percutaneous coronary procedures: rationale and design of the minimizing adverse haemorrhagic events by TRansradial access site and systemic implementation of angioX – RAdiation Dose study (RAD-MATRIX)

Energy Technology Data Exchange (ETDEWEB)

Sciahbasi, Alessandro, E-mail: alessandro.sciahbasi@fastwebnet.it [Interventional Cardiology, Sandro Pertini Hospital – ASL RMB, Rome (Italy); Calabrò, Paolo [Division of Cardiology - Department of Cardio-Thoracic Sciences - Second University of Naples (Italy); Sarandrea, Alessandro [HSE Management, Rome (Italy); Rigattieri, Stefano [Interventional Cardiology, Sandro Pertini Hospital – ASL RMB, Rome (Italy); Tomassini, Francesco [Department of Cardiology, Infermi Hospital, Rivoli (Italy); Sardella, Gennaro [La Sapienza University, Rome (Italy); Zavalloni, Dennis [UO Emodinamica e Cardiologia Invasiva, IRCCS, Istituto Clinico Humanitas, Rozzano (Italy); Cortese, Bernardo [Interventional Cardiology, Fatebenefratelli Hospital, Milan (Italy); Limbruno, Ugo [Cardiology Unit, Misericordia Hospital, Grosseto (Italy); Tebaldi, Matteo [Cardiology Department, University of Ferrara, Department of Cardiology (Italy); Gagnor, Andrea [Department of Cardiology, Infermi Hospital, Rivoli (Italy); Rubartelli, Paolo [Villa Scassi Hospital, Genova (Italy); Zingarelli, Antonio [San Martino Hospital, Genova (Italy); Valgimigli, Marco [Thoraxcenter, Rotterdam (Netherlands)

2014-06-15

Background: Radiation absorbed by interventional cardiologists is a frequently under-evaluated important issue. Aim is to compare radiation dose absorbed by interventional cardiologists during percutaneous coronary procedures for acute coronary syndromes comparing transradial and transfemoral access. Methods: The randomized multicentre MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX) trial has been designed to compare the clinical outcome of patients with acute coronary syndromes treated invasively according to the access site (transfemoral vs. transradial) and to the anticoagulant therapy (bivalirudin vs. heparin). Selected experienced interventional cardiologists involved in this study have been equipped with dedicated thermoluminescent dosimeters to evaluate the radiation dose absorbed during transfemoral or right transradial or left transradial access. For each access we evaluate the radiation dose absorbed at wrist, at thorax and at eye level. Consequently the operator is equipped with three sets (transfemoral, right transradial or left transradial access) of three different dosimeters (wrist, thorax and eye dosimeter). Primary end-point of the study is the procedural radiation dose absorbed by operators at thorax. An important secondary end-point is the procedural radiation dose absorbed by operators comparing the right or left radial approach. Patient randomization is performed according to the MATRIX protocol for the femoral or radial approach. A further randomization for the radial approach is performed to compare right and left transradial access. Conclusions: The RAD-MATRIX study will probably consent to clarify the radiation issue for interventional cardiologist comparing transradial and transfemoral access in the setting of acute coronary syndromes.

Environmental procedures

International Nuclear Information System (INIS)

1992-01-01

The European Bank has pledged in its Agreement to place environmental management at the forefront of its operations to promote sustainable economic development in central and eastern Europe. The Bank's environmental policy is set out in the document titled, Environmental Management: The Bank's Policy Approach. This document, Environmental Procedures, presents the procedures which the European Bank has adopted to implement this policy approach with respect to its operations. The environmental procedures aim to: ensure that throughout the project approval process, those in positions of responsibility for approving projects are aware of the environmental implications of the project, and can take these into account when making decisions; avoid potential liabilities that could undermine the success of a project for its sponsors and the Bank; ensure that environmental costs are estimated along with other costs and liabilities; and identify opportunities for environmental enhancement associated with projects. The review of environmental aspects of projects is conducted by many Bank staff members throughout the project's life. This document defines the responsibilities of the people and groups involved in implementing the environmental procedures. Annexes contain Environmental Management: The Bank's Policy Approach, examples of environmental documentation for the project file and other ancillary information

New image-processing and noise-reduction software reduces radiation dose during complex endovascular procedures.

Science.gov (United States)

Kirkwood, Melissa L; Guild, Jeffrey B; Arbique, Gary M; Tsai, Shirling; Modrall, J Gregory; Anderson, Jon A; Rectenwald, John; Timaran, Carlos

2016-11-01

A new proprietary image-processing system known as AlluraClarity, developed by Philips Healthcare (Best, The Netherlands) for radiation-based interventional procedures, claims to lower radiation dose while preserving image quality using noise-reduction algorithms. This study determined whether the surgeon and patient radiation dose during complex endovascular procedures (CEPs) is decreased after the implementation of this new operating system. Radiation dose to operators, procedure type, reference air kerma, kerma area product, and patient body mass index were recorded during CEPs on two Philips Allura FD 20 fluoroscopy systems with and without Clarity. Operator dose during CEPs was measured using optically stimulable, luminescent nanoDot (Landauer Inc, Glenwood, Ill) detectors placed outside the lead apron at the left upper chest position. nanoDots were read using a microStar ii (Landauer Inc) medical dosimetry system. For the CEPs in the Clarity group, the radiation dose to surgeons was also measured by the DoseAware (Philips Healthcare) personal dosimetry system. Side-by-side measurements of DoseAware and nanoDots allowed for cross-calibration between systems. Operator effective dose was determined using a modified Niklason algorithm. To control for patient size and case complexity, the average fluoroscopy dose rate and the dose per radiographic frame were adjusted for body mass index differences and then compared between the groups with and without Clarity by procedure. Additional factors, for example, physician practice patterns, that may have affected operator dose were inferred by comparing the ratio of the operator dose to procedural kerma area product with and without Clarity. A one-sided Wilcoxon rank sum test was used to compare groups for radiation doses, reference air kermas, and operating practices for each procedure type. The analysis included 234 CEPs; 95 performed without Clarity and 139 with Clarity. Practice patterns of operators during

Results of a national survey on nuclear medicine procedures

International Nuclear Information System (INIS)

Curti, A.R.; Gatica, N.A.; Melis, H.J.

1998-01-01

Full text: In 1997, the Nuclear Regulatory Authority of Argentina carried out a compilation of data on radiopharmaceuticals administered to patients in nuclear medicine procedures. Its aim was to get information on the radiopharmaceuticals that are used in different procedures and the activity administered to the patient, to assess the radiation exposure of the population and to contribute to a global survey of medical radiation usage and exposures conducted by the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), by sending information of the country. The data compiled were analysed, and for the most frequent procedures, the mean activity administered, the standard deviation, the distribution of the number of procedures for different age groups, sex and radiopharmaceuticals were assessed. The radiation exposure for children and adults was estimated. For the main diagnostic examinations, the results of the survey were compared with specific values published in the Basic Safety Standards of the International Atomic Energy Agency (Safety Series No. 115, 1996). As a conclusion, it may be point out the importance of continuing with the compilation of this kind of information in order to identify emerging trends on the use of nuclear medicine procedures in Argentina and the activity of radiopharmaceuticals administered to the patients. (author) [es

Civil Procedure In Denmark

DEFF Research Database (Denmark)

Werlauff, Erik

scientific activities conducted by the author, partly based on the author's experience as a member, through a number of years, of the Danish Standing Committee on Procedural Law (Retsplejeraadet), which on a continuous basis evaluates the need for civil procedural reforms in Denmark, and finally also based......The book contains an up-to-date survey of Danish civil procedure after the profound Danish procedural reforms in 2007. It deals with questions concerning competence and function of Danish courts, commencement and preparation of civil cases, questions of evidence and burden of proof, international...... procedural questions, including relations to the Brussels I Regulation and Denmark's participation in this Regulation via a parallel convention with the EU countries, impact on Danish civil procedure of the convention on human rights, preparation and pronouncement of judgment and verdict, questions of appeal...

Prospective randomized assessment of single versus double-gloving for general surgical procedures.

Science.gov (United States)

Na'aya, H U; Madziga, A G; Eni, U E

2009-01-01

There is increased tendency towards double-gloving by general surgeons in our practice, due probably to awareness of the risk of contamination with blood or other body fluids during surgery. The aim of the study was to compare the relative frequency of glove puncture in single-glove versus double glove sets in general surgical procedures, and to determine if duration of surgery affects perforation rate. Surgeons at random do single or double gloves at their discretion, for general surgical procedures. All the gloves used by the surgeons were assessed immediately after surgery for perforation. A total of 1120 gloves were tested, of which 880 were double-glove sets and 240 single-glove sets. There was no significant difference in the overall perforation rate between single and double glove sets (18.3% versus 20%). However, only 2.3% had perforations in both the outer and inner gloves in the double glove group. Therefore, there was significantly greater risk for blood-skin exposure in the single glove sets (p < 0.01). The perforation rate was also significantly greater during procedures lasting an hour or more compared to those lasting less than an hour (p < 0.01). Double-gloving reduces the risk of blood-skin contamination in all general surgical procedures, and especially so in procedures lasting an hour or more.

Influence of mixing procedure on robustness of self-consolidating concrete.

Science.gov (United States)

2014-08-01

Self-Consolidating Concrete is, in the fresh state, more sensitive to small variations in the constituent elements and the mixing : procedure compared to Conventional Vibrated Concrete. Several studies have been performed recently to identify robustn...

Dissociation of Procedural and Working Memory in Pigeons (Columba livia

Directory of Open Access Journals (Sweden)

Walter T. Herbranson

2016-07-01

Full Text Available A new method was developed to concurrently investigate procedural memory and working memory in pigeons. Pigeons performed a sequence of keypecks across 3 response keys in a serial response task, with periodic choice probes for the location of a recently produced response. Procedural memory was operationally defined as decreasing response times to predictable cues in the sequence. Working memory was reflected by accurate responses to the choice probes. Changing the sequence of required keypecks to a random sequence interfered with procedural memory in the form of slowed response times, but did not prevent pigeons from effectively using working memory to remember specific cue locations. Conversely, changing exposure duration of to a cue location influenced working memory but had no effect on procedural memory. Double dissociations such as this have supported the multiple systems approach to the study of memory in cognitive psychology and neuroscience, and they encourage a similar approach in comparative psychology.

Definition of an XML markup language for clinical laboratory procedures and comparison with generic XML markup.

Science.gov (United States)

Saadawi, Gilan M; Harrison, James H

2006-10-01

Clinical laboratory procedure manuals are typically maintained as word processor files and are inefficient to store and search, require substantial effort for review and updating, and integrate poorly with other laboratory information. Electronic document management systems could improve procedure management and utility. As a first step toward building such systems, we have developed a prototype electronic format for laboratory procedures using Extensible Markup Language (XML). Representative laboratory procedures were analyzed to identify document structure and data elements. This information was used to create a markup vocabulary, CLP-ML, expressed as an XML Document Type Definition (DTD). To determine whether this markup provided advantages over generic markup, we compared procedures structured with CLP-ML or with the vocabulary of the Health Level Seven, Inc. (HL7) Clinical Document Architecture (CDA) narrative block. CLP-ML includes 124 XML tags and supports a variety of procedure types across different laboratory sections. When compared with a general-purpose markup vocabulary (CDA narrative block), CLP-ML documents were easier to edit and read, less complex structurally, and simpler to traverse for searching and retrieval. In combination with appropriate software, CLP-ML is designed to support electronic authoring, reviewing, distributing, and searching of clinical laboratory procedures from a central repository, decreasing procedure maintenance effort and increasing the utility of procedure information. A standard electronic procedure format could also allow laboratories and vendors to share procedures and procedure layouts, minimizing duplicative word processor editing. Our results suggest that laboratory-specific markup such as CLP-ML will provide greater benefit for such systems than generic markup.

A randomized controlled trial to compare fentanyl-propofol and ketamine-propofol combination for procedural sedation and analgesia in laparoscopic tubal ligation

Directory of Open Access Journals (Sweden)

Ranju Singh

2013-01-01

Full Text Available Background: Procedural sedation and analgesia is widely being used for female laparoscopic sterilization using combinations of different drugs at varying doses. This study compared the combination of fentanyl and propofol, and ketamine and propofol in patients undergoing outpatient laparoscopic tubal ligation, with respect to their hemodynamic effects, postoperative recovery characteristics, duration of hospital stay, adverse effects, and patient comfort and acceptability. Settings and Design: Randomized, double blind. Methods: Patients were assigned to receive premixed injection of either fentanyl 1.5 μg/kg + propofol 2 mg/kg (Group PF, n0=50 or ketamine 0.5 mg/kg + propofol 2 mg/kg (Group PK, n=50. Hemodynamic data, peripheral oxygen saturation, and respiratory rate were recorded perioperatively. Recovery time, time to discharge, and comfort score were noted. Statistical Analysis: Chi-square (χ2 test was used for categorical data. Student′s t-test was used for quantitative variables for comparison between the two groups. For intragroup comparison, paired t-test was used. SPSS 14.0 was used for analysis. Results: Although the heart rate was comparable, blood pressures were consistently higher in group PK. Postoperative nausea and vomiting and delay in voiding were more frequent in group PK ( P<0.05. The time to reach Aldrete score ≥8 was significantly longer in group PK (11.14±3.29 min in group PF vs. 17.3±6.32 min in group PK, P<0.01. The time to discharge was significantly longer in group PK (105.8±13.07 min in group PF vs.138.18±13.20 min in group PK, P<0.01. Patient comfort and acceptability was better in group PF, P<0.01. Conclusion: As compared to ketamine-propofol, fentanyl-propofol combination is associated with faster recovery, earlier discharge, and better patient acceptability.

Precision of guided scanning procedures for full-arch digital impressions in vivo.

Science.gov (United States)

Zimmermann, Moritz; Koller, Christina; Rumetsch, Moritz; Ender, Andreas; Mehl, Albert

2017-11-01

System-specific scanning strategies have been shown to influence the accuracy of full-arch digital impressions. Special guided scanning procedures have been implemented for specific intraoral scanning systems with special regard to the digital orthodontic workflow. The aim of this study was to evaluate the precision of guided scanning procedures compared to conventional impression techniques in vivo. Two intraoral scanning systems with implemented full-arch guided scanning procedures (Cerec Omnicam Ortho; Ormco Lythos) were included along with one conventional impression technique with irreversible hydrocolloid material (alginate). Full-arch impressions were taken three times each from 5 participants (n = 15). Impressions were then compared within the test groups using a point-to-surface distance method after best-fit model matching (OraCheck). Precision was calculated using the (90-10%)/2 quantile and statistical analysis with one-way repeated measures ANOVA and post hoc Bonferroni test was performed. The conventional impression technique with alginate showed the lowest precision for full-arch impressions with 162.2 ± 71.3 µm. Both guided scanning procedures performed statistically significantly better than the conventional impression technique (p Cerec Omnicam Ortho were 74.5 ± 39.2 µm and for group Ormco Lythos 91.4 ± 48.8 µm. The in vivo precision of guided scanning procedures exceeds conventional impression techniques with the irreversible hydrocolloid material alginate. Guided scanning procedures may be highly promising for clinical applications, especially for digital orthodontic workflows.

The medical practice of euthanasia in Belgium and The Netherlands: legal notification, control and evaluation procedures.

Science.gov (United States)

Smets, Tinne; Bilsen, Johan; Cohen, Joachim; Rurup, Mette L; De Keyser, Els; Deliens, Luc

2009-05-01

To describe and compare current legal procedures for notifying, controlling and evaluating (NCE-procedures) euthanasia in Belgium and the Netherlands, and to discuss the implications for a safe and controllable euthanasia practice. We systematically studied and compared official documents relating to the Belgian and the Dutch NCE-procedures for euthanasia. In both countries, physicians are required to notify their cases to a review Committee, stimulating them to safeguard the quality of their euthanasia practice and to make societal control over the practice of euthanasia possible. However, the procedures in both countries differ. The main differences are that the Dutch notification and control procedures are more elaborate and transparent than the Belgian, and that the Belgian procedures are primarily anonymous, whereas the Dutch are not. Societal evaluation is made in both countries through the Committees' summary reports to Parliament. Transparent procedures like the Dutch may better facilitate societal control. Informing physicians about the law and the due care requirements for euthanasia, and systematic feedback about their medical actions are both pivotal to achieving efficient societal control and engendering the level of care needed when performing such far-reaching medical acts.

Frey procedure combined with biliary diversion in chronic pancreatitis.

Science.gov (United States)

Merdrignac, Aude; Bergeat, Damien; Rayar, Michel; Harnoy, Yann; Turner, Kathleen; Courtin-Tanguy, Laetitia; Boudjema, Karim; Meunier, Bernard; Sulpice, Laurent

2016-11-01

The Frey procedure has become the standard operative treatment in chronic painful pancreatitis. Biliary diversion could be combined when associated with common bile duct obstruction. The aim of the present study was to evaluate the impact of the type of biliary diversion combined with the Frey procedure on late morbidity. The data from consecutive patients undergoing the Frey procedure and having a minimum follow-up of 2 years were extracted from a maintained prospective database. The mean endpoint was the rate of secondary biliary stricture after the Frey procedure combined with biliary diversion (bilioenteric anastomosis or common bile duct reinsertion in the resection cavity). Between 2006 and 2013, 55 consecutive patients underwent the Frey procedure. Twenty-nine patients had common bile duct obstruction (52.7%). The technique of biliary diversion resulted in bilioenteric anastomosis in 19 patients (65.5%) and common bile duct reinsertion in 10 patients (34.5%). Preoperative characteristics and early surgical outcomes were comparable. Pain control was similar. There was significantly more secondary biliary stricture after common bile duct reinsertion than after bilioenteric anastomosis (60% vs 11%, P = .008). Combined bilioenteric anastomosis during the Frey procedure is an efficient technique for treating common bile duct obstruction that complicates chronic painful pancreatitis. Bilioenteric anastomosis was associated with less secondary biliary stricture than common bile duct reinsertion in the pancreatic resection cavity. Copyright © 2016 Elsevier Inc. All rights reserved.

Robotic Whipple Procedure for Pancreatic Cancer: The Moffitt Cancer Center Pathway.

Science.gov (United States)

Rashid, Omar M; Mullinax, John E; Pimiento, Jose M; Meredith, Kenneth L; Malafa, Mokenge P

2015-07-01

Resection of malignancies in the head and uncinate process of the pancreas (Whipple procedure) using a robotic approach is emerging as a surgical option. Although several case series of the robotic Whipple procedure have been reported, detailed descriptions of operative techniques and a clear pathway for adopting this technology are lacking. We present a focused review of the procedure as it applies to pancreatic cancer and describe our clinical pathway for the robotic Whipple procedure used in pancreatic cancer and review the outcomes of our early experience. A systematic review of the literature is provided, focusing on the indications, variations in surgical techniques, complications, and oncological results of the robotic Whipple procedure. A clinical pathway has been defined for preoperative training of surgeons, the requirements for hospital privileges, patient selection, and surgical techniques for the robotic Whipple procedure. The robotic technique for managing malignant lesions of the pancreas head is safe when following well-established guidelines for adopting the technology. Preliminary data demonstrate that perioperative convalescence may exceed end points when compared with the open technique. The robotic Whipple procedure is a minimally invasive approach for select patients as part of multidisciplinary management of periampullary lesions in tertiary centers where clinicians have developed robotic surgical programs. Prospective trials are needed to define the short- and long-term benefits of the robotic Whipple procedure.

A simple but accurate procedure for solving the five-parameter model

International Nuclear Information System (INIS)

Mares, Oana; Paulescu, Marius; Badescu, Viorel

2015-01-01

Highlights: • A new procedure for extracting the parameters of the one-diode model is proposed. • Only the basic information listed in the datasheet of PV modules are required. • Results demonstrate a simple, robust and accurate procedure. - Abstract: The current–voltage characteristic of a photovoltaic module is typically evaluated by using a model based on the solar cell equivalent circuit. The complexity of the procedure applied for extracting the model parameters depends on data available in manufacture’s datasheet. Since the datasheet is not detailed enough, simplified models have to be used in many cases. This paper proposes a new procedure for extracting the parameters of the one-diode model in standard test conditions, using only the basic data listed by all manufactures in datasheet (short circuit current, open circuit voltage and maximum power point). The procedure is validated by using manufacturers’ data for six commercially crystalline silicon photovoltaic modules. Comparing the computed and measured current–voltage characteristics the determination coefficient is in the range 0.976–0.998. Thus, the proposed procedure represents a feasible tool for solving the five-parameter model applied to crystalline silicon photovoltaic modules. The procedure is described in detail, to guide potential users to derive similar models for other types of photovoltaic modules.

A new immunization procedure for the obtention of anti-leucine enkephalin antibodies. Part I. Immunization procedure and physicochemical characteristics of antibodies.

Science.gov (United States)

Cupo, A; Vion-Dury, J; Jarry, T

1986-10-01

We described here a new immunization procedure to obtain high titre and high specific antibodies against Leu-enkephalin (LE). The immunogen form is composed of one part of LE conjugate and one part of LE-Arg6 conjugate. We have observed an increase of titre, affinity and specificity of the antibodies in the coimmunization procedure compared to those obtained by conventional immunization involving only the LE conjugate. The Leu-enkephalin antibodies exhibit a high affinity (KD 8 X 10(-12) M) and we are able to detect the Leu-enkephalin at the 10(-15) mole level. These LE antibodies are highly specific of the C part of LE peptide and cross-react weakly with Met-enkephalin (1%).

Effects of combination of sibutramine and L-carnitine compared with sibutramine monotherapy on inflammatory parameters in diabetic patients.

Science.gov (United States)

Derosa, Giuseppe; Maffioli, Pamela; Salvadeo, Sibilla A T; Ferrari, Ilaria; Gravina, Alessia; Mereu, Roberto; D'Angelo, Angela; Palumbo, Ilaria; Randazzo, Sabrina; Cicero, Arrigo F G

2011-03-01

The aim of the study was to evaluate the effects of 12-month treatment with sibutramine plus L-carnitine compared with sibutramine alone on body weight, glycemic control, insulin resistance, and inflammatory state in type 2 diabetes mellitus patients. Two hundred fifty-four patients with uncontrolled type 2 diabetes mellitus (glycated hemoglobin [HbA(1c)] >8.0%) in therapy with different oral hypoglycemic agents or insulin were enrolled in this study and randomized to take sibutramine 10 mg plus L-carnitine 2 g or sibutramine 10 mg in monotherapy. We evaluated at baseline and after 3, 6, 9, and 12 months these parameters: body weight, body mass index, HbA(1c), fasting plasma glucose, postprandial plasma glucose, fasting plasma insulin, homeostasis model assessment of insulin resistance index, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, leptin, tumor necrosis factor-α, adiponectin, vaspin, and high-sensitivity C-reactive protein. Sibutramine plus L-carnitine gave a faster improvement of fasting plasma glucose, postprandial plasma glucose, lipid profile, leptin, tumor necrosis factor-α, and high-sensitivity C-reactive protein compared with sibutramine alone. Furthermore, there was a better improvement of body weight, HbA(1c), fasting plasma insulin, homeostasis model assessment of insulin resistance index, vaspin, and adiponectin with sibutramine plus L-carnitine compared with sibutramine alone. Sibutramine plus L-carnitine gave a better and faster improvement of all the analyzed parameters compared with sibutramine alone without giving any severe adverse effect. Copyright © 2011 Elsevier Inc. All rights reserved.

Occupational and patient exposure in coronary angiography procedures

International Nuclear Information System (INIS)

Sulieman, A.; Alzimami, K.; Gafar, R.; Babikir, E.; Alsafi, K.; Suliman, I.I.

2014-01-01

Cardiac catheterization is the gold standard in the diagnosis and management of coronary artery diseases. The objectives of this study were to evaluate the radiation dose of patients and staff during cardiology procedures. Staff was monitored using thermoluminescence dosimeter (TLD) chips for 86 procedures. The mean patient dose was 2813.6 µGy m 2 and the mean fluoroscopic time was 4.8 min. The mean radiation doses for cardiologists were 0.9 mGy for the forehead, 0.92 mGy for the thyroid, 1.38 mGy for the chest, 1.28 mGy for the waist and 1.41 mGy for the hand. The mean radiation doses for assistants were 0.72 mGy for the chest, 0.82 mGy for the hand. High patient and staff exposure is due to lack of experience and protective equipment, exacerbated by a high workload. Interventional procedures remain operator dependent; therefore, continuous training is crucial. - Highlights: • Patients and staff radiation doses were evaluated during coronary angiography procedures. • Radiation doses were measured using calibrated TLD GR200A. • Radiation doses to patients and staff are comparable with previous studies. • Patient radiation doses fall below the threshold for radiation-induced skin injuries

[Results of an experience with the Bentall procedure].

Science.gov (United States)

Gallego, Javier; Ferreira, R; Roque, J; Guerra, N; Gennari, M; Serpa, C; Mendes, S; Mendes, M; Lucero, R; Lemos, A; Pereira, R; Nobre, A; Cravino, J

2008-01-01

The authors report a retrospective study of patients who underwent a Bentall procedure in the Cardio-Thoracic Surgery Department of Hospital Santa Maria, Lisbon. Data were obtained from 42 patients who underwent the Bentall procedure between 1991 and 2008. Different parameters were compared as well as the short and long term results. The median age was 58,5 years being 88% of patients of male gender. 32 (76,27%) presented with ascending aorta degenerative aneurism, 6 p (14,3%) with type A aortic dissection and 4p (9,5%) with Marfan syndrome. 10p(23.8%) had associated coronary artery disease and there were 6p (14.3%) who underwent emergency surgery. Among the risk factors associated, 24 p (57,1%) had hypertension, 12 p (28,6%) dyslipidemia, 4p (9,5%) had history of smoking, 7 p (16,7%) diabetes, 6 p (14,3%) CPOD, 2 p (4,8%) renal dysfunction and 2 had a recent myocardial infarction. There were 7p (16,7%) with left ventricular dysfunction (EFBentall procedure obtained good results in short and long term and, despite the emerging of new and more complex techniques like remodelling and reimplantation, our results support the maintenance of this procedure as the preferential treatment for aortic root and valvular disease.

Multivessel supercritical fluid extraction of food items in Total Diet Study.

Science.gov (United States)

Hopper, M L; King, J W; Johnson, J H; Serino, A A; Butler, R J

1995-01-01

An off-line, large capacity, multivessel supercritical fluid extractor (SFE) was designed and constructed for extraction of large samples. The extractor can simultaneously process 1-6 samples (15-25 g) by using supercritical carbon dioxide (SC-CO2), which is relatively nontoxic and nonflammable, as the solvent extraction medium. Lipid recoveries for the SFE system were comparable to those obtained by blending or Soxhlet extraction procedures. Extractions at 10,000 psi, 80 degrees C, expanded gaseous CO2 flow rates of 4-5 L/min (35 degrees C), and 1-3 h extraction times gave reproducible lipid recoveries for pork sausage (relative standard deviation [RSD], 1.32%), corn chips (RSD, 0.46%), cheddar cheese (RSD, 1.14%), and peanut butter (RSD, 0.44%). In addition, this SFE system gave reproducible recoveries (> 93%) for butter fortified with cis-chlordane and malathion at the 100 ppm and 0.1 ppm levels. Six portions each of cheddar cheese, saltine crackers, sandwich cookies, and ground hamburger also were simultaneously extracted with SC-CO2 and analyzed for incurred pesticide residues. Results obtained with this SFE system were reproducible and comparable with results from organic-solvent extraction procedures currently used in the Total Diet Study; therefore, use and disposal of large quantities of organic solvents can be eliminated.

Determination of the performance of the Kaplan hydraulic turbines through simplified procedure

Science.gov (United States)

Pădureanu, I.; Jurcu, M.; Campian, C. V.; Haţiegan, C.

2018-01-01

A simplified procedure has been developed, compared to the complex one recommended by IEC 60041 (i.e. index samples), for measurement of the performance of the hydraulic turbines. The simplified procedure determines the minimum and maximum powers, the efficiency at maximum power, the evolution of powers by head and flow and to determine the correct relationship between runner/impeller blade angle and guide vane opening for most efficient operation of double-regulated machines. The simplified procedure can be used for a rapid and partial estimation of the performance of hydraulic turbines for repair and maintenance work.

Patient radiation dose audits for fluoroscopically guided interventional procedures

International Nuclear Information System (INIS)

Balter, Stephen; Rosenstein, Marvin; Miller, Donald L.; Schueler, Beth; Spelic, David

2011-01-01

Purpose: Quality management for any use of medical x-ray imaging should include monitoring of radiation dose. Fluoroscopically guided interventional (FGI) procedures are inherently clinically variable and have the potential for inducing deterministic injuries in patients. The use of a conventional diagnostic reference level is not appropriate for FGI procedures. A similar but more detailed quality process for management of radiation dose in FGI procedures is described. Methods: A method that takes into account both the inherent variability of FGI procedures and the risk of deterministic injuries from these procedures is suggested. The substantial radiation dose level (SRDL) is an absolute action level (with regard to patient follow-up) below which skin injury is highly unlikely and above which skin injury is possible. The quality process for FGI procedures collects data from all instances of a given procedure from a number of facilities into an advisory data set (ADS). An individual facility collects a facility data set (FDS) comprised of all instances of the same procedure at that facility. The individual FDS is then compared to the multifacility ADS with regard to the overall shape of the dose distributions and the percent of instances in both the ADS and the FDS that exceed the SRDL. Results: Samples of an ADS and FDS for percutaneous coronary intervention, using the dose metric of reference air kerma (K a,r ) (i.e., the cumulative air kerma at the reference point), are used to illustrate the proposed quality process for FGI procedures. Investigation is warranted whenever the FDS is noticeably different from the ADS for the specific FGI procedure and particularly in two circumstances: (1) When the facility's local median K a,r exceeds the 75th percentile of the ADS and (2) when the percent of instances where K a,r exceeds the facility-selected SRDL is greater for the FDS than for the ADS. Conclusions: Analysis of the two data sets (ADS and FDS) and of the

House officer procedure documentation using a personal digital assistant: a longitudinal study

Directory of Open Access Journals (Sweden)

Lane David R

2006-01-01

Full Text Available Abstract Background Personal Digital Assistants (PDAs have been integrated into daily practice for many emergency physicians and house officers. Few objective data exist that quantify the effect of PDAs on documentation. The objective of this study was to determine whether use of a PDA would improve emergency medicine house officer documentation of procedures and patient resuscitations. Methods Twelve first-year Emergency Medicine (EM residents were provided a Palm V (Palm, Inc., Santa Clara, California, USA PDA. A customizable patient procedure and encounter program was constructed and loaded into each PDA. Residents were instructed to enter information on patients who had any of 20 procedures performed, were deemed clinically unstable, or on whom follow-up was obtained. These data were downloaded to the residency coordinator's desktop computer on a weekly basis for 36 months. The mean number of procedures and encounters performed per resident over a three year period were then compared with those of 12 historical controls from a previous residency class that had recorded the same information using a handwritten card system for 36 months. Means of both groups were compared a two-tailed Student's t test with a Bonferroni correction for multiple comparisons. One hundred randomly selected entries from both the PDA and handwritten groups were reviewed for completeness. Another group of 11 residents who had used both handwritten and PDA procedure logs for one year each were asked to complete a questionnaire regarding their satisfaction with the PDA system. Results Mean documentation of three procedures significantly increased in the PDA vs handwritten groups: conscious sedation 24.0 vs 0.03 (p = 0.001; thoracentesis 3.0 vs 0.0 (p = 0.001; and ED ultrasound 24.5 vs. 0.0 (p = 0.001. In the handwritten cohort, only the number of cardioversions/defibrillations (26.5 vs 11.5 was statistically increased (p = 0.001. Of the PDA entries, 100% were entered

Exposure from diagnostic nuclear medicine procedures

International Nuclear Information System (INIS)

Iacob, O.; Diaconescu, C.; Isac, R.

2002-01-01

According to our last national study on population exposures from natural and artificial sources of ionizing radiation, 16% of overall annual collective effective dose represent the contribution of diagnostic medical exposures. Of this value, 92% is due to diagnostic X-ray examinations and only 8% arise from diagnostic nuclear medicine procedures. This small contribution to collective dose is mainly the result of their lower frequency compared to that of the X-ray examinations, doses delivered to patients being, on average, ten times higher. The purpose of this review was to reassess the population exposure from in vivo diagnostic nuclear medicine procedures and to evaluate the temporal trends of diagnostic usage of radiopharmaceuticals in Romania. The current survey is the third one conducted in the last decade. As in the previous ones (1990 and 1995), the contribution of the Radiation Hygiene Laboratories Network of the Ministry of Health and Family in collecting data from nuclear medicine departments in hospitals was very important

Comparative Study of the Mutant Prevention Concentrations of Moxifloxacin, Levofloxacin, and Gemifloxacin against Pneumococci▿ †

Science.gov (United States)

Credito, Kim; Kosowska-Shick, Klaudia; McGhee, Pamela; Pankuch, Glenn A.; Appelbaum, Peter C.

2010-01-01

We tested the propensity of three quinolones to select for resistant Streptococcus pneumoniae mutants by determining the mutant prevention concentration (MPC) against 100 clinical strains, some of which harbored mutations in type II topoisomerases. Compared with levofloxacin and gemifloxacin, moxifloxacin had the lowest number of strains with MPCs above the susceptibility breakpoint (P < 0.001), thus representing a lower selective pressure for proliferation of resistant mutants. Only moxifloxacin gave a 50% MPC (MPC50) value (1 μg/ml) within the susceptible range. PMID:20008781

Comparative efficacy and safety of the left versus right radial approach for percutaneous coronary procedures: a meta-analysis including 6870 patients

Directory of Open Access Journals (Sweden)

S.L. Xia

2015-08-01

Full Text Available The radial approach is widely used in the treatment of patients with coronary artery disease. We conducted a meta-analysis of published results on the efficacy and safety of the left and right radial approaches in patients undergoing percutaneous coronary procedures. A systematic search of reference databases was conducted, and data from 14 randomized controlled trials involving 6870 participants were analyzed. The left radial approach was associated with significant reductions in fluoroscopy time [standardized mean difference (SMD=-0.14, 95% confidence interval (CI=-0.19 to -0.09; P<0.00001] and contrast volume (SMD=-0.07, 95%CI=-0.12 to -0.02; P=0.009. There were no significant differences in rate of procedural failure of the left and the right radial approaches [risk ratios (RR=0.98; 95%CI=0.77-1.25; P=0.88] or procedural time (SMD=-0.05, 95%CI=0.17-0.06; P=0.38. Tortuosity of the subclavian artery (RR=0.27, 95%CI=0.14-0.50; P<0.0001 was reported more frequently with the right radial approach. A greater number of catheters were used with the left than with the right radial approach (SMD=0.25, 95%CI=0.04-0.46; P=0.02. We conclude that the left radial approach is as safe as the right radial approach, and that the left radial approach should be recommended for use in percutaneous coronary procedures, especially in percutaneous coronary angiograms.

DMM assessments of attachment and adaptation: Procedures, validity and utility.

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Farnfield, Steve; Hautamäki, Airi; Nørbech, Peder; Sahhar, Nicola

2010-07-01

This article gives a brief over view of the Dynamic-Maturational Model of attachment and adaptation (DMM; Crittenden, 2008) together with the various DMM assessments of attachment that have been developed for specific stages of development. Each assessment is discussed in terms of procedure, outcomes, validity, advantages and limitations, comparable procedures and areas for further research and validation. The aims are twofold: to provide an introduction to DMM theory and its application that underlie the articles in this issue of CCPP; and to provide researchers and clinicians with a guide to DMM assessments.

A monthly quality assurance procedure for 3D surface imaging.

Science.gov (United States)

Wooten, H Omar; Klein, Eric E; Gokhroo, Garima; Santanam, Lakshmi

2010-12-21

A procedure for periodic quality assurance of a video surface imaging system is introduced. AlignRT is a video camera-based patient localization system that captures and compares images of a patient's topography to a DICOM-formatted external contour, then calculates shifts required to accurately reposition the patient. This technical note describes the tools and methods implemented in our department to verify correct and accurate operation of the AlignRT hardware and software components. The procedure described is performed monthly and complements a daily calibration of the system.

The influence of different measurement structures on NRTA test procedures

International Nuclear Information System (INIS)

Beedgen, R.

1986-01-01

The development of sequential statistical test procedures in the area of near real time material accountancy (NRTA) mostly assumed a fixed measurement model of a given model facility. In this paper different measurement models (dispersion matrices) for a sequence of balance periods are studied. They are used to compare the detection probabilities of three different sequential test procedures for losses of material. It is shown how different plant models have an influence on the sensitivity of specified tests. Great importance for that analysis have the optimal loss patterns in each measurement situation

Self-Management Procedures: A Comparison across the Autism Spectrum

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Southall, Candice M.; Gast, David L.

2011-01-01

Individuals with autism spectrum disorders (ASD) have difficulty generalizing learned behavior to varied environments with independence. This review of 24 empirical studies compares self-management as a systematic procedure for modifying one's own behavior, to increase target behaviors in students with either autistic disorder (AD) or…

Comparative Genomics of Ten Solanaceous Plastomes

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Harpreet Kaur

2014-01-01

Full Text Available Availability of complete plastid genomes of ten solanaceous species, Atropa belladonna, Capsicum annuum, Datura stramonium, Nicotiana sylvestris, Nicotiana tabacum, Nicotiana tomentosiformis, Nicotiana undulata, Solanum bulbocastanum, Solanum lycopersicum, and Solanum tuberosum provided us with an opportunity to conduct their in silico comparative analysis in depth. The size of complete chloroplast genomes and LSC and SSC regions of three species of Solanum is comparatively smaller than that of any other species studied till date (exception: SSC region of A. belladonna. AT content of coding regions was found to be less than noncoding regions. A duplicate copy of trnH gene in C. annuum and two alternative tRNA genes for proline in D. stramonium were observed for the first time in this analysis. Further, homology search revealed the presence of rps19 pseudogene and infA genes in A. belladonna and D. stramonium, a region identical to rps19 pseudogene in C. annum and orthologues of sprA gene in another six species. Among the eighteen intron-containing genes, 3 genes have two introns and 15 genes have one intron. The longest insertion was found in accD gene in C. annuum. Phylogenetic analysis using concatenated protein coding sequences gave two clades, one for Nicotiana species and another for Solanum, Capsicum, Atropa, and Datura.

Outcome of Cesarean Myomectomy: Is it a Safe Procedure?

Science.gov (United States)

Senturk, Mehmet Baki; Polat, Mesut; Doğan, Ozan; Pulatoğlu, Çiğdem; Yardımcı, Oğuz Devrim; Karakuş, Resul; Tayyar, Ahter Tanay

2017-11-01

Myomectomy performed during cesarean section is still controversial because of the potential for associated complications, especially with large myomas. Many obstetricians avoid performing cesarean myomectomy procedures because of the risk of uncontrollable hemorrhage. However, the prevalence of pregnant women with myomas is increasing, leading to an increase in the likelihood that physicians will encounter this issue. The aim of this study was to compare outcomes and complications of patients who either had or did not have cesarean myomectomy. A total of 361 patients were evaluated in this retrospective study. Patients who had cesarean section with myomectomy and patients had cesarean section without myomectomy were compared with regard to demographics, drop in hemoglobin levels, complications, blood transfusion rates and duration of operation. These parameters were also compared when the diameter of the myoma was larger than 5 cm. Values of p  0.05), the mean myoma diameter was smaller and the duration of operation was longer in the group who underwent cesarean myomectomy (p  0.05). This study shows that myomectomy during cesarean section does not increase complications or transfusion rates and appears to be a safe procedure.

A 12 years audit of upper gastrointestinal endoscopic procedures

International Nuclear Information System (INIS)

Khurram, M.; Khaar, H.B.; Hasan, Z.; Umar, M.; Javed, S.; Asghar, T.; Minhas, Z.; Akbar, A.; Atta, N.; Nassar, F.; Sultana, Q.; Pervaiz, A.; Masoom, A.

2003-01-01

Objective: Evaluation of upper gastrointestinal (GI) endoscopy in terms of indications, diagnostic efficacy, and diseases diagnosed. Results: Of the 8481 patients, 4935 (58.2%) were female and 3546 (41.8%) male. Mean patient age was 40.5 years. Dyspepsia (42.6%), upper GI bleed (32.8%), and evaluation of chronic liver disease (10.2%) were common indications of the procedure. An endoscopic diagnosis was possible in 82.6% patients. Varices, gastritis, duodenitis, and combined lesions were common endoscopic diagnosis. Gastritis and duodenitis were most frequent causes of upper GI bleed. We noted more gastric ulcers compared to duodenal ulcers. Females had significantly more normal endoscopies, p-value = 0.02. Conclusion: Upper GI endoscopy is an effective procedure. Dyspepsia evaluation is commonest indication for upper GI endoscopy in our patients. Etiology of upper GI bleed, and incidence of duodenal ulcer compared to gastric ulcer in our patients are different than described in literature. Females have significantly more normal endoscopies. (author)

Pancreaticoduodenectomy for pancreatic head cancer: PPPD versus Whipple procedure.

Science.gov (United States)

Lin, Pin-Wen; Shan, Yan-Shen; Lin, Yih-Jyh; Hung, Chung-Jye

2005-01-01

Resectable carcinoma of the head of the pancreas can be treated with either standard (the Whipple) or pylorus-preserving pancreaticoduodenectomy (PPPD). Only a few reports compared the differences between these two procedures. From July 1994 to Oct 2002, a prospective randomized comparison between the Whipple procedure and PPPD done by the same surgeon for the patients with carcinoma of the head of the pancreas was conducted. Thirty-six patients diagnosed as pancreatic head adenocarcinoma were randomized to receive either the Whipple procedure or a PPPD. Three patients initially randomized to have a PPPD were converted to the Whipple procedure due to gross duodenal involvement. Finally, 19 patients received the Whipple procedure, 14 patients underwent PPPD and three patients had conversion. Two perioperative deaths in the Whipple group and one perioperative death in PPPD resulted in an 8 percent mortality rate in the 36 patients. Median duration of the Whipple operation was 265 (range 203-475) min with a median blood loss of 570 (50-8540) mL. In the patients who had PPPD, median operating time was 232 (range 165-270) min, and median blood loss was 375 (range 100-1300) mL. There was one minor leak from the pancreaticojejunostomy in each group, resulting in a 5.5 percent minor leak in 36 patients. These outcomes were not significantly different. Delayed gastric emptying was observed more frequently after PPPD (six of 14 patients) than after the Whipple procedure (none of 19 patients) (P Whipple procedure and PPPD in terms of median survival and 5-year survival rate. The median survival time was 16.0 months and 5-year survival rate was 9.4 percent in the 36 patients. Blood loss during operation influenced the prognosis. There was no significant difference between the Whipple procedure and PPPD for the treatment of pancreatic head cancer in terms of operating time, blood loss, operative mortality and long-term survival. But delayed gastric emptying was more frequently

Transvaginal mesh procedures for pelvic organ prolapse.

Science.gov (United States)

Walter, Jens-Erik

2011-02-01

To provide an update on transvaginal mesh procedures, newly available minimally invasive surgical techniques for pelvic floor repair. The discussion is limited to minimally invasive transvaginal mesh procedures. PubMed and Medline were searched for articles published in English, using the key words "pelvic organ prolapse," transvaginal mesh," and "minimally invasive surgery." Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Searches were updated on a regular basis, and articles were incorporated in the guideline to May 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on the Preventive Health Care. Recommendations for practice were ranked according to the method described in that report (Table 1). Counselling for the surgical treatment of pelvic organ prolapse should consider all benefits, harms, and costs of the surgical procedure, with particular emphasis on the use of mesh. 1. Patients should be counselled that transvaginal mesh procedures are considered novel techniques for pelvic floor repair that demonstrate high rates of anatomical cure in uncontrolled short-term case series. (II-2B) 2. Patients should be informed of the range of success rates until stronger evidence of superiority is published. (II-2B) 3. Training specific to transvaginal mesh procedures should be undertaken before procedures are performed. (III-C) 4. Patients should undergo thorough preoperative counselling regarding (a) the potential serious adverse sequelae of transvaginal mesh repairs, including mesh exposure, pain, and dyspareunia; and (b) the limited data available

Management of recurrent stress urinary incontinence after burch and sling procedures.

Science.gov (United States)

Zimmern, Philippe E; Gormley, E Ann; Stoddard, Anne M; Lukacz, Emily S; Sirls, Larry; Brubaker, Linda; Norton, Peggy; Oliphant, Sallie S; Wilson, Tracey

2016-03-01

To examine treatment options selected for recurrent stress urinary incontinence (rSUI) in follow-up after Burch, autologous fascial and synthetic midurethral sling (MUS) procedures. We performed a secondary analysis of the SISTER and ToMUS trials of participants who underwent primary stress urinary incontinence (SUI) treatment (without prior SUI surgery or concomitant procedures). Using Kaplan-Meier analysis, retreatment-free survival rates by initial surgical procedure were compared. Mean MESA (Medical Epidemiologic and Social Aspects of Aging) stress index was also compared between those retreated for rSUI compared to those not retreated. Half of the women in the SISTEr trial met inclusion criteria for this analysis (329/655, 174 Burch and 155 fascial sling), as did 444/597 (74%) of subjects in ToMUS (221 transobturator midurethral sling (TMUS), and 223 retropubic midurethral sling (RMUS). Types of surgical retreatment included autologous fascial sling (19), synthetic sling (1), and bulking agent (18). Five-year retreatment free survival rates (and standard errors) were 87% (3%), 96% (2%), 97% (1%), and 99% (0.7%) for Burch, autologous fascial sling, TMUS, and RMUS groups respectively (P < 0.0001). For all index surgery groups, the mean MESA stress index at last visit prior to retreatment for those retreated (n = 23) was significantly higher than mean MESA stress index at last visit for those not retreated (n = 645) (P < 0.0001). In these cohorts, 6% of women after standard anti-incontinence procedures were retreated within 5 years, mostly with injection therapy or autologous fascial sling. Not all women with rSUI chose surgical retreatment. © 2015 Wiley Periodicals, Inc.

Differences in utilization of dental procedures by children enrolled in Wisconsin Medicaid and Delta Dental insurance plans.

Science.gov (United States)

Bhagavatula, Pradeep; Xiang, Qun; Szabo, Aniko; Eichmiller, Fredrick; Okunseri, Christopher

2017-12-01

Few studies have directly compared dental procedures provided in public and private insurance plans for enrollees living in dental health professional shortage areas (DHPSAs). We examined the rates for the different types of dental procedures received by 0-18-year-old children living in DHPSAs and non-DHPSAs who were enrolled in Medicaid and those enrolled under Delta Dental of Wisconsin (DDW) for years 2002 to 2008. Medicaid and DDW dental claims data for 2002 to 2008 was analyzed. Enrollees were divided into DDW-DHPSA and non-DHPSA and Medicaid-DHPSA and non-DHPSA groups. Descriptive and multivariable analyses using over-dispersed Poisson regression were performed to examine the effect of living in DHPSAs and insurance type in relation to the number of procedures received. Approximately 49 and 65 percent of children living in non-DHPSAs that were enrolled in Medicaid and DDW received at least one preventive dental procedure annually, respectively. Children in DDW non-DHPSA group had 1.79 times as many preventive, 0.27 times fewer complex restorative and 0.51 times fewer endodontic procedures respectively, compared to those in Medicaid non-DHPSA group. Children enrolled in DDW-DHPSA group had 1.53 times as many preventive and 0.25 times fewer complex restorative procedures, compared to children in Medicaid-DHPSA group. DDW enrollees had significantly higher utilization rates for preventive procedures than children in Medicaid. There were significant differences across Medicaid and DDW between non-DHPSA and DHPSA for most dental procedures received by enrollees. © 2016 American Association of Public Health Dentistry.

Electronic Procedures for Medical Operations

Science.gov (United States)

2015-01-01

Electronic procedures are replacing text-based documents for recording the steps in performing medical operations aboard the International Space Station. S&K Aerospace, LLC, has developed a content-based electronic system-based on the Extensible Markup Language (XML) standard-that separates text from formatting standards and tags items contained in procedures so they can be recognized by other electronic systems. For example, to change a standard format, electronic procedures are changed in a single batch process, and the entire body of procedures will have the new format. Procedures can be quickly searched to determine which are affected by software and hardware changes. Similarly, procedures are easily shared with other electronic systems. The system also enables real-time data capture and automatic bookmarking of current procedure steps. In Phase II of the project, S&K Aerospace developed a Procedure Representation Language (PRL) and tools to support the creation and maintenance of electronic procedures for medical operations. The goal is to develop these tools in such a way that new advances can be inserted easily, leading to an eventual medical decision support system.

Classification of radiological procedures

International Nuclear Information System (INIS)

1989-01-01

A classification for departments in Danish hospitals which use radiological procedures. The classification codes consist of 4 digits, where the first 2 are the codes for the main groups. The first digit represents the procedure's topographical object and the second the techniques. The last 2 digits describe individual procedures. (CLS)

A new procedure for the treatment of an industrial waste containing flotation reagents

Directory of Open Access Journals (Sweden)

Milosavljević Milutin M.

2014-01-01

Full Text Available Flotation reagents can be transformed to industrial waste if they are stored for a long period of time. Also, if synthesis or drying process is not performed under defined conditions in industrial plants, which produce flotation reagents, batch of waste may arise and be stored as a waste. The chemical composition of this waste depends on the phase in which it was created, but typically includes: unreacted alkali hydroxide, solvent - alcohol and trithiocarbonate and oxidation product - dixanthogenate. In this paper a new laboratory procedure for the treatment of such wastes is described. The identification and separation of industrial waste components is also included. From the separated dixantogenate and xanthate a laboratory synthesis of thioncarbamates is given. In addition, a semi-industrial treatment of waste xanthate is presented. Synthesis of N-alkyl and N,N-dialkyl-O-isobutylthioncarbamates were obtained from the filtrate obtained in the first step. As a by-product, sodium thioglycolate was produced. This by-product is transformed to a thioglycolic acid by the addition of an acid. Also, the synthesis of thioncarbamates from dixanthogenates, isolated from industrial waste as a cake, is desribed. Described waste treatment is additionally interesting due to the production of sulphur as another by-product. Laboratory synthesis gave thioncarbamates in yields from 69.7 to 87.7 %, while the semi-industrial process for the selected batches produced thioncarbamates in yields from 74.2 to 80.5 %. Taking into account the importance of the synthesized compounds as selective flotation reagents, a new procedure of their synthesis from industrial waste is characterized by good yields and purity of the obtained compounds, the simplicity of process, low environmental impact and short reaction times of synthesis. [Projekat Ministarstva nauke Republike Srbije, br. III 43007

Knowing the operative game plan: a novel tool for the assessment of surgical procedural knowledge.

Science.gov (United States)

Balayla, Jacques; Bergman, Simon; Ghitulescu, Gabriela; Feldman, Liane S; Fraser, Shannon A

2012-08-01

What is the source of inadequate performance in the operating room? Is it a lack of technical skills, poor judgment or a lack of procedural knowledge? We created a surgical procedural knowledge (SPK) assessment tool and evaluated its use. We interviewed medical students, residents and training program staff on SPK assessment tools developed for 3 different common general surgery procedures: inguinal hernia repair with mesh in men, laparoscopic cholecystectomy and right hemicolectomy. The tools were developed as a step-wise assessment of specific surgical procedures based on techniques described in a current surgical text. We compared novice (medical student to postgraduate year [PGY]-2) and expert group (PGY-3 to program staff) scores using the Mann-Whitney U test. We calculated the total SPK score and defined a cut-off score using receiver operating characteristic analysis. In all, 5 participants in 7 different training groups (n = 35) underwent an interview. Median scores for each procedure and overall SPK scores increased with experience. The median SPK for novices was 54.9 (95% confidence interval [CI] 21.6-58.8) compared with 98.05 (95% CP 94.1-100.0) for experts (p = 0.012). The SPK cut-off score of 93.1 discriminates between novice and expert surgeons. Surgical procedural knowledge can reliably be assessed using our SPK assessment tool. It can discriminate between novice and expert surgeons for common general surgical procedures. Future studies are planned to evaluate its use for more complex procedures.

Radiation dose during angiographic procedures

International Nuclear Information System (INIS)

Lavoie, Ch.; Rasuli, P.

2001-01-01

The use of angiographic procedures is becoming more prevalent as new techniques and equipment are developed. There have been concerns in the scientific community about the level of radiation doses received by patients, and indirectly by staff, during some of these radiological procedures. The purpose of this study was to assess the level of radiation dose from angiographic procedures to patient at the Ottawa Hospital, General Campus. Radiation dose measurements, using Thermo-Luminescent Dosimeters (TLDs), were performed on more than 100 patients on various procedures. The results show that while the patient dose from the great majority of angiographic procedures is less than 2 Gy, a significant number of procedures, especially interventional procedures may have doses greater than 2 Gy and may lead to deterministic effects. (author)

Evaluation of various digestion procedures for trace element contents of some food materials

International Nuclear Information System (INIS)

Demirel, Sule; Tuzen, Mustafa; Saracoglu, Sibel; Soylak, Mustafa

2008-01-01

The levels of trace elements in different types of food material consumed in Turkey were determined by flame and graphite furnace atomic absorption spectrometry. Food samples were digested with dry ashing, wet ashing and microwave digestion procedures in this study. The microwave digestion procedure was chosen for the digestion of all the food samples because it required shorter time and made higher recovery (specially for Se). Fe, Cu, Mn, Zn, Al and Se were determined by flame and graphite furnace atomic absorption spectrometry, respectively. Relative standard deviations (RSD) were found below 10%. The accuracy of the procedure was confirmed by certified reference materials. Moreover, this procedure was easier to use when compared with dry and wet digestions

Decision-making Procedures

DEFF Research Database (Denmark)

Aldashev, Gani; Kirchsteiger, Georg; Sebald, Alexander Christopher

2009-01-01

define procedures as mechanisms that influence the probabilities of reaching different endnodes. We show that for such procedural games a sequential psychological equilibrium always exists. Applying this approach within a principal-agent context we show that the way less attractive jobs are allocated...

Ulnar artery: The Ulysses ultimate resort for coronary procedures

Directory of Open Access Journals (Sweden)

George Hahalis, MD, PhD

2016-07-01

Full Text Available Despite the increasing worldwide adoption of the transradial access site, the ulnar artery (UA only very infrequently serves as a primary option for coronary procedures. In contrast to the uncertainty surrounding previous reports regarding the feasibility and safety, recent data from larger registries and randomized trials provide more conclusive evidence that the transulnar route may be safely selected as an alternative arterial access approach. However, a default transulnar strategy appears time-consuming and is associated with higher crossover rates compared with the radial artery (RA. Once arterial access is obtained, the likelihood of a successful coronary procedure is high and similar between the two forearm arteries. The UA has similar flow-mediating vasodilating properties with and seems at least as vulnerable as the RA with regard to incident occlusion, with UA occlusion (UAO rates being probably higher than previously anticipated. A learning curve effect may not be apparent for crossover rates among experienced radialists, but increasing experience is associated with reduction in the fluoroscopy time, contrast volume and frequency of large hematoma formation. The UA may represents an important alternative access site for coronary procedures, and experienced radial operators should obtain additional skills to perform the transulnar approach. Nevertheless, in view of this method's lower feasibility compared to the RA, an initial ulnar access strategy should be reserved for carefully selected patients to ensure satisfactory cannulation rates.

Pediatric abdominal non-Hodgkin's lymphoma: diagnosis through surgical and non-surgical procedures.

Science.gov (United States)

Aguiar, Arthur Almeida; Lima, Luciana Cavalvanti; Araújo, Cláudia Corrêa de; Gallindo, Rodrigo Melo

2017-12-29

To describe the success rate and the complications after procedures to diagnose abdominal non-Hodgkin's lymphoma in children and adolescents. A retrospective cross-sectional study was conducted with a population consisting of children and adolescents with abdominal non-Hodgkin's lymphoma diagnosed between September 1994 and December 2012. The sample comprised of 100 patients who underwent 113 diagnostic procedures, including urgent surgery (n=21), elective surgery (n=36), and non-surgical diagnosis (n=56). The most frequent procedures were laparotomy (46.9%) and ultrasound-guided core biopsy (25.6%). The rate of diagnostic success was 95.2% for urgent surgeries; 100% for elective surgeries and 82.1% for non-surgical procedures (p<0.05). The rates of complication during the three diagnosis procedures considered were significant (p<0.001; 95.2% of the urgent surgeries, 83.8% of the elective surgeries, and 10.7% of the non-surgical procedures). The length of time before resuming a full diet and starting chemotherapy was significantly reduced for patients who underwent non-surgical procedures when compared with the other procedures (p<0.001). Non-surgical procedures for the diagnosis of pediatric abdominal non-Hodgkin's lymphoma are an effective option with low morbidity rate, allowing an earlier resumption of a full diet and chemotherapy initiation. Furthermore, non-surgical procedures should also be considered for obtaining tumor samples from patients with extensive disease. Copyright © 2017. Published by Elsevier Editora Ltda.

Field screening procedures for determining the presence of volatile organic compounds in soil

International Nuclear Information System (INIS)

Crockett, A.B.; DeHaan, M.S.

1991-01-01

Many field screening procedures have been used to detect the presence of volatile organic compounds (VOC) in soils but almost none have been documented and verified. Users of these procedures have not really known whether their objectives in screening were met. A reliable VOC screening procedure could significantly reduce the number of samples currently being submitted to laboratories, thereby reducing costs and improving site characterization. The Environmental Protection Agency's Environmental Monitoring Systems Laboratory in Las Vegas (EMSL-LV) has therefore sponsored a research effort to evaluate and improve headspace methods for screening soils for VOC in the field. The research involved comparing several extraction procedures using soils from actual waste sites, and determining the agitation and mixing necessary to achieve equilibrium. Headspace was analyzed using a relatively simple portable gas chromatograph with a short column. The results were variable and show that several procedures should be attempted and the results evaluated before selecting a screening procedure. 10 refs., 6 tabs

Prevalence of extravertebral cement leakage after vertebroplasty: procedural documentation versus CT detection

International Nuclear Information System (INIS)

Martin, Douglas J.; Rad, Arash Ehteshami; Kallmes, David F.

2012-01-01

Background: Reported incidence of extravertebral cement leakage after vertebroplasty varies widely across studies. Purpose: To retrospectively compare the relative detection rates of extravertebral leakage noted under intra-procedural fluoroscopic surveillance, post procedure plain radiographs, and post procedure computed tomography (CT) in a cohort of patients undergoing vertebroplasty. Material and Methods: With IRB approval, we retrospectively identified 181 patients with 277 levels treated with percutaneous vertebroplasty among a total of 1255 patients undergoing vertebroplasty between 1999 and 2010 who had subsequently undergone a CT examination that included the treated level(s). Categories of leakage were paravertebral, end plate, epidural, and pre vertebral venous leakage. CT-detected leak rates were then compared to those noted on the vertebroplasty procedure reports and the archived fluoroscopic images for this same cohort using Pearson's χ 2 test. Results: One hundred and forty-nine (82%, 95% CI 76-87%) of 181 patients demonstrated evidence of some type of leakage on CT at one or more treated levels. Sixty-two (34 %, 95 % CI 28-42 %) and seventy-seven (50%, 95% CI 43-57%) of 149 CT-detected leaks were reported in the procedural dictation or detected on plain radiography (P 0.01 and 0.006, respectively). The most common type of leakage noted on CT was end plate (n = 81, 45%, 95% CI 38-52%), followed by paravertebral (n 64, 35%, 95% CI 29-43%), epidural (n = 36, 20%, 95% CI 15-26%), and pre vertebral venous (n = 32, 18%, 95% CI 13-24%). Conclusion: Cement leakage after vertebroplasty is common and is often not reported by operators in procedural dictations. CT detects substantially more leaks than plain radiography

Procedural sedation analgesia

Directory of Open Access Journals (Sweden)

Sheta Saad

2010-01-01

Full Text Available The number of noninvasive and minimally invasive procedures performed outside of the operating room has grown exponentially over the last several decades. Sedation, analgesia, or both may be needed for many of these interventional or diagnostic procedures. Individualized care is important when determining if a patient requires procedural sedation analgesia (PSA. The patient might need an anti-anxiety drug, pain medicine, immobilization, simple reassurance, or a combination of these interventions. The goals of PSA in four different multidisciplinary practices namely; emergency, dentistry, radiology and gastrointestinal endoscopy are discussed in this review article. Some procedures are painful, others painless. Therefore, goals of PSA vary widely. Sedation management can range from minimal sedation, to the extent of minimal anesthesia. Procedural sedation in emergency department (ED usually requires combinations of multiple agents to reach desired effects of analgesia plus anxiolysis. However, in dental practice, moderate sedation analgesia (known to the dentists as conscious sedation is usually what is required. It is usually most effective with the combined use of local anesthesia. The mainstay of success for painless imaging is absolute immobility. Immobility can be achieved by deep sedation or minimal anesthesia. On the other hand, moderate sedation, deep sedation, minimal anesthesia and conventional general anesthesia can be all utilized for management of gastrointestinal endoscopy.

Comparison of 2015 Medicare relative value units for gender-specific procedures: Gynecologic and gynecologic-oncologic versus urologic CPT coding. Has time healed gender-worth?

Science.gov (United States)

Benoit, M F; Ma, J F; Upperman, B A

2017-02-01

In 1992, Congress implemented a relative value unit (RVU) payment system to set reimbursement for all procedures covered by Medicare. In 1997, data supported that a significant gender bias existed in reimbursement for gynecologic compared to urologic procedures. The present study was performed to compare work and total RVU's for gender specific procedures effective January 2015 and to evaluate if time has healed the gender-based RVU worth. Using the 2015 CPT codes, we compared work and total RVU's for 50 pairs of gender specific procedures. We also evaluated 2015 procedure related provider compensation. The groups were matched so that the procedures were anatomically similar. We also compared 2015 to 1997 RVU and fee schedules. Evaluation of work RVU's for the paired procedures revealed that in 36 cases (72%), male vs female procedures had a higher wRVU and tRVU. For total fee/reimbursement, 42 (84%) male based procedures were compensated at a higher rate than the paired female procedures. On average, male specific surgeries were reimbursed at an amount that was 27.67% higher for male procedures than for female-specific surgeries. Female procedure based work RVU's have increased minimally from 1997 to 2015. Time and effort have trended towards resolution of some gender-related procedure worth discrepancies but there are still significant RVU and compensation differences that should be further reviewed and modified as surgical time and effort highly correlate. Copyright © 2016. Published by Elsevier Inc.

Radiation risk of diagnostical procedures

International Nuclear Information System (INIS)

Pohlit, W.

1986-01-01

The environmental radiation burden of man in Germany is about 1 mGy (Milligray) per year. This is, of course, also valid for children. Due to diagnostical procedures this burden is increased to about 1.3 mGy. The question arises wether this can be neglected, or important consequences have to be drawn. To give a clear answer, the action of ionizing radiation in living cells and in organisms is explained in detail. Many of the radiation actions at the DNA can soon be repaired by the cell, if the radiation dose was small. Some damage, however will remain irreparable for the cell and consequently leads to cell death, to mutations or to cell transformation. The number of these lesion increases or decreases linearily with radiation dose. Therefore, it must be expected that the risk of tumour induction is increased to above the normal background even by the smallest doses. This small but not negligible risk has to be compared with other risks of civilization or with other medical risks. But also the benefit and the efficacy of diagnostic procedures have to be considered. (orig./HSCH) [de

CMOS gate array characterization procedures

Science.gov (United States)

Spratt, James P.

1993-09-01

Present procedures are inadequate for characterizing the radiation hardness of gate array product lines prior to personalization because the selection of circuits to be used, from among all those available in the manufacturer's circuit library, is usually uncontrolled. (Some circuits are fundamentally more radiation resistant than others.) In such cases, differences in hardness can result between different designs of the same logic function. Hardness also varies because many gate arrays feature large custom-designed megacells (e.g., microprocessors and random access memories-MicroP's and RAM's). As a result, different product lines cannot be compared equally. A characterization strategy is needed, along with standardized test vehicle(s), methodology, and conditions, so that users can make informed judgments on which gate arrays are best suited for their needs. The program described developed preferred procedures for the radiation characterization of gate arrays, including a gate array evaluation test vehicle, featuring a canary circuit, designed to define the speed versus hardness envelope of the gate array. A multiplier was chosen for this role, and a baseline multiplier architecture is suggested that could be incorporated into an existing standard evaluation circuit chip.

Actor-Network Procedures

NARCIS (Netherlands)

Pavlovic, Dusko; Meadows, Catherine; Ramanujam, R.; Ramaswamy, Srini

2012-01-01

In this paper we propose actor-networks as a formal model of computation in heterogenous networks of computers, humans and their devices, where these new procedures run; and we introduce Procedure Derivation Logic (PDL) as a framework for reasoning about security in actor-networks, as an extension

Parametric Sensitivity Tests—European Polymer Electrolyte Membrane Fuel Cell Stack Test Procedures

DEFF Research Database (Denmark)

Araya, Samuel Simon; Andreasen, Søren Juhl; Kær, Søren Knudsen

2014-01-01

performed based on test procedures proposed by a European project, Stack-Test. The sensitivity of a Nafion-based low temperature PEMFC stack’s performance to parametric changes was the main objective of the tests. Four crucial parameters for fuel cell operation were chosen; relative humidity, temperature......As fuel cells are increasingly commercialized for various applications, harmonized and industry-relevant test procedures are necessary to benchmark tests and to ensure comparability of stack performance results from different parties. This paper reports the results of parametric sensitivity tests......, pressure, and stoichiometry at varying current density. Furthermore, procedures for polarization curve recording were also tested both in ascending and descending current directions....

Comparative study of different methodologies to detect the JAK2 V617F mutation in chronic BCR-ABL1 negative myeloproliferative neoplasms

Directory of Open Access Journals (Sweden)

Alline Didone

2016-04-01

Full Text Available Objectives: A mutation in the JAK2 gene, V617F, has been identified in several BCR-ABL1 negative myeloproliferative neoplasms (MPN: polycythemia vera (PV, essential thrombocythemia (ET, and primary myelofibrosis (PMF. Defining the presence or absence of this mutation is an essential part of clinical diagnostic algorithms and patient management. Here, we aimed to evaluate the performance of three PCR-based assays: Amplification Refractory Mutation System (ARMS, High-Resolution Melting analysis (HRM, and Sanger direct sequencing, and compare their results with those obtained by a PCR restriction fragment polymorphism assay (PCR-RFLP. Design and methods: We used blood samples from 136 patients (PV=20; PMF=20; ET=28, and other MPN suspected cases=68. Results: Comparable results were observed among the four assays in patients with PV, PMF, and MPN suspected cases. In patients with a diagnosis of ET, the JAK2 V617F mutation was detected in 67.8% of them by the PCR-ARMS and PCR-HRM assay and in 64% of them by the conventional Sanger sequence approach. The PCR-ARMS and PCR-HRM assays were 100% concordant. With these tests, only one of the 20 patients with ET and one of the three patients with clinically suspected MPN gave different results compared with those obtained by the PCR-RFLP. Conclusions: Our results have demonstrated that the PCR-ARMS and PCR-HRM assays could detect the JAK2 V617F mutation effectively in MPN patients, but PCR-HRM assays are rapid and the most cost-effective procedures. Keywords: Myeloproliferative, JAK2 V617F, Mutation, Wild type, Screening

Foods The Indians Gave Us. Coloring Book.

Science.gov (United States)

Hail, Raven

This children's coloring book devotes a page to each of twenty of the most familiar American Indian plant foods: avocado, green beans, black walnuts, cocoa, corn, peanuts, pecans, chile peppers, pineapples, popcorn, potatoes, pumpkins, squash, strawberries, sugar maple, sunflowers, sweet potatoes, tapioca, tomatoes, and vanilla. Illustrating each…

Use of performance curves in estimating number of procedures required to achieve proficiency in coronary angiography

DEFF Research Database (Denmark)

Räder, Sune B E W; Jørgensen, Erik; Bech, Bo

2011-01-01

.001 for all parameters. To approach the experts' level of DAP and contrast media use, trainees need 394 and 588 procedures, respectively. Performance curves showed large individual differences in the development of competence. Conclusion: On average, trainees needed 300 procedures to reach sufficient level...... needed for trainees to reach recommended reference levels was estimated as 226 and 353, for DAP and use of contrast media, respectively. After 300 procedures, trainees' procedure time, fluoroscopy time, DAP, and contrast media volume were significantly higher compared with experts' performance, P ...Background: Current guidelines in cardiology training programs recommend 100-300 coronary angiography procedures for certification. We aimed to assess the number of procedures needed to reach sufficient proficiency. Methods: Procedure time, fluoroscopy time, dose area product (DAP), and contrast...

Configural and component processing in simultaneous and sequential lineup procedures

OpenAIRE

Flowe, HD; Smith, HMJ; Karoğlu, N; Onwuegbusi, TO; Rai, L

2015-01-01

Configural processing supports accurate face recognition, yet it has never been examined within the context of criminal identification lineups. We tested, using the inversion paradigm, the role of configural processing in lineups. Recent research has found that face discrimination accuracy in lineups is better in a simultaneous compared to a sequential lineup procedure. Therefore, we compared configural processing in simultaneous and sequential lineups to examine whether there are differences...

Procedural training in virtual reality: A comparison of technology types

International Nuclear Information System (INIS)

Sebok, A.; Nystad, E.

2006-01-01

This paper describes a study investigating questions of learning effectiveness in different VR technology types. Four VR display technology types were compared in terms of their ability to support procedural learning. The VR systems included two desktop displays (mono-scopic and stereoscopic view), a large screen stereoscopic display, and a mono-scopic head-mounted display. Twenty-four participants completed procedural training scenarios on these different display types. Training effectiveness was assessed in terms of objective task performance. Following the training session, participants performed the procedure they had just learned using the same VR display type they used for training. Time to complete the procedure and errors were recorded. Retention and transfer of training were evaluated in a talk-through session 24 hours after the training. In addition, subjective questionnaire data were gathered to investigate perceived workload, Sense of Presence, simulator sickness, perceived usability, and ease of navigation. While no difference was found for the short-term learning, the study results indicate that retention and transfer of training were better supported by the large screen stereoscopic condition. (authors)

Office-based deep sedation for pediatric ophthalmologic procedures using a sedation service model.

Science.gov (United States)

Lalwani, Kirk; Tomlinson, Matthew; Koh, Jeffrey; Wheeler, David

2012-01-01

Aims. (1) To assess the efficacy and safety of pediatric office-based sedation for ophthalmologic procedures using a pediatric sedation service model. (2) To assess the reduction in hospital charges of this model of care delivery compared to the operating room (OR) setting for similar procedures. Background. Sedation is used to facilitate pediatric procedures and to immobilize patients for imaging and examination. We believe that the pediatric sedation service model can be used to facilitate office-based deep sedation for brief ophthalmologic procedures and examinations. Methods. After IRB approval, all children who underwent office-based ophthalmologic procedures at our institution between January 1, 2000 and July 31, 2008 were identified using the sedation service database and the electronic health record. A comparison of hospital charges between similar procedures in the operating room was performed. Results. A total of 855 procedures were reviewed. Procedure completion rate was 100% (C.I. 99.62-100). There were no serious complications or unanticipated admissions. Our analysis showed a significant reduction in hospital charges (average of $1287 per patient) as a result of absent OR and recovery unit charges. Conclusions. Pediatric ophthalmologic minor procedures can be performed using a sedation service model with significant reductions in hospital charges.

Office-Based Deep Sedation for Pediatric Ophthalmologic Procedures Using a Sedation Service Model

Directory of Open Access Journals (Sweden)

Kirk Lalwani

2012-01-01

Full Text Available Aims. (1 To assess the efficacy and safety of pediatric office-based sedation for ophthalmologic procedures using a pediatric sedation service model. (2 To assess the reduction in hospital charges of this model of care delivery compared to the operating room (OR setting for similar procedures. Background. Sedation is used to facilitate pediatric procedures and to immobilize patients for imaging and examination. We believe that the pediatric sedation service model can be used to facilitate office-based deep sedation for brief ophthalmologic procedures and examinations. Methods. After IRB approval, all children who underwent office-based ophthalmologic procedures at our institution between January 1, 2000 and July 31, 2008 were identified using the sedation service database and the electronic health record. A comparison of hospital charges between similar procedures in the operating room was performed. Results. A total of 855 procedures were reviewed. Procedure completion rate was 100% (C.I. 99.62–100. There were no serious complications or unanticipated admissions. Our analysis showed a significant reduction in hospital charges (average of $1287 per patient as a result of absent OR and recovery unit charges. Conclusions. Pediatric ophthalmologic minor procedures can be performed using a sedation service model with significant reductions in hospital charges.

Proposal of a segmentation procedure for skid resistance data

International Nuclear Information System (INIS)

Tejeda, S. V.; Tampier, Hernan de Solominihac; Navarro, T.E.

2008-01-01

Skin resistance of pavements presents a high spatial variability along a road. This pavement characteristic is directly related to wet weather accidents; therefore, it is important to identify and characterize the skid resistance of homogeneous segments along a road in order to implement proper road safety management. Several data segmentation methods have been applied to other pavement characteristics (e.g. roughness). However, no application to skin resistance data was found during the literature review for this study. Typical segmentation methods are rather too general or too specific to ensure a detailed segmentation of skid resistance data, which can be used for managing pavement performance. The main objective of this paper is to propose a procedure for segmenting skid resistance data, based on existing data segmentation methods. The procedure needs to be efficient and to fulfill road management requirements. The proposed procedure considers the Leverage method to identify outlier data, the CUSUM method to accomplish initial data segmentation and a statistical method to group consecutive segments that are statistically similar. The statistical method applies the Student's t-test of mean equities, along with analysis of variance and the Tuckey test for the multiple comparison of means. The proposed procedure was applied to a sample of skid resistance data measured with SCRIM (Side Force Coefficient Routine Investigatory Machine) on a 4.2 km section of Chilean road and was compared to conventional segmentation methods. Results showed that the proposed procedure is more efficient than the conventional segmentation procedures, achieving the minimum weighted sum of square errors (SSEp) with all the identified segments statistically different. Due to its mathematical basis, proposed procedure can be easily adapted and programmed for use in road safety management. (author)

The learning effect of intraoperative video-enhanced surgical procedure training.

Science.gov (United States)

van Det, M J; Meijerink, W J H J; Hoff, C; Middel, L J; Koopal, S A; Pierie, J P E N

2011-07-01

The transition from basic skills training in a skills lab to procedure training in the operating theater using the traditional master-apprentice model (MAM) lacks uniformity and efficiency. When the supervising surgeon performs parts of a procedure, training opportunities are lost. To minimize this intervention by the supervisor and maximize the actual operating time for the trainee, we created a new training method called INtraoperative Video-Enhanced Surgical Training (INVEST). Ten surgical residents were trained in laparoscopic cholecystectomy either by the MAM or with INVEST. Each trainee performed six cholecystectomies that were objectively evaluated on an Objective Structured Assessment of Technical Skills (OSATS) global rating scale. Absolute and relative improvements during the training curriculum were compared between the groups. A questionnaire evaluated the trainee's opinion on this new training method. Skill improvement on the OSATS global rating scale was significantly greater for the trainees in the INVEST curriculum compared to the MAM, with mean absolute improvement 32.6 versus 14.0 points and mean relative improvement 59.1 versus 34.6% (P=0.02). INVEST significantly enhances technical and procedural skill development during the early learning curve for laparoscopic cholecystectomy. Trainees were positive about the content and the idea of the curriculum.

Functional and morphological differences following Monarc and TVT-O procedures.

Science.gov (United States)

Huang, W-C; Yang, S-H; Yang, J-M; Tzeng, C-R

2012-12-01

To explore function of the lower urinary tract and morphology of tape and urethra following Monarc or TVT-O suburethral tape placement for urodynamic stress incontinence (USI). We recruited prospectively women undergoing either Monarc or TVT-O placement for USI. Before and 3 months after the procedure, participants were evaluated by a question-directed interview, the measures of Sandvik Incontinence Severity Index (SISI), Incontinence Bother Scale (IBS), Ingelman-Sundberg Score (ISS) and short forms of Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7), physical examination, a cough stress test and 4D ultrasound investigation. The primary outcome was participants' responses to clinical assessments and the secondary outcome was ultrasound findings. A total of 67 women with Monarc procedures and 60 women with TVT-O procedures completed the survey both preoperatively and 3 months postoperatively. There were significant improvements in scores of SISI, IBS, ISS, UDI-6 and IIQ-7 after both Monarc and TVT-O procedures. At the 3-month follow-up, both procedures had similar success rates, SISI scores, IBS scores, ISS scores, UDI-6 scores and IIQ-7 scores, and similar incidences of postoperative voiding difficulty and overactive bladder symptoms. After Bonferroni correction, all ultrasound parameters representing tape location, tape tension and urethral mobility were similar between the two procedures. At short-term follow-up, Monarc and TVT-O procedures are comparable in both functional outcome of the lower urinary tract and morphology on ultrasound as assessed by parameters representing tape location, tape tension and urethral mobility. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

Dental Procedures and the Risk of Infective Endocarditis

Science.gov (United States)

Chen, Pei-Chun; Tung, Ying-Chang; Wu, Patricia W.; Wu, Lung-Sheng; Lin, Yu-Sheng; Chang, Chee-Jen; Kung, Suefang; Chu, Pao-Hsien

2015-01-01

Abstract Infective endocarditis (IE) is an uncommon but potentially devastating disease. Recently published data have revealed a significant increase in the incidence of IE following the restriction on indications for antibiotic prophylaxis as recommended by the revised guidelines. This study aims to reexamine the basic assumption behind the rationale of prophylaxis that dental procedures increase the risk of IE. Using the Longitudinal Health Insurance Database of Taiwan, we retrospectively analyzed a total of 739 patients hospitalized for IE between 1999 and 2012. A case-crossover design was conducted to compare the odds of exposure to dental procedures within 3 months preceding hospitalization with that during matched control periods when no IE developed. In the unadjusted model, the odds ratio (OR) was 0.93 for tooth extraction (95% confidence interval [CI] 0.54–1.59), 1.64 for surgery (95% CI 0.61–4.42), 0.92 for dental scaling (95% CI 0.59–1.42), 1.69 for periodontal treatment (95% CI 0.88–3.21), and 1.29 for endodontic treatment (95% CI 0.72–2.31). The association between dental procedures and the risk of IE remained insignificant after adjustment for antibiotic use, indicating that dental procedures did not increase the risk of IE. Therefore, this result may argue against the conventional assumption on which the recommended prophylaxis for IE is based. PMID:26512586

Model of Procedure Usage – Results from a Qualitative Study to Inform Design of Computer-Based Procedures

Energy Technology Data Exchange (ETDEWEB)

Johanna H Oxstrand; Katya L Le Blanc

2012-07-01

The nuclear industry is constantly trying to find ways to decrease the human error rate, especially the human errors associated with procedure use. As a step toward the goal of improving procedure use performance, researchers, together with the nuclear industry, have been looking at replacing the current paper-based procedures with computer-based procedure systems. The concept of computer-based procedures is not new by any means; however most research has focused on procedures used in the main control room. Procedures reviewed in these efforts are mainly emergency operating procedures and normal operating procedures. Based on lessons learned for these previous efforts we are now exploring a more unknown application for computer based procedures - field procedures, i.e. procedures used by nuclear equipment operators and maintenance technicians. The Idaho National Laboratory, the Institute for Energy Technology, and participants from the U.S. commercial nuclear industry are collaborating in an applied research effort with the objective of developing requirements and specifications for a computer-based procedure system to be used by field operators. The goal is to identify the types of human errors that can be mitigated by using computer-based procedures and how to best design the computer-based procedures to do this. The underlying philosophy in the research effort is “Stop – Start – Continue”, i.e. what features from the use of paper-based procedures should we not incorporate (Stop), what should we keep (Continue), and what new features or work processes should be added (Start). One step in identifying the Stop – Start – Continue was to conduct a baseline study where affordances related to the current usage of paper-based procedures were identified. The purpose of the study was to develop a model of paper based procedure use which will help to identify desirable features for computer based procedure prototypes. Affordances such as note taking, markups

Effective dose estimation to patients and staff during urethrography procedures

International Nuclear Information System (INIS)

Sulieman, A.; Barakat, H.; Alkhorayef, M.; Babikir, E.; Dalton, A.; Bradley, D.

2015-10-01

Medical-related radiation is the largest source of controllable radiation exposure to humans and it accounts for more than 95% of radiation exposure from man-made sources. Few data were available worldwide regarding patient and staff dose during urological ascending urethrography (ASU) procedure. The purposes of this study are to measure patient and staff entrance surface air kerma dose (ESAK) during ASU procedure and evaluate the effective doses. A total of 243 patients and 145 staff (Urologist) were examined in three Hospitals in Khartoum state. ESAKs were measured for patient and staff using thermoluminescent detectors (TLDs). Effective doses (E) were calculated using published conversion factors and methods recommended by the national Radiological Protection Board (NRPB). The mean ESAK dose for patients and staff dose were 7.79±6.7 mGy and 0.161±0.30 mGy per procedures respectively. The mean and range of the effective dose was 1.21 mSv per procedure. The radiation dose in this study is comparable with previous studies except Hospital C. It is obvious that high patient and staff exposure is due to the lack of experience and protective equipment s. Interventional procedures remain operator dependent; therefore continuous training is crucial. (Author)

Effective dose estimation to patients and staff during urethrography procedures

Energy Technology Data Exchange (ETDEWEB)

Sulieman, A. [Prince Sattam bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, P. O- Box 422, Alkharj 11942 (Saudi Arabia); Barakat, H. [Neelain University, College of Science and Technology, Medical Physics Department, Khartoum (Sudan); Alkhorayef, M.; Babikir, E. [King Saud University, College of Applied Sciences, Radiological Sciences Department, P. O. Box 10219, Riyadh 11433 (Saudi Arabia); Dalton, A.; Bradley, D. [University of Surrey, Centre for Nuclear and Radiation Physics, Department of Physics, Surrey, GU2 7XH Guildford (United Kingdom)

2015-10-15

Medical-related radiation is the largest source of controllable radiation exposure to humans and it accounts for more than 95% of radiation exposure from man-made sources. Few data were available worldwide regarding patient and staff dose during urological ascending urethrography (ASU) procedure. The purposes of this study are to measure patient and staff entrance surface air kerma dose (ESAK) during ASU procedure and evaluate the effective doses. A total of 243 patients and 145 staff (Urologist) were examined in three Hospitals in Khartoum state. ESAKs were measured for patient and staff using thermoluminescent detectors (TLDs). Effective doses (E) were calculated using published conversion factors and methods recommended by the national Radiological Protection Board (NRPB). The mean ESAK dose for patients and staff dose were 7.79±6.7 mGy and 0.161±0.30 mGy per procedures respectively. The mean and range of the effective dose was 1.21 mSv per procedure. The radiation dose in this study is comparable with previous studies except Hospital C. It is obvious that high patient and staff exposure is due to the lack of experience and protective equipment s. Interventional procedures remain operator dependent; therefore continuous training is crucial. (Author)

Noise annoyance caused by continuous descent approaches compared to regular descent procedures

NARCIS (Netherlands)

White, K.; Arntzen, M.; Walker, F.; Waiyaki, F.M.; Meeter, M.; Bronkhorst, A.W.

2017-01-01

During Continuous Descent Approaches (CDAs) aircraft glide towards the runway resulting in reduced noise and fuel usage. Here, we investigated whether such landings cause less noise annoyance than a regular stepwise approach. Both landing types were compared in a controlled laboratory setting with a

[Costing nuclear medicine diagnostic procedures].

Science.gov (United States)

Markou, Pavlos

2005-01-01

To the Editor: Referring to a recent special report about the cost analysis of twenty-nine nuclear medicine procedures, I would like to clarify some basic aspects for determining costs of nuclear medicine procedure with various costing methodologies. Activity Based Costing (ABC) method, is a new approach in imaging services costing that can provide the most accurate cost data, but is difficult to perform in nuclear medicine diagnostic procedures. That is because ABC requires determining and analyzing all direct and indirect costs of each procedure, according all its activities. Traditional costing methods, like those for estimating incomes and expenses per procedure or fixed and variable costs per procedure, which are widely used in break-even point analysis and the method of ratio-of-costs-to-charges per procedure may be easily performed in nuclear medicine departments, to evaluate the variability and differences between costs and reimbursement - charges.

Bentall Procedure Using Cryopreserved Valved Aortic Homografts

Science.gov (United States)

Christenson, Jan T.; Sierra, Jorge; Trindade, Pedro T.; Didier, Dominique; Kalangos, Afksendiyos

2004-01-01

The Bentall procedure is the standard operation for patients who have lesions of the ascending aorta associated with aortic valve disease. In many cases, however, mechanical prosthetic conduits are not suitable. There are few reports in the English-language medical literature concerning the mid- to long-term outcome of Bentall operations with cryopreserved homografts. Therefore, we reviewed our experience with this procedure and valved homografts. From January 1997 through December 2002, 21 patients underwent a Bentall operation with cryopreserved homografts at our institution. There were 14 males and 7 females; the mean age was 36 ± 21 years (range, 15–74 years). Eleven patients had undergone previous aortic valve surgery. All patients had aortic dilatation or aneurysms involving the ascending aorta. Indications for surgery included aortic valve stenosis or insufficiency, and aortic valve endocarditis (native valve or prosthetic). One patient had Takayasu's arteritis and 3 had Marfan syndrome. There was 1 hospital death (due to sepsis), but no other major postoperative complications. The mean hospital stay was 14 ± 7 days. Follow-up echocardiographic and computed tomographic scans were performed yearly. The mean follow-up was 34 months (6–72 months). Follow-up imaging revealed no calcifications or degenerative processes related to the homograft. Four patients had minimal valve regurgitation. Two patients died during follow-up. The 3-year actuarial survival rate was 85.7%. Our data suggest that the Bentall procedure with a valved homograft conduit is a safe procedure with excellent mid- to long-term results, comparable to results reported with aortic valve replacement with a homograft. PMID:15745290

Reliability of procedures used for scaling loudness

DEFF Research Database (Denmark)

Jesteadt, Walt; Joshi, Suyash Narendra

2013-01-01

In this study, 16 normally-hearing listeners judged the loudness of 1000-Hz sinusoids using magnitude estimation (ME), magnitude production (MP), and categorical loudness scaling (CLS). Listeners in each of four groups completed the loudness scaling tasks in a different sequence on the first visit...... (ME, MP, CLS; MP, ME, CLS; CLS, ME, MP; CLS, MP, ME), and the order was reversed on the second visit. This design made it possible to compare the reliability of estimates of the slope of the loudness function across procedures in the same listeners. The ME data were well fitted by an inflected...... results were the most reproducible, they do not provide direct information about the slope of the loudness function because the numbers assigned to CLS categories are arbitrary. This problem can be corrected by using data from the other procedures to assign numbers that are proportional to loudness...

Simultaneous bilateral stereotactic procedure for deep brain stimulation implants: a significant step for reducing operation time.

Science.gov (United States)

Fonoff, Erich Talamoni; Azevedo, Angelo; Angelos, Jairo Silva Dos; Martinez, Raquel Chacon Ruiz; Navarro, Jessie; Reis, Paul Rodrigo; Sepulveda, Miguel Ernesto San Martin; Cury, Rubens Gisbert; Ghilardi, Maria Gabriela Dos Santos; Teixeira, Manoel Jacobsen; Lopez, William Omar Contreras

2016-07-01

OBJECT Currently, bilateral procedures involve 2 sequential implants in each of the hemispheres. The present report demonstrates the feasibility of simultaneous bilateral procedures during the implantation of deep brain stimulation (DBS) leads. METHODS Fifty-seven patients with movement disorders underwent bilateral DBS implantation in the same study period. The authors compared the time required for the surgical implantation of deep brain electrodes in 2 randomly assigned groups. One group of 28 patients underwent traditional sequential electrode implantation, and the other 29 patients underwent simultaneous bilateral implantation. Clinical outcomes of the patients with Parkinson's disease (PD) who had undergone DBS implantation of the subthalamic nucleus using either of the 2 techniques were compared. RESULTS Overall, a reduction of 38.51% in total operating time for the simultaneous bilateral group (136.4 ± 20.93 minutes) as compared with that for the traditional consecutive approach (220.3 ± 27.58 minutes) was observed. Regarding clinical outcomes in the PD patients who underwent subthalamic nucleus DBS implantation, comparing the preoperative off-medication condition with the off-medication/on-stimulation condition 1 year after the surgery in both procedure groups, there was a mean 47.8% ± 9.5% improvement in the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) score in the simultaneous group, while the sequential group experienced 47.5% ± 15.8% improvement (p = 0.96). Moreover, a marked reduction in the levodopa-equivalent dose from preoperatively to postoperatively was similar in these 2 groups. The simultaneous bilateral procedure presented major advantages over the traditional sequential approach, with a shorter total operating time. CONCLUSIONS A simultaneous stereotactic approach significantly reduces the operation time in bilateral DBS procedures, resulting in decreased microrecording time, contributing to the optimization of functional

A CFD-based aerodynamic design procedure for hypersonic wind-tunnel nozzles

Science.gov (United States)

Korte, John J.

1993-01-01

A new procedure which unifies the best of current classical design practices, computational fluid dynamics (CFD), and optimization procedures is demonstrated for designing the aerodynamic lines of hypersonic wind-tunnel nozzles. The new procedure can be used to design hypersonic wind tunnel nozzles with thick boundary layers where the classical design procedure has been shown to break down. An efficient CFD code, which solves the parabolized Navier-Stokes (PNS) equations using an explicit upwind algorithm, is coupled to a least-squares (LS) optimization procedure. A LS problem is formulated to minimize the difference between the computed flow field and the objective function, consisting of the centerline Mach number distribution and the exit Mach number and flow angle profiles. The aerodynamic lines of the nozzle are defined using a cubic spline, the slopes of which are optimized with the design procedure. The advantages of the new procedure are that it allows full use of powerful CFD codes in the design process, solves an optimization problem to determine the new contour, can be used to design new nozzles or improve sections of existing nozzles, and automatically compensates the nozzle contour for viscous effects as part of the unified design procedure. The new procedure is demonstrated by designing two Mach 15, a Mach 12, and a Mach 18 helium nozzles. The flexibility of the procedure is demonstrated by designing the two Mach 15 nozzles using different constraints, the first nozzle for a fixed length and exit diameter and the second nozzle for a fixed length and throat diameter. The computed flow field for the Mach 15 least squares parabolized Navier-Stokes (LS/PNS) designed nozzle is compared with the classically designed nozzle and demonstrates a significant improvement in the flow expansion process and uniform core region.

Effectiveness of sublingual nitroglycerin before puncture compared with conventional intra-arterial nitroglycerin in transradial procedures: a randomized trial

Energy Technology Data Exchange (ETDEWEB)

Turan, Burak, E-mail: drburakturan@gmail.com; Daşlı, Tolga; Erkol, Ayhan; Erden, İsmail

2015-10-15

Aim: Sublingual (SL) nitroglycerin administered before radial artery puncture can improve cannulation success and decrease the incidence of radial artery spasm (RAS) compared with intra-arterial (IA) nitroglycerin in transradial procedures. Methods: Patients undergoing diagnostic transradial angiography were randomized to IA (200 mcg) or SL (400 mcg) nitroglycerin. Primary endpoints were puncture time and puncture attempts. Secondary endpoint was the incidence of RAS. Results: Total of 101 participants (mean age 60 ± 11 years, 53% male) were randomized (51 in IA and 50 in SL groups). Puncture time (50 [36–75] vs 50 [35–90] sec), puncture attempts (1.18 ± 0.48 vs 1.20 ± 0.49), multiple punctures (13.7 vs 16.0%) and RAS (19.6 vs 24.0%) were not statistically different between IA vs SL groups respectively. A composite endpoint of all adverse events related to transradial angiography (multiple punctures, RAS, access site crossover, hypotension/bradycardia associated with nitroglycerin and radial artery occlusion) was very similar in IA vs SL groups (39 vs 40%, respectively). However puncture time was significantly longer with SL nitroglycerin in patients < 1.65 m height (47 [36–66] vs 63 [41–110] sec, p = 0.042). Multiple punctures seemed higher with SL nitroglycerin in patients with diabetes (0 vs 30%, p = 0.028) or in patients < 1.65 m height (7.4 vs 25%, p = 0.085). Likewise, RAS with SL nitroglycerin seemed more frequent in smokers compared to IA nitroglycerin (0 vs 27%, p = 0.089). Conclusions: SL nitroglycerin was not different from IA nitroglycerin in terms of efficiency and safety in overall study population. However it may be inferior to IA nitroglycerin in certain subgroups (shorter individuals, diabetics and smokers). - Highlights: • Improvement in radial artery puncture time and success with subcutaneous nitrate was reported. • Giving nitrate sublingually may have vasodilation along entire length of radial artery and may prevent RAS

Failure mode and effects analysis: an empirical comparison of failure mode scoring procedures.

Science.gov (United States)

Ashley, Laura; Armitage, Gerry

2010-12-01

To empirically compare 2 different commonly used failure mode and effects analysis (FMEA) scoring procedures with respect to their resultant failure mode scores and prioritization: a mathematical procedure, where scores are assigned independently by FMEA team members and averaged, and a consensus procedure, where scores are agreed on by the FMEA team via discussion. A multidisciplinary team undertook a Healthcare FMEA of chemotherapy administration. This included mapping the chemotherapy process, identifying and scoring failure modes (potential errors) for each process step, and generating remedial strategies to counteract them. Failure modes were scored using both an independent mathematical procedure and a team consensus procedure. Almost three-fifths of the 30 failure modes generated were scored differently by the 2 procedures, and for just more than one-third of cases, the score discrepancy was substantial. Using the Healthcare FMEA prioritization cutoff score, almost twice as many failure modes were prioritized by the consensus procedure than by the mathematical procedure. This is the first study to empirically demonstrate that different FMEA scoring procedures can score and prioritize failure modes differently. It found considerable variability in individual team members' opinions on scores, which highlights the subjective and qualitative nature of failure mode scoring. A consensus scoring procedure may be most appropriate for FMEA as it allows variability in individuals' scores and rationales to become apparent and to be discussed and resolved by the team. It may also yield team learning and communication benefits unlikely to result from a mathematical procedure.

A rapid and sensitive loop-mediated isothermal amplification procedure (LAMP) for Mycoplasma hyopneumoniae detection based on the p36 gene.

Science.gov (United States)

Liu, M J; Du, G M; Bai, F F; Wu, Y Z; Xiong, Q Y; Feng, Z X; Li, B; Shao, G Q

2015-05-04

The aim of this study was to establish a method for sensitive and rapid diagnosis of Mycoplasma hyopneumoniae in clinical specimens. To this effect, we employed three sets of primers specifically designed for amplification of nucleic acids under isothermal conditions. After optimization of reaction conditions, M. hyopneumoniae could be successfully detected at 63°C in 45 min through use of the loop-mediated isothermal amplification (LAMP) assay. A positive reaction was identified visually as white precipitate and confirmed by gel electrophoresis. The detection limit for this assay was 10 copies/μL, as observed by electrophoretic analysis. The accuracy of the LAMP reaction was confirmed by restriction endonuclease digestion as well as by direct sequencing of the amplified product. This method can specifically detect M. hyopneumoniae; other species with high homology and other bacterial and virus strains gave negative results. To test the utility of this procedure, the LAMP assay was applied to 40 clinical samples collected from swine lung tissues experimentally challenged with M. hyopneumoniae isolates, and compared to the results from a real-time polymerase chain reaction (PCR) assay. A concordance of 100% was observed between the two assays. In conclusion, the results from our study demonstrated that the LAMP assay provided a rapid reaction and was inexpensive to perform, with no need of complex instruments or systems such as Geneamp PCR. The LAMP assay may therefore be applied in routine diagnosis in the clinical laboratory and for in-field detection of M. hyopneumoniae infection.

FREY’S PROCEDURE- TO ANALYSE THE OUTCOME OF THIS PROCEDURE IN CHRONIC PANCREATITIS

Directory of Open Access Journals (Sweden)

Shilpa Mariappa Casaba

2017-04-01

Full Text Available BACKGROUND Chronic Pancreatitis (CP is a progressive inflammatory disease characterised by debilitating pain and pancreatic insufficiency. There is enormous personal and socio-economic impact on impairment of quality of life, inability to work and even shortening of life expectancy. Although, pancreaticoduodenectomy had been considered the standard surgical procedure for patients with CP because of its high post-op complications with exocrine and endocrine insufficiency, it is not preferred. This has led to a hybrid procedure described by Frey’s, which is used in our study for CP. We aim to analyse the short-term and long-term outcomes of Frey’s procedure at a tertiary care center in patients with chronic pancreatitis. MATERIALS AND METHODS A retrospective review of all CP patients who underwent Frey procedure were reviewed from January 2007-January 2016. Perioperative variables, short-term (30 days and long-term (3 years outcomes were reviewed. Data are frequency (% or mean. RESULTS A total of 97 patients underwent Frey’s procedure. A total of 72 (70.7% were men and 25 (29.3% were women. Mean age was 38 years (range 14-66 years. Indications for surgery included intractable pain (n=97, 100% and obstructive jaundice (n=4, 4.3%. 9 patients (32.6% were diabetic preoperatively. Concomitant procedures include biliary drainage procedure was done for 4 patients (4.3%, i.e. choledochojejunostomy and splenectomy for 2 patients (2.1%, cholecystectomy (n=6, 6%. Short-term outcomes include surgical site infection (n=10, 10%, pancreatic leak (n=6, 5.82% and 2 patients required reoperation for bleeding and no mortality (30 days, diabetic ketoacidosis (n=2, 2%. Pancreatic carcinoma was detected in 3 (2.1% patients. Long-term outcomes include pain free status (n=80, 86.9%, median follow-up of 3 years. Redo pancreatic procedure was performed in 1 (4.3% for anastomotic leak. CONCLUSION Frey’s procedure is a safe and effective pain palliative option for CP

Procedure for taking physical inventories

International Nuclear Information System (INIS)

Anon.

1981-01-01

This session is intended to apprise one of the various aspects of procedures and routines that Exxon Nuclear uses with respect to its nuclear materials physical inventory program. The presentation describes how plant physical inventories are planned and taken. The description includes the planning and preparation for taking the inventory, the clean-out procedures for converting in-process material to measurable items, the administrative procedures for establishing independent inventory teams and for inventorying each inventory area, the verification procedures used to include previously measured tamper-safed items in the inventory, and lastly, procedures used to reconcile the inventory and calculate MUF (materials unaccounted for). The purpose of the session is to enable participants to: (1) understand the planning and pre-inventorty procedures and their importance; (2) understand the need for and the required intensity of clean-out procedures; (3) understand how inventory teams are formed, and how the inventory is conducted; (4) understand the distinction between inventory previously measured tamper-safed items and other materials not so characterized; (5) understand the reconciliation procedures; and (6) calculate a MUF given the book and inventory results

Radiation dose to procedural personnel and patients from an X-ray volume imaging system

International Nuclear Information System (INIS)

Paul, Jijo; Mbalisike, Emmanuel C.; Vogl, Thomas J.

2013-01-01

To evaluate the radiation dose received by procedural personnel and patients from an X-ray volume imaging (XVI) system during interventional procedures. Forty patients were examined using catheter angiography (group A), digital subtraction angiography (group B) and cone-beam CT (CBCT, group C). Doses to procedural personnel (using thermo-luminescent dosimeters, TLDs) and patients were estimated. Image quality and lesion delineation were assessed using objective and subjective methods. Shapiro-Wilk, two-sided Student's t and Wilcoxon matched-pairs tests were used to test statistical significance. Doses (milligrays) measured in the hands and left knee of the interventionist were higher than those in an assistant physician (P < 0.05). Doses (dose-area product and skin entry dose) were lower in group A and higher in C compared with other groups; moreover, comparison among the groups were significant (all P = 0.0001). Subjective and objective lesion delineation showed significant results (all P < 0.05) among the tumour types considered. Image quality estimation showed the opposite results for objective and subjective analysis. More doses were obtained for hands of the procedural personnel compared to other anatomical regions measured. Catheter angiography showed lower dose compared with other imaging groups examined. Lesion delineation was clearly possible using CBCT. Objective and subjective analysis showed the opposite results regarding image quality because of higher noise levels and artefacts. (orig.)

Same, same but different. A comparative perspective on participation and acceptance in siting procedures for HLW repositories in France, Sweden and Finland

Energy Technology Data Exchange (ETDEWEB)

Di Nucci, Maria Rosaria; Isidoro Losada, Ana Maria; Brunnengraeber, Achim [Freie Univ. Berlin (Germany). Environmental Policy Research Centre

2015-07-01

This paper compares national approaches in Finland, Sweden, and France. These three EURATOM Member States are in an advanced stage of siting deep geological disposal (DGD) facilities. The procedures in these countries are largely based on voluntarism, but differ in their approach to public consultation as they were based on the so-called staged volunteer process leading to working partnership arrangements between the operator and the hosting communities and veto rights (Sweden), decisions with strong local community support and veto rights for municipalities until the final decision (Finland), and final top-down decision making after consultative processes (debat public) with the affected communities without veto rights (France). This presentation focuses on participation and acceptance issues; it analyses the different modes of governance with diverse conditions regarding transparency, trust, communication, and participation that have been at work. Moving beyond the fact that variance exists with regard to the relevant national institutional, legal, cultural, industrial, and energy frameworks, the authors take evidence from national case studies and look for common patterns.

Same, same but different. A comparative perspective on participation and acceptance in siting procedures for HLW repositories in France, Sweden and Finland

International Nuclear Information System (INIS)

Di Nucci, Maria Rosaria; Isidoro Losada, Ana Maria; Brunnengraeber, Achim

2015-01-01

This paper compares national approaches in Finland, Sweden, and France. These three EURATOM Member States are in an advanced stage of siting deep geological disposal (DGD) facilities. The procedures in these countries are largely based on voluntarism, but differ in their approach to public consultation as they were based on the so-called staged volunteer process leading to working partnership arrangements between the operator and the hosting communities and veto rights (Sweden), decisions with strong local community support and veto rights for municipalities until the final decision (Finland), and final top-down decision making after consultative processes (debat public) with the affected communities without veto rights (France). This presentation focuses on participation and acceptance issues; it analyses the different modes of governance with diverse conditions regarding transparency, trust, communication, and participation that have been at work. Moving beyond the fact that variance exists with regard to the relevant national institutional, legal, cultural, industrial, and energy frameworks, the authors take evidence from national case studies and look for common patterns.

In-Trail Procedure Air Traffic Control Procedures Validation Simulation Study

Science.gov (United States)

Chartrand, Ryan C.; Hewitt, Katrin P.; Sweeney, Peter B.; Graff, Thomas J.; Jones, Kenneth M.

2012-01-01

In August 2007, Airservices Australia (Airservices) and the United States National Aeronautics and Space Administration (NASA) conducted a validation experiment of the air traffic control (ATC) procedures associated with the Automatic Dependant Surveillance-Broadcast (ADS-B) In-Trail Procedure (ITP). ITP is an Airborne Traffic Situation Awareness (ATSA) application designed for near-term use in procedural airspace in which ADS-B data are used to facilitate climb and descent maneuvers. NASA and Airservices conducted the experiment in Airservices simulator in Melbourne, Australia. Twelve current operational air traffic controllers participated in the experiment, which identified aspects of the ITP that could be improved (mainly in the communication and controller approval process). Results showed that controllers viewed the ITP as valid and acceptable. This paper describes the experiment design and results.

Electronic procedure distribution

International Nuclear Information System (INIS)

Slone, B.J. III; Richardson, C.E.

1993-01-01

Printed procedures can offer a mix of text and graphic information that improves readability and increases understanding. A typical procedure uses illustrations and graphics to clarify concepts, a variety of type styles and weights to make it easier to find different topics and sections, white space to improve readability, and familiar navigational clues such as page numbers and topic headers. Initially, electronic procedure systems had limited typeface options, often only a single typeface, with no capability for enhancing readability by varying type size bolding, italicizing, or underlining, and no ability to include graphics. Even recently, many text-only electronic procedures were originally created in a modern What-You-See-Is-What-You-Get (WYSI-WYG) document authoring system, only to be converted to pages and pages of plain type for electronic distribution. Given the choice of paper or on-line producers, most users have chosen paper for its readability. But current-generation electronic document systems that use formatted text and embedded graphics offer users vastly improved readability. Further, they are offering ever-better search tools to enable rapid location of material of interest

Modified arthroscopic Brostrom procedure.

Science.gov (United States)

Lui, Tun Hing

2015-09-01

The open modified Brostrom anatomic repair technique is widely accepted as the reference standard for lateral ankle stabilization. However, there is high incidence of intra-articular pathologies associated with chronic lateral ankle instability which may not be addressed by an isolated open Brostrom procedure. Arthroscopic Brostrom procedure with suture anchor has been described for anatomic repair of chronic lateral ankle instability and management of intra-articular lesions. However, the complication rates seemed to be higher than open Brostrom procedure. Modification of the arthroscopic Brostrom procedure with the use of bone tunnel may reduce the risk of certain complications. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Ulnar artery: The Ulysses ultimate resort for coronary procedures.

Science.gov (United States)

Hahalis, George; Deftereos, Spyridon; Bertrand, Olivier F

2016-08-20

Despite the increasing worldwide adoption of the transradial access site, the ulnar artery (UA) only very infrequently serves as a primary option for coronary procedures. In contrast to the uncertainty surrounding previous reports regarding the feasibility and safety, recent data from larger registries and randomized trials provide more conclusive evidence that the transulnar route may be safely selected as an alternative arterial access approach. However, a default transulnar strategy appears time-consuming and is associated with higher crossover rates compared with the radial artery (RA). Once arterial access is obtained, the likelihood of a successful coronary procedure is high and similar between the two forearm arteries. The UA has similar flow-mediating vasodilating properties with and seems at least as vulnerable as the RA with regard to incident occlusion, with UA occlusion (UAO) rates being probably higher than previously anticipated. A learning curve effect may not be apparent for crossover rates among experienced radialists, but increasing experience is associated with reduction in the fluoroscopy time, contrast volume and frequency of large hematoma formation. The UA may represents an important alternative access site for coronary procedures, and experienced radial operators should obtain additional skills to perform the transulnar approach. Nevertheless, in view of this method's lower feasibility compared to the RA, an initial ulnar access strategy should be reserved for carefully selected patients to ensure satisfactory cannulation rates. Copyright © 2016 Hellenic Cardiological Society. Published by Elsevier B.V. All rights reserved.

Assessment of different concentrations of ketofol in procedural operations

International Nuclear Information System (INIS)

Daabiss, Mohamed; Elsherbiny, Medhat; Al Otaibi, Rashed

2009-01-01

Propofol is an intravenous anesthetic that is often used as an adjuvant during monitored anesthesia care, the addition of ketamine to propofol may counteract the cardiorespiratory depression seen with propofol used alone. Ketofol (ketamine/propofol combination) was used for procedural sedation and analgesia. However, evaluation of the effectiveness of different concentrations of Ketofol in procedural operation regarding changes in haemodynamics, emergence phenomena, recovery time, the doses, and adverse effects was not yet studied, so this randomized, double blinded study was designed to compare the quality of analgesia and side effects of intravenous different concentrations of ketofol. One hundred children of both sex undergoing procedural operation, e.g. esophgoscopy, rectoscopy, bone marrow aspiration and liver biopsy participated in this. Patients received an infusion of a solution containing either combination of propofol: ketamine (1:1) (Group I) or propofol: ketamine (4:1) (Group II). Subsequent infusion rates to a predetermined sedation level using Ramsay Sedation Scale. Heart rate, noninvasive arterial blood pressure (NIBP), oxygen saturation (SpO2), end tidal carbon dioxide (Etco 2 ) and incidence of any side effects were recorded. There were no significant hemodynamic changes in both groups after induction. However, there was an increase in postoperative nausea, psychomimetic side effects, and delay in discharge times in group I compared to group II. The adjunctive use of smaller dose of ketamine in ketofol combination minimizes the psychomimetic side effects and shortens the time of hospital discharge. (author)

Reporting on a Talk I Gave Some Months Ago, the Headline in "La Opinion," Los Angeles' Premier Spanish Language Newspaper, Declared the City's School System "en crisis permanente." No One Wrote in to Disagree. The Claremont Letter. Volume 3, Issue 1

Science.gov (United States)

Kerchner, Charles T.

2008-01-01

Reporting on a talk the author gave some months ago, the headline in "La Opinion," Los Angeles' premier Spanish language newspaper, declared the city's school system "en crisis permanente." No one wrote in to disagree. Indeed, at the end of "Learning from L.A.: Institutional Change in American Public Education" (Harvard Education Press) the author…

Radiographic implications of procedures involving cardiac implantable electronic devices (CIEDs – Selected aspects

Directory of Open Access Journals (Sweden)

Roman Steckiewicz

2017-06-01

Full Text Available Background: Some cardiac implantable electronic device (CIED implantation procedures require the use of X-rays, which is reflected by such parameters as total fluoroscopy time (TFT and dose-area product (DAP – defined as the absorbed dose multiplied by the area irradiated. Material and Methods: This retrospective study evaluated 522 CIED implantation (424 de novo and 98 device upgrade and new lead placement procedures in 176 women and 346 men (mean age 75±11 years over the period 2012–2015. The recorded procedure-related parameters TFT and DAP were evaluated in the subgroups specified below. The group of 424 de novo procedures included 203 pacemaker (PM and 171 implantable cardioverter-defibrillator (ICD implantation procedures, separately stratified by single-chamber and dual-chamber systems. Another subgroup of de novo procedures involved 50 cardiac resynchronization therapy (CRT devices. The evaluated parameters in the group of 98 upgrade procedures were compared between 2 subgroups: CRT only and combined PM and ICD implantation procedures. Results: We observed differences in TFT and DAP values between procedure types, with PM-related procedures showing the lowest, ICD – intermediate (with values for single-chamber considerably lower than those for dual-chamber systems and CRT implantation procedures – highest X-ray exposure. Upgrades to CRT were associated with 4 times higher TFT and DAP values in comparison to those during other upgrade procedures. Cardiac resynchronization therapy de novo implantation procedures and upgrades to CRT showed similar mean values of these evaluated parameters. Conclusions: Total fluoroscopy time and DAP values correlated progressively with CIED implantation procedure complexity, with CRT-related procedures showing the highest values of both parameters. Med Pr 2017;68(3:363–374

Reduced infant response to a routine care procedure after sucrose analgesia.

Science.gov (United States)

Taddio, Anna; Shah, Vibhuti; Katz, Joel

2009-03-01

Sucrose has analgesic and calming effects in newborns. To date, it is not known whether the beneficial effects extend to caregiving procedures that are performed after painful procedures. Our objective was to determine the effect of sucrose analgesia for procedural pain on infant pain responses during a subsequent caregiving procedure. We conducted a double-blind, randomized, controlled trial. Healthy neonates within 2 strata (normal infants and infants of diabetic mothers) were randomly assigned to a sucrose or placebo water group before all needle procedures after birth. Pain response during a diaper change performed after venipuncture for the newborn screening test was determined by using a validated multidimensional measure, the Premature Infant Pain Profile. The study was conducted between September 15, 2003, and July 27, 2004. Altogether, 412 parents were approached; 263 consented. Twenty-three infants were not assigned, leaving 240 for participation (n = 120 per group), with an equal number in each infant strata. Of those, 186 (78%) completed the study. There were no significant differences in birth characteristics between groups. During diaper change, sucrose-treated infants had lower pain scores than placebo-treated infants. The relative risk of having pain, defined as a Premature Infant Pain Profile score of >/=6, was 0.64 with sucrose compared with placebo. This study demonstrates that when used to manage pain, sucrose reduces the pain response to a subsequent routine caregiving procedure. Therefore, the benefits of sucrose analgesia extend beyond the painful event to other aversive and potentially painful procedures.

Revision Arthroscopic Repair Versus Latarjet Procedure in Patients With Recurrent Instability After Initial Repair Attempt: A Cost-Effectiveness Model.

Science.gov (United States)

Makhni, Eric C; Lamba, Nayan; Swart, Eric; Steinhaus, Michael E; Ahmad, Christopher S; Romeo, Anthony A; Verma, Nikhil N

2016-09-01

To compare the cost-effectiveness of arthroscopic revision instability repair and Latarjet procedure in treating patients with recurrent instability after initial arthroscopic instability repair. An expected-value decision analysis of revision arthroscopic instability repair compared with Latarjet procedure for recurrent instability followed by failed repair attempt was modeled. Inputs regarding procedure cost, clinical outcomes, and health utilities were derived from the literature. Compared with revision arthroscopic repair, Latarjet was less expensive ($13,672 v $15,287) with improved clinical outcomes (43.78 v 36.76 quality-adjusted life-years). Both arthroscopic repair and Latarjet were cost-effective compared with nonoperative treatment (incremental cost-effectiveness ratios of 3,082 and 1,141, respectively). Results from sensitivity analyses indicate that under scenarios of high rates of stability postoperatively, along with improved clinical outcome scores, revision arthroscopic repair becomes increasingly cost-effective. Latarjet procedure for failed instability repair is a cost-effective treatment option, with lower costs and improved clinical outcomes compared with revision arthroscopic instability repair. However, surgeons must still incorporate clinical judgment into treatment algorithm formation. Level IV, expected value decision analysis. Copyright © 2016. Published by Elsevier Inc.

Radiosurgical fistulotomy; an alternative to conventional procedure in fistula in ano.

Science.gov (United States)

Gupta, Pravin J

2003-01-01

Most surgeons continue to prefer the classic lay open technique [fistulotomy] as the gold standard of treatment in anal fistula. In this randomized study, a comparison is made between conventional fistulotomy and fistulotomy performed by a radio frequency device. One hundred patients of low anal fistula posted for fistulotomy were randomized prospectively to either a conventional or radio frequency technique. Parameters measured included time taken for the procedure, amount of blood loss, postoperative pain, return to work, and recurrence rate. The patient demographic was comparable in 2 groups. The radio frequency fistulotomy was quicker as compared to a conventional one [22 versus 37 minutes, p = 0.001], amount of bleeding was significantly less [47 ml versus 134 ml, p = 0.002], and hospital stay was less when patient was operated by radio frequency method [37 hours versus 56 hours in conventional method, p = 0.001]. The postoperative pain in the first 24 hours was more in conventional group [2 to 5 versus 0 to 3 on visual analogue scale]. The patients from radio frequency group resumed their duties early with a reduced healing period of the wounds [47 versus 64 days, p = 0.01]. The recurrence or failure rates were comparable in the radio frequency and conventional groups [2% versus 6%]. Fistulotomy procedure using a radio frequency technique has significant advantages over a conventional procedure with regard to operation time, blood loss, return to normal activity, and healing time of the wound.

Phenolic composition, antioxidant and anti-inflammatory activities of extracts from Moroccan Opuntia ficus-indica flowers obtained by different extraction methods

OpenAIRE

Benayad, Z.; Martínez Villaluenga, Cristina; Frías, Juana; Gómez-Cordovés, Carmen; Es-Safi, N. E

2014-01-01

© 2014 Elsevier B.V. The objectives of this study were to compare the phenolic extraction efficiency of four extraction procedures, to explore the extract phenolic profile by HPLC-DAD-ESI-MS and to evaluate the antioxidant and anti-inflammatory activities of cactus flowers from Morocco. accelerated solvent extraction (ASE) with 80% acetone in water at 80. °C gave rise to extracts with higher yields of total polyphenols, procyanidins and flavonoids. The qualitative analysis of the phenolic com...

Comparative study of radiometric and calorimetric methods for total hemispherical emissivity measurements

Science.gov (United States)

Monchau, Jean-Pierre; Hameury, Jacques; Ausset, Patrick; Hay, Bruno; Ibos, Laurent; Candau, Yves

2018-05-01

Accurate knowledge of infrared emissivity is important in applications such as surface temperature measurements by infrared thermography or thermal balance for building walls. A comparison of total hemispherical emissivity measurement was performed by two laboratories: the Laboratoire National de Métrologie et d'Essais (LNE) and the Centre d'Études et de Recherche en Thermique, Environnement et Systèmes (CERTES). Both laboratories performed emissivity measurements on four samples, chosen to cover a large range of emissivity values and angular reflectance behaviors. The samples were polished aluminum (highly specular, low emissivity), bulk PVC (slightly specular, high emissivity), sandblasted aluminum (diffuse surface, medium emissivity), and aluminum paint (slightly specular surface, medium emissivity). Results obtained using five measurement techniques were compared. LNE used a calorimetric method for direct total hemispherical emissivity measurement [1], an absolute reflectometric measurement method [2], and a relative reflectometric measurement method. CERTES used two total hemispherical directional reflectometric measurement methods [3, 4]. For indirect techniques by reflectance measurements, the total hemispherical emissivity values were calculated from directional hemispherical reflectance measurement results using spectral integration when required and directional to hemispherical extrapolation. Results were compared, taking into account measurement uncertainties; an added uncertainty was introduced to account for heterogeneity over the surfaces of the samples and between samples. All techniques gave large relative uncertainties for a low emissive and very specular material (polished aluminum), and results were quite scattered. All the indirect techniques by reflectance measurement gave results within ±0.01 for a high emissivity material. A commercial aluminum paint appears to be a good candidate for producing samples with medium level of emissivity

Biaxial testing for fabrics and foils optimizing devices and procedures

CERN Document Server

Beccarelli, Paolo

2015-01-01

This book offers a well-structured, critical review of current design practice for tensioned membrane structures, including a detailed analysis of the experimental data required and critical issues relating to the lack of a set of design codes and testing procedures. The technical requirements for biaxial testing equipment are analyzed in detail, and aspects that need to be considered when developing biaxial testing procedures are emphasized. The analysis is supported by the results of a round-robin exercise comparing biaxial testing machines that involved four of the main research laboratories in the field. The biaxial testing devices and procedures presently used in Europe are extensively discussed, and information is provided on the design and implementation of a biaxial testing rig for architectural fabrics at Politecnico di Milano, which represents a benchmark in the field. The significance of the most recent developments in biaxial testing is also explored.

Standardized Procedure Content And Data Structure Based On Human Factors Requirements For Computer-Based Procedures

International Nuclear Information System (INIS)

Bly, Aaron; Oxstrand, Johanna; Le Blanc, Katya L

2015-01-01

Most activities that involve human interaction with systems in a nuclear power plant are guided by procedures. Traditionally, the use of procedures has been a paper-based process that supports safe operation of the nuclear power industry. However, the nuclear industry is constantly trying to find ways to decrease the human error rate, especially the human errors associated with procedure use. Advances in digital technology make computer-based procedures (CBPs) a valid option that provides further enhancement of safety by improving human performance related to procedure use. The transition from paper-based procedures (PBPs) to CBPs creates a need for a computer-based procedure system (CBPS). A CBPS needs to have the ability to perform logical operations in order to adjust to the inputs received from either users or real time data from plant status databases. Without the ability for logical operations the procedure is just an electronic copy of the paper-based procedure. In order to provide the CBPS with the information it needs to display the procedure steps to the user, special care is needed in the format used to deliver all data and instructions to create the steps. The procedure should be broken down into basic elements and formatted in a standard method for the CBPS. One way to build the underlying data architecture is to use an Extensible Markup Language (XML) schema, which utilizes basic elements to build each step in the smart procedure. The attributes of each step will determine the type of functionality that the system will generate for that step. The CBPS will provide the context for the step to deliver referential information, request a decision, or accept input from the user. The XML schema needs to provide all data necessary for the system to accurately perform each step without the need for the procedure writer to reprogram the CBPS. The research team at the Idaho National Laboratory has developed a prototype CBPS for field workers as well as the

Standardized Procedure Content And Data Structure Based On Human Factors Requirements For Computer-Based Procedures

Energy Technology Data Exchange (ETDEWEB)

Bly, Aaron; Oxstrand, Johanna; Le Blanc, Katya L

2015-02-01

Most activities that involve human interaction with systems in a nuclear power plant are guided by procedures. Traditionally, the use of procedures has been a paper-based process that supports safe operation of the nuclear power industry. However, the nuclear industry is constantly trying to find ways to decrease the human error rate, especially the human errors associated with procedure use. Advances in digital technology make computer-based procedures (CBPs) a valid option that provides further enhancement of safety by improving human performance related to procedure use. The transition from paper-based procedures (PBPs) to CBPs creates a need for a computer-based procedure system (CBPS). A CBPS needs to have the ability to perform logical operations in order to adjust to the inputs received from either users or real time data from plant status databases. Without the ability for logical operations the procedure is just an electronic copy of the paper-based procedure. In order to provide the CBPS with the information it needs to display the procedure steps to the user, special care is needed in the format used to deliver all data and instructions to create the steps. The procedure should be broken down into basic elements and formatted in a standard method for the CBPS. One way to build the underlying data architecture is to use an Extensible Markup Language (XML) schema, which utilizes basic elements to build each step in the smart procedure. The attributes of each step will determine the type of functionality that the system will generate for that step. The CBPS will provide the context for the step to deliver referential information, request a decision, or accept input from the user. The XML schema needs to provide all data necessary for the system to accurately perform each step without the need for the procedure writer to reprogram the CBPS. The research team at the Idaho National Laboratory has developed a prototype CBPS for field workers as well as the

Pelvic denervation procedures for dysmenorrhea.

Science.gov (United States)

Ramirez, Christina; Donnellan, Nicole

2017-08-01

Chronic pelvic pain and dysmenorrhea are common conditions affecting reproductive-age women. Surgical pelvic denervation procedures may be a treatment option for women with midline dysmenorrhea, in which medical management is declined by the patient, ineffective at managing symptoms, or medically contraindicated. This review describes the surgical techniques and complications associated with pelvic denervation procedures as well as the current evidence for these procedures in women with primary dysmenorrhea and dysmenorrhea secondary to endometriosis. Presacral neurectomy is the preferred pelvic denervation procedure in patients with primary dysmenorrhea and midline chronic pelvic pain associated with endometriosis. In patients with endometriosis presacral neurectomy is a useful adjunct to excision or ablation of all endometrial lesions to improve postoperative pain relief. There is no additional patient benefit of performing combined presacral neurectomy and uterine nerve ablation procedures. Pelvic denervation procedures can be performed safely and quickly with a low risk of complication if the surgeon is knowledgeable and skilled in operating in the presacral space. Patients should be adequately counseled on expected success rates and potential complications associated with pelvic denervation procedures.

[The transrectus sheath preperitoneal procedure: a safe, effective and cheap surgical approach to inguinal hernia?].

Science.gov (United States)

Prins, M W Wiesje; Voropai, D A Dasha; van Laarhoven, C J H M Kees; Akkersdijk, Willem L

2013-01-01

The main complication of surgery for inguinal hernia is chronic postoperative pain. This is often reported following the Lichtenstein procedure. A new, open surgical technique for the repair of inguinal hernia has been developed. This procedure is called the transrectus sheath preperitoneal procedure (TREPP). At TREPP a lightweight mesh with a ring made of memory metal is introduced into the preperitoneal space through the transrectus sheath. The first results of this operative technique are very promising: short operation time, short learning curve and not many patients with chronic postoperative pain. In a randomised, multi-centre study which will start mid-2013 (ISRCTN18591339), the TREPP procedure is compared with the transinguinal preperitoneal procedure. The primary outcome measure of this study is chronic postoperative pain.

Retrofit of heat exchanger networks considering pressure drop and existing structure: a new targeting procedure

International Nuclear Information System (INIS)

PanjehShahi, M.H.; Nouzari, M.M.

2002-01-01

A new retrofit targeting procedure, based on pinch technology has been developed. The procedure considers existing structure and hydrodynamic system of a given network as two main constraint during targeting. The procedure uses a linear programming model to consider existing structure. The model finds a network structure that has maximum compatibility with existing structure. Furthermore, the procedure using the pressure drop equations, can consider decreasing the film coefficients of streams due to increasing network area. Good compatibility between old and new networks and non replacement of hydrodynamic equipment cause to the best use of capital in retrofit projects. The procedure has been checked by doing two case studies, in which the results compared to the established methods, and realized significant improvement

76 FR 62092 - Filing Procedures

Science.gov (United States)

2011-10-06

... INTERNATIONAL TRADE COMMISSION Filing Procedures AGENCY: International Trade Commission. ACTION: Notice of issuance of Handbook on Filing Procedures. SUMMARY: The United States International Trade Commission (``Commission'') is issuing a Handbook on Filing Procedures to replace its Handbook on Electronic...

Measuring automatic retrieval: a comparison of implicit memory, process dissociation, and speeded response procedures.

Science.gov (United States)

Horton, Keith D; Wilson, Daryl E; Vonk, Jennifer; Kirby, Sarah L; Nielsen, Tina

2005-07-01

Using the stem completion task, we compared estimates of automatic retrieval from an implicit memory task, the process dissociation procedure, and the speeded response procedure. Two standard manipulations were employed. In Experiment 1, a depth of processing effect was found on automatic retrieval using the speeded response procedure although this effect was substantially reduced in Experiment 2 when lexical processing was required of all words. In Experiment 3, the speeded response procedure showed an advantage of full versus divided attention at study on automatic retrieval. An implicit condition showed parallel effects in each study, suggesting that implicit stem completion may normally provide a good estimate of automatic retrieval. Also, we replicated earlier findings from the process dissociation procedure, but estimates of automatic retrieval from this procedure were consistently lower than those from the speeded response procedure, except when conscious retrieval was relatively low. We discuss several factors that may contribute to the conflicting outcomes, including the evidence for theoretical assumptions and criterial task differences between implicit and explicit tests.

Dynamic alarm response procedures

International Nuclear Information System (INIS)

Martin, J.; Gordon, P.; Fitch, K.

2006-01-01

The Dynamic Alarm Response Procedure (DARP) system provides a robust, Web-based alternative to existing hard-copy alarm response procedures. This paperless system improves performance by eliminating time wasted looking up paper procedures by number, looking up plant process values and equipment and component status at graphical display or panels, and maintenance of the procedures. Because it is a Web-based system, it is platform independent. DARP's can be served from any Web server that supports CGI scripting, such as Apache R , IIS R , TclHTTPD, and others. DARP pages can be viewed in any Web browser that supports Javascript and Scalable Vector Graphics (SVG), such as Netscape R , Microsoft Internet Explorer R , Mozilla Firefox R , Opera R , and others. (authors)

Effective and efficient learning in the operating theater with intraoperative video-enhanced surgical procedure training.

Science.gov (United States)

van Det, M J; Meijerink, W J H J; Hoff, C; Middel, B; Pierie, J P E N

2013-08-01

INtraoperative Video Enhanced Surgical procedure Training (INVEST) is a new training method designed to improve the transition from basic skills training in a skills lab to procedural training in the operating theater. Traditionally, the master-apprentice model (MAM) is used for procedural training in the operating theater, but this model lacks uniformity and efficiency at the beginning of the learning curve. This study was designed to investigate the effectiveness and efficiency of INVEST compared to MAM. Ten surgical residents with no laparoscopic experience were recruited for a laparoscopic cholecystectomy training curriculum either by the MAM or with INVEST. After a uniform course in basic laparoscopic skills, each trainee performed six cholecystectomies that were digitally recorded. For 14 steps of the procedure, an observer who was blinded for the type of training determined whether the step was performed entirely by the trainee (2 points), partially by the trainee (1 point), or by the supervisor (0 points). Time measurements revealed the total procedure time and the amount of effective procedure time during which the trainee acted as the operating surgeon. Results were compared between both groups. Trainees in the INVEST group were awarded statistically significant more points (115.8 vs. 70.2; p < 0.001) and performed more steps without the interference of the supervisor (46.6 vs. 18.8; p < 0.001). Total procedure time was not lengthened by INVEST, and the part performed by trainees was significantly larger (69.9 vs. 54.1 %; p = 0.004). INVEST enhances effectiveness and training efficiency for procedural training inside the operating theater without compromising operating theater time efficiency.

A comparative study of an elisa test and an indirect immunofluorescence test for serological diagnosis of Babesia bovis infection

International Nuclear Information System (INIS)

Martins, J.R.; Cheong, F.H.; Correa, B.L.; Radley, D.E.; Cereser, V.H.

1998-01-01

Detection of antibodies to Babesia bovis in cattle is essential for the understanding of the epidemiology of babesiosis and this study was concerned with comparing the indirect fluorescent antibody with the ELISA. Both assays gave rise to 100% sensitivity whilst the ELISA was shown to be marginally more specific at 98%. The ease of use and low cost of the ELISA would make it the more obvious choice in conducting future serological surveys for this parasite. (author)

Emergency Kausch-Whipple procedure: indications and experiences.

Science.gov (United States)

Standop, Jens; Glowka, Tim; Schmitz, Volker; Schaefer, Nico; Hirner, Andreas; Kalff, Jörg C

2010-03-01

Pancreaticoduodenectomy is a demanding procedure even in selected patients but becomes formidable when performed in cases of emergency. This study analyzed our experience with urgent pancreatoduodenectomies; special emphases were put on the evaluation of diagnostic means and the validation of existing indications for performance of this procedure. Three hundred one patients who underwent pancreatoduodenectomy between 1989 and 2008 were identified from a pancreatic resection database and reviewed for emergency indications. Six patients (2%) underwent emergency pancreatoduodenectomy. Indications included endoscopy-related perforation, postoperative complications, and uncontrollable intraduodenal tumor bleeding. Length of stay and occurrence of nonsurgical complications were increased in emergency compared with elective pancreatoduodenectomies. Although increased, no significant differences were found regarding mortality and surgery-related complications. Indications for emergency pancreatoduodenectomies were based on clinical decisions rather than on radiologic diagnostics. Urgent pancreatic head resections may be considered as an option in selected patients if handling of local complications by interventional measures or limited surgery seems unsafe.

Technical and surgical aspects of the sphenopalatine ganglion (SPG) microstimulator insertion procedure

DEFF Research Database (Denmark)

Assaf, A T; Hillerup, S; Rostgaard, J

2016-01-01

into the pterygopalatine fossa (PPF) is presented herein. Technical aspects include detailed descriptions of the preoperative planning using computed tomography or cone beam computed tomography scans for presurgical digital microstimulator insertion into the patient-specific anatomy and intraoperative verification......), and removal (n=5). This SPG microstimulator insertion procedure has sequelae comparable to other oral cavity procedures including tooth extractions, sinus surgery, and dental implant placement. Twenty-five of 29 subjects (86%) completing a self-assessment questionnaire indicated that the surgical effects were...

Primary Definitive Procedure versus Conventional Three-staged Procedure for the Management of Low-type Anorectal Malformation in Females: A Randomized Controlled Trial.

Science.gov (United States)

Gupta, Alisha; Agarwala, Sandeep; Sreenivas, Vishnubhatla; Srinivas, Madhur; Bhatnagar, Veereshwar

2017-01-01

Females with Krickenbeck low-type anorectal malformations - vestibular fistula (VF) and perineal fistula (PF) - are managed either by a primary definitive or conventional three-staged approach. Ultimate outcome in these children may be affected by wound dehiscence leading to healing by fibrosis. Most of the literature favors one approach over other based on retrospective analysis of their outcomes. Whether a statistically significant difference in wound dehiscence rates between these approaches exists needed to be seen. A randomized controlled trial for girls <14 years with VF or PF was done. Random tables were used to randomize 33 children to Group I (primary procedure) and 31 to Group II (three-staged procedure). Statistical analysis was done for significance of difference ( P < 0.05) in the primary outcome (wound dehiscence) and secondary outcomes (immediate and early postoperative complications). Of the 64 children randomized, 54 (84%) had VF. Both groups were comparable in demography, clinical profile and age at surgery. The incidence of wound dehiscence (39.4% vs. 18.2%; P = 0.04), immediate postoperative complications (51.5% vs. 12.9%; P = 0.001), and early postoperative complications (42.4% vs. 12.9%; P = 0.01) was significantly higher in Group I as compared to Group II. Six of 13 children (46.2%) with dehiscence in Group I required a diverting colostomy to be made. Females with VF or PF undergoing primary definitive procedure have a significantly higher incidence of wound dehiscence ( P = 0.04), immediate ( P = 0.001) and early postoperative complications ( P = 0.01).

The use of analytical procedures in the internal audit of the restaurant business expenses

Directory of Open Access Journals (Sweden)

T.Yu. Kopotienko

2015-06-01

Full Text Available The important task of carrying out the internal audit of expenses is to get the sufficient and reliable audit evidence. This can be achieved by using the analytical procedures in the audit process. The identification of the analytical procedures with the financial analysis of the business activities prevents from the efficient usage of them in the internal audit of the restaurant business expenses. The knowledge of internal auditors about the instructional techniques of analytical procedures and their tasks, depending on the verification steps are insufficient. The purpose of the article is the developing the methods of the internal audit of the restaurant business expenses based on an integrated application of analytical procedures. The nature and purpose of analytical procedures have been investigated in the article. It have been identified the factors influencing on auditor’s decision about the choice of analytical procedures complex. It was recommended to identify among them the purpose of analytical procedures, the type and structure of the enterprise, the source of the available information, the existence of financial and non-financial information, reliability and comparability of the available information. It have been identified the tasks of analytical procedures, depending on the verification steps. It was offered the analytical procedures complex as a part of internal audit of the restaurant business expenses. This complex contains a list of the analytical procedures, instructional techniques of analysis that are used in the appropriate procedure and the brief overview of the content of procedure.

The development of a purification procedure for saxitoxin-induced protein.

Science.gov (United States)

Smith, D S; Kitts, D D; Fenske, B; Owen, T G; Shyng, S

1995-02-01

A simple economical procedure for purifying saxitoxin-induced protein (SIP) from crude extracts of the small shore crab, Hemigrapsus oregenesis, was developed. (NH4)2SO4 precipitation, chymotrypsin digestion, heat treatment, gel filtration and ion-exchange-chromatography procedures were evaluated in purifying SIP. An enzyme immunoassay was used to determine the SIP yield and relative purity at each step of three procedures, thus permitting an assessment of the conditions required for maximum recovery. Response surface analysis was used in an attempt to determine the optimum temperature and exposure time for the heat treatment. A 20 min incubation at 65 degrees C was confirmed by electrophoretic analysis to be the best combination of time and temperature for achieving both an acceptable yield and purity of SIP. SIP in desalted concentrate was shown to be resistant to chymotrypsin proteolysis; however, this enzyme had deleterious effects on SIP purification at later stages of the procedure. The omission of the chymotrypsin digestion, and the inclusion of gel-filtration chromatography in the final clean-up step, resulted in the purification of SIP comparable with that achieved with affinity chromatography.

Pediatric patient doses in interventional cardiology procedures

International Nuclear Information System (INIS)

Medeiros, R.B.; Murata, C.H.; Moreira, A.C.

2014-01-01

The radiation doses from interventional procedures is relevant when treating children because of their greater radiosensitivity compared with adults. The purposes of this paper were to estimate the dose received by 18 pediatric patients who underwent cardiac interventional procedures and to correlate the maximum entrance surface air kerma (Ke,max), estimated with radiochromic films, with the cumulative air kerma values displayed at the end of procedures. This study was performed in children up to 6 years. The study was performed in two hospitals, one located in Recife and the other one in São Paulo. The x-ray imaging systems used were Phillips Allura 12 model with image intensifier system and a Phillips Allura FD10 flat panel system. To estimate the Ke,max on the patient’s skin radiochromic films(Gafchromic XR-RV2) were used. These values were estimated from the maximum optical density measured on film using a calibration curve. The results showed cumulative air kerma values ranging from 78.3- 500.0mGy, with a mean value of 242,3 mGy. The resulting Ke,max values ranged from 20.0-461.8 mGy, with a mean value of 208,8 mGy. The Ke,max values were correlated with the displayed cumulative air kerma values. The correlation factor R² was 0.78, meaning that the value displayed in the equipment’s console can be useful for monitoring the skin absorbed dose throughout the procedure. The routine fluoroscopy time records is not able by itself alert the physician about the risk of dose exceeding the threshold of adverse reactions, which can vary from an early erythema to serious harmful skin damage. (author)

Evaluation of sedation for standing clinical procedures in horses using detomidine combined with buprenorphine.

Science.gov (United States)

Taylor, Polly; Coumbe, Karen; Henson, Frances; Scott, David; Taylor, Alan

2014-01-01

To examine the effect of including buprenorphine with detomidine for sedation of horses undergoing clinical procedures. Partially blinded, randomised, prospective clinical field trial. Eighty four client-owned horses scheduled for minor surgery or diagnostic investigation under standing sedation. The effects of buprenorphine (5 μg kg(-1) ) (Group B, n = 46) or placebo (5% glucose solution) (Group C, n = 38) in combination with detomidine (10 μg kg(-1) ) were compared in standing horses undergoing minor clinical procedures. The primary outcome measure was successful completion of the procedure. The degree of sedation and ataxia were scored using simple descriptive scales. Heart and respiratory rates were recorded at 15-30 minute intervals. Parametric data from each group were compared using anova or t-test and non parametric data using the Mann-Whitney U test. The procedure was carried out successfully in 91% of Group B and 63% of Group C (p detomidine, increased after buprenorphine but not glucose administration, was more profound in group B and lasted longer (60 versus 30 minutes) p detomidine 10 and 20 μg kg(-1) with minor side effects similar to other alpha2 agonist/opioid combinations. Detomidine-buprenorphine sedation is suitable for standing procedures in horses. © 2013 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

Predisposing cardiac conditions, interventional procedures, and antibiotic prophylaxis among patients with infective endocarditis.

Science.gov (United States)

Chirillo, Fabio; Faggiano, Pompilio; Cecconi, Moreno; Moreo, Antonella; Squeri, Angelo; Gaddi, Oscar; Cecchi, Enrico

2016-09-01

Efficacy and safety of antibiotic prophylaxis (AP) for prevention of infective endocarditis (IE) in patients with predisposing cardiac condition (PCC) undergoing invasive procedures is still debated. We sought to assess the prevalence of PCC, the type of interventional procedures preceding the onset of symptoms, and the usefulness of AP in a large cohort of consecutive patients with definite IE. We examined 677 (median age 65.34 years; male 492 [73%]) consecutive patients with IE enrolled from July 2007 through 2010 into the Italian Registry of Infective Endocarditis. Predisposing cardiac condition was present in 341 patients (50%).Thirty-two patients (4.7%) underwent dental procedures. Of 20 patients with PCC undergoing dental procedure, 13 had assumed AP. Viridans group streptococci were isolated from blood cultures in 8 of 20 patients with PCC and prior dental procedure. Nondental procedures preceded IE in 139 patients (21%). They were significantly older and had more comordibities compared with patients undergoing dental procedures. Predisposing cardiac condition was identified in 91 patients. Perioperative antimicrobial prophylaxis was administered to 67 patients. Staphylococcus aureus was the most frequent causative agent. Cardiac surgery was necessary in 85 patients (20 with prior dental and 65 with nondental procedure). Surgical mortality (12% vs 0%, P = .03) and hospital mortality (23% vs 3%, P = .001) were significantly larger among patients with nondental procedures. In a large unselected cohort of patients with IE, the incidence of preceding dental procedures was minimal. The number of cases potentially preventable by means of AP was negligible. Nondental procedures were more frequent than dental procedures and were correlated with poorer prognosis. Copyright © 2016 Elsevier Inc. All rights reserved.

Correlation functional in screened-exchange density functional theory procedures.

Science.gov (United States)

Chan, Bun; Kawashima, Yukio; Hirao, Kimihiko

2017-10-15

In the present study, we have explored several prospects for the further development of screened-exchange density functional theory (SX-DFT) procedures. Using the performance of HSE06 as our measure, we find that the use of alternative correlation functionals (as oppose to PBEc in HSE06) also yields adequate results for a diverse set of thermochemical properties. We have further examined the performance of new SX-DFT procedures (termed HSEB-type methods) that comprise the HSEx exchange and a (near-optimal) reparametrized B97c (c OS,0  = c SS,0  = 1, c OS,1  = -1.5, c OS,2  = -0.644, c SS,1  = -0.5, and c SS,2  = 1.10) correlation functionals. The different variants of HSEB all perform comparably to or slightly better than the original HSE-type procedures. These results, together with our fundamental analysis of correlation functionals, point toward various directions for advancing SX-DFT methods. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Procedures in diagnostic radiology

International Nuclear Information System (INIS)

Doyle, T.; Hare, W.S.C.; Thomson, K.; Tess, B.

1989-01-01

This book outlines the various procedures necessary for the successful practice of diagnostic radiology. Topics covered are: general principles, imaging of the urinary and gastrointestinal tracts, vascular radiology, arthrography, and miscellaneous diagnostic radiologic procedures

Miniaturized chromatographic radiochemical procedure for 131I - MIBG

International Nuclear Information System (INIS)

Barboza, M.F. de; Pereira, N.S. de; Colturato, M.T.; Silva, C.P.G. da.

1989-12-01

Different solvents were used in paper chromatographic methods to obtain the best system in routine radiochemical control for 131 I-MIBG produced at IPEN-CNEN/SP. The dates were compared with those obtained with eletrophoresis method in buffer acetate, pH=4.5, 350V, during 40 minutes. The stability of the labeled compound store under 4 0 C was studied during 15 days. Miniaturized chromatographic procedures were established using Whatman 3MM (8x1cm) and n-butanol-:acetic acid: water (S:2:1) as a solvent. the Rf values were: 0.3 (I - ) and 1.0 (MIBG). The radiochemical purity was 99.3 and 99.2% (first day) obtained with eletrophoresis and miniaturized chromatographic procedures, respectively and, 84.7% after 15 days of its preparation. It is a rapid, practical and reproductive method. (author) [pt

Averaging models: parameters estimation with the R-Average procedure

Directory of Open Access Journals (Sweden)

S. Noventa

2010-01-01

Full Text Available The Functional Measurement approach, proposed within the theoretical framework of Information Integration Theory (Anderson, 1981, 1982, can be a useful multi-attribute analysis tool. Compared to the majority of statistical models, the averaging model can account for interaction effects without adding complexity. The R-Average method (Vidotto & Vicentini, 2007 can be used to estimate the parameters of these models. By the use of multiple information criteria in the model selection procedure, R-Average allows for the identification of the best subset of parameters that account for the data. After a review of the general method, we present an implementation of the procedure in the framework of R-project, followed by some experiments using a Monte Carlo method.

Comparison of different methods for activation analysis of geological and pedological samples: Reactor and epithermal neutron activation, relative and monostandard method

International Nuclear Information System (INIS)

Alian, A.; Sansoni, B.

1980-04-01

Using purely instrumental methods, a comparative study is presented on neutron activation analysis of rock and soil samples by whole reactor neutron spectrum and epithermal neutrons with both relative and monostandard procedures. The latter procedure used with epithermal neutron activation analysis of soil samples necessitated the use of the 'effective resonance integrals' which were determined experimentally. The incorporation of the #betta# factor, representing deviation of reactor epithermal neutron flux from 1/E law, is developed in the present work. The main criteria for the choice of one or more of the procedures studied for a given purpose are also indicated. Analysis of 15 trace elements, Ca and Fe in the standard Japanese granite JG-1 using monostandard epithermal neutron activation gave results in good agreement with the average literature values. (orig./RB) [de

INITIATION AND CONDUCT OF ADMINISTRATIVE PROCEDURE

Directory of Open Access Journals (Sweden)

Milan Stipic

2013-12-01

Full Text Available General administrative procedure act contains legal norms that are valid for all identical cases. In addition to the general, there are special administrative procedures, customized to the specific administrative areas. Procedure initiation is regulated. Administrative procedure can be initiated at the request of the proponent and ex officio. When the official determines that the conditions for the conduct of administrative procedure are met, before making a decision, all the facts and circumstances relevant to the resolution of administrative matter have to be identified. When there are no legal requirements for the initiation of procedures, the official shall make a decision to reject the application of the party. The procedure is initiated ex officio when stipulated by law or when protection of public interest requires it. When initiating procedure ex officio, the public authority shall take into consideration the petition or other information that indicate the need to protect the public interest. In such cases the applicant is not a party, and the official is obliged to notify the applicant, if initiation of procedures is not accepted ex officio. Based on the notification, the applicant has a right to complain, including the situation when there is no response within the prescribed period of 30 days. Public authority may, therefore it is not obliged to, initiate administrative procedure by public announcement only in a situation where the parties are unknown, while it is obliged to initiate procedure by public announcement when this method of initiating the procedure is prescribed by law. Initiation of procedure with public announcement occurs in rare cases. Due to the application of efficiency and cost-effectiveness principle, two or more administrative procedures can be merged into one procedure by a conclusion. The condition for this is that the rights or obligations of the parties are based on the same legal basis and on the same or

Quantization Procedures; Sistemas de cuantificacion

Energy Technology Data Exchange (ETDEWEB)

Cabrera, J. A.; Martin, R.

1976-07-01

We present in this work a review of the conventional quantization procedure, the proposed by I.E. Segal and a new quantization procedure similar to this one for use in non linear problems. We apply this quantization procedures to different potentials and we obtain the appropriate equations of motion. It is shown that for the linear case the three procedures exposed are equivalent but for the non linear cases we obtain different equations of motion and different energy spectra. (Author) 16 refs.

Survival comparison of the Ross procedure and mechanical valve replacement with optimal self-management anticoagulation therapy: propensity-matched cohort study.

Science.gov (United States)

Mokhles, M Mostafa; Körtke, Heinrich; Stierle, Ulrich; Wagner, Otto; Charitos, Efstratios I; Bogers, Ad J J C; Gummert, Jan; Sievers, Hans-Hinrich; Takkenberg, Johanna J M

2011-01-04

It is suggested that in young adults the Ross procedure results in better late patient survival compared with mechanical prosthesis implantation. We performed a propensity score-matched study that assessed late survival in young adult patients after a Ross procedure versus that after mechanical aortic valve replacement with optimal self-management anticoagulation therapy. We selected 918 Ross patients and 406 mechanical valve patients 18 to 60 years of age without dissection, aneurysm, or mitral valve replacement who survived an elective procedure (1994 to 2008). With the use of propensity score matching, late survival was compared between the 2 groups. Two hundred fifty-three patients with a mechanical valve (mean follow-up, 6.3 years) could be propensity matched to a Ross patient (mean follow-up, 5.1 years). Mean age of the matched cohort was 47.3 years in the Ross procedure group and 48.0 years in the mechanical valve group (P=0.17); the ratio of male to female patients was 3.2 in the Ross procedure group and 2.7 in the mechanical valve group (P=0.46). Linearized all-cause mortality rate was 0.53% per patient-year in the Ross procedure group compared with 0.30% per patient-year in the mechanical valve group (matched hazard ratio, 1.86; 95% confidence interval, 0.58 to 5.91; P=0.32). Late survival was comparable to that of the general German population. In comparable patients, there is no late survival difference in the first postoperative decade between the Ross procedure and mechanical aortic valve implantation with optimal anticoagulation self-management. Survival in these selected young adult patients closely resembles that of the general population, possibly as a result of highly specialized anticoagulation self-management, better timing of surgery, and improved patient selection in recent years.

Stricture location predicts swallowing outcomes following endoscopic rendezvous procedures.

Science.gov (United States)

Adams, Katherine N; Shah, Rupali N; Buckmire, Robert A

2017-06-01

Complete pharyngoesophageal strictures may be encountered by the otolaryngologist as a consequence of radiation/chemoradiotherapy therapies for head and neck cancer. A combined anterograde and retrograde dilation procedure (rendezvous procedure) has proven to be a useful surgical intervention in these cases. We assess the long-term swallowing outcomes of this patient cohort including gastrostomy tube (G-tube) reliance, swallowing quality of life, and variables that contribute to improved swallowing outcomes. Retrospective chart review. A retrospective chart review of 18 consecutive patients treated with rendezvous procedures between April 2007 and May 2015 was carried out. Data were collected from chart review and follow-up telephone calls including demographics, surgical/postoperative course details, and Eating Assessment Tool (EAT-10) (swallowing quality of life) scores. The completion rate of the procedure was 83% (15 completed/3 procedures aborted). Average follow-up was 22 months. Thirteen of 15 (86.7%) achieved an oral diet, and 7/15 (46.7%) had their G-tube removed. G-tube-independent (GTI) patients had an average stricture length of 2.33 cm and an average distance from the incisors of 17.4 cm compared to G-tube dependent-(GTD) patients who had an average stricture length of 2.63 cm and 14.6 cm mean distance from the incisors (P = .66 and .0343, respectively). Final EAT-10 scores averaged 20.1 in GTI patients and 33.8 in GTD patients (P = .022). Stricture/incisor distance and EAT-10 scores demonstrated a moderate to strong negative correlation (r = -0.67). Following the endoscopic rendezvous procedure, swallowing outcomes and G-tube status is related to the distance of the stricture from the incisors. 2b Laryngoscope, 127:1388-1391, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Comparative evaluation of trace elements in blood

International Nuclear Information System (INIS)

Goeij, J.J.M. de; Tjioe, P.S.; Pries, C.; Zwiers, J.H.L.

1976-01-01

The Interuniversitair Reactor Instituut and the Centraal Laboratorium TNO have carried out a common investigation on neutron-activation-analytical procedures for the determination of trace elements in blood. A comparative evaluation of five methods, destructive as well as non-destructive, is given. The sensitivity and reproducibility of the procedures are discussed. By combining some of the methods it is possible, starting with 1 ml blood, to give quantitative information on 14 important trace elements: antimony, arsenic, bromine, cadmium, cobalt, gold, copper, mercury, molybdenum, nickel, rubidium, selenium, iron and zinc. The methods have also been applied to sodium, chromium and potassium

Simplified Laboratory Runoff Procedure (SLRP): Procedure and Application

National Research Council Canada - National Science Library

Price, Richard

2000-01-01

The Simplified Laboratory Runoff Procedure (SLRP) was developed to provide a faster, less expensive approach to evaluate surface runoff water quality from dredged material placed in an upland environment...

COPMA-III - Intelligent handling of existing procedures

International Nuclear Information System (INIS)

Hulsund, John-Einar; Jung, Yeonsub; Nilsen, Svein

1999-04-01

This report describes how COPMA-III makes it possible to enhance old procedures without having to change much of their original layout. By means of COPMA-III one can insert into the old procedure text tags that describe the 'meaning' of the various textual elements in the procedure. Those tags can be made invisible to the person using the procedure, but the computer is able to inspect the tags and give appropriate assistance in carrying through the procedure. Previous versions of COPMA required a reformulation and most often a re-structuring of the procedures before taking them into use. A fixed set of instructions and a fixed procedure structure made the computerised procedure different from the original procedure (in most cases). This is no more so in COPMA-III. By means of small procedural elements (microelements), it is possible to configure the COPMA-III system to fit the set of instructions and the procedure structure that is being used in the old procedure system. This report describes an example case, starting with an old procedure, goes through a set of working steps and ends up with a procedure having exactly the same appearance as the old procedure, but having assistance from the COPMA-III system in executing the procedure (author) (ml)

Aesthetic procedures in office practice.

Science.gov (United States)

Small, Rebecca

2009-12-01

Since the approval of botulinum toxin, dermal fillers, and lasers for cosmetic use, minimally invasive aesthetic procedures have rapidly become the treatments of choice for age-related facial changes. In the past 10 years, aesthetic procedures have increased nearly five-fold. Of the 10.2 million aesthetic treatments performed in 2008, 83 percent were minimally invasive procedures. Botulinum toxin and dermal filler injections, laser hair reduction, chemical peels, laser skin resurfacing, microdermabrasion, and intense pulsed light photorejuvenation were the most commonly performed procedures in 2008. These procedures are effective and associated with minimal discomfort, and they have a low incidence of adverse effects and short recovery times. High patient and physician satisfaction have contributed to their growing popularity and availability in the primary care setting. As patient demand for aesthetic treatments increases, family physicians should be familiar with common minimally invasive aesthetic procedures when advising patients or incorporating aesthetic care into office practice.

The Manchester procedure versus vaginal hysterectomy in the treatment of uterine prolapse

DEFF Research Database (Denmark)

Tolstrup, Cæcilie Krogsgaard; Lose, Gunnar; Klarskov, Niels

2017-01-01

INTRODUCTION AND HYPOTHESIS: Uterine prolapse is a common health problem and the number of surgical procedures is increasing. No consensus regarding the surgical strategy for repair of uterine prolapse exists. Vaginal hysterectomy (VH) is the preferred surgical procedure worldwide, but uterus......-intervention rate, complications and operative outcomes. METHODS: We systematically searched Embase, PubMed, the Cochrane databases, Clinicaltrials and Clinical trials register using the MeSh terms "uterine prolapse", "uterus prolapse", "vaginal prolapse" "pelvic organ prolapse", "prolapsed uterus", "Manchester...... procedure" and "vaginal hysterectomy". No limitations regarding language, study design or methodology were applied. In total, nine studies published from 1966 to 2014 comparing the MP to VH were included. RESULTS: The anatomical recurrence rate for the middle compartment was 4-7 % after VH, whereas...

Effective dose to patient during cardiac interventional procedures (Prague workplaces)

International Nuclear Information System (INIS)

Stisova, V.

2004-01-01

The aim of this study was to assess effective dose to a patient during cardiac procedures, such as coronary angiography (CA) and percutaneous transluminal angioplasty (PTCA). Measurements were performed on 185 patients in four catheterisation laboratories in three hospitals in Prague using the dose area product (DAP) meter. Calculations of surface and effective dose were performed with Monte-Carlo-based program PCXMC. The mean DAP value per procedure determined in all workplaces ranged between 25.0 and 54.5 Gy cm 2 for CA and 43.0-104.5 Gy cm 2 for PTCA. In three cases, the surface dose exceeded the 2 Gy level for occurrence of transient erythema. The mean effective dose per procedure in an workplaces was determined to be in the range of 2.7-8.8 mSv for CA and 5.7-15.3 mSv for CA + PTCA combined. The results presented are comparable with those published by other authors. (authors)

Reducing costs while maintaining quality in endovascular neurosurgical procedures.

Science.gov (United States)

Kashlan, Osama N; Wilson, Thomas J; Chaudhary, Neeraj; Gemmete, Joseph J; Stetler, William R; Dunnick, N Reed; Thompson, B Gregory; Pandey, Aditya S

2014-11-01

As medical costs continue to rise during a time of increasing medical resource utilization, both hospitals and physicians must attempt to limit superfluous health care expenses. Neurointerventional treatment has been shown to be costly, but it is often the best treatment available for certain neuropathologies. The authors studied the effects of 3 policy changes designed to limit the costs of performing neurointerventional procedures at the University of Michigan. The authors retrospectively analyzed the costs of performing neurointerventional procedures during the 6-month periods before and after the implementation of 3 cost-saving policies: 1) the use of an alternative, more economical contrast agent, 2) standardization of coil prices through negotiation with industry representatives to receive economies of scale, and 3) institution of a feedback method to show practitioners the costs of unused products per patient procedure. The costs during the 6-month time intervals before and after implementation were also compared with costs during the most recent 6-month time period. The policy requiring use of a more economical contrast agent led to a decrease in the cost of contrast usage of $42.79 per procedure for the first 6 months after implementation, and $137.09 per procedure for the most current 6-month period, resulting in an estimated total savings of $62,924.31 for the most recent 6-month period. The standardized coil pricing system led to savings of $159.21 per coil after the policy change, and $188.07 per coil in the most recent 6-month period. This yielded total estimated savings of $76,732.56 during the most recent 6-month period. The feedback system for unused items decreased the cost of wasted products by approximately $44.36 per procedure in the 6 months directly after the policy change and by $48.20 per procedure in the most recent 6-month period, leading to total estimated savings of $22,123.80 during the most recent 6-month period. According to

Procedure for extraction of disparate data from maps into computerized data bases

Science.gov (United States)

Junkin, B. G.