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Sample records for proved extremely difficult

  1. Rules and technical tricks in extremely difficult laparoscopic cholecystectomies

    Directory of Open Access Journals (Sweden)

    Liviu Drăghici

    2017-11-01

    Full Text Available We remind you of some technical artifices required in order to resolve difficult cases, such as: antegrade laparoscopic cholecystectomy (LC, subtotal laparoscopic cholecystectomy (SLC and the “stairs” clipping of the cystic duct. Also we acknowledge the closing of the cystic duct. We analyzed the medical records of 15251 laparoscopic cholecystectomies performed during 1994-2015, with emphasis on: surgical technique, conversion rate, hemorrhage, postoperative bile leaking, iatrogenic MBD injuries and mortality. We divided the cases in 5 study groups, group 1 (1994- 2004 N= 5138, group 2 (2005-2015 N= 10113, group 3 (fundus first cholecystectomies, N=2348, group 4 (retrograde cholecystectomies, N=12889 and group 5 (subtotal laparoscopic cholecystectomy-SLC, N=14 which we compared regarding the main parameters. We prefer to perform a “step by step” clipping each time the length of the clip does not cover all the circumference of the cystic duct. This artifices, is a simple laparoscopic gesture easy to perform and has the advantage of avoiding a large excessive and risky laparoscopic dissection in the vicinity of the main biliary duct. More seldom we appeal to the suture of the cystic stump using the intracorporeal knots or a simple stump ligation with an extracorporeal preformed not. We did not encounter any late or early complications following the implementation of this technical laparoscopic artifice. Laborious laparoscopic cholecystectomies performed by a well-trained surgical team ensure the premises of a good performance even while adopting laparoscopic ingenious and difficile gestures that also respect the intraoperatory rules and principals.

  2. Difficult to predict early failure after major lower-extremity amputations

    DEFF Research Database (Denmark)

    Kristensen, Morten Tange; Holm, Gitte; Gebuhr, Peter

    2015-01-01

    INTRODUCTION: The successful outcome of a major amputation depends on several factors, including stump wound healing. The purpose of this study was to examine the criteria upon which the index amputation was based and to identify factors associated with early amputation failure after major non......-traumatic lower-extremity amputation. METHODS: We studied a consecutive one-year series of 36 men and 34 women with a median (25-75% quartiles) age of 72 (63-83) years who were treated in an acute orthopaedic ward; 44 below-knee and 26 above-knee amputees of whom 47 had an American Society of Anesthesiologists...... rating above two. Patient characteristics and other factors potentially influencing early amputation failure within 30 days were evaluated. RESULTS: Eleven patients died (16%) and 11 (16%) had a re-amputation at a higher level, whereas four (6%) had a major revision at the same level within 30 days...

  3. Extreme Wind, Rain, Storm Surge, and Flooding: Why Hurricane Impacts are Difficult to Forecast?

    Science.gov (United States)

    Chen, S. S.

    2017-12-01

    The 2017 hurricane season is estimated as one of the costliest in the U.S. history. The damage and devastation caused by Hurricane Harvey in Houston, Irma in Florida, and Maria in Puerto Rico are distinctly different in nature. The complexity of hurricane impacts from extreme wind, rain, storm surge, and flooding presents a major challenge in hurricane forecasting. A detailed comparison of the storm impacts from Harvey, Irma, and Maria will be presented using observations and state-of-the-art new generation coupled atmosphere-wave-ocean hurricane forecast model. The author will also provide an overview on what we can expect in terms of advancement in science and technology that can help improve hurricane impact forecast in the near future.

  4. What Makes Difficult History Difficult?

    Science.gov (United States)

    Gross, Magdalena H.; Terra, Luke

    2018-01-01

    All modern nation-states have periods of difficult history that teachers fail to address or address inadequately. The authors present a framework for defining difficult histories and understanding what makes them difficult. These events 1) are central to a nation's history, 2) contradict accepted histories or values, 3) connect with present…

  5. Conflict management: difficult conversations with difficult people.

    Science.gov (United States)

    Overton, Amy R; Lowry, Ann C

    2013-12-01

    Conflict occurs frequently in any workplace; health care is not an exception. The negative consequences include dysfunctional team work, decreased patient satisfaction, and increased employee turnover. Research demonstrates that training in conflict resolution skills can result in improved teamwork, productivity, and patient and employee satisfaction. Strategies to address a disruptive physician, a particularly difficult conflict situation in healthcare, are addressed.

  6. Conflict Management: Difficult Conversations with Difficult People

    OpenAIRE

    Overton, Amy R.; Lowry, Ann C.

    2013-01-01

    Conflict occurs frequently in any workplace; health care is not an exception. The negative consequences include dysfunctional team work, decreased patient satisfaction, and increased employee turnover. Research demonstrates that training in conflict resolution skills can result in improved teamwork, productivity, and patient and employee satisfaction. Strategies to address a disruptive physician, a particularly difficult conflict situation in healthcare, are addressed.

  7. Proving Non-Deterministic Computations in Agda

    Directory of Open Access Journals (Sweden)

    Sergio Antoy

    2017-01-01

    Full Text Available We investigate proving properties of Curry programs using Agda. First, we address the functional correctness of Curry functions that, apart from some syntactic and semantic differences, are in the intersection of the two languages. Second, we use Agda to model non-deterministic functions with two distinct and competitive approaches incorporating the non-determinism. The first approach eliminates non-determinism by considering the set of all non-deterministic values produced by an application. The second approach encodes every non-deterministic choice that the application could perform. We consider our initial experiment a success. Although proving properties of programs is a notoriously difficult task, the functional logic paradigm does not seem to add any significant layer of difficulty or complexity to the task.

  8. Psychopathology in difficult asthma

    NARCIS (Netherlands)

    Prins, L.C.; van Son, M.J.M.; Keimpema, A.R.; van Ranst, D; Pommer, A; Meijer, J.W.; Pop, V.J.M.

    2015-01-01

    OBJECTIVE: Within the asthma population, difficult asthma (DA) is a severe condition in which patients present with frequent exacerbations, hospitalizations and emergency room visits. The identification and treatment of psychopathology is included in the management of DA. Psychopathology is supposed

  9. Elliptic curves and primality proving

    Science.gov (United States)

    Atkin, A. O. L.; Morain, F.

    1993-07-01

    The aim of this paper is to describe the theory and implementation of the Elliptic Curve Primality Proving algorithm. Problema, numeros primos a compositis dignoscendi, hosque in factores suos primos resolvendi, ad gravissima ac utilissima totius arithmeticae pertinere, et geometrarum tum veterum tum recentiorum industriam ac sagacitatem occupavisse, tam notum est, ut de hac re copiose loqui superfluum foret.

  10. Geometric inequalities methods of proving

    CERN Document Server

    Sedrakyan, Hayk

    2017-01-01

    This unique collection of new and classical problems provides full coverage of geometric inequalities. Many of the 1,000 exercises are presented with detailed author-prepared-solutions, developing creativity and an arsenal of new approaches for solving mathematical problems. This book can serve teachers, high-school students, and mathematical competitors. It may also be used as supplemental reading, providing readers with new and classical methods for proving geometric inequalities. .

  11. Making marketing difficult

    DEFF Research Database (Denmark)

    Meyer, Gitte

    2005-01-01

    embraced by the market-place, while maintaining the old scientific alienation from political life. The case is made that modern science was born ambiguous towards the market-place, and that such ambivalence - relating to different interpretations of the idea of knowledge as a common good - is still...... to be encountered among scientists. Drawing on series of interviews with scientists from bioscience and biotechnology it is argued that, on the one hand, scientists are into marketing and PR exercises; but, on the other hand, they also voice a demand that journalists should make such marketing difficult...

  12. Why Translation Is Difficult

    DEFF Research Database (Denmark)

    Carl, Michael; Schaeffer, Moritz Jonas

    2017-01-01

    The paper develops a definition of translation literality that is based on the syntactic and semantic similarity of the source and the target texts. We provide theoretical and empirical evidence that absolute literal translations are easy to produce. Based on a multilingual corpus of alternative...... translations we investigate the effects of cross-lingual syntactic and semantic distance on translation production times and find that non-literality makes from-scratch translation and post-editing difficult. We show that statistical machine translation systems encounter even more difficulties with non-literality....

  13. Dealing with difficult pasts

    DEFF Research Database (Denmark)

    McAtackney, Laura

    2013-01-01

    develop. I argue that such politically loaded manifestations of difficult pasts are highly significant during post-conflict renegotiations of society. They act as reminders of what happened, a commentary on how far society has – or has not moved on – and the potential for future relations and directions....... Using Robben Island and Long Kesh / Maze as case-studies this paper will explore the physical manifestations of political imprisonment, their experiences in the post-conflict context and reveal contestations of meaning at these dark heritage sites....

  14. Difficult diagnoses in the skeletal radiology

    International Nuclear Information System (INIS)

    Freyschmidt, Juergen

    2013-01-01

    The book on difficult diagnoses in the skeletal radiology discusses the path from symptom to diagnoses including image interpretation. Specific case studies concern the skull, the spinal cord, pelvis, shoulder and chest, upper and lower extremities. The used radiological techniques include projecting radiography, computerized tomography, scintiscanning, PET/CT, NNR imaging and ultrasonography.

  15. Lymphoscintigraphy of the lower extremity

    International Nuclear Information System (INIS)

    Abbasi, N.Z.

    1990-01-01

    Fifty one lower extremities of 26 normal healthy volunteers and 26 extremities of 13 patients with oedema have been studied. Dynamic quantitative lymphoscintigraphy using 99Tc-m antimony sulphide colloid during passive exercise as well as before and after active exercise was performed. parameters of lymphatic function including percentage of radioactivity cleared from the injection site, the percentage uptake by the inguinal lymph nodes, the time of arrival of activity at the regional lymph nodes and the lymphatic reserve index have been evaluated. The percentage clearance of activity from the injection site was found technically difficult to standardize and proved to be an unreliable parameter of lymphatic function. However, the quantitation of nodal uptake, the lymphatic transit time and the lymphatic reserve capacity accurately depicted the lymphatic functional status of an individual. The physiologic parameters of lymphatic function of the contralateral lower extremities were compared and a physiologic difference in the lymphatic capacity of the two limbs was scintigraphically documented. (author)

  16. Symbolic logic and mechanical theorem proving

    CERN Document Server

    Chang, Chin-Liang

    1969-01-01

    This book contains an introduction to symbolic logic and a thorough discussion of mechanical theorem proving and its applications. The book consists of three major parts. Chapters 2 and 3 constitute an introduction to symbolic logic. Chapters 4-9 introduce several techniques in mechanical theorem proving, and Chapters 10 an 11 show how theorem proving can be applied to various areas such as question answering, problem solving, program analysis, and program synthesis.

  17. Proving productivity in infinite data structures

    NARCIS (Netherlands)

    Zantema, H.; Raffelsieper, M.; Lynch, C.

    2010-01-01

    For a general class of infinite data structures including streams, binary trees, and the combination of finite and infinite lists, we investigate the notion of productivity. This generalizes stream productivity. We develop a general technique to prove productivity based on proving context-sensitive

  18. Proving relations between modular graph functions

    International Nuclear Information System (INIS)

    Basu, Anirban

    2016-01-01

    We consider modular graph functions that arise in the low energy expansion of the four graviton amplitude in type II string theory. The vertices of these graphs are the positions of insertions of vertex operators on the toroidal worldsheet, while the links are the scalar Green functions connecting the vertices. Graphs with four and five links satisfy several non-trivial relations, which have been proved recently. We prove these relations by using elementary properties of Green functions and the details of the graphs. We also prove a relation between modular graph functions with six links. (paper)

  19. LIHTC Difficult to Develop Areas

    Data.gov (United States)

    Department of Housing and Urban Development — A Difficult Development Area (DDA) for the Low Income Housing Tax Credit program is an area designated by the U.S. Department of Housing and Urban Development (HUD)...

  20. Psychopathology in difficult asthma : Review

    NARCIS (Netherlands)

    Prins, L.C.J.; van Son, M.A.C.; van Keimpema, A.R.J.; van Ranst, D.; Antonissen-Pommer, A.M.; Meijer, J.W.G.; Pop, V.J.M.

    2015-01-01

    Objective: Within the asthma population, difficult asthma (DA) is a severe condition in which patients present with frequent exacerbations, hospitalizations and emergency room visits. The identification and treatment of psychopathology is included in the management of DA. Psychopathology is supposed

  1. Difficult to control atopic dermatitis

    NARCIS (Netherlands)

    U. Darsow (U.); A. Wollenberg (A.); D. Simon; A. Taieb; T. Werfel; A.P. Oranje (Arnold); C. Gelmetti (C.); Ã. Svensson (Ãke); M. Deleuran (M.); A.M. Calza; F. Giusti; J. Lübbe (Jann); S. Seidenari (Stefania); J. Ring (J.)

    2013-01-01

    textabstractDifficult to control atopic dermatitis (AD) presents a therapeutic challenge and often requires combinations of topical and systemic treatment. Anti-inflammatory treatment of severe AD most commonly includes topical glucocorticosteroids and topical calcineurin antagonists used for

  2. Effective communication during difficult conversations.

    Science.gov (United States)

    Polito, Jacquelyn M

    2013-06-01

    A strong interest and need exist in the workplace today to master the skills of conducting difficult conversations. Theories and strategies abound, yet none seem to have found the magic formula with universal appeal and success. If it is such an uncomfortable skill to master is it better to avoid or initiate such conversations with employees? Best practices and evidence-based management guide us to the decision that quality improvement dictates effective communication, even when difficult. This brief paper will offer some suggestions for strategies to manage difficult conversations with employees. Mastering the skills of conducting difficult conversations is clearly important to keeping lines of communication open and productive. Successful communication skills may actually help to avert confrontation through employee engagement, commitment and appropriate corresponding behavior

  3. Overcoming the Obstacle of Poor Knowledge in Proving Geometry Tasks

    Directory of Open Access Journals (Sweden)

    Zlatan Magajna

    2013-12-01

    Full Text Available Proving in school geometry is not just about validating the truth of a claim. In the school setting, the main function of the proof is to convince someone that a claim is true by providing an explanation. Students consider proving to be difficult; in fact, they find the very concept of proof demanding. Proving a claim in planar geometry involves several processes, the most salient being visual observation and deductive argumentation. These two processes are interwoven, but often poor observation hinders deductive argumentation. In the present article, we consider the possibility of overcoming the obstacle of a student’s poor observation by making use of computer-aided observation with appropriate software. We present the results of two small-scale research projects, both of which indicate that students are able to work out considerably more deductions if computer-aided observation is used. Not all students use computer-aided observation effectively in proving tasks: some find an exhaustive computer-provided list of properties confusing and are not able to choose the properties that are relevant to the task.

  4. Management of the difficult airway.

    Science.gov (United States)

    Schwartz, D E; Wiener-Kronish, J P

    1991-09-01

    For clinicians involved in airway management, a plan of action for dealing with the difficult airway or a failed intubation should be developed well in advance of encountering a patient in whom intubation is not routine. When difficulty is anticipated, the equipment necessary for performing a difficult intubation should be immediately available. It also is prudent to have a surgeon skilled in performing a tracheotomy and a criothyroidotomy stand by. The intubation should be attempted in the awake state, preferably using the fiberoptic bronchoscope. The more challenging situation is when the difficult airway is confronted unexpectedly. After the first failed attempt at laryngoscopy, head position should be checked and the patient ventilated with oxygen by mask. A smaller styletted tube and possibly a different laryngoscope blade should be selected for a second attempt at intubation. The fiberoptic bronchoscope and other equipment for difficult intubation should be obtained. A second attempt should then be made. If this is unsuccessful, the patient should be reoxygenated, and assistance including a skilled anesthesiologist and surgeon should be summoned. On a third attempt, traction to the tongue can be applied by an assistant, a tube changer could be used to enter the larynx, or one of the other special techniques previously described can be used. If this third attempt fails, it may be helpful to have a physician more experienced in airway management attempt intubation after oxygen has been administered to the patient. If all attempts are unsuccessful, then invasive techniques to secure the airway will have to be performed.

  5. Generic Example Proving Criteria for All

    Science.gov (United States)

    Yopp, David; Ely, Rob; Johnson­-Leung, Jennifer

    2015-01-01

    We review literature that discusses generic example proving and highlight ambiguities that pervade our research community's discourse about generic example arguments. We distinguish between pedagogical advice for choosing good examples that can serve as generic examples when teaching and advice for developing generic example arguments. We provide…

  6. On proving syntactic properties of CPS programs

    DEFF Research Database (Denmark)

    Danvy, Olivier; Dzafic, Belmina; Pfenning, Frank

    1999-01-01

    Higher-order program transformations raise new challenges for proving properties of their output, since they resist traditional, first-order proof techniques. In this work, we consider (1) the “one-pass” continuation-passing style (CPS) transformation, which is second-order, and (2) the occurrences...

  7. SARS – Koch´Postulates proved.

    Indian Academy of Sciences (India)

    SARS – Koch´Postulates proved. Novel coronavirus identified from fluids of patients. Virus cultured in Vero cell line. Sera of patients have antibodies to virus. Cultured virus produces disease in Macaque monkeys. -produces specific immune response; -isolated virus is SARS CoV; -pathology similar to human.

  8. On proving syntactic properties of CPS programs

    DEFF Research Database (Denmark)

    Danvy, Olivier; Dzafic, Belmina; Pfenning, Frank

    1999-01-01

    Higher-order program transformations raise new challenges for proving properties of their output, since they resist traditional, first-order proof techniques. In this work, we consider (1) the “one-pass” continuation-passing style (CPS) transformation, which is second-order, and (2) the occurrences...... of parameters of continuations in its output. To this end, we specify the one-pass CPS transformation relationally and we use the proof technique of logical relations....

  9. Theorem Proving In Higher Order Logics

    Science.gov (United States)

    Carreno, Victor A. (Editor); Munoz, Cesar A.; Tahar, Sofiene

    2002-01-01

    The TPHOLs International Conference serves as a venue for the presentation of work in theorem proving in higher-order logics and related areas in deduction, formal specification, software and hardware verification, and other applications. Fourteen papers were submitted to Track B (Work in Progress), which are included in this volume. Authors of Track B papers gave short introductory talks that were followed by an open poster session. The FCM 2002 Workshop aimed to bring together researchers working on the formalisation of continuous mathematics in theorem proving systems with those needing such libraries for their applications. Many of the major higher order theorem proving systems now have a formalisation of the real numbers and various levels of real analysis support. This work is of interest in a number of application areas, such as formal methods development for hardware and software application and computer supported mathematics. The FCM 2002 consisted of three papers, presented by their authors at the workshop venue, and one invited talk.

  10. Automated theorem proving theory and practice

    CERN Document Server

    Newborn, Monty

    2001-01-01

    As the 21st century begins, the power of our magical new tool and partner, the computer, is increasing at an astonishing rate. Computers that perform billions of operations per second are now commonplace. Multiprocessors with thousands of little computers - relatively little! -can now carry out parallel computations and solve problems in seconds that only a few years ago took days or months. Chess-playing programs are on an even footing with the world's best players. IBM's Deep Blue defeated world champion Garry Kasparov in a match several years ago. Increasingly computers are expected to be more intelligent, to reason, to be able to draw conclusions from given facts, or abstractly, to prove theorems-the subject of this book. Specifically, this book is about two theorem-proving programs, THEO and HERBY. The first four chapters contain introductory material about automated theorem proving and the two programs. This includes material on the language used to express theorems, predicate calculus, and the rules of...

  11. Difficult to control atopic dermatitis

    Science.gov (United States)

    2013-01-01

    Difficult to control atopic dermatitis (AD) presents a therapeutic challenge and often requires combinations of topical and systemic treatment. Anti-inflammatory treatment of severe AD most commonly includes topical glucocorticosteroids and topical calcineurin antagonists used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, the topical calcineurin inhibitors tacrolimus and pimecrolimus are preferred in certain locations. Systemic anti-inflammatory treatment is an option for severe refractory cases. Microbial colonization and superinfection contribute to disease exacerbation and thus justify additional antimicrobial / antiseptic treatment. Systemic antihistamines (H1) may relieve pruritus but do not have sufficient effect on eczema. Adjuvant therapy includes UV irradiation preferably of UVA1 wavelength. “Eczema school” educational programs have been proven to be helpful. PMID:23663504

  12. Theorem Proving in Intel Hardware Design

    Science.gov (United States)

    O'Leary, John

    2009-01-01

    For the past decade, a framework combining model checking (symbolic trajectory evaluation) and higher-order logic theorem proving has been in production use at Intel. Our tools and methodology have been used to formally verify execution cluster functionality (including floating-point operations) for a number of Intel products, including the Pentium(Registered TradeMark)4 and Core(TradeMark)i7 processors. Hardware verification in 2009 is much more challenging than it was in 1999 - today s CPU chip designs contain many processor cores and significant firmware content. This talk will attempt to distill the lessons learned over the past ten years, discuss how they apply to today s problems, outline some future directions.

  13. Difficult airway in a patient with Coffin-Siris syndrome.

    Science.gov (United States)

    Dimaculangan, D; Lokhandwala, B; Wlody, D; Gross, R

    2001-02-01

    We report on a patient with Coffin-Siris syndrome and consider a potential association between this condition and difficult intubation. Although this inherited condition is extremely rare, anesthesiologists should be aware of its existence and prepare for potential airway management problems whenever it is encountered.

  14. Difficult physician-patient relationships.

    Science.gov (United States)

    Reifsteck, S W

    1998-01-01

    Changes in the delivery of health care services in the United States are proceeding so rapidly that many providers are asking how the working relationships between doctors and patients will be effected. Accelerated by cost containment, quality improvement and the growth of managed care, these changes have caused some critics to feel that shorter visits and gatekeeper systems will promote an adversarial relationship between physicians and patients. However, proponents of the changing system feel that better prevention, follow-up care and the attention to customer service these plans can offer will lead to increased patient satisfaction and improved doctor-patient communication. Dedicated to addressing these concerns, the Bayer Institute for Health Care Communication was established in 1987 as a continuing medical education program (CME) focusing on this topic. A half-day workshop on clinician-patient communication to enhance health outcomes was introduced in 1992 and a second workshop, "Difficult' Clinician-Patient Relationships," was developed two years later. The two courses discussed in this article are offered to all physicians, residents, medical students, mid-level providers and other interested staff within the Carle system.

  15. Valutazione economica dello studio PROVE-IT

    Directory of Open Access Journals (Sweden)

    Lorenzo G. Mantovani

    2007-10-01

    Full Text Available Introduction: the PROVE-IT (“Intensive versus moderate lipid lowering with statins after acute coronary syndromes” was a comparison of pravastatin 40 mg/die versus atorvastatin 80 mg/die in patients with an acute coronary syndrome (ACS. Aim: our aim was to investigate the economic consequence of high dose of atorvastatin vs usual-dose of pravastatin in Italian patients with a history of acute coronary syndrome. Methods: the analysis is conducted on the basis of clinical outcomes of the PROVE-IT study. We conducted a cost-effectiveness analysis, comparing high dose of atorvastatin (80 mg/die versus usual-dose of pravastatin (40 mg/die in the perspective of the Italian National Health Service. We identified and quantified medical costs: drug costs according to the Italian National Therapeutic Formulary and hospitalizations were quantified based on the Italian National Health Service tariffs (2006. Effects were measured in terms of mortality and morbidity reduction (number of deaths, life years gained and frequency of hospitalizations. We considered an observation period of 24 months. The costs borne after the first 12 months were discounted using an annual rate of 3%. We conducted one and multi-way sensitivity analyses on unit cost and effectiveness. We also conducted a threshold analysis. Results: the cost of pravastatin or atorvastatin therapy over the 2 years period amounted to approximately 1.3 millions euro and 870,000 euro per 1,000 patients respectively. Atorvastatin was more efficacious compared to pravastatin and the overall cost of care per 1,000 patients over 24 months of follow-up was estimated at 3.2 millions euro in the pravastatin and 2.5 millions euro in the atorvastatin group, resulting into a cost saving of about 700,000 euro that is 27% of total costs occurred in the pravastatin group. Discussion: this study demonstrates that high does atorvastatin treatment leads to a reduction of direct costs for the National Health System

  16. a Test to Prove Cloud Whitening THEORY!

    Science.gov (United States)

    Buttram, J. W.

    2011-12-01

    Climate science researchers believe our planet can possibly tolerate twice the present carbon dioxide levels with no upwards temperature change, IF we could increase the amount of energy reflected back out into space by about 2.0%. (c)Cloudtec basically alters a blend of seawater and applies heat derived from magma to it at a temperature exceeding 2,000 degrees F. The interaction of seawater and magma displaces the oxygen, causing the volume of water to vaporize and expand over 4,000 times - transforming billions of tons of seawater into thousands of cubic miles of white, maritime, stratocumulus clouds to reflect the incident Sun's rays back out into space. A 6 month test to prove Cloud Whitening Theory will cost 6 million dollars. (No profit added.) This study will enable everyone on the planet with a computer the transparency to use satellite imagery and check out for themselves - if and when Cloud Whitening is occurring. If Cloud Whitening Theory is validated, (c)Cloudtec's innovation can strategically create the clouds we need to reflect the Sun's rays back out into space and help neutralize the projected 3.6 degrees F rise in temperature. Based on reasonable calculations of anthropogenic global warming: this one move alone would be comparable to slashing global carbon dioxide emissions by over 60% over the next 40 years.

  17. A note on extreme sets

    Directory of Open Access Journals (Sweden)

    Radosław Cymer

    2017-10-01

    Full Text Available In decomposition theory, extreme sets have been studied extensively due to its connection to perfect matchings in a graph. In this paper, we first define extreme sets with respect to degree-matchings and next investigate some of their properties. In particular, we prove the generalized Decomposition Theorem and give a characterization for the set of all extreme vertices in a graph.

  18. Mandelbrot's Extremism

    NARCIS (Netherlands)

    Beirlant, J.; Schoutens, W.; Segers, J.J.J.

    2004-01-01

    In the sixties Mandelbrot already showed that extreme price swings are more likely than some of us think or incorporate in our models.A modern toolbox for analyzing such rare events can be found in the field of extreme value theory.At the core of extreme value theory lies the modelling of maxima

  19. Interesting cases which were difficult to diagnose by CT

    International Nuclear Information System (INIS)

    Ueki, Koji; Okubo, Koichi; Shinohara, Shinji

    1981-01-01

    Computed tomography (CT) clinically provides us with much more useful diagnostic informations regarding the localization, size, shape, extent and inner structure of the lesions and then in some cases the specific diagnosis can be also obtained by CT alone. However, it is usually difficult to define the longitudinal extent of the lesions, their relation to adjacent tissues, the originated site in enormous lesion and histological type also. At CT examination, it is essential to recognize these drawback and limitation on CT. From these points of view, six interesting cases (i.e. pericardial diverticulum, hepatoma with retroperitoneal metastasis, cholangiohepatoma, afferent loop syndrome, invagination and retroperitoneal malignant schwannoma) which were difficult to diagnose by CT and proved ultimately with operation or autopsy were illustrated with some reviews. (author)

  20. Clinical review: Management of difficult airways

    Science.gov (United States)

    Langeron, Olivier; Amour, Julien; Vivien, Benoît; Aubrun, Frédéric

    2006-01-01

    Difficulties or failure in airway management are still important factors in morbidity and mortality related to anesthesia and intensive care. A patent and secure airway is essential to manage anesthetized or critically ill patients. Oxygenation maintenance during tracheal intubation is the cornerstone of difficult airway management and is always emphasized in guidelines. The occurrence of respiratory adverse events has decreased in claims for injuries due to inadequate airway management mainly at induction of anesthesia. Nevertheless, claim reports emphasize that airway emergencies, tracheal extubation and/or recovery of anesthesia phases are still associated with death or brain damage, indicating that additional educational support and management strategies to improve patient safety are required. The present brief review analyses specific problems of airway management related to difficult tracheal intubation and to difficult mask ventilation prediction. The review will focus on basic airway management including preoxygenation, and on some oxygenation and tracheal intubation techniques that may be performed to solve a difficult airway. PMID:17184555

  1. Clinical review: management of difficult airways.

    Science.gov (United States)

    Langeron, Olivier; Amour, Julien; Vivien, Benoît; Aubrun, Frédéric

    2006-01-01

    Difficulties or failure in airway management are still important factors in morbidity and mortality related to anesthesia and intensive care. A patent and secure airway is essential to manage anesthetized or critically ill patients. Oxygenation maintenance during tracheal intubation is the cornerstone of difficult airway management and is always emphasized in guidelines. The occurrence of respiratory adverse events has decreased in claims for injuries due to inadequate airway management mainly at induction of anesthesia. Nevertheless, claim reports emphasize that airway emergencies, tracheal extubation and/or recovery of anesthesia phases are still associated with death or brain damage, indicating that additional educational support and management strategies to improve patient safety are required. The present brief review analyses specific problems of airway management related to difficult tracheal intubation and to difficult mask ventilation prediction. The review will focus on basic airway management including preoxygenation, and on some oxygenation and tracheal intubation techniques that may be performed to solve a difficult airway.

  2. Overcoming difficult conversations in clinical supervision

    Directory of Open Access Journals (Sweden)

    Williams B

    2016-06-01

    Full Text Available Brett Williams,1 Christine King,1 Tanya Edlington,21Department of Community Emergency Health and Paramedic Practice, Monash University, Franskton, VIC, 2The Conversation Clinic Pty Ltd, Melbourne, VIC, Australia Background: Clinical supervisors are responsible for managing many facets of clinical learning and face a range of challenges when the need for "difficult" conversations arises, including the need to manage conflict and relationships. Methods: Spotlight on Conversations Workshop was developed to improve the capacity of clinical supervisors to engage in difficult conversations. They were designed to challenge the mindset of clinical supervisors about difficult conversations with students, the consequences of avoiding difficult conversations, and to offer activities for practicing difficult conversations. Preworkshop, postworkshop, and 4-month follow-up evaluations assessed improvements in knowledge, intent to improve, and confidence along with workshop satisfaction. Results: Nine workshops were delivered in a range of locations across Victoria, Australia, involving a total of 117 clinical supervisors. Preworkshop evaluations illustrated that more than half of the participants had avoided up to two difficult conversations in the last month in their workplace. Postworkshop evaluation at 4 months showed very high levels of satisfaction with the workshop's relevancy, content, and training, as well as participants' intention to apply knowledge and skills. Also shown were significant changes in participants' confidence to have difficult conversations not only with students but also with other peers and colleagues. In follow-up in-depth interviews with 20 of the 117 participants, 75% said they had made definite changes in their practice because of what they learned in the workshop and another 10% said they would make changes to their practice, but had not had the opportunity yet to do so. Conclusion: We conclude that the Spotlight on

  3. How Difficult It Is to Be God

    DEFF Research Database (Denmark)

    Wilson, Fiona

    2014-01-01

    Book review of Carlos Iván Degregori, How Difficult It Is to Be God: Shining Path's Politics of War in Peru,1980–1999 (Madison, WI: University of Wisconsin Press, 2012)......Book review of Carlos Iván Degregori, How Difficult It Is to Be God: Shining Path's Politics of War in Peru,1980–1999 (Madison, WI: University of Wisconsin Press, 2012)...

  4. The greenhouse effect and extreme weather

    International Nuclear Information System (INIS)

    Groenaas, Sigbjoern; Kvamstoe, Nils Gunnar

    2002-01-01

    The article asserts that an anthropogenic global warming is occurring. This greenhouse effect is expected to cause more occurrences of extreme weather. It is extremely difficult, however, to relate specific weather catastrophes to global warming with certainty, since such extreme weather conditions are rare historically. The subject is controversial. The article also discusses the public debate and the risk of floods

  5. Preservice Mathematics Teachers' Metaphorical Perceptions towards Proof and Proving

    Science.gov (United States)

    Ersen, Zeynep Bahar

    2016-01-01

    Since mathematical proof and proving are in the center of mathematics; preservice mathematics teachers' perceptions against these concepts have a great importance. Therefore, the study aimed to determine preservice mathematics teachers' perceptions towards proof and proving through metaphors. The participants consisted of 192 preservice…

  6. Proving termination of logic programs with delay declarations

    NARCIS (Netherlands)

    E. Marchiori; F. Teusink (Frank)

    1996-01-01

    textabstractIn this paper we propose a method for proving termination of logic programs with delay declarations. The method is based on the notion of recurrent logic program, which is used to prove programs terminating wrt an arbitrary selection rule. Most importantly, we use the notion of bound

  7. 20 CFR 219.23 - Evidence to prove death.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Evidence to prove death. 219.23 Section 219... EVIDENCE REQUIRED FOR PAYMENT Evidence of Age and Death § 219.23 Evidence to prove death. (a) Preferred evidence of death. The best evidence of a person's death is— (1) A certified copy of or extract from the...

  8. A New Approach for Proving or Generating Combinatorial Identities

    Science.gov (United States)

    Gonzalez, Luis

    2010-01-01

    A new method for proving, in an immediate way, many combinatorial identities is presented. The method is based on a simple recursive combinatorial formula involving n + 1 arbitrary real parameters. Moreover, this formula enables one not only to prove, but also generate many different combinatorial identities (not being required to know them "a…

  9. Reasoning and Proving Opportunities in Textbooks: A Comparative Analysis

    Science.gov (United States)

    Hong, Dae S.; Choi, Kyong Mi

    2018-01-01

    In this study, we analyzed and compared reasoning and proving opportunities in geometry lessons from American standard-based textbooks and Korean textbooks to understand how these textbooks provide student opportunities to engage in reasoning and proving activities. Overall, around 40% of exercise problems in Core Plus Mathematics Project (CPMP)…

  10. The Earth is Flat, and I Can Prove It!

    Science.gov (United States)

    Klinger, Art

    1998-01-01

    Describes an educational program that asks students to attempt to prove that the earth is spherical and that it rotates. Presents tips to pique student interest and charts related to sensing the spin, nonrotation notions, flat earth fallacies, evidence that the earth is spherical and rotates, and the role of watersheds in proving that the earth…

  11. Extreme cosmos

    CERN Document Server

    Gaensler, Bryan

    2011-01-01

    The universe is all about extremes. Space has a temperature 270°C below freezing. Stars die in catastrophic supernova explosions a billion times brighter than the Sun. A black hole can generate 10 million trillion volts of electricity. And hypergiants are stars 2 billion kilometres across, larger than the orbit of Jupiter. Extreme Cosmos provides a stunning new view of the way the Universe works, seen through the lens of extremes: the fastest, hottest, heaviest, brightest, oldest, densest and even the loudest. This is an astronomy book that not only offers amazing facts and figures but also re

  12. Clinicians' recognition and management of emotions during difficult healthcare conversations.

    Science.gov (United States)

    Martin, Elliott B; Mazzola, Natalia M; Brandano, Jessica; Luff, Donna; Zurakowski, David; Meyer, Elaine C

    2015-10-01

    To examine the most commonly reported emotions encountered among healthcare practitioners when holding difficult conversations, including frequency and impact on care delivery. Interprofessional learners from a range of experience levels and specialties completed self-report questionnaires prior to simulation-based communication workshops. Clinicians were asked to describe up to three emotions they experienced when having difficult healthcare conversations; subsequent questions used Likert-scales to measure frequency of each emotion, and whether care was affected. 152 participants completed questionnaires, including physicians, nurses, and psychosocial professionals. Most commonly reported emotions were anxiety, sadness, empathy, frustration, and insecurity. There were significant differences in how clinicians perceived these different emotions affecting care. Empathy and anxiety were emotions perceived to influence care more than sadness, frustration, and insecurity. Most clinicians, regardless of clinical experience and discipline, find their emotional state influences the quality of their care delivery. Most clinicians rate themselves as somewhat to quite capable of recognizing and managing their emotions, acknowledging significant room to grow. Further education designed to increase clinicians' recognition of, reflection on, and management of emotion would likely prove helpful in improving their ability to navigate difficult healthcare conversations. Interventions aimed at anxiety management are particularly needed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. A practical approach to proving waste metals suitable for consignment as radiologically exempt materials - 59266

    International Nuclear Information System (INIS)

    Carvel, Iain; Gunn, Richard D.; Orr, Christopher H.; Strange, Robin

    2012-01-01

    Building 220 at Harwell was built by the Ministry of Works as a Radiochemical Research and Development facility in the latter part of the 1940's. The facility has been operational since 1949 and has been extended several times, most notably the Plutonium Glove Box Wing in the 1950's and the Remote Handling Wing in the 1980's. Only the Remote Handling wing remains operational, processing Historic Waste which is being recovered from storage holes elsewhere on site. The remainder of the facility is undergoing progressive strip out and decommissioning. In the Plutonium Wing and associated areas the waste 'fingerprint' (nuclide vector) consists predominately of alpha emitting radionuclides. Decommissioning and Decontamination (D and D) operations often result in the production of large volumes of scrap metal waste with little or no radioactive contamination. Proving that the waste is clean can be costly and time consuming, as the shape and size of the metallic waste items often means that it is difficult or impossible to monitor all surfaces using conventional hand-held survey meters. This is a particular problem for alpha contamination measurement. Traditional radiological surveying techniques are very labour intensive and involve surveyors checking every surface using hand held instruments and smear sampling the hard to access areas. Even then 100% monitoring cannot be guaranteed. An alternative to traditional methods is the Long Range Alpha Detection (LRAD) technique which remotely detects and measures secondary ionization created in air by alpha particle interactions, allowing extremely low levels of alpha contamination to be measured. A survey system, IonSens R , using the LRAD technique, was developed by BNFL Instruments Ltd (now Babcock Nuclear) which allows rapid surveying of scrap metal for alpha contamination at very low levels. Two versions of this system exist but both essentially comprise a measurement chamber into which scrap metal is placed and sealed

  14. Difficult intubation: are you prepared for it?

    Science.gov (United States)

    Balcom, C

    1994-01-01

    The endotracheal intubation of a patient for surgery requires an anaesthetist who is aided by a skilled and experienced helper. This paper explores reasons why some patients are difficult to intubate. Some are predictable on pre-operative assessment and others are not. Suggestions are given on how the helper is useful to the anaesthetist in this potentially critical situation.

  15. Preoperative Ultrasonography as a Predictor of Difficult ...

    African Journals Online (AJOL)

    patient.[8]. On the basis of ultrasound findings, surgeons can select the cases appropriate for their skills aiming at reducing operative complications and minimizing the waste of operative time.[2]. Based on ... bed-more than 20 min. 4. Spillage of bile and ... gallbladder turned out to be difficult laparoscopically. The positive ...

  16. Preoperative Prediction of Difficult Laparoscopic Cholecystectomy: A ...

    African Journals Online (AJOL)

    Pujahari[2] [Table 1]. The scores were added up to get a total score and the patients were divided into categories of risks based on the total score [Table 2]. The following operative parameters ... The timing was noted from the first port site incision till the last ports closure. ..... Dhanke PS, Vgane SP. Factors predicting difficult ...

  17. On the problem of proving the existence of ''charmed'' particles

    International Nuclear Information System (INIS)

    Tyapkin, A.A.

    1975-01-01

    In order to search for ''charmed'' particles a possibility of performing an experiment is discussed in which one could observe a new particle and prove a necessity of introducting for this particle a new quantum number conserved in strong interactions

  18. Crisis management during anaesthesia: difficult intubation.

    Science.gov (United States)

    Paix, A D; Williamson, J A; Runciman, W B

    2005-06-01

    Anaesthetists may experience difficulty with intubation unexpectedly which may be associated with difficulty in ventilating the patient. If not well managed, there may be serious consequences for the patient. A simple structured approach to this problem was developed to assist the anaesthetist in this difficult situation. To examine the role of a specific sub-algorithm for the management of difficult intubation. The potential performance of a structured approach developed by review of the literature and analysis of each of the relevant incidents among the first 4000 reported to the Australian Incident Monitoring Study (AIMS) was compared with the actual management as reported by the anaesthetists involved. There were 147 reports of difficult intubation capable of analysis among the first 4000 incidents reported to AIMS. The difficulty was unexpected in 52% of cases; major physiological changes occurred in 37% of these cases. Saturation fell below 90% in 22% of cases, oesophageal intubation was reported in 19%, and an emergency transtracheal airway was required in 4% of cases. Obesity and limited neck mobility and mouth opening were the most common anatomical contributing factors. The data confirm previously reported failures to predict difficult intubation with existing preoperative clinical tests and suggest an ongoing need to teach a pre-learned strategy to deal with difficult intubation and any associated problem with ventilation. An easy-to-follow structured approach to these problems is outlined. It is recommended that skilled assistance be obtained (preferably another anaesthetist) when difficulty is expected or the patient's cardiorespiratory reserve is low. Patients should be assessed postoperatively to exclude any sequelae and to inform them of the difficulties encountered. These should be clearly documented and appropriate steps taken to warn future anaesthetists.

  19. Models and Techniques for Proving Data Structure Lower Bounds

    DEFF Research Database (Denmark)

    Larsen, Kasper Green

    In this dissertation, we present a number of new techniques and tools for proving lower bounds on the operational time of data structures. These techniques provide new lines of attack for proving lower bounds in both the cell probe model, the group model, the pointer machine model and the I...... bound of tutq = (lgd􀀀1 n). For ball range searching, we get a lower bound of tutq = (n1􀀀1=d). The highest previous lower bound proved in the group model does not exceed ((lg n= lg lg n)2) on the maximum of tu and tq. Finally, we present a new technique for proving lower bounds....../O-model. In all cases, we push the frontiers further by proving lower bounds higher than what could possibly be proved using previously known techniques. For the cell probe model, our results have the following consequences: The rst (lg n) query time lower bound for linear space static data structures...

  20. The long shadows of the difficult past?

    DEFF Research Database (Denmark)

    Wolnik, Kevin; Busse, Britta; Tholen, Jochen

    2017-01-01

    This paper focuses on the question of how young people today evaluate the Second World War today and how this ‘difficult past’ determines their political attitudes. Furthermore, the channels through which the current young generation in Europe is informed about the events dating back to the first...... half of the twentieth century (e.g. parents and grandparents, schools, the media) are examined. The theoretical basis chosen for addressing these questions is the work of Mannheim (1928) on the formation of successive generations, and the theories of collective memories and identities of Eisenstadt...... and his followers. Our empirical evidence comes from a transnational comparison of young people’s memories of this difficult past in Denmark, Finland and Germany. From a historical perspective a comparison of the three countries is particularly interesting as they played different roles during the Second...

  1. Clinical review: Management of difficult airways

    OpenAIRE

    Langeron, Olivier; Amour, Julien; Vivien, Benoît; Aubrun, Frédéric

    2006-01-01

    Difficulties or failure in airway management are still important factors in morbidity and mortality related to anesthesia and intensive care. A patent and secure airway is essential to manage anesthetized or critically ill patients. Oxygenation maintenance during tracheal intubation is the cornerstone of difficult airway management and is always emphasized in guidelines. The occurrence of respiratory adverse events has decreased in claims for injuries due to inadequate airway management mainl...

  2. Seismic proving test of PWR reactor containment vessel

    International Nuclear Information System (INIS)

    Akiyama, H.; Yoshikawa, T.; Tokumaru, Y.

    1987-01-01

    The seismic reliability proving tests of nuclear power plant facilities are carried out by Nuclear Power Engineering Test Center (NUPEC), using the large-scale, high-performance vibration of Tadotsu Engineering Laboratory, and sponsored by the Ministry of International Trade and Industry (MITI). In 1982, the seismic reliability proving test of PWR containment vessel started using the test component of reduced scale 1/3.7 and the test component proved to have structural soundness against earthquakes. Subsequently, the detailed analysis and evaluation of these test results were carried out, and the analysis methods for evaluating strength against earthquakes were established. Whereupon, the seismic analysis and evaluation on the actual containment vessel were performed by these analysis methods, and the safety and reliability of the PWR reactor containment vessel were confirmed

  3. Proving test on the reliability for nuclear valves

    International Nuclear Information System (INIS)

    Kajiyama, Yasuo; Tashiro, Hisao; Uga, Takeo; Maeda, Shunichi.

    1986-01-01

    Since valves are the most common components, they could be the most frequent causes of troubles in nuclear power plants. This proving test, therefore, has an important meaning to examine and verify the reliability of various valves under simulating conditions of abnormal and transient operations of the nuclear power plant. The test was performed mainly for the various types and pressure ratings of valves which were used in the primary and secondary systems in BWR and PWR nuclear power plants and which had major operating or safety related functions in those nuclear power plants. The results of the proving test, confirmed for more than four years, showed relatively favourable performance of the tested valves. It is concluded that performances of valves including operability, seat sealing and structural integrity were proved under the thermal cycling, vibration and pipe reaction load conditions. Operating functions during and after accident such as loss of coolant accident were satisfactory. From these results, it was considered that the purpose of this proving test was satisfactorily fulfilled. Several data accumulated by the test would be useful to get better reliability if it was evaluated with the actually experienced data of valves in the nuclear power plants. (Nogami, K.)

  4. Responsibility for proving and defining in abstract algebra class

    Science.gov (United States)

    Fukawa-Connelly, Timothy

    2016-07-01

    There is considerable variety in inquiry-oriented instruction, but what is common is that students assume roles in mathematical activity that in a traditional, lecture-based class are either assumed by the teacher (or text) or are not visible at all in traditional math classrooms. This paper is a case study of the teaching of an inquiry-based undergraduate abstract algebra course. In particular, gives a theoretical account of the defining and proving processes. The study examines the intellectual responsibility for the processes of defining and proving that the professor devolved to the students. While the professor wanted the students to engage in all aspects of defining and proving, he was only successful at devolving responsibility for certain aspects and much more successful at devolving responsibility for proving than conjecturing or defining. This study suggests that even a well-intentioned instructor may not be able to devolve responsibility to students for some aspects of mathematical practice without using a research-based curriculum or further professional development.

  5. Pengembangan Perangkat Pembelajaran Geometri Ruang dengan Model Proving Theorem

    Directory of Open Access Journals (Sweden)

    Bambang Eko Susilo

    2016-03-01

    Full Text Available Kemampuan berpikir kritis dan kreatif mahasiswa masih lemah. Hal ini ditemukan pada mahasiswa yang mengambil mata kuliah Geometri Ruang yaitu dalam membuktikan soal-soal pembuktian (problem to proof. Mahasiswa masih menyelesaikan secara algoritmik atau prosedural sehingga diperlukan pengembangan perangkat pembelajaran Geometri Ruang berbasis kompetensi dan konservasi dengan model Proving Theorem. Dalam penelitian ini perangkat perkuliahan yang dikembangkan yaitu Silabus, Satuan Acara Perkuliahan (SAP, Kontrak Perkuliahan, Media Pembelajaran, Bahan Ajar, Tes UTS dan UAS serta Angket Karakter Konservasi telah dilaksanakan dengan baik dengan kriteria (1 validasi perangkat pembelajaran mata kuliah Geometri ruang berbasis kompetensi dan konservasi dengan model proving theorem berkategori baik dan layak digunakan dan (2 keterlaksanaan RPP pada pembelajaran yang dikembangkan secara keseluruhan berkategori baik.Critical and creative thinking abilities of students still weak. It is found in students who take Space Geometry subjects that is in solving problems to to prove. Students still finish in algorithmic or procedural so that the required the development of Space Geometry learning tools based on competency and conservation with Proving Theorem models. This is a research development which refers to the 4-D models that have been modified for the Space Geometry learning tools, second semester academic year 2014/2015. Instruments used include validation sheet, learning tools and character assessment questionnaire. In this research, the learning tools are developed, namely Syllabus, Lesson Plan, Lecture Contract, Learning Media, Teaching Material, Tests, and Character Conservation Questionnaire had been properly implemented with the criteria (1 validation of Space Geometry learning tools based on competency and conservation with Proving Theorem models categorized good and feasible to use, and (2 the implementation of Lesson Plan on learning categorized

  6. Searching for fixed point combinators by using automated theorem proving: A preliminary report

    International Nuclear Information System (INIS)

    Wos, L.; McCune, W.

    1988-09-01

    In this report, we establish that the use of an automated theorem- proving program to study deep questions from mathematics and logic is indeed an excellent move. Among such problems, we focus mainly on that concerning the construction of fixed point combinators---a problem considered by logicians to be significant and difficult to solve, and often computationally intensive and arduous. To be a fixed point combinator, Θ must satisfy the equation Θx = x(Θx) for all combinators x. The specific questions on which we focus most heavily ask, for each chosen set of combinators, whether a fixed point combinator can be constructed from the members of that set. For answering questions of this type, we present a new, sound, and efficient method, called the kernel method, which can be applied quite easily by hand and very easily by an automated theorem-proving program. For the application of the kernel method by a theorem-proving program, we illustrate the vital role that is played by both paramodulation and demodulation---two of the powerful features frequently offered by an automated theorem-proving program for treating equality as if it is ''understood.'' We also state a conjecture that, if proved, establishes the completeness of the kernel method. From what we can ascertain, this method---which relies on the introduced concepts of kernel and superkernel---offers the first systematic approach for searching for fixed point combinators. We successfully apply the new kernel method to various sets of combinators and, for the set consisting of the combinators B and W, construct an infinite set of fixed point combinators such that no two of the combinators are equal even in the presence of extensionality---a law that asserts that two combinators are equal if they behave the same. 18 refs

  7. Searching for fixed point combinators by using automated theorem proving: A preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Wos, L.; McCune, W.

    1988-09-01

    In this report, we establish that the use of an automated theorem- proving program to study deep questions from mathematics and logic is indeed an excellent move. Among such problems, we focus mainly on that concerning the construction of fixed point combinators---a problem considered by logicians to be significant and difficult to solve, and often computationally intensive and arduous. To be a fixed point combinator, THETA must satisfy the equation THETAx = x(THETAx) for all combinators x. The specific questions on which we focus most heavily ask, for each chosen set of combinators, whether a fixed point combinator can be constructed from the members of that set. For answering questions of this type, we present a new, sound, and efficient method, called the kernel method, which can be applied quite easily by hand and very easily by an automated theorem-proving program. For the application of the kernel method by a theorem-proving program, we illustrate the vital role that is played by both paramodulation and demodulation---two of the powerful features frequently offered by an automated theorem-proving program for treating equality as if it is ''understood.'' We also state a conjecture that, if proved, establishes the completeness of the kernel method. From what we can ascertain, this method---which relies on the introduced concepts of kernel and superkernel---offers the first systematic approach for searching for fixed point combinators. We successfully apply the new kernel method to various sets of combinators and, for the set consisting of the combinators B and W, construct an infinite set of fixed point combinators such that no two of the combinators are equal even in the presence of extensionality---a law that asserts that two combinators are equal if they behave the same. 18 refs.

  8. Difficult weaning in delayed onset diaphragmatic hernia

    Directory of Open Access Journals (Sweden)

    Ahmed Syed

    2009-01-01

    Full Text Available Diaphragmatic injuries are relatively rare and result from either blunt or penetrating trauma. Regardless of the mechanism, diagnosis is often missed and high index of suspicion is vital. The clinical signs associated with a diaphragmatic hernia can range from no outward signs to immediately life-threatening respiratory compromise. Establishing the clinical diagnosis of diaphragmatic injuries (DI can be challenging as it is often clinically occult. Accurate diagnosis is critical since missed DI may result in grave sequelae due to herniation and strangulation of displaced intra-abdominal organs. We present a case of polytrauma with rib fracture and delayed appearance of diaphragmatic hernia manifesting as difficult weaning from ventilatory support.

  9. Foreign body aspiration masquerading as difficult asthma

    Directory of Open Access Journals (Sweden)

    Rai S

    2007-01-01

    Full Text Available It is important to assess patients of difficult/therapy resistant asthma carefully in order to identify whether there are any correctable factors that may contribute to their poor control. It is critical to make a diagnosis of asthma and to exclude other airway diseases. A 65-years-old lady presented with repeated acute episodes of dyspnoea and wheezing. She was on regular medication for bronchial asthma for 18 years. There was no history of foreign body aspiration or loss of consciousness. Her chest radiograph was normal. She showed poor response to corticosteroids and bronchodilators. Fibreoptic bronchoscopy (FOB showed intracordal cyst of the left vocal cord and 1cm size irregular piece of betel nut in right main bronchus, which was removed endoscopically with the help of dormia basket, following which her condition improved and asthma was controlled on inhaled bronchodilators.

  10. Effective Climate Communication with Difficult Audiences

    Science.gov (United States)

    Denning, S.

    2015-12-01

    Climate communication is often fraught with ideological baggage ("noise") that makes it very difficult to connect to audiences. In these cases, it is helpful to use "best practices" known from other fields of communication. Engaging audiences with authenticity, using plain language, respecting cultural and political differences, and a sprinkling of humor can go a long way toward establishing a connection. It's important to avoid common but polarizing tropes from popular media, and often quite helpful to frame climate issues in novel or unexpected ways that cut across entrenched political discourse. Emerging social science research Beyond ideology, climate change is Simple, Serious, and Solvable. Effective communication of these three key ideas can succeed when the science argument is carefully framed to avoid attack of the audience's ethical identity. Simple arguments from common sense and everyday experience are more successful than data. Serious consequences to values that resonate with the audience can be avoided by solutions that don't threaten those values.

  11. Chernobyl: Chronicle of difficult weeks [videorecording

    Energy Technology Data Exchange (ETDEWEB)

    Volodymyr, S

    1987-07-01

    1. Chernobyl : chronicle of difficult weeks. Shevchenko's film crew was the first in the disaster zone following the meltdown of the core of the Chernobyl nuclear power plant in 1986. They shot continuously for more than three months. Portions of the film are exposed with white blotches - a radiation leakage. The film demonstrates how authorities and volunteers dealt with the accident, shows the efforts to get the fire under control, to take care of patients with radiation injuries, and to evacuate about 100,000 inhabitants of the area. 2. The BAM zone : permanent residents. The Baikal-Amur Mainline (BAM) railroad in Siberia is called the longest monument to the stagnation of the Brezhnev years. The film shows the lives and fates of the people in contrast to the marches and songs praising the project.

  12. The reentry catheter: a second chance for endoluminal reentry at difficult lower extremity subintimal arterial recanalizations.

    Science.gov (United States)

    Etezadi, Vahid; Benenati, James F; Patel, Parag J; Patel, Rahul S; Powell, Alex; Katzen, Barry T

    2010-05-01

    From January 2005 to July 2008, a retrospective study was conducted at a single institution to investigate technical success of the use of a reentry device (Outback LTD reentry catheter) in aortoiliac and femoropopliteal artery recanalization in 34 patients (18 men; mean age +/- SD, 72 years +/- 11) in whom the conventional guide wires and catheters failed to reenter the true lumen. True lumen reentry was achieved in 87% (n = 23) and 91% (n = 11) of patients with femoropopliteal and aortoiliac occlusions, respectively. The overall technical success rate with the device was 88% (n = 34). The device success rate in Transatlantic Inter-Society Consensus II class D lesions was significantly lower than in lower lesion classes (71.4% vs 100%; P < .05). No procedure-related complications were encountered. In conclusion, the use of the reentry catheter enhances the likelihood of successful subintimal recanalization of chronic occlusions in femoropopliteal and aortoiliac arteries.

  13. Unexploded ordnance issues at Aberdeen Proving Ground: Background information

    Energy Technology Data Exchange (ETDEWEB)

    Rosenblatt, D.H.

    1996-11-01

    This document summarizes currently available information about the presence and significance of unexploded ordnance (UXO) in the two main areas of Aberdeen Proving Ground: Aberdeen Area and Edgewood Area. Known UXO in the land ranges of the Aberdeen Area consists entirely of conventional munitions. The Edgewood Area contains, in addition to conventional munitions, a significant quantity of chemical-munition UXO, which is reflected in the presence of chemical agent decomposition products in Edgewood Area ground-water samples. It may be concluded from current information that the UXO at Aberdeen Proving Ground has not adversely affected the environment through release of toxic substances to the public domain, especially not by water pathways, and is not likely to do so in the near future. Nevertheless, modest but periodic monitoring of groundwater and nearby surface waters would be a prudent policy.

  14. Unicorns do exist: a tutorial on "proving" the null hypothesis.

    Science.gov (United States)

    Streiner, David L

    2003-12-01

    Introductory statistics classes teach us that we can never prove the null hypothesis; all we can do is reject or fail to reject it. However, there are times when it is necessary to try to prove the nonexistence of a difference between groups. This most often happens within the context of comparing a new treatment against an established one and showing that the new intervention is not inferior to the standard. This article first outlines the logic of "noninferiority" testing by differentiating between the null hypothesis (that which we are trying to nullify) and the "nill" hypothesis (there is no difference), reversing the role of the null and alternate hypotheses, and defining an interval within which groups are said to be equivalent. We then work through an example and show how to calculate sample sizes for noninferiority studies.

  15. Logic for computer science foundations of automatic theorem proving

    CERN Document Server

    Gallier, Jean H

    2015-01-01

    This advanced text for undergraduate and graduate students introduces mathematical logic with an emphasis on proof theory and procedures for algorithmic construction of formal proofs. The self-contained treatment is also useful for computer scientists and mathematically inclined readers interested in the formalization of proofs and basics of automatic theorem proving. Topics include propositional logic and its resolution, first-order logic, Gentzen's cut elimination theorem and applications, and Gentzen's sharpened Hauptsatz and Herbrand's theorem. Additional subjects include resolution in fir

  16. IHSI [Induction Heating Stress Improvement] proves its worth

    International Nuclear Information System (INIS)

    Froehlich, C.H.; Cofie, N.G.; Sheffield, J.R.

    1988-01-01

    Based upon the wealth of experimental test data, extensive and successful in-plant application, and the decreasing cost of applying the process, IHSI is proving itself an important part of overall IGSCC mitigation programmes. Work is ongoing on the development of new temperature sensing systems, more efficient equipment immobilization/demobilization hardware configurations, and craft support management practices to further enhance the cost-effectiveness of IHSI. (author)

  17. Renewable Energy Opportunties at Dugway Proving Ground, Utah

    Energy Technology Data Exchange (ETDEWEB)

    Orrell, Alice C.; Kora, Angela R.; Russo, Bryan J.; Horner, Jacob A.; Williamson, Jennifer L.; Weimar, Mark R.; Gorrissen, Willy J.; Nesse, Ronald J.; Dixon, Douglas R.

    2010-05-31

    This document provides an overview of renewable resource potential at Dugway Proving Ground, based primarily upon analysis of secondary data sources supplemented with limited on-site evaluations. This effort focuses on grid-connected generation of electricity from renewable energy sources and ground source heat pumps (GSHPs). The effort was funded by the U.S. Army Installation Management Command (IMCOM) as follow-on to the 2005 Department of Defense (DoD) Renewables Assessment.

  18. Seismic proving test of BWR primary loop recirculation system

    International Nuclear Information System (INIS)

    Sato, H.; Shigeta, M.; Karasawa, Y.

    1987-01-01

    The seismic proving test of BWR Primary Loop Recirculation system is the second test to use the large-scale, high-performance vibration table of Tadotsu Engineering Laboratory. The purpose of this test is to prove the seismic reliability of the primary loop recirculation system (PLR), one of the most important safety components in the BWR nuclear plants, and also to confirm the adequacy of seismic analysis method used in the current seismic design. To achieve the purpose, the test was conducted under conditions and scale as near as possible to actual systems. The strength proving test was carried out with the test model mounted on the vibration table in consideration of basic design earthquake ground motions and other conditions to confirm the soundness of structure and the strength against earthquakes. Detailed analysis and analytic evaluation of the data obtained from the test was conducted to confirm the adequacy of the seismic analysis method and earthquake response analysis method used in the current seismic design. Then, on the basis of the results obtained, the seismic safety and reliability of BWR primary loop recirculation of the actual plants was fully evaluated

  19. Preparing for Mars: The Evolvable Mars Campaign 'Proving Ground' Approach

    Science.gov (United States)

    Bobskill, Marianne R.; Lupisella, Mark L.; Mueller, Rob P.; Sibille, Laurent; Vangen, Scott; Williams-Byrd, Julie

    2015-01-01

    As the National Aeronautics and Space Administration (NASA) prepares to extend human presence beyond Low Earth Orbit, we are in the early stages of planning missions within the framework of an Evolvable Mars Campaign. Initial missions would be conducted in near-Earth cis-lunar space and would eventually culminate in extended duration crewed missions on the surface of Mars. To enable such exploration missions, critical technologies and capabilities must be identified, developed, and tested. NASA has followed a principled approach to identify critical capabilities and a "Proving Ground" approach is emerging to address testing needs. The Proving Ground is a period subsequent to current International Space Station activities wherein exploration-enabling capabilities and technologies are developed and the foundation is laid for sustained human presence in space. The Proving Ground domain essentially includes missions beyond Low Earth Orbit that will provide increasing mission capability while reducing technical risks. Proving Ground missions also provide valuable experience with deep space operations and support the transition from "Earth-dependence" to "Earth-independence" required for sustainable space exploration. A Technology Development Assessment Team identified a suite of critical technologies needed to support the cadence of exploration missions. Discussions among mission planners, vehicle developers, subject-matter-experts, and technologists were used to identify a minimum but sufficient set of required technologies and capabilities. Within System Maturation Teams, known challenges were identified and expressed as specific performance gaps in critical capabilities, which were then refined and activities required to close these critical gaps were identified. Analysis was performed to identify test and demonstration opportunities for critical technical capabilities across the Proving Ground spectrum of missions. This suite of critical capabilities is expected to

  20. Nostalgia: retreat or support in difficult times?

    Science.gov (United States)

    Batcho, Krystine Irene

    2013-01-01

    The relationship between nostalgia and coping during difficult times was explored in 2 empirical studies. In the first, 80 undergraduates, 60 women and 20 men, completed the Nostalgia Inventory, a measure of nostalgia proneness, the COPE Inventory, a dispositional measure of strategies for coping with stressful events, and the Childhood Survey, a survey of impressions of childhood experiences. Nostalgia proneness correlated with use of adaptive coping, including emotional social support, expressing emotions, turning to religion, and suppressing competing activities, and did not correlate with escapist or avoidance strategies, including denial, behavioral disengagement, and substance abuse. Nostalgia proneness was related positively to favorable emotional and behavioral childhood experiences and did not correlate with adverse experiences. Favorable impressions of childhood correlated positively with adaptive coping strategies and inversely with dysfunctional ones, whereas unfavorable childhood experiences correlated positively with dysfunctional coping. Regression analyses suggested that the relationship between nostalgia proneness and certain coping strategies may be mediated in part by childhood experiences. In a second study, 100 undergraduates, 86 women and 14 men, completed the Nostalgia Inventory, recalled autobiographical memories that illustrated how childhood is either special or similar to their present life, and rated their likely use of strategies in dealing with 2 hypothetical problems. Nostalgia proneness correlated with emotional and instrumental social coping and with the goal-directed strategies of planning, taking action, and positive reframing. Further research is recommended to explore the role of childhood memories in coping and to identify mechanisms that mediate the relationship between nostalgia and coping.

  1. Why behavior change is difficult to sustain.

    Science.gov (United States)

    Bouton, Mark E

    2014-11-01

    Unhealthy behavior is responsible for much human disease, and a common goal of contemporary preventive medicine is therefore to encourage behavior change. However, while behavior change often seems easy in the short run, it can be difficult to sustain. This article provides a selective review of research from the basic learning and behavior laboratory that provides some insight into why. The research suggests that methods used to create behavior change (including extinction, counterconditioning, punishment, reinforcement of alternative behavior, and abstinence reinforcement) tend to inhibit, rather than erase, the original behavior. Importantly, the inhibition, and thus behavior change more generally, is often specific to the "context" in which it is learned. In support of this view, the article discusses a number of lapse and relapse phenomena that occur after behavior has been changed (renewal, spontaneous recovery, reinstatement, rapid reacquisition, and resurgence). The findings suggest that changing a behavior can be an inherently unstable and unsteady process; frequent lapses should be expected. In the long run, behavior-change therapies might benefit from paying attention to the context in which behavior change occurs. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. On proving confluence modulo equivalence for Constraint Handling Rules

    DEFF Research Database (Denmark)

    Christiansen, Henning; Kirkeby, Maja Hanne

    2017-01-01

    -logical built-in predicates such as var/1 and incomplete ones such as is/2, that are ignored in previous work on confluence. To this end, a new operational semantics for CHR is developed which includes such predicates. In addition, this semantics differs from earlier approaches by its simplicity without loss......Previous results on proving confluence for Constraint Handling Rules are extended in two ways in order to allow a larger and more realistic class of CHR programs to be considered confluent. Firstly, we introduce the relaxed notion of confluence modulo equivalence into the context of CHR: while...

  3. Proving Test on the Reliability for Reactor Containment Vessel

    International Nuclear Information System (INIS)

    Takumi, K.; Nonaka, A.

    1988-01-01

    NUPEC (Nuclear Power Engineering Test Center) has started an eight-year project of Proving Test on the Reliability for Reactor Containment Vessel since June 1987. The objective of this project is to confirm the integrity of containment vessels under severe accident conditions. This paper shows the outline of this project. The test Items are (1) Hydrogen mixing and distribution test, (2) Hydrogen burning test, (3) Iodine trapping characteristics test, and (4) Structural behavior test. Based on the test results, computer codes are verified and as the results of analysis and evaluation by the computer codes, containment integrity is to be confirmed

  4. Reasoning by analogy as an aid to heuristic theorem proving.

    Science.gov (United States)

    Kling, R. E.

    1972-01-01

    When heuristic problem-solving programs are faced with large data bases that contain numbers of facts far in excess of those needed to solve any particular problem, their performance rapidly deteriorates. In this paper, the correspondence between a new unsolved problem and a previously solved analogous problem is computed and invoked to tailor large data bases to manageable sizes. This paper outlines the design of an algorithm for generating and exploiting analogies between theorems posed to a resolution-logic system. These algorithms are believed to be the first computationally feasible development of reasoning by analogy to be applied to heuristic theorem proving.

  5. Case report 486: Spondyloepiphyseal dysplasia tarda (SDT) (presumptively proved)

    International Nuclear Information System (INIS)

    Brown, D.D.; Childress, M.H.

    1988-01-01

    A 51 year old man with severe degenerative joint disease, short stature, barrel chest deformity, platyspondyly, a narrow pelvis, small iliac bones, dysplastic femoral heads and necks, notching of the patellae and flattening of the femoral intercondylar notches has been described as an example of Spondyloepiphyseal dysplasia tarda SDT. The entity was discussed in detail. The notching of the patellae has not been reported in association with SDT to the authors' knowledge. Characteristic features of SDT allow it to be differentiated from other arthropathies and dysplasias and these distinctions have been emphasized in the discussion. The diagnosis in this case can only be considered presumptively proved. (orig./MG)

  6. Combined precut in difficult biliary cannulation

    Directory of Open Access Journals (Sweden)

    Jesús Espinel-Díez

    2013-06-01

    Full Text Available Aim: precut sphincterotomy refers to a variety of endoscopic techniques that are used in order to access the bile duct when conventional methods of cannulation have failed. There are not significant data (such as efficacy, safety about the use of different techniques of precutting at the same session. We have described our experience with combined precut sphincterotomy (CPS and we have compared our results to the use of an isolated precut. Patients and methods: we have performed 247 precuts of a total of 2.390 ERCPs. Patients were distributed according to the type of precut practiced: Needle-knife, transpancreatic and combined precut sphincterotomies. "Combined precut" consisted in performing first a transpancreatic sphincterotomy and, if the access was not achieved, then performing a needle-knife sphincterotomy in the same session. The data about safety and efficacy were prospectively collected. The complications were defined according to the consensus criteria. Results: we performed precutting techniques in 247 patients. Needle-knife, transpancreatic, and combined precuts were performed in 125 (6.9%, 74 (4.1% and 48 (2.6% patients, respectively. Bile duct cannulation was successful in 48 patients (100% in the group of combined precut, 121 patients (96.8% in the transpancreatic group, and 67 patients (90.5% in the needle-knife group (p = 0.03. There were not differences in complications rates between the three groups. There was no pancreatitis in the combined precut group. The complications were successfully managed with conservative treatment. Conclusions: combined precut sphincterotomy seems to be a safe and successful technique in those cases of difficult bile duct cannulation.

  7. Mathematical Understanding and Proving Abilities: Experiment With Undergraduate Student By Using Modified Moore Learning Approach

    Directory of Open Access Journals (Sweden)

    Rippi Maya

    2011-07-01

    Full Text Available This paper reports findings of  a  post test experimental control group design conducted to investigate the role of modified Moore learning approach  on improving students’ mathematical understanding and proving abilities. Subject of study were 56 undergradute students of one state university in Bandung, who took advanced abstract algebra course. Instrument of study were a set test of mathematical understanding ability, a set test of mathematical proving ability, and a set of students’ opinion scale on modified Moore learning approach. Data were analyzed by using two path ANOVA. The study found that proof construction process was more difficult than mathematical understanding  task  for all students, and students still posed some difficulties on constructing mathematical proof task.  The study also found there were not differences  between students’  abilities on mathematical understanding and on proving abilities of  the both classes, and both abilities were classified as mediocre. However, in modified Moore learning approach class there were more students who got above average grades on mathematical understanding than those of conventional class. Moreover, students performed positive  opinion toward  modified Moore learning approach. They  were  active in questioning and solving problems, and in explaining their works in front of class as well, while students of conventional teaching prefered to listen to lecturer’s explanation. The study also found that there was no interaction between learning approach and students’ prior mathematics ability on mathematical understanding and proving abilities,  but  there were  quite strong  association between students’ mathematical understanding and proving abilities.Keywords:  modified Moore learning approach, mathematical understanding ability, mathematical proving ability. DOI: http://dx.doi.org/10.22342/jme.2.2.751.231-250

  8. Evolution caused by extreme events.

    Science.gov (United States)

    Grant, Peter R; Grant, B Rosemary; Huey, Raymond B; Johnson, Marc T J; Knoll, Andrew H; Schmitt, Johanna

    2017-06-19

    Extreme events can be a major driver of evolutionary change over geological and contemporary timescales. Outstanding examples are evolutionary diversification following mass extinctions caused by extreme volcanism or asteroid impact. The evolution of organisms in contemporary time is typically viewed as a gradual and incremental process that results from genetic change, environmental perturbation or both. However, contemporary environments occasionally experience strong perturbations such as heat waves, floods, hurricanes, droughts and pest outbreaks. These extreme events set up strong selection pressures on organisms, and are small-scale analogues of the dramatic changes documented in the fossil record. Because extreme events are rare, almost by definition, they are difficult to study. So far most attention has been given to their ecological rather than to their evolutionary consequences. We review several case studies of contemporary evolution in response to two types of extreme environmental perturbations, episodic (pulse) or prolonged (press). Evolution is most likely to occur when extreme events alter community composition. We encourage investigators to be prepared for evolutionary change in response to rare events during long-term field studies.This article is part of the themed issue 'Behavioural, ecological and evolutionary responses to extreme climatic events'. © 2017 The Author(s).

  9. All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in obstetrics

    Directory of Open Access Journals (Sweden)

    Venkateswaran Ramkumar

    2016-01-01

    Full Text Available The various physiological changes in pregnancy make the parturient vulnerable for early and rapid desaturation. Severe hypoxaemia during intubation can potentially compromise two lives (mother and foetus. Thus tracheal intubation in the pregnant patient poses unique challenges, and necessitates meticulous planning, ready availability of equipment and expertise to ensure maternal and foetal safety. The All India Difficult Airway Association (AIDAA proposes a stepwise plan for the safe management of the airway in obstetric patients. These guidelines have been developed based on available evidence; wherever robust evidence was lacking, recommendations were arrived at by consensus opinion of airway experts, incorporating the responses to a questionnaire sent to members of the AIDAA and the Indian Society of Anaesthesiologists (ISA. Modified rapid sequence induction using gentle intermittent positive pressure ventilation with pressure limited to ≤20 cm H 2 O is acceptable. Partial or complete release of cricoid pressure is recommended when face mask ventilation, placement of supraglottic airway device (SAD or tracheal intubation prove difficult. One should call for early expert assistance. Maternal SpO 2 should be maintained ≥95%. Apnoeic oxygenation with nasal insufflation of 15 L/min oxygen during apnoea should be performed in all patients. If tracheal intubation fails, a second- generation SAD should be inserted. The decision to continue anaesthesia and surgery via the SAD, or perform fibreoptic-guided intubation via the SAD or wake up the patient depends on the urgency of surgery, foeto-maternal status and availability of resources and expertise. Emergency cricothyroidotomy must be performed if complete ventilation failure occurs.

  10. Is the greenhouse effect proving a pitfall in France?

    International Nuclear Information System (INIS)

    Godard, O.

    1998-01-01

    After Rio and Kyoto, the Buenos-Aires environmental summit comes nearer. The agreements to reduce the production of greenhouse effect gases have failed. The next step might be negotiable and transferable licences with the setting of a quota system. The discussions are expected to be difficult. This new compelling regulation could force some industrial countries to introduce green fiscal reforms. France with its 75% energy coming from nuclear plants has a reduced margin to manage. France cannot accept to be deprived of its right to abandon nuclear energy because of the imposed no-rising of greenhouse effect gases production. (A.C.)

  11. A Hybrid Approach to Proving Memory Reference Monotonicity

    KAUST Repository

    Oancea, Cosmin E.

    2013-01-01

    Array references indexed by non-linear expressions or subscript arrays represent a major obstacle to compiler analysis and to automatic parallelization. Most previous proposed solutions either enhance the static analysis repertoire to recognize more patterns, to infer array-value properties, and to refine the mathematical support, or apply expensive run time analysis of memory reference traces to disambiguate these accesses. This paper presents an automated solution based on static construction of access summaries, in which the reference non-linearity problem can be solved for a large number of reference patterns by extracting arbitrarily-shaped predicates that can (in)validate the reference monotonicity property and thus (dis)prove loop independence. Experiments on six benchmarks show that our general technique for dynamic validation of the monotonicity property can cover a large class of codes, incurs minimal run-time overhead and obtains good speedups. © 2013 Springer-Verlag.

  12. Formal Analysis of Soft Errors using Theorem Proving

    Directory of Open Access Journals (Sweden)

    Sofiène Tahar

    2013-07-01

    Full Text Available Modeling and analysis of soft errors in electronic circuits has traditionally been done using computer simulations. Computer simulations cannot guarantee correctness of analysis because they utilize approximate real number representations and pseudo random numbers in the analysis and thus are not well suited for analyzing safety-critical applications. In this paper, we present a higher-order logic theorem proving based method for modeling and analysis of soft errors in electronic circuits. Our developed infrastructure includes formalized continuous random variable pairs, their Cumulative Distribution Function (CDF properties and independent standard uniform and Gaussian random variables. We illustrate the usefulness of our approach by modeling and analyzing soft errors in commonly used dynamic random access memory sense amplifier circuits.

  13. Evaluation of Truview evo2® Laryngoscope In Anticipated Difficult Intubation-A Comparison To Macintosh Laryngoscope

    Directory of Open Access Journals (Sweden)

    Ishwar Singh

    2009-01-01

    Full Text Available The aim of the study was to assess and compare laryngoscopic view of Truview evo2 laryngoscope with that of Macintosh laryngoscope in patients with one or more predictors of difficult intubation (PDI. Moreover ease of intubation with Truview evo2 in terms of absolute time requirement was also aimed at. Patients for elective surgery requiring endotracheal intubation were initially assessed for three PDI parameters - modified Mallampati test, thyro-mental distance& Atlanto-occipital (AO joint extension. Patients with cumulative PDI scores of 2 to 5 (in a scale of 0 to 8 were evaluated for Cormack& Lehane (CL grading by Macintosh blade after standard induction. Cases with CL grade of two or more were further evaluated by Truview evo2 laryngoscope and corresponding CL grades were assigned. Intubation attempted under Truview evo2 vision and time required for each successful tracheal intubation (i.e. tracheal intubation completed within one minute was noted. Total fifty cases were studied. The CL grades assigned by Macintosh blade correlated well with the cumulative PDI scores assigned preoperatively, confirming there predictability. Truview evo2 improved laryngeal view in 92 % cases by one or more CL grade. Intubation with Truview evo2 was possible in 88% cases within stipulated time of one minute and mean time of 28.6 seconds with SD of 11.23 was reasonably quick. No significant complication like oro- pharyngeal trauma or extreme pressor response to laryngoscopy was noticed. To conclude, Truview evo2 proved to be a better tool than conventional laryngoscope in anticipated difficult situations.

  14. Evaluation of depleted uranium in the environment at Aberdeen Proving Grounds, Maryland and Yuma Proving Grounds, Arizona. Final report

    International Nuclear Information System (INIS)

    Kennedy, P.L.; Clements, W.H.; Myers, O.B.; Bestgen, H.T.; Jenkins, D.G.

    1995-01-01

    This report represents an evaluation of depleted uranium (DU) introduced into the environment at the Aberdeen Proving Grounds (APG), Maryland and Yuma Proving Grounds (YPG) Arizona. This was a cooperative project between the Environmental Sciences and Statistical Analyses Groups at LANL and with the Department of Fishery and Wildlife Biology at Colorado State University. The project represents a unique approach to assessing the environmental impact of DU in two dissimilar ecosystems. Ecological exposure models were created for each ecosystem and sensitivity/uncertainty analyses were conducted to identify exposure pathways which were most influential in the fate and transport of DU in the environment. Research included field sampling, field exposure experiment, and laboratory experiments. The first section addresses DU at the APG site. Chapter topics include bioenergetics-based food web model; field exposure experiments; bioconcentration by phytoplankton and the toxicity of U to zooplankton; physical processes governing the desorption of uranium from sediment to water; transfer of uranium from sediment to benthic invertebrates; spead of adsorpion by benthic invertebrates; uptake of uranium by fish. The final section of the report addresses DU at the YPG site. Chapters include the following information: Du transport processes and pathway model; field studies of performance of exposure model; uptake and elimination rates for kangaroo rates; chemical toxicity in kangaroo rat kidneys

  15. Evaluation of depleted uranium in the environment at Aberdeen Proving Grounds, Maryland and Yuma Proving Grounds, Arizona. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Kennedy, P.L.; Clements, W.H.; Myers, O.B.; Bestgen, H.T.; Jenkins, D.G. [Colorado State Univ., Fort Collins, CO (United States). Dept. of Fishery and Wildlife Biology

    1995-01-01

    This report represents an evaluation of depleted uranium (DU) introduced into the environment at the Aberdeen Proving Grounds (APG), Maryland and Yuma Proving Grounds (YPG) Arizona. This was a cooperative project between the Environmental Sciences and Statistical Analyses Groups at LANL and with the Department of Fishery and Wildlife Biology at Colorado State University. The project represents a unique approach to assessing the environmental impact of DU in two dissimilar ecosystems. Ecological exposure models were created for each ecosystem and sensitivity/uncertainty analyses were conducted to identify exposure pathways which were most influential in the fate and transport of DU in the environment. Research included field sampling, field exposure experiment, and laboratory experiments. The first section addresses DU at the APG site. Chapter topics include bioenergetics-based food web model; field exposure experiments; bioconcentration by phytoplankton and the toxicity of U to zooplankton; physical processes governing the desorption of uranium from sediment to water; transfer of uranium from sediment to benthic invertebrates; spead of adsorpion by benthic invertebrates; uptake of uranium by fish. The final section of the report addresses DU at the YPG site. Chapters include the following information: Du transport processes and pathway model; field studies of performance of exposure model; uptake and elimination rates for kangaroo rates; chemical toxicity in kangaroo rat kidneys.

  16. Extreme Events in Nature and Society

    CERN Document Server

    Albeverio, Sergio; Kantz, Holger

    2006-01-01

    Significant, and usually unwelcome, surprises, such as floods, financial crisis, epileptic seizures, or material rupture, are the topics of Extreme Events in Nature and Society. The book, authored by foremost experts in these fields, reveals unifying and distinguishing features of extreme events, including problems of understanding and modelling their origin, spatial and temporal extension, and potential impact. The chapters converge towards the difficult problem of anticipation: forecasting the event and proposing measures to moderate or prevent it. Extreme Events in Nature and Society will interest not only specialists, but also the general reader eager to learn how the multifaceted field of extreme events can be viewed as a coherent whole.

  17. The GOES-R Proving Ground: 2012 Update

    Science.gov (United States)

    Gurka, J.; Goodman, S. J.; Schmit, T.; Demaria, M.; Mostek, A.; Siewert, C.; Reed, B.

    2011-12-01

    The Geostationary Operational Environmental Satellite (GOES)-R will provide a great leap forward in observing capabilities, but will also offer a significant challenge to ensure that users are ready to exploit the vast improvements in spatial, spectral, and temporal resolutions. To ensure user readiness, forecasters and other users must have access to prototype advanced products well before launch, and have the opportunity to provide feedback to product developers and computing and communications managers. The operational assessment is critical to ensure that the end products and NOAA's computing and communications systems truly meet their needs in a rapidly evolving environment. The GOES-R Proving Ground (PG) engages the National Weather Service (NWS) forecast, watch and warning community and other agency users in pre-operational demonstrations of select products with GOES-R attributes (enhanced spectral, spatial, and temporal resolution). In the PG, developers and forecasters test and apply algorithms for new GOES-R satellite data and products using proxy and simulated data sets, including observations from current and future satellite instruments (MODIS, AIRS, IASI, SEVIRI, NAST-I, NPP/VIIRS/CrIS, LIS), lightning networks, and computer simulated products. The complete list of products to be evaluated in 2012 will be determined after evaluating results from experiments in 2011 at the NWS' Storm Prediction Center, National Hurricane Center, Aviation Weather Center, Ocean Prediction Center, Hydrometeorological Prediction Center, and from the six NWS regions. In 2012 and beyond, the PG will test and validate data processing and distribution systems and the applications of these products in operational settings. Additionally developers and forecasters will test and apply display techniques and decision aid tools in operational environments. The PG is both a recipient and a source of training. Training materials are developed using various distance training tools in

  18. NASA SPoRT GOES-R Proving Ground Activities

    Science.gov (United States)

    Stano, Geoffrey T.; Fuell, Kevin K.; Jedloec, Gary J.

    2010-01-01

    The NASA Short-term Prediction Research and Transition (SPoRT) program is a partner with the GOES-R Proving Ground (PG) helping prepare forecasters understand the unique products to come from the GOES-R instrument suite. SPoRT is working collaboratively with other members of the GOES-R PG team and Algorithm Working Group (AWG) scientists to develop and disseminate a suite of proxy products that address specific forecast problems for the WFOs, Regional and National Support Centers, and other NOAA users. These products draw on SPoRT s expertise with the transition and evaluation of products into operations from the MODIS instrument and the North Alabama Lightning Mapping Array (NALMA). The MODIS instrument serves as an excellent proxy for the Advanced Baseline Imager (ABI) that will be aboard GOES-R. SPoRT has transitioned and evaluated several multi-channel MODIS products. The true and false color products are being used in natural hazard detection by several SPoRT partners to provide better observation of land features, such as fires, smoke plumes, and snow cover. Additionally, many of SPoRT s partners are coastal offices and already benefit from the MODIS sea surface temperature composite. This, along with other surface feature observations will be developed into ABI proxy products for diagnostic use in the forecast process as well as assimilation into forecast models. In addition to the MODIS instrument, the NALMA has proven very valuable to WFOs with access to these total lightning data. These data provide situational awareness and enhanced warning decision making to improve lead times for severe thunderstorm and tornado warnings. One effort by SPoRT scientists includes a lightning threat product to create short-term model forecasts of lightning activity. Additionally, SPoRT is working with the AWG to create GLM proxy data from several of the ground based total lightning networks, such as the NALMA. The evaluation will focus on the vastly improved spatial

  19. Geophysics: Building E5481 decommissioning, Aberdeen Proving Ground

    International Nuclear Information System (INIS)

    Thompson, M.D.; McGinnis, M.G.; McGinnis, L.D.; Miller, S.F.

    1992-11-01

    Building E5481 is one of ten potentially contaminated sites in the Canal Creek and Westwood areas of the Edgewood section of Aberdeen Proving Ground examined by a geophysical team from Argonne National Laboratory in April and May of 1992. Noninvasive geophysical surveys, including magnetics, electrical resistivity, and ground-penetrating radar, were conducted around the perimeter of the building to guide a sampling program prior to decommissioning and dismantling. The building is located on the northern margin of a landfill that was sited in a wetland. The large number of magnetic sources surrounding the building are believed to be contained in construction fill that had been used to raise the grade. The smaller anomalies, for the most part, are not imaged with ground radar or by electrical profiling. A conductive zone trending northwest to southeast across the site is spatially related to an old roadbed. Higher resistivity areas in the northeast and east are probably representive of background values. Three high-amplitude, positive, rectangular magnetic anomalies have unknown sources. The features do not have equivalent electrical signatures, nor are they seen with radar imaging

  20. Geophysics: Building E5476 decommissiong, Aberdeen Proving Ground

    International Nuclear Information System (INIS)

    Miller, S.F.; Thompson, M.D.; McGinnis, M.G.; McGinnis, L.D.

    1992-11-01

    Building E5476 was one of ten potentially contaminated sites in the Canal Creek and Westwood areas of the Edgewood section of Aberdeen Proving Ground examined by a geophysical team from Argonne National Laboratory in April and May of 1992. Noninvasive geophysical surveys, including magnetics, electrical resistivity, and ground-penetrating radar, were conducted around the perimeter of the building to guide a sampling program prior to decommissioning and dismantling. The large number of magnetic sources surrounding the building are believed to be contained in construction fill. The smaller anomalies, for the most part, were not imaged with ground radar or by electrical profiling. Large magnetic anomalies near the southwest comer of the building are due to aboveground standpipes and steel-reinforced concrete. Two high-resistivity areas, one projecting northeast from the building and another south of the original structure, may indicate the presence of organic pore fluids in the subsurface. A conductive lineament protruding from the south wall that is enclosed by the southem, high-resistivity feature is not associated with an equivalent magnetic anomaly. Magnetic and electrical anomalies south of the old landfill boundary are probably not associated with the building. The boundary is marked by a band of magnetic anomalies and a conductive zone trending northwest to southeast. The cause of high resistivities in a semicircular area in the southwest comer, within the landfill area, is unexplained

  1. Geophysics: Building E5375 decommissioning, Aberdeen Proving Ground

    International Nuclear Information System (INIS)

    McGinnis, M.G.; McGinnis, L.D.; Miller, S.F.; Thompson, M.D.

    1992-08-01

    Building E5375 was one of ten potentially contaminated sites in the Canal Creek area of the Edgewood section of Aberdeen Proving Ground examined by a geophysical team from Argonne National Laboratory in April and May 1992. Noninvasive geophysical surveys, including magnetics, electrical resistivity, and ground-penetrating radar (GPR), were conducted around the perimeter of the building to guide a sampling program prior to decommissioning and dismantling. Several anomalies wear, noted: (1) An underground storage tank located 25 ft east of Building E5375 was identified with magnetic, resistivity, and GPR profiling. (2) A three-point resistivity anomaly, 12 ft east of the northeast comer of Building E5374 (which borders Building E5375) and 5 ft south of the area surveyed with the magnetometer, may be caused by another underground storage tank. (3) A 2,500-gamma magnetic anomaly near the northeast corner of the site has no equivalent resistivity anomaly, although disruption in GPR reflectors was observed. (4) A one-point magnetic anomaly was located at the northeast comer, but its source cannot be resolved. A chaotic reflective zone to the east represents the radar signature of Building E5375 construction fill

  2. Safety objectives for next generation reactors: proving their achievement

    International Nuclear Information System (INIS)

    Tanguy, P.Y.

    1996-01-01

    Assuming that there is a consensus between regulatory bodies and nuclear operating organizations on safety objectives for future plants, how are we going to demonstrate that they have been achieved, with a reasonable certainty? Right from the beginning, I would like to underline the importance of convincing the public that high level safety objectives will be effectively achieved in future nuclear power plants. The mere fulfillment of administrative requirements might not be sufficient to obtain public acceptance. One has to take into account the changes that have occurred in the public preception of nuclear risks in the wake of the Chernobyl accident. Today public opinion rules out the possibility not only that such a catastrophic accident could recur, but also that any accident with detrimental health consequences off-site could occur. The nuclear industry has to reflect this concern in its safety demonstration, independently of proving the achievement of technical safety goals. The public opinion issue will be readdressed at the end of this paper. (orig.)

  3. Potential Cislunar and Interplanetary Proving Ground Excursion Trajectory Concepts

    Science.gov (United States)

    McGuire, Melissa L.; Strange, Nathan J.; Burke, Laura M.; MacDonald, Mark A.; McElrath, Timothy P.; Landau, Damon F.; Lantoine, Gregory; Hack, Kurt J.; Lopez, Pedro

    2016-01-01

    NASA has been investigating potential translunar excursion concepts to take place in the 2020s that would be used to test and demonstrate long duration life support and other systems needed for eventual Mars missions in the 2030s. These potential trajectory concepts could be conducted in the proving ground, a region of cislunar and near-Earth interplanetary space where international space agencies could cooperate to develop the technologies needed for interplanetary spaceflight. Enabled by high power Solar Electric Propulsion (SEP) technologies, the excursion trajectory concepts studied are grouped into three classes of increasing distance from the Earth and increasing technical difficulty: the first class of excursion trajectory concepts would represent a 90-120 day round trip trajectory with abort to Earth options throughout the entire length, the second class would be a 180-210 day round trip trajectory with periods in which aborts would not be available, and the third would be a 300-400 day round trip trajectory without aborts for most of the length of the trip. This paper provides a top-level summary of the trajectory and mission design of representative example missions of these three classes of excursion trajectory concepts.

  4. Why prove it again? alternative proofs in mathematical practice

    CERN Document Server

    Dawson, Jr , John W

    2015-01-01

    This monograph considers several well-known mathematical theorems and asks the question, “Why prove it again?” while examining alternative proofs.   It  explores the different rationales mathematicians may have for pursuing and presenting new proofs of previously established results, as well as how they judge whether two proofs of a given result are different.  While a number of books have examined alternative proofs of individual theorems, this is the first that presents comparative case studies of other methods for a variety of different theorems. The author begins by laying out the criteria for distinguishing among proofs and enumerates reasons why new proofs have, for so long, played a prominent role in mathematical practice.  He then outlines various purposes that alternative proofs may serve.  Each chapter that follows provides a detailed case study of alternative proofs for particular theorems, including the Pythagorean Theorem, the Fundamental Theorem of Arithmetic, Desargues’ Theorem, the...

  5. Depleted uranium risk assessment at Aberdeen Proving Ground

    International Nuclear Information System (INIS)

    Ebinger, M.H.; Myers, O.B.; Kennedy, P.L.; Clements, W.H.

    1993-01-01

    The Environmental Science Group at Los Alamos and the Test and Evaluation Command (TECOM) are assessing the risk of depleted uranium (DU) testing at Aberdeen Proving Ground (APG). Conceptual and mathematical models of DU transfer through the APG ecosystem have been developed in order to show the mechanisms by which DU migrates or remains unavailable to different flora and fauna and to humans. The models incorporate actual rates of DU transfer between different ecosystem components as much as possible. Availability of data on DU transport through different pathways is scarce and constrains some of the transfer rates that can be used. Estimates of transfer rates were derived from literature sources and used in the mass-transfer models when actual transfer rates were unavailable. Objectives for this risk assessment are (1) to assess if DU transports away from impact areas; (2) to estimate how much, if any, DU migrates into Chesapeake Bay; (3) to determine if there are appreciable risks to the ecosystems due to DU testing; (4) to estimate the risk to human health as a result of DU testing

  6. Rosetta Structure Prediction as a Tool for Solving Difficult Molecular Replacement Problems.

    Science.gov (United States)

    DiMaio, Frank

    2017-01-01

    Molecular replacement (MR), a method for solving the crystallographic phase problem using phases derived from a model of the target structure, has proven extremely valuable, accounting for the vast majority of structures solved by X-ray crystallography. However, when the resolution of data is low, or the starting model is very dissimilar to the target protein, solving structures via molecular replacement may be very challenging. In recent years, protein structure prediction methodology has emerged as a powerful tool in model building and model refinement for difficult molecular replacement problems. This chapter describes some of the tools available in Rosetta for model building and model refinement specifically geared toward difficult molecular replacement cases.

  7. Test fields cannot destroy extremal black holes

    International Nuclear Information System (INIS)

    Natário, José; Queimada, Leonel; Vicente, Rodrigo

    2016-01-01

    We prove that (possibly charged) test fields satisfying the null energy condition at the event horizon cannot overspin/overcharge extremal Kerr–Newman or Kerr–Newman–anti de Sitter black holes, that is, the weak cosmic censorship conjecture cannot be violated in the test field approximation. The argument relies on black hole thermodynamics (without assuming cosmic censorship), and does not depend on the precise nature of the fields. We also discuss generalizations of this result to other extremal black holes. (paper)

  8. Environmental geophysics at J-Field, Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Daudt, C.R.; McGinnis, L.D.; Miller, S.F.; Thompson, M.D.

    1994-11-01

    Geophysical data collected at J-Field, Aberdeen Proving Ground, Maryland, were used in the characterization of the natural hydrogeologic framework of the J-Field area and in the identification of buried disturbances (trenches and other evidences of contamination). Seismic refraction and reflection data and electrical resistivity data have aided in the characterization of the leaky confining unit at the base of the surficial aquifer (designated Unit B of the Tertiary Talbot Formation). Excellent reflectors have been observed for both upper and lower surfaces of Unit B that correspond to stratigraphic units observed in boreholes and on gamma logs. Elevation maps of both surfaces and an isopach map of Unit B, created from reflection data at the toxic burning pits site, show a thickening of Unit B to the east. Abnormally low seismic compressional-wave velocities suggest that Unit B consists of gassy sediments whose gases are not being flushed by upward or downward moving groundwater. The presence of gases suggests that Unit B serves as an efficient aquitard that should not be penetrated by drilling or other activities. Electromagnetic, total-intensity magnetic, and ground-penetrating radar surveys have aided in delineating the limits of two buried trenches, the VX burning pit and the liquid smoke disposal pit, both located at the toxic burning pits site. The techniques have also aided in determining the extent of several other disturbed areas where soils and materials were pushed out of disposal pits during trenching activities. Surveys conducted from the Prototype Building west to the Gunpowder River did not reveal any buried trenches.

  9. Automated Theorem Proving in High-Quality Software Design

    Science.gov (United States)

    Schumann, Johann; Swanson, Keith (Technical Monitor)

    2001-01-01

    The amount and complexity of software developed during the last few years has increased tremendously. In particular, programs are being used more and more in embedded systems (from car-brakes to plant-control). Many of these applications are safety-relevant, i.e. a malfunction of hardware or software can cause severe damage or loss. Tremendous risks are typically present in the area of aviation, (nuclear) power plants or (chemical) plant control. Here, even small problems can lead to thousands of casualties and huge financial losses. Large financial risks also exist when computer systems are used in the area of telecommunication (telephone, electronic commerce) or space exploration. Computer applications in this area are not only subject to safety considerations, but also security issues are important. All these systems must be designed and developed to guarantee high quality with respect to safety and security. Even in an industrial setting which is (or at least should be) aware of the high requirements in Software Engineering, many incidents occur. For example, the Warshaw Airbus crash, was caused by an incomplete requirements specification. Uncontrolled reuse of an Ariane 4 software module was the reason for the Ariane 5 disaster. Some recent incidents in the telecommunication area, like illegal "cloning" of smart-cards of D2GSM handies, or the extraction of (secret) passwords from German T-online users show that also in this area serious flaws can happen. Due to the inherent complexity of computer systems, most authors claim that only a rigorous application of formal methods in all stages of the software life cycle can ensure high quality of the software and lead to real safe and secure systems. In this paper, we will have a look, in how far automated theorem proving can contribute to a more widespread application of formal methods and their tools, and what automated theorem provers (ATPs) must provide in order to be useful.

  10. Depleted uranium human health risk assessment, Jefferson Proving Ground, Indiana

    International Nuclear Information System (INIS)

    Ebinger, M.H.; Hansen, W.R.

    1994-01-01

    The risk to human health from fragments of depleted uranium (DU) at Jefferson Proving Ground (JPG) was estimated using two types of ecosystem pathway models. A steady-state, model of the JPG area was developed to examine the effects of DU in soils, water, and vegetation on deer that were hunted and consumed by humans. The RESRAD code was also used to estimate the effects of farming the impact area and consuming the products derived from the farm. The steady-state model showed that minimal doses to humans are expected from consumption of deer that inhabit the impact area. Median values for doses to humans range from about 1 mrem (±2.4) to 0.04 mrem (±0.13) and translate to less than 1 x 10 -6 detriments (excess cancers) in the population. Monte Carlo simulation of the steady-state model was used to derive the probability distributions from which the median values were drawn. Sensitivity analyses of the steady-state model showed that the amount of DU in airborne dust and, therefore, the amount of DU on the vegetation surface, controlled the amount of DU ingested by deer and by humans. Human doses from the RESRAD estimates ranged from less than 1 mrem/y to about 6.5 mrem/y in a hunting scenario and subsistence fanning scenario, respectively. The human doses exceeded the 100 mrem/y dose limit when drinking water for the farming scenario was obtained from the on-site aquifer that was presumably contaminated with DU. The two farming scenarios were unrealistic land uses because the additional risk to humans due to unexploded ordnance in the impact area was not figured into the risk estimate. The doses estimated with RESRAD translated to less than 1 x 10 -6 detriments to about 1 x 10 -3 detriments. The higher risks were associated only with the farming scenario in which drinking water was obtained on-site

  11. Bronchoscopic diagnostic procedures and microbiological examinations in proving endobronchial tuberculosis

    Directory of Open Access Journals (Sweden)

    Abdullah Şimşek

    Full Text Available ABSTRACT Objective: To determine the proportional distribution of endobronchial tuberculosis (EBTB subtypes and to evaluate the types of bronchoscopic diagnostic procedures that can prove granulomatous inflammation. Methods: This was a retrospective study of 18 HIV-negative patients with biopsy-proven EBTB treated between 2010 and 2014. Results: The most common EBTB subtypes, as classified by the bronchoscopic features, were tumorous and granular (in 22.2% for both. Sputum smear microscopy was performed in 11 patients and was positive for AFB in 4 (36.3%. Sputum culture was also performed in 11 patients and was positive for Mycobacterium tuberculosis in 10 (90.9%. Smear microscopy of BAL fluid (BALF was performed in 16 patients and was positive for AFB in 10 (62.5%. Culture of BALF was also performed in 16 patients and was positive for M. tuberculosis in 15 (93.7%. Culture of BALF was positive for M. tuberculosis in 93.7% of the 16 patients tested. Among the 18 patients with EBTB, granulomatous inflammation was proven by the following bronchoscopic diagnostic procedures: bronchial mucosal biopsy, in 8 (44.4%; bronchial brushing, in 7 (38.8%; fine-needle aspiration biopsy, in 2 (11.1%; and BAL, in 2 (11.1%. Bronchial anthracofibrosis was observed in 5 (27.7% of the 18 cases evaluated. Conclusions: In our sample of EBTB patients, the most common subtypes were the tumorous and granular subtypes. We recommend that sputum samples and BALF samples be evaluated by smear microscopy for AFB and by culture for M. tuberculosis, which could increase the rates of early diagnosis of EBTB. We also recommend that bronchial brushing be employed together with other bronchoscopic diagnostic procedures in patients suspected of having EBTB.

  12. Infrared spectrum of an extremely cool white-dwarf star

    Science.gov (United States)

    Hodgkin; Oppenheimer; Hambly; Jameson; Smartt; Steele

    2000-01-06

    White dwarfs are the remnant cores of stars that initially had masses of less than 8 solar masses. They cool gradually over billions of years, and have been suggested to make up much of the 'dark matter' in the halo of the Milky Way. But extremely cool white dwarfs have proved difficult to detect, owing to both their faintness and their anticipated similarity in colour to other classes of dwarf stars. Recent improved models indicate that white dwarfs are much more blue than previously supposed, suggesting that the earlier searches may have been looking for the wrong kinds of objects. Here we report an infrared spectrum of an extremely cool white dwarf that is consistent with the new models. We determine the star's temperature to be 3,500 +/- 200 K, making it the coolest known white dwarf. The kinematics of this star indicate that it is in the halo of the Milky Way, and the density of such objects implied by the serendipitous discovery of this star is consistent with white dwarfs dominating the dark matter in the halo.

  13. Three Smoking Guns Prove Falsity of Green house Warming

    Science.gov (United States)

    Fong, P.

    2001-12-01

    Three observed facts: 1, the cloud coverage increased 4.1% in 50 years; 2. the precipitation increased 7.8% in 100 years; 3. the two rates are the same. {Interpretation}. 1, By the increased albedo of the clouds heat dissipation is increased 3.98 W/m2 by 2XCO2 time, canceling out greenhouse warming of 4 W/m{2}. Thus no global warming. 2, The precipitation increase show the increased release of latent heat of vaporization, which turns out to be equal to that absorbed by ocean due to increased evaporation by the greenhouse forcing. This all greenhouse heat is used up in evaporation and the warming of the earth is zero. 3, The identity of the two rates double-checked the two independent proofs. Therefore experimentally no greenhouse warming is triply proved. A new branch of science Pleistocene Climatology is developed to study the theoretical origin of no greenhouse warming. Climatology, like mechanics of a large number of particles, is of course complex and unwieldy. If totally order-less then there is no hope. However, if some regularity appears, then a systematic treatment can be done to simplify the complexity. The rigid bodies are subjected to a special simplifying condition (the distances between all particles are constant) and only 6 degrees of freedom are significant, all others are sidetracked. To study the spinning top there is no need to study the dynamics of every particle of the top by Newton's laws through super-computer. It only needs to solve the Euler equations without computer. In climate study the use of super-computer to study all degrees of freedom of the climate is as untenable as the study of the spinning top by super-computer. Yet in spite of the complexity there is strict regularity as seen in the ice ages, which works as the simplifying conditions to establish a new science Pleistocene climatology. See my book Greenhouse Warming and Nuclear Hazards just published (www.PeterFongBook.com). This time the special condition is the presence of a

  14. Information-causality and extremal tripartite correlations

    International Nuclear Information System (INIS)

    Yang, Tzyh Haur; Cavalcanti, Daniel; Almeida, Mafalda L; Teo, Colin; Scarani, Valerio

    2012-01-01

    We study the principle of information-causality (IC) in the presence of extremal no-signaling correlations on a tripartite scenario. We prove that all, except one, of the non-local correlations lead to violation of IC. The remaining non-quantum correlation is shown to satisfy any bipartite physical principle. (paper)

  15. Extremal black holes as exact string solutions

    International Nuclear Information System (INIS)

    Horowitz, G.T.; Tseytlin, A.A.

    1994-01-01

    We show that the leading order solution describing an extremal electrically charged black hole in string theory is, in fact, an exact solution to all orders in α' when interpreted in a Kaluza-Klein fashion. This follows from the observation that it can be obtained via dimensional reduction from a five-dimensional background which is proved to be an exact string solution

  16. Tribal Colleges: The Original Extreme Makeover Experts

    Science.gov (United States)

    Powless, Donna

    2015-01-01

    In this article, the author states "our experience with education is a prime example in proving we are experts at problem-solving and are the originators of the extreme makeover." Educational institutions were introduced to the Native people in an outrageous manner--often as a mask for assimilating American Indians, routinely resulting…

  17. Extremely Preterm Birth

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Extremely Preterm Birth Home For Patients Search FAQs Extremely Preterm Birth ... Spanish FAQ173, June 2016 PDF Format Extremely Preterm Birth Pregnancy When is a baby considered “preterm” or “ ...

  18. Bronchoscopic diagnostic procedures and microbiological examinations in proving endobronchial tuberculosis.

    Science.gov (United States)

    Şimşek, Abdullah; Yapıcı, İlhami; Babalık, Mesiha; Şimşek, Zekiye; Kolsuz, Mustafa

    2016-01-01

    To determine the proportional distribution of endobronchial tuberculosis (EBTB) subtypes and to evaluate the types of bronchoscopic diagnostic procedures that can prove granulomatous inflammation. This was a retrospective study of 18 HIV-negative patients with biopsy-proven EBTB treated between 2010 and 2014. The most common EBTB subtypes, as classified by the bronchoscopic features, were tumorous and granular (in 22.2% for both). Sputum smear microscopy was performed in 11 patients and was positive for AFB in 4 (36.3%). Sputum culture was also performed in 11 patients and was positive for Mycobacterium tuberculosis in 10 (90.9%). Smear microscopy of BAL fluid (BALF) was performed in 16 patients and was positive for AFB in 10 (62.5%). Culture of BALF was also performed in 16 patients and was positive for M. tuberculosis in 15 (93.7%). Culture of BALF was positive for M. tuberculosis in 93.7% of the 16 patients tested. Among the 18 patients with EBTB, granulomatous inflammation was proven by the following bronchoscopic diagnostic procedures: bronchial mucosal biopsy, in 8 (44.4%); bronchial brushing, in 7 (38.8%); fine-needle aspiration biopsy, in 2 (11.1%); and BAL, in 2 (11.1%). Bronchial anthracofibrosis was observed in 5 (27.7%) of the 18 cases evaluated. In our sample of EBTB patients, the most common subtypes were the tumorous and granular subtypes. We recommend that sputum samples and BALF samples be evaluated by smear microscopy for AFB and by culture for M. tuberculosis, which could increase the rates of early diagnosis of EBTB. We also recommend that bronchial brushing be employed together with other bronchoscopic diagnostic procedures in patients suspected of having EBTB. Determinar a distribuição proporcional dos subtipos de tuberculose endobrônquica (TBEB) e avaliar os tipos de procedimentos diagnósticos broncoscópicos que podem revelar inflamação granulomatosa. Este foi um estudo retrospectivo com 18 pacientes HIV negativos com TBEB comprovada

  19. Validated questionnaires heighten detection of difficult asthma comorbidities.

    Science.gov (United States)

    Radhakrishna, Naghmeh; Tay, Tunn Ren; Hore-Lacy, Fiona; Stirling, Robert; Hoy, Ryan; Dabscheck, Eli; Hew, Mark

    2017-04-01

    Multiple extra-pulmonary comorbidities contribute to difficult asthma, but their diagnosis can be challenging and time consuming. Previous data on comorbidity detection have focused on clinical assessment, which may miss certain conditions. We aimed to locate relevant validated screening questionnaires to identify extra-pulmonary comorbidities that contribute to difficult asthma, and evaluate their performance during a difficult asthma evaluation. MEDLINE was searched to identify key extra-pulmonary comorbidities that contribute to difficult asthma. Screening questionnaires were chosen based on ease of use, presence of a cut-off score, and adequate validation to help systematically identify comorbidities. In a consecutive series of 86 patients referred for systematic evaluation of difficult asthma, questionnaires were administered prior to clinical consultation. Six difficult asthma comorbidities and corresponding screening questionnaires were found: sinonasal disease (allergic rhinitis and chronic rhinosinusitis), vocal cord dysfunction, dysfunctional breathing, obstructive sleep apnea, anxiety and depression, and gastro-oesophageal reflux disease. When the questionnaires were added to the referring clinician's impression, the detection of all six comorbidities was significantly enhanced. The average time for questionnaire administration was approximately 40 minutes. The use of validated screening questionnaires heightens detection of comorbidities in difficult asthma. The availability of data from a battery of questionnaires prior to consultation can save time and allow clinicians to systematically assess difficult asthma patients and to focus on areas of particular concern. Such an approach would ensure that all contributing comorbidities have been addressed before significant treatment escalation is considered.

  20. Therapist reactions in self-experienced difficult situations: an exploration

    NARCIS (Netherlands)

    Smith, A.J.M.; Kleijn, W.C.; Hutschemaekers, G.J.M.

    2007-01-01

    This article describes a qualitative study of 63 difficult therapeutic situations described by 26 therapists. The study was part of research on specific reactions of therapists to traumatized clients. The research questions for the current analyses focused on the categorization of difficult

  1. Unusual tumour ablations: report of difficult and interesting cases

    OpenAIRE

    Mauri, Giovanni; Nicosia, Luca; Varano, Gianluca Maria; Shyn, Paul; Sartori, Sergio; Tombesi, Paola; Di Vece, Francesca; Orsi, Franco; Solbiati, Luigi

    2017-01-01

    Image-guided ablations are nowadays applied in the treatment of a wide group of diseases and in different organs and regions, and every day interventional radiologists have to face more difficult and unusual cases of tumour ablation. In the present case review, we report four difficult and unusual cases, reporting some tips and tricks for a successful image-guided treatment.

  2. Pharmacotherapeutic approaches for treating psoriasis in difficult-to-treat areas.

    Science.gov (United States)

    Kivelevitch, Dario; Frieder, Jillian; Watson, Ian; Paek, So Yeon; Menter, M Alan

    2018-04-01

    Despite great therapeutic advancements in psoriasis, four notable difficult-to-treat areas including the scalp, nails, intertriginous (including genitals), and palmoplantar regions, pose a challenge to both physicians and patients. Localized disease of these specific body regions inflicts a significant burden on patients' quality of life and requires an adequate selection of treatments. Areas covered: This manuscript discusses appropriate therapies and important treatment considerations for these difficult-to-treat areas based on the available clinical data from the literature. Expert opinion: Clinical trials assessing therapies for the difficult-to-treat areas have been inadequate. With the first biological clinical trial for genital psoriasis pending publication, it is with hope that other biological agents will be evaluated for region-specific psoriasis. A greater understanding of the genetic and immunologic aspects of regional psoriasis, as well as identification of unique biomarkers, will further guide management decisions. For example, the recent discovery of the IL-36 receptor gene for generalized pustular psoriasis may prove valuable for other forms of psoriasis. Ultimately, identification of the most beneficial treatments for each psoriasis subtype and difficult-to-treat area will provide patients with maximal quality of life.

  3. Extremal vacuum black holes in higher dimensions

    International Nuclear Information System (INIS)

    Figueras, Pau; Lucietti, James; Rangamani, Mukund; Kunduri, Hari K.

    2008-01-01

    We consider extremal black hole solutions to the vacuum Einstein equations in dimensions greater than five. We prove that the near-horizon geometry of any such black hole must possess an SO(2,1) symmetry in a special case where one has an enhanced rotational symmetry group. We construct examples of vacuum near-horizon geometries using the extremal Myers-Perry black holes and boosted Myers-Perry strings. The latter lead to near-horizon geometries of black ring topology, which in odd spacetime dimensions have the correct number of rotational symmetries to describe an asymptotically flat black object. We argue that a subset of these correspond to the near-horizon limit of asymptotically flat extremal black rings. Using this identification we provide a conjecture for the exact 'phase diagram' of extremal vacuum black rings with a connected horizon in odd spacetime dimensions greater than five.

  4. Guidelines and algorithms for managing the difficult airway.

    Science.gov (United States)

    Gómez-Ríos, M A; Gaitini, L; Matter, I; Somri, M

    2018-01-01

    The difficult airway constitutes a continuous challenge for anesthesiologists. Guidelines and algorithms are key to preserving patient safety, by recommending specific plans and strategies that address predicted or unexpected difficult airway. However, there are currently no "gold standard" algorithms or universally accepted standards. The aim of this article is to present a synthesis of the recommendations of the main guidelines and difficult airway algorithms. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. How libraries make tough choices in difficult times purposeful abandonment

    CERN Document Server

    Stern, David

    2013-01-01

    Contemporary library managers face the need to make difficult choices regarding resource allocation in the modern business environment. How Libraries Make Tough Choices in Difficult Times is a practical guide for library managers, offering techniques to analyze existing and potential services, implement best practices for maximizing existing resources, and utilize pressing financial scenarios in order to justify making difficult reallocation decisions. The book begins by asking the fundamental questions of why, what, and how, moving on to look at how to manage expectations and report to both a

  6. Estimation of extreme risk regions under multivariate regular variation

    NARCIS (Netherlands)

    Cai, J.; Einmahl, J.H.J.; de Haan, L.F.M.

    2011-01-01

    When considering d possibly dependent random variables, one is often interested in extreme risk regions, with very small probability p. We consider risk regions of the form {z ∈ Rd : f (z) ≤ β}, where f is the joint density and β a small number. Estimation of such an extreme risk region is difficult

  7. A Fiducial Approach to Extremes and Multiple Comparisons

    Science.gov (United States)

    Wandler, Damian V.

    2010-01-01

    Generalized fiducial inference is a powerful tool for many difficult problems. Based on an extension of R. A. Fisher's work, we used generalized fiducial inference for two extreme value problems and a multiple comparison procedure. The first extreme value problem is dealing with the generalized Pareto distribution. The generalized Pareto…

  8. Students' perceptions of difficult concepts in biology in senior ...

    African Journals Online (AJOL)

    Students' perceptions of difficult concepts in biology in senior secondary schools in ... that students in Senior Secondary School Two (SSII) have difficulties in learning, the ... However, teaching strategies, students' attitude, inadequate learning ...

  9. Extreme environment electronics

    CERN Document Server

    Cressler, John D

    2012-01-01

    Unfriendly to conventional electronic devices, circuits, and systems, extreme environments represent a serious challenge to designers and mission architects. The first truly comprehensive guide to this specialized field, Extreme Environment Electronics explains the essential aspects of designing and using devices, circuits, and electronic systems intended to operate in extreme environments, including across wide temperature ranges and in radiation-intense scenarios such as space. The Definitive Guide to Extreme Environment Electronics Featuring contributions by some of the world's foremost exp

  10. Difficult Sudoku Puzzles Created by Replica Exchange Monte Carlo Method

    OpenAIRE

    Watanabe, Hiroshi

    2013-01-01

    An algorithm to create difficult Sudoku puzzles is proposed. An Ising spin-glass like Hamiltonian describing difficulty of puzzles is defined, and difficult puzzles are created by minimizing the energy of the Hamiltonian. We adopt the replica exchange Monte Carlo method with simultaneous temperature adjustments to search lower energy states efficiently, and we succeed in creating a puzzle which is the world hardest ever created in our definition, to our best knowledge. (Added on Mar. 11, the ...

  11. Technology improves upper extremity rehabilitation.

    Science.gov (United States)

    Kowalczewski, Jan; Prochazka, Arthur

    2011-01-01

    Stroke survivors with hemiparesis and spinal cord injury (SCI) survivors with tetraplegia find it difficult or impossible to perform many activities of daily life. There is growing evidence that intensive exercise therapy, especially when supplemented with functional electrical stimulation (FES), can improve upper extremity function, but delivering the treatment can be costly, particularly after recipients leave rehabilitation facilities. Recently, there has been a growing level of interest among researchers and healthcare policymakers to deliver upper extremity treatments to people in their homes using in-home teletherapy (IHT). The few studies that have been carried out so far have encountered a variety of logistical and technical problems, not least the difficulty of conducting properly controlled and blinded protocols that satisfy the requirements of high-level evidence-based research. In most cases, the equipment and communications technology were not designed for individuals with upper extremity disability. It is clear that exercise therapy combined with interventions such as FES, supervised over the Internet, will soon be adopted worldwide in one form or another. Therefore it is timely that researchers, clinicians, and healthcare planners interested in assessing IHT be aware of the pros and cons of the new technology and the factors involved in designing appropriate studies of it. It is crucial to understand the technical barriers, the role of telesupervisors, the motor improvements that participants can reasonably expect and the process of optimizing IHT-exercise therapy protocols to maximize the benefits of the emerging technology. Copyright © 2011 Elsevier B.V. All rights reserved.

  12. Atomic collisions under extreme conditions in space

    International Nuclear Information System (INIS)

    Itikawa, Yukikazu

    1987-01-01

    In space, atoms and molecules are often placed under the extreme conditions which are very difficult to be realized on Earth. For instance, extremely hot and dense plasmas are found in and around various stellar objects (e.g., neutron stars) on one hand and extremely cold and diffuse gases prevail in interstellar space on the other. There is so strong a magnetic field that electron clouds in atoms and molecules are distorted. The study of atomic collisions under the extreme conditions is not only helpful in understanding the astrophysical environment but also reveals new aspects of the physics of atoms and molecules. This paper is an invitation to the study. (References are not exhaustive but only provide a clue with which more details can be found.) (author)

  13. Extreme value distributions

    CERN Document Server

    Ahsanullah, Mohammad

    2016-01-01

    The aim of the book is to give a through account of the basic theory of extreme value distributions. The book cover a wide range of materials available to date. The central ideas and results of extreme value distributions are presented. The book rwill be useful o applied statisticians as well statisticians interrested to work in the area of extreme value distributions.vmonograph presents the central ideas and results of extreme value distributions.The monograph gives self-contained of theory and applications of extreme value distributions.

  14. Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics*

    OpenAIRE

    Mushambi, M C; Kinsella, S M; Popat, M; Swales, H; Ramaswamy, K K; Winton, A L; Quinn, A C

    2015-01-01

    The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent ...

  15. How to manage a child with difficult asthma?

    Science.gov (United States)

    Saglani, Sejal; Fleming, Louise

    2016-08-01

    Children with difficult asthma have significant morbidity and fail to achieve asthma control despite being prescribed high dose maintenance treatment. If control remains poor after diagnostic confirmation, detailed assessments of the reasons for asthma being difficult-to-control are needed. Underlying modifiable factors including non-adherence to medication, persistent environmental exposures that trigger asthma symptoms and psychosocial factors contribute to poor control in these patients. The focus of this review is to provide a practical approach to the diagnosis and management of difficult asthma including an overview of long term assessments to identify potential progression to true, severe asthma. A multi-disciplinary team is critical to enable modifiable factors to be identified and addressed. Significant resources are required to manage paediatric difficult asthma optimally and only specialist centres should be tasked with the assessment of these patients. Although this may have an impact on healthcare resources, long term benefits for lung health are significant. Expert commentary: The management of paediatric difficult asthma is not simple and involves numerous professionals with varied expertise. However, if it is not undertaken with the appropriate skills, there is a significant risk of children receiving inappropriate invasive investigations and therapies that will have no impact on morbidity.

  16. Performance testing of extremity dosimeters, Study 2

    International Nuclear Information System (INIS)

    Harty, R.; Reece, W.D.; Hooker, C.D.

    1990-04-01

    The Health Physics Society Standards Committee (HPSSC) Working Group on Performance Testing of Extremity Dosimeters has issued a draft of a proposed standard for extremity dosimeters. The draft standard proposes methods to be used for testing dosimetry systems that determine occupational radiation dose to the extremities and the performance criterion used to determine compliance with the standard. Pacific Northwest Laboratory (PNL) has conducted two separate evaluations of the performance of extremity dosimeter processors to determine the appropriateness of the draft standard, as well as to obtain information regarding the performance of extremity dosimeters. Based on the information obtained during the facility visits and the results obtained from the performance testing, it was recommended that changes be made to ensure that the draft standard is appropriate for extremity dosimeters. The changes include: subdividing the mixture category and the beta particle category; eliminating the neutron category until appropriate flux-to-dose equivalent conversion factors are derived; and changing the tolerance level for the performance criterion to provide consistency with the performance criterion for whole body dosimeters, and to avoid making the draft standard overly difficult for processors of extremity dosimeters to pass. 20 refs., 10 figs., 6 tabs

  17. A novel cannulation technique for difficult urethral catheterization

    Directory of Open Access Journals (Sweden)

    Mehmet Kaynar

    2016-03-01

    Full Text Available Introduction: To propose a novel cannulation technique for difficult urethral catheterization procedures. Technique: The sheath tip of an intravenous catheter is cut off, replaced to the needle tip and pushed through the distal drainage side hole to Foley catheter tip, and finally withdrawn for cannulation. In situations making urethral catheterization difficult, a guide wire is placed under direct vision. The modified Foley catheter is slid successfully over the guide wire from its distal end throughout the urethral passage into the bladder. Results: The modified Foley catheter was used successfully in our clinic in cases requiring difficult urethral catheterization. Conclusions: This easy and rapid modification of a Foley catheter may minimize the potential complications of blind catheter placement in standard catheterization.

  18. Medical Students' Personal Determinants of Overcoming Strategies in Difficult Situations

    Directory of Open Access Journals (Sweden)

    Veretelnikova Yu.Ya.

    2013-03-01

    Full Text Available Goal of the research was to study conditionality of overcoming strategies in difficult situations of social interaction by personal representations of attitude to others among medical students. Material and methods. 134 first-year students of Saratov State Medical University n.a. V. I. Razumovsky took part in the comparative diagnostic study. Results. Comparison of average indices of various strategies evidence in coping behaviour allowed revealing statistically significant dependence of coping behaviour modi in difficult situations of social interaction upon types of personal representations of attitude toward others and gender features of forming effective strategies of coping behaviour among medical students. Conclusion. Correlation between coping behaviour modi in difficult situations of social interaction and typology of personal representations of attitudes toward others among medical students was marked.

  19. How extreme is extreme hourly precipitation?

    Science.gov (United States)

    Papalexiou, Simon Michael; Dialynas, Yannis G.; Pappas, Christoforos

    2016-04-01

    The importance of accurate representation of precipitation at fine time scales (e.g., hourly), directly associated with flash flood events, is crucial in hydrological design and prediction. The upper part of a probability distribution, known as the distribution tail, determines the behavior of extreme events. In general, and loosely speaking, tails can be categorized in two families: the subexponential and the hyperexponential family, with the first generating more intense and more frequent extremes compared to the latter. In past studies, the focus has been mainly on daily precipitation, with the Gamma distribution being the most popular model. Here, we investigate the behaviour of tails of hourly precipitation by comparing the upper part of empirical distributions of thousands of records with three general types of tails corresponding to the Pareto, Lognormal, and Weibull distributions. Specifically, we use thousands of hourly rainfall records from all over the USA. The analysis indicates that heavier-tailed distributions describe better the observed hourly rainfall extremes in comparison to lighter tails. Traditional representations of the marginal distribution of hourly rainfall may significantly deviate from observed behaviours of extremes, with direct implications on hydroclimatic variables modelling and engineering design.

  20. Optimization with Extremal Dynamics

    International Nuclear Information System (INIS)

    Boettcher, Stefan; Percus, Allon G.

    2001-01-01

    We explore a new general-purpose heuristic for finding high-quality solutions to hard discrete optimization problems. The method, called extremal optimization, is inspired by self-organized criticality, a concept introduced to describe emergent complexity in physical systems. Extremal optimization successively updates extremely undesirable variables of a single suboptimal solution, assigning them new, random values. Large fluctuations ensue, efficiently exploring many local optima. We use extremal optimization to elucidate the phase transition in the 3-coloring problem, and we provide independent confirmation of previously reported extrapolations for the ground-state energy of ±J spin glasses in d=3 and 4

  1. Braving difficult choices alone: children's and adolescents' medical decision making.

    Directory of Open Access Journals (Sweden)

    Azzurra Ruggeri

    Full Text Available OBJECTIVE: What role should minors play in making medical decisions? The authors examined children's and adolescents' desire to be involved in serious medical decisions and the emotional consequences associated with them. METHODS: Sixty-three children and 76 adolescents were presented with a cover story about a difficult medical choice. Participants were tested in one of four conditions: (1 own informed choice; (2 informed parents' choice to amputate; (3 informed parents' choice to continue a treatment; and (4 uninformed parents' choice to amputate. In a questionnaire, participants were asked about their choices, preference for autonomy, confidence, and emotional reactions when faced with a difficult hypothetical medical choice. RESULTS: Children and adolescents made different choices and participants, especially adolescents, preferred to make the difficult choice themselves, rather than having a parent make it. Children expressed fewer negative emotions than adolescents. Providing information about the alternatives did not affect participants' responses. CONCLUSIONS: Minors, especially adolescents, want to be responsible for their own medical decisions, even when the choice is a difficult one. For the adolescents, results suggest that the decision to be made, instead of the agent making the decision, is the main element influencing their emotional responses and decision confidence. For children, results suggest that they might be less able than adolescents to project how they would feel. The results, overall, draw attention to the need to further investigate how we can better involve minors in the medical decision-making process.

  2. Why reference to the past is difficult for agrammatic speakers

    NARCIS (Netherlands)

    Bastiaanse, Roelien

    Many studies have shown that verb inflections are difficult to produce for agrammatic aphasic speakers: they are frequently omitted and substituted. The present article gives an overview of our search to understanding why this is the case. The hypothesis is that grammatical morphology referring to

  3. Difficult management of posterior urethra gunshot wound combined ...

    African Journals Online (AJOL)

    Posterior urethra gunshot wounds are poorly described in the literature. They are often associated with pelvic vital lesions making difficult early repair of urethral injuries. They can be complicated by urethrorectal fistula, which makes their management more complicated. We report a new case of posterior urethra disruption ...

  4. Seeking the best training model for difficult conversations in neonatology.

    Science.gov (United States)

    Lechner, Beatrice E; Shields, Robin; Tucker, Richard; Bender, G Jesse

    2016-05-01

    We hypothesize that a formal simulation curriculum prepares neonatology fellows for difficult conversations better than traditional didactics. Single-center neonatology fellowship graduates from 1999 to 2013 were sent a retrospective web-based survey. Some had been exposed to a Difficult Conversations curriculum (simulation group), others had not (no simulation group). The simulation group participated in one workshop annually, consisting of lecture, simulation, and debriefing. Scenarios were customized to year of training. Epoch comparisons were made between the simulation and no simulation groups. Self-rated baseline effectiveness at discussing difficult topics was not different. The simulation group reported more supervised family meetings and feedback after fellow-led meetings. Simulations were rated very positively. The simulation group reported increased comfort levels. Strategic pause and body positioning were specific communication skills more frequently acquired in the simulation group. In both groups, the highest ranked contributors to learning were mentor observation and clinical practice. In the simulation group, simulation and debriefing outranked didactics or other experiences. Simulation-based workshops improve communication skills in high stakes conversations. However, they do not substitute for mentor observation and experience. Establishing a structured simulation-based difficult conversations curriculum refines vital communication skills necessary for the high stakes conversations neonatologists direct in clinical practice.

  5. Percutaneous transhepatic cholelithotripsy for difficult common bile duct stones

    DEFF Research Database (Denmark)

    Stage, J G; Moesgaard, F; Grønvall, S

    1998-01-01

    or ureteroscope in ten patients and by stone removal by basket in the remaining four patients. The procedure was carried out using local anesthesia in the last 11 patients. Except for two patients with transient cholangitis, no complications occurred. CONCLUSIONS: Difficult bile duct and intrahepatic stones can...

  6. Confronting "Difficult Knowledge": Critical Aesthetics and War in the Classroom

    Science.gov (United States)

    Heybach Vivirito, Jessica A.

    2012-01-01

    This qualitative multi-site case study explores critical aesthetic experiences in teacher education classrooms, and advocates for the inclusion of theoretical and practical knowledge of "difficult knowledge," visual culture, and critical aesthetics in the classroom. Social reality consists of a perpetual stream of tragic and horrific…

  7. Braving difficult choices alone: children's and adolescents' medical decision making.

    Science.gov (United States)

    Ruggeri, Azzurra; Gummerum, Michaela; Hanoch, Yaniv

    2014-01-01

    What role should minors play in making medical decisions? The authors examined children's and adolescents' desire to be involved in serious medical decisions and the emotional consequences associated with them. Sixty-three children and 76 adolescents were presented with a cover story about a difficult medical choice. Participants were tested in one of four conditions: (1) own informed choice; (2) informed parents' choice to amputate; (3) informed parents' choice to continue a treatment; and (4) uninformed parents' choice to amputate. In a questionnaire, participants were asked about their choices, preference for autonomy, confidence, and emotional reactions when faced with a difficult hypothetical medical choice. Children and adolescents made different choices and participants, especially adolescents, preferred to make the difficult choice themselves, rather than having a parent make it. Children expressed fewer negative emotions than adolescents. Providing information about the alternatives did not affect participants' responses. Minors, especially adolescents, want to be responsible for their own medical decisions, even when the choice is a difficult one. For the adolescents, results suggest that the decision to be made, instead of the agent making the decision, is the main element influencing their emotional responses and decision confidence. For children, results suggest that they might be less able than adolescents to project how they would feel. The results, overall, draw attention to the need to further investigate how we can better involve minors in the medical decision-making process.

  8. Braving Difficult Choices Alone: Children's and Adolescents' Medical Decision Making

    Science.gov (United States)

    Ruggeri, Azzurra; Gummerum, Michaela; Hanoch, Yaniv

    2014-01-01

    Objective What role should minors play in making medical decisions? The authors examined children's and adolescents' desire to be involved in serious medical decisions and the emotional consequences associated with them. Methods Sixty-three children and 76 adolescents were presented with a cover story about a difficult medical choice. Participants were tested in one of four conditions: (1) own informed choice; (2) informed parents' choice to amputate; (3) informed parents' choice to continue a treatment; and (4) uninformed parents' choice to amputate. In a questionnaire, participants were asked about their choices, preference for autonomy, confidence, and emotional reactions when faced with a difficult hypothetical medical choice. Results Children and adolescents made different choices and participants, especially adolescents, preferred to make the difficult choice themselves, rather than having a parent make it. Children expressed fewer negative emotions than adolescents. Providing information about the alternatives did not affect participants' responses. Conclusions Minors, especially adolescents, want to be responsible for their own medical decisions, even when the choice is a difficult one. For the adolescents, results suggest that the decision to be made, instead of the agent making the decision, is the main element influencing their emotional responses and decision confidence. For children, results suggest that they might be less able than adolescents to project how they would feel. The results, overall, draw attention to the need to further investigate how we can better involve minors in the medical decision-making process. PMID:25084274

  9. Difficult Temperament, Parental Relationships, and Adolescent Alcohol Use Disorder Symptoms.

    Science.gov (United States)

    Neighbors, Bryan D.; Clark, Duncan B.; Donovan, John E.; Brody, Gene H.

    2000-01-01

    Study tested the hypothesis that the quality of the parent-adolescent relationship mediates the association between difficult temperament and alcohol use disorder (AUD) symptoms. Results suggest that alcohol abuse prevention and treatment programs should consider the role of basic temperamental characteristics in pathological drinking, and the…

  10. Confusing cracks and difficult deformations : Interpreting structural damage in masonry

    NARCIS (Netherlands)

    De Vent, I.; Rots, J.G.; Van Hees, R.P.J.; Hobbelman, G.J.

    2012-01-01

    Cracks and deformatiçns in masonry are common phenomena in historical buildings. If they are interpreted correctly, they can be an extremely valuable source çf informatiçn on the load history of the premises. Nevertheless, this interpretation is not always as obvious as one may think. In the

  11. Classifying Returns as Extreme

    DEFF Research Database (Denmark)

    Christiansen, Charlotte

    2014-01-01

    I consider extreme returns for the stock and bond markets of 14 EU countries using two classification schemes: One, the univariate classification scheme from the previous literature that classifies extreme returns for each market separately, and two, a novel multivariate classification scheme tha...

  12. Relationships and their potential for change developed in difficult type 1 diabetes

    DEFF Research Database (Denmark)

    Zoffmann, Vibeke; Kirkevold, Marit

    2007-01-01

    Few researchers have explored how relationships between patients and providers might change problem solving in clinical practice. The authors used grounded theory to study dyads of 11 people with diabetes and poor glycemic control, and 8 nurses interacting in diabetes teams. Relational Potential...... for Change was identified as a core category that involved three types of relationships. Professionals mostly shifted between less effective relationships characterized by I-you-distant provider dominance and I-you-blurred sympathy. Although rarely seen, a third relationship, I-you-sorted mutuality proved...... more effective than the others in exploiting the Relational Potential for Change. The three types of relationship differed in (a) scope of problem solving, (b) the roles assigned to the patient and the professionals, (c) use of difficult feelings and different points of view, and (d) quality...

  13. Near-horizon symmetries of extremal black holes

    International Nuclear Information System (INIS)

    Kunduri, Hari K; Lucietti, James; Reall, Harvey S

    2007-01-01

    Recent work has demonstrated an attractor mechanism for extremal rotating black holes subject to the assumption of a near-horizon SO(2, 1) symmetry. We prove the existence of this symmetry for any extremal black hole with the same number of rotational symmetries as known four- and five-dimensional solutions (including black rings). The result is valid for a general two-derivative theory of gravity coupled to Abelian vectors and uncharged scalars, allowing for a non-trivial scalar potential. We prove that it remains valid in the presence of higher-derivative corrections. We show that SO(2, 1)-symmetric near-horizon solutions can be analytically continued to give SU(2)-symmetric black hole solutions. For example, the near-horizon limit of an extremal 5D Myers-Perry black hole is related by analytic continuation to a non-extremal cohomogeneity-1 Myers-Perry solution

  14. Emotional distance to so-called difficult patients

    DEFF Research Database (Denmark)

    Michaelsen, Jette Joost

    2012-01-01

    Scand J Caring Sci; 2011 Emotional distance to so-called difficult patients Purpose: To explore nurses' relationships with patients they regard as being difficult. How do nurses feel about such patients and relate to them, and what are the consequences for nurse and patient? Design and methods....... Patients' case records were studied and four meetings with the staff were arranged to discuss the findings. Data collection lasted 18 months in all. Findings: Three strategies were identified: persuasion, avoidance (emotional distance), and compromise. Interestingly, in the relationship with a particular...... patient, the avoidance strategy did not necessarily represent the terminal stage, since a nurse could revert to the compromise strategy. Some of the nurses experienced painful emotions regarding these interactions. Conclusions: The avoidance strategy (emotional distance) resulted in important social...

  15. Difficult Tracheal Intubation in Obese Gastric Bypass patients

    DEFF Research Database (Denmark)

    Dohrn, Niclas; Sommer, Thorbjørn; Bisgaard, J.

    2016-01-01

    Endotracheal intubation is commonly perceived to be more difficult in obese patients than in lean patients. Primarily, we investigated the association between difficult tracheal intubation (DTI) and obesity, and secondarily, the association between DTI and validated scoring systems used to assess...... the airways, the association between DTI and quantities of anesthetics used to induce general anesthesia, and the association between DTI and difficulties with venous and arterial cannulation. This is a monocentric prospective observational clinical study of a consecutive series of 539 obese patients...... was 3.5 % and the patients with DTI were more frequently males, had higher CLC, higher American Society of Anesthesiologists physical status classification (ASA), and noticeably, a lower BMI compared to the patients with easy tracheal intubation. After adjustment with multivariable analyses body mass...

  16. Team Work in International Programs: Why is it so difficult?

    DEFF Research Database (Denmark)

    Lauridsen, Karen M.; Madsen, Henning

    intercultural collaboration. The issues that arise seem to be grounded in linguistic, cultural and educational factors. This paper reports on and discusses a study of student responses to intercultural collaboration (in English) in two programmes at Aarhus University, Denmark. One conclusion...... is that the international students are more prepared to work in multicultural teams than their Danish peers. Another one tells us that once students have experience with the diversity of these teams, at least some of them become more open towards working in such teams in the future. It is interesting to discuss......Team Work in International Programs: Why is it so difficult? And what can we do about it? It is common knowledge that students often find it difficult to collaborate on assignments, projects, etc., but we require that they do so for a number of reasons, e.g. to learn how to work in teams or take...

  17. Distant Galaxy Clusters Hosting Extreme Central Galaxies

    Science.gov (United States)

    McDonald, Michael

    2014-09-01

    The recently-discovered Phoenix cluster harbors the most star-forming central cluster galaxy of any cluster in the known Universe, by nearly a factor of 10. This extreme system appears to be fulfilling early cooling flow predictions, although the lack of similar systems makes any interpretation difficult. In an attempt to find other "Phoenix-like" clusters, we have cross-correlated archival all-sky surveys (in which Phoenix was detected) and isolated 4 similarly-extreme systems which are also coincident in position and redshift with an overdensity of red galaxies. We propose here to obtain Chandra observations of these extreme, Phoenix-like systems, in order to confirm them as relaxed, rapidly-cooling galaxy clusters.

  18. Radiofrequency ablation for hepatocellular carcinoma: assistant techniques for difficult cases.

    Science.gov (United States)

    Inoue, Tatsuo; Minami, Yasunori; Chung, Hobyung; Hayaishi, Sousuke; Ueda, Taisuke; Tatsumi, Chie; Takita, Masahiro; Kitai, Satoshi; Hatanaka, Kinuyo; Ishikawa, Emi; Yada, Norihisa; Hagiwara, Satoru; Ueshima, Kazuomi; Kudo, Masatoshi

    2010-07-01

    To confirm the safety and effectiveness of techniques to assist radiofrequency ablation (RFA) for difficult cases, we retrospectively evaluated successful treatment rates, early complications and local tumor progressions. Between June 1999 and April 2009, a total of 341 patients with 535 nodules were treated as difficult cases. Artificial pleural effusion assisted ablation was performed on 64 patients with 82 nodules. Artificial ascites-assisted ablation was performed on 11 patients with 13 nodules. Cooling by endoscopic nasobiliary drainage (ENBD) tube-assisted ablation was performed on 6 patients with 8 nodules. When the tumors were not well visualized with conventional B-mode ultrasonography (US), contrast-enhanced US-assisted ablation with Levovist or Sonazoid or virtual CT sonography-assisted ablation was performed. Contrast-enhanced US-assisted ablation was performed on 139 patients with 224 nodules and virtual CT sonography-assisted ablation was performed on 121 patients with 209 nodules. In total, complete ablation was achieved in 514 of 535 (96%) nodules in difficult cases. For RFA with artificial pleural effusion, artificial ascites and ENBD, complete response was confirmed in all cases. For contrast-enhanced US- and CT sonography-assisted ablation, complete response was 95%. Early complications were recognized in 24 cases (4.5%). All cases recovered with no invasive treatment. Local tumor recurrence was investigated in 377 nodules of 245 patients, and 69 (18%) nodules were positive. Tumor recurrences in each assisted technique were 14.7% in artificial pleural effusion cases, 7% in artificial ascites, 12.5% in ENBD tube cases, 31% in virtual CT sonography, and 8.5% in contrast-enhanced US. Although local tumor progression needs to be carefully monitored, assisted techniques of RFA for difficult cases are well tolerated and expand the indications of RFA. Copyright (c) 2010 S. Karger AG, Basel.

  19. Difficult factors in Management of Impacted Dental Prosthesis in Esophagus

    Directory of Open Access Journals (Sweden)

    Efiaty A. Soepardi

    2005-03-01

    Full Text Available A dental prosthesis which ingested and impacted in esophagus, is an emergency case and life threatening, so require immediate esophagoscopy intervention for removing. The objective of this study is to assess some factors can caused dtfficulties in diagnosing and treating the ingested and impacted dental prosthesis in the esophagus and their complications. This retrospective study analyzed patient’s chart whose underwent esophagoscopy for removing the impacted dental prosthesis in Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia during a period between January 1997 and December 2003. Neck-chest X-ray and esophagoscopy were performed in all patients to identify the existence of the dental prosthesis as a diagnostic and treatment procedure. The length of time for removing the dental prosthesis was recorded and stated as a less difficult esophagoscopy when it takes time less than 60 minutes and as a difficult  esophagoscopy takes 60 minutes or longer. Some risk difficulties factors were statistically analyzed. There were 53 patients of ingested dental prosthesis in esophagus. Only 51 cases were analyzed According to the length of time for removing the dental prosthesis by esophagoscopy, 22 patients were recorded as less difficult cases and 29 patients as difficult cases. Two cases among the cases needed cervicotomy after unsuccessful esophagoscopy removal. The difficulties to diagnose an impacted dental prosthesis in the esophagus caused by unreliable clinical history, unclear signs and symptoms, unable to be detected by X-ray and was not found during esophagoscopy. The difficulties in treating due to mucosal laceration, edema, bleeding, failure of the first extraction and conformity with the size and shape, the wire outside the dental prosthesis and the length of time stayed in the esophagus. (Med J Indones 2005; 14: 33-6Keywords: ingested dental prosthesis, radioluscent foreign body, length of time of esophagoscopy

  20. Medicare Home Health Services: A Difficult Program to Control

    Science.gov (United States)

    1981-09-25

    represent about one-third of all visits provided under the program. Family and friends altio provide similar services to the elderly and consequently...example, that the individual is to be confined to his or her home but that this does not necessarily mean that the patient is bedridden . At the same...34feebleness" and "insecurity" cannot be considered home- bound. We believe that in many cases (particularly for the elderly ) it would be extremely

  1. Extremity doses to interventional radiologists

    International Nuclear Information System (INIS)

    Wihtby, M.; Martin, C. J.

    2002-01-01

    Radiologists performing interventional procedures are often required to stand close to the patient's side when carrying out manipulations under fluoroscopic control. This can result in their extremities receiving a high radiation dose, due to scattered radiation. These doses are sometimes high enough to warrant that the radiologist in question be designated a classified radiation worker. Classification in the UK is a result of any worker receiving or likely to receive in the course of their duties in excess of 3/10ths of any annual dose limit (500mSv to extremities, skin). The doses to the legs of radiologists have received less attention than those to the hands, however the doses may be high, due to the proximity of the legs and feet to scattered radiation. The legs can be exposed to a relatively high level of scattered radiation as the radiation in produced from scatter of the un attenuated beam from the bottom of the patient couch. The routine monitoring of extremity doses in interventional radiology is difficult due to several factors. Firstly a wide range of interventional procedures in undertaken in every radiology department, and these procedures require many different techniques, equipment and skills. This means that the position the radiologist adopts in relation to scattering medium and therefore their exposure, depends heavily on the type of procedure. As the hands which manipulate the catheters within the patient are often located close to the patients side and to the area under irradiation, the distribution of dose across the hands can be variable, with very high localised doses, making routine monitoring difficult. The purpose of this study was to determine the magnitude and distribution of dose to the hands and legs of interventional radiologists carrying out a wide range of both diagnostic and therapeutic interventional procedures. To ascertain the most effective method of monitoring the highest dose in accordance with the Basic safety standards

  2. Extremal surface barriers

    International Nuclear Information System (INIS)

    Engelhardt, Netta; Wall, Aron C.

    2014-01-01

    We present a generic condition for Lorentzian manifolds to have a barrier that limits the reach of boundary-anchored extremal surfaces of arbitrary dimension. We show that any surface with nonpositive extrinsic curvature is a barrier, in the sense that extremal surfaces cannot be continuously deformed past it. Furthermore, the outermost barrier surface has nonnegative extrinsic curvature. Under certain conditions, we show that the existence of trapped surfaces implies a barrier, and conversely. In the context of AdS/CFT, these barriers imply that it is impossible to reconstruct the entire bulk using extremal surfaces. We comment on the implications for the firewall controversy

  3. Diversity of life. Effects of power generation and transmission on biodiversity difficult to assess

    Energy Technology Data Exchange (ETDEWEB)

    Hongisto, M.; Nikula, A.

    1996-11-01

    Scientific theories do not necessarily enable us to forecast the consequences of our actions on wildlife. Presumably, nature is able to adapt to environmental changes through variations on the genetic, species and ecosystem level; i.e. by means of biodiversity. The first studies conducted within the electricity sector show that the effects of emissions form an individual power plant on biodiversity are extremely difficult to assess because of long-range dispersion of the emission and many other factors simultaneously acting on the environment. Some concrete information about the impact of power transmission lines on biodiversity was obtained. These effects were primarily reversible. Some transmission line zones may even have favourable effects on biodiversity and on the living conditions of certain endangered species. (orig.)

  4. Diversity of life. Effects of power generation and transmission on biodiversity difficult to assess

    International Nuclear Information System (INIS)

    Hongisto, M.; Nikula, A.

    1996-01-01

    Scientific theories do not necessarily enable us to forecast the consequences of our actions on wildlife. Presumably, nature is able to adapt to environmental changes through variations on the genetic, species and ecosystem level; i.e. by means of biodiversity. The first studies conducted within the electricity sector show that the effects of emissions form an individual power plant on biodiversity are extremely difficult to assess because of long-range dispersion of the emission and many other factors simultaneously acting on the environment. Some concrete information about the impact of power transmission lines on biodiversity was obtained. These effects were primarily reversible. Some transmission line zones may even have favourable effects on biodiversity and on the living conditions of certain endangered species. (orig.)

  5. [Intraoperative choledochoscopy usefulness in the treatment of difficult biliary stones].

    Science.gov (United States)

    Cuendis-Velázquez, A; Rojano-Rodríguez, M E; Morales-Chávez, C E; González Angulo-Rocha, A; Fernández-Castro, E; Aguirre-Olmedo, I; Torres-Ruiz, M F; Orellana-Parra, J C; Cárdenas-Lailson, L E

    2014-01-01

    Choledocholithiasis presents in 5-10% of the patients with biliary lithiasis. Numerous treatment algorithms have been considered for this disease, however, up to 10% of these therapeutic procedures may fail. Intraoperative choledochoscopy has become a useful tool in the treatment of patients with difficult-to-manage choledocholithiasis. To determine the usefulness of intraoperative choledochoscopy in the laparoendoscopic treatment of difficult stones that was carried out in our service. A cross-sectional study was conducted. The case records were reviewed of the patients that underwent intraoperative choledochoscopy during biliary tree exploration plus laparoscopic choledochoduodenal anastomosis within the time frame of March 1, 2011 and May 31, 2012, at the Hospital General Dr. Manuel Gea González. Transabdominal choledochoscopies were performed with active stone extraction when necessary, followed by peroral choledochoscopies through the recently formed bilioenteric anastomosis. The data were analyzed with descriptive statistics and measures of central tendency. The mean age was 71 years, 57% of the patients were women, and the ASA III score predominated. Active extraction of stones with 7 to 35mm diameters was carried out in 4 of the cases and the absence of stones in the biliary tract was corroborated in all the patients. The mean surgery duration was 18 minutes (range: 4 to 45min). Choledochoscopy is a safe and effective minimally invasive procedure for the definitive treatment of difficult stones. Copyright © 2013 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

  6. Statistics of Extremes

    KAUST Repository

    Davison, Anthony C.; Huser, Raphaë l

    2015-01-01

    Statistics of extremes concerns inference for rare events. Often the events have never yet been observed, and their probabilities must therefore be estimated by extrapolation of tail models fitted to available data. Because data concerning the event

  7. Analysis of extreme events

    CSIR Research Space (South Africa)

    Khuluse, S

    2009-04-01

    Full Text Available ) determination of the distribution of the damage and (iii) preparation of products that enable prediction of future risk events. The methodology provided by extreme value theory can also be a powerful tool in risk analysis...

  8. Acute lower extremity ischaemia

    African Journals Online (AJOL)

    Acute lower extremity ischaemia. Acute lower limb ischaemia is a surgical emergency. ... is ~1.5 cases per 10 000 persons per year. Acute ischaemia ... Table 2. Clinical features discriminating embolic from thrombotic ALEXI. Clinical features.

  9. The Difficult Empowerment in Danish Hospital: Power to the nurses!?

    DEFF Research Database (Denmark)

    Witt, Flemming; Nielsen, Jørn Flohr

    The employee empowerment literature promises better organizational performance as well as more motivated and satisfied employees. However, this literature often neglects the specific context of public services in general, or the health care sector, hospitals, and nursing in particular. Nurses...... in Danish public hospitals work in a unique situation that makes the uncritical transfer of empowerment interventions intended to redesign their work difficult or even unfeasible. Analysis from an institutional perspective of the ongoing power struggle between agens of change at several levels in the Danish...

  10. Hemorrhagic herpes encephalitis: A difficult diagnosis in computed tomography

    International Nuclear Information System (INIS)

    Neumann, N.U.; Albert, H.H. von

    1982-01-01

    Herpes simplex encephalitis (HSE) is the most common sporadically appearing encephalitis in Central Europe. Differential diagnosis to brain tumors or spontaneous intercerebral hemorrhage is difficult. There are CT scan findings which are characteristic of HSE but there are no pathognomonic patterns. These characteristic findings are helpful in differential diagnosis to neoplastic or vascular processes. Thus, other diagnostic procedures (i.e. brain biopsy) to confirm diagnosis of HSE and effective therapy may be carried out in time. The difficulties in differential diagnosis are shown by the presented case. (orig.) [de

  11. Proving the AGT relation for N f = 0, 1, 2 antifundamentals

    Science.gov (United States)

    Hadasz, Leszek; Jaskólski, Zbigniew; Suchanek, Paulina

    2010-06-01

    Using recursive relations satisfied by Nekrasov partition functions and by irregular conformal blocks we prove the AGT correspondence in the case of mathcal{N} = 2 superconformal SU(2) quiver gauge theories with N f = 0, 1, 2 antifundamental hypermultiplets.

  12. Classificació de proves no paramètriques. Com aplicar-les en SPSS

    Directory of Open Access Journals (Sweden)

    Vanesa Berlanga-Silvente

    2012-07-01

    Full Text Available Les proves no paramètriques engloben una sèrie de proves estadístiques, que tenen com a denominador comú l'absència de assumpcions sobre la llei de probabilitat que segueix la població de la qual ha estat extreta la mostra. Per aquesta raó és comú referir-s'hi com a proves de distribució lliure. A l'article es descriuen i treballen les proves no paramètriques ressaltant el seu fonament i les indicacions per al seu ús quan es tracta d'una sola mostra (Chi-quadrat, de dues mostres amb dades independents (U de Mann-Whitney, de dues mostres amb dades relacionades (T de Wilcoxon, de diverses mostres amb dades independents (H de Kruskal-Wallis i de diverses mostres amb dades relacionades (Friedman.

  13. “Deliberate distortion of facts” and the problem of proving bias:

    African Journals Online (AJOL)

    user

    informed observer would reasonably perceive bias on the part of the officer .... represent an excellent illustration of what an Australian Chief Justice once .... the appellants prove that the Justice of Appeal who had no financial or other.

  14. PROVE Land Cover and Leaf Area of Jornada Experimental Range, New Mexico, 1997

    Data.gov (United States)

    National Aeronautics and Space Administration — Field measurement of shrubland ecological properties is important for both site monitoring and validation of remote-sensing information. During the PROVE exercise on...

  15. PROVE Land Cover and Leaf Area of Jornada Experimental Range, New Mexico, 1997

    Data.gov (United States)

    National Aeronautics and Space Administration — ABSTRACT: Field measurement of shrubland ecological properties is important for both site monitoring and validation of remote-sensing information. During the PROVE...

  16. High Metal Removal Rate Process for Machining Difficult Materials

    Energy Technology Data Exchange (ETDEWEB)

    Bates, Robert; McConnell, Elizabeth

    2016-06-29

    Machining methods across many industries generally require multiple operations to machine and process advanced materials, features with micron precision, and complex shapes. The resulting multiple machining platforms can significantly affect manufacturing cycle time and the precision of the final parts, with a resultant increase in cost and energy consumption. Ultrafast lasers represent a transformative and disruptive technology that removes material with micron precision and in a single step manufacturing process. Such precision results from athermal ablation without modification or damage to the remaining material which is the key differentiator between ultrafast laser technologies and traditional laser technologies or mechanical processes. Athermal ablation without modification or damage to the material eliminates post-processing or multiple manufacturing steps. Combined with the appropriate technology to control the motion of the work piece, ultrafast lasers are excellent candidates to provide breakthrough machining capability for difficult-to-machine materials. At the project onset in early 2012, the project team recognized that substantial effort was necessary to improve the application of ultrafast laser and precise motion control technologies (for micromachining difficult-to-machine materials) to further the aggregate throughput and yield improvements over conventional machining methods. The project described in this report advanced these leading-edge technologies thru the development and verification of two platforms: a hybrid enhanced laser chassis and a multi-application testbed.

  17. Determination of difficult to measure actinides in radioactive liquid waste

    International Nuclear Information System (INIS)

    Drabova, V.; Galanda, D.; Dulanska, S.; Remenec, B.; Kuruc, J.

    2014-01-01

    In decommissioning of a nuclear facilities and radioactive waste treatment the activity of various radionuclides need to be measured for the waste characterization. Radiochemical separation of 241 Am, 237 Np and isotopes of plutonium was tested on model solution of evaporator concentrate sample for isolation of each of them for alpha-spectrometry analysis. This paper describes use of the molecular recognition technology product AnaLig(R)Pu-01 gel from IBC Advanced technologies, Inc. to effectively and selectively pre-concentrate, separate and recover difficult-to-measure actinides from model solution of evaporator concentrate samples which belong to the most difficult matrices to analyse. The method is suitable for analysing highly contaminated samples of radioactive waste in a relatively short time. For counting the alpha activity of 241 Am, 239,240 Pu, 238 Pu and 237 Np ORTEC 576A alpha-spectrometer equipped with ULTRA TM ion implanted silicon detectors (600 mm 2 active area) was used. The spectra were processed by using the Alpha-vision TM 32-bit emulation software from the EG and G ORTEC company. (authors)

  18. Maxillofacial trauma patient: coping with the difficult airway

    Directory of Open Access Journals (Sweden)

    Barak Michal

    2009-05-01

    Full Text Available Abstract Establishing a secure airway in a trauma patient is one of the primary essentials of treatment. Any flaw in airway management may lead to grave morbidity and mortality. Maxillofacial trauma presents a complex problem with regard to the patient's airway. By definition, the injury compromises the patient's airway and it is, therefore, must be protected. In most cases, the patient undergoes surgery for maxillofacial trauma or for other, more severe, life-threatening injuries, and securing the airway is the first step in the introduction of general anaesthesia. In such patients, we anticipate difficult endotracheal intubation and, often, also difficult mask ventilation. In addition, the patient is usually regarded as having a "full stomach" and has not been cleared of a C-spine injury, which may complicate airway management furthermore. The time available to accomplish the task is short and the patient's condition may deteriorate rapidly. Both decision-making and performance are impaired in such circumstances. In this review, we discuss the complexity of the situation and present a treatment approach.

  19. Risk assessment of precipitation extremes in northern Xinjiang, China

    Science.gov (United States)

    Yang, Jun; Pei, Ying; Zhang, Yanwei; Ge, Quansheng

    2018-05-01

    This study was conducted using daily precipitation records gathered at 37 meteorological stations in northern Xinjiang, China, from 1961 to 2010. We used the extreme value theory model, generalized extreme value (GEV) and generalized Pareto distribution (GPD), statistical distribution function to fit outputs of precipitation extremes with different return periods to estimate risks of precipitation extremes and diagnose aridity-humidity environmental variation and corresponding spatial patterns in northern Xinjiang. Spatiotemporal patterns of daily maximum precipitation showed that aridity-humidity conditions of northern Xinjiang could be well represented by the return periods of the precipitation data. Indices of daily maximum precipitation were effective in the prediction of floods in the study area. By analyzing future projections of daily maximum precipitation (2, 5, 10, 30, 50, and 100 years), we conclude that the flood risk will gradually increase in northern Xinjiang. GEV extreme value modeling yielded the best results, proving to be extremely valuable. Through example analysis for extreme precipitation models, the GEV statistical model was superior in terms of favorable analog extreme precipitation. The GPD model calculation results reflect annual precipitation. For most of the estimated sites' 2 and 5-year T for precipitation levels, GPD results were slightly greater than GEV results. The study found that extreme precipitation reaching a certain limit value level will cause a flood disaster. Therefore, predicting future extreme precipitation may aid warnings of flood disaster. A suitable policy concerning effective water resource management is thus urgently required.

  20. Multidisciplinary Difficult Airway Course: An Essential Educational Component of a Hospital-Wide Difficult Airway Response Program.

    Science.gov (United States)

    Leeper, W Robert; Haut, Elliott R; Pandian, Vinciya; Nakka, Sajan; Dodd-O, Jeffrey; Bhatti, Nasir; Hunt, Elizabeth A; Saheed, Mustapha; Dalesio, Nicholas; Schiavi, Adam; Miller, Christina; Kirsch, Thomas D; Berkow, Lauren

    2018-04-05

    A hospital-wide difficult airway response team was developed in 2008 at The Johns Hopkins Hospital with three central pillars: operations, safety monitoring, and education. The objective of this study was to assess the outcomes of the educational pillar of the difficult airway response team program, known as the multidisciplinary difficult airway course (MDAC). The comprehensive, full-day MDAC involves trainees and staff from all provider groups who participate in airway management. The MDAC occurs within the Johns Hopkins Medicine Simulation Center approximately four times per year and uses a combination of didactic lectures, hands-on sessions, and high-fidelity simulation training. Participation in MDAC is the main intervention being investigated in this study. Data were collected prospectively using course evaluation survey with quantitative and qualitative components, and prepost course knowledge assessment multiple choice questions (MCQ). Outcomes include course evaluation scores and themes derived from qualitative assessments, and prepost course knowledge assessment MCQ scores. Tertiary care academic hospital center PARTICIPANTS: Students, residents, fellows, and practicing physicians from the departments of Surgery, Otolaryngology Head and Neck Surgery, Anesthesiology/Critical Care Medicine, and Emergency Medicine; advanced practice providers (nurse practitioners and physician assistants), nurse anesthetists, nurses, and respiratory therapists. Totally, 23 MDACs have been conducted, including 499 participants. Course evaluations were uniformly positive with mean score of 86.9 of 95 points. Qualitative responses suggest major value from high-fidelity simulation, the hands-on skill stations, and teamwork practice. MCQ scores demonstrated significant improvement: median (interquartile range) pre: 69% (60%-81%) vs post: 81% (72%-89%), p < 0.001. Implementation of a MDAC successfully disseminated principles and protocols to all airway providers. Demonstrable

  1. Extreme Programming: Maestro Style

    Science.gov (United States)

    Norris, Jeffrey; Fox, Jason; Rabe, Kenneth; Shu, I-Hsiang; Powell, Mark

    2009-01-01

    "Extreme Programming: Maestro Style" is the name of a computer programming methodology that has evolved as a custom version of a methodology, called extreme programming that has been practiced in the software industry since the late 1990s. The name of this version reflects its origin in the work of the Maestro team at NASA's Jet Propulsion Laboratory that develops software for Mars exploration missions. Extreme programming is oriented toward agile development of software resting on values of simplicity, communication, testing, and aggressiveness. Extreme programming involves use of methods of rapidly building and disseminating institutional knowledge among members of a computer-programming team to give all the members a shared view that matches the view of the customers for whom the software system is to be developed. Extreme programming includes frequent planning by programmers in collaboration with customers, continually examining and rewriting code in striving for the simplest workable software designs, a system metaphor (basically, an abstraction of the system that provides easy-to-remember software-naming conventions and insight into the architecture of the system), programmers working in pairs, adherence to a set of coding standards, collaboration of customers and programmers, frequent verbal communication, frequent releases of software in small increments of development, repeated testing of the developmental software by both programmers and customers, and continuous interaction between the team and the customers. The environment in which the Maestro team works requires the team to quickly adapt to changing needs of its customers. In addition, the team cannot afford to accept unnecessary development risk. Extreme programming enables the Maestro team to remain agile and provide high-quality software and service to its customers. However, several factors in the Maestro environment have made it necessary to modify some of the conventional extreme

  2. Surviving extreme polar winters by desiccation: clues from Arctic springtail (Onychiurus arcticus EST libraries

    Directory of Open Access Journals (Sweden)

    Kube Michael

    2007-12-01

    Full Text Available Abstract Background Ice, snow and temperatures of -14°C are conditions which most animals would find difficult, if not impossible, to survive in. However this exactly describes the Arctic winter, and the Arctic springtail Onychiurus arcticus regularly survives these extreme conditions and re-emerges in the spring. It is able to do this by reducing the amount of water in its body to almost zero: a process that is called "protective dehydration". The aim of this project was to generate clones and sequence data in the form of ESTs to provide a platform for the future molecular characterisation of the processes involved in protective dehydration. Results Five normalised libraries were produced from both desiccating and rehydrating populations of O. arcticus from stages that had previously been defined as potentially informative for molecular analyses. A total of 16,379 EST clones were generated and analysed using Blast and GO annotation. 40% of the clones produced significant matches against the Swissprot and trembl databases and these were further analysed using GO annotation. Extraction and analysis of GO annotations proved an extremely effective method for identifying generic processes associated with biochemical pathways, proving more efficient than solely analysing Blast data output. A number of genes were identified, which have previously been shown to be involved in water transport and desiccation such as members of the aquaporin family. Identification of these clones in specific libraries associated with desiccation validates the computational analysis by library rather than producing a global overview of all libraries combined. Conclusion This paper describes for the first time EST data from the arctic springtail (O. arcticus. This significantly enhances the number of Collembolan ESTs in the public databases, providing useful comparative data within this phylum. The use of GO annotation for analysis has facilitated the identification of a

  3. Existence of extremal periodic solutions for quasilinear parabolic equations

    Directory of Open Access Journals (Sweden)

    Siegfried Carl

    1997-01-01

    bounded domain under periodic Dirichlet boundary conditions. Our main goal is to prove the existence of extremal solutions among all solutions lying in a sector formed by appropriately defined upper and lower solutions. The main tools used in the proof of our result are recently obtained abstract results on nonlinear evolution equations, comparison and truncation techniques and suitably constructed special testfunction.

  4. Extreme meteorological conditions

    International Nuclear Information System (INIS)

    Altinger de Schwarzkopf, M.L.

    1983-01-01

    Different meteorological variables which may reach significant extreme values, such as the windspeed and, in particular, its occurrence through tornadoes and hurricanes that necesarily incide and wich must be taken into account at the time of nuclear power plants' installation, are analyzed. For this kind of study, it is necessary to determine the basic phenomenum of design. Two criteria are applied to define the basic values of design for extreme meteorological variables. The first one determines the expected extreme value: it is obtained from analyzing the recurence of the phenomenum in a convened period of time, wich may be generally of 50 years. The second one determines the extreme value of low probability, taking into account the nuclear power plant's operating life -f.ex. 25 years- and considering, during said lapse, the occurrence probabilities of extreme meteorological phenomena. The values may be determined either by the deterministic method, which is based on the acknowledgement of the fundamental physical characteristics of the phenomena or by the probabilistic method, that aims to the analysis of historical statistical data. Brief comments are made on the subject in relation to the Argentine Republic area. (R.J.S.) [es

  5. Radon mitigation experience in difficult-to-mitigate schools

    International Nuclear Information System (INIS)

    Leovic, K.W.; Craig, A.B.

    1990-01-01

    Initial radon mitigation experience in schools has shown sub-slab depressurization (SSD) to be generally effective in reducing elevated levels of radon in schools that have a continuous layer of clean, coarse aggregate underneath the slab. However, mitigation experience is limited in schools without sub-slab aggregate and in schools with characteristics such as return-air ductwork underneath the slab or unducted return-air plenums in the drop ceiling that are open to the sub-slab area (via open tops of block walls). Mitigation of schools with utility tunnels and of schools constructed over crawl spaces is also limited. Three Maryland schools exhibiting some of the above characteristics are being researched to help understand the mechanisms that control radon entry and mitigation in schools where standard SSD systems are not effective. This paper discusses specific characteristics of potentially difficult-to-mitigate schools and, where applicable, details examples from the three Maryland schools

  6. Management of difficult airway in intratracheal tumor surgery

    Directory of Open Access Journals (Sweden)

    Agarwal Surendra K

    2005-06-01

    Full Text Available Abstract Background Tracheal malignancies are usual victim of delay in diagnosis by virtue of their symptoms resembling asthma. Sometimes delayed diagnosis may lead to almost total airway obstruction. For difficult airways, not leaving any possibility of manipulation into neck region or endoscopic intervention, femorofemoral cardiopulmonary bypass can be a promising approach. Case Presentation We are presenting a case of tracheal adenoid cystic carcinoma (cylindroma occupying about 90% of the tracheal lumen. It was successfully managed by surgical excision of mass by sternotomy and tracheotomy under femorofemoral cardiopulmonary bypass (CPB. Conclusion Any patient with recurrent respiratory symptoms should be evaluated by radiological and endoscopic means earlier to avoid delay in diagnosis of such conditions. Femorofemoral cardiopulmonary bypass is a relatively safe way of managing certain airway obstructions.

  7. Ploughs for difficult seams of Bergbau AG Niederrhein

    Energy Technology Data Exchange (ETDEWEB)

    Klimek, K.-H.

    1989-06-29

    Ploughs for difficult seams have been used in five panels at collieries of Bergbau AG Niederrhein. It was determined during operation that short or standard ploughs achieve a 30% higher area rate of advance than double ploughs. Differences in pitch in the plough chain lead to regenerative operation of the motor with the greater chain pitch in the case of deviations over 1.5%. An excessively high pretensioning force depending on the wire diameter may lead to an increase in the no-load power up to 100%. In future special attention must be paid to observance of a defined cutting depth; systems for load equalisation and the tensioner for the plough chain which can be used during continuous operation, must be further developed. 6 refs., 4 figs., 1 tab.

  8. U. K. storage market improves after difficult start to year

    Energy Technology Data Exchange (ETDEWEB)

    Kingston, J

    1979-07-15

    According to J. Kingston of PD Oil and Chemical Storage Ltd., the present shortage of oil and product supplies has raised storage capacity rates and some tankage expansion is being considered, but there is no prospect of new terminal construction in the short-term without considerable hardening of storage tariffs. The few tanks under construction are for the specific requirements of certain chemical producers. PD Oil and Chemical operates three storage facilities at Barry, South Wales, where many tanks are specially lined for handling difficult products, Ipswich, and Purfleet, U.K., which have a total capacity of 733,600 cu m, as well as seven others in South Africa, Australia, Spain, France, the U.S., Canary Islands, and Cape Verde Islands in conjunction with subsidiary or associated companies. A table lists PD Oil and Chemical's facilities in the U.K., including location, type of storage, capacity, and accessibility.

  9. Cylindrical plunge grinding of difficult to grind materials

    International Nuclear Information System (INIS)

    Nakajima, Toshikatsu; Uno, Yoshiyuki; Kayahara, Masayuki.

    1983-01-01

    Cylindrical plunge grinding processes of titanium alloy and nickel-base superalloys with various kinds of conventional grinding wheels, which are known as difficult to grind materials, are experimentally investigated, analyzing size generation process, grinding force, surface roughness, wheel wear, grinding ratio and so on. For grinding titanium alloy Ti-6Al-4V, GC grinding wheel yields most superior grinding results which leads to lower grinding force, smaller residual stock, less wheel wear and higher grinding ratio up to about 3 with GC 80 L 9 V wheel. Then, for grinding nickelbase superalloys Waspaloy and Rene 41, WA 150 L 9 V wheel yields better grinding results in surface roughness, wheel wear, grinding ratio without chatter vibration though grinding force is higher, and the grinding ratio about 3 is obtained. Furthermore, higher plunge speed and speed ratio result in higher grinding efficiency though grinding force, surface roughness, wheel wear increase for grinding titanium alloy and nickel-base superalloys. (author)

  10. Difficult colonoscopy: air, carbon dioxide, or water insufflation?

    Science.gov (United States)

    Chaubal, Alisha; Pandey, Vikas; Patel, Ruchir; Poddar, Prateik; Phadke, Aniruddha; Ingle, Meghraj; Sawant, Prabha

    2018-04-01

    This study aimed to compare tolerance to air, carbon dioxide, or water insufflation in patients with anticipated difficult colonoscopy (young, thin, obese individuals, and patients with prior abdominal surgery or irradiation). Patients with body mass index (BMI) less than 18 kg/m 2 or more than 30 kg/m 2 , or who had undergone previous abdominal or pelvic surgeries were randomized to air, carbon dioxide, or water insufflation during colonoscopy. The primary endpoint was cecal intubation with mild pain (less than 5 on visual analogue scale [VAS]), without use of sedation. The primary end point was achieved in 32.7%, 43.8%, and 84.9% of cases with air, carbon dioxide and water insufflation ( P carbon dioxide, and water insufflation ( P carbon dioxide for pain tolerance. This was seen in the subgroups with BMI 30 kg/m 2 .

  11. Contentious Conversations: Using Mediation Techniques in Difficult Clinical Ethics Consultations.

    Science.gov (United States)

    Fiester, Autumn

    2015-01-01

    Mediators utilize a wide range of skills in the process of facilitating dialogue and resolving conflicts. Among the most useful techniques for clinical ethics consultants (CECs)-and surely the least discussed-are those employed in acrimonious, hostile conversations between stakeholders. In the context of clinical ethics disputes or other bedside conflicts, good mediation skills can reverse the negative interactions that have prevented the creation of workable treatment plans or ethical consensus. This essay lays out the central framework mediators use in distinguishing positions from interests and describes a set of strategies for managing contentious ethics consultations or working with "difficult" patients, families, or patient-careprovider interactions. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.

  12. Penile Corporeal Reconstruction during Difficult Placement of a Penile Prosthesis

    Directory of Open Access Journals (Sweden)

    Viet Q. Tran

    2008-01-01

    Full Text Available For some patients with impotence and concomitant severe tunical/corporeal tissue fibrosis, insertion of a penile prosthesis is the only option to restore erectile function. Closing the tunica over an inflatable penile prosthesis in these patients can be challenging. We review our previous study which included 15 patients with severe corporeal or tunical fibrosis who underwent corporeal reconstruction with autologous rectus fascia to allow placement of an inflatable penile prosthesis. At a mean follow-up of 18 months (range 12 to 64, all patients had a prosthesis that was functioning properly without evidence of separation, herniation, or erosion of the graft. Sexual activity resumed at a mean time of 9 weeks (range 8 to 10. There were no adverse events related to the graft or its harvest. Use of rectus fascia graft for coverage of a tunical defect during a difficult penile prosthesis placement is surgically feasible, safe, and efficacious.

  13. Taking a holistic approach to managing difficult stress fractures.

    Science.gov (United States)

    Miller, Timothy L; Best, Thomas M

    2016-09-09

    Stress fractures and other bony stress injuries occur along a spectrum of severity which can impact treatment and prognosis. When treating these injuries, it should be borne in mind that no two stress fractures behave exactly alike. Given that they are not a consistent injury, standardized treatment protocols can be challenging to develop. Treatment should be individualized to the patient or athlete, the causative activity, the anatomical site, and the severity of the injury. A holistic approach to the treatment of the most difficult stress fractures should be taken by orthopedists and sports medicine specialists. This approach is necessary to obtain optimal outcomes, minimize loss of fitness and time away from sports participation, and decrease the risk of recurrence.

  14. Acceptance issues for large items and difficult waste

    International Nuclear Information System (INIS)

    Palmer, J.; Lock, Peter

    2002-01-01

    Peter Lock described some particular cases which had given rise to difficult acceptance issues at NIREX, ranging from large size items to the impacts of chemicals used during decontamination on the mobility of radionuclides in a disposal facility: The UK strategy for intermediate level and certain low level radioactive waste disposal is based on production of cementitious waste-forms packaged in a standard range of containers as follows: 500 litre Drum - the normal container for most operational ILW (0.8 m diameter x 1.2 m high); 3 m"3 Box - a larger container for solid wastes (1.72 m x 1.72 m plan x 1.2 m high); 3 m"3 Drum - a larger container for in-drum mixing and immobilisation of sludge waste-forms (1.72 m diameter x 1.2 m high); 4 m Box - for large items of waste, especially from decommissioning (4.0 m x 2.4 m plan x 2.2 m high); 2 m LLW Box - for higher-density wastes (2.0 m x 2.4 m plan x 2.2 m high). In addition the majority of LLW is packaged by supercompaction followed by grouting in modified ISO freight containers (6 m x 2.5 m x 2.5 m). Some wastes do not fit easily into this strategy. These wastes include: very large items, (too big for the 4 m box) which, if dealt with whole, pose transport and disposal problems. These items are discussed further in Section 2; waste whose characteristics make packaging difficult. Such wastes are described in more detail in Section 3

  15. Performance specifications: the nearly impossible versus the merely difficult

    Science.gov (United States)

    Hopper, Darrel G.

    2000-08-01

    Affordability is the objective of acquisition reform. The institution of 'performance' specifications in lieu of 'design' specifications is a key strategy. Design of a cockpit display, for example, is left to the prime contractor based on a performance requirement stated by the government. The prime delegates to the integrator. The integrator develops the display and bill of materials provided by vendors. There is no feedback loop from the vendors to the ultimate customer, the government. As a result of this situation a communication gap exists: the government, primes, and integrators have concluded that they should pay commodity prices for custom displays. One step in the closing of this gap is the establishment of cross- cutting common reference performance specifications for aerospace and defense displays. The performance specification for cockpit displays is nearly impossible to achieve -- the last ounce of technology and more is required. Commodity markets, such as consumer notebook computers, are based on but a fraction of currently available technology -- companies 'bank' technology and roll it out across several 18-month product generations. Ruggedized consumer displays can be used in aerospace and defense applications other than the cockpit, such as mission crew stations. The performance specification for non-cockpit aerospace and defense applications is merely difficult. Acquisition reform has been defined by the Secretary of Defense to mean DoD should leverage the commercial market to the maximal extent possible. For the achievement of this end, an entirely different approach is wanted for cockpit displays versus large platform mission displays. That is, the nearly impossible requires a different design and business approach from the merely difficult.

  16. Discussion of difficult problems of early diagnosis of pancreatic cancer

    Directory of Open Access Journals (Sweden)

    GUO Xiaozhong

    2014-08-01

    Full Text Available Pancreatic cancer is a common malignant neoplasm of the pancreas with an extremely high mortality. Currently, the early diagnosis of pancreatic cancer is still not ideal. Attention should be paid to some clinical warning symptoms, such as unexplained abdominal and back pain, jaundice, and unexpected diabetes. Additionally, the combined use of CA19-9, CEA, and other tumor markers, the attention to biochemical indicators, the detection of mutation in KAI1 or p53 gene, and the exploration of the value of miRNA in clinical diagnosis are of great significance. On the other hand, ultrasound, CT, MRCP, ERCP, PET-CT, and other imaging methods, as well as effective collection of cytology specimens, should be performed. Thus, there is hope for the early diagnosis of pancreatic cancer.

  17. The probability distribution of extreme precipitation

    Science.gov (United States)

    Korolev, V. Yu.; Gorshenin, A. K.

    2017-12-01

    On the basis of the negative binomial distribution of the duration of wet periods calculated per day, an asymptotic model is proposed for distributing the maximum daily rainfall volume during the wet period, having the form of a mixture of Frechet distributions and coinciding with the distribution of the positive degree of a random variable having the Fisher-Snedecor distribution. The method of proving the corresponding result is based on limit theorems for extreme order statistics in samples of a random volume with a mixed Poisson distribution. The adequacy of the models proposed and methods of their statistical analysis is demonstrated by the example of estimating the extreme distribution parameters based on real data.

  18. Gene adaptation to extreme environments

    International Nuclear Information System (INIS)

    Marlaire, P.; Rodriguez, V.; Kerner, N.

    2005-01-01

    Full text: This work is oriented to the study of gene adaptation to extreme conditions, such as the hydrothermal system located in Copahue, Neuquen, Argentina. The organisms living there develop under two pressure selection conditions: the high temperature of thermal water and the strong impact of ultraviolet (UV) radiation. Several microorganisms found in this region were isolated and different colonies resistant to UV radiation were selected, a Geobacillus thermoleovorans strain identified through 16S RNA sequence, being the most remarkable. A gene library was prepared out of this strain with UV sensitive bacteria BH200 (uvrA::Tn10). A number of clones were isolated by means of UV selection, the most outstanding being a gene carrier able to codify for the guanosine monophosphate synthetase enzyme (GMPs). The suitability of said enzyme was proved by means of additional assays performed on ght 1 bacteria (guaA26::Tn 10) which lacked the enzyme. A transcript of 1100 pb was detected through Northern Blot. The result was consistent with that obtained for the mapping of the starting transcription site. The cloned GMPs produces an increase in growth speed and a greater biomass in BH200 bacteria. (author)

  19. Acclimatization to extreme heat

    Science.gov (United States)

    Warner, M. E.; Ganguly, A. R.; Bhatia, U.

    2017-12-01

    Heat extremes throughout the globe, as well as in the United States, are expected to increase. These heat extremes have been shown to impact human health, resulting in some of the highest levels of lives lost as compared with similar natural disasters. But in order to inform decision makers and best understand future mortality and morbidity, adaptation and mitigation must be considered. Defined as the ability for individuals or society to change behavior and/or adapt physiologically, acclimatization encompasses the gradual adaptation that occurs over time. Therefore, this research aims to account for acclimatization to extreme heat by using a hybrid methodology that incorporates future air conditioning use and installation patterns with future temperature-related time series data. While previous studies have not accounted for energy usage patterns and market saturation scenarios, we integrate such factors to compare the impact of air conditioning as a tool for acclimatization, with a particular emphasis on mortality within vulnerable communities.

  20. Extremely deformable structures

    CERN Document Server

    2015-01-01

    Recently, a new research stimulus has derived from the observation that soft structures, such as biological systems, but also rubber and gel, may work in a post critical regime, where elastic elements are subject to extreme deformations, though still exhibiting excellent mechanical performances. This is the realm of ‘extreme mechanics’, to which this book is addressed. The possibility of exploiting highly deformable structures opens new and unexpected technological possibilities. In particular, the challenge is the design of deformable and bi-stable mechanisms which can reach superior mechanical performances and can have a strong impact on several high-tech applications, including stretchable electronics, nanotube serpentines, deployable structures for aerospace engineering, cable deployment in the ocean, but also sensors and flexible actuators and vibration absorbers. Readers are introduced to a variety of interrelated topics involving the mechanics of extremely deformable structures, with emphasis on ...

  1. Statistics of Extremes

    KAUST Repository

    Davison, Anthony C.

    2015-04-10

    Statistics of extremes concerns inference for rare events. Often the events have never yet been observed, and their probabilities must therefore be estimated by extrapolation of tail models fitted to available data. Because data concerning the event of interest may be very limited, efficient methods of inference play an important role. This article reviews this domain, emphasizing current research topics. We first sketch the classical theory of extremes for maxima and threshold exceedances of stationary series. We then review multivariate theory, distinguishing asymptotic independence and dependence models, followed by a description of models for spatial and spatiotemporal extreme events. Finally, we discuss inference and describe two applications. Animations illustrate some of the main ideas. © 2015 by Annual Reviews. All rights reserved.

  2. Technical report on the Piping Reliability Proving Tests at the Japan Atomic Energy Research Institute

    International Nuclear Information System (INIS)

    1993-05-01

    Japan Atomic Energy Research Institute (JAERI) conducts Piping Reliability Proving Tests from 1975 to 1992 based upon the contracts between JAERI and Science and Technology Agency of Japan (STA) under the auspices of the special account law for electric power development promotion. The purpose of these tests are to prove the structural reliability of the primary cooling piping constituting a part of the pressure boundary in the light water reactor power plants. The tests with large experimental facilities had ended already in 1990. Presently piping reliability analysis by the probabilistic fracture mechanics method is being done. Until now annual reports concerning the proving tests were produced and submitted to STA, whereas this report summarizes the test results done during these 16 years. Objectives of the piping reliability proving tests are to prove that the primary piping of the light water reactor (1) be reliable throughout the service period, (2) have no possibility of rupture, (3) bring no detrimental influence on the surrounding instrumentations or equipments near the break location even if it ruptured suddenly. To attain these objectives (i) pipe fatigue tests, (ii) unstable pipe fracture tests, (iii) pipe rupture tests and also the analyses by computer codes were done. After carrying out these tests, it is verified that the piping is reliable throughout the service period. The authors of this report are T. Isozaki, K. Shibata, S. Ueda, R. Kurihara, K. Onizawa and A. Kohsaka. The parts they wrote are shown in contents. (author)

  3. JPSS Proving Ground Activities with NASA's Short-term Prediction Research and Transition (SPoRT) Center

    Science.gov (United States)

    Schultz, L. A.; Smith, M. R.; Fuell, K.; Stano, G. T.; LeRoy, A.; Berndt, E.

    2015-12-01

    Instruments aboard the Joint Polar Satellite System (JPSS) series of satellites will provide imagery and other data sets relevant to operational weather forecasts. To prepare current and future weather forecasters in application of these data sets, Proving Ground activities have been established that demonstrate future JPSS capabilities through use of similar sensors aboard NASA's Terra and Aqua satellites, and the S-NPP mission. As part of these efforts, NASA's Short-term Prediction Research and Transition (SPoRT) Center in Huntsville, Alabama partners with near real-time providers of S-NPP products (e.g., NASA, UW/CIMSS, UAF/GINA, etc.) to demonstrate future capabilities of JPSS. This includes training materials and product distribution of multi-spectral false color composites of the visible, near-infrared, and infrared bands of MODIS and VIIRS. These are designed to highlight phenomena of interest to help forecasters digest the multispectral data provided by the VIIRS sensor. In addition, forecasters have been trained on the use of the VIIRS day-night band, which provides imagery of moonlit clouds, surface, and lights emitted by human activities. Hyperspectral information from the S-NPP/CrIS instrument provides thermodynamic profiles that aid in the detection of extremely cold air aloft, helping to map specific aviation hazards at high latitudes. Hyperspectral data also support the estimation of ozone concentration, which can highlight the presence of much drier stratospheric air, and map its interaction with mid-latitude or tropical cyclones to improve predictions of their strengthening or decay. Proving Ground activities are reviewed, including training materials and methods that have been provided to forecasters, and forecaster feedback on these products that has been acquired through formal, detailed assessment of their applicability to a given forecast threat or task. Future opportunities for collaborations around the delivery of training are proposed

  4. Adventure and Extreme Sports.

    Science.gov (United States)

    Gomez, Andrew Thomas; Rao, Ashwin

    2016-03-01

    Adventure and extreme sports often involve unpredictable and inhospitable environments, high velocities, and stunts. These activities vary widely and include sports like BASE jumping, snowboarding, kayaking, and surfing. Increasing interest and participation in adventure and extreme sports warrants understanding by clinicians to facilitate prevention, identification, and treatment of injuries unique to each sport. This article covers alpine skiing and snowboarding, skateboarding, surfing, bungee jumping, BASE jumping, and whitewater sports with emphasis on epidemiology, demographics, general injury mechanisms, specific injuries, chronic injuries, fatality data, and prevention. Overall, most injuries are related to overuse, trauma, and environmental or microbial exposure. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Extremal graph theory

    CERN Document Server

    Bollobas, Bela

    2004-01-01

    The ever-expanding field of extremal graph theory encompasses a diverse array of problem-solving methods, including applications to economics, computer science, and optimization theory. This volume, based on a series of lectures delivered to graduate students at the University of Cambridge, presents a concise yet comprehensive treatment of extremal graph theory.Unlike most graph theory treatises, this text features complete proofs for almost all of its results. Further insights into theory are provided by the numerous exercises of varying degrees of difficulty that accompany each chapter. A

  6. Prediction is Difficult, Especially the Future: A Progress Report

    Directory of Open Access Journals (Sweden)

    Andrew Booth

    2007-03-01

    Full Text Available Objective This paper reviews developments in the consolidation and diversification of the evidence based library and information practice (EBLIP paradigm since publication of the authors’ book Evidence Based Practice for Information Professionals: a Handbook in 2004.Methods The authors provide an updated narrative review of key themes in the development of evidence based librarianship within the context of the new consensual term ‘EBLIP.’ Sources for this thematic framework included professional literature, Internet searches, and the authors’ personal experiences.Results ‐ While considerable achievements have been realized within a three‐year period, most notably the instigation of the journal known as EBLIP, a broadening of the paradigm to other library sectors, and increased availability of implementation studies, many challenges remain. Of particular concern is the lack of international strategic foresight in determining rotation of the biennial international conferences and distribution of influential EBLIP infrastructures and initiatives.Conclusion ‐ While the enthusiasms and energies of individual practitioners and work teams have made considerable progress in meeting short‐term objectives, uncertainty remains concerning how longer‐term objectives requiring infrastructure and resources might be realized. From its faltering steps as a toddler EBLIP has developed to a ‘prepubescent’ stage with the promise of ‘growth spurts’ and ‘emotional crises.’ The next three years should prove both challenging and demanding.

  7. Past and future changes in extreme sea levels and waves

    Digital Repository Service at National Institute of Oceanography (India)

    Lawe, J.A.; Woodworth, P.L.; Knutson, T.; McDonald, R.E.; Mclnnes, K.L.; Woth, K.; Von Storch, H.; Wolf, J.; Swail, V.; Bernier, N.B.; Gulev, S.; Horsburgh, K.J.; Unnikrishnan, A.S.; Hunter, J.R.; Weisse, R.

    of Extreme Sea Level 11.3.1 An Introduction to Storms Both mid-latitude and tropical storms are associated with extremes of sea level. Storm surges are generated by low atmospheric pressure and intense winds over the ocean. The latter also cause high wave... timescales, extremes and mean-sea-level change are both major factors in determining coastal evolution including the development of coastal ecosystems. It will be seen below that, although it is difficult to determine how mean sea level has changed...

  8. Extremes in random fields a theory and its applications

    CERN Document Server

    Yakir, Benjamin

    2013-01-01

    Presents a useful new technique for analyzing the extreme-value behaviour of random fields Modern science typically involves the analysis of increasingly complex data. The extreme values that emerge in the statistical analysis of complex data are often of particular interest. This book focuses on the analytical approximations of the statistical significance of extreme values. Several relatively complex applications of the technique to problems that emerge in practical situations are presented.  All the examples are difficult to analyze using classical methods, and as a result, the author pr

  9. Proving the correctness of unfold/fold program transformations using bisimulation

    DEFF Research Database (Denmark)

    Hamilton, Geoff W.; Jones, Neil

    2011-01-01

    by a labelled transition system whose bisimilarity relation is a congruence that coincides with contextual equivalence. Labelled transition systems are well-suited to represent global program behaviour. On the other hand, unfold/fold program transformations use generalization and folding, and neither is easy......This paper shows that a bisimulation approach can be used to prove the correctness of unfold/fold program transformation algorithms. As an illustration, we show how our approach can be use to prove the correctness of positive supercompilation (due to Sørensen et al). Traditional program equivalence...... to describe contextually, due to use of non-local information. We show that weak bisimulation on labelled transition systems gives an elegant framework to prove contextual equivalence of original and transformed programs. One reason is that folds can be seen in the context of corresponding unfolds....

  10. Formalizing and proving a typing result for security protocols in Isabelle/HOL

    DEFF Research Database (Denmark)

    Hess, Andreas Viktor; Modersheim, Sebastian

    2017-01-01

    or the positive output of a verification tool. However several of these works have used a typed model, where the intruder is restricted to "well-typed" attacks. There also have been several works that show that this is actually not a restriction for a large class of protocols, but all these results so far...... are again pen-and-paper proofs. In this work we present a formalization of such a typing result in Isabelle/HOL. We formalize a constraint-based approach that is used in the proof argument of such typing results, and prove its soundness, completeness and termination. We then formalize and prove the typing...... result itself in Isabelle. Finally, to illustrate the real-world feasibility, we prove that the standard Transport Layer Security (TLS) handshake satisfies the main condition of the typing result....

  11. DIRECTIONS OF EXTREME TOURISM IN UKRAINE

    Directory of Open Access Journals (Sweden)

    L. V. Martseniuk

    2016-02-01

    Full Text Available Purpose. In the world market of tourist services the extreme tourism is very popular, as it does not require the significant financial costs and enables year on year to increase the offers of holiday packages, associated with active travel. Ukraine has significant potential for the development of extreme kinds of rest, but it is not developed enough. Forms of extreme tourism are unknown for domestic tourists, and therefore, they formed a negative attitude. The aim of the article is the analysis of extreme resort potential of Ukraine and promotion of the development of extreme tourism destinations in the travel market. Theoretical and methodological basis of research is the system analysis of the problems of ensuring the competitiveness of the tourism industry, theoretical principles of economic science in the field of the effectiveness of extreme tourism and management of tourist flows. Methodology. The author offers the directions of tourist flows control, which differ from the current expansion of services to tourists in Ukraine. The development of extreme tourism with the help of co-operation of railways and sport federations was proposed. Findings. During the research the author proved that the implementation of the tasks will be promote: 1 increase in budget revenues at all levels of the inner extreme tourism; 2 raise the image of Ukraine and Ukrainian Railways; 3 increase the share of tourism and resorts in the gross domestic product to the level of developed countries; 4 bringing the number of employees in tourism and resorts to the level of developed countries; 5 the creation of an effective system of monitoring the quality of tourist services; 6 the creation of an attractive investment climate for attracting the investment in the broad development of tourism, engineering and transport and municipal infrastructure; 7 improvement the safety of tourists, ensure the effective protection of their rights and legitimate interests and

  12. Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics.

    Science.gov (United States)

    Mushambi, M C; Kinsella, S M; Popat, M; Swales, H; Ramaswamy, K K; Winton, A L; Quinn, A C

    2015-11-01

    The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent the rapid oxygen desaturation seen in pregnant women by advocating nasal oxygenation and mask ventilation immediately after induction; limiting intubation attempts to two; and consideration of early release of cricoid pressure if difficulties are encountered. Algorithm 2 summarises the management after declaring failed tracheal intubation with clear decision points, and encourages early insertion of a (preferably second-generation) supraglottic airway device if appropriate. Algorithm 3 covers the management of the 'can't intubate, can't oxygenate' situation and emergency front-of-neck airway access, including the necessity for timely perimortem caesarean section if maternal oxygenation cannot be achieved. Table 1 gives a structure for assessing the individual factors relevant in the decision to awaken or proceed should intubation fail, which include: urgency related to maternal or fetal factors; seniority of the anaesthetist; obesity of the patient; surgical complexity; aspiration risk; potential difficulty with provision of alternative anaesthesia; and post-induction airway device and airway patency. This decision should be considered by the team in advance of performing a general anaesthetic to make a provisional plan should failed intubation occur. The table is also intended to be used as a teaching tool to facilitate discussion and learning regarding the complex nature of decision-making when faced with a failed intubation. Table 2 gives practical considerations of how to

  13. The in-pile proving test for fuel assembly of Qinshan nuclear power plant

    International Nuclear Information System (INIS)

    Chen Dianshan; Zhang Shucheng; Kang Rixin; Wang Huarong; Chen Guanghan

    1989-10-01

    The in-pile proving test for fuel assembly of Qinshan nuclear power plant had been conducted in the experimental loop of HWRR at IAE (Institute of Atomic Energy) in Beijing, China, from January 1985 to December 1986. Average burnup of 27000 MWd/tU and peak burnup of 34000 MWd/tU of fuel rod had already been reached. The basic status of the experiment are described, emphasis is placed on the discussion of proving test parameters and analysis of experiment results

  14. Stellar extreme ultraviolet astronomy

    International Nuclear Information System (INIS)

    Cash, W.C. Jr.

    1978-01-01

    The design, calibration, and launch of a rocket-borne imaging telescope for extreme ultraviolet astronomy are described. The telescope, which employed diamond-turned grazing incidence optics and a ranicon detector, was launched November 19, 1976, from the White Sands Missile Range. The telescope performed well and returned data on several potential stellar sources of extreme ultraviolet radiation. Upper limits ten to twenty times more sensitive than previously available were obtained for the extreme ultraviolet flux from the white dwarf Sirius B. These limits fall a factor of seven below the flux predicted for the star and demonstrate that the temperature of Sirius B is not 32,000 K as previously measured, but is below 30,000 K. The new upper limits also rule out the photosphere of the white dwarf as the source of the recently reported soft x-rays from Sirius. Two other white dwarf stars, Feige 24 and G191-B2B, were observed. Upper limits on the flux at 300 A were interpreted as lower limits on the interstellar hydrogen column densities to these stars. The lower limits indicate interstellar hydrogen densitites of greater than .02 cm -3 . Four nearby stars (Sirius, Procyon, Capella, and Mirzam) were observed in a search for intense low temperature coronae or extended chromospheres. No extreme ultraviolet radiation from these stars was detected, and upper limits to their coronal emisson measures are derived

  15. Extremity x-ray

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003461.htm Extremity x-ray To use the sharing features on this page, ... in the body Risks There is low-level radiation exposure. X-rays are monitored and regulated to provide the ...

  16. Extremity perfusion for sarcoma

    NARCIS (Netherlands)

    Hoekstra, Harald Joan

    2008-01-01

    For more than 50 years, the technique of extremity perfusion has been explored in the limb salvage treatment of local, recurrent, and multifocal sarcomas. The "discovery" of tumor necrosis factor-or. in combination with melphalan was a real breakthrough in the treatment of primarily irresectable

  17. Statistics of Local Extremes

    DEFF Research Database (Denmark)

    Larsen, Gunner Chr.; Bierbooms, W.; Hansen, Kurt Schaldemose

    2003-01-01

    . A theoretical expression for the probability density function associated with local extremes of a stochasticprocess is presented. The expression is basically based on the lower four statistical moments and a bandwidth parameter. The theoretical expression is subsequently verified by comparison with simulated...

  18. Pipeline developments 1998 and beyond : more choices, more difficult decisions

    International Nuclear Information System (INIS)

    VanderSchee, K.

    1998-01-01

    Some of the basic economic principles that drive gas prices and gas flows across North America, and the pressures these have placed on the pipeline sector, are reviewed. Of pressing importance to the natural gas industry in Western Canada is the prospect that in the near future industrial gas users in eastern Canada will have a wider array of pipeline choices available to them than ever before. This will mean that the users will face more offerings from more pipeline providers, forcing pipeline owners to make more difficult decisions regarding new pipeline capacity. Variables such as price, terms and conditions will become increasingly negotiable. Market power concerns also remain an important issue. As a result, there is increasing call for market-based financial regulation of pipelines. 'Market gaming' a condition where a firm manipulates the market to its own market advantage is also receiving considerable attention. The latter is of particular concern in the United States. Against this background, the nature of competition (or the lack of it) in natural gas transport, the influence of short-term service revenues for pipelines, pipeline commitments through subsidiaries, and concerns over short term pipeline valuations skewing investment decisions, are issues that will continue to invite much attention. Regarding market outlook, it was noted that significantly increased export capacity from Alberta could raise the costs of Alberta supplies to eastern Canadian end-users relative to other supply/transport options which may now be viable economic alternatives. figs

  19. Pipeline developments 1998 and beyond : more choices, more difficult decisions

    Energy Technology Data Exchange (ETDEWEB)

    VanderSchee, K. [EnergyERA (Canada)

    1998-12-31

    Some of the basic economic principles that drive gas prices and gas flows across North America, and the pressures these have placed on the pipeline sector, are reviewed. Of pressing importance to the natural gas industry in Western Canada is the prospect that in the near future industrial gas users in eastern Canada will have a wider array of pipeline choices available to them than ever before. This will mean that the users will face more offerings from more pipeline providers, forcing pipeline owners to make more difficult decisions regarding new pipeline capacity. Variables such as price, terms and conditions will become increasingly negotiable. Market power concerns also remain an important issue. As a result, there is increasing call for market-based financial regulation of pipelines. `Market gaming` a condition where a firm manipulates the market to its own market advantage is also receiving considerable attention. The latter is of particular concern in the United States. Against this background, the nature of competition (or the lack of it) in natural gas transport, the influence of short-term service revenues for pipelines, pipeline commitments through subsidiaries, and concerns over short term pipeline valuations skewing investment decisions, are issues that will continue to invite much attention. Regarding market outlook, it was noted that significantly increased export capacity from Alberta could raise the costs of Alberta supplies to eastern Canadian end-users relative to other supply/transport options which may now be viable economic alternatives. figs.

  20. The Difficult Chore of Measuring Coordination by EXAFS

    International Nuclear Information System (INIS)

    Ravel, B.; Kelly, S. D.

    2007-01-01

    Neither the theory nor the interpretation of Extended X-Ray-Absorption Fine-Structure (EXAFS) spectroscopy requires assumptions of crystalline symmetry or periodicity. As a result, EXAFS is a tool applied to a wide range of scientific disciplines and to a wide variety of experimental systems. A simple enumeration of the atoms in the coordination environment of the absorber is often the primary goal of an EXAFS experiment. There are, however, a number of pitfalls in the way of an accurate determination of coordination number (CN). These include statistical limitations of the EXAFS fitting problem, empirical effects due to sample preparation, and the assumptions made about the physical structure surrounding the absorber in the course of data analysis. In this paper we examine several of these pitfalls and their effects upon the determination of CN. Where possible, we offer suggestions for avoiding or mitigating the pitfalls. We hope this paper will help guide the general EXAFS practitioner through the difficult chore of accurately determining CN

  1. Improving oncology nurses' communication skills for difficult conversations.

    Science.gov (United States)

    Baer, Linda; Weinstein, Elizabeth

    2013-06-01

    When oncology nurses have strong communication skills, they play a pivotal role in influencing patient satisfaction, adherence to plans of care, and overall clinical outcomes. However, research studies indicate that nurses tend to keep communication with patients and families at a superficial, nontherapeutic level. Processes for teaching goals-of-care communication skills and for implementing skills into clinical practice are not clearly defined. Nurses at a large comprehensive cancer center recognized the need for help with this skill set and sought out communication experts to assist in providing the needed education. An educational project was developed to improve therapeutic communication skills in oncology nurses during goals-of-care discussions and giving bad news. The program was tailored to nurses and social workers providing care to patients in a busy, urban, academic, outpatient oncology setting. Program topics included exploring the patient's world, eliciting hopes and concerns, and dealing with conflict about goals. Sharing and discussing specific difficult questions and scenarios were encouraged throughout the program. The program was well attended and well received by oncology nurses and social workers. Participants expressed interest in the continuation of communication programs to further enhance skills.

  2. [Decubitus ulcer in the calcaneus region: rapid development, difficult recovery].

    Science.gov (United States)

    Fugazza, G; Bona, F

    1996-03-01

    Heel pressure sores frequently arise in patients kept in bed for a long time independently of their primary disease. In account of this event the authors completed a study concerning possible mutual relations between heel pressure sores and primary disease of the patients; to validate the pharmacological treatment in less severe sores and the surgical resolution in more serious cutaneous lesions. In the last 3 years (1992-1995) at the Rehabilitation Centre of Montescano the authors have treated 39 patients suffering from 63 different severe cutaneous lesions: from phlycten to deep necrosis. The therapeutic plane utilized pharmacological treatment for 1st, 2nd, 3rd degree pressure sores, and surgical treatment for 4th degree. Pharmacological treatment included: enzymatic drugs, bactericidal and bacteriostatic medicines and cicatrizing substances. Different healing times were related to different pressure sore severity. Surgical treatment consisted of transposition of flap into wound defect. This system caused considerable reduction in resolution times. The authors noticed how easily pressure sores arise in the heel region, and how difficultly they heal. This is probably connected with particular anatomical and vascular characteristics of this region.

  3. Genetic evidence of multiple loci in dystocia - difficult labour

    Directory of Open Access Journals (Sweden)

    Westgren Magnus

    2010-06-01

    Full Text Available Abstract Background Dystocia, difficult labour, is a common but also complex problem during childbirth. It can be attributed to either weak contractions of the uterus, a large infant, reduced capacity of the pelvis or combinations of these. Previous studies have indicated that there is a genetic component in the susceptibility of experiencing dystocia. The purpose of this study was to identify susceptibility genes in dystocia. Methods A total of 104 women in 47 families were included where at least two sisters had undergone caesarean section at a gestational length of 286 days or more at their first delivery. Study of medical records and a telephone interview was performed to identify subjects with dystocia. Whole-genome scanning using Affymetrix genotyping-arrays and non-parametric linkage (NPL analysis was made in 39 women exhibiting the phenotype of dystocia from 19 families. In 68 women re-sequencing was performed of candidate genes showing suggestive linkage: oxytocin (OXT on chromosome 20 and oxytocin-receptor (OXTR on chromosome 3. Results We found a trend towards linkage with suggestive NPL-score (3.15 on chromosome 12p12. Suggestive linkage peaks were observed on chromosomes 3, 4, 6, 10, 20. Re-sequencing of OXT and OXTR did not reveal any causal variants. Conclusions Dystocia is likely to have a genetic component with variations in multiple genes affecting the patient outcome. We found 6 loci that could be re-evaluated in larger patient cohorts.

  4. Genetic evidence of multiple loci in dystocia - difficult labour

    Science.gov (United States)

    2010-01-01

    Background Dystocia, difficult labour, is a common but also complex problem during childbirth. It can be attributed to either weak contractions of the uterus, a large infant, reduced capacity of the pelvis or combinations of these. Previous studies have indicated that there is a genetic component in the susceptibility of experiencing dystocia. The purpose of this study was to identify susceptibility genes in dystocia. Methods A total of 104 women in 47 families were included where at least two sisters had undergone caesarean section at a gestational length of 286 days or more at their first delivery. Study of medical records and a telephone interview was performed to identify subjects with dystocia. Whole-genome scanning using Affymetrix genotyping-arrays and non-parametric linkage (NPL) analysis was made in 39 women exhibiting the phenotype of dystocia from 19 families. In 68 women re-sequencing was performed of candidate genes showing suggestive linkage: oxytocin (OXT) on chromosome 20 and oxytocin-receptor (OXTR) on chromosome 3. Results We found a trend towards linkage with suggestive NPL-score (3.15) on chromosome 12p12. Suggestive linkage peaks were observed on chromosomes 3, 4, 6, 10, 20. Re-sequencing of OXT and OXTR did not reveal any causal variants. Conclusions Dystocia is likely to have a genetic component with variations in multiple genes affecting the patient outcome. We found 6 loci that could be re-evaluated in larger patient cohorts. PMID:20587075

  5. Simultaneous Optimization of Tallies in Difficult Shielding Problems

    International Nuclear Information System (INIS)

    Peplow, Douglas E.; Evans, Thomas M.; Wagner, John C.

    2008-01-01

    Monte Carlo is quite useful for calculating specific quantities in complex transport problems. Many variance reduction strategies have been developed that accelerate Monte Carlo calculations for specific tallies. However, when trying to calculate multiple tallies or a mesh tally, users have had to accept different levels of relative uncertainty among the tallies or run separate calculations optimized for each individual tally. To address this limitation, an extension of the CADIS (Consistent Adjoint Driven Importance Sampling) method, which is used for difficult source/detector problems, has been developed to optimize several tallies or the cells of a mesh tally simultaneously. The basis for this method is the development of an importance function that represents the importance of particles to the objective of uniform Monte Carlo particle density in the desired tally regions. This method utilizes the results of a forward discrete ordinates solution, which may be based on a quick, coarse-mesh calculation, to develop a forward-weighted source for the adjoint calculation. The importance map and the biased source computed from the adjoint flux are then used in the forward Monte Carlo calculation to obtain approximately uniform relative uncertainties for the desired tallies. This extension is called forward-weighted CADIS, or FW-CADIS

  6. Radionuclides difficult to measure in waste packages. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Thierfeldt, S; Deckert, A [Brenk Systemplanung, Aachen (Germany)

    1995-11-01

    In this study nuclide specific correlation analyses between key nuclides that can be easily measured and nuclides that are difficult to measure are presented. Data are taken from studies and data compilations from various countries. The results of this study can serve to perform assays of the nuclide specific radionuclide contents in waste packages by gamma measurements of {sup 60}Co and {sup 137}Cs and calculation of the contents of other nuclides via the correlation analyses, sometimes referred to as `scaling factor method`. It can thus be avoided to have to take samples from the waste for separate analysis. An attempt is made to also investigate the physical and chemical backgrounds behind the proposed correlations. For example, a formation pathway common to the two nuclides to be correlated can be regarded as an explanation, if a good correlation is found. On the other hand, if the observed correlation is of poor quality, reasons may possibly lie in different behaviour of the two nuclides in the water system of the nuclear plant. This implies not only chemical solubility, transfer constants etc. in the water system, which would not only affect the proportionality between the two nuclides, but a different behavior in different parts of the water system must be assumed (e.g. different filter efficiencies etc). 47 refs, 57 figs, 40 tabs.

  7. A technical solution to a difficult problem - An update

    International Nuclear Information System (INIS)

    Asselstine, J.K.

    1985-01-01

    A goal of the Reduced Enrichment Research and Test Reactor Program (RERTR) established by the U.S. Department of Energy is to develop the technical means needed to utilize LEU instead of HEU fuels in research and test reactors and to do so without operational penalties and without affecting safety characteristics. This goal has been pursued now for seven years in cooperation with many of you who are participants in this conference. The program has made significant progress in the development, demonstration and application of new LEU research reactor fuels. According to recent projections, the percentage of HEU fuel in international commerce which is technically replaceable with LEU fuels has been growing steadily as research continues. There appears to be no technical barrier to eventual replacement of HEU fuel with LEU fuel in research and test reactors. While there are many politically complex and technically difficult issues involved in nonproliferation, I conclude that the use of highly enriched weapons grade uranium as a fuel in civilian research reactors stands out as one problem which has a straight forward technical solution. The technical solution is the effort you in the RERTR program are embarked on. Once that solution is in hand, the operators of research reactors are urged to take political and legal initiatives to make the conversion happen. By effecting this conversion they will help minimize the trade in highly enriched uranium and make the world a little safer

  8. Protection of mineral deposits - a way towards difficult compromises

    Science.gov (United States)

    Radwanek-Bąk, Barbara; Nieć, Marek

    2014-05-01

    Mineral deposits are non-renewable natural resources. Their protection and reasonable exploitation are crucial requests resulting from sustainable development principles. Those are also fundamental issues in frame of the intergeneration justice and fairness concept. Protection of mineral resources should be based on interrelated activities: maintaining the possibility of economic use of the identified mineral resources, reduced consumption of mineral resources and ensuring satisfactory results of new prospecting and development of innovative technologies for the mineral resources base. The main problem with guarantee to the use of mineral resources is the accessibility to sites with documented deposits and prospective areas of their occurrence. Often, this contradicts with the interests of residents, planners and needs of the biotic environment protection, thus is often a source of conflicts. Legislative regulations are necessary to mitigate such arguable matters. SWOT analysis carried out with respect to introducing such legal regulations serves to identify the sources of conflicts and difficulties associated with their solution. Consensus reaching is a difficult task, so all decision makers are required to show their mutual understanding and willingness to achieve the goals taking into consideration all benefits for the population (including future generations). Foundations for finding the middle ground are: making the communities aware of their demands on minerals and of indispensable conditions for satisfying these demands; providing complete and accessible information; factual, non-emotional negotiations between decision makers and the public.

  9. Difficult issues in mentoring: recommendations on making the "undiscussable" discussable.

    Science.gov (United States)

    Bickel, Janet; Rosenthal, Susan L

    2011-10-01

    Many mentoring relationships do not reach fruition because the individuals fail to bridge a critical difference. When a difference prevents a learning partnership from achieving its potential, the loss is multidimensional for the individuals and the institution--wasting opportunities for the fostering of current and future talent. Insights into when such impasses are likely to arise may help both mentors and mentees address what feels "undiscussable." The authors offer numerous examples of how differences related to ethnicity, language, gender, and generation may interfere with the development of mentoring relationships. Next, the authors offer recommendations on preparing for and handling difficult conversations, including creating safety, noticing assumptions and emotions, and raising sensitive issues. Virtually all faculty can become more effective at communicating across differences and addressing difficulties that prevent mentoring relationships from achieving their potential. The pay-offs for these efforts are indisputable: increased effect in the limited time available for mentoring, an expanded legacy of positive influence, and enhanced communication and leadership skills. The honing of these relational skills enhances the colleagueship and teamwork on which virtually all research, clinical, and educational enterprises depend. Academic health centers that systematically support mentoring enhance institutional stability, talent development, and leadership capacity.

  10. Plasma hot machining for difficult-to-cut materials, 1

    International Nuclear Information System (INIS)

    Kitagawa, Takeaki; Maekawa, Katsuhiro; Kubo, Akihiko

    1987-01-01

    Machinability of difficult-to-cut materials has been a great concern to manufacturing engineers since demands for new materials in the aerospace and nuclear industries are more and more increasing. The purpose of this study is to develop a hot machining to improve machinability of high hardness materials. A plasma arc is used for heating materials cut. The surface just after being heated is removed as a chip by tungsten carbide tools. The turning experiments of high hardness steels with aid of plasma arc heating show not only the decrease in cutting forces but also the following effectiveness: (1) The application of the plasma hot machining to the condition, under which a built-up edge (BUE) appears in turning 0.46%C steel, makes the BUE disappeared, bringing less flank wear. (2) In the case of 18%Mn steel cutting, deep groove wear on the end-cutting edge diminishes, and roughness of the machined surface is improved by the prevention from chatter. (3) Although the chilled cast iron has high hardness of above HB = 350, the plasma hot machining makes it possible to cut it with tungsten carbide tools having less chipping and flank wear. (author)

  11. Nuclear energy and public opinion - a difficult relationship

    International Nuclear Information System (INIS)

    Kaase, M.

    1990-01-01

    Nuclear energy remains an explosive subject. Less people demand to give up nuclear energy at once but the emotional and cognitive environment of attitudes to nuclear energy makes this relative 'peaceabilty' seem a very precarious issue. The Chernobyl shock is still active. The future will depend on whether new accidents will occur in nuclear power stations and how dangerous they will be. The highly political nature and the polarization of the subject together with an assumingly still negative coverage by the mass media and a general distrust of the people in established politics will make it very difficult to influence attitudes by means of information. We should attempt to bring sober facts and objectiveness to the discussion of nuclear energy and to involve citizens more actively than in the past while ensuring that there is less auto-selectivity (bias). What we also need is the basic and credible readiness of all participants to accept the results of a democratic process of the development of opinion. (orig./HSCH) [de

  12. A technical solution to a difficult problem - An update

    Energy Technology Data Exchange (ETDEWEB)

    Asselstine, J K

    1985-07-01

    A goal of the Reduced Enrichment Research and Test Reactor Program (RERTR) established by the U.S. Department of Energy is to develop the technical means needed to utilize LEU instead of HEU fuels in research and test reactors and to do so without operational penalties and without affecting safety characteristics. This goal has been pursued now for seven years in cooperation with many of you who are participants in this conference. The program has made significant progress in the development, demonstration and application of new LEU research reactor fuels. According to recent projections, the percentage of HEU fuel in international commerce which is technically replaceable with LEU fuels has been growing steadily as research continues. There appears to be no technical barrier to eventual replacement of HEU fuel with LEU fuel in research and test reactors. While there are many politically complex and technically difficult issues involved in nonproliferation, I conclude that the use of highly enriched weapons grade uranium as a fuel in civilian research reactors stands out as one problem which has a straight forward technical solution. The technical solution is the effort you in the RERTR program are embarked on. Once that solution is in hand, the operators of research reactors are urged to take political and legal initiatives to make the conversion happen. By effecting this conversion they will help minimize the trade in highly enriched uranium and make the world a little safer.

  13. Red Indian Lake fishway, an innovative design for difficult conditions

    International Nuclear Information System (INIS)

    Helwig, P.C.; Goosney, R.; Smith, W.L.

    1993-01-01

    Red Indian Lake Dam is a large concrete gravity structure, 10-12 m high and 245 m long, in the Exploits River watershed in Newfoundland. The watershed is an ideal habitat for production of Atlantic salmon. Since 1985, the watershed above the dam has undergone an extensive stocking program to optimize the salmon production capacity of the upper reaches of the system. To sustain this development, a fishway was needed to permit returning salmon to bypass Red Indian Lake Dam, the last remaining migrational barrier. The difficulties with installing a fishway at the dam site included extreme variation in upstream water levels, the need to retrofit a fishway into an existing structure, and the necessity to attract fish into the fishway in competition with other flows from power plant, spillway, or waterfall. After examining several design approaches, an innovative design was developed incorporating two separate but interrelated flow ways: one to handle attraction water and the other for transportation water. The latter passage leads to a trap at the upper end of the fishway from which salmon are hoisted via a hopper/monorail system across the dam and into the lake. Construction of the fishway was staged over four phases between December 1985 and December 1988. 3 refs., 1 fig

  14. Soft tissue masses of extremities: MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Son, Seok Hyun; Yang, Seoung Oh; Choi, Jong Chul; Park, Byeong Ho; Lee, Ki Nam; Choi, Sun Seob; Chung, Duck Hwan [Dong-A University College of Medicine, Pusan (Korea, Republic of)

    1993-11-15

    To evaluate MR findings of soft tissue masses in extremities and to find the helpful findings of distinguish benignity from malignancy, 28 soft tissue masses (22 benign and 6 malignant) in extremities were reviewed. TI-weighted, proton density, T2-weighted and Gd-DTPA enhanced images were obtained. MR images allowed a specific diagnosis in large number of benign masses, such as hemangioma(8/9), lipoma(2/2), angiolipoma(1/1), epidermoid cyst(2/2), myositis ossificans(1/1), synovial chondromatosis(1/1) and pigmented villonodular synovitis(1/2). Specific diagnosis was difficult in the rest of the masses including malignancy. However, inhomogeneous signal intensities with necrosis and inhomogeneous enhancement may suggest malignant masses.

  15. The “incredible” difficulty of proving “incredibility” – Example of fire-induced multiple spurious operations

    International Nuclear Information System (INIS)

    Gallucci, Raymond H.V.

    2016-01-01

    “Risk-informed” regulation is often an alternative to “deterministically-based” regulation that offers relaxation in criteria for acceptability while possibly requiring greater analytical effort. “Risk-informed determinism” is an attempt to meld the best of both worlds by using risk information to set deterministic acceptance criteria a priori. A recent joint effort by the US Nuclear Regulatory Commission’s Office of Nuclear Regulatory Research (RES) and Electric Power Research Institute (EPRI) originally endeavored to do this for several examples involving fire-induced multiple spurious operations (MSOs) in electrical circuits at nuclear power plants. While a noble effort, this did not consider the actual distributions involved in the events, originally limiting the analysis to mean values and, in some cases, qualitative considerations. A much more comprehensive and defensible approach is performed here where the probabilistic distributions for all the factors are considered via simulation to meet quantitative acceptance criteria related to the concept of “incredibility” that is often the figure of merit that must be met in a deterministic world. The effort demonstrates that it can be “incredibly” difficult to prove “incredibility” in this context.

  16. The “incredible” difficulty of proving “incredibility” – Example of fire-induced multiple spurious operations

    Energy Technology Data Exchange (ETDEWEB)

    Gallucci, Raymond H.V., E-mail: Ray.Gallucci@nrc.gov

    2016-11-15

    “Risk-informed” regulation is often an alternative to “deterministically-based” regulation that offers relaxation in criteria for acceptability while possibly requiring greater analytical effort. “Risk-informed determinism” is an attempt to meld the best of both worlds by using risk information to set deterministic acceptance criteria a priori. A recent joint effort by the US Nuclear Regulatory Commission’s Office of Nuclear Regulatory Research (RES) and Electric Power Research Institute (EPRI) originally endeavored to do this for several examples involving fire-induced multiple spurious operations (MSOs) in electrical circuits at nuclear power plants. While a noble effort, this did not consider the actual distributions involved in the events, originally limiting the analysis to mean values and, in some cases, qualitative considerations. A much more comprehensive and defensible approach is performed here where the probabilistic distributions for all the factors are considered via simulation to meet quantitative acceptance criteria related to the concept of “incredibility” that is often the figure of merit that must be met in a deterministic world. The effort demonstrates that it can be “incredibly” difficult to prove “incredibility” in this context.

  17. Origin of choriocarcinoma in previous molar pregnancy proved by DNA analysis

    International Nuclear Information System (INIS)

    Vojtassak, J.; Repiska, V.; Konecna, B.; Zajac, V.; Korbel, M.; Danihel, L.

    1996-01-01

    A 17-year old woman had in a short time period (seven months) a very exciting reproduction history. Molar pregnancy in December 1993, choriocarcinoma in January 1994 and induced abortion in June 1994. DNA analysis proved the origin of the choriocarcinoma in the previous molar pregnancy. (author)

  18. Automatically Proving Termination and Memory Safety for Programs with Pointer Arithmetic

    DEFF Research Database (Denmark)

    Ströder, Thomas; Giesl, Jürgen; Brockschmidt, Marc

    2017-01-01

    While automated verification of imperative programs has been studied intensively, proving termination of programs with explicit pointer arithmetic fully automatically was still an open problem. To close this gap, we introduce a novel abstract domain that can track allocated memory in detail. We use...

  19. Wind tunnel experiments to prove a hydraulic passive torque control concept for variable speed wind turbines

    NARCIS (Netherlands)

    Diepeveen, N.F.B.; Jarquin-Laguna, A.

    2014-01-01

    In this paper the results are presented of experiments to prove an innovative concept for passive torque control of variable speed wind turbines using fluid power technology. It is demonstrated that by correctly configuring the hydraulic drive train, the wind turbine rotor operates at or near

  20. 20 CFR 416.1603 - How to prove you are a resident of the United States.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false How to prove you are a resident of the United States. 416.1603 Section 416.1603 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... as— (1) Property, income, or other tax forms or receipts; (2) Utility bills, leases or rent payment...

  1. Using eternity variables to specify and prove a serializable database interface

    NARCIS (Netherlands)

    Hesselink, Wim H.

    Eternity variables are introduced to specify and verify serializability of transactions of a distributed database. Eternity variables are a new kind of auxiliary variables. They do not occur in the implementation but are used in specification and verification. Elsewhere it has been proved that

  2. Proving termination of graph transformation systems using weighted type graphs over semirings

    NARCIS (Netherlands)

    Bruggink, H.J.S.; König, B.; Nolte, D.; Zantema, H.; Parisi-Presicce, F.; Westfechtel, B.

    2015-01-01

    We introduce techniques for proving uniform termination of graph transformation systems, based on matrix interpretations for string rewriting. We generalize this technique by adapting it to graph rewriting instead of string rewriting and by generalizing to ordered semirings. In this way we obtain a

  3. Proof and Proving: Logic, Impasses, and the Relationship to Problem Solving

    Science.gov (United States)

    Savic, Milos

    2012-01-01

    Becoming a skillful prover is critical for success in advanced undergraduate and graduate mathematics courses. In this dissertation, I report my investigations of proof and the proving process in three separate studies. In the first study, I examined the amount of logic used in student-constructed proofs to help in the design of…

  4. The Secret Prover : Proving Possession of Arbitrary Files While not Giving Them Away

    NARCIS (Netherlands)

    Teepe, Wouter

    2005-01-01

    The Secret Prover is a Java application which allows a user (A) to prove to another user (B), that A possesses a file. If B also possesses this file B will get convinced, and if B does not possess this file B will gain no information on (the contents of) this file. This is the first implementation

  5. Public health in Kosovo after five difficult years of independence

    Directory of Open Access Journals (Sweden)

    Naim Jerliu

    2015-12-01

    administration. Regarding the health status, five years after independence, compared with other European countries, post-war transitional Kosovo is still characterized by higher mortality rates including traditional public health problems pertinent to infant mortality and maternal deaths. In parallel, however, Kosovo is undergoing a rapid process of epidemiological transition characterized by an aging trend which is inevitably coupled with high cardiovascular and cancer mortality and morbidity along with an excess mortality in external causes of death and injuries among the adult population. Adoption of the new Health Law in December 2012 by the Kosovo Assembly aims the transition from centralized health care system established under emergency conditions of the post-war period towards a contemporary modern health care system with a clear purchaser-provider split based on a high transparency and accountability of the health care providers and their contractors. The health care reform, leading eventually to significant changes within the health sector in Kosovo, consists of two main pillars: (i structural and functional reorganization of the health care system through establishment of Kosovo Health Service (an autonomous and non-for-profit public enterprise at central level of the health care sector, and; (ii establishment for the first time of the public health insurance system with a Health Insurance Fund as its main body. Nevertheless, five years after declaration of independence, Kosovo, the newest state in Europe consisting of the youngest population, is currently facing a particularly difficult socioeconomic and political transition and is additionally struggling and mainstreaming all energies and efforts in order to get full international recognition.

  6. Species delimitation in taxonomically difficult fungi: the case of Hymenogaster.

    Directory of Open Access Journals (Sweden)

    Benjamin Stielow

    2011-01-01

    Full Text Available False truffles are ecologically important as mycorrhizal partners of trees and evolutionarily highly interesting as the result of a shift from epigeous mushroom-like to underground fruiting bodies. Since its first description by Vittadini in 1831, inappropriate species concepts in the highly diverse false truffle genus Hymenogaster has led to continued confusion, caused by a large variety of prevailing taxonomical opinions.In this study, we reconsidered the species delimitations in Hymenogaster based on a comprehensive collection of Central European taxa comprising more than 140 fruiting bodies from 20 years of field work. The ITS rDNA sequence dataset was subjected to phylogenetic analysis as well as clustering optimization using OPTSIL software.Among distinct species concepts from the literature used to create reference partitions for clustering optimization, the broadest concept resulted in the highest agreement with the ITS data. Our results indicate a highly variable morphology of H. citrinus and H. griseus, most likely linked to environmental influences on the phenology (maturity, habitat, soil type and growing season. In particular, taxa described in the 19(th century frequently appear as conspecific. Conversely, H. niveus appears as species complex comprising seven cryptic species with almost identical macro- and micromorphology. H. intermedius and H. huthii are described as novel species, each of which with a distinct morphology intermediate between two species complexes. A revised taxonomy for one of the most taxonomically difficult genera of Basidiomycetes is proposed, including an updated identification key. The (semi-automated selection among species concepts used here is of importance for the revision of taxonomically problematic organism groups in general.

  7. Techniques for assisting difficult delivery at caesarean section.

    Science.gov (United States)

    Waterfall, Heather; Grivell, Rosalie M; Dodd, Jodie M

    2016-01-31

    Caesarean section involves making an incision in the woman's abdomen and cutting through the uterine muscle. The baby is then delivered through that incision. Difficult caesarean birth may result in injury for the infant or complications for the mother. Methods to assist with delivery include vacuum or forceps extraction or manual delivery utilising fundal pressure. Medication that relaxes the uterus (tocolytic medication) may facilitate the birth of the baby at caesarean section. Delivery of the impacted head after prolonged obstructed labour can be associated with significant maternal and neonatal complication; to facilitate delivery of the head the surgeon may utilise either reverse breech extraction or head pushing. To compare the use of tocolysis (routine or selective use) with no use of tocolysis or placebo and to compare different extraction methods at the time of caesarean section for outcomes of infant birth trauma, maternal complications (particularly postpartum haemorrhage requiring blood transfusion), and long-term measures of infant and childhood morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2015) and reference lists of retrieved studies. All published, unpublished, and ongoing randomised controlled trials comparing the use of tocolytic agents (routine or selective) at caesarean section versus no use of tocolytic or placebo at caesarean section to facilitate the birth of the baby. Use of instrument versus manual delivery to facilitate birth of the baby. Reverse breech extraction versus head pushing to facilitate delivery of the deeply impacted fetal head. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Seven randomised controlled trials, involving 582 women undergoing caesarean section were included in this review. The risk of bias of included trials was variable, with some trials not adequately describing allocation or

  8. Maritime Military Decision Making in Environments of Extreme Information Ambiguity: An Initial Exploration

    National Research Council Canada - National Science Library

    Reeves, Andrew T

    2005-01-01

    ... to make effective decisions. An environment of extreme information ambiguity, a dependent variable, is one of the most difficult components of a battle where the decision maker may reach a confusing and debilitating point...

  9. Extremes in nature

    CERN Document Server

    Salvadori, Gianfausto; Kottegoda, Nathabandu T

    2007-01-01

    This book is about the theoretical and practical aspects of the statistics of Extreme Events in Nature. Most importantly, this is the first text in which Copulas are introduced and used in Geophysics. Several topics are fully original, and show how standard models and calculations can be improved by exploiting the opportunities offered by Copulas. In addition, new quantities useful for design and risk assessment are introduced.

  10. Noninvasive carcinoma ex pleomorphic adenoma of the parotid gland: A difficult diagnosis on fine needle aspiration

    Directory of Open Access Journals (Sweden)

    Theresa Scognamiglio

    2015-01-01

    Full Text Available Carcinoma ex pleomorphic adenoma (CXPA is a rare epithelial malignancy that arises from a primary or recurrent pleomorphic adenoma (PA. It may be noninvasive (NI or invasive. NI CXPA is extremely rare. Preoperative diagnosis on fine needle aspiration (FNA of CXPA may be difficult and poses a diagnostic challenge to clinicians and pathologists. Herein, we describe the FNA findings of a case of NI-CXPA. A 69-year-old woman presented with rapid enlargement of a stable parotid mass of 25 years. Cytologically, malignant cells were focally associated with metachromatic fibromyxoid matrix that was homogeneous and dense with a vague fibrillary quality. There were cell groups, papillary-like clusters and single malignant cells. The nuclei were pleomorphic with irregularly dispersed chromatin, and the cytoplasm was ill-defined and granular. Nucleoli were small to inconspicuous. Mitoses and necrosis were not seen. Cytological features were not specific for any type of salivary gland carcinoma. The FNA diagnosis was primary high-grade adenocarcinoma of the parotid gland, not otherwise specified. Facial nerve-sparing total parotidectomy was performed, which histologically showed PA interspersed with ducts and nests composed of pleomorphic atypical nuclei surrounded by extensive hyalinization. Single cells were also noted. No capsular infiltration was seen in the entirely sampled tumor. Immunohistochemistry for Ki-67 showed a higher proliferation rate in the malignant ducts and p63 positive cells focally surrounded some of the malignant ducts. Histological diagnosis was NI-CXPA. Accurate diagnosis is important for proper surgical management; however, the preoperative diagnosis of NI-CXPA is difficult to make on FNA.

  11. Noninvasive carcinoma ex pleomorphic adenoma of the parotid gland: A difficult diagnosis on fine needle aspiration

    Science.gov (United States)

    Scognamiglio, Theresa; Joshi, Rohan; Kuhel, William I.; Tabbara, Sana O.; Rezaei, M. Katayoon; Hoda, Rana S.

    2015-01-01

    Carcinoma ex pleomorphic adenoma (CXPA) is a rare epithelial malignancy that arises from a primary or recurrent pleomorphic adenoma (PA). It may be noninvasive (NI) or invasive. NI CXPA is extremely rare. Preoperative diagnosis on fine needle aspiration (FNA) of CXPA may be difficult and poses a diagnostic challenge to clinicians and pathologists. Herein, we describe the FNA findings of a case of NI-CXPA. A 69-year-old woman presented with rapid enlargement of a stable parotid mass of 25 years. Cytologically, malignant cells were focally associated with metachromatic fibromyxoid matrix that was homogeneous and dense with a vague fibrillary quality. There were cell groups, papillary-like clusters and single malignant cells. The nuclei were pleomorphic with irregularly dispersed chromatin, and the cytoplasm was ill-defined and granular. Nucleoli were small to inconspicuous. Mitoses and necrosis were not seen. Cytological features were not specific for any type of salivary gland carcinoma. The FNA diagnosis was primary high-grade adenocarcinoma of the parotid gland, not otherwise specified. Facial nerve-sparing total parotidectomy was performed, which histologically showed PA interspersed with ducts and nests composed of pleomorphic atypical nuclei surrounded by extensive hyalinization. Single cells were also noted. No capsular infiltration was seen in the entirely sampled tumor. Immunohistochemistry for Ki-67 showed a higher proliferation rate in the malignant ducts and p63 positive cells focally surrounded some of the malignant ducts. Histological diagnosis was NI-CXPA. Accurate diagnosis is important for proper surgical management; however, the preoperative diagnosis of NI-CXPA is difficult to make on FNA. PMID:25972908

  12. Rhabdomyosarcoma of the extremity

    International Nuclear Information System (INIS)

    Rao, Bhaskar N

    1997-01-01

    Rhabdomyosarcoma is the most common soft tissue sarcoma accounting for almost 55%. These tumors arise from unsegmented mesoderm or primitive mesenchyma, which have the capacity to differentiate into muscle. Less than 5% occur in the first year of life. Extremity rhabdomyosarcoma are mainly seen in the adolescent years. The most common histologic subtype is the alveolar variant. Other characteristics of extremity rhabdomyosarcoma include a predilection for lymph node metastasis, a high local failure, and a relatively low survival rate. They often present as slow painless masses; however, lesions in the hand and foot often present as painful masses and imaging studies may show invasion of the bone. Initial diagnostic approaches include needle biopsy or incisional biopsy for larger lesions. Excisional biopsy is indicated preferably for lesions less than 2.5 cm. following this in most instances therapy is initiated with multi agent chemotherapy depending upon response, the next modality may be either surgery with intent to cure or radiation therapy. Amputation of an extremity for local control is not considered in most instances. Prognostic factors that have been determined over the years to be of significance by multi variant analysis have included age, tumor size, invasiveness, presence of either nodal or distant metastasis, and complete excision whenever feasible, with supplemental radiation therapy for local control

  13. Pulmonary embolism and difficult-to-treat asthma

    Directory of Open Access Journals (Sweden)

    Catarina Teles Martins

    2007-11-01

    Full Text Available Asthma control is a key point in patient management. GINA's most recent report emphasises the need to investigate uncontrolled asthma, of which non-compliance with treatment, COPD, smoking, chronic sinusitis, gastroesophageal reflux disease and obesity are the usual causes.The aim of this work is to evaluate the role of pulmonary thromboembolism (PTE in cases of difficult-to-treat asthma. We reviewed the case reports of patients with severe persistent asthma followed in our Asthma Outpatients Clinic between 2004 and 2006. We selected the ones that maintained uncontrolled disease despite an optimal therapeutical approach and investigated the causes.In this group (n = 254, 28 (11% had severe persistent asthma and their mean age was 44 ± SD18 years old. 86% were females. Of these, 57% (n = 16 had uncontrolled disease: 35% (n = 6 due to non-compliance with treatment; 29% (n = 5 pulmonary thrombombolism (scintigraphic confirmation; 12% (n = 2 severe rhinosinusitis; 6% (n = 1 hypereosinophilic syndrome; 6% (n = 1 persistent allergen exposure and 6% (n = 1 are still being investigated.Patients with TPE (mean age 56 ± SD9 years old; 80% females; 80% Caucasians were diagnosed with asthma as adults (mean age 37 ± SD14 years old. The mean time until the diagnosis of TPE was 18 ± SD12 years. Predisposing factors for TPE were venous insufficiency (40%, hypertension (40% and deficit of functional protein C and S (20%.All these patients received anticoagulant therapy (80% are still medicated. It should be noted that after the beginning of anticoagulants, 40% of the patients achieved control of their asthma and 40% have partially controlled disease. There were no hospital admissions for asthma exacerbations after the beginning of anticoagulation in this group.This study supports the inclusion of TPE in the group of comorbidities to consider while investigating uncontrolled

  14. Impact of cooking, proving, and baking on the (poly)phenol content of wild blueberry.

    Science.gov (United States)

    Rodriguez-Mateos, Ana; Cifuentes-Gomez, Tania; George, Trevor W; Spencer, Jeremy P E

    2014-05-07

    Accumulating evidence suggests that diets rich in (poly)phenols may have positive effects on human health. Currently there is limited information regarding the effects of processing on the (poly)phenolic content of berries, in particular in processes related to the baking industry. This study investigated the impact of cooking, proving, and baking on the anthocyanin, procyanidin, flavonol, and phenolic acid contents of wild blueberry using HPLC with UV and fluorescence detection. Anthocyanin levels decreased during cooking, proving, and baking, whereas no significant changes were observed for total procyanidins. However, lower molecular weight procyanidins increased and high molecular weight oligomers decreased during the process. Quercetin and ferulic and caffeic acid levels remained constant, whereas increases were found for chlorogenic acid. Due to their possible health benefits, a better understanding of the impact of processing is important to maximize the retention of these phytochemicals in berry-containing products.

  15. Research in advanced formal theorem-proving techniques. [design and implementation of computer languages

    Science.gov (United States)

    Raphael, B.; Fikes, R.; Waldinger, R.

    1973-01-01

    The results are summarised of a project aimed at the design and implementation of computer languages to aid in expressing problem solving procedures in several areas of artificial intelligence including automatic programming, theorem proving, and robot planning. The principal results of the project were the design and implementation of two complete systems, QA4 and QLISP, and their preliminary experimental use. The various applications of both QA4 and QLISP are given.

  16. Remedial investigation report for J-Field, Aberdeen Proving Ground, Maryland. Volume 3: Ecological risk assessment

    International Nuclear Information System (INIS)

    Hlohowskyj, I.; Hayse, J.; Kuperman, R.; Van Lonkhuyzen, R.

    2000-01-01

    The Environmental Management Division of the U.S. Army Aberdeen Proving Ground (APG), Maryland, is conducting a remedial investigation (RI) and feasibility study (FS) of the J-Field area at APG, pursuant to the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), as amended. As part of that activity, Argonne National Laboratory (ANL) conducted an ecological risk assessment (ERA) of the J-Field site. This report presents the results of that assessment

  17. Remedial investigation report for J-Field, Aberdeen Proving Ground, Maryland. Volume 3: Ecological risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Hlohowskyj, I.; Hayse, J.; Kuperman, R.; Van Lonkhuyzen, R.

    2000-02-25

    The Environmental Management Division of the U.S. Army Aberdeen Proving Ground (APG), Maryland, is conducting a remedial investigation (RI) and feasibility study (FS) of the J-Field area at APG, pursuant to the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), as amended. As part of that activity, Argonne National Laboratory (ANL) conducted an ecological risk assessment (ERA) of the J-Field site. This report presents the results of that assessment.

  18. An Archeological Overview and Management Plan for the Dugway Proving Ground.

    Science.gov (United States)

    1984-03-29

    niches, particulary the lacustrine environment of the Great Basin (Baumhoff and Heizer 1965, Butler 1978, Heizer and Krieger 1956, Heizer and Harper...power that would capture the animals souls, rendering them docile and stupid (Steward 1970:34). Other large game was present, but were not numerous...uni versity. Baum, Bernard. 1947. Dugway Proving Ground. Aberdeen: U.S. Army Chemical Corps.* Bailmhoff, W.A. and R.F. Heizer . 1965. Postglacial

  19. JPSS Preparations at the Satellite Proving Ground for Marine, Precipitation, and Satellite Analysis

    Science.gov (United States)

    Folmer, Michael J.; Berndt, E.; Clark, J.; Orrison, A.; Kibler, J.; Sienkiewicz, J.; Nelson, J.; Goldberg, M.; Sjoberg, W.

    2016-01-01

    The ocean prediction center at the national hurricane center's tropical analysis and forecast Branch, the Weather Prediction center and the Satellite analysis branch of NESDIS make up the Satellite Proving Ground for Marine, Precipitation and Satellite Analysis. These centers had early exposure to JPSS products using the S-NPP Satellite that was launched in 2011. Forecasters continue to evaluate new products in anticipation for the launch of JPSS-1 sometime in 2017.

  20. Conceptualizing reasoning-and-proving opportunities in textbook expositions : Cases from secondary calculus

    OpenAIRE

    Bergwall, Andreas

    2017-01-01

    Several recent textbook studies focus on opportunities to learn reasoning-and-proving. They typically investigate the extent to which justifications are general proofs and what opportunities exist for learning important elements of mathematical reasoning. In this paper, I discuss how a particular analytical framework for this might be refined. Based on an in-depth analysis of certain textbook passages in upper secondary calculus textbooks, I make an account for analytical issues encountered d...

  1. Chiral gravity, log gravity, and extremal CFT

    International Nuclear Information System (INIS)

    Maloney, Alexander; Song Wei; Strominger, Andrew

    2010-01-01

    We show that the linearization of all exact solutions of classical chiral gravity around the AdS 3 vacuum have positive energy. Nonchiral and negative-energy solutions of the linearized equations are infrared divergent at second order, and so are removed from the spectrum. In other words, chirality is confined and the equations of motion have linearization instabilities. We prove that the only stationary, axially symmetric solutions of chiral gravity are BTZ black holes, which have positive energy. It is further shown that classical log gravity--the theory with logarithmically relaxed boundary conditions--has finite asymptotic symmetry generators but is not chiral and hence may be dual at the quantum level to a logarithmic conformal field theories (CFT). Moreover we show that log gravity contains chiral gravity within it as a decoupled charge superselection sector. We formally evaluate the Euclidean sum over geometries of chiral gravity and show that it gives precisely the holomorphic extremal CFT partition function. The modular invariance and integrality of the expansion coefficients of this partition function are consistent with the existence of an exact quantum theory of chiral gravity. We argue that the problem of quantizing chiral gravity is the holographic dual of the problem of constructing an extremal CFT, while quantizing log gravity is dual to the problem of constructing a logarithmic extremal CFT.

  2. SPoRT's Participation in the GOES-R Proving Ground Activity

    Science.gov (United States)

    Jedlovec, Gary; Fuell, Kevin; Smith, Matthew; Stano, Geoffrey; Molthan, Andrew

    2011-01-01

    The next generation geostationary satellite, GOES-R, will carry two new instruments with unique atmospheric and surface observing capabilities, the Advanced Baseline Imager (ABI) and the Geostationary Lightning Mapper (GLM), to study short-term weather processes. The ABI will bring enhanced multispectral observing capabilities with frequent refresh rates for regional and full disk coverage to geostationary orbit to address many existing and new forecast challenges. The GLM will, for the first time, provide the continuous monitoring of total lightning flashes over a hemispherical region from space. NOAA established the GOES-R Proving Ground activity several years ago to demonstrate the new capabilities of these instruments and to prepare forecasters for their day one use. Proving Ground partners work closely with algorithm developers and the end user community to develop and transition proxy data sets representing GOES-R observing capabilities. This close collaboration helps to maximize refine algorithms leading to the delivery of a product that effectively address a forecast challenge. The NASA Short-term Prediction Research and Transition (SPoRT) program has been a participant in the NOAA GOES-R Proving Ground activity by developing and disseminating selected GOES-R proxy products to collaborating WFOs and National Centers. Established in 2002 to demonstrate the weather and forecasting application of real-time EOS measurements, the SPoRT program has grown to be an end-to-end research to operations activity focused on the use of advanced NASA modeling and data assimilation approaches, nowcasting techniques, and unique high-resolution multispectral data from EOS satellites to improve short-term weather forecasts on a regional and local scale. Participation in the Proving Ground activities extends SPoRT s activities and taps its experience and expertise in diagnostic weather analysis, short-term weather forecasting, and the transition of research and experimental

  3. [Difficult Ventilation Requiring Emergency Endotracheal Intubation during Awake Craniotomy Managed by Laryngeal Mask Airway].

    Science.gov (United States)

    Matsuda, Asako; Mizota, Toshiyuki; Tanaka, Tomoharu; Segawa, Hajime; Fukuda, Kazuhiko

    2016-04-01

    We report a case of difficult ventilation requiring emergency endotracheal intubation during awake craniotomy managed by laryngeal mask airway (LMA). A 45-year-old woman was scheduled to receive awake craniotomy for brain tumor in the frontal lobe. After anesthetic induction, airway was secured using ProSeal LMA and patient was mechanically ventilated in pressure-control mode. Patient's head was fixed with head-pins at anteflex position, and the operation started. About one hour after the start of the operation, tidal volume suddenly decreased. We immediately started manual ventilation, but the airway resistance was extremely high and we could not adequately ventilate the patient. We administered muscle relaxant for suspected laryngospasm, but ventilatory status did not improve; so we decided to conduct emergency endotracheal intubation. We tried to intubate using Airwayscope or LMA-Fastrach, but they were not effective in our case. Finally trachea was intubated using transnasal fiberoptic bronchoscopy. We discuss airway management during awake craniotomy, focusing on emergency endotracheal intubation during surgery.

  4. Extreme Programming Pocket Guide

    CERN Document Server

    Chromatic

    2003-01-01

    Extreme Programming (XP) is a radical new approach to software development that has been accepted quickly because its core practices--the need for constant testing, programming in pairs, inviting customer input, and the communal ownership of code--resonate with developers everywhere. Although many developers feel that XP is rooted in commonsense, its vastly different approach can bring challenges, frustrations, and constant demands on your patience. Unless you've got unlimited time (and who does these days?), you can't always stop to thumb through hundreds of pages to find the piece of info

  5. Upper extremity golf injuries.

    Science.gov (United States)

    Cohn, Michael A; Lee, Steven K; Strauss, Eric J

    2013-01-01

    Golf is a global sport enjoyed by an estimated 60 million people around the world. Despite the common misconception that the risk of injury during the play of golf is minimal, golfers are subject to a myriad of potential pathologies. While the majority of injuries in golf are attributable to overuse, acute traumatic injuries can also occur. As the body's direct link to the golf club, the upper extremities are especially prone to injury. A thorough appreciation of the risk factors and patterns of injury will afford accurate diagnosis, treatment, and prevention of further injury.

  6. Extreme Rainfall In A City

    Science.gov (United States)

    Nkemdirim, Lawrence

    industrialization. The development of small cloud droplets into larger particles requires time. A single thunderstorm cell has a mean development time of about 20 minutes and a life time of around 45 minutes with a mean mind of 10m/s, an air parcel would travel 12 km from the beginning of droplet formation to the first precipitation. That means that the precipitation field is shifted downwind of settlements. It could also explain the the higher frequency of the trace to small amounts observed in Calgary since those events occur under relatively calm weather. Whereas the majority of studies have focused on summer convectional type events, little appears to have been done on the extreme rainfall events on which most structural designs are based. Is there a detectable urban bias in these events? Do urban areas intensify them? What are the implications of point distribution of extreme rainfall events on flood frequency across a city. This paper examines the spatial distribution of the mean annual maximum rainfall event in Calgary, Canada, with a view to determining the relative contribution of geographical setting and urbanisation to point patterns. The data are subsequently maximized to produce maps of probable maximum precipitation for the city. The major results are as follows: (a) position along storm path is the most important variable determining maximum rainfall hazard, (b) higher grounds receive up to seventy percent more maximum rainfall than values based on spatial trend, (c) urban structure and geometry correlate negatively with maximum rainfall intensity, however, (d) zones of maximum flood peaks are found down slope of areas of maximum precipitation increasing flood hazard in the inner city in spite of its lower precipitation. Drainage networks based on point rainfall patterns have proved grossly inadequate for flood mitigation. The new design based on this study recognizes the strong moisture gradients caused by rapid movement of water and other elements down slope. Snow

  7. 76 FR 50771 - Submission for Review: RI 25-37, Evidence To Prove Dependency of a Child, 3206-0206

    Science.gov (United States)

    2011-08-16

    ... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: RI 25-37, Evidence To Prove Dependency of a...) 3206-0206, Evidence to Prove Dependency of a Child. As required by the Paperwork Reduction Act of 1995... or faxed to (202) 395-6974. SUPPLEMENTARY INFORMATION: Evidence to Prove Dependency of a Child is...

  8. Computational discovery of extremal microstructure families

    Science.gov (United States)

    Chen, Desai; Skouras, Mélina; Zhu, Bo; Matusik, Wojciech

    2018-01-01

    Modern fabrication techniques, such as additive manufacturing, can be used to create materials with complex custom internal structures. These engineered materials exhibit a much broader range of bulk properties than their base materials and are typically referred to as metamaterials or microstructures. Although metamaterials with extraordinary properties have many applications, designing them is very difficult and is generally done by hand. We propose a computational approach to discover families of microstructures with extremal macroscale properties automatically. Using efficient simulation and sampling techniques, we compute the space of mechanical properties covered by physically realizable microstructures. Our system then clusters microstructures with common topologies into families. Parameterized templates are eventually extracted from families to generate new microstructure designs. We demonstrate these capabilities on the computational design of mechanical metamaterials and present five auxetic microstructure families with extremal elastic material properties. Our study opens the way for the completely automated discovery of extremal microstructures across multiple domains of physics, including applications reliant on thermal, electrical, and magnetic properties. PMID:29376124

  9. Research Objectives for Human Missions in the Proving Ground of Cis-Lunar Space

    Science.gov (United States)

    Spann, James; Niles, Paul; Eppler, Dean; Kennedy, Kriss; Lewis, Ruthan; Sullivan, Thomas

    2016-07-01

    Introduction: This talk will introduce the preliminary findings in support of NASA's Future Capabilities Team. In support of the ongoing studies conducted by NASA's Future Capabilities Team, we are tasked with collecting re-search objectives for the Proving Ground activities. The objectives could include but are certainly not limited to: demonstrating crew well being and performance over long duration missions, characterizing lunar volatiles, Earth monitoring, near Earth object search and identification, support of a far-side radio telescope, and measuring impact of deep space environment on biological systems. Beginning in as early as 2023, crewed missions beyond low Earth orbit will be enabled by the new capabilities of the SLS and Orion vehicles. This will initiate the "Proving Ground" phase of human exploration with Mars as an ultimate destination. The primary goal of the Proving Ground is to demonstrate the capability of suitably long dura-tion spaceflight without need of continuous support from Earth, i.e. become Earth Independent. A major component of the Proving Ground phase is to conduct research activities aimed at accomplishing major objectives selected from a wide variety of disciplines including but not limited to: Astronomy, Heliophysics, Fun-damental Physics, Planetary Science, Earth Science, Human Systems, Fundamental Space Biology, Microgravity, and In Situ Resource Utilization. Mapping and prioritizing the most important objectives from these disciplines will provide a strong foundation for establishing the architecture to be utilized in the Proving Ground. Possible Architectures: Activities and objectives will be accomplished during the Proving Ground phase using a deep space habitat. This habitat will potentially be accompanied by a power/propulsion bus capable of moving the habitat to accomplish different objectives within cis-lunar space. This architecture can also potentially support stag-ing of robotic and tele-robotic assets as well as

  10. How cytogenetical methods help victims prove radiation exposure and claim right for social support: NCERM experience

    International Nuclear Information System (INIS)

    Aleksanin, S.; Slozina, N.; Neronova, E.; Smoliakov, E.

    2011-01-01

    Russian citizens who were irradiated because of radiation disasters, nuclear weapons testing and some other sources have a right to some social support and financial compensation. In order to get this compensation people have to prove that they were irradiated. As it is, not all victims for a variety of reasons have formal documents. Thus they apply for cytogenetic investigation to prove irradiation months, years and even decades after irradiation. Since 1992 the cytogenetic investigations related to radiation exposure were performed in NRCERM for more than 700 people. At the beginning of this investigation FISH method was not certified as a biodosimenty test in Russia. Only dicentric analysis was approved as a proof of irradiation. It is known that the rate of dicentrics decrease in time, but the residual level of cytogenetical markers could be revealed a long time after a radiation accident. Thus the dicentric analysis was performed for the people who applied for biological indication of radiation exposure at that time. Rates of dicentrics exceeding control levels were revealed in half the people who applied for radiation conformation. Now FISH method is certified in Russia and both cytogenetic tests of biodosimetry (dicentrics and FISH) are available for all comers. Increased levels of translocations were found in 8 cases (the dose rate from 0.16 to 0.64 Gy). On the basis of the results of cytogenetic tests official documents were supplied to these people and they were entitled to apply for radiation exposure compensation. Thus cytogenetic tests are very effective and in some cases the only possible way for the victims to prove irradiation exposure and to apply for radiation exposure compensation a long time after an accident.

  11. How cytogenetical methods help victims prove radiation exposure and claim right for social support: NCERM experience

    Energy Technology Data Exchange (ETDEWEB)

    Aleksanin, S., E-mail: Aleksanin@arcerm.spb.ru [Nikiforov Russian Center of Emergency and Radiation Medicine EMERCOM of Russia, (NRCERM) ul. Akademika Lebedeva 4/2, 194044 St. Petersburg (Russian Federation); Slozina, N., E-mail: NataliaSlozina@peterlink.ru [Nikiforov Russian Center of Emergency and Radiation Medicine EMERCOM of Russia, (NRCERM) ul. Akademika Lebedeva 4/2, 194044 St. Petersburg (Russian Federation); Neronova, E.; Smoliakov, E. [Nikiforov Russian Center of Emergency and Radiation Medicine EMERCOM of Russia, (NRCERM) ul. Akademika Lebedeva 4/2, 194044 St. Petersburg (Russian Federation)

    2011-09-15

    Russian citizens who were irradiated because of radiation disasters, nuclear weapons testing and some other sources have a right to some social support and financial compensation. In order to get this compensation people have to prove that they were irradiated. As it is, not all victims for a variety of reasons have formal documents. Thus they apply for cytogenetic investigation to prove irradiation months, years and even decades after irradiation. Since 1992 the cytogenetic investigations related to radiation exposure were performed in NRCERM for more than 700 people. At the beginning of this investigation FISH method was not certified as a biodosimenty test in Russia. Only dicentric analysis was approved as a proof of irradiation. It is known that the rate of dicentrics decrease in time, but the residual level of cytogenetical markers could be revealed a long time after a radiation accident. Thus the dicentric analysis was performed for the people who applied for biological indication of radiation exposure at that time. Rates of dicentrics exceeding control levels were revealed in half the people who applied for radiation conformation. Now FISH method is certified in Russia and both cytogenetic tests of biodosimetry (dicentrics and FISH) are available for all comers. Increased levels of translocations were found in 8 cases (the dose rate from 0.16 to 0.64 Gy). On the basis of the results of cytogenetic tests official documents were supplied to these people and they were entitled to apply for radiation exposure compensation. Thus cytogenetic tests are very effective and in some cases the only possible way for the victims to prove irradiation exposure and to apply for radiation exposure compensation a long time after an accident.

  12. Initial building investigations at Aberdeen Proving Ground, Maryland: Objectives and methodology

    Energy Technology Data Exchange (ETDEWEB)

    Brubaker, K.L.; Dougherty, J.M.; McGinnis, L.D.

    1994-12-01

    As part of an environmental-contamination source-definition program at Aberdeen Proving Ground, detailed internal and external inspections of 23 potentially contaminated buildings are being conducted to describe and characterize the state of each building as it currently exists and to identify areas potentially contaminated with toxic or other hazardous substances. In addition, a detailed geophysical investigation is being conducted in the vicinity of each target building to locate and identify subsurface structures, associated with former building operations, that are potential sources of contamination. This report describes the objectives of the initial building inspections, including the geophysical investigations, and discusses the methodology that has been developed to achieve these objectives.

  13. Using aetnanova to formally prove that the Davis-Putnam satisfiability test is correct

    Directory of Open Access Journals (Sweden)

    Eugenio G. Omodeo

    2008-05-01

    Full Text Available This paper reports on using the ÆtnaNova/Referee proof-verification system to formalize issues regarding the satisfiability of CNF-formulae of propositional logic. We specify an “archetype” version of the Davis-Putnam-Logemann-Loveland algorithm through the THEORY of recursive functions based on a well-founded relation, and prove it to be correct.Within the same framework, and by resorting to the Zorn lemma, we develop a straightforward proof of the compactness theorem.

  14. Divide and conquer method for proving gaps of frustration free Hamiltonians

    DEFF Research Database (Denmark)

    Kastoryano, Michael J.; Lucia, Angelo

    2018-01-01

    Providing system-size independent lower bounds on the spectral gap of local Hamiltonian is in general a hard problem. For the case of finite-range, frustration free Hamiltonians on a spin lattice of arbitrary dimension, we show that a property of the ground state space is sufficient to obtain...... such a bound. We furthermore show that such a condition is necessary and equivalent to a constant spectral gap. Thanks to this equivalence, we can prove that for gapless models in any dimension, the spectral gap on regions of diameter $n$ is at most $o\\left(\\frac{\\log(n)^{2+\\epsilon}}{n}\\right)$ for any...... positive $\\epsilon$....

  15. Application of proving-ring technology to measure thermally induced displacements in large boreholes in rock

    International Nuclear Information System (INIS)

    Patrick, W.C.; Reactor, N.L.; Butkovich, T.R.

    1984-03-01

    A strain-gauged proving-ring transducer was designed and deployed to measure small diametral displacements in 0.61-m diameter boreholes in rock. The rock surrounding the boreholes was previously heated by storage of spent nuclear fuel assemblies and measurements during post-retrieval cooling of the rock were made. To accomplish this, a transducer was designed to measure displacements in the range of 10 to 100 μm, to function in a time-varying temperature regime of 30 0 to 60 0 C at a relative humidity of 100%, to be of low stiffness, and to be easily and quickly installed. 7 references, 6 figures, 1 table

  16. Seismic proving test of ultimate piping strength (current status of preliminary tests)

    International Nuclear Information System (INIS)

    Suzuki, K.; Namita, Y.; Abe, H.; Ichihashi, I.; Suzuki, K.; Ishiwata, M.; Fujiwaka, T.; Yokota, H.

    2001-01-01

    In 1998 Fiscal Year, the 6 year program of piping tests was initiated with the following objectives: i) to clarify the elasto-plastic response and ultimate strength of nuclear piping, ii) to ascertain the seismic safety margin of the current seismic design code for piping, and iii) to assess new allowable stress rules. In order to resolve extensive technical issues before proceeding on to the seismic proving test of a large-scale piping system, a series of preliminary tests of materials, piping components and simplified piping systems is intended. In this paper, the current status of the material tests and the piping component tests is reported. (author)

  17. Investigating NARCCAP Precipitation Extremes via Bivariate Extreme Value Theory (Invited)

    Science.gov (United States)

    Weller, G. B.; Cooley, D. S.; Sain, S. R.; Bukovsky, M. S.; Mearns, L. O.

    2013-12-01

    We introduce methodology from statistical extreme value theory to examine the ability of reanalysis-drive regional climate models to simulate past daily precipitation extremes. Going beyond a comparison of summary statistics such as 20-year return values, we study whether the most extreme precipitation events produced by climate model simulations exhibit correspondence to the most extreme events seen in observational records. The extent of this correspondence is formulated via the statistical concept of tail dependence. We examine several case studies of extreme precipitation events simulated by the six models of the North American Regional Climate Change Assessment Program (NARCCAP) driven by NCEP reanalysis. It is found that the NARCCAP models generally reproduce daily winter precipitation extremes along the Pacific coast quite well; in contrast, simulation of past daily summer precipitation extremes in a central US region is poor. Some differences in the strength of extremal correspondence are seen in the central region between models which employ spectral nudging and those which do not. We demonstrate how these techniques may be used to draw a link between extreme precipitation events and large-scale atmospheric drivers, as well as to downscale extreme precipitation simulated by a future run of a regional climate model. Specifically, we examine potential future changes in the nature of extreme precipitation along the Pacific coast produced by the pineapple express (PE) phenomenon. A link between extreme precipitation events and a "PE Index" derived from North Pacific sea-surface pressure fields is found. This link is used to study PE-influenced extreme precipitation produced by a future-scenario climate model run.

  18. Ecological survey of M-Field, Edgewood Area Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Downs, J.L.; Eberhardt, L.E.; Fitzner, R.E.; Rogers, L.E.

    1991-12-01

    An ecological survey was conducted on M-Field, at the Edgewood Area, Aberdeen Proving Ground, Maryland. M-Field is used routinely to test army smokes and obscurants, including brass flakes, carbon fibers, and fog oils. The field has been used for testing purposes for the past 40 years, but little documented history is available. Under current environmental regulations, the test field must be assessed periodically to document the presence or potential use of the area by threatened and endangered species. The M-Field area is approximately 370 acres and is part of the US Army's Edgewood Area at Aberdeen Proving Ground in Harford County, Maryland. The grass-covered field is primarily lowlands with elevations from about 1.0 to 8 m above sea level, and several buildings and structures are present on the field. The ecological assessment of M-Field was conducted in three stages, beginning with a preliminary site visit in May to assess sampling requirements. Two field site visits were made June 3--7, and August 12--15, 1991, to identify the biota existing on the site. Data were gathered on vegetation, small mammals, invertebrates, birds, large mammals, amphibians, and reptiles.

  19. Ecological survey of M-Field, Edgewood Area Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Downs, J.L.; Eberhardt, L.E.; Fitzner, R.E.; Rogers, L.E.

    1991-12-01

    An ecological survey was conducted on M-Field, at the Edgewood Area, Aberdeen Proving Ground, Maryland. M-Field is used routinely to test army smokes and obscurants, including brass flakes, carbon fibers, and fog oils. The field has been used for testing purposes for the past 40 years, but little documented history is available. Under current environmental regulations, the test field must be assessed periodically to document the presence or potential use of the area by threatened and endangered species. The M-Field area is approximately 370 acres and is part of the US Army`s Edgewood Area at Aberdeen Proving Ground in Harford County, Maryland. The grass-covered field is primarily lowlands with elevations from about 1.0 to 8 m above sea level, and several buildings and structures are present on the field. The ecological assessment of M-Field was conducted in three stages, beginning with a preliminary site visit in May to assess sampling requirements. Two field site visits were made June 3--7, and August 12--15, 1991, to identify the biota existing on the site. Data were gathered on vegetation, small mammals, invertebrates, birds, large mammals, amphibians, and reptiles.

  20. Proving test on the performance of a Multiple-Excitation Simulator

    International Nuclear Information System (INIS)

    Fujita, Katsuhisa; Ito, Tomohiro; Kojima, Nobuyuki; Sasaki, Yoichi; Abe, Hiroshi; Kuroda, Katsuhiko

    1995-01-01

    Seismic excitation test on large scale piping systems is scheduled to be carried out by the Nuclear power Engineering Corporation (NUPEC) using the large-scale, high-performance vibration table at the Tadotsu Engineering Laboratory, under the sponsorship of the Ministry of International Trade and Industry (MITI). In the test, the piping systems simulate the main steam piping system and the main feed water piping system in the nuclear power plants. In this study, a fundamental test was carried out to prove the performance of the Multiple Excitation Simulator which consists of the hydraulic actuator and the control system. An L-shaped piping system and a hydraulic actuator were installed on the shaking table. Acceleration and displacement generated by the actuator were measured. The performance of the actuator and the control system was discussed comparing the measured values and the target values on the time histories and the response spectrum of the acceleration. As a result, it was proved that the actuator and the control system have good performance and will be applicable to the verification test

  1. Seismic proving tests on the reliability for large components and equipment of nuclear power plants

    International Nuclear Information System (INIS)

    Ohno, Tokue; Tanaka, Nagatoshi

    1988-01-01

    Since Japan has destructive earthquakes frequently, the structural reliability for large components and equipment of nuclear power plants are rigorously required. They are designed using sophisticated seismic analyses and have not yet encountered a destructive earthquake. When nuclear power plants are planned, it is very important that the general public understand the structural reliability during and after an earthquake. Seismic Proving Tests have been planned by Ministry of International Trade and Industry (Miti) to comply with public requirement in Japan. A large-scale high-performance vibration table was constructed at Tasted Engineering Laboratory of Nuclear Power Engineering Test Center (NU PEC), in order to prove the structural reliability by vibrating the test model (of full scale or close to the actual size) in the condition of a destructive earthquake. As for the test models, the following four items were selected out of large components and equipment important to the safety: Reactor Containment Vessel; Primary Coolant Loop or Primary Loop Recirculation System; Reactor Pressure Vessel; and Reactor Core Internals. Here is described a brief of the vibration table, the test method and the results of the tests on PWR Reactor Containment Vessel and BWR Primary Loop Recirculation System (author)

  2. Spatial extreme value analysis to project extremes of large-scale indicators for severe weather.

    Science.gov (United States)

    Gilleland, Eric; Brown, Barbara G; Ammann, Caspar M

    2013-09-01

    Concurrently high values of the maximum potential wind speed of updrafts ( W max ) and 0-6 km wind shear (Shear) have been found to represent conducive environments for severe weather, which subsequently provides a way to study severe weather in future climates. Here, we employ a model for the product of these variables (WmSh) from the National Center for Atmospheric Research/United States National Center for Environmental Prediction reanalysis over North America conditioned on their having extreme energy in the spatial field in order to project the predominant spatial patterns of WmSh. The approach is based on the Heffernan and Tawn conditional extreme value model. Results suggest that this technique estimates the spatial behavior of WmSh well, which allows for exploring possible changes in the patterns over time. While the model enables a method for inferring the uncertainty in the patterns, such analysis is difficult with the currently available inference approach. A variation of the method is also explored to investigate how this type of model might be used to qualitatively understand how the spatial patterns of WmSh correspond to extreme river flow events. A case study for river flows from three rivers in northwestern Tennessee is studied, and it is found that advection of WmSh from the Gulf of Mexico prevails while elsewhere, WmSh is generally very low during such extreme events. © 2013 The Authors. Environmetrics published by JohnWiley & Sons, Ltd.

  3. Improving working equine welfare in 'hard-win' situations, where gains are difficult, expensive or marginal.

    Science.gov (United States)

    Pritchard, Joy; Upjohn, Melissa; Hirson, Tamsin

    2018-01-01

    Brooke is a non-government organisation with working equine welfare programmes across Africa, Asia and Latin America. In 2014, staff from ten country programmes were asked to identify 'no-win' situations (subsequently reframed as 'hard-wins')-where improving equine welfare is proving difficult, expensive and/or marginal-in order to inform strategic decisions on how to approach, manage and mitigate for such situations. The Delphi-type consultation process had three phases. Round 1 posed five questions in the form of a workshop, survey and semi-structured interviews. Round 2 re-presented key themes and sense-checked initial conclusions. Round 3 reviewed the nature and prevalence of hard-win situations at an international meeting of all participants. Reasons given for hard-win situations included: no economic or social benefit from caring for working animals; poor resource availability; lack of empathy for working equids or their owners among wider stakeholders; deep-seated social issues, such as addiction or illegal working; areas with a high animal turnover or migratory human population; lack of community cooperation or cohesion; unsafe areas where welfare interventions cannot be adequately supported. Participants estimated the prevalence of hard-win situations as 40-70% of their work. They suggested some current ways of working that may be contributing to the problem, and opportunities to tackle hard-wins more effectively. Respondents agreed that if equine welfare improvements are to span generations of animals, interventions cannot rely on relatively simple, technical knowledge-transfer strategies and quick-wins alone. Programmes need to be more flexible and iterative and less risk-averse in their approaches to embedding good equine welfare practices in all relevant actors. Consultation recommendations informed development of Brooke's new global strategy, a revised organisational structure and redefinition of roles and responsibilities to streamline ways to

  4. [A Case of Pyoderma Gangrenosum of the Penis Difficult to Distinguish from Fournier Gangrene].

    Science.gov (United States)

    Taguchi, Makoto; Inoue, Takaaki; Nishida, Teruhisa; Kawabata, Takashi; Kawakita, Shigenari; Muguruma, Kouei; Murota, Takashi; Kinoshita, Hidefumi; Matsuda, Tadashi

    2015-11-01

    Here, we report a case of pyoderma gangrenosum of the penis which was difficult to distinguish from Fournier gangrene. The patient was a 54-year-old male who was aware of redness and swelling of the glanspenis for 1 month prior to a consultation at our department. Although he was diagnosed with herpes and treated at a nearby hospital, his symptoms did not improve. Subsequently, the patient visited our department following the onset of pain and fever. During his initial consultation, he had a fever of 39 °C as well as redness and swelling of the glans penis with partial spontaneous purulent discharge. His blood test revealed an elevated white blood cell count (20, 000/μl) and C-reactive protein (19.1 mg/dl). Because Fournier gangrene was suspected, administration of broad-spectrum antimicrobial agents was initiated but proved to be ineffective. An abscess (2 cm in diameter) was also noted in the umbilical region.Enterococcus faecalis was detected by the bacterial culture ; and therefore, Fournier gangrene was diagnosed. A partial penectomy was performed to control the infection. Pathological findings showed only non-specific inflammation ; however, fever persisted postoperatively and blood test results showed no improvement. Furthermore, new abscess lesions emerged on the right heel and back. Because the re-performed abscess bacterial culture test result was negative, pyoderma gangrenosum was suspected, and he was started on oral prednisolone (20 mg/day). On the following day, his fever subsided and his blood test results also showed improvement. A final diagnosis of pyoderma gangrenosum was ultimately made.

  5. Use of a Flexible Intubating Scope in Combination with a Channeled Video Laryngoscope for Managing a Difficult Airway in the Emergency Department.

    Science.gov (United States)

    Sowers, Nicholas; Kovacs, George

    2016-02-01

    Difficulty with intubation is not uncommon in the emergency setting. Video laryngoscopes (VLs) are commonly used to manage the difficult airway in the emergency department (ED). Intubation using a flexible bronchoscope, while considered the gold standard for managing the anticipated difficult airway in the operating room, is not commonly used in the ED. We present a case describing VL-assisted flexible scope intubation performed in the ED as a novel feasible approach to managing the difficult airway. A 65-year-old male, post cardiac arrest, with multiple unsuccessful attempts at prehospital intubation had rapid sequence intubation (RSI) performed and, despite obtaining a view with a King Vision™ VL, the skilled operator was unable to advance the endotracheal tube (ETT). An Ambu™ aScope3 flexible intubating scope (FIS) was placed through the ETT loaded in the channel of the King Vision and advanced through the cords to a position proximal to the carina. The ETT was then advanced easily over the FIS and down the trachea. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although video laryngoscopy is commonly used in the ED, intubation can prove difficult, despite having an adequate view of the glottis. Use of an FIS, however, through a channeled VL makes navigation of the ETT easier and facilitates tube advancement, which can be difficult with VL. Channeled VL-assisted use of an FIS is a viable option for managing the difficult airway. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. The attitudes of neonatal nurses towards extremely preterm infants.

    Science.gov (United States)

    Gallagher, Katie; Marlow, Neil; Edgley, Alison; Porock, Davina

    2012-08-01

    The paper is a report of a study of the attitudes of neonatal nurses towards extremely preterm infants. Alongside advancing survival at extremely preterm gestational ages, ethical debates concerning the provision of invasive care have proliferated in light of the high morbidity. Despite nurses being the healthcare professionals who work closest with the infant and their family, their potential influence is usually ignored when determining how parents come to decisions about future care for their extremely premature infant. A Q methodology was employed to explore the attitudes of neonatal nurses towards caring for extremely preterm infants. Data were collected between 2007 and 2008 and analysed using PQMethod and Card Content Analysis. Thirty-six nurses from six neonatal units in the United Kingdom participated. Although there was consensus around the professional role of the nurse, when faced with the complexities of neonatal nursing three distinguishing factors emerged: the importance of parental choice in decision-making, the belief that technology should be used to assess response to treatment, and the belief that healthcare professionals should undertake difficult decisions. Neonatal nurses report unexpected difficulties in upholding their professionally defined role through highly complex and ever varied decision-making processes. Recognition of individual attitudes to the care of extremely preterm infants and the role of the family in the face of difficult decisions should facilitate more open communication between the nurse and the parents and improve the experience of both the nurse and the family during these emotional situations. © 2011 Blackwell Publishing Ltd.

  7. Defining difficult laryngoscopy findings by using multiple parameters: A machine learning approach

    Directory of Open Access Journals (Sweden)

    Moustafa Abdelaziz Moustafa

    2017-04-01

    Conclusion: “Alex Difficult Laryngoscopy Software” (ADLS is a machine learning program for prediction of difficult laryngoscopy. New cases can be entered to the training set thus improving the accuracy of the software.

  8. Two centuries of extreme events over the Baltic Sea and North Sea regions

    Science.gov (United States)

    Stendel, Martin; den Besselaar Else, van; Abdel, Hannachi; Jaak, Jaagus; Elizabeth, Kent; Christiana, Lefebvre; Gudrun, Rosenhagen; Anna, Rutgersson; Frederik, Schenk; der Schrier Gerard, van; Tim, Woolings

    2017-04-01

    Two centuries of extreme events over the Baltic Sea and North Sea regions In the framework of the BACC 2 (for the Baltic Sea) and NOSCCA projects (for the North Sea region), studies of past and present variability and changes in atmospheric variables within the North Sea region over the instrumental period (roughly the past 200 years) have been investigated. Findings on trends in temperature and precipitation have already been presented. Here we focus on data homogeneity issues and examine how reliable reanalyses are in this context. Unlike most other regions in the world, there is a wealth of old observations available for the Baltic and North Sea regions, most of it in handwritten form in meteorological journals and other publications. These datasets need to be carefully digitised and homogenized. For this, a thorough quality control must be applied; otherwise the digitised datasets may prove useless or even counterproductive. We present evidence that this step cannot be conducted without human interference and thus cannot be fully automated. Furthermore, inhomogeneities due to e.g. instrumentation and station relocations need to be addressed. A wealth of reanalysis products is available, which can help detect such inhomogeneities in observed time series, but at the same time are prone to biases and/or spurious trends themselves e.g. introduced by changes in the availability and quality of the underlying assimilated data. It therefore in general remains unclear in how far we can simulate the pre-satellite era with respect to homogeneity with reanalyses based only on parts of the observing system. Extreme events and changes in extreme situations are more important and of greater (societal) significance than changes in mean climate. However, changes in extreme weather events are difficult to assess not only because they are, per definition, rare events, but also due to the homogeneity issues outlined above. Taking these into account, we present evidence for changes

  9. Seismic proving test of process computer systems with a seismic floor isolation system

    International Nuclear Information System (INIS)

    Fujimoto, S.; Niwa, H.; Kondo, H.

    1995-01-01

    The authors have carried out seismic proving tests for process computer systems as a Nuclear Power Engineering Corporation (NUPEC) project sponsored by the Ministry of International Trade and Industry (MITI). This paper presents the seismic test results for evaluating functional capabilities of process computer systems with a seismic floor isolation system. The seismic floor isolation system to isolate the horizontal motion was composed of a floor frame (13 m x 13 m), ball bearing units, and spring-damper units. A series of seismic excitation tests was carried out using a large-scale shaking table of NUPEC. From the test results, the functional capabilities during large earthquakes of computer systems with a seismic floor isolation system were verified

  10. Remediation application strategies for depleted uranium contaminated soils at the US Army Yuma Proving Ground

    International Nuclear Information System (INIS)

    Vandel, D.S.; Medina, S.M.; Weidner, J.R.

    1994-03-01

    The US Army Yuma Proving Ground (YPG), located in the southwest portion of Arizona conducts firing of projectiles into the Gunpoint (GP-20) firing range. The penetrators are composed of titanium and DU. The purpose of this project was to determine feasible cleanup technologies and disposal alternatives for the cleanup of the depleted uranium (DU) contaminated soils at YPG. The project was split up into several tasks that include (a) collecting and analyzing samples representative of the GP-20 soils, (b) evaluating the data results, (c) conducting a literature search of existing proven technologies for soil remediation, and (0) making final recommendations for implementation of this technology to the site. As a result of this study, several alternatives for the separation, treatment, and disposal procedures are identified that would result in meeting the cleanup levels defined by the Nuclear Regulatory Commission for unrestricted use of soils and would result in a significant cost savings over the life of the firing range

  11. Proving Continuity of Coinductive Global Bisimulation Distances: A Never Ending Story

    Directory of Open Access Journals (Sweden)

    David Romero-Hernández

    2015-12-01

    Full Text Available We have developed a notion of global bisimulation distance between processes which goes somehow beyond the notions of bisimulation distance already existing in the literature, mainly based on bisimulation games. Our proposal is based on the cost of transformations: how much we need to modify one of the compared processes to obtain the other. Our original definition only covered finite processes, but a coinductive approach allows us to extend it to cover infinite but finitary trees. After having shown many interesting properties of our distance, it was our intention to prove continuity with respect to projections, but unfortunately the issue remains open. Nonetheless, we have obtained several partial results that are presented in this paper.

  12. Fractal geometry as a new approach for proving nanosimilarity: a reflection note.

    Science.gov (United States)

    Demetzos, Costas; Pippa, Natassa

    2015-04-10

    Nanosimilars are considered as new medicinal outcomes combining the generic drugs and the nanocarrier as an innovative excipient, in order to evaluate them as final products. They belong to the grey area - concerning the evaluation process - between generic drugs and biosimilar medicinal products. Generic drugs are well documented and a huge number of them are in market, replacing effectively the off-patent drugs. The scientific approach for releasing them to the market is based on bioequivalence studies, which are well documented and accepted by the regulatory agencies. On the other hand, the structural complexity of biological/biotechnology-derived products demands a new approach for the approval process taking into consideration that bioequivalence studies are not considered as sufficient as in generic drugs, and new clinical trials are needed to support their approval process of the product to the market. In proportion, due to technological complexity of nanomedicines, the approaches for proving the statistical identity or the similarity for generic and biosimilar products, respectively, with those of prototypes, are not considered as effective for nanosimilar products. The aim of this note is to propose a complementary approach which can provide realistic evidences concerning the nanosimilarity, based on fractal analysis. This approach is well fit with the structural complexity of nanomedicines and smooths the difficulties for proving the similarity between off-patent and nanosimilar products. Fractal analysis could be considered as the approach that completely characterizes the physicochemical/morphological characteristics of nanosimilar products and could be proposed as a start point for a deep discussion on nanosimilarity. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Fake News: A Technological Approach to Proving the Origins of Content, Using Blockchains.

    Science.gov (United States)

    Huckle, Steve; White, Martin

    2017-12-01

    In this article, we introduce a prototype of an innovative technology for proving the origins of captured digital media. In an era of fake news, when someone shows us a video or picture of some event, how can we trust its authenticity? It seems that the public no longer believe that traditional media is a reliable reference of fact, perhaps due, in part, to the onset of many diverse sources of conflicting information, via social media. Indeed, the issue of "fake" reached a crescendo during the 2016 U.S. Presidential Election, when the winner, Donald Trump, claimed that The New York Times was trying to discredit him by pushing disinformation. Current research into overcoming the problem of fake news does not focus on establishing the ownership of media resources used in such stories-the blockchain-based application introduced in this article is technology that is capable of indicating the authenticity of digital media. Put simply, using the trust mechanisms of blockchain technology, the tool can show, beyond doubt, the provenance of any source of digital media, including images used out of context in attempts to mislead. Although the application is an early prototype and its capability to find fake resources is somewhat limited, we outline future improvements that would overcome such limitations. Furthermore, we believe that our application (and its use of blockchain technology and standardized metadata) introduces a novel approach to overcoming falsities in news reporting and the provenance of media resources used therein. However, while our application has the potential to be able to verify the originality of media resources, we believe that technology is only capable of providing a partial solution to fake news. That is because it is incapable of proving the authenticity of a news story as a whole. We believe that takes human skills.

  14. Extremely secure identification documents

    International Nuclear Information System (INIS)

    Tolk, K.M.; Bell, M.

    1997-09-01

    The technology developed in this project uses biometric information printed on the document and public key cryptography to ensure that an adversary cannot issue identification documents to unauthorized individuals or alter existing documents to allow their use by unauthorized individuals. This process can be used to produce many types of identification documents with much higher security than any currently in use. The system is demonstrated using a security badge as an example. This project focused on the technologies requiring development in order to make the approach viable with existing badge printing and laminating technologies. By far the most difficult was the image processing required to verify that the picture on the badge had not been altered. Another area that required considerable work was the high density printed data storage required to get sufficient data on the badge for verification of the picture. The image processing process was successfully tested, and recommendations are included to refine the badge system to ensure high reliability. A two dimensional data array suitable for printing the required data on the badge was proposed, but testing of the readability of the array had to be abandoned due to reallocation of the budgeted funds by the LDRD office

  15. Are BALQSOs extreme accretors?

    Science.gov (United States)

    Yuan, M. J.; Wills, B. J.

    2002-12-01

    Broad Absorption Line (BAL) QSOs are QSOs with massive absorbing outflows up to 0.2c. Two hypothesis have been suggested in the past about the nature of BALQSOs: Every QSO might have BAL outflow with some covering factor. BALQSOs are those which happen to have outflow along our line of sight. BALQSOs have intrinsically different physical properties than non-BALQSOs. Based on BALQSO's optical emission properties and a large set of correlations linking many general QSO emission line and continuum properties, it has been suggested that BALQSOs might accrete at near Eddington limit with abundant of fuel supplies. With new BALQSO Hβ region spectroscopic observation conducted at UKIRT and re-analysis of literature data for low and high redshift non-BALQSOs, We confirm that BALQSOs have extreme Fe II and [O III] emission line properties. Using results derived from the latest QSO Hβ region reverberation mapping, we calculated Eddington ratios (˙ {M}/˙ {M}Edd) for our BAL and non-BALQSOs. The Fe II and [O III] strengths are strongly correlated with Eddington ratios. Those correlations link Eddington ratio to a large set of general QSO properties through the Boroson & Green Eigenvector 1. We find that BALQSOs have Eddington ratios close to 1. However, all high redshift, high luminosity QSOs have rather high Eddington ratios. We argue that this is a side effect from selecting the brightest objects. In fact, our high redshift sample might constitute BALQSO's high Eddington ratio orientation parent population.

  16. Disarming Contankerous People: Coping with Difficult Personalities in ECE Work Settings

    Science.gov (United States)

    Hernandez, Luis; Smith, Connie Jo

    2009-01-01

    Difficult personalities come in a variety of roles in just about every setting. While types have been identified in the typical corporate and business culture, difficult work personalities also inhabit the world of early childhood education (ECE) workplaces. Because difficult people have an impact on workplace morale and productivity, the topic…

  17. Difficult Children

    DEFF Research Database (Denmark)

    Christensen, Else

    . Especially on children and their development in social relations to children at the same age, on how the mothers experience their child and on the parent’s resources concerning health, education and job situation. The paper presents results from the first two data collections (1996 and 1999) in a prospective...... in contact with their peers, more attention-related problems and less emotional or psychological resources. Furthermore the mothers experience more trouble in child rearing than what is found in an average family. The results are important in the way that they attract attention to the child’s own situation...... the family in a poor position regarding the children’s well-being, health and development, but not so severe that the child is to be placed out of home. The paper concentrates attention on differences between families with and without contact to the social service department for reasons related to the child...

  18. Likelihood estimators for multivariate extremes

    KAUST Repository

    Huser, Raphaë l; Davison, Anthony C.; Genton, Marc G.

    2015-01-01

    The main approach to inference for multivariate extremes consists in approximating the joint upper tail of the observations by a parametric family arising in the limit for extreme events. The latter may be expressed in terms of componentwise maxima, high threshold exceedances or point processes, yielding different but related asymptotic characterizations and estimators. The present paper clarifies the connections between the main likelihood estimators, and assesses their practical performance. We investigate their ability to estimate the extremal dependence structure and to predict future extremes, using exact calculations and simulation, in the case of the logistic model.

  19. Likelihood estimators for multivariate extremes

    KAUST Repository

    Huser, Raphaël

    2015-11-17

    The main approach to inference for multivariate extremes consists in approximating the joint upper tail of the observations by a parametric family arising in the limit for extreme events. The latter may be expressed in terms of componentwise maxima, high threshold exceedances or point processes, yielding different but related asymptotic characterizations and estimators. The present paper clarifies the connections between the main likelihood estimators, and assesses their practical performance. We investigate their ability to estimate the extremal dependence structure and to predict future extremes, using exact calculations and simulation, in the case of the logistic model.

  20. Further outlooks: extremely uncomfortable; Die weiteren Aussichten: extrem ungemuetlich

    Energy Technology Data Exchange (ETDEWEB)

    Resenhoeft, T.

    2006-07-01

    Climate is changing extremely in the last decades. Scientists dealing with extreme weather, should not only stare at computer simulations. They have also to turn towards psyche, seriously personal experiences, knowing statistics, relativise supposed sensational reports and last not least collecting more data. (GL)

  1. Assessing Climate Variability using Extreme Rainfall and ...

    African Journals Online (AJOL)

    user1

    extreme frequency); the average intensity of rainfall from extreme events ... frequency and extreme intensity indices, suggesting that extreme events are more frequent and intense during years with high rainfall. The proportion of total rainfall from ...

  2. Kidney paired exchange and desensitization: Strategies to transplant the difficult to match kidney patients with living donors.

    Science.gov (United States)

    Pham, Thomas A; Lee, Jacqueline I; Melcher, Marc L

    2017-01-01

    With organs in short supply, only a limited number of kidney transplants can be performed a year. Live donor donation accounts for 1/3rd of all kidney transplants performed in the United States. Unfortunately, not every donor recipient pair is feasible because of Human leukocyte antigen (HLA) sensitization and ABO incompatibility. To overcome these barriers to transplant, strategies such as kidney paired donation (KPD) and desensitization have been developed. KPD is the exchange of donors between at least two incompatible donor-recipient pairs such that they are now compatible. Desensitization is the removal of circulating donor specific antibodies to prevent graft rejection. Regardless of the treatment strategy, highly sensitized patients whose calculated panel reactive antibody (cPRA) is ≥95% remain difficult to transplant with match rates as low as 15% in KPD pools. Desensitization has proved to be difficult in those with high antibody titers. A novel approach is the combination of both KPD and desensitization to facilitate compatible and successful transplantation. A highly sensitized patient can be paired with a better immunological match in the KPD pool and subsequently desensitized to a lesser degree. This article reviews the current progress in KPD and desensitization and their use as a combined therapy. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. ECMWF Extreme Forecast Index for water vapor transport: A forecast tool for atmospheric rivers and extreme precipitation

    Science.gov (United States)

    Lavers, David A.; Pappenberger, Florian; Richardson, David S.; Zsoter, Ervin

    2016-11-01

    In winter, heavy precipitation and floods along the west coasts of midlatitude continents are largely caused by intense water vapor transport (integrated vapor transport (IVT)) within the atmospheric river of extratropical cyclones. This study builds on previous findings that showed that forecasts of IVT have higher predictability than precipitation, by applying and evaluating the European Centre for Medium-Range Weather Forecasts Extreme Forecast Index (EFI) for IVT in ensemble forecasts during three winters across Europe. We show that the IVT EFI is more able (than the precipitation EFI) to capture extreme precipitation in forecast week 2 during forecasts initialized in a positive North Atlantic Oscillation (NAO) phase; conversely, the precipitation EFI is better during the negative NAO phase and at shorter leads. An IVT EFI example for storm Desmond in December 2015 highlights its potential to identify upcoming hydrometeorological extremes, which may prove useful to the user and forecasting communities.

  4. 76 FR 22938 - Submission for Review: RI 25-37, Evidence To Prove Dependency of a Child

    Science.gov (United States)

    2011-04-25

    ... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: RI 25-37, Evidence To Prove Dependency of a..., Evidence to Prove Dependency of a Child. As required by the Paperwork Reduction Act of 1995 (Pub. L. 104-13... Dependency of a Child, is designed to collect sufficient information for the Office of Personnel Management...

  5. Management of the mangled extremity

    NARCIS (Netherlands)

    Prasarn, Mark L.; Helfet, David L.; Kloen, Peter

    2012-01-01

    The management of a mangled extremity continues to be a matter of debate. With modern advances in trauma resuscitation, microvascular tissue transfer, and fracture fixation, severe traumatic extremity injuries that would historically have been amputated are often salvaged. Even if preserving a

  6. A decade of weather extremes

    NARCIS (Netherlands)

    Coumou, Dim; Rahmstorf, Stefan

    The ostensibly large number of recent extreme weather events has triggered intensive discussions, both in- and outside the scientific community, on whether they are related to global warming. Here, we review the evidence and argue that for some types of extreme - notably heatwaves, but also

  7. Attitude extremity, consensus and diagnosticity

    NARCIS (Netherlands)

    van der Pligt, J.; Ester, P.; van der Linden, J.

    1983-01-01

    Studied the effects of attitude extremity on perceived consensus and willingness to ascribe trait terms to others with either pro- or antinuclear attitudes. 611 Ss rated their attitudes toward nuclear energy on a 5-point scale. Results show that attitude extremity affected consensus estimates. Trait

  8. Contamination source review for Building E2370, Edgewood Area, Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    O`Reilly, D.P.; Glennon, M.A.; Draugelis, A.K.; Rueda, J.; Zimmerman, R.E.

    1995-09-01

    The US Army Aberdeen Proving Ground (APG) commissioned Argonne National Laboratory (ANL) to conduct a contamination source review to identify and define areas of toxic or hazardous contaminants and to assess the physical condition and accessibility of APG buildings. The information obtained from this review may be used to assist the US Army in planning for the future use or disposition of the buildings. The contamination source review consisted of the following tasks: historical records search, physical inspection, photographic documentation, and geophysical investigation. This report provides the results of the contamination source review for Building E2370. Many of the APG facilities constructed between 1917 and the 1960s are no longer used because of obsolescence and their poor state of repair. Because many of these buildings were used for research, development, testing, and/or pilot-scale production of chemical warfare agents and other military substances, the potential exists for portions of the buildings to be contaminated with these substances, their degradation products, and other laboratory or industrial chemicals. These buildings and associated structures or appurtenances may contribute to environmental concerns at APG.

  9. Environmental geophysics at the Southern Bush River Peninsula, Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Davies, B.E.; Miller, S.F.; McGinnis, L.D. [and others

    1995-05-01

    Geophysical studies have been conducted at five sites in the southern Bush River Peninsula in the Edgewood Area of Aberdeen Proving Ground, Maryland. The goals of the studies were to identify areas containing buried metallic objects and to provide diagnostic signatures of the hydrogeologic framework of the site. These studies indicate that, during the Pleistocene Epoch, alternating stands of high and low sea level resulted in a complex pattern of channel-fill deposits. Paleochannels of various sizes and orientations have been mapped throughout the study area by means of ground-penetrating radar and EM-31 techniques. The EM-31 paleochannel signatures are represented onshore either by conductivity highs or lows, depending on the depths and facies of the fill sequences. A companion study shows the features as conductivity highs where they extend offshore. This erosional and depositional system is environmentally significant because of the role it plays in the shallow groundwater flow regime beneath the site. Magnetic and electromagnetic anomalies outline surficial and buried debris throughout the areas surveyed. On the basis of geophysical measurements, large-scale (i.e., tens of feet) landfilling has not been found in the southern Bush River Peninsula, though smaller-scale dumping of metallic debris and/or munitions cannot be ruled out.

  10. Interim progress report -- geophysics: Decommissioning of Buildings E5974 and E5978, Aberdeen Proving Ground

    International Nuclear Information System (INIS)

    McGinnis, M.G.; McGinnis, L.D.; Miller, S.F.; Thompson, M.D.

    1992-11-01

    Buildings E5974 and E5978, located near the mouth of Canal Creek, were among 10 potentially contaminated sites in the Westwood and Canal Creek areas of the Edgewood section of Aberdeen Proving Ground examined by a geophysical team from Argonne National Laboratory in April and May of 1992. Noninvasive geophysical surveys, including the complementary technologies of magnetics, electrical resistivity, and ground-penetrating radar, were conducted around the perimeters of the buildings to guide a sampling program prior to decommissioning and dismantling. The magnetic anomalies and the electrically conductive areas around these buildings have a spatial relationship similar to that observed in low-lying sites in the Canal Creek area; they are probably associated with construction fill. Electrically conductive terrain is dominant on the eastern side of the site, and resistive terrain predominates on the west. The smaller magnetic anomalies are not imaged with ground radar or by electrical profiling. The high resistivities in the northwest quadrant are believed to be caused by a natural sand lens. The causes of three magnetic anomalies in the high-resistivity area are unidentified, but they are probably anthropogenic

  11. A Mechanically Proved and an Incremental Development of the Session Initiation Protocol INVITE Transaction

    Directory of Open Access Journals (Sweden)

    Rajaa Filali

    2014-01-01

    Full Text Available The Session Initiation Protocol (SIP is an application layer signaling protocol used to create, manage, and terminate sessions in an IP based network. SIP is considered as a transactional protocol. There are two main SIP transactions, the INVITE transaction and the non-INVITE transaction. The SIP INVITE transaction specification is described in an informal way in Request for Comments (RFC 3261 and modified in RFC 6026. In this paper we focus on the INVITE transaction of SIP, over reliable and unreliable transport mediums, which is used to initiate a session. In order to ensure the correctness of SIP, the INVITE transaction is modeled and verified using event-B method and its Rodin platform. The Event-B refinement concept allows an incremental development by defining the studied system at different levels of abstraction, and Rodin discharges almost all proof obligations at each level. This interaction between modeling and proving reduces the complexity and helps in assuring that the INVITE transaction SIP specification is correct, unambiguous, and easy to understand.

  12. The written mathematical communication profile of prospective math teacher in mathematical proving

    Science.gov (United States)

    Pantaleon, K. V.; Juniati, D.; Lukito, A.; Mandur, K.

    2018-01-01

    Written mathematical communication is the process of expressing mathematical ideas and understanding in writing. It is one of the important aspects that must be mastered by the prospective math teacher as tool of knowledge transfer. This research was a qualitative research that aimed to describe the mathematical communication profile of the prospective mathematics teacher in mathematical proving. This research involved 48 students of Mathematics Education Study Program; one of them with moderate math skills was chosen as the main subject. Data were collected through tests, assignments, and task-based interviews. The results of this study point out that in the proof of geometry, the subject explains what is understood, presents the idea in the form of drawing and symbols, and explains the content/meaning of a representation accurately and clearly, but the subject can not convey the argument systematically and logically. Whereas in the proof of algebra, the subject describes what is understood, explains the method used, and describes the content/meaning of a symbolic representation accurately, systematically, logically, but the argument presented is not clear because it is insufficient detailed and complete.

  13. Hydrogeologic and chemical data for the O-Field area, Aberdeen Proving Ground, Maryland

    International Nuclear Information System (INIS)

    Nemoff, P.R.; Vroblesky, D.A.

    1989-01-01

    O-Field, located at the Edgewood area of Aberdeen Proving Ground, Maryland, was periodically used for disposal of munitions, waste chemicals, and chemical-warfare agents from World War II through the 1950's. This report includes various physical, geologic, chemical, and hydrologic data obtained from well-core, groundwater, surface water, and bottom-sediment sampling sites at and near the O-Field disposal area. The data are presented in tables and hydrographs. Three site-location maps are also included. Well-core data include lithologic logs for 11 well-cluster sites, grain-size distributions, various chemical characteristics, and confining unit characteristics. Groundwater data include groundwater chemistry, method blanks for volatile organic carbon, available data on volatile and base/neutral organics, and compilation of corresponding method blanks, chemical-warfare agents, explosive-related products, radionuclides, herbicides, and groundwater levels. Surface-water data include field-measured characteristics; concentrations of various inorganic constituents including arsenic; selected organic constituents with method blanks; detection limits of organics; and a compilation of information on corresponding acids, volatiles, and semivolatiles; and method blanks corresponding to acids, volatiles, and semivolatiles. A set of 15 water-level hydrographs for the period March 1986 through September 1987 also is included in the report. 3 refs., 18 figs., 24 tabs

  14. Modeling exposure to depleted uranium in support of decommissioning at Jefferson Proving Ground, Indiana

    Energy Technology Data Exchange (ETDEWEB)

    Ebinger, M.H. [Los Alamos National Lab., NM (United States); Oxenburg, T.P. [Army Test and Evaluation Command, Aberdeen Proving Ground, MD (United States)

    1997-02-01

    Jefferson Proving Ground was used by the US Army Test and Evaluation Command for testing of depleted uranium munitions and closed in 1995 under the Base Realignment and Closure Act. As part of the closure of JPG, assessments of potential adverse health effects to humans and the ecosystem were conducted. This paper integrates recent information obtained from site characterization surveys at JPG with environmental monitoring data collected from 1983 through 1994 during DU testing. Three exposure scenarios were evaluated for potential adverse effects to human health: an occasional use scenario and two farming scenarios. Human exposure was minimal from occasional use, but significant risk were predicted from the farming scenarios when contaminated groundwater was used by site occupants. The human health risk assessments do not consider the significant risk posed by accidents with unexploded ordnance. Exposures of white-tailed deer to DU were also estimated in this study, and exposure rates result in no significant increase in either toxicological or radiological risks. The results of this study indicate that remediation of the DU impact area would not substantially reduce already low risks to humans and the ecosystem, and that managed access to JPG is a reasonable model for future land use options.

  15. Contamination source review for Building E3236, Edgewood Area, Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Zellmer, S.D.; Smits, M.P.; Draugelis, A.K.; Glennon, M.A.; Rueda, J.; Zimmerman, R.E.

    1995-09-01

    The US Army Aberdeen Proving Ground (APG) commissioned Argonne National Laboratory (ANL) to conduct a contamination source review to identify and define areas of toxic or hazardous contaminants and to assess the physical condition and accessibility of APG buildings. The information obtained from the review may be used to assist the US Army in planning for the future use or disposition of the buildings. The contamination source review consisted of the following tasks: historical records search, physical inspection, photographic documentation, geophysical investigation, and review of available records regarding underground storage tanks associated with each building. This report provides the results of the contamination source review for Building E3236. Many of the APG facilities constructed between 1917 and the 1960s are no longer used because of obsolescence and their poor state of repair. Because many of these buildings were used for research, development, testing, and/or pilot- scale production of chemical warfare agents and other military substances, the potential exists for portions of the buildings to be contaminated with these substances, their degradation products, and other laboratory or industrial chemicals. These buildings and associated structures or appurtenances may contribute to environmental concerns at APG.

  16. Remedial investigation report for J-Field, Aberdeen Proving Ground, Maryland. Volume 1: Remedial investigation results

    International Nuclear Information System (INIS)

    Yuen, C. R.; Martino, L. E.; Biang, R. P.; Chang, Y. S.; Dolak, D.; Van Lonkhuyzen, R. A.; Patton, T. L.; Prasad, S.; Quinn, J.; Rosenblatt, D. H.; Vercellone, J.; Wang, Y. Y.

    2000-01-01

    This report presents the results of the remedial investigation (RI) conducted at J-Field in the Edgewood Area of Aberdeen Proving Ground (APG), a U.S. Army installation located in Harford County, Maryland. Since 1917, activities in the Edgewood Area have included the development, manufacture, and testing of chemical agents and munitions and the subsequent destruction of these materials at J-Field by open burning and open detonation. These activities have raised concerns about environmental contamination at J-Field. This RI was conducted by the Environmental Conservation and Restoration Division, Directorate of Safety, Health and Environmental Division of APG, pursuant to requirements outlined under the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (CERCLA). The RI was accomplished according to the procedures developed by the U.S. Environmental Protection Agency (EPA 1988). The RI provides a comprehensive evaluation of the site conditions, nature of contaminants present, extent of contamination, potential release mechanisms and migration pathways, affected populations, and risks to human health and the environment. This information will be used as the basis for the design and implementation of remedial actions to be performed during the remedial action phase, which will follow the feasibility study (FS) for J-Field

  17. How to prove the Earth's daily and annual direction of its spinning

    Directory of Open Access Journals (Sweden)

    Drago Špoljarić

    2014-12-01

    Full Text Available Every day, we can observe the Sun's apparent motion around the sky. It rises in the east, gets to its highest point above the horizon at noon, and sets in the west. The stars appear to be fixed on the sky and move around apparently together with the Sun. We have daytime1 and night. The apparent annual motion of the Sun results in seasons when we can see different stars. These directly visible daily and annual changes result from real Earth’s motions – the Earth’s daily and annual spinning (rotation and revolution and they are not easily explainable without understanding the Earth’s motions. In order to understand the apparent daily and annual motions and motion direction of the Sun and stars (night sky, it is very important to know where we are on the Earth, what is our geographic position, i.e. to know the cardinal points. At the same time, one should take into consideration also the direction of the Earth’s rotation and revolution. What is the Earth’s daily or annual direction of spinning as related to the direction of clock hands, and how do we prove it?

  18. Remedial investigation report for J-Field, Aberdeen Proving Ground, Maryland. Volume 1: Remedial investigation results

    Energy Technology Data Exchange (ETDEWEB)

    Yuen, C. R.; Martino, L. E.; Biang, R. P.; Chang, Y. S.; Dolak, D.; Van Lonkhuyzen, R. A.; Patton, T. L.; Prasad, S.; Quinn, J.; Rosenblatt, D. H.; Vercellone, J.; Wang, Y. Y.

    2000-03-14

    This report presents the results of the remedial investigation (RI) conducted at J-Field in the Edgewood Area of Aberdeen Proving Ground (APG), a U.S. Army installation located in Harford County, Maryland. Since 1917, activities in the Edgewood Area have included the development, manufacture, and testing of chemical agents and munitions and the subsequent destruction of these materials at J-Field by open burning and open detonation. These activities have raised concerns about environmental contamination at J-Field. This RI was conducted by the Environmental Conservation and Restoration Division, Directorate of Safety, Health and Environmental Division of APG, pursuant to requirements outlined under the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (CERCLA). The RI was accomplished according to the procedures developed by the U.S. Environmental Protection Agency (EPA 1988). The RI provides a comprehensive evaluation of the site conditions, nature of contaminants present, extent of contamination, potential release mechanisms and migration pathways, affected populations, and risks to human health and the environment. This information will be used as the basis for the design and implementation of remedial actions to be performed during the remedial action phase, which will follow the feasibility study (FS) for J-Field.

  19. The existence of propagated sensation along the meridian proved by neuroelectrophysiology

    Science.gov (United States)

    Xu, Jinsen; Zheng, Shuxia; Pan, Xiaohua; Zhu, Xiaoxiang; Hu, Xianglong

    2013-01-01

    Propagated sensation along the meridian can occur when acupoints are stimulated by acupuncture or electrical impulses. In this study, participants with notable propagated sensation along the dian were given electro-acupuncture at the Jianyu (LI15) acupoint of the large intestine meridian. When participants stated that the sensation reached the back of their hand, regular nervous system action discharge was examined using a physiological recording electrode placed on the superficial branch of the radial nerve. The topographical maps of brain-evoked potential in the primary cortical somatosensory area were also detected. When Guangming (GB37) acupoint in the lower limb and Hegu (LI4) acupoint in the upper limb were stimulated, subjects without propagated sensation along the meridian exhibited a high potential reaction in the corresponding area of the brain cortical so-matosensory area. For subjects with a notable propagated sensation along the meridian, the tion area was larger and extended into the face representative area. These electrophysiological measures directly prove the existence of propagated sensation along the meridian, and the pheral stimulated site is consistent with the corresponding primary cortical somatosensory area, which presents a high potential reaction. PMID:25206574

  20. Transgenic Drosophila simulans strains prove the identity of the speciation gene Lethal hybrid rescue.

    Science.gov (United States)

    Prigent, Stéphane R; Matsubayashi, Hiroshi; Yamamoto, Masa-Toshi

    2009-10-01

    Speciation genes are responsible for genetic incompatibilities in hybrids of incipient species and therefore participate in reproductive isolation leading to complete speciation. Hybrid males between Drosophila melanogaster females and D. simulans males die at late larval or prepupal stages due to a failure in chromosome condensation during mitosis. However a mutant male of D. simulans, named Lethal hybrid rescue (Lhr), produces viable hybrid males when crossed to females of D. melanogaster. Recently the Lhr gene has been proposed as corresponding to the CG18468 gene in D. melanogaster. However this identification relied on sequence characteristics more than on a precise mapping and the use of the GAL4/UAS system to drive the transgene in D. melanogaster might have increased the complexity of interaction. Thus here we propose an independent identification of the Lhr gene based on a more precise mapping and transgenic experiments in D. simulans. We have mapped the Lhr gene by using Single Nucleotide Polymorphisms (SNPs) and identified within the candidate region the gene homologous to CG18468 as the Lhr gene as it was previously reported. Transgenic experiments in D. simulans with the native promoter of CG18468 prove that it is the Lhr gene of D. simulans by inducing the lethality of the hybrid males.

  1. Review of analytical results from the proposed agent disposal facility site, Aberdeen Proving Ground

    Energy Technology Data Exchange (ETDEWEB)

    Brubaker, K.L.; Reed, L.L.; Myers, S.W.; Shepard, L.T.; Sydelko, T.G.

    1997-09-01

    Argonne National Laboratory reviewed the analytical results from 57 composite soil samples collected in the Bush River area of Aberdeen Proving Ground, Maryland. A suite of 16 analytical tests involving 11 different SW-846 methods was used to detect a wide range of organic and inorganic contaminants. One method (BTEX) was considered redundant, and two {open_quotes}single-number{close_quotes} methods (TPH and TOX) were found to lack the required specificity to yield unambiguous results, especially in a preliminary investigation. Volatile analytes detected at the site include 1, 1,2,2-tetrachloroethane, trichloroethylene, and tetrachloroethylene, all of which probably represent residual site contamination from past activities. Other volatile analytes detected include toluene, tridecane, methylene chloride, and trichlorofluoromethane. These compounds are probably not associated with site contamination but likely represent cross-contamination or, in the case of tridecane, a naturally occurring material. Semivolatile analytes detected include three different phthalates and low part-per-billion amounts of the pesticide DDT and its degradation product DDE. The pesticide could represent residual site contamination from past activities, and the phthalates are likely due, in part, to cross-contamination during sample handling. A number of high-molecular-weight hydrocarbons and hydrocarbon derivatives were detected and were probably naturally occurring compounds. 4 refs., 1 fig., 8 tabs.

  2. Ecological risk assessment of depleted uranium in the environment at Aberdeen Proving Ground

    International Nuclear Information System (INIS)

    Clements, W.H.; Kennedy, P.L.; Myers, O.B.

    1993-01-01

    A preliminary ecological risk assessment was conducted to evaluate the effects of depleted uranium (DU) in the Aberdeen Proving Ground (APG) ecosystem and its potential for human health effects. An ecological risk assessment of DU should include the processes of hazard identification, dose-response assessment, exposure assessment, and risk characterization. Ecological risk assessments also should explicitly examine risks incurred by nonhuman as well as human populations, because risk assessments based only on human health do not always protect other species. To begin to assess the potential ecological risk of DU release to the environment we modeled DU transport through the principal components of the aquatic ecosystem at APG. We focused on the APG aquatic system because of the close proximity of the Chesapeake Bay and concerns about potential impacts on this ecosystem. Our objective in using a model to estimate environmental fate of DU is to ultimately reduce the uncertainty about predicted ecological risks due to DU from APG. The model functions to summarize information on the structure and functional properties of the APG aquatic system, to provide an exposure assessment by estimating the fate of DU in the environment, and to evaluate the sources of uncertainty about DU transport

  3. Consistency of extreme flood estimation approaches

    Science.gov (United States)

    Felder, Guido; Paquet, Emmanuel; Penot, David; Zischg, Andreas; Weingartner, Rolf

    2017-04-01

    Estimations of low-probability flood events are frequently used for the planning of infrastructure as well as for determining the dimensions of flood protection measures. There are several well-established methodical procedures to estimate low-probability floods. However, a global assessment of the consistency of these methods is difficult to achieve, the "true value" of an extreme flood being not observable. Anyway, a detailed comparison performed on a given case study brings useful information about the statistical and hydrological processes involved in different methods. In this study, the following three different approaches for estimating low-probability floods are compared: a purely statistical approach (ordinary extreme value statistics), a statistical approach based on stochastic rainfall-runoff simulation (SCHADEX method), and a deterministic approach (physically based PMF estimation). These methods are tested for two different Swiss catchments. The results and some intermediate variables are used for assessing potential strengths and weaknesses of each method, as well as for evaluating the consistency of these methods.

  4. Research into Financial Position of Listed Companies following Classification via Extreme Learning Machine Based upon DE Optimization

    OpenAIRE

    Fu Yu; Mu Jiong; Duan Xu Liang

    2016-01-01

    By means of the model of extreme learning machine based upon DE optimization, this article particularly centers on the optimization thinking of such a model as well as its application effect in the field of listed company’s financial position classification. It proves that the improved extreme learning machine algorithm based upon DE optimization eclipses the traditional extreme learning machine algorithm following comparison. Meanwhile, this article also intends to introduce certain research...

  5. Improving working equine welfare in 'hard-win' situations, where gains are difficult, expensive or marginal.

    Directory of Open Access Journals (Sweden)

    Joy Pritchard

    Full Text Available Brooke is a non-government organisation with working equine welfare programmes across Africa, Asia and Latin America. In 2014, staff from ten country programmes were asked to identify 'no-win' situations (subsequently reframed as 'hard-wins'-where improving equine welfare is proving difficult, expensive and/or marginal-in order to inform strategic decisions on how to approach, manage and mitigate for such situations.The Delphi-type consultation process had three phases. Round 1 posed five questions in the form of a workshop, survey and semi-structured interviews. Round 2 re-presented key themes and sense-checked initial conclusions. Round 3 reviewed the nature and prevalence of hard-win situations at an international meeting of all participants.Reasons given for hard-win situations included: no economic or social benefit from caring for working animals; poor resource availability; lack of empathy for working equids or their owners among wider stakeholders; deep-seated social issues, such as addiction or illegal working; areas with a high animal turnover or migratory human population; lack of community cooperation or cohesion; unsafe areas where welfare interventions cannot be adequately supported. Participants estimated the prevalence of hard-win situations as 40-70% of their work. They suggested some current ways of working that may be contributing to the problem, and opportunities to tackle hard-wins more effectively.Respondents agreed that if equine welfare improvements are to span generations of animals, interventions cannot rely on relatively simple, technical knowledge-transfer strategies and quick-wins alone. Programmes need to be more flexible and iterative and less risk-averse in their approaches to embedding good equine welfare practices in all relevant actors. Consultation recommendations informed development of Brooke's new global strategy, a revised organisational structure and redefinition of roles and responsibilities to

  6. Experimental study of soil-structure interaction for proving the three dimensional thin layered element method

    International Nuclear Information System (INIS)

    Kuwabara, Y.; Ogiwara, Y.; Suzuki, T.; Tsuchiya, H.; Nakayama, M.

    1981-01-01

    It is generally recognized that the earthquake response of a structure can be significantly affected by the dynamic interaction between the structure and the surrounding soil. Dynamic soil-structure interaction effects are usually analyzed by using a lumped mass model or a finite element model. In the lumped mass model, the soil is represented by springs and dashpots based on the half-space elastic theory. Each model has its advantages and limitations. The Three Dimensional Thin Layered Element Theory has been developed by Dr. Hiroshi Tajimi based on the combined results of the abovementioned lumped mass model and finite element model. The main characteristic of this theory is that, in consideration and can be applied in the analysis of many problems in soil-structure interaction, such as those involving radiation damping, embedded structures, and multi-layered soil deposits. This paper describes test results on a small scale model used to prove the validity of the computer program based on the Thin Layered Element Theory. As a numerical example, the response analysis of a PWR nuclear power plant is carried out using this program. The vibration test model is simplified and the scale is 1/750 for line. The soil layer of the model is made of congealed gelatine. The test soil layer is 80 cm long, 35 cm wide and 10 cm thick. The super structure is a one mass model made of metal sheet spring and solid mass metal. As fixed inputs, sinusoidal waves (10, 20 gal level) are used. The displacements of the top and base of the super structure, and the accelerations and the displacements of the shaking table are measured. The main parameter of the test is the shear wave velocity of the soil layer. (orig./RW)

  7. Potential health impacts from range fires at Aberdeen Proving Ground, Maryland

    International Nuclear Information System (INIS)

    Willians, G.P.; Hermes, A.M.; Policastro, A.J.; Hartmann, H.M.; Tomasko, D.

    1998-03-01

    This study uses atmospheric dispersion computer models to evaluate the potential for human health impacts from exposure to contaminants that could be dispersed by fires on the testing ranges at Aberdeen Proving Ground, Maryland. It was designed as a screening study and does not estimate actual human health risks. Considered are five contaminants possibly present in the soil and vegetation from past human activities at APG--lead, arsenic, trichloroethylene (TCE), depleted uranium (DU), and dichlorodiphenyltrichloroethane (DDT); and two chemical warfare agents that could be released from unexploded ordnance rounds heated in a range fire--mustard and phosgene. For comparison, dispersion of two naturally occurring compounds that could be released by burning of uncontaminated vegetation--vinyl acetate and 2-furaldehyde--is also examined. Data from previous studies on soil contamination at APG are used in conjunction with conservative estimates about plant uptake of contaminants, atmospheric conditions, and size and frequency of range fires at APG to estimate dispersion and possible human exposure. The results are compared with US Environmental Protection Agency action levels. The comparisons indicate that for all of the anthropogenic contaminants except arsenic and mustard, exposure levels would be at least an order of magnitude lower than the corresponding action levels. Because of the compoundingly conservative nature of the assumptions made, they conclude that the potential for significant human health risks from range fires is low. The authors recommend that future efforts be directed at fire management and control, rather than at conducting additional studies to more accurately estimate actual human health risk from range fires

  8. JPSS Preparations at the Satellite Proving Ground for Marine, Precipitation, and Satellite Analysis

    Science.gov (United States)

    Folmer, M. J.; Berndt, E.; Clark, J.; Orrison, A.; Kibler, J.; Sienkiewicz, J. M.; Nelson, J. A., Jr.; Goldberg, M.

    2016-12-01

    The National Oceanic and Atmospheric Administration (NOAA) Satellite Proving Ground (PG) for Marine, Precipitation, and Satellite Analysis (MPS) has been demonstrating and evaluating Suomi National Polar-orbiting Partnership (S-NPP) products along with other polar-orbiting satellite platforms in preparation for the Joint Polar Satellite System - 1 (JPSS-1) launch in March 2017. The first S-NPP imagery was made available to the MPS PG during the evolution of Hurricane Sandy in October 2012 and has since been popular in operations. Since this event the MPS PG Satellite Liaison has been working with forecasters on ways to integrate single-channel and multispectral imagery from the Visible Infrared Imaging Radiometer Suite (VIIRS), the Moderate Resolution Imaging Spectroradiometer (MODIS), and the Advanced Very High Resolution Radiometer (AVHRR)into operations to complement numerical weather prediction and geostationary satellite savvy National Weather Service (NWS) National Centers. Additional unique products have been introduced to operations to address specific forecast challenges, including the Cooperative Institute for Research in the Atmosphere (CIRA) Layered Precipitable Water, the National Environmental Satellite, Data, and Information Service (NESDIS) Snowfall Rate product, NOAA Unique Combined Atmospheric Processing System (NUCAPS) Soundings, ozone products from the Atmospheric Infrared Sounder (AIRS), Cross-track Infrared Sounder/Advanced Technology Microwave Sounder (CrIS/ATMS), and Infrared Atmospheric Sounding Interferometer (IASI). In addition, new satellite domains have been created to provide forecasters at the NWS Ocean Prediction Center and Weather Prediction Center with better quality imagery at high latitudes. This has led to research projects that are addressing forecast challenges such as tropical to extratropical transition and explosive cyclogenesis. This presentation will provide examples of how the MPS PG has been introducing and integrating

  9. Environmental radiation monitoring plan for depleted uranium and beryllium areas, Yuma Proving Ground

    International Nuclear Information System (INIS)

    Ebinger, M.H.; Hansen, W.R.

    1994-01-01

    This Environmental Radiation Monitoring Plan (ERM) discusses sampling soils, vegetation, and biota for depleted uranium (DU) and beryllium (Be) at Yuma Proving Ground (YPG). The existing ERM plan was used and modified to more adequately assess the potential of DU and Be migration through the YPG ecosystem. The potential pathways for DU and Be migration are discussed and include soil to vegetation, soil to animals, vegetation to animals, animals to animals, and animals to man. Sample collection will show DU deposition and will be used to estimate DU migration. The number of samples from each area varies and depends on if the firing range of interest is currently used for DU testing (GP 17A) or if the range is not used currently for DU testing (GP 20). Twenty to thirty-five individual mammals or lizards will be sampled from each transect. Air samples and samples of dust in the air fall will be collected in three locations in the active ranges. Thirty to forty-five sediment samples will be collected from different locations in the arroys near the impact areas. DU and Be sampling in the Hard Impact and Soft Impact areas changed only slightly from the existing ERM. The modifications are changes in sample locations, addition of two sediment transport locations, addition of vegetation samples, mammal samples, and air sampling from three to five positions on the impact areas. Analysis of samples for DU or total U by inductively-coupled mass spectroscopy (ICP/MS), cc spectroscopy, neutron activation analysis (NAA), and kinetic phosphorimetric analysis (KPA) are discussed, and analysis for Be by ICP/MS are recommended. Acquiring total U (no isotope data) from a large number of samples and analysis of those samples with relatively high total U concentrations results in fewer isotopic identifications but more information on U distribution. From previous studies, total U concentrations greater than about 3 times natural background are usually DU by isotopic confirmation

  10. Work plan for conducting an ecological risk assessment at J-Field, Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Hlohowskyj, I.; Hayse, J.; Kuperman, R. [Argonne National Lab., IL (United States). Environmental Assessment Div.] [and others

    1995-03-01

    The Environmental Management Division of Aberdeen Proving Ground (APG), Maryland, is conducting a remedial investigation and feasibility study (RI/FS) of the J-Field area at APG pursuant to the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), as amended. J-Field is within the Edgewood Area of APG in Harford County, Maryland, and activities at the Edgewood Area since World War II have included the development, manufacture, testing, and destruction of chemical agents and munitions. The J-Field site was used to destroy chemical agents and munitions by open burning and open detonation. This work plan presents the approach proposed to conduct an ecological risk assessment (ERA) as part of the RI/FS program at J-Field. This work plan identifies the locations and types of field studies proposed for each area of concern (AOC), the laboratory studies proposed to evaluate toxicity of media, and the methodology to be used in estimating doses to ecological receptors and discusses the approach that will be used to estimate and evaluate ecological risks at J-Field. Eight AOCs have been identified at J-Field, and the proposed ERA is designed to evaluate the potential for adverse impacts to ecological receptors from contaminated media at each AOC, as well as over the entire J-Field site. The proposed ERA approach consists of three major phases, incorporating field and laboratory studies as well as modeling. Phase 1 includes biotic surveys of the aquatic and terrestrial habitats, biological tissue sampling and analysis, and media toxicity testing at each AOC and appropriate reference locations. Phase 2 includes definitive toxicity testing of media from areas of known or suspected contamination or of media for which the Phase 1 results indicate toxicity or adverse ecological effects. In Phase 3, the uptake models initially developed in Phase 2 will be finalized, and contaminant dose to each receptor from all complete pathways will be estimated.

  11. Potential health impacts from range fires at Aberdeen Proving Ground, Maryland.

    Energy Technology Data Exchange (ETDEWEB)

    Willians, G.P.; Hermes, A.M.; Policastro, A.J.; Hartmann, H.M.; Tomasko, D.

    1998-03-01

    This study uses atmospheric dispersion computer models to evaluate the potential for human health impacts from exposure to contaminants that could be dispersed by fires on the testing ranges at Aberdeen Proving Ground, Maryland. It was designed as a screening study and does not estimate actual human health risks. Considered are five contaminants possibly present in the soil and vegetation from past human activities at APG--lead, arsenic, trichloroethylene (TCE), depleted uranium (DU), and dichlorodiphenyltrichloroethane (DDT); and two chemical warfare agents that could be released from unexploded ordnance rounds heated in a range fire--mustard and phosgene. For comparison, dispersion of two naturally occurring compounds that could be released by burning of uncontaminated vegetation--vinyl acetate and 2-furaldehyde--is also examined. Data from previous studies on soil contamination at APG are used in conjunction with conservative estimates about plant uptake of contaminants, atmospheric conditions, and size and frequency of range fires at APG to estimate dispersion and possible human exposure. The results are compared with US Environmental Protection Agency action levels. The comparisons indicate that for all of the anthropogenic contaminants except arsenic and mustard, exposure levels would be at least an order of magnitude lower than the corresponding action levels. Because of the compoundingly conservative nature of the assumptions made, they conclude that the potential for significant human health risks from range fires is low. The authors recommend that future efforts be directed at fire management and control, rather than at conducting additional studies to more accurately estimate actual human health risk from range fires.

  12. Generator, mechanical, smoke: For dual-purpose unit, XM56, Yuma Proving Ground, Yuma, Arizona

    Energy Technology Data Exchange (ETDEWEB)

    Driver, C.J.; Ligotke, M.W.; Moore, E.B. Jr. (Pacific Northwest Lab., Richland, WA (United States)); Bowers, J.F. (Dugway Proving Ground, UT (United States))

    1991-10-01

    The US Army Chemical Research, Development and Engineering Center (CRDEC) is planning to perform a field test of the XM56 smoke generator at the US Army Yuma Proving Ground (YPG), Arizona. The XM56, enabling the use of fog oil in combination with other materials, such as graphite flakes, is part of an effort to improve the efficiency of smoke generation and to extend the effectiveness of the resulting obscurant cloud to include the infrared spectrum. The plan field operation includes a road test and concurrent smoke- generation trials. Three M1037 vehicles with operation XM56 generators will be road-tested for 100 h. Smoke will be generated for 30 min from a single stationary XM56 four times during the road test, resulting in a total of 120 min of smoke generation. The total aerial release of obscurant materials during this test is expected to be 556 kg (1,220 lb) of fog oil and 547 kg (1,200 lb) of graphite flakes. This environmental assessment has evaluated the consequences of the proposed action. Air concentrations and surface deposition levels were estimated using an atmospheric dispersion model. Degradation of fog oil and incorporation of graphite in the soil column will limit the residual impacts of the planned action. No significant impacts to air, water, and soil quality are anticipated. risks to the environment posed by the proposed action were determined to be minimal or below levels previously found to pose measurable impacts. Cultural resources are present on YPG and have been identified in adjacent areas; therefore, off-road activities should be preceded by a cultural resource survey. A Finding of No Significant Impact is recommended. 61 refs., 1 fig.

  13. Prevention of Dental Damage and Improvement of Difficult Intubation Using a Paraglossal Technique With a Straight Miller Blade

    Directory of Open Access Journals (Sweden)

    Yu-Feng Huang

    2010-10-01

    Full Text Available Patients with diseased teeth, or those who are difficult to intubate, have a higher risk of dental injury during laryngoscopy. We report 3 cases of smooth endotracheal intubation using a paraglossal technique with a straight Miller blade in patients with poor dentition. Three patients with poor dentition were scheduled to undergo surgery under general anesthesia. All patients presented with extremely loose upper central incisors and had lost the other right upper teeth, while micrognathia and prominent, loose upper incisors were noted in 1 case. We elected to use a straight Miller blade using a paraglossal approach. A nasopharyngeal airway was inserted after induction of general anesthesia to facilitate mask ventilation and prevent air leakage from the mask. The Miller blade was then inserted from the right corner of the mouth, avoiding contact with the vulnerable incisors, and advanced along the groove between the tongue and tonsil. The endotracheal tube was subsequently smoothly inserted after obtaining a grade 1 Cormack and Lehane view without dental trauma in all 3 cases. Direct laryngoscopy using the paraglossal straight blade technique avoids dental damage in patients with mobile upper incisors and no right maxillary molars. It is a practical alternative method that differs from the traditional Macintosh laryngoscope in patients with a high risk of dental injury during the procedure. This technique, which provides an improved view of the larynx, might also be helpful with patients in whom intubation is difficult.

  14. The effectiveness of search dogs compared with humans in searching difficult terrain at turbine sites for bat fatalities

    Energy Technology Data Exchange (ETDEWEB)

    Mathews, Fiona

    2011-07-01

    Full text: Many wind farms in the UK and elsewhere in northern Europe are situated in habitat with dense tall vegetation such as arable fields and upland heaths. This makes surveying for bat fatalities extremely difficult. To facilitate a multi-centre study of the effects of wind turbines on British bats, we have therefore conducted controlled trials of the relative success of trained search dogs and ecologists in retrieving bat carcasses. Although dogs have been used previously in ecological surveys for bats, this is the first time they have been specifically trained for use in 'difficult to survey' habitats. Two ecologists and two Labrador dogs with handlers were each given the opportunity to retrieve up to 45 bat carcasses in a range of habitat types. Their efficiency in terms of overall search time, costs, and retrieval abilities were evaluated. Our results indicate that high rates of retrieval can be achieved by dogs, even in dense vegetation up to 75cm high. Further, a typical 100m2 search area can be surveyed in less than half the time taken by humans. The limitations of using search dogs, and their ability to detect the presence of bats that have been scavenged are also presented (presentation supported with video footage). (Author)

  15. Spatial dependence of extreme rainfall

    Science.gov (United States)

    Radi, Noor Fadhilah Ahmad; Zakaria, Roslinazairimah; Satari, Siti Zanariah; Azman, Muhammad Az-zuhri

    2017-05-01

    This study aims to model the spatial extreme daily rainfall process using the max-stable model. The max-stable model is used to capture the dependence structure of spatial properties of extreme rainfall. Three models from max-stable are considered namely Smith, Schlather and Brown-Resnick models. The methods are applied on 12 selected rainfall stations in Kelantan, Malaysia. Most of the extreme rainfall data occur during wet season from October to December of 1971 to 2012. This period is chosen to assure the available data is enough to satisfy the assumption of stationarity. The dependence parameters including the range and smoothness, are estimated using composite likelihood approach. Then, the bootstrap approach is applied to generate synthetic extreme rainfall data for all models using the estimated dependence parameters. The goodness of fit between the observed extreme rainfall and the synthetic data is assessed using the composite likelihood information criterion (CLIC). Results show that Schlather model is the best followed by Brown-Resnick and Smith models based on the smallest CLIC's value. Thus, the max-stable model is suitable to be used to model extreme rainfall in Kelantan. The study on spatial dependence in extreme rainfall modelling is important to reduce the uncertainties of the point estimates for the tail index. If the spatial dependency is estimated individually, the uncertainties will be large. Furthermore, in the case of joint return level is of interest, taking into accounts the spatial dependence properties will improve the estimation process.

  16. Monitoring the Carbon Cycle: Improving Our Ability to Proved Policy Relevant Information

    Science.gov (United States)

    Bruhwiler, L.

    2017-12-01

    Humans have altered the energy balance of the climate system mainly by producing and consuming fossil fuels, but also by emissions from food production. Manufacture and use of halocarbons, many of which are also strong greenhouse gases (GHGs) have added to anthropogenic radiative forcing. In response, the global atmosphere has warmed over the last half century at a rate of 0.17°C. The largest contribution to radiative forcing is due to CO2, and at present, about half of all anthropogenic CO2 emissions have been taken up by the oceans and terrestrial biosphere. The size of this "carbon emission discount" may change in the future as more carbon accumulates in the oceans, as human alter landscapes, and as climate changes. Efforts to limit global average temperature increases to 2°C and avoid the most catastrophic consequences of climate change depend on keeping track of both human emissions of greenhouse gases and changes in natural fluxes of carbon and nitrogen that occur in response to human activities and changing climate. Global in situ network observations provide information about changes in global GHG abundances over recent decades, as well as changing distributions between hemispheres. This information gives insight into changes in global and hemispheric sources and sinks of GHGs. It is, however, currently difficult to obtain robust information about regional sources and to discriminate between natural and anthropogenic fluxes. Information about regional sources is needed for GHG policymaking, while discrimination of natural sources is necessary for detection of trends in GHG fluxes and evaluation of coupled carbon cycle climate models. Although column average GHG abundances from space-based remote sensing data could provide considerable constraints on GHG budgets, there are still technical challenges to be overcome. Possible strategies for making progress involve greater increased observational coverage and more international collaboration, as well as

  17. The Prudential Regulation of Financial Institutions: Why Regulatory Responses to the Crisis Might Not Prove Sufficient

    Directory of Open Access Journals (Sweden)

    William R. White

    2013-10-01

    Full Text Available It is now six years since a devastating financial and economic crisis rocked the global economy. Supported strongly by the G20 process, international regulators led by the Financial Stability Board have been working hard ever since to develop new regulatory standards designed to prevent a recurrence of these events. These international standards are intended to provide guidance for the drawing up of national legislation and regulation, and have already had a pervasive influence around the world. This paper surveys recent international developments concerning the prudential regulation of financial institutions: banks, the shadow banking system and insurance companies. It concludes that, while substantial progress has been made, the global economy nevertheless remains vulnerable to possible future financial instability. This possibility reflects three sets of concerns. First, measures taken to manage the crisis to date have actually made the prevention of future crises more difficult. Second, the continuing active debate over virtually every aspect of the new regulatory guidelines indicates that the analytical foundations of what is being proposed remain highly contestable. Third, implementation of the new proposals could suffer from different practices across regions. Looking forward, the financial sector will undoubtedly continue to innovate in response to competitive pressures and in an attempt to circumvent whatever regulations do come into effect. If we view the financial sector as a complex adaptive system, continuous innovation would only be expected. This perspective also provides a number of insights as to how regulators should respond in turn. Not least, it suggests that attempts to reduce complexity would not be misguided and that complex behaviour need not necessarily be accompanied by still more complex regulation. Removing impediments to more effective self discipline and market discipline in the financial sector would also seem

  18. Incidence of unanticipated difficult airway using an objective airway score versus a standard clinical airway assessment

    DEFF Research Database (Denmark)

    Nørskov, Anders Kehlet; Rosenstock, Charlotte Valentin; Wetterslev, Jørn

    2013-01-01

    -specific assessment. Data from patients' pre-operative airway assessment are registered in the Danish Anaesthesia Database. Objective scores for intubation and mask ventilation grade the severity of airway managements. The accuracy of predicting difficult intubation and mask ventilation is measured for each group...... the examination and registration of predictors for difficult mask ventilation with a non-specified clinical airway assessment on prediction of difficult mask ventilation.Method/Design: We cluster-randomized 28 Danish departments of anaesthesia to airway assessment either by the SARI or by usual non...... that registration of the SARI and predictors for difficult mask ventilation are mandatory for the intervention group but invisible to controls....

  19. Prospective Retinal and Optic Nerve Vitrectomy Evaluation (PROVE study: findings at 3 months

    Directory of Open Access Journals (Sweden)

    Reddy RK

    2013-09-01

    Full Text Available Rahul K Reddy,1 Maziar Lalezary,1 Stephen J Kim,1 Jeffrey A Kammer,1 Rachel W Kuchtey,1 Edward F Cherney,1 Franco M Recchia,2 Karen M Joos,1 Anita Agarwal,1 Janice C Law11Department of Ophthalmology, Vanderbilt University School of Medicine, Nashville, TN, USA; 2Tennessee Retina, PC, Nashville, TN, USABackground: The purpose of this paper is to report the 3-month findings of the Prospective Retinal and Optic Nerve Vitrectomy Evaluation (PROVE study.Methods: Eighty eyes of 40 participants undergoing vitrectomy were enrolled. Participants underwent baseline evaluation of the study (surgical and fellow (control eye that included: intraocular pressure, central corneal thickness, gonioscopy, cup-to-disc ratio measurement, color fundus and optic disc photography, automated perimetry, and optical coherence tomography of the macula and optic nerve. Evaluation was repeated at 3 months. Main outcome measures were changes in macula and retinal nerve fiber layer (RNFL thickness and intraocular pressure.Results: All participants completed follow-up. Mean cup-to-disc ratio of study and fellow eyes at baseline was 0.43 ± 0.2 and 0.46 ± 0.2, respectively, and 13% of participants had undiagnosed narrow angles. There was no significant change in intraocular pressure, cup-to-disc ratio, or pattern standard deviation in study eyes compared with baseline or fellow eyes at 3 months. Vision improved in all study eyes at 3 months compared with baseline (P = 0.013, but remained significantly worse than fellow eyes (P < 0.001. Central subfield and temporal peripapillary RNFL thickness were significantly greater in eyes with epiretinal membrane (P < 0.05, and resolution after surgery correlated with visual improvement (P < 0.05.Conclusion: The 3-month results do not indicate any increased risk for open-angle glaucoma but suggest that a relatively high percentage of eyes may be at risk of angle closure glaucoma. Temporal RNFL thickness and central subfield were increased

  20. Statistical Model of Extreme Shear

    DEFF Research Database (Denmark)

    Larsen, Gunner Chr.; Hansen, Kurt Schaldemose

    2004-01-01

    In order to continue cost-optimisation of modern large wind turbines, it is important to continously increase the knowledge on wind field parameters relevant to design loads. This paper presents a general statistical model that offers site-specific prediction of the probability density function...... by a model that, on a statistically consistent basis, describe the most likely spatial shape of an extreme wind shear event. Predictions from the model have been compared with results from an extreme value data analysis, based on a large number of high-sampled full-scale time series measurements...... are consistent, given the inevitabel uncertainties associated with model as well as with the extreme value data analysis. Keywords: Statistical model, extreme wind conditions, statistical analysis, turbulence, wind loading, statistical analysis, turbulence, wind loading, wind shear, wind turbines....

  1. Racial Extremism in the Army

    National Research Council Canada - National Science Library

    Hudson, Walter M

    1998-01-01

    ... modem phenomenon of "skinheads." I then discuss the history of white supremacist extremism in the Army, culminating in the December, 1995 murders of two black civilians by soldiers assigned to the 82d Airborne Division at Fort Bragg, North Carolina...

  2. Interevent Time Distribution of Renewal Point Process, Case Study: Extreme Rainfall in South Sulawesi

    Science.gov (United States)

    Sunusi, Nurtiti

    2018-03-01

    The study of time distribution of occurrences of extreme rain phenomena plays a very important role in the analysis and weather forecast in an area. The timing of extreme rainfall is difficult to predict because its occurrence is random. This paper aims to determine the inter event time distribution of extreme rain events and minimum waiting time until the occurrence of next extreme event through a point process approach. The phenomenon of extreme rain events over a given period of time is following a renewal process in which the time for events is a random variable τ. The distribution of random variable τ is assumed to be a Pareto, Log Normal, and Gamma. To estimate model parameters, a moment method is used. Consider Rt as the time of the last extreme rain event at one location is the time difference since the last extreme rainfall event. if there are no extreme rain events up to t 0, there will be an opportunity for extreme rainfall events at (t 0, t 0 + δt 0). Furthermore from the three models reviewed, the minimum waiting time until the next extreme rainfall will be determined. The result shows that Log Nrmal model is better than Pareto and Gamma model for predicting the next extreme rainfall in South Sulawesi while the Pareto model can not be used.

  3. Legacies from extreme drought increase ecosystem sensitivity to future extremes

    Science.gov (United States)

    Smith, M. D.; Knapp, A.; Hoover, D. L.; Avolio, M. L.; Felton, A. J.; Wilcox, K. R.

    2016-12-01

    Climate extremes, such as drought, are increasing in frequency and intensity, and the ecological consequences of these extreme events can be substantial and widespread. Although there is still much to be learned about how ecosystems will respond to an intensification of drought, even less is known about the factors that determine post-drought recovery of ecosystem function. Such knowledge is particularly important because post-drought recovery periods can be protracted depending on the extent to which key plant populations, community structure and biogeochemical processes are affected. These drought legacies may alter ecosystem function for many years post-drought and may impact future sensitivity to climate extremes. We experimentally imposed two extreme growing season droughts in a central US grassland to assess the impacts of repeated droughts on ecosystem resistance (response) and resilience (recovery). We found that this grassland was not resistant to the first extreme drought due to reduced productivity and differential sensitivity of the co-dominant C4 grass (Andropogon gerardii) and C3 forb (Solidago canadensis) species. This differential sensitivity led to a reordering of species abundances within the plant community. Yet, despite this large shift in plant community composition, which persisted post-drought, the grassland was highly resilient post-drought, due to increased abundance of the dominant C4 grass. Because of this shift to increased C4 grass dominance, we expected that previously-droughted grassland would be more resistant to a second extreme drought. However, contrary to these expectations, previously droughted grassland was more sensitive to drought than grassland that had not experienced drought. Thus, our result suggest that legacies of drought (shift in community composition) may increase ecosystem sensitivity to future extreme events.

  4. Global predictability of temperature extremes

    Science.gov (United States)

    Coughlan de Perez, Erin; van Aalst, Maarten; Bischiniotis, Konstantinos; Mason, Simon; Nissan, Hannah; Pappenberger, Florian; Stephens, Elisabeth; Zsoter, Ervin; van den Hurk, Bart

    2018-05-01

    Extreme temperatures are one of the leading causes of death and disease in both developed and developing countries, and heat extremes are projected to rise in many regions. To reduce risk, heatwave plans and cold weather plans have been effectively implemented around the world. However, much of the world’s population is not yet protected by such systems, including many data-scarce but also highly vulnerable regions. In this study, we assess at a global level where such systems have the potential to be effective at reducing risk from temperature extremes, characterizing (1) long-term average occurrence of heatwaves and coldwaves, (2) seasonality of these extremes, and (3) short-term predictability of these extreme events three to ten days in advance. Using both the NOAA and ECMWF weather forecast models, we develop global maps indicating a first approximation of the locations that are likely to benefit from the development of seasonal preparedness plans and/or short-term early warning systems for extreme temperature. The extratropics generally show both short-term skill as well as strong seasonality; in the tropics, most locations do also demonstrate one or both. In fact, almost 5 billion people live in regions that have seasonality and predictability of heatwaves and/or coldwaves. Climate adaptation investments in these regions can take advantage of seasonality and predictability to reduce risks to vulnerable populations.

  5. GOES-R Proving Ground Activities at the NASA Short-Term Prediction Research and Transition (SPoRT) Center

    Science.gov (United States)

    Molthan, Andrew

    2011-01-01

    SPoRT is actively involved in GOES-R Proving Ground activities in a number of ways: (1) Applying the paradigm of product development, user training, and interaction to foster interaction with end users at NOAA forecast offices national centers. (2) Providing unique capabilities in collaboration with other GOES-R Proving Ground partners (a) Hybrid GOES-MODIS imagery (b) Pseudo-GLM via regional lightning mapping arrays (c) Developing new RGB imagery from EUMETSAT guidelines

  6. Incidence and predictors of difficult laryngoscopy in 11,219 pediatric anesthesia procedures.

    Science.gov (United States)

    Heinrich, Sebastian; Birkholz, Torsten; Ihmsen, Harald; Irouschek, Andrea; Ackermann, Andreas; Schmidt, Joachim

    2012-08-01

    Difficult laryngoscopy in pediatric patients undergoing anesthesia. This retrospective analysis was conducted to investigate incidence and predictors of difficult laryngoscopy in a large cohort of pediatric patients receiving general anesthesia with endotracheal intubation. Young age and craniofacial dysmorphy are predictors for the difficult pediatric airway and difficult laryngoscopy. For difficult laryngoscopy, other general predictors are not yet described. Retrospectively, from a 5-year period, data from 11.219 general anesthesia procedures in pediatric patients with endotracheal intubation using age-adapted Macintosh blades in a single center (university hospital) were analyzed statistically. The overall incidence of difficult laryngoscopy [Cormack and Lehane (CML) grade III and IV] was 1.35%. In patients younger than 1 year, the incidence of CML III or IV was significantly higher than in the older patients (4.7% vs 0.7%). ASA Physical Status III and IV, a higher Mallampati Score (III and IV) and a low BMI were all associated (P pediatric anesthesia is lower than in adults. Our results show that the risk of difficult laryngoscopy is much higher in patients below 1 year of age, in underweight patients and in ASA III and IV patients. The underlying disease might also contribute to the risk. If the Mallampati score could be obtained, prediction of difficult laryngoscopy seems to be reliable. Our data support the existing recommendations for a specialized anesthesiological team to provide safe anesthesia for infants and neonates. © 2012 Blackwell Publishing Ltd.

  7. Identifying and Investigating Difficult Concepts in Engineering Mechanics and Electric Circuits. Research Brief

    Science.gov (United States)

    Streveler, Ruth; Geist, Monica; Ammerman, Ravel; Sulzbach, Candace; Miller, Ronald; Olds, Barbara; Nelson, Mary

    2007-01-01

    This study extends ongoing work to identify difficult concepts in thermal and transport science and measure students' understanding of those concepts via a concept inventory. Two research questions provided the focal point: "What important concepts in electric circuits and engineering mechanics do students find difficult to learn?" and…

  8. Awake fiberoptic or awake video laryngoscopic tracheal intubation in patients with anticipated difficult airway management

    DEFF Research Database (Denmark)

    Rosenstock, Charlotte Vallentin; Thøgersen, Bente; Afshari, Arash

    2012-01-01

    Awake flexible fiberoptic intubation (FFI) is the gold standard for management of anticipated difficult tracheal intubation. The purpose of this study was to compare awake FFI to awake McGrath® video laryngoscope, (MVL), (Aircraft Medical, Edinburgh, Scotland, United Kingdom) intubation in patients...... with an anticipated difficult intubation. The authors examined the hypothesis that MVL intubation would be faster than FFI....

  9. Between Trauma and Perpetration: Psychoanalytical and Social Psychological Perspectives on Difficult Histories in the Israeli Context

    Science.gov (United States)

    Goldberg, Tsafrir

    2017-01-01

    This study explores the applicability of psychoanalytic trauma-centered perspectives and social psychological intergroup comparison perspectives to difficult histories of the Israeli context. The study describes 2 test cases of difficult histories in the Jewish-Israeli context at the levels of curriculum policy, teachers, and learners. The first…

  10. Difficult Knowledge and the English Classroom: A Catholic Framework Using Cormac McCarthy's "The Road"

    Science.gov (United States)

    Jarvie, Scott; Burke, Kevin

    2015-01-01

    In this article, the authors explore the generative possibilities of risk-taking in the Catholic school English classroom. They associate pedagogical risk with what Deborah Britzman (1998) has called "difficult knowledge"--content that causes students to consider social trauma. Incorporating difficult knowledge meaningfully requires…

  11. Diagnosis and management of deep vein thrombosis of the upper extremity: a review

    International Nuclear Information System (INIS)

    Baarslag, Henk J.; Reekers, Jim A.; Koopman, Maria M.W.; Beek, Edwin J.R. van

    2004-01-01

    Deep vein thrombosis of the upper extremity is an increasing clinical problem due to the use of long-term indwelling catheters for chemotherapy or long-term feeding. The clinical diagnosis is difficult to make, and various imaging modalities have been used for this purpose. The use of (interventional) radiological procedures has been advancing in recent years. This review describes the clinical background, the imaging modalities that may be employed, treatment options and outcome of patients with upper extremity thrombosis. (orig.)

  12. Ideologies and Discourses: Extreme Narratives in Extreme Metal Music

    Directory of Open Access Journals (Sweden)

    Bojana Radovanović

    2016-10-01

    Full Text Available Historically speaking, metal music has always been about provoking a strong reaction. Depending on the characteristics of different sub-genres, one can focus on the sound, technique, visual appearance, and furthermore, the ideologies and ideas that are the foundation for each of the sub-genres. Although the majority of the metal community rejects accusations of being racially intolerant, some ideologies of extreme sub-genres (such as black metal are in fact formed around the ideas of self-conscious elitism expressed through interest in pagan mythology, racism, Nazism and fascism. There has been much interest in the Nazi era within the extreme metal scene thus influencing other sub-genres and artists. The aim of this paper is to examine various appearances of extreme narratives such as Nazism and racism in  different sub-genres of metal, bearing in mind variations dependent on geographical, political, and other factors.

  13. Improved Extreme-Scenario Extraction Method For The Economic Dispatch Of Active Distribution Networks

    DEFF Research Database (Denmark)

    Zhang, Yipu; Ai, Xiaomeng; Fang, Jiakun

    2017-01-01

    ) of active distribution network with renewables. The extreme scenarios are selected from the historical data using the improved minimum volume enclosing ellipsoid (MVEE) algorithm to guarantee the security of system operation while avoid frequently switching the transformer tap. It is theoretically proved...

  14. An Extreme-Value Analysis of the LIL for Brownian Motion

    OpenAIRE

    Khoshnevisan, Davar; Levin, David; Shi, Zhan

    2005-01-01

    We use excursion theory and the ergodic theorem to present an extreme-value analysis of the classical law of the iterated logarithm (LIL) for Brownian motion. A simplified version of our method also proves, in a paragraph, the classical theorem of Darling and Erdős (1956).

  15. Cosmic censorship principle in two-dimensional charged extreme black hole

    Energy Technology Data Exchange (ETDEWEB)

    Wang Bin; Ru Keng Su [Fudan Univ., Shanghai (China). Dept. of Physics; Cheung, T. [Hong Kong City Univ., Hong Kong (China). Dept. of Physics

    1999-10-01

    By constructing a gedanken experiment, the authors prove that the event horizon of a two-dimensional charged extreme black hole cannot be removed. Singularities are found to be formed on the horizon through analyzing the fate of Hawking partner and application of Helliwell-Konkowski conjecture. The cosmic censorship principle is well protected in this black hole.

  16. On the Fermat-Lagrange principle for mixed smooth convex extremal problems

    International Nuclear Information System (INIS)

    Brinkhuis, Ya

    2001-01-01

    A simple geometric condition that can be attached to an extremal problem of a fairly general form included in a family of problems is indicated. This is used to demonstrate that the task of formulating a uniform condition for smooth convex problems can be satisfactorily accomplished. On the other hand, the necessity of this new condition of optimality is proved under certain technical assumptions

  17. Extremal surfaces and the rigidity of null geodesic incompleteness

    International Nuclear Information System (INIS)

    Silva, I P Costa e; Flores, J L

    2015-01-01

    An important, if relatively less well known aspect of the singularity theorems in Lorentzian geometry, is to understand how their conclusions fare upon weakening or suppression of one or more of their hypotheses. Then, theorems with modified conclusion may arise, showing that those conclusions will fail only in special cases, at least some of which may be described. These are the so-called rigidity theorems, and have many important examples in the specialized literature. In this paper, we prove rigidity results for generalized plane waves and certain globally hyperbolic spacetimes in the presence of extremal compact surfaces. (paper)

  18. Difficult behaviors in the emergency department: a cohort study of housed, homeless and alcohol dependent individuals.

    Directory of Open Access Journals (Sweden)

    Tomislav Svoboda

    Full Text Available This study contrasted annual rates of difficult behaviours in emergency departments among cohorts of individuals who were homeless and low-income housed and examined predictors of these events.Interviews in 1999 with men who were chronically homeless with drinking problems (CHDP (n = 50, men from the general homeless population (GH (n = 61, and men residing in low-income housing (LIH (n = 58 were linked to catchment area emergency department records (n = 2817 from 1994 to 1999. Interview and hospital data were linked to measures of difficult behaviours.Among the CHDP group, annual rates of visits with difficult behaviours were 5.46; this was 13.4 (95% CI 10.3-16.5 and 14.3 (95% CI 11.2-17.3 times higher than the GH and LIH groups. Difficult behaviour incidents included physical violence, verbal abuse, uncooperativeness, drug seeking, difficult histories and security involvement. Difficult behaviours made up 57.54% (95% CI 55.43-59.65%, 24% (95% CI 19-29%, and 20% (95% CI 16-24% of CHDP, GH and LIH visits. Among GH and LIH groups, 87% to 95% were never involved in verbal abuse or violence. Intoxication increased all difficult behaviours while decreasing drug seeking and leaving without being seen. Verbal abuse and violence were less likely among those housed, with odds ratios of 0.24 (0.08, 0.72 and 0.32 (0.15, 0.69, respectively.Violence and difficult behaviours are much higher among chronically homeless men with drinking problems than general homeless and low-income housed populations. They are concentrated among subgroups of individuals. Intoxication is the strongest predictor of difficult behaviour incidents.

  19. Users manual on database of the Piping Reliability Proving Tests at the Japan Atomic Energy Research Institute

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-09-01

    Japan Atomic Energy Research Institute(JAERI) conducted Piping Reliability Proving Tests from 1975 to 1992 based upon the contracts between JAERI and Science and Technology Agency of Japan under the auspices of the special account law for electric power development promotion. The purposes of those tests are to prove the structural reliability of the primary cooling piping constituting a part of the pressure boundary in the water reactor power plants. The tests with large experimental facilities had ended already in 1990. After that piping reliability analysis by the probabilistic method followed until 1992. This report describes the users manual on databases about the test results using the large experimental facilities. Objectives of the piping reliability proving tests are to prove that the primary piping of the water reactor (1) be reliable throughout the service period, (2) have no possibility of rupture, (3) bring no detrimental influence on the surrounding instrumentations or equipments near the break location. The research activities using large scale piping test facilities are described. The present report does the database about the test results pairing the former report. With these two reports, all the feature of Piping Reliability Proving Tests is made clear. Briefings of the tests are described also written in Japanese or English. (author)

  20. Statistical analyses of extreme food habits

    International Nuclear Information System (INIS)

    Breuninger, M.; Neuhaeuser-Berthold, M.

    2000-01-01

    This report is a summary of the results of the project ''Statistical analyses of extreme food habits'', which was ordered from the National Office for Radiation Protection as a contribution to the amendment of the ''General Administrative Regulation to paragraph 45 of the Decree on Radiation Protection: determination of the radiation exposition by emission of radioactive substances from facilities of nuclear technology''. Its aim is to show if the calculation of the radiation ingested by 95% of the population by food intake, like it is planned in a provisional draft, overestimates the true exposure. If such an overestimation exists, the dimension of it should be determined. It was possible to prove the existence of this overestimation but its dimension could only roughly be estimated. To identify the real extent of it, it is necessary to include the specific activities of the nuclides, which were not available for this investigation. In addition to this the report shows how the amounts of food consumption of different groups of foods influence each other and which connections between these amounts should be taken into account, in order to estimate the radiation exposition as precise as possible. (orig.) [de

  1. Tolerances of microorganisms to extreme environmental conditions

    International Nuclear Information System (INIS)

    West, J.M.; Arme, S.C.

    1985-03-01

    Microbial isolates from sites relevant to the disposal of radioactive wastes have been subjected to extreme environmental conditions in order to ascertain their tolerance ability. Two groups were chosen, sulphate reducing bacteria and sulphur oxidising bacteria, because of their potential effects on waste containment. They have been subjected to high temperatures, pressures and radiation (delta-emissions) in optimal media conditions and their ability to tolerate the conditions has been ascertained by epifluorescence microscopy and adenosine tri-phosphate (ATP) analysis followed by 'culture-on' to assess post experimental viability. Results indicate that the sulphate reducers in general, are more tolerant to these conditions than the sulphur oxidisers, some proving to be thermophilic. The sulphate reducer showed increased growth rates, as determined by population numbers, at 50 0 C and survived at 80 0 C, 4,500 psig (310 bar) with no subsequent loss in viability. Gamma irradiation of this group and an isolate of 10 5 rad over 4 hours had no effect on population numbers or viability. Such resistances are not apparent with the sulphur oxidisers whose numbers decreased with increasing radiation dose and are destroyed with pressure. (author)

  2. Minute synthesis of extremely stable gold nanoparticles.

    Science.gov (United States)

    Zhou, Min; Wang, Baoxiang; Rozynek, Zbigniew; Xie, Zhaohui; Fossum, Jon Otto; Yu, Xiaofeng; Raaen, Steinar

    2009-12-16

    We describe a rapid environmentally friendly wet-chemical approach to synthesize extremely stable non-toxic, biocompatible, water-soluble monodispersed gold nanoparticles (AuNPs) in one step at room temperature. The particles have been successfully achieved in just a few minutes by merely adding sodium hydroxide (NaOH) acting as an initiator for the reduction of HAuCl(4) in aqueous solution in the presence of polyvinylpyrrolidone (PVP) without the use of any reducing agent. It is also proved to be highly efficient for the preparation of AuNPs with controllable sizes. The AuNPs show remarkable stability in water media with high concentrations of salt, various buffer solutions and physiological conditions in biotechnology and biomedicine. Moreover, the AuNPs are also non-toxic at high concentration (100 microM). Therefore, it provides great opportunities to use these AuNPs for biotechnology and biomedicine. This new approach also involved several green chemistry concepts, such as the selection of environmentally benign reagents and solvents, without energy consumption, and less reaction time.

  3. Minute synthesis of extremely stable gold nanoparticles

    International Nuclear Information System (INIS)

    Zhou Min; Wang Baoxiang; Rozynek, Zbigniew; Xie Zhaohui; Fossum, Jon Otto; Yu Xiaofeng; Raaen, Steinar

    2009-01-01

    We describe a rapid environmentally friendly wet-chemical approach to synthesize extremely stable non-toxic, biocompatible, water-soluble monodispersed gold nanoparticles (AuNPs) in one step at room temperature. The particles have been successfully achieved in just a few minutes by merely adding sodium hydroxide (NaOH) acting as an initiator for the reduction of HAuCl 4 in aqueous solution in the presence of polyvinylpyrrolidone (PVP) without the use of any reducing agent. It is also proved to be highly efficient for the preparation of AuNPs with controllable sizes. The AuNPs show remarkable stability in water media with high concentrations of salt, various buffer solutions and physiological conditions in biotechnology and biomedicine. Moreover, the AuNPs are also non-toxic at high concentration (100 μM). Therefore, it provides great opportunities to use these AuNPs for biotechnology and biomedicine. This new approach also involved several green chemistry concepts, such as the selection of environmentally benign reagents and solvents, without energy consumption, and less reaction time.

  4. Detection strategies for extreme mass ratio inspirals

    International Nuclear Information System (INIS)

    Cornish, Neil J

    2011-01-01

    The capture of compact stellar remnants by galactic black holes provides a unique laboratory for exploring the near-horizon geometry of the Kerr spacetime, or possible departures from general relativity if the central cores prove not to be black holes. The gravitational radiation produced by these extreme mass ratio inspirals (EMRIs) encodes a detailed map of the black hole geometry, and the detection and characterization of these signals is a major scientific goal for the LISA mission. The waveforms produced are very complex, and the signals need to be coherently tracked for tens of thousands of cycles to produce a detection, making EMRI signals one of the most challenging data analysis problems in all of gravitational wave astronomy. Estimates for the number of templates required to perform an exhaustive grid-based matched-filter search for these signals are astronomically large, and far out of reach of current computational resources. Here I describe an alternative approach that employs a hybrid between genetic algorithms and Markov chain Monte Carlo techniques, along with several time-saving techniques for computing the likelihood function. This approach has proven effective at the blind extraction of relatively weak EMRI signals from simulated LISA data sets.

  5. Team-client Relationships And Extreme Programming

    Directory of Open Access Journals (Sweden)

    John Karn

    2008-01-01

    Full Text Available This paper describes a study that examined the relationship between software engineering teams who adhered to the extreme programming (XP methodology and their project clients. The study involved observing teams working on projects for clients who had commissioned a piece of software to be used in the real world. Interviews were conducted during and at the end of the project to get client opinion on how the project had progressed. Of interest to the researchers were opinions on frequency of feedback, how the team captured requirements, whether or not the iterative approach of XP proved to be helpful, and the level of contextual and software engineering knowledge the client had at the start of the project. In theory, fidelity to XP should result in enhanced communication, reduce expectation gaps, and lead to greater client satisfaction. Our results suggest that this depends heavily on the communication skills of the team and of the client, the expectations of the client, and the nature of the project.

  6. Seasonal temperature extremes in Potsdam

    Science.gov (United States)

    Kundzewicz, Zbigniew; Huang, Shaochun

    2010-12-01

    The awareness of global warming is well established and results from the observations made on thousands of stations. This paper complements the large-scale results by examining a long time-series of high-quality temperature data from the Secular Meteorological Station in Potsdam, where observation records over the last 117 years, i.e., from January 1893 are available. Tendencies of change in seasonal temperature-related climate extremes are demonstrated. "Cold" extremes have become less frequent and less severe than in the past, while "warm" extremes have become more frequent and more severe. Moreover, the interval of the occurrence of frost has been decreasing, while the interval of the occurrence of hot days has been increasing. However, many changes are not statistically significant, since the variability of temperature indices at the Potsdam station has been very strong.

  7. Videolaryngoscopy versus Fiber-optic Intubation through a Supraglottic Airway in Children with a Difficult Airway: An Analysis from the Multicenter Pediatric Difficult Intubation Registry.

    Science.gov (United States)

    Burjek, Nicholas E; Nishisaki, Akira; Fiadjoe, John E; Adams, H Daniel; Peeples, Kenneth N; Raman, Vidya T; Olomu, Patrick N; Kovatsis, Pete G; Jagannathan, Narasimhan; Hunyady, Agnes; Bosenberg, Adrian; Tham, See; Low, Daniel; Hopkins, Paul; Glover, Chris; Olutoye, Olutoyin; Szmuk, Peter; McCloskey, John; Dalesio, Nicholas; Koka, Rahul; Greenberg, Robert; Watkins, Scott; Patel, Vikram; Reynolds, Paul; Matuszczak, Maria; Jain, Ranu; Khalil, Samia; Polaner, David; Zieg, Jennifer; Szolnoki, Judit; Sathyamoorthy, Kumar; Taicher, Brad; Riveros Perez, N Ricardo; Bhattacharya, Solmaletha; Bhalla, Tarun; Stricker, Paul; Lockman, Justin; Galvez, Jorge; Rehman, Mohamed; Von Ungern-Sternberg, Britta; Sommerfield, David; Soneru, Codruta; Chiao, Franklin; Richtsfeld, Martina; Belani, Kumar; Sarmiento, Lina; Mireles, Sam; Bilen Rosas, Guelay; Park, Raymond; Peyton, James

    2017-09-01

    The success rates and related complications of various techniques for intubation in children with difficult airways remain unknown. The primary aim of this study is to compare the success rates of fiber-optic intubation via supraglottic airway to videolaryngoscopy in children with difficult airways. Our secondary aim is to compare the complication rates of these techniques. Observational data were collected from 14 sites after management of difficult pediatric airways. Patient age, intubation technique, success per attempt, use of continuous ventilation, and complications were recorded for each case. First-attempt success and complications were compared in subjects managed with fiber-optic intubation via supraglottic airway and videolaryngoscopy. Fiber-optic intubation via supraglottic airway and videolaryngoscopy had similar first-attempt success rates (67 of 114, 59% vs. 404 of 786, 51%; odds ratio 1.35; 95% CI, 0.91 to 2.00; P = 0.16). In subjects less than 1 yr old, fiber-optic intubation via supraglottic airway was more successful on the first attempt than videolaryngoscopy (19 of 35, 54% vs. 79 of 220, 36%; odds ratio, 2.12; 95% CI, 1.04 to 4.31; P = 0.042). Complication rates were similar in the two groups (20 vs. 13%; P = 0.096). The incidence of hypoxemia was lower when continuous ventilation through the supraglottic airway was used throughout the fiber-optic intubation attempt. In this nonrandomized study, first-attempt success rates were similar for fiber-optic intubation via supraglottic airway and videolaryngoscopy. Fiber-optic intubation via supraglottic airway is associated with higher first-attempt success than videolaryngoscopy in infants with difficult airways. Continuous ventilation through the supraglottic airway during fiber-optic intubation attempts may lower the incidence of hypoxemia.

  8. Use of versapoint to refashion the cervical canal to overcome unusually difficult embryo transfers and improve in-vitro fertilization-embryo transfer outcome: A case series

    Directory of Open Access Journals (Sweden)

    Nalini Mahajan

    2011-01-01

    Full Text Available Background : Smooth atraumatic embryo transfer is paramount for the success of in-vitro fertilization (IVF. In difficult cases, cervical canal manipulation may be required. Aim : To see if surgical correction of the cervical canal or cervical canal refashioning could improve ease of embryo transfer. Setting : Private infertility and IVF hospital. Design : Prospective study. Materials and Methods : Patients: 11 women with failed 1-3 IVF cycles with history of extremely difficult embryo transfers (ETs despite undergoing cervical dilatation in the cycle prior to IVF. Interventions : Operative hysteroscopy using Versapoint for refashioning of the cervical canal. Main Outcome Measures : Ease of ET in the subsequent IVF cycle. Secondary outcome measure was to assess reproductive outcome. Results : Easy and atraumatic ET in the IVF cycle after procedure in 100% patients. PR was 46.5%. Conclusions : Use of Versapoint for refashioning the cervical canal can improve the quality of ET and PR.

  9. Research into Financial Position of Listed Companies following Classification via Extreme Learning Machine Based upon DE Optimization

    Directory of Open Access Journals (Sweden)

    Fu Yu

    2016-01-01

    Full Text Available By means of the model of extreme learning machine based upon DE optimization, this article particularly centers on the optimization thinking of such a model as well as its application effect in the field of listed company’s financial position classification. It proves that the improved extreme learning machine algorithm based upon DE optimization eclipses the traditional extreme learning machine algorithm following comparison. Meanwhile, this article also intends to introduce certain research thinking concerning extreme learning machine into the economics classification area so as to fulfill the purpose of computerizing the speedy but effective evaluation of massive financial statements of listed companies pertain to different classes

  10. Statistical Model of Extreme Shear

    DEFF Research Database (Denmark)

    Hansen, Kurt Schaldemose; Larsen, Gunner Chr.

    2005-01-01

    In order to continue cost-optimisation of modern large wind turbines, it is important to continuously increase the knowledge of wind field parameters relevant to design loads. This paper presents a general statistical model that offers site-specific prediction of the probability density function...... by a model that, on a statistically consistent basis, describes the most likely spatial shape of an extreme wind shear event. Predictions from the model have been compared with results from an extreme value data analysis, based on a large number of full-scale measurements recorded with a high sampling rate...

  11. Automation Rover for Extreme Environments

    Science.gov (United States)

    Sauder, Jonathan; Hilgemann, Evan; Johnson, Michael; Parness, Aaron; Hall, Jeffrey; Kawata, Jessie; Stack, Kathryn

    2017-01-01

    Almost 2,300 years ago the ancient Greeks built the Antikythera automaton. This purely mechanical computer accurately predicted past and future astronomical events long before electronics existed1. Automata have been credibly used for hundreds of years as computers, art pieces, and clocks. However, in the past several decades automata have become less popular as the capabilities of electronics increased, leaving them an unexplored solution for robotic spacecraft. The Automaton Rover for Extreme Environments (AREE) proposes an exciting paradigm shift from electronics to a fully mechanical system, enabling longitudinal exploration of the most extreme environments within the solar system.

  12. Hygienic diagnosis in extreme conditions

    International Nuclear Information System (INIS)

    Sofronov, G.A.

    1997-01-01

    Review for book by M.P. Zakharchenko, S.A. Lopatin, G.N. Novozhilov, V.I. Zakharov Hygienic diagnosis in extreme conditions is presented discussing the problem of people health preservation under extreme conditions. Hygienic diagnosis is considered illustrated by cases of hostilities (Afghan War), earthquake response in Armenia (1988) and Chernobyl accident response. Attention is paid to the estimation of radiation doses to people and characteristics of main types of dosimeters. The high scientific level of the book is marked

  13. Extreme Conditions Modeling Workshop Report

    Energy Technology Data Exchange (ETDEWEB)

    Coe, R. G.; Neary, V. S.; Lawson, M. J.; Yu, Y.; Weber, J.

    2014-07-01

    Sandia National Laboratories (SNL) and the National Renewable Energy Laboratory (NREL) hosted the Wave Energy Converter (WEC) Extreme Conditions Modeling (ECM) Workshop in Albuquerque, NM on May 13th-14th, 2014. The objective of the workshop was to review the current state of knowledge on how to model WECs in extreme conditions (e.g. hurricanes and other large storms) and to suggest how U.S. Department of Energy (DOE) and national laboratory resources could be used to improve ECM methods for the benefit of the wave energy industry.

  14. Extremely Randomized Machine Learning Methods for Compound Activity Prediction

    Directory of Open Access Journals (Sweden)

    Wojciech M. Czarnecki

    2015-11-01

    Full Text Available Speed, a relatively low requirement for computational resources and high effectiveness of the evaluation of the bioactivity of compounds have caused a rapid growth of interest in the application of machine learning methods to virtual screening tasks. However, due to the growth of the amount of data also in cheminformatics and related fields, the aim of research has shifted not only towards the development of algorithms of high predictive power but also towards the simplification of previously existing methods to obtain results more quickly. In the study, we tested two approaches belonging to the group of so-called ‘extremely randomized methods’—Extreme Entropy Machine and Extremely Randomized Trees—for their ability to properly identify compounds that have activity towards particular protein targets. These methods were compared with their ‘non-extreme’ competitors, i.e., Support Vector Machine and Random Forest. The extreme approaches were not only found out to improve the efficiency of the classification of bioactive compounds, but they were also proved to be less computationally complex, requiring fewer steps to perform an optimization procedure.

  15. Moving in extreme environments: what's extreme and who decides?

    Science.gov (United States)

    Cotter, James David; Tipton, Michael J

    2014-01-01

    Humans work, rest and play in immensely varied extreme environments. The term 'extreme' typically refers to insufficiency or excess of one or more stressors, such as thermal energy or gravity. Individuals' behavioural and physiological capacity to endure and enjoy such environments varies immensely. Adverse effects of acute exposure to these environments are readily identifiable (e.g. heat stroke or bone fracture), whereas adverse effects of chronic exposure (e.g. stress fractures or osteoporosis) may be as important but much less discernable. Modern societies have increasingly sought to protect people from such stressors and, in that way, minimise their adverse effects. Regulations are thus established, and advice is provided on what is 'acceptable' exposure. Examples include work/rest cycles in the heat, hydration regimes, rates of ascent to and duration of stay at altitude and diving depth. While usually valuable and well intentioned, it is important to realise the breadth and importance of limitations associated with such guidelines. Regulations and advisories leave less room for self-determination, learning and perhaps adaptation. Regulations based on stress (e.g. work/rest cycles relative to WBGT) are more practical but less direct than those based on strain (e.g. core temperature), but even the latter can be substantively limited (e.g. by lack of criterion validation and allowance for behavioural regulation in the research on which they are based). Extreme Physiology & Medicine is publishing a series of reviews aimed at critically examining the issues involved with self- versus regulation-controlled human movement acutely and chronically in extreme environments. These papers, arising from a research symposium in 2013, are about the impact of people engaging in such environments and the effect of rules and guidelines on their safety, enjoyment, autonomy and productivity. The reviews will cover occupational heat stress, sporting heat stress, hydration, diving

  16. E-squared nine do-it-yourself energy experiments that prove your thoughts create your reality

    CERN Document Server

    Grout, Pam

    2013-01-01

    E-Squared is a lab manual with simple experiments to prove once and for all that there really is a good, loving, totally hip force in the universe. Rather than take it on faith, you are invited to conduct ten 48-hour experiments to prove each of the principles in this book. Yes, you read that right. It says prove. The experiments, each of which can be conducted with absolutely no money and very little time expenditure, demonstrate that spiritual principles are as dependable as gravity, as consistent as Newton's 2nd law of motion. For years, you've been hoping and praying that spiritual principles are true. Now, you can know.

  17. The effects of GeoGebra software on pre-service mathematics teachers' attitudes and views toward proof and proving

    Science.gov (United States)

    Zengin, Yılmaz

    2017-11-01

    The purpose of this study is to determine the effect of GeoGebra software on pre-service mathematics teachers' attitudes towards proof and proving and to determine pre-service teachers' pre- and post-views regarding proof. The study lasted nine weeks and the participants of the study consisted of 24 pre-service mathematics teachers. The study used the 'Attitude Scale Towards Proof and Proving' and an open-ended questionnaire that were administered before and after the intervention as data collection tools. Paired samples t-test analysis was used for the analysis of quantitative data and content and descriptive analyses were utilized for the analysis of qualitative data. As a result of the data analysis, it was determined that GeoGebra software was an effective tool in increasing pre-service teachers' attitudes towards proof and proving.

  18. Randomized controlled trial of the Pentax AWS, Glidescope, and Macintosh laryngoscopes in predicted difficult intubation.

    LENUS (Irish Health Repository)

    Malik, M A

    2009-11-01

    The purpose of this study was to determine the potential for the Pentax AWS and the Glidescope to reduce the difficulty of tracheal intubation in patients at increased risk for difficult tracheal intubation, in a randomized, controlled clinical trial.

  19. Implications of Age-Related Changes in Anatomy for Geriatric-Focused Difficult Airways

    Directory of Open Access Journals (Sweden)

    Shih-Yi Lee

    2017-09-01

    Full Text Available The structure and function surrounding the airway change by the age, which may ultimately result in having anatomic features of difficult airways in the elderly. Hence, we reviewed the literature focusing on the age-related anatomic changes and accordingly to compare the characteristics of difficult airways. With age, teeth wear and loss, protein and collagen synthesis reduction, and bone loss and muscle atrophy results in aged face (chin protrusion, cheek retraction and drooping, jaw restriction (temporo-madibular joint disc displacement and osteoarthritis, neck and back stiffness, and kyphotic deformities (degeneration of spinal articular cartilage, intervertebral discs, and spinal osteoporosis. These age-related changes in anatomy are compatible with the predictors of a difficult airway. We hope that these age-related anatomic approaches will prospectively allow a detailed understanding of the hallmarks resulting in geriatric-focused difficult airways in the future studies.

  20. Assessment of the Difficult Areas of the Senior Secondary School 2 ...

    African Journals Online (AJOL)

    Assessment of the Difficult Areas of the Senior Secondary School 2 (Two) ... Correlation between the students' perceived difficulty and their achievement in a test and ... Students need counseling, encouragement and enlightenment in order to ...

  1. Difficult Airway Response Team: A Novel Quality Improvement Program for Managing Hospital-Wide Airway Emergencies

    Science.gov (United States)

    Mark, Lynette J.; Herzer, Kurt R.; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I.; Berkow, Lauren C.; Haut, Elliott R.; Hillel, Alexander T.; Miller, Christina R.; Feller-Kopman, David J.; Schiavi, Adam J.; Xie, Yanjun J.; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W.; Mirski, Marek A.

    2015-01-01

    Background Difficult airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency airway management outside the operating room is particularly challenging. Methods We developed a quality improvement program—the Difficult Airway Response Team (DART)—to improve emergency airway management outside the operating room. DART was implemented by a team of anesthesiologists, otolaryngologists, trauma surgeons, emergency medicine physicians, and risk managers in 2005 at The Johns Hopkins Hospital in Baltimore, Maryland. The DART program had three core components: operations, safety, and education. The operations component focused on developing a multidisciplinary difficult airway response team, standardizing the emergency response process, and deploying difficult airway equipment carts throughout the hospital. The safety component focused on real-time monitoring of DART activations and learning from past DART events to continuously improve system-level performance. This objective entailed monitoring the paging system, reporting difficult airway events and DART activations to a web-based registry, and using in situ simulations to identify and mitigate defects in the emergency airway management process. The educational component included development of a multispecialty difficult airway curriculum encompassing case-based lectures, simulation, and team building/communication to ensure consistency of care. Educational materials were also developed for non-DART staff and patients to inform them about the needs of patients with difficult airways and ensure continuity of care with other providers after discharge. Results Between July 2008 and June 2013, DART managed 360 adult difficult airway events comprising 8% of all code activations. Predisposing patient factors included body mass index > 40, history of head and neck tumor, prior difficult intubation, cervical spine injury, airway edema, airway bleeding, and previous

  2. Difficult airway response team: a novel quality improvement program for managing hospital-wide airway emergencies.

    Science.gov (United States)

    Mark, Lynette J; Herzer, Kurt R; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I; Berkow, Lauren C; Haut, Elliott R; Hillel, Alexander T; Miller, Christina R; Feller-Kopman, David J; Schiavi, Adam J; Xie, Yanjun J; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W; Mirski, Marek A

    2015-07-01

    Difficult airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency airway management outside the operating room is particularly challenging. We developed a quality improvement program-the Difficult Airway Response Team (DART)-to improve emergency airway management outside the operating room. DART was implemented by a team of anesthesiologists, otolaryngologists, trauma surgeons, emergency medicine physicians, and risk managers in 2005 at The Johns Hopkins Hospital in Baltimore, Maryland. The DART program had 3 core components: operations, safety, and education. The operations component focused on developing a multidisciplinary difficult airway response team, standardizing the emergency response process, and deploying difficult airway equipment carts throughout the hospital. The safety component focused on real-time monitoring of DART activations and learning from past DART events to continuously improve system-level performance. This objective entailed monitoring the paging system, reporting difficult airway events and DART activations to a Web-based registry, and using in situ simulations to identify and mitigate defects in the emergency airway management process. The educational component included development of a multispecialty difficult airway curriculum encompassing case-based lectures, simulation, and team building/communication to ensure consistency of care. Educational materials were also developed for non-DART staff and patients to inform them about the needs of patients with difficult airways and ensure continuity of care with other providers after discharge. Between July 2008 and June 2013, DART managed 360 adult difficult airway events comprising 8% of all code activations. Predisposing patient factors included body mass index >40, history of head and neck tumor, prior difficult intubation, cervical spine injury, airway edema, airway bleeding, and previous or current tracheostomy. Twenty

  3. Usage of I++ Simulator to Program Coordinate Measuring Machines when Common Programming Methods are difficult to apply

    Directory of Open Access Journals (Sweden)

    Gąska A.

    2014-02-01

    Full Text Available Nowadays, simulators facilitate tasks performed daily by the engineers of different branches, including coordinate metrologists. Sometimes it is difficult or almost impossible to program a Coordinate Measuring Machine (CMM using standard methods. This happens, for example, during measurements of nano elements or in cases when measurements are performed on high-precision (accurate measuring machines which work in strictly air-conditioned spaces and the presence of the operator in such room during the programming of CMM could cause an increase in temperature, which in turn could make it necessary to wait some time until conditions stabilize. This article describes functioning of a simulator and its usage during Coordinate Measuring Machine programming in the latter situation. Article also describes a general process of programming CMMs which ensures the correct machine performance after starting the program on a real machine. As an example proving the presented considerations, measurement of exemplary workpiece, which was performed on the machine working in the strictly air-conditioned room, was described

  4. Difficult airway management patterns among anesthesiologists practicing in Cairo University Hospitals

    Directory of Open Access Journals (Sweden)

    Neamat I. Abdel rahman

    2016-01-01

    Conclusion: The practice of anesthesiologists in Cairo university hospitals is close to the recommendations of the ASA guidelines for management of difficult airway. There is increased skills in fiberoptic bronchoscopes and SGA with increased frequency of difficult airway managements training courses; however, they need to improve their skills in awake fiberoptic intubations technique and they need to be trained on invasive airway management access to close the discrepancy between their theoretical choices in different situations and their actual skills.

  5. Difficult intubation in a parturient with syringomyelia and Arnold–Chiari malformation: Use of Airtraq™ laryngoscope

    Science.gov (United States)

    Mustapha, Bensghir; Chkoura, K.; Elhassani, M.; Ahtil, R.; Azendour, H.; Kamili, N. Drissi

    2011-01-01

    Anesthetic technique in parturient with syringomyelia and Arnold–Chiari malformation is variable depending on the teams. Difficult intubation is one of the risks when general anesthesia is opted. Different devices have been used to manage the difficult intubation in pregnant women. We report the use of Airtraq™ laryngoscope after failed standard laryngoscopy in a parturient with syringomyelia and Arnold–Chiari type I malformation. PMID:22144932

  6. Difficult intubation in a parturient with syringomyelia and Arnold-Chiari malformation: Use of Airtraq™ laryngoscope

    Directory of Open Access Journals (Sweden)

    Bensghir Mustapha

    2011-01-01

    Full Text Available Anesthetic technique in parturient with syringomyelia and Arnold-Chiari malformation is variable depending on the teams. Difficult intubation is one of the risks when general anesthesia is opted. Different devices have been used to manage the difficult intubation in pregnant women. We report the use of Airtraq™ laryngoscope after failed standard laryngoscopy in a parturient with syringomyelia and Arnold-Chiari type I malformation.

  7. New Methodologies for Development of High Efficient Machining of Difficult to Cut Materials

    International Nuclear Information System (INIS)

    Durante, S; Comoglio, M; Rostagno, M

    2011-01-01

    The article focuses on the automotive and aerospace industries. In these industries the need for enhanced materials performance is necessary if they are to remain competitive in global terms. Unfortunately the material properties, which make them so attractive to the aerospace and automotive industry can also make them difficult to machine. This paper will discuss integrated developments in machining techniques and cutting tools, which are emerging to cope with difficult to cut materials.

  8. [Correlation between obstructive apnea syndrome and difficult airway in ENT surgery].

    Science.gov (United States)

    Pera, Marcia Hiray; Tardelli, Maria Angela; Novo, Neil Ferreira; Juliano, Yara; Silva, Helga Cristina Almeida da

    2017-12-21

    ENT patients with obstructive sleep apnea syndrome have a tendency of collapsing the upper airways in addition to anatomical obstacles. Obstructive sleep apnea syndrome is related to the increased risk of difficult airway and also increased perioperative complications. In order to identify these patients in the preoperative period, the STOP Bang questionnaire has been highlighted because it is summarized and easy to apply. Evaluate through the STOP Bang questionnaire whether patients undergoing ENT surgery with a diagnosis of obstructive sleep apnea syndrome have a higher risk of complications, particularly the occurrence of difficult airway. Measurements of anatomical parameters for difficult airway and questionnaire application for clinical prediction of obstructive sleep apnea syndrome were performed in 48 patients with a previous polysomnographic study. The sample detected difficult airway in about 18.7% of patients, all of them with obstructive sleep apnea syndrome. This group had older age, cervical circumference > 40cm, ASA II and Cormack III/IV. Patients with obstructive sleep apnea syndrome had higher body mass index, cervical circumference, and frequent apnea. In subgroup analysis, the group with severe obstructive sleep apnea syndrome showed a significantly higher SB score compared to patients without this syndrome or with a mild/moderate obstructive sleep apnea syndrome. The STOP Bang questionnaire was not able to predict difficult airway and mild obstructive sleep apnea syndrome, but it identified marked obstructive sleep apnea syndrome. All patients with difficult airway had moderate and marked obstructive sleep apnea syndrome, although this syndrome did not involve difficult airway. The variables Cormack III/IV and BMI greater than 35 Kg.m -2 were able to predict difficult airway and obstructive sleep apnea syndrome, respectively. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  9. Advances in Rosetta structure prediction for difficult molecular-replacement problems

    International Nuclear Information System (INIS)

    DiMaio, Frank

    2013-01-01

    Modeling advances using Rosetta structure prediction to aid in solving difficult molecular-replacement problems are discussed. Recent work has shown the effectiveness of structure-prediction methods in solving difficult molecular-replacement problems. The Rosetta protein structure modeling suite can aid in the solution of difficult molecular-replacement problems using templates from 15 to 25% sequence identity; Rosetta refinement guided by noisy density has consistently led to solved structures where other methods fail. In this paper, an overview of the use of Rosetta for these difficult molecular-replacement problems is provided and new modeling developments that further improve model quality are described. Several variations to the method are introduced that significantly reduce the time needed to generate a model and the sampling required to improve the starting template. The improvements are benchmarked on a set of nine difficult cases and it is shown that this improved method obtains consistently better models in less running time. Finally, strategies for best using Rosetta to solve difficult molecular-replacement problems are presented and future directions for the role of structure-prediction methods in crystallography are discussed

  10. Angiography of the upper extremity

    International Nuclear Information System (INIS)

    Janevski, B.K.

    1982-01-01

    This thesis provides a description of the technical and medical aspects of arteriography of the upper extremity and an extensive analysis of the angiographic anatomy and pathology of 750 selective studies performed in more than 500 patients. A short historical review is provided of angiography as a whole and of arteriography of the hand in particular. The method of percutaneous transfemoral catheterization of the arteries of the upper extremity and particularly the arteries of the hand is considered, discussing the problems the angiographer encounters frequently, describing the angiographic complications which may occur and emphasizing the measures to keep them to a minimum. The use of vasodilators in hand angiography is discussed. A short description of the embryological patterns persisting in the arteries of the arm is included in order to understand the congenital variations of the arteries of the upper extremity. The angiographic patterns and clinical aspects of the most common pathological processes involving the arteries of the upper extremities are presented. Special attention is paid to the correlation between angiography and pathology. (Auth.)

  11. Extreme conditions (p, T, H)

    Energy Technology Data Exchange (ETDEWEB)

    Mesot, J [Lab. for Neutron Scattering ETH Zurich, Zurich (Switzerland) and Paul Scherrer Institute, Villigen (Switzerland)

    1996-11-01

    The aim of this paper is to summarize the sample environment which will be accessible at the SINQ. In order to illustrate the type of experiments which will be feasible under extreme conditions of temperature, magnetic field and pressure at the SINQ a few selected examples are also given. (author) 7 figs., 14 refs.

  12. Book review: Extreme ocean waves

    Science.gov (United States)

    Geist, Eric L.

    2011-01-01

    ‘‘Extreme Ocean Waves’’ is a collection of ten papers edited by Efim Pelinovsky and Christian Kharif that followed the April 2007 meeting of the General Assembly of the European Geosciences Union. A note on terminology: extreme waves in this volume broadly encompass different types of waves, includ- ing deep-water and shallow-water rogue waves (alternatively termed freak waves), storm surges from cyclones, and internal waves. Other types of waves such as tsunamis or rissaga (meteotsunamis) are not discussed in this volume. It is generally implied that ‘‘extreme’’ has a statistical connotation relative to the average or significant wave height specific to each type of wave. Throughout the book, in fact, the reader will find a combination of theoretical and statistical/ empirical treatment necessary for the complete examination of this subject. In the introduction, the editors underscore the importance of studying extreme waves, documenting several dramatic instances of damaging extreme waves that occurred in 2007. 

  13. Extreme Energy Events Monitoring report

    CERN Document Server

    Baimukhamedova, Nigina

    2015-01-01

    Following paper reflects the progress I made on Summer Student Program within Extreme Energy Events Monitor project I was working on. During 8 week period I managed to build a simple detector system that is capable of triggering events similar to explosions (sudden change in sound levels) and measuring approximate location of the event. Source codes are available upon request and settings described further.

  14. Astrobiology: Life in Extreme Environments

    Science.gov (United States)

    Kaur, Preeti

    2011-01-01

    Astrobiology is the study of the origin, evolution and distribution of life in the universe. It seeks to answer two important scientific questions: how did we get here and are we alone in the universe? Scientists begin by studying life on Earth and its limits. The discovery of extremophiles on Earth capable of surviving extremes encourages the…

  15. Nutrition security under extreme events

    Science.gov (United States)

    Martinez, A.

    2017-12-01

    Nutrition security under extreme events. Zero hunger being one of the Sustainable Development Goal from the United Nations, food security has become a trending research topic. However extreme events impact on global food security is not yet 100% understood and there is a lack of comprehension of the underlying mechanisms of global food trade and nutrition security to improve countries resilience to extreme events. In a globalized world, food is still a highly regulated commodity and a strategic resource. A drought happening in a net food-exporter will have little to no effect on its own population but the repercussion on net food-importers can be extreme. In this project, we propose a methodology to describe and quantify the impact of a local drought to human health at a global scale. For this purpose, nutrition supply and global trade data from FAOSTAT have been used with domestic food production from national agencies and FAOSTAT, global precipitation from the Climate Research Unit and health data from the World Health Organization. A modified Herfindahl-Hirschman Index (HHI) has been developed to measure the level of resilience of one country to a drought happening in another country. This index describes how a country is dependent of importation and how diverse are its importation. Losses of production and exportation due to extreme events have been calculated using yield data and a simple food balance at country scale. Results show that countries the most affected by global droughts are the one with the highest dependency to one exporting country. Changes induced by droughts also disturbed their domestic proteins, fat and calories supply resulting most of the time in a higher intake of calories or fat over proteins.

  16. Malignant bone tumors of the pelvis and of the extremities

    International Nuclear Information System (INIS)

    Gullotta, U.; Reiser, M.; Feuerbach, S.; Biehl, T.; Technische Univ. Muenchen

    1981-01-01

    Bone tumors of the extremities are usually diagnosed by conventional radiography. A good angiogram may render information not only about intra- and extraosseous extension of the tumor, but often also about the biological dignity. CT is usually not necessary, especially since it is sometimes difficult to define the extraosseous borders of these extremity tumors with this method. In bone tumors of the pelvis, however, neither conventional radiography nor angiography render reliable information about the extent of the tumor, which CT is very well able to do. Therefore CT is primarily indicated for evaluation of bone tumors in this region. Angiography is done only for preoperative evaluation of the vascular architecture or for potential therapeutic embolisation. (orig.) [de

  17. Determining extreme parameter correlation in ground water models

    DEFF Research Database (Denmark)

    Hill, Mary Cole; Østerby, Ole

    2003-01-01

    can go undetected even by experienced modelers. Extreme parameter correlation can be detected using parameter correlation coefficients, but their utility depends on the presence of sufficient, but not excessive, numerical imprecision of the sensitivities, such as round-off error. This work...... investigates the information that can be obtained from parameter correlation coefficients in the presence of different levels of numerical imprecision, and compares it to the information provided by an alternative method called the singular value decomposition (SVD). Results suggest that (1) calculated...... correlation coefficients with absolute values that round to 1.00 were good indicators of extreme parameter correlation, but smaller values were not necessarily good indicators of lack of correlation and resulting unique parameter estimates; (2) the SVD may be more difficult to interpret than parameter...

  18. Identification of Climate Change with Generalized Extreme Value (GEV) Distribution Approach

    International Nuclear Information System (INIS)

    Rahayu, Anita

    2013-01-01

    Some events are difficult to avoid and gives considerable influence to humans and the environment is extreme weather and climate change. Many of the problems that require knowledge about the behavior of extreme values and one of the methods used are the Extreme Value Theory (EVT). EVT used to draw up reliable systems in a variety of conditions, so as to minimize the risk of a major disaster. There are two methods for identifying extreme value, Block Maxima with Generalized Extreme Value (GEV) distribution approach and Peaks over Threshold (POT) with Generalized Pareto Distribution (GPD) approach. This research in Indramayu with January 1961-December 2003 period, the method used is Block Maxima with GEV distribution approach. The result showed that there is no climate change in Indramayu with January 1961-December 2003 period.

  19. Arctic sea ice, Eurasia snow, and extreme winter haze in China.

    Science.gov (United States)

    Zou, Yufei; Wang, Yuhang; Zhang, Yuzhong; Koo, Ja-Ho

    2017-03-01

    The East China Plains (ECP) region experienced the worst haze pollution on record for January in 2013. We show that the unprecedented haze event is due to the extremely poor ventilation conditions, which had not been seen in the preceding three decades. Statistical analysis suggests that the extremely poor ventilation conditions are linked to Arctic sea ice loss in the preceding autumn and extensive boreal snowfall in the earlier winter. We identify the regional circulation mode that leads to extremely poor ventilation over the ECP region. Climate model simulations indicate that boreal cryospheric forcing enhances the regional circulation mode of poor ventilation in the ECP region and provides conducive conditions for extreme haze such as that of 2013. Consequently, extreme haze events in winter will likely occur at a higher frequency in China as a result of the changing boreal cryosphere, posing difficult challenges for winter haze mitigation but providing a strong incentive for greenhouse gas emission reduction.

  20. Infant difficult behaviors in the context of perinatal biomedical conditions and early child environment

    Directory of Open Access Journals (Sweden)

    Sirvinskiene Giedre

    2012-04-01

    Full Text Available Abstract Background Problems experienced within the first year of an infant's life can be precursors of later mental health conditions. The purpose of this study was to examine the frequency and continuity of difficult behaviors in infants at 3 and 6 months of age and the associations of these difficulties with biomedical and psychosocial factors. Methods This study was a part of an ongoing prospective birth-cohort study. Study participants were 189 uniparous mothers and their full-term newborns. The index of infant difficult behavior was constructed. This index was then associated with the following factors: delivery mode, newborn function after birth, maternal emotional well-being, risk behavior, subjective evaluation of the quality of the relationship of the couple, and attitudes toward infant-rearing. Results Common difficult behaviors, including crying, sleeping and eating problems, were characteristic for 30.2% of 3 month old and for 22.2% of 6 month old full-term infants. The expression of infant difficult behaviors at the age of 3 months increased the likelihood of the expression of these difficulties at 6 months by more than 5 times. Factors including younger maternal age, poor prenatal and postnatal emotional well-being, prenatal alcohol consumption, low satisfaction with the couple's relationship before pregnancy, and deficiency of infant-centered maternal attitudes towards infant-rearing increased the likelihood of difficult behaviors in infants at the age of 3 months. Low maternal satisfaction with the relationship of the couple before pregnancy, negative emotional reactions of both parents toward pregnancy (as reported by the mother and the deficiency of an infant-centered maternal attitude towards infant-rearing increased the likelihood of infant difficult behaviors continuing between the ages of 3 to 6 months. Perinatal biomedical conditions were not related to the difficult behaviors in infants. Conclusions Our study suggests

  1. A new extremity dosemeter for beta and gamma radiation

    International Nuclear Information System (INIS)

    Heinzelmann, M.; Pagenkamper, M.

    1988-01-01

    An extremity dosemeter developed at the Juelich Nuclear Research Centre is very well suited for the precise and energy-independent measurement of the skin dose generated by beta or gamma radiation. This is also confirmed by the results of this intercomparison programme. The dosemeter contains three TLDs of LiF in Teflon mounted behind a window of 0.9 mg/cm 2 . The great advantage of this dosemeter is three TLD's enabling statements about the radiation quality. However, the dosemeter has two disadvantages The dosemeter is complicated to manufacture. A very thin plastic foil of 0.9 mg/cm 2 must be attached to a support. This work is difficult and time-consuming and cannot be automated. The window in front of the TLD is not sturdy enough and is occasionally destroyed when the dosemeter is being worn. These two disadvantages prevent this extremity dosemeter from being used more frequently. For this reason, work was begun on developing a new extremity dosemeter without these two disadvantages. The great advantage of the previous dosemeter of obtaining statements about the type of radiation with the aid of readings from three TLD's was to be retained. The improved extremity dosemeter has a more sturdy and thicker window with a similar response as the previous dosemeter with a thinner window

  2. Concepts and procedures required for successful reduction of tensor magnetic gradiometer data obtained from an unexploded ordnance detection demonstration at Yuma Proving Grounds, Arizona

    Science.gov (United States)

    Bracken, Robert E.; Brown, Philip J.

    2006-01-01

    On March 12, 2003, data were gathered at Yuma Proving Grounds, in Arizona, using a Tensor Magnetic Gradiometer System (TMGS). This report shows how these data were processed and explains concepts required for successful TMGS data reduction. Important concepts discussed include extreme attitudinal sensitivity of vector measurements, low attitudinal sensitivity of gradient measurements, leakage of the common-mode field into gradient measurements, consequences of thermal drift, and effects of field curvature. Spatial-data collection procedures and a spin-calibration method are addressed. Discussions of data-reduction procedures include tracking of axial data by mathematically matching transfer functions among the axes, derivation and application of calibration coefficients, calculation of sensor-pair gradients, thermal-drift corrections, and gradient collocation. For presentation, the magnetic tensor at each data station is converted to a scalar quantity, the I2 tensor invariant, which is easily found by calculating the determinant of the tensor. At important processing junctures, the determinants for all stations in the mapped area are shown in shaded relief map-view. Final processed results are compared to a mathematical model to show the validity of the assumptions made during processing and the reasonableness of the ultimate answer obtained.

  3. Endotypes of difficult-to-control asthma in inner-city African American children.

    Directory of Open Access Journals (Sweden)

    K R Brown

    Full Text Available African Americans have higher rates of asthma prevalence, morbidity, and mortality in comparison with other racial groups. We sought to characterize endotypes of childhood asthma severity in African American patients in an inner-city pediatric asthma population. Baseline blood neutrophils, blood eosinophils, and 38 serum cytokine levels were measured in a sample of 235 asthmatic children (6-17 years enrolled in the NIAID (National Institute of Allergy and Infectious Diseases-sponsored Asthma Phenotypes in the Inner City (APIC study (ICAC (Inner City Asthma Consortium-19. Cytokines were quantified using a MILLIPLEX panel and analyzed on a Luminex analyzer. Patients were classified as Easy-to-Control or Difficult-to-Control based on the required dose of controller medications over one year of prospective management. A multivariate variable selection procedure was used to select cytokines associated with Difficult-to-Control versus Easy-to-Control asthma, adjusting for age, sex, blood eosinophils, and blood neutrophils. In inner-city African American children, 12 cytokines were significant predictors of Difficult-to-Control asthma (n = 235. CXCL-1, IL-5, IL-8, and IL-17A were positively associated with Difficult-to-Control asthma, while IL-4 and IL-13 were positively associated with Easy-to-Control asthma. Using likelihood ratio testing, it was observed that in addition to blood eosinophils and neutrophils, serum cytokines improved the fit of the model. In an inner-city pediatric population, serum cytokines significantly contributed to the definition of Difficult-to-Control asthma endotypes in African American children. Mixed responses characterized by TH2 (IL-5 and TH17-associated cytokines were associated with Difficult-to-Control asthma. Collectively, these data may contribute to risk stratification of Difficult-to-Control asthma in the African American population.

  4. Difficult incidents and tutor interventions in problem-based learning tutorials.

    Science.gov (United States)

    Kindler, Pawel; Grant, Christopher; Kulla, Steven; Poole, Gary; Godolphin, William

    2009-09-01

    Tutors report difficult incidents and distressing conflicts that adversely affect learning in their problem-based learning (PBL) groups. Faculty development (training) and peer support should help them to manage this. Yet our understanding of these problems and how to deal with them often seems inadequate to help tutors. The aim of this study was to categorise difficult incidents and the interventions that skilled tutors used in response, and to determine the effectiveness of those responses. Thirty experienced and highly rated tutors in our Year 1 and 2 medical curriculum took part in semi-structured interviews to: identify and describe difficult incidents; describe how they responded, and assess the success of each response. Recorded and transcribed data were analysed thematically to develop typologies of difficult incidents and interventions and compare reported success or failure. The 94 reported difficult incidents belonged to the broad categories 'individual student' or 'group dynamics'. Tutors described 142 interventions in response to these difficult incidents, categorised as: (i) tutor intervenes during tutorial; (ii) tutor gives feedback outside tutorial, or (iii) student or group intervenes. Incidents in the 'individual student' category were addressed relatively unsuccessfully (effective 75% of the time) by response (iii). None of the interventions worked well when used in response to problems related to 'group dynamics'. Overall, 59% of the difficult incidents were dealt with successfully. Dysfunctional PBL groups can be highly challenging, even for experienced and skilled tutors. Within-tutorial feedback, the treatment that tutors are most frequently advised to apply, was often not effective. Our study suggests that the collective responsibility of the group, rather than of the tutor, to deal with these difficulties should be emphasised.

  5. Extreme climatic events in relation to global change and their impact on life histories

    Directory of Open Access Journals (Sweden)

    Juan MORENO, Anders Pape Møller

    2011-06-01

    Full Text Available Extreme weather conditions occur at an increasing rate as evidenced by higher frequency of hurricanes and more extreme precipitation and temperature anomalies. Such extreme environmental conditions will have important implications for all living organisms through greater frequency of reproductive failure and reduced adult survival. We review examples of reproductive failure and reduced survival related to extreme weather conditions. Phenotypic plasticity may not be sufficient to allow adaptation to extreme weather for many animals. Theory predicts reduced reproductive effort as a response to increased stochasticity. We predict that patterns of natural selection will change towards truncation selection as environmental conditions become more extreme. Such changes in patterns of selection may facilitate adaptation to extreme events. However, effects of selection on reproductive effort are difficult to detect. We present a number of predictions for the effects of extreme weather conditions in need of empirical tests. Finally, we suggest a number of empirical reviews that could improve our ability to judge the effects of extreme environmental conditions on life history [Current Zoology 57 (3: 375–389, 2011].

  6. Difficult airway equipment in departments of emergency medicine in Ireland: results of a national survey.

    LENUS (Irish Health Repository)

    Walsh, K

    2012-02-03

    BACKGROUND AND OBJECTIVE: Adverse effects associated with difficult airway management can be catastrophic and include death, brain injury and myocardial injury. Closed-malpractice claims have shown prolonged and persistent attempts at endotracheal intubation to be the most common situation leading to disastrous respiratory events. To date, there has been no evaluation of the types of difficult airway equipment currently available in Irish departments of emergency medicine. The objective of this survey was to identify the difficult airway equipment available in Irish departments of emergency medicine. METHODS: Departments of emergency medicine in the Republic of Ireland with at least one dedicated Emergency Medicine consultant were surveyed via telephone. RESULTS: All of the departments contacted held at least one alternative device on site for both ventilation and intubation. The most common alternative ventilation device was the laryngeal mask airway (89%). The most common alternative intubating device was the surgical airway device (100%). CONCLUSIONS: Irish departments of emergency medicine compare well with those in the UK and USA, when surveyed concerning difficult airway equipment. However, we believe that this situation could be further improved by training inexperienced healthcare providers in the use of the laryngeal mask airway and intubating laryngeal mask airway, by placing greater emphasis on the ready availability of capnography and by the increased use of portable difficult airway storage units.

  7. Distractor dwelling, skipping, and revisiting determine target absent performance in difficult visual search

    Directory of Open Access Journals (Sweden)

    Gernot Horstmann

    2016-08-01

    Full Text Available Some targets in visual search are more difficult to find than others. In particular, a target that is similar to the distractors is more difficult to find than a target that is dissimilar to the distractors. Efficiency differences between easy and difficult searches are manifest not only in target-present trials but also in target-absent trials. In fact, even physically identical displays are searched through with different efficiency depending on the searched-for target. Here, we monitored eye movements in search for a target similar to the distractors (difficult search versus a target dissimilar to the distractors (easy search. We aimed to examine three hypotheses concerning the causes of differential search efficiencies in target-absent trials: (a distractor dwelling (b distractor skipping, and (c distractor revisiting. Reaction times increased with target similarity which is consistent with existing theories and replicates earlier results. Eye movement data indicated guidance in target trials, even though search was very slow. Dwelling, skipping, and revisiting contributed to low search efficiency in difficult search, with dwelling being the strongest factor. It is argued that differences in dwell time account for a large amount of total search time differences.

  8. Flow cytometry of duodenal intraepithelial lymphocytes improves diagnosis of celiac disease in difficult cases.

    Science.gov (United States)

    Valle, Julio; Morgado, José Mario T; Ruiz-Martín, Juan; Guardiola, Antonio; Lopes-Nogueras, Miriam; García-Vela, Almudena; Martín-Sacristán, Beatriz; Sánchez-Muñoz, Laura

    2017-10-01

    Diagnosis of celiac disease is difficult when the combined results of serology and histology are inconclusive. Studies using flow cytometry of intraepithelial lymphocytes (IELs) have found that celiac patients have increased numbers of γδ IELs, along with a decrease in CD3-CD103 + IELs. The objective of this article is to assess the role of flow cytometric analysis of IELs in the diagnosis of celiac disease in difficult cases. A total of 312 patients with suspicion of celiac disease were included in the study. Duodenal biopsy samples were used for histological assessment and for flow cytometric analysis of IELs. In 46 out of 312 cases (14.7%) the combination of serology and histology did not allow the confirmation or exclusion of celiac disease. HLA typing had been performed in 42 of these difficult cases. Taking into account HLA typing and the response to a gluten-free diet, celiac disease was excluded in 30 of these cases and confirmed in the remaining 12. Flow cytometric analysis of IELs allowed a correct diagnosis in 39 out of 42 difficult cases (92.8%) and had a sensitivity of 91.7% (95% CI: 61.5% to 99.8%) and a specificity of 93.3% (95% CI: 77.9% to 99.2%) for the diagnosis of celiac disease in this setting. Flow cytometric analysis of IELs is useful for the diagnosis of celiac disease in difficult cases.

  9. Distractor Dwelling, Skipping, and Revisiting Determine Target Absent Performance in Difficult Visual Search

    Science.gov (United States)

    Horstmann, Gernot; Herwig, Arvid; Becker, Stefanie I.

    2016-01-01

    Some targets in visual search are more difficult to find than others. In particular, a target that is similar to the distractors is more difficult to find than a target that is dissimilar to the distractors. Efficiency differences between easy and difficult searches are manifest not only in target-present trials but also in target-absent trials. In fact, even physically identical displays are searched through with different efficiency depending on the searched-for target. Here, we monitored eye movements in search for a target similar to the distractors (difficult search) versus a target dissimilar to the distractors (easy search). We aimed to examine three hypotheses concerning the causes of differential search efficiencies in target-absent trials: (a) distractor dwelling (b) distractor skipping, and (c) distractor revisiting. Reaction times increased with target similarity which is consistent with existing theories and replicates earlier results. Eye movement data indicated guidance in target trials, even though search was very slow. Dwelling, skipping, and revisiting contributed to low search efficiency in difficult search, with dwelling being the strongest factor. It is argued that differences in dwell time account for a large amount of total search time differences. PMID:27574510

  10. Pediatric lower extremity mower injuries.

    Science.gov (United States)

    Hill, Sean M; Elwood, Eric T

    2011-09-01

    Lawn mower injuries in children represent an unfortunate common problem to the plastic reconstructive surgeon. There are approximately 68,000 per year reported in the United States. Compounding this problem is the fact that a standard treatment algorithm does not exist. This study follows a series of 7 pediatric patients treated for lower extremity mower injuries by a single plastic surgeon. The extent of soft tissue injury varied. All patients were treated with negative pressure wound therapy as a bridge to definitive closure. Of the 7 patients, 4 required skin grafts, 1 required primary closure, 1 underwent a lower extremity amputation secondary to wounds, and 1 was repaired using a cross-leg flap. Function limitations were minimal for all of our patients after reconstruction. Our basic treatment algorithm is presented with initial debridement followed by the simplest method possible for wound closure using negative pressure wound therapy, if necessary.

  11. Extreme Conditions Modeling Workshop Report

    Energy Technology Data Exchange (ETDEWEB)

    Coe, Ryan Geoffrey [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Neary, Vincent Sinclair [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Lawon, Michael J. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Yu, Yi-Hsiang [National Renewable Energy Lab. (NREL), Golden, CO (United States); Weber, Jochem [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2014-07-01

    Sandia National Laboratories (SNL) and the National Renewable Energy Laboratory (NREL) hosted the Wave Energy Converter (WEC) Extreme Conditions Modeling (ECM) Workshop in Albuquerque, New Mexico on May 13–14, 2014. The objective of the workshop was to review the current state of knowledge on how to numerically and experimentally model WECs in extreme conditions (e.g. large ocean storms) and to suggest how national laboratory resources could be used to improve ECM methods for the benefit of the wave energy industry. More than 30 U.S. and European WEC experts from industry, academia, and national research institutes attended the workshop, which consisted of presentations from W EC developers, invited keynote presentations from subject matter experts, breakout sessions, and a final plenary session .

  12. Extreme project. Progress report 2006

    International Nuclear Information System (INIS)

    Eyrolle, F.; Masson, O.; Charmasson, S.

    2007-01-01

    The E.X.T.R.E.M.E. project introduced in 2005 to the S.E.S.U.R.E. / L.E.R.C.M. has for objectives to acquire data on the consequences of the extreme climatic meteorological episodes on the distribution of the artificial radioisotopes within the various compartments of the geosphere. This report presents the synthesis of the actions developed in 2006 in positioning and in co financing of the project by means of regional or national research programs (C.A.R.M.A., E.X.T.R.E.M.A., E.C.C.O.R.E.V.I.), of data acquisition, valuation and scientific collaboration. (N.C.)

  13. On causality of extreme events

    Directory of Open Access Journals (Sweden)

    Massimiliano Zanin

    2016-06-01

    Full Text Available Multiple metrics have been developed to detect causality relations between data describing the elements constituting complex systems, all of them considering their evolution through time. Here we propose a metric able to detect causality within static data sets, by analysing how extreme events in one element correspond to the appearance of extreme events in a second one. The metric is able to detect non-linear causalities; to analyse both cross-sectional and longitudinal data sets; and to discriminate between real causalities and correlations caused by confounding factors. We validate the metric through synthetic data, dynamical and chaotic systems, and data representing the human brain activity in a cognitive task. We further show how the proposed metric is able to outperform classical causality metrics, provided non-linear relationships are present and large enough data sets are available.

  14. Extreme Nonlinear Optics An Introduction

    CERN Document Server

    Wegener, Martin

    2005-01-01

    Following the birth of the laser in 1960, the field of "nonlinear optics" rapidly emerged. Today, laser intensities and pulse durations are readily available, for which the concepts and approximations of traditional nonlinear optics no longer apply. In this regime of "extreme nonlinear optics," a large variety of novel and unusual effects arise, for example frequency doubling in inversion symmetric materials or high-harmonic generation in gases, which can lead to attosecond electromagnetic pulses or pulse trains. Other examples of "extreme nonlinear optics" cover diverse areas such as solid-state physics, atomic physics, relativistic free electrons in a vacuum and even the vacuum itself. This book starts with an introduction to the field based primarily on extensions of two famous textbook examples, namely the Lorentz oscillator model and the Drude model. Here the level of sophistication should be accessible to any undergraduate physics student. Many graphical illustrations and examples are given. The followi...

  15. Promoting Exit from Violent Extremism

    DEFF Research Database (Denmark)

    Dalgaard-Nielsen, Anja

    2013-01-01

    A number of Western countries are currently adding exit programs targeting militant Islamists to their counterterrorism efforts. Drawing on research into voluntary exit from violent extremism, this article identifies themes and issues that seem to cause doubt, leading to exit. It then provides a ...... the influence attempt as subtle as possible, use narratives and self-affirmatory strategies to reduce resistance to persuasion, and consider the possibility to promote attitudinal change via behavioral change as an alternative to seek to influence beliefs directly....

  16. Racial Extremism in the Army

    Science.gov (United States)

    1998-04-01

    of Deference ...................................................................................................... 46 1. The Separation of Powers Doctrine...to the military. This deference has a two-fold basis. First, the separation of powers in the U.S. Constitution gives authority to the executive (and...Why should there be judicial deference to the Army’s policy on extremism? There are two principal reasons. First, the Constitution’s separation of powers doctrine

  17. Large Extremity Peripheral Nerve Repair

    Science.gov (United States)

    2016-12-01

    LM, de Crombrugghe B. Some recent advances in the chemistry and biology of trans- forming growth factor-beta. J Cell Biol 1987;105:1039e45. 12. Hao Y...SUPPLEMENTARY NOTES 14. ABSTRACT In current war trauma, 20-30% of all extremity injuries and >80% of penetrating injuries being associated with peripheral nerve...through both axonal advance and in revascularization of the graft following placement. We are confident that this technology may allow us to

  18. Reviewing Hit Discovery Literature for Difficult Targets: Glutathione Transferase Omega-1 as an Example.

    Science.gov (United States)

    Xie, Yiyue; Dahlin, Jayme L; Oakley, Aaron J; Casarotto, Marco G; Board, Philip G; Baell, Jonathan B

    2018-05-10

    Early stage drug discovery reporting on relatively new or difficult targets is often associated with insufficient hit triage. Literature reviews of such targets seldom delve into the detail required to critically analyze the associated screening hits reported. Here we take the enzyme glutathione transferase omega-1 (GSTO1-1) as an example of a relatively difficult target and review the associated literature involving small-molecule inhibitors. As part of this process we deliberately pay closer-than-usual attention to assay interference and hit quality aspects. We believe this Perspective will be a useful guide for future development of GSTO1-1 inhibitors, as well serving as a template for future review formats of new or difficult targets.

  19. The primary study of fistulae isolation for difficult-cured traumatic carotid cavernous by two accesses

    International Nuclear Information System (INIS)

    Wang Ziliang; Li Tianxiao; Zhai Shuiting; Cao Huicun; Xu Jiangyu; Bai Weixing; Liu Jian

    2007-01-01

    Objective: To investigate the feasibility and security of the isolation of fistulae for difficult-cured traumatic carotid cavernous by the anterio or inferior communicating artery. Methods: Five patients with difficult-cured TCCF including four males and one female. They were cathetered by both femoral arteries. Balloon-catheter directly attached to the near of fistulae and microcatheter conversely attached to the far of fistulae. Detachable balloons and micro coils were used to isolated the fistulae. Results: Five patients were cured with fistulae isolation and angiography did not show remnants fistulae in time. Clinical signs and symptoms got better and better. During follows-up no one recurred. Conclusions: The isolation of fistulae is a feasible and secure therapy for the difficult-cured traumatic direct carotid cavernous fistulae. (authors)

  20. Treatment of psychological factors in a child with difficult asthma: a case report.

    Science.gov (United States)

    Anbar, Ran D; Sachdeva, Shagun

    2011-07-01

    Difficult asthma is defined as the persistence of asthma symptoms, abnormal pulmonary function showing airway obstruction, and continued requirement for short-acting bronchodilator therapy, despite adequate treatment with inhaled corticosteroids. It calls for a thorough evaluation of the patient to look into alternate and complicating diagnoses. The authors report a case of a 9-year-old patient with difficult asthma who failed to respond to conventional therapy. Although it was recognized that he had a number of potential medical complicating factors including allergies, chronic sinusitis, and gastroesophageal reflux, a psychological intervention using hypnosis ultimately appeared to help alleviate his symptoms completely. Thus, psychological evaluation and intervention should be considered early in the course of management of a patient with difficult asthma, because it may help avoid time-consuming and expensive investigations of potential complicating factors, and it may yield rapid improvement in the patient's clinical condition.

  1. The "difficult" patient reconceived: an expanded moral mandate for clinical ethics.

    Science.gov (United States)

    Fiester, Autumn

    2012-01-01

    Between 15 and 60% of patients are considered "difficult" by their treating physicians. Patient psychiatric pathology is the conventional explanation for why patients are deemed "difficult." But the prevalence of the problem suggests the possibility of a less pathological cause. I argue that the phenomenon can be better explained as a response to problematic interactions related to health care delivery. If there are grounds to reconceive the "difficult" patient as reacting to the perception of ill treatment, then there is an ethical obligation to address this perception of harm. Resolution of such conflicts currently lies with the provider and patient. But the ethical stakes place these conflicts into the province of the ethics consult service. As the resource for addressing ethical dilemmas, there is a moral mandate to offer assistance in the resolution of these ethically charged conflicts that is no less pressing than the more familiar terrain of clinical ethics consultation.

  2. Typologies of extreme longevity myths.

    Science.gov (United States)

    Young, Robert D; Desjardins, Bertrand; McLaughlin, Kirsten; Poulain, Michel; Perls, Thomas T

    2010-01-01

    Purpose. Political, national, religious, and other motivations have led the media and even scientists to errantly accept extreme longevity claims prima facie. We describe various causes of false claims of extraordinary longevity. Design and Methods. American Social Security Death Index files for the period 1980-2009 were queried for individuals with birth and death dates yielding ages 110+ years of age. Frequency was compared to a list of age-validated supercentenarians maintained by the Gerontology Research Group who died during the same time period. Age claims of 110+ years and the age validation experiences of the authors facilitated a list of typologies of false age claims. Results. Invalid age claim rates increase with age from 65% at age 110-111 to 98% by age 115 to 100% for 120+ years. Eleven typologies of false claims were: Religious Authority Myth, Village Elder Myth, Fountain of Youth Myth (substance), Shangri-La Myth (geographic), Nationalist Pride, Spiritual Practice, Familial Longevity, Individual and/or Family Notoriety, Military Service, Administrative Entry Error, and Pension-Social Entitlement Fraud. Conclusions. Understanding various causes of false extreme age claims is important for placing current, past, and future extreme longevity claims in context and for providing a necessary level of skepticism.

  3. Moderate and extreme maternal obesity.

    LENUS (Irish Health Repository)

    Abdelmaboud, M O

    2012-05-01

    The aim of this study was to investigate the prevalence of moderate and extreme obesity among an Irish obstetric population over a 10-year period, and to evaluate the obstetric features of such pregnancies. Of 31,869 women delivered during the years 2000-2009, there were 306 women in the study group, including 173 in the moderate or Class 2 obese category (BMI 35-39.9) and 133 in the extreme or Class 3 obese category (BMI > or = 40).The prevalence of obese women with BMI > or = 35 was 9.6 per 1000 (0.96%), with an upward trend observed from 2.1 per 1000 in the year 2000, to 11.8 per 1000 in the year 2009 (P = 0.001). There was an increase in emergency caesarean section (EMCS) risk for primigravida versus multigravid women, within both obese categories (P < 0.001). However, there was no significant difference in EMCS rates observed between Class 2 and Class 3 obese women, when matched for parity. The prevalence of moderate and extreme obesity reported in this population is high, and appears to be increasing. The increased rates of abdominal delivery, and the levels of associated morbidity observed, have serious implications for such women embarking on pregnancy.

  4. Attribution of climate extreme events

    Science.gov (United States)

    Trenberth, Kevin E.; Fasullo, John T.; Shepherd, Theodore G.

    2015-08-01

    There is a tremendous desire to attribute causes to weather and climate events that is often challenging from a physical standpoint. Headlines attributing an event solely to either human-induced climate change or natural variability can be misleading when both are invariably in play. The conventional attribution framework struggles with dynamically driven extremes because of the small signal-to-noise ratios and often uncertain nature of the forced changes. Here, we suggest that a different framing is desirable, which asks why such extremes unfold the way they do. Specifically, we suggest that it is more useful to regard the extreme circulation regime or weather event as being largely unaffected by climate change, and question whether known changes in the climate system's thermodynamic state affected the impact of the particular event. Some examples briefly illustrated include 'snowmaggedon' in February 2010, superstorm Sandy in October 2012 and supertyphoon Haiyan in November 2013, and, in more detail, the Boulder floods of September 2013, all of which were influenced by high sea surface temperatures that had a discernible human component.

  5. Typologies of Extreme Longevity Myths

    Directory of Open Access Journals (Sweden)

    Robert D. Young

    2010-01-01

    Full Text Available Purpose. Political, national, religious, and other motivations have led the media and even scientists to errantly accept extreme longevity claims prima facie. We describe various causes of false claims of extraordinary longevity. Design and Methods. American Social Security Death Index files for the period 1980–2009 were queried for individuals with birth and death dates yielding ages 110+ years of age. Frequency was compared to a list of age-validated supercentenarians maintained by the Gerontology Research Group who died during the same time period. Age claims of 110+ years and the age validation experiences of the authors facilitated a list of typologies of false age claims. Results. Invalid age claim rates increase with age from 65% at age 110-111 to 98% by age 115 to 100% for 120+ years. Eleven typologies of false claims were: Religious Authority Myth, Village Elder Myth, Fountain of Youth Myth (substance, Shangri-La Myth (geographic, Nationalist Pride, Spiritual Practice, Familial Longevity, Individual and/or Family Notoriety, Military Service, Administrative Entry Error, and Pension-Social Entitlement Fraud. Conclusions. Understanding various causes of false extreme age claims is important for placing current, past, and future extreme longevity claims in context and for providing a necessary level of skepticism.

  6. Energy, entropy, environment: Why is protection of the environment objectively difficult?

    Energy Technology Data Exchange (ETDEWEB)

    Rebane, Karl K [Institute of Physics, Tartu (Estonia)

    1995-05-01

    Evolution and man`s history indicate that the winners are the species and societies that act faster and consume more high-quality energy and materials: in other words, those which cause more pollution and faster growth of entropy. This could be the reason why protection of the environment is objectively difficult and, in particular, why it is almost impossible to considerably reduce man`s consumption of energy and materials in a world of competition. To escape this fatal evolutionary outcome, fundamentally new thinking is needed, thinking which takes the survival of mankind as the primary value. The role of religion in solving this tremendously difficult task should not be neglected

  7. Edward’s syndrome: A rare cause of difficult intubation-utility of left molar approach

    Directory of Open Access Journals (Sweden)

    Teena Bansal

    2016-04-01

    Full Text Available Edward’s syndrome (trisomy 18 is an autosomal abnormality with dysmorphic face, visceral deformities and delayed mental and motor development including congenital heart disease. Challenges may arise during mask ventilation, laryngoscopy and/or intubation of the trachea due to dysmorphic face. Difficult airway cart should be kept ready. Left molar approach using a standard Macintosh blade improves the laryngoscopic view in patients with difficult midline laryngoscopy. We hereby present a case report of a 2 year old male child with Edward’s syndrome posted for evacuation and drainage of brain abscess, intubated successfully using left molar approach.

  8. Making difficult decisions how to be decisive and get the business done

    CERN Document Server

    Shaw, Peter J A

    2010-01-01

    You are faced with so many difficult decisions. Often your decision making seems random. It can be swayed by different situations and emotions. You need to be more rigorous in the way you make decisions and yet you have very little time to do so. Experience from others who have made tough decisions and a framework to help you do so would be invaluable. The courage to make decisions is sometimes a bit elusive. It is difficult to find the calmness to be able to make and live with those decisions. There is so much that can be learned from the experience of others. After working through this boo

  9. The importance of subjective facial appearance on the ability of anesthesiologists to predict difficult intubation.

    Science.gov (United States)

    Connor, Christopher W; Segal, Scott

    2014-02-01

    Previously we demonstrated that a computer algorithm based on bedside airway examinations and facial photographs accurately classified easy and difficult airways. The extent of the ability of anesthesiologists to perform the same task is unknown. We hypothesized that providing photographs would add to the predictive ability of anesthesiologists over that achieved when provided only with the Mallampati (MP) score and the thyromental distance (TMD). We further hypothesized that human observers would implicitly bias their predictions toward more sensitive determination of difficult airways, rather than more specific determination of easy airways. Residents, fellows, and attending anesthesiologists with varying levels of experience (N = 160) were presented with MP and TMD information from 80 Caucasian men subjects. The same subjects' data, accompanied by 3 facial photographs in head-on and right and left profiles, were also presented. Anesthesiologists classified the airways as easy or difficult according to specified criteria ("easy" defined as a single attempt with a Macintosh 3 blade resulting in a grade 1 laryngoscopic view; "difficult" defined as >1 attempt by an operator with at least 12 months anesthesia experience, grade 3 or 4 laryngoscopic view, need for a second operator, or nonelective use of an alternative airway device). Accuracy, sensitivity, and specificity were calculated for each anesthesiologist. We further developed a cost function to quantify a relative bias toward avoiding an unexpectedly difficult intubation versus overpreparing for an easy intubation. One hundred sixty respondents completed the study. Presenting photographs improved respondents' sensitivity and accuracy in classifying airways, though specificity decreased slightly. Overall accuracy when given photographs was 61.6% (95% confidence interval, 60.8%-62.4%), which was significantly lower than the computer's performance of 87.5% (t test, P interval, 4.9:1-8.4:1). Anesthesiologists can

  10. High levels of IGF-1 predict difficult intubation of patients with acromegaly.

    Science.gov (United States)

    Zhang, Yu; Guo, Xiaopeng; Pei, Lijian; Zhang, Zhuhua; Tan, Gang; Xing, Bing

    2017-08-01

    To investigate the characteristics of difficult intubation and identify novel efficient predictors in patients with acromegaly. Patients with either untreated acromegaly or non-functional pituitary adenomas were enrolled. Patients with acromegaly underwent hormone assays, upper airway computed tomography and magnetic resonance imaging examinations and preoperative overnight polysomnography. The modified Mallampati classification, mouth opening, neck circumference, and neck extension were assessed, and the Cormack-Lehane grades and the time of tracheal intubation were recorded. Patients with acromegaly had a higher incidence of difficult intubation (62.5%). The time of tracheal intubation was prolonged, the neck circumference was enlarged, and the neck extension was confined. In patients with acromegaly and difficult intubation, the insulin-like growth factor 1 levels and apnea/hypoxia index were significantly higher compared to patients without difficult intubation (1115.40 ± 253.73 vs. 791.67 ± 206.62 ng/ml, P = 0.020; 22.17 ± 23.25 vs. 2.47 ± 2.84, P = 0.026, respectively). The bilateral regression analysis revealed that high levels of insulin-like growth factor 1 were an independent risk factor for developing difficult intubation (p = 0.042, Exp B = 1.006). The modified Mallampati classification was positively correlated with apnea/hypoxia index and could be calculated using the following logarithmic equation: MMC = 0.2982 * ln (AHI) + 2.1836. In patients with acromegaly, neck movement is confined, the time of tracheal intubation is prolonged, and the neck circumference is enlarged, and these patients suffer from an increased incidence of difficult intubation (62.5%) during anesthesia induction. The apnea/hypoxia index and insulin-like growth factor 1 levels are both increased in acromegalic patients with difficult intubation, and elevated insulin-like growth factor 1 levels are an independent risk factor of difficult

  11. Assessment of the storz video Macintosh laryngoscope for use in difficult airways: A human simulator study.

    Science.gov (United States)

    Bair, Aaron E; Olmsted, Kalani; Brown, Calvin A; Barker, Tobias; Pallin, Daniel; Walls, Ron M

    2010-10-01

    Video laryngoscopy has been shown to improve glottic exposure when compared to direct laryngoscopy in operating room studies. However, its utility in the hands of emergency physicians (EPs) remains undefined. A simulated difficult airway was used to determine if intubation by EPs using a video Macintosh system resulted in an improved glottic view, was easier, was faster, or was more successful than conventional direct laryngoscopy. Emergency medicine (EM) residents and attending physicians at two academic institutions performed endotracheal intubation in one normal and two identical difficult airway scenarios. With the difficult scenarios, the participants used video laryngoscopy during the second case. Intubations were performed on a medium-fidelity human simulator. The difficult scenario was created by limiting cervical spine mobility and inducing trismus. The primary outcome was the proportion of direct versus video intubations with a grade I or II Cormack-Lehane glottic view. Ease of intubation (self-reported via 10-cm visual analog scale [VAS]), time to intubation, and success rate were also recorded. Descriptive statistics as well as medians with interquartile ranges (IQRs) are reported where appropriate. The Wilcoxon matched pairs signed-rank test was used for comparison testing of nonparametric data. Participants (n = 39) were residents (59%) and faculty. All had human intubation experience; 51% reported more than 100 prior intubations. On difficult laryngoscopy, a Cormack-Lehane grade I or II view was obtained in 20 (51%) direct laryngoscopies versus 38 (97%) of the video-assisted laryngoscopies (p < 0.01). The median VAS score for difficult airways was 50 mm (IQR = 28–73 mm) for direct versus 18 mm (IQR = 9–50 mm) for video (p < 0.01). The median time to intubation in difficult airways was 25 seconds (IQR = 16–44 seconds) for direct versus 20 seconds (IQR = 12–35 seconds) for video laryngoscopy (p < 0.01). All intubations were successful without

  12. Durability and service life design of concrete structures. Experiences and the way to prove in The Netherlands

    NARCIS (Netherlands)

    Siemes, A.J.M.; Vrouwenvelder, A.C.W.M.

    2002-01-01

    After the introduction of reinforced concrete it was believed that the material was extremely durable. Soon it was found however, that reinforced concrete could have serious durability problems and that special care should be taken to avoid them. Durability became an issue.

  13. Prospect for extreme field science

    Energy Technology Data Exchange (ETDEWEB)

    Tajima, T. [Ludwig Maximilian Univ. and Max Planck Institute for Quantum Optics, Garching (Germany); Japan Atomic Energy Agency, Kyoto and KEK, Tsukuba (Japan)

    2009-11-15

    The kind of laser extreme light infrastructure (ELI) provides will usher in a class of experiments we have only dreamed of for years. The characteristics that ELI brings in include: the highest intensity ever, large fluence, and relatively high repetition rate. A personal view of the author on the prospect of harnessing this unprecedented opportunity for advancing science of extreme fields is presented. The first characteristic of ELI, its intensity, will allow us to access, as many have stressed already, extreme fields that hover around the Schwinger field or at the very least the neighboring fields in which vacuum begins to behave as a nonlinear medium. In this sense, we are seriously probing the 'material' property of vacuum and thus the property that theory of relativity itself described and will entail. We will probe both special theory and general theory of relativity in regimes that have been never tested so far. We may see a glimpse into the reach of relativity or even its breakdown in some extreme regimes. We will learn Einstein and may even go beyond Einstein, if our journey is led. Laser-driven acceleration both by the laser field itself and by the wakefield that is triggered in a plasma is huge. Energies, if not luminosity, we can access, may be unprecedented going far beyond TeV. The nice thing about ELI is that it has relatively high repetition rate and average fluence as compared with other extreme lasers. This high fluence can be a key element that leads to applications to high energy physics, such as gamma-gamma collider driver experiment, and some gamma ray experiments that may be relevant in the frontier of photo-nuclear physics, and atomic energy applications. Needless to say, high fluence is one of most important features that industrial and medical applications may need. If we are lucky, we may see a door opens at the frontier of novel physics that may not be available by any other means. (authors)

  14. Meeting on Solute/Solvent Interactions Held in Aberdeen Proving Ground, Maryland on May 29-30, 1991

    Science.gov (United States)

    1992-01-01

    the magnitudes of the nuclear charges and therefore cannot be assumed to indicate relative reactivities toward nucleophiles. There is accordingly no...APPENDIX 3 ORGANIZATIONS OF AUTHORS IN THESE PROCEEDINGS Central Michigan University 49 Instituto de Quimica Fisica 33 La Sierra University, Riverside 71...Aberdeen Proving Gd, MD Joxe-Luis Abbud Christopher Cramer Instituto de Quimica Fisica SMCCR-RSP-C "Rocasolano" U.S. Army Chemical RD&E Center Conajo

  15. Non-linear quenching of current fluctuations in a self-exciting homopolar dynamo, proved by feedback system theory

    Science.gov (United States)

    de Paor, A. M.

    Hide (Nonlinear Processes in Geophysics, 1998) has produced a new mathematical model of a self-exciting homopolar dynamo driving a series- wound motor, as a continuing contribution to the theory of the geomagnetic field. By a process of exact perturbation analysis, followed by combination and partial solution of differential equations, the complete nonlinear quenching of current fluctuations reported by Hide in the case that a parameter ɛ has the value 1 is proved via the Popov theorem from feedback system stability theory.

  16. Non-linear quenching of current fluctuations in a self-exciting homopolar dynamo, proved by feedback system theory

    OpenAIRE

    A. M. de Paor

    1998-01-01

    International audience; Hide (Nonlinear Processes in Geophysics, 1998) has produced a new mathematical model of a self-exciting homopolar dynamo driving a series- wound motor, as a continuing contribution to the theory of the geomagnetic field. By a process of exact perturbation analysis, followed by combination and partial solution of differential equations, the complete nonlinear quenching of current fluctuations reported by Hide in the case that a parameter ? has the value 1 is proved via ...

  17. Seismic test facilities at the ENEA Casaccia Research Center; Prove sismiche con le tavole vibranti al centro ricerche Enea Casaccia

    Energy Technology Data Exchange (ETDEWEB)

    De Canio, G. [ENEA, Divisione Servizi Tecnologici, Centro Ricerche Casaccia, Rome (Italy)

    2000-07-01

    The main experimental facilities for seismic tests at the ENEA C.R. Casaccia laboratories consist of two high performance shake table for three axial seismic tests of structures up to 10 ton mass and 3g acceleration applied at the Center of Gravity at 1m from the base table. The activities are principally devoted to the dynamic characterization and vibration tests for mechanical and aero spatial structures, and the experimental analysis of innovative systems for the seismic isolation and retrofitting of civil, industrial, and historical buildings; together with the seismic tests of sub-structures and scaled mock-ups, in order to evaluate the isolation/dissipation performance of the anti-seismic devices, and the failure modes of the structural parts of the building. [Italian] Le principali attrezzature per le prove sismiche presso i laboratori del C.R. Casaccia consistono di due tavole vibranti triassali per prove su strutture fino a 10t di peso con una accelerazione di 3g applicata al centro di gravita' posto ad 1 m di altezza dal piano della tavola. Le principali attivita' riguardano: (a) test di caratterizzazione dinamica e prove di vibrazioni per strutture meccaniche ed aerospaziali; (b) l'analisi sperimentale di sistemi innovativi per l'isolamento sismico ed il consolidamento di strutture civili, industriali e storico monumentali, e le prove sismiche di elementi strutturali e di modelli in scala per la valutazione della capacita' di dissipazione dei dispositivi antisismici e le modalita' di formazione delle fratture.

  18. Depleted uranium risk assessment for Jefferson Proving Ground using data from environmental monitoring and site characterization. Final report

    International Nuclear Information System (INIS)

    Ebinger, M.H.; Hansen, W.R.

    1996-10-01

    This report documents the third risk assessment completed for the depleted uranium (DU) munitions testing range at Jefferson Proving Ground (JPG), Indiana, for the U.S. Army Test and Evaluation command. Jefferson Proving Ground was closed in 1995 under the Base Realignment and Closure Act and the testing mission was moved to Yuma Proving Ground. As part of the closure of JPG, assessments of potential adverse health effects to humans and the ecosystem were conducted. This report integrates recent information obtained from site characterization surveys at JPG with environmental monitoring data collected from 1983 through 1994 during DU testing. Three exposure scenarios were evaluated for potential adverse effects to human health: an occasional use scenario and two farming scenarios. Human exposure was minimal from occasional use, but significant risk were predicted from the farming scenarios when contaminated groundwater was used by site occupants. The human health risk assessments do not consider the significant risk posed by accidents with unexploded ordnance. Exposures of white-tailed deer to DU were also estimated in this study, and exposure rates result in no significant increase in either toxicological or radiological risks. The results of this study indicate that remediation of the DU impact area would not substantially reduce already low risks to humans and the ecosystem, and that managed access to JPG is a reasonable model for future land use options

  19. Learn, see, practice, prove, do, maintain: an evidence-based pedagogical framework for procedural skill training in medicine.

    Science.gov (United States)

    Sawyer, Taylor; White, Marjorie; Zaveri, Pavan; Chang, Todd; Ades, Anne; French, Heather; Anderson, JoDee; Auerbach, Marc; Johnston, Lindsay; Kessler, David

    2015-08-01

    Acquisition of competency in procedural skills is a fundamental goal of medical training. In this Perspective, the authors propose an evidence-based pedagogical framework for procedural skill training. The framework was developed based on a review of the literature using a critical synthesis approach and builds on earlier models of procedural skill training in medicine. The authors begin by describing the fundamentals of procedural skill development. Then, a six-step pedagogical framework for procedural skills training is presented: Learn, See, Practice, Prove, Do, and Maintain. In this framework, procedural skill training begins with the learner acquiring requisite cognitive knowledge through didactic education (Learn) and observation of the procedure (See). The learner then progresses to the stage of psychomotor skill acquisition and is allowed to deliberately practice the procedure on a simulator (Practice). Simulation-based mastery learning is employed to allow the trainee to prove competency prior to performing the procedure on a patient (Prove). Once competency is demonstrated on a simulator, the trainee is allowed to perform the procedure on patients with direct supervision, until he or she can be entrusted to perform the procedure independently (Do). Maintenance of the skill is ensured through continued clinical practice, supplemented by simulation-based training as needed (Maintain). Evidence in support of each component of the framework is presented. Implementation of the proposed framework presents a paradigm shift in procedural skill training. However, the authors believe that adoption of the framework will improve procedural skill training and patient safety.

  20. Extreme weather and climate events with ecological relevance: a review.

    Science.gov (United States)

    Ummenhofer, Caroline C; Meehl, Gerald A

    2017-06-19

    Robust evidence exists that certain extreme weather and climate events, especially daily temperature and precipitation extremes, have changed in regard to intensity and frequency over recent decades. These changes have been linked to human-induced climate change, while the degree to which climate change impacts an individual extreme climate event (ECE) is more difficult to quantify. Rapid progress in event attribution has recently been made through improved understanding of observed and simulated climate variability, methods for event attribution and advances in numerical modelling. Attribution for extreme temperature events is stronger compared with other event types, notably those related to the hydrological cycle. Recent advances in the understanding of ECEs, both in observations and their representation in state-of-the-art climate models, open new opportunities for assessing their effect on human and natural systems. Improved spatial resolution in global climate models and advances in statistical and dynamical downscaling now provide climatic information at appropriate spatial and temporal scales. Together with the continued development of Earth System Models that simulate biogeochemical cycles and interactions with the biosphere at increasing complexity, these make it possible to develop a mechanistic understanding of how ECEs affect biological processes, ecosystem functioning and adaptation capabilities. Limitations in the observational network, both for physical climate system parameters and even more so for long-term ecological monitoring, have hampered progress in understanding bio-physical interactions across a range of scales. New opportunities for assessing how ECEs modulate ecosystem structure and functioning arise from better scientific understanding of ECEs coupled with technological advances in observing systems and instrumentation.This article is part of the themed issue 'Behavioural, ecological and evolutionary responses to extreme climatic events

  1. Maternal Affective-Cognitive Processes in the Perception of Newborn Difficultness.

    Science.gov (United States)

    Wolke, Dieter; St. James-Roberts, Ian

    A short-term longitudinal study investigated the way parents come to perceive their infant's temperament as difficult, and to identify factors influencing parents' impression formation. Subjects were 40 middle and lower middle class breastfeeding mothers and their singleton newborns of 38 weeks gestation and 2500 grams birth weight. All mothers…

  2. Characterization of parameters and strategies used by physical therapists in difficult mechanical ventilation weaning

    Directory of Open Access Journals (Sweden)

    Fabíola Maria Sabino Meireles

    2013-03-01

    Full Text Available Objective: To characterize the main strategies and parameters used by physical therapists in difficult mechanical ventilation weaning. Methods: Cross-sectional study including all the physical therapists working in adult Intensive Care Units in three public hospitals in Fortaleza-CE. A questionnaire with closed questions related to difficult mechanical ventilation weaning was applied, with either one or multiple answers. The data was treated with descriptive and non-parametric analysis. Results: Among the parameters mostly used by the 56 interviewed physical therapists for the difficult weaning, were found: current volume reduction (26 - 46.4% and desaturation during aspiration (17 - 30.4%. It was observed that 38 (67.9% alternate T-tube and continuous positive airway pressure (CPAP as strategies for difficult weaning, and 28 (50% reported reducing the pressure support. There was no statistical difference between the strategies used in the studied hospitals, neither correlation between strategies and parameters. Conclusion: It was found that physical therapists have been performing similar strategies, which are also shown in the literature, but this is not the case with the parameters. The parameters used are not supported by the literature.

  3. Problems in psychiatric care of 'difficult patients': a Delphi-study

    NARCIS (Netherlands)

    Koekkoek, Bauke; van Meijel, Berno; Schene, Aart; Hutschemaekers, Giel

    2009-01-01

    'difficult patients' may evoke strong feelings in health professionals. The ambivalent attitude of, especially, non-psychotic chronic patients towards psychiatric care may be frustrating and burdensome to professionals. Many of these patients are cared for in non-specialized services, where

  4. Problems in psychiatric care of 'difficult patients': a Delphi-study

    NARCIS (Netherlands)

    Koekkoek, B.W.; Meijel, B.K.G. van; Schene, A.H.; Hutschemaekers, G.J.M.

    2009-01-01

    Aims - 'difficult patients' may evoke strong feelings in health professionals. The ambivalent attitude of, especially, non-psychotic chronic patients towards psychiatric care may be frustrating and burdensome to professionals. Many of these patients are cared for in non-specialized services, where

  5. Regional anesthesia in difficult airway: The quest for a solution continues.

    Science.gov (United States)

    Khetarpal, Ranjana; Chatrath, Veena; Dhawan, Akshay; Attri, Joginder Pal

    2016-01-01

    Difficult airway, a scenario with potentially life threatening outcome, is routinely encountered by an anesthesiologist leaving him with the dilemma of whether to use regional anesthesia (RA) or general anesthesia. Our study aims to look into this problem. The literature search was performed in the Google, PubMed, and Medscape using key words "regional anesthesia, difficult airway, pregnancy, ventilation, intubation, epidural anesthesia, nerve blocks." More than 38 free full articles and books published from the year 1987 to 2014 were retrieved and studied. At first sight, RA may appear to offer an ideal solution as it helps to avoid the problem of difficult airway. However, the possibility of a total spinal block, failed or incomplete RA, local anesthetic toxicity or unforeseen surgical complication may make it imperative that the airway is secured. The correct decision can only be made by the anesthetist when all the relevant clinical information is taken into account. It is also important to ensure that before considering RA in a patient of difficult airway, an anesthesiologist must have a preformulated strategy for intubation.

  6. How to Handle Difficult Parents: Proven Solutions for Teachers. Second Edition

    Science.gov (United States)

    Tingley, Suzanne Capek

    2012-01-01

    "How to Handle Difficult Parents" is a funny, but practical, guide to working effectively with parents and avoiding unnecessary conflict. Whether you're a teacher (regular or special education) or a coach, this book will give you practical suggestions regarding what to say and how to say it to parents who question your lesson plans, challenge your…

  7. Prehospital prognosis is difficult in patients with acute exacerbation of chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Lindvig, Katrine P.; Brøchner, Anne C.; Lassen, Annmarie T.

    2017-01-01

    in the form of intubation. The emergency physician faces difficult treatment decisions, however, and prognostic tools that could assist in determining which patients would benefit from intubation and ventilator support would be helpful. The aim of the current study was to identify prehospital clinical...

  8. Which Aspects of the English Language Do Distance Learners Find Difficult?

    Science.gov (United States)

    Teoh, George Boon Sai; Lin, Agnes Liau Wei; Belaja, Kathy

    2016-01-01

    This study reports the findings of a research carried out on distance learners at the School of Distance Education (SDE), University Sains Malaysia (USM). The study was explorative in nature with the purpose identifying the aspects of the English language which distance learners found difficult to learn. A quantitative survey questionnaire design…

  9. Long-Term Memory for Pictures under Conditions of Difficult Foil Discriminability.

    Science.gov (United States)

    Homa, Donald; Viera, Cynthia

    Research has demonstrated that subjects are sensitive to both thematic and non-thematic information in pictorial stimuli. Three experiments were conducted to investigate memory for pictures under conditions of difficult foil discriminability and lengthy retention intervals. The foils differed from the studied persons in the number and quality of…

  10. Difficult management of posterior urethra gunshot wound combined with urethro-rectal fistula

    Directory of Open Access Journals (Sweden)

    Walid Kerkeni

    2015-06-01

    Full Text Available Posterior urethra gunshot wounds are poorly described in the literature. They are often associated with pelvic vital lesions making difficult early repair of urethral injuries. They can be complicated by urethro-rectal fistula, which makes their management more complicated. We report a new case of posterior urethra disruption due to a gunshot wound and complicated by urethro-rectal fistula.

  11. Difficult management of posterior urethra gunshot wound combined with urethro-rectal fistula

    OpenAIRE

    Walid Kerkeni; Ahmed Saadi; Mohamed Hédi Rebai; Abderrazak Bouzouita; Mohamed Cherif; Amine Derouiche; Tahar Khalfallah; Mohamed Riadh Ben Slama; Mohamed Chebil

    2015-01-01

    Posterior urethra gunshot wounds are poorly described in the literature. They are often associated with pelvic vital lesions making difficult early repair of urethral injuries. They can be complicated by urethro-rectal fistula, which makes their management more complicated. We report a new case of posterior urethra disruption due to a gunshot wound and complicated by urethro-rectal fistula.

  12. Environmental risk evaluation of difficult substances in USES 2.0

    NARCIS (Netherlands)

    Beelen P van; ECO

    1998-01-01

    An inventory is given of the problems which arise when difficult substances are evaluated with the Uniform System for the Evaluation of Substances (USES). It gives an indication about the different classes of chemicals which can give problems in USES. Further, it describes the problems which occur

  13. Has it become more difficult for young households in rental housing to become homeowners?

    DEFF Research Database (Denmark)

    Skak, Morten; Bloze, Gintautas

    2013-01-01

    by increased income inequality. In this paper we present calculations of the number of month it takes for an average young wage earner family that is presently in a tenant position to save 10 per cent of the average dwelling value. Our calculations show that it has become more difficult for young families...

  14. Difficult Dialogues, Rewarding Solutions: Strategies to Expand Postsecondary Opportunities While Controlling Costs

    Science.gov (United States)

    Immerwahr, John

    2009-01-01

    This report from Public Agenda is a summary of the process and outcomes of the "Difficult Dialogues" that took place in November 2008 at the 4th annual policy summit of the Midwestern Higher Education Compact (MHEC). Nearly 200 state legislators, institutional and system-level leaders and governing board members, faculty, executive…

  15. A New CT-Guided Modified Trocar Technique for Drainage of Difficult Locations Abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Tyng, Chiang J., E-mail: chiangjengtyng@gmail.com; Amoedo, Maurício K.; Bohrer, Yves; Bitencourt, Almir G. V.; Barbosa, Paula N. V.; Almeida, Maria Fernanda A.; Zurstrassen, Charles E. [AC Camargo Cancer Center, Department of Imaging (Brazil); Coimbra, Felipe J. F.; Costa, Wilson L. da [AC Camargo Cancer Center, Department of Abdominal Surgery (Brazil); Chojniak, Rubens [AC Camargo Cancer Center, Department of Imaging (Brazil)

    2017-05-15

    PurposeComputed tomography (CT) is commonly used to guide drainage of deep-seated abdominal fluid collections. However, in some cases, these collections seem to be inaccessible due to surrounding organs or their being in difficult locations. The aim of this study is to describe a modified Trocar technique to drain collections in difficult locations, especially those in the subphrenic space, without passing through intervening organs.Materials and MethodsThis retrospective case series study describes seven inpatients who underwent CT-guided drainage using a modified Trocar technique for abscesses that are difficult to access percutaneously. All patients provided written informed consent prior to the procedure. After placement of a 12–14F catheter inside the peritoneum, the Trocar stylet was removed so that the tip of the catheter became blunt and flexible to avoid injury to organs and structures in the catheter route, and the catheter was slowly advanced towards the collection using CT guidance and tactile sensation. After reaching the target, the stylet was reintroduced to enter the abscess wall.ResultsAll procedures were performed using an anterior abdominal wall access with adequate catheter positioning and resulted in clinical status improvement in the days after the drainage. No complications related to the procedure were identified in any of the patients.ConclusionsThe modified Trocar technique for percutaneous CT-guided drainage of abdominal abscesses may be feasible for lesions that are difficult to access with conventional methods.

  16. Intraabdominal actinomycosis resulting in a difficult to diagnose intraperitoneal mass: A case report.

    Science.gov (United States)

    Tsujimura, Naoto; Takemoto, Hiroyoshi; Nakahara, Yujiro; Wakasugi, Masaki; Matsumoto, Takashi; Nishioka, Kiyonori; Takachi, Kou; Oshima, Satoshi; Yoshida, Kyotaro

    2018-01-01

    Actinomycosis is a chronic suppurative granulomatous disease caused by Actinomyces israelii. Preoperative confirmed diagnosis is very difficult, so most cases are diagnosed preoperatively as malignant tumors. We report a case of intraabdominal actinomycosis which was difficult to diagnose preoperatively. A woman, 60 years old, experienced discomfort in her lower right abdomen. She complained of nausea and anorexia and visited our hospital. Laboratory blood tests, abdominal CT, and abdominal MRI led to a diagnosis of a uterine sarcoma or primary intestinal mass, and she underwent surgery. Her histopathological diagnosis was intraabdominal actinomycosis. Actinomycosis is a chronic purulent granulomatous inflammation caused by Actinomyces israelii. No clinical symptoms or laboratory findings are characteristic of abdominal actinomycosis, so this disorder is very difficult to diagnose preoperatively. Therefore, many cases are diagnosed as malignant tumors and undergo surgery. After surgery, long-term antibiotic treatment (penicillin) is usually administered. We reported a case of intraabdominal actinomycosis that resulted in a difficult to diagnose intraperitoneal mass. When a large intraperitoneal mass is found, actinomycosis needs to be included as one of differential diagnoses. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Information-Limited Parallel Processing in Difficult Heterogeneous Covert Visual Search

    Science.gov (United States)

    Dosher, Barbara Anne; Han, Songmei; Lu, Zhong-Lin

    2010-01-01

    Difficult visual search is often attributed to time-limited serial attention operations, although neural computations in the early visual system are parallel. Using probabilistic search models (Dosher, Han, & Lu, 2004) and a full time-course analysis of the dynamics of covert visual search, we distinguish unlimited capacity parallel versus serial…

  18. "Everything Is about Balance": Graduate Education Faculty and the Navigation of Difficult Discourses on Race

    Science.gov (United States)

    Murray-Johnson, Kayon; Ross-Gordon, Jovita M.

    2018-01-01

    The purpose of this multiple case study was to describe the experiences of graduate education faculty of varying racial/ethnic backgrounds, learning to navigate difficult discourses on race effectively over time. The study employed positionality as a theoretical framework. Findings indicate that faculty balance what we refer to as "strategies…

  19. The Difficult Patron in the Academic Library: Problem Issues or Problem Patrons?

    Science.gov (United States)

    Simmonds Patience L.; Ingold, Jane L.

    2002-01-01

    Identifies difficult patron issues in academic libraries from the librarians' perspectives and offers solutions to try and prevent them from becoming problems. Topics include labeling academic library users; eliminating sources of conflict between faculty and library staff; and conflicts between students and library staff. (Author/LRW)

  20. Difficult airways: a reliable “Plan B” | Bishop | Southern African ...

    African Journals Online (AJOL)

    Percutaneous transtracheal jet ventilation (PTJV) is an accepted method of rescue ventilation following unsuccessful attempts to secure the airway through conventional methods. Pre-emptive use of PTJV in the difficult airway has also been described as using either a specifically designed jet ventilation catheter, or other ...

  1. Making Difficult History Public: The Pedagogy of Remembering and Forgetting in Two Washington DC Museums

    Science.gov (United States)

    Segall, Avner

    2014-01-01

    In this article, Avner Segall explores some pedagogical processes in the context of two museums in Washington, DC, that focus on difficult knowledge, the National Museum of the American Indian (NMAI) and the United States Holocaust Memorial Museum. In doing so, Segall's aim is not to explore the museums as a whole or provide a comprehensive…

  2. Successful difficult airway management of a child with Coffin-siris syndrome.

    Science.gov (United States)

    Ozkan, Ahmet Selim; Akbas, Sedat; Yalin, Mehmet Ridvan; Ozdemir, Emine; Koylu, Zeynep

    2017-08-01

    Management of airway in patients who have Coffin-Siris syndrome (CSS) is often problematic because most of these patients have difficult airway. NTI via C-MAC VL is an useful alternative to direct laryngoscope for orotracheal intubation in airway and anesthetic management in a case of CSS. Alternative airway devices should be readily available.

  3. Successful difficult airway management of a child with Coffin?siris syndrome

    OpenAIRE

    Ozkan, Ahmet Selim; Akbas, Sedat; Yalin, Mehmet Ridvan; Ozdemir, Emine; Koylu, Zeynep

    2017-01-01

    Key Clinical Message Management of airway in patients who have Coffin?Siris syndrome (CSS) is often problematic because most of these patients have difficult airway. NTI via C?MAC VL is an useful alternative to direct laryngoscope for orotracheal intubation in airway and anesthetic management in a case of CSS. Alternative airway devices should be readily available.

  4. Vulnerability as a Key Concept in Museum Pedagogy on Difficult Matters

    Science.gov (United States)

    Tinning, Katrine

    2018-01-01

    In recent years there has been an increasing interest in museum studies in exhibitions on what is termed Difficult Matters (Silvén and Björklund 2006)--such as rape and mass murder--and how such exhibitions may evoke ethical change. This raises the question about the conditions on which such exhibitions can lead to an ethical change. By developing…

  5. Assessment of risk factors responsible for difficult weaning from mechanical ventilation in adults

    Directory of Open Access Journals (Sweden)

    Yehia Khalil

    2012-07-01

    Conclusion: All potential causes of ventilator dependency should be identified when a patient is difficult-to-wean. Then, a plan should be developed that uses a multidisciplinary team approach to correct the reversible causes of weaning failure and facilitates weaning thereafter.

  6. Comparison of different tests to determine difficult intubation in pediatric patients

    Directory of Open Access Journals (Sweden)

    Mehmet Turan Inal

    2014-12-01

    Full Text Available Background: The difficulties with airway management is the main reason for pediatric anesthesia-related morbidity and mortality. Objective: To assess the value of modified Mallampati test, Upper-Lip-Bite test, thyromental distance and the ratio of height to thyromental distance to predict difficult intubation in pediatric patients. Design: Prospective analysis. Measurements and results: Data were collected from 5 to 11 years old 250 pediatric patients requiring tracheal intubation. The Cormack and Lehane classification was used to evaluate difficult laryngoscopy. Sensitivity, specificity, positive predictive value and AUC values for each test were measured. Results: The sensitivity and specificity of modified Mallampati test were 76.92% and 95.54%, while those for ULBT were 69.23% and 97.32%. The optimal cutoff point for the ratio of height to thyromental distance and thyromental distance for predicting difficult laryngoscopy was 23.5 (sensitivity, 57.69%; specificity, 86.61% and 5.5 cm (sensitivity, 61.54%; specificity, 99.11%. The modified Mallampati was the most sensitive of the tests. The ratio of height to thyromental distance was the least sensitive test. Conclusion: These results suggested that the modified Mallampati and Upper-Lip-Bite tests may be useful in pediatric patients for predicting difficult intubation.

  7. Do Early Difficult Temperament and Harsh Parenting Differentially Predict Reactive and Proactive Aggression?

    Science.gov (United States)

    Vitaro, Frank; Barker, Edward Dylan; Boivin, Michel; Brendgen, Mara; Tremblay, Richard E.

    2006-01-01

    The goal of this study was to examine the links between difficult temperament (i.e., negative emotionality) and harsh parental discipline during toddlerhood, and reactive and proactive aggression in kindergarten. These links were assessed on a longitudinal population-based study of 1516 boys and girls followed longitudinally from the age of 17…

  8. Why Do Disadvantaged Filipino Children Find Word Problems in English Difficult?

    Science.gov (United States)

    Bautista, Debbie; Mulligan, Joanne

    2010-01-01

    Young Filipino students are expected to solve mathematical word problems in English, a language that many encounter only in schools. Using individual interviews of 17 Filipino children, we investigated why word problems in English are difficult and the extent to which the language interferes with performance. Results indicate that children could…

  9. "Chalepa Ta Kala," "Fine Things Are Difficult": Socrates' Insights into the Psychology of Teaching and Learning

    Science.gov (United States)

    Mintz, Avi I.

    2010-01-01

    The proverb "chalepa ta kala" ("fine things are difficult") is invoked in three dialogues in the Platonic corpus: "Hippias Major," "Cratylus" and "Republic." In this paper, I argue that the context in which the proverb arises reveals Socrates' considerable pedagogical dexterity as he uses the proverb to rebuke his interlocutor in one dialogue but…

  10. Cutting Costs, Keeping Quality: Financing Strategies for Youth-Serving Organizations in a Difficult Economy

    Science.gov (United States)

    Keller, Eric

    2010-01-01

    This research brief highlights three effective financing strategies that successful youth-serving organizations are using to maintain quality services despite difficult economic times. The brief provides examples of how organizations have implemented these strategies and offers tips to help leaders consider how best to adapt these strategies to…

  11. Difficult airway management of children in ambulatory anesthesia: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Huang AS

    2016-11-01

    Full Text Available Andrea S Huang,1 Lindsey Rutland,2 John Hajduk,1 Narasimhan Jagannathan1,2 1Department of Pediatric Anesthesia, Ann and Robert H. Lurie Children’s Hospital of Chicago, 2Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Abstract: As the field of pediatric ambulatory anesthesia expands, anesthesiologists can anticipate encountering an increasing number of patients with expected and unexpected difficult airways. This unique setting and patient population both present challenges in making a decision whether and how to safely proceed in the case of a child with a difficult airway. A host of patient, provider, procedure, and facility-specific factors should be considered. Providers should understand the differences between the pediatric and adult airway, recognize common features and syndromes associated with difficult airways, and be comfortable with different airway equipment and techniques available in the ambulatory setting. Early anticipation, a comprehensive patient assessment, and a clear decision-making algorithm with multiple airway management plans are all critical in safely and effectively managing these patients. These issues and recommendations will be discussed in this comprehensive narrative review. Keywords: difficult airway, pediatrics, ambulatory surgery, airway devices, children

  12. Combination therapy versus monotherapy for gastroesophageal reflux in children with difficult-to-treat bronchial asthma

    Directory of Open Access Journals (Sweden)

    Adel Salah Bediwy

    2014-01-01

    Conclusions: Combination of domperidone and esomeprazole was more effective in improving the endoscopic reflux score, childhood-asthma control test (C-ACT and FEV1 (% of predicted and significantly reduced the sputum SP than the use of esomeprazole only in children with difficult-to-treat asthma.

  13. Martin Award Paper: Development of Interactive Virtual Laboratories to Help Students Learn Difficult Concepts in Thermodynamics

    Science.gov (United States)

    Bowen, Alec S.; Reid, Daniel R.; Koretsky, Milo D.

    2015-01-01

    In this project, we explore the use of threshold concept theory as a design basis for development of Interactive Virtual Laboratories in thermodynamics. Thermodynamics is a difficult subject for chemical and biological engineering students to master. One reason for the difficulty is the diverse and challenging set of threshold concepts that they…

  14. The effect of herbal formula PROVE 1 and Stevia levels in diets on diet utilization of growing pigs

    Directory of Open Access Journals (Sweden)

    Kooprasert, S.

    2007-05-01

    Full Text Available The objective of this experiment was to study the effect of 0.2% antibiotic (ascomix-s®, one kilogram of which contains lincomycin hydrochloride 44 g and sulfamethazine 110 g or 0.25% herbal formulaPROVE 1, combined with five levels of Stevia supplementation in the diets on digestibility of pigs. Two factors; 1 type of drug (0.2% antibiotic and 0.25% herbal formula PROVE 1 and 2 five Stevia levels (0,0.2, 0.4, 0.6 and 0.8% were investigated and 10 dietary treatments were used in this study. Ten related growing crossbred (Large White x Landrace barrow pigs (30±1.5 kg body weight were raised in individualmetabolism cages for three collecting periods (30, 40 and 50 kg body weight, each pig was fed one experimental diet throughout the collecting period.The results showed that pigs fed diet with either 0.2% antibiotic or 0.25% herbal formula PROVE 1 had similar digestibility of diet, crude protein (CP, fiber, ash and nitrogen free extract (NFE (89.01 vs 87.83,94.96 vs 94.23, 60.73 vs 59.03, 61.22 vs 60.44 and 93.28 vs 92.03%, respectively. Negligible differences were observed between 0 and 0.4% Stevia supplementation in diet, but levels showed better digestibility than the other levels of Stevia supplementation, and the diet with 0.4% Stevia supplementation had the highestdigestibility of diet, CP, fiber, ash and NFE (91.04, 96.43, 69.48, 70.47 and 94.07%, respectively. The diet with antibiotic combined with 0.4% Stevia had digestibility of diet, CP, fat and fiber better than the otherlevels of Stevia supplementation, especially digestibility of ash, which was significantly higher than that of diet with 0.2% Stevia, but not significantly different from the other levels of Stevia supplementation. A partof herbal formula PROVE1 combined with 0% Stevia had the highest digestibility of ash (72.90%, significantly higher than the other levels of Stevia supplementation, except the diet with herbal formula PROVE 1combined with 0.4% Stevia supplementation

  15. Cause and Properties of the Extreme Space Weather Event of 2012 July 23

    Science.gov (United States)

    Liu, Y. D.; Luhmann, J. G.; Kajdic, P.; Kilpua, E.; Lugaz, N.; Nitta, N.; Lavraud, B.; Bale, S. D.; Farrugia, C. J.; Galvin, A. B.

    2013-12-01

    Extreme space weather refers to extreme conditions in space driven by solar eruptions and subsequent disturbances in interplanetary space, or otherwise called solar superstorms. Understanding extreme space weather events is becoming ever more vital, as the vulnerability of our society and its technological infrastructure to space weather has increased dramatically. Instances of extreme space weather, however, are very rare by definition and therefore are difficult to study. Here we report and investigate an extreme event, which occurred on 2012 July 23 with a maximum speed of about 3050 km/s near the Sun. This event, with complete modern remote sensing and in situ observations from multiple vantage points, provides an unprecedented opportunity to study the cause and consequences of extreme space weather. It produced a superfast shock with a peak solar wind speed of 2246 km/s and a superstrong magnetic cloud with a peak magnetic field of 109 nT observed near 1 AU at STEREO A. The record solar wind speed and magnetic field would produce a record geomagnetic storm since the space era with a minimum Dst of -1200 - -600 nT, if this event hit the Earth. We demonstrate how successive coronal mass ejections (CMEs) can be enhanced into a solar superstorm as they interact en route from the Sun to 1 AU. These results not only provide a benchmark for studies of extreme space weather, but also present a new view of how an extreme space weather event can be generated from usual solar eruptions.

  16. Outcomes for Extremely Premature Infants

    Science.gov (United States)

    Glass, Hannah C.; Costarino, Andrew T.; Stayer, Stephen A.; Brett, Claire; Cladis, Franklyn; Davis, Peter J.

    2015-01-01

    Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for four years and is now approximately 11.5%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23–24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal EDC. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (ELBW) (CPAP, mechanical ventilation, and exogenous surfactant increased survival and spurred the development of neonatal intensive care in the 1970s through the early 1990s. Routine administration of antenatal steroids during premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91–95% (compared to 85–89%) avoids excess mortality. However, final analyses of data from these trials have not been published, so definitive recommendations are still pending The development of neonatal neurocognitive care visits may improve neurocognitive outcomes in this high-risk group. Long-term follow up to detect and address developmental, learning, behavioral, and social problems is critical for children born at these early gestational ages. The striking similarities in response to extreme prematurity in the lung and brain imply that agents and

  17. Gravity and Extreme Magnetism SMEX

    Science.gov (United States)

    2012-01-01

    The Gravity and Extreme Magnetism SMEX mission will be the first mission to catalogue the X-ray polarisation of many astrophysical objects including black-holes and pulsars. This first of its kind mission is enabled by the novel use of a time projection chamber as an X-ray polarimeter. The detector has been developed over the last 5 years, with the current effort charged toward a demonstration of it's technical readiness to be at level 6 prior to the preliminary design review. This talk will describe the design GEMS polarimeter and the results to date from the engineering test unit.

  18. Climate change & extreme weather vulnerability assessment framework.

    Science.gov (United States)

    2012-12-01

    The Federal Highway Administrations (FHWAs) Climate Change and Extreme Weather Vulnerability : Assessment Framework is a guide for transportation agencies interested in assessing their vulnerability : to climate change and extreme weather event...

  19. Frequently Asked Questions (FAQ) about Extreme Heat

    Science.gov (United States)

    ... Extreme Heat Older Adults (Aged 65+) Infants and Children Chronic Medical Conditions Low Income Athletes Outdoor Workers Pets Hot Weather Tips Warning Signs and Symptoms FAQs Social Media How to Stay Cool Missouri Cooling Centers Extreme ...

  20. Extreme Maximum Land Surface Temperatures.

    Science.gov (United States)

    Garratt, J. R.

    1992-09-01

    There are numerous reports in the literature of observations of land surface temperatures. Some of these, almost all made in situ, reveal maximum values in the 50°-70°C range, with a few, made in desert regions, near 80°C. Consideration of a simplified form of the surface energy balance equation, utilizing likely upper values of absorbed shortwave flux (1000 W m2) and screen air temperature (55°C), that surface temperatures in the vicinity of 90°-100°C may occur for dry, darkish soils of low thermal conductivity (0.1-0.2 W m1 K1). Numerical simulations confirm this and suggest that temperature gradients in the first few centimeters of soil may reach 0.5°-1°C mm1 under these extreme conditions. The study bears upon the intrinsic interest of identifying extreme maximum temperatures and yields interesting information regarding the comfort zone of animals (including man).

  1. Difficult cannulation as defined by a prospective study of the Scandinavian Association for Digestive Endoscopy (SADE) in 907 ERCPs

    DEFF Research Database (Denmark)

    Halttunen, Jorma; Meisner, Søren; Aabakken, Lars

    2014-01-01

    BACKGROUND: The definition of a "difficult" cannulation varies considerably in reports of endoscopic retrograde cholangiopancreatography (ERCP). AIMS: To define a difficult cannulation, which translates into higher risk of post-ERCP pancreatitis. PATIENTS AND METHODS: Prospective consecutive reco...

  2. Exascale Co-design for Modeling Materials in Extreme Environments

    Energy Technology Data Exchange (ETDEWEB)

    Germann, Timothy C. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2014-07-08

    Computational materials science has provided great insight into the response of materials under extreme conditions that are difficult to probe experimentally. For example, shock-induced plasticity and phase transformation processes in single-crystal and nanocrystalline metals have been widely studied via large-scale molecular dynamics simulations, and many of these predictions are beginning to be tested at advanced 4th generation light sources such as the Advanced Photon Source (APS) and Linac Coherent Light Source (LCLS). I will describe our simulation predictions and their recent verification at LCLS, outstanding challenges in modeling the response of materials to extreme mechanical and radiation environments, and our efforts to tackle these as part of the multi-institutional, multi-disciplinary Exascale Co-design Center for Materials in Extreme Environments (ExMatEx). ExMatEx has initiated an early and deep collaboration between domain (computational materials) scientists, applied mathematicians, computer scientists, and hardware architects, in order to establish the relationships between algorithms, software stacks, and architectures needed to enable exascale-ready materials science application codes within the next decade. We anticipate that we will be able to exploit hierarchical, heterogeneous architectures to achieve more realistic large-scale simulations with adaptive physics refinement, and are using tractable application scale-bridging proxy application testbeds to assess new approaches and requirements. Such current scale-bridging strategies accumulate (or recompute) a distributed response database from fine-scale calculations, in a top-down rather than bottom-up multiscale approach.

  3. Observed increase in extreme daily rainfall in the French Mediterranean

    Science.gov (United States)

    Ribes, Aurélien; Thao, Soulivanh; Vautard, Robert; Dubuisson, Brigitte; Somot, Samuel; Colin, Jeanne; Planton, Serge; Soubeyroux, Jean-Michel

    2018-04-01

    We examine long-term trends in the historical record of extreme precipitation events occurring over the French Mediterranean area. Extreme events are considered in terms of their intensity, frequency, extent and precipitated volume. Changes in intensity are analysed via an original statistical approach where the annual maximum rainfall amounts observed at each measurement station are aggregated into a univariate time-series according to their dependence. The mean intensity increase is significant and estimated at + 22% (+ 7 to + 39% at the 90% confidence level) over the 1961-2015 period. Given the observed warming over the considered area, this increase is consistent with a rate of about one to three times that implied by the Clausius-Clapeyron relationship. Changes in frequency and other spatial features are investigated through a Generalised Linear Model. Changes in frequency for events exceeding high thresholds (about 200 mm in 1 day) are found to be significant, typically near a doubling of the frequency, but with large uncertainties in this change ratio. The area affected by severe events and the water volume precipitated during those events also exhibit significant trends, with an increase by a factor of about 4 for a 200 mm threshold, again with large uncertainties. All diagnoses consistently point toward an intensification of the most extreme events over the last decades. We argue that it is difficult to explain the diagnosed trends without invoking the human influence on climate.

  4. An overview on extremity dosimetry in medical applications

    International Nuclear Information System (INIS)

    Vanhavere, F.; Carinou, E.; Donadille, L.; Ginjaume, M.; Jankowski, J.; Rimpler, A.; Sans Merce, M.

    2008-01-01

    Some activities of EURADOS Working Group 9 (WG9) are presently funded by the European Commission (CONRAD project). The objective of WG9 is to promote and co-ordinate research activities for the assessment of occupational exposures to staff at workplaces in interventional radiology (IR) and nuclear medicine. For some of these applications, the skin of the fingers is the limiting organ for individual monitoring of external radiation. Therefore, sub-group 1 of WG9 deals with the use of extremity dosemeters in medical radiation fields. The wide variety of radiation field characteristics present in a medical environment together with the difficulties in measuring a local dose that is representative for the maximum skin dose, usually with one single detector, makes it difficult to perform accurate extremity dosimetry. Sub-group 1 worked out a thorough literature review on extremity dosimetry issues in diagnostic and therapeutic nuclear medicine and positron emission tomography, interventional radiology and interventional cardiology and brachytherapy. Some studies showed that the annual dose limits could be exceeded if the required protection measures are not taken, especially in nuclear medicine. The continuous progress in new applications and techniques requires an important effort in radiation protection and training. (authors)

  5. Can Concentration - Discharge Relationships Diagnose Material Source During Extreme Events?

    Science.gov (United States)

    Karwan, D. L.; Godsey, S.; Rose, L.

    2017-12-01

    Floods can carry >90% of the basin material exported in a given year as well as alter flow pathways and material sources. In turn, sediment and solute fluxes can increase flood damages and negatively impact water quality and integrate physical and chemical weathering of landscapes and channels. Concentration-discharge (C-Q) relationships are used to both describe export patterns as well as compute them. Metrics for describing C-Q patterns and inferring their controls are vulnerable to infrequent sampling that affects how C-Q relationships are interpolated and interpreted. C-Q relationships are typically evaluated from multiple samples, but because hydrological extremes are rare, data are often unavailable for extreme events. Because solute and sediment C-Q relationships likely respond to changes in hydrologic extremes in different ways, there is a pressing need to define their behavior under extreme conditions, including how to properly sample to capture these patterns. In the absence of such knowledge, improving load estimates in extreme floods will likely remain difficult. Here we explore the use of C-Q relationships to determine when an event alters a watershed system such that it enters a new material source/transport regime. We focus on watersheds with sediment and discharge time series include low-frequency and/or extreme events. For example, we compare solute and sediment patterns in White Clay Creek in southeastern Pennsylvania across a range of flows inclusive of multiple hurricanes for which we have ample ancillary hydrochemical data. TSS is consistently mobilized during high flow events, even during extreme floods associated with hurricanes, and sediment fingerprinting indicates different sediment sources, including in-channel remobilization and landscape erosion, are active at different times. In other words, TSS mobilization in C-Q space is not sensitive to the source of material being mobilized. Unlike sediments, weathering solutes in this watershed

  6. Non-linear quenching of current fluctuations in a self-exciting homopolar dynamo, proved by feedback system theory

    Directory of Open Access Journals (Sweden)

    A. M. de Paor

    1998-01-01

    Full Text Available Hide (Nonlinear Processes in Geophysics, 1998 has produced a new mathematical model of a self-exciting homopolar dynamo driving a series- wound motor, as a continuing contribution to the theory of the geomagnetic field. By a process of exact perturbation analysis, followed by combination and partial solution of differential equations, the complete nonlinear quenching of current fluctuations reported by Hide in the case that a parameter ε has the value 1 is proved via the Popov theorem from feedback system stability theory.

  7. Comparison on the Analysis on PM10 Data based on Average and Extreme Series

    Directory of Open Access Journals (Sweden)

    Mohd Amin Nor Azrita

    2018-01-01

    Full Text Available The main concern in environmental issue is on extreme phenomena (catastrophic instead of common events. However, most statistical approaches are concerned primarily with the centre of a distribution or on the average value rather than the tail of the distribution which contains the extreme observations. The concept of extreme value theory affords attention to the tails of distribution where standard models are proved unreliable to analyse extreme series. High level of particulate matter (PM10 is a common environmental problem which causes various impacts to human health and material damages. If the main concern is on extreme events, then extreme value analysis provides the best result with significant evidence. The monthly average and monthly maxima PM10 data for Perlis from 2003 to 2014 were analysed. Forecasting for average data is made by Holt-Winters method while return level determine the predicted value of extreme events that occur on average once in a certain period. The forecasting from January 2015 to December 2016 for average data found that the highest forecasted value is 58.18 (standard deviation 18.45 on February 2016 while return level achieved 253.76 units for 24 months (2015-2016 return periods.

  8. [Algorithm for securing an unexpected difficult airway : User analysis on a simulator].

    Science.gov (United States)

    Ott, T; Truschinski, K; Kriege, M; Naß, M; Herrmann, S; Ott, V; Sellin, S

    2018-01-01

    Critical incidents in difficult airway management are still a main contributory factor for perioperative morbidity and mortality. Many national associations have developed algorithms for management of these time critical events. For implementation of these algorithms the provision of technical requirements and procedure-related training are essential. Severe airway incidents are rare events and clinical experience of the individual operators is limited; therefore, simulation is an adequate instrument for training and evaluating difficult airway algorithms. The aim of this observational study was to evaluate the application of the institutional difficult airway algorithm among anesthetists. After ethics committee approval, anesthetists were observed while treating a "cannot intubate" (CI) and a "cannot intubate, cannot ventilate" (CICV) situation in the institutional simulation center. As leader of a supportive team the participants had to deal with an unexpected difficult airway after induction of anesthesia in a patient simulator. The following data were recorded: sequence of the applied airway instruments, time to ventilation after establishing a secured airway using any instrument in the CI situation and time to ventilation via cricothyrotomy in the CICV situation. Conformity to the algorithm was defined by the sequence of the applied instruments. Analysis comprised conformity to the algorithm, non-parametric tests for time to ventilation and differences between junior and senior anesthetists. Out of 50 participants 45 were analyzed in the CI situation. In this situation 93% of the participants acted in conformity with the algorithm. In 62% the airway was secured by flexible intubation endoscopy, in 38% with another device. Data from 46 participants were analyzed in the CICV situation. In this situation 91% acted in conformity with the algorithm. The last device used prior to the decision for cricothyrotomy was flexible intubation endoscopy in 39%, a

  9. Anaesthetic management in a case of large plunging ranula with difficult airway: A case report

    Directory of Open Access Journals (Sweden)

    Surendra Kumar Sethi

    2017-04-01

    Full Text Available Plunging ranula is a mucous retention cyst found on the floor of mouth which arises from the submandibular and sublingual salivary glands extending to lateral aspect of neck, which may often cause potential airway obstruction leading to difficulty in airway management. A forty year old female patient was admitted to our hospital with large, painless swelling in the floor of mouth extending to the lateral part of body of mandible and neck. This intraoral swelling distorted the normal airway anatomy thus making airway management difficult as the patient was planned for excision of swelling under general anaesthesia. So we present a case of successful management of a difficult airway by using awake fibre optic intubation in a patient posted for excision of a large plunging ranula under general anaesthesia.

  10. Infrared Red Intubation System (IRRIS) guided flexile videoscope assisted difficult airway management

    DEFF Research Database (Denmark)

    Kristensen, M S; Fried, E; Biro, P

    2018-01-01

    BACKGROUND: Tracheal intubation with a flexible scope is a cornerstone technique in patients with severely difficult airways, but may fail. We report on a technique, Infrared Red Intubation System (IRRIS), that seems to facilitate the identification of the glottis. METHODS: The IRRIS is placed over...... the patient's cricothyroid membrane and emits blinking infrared light through the patient's skin into the subglottic space. When a flexible videoscope (one that does not filter infrared light) is introduced into the airway, it will display this as a blinking white light emerging from the glottis, retrograde...... transillumination, showing the pathway to the trachea. We have introduced this as an adjunct when managing our patients with difficult airways. We describe the technique and retrospectively report on the first ten patients where it was used. RESULTS: All ten patients had significant pathology in the airway...

  11. An anatomy of countertransference: staff reactions to difficult psychiatric hospital patients.

    Science.gov (United States)

    Colson, D B; Allen, J G; Coyne, L; Dexter, N; Jehl, N; Mayer, C A; Spohn, H

    1986-09-01

    Countertransference among hospital staff was investigated as part of ongoing research on difficult-to-treat psychiatric hospital patients. Staff's ratings of their emotional reactions to 127 patients on long-term units were analyzed by factor analysis, and the resulting factors were correlated by discipline with patient problem behaviors. Among the conclusions were that different forms of psychopathology elicit characteristic patterns of emotional reaction from staff; that some dimensions of psychopathology, particularly suicidal-depressed behavior and violence-agitation, elicit different emotional reactions among different disciplines, thus laying the groundwork for division among staff; and that the more difficult the process of hospital treatment, the more likely staff will experience a variety of emotions.

  12. The Positive Effect of Resilience on Stress and Business Outcomes in Difficult Work Environments.

    Science.gov (United States)

    Shatté, Andrew; Perlman, Adam; Smith, Brad; Lynch, Wendy D

    2017-02-01

    To examine whether resilience has a protective effect in difficult work environments. A survey of 2063 individuals measured individual resilience, stress, burnout, sleep problems, likelihood of depression, job satisfaction, intent to quit, absences, and productivity. It also measured work characteristics: job demands, job influence, and social support. Multivariate and logistic regression models examined the main effects and interactions of resilience and job characteristics. High strain work environments (high demand, low influence, and low support) have an unfavorable effect on all outcomes. Resilience has a protective effect on all outcomes. For stress, burnout, and sleep, higher resilience has a more protective effect under low-strain conditions. For depression, absence and productivity, resilience has a more protective effect when job strain is high. Workers with high resilience have better outcomes in difficult work environments.

  13. Methods to ease the release of thin polydimethylsiloxane films from difficult substrates

    DEFF Research Database (Denmark)

    Vudayagiri, Sindhu; Skov, Anne Ladegaard

    2014-01-01

    permissible thickness is around 25–50 µm. The relatively small Young's modulus for these elastomers is a requirement for actuation capabilities. However, peeling and release of such films during manufacture processes are very difficult. To ease the release of the films, techniques such as the use of release....... Polysorbate-20, a non-ionic surfactant, fulfills all requirements and gives the lowest peel forces for the films....

  14. Quality Assurance in the National Tests of English: Investigating What Makes Reading Difficult

    Directory of Open Access Journals (Sweden)

    Angela Hasselgreen

    2017-09-01

    Full Text Available This article presents a piece of research, conducted in order to validate the claims made in test results, concerning what it means – in terms of reading ability – to be placed at a particular mastery level. It will consider the question of what makes reading tasks difficult, and whether data from the National Tests of English (NTE supports the progression of subskills/reading operations as presented in the mastery level descriptors, which are the basis of test results

  15. Real life study of three years omalizumab in patients with difficult-to-control asthma.

    Science.gov (United States)

    López Tiro, J Jesús; Contreras, E Angélica Contreras; del Pozo, M Elena Ramírez; Gómez Vera, J; Larenas Linnemann, D

    2015-01-01

    Even though there are multiple options for the treatment of asthma, there still exists a fair group of patients with difficult-to-control asthma. We describe for the first time the real-world effects of three-year omalizumab treatment on patients with difficult-to-control asthma, seen in a social security hospital in a Latin American country. Difficult-to-control asthmatic patients from the out-patient clinic of a regional hospital were recruited to receive a three-year omalizumab course. Efficacy parameters were asthma control test (ACT) score; FEV1; daily beclomethasone maintenance dose; and unplanned visits for asthma exacerbations (emergency room (ER), hospitalisations, intensive care). 52 patients were recruited, 47 completed the three-year treatment (42 female, 15-67 years, mean age 43.5). Comparing efficacy parameters of the year before omalizumab with the 3rd year of omalizumab: mean ACT improved from 12.4 to 20.5, mean FEV1 from 66.3% (standard deviation (SD) 19.1%) to 88.4% (SD 16.2%) of predicted, while mean beclomethasone dose reduced from 1750 to 766 mcg/day and there was a significant reduction in patients experiencing ER visits (from 95% to 19%, pomalizumab, two because of an adverse event (anaphylaxis, severe headache, both resolved without sequelae). Omalizumab improved most clinical parameters of Mexican patients with difficult-to-control asthma. Especially the rates of ER visits and hospitalisation were significantly reduced, thus reducing costs. Omalizumab was generally well tolerated. Copyright © 2013 SEICAP. Published by Elsevier Espana. All rights reserved.

  16. Use of Adult Fibreoptic Bronchoscope for Difficult Paediatric Intubation: A Case Report

    Directory of Open Access Journals (Sweden)

    Kundan Sandugir Gosavi

    2015-06-01

    Full Text Available Difficult airway management in paediatric patients may require a technique different from the standard one. We report the use of an adult fibreoptic bronchoscope and J tipped guidewire to intubate a child having temporo-mandibular joint ankylosis. Spontaneous respiration was maintained and local anaesthesia was provided to the upper airway during the procedure and the successful use of this technique avoided the requirement of surgical airway.

  17. Machining of Some Difficult-to-Cut Materials with Rotary Cutting Tools

    OpenAIRE

    Stjernstoft, Tero

    2004-01-01

    Automobile and aero industries have an increasing interestin materials with improved mechanical properties. However, manyof these new materials are classified as difficult-to-cut withconventional tools. It is obvious that tools, cutting processesand cutting models has to be devel-oped parallel to materialsscience. In this thesis rotary cutting tools are tested as analternative toexpensive diamond or cubic bore nitridetools. Metal matrix composites mostly consist of a light metalalloy (such as...

  18. Deep Help in Complex Project Work: Guiding and Path-Clearing Across Difficult Terrain

    OpenAIRE

    Fisher, Colin M.; Pillemer, Julianna; Amabile, Teresa M.

    2017-01-01

    How do teams working on complex projects get the help they need? Our qualitative investigation of the help provided to project teams at a prominent design firm revealed two distinct helping processes, both characterized by deep, sustained engagement that far exceeds the brief interactions described in the helping literature. Such deep help consisted of (1) guiding a team through a difficult juncture by working with its members in several prolonged, tightly clustered sessions, or (2) path-clea...

  19. Post analysis simulated correlation of the El-Ganzouri airway difficulty score with difficult airway.

    Science.gov (United States)

    Corso, Ruggero M; Cattano, Davide; Buccioli, Matteo; Carretta, Elisa; Maitan, Stefano

    2016-01-01

    Difficult airway (DA) occurs frequently (5-15%) in clinical practice. The El-Ganzouri Risk Index (EGRI) has a high sensitivity for predicting a difficult intubation (DI). However difficult mask ventilation (DMV) was never included in the EGRI. Since DMV was not included in the EGRI assessment, and obstructive sleep apnea (OSA) is also correlated with DMV, a study correlating the prediction of DA and OSA (identified by STOP-Bang questionnaire, SB) seemed important. We accessed a database previously collected for a post analysis simulation of the airway difficulty predictivity of the EGRI, associated with normal and difficult airway, particularly DMV. As secondary aim, we measured the correlation between the SB prediction system and DA, compared to the EGRI. A total of 2747 patients were included in the study. The proportion of patients with DI was 14.7% (95% CI 13.4-16) and the proportion of patients with DMV was 3.42% (95% CI 2.7-4.1). The incidence of DMV combined with DI was (2.3%). The optimal cutoff value of EGRI was 3. EGRI registered also an higher ability to predict DMV (AUC=0.76 (95% CI 0.71-0.81)). Adding the SB variables in the logistic model, the AUC increases with the inclusion of "observed apnea" variable (0.83 vs. 0.81, p=0.03). The area under the ROC curve for the patients with DI and DMV was 0.77 (95% CI 0.72-0.83). This study confirms that the incidence of DA is not negligible and suggests the use of the EGRI as simple bedside predictive score to improve patient safety. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  20. [Post analysis simulated correlation of the El-Ganzouri airway difficulty score with difficult airway].

    Science.gov (United States)

    Corso, Ruggero M; Cattano, Davide; Buccioli, Matteo; Carretta, Elisa; Maitan, Stefano

    2016-01-01

    Difficult airway (DA) occurs frequently (5-15%) in clinical practice. The El-Ganzouri Risk Index (EGRI) has a high sensitivity for predicting a difficult intubation (DI). However difficult mask ventilation (DMV) was never included in the EGRI. Since DMV was not included in the EGRI assessment, and obstructive sleep apnea (OSA) is also correlated with DMV, a study correlating the prediction of DA and OSA (identified by STOP-Bang questionnaire, SB) seemed important. We accessed a database previously collected for a post analysis simulation of the airway difficulty predictivity of the EGRI, associated with normal and difficult airway, particularly DMV. As secondary aim, we measured the correlation between the SB prediction system and DA, compared to the EGRI. A total of 2747 patients were included in the study. The proportion of patients with DI was 14.7% (95% CI 13.4-16) and the proportion of patients with DMV was 3.42% (95% CI 2.7-4.1). The incidence of DMV combined with DI was (2.3%). The optimal cutoff value of EGRI was 3. EGRI registered also an higher ability to predict DMV (AUC=0.76 (95% CI 0.71-0.81)). Adding the SB variables in the logistic model, the AUC increases with the inclusion of "observed apnea" variable (0.83 vs. 0.81, p=0.03). The area under the ROC curve for the patients with DI and DMV was 0.77 (95% CI 0.72-0.83). This study confirms that the incidence of DA is not negligible and suggests the use of the EGRI as simple bedside predictive score to improve patient safety. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.