Appropriateness of Intra-Operative Blood Transfusion In Children at ...

African Journals Online (AJOL)

Background: The decision to transfuse intra-operatively is based on preoperative haemoglobin (Hb), estimated blood loss and physiological variables. The visual estimate of blood loss is notoriously unreliable especially with small volumes of blood losses in children. Objectives :We sought therefore to determine the ...

Intra-operative digital imaging: assuring the alignment of components when undertaking total hip arthroplasty.

Science.gov (United States)

Hambright, D; Hellman, M; Barrack, R

2018-01-01

The aims of this study were to examine the rate at which the positioning of the acetabular component, leg length discrepancy and femoral offset are outside an acceptable range in total hip arthroplasties (THAs) which either do or do not involve the use of intra-operative digital imaging. A retrospective case-control study was undertaken with 50 patients before and 50 patients after the integration of an intra-operative digital imaging system in THA. The demographics of the two groups were comparable for body mass index, age, laterality and the indication for surgery. The digital imaging group had more men than the group without. Surgical data and radiographic parameters, including the inclination and anteversion of the acetabular component, leg length discrepancy, and the difference in femoral offset compared with the contralateral hip were collected and compared, as well as the incidence of altering the position of a component based on the intra-operative image. Digital imaging took a mean of five minutes (2.3 to 14.6) to perform. Intra-operative changes with the use of digital imaging were made for 43 patients (86%), most commonly to adjust leg length and femoral offset. There was a decrease in the incidence of outliers when using intra-operative imaging compared with not using it in regard to leg length discrepancy (20% versus 52%, p = 0.001) and femoral offset inequality (18% versus 44%, p = 0.004). There was also a difference in the incidence of outliers in acetabular inclination (0% versus 7%, p = 0.023) and version (0% versus 4%, p = 0.114) compared with historical results of a high-volume surgeon at the same centre. The use of intra-operative digital imaging in THA improves the accuracy of the positioning of the components at THA without adding a substantial amount of time to the operation. Cite this article: Bone Joint J 2018;100B(1 Supple A):36-43. ©2018 The British Editorial Society of Bone & Joint Surgery.

Impact of intra-operative intraperitoneal chemotherapy on organ/space surgical site infection in patients with gastric cancer.

Science.gov (United States)

Liu, X; Duan, X; Xu, J; Jin, Q; Chen, F; Wang, P; Yang, Y; Tang, X

2015-11-01

Various risk factors for surgical site infection (SSI) have been identified such as age, overweight, duration of surgery, blood loss, etc. Intraperitoneal chemotherapy during surgery is a common procedure in patients with gastric cancer, yet its impact on SSI has not been evaluated. To evaluate whether intra-operative intraperitoneal chemotherapy is a key risk factor for organ/space SSI in patients with gastric cancer. All patients with gastric cancer who underwent surgery at the Department of Gastrointestinal Surgery between January 2008 and December 2013 were studied. The organ/space SSI rates were compared between patients who received intra-operative intraperitoneal chemotherapy and patients who did not receive intra-operative intraperitoneal chemotherapy, and the risk factors for organ/space SSI were analysed by univariate and multi-variate regression analyses. The microbial causes of organ/space SSI were also identified. Of the eligible 845 patients, 356 received intra-operative intraperitoneal chemotherapy, and the organ/space SSI rate was higher in these patients compared with patients who did not receive intra-operative intraperitoneal chemotherapy (9.01% vs 3.88%; P = 0.002). Univariate analysis confirmed the significance of this finding (odds ratio 2.443; P = 0.003). As a result, hospital stay was increased in patients who received intra-operative intraperitoneal chemotherapy {mean 20.91 days [95% confidence interval (CI) 19.76-22.06] vs 29.72 days (95% CI 25.46-33.99); P = 0.000}. The results also suggested that intra-operative intraperitoneal chemotherapy may be associated with more Gram-negative bacterial infections. Intra-operative intraperitoneal chemotherapy is a significant risk factor for organ/space SSI in patients with gastric cancer. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Role of imprint cytology in intra operative diagnosis of thyroid lesions.

Science.gov (United States)

Anila, K R; Krishna, G

2014-07-01

Intra-operative imprint cytology is an important diagnostic modality in the diagnosis of thyroid lesions. A correct intra-operative diagnosis helps eliminate the need for second surgery. To study diagnostic accuracy of imprint cytology and to compare the imprint cytology results with that of the corresponding paraffin section diagnosis in thyroidectomy cases. This is a prospective study of 84 patients who have undergone thyroidectomies over a period of one year at the Department of Surgery, Thiruvananthapuram, Kerala, India. The intraoperative imprint cytology smears were stained by Papanicolaou method. The imprint cytology interpretation was later compared with the paraffin section diagnosis. Of the 84 patients using haematoxylin and eosin stained histopathology sections as the gold standard, the diagnostic sensitivity of imprint cytology was 75% and specificity was 100%. Positive predictive value was 100%. Negative predictive value was 98.74%. Imprint cytology has high sensitivity and specificity in diagnosing lesions of the thyroid. The problems faced were in diagnosing follicular carcinomas and differentiating low grade lymphoma from lymphocytic thyroiditis. Imprint cytology is a simple, reliable diagnostic technique. It has high sensitivity and specificity in intra-operative diagnosis of lesions of thyroid. In spite of the advent of newer diagnostic modalities like frozen sections, imprint cytology still holds its unique position in the current perspective.

Comparative Study Of Intra-Operative Pelvimetry With Calipers And ...

African Journals Online (AJOL)

The pelvic measurement of patients who have had a caesarean section was done using Pelvic Calipers (intra-operative) and x-ray methods. In the former method, during Caesarean sections and after closure of the lower uterine segment incision, a pair of pelvic calipers was used to measure the true conjugate of the pelvis.

Studies on the reliability of high-field intra-operative MRI in brain glioma resection

Directory of Open Access Journals (Sweden)

Zhi-jun SONG

2011-07-01

Full Text Available Objective To evaluate the reliability of high-field intra-operative magnetic resonance imaging(iMRI in detecting the residual tumors during glioma resection.Method One hundred and thirty-one cases of brain glioma(69 males and 62 females,aged from 7 to 79 years with mean of 39.6 years hospitalized from Nov.2009 to Aug.2010 were involved in present study.All the patients were evaluated using magnetic resonance imaging(MRI before the operation.The tumors were resected under conventional navigation microscope,and the high-field iMRI was used for all the patients when the operators considered the tumor was satisfactorily resected,while the residual tumor was difficult to detect under the microscope,but resected after being revealed by high-field iMRI.Histopathological examination was performed.The patients without residual tumors recieved high-field MRI scan at day 4 or 5 after operation to evaluate the accuracy of high-field iMRI during operation.Results High quality intra-operative images were obtained by using high-field iMRI.Twenty-eight cases were excluded because their residual tumors were not resected due to their location too close to functional area.Combined with the results of intra-operative histopathological examination and post-operative MRI at the early recovery stage,the sensitivity of high-field iMRI in residual tumor diagnosis was 98.0%(49/50,the specificity was 94.3%(50/53,and the accuracy was 96.1%(99/103.Conclusion High-quality intra-operative imaging could be acquired by high-field iMRI,which maybe used as a safe and reliable method in detecting the residual tumors during glioma resection.

The value of the intra-operative clinical mechanical axis measurement in open-wedge valgus high tibial osteotomies

NARCIS (Netherlands)

van de Pol, G.J.; Verdonschot, Nicolaas Jacobus Joseph; van Kampen, A.

2012-01-01

Introduction: In high tibial osteotomies (HTO) the correction needs to be precise and intra-operative assessment is essential. The purpose of this study was to evaluate the use of the intra-operative clinical mechanical axis measurement and compare it to the post-operative weight bearing situation

Intra-operative maternal complications of emergency cesarean section done in advanced labor

International Nuclear Information System (INIS)

Nisa, M.U.

2013-01-01

Background: Emergency cesarean section done in advanced labor is a big challenge in obstetrics due to increased risk of intraoperative complications. In the last decade, a rapid increase in cesarean section done in advanced labor has been observed. Difficult deli-very of the fetal head during cesarean section carries a high risk of intraoperative complications like cervical and uterine tears, intra operative hemorrhage and trauma to the baby. Objectives: The purpose of this study is to find out the frequency and risk factors for intra-operative complications in emergency cesarean section done in advanced labor, so that appropriate management protocols can be planned to reduce these complications. Study Design: Prospective cohort study. Materials and Methods: This prospective study was carried out in Obstetrics and Gynecology Unit - 2 of Services Institute of Medical Sciences, Services Hospital, Lahore; from 1st January 2007 to 31st December 2007. All patients undergoing emergency cesarean sections done on laboring mothers were included in the study. The sample was divided into two groups; emergency C-section done in advanced labor as the study group and emergency C-section in early labor as the control group. Data were collected regarding age, parity, booked or unbooked status, indications for cesarean section, level of competence of operating surgeon, intra-operative complications and the risk factors for these complications. Data were recorded on a structured proforma and compared between the two groups. Statistical Analysis: Data were analyzed using computer programme SPSS Version 14 for windows applying student t-test for quantitative and chai square test for qualitative parameters. A p-value < 0.05 was used as statistically significant. Results: Out of 2064 total deliveries in the year 2007, 1290 (62.5%) were vaginal deliveries and 774 (37.5%) were C-Sections. Out of 774 C-Section, 174 (23%) were elective and 600 (77%) were emergency. Out of 600 emergency C

Pre-operative Duplex Ultrasonography in Arteriovenous Fistula Creation: Intra- and Inter-observer Agreement.

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Zonnebeld, Niek; Maas, Tommy M G; Huberts, Wouter; van Loon, Magda M; Delhaas, Tammo; Tordoir, Jan H M

2017-11-01

Although clinical guidelines on arteriovenous fistula (AVF) creation advocate minimum luminal arterial and venous diameters, assessed by duplex ultrasonography (DUS), the clinical value of routine DUS examination is under debate. DUS might be an insufficiently repeatable and/or reproducible imaging modality because of its operator dependency. The present study aimed to assess intra- and inter-observer agreement of DUS examination in support of AVF surgery planning. Ten end stage renal disease patients were included, to assess intra- and inter-observer agreement of pre-operative DUS measurements. All measurements were performed by two trained and experienced vascular technicians, blinded to measurement readings. From the routine DUS protocol, representative measurements (venous diameters, and arterial diameters and volume flow in the upper arm and forearm) were selected. For intra-observer agreement the measurements were performed in triplicate, with the probe released from the skin between each. Intraclass correlation coefficients were calculated for intra- and inter-observer agreement, and Bland-Altman plots used to graphically display mean measurement differences and limits of agreement. Ten patients (6 male, 59.4±19.7 years) consented to participate, and all predefined measurements were obtained. Intraclass correlation coefficients for intra-observer agreement of diameter measurements were at least 0.90 (95% CI 0.74-0.97; radial artery). Inter-observer agreement was at least 0.83 (0.46-0.96; lateral diameter upper arm cephalic vein). The Bland-Altman plots showed acceptable mean measurement differences and limits of agreement. In experienced hands, excellent intra- and inter-observer agreement can be reached for the discrete pre-operative DUS measurements advocated in clinical guidelines. DUS is therefore a reliable imaging modality to support AVF surgery planning. The content of DUS protocols, however, needs further standardisation. Copyright © 2017 European

Intra-Hour Dispatch and Automatic Generator Control Demonstration with Solar Forecasting - Final Report

Energy Technology Data Exchange (ETDEWEB)

Coimbra, Carlos F. M. [Univ. of California, San Diego, CA (United States

2016-02-25

In this project we address multiple resource integration challenges associated with increasing levels of solar penetration that arise from the variability and uncertainty in solar irradiance. We will model the SMUD service region as its own balancing region, and develop an integrated, real-time operational tool that takes solar-load forecast uncertainties into consideration and commits optimal energy resources and reserves for intra-hour and intra-day decisions. The primary objectives of this effort are to reduce power system operation cost by committing appropriate amount of energy resources and reserves, as well as to provide operators a prediction of the generation fleet’s behavior in real time for realistic PV penetration scenarios. The proposed methodology includes the following steps: clustering analysis on the expected solar variability per region for the SMUD system, Day-ahead (DA) and real-time (RT) load forecasts for the entire service areas, 1-year of intra-hour CPR forecasts for cluster centers, 1-year of smart re-forecasting CPR forecasts in real-time for determination of irreducible errors, and uncertainty quantification for integrated solar-load for both distributed and central stations (selected locations within service region) PV generation.

The ultrastructure of tumor cells in patients with rectal cancer after pre-operative irradiation and intra-operative cryotherapy

International Nuclear Information System (INIS)

Vyinnik, Yu.O.; Kotenko, O.Je.; Nevzorov, V.P.; Chyibyisov, L.P.

2000-01-01

Electronic microscopy of the tumor cells was performed to confirm the efficacy of combined pre-operative gamma-therapy and intraoperative cryotherapy (CT). Pre-operative irradiation at the dose of 20 Gy accompanied by intra-operative cryotherapy caused the changes in the ultrastructure, the depth and degree of which allow to consider them destructive and irreversible

Simple and Realistic Data Generation

DEFF Research Database (Denmark)

Pedersen, Kenneth Houkjær; Torp, Kristian; Wind, Rico

2006-01-01

This paper presents a generic, DBMS independent, and highly extensible relational data generation tool. The tool can efficiently generate realistic test data for OLTP, OLAP, and data streaming applications. The tool uses a graph model to direct the data generation. This model makes it very simple...... to generate data even for large database schemas with complex inter- and intra table relationships. The model also makes it possible to generate data with very accurate characteristics....

Generating realistic environments for cyber operations development, testing, and training

Science.gov (United States)

Berk, Vincent H.; Gregorio-de Souza, Ian; Murphy, John P.

2012-06-01

Training eective cyber operatives requires realistic network environments that incorporate the structural and social complexities representative of the real world. Network trac generators facilitate repeatable experiments for the development, training and testing of cyber operations. However, current network trac generators, ranging from simple load testers to complex frameworks, fail to capture the realism inherent in actual environments. In order to improve the realism of network trac generated by these systems, it is necessary to quantitatively measure the level of realism in generated trac with respect to the environment being mimicked. We categorize realism measures into statistical, content, and behavioral measurements, and propose various metrics that can be applied at each level to indicate how eectively the generated trac mimics the real world.

Intra-operative warming with a forced-air warmer in preventing hypothermia after tourniquet deflation in elderly patients.

Science.gov (United States)

Kim, Y-S; Jeon, Y-S; Lee, J-A; Park, W-K; Koh, H-S; Joo, J-D; In, J-H; Seo, K-W

2009-01-01

This randomized, single-blind study aimed to explore the effects of intra-operative warming with a forced-air warmer in the prevention of hypothermia after tourniquet deflation in elderly patients undergoing unilateral total knee replacement arthroplasty under general anaesthesia. Patients were randomized to receive either intra-operative warming using a forced-air warmer with an upper body blanket (warming group; n = 12) or no intra-operative warming (nonwarming group; n = 12). Oesophageal temperature was measured as core body temperature. At 30 min following tourniquet inflation, the core body temperature started to increase in the warming group whereas it continued to drop in the non-warming group. This difference was statistically significant. The final core body temperature after tourniquet deflation was significantly higher in the warming group (mean +/- SD 36.1 +/- 0.2 degrees C) than in the non-warming group (35.4 +/- 0.3 degrees C). Intra-operative forced-air warming increased the core body temperature before tourniquet deflation and prevented subsequent hypothermia in elderly patients under general anaesthesia.

Intra-operative Ultrasound as a Tool to Assess Free Borders of Primary Vascular Aortic Tumors During Resection

Directory of Open Access Journals (Sweden)

R.M. Andersen

Full Text Available : Introduction: Primary vascular tumors are rare and, in general, have a poor prognosis. Complete resection is associated with a better prognosis. Radical resection depends on safe discrimination of tumor borders. Technical summary: A 54 year old woman presented with abdominal pain. Imaging revealed a mass in the thoracic aorta, highly suspicious of angiosarcoma which was confirmed post-operatively by histological analysis. Open surgery was performed. Prior to clamping of the aorta, intra-operative ultrasound established clear delineation of the tumor borders. Conclusion: Intra-operative ultrasound was, in this case, a safe and easy method to determine the tumor borders, providing a simple guide to in toto tumor removal. Keywords: Angiosarcoma, Intra-operative ultrasound, In toto tumor removal, Fludeoxyglucose positron emission tomography/computed tomography, Magnetic resonance imaging

Simulation Evaluation of Controller-Managed Spacing Tools under Realistic Operational Conditions

Science.gov (United States)

Callantine, Todd J.; Hunt, Sarah M.; Prevot, Thomas

2014-01-01

Controller-Managed Spacing (CMS) tools have been developed to aid air traffic controllers in managing high volumes of arriving aircraft according to a schedule while enabling them to fly efficient descent profiles. The CMS tools are undergoing refinement in preparation for field demonstration as part of NASA's Air Traffic Management (ATM) Technology Demonstration-1 (ATD-1). System-level ATD-1 simulations have been conducted to quantify expected efficiency and capacity gains under realistic operational conditions. This paper presents simulation results with a focus on CMS-tool human factors. The results suggest experienced controllers new to the tools find them acceptable and can use them effectively in ATD-1 operations.

A Novel Stress-Diathesis Model to Predict Risk of Post-operative Delirium: Implications for Intra-operative Management

Directory of Open Access Journals (Sweden)

Renée El-Gabalawy

2017-08-01

Full Text Available Introduction: Risk assessment for post-operative delirium (POD is poorly developed. Improved metrics could greatly facilitate peri-operative care as costs associated with POD are staggering. In this preliminary study, we develop a novel stress-diathesis model based on comprehensive pre-operative psychiatric and neuropsychological testing, a blood oxygenation level-dependent (BOLD magnetic resonance imaging (MRI carbon dioxide (CO2 stress test, and high fidelity measures of intra-operative parameters that may interact facilitating POD.Methods: The study was approved by the ethics board at the University of Manitoba and registered at clinicaltrials.gov as NCT02126215. Twelve patients were studied. Pre-operative psychiatric symptom measures and neuropsychological testing preceded MRI featuring a BOLD MRI CO2 stress test whereby BOLD scans were conducted while exposing participants to a rigorously controlled CO2 stimulus. During surgery the patient had hemodynamics and end-tidal gases downloaded at 0.5 hz. Post-operatively, the presence of POD and POD severity was comprehensively assessed using the Confusion Assessment Measure –Severity (CAM-S scoring instrument on days 0 (surgery through post-operative day 5, and patients were followed up at least 1 month post-operatively.Results: Six of 12 patients had no evidence of POD (non-POD. Three patients had POD and 3 had clinically significant confusional states (referred as subthreshold POD; ST-POD (score ≥ 5/19 on the CAM-S. Average severity for delirium was 1.3 in the non-POD group, 3.2 in ST-POD, and 6.1 in POD (F-statistic = 15.4, p < 0.001. Depressive symptoms, and cognitive measures of semantic fluency and executive functioning/processing speed were significantly associated with POD. Second level analysis revealed an increased inverse BOLD responsiveness to CO2 pre-operatively in ST-POD and marked increase in the POD groups when compared to the non-POD group. An association was also noted for

Intra-Operative Amylase Concentration in Peri-Pancreatic Fluid Predicts Pancreatic Fistula After Distal Pancreatectomy

NARCIS (Netherlands)

Nahm, C.B.; Reuver, P.R.; Hugh, T.J.; Pearson, A.; Gill, A.J.; Samra, J.S.; Mittal, A.

2017-01-01

Post-operative pancreatic fistula (POPF) is a potentially severe complication following distal pancreatectomy. The aim of this study was to assess the predictive value of intra-operative amylase concentration (IOAC) in peri-pancreatic fluid after distal pancreatectomy for the diagnosis of POPF.

l-Arginine Pathway Metabolites Predict Need for Intra-operative Shunt During Carotid Endarterectomy

DEFF Research Database (Denmark)

Szabo, P; Lantos, J; Nagy, L

2016-01-01

lactate levels were increased during reperfusion (p = .02). The median pre-operative concentration of l-arginine was lower in patients requiring an intra-operative shunt than in patients without need of shunt (median: 30.3 μmol/L [interquartile range 24.4-34.4 μmol/L] vs. 57.6 μmol/L [interquartile range...

Intra-operative nuclear imaging based on positron-emitting radiotracers

International Nuclear Information System (INIS)

Shakir, Dzhoshkun Ismail

2014-01-01

Positron-emitting radiotracers are an important part of nuclear medical imaging processes. Besides the very famous glucose analog [ 18 F]FDG, many not so well known ones exist, among them the particularly interesting amino acid-based tracers like [ 18 F]FET. Although peri-operative imaging with positron-emitting radiotracers has become state-of- the-art in cases of many types of cancer, their capability is not fully exploited in the operating room yet. In this thesis we explore two intra-operative nuclear imaging modalities exploiting different aspects of positron radiation towards quality assurance in challenging surgical treatment scenarios. The first modality freehand PET provides a tomographic image of a volume of interest and aims at minimizing invasiveness by assisting the surgeon in pinpointing target structures marked with a radiotracer. The second imaging modality epiphanography generates an image of the radiotracer distribution on a surface of interest and aims at providing a means for improving the control of tumor resection margins. The word epiphanography is a compound of the Greek words επιφανεια (epiphaneia) for surface and ζωγραφια (ographia) for image, and hence means the image of the surface similar to the compound τομοζ (tomos) for slice/volume and ζωγραφια (ographia) for image, meaning the image of the volume, i.e. tomography. To our knowledge this is the first use of the word epiphanography in the context of nuclear medical imaging. In this thesis we present our approach to modeling, developing and calibrating these two novel imaging modalities. In addition, we present our work towards their clinical integration. In the case of freehand PET, we have already acquired the first intra-operative datasets of a patient. We present this first experience in the operating room together with our phantom studies. In the case of epiphanography, we present our phantom studies with neurosurgeons towards the integration of this

Lymphoscintigraphy and intra-operative gamma probe in detection of sentinel lymph node for breast cancer surgery

International Nuclear Information System (INIS)

Le Ngoc Ha; Le Manh Ha; Bui Quang Bieu

2011-01-01

Sentinel lymph node biopsy (SLNB) has been emerged as a highly accurate method of axillary staging in management of breast cancer patients. Sentinel lymph node detection (SLND) by lymphoscintigraphy and intra-operative gamma probe for SLNB have been widely used in the world. Objectives: the purpose of our study was to evaluate the result of techniques using lymphoscintigraphy and intra-operative gamma probe for SLND in breast carcinoma patients. Materials and Methods: 102 patients with early breast carcinoma were enrolled in the study. Lymphoscintigraphy using Tc-99m-human serum albumin colloid, intra-operative gamma probe were undergone for localization and SLNB. Total axillary lymph node was dissected in breast cancer surgery. Results: The success rate of lymphoscintigraphy and SLND was 98.0% (100/102 patients), mean number of sentinel lymph node (SLN)/patient was 1.56 ± 0.79 (ranged 1 - 3), number of lymphatic vessel/SLN was 1.5 ± 0.69 (ranged 1 - 4) and mean time for SLND on lymphoscintigraphy was 4.21 ± 13.4 minutes (2 - 15 minutes). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of radio-guided SLNB for axillary staging was 100%, 70.6%, 41.2%, 100% and 75.6 % respectively. Conclusions: radio-guided SLNB by lymphoscintigraphy and intra-operative gamma probe is feasible and reliable for axillary staging in early breast carcinoma patients. (author)

A Clinically Realistic Large Animal Model of Intra-Articular Fracture

Science.gov (United States)

2014-12-01

of the left hock using a purpose-designed “offset” impaction technique (Figure 3).1,2 First, the distal impact “tripod” is anchored to the talus...injury to PTOA. While development of PTOA in the human ankle is often reported to occur very quickly (approximately 2 years after injury), even this...vinylpyridine. Anal Biochem 1980; 106(1): 207-12. Distribution and Progression of Chondrocyte Damage in a Whole-Organ Model of Human Ankle Intra

Intra-operative radiation treatment of cancers

International Nuclear Information System (INIS)

Dubois, J.B.; Joyeux, H.; Solassol, C.; Pujol, H.

1986-01-01

Intra-operative radiation treatment (I.O.R.T.) is concerning the treatment either of an unresectable tumor or of tumor bed after complete excision of a primary tumor and its first draining lymph nodes. We describe X-ray and electrons techniques and we discuss the delivered doses according to experimental and clinical data. According to the residual disease (macroscopic or microscopic), to the healthy tissues in the target volume, and the histological type, single doses from 20 Gy to 40 Gy can be delivered. Our preliminary results are reported: 25 patients with resectable tumors of the cardia, the stomach and the pancreas, 5 patients with pelvic recurrences of colon and rectum carcinomas. Therapeutic results of the I.O.R.T. providing from the literature are discussed. The I.O.R.T. indications are defined as palliative (unresectable tumors) and curative (irradiation of tumor bed after complete excision of the tumor) [fr

Intra-operative neurophysiological mapping and monitoring during brain tumour surgery in children: an update.

Science.gov (United States)

Coppola, Angela; Tramontano, Vincenzo; Basaldella, Federica; Arcaro, Chiara; Squintani, Giovanna; Sala, Francesco

2016-10-01

Over the past decade, the reluctance to operate in eloquent brain areas has been reconsidered in the light of the advent of new peri-operative functional neuroimaging techniques and new evidence from neuro-oncology. To maximise tumour resection while minimising morbidity should be the goal of brain surgery in children as much as it is in adults, and preservation of brain functions is critical in the light of the increased survival and the expectations in terms of quality of life. Intra-operative neurophysiology is the gold standard to localise and preserve brain functions during surgery and is increasingly used in paediatric neurosurgery. Yet, the developing nervous system has peculiar characteristics in terms of anatomical and physiological maturation, and some technical aspects need to be tailored for its use in children, especially in infants. This paper will review the most recent advances in the field of intra-operative neurophysiology (ION) techniques during brain surgery, focussing on those aspects that are relevant to the paediatric neurosurgery practice.

Correlation between intra- and extracranial background EEG

DEFF Research Database (Denmark)

Duun-Henriksen, Jonas; Kjaer, Troels W.; Madsen, Rasmus E.

2012-01-01

Scalp EEG is the most widely used modality to record the electrical signals of the brain. It is well known that the volume conduction of these brain waves through the brain, cerebrospinal fluid, skull and scalp reduces the spatial resolution and the signal amplitude. So far the volume conduction...... has primarily been investigated by realistic head models or interictal spike analysis. We have set up a novel and more realistic experiment that made it possible to compare the information in the intra- and extracranial EEG. We found that intracranial EEG channels contained correlated patterns when...... placed less than 30 mm apart, that intra- and extracranial channels were partly correlated when placed less than 40 mm apart, and that extracranial channels probably were correlated over larger distances. The underlying cortical area that influences the extracranial EEG is found to be up to 45 cm2...

Intra-operative 3-T MRI for paediatric brain tumours: challenges and perspectives

International Nuclear Information System (INIS)

Abernethy, L.J.; Avula, S.; Hughes, G.M.; Wright, E.J.; Mallucci, C.L.

2012-01-01

MRI is the ideal modality for imaging intracranial tumours. Intraoperative MRI (ioMRI) makes it possible to obtain scans during a neurosurgical operation that can aid complete macroscopic tumour resection - a major prognostic factor in the majority of brain tumours in children. Intra-operative MRI can also help limit damage to normal brain tissue. It therefore has the potential to improve the survival of children with brain tumours and to minimise morbidity, including neurological deficits. The use of ioMRI is also likely to reduce the need for second look surgery, and may reduce the need for chemotherapy and radiotherapy. High-field MRI systems provide better anatomical information and also enable effective utilisation of advanced MRI techniques such as perfusion imaging, diffusion tensor imaging, and magnetic resonance spectroscopy. However, high-field ioMRI facilities require substantial capital investment, and careful planning is required for optimal benefit. Safe ioMRI requires meticulous attention to detail and rigorous application of magnetic field safety precautions. Interpretation of ioMRI can be challenging and requires experience and understanding of artefacts that are common in the intra-operative setting. (orig.)

Inter- and intra-operator reliability and repeatability of shear wave elastography in the liver: a study in healthy volunteers.

Science.gov (United States)

Hudson, John M; Milot, Laurent; Parry, Craig; Williams, Ross; Burns, Peter N

2013-06-01

This study assessed the reproducibility of shear wave elastography (SWE) in the liver of healthy volunteers. Intra- and inter-operator reliability and repeatability were quantified in three different liver segments in a sample of 15 subjects, scanned during four independent sessions (two scans on day 1, two scans 1 wk later) by two operators. A total of 1440 measurements were made. Reproducibility was assessed using the intra-class correlation coefficient (ICC) and a repeated measures analysis of variance. The shear wave speed was measured and used to estimate Young's modulus using the Supersonics Imagine Aixplorer. The median Young's modulus measured through the inter-costal space was 5.55 ± 0.74 kPa. The intra-operator reliability was better for same-day evaluations (ICC = 0.91) than the inter-operator reliability (ICC = 0.78). Intra-observer agreement decreased when scans were repeated on a different day. Inter-session repeatability was between 3.3% and 9.9% for intra-day repeated scans, compared with to 6.5%-12% for inter-day repeated scans. No significant difference was observed in subjects with a body mass index greater or less than 25 kg/m(2). Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Comparison of preoperative computerized tomography scan imaging of temporal bone with the intra-operative findings in patients undergoing mastiodectomy

International Nuclear Information System (INIS)

Gerami, H.; Naghavi, E.; Wahabi-Moghadam, M.; Forghanparast, K.; Akbar, Manzar H.

2009-01-01

Objective was to compare the consistency rates of pre- and intra-operative radiological findings in patients with chronic suppurative otitis media (CSOM). In a cross-sectional study, 80 patients with CSOM underwent pre-operative CT scanning and we compared the results with intra-operative clinical findings during mastiodectomy from 2000-2004 in the Otology Department, Amiralmomenin Hospital of Guilan Medical University, Rasht, Iran. Sensitivity, specificity, positive and negative predictive value of CT scan in tympanic and mastoid cholesteatoma, ossicular chain erosion, tegmentympani erosion, dehiscence of facial canal, lateral semicircular canal (LSCC) fistula were assessed. Then, correlation between radiological findings and intra-operative findings were calculated. The mean age of patients was 27.9+-16.3 years. Mostly were males (n=57 [71.3%]). Correlation of preoperative radiological images with intra-operative clinical findings were moderate to good on tympanic cholesteatoma, mastoid cholesteatoma and ossicular chain erosion, but weak and insignificant in cases of tegmen erosion, facial canal dehiscene and LSCC fistulae. Preoperative CT scan may be helpful in decision-making for surgery in cases of cholesteatoma and ossicular erosion. Despite of limitations radiological scanning is a useful adjunct to management of CSOM. (author)

Estimation of intra-operator variability in perfusion parameter measurements using DCE-US.

Science.gov (United States)

Gauthier, Marianne; Leguerney, Ingrid; Thalmensi, Jessie; Chebil, Mohamed; Parisot, Sarah; Peronneau, Pierre; Roche, Alain; Lassau, Nathalie

2011-03-28

To investigate intra-operator variability of semi-quantitative perfusion parameters using dynamic contrast-enhanced ultrasonography (DCE-US), following bolus injections of SonoVue(®). The in vitro experiments were conducted using three in-house sets up based on pumping a fluid through a phantom placed in a water tank. In the in vivo experiments, B16F10 melanoma cells were xenografted to five nude mice. Both in vitro and in vivo, images were acquired following bolus injections of the ultrasound contrast agent SonoVue(®) (Bracco, Milan, Italy) and using a Toshiba Aplio(®) ultrasound scanner connected to a 2.9-5.8 MHz linear transducer (PZT, PLT 604AT probe) (Toshiba, Japan) allowing harmonic imaging ("Vascular Recognition Imaging") involving linear raw data. A mathematical model based on the dye-dilution theory was developed by the Gustave Roussy Institute, Villejuif, France and used to evaluate seven perfusion parameters from time-intensity curves. Intra-operator variability analyses were based on determining perfusion parameter coefficients of variation (CV). In vitro, different volumes of SonoVue(®) were tested with the three phantoms: intra-operator variability was found to range from 2.33% to 23.72%. In vivo, experiments were performed on tumor tissues and perfusion parameters exhibited values ranging from 1.48% to 29.97%. In addition, the area under the curve (AUC) and the area under the wash-out (AUWO) were two of the parameters of great interest since throughout in vitro and in vivo experiments their variability was lower than 15.79%. AUC and AUWO appear to be the most reliable parameters for assessing tumor perfusion using DCE-US as they exhibited the lowest CV values.

Intra-operative mapping of the atria: the first step towards individualization of atrial fibrillation therapy?

Science.gov (United States)

Kik, Charles; Mouws, Elisabeth M J P; Bogers, Ad J J C; de Groot, Natasja M S

2017-07-01

Atrial fibrillation (AF), an age-related progressive disease, is becoming a worldwide epidemic with a prevalence rate of 33 million. Areas covered: In this expert review, an overview of important results obtained from previous intra-operative mapping studies is provided. In addition, our novel intra-operative high resolution mapping studies, its surgical considerations and data analyses are discussed. Furthermore, the importance of high resolution mapping studies of both sinus rhythm and AF for the development of future AF therapy is underlined by our most recent results. Expert commentary: Progression of AF is determined by the extensiveness of electropathology which is defined as conduction disorders caused by structural damage of atrial tissue. The severity of electropathology is a major determinant of therapy failure. At present, we do not have any diagnostic tool to determine the degree of electropathology in the individual patient and we can thus not select the most optimal treatment modality for the individual patient. An intra-operative, high resolution scale, epicardial mapping approach combined with quantification of electrical parameters may serve as a diagnostic tool to stage AF in the individual patient and to provide patient tailored therapy.

Evaluation of measures to decrease intra-operative bacterial contamination in orthopaedic implant surgery

NARCIS (Netherlands)

Knobben, BAS; van Horn, [No Value; van der Mei, HC; Busscher, HJ

The aim of this study was to evaluate whether behavioural and systemic measures wilt decrease intra-operative contamination during total hip or knee replacements. The influence of these measures on subsequent prolonged wound discharge, superficial surgical site infection and deep periprosthetic

Bell Operator Method to Classify Local Realistic Theories

International Nuclear Information System (INIS)

Nagata, Koji

2010-01-01

We review the historical fact of multipartite Bell inequalities with an arbitrary number of settings. An explicit local realistic model for the values of a correlation function, given in a two-setting Bell experiment (two-setting model), works only for the specific set of settings in the given experiment, but cannot construct a local realistic model for the values of a correlation function, given in a continuous-infinite settings Bell experiment (infinite-setting model), even though there exist two-setting models for all directions in space. Hence, the two-setting model does not have the property that the infinite-setting model has. Here, we show that an explicit two-setting model cannot construct a local realistic model for the values of a correlation function, given in an M-setting Bell experiment (M-setting model), even though there exist two-setting models for the M measurement directions chosen in the given M-setting experiment. Hence, the two-setting model does not have the property that the M-setting model has. (general)

The effect of Kombucha on post-operative intra-abdominal adhesion formation in rats.

Science.gov (United States)

Maghsoudi, Hemmat; Mohammadi, Hussein Benagozar

2009-04-01

Peritoneal adhesions are fibrous bands of tissues formed between organs that are normally separated and/or between organs and the internal body wall after peritoneal injury. The aim of the study was to investigate the effect of intra-peritoneal administration of Kombucha on intra-peritoneal adhesions. Eighty Wistar rats were subjected to standardized lesion by scraping model and were randomly divided into two groups. Group I received no treatment, and Group II received 15 ml of Kombucha solution intra-peritoneally. On the post-operative 14th day adhesion intensity score, inflammatory cell reaction and number of adhesion bands were determined. In the control group, there were no rats with grade 0 and I adhesions. In the group II, there were 26 rats (78.8%) with grade 0-2 adhesions. Adhesion intensity was significantly less in group II (PKombucha might be useful for preventing peritoneal adhesions.

Realistic neurons can compute the operations needed by quantum probability theory and other vector symbolic architectures.

Science.gov (United States)

Stewart, Terrence C; Eliasmith, Chris

2013-06-01

Quantum probability (QP) theory can be seen as a type of vector symbolic architecture (VSA): mental states are vectors storing structured information and manipulated using algebraic operations. Furthermore, the operations needed by QP match those in other VSAs. This allows existing biologically realistic neural models to be adapted to provide a mechanistic explanation of the cognitive phenomena described in the target article by Pothos & Busemeyer (P&B).

Presentation of the GIE INTRA Group's operational means

International Nuclear Information System (INIS)

Cochard, A.

2010-01-01

Located on the Chinon nuclear power plant site, the Intra Group is an economic interest grouping which has been created by the three French nuclear operators (EDF, CEA, and COGEMA now AREVA) after the Chernobyl accident. Its missions are to possess permanently available means of intervention in case of severe accident or radiological situation, to be able to intervene at any time on the French territory, to develop a European network of expertise, and to build up an ability centre for robotic intervention in hostile environment. This document briefly presents its different available means: remotely controlled equipment (inside and outside equipment, public works equipment), and radiological characterization equipment. Other aspects are briefly evoked: organization, information transmission, exercises and interventions, international relationships, future trends

Extended endoscopic endonasal surgery using three-dimensional endoscopy in the intra-operative MRI suite for supra-diaphragmatic ectopic pituitary adenoma.

Science.gov (United States)

Fuminari, Komatsu; Hideki, Atsumi; Manabu, Osakabe; Mitsunori, Matsumae

2015-01-01

We describe a supra-diaphragmatic ectopic pituitary adenoma that was safely removed using the extended endoscopic endonasal approach, and discuss the value of three-dimensional (3D) endoscopy and intra-operative magnetic resonance imaging (MRI) to this type of procedure. A 61-year-old-man with bitemporal hemianopsia was referred to our hospital, where MRI revealed an enhanced suprasellar tumor compressing the optic chiasma. The tumor extended on the planum sphenoidale and partially encased the right internal carotid artery. An endocrinological assessment indicated normal pituitary function. The extended endoscopic endonasal approach was taken using a 3D endoscope in the intraoperative MRI suite. The tumor was located above the diaphragma sellae and separated from the normal pituitary gland. The pathological findings indicated non-functioning pituitary adenoma and thus the tumor was diagnosed as a supra-diaphragmatic ectopic pituitary adenoma. Intra-operative MRI provided useful information to minimize dural opening and the supra-diaphragmatic ectopic pituitary adenoma was removed from the complex neurovascular structure via the extended endoscopic endonasal approach under 3D endoscopic guidance in the intra-operative suite. Safe and effective removal of a supra-diaphragmatic ectopic pituitary adenoma was accomplished via the extended endoscopic endonasal approach with visual information provided by 3D endoscopy and intra-operative MRI.

Intra-Operative Surgical Irrigation of the Surgical Incision: What Does the Future Hold-Saline, Antibiotic Agents, or Antiseptic Agents?

Science.gov (United States)

Edmiston, Charles E; Leaper, David J

2016-12-01

Intra-operative surgical site irrigation (lavage) is common practice in surgical procedures in general, with all disciplines advocating some form of irrigation before incision closure. This practice, however, has been neither standardized nor is there compelling evidence that it effectively reduces the risk of surgical site infection (SSI). This narrative review addresses the laboratory and clinical evidence that is available to support the practice of irrigation of the abdominal cavity and superficial/deep incisional tissues, using specific irrigation solutions at the end of an operative procedure to reduce the microbial burden at wound closure. Review of PubMed and OVID for pertinent, scientific, and clinical publications in the English language was performed. Incision irrigation was found to afford a three-fold benefit: First, to hydrate the bed; second, to assist in allowing better examination of the area immediately before closure; and finally, by removing superficial and deep incisional contamination and lowering the bioburden, expedite the healing process. The clinical practice of intra-operative peritoneal lavage is highly variable and is dependent solely on surgeon preference. By contrast, intra-operative irrigation after device-related procedures has become a standard of care for the prophylaxis of acute peri-prosthetic infection. The clinical evidence that supports the use of antibiotic irrigation is limited and based on retrospective analysis and few acceptable randomized controlled trials. The results of laboratory and animal studies using aqueous 0.05% chlorhexidine gluconate are favorable, suggesting that further studies are justified to determine its clinical efficacy. The adoption of appropriate and standardized intra-operative irrigation practices into peri-operative care bundles, which include other evidence-based strategies (weight-based antimicrobial prophylaxis, antimicrobial sutures, maintenance of normothermia, and glycemic control), offers

Framework for a low-cost intra-operative image-guided neuronavigator including brain shift compensation

OpenAIRE

Bucki, Marek; Lobos, Claudio; Payan, Yohan

2007-01-01

In this paper we present a methodology to address the problem of brain tissue deformation referred to as 'brain-shift'. This deformation occurs throughout a neurosurgery intervention and strongly alters the accuracy of the neuronavigation systems used to date in clinical routine which rely solely on pre-operative patient imaging to locate the surgical target, such as a tumour or a functional area. After a general description of the framework of our intra-operative image-guided system, we desc...

Intra-operative 3D imaging system for robot-assisted fracture manipulation.

Science.gov (United States)

Dagnino, G; Georgilas, I; Tarassoli, P; Atkins, R; Dogramadzi, S

2015-01-01

Reduction is a crucial step in the treatment of broken bones. Achieving precise anatomical alignment of bone fragments is essential for a good fast healing process. Percutaneous techniques are associated with faster recovery time and lower infection risk. However, deducing intra-operatively the desired reduction position is quite challenging due to the currently available technology. The 2D nature of this technology (i.e. the image intensifier) doesn't provide enough information to the surgeon regarding the fracture alignment and rotation, which is actually a three-dimensional problem. This paper describes the design and development of a 3D imaging system for the intra-operative virtual reduction of joint fractures. The proposed imaging system is able to receive and segment CT scan data of the fracture, to generate the 3D models of the bone fragments, and display them on a GUI. A commercial optical tracker was included into the system to track the actual pose of the bone fragments in the physical space, and generate the corresponding pose relations in the virtual environment of the imaging system. The surgeon virtually reduces the fracture in the 3D virtual environment, and a robotic manipulator connected to the fracture through an orthopedic pin executes the physical reductions accordingly. The system is here evaluated through fracture reduction experiments, demonstrating a reduction accuracy of 1.04 ± 0.69 mm (translational RMSE) and 0.89 ± 0.71 ° (rotational RMSE).

Intra-operative monitoring of the common peroneal nerve during total knee replacement.

Science.gov (United States)

Unwin, A J; Thomas, M

1994-01-01

We present a method allowing intra-operative monitoring of the common peroneal nerve during total knee arthroplasty using a magnetic stimulator. Previous reports have shown no pre-operative method successful in selecting those patients prone to develop a post-operative palsy. The device, placed beneath the lumbar spine, stimulates the cauda equina; common peroneal nerve function is assessed via the response in extensor digitorum brevis. There is a loss of signal from the nerve with the use of a tourniquet 25 min following its application. The protocol therefore requires that a tourniquet is used at least only for fixation of the prosthetic components. The method is quick, safe, non-invasive and reproducible, and is of use both in at-risk patients and in research work. Images Figure 6. PMID:7837197

Intra-operative multi-site stimulation: Expanding methodology for cortical brain mapping of language functions.

Science.gov (United States)

Gonen, Tal; Gazit, Tomer; Korn, Akiva; Kirschner, Adi; Perry, Daniella; Hendler, Talma; Ram, Zvi

2017-01-01

Direct cortical stimulation (DCS) is considered the gold-standard for functional cortical mapping during awake surgery for brain tumor resection. DCS is performed by stimulating one local cortical area at a time. We present a feasibility study using an intra-operative technique aimed at improving our ability to map brain functions which rely on activity in distributed cortical regions. Following standard DCS, Multi-Site Stimulation (MSS) was performed in 15 patients by applying simultaneous cortical stimulations at multiple locations. Language functioning was chosen as a case-cognitive domain due to its relatively well-known cortical organization. MSS, performed at sites that did not produce disruption when applied in a single stimulation point, revealed additional language dysfunction in 73% of the patients. Functional regions identified by this technique were presumed to be significant to language circuitry and were spared during surgery. No new neurological deficits were observed in any of the patients following surgery. Though the neuro-electrical effects of MSS need further investigation, this feasibility study may provide a first step towards sophistication of intra-operative cortical mapping.

Use of auditory evoked potentials for intra-operative awareness in anesthesia: a consciousness-based conceptual model.

Science.gov (United States)

Dong, Xuebao; Suo, Puxia; Yuan, Xin; Yao, Xuefeng

2015-01-01

Auditory evoked potentials (AEPs) have been used as a measure of the depth of anesthesia during the intra-operative process. AEPs are classically divided, on the basis of their latency, into first, fast, middle, slow, and late components. The use of auditory evoked potential has been advocated for the assessment of Intra-operative awareness (IOA), but has not been considered seriously enough to universalize it. It is because we have not explored enough the impact of auditory perception and auditory processing on the IOA phenomena as well as on the subsequent psychological impact of IOA on the patient. More importantly, we have seldom tried to look at the phenomena of IOP from the perspective of consciousness itself. This perspective is especially important because many of IOA phenomena exist in the subconscious domain than they do in the conscious domain of explicit recall. Two important forms of these subconscious manifestations of IOA are the implicit recall phenomena and post-operative dreams related to the operation. Here, we present an integrated auditory consciousness-based model of IOA. We start with a brief description of auditory awareness and the factors affecting it. Further, we proceed to the evaluation of conscious and subconscious information processing by auditory modality and how they interact during and after intra-operative period. Further, we show that both conscious and subconscious auditory processing affect the IOA experience and both have serious psychological implications on the patient subsequently. These effects could be prevented by using auditory evoked potential during monitoring of anesthesia, especially the mid-latency auditory evoked potentials (MLAERs). To conclude our model with present hypothesis, we propose that the use of auditory evoked potential should be universal with general anesthesia use in order to prevent the occurrences of distressing outcomes resulting from both conscious and subconscious auditory processing during

Analysis of unregulated emissions from an off-road diesel engine during realistic work operations

Science.gov (United States)

Lindgren, Magnus; Arrhenius, Karine; Larsson, Gunnar; Bäfver, Linda; Arvidsson, Hans; Wetterberg, Christian; Hansson, Per-Anders; Rosell, Lars

2011-09-01

Emissions from vehicle diesel engines constitute a considerable share of anthropogenic emissions of pollutants, including many non-regulated compounds such as aromatic hydrocarbons and alkenes. One way to reduce these emissions might be to use fuels with low concentrations of aromatic hydrocarbons, such as Fischer-Tropsch (F-T) diesels. Therefore this study compared Swedish Environmental Class 1 diesel (EC1) with the F-T diesel fuel Ecopar™ in terms of emissions under varied conditions (steady state, controlled transients and realistic work operations) in order to identify factors influencing emissions in actual operation. Using F-T diesel reduced emissions of aromatic hydrocarbons, but not alkenes. Emissions were equally dependent on work operation character (load, engine speed, occurrence of transients) for both fuels. There were indications that the emissions originated from unburnt fuel, rather than from combustion products.

Peri-acetabular radiolucent lines: inter- and intra-observer agreement on post-operative radiographs

OpenAIRE

Kneif, D.; Downing, M.; Ashcroft, G. P.; Gibson, P.; Knight, D.; Ledingham, W.; Hutchison, J.

2005-01-01

Peri-acetabular radiolucent lines (RLLs) seen on “early” post-operative radiographs have been identified as a potential predictor of long-term implant performance. This study examines the inter- and intra-observer variation encountered when assessing such radiographs. Four consultant orthopaedic surgeons assessed the presence, extent and width of RLLs in 220 radiographs performed on 50 patients taken one to two weeks, six weeks, six months and one year following surgery. Inter-observer agreem...

Performance assessment of a micro-cogeneration system under realistic operating conditions

International Nuclear Information System (INIS)

Rosato, Antonio; Sibilio, Sergio

2013-01-01

Highlights: • Performances of a micro-cogeneration system have been experimentally evaluated. • Cogenerator performances have been compared with those of a traditional system. • Measured data have been analyzed from both energy and exergy points of view. - Abstract: The European Parliament stated that high-efficiency cogeneration is a Community priority given the potential benefits of cogeneration with regard to saving primary energy and reducing emissions. According to this position, the performance of many micro-cogeneration systems have been assessed from an energy and environmental point of view. However, in the most part of cases, the assessments have been performed by using technical data from manufacturers and/or experimental results measured during steady-state operation, without considering the inefficiencies related to the transient periods; in addition, few works have been devoted to analyze the system operation from an exergy-based point of view. In this paper the electric load-following operation of an internal combustion engine based micro-cogeneration unit with 6.0 kW as nominal electric output has been experimentally investigated in electric load-following operation during a 24 h dynamic test with the application of a realistic daily load profile representing the Italian domestic non-HVAC electric demand for a multi-family house of five dwellings. The measured data have been compared with those that would be associated with servicing the building with electricity from the central electric grid and heat from a natural gas fired boiler from an energy, exergy and environmental points of view

SU-E-T-285: Revisiting the Nomogram for Intra-Operative Planning Based Pd-103 Brachytherapy

Energy Technology Data Exchange (ETDEWEB)

Narayanan, S; Cho, P [Virginia Mason Medical Center, Seattle, WA (United States)

2014-06-01

Purpose: The seed implant technique at our institution involves using a published nomogram for seed ordering based on CT based volume studies of the prostate. Ultrasound volume studies are subsequently used in the operating room for planning a modified peripheral loading with urethra sparing seed implant. The purpose of this study is to determine the appropriate modality for prostate volume measurement and creating an updated nomogram for intra-operative planning specific to our technique for pd-103 brachytherapy for efficient seed ordering. Methods: Prostate volumes based on pre-implant CT (Pre-CT), intra-operative ultrasound (TRUS), and post-implant CT (post-CT) studies as well as the total airkerma strength (AKS) of the implants were analyzed for 135 seed implant cases (69 monotherapy, 66 boost). Regression analysis was performed to derive the relationship between the total AKS and pre-CT and TRUS volumes. The correlation between TRUS and pre-CT volumes and TRUS and post-CT volumes were also studied. Results: Ultrasound based prostate volume exhibited a stronger correlation with total AKS than the pre-implant CT volume (R{sup 2} = 0.97 vs 0.88 for monotherapy and 0.96 vs 0.89 for boost). In general the pre-CT overestimated the prostate volume leading to ordering of a larger number of seeds and thus leading to higher number of unused/wasted seeds. Newly derived TRUS based nomogram was better suited for our technique than the published data. The post-implant CT volume closely followed the ultrasound volume (R{sup 2} = 0.88) as compared to pre-implant CT volumes (R{sup 2} = 0.57). Conclusion: In an era of costconscious health care where waste reduction is of utmost importance, an updated technique-specific nomogram is useful for ordering optimal number of seeds resulting in significant cost savings. In addition, our study shows that ultrasound based prostate volume is a better predictor for seed ordering for intra-operative planning than pre-implant CT.

Intra-Operative Amylase Concentration in Peri-Pancreatic Fluid Predicts Pancreatic Fistula After Distal Pancreatectomy.

Science.gov (United States)

Nahm, Christopher B; de Reuver, Philip R; Hugh, Thomas J; Pearson, Andrew; Gill, Anthony J; Samra, Jaswinder S; Mittal, Anubhav

2017-06-01

Post-operative pancreatic fistula (POPF) is a potentially severe complication following distal pancreatectomy. The aim of this study was to assess the predictive value of intra-operative amylase concentration (IOAC) in peri-pancreatic fluid after distal pancreatectomy for the diagnosis of POPF. Consecutive patients who underwent a distal pancreatectomy between November 2014 and September 2016 were included in the analysis. IOAC was measured, followed by drain fluid analysis for amylase on post-operative days (PODs) 1, 3, and 5. Receiver operator characteristic (ROC) analysis was performed to evaluate the discriminative capacity of IOAC as a predictor of POPF. IOAC was measured after distal pancreatectomy in 26 patients. The IOAC correlated significantly with (i) PODs 1, 3, and 5 drain amylase (p  1000 experienced a post-operative complication (OR 18.3, 95% CI 2.51-103, p pancreatectomy.

Evaluation of the use of intra-operative radiology for open placement of lag screws for the stabilization of sacroiliac luxation in cats.

Science.gov (United States)

Silveira, Francisco; Quinn, Robert J; Adrian, Anna M; Owen, Martin R; Bush, Mark A

2017-01-16

To assess the effect of intra-operative radiology on the quality of lag screw insertion for the management of sacroiliac joint luxations in cats. In this retrospective single-centre study, the surgical, anaesthetic and imaging records of 40 screws (32 cats) placed with lag effect for management of sacroiliac luxation were reviewed. Postoperative radiographs were assessed for sacroiliac joint reduction, screw position, and sacral width purchased by each screw. Cases were divided into two groups according to the use of (IOR) or the absence of intra-operative radiology (NIOR). A total of 23 lag screws were placed with the aid of intra-operative radiology and 17 without. Three of the 23 screws placed in the IOR group exited the sacrum as opposed to eight of 17 screws in the NIOR group (p = 0.03). Mean sacral width purchased by the screws in the IOR group (70.8%) was also significantly higher (p = 0.002) than in the NIOR group (54.6%). Mean general anaesthetic times for unilateral and bilateral screw placement for the IOR group and NIOR group were not significantly different. The use of intra-operative radiology can significantly improve the quality of lag screw insertion for the stabilization of sacroiliac luxations in cats, which should lead to a reduced incidence of postoperative screw loosening.

An investigation into the causes of unexpected intra-operative transoesophageal echocardiography findings.

Science.gov (United States)

Skinner, H J; Mahmoud, A; Uddin, A; Mathew, T

2012-04-01

There is uncertainty regarding echocardiography before cardiac surgery, especially with regard to timing and disease progression as well as potential errors. We investigated the causes of unexpected intra-operative transoesophageal echocardiography findings by performing a 33-month audit. We found that there were 50/797 (6%) unexpected findings that led to an alteration in surgical strategy in 34 (4%) patients. Of the unexpected findings, 25 (50%) were unrelated to pre-operative pathology. After reviewing pre-operative studies and reports, unexpected findings were found to be due to: reporting errors in 20 patients (44%); limitations in transthoracic compared to transoesophageal echocardiography in 14 patients (30%); disease progression in 10 patients (22%); and inter-observer variability in two patients (4%). We identified six reports out of 797 (0.8%) that contained potentially serious errors. Surgical management changed in 18/20 (90%) patients in whom the unexpected change was due to reporting error, compared to 16/30 (53%) patients whose pre-operative echocardiogram was correctly reported (p = 0.006). Our study suggests that pre-operative echocardiography reporting errors are common and important. Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland.

Operative treatment of intra-articular calcaneal fractures with calcaneal plates and its complications

Directory of Open Access Journals (Sweden)

Rak Vaclav

2009-01-01

Full Text Available Background: In a retrospective study we analysed intra-articular calcaneal fracture treatment by comparing results and complications related to fracture stabilization with nonlocking calcaneal plates and locking compression plates. Materials and Methods: We performed 76 osteosynthesis (67 patients of intra-articular calcaneal fractures using the standard extended lateral approach from February 2004 to October 2007. Forty-two operations using nonlocking calcaneal plates (group A were performed during the first three years, and 34 calcaneal fractures were stabilized using locking compression plates (group B in 2007. In the Sanders type IV fractures, reconstruction of the calcaneal shape was attempted. Depending on the type of late complication, we performed subtalar arthroscopy in six cases, arthroscopically assisted subtalar distraction bone block arthrodesis in six cases, and plate removal with lateral-wall decompression in five cases. The patients were evaluated by the AOFAS Ankle-Hindfoot Scale. Results: Wound healing complications were 7/42 (17% in group A and 1/34 (3% in group B. No patient had deep osseous infection or foot rebound compartment syndrome. Preoperative size of Bφhler´s angle correlated with postoperative clinical results in both groups. There were no late complications necessitating corrective procedure or arthroscopy until December 2008 in Group B. All late complications ccurred in Group A. The overall results according to the AOFAS Ankle Hindfoot Scale were good or excellent in 23/42 (55% in group A and in 30/34 (85% in group B. Conclusion: Open reduction and internal fixation of intra-articular calcaneal fractures has become a standard surgical method. Fewer complications and better results related to treatment with locking compression plates confirmed in comparison to nonlocking ones were noted for all Sanders types of intra-articular calcaneal fractures. Age and Sanders type IV fractures are not considered to be the

Intra-operative radiation therapy in cancer of the pancreas

International Nuclear Information System (INIS)

Dubois, J.B.; Gu, S.D.; Saint-Aubert, B.; Joyeux, H.; Solassol, C.; Pujol, H.

1991-01-01

We report our experience concerning 22 pancreatic carcinoma bearing patients treated with intra-operative radiation therapy (IORT) after complete surgical excision: duodenopancreatectomy: 15 patients; isthmic and caudal pancreatectomy: 2 patients; total pancreatectomy: 5 patients. The dose delivered to the tumor bed was 20 Gy in 12 patients, 18 Gy in 3 patients and 15 Gy in 7 patients. Three patients died within the 1st month post-surgery from intercurrent diseases. Post-operative morbidity was not significantly modified by IORT as compared to purely surgical treated patients. Out of 19 evaluable patients, we observed local control in 16 patients (79.4%). Causes of death (15/19 patients) were: distant metastases with local control: 7 patients; in situ local failure: 3 patients; regional recurrence outside of the IORT fields: 2 patients; intercurrent diseases: 3 patients. Four patients are still alive without evolutive disease. The median overall survival is 6 months. The mean overall survival is 10.56 months. Excluding patients who died from complications and intercurrent diseases, the median survival is 10 mths and the mean survival 14.5 mths. These results emphasize the improvement in local control with IORT, but without significant improvement in survival which is dependent on local evolution and also systemic disease [fr

Intra-operative cerebrospinal fluid sampling versus post-operative lumbar puncture for detection of leptomeningeal disease in malignant paediatric brain tumours.

Directory of Open Access Journals (Sweden)

Sharon Y Y Low

Full Text Available Leptomeningeal disease is a feared sequelae of malignant paediatric brain tumours. Current methods for its detection is the combined use of cranio-spinal MRI, and CSF cytology from a post-operative lumbar puncture. In this study, the authors hypothesize that CSF taken at the start of surgery, either from an external ventricular drain or neuroendoscope will have equal sensitivity for positive tumour cells, in comparison to lumbar puncture. Secondary hypotheses include positive correlation between CSF cytology and MRI findings of LMD. From a clinical perspective, the key aim of the study was for affected paediatric patients to avoid an additional procedure of a lumbar puncture, often performed under anaesthesia after neurosurgical intervention.This is single-institution, retrospective study of paediatric patients diagnosed with malignant brain tumours. Its main aim was to compare cytological data from CSF collected at the time of surgery versus data from an interval lumbar puncture. In addition, MRI imaging of the same cohort of patients was examined for leptomeningeal disease and corroborated against CSF tumour cytology findings.Thirty patients are recruited for this study. Data analysis demonstrates a statistically significant association between our intra-operative CSF and LP sampling. Furthermore, our results also show for significant correlation between evidence of leptomeningeal disease on MRI findings versus intra-operative CSF positivity for tumour cells.Although this is a retrospective study with a limited population, our data concurs with potential to avoid an additional procedure for the paediatric patient diagnosed with a malignant brain tumour.

Intra and post-operative complications of esophageal achalasia.

Science.gov (United States)

Pugliese, Luigi; Peri, Andrea; Tinozzi, Francesco Paolo; Zonta, Sandro; di Stefano, Michele; Meloni, Federica; Pietrabissa, Andrea

2013-01-01

To evaluate and discuss all the potential complications affecting morbidity of patients treated with surgery for primary achalasia. A review of the available English literature published to date has been conducted. All articles reporting surgical experience in achalasia were examined and then were selected only those specifically inherent to the topic at issue. Mucosal perforation is the main intra-operative complication while persistence or recurrence of the disease and gastro-esophageal reflux are those mostly affecting patients afterwards, even at long-term follow-up. A few other less common morbidities, as well as the technical considerations useful to minimize and manage each complication mentioned, are reported. Minimally invasive surgery for achalasia consent to treat patients with a low rate of perioperative complications that can be managed with conservative approach in the majority of cases. Risk of esophageal cancer exists in these patients and remains although surgical therapy. Laparoscopic Heller myotomy along with partial fundoplication is a safe and effective procedure that should be considered as the treatment of choice at first evaluation of achalasic patients rather than endoscopic techniques. Robotic technology may add further contribution in diminishing perioperative complications.

Intra-operative probe for brain cancer: feasibility study

Science.gov (United States)

Vu Thi, M. H.; Charon, Y.; Duval, M. A.; Lefebvre, F.; Menard, L.; Pitre, S.; Pinot, L.; Siebert, R.

2007-07-01

The present work aims a new medical probe for surgeons devoted to brain cancers, in particular glioblastoma multiforme. Within the last years, our group has started the development of a new intra-operative beta imaging probe. More recently, we took an alternative approach for the same application: a fluorescence probe. In both cases the purpose is to differentiate normal from tumor brain tissue. In a first step, we developed set-ups capable to measure autofluorescence. They are based on a dedicated epi-fluorescence design and on specific fiber optic probes. Relative signal amplitude, spectral shape and fluorescence lifetime measurements are foreseen to distinguish normal and cancer tissue by analyzing fluorophores like NADH, lipopigments and porphyrines. The autofluorescence spectra are recorded in the 460-640 nm range with a low resolution spectrometer. For lifetime measurements a fast detector (APD) is used together with a TCSPC-carte. Intrinsic wavelength- and time-resolutions are a few nm and 200 ps, respectively. Different samples have been analyzed to validate our new detection system and to allow a first configuration of our medical fluorescence probe. First results from the tissue measurements are shown.

Fracture Surgery of the extremities with the intra-operative use of 3D-RX: A randomized multicenter trial (EF3X-trial

Directory of Open Access Journals (Sweden)

Marmor Meir

2011-07-01

Full Text Available Abstract Background Posttraumatic osteoarthritis can develop after an intra-articular extremity fracture, leading to pain and loss of function. According to international guidelines, anatomical reduction and fixation are the basis for an optimal functional result. In order to achieve this during fracture surgery, an optimal view on the position of the bone fragments and fixation material is a necessity. The currently used 2D-fluoroscopy does not provide sufficient insight, in particular in cases with complex anatomy or subtle injury, and even an 18-26% suboptimal fracture reduction is reported for the ankle and foot. More intra-operative information is therefore needed. Recently the 3D-RX-system was developed, which provides conventional 2D-fluoroscopic images as well as a 3D-reconstruction of bony structures. This modality provides more information, which consequently leads to extra corrections in 18-30% of the fracture operations. However, the effect of the extra corrections on the quality of the anatomical fracture reduction and fixation as well as on patient relevant outcomes has never been investigated. The objective of this study protocol is to investigate the effectiveness of the intra-operative use of the 3D-RX-system as compared to the conventional 2D-fluoroscopy in patients with traumatic intra-articular fractures of the wrist, ankle and calcaneus. The effectiveness will be assessed in two different areas: 1 the quality of fracture reduction and fixation, based on the current golden standard, Computed Tomography. 2 The patient-relevant outcomes like functional outcome range of motion and pain. In addition, the diagnostic accuracy of the 3D-RX-scan will be determined in a clinical setting and a cost-effectiveness as well as a cost-utility analysis will be performed. Methods/design In this protocol for an international multicenter randomized clinical trial, adult patients (age > 17 years with a traumatic intra-articular fracture of the

Framework for a low-cost intra-operative image-guided neuronavigator including brain shift compensation.

Science.gov (United States)

Bucki, M; Lobos, C; Payan, Y

2007-01-01

In this paper we present a methodology to address the problem of brain tissue deformation referred to as 'brain-shift'. This deformation occurs throughout a neurosurgery intervention and strongly alters the accuracy of the neuronavigation systems used to date in clinical routine which rely solely on pre-operative patient imaging to locate the surgical target, such as a tumour or a functional area. After a general description of the framework of our intra-operative image-guided system, we describe a procedure to generate patient specific finite element meshes of the brain and propose a biomechanical model which can take into account tissue deformations and surgical procedures that modify the brain structure, like tumour or tissue resection.

A standardized and safe method of sterile field maintenance during intra-operative horizontal plane fluoroscopy

Directory of Open Access Journals (Sweden)

Kaska Serge C

2010-12-01

Full Text Available Abstract Background Intra-operative fluoroscopy for orthopaedic procedures frequently involves imaging in the horizontal plane, which requires the lower portion of the C-arm (x-ray tube to be rotated from an unsterile zone (beneath the table into the sterile field. To protect the integrity of the sterile field the C-arm must be draped repeatedly throughout the surgical case. The current, un-standardized, practice employs draping procedures which violate the Association of peri-Operative Registered Nurses (AORN Standards and Recommended Practices, waste time and material, and pose an increased risk for surgical site infection. Presentation of the hypothesis Use of a novel sterile C-arm drape (C-armor that maintains the integrity of the sterile field, will improve operating room efficiency and reduce surgical site infection risk factors. This reduction in risk factors may potentially reduce surgical site infections in orthopaedic surgical cases requiring repeated horizontal x-ray imaging. Testing the Hypothesis Savings in time and material and the reduction in surgical site infection risk factors afforded by using C-armor are intuitive to those skilled in the practice of orthopaedic surgery. Testing for a reduction in the number of microorganisms introduced to the surgical site by improved C-arm draping would be challenging due to the multiple confounding factors during a surgical operation. Determination of an absolute reduction in surgical site infections may be possible, but will require accounting for many confounding variables and a large study sample in order to achieve statistical significance. Implications of the Hypothesis Improved intraoperative workflow, healthcare savings and a reduction in surgical site infection risk factors will be achieved by utilizing a standardized and safe method of sterile field maintenance during intra-operative horizontal plane fluoroscopy.

SU-F-T-80: A Mobile Application for Intra-Operative Electron Radiotherapy Treatment Planning

International Nuclear Information System (INIS)

Williams, C; Crowley, E; Wolfgang, J

2016-01-01

Purpose: Intraoperative electron radiotherapy (IORT) poses a unique set of challenges for treatment planning. Planning must be performed in a busy operating room environment over a short timeframe often with little advance knowledge of the treatment depth or applicator size. Furthermore, IORT accelerators can have a large number of possible applicators, requiring extensive databooks that must be searched for the appropriate dosimetric parameters. The goal of this work is to develop a software tool to assist in the planning process that is suited to the challenges faced in the IORT environment. Methods: We developed a mobile application using HTML5 and Javascript that can be deployed to tablet devices suitable for use in the operating room. The user selects the desired treatment parameters cone diameter, bevel angle, and energy (a total of 141 datasets) and desired bolus. The application generates an interactive display that allows the user to dynamically select points on the depth-dose curve and to visualize the shape of the corresponding isodose contours. The user can indicate a prescription isodose line or depth. The software performs a monitor unit calculation and generates a PDF report. Results: We present our application, which is now used routinely in our IORT practice. It has been employed successfully in over 23 cases. The interactivity of the isodose distributions was found to be of particular use to physicians who are less-frequent IORT users, as well as for the education of residents and trainees. Conclusion: This software has served as a useful tool in IORT planning, and demonstrates the need for treatment planning tools that are designed for the specialized challenges encountered in IORT. This software is the subject of a license agreement with the IntraOp Medical Corporation. This software is the subject of a license agreement between Massachusetts General Hospital / Partners Healthcare and the IntraOp Medical Corporation. CLW is consulting on

SU-F-T-80: A Mobile Application for Intra-Operative Electron Radiotherapy Treatment Planning

Energy Technology Data Exchange (ETDEWEB)

Williams, C [Brigham and Women’s Hospital & Dana Farber Cancer Institute, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Crowley, E; Wolfgang, J [Harvard Medical School, Boston, MA (United States); Massachusetts General Hospital, Boston, MA (United States)

2016-06-15

Purpose: Intraoperative electron radiotherapy (IORT) poses a unique set of challenges for treatment planning. Planning must be performed in a busy operating room environment over a short timeframe often with little advance knowledge of the treatment depth or applicator size. Furthermore, IORT accelerators can have a large number of possible applicators, requiring extensive databooks that must be searched for the appropriate dosimetric parameters. The goal of this work is to develop a software tool to assist in the planning process that is suited to the challenges faced in the IORT environment. Methods: We developed a mobile application using HTML5 and Javascript that can be deployed to tablet devices suitable for use in the operating room. The user selects the desired treatment parameters cone diameter, bevel angle, and energy (a total of 141 datasets) and desired bolus. The application generates an interactive display that allows the user to dynamically select points on the depth-dose curve and to visualize the shape of the corresponding isodose contours. The user can indicate a prescription isodose line or depth. The software performs a monitor unit calculation and generates a PDF report. Results: We present our application, which is now used routinely in our IORT practice. It has been employed successfully in over 23 cases. The interactivity of the isodose distributions was found to be of particular use to physicians who are less-frequent IORT users, as well as for the education of residents and trainees. Conclusion: This software has served as a useful tool in IORT planning, and demonstrates the need for treatment planning tools that are designed for the specialized challenges encountered in IORT. This software is the subject of a license agreement with the IntraOp Medical Corporation. This software is the subject of a license agreement between Massachusetts General Hospital / Partners Healthcare and the IntraOp Medical Corporation. CLW is consulting on

Intra-operative ultrasound-based augmented reality guidance for laparoscopic surgery.

Science.gov (United States)

Singla, Rohit; Edgcumbe, Philip; Pratt, Philip; Nguan, Christopher; Rohling, Robert

2017-10-01

In laparoscopic surgery, the surgeon must operate with a limited field of view and reduced depth perception. This makes spatial understanding of critical structures difficult, such as an endophytic tumour in a partial nephrectomy. Such tumours yield a high complication rate of 47%, and excising them increases the risk of cutting into the kidney's collecting system. To overcome these challenges, an augmented reality guidance system is proposed. Using intra-operative ultrasound, a single navigation aid, and surgical instrument tracking, four augmentations of guidance information are provided during tumour excision. Qualitative and quantitative system benefits are measured in simulated robot-assisted partial nephrectomies. Robot-to-camera calibration achieved a total registration error of 1.0 ± 0.4 mm while the total system error is 2.5 ± 0.5 mm. The system significantly reduced healthy tissue excised from an average (±standard deviation) of 30.6 ± 5.5 to 17.5 ± 2.4 cm 3 ( p < 0.05) and reduced the depth from the tumor underside to cut from an average (±standard deviation) of 10.2 ± 4.1 to 3.3 ± 2.3 mm ( p < 0.05). Further evaluation is required in vivo, but the system has promising potential to reduce the amount of healthy parenchymal tissue excised.

Intra-operative X-ray diagnostics in the detection and localization of residual concretions in the kidney

International Nuclear Information System (INIS)

Soekeland, J.; Degenhardt, W.

1979-01-01

Problems of intra-operative X-ray diagnostics in the detection and localization of residual concretions in the kidney are discussed, together with the limitations of image-intensifier techniques, automatic exposure control, and the use of modified dental X-ray equipment. A technique using a film-screen combination and X-ray tube designed for mammography is discussed, together with its applications and possible future development. (Auth.)

The effect of post-traumatic-stress-disorder on intra-operative analgesia in a veteran population during cataract procedures carried out using retrobulbar or topical anesthesia: a retrospective study.

Science.gov (United States)

Rapoport, Yuna; Wayman, Laura L; Chomsky, Amy S

2017-06-07

A growing proportion of veterans treated at the Veterans Health Administration (VA) have a history of post-traumatic-stress-disorder (PTSD), and there exists a higher rate of PTSD amongst veterans than the general population. The purpose of this study is to determine the correlation between PTSD and intra-operative analgesia, intra-operative time, and anesthesia type for cataract surgery in a veteran population. Secondary objectives are to determine if patient age, and first or second eye surgery affect intra-operative pain control or are correlated with type of anesthesia modality. A retrospective study of 330 cataract surgeries performed by resident physicians between January and September 2012 at the Veterans Affairs Medical Center Tennessee Valley Healthcare System, Nashville and Murfreesboro Campuses was completed. Three hundred and thirty veteran patients were selected if their cataract surgery was performed between January and September 2012. Combined cases were excluded. The primary outcome evaluated was intra-operative analgesia. Secondary outcomes included history of post-traumatic-stress-disorder, anesthesia type, first or second eye, pain control, intra-operative heart rate and blood pressure, age, and case complexity. Data was analyzed using an unpaired two-sample Welch's t-test assuming unequal variance and Z test of comparison of proportions. Patients with post-traumatic-stress-disorder reported higher pain scores, had longer operative times, and were more likely to have received a retrobulbar block. Operative time was not associated with an increased pain score, irrespective of anesthesia type, when controlled for PTSD. Complex cases had longer operative times, more sedation, and higher pain scores. P < 0.05 was used consistently. Post-traumatic stress disorder and anxiety are more prevalent in the veteran population. Our data suggests that a history of post-traumatic-stress-disorder was correlated with higher pain scores, longer operative times

Intra-operative ultrasound hand-held strain imaging for the visualization of ablations produced in the liver with a toroidal HIFU transducer: first in vivo results

Energy Technology Data Exchange (ETDEWEB)

Chenot, J; Melodelima, D; N' Djin, W A; Souchon, Remi; Rivoire, M; Chapelon, J Y, E-mail: jeremy.chenot@inserm.f [Inserm, U556, Lyon, F-69003 (France)

2010-06-07

The use of hand-held ultrasound strain imaging for the intra-operative real-time visualization of HIFU (high-intensity focused ultrasound) ablations produced in the liver by a toroidal transducer was investigated. A linear 12 MHz ultrasound imaging probe was used to obtain radiofrequency signals. Using a fast cross-correlation algorithm, strain images were calculated and displayed at 60 frames s{sup -1}, allowing the use of hand-held strain imaging intra-operatively. Fourteen HIFU lesions were produced in four pigs. Intra-operative strain imaging of HIFU ablations in the liver was feasible owing to the high frame rate. The correlation between dimensions measured on gross pathology and dimensions measured on B-mode images and on strain images were R = 0.72 and R = 0.94 respectively. The contrast between ablated and non-ablated tissue was significantly higher (p < 0.05) in the strain images (22 dB) than in the B-mode images (9 dB). Strain images allowed equivalent or improved definition of ablated regions when compared with B-mode images. Real-time intra-operative hand-held strain imaging seems to be a promising complement to conventional B-mode imaging for the guidance of HIFU ablations produced in the liver during an open procedure. These results support that hand-held strain imaging outperforms conventional B-mode ultrasound and could potentially be used for the assessment of thermal therapies.

Radio-guided surgery with the use of [99mTc-EDDA/HYNIC]octreotate in intra-operative detection of neuroendocrine tumours of the gastrointestinal tract.

Science.gov (United States)

Hubalewska-Dydejczyk, A; Kulig, J; Szybinski, P; Mikolajczak, R; Pach, D; Sowa-Staszczak, A; Fröss-Baron, K; Huszno, B

2007-10-01

Radio-guided surgery (RGS) is an intra-operative localising technique which enables identification of tissue "marked" by a specific radiotracer injected before surgery. It is mainly used for sentinel node mapping and for detection of parathyroid adenomas and other tumours, including neuroendocrine tumours of the gastrointestinal tract (GEP-NET). The aim of this study was to determine whether intra-operative radio-detection with the use of [(99m)Tc-EDDA/HYNIC]octreotate, a new somatostatin analogue, is able to reveal an unknown primary and secondary sites, thereby improving surgical treatment and the final outcome of GEP-NET. The study group included nine patients with suspected GEP-NET (four carcinoids, five pancreatic NET) localised with somatostatin receptor scintigraphy (with [(99m)Tc-EDDA/HYNIC]octreotate), who had negative results on other pre-operative imaging tests. At surgery, suspected tumours were measured in situ and ex vivo and precise exploration of the abdominal cavity was performed with the intra-operative scintillation detector (Navigator). Intra-operative gamma counting localised three carcinoids. In one patient SRS was false positive (owing to inflammatory infiltration). Compared with SRS, RGS revealed additional lymph node metastases in one case. RGS resulted in successful localisation of all pancreatic NET (the smallest lesion was 8 mm in diameter). [(99m)Tc-EDDA/HYNIC]octreotate SRS followed by RGS is a promising technique to improve the rate of detection and efficacy of treatment of GEP-NET, especially in the presence of occult endocrine tumours. The imaging properties of [(99m)Tc-EDDA/HYNIC]octreotate and the 1-day imaging protocol offer opportunities for more widespread application of this tracer followed by RGS in oncology.

Radio-guided surgery with the use of [99mTc-EDDA/HYNIC]octreotate in intra-operative detection of neuroendocrine tumours of the gastrointestinal tract

International Nuclear Information System (INIS)

Hubalewska-Dydejczyk, A.; Kulig, J.; Szybinski, P.; Mikolajczak, R.; Pach, D.; Sowa-Staszczak, A.; Froess-Baron, K.; Huszno, B.

2007-01-01

Radio-guided surgery (RGS) is an intra-operative localising technique which enables identification of tissue ''marked'' by a specific radiotracer injected before surgery. It is mainly used for sentinel node mapping and for detection of parathyroid adenomas and other tumours, including neuroendocrine tumours of the gastrointestinal tract (GEP-NET). The aim of this study was to determine whether intra-operative radio-detection with the use of [ 99m Tc-EDDA/HYNIC]octreotate, a new somatostatin analogue, is able to reveal an unknown primary and secondary sites, thereby improving surgical treatment and the final outcome of GEP-NET. The study group included nine patients with suspected GEP-NET (four carcinoids, five pancreatic NET) localised with somatostatin receptor scintigraphy (with [ 99m Tc-EDDA/HYNIC]octreotate), who had negative results on other pre-operative imaging tests. At surgery, suspected tumours were measured in situ and ex vivo and precise exploration of the abdominal cavity was performed with the intra-operative scintillation detector (Navigator). Intra-operative gamma counting localised three carcinoids. In one patient SRS was false positive (owing to inflammatory infiltration). Compared with SRS, RGS revealed additional lymph node metastases in one case. RGS resulted in successful localisation of all pancreatic NET (the smallest lesion was 8 mm in diameter). [ 99m Tc-EDDA/HYNIC]octreotate SRS followed by RGS is a promising technique to improve the rate of detection and efficacy of treatment of GEP-NET, especially in the presence of occult endocrine tumours. The imaging properties of [ 99m Tc-EDDA/HYNIC]octreotate and the 1-day imaging protocol offer opportunities for more widespread application of this tracer followed by RGS in oncology. (orig.)

Intra-operative cone beam computed tomography can help avoid reinterventions and reduce CT follow up after infrarenal EVAR.

Science.gov (United States)

Törnqvist, P; Dias, N; Sonesson, B; Kristmundsson, T; Resch, T

2015-04-01

Re-interventions after endovascular abdominal aortic aneurysm repair (EVAR) are common and therefore a strict imaging follow up protocol is required. The purpose of this study was to evaluate whether cone beam computed tomography (CBCT) can detect intra-operative complications and to compare this with angiography and the 1 month CT follow up (computed tomography angiography [CTA]). Fifty-one patients (44 men) were enrolled in a prospective trial. Patients underwent completion angiography and CBCT during infrarenal EVAR. Contrast was used except when pre-operative renal insufficiency was present or if the maximum contrast dose threshold was reached. CBCT reconstruction included the top of the stent graft to the iliac bifurcation. Endoleaks, kinks, or compressions were recorded. CBCT was technically successful in all patients. Twelve endoleaks were detected on completion digital subtraction angiography (CA). CBCT detected 4/5 type 1 endoleaks, but only one type 2 endoleak. CTA identified eight type 2 endoleaks and one residual type I endoleak. Two cases of stent compression were seen on CA. CBCT revealed five stent compressions and one kink, which resulted in four intra-operative adjunctive manoeuvres. CTA identified all cases of kinks or compressions that were left untreated. Two of them were corrected later. No additional kinks/compressions were found on CTA. Groin closure consisted of 78 fascia sutures, nine cut downs, and 11 percutaneous sutures. Seven femoral artery pseudoaneurysms (<1 cm) were detected on CTA, but no intervention was needed. CA is better than CBCT in detecting and categorizing endoleaks but CBCT (with or without contrast) is better than CA for detection of kinks or stentgraft compression. CTA plus CBCT identified all significant complications noted on the 1 month follow up CTA. The use of intra-operative CA and CBCT could replace early CTA after standard EVAR thus reducing overall radiation and contrast use. Technical development might further

TAX TREATMENT SPECIFIC TO INTRA COMMUNITY COMMERCIAL BUSINESS TRANSACTIONS - ACQUISITION AND INTRA-COMMUNITY SUPPLY OF GOODS

Directory of Open Access Journals (Sweden)

Paliu -Popa Lucia

2009-11-01

Full Text Available Romania's accession to the European Union has imposed harmonize national legislation with Community law, registering significant changes in the tax area, particularly on value added tax. In order to determine the person liable to pay value added tax, related to intra-community commercial transactions, must to clarify tax matters for those operations. Given the complexity of intra-community commercial transactions and their taxation, in the following issues we will address the intra-community trade in goods, with reference to specific tax treatment of supplies and intra-community acquisitions of goods. To do this we will consider more specific situations that arise in trade relationship between EU Member States, examples that will allow us to draw some conclusions on tax matters arising in intracommunity commercial relationship

Potential predictors for the amount of intra-operative brain shift during deep brain stimulation surgery

Science.gov (United States)

Datteri, Ryan; Pallavaram, Srivatsan; Konrad, Peter E.; Neimat, Joseph S.; D'Haese, Pierre-François; Dawant, Benoit M.

2011-03-01

A number of groups have reported on the occurrence of intra-operative brain shift during deep brain stimulation (DBS) surgery. This has a number of implications for the procedure including an increased chance of intra-cranial bleeding and complications due to the need for more exploratory electrodes to account for the brain shift. It has been reported that the amount of pneumocephalus or air invasion into the cranial cavity due to the opening of the dura correlates with intraoperative brain shift. Therefore, pre-operatively predicting the amount of pneumocephalus expected during surgery is of interest toward accounting for brain shift. In this study, we used 64 DBS patients who received bilateral electrode implantations and had a post-operative CT scan acquired immediately after surgery (CT-PI). For each patient, the volumes of the pneumocephalus, left ventricle, right ventricle, third ventricle, white matter, grey matter, and cerebral spinal fluid were calculated. The pneumocephalus was calculated from the CT-PI utilizing a region growing technique that was initialized with an atlas-based image registration method. A multi-atlas-based image segmentation method was used to segment out the ventricles of each patient. The Statistical Parametric Mapping (SPM) software package was utilized to calculate the volumes of the cerebral spinal fluid (CSF), white matter and grey matter. The volume of individual structures had a moderate correlation with pneumocephalus. Utilizing a multi-linear regression between the volume of the pneumocephalus and the statistically relevant individual structures a Pearson's coefficient of r = 0.4123 (p = 0.0103) was found. This study shows preliminary results that could be used to develop a method to predict the amount of pneumocephalus ahead of the surgery.

Iterated interactions method. Realistic NN potential

International Nuclear Information System (INIS)

Gorbatov, A.M.; Skopich, V.L.; Kolganova, E.A.

1991-01-01

The method of iterated potential is tested in the case of realistic fermionic systems. As a base for comparison calculations of the 16 O system (using various versions of realistic NN potentials) by means of the angular potential-function method as well as operators of pairing correlation were used. The convergence of genealogical series is studied for the central Malfliet-Tjon potential. In addition the mathematical technique of microscopical calculations is improved: new equations for correlators in odd states are suggested and the technique of leading terms was applied for the first time to calculations of heavy p-shell nuclei in the basis of angular potential functions

Any realistic theory must be computationally realistic: a response to N. Gisin's definition of a Realistic Physics Theory

OpenAIRE

Bolotin, Arkady

2014-01-01

It is argued that the recent definition of a realistic physics theory by N. Gisin cannot be considered comprehensive unless it is supplemented with requirement that any realistic theory must be computationally realistic as well.

Analysis of radiation risk to patients from intra-operative use of the mobile X-ray system (C-arm

Directory of Open Access Journals (Sweden)

Yang-Sub Lee

2015-01-01

Full Text Available Background: The aim of this study was to investigate clinical applications of mobile C-arms and consequent radiation risk, to increase medical attention on radiation protection, and to provide basic data for safe radiation use in the operating room. Materials and Methods: In this study, a total of 374 surgical operations, conducted using a portable fluoroscopic X-ray system from January to March of 2013, were analyzed. Dose summaries produced by the General Electric C-arm and data elements in digital imaging and communications in the medicine header of Ziehm C-arm, fluoroscopy time were used to obtain dose-area product (DAP and effective dose. Corresponding mean and maximum values were calculated, and the resulting data on the frequency of application, fluoroscopy time, DAP, and effective dose were compared and analyzed in terms of surgical specialty and operation types. Results: Orthopedic surgery was the most frequent with 165 cases (44.1%. The highest DAP value and effective dose were found in liver transplant among surgical specialty fields, with mean values of 2.90 ± 3.76 mGy∙m 2 and 58 ± 75.2 mSv, respectively (P = 0.0001. The highest DAP value and effective dose were observed in intra-operative mesenteric portography among types of surgery, showing mean values of 2.90 ± 3.81 mGy∙m 2 and 58.03 ± 76.24 mSv, respectively (P = 0.0001. Conclusion: Because DAP varies significantly across surgical specialties and types of operation, aggressive efforts to understand the effects of radiation dose is critical for radiation protection from intra-operative use of mobile C-arms.

INTRA graphical package - INTRA-Graph 1.0

International Nuclear Information System (INIS)

Hofman, D.; Edlund, O.

2001-04-01

INTRA-Graph 1.0 has been developed at Studsvik Eco and Safety AB in the frame of the European Fusion Technology Programme for application in the safety analysis using the INTRA code. INTRA-Graph 1.0 is a graphical package producing 2-dimensional plots of results generated by the INTRA code. INTRA-Graph 1.0 has been developed by extending the Grace package source code, distributed under the terms of GNU General Public License. The changes in the Grace source files are limited to provide easy updates of the INTRA-Graph when a new version of Grace will be released. The INTRA-related functionality has been implemented in new source files. The present report describes and gives complete listing of these files. The changes in the Grace source files are also described and the listing of the changed parts of the files is presented. The report gives detailed explanations and examples of files required for installation and configuration of INTRA-Graph on the different types of Unix workstations

Optimizing Wind And Hydropower Generation Within Realistic Reservoir Operating Policy

Science.gov (United States)

Magee, T. M.; Clement, M. A.; Zagona, E. A.

2012-12-01

Previous studies have evaluated the benefits of utilizing the flexibility of hydropower systems to balance the variability and uncertainty of wind generation. However, previous hydropower and wind coordination studies have simplified non-power constraints on reservoir systems. For example, some studies have only included hydropower constraints on minimum and maximum storage volumes and minimum and maximum plant discharges. The methodology presented here utilizes the pre-emptive linear goal programming optimization solver in RiverWare to model hydropower operations with a set of prioritized policy constraints and objectives based on realistic policies that govern the operation of actual hydropower systems, including licensing constraints, environmental constraints, water management and power objectives. This approach accounts for the fact that not all policy constraints are of equal importance. For example target environmental flow levels may not be satisfied if it would require violating license minimum or maximum storages (pool elevations), but environmental flow constraints will be satisfied before optimizing power generation. Additionally, this work not only models the economic value of energy from the combined hydropower and wind system, it also captures the economic value of ancillary services provided by the hydropower resources. It is recognized that the increased variability and uncertainty inherent with increased wind penetration levels requires an increase in ancillary services. In regions with liberalized markets for ancillary services, a significant portion of hydropower revenue can result from providing ancillary services. Thus, ancillary services should be accounted for when determining the total value of a hydropower system integrated with wind generation. This research shows that the end value of integrated hydropower and wind generation is dependent on a number of factors that can vary by location. Wind factors include wind penetration level

Intra-active subject formation – with friends and violent video games

DEFF Research Database (Denmark)

Søndergaard, Dorte Marie

Violent videogames and their implications for children’s and youth’s subject formation have engaged researchers and educational professionals for many years. In a study on bullying, I asked: Why does online violent gaming become so attractive to children and youth positioned in schools saturated...... with bullying practices? How do they encounter and develop this relevance together? I will discuss the potentials and limitations in an agential realist approach to analyses rooted in these questions, and argue that although agential realist conceptualizations of diffraction and material-discursive intra......-activity promise a strong potential re. attention to complexity, in order to be helpful the concepts need further diffractive readings with theories that offer refined understandings of subject formation. And – that the science-approach of agential realisme, in relation to analyses of ethnographic material, must...

Factors impacting short and long-term kidney graft survival: modification by single intra-operative -high-dose induction with ATG-Fresenius.

Science.gov (United States)

Kaden, Jürgen; May, Gottfried; Völp, Andreas; Wesslau, Claus

2011-01-01

A majority of recipients benefited from the intra-operative single high-dose induction (HDI) with ATG-Fresenius (ATG-F) still leaving a group of recipients who did not profit from this kind of induction. Therefore the aim of this retrospective analysis was 1st to identify the risk factors impacting short and long-term graft survival, and 2nd to assess the efficacy of this type of induction in kidney graft recipients with or without these risk factors. A total of 606 recipients receiving two different immunosuppressive treatment regimens (1st: Triple drug therapy [TDT, n=196] consisting mainly of steroids, azathioprine and cyclosporine; 2nd: TDT + 9 mg/kg ATG-F intra-operatively [HDI, n=410]) were included in this analysis and grouped according to their kidney graft survival time (short GST: ≤1 yr, n=100 and long GST: >5 yrs, n=506). The main risk factors associated with a shortened graft survival were pre-transplant sensitization, re-transplantation, rejections (in particular vascular or mixed ones) and the necessity of a long-term anti-rejection therapy. Adding ATG-F single high dose induction to TDT was more efficient in prolonging kidney graft survival than TDT alone not only in recipients without any risk factors (p<0.005) but also in recipients with at least one risk factor (p<0.021). Only in 4.6% of recipients having two or more risk factors this effect could not be demonstrated. The intra-operative single high-dose induction with ATG-F significantly improves the kidney graft survival in recipients with or without risk factors and can therefore be recommended.

The unsuspected prosthetic joint infection : incidence and consequences of positive intra-operative cultures in presumed aseptic knee and hip revisions.

Science.gov (United States)

Jacobs, A M E; Bénard, M; Meis, J F; van Hellemondt, G; Goosen, J H M

2017-11-01

Positive cultures are not uncommon in cases of revision total knee and hip arthroplasty (TKA and THA) for presumed aseptic causes. The purpose of this study was to assess the incidence of positive intra-operative cultures in presumed aseptic revision of TKA and THA, and to determine whether the presence of intra-operative positive cultures results in inferior survival in such cases. A retrospective cohort study was assembled with 679 patients undergoing revision knee (340 cases) or hip arthroplasty (339 cases) for presumed aseptic causes. For all patients three or more separate intra-operative cultures were obtained. Patients were diagnosed with a previously unsuspected prosthetic joint infection (PJI) if two or more cultures were positive with the same organism. Records were reviewed for demographic details, pre-operative laboratory results and culture results. The primary outcome measure was infection-free implant survival at two years. The incidence of unsuspected PJI was 27 out of 340 (7.9%) in TKA and 41 out of 339 (12.1%) in THA. Following revision TKA, the rate of infection-free implant survival in patients with an unsuspected PJI was 88% (95% confidence intervals (CI) 60 to 97) at two years compared with 98% (95% CI 94 to 99) in patients without PJI (p = 0.001). After THA, the rate of survival was similar in those with unsuspected PJI (92% (95% CI 73 to 98) at two years) and those without (94% (95% CI 89 to 97), p = 0.31). Following revision of TKA and THA for aseptic diagnoses, around 10% of cases were found to have positive cultures. In the knee, such cases had inferior infection-free survival at two years compared with those with negative cultures; there was no difference between the groups following THA. Cite this article: Bone Joint J 2017;99-B:1482-9. ©2017 The British Editorial Society of Bone & Joint Surgery.

Utility of intra-operative ultrasound in choosing the appropriate site for blood pressure monitoring in Takayasu′s arteritis

Directory of Open Access Journals (Sweden)

Prasad Krishnamurthy Narasimha

2013-01-01

Full Text Available Takayasu′s arteritis (TA is rare, chronic progressive, pan-endarteritis involving the aorta and its main branches, with a specific predilection for young Asian women. Anaesthesia for TA patients is complicated by their severe uncontrolled hypertension, extreme arterial blood pressure differentials, aortic regurgitation (AR, end-organ dysfunction, stenosis/aneurysms of major blood vessels and difficulties encountered in monitoring arterial blood pressure. We present the usefulness of ultrasound during anaesthetic management of a 35-year-old woman posted for emergency caesarean section due to intra-uterine growth retardation, foetal tachycardia in active labour, who was already diagnosed to have TA along with moderate AR and uncontrolled hypertension, using epidural technique. The use of intra-operative doppler helped resolve the initial dilemma about the diagnosis and treatment of the differential blood pressure between the affected and the normal upper limb in the absence of prior arteriogram.

A Generalized Pyramid Matching Kernel for Human Action Recognition in Realistic Videos

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Wenjun Zhang

2013-10-01

Full Text Available Human action recognition is an increasingly important research topic in the fields of video sensing, analysis and understanding. Caused by unconstrained sensing conditions, there exist large intra-class variations and inter-class ambiguities in realistic videos, which hinder the improvement of recognition performance for recent vision-based action recognition systems. In this paper, we propose a generalized pyramid matching kernel (GPMK for recognizing human actions in realistic videos, based on a multi-channel “bag of words” representation constructed from local spatial-temporal features of video clips. As an extension to the spatial-temporal pyramid matching (STPM kernel, the GPMK leverages heterogeneous visual cues in multiple feature descriptor types and spatial-temporal grid granularity levels, to build a valid similarity metric between two video clips for kernel-based classification. Instead of the predefined and fixed weights used in STPM, we present a simple, yet effective, method to compute adaptive channel weights of GPMK based on the kernel target alignment from training data. It incorporates prior knowledge and the data-driven information of different channels in a principled way. The experimental results on three challenging video datasets (i.e., Hollywood2, Youtube and HMDB51 validate the superiority of our GPMK w.r.t. the traditional STPM kernel for realistic human action recognition and outperform the state-of-the-art results in the literature.

Intra-operative rapid diagnostic method based on CK19 mRNA expression for the detection of lymph node metastases in breast cancer

NARCIS (Netherlands)

Visser, Mike; Jiwa, Mehdi; Horstman, Anja; Brink, Antoinette A. T. P.; Pol, Rene P.; van Diest, Paul; Snijders, Peter J. F.; Meijer, Chris J. L. M.

2008-01-01

Staging by sentinel node (SN) biopsy is the standard procedure for clinically node-negative breast cancer patients. Intra-operative analysis of the SN allows immediate axillary lymph node (ALN) dissection in SN positive patients, but a quick, reliable and reproducible method is lacking. We tested

Systematic Review and Meta-Analysis of Randomized Controlled Trials Evaluating Prophylactic Intra-Operative Wound Irrigation for the Prevention of Surgical Site Infections

NARCIS (Netherlands)

de Jonge, Stijn W.; Boldingh, Quirine J. J.; Solomkin, Joseph S.; Allegranzi, Benedetta; Egger, Matthias; Dellinger, E. Patchen; Boermeester, Marja A.

2017-01-01

Surgical site infections (SSIs) are one of the most common hospital-acquired infections. To reduce SSIs, prophylactic intra-operative wound irrigation (pIOWI) has been advocated, although the results to date are equivocal. To develop recommendations for the new World Health Organization (WHO) SSI

Frozen section is superior to imprint cytology for the intra-operative assessment of sentinel lymph node metastasis in Stage I Breast cancer patients

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Makita Masujiro

2006-05-01

Full Text Available Abstract Background A standard intra-operative procedure for assessing sentinel lymph node metastasis in breast cancer patients has not yet been established. Patients and methods One hundred and thirty-eight patients with stage I breast cancer who underwent sentinel node biopsy using both imprint cytology and frozen section were analyzed. Results Seventeen of the 138 patients had sentinel node involvement. Results of imprint cytology included nine false negative cases (sensitivity, 47.1%. In contrast, only two cases of false negatives were found on frozen section (sensitivity, 88.2%. There were two false positive cases identified by imprint cytology (specificity, 98.3%. On the other hand, frozen section had 100% specificity. Conclusion These findings suggest that frozen section is superior to imprint cytology for the intra-operative determination of sentinel lymph node metastasis in stage I breast cancer patients.

SU-F-T-44: A Comparison of the Pre-Plan, Intra-Operative Plan, and Post-Implant Dosimetry for a Prostate Implant Case Using Prefabricated Linear Polymer-Encapsulated Pd-103

International Nuclear Information System (INIS)

Sheu, R; Powers, A; McGee, H; Stock, R; Lo, Y

2016-01-01

Purpose: To investigate the reproducibility and limitations of Pd-103 prostate brachytherapy using fixed length linear sources (CivaString). Methods: An LDR prostate brachytherapy case which was preplanned on MR images with prefabricated linear polymer-encapsulated Pd-103 sources (CivaString) was studied and compared with ultrasound based intra-operative planning and CT based post-implant dosimetry. We evaluated the following parameters among the three studies: prostate geometry (volume and cross sectional area), needle position and alignment deviations, and dosimetry parameters (D90). Results: The prostate volumes and axial cross sectional areas at center of prostate were measured as 41.8, 39.3 and 36.8 cc, and 14.9, 14.3, and 11.3 respectively on pre-plan MR, inter-op US, and post-implant CT studies. The deviation of prostate volumes and axial cross sectional areas measured on pre-planning MR and intra-operative US were within 5%. 17 out of 19 pre-planned needles were positioned within 5mm (the template grid size). One needle location was adjusted intra-operatively and another needle was removed due to proximity to urethra. The needle pathways were not always parallel to the trans-rectal probe due to the flexibility of CivaString. The angle of deviation was up to 10 degrees. Two pairs of needles were exchanged to better fit the length of prostate at the time of implant. This resulted in a prostate D90 of 153.8 Gy (124%) and 131.4 Gy (106.7%) for intra-op and PID respectively. Conclusion: Preplanning is a necessary part of implants performed with prefabricated linear polymer sources. However, as is often the case, there were real-time deviations from the pre-plan. Intra-op planning provides the ability conform to anatomy at the time of implant. Therefore, we propose to develop a systematic way to order extra strings of different length to provide the flexibility to perform intra-operative planning with fixed length strands.

SU-F-T-44: A Comparison of the Pre-Plan, Intra-Operative Plan, and Post-Implant Dosimetry for a Prostate Implant Case Using Prefabricated Linear Polymer-Encapsulated Pd-103

Energy Technology Data Exchange (ETDEWEB)

Sheu, R; Powers, A; McGee, H; Stock, R; Lo, Y [Mount Sinai Medical Center, New York, NY (United States)

2016-06-15

Purpose: To investigate the reproducibility and limitations of Pd-103 prostate brachytherapy using fixed length linear sources (CivaString). Methods: An LDR prostate brachytherapy case which was preplanned on MR images with prefabricated linear polymer-encapsulated Pd-103 sources (CivaString) was studied and compared with ultrasound based intra-operative planning and CT based post-implant dosimetry. We evaluated the following parameters among the three studies: prostate geometry (volume and cross sectional area), needle position and alignment deviations, and dosimetry parameters (D90). Results: The prostate volumes and axial cross sectional areas at center of prostate were measured as 41.8, 39.3 and 36.8 cc, and 14.9, 14.3, and 11.3 respectively on pre-plan MR, inter-op US, and post-implant CT studies. The deviation of prostate volumes and axial cross sectional areas measured on pre-planning MR and intra-operative US were within 5%. 17 out of 19 pre-planned needles were positioned within 5mm (the template grid size). One needle location was adjusted intra-operatively and another needle was removed due to proximity to urethra. The needle pathways were not always parallel to the trans-rectal probe due to the flexibility of CivaString. The angle of deviation was up to 10 degrees. Two pairs of needles were exchanged to better fit the length of prostate at the time of implant. This resulted in a prostate D90 of 153.8 Gy (124%) and 131.4 Gy (106.7%) for intra-op and PID respectively. Conclusion: Preplanning is a necessary part of implants performed with prefabricated linear polymer sources. However, as is often the case, there were real-time deviations from the pre-plan. Intra-op planning provides the ability conform to anatomy at the time of implant. Therefore, we propose to develop a systematic way to order extra strings of different length to provide the flexibility to perform intra-operative planning with fixed length strands.

VALIDATION OF MITRAL VALVE ANNULUS DIMENSIONS MEASURED BY 2D TRANS-THORACIC ECHOCARDIOGRAPHY WITH GOLD STANDARD DIRECT INTRA-OPERATIVE MEASUREMENT

OpenAIRE

Praveen; Yadav; Ankur; Saket; Kaushal

2014-01-01

CONTEXT: Precise estimation of Mitral valve annulus dimensions preoperatively through Echocardiography is of paramount importance in replacement/repair surgeries. However a frequent disagreement was experienced between anticipated size of prosthetic valve based on echocardiography and actual valve size. This fact encouraged the authors to validate the measurements through echocardiography with gold-standard direct intra operative measurement. AIM: To compare the mitral val...

On Realistically Attacking Tor with Website Fingerprinting

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Wang Tao

2016-10-01

Full Text Available Website fingerprinting allows a local, passive observer monitoring a web-browsing client’s encrypted channel to determine her web activity. Previous attacks have shown that website fingerprinting could be a threat to anonymity networks such as Tor under laboratory conditions. However, there are significant differences between laboratory conditions and realistic conditions. First, in laboratory tests we collect the training data set together with the testing data set, so the training data set is fresh, but an attacker may not be able to maintain a fresh data set. Second, laboratory packet sequences correspond to a single page each, but for realistic packet sequences the split between pages is not obvious. Third, packet sequences may include background noise from other types of web traffic. These differences adversely affect website fingerprinting under realistic conditions. In this paper, we tackle these three problems to bridge the gap between laboratory and realistic conditions for website fingerprinting. We show that we can maintain a fresh training set with minimal resources. We demonstrate several classification-based techniques that allow us to split full packet sequences effectively into sequences corresponding to a single page each. We describe several new algorithms for tackling background noise. With our techniques, we are able to build the first website fingerprinting system that can operate directly on packet sequences collected in the wild.

Intra-bunch-train transverse dynamics in the superconducting accelerators FLASH and European XFEL

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Hellert, Thorsten

2017-11-15

FLASH and the European XFEL are linear accelerator driven SASE-FELs, operating in a pulsed mode with long bunch-trains. Multi-bunch FEL operation requires longitudinal and transverse stability within the bunch-train. The purpose of this work is to investigate the intra-bunch-train transverse dynamics at FLASH and XFEL. Key relationships of superconducting RF cavity operation, their misalignments and the resulting impact on the intra-bunch-train trajectory variation are described. In this thesis a numerical model is developed and simulations for different accelerating sections at FLASH and XFEL are performed. With the current operational setup significant intra-bunch-train trajectory variation must be considered, hence approaches for their reduction are discussed. The theoretical studies are compared to experimental results at FLASH. The observed trajectory variation during multi-bunch user runs is analyzed and related to causal intra-bunch-train variations of the RF and the following impact on the multi-bunch SASSE performance. Furthermore, HOM-based cavity misalignment measurements are performed and the deduction of misalignments from multi-bunch data is considered.

Intra-bunch-train transverse dynamics in the superconducting accelerators FLASH and European XFEL

International Nuclear Information System (INIS)

Hellert, Thorsten

2017-11-01

FLASH and the European XFEL are linear accelerator driven SASE-FELs, operating in a pulsed mode with long bunch-trains. Multi-bunch FEL operation requires longitudinal and transverse stability within the bunch-train. The purpose of this work is to investigate the intra-bunch-train transverse dynamics at FLASH and XFEL. Key relationships of superconducting RF cavity operation, their misalignments and the resulting impact on the intra-bunch-train trajectory variation are described. In this thesis a numerical model is developed and simulations for different accelerating sections at FLASH and XFEL are performed. With the current operational setup significant intra-bunch-train trajectory variation must be considered, hence approaches for their reduction are discussed. The theoretical studies are compared to experimental results at FLASH. The observed trajectory variation during multi-bunch user runs is analyzed and related to causal intra-bunch-train variations of the RF and the following impact on the multi-bunch SASSE performance. Furthermore, HOM-based cavity misalignment measurements are performed and the deduction of misalignments from multi-bunch data is considered.

Randomized trial for superiority of high field strength intra-operative magnetic resonance imaging guided resection in pituitary surgery.

Science.gov (United States)

Tandon, Vivek; Raheja, Amol; Suri, Ashish; Chandra, P Sarat; Kale, Shashank S; Kumar, Rajinder; Garg, Ajay; Kalaivani, Mani; Pandey, Ravindra M; Sharma, Bhawani S

2017-03-01

Till date there are no randomized trials to suggest the superiority of intra-operative magnetic resonance imaging (IOMRI) guided trans-sphenoidal pituitary resection over two dimensional fluoroscopic (2D-F) guided resections. We conducted this trial to establish the superiority of IOMRI in pituitary surgery. Primary objective was to compare extent of tumor resection between the two study arms. It was a prospective, randomized, outcome assessor and statistician blinded, two arm (A: IOMRI, n=25 and B: 2D-F, n=25), parallel group clinical trial. 4 patients from IOMRI group cross-over to 2D-F group and were consequently analyzed in latter group, based on modified intent to treat method. A total of 50 patients were enrolled till completion of trial (n=25 in each study arm). Demographic profile and baseline parameters were comparable among the two arms (p>0.05) except for higher number of endoscopic procedures and experienced neurosurgeons (>10years) in arm B (p=0.02, 0.002 respectively). Extent of resection was similar in both study arms (A, 94.9% vs B, 93.6%; p=0.78), despite adjusting for experience of operating surgeon and use of microscope/endoscope for surgical resection. We observed that use of IOMRI helped optimize the extent of resection in 5/20 patients (25%) for pituitary tumor resection in-group A. Present study failed to observe superiorty of IOMRI over conventional 2D-F guided resection in pituitary macroadenoma surgery. By use of this technology, younger surgeons could validate their results intra-operatively and hence could increase EOR without causing any increase in complications. Copyright © 2016 Elsevier Ltd. All rights reserved.

Automatic Adjustments of a Trans-oesophageal Ultrasound Robot for Monitoring Intra-operative Catheters

Science.gov (United States)

Wang, Shuangyi; Housden, James; Singh, Davinder; Rhode, Kawal

2017-12-01

3D trans-oesophageal echocardiography (TOE) has become a powerful tool for monitoring intra-operative catheters used during cardiac procedures in recent years. However, the control of the TOE probe remains as a manual task and therefore the operator has to hold the probe for a long period of time and sometimes in a radiation environment. To solve this problem, an add-on robotic system has been developed for holding and manipulating a commercial TOE probe. This paper focuses on the application of making automatic adjustments to the probe pose in order to accurately monitor the moving catheters. The positioning strategy is divided into an initialization step based on a pre-planning method and a localized adjustments step based on the robotic differential kinematics and related image servoing techniques. Both steps are described in the paper along with simulation experiments performed to validate the concept. The results indicate an error less than 0.5 mm for the initialization step and an error less than 2 mm for the localized adjustments step. Compared to the much bigger live 3D image volume, it is concluded that the methods are promising. Future work will focus on evaluating the method in the real TOE scanning scenario.

Rehand: Realistic electric prosthetic hand created with a 3D printer.

Science.gov (United States)

Yoshikawa, Masahiro; Sato, Ryo; Higashihara, Takanori; Ogasawara, Tsukasa; Kawashima, Noritaka

2015-01-01

Myoelectric prosthetic hands provide an appearance with five fingers and a grasping function to forearm amputees. However, they have problems in weight, appearance, and cost. This paper reports on the Rehand, a realistic electric prosthetic hand created with a 3D printer. It provides a realistic appearance that is same as the cosmetic prosthetic hand and a grasping function. A simple link mechanism with one linear actuator for grasping and 3D printed parts achieve low cost, light weight, and ease of maintenance. An operating system based on a distance sensor provides a natural operability equivalent to the myoelectric control system. A supporter socket allows them to wear the prosthetic hand easily. An evaluation using the Southampton Hand Assessment Procedure (SHAP) demonstrated that an amputee was able to operate various objects and do everyday activities with the Rehand.

Realistic full wave modeling of focal plane array pixels.

Energy Technology Data Exchange (ETDEWEB)

Campione, Salvatore [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States). Electromagnetic Theory Dept.; Warne, Larry K. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States). Electromagnetic Theory Dept.; Jorgenson, Roy E. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States). Electromagnetic Theory Dept.; Davids, Paul [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States). Applied Photonic Microsystems Dept.; Peters, David W. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States). Applied Photonic Microsystems Dept.

2017-11-01

Here, we investigate full-wave simulations of realistic implementations of multifunctional nanoantenna enabled detectors (NEDs). We focus on a 2x2 pixelated array structure that supports two wavelengths of operation. We design each resonating structure independently using full-wave simulations with periodic boundary conditions mimicking the whole infinite array. We then construct a supercell made of a 2x2 pixelated array with periodic boundary conditions mimicking the full NED; in this case, however, each pixel comprises 10-20 antennas per side. In this way, the cross-talk between contiguous pixels is accounted for in our simulations. We observe that, even though there are finite extent effects, the pixels work as designed, each responding at the respective wavelength of operation. This allows us to stress that realistic simulations of multifunctional NEDs need to be performed to verify the design functionality by taking into account finite extent and cross-talk effects.

MetAssimulo:Simulation of Realistic NMR Metabolic Profiles

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De Iorio Maria

2010-10-01

Full Text Available Abstract Background Probing the complex fusion of genetic and environmental interactions, metabolic profiling (or metabolomics/metabonomics, the study of small molecules involved in metabolic reactions, is a rapidly expanding 'omics' field. A major technique for capturing metabolite data is 1H-NMR spectroscopy and this yields highly complex profiles that require sophisticated statistical analysis methods. However, experimental data is difficult to control and expensive to obtain. Thus data simulation is a productive route to aid algorithm development. Results MetAssimulo is a MATLAB-based package that has been developed to simulate 1H-NMR spectra of complex mixtures such as metabolic profiles. Drawing data from a metabolite standard spectral database in conjunction with concentration information input by the user or constructed automatically from the Human Metabolome Database, MetAssimulo is able to create realistic metabolic profiles containing large numbers of metabolites with a range of user-defined properties. Current features include the simulation of two groups ('case' and 'control' specified by means and standard deviations of concentrations for each metabolite. The software enables addition of spectral noise with a realistic autocorrelation structure at user controllable levels. A crucial feature of the algorithm is its ability to simulate both intra- and inter-metabolite correlations, the analysis of which is fundamental to many techniques in the field. Further, MetAssimulo is able to simulate shifts in NMR peak positions that result from matrix effects such as pH differences which are often observed in metabolic NMR spectra and pose serious challenges for statistical algorithms. Conclusions No other software is currently able to simulate NMR metabolic profiles with such complexity and flexibility. This paper describes the algorithm behind MetAssimulo and demonstrates how it can be used to simulate realistic NMR metabolic profiles with

A realistic neural mass model of the cortex with laminar-specific connections and synaptic plasticity - evaluation with auditory habituation.

Directory of Open Access Journals (Sweden)

Peng Wang

Full Text Available In this work we propose a biologically realistic local cortical circuit model (LCCM, based on neural masses, that incorporates important aspects of the functional organization of the brain that have not been covered by previous models: (1 activity dependent plasticity of excitatory synaptic couplings via depleting and recycling of neurotransmitters and (2 realistic inter-laminar dynamics via laminar-specific distribution of and connections between neural populations. The potential of the LCCM was demonstrated by accounting for the process of auditory habituation. The model parameters were specified using Bayesian inference. It was found that: (1 besides the major serial excitatory information pathway (layer 4 to layer 2/3 to layer 5/6, there exists a parallel "short-cut" pathway (layer 4 to layer 5/6, (2 the excitatory signal flow from the pyramidal cells to the inhibitory interneurons seems to be more intra-laminar while, in contrast, the inhibitory signal flow from inhibitory interneurons to the pyramidal cells seems to be both intra- and inter-laminar, and (3 the habituation rates of the connections are unsymmetrical: forward connections (from layer 4 to layer 2/3 are more strongly habituated than backward connections (from Layer 5/6 to layer 4. Our evaluation demonstrates that the novel features of the LCCM are of crucial importance for mechanistic explanations of brain function. The incorporation of these features into a mass model makes them applicable to modeling based on macroscopic data (like EEG or MEG, which are usually available in human experiments. Our LCCM is therefore a valuable building block for future realistic models of human cognitive function.

Comparison of intra-articular bupivacaine-morphine with bupivacaine-tenoxicam combinations on post-operative analgesia in patients with arthroscopic meniscectomy: a prospective, randomised study.

Science.gov (United States)

Sanel, Selim; Arpaz, Osman; Unay, Koray; Turkmen, Ismail; Simsek, Selcuk; Ugutmen, Ender

2016-03-01

There are many alternatives for post-operative pain relief in patients who have had general anaesthesia. The aim of this study was to evaluate the efficacy of intra-articular bupivacaine + morphine and bupivacaine + tenoxicam applications in post-operative pain control in patients undergoing knee arthroscopy with general anaesthesia. This was a prospective study. Standard anaesthesia procedures were applied to each patient, and the 240 patients chosen at random were then divided into two groups. Each group received a different combination of drugs for this double-blind study. The first group (group A: 120 patients) received 0.5% bupivacaine 100 mg + tenoxicam 20 mg (22 ml); the second group (group B) received 0.5% bupivacaine 100 mg + morphine 2 mg (22 ml); both groups received their drugs at the end of the intra-articular operation before tourniquet deflation. Before the operation, patients were asked about their post-operative pain at particular periods over the following 24 hours using the visual analogue scale (VAS) and the numeric rating scale (NRS). An additional analgaesic requirement and possible side effects were also recorded. Group A patients needed analgaesics sooner after operation than patients in group B. In Group B, VAS and NRS values were statistically higher compared with group A at the 12th hour. There were also fewer side effects seen in group A versus group B. Effective and reliable results were obtained in post-operative pain control in bupivacaine added to the morphine or tenoxicam groups following arthroscopic meniscectomy. In the tenoxicam group, patients reported less pain, fewer side effects and less need for analgesics at 12 hours after the operation. level 1, therapeutic, randomised, multicentric study.

Effect of Intra Vitreal Injection of Bevacizumab on Intra-Occular Pressure

International Nuclear Information System (INIS)

Jaffar, S.; Tayyab, A.; Matin, Z. I.; Masrur, A.; Naqaish, R.

2016-01-01

Background: Bevacizumab has been in use as a therapeutic agent for macular oedema for several years. While its efficacy has been well documented, its use has been shown to cause a transient rise in the intra-ocular pressure. The aim of this study was to evaluate the long term effect of intra-vitreal injection of Bevacizumab on Intra-ocular pressure. Methods: One hundred eyes (n=100) of one hundred patients, requiring intra-vitreal injection of Bevacizumab for diabetic macular oedema were recruited from Shifa Foundation Community Health Centre (SFCHC) between January and December 2014. Patients of glaucoma, ocular hyper-tension, known allergy to Bevacizumab or had injections of Bevacizumab prior to the study were excluded. Intra-ocular pressure was measured using a Goldmann applanation tonometer, prior to, and at six and twelve months after the injection. The pre- and post- injection Intra-ocular pressure was entered into the database. Test of significance was applied to investigate whether there was a significant change in intra-ocular pressure after the injection. Results: The mean age of the patient was 56.97 years (±14.97). The mean intra-ocular pressure was 13.86 (±3.16) mmHg before injection, while post-injection mean Intra-Ocular pressure was 14.21 (±3.12) mmHg and 13.79 (±3.07) at six and twelve months respectively. Between baseline and six months there was a statistically significant difference in intra-ocular pressure (p=0.03), while no significant difference existed in the intra-ocular pressure between baseline and twelve months (p=0.92). Conclusion: Intra-vitreal injection of Bevacizumab is associated with a statically significant rise in intra-ocular pressure at six months, while no significant difference was seen at twelve months compared to baseline. (author)

Fluorocholangiography: reincarnation in the laparoscopic era-evaluation of intra-operative cholangiography in 3635 laparoscopic cholecystectomies.

Science.gov (United States)

Nassar, Ahmad H M; Mirza, Ahmad; Qandeel, Haitham; Ahmed, Zubir; Zino, Samer

2016-05-01

The introduction of laparoscopic cholecystectomy (LC) resulted in the decline of routine intra-operative cholangiography (IOC). Common bile duct stones are being diagnosed preoperatively using magnetic resonance cholangiopancreatography (MRCP). We aim to evaluate the use and benefits of IOC during laparoscopic biliary surgery at a high-volume biliary surgery unit. Prospective data from 4088 patients undergoing LC over 22 years were analysed. Referral protocols allow one firm to receive the great majority of biliary emergencies and all suspected ductal stones. All patients with gall stones on ultrasound scanning, fit for surgery, will undergo LC during the index admission. MRCP and ERCP are not part of preoperative investigation. A four-port LC is performed with a size 5Fr ureteric catheter within an open cannula to obtain an IOC through right sub-costal port. Of 4088 patients, IOC was attempted in 3691 (90.2 %) and 3635 had a successful IOC (98.4 %). 75 % were females. The mean age was 59 years. Patients presented with one or more of the following: chronic biliary pain in 60 %, acute pain 26.7 %, acute cholecystitis 8.4 %, gallstone pancreatitis 7.8 % and jaundice with or without cholangitis in 19.2 %. A total of 1328 patients (36.5 %) had risk factors for CBD stones. The IOC was abnormal in 975 cases (26.8 %), recording 1599 abnormalities. IOC identified 774 patients with CBD stones (21.3 %), including previously unsuspected CBD stones in 4.7 %. IOC was false negative in 20 cases (0.5 %) found to have stones on basket exploration. A decision not to perform IOC in 453 cases (11 %) was made preoperatively in 74.2 % and intra-operatively in 12.3 %. IOC can be safely and routinely performed in LC. It helps to identify CBD stones, even in patients with no known risk factors, delineate bile duct anatomy and facilitate single-stage management of CBD stones.

Randomised study on single stage laparo-endoscopic rendezvous (intra-operative ERCP) procedure versus two stage approach (Pre-operative ERCP followed by laparoscopic cholecystectomy) for the management of cholelithiasis with choledocholithiasis.

Science.gov (United States)

Sahoo, Manash Ranjan; Kumar, Anil T; Patnaik, Aashish

2014-07-01

The 'Rendezvous' technique consists of laparoscopic cholecystectomy (LC) standards with intra-operative cholangiography followed by endoscopic sphincterotomy. The sphincterotome is driven across the papilla through a guidewire inserted by the transcystic route. In this study, we intended to compare the two methods in a prospective randomised trial. From 2005 to 2012, we enrolled 83 patients with a diagnosis of cholecysto-choledocolithiasis. They were randomised into two groups. In 'group-A',41 patients were treated with two stages management, first by pre-operative endoscopic retrograde cholangiopancreatography (ERCP) and common bile duct (CBD) clearance and second by LC. In 'group-B', 42 patients were treated with LC and intra-operative cholangiography; and when diagnosis of choledocholithiasis was confirmed, patients had undergone one stage management of by Laparo-endoscopic Rendezvous technique. In arm-A and arm-B groups, complete CBD clearance was achieved in 29 and 38 patients, respectively. Failure of the treatment in arm-A was 29% and in arm-B was 9.5%. In arm-A, selective CBD cannulation was achieved in 33 cases (80.5%) and in arm-B in 39 cases (93%). In arm-Agroup, post-ERCP hyperamylasia was presented in nine patients (22%) and severe pancreatitis in five patients (12%) versus none of the patients (0%) in arm-B group, respectively. Mean post-operative hospital stay in arm-A and arm-B groups are 10.9 and 6.8 days, respectively. One stage laparo-endoscopic rendezvous approach increases selective cannulation of CBD, reduces post-ERCP pancreatitis, reduces days of hospital stay, increases patient's compliance and prevents unnecessary intervention to CBD.

[Inflammatory pseudotumour of the liver. Importance of intra-operative histopathology].

Science.gov (United States)

Onieva-González, Francisco Gabriel; Galeano-Díaz, Francisco; Matito-Díaz, María José; López-Guerra, Diego; Fernández-Pérez, Juana; Blanco-Fernández, Gerardo

2015-01-01

Inflammatory pseudotumour is a rare entity, considered benign, and characterised by inflammatory cell mesenchymal proliferation. The case is presented 70 year-old man with fever of unknown origin syndrome. He was diagnosed with liver abscesses (one segment IV, adjacent to gallbladder fundus and segment VI), who progressed slowly after antibiotic treatment. In the absence of a diagnosis, although fine needle puncture-aspiration and different imaging tests were performed, elective surgery was decided. The intra-operative histopathology reported the existence of an inflammatory pseudotumour. Inflammatory pseudotumours are clinically classified into different types according to their aetiology, varying therapeutic management based on the same. It is very difficult to diagnose because of the absence of symptoms, blood disorders, or specific radiological findings. Definitive diagnosis often requires histopathological confirmation, in most cases by percutaneous liver puncture, but sometimes exploratory laparotomy or even performing a hepatectomy for confirmation is necessary. The natural history of inflammatory pseudotumour is its regression; thus conservative management may be used through regular checks until resolution, or can be treated with antibiotics, anti-inflammatories and even corticosteroids. Surgical resection is indicated for persistent unresolved systemic symptoms despite medical treatment, in those situations where growth is evident, with or without symptoms, when involving the hepatic hilum, and finally, in case where the possibility of malignancy cannot be ruled out. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Pre-operative and intra-operative detection of axillary lymph node metastases in 108 patients with invasive lobular breast cancer undergoing mastectomy.

Science.gov (United States)

Novak, Jerica; Besic, Nikola; Dzodic, Radan; Gazic, Barbara; Vogrin, Andrej

2018-02-05

Despite the recent changes in the treatment of the axilla in selected breast cancer patient, positive sentinel lymph node (SLN) in patients undergoing mastectomy still necessitates axillary lymph node dissection (ALND). In invasive lobular carcinoma (ILC), pre-operative detection of the lymph node metastasis may be demanding due to its unique morphology. The aim of this study was to examine the benefit of preoperative axillary ultrasound (AUS), ultrasound-guided fine-needle aspiration biopsy (US-FNAB), and intra-operative imprint cytology (IIC), in order to avoid two-stage axillary surgery in patients with ILC undergoing mastectomy. The object of this study were 102 patients (median age 52, range 34-73 years) with clinically non-suspicious axilla in whom 108 mastectomies were performed after a pre-operative AUS investigation. Whenever a metastasis was detected in a sentinel lymph node, ALND was done. Reports of the pre-operative AUS investigation, US-FNAB, and IIC were compared with definitive histopathological reports of surgical specimens. In 46 cases lymph node metastases were diagnosed. AUS suspicious lymph nodes were found in 29/108 cases and histopathology confirmed metastases in 22/30 cases. US-FNAB was performed in 29 cases with AUS suspicious lymph nodes. Cytology proved metastases in 11/29 cases. Histopathology confirmed metastases in 10/11 cases with only isolated tumor cells found in one case. IIC investigation was performed in 63 cases and in 10/27 cases metastases were confirmed by histopathology. Pre-operative AUS, US-FNAB, and/or IIC investigation enabled ALND during a single surgical procedure in 20/46 patients with metastases in lymph nodes. Pre-operative AUS, US-FNAB, and/or IIC are/is beneficial in patients with ILC planned for mastectomy in order to decrease the number of two stage axillary procedures.

T cell lymphoblastic lymphoma/leukemia within an adrenocorticotropic hormone and thyroid stimulating hormone positive pituitary adenoma: A cytohistological correlation emphasizing importance of intra-operative squash smear.

Science.gov (United States)

Gupta, Rakesh K; Saran, Ravindra K; Srivastava, Arvind K; Jagetia, Anita; Garg, Lalit; Sharma, Mehar C

2017-08-01

We present a rare case of primary pituitary T cell lymphoma/leukemia (T-LBL) in association with adrenocorticotropic hormone (ACTH) and thyroid stimulating hormone (TSH) expressing pituitary adenoma in a 55-year-old woman highlighting the importance of intra-operative squash smears examination. The patient presented with complaints of headache, diminution of vision and recent onset altered sensorium. MRI revealed a mass lesion in the sellar-suprasellar region with non-visualization of pituitary gland separately, extending to involve adjacent structures diagnosed as invasive pituitary macroadenoma. Intra-operative tissue was sent for squash smear examination. The cytology showed a tumor comprising of sheets of immature lymphoid cells intermixed with clusters of pituitary acinar cells with many mitoses and tingible body macrophages. A diagnosis of presence of immature lymphoid cells within the pituitary was offered and differentials of infiltration by lymphoma cells from systemic disease versus primary central nervous lymphoma-like lymphoma arising in the pituitary adenoma were considered. Later paraffin section examination and immunohistochemistry corroborated with the squash findings and a final diagnosis of primary pituitary T cell lymphoma/leukemia in association with ACTH and TSH expressing pituitary adenoma was made. To date, only six cases of primary pituitary T cell lymphomas, including three T-LBL cases, have been reported. This is the seventh case and first one additionally describing cytohistological correlation and importance of intra-operative cytology. © 2017 Japanese Society of Neuropathology.

Retrospective analysis of dose delivery in intra-operative high dose rate brachytherapy

International Nuclear Information System (INIS)

Oh, M.; Avadhani, J.S.; Malhotra, H.K.; Cunningham, B.; Tripp, P.; Jaggernauth, W.; Podgorsak, M.B.

2007-01-01

Background. This study was performed to quantify the inaccuracy in clinical dose delivery due to the incomplete scatter conditions inherent in intra-operative high dose rate (IOHDR) brachytherapy. Methods. Treatment plans of 10 patients previously treated in our facility, which had irregular shapes of treated areas, were used. Treatment geometries reflecting each clinical case were simulated using a phantom assembly with no added build-up on top of the applicator. The treatment planning geometry (full scatter surrounding the applicator) was subsequently simulated for each case by adding bolus on top of the applicator. Results. For geometries representing the clinical IOHDR incomplete scatter environment, measured doses at the 5 mm and 10 mm prescription depths were lower than the corresponding prescribed doses by about 7.7% and 11.1%, respectively. Also, for the two prescription methods, an analysis of the measured dose distributions and their corresponding treatment plans showed average decreases of 1.2 mm and 2.2 mm in depth of prescription dose, respectively. Conclusions. Dosimetric calculations with the assumption of an infinite scatter environment around the applicator and target volume have shown to result in dose delivery errors that significantly decrease the prescription depth for IOHDR treatment.(author)

IBM parameters derived from realistic shell-model Hamiltonian via Hn-cooling method

International Nuclear Information System (INIS)

Nakada, Hitoshi

1997-01-01

There is a certain influence of non-collective degrees-of-freedom even in lowest-lying states of medium-heavy nuclei. This influence seems to be significant for some of the IBM parameters. In order to take it into account, several renormalization approaches have been applied. It has been shown in the previous studies that the influence of the G-pairs is important, but does not fully account for the fitted values. The influence of the non-collective components may be more serious when we take a realistic effective nucleonic interaction. To incorporate this influence into the IBM parameters, we employ the recently developed H n -cooling method. This method is applied to renormalize the wave functions of the states consisting of the SD-pairs, for the Cr-Fe nuclei. On this ground, the IBM Hamiltonian and transition operators are derived from corresponding realistic shell-model operators, for the Cr-Fe nuclei. Together with some features of the realistic interaction, the effects of the non-SD degrees-of-freedom are presented. (author)

[Pre-operation evaluation and intra-operation management of cochlear implantation].

Science.gov (United States)

Zhang, Dao-xing; Hu, Bao-hua; Xiao, Yu-li; Shi, Bo-ning

2004-10-01

To summarize pre-operation evaluation experiences in cochlear implantation. Performing auditory evaluation and image analysis seriously in 158 severe hearing loss or total deaf cases before cochlear implantation, comparing their performance with the findings during and post operation. Among the total 158 cases, 116 cases with normal structure, 42 cases with the abnormal findings of the inner or middle ear. Stapedial gusher happened in 6 cases, 1 case was not predicted before operation. Except 1 case with serious malformation, the findings of other 157 cases in operation were consistent with the pre-operation evaluation. We helped all patients reconstruct auditory conduction with cochlear implantation, and the average hearing level up to 37.6 dB SPL. Performing image analysis seriously before operation and planning for operation according to HRCT can do great help to cochlear implantation. The operation under the HRCT instruction has less complications.

Intra-site Secure Transport Vehicle test and evaluation

International Nuclear Information System (INIS)

Scott, S.

1995-01-01

In the past many DOE and DoD facilities involved in handling nuclear material realized a need to enhance the safely and security for movement of sensitive materials within their facility, or ''intra-site''. There have been prior efforts to improve on-site transportation; however, there remains a requirement for enhanced on-site transportation at a number of facilities. The requirements for on-site transportation are driven by security, safety, and operational concerns. The Intra-site Secure Transport Vehicle (ISTV) was designed to address these concerns specifically for DOE site applications with a standardized vehicle design. This paper briefly reviews the ISTV design features providing significant enhancement of onsite transportation safety and security, and also describes the test and evaluation activities either complete of underway to validate the vehicle design and operation

The Intra Uterine Morcellator: a new hysteroscopic operating technique to remove intrauterine polyps and myomas.

Science.gov (United States)

Emanuel, Mark Hans; Wamsteker, Kees

2005-01-01

A new hysteroscopic operating technique was compared retrospectively with conventional resectoscopy. Retrospective comparison (Canadian Task Force Classification II-2). Gynecology department of a university-affiliated teaching hospital. Fifty-five women, 27 with endometrial polyps and 28 with submucous myomas. Patients were treated with a prototype of the Intra Uterine Morcellator (IUM). This cutting device, 35 cm in length, was inserted into a straight working channel of a 90-mm hysteroscope. The major advantages were ease of removal of tissue fragments through the instrument and the use of saline solution instead of electrolyte-free solutions used in monopolar high-frequency resectoscopy. The mean operating time was 8.7 minutes (95% CI: 7.3-10.1) for the removal of endometrial polyps compared with 30.9 minutes (CI: 27.0-34.8) for resectoscopy, and 16.4 minutes (CI: 12.6-20.2) for submucous myomas compared with 42.2 minutes (CI: 39.7-44.7) for resectoscopy. All procedures were uneventful. This new technique is faster, and it appears to be easier to perform. Therefore, it can be expected to result in fewer fluid-related complications and to lead to a shorter learning curve when compared with conventional resectoscopy.

A novel intra-operative, high-resolution atrial mapping approach.

Science.gov (United States)

Yaksh, Ameeta; van der Does, Lisette J M E; Kik, Charles; Knops, Paul; Oei, Frans B S; van de Woestijne, Pieter C; Bekkers, Jos A; Bogers, Ad J J C; Allessie, Maurits A; de Groot, Natasja M S

2015-12-01

A new technique is demonstrated for extensive high-resolution intra-operative atrial mapping that will facilitate the localization of atrial fibrillation (AF) sources and identification of the substrate perpetuating AF. Prior to the start of extra-corporal circulation, a 8 × 24-electrode array (2-mm inter-electrode distance) is placed subsequently on all the right and left epicardial atrial sites, including Bachmann's bundle, for recording of unipolar electrograms during sinus rhythm and (induced) AF. AF is induced by high-frequency pacing at the right atrial free wall. A pacemaker wire stitched to the right atrium serves as a reference signal. The indifferent pole is connected to a steal wire fixed to subcutaneous tissue. Electrograms are recorded by a computerized mapping system and, after amplification (gain 1000), filtering (bandwidth 0.5-400 Hz), sampling (1 kHz) and analogue to digital conversion (16 bits), automatically stored on hard disk. During the mapping procedure, real-time visualization secures electrogram quality. Analysis will be performed offline. This technique was performed in 168 patients of 18 years and older, with coronary and/or structural heart disease, with or without AF, electively scheduled for cardiac surgery and a ventricular ejection fraction above 40 %. The mean duration of the entire mapping procedure including preparation time was 9 ± 2 min. Complications related to the mapping procedure during or after cardiac surgery were not observed. We introduce the first epicardial atrial mapping approach with a high resolution of ≥1728 recording sites which can be performed in a procedure time of only 9±2 mins. This mapping technique can potentially identify areas responsible for initiation and persistence of AF and hopefully can individualize both diagnosis and therapy of AF.

Randomised study on single stage laparo-endoscopic rendezvous (intra-operative ERCP procedure versus two stage approach (Pre-operative ERCP followed by laparoscopic cholecystectomy for the management of cholelithiasis with choledocholithiasis

Directory of Open Access Journals (Sweden)

Manash Ranjan Sahoo

2014-01-01

Full Text Available Introduction : The ′Rendezvous′ technique consists of laparoscopic cholecystectomy (LC standards with intra-operative cholangiography followed by endoscopic sphincterotomy. The sphincterotome is driven across the papilla through a guidewire inserted by the transcystic route. In this study, we intended to compare the two methods in a prospective randomised trial. Materials And Methods: From 2005 to 2012, we enrolled 83 patients with a diagnosis of cholecysto-choledocolithiasis. They were randomised into two groups. In ′group-A′,41 patients were treated with two stages management, first by pre-operative endoscopic retrograde cholangiopancreatography (ERCP and common bile duct (CBD clearance and second by LC. In ′group-B′, 42 patients were treated with LC and intra-operative cholangiography; and when diagnosis of choledocholithiasis was confirmed, patients had undergone one stage management of by Laparo-endoscopic Rendezvous technique. Results: In arm-A and arm-B groups, complete CBD clearance was achieved in 29 and 38 patients, respectively. Failure of the treatment in arm-A was 29% and in arm-B was 9.5%. In arm-A, selective CBD cannulation was achieved in 33 cases (80.5% and in arm-B in 39 cases (93%. In arm-Agroup, post-ERCP hyperamylasia was presented in nine patients (22% and severe pancreatitis in five patients (12% versus none of the patients (0% in arm-B group, respectively. Mean post-operative hospital stay in arm-A and arm-B groups are 10.9 and 6.8 days, respectively. Conclusion: One stage laparo-endoscopic rendezvous approach increases selective cannulation of CBD, reduces post-ERCP pancreatitis, reduces days of hospital stay, increases patient′s compliance and prevents unnecessary intervention to CBD.

Evaluation of hyperglycaemic response to intra-operative dexamethasone administration in patients undergoing elective intracranial surgery: A randomised, prospective study.

Science.gov (United States)

Sethi, Rakesh; Naqash, Imtiaz A; Bajwa, Sukhminder Jit Singh; Dutta, Vikas; Ramzan, Altaf Umar; Zahoor, Syed Amir

2016-01-01

The glucocorticoid dexamethasone in a bolus dose of 8-10 mg followed by quarterly dose of 4 mg is commonly used during intracranial surgery so as to reduce oedema and vascular permeability. However, the detrimental hyperglycaemic effects of dexamethasone may override its potentially beneficial effects. The present prospective, randomised study aimed at comparing the degree and magnitude of hyperglycaemia induced by prophylactic administration of dexamethasone in patients undergoing elective craniotomy. Sixty American Society of Anaesthesiologist (ASA) grade-I and II patients were randomly assigned to three groups of 20 patients each. Group-I received dexamethasone during surgery for the first time. Group-II received dexamethasone in addition to receiving it pre-operatively, whereas Group-III (control group) patients were administered normal saline as placebo. Baseline blood glucose (BG) was measured in all the three groups before induction of anaesthesia and thereafter after every hour for 4 h and then two-hourly. Besides intra- and intergroup comparison of BG, peak BG concentration was also recorded for each patient. Statistical analysis was carried out with analysis of variance (ANOVA) and Student's t-test and value of P < 0.05 was considered statistically significant. Baseline BG reading were higher and statistically significant in Group-II as compared with Group-I and Group-III (P < 0.05). However, peak BG levels were significantly higher in Group-I than in Group-II and III (P < 0.05). Similarly, the magnitude of change in peak BG was significantly higher in Group-I as compared to Group-II and III (P < 0.05). Peri-operative administration of dexamethasone during neurosurgical procedures can cause significant increase in BG concentration especially in patients who receive dexamethasone intra-operatively only.

Arterio-venous flow between monochorionic twins determined during intra-uterine transfusion. Nonlinear decay of adult red blood cells

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Gemert, Martin J C van; Wijngaard, Jeroen P H M van den [Laser Centre and Department of Obstetrics, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Pasman, Suzanne A; Vandenbussche, Frank P H A [Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Centre, Leiden (Netherlands); Lopriore, Enrico [Division of Neonatology, Department of Pediatrics, Leiden University Medical Centre, Leiden (Netherlands)], E-mail: m.j.vangemert@amc.uva.nl

2008-07-07

Recently, we derived equations relating the flow of adult red blood cells through a placental arterio-venous anastomosis with intra-uterine and post-natal measured adult hemoglobin concentrations. In this letter, we re-derived the equations, now including a more realistic nonlinear decay of adult red blood cells, and re-evaluated the measurement accuracy of the arterio-venous flow and the lifetime of the red blood cells. (letter to the editor)

Intra-operative adjustment of standard planes in C-arm CT image data.

Science.gov (United States)

Brehler, Michael; Görres, Joseph; Franke, Jochen; Barth, Karl; Vetter, Sven Y; Grützner, Paul A; Meinzer, Hans-Peter; Wolf, Ivo; Nabers, Diana

2016-03-01

With the help of an intra-operative mobile C-arm CT, medical interventions can be verified and corrected, avoiding the need for a post-operative CT and a second intervention. An exact adjustment of standard plane positions is necessary for the best possible assessment of the anatomical regions of interest but the mobility of the C-arm causes the need for a time-consuming manual adjustment. In this article, we present an automatic plane adjustment at the example of calcaneal fractures. We developed two feature detection methods (2D and pseudo-3D) based on SURF key points and also transferred the SURF approach to 3D. Combined with an atlas-based registration, our algorithm adjusts the standard planes of the calcaneal C-arm images automatically. The robustness of the algorithms is evaluated using a clinical data set. Additionally, we tested the algorithm's performance for two registration approaches, two resolutions of C-arm images and two methods for metal artifact reduction. For the feature extraction, the novel 3D-SURF approach performs best. As expected, a higher resolution ([Formula: see text] voxel) leads also to more robust feature points and is therefore slightly better than the [Formula: see text] voxel images (standard setting of device). Our comparison of two different artifact reduction methods and the complete removal of metal in the images shows that our approach is highly robust against artifacts and the number and position of metal implants. By introducing our fast algorithmic processing pipeline, we developed the first steps for a fully automatic assistance system for the assessment of C-arm CT images.

Improved long-term survival after intra-operative single high-dose ATG-Fresenius induction in renal transplantation: a single centre experience.

Science.gov (United States)

Kaden, Jürgen; May, Gottfried; Völp, Andreas; Wesslau, Claus

2009-01-01

In organ grafts donor-specific sensitization is initiated immediately after revascularization. Therefore, in 1990 we introduced the intra-operative single high-dose ATG-Fresenius (ATG-F) induction in addition to standard triple drug therapy (TDT) consisting of steroids, azathioprine and cyclosporin. A total of 778 first renal transplantations from deceased donors, performed between 1987 and 1998, were included in this evaluation. This retrospective analysis of clinic records and electronic databases presents data of all recipients of first kidney grafts who received two different ATG-F inductions (1(st) group: 9 mg/kg body weight as single high-dose intra-operatively, n=484; 2(nd) group: 3 mg/kg body weight on 7 or 8 consecutive days as multiple-dose starting also intra-operatively, n=78) and standard TDT alone (3(rd) group: TDT alone, n=216). The 10-year patient survival rates were 72.6+/-2.6% (TDT + ATG-F single high-dose), 79.5+/-5.1% (TDT + ATG-F multiple-dose) and 67.2+/-3.7%% (TDT alone; Kaplan-Meier estimates with standard errors; ATG-F vs TDT alone, p=0.001). The 10-year graft survival rates with censoring of patients that died with a functioning graft were 73.8+/-2.4%, 57.7+/-5.8% and 58.4+/-3.6% (Kaplan-Meier estimates with standard errors; 1(st) vs 2(nd )and 3(rd) group, respectively, p<0.001) and the 10-year graft survival rates with patient death counted as graft failure were 58.3+/-2.7%, 55.7+/-5.8% and 48.2+/-3.5% (Kaplan-Meier estimates with standard errors; ATG-F single high-dose vs TDT, p=0.023). In pre-sensitized recipients there were also significant differences in favour of ATG-F, more notably in the single high-dose ATG-F induction. A total of 69% of the patients in the two cohorts receiving ATG-F did not experience any transplant rejections compared to 56% in patients undergoing TDT alone (p=0.018). The incidence of infectious complications was comparable across all groups. According to evidence obtained from the routine documentation of 778

Assessment and validation of CT scanogram to compare per-operative and post-operative mechanical axis after navigated total knee replacement

Science.gov (United States)

Jain, Sunil

2008-01-01

Our objective was to assess and validate low-dose computed tomography (CT) scanogram as a post-operative imaging modality to measure the mechanical axis after navigated total knee replacement. A prospective study was performed to compare intra-operative and post-operative mechanical axis after navigated total knee replacements. All consecutive patients who underwent navigated total knee replacement between May and December 2006 were included. The intra-operative final axis was recorded, and post-operatively a CT scanogram of lower limbs was performed. The mechanical axis was measured and compared against the intra-operative measurement. There were 15 patients ranging in age from 57 to 80 (average 70) years. The average final intra-operative axis was 0.56° varus (4° varus to 1.5° valgus) and post-operative CT scanogram axis was 0.52° varus (3.1° varus to 1.8° valgus). The average deviation from final axes to CT scanogram axes was 0.12° valgus with a correlation coefficient of 0.9. Our study suggests that CT scanogram is an imaging modality with reasonable accuracy for measuring mechanical axis despite significantly low radiation. It also confirms a high level of correlation between intra-operative and post-operative mechanical axis after navigated total knee replacement. PMID:18696064

Realistic Visualization of Virtual Views

DEFF Research Database (Denmark)

Livatino, Salvatore

2005-01-01

that can be impractical and sometime impossible. In addition, the artificial nature of data often makes visualized virtual scenarios not realistic enough. Not realistic in the sense that a synthetic scene is easy to discriminate visually from a natural scene. A new field of research has consequently...... developed and received much attention in recent years: Realistic Virtual View Synthesis. The main goal is a high fidelity representation of virtual scenarios while easing modeling and physical phenomena simulation. In particular, realism is achieved by the transfer to the novel view of all the physical...... phenomena captured in the reference photographs, (i.e. the transfer of photographic-realism). An overview of most prominent approaches in realistic virtual view synthesis will be presented and briefly discussed. Applications of proposed methods to visual survey, virtual cinematography, as well as mobile...

Do absorption and realistic distraction influence performance of component task surgical procedure?

NARCIS (Netherlands)

Pluyter, J.R.; Buzink, S.N.; Rutkowski, A.F.; Jakimowicz, J.J.

2009-01-01

Background. Surgeons perform complex tasks while exposed to multiple distracting sources that may increase stress in the operating room (e.g., music, conversation, and unadapted use of sophisticated technologies). This study aimed to examine whether such realistic social and technological

Protecting Patients from an Unsafe System: The Etiology & Recovery of Intra-Operative Deviations in Care

Science.gov (United States)

Hu, Yue-Yung; Arriaga, Alexander F.; Roth, Emilie M.; Peyre, Sarah E.; Corso, Katherine A.; Swanson, Richard S.; Osteen, Robert T.; Schmitt, Pamela; Bader, Angela M.; Zinner, Michael J.; Greenberg, Caprice C.

2012-01-01

Objective To understand the etiology and resolution of unanticipated events in the operating room (OR). Background The majority of surgical adverse events occur intra-operatively. The OR represents a complex, high-risk system. The influence of different human, team, and organizational/environmental factors on safety and performance is unknown. Methods We video-recorded and transcribed 10 high-acuity operations, representing 43.7 hours of patient care. Deviations, defined as delays and/or episodes of decreased patient safety, were identified by majority consensus of a multidisciplinary team. Factors that contributed to each event and/or mitigated its impact were determined and attributed to the patient, providers, or environment/organization. Results Thirty-three deviations (10 delays, 17 safety compromises, 6 both) occurred – with a mean of one every 79.4 minutes. These deviations were multifactorial (mean 3.1 factors). Problems with communication and organizational structure appeared repeatedly at the root of both types of deviations. Delays tended to be resolved with vigilance, communication, coordination, and cooperation, while mediation of safety compromises was most frequently accomplished with vigilance, leadership, communication, and/or coordination. The organization/environment was not found to play a direct role in compensation. Conclusions Unanticipated events are common in the OR. Deviations result from poor organizational/environmental design and suboptimal team dynamics, with caregivers compensating to avoid patient harm. While recognized in other high risk domains, such human resilience has not yet been described in surgery and has major implications for the design of safety interventions. PMID:22750753

Diagnosis and management of an intra-articular foreign body in the foot.

LENUS (Irish Health Repository)

Mulhall, K J

2002-10-01

We describe a case of a small intra-articular foreign body in the foot presenting 48 hours following injury, which at operation showed early evidence of septic arthritis. It is essential to accurately localise periarticular foreign bodies in the foot and proceed to arthrotomy and debridement in all cases where there is radiological or clinical evidence to suggest intra-articular retention of a foreign body.

MANAJEMEN LABA: PERILAKU MANAJEMEN OPPORTUNISTIC ATAU REALISTIC ?

Directory of Open Access Journals (Sweden)

I Nyoman Wijana Asmara Putra

2011-01-01

Full Text Available Earnings management is a still attractive issue. It is often associatedwith negative behavior conducted by management for its own interest. In fact,it also has different side to be examined. There is another motivation to do so,such as to improve the company’s operation. This literature study aims toreview management motivation of doing earnings management, whetheropportunistic or realistic. What conflict that earnings management brings,what pro and cons about it, what would happen if earnings is not managed,whether the company would be better off or worse off.

Realistic electricity market simulator for energy and economic studies

International Nuclear Information System (INIS)

Bernal-Agustin, Jose L.; Contreras, Javier; Conejo, Antonio J.; Martin-Flores, Raul

2007-01-01

Electricity market simulators have become a useful tool to train engineers in the power industry. With the maturing of electricity markets throughout the world, there is a need for sophisticated software tools that can replicate the actual behavior of power markets. In most of these markets, power producers/consumers submit production/demand bids and the Market Operator clears the market producing a single price per hour. What makes markets different from each other are the bidding rules and the clearing algorithms to balance the market. This paper presents a realistic simulator of the day-ahead electricity market of mainland Spain. All the rules that govern this market are modeled. This simulator can be used either to train employees by power companies or to teach electricity markets courses in universities. To illustrate the tool, several realistic case studies are presented and discussed. (author)

Effective realistic interactions for low momentum Hilbert spaces

International Nuclear Information System (INIS)

Weber, Dennis

2012-01-01

Realistic nucleon-nucleon potentials are an essential ingredient of modern microscopic many-body calculations. These potentials can be represented in two different ways: operator representation or matrix element representation. In operator representation the potential is represented by a set of quantum mechanical operators while in matrix element representation it is defined by the matrix elements in a given basis. Many modern potentials are constructed directly in matrix element representation. While the matrix element representation can be calculated from the operator representation, the determination of the operator representation from the matrix elements is more difficult. Some methods to solve the nuclear many-body problem, such as Fermionic Molecular Dynamics (FMD) or the Green's Function Monte Carlo (GFMC) method, however require explicitly the operator representation of the potential, as they do not work in a fixed many-body basis. It is therefore desirable to derive an operator representation also for the interactions given by matrix elements. In this work a method is presented which allows the derivation of an approximate operator representation starting from the momentum space partial wave matrix elements of the interaction. For that purpose an ansatz for the operator representation is chosen. The parameters in the ansatz are determined by a fit to the partial wave matrix elements. Since a perfect reproduction of the matrix elements in general cannot be achieved with a finite number of operators and the quality of the results depends on the choice of the ansatz, the obtained operator representation is tested in nuclear many-body calculations and the results are compared with those from the initial interaction matrix elements. For the calculation of the nucleon-nucleon scattering phase shifts and the deuteron properties a computer code written within this work is used. For larger nuclei the No Core Shell Model (NCSM) and FMD are applied. The described

LETTER TO THE EDITOR: Arterio-venous flow between monochorionic twins determined during intra-uterine transfusion. Nonlinear decay of adult red blood cells

Science.gov (United States)

van Gemert, Martin J. C.; Pasman, Suzanne A.; van den Wijngaard, Jeroen P. H. M.; Lopriore, Enrico; Vandenbussche, Frank P. H. A.

2008-07-01

Recently, we derived equations relating the flow of adult red blood cells through a placental arterio-venous anastomosis with intra-uterine and post-natal measured adult hemoglobin concentrations. In this letter, we re-derived the equations, now including a more realistic nonlinear decay of adult red blood cells, and re-evaluated the measurement accuracy of the arterio-venous flow and the lifetime of the red blood cells.

Triangulating and guarding realistic polygons

NARCIS (Netherlands)

Aloupis, G.; Bose, P.; Dujmovic, V.; Gray, C.M.; Langerman, S.; Speckmann, B.

2014-01-01

We propose a new model of realistic input: k-guardable objects. An object is k-guardable if its boundary can be seen by k guards. We show that k-guardable polygons generalize two previously identified classes of realistic input. Following this, we give two simple algorithms for triangulating

Building Realistic Mobility Models for Mobile Ad Hoc Networks

Directory of Open Access Journals (Sweden)

Adrian Pullin

2018-04-01

Full Text Available A mobile ad hoc network (MANET is a self-configuring wireless network in which each node could act as a router, as well as a data source or sink. Its application areas include battlefields and vehicular and disaster areas. Many techniques applied to infrastructure-based networks are less effective in MANETs, with routing being a particular challenge. This paper presents a rigorous study into simulation techniques for evaluating routing solutions for MANETs with the aim of producing more realistic simulation models and thereby, more accurate protocol evaluations. MANET simulations require models that reflect the world in which the MANET is to operate. Much of the published research uses movement models, such as the random waypoint (RWP model, with arbitrary world sizes and node counts. This paper presents a technique for developing more realistic simulation models to test and evaluate MANET protocols. The technique is animation, which is applied to a realistic scenario to produce a model that accurately reflects the size and shape of the world, node count, movement patterns, and time period over which the MANET may operate. The animation technique has been used to develop a battlefield model based on established military tactics. Trace data has been used to build a model of maritime movements in the Irish Sea. Similar world models have been built using the random waypoint movement model for comparison. All models have been built using the ns-2 simulator. These models have been used to compare the performance of three routing protocols: dynamic source routing (DSR, destination-sequenced distance-vector routing (DSDV, and ad hoc n-demand distance vector routing (AODV. The findings reveal that protocol performance is dependent on the model used. In particular, it is shown that RWP models do not reflect the performance of these protocols under realistic circumstances, and protocol selection is subject to the scenario to which it is applied. To

Rapid intra-operative diagnosis of kidney cancer by attenuated total reflection infrared spectroscopy of tissue smears.

Science.gov (United States)

Pucetaite, Milda; Velicka, Martynas; Urboniene, Vidita; Ceponkus, Justinas; Bandzeviciute, Rimante; Jankevicius, Feliksas; Zelvys, Arunas; Sablinskas, Valdas; Steiner, Gerald

2018-01-09

Herein, a technique to analyze air-dried kidney tissue impression smears by means of attenuated total reflection infrared (ATR-IR) spectroscopy is presented. Spectral tumor markers-absorption bands of glycogen-are identified in the ATR-IR spectra of the kidney tissue smear samples. Thin kidney tissue cryo-sections currently used for IR spectroscopic analysis lack such spectral markers as the sample preparation causes irreversible molecular changes in the tissue. In particular, freeze-thaw cycle results in degradation of the glycogen and reduction or complete dissolution of its content. Supervised spectral classification was applied to the recorded spectra of the smears and the test spectra were classified with a high accuracy of 92% for normal tissue and 94% for tumor tissue, respectively. For further development, we propose that combination of the method with optical fiber ATR probes could potentially be used for rapid real-time intra-operative tissue analysis without interfering with either the established protocols of pathological examination or the ordinary workflow of operating surgeon. Such approach could ensure easier transition of the method to clinical applications where it may complement the results of gold standard histopathology examination and aid in more precise resection of kidney tumors. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Comparison of the time taken for localised breast surgery pre- and post-introduction of intra-operative digital specimen mammography.

Science.gov (United States)

Carraro do Nascimento, Vinicius; Bourke, Anita G

2018-02-01

More than half of the patients with an impalpable malignant breast lesion have a mammographically detected and imaged-guided localisation, which can be technically challenging for the breast surgeon. Specimen imaging is used to confirm successful excision of the localised index lesion and has improved the operating list efficiency resulting in a higher number of excisions per surgical list. The aim of this study was to evaluate whether introducing IDSM (intra-operative digital specimen mammography) saved operation time for localised breast surgery. A single-centre retrospective review was undertaken to compare the operation time (from incision to wound closure) taken for excision of 114 consecutive image-guided localised impalpable breast lesions, performed using departmental specimen radiography (DSR), 6 months prior to the introduction of IDSM (Hologic, Trident ® ) in March 2013, with the theatre time taken for excision of 121 consecutive image-guided localised impalpable breast lesions in the 6 months following introduction of IDSM. There was no significant difference in mean surgical time, which were 47.8 (±27.3) minutes in the CSR group and 48.8 (±25.7) minutes in the IDSM group. We were expecting to confirm a reduction in theatre time with the introduction of IDSM. Surprisingly, no difference in operating times was demonstrated. Factors that influenced the impact of IDSM included the proximity of the imaging department to the operating theatre. © 2017 The Royal Australian and New Zealand College of Radiologists.

Realistic roofs over a rectilinear polygon

KAUST Repository

Ahn, Heekap

2013-11-01

Given a simple rectilinear polygon P in the xy-plane, a roof over P is a terrain over P whose faces are supported by planes through edges of P that make a dihedral angle π/4 with the xy-plane. According to this definition, some roofs may have faces isolated from the boundary of P or even local minima, which are undesirable for several practical reasons. In this paper, we introduce realistic roofs by imposing a few additional constraints. We investigate the geometric and combinatorial properties of realistic roofs and show that the straight skeleton induces a realistic roof with maximum height and volume. We also show that the maximum possible number of distinct realistic roofs over P is ((n-4)(n-4)/4 /2⌋) when P has n vertices. We present an algorithm that enumerates a combinatorial representation of each such roof in O(1) time per roof without repetition, after O(n4) preprocessing time. We also present an O(n5)-time algorithm for computing a realistic roof with minimum height or volume. © 2013 Elsevier B.V.

Intra-operative pubic arch interference during prostate seed brachytherapy in patients with CT-based pubic arch interference of ≤1 cm

International Nuclear Information System (INIS)

Sejpal, Samir V.; Sathiaseelan, Vythialingam; Helenowski, Irene B.; Kozlowski, James M.; Carter, Michael F.; Nadler, Robert B.; Dalton, Daniel P.; McVary, Kevin T.; Lin, William W.; Garnett, John E.; Kalapurakal, John A.

2009-01-01

Purpose: There are only a few reports on the frequency of intra-operative pubic arch interference (I-PAI) during prostate seed brachytherapy (PB). Materials and methods: Two hundred and forty-three patients with a CT-based pubic arch interference (PAI) of ≤1 cm and a prostate volume of ≤50-60 cc underwent PB. Those patients requiring needle repositioning by ≥0.5 cm on the template were scored as having I-PAI. The incidence of I-PAI and its impact on biochemical control were analyzed. Results: Intra-operative PAI was encountered in 47 (19.3%) patients. Forty two patients (17.3%) had I-PAI in 1-2 needles, two (0.8%) had I-PAI in four needles and three patients (1.2%) had I-PAI in six needles. Overall, 1.4% of needles required repositioning due to I-PAI. BMI > 27 kg/m 2 and wider (>75 mm) pubic bone separation at mid ramus (PS-ML) were associated with a lower incidence of I-PAI. At a median follow-up of 50.1 months, the 3- and 5-year bPFS was 97.3% and 95.2%, respectively. The 5-year bPFS rates for patients with and without I-PAI were 95.6% and 95%, respectively (p = 0.28). Conclusions: The use of CT-based PAI of ≤1 cm as a selection criterion for PB is a simple and reliable method for minimizing the incidence of I-PAI and maintaining excellent biochemical control rates.

Radiation Protection in the intra-and post-operative diagnosis of the sentinel lymph node (SLN)

International Nuclear Information System (INIS)

Kopp, J.; Wengenmair, H.

2002-01-01

Radioactive marked colloids have gained wide acceptance in the diagnosis of sentinel lymph nodes (SLN) compared to dyes. Therefore various aspects of radiation protection have to be taken into account. Application and preoperative diagnosis usually takes place in a nuclear medicine ward where the personnel is highly trained in the use of radioactive materials. Intra-and postoperative diagnosis involves personnel in the operating cabinet and the pathology that is not necessarily radiation protected and trained and therefore should not exceed a yearly dose of ImSv. Organizational problems would arise if all those people have to be included into a full radiation protection program and supervision. The expected exposure has to considered to decide about the necessary actions that have to be taken. Additionally the exposure of the patient has to be estimated to assess the corresponding radiation risk. The reason for a wide resulting variation of organ dose are the uncertainties of the various methods of dose calculation, the individual differences of the patients (e. g. size of mamma) and the differences in surgical removal of radioactivity contaminated tissue. (Author)

Improvement on the KFOOD code for more realistic assessment of the annual food chain radiation dose due to operating nuclear facilities

International Nuclear Information System (INIS)

Choi, Yong Ho; Lee, Chang Woo; Kim, Jin Kyu; Lee, Myung Ho; Lee, Jeong Ho

1993-01-01

More realistic calculation models for evaluating man's annual intakes of radionuclides released from operating nuclear facilities were established. For the application of these models, the harvest years of food and feed crops consumed in the year of dose assessment and every year's average concentrations of a radionuclide in air and in water for the whole period of real operation had to be taken into account. KFOOD, an existing equilibrium food chain computer code for the Korean dose assessment, was modified according to the models. Sample runs of the modified code on the assumption of a constant release during 10 years' operation were made with three kinds of the input data files enabling the dose assessment in the improved method, the KFOOD method and another existing method, respectively, and the results were compared. Annual committed effective doses to Korean adult by intakes of Mn-54, Co-60, Sr-90, I-131 and Cs-137 calculated in the improved method were about 11, 2, 5, 60 and 3 %, respectively, lower than the corresponding KFOOD dose. To the intakes of the radionuclides except Sr-90 evaluated in the improved method, foliar uptake contributed much more than root uptake did but, in the case of Sr-90, the result was opposite. (Author)

Elbow dislocation with intra-articular fracture: the results of operative treatment without repair of the medial collateral ligament.

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Forthman, Christopher; Henket, Marjolijn; Ring, David C

2007-10-01

To determine the effectiveness of a protocol for the treatment of fracture-dislocations of the elbow based on the concept that, if dislocation of the elbow with associated fractures can be made to resemble a simple elbow dislocation by repairing or reconstructing the fractured structures, repair of the medial collateral ligament (MCL) will not be necessary. Over a 5-year period, a single surgeon operated on 34 patients with a posterior dislocation of the elbow associated with one or more intra-articular fractures. The mean age of these 19 men and 15 women was 48 years. Associated fractures included the capitellum, trochlea, and lateral epicondyle in 3 patients; the olecranon in 1 patient; and the radial head in 30 patients (with concomitant fracture of the coronoid process-the so-called "terrible triad" of the elbow-in 22 patients, and concomitant fracture of the coronoid and olecranon in 1 patient). Operative treatment consisted of open reduction internal fixation (ORIF) or prosthetic replacement of all fractures and reattachment of the origin of the lateral collateral ligament (LCL) complex to the lateral epicondyle. The MCL was not repaired. Two patients (1 with a terrible triad injury and 1 with fracture of the capitellum and trochlea) had postoperative instability related to noncompliance, had reconstructive procedures, and were considered failures. An average of 32 months after injury, the remaining 32 patients regained an average of 120 degrees ulnohumeral motion and 142 degrees forearm rotation. Twenty-five of 34 patients (74%) had good or excellent results according to the system of Broberg and Morrey. Patients with terrible triad injuries had an average of 117 degrees ulnohumeral motion and 137 degrees forearm rotation, and 17 of 22 patients (77%) had good or excellent results. MCL repair is unnecessary in the treatment of dislocation of the elbow with associated intra-articular fractures, provided that the articular fractures and the LCL are repaired or

Uncertainty and operational considerations in mass prophylaxis workforce planning.

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Hupert, Nathaniel; Xiong, Wei; King, Kathleen; Castorena, Michelle; Hawkins, Caitlin; Wu, Cindie; Muckstadt, John A

2009-12-01

The public health response to an influenza pandemic or other large-scale health emergency may include mass prophylaxis using multiple points of dispensing (PODs) to deliver countermeasures rapidly to affected populations. Computer models created to date to determine "optimal" staffing levels at PODs typically assume stable patient demand for service. The authors investigated POD function under dynamic and uncertain operational environments. The authors constructed a Monte Carlo simulation model of mass prophylaxis (the Dynamic POD Simulator, or D-PODS) to assess the consequences of nonstationary patient arrival patterns on POD function under a variety of POD layouts and staffing plans. Compared are the performance of a standard POD layout under steady-state and variable patient arrival rates that may mimic real-life variation in patient demand. To achieve similar performance, PODs functioning under nonstationary patient arrival rates require higher staffing levels than would be predicted using the assumption of stationary arrival rates. Furthermore, PODs may develop severe bottlenecks unless staffing levels vary over time to meet changing patient arrival patterns. Efficient POD networks therefore require command and control systems capable of dynamically adjusting intra- and inter-POD staff levels to meet demand. In addition, under real-world operating conditions of heightened uncertainty, fewer large PODs will require a smaller total staff than many small PODs to achieve comparable performance. Modeling environments that capture the effects of fundamental uncertainties in public health disasters are essential for the realistic evaluation of response mechanisms and policies. D-PODS quantifies POD operational efficiency under more realistic conditions than have been modeled previously. The authors' experiments demonstrate that effective POD staffing plans must be responsive to variation and uncertainty in POD arrival patterns. These experiments highlight the need

Navigation system for robot-assisted intra-articular lower-limb fracture surgery.

Science.gov (United States)

Dagnino, Giulio; Georgilas, Ioannis; Köhler, Paul; Morad, Samir; Atkins, Roger; Dogramadzi, Sanja

2016-10-01

In the surgical treatment for lower-leg intra-articular fractures, the fragments have to be positioned and aligned to reconstruct the fractured bone as precisely as possible, to allow the joint to function correctly again. Standard procedures use 2D radiographs to estimate the desired reduction position of bone fragments. However, optimal correction in a 3D space requires 3D imaging. This paper introduces a new navigation system that uses pre-operative planning based on 3D CT data and intra-operative 3D guidance to virtually reduce lower-limb intra-articular fractures. Physical reduction in the fractures is then performed by our robotic system based on the virtual reduction. 3D models of bone fragments are segmented from CT scan. Fragments are pre-operatively visualized on the screen and virtually manipulated by the surgeon through a dedicated GUI to achieve the virtual reduction in the fracture. Intra-operatively, the actual position of the bone fragments is provided by an optical tracker enabling real-time 3D guidance. The motion commands for the robot connected to the bone fragment are generated, and the fracture physically reduced based on the surgeon's virtual reduction. To test the system, four femur models were fractured to obtain four different distal femur fracture types. Each one of them was subsequently reduced 20 times by a surgeon using our system. The navigation system allowed an orthopaedic surgeon to virtually reduce the fracture with a maximum residual positioning error of [Formula: see text] (translational) and [Formula: see text] (rotational). Correspondent physical reductions resulted in an accuracy of 1.03 ± 0.2 mm and [Formula: see text], when the robot reduced the fracture. Experimental outcome demonstrates the accuracy and effectiveness of the proposed navigation system, presenting a fracture reduction accuracy of about 1 mm and [Formula: see text], and meeting the clinical requirements for distal femur fracture reduction procedures.

Gallic Acid Attenuates Postoperative Intra-Abdominal Adhesion by Inhibiting Inflammatory Reaction in a Rat Model

Science.gov (United States)

Wei, Guangbing; Wu, Yunhua; Gao, Qi; Shen, Cong; Chen, Zilu; Wang, Kang; Yu, Junhui

2018-01-01

Background Intra-abdominal adhesion is one of the most common complications after abdominal surgery. The efficacy of current treatments for intra-abdominal adhesion is unsatisfactory. In this study, we investigated the effect of gallic acid on the prevention and treatment of intra-abdominal adhesions after abdominal surgery using an intra-abdominal adhesion rat model. Material/Methods The experimental rats were randomly divided into the sham operation group, the control group, the chitosan group, and 3 gallic acid groups of different concentrations. All rats except those in the sham operation group received cecal abrasion to induce adhesion. From the first postoperative day, the rats in the gallic acid groups were administered different concentrations of gallic acid in a 2-ml gavage daily. All rats were sacrificed on postoperative day 7, and the degree of intra-abdominal adhesion was evaluated by the naked eye. The amount of collagen deposited between the injured peritoneal tissues was assessed by Sirius red staining. Serum levels of interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and transforming growth factor-β (TGF-β) were measured by ELISA. Western blot was used to detect the level of NF-κB phosphorylation in the injured peritoneal or adhesion tissues of the rats. Results Compared with the control group, the scores of intra-abdominal adhesions in the rats treated with larger doses of gallic acid were significantly decreased, and the degree of inflammation and fibrosis was also significantly decreased. Gallic acid significantly reduced IL-6, TNF-α, and TGF-β1 serum levels. NF-κB phosphorylation in the higher gallic acid groups was significantly reduced. Conclusions Gallic acid inhibits the formation of postoperative intra-abdominal adhesions in rats by inhibiting the inflammatory reaction and fibrogenesis. Gallic acid is a promising drug for preventing intra-abdominal adhesions. PMID:29429982

Feasibility of integrating a multi-camera optical tracking system in intra-operative electron radiation therapy scenarios

International Nuclear Information System (INIS)

García-Vázquez, V; Marinetto, E; Santos-Miranda, J A; Calvo, F A; Desco, M; Pascau, J

2013-01-01

Intra-operative electron radiation therapy (IOERT) combines surgery and ionizing radiation applied directly to an exposed unresected tumour mass or to a post-resection tumour bed. The radiation is collimated and conducted by a specific applicator docked to the linear accelerator. The dose distribution in tissues to be irradiated and in organs at risk can be planned through a pre-operative computed tomography (CT) study. However, surgical retraction of structures and resection of a tumour affecting normal tissues significantly modify the patient's geometry. Therefore, the treatment parameters (applicator dimension, pose (position and orientation), bevel angle, and beam energy) may require the original IOERT treatment plan to be modified depending on the actual surgical scenario. We propose the use of a multi-camera optical tracking system to reliably record the actual pose of the IOERT applicator in relation to the patient's anatomy in an environment prone to occlusion problems. This information can be integrated in the radio-surgical treatment planning system in order to generate a real-time accurate description of the IOERT scenario. We assessed the accuracy of the applicator pose by performing a phantom-based study that resembled three real clinical IOERT scenarios. The error obtained (2 mm) was below the acceptance threshold for external radiotherapy practice, thus encouraging future implementation of this approach in real clinical IOERT scenarios. (paper)

High-dose rate intra-operative radiation therapy for local advanced and recurrent colorectal cancer

International Nuclear Information System (INIS)

Harrison, L.B.; Mychalczak, B.; Enker, W.; Anderson, L.; Cohen, A.E.; Minsky, B.

1996-01-01

In an effort to improve the local control for advanced and recurrent cancers of the rectum, we have integrated high-dose rate intra-operative radiation therapy (HDR-IORT) into the treatment program. Between 11/92 and 10/95, 47 patients (pts) were treated. There were 26 males and 21 females whose ages ranged from 30-80 (median = 62) years. There were 19 pts with primary unresectable rectal cancer, and 28 pts who were treated for recurrent rectal cancer. Histology was adenocarcinoma - 45 pts, squamous cancer - 2 pts. The range of follow-up is 1-34 months (median = 14 months). The majority of primary unresectable pts received pre-operative radiation therapy (4500-5040 cGy) with chemotherapy (5-FU with Leucovorin) 4-6 weeks later, they underwent resection + HDR-IORT (1200 cGy). For the 28 pts with recurrent cancer, the majority received surgery and HDR-IORT alone because they had received prior RT. For the pts with primary unresectable disease, actuarial 2-year local control was 77%, actuarial distant metastasis-free survival was 71%, disease free survival was 66%, and overall survival was 84%. For those pts with recurrent disease, actuarial 2-year local control rate was 65%, distant metastasis-free survival was 65%, disease free survival was 47%, and overall survival was 61%. Complications occurred in 36%. There were no cases where the anatomical distribution of disease, or technical limitations prevented the adequate delivery of HDR-IORT. We conclude that this technique was most versatile, and enabled all appropriate pts to receive IORT. The preliminary data in terms of local control are encouraging, even for the poor prognostic sub-group of pts with recurrent cancer

Intra-operative radiation therapy in cancer of the pancreas. La radiotherapie peroperatoire dans les cancers du pancreas

Energy Technology Data Exchange (ETDEWEB)

Dubois, J.B.; Gu, S.D.; Saint-Aubert, B.; Joyeux, H.; Solassol, C.; Pujol, H. (Centre Regional de Lutte contre le Cancer, 34 - Montpellier (FR))

1991-03-01

We report our experience concerning 22 pancreatic carcinoma bearing patients treated with intra-operative radiation therapy (IORT) after complete surgical excision: duodenopancreatectomy: 15 patients; isthmic and caudal pancreatectomy: 2 patients; total pancreatectomy: 5 patients. The dose delivered to the tumor bed was 20 Gy in 12 patients, 18 Gy in 3 patients and 15 Gy in 7 patients. Three patients died within the 1st month post-surgery from intercurrent diseases. Post-operative morbidity was not significantly modified by IORT as compared to purely surgical treated patients. Out of 19 evaluable patients, we observed local control in 16 patients (79.4%). Causes of death (15/19 patients) were: distant metastases with local control: 7 patients; in situ local failure: 3 patients; regional recurrence outside of the IORT fields: 2 patients; intercurrent diseases: 3 patients. Four patients are still alive without evolutive disease. The median overall survival is 6 months. The mean overall survival is 10.56 months. Excluding patients who died from complications and intercurrent diseases, the median survival is 10 mths and the mean survival 14.5 mths. These results emphasize the improvement in local control with IORT, but without significant improvement in survival which is dependent on local evolution and also systemic disease.

Intra-arterial and intra-venous chemotherapy combined with radiation in the treatment of brain tumours

International Nuclear Information System (INIS)

Watne, K.

1992-01-01

The present investigations were undertaken to study the effect of combining different modalities of chemotherapy with radiation in post-operative treatment of brain tumours. The conclusions and clinical implication of the investigations are as follows: The combination of combined intra-arterial chemotherapy followed by radiation leads to an increased median survival with more long term survivors in patients with anaplastic astrocytomas and in patients older than 40 years with astrocytomas. In patients with glioblastoma multiforme, this modality of treatment do not improve median survival, but an increased number of long-term survivors may be seen. Patients younger than 40 years with astrocytomas do not benefit from this modality of treatment. A parallelism exists between sensitivity to chemotherapy and response to radiotherapy. Patients who will benefit from the treatment may be selected early, normally two months after treatment start. Combining intra-arterial chemotherapy and radiation does not lead to an increased incidence of adverse CNS reactions. Specific transient abnormalities in the brain may occur during the first year after treatment and may be misinterpreted as tumour recurrence. EEG may be valuable in predicting adverse CNS reactions following treatment. Nuclear brain scan may be of valuable in selecting the patients who are in danger of developing adverse CNS reactions. Intra-arterial chemotherapy does have an effect in patients with brain tumours who have recurrent tumour after radiation. The most important prognostic factors are age, corticosteroid dependency at treatment start, performance status, histology and frontal lobe location. 103 refs., 2 tabs

Psychophysical workload in the operating room: primary surgeon versus assistant.

Science.gov (United States)

Rieger, Annika; Fenger, Sebastian; Neubert, Sebastian; Weippert, Matthias; Kreuzfeld, Steffi; Stoll, Regina

2015-07-01

Working in the operating room is characterized by high demands and overall workload of the surgical team. Surgeons often report that they feel more stressed when operating as a primary surgeon than in the function as an assistant which has been confirmed in recent studies. In this study, intra-individual workload was assessed in both intraoperative functions using a multidimensional approach that combined objective and subjective measures in a realistic work setting. Surgeons' intraoperative psychophysiologic workload was assessed through a mobile health system. 25 surgeons agreed to take part in the 24-hour monitoring by giving their written informed consent. The mobile health system contained a sensor electronic module integrated in a chest belt and measuring physiological parameters such as heart rate (HR), breathing rate (BR), and skin temperature. Subjective workload was assessed pre- and postoperatively using an electronic version of the NASA-TLX on a smartphone. The smartphone served as a communication unit and transferred objective and subjective measures to a communication server where data were stored and analyzed. Working as a primary surgeon did not result in higher workload. Neither NASA-TLX ratings nor physiological workload indicators were related to intraoperative function. In contrast, length of surgeries had a significant impact on intraoperative physical demands (p NASA-TLX sum score (p < 0.01; η(2) = 0.287). Intra-individual workload differences do not relate to intraoperative role of surgeons when length of surgery is considered as covariate. An intelligent operating management that considers the length of surgeries by implementing short breaks could contribute to the optimization of intraoperative workload and the preservation of surgeons' health, respectively. The value of mobile health systems for continuous psychophysiologic workload assessment was shown.

A novel intra-operative positron imager for rapid localization of tumor margins

Science.gov (United States)

Sabet, Hamid; Stack, Brendan C.; Nagarkar, Vivek V.

2014-03-01

We have developed an intra-operative and compact imaging tool for surgeons to detect PET- positive lesions. Currently, most such probes on the market are non-imaging, and provide no ancillary information of surveyed areas, such as clear delineations of malignant tissues. Our probe consists of a novel hybrid scintillator coupled to a compact silicon photomultiplier (SiPM) array with associated front-end electronics encapsulated in an ergonomic housing. Pulse shape discrimination electronics has been implemented and integrated into the downstream data acquisition system. The hybrid scintillator consists of a 0.4 mm thick layer of CsI:Tl scintillator coupled to a 1 mm thick LYSO crystal. To achieve high spatial resolution, CsI:Tl is pixelated to 0.5×0.5 mm2 pixels using laser ablation technique. While CsI:Tl act as beta-sensitive scintillator, LYSO senses the gamma radiation and can be used to navigate the probe to the locations of interest. The gamma response is also subtracted from the beta image for improved SNR and contrast. To achieve accurate centroid position estimation and uniform beta sensitivity over the entire imaging area, the LYSO thickness is optimized such that it acts as scintillation light diffuser by spreading CsI:Tl light over multiple SiPM pixels. The results show that the response of the two scintillators exposed to radiation could be easily distinguished based on their pulse shapes. The probe's spatial resolution is beta radiation even in presence of strong gamma background.

Hemodynamic effects of dexmedetomidine during intra-operative electrocorticography for epilepsy surgery

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G Chaitanya

2014-01-01

Full Text Available Background: Dexmedetomidine, a predominant alpha-2-adrenergic agonist has been used in anesthetic practice to provide good sedation. The drug is being recently used in neuroanesthesia during awake surgery for brain tumors and in functional neurosurgery. Materials and Methods: This prospective study analyzed the hemodynamic effects of dexmedetomidine infusion during electrocorticography in patients undergoing surgery for mesial temporal sclerosis. Dexmedetomidine infusion was administered during intra-operative electrocorticography recording, 15 minutes after the end tidal MAC of N 2 O and isoflurane were decreased to zero. Anesthesia was maintained with O 2 :air mixture = 50:50, vecuronium and fentanyl. Heart rate (HR, mean arterial pressure (MAP and end tidal carbon dioxide (ETCO 2 were recorded across at induction, 2 min prior to dexmedetomidine (PreDEX, 5 min during dexmedetomidine infusion (DEX; 1 μg/kg, 5 min after stopping dexmedetomidine and 10 minutes after stopping dexmedetomidine. Results: Forty patients with mesial temporal sclerosis (M: F = 27:13, mean age = 28.15 ± 10.9 years; duration of epilepsy = 12.0 ± 7.9 years underwent anterior temporal lobe resection with amygdalohippocampectomy for drug-resistant epilepsy. Infusion of dexmedetomidine caused a transient fall in HR in 87.5% of patients and an increase in MAP in 62.5% of patients, which showed a tendency to revert back towards PreDEX values within 10 min after stopping the infusion. Sixty-five percent of the patients showed ≤25% reduction and 10% of them showed >25% reduction in HR. 47.5% of the patients showed ≤25% increase and 15% of them showed >25% increase in MAP. These changes were over a narrow range and within physiological limits. Conclusion: The infusion of dexmedetomidine for a short period causes reduction of HR and increase in MAP in patients, however the variations are within acceptable range.

Realistic minimum accident source terms - Evaluation, application, and risk acceptance

International Nuclear Information System (INIS)

Angelo, P. L.

2009-01-01

The evaluation, application, and risk acceptance for realistic minimum accident source terms can represent a complex and arduous undertaking. This effort poses a very high impact to design, construction cost, operations and maintenance, and integrated safety over the expected facility lifetime. At the 2005 Nuclear Criticality Safety Division (NCSD) Meeting in Knoxville Tenn., two papers were presented mat summarized the Y-12 effort that reduced the number of criticality accident alarm system (CAAS) detectors originally designed for the new Highly Enriched Uranium Materials Facility (HEUMF) from 258 to an eventual as-built number of 60. Part of that effort relied on determining a realistic minimum accident source term specific to the facility. Since that time, the rationale for an alternate minimum accident has been strengthened by an evaluation process that incorporates realism. A recent update to the HEUMF CAAS technical basis highlights the concepts presented here. (authors)

Asymmetric focusing study from twin input power couplers using realistic rf cavity field maps

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Colwyn Gulliford

2011-03-01

Full Text Available Advanced simulation codes now exist that can self-consistently solve Maxwell’s equations for the combined system of an rf cavity and a beam bunch. While these simulations are important for a complete understanding of the beam dynamics in rf cavities, they require significant time and computing power. These techniques are therefore not readily included in real time simulations useful to the beam physicist during beam operations. Thus, there exists a need for a simplified algorithm which simulates realistic cavity fields significantly faster than self-consistent codes, while still incorporating enough of the necessary physics to ensure accurate beam dynamics computation. To this end, we establish a procedure for producing realistic field maps using lossless cavity eigenmode field solvers. This algorithm incorporates all relevant cavity design and operating parameters, including beam loading from a nonrelativistic beam. The algorithm is then used to investigate the asymmetric quadrupolelike focusing produced by the input couplers of the Cornell ERL injector cavity for a variety of beam and operating parameters.

Automatic intra-operative generation of geometric left atrium/pulmonary vein models from rotational X-ray angiography.

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Meyer, Carsten; Manzke, Robert; Peters, Jochen; Ecabert, Olivier; Kneser, Reinhard; Reddy, Vivek Y; Chan, Raymond C; Weese, Jürgen

2008-01-01

Pre-procedural imaging with cardiac CT or MR has become popular for guiding complex electrophysiology procedures such as those used for atrial fibrillation ablation therapy. Electroanatomical mapping and ablation within the left atrium and pulmonary veins (LAPV) is facilitated using such data, however the pre-procedural anatomy can be quite different from that at the time of intervention. Recently, a method for intra-procedural LAPV imaging has been developed based on contrast-enhanced 3-D rotational X-ray angiography (3-D RA). These intraprocedural data now create a compelling need for rapid and automated extraction of the LAPV geometry for catheter guidance. We present a new approach to automatic intra-procedural generation of LAPV surfaces from 3-D RA volumes. Using model-based segmentation, our technique is robust to imaging noise and artifacts typical of 3-D RA imaging, strongly minimizes the user interaction time required for segmentation, and eliminates inter-subject variability. Our findings in 33 patients indicate that intra-procedural LAPV surface models accurately represent the anatomy at the time of intervention and are comparable to pre-procedural models derived from CTA or MRA.

Intra-oral pressure-based voicing control of electrolaryngeal speech with intra-oral vibrator.

Science.gov (United States)

Takahashi, Hirokazu; Nakao, Masayuki; Kikuchi, Yataro; Kaga, Kimitaka

2008-07-01

In normal speech, coordinated activities of intrinsic laryngeal muscles suspend a glottal sound at utterance of voiceless consonants, automatically realizing a voicing control. In electrolaryngeal speech, however, the lack of voicing control is one of the causes of unclear voice, voiceless consonants tending to be misheard as the corresponding voiced consonants. In the present work, we developed an intra-oral vibrator with an intra-oral pressure sensor that detected utterance of voiceless phonemes during the intra-oral electrolaryngeal speech, and demonstrated that an intra-oral pressure-based voicing control could improve the intelligibility of the speech. The test voices were obtained from one electrolaryngeal speaker and one normal speaker. We first investigated on the speech analysis software how a voice onset time (VOT) and first formant (F1) transition of the test consonant-vowel syllables contributed to voiceless/voiced contrasts, and developed an adequate voicing control strategy. We then compared the intelligibility of consonant-vowel syllables among the intra-oral electrolaryngeal speech with and without online voicing control. The increase of intra-oral pressure, typically with a peak ranging from 10 to 50 gf/cm2, could reliably identify utterance of voiceless consonants. The speech analysis and intelligibility test then demonstrated that a short VOT caused the misidentification of the voiced consonants due to a clear F1 transition. Finally, taking these results together, the online voicing control, which suspended the prosthetic tone while the intra-oral pressure exceeded 2.5 gf/cm2 and during the 35 milliseconds that followed, proved efficient to improve the voiceless/voiced contrast.

Intra-parotid dermoid cyst: excision through a face lift incision.

Science.gov (United States)

Shakeel, M; Keh, S M; Chapman, A; Hussain, A

2014-11-01

Intra-parotid dermoid cysts are extremely rare. Clinically, they present like any other parotid lump and pre-operative diagnosis is rarely possible. A 62 years old Caucasian man presented with a painless lump in his right parotid region. The Magnetic Resonance Imaging (MRI) scan revealed a 3 x 3 cm mass in the parotid tail. Cytological examination was unhelpful. The patient underwent successful excision of the cyst through a small face lift incision. No drain was inserted and the patient was discharged home the same day. The patient made an uneventful recovery and was highly satisfied with the aesthetic outcome. The definite histopathological diagnosis was an intra-parotid dermoid cyst.

Effect of intra-abdominal volume increment technique for the treatment of intra-abdominal hypertension on the liver after resuscitation of hemorrhagic shock in pig

Directory of Open Access Journals (Sweden)

Zheng-gang WANG

2012-02-01

Full Text Available Objective  To observe the effect of vacuum sealing drainage (VSD assisted intra-abdominal volume increment (IAVI technique on the liver in the treatment of intra-abdominal hypertension (IAH following hemorrhagic shock resuscitation in pigs. Methods  Twelve healthy mini-pigs (Bama, Guangxi were selected for bloodletting from the femoral artery to reproduce hemorrhagic shock model (mean arterial blood pressure, 50mmHg, 1h, and IAH model was successfully reproduced in eight pigs by partial occlusion of portal vein. The eight pigs were randomly divided into the intra-abdominal volume increment treatment (IT group (n=4 and sham operation control (SC group (n=4. Vesical pressure (VP and inferior vena cava pressure (IVCP were observed before shock, 2h after IAH, and 22h after IAVI treatment. Aspartate aminotransferase (AST and alanine aminotransferase (ALT were measured. In addition, the ratio of the abdominal anteroposterior diameter to the transverse diameter was assessed, and the liver CT values were measured after enhanced CT scanning. The pigs were sacrificed 26h after operation. Liver specimens were collected to measure the ratio of wet weight to dry weight and pathological examination. Results  The VP in 8 IAH pigs was 21.16±4.63mmHg. The ratio of abdominal anteroposterior diameter to the transverse diameter increased remarkably 2h after IAH compared with that before shock (1.22±1.41 vs 0.96±0.08, PPvs 42.73±4.92HU, PPPvs 5.14±0.71, PConclusions  The established model could better reproduce the symptoms of IAH after hemorrhagic shock and fluid resuscitation, accompanied by liver damage. IAVI helps to relieve liver functional disturbance after IAH, which is related to decreased intra-abdominal pressure and hypoxia-ischemia of the liver.

Margin improvement initiatives: realistic approaches

Energy Technology Data Exchange (ETDEWEB)

Chan, P.K.; Paquette, S. [Royal Military College of Canada, Chemistry and Chemical Engineering Dept., Kingston, ON (Canada); Cunning, T.A. [Department of National Defence, Ottawa, ON (Canada); French, C.; Bonin, H.W. [Royal Military College of Canada, Chemistry and Chemical Engineering Dept., Kingston, ON (Canada); Pandey, M. [Univ. of Waterloo, Waterloo, ON (Canada); Murchie, M. [Cameco Fuel Manufacturing, Port Hope, ON (Canada)

2014-07-01

With reactor core aging, safety margins are particularly tight. Two realistic and practical approaches are proposed here to recover margins. The first project is related to the use of a small amount of neutron absorbers in CANDU Natural Uranium (NU) fuel bundles. Preliminary results indicate that the fuelling transient and subsequent reactivity peak can be lowered to improve the reactor's operating margins, with minimal impact on burnup when less than 1000 mg of absorbers is added to a fuel bundle. The second project involves the statistical analysis of fuel manufacturing data to demonstrate safety margins. Probability distributions are fitted to actual fuel manufacturing datasets provided by Cameco Fuel Manufacturing, Inc. They are used to generate input for ELESTRES and ELOCA. It is found that the fuel response distributions are far below industrial failure limits, implying that margin exists in the current fuel design. (author)

Realistic control considerations for electromagnetically levitated urban transit vehicles

Energy Technology Data Exchange (ETDEWEB)

Billing, J R

1976-04-01

A discussion is given of realistic control considerations of suspension dynamics and vehicle/guideway interaction for electromagnetically-levitated urban transit vehicles in the context of revenue applications. The emphasis is on safety, reliability, and maintainability rather than performance. An example urban transit system is described, and the following considerations of dynamics and control are examined: stability, magnet force requirements, magnet airgap requirements, vehicle ride, and component failures. It is shown that it is a formidable problem to ensure suspension stability under all conditions; that operation on curves is a critical magnet and control system design case; that operation of the magnets in the non-linear regime is unavoidable and that component failures will be a major problem. However, good vehicle ride is to be expected. It is concluded that magnetic levitation suspension technology requires substantial development effort before it can be considered suitable for revenue operation.

Predictors of cardiogenic shock in cardiac surgery patients receiving intra-aortic balloon pumps.

Science.gov (United States)

Iyengar, Amit; Kwon, Oh Jin; Bailey, Katherine L; Ashfaq, Adeel; Abdelkarim, Ayman; Shemin, Richard J; Benharash, Peyman

2018-02-01

Cardiogenic shock after cardiac surgery leads to severely increased mortality. Intra-aortic balloon pumps may be used during the preoperative period to increase coronary perfusion. The purpose of this study was to characterize predictors of postoperative cardiogenic shock in cardiac surgery patients with and without intra-aortic balloon pumps support. We performed a retrospective analysis of our institutional database of the Society of Thoracic Surgeons for patients operated between January 2008 to July 2015. Multivariable logistic regression was used to model postoperative cardiogenic shock in both the intra-aortic balloon pumps and matched control cohorts. Overall, 4,741 cardiac surgery patients were identified during the study period, of whom 192 (4%) received a preoperative intra-aortic balloon pump. Intra-aortic balloon pumps patients had a greater prevalence of diabetes, previous cardiac surgery, congestive heart failure, and an urgent/emergent status (P pumps patients also had greater 30-day mortality and more postoperative cardiogenic shock (9% vs 3%, P pumps cohort, only sex, previous percutaneous coronary intervention and preoperative arrhythmia remained significant on multivariable analysis (all P pumps and those who do not. Further analysis of the effects of prophylactic intra-aortic balloon pumps support is warranted. (Surgery 2017;160:XXX-XXX.). Copyright © 2017 Elsevier Inc. All rights reserved.

Analgesic efficacy of intracapsular and intra-articular local anaesthesia for knee arthroplasty

DEFF Research Database (Denmark)

Andersen, L Ø; Husted, H; Kristensen, B B

2010-01-01

The optimal site for wound delivery of local anaesthetic after total knee arthroplasty is undetermined. Sixty patients having total knee arthroplasty received intra-operative infiltration analgesia with ropivacaine 0.2% and were then were randomly assigned to receive either intracapsular or intra......-articular catheters with 20 ml ropivacaine 0.5% given at 6 h and again at 24 h, postoperatively. Analgesic efficacy was assessed for 3 h after each injection, using a visual analogue score, where 0 = no pain and 100 = worst pain. There was no statistically significant difference between groups. Maximum pain relief...

A comparative study to validate the use of ultrasonography and computed tomography in patients with post-operative intra-abdominal sepsis

International Nuclear Information System (INIS)

Go, H.L.S.; Baarslag, H.J.; Vermeulen, H.; Lameris, J.S.; Legemate, D.A.

2005-01-01

Purpose: To validate abdominal ultrasonography and helical computed tomography in detecting causes for sepsis in patients after abdominal surgery and to determine improved criteria for its use. Materials and methods: Eighty-five consecutive surgical patients primarily operated for non-infectious disease were included in this prospective study. Forty-one patients were admitted to the intensive care unit. All patients were suspected of an intra-abdominal sepsis after abdominal surgery. Both ultrasonography (US) and helical abdominal computed tomography (CT) were performed to investigate the origin of an intra-abdominal sepsis. The images of both US and CT were interpreted on a four-point scale by different radiologists or residents in radiology, the investigators were blinded of each other's test. Interpretations of US and CT were compared with a reference standard which was defined by the result of diagnostic aspiration of suspected fluid collections (re)laparotomy, clinical course or the opinion of an independent panel. Likelihood ratios and post-test probabilities were calculated and interobserver agreement was determined using κ statistics. Results: The overall prevalence of an abdominal infection was 0.49. The likelihood ratio (LR) of a positive test-result for US was 1.33 (95% CI: 0.8-2.5) and for CT scan 2.53 (95% CI: 1.4-5.0); corresponding post-test probabilities for US 0.57 (95% CI: 0.42-0.70) and for CT 0.71 (95% CI: 0.57-0.83). The LR of a negative test-result was, respectively, 0.60 (95% CI: 0.3-1.3) and 0.18 (95% CI: 0.06-0.5); corresponding post-test probabilities for US 0.37 (95% CI: 0.20-0.57) and for CT 0.15 (95% CI: 0.06-0.32) were calculated. Conclusion: Computed tomography can be used as the imaging modality of choice in patients suspected of intra-abdominal sepsis after abdominal surgery. Because of the low discriminatory power ultrasonography should not be performed as initial diagnostic test

The Increase of Intra-Abdominal Pressure Can Affect Intraocular Pressure

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Ilhan Ece

2015-01-01

Full Text Available Objective. This study aims to explore the usage of intraocular pressure measurements as the early indicator of the increase in intra-abdominal pressure. Methods. In this prospective study, 40 patients undergoing elective surgery were included. Patients were divided into four groups of 10 patients. The control group (Group C was not subjected to laparoscopic intervention. Laparoscopic surgery was, respectively, performed with an intra-abdominal pressure of 9, 12, and 15 mmHg in Groups L (low, M (medium, and H (high pressure. Intraocular pressure was measured binocularly in each patient at three different times (before, during, and end of surgery using a contact tonometer. Results. Patients’ gender, age, body mass index (BMI, American Society of Anesthesiology (ASA class, and operative times were not different among the groups. No complications occurred with either the surgery or measurement of intraocular pressure. Intubation was associated with a severe rise in IOP (P<0.05. An increase in intraocular pressure was seen in groups M and H (P<0.05. Conclusion. Intraocular pressure was increased in the groups with an intra-abdominal pressure of 12 mmHg or more. Measuring the intraocular pressure might be a useful method to estimate the intra-abdominal pressure. This trial is registered with NCT02319213.

Intra-operative colloid administration increases the clearance of a post-operative fluid load

DEFF Research Database (Denmark)

Borup, Tine; Hahn, Robert; Holte, K

2009-01-01

using volume kinetics based on the plasma dilution alone. The pre-operative plasma clearance was compared with the post-operative plasma clearance and patients served as their own control. RESULTS: The urinary excretion averaged 350 ml for the pre-operative infusion and 612 ml post-operatively, which...

A psychology of religious plurality: from intra-religious dialogue to intra-psychic reality.

Science.gov (United States)

Kramp, Joseph M

2012-09-01

Panikkar's (The intra-religious dialogue, 1978) classic, re-issued by Paulist Press in 1999, grapples with the theological challenges in the disciplines of comparative theology and the theology of religions through what he terms, "intra-religious dialogue." In this psychology of religious plurality, I use works from a variety of disciplines to highlight the achievements of Panikkar's intra-religious dialogue, as well as to critique his work in the hope of finding categories of understanding that can be profitably used to face the inter-personal crises of the contemporary world, namely religious terrorism.

Tuukka Kaidesoja on Critical Realist Transcendental Realism

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Groff Ruth

2015-09-01

Full Text Available I argue that critical realists think pretty much what Tukka Kaidesoja says that he himself thinks, but also that Kaidesoja’s objections to the views that he attributes to critical realists are not persuasive.

Tight intra-operative blood pressure control versus standard care for patients undergoing hip fracture repair - Hip Fracture Intervention Study for Prevention of Hypotension (HIP-HOP) trial: study protocol for a randomised controlled trial.

Science.gov (United States)

Moppett, Iain Keith; White, Stuart; Griffiths, Richard; Buggy, Donal

2017-07-25

Hypotension during anaesthesia for hip fracture surgery is common. Recent data suggest that there is an association between the lowest intra-operative blood pressure and mortality, even when adjusted for co-morbidities. This is consistent with data derived from the wider surgical population, where magnitude and duration of hypotension are associated with mortality and peri-operative complications. However, there are no trial to data to support more aggressive blood pressure control. We are conducting a three-centre, randomised, double-blinded pilot study in three hospitals in the United Kingdom. The sample size will be 75 patients (25 from each centre). Randomisation will be done using computer-generated concealed tables. Both participants and investigators will be blinded to group allocation. Participants will be aged >70 years, cognitively intact (Abbreviated Mental Test Score 7 or greater), able to give informed consent and admitted directly through the emergency department with a fractured neck of the femur requiring operative repair. Patients randomised to tight blood pressure control or avoidance of intra-operative hypotension will receive active treatment as required to maintain both of the following: systolic arterial blood pressure >80% of baseline pre-operative value and mean arterial pressure >75 mmHg throughout. All participants will receive standard hospital care, including spinal or general anaesthesia, at the discretion of the clinical team. The primary outcome is a composite of the presence or absence of defined cardiovascular, renal and delirium morbidity within 7 days of surgery (myocardial injury, stroke, acute kidney injury, delirium). Secondary endpoints will include the defined individual morbidities, mortality, early mobility and discharge to usual residence. This is a small-scale pilot study investigating the feasibility of a trial of tight intra-operative blood pressure control in a frail elderly patient group with known high morbidity

Intra-abdominal pressure during swimming.

Science.gov (United States)

Moriyama, S; Ogita, F; Huang, Z; Kurobe, K; Nagira, A; Tanaka, T; Takahashi, H; Hirano, Y

2014-02-01

The present study aimed to determine the intra-abdominal pressure during front crawl swimming at different velocities in competitive swimmers and to clarify the relationships between stroke indices and changes in intra-abdominal pressure. The subjects were 7 highly trained competitive collegiate male swimmers. Intra-abdominal pressure was measured during front crawl swimming at 1.0, 1.2 and 1.4 m · s(-1) and during the Valsalva maneuver. Intra-abdominal pressure was taken as the difference between minimum and maximum values, and the mean of 6 stable front crawl stroke cycles was used. Stroke rate and stroke length were also measured as stroke indices. There were significant differences in stroke rate among all velocities (P pressure and stroke rate or stroke length (P pressure and stroke indices when controlling for swimming velocity. These findings do not appear to support the effectiveness of trunk training performed by competitive swimmers aimed at increasing intra-abdominal pressure. © Georg Thieme Verlag KG Stuttgart · New York.

Validation of a computational method for assessing the impact of intra-fraction motion on helical tomotherapy plans

Energy Technology Data Exchange (ETDEWEB)

Ngwa, Wilfred; Meeks, Sanford L; Kupelian, Patrick A; Langen, Katja M [Department of Radiation Oncology, M D Anderson Cancer Center Orlando, 1400 South Orange Avenue, Orlando, FL 32806 (United States); Schnarr, Eric [TomoTherapy, Inc., 1240 Deming Way, Madison, WI 53717 (United States)], E-mail: wilfred.ngwa@orlandohealth.com

2009-11-07

In this work, a method for direct incorporation of patient motion into tomotherapy dose calculations is developed and validated. This computational method accounts for all treatment dynamics and can incorporate random as well as cyclical motion data. Hence, interplay effects between treatment dynamics and patient motion are taken into account during dose calculation. This allows for a realistic assessment of intra-fraction motion on the dose distribution. The specific approach entails modifying the position and velocity events in the tomotherapy delivery plan to accommodate any known motion. The computational method is verified through phantom and film measurements. Here, measured prostate motion and simulated respiratory motion tracks were incorporated in the dose calculation. The calculated motion-encoded dose profiles showed excellent agreement with the measurements. Gamma analysis using 3 mm and 3% tolerance criteria showed over 97% and 96% average of points passing for the prostate and breathing motion tracks, respectively. The profile and gamma analysis results validate the accuracy of this method for incorporating intra-fraction motion into the dose calculation engine for assessment of dosimetric effects on helical tomotherapy dose deliveries.

Splenectomy in a Nigerian Teaching Hospital: A comparison of sonographic correlation with intra-operative findings in trauma

Directory of Open Access Journals (Sweden)

Oludolapo Afuwape

2013-01-01

Full Text Available Background: Missed or inappropriately-treated splenic injury is a significant cause of preventable trauma-related death. Physical examination and abdominal ultrasonography are essential tools for early diagnosis of splenic injury. However, some injuries may not be accurately diagnosed by ultrasonography at initial evaluation. Aim: The aim of this study was to audit indications for splenectomy at the University College Hospital, Ibadan and to compare the intra-operative findings in trauma-related cases with the sonographic findings. Materials and Methods: We retrospectively reviewed all adult (12 years and older patients′ records who had splenectomy between July 2003 and June 2010. The data extracted included patient demographics and indications for splenectomy. In trauma cases, the mode of injury and vital signs at presentation, sonographic findings, and operation findings were recorded. The intervals between injury and sonography and duration to surgery were also noted respectively. Results: Eighty-four patients were reviewed in the 7-year review period. The male to female ratio was approximately 2:1. The ages ranged from 14 to 76 years with a peak incidence in the third decade. Elective indications for splenectomy were 14 (16.6%, while 70 (83.3% were emergency cases. Forty-four of the trauma-related patients had pre-operative abdominal ultrasound, of which 31 (70% was reported as sonographically normal prior to surgery, while the rest of the trauma-related cases were considered too ill for ultrasonography. Conclusion: Potentially significant injuries may be missed with screening sonography. For this reason, a physician must maintain a high index of suspicion and consider the patient′s clinical status or an alternative imaging modality in excluding a diagnosis of splenic injury.

Do absorption and realistic distraction influence performance of component task surgical procedure?

OpenAIRE

Pluyter, J.R.; Buzink, S.N.; Rutkowski, A.F.; Jakimowicz, J.J.

2009-01-01

Background. Surgeons perform complex tasks while exposed to multiple distracting sources that may increase stress in the operating room (e.g., music, conversation, and unadapted use of sophisticated technologies). This study aimed to examine whether such realistic social and technological distracting conditions may influence surgical performance. Methods. Twelve medical interns performed a laparoscopic cholecystectomy task with the Xitact LC 3.0 virtual reality simulator under distracting con...

Generating realistic roofs over a rectilinear polygon

KAUST Repository

Ahn, Heekap

2011-01-01

Given a simple rectilinear polygon P in the xy-plane, a roof over P is a terrain over P whose faces are supported by planes through edges of P that make a dihedral angle π/4 with the xy-plane. In this paper, we introduce realistic roofs by imposing a few additional constraints. We investigate the geometric and combinatorial properties of realistic roofs, and show a connection with the straight skeleton of P. We show that the maximum possible number of distinct realistic roofs over P is ( ⌊(n-4)/4⌋ (n-4)/2) when P has n vertices. We present an algorithm that enumerates a combinatorial representation of each such roof in O(1) time per roof without repetition, after O(n 4) preprocessing time. We also present an O(n 5)-time algorithm for computing a realistic roof with minimum height or volume. © 2011 Springer-Verlag.

Intra-day and regime-switching dynamics in electricity price formation

International Nuclear Information System (INIS)

Karakatsani, Nektaria V.; Bunn, Derek W.

2008-01-01

This paper analyses the complex, non-linear effects of spot price drivers in wholesale electricity markets: their intra-day dynamics and transient irregularities. The context is the UK market, after the reforms introduced in March 2001, analysed with an original set of price drivers reflecting economic, technical, strategic, risk, behavioural and market design effects. Models are estimated separately as daily time-series of the 48 half-hourly trading periods. All coefficients exhibit substantial intra-day variation, relating to the heterogeneity of operating plants and market design aspects. This reveals a market responding to economic fundamentals and plant operating properties, with learning and emergent financial characteristics, as well as some strategic manipulation of capacity, most effectively exercised by the more flexible plants. Using regime-switching parameters, the effects of capacity margin and inter-day capacity adjustment are elucidated, suggesting rent-seeking behaviour, despite the relatively low prices at the time. Overall, high-frequency, aggregate fundamental price models can usefully uncover critical aspects of market performance, evolution and agent behaviour. (author)

Development of a realistic human airway model.

Science.gov (United States)

Lizal, Frantisek; Elcner, Jakub; Hopke, Philip K; Jedelsky, Jan; Jicha, Miroslav

2012-03-01

Numerous models of human lungs with various levels of idealization have been reported in the literature; consequently, results acquired using these models are difficult to compare to in vivo measurements. We have developed a set of model components based on realistic geometries, which permits the analysis of the effects of subsequent model simplification. A realistic digital upper airway geometry except for the lack of an oral cavity has been created which proved suitable both for computational fluid dynamics (CFD) simulations and for the fabrication of physical models. Subsequently, an oral cavity was added to the tracheobronchial geometry. The airway geometry including the oral cavity was adjusted to enable fabrication of a semi-realistic model. Five physical models were created based on these three digital geometries. Two optically transparent models, one with and one without the oral cavity, were constructed for flow velocity measurements, two realistic segmented models, one with and one without the oral cavity, were constructed for particle deposition measurements, and a semi-realistic model with glass cylindrical airways was developed for optical measurements of flow velocity and in situ particle size measurements. One-dimensional phase doppler anemometry measurements were made and compared to the CFD calculations for this model and good agreement was obtained.

Wave of chaos in a diffusive system: Generating realistic patterns of patchiness in plankton-fish dynamics

International Nuclear Information System (INIS)

Upadhyay, Ranjit Kumar; Kumari, Nitu; Rai, Vikas

2009-01-01

We show that wave of chaos (WOC) can generate two-dimensional time-independent spatial patterns which can be a potential candidate for understanding planktonic patchiness observed in marine environments. These spatio-temporal patterns were obtained in computer simulations of a minimal model of phytoplankton-zooplankton dynamics driven by forces of diffusion. We also attempt to figure out the average lifetimes of these non-linear non-equilibrium patterns. These spatial patterns serve as a realistic model for patchiness found in aquatic systems (e.g., marine and oceanic). Additionally, spatio-temporal chaos produced by bi-directional WOCs is robust to changes in key parameters of the system; e.g., intra-specific competition among individuals of phytoplankton and the rate of fish predation. The ideas contained in the present paper may find applications in diverse fields of human endeavor.

How markets can end persistent intra-organizational conflict

OpenAIRE

David Zetland

2011-01-01

The literature has described the origin and cost of intra-organizational conflict within the Metropolitan Water District of Southern California (MET). This article explores how this conflict has persisted and suggest ways to resolve it. The key action requires that institutions designed with the assumption of abundant water be reformed to manage scarce water. Without modification to MET’s legal and operational structures, an internal auction market can efficiently and transparently allocate w...

Lasers with intra-cavity phase elements

Science.gov (United States)

Gulses, A. Alkan; Kurtz, Russell; Islas, Gabriel; Anisimov, Igor

2018-02-01

Conventional laser resonators yield multimodal output, especially at high powers and short cavity lengths. Since highorder modes exhibit large divergence, it is desirable to suppress them to improve laser quality. Traditionally, such modal discriminations can be achieved by simple apertures that provide absorptive loss for large diameter modes, while allowing the lower orders, such as the fundamental Gaussian, to pass through. However, modal discrimination may not be sufficient for short-cavity lasers, resulting in multimodal operation as well as power loss and overheating in the absorptive part of the aperture. In research to improve laser mode control with minimal energy loss, systematic experiments have been executed using phase-only elements. These were composed of an intra-cavity step function and a diffractive out-coupler made of a computer-generated hologram. The platform was a 15-cm long solid-state laser that employs a neodymium-doped yttrium orthovanadate crystal rod, producing 1064 nm multimodal laser output. The intra-cavity phase elements (PEs) were shown to be highly effective in obtaining beams with reduced M-squared values and increased output powers, yielding improved values of radiance. The utilization of more sophisticated diffractive elements is promising for more difficult laser systems.

Kuhn: Realist or Antirealist?

Directory of Open Access Journals (Sweden)

Michel Ghins

1998-06-01

Full Text Available Although Kuhn is much more an antirealist than a realist, the earlier and later articulations of realist and antirealist ingredients in his views merit close scrutiny. What are the constituents of the real invariant World posited by Kuhn and its relation to the mutable paradigm-related worlds? Various proposed solutions to this problem (dubbed the "new-world problem" by Ian Hacking are examined and shown to be unsatisfactory. In The Structure of Scientific Revolutions, the stable World can reasonably be taken to be made up of ordinary perceived objects, whereas in Kuhn's later works the transparadigmatic World is identified with something akin to the Kantian world-in-itself. It is argued that both proposals are beset with insuperable difficulties which render Kuhn's earlier and later versions of antirealism implausible.

Intra-operative Vector Flow Imaging Using Ultrasound of the Ascending Aorta among 40 Patients with Normal, Stenotic and Replaced Aortic Valves

DEFF Research Database (Denmark)

Hansen, Kristoffer Lindskov; Møller-Sørensen, Hasse; Kjaergaard, Jesper

2016-01-01

Stenosis of the aortic valve gives rise to more complex blood flows with increased velocities. The angleindependent vector flow ultrasound technique transverse oscillation was employed intra-operatively on the ascending aorta of (I) 20 patients with a healthy aortic valve and 20 patients with aor...... replacement corrects some of these changes. Transverse oscillation may be useful for assessment of aortic stenosis and optimization of valve surgery. (E-mail: lindskov@gmail.com) 2016 World Federation for Ultrasound in Medicine & Biology...... with aortic stenosis before (IIa) and after (IIb) valve replacement. The results indicate that aortic stenosis increased flow complexity (p , 0.0001), induced systolic backflow (p , 0.003) and reduced systolic jet width (p , 0.0001). After valve replacement, the systolic backflow and jet width were normalized...

The intracranial aneurysm: cost-effective of the aneurysm intra-artery GDC embolization and the aneurysm incarcerated operation

International Nuclear Information System (INIS)

Pan Jie; Zhang Shizheng

2008-01-01

Objective: To evaluate the cost-effectiveness of the aneurysm intra-artery GDC embolization and the aneurysm clapping of intracranial aneurysm, and to give the instruction for the clinical practice. Methods: A case control study (1 vs. 1) was developed to evaluate the cost in hospital, the cost for return visit and the Quality-adusted Life-Year (QALY) and lifetime costs of the intra-artery GDC embolization and the aneurysm clapping of intraeranial aneurysm, under the matching of the age, sex, living place, the size and place of the aneurysm, and the Hunt and Hess score. Clinically effectiveness dates were derived from the medical records. Cost dates were derived from follow-up by telephones or letters. The correlation analysis was done with the SPSS 13.0. Results: The cost in hospital in AC group was (54 945±16 946)RMBs, which was higher than the ones in AE group (63 768±12 665) RMBs, (t=1.71, P 0.05). Conclusion: The results suggest that the two therapies have no difference in cost effective rate. Considering the physical and mental loss, the aneurysm intra-arteu GDC embolization was better than the aneurysm clapping for the patients with aneurysm that diameter less than 25 mm. (authors)

Intra-Abdominal Hydatid Cyst: Sociodemographics, Clinical Profiles, and Outcomes of Patients Operated on at a Tertiary Hospital in Addis Ababa, Ethiopia

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Engida Abebe

2017-01-01

Full Text Available Background. Hydatid cyst is caused by the tapeworm Echinococcus granulosus. The abdomen, specifically the liver, is the most common site affected. Objective. Determine the presentation patterns, types of surgical management, and outcomes of patients operated for intra-abdominal hydatid cyst (IAHC. Methodology. A retrospective descriptive study of patients admitted and operated for IAHC from September 1, 2011, to August 31, 2015. Results. Forty-two patients whose age ranged from 10 to 65 (mean of 37 years were operated on. Females comprised 27 (64.3% of the patients. The commonest presenting complaint was abdominal pain (41, 97.6%. Abdominal mass was documented in 23 (54.7% cases. Abdominal ultrasound (AUS and CT were the main imaging studies done on 38 (90.5% and 24 (57.1% patients, respectively. Cysts measuring more than 10 cm in diameter were the most common finding in both studies. Liver was the primary site involved, 30 (71.4% cases, the right lobe being the main side, 73%. Thirty-eight (90.5% patients underwent deroofing, evacuation, marsupialization, and omentoplasty (DEMO. There was no perioperative death, but 4 (9.5% of the patients had post-op complications. Conclusion. Abdominal pain was the most common presenting complaint. AUS and CT remain the preferred imaging. DEMO was the most common surgery.

Relevance of intra operative radiotherapy in the treatment of uterine carcinoma - Lyon preliminary experience

International Nuclear Information System (INIS)

Gerard, J.P.; Braillon, G.; Gilly, F.N.; Romestaing, P.; Sentenac, I.; Rocher, F.P.; Berger, C.; Chipier, V.; Dargent, D.; Chabert, P.; Raudrant, D.; Adeleine, P.

1994-01-01

Aim: Retrospective analysis of Intra operative Radiotherapy (IORT) in recurrent uterine carcinoma (RUC) and prospective pilot study of IORT in advanced cervix cancer (ACC) with high risk of local failure. Patients-Treatments: (1) RUC: from 1988 to 1991, 34 patients with RUC have been treated. Primary cancer was: cervix uterus: 28, endometrium: six. Site of recurrence: centro pelvis: four, latero pelvis: 25, lombo aortic: five. Total gross resection was only possible in 12 patients. A dose of 15 to 22 Gy was given by IORT according to the residual tumour size. External beam irradiation was added in 16 patients; (2) ACC: January 1991 to November 1992, 20 patients were included in this pilot study, stage IIB: seven, stage III: 12, stage IV: 1. Preoperative retroperitoneal pelviscopy showed 13 pN1 patients and NMR imaging ten tumours of 6 cm or larger in diameter. Treatment started with concomitant pelvic irradiation (44 Gy) and one concomitant cycle of 5 Fu-CDDP, followed by a short course of high dose rate upper vagina brachytherapy (4Gy). Four weeks later a radical Wertheim operation was performed together with IORT on the lateral pelvis. Results: (1) RUC: overall survival (Kaplan Meier) at 4 years is 32% (±8). Local relapse in the field of IORT was observed in six patients. Grade 2-3 complications: six patients (radiation proctitis, neuritis, vertebral collapse, ureteral stenosis); (2) ACC: the median follow up is short (18 months). Four cases of pelvic relapse, no postoperative death. The first line radio chemotherapy was associated with two G3 early complications. Postoperative radiation complication was less than 10% G3. Discussion: promising results of IORT in RUC have been observed especially if no irradiation is given during the primary treatment. Good feasibility of the pilot study of IORT in ACC was also observed. It could be followed by a multicentric feasibility trial. (authors). 38 refs., 4 tabs., 1 fig

HORIZONTAL AND VERTICAL INTRA-INDUSTRY TRADE OF TURKEY

Directory of Open Access Journals (Sweden)

NEVZAT ŞİMŞEK

2013-06-01

Full Text Available Crucial improvement have taken place in intra-industry trade literature since intra-industry trade phenomenon was empirically determined. Nowadays economists discuss on the necessity of distinguishing between horizontal and vertical intra-industry trade especially relating to product differentiation in each industry. As standard Grubel-Lloyd index does not determine the time when two way trade is taken into consideration, in this paper first of all Two-Way Trade index is used and then horizontal intra-industry trade and low-high quality vertical intra-industry trade are distinguished from each other regarding unit value differential. As a result of the analysis the findings show that low quality vertical intra-industry trade dominate in Turkey's intra-industry trade.

SU-E-T-537: Comparison of Intra-Operative Soft X-Rays to Low Energy Electron Beams for Treatment of Superficial Lesions

International Nuclear Information System (INIS)

Chinsky, B; Diak, A; Gros, S; Sethi

2014-01-01

Purpose: Superficial soft x-ray applicators have recently been designed for use with existing intra-operative radiotherapy systems. These applicators may be used in treating superficial lesions which are conventionally treated with electron beams. The purpose of this abstract is to compare dose distributions of an intra-operative 50kV x-ray unit with low energy electrons for the treatment of superficial lesions. Methods: Dosimetric parameters for 1 and 3-cm diameter Intrabeam superficial x-ray applicators were measured with EBT3 Gafchromic film in a solid water phantom. Depth dose distributions and profiles (d=2, 5, 10 and 15mm) were obtained by prescribing a dose of 400cGy at 5mm depth below the phantom surface. Corresponding dose profiles for 6-MeV electrons were acquired from a Varian Clinac 21EX at 100 SSD. H and D calibration curves were generated for each modality for 0-800cGy. Results: Dose coverage, penumbra, dose uniformity, surface dose, and dose fall-off were examined. Compared to electrons, Intrabeam lateral dose coverage at 5mm depth was 70% larger with a much sharper (1/4) penumbra. Electron isodose levels bulged with depth, whereas Intrabeam isodose levels exhibited a convex cone shape. The Intrabeam dose profiles demonstrated horns in the dose distribution up to a 5mm depth and an exponential dose fall-off. Relative surface dose was higher for the Intrabeam applicators. Treatment times were comparable for both modalities. Conclusions: The very small penumbra of Intrabeam at shallow depths could be useful in treating superficial lesions adjacent to critical structures. The exponential dose fall-off of Intrabeam makes it appealing in the sparing of structures beyond the lesion. However, for lesions past a depth of 5mm, electrons would be desirable as they penetrate farther and provide skin sparing. Intrabeam may be preferable for sites that are difficult to treat with electrons due to mechanical and physical limitations

[Inter-and intra-operator variability in the analysis of semen parameters: results from a quality control program].

Science.gov (United States)

Daoud, Salima; Chakroun-Feki, Nozha; Sellami, Afifa; Ammar-Keskes, Leila; Rebai, Tarek

2016-01-01

Semen analysis is a key part of male infertility investigation. The necessity of quality management implementation in the andrology laboratory has been recognized in order to ensure the reliability of its results. The aim of this study was to evaluate intra- and inter-individual variability in the assessment of semen parameters in our laboratory through a quality control programme. Four participants from the laboratory with different experience levels have participated in this study. Semen samples of varying quality were assessed for sperm motility, concentration and morphology and the results were used to evaluate inter-participant variability. In addition, replicates of each semen sample were analyzed to determine intra-individual variability for semen parameters analysis. The average values of inter-participant coefficients of variation for sperm motility, concentration and morphology were 12.8%, 19.8% and 48.9% respectively. The mean intra-participant coefficients of variation were, respectively, 6.9%, 12.3% and 42.7% for sperm motility, concentration and morphology. Despite some random errors of under- or overestimation, the overall results remained within the limits of acceptability for all participants. Sperm morphology assessment was particularly influenced by the participant's level of experience. The present data emphasize the need for appropriate training of the laboratory staff and for regular participation in internal quality control programmes in order to improve the reliability of laboratory results.

The push factors of intra-urban residential mobility in Calabar, Nigeria

African Journals Online (AJOL)

The paper takes a critical look at the push factors of intra-urban residential mobility in Calabar. Push factors are defined as those which operate to induce or encourage households to change their residence in the city. The paper notes that changing of residence by urban households in Western cities is a common ...

Effects of hip joint position and intra-capsular volume on hip joint intra-capsular pressure: a human cadaveric model

Directory of Open Access Journals (Sweden)

Tse Paul

2009-04-01

Full Text Available Abstract Background Increase in hip intra-capsular pressure has been implicated in various hip pathologies, such as avascular necrosis complicating undisplaced femoral neck fracture. Our study aimed at documenting the relationship between intra-capsular volume and pressure in various hip positions. Methods Fifty-two cadaveric hips were studied. An electronic pressure-monitoring catheter recorded the intra-capsular hip pressure after each instillation of 2 ml of normal saline and in six hip positions. Results In neutral hip position, the control position for investigation, intra-capsular pressure remained unchanged when its content was below 10 ml. Thereafter, it increased exponentially. When the intra-capsular volume was 12 ml, full abduction produced a 2.1-fold increase (p = 0.028 of the intra-capsular hip joint pressure; full external rotation and full internal rotation increased the pressure by at least 4-fold (p Conclusion Intra-capsular pressure increases with its volume, but with a wide variation with different positions. It would be appropriate to recommend that hips with haemarthrosis or effusion should be positioned in 45-degree flexion.

Adapting realist synthesis methodology: The case of workplace harassment interventions.

Science.gov (United States)

Carr, Tracey; Quinlan, Elizabeth; Robertson, Susan; Gerrard, Angie

2017-12-01

Realist synthesis techniques can be used to assess complex interventions by extracting and synthesizing configurations of contexts, mechanisms, and outcomes found in the literature. Our novel and multi-pronged approach to the realist synthesis of workplace harassment interventions describes our pursuit of theory to link macro and program level theories. After discovering the limitations of a dogmatic approach to realist synthesis, we adapted our search strategy and focused our analysis on a subset of data. We tailored our realist synthesis to understand how, why, and under what circumstances workplace harassment interventions are effective. The result was a conceptual framework to test our theory-based interventions and provide the basis for subsequent realist evaluation. Our experience documented in this article contributes to an understanding of how, under what circumstances, and with what consequences realist synthesis principles can be customized. Copyright © 2017 John Wiley & Sons, Ltd.

Arthroscopic intra- and extra-articular anterior cruciate ligament reconstruction with gracilis and semitendinosus tendons: a review

OpenAIRE

Marcacci, Maurilio; Zaffagnini, Stefano; Marcheggiani Muccioli, Giulio Maria; Neri, Maria Pia; Bondi, Alice; Nitri, Marco; Bonanzinga, Tommaso; Grassi, Alberto

2011-01-01

The purposes of this paper are to summarize the concepts relating to the use of a combined intra-articular and extra-articular reconstructive procedure in the arthroscopic treatment of a torn ACL and to review several operative techniques utilizing gracilis and semitendinosus tendons that are currently in use to treat this instability. The highly satisfactory results obtained over the time show that a combination of intra- and extra-articular procedures for ACL reconstruction is a valid surgi...

Real-time simulation for intra-operative navigation in robotic surgery. Using a mass spring system for a basic study of organ deformation.

Science.gov (United States)

Kawamura, Kazuya; Kobayashi, Yo; Fujie, Masakatsu G

2007-01-01

Medical technology has advanced with the introduction of robot technology, making previous medical treatments that were very difficult far more possible. However, operation of a surgical robot demands substantial training and continual practice on the part of the surgeon because it requires difficult techniques that are different from those of traditional surgical procedures. We focused on a simulation technology based on the physical characteristics of organs. In this research, we proposed the development of surgical simulation, based on a physical model, for intra-operative navigation by a surgeon. In this paper, we describe the design of our system, in particular our organ deformation calculator. The proposed simulation system consists of an organ deformation calculator and virtual slave manipulators. We obtained adequate experimental results of a target node at a nearby point of interaction, because this point ensures better accuracy for our simulation model. The next research step would be to focus on a surgical environment in which internal organ models would be integrated into a slave simulation system.

Evaluation of photovoltaic panel temperature in realistic scenarios

International Nuclear Information System (INIS)

Du, Yanping; Fell, Christopher J.; Duck, Benjamin; Chen, Dong; Liffman, Kurt; Zhang, Yinan; Gu, Min; Zhu, Yonggang

2016-01-01

Highlights: • The developed realistic model captures more reasonably the thermal response and hysteresis effects. • The predicted panel temperature is as high as 60 °C under a solar irradiance of 1000 W/m"2 in no-wind weather. • In realistic scenarios, the thermal response normally takes 50–250 s. • The actual heating effect may cause a photoelectric efficiency drop of 2.9–9.0%. - Abstract: Photovoltaic (PV) panel temperature was evaluated by developing theoretical models that are feasible to be used in realistic scenarios. Effects of solar irradiance, wind speed and ambient temperature on the PV panel temperature were studied. The parametric study shows significant influence of solar irradiance and wind speed on the PV panel temperature. With an increase of ambient temperature, the temperature rise of solar cells is reduced. The characteristics of panel temperature in realistic scenarios were analyzed. In steady weather conditions, the thermal response time of a solar cell with a Si thickness of 100–500 μm is around 50–250 s. While in realistic scenarios, the panel temperature variation in a day is different from that in steady weather conditions due to the effect of thermal hysteresis. The heating effect on the photovoltaic efficiency was assessed based on real-time temperature measurement of solar cells in realistic weather conditions. For solar cells with a temperature coefficient in the range of −0.21%∼−0.50%, the current field tests indicated an approximate efficiency loss between 2.9% and 9.0%.

A Local Realistic Reconciliation of the EPR Paradox

Science.gov (United States)

Sanctuary, Bryan

2014-03-01

The exact violation of Bell's Inequalities is obtained with a local realistic model for spin. The model treats one particle that comprises a quantum ensemble and simulates the EPR data one coincidence at a time as a product state. Such a spin is represented by operators σx , iσy ,σz in its body frame rather than the usual set of σX ,σY ,σZ in the laboratory frame. This model, assumed valid in the absence of a measuring probe, contains both quantum polarizations and coherences. Each carries half the EPR correlation, but only half can be measured using coincidence techniques. The model further predicts the filter angles that maximize the spin correlation in EPR experiments.

MO-E-BRD-03: Intra-Operative Breast Brachytherapy: Is One Stop Shopping Best?

International Nuclear Information System (INIS)

Libby, B.

2015-01-01

Is Non-invasive Image-Guided Breast Brachytherapy Good? – Jess Hiatt, MS Non-invasive Image-Guided Breast Brachytherapy (NIBB) is an emerging therapy for breast boost treatments as well as Accelerated Partial Breast Irradiation (APBI) using HDR surface breast brachytherapy. NIBB allows for smaller treatment volumes while maintaining optimal target coverage. Considering the real-time image-guidance and immobilization provided by the NIBB modality, minimal margins around the target tissue are necessary. Accelerated Partial Breast Irradiation in brachytherapy: is shorter better? - Dorin Todor, PhD VCU A review of balloon and strut devices will be provided together with the origins of APBI: the interstitial multi-catheter implant. A dosimetric and radiobiological perspective will help point out the evolution in breast brachytherapy, both in terms of devices and the protocols/clinical trials under which these devices are used. Improvements in imaging, delivery modalities and convenience are among the factors driving the ultrashort fractionation schedules but our understanding of both local control and toxicities associated with various treatments is lagging. A comparison between various schedules, from a radiobiological perspective, will be given together with a critical analysis of the issues. to review and understand the evolution and development of APBI using brachytherapy methods to understand the basis and limitations of radio-biological ‘equivalence’ between fractionation schedules to review commonly used and proposed fractionation schedules Intra-operative breast brachytherapy: Is one stop shopping best?- Bruce Libby, PhD. University of Virginia A review of intraoperative breast brachytherapy will be presented, including the Targit-A and other trials that have used electronic brachytherapy. More modern approaches, in which the lumpectomy procedure is integrated into an APBI workflow, will also be discussed. Learning Objectives: To review past and current

Realist synthesis: illustrating the method for implementation research

Directory of Open Access Journals (Sweden)

Rycroft-Malone Jo

2012-04-01

Full Text Available Abstract Background Realist synthesis is an increasingly popular approach to the review and synthesis of evidence, which focuses on understanding the mechanisms by which an intervention works (or not. There are few published examples of realist synthesis. This paper therefore fills a gap by describing, in detail, the process used for a realist review and synthesis to answer the question ‘what interventions and strategies are effective in enabling evidence-informed healthcare?’ The strengths and challenges of conducting realist review are also considered. Methods The realist approach involves identifying underlying causal mechanisms and exploring how they work under what conditions. The stages of this review included: defining the scope of the review (concept mining and framework formulation; searching for and scrutinising the evidence; extracting and synthesising the evidence; and developing the narrative, including hypotheses. Results Based on key terms and concepts related to various interventions to promote evidence-informed healthcare, we developed an outcome-focused theoretical framework. Questions were tailored for each of four theory/intervention areas within the theoretical framework and were used to guide development of a review and data extraction process. The search for literature within our first theory area, change agency, was executed and the screening procedure resulted in inclusion of 52 papers. Using the questions relevant to this theory area, data were extracted by one reviewer and validated by a second reviewer. Synthesis involved organisation of extracted data into evidence tables, theming and formulation of chains of inference, linking between the chains of inference, and hypothesis formulation. The narrative was developed around the hypotheses generated within the change agency theory area. Conclusions Realist synthesis lends itself to the review of complex interventions because it accounts for context as well as

Sotsialistlik realist Keskküla

Index Scriptorium Estoniae

1998-01-01

Londonis 1998. a. ilmunud inglise kunstikriitiku Matthew Cullerne Bowni monograafias "Socialist Realist Painting" on eesti kunstnikest Enn Põldroos, Nikolai Kormashov, Ando Keskküla, Kormashovi ja Keskküla maalide reproduktsioonid

Intra-abdominal solid organ injuries: an enhanced management algorithm.

Science.gov (United States)

Kokabi, Nima; Shuaib, Waqas; Xing, Minzhi; Harmouche, Elie; Wilson, Kenneth; Johnson, Jamlik-Omari; Khosa, Faisal

2014-11-01

The organ injury scale grading system proposed by the American Association for the Surgery of Trauma provides guidelines for operative versus nonoperative management in solid organ injuries; however, major shortcomings of the American Association for the Surgery of Trauma injury scale may become apparent with low-grade injuries, in which conservative management may fail. Nonoperative management of common intra-abdominal solid organ injuries relies increasingly on computed tomographic findings and other clinical factors, including patient age, presence of concurrent injuries, and serial clinical assessments. Familiarity with characteristic imaging features is essential for the prompt diagnosis and appropriate treatment of blunt abdominal trauma. In this pictorial essay, the spectrum of the American Association for the Surgery of Trauma organ injury scale grading system is illustrated, and a multidisciplinary management algorithm for common intra-abdominal solid organ injuries is proposed. Copyright © 2014 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Interplay of vacuum-mediated inter- and intra-atomic couplings in a pair of atoms

International Nuclear Information System (INIS)

Schmid, Sandra Isabelle; Evers, Joerg

2010-01-01

The resonance fluorescence emitted by a system of two dipole-dipole interacting nearby four-level atoms in a J=1/2↔J=1/2 configuration is studied. This setup is the simplest realistic model system which provides a complete description of the (inter-atomic) dipole-dipole interaction for arbitrary orientation of the inter-atomic distance vector, and at the same time allows for intra-atomic spontaneously generated coherences. Our main interest is the interplay of both these different coupling mechanisms. We discuss different methods to analyze the contribution of the various vacuum-induced coupling constants to the total resonance fluorescence spectrum. These allow us to find a dressed state interpretation of the contribution of the different inter-atomic dipole-dipole couplings to the total spectrum. We further study the role of the spontaneously generated coherences, and identify two different contributions to the single-particle vacuum-induced couplings. We show that they have a noticeable impact on the total resonance fluorescence spectrum down to small inter-atomic distances, even though the dipole-dipole coupling constants then are much larger in magnitude than the the single-particle coupling constants. Interestingly, we find that the inter-atomic couplings can induce an effect of the intra-atomic spontaneously generated coherences on the observed spectra which is not present in single-atom systems.

An evaluation of intra-operative and post-operative blood loss in ...

African Journals Online (AJOL)

Background: Total knee replacement is a rewarding and reliable procedure, producing a lasting relief to severe knee pains. However, significant blood loss usually in the post-operative period may be a challenge, necessitating prompt restoration of circulating blood volume to minimize morbidity and mortality. The aim of this ...

Precision resection of intra-axial CNS lesions by CT-based stereotactic craniotomy and computer monitored CO2 laser

International Nuclear Information System (INIS)

Kelly, P.J.; Kall, B.; Goerss, S.; Alker, G.J. Jr.

1983-01-01

This report describes an open stereotactic technique by which a tumour volume reconstructed in stereotactic space from CT data is removed by stereotactic CO 2 laser vaporization. The position of the laser beam in relation to the tumour outlines is monitored by computer and displayed to the surgeon on a graphics display terminal in the operating room. Twenty-six (26) of these procedures have been performed on twenty-four (24) patients with deep-seated intra-axial neoplasms (23) and arteriovenous malformation. Post-operative CT scanning revealed no evidence of contrast enhancing lesions in nineteen (19) patients while a small amount of residual tumour was noted in five (5) patients post-operatively. This method has proven itself valuable for maintaining three-dimensional surgical orientation for the resection of intra-axial neoplasms from neurologically important areas. (Author)

Are there realistically interpretable local theories?

International Nuclear Information System (INIS)

d'Espagnat, B.

1989-01-01

Although it rests on strongly established proofs, the statement that no realistically interpretable local theory is compatible with some experimentally testable predictions of quantum mechanics seems at first sight to be incompatible with a few general ideas and clear-cut statements occurring in recent theoretical work by Griffiths, Omnes, and Ballentine and Jarrett. It is shown here that in fact none of the developments due to these authors can be considered as a realistically interpretable local theory, so that there is no valid reason for suspecting that the existing proofs of the statement in question are all flawed

Realistic Real-Time Outdoor Rendering in Augmented Reality

Science.gov (United States)

Kolivand, Hoshang; Sunar, Mohd Shahrizal

2014-01-01

Realistic rendering techniques of outdoor Augmented Reality (AR) has been an attractive topic since the last two decades considering the sizeable amount of publications in computer graphics. Realistic virtual objects in outdoor rendering AR systems require sophisticated effects such as: shadows, daylight and interactions between sky colours and virtual as well as real objects. A few realistic rendering techniques have been designed to overcome this obstacle, most of which are related to non real-time rendering. However, the problem still remains, especially in outdoor rendering. This paper proposed a much newer, unique technique to achieve realistic real-time outdoor rendering, while taking into account the interaction between sky colours and objects in AR systems with respect to shadows in any specific location, date and time. This approach involves three main phases, which cover different outdoor AR rendering requirements. Firstly, sky colour was generated with respect to the position of the sun. Second step involves the shadow generation algorithm, Z-Partitioning: Gaussian and Fog Shadow Maps (Z-GaF Shadow Maps). Lastly, a technique to integrate sky colours and shadows through its effects on virtual objects in the AR system, is introduced. The experimental results reveal that the proposed technique has significantly improved the realism of real-time outdoor AR rendering, thus solving the problem of realistic AR systems. PMID:25268480

Realistic real-time outdoor rendering in augmented reality.

Directory of Open Access Journals (Sweden)

Hoshang Kolivand

Full Text Available Realistic rendering techniques of outdoor Augmented Reality (AR has been an attractive topic since the last two decades considering the sizeable amount of publications in computer graphics. Realistic virtual objects in outdoor rendering AR systems require sophisticated effects such as: shadows, daylight and interactions between sky colours and virtual as well as real objects. A few realistic rendering techniques have been designed to overcome this obstacle, most of which are related to non real-time rendering. However, the problem still remains, especially in outdoor rendering. This paper proposed a much newer, unique technique to achieve realistic real-time outdoor rendering, while taking into account the interaction between sky colours and objects in AR systems with respect to shadows in any specific location, date and time. This approach involves three main phases, which cover different outdoor AR rendering requirements. Firstly, sky colour was generated with respect to the position of the sun. Second step involves the shadow generation algorithm, Z-Partitioning: Gaussian and Fog Shadow Maps (Z-GaF Shadow Maps. Lastly, a technique to integrate sky colours and shadows through its effects on virtual objects in the AR system, is introduced. The experimental results reveal that the proposed technique has significantly improved the realism of real-time outdoor AR rendering, thus solving the problem of realistic AR systems.

'Semi-realistic'F-term inflation model building in supergravity

International Nuclear Information System (INIS)

Kain, Ben

2008-01-01

We describe methods for building 'semi-realistic' models of F-term inflation. By semi-realistic we mean that they are built in, and obey the requirements of, 'semi-realistic' particle physics models. The particle physics models are taken to be effective supergravity theories derived from orbifold compactifications of string theory, and their requirements are taken to be modular invariance, absence of mass terms and stabilization of moduli. We review the particle physics models, their requirements and tools and methods for building inflation models

Generating realistic images using Kray

Science.gov (United States)

Tanski, Grzegorz

2004-07-01

Kray is an application for creating realistic images. It is written in C++ programming language, has a text-based interface, solves global illumination problem using techniques such as radiosity, path tracing and photon mapping.

Balancing renewable on intra day electricity markets

International Nuclear Information System (INIS)

Sokol, R.; Bems, J.

2012-01-01

Intra day electricity markets contribute to facilitate transition from conventional sources to renewable which need to be balanced on real-time basic due to the unpredictable nature of weather. This paper describes the way from regional electricity markets to a single pan-european market model which is target model of the European Commission. Single liquid intra day electricity market where market participants can balance their portfolios is prerequisite to a full utilisation of renewable power sources and a solution for some problems experienced by TSOs with loop and parallel flows from neighbouring countries. Integrated German and French intra day electricity market which uses Flexible Intra day Trading Scheme is described in this paper as a market which could be extended further to the CEE region with very poor liquidity of its local intra day markets. (Authors)

Designing field-controllable graphene-dot-graphene single molecule switches: A quantum-theoretical proof-of-concept under realistic operating conditions.

Science.gov (United States)

Pejov, Ljupčo; Petreska, Irina; Kocarev, Ljupčo

2015-12-28

A theoretical proof of the concept that a particularly designed graphene-based moletronics device, constituted by two semi-infinite graphene subunits, acting as source and drain electrodes, and a central benzenoid ring rotator (a "quantum dot"), could act as a field-controllable molecular switch is outlined and analyzed with the density functional theory approach. Besides the ideal (0 K) case, we also consider the operation of such a device under realistic operating (i.e., finite-temperature) conditions. An in-depth insight into the physics behind device controllability by an external field was gained by thorough analyses of the torsional potential of the dot under various conditions (absence or presence of an external gating field with varying strength), computing the torsional correlation time and transition probabilities within the Bloembergen-Purcell-Pound formalism. Both classical and quantum mechanical tunneling contributions to the intramolecular rotation were considered in the model. The main idea that we put forward in the present study is that intramolecular rotors can be controlled by the gating field even in cases when these groups do not possess a permanent dipole moment (as in cases considered previously by us [I. Petreska et al., J. Chem. Phys. 134, 014708-1-014708-12 (2011)] and also by other groups [P. E. Kornilovitch et al., Phys. Rev. B 66, 245413-1-245413-7 (2002)]). Consequently, one can control the molecular switching properties by an external electrostatic field utilizing even nonpolar intramolecular rotors (i.e., in a more general case than those considered so far). Molecular admittance of the currently considered graphene-based molecular switch under various conditions is analyzed employing non-equilibrium Green's function formalism, as well as by analysis of frontier molecular orbitals' behavior.

Surgical strategy for intra- and extra-vertebral dumbbell-shaped tumors

Directory of Open Access Journals (Sweden)

SUN Li-yong

2013-12-01

Full Text Available Objective To investigate the clinical features and surgical strategy of intra- and extra-vertebral dumbbell-shaped tumors. Methods Clinical data of 39 patients with intra- and extra-vertebral tumor were retrospectively studied. The tumors were removed via posterior midline approach in 33 patients, and via posterior combined with anterior approach in 6 patients. Thirty patients underwent tumor resection and internal fixation. Lateral mass screw fixation was performed in the level of C3-7, while the pedicular screw fixation was performed in the level of C2 and thoracic and lumbar segment. Results Tumors were totally excised in all the cases. The patients were followed-up for 6 months to 5 years with an average of 18.67 months. Pain relief occured in 29 cases, of whom the average Visual Analogue Scale (VAS score decreased from (7.51 ± 1.05 before surgery to (3.17 ± 1.17 24 h after surgery (P < 0.05. The numbness area emerged or enlarged in 12 cases and was unchanged in 3 cases. The average American Spinal Injury Association (ASIA sensation score decreased from (218.67 ± 2.80 before surgery to (213.33 ± 2.16 24 h after surgery (P < 0.05, but it increased to (216.78 ± 1.47 6 months after operation (P < 0.05. The motor function improved in 18 cases, and ASIA motor function score improved from (92.33 ± 1.63 before surgery to (95.05 ± 1.41 6 months after operation (P < 0.05. No tumor recurrence and secondary spinal deformity were found. Conclusion Most cases of dumbbell-shaped intra- and extra-vertebral tumor can be totally removed with one-session microsurgery. In the cases with bony erosion caused by tumor and facetectomy, concurrent internal fixation and fusion were recommended in order to maintain spinal stability.

Intra-operative parathyroid hormone monitoring through central laboratory is accurate in renal secondary hyperparathyroidism.

Science.gov (United States)

Vulpio, Carlo; Bossola, Maurizio; Di Stasio, Enrico; Pepe, Gilda; Nure, Eda; Magalini, Sabina; Agnes, Salvatore

2016-05-01

The usefulness, the methods and the criteria of intra-operative monitoring of the parathyroid hormone (ioPTH) during parathyroidectomy (PTX) for renal secondary hyperparathyroidism (rSHPT) in patients on chronic hemodialysis remain still matter of debate. The present study aimed to evaluate the ability of a low cost central-laboratory second generation PTH assay to predict an incomplete resection of parathyroid glands (PTG). The ioPTH decay was determined In 42 consecutive patients undergoing PTX (15 subtotal and 27 total without auto-transplant of PTG) for rSHPT. The ioPTH monitoring included five samples: pre-intubation, post-manipulation of PTG and at 10, 20 and 30min post-PTG excision. The patients with PTH exceeding the normal value (65pg/ml) at the first postoperative week, 6 and 12months were classified as persistent rSHPT. The concentrations of ioPTH declined significantly over time in patients who received total or subtotal PTX; however, no difference was found between the two types of PTX. Irrespective of the type of PTX and the number of PTG removed, combining the absolute and percentage of ioPTH decay at 30min after PTG excision, we found high sensitivity (100%), specificity (92%), negative predictive value (100%) and accuracy (93%) in predicting the persistence of rSHPT. The monitoring of the ioPTH decline by a low cost central-laboratory second generation assay is extremely accurate in predicting the persistence of disease in patients on maintenance hemodialysis undergoing surgery for rSHPT. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Intra-articular decorin influences the fibrosis genetic expression profile in a rabbit model of joint contracture.

Science.gov (United States)

Abdel, M P; Morrey, M E; Barlow, J D; Grill, D E; Kolbert, C P; An, K N; Steinmann, S P; Morrey, B F; Sanchez-Sotelo, J

2014-01-01

The goal of this study was to determine whether intra-articular administration of the potentially anti-fibrotic agent decorin influences the expression of genes involved in the fibrotic cascade, and ultimately leads to less contracture, in an animal model. A total of 18 rabbits underwent an operation on their right knees to form contractures. Six limbs in group 1 received four intra-articular injections of decorin; six limbs in group 2 received four intra-articular injections of bovine serum albumin (BSA) over eight days; six limbs in group 3 received no injections. The contracted limbs of rabbits in group 1 were biomechanically and genetically compared with the contracted limbs of rabbits in groups 2 and 3, with the use of a calibrated joint measuring device and custom microarray, respectively. There was no statistical difference in the flexion contracture angles between those limbs that received intra-articular decorin versus those that received intra-articular BSA (66° vs 69°; p = 0.41). Likewise, there was no statistical difference between those limbs that received intra-articular decorin versus those who had no injection (66° vs 72°; p = 0.27). When compared with BSA, decorin led to a statistically significant increase in the mRNA expression of 12 genes (p Cite this article: Bone Joint Res 2014;3:82-8.

Toward realistic pursuit-evasion using a roadmap-based approach

KAUST Repository

Rodriguez, Samuel; Denny, Jory; Burgos, Juan; Mahadevan, Aditya; Manavi, Kasra; Murray, Luke; Kodochygov, Anton; Zourntos, Takis; Amato, Nancy M.

2011-01-01

be applied to more realistic scenarios than are typically studied in most previous work, including agents moving in 3D environments such as terrains, multi-story buildings, and dynamic environments. We also support more realistic three-dimensional visibility

Intra-Industry Trade in Tourism Services

Directory of Open Access Journals (Sweden)

Nuno Carlos LEITÃO

2011-06-01

Full Text Available Usually the tourism flows are explained by demand, economic growth, and revealed comparative advantage (neoclassic trade theory.This manuscript examines the link between intra-industry trade and international tourism flows. We have examined the Portuguese intra-industry trade in this sector. The analysis apply the static (Grubel and Lloyd and dynamic index (Brülhart. Our results show that the tourism services are important for a small economy such as Portugal. The intra-industry trade is very significant between Portugal and the following countries: Spain, USA, Italy, Greece, Turkey and Canada.

Intra-aneurysmal flow disruption after implantation of the Medina® Embolization Device depends on aneurysm neck coverage.

Science.gov (United States)

Frölich, Andreas Maximilian; Nawka, Marie Teresa; Ernst, Marielle; Frischmuth, Isabell; Fiehler, Jens; Buhk, Jan-Hendrik

2018-01-01

Flow disruption achieved by braided intrasaccular implants is a novel treatment strategy for cerebrovascular aneurysms. We hypothesized that the degree of intra-aneurysmal flow disruption can be quantified in vitro and is influenced by device position across the aneurysm neck. We tested this hypothesis using the Medina® Embolization Device (MED). Ten different patient-specific elastic vascular models were manufactured. Models were connected to a pulsatile flow circuit, filled with a blood-mimicking fluid and treated by two operators using a single MED. Intra-aneurysmal flow velocity was measured using conventional and high-frequency digital subtraction angiography (HF-DSA) before and after each deployment. Aneurysm neck coverage by the implanted devices was assessed with flat detector computed tomography on a three-point Likert scale. A total of 80 individual MED deployments were performed by the two operators. The mean intra-aneurysmal flow velocity reduction after MED implantation was 33.6% (27.5-39.7%). No significant differences in neck coverage (p = 0.99) or flow disruption (p = 0.84) were observed between operators. The degree of flow disruption significantly correlated with neck coverage (ρ = 0.42, 95% CI: 0.21-0.59, p = 0.002) as well as with neck area (ρ = -0,35, 95% CI: -0.54 --0.13, p = 0.024). On multiple regression analysis, both neck coverage and total neck area were independent predictors of flow disruption. The degree of intra-aneurysmal flow disruption after MED implantation can be quantified in vitro and varies considerably between different aneurysms and different device configurations. Optimal device coverage across the aneurysm neck improves flow disruption and may thus contribute to aneurysm occlusion.

Realistic Material Appearance Modelling

Czech Academy of Sciences Publication Activity Database

Haindl, Michal; Filip, Jiří; Hatka, Martin

2010-01-01

Roč. 2010, č. 81 (2010), s. 13-14 ISSN 0926-4981 R&D Projects: GA ČR GA102/08/0593 Institutional research plan: CEZ:AV0Z10750506 Keywords : bidirectional texture function * texture modelling Subject RIV: BD - Theory of Information http:// library .utia.cas.cz/separaty/2010/RO/haindl-realistic material appearance modelling.pdf

Feasibility of Optical Coherence Tomography (OCT for Intra-Operative Detection of Blood Flow during Gastric Tube Reconstruction

Directory of Open Access Journals (Sweden)

Sanne M. Jansen

2018-04-01

Full Text Available In this study; an OCT-based intra-operative imaging method for blood flow detection during esophagectomy with gastric tube reconstruction is investigated. Change in perfusion of the gastric tube tissue can lead to ischemia; with a high morbidity and mortality as a result. Anastomotic leakage (incidence 5–20% is one of the most severe complications after esophagectomy with gastric tube reconstruction. Optical imaging techniques provide for minimal-invasive and real-time visualization tools that can be used in intraoperative settings. By implementing an optical technique for blood flow detection during surgery; perfusion can be imaged and quantified and; if needed; perfusion can be improved by either a surgical intervention or the administration of medication. The feasibility of imaging gastric microcirculation in vivo using optical coherence tomography (OCT during surgery of patients with esophageal cancer by visualizing blood flow based on the speckle contrast from M-mode OCT images is studied. The percentage of pixels exhibiting a speckle contrast value indicative of flow was quantified to serve as an objective parameter to assess blood flow at 4 locations on the reconstructed gastric tube. Here; it was shown that OCT can be used for direct blood flow imaging during surgery and may therefore aid in improving surgical outcomes for patients.

Measurement of scattered and transmitted X-rays from intra-oral and panoramic dental X-ray equipment.

Science.gov (United States)

Holroyd, John Richard

2018-04-10

To quantify the levels of transmitted radiation arising from the use of intra-oral dental X-ray equipment and scattered radiation arising from the use of both intra-oral and panoramic X-ray equipment. Methods: Levels of scattered radiation were measured at 1 m from a phantom, using an 1800 cc ion chamber. Transmitted radiation was measured using both: i) a phantom and Dose Area Product (DAP) meter, ii) a patient and an 1800 cc ion chamber. Results: For intra-oral radiography the patient study gave a maximum transmission of 1.80% (range 0.04% to 1.80%, mean 0.26%) and the phantom study gave a maximum transmission of 6% (range 2% to 6%, mean 5%). The maximum scattered radiation, per unit DAP, was 5.5 nGy (mGy cm2)-1 at 70 kVp and a distance of 1 m. For panoramic radiography the maximum scattered radiation was 9.3 nGy (mGy cm2)-1 at 80 kVp and a distance of 1 m. Conclusions: Typical doses from scattered and transmitted radiation in modern dental practice have been measured and values are presented to enable the calculation of adequate protection measures for dental radiography rooms. Advances in knowledge: Previous studies have used a phantom and measured radiation doses at 1 m from the phantom to determine the radiation dose transmitted through a patient, whereas this study uses both patient and phantom measurements together with a large area dose meter, positioned to capture the entire X-ray beam, to ensure more realistic dose measurements can be made. © 2018 IOP Publishing Ltd.

A Radiosity Approach to Realistic Image Synthesis

Science.gov (United States)

1992-12-01

AD-A259 082 AFIT/GCE/ENG/92D-09 A RADIOSITY APPROACH TO REALISTIC IMAGE SYNTHESIS THESIS Richard L. Remington Captain, USAF fl ECTE AFIT/GCE/ENG/92D...09 SJANl 1993U 93-00134 Approved for public release; distribution unlimited 93& 1! A -A- AFIT/GCE/ENG/92D-09 A RADIOSITY APPROACH TO REALISTIC IMAGE...assistance in creating the input geometry file for the AWACS aircraft interior. Without his assistance, a good model for the diffuse radiosity implementation

Intra-articular therapies for osteoarthritis.

Science.gov (United States)

Yu, Shirley P; Hunter, David J

2016-10-01

Conventional medical therapies for osteoarthritis are mainly palliative in nature, aiming to control pain and symptoms. Traditional intra-articular therapies are not recommended in guidelines as first line therapy, but are potential alternatives, when conventional therapies have failed. Current and future intra-articular drug therapies for osteoarthritis are highlighted, including corticosteroids, hyaluronate, and more controversial treatments marketed commercially, namely platelet rich plasma and mesenchymal cell therapy. Intraarticular disease modifying osteoarthritis drugs are the future of osteoarthritis treatments, aiming at structural modification and altering the disease progression. Interleukin-1β inhibitor, bone morphogenic protein-7, fibroblast growth factor 18, bradykinin B2 receptor antagonist, human serum albumin, and gene therapy are discussed in this review. The evolution of drug development in osteoarthritis is limited by the ability to demonstrate effect. High quality trials are required to justify the use of existing intra-articular therapies and to advocate for newer, promising therapies. Challenges in osteoarthritis therapy research are fundamentally related to the complexity of the pathological mechanisms of osteoarthritis. Novel drugs offer hope in a disease with limited medical therapy options. Whether these future intra-articular therapies will provide clinically meaningful benefits, remains unknown.

[The influnence of dachengqi tang on acute lung injury and intra abdominal hypertension in rats with acute pancreatitis].

Science.gov (United States)

Wan, Mei-Hua; Li, Juan; Tang, Wen-Fu; Gong, Han-Lin; Chen, Guang-Yuan; Xue, Ping; Zhao, Xian-Lin; Xia, Qing

2011-09-01

To test the hypothesis "lung and large intestine are interior exteriorly related" through investgating into the effect of Dacheng qi tang (DCQT) on intra abdominal hypertension (IAH) and acute lung injury (ALI) in rats with acute pancreatitis. Male SD rats were randomly divided into three groups with ten rats for each group: rats with sham-operations (SO); rats with acute necrosis pancreatitis (ANP); rats with ANP plus DCQT treatment. ANP was induced by retrograde infusion of 5% taurocholic acid into pancreatic duct. Two hours after operations, 10 mL/kg of normal saline was orally adminstered to the rats in both SO and ANP groups, whereas 10 mL/kg DCQT was adminstered to the rats in the treatment group. Aterial blood, pancreas and lung tissues were collected for biomarkers and histopathology 24 hours after operations. Intra-abdominal pressure and intestinal propulsion rate were also measured. RESULTS; DCQT treatment reduced intra-abdominal pressure and improved intestinal propulsion rate compared with those treated with saline (P 0.05). Only two rats in the ANP group died. DCQT can effectively relieve IAH and cure ALI at the same time in rats with acute pancreatitis. The result provides evidence to support the hypothesis "lung and large intestine are interior exteriorly related".

Three-dimensional echocardiography: assessment of inter- and intra-operator variability and accuracy in the measurement of left ventricular cavity volume and myocardial mass

International Nuclear Information System (INIS)

Nadkarni, S.K.; Drangova, M.; Boughner, D.R.; Fenster, A.; Department of Medical Biophysics, Medical Sciences Building, University of Western Ontario, London, Ontario N6A 5C1

2000-01-01

Accurate left ventricular (LV) volume and mass estimation is a strong predictor of cardiovascular morbidity and mortality. We propose that our technique of 3D echocardiography provides an accurate quantification of LV volume and mass by the reconstruction of 2D images into 3D volumes, thus avoiding the need for geometric assumptions. We compared the accuracy and variability in LV volume and mass measurement using 3D echocardiography with 2D echocardiography, using in vitro studies. Six operators measured the LV volume and mass of seven porcine hearts, using both 3D and 2D techniques. Regression analysis was used to test the accuracy of results and an ANOVA test was used to compute variability in measurement. LV volume measurement accuracy was 9.8% (3D) and 18.4% (2D); LV mass measurement accuracy was 5% (3D) and 9.2% (2D). Variability in LV volume quantification with 3D echocardiography was %SEM inter = 13.5%, %SEM intra = 11.4%, and for 2D echocardiography was %SEM inter = 21.5%, %SEM intra = 19.1%. We derived an equation to predict uncertainty in measurement of LV volume and mass using 3D echocardiography, the results of which agreed with our experimental results to within 13%. 3D echocardiography provided twice the accuracy for LV volume and mass measurement and half the variability for LV volume measurement as compared with 2D echocardiography. (author)

Correlation of intra-tumour heterogeneity on 18F-FDG PET with pathologic features in non-small cell lung cancer: A feasibility study

International Nuclear Information System (INIS)

Baardwijk, Angela van; Bosmans, Geert; Suylen, Robert Jan van; Kroonenburgh, Marinus van; Hochstenbag, Monique; Geskes, Gijs; Lambin, Philippe; De Ruysscher, Dirk

2008-01-01

We evaluated the feasibility to correlate intra-tumour heterogeneity as visualized on 18 F-FDG PET with histology for NSCLC. For this purpose we used an ex-vivo model. The procedure was feasible in all operated patients. We have shown that this method is suitable for correlating intra-tumour heterogeneity in tracer uptake with histology

Realistic bandwidth estimation in the theoretically predicted radionuclide inventory of PWR-UO2 spent fuel derived from reactor design and operating data

International Nuclear Information System (INIS)

Fast, Ivan

2017-01-01

Nuclear energy for power generation produces heat-generating high- and intermediate level radioactive waste (HLW and ILW) for which a safe solution for the handling and disposal has to be found. Currently, many European countries consider the final disposal of HLW and ILW in deep geological formations as the most preferable option. In Germany the main stream of HLW and ILW include spent fuel assemblies from nuclear power plants (NPPs), the vitrified waste and compacted metallic waste of the fuel assembly structural parts originate from reprocessing plants. An important task that occurs within the framework of the Product Quality Control (PQC) of nuclear waste is the assessment of the compliance of any reprocessed waste product inventory with the prescribed limits for each relevant radionuclide (RN). The PQC task is to verify the required quality and safety of nuclear waste prior to transportation to a German repository and to avert the disposal of non-conform waste packages. The verification is usually based on comparing the declared radionuclide inventory of the waste with the presumed or expected composition, which is estimated, based on the known history of the waste and its processing. The difficulty of such estimations for radioactive components from nuclear fuel assemblies is that reactor design parameters and operating histories can have a significant influence on the nuclide inventory of any individual fuel assembly. Thus, knowledge of these parameters is a key issue to determine the realistic concentration ranges, or bandwidths, of the radionuclide inventory. As soon as a governmental decision on the construction of a high-level waste repository will be made, comprehensive radionuclide inventories of the wastes assigned for the deposition will be required. The list of final repository relevant radionuclide is based on the safety assessment for this particular repository, thus it is likely to comprise more-or-less the same radionuclides that need to be

Realistic bandwidth estimation in the theoretically predicted radionuclide inventory of PWR-UO2 spent fuel derived from reactor design and operating data

Energy Technology Data Exchange (ETDEWEB)

Fast, Ivan

2017-06-01

Nuclear energy for power generation produces heat-generating high- and intermediate level radioactive waste (HLW and ILW) for which a safe solution for the handling and disposal has to be found. Currently, many European countries consider the final disposal of HLW and ILW in deep geological formations as the most preferable option. In Germany the main stream of HLW and ILW include spent fuel assemblies from nuclear power plants (NPPs), the vitrified waste and compacted metallic waste of the fuel assembly structural parts originate from reprocessing plants. An important task that occurs within the framework of the Product Quality Control (PQC) of nuclear waste is the assessment of the compliance of any reprocessed waste product inventory with the prescribed limits for each relevant radionuclide (RN). The PQC task is to verify the required quality and safety of nuclear waste prior to transportation to a German repository and to avert the disposal of non-conform waste packages. The verification is usually based on comparing the declared radionuclide inventory of the waste with the presumed or expected composition, which is estimated, based on the known history of the waste and its processing. The difficulty of such estimations for radioactive components from nuclear fuel assemblies is that reactor design parameters and operating histories can have a significant influence on the nuclide inventory of any individual fuel assembly. Thus, knowledge of these parameters is a key issue to determine the realistic concentration ranges, or bandwidths, of the radionuclide inventory. As soon as a governmental decision on the construction of a high-level waste repository will be made, comprehensive radionuclide inventories of the wastes assigned for the deposition will be required. The list of final repository relevant radionuclide is based on the safety assessment for this particular repository, thus it is likely to comprise more-or-less the same radionuclides that need to be

INTRA - Maintenance and Validation. Final Report

International Nuclear Information System (INIS)

Edlund, Ove; Jahn, Hermann; Yitbarek, Z.

2002-05-01

The INTRA code is specified by the ITER Joint Central Team and the European Community as a reference code for safety analyses of Tokamak type fusion reactors. INTRA has been developed by GRS and Studsvik EcoSafe to analyse integrated behaviours such as pressurisation, chemical reactions and temperature transients inside the plasma chamber and adjacent rooms, following postulated accidents, e.g. ingress of coolant water or air. Important results of the ICE and EVITA experiments, which became available early 2001, were used to validate and improve specific INTRA models. Large efforts were spent on the behaviour of water and steam injection into a low-pressure volumes at high temperature as well as on the modelling of boiling of water in contact with hot surfaces. As a result of this a new version, INTRA/Mod4, was documented and issued. The work included implementation and validation of selected physical models in the code, maintaining code versions, preparation review and distribution of code documents, and monitoring of the code related activities being performed by the GRS under a separate contract. The INTRA/Mod4 Manual and Code Description is documented in four volumes: Volume 1 - Physical Modelling, Volume 2 - User's Manual, Volume 3 -Code Structure and Volume 4 - Validation

Comparison of analgesic effect of intra-articular administration of levobupivacaine and clonidine versus ropivacaine and clonidine in day care knee arthroscopic surgery under spinal anesthesia

Directory of Open Access Journals (Sweden)

Sudeshna Senapati

2016-01-01

Full Text Available Introduction: Intra-articular (IA local anesthetics are often used for the management and prevention of pain after arthroscopic knee surgery. Clonidine prolongs the duration of local anesthetics. In this study, analgesic effect of intra-articular administration of levobupivacaine and clonidine was compared with ropivacaine and clonidine in knee joint arthroscopic surgery under spinal anesthesia. Method: 88 patients, aged between 15 to 55 years, ASA I and II undergoing knee arthroscopy under spinal anesthesia were assigned into two equal groups (n = 44 in a randomized double blind protocol. Patients in Group L received 10 ml of 0.50% levobupivacaine and 1 mcg/kg clonidine and Group R received 10 ml of 0.75% ropivacaine and 1 mcg/kg of clonidine through intra-articular route at the end of the procedure. In the post-operative period, pain intensity was assessed by VAS (Visual Analogue Scale Score recorded at 1 st , 5 th , 8 th , 12 th , 18 th post-operative hours. Duration of analgesia, total rescue analgesic dose in first 18 hours and any side effects were also recorded. Result: Group L experienced significantly longer duration of effective postoperative analgesia and lesser rescue analgesic compared to group R. Group R had higher mean VAS score at 5 th and 12 th post-operative hours (P < 0.05. No side effects were observed among the groups. Conclusion: Intra-articular administration of levobupivacaine and clonidine give better post-operative pain relief by increasing duration of analgesia, and decreasing need of rescue analgesic compared to intra-articular ropivacaine and clonidine.

Psychological consideration in patients with cerebral gliomas candidates for intra-operative radiation therapy based on tumor location.

Science.gov (United States)

Seddighi, Afsoun; Akbari, Mohammad Esmaeil; Seddighi, Amir Saied; Nikouei, Amir

2017-01-01

Intra-operative Radiation Therapy (IORT) is gaining popularity as an adjuvant option to surgical resection, in treatment of glioblastoma multiforme (GBM) for increasing survival rate, which a highly aggressive cerebral tumor with poor prognosis. Τhe authors plan to investigate the effects of IORT combined with surgical resection on the psychological status of these patients based on tumor location. From December 2013 to February 2017, we have enrolled 109 patients with high grade cerebral gliomas, documented by Magnetic Resonance Spectroscopy (MRS). Patients with previous history of brain surgery or radiation, altered mental status and psychological content and patients diagnosed with metastases were excluded. Demographic data, tumor volume based on pre-operative Magnetic Resonance Imaging (MRI) and psychological status were recorded based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. The remaining 56 patients, were equally randomized into conventional (surgical resection-group A), and trial (surgical resection with IORT-group B) who underwent IORT using the 50kV INTRABEAM® system (Carl Zeiss Meditec AG, Germany). Psychological profiles of both groups were re-evaluated in the 3 rd post-operative month. Group A consisted of 18 males and 10 females with mean age of 54.4 years, while group B consisted of 16 males and 12 females with mean age of 57.8 years. Tumor volumetry revealed mean 81.52cc and 82.8cc for group A and B respectively. (P value 0.14) Patients were classified based on glioma location on pre-operative MRI: a) left parietal lobe (6 in group A, 5 in group B); b) left temporal lobe (7 in group A, 5 in group B); c) right parietal lobe (5 in group A, 6 in group B); d) left fronto-temporal lobe (4 in group A, 6 in group B); e) left parieto-temporal lobe (4 in group A, 5 in group B); and, f) right frontal lobe (2 in group A, 1 in group B). Group B received mean 8.05 Gy radiation for mean 11.2 minutes. Post-operative

Survey of Approaches to Generate Realistic Synthetic Graphs

Energy Technology Data Exchange (ETDEWEB)

Lim, Seung-Hwan [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Lee, Sangkeun [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Powers, Sarah S [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Shankar, Mallikarjun [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Imam, Neena [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2016-10-01

A graph is a flexible data structure that can represent relationships between entities. As with other data analysis tasks, the use of realistic graphs is critical to obtaining valid research results. Unfortunately, using the actual ("real-world") graphs for research and new algorithm development is difficult due to the presence of sensitive information in the data or due to the scale of data. This results in practitioners developing algorithms and systems that employ synthetic graphs instead of real-world graphs. Generating realistic synthetic graphs that provide reliable statistical confidence to algorithmic analysis and system evaluation involves addressing technical hurdles in a broad set of areas. This report surveys the state of the art in approaches to generate realistic graphs that are derived from fitted graph models on real-world graphs.

Intra-islet glucagon secretion and action in the regulation of glucose homeostasis.

Directory of Open Access Journals (Sweden)

Qinghua eWang

2013-01-01

Full Text Available Glucagon, a key hormone in the regulation of glucose homeostasis, acts as a counter-regulatory hormone to insulin by promoting hepatic glucose output. Under normal conditions, insulin and glucagon operate in concert to maintain the glucose level within a narrow physiological range. In diabetes, however, while insulin secretion or action is insufficient, the production and secretion of glucagon are excessive, contributing to the development of diabetic hyperglycemia. Within an islet, intra-islet insulin, in cooperation with intra-islet GABA, suppresses glucagon secretion via direct modulation of -cell intracellular signaling pathways involving Akt activation, GABA receptor phosphorylation and the receptor plasma membrane translocation, while intra-islet glucagon plays an important role in modulating β-cell function and insulin secretion. Defects in the insulin-glucagon fine-tuning machinery may result in β-cell glucose incompetence, leading to unsuppressed glucagon secretion and subsequent hyperglycemia, which often occur under extreme conditions of glucose influx or efflux. Therefore, deciphering the precise molecular mechanisms underlying glucagon secretion and action will facilitate our understanding of glucagon physiology, in particular, its role in regulating islet β-cell function, and hence the mechanisms behind body glucose homeostasis.

Guide to intra-arterial infusion chemotherapy for pancreatic cancers (draft text)

International Nuclear Information System (INIS)

2012-01-01

Pancreatic cancer is one of most malignant solid tumors. Trans-arterial infusion chemotherapy has been used for the inoperable pancreatic cancers. The local drug concentration in intra-arterial infusion chemotherapy is much higher than that in intravenous chemotherapy. Thus, a better therapeutic effect can be surely achieved, the disease-related symptoms can be well improved, the patient's survival time can be markedly prolonged, and the liver metastases can be effectively reduced. This paper aims to suggest a more detailed and standardized therapeutic scheme to perform intra-arterial infusion chemotherapy for inoperable pancreatic cancers, focusing on the relevant concept, contraindications, indications, preoperative preparation, methods of operation, postoperative treatment, the prevention and treatment of complications, etc. The scheme will help domestic interventional physicians to make reasonable decisions in their clinical practice. Of course, the scheme proposed here is not a mandatory standard, and it can not resolve all the problems which might be encountered in employing intra-arterial infusion chemotherapy for patients with inoperable pancreatic cancer. Therefore, the interventional physicians should fully understand the most useful medical evidence of a given patient and sincerely take the patient's own will into consideration before an individualized and reasonable therapeutic plan is able to be worked out. (authors)

Symposium: evidence for the use of intra-articular cortisone or hyaluronic acid injection in the hip

Science.gov (United States)

Chandrasekaran, Sivashankar; Lodhia, Parth; Suarez-Ahedo, Carlos; Vemula, S. Pavan; Martin, Timothy J.; Domb, Benjamin G.

2016-01-01

The primary purpose of this review article is to discuss the role of diagnostic, corticosteroid, hyaluronic acid (HA) and platelet rich plasma (PRP) in the treatment of osteoarthritis (OA) and femoroacetabular impingement (FIA). These treatments play an important biological role in the non-operative management of these conditions. Two independent reviewers performed an search of PubMed for articles that contained at least one of the following search terms pertaining to intra-articular hip injection—local anaesthetic, diagnostic, ultrasound, fluoroscopic, image guided, corticosteroid, HA, PRP, OA, labral tears and FAI. Seventy-two full text articles were suitable for inclusion. There were 18 articles addressing the efficacy of diagnostic intra-articular hip injections. With respect to efficacy in OA there were 25 articles pertaining to efficacy of corticosteroid, 22 of HA and 4 of PRP. There were three articles addressing the efficacy of biologics in FAI. Diagnostic intra-articular hip injections are sensitive and specific for differentiating between intra-articular, extra-articular and spinal causes of hip symptoms. Ultrasound and fluoroscopy improves the precision of intra-articular positioning of diagnostic injections. Corticosteroids are more effective than HA and PRP in alleviating pain from hip OA. A higher dose of corticosteroids produces a longer benefit but volume of injection has no significant effect. Intra-articular corticosteroids do not increase infection rates of subsequent arthroplasty. There is currently limited evidence to warrant the routine use of therapeutic injections in the management of labral tears and FIA. PMID:27026814

On intra-supply chain system with an improved distribution plan, multiple sales locations and quality assurance.

Science.gov (United States)

Chiu, Singa Wang; Huang, Chao-Chih; Chiang, Kuo-Wei; Wu, Mei-Fang

2015-01-01

Transnational companies, operating in extremely competitive global markets, always seek to lower different operating costs, such as inventory holding costs in their intra- supply chain system. This paper incorporates a cost reducing product distribution policy into an intra-supply chain system with multiple sales locations and quality assurance studied by [Chiu et al., Expert Syst Appl, 40:2669-2676, (2013)]. Under the proposed cost reducing distribution policy, an added initial delivery of end items is distributed to multiple sales locations to meet their demand during the production unit's uptime and rework time. After rework when the remaining production lot goes through quality assurance, n fixed quantity installments of finished items are then transported to sales locations at a fixed time interval. Mathematical modeling and optimization techniques are used to derive closed-form optimal operating policies for the proposed system. Furthermore, the study demonstrates significant savings in stock holding costs for both the production unit and sales locations. Alternative of outsourcing product delivery task to an external distributor is analyzed to assist managerial decision making in potential outsourcing issues in order to facilitate further reduction in operating costs.

A Low-cost System for Generating Near-realistic Virtual Actors

Science.gov (United States)

Afifi, Mahmoud; Hussain, Khaled F.; Ibrahim, Hosny M.; Omar, Nagwa M.

2015-06-01

Generating virtual actors is one of the most challenging fields in computer graphics. The reconstruction of a realistic virtual actor has been paid attention by the academic research and the film industry to generate human-like virtual actors. Many movies were acted by human-like virtual actors, where the audience cannot distinguish between real and virtual actors. The synthesis of realistic virtual actors is considered a complex process. Many techniques are used to generate a realistic virtual actor; however they usually require expensive hardware equipment. In this paper, a low-cost system that generates near-realistic virtual actors is presented. The facial features of the real actor are blended with a virtual head that is attached to the actor's body. Comparing with other techniques that generate virtual actors, the proposed system is considered a low-cost system that requires only one camera that records the scene without using any expensive hardware equipment. The results of our system show that the system generates good near-realistic virtual actors that can be used on many applications.

Problem Posing with Realistic Mathematics Education Approach in Geometry Learning

Science.gov (United States)

Mahendra, R.; Slamet, I.; Budiyono

2017-09-01

One of the difficulties of students in the learning of geometry is on the subject of plane that requires students to understand the abstract matter. The aim of this research is to determine the effect of Problem Posing learning model with Realistic Mathematics Education Approach in geometry learning. This quasi experimental research was conducted in one of the junior high schools in Karanganyar, Indonesia. The sample was taken using stratified cluster random sampling technique. The results of this research indicate that the model of Problem Posing learning with Realistic Mathematics Education Approach can improve students’ conceptual understanding significantly in geometry learning especially on plane topics. It is because students on the application of Problem Posing with Realistic Mathematics Education Approach are become to be active in constructing their knowledge, proposing, and problem solving in realistic, so it easier for students to understand concepts and solve the problems. Therefore, the model of Problem Posing learning with Realistic Mathematics Education Approach is appropriately applied in mathematics learning especially on geometry material. Furthermore, the impact can improve student achievement.

Intra-Operative Inspired Fraction of Oxygen and the Risk of Surgical Site Infections in Patients with Type 1 Surgical Incisions.

Science.gov (United States)

Wanta, Brendan T; Hanson, Kristine T; Hyder, Joseph A; Stewart, Thomas M; Curry, Timothy B; Berbari, Elie F; Habermann, Elizabeth B; Kor, Daryl J; Brown, Michael J

2018-04-02

Whether the fraction of inspired oxygen (F I O 2 ) influences the risk of surgical site infection (SSI) is controversial. The World Health Organization and the World Federation of Societies of Anesthesiologists offer conflicting recommendations. In this study, we evaluate simultaneously three different definitions of F I O 2 exposure and the risk of SSI in a large surgical population. Patients with clean (type 1) surgical incisions who developed superficial and deep organ/space SSI within 30 days after surgery from January 2003 through December 2012 in five surgical specialties were matched to specialty-specific controls. Fraction of inspired oxygen exposure was defined as (1) nadir F I O 2 , (2) percentage of operative time with F I O 2 greater than 50%, and (3) cumulative hyperoxia exposure, calculated as the area under the curve (AUC) of F I O 2 by time for the duration in which F I O 2 greater than 50%. Stratified univariable and multivariable logistic regression models tested associations between F I O 2 and SSI. One thousand two hundred fifty cases of SSI were matched to 3,248 controls. Increased oxygen exposure, by any of the three measures, was not associated with the outcome of any SSI in a multivariable logistic regression model. Elevated body mass index (BMI; 35+ vs. operative oxygen exposure was associated with higher odds of SSI in the neurosurgical and spine populations. Increased intra-operative inspired fraction of oxygen was not associated with a reduction in SSI. These findings do not support the practice of increasing F I O 2 for the purpose of SSI reduction in patients with clean surgical incisions.

Novel high-fidelity realistic explosion damage simulation for urban environments

Science.gov (United States)

Liu, Xiaoqing; Yadegar, Jacob; Zhu, Youding; Raju, Chaitanya; Bhagavathula, Jaya

2010-04-01

Realistic building damage simulation has a significant impact in modern modeling and simulation systems especially in diverse panoply of military and civil applications where these simulation systems are widely used for personnel training, critical mission planning, disaster management, etc. Realistic building damage simulation should incorporate accurate physics-based explosion models, rubble generation, rubble flyout, and interactions between flying rubble and their surrounding entities. However, none of the existing building damage simulation systems sufficiently faithfully realize the criteria of realism required for effective military applications. In this paper, we present a novel physics-based high-fidelity and runtime efficient explosion simulation system to realistically simulate destruction to buildings. In the proposed system, a family of novel blast models is applied to accurately and realistically simulate explosions based on static and/or dynamic detonation conditions. The system also takes account of rubble pile formation and applies a generic and scalable multi-component based object representation to describe scene entities and highly scalable agent-subsumption architecture and scheduler to schedule clusters of sequential and parallel events. The proposed system utilizes a highly efficient and scalable tetrahedral decomposition approach to realistically simulate rubble formation. Experimental results demonstrate that the proposed system has the capability to realistically simulate rubble generation, rubble flyout and their primary and secondary impacts on surrounding objects including buildings, constructions, vehicles and pedestrians in clusters of sequential and parallel damage events.

Progress in realistic LOCA analysis

Energy Technology Data Exchange (ETDEWEB)

Young, M Y; Bajorek, S M; Ohkawa, K [Westinghouse Electric Corporation, Pittsburgh, PA (United States)

1994-12-31

While LOCA is a complex transient to simulate, the state of art in thermal hydraulics has advanced sufficiently to allow its realistic prediction and application of advanced methods to actual reactor design as demonstrated by methodology described in this paper 6 refs, 5 figs, 3 tabs

Should scientific realists be platonists?

DEFF Research Database (Denmark)

Busch, Jacob; Morrison, Joe

2015-01-01

an appropriate use of the resources of Scientific Realism (in particular, IBE) to achieve platonism? (§2) We argue that just because a variety of different inferential strategies can be employed by Scientific Realists does not mean that ontological conclusions concerning which things we should be Scientific...

Manipulating the wavelength-drift of a Tm laser for resonance enhancement in an intra-cavity pumped Ho laser.

Science.gov (United States)

Huang, Haizhou; Huang, Jianhong; Liu, Huagang; Li, Jinhui; Lin, Zixiong; Ge, Yan; Dai, Shutao; Deng, Jing; Lin, Wenxiong

2018-03-05

We demonstrate an enhancement mechanism and thermal model for intra-cavity pumped lasers, where resonance enhancement in intra-cavity pumped Ho laser was achieved by manipulating the wavelength-drift nature of the Tm laser for the first time. Optical conversion efficiency of 37.5% from an absorbed 785 nm diode laser to a Ho laser was obtained with a maximum output power of 7.51 W at 2122 nm, which is comparable to the conversion efficiency in 1.9 μm LD pumped Ho lasers. Meanwhile, more severe thermal effects in the Ho-doped gain medium than the Tm-doped one at high power operation were verified based on the built thermal model. This work benefits the design or evaluation of intra-cavity pumped lasers, and the resonance enhancement originated from the difference in reabsorption loss between stark levels at the lasing manifolds of quasi-three-level rare-earth ions has great interest to improve the existing intra-cavity pumped lasers or explore novel lasers.

Intra-articular injection of hyaluronic acid for treatment of osteoarthritis knee: comparative study to intra-articular corticosteroids

Directory of Open Access Journals (Sweden)

Soad A Elsawy

2017-01-01

Conclusion Both HA and corticosteroid groups showed improvement in pain and knee function, but the intra-articular HA was superior to corticosteroid on long-term follow-up. This supports the potential rate of intra-articular HA as an effective long-term therapeutic option for patients with OA of the knee.

Comparison of Sigma-Point and Extended Kalman Filters on a Realistic Orbit Determination Scenario

Science.gov (United States)

Gaebler, John; Hur-Diaz. Sun; Carpenter, Russell

2010-01-01

Sigma-point filters have received a lot of attention in recent years as a better alternative to extended Kalman filters for highly nonlinear problems. In this paper, we compare the performance of the additive divided difference sigma-point filter to the extended Kalman filter when applied to orbit determination of a realistic operational scenario based on the Interstellar Boundary Explorer mission. For the scenario studied, both filters provided equivalent results. The performance of each is discussed in detail.

Systematic Review and Meta-Analysis of Randomized Controlled Trials Evaluating Prophylactic Intra-Operative Wound Irrigation for the Prevention of Surgical Site Infections.

Science.gov (United States)

de Jonge, Stijn W; Boldingh, Quirine J J; Solomkin, Joseph S; Allegranzi, Benedetta; Egger, Matthias; Dellinger, E Patchen; Boermeester, Marja A

Surgical site infections (SSIs) are one of the most common hospital-acquired infections. To reduce SSIs, prophylactic intra-operative wound irrigation (pIOWI) has been advocated, although the results to date are equivocal. To develop recommendations for the new World Health Organization (WHO) SSI prevention guidelines, a systematic literature review and a meta-analysis were conducted on the effectiveness of pIOWI using different agents as a means of reducing SSI. The PUBMED, Embase, CENTRAL, CINAHL, and WHO databases were searched. Randomized controlled trials (RCTs) comparing either pIOWI with no pIOWI or with pIOWI using different solutions and techniques were retrieved with SSI as the primary outcome. Meta-analyses were performed, and odds ratios (OR) and the mean difference with 95% confidence intervals (CI) were extracted and pooled with a random effects model. Twenty-one studies were suitable for analysis, and a distinction was made between intra-peritoneal, mediastinal, and incisional wound irrigation. A low quality of evidence demonstrated a statistically significant benefit for incisional wound irrigation with an aqueous povidone-iodine (PVP-I) solution in clean and clean contaminated wounds (OR 0.31; 95% CI 0.13-0.73; p = 0.007); 50 fewer SSIs per 1,000 procedures (from 19 fewer to 64 fewer)). Antibiotic irrigation had no significant effect in reducing SSIs (OR 1.16; 95% CI 0.64-2.12; p = 0.63). Low-quality evidence suggests considering the use of prophylactic incisional wound irrigation to prevent SSI with an aqueous povidone-iodine solution. Antibiotic irrigation does not show a benefit and therefore is discouraged.

Single-dose intra-articular bupivacaine plus morphine versus bupivacaine alone after arthroscopic knee surgery: a meta-analysis of randomized controlled trials.

Science.gov (United States)

Yang, Ye; Zeng, Chao; Wei, Jie; Li, Hui; Yang, Tuo; Deng, Zhen-Han; Li, Yu-Sheng; Yang, Tu-Bao; Lei, Guang-Hua

2017-03-01

The purpose of this meta-analysis was to compare the efficacy and safety of single-dose intra-articular bupivacaine plus morphine versus bupivacaine alone for pain management following arthroscopic knee surgery. A comprehensive literature search was conducted to identify randomized controlled trials that used single-dose intra-articular bupivacaine plus morphine and bupivacaine alone for post-operative pain, using MEDLINE (1966-2014), Cochrane Library and EMBASE databases. The weighted mean difference (WMD), relative risk (RR) and their corresponding 95 % confidence intervals (CIs) were calculated using RevMan statistical software. A total of twenty-nine trials (n = 1167) were included. The post-operative visual analog scale (VAS) pain score of the bupivacaine plus morphine group compared with the bupivacaine alone group was significantly lower (WMD -1.15, 95 % CI -1.67 to -0.63, p bupivacaine plus morphine was shown to be significantly better than bupivacaine alone at relieving post-operative pain after arthroscopic knee surgery without increasing the short-term side effects. Routine use of single-dose intra-articular bupivacaine plus morphine is an effective way for pain management after arthroscopic knee surgery. II.

Intra-Diegetic Cameras as Cinematic Actor Assemblages in Found Footage Horror Cinema

DEFF Research Database (Denmark)

Rødje, Kjetil

2017-01-01

that comprises what is commonly known as human actors as well as material entities that play an active part in motion picture images. The use of intra-diegetic cameras in contemporary found footage horror films constitutes a particular case of such cinematic actor assemblages. Through a dynamic relational...... performance, cameras here take on roles as active agents with the potential to affect other elements within the images as well as the films’ audiences. In found footage horror the assemblage mode of operation creates suspense, since the vulnerability of the camera threatens the viewer's access to the depicted...... events. While human characters and individual entities making up the camera assemblage are disposable, the recording is not. Found footage horror crucially hinges upon the survival of the footage. I will further suggest that these films allow filmmakers to experiment with the acting capabilities of intra...

Use of Intra-Arterial Chemotherapy and Embolization Before Limb Salvage Surgery for Osteosarcoma of the Lower Extremity

International Nuclear Information System (INIS)

Zhang Huojun; Yang Jijin; Lu Jianping; Lai Chaojen; Sheng Jin; Li Yuxiao; Hao Qiang; Zhang Shunmin; Gupta, Sanjay

2009-01-01

We report our experience with the use of intra-arterial chemotherapy and embolization before limb salvage surgery in patients with osteosarcoma of the lower extremity. We evaluated the effect of this procedure on the degree of tumor necrosis and on the amount of blood loss during surgery. We reviewed the medical records of all patients who received intra-arterial chemotherapy and embolization before undergoing limb salvage surgery for osteosarcoma of the lower extremity at our institution between January 2003 and April 2008. Patient demographic, tumor characteristics, treatment details, postembolization complications, and surgical and pathological findings were recorded for each patient. We evaluated the operative time, estimated blood loss (EBL), and volume of blood transfusion during surgery and in the postoperative period in all patients in the study group. The same parameters were recorded for 65 other patients with lower extremity osteosarcoma who underwent limb salvage operation at our institution without undergoing preoperative intervention. The study included 47 patients (25 males and 22 females). Angiography showed that the tumors were hypervascular. Intra-arterial chemotherapy and embolization were performed successfully, resulting in a substantial reduction or complete disappearance of tumor stain in all patients. No major complications were encountered. At the time of surgery, performed 3-7 days after embolization, a fibrous edematous band around the tumor was observed in 43 of the 47 patients, facilitating surgery. The goal of limb salvage was achieved successfully in all cases. Percentage tumor necrosis induced by treatment ranged from 70.2% to 94.2% (average, 82.9%). EBL during surgery, EBL from drains in the postoperative period, total EBL, and transfusion volumes were significantly lower in the 47 study patients compared to the 65 patients who underwent surgery without preoperative treatment with intra-arterial chemotherapy and embolization. The

Design of a Realistic Test Simulator For a Built-In Self Test Environment

Directory of Open Access Journals (Sweden)

A. Ahmad

2010-12-01

Full Text Available This paper presents a realistic test approach suitable to Design For Testability (DFT and Built- In Self Test (BIST environments. The approach is culminated in the form of a test simulator which is capable of providing a required goal of test for the System Under Test (SUT. The simulator uses the approach of fault diagnostics with fault grading procedure to provide the tests. The tool is developed on a common PC platform and hence no special software is required. Thereby, it is a low cost tool and hence economical. The tool is very much suitable for determining realistic test sequences for a targeted goal of testing for any SUT. The developed tool incorporates a flexible Graphical User Interface (GUI procedure and can be operated without any special programming skill. The tool is debugged and tested with the results of many bench mark circuits. Further, this developed tool can be utilized for educational purposes for many courses such as fault-tolerant computing, fault diagnosis, digital electronics, and safe - reliable - testable digital logic designs.

Time management: a realistic approach.

Science.gov (United States)

Jackson, Valerie P

2009-06-01

Realistic time management and organization plans can improve productivity and the quality of life. However, these skills can be difficult to develop and maintain. The key elements of time management are goals, organization, delegation, and relaxation. The author addresses each of these components and provides suggestions for successful time management.

Triangulating and guarding realistic polygons

NARCIS (Netherlands)

Aloupis, G.; Bose, P.; Dujmovic, V.; Gray, C.M.; Langerman, S.; Speckmann, B.

2008-01-01

We propose a new model of realistic input: k-guardable objects. An object is k-guardable if its boundary can be seen by k guards in the interior of the object. In this abstract, we describe a simple algorithm for triangulating k-guardable polygons. Our algorithm, which is easily implementable, takes

Management of interstitial ectopic pregnancies with a combined intra-amniotic and systemic approach.

Science.gov (United States)

Swank, Morgan L; Harken, Tabetha R; Porto, Manuel

2013-08-01

Approximately 2% of all pregnancies are ectopic; of these, 4% are interstitial or cervical. There exists no clear consensus as to whether surgical or medical management is superior. We present three cases of advanced nonfallopian tube ectopic pregnancies from 6 to 8 weeks of gestation. Our first two cases were managed with a combined intrafetal, intra-amniotic and systemic approach using methotrexate and potassium chloride, whereas our third case was managed with an intra-amniotic approach alone. Our combined approach cases were successful, with resolution of human chorionic gonadotropin in 50 and 34 days, whereas our single approach case re-presented with bleeding requiring uterine artery embolization and operative removal of products of conception. Patients presenting with advanced interstitial or cervical pregnancies who are clinically stable can be offered medical management with a combined approach.

Intra-Industry Affiliate Trade of Foreign-Owned Companies in Transition Economies:

DEFF Research Database (Denmark)

Nielsen, Jørgen Ulff-Møller; Pawlik, Konrad

2008-01-01

Using a database containing trade and industry variables of foreign-owned companies in the Polish manufacturing industry for the years 1993-2002, we investigate the relationship between the organizational structure of multinational enterprises (MNE) in Poland and the intra-industry trade of their...... become a more important mode of organization for multinational enterprises as Poland has evolved into a relatively stable economic environment where MNEs feel comfortable basing their regional operations.......Using a database containing trade and industry variables of foreign-owned companies in the Polish manufacturing industry for the years 1993-2002, we investigate the relationship between the organizational structure of multinational enterprises (MNE) in Poland and the intra-industry trade...... of their affiliates (IIAT). We find labour intensity; scale economies and absorptive capacity of affiliates are the main explanatory variables for IIAT. Given the overall rise in export and import intensities of foreign affiliates over the period of investigation, our findings suggest that export-platform FDI has...

Microscopic calculations of elastic scattering between light nuclei based on a realistic nuclear interaction

Energy Technology Data Exchange (ETDEWEB)

Dohet-Eraly, Jeremy [F.R.S.-FNRS (Belgium); Sparenberg, Jean-Marc; Baye, Daniel, E-mail: jdoheter@ulb.ac.be, E-mail: jmspar@ulb.ac.be, E-mail: dbaye@ulb.ac.be [Physique Nucleaire et Physique Quantique, CP229, Universite Libre de Bruxelles (ULB), B-1050 Brussels (Belgium)

2011-09-16

The elastic phase shifts for the {alpha} + {alpha} and {alpha} + {sup 3}He collisions are calculated in a cluster approach by the Generator Coordinate Method coupled with the Microscopic R-matrix Method. Two interactions are derived from the realistic Argonne potentials AV8' and AV18 with the Unitary Correlation Operator Method. With a specific adjustment of correlations on the {alpha} + {alpha} collision, the phase shifts for the {alpha} + {alpha} and {alpha} + {sup 3}He collisions agree rather well with experimental data.

Reducing bacterial contamination in an Orthopedic Theatre ventilated by natural ventilation, in a Developing Country.

Science.gov (United States)

Thomas, Stephanie; Palmer, Rish; Phillipo, Edward; Chipungu, Geoffrey

2016-05-31

All surgical procedures have the potential for infection and some of the main sources are contamination from airborne particles, theatre personnel and the theatre environment.  There is strong evidence that the use of ultra-clean air flow systems in orthopedic operating theatres reduces the incidence of deep sepsis after surgery. In the developing world however, this is often an unrealistic solution. The aim of this study was to establish baseline levels of contamination in a working orthopedic theatre, at the Queen Elizabeth Central Hospital, Blantyre, Malawi. To feedback results to the theatre team, promote infection prevention discussion and work with the team to implement workable and realistic goals to improve the intra-operative environment. Samples were collected from theatre equipment available at the time of surgery, from theatre water and theatre air using passive air sampling techniques. Samples were immediately transferred to the Central Microbiology Laboratory for culture on basic culture media. Bacterial contamination of theatre equipment, intra-operative theatre air and water was detected. Results were discussed with the theatre and infection prevention team who were receptive to feedback with regards to infection prevention strategies and keen to develop simple measures which could be put in place to change practice. In this setting, we suggest that implementing workable and realistic goals such as, establishing baseline rates of bacterial contamination and introduction of strict protocols for asepsis and theatre etiquette, may reduce bacterial contamination rates and subsequent intra-operative infection in the absence of expensive engineering solutions.

Using Concrete and Realistic Data in Evaluating Initial Visualization Designs

DEFF Research Database (Denmark)

Knudsen, Søren; Pedersen, Jeppe Gerner; Herdal, Thor

2016-01-01

We explore means of designing and evaluating initial visualization ideas, with concrete and realistic data in cases where data is not readily available. Our approach is useful in exploring new domains and avenues for visualization, and contrasts other visualization work, which typically operate...... under the assumption that data has already been collected, and is ready to be visualized. We argue that it is sensible to understand data requirements and evaluate the potential value of visualization before devising means of automatic data collection. We base our exploration on three cases selected...... the design case and problem, the manner in which we collected data, and the findings obtained from evaluations. Afterwards, we describe four factors of our data collection approach, and discuss potential outcomes from it....

[Clinical analysis of acute encephalocele during operation in 21 patients with severe craniocerebral injury].

Science.gov (United States)

Zhuang, Qiang; Qu, Chun-cheng; Liang, Wen-zhi; Qin, Hao; Yu, Rui

2011-03-08

To analyze the clinical features of acute intra-operative encephalocele and the proper prophylactic-therapeutic measures for severe craniocerebral injury. The clinical data were collected and analyzed for 21 patients with severe head injuries who suffered acute intra-operative encephalocele from June 2008 to May 2010. There were 12 males and 9 females with an age range of 18 - 69 years old. Among these patients, 6 died with a mortality rate of 28.5%. It was lower than that reported in literatures. One patient died post-operatively of severe brain swelling and intracranial infection secondary to leakage of cerebrospinal fluid. Four patients died of severe craniocerebral injury, brain swelling and brain stem failure. And 1 patient died after his guardian abandoned the treatment. The follow-up period for the remaining 15 surviving patients was 3 - 6 months. According to the Glasgow outcome score (GOS), there were a favorable prognosis (n = 9), moderate disabilities (n = 5) and severe disability (n = 1). The probability of acute intra-operative encephalocele may be predicted in advance with a combination of clinical features and computed tomographic scans. The therapeutic success rate of acute encephalocele will be boosted by taking protective and therapeutic measures pre- and intra-operatively.

ATHENA/INTRA analyses for ITER, NSSR-2

International Nuclear Information System (INIS)

Shen, Kecheng; Eriksson, John; Sjoeberg, A.

1999-02-01

The present report is a summary report including thermal-hydraulic analyses made at Studsvik Eco and Safety AB for the ITER NSSR-2 safety documentation. The objective of the analyses was to reveal the safety characteristics of various heat transfer systems at specified operating conditions and to indicate the conditions for which there were obvious risks of jeopardising the structural integrity of the coolant systems. In the latter case also some analyses were made to indicate conceivable mitigating measures for maintaining the integrity.The analyses were primarily concerned with the First Wall and Divertor heat transfer systems. Several enveloping transients were analysed with associated specific flow and heat load boundary conditions. The analyses were performed with the ATHENA and INTRA codes

ATHENA/INTRA analyses for ITER, NSSR-2

Energy Technology Data Exchange (ETDEWEB)

Shen, Kecheng; Eriksson, John; Sjoeberg, A

1999-02-01

The present report is a summary report including thermal-hydraulic analyses made at Studsvik Eco and Safety AB for the ITER NSSR-2 safety documentation. The objective of the analyses was to reveal the safety characteristics of various heat transfer systems at specified operating conditions and to indicate the conditions for which there were obvious risks of jeopardising the structural integrity of the coolant systems. In the latter case also some analyses were made to indicate conceivable mitigating measures for maintaining the integrity.The analyses were primarily concerned with the First Wall and Divertor heat transfer systems. Several enveloping transients were analysed with associated specific flow and heat load boundary conditions. The analyses were performed with the ATHENA and INTRA codes 8 refs, 14 figs, 15 tabs

Preventing intra-urethral migration of a guidewire during antegrade placement of a JJ stent: a technical modification.

Science.gov (United States)

Bansal, Ankur; Gupta, Piyush; Dalela, Disha; Dalela, Diwakar

2016-03-07

A JJ stent is usually inserted in antegrade fashion after percutaneous renal surgery. We describe a new technical modification for antegrade stent insertion that prevents intraoperative intra-urethral migration of the guidewire and saves operative time and cost. 2016 BMJ Publishing Group Ltd.

Intra-arterial port implantation for intra-arterial chemotherapy : comparison between PIPS(Percutaneously Implantable Port System) and port system

International Nuclear Information System (INIS)

Yoon, Sang Jin; Shim, Hyung Jin; Jung, Hun Young; Choi, Yong Ho; Kim, Yang Soo; Song, In Sup; Kwak, Byung Kook

1999-01-01

To compare the techniques and complications of intra-arterial port implantation for intra-arterial chemotherapy between PIPS and the port system. For intra-arterial port implantation, 27 cases in 27 patients were retrospectively evaluated using PIPS(PIPS-200, William Cook Europe, Denmark) while for 21 cases in 19 patients a pediatric venous port system(Port-A-Cath, 5.8F, SIMS Deltec, U. S. A.) was used. All intra-arterial port implantation was performed percuteneously in an angiographic ward. Hepatocellular carcinoma was diagnosed in 18 patients and hepatic metastasis in 16. Peripheral cholangiocarcinoma, and pancreatic gastric, ovarian, renal cell and colon carcinoma were included. We compared the techniques and complications between PIPS and the port system. The follow up period ranged from 23 to 494(mean, 163) days in PIPS and from 12 to 431(mean, 150) days in the port system. In all cases, intra-arterial port implantations were technically successful. Port catheter tips were located in the common hepatic artery(n=8), proper hepatic artery(n=7), right hepatic artery(n=5), gastroduodenal artery(n=2), left hepatic artery(n=1), pancreaticoduodenal artery(n=1), inferior mesenteric artery(n=1), lumbar artery(n=1), and renal artery(n=1) in PIPS, and in the proper hepatic artery(n=6), gastroduodenal artery(n=6), common hepatic artery(n=3), right hepatic artery(n=4), inferior mesenteric artery(n=1), and internal iliac artery(n=1) in the port system. Port chambers were buried in infrainguinal subcutaneous tissue. Using PIPS, complications developed in seven cases(25.9%) and of these, four (57.1%) were catheter or chamber related. In the port system, catheter or chamber related complications developed in four cases(19.0%). Because PIPS and the port system have relative merits and demetrits, successful intra-arterial port implantation is possible if equipment is properly selected

MR-based measurements and simulations of the magnetic field created by a realistic transcranial magnetic stimulation (TMS) coil and stimulator.

Science.gov (United States)

Mandija, Stefano; Petrov, Petar I; Neggers, Sebastian F W; Luijten, Peter R; van den Berg, Cornelis A T

2016-11-01

Transcranial magnetic stimulation (TMS) is an emerging technique that allows non-invasive neurostimulation. However, the correct validation of electromagnetic models of typical TMS coils and the correct assessment of the incident TMS field (B TMS ) produced by standard TMS stimulators are still lacking. Such a validation can be performed by mapping B TMS produced by a realistic TMS setup. In this study, we show that MRI can provide precise quantification of the magnetic field produced by a realistic TMS coil and a clinically used TMS stimulator in the region in which neurostimulation occurs. Measurements of the phase accumulation created by TMS pulses applied during a tailored MR sequence were performed in a phantom. Dedicated hardware was developed to synchronize a typical, clinically used, TMS setup with a 3-T MR scanner. For comparison purposes, electromagnetic simulations of B TMS were performed. MR-based measurements allow the mapping and quantification of B TMS starting 2.5 cm from the TMS coil. For closer regions, the intra-voxel dephasing induced by B TMS prohibits TMS field measurements. For 1% TMS output, the maximum measured value was ~0.1 mT. Simulations reflect quantitatively the experimental data. These measurements can be used to validate electromagnetic models of TMS coils, to guide TMS coil positioning, and for dosimetry and quality assessment of concurrent TMS-MRI studies without the need for crude methods, such as motor threshold, for stimulation dose determination. Copyright © 2016 John Wiley & Sons, Ltd.

Carbachol as miotic agent in intra-ocular lens implant surgery

Directory of Open Access Journals (Sweden)

Agarwal Jitendra

1988-01-01

Full Text Available The intra cameral use of 0.025% carbachol as a miotic agent in anterior chamber intraocular lens im-plant surgery us reported in 15 cases. Carbachol produced prompt and effective moisis and was found to be harmless and non-irritating to the anterior chamber structures. A rebound dialatation of the pipit was noticed in the post operative period in 3 of our first 5 cases where only carbachol was used. For prolonged miosis instillation of a more powerful miotic like pilocarpine is recommended at the completion of surgery:

Separable expansion for realistic multichannel scattering problems

International Nuclear Information System (INIS)

Canton, L.; Cattapan, G.; Pisent, G.

1987-01-01

A new approach to the multichannel scattering problem with realistic local or nonlocal interactions is developed. By employing the negative-energy solutions of uncoupled Sturmian eigenvalue problems referring to simple auxiliary potentials, the coupling interactions appearing to the original multichannel problem are approximated by finite-rank potentials. By resorting to integral-equation tecniques the coupled-channel equations are then reduced to linear algebraic equations which can be straightforwardly solved. Compact algebraic expressions for the relevant scattering matrix elements are thus obtained. The convergence of the method is tasted in the single-channel case with realistic optical potentials. Excellent agreement is obtained with a few terms in the separable expansion for both real and absorptive interactions

Vascular anatomy of the medial sural artery perforator flap: a new classification system of intra-muscular branching patterns.

Science.gov (United States)

Dusseldorp, Joseph R; Pham, Quy J; Ngo, Quan; Gianoutsos, Mark; Moradi, Pouria

2014-09-01

The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap. The main difficulty encountered when raising the MSAP flap is in obtaining adequate pedicle length during intra-muscular dissection. The objective of this study was to determine the pattern of intra-muscular course of the MSAP flap pedicle. 14 cadaveric specimens were dissected and CT angiograms of 84 legs were examined. The intra-muscular branching pattern and depths of the medial sural artery branches were analyzed. The number of perforators, position of the dominant perforator and both intra-muscular and total pedicle length were also recorded and compared to existing anatomical data. Three types of arterial branching pattern were identified within the medial gastrocnemius, demonstrating one (31%), two (59%) or three or more (10%) main branches. A dominant perforator from the medial sural artery was present in 92% of anatomical specimens (13/14). Vertically, the location of the perforator from the popliteal crease was on average 13 cm (±2 cm). Transversely, the perforator originated 2.5 cm (±1 cm) from the posterior midline. Using CT angiography it was possible in 10 consecutive patients to identify a more superficial intra-muscular branch and determine the leg with the optimal branching pattern type for flap harvest. This study is the first to describe the variability of the intra-muscular arterial anatomy of the medial head of gastrocnemius muscle. Surgeons utilizing the MSAP flap option should be aware of the possible branching pattern types and consequently the differing perforator distribution and depths of intra-muscular branches. Routine use of pre-operative CT angiogram may help determine which leg has the most favorable branching pattern type and intra-muscular course for flap harvest. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Realistic nurse-led policy implementation, optimization and evaluation: novel methodological exemplar.

Science.gov (United States)

Noyes, Jane; Lewis, Mary; Bennett, Virginia; Widdas, David; Brombley, Karen

2014-01-01

To report the first large-scale realistic nurse-led implementation, optimization and evaluation of a complex children's continuing-care policy. Health policies are increasingly complex, involve multiple Government departments and frequently fail to translate into better patient outcomes. Realist methods have not yet been adapted for policy implementation. Research methodology - Evaluation using theory-based realist methods for policy implementation. An expert group developed the policy and supporting tools. Implementation and evaluation design integrated diffusion of innovation theory with multiple case study and adapted realist principles. Practitioners in 12 English sites worked with Consultant Nurse implementers to manipulate the programme theory and logic of new decision-support tools and care pathway to optimize local implementation. Methods included key-stakeholder interviews, developing practical diffusion of innovation processes using key-opinion leaders and active facilitation strategies and a mini-community of practice. New and existing processes and outcomes were compared for 137 children during 2007-2008. Realist principles were successfully adapted to a shorter policy implementation and evaluation time frame. Important new implementation success factors included facilitated implementation that enabled 'real-time' manipulation of programme logic and local context to best-fit evolving theories of what worked; using local experiential opinion to change supporting tools to more realistically align with local context and what worked; and having sufficient existing local infrastructure to support implementation. Ten mechanisms explained implementation success and differences in outcomes between new and existing processes. Realistic policy implementation methods have advantages over top-down approaches, especially where clinical expertise is low and unlikely to diffuse innovations 'naturally' without facilitated implementation and local optimization. © 2013

Application and influence of preoperative intervention intra-arterial chemotherapy (NAC) of uterine artery for endometrial carcinoma

International Nuclear Information System (INIS)

Zhu Xueqiong; Yue Tianfu; Wang Dehua

2001-01-01

Objective: To analyse the effect of preoperative persistent infusion chemotherapy via uterine artery on endometrial carcinoma and followed by hysterectomy. Methods: According to the Seldinger's technique, polyethylene catheter was super selected into the uterine artery. The drugs were infused with cisplatin 100 mg and doxorubicin 50 mg in a consecutive low-dose method for five days. Radical surgery was performed about three or four weeks after NAC. The NAC group (n = 20) underwent surgery following intra-arterial chemotherapy, while the control group (n = 40) was randomly selected among the patients of endometrial carcinoma performed operations in the hospital. Results: One (5.0%) patient showed complete response in NAC group, the rates of complete response plus partial response were 60.0%. There were no significant differences in bleeding amounts, the operation time, the function recovery of bladder and bowel, the healing time of the incision between the two groups. Compared with the control group, infiltration larger than half of myometrium and lymph nodes involvement were statistically significant lower in NAC group (P < 0.05). Conclusions: Preparing intra-arterial chemotherapy may reduce tumor volume and possibly eradicate subclinical metastases without increasing the incidence of operative complications

Dose optimization of intra-operative high dose rate interstitial brachytherapy implants for soft tissue sarcoma

Directory of Open Access Journals (Sweden)

Jamema Swamidas

2009-01-01

Full Text Available Objective : A three dimensional (3D image-based dosimetric study to quantitatively compare geometric vs. dose-point optimization in combination with graphical optimization for interstitial brachytherapy of soft tissue sarcoma (STS. Materials and Methods : Fifteen consecutive STS patients, treated with intra-operative, interstitial Brachytherapy, were enrolled in this dosimetric study. Treatment plans were generated using dose points situated at the "central plane between the catheters", "between the catheters throughout the implanted volume", at "distances perpendicular to the implant axis" and "on the surface of the target volume" Geometrically optimized plans had dose points defined between the catheters, while dose-point optimized plans had dose points defined at a plane perpendicular to the implant axis and on the target surface. Each plan was graphically optimized and compared using dose volume indices. Results : Target coverage was suboptimal with coverage index (CI = 0.67 when dose points were defined at the central plane while it was superior when the dose points were defined at the target surface (CI=0.93. The coverage of graphically optimized plans (GrO was similar to non-GrO with dose points defined on surface or perpendicular to the implant axis. A similar pattern was noticed with conformity index (0.61 vs. 0.82. GrO were more conformal and less homogeneous compared to non-GrO. Sum index was superior for dose points defined on the surface of the target and relatively inferior for plans with dose points at other locations (1.35 vs. 1.27. Conclusions : Optimization with dose points defined away from the implant plane and on target results in superior target coverage with optimal values of other indices. GrO offer better target coverage for implants with non-uniform geometry and target volume.

Statistical multi-path exposure method for assessing the whole-body SAR in a heterogeneous human body model in a realistic environment.

Science.gov (United States)

Vermeeren, Günter; Joseph, Wout; Martens, Luc

2013-04-01

Assessing the whole-body absorption in a human in a realistic environment requires a statistical approach covering all possible exposure situations. This article describes the development of a statistical multi-path exposure method for heterogeneous realistic human body models. The method is applied for the 6-year-old Virtual Family boy (VFB) exposed to the GSM downlink at 950 MHz. It is shown that the whole-body SAR does not differ significantly over the different environments at an operating frequency of 950 MHz. Furthermore, the whole-body SAR in the VFB for multi-path exposure exceeds the whole-body SAR for worst-case single-incident plane wave exposure by 3.6%. Moreover, the ICNIRP reference levels are not conservative with the basic restrictions in 0.3% of the exposure samples for the VFB at the GSM downlink of 950 MHz. The homogeneous spheroid with the dielectric properties of the head suggested by the IEC underestimates the absorption compared to realistic human body models. Moreover, the variation in the whole-body SAR for realistic human body models is larger than for homogeneous spheroid models. This is mainly due to the heterogeneity of the tissues and the irregular shape of the realistic human body model compared to homogeneous spheroid human body models. Copyright © 2012 Wiley Periodicals, Inc.

Intra-Operational Area Coordination: The Zone EOC Concept

Science.gov (United States)

2015-09-01

200, operating as Asiana Airlines flight 214 , was on approach to runway 28L when it struck a seawall at San Francisco International Airport (SFIA...training and lacked the necessary training and experience to land a jumbo jet onto an airstrip with a sea wall. The Asiana Airline incident also...Crash of Asiana Flight 214 Accident Report Summary, 2014, accessed August 31, 2015, http://www.ntsb.gov/news/events/Pages/ 2014_Asiana_BMG

Mechanical ventilation and intra-abdominal hypertension: 'Beyond Good and Evil'

OpenAIRE

Pelosi, Paolo; Vargas, Maria

2012-01-01

Intra-abdominal hypertension is frequent in surgical and medical critically ill patients. Intra-abdominal hypertension has a serious impact on the function of respiratory as well as peripheral organs. In the presence of alveolar capillary damage, which occurs in acute respiratory distress syndrome (ARDS), intra-abdominal hypertension promotes lung injury as well as edema, impedes the pulmonary lymphatic drainage, and increases intra-thoracic pressures, leading to atelectasis, airway closure, ...

Comparison of hyaluronic acid and PRP intra-articular injection with combined intra-articular and intraosseous PRP injections to treat patients with knee osteoarthritis.

Science.gov (United States)

Su, Ke; Bai, Yuming; Wang, Jun; Zhang, Haisen; Liu, Hao; Ma, Shiyun

2018-05-01

The aim of this study was to evaluate the benefit provided by intraosseous infiltration combined with intra-articular injection of platelet-rich plasma to treat mild and moderate stages of knee joint degeneration (Kellgren-Lawrence score II-III) compared with other treatments, specifically intra-articular injection of PRP and of HA. Eighty-six patients with grade II to grade III knee OA according to the Kellgren-Lawrence classification were randomly assigned to intra-articular combined with intraosseous injection of PRP (group A), intra-articular PRP (group B), or intra-articular HA (group C). Patients in group A received intra-articular combined with intraosseous injection of PRP (administered twice, 2 weeks apart). Patients in group B received intra-articular injection of PRP every 14 days. Patients in group C received a series of five intra-articular injections of HA every 7 days. All patients were evaluated using the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities (WOMAC) score before the treatment and at 1, 3, 6, 12, and 18 months after treatment. There were significant improvements at the end of the 1st month. Notably, group A patients had significantly superior VAS and WOMAC scores than were observed in groups B and C. The VAS scores were similar in groups B and group C after the 6th month. Regarding the WOMAC scores, groups B and C differed at the 1st, 3rd, 6th, and 12th months; however, no significant difference was observed at the 18th month. The combination of intraosseous with intra-articular injections of PRP resulted in a significantly superior clinical outcome, with sustained lower VAS and WOMAC scores and improvement in quality of life within 18 months.

RenderGAN: Generating Realistic Labeled Data

Directory of Open Access Journals (Sweden)

Leon Sixt

2018-06-01

Full Text Available Deep Convolutional Neuronal Networks (DCNNs are showing remarkable performance on many computer vision tasks. Due to their large parameter space, they require many labeled samples when trained in a supervised setting. The costs of annotating data manually can render the use of DCNNs infeasible. We present a novel framework called RenderGAN that can generate large amounts of realistic, labeled images by combining a 3D model and the Generative Adversarial Network framework. In our approach, image augmentations (e.g., lighting, background, and detail are learned from unlabeled data such that the generated images are strikingly realistic while preserving the labels known from the 3D model. We apply the RenderGAN framework to generate images of barcode-like markers that are attached to honeybees. Training a DCNN on data generated by the RenderGAN yields considerably better performance than training it on various baselines.

GADEN: A 3D Gas Dispersion Simulator for Mobile Robot Olfaction in Realistic Environments.

Science.gov (United States)

Monroy, Javier; Hernandez-Bennets, Victor; Fan, Han; Lilienthal, Achim; Gonzalez-Jimenez, Javier

2017-06-23

This work presents a simulation framework developed under the widely used Robot Operating System (ROS) to enable the validation of robotics systems and gas sensing algorithms under realistic environments. The framework is rooted in the principles of computational fluid dynamics and filament dispersion theory, modeling wind flow and gas dispersion in 3D real-world scenarios (i.e., accounting for walls, furniture, etc.). Moreover, it integrates the simulation of different environmental sensors, such as metal oxide gas sensors, photo ionization detectors, or anemometers. We illustrate the potential and applicability of the proposed tool by presenting a simulation case in a complex and realistic office-like environment where gas leaks of different chemicals occur simultaneously. Furthermore, we accomplish quantitative and qualitative validation by comparing our simulated results against real-world data recorded inside a wind tunnel where methane was released under different wind flow profiles. Based on these results, we conclude that our simulation framework can provide a good approximation to real world measurements when advective airflows are present in the environment.

Neutron star models with realistic high-density equations of state

International Nuclear Information System (INIS)

Malone, R.C.; Johnson, M.B.; Bethe, H.A.

1975-01-01

We calculate neutron star models using four realistic high-density models of the equation of state. We conclude that the maximum mass of a neutron star is unlikely to exceed 2 M/sub sun/. All of the realistic models are consistent with current estimates of the moment of inertia of the Crab pulsar

Intra-industry Affiliate Trade of Foreign Owned Companies in Poland 1993-2002

DEFF Research Database (Denmark)

Nielsen, Jørgen Ulff-Møller; Pawlik, Konrad

2004-01-01

The concept of intra-industry international exchange of goods and assets has attracted a lot of interests within the last 30 years. Concepts like intra-industry trade, intra-industry foreign direct investments, intra-industry affiliate sale, and intra-industry supply have been used in theoretical...... (exports and imports) and industry variables (wages, employment, foreign capital share, investments, sales, etc.) of foreign owned companies in the Polish manufacturing industry for the years 1993-2002, this paper, investigates for the first time intra-industry affiliate trade (IIAT), including its...... and empirical research with most emphasis laid on intra-industry trade. What has not been investigated until now is a subgroup within intra-industry trade, namely intra-industry affiliate trade which is two-way trade from foreign owned affiliates in a country. By use of a unique database containing trade...

Intra-industry Affiliate Trade of Foreign Owned Companies in Poland 1993-2002

DEFF Research Database (Denmark)

Nielsen, Jørgen Ulff-Møller; Pawlik, Konrad

The concept of intra-industry international exchange of goods and assets has attracted a lot of interests within the last 30 years. Concepts like intra-industry trade, intra-industry foreign direct investments, intra-industry affiliate sale, and intra-industry supply have been used in theoretical...... and empirical research with most emphasis laid on intra-industry trade. What has not been investigated until now is a subgroup within intra-industry trade, namely intra-industry affiliate trade, which is two-way trade from/to foreign owned affiliates in a country. By use of a unique database containing trade...... (exports and imports) and industry variables (wages, employment, foreign capital share, investments, sales, etc.) of foreign owned companies in the Polish manufacturing industry for the years 1993-2002, this paper, investigates for the first time intra-industry affiliate trade (IIAT), including its...

Intra-Industry Trade in Tourism Services

OpenAIRE

Nuno Carlos LEITÃO

2011-01-01

Usually the tourism flows are explained by demand, economic growth, and revealed comparative advantage (neoclassic trade theory). This manuscript examines the link between intra-industry trade and international tourism flows. We have examined the Portuguese intra-industry trade in this sector. The analysis apply the static (Grubel and Lloyd) and dynamic index (Brülhart). Our results show that the tourism services are important for a small economy such as Portugal. The int...

Incidence and treatment of intra-articular lesions associated with anterior cruciate ligament tears.

Science.gov (United States)

Todor, Adrian; Nistor, Dan; Buescu, Cristian; Pojar, Adina; Lucaciu, Dan

2014-01-01

The aim of the study is to retrospectively review the patients admitted and treated in the "Alexandru Rădulescu" Orthopedics and Traumatology Clinic, Cluj-Napoca for an anterior cruciate ligament tear over a 2-year period and document the intra-articular lesions found at arthroscopy as well as the treatment used for these associated lesions. The case records of 88 patients operated for anterior cruciate ligament tear over a period of 2 years were reviewed. There were 67 males and 21 females with a mean age of 28.9 years, ranging from 14 to 49 years. After recording the patient demographics, we documented all the intra-articular lesions found during knee arthroscopy, as well as all procedures undertaken concomitant with the ACL reconstruction. 50 of the 88 patients (56.8%) had associated intra-articular lesions at the time of anterior cruciate ligament reconstruction. The most common injury found was a meniscus tear, 48 patients (54.5%) had a meniscal pathology at the time of ligament reconstruction, medial meniscus being the most frequent injured one, found in 37 patients. Meniscectomy and meniscus suture were the procedures performed for these lesions, meniscectomy being more frequent. Chondral defects were the next associated injuries found with an incidence of 15.9% of the cases. The medial side of the knee was the most common site of chondral pathology. ACL tears are frequently associated with other intra-articular lesions, especially medial meniscus tears and chondral defects affecting the medial compartment. Such pathology most often needs surgical attention during the anterior cruciate ligament reconstruction.

Thermohydraulic simulation of HTR-10 nuclear reactor core using realistic CFD approach

International Nuclear Information System (INIS)

Silva, Alexandro S.; Dominguez, Dany S.; Mazaira, Leorlen Y. Rojas; Hernandez, Carlos R.G.; Lira, Carlos Alberto Brayner de Oliveira

2015-01-01

High-temperature gas-cooled reactors (HTGRs) have the potential to be used as possible energy generation sources in the near future, owing to their inherently safe performance by using a large amount of graphite, low power density design, and high conversion efficiency. However, safety is the most important issue for its commercialization in nuclear energy industry. It is very important for safety design and operation of an HTGR to investigate its thermal–hydraulic characteristics. In this article, it was performed the thermal–hydraulic simulation of compressible flow inside the core of the pebble bed reactor HTR (High Temperature Reactor)-10 using Computational Fluid Dynamics (CFD). The realistic approach was used, where every closely packed pebble is realistically modelled considering a graphite layer and sphere of fuel. Due to the high computational cost is impossible simulate the full core; therefore, the geometry used is a column of FCC (Face Centered Cubic) cells, with 41 layers and 82 pebbles. The input data used were taken from the thermohydraulic IAEA Benchmark (TECDOC-1694). The results show the profiles of velocity and temperature of the coolant in the core, and the temperature distribution inside the pebbles. The maximum temperatures in the pebbles do not exceed the allowable limit for this type of nuclear fuel. (author)

Blend Shape Interpolation and FACS for Realistic Avatar

Science.gov (United States)

Alkawaz, Mohammed Hazim; Mohamad, Dzulkifli; Basori, Ahmad Hoirul; Saba, Tanzila

2015-03-01

The quest of developing realistic facial animation is ever-growing. The emergence of sophisticated algorithms, new graphical user interfaces, laser scans and advanced 3D tools imparted further impetus towards the rapid advancement of complex virtual human facial model. Face-to-face communication being the most natural way of human interaction, the facial animation systems became more attractive in the information technology era for sundry applications. The production of computer-animated movies using synthetic actors are still challenging issues. Proposed facial expression carries the signature of happiness, sadness, angry or cheerful, etc. The mood of a particular person in the midst of a large group can immediately be identified via very subtle changes in facial expressions. Facial expressions being very complex as well as important nonverbal communication channel are tricky to synthesize realistically using computer graphics. Computer synthesis of practical facial expressions must deal with the geometric representation of the human face and the control of the facial animation. We developed a new approach by integrating blend shape interpolation (BSI) and facial action coding system (FACS) to create a realistic and expressive computer facial animation design. The BSI is used to generate the natural face while the FACS is employed to reflect the exact facial muscle movements for four basic natural emotional expressions such as angry, happy, sad and fear with high fidelity. The results in perceiving the realistic facial expression for virtual human emotions based on facial skin color and texture may contribute towards the development of virtual reality and game environment of computer aided graphics animation systems.

Fatigue - determination of a more realistic usage factor

International Nuclear Information System (INIS)

Lang, H.

2001-01-01

The ability to use a suitable counting method for determining the stress range spectrum in elastic and simplified elastic-plastic fatigue analyses is of crucial importance for enabling determination of a realistic usage factor. Determination of elastic-plastic strain range using the K e factor from fictitious elastically calculated loads is also important in the event of elastic behaviour being exceeded. This paper thus examines both points in detail. A fatigue module with additional options, which functions on this basis is presented. The much more realistic determination of usage factor presented here offers various economic benefits depending on the application

Seismic hazard assessment in intra-plate areas and backfitting

International Nuclear Information System (INIS)

Asmis, G.J.K.; Eng, P.

2001-01-01

Typically, fuel cycle facilities have been constructed over a 40 year time period incorporating various ages of seismic design provisions ranging from no specific seismic requirements to the life safety provisions normally incorporated in national building codes through to the latest seismic nuclear codes that provide not only for structural robustness but also include operational requirements for continued operation of essential safety functions. The task is to ensure uniform seismic risk in all facilities. Since the majority of the fuel cycle infrastructure has been built the emphasis is on re-evaluation and backfitting. The wide range of facilities included in the fuel cycle and the vastly varying hazard to safety, health and the environment suggest a performance based approach. This paper presents such an approach, placed in an intra-plate setting of a Stable Continental Region (SCR) typical to that found in Eastern Canada. (author)

Realistic rhetoric and legal decision

Directory of Open Access Journals (Sweden)

João Maurício Adeodato

2017-06-01

Full Text Available The text aims to lay the foundations of a realistic rhetoric, from the descriptive perspective of how the legal decision actually takes place, without normative considerations. Aristotle's rhetorical idealism and its later prestige reduced rhetoric to the art of persuasion, eliminating important elements of sophistry, especially with regard to legal decision. It concludes with a rhetorical perspective of judicial activism in complex societies.

Realistic molecular model of kerogen's nanostructure.

Science.gov (United States)

Bousige, Colin; Ghimbeu, Camélia Matei; Vix-Guterl, Cathie; Pomerantz, Andrew E; Suleimenova, Assiya; Vaughan, Gavin; Garbarino, Gaston; Feygenson, Mikhail; Wildgruber, Christoph; Ulm, Franz-Josef; Pellenq, Roland J-M; Coasne, Benoit

2016-05-01

Despite kerogen's importance as the organic backbone for hydrocarbon production from source rocks such as gas shale, the interplay between kerogen's chemistry, morphology and mechanics remains unexplored. As the environmental impact of shale gas rises, identifying functional relations between its geochemical, transport, elastic and fracture properties from realistic molecular models of kerogens becomes all the more important. Here, by using a hybrid experimental-simulation method, we propose a panel of realistic molecular models of mature and immature kerogens that provide a detailed picture of kerogen's nanostructure without considering the presence of clays and other minerals in shales. We probe the models' strengths and limitations, and show that they predict essential features amenable to experimental validation, including pore distribution, vibrational density of states and stiffness. We also show that kerogen's maturation, which manifests itself as an increase in the sp(2)/sp(3) hybridization ratio, entails a crossover from plastic-to-brittle rupture mechanisms.

Understanding Intra-Class Knowledge Inside CNN

OpenAIRE

Wei, Donglai; Zhou, Bolei; Torrabla, Antonio; Freeman, William

2015-01-01

Convolutional Neural Network (CNN) has been successful in image recognition tasks, and recent works shed lights on how CNN separates different classes with the learned inter-class knowledge through visualization. In this work, we instead visualize the intra-class knowledge inside CNN to better understand how an object class is represented in the fully-connected layers. To invert the intra-class knowledge into more interpretable images, we propose a non-parametric patch prior upon previous CNN...

Comparison between Modified Neuroendoscopy and Craniotomy Evacuation of Spontaneous Intra-Cerebral Hemorrhages: Study of Clinical Outcome and Glasgow Outcome Score

Directory of Open Access Journals (Sweden)

Arie Ibrahim

2016-08-01

Full Text Available Background and Purposes: Stroke is still one of a leading health-care problem in industrial country and in the developing country. Spontaneous Intra-cerebral Hemorrhage accounts for 30–60% of all stroke admissions into a hospital. Presence of intra-cerebral hemorrhage is considered a poor prognostic factor due to the resultant obstruction to the mass effect following the presence of blood resulting in raised intracranial pressure. While the craniotomy procedure failed to show more benefits over functional outcome, a less invasive and quicker surgical decompression might improve the outcome. Neuroendoscopy is one of promising optional  on minimal invasive  treatment  for spontaneous intra-cerebral hemorrhage. Material and Methods: We evaluated Glasgow Outcome Score and clinical outcome of patients with Spontaneous Intra-cerebral Hemorrhage who underwent modified neuroendoscopic surgery and craniotomy. Randomized control trial was performed during 27 months in 43 patients. Twenty-five patients treated with neuroendoscopy surgery and 18 patients with craniotomy. The removal of intra-cerebral hemorrhage was done by a modified neuroendoscopic transparent sheath made of silastic material, derived from pieces of thoracic tube No. 21F as a conduit working channel. Results: We analyzed statistically, clinical outcome assessment and Glasgow Outcome Scale 6 months post operative follow-up period. The mortality rate was significantly higher by Pearson chi-square methods, in craniotomy group n=12 (63.2% compared with neuroendoscopy group, n=7 (36.8% (p<.005. Patients with Glasgow Outcome Scale score 3–5 was higher in neuroendoscopy group, n=18 (75% compared with craniotomy group n=6 (25%. The survival rate analyzed by Kaplan Meier methods, found that patients in the neuroendoscopy group were a significantly longer survival rate compare with the craniotomy group during 6 months post operative follow-up period. Conclusions: Treatment of spontaneous

On the Realistic Stochastic Model of GPS Observables: Implementation and Performance

Science.gov (United States)

Zangeneh-Nejad, F.; Amiri-Simkooei, A. R.; Sharifi, M. A.; Asgari, J.

2015-12-01

High-precision GPS positioning requires a realistic stochastic model of observables. A realistic GPS stochastic model of observables should take into account different variances for different observation types, correlations among different observables, the satellite elevation dependence of observables precision, and the temporal correlation of observables. Least-squares variance component estimation (LS-VCE) is applied to GPS observables using the geometry-based observation model (GBOM). To model the satellite elevation dependent of GPS observables precision, an exponential model depending on the elevation angles of the satellites are also employed. Temporal correlation of the GPS observables is modelled by using a first-order autoregressive noise model. An important step in the high-precision GPS positioning is double difference integer ambiguity resolution (IAR). The fraction or percentage of success among a number of integer ambiguity fixing is called the success rate. A realistic estimation of the GNSS observables covariance matrix plays an important role in the IAR. We consider the ambiguity resolution success rate for two cases, namely a nominal and a realistic stochastic model of the GPS observables using two GPS data sets collected by the Trimble R8 receiver. The results confirm that applying a more realistic stochastic model can significantly improve the IAR success rate on individual frequencies, either on L1 or on L2. An improvement of 20% was achieved to the empirical success rate results. The results also indicate that introducing the realistic stochastic model leads to a larger standard deviation for the baseline components by a factor of about 2.6 on the data sets considered.

Modelling Analysis of Echo Signature and Target Strength of a Realistically Modelled Ship Wake for a Generic Forward Looking Active Sonar

NARCIS (Netherlands)

Schippers, P.

2009-01-01

The acoustic modelling in TNO’s ALMOST (=Acoustic Loss Model for Operational Studies and Tasks) uses a bubble migration model as realistic input for wake modelling. The modelled bubble cloud represents the actual ship wake. Ship hull, propeller and bow wave are the main generators of bubbles in the

Intra-abdominal fat: Comparison of computed tomography fat ...

African Journals Online (AJOL)

Background: Intra-abdominal fat is an important factor in determining the metabolic syndrome/insulin resistance, and thus the risk of diabetes and ischaemic heart disease. Computed Tomography (CT) fat segmentation represents a defined method of quantifying intra-abdominal fat, with attendant radiation risks.

Measurements of Intra-Aortic Balloon Wall Movement During Inflation and Deflation: Effects of Angulation.

Science.gov (United States)

Bruti, Gianpaolo; Kolyva, Christina; Pepper, John R; Khir, Ashraf W

2015-08-01

The intra-aortic balloon pump (IABP) is a ventricular assist device that is used with a broad range of pre-, intra-, and postoperative patients undergoing cardiac surgery. Although the clinical efficacy of the IABP is well documented, the question of reduced efficacy when patients are nursed in the semi-recumbent position remains outstanding. The aim of the present work is therefore to investigate the underlying mechanics responsible for the loss of IABP performance when operated at an angle to the horizontal. Simultaneous recordings of balloon wall movement, providing an estimate of its diameter (D), and fluid pressure were taken at three sites along the intra-aortic balloon (IAB) at 0 and 45°. Flow rate, used for the calculation of displaced volume, was also recorded distal to the tip of the balloon. An in vitro experimental setup was used, featuring physiological impedances on either side of the IAB ends. IAB inflation at an angle of 45° showed that D increases at the tip of the IAB first, presenting a resistance to the flow displaced away from the tip of the balloon. The duration of inflation decreased by 15.5%, the inflation pressure pulse decreased by 9.6%, and volume decreased by 2.5%. Similarly, changing the position of the balloon from 0 to 45°, the balloon deflation became slower by 35%, deflation pressure pulse decreased by 14.7%, and volume suctioned was decreased by 15.2%. IAB wall movement showed that operating at 45° results in slower deflation compared with 0°. Slow wall movement, and changes in inflation and deflation onsets, result in a decreased volume displacement and pressure pulse generation. Operating the balloon at an angle to the horizontal, which is the preferred nursing position in intensive care units, results in reduced IAB inflation and deflation performance, possibly compromising its clinical benefits. Copyright © 2015 The Authors. Artificial Organs published by Wiley Periodicals, Inc. on behalf of International Center for

Posterior-only spinal fusion without rib head resection for treating type I neurofibromatosis with intra-canal rib head dislocation

Directory of Open Access Journals (Sweden)

Dong Sun

2013-12-01

Full Text Available OBJECTIVES: Patients with Type I neurofibromatosis scoliosis with intra-canal rib head protrusion are extremely rare. Current knowledge regarding the diagnosis and treatment for this situation are insufficient. The purpose of this study is to share our experience in the diagnosis and surgical treatments for such unique deformities. METHODS: Six patients with Type I neurofibromatosis scoliosis with rib head dislocation into the spinal canal were diagnosed at our institution. Posterior instrumentation and spinal fusion without intra-canal rib head resection via a posterior-only approach was performed for deformity correction and rib head extraction. The efficacy and outcomes of the surgery were evaluated by measurements before, immediately and 24 months after the surgery using the following parameters: coronal spinal Cobb angle, apex rotation and kyphosis of the spine and the intra-canal rib head position. Post-operative complications, surgery time and blood loss were also evaluated. RESULTS: Patients were followed up for at least 24 months post-operatively. The three dimensional spinal deformity was significantly improved and the intra-canal rib head was significantly extracted from the canal immediately after the surgery. At follow-up 24 months after surgery, solid fusions were achieved along the fusion segments, and the deformity corrections and rib head positions were well maintained. There were no surgery-related complications any time after the surgery. CONCLUSIONS: Systematic examinations are needed to identify patients with Type I neurofibromatosis scoliosis with rib head dislocation into the canal who can be treated by posterior-only spinal fusion without rib head resection.

Photo-Realistic Image Synthesis and Virtual Cinematography

DEFF Research Database (Denmark)

Livatino, Salvatore

2005-01-01

Realistic Virtual View Synthesis is a new field of research that has received increasing attention in recent years. It is strictly related to the grown popularity of virtual reality and the spread of its applications, among which virtual photography and cinematography. The use of computer generated...... characters, "virtual actors", in the motion picture production increases every day. While the most known computer graphics techniques have largely been adopted successfully in nowadays fictions, it still remains very challenging to implement virtual actors which would resemble, visually, human beings....... Interestingly, film directors have been looking at the recent progress achieved by the research community in the field of realistic visualization of virtual views, and they have successfully implemented state of the art research approaches in their productions. An innovative concept is then gaining consensus...

Gyroaveraging operations using adaptive matrix operators

Science.gov (United States)

Dominski, Julien; Ku, Seung-Hoe; Chang, Choong-Seock

2018-05-01

A new adaptive scheme to be used in particle-in-cell codes for carrying out gyroaveraging operations with matrices is presented. This new scheme uses an intermediate velocity grid whose resolution is adapted to the local thermal Larmor radius. The charge density is computed by projecting marker weights in a field-line following manner while preserving the adiabatic magnetic moment μ. These choices permit to improve the accuracy of the gyroaveraging operations performed with matrices even when strong spatial variation of temperature and magnetic field is present. Accuracy of the scheme in different geometries from simple 2D slab geometry to realistic 3D toroidal equilibrium has been studied. A successful implementation in the gyrokinetic code XGC is presented in the delta-f limit.

I-Love relations for incompressible stars and realistic stars

Science.gov (United States)

Chan, T. K.; Chan, AtMa P. O.; Leung, P. T.

2015-02-01

In spite of the diversity in the equations of state of nuclear matter, the recently discovered I-Love-Q relations [Yagi and Yunes, Science 341, 365 (2013), 10.1126/science.1236462], which relate the moment of inertia, tidal Love number (deformability), and the spin-induced quadrupole moment of compact stars, hold for various kinds of realistic neutron stars and quark stars. While the physical origin of such universality is still a current issue, the observation that the I-Love-Q relations of incompressible stars can well approximate those of realistic compact stars hints at a new direction to approach the problem. In this paper, by establishing recursive post-Minkowskian expansion for the moment of inertia and the tidal deformability of incompressible stars, we analytically derive the I-Love relation for incompressible stars and show that the so-obtained formula can be used to accurately predict the behavior of realistic compact stars from the Newtonian limit to the maximum mass limit.

INTRA/Mod3.2. Manual and code description. Volume 2 - User's manual

International Nuclear Information System (INIS)

Andersson, Jenny; Edlund, O.; Hermann, J.; Johansson, Lise-Lotte

1999-01-01

The INTRA Manual consists of two volumes. Volume I of the manual is a thorough description of the code INTRA, the physical modelling of INTRA and the ruling numerics, and volume II, the User's Manual is an input description. This document, the User's Manual, Volume II, contains a detailed description of how to use INTRA, how to set up an input file, how to run INTRA and also post-processing

Important characteristics of operational force members

CSIR Research Space (South Africa)

Van Heerden, Adelai

2017-10-01

Full Text Available The operational forces military context is generally acknowledged as one of the most stressful contexts as it is demanding of members on a physical, psychological, social level with organisational, intra- and inter-personal demands of an extreme...

Do absorption and realistic distraction influence performance of component task surgical procedure?

Science.gov (United States)

Pluyter, Jon R; Buzink, Sonja N; Rutkowski, Anne-F; Jakimowicz, Jack J

2010-04-01

Surgeons perform complex tasks while exposed to multiple distracting sources that may increase stress in the operating room (e.g., music, conversation, and unadapted use of sophisticated technologies). This study aimed to examine whether such realistic social and technological distracting conditions may influence surgical performance. Twelve medical interns performed a laparoscopic cholecystectomy task with the Xitact LC 3.0 virtual reality simulator under distracting conditions (exposure to music, conversation, and nonoptimal handling of the laparoscope) versus nondistracting conditions (control condition) as part of a 2 x 2 within-subject experimental design. Under distracting conditions, the medical interns showed a significant decline in task performance (overall task score, task errors, and operating time) and significantly increased levels of irritation toward both the assistant handling the laparoscope in a nonoptimal way and the sources of social distraction. Furthermore, individual differences in cognitive style (i.e., cognitive absorption and need for cognition) significantly influenced the levels of irritation experienced by the medical interns. The results suggest careful evaluation of the social and technological sources of distraction in the operation room to reduce irritation for the surgeon and provision of proper preclinical laparoscope navigation training to increase security for the patient.

Intra-hospital use of a telepathology system.

Science.gov (United States)

Ongürü, O; Celasun, B

2000-01-01

Utilization of telepathology systems to cover distant geographical areas has increased recently. However, the potential usefulness of similar systems for closer distances does not seem to be widely appreciated. In this study, we present data on the use of a simple telepathology system connecting the pathology department and the intra-operative consultation room within the operating theaters of the hospital. Ninety-eight frozen section cases from a past period have been re-evaluated using a real-time setup. Forty-eight of the cases have been re-evaluated in the customary fashion; allowing both ends to communicate and cooperate freely. Fifty of the cases, however, were evaluated by the consultant while the operating room end behaved like a robot; moving the stage of the microscope, changing and focusing the objectives. The deferral rate was lower than the original frozen section evaluations. Overall, the sensitivity was 100%, specificity 98%, negative predictive value 96, 5% and positive predictive value 100%. No significant difference was found for the diagnostic performances between the cooperative and robotic simulation methods.Our results strengthen the belief that telepathology is a valuable tool in offering pathology services to remote areas. The far side of a hospital building can also be a remote area and a low cost system can be helpful for intraoperative consultations. Educational value of such a system is also commendable.

Hyper-realistic face masks: a new challenge in person identification.

Science.gov (United States)

Sanders, Jet Gabrielle; Ueda, Yoshiyuki; Minemoto, Kazusa; Noyes, Eilidh; Yoshikawa, Sakiko; Jenkins, Rob

2017-01-01

We often identify people using face images. This is true in occupational settings such as passport control as well as in everyday social environments. Mapping between images and identities assumes that facial appearance is stable within certain bounds. For example, a person's apparent age, gender and ethnicity change slowly, if at all. It also assumes that deliberate changes beyond these bounds (i.e., disguises) would be easy to spot. Hyper-realistic face masks overturn these assumptions by allowing the wearer to look like an entirely different person. If unnoticed, these masks break the link between facial appearance and personal identity, with clear implications for applied face recognition. However, to date, no one has assessed the realism of these masks, or specified conditions under which they may be accepted as real faces. Herein, we examined incidental detection of unexpected but attended hyper-realistic masks in both photographic and live presentations. Experiment 1 (UK; n = 60) revealed no evidence for overt detection of hyper-realistic masks among real face photos, and little evidence of covert detection. Experiment 2 (Japan; n = 60) extended these findings to different masks, mask-wearers and participant pools. In Experiment 3 (UK and Japan; n = 407), passers-by failed to notice that a live confederate was wearing a hyper-realistic mask and showed limited evidence of covert detection, even at close viewing distance (5 vs. 20 m). Across all of these studies, viewers accepted hyper-realistic masks as real faces. Specific countermeasures will be required if detection rates are to be improved.

Clinical observation on treatment of Meibomian gland before IntraLase LASIK in patients with Meibomian gland dysfunction

Directory of Open Access Journals (Sweden)

He Huang

2016-04-01

Full Text Available AIM:To observe the changes of ocular surface inflammation and tear film state before and after the operation after preoperative targeted therapy for Meibomian gland in the patients scheduled for IntraLase-LASIK with Meibomian gland dysfunction(MGD. METHODS: Thirty-five patients(70 eyesscheduled for IntraLase-LASIK with different degrees of MGD from March to September 2014 were enrolled in this study. All patients were randomly divided into 2 groups, 17 patients(34 eyesin the observation group accepted preoperative targeted therapy for Meibomian gland; 18 patients(36 eyesin the control group did not give the treatment for Meibomian gland, the rest treatments were the same. The change of conjunctival congestion, photophobia, dry symptom score and tear break-up time(BUTwere observed at 1d and 1wk after IntraLase-LASIK. RESULTS: At 1d and 1wk postoperatively, the scores of conjunctival congestion, photophobia, dry symptom and BUT of the observation group were all lower than those of the control group, and the differences were significant(PCONCLUSION: For the patients scheduled for IntraLase-LASIK with MGD, preoperative targeted therapy for Meibomian gland can reduce the postoperative symptoms of ocular surface irritation, stabilize the tear film, improve the postoperative effect and improve the comfort of patients.

Intra-familial physical violence among Mexican and Egyptian youth Violência física intra-familiar entre jovens mexicanos e egípcios

Directory of Open Access Journals (Sweden)

Leonor Rivera-Rivera

2005-10-01

Full Text Available OBJECTIVE: To determine the prevalence of experiencing intra-familial violence among Mexican and Egyptian youth and to describe its associated risk factors. METHODS: Data from questionnaires applied to 12,862 Mexican and 5,662 Egyptian youth, aged 10 to 19, who attended public schools were analyzed. Biviarate and logistic regression analysis were used to determine the relationship between socio-demographics, the experience of intra-familial violence and violence perpetration. RESULTS: The prevalence of having experienced intra-familial violence was comparable across the Mexican and Egyptian populations (14% and 17%, respectively. In Mexico, young men were more likely to have experienced such violence (OR=2.36 than women, whereas in Egypt, young women were at slightly greater risk than young men (OR=1.25. Older age, male gender and urban residence were independent correlates of experiencing intra-familial violence among Mexican youth. For Egyptian adolescents, in contrast, younger age, female gender and having non-married parents were independent correlates of victimization. Intra-familial violence victims were also more likely than non-victims to perpetrate violence (Mexico: OR=13.13; Egypt: OR=6.58. CONCLUSIONS: Mexican and Egyptian youth experienced intra-familial violence at a relatively low prevalence when compared with youth of other countries. A strong association was found between experiencing intra-familial violence and perpetrating violence.OBJETIVO: Determinar a prevalência da violência intra-familiar sofrida por jovens mexicanos e egípcios, e descrever os fatores de risco associados. MÉTODOS: Os dados analisados foram obtidos de questionários aplicados a 12.862 mexicanos e 5.662 egípcios, jovens de 10 a 19 anos, que freqüentam escolas públicas. O relacionamento entre fatores sociodemográficos, a violência sofrida e sua perpetração foram investigados por meio de análise bivariada e regressão logística. RESULTADOS: A

Operational safety evaluation for minor reactor accidents

International Nuclear Information System (INIS)

Wang, O.S.

1981-01-01

The purpose of this paper is to address a concern of applying conservatism in analysing minor reactor incidents. A so-called ''conservative'' safety analysis may exaggerate the system responses and result in a reactor scram tripped by the reactor protective system (RPS). In reality, a minor incident may lead the reactor to a new thermal hydraulic steady-state without scram, and the mitigation or termination of the incident may entirely depend on operator actions. An example on a small steamline break evaluation for a pressurized water reactor recently investigated by the staff at the Washington Public Power Supply System is presented to illustrate this point. A safety evaluation using mainly the safety-related systems to be consistent with the conservative assumptions used in the Safety Analysis Report was conducted. For comparison, a realistic analysis was also performed using both the safety- and control-related systems. The analyses were performed using the RETRAN plant simulation computer code. The ''conservative'' safety analysis predicts that the incident can be turned over by the RPS scram trips without operator intervention. However, the realistic analysis concludes that the reactor will reach a new steady-state at a different plant thermal hydraulic condition. As a result, the termination of the incident at this stage depends entirely on proper operator action. On the basis of this investigation it is concluded that, for minor incidents, ''conservative'' assumptions are not necessary, sometimes not justifiable. A realistic investigation from the operational safety point of view is more appropriate. It is essential to highlight the key transient indications for specific incident recognition in the operator training program

Resource allocation in shared spectrum access communications for operators with diverse service requirements

Science.gov (United States)

Kibria, Mirza Golam; Villardi, Gabriel Porto; Ishizu, Kentaro; Kojima, Fumihide; Yano, Hiroyuki

2016-12-01

In this paper, we study inter-operator spectrum sharing and intra-operator resource allocation in shared spectrum access communication systems and propose efficient dynamic solutions to address both inter-operator and intra-operator resource allocation optimization problems. For inter-operator spectrum sharing, we present two competent approaches, namely the subcarrier gain-based sharing and fragmentation-based sharing, which carry out fair and flexible allocation of the available shareable spectrum among the operators subject to certain well-defined sharing rules, traffic demands, and channel propagation characteristics. The subcarrier gain-based spectrum sharing scheme has been found to be more efficient in terms of achieved throughput. However, the fragmentation-based sharing is more attractive in terms of computational complexity. For intra-operator resource allocation, we consider resource allocation problem with users' dissimilar service requirements, where the operator supports users with delay constraint and non-delay constraint service requirements, simultaneously. This optimization problem is a mixed-integer non-linear programming problem and non-convex, which is computationally very expensive, and the complexity grows exponentially with the number of integer variables. We propose less-complex and efficient suboptimal solution based on formulating exact linearization, linear approximation, and convexification techniques for the non-linear and/or non-convex objective functions and constraints. Extensive simulation performance analysis has been carried out that validates the efficiency of the proposed solution.

Putting a Realistic Theory of Mind into Agency Theory

DEFF Research Database (Denmark)

Foss, Nicolai Juul; Stea, Diego

2014-01-01

Agency theory is one of the most important foundational theories in management research, but it rests on contestable cognitive assumptions. Specifically, the principal is assumed to hold a perfect (correct) theory regarding some of the content of the agent's mind, while he is entirely ignorant...... concerning other such content. More realistically, individuals have some limited access to the minds of others. We explore the implications for classical agency theory of realistic assumptions regarding the human potential for interpersonal sensemaking. We discuss implications for the design and management...

Realistic searches on stretched exponential networks

Indian Academy of Sciences (India)

We consider navigation or search schemes on networks which have a degree distribution of the form () ∝ exp(−). In addition, the linking probability is taken to be dependent on social distances and is governed by a parameter . The searches are realistic in the sense that not all search chains can be completed.

New Technique of Direct Intra-abdominal Pressure Measurement

Directory of Open Access Journals (Sweden)

Elena Risin

2006-10-01

Conclusion: Direct measurement of intra-abdominal pressure using 14-Fr PVC round drain is a newly described technique that is simple, fast and credible. Future investigation will be needed to confirm the reliability of this method during postoperative follow-up of intra-abdominal pressures in selected patients.

Results of recent calculations using realistic potentials

International Nuclear Information System (INIS)

Friar, J.L.

1987-01-01

Results of recent calculations for the triton using realistic potentials with strong tensor forces are reviewed, with an emphasis on progress made using the many different calculational schemes. Several test problems are suggested. 49 refs., 5 figs

Operational Aspects of C/C++ Concurrency

OpenAIRE

Podkopaev, Anton; Sergey, Ilya; Nanevski, Aleksandar

2016-01-01

In this work, we present a family of operational semantics that gradually approximates the realistic program behaviors in the C/C++11 memory model. Each semantics in our framework is built by elaborating and combining two simple ingredients: viewfronts and operation buffers. Viewfronts allow us to express the spatial aspect of thread interaction, i.e., which values a thread can read, while operation buffers enable manipulation with the temporal execution aspect, i.e., determining the order in...

Intra-abdominal pressure: an integrative review.

Science.gov (United States)

Milanesi, Rafaela; Caregnato, Rita Catalina Aquino

2016-01-01

There is a growing request for measuring intra-abdominal pressure in critically ill patients with acute abdominal pain to be clarified. Summarizing the research results on measurement of vesical intra-abdominal pressure and analyzing the level of evidence were the purposes of this integrative literature review, carried out based on the databases LILACS, MEDLINE and PubMed, from 2005 to July 2012. Twenty articles were identified, in that, 12 literature reviews, 4 descriptive and exploratory studies, 2 expert opinions, one prospective cohort study and one was an experience report. The vesical intra-abdominal pressure measurement was considered gold standard. There are variations in the technique however, but some common points were identified: complete supine position, in absence of abdominal contracture, in the end of expiration and expressed in mmHg. Most research results indicate keeping the transducer zeroed at the level of the mid-axillary line at the iliac crest level, and instill 25mL of sterile saline. Strong evidence must be developed. RESUMO Em pacientes críticos com quadros abdominais agudos a esclarecer é crescente a solicitação da aferição da pressão intra-abdominal. Sintetizar resultados de pesquisas sobre a mensuração da pressão intra-abdominal pela via vesical e analisar o nível de evidência foram os objetivos desta revisão integrativa da literatura, realizada nas bases LILACS, MEDLINE e PubMed, no período de 2005 a julho de 2012. Identificaram-se 20 artigos, sendo 12 revisões de literatura, 4 estudos exploratório-descritivos, 2 opiniões de especialistas, 1 estudo de coorte prospectivo e 1 relato de experiência. O método vesical para mensuração da pressão intra-abdominal foi considerado padrão-ouro. Existem variações na técnica, entretanto pontos em comum foram identificados: posição supina completa, na ausência de contratura abdominal, ao final da expiração e expressa em mmHg. A maioria indica posicionar o ponto zero do

Frequent intra-subtype recombination among HIV-1 circulating in Tanzania.

Directory of Open Access Journals (Sweden)

Ireen E Kiwelu

Full Text Available The study estimated the prevalence of HIV-1 intra-subtype recombinant variants among female bar and hotel workers in Tanzania. While intra-subtype recombination occurs in HIV-1, it is generally underestimated. HIV-1 env gp120 V1-C5 quasispecies from 45 subjects were generated by single-genome amplification and sequencing (median (IQR of 38 (28-50 sequences per subject. Recombination analysis was performed using seven methods implemented within the recombination detection program version 3, RDP3. HIV-1 sequences were considered recombinant if recombination signals were detected by at least three methods with p-values of ≤0.05 after Bonferroni correction for multiple comparisons. HIV-1 in 38 (84% subjects showed evidence for intra-subtype recombination including 22 with HIV-1 subtype A1, 13 with HIV-1 subtype C, and 3 with HIV-1 subtype D. The distribution of intra-patient recombination breakpoints suggested ongoing recombination and showed selective enrichment of recombinant variants in 23 (60% subjects. The number of subjects with evidence of intra-subtype recombination increased from 29 (69% to 36 (82% over one year of follow-up, although the increase did not reach statistical significance. Adjustment for intra-subtype recombination is important for the analysis of multiplicity of HIV infection. This is the first report of high prevalence of intra-subtype recombination in the HIV/AIDS epidemic in Tanzania, a region where multiple HIV-1 subtypes co-circulate. HIV-1 intra-subtype recombination increases viral diversity and presents additional challenges for HIV-1 vaccine design.

Realistic Approach for Phasor Measurement Unit Placement

DEFF Research Database (Denmark)

Rather, Zakir Hussain; Chen, Zhe; Thøgersen, Paul

2015-01-01

This paper presents a realistic cost-effectivemodel for optimal placement of phasor measurement units (PMUs) for complete observability of a power system considering practical cost implications. The proposed model considers hidden or otherwise unaccounted practical costs involved in PMU...... installation. Consideration of these hidden but significant and integral part of total PMU installation costs was inspired from practical experience on a real-life project. The proposedmodel focuses on the minimization of total realistic costs instead of a widely used theoretical concept of a minimal number...... of PMUs. The proposed model has been applied to IEEE 14-bus, IEEE 24-bus, IEEE 30-bus, New England 39-bus, and large power system of 300 buses and real life Danish grid. A comparison of the presented results with those reported by traditionalmethods has also been shown to justify the effectiveness...

Getting realistic; Endstation Demut

Energy Technology Data Exchange (ETDEWEB)

Meyer, J.P.

2004-01-28

The fuel cell hype of the turn of the millenium has reached its end. The industry is getting realistic. If at all, fuel cell systems for private single-family and multiple dwellings will not be available until the next decade. With a Europe-wide field test, Vaillant intends to advance the PEM technology. [German] Der Brennstoffzellen-Hype der Jahrtausendwende ist verfolgen. Die Branche uebt sich in Bescheidenheit. Die Marktreife der Systeme fuer Ein- und Mehrfamilienhaeuser wird - wenn ueberhaupt - wohl erst im naechsten Jahrzehnt erreicht sein. Vaillant will durch einen europaweiten Feldtest die Entwicklung der PEM-Technologie vorantreiben. (orig.)

Crustal Structure of the Tengchong Intra-plate Volcanic Area

Science.gov (United States)

Qian, Rongyi; Tong, Vincent C. H.

2015-09-01

We here provide an overview of our current understanding of the crustal structure of Tengchong in southwest China, a key intra-plate volcanic area along the Himalayan geothermal belt. Given that there is hitherto a lack of information about the near-surface structure of intra-plate volcanic areas, we present the first seismic reflection and velocity constraints on the shallow crust between intra-plate volcanoes. Our near-surface seismic images reveal the existence of dome-shaped seismic reflectors (DSRs) in the shallow crust between intra-plate volcanic clusters in Tengchong. The two DSRs are both ~2 km wide, and the shallowest parts of the DSRs are found at the depth of 200-300 m. The velocity model shows that the shallow low-velocity layer (<4 km/s) is anomalously thick (~1 km) in the region where the DSRs are observed. The presence of DSRs indicates significant levels of intra-plate magmatism beneath the along-axis gap separating two volcano clusters. Along-axis gaps between volcano clusters are therefore not necessarily an indicator of lower levels of magmatism. The seismic images obtained in this technically challenging area for controlled-source seismology allow us to conclude that shallow crustal structures are crucial for understanding the along-axis variations of magmatism and hydrothermal activities in intra-plate volcanic areas.

Intra-beam Scattering Theory and RHIC Experiments

International Nuclear Information System (INIS)

Wei, J.; Fedotov, A.; Fischer, W.; Malitsky, N.; Parzen, G.; Qiang, J.

2005-01-01

Intra-beam scattering is the leading mechanism limiting the luminosity in heavy-ion storage rings like the Relativistic Heavy Ion Collider (RHIC). The multiple Coulomb scattering among the charged particles causes transverse emittance growth and longitudinal beam de-bunching and beam loss, compromising machine performance during collision. Theoretically, the original theories developed by Piwinski, Bjorken, and Mtingwa only describe the rms beam size growth of an unbounded Gaussian distribution. Equations based on the Fokker-Planck approach are developed to further describe the beam density profile evolution and beam loss. During the 2004 RHIC heavy-ion operation, dedicated IBS experiments were performed to bench-mark the rms beam size growth, beam loss, and profile evolution both for a Gaussian-like and a longitudinal hollow beam. This paper summarizes the IBS theory and discusses the experimental bench-marking results

Transcranial magnetic stimulation in the semi-quantitative, pre-operative assessment of patients undergoing spinal deformity surgery.

Science.gov (United States)

Glasby, Michael A; Tsirikos, Athanasios I; Henderson, Lindsay; Horsburgh, Gillian; Jordan, Brian; Michaelson, Ciara; Adams, Christopher I; Garrido, Enrique

2017-08-01

To compare measurements of motor evoked potential latency stimulated either magnetically (mMEP) or electrically (eMEP) and central motor conduction time (CMCT) made pre-operatively in conscious patients using transcranial and intra-operatively using electrical cortical stimulation before and after successful instrumentation for the treatment of adolescent idiopathic scoliosis. A group initially of 51 patients with adolescent idiopathic scoliosis aged 12-19 years was evaluated pre-operatively in the outpatients' department with transcranial magnetic stimulation. The neurophysiological data were then compared statistically with intra-operative responses elicited by transcranial electrical stimulation both before and after successful surgical intervention. MEPs were measured as the cortically evoked compound action potentials of Abductor hallucis. Minimum F-waves were measured using conventional nerve conduction methods and the lower motor neuron conduction time was calculated and this was subtracted from MEP latency to give CMCT. Pre-operative testing was well tolerated in our paediatric/adolescent patients. No neurological injury occurred in any patient in this series. There was no significant difference in the values of mMEP and eMEP latencies seen pre-operatively in conscious patients and intra-operatively in patients under anaesthetic. The calculated quantities mCMCT and eCMCT showed the same statistical correlations as the quantities mMEP and eMEP latency. The congruency of mMEP and eMEP and of mCMCT and eCMCT suggests that these measurements may be used comparatively and semi-quantitatively for the comparison of pre-, intra-, and post-operative spinal cord function in spinal deformity surgery.

PIV-measured versus CFD-predicted flow dynamics in anatomically realistic cerebral aneurysm models.

Science.gov (United States)

Ford, Matthew D; Nikolov, Hristo N; Milner, Jaques S; Lownie, Stephen P; Demont, Edwin M; Kalata, Wojciech; Loth, Francis; Holdsworth, David W; Steinman, David A

2008-04-01

between PIV and CFD suggests that CFD can reliably predict the details of the intra-aneurysmal flow dynamics observed in anatomically realistic in vitro models. Nevertheless, given the various modeling assumptions, this does not prove that they are mimicking the actual in vivo hemodynamics, and so validations against in vivo data are encouraged whenever possible.

Protocol for fermionic positive-operator-valued measures

Science.gov (United States)

Arvidsson-Shukur, D. R. M.; Lepage, H. V.; Owen, E. T.; Ferrus, T.; Barnes, C. H. W.

2017-11-01

In this paper we present a protocol for the implementation of a positive-operator-valued measure (POVM) on massive fermionic qubits. We present methods for implementing nondispersive qubit transport, spin rotations, and spin polarizing beam-splitter operations. Our scheme attains linear opticslike control of the spatial extent of the qubits by considering ground-state electrons trapped in the minima of surface acoustic waves in semiconductor heterostructures. Furthermore, we numerically simulate a high-fidelity POVM that carries out Procrustean entanglement distillation in the framework of our scheme, using experimentally realistic potentials. Our protocol can be applied not only to pure ensembles with particle pairs of known identical entanglement, but also to realistic ensembles of particle pairs with a distribution of entanglement entropies. This paper provides an experimentally realizable design for future quantum technologies.

Phased operations and recovery options

International Nuclear Information System (INIS)

Mankamo, T.

1989-01-01

The event sequence diagram is extended with embedded state submodels. This allows process oriented modeling of phased missions, and flexible modeling of recovery from failure states. This also enhances the structured consideration of time dependences in process conditions, and earlier scenario of events. Operational decision alternatives can straightforwardly be included. In fact, the approach has been developed for the analysis of operational alternatives such as plant shutdown versus continued operation, in failure situations of standby safety systems, with the aim of realistic quantification of shutdown related transient risks

Two-Capacitor Problem: A More Realistic View.

Science.gov (United States)

Powell, R. A.

1979-01-01

Discusses the two-capacitor problem by considering the self-inductance of the circuit used and by determining how well the usual series RC circuit approximates the two-capacitor problem when realistic values of L, C, and R are chosen. (GA)

Effects of realistic force feedback in a robotic assisted minimally invasive surgery system.

Science.gov (United States)

Moradi Dalvand, Mohsen; Shirinzadeh, Bijan; Nahavandi, Saeid; Smith, Julian

2014-06-01

Robotic assisted minimally invasive surgery systems not only have the advantages of traditional laparoscopic procedures but also restore the surgeon's hand-eye coordination and improve the surgeon's precision by filtering hand tremors. Unfortunately, these benefits have come at the expense of the surgeon's ability to feel. Several research efforts have already attempted to restore this feature and study the effects of force feedback in robotic systems. The proposed methods and studies have some shortcomings. The main focus of this research is to overcome some of these limitations and to study the effects of force feedback in palpation in a more realistic fashion. A parallel robot assisted minimally invasive surgery system (PRAMiSS) with force feedback capabilities was employed to study the effects of realistic force feedback in palpation of artificial tissue samples. PRAMiSS is capable of actually measuring the tip/tissue interaction forces directly from the surgery site. Four sets of experiments using only vision feedback, only force feedback, simultaneous force and vision feedback and direct manipulation were conducted to evaluate the role of sensory feedback from sideways tip/tissue interaction forces with a scale factor of 100% in characterising tissues of varying stiffness. Twenty human subjects were involved in the experiments for at least 1440 trials. Friedman and Wilcoxon signed-rank tests were employed to statistically analyse the experimental results. Providing realistic force feedback in robotic assisted surgery systems improves the quality of tissue characterization procedures. Force feedback capability also increases the certainty of characterizing soft tissues compared with direct palpation using the lateral sides of index fingers. The force feedback capability can improve the quality of palpation and characterization of soft tissues of varying stiffness by restoring sense of touch in robotic assisted minimally invasive surgery operations.

Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study

Directory of Open Access Journals (Sweden)

Sartelli Massimo

2012-11-01

Full Text Available Abstract The CIAO Study (“Complicated Intra-Abdominal infection Observational” Study is a multicenter investigation performed in 68 medical institutions throughout Europe over the course of a 6-month observational period (January-June 2012. Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs were included in the study. 2,152 patients with a mean age of 53.8 years (range: 4–98 years were enrolled in the study. 46.3% of the patients were women and 53.7% were men. Intraperitoneal specimens were collected from 62.2% of the enrolled patients, and from these samples, a variety of microorganisms were collectively identified. The overall mortality rate was 7.5% (163/2.152. According to multivariate analysis of the compiled data, several criteria were found to be independent variables predictive of patient mortality, including patient age, the presence of an intestinal non-appendicular source of infection (colonic non-diverticular perforation, complicated diverticulitis, small bowel perforation, a delayed initial intervention (a delay exceeding 24 hours, sepsis and septic shock in the immediate post-operative period, and ICU admission. Given the sweeping geographical distribution of the participating medical centers, the CIAO Study gives an accurate description of the epidemiological, clinical, microbiological, and treatment profiles of complicated intra-abdominal infections (IAIs throughout Europe.

Satellite Maps Deliver More Realistic Gaming

Science.gov (United States)

2013-01-01

When Redwood City, California-based Electronic Arts (EA) decided to make SSX, its latest snowboarding video game, it faced challenges in creating realistic-looking mountains. The solution was NASA's ASTER Global Digital Elevation Map, made available by the Jet Propulsion Laboratory, which EA used to create 28 real-life mountains from 9 different ranges for its award-winning game.

INTRA/Mod3.2. Manual and Code Description. Volume I - Physical Modelling

International Nuclear Information System (INIS)

Andersson, Jenny; Edlund, O.; Hermann, J.; Johansson, Lise-Lotte

1999-01-01

The INTRA Manual consists of two volumes. Volume I of the manual is a thorough description of the code INTRA, the Physical modelling of INTRA and the ruling numerical methods and volume II, the User's Manual is an input description. This document, the Physical modelling of INTRA, contains code characteristics, integration methods and applications

INTRA/Mod3.2. Manual and Code Description. Volume I - Physical Modelling

Energy Technology Data Exchange (ETDEWEB)

Andersson, Jenny; Edlund, O; Hermann, J; Johansson, Lise-Lotte

1999-01-01

The INTRA Manual consists of two volumes. Volume I of the manual is a thorough description of the code INTRA, the Physical modelling of INTRA and the ruling numerical methods and volume II, the User`s Manual is an input description. This document, the Physical modelling of INTRA, contains code characteristics, integration methods and applications

Curative effect analysis of invasive bladder cancer by joint surgical operation with interventional therapy

International Nuclear Information System (INIS)

Xu Biao; Wen Bin; Liu Tisheng; Wei Liqian

2007-01-01

Objective: To explore the effective therapy for invasive bladder cancer. Methods: Forty patients with invasive bladder cancer were divided into group A and group B. Intra-internal lilac-arterial chemotherapy and infusion pump chemotherapy combined with surgical operation were performed in group A and only surgical operation for group B. The differences of recurrence rates and survival rates between the two groups together with the effectiveness of intra-arterial chemotherapy combined surgical operation were evaluated at the same time. Results: Reduction in volumes of cancer and hematuria were obvious and nearly disappeared in group A patients with pathomorphological features demonstrating large pachyareas of necrosis together with degeneration and inflammatory changes of carcinoma tissue; outcoming with five recurrent cases (20%) and 2 deaths (10%). In group B, 9 cases relapsed(45%) and 4 eases died(20%). Conclusion: The combination of intra-internal lilac-arterial chemoembolization with infusion pump chemotherapy together with surgical operation is safe, effective for invasive bladder cancer, resulting in high raise of survival and life quality. (authors)

Evidence of a shared purpose, critical reflection, innovation and leadership in interprofessional healthcare teams: a realist synthesis.

Science.gov (United States)

Sims, Sarah; Hewitt, Gillian; Harris, Ruth

2015-05-01

Realist synthesis is a theory-driven approach for evaluating complex interventions using empirical evidence, which seeks an explanatory analysis of who a complex intervention works for, how, why, and in what circumstances. Interprofessional teamworking in healthcare is one such complex intervention, as teams are influenced by social and organizational factors, which makes them highly variable and context dependent. This article concludes a series of four articles that report on a realist synthesis of interprofessional teamworking. The synthesis identified 13 mechanisms that are reported in the literature to be the underlying processes through which interprofessional teamworking produces its effects. This article explores four of these mechanisms: a shared purpose; critical reflection; innovation; and leadership. These mechanisms together explain how a team sets and maintains its focus and direction. This article highlights that whilst many assumptions are made within the healthcare literature about how these mechanisms operate within teams, these assumptions are not always founded upon strong empirical evidence.

Health Monitoring System Based on Intra-Body Communication

Science.gov (United States)

Razak, A. H. A.; Ibrahim, I. W.; Ayub, A. H.; Amri, M. F.; Hamzi, M. H.; Halim, A. K.; Ahmad, A.; Junid, S. A. M. Al

2015-11-01

This paper presents a model of a Body Area Network (BAN) health monitoring system based on Intra-Body Communication. Intra-body Communication (IBC) is a communication technique that uses the human body as a medium for electrical signal communication. One of the visions in the health care industry is to provide autonomous and continuous self and the remote health monitoring system. This can be achieved via BAN, LAN and WAN integration. The BAN technology itself consists of short range data communication modules, sensors, controller and actuators. The information can be transmitted to the LAN and WAN via the RF technology such as Bluetooth, ZigBee and ANT. Although the implementations of RF communication have been successful, there are still limitations in term of power consumption, battery lifetime, interferences and signal attenuations. One of the solutions for Medical Body Area Network (MBANs) to overcome these issues is by using an IBC technique because it can operate at lower frequencies and power consumption compared to the existing techniques. The first objective is to design the IBC's transmitter and receiver modules using the off the shelf components. The specifications of the modules such as frequency, data rate, modulation and demodulation coding system were defined. The individual module were designed and tested separately. The modules was integrated as an IBC system and tested for functionality then was implemented on PCB. Next objective is to model and implement the digital parts of the transmitter and receiver modules on the Altera's FPGA board. The digital blocks were interfaced with the FPGA's on board modules and the discrete components. The signals that have been received from the transmitter were converted into a proper waveform and it can be viewed via external devices such as oscilloscope and Labview. The signals such as heartbeats or pulses can also be displayed on LCD. In conclusion, the IBC project presents medical health monitoring model

Does intra-abdominal fluid increase the resting energy expenditure?

Science.gov (United States)

Zarling, E J; Grande, A; Hano, J

1997-10-01

In patients with intra-abdominal fluid collection, caloric needs are based on an estimated dry weight. This is done because intra-abdominal fluid has been assumed to be metabolically inactive. One recent study of patients with slowly resolving ascites suggested otherwise. In our study, the effect of intra-abdominal fluid on the resting energy expenditure (REE) and apparent lean body mass was determined in 10 stable patients requiring peritoneal dialysis. For each subject, in both the empty and full state, we measured REE by indirect calorimetry, and body composition by the bioelectric impedance method. In the full state, the VCO2 was significantly increased (210 +/- 11 versus 197 +/- 9 mL/min, P empty state. This caused an increase in the calculated resting energy expenditure (1531 +/- 88 kcal/d empty versus 1593 +/- 94 kcal/d full, P calories derived from glucose absorbed out of the dialysate. Estimates of body fat, lean body mass, and total water also were not affected by the intra-abdominal fluid. We conclude that intra-abdominal fluid will not affect the measured REE and hence may be considered to be metabolically inactive.

Intra-individual variability as a predictor of learning

Directory of Open Access Journals (Sweden)

Matija Svetina

2004-05-01

Full Text Available Learning is one of the most important aspects of children's behaviour. A new theory that emerged from evolutionary principles and information-processing models assumes learning to be run by two basic mechanisms: variability and selection. The theory is based on the underlying assumption that intra-individual variability of strategies that children use to solve a problem, is a core mechanism of learning change. This assumption was tested in the case of multiple classification (MC task. 30 6-year-old children were tested for intelligence, short-term memory, and MC. Procedure followed classical pre-test/learning/post-test scheme. Amount of learning was measured through percentage of correct answers before and after learning sessions, whereas intra-individual variability was assessed through children's explanations of their answers on MC problems. The results yielded intra-individual variability to explain learning changes beyond inter-individual differences in intelligence or short-term memory. Although the results rose some new questions to be considered in further research, the data supported the hypothesis of intra-individual variability as predictor of learning change.

Resultados da troca de lente intra-ocular de hidrogel opacificada

Directory of Open Access Journals (Sweden)

Salera Cristina Moreira

2004-01-01

Full Text Available OBJETIVO: Avaliar os resultados da explantação e substituição das lentes intra-oculares (LIO de hidrogel opacificadas. MÉTODOS: Foram analisados retrospectivamente os prontuários de 12 pacientes (15 olhos submetidos à explantação e substituição das lentes intra-oculares de hidrogel opacificadas. RESULTADOS: A opacificação das lentes intra-oculares de hidrogel causou perdas de linhas de visão em 13 olhos (86,7%. A troca das lentes intra-oculares opacificadas promoveu o ganho de linhas de visão em 11 olhos (73,3%. As complicações peroperatórias ocorreram em três olhos (20% e foram as seguintes: perda de óleo de silicone, ruptura total de zônula com perda do saco capsular e ruptura parcial de zônula. Durante a explantação das lentes intra-oculares foi necessária a realização de incisões relaxantes na borda da capsulorrexe anterior em três olhos (20% e em dois olhos (13,3% os hápticos foram cortados sendo retirada somente a zona óptica das lentes intra-oculares. CONCLUSÃO: A cirurgia para explantação e substituição das lentes intra-oculares opacificadas mostrou-se eficaz naqueles pacientes com perdas de linhas de visão (p > 0,05.

Intra and interobserver variability of intrapartum transperineal ultrasound measurements with contraction and pushing.

Science.gov (United States)

Sainz, José A; Fernández-Palacín, Ana; Borrero, Carlota; Aquise, Adriana; Ramos, Zenaida; García-Mejido, José A

2018-04-01

The aim of this study was to evaluate the inter- and intraobserver correlation of the different intrapartum-transperineal-ultrasound-parameters(ITU) (angle of progression (AoP), progression-distance (PD), head-direction (HD), midline-angle (MLA) and head-perineum distance (HPD)) with contraction and pushing. We evaluated 28 nulliparous women at full dilatation under epidural analgesia. We performed a transperineal ultrasound evaluating AoP and PD in the longitudinal plane, and MLA and HPD in the transverse plane. Interclass correlation coefficients (ICC) with 95% CIs and Bland-Altman analysis were used to assess intra- and interobserver measurement's repeatability. The ICC of the ITU for the same observer was adequate for all the parameters (p pushing under epidural analgesia. Impact statement What is already known on this subject: The intrapartum transperineal ultrasound parameters can be used with contraction and pushing under epidural analgesia. What the results of this study add to what we know: ITU may be used to evaluate the difficulty of instrumental delivery/to evaluate the difficulty of instrumentation in vaginal operative deliveries and this study concludes that ITU is reproducible during uterine contraction with pushing. What the implications are of these findings for clinical practice and/or further research: Therefore, ITU could be used without difficulty with an adequate intra- and interobserver correlation for the prediction of instrumentation difficulty in operative vaginal deliveries.

Intra-abdominal fat area measurement using chest CT data

International Nuclear Information System (INIS)

Moriya, Hiroshi; Midorikawa, Shigeo; Hashimoto, Kouji; Ishii, Akira; Saitou, Kumi; Andou, Tomonori; Kitamura, Naoko; Sakuma, Koutarou

2007-01-01

Intra-abdominal fat obesity, which is linked with the metabolic syndrome, is usually characterized by measuring intra-abdominal fat area at the umbilical level of abdominal CT scan. In recent year, the chances of chest CT scanning are increased, as lung cancer screening survey or individual medical examination. Thus, we presented a method of measuring the areas of intra-abdominal fat and subcutaneous fat at the lower slice of chest CT scan. Fat areas found with this method were significantly correlated with those obtained at the umbilical level. (author)

Intra-cavity generation of superpositions of Laguerre-Gaussian beams

CSIR Research Space (South Africa)

Naidoo, Darryl

2012-01-01

Full Text Available In this paper we demonstrate experimentally the intra-cavity generation of a coherent superposition of Laguerre–Gaussian modes of zero radial order but opposite azimuthal order. The superposition is created with a simple intra-cavity stop...

The Joint Influence of Intra- and Inter-Team Learning Processes on Team Performance : A Constructive or Destructive Combination?

NARCIS (Netherlands)

Bron, Rike; Endedijk, Maaike D.; van Veelen, Ruth; Veldkamp, Bernard P.

2018-01-01

In order for teams to build a shared conception of their task, team learning is crucial. Benefits of intra-team learning have been demonstrated in numerous studies. However, teams do not operate in a vacuum, and interact with their environment to execute their tasks. Our knowledge of the added value

Detection of intra-cardiac and intra-arterial thrombi using labelled platelets

International Nuclear Information System (INIS)

Bernard, P.J.; Laforte, C. de

1990-01-01

Scintigraphy with 111 Indium labelled platelets is a powerful tool to detect platelet deposits in vessels. This quantitative and functional imaging method needs a labeling procedure which completely preserves the properties of the platelets and allows the concept of hematologically active clot. Three main groups of patients were examined. 1-91 hematologically active intra-cardiac thrombi were detected. The follow-up of 19 of them shows 5 deaths and 7 cerebral embolisms. 2-372 patients with lower limb ischemia, mainly in the case of blue toe syndrome were examined. 158 times a comparison with the surgical patterns was possible, there were 3 false positive and 9 false negative results. 3-In a group of 310 patients with transient cerebro-vascular accidents, 38 times the records were poorly significant. In 27 patients we were able to compare the morphological examinations (including platelet scintigraphy) to the anatomical findings. Sensitivity was only 64% and specificity 71%. As in the cases of intra-cardiac thrombi, the method allows the follow-up of pharmacological therapy. Platelets labelled with 111 Indium provide the means for sensitive and specific detection of hematologically active clots in cardiac and arterial pathology [fr

Predictors of "occult" intra-abdominal injuries in blunt trauma patients.

Science.gov (United States)

Parreira, José Gustavo; Malpaga, Juliano Mangini Dias; Olliari, Camilla Bilac; Perlingeiro, Jacqueline A G; Soldá, Silvia C; Assef, José Cesar

2015-01-01

to assess predictors of intra-abdominal injuries in blunt trauma patients admitted without abdominal pain or abnormalities on the abdomen physical examination. We conducted a retrospective analysis of trauma registry data, including adult blunt trauma patients admitted from 2008 to 2010 who sustained no abdominal pain or abnormalities on physical examination of the abdomen at admission and were submitted to computed tomography of the abdomen and/or exploratory laparotomy. Patients were assigned into: Group 1 (with intra-abdominal injuries) or Group 2 (without intra-abdominal injuries). Variables were compared between groups to identify those significantly associated with the presence of intra-abdominal injuries, adopting ptrauma mechanism (ptrauma mechanism (p=0.008 - OR 2.85; 95%CI 1.13-6.22) and abnormal neurological physical exam at admission (p=0.015 - OR 0.44; 95%CI 0.22-0.85). Intra-abdominal injuries were predominantly associated with trauma mechanism and presence of chest injuries.

Recent developments in the specification and achievement of realistic neutron calibration fields

International Nuclear Information System (INIS)

Chartier, J.L.; Kluges, H.; Wiegel, B.; Schraube, H.

1997-01-01

In order to calibrate more accurately the neutron dosemeters involved in radiation protection, the concept of 'Realistic Neutron Calibration Fields' is considered as an appropriate alternative solution, making necessary new irradiation facilities which generate well-characterised neutron fields with energy and angular distribution replicating more closely practical workplace conditions. Several experienced laboratories have collaborated on a European project and proposed various approaches which are reviewed in this paper. A short description of the facilities currently in operation is given as well as a few characteristics of the available radiation fields. This description of the state of art is followed by a discussion of the problems to be solved for using such facilities for calibration purposes according to well-specified calibration procedures. (author)

Interaction between intra-abdominal pressure and positive-end expiratory pressure

Directory of Open Access Journals (Sweden)

Jamili Anbar Torquato

2009-02-01

Full Text Available OBJECTIVE: The aim of this study was to quantify the interaction between increased intra-abdominal pressure and Positive-End Expiratory Pressure. METHODS: In 30 mechanically ventilated ICU patients with a fixed tidal volume, respiratory system plateau and abdominal pressure were measured at a Positive-End Expiratory Pressure level of zero and 10 cm H2O. The measurements were repeated after placing a 5 kg weight on the patients' belly. RESULTS: After the addition of 5 kg to the patients' belly at zero Positive-End Expiratory Pressure, both intra-abdominal pressure (p<0.001 and plateau pressures (p=0.005 increased significantly. Increasing the Positive-End Expiratory Pressure levels from zero to 10 cm H2O without weight on the belly did not result in any increase in intra-abdominal pressure (p=0.165. However, plateau pressures increased significantly (p< 0.001. Increasing Positive-End Expiratory Pressure from zero to 10 cm H2O and adding 5 kg to the belly increased intra-abdominal pressure from 8.7 to 16.8 (p<0.001 and plateau pressure from 18.26 to 27.2 (p<0.001. Maintaining Positive-End Expiratory Pressure at 10 cm H2O and placing 5 kg on the belly increased intra-abdominal pressure from 12.3 +/- 1.7 to 16.8 +/- 1.7 (p<0.001 but did not increase plateau pressure (26.6+/-1.2 to 27.2 +/-1.1 -p=0.83. CONCLUSIONS: The addition of a 5kg weight onto the abdomen significantly increased both IAP and the airway plateau pressure, confirming that intra-abdominal hypertension elevates the plateau pressure. However, plateau pressure alone cannot be considered a good indicator for the detection of elevated intra-abdominal pressure in patients under mechanical ventilation using PEEP. In these patients, the intra-abdominal pressure must also be measured.

Interferometric data modelling: issues in realistic data generation

International Nuclear Information System (INIS)

Mukherjee, Soma

2004-01-01

This study describes algorithms developed for modelling interferometric noise in a realistic manner, i.e. incorporating non-stationarity that can be seen in the data from the present generation of interferometers. The noise model is based on individual component models (ICM) with the application of auto regressive moving average (ARMA) models. The data obtained from the model are vindicated by standard statistical tests, e.g. the KS test and Akaike minimum criterion. The results indicate a very good fit. The advantage of using ARMA for ICMs is that the model parameters can be controlled and hence injection and efficiency studies can be conducted in a more controlled environment. This realistic non-stationary noise generator is intended to be integrated within the data monitoring tool framework

Realist cinema as world cinema

OpenAIRE

Nagib, Lucia

2017-01-01

The idea that “realism” is the common denominator across the vast range of productions normally labelled as “world cinema” is widespread and seemly uncontroversial. Leaving aside oppositional binaries that define world cinema as the other of Hollywood or of classical cinema, this chapter will test the realist premise by locating it in the mode of production. It will define this mode as an ethics that engages filmmakers, at cinema’s creative peaks, with the physical and historical environment,...

Repeated exposure to intra-amniotic LPS partially protects against adverse effects of intravenous LPS in preterm lambs.

Science.gov (United States)

Gisslen, Tate; Hillman, Noah H; Musk, Gabrielle C; Kemp, Matthew W; Kramer, Boris W; Senthamaraikannan, Paranthaman; Newnham, John P; Jobe, Alan H; Kallapur, Suhas G

2014-02-01

Histologic chorioamnionitis, frequently associated with preterm births and adverse outcomes, results in prolonged exposure of preterm fetuses to infectious agents and pro-inflammatory mediators, such as LPS. Endotoxin tolerance-type effects were demonstrated in fetal sheep following repetitive systemic or intra-amniotic (i.a.) exposures to LPS, suggesting that i.a. LPS exposure would cause endotoxin tolerance to a postnatal systemic dose of LPS in preterm sheep. In this study, randomized pregnant ewes received either two i.a. injections of LPS or saline prior to preterm delivery. Following operative delivery, the lambs were treated with surfactant, ventilated, and randomized to receive either i.v. LPS or saline at 30  min of age. Physiologic variables and indicators of systemic and lung inflammation were measured. Intravenous LPS decreased blood neutrophils and platelets values following i.a. saline compared to that after i.a. LPS. Intra-amniotic LPS prevented blood pressure from decreasing following the i.v. LPS, but also caused an increased oxygen index. Intra-amniotic LPS did not cause endotoxin tolerance as assessed by cytokine expression in the liver, lung or plasma, but increased myeloperoxidase-positive cells in the lung. The different compartments of exposure to LPS (i.a. vs i.v.) are unique to the fetal to newborn transition. Intra-amniotic LPS incompletely tolerized fetal lambs to postnatal i.v. LPS.

Successful Management of Perforated Duodenal Diverticulitis With Intra-abdominal Drainage and Feeding Jejunostomy: A Case Report and Literature Review

Directory of Open Access Journals (Sweden)

Chin-Fan Chen

2008-08-01

Full Text Available We report the clinical experience of one patient with perforated duodenal diverticulitis who was successfully treated by intra-abdominal drainage and feeding jejunostomy. A 53-year-old male patient visited our hospital due to acute onset of abdominal pain and distension. Physical examination revealed tenderness over the epigastric area and right-lower quadrant of the abdomen without obvious rebound tenderness or muscle guarding. Duodenal diverticulitis with a retroperitoneal abscess was identified by abdominal computed tomography scan. Surgical intervention was performed after the failure of conservative treatment. The operative findings were compatible with perforated duodenal diverticulitis, and intra-abdominal drainage of retroperitoneal abscess with simultaneous feeding jejunostomy was undertaken. The patient was doing well at the 4-month postoperative follow-up visit. We suggest the use of a conservative operative method, as opposed to conventional diverticulectomy and duodenorrhaphy, as an alternative approach for the management of this disorder, especially when conservative treatment has failed.

Automatic intra-modality brain image registration method

International Nuclear Information System (INIS)

Whitaker, J.M.; Ardekani, B.A.; Braun, M.

1996-01-01

Full text: Registration of 3D images of brain of the same or different subjects has potential importance in clinical diagnosis, treatment planning and neurological research. The broad aim of our work is to produce an automatic and robust intra-modality, brain image registration algorithm for intra-subject and inter-subject studies. Our algorithm is composed of two stages. Initial alignment is achieved by finding the values of nine transformation parameters (representing translation, rotation and scale) that minimise the nonoverlapping regions of the head. This is achieved by minimisation of the sum of the exclusive OR of two binary head images, produced using the head extraction procedure described by Ardekani et al. (J Comput Assist Tomogr, 19:613-623, 1995). The initial alignment successfully determines the scale parameters and gross translation and rotation parameters. Fine alignment uses an objective function described for inter-modality registration in Ardekani et al. (ibid.). The algorithm segments one of the images to be aligned into a set of connected components using K-means clustering. Registration is achieved by minimising the K-means variance of the segmentation induced in the other image. Similarity of images of the same modality makes the method attractive for intra-modality registration. A 3D MR image, with voxel dimensions, 2x2x6 mm, was misaligned. The registered image shows visually accurate registration. The average displacement of a pixel from its correct location was measured to be 3.3 mm. The algorithm was tested on intra-subject MR images and was found to produce good qualitative results. Using the data available, the algorithm produced promising qualitative results in intra-subject registration. Further work is necessary in its application to intersubject registration, due to large variability in brain structure between subjects. Clinical evaluation of the algorithm for selected applications is required

Quantitative, steady-state properties of Catania's computational model of the operant reserve.

Science.gov (United States)

Berg, John P; McDowell, J J

2011-05-01

Catania (2005) found that a computational model of the operant reserve (Skinner, 1938) produced realistic behavior in initial, exploratory analyses. Although Catania's operant reserve computational model demonstrated potential to simulate varied behavioral phenomena, the model was not systematically tested. The current project replicated and extended the Catania model, clarified its capabilities through systematic testing, and determined the extent to which it produces behavior corresponding to matching theory. Significant departures from both classic and modern matching theory were found in behavior generated by the model across all conditions. The results suggest that a simple, dynamic operant model of the reflex reserve does not simulate realistic steady state behavior. Copyright © 2011 Elsevier B.V. All rights reserved.

The Effect of Realistic Mathematics Education Approach on Students' Achievement And Attitudes Towards Mathematics

Directory of Open Access Journals (Sweden)

Effandi Zakaria

2017-02-01

Full Text Available This study was conducted to determine the effect of Realistic Mathematics Education Approach on mathematics achievement and student attitudes towards mathematics. This study also sought determine the relationship between student achievement and attitudes towards mathematics. This study used a quasi-experimental design conducted on 61 high school students at SMA Unggul Sigli. Students were divided into two groups, the treatment group $(n = 30$ namely, the Realistic Mathematics Approach group (PMR and the control group $(n = 31$ namely, the traditional group. This study was conducted for six weeks. The instruments used in this study were the achievement test and the attitudes towards mathematics questionnaires. Data were analyzed using SPSS. To determine the difference in mean achievement and attitudes between the two groups, data were analyzed using one-way ANOVA test. The result showed significant differences between the Realistic Mathematics Approach and the traditional approach in terms of achievement. The study showed no significant difference between the Realistic Mathematics Approach and the traditional approach in term of attitudes towards mathematics. It can be concluded that the use of realistic mathematics education approach enhanced students' mathematics achievement, but not attitudes towards mathematics. The Realistic Mathematics Education Approach encourage students to participate actively in the teaching and learning of mathematics. Thus, Realistic Mathematics Education Approach is an appropriate methods to improve the quality of teaching and learning process.

INTRA/Mod3.2. Manual and code description. Volume 2 - User`s manual

Energy Technology Data Exchange (ETDEWEB)

Andersson, Jenny; Edlund, O.; Hermann, J.; Johansson, Lise-Lotte

1999-01-01

The INTRA Manual consists of two volumes. Volume I of the manual is a thorough description of the code INTRA, the physical modelling of INTRA and the ruling numerics, and volume II, the User`s Manual is an input description. This document, the User`s Manual, Volume II, contains a detailed description of how to use INTRA, how to set up an input file, how to run INTRA and also post-processing

Intra-operative wound irrigation to reduce surgical site infections after abdominal surgery: a systematic review and meta-analysis.

Science.gov (United States)

Mueller, Tara C; Loos, Martin; Haller, Bernhard; Mihaljevic, André L; Nitsche, Ulrich; Wilhelm, Dirk; Friess, Helmut; Kleeff, Jörg; Bader, Franz G

2015-02-01

Surgical site infection (SSI) remains to be one of the most frequent infectious complications following abdominal surgery. Prophylactic intra-operative wound irrigation (IOWI) before skin closure has been proposed to reduce bacterial wound contamination and the risk of SSI. However, current recommendations on its use are conflicting especially concerning antibiotic and antiseptic solutions because of their potential tissue toxicity and enhancement of bacterial drug resistances. To analyze the existing evidence for the effect of IOWI with topical antibiotics, povidone-iodine (PVP-I) solutions or saline on the incidence of SSI following open abdominal surgery, a systematic review and meta-analysis of randomized controlled trials (RCTs) was carried out according to the recommendations of the Cochrane Collaboration. Forty-one RCTs reporting primary data of over 9000 patients were analyzed. Meta-analysis on the effect of IOWI with any solution compared to no irrigation revealed a significant benefit in the reduction of SSI rates (OR = 0.54, 95 % confidence Interval (CI) [0.42; 0.69], p < 0.0001). Subgroup analyses showed that this effect was strongest in colorectal surgery and that IOWI with antibiotic solutions had a stronger effect than irrigation with PVP-I or saline. However, all of the included trials were at considerable risk of bias according to the quality assessment. These results suggest that IOWI before skin closure represents a pragmatic and economical approach to reduce postoperative SSI after abdominal surgery and that antibiotic solutions seem to be more effective than PVP-I solutions or simple saline, and it might be worth to re-evaluate their use for specific indications.

A more realistic simulation of the performance of the infra-sound monitoring network

International Nuclear Information System (INIS)

Le Pichon, A.; Vergoz, J.; Blanc, E.

2008-01-01

The first global maps showing the performance of the infra-sound network of the international monitoring system were set in the nineties. Recent measurement of the background noise by the 36 operating stations combined with advanced models of wind give now a more realistic mapping. It has become possible to validate simulations by measuring real events. For instance the explosion that happened in March 2008 in an ammunition storehouse in Albania was detected till Zalesovo (Russia) 4920 km away. These new simulations confirm the detection capability of the network to detect and localize atmospheric explosions whose energy is over 1 kt. It is also shown that the detection performance are very sensitive to both time and places. (A.C.)

Chemical meningitis related to intra-CSF liposomal cytarabine.

Science.gov (United States)

Durand, Bénédicte; Zairi, Fahed; Boulanger, Thomas; Bonneterre, Jacques; Mortier, Laurent; Le Rhun, Emilie

2017-10-01

Therapeutic options of leptomeningeal metastases include intra-cerebrospinal fluid (CSF) chemotherapy. Among intra-CSF agents, liposomal cytarabine has advantages but can induce specific toxicities. A BRAF-V600E-mutated melanoma leptomeningeal metastases patient, treated by dabrafenib and liposomal cytarabine, presented after the first injection of liposomal cytarabine with hyperthermia and headaches. Despite sterile CSF/blood analyses, extended intravenous antibiotics were given and the second injection was delayed. The diagnosis of chemical meningitis was finally made. Dose reduction and appropriate symptomatic treatment permitted the administration of 15 injections of liposomal cytarabine combined with dabrafenib. A confirmation of the diagnosis of chemical meningitis is essential in order (1) not to delay intra-CSF or systemic chemotherapy or (2) to limit the administration of unnecessary but potentially toxic antibiotics.

Experience with Extra Hepatic Intra Abdominal Hydatid Cyst

Directory of Open Access Journals (Sweden)

Altaf Ahmed Talpur

2016-10-01

showed hydatid cyst spleen in 02 (18.1% patients, epigastrium in 04 (36.3% patients, beneath left crus of diaphragm in 02 (18.1% patients & right iliac fossa & pelvis in 1 (9.09% patient. In 02 (18.1% patients multiple Hydatid cysts were noted. Hydatid cysts liver found in 07 (63.6% patients. C.T scan Abdomen was performed in 09 (81.8% patients. Surgical procedures performed include Saucerization & omental packing in liver Hydatid cysts; Splenectomy for Splenic disease & complete excision of remaining intra-abdominal Hydatid cysts. Postoperative complications noted in 05 (45.4% patients. Conclusion: Extra hepatic intra abdominal is an infrequent disease presents signicant diagnostic & therapeutic challenge for surgeons.  Keywords: extra hepatic; hydatid disease; intra abdominal.

Simultaneous intra-arterial chemotherapy and radiotherapy for carcinoma of oropharynx without neck metastasis

International Nuclear Information System (INIS)

Tomita, Kichinobu; Higaki, Yuichiro

2000-01-01

We evaluated the usefulness of simultaneous intra-arterial chemotherapy and radiotherapy for oropharyngeal cancer without neck metastasis. Fifty eight cases without neck metastasis out of previously untreated 117 patients with oropharyngeal cancer treated at National Kyushu Cancer Center from 1972 to 1995 were examined. Seventeen patients were in T1, 27 in T2, 10 in T3, 4 in T4. Fourteen patients of 58 patients were treated by simultaneous intra-arterial chemotherapy and radiation therapy. The 5-year survival rate by Kaplan-Meier method for intra-arterial infusion group and non intra-arterial infusion group were 86% and 71%, respectively. Thirty one patients were treated with irradiation without surgery. In 31 cases without surgery, the 5-year survival rate for intra-arterial infusion group (13 cases) was 85%, while that for non intra-arterial infusion group (18 cases) was 60%, and the local control rate for intra-arterial infusion group is 92%, while that for non intra-arterial infusion group was 56%. Simultaneous intra-arterial chemotherapy and radiotherapy for oropharyngeal cancer without neck metastasis is useful to improve the prognosis with preserving the function. (author)

Realistic Noise Assessment and Strain Analysis of Iranian Permanent GPS Stations

Science.gov (United States)

Razeghi, S. M.; Amiri Simkooei, A. A.; Sharifi, M. A.

2012-04-01

To assess noise characteristics of Iranian Permanent GPS Stations (IPGS), northwestern part of this network namely Azerbaijan Continuous GPS Station (ACGS), was selected. For a realistic noise assessment it is required to model all deterministic signals of the GPS time series by means of least squares harmonic estimation (LS-HE) and derive all periodic behavior of the series. After taking all deterministic signals into account, the least squares variance component estimation (LS-VCE) is used to obtain a realistic noise model (white noise plus flicker noise) of the ACGS. For this purpose, one needs simultaneous GPS time series for which a multivariate noise assessment is applied. Having determined realistic noise model, a realistic strain analysis of the network is obtained for which one relies on the finite element methods. Finite element is now considered to be a new functional model and the new stochastic model is given based on the multivariate noise assessment using LS-VCE. The deformation rates of the components along with their full covariance matries are input to the strain analysis. Further, the results are also provided using a pure white noise model. The normalized strains for these two models show that the strain parameters derived from a realistic noise model are less significant than those derived from the white model. This could be either due to the short time span of the time series used or due to the intrinsic behavior of the strain parameters in the ACGS. Longer time series are required to further elaborate this issue.

Superselective intra-arterial hepatic injection of indocyanine green (ICG) for fluorescence image-guided segmental positive staining: experimental proof of the concept.

Science.gov (United States)

Diana, Michele; Liu, Yu-Yin; Pop, Raoul; Kong, Seong-Ho; Legnèr, Andras; Beaujeux, Remy; Pessaux, Patrick; Soler, Luc; Mutter, Didier; Dallemagne, Bernard; Marescaux, Jacques

2017-03-01

Intraoperative liver segmentation can be obtained by means of percutaneous intra-portal injection of a fluorophore and illumination with a near-infrared light source. However, the percutaneous approach is challenging in the minimally invasive setting. We aimed to evaluate the feasibility of fluorescence liver segmentation by superselective intra-hepatic arterial injection of indocyanine green (ICG). Eight pigs (mean weight: 26.01 ± 5.21 kg) were involved. Procedures were performed in a hybrid experimental operative suite equipped with the Artis Zeego ® , multiaxis robotic angiography system. A pneumoperitoneum was established and four laparoscopic ports were introduced. The celiac trunk was catheterized, and a microcatheter was advanced into different segmental hepatic artery branches. A near-infrared laparoscope (D-Light P, Karl Storz) was used to detect the fluorescent signal. To assess the correspondence between arterial-based fluorescence demarcation and liver volume, metallic markers were placed along the fluorescent border, followed by a 3D CT-scanning, after injecting intra-arterial radiological contrast (n = 3). To assess the correspondence between arterial and portal supplies, percutaneous intra-portal angiography and intra-arterial angiography were performed simultaneously (n = 1). Bright fluorescence signal enhancing the demarcation of target segments was obtained from 0.1 mg/mL, in matter of seconds. Correspondence between the volume of hepatic segments and arterial territories was confirmed by CT angiography. Higher background fluorescence noise was found after positive staining by intra-portal ICG injection, due to parenchymal accumulation and porto-systemic shunting. Intra-hepatic arterial ICG injection, rapidly highlights hepatic target segment borders, with a better signal-to-background ratio as compared to portal vein injection, in the experimental setting.

Satisfaction and sustainability: a realist review of decentralized models of perinatal surgery for rural women.

Science.gov (United States)

Kornelsen, Jude; McCartney, Kevin; Williams, Kim

2016-01-01

This article was developed as part of a larger realist review investigating the viability and efficacy of decentralized models of perinatal surgical services for rural women in the context of recent and ongoing service centralization witnessed in many developed nations. The larger realist review was commissioned by the British Columbia Ministry of Health and Perinatal Services of British Columbia, Canada. Findings from that review are addressed in this article specific to the sustainability of rural perinatal surgical sites and the satisfaction of providers that underpins their recruitment to and retention at such sites. A realist method was used in the selection and analysis of literature with the intention to iteratively develop a sophisticated understanding of how perinatal surgical services can best meet the needs of women who live in rural and remote environments. The goal of a realist review is to examine what works for whom under what circumstances and why. The high sensitivity search used language (English) and year (since 1990) limiters in keeping with both a realist and rapid review tradition of using reasoned contextual boundaries. No exclusions were made based on methodology or methodological approach in keeping with a realist review. Databases searched included MEDLINE, PubMed, EBSCO, CINAHL, EBM Reviews, NHS Economic Evaluation Database and PAIS International for literature in December 2013. Database searching produced 103 included academic articles. A further 59 resources were added through pearling and 13 grey literature reports were added on recommendation from the commissioner. A total of 42 of these 175 articles were included in this article as specific to provider satisfaction and service sustainability. Operative perinatal practice was found to be a lynchpin of sustainable primary and surgical services in rural communities. Rural shortages of providers, including challenges with recruitment and retention, were found to be a complex issue, with

Generating realistic roofs over a rectilinear polygon

KAUST Repository

Ahn, Heekap; Bae, Sangwon; Knauer, Christian; Lee, Mira; Shin, Chansu; Vigneron, Antoine E.

2011-01-01

Given a simple rectilinear polygon P in the xy-plane, a roof over P is a terrain over P whose faces are supported by planes through edges of P that make a dihedral angle π/4 with the xy-plane. In this paper, we introduce realistic roofs by imposing

Realistic Visualization of Virtual Views and Virtual Cinema

DEFF Research Database (Denmark)

Livatino, Salvatore

2005-01-01

Realistic Virtual View Visualization is a new field of research which has received increasing attention in recent years. It is strictly related to the increased popularity of virtual reality and the spread of its applications, among which virtual photography and cinematography. The use of computer...... generated characters, "virtual actors", in the motion picture production increases every day. While the most known computer graphics techniques have largely been adopted successfully in nowadays fictions, it still remains very challenging to implement virtual actors which would resemble, visually, human...... beings. Interestingly, film directors have been looking at the recent progress achieved by the research community in the field of realistic visualization of virtual views, and they have successfully implemented state of the art research approaches in their productions. An innovative concept...

Realistic and efficient 2D crack simulation

Science.gov (United States)

Yadegar, Jacob; Liu, Xiaoqing; Singh, Abhishek

2010-04-01

Although numerical algorithms for 2D crack simulation have been studied in Modeling and Simulation (M&S) and computer graphics for decades, realism and computational efficiency are still major challenges. In this paper, we introduce a high-fidelity, scalable, adaptive and efficient/runtime 2D crack/fracture simulation system by applying the mathematically elegant Peano-Cesaro triangular meshing/remeshing technique to model the generation of shards/fragments. The recursive fractal sweep associated with the Peano-Cesaro triangulation provides efficient local multi-resolution refinement to any level-of-detail. The generated binary decomposition tree also provides efficient neighbor retrieval mechanism used for mesh element splitting and merging with minimal memory requirements essential for realistic 2D fragment formation. Upon load impact/contact/penetration, a number of factors including impact angle, impact energy, and material properties are all taken into account to produce the criteria of crack initialization, propagation, and termination leading to realistic fractal-like rubble/fragments formation. The aforementioned parameters are used as variables of probabilistic models of cracks/shards formation, making the proposed solution highly adaptive by allowing machine learning mechanisms learn the optimal values for the variables/parameters based on prior benchmark data generated by off-line physics based simulation solutions that produce accurate fractures/shards though at highly non-real time paste. Crack/fracture simulation has been conducted on various load impacts with different initial locations at various impulse scales. The simulation results demonstrate that the proposed system has the capability to realistically and efficiently simulate 2D crack phenomena (such as window shattering and shards generation) with diverse potentials in military and civil M&S applications such as training and mission planning.

Analysis of Heterogeneous Networks with Dual Connectivity in a Realistic Urban Deployment

DEFF Research Database (Denmark)

Gerardino, Guillermo Andrés Pocovi; Barcos, Sonia; Wang, Hua

2015-01-01

the performance in this realistic layout. Due to the uneven load distribution observed in realistic deployments, DC is able to provide fast load balancing gains also at relatively high load - and not only at low load as typically observed in 3GPP scenarios. For the same reason, the proposed cell selection...

Intra-Articular Osteotomy for Distal Humerus Malunion

Directory of Open Access Journals (Sweden)

René K. Marti

2009-01-01

Full Text Available Intra-articular osteotomy is considered in the rare case of malunion after a fracture of the distal humerus to restore humeral alignment and gain a functional arc of elbow motion. Traumatic and iatrogenic disruption of the limited blood flow to the distal end of the humerus resulting in avascular necrosis of capitellum or trochlea is a major pitfall of the this technically challenging procedure. Two cases are presented which illustrate the potential problems of intra-articular osteotomy for malunion of the distal humerus.

Context-sensitive intra-class clustering

KAUST Repository

Yu, Yingwei; Gutierrez-Osuna, Ricardo; Choe, Yoonsuck

2014-01-01

This paper describes a new semi-supervised learning algorithm for intra-class clustering (ICC). ICC partitions each class into sub-classes in order to minimize overlap across clusters from different classes. This is achieved by allowing partitioning

When and how should we measure intra- abdominal pressure?

African Journals Online (AJOL)

2008-11-11

Nov 11, 2008 ... developing intra-abdominal hypertension (IAH) and. ACS. This may be ... the development of systemic inflammatory response syndrome (SIRS) ... of this technique are that it places the patient at increased risk for .... 9. Malbrain ML. Different techniques to measure intra-abdominal pressure (IAP): time for a.

An Overview of Westinghouse Realistic Large Break LOCA Evaluation Model

Directory of Open Access Journals (Sweden)

Cesare Frepoli

2008-01-01

Full Text Available Since the 1988 amendment of the 10 CFR 50.46 rule in 1988, Westinghouse has been developing and applying realistic or best-estimate methods to perform LOCA safety analyses. A realistic analysis requires the execution of various realistic LOCA transient simulations where the effect of both model and input uncertainties are ranged and propagated throughout the transients. The outcome is typically a range of results with associated probabilities. The thermal/hydraulic code is the engine of the methodology but a procedure is developed to assess the code and determine its biases and uncertainties. In addition, inputs to the simulation are also affected by uncertainty and these uncertainties are incorporated into the process. Several approaches have been proposed and applied in the industry in the framework of best-estimate methods. Most of the implementations, including Westinghouse, follow the Code Scaling, Applicability and Uncertainty (CSAU methodology. Westinghouse methodology is based on the use of the WCOBRA/TRAC thermal-hydraulic code. The paper starts with an overview of the regulations and its interpretation in the context of realistic analysis. The CSAU roadmap is reviewed in the context of its implementation in the Westinghouse evaluation model. An overview of the code (WCOBRA/TRAC and methodology is provided. Finally, the recent evolution to nonparametric statistics in the current edition of the W methodology is discussed. Sample results of a typical large break LOCA analysis for a PWR are provided.

A case of supratentorial intra-axial ependymoma showing exophytic growth

Energy Technology Data Exchange (ETDEWEB)

Lee, Seung Woo; Kim, Eung Yeop [Yonsei University College of Medicine, Seoul (Korea, Republic of)

2007-11-15

A 17-year-old female had headache for several weeks and she developed an episode of seizure one day prior to admission. She underwent both CT and MRI, which both revealed a large tumor with cystic and solid portions at the right frontoparietal convexity. During operation, a well-defined tumor was found to have a stalk connecting the tumor itself with the brain parenchyma, proving that it was growing exophytically and expanding into the subarachnoid space. Histopathological examination revealed an anaplastic ependymoma with high cellularity. We report here on this case of an unusual supratentorial ependymoma with exophytic growth, and this can be mistaken as another exophytic growing intra-axial tumor or even as an extra-axial tumor.

FROM GLOBAL TO INTRA-REGIONAL TOURISM

Directory of Open Access Journals (Sweden)

Anders Steene

2016-12-01

Full Text Available Regardless of how society has evolved, travel and tourism have had a positive development since the end of Second World War. But now it seems that the perception of risk and danger is accentuated and the tourists choose destinations based on more safety and security for tourists. Risks often seem to be based on different global activities and actions from different groups, which the individual can not affect or influence over. These perceived risks thus affect the development of tourism and travel in a global perspective. This article would discuss the new threats to the global tourism due to the terrorist attacks that target different countries and in many cases the popular tourist destinations. With the result that travel has become more intra-regional again. The article makes a review of the slightly incomplete statistics available in the area and discuss possible strategies for overcoming the existing terrorist attacks. The conclusions of the article points to a more concrete cooperation between international and national organizations, governments, as well as NGOs, tour operators and civil society in general.

TAXATION SYSTEM AT INTRA PRODUCTION LEVEL

Directory of Open Access Journals (Sweden)

L. I. Podderegina

2006-01-01

Full Text Available The paper presents results of the analysis concerning taxation in the country at the level of an enteфrise and its structural sub-divisions in the period of transforming economy.Recommendations are given on the following aspects: modernization of income taxation system for natural persons; tax payment in case of wage computation; exclusion of tax payments and assignments fi-om production cost value which are not connected with the production process; tax computation for real property; evaluation of enterprise taxation level.The paper shows the possible cases concerning formation of tax payments and assignments of an enterprise and its structural sub-divisions.Taxation system is shown at the level of enterprise structural sub-divisions (shop, department, at the level of shop structural sub-divisions (section, team, for works to be executed by an individual person of the production process (operation, product, works, services. This system promotes to efficient functioning of intra-production economical relations.The paper provides possible variants of formation of taxation payments and assignments for an enterprise and its structural sub-divisions.

Intra-abdominal fungal pseudomycetoma in two cats.

Science.gov (United States)

Bianchi, Matheus V; Laisse, Cláudio J M; Vargas, Thainã P; Wouters, Flademir; Boabaid, Fabiana M; Pavarini, Saulo P; Ferreiro, Laerte; Driemeier, David

Pseudomycetomas are deep cutaneous to subcutaneous lesions caused by Microsporum canis mainly described in Persian cats, with few reports of intra-abdominal location. This report describes the clinical signs and lesions of intra-abdominal pseudomycetomas caused by M. canis in two Persian cats. Two Persian cats with a history of previous laparotomy (ovariohysterectomy and nephrostomy) and fecal impaction were examined. Cat #1 was euthanized and subjected to necropsy, histopathology and mycological evaluation. Cat #2 presented with chronic dermatophytosis, and an intra-abdominal mass, that was subjected to histopathology evaluation. Cat #1 presented at necropsy a white-grayish, firm mass (6cm×3.5cm×2.8cm) in the uterine cervix. Cat #2 presented a firm whitish mass (6.5cm×1.5cm×0.5cm) located close to the left kidney. Histologically, both masses contained multifocal granules with hyphae and spores surrounded by Splendore-Hoeppli reaction, with a pyogranulomatous inflammatory infiltrate and fibrous connective tissue proliferation in the periphery. Hyphae and spores exhibited marked Grocott and periodic acid-Schiff staining. M. canis was identified by fungal isolation in cat #1. Pseudomycetoma should be considered as a differential diagnosis in cats, especially in Persian cats presenting with an intra-abdominal mass. Entrance of the agent into the cavity can occur during laparotomy. Copyright © 2016 Asociación Española de Micología. Publicado por Elsevier España, S.L.U. All rights reserved.

Intra-articular morphine in horses

DEFF Research Database (Denmark)

Lindegaard, Casper

separated by a three week washout period. Before each treatment, radiocarpal synovitis was induced by IA injection of lipopolysaccharide (LPS). For each of the two 168-hours study periods, local and systemic measures of pain and inflammation as well as blood and synovial fluid (SF) samples...... for pharmacological analysis were obtained repeatedly. Pain was evaluated by degree of lameness as well as using a visual analogue scale of pain intensity (VAS) and a composite measure pain scale (CMPS), developed for this purpose. Intra-articular injection of LPS elicited a marked synovitis resulting in lameness...... and pain. Intra-articularly administered morphine showed a significant analgesic effect as measured by reduced lameness scores, less administered rescue analgesia and lower pain scores. A significant anti-inflammatory effect was demonstrated by reduced joint swelling, reduced SF serum amyloid A (SAA...

Trainer module for security control center operations

International Nuclear Information System (INIS)

Bernard, E.A.

1982-01-01

An operator trainer module has been developed to be used with the security control center equipment to be installed as part of a safeguards physical protection system. The module is designed to provide improved training and testing capabilities for control center operators through the use of simulations for perimeter equipment operations. Operators, through the trainer module, can be challenged with a variety of realistic situations which require responsive action identical to that needed in an actual system. This permits a consistent evaluation and confirmation of operator capabilities prior to assignment as an operator and allows for periodic retesting to verify that adequate performance levels are maintained

Intra-osseous vascular malformation in the maxilla

OpenAIRE

Naveenjayakumar,; Vivek, N.; Pradeep,; Nithin,; Salins, P.; Subhashraj,

2009-01-01

Las malformaciones arterio-venosas intraóseas (MAVs) en la región maxilofacial son entidades clínicas poco frecuentes. Ofrecen una amplia gama de presentación clínica y no siempre se diagnostican sin sorpresa. El tratamiento de estas lesiones siempre ha representado un reto para el cirujano debido a su intensa vascularización y a la elevada incidencia de recurrencia. Se presenta el caso de una malformación arterio-venosa intraósea en el maxilar superior que se manifiesta como sangrado gingiva...

On the Determinants of Intra-industry Trade: Specialization and Relative Factor Endowments

Directory of Open Access Journals (Sweden)

E. Young Song

2007-12-01

Full Text Available This paper derives a general relationship among intra-industry trade, specialization, and gravity. This relationship holds in any two-country trade model under assumptions that are frequently adopted in theoretical trade models. Using this general relationship, we can take an integrated approach to the theory of intra-industry trade. In two-good, two-factor models, this relationship implies that the intensity of intra-industry trade is decreasing in the difference in factor proportions and is increasing in the product of per-worker GDPs. Thus, the popular assertion that a negative correlation between the intensity of intra- industry trade and the difference in factor proportions supports monopolistic competition is groundless. Using panel data on bilateral trade flows, we estimate these relationships. We find that the negative correlation between intra-industry trade and specialization is quite robust. We also find a robust positive correlation between intra-industry trade and the product of per-capita GDPs.

Pre-operative planning and intra-operative guidance in modern neurosurgery: a review of 300 cases.

Science.gov (United States)

Wadley, J.; Dorward, N.; Kitchen, N.; Thomas, D.

1999-01-01

Operative neurosurgery has recently entered an exciting era of image guided surgery or neuronavigation and application of this novel technology is beginning to have a significant impact in many ways in a variety of intracranial procedures. In order to fully assess the advantages of image guided techniques over conventional planning and surgery in selected cases, detailed prospective evaluation has been carried out during the advanced development of an optically tracked neuronavigation system. Over a 2-year period, 300 operative neurosurgical procedures have been performed with the assistance of interactive image guidance, as well as the development of new software applications and hardware tools. A broad range of intracranial neurosurgical procedures were seen to benefit from image guidance, including 163 craniotomies, 53 interactive stereotactic biopsies, 7 tracked neuroendoscopies and 37 complex skull base procedures. The most common pathological diagnoses were cerebral glioma in 98 cases, meningioma in 64 and metastasis in 23. Detailed analysis of a battery of postoperative questions revealed benefits in operative planning, appreciation of anatomy, lesion location, safety of surgery and greatly enhanced surgical confidence. The authors believe that image guided surgical technology, with new developments such as those described, has a significant role to play in contemporary neurosurgery and its widespread adoption in practice will be realised in the near future. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 PMID:10615186

PSA-operations synergism for the advanced test reactor shutdown operations PSA

International Nuclear Information System (INIS)

Atkinson, S.A.

1996-01-01

The Advanced Test Reactor (ATR) Probabilistic Safety Assessment (PSA) for shutdown operations, cask handling, and canal draining is a successful example of the importance of good PSA-operations synergism for achieving a realistic and accepted assessment of the risks and for achieving desired risk reduction and safety improvement in a best and cost-effective manner. The implementation of the agreed-upon upgrades and improvements resulted in the reductions of the estimated mean frequency for core or canal irradiated fuel uncovery events, a total reduction in risk by a factor of nearly 1000 to a very low and acceptable risk level for potentially severe events

Analysis of Urobilinogen and Urine Bilirubin for Intra-Abdominal Injury in Blunt Trauma Patients

Directory of Open Access Journals (Sweden)

Gorchynski, Julie

2009-05-01

Full Text Available OBJECTIVE: To determine the point prevalence of urine bilirubin, urine hemoglobin and urobilinogen in blunt trauma patients, and to evaluate its utility as a screening tool for intra-abdominal injury.METHODS: Data analysis of 986 consecutive trauma patients of which 698 were adult blunt trauma patients. Five-hundred sixteen subjects had a urinalysis and a CT scan of the abdomen/pelvis or exploratory laparotomy. We reviewed initial urinalysis results from trauma patients in the emergency department (ED for the presence of urine hemoglobin, uroblinogen and urine bilirubin. Computed tomography (CT scan results and operative reports were reviewed from the trauma registry for evidence of liver laceration, spleen laceration, bowel or mesenteric injuries.RESULTS: There were 73 injuries and 57/516 patients (11% with intra-abdominal injury. Urinalysis was positive for urobilinogen in 28/516 (5.4% patients, urine bilirubin in 15/516 (2.9% patients and urine hemoglobin in 313/516 (61% patients. Nineteen/forty-seven (4% subjects had liver lacerations, 28/56 (5% splenic lacerations, and 15/5 (3% bowel or mesenteric injury. Comparing the proportion of patients that had urobilinogen detected in the group with and without intra-abdominal injury, 8/28 (29% subjects with urobilinogen, 5/15 (33% subjects with bilirubin and 47/313 (15% subjects with urine hemoglobin were found to have liver lacerations, spleen lacerations, or bowel/mesenteric injuries. Preexisting liver or biliary conditions were not statistically associated with elevation of urine bilirubin, urine hemoglobin or urobilinogen on initial urinalysis after blunt abdominal trauma. Point prevalence for urobilinogen, urine bilirubin and urine hemoglobin are 5.43% (28/516, 2.91% (15/516 and 60.7% (313/516 respectively.CONCLUSIONS: The utility of the initial routine urinalysis in the ED for adult blunt abdominal trauma patients should not be used as a screening tool for the evaluation of intra

Analysis of urobilinogen and urine bilirubin for intra-abdominal injury in blunt trauma patients.

Science.gov (United States)

Gorchynski, Julie; Dean, Kevin; Anderson, Craig L

2009-05-01

To determine the point prevalence of urine bilirubin, urine hemoglobin and urobilinogen in blunt trauma patients, and to evaluate its utility as a screening tool for intra-abdominal injury. Data analysis of 986 consecutive trauma patients of which 698 were adult blunt trauma patients. Five-hundred sixteen subjects had a urinalysis and a CT scan of the abdomen/pelvis or exploratory laparotomy. We reviewed initial urinalysis results from trauma patients in the emergency department (ED) for the presence of urine hemoglobin, uroblinogen and urine bilirubin. Computed tomography (CT) scan results and operative reports were reviewed from the trauma registry for evidence of liver laceration, spleen laceration, bowel or mesenteric injuries. There were 73 injuries and 57/516 patients (11%) with intra-abdominal injury. Urinalysis was positive for urobilinogen in 28/516 (5.4%) patients, urine bilirubin in 15/516 (2.9%) patients and urine hemoglobin in 313/516 (61%) patients. Nineteen/forty-seven (4%) subjects had liver lacerations, 28/56 (5%) splenic lacerations, and 15/5 (3%) bowel or mesenteric injury. Comparing the proportion of patients that had urobilinogen detected in the group with and without intra-abdominal injury, 8/28 (29%) subjects with urobilinogen, 5/15 (33%) subjects with bilirubin and 47/313 (15%) subjects with urine hemoglobin were found to have liver lacerations, spleen lacerations, or bowel/mesenteric injuries. Preexisting liver or biliary conditions were not statistically associated with elevation of urine bilirubin, urine hemoglobin or urobilinogen on initial urinalysis after blunt abdominal trauma. Point prevalence for urobilinogen, urine bilirubin and urine hemoglobin are 5.43% (28/516), 2.91% (15/516) and 60.7% (313/516) respectively. The utility of the initial routine urinalysis in the ED for adult blunt abdominal trauma patients should not be used as a screening tool for the evaluation of intra-abdominal injury.

TMS modeling toolbox for realistic simulation.

Science.gov (United States)

Cho, Young Sun; Suh, Hyun Sang; Lee, Won Hee; Kim, Tae-Seong

2010-01-01

Transcranial magnetic stimulation (TMS) is a technique for brain stimulation using rapidly changing magnetic fields generated by coils. It has been established as an effective stimulation technique to treat patients suffering from damaged brain functions. Although TMS is known to be painless and noninvasive, it can also be harmful to the brain by incorrect focusing and excessive stimulation which might result in seizure. Therefore there is ongoing research effort to elucidate and better understand the effect and mechanism of TMS. Lately Boundary element method (BEM) and Finite element method (FEM) have been used to simulate the electromagnetic phenomenon of TMS. However, there is a lack of general tools to generate the models of TMS due to some difficulties in realistic modeling of the human head and TMS coils. In this study, we have developed a toolbox through which one can generate high-resolution FE TMS models. The toolbox allows creating FE models of the head with isotropic and anisotropic electrical conductivities in five different tissues of the head and the coils in 3D. The generated TMS model is importable to FE software packages such as ANSYS for further and efficient electromagnetic analysis. We present a set of demonstrative results of realistic simulation of TMS with our toolbox.

Junior Leader Training Development in Operational Units

Science.gov (United States)

2012-04-01

UNITS Successful operational units do not arise without tough, realistic, and challenging training. Field Manual (FM) 7-0, Training Units and D...operations. The manual provides junior leaders with guidance on how to conduct training and training management. Of particular importance is the definition...1 Relation htp between ADDIE and the Anny Training Management Model. The Army Training Management Model and ADDIE process appear in TRADOC PAM 350

Coil Embolization of an Arteriobiliary Fistula Caused by Hepatic Intra-Arterial Chemotherapy

International Nuclear Information System (INIS)

Takao, Hidemasa; Doi, Ippei; Makita, Kohzoh; Watanabe, Toshiaki

2005-01-01

Arteriobiliary fistula is a rare complication of hepatic intra-arterial chemotherapy. We report successful coil embolization of an arteriobiliary fistula. An 80-year-old woman underwent percutaneous placement of an indwelling catheter into the replaced right hepatic artery for intra-arterial chemotherapy of liver metastases. Coil embolization of the left hepatic artery was not performed. The patient complained of abdominal pain during intra-arterial chemotherapy. Angiography revealed a fistula between the replaced right hepatic artery and the common bile duct. The fistula was successfully treated by coil embolization via the indwelling catheter, and the indwelling catheter was removed. Although such complications usually herald the termination of intra-arterial chemotherapy, the patient underwent percutaneous implantation of a new catheter-port system, and intra-arterial chemotherapy was restarted

Usefulness of fluoroscopy-guided intra-articular injection of the knee

Energy Technology Data Exchange (ETDEWEB)

Myung, Jae Sung; Lee, Joon Woo [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Lee, Ji Yeon [Kangwon National University College of Medicine, Chuncheon (Korea, Republic of)] (and others)

2007-06-15

To determine the accuracy of the intra-articular location of hyaluronic acid injection using a blind approach and to establish the usefulness of fluoroscopy-guided intra-articular injection. A fluoroscopy unit was used for 368 intra-articular injections of hyaluronic acid to 93 knees in 65 patients. Initially, blind needle positioning was conducted on the fluoroscopy table. The failure rate of the blind approach among the 368 injections was evaluated, and a relationship between the Kellgren-Lawrence grade (K-L grade) and the incidence of repeated failures using the blind approach was determined for injections to 52 knees in 37 patients who received a complete cycle of injections (five consecutive injections with a one-week interval between injections). Using a blind approach, 298 of 368 trials (81.2%) resulted in a needle tip being placed in an intra-articular location, while 70 of 368 trials resulted in an extra-articular placement of the needle tip. Among 52 knees to which a complete cycle of injection (five consecutive injections with a one-week interval between injections) was administered, repeated failure of intra-articular placement using the blind approach was seen for 18 knees (34.6%); a more severe K-L grade assigned was associated with a higher rate of repeated failure. However, the trend was not statistically significant based on the Chi-squared test ({rho} value = 0.14). Fluoroscopy-guided needle placement may be helpful to ensure therapeutic intra-articular injection of the knee.

Usefulness of fluoroscopy-guided intra-articular injection of the knee

International Nuclear Information System (INIS)

Myung, Jae Sung; Lee, Joon Woo; Lee, Ji Yeon

2007-01-01

To determine the accuracy of the intra-articular location of hyaluronic acid injection using a blind approach and to establish the usefulness of fluoroscopy-guided intra-articular injection. A fluoroscopy unit was used for 368 intra-articular injections of hyaluronic acid to 93 knees in 65 patients. Initially, blind needle positioning was conducted on the fluoroscopy table. The failure rate of the blind approach among the 368 injections was evaluated, and a relationship between the Kellgren-Lawrence grade (K-L grade) and the incidence of repeated failures using the blind approach was determined for injections to 52 knees in 37 patients who received a complete cycle of injections (five consecutive injections with a one-week interval between injections). Using a blind approach, 298 of 368 trials (81.2%) resulted in a needle tip being placed in an intra-articular location, while 70 of 368 trials resulted in an extra-articular placement of the needle tip. Among 52 knees to which a complete cycle of injection (five consecutive injections with a one-week interval between injections) was administered, repeated failure of intra-articular placement using the blind approach was seen for 18 knees (34.6%); a more severe K-L grade assigned was associated with a higher rate of repeated failure. However, the trend was not statistically significant based on the Chi-squared test (ρ value = 0.14). Fluoroscopy-guided needle placement may be helpful to ensure therapeutic intra-articular injection of the knee

Realistic edge field model code REFC for designing and study of isochronous cyclotron

International Nuclear Information System (INIS)

Ismail, M.

1989-01-01

The focussing properties and the requirements for isochronism in cyclotron magnet configuration are well-known in hard edge field model. The fact that they quite often change considerably in realistic field can be attributed mainly to the influence of the edge field. A solution to this problem requires a field model which allows a simple construction of equilibrium orbit and yield simple formulae. This can be achieved by using a fitted realistic edge field (Hudson et al 1975) in the region of the pole edge and such a field model is therefore called a realistic edge field model. A code REFC based on realistic edge field model has been developed to design the cyclotron sectors and the code FIELDER has been used to study the beam properties. In this report REFC code has been described along with some relevant explaination of the FIELDER code. (author). 11 refs., 6 figs

Sugli investimenti esteri diretti "intra-settoriali". (A note on intra-industry foreign direct investment

Directory of Open Access Journals (Sweden)

J.H. DUNNING

2013-12-01

Full Text Available Questa nota suggerisce che i modelli di investimenti diretti internazionale nel settore della produzione , non solo tendono a seguire quelli di commercio delle materie prime , ma che , nel corso degli anni 1965-1975 , la componente intra-industriale di tali investimenti tendeva ad aumentare.  Tuttavia, i dati relativi interni ed esterni relativi ai beni di investimento diretto in cinque paesi oltre questo periodo di 10 anni rivelano alcuni spunti interessantiThis note suggests that patterns of international direct investment in manufacturing industry not only tend to follow those of commodity trade, but that, over the years 1965-1975, the intra-industry component of such investment had tended to increase. However, there are only a few countries in the world which are both substantial inward and outward direct investors. Nevertheless, data on outward and inward direct investment assets in five countries over this 10 year period reveal some interesting insights.JEL: F21

Are intravenous injections of contrast media really less nephrotoxic than intra-arterial injections?

Energy Technology Data Exchange (ETDEWEB)

Nyman, Ulf [University of Lund, Department of Diagnostic Radiology, Trelleborg (Sweden); Almen, Torsten [Skaane University Hospital, Department of Clinical Sciences/Medical Radiology, University of Lund, Malmoe (Sweden); Jacobsson, Bo [University of Gothenburg and the Sahlgrenska Academy, Department of Diagnostic Radiology, The Queen Silvia Children' s Hospital, Goeteborg (Sweden); Aspelin, Peter [Karolinska Institute and University Hospital, Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden)

2012-06-15

We oppose the opinion that the intra-arterial administration of iodine-based contrast media (CM) appears to pose a greater risk of contrast medium-induced nephropathy (CIN) than intravenous administration since (1) in intra-arterial coronary procedures and most other intra-arterial angiographic examinations, CM injections are also intravenous relative to the kidneys, (2) there is a lack of comparative trials studying the risk of CIN between intra-arterial and intravenous procedures with matched risk factors and CM doses, (3) a bias selection of patients with fewer risk factors may explain the seemingly lower rate of CIN after CT in comparison with coronary interventions, (4) the rate of CIN following intra-arterial coronary procedures may also be exaggerated owing to other causes of acute kidney failure, such as haemodynamic instability and microembolisation, (5) roughly the same gram-iodine/GFR ratio ({approx}1:1) as a limit of relatively safe CM doses has preliminarily been found for both intravenous CT and intra-arterial coronary procedures and (6) the substantially higher injected intravenous CM dose rate during CT relative to an intra-arterial coronary procedure might actually pose a higher risk of CIN following CT. Key Points circle Most intra-arterial injections of contrast media are intravenous relative to the kidneys. circle No evidence that intravenous CM injections should be less nephrotoxic than intra-arterial. circle Considerably higher dose rates of CM are used for CT relative to intra-arterial procedures. circle Higher dose rates may pose higher nephrotoxic risk for intravenous based CT studies. (orig.)

Realistic terrain visualization based on 3D virtual world technology

Science.gov (United States)

Huang, Fengru; Lin, Hui; Chen, Bin; Xiao, Cai

2010-11-01

The rapid advances in information technologies, e.g., network, graphics processing, and virtual world, have provided challenges and opportunities for new capabilities in information systems, Internet applications, and virtual geographic environments, especially geographic visualization and collaboration. In order to achieve meaningful geographic capabilities, we need to explore and understand how these technologies can be used to construct virtual geographic environments to help to engage geographic research. The generation of three-dimensional (3D) terrain plays an important part in geographical visualization, computer simulation, and virtual geographic environment applications. The paper introduces concepts and technologies of virtual worlds and virtual geographic environments, explores integration of realistic terrain and other geographic objects and phenomena of natural geographic environment based on SL/OpenSim virtual world technologies. Realistic 3D terrain visualization is a foundation of construction of a mirror world or a sand box model of the earth landscape and geographic environment. The capabilities of interaction and collaboration on geographic information are discussed as well. Further virtual geographic applications can be developed based on the foundation work of realistic terrain visualization in virtual environments.

Realistic Affective Forecasting: The Role of Personality

Science.gov (United States)

Hoerger, Michael; Chapman, Ben; Duberstein, Paul

2016-01-01

Affective forecasting often drives decision making. Although affective forecasting research has often focused on identifying sources of error at the event level, the present investigation draws upon the ‘realistic paradigm’ in seeking to identify factors that similarly influence predicted and actual emotions, explaining their concordance across individuals. We hypothesized that the personality traits neuroticism and extraversion would account for variation in both predicted and actual emotional reactions to a wide array of stimuli and events (football games, an election, Valentine’s Day, birthdays, happy/sad film clips, and an intrusive interview). As hypothesized, individuals who were more introverted and neurotic anticipated, correctly, that they would experience relatively more unpleasant emotional reactions, and those who were more extraverted and less neurotic anticipated, correctly, that they would experience relatively more pleasant emotional reactions. Personality explained 30% of the concordance between predicted and actual emotional reactions. Findings suggest three purported personality processes implicated in affective forecasting, highlight the importance of individual-differences research in this domain, and call for more research on realistic affective forecasts. PMID:26212463

Collective multipole excitations based on correlated realistic nucleon-nucleon interactions

International Nuclear Information System (INIS)

Paar, N.; Papakonstantinou, P.; Hergert, H.; Roth, R.

2006-01-01

We investigate collective multipole excitations for closed shell nuclei from 16 O to 208 Pb using correlated realistic nucleon-nucleon interactions in the framework of the random phase approximation (RPA). The dominant short-range central and tensor correlations a re treated explicitly within the Unitary Correlation Operator Method (UCOM), which provides a phase-shift equivalent correlated interaction VUCOM adapted to simple uncorrelated Hilbert spaces. The same unitary transformation that defines the correlated interaction is used to derive correlated transition operators. Using VUCOM we solve the Hartree-Fock problem and employ the single-particle states as starting point for the RPA. By construction, the UCOM-RPA is fully self-consistent, i.e. the same correlated nucleon-nucleon interact ion is used in calculations of the HF ground state and in the residual RPA interaction. Consequently, the spurious state associated with the center-of-mass motion is properly removed and the sum-rules are exhausted within ±3%. The UCOM-RPA scheme results in a collective character of giant monopole, dipole, and quadrupole resonances in closed-shell nuclei across the nuclear chart. For the isoscalar giant monopole resonance, the resonance energies are in agreement with experiment hinting at a reasonable compressibility. However, in the 1 - and 2 + channels the resonance energies are overestimated due to missing long-range correlations and three-body contributions. (orig.)

Case Study: Intra-abdominal hypertension

African Journals Online (AJOL)

2014-05-05

May 5, 2014 ... his weight estimated to be 75 kg, with a body mass index (BMI) of 27.5kg/m2. ... critically ill adults).1 During the laparotomy, a diagnosis of intra- ... Peer reviewed. ..... Best practices for determining resting energy expenditure in.

Beyond the realist turn: a socio-material analysis of heart failure self-care.

Science.gov (United States)

McDougall, Allan; Kinsella, Elizabeth Anne; Goldszmidt, Mark; Harkness, Karen; Strachan, Patricia; Lingard, Lorelei

2018-01-01

For patients living with chronic illnesses, self-care has been linked with positive outcomes such as decreased hospitalisation, longer lifespan, and improved quality of life. However, despite calls for more and better self-care interventions, behaviour change trials have repeatedly fallen short on demonstrating effectiveness. The literature on heart failure (HF) stands as a case in point, and a growing body of HF studies advocate realist approaches to self-care research and policymaking. We label this trend the 'realist turn' in HF self-care. Realist evaluation and realist interventions emphasise that the relationship between self-care interventions and positive health outcomes is not fixed, but contingent on social context. This paper argues socio-materiality offers a productive framework to expand on the idea of social context in realist accounts of HF self-care. This study draws on 10 interviews as well as researcher reflections from a larger study exploring health care teams for patients with advanced HF. Leveraging insights from actor-network theory (ANT), this study provides two rich narratives about the contextual factors that influence HF self-care. These descriptions portray not self-care contexts but self-care assemblages, which we discuss in light of socio-materiality. © 2018 Foundation for the Sociology of Health & Illness.

Diagnosis of intra-abdominal infections and management of catastrophic outcomes

NARCIS (Netherlands)

Atema, J.J.

2015-01-01

Intra-abdominal infections are a diverse group of frequently encountered conditions of varying severity with various underlying pathologies. The first part of this thesis focused on the diagnostic work-up of suspected intra-abdominal infections. The diagnosticvalue of commonly used inflammatory

Pre- and/or Intra-Operative Prescription of Diuretics, but Not Renin-Angiotensin-System Inhibitors, Is Significantly Associated with Acute Kidney Injury after Non-Cardiac Surgery: A Retrospective Cohort Study.

Science.gov (United States)

Tagawa, Miho; Ogata, Ai; Hamano, Takayuki

2015-01-01

Pre- and/or intra-operative use of diuretics, angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin II receptor blockers (ARB) constitutes a potentially modifiable risk factor for postoperative acute kidney injury (AKI). It has been studied whether use of these drugs predicts AKI after cardiac surgery. The objective of this study was to examine whether administration of these agents was independently associated with AKI after non-cardiac surgery. This was a retrospective observational study. Inclusion criteria were adult patients (age ≥ 18) who underwent non-cardiac surgery under general anesthesia from 2007 to 2009 at Kyoto Katsura Hospital. Exclusion criteria were urological surgery, missing creatinine values, and preoperative dialysis. The exposures of interest were pre- and/or intra-operative use of diuretics or ACE-I/ARB. Outcome variables were postoperative AKI as defined by the AKI Network (increase in creatinine ≥ 0.3 mg/dL or 150% within 48 hours, or urine output 6 hours). Multivariable logistic regression analyses were conducted and adjusted for potential confounders. Propensity scores (PS) for receiving diuretics or ACE-I/ARB therapy were estimated and PS adjustment, PS matching, and inverse probability weighting were performed. There were 137 AKI cases (5.0%) among 2,725 subjects. After statistical adjustment for patient and surgical characteristics, odds (95% CI) of postoperative AKI were 2.07 (1.10-3.89) (p = 0.02) and 0.89 (0.56-1.42) (p = 0.63) in users of diuretics and ACE-I/ARB, respectively, compared with non-users. PS adjustment, PS matching, and inverse probability weighting yielded similar results. The effect size of diuretics was significantly greater in the patients with lower propensity for diuretic use (p for interaction diuretics, but not ACE-I/ARB, was independently associated with postoperative AKI after non-cardiac surgery, especially in patients with low propensity for diuretic use. It might be reasonable to withhold

Catheter placement via the occipital artery to achieve superselective intra-arterial chemotherapy for oral cancer

International Nuclear Information System (INIS)

Iwai, Toshinori; Mitsudo, Kenji; Fukui, Takafumi

2008-01-01

Superselective intra-arterial chemotherapy via the superficial temporal artery (STA) has become useful for oral cancer. However, this method can not be performed if catheter placement via the STA is impossible. Therefore, we report a surgical method for catheter placement via the occipital artery (OA) to achieve retrograde superselective intra-arterial chemotherapy. Preoperatively, three-dimensional computed tomography angiography was performed to identify the course of the external carotid artery and the relationship between OA and the target artery. Ten patients with oral cancer underwent catheter placement via the OA with Doppler ultrasound and Harmonic Scalpel under local anesthesia. Catheter placement via the OA was superselectively successful in all the patients. The mean exposure time of OA and mean operating time were 17.5 min and 70.5 min, respectively. Catheter placement via the OA is useful when catheter placement via the STA is impossible. Three-dimensional vascular mapping and the use of Doppler ultrasound and Harmonic Scalpel can shorten the surgical time. (author)

Effects of tramadol or morphine in dogs undergoing castration on intra-operative electroencephalogram responses and post-operative pain.

Science.gov (United States)

Kongara, K; Chambers, J P; Johnson, C B; Dukkipati, V S R

2013-11-01

To compare the effects of pre-operatively administered tramadol with those of morphine on electroencephalographic responses to surgery and post-operative pain in dogs undergoing castration. Dogs undergoing castration were treated with either pre-operative morphine (0.5 mg/kg S/C, n = 8) or tramadol (3 mg/kg S/C, n = 8). All dogs also received 0.05 mg/kg acepromazine and 0.04 mg/kg atropine S/C in addition to the test analgesic. Anaesthesia was induced with thiopentone administered I/V to effect and maintained with halothane in oxygen. Respiratory rate, heart rate, end-tidal halothane tension (EtHal) and end-tidal CO2 tension (EtCO2) were monitored throughout surgery. Electroencephalograms (EEG) were recorded continuously using a three electrode montage. Median frequency (F50), total power (Ptot) and 95% spectral edge frequency (F95) derived from EEG power spectra recorded before skin incision (baseline) were compared with those recorded during ligation of the spermatic cords of both testicles. Post-operatively, pain was assessed after 1, 3, 6 and 9 h using the short form of the Glasgow composite measure pain scale (CMPS-SF). Dogs premedicated with tramadol had higher mean F50 (12.2 (SD 0.2) Hz) and lower Ptot (130.39 (SD 12.1) µv(2)) compared with those premedicated with morphine (11.5 (SD 0.2) Hz and 161.8 (SD 15.1) µv(2), respectively; p0.05). The F95 of the EEG did not differ between the two groups during the ligation of either testicle (p > 0.05). Post-operatively, no significant differences in the CMPS-SF score were found between animals premedicated with tramadol and morphine at any time during the post-operative period. No dog required rescue analgesia. Tramadol and morphine administered pre-operatively provided a similar degree of post-operative analgesia in male dogs at the doses tested.

Pre-operative irradiation with rectal carcinoma - clinical practices and results

International Nuclear Information System (INIS)

Rendl, H.

1986-01-01

The goal of this work is to portray the effect of a high-dosed short-timed pre-irradiation on intra- and post-operative therapy of rectal carcinoma and the appearance of recidivistic tumors, respectively distant metastasis. This intermediate balance should help make the decision easier as to whether to continue to use this combined treatment form. The subjects consisted of 65 rectal carcinoma patients - pre-irradiated and operated - and 95 only operated patients. The irradiation was completed using a 8 MeV linear accelerator with ultra hard x-radiation. Dosing - (more than 80%) as short-timed irradiation with 16 Gy (4 x 4 Gy in 2 days) - 25 Gy (10 x 2,5 Gy in 12 days); average field size 150 mm x 150 mm. There were no significant differences with regard to intra- and post-operative complications, late complications or distant metastasis, but there was with tumor recidivision reduced with pre-irradiated. Regarding the survival rate, there was a slight tendency in favor of the pre-irradiated. (orig./MG) [de

Role-playing for more realistic technical skills training.

Science.gov (United States)

Nikendei, C; Zeuch, A; Dieckmann, P; Roth, C; Schäfer, S; Völkl, M; Schellberg, D; Herzog, W; Jünger, J

2005-03-01

Clinical skills are an important and necessary part of clinical competence. Simulation plays an important role in many fields of medical education. Although role-playing is common in communication training, there are no reports about the use of student role-plays in the training of technical clinical skills. This article describes an educational intervention with analysis of pre- and post-intervention self-selected student survey evaluations. After one term of skills training, a thorough evaluation showed that the skills-lab training did not seem very realistic nor was it very demanding for trainees. To create a more realistic training situation and to enhance students' involvement, case studies and role-plays with defined roles for students (i.e. intern, senior consultant) were introduced into half of the sessions. Results of the evaluation in the second term showed that sessions with role-playing were rated significantly higher than sessions without role-playing.

Intra-party democracy beyond aggregation

DEFF Research Database (Denmark)

Wolkenstein, Fabio

2016-01-01

, discussing several functions intra-party deliberation is said to serve in the democratic theory literature. It then goes on to explore the deliberative credentials of political discussion between party members, drawing on group interviews with party members in two Social Democratic parties in Germany...

The effect of intra-abdominal hypertension incorporating severe acute pancreatitis in a porcine model.

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Lu Ke

Full Text Available INTRODUCTION: Abdominal compartment syndrome (ACS and intra abdominal hypertension(IAH are common clinical findings in patients with severe acute pancreatitis(SAP. It is thought that an increased intra abdominal pressure(IAP is associated with poor prognosis in SAP patients. But the detailed effect of IAH/ACS on different organ system is not clear. The aim of this study was to assess the effect of SAP combined with IAH on hemodynamics, systemic oxygenation, and organ damage in a 12 h lasting porcine model. MEASUREMENTS AND METHODS: Following baseline registrations, a total of 30 animals were divided into 5 groups (6 animals in each group: SAP+IAP30 group, SAP+IAP20 group, SAP group, IAP30 group(sham-operated but without SAP and sham-operated group. We used a N(2 pneumoperitoneum to induce different levels of IAH and retrograde intra-ductal infusion of sodium taurocholate to induce SAP. The investigation period was 12 h. Hemodynamic parameters (CO, HR, MAP, CVP, urine output, oxygenation parameters(e.g., S(vO(2, PO(2, PaCO(2, peak inspiratory pressure, as well as serum parameters (e.g., ALT, amylase, lactate, creatinine were recorded. Histological examination of liver, intestine, pancreas, and lung was performed. MAIN RESULTS: Cardiac output significantly decreased in the SAP+IAH animals compared with other groups. Furthermore, AST, creatinine, SUN and lactate showed similar increasing tendency paralleled with profoundly decrease in S(vO(2. The histopathological analyses also revealed higher grade injury of liver, intestine, pancreas and lung in the SAP+IAH groups. However, few differences were found between the two SAP+IAH groups with different levels of IAP. CONCLUSIONS: Our newly developed porcine SAP+IAH model demonstrated that there were remarkable effects on global hemodynamics, oxygenation and organ function in response to sustained IAH of 12 h combined with SAP. Moreover, our model should be helpful to study the mechanisms of IAH

Toward realistic pursuit-evasion using a roadmap-based approach

KAUST Repository

Rodriguez, Samuel

2011-05-01

In this work, we describe an approach for modeling and simulating group behaviors for pursuit-evasion that uses a graph-based representation of the environment and integrates multi-agent simulation with roadmap-based path planning. Our approach can be applied to more realistic scenarios than are typically studied in most previous work, including agents moving in 3D environments such as terrains, multi-story buildings, and dynamic environments. We also support more realistic three-dimensional visibility computations that allow evading agents to hide in crowds or behind hills. We demonstrate the utility of this approach on mobile robots and in simulation for a variety of scenarios including pursuit-evasion and tag on terrains, in multi-level buildings, and in crowds. © 2011 IEEE.

Evolutionary approaches for the reverse-engineering of gene regulatory networks: A study on a biologically realistic dataset

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Gidrol Xavier

2008-02-01

Full Text Available Abstract Background Inferring gene regulatory networks from data requires the development of algorithms devoted to structure extraction. When only static data are available, gene interactions may be modelled by a Bayesian Network (BN that represents the presence of direct interactions from regulators to regulees by conditional probability distributions. We used enhanced evolutionary algorithms to stochastically evolve a set of candidate BN structures and found the model that best fits data without prior knowledge. Results We proposed various evolutionary strategies suitable for the task and tested our choices using simulated data drawn from a given bio-realistic network of 35 nodes, the so-called insulin network, which has been used in the literature for benchmarking. We assessed the inferred models against this reference to obtain statistical performance results. We then compared performances of evolutionary algorithms using two kinds of recombination operators that operate at different scales in the graphs. We introduced a niching strategy that reinforces diversity through the population and avoided trapping of the algorithm in one local minimum in the early steps of learning. We show the limited effect of the mutation operator when niching is applied. Finally, we compared our best evolutionary approach with various well known learning algorithms (MCMC, K2, greedy search, TPDA, MMHC devoted to BN structure learning. Conclusion We studied the behaviour of an evolutionary approach enhanced by niching for the learning of gene regulatory networks with BN. We show that this approach outperforms classical structure learning methods in elucidating the original model. These results were obtained for the learning of a bio-realistic network and, more importantly, on various small datasets. This is a suitable approach for learning transcriptional regulatory networks from real datasets without prior knowledge.

Orchiopexy for intra-abdominal testes: factors predicting success.

Science.gov (United States)

Stec, Andrew A; Tanaka, Stacy T; Adams, Mark C; Pope, John C; Thomas, John C; Brock, John W

2009-10-01

Intra-abdominal testes can be treated with several surgical procedures. We evaluated factors influencing the outcome of orchiopexy for intra-abdominal testis. We retrospectively reviewed 156 consecutive orchiopexies performed for intra-abdominal testis, defined as a nonpalpable testis on examination and located in the abdomen at surgery. All surgical approaches were included in the study. Primary outcome was the overall success rate and secondary outcomes were success based on surgical approach, age and a patent processus vaginalis. Success was considered a testis with normal texture and size compared to the contralateral testis at followup. Multivariate analysis was performed to determine factors predictive of success. The overall success rate of all orchiopexies was 79.5%. Median patient age at orchiopexy was 12 months and mean followup was 16 months. Of the patients 117 had a patent processus vaginalis at surgery. One-stage abdominal orchiopexy was performed in 92 testes with 89.1% success. Of these cases 32 were performed laparoscopically with 96.9% success. One-stage Fowler-Stephens orchiopexy was performed in 27 testes and 2-stage Fowler-Stephens orchiopexy was performed in 37 with success in 63.0% and 67.6%, respectively. Multivariate analysis revealed that 1-stage orchiopexy without vessel division had more successful outcomes than 1 and 2-stage Fowler-Stephens orchiopexy (OR 0.24, p = 0.007 and 0.29, p = 0.19, respectively). Neither age at surgery nor an open internal ring was significant (p = 0.49 and 0.12, respectively). The overall success of orchiopexy for intra-abdominal testis is 79.5%. While patient selection remains a critical factor, 1-stage orchiopexy without vessel division was significantly more successful and a laparoscopic approach was associated with the fewest failures for intra-abdominal testes.

Intra-articular ganglion cysts of the knee: clinical and MR imaging features

International Nuclear Information System (INIS)

Kim, M.G.; Cho, W.H.; Kim, B.H.; Choi, J.A.; Lee, N.J.; Chung, K.B.; Choi, Y.S.; Cho, S.B.; Lim, H.C.

2001-01-01

The purpose of this study was to present clinical and MR imaging features of intra-articular ganglion cysts of the knee. Retrospective review of 1685 consecutive medical records and MR examinations of the knee performed at three imaging centers allowed identification of 20 patients (13 men and 7 women; mean age 35 years), in whom evidence of intra-articular ganglion cyst was seen. Of the 20 ganglion cysts, 5 were found in the infrapatellar fat pad, 10 arose from the posterior cruciate ligament, and 5 from the anterior cruciate ligament. Three of five patients with ganglion cyst in the infrapatellar fat pad had a palpable mass. In 7 of 15 patients with ganglion cyst in the intercondylar notch, exacerbation of pain occurred in a squatting position. On four MR arthrographies, ganglion cysts were an intra-articular round, lobulated, low signal intensity lesion. Five cases of fat-suppressed contrast-enhanced T1-weighted SE images demonstrated peripheral thin rim enhancement. The clinical presentation of intra-articular ganglion cyst is varied according to its intra-articular location. The MR appearance of intra-articular ganglion cyst is characteristic and usually associated with the cruciate ligament or the infrapatellar fat pad. Magnetic resonance arthrography has no definite advantage over conventional MR in the evaluation of the lesion. For intra-articular ganglion cyst in the infrapatellar fat pad, fat-suppressed contrast-enhanced MR imaging could be useful, because a thin, rim-enhancing feature of intra-articular ganglion cyst allows it to be distinguished from synovial hemangioma and synovial sarcoma. (orig.)

Recent advances on thermohydraulic simulation of HTR-10 nuclear reactor core using realistic CFD approach

Energy Technology Data Exchange (ETDEWEB)

Silva, Alexandro S., E-mail: alexandrossilva@ifba.edu.br [Instituto Federal de Educacao, Ciencia e Tecnologia da Bahia (IFBA), Vitoria da Conquista, BA (Brazil); Mazaira, Leorlen Y.R., E-mail: leored1984@gmail.com, E-mail: cgh@instec.cu [Instituto Superior de Tecnologias y Ciencias Aplicadas (INSTEC), La Habana (Cuba); Dominguez, Dany S.; Hernandez, Carlos R.G., E-mail: alexandrossilva@gmail.com, E-mail: dsdominguez@gmail.com [Universidade Estadual de Santa Cruz (UESC), Ilheus, BA (Brazil). Programa de Pos-Graduacao em Modelagem Computacional; Lira, Carlos A.B.O., E-mail: cabol@ufpe.br [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil)

2015-07-01

High-temperature gas-cooled reactors (HTGRs) have the potential to be used as possible energy generation sources in the near future, owing to their inherently safe performance by using a large amount of graphite, low power density design, and high conversion efficiency. However, safety is the most important issue for its commercialization in nuclear energy industry. It is very important for safety design and operation of an HTGR to investigate its thermal-hydraulic characteristics. In this article, it was performed the thermal-hydraulic simulation of compressible flow inside the core of the pebble bed reactor HTR (High Temperature Reactor)-10 using Computational Fluid Dynamics (CFD). The realistic approach was used, where every closely packed pebble is realistically modelled considering a graphite layer and sphere of fuel. Due to the high computational cost is impossible simulate the full core; therefore, the geometry used is a FCC (Face Centered Cubic) cell with the half height of the core, with 21 layers and 95 pebbles. The input data used were taken from the thermal-hydraulic IAEA Bechmark. The results show the profiles of velocity and temperature of the coolant in the core, and the temperature distribution inside the pebbles. The maximum temperatures in the pebbles do not exceed the allowable limit for this type of nuclear fuel. (author)

Recent advances on thermohydraulic simulation of HTR-10 nuclear reactor core using realistic CFD approach

International Nuclear Information System (INIS)

Silva, Alexandro S.; Mazaira, Leorlen Y.R.; Dominguez, Dany S.; Hernandez, Carlos R.G.

2015-01-01

High-temperature gas-cooled reactors (HTGRs) have the potential to be used as possible energy generation sources in the near future, owing to their inherently safe performance by using a large amount of graphite, low power density design, and high conversion efficiency. However, safety is the most important issue for its commercialization in nuclear energy industry. It is very important for safety design and operation of an HTGR to investigate its thermal-hydraulic characteristics. In this article, it was performed the thermal-hydraulic simulation of compressible flow inside the core of the pebble bed reactor HTR (High Temperature Reactor)-10 using Computational Fluid Dynamics (CFD). The realistic approach was used, where every closely packed pebble is realistically modelled considering a graphite layer and sphere of fuel. Due to the high computational cost is impossible simulate the full core; therefore, the geometry used is a FCC (Face Centered Cubic) cell with the half height of the core, with 21 layers and 95 pebbles. The input data used were taken from the thermal-hydraulic IAEA Bechmark. The results show the profiles of velocity and temperature of the coolant in the core, and the temperature distribution inside the pebbles. The maximum temperatures in the pebbles do not exceed the allowable limit for this type of nuclear fuel. (author)

Intra-arterial papaverine and leg vascular resistance during in situ bypass surgery with high or low epidural anaesthesia

DEFF Research Database (Denmark)

Rørdam, Peter; Jensen, Leif Panduro; Schroeder, T V

1993-01-01

In situ saphenous vein arterial bypass flow was studied in 16 patients with respect to level of epidural anaesthesia. Arterial pressure and electromagnetic flow were used to evaluate arterial tone by intra-arterial (i.a.) papaverine. Eight patients had a low epidural block (... patients were operated during high epidural anaesthesia (> Th. 10). Flow increased and arterial pressure decreased after i.a. papaverine in all patients. When compared with patients operated during high epidural anaesthesia, flow increase and decrease in vascular resistance took place in patients operated...... during low epidural anaesthesia (P i.a. papaverine was not significantly different in patients operated in low epidural and general anaesthesia (n = 8). In eight patients with insulin-dependent diabetes mellitus who had low epidural anaesthesia, the increase...

Complicated Intra-Abdominal Infections Observational European study (CIAO Study

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Sartelli Massimo

2011-12-01

Full Text Available Abstract Complicated intra-abdominal infections are frequently associated with poor prognoses and high morbidity and mortality rates. Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. In order to describe the clinical, microbiological, and management-related profiles of both community-acquired and healthcare-acquired complicated intra-abdominal infections (IAIs, the World Society of Emergency Surgery (WSES, in collaboration with the Surgical Infections Society of Europe (SIS-E and other prominent European surgical societies, has designed the CIAO study. The CIAO study is a multicenter, observational study and will be carried out in various surgical departments throughout Europe. The study will include patients undergoing surgery or interventional drainage for complicated IAI.

Entrepreneurial Education: A Realistic Alternative for Women and Minorities.

Science.gov (United States)

Steward, James F.; Boyd, Daniel R.

1989-01-01

Entrepreneurial education is a valid, realistic occupational training alternative for minorities and women in business. Entrepreneurship requires that one become involved with those educational programs that contribute significantly to one's success. (Author)

Postoperative intra-abdominal collections using a sodium hyaluronate-carboxymethylcellulose (HA-CMC) barrier at the time of laparotomy for uterine or cervical cancers.

Science.gov (United States)

Leitao, Mario M; Byrum, Graham V; Abu-Rustum, Nadeem R; Brown, Carol L; Chi, Dennis S; Sonoda, Yukio; Levine, Douglas A; Gardner, Ginger J; Barakat, Richard R

2010-11-01

A prior analysis of patients undergoing laparotomy for ovarian malignancies at our institution revealed an increased rate of intra-abdominal collections using HA-CMC film during debulking surgery. The primary objective of the current study was to determine whether the use of HA-CMC is associated with the development of postoperative intra-abdominal collections in patients undergoing laparotomy for uterine or cervical malignancies. We retrospectively identified all laparotomies performed for these malignancies from 3/1/05 to 12/31/07. We identified cases involving the use of HA-CMC via billing records and operative reports. Intra-abdominal collections were defined as localized intraperitoneal fluid accumulations in the absence of re-accumulating ascites. We noted incidences of intra-abdominal collections, as well as other complications. Appropriate statistical tests were applied using SPSS 15.0. We identified 169 laparotomies in which HA-CMC was used and 347 in which HA-CMC was not used. The following were statistically similar in both cohorts: age, body mass index (BMI), primary site, surgery for recurrent disease, prior intraperitoneal surgery, and extent of current surgery. Intra-abdominal collections were seen in 6 (3.6%) of 169 HA-CMC cases compared to 10 (2.9%) of 347 non-HA-CMC cases (p=0.7). The rate of infected collections was similar in both groups (1.2% vs. 1.4%). In the subgroup that underwent tumor debulking, intra-abdominal collections were seen in 3 (11.5%) of 26 HA-CMC cases compared to 2 (5.4%) of 37 non-HA-CMC cases (p=0.6). HA-CMC use does not appear to be associated with postoperative intra-abdominal collections in patients undergoing laparotomy for uterine or cervical cancer. Copyright © 2010 Elsevier Inc. All rights reserved.

Intra-abdominal pressure and abdominal compartment syndrome in acute general surgery.

LENUS (Irish Health Repository)

Sugrue, Michael

2012-01-31

BACKGROUND: Intra-abdominal pressure (IAP) is a harbinger of intra-abdominal mischief, and its measurement is cheap, simple to perform, and reproducible. Intra-abdominal hypertension (IAH), especially grades 3 and 4 (IAP > 18 mmHg), occurs in over a third of patients and is associated with an increase in intra-abdominal sepsis, bleeding, renal failure, and death. PATIENTS AND METHODS: Increased IAP reading may provide an objective bedside stimulus for surgeons to expedite diagnostic and therapeutic work-up of critically ill patients. One of the greatest challenges surgeons and intensivists face worldwide is lack of recognition of the known association between IAH, ACS, and intra-abdominal sepsis. This lack of awareness of IAH and its progression to ACS may delay timely intervention and contribute to excessive patient resuscitation. CONCLUSIONS: All patients entering the intensive care unit (ICU) after emergency general surgery or massive fluid resuscitation should have an IAP measurement performed every 6 h. Each ICU should have guidelines relating to techniques of IAP measurement and an algorithm for management of IAH.

Protocol - realist and meta-narrative evidence synthesis: Evolving Standards (RAMESES

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Westhorp Gill

2011-08-01

Full Text Available Abstract Background There is growing interest in theory-driven, qualitative and mixed-method approaches to systematic review as an alternative to (or to extend and supplement conventional Cochrane-style reviews. These approaches offer the potential to expand the knowledge base in policy-relevant areas - for example by explaining the success, failure or mixed fortunes of complex interventions. However, the quality of such reviews can be difficult to assess. This study aims to produce methodological guidance, publication standards and training resources for those seeking to use the realist and/or meta-narrative approach to systematic review. Methods/design We will: [a] collate and summarise existing literature on the principles of good practice in realist and meta-narrative systematic review; [b] consider the extent to which these principles have been followed by published and in-progress reviews, thereby identifying how rigour may be lost and how existing methods could be improved; [c] using an online Delphi method with an interdisciplinary panel of experts from academia and policy, produce a draft set of methodological steps and publication standards; [d] produce training materials with learning outcomes linked to these steps; [e] pilot these standards and training materials prospectively on real reviews-in-progress, capturing methodological and other challenges as they arise; [f] synthesise expert input, evidence review and real-time problem analysis into more definitive guidance and standards; [g] disseminate outputs to audiences in academia and policy. The outputs of the study will be threefold: 1. Quality standards and methodological guidance for realist and meta-narrative reviews for use by researchers, research sponsors, students and supervisors 2. A 'RAMESES' (Realist and Meta-review Evidence Synthesis: Evolving Standards statement (comparable to CONSORT or PRISMA of publication standards for such reviews, published in an open

Evaluations of Factors Predicting the Need for an Extra-Cervical Approach for Intra-Thoracic Goiter

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Ali Sadrizadeh

2015-11-01

Full Text Available Introduction: Intra-thoracic goiter refers to the extension of enlarged thyroid tissue into the thoracic inlet. This condition can produce symptoms of compression on adjacent organs and can sometimes be accompanied by malignant transformation. Therefore surgical treatment is almost always necessary. In order to remove the pathology with the fewest post-operative complications, selection of the appropriate surgical approach is essential. In this study we aimed to detect the criteria which help us select the best therapeutic approach.   Materials and Methods: In this retrospective study, 82 patients with intra-thoracic goiter were investigated. Their data were extracted from medical records and analyzed using SPSS software.   Results: Overall 82 patients, 18 (21% males and 64 (78% females with mean age of 56.38 years were studied. The most common clinical symptoms were mass (95% and dyspnea (73%. In most patients, the surgical approach was cervical (90.2%, while 9.8% of patients required an extra-cervical approach. Post-operation complications were observed in 17.1% of patients; the most common being transient recurrent laryngeal nerve paralysis (4.9%. Malignancy was reported in the histopathology of seven patients (8.5%. The most common malignant histopathology was papillary thyroid carcinoma (7.3%. Extension of the thyroid tissue below the uppermost level of the aortic arch was significantly correlated with the need for an extra-cervical approach to surgery (P

Fusion safety codes International modeling with MELCOR and ATHENA- INTRA

CERN Document Server

Marshall, T; Topilski, L; Merrill, B

2002-01-01

For a number of years, the world fusion safety community has been involved in benchmarking their safety analyses codes against experiment data to support regulatory approval of a next step fusion device. This paper discusses the benchmarking of two prominent fusion safety thermal-hydraulic computer codes. The MELCOR code was developed in the US for fission severe accident safety analyses and has been modified for fusion safety analyses. The ATHENA code is a multifluid version of the US-developed RELAP5 code that is also widely used for fusion safety analyses. The ENEA Fusion Division uses ATHENA in conjunction with the INTRA code for its safety analyses. The INTRA code was developed in Germany and predicts containment building pressures, temperatures and fluid flow. ENEA employs the French-developed ISAS system to couple ATHENA and INTRA. This paper provides a brief introduction of the MELCOR and ATHENA-INTRA codes and presents their modeling results for the following breaches of a water cooling line into the...

The impact of intra-group processes on family business success

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Shelley Farrington

2011-03-01

Full Text Available Interpersonal ties and intra-group processes influence the ability of people to work together effectively as teams. In the context of the family business team, intra-group processes describe the interaction that takes place between the family members and the resultant psychological climate that exists in the family business. Given the increasing number of sibling teams among family businesses, as well as the challenges they face as team members, this study focuses on sibling teams in family businesses and the intra-group processes that influence their success. Consequently, the primary objective of this study is to identify and empirically test the intra-group processes influencing the effectiveness of sibling partnerships. A structured questionnaire was distributed to 1323 sibling partner respondents. The respondents were identified by means of a convenience snowball sampling technique, and the data were collected from 371 usable questionnaires. The empirical findings of this study show that the sibling relationship and fairness are important determinants of sibling team effectiveness.

Intra-Family Gamete Donation: A Solution to Concerns Regarding Gamete Donation in China?

Science.gov (United States)

Liao, Juhong; Devolder, Katrien

2016-09-01

Gamete donation from third parties is controversial in China as it severs blood ties, which are considered of utmost importance in Confucian tradition. In recent years, infertile couples are increasingly demonstrating a preference for the use of gametes donated by family members to conceive children-known as "intra-family gamete donation." The main advantage of intra-family gamete donation is that it maintains blood ties between children and both parents. To date there is no practice of intra-family gamete donation in China. In this paper, we investigate intra-family adoption in China in order to illustrate that intra-family gamete donation is consistent with Confucian tradition regarding the importance of maintaining blood ties within the family. There are several specific ethical issues raised by intra-family gamete donation. It may, for example, result in consanguinity and the semblance of incest, lead to confused family relationships, and raise concerns about possible coercion of familial donors. Confucian tradition provides a new approach to understand and deal with these ethical issues in a way that Western tradition does not. As a result, we suggest intra-family gamete donation could be an acceptable solution to the problem of infertility in China. However, further discussion and open debates on the ethical issues raised by intra-family gamete donation are needed in China.

Value and limitations of transpulmonary pressure calculations during intra-abdominal hypertension.

Science.gov (United States)

Cortes-Puentes, Gustavo A; Gard, Kenneth E; Adams, Alexander B; Faltesek, Katherine A; Anderson, Christopher P; Dries, David J; Marini, John J

2013-08-01

To clarify the effect of progressively increasing intra-abdominal pressure on esophageal pressure, transpulmonary pressure, and functional residual capacity. Controlled application of increased intra-abdominal pressure at two positive end-expiratory pressure levels (1 and 10 cm H2O) in an anesthetized porcine model of controlled ventilation. Large animal laboratory of a university-affiliated hospital. Eleven deeply anesthetized swine (weight 46.2 ± 6.2 kg). Air-regulated intra-abdominal hypertension (0-25 mm Hg). Esophageal pressure, tidal compliance, bladder pressure, and end-expiratory lung aeration by gas dilution. Functional residual capacity was significantly reduced by increasing intra-abdominal pressure at both positive end-expiratory pressure levels (p ≤ 0.0001) without corresponding changes of end-expiratory esophageal pressure. Above intra-abdominal pressure 5 mm Hg, plateau airway pressure increased linearly by ~ 50% of the applied intra-abdominal pressure value, associated with commensurate changes of esophageal pressure. With tidal volume held constant, negligible changes occurred in transpulmonary pressure due to intra-abdominal pressure. Driving pressures calculated from airway pressures alone (plateau airway pressure--positive end-expiratory pressure) did not equate to those computed from transpulmonary pressure (tidal changes in transpulmonary pressure). Increasing positive end-expiratory pressure shifted the predominantly negative end-expiratory transpulmonary pressure at positive end-expiratory pressure 1 cm H2O (mean -3.5 ± 0.4 cm H2O) into the positive range at positive end-expiratory pressure 10 cm H2O (mean 0.58 ± 1.2 cm H2O). Despite its insensitivity to changes in functional residual capacity, measuring transpulmonary pressure may be helpful in explaining how different levels of positive end-expiratory pressure influence recruitment and collapse during tidal ventilation in the presence of increased intra-abdominal pressure and in

Intra-uterine hematoma in pregnancy

DEFF Research Database (Denmark)

Glavind, K; Nøhr, S; Nielsen, P H

1991-01-01

In 60 patients with a live fetus and an intra-uterine hematoma (IUH) proven by ultrasonic scanning the outcome of pregnancy was spontaneous abortion in 12% and premature delivery in 10%. No correlation between the outcome of the pregnancy and the maximum size of the hematoma or the week...

Intra-Organizational Conflict in Schools.

Science.gov (United States)

Wynn, Richard

There is no abundance of research on intra-organizational conflict, and there are no simple answers to the tricky business of managing organizational conflicts. This paper states some propositions about conflict and suggests some management stratagems that can be used in sustaining constructive organizational characteristics. The propositions are…

Multiple Myeloma Presenting as Massive Amyloid Deposition in a Parathyroid Gland Associated with Amyloid Goiter: A Medullary Thyroid Carcinoma Mimic on Intra-operative Frozen Section.

Science.gov (United States)

Hill, Kirk; Diaz, Jason; Hagemann, Ian S; Chernock, Rebecca D

2018-06-01

Clinical examples of amyloid deposition in parathyroid glands are exceedingly rare and usually present as an incidental finding in a patient with amyloid goiter. Here, we present the first histologically documented case of parathyroid amyloid deposition that presented as a mass. The patient did not have hyperparathyroidism. The parathyroid gland was submitted for intra-operative frozen section and concern for medullary thyroid carcinoma was raised. An important histologic clue arguing against medullary thyroid carcinoma was the evenly dispersed nature of the amyloid. Histologic perinuclear clearing and parathyroid hormone immunohistochemistry confirmed parathyroid origin on permanent sections. The patient was also found to have associated amyloid goiter. Mass spectrometry of the amyloid showed it to be composed of kappa light chains. On further work-up, the patient was diagnosed with multiple myeloma. Awareness of parathyroid amyloid deposition is important as it is a histologic mimic of medullary thyroid carcinoma, especially on frozen section. Amyloid typing with evaluation for multiple myeloma in any patient with kappa or lambda light chain restriction is also important.

Utilization of independent component analysis for accurate pathological ripple detection in intracranial EEG recordings recorded extra- and intra-operatively.

Science.gov (United States)

Shimamoto, Shoichi; Waldman, Zachary J; Orosz, Iren; Song, Inkyung; Bragin, Anatol; Fried, Itzhak; Engel, Jerome; Staba, Richard; Sharan, Ashwini; Wu, Chengyuan; Sperling, Michael R; Weiss, Shennan A

2018-01-01

To develop and validate a detector that identifies ripple (80-200 Hz) events in intracranial EEG (iEEG) recordings in a referential montage and utilizes independent component analysis (ICA) to eliminate or reduce high-frequency artifact contamination. Also, investigate the correspondence of detected ripples and the seizure onset zone (SOZ). iEEG recordings from 16 patients were first band-pass filtered (80-600 Hz) and Infomax ICA was next applied to derive the first independent component (IC1). IC1 was subsequently pruned, and an artifact index was derived to reduce the identification of high-frequency events introduced by the reference electrode signal. A Hilbert detector identified ripple events in the processed iEEG recordings using amplitude and duration criteria. The identified ripple events were further classified and characterized as true or false ripple on spikes, or ripples on oscillations by utilizing a topographical analysis to their time-frequency plot, and confirmed by visual inspection. The signal to noise ratio was improved by pruning IC1. The precision of the detector for ripple events was 91.27 ± 4.3%, and the sensitivity of the detector was 79.4 ± 3.0% (N = 16 patients, 5842 ripple events). The sensitivity and precision of the detector was equivalent in iEEG recordings obtained during sleep or intra-operatively. Across all the patients, true ripple on spike rates and also the rates of false ripple on spikes, that were generated due to filter ringing, classified the seizure onset zone (SOZ) with an area under the receiver operating curve (AUROC) of >76%. The magnitude and spectral content of true ripple on spikes generated in the SOZ was distinct as compared with the ripples generated in the NSOZ (p ripple rates and properties defined using this approach may accurately delineate the seizure onset zone. Strategies to improve the spatial resolution of intracranial EEG and reduce artifact can help improve the clinical utility of

Re-operation for aortic and mitral prosthetic dysfunctions.

Science.gov (United States)

Kaul, T K; Sastry, M R; Mercer, J L; Meade, J B

1985-01-01

The overall incidence of re-operation and prosthetic valve endocarditis was low in the present series as mechanical prostheses were used predominantly. The prosthetic dysfunctions were less frequent following the primary implantation with Bjork Shiley prostheses, but high operative risk was associated with the clotted Bjork Shiley prostheses. We also had unusual experience of strut fracture and sticking of Bjork Shiley discs in the closed position in both aortic and mitral positions. The early deaths were nil since the use of cardioplegic protection. Intra-operative bleeding due to adhesions can be minimised by using synthetic or heterologous pericardium during the primary operation.

A case study in intra-abdominal sepsis.

Science.gov (United States)

Paul, Jasmeet S; Ridolfi, Timothy J

2012-12-01

Intra-abdominal infections are a common problem for the general surgeon and major sources of morbidity and mortality in the intensive care unit. Some of these patients present with peritonitis that can rapidly progress to septic shock. The basic principles of care include prompt resuscitation, antibiotics, and source control. This article will use a detailed case study to outline the management of a patient with severe intra-abdominal infection from diverticulitis from initial resuscitation to reconstruction. Components of the Surviving Sepsis Campaign as they pertain to surgical patients are discussed and updated, and the concept of damage control general surgery is applied. Copyright © 2012. Published by Elsevier Inc.

Principles of maximally classical and maximally realistic quantum ...

Indian Academy of Sciences (India)

Principles of maximally classical and maximally realistic quantum mechanics. S M ROY. Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400 005, India. Abstract. Recently Auberson, Mahoux, Roy and Singh have proved a long standing conjecture of Roy and Singh: In 2N-dimensional phase space, ...

Characterization of a microDiamond detector in high-dose-per-pulse electron beams for intra operative radiation therapy.

Science.gov (United States)

Di Venanzio, C; Marinelli, Marco; Tonnetti, A; Verona-Rinati, G; Falco, M D; Pimpinella, M; Ciccotelli, A; De Stefano, S; Felici, G; Marangoni, F

2015-12-01

To characterize a synthetic diamond dosimeter (PTW Freiburg microDiamond 60019) in high dose-per-pulse electron beams produced by an Intra Operative Radiation Therapy (IORT) dedicated accelerator. The dosimetric properties of the microDiamond were assessed under 6, 8 and 9 MeV electron beams by a NOVAC11 mobile accelerator (Sordina IORT Technologies S.p.A.). The characterization was carried out with dose-per-pulse ranging from 26 to 105 mGy per pulse. The microDiamond performance was compared with an Advanced Markus ionization chamber and a PTW silicon diode E in terms of dose linearity, percentage depth dose (PDD) curves, beam profiles and output factors. A good linearity of the microDiamond response was verified in the dose range from 0.2 Gy to 28 Gy. A sensitivity of 1.29 nC/Gy was measured under IORT electron beams, resulting within 1% with respect to the one obtained in reference condition under (60)Co gamma irradiation. PDD measurements were found in agreement with the ones by the reference dosimeters, with differences in R50 values below 0.3 mm. Profile measurements evidenced a high spatial resolution of the microDiamond, slightly worse than the one of the silicon diode. The penumbra widths measured by the microDiamond resulted approximately 0.5 mm larger than the ones by the Silicon diode. Output factors measured by the microDiamond were found within 2% with those obtained by the Advanced Markus down to 3 cm diameter field sizes. The microDiamond dosimeter was demonstrated to be suitable for precise dosimetry in IORT applications under high dose-per-pulse conditions. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Toward the M(F)--Theory Embedding of Realistic Free-Fermion Models

CERN Document Server

Berglund, P; Faraggi, A E; Nanopoulos, Dimitri V; Qiu, Z; Berglund, Per; Ellis, John; Faraggi, Alon E.; Qiu, Zongan

1998-01-01

We construct a Landau-Ginzburg model with the same data and symmetries as a $Z_2\\times Z_2$ orbifold that corresponds to a class of realistic free-fermion models. Within the class of interest, we show that this orbifolding connects between different $Z_2\\times Z_2$ orbifold models and commutes with the mirror symmetry. Our work suggests that duality symmetries previously discussed in the context of specific $M$ and $F$ theory compactifications may be extended to the special $Z_2\\times Z_2$ orbifold that characterizes realistic free-fermion models.

Ultra-realistic imaging advanced techniques in analogue and digital colour holography

CERN Document Server

Bjelkhagen, Hans

2013-01-01

Ultra-high resolution holograms are now finding commercial and industrial applications in such areas as holographic maps, 3D medical imaging, and consumer devices. Ultra-Realistic Imaging: Advanced Techniques in Analogue and Digital Colour Holography brings together a comprehensive discussion of key methods that enable holography to be used as a technique of ultra-realistic imaging.After a historical review of progress in holography, the book: Discusses CW recording lasers, pulsed holography lasers, and reviews optical designs for many of the principal laser types with emphasis on attaining th

SMC1-Mediated Intra-S-Phase Arrest Facilitates Bocavirus DNA Replication

Science.gov (United States)

Luo, Yong; Deng, Xuefeng; Cheng, Fang; Li, Yi

2013-01-01

Activation of a host DNA damage response (DDR) is essential for DNA replication of minute virus of canines (MVC), a member of the genus Bocavirus of the Parvoviridae family; however, the mechanism by which DDR contributes to viral DNA replication is unknown. In the current study, we demonstrate that MVC infection triggers the intra-S-phase arrest to slow down host cellular DNA replication and to recruit cellular DNA replication factors for viral DNA replication. The intra-S-phase arrest is regulated by ATM (ataxia telangiectasia-mutated kinase) signaling in a p53-independent manner. Moreover, we demonstrate that SMC1 (structural maintenance of chromosomes 1) is the key regulator of the intra-S-phase arrest induced during infection. Either knockdown of SMC1 or complementation with a dominant negative SMC1 mutant blocks both the intra-S-phase arrest and viral DNA replication. Finally, we show that the intra-S-phase arrest induced during MVC infection was caused neither by damaged host cellular DNA nor by viral proteins but by replicating viral genomes physically associated with the DNA damage sensor, the Mre11-Rad50-Nbs1 (MRN) complex. In conclusion, the feedback loop between MVC DNA replication and the intra-S-phase arrest is mediated by ATM-SMC1 signaling and plays a critical role in MVC DNA replication. Thus, our findings unravel the mechanism underlying DDR signaling-facilitated MVC DNA replication and demonstrate a novel strategy of DNA virus-host interaction. PMID:23365434

Peroneal tendon displacement accompanying intra-articular calcaneal fractures.

Science.gov (United States)

Toussaint, Rull James; Lin, Darius; Ehrlichman, Lauren K; Ellington, J Kent; Strasser, Nicholas; Kwon, John Y

2014-02-19

Peroneal tendon displacement (subluxation or dislocation) accompanying an intra-articular calcaneal fracture is often undetected and under-treated. The goals of this study were to determine (1) the prevalence of peroneal tendon displacement accompanying intra-articular calcaneal fractures, (2) the association of tendon displacement with fracture classifications, (3) the association of tendon displacement with heel width, and (4) the rate of missed diagnosis of the tendon displacement on radiographs and computed tomography (CT) scans and the resulting treatment rate. A retrospective radiographic review of all calcaneal fractures presenting at three institutions from June 30, 2006, to June 30, 2011, was performed. CT imaging of 421 intra-articular calcaneal fractures involving the posterior facet was available for review. The prevalence of peroneal tendon displacement was noted and its associations with fracture classification and heel width were evaluated. Peroneal tendon displacement was identified in 118 (28.0%) of the 421 calcaneal fracture cases. The presence of tendon displacement was significantly associated with joint-depression fractures compared with tongue-type fractures (p displacement had been identified in the radiology reports. Although sixty-five (55.1%) of the fractures with tendon displacement had been treated with internal fixation, the tendon displacement was treated surgically in only seven (10.8%) of these cases. Analysis of CT images showed a 28% prevalence of peroneal tendon displacement accompanying intra-articular calcaneal fractures. Surgeons and radiologists are encouraged to consider this association.

On the main stages of the history of intra-articular therapy

Directory of Open Access Journals (Sweden)

L. Punzi

2011-09-01

Full Text Available In this review the main stages in the history of intra-articular therapy of the rheumatic diseases are summarized. The first approach to such a local treatment has been likely performed in 1792 by the French physician Jean Gay, who injected in a swelling knee the “eau du Goulard” (Goulard’s water, namely a mixture based on lead compounds. In the XIX century iodine derivatives have been mainly applied as an intra-articular treatment. In the XX century, before the wide use of intra-articular corticosteroids, chiefly due to the Joseph Lee Hollander’s experiences, a variety of drugs has been employed, including cytostatics and sclerosing substances. A further important stage has been synoviorthesis, by using specific radionuclides, that would actually represent an anti-synovial treatment. In the last years a spread use of intra-articular hyaluronic acid, particularly in osteoarthritis, has been recorded, with the aim to warrant articular viscosupplementation. Future of intra-articular treatment should be represented by the biological drugs, i.e., anti-TNF, but it is still untimely to define the exact role of such a local treatment of arthritis.

Using a Realist Research Methodology in Policy Analysis

Science.gov (United States)

Lourie, Megan; Rata, Elizabeth

2017-01-01

The article describes the usefulness of a realist methodology in linking sociological theory to empirically obtained data through the development of a methodological device. Three layers of analysis were integrated: 1. the findings from a case study about Maori language education in New Zealand; 2. the identification and analysis of contradictions…

Germ cells may survive clipping and division of the spermatic vessels in surgery for intra-abdominal testes

DEFF Research Database (Denmark)

Thorup, J M; Cortes, D; Visfeldt, J

1999-01-01

PURPOSE: Laparoscopy is a well described modality that provides an accurate visual diagnosis upon which further management of intra-abdominal testes may be based. Laparoscopic ligation of spermatic vessels as stage 1 of the procedure is a natural extension of laparoscopy. A staged approach provides...... studied 17 nonpalpable testes in 10 patients 1 year and 7 months to 13(1/2) years old. Results of testicular biopsies of 13 intra-abdominal testes taken at stages 1 and 2 of surgery were available for histological comparison. RESULTS: Median number of spermatogonia per tubular cross section...... of the biopsies taken at stage 2 was slightly lower (0.03) compared to the median number at stage 1 (0.06) of the operation but this difference was not significant (p = 0.2031). CONCLUSIONS: Our study shows that the spermatogonia may survive clipping and division of the spermatic vessels, although the number...

Case report: pre-eruptive intra-coronal radiolucencies revisited.

LENUS (Irish Health Repository)

Counihan, K P

2012-08-01

Pre-eruptive intra-coronal radiolucency (PEIR) describes a radiolucent lesion located in the coronal dentine, just beneath the enamel-dentine junction of unerupted teeth. The prevalence of this lesion varies depending on the type and quality of radiographic exposure and age of patients used for assessment. The aetiology of pre-eruptive intra-coronal radiolucent lesions is not fully understood, but published clinical and histological evidence suggest that these lesions are resorptive in nature. Issues around the diagnosis, treatment planning and clinical management of this lesion are explored using previously unreported cases.

Intra- and Intercellular Quality Control Mechanisms of Mitochondria

Directory of Open Access Journals (Sweden)

Yoshimitsu Kiriyama

2017-12-01

Full Text Available Mitochondria function to generate ATP and also play important roles in cellular homeostasis, signaling, apoptosis, autophagy, and metabolism. The loss of mitochondrial function results in cell death and various types of diseases. Therefore, quality control of mitochondria via intra- and intercellular pathways is crucial. Intracellular quality control consists of biogenesis, fusion and fission, and degradation of mitochondria in the cell, whereas intercellular quality control involves tunneling nanotubes and extracellular vesicles. In this review, we outline the current knowledge on the intra- and intercellular quality control mechanisms of mitochondria.

Comparison of efficacy of intra-articular morphine and steroid in patients with knee osteoarthritis

Directory of Open Access Journals (Sweden)

Serbülent Gökhan Beyaz

2012-01-01

Full Text Available Introduction: Primary therapeutic aim in treatment of osteoarthritis of the knee is to relieve the pain of osteoarthritis. The aim of this study was to compare the efficacy of intra-articular triamcinolone with intra-articular morphine in pain relief due to osteoarthritis of the knee in the elderly population. Materials and Methods: Patients between 50 and 80 years of age were randomized into three groups. Group M received morphine plus bupivacaine intra-articularly, Group T received triamcinolone plus bupivacaine intra-articularly, and Group C received saline plus bupivacaine intra-articularly. Patients were evaluated before injection and in 2nd, 4th, 6th, and 12th weeks after injection. First-line supplementary analgesic was oral paracetamol 1500 mg/day. If analgesia was insufficient with paracetamol, oral dexketoprofen trometamol 50 mg/day was recommended to patients. Results: After the intra-articular injection, there was statistically significant decrease in visual analog scale (VAS scores in Groups M and T, when compared to Group C. The decrease of VAS scores seen at the first 2 weeks continued steadily up to the end of 12th week. There was a significant decrease in Groups M and T in the WOMAC scores, when compared to Group C. There was no significant difference in the WOMAC scores between morphine and steroid groups. Significantly less supplementary analgesics was used in the morphine and steroid groups. Conclusion: Intra-articular morphine was as effective as intra-articular triamcinolone for analgesia in patients with osteoarthritis knee. Intra-articular morphine is possibly a better option than intra-articular steroid as it has lesser side effects.

Design and evaluation of a portable intra-operative unified-planning-and-guidance framework applied to distal radius fracture surgery.

Science.gov (United States)

Magaraggia, Jessica; Wei, Wei; Weiten, Markus; Kleinszig, Gerhard; Vetter, Sven; Franke, Jochen; John, Adrian; Egli, Adrian; Barth, Karl; Angelopoulou, Elli; Hornegger, Joachim

2017-01-01

During a standard fracture reduction and fixation procedure of the distal radius, only fluoroscopic images are available for planning of the screw placement and monitoring of the drill bit trajectory. Our prototype intra-operative framework integrates planning and drill guidance for a simplified and improved planning transfer. Guidance information is extracted using a video camera mounted onto a surgical drill. Real-time feedback of the drill bit position is provided using an augmented view of the planning X-rays. We evaluate the accuracy of the placed screws on plastic bones and on healthy and fractured forearm specimens. We also investigate the difference in accuracy between guided screw placement versus freehand. Moreover, the accuracy of the real-time position feedback of the drill bit is evaluated. A total of 166 screws were placed. On 37 plastic bones, our obtained accuracy was [Formula: see text] mm, [Formula: see text] and [Formula: see text] in tip position and orientation (azimuth and elevation), respectively. On the three healthy forearm specimens, our obtained accuracy was [Formula: see text] mm, [Formula: see text] and [Formula: see text]. On the two fractured specimens, we attained: [Formula: see text] mm, [Formula: see text] and [Formula: see text]. When screw plans were applied freehand (without our guidance system), the achieved accuracy was [Formula: see text] mm, [Formula: see text], while when they were transferred under guidance, we obtained [Formula: see text] mm, [Formula: see text]. Our results show that our framework is expected to increase the accuracy in screw positioning and to improve robustness w.r.t. freehand placement.

Improved lossless intra coding for H.264/MPEG-4 AVC.

Science.gov (United States)

Lee, Yung-Lyul; Han, Ki-Hun; Sullivan, Gary J

2006-09-01

A new lossless intra coding method based on sample-by-sample differential pulse code modulation (DPCM) is presented as an enhancement of the H.264/MPEG-4 AVC standard. The H.264/AVC design includes a multidirectional spatial prediction method to reduce spatial redundancy by using neighboring samples as a prediction for the samples in a block of data to be encoded. In the new lossless intra coding method, the spatial prediction is performed based on samplewise DPCM instead of in the block-based manner used in the current H.264/AVC standard, while the block structure is retained for the residual difference entropy coding process. We show that the new method, based on samplewise DPCM, does not have a major complexity penalty, despite its apparent pipeline dependencies. Experiments show that the new lossless intra coding method reduces the bit rate by approximately 12% in comparison with the lossless intra coding method previously included in the H.264/AVC standard. As a result, the new method is currently being adopted into the H.264/AVC standard in a new enhancement project.

Intra-industry momentum and product market competition around the world

Directory of Open Access Journals (Sweden)

Ting Li

2016-06-01

Full Text Available This paper examines the relationship between product market competition and intra-industry momentum returns. Based on 12,982 firm observations from 19 developed markets for the period of 1990–2010, I find that buying winners and selling losers in competitive industries generates significantly higher momentum profits than that in concentrated industries. The higher the intensity of product market competition, the larger are the intra-industry momentum returns. The results are robust to sub-samples (periods of the U.S., non-U.S. countries, the G7 countries, 1990–2000, and 2001–2010. I further employ the nearness of a stock's price to the 52-week high to determine past winners and losers and find stronger results. I also compare intra-industry momentum returns with Jegadeesh and Titman (1993 individual stock momentum and Moskowitz and Grinblatt (1999 inter-industry momentum strategies. My results suggest that intra-industry momentum strategy outperforms the latter two strategies in most cases. The overall results are consistent with the notion that severe product market competition induces managers to improve financial performance.

A Local-Realistic Model of Quantum Mechanics Based on a Discrete Spacetime

Science.gov (United States)

Sciarretta, Antonio

2018-01-01

This paper presents a realistic, stochastic, and local model that reproduces nonrelativistic quantum mechanics (QM) results without using its mathematical formulation. The proposed model only uses integer-valued quantities and operations on probabilities, in particular assuming a discrete spacetime under the form of a Euclidean lattice. Individual (spinless) particle trajectories are described as random walks. Transition probabilities are simple functions of a few quantities that are either randomly associated to the particles during their preparation, or stored in the lattice nodes they visit during the walk. QM predictions are retrieved as probability distributions of similarly-prepared ensembles of particles. The scenarios considered to assess the model comprise of free particle, constant external force, harmonic oscillator, particle in a box, the Delta potential, particle on a ring, particle on a sphere and include quantization of energy levels and angular momentum, as well as momentum entanglement.

Regression of sporadic intra-abdominal desmoid tumour following administration of non-steroidal anti-inflammatory drug

Directory of Open Access Journals (Sweden)

Fujiwara Yoshinori

2008-02-01

Full Text Available Abstract Background Desmoid tumours or fibromatoses are rare entities characterized by the benign proliferation of fibroblasts, which can be life-threatening due to their locally aggressive properties. Surgery is widely accepted as the first line of treatment for extra-abdominal desmoids; however, it is not recommended for intra-abdominal desmoids because of the high-risk of recurrence and difficulties with the operation. Here, we report on a patient with sporadic intra-abdominal desmoid tumours, who showed partial response following the intake of non-steroidal anti-inflammatory drugs. Case presentation A 73-year-old man presented with swelling and pain of the right leg. Computed tomography showed an abnormal multilocular soft-tissue mass (95 × 70 mm in the right pelvis, which was revealed by biopsy to be a desmoid tumour. Immunohistochemical analysis showed that the tumour cells expressed vimentin, but not smooth-muscle actin, CD34, or desmin. Very few Ki-67-positive cells were found. Non-cytotoxic treatment with etodolac (200 mg/day was chosen because of the patient's age, lack of bowel obstruction, and the likelihood of prostate cancer. Two years after the commencement of non-steroidal anti-inflammatory drug administration, computed tomography showed a decrease in tumour size (63 × 49 mm, and the disappearance of intratumoural septa. Conclusion Our case report suggests that non-steroidal anti-inflammatory drug treatment should be taken into consideration for use as first-line treatment in patients with sporadic intra-abdominal desmoid tumours.

Regression of sporadic intra-abdominal desmoid tumour following administration of non-steroidal anti-inflammatory drug

Science.gov (United States)

Tanaka, Keita; Yoshikawa, Reigetsu; Yanagi, Hidenori; Gega, Makoto; Fujiwara, Yoshinori; Hashimoto-Tamaoki, Tomoko; Hirota, Syozo; Tsujimura, Tohru; Tomita, Naohiro

2008-01-01

Background Desmoid tumours or fibromatoses are rare entities characterized by the benign proliferation of fibroblasts, which can be life-threatening due to their locally aggressive properties. Surgery is widely accepted as the first line of treatment for extra-abdominal desmoids; however, it is not recommended for intra-abdominal desmoids because of the high-risk of recurrence and difficulties with the operation. Here, we report on a patient with sporadic intra-abdominal desmoid tumours, who showed partial response following the intake of non-steroidal anti-inflammatory drugs. Case presentation A 73-year-old man presented with swelling and pain of the right leg. Computed tomography showed an abnormal multilocular soft-tissue mass (95 × 70 mm) in the right pelvis, which was revealed by biopsy to be a desmoid tumour. Immunohistochemical analysis showed that the tumour cells expressed vimentin, but not smooth-muscle actin, CD34, or desmin. Very few Ki-67-positive cells were found. Non-cytotoxic treatment with etodolac (200 mg/day) was chosen because of the patient's age, lack of bowel obstruction, and the likelihood of prostate cancer. Two years after the commencement of non-steroidal anti-inflammatory drug administration, computed tomography showed a decrease in tumour size (63 × 49 mm), and the disappearance of intratumoural septa. Conclusion Our case report suggests that non-steroidal anti-inflammatory drug treatment should be taken into consideration for use as first-line treatment in patients with sporadic intra-abdominal desmoid tumours. PMID:18257933

Intra-Appendiceal Air at CT: Is It a Useful or a Confusing Sign for the Diagnosis of Acute Appendicitis?

Science.gov (United States)

Cho, Hyun Suk; Woo, Ji Young; Lee, Yul; Yang, Ik; Hwang, Ji-Young; Kim, Han Myun; Kim, Jeong Won

2016-01-01

Objective To investigate the significance of intra-appendiceal air at CT for the evaluation of appendicitis. Materials and Methods We retrospectively analyzed 458 patients (216 men, 242 women; age range, 18-91 years) who underwent CT for suspected appendicitis. Two independent readers reviewed the CT. Prevalence, amount, and appearance of intra-appendiceal air were assessed and compared between the patients with and without appendicitis. Performance of CT diagnosis was evaluated in two reading strategies: once ignoring appendiceal air (strategy 1), and the other time considering presence of appendiceal air as indicative of no appendicitis in otherwise indeterminate cases (strategy 2), using receiver operating characteristic (ROC) analysis. Results Of the 458 patients, 102 had confirmed appendicitis. The prevalence of intra-appendiceal air was significantly different between patients with (13.2%) and without (79.8%) appendicitis (p appendicitis as compared with the normal group, for both reader 1 (p = 0.011) and reader 2 (p = 0.002). Stool-like appearance and air-fluid levels were more common in the appendicitis group than in the normal appendix for both readers (p appendicitis, it has a limited incremental value for the diagnosis of acute appendicitis. PMID:26798214

An Estimation of Operator's Diagnostic Time for Feed-And-Bleed Operation under Various Scenarios

Energy Technology Data Exchange (ETDEWEB)

Kim, Bo Gyung; Kang, Hyun Gook [KAIST, Daejeon (Korea, Republic of); Yoon, Ho Joon [Khalifa University of Science, Abu Dhabi (United Arab Emirates)

2015-10-15

In order to assess realistic safety of plant, effects of interactions between components, operator, and plant condition are needed to be considered in the PSA model. One of the important issues to estimate the CDF is the estimation of human error probability (HEP). When an accident occurs, operators follow the emergency operating procedure and check various alarm, parameters, and signals. In the conventional Korean PSA model, the Korean standard HRA (K-HRA) method is used. In this method, the HEP is the sum of diagnosis error probability and execution error probability. A diagnosis error probability is expressed by the available time for diagnosis and adjusting performance shaping factors, and an execution error probability is a function of task type and stress level. Available time for diagnosis is very important factor of HEP. If the available time for diagnosis is short, the HEP becomes high. In order to obtain the realistic risk assessment results, we first focus on the estimation of HEP considering the plant dynamics under various scenarios. Target operation and scenarios are feed-and bleed operation (F and B operation) and total loss of feedwater (TLOFW) accident with/without loss of coolant accident (LOCA). One of the highest HEP is HEP of FnB operation. In additional, Scenarios, which are related to combination secondary heat removal failure and primary heat removal failure, are most critical core damage scenario of the combined accident except scenarios related to station black out (SBO). In these scenarios, the FnB operation is last resort to prevent core damage. To estimate available operator diagnosis time, we identify the relationship between accidents, mitigation function, and plant condition. Distribution of available time of diagnosis was estimated using the MOSAIQUE. The variables are break size, break timing, trip timing of RCP, and availability of high pressure safety injection (HPSI) pump under the TLOFW accident with LOCA. For Type 1 accident

Fully Realistic Multi-Criteria Multi-Modal Routing

OpenAIRE

Gündling, Felix; Keyhani, Mohammad Hossein; Schnee, Mathias; Weihe, Karsten

2014-01-01

We report on a multi-criteria search system, in which the German long- and short-distance trains, local public transport, walking, private car, private bike, and taxi are incorporated. The system is fully realistic. Three optimization criteria are addressed: travel time, travel cost, and convenience. Our algorithmic approach computes a complete Pareto set of reasonable connections. The computational study demonstrates that, even in such a large-scale, highly complex scenario, approp...

Quantifying introgression risk with realistic population genetics

OpenAIRE

Ghosh, Atiyo; Meirmans, Patrick G.; Haccou, Patsy

2012-01-01

Introgression is the permanent incorporation of genes from the genome of one population into another. This can have severe consequences, such as extinction of endemic species, or the spread of transgenes. Quantification of the risk of introgression is an important component of genetically modified crop regulation. Most theoretical introgression studies aimed at such quantification disregard one or more of the most important factors concerning introgression: realistic genetical mechanisms, rep...

Quantum cryptography: towards realization in realistic conditions

International Nuclear Information System (INIS)

Imoto, M.; Koashi, M.; Shimizu, K.; Huttner, B.

1997-01-01

Many of quantum cryptography schemes have been proposed based on some assumptions such as no transmission loss, no measurement error, and an ideal single photon generator. We have been trying to develop a theory of quantum cryptography considering realistic conditions. As such attempts, we propose quantum cryptography with coherent states, quantum cryptography with two-photon interference, and generalization of two-state cryptography to two-mixed-state cases. (author)

Effect of exercise training on in vivo lipolysis in intra-abdominal adipose tissue in rats

DEFF Research Database (Denmark)

Enevoldsen, L H; Stallknecht, B; Fluckey, J D

2000-01-01

Intra-abdominal obesity is associated with cardiovascular disease and non-insulin-dependent diabetes mellitus, and physical training has been suggested to alleviate these conditions. We compared epinephrine-stimulated lipolysis in vivo in three intra-abdominal adipose tissues (ATs: retroperitonea...... be beneficial in alleviating intra-abdominal obesity by enhancing lipolysis in intra-abdominal fat depots.......Intra-abdominal obesity is associated with cardiovascular disease and non-insulin-dependent diabetes mellitus, and physical training has been suggested to alleviate these conditions. We compared epinephrine-stimulated lipolysis in vivo in three intra-abdominal adipose tissues (ATs: retroperitoneal......: 73 +/- 12 (trained) vs. 14 +/- 4 (sedentary) ml. 100 g(-1). min(-1), P abdominal than in subcutaneous AT in both trained...

A possible definition of a {\\it Realistic} Physics Theory

OpenAIRE

Gisin, Nicolas

2014-01-01

A definition of a {\\it Realistic} Physics Theory is proposed based on the idea that, at all time, the set of physical properties possessed (at that time) by a system should unequivocally determine the probabilities of outcomes of all possible measurements.

Numerical computation of aeroacoustic transfer functions for realistic airfoils

NARCIS (Netherlands)

De Santana, Leandro Dantas; Miotto, Renato Fuzaro; Wolf, William Roberto

2017-01-01

Based on Amiet's theory formalism, we propose a numerical framework to compute the aeroacoustic transfer function of realistic airfoil geometries. The aeroacoustic transfer function relates the amplitude and phase of an incoming periodic gust to the respective unsteady lift response permitting,

Student Work Experience: A Realistic Approach to Merchandising Education.

Science.gov (United States)

Horridge, Patricia; And Others

1980-01-01

Relevant and realistic experiences are needed to prepare the student for a future career. Addresses the results of a survey of colleges and universities in the United States in regard to their student work experience (SWE) in fashion merchandising. (Author)

Intra-fraction motion of the prostate during treatment with helical tomotherapy

International Nuclear Information System (INIS)

Thomas, Simon J.; Ashburner, Mark; Tudor, George Samuel J.; Treeby, Jo; Dean, June; Routsis, Donna; Rimmer, Yvonne L.; Russell, Simon G.; Burnet, Neil G.

2013-01-01

Background and purpose: To measure the geometric uncertainty resulting from intra-fraction motion and intra-observer image matching, for patients having image-guided prostate radiotherapy on TomoTherapy. Material and methods: All patients had already been selected for prostate radiotherapy on TomoTherapy, with daily MV-CT imaging. The study involved performing an additional MV-CT image at the end of treatment, on 5 occasions during the course of 37 treatments. 54 patients were recruited to the study. A new formula was derived to calculate the PTV margin for intra-fraction motion. Results: The mean values of the intra-fraction differences were 0.0 mm, 0.5 mm, 0.5 mm and 0.0° for LR, SI, AP and roll, respectively. The corresponding standard deviations were 1.1 mm, 0.8 mm, 0.8 mm and 0.6° for systematic uncertainties (Σ), 1.3 mm, 2.0 mm, 2.2 mm and 0.3° for random uncertainties (σ). This intra-fraction motion requires margins of 2.2 mm in LR, 2.1 mm in SI and 2.1 mm in AP directions. Inclusion of estimates of the effect of rotations and matching errors increases these margins to approximately 4 mm in LR and 5 mm in SI and AP directions. Conclusions: A new margin recipe has been developed to calculate margins for intra-fraction motion. This recipe is applicable to any measurement technique that is based on the difference between images taken before and after treatment

Generalized Warburg impedance on realistic self-affine fractals ...

Indian Academy of Sciences (India)

Administrator

Generalized Warburg impedance on realistic self-affine fractals: Comparative study of statistically corrugated and isotropic roughness. RAJESH KUMAR and RAMA KANT. Journal of Chemical Sciences, Vol. 121, No. 5, September 2009, pp. 579–588. 1. ( ) c. L. R ω on page 582, column 2, para 2, after eq (8) should read as ...

Case volumes of intra-arterial and intravenous treatment of ischemic stroke in the USA.

Science.gov (United States)

Hirsch, J A; Yoo, A J; Nogueira, R G; Verduzco, L A; Schwamm, L H; Pryor, J C; Rabinov, J D; González, R G

2009-07-01

Ischemic stroke is a major cause of disability and death in the USA. Intravenous tissue plasminogen activator (t-PA) remains underutilized. With the development of newer intra-arterial reperfusion therapies, there is increased opportunity to address the more devastating large-vessel occlusions. We seek to identify the numbers of patients with stroke treated with intravenous and intra-arterial therapies, as well as to estimate the potential number of intra-arterial cases in the foreseeable future. We performed a literature search to determine case volumes of intravenous t-PA use. We extrapolated the current case volume of intra-arterial stroke therapies from the numbers of cases in which the Merci retrieval device was used. In order to estimate the potential numbers of intra-arterial stroke cases, we characterized the percentage of patients with stroke who received intra-arterial therapy at two leading stroke centers. We applied these percentages to the numbers of patients with stroke seen at the top 100, 200 and 500 stroke centers by volume. The rate of intravenous t-PA use is 2.4-3.6%, resulting in 15 000-22 000 cases/year in the USA. The estimated case volume of intra-arterial therapies is 3500-7200 in 2006. Based on data from St. Luke's Brain and Stroke Institute and Massachusetts General Hospital, approximately 5-20% of patients with ischemic stroke can be treated with intra-arterial therapies. Extrapolating this to the top 500 stroke centers by volume, the potential number of intra-arterial cases in the USA is 10 400-41 500/year. Based on the current numbers of intra-arterial cases, our theoretical model identifies a potential for significant growth of this stroke therapy.

Intra-familial physical violence among Mexican and Egyptian youth Violência física intra-familiar entre jovens mexicanos e egípcios

OpenAIRE

Leonor Rivera-Rivera; Betania Allen; James F Thrasher; Ruben Chavez; Cielo Fernandez-Ortega; Osman Galal; Eduardo C Lazcano-Ponce

2005-01-01

OBJECTIVE: To determine the prevalence of experiencing intra-familial violence among Mexican and Egyptian youth and to describe its associated risk factors. METHODS: Data from questionnaires applied to 12,862 Mexican and 5,662 Egyptian youth, aged 10 to 19, who attended public schools were analyzed. Biviarate and logistic regression analysis were used to determine the relationship between socio-demographics, the experience of intra-familial violence and violence perpetration. RESULTS: The pre...

Proposed radiological criteria for pre-operative determination of resectability in peritoneal-based malignancies

International Nuclear Information System (INIS)

Tan, Grace Hwei Ching; Chanyaputhipong, Jendana; Teo, Melissa Ching Ching; Kwek, Jin Wei; Hosseini, Reza; Tham, Chee Kian; Soo, Khee Chee

2016-01-01

The selection of patients for cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy infusion (HIPEC) is important, and relies heavily on imaging. However, it has been reported that Computer Tomographic (CT) scans may only achieve a low sensitivity of 33% for peritoneal disease. We propose a set of radiological criteria for pre-operative determination of resectability of peritoneal disease in peritoneal-based malignancies and validate this in our cohort of patients. A retrospective review of all patients who underwent laparotomy with a view for CRS and HIPEC, at the National Cancer Centre Singapore from January 2000 to April 2010, was performed. Intra-operative Peritoneal Cancer Index (PCI) scores were recorded. The pre-operative imaging was reviewed with a senior radiologist who was blinded, and recorded the radiological PCI scores (CT-PCI) and eight additional CT prognostic factors (CT-PF). The CT-PCI and CT-PF scores were then compared with the intra-operative findings to determine the radiological accuracy. The scores and the individual prognostic factors were then evaluated for their predictive ability for unresectability. Comparison of the CT-PCI and PCI scores showed a concordance correlation coefficient at 0.52 (95% CI 0.34–0.7). Accuracy was increased with the addition CT-PF. The presence of omental caking and ascites were predictors of unresectability. We propose a scoring system which is able to predict for unresectable disease with a specificity of 80% and a sensitivity of 62%. With our proposed criteria, and scoring system, the selection of patients for CRS and HIPEC can be improved, and unnecessary exploratory operations avoided.

A Bio-Realistic Analog CMOS Cochlea Filter With High Tunability and Ultra-Steep Roll-Off.

Science.gov (United States)

Wang, Shiwei; Koickal, Thomas Jacob; Hamilton, Alister; Cheung, Rebecca; Smith, Leslie S

2015-06-01

This paper presents the design and experimental results of a cochlea filter in analog very large scale integration (VLSI) which highly resembles physiologically measured response of the mammalian cochlea. The filter consists of three specialized sub-filter stages which respectively provide passive response in low frequencies, actively tunable response in mid-band frequencies and ultra-steep roll-off at transition frequencies from pass-band to stop-band. The sub-filters are implemented in balanced ladder topology using floating active inductors. Measured results from the fabricated chip show that wide range of mid-band tuning including gain tuning of over 20 dB, Q factor tuning from 2 to 19 as well as the bio-realistic center frequency shift are achieved by adjusting only one circuit parameter. Besides, the filter has an ultra-steep roll-off reaching over 300 dB/dec. By changing biasing currents, the filter can be configured to operate with center frequencies from 31 Hz to 8 kHz. The filter is 9th order, consumes 59.5 ∼ 90.0 μW power and occupies 0.9 mm2 chip area. A parallel bank of the proposed filter can be used as the front-end in hearing prosthesis devices, speech processors as well as other bio-inspired auditory systems owing to its bio-realistic behavior, low power consumption and small size.

Scaling up complex interventions: insights from a realist synthesis.

Science.gov (United States)

Willis, Cameron D; Riley, Barbara L; Stockton, Lisa; Abramowicz, Aneta; Zummach, Dana; Wong, Geoff; Robinson, Kerry L; Best, Allan

2016-12-19

Preventing chronic diseases, such as cancer, cardiovascular disease and diabetes, requires complex interventions, involving multi-component and multi-level efforts that are tailored to the contexts in which they are delivered. Despite an increasing number of complex interventions in public health, many fail to be 'scaled up'. This study aimed to increase understanding of how and under what conditions complex public health interventions may be scaled up to benefit more people and populations.A realist synthesis was conducted and discussed at an in-person workshop involving practitioners responsible for scaling up activities. Realist approaches view causality through the linkages between changes in contexts (C) that activate mechanisms (M), leading to specific outcomes (O) (CMO configurations). To focus this review, three cases of complex interventions that had been successfully scaled up were included: Vibrant Communities, Youth Build USA and Pathways to Education. A search strategy of published and grey literature related to each case was developed, involving searches of relevant databases and nominations from experts. Data extracted from included documents were classified according to CMO configurations within strategic themes. Findings were compared and contrasted with guidance from diffusion theory, and interpreted with knowledge users to identify practical implications and potential directions for future research.Four core mechanisms were identified, namely awareness, commitment, confidence and trust. These mechanisms were activated within two broad scaling up strategies, those of renewing and regenerating, and documenting success. Within each strategy, specific actions to change contexts included building partnerships, conducting evaluations, engaging political support and adapting funding models. These modified contexts triggered the identified mechanisms, leading to a range of scaling up outcomes, such as commitment of new communities, changes in relevant

Quantitative Shear-Wave Elastography of the Liver in Preterm Neonates with Intra-Uterine Growth Restriction.

Directory of Open Access Journals (Sweden)

Marianne Alison

Full Text Available The feasibility and reproducibility of liver stiffness measurements using Supersonic Shear-wave Imaging (SSI in preterm neonate have not been reported. Our aim was to determine if liver stiffness differs between intra-uterine growth restriction (IUGR and appropriate for gestational age (AGA preterm infants with/without cholestasis. We measured liver stiffness (in kPa in 45 AGA and 18 IUGR preterm infants, and assessed reproducibility in 26 preterms using Intraclass Correlation Coefficients (ICC and Bland-Altman tests. Liver stiffness values were compared between AGA and IUGR with and without cholestasis and correlated with birth weight. Measurements showed high reproducibility (ICC = 0.94-0.98 for intra-operator, 0.86 for inter-operator with good agreement (95% limits: -1.24 to 1.24 kPa. During the first postnatal week, liver stiffness was higher in IUGR (7.50 ±1.53 kPa than in AGA infants (5.11 ±0.80 kPa, p<0.001. After day 8, liver stiffness remained unchanged in AGA but increased progressively in IUGR infants (15.57 ±6.49 kPa after day 21. Liver stiffness was higher in IUGR neonates with cholestasis (19.35 ± 9.80 kPa than without cholestasis (7.72 ± 1.27 kPa, p<0.001. In conclusion, quantitative liver SSI in preterms is feasible and reproducible. IUGR preterms who will develop cholestasis present high liver stiffness even at birth, before biological cholestasis occurs.

Traumatic chorioretinal folds treated with intra-vitreal triamcinolone injection

Directory of Open Access Journals (Sweden)

Kook Young Kim

2013-01-01

Full Text Available A 34-year-old male visited the hospital due to decreased visual acuity in the left eye following an injury from a car accident. In the left eye, best-corrected visual acuity (BCVA was hand motion and intraocular pressure (IOP was 8 mmHg. Choroidal vasodilation and chorioretinal folds were observed by spectral domain-optical coherence tomography (SD-OCT. Topical and systemic steroid treatments did not improve the chorioretinal folds. Twelve months after the injury, intra-vitreal triamcinolone (4 mg/0.1 ml was injected. Six months after intra-vitreal triamcinolone injection, BCVA in the left eye had improved to 20/100. Fundus examination showed improvement in retinal vascular tortuosity and SD-OCT revealed improvements in choroidal vasodilation and chorioretinal folds. Intra-vitreal triamcinolone injection (IVTI was effective against traumatic chorioretinal folds with no recurrence based on objective observation by fundus photography and SD-OCT.

A comparison of laparoscopic and open surgery following pre-operative chemoradiation therapy for locally advanced lower rectal cancer

International Nuclear Information System (INIS)

Kusano, Toru; Inomata, Masafumi; Hiratsuka, Takahiro

2014-01-01

Although pre-operative chemoradiation therapy for advanced lower rectal cancer is a controversial treatment modality, it is increasingly used in combination with surgery. Few studies have considered the combination of chemoradiation therapy followed by laparoscopic surgery for locally advanced lower rectal cancer; therefore, this study aimed to assess the usefulness of this therapeutic combination. We retrospectively reviewed the medical records of patients with locally advanced lower rectal cancer treated by pre-operative chemoradiation therapy and surgery from February 2002 to November 2012 at Oita University. We divided patients into an open surgery group and a laparoscopic surgery group and evaluated various parameters by univariate and multivariate analyses. In total, 33 patients were enrolled (open surgery group, n=14; laparoscopic surgery group, n=19). Univariate analysis revealed that compared with the open surgery group, operative time was significantly longer, whereas intra-operative blood loss and intra-operative blood transfusion requirements were significantly less in the laparoscopic surgery group. There were no significant differences in post-operative complication and recurrence rates between the two groups. According to multivariate analysis, operative time and intra-operative blood loss were significant predictors of outcome in the laparoscopic surgery group. This study suggests that laparoscopic surgery after chemoradiation therapy for locally advanced lower rectal cancer is a safe procedure. Further prospective investigation of the long-term oncological outcomes of laparoscopic surgery after chemoradiation therapy for locally advanced lower rectal cancer is required to confirm the advantages of laparoscopic surgery over open surgery. (author)

Non realist tendencies in new Turkish cinema

OpenAIRE

Can, İclal

2016-01-01

http://hdl.handle.net/11693/29111 Thesis (M.S.): Bilkent University, Department of Communication and Design, İhsan Doğramacı Bilkent University, 2016. Includes bibliographical references (leaves 113-123). The realist tendency which had been dominant in cinema became more apparent with Italian neorealism affecting other national cinemas to a large extent. With the changing and developing socio economic and cultural dynamics, realism gradually has stopped being a natural const...

Security of quantum cryptography with realistic sources

International Nuclear Information System (INIS)

Lutkenhaus, N.

1999-01-01

The interest in practical implementations of quantum key distribution is steadily growing. However, there is still a need to give a precise security statement which adapts to realistic implementation. In this paper I give the effective key rate we can obtain in a practical setting within scenario of security against individual attacks by an eavesdropper. It illustrates previous results that high losses together with detector dark counts can make secure quantum key distribution impossible. (Author)

Quantum cryptography: towards realization in realistic conditions

Energy Technology Data Exchange (ETDEWEB)

Imoto, M; Koashi, M; Shimizu, K [NTT Basic Research Laboratories, 3-1 Morinosato-Wakamiya, Atsugi-shi, Kanagawa 243-01 (Japan); Huttner, B [Universite de Geneve, GAP-optique, 20, Rue de l` Ecole de Medecine CH1211, Geneve 4 (Switzerland)

1997-05-11

Many of quantum cryptography schemes have been proposed based on some assumptions such as no transmission loss, no measurement error, and an ideal single photon generator. We have been trying to develop a theory of quantum cryptography considering realistic conditions. As such attempts, we propose quantum cryptography with coherent states, quantum cryptography with two-photon interference, and generalization of two-state cryptography to two-mixed-state cases. (author) 15 refs., 1 fig., 1 tab.

Security of quantum cryptography with realistic sources

Energy Technology Data Exchange (ETDEWEB)

Lutkenhaus, N [Helsinki Institute of Physics, P.O. Box 9, 00014 Helsingin yliopisto (Finland)

1999-08-01

The interest in practical implementations of quantum key distribution is steadily growing. However, there is still a need to give a precise security statement which adapts to realistic implementation. In this paper I give the effective key rate we can obtain in a practical setting within scenario of security against individual attacks by an eavesdropper. It illustrates previous results that high losses together with detector dark counts can make secure quantum key distribution impossible. (Author)

Rethinking Mathematics Teaching in Liberia: Realistic Mathematics Education

Science.gov (United States)

Stemn, Blidi S.

2017-01-01

In some African cultures, the concept of division does not necessarily mean sharing money or an item equally. How an item is shared might depend on the ages of the individuals involved. This article describes the use of the Realistic Mathematics Education (RME) approach to teach division word problems involving money in a 3rd-grade class in…

Intra-uterine insemination for male subfertility

NARCIS (Netherlands)

Bensdorp, A. J.; Cohlen, B. J.; Heineman, M. J.; Vandekerckhove, P.

2007-01-01

BACKGROUND: Intra-uterine insemination (IUI) is one of the most frequently used fertility treatments for couples with male subfertility. Its use, especially when combined with ovarian hyperstimulation (OH) has been subject of discussion. Although the treatment itself is less invasive and expensive

Facilities upgrade for natural forces: traditional vs. realistic approach

International Nuclear Information System (INIS)

Terkun, V.

1985-01-01

The traditional method utilized for upgrading existing buildings and equipment involves the following steps: performs structural study using finite element analysis and some in situ testing; compare predicted member forces/stresses to material code allowables; determine strengthening schemes for those structural members judged to be weak; estimate cost for required upgrades. This approach will result in structural modifications that are not only conservative but very expensive as well. The realistic structural evaluation approach uses traditional data to predict structural weaknesses as a final step. Next, using considerable information now available for buildings and equipment exposed to natural hazards, engineering judgments about structures being evaluated can be made with a great deal of confidence. This approach does not eliminate conservatism entirely, but it does reduce it to a reasonable and realistic level. As a result, the upgrade cost goes down without compromising the low risk necessary for vital facilities

Radiographic detection of artificial intra-bony defects in the edentulous area.

Science.gov (United States)

Van Assche, N; Jacobs, R; Coucke, W; van Steenberghe, D; Quirynen, M

2009-03-01

Since intra-bony pathologies might jeopardize implant outcome, their preoperative detection is crucial. In sixteen human cadaver bloc sections from upper and lower jaws, artificial defects with progressively increasing size (n=7) have been created. From each respective defect, analogue and digital intra-oral radiographs were taken, the latter processed via a periodontal filter and afterwards presented in black-white as well as in colour, resulting in three sets of 7 images per bloc section. Eight observers were asked to diagnosis an eventual defect on randomly presented radiographs, and at another occasion to rank each set based on the defect size. The clinicians were only able to identify a defect, when the junctional area was involved, except for bony pieces with a very homogeneous structure. For longitudinal evaluation of healing bone (e.g. after tooth extraction), colour digital images can be recommended. These observations indicate that intra-oral radiographs are not always reliable for the detection of any intra-bony defect.

Gauge coupling unification in realistic free-fermionic string models

International Nuclear Information System (INIS)

Dienes, K.R.; Faraggi, A.E.

1995-01-01

We discuss the unification of gauge couplings within the framework of a wide class of realistic free-fermionic string models which have appeared in the literature, including the flipped SU(5), SO(6)xSO(4), and various SU(3)xSU(2)xU(1) models. If the matter spectrum below the string scale is that of the Minimal Supersymmetric Standard Model (MSSM), then string unification is in disagreement with experiment. We therefore examine several effects that may modify the minimal string predictions. First, we develop a systematic procedure for evaluating the one-loop heavy string threshold corrections in free-fermionic string models, and we explicitly evaluate these corrections for each of the realistic models. We find that these string threshold corrections are small, and we provide general arguments explaining why such threshold corrections are suppressed in string theory. Thus heavy thresholds cannot resolve the disagreement with experiment. We also study the effect of non-standard hypercharge normalizations, light SUSY thresholds, and intermediate-scale gauge structure, and similarly conclude that these effects cannot resolve the disagreement with low-energy data. Finally, we examine the effects of additional color triplets and electroweak doublets beyond the MSSM. Although not required in ordinary grand unification scenarios, such states generically appear within the context of certain realistic free-fermionic string models. We show that if these states exist at the appropriate thresholds, then the gauge couplings will indeed unify at the string scale. Thus, within these string models, string unification can be in agreement with low-energy data. (orig.)

Horizontal and Vertical Intra-Industry Trade: Is the Empirical Classification Usable?

DEFF Research Database (Denmark)

Nielsen, Jørgen Ulff-Møller; Lüthje, Teit

2002-01-01

On the basis of OECD trade statistics at SITC 5 digit level for the period 1961-1999 this paper shows the classification of international trade in (1) inter-industry trade; (2) horizontal intra-industry; and (3) vertical intra-industry trade used in the empirical trade literature to be unstable...

Intra- and interoperator variability of lobar pulmonary volumes and emphysema scores in patients with chronic obstructive pulmonary disease and emphysema: comparison of manual and semi-automated segmentation techniques.

Science.gov (United States)

Molinari, Francesco; Pirronti, Tommaso; Sverzellati, Nicola; Diciotti, Stefano; Amato, Michele; Paolantonio, Guglielmo; Gentile, Luigia; Parapatt, George K; D'Argento, Francesco; Kuhnigk, Jan-Martin

2013-01-01

We aimed to compare the intra- and interoperator variability of lobar volumetry and emphysema scores obtained by semi-automated and manual segmentation techniques in lung emphysema patients. In two sessions held three months apart, two operators performed lobar volumetry of unenhanced chest computed tomography examinations of 47 consecutive patients with chronic obstructive pulmonary disease and lung emphysema. Both operators used the manual and semi-automated segmentation techniques. The intra- and interoperator variability of the volumes and emphysema scores obtained by semi-automated segmentation was compared with the variability obtained by manual segmentation of the five pulmonary lobes. The intra- and interoperator variability of the lobar volumes decreased when using semi-automated lobe segmentation (coefficients of repeatability for the first operator: right upper lobe, 147 vs. 96.3; right middle lobe, 137.7 vs. 73.4; right lower lobe, 89.2 vs. 42.4; left upper lobe, 262.2 vs. 54.8; and left lower lobe, 260.5 vs. 56.5; coefficients of repeatability for the second operator: right upper lobe, 61.4 vs. 48.1; right middle lobe, 56 vs. 46.4; right lower lobe, 26.9 vs. 16.7; left upper lobe, 61.4 vs. 27; and left lower lobe, 63.6 vs. 27.5; coefficients of reproducibility in the interoperator analysis: right upper lobe, 191.3 vs. 102.9; right middle lobe, 219.8 vs. 126.5; right lower lobe, 122.6 vs. 90.1; left upper lobe, 166.9 vs. 68.7; and left lower lobe, 168.7 vs. 71.6). The coefficients of repeatability and reproducibility of emphysema scores also decreased when using semi-automated segmentation and had ranges that varied depending on the target lobe and selected threshold of emphysema. Semi-automated segmentation reduces the intra- and interoperator variability of lobar volumetry and provides a more objective tool than manual technique for quantifying lung volumes and severity of emphysema.

The Electrostatic Instability for Realistic Pair Distributions in Blazar/EBL Cascades

Science.gov (United States)

Vafin, S.; Rafighi, I.; Pohl, M.; Niemiec, J.

2018-04-01

This work revisits the electrostatic instability for blazar-induced pair beams propagating through the intergalactic medium (IGM) using linear analysis and PIC simulations. We study the impact of the realistic distribution function of pairs resulting from the interaction of high-energy gamma-rays with the extragalactic background light. We present analytical and numerical calculations of the linear growth rate of the instability for the arbitrary orientation of wave vectors. Our results explicitly demonstrate that the finite angular spread of the beam dramatically affects the growth rate of the waves, leading to the fastest growth for wave vectors quasi-parallel to the beam direction and a growth rate at oblique directions that is only a factor of 2–4 smaller compared to the maximum. To study the nonlinear beam relaxation, we performed PIC simulations that take into account a realistic wide-energy distribution of beam particles. The parameters of the simulated beam-plasma system provide an adequate physical picture that can be extrapolated to realistic blazar-induced pairs. In our simulations, the beam looses only 1% of its energy, and we analytically estimate that the beam would lose its total energy over about 100 simulation times. An analytical scaling is then used to extrapolate the parameters of realistic blazar-induced pair beams. We find that they can dissipate their energy slightly faster by the electrostatic instability than through inverse-Compton scattering. The uncertainties arising from, e.g., details of the primary gamma-ray spectrum are too large to make firm statements for individual blazars, and an analysis based on their specific properties is required.

Intra-family messaging with family circles

NARCIS (Netherlands)

Schatorjé, R.J.W.; Markopoulos, P.; Neustaedter, C.; Harrison, S.; Sellen, A.

2013-01-01

This chapter makes the argument that intra-family communication is not an issue of connectivity anytime anywhere, but of providing communication media that are flexible and expressive allowing families to appropriate them and fit their own idiosyncratic ways of communicating with each other. We

Diagnostic accuracy of touch imprint cytology for head and neck malignancies: a useful intra-operative tool in resource limited countries.

Science.gov (United States)

Naveed, Hania; Abid, Mariam; Hashmi, Atif Ali; Edhi, Muhammad Muzammamil; Sheikh, Ahmareen Khalid; Mudassir, Ghazala; Khan, Amir

2017-01-01

Intraoperative consultation is an important tool for the evaluation of the upper aerodigestive tract (UAT) malignancies. Although frozen section analysis is a preferred method of intra-operative consultation, however in resource limited countries like Pakistan, this facility is not available in most institutes; therefore, we aimed to evaluate the diagnostic accuracy of touch imprint cytology for UAT malignancies using histopathology of the same tissue as gold standard. The study involved 70 cases of UAT lesions operated during the study period. Intraoperatively, after obtaining the fresh biopsy specimen and prior to placing them in fixative, each specimen was imprinted on 4-6 glass slides, fixed immediately in 95% alcohol and stained with Hematoxylin and Eosin stain. After completion of the cytological procedure, the surgical biopsy specimen was processed. The slides of both touch Imprint cytology and histopathology were examined by two consultant histopathologists. The result of touch imprint cytology showed that touch imprint cytology was diagnostic in 68 cases (97.1%), 55 (78.6%) being malignant, 2 cases (2.9%) were suspicious for malignancy, 11 cases (15.7%) were negative for malignancy while 2 cases (2.9%) were false negative. Amongst the 70 cases, 55 cases (78.6%) were malignant showing squamous cell carcinoma in 49 cases (70%), adenoid cystic carcinoma in 2 cases (2.9%), non-Hodgkin lymphoma 2 cases (2.9%), Mucoepidermoid carcinoma 1 case (1.4%), spindle cell sarcoma in 1 case (1.4%). Two cases (2.9%) were suspicious of malignancy showing atypical squamoid cells on touch imprint cytology, while 13 cases (18.6%) were negative for malignancy, which also included 2 false negative cases. The overall diagnostic accuracy of touch imprint cytology came out to be 96.7% with a sensitivity and specificity of 96 and 100%, respectively while PPV and NPV of touch imprint cytology was found to be 100 and 84%, respectively. Our experience in this study has demonstrated

Determinants of Iran's BilateralIntra-industry Trade in Pharmaceutical Industry.

Science.gov (United States)

Aghlmand, Siamak; Rahimi, Bahlol; Farrokh-Eslamlou, Hamidreza; Nabilou, Bahram; Yusefzadeh, Hassan

2018-01-01

Among non-oil and in trade arena, drug has always been strategic importance and most government especially industrialized countries pay special attention to its production and trade issues. Thus, having a comprehensive view from economic perspective to this section is essential for suggesting intervention. This was a descriptive-analytical and panel study. In this study, gravity model is used to estimate Iran's bilateral intra-industry trade in pharmaceutical products in the 2001-2012 periods. To illustrate the extent of pharmaceutical's intra-industry trade between Iran and its major trading partners, the explanatory variables of market size, income, factor endowments, distance, cultural contributions, and similarities and also special trade arrangements have been applied. Analysis of factors affecting Iran's bilateral intra-industry trade in pharmaceutical industry showed that the average GDP and cultural similarities had a significant positive impact on Iran's bilateral IIT, while the difference in GDP has a negative and significant effect. Coefficients obtained for the geographical distance and the average ratio of total capital to the labor force is not consistent with theoretical expectations. Special trade arrangements did not have significant impact on the extent of bilateral intra-industry trade between Iran and its trading partners. The knowledge of the intra-industry trade between Iran and its trade partners make integration between the countries. Factors affecting this type of trade pattern underlie its development in trade relationship. Therefore, the findings of this study would be useful in helping to develop and implement policies for the expansion of the pharmaceutical trade.

Measurable realistic image-based 3D mapping

Science.gov (United States)

Liu, W.; Wang, J.; Wang, J. J.; Ding, W.; Almagbile, A.

2011-12-01

Maps with 3D visual models are becoming a remarkable feature of 3D map services. High-resolution image data is obtained for the construction of 3D visualized models.The3D map not only provides the capabilities of 3D measurements and knowledge mining, but also provides the virtual experienceof places of interest, such as demonstrated in the Google Earth. Applications of 3D maps are expanding into the areas of architecture, property management, and urban environment monitoring. However, the reconstruction of high quality 3D models is time consuming, and requires robust hardware and powerful software to handle the enormous amount of data. This is especially for automatic implementation of 3D models and the representation of complicated surfacesthat still need improvements with in the visualisation techniques. The shortcoming of 3D model-based maps is the limitation of detailed coverage since a user can only view and measure objects that are already modelled in the virtual environment. This paper proposes and demonstrates a 3D map concept that is realistic and image-based, that enables geometric measurements and geo-location services. Additionally, image-based 3D maps provide more detailed information of the real world than 3D model-based maps. The image-based 3D maps use geo-referenced stereo images or panoramic images. The geometric relationships between objects in the images can be resolved from the geometric model of stereo images. The panoramic function makes 3D maps more interactive with users but also creates an interesting immersive circumstance. Actually, unmeasurable image-based 3D maps already exist, such as Google street view, but only provide virtual experiences in terms of photos. The topographic and terrain attributes, such as shapes and heights though are omitted. This paper also discusses the potential for using a low cost land Mobile Mapping System (MMS) to implement realistic image 3D mapping, and evaluates the positioning accuracy that a measureable

Intra-articular steroid injection for osteoarthritis of the hip prior to total hip arthroplasty : is it safe? a systematic review.

Science.gov (United States)

Pereira, L C; Kerr, J; Jolles, B M

2016-08-01

Using a systematic review, we investigated whether there is an increased risk of post-operative infection in patients who have received an intra-articular corticosteroid injection to the hip for osteoarthritis prior to total hip arthroplasty (THA). Studies dealing with an intra-articular corticosteroid injection to the hip and infection following subsequent THA were identified from databases for the period between 1990 to 2013. Retrieved articles were independently assessed for their methodological quality. A total of nine studies met the inclusion criteria. Two recommended against a steroid injection prior to THA and seven found no risk with an injection. No prospective controlled trials were identified. Most studies were retrospective. Lack of information about the methodology was a consistent flaw. The literature in this area is scarce and the evidence is weak. Most studies were retrospective, and confounding factors were poorly defined or not addressed. There is thus currently insufficient evidence to conclude that an intra-articular corticosteroid injection administered prior to THA increases the rate of infection. High quality, multicentre randomised trials are needed to address this issue. Cite this article: Bone Joint J 2016;98-B:1027-35. ©2016 The British Editorial Society of Bone & Joint Surgery.

Dual phase helical CT versus portal venous phase CT for the detection of colorectal liver metastases: Correlation with intra-operative sonography, surgical and pathological findings

International Nuclear Information System (INIS)

Scott, D. John; Guthrie, J. Ashley; Arnold, Paul; Ward, Janice; Atchley, Julian; Wilson, Daniel; Robinson, Philip J.

2001-01-01

AIM: To assess whether dual phase helical computed tomography (DPCT) of the liver improves the detection of colorectal liver metastases compared with portal venous phase (PVP) imaging alone. MATERIALS AND METHODS: DPCT was performed in 33 consecutive patients before laparotomy for resection of colorectal liver metastases. CT comprised 8-mm slice collimation with a pitch of 1 to 1.25; imaging was commenced 20-25 and 65-70 s after the start of injection of 150 ml of contrast medium at 5 ml/s to coincide with hepatic arterial phase (HAP) and PVP contrast enhancement, respectively. Four blinded observers independently reviewed the HAP, PVP and DPCT images recording the site and size of all lesions. Alternative-free response receiver operating characteristic (AFROC) methodology was used to analyse the results, which were correlated with surgery, intra-operative ultrasound and histology. RESULTS: The mean observer sensitivities for malignant lesion detection were 75.3% for DPCT, 69.7% for PVP imaging and 66.7% for HAP imaging alone. There was a statistically significant improvement in malignant lesion detection using DPCT when compared with PVP imaging alone (P < 0.05). The mean areas under the AFROC curves were 0.84 for DPCT and 0.82 for PVP (P < 0.03) imaging alone. CONCLUSION: The detection of colorectal liver metastases was marginally better with DPCT than with PVP imaging alone, but the discovery of additional lesions did not affect the management of any of the patients in this study. Scott, D.J. et al. (2001)

Neutron dosemeter responses in workplace fields and the implications of using realistic neutron calibration fields

International Nuclear Information System (INIS)

Thomas, D.J.; Horwood, N.; Taylor, G.C.

1999-01-01

The use of realistic neutron calibration fields to overcome some of the problems associated with the response functions of presently available dosemeters, both area survey instruments and personal dosemeters, has been investigated. Realistic calibration fields have spectra which, compared to conventional radionuclide source based calibration fields, more closely match those of the workplace fields in which dosemeters are used. Monte Carlo simulations were performed to identify laboratory systems which would produce appropriate workplace-like calibration fields. A detailed analysis was then undertaken of the predicted under- and over-responses of dosemeters in a wide selection of measured workplace field spectra assuming calibration in a selection of calibration fields. These included both conventional radionuclide source calibration fields, and also several proposed realistic calibration fields. The present state of the art for dosemeter performance, and the possibilities of improving accuracy by using realistic calibration fields are both presented. (author)

Nucleon decay in a realistic SO(10) SUSY GUT

International Nuclear Information System (INIS)

Lucas, V.; Raby, S.

1997-01-01

In this paper, we calculate neutron and proton decay rates and branching ratios in a predictive SO(10) SUSY GUT which agrees well with low energy data. We show that the nucleon lifetimes are consistent with the experimental bounds. The nucleon decay rates are calculated using all one-loop chargino and gluino-dressed diagrams regardless of their chiral structure. We show that the four-fermion operator C jk (u R d jR )(d kL ν τL ), commonly neglected in previous nucleon decay calculations, not only contributes significantly to nucleon decay, but, for many values of the initial GUT parameters and for large tanβ, actually dominates the decay rate. As a consequence, we find that τ p /τ n is often substantially larger than the prediction obtained in small tanβ models. We also find that gluino-dressed diagrams, often neglected in nucleon decay calculations, contribute significantly to nucleon decay. In addition we find that the branching ratios obtained from this realistic SO(10) SUSY GUT differ significantly from the predictions obtained from open-quotes genericclose quotes SU(5) SUSY GUT close-quote s. Thus, nucleon decay branching ratios, when observed, can be used to test theories of fermion masses. copyright 1997 The American Physical Society

The prognostic value of irradiated lung volumes on the prediction of intra-/ post-operative mortality in patients after neoadjuvant radiochemotherapy for esophageal cancer. A retrospective multicenter study.

Science.gov (United States)

Kup, Philipp Günther; Nieder, Carsten; Geinitz, Hans; Henkenberens, Christoph; Besserer, Angela; Oechsner, Markus; Schill, Sabine; Mücke, Ralph; Scherer, Vera; Combs, Stephanie E; Adamietz, Irenäus A; Fakhrian, Khashayar

2015-01-01

To assess the association between dosimetric factors of the lung and incidence of intra- and postoperative mortality among esophageal cancer (EC) patients treated with neoadjuvant radiochemotherapy (N-RCT) followed by surgery (S). Inclusion criteria were: age volume histogram (DVH) data. One-hundred thirty-five patients met our inclusion criteria. Median age was 62 years. N-RCT consisted of 36 - 50.4 Gy (median 45 Gy), 1.8 - 2 Gy per fraction. Concomitant chemotherapy consisted of 5-Fluoruracil (5-FU) and cisplatin in 113 patients and cisplatin and taxan-derivates in 15 patients. Seven patients received a single cytotoxic agent. In 130 patients an abdominothoracal and in 5 patients a transhiatal resection was performed. The following dosimetric parameters were generated from the total lung DVH: mean dose, V5, V10, V15, V20, V30, V40, V45 and V50. The primary endpoint was the rate of intra- and postoperative mortality (from the start of N-RCT to 60 days after surgical resection). A total of ten postoperative deaths (7%) were observed: 3 within 30 days (2%) and 7 between 30 and 60 days after surgical intervention (5%); no patient died during the operation. In the univariate analysis, weight loss (≥10% in 6 months prior to diagnosis, risk ratio: 1.60, 95%CI: 0.856-2.992, p=0.043), Eastern Cooperative Oncology Group-performance status (ECOG 2 vs. 1, risk ratio: 1.931, 95%CI: 0.898-4.150, p=0.018) and postoperative pulmonary plus non-pulmonary complications (risk ratio: 2.533, 95%CI: 0.978-6.563, p=0.004) were significantly associated with postoperative mortality. There was no significant association between postoperative mortality and irradiated lung volumes. Lung V45 was the only variable which was significantly associated with higher incidence of postoperative pulmonary plus non-pulmonary complications (Exp(B): 1.285, 95%CI 1.029-1.606, p=0.027), but not with the postoperative pulmonary complications (Exp(B): 1.249, 95%CI 0.999-1.561, p=0.051). Irradiated lung

Traversable intra-Universe wormholes and timeholes in General Relativity: two new solutions

Science.gov (United States)

Smirnov, Alexey L.

2016-11-01

Using thin shell formalism we construct two solutions of intra-Universe wormholes. The first model is a cosmological analog of the Aichelburg-Schein timehole, while another one is an intra-Universe form of the Bronnikov-Ellis solution.

International Management: Creating a More Realistic Global Planning Environment.

Science.gov (United States)

Waldron, Darryl G.

2000-01-01

Discusses the need for realistic global planning environments in international business education, introducing a strategic planning model that has teams interacting with teams to strategically analyze a selected multinational company. This dynamic process must result in a single integrated written analysis that specifies an optimal strategy for…

Ectopic intra-abdominal fascioliasis

OpenAIRE

ÖNGÖREN, Ali Ulvi

2009-01-01

Human fascioliasis, caused by Fasciola hepatica, is emerging as an important chronic zoonotic disease in many areas of the world, including Turkey. It primarily involves the liver and may also cause severe damage in the tissue. Herein we report on a patient with ectopic intra-abdominal fascioliasis that presented to our clinic with abdominal pain and distention. Physical and radiological examination as well as an exploratory laparotomy revealed a 10 × 10-cm mass in the splenic flexura of the ...

Traversable intra-Universe wormholes and timeholes in General Relativity: two new solutions

International Nuclear Information System (INIS)

Smirnov, Alexey L

2016-01-01

Using thin shell formalism we construct two solutions of intra-Universe wormholes. The first model is a cosmological analog of the Aichelburg–Schein timehole, while another one is an intra-Universe form of the Bronnikov–Ellis solution. (paper)

Intra-abdominal fat: Comparison of computed tomography fat segmentation and bioimpedance spectroscopy.

Science.gov (United States)

Finch, Peter

2017-06-01

Intra-abdominal fat is an important factor in determining the metabolic syndrome/insulin resistance, and thus the risk of diabetes and ischaemic heart disease. Computed Tomography (CT) fat segmentation represents a defined method of quantifying intra-abdominal fat, with attendant radiation risks. Bioimpedance spectroscopy may offer a method of assessment without any risks to the patients. A comparison is made of these two methods. This was a preliminary study of the utility of multifrequency bioimpedance spectroscopy of the mid abdomen as a measure of intra-abdominal fat, by comparison with fat segmentation of an abdominal CT scan in the -30 to -190 HU range. There was a significant (P abdominal fat and mid-upper arm circumference, as well as the bioimpedance parameter, the R/S ratio. Multivariate analysis showed that these were the only independant variables and allowed the derivation of a formula to estimate intra-abdominal fat: IAF = 0.02 × MAC - 0.757 × R/S + 0.036. Circumabdominal bioimpedance spectroscopy may prove a useful method of assessing intra-abdominal fat, and may be suitable for use in studies to enhance other measures of body composition, such as mid-upper arm circumference.

EFEK INTRA INDUSTRI, DAMPAK PERUSAHAAN REPORTER DAN NONREPORTER DIVIDEN TERHADAP KANDUNGAN INFORMASI

Directory of Open Access Journals (Sweden)

Emrinaldi Nur DP

2017-03-01

Full Text Available The influence of information not only for company itself which announcement company policy like financialstatement, dividend or others, but also the other company in same industry or same market. The purpose of theresearch was to investigate the information content and intra industry effect of dividend announcement. Theanalysis include four aspects: information content, risk (beta, intra industry effect of dividen by big and smallsize firms, and impact firm characteristics to abnormal return nonreporter firm.The analysis for informationcontent, risk (beta, intra industry effect used event study and for impact of firm characteristics used multiplelinier regressions.Result of this research showed that there was information content around the date of dividendannouncement, but there was no difference between abnormal return by big and small size firms. Thedifference between beta before and after dividend announcement is not significant. The difference between betabig size firms and small size firms after dividend announcement is not significant. The intra industry effect ofdividend announcement showed abnormal return with two effects: competitive effect and contagion effect. Thefirm specific characteristics used in this research were not significant to explain the fenomena intra industry.

Ultra-realistic 3-D imaging based on colour holography

International Nuclear Information System (INIS)

Bjelkhagen, H I

2013-01-01

A review of recent progress in colour holography is provided with new applications. Colour holography recording techniques in silver-halide emulsions are discussed. Both analogue, mainly Denisyuk colour holograms, and digitally-printed colour holograms are described and their recent improvements. An alternative to silver-halide materials are the panchromatic photopolymer materials such as the DuPont and Bayer photopolymers which are covered. The light sources used to illuminate the recorded holograms are very important to obtain ultra-realistic 3-D images. In particular the new light sources based on RGB LEDs are described. They show improved image quality over today's commonly used halogen lights. Recent work in colour holography by holographers and companies in different countries around the world are included. To record and display ultra-realistic 3-D images with perfect colour rendering are highly dependent on the correct recording technique using the optimal recording laser wavelengths, the availability of improved panchromatic recording materials and combined with new display light sources.

Nodular intra-abdominal panniculitis: an accompaniment of colorectal carcinoma and diverticular disease

DEFF Research Database (Denmark)

Bak, Martin

1996-01-01

should not be regarded as a specific nosological entity but merely a result of injury to the fat cells. Intra-abdominal panniculitis is seen more often as a secondary local phenomenon than as a primary condition, and in both cases it is associated with considerable differential diagnostic problems......Intra-abdominal panniculitis is a tumour-like inflammatory condition of adipose tissue. The aetiology and pathogenesis of the disease is unknown, but a number of associated diseases have been recorded. It has been customary to deal with only primary cases in the literature. This study...... was undertaken in order to describe the entire spectrum of the disease including primary as well as secondary cases. Eleven patients are reported, nine of which had an associated colorectal disease in direct continuity with areas of intra-abdominal panniculitis. It is concluded that intra-abdominal panniculitis...

Continuous intra-arterial blood-gas monitoring

Science.gov (United States)

Divers, George A.; Riccitelli, Samuel D.; Blais, Maurice; Hui, Henry K.

1993-05-01

Fiber optic technology and optical fluorescence have made the continuous monitoring of arterial blood gases a reality. Practical products that continuously monitor blood gases by use of an invasive sensor are now available. Anesthesiologists and intensive care physicians are beginning to explore the practical implications of this technology. With the advent of intra- arterial blood gas monitors it is possible to assess arterial blood gas values without the labor intensive steps of drawing blood and transporting a blood sample to the lab followed by the actual analysis. These intra-arterial blood gas monitors use new optical sensor technologies that can be reduced in size to the point that the sensor can be inserted into the arterial blood flow through a 20-gauge arterial cannula. In the best of these technologies the sensors accuracy and precision are similar to those in vitro analyzers. This presentation focuses on background technology and in vivo performance of a device developed, manufactured, and marketed by Puritan-Bennett Corporation.

Understanding how appraisal of doctors produces its effects: a realist review protocol.

Science.gov (United States)

Brennan, Nicola; Bryce, Marie; Pearson, Mark; Wong, Geoff; Cooper, Chris; Archer, Julian

2014-06-23

UK doctors are now required to participate in revalidation to maintain their licence to practise. Appraisal is a fundamental component of revalidation. However, objective evidence of appraisal changing doctors' behaviour and directly resulting in improved patient care is limited. In particular, it is not clear how the process of appraisal is supposed to change doctors' behaviour and improve clinical performance. The aim of this research is to understand how and why appraisal of doctors is supposed to produce its effect. Realist review is a theory-driven interpretive approach to evidence synthesis. It applies realist logic of inquiry to produce an explanatory analysis of an intervention that is, what works, for whom, in what circumstances, in what respects. Using a realist review approach, an initial programme theory of appraisal will be developed by consulting with key stakeholders in doctors' appraisal in expert panels (ethical approval is not required), and by searching the literature to identify relevant existing theories. The search strategy will have a number of phases including a combination of: (1) electronic database searching, for example, EMBASE, MEDLINE, the Cochrane Library, ASSIA, (2) 'cited by' articles search, (3) citation searching, (4) contacting authors and (5) grey literature searching. The search for evidence will be iteratively extended and refocused as the review progresses. Studies will be included based on their ability to provide data that enable testing of the programme theory. Data extraction will be conducted, for example, by note taking and annotation at different review stages as is consistent with the realist approach. The evidence will be synthesised using realist logic to interrogate the final programme theory of the impact of appraisal on doctors' performance. The synthesis results will be written up according to RAMESES guidelines and disseminated through peer-reviewed publication and presentations. The protocol is registered with

Algorithm and Hardware Design of a Fast Intra Frame Mode Decision Module for H.264/AVC Encoders

Directory of Open Access Journals (Sweden)

Daniel Palomino

2012-01-01

Full Text Available In the rate-distortion optimization (RDO, the process of choosing the best prediction mode is performed through exhaustive executions of the whole encoding process, increasing significantly the encoder computational complexity. Considering H.264/AVC intra frame prediction, there are several modes to encode a macroblock (MB. This work proposes an algorithm and the hardware design for a fast intra frame mode decision module for H.264/AVC encoders. The application of the proposed algorithm reduces in more than 10 times the number of encoding iterations for choosing the best intramode when compared with RDO-based decision. The architecture was synthesized to FPGA and achieved an operation frequency of 98 MHz processing more than 300 HD1080p frames per second. With this approach, we achieved one order-of-magnitude performance improvement compared with RDO-based approaches, which is very important not only from the performance but also from the energy consumption perspective for battery-operated devices. In order to compare the architecture with previously published works, we also synthesized it to standard cells. Compared with the best previous results reported, the implemented architecture achieves a complexity reduction of five times, a processing capability increase of 14 times, and a reduction in the number of clock cycles per MB of 11 times.

Intra- and inter-observer agreement in MRI assessment of rotator cuff healing using the Sugaya classification 10years after surgery.

Science.gov (United States)

Niglis, L; Collin, P; Dosch, J-C; Meyer, N; Kempf, J-F

2017-10-01

The long-term outcomes of rotator cuff repair are unclear. Recurrent tears are common, although their reported frequency varies depending on the type and interpretation challenges of the imaging method used. The primary objective of this study was to assess the intra- and inter-observer reproducibility of the MRI assessment of rotator cuff repair using the Sugaya classification 10years after surgery. The secondary objective was to determine whether poor reproducibility, if found, could be improved by using a simplified yet clinically relevant classification. Our hypothesis was that reproducibility was limited but could be improved by simplifying the classification. In a retrospective study, we assessed intra- and inter-observer agreement in interpreting 49 magnetic resonance imaging (MRI) scans performed 10years after rotator cuff repair. These 49 scans were taken at random among 609 cases that underwent re-evaluation, with imaging, for the 2015 SoFCOT symposium on 10-year and 20-year clinical and anatomical outcomes of rotator cuff repair for full-thickness tears. Each of three observers read each of the 49 scans on two separate occasions. At each reading, they assessed the supra-spinatus tendon according to the Sugaya classification in five types. Intra-observer agreement for the Sugaya type was substantial (κ=0.64) but inter-observer agreement was only fair (κ=0.39). Agreement improved when the five Sugaya types were collapsed into two categories (1-2-3 and 4-5) (intra-observer κ=0.74 and inter-observer κ=0.68). Using the Sugaya classification to assess post-operative rotator cuff healing was associated with substantial intra-observer and fair inter-observer agreement. A simpler classification into two categories improved agreement while remaining clinically relevant. II, prospective randomised low-power study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Proteins mediating intra- and intercellular transport of lipids and lipid-modified proteins

NARCIS (Netherlands)

Neumann, S.

2008-01-01

Proteins mediating intra- and intercellular transport of lipids and lipid-modified proteins In this thesis, I studied the intra- and intercellular transport of lipidic molecules, in particular glycosphingolipids and lipid-modified proteins. The first part focuses on the intracellular transport of

Can the rapid identification of mature spermatozoa during microdissection testicular sperm extraction guide operative planning?

Science.gov (United States)

Alrabeeah, K; Doucet, R; Boulet, E; Phillips, S; Al-Hathal, N; Bissonnette, F; Kadoch, I J; Zini, A

2015-05-01

The minimum sperm count and quality that must be identified during microdissection testicular sperm extraction (micro-TESE) to deem the procedure successful remains to be established. We conducted a retrospective study of 81 consecutive men with non-obstructive azoospermia who underwent a primary (first) micro-TESE between March 2007 and October 2013. Final assessment of sperm recovery [reported on the day of (intracytoplasmic sperm injection) ICSI] was recorded as (i) successful (available spermatozoa for ICSI) or (ii) unsuccessful (no spermatozoa for ICSI). The decision to perform a unilateral (with limited or complete microdissection) or bilateral micro-TESE was guided by the intra-operative identification of sperm recovery (≥5 motile or non-motile sperm) from the first testicle. Overall, sperm recovery was successful in 56% (45/81) of the men. A unilateral micro-TESE was performed in 47% (38/81) of the men (based on intra-operative identification of sperm) and in 100% (38/38) of these men, spermatozoa was found on final assessment. In 42% (16/38) of the unilateral cases, a limited microdissection was performed (owing to the rapid intra-operative identification of sperm). The remaining 43 men underwent a bilateral micro-TESE and 16% (7/43) of these men had sperm identified on final assessment. The cumulative ICSI pregnancy rates (per cycle started and per embryo transfer) were 47% (21/45) and 60% (21/35), respectively, with a mean (±SD) of 1.9 ± 1.0 embryos transferred. The data demonstrate that intra-operative assessment of sperm recovery can correctly identify those men that require a unilateral micro-TESE. Moreover, the rapid identification of sperm recovery can allow some men to undergo a limited unilateral micro-TESE and avoid the need for complete testicular microdissection. © 2015 American Society of Andrology and European Academy of Andrology.

LIBERALIZATION AND UNITED STATES’ INTRA-INDUSTRY TRADE

Directory of Open Access Journals (Sweden)

Nuno Carlos Leitão

2012-01-01

Full Text Available The recent trend of globalization has given rise to a new paradigm in international economics, i.e. the simultaneous exports and imports of a product within country or a particular industry called intra-industry trade (IIT or two-way trade. This study examines country-levels determinants of intra-industry trade, in U.S. trade. The manuscript applies a static and dynamic panel data approach. In contrast to previous studies, this paper used a dynamic panel data to solve the problems of serial correlation and endogeneity. The results indicate that IIT occurs more frequently among countries that are similar in terms of factor endowments. We also introduce economic dimension; this proxy confirms the positive effect of IIT. Our results also confirm the hypothesis that trade increases if the transportation costs decrease.

An Intra-Group Perspective on Leader Preferences

DEFF Research Database (Denmark)

Bøggild, Troels; Laustsen, Lasse

2016-01-01

This article argues that followers’ preferences for dominant leadership vary according to two types of exploitation risks from other individuals within the group. Previous work demonstrates that contexts of inter-group war and peace make followers prefer dominant- and non-dominant-looking leaders......, respectively. We add an intra-group perspective to this literature. Four original studies demonstrate that contexts with high risks of free-riding and criminal behavior from other group members (i.e., horizontal exploitation) increase preferences for dominant-looking leaders, whereas contexts with high risks...... of unresponsive, self-interested behavior from leaders themselves (i.e., vertical exploitation) decrease preferences for dominant-looking leaders. Moreover, within this framework of intra-group exploitation risks we show that followers prefer leaders from another vis-à-vis their own ethnic coalition to look less...

Improving Mathematics Teaching in Kindergarten with Realistic Mathematical Education

Science.gov (United States)

Papadakis, Stamatios; Kalogiannakis, Michail; Zaranis, Nicholas

2017-01-01

The present study investigates and compares the influence of teaching Realistic Mathematics on the development of mathematical competence in kindergarten. The sample consisted of 231 Greek kindergarten students. For the implementation of the survey, we conducted an intervention, which included one experimental and one control group. Children in…

Development of realistic thermal hydraulic system analysis code

Energy Technology Data Exchange (ETDEWEB)

Lee, Won Jae; Chung, B. D; Kim, K. D. [and others

2002-05-01

The realistic safety analysis system is essential for nuclear safety research, advanced reactor development, safety analysis in nuclear industry and 'in-house' plant design capability development. In this project, we have developed a best-estimate multi-dimensional thermal-hydraulic system code, MARS, which is based on the integrated version of the RELAP5 and COBRA-TF codes. To improve the realistic analysis capability, we have improved the models for multi-dimensional two-phase flow phenomena and for advanced two-phase flow modeling. In addition, the GUI (Graphic User Interface) feature were developed to enhance the user's convenience. To develop the coupled analysis capability, the MARS code were linked with the three-dimensional reactor kinetics code (MASTER), the core thermal analysis code (COBRA-III/CP), and the best-estimate containment analysis code (CONTEMPT), resulting in MARS/MASTER/COBRA/CONTEMPT. Currently, the MARS code system has been distributed to 18 domestic organizations, including research, industrial, regulatory organizations and universities. The MARS has been being widely used for the safety research of existing PWRs, advanced PWR, CANDU and research reactor, the pre-test analysis of TH experiments, and others.

Development of realistic thermal hydraulic system analysis code

International Nuclear Information System (INIS)

Lee, Won Jae; Chung, B. D; Kim, K. D.

2002-05-01

The realistic safety analysis system is essential for nuclear safety research, advanced reactor development, safety analysis in nuclear industry and 'in-house' plant design capability development. In this project, we have developed a best-estimate multi-dimensional thermal-hydraulic system code, MARS, which is based on the integrated version of the RELAP5 and COBRA-TF codes. To improve the realistic analysis capability, we have improved the models for multi-dimensional two-phase flow phenomena and for advanced two-phase flow modeling. In addition, the GUI (Graphic User Interface) feature were developed to enhance the user's convenience. To develop the coupled analysis capability, the MARS code were linked with the three-dimensional reactor kinetics code (MASTER), the core thermal analysis code (COBRA-III/CP), and the best-estimate containment analysis code (CONTEMPT), resulting in MARS/MASTER/COBRA/CONTEMPT. Currently, the MARS code system has been distributed to 18 domestic organizations, including research, industrial, regulatory organizations and universities. The MARS has been being widely used for the safety research of existing PWRs, advanced PWR, CANDU and research reactor, the pre-test analysis of TH experiments, and others

An inexpensive yet realistic model for teaching vasectomy

Directory of Open Access Journals (Sweden)

Taylor M. Coe

2015-04-01

Full Text Available Purpose Teaching the no-scalpel vasectomy is important, since vasectomy is a safe, simple, and cost-effective method of contraception. This minimally invasive vasectomy technique involves delivering the vas through the skin with specialized tools. This technique is associated with fewer complications than the traditional incisional vasectomy (1. One of the most challenging steps is the delivery of the vas through a small puncture in the scrotal skin, and there is a need for a realistic and inexpensive scrotal model for beginning learners to practice this step. Materials and Methods After careful observation using several scrotal models while teaching residents and senior trainees, we developed a simplified scrotal model that uses only three components–bicycle inner tube, latex tubing, and a Penrose drain. Results This model is remarkably realistic and allows learners to practice a challenging step in the no-scalpel vasectomy. The low cost and simple construction of the model allows wide dissemination of training in this important technique. Conclusions We propose a simple, inexpensive model that will enable learners to master the hand movements involved in delivering the vas through the skin while mitigating the risks of learning on patients.