WorldWideScience

Sample records for replace in-depth analysis

  1. Leak on a steam generator tube: in-depth analysis

    International Nuclear Information System (INIS)

    Berger, J.; Deotto, G.; Mathon, C.; Madurel, A.; Pitner, P.; Gay, N.; Guivarch, M.

    2015-01-01

    A circumferential through crack was observed on a steam generator tube of the unit 2 of the Fessenheim plant. Destructive tests showed that the crack was due to cycle fatigue combined with the presence of inter-granular corrosion zones. An in-depth analysis based on simulations shows that the combination of 5 elements caused the crack. First, a specific position of the anti-vibration bar near this tube, secondly, a local presence of fouling, these 2 first elements led to an increase of the tube vibratory level. Thirdly, the 600 MA alloy used is known to be susceptible to corrosion. Fourthly, the trapping of chemical species on the secondary circuit side due to the presence of interstices on the crosspiece and fifthly, the presence of spots where inter-granular corrosion developed. (A.C.)

  2. It's not about pager replacement: an in-depth look at the interprofessional nature of communication in healthcare.

    Science.gov (United States)

    Quan, Sherman D; Wu, Robert C; Rossos, Peter G; Arany, Teri; Groe, Silvi; Morra, Dante; Wong, Brian M; Cavalcanti, Rodrigo; Coke, William; Lau, Francis Y

    2013-03-01

    Institutions have tried to replace the use of numeric pagers for clinical communication by implementing health information technology (HIT) solutions. However, failing to account for the sociotechnical aspects of HIT or the interplay of technology with existing clinical workflow, culture, and social interactions may create other unintended consequences. To evaluate a Web-based messaging system that allows asynchronous communication between health providers and identify the unintended consequences associated with implementing such technology. Intervention-a Web-based messaging system at the University Health Network to replace numeric paging practices in May 2010. The system facilitated clinical communication on the medical wards for coordinating patient care. Study design-pre-post mixed methods utilizing both quantitative and qualitative measures. Five residents, 8 nurses, 2 pharmacists, and 2 social workers were interviewed. Pre-post interruption-15 residents from 5 clinical teams in both periods. The study compared the type of messages sent to physicians before and after implementation of the Web-based messaging system; a constant comparative analysis of semistructured interviews was used to generate key themes related to unintended consequences. Interruptions increased 233%, from 3 pages received per resident per day pre-implementation to 10 messages received per resident per day post-implementation. Key themes relating to unintended consequences that emerged from the interviews included increase in interruptions, accountability, and tactics to improve personal productivity. Meaningful improvements in clinical communication can occur but require more than just replacing pagers. Introducing HIT without addressing the sociotechnical aspects of HIT that underlie clinical communication can lead to unintended consequences. Copyright © 2013 Society of Hospital Medicine.

  3. In-depth resistome analysis by targeted metagenomics.

    Science.gov (United States)

    Lanza, Val F; Baquero, Fernando; Martínez, José Luís; Ramos-Ruíz, Ricardo; González-Zorn, Bruno; Andremont, Antoine; Sánchez-Valenzuela, Antonio; Ehrlich, Stanislav Dusko; Kennedy, Sean; Ruppé, Etienne; van Schaik, Willem; Willems, Rob J; de la Cruz, Fernando; Coque, Teresa M

    2018-01-15

    Antimicrobial resistance is a major global health challenge. Metagenomics allows analyzing the presence and dynamics of "resistomes" (the ensemble of genes encoding antimicrobial resistance in a given microbiome) in disparate microbial ecosystems. However, the low sensitivity and specificity of available metagenomic methods preclude the detection of minority populations (often present below their detection threshold) and/or the identification of allelic variants that differ in the resulting phenotype. Here, we describe a novel strategy that combines targeted metagenomics using last generation in-solution capture platforms, with novel bioinformatics tools to establish a standardized framework that allows both quantitative and qualitative analyses of resistomes. We developed ResCap, a targeted sequence capture platform based on SeqCapEZ (NimbleGene) technology, which includes probes for 8667 canonical resistance genes (7963 antibiotic resistance genes and 704 genes conferring resistance to metals or biocides), and 2517 relaxase genes (plasmid markers) and 78,600 genes homologous to the previous identified targets (47,806 for antibiotics and 30,794 for biocides or metals). Its performance was compared with metagenomic shotgun sequencing (MSS) for 17 fecal samples (9 humans, 8 swine). ResCap significantly improves MSS to detect "gene abundance" (from 2.0 to 83.2%) and "gene diversity" (26 versus 14.9 genes unequivocally detected per sample per million of reads; the number of reads unequivocally mapped increasing up to 300-fold by using ResCap), which were calculated using novel bioinformatic tools. ResCap also facilitated the analysis of novel genes potentially involved in the resistance to antibiotics, metals, biocides, or any combination thereof. ResCap, the first targeted sequence capture, specifically developed to analyze resistomes, greatly enhances the sensitivity and specificity of available metagenomic methods and offers the possibility to analyze genes

  4. In-Depth Analysis of Citrulline Specific CD4 T-Cells in Rheumatoid Arthritis

    Science.gov (United States)

    2017-01-01

    AWARD NUMBER: W81XWH-15-1-0004 TITLE: In-Depth Analysis of Citrulline-Specific CD4 T - Cells in Rheumatoid Arthritis PRINCIPAL INVESTIGATOR...2016 4. TITLE AND SUBTITLE In-Depth Analysis of Citrulline-Specific CD4 T Cells in Rheumatoid Arthritis 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH...NOTES 14. ABSTRACT The goal of this project is to test the hypothesis that cit-specific CD4 T cells present in rheumatoid arthritis (RA) patients

  5. In-Depth Analysis of Citrulline-Specific CD4 T-Cells in Rheumatoid Arthritis

    Science.gov (United States)

    2016-01-01

    be used to identify and characterize CD4+T cells specific for influenza A, West Nile, Yellow fever , Dengue and Japanese Encephalitis viruses. The...four difference species of Flavivirus using the TGEM approach. These will include: Yellow Fever Virus, West Nile Virus, Dengue Virus and Japanese...1 AWARD NUMBER: W81XWH-15-1-0004 TITLE: In-Depth Analysis of Citrulline-Specific CD4 T-Cells in Rheumatoid Arthritis PRINCIPAL INVESTIGATOR

  6. Collaboration in sensor network research: an in-depth longitudinal analysis of assortative mixing patterns.

    Science.gov (United States)

    Pepe, Alberto; Rodriguez, Marko A

    2010-09-01

    Many investigations of scientific collaboration are based on statistical analyses of large networks constructed from bibliographic repositories. These investigations often rely on a wealth of bibliographic data, but very little or no other information about the individuals in the network, and thus, fail to illustrate the broader social and academic landscape in which collaboration takes place. In this article, we perform an in-depth longitudinal analysis of a relatively small network of scientific collaboration (N = 291) constructed from the bibliographic record of a research centerin the development and application of wireless and sensor network technologies. We perform a preliminary analysis of selected structural properties of the network, computing its range, configuration and topology. We then support our preliminary statistical analysis with an in-depth temporal investigation of the assortative mixing of selected node characteristics, unveiling the researchers' propensity to collaborate preferentially with others with a similar academic profile. Our qualitative analysis of mixing patterns offers clues as to the nature of the scientific community being modeled in relation to its organizational, disciplinary, institutional, and international arrangements of collaboration.

  7. An in-depth longitudinal analysis of mixing patterns in a small scientific collaboration network

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, Marko A [Los Alamos National Laboratory; Pepe, Alberto [UCLA

    2009-01-01

    Many investigations of scientific collaboration are based on large-scale statistical analyses of networks constructed from bibliographic repositories. These investigations often rely on a wealth of bibliographic data, but very little or no other information about the individuals in the network, and thus, fail to illustate the broader social and academic landscape in which collaboration takes place. In this article, we perform an in-depth longitudinal analysis of a small-scale network of scientific collaboration (N = 291) constructed from the bibliographic record of a research center involved in the development and application of sensor network technologies. We perform a preliminary analysis of selected structural properties of the network, computing its range, configuration and topology. We then support our preliminary statistical analysis with an in-depth temporal investigation of the assortativity mixing of these node characteristics: academic department, affiliation, position, and country of origin of the individuals in the network. Our qualitative analysis of mixing patterns offers clues as to the nature of the scientific community being modeled in relation to its organizational, disciplinary, institutional, and international arrangements of collaboration.

  8. Practical In-Depth Analysis of IDS Alerts for Tracing and Identifying Potential Attackers on Darknet

    Directory of Open Access Journals (Sweden)

    Jungsuk Song

    2017-02-01

    Full Text Available The darknet (i.e., a set of unused IP addresses is a very useful solution for observing the global trends of cyber threats and analyzing attack activities on the Internet. Since the darknet is not connected with real systems, in most cases, the incoming packets on the darknet (‘the darknet traffic’ do not contain a payload. This means that we are unable to get real malware from the darknet traffic. This situation makes it difficult for security experts (e.g., academic researchers, engineers, operators, etc. to identify whether the source hosts of the darknet traffic are infected by real malware or not. In this paper, we present the overall procedure of the in-depth analysis between the darknet traffic and IDS alerts using real data collected at the Science and Technology Cyber Security Center (S&T CSC in Korea and provide the detailed in-depth analysis results. The ultimate goal of this paper is to provide practical experience, insight and know-how to security experts so that they are able to identify and trace the root cause of the darknet traffic. The experimental results show that correlation analysis between the darknet traffic and IDS alerts is very useful to discover potential attack hosts, especially internal hosts, and to find out what kinds of malware infected them.

  9. In-depth analysis of accidental criticality in a reprocessing plant

    International Nuclear Information System (INIS)

    Thomas, W.; Gmal, B.

    1989-01-01

    An in-depth-analysis including probabilistic considerations has been performed for a potential criticality excursion in two large vessels in a planned reprocessing plant. Criticality safety of these components is based on limitation of uranium and plutonium concentration. The main intention of this study was to investigate the potential and probable magnitude of a criticality in greater detail and to detect possible weaknesses of criticality safety provisions. The results of the analysis show, that the calculated probability of less than 5 · 10 -4 /a a for a criticality excursion in the most relevant rework tank may be further reduced. The peak power rework tank may be further reduced by design modifications. The peak power and total fissions of the critical excursion as assessed in a preceding analysis for licensing are conservative by factors of 10 and 4, respectively

  10. An in-depth analysis of theoretical frameworks for the study of care coordination

    Directory of Open Access Journals (Sweden)

    Sabine Van Houdt

    2013-06-01

    Full Text Available Introduction: Complex chronic conditions often require long-term care from various healthcare professionals. Thus, maintaining quality care requires care coordination. Concepts for the study of care coordination require clarification to develop, study and evaluate coordination strategies. In 2007, the Agency for Healthcare Research and Quality defined care coordination and proposed five theoretical frameworks for exploring care coordination. This study aimed to update current theoretical frameworks and clarify key concepts related to care coordination. Methods: We performed a literature review to update existing theoretical frameworks. An in-depth analysis of these theoretical frameworks was conducted to formulate key concepts related to care coordination.Results: Our literature review found seven previously unidentified theoretical frameworks for studying care coordination. The in-depth analysis identified fourteen key concepts that the theoretical frameworks addressed. These were ‘external factors’, ‘structure’, ‘tasks characteristics’, ‘cultural factors’, ‘knowledge and technology’, ‘need for coordination’, ‘administrative operational processes’, ‘exchange of information’, ‘goals’, ‘roles’, ‘quality of relationship’, ‘patient outcome’, ‘team outcome’, and ‘(interorganizational outcome’.Conclusion: These 14 interrelated key concepts provide a base to develop or choose a framework for studying care coordination. The relational coordination theory and the multi-level framework are interesting as these are the most comprehensive.

  11. An In-Depth Analysis of Tags and Controlled Metadata for Book Search

    DEFF Research Database (Denmark)

    Bogers, Toine; Petras, Vivien

    2017-01-01

    Book search for information needs that go beyond standard bibliographic data is far from a solved problem. Such complex information needs often cover a combination of di erent aspects, such as specific genres or plot elements, engagement or novelty. By design, subject information in controlled...... vocabularies is not always adequate in covering such complex needs, and social tags have been proposed as an alternative. In this paper we present a large-scale empirical comparison and in-depth analysis of the value of controlled vocabularies and tags for book retrieval using a test collection of over 2....... Finally, we perform a detailed failure analysis and show, using tags and controlled vocabulary terms, that some request types are inherently more di cult to solve than others....

  12. In-Depth Analysis of Simulation Engine Codes for Comparison with DOE s Roof Savings Calculator and Measured Data

    Energy Technology Data Exchange (ETDEWEB)

    New, Joshua Ryan [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Levinson, Ronnen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Huang, Yu [White Box Technologies, Salt Lake City, UT (United States); Sanyal, Jibonananda [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Miller, William A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Mellot, Joe [The Garland Company, Cleveland, OH (United States); Childs, Kenneth W. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Kriner, Scott [Green Metal Consulting, Inc., Macungie, PA (United States)

    2014-06-01

    The Roof Savings Calculator (RSC) was developed through collaborations among Oak Ridge National Laboratory (ORNL), White Box Technologies, Lawrence Berkeley National Laboratory (LBNL), and the Environmental Protection Agency in the context of a California Energy Commission Public Interest Energy Research project to make cool-color roofing materials a market reality. The RSC website and a simulation engine validated against demonstration homes were developed to replace the liberal DOE Cool Roof Calculator and the conservative EPA Energy Star Roofing Calculator, which reported different roof savings estimates. A preliminary analysis arrived at a tentative explanation for why RSC results differed from previous LBNL studies and provided guidance for future analysis in the comparison of four simulation programs (doe2attic, DOE-2.1E, EnergyPlus, and MicroPas), including heat exchange between the attic surfaces (principally the roof and ceiling) and the resulting heat flows through the ceiling to the building below. The results were consolidated in an ORNL technical report, ORNL/TM-2013/501. This report is an in-depth inter-comparison of four programs with detailed measured data from an experimental facility operated by ORNL in South Carolina in which different segments of the attic had different roof and attic systems.

  13. In-depth analysis of the causal factors of incidents reported in the Greek petrochemical industry

    International Nuclear Information System (INIS)

    Konstandinidou, Myrto; Nivolianitou, Zoe; Kefalogianni, Eirini; Caroni, Chrys

    2011-01-01

    This paper presents a statistical analysis of all reported incidents in the Greek petrochemical industry from 1997 to 2003. A comprehensive database has been developed to include industrial accidents (fires, explosions and substance releases), occupational accidents, incidents without significant consequences and near misses. The study concentrates on identifying and analyzing the causal factors related to different consequences of incidents, in particular, injury, absence from work and material damage. Methods of analysis include logistic regression with one of these consequences as dependent variable. The causal factors that are considered cover four major categories related to organizational issues, equipment malfunctions, human errors (of commission or omission) and external causes. Further analyses aim to confirm the value of recording near misses by comparing their causal factors with those of more serious incidents. The statistical analysis highlights the connection between the human factor and the underlying causes of accidents or incidents. - Highlights: → The research work is original, based on field data collected directly from the petrochemical industry. → It deals with the in-depth statistical analysis of accident data on human-organizational causes. → It researches underlying causes of accidents and the parameters affecting them. → The causal factors that are considered cover four big taxonomies. → Near misses are worth recording for comparing their causal factors with more serious incidents.

  14. In-depth analysis of the causal factors of incidents reported in the Greek petrochemical industry

    Energy Technology Data Exchange (ETDEWEB)

    Konstandinidou, Myrto [Institute of Nuclear Technology-Radiation Protection, National Center for Scientific Research ' Demokritos' , Aghia Paraskevi 15310 (Greece); Nivolianitou, Zoe, E-mail: zoe@ipta.demokritos.gr [Institute of Nuclear Technology-Radiation Protection, National Center for Scientific Research ' Demokritos' , Aghia Paraskevi 15310 (Greece); Kefalogianni, Eirini; Caroni, Chrys [School of Applied Mathematical and Physical Sciences, National Technical University of Athens, 9 Iroon Polytexneiou Str., Zografou Campus, 157 80 Athens (Greece)

    2011-11-15

    This paper presents a statistical analysis of all reported incidents in the Greek petrochemical industry from 1997 to 2003. A comprehensive database has been developed to include industrial accidents (fires, explosions and substance releases), occupational accidents, incidents without significant consequences and near misses. The study concentrates on identifying and analyzing the causal factors related to different consequences of incidents, in particular, injury, absence from work and material damage. Methods of analysis include logistic regression with one of these consequences as dependent variable. The causal factors that are considered cover four major categories related to organizational issues, equipment malfunctions, human errors (of commission or omission) and external causes. Further analyses aim to confirm the value of recording near misses by comparing their causal factors with those of more serious incidents. The statistical analysis highlights the connection between the human factor and the underlying causes of accidents or incidents. - Highlights: > The research work is original, based on field data collected directly from the petrochemical industry. > It deals with the in-depth statistical analysis of accident data on human-organizational causes. > It researches underlying causes of accidents and the parameters affecting them. > The causal factors that are considered cover four big taxonomies. > Near misses are worth recording for comparing their causal factors with more serious incidents.

  15. The concept of 'vulnerability' in research ethics: an in-depth analysis of policies and guidelines.

    Science.gov (United States)

    Bracken-Roche, Dearbhail; Bell, Emily; Macdonald, Mary Ellen; Racine, Eric

    2017-02-07

    The concept of vulnerability has held a central place in research ethics guidance since its introduction in the United States Belmont Report in 1979. It signals mindfulness for researchers and research ethics boards to the possibility that some participants may be at higher risk of harm or wrong. Despite its important intended purpose and widespread use, there is considerable disagreement in the scholarly literature about the meaning and delineation of vulnerability, stemming from a perceived lack of guidance within research ethics standards. The aim of this study was to assess the concept of vulnerability as it is employed in major national and international research ethics policies and guidelines. We conducted an in-depth analysis of 11 (five national and six international) research ethics policies and guidelines, exploring their discussions of the definition, application, normative justification and implications of vulnerability. Few policies and guidelines explicitly defined vulnerability, instead relying on implicit assumptions and the delineation of vulnerable groups and sources of vulnerability. On the whole, we found considerable richness in the content on vulnerability across policies, but note that this relies heavily on the structure imposed on the data through our analysis. Our results underscore a need for policymakers to revisit the guidance on vulnerability in research ethics, and we propose that a process of stakeholder engagement would well-support this effort.

  16. Quantitative and qualitative proteome characteristics extracted from in-depth integrated genomics and proteomics analysis

    NARCIS (Netherlands)

    Low, T.Y.; van Heesch, S.; van den Toorn, H.; Giansanti, P.; Cristobal, A.; Toonen, P.; Schafer, S.; Hubner, N.; van Breukelen, B.; Mohammed, S.; Cuppen, E.; Heck, A.J.R.; Guryev, V.

    2013-01-01

    Quantitative and qualitative protein characteristics are regulated at genomic, transcriptomic, and posttranscriptional levels. Here, we integrated in-depth transcriptome and proteome analyses of liver tissues from two rat strains to unravel the interactions within and between these layers. We

  17. Some practical examples of defence in depth analysis for category IV gamma irradiators

    International Nuclear Information System (INIS)

    Rodrigues Junior, Ary de Araujo

    2014-01-01

    The Defence in Depth concept provides a major contribution to the safety philosophy of irradiation facilities. But problems occur when somebody tries to understand or analyse a safety system or develop a new one because there is a lack of practical examples in Safety Series 107 or other IAEA (International Atomic Energy Agency) publications for irradiation facilities. This paper tries to fill this lack of information by providing a series of practical examples and explanations about Defence in Depth concepts. (author)

  18. Some practical examples of defence in depth analysis for category IV gamma irradiators

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigues Junior, Ary de Araujo, E-mail: aryarj@ig.com.br [Universidade Estadual de Maringa (UEM), Maringa, PR (Brazil). Dept. de Fisica

    2014-07-01

    The Defence in Depth concept provides a major contribution to the safety philosophy of irradiation facilities. But problems occur when somebody tries to understand or analyse a safety system or develop a new one because there is a lack of practical examples in Safety Series 107 or other IAEA (International Atomic Energy Agency) publications for irradiation facilities. This paper tries to fill this lack of information by providing a series of practical examples and explanations about Defence in Depth concepts. (author)

  19. What Matters in Weight Loss? An In-Depth Analysis of Self-Monitoring.

    Science.gov (United States)

    Painter, Stefanie Lynn; Ahmed, Rezwan; Hill, James O; Kushner, Robert F; Lindquist, Richard; Brunning, Scott; Margulies, Amy

    2017-05-12

    Using technology to self-monitor body weight, dietary intake, and physical activity is a common practice used by consumers and health companies to increase awareness of current and desired behaviors in weight loss. Understanding how to best use the information gathered by these relatively new methods needs to be further explored. The purpose of this study was to analyze the contribution of self-monitoring to weight loss in participants in a 6-month commercial weight-loss intervention administered by Retrofit and to specifically identify the significant contributors to weight loss that are associated with behavior and outcomes. A retrospective analysis was performed using 2113 participants enrolled from 2011 to 2015 in a Retrofit weight-loss program. Participants were males and females aged 18 years or older with a starting body mass index of ≥25 kg/m2, who also provided a weight measurement at the sixth month of the program. Multiple regression analysis was performed using all measures of self-monitoring behaviors involving weight measurements, dietary intake, and physical activity to predict weight loss at 6 months. Each significant predictor was analyzed in depth to reveal the impact on outcome. Participants in the Retrofit Program lost a mean -5.58% (SE 0.12) of their baseline weight with 51.87% (1096/2113) of participants losing at least 5% of their baseline weight. Multiple regression model (R 2 =.197, Pself-monitoring behaviors of self-weigh-in, daily steps, high-intensity activity, and persistent food logging were significant predictors of weight loss during a 6-month intervention. ©Stefanie Lynn Painter, Rezwan Ahmed, James O Hill, Robert F Kushner, Richard Lindquist, Scott Brunning, Amy Margulies. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 12.05.2017.

  20. Confocal Raman microscopy for in depth analysis in the field of cultural heritage

    Science.gov (United States)

    Lorenzetti, G.; Striova, J.; Zoppi, A.; Castellucci, E. M.

    2011-05-01

    In the field of cultural heritage, the main concern when a sample is analyzed is its safeguard, and this means that non-destructive techniques are required. In this work, we show how confocal Raman microscopy (CRM) may be successfully applied in the study of works of art as a valuable alternative to other well established techniques. CRM with a metallurgical objective was tested for the in depth study of thin samples that are of interest in the field of cultural heritage. The sensitivity of the instrumentation was first evaluated by analyzing single layers of pure polyethylene terephthalate (PET) films having a thickness of 12, 25, and 50 μm, respectively, and a multilayer sample of polypropylene (PP) and polyethylene (PE). Subsequently, the technique was applied to the analysis of historical dyed cotton yarns in order to check whether it was possible to achieve a better discrimination of the fibres' signals for an easier identification. A substantial improvement of the signal to noise ratio was found in the confocal arrangement with respect to the non-confocal one, suggesting the use of this technique for this kind of analysis in the field of cultural heritage. Furthermore, Raman spectroscopy in confocal configuration was exploited in the evaluation of cleaning performed on the mural painting specimens, treated with acrylic resin (Paraloid B72). Confocal Raman experiments were performed before and after laser cleaning (at different conditions) in order to monitor the presence and to approximate the polymer thickness: the method proved to be a valid comparative tool in assessment of cleaning efficiencies.

  1. Bruce NGS a loss of flow analysis for effectiveness of level 2 defence-in-depth provisions

    International Nuclear Information System (INIS)

    Won, W.; Jiang, Y.; Kwee, M.; Xue, J.

    2014-01-01

    The concept of defence-in-depth is applied to CANDU (CANada Deuterium Uranium) reactor designs and operations to provide series of levels of defence to prevent accidents progressing and to provide protection for reactor and public safety. The level 2 defence-in-depth provisions are designed to detect and intercept deviation from normal operation in order to prevent anticipated operating occurrences (AOOs) from escalating to accident conditions, and to return the plant to a state of normal operations, according to the Canada Nuclear Safety Commission (CNSC) regulatory document RD-337. Historically, safety analysis has focused on the effectiveness of level 3 defence-in-depth provisions in accident conditions, and the effectiveness of level 2 defence-in-depth has not been assessed. In this study, the effectiveness of Level 2 defence-in-depth is assessed for loss of flow (LOF) events for Bruce Nuclear Generating Station (NGS) A reactors. The level 2 defence-in-depth in Bruce NGS A design is identified to be the stepback function of reactor regulating system (RRS). The behavior of RRS stepback following the initiation of loss of flow event is simulated using RFSP/TUF/RRS - em coupled code. The behavior of full system and single channel is simulated and assessed against the acceptance criteria - fitness for service of systems, structures and components (SSCs). (author)

  2. Bruce NGS a loss of flow analysis for effectiveness of level 2 defence-in-depth provisions

    Energy Technology Data Exchange (ETDEWEB)

    Won, W. [AMEC NSS, Toronto, ON (Canada); Jiang, Y.; Kwee, M.; Xue, J. [Bruce Power, Toronto, ON (Canada)

    2014-07-01

    The concept of defence-in-depth is applied to CANDU (CANada Deuterium Uranium) reactor designs and operations to provide series of levels of defence to prevent accidents progressing and to provide protection for reactor and public safety. The level 2 defence-in-depth provisions are designed to detect and intercept deviation from normal operation in order to prevent anticipated operating occurrences (AOOs) from escalating to accident conditions, and to return the plant to a state of normal operations, according to the Canada Nuclear Safety Commission (CNSC) regulatory document RD-337. Historically, safety analysis has focused on the effectiveness of level 3 defence-in-depth provisions in accident conditions, and the effectiveness of level 2 defence-in-depth has not been assessed. In this study, the effectiveness of Level 2 defence-in-depth is assessed for loss of flow (LOF) events for Bruce Nuclear Generating Station (NGS) A reactors. The level 2 defence-in-depth in Bruce NGS A design is identified to be the stepback function of reactor regulating system (RRS). The behavior of RRS stepback following the initiation of loss of flow event is simulated using RFSP/TUF/RRS{sub -}em coupled code. The behavior of full system and single channel is simulated and assessed against the acceptance criteria - fitness for service of systems, structures and components (SSCs). (author)

  3. Influence of Enamel Thickness on Bleaching Efficacy: An In-Depth Color Analysis.

    Science.gov (United States)

    Públio, Juliana do Carmo; D'Arce, Maria Beatriz Freitas; Catelan, Anderson; Ambrosano, Gláucia Maria Bovi; Aguiar, Flávio Henrique Baggio; Lovadino, José Roberto; Lima, Débora Alves Nunes Leite

    2016-01-01

    This study evaluated the influence of different enamel thicknesses and bleaching agents on treatment efficacy in-depth by spectrophotometry color analysis. Eighty bovine dental fragments were previously stained in black tea solution and randomly assigned into eight groups (n=10), 1.75mm dentin thickness and different enamel thicknesses as follows: 0.5mm, 1.0mm planned, 1.0mm unplanned (aprismatic enamel), and absence of enamel. The 10% carbamide peroxide (CP) and 35% hydrogen peroxide (HP) bleaching gels were applied on the enamel surface following the manufacturer's recommendations. Color of underlying dentin was evaluated at four times: after staining with tea (baseline) and after each one of the three weeks of bleaching treatment, by CIE L*a*b* system using reflectance spectrophotometer (CM 700d, Konica Minolta). The ΔE, ΔL, Δa, and Δb values were recorded and subjected to repeated measures ANOVA and Tukey's test (α=0.05). The results showed an increase on lightness (L*), with decreased redness (a*) and yellowness (b*). At first and second week, bleaching with CP showed higher whitening effectiveness compared to bleaching with HP and the presence of aprismatic enamel significantly reduced ΔE for bleaching with CP. After three weeks of bleaching, few differences were observed between CP and HP groups, and outer enamel layer caused no influence on bleaching effectiveness. Overall, both at-home and in-office bleaching treatments were effective and the presence of aprismatic enamel did not interfere on the whitening efficacy.

  4. Consideration of sample heterogeneity and in-depth analysis of individual differences in sensory analysis

    DEFF Research Database (Denmark)

    Bavay, Cécile; Brockhoff, Per B.; Kuznetsova, Alexandra

    2014-01-01

    In descriptive sensory analysis, large variations may be observed between scores. Individual differences between assessors have been identified as one cause for these variations. Much work has been done on modeling these differences and accounting for them through analysis of variance (ANOVA). When......, an extended version of the assessor model approach is applied. The data set used in the paper is based on sensory evaluations of three apple samples scored by a panel of 19 assessors using seven descriptors in four replicates. The application of the extended assessor model approach to unbalanced data provides...

  5. Quantitative and Qualitative Proteome Characteristics Extracted from In-Depth Integrated Genomics and Proteomics Analysis

    NARCIS (Netherlands)

    Low, Teck Yew; van Heesch, Sebastiaan; van den Toorn, Henk; Giansanti, Piero; Cristobal, Alba; Toonen, Pim; Schafer, Sebastian; Huebner, Norbert; van Breukelen, Bas; Mohammed, Shabaz; Cuppen, Edwin; Heck, Albert J. R.; Guryev, Victor

    2013-01-01

    Quantitative and qualitative protein characteristics are regulated at genomic, transcriptomic, and post-transcriptional levels. Here, we integrated in-depth transcriptome and proteome analyses of liver tissues from two rat strains to unravel the interactions within and between these layers. We

  6. In-Depth Analysis of Handwriting Curriculum and Instruction in Four Kindergarten Classrooms

    Science.gov (United States)

    Vander Hart, Nanho; Fitzpatrick, Paula; Cortesa, Cathryn

    2010-01-01

    The quality of handwriting curriculum and instructional practices in actual classrooms was investigated in an in-depth case study of four inner city kindergarten classrooms using quantitative and qualitative methods. The handwriting proficiency of students was also evaluated to assess the impact of the instructional practices observed. The…

  7. Dutch in-depth accident investigation: first experiences and analysis results for motorcycles and mopeds

    NARCIS (Netherlands)

    Mooi, H.G.; Galliano, F.

    2001-01-01

    In September 1999 the Dutch Accident Research Team (DART) within TNO Automotive started with the in-depth investigation of traffic accidents. In this paper, the methodology, working procedures and experiences of the team are described and explained in detail. Furthermore, an elaborate description of

  8. In-Depth Analysis of Human Neonatal and Adult IgM Antibody Repertoires

    Directory of Open Access Journals (Sweden)

    Binbin Hong

    2018-02-01

    Full Text Available Although high-throughput sequencing and associated bioinformatics technologies have enabled the in-depth, sequence-based characterization of human immune repertoires, only a few studies on a relatively small number of sequences explored the characteristics of antibody repertoires in neonates, with contradictory conclusions. To gain a more comprehensive understanding of the human IgM antibody repertoire, we performed Illumina sequencing and IMGT/HighV-QUEST analysis of IgM heavy chain repertoire of the B lymphocytes from the cord blood (CB of neonates, as well as the repertoire from peripheral blood of healthy human adults (HH. The comparative study revealed unexpectedly high levels of similarity between the neonatal and adult repertoires. In both repertoires, the VDJ gene usage showed no significant difference, and the most frequently used VDJ gene was IGHV4-59, IGHD3-10, and IGHJ3. The average amino acid (aa length of CDR1 (CB: 8.5, HH: 8.4 and CDR2 (CB: 7.6, HH: 7.5, as well as the aa composition and the average hydrophobicity of the CDR3 demonstrated no significant difference between the two repertories. However, the average aa length of CDR3 was longer in the HH repertoire than the CB repertoire (CB: 14.5, HH: 15.5. Besides, the frequencies of aa mutations in CDR1 (CB: 19.33%, HH: 25.84% and CDR2 (CB: 9.26%, HH: 17.82% were higher in the HH repertoire compared to the CB repertoire. Interestingly, the most prominent difference between the two repertoires was the occurrence of N2 addition (CB: 64.87%, HH: 85.69%, a process that occurs during V-D-J recombination for introducing random nucleotide additions between D- and J-gene segments. The antibody repertoire of healthy adults was more diverse than that of neonates largely due to the higher occurrence of N2 addition. These findings may lead to a better understanding of antibody development and evolution pathways and may have potential practical value for facilitating the generation of more

  9. Team Regulation in a Simulated Medical Emergency: An In-Depth Analysis of Cognitive, Metacognitive, and Affective Processes

    Science.gov (United States)

    Duffy, Melissa C.; Azevedo, Roger; Sun, Ning-Zi; Griscom, Sophia E.; Stead, Victoria; Crelinsten, Linda; Wiseman, Jeffrey; Maniatis, Thomas; Lachapelle, Kevin

    2015-01-01

    This study examined the nature of cognitive, metacognitive, and affective processes among a medical team experiencing difficulty managing a challenging simulated medical emergency case by conducting in-depth analysis of process data. Medical residents participated in a simulation exercise designed to help trainees to develop medical expertise,…

  10. Defense In-Depth Accident Analysis Evaluation of Tritium Facility Bldgs. 232-H, 233-H, and 234-H

    International Nuclear Information System (INIS)

    Blanchard, A.

    1999-01-01

    'The primary purpose of this report is to document a Defense-in-Depth (DID) accident analysis evaluation for Department of Energy (DOE) Savannah River Site (SRS) Tritium Facility Buildings 232-H, 233-H, and 234-H. The purpose of a DID evaluation is to provide a more realistic view of facility radiological risks to the offsite public than the bounding deterministic analysis documented in the Safety Analysis Report, which credits only Safety Class items in the offsite dose evaluation.'

  11. Replacement

    Directory of Open Access Journals (Sweden)

    S. Radhakrishnan

    2014-03-01

    Full Text Available The fishmeal replaced with Spirulina platensis, Chlorella vulgaris and Azolla pinnata and the formulated diet fed to Macrobrachium rosenbergii postlarvae to assess the enhancement ability of non-enzymatic antioxidants (vitamin C and E, enzymatic antioxidants (superoxide dismutase (SOD and catalase (CAT and lipid peroxidation (LPx were analysed. In the present study, the S. platensis, C. vulgaris and A. pinnata inclusion diet fed groups had significant (P < 0.05 improvement in the levels of vitamins C and E in the hepatopancreas and muscle tissue. Among all the diets, the replacement materials in 50% incorporated feed fed groups showed better performance when compared with the control group in non-enzymatic antioxidant activity. The 50% fishmeal replacement (best performance diet fed groups taken for enzymatic antioxidant study, in SOD, CAT and LPx showed no significant increases when compared with the control group. Hence, the present results revealed that the formulated feed enhanced the vitamins C and E, the result of decreased level of enzymatic antioxidants (SOD, CAT and LPx revealed that these feeds are non-toxic and do not produce any stress to postlarvae. These ingredients can be used as an alternative protein source for sustainable Macrobrachium culture.

  12. THE IMPACT OF IFRS ON REPORTING FOR BUSINESS COMBINATIONS: AN IN-DEPTH ANALYSIS USING THE TELECOMMUNICATIONS INDUSTRY

    Directory of Open Access Journals (Sweden)

    Cunningham Garry M.

    2011-07-01

    Full Text Available The mandatory use of IFRS by all publicly listed companies in the European Union created challenges for accounting and reporting of business combinations, goodwill impairment and disclosures for these items. Major issues are allocation of amounts to goodwill and specific intangible assets arising from acquisition. This study presents an in-depth exploration of compliance with IFRS 3 and IAS 36 using content analysis methodology of annual reports of eight European telecommunications that were chose because the industry is well known for significant acquisitions involving intangibles. The results show only partial compliance with little change over the four year period since mandatory IFRS adoption. While results cannot be generalized outside this group, the in-depth analysis yielded important insights for continued research using broader research methods.

  13. Local in-depth analysis of ceramic materials by neutral beam secondary ion mass spectrometry

    International Nuclear Information System (INIS)

    Borchardt, G.; Scherrer, H.; Weber, S.; Scherrer, S.

    1980-01-01

    Local microanalysis of non-conducting surfaces by means of modern physical methods which use charged low-energy primary particles brings about severe problems because of the electrostatic charge accumulated on the sample surface. This is also true of secondary ion mass spectrometry (SIMS) where ions are usually used as primary particles. In the present work the basic features for production of neutral primary beams in commercial SIMS instruments by a simple technique are described. With suitably high sputtering rates, surface analyses and in-depth profiles can be made in reasonable measuring times. Results are given for chemical concentration distributions in the near-surface regions of an oxide glass and for the isotopic diffusion of Si-30 in a crystalline silicate with olivine structure (Co 2 SiO 4 ). (orig.)

  14. Defense In-Depth Accident Analysis Evaluation of Tritium Facility Bldgs. 232-H, 233-H, and 234-H

    Energy Technology Data Exchange (ETDEWEB)

    Blanchard, A.

    1999-05-10

    'The primary purpose of this report is to document a Defense-in-Depth (DID) accident analysis evaluation for Department of Energy (DOE) Savannah River Site (SRS) Tritium Facility Buildings 232-H, 233-H, and 234-H. The purpose of a DID evaluation is to provide a more realistic view of facility radiological risks to the offsite public than the bounding deterministic analysis documented in the Safety Analysis Report, which credits only Safety Class items in the offsite dose evaluation.'

  15. Wind wave analysis in depth limited water using OCEANLYZ, A MATLAB toolbox

    Science.gov (United States)

    Karimpour, Arash; Chen, Qin

    2017-09-01

    There are a number of well established methods in the literature describing how to assess and analyze measured wind wave data. However, obtaining reliable results from these methods requires adequate knowledge on their behavior, strengths and weaknesses. A proper implementation of these methods requires a series of procedures including a pretreatment of the raw measurements, and adjustment and refinement of the processed data to provide quality assurance of the outcomes, otherwise it can lead to untrustworthy results. This paper discusses potential issues in these procedures, explains what parameters are influential for the outcomes and suggests practical solutions to avoid and minimize the errors in the wave results. The procedure of converting the water pressure data into the water surface elevation data, treating the high frequency data with a low signal-to-noise ratio, partitioning swell energy from wind sea, and estimating the peak wave frequency from the weighted integral of the wave power spectrum are described. Conversion and recovery of the data acquired by a pressure transducer, particularly in depth-limited water like estuaries and lakes, are explained in detail. To provide researchers with tools for a reliable estimation of wind wave parameters, the Ocean Wave Analyzing toolbox, OCEANLYZ, is introduced. The toolbox contains a number of MATLAB functions for estimation of the wave properties in time and frequency domains. The toolbox has been developed and examined during a number of the field study projects in Louisiana's estuaries.

  16. In-depth proteomic analysis of banana (Musa spp.) fruit with combinatorial peptide ligand libraries.

    Science.gov (United States)

    Esteve, Clara; D'Amato, Alfonsina; Marina, María Luisa; García, María Concepción; Righetti, Pier Giorgio

    2013-01-01

    Musa ssp. is among the world's leading fruit crops. Although a strong interest on banana biochemistry exists in the scientific community, focused on metabolite composition, proteins have been scarcely investigated even if they play an important role in food allergy and stability, are a source of biologically active peptides, and can provide information about nutritional aspects of this fruit. In this work we have employed the combinatorial peptide ligand libraries after different types of protein extractions, for searching the very low-abundance proteins in banana. The use of advanced MS techniques and Musa ssp. mRNAs database in combination with the Uniprot_viridiplantae database allowed us to identify 1131 proteins. Among this huge amount of proteins we found several already known allergens such as Mus a 1, pectinesterase, superoxide dismutase, and potentially new allergens. Additionally several enzymes involved in degradation of starch granules and strictly correlated to ripening stage were identified. This is the first in-depth exploration of the banana fruit proteome and one of the largest descriptions of the proteome of any vegetable system. © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  17. Idiosyncratic Presentation of Cemento-Osseous Dysplasia - An in Depth Analysis Using Cone Beam Computed Tomography.

    Science.gov (United States)

    Chennoju, Sai Kiran; Pachigolla, Ramaswamy; Govada, Vanya Mahitha; Alapati, Satish; Balla, Smitha

    2016-05-01

    Bone dysplasias comprise of a condition where the normal bone is replaced with fibrous tissue. Periapical Cemento-Osseous Dysplasia (PCOD) is a benign fibro-osseous condition where bone tissue is supplanted with fibrous tissue and cementum-like material. This condition affects mostly mandibular anterior region and rarely occurs in the maxilla. PCOD is seen above 30 years of age and has slight female predilection. Generally the teeth related to such lesions appear to be vital and are usually asymptomatic. These lesions are mostly seen during routine radiographic examination whose presentation may vary from complete radiolucency to dense radiopacity. The advent of Cone Beam Computed Tomography (CBCT) has brought a massive change in the field of dentistry which has become an important tool for diagnosis. Hence we hereby present an unusual case of cemento-osseous dysplasia in an unfamiliar location with an atypical presentation. The shape of the pathology was completely idiosyncratic and different from an orthodox lesion of COD, as the lesion was observed to grow out of the palatal surface with a prominent palatal expansion. This case highlights the importance of CBCT in radiographic diagnosis and in evaluating the characteristics of such lesion, which present with high diagnostic dilemma.

  18. In-depth motivic analysis based on multiparametric closed pattern and cyclic sequence mining

    DEFF Research Database (Denmark)

    Lartillot, Olivier

    2014-01-01

    presents a much simpler description and justification of this general strategy, as well as significant simplifications of the model, in particular concerning the management of pattern cyclicity. A new method for automated bundling of patterns belonging to same motivic or thematic classes is also presented....... The good performance of the method is shown through the analysis of a piece from the JKUPDD database. Ground-truth motives are detected, while additional relevant information completes the ground-truth musicological analysis. The system, implemented in Matlab, is made publicly available as part of Mining......Suite, a new open-source framework for audio and music analysis....

  19. In-depth analysis of nitrogen flow in urban system in Low Income ...

    African Journals Online (AJOL)

    The discharged nitrogen degrades the urban environment and increases human ... To address sustainable mitigation measures, three resource recovery ... for environmental risk mitigation and improved agriculture by nutrient recovery. ... Urban Waste Management; Monte Carlo simulation, Côte d'Ivoire, Sensitivity analysis ...

  20. Female entrepreneurship in rural Uganda : a poverty trap analysis based on in-depth interviews

    NARCIS (Netherlands)

    Romijn, H.A.; Kyejjusa, S.

    2017-01-01

    Rural female entrepreneurs in sub-Saharan Africa are less privileged and often have limited resources and edification. Poverty traps analysis on rural female entrepreneurs in food processing in Uganda focused on identifying and explaining the existence of low well-being “basins of attraction”.

  1. In-depth analysis of the adipocyte proteome by mass spectrometry and bioinformatics

    DEFF Research Database (Denmark)

    Adachi, Jun; Kumar, Chanchal; Zhang, Yanling

    2007-01-01

    , mitochondria, membrane, and cytosol of 3T3-L1 adipocytes. We identified 3,287 proteins while essentially eliminating false positives, making this one of the largest high confidence proteomes reported to date. Comprehensive bioinformatics analysis revealed that the adipocyte proteome, despite its specialized...

  2. Effect-directed analysis supporting monitoring of aquatic environments — An in-depth overview

    NARCIS (Netherlands)

    Brack, W.; Ait-Aissa, S.; Burgess, R.M.; Creusot, N.; Di Paolo, C.; Escher, B.I.; Hewitt, L.M.; Hilscherova, K.; Hollender, J.; Hollert, H.; Jonker, W.; Kool, J.; Lamoree, M.H.; Muschket, M.; Neumann, S.; Rostkowski, P.; Ruttkies, C.; Schollee, J.; Schymanski, E.L.; Schulze, T.; Seiler, T.; Tindall, A.J.; De Aragão Umbuzeiro, G.; Vrana, B.; Krauss, M.

    2016-01-01

    Aquatic environments are often contaminated with complex mixtures of chemicals that may pose a risk to ecosystems and human health. This contamination cannot be addressed with target analysis alone but tools are required to reduce this complexity and identify those chemicals that might cause adverse

  3. Quantitative Analysis of Human Pluripotency and Neural Specification by In-Depth (PhosphoProteomic Profiling

    Directory of Open Access Journals (Sweden)

    Ilyas Singec

    2016-09-01

    Full Text Available Controlled differentiation of human embryonic stem cells (hESCs can be utilized for precise analysis of cell type identities during early development. We established a highly efficient neural induction strategy and an improved analytical platform, and determined proteomic and phosphoproteomic profiles of hESCs and their specified multipotent neural stem cell derivatives (hNSCs. This quantitative dataset (nearly 13,000 proteins and 60,000 phosphorylation sites provides unique molecular insights into pluripotency and neural lineage entry. Systems-level comparative analysis of proteins (e.g., transcription factors, epigenetic regulators, kinase families, phosphorylation sites, and numerous biological pathways allowed the identification of distinct signatures in pluripotent and multipotent cells. Furthermore, as predicted by the dataset, we functionally validated an autocrine/paracrine mechanism by demonstrating that the secreted protein midkine is a regulator of neural specification. This resource is freely available to the scientific community, including a searchable website, PluriProt.

  4. In-depth analysis of low abundant proteins in bovine colostrum using different fractionation techniques

    DEFF Research Database (Denmark)

    Nissen, Asger; Bendixen, Emøke; Ingvartsen, Klaus Lønne

    2012-01-01

    Bovine colostrum is well known for its large content of bioactive components and its importance for neonatal survival. Unfortunately, the colostrum proteome is complicated by a wide dynamic range, because of a few dominating proteins that hamper sensitivity and proteome coverage achieved on low...... abundant proteins. Moreover, the composition of colostrum is complex and the proteins are located within different physical fractions that make up the colostrum. To gain a more exhaustive picture of the bovine colostrum proteome and gather information on protein location, we performed an extensive pre......-analysis fractionation of colostrum prior to 2D-LC-MS/MS analysis. Physical and chemical properties of the proteins and colostrum were used alone or in combination for the separation of proteins. ELISA was used to quantify and verify the presence of proteins in colostrum. In total, 403 proteins were identified...

  5. In-Depth Modeling of the UNIX Operating System for Architectural Cyber Security Analysis

    OpenAIRE

    Vernotte, Alexandre; Johnson, Pontus; Ekstedt, Mathias; Lagerström, Robert

    2017-01-01

    ICT systems have become an integral part of business and life. At the same time, these systems have become extremely complex. In such systems exist numerous vulnerabilities waiting to be exploited by potential threat actors. pwnPr3d is a novel modelling approach that performs automated architectural analysis with the objective of measuring the cyber security of the modeled architecture. Its integrated modelling language allows users to model software and hardware components with great level o...

  6. Effect-directed analysis supporting monitoring of aquatic environments--An in-depth overview.

    Science.gov (United States)

    Brack, Werner; Ait-Aissa, Selim; Burgess, Robert M; Busch, Wibke; Creusot, Nicolas; Di Paolo, Carolina; Escher, Beate I; Mark Hewitt, L; Hilscherova, Klara; Hollender, Juliane; Hollert, Henner; Jonker, Willem; Kool, Jeroen; Lamoree, Marja; Muschket, Matthias; Neumann, Steffen; Rostkowski, Pawel; Ruttkies, Christoph; Schollee, Jennifer; Schymanski, Emma L; Schulze, Tobias; Seiler, Thomas-Benjamin; Tindall, Andrew J; De Aragão Umbuzeiro, Gisela; Vrana, Branislav; Krauss, Martin

    2016-02-15

    Aquatic environments are often contaminated with complex mixtures of chemicals that may pose a risk to ecosystems and human health. This contamination cannot be addressed with target analysis alone but tools are required to reduce this complexity and identify those chemicals that might cause adverse effects. Effect-directed analysis (EDA) is designed to meet this challenge and faces increasing interest in water and sediment quality monitoring. Thus, the present paper summarizes current experience with the EDA approach and the tools required, and provides practical advice on their application. The paper highlights the need for proper problem formulation and gives general advice for study design. As the EDA approach is directed by toxicity, basic principles for the selection of bioassays are given as well as a comprehensive compilation of appropriate assays, including their strengths and weaknesses. A specific focus is given to strategies for sampling, extraction and bioassay dosing since they strongly impact prioritization of toxicants in EDA. Reduction of sample complexity mainly relies on fractionation procedures, which are discussed in this paper, including quality assurance and quality control. Automated combinations of fractionation, biotesting and chemical analysis using so-called hyphenated tools can enhance the throughput and might reduce the risk of artifacts in laboratory work. The key to determining the chemical structures causing effects is analytical toxicant identification. The latest approaches, tools, software and databases for target-, suspect and non-target screening as well as unknown identification are discussed together with analytical and toxicological confirmation approaches. A better understanding of optimal use and combination of EDA tools will help to design efficient and successful toxicant identification studies in the context of quality monitoring in multiply stressed environments. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. In-depth analysis of eight criteria for integrated leakage rate tests for nuclear power plant containment buildings

    International Nuclear Information System (INIS)

    Wagner, W.T.; Langan, J.P.; Norris, W.F.; Lurie, D.

    1989-01-01

    A U.S. Nuclear Regulatory Commission (NRC) Small Business Innovation research (SBIR) Contract investigated ten integrated leakage rate test (ILRT) analysis models which have been proposed for evaluation of ILRT data. This contract involved in-depth analysis of two ILRTs with data collected at accelerated rates and 80 conventional ILRTs with data collected at a frequency between 10-15 minutes. All ten methods were applied to all data. The study considered the appropriateness of each method to analyze containment data (air mass versus time), the influence of data collection frequency on ILRT duration, and the influence of collection frequency on each method. The study is described in the paper. Results are presented

  8. International review of Kursk unit 1 in-depth safety analysis report

    International Nuclear Information System (INIS)

    Chouha, M.; Bolshov, L.; Butcher, P.; Janke, R.; Parsons, T.; Weber, J.P.

    2004-01-01

    The paper presents the objectives, organisation, main findings and conclusions of the international review of the Kursk unit 1 safety analysis report (K1IRSR). The K1IRSR was administered by RISKAUDIT IRSN/GRS international and carried out by international experts from 7 western countries plus the Russian Federation, under the supervision of the safety review group (SRG) of the European bank for reconstruction and development (EBRD). The project was financed by the nuclear safety account (NSA) administered by the EBRD. The Russian experts worked under a contract with IBRAE financed by Rosenergoatom. The main conclusions were that the SAR followed a correct approach, broadly in line with Russian and international guidance documents, but needed improvement in structure and content. It established that the safety level of the unit has been increased significantly by the modernisation programme. The important deviations of the unit from current Russian regulations and the IAEA safety issues for RBMK are either fully resolved or are being addressed to the extent possible by compensatory measures to further reduce the risk. The K1IRSR experts have made a number of recommendations for improvement of the K1SAR. The authors agreed to take the recommendations into account in future revision of the K1SAR. (orig.)

  9. In-depth analysis of the chicken egg white proteome using an LTQ Orbitrap Velos

    Directory of Open Access Journals (Sweden)

    Mann Matthias

    2011-02-01

    Full Text Available Abstract Background Hen's egg white has been the subject of intensive chemical, biochemical and food technological research for many decades, because of its importance in human nutrition, its importance as a source of easily accessible model proteins, and its potential use in biotechnological processes. Recently the arsenal of tools used to study the protein components of egg white has been complemented by mass spectrometry-based proteomic technologies. Application of these fast and sensitive methods has already enabled the identification of a large number of new egg white proteins. Recent technological advances may be expected to further expand the egg white protein inventory. Results Using a dual pressure linear ion trap Orbitrap instrument, the LTQ Orbitrap Velos, in conjunction with data analysis in the MaxQuant software package, we identified 158 proteins in chicken egg white with two or more sequence unique peptides. This group of proteins identified with very high confidence included 79 proteins identified in egg white for the first time. In addition, 44 proteins were identified tentatively. Conclusions Our results, apart from identifying many new egg white components, indicate that current mass spectrometry technology is sufficiently advanced to permit direct identification of minor components of proteomes dominated by a few major proteins without resorting to indirect techniques, such as chromatographic depletion or peptide library binding, which change the composition of the proteome.

  10. Understanding product cost vs. performance through an in-depth system Monte Carlo analysis

    Science.gov (United States)

    Sanson, Mark C.

    2017-08-01

    The manner in which an optical system is toleranced and compensated greatly affects the cost to build it. By having a detailed understanding of different tolerance and compensation methods, the end user can decide on the balance of cost and performance. A detailed phased approach Monte Carlo analysis can be used to demonstrate the tradeoffs between cost and performance. In complex high performance optical systems, performance is fine-tuned by making adjustments to the optical systems after they are initially built. This process enables the overall best system performance, without the need for fabricating components to stringent tolerance levels that often can be outside of a fabricator's manufacturing capabilities. A good performance simulation of as built performance can interrogate different steps of the fabrication and build process. Such a simulation may aid the evaluation of whether the measured parameters are within the acceptable range of system performance at that stage of the build process. Finding errors before an optical system progresses further into the build process saves both time and money. Having the appropriate tolerances and compensation strategy tied to a specific performance level will optimize the overall product cost.

  11. In-depth analysis of subclass-specific conformational preferences of IgG antibodies

    Directory of Open Access Journals (Sweden)

    Xinsheng Tian

    2015-01-01

    Full Text Available IgG subclass-specific differences in biological function and in vitro stability are often referred to variations in the conformational flexibility, while this flexibility has rarely been characterized. Here, small-angle X-ray scattering data from IgG1, IgG2 and IgG4 antibodies, which were designed with identical variable regions, were thoroughly analysed by the ensemble optimization method. The extended analysis of the optimized ensembles through shape clustering reveals distinct subclass-specific conformational preferences, which provide new insights for understanding the variations in physical/chemical stability and biological function of therapeutic antibodies. Importantly, the way that specific differences in the linker region correlate with the solution structure of intact antibodies is revealed, thereby visualizing future potential for the rational design of antibodies with designated physicochemical properties and tailored effector functions. In addition, this advanced computational approach is applicable to other flexible multi-domain systems and extends the potential for investigating flexibility in solutions of macromolecules by small-angle X-ray scattering.

  12. An in-depth analysis of original antigenic sin in dengue virus infection.

    Science.gov (United States)

    Midgley, Claire M; Bajwa-Joseph, Martha; Vasanawathana, Sirijitt; Limpitikul, Wannee; Wills, Bridget; Flanagan, Aleksandra; Waiyaiya, Emily; Tran, Hai Bac; Cowper, Alison E; Chotiyarnwong, Pojchong; Chotiyarnwon, Pojchong; Grimes, Jonathan M; Yoksan, Sutee; Malasit, Prida; Simmons, Cameron P; Mongkolsapaya, Juthathip; Screaton, Gavin R

    2011-01-01

    The evolution of dengue viruses has resulted in four antigenically similar yet distinct serotypes. Infection with one serotype likely elicits lifelong immunity to that serotype, but generally not against the other three. Secondary or sequential infections are common, as multiple viral serotypes frequently cocirculate. Dengue infection, although frequently mild, can lead to dengue hemorrhagic fever (DHF) which can be life threatening. DHF is more common in secondary dengue infections, implying a role for the adaptive immune response in the disease. There is currently much effort toward the design and implementation of a dengue vaccine but these efforts are made more difficult by the challenge of inducing durable neutralizing immunity to all four viruses. Domain 3 of the dengue virus envelope protein (ED3) has been suggested as one such candidate because it contains neutralizing epitopes and it was originally thought that relatively few cross-reactive antibodies are directed to this domain. In this study, we performed a detailed analysis of the anti-ED3 response in a cohort of patients suffering either primary or secondary dengue infections. The results show dramatic evidence of original antigenic sin in secondary infections both in terms of binding and enhancement activity. This has important implications for dengue vaccine design because heterologous boosting is likely to maintain the immunological footprint of the first vaccination. On the basis of these findings, we propose a simple in vitro enzyme-linked immunosorbent assay (ELISA) to diagnose the original dengue infection in secondary dengue cases.

  13. Dissecting the determinants of depressive disorders outcome: an in depth analysis of two clinical cases

    Directory of Open Access Journals (Sweden)

    Oasi Osmano

    2007-02-01

    Full Text Available Abstract Clinicians face everyday the complexity of depression. Available pharmacotherapies and psychotherapies improve patients suffering in a large part of subjects, however up to half of patients do not respond to treatment. Clinicians may forecast to a good extent if a given patient will respond or not, based on a number of data and sensations that emerge from face to face assessment. Conversely, clinical predictors of non response emerging from literature are largely unsatisfactory. Here we try to fill this gap, suggesting a comprehensive assessment of patients that may overcome the limitation of standardized assessments and detecting the factors that plausibly contribute to so marked differences in depressive disorders outcome. For this aim we present and discuss two clinical cases. Mr. A was an industrial manager who came to psychiatric evaluation with a severe depressive episode. His employment was demanding and the depressive episode undermined his capacity to manage it. Based on standardized assessment, Mr. A condition appeared severe and potentially dramatic. Mrs. B was a housewife who came to psychiatric evaluation with a moderate depressive episode. Literature predictors would suggest Mrs. B state as associated with a more favourable outcome. However the clinician impression was not converging with the standardized assessment and in fact the outcome will reverse the prediction based on the initial formal standard evaluation. Although the present report is based on two clinical cases and no generalizability is possible, a more detailed analysis of personality, temperament, defense mechanisms, self esteem, intelligence and social adjustment may allow to formalize the clinical impressions used by clinicians for biologic and pharmacologic studies.

  14. The quality of Internet advertising in aesthetic surgery: an in-depth analysis.

    Science.gov (United States)

    Wong, Wendy W; Camp, Matthew C; Camp, Jennifer S; Gupta, Subhas C

    2010-09-01

    The aesthetic market is a growing business, as evidenced by the American Society for Aesthetic Plastic Surgery (ASAPS) reporting an increase of 147% in the number of cosmetic procedures performed by members since 1997. This market is consumer-oriented, relying heavily on advertising for survival amid the increasing provider competition. The authors evaluate trends, ethics, and efficacy of Internet advertising in aesthetic surgery. Medical cosmetic providers in Southern California and their Web sites were catalogued through sales lists from manufacturers (Medicis and Allergan) and combined with advertised providers of surgical treatments. Using the ASAPS/American Society of Aesthetic Plastic Surgeons (ASPS) and American Medical Association Codes of Ethics as guidelines, scores were assigned to each Web site and evaluated with the provider's board certification. A geographical analysis determined whether the presence of high numbers of competitors had an impact on the adherence to ethical guidelines for advertising. To examine patient preferences in physician advertising, a survey was conducted online. Board-certified plastic surgeons showed the highest total ethical scores, followed by otolaryngologists, oromaxillofacial surgeons, and ophthalmologists. No decrement in the quality of the advertising was found in densely competitive environments. A consistent correlation was found between superior compliance with ethical guidelines and board certification in plastic surgery. The patient preference survey of 208 individuals demonstrated their desire for a well-trained, board-certified plastic surgeon to perform their cosmetic procedures. Although plastic surgeons demonstrate greater overall compliance with the ASAPS/ASPS Advertising Code of Ethics, they can continue to improve. With the large variety of cosmetic physicians offering the same procedures, maintaining open, honest, and forthright communication with the public is essential.

  15. In-depth diversity analysis of the bacterial community resident in the camel rumen.

    Science.gov (United States)

    Gharechahi, Javad; Zahiri, Hossein Shahbani; Noghabi, Kambiz Akbari; Salekdeh, Ghasem Hosseini

    2015-02-01

    The rumen compartment of the ruminant digestive tract is an enlarged fermentation chamber which houses a diverse collection of symbiotic microorganisms that provide the host animal with a remarkable ability to digest plant lignocellulosic materials. Characterization of the ruminal microbial community provides opportunities to improve animal food digestion efficiency, mitigate methane emission, and develop efficient fermentation systems to convert plant biomasses into biofuels. In this study, 16S rRNA gene amplicon pyrosequencing was applied in order to explore the structure of the bacterial community inhabiting the camel rumen. Using 76,333 quality-checked, chimera- and singleton-filtered reads, 4954 operational taxonomic units (OTUs) were identified at a 97% species level sequence identity. At the phylum level, more than 96% of the reads were affiliated to OTUs belonging to Bacteroidetes (51%), Firmicutes (31%), Proteobacteria (4.8%), Spirochaetes (3.5%), Fibrobacteres (3.1%), Verrucomicrobia (2.7%), and Tenericutes (0.95%). A total of 15% of the OTUs (746) that contained representative sequences from all major taxa were shared by all animals and they were considered as candidate members of the core camel rumen microbiome. Analysis of microbial composition through the solid and liquid fractions of rumen digesta revealed differential enrichment of members of Fibrobacter, Clostridium, Ruminococcus, and Treponema in the solid fraction, as well as members of Prevotella, Verrucomicrobia, Cyanobacteria, and Succinivibrio in the liquid fraction. The results clearly showed that the camel rumen microbiome was structurally similar but compositionally distinct from that of other ruminants, such as the cow. The unique characteristic of the camel rumen microbiome that differentiated it from those of other ruminants was the significant enrichment for cellulolytic bacteria. Copyright © 2014. Published by Elsevier GmbH.

  16. In depth analysis of motivational factors at work in the health industry

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2010-01-01

    Full Text Available Background: Motivation of health workers is necessary to generate the organizational commitment towards the patients and the hospital and therefore the knowledge about what motivates and satisfies them is very essential.The aim of the project was to investigate and analyze the various factors that help in motivation of the health workers while performing their clinical duties in the hospital. Materials and Methods: A simple random study was conducted among 100 employees of our institute, which included doctors, staff nurses and paramedical staff. One hundred employees from Gian Sagar Institute were chosen randomly for the purpose of our study. All the employees were enquired by the questionnaire method as well as by individual interviews regarding the various motivating and demotivating factors at the work place. Detailed enquiries were performed regarding the various aspects concerning the job factors and work satisfaction. All the answers and findings were observed and recorded. Results: Statistical Analysis Used: Simple non-parametric tests like mean, percentages and chi square tests were employed to analyze the data.The demographic profile of all the employees showed only minor differences which were statistically non-significant. Skills, task identity, task significance, autonomy, feedback, environment, job security and compensation were observed to be the important factors for the motivation of employees. The depth and the extent to which these factors were studied at work in the hospital showed remarkable differences. Conclusion: All the factors studied in this project are essential basis for organizational commitment, but feedback represents the factor with the highest motivation potential especially among the younger population.

  17. In Depth Analysis of AVCOAT TPS Response to a Reentry Flow

    International Nuclear Information System (INIS)

    Titov, E. V.; Kumar, Rakesh; Levin, D. A.

    2011-01-01

    Modeling of the high altitude portion of reentry vehicle trajectories with DSMC or statistical BGK solvers requires accurate evaluation of the boundary conditions at the ablating TPS surface. Presented in this article is a model which takes into account the complex ablation physics including the production of pyrolysis gases, and chemistry at the TPS surface. Since the ablation process is time dependent the modeling of the material response to the high energy reentry flow starts with the solution of the rarefied flow over the vehicle and then loosely couples with the material response. The objective of the present work is to carry out conjugate thermal analysis by weakly coupling a flow solver to a material thermal response model. The latter model solves the one dimensional heat conduction equation accounting for the pyrolysis process that takes place in the reaction zone of an ablative thermal protection system (TPS) material. An estimate of the temperature range within which the pyrolysis reaction (decomposition and volatilization) takes place is obtained from Ref. [1]. The pyrolysis reaction results in the formation of char and the release of gases through the porous charred material. These gases remove additional amount of heat as they pass through the material, thus cooling the material (the process known as transpiration cooling). In the present work, we incorporate the transpiration cooling model in the material thermal response code in addition to the pyrolysis model. The flow in the boundary layer and in the vicinity of the TPS material is in the transitional flow regime. Therefore, we use a previously validated statistical BGK method to model the flow physics in the vicinity of the micro-cracks, since the BGK method allows simulations of flow at pressures higher than can be computed using DSMC.

  18. In-depth proteome analysis of the rubber particle of Hevea brasiliensis (para rubber tree).

    Science.gov (United States)

    Dai, Longjun; Kang, Guijuan; Li, Yu; Nie, Zhiyi; Duan, Cuifang; Zeng, Rizhong

    2013-05-01

    The rubber particle is a special organelle in which natural rubber is synthesised and stored in the laticifers of Hevea brasiliensis. To better understand the biological functions of rubber particles and to identify the candidate rubber biosynthesis-related proteins, a comprehensive proteome analysis was performed on H. brasiliensis rubber particles using shotgun tandem mass spectrometry profiling approaches-resulting in a thorough report on the rubber particle proteins. A total of 186 rubber particle proteins were identified, with a range in relative molecular mass of 3.9-194.2 kDa and in isoelectric point values of 4.0-11.2. The rubber particle proteins were analysed for gene ontology and could be categorised into eight major groups according to their functions: including rubber biosynthesis, stress- or defence-related responses, protein processing and folding, signal transduction and cellular transport. In addition to well-known rubber biosynthesis-related proteins such as rubber elongation factor (REF), small rubber particle protein (SRPP) and cis-prenyl transferase (CPT), many proteins were firstly identified to be on the rubber particles, including cyclophilin, phospholipase D, cytochrome P450, small GTP-binding protein, clathrin, eukaryotic translation initiation factor, annexin, ABC transporter, translationally controlled tumour protein, ubiquitin-conjugating enzymes, and several homologues of REF, SRPP and CPT. A procedure of multiple reaction monitoring was established for further protein validation. This comprehensive proteome data of rubber particles would facilitate investigation into molecular mechanisms of biogenesis, self-homeostasis and rubber biosynthesis of the rubber particle, and might serve as valuable biomarkers in molecular breeding studies of H. brasiliensis and other alternative rubber-producing species.

  19. Mosaicism in segmental darier disease: an in-depth molecular analysis quantifying proportions of mutated alleles in various tissues

    DEFF Research Database (Denmark)

    Harboe, Theresa Larriba; Willems, Patrick; Jespersgaard, Cathrine

    2011-01-01

    Darier disease is an autosomal dominant genodermatosis caused by germline mutations in the ATP2A2 gene. Clinical expression is variable, including rare segmental phenotypes thought to be caused by postzygotic mosaicism. Genetic counseling of segmental Darier patients is complex, as risk of transm......Darier disease is an autosomal dominant genodermatosis caused by germline mutations in the ATP2A2 gene. Clinical expression is variable, including rare segmental phenotypes thought to be caused by postzygotic mosaicism. Genetic counseling of segmental Darier patients is complex, as risk...... of transmitting a nonsegmental phenotype to offspring is of unknown magnitude. We present the first in-depth molecular analysis of a mosaic patient with segmental disease, quantifying proportions of mutated and normal alleles in various tissues. Pyrosequence analysis of DNA from semen, affected and normal skin......, peripheral leukocytes and hair revealed an uneven distribution of the mutated allele, from 14% in semen to 37% in affected skin. We suggest a model for segmental manifestation expression where a threshold number of mutated cells is needed for manifestation development. We further recommend molecular analysis...

  20. Guidelines on the defense-in-depth and diversity planning and analysis in digital instrumentation and control systems

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Se Woo; Park, Jong Kyun; Lee, Ki Young; Kwon, Ki Choon; Lee, Jang Soo; Kim, Jang Yeol

    2000-08-01

    Digital instrumentation and control (I and C) systems are becoming an ever-increasing part in I and C systems of nuclear power plants due to such features such as versatility, flexibility, and reduced sizes. The digital technology introduces a possibility that common-cause or common-mode failures (CCF or CMF) may cause redundant safety systems to fail in such a way that there is loss of safety function. A special form of CMF analysis called 'defense-in-depth and diversity' (D-in-D and D) analysis has been developed to identify possible common-mode failure vulnerabilities and to support a specific licensing action in digital systems. There are two main stages in D-in-D and D activities: both plan and analysis. The purposes of this technical report are (i) to review background of D-in-D and D and some of important issues in digital D-in-D and D, (ii) to provide guidelines for a vendor to prepare planning and/or analysis documents on D-in-D and D, and (iii) to provide guidelines for an evaluator to review applicant's D-in-D and D planning and/or analysis documents, to ensure that the requirements of the D-in-D and D for digital I and C systems are followed. Most of guidelines suggested in this report were based on NUREG/CR-6303 which was published in 1994. The report will be helpful for a vendor to prepare and for an evaluator to review both D-in-D and D planning or analysis documents for digital I and C systems such as the KNGR project.

  1. Guidelines on the defense-in-depth and diversity planning and analysis in digital instrumentation and control systems

    International Nuclear Information System (INIS)

    Cheon, Se Woo; Park, Jong Kyun; Lee, Ki Young; Kwon, Ki Choon; Lee, Jang Soo; Kim, Jang Yeol

    2000-08-01

    Digital instrumentation and control (I and C) systems are becoming an ever-increasing part in I and C systems of nuclear power plants due to such features such as versatility, flexibility, and reduced sizes. The digital technology introduces a possibility that common-cause or common-mode failures (CCF or CMF) may cause redundant safety systems to fail in such a way that there is loss of safety function. A special form of CMF analysis called 'defense-in-depth and diversity' (D-in-D and D) analysis has been developed to identify possible common-mode failure vulnerabilities and to support a specific licensing action in digital systems. There are two main stages in D-in-D and D activities: both plan and analysis. The purposes of this technical report are i) to review background of D-in-D and D and some of important issues in digital D-in-D and D, ii) to provide guidelines for a vendor to prepare planning and/or analysis documents on D-in-D and D, and iii) to provide guidelines for an evaluator to review applicant's D-in-D and D planning and/or analysis documents, to ensure that the requirements of the D-in-D and D for digital I and C systems are followed. Most of guidelines suggested in this report were based on NUREG/CR-6303 which was published in 1994. The report will be helpful for a vendor to prepare and for an evaluator to review both D-in-D and D planning or analysis documents for digital I and C systems such as the KNGR project

  2. Covering Risks in the Public Administration – an In-Depth Analysis of the Regulatory Changes in Romania

    Directory of Open Access Journals (Sweden)

    Madalina Cocosatu

    2011-05-01

    Full Text Available The paper aims at analyzing in a trans-disciplinary manner the institutional and functional changesof the public administration under crisis. The current analysis looks in depth of the financial, economic, and,more importantly, social crisis in relation to the reforms imposed by both the internal and externalstakeholders. The decision-makers have not taken into account the risk factors, triggering legislativeincoherence and instability due to the challenging and approval as non-constitutional of many such normativeacts by the Romanian Constitutional Court. The research objectives search to clear up the measures’coherence in the context of a declining public budget and a negative growth period, when the shrunk publicfunds need to be properly allocated. Therefore, the answer that our research is looking for should pertain tothe following concern: can the government’s actions be considered solutions to the problems raised by thecurrent context? The answers shall aim at both restoring the legal and economic balance, as defined in theworking hypothesis. The lax fiscal policy of the expenditures brings about an involuntary fiscal contraction inthe event of an economic downturn (Rosen and Gayer, 2010, as it was the case in Romania. Those lack ofprudence shall be addressed in our analysis, with specific reference to the already established literatureexplanations involving the decision-makers trust in the „good days shall be around forever”, which triggers abelief that the expenditures’ expansion can be permanent. Regarding the paper methodology, this study isproceeding via bibliographical research, so that the reasoning behind the paper is clearly underlined as thisresearch is actually triggered by the radical changes made by both legislatures and practitioners as a responseto crisis. Further, the manuscript makes use of direct observation and legislative analysis and extensivedocumentary research of national tax policy and statistics relevant

  3. Hip Replacement Surgery

    Science.gov (United States)

    ... Outreach Initiative Breadcrumb Home Health Topics English Español Hip Replacement Surgery Basics In-Depth Download Download EPUB ... PDF What is it? Points To Remember About Hip Replacement Surgery Hip replacement surgery removes damaged or ...

  4. Replacement Energy Cost Analysis Package (RECAP): User's guide. Revision 1

    International Nuclear Information System (INIS)

    VanKuiken, J.C.; Willing, D.L.

    1994-07-01

    A microcomputer program called the Replacement Energy Cost Analysis Package (RECAP) has been developed to assist the US Nuclear Regulatory Commission (NRC) in determining the replacement energy costs associated with short-term shutdowns or deratings of one or more nuclear reactors. The calculations are based on the seasonal, unit-specific cost estimates for 1993--1996 previously published in NRC Report NUREG/CR--4012, Vol. 3 (1992), for all 112 US reactors. Because the RECAP program is menu-driven, the user can define specific case studies in terms of such parameters as the units to be included, the length and timing of the shutdown or derating period, the unit capacity factors, and the reference year for reporting cost results. In addition to simultaneous shutdown cases, more complicated situations, such as overlapping shutdown periods or shutdowns that occur in different years, can be examined through the use of a present-worth calculation option

  5. A Cost Analysis of Kidney Replacement Therapy Options in Palestine

    Directory of Open Access Journals (Sweden)

    Mustafa Younis Ph.D.

    2015-03-01

    Full Text Available This study provides a cost analysis of kidney replacement therapy options in Palestine. It informs evidence-based resource allocation decisions for government-funded kidney disease services where transplant donors are limited, and some of the common modalities, i.e., peritoneal dialysis (PD and home hemodialysis (HD, are not widely available due to shortages of qualified staff, specialists, and centers to follow the patient cases, provide training, make home visits, or provide educational programs for patients. The average cost of kidney transplant was US$16 277 for the first year; the estimated cost of HD per patient averaged US$16 085 per year—nearly as much as a transplant. Consistent with prior literature and experience, while live, related kidney donors are scarce, we found that kidney transplant was more adequate and less expensive than HD. These results have direct resource allocation implications for government-funded kidney disease services under Palestinian Ministry of Health. Our findings strongly suggest that investing in sufficient qualified staff, equipment, and clinical infrastructure to replace HD services with transplantation whenever medically indicated and suitable kidney donors are available, as well as deploying PD programs and Home HD programs, will result in major overall cost savings. Our results provide a better understanding of the costs of kidney disease and will help to inform Ministry of Health and related policy makers as they develop short- and long-term strategies for the population, in terms of both cost savings and enhanced quality of life.

  6. Idiosyncratic Presentation of Cemento-Osseous Dysplasia – An in Depth Analysis Using Cone Beam Computed Tomography

    OpenAIRE

    Chennoju, Sai Kiran; Pachigolla, Ramaswamy; Govada, Vanya Mahitha; Alapati, Satish; Balla, Smitha

    2016-01-01

    Bone dysplasias comprise of a condition where the normal bone is replaced with fibrous tissue. Periapical Cemento-Osseous Dysplasia (PCOD) is a benign fibro-osseous condition where bone tissue is supplanted with fibrous tissue and cementum-like material. This condition affects mostly mandibular anterior region and rarely occurs in the maxilla. PCOD is seen above 30 years of age and has slight female predilection. Generally the teeth related to such lesions appear to be vital and are usually a...

  7. Discrete-continuous analysis of optimal equipment replacement

    OpenAIRE

    YATSENKO, Yuri; HRITONENKO, Natali

    2008-01-01

    In Operations Research, the equipment replacement process is usually modeled in discrete time. The optimal replacement strategies are found from discrete (or integer) programming problems, well known for their analytic and computational complexity. An alternative approach is represented by continuous-time vintage capital models that explicitly involve the equipment lifetime and are described by nonlinear integral equations. Then the optimal replacement is determined via the opt...

  8. Gait analysis after successful mobile bearing total ankle replacement.

    NARCIS (Netherlands)

    Doets, H.C.; van Middelkoop, M.; Houdijk, J.H.P.; Nelissen, R.G.; Veeger, H.E.J.

    2007-01-01

    Background: The effect of total ankle replacement on gait is not fully known in terms of joint kinematics, ground reaction force, and activity of the muscles of the lower leg. Methods: A comparative gait study was done in 10 patients after uneventful unilateral mobile-bearing total ankle replacement

  9. Idiosyncratic Presentation of Cemento-Osseous Dysplasia – An in Depth Analysis Using Cone Beam Computed Tomography

    Science.gov (United States)

    Pachigolla, Ramaswamy; Govada, Vanya Mahitha; Alapati, Satish; Balla, Smitha

    2016-01-01

    Bone dysplasias comprise of a condition where the normal bone is replaced with fibrous tissue. Periapical Cemento-Osseous Dysplasia (PCOD) is a benign fibro-osseous condition where bone tissue is supplanted with fibrous tissue and cementum-like material. This condition affects mostly mandibular anterior region and rarely occurs in the maxilla. PCOD is seen above 30 years of age and has slight female predilection. Generally the teeth related to such lesions appear to be vital and are usually asymptomatic. These lesions are mostly seen during routine radiographic examination whose presentation may vary from complete radiolucency to dense radiopacity. The advent of Cone Beam Computed Tomography (CBCT) has brought a massive change in the field of dentistry which has become an important tool for diagnosis. Hence we hereby present an unusual case of cemento-osseous dysplasia in an unfamiliar location with an atypical presentation. The shape of the pathology was completely idiosyncratic and different from an orthodox lesion of COD, as the lesion was observed to grow out of the palatal surface with a prominent palatal expansion. This case highlights the importance of CBCT in radiographic diagnosis and in evaluating the characteristics of such lesion, which present with high diagnostic dilemma. PMID:27437374

  10. Defence in depth perspectives

    International Nuclear Information System (INIS)

    Veneau, Tania; Ferrier, Agnes; Barbaud, Jean

    2017-01-01

    The Defence in Depth (DiD) concept was introduced to the field of nuclear safety in the sixties and early seventies. Even though it was not well developed at the beginning, the principles rapidly became close to those currently used. The concept was then composed of 3 levels, and was already associated with operating conditions. These principles have progressed over time and now there are five levels, including progressively situations issued from design extension conditions, to cope with severe accidents and dealing with accident management off-site. Indeed, human and organizational features are considered as a part of the safety provisions at all levels in an integrated approach that is not just related to reactor design. That's the current vision from IAEA, addressed first in INSAG 3 then in INSAG 10, and in the IAEA standards requirements currently addressed by SSR-2/1 superseding NS-R-1). These five levels of DiD are also referred to in other texts including WENRA documents in Europe, but also in the national requirements from different countries. Thus, the application of DiD principle has become a recognized international practice. The 2011 Fukushima Daiichi accidents, even if they raised many questions on nuclear safety issues, confirmed the merits of the DiD concept. Indeed, lessons learned from the accidents have reinforced the use of the DiD concept to ensure adequate safety. The discussions focused more on the implementation of the concept (how it has been or can be used in practice) than the concept itself, and in particular on the following subjects: the notion of level robustness, generally addressed separately from the levels definition, but playing an important role for the efficiency of the concept; the notion of levels independence and the need for strengthening them; the role of diversity to achieve levels independence. However, a prescription of additional diversity and independence across all safety levels could result in inappropriately

  11. The role of the safety analysis organization in steam generators replacement and reactor vessel head replacement evaluations

    International Nuclear Information System (INIS)

    Choe, Whee G.; Boatwright, W.J.

    2004-01-01

    When a major component in a nuclear power plant is replaced, especially the steam generators, the plant operator is presented a rare opportunity to learn from operating experience and significantly improve the performance, reliability and robustness of the plant. In addition to the use of improved materials, improved design margins can be built into the component specification that can later be used to provide meaningful operating margins. A Safety Analysis organization that is well-integrated with other plant organizations and possesses a detailed knowledge of the plant design and licensing bases can effectively balance the wants and needs of each organization to optimize the benefits realized by the plant as a whole. Knowledge of the assumptions, limitations, and available margins, both analytical and operating, can be used to specify a replacement steam generator design that optimizes costs and operating improvements. The work scope required to support the new design can be controlled through carefully selected and evaluated restrictions in operations, development of alternate operating strategies, and imposition of appropriate limitations. The important point is that the effective Safety Analysis organization must possess both the breadth and depth of knowledge of the plant design and operations and proactively use this information to support the replacement steam generator project. (author)

  12. In-Depth Analysis of Energy Efficiency Related Factors in Commercial Buildings Using Data Cube and Association Rule Mining

    Directory of Open Access Journals (Sweden)

    Byeongjoon Noh

    2017-11-01

    Full Text Available Significant amounts of energy are consumed in the commercial building sector, resulting in various adverse environmental issues. To reduce energy consumption and improve energy efficiency in commercial buildings, it is necessary to develop effective methods for analyzing building energy use. In this study, we propose a data cube model combined with association rule mining for more flexible and detailed analysis of building energy consumption profiles using the Commercial Buildings Energy Consumption Survey (CBECS dataset, which has accumulated over 6700 existing commercial buildings across the U.S.A. Based on the data cube model, a multidimensional commercial sector building energy analysis was performed based upon on-line analytical processing (OLAP operations to assess the energy efficiency according to building factors with various levels of abstraction. Furthermore, the proposed analysis system provided useful information that represented a set of energy efficient combinations by applying the association rule mining method. We validated the feasibility and applicability of the proposed analysis model by structuring a building energy analysis system and applying it to different building types, weather conditions, composite materials, and heating/cooling systems of the multitude of commercial buildings classified in the CBECS dataset.

  13. In-depth statistical analysis of the use of a website providing patients' narratives on lifestyle change when living with chronic back pain or coronary heart disease.

    Science.gov (United States)

    Schweier, Rebecca; Grande, Gesine; Richter, Cynthia; Riedel-Heller, Steffi G; Romppel, Matthias

    2018-07-01

    To investigate the use of lebensstil-aendern.de ("lifestyle change"), a website providing peer narratives of experiences with successful lifestyle change, and to analyze whether peer model characteristics, clip content, and media type have an influence on the number of visitors, dwell time, and exit rates. An in-depth statistical analysis of website use with multilevel regression analyses. In two years, lebensstil-aendern.de attracted 12,844 visitors. The in-depth statistical analysis of usage rates demonstrated that audio clips were less popular than video or text-only clips, longer clips attracted more visitors, and clips by younger and female interviewees were preferred. User preferences for clip content categories differed between heart and back pain patients. Clips about stress management drew the smallest numbers of visitors in both indication modules. Patients are interested in the experiences of others. Because the quality of information for user-generated content is generally low, healthcare providers should include quality-assured patient narratives in their interventions. User preferences for content, medium, and peer characteristics need to be taken into account. If healthcare providers decide to include patient experiences in their websites, they should plan their intervention according to the different needs and preferences of users. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Competitive Advantage or Market Saturation: An In-Depth Comparison of Flash-Sale Sites Through Content Analysis

    OpenAIRE

    Aday, J. B.; Phelan, K. V.

    2015-01-01

    This study aims to identify the representativeness of hospitality and service industry firms on flash-sale sites such as Groupon and LivingSocial. Currently, academic findings related to the frequency of offerings from these firms are nonexistent. This research relied upon a content analysis rubric and daily measurement of offerings from randomly selected cities represented by Groupon and LivingSocial for a period of 6 weeks. The daily offerings for specific cities on the Groupon and LivingSo...

  15. In-Depth, Label-Free Analysis of the Erythrocyte Cytoplasmic Proteome in Diamond Blackfan Anemia Identifies a Unique Inflammatory Signature.

    Directory of Open Access Journals (Sweden)

    Esther N Pesciotta

    Full Text Available Diamond Blackfan Anemia (DBA is a rare, congenital erythrocyte aplasia that is usually caused by haploinsufficiency of ribosomal proteins due to diverse mutations in one of several ribosomal genes. A striking feature of this disease is that a range of different mutations in ribosomal proteins results in similar disease phenotypes primarily characterized by erythrocyte abnormalities and macrocytic anemia, while most other cell types in the body are minimally affected. Previously, we analyzed the erythrocyte membrane proteomes of several DBA patients and identified several proteins that are not typically associated with this cell type and that suggested inflammatory mechanisms contribute to the pathogenesis of DBA. In this study, we evaluated the erythrocyte cytosolic proteome of DBA patients through in-depth analysis of hemoglobin-depleted erythrocyte cytosols. Simple, reproducible, hemoglobin depletion using nickel columns enabled in-depth analysis of over 1000 cytosolic erythrocyte proteins with only moderate total analysis time per proteome. Label-free quantitation and statistical analysis identified 29 proteins with significantly altered abundance levels in DBA patients compared to matched healthy control donors. Proteins that were significantly increased in DBA erythrocyte cytoplasms included three proteasome subunit beta proteins that make up the immunoproteasome and proteins induced by interferon-γ such as n-myc interactor and interferon-induced 35 kDa protein [NMI and IFI35 respectively]. Pathway analysis confirmed the presence of an inflammatory signature in erythrocytes of DBA patients and predicted key upstream regulators including mitogen activated kinase 1, interferon-γ, tumor suppressor p53, and tumor necrosis factor. These results show that erythrocytes in DBA patients are intrinsically different from those in healthy controls which may be due to an inflammatory response resulting from the inherent molecular defect of ribosomal

  16. Determinants of child stunting in the Royal Kingdom of Bhutan: an in-depth analysis of nationally representative data

    Science.gov (United States)

    Aguayo, Victor M; Badgaiyan, Nina; Paintal, Kajali

    2015-01-01

    Stunting is associated with poor survival and development in children. Our analysis identifies the factors most significantly associated with child stunting in Bhutan using a nationally representative sample of 2085 children 0–23 months old. We find that 27.5% of children were stunted and almost half (42.6%) of the stunted children were severely stunted. Children's mean height-for-age z-score deteriorated significantly with age (from −0.23 in infants 0–5 months old to −1.60 in children 18–23 months old) and levels of severe stunting were significantly higher among boys. Multivariate regression analysis indicates that children from the Eastern/Western regions had a 64% higher odds of being stunted than children from the Central region (OR 1.64; 95% CI 1.29–2.07); similarly, children from the two lower wealth quintiles had 37% higher odds of being stunted than children from the two upper wealth quintiles (OR 1.37; 95% CI 1.00–1.87). Children whose mothers received three or fewer antenatal care visits during the last pregnancy had a 31% higher odds of being stunted (OR 1.31; 95% CI 1.01–1.69) while children whose mothers did not receive antenatal care from a doctor, nurse or midwife had a 51% higher odds of being stunted (OR 1.51; 95% CI 1.18–1.92). Recommended complementary feeding practices tended to be associated with lower odds of stunting, particularly in the first year of life. Specifically, children who were not fed complementary foods at 6–8 months had about threefold higher odds of being severely stunted than children who were fed complementary foods (OR 2.73; 95% CI 1.06–7.02). PMID:25536283

  17. Breastfeeding initiation: An in-depth qualitative analysis of the perspectives of women and midwives using Social Cognitive Theory.

    Science.gov (United States)

    Edwards, M E; Jepson, R G; McInnes, R J

    2018-02-01

    to explore women's and midwives' expectations, knowledge and experiences of breastfeeding initiation using Social Cognitive Theory. a qualitative study using focus group discussions and individual interviews. Breastfeeding initiation was defined for this study as a process within the first 48hours after birth. Data were analysed using qualitative inductive analysis then further deductive analysis using Social Cognitive Theory (SCT). a purposefully selected sample of primigravid antenatal and postnatal women (n=18) and practising midwives (n=18) from one Health Board area in Scotland. attachment of the baby to the breast at birth was hindered by sleepy babies and the busy unfamiliar hospital environment. These resulted in mothers struggling to maintain their motivation to breastfeed and to develop low self-efficacy. Instinctive attachment was rare. Midwives who considered it was normal for babies to be sleepy and unable to attach or feed at birth did not facilitate instinctive baby behaviour. Midwives sometimes experienced lack of autonomy and environmental circumstances that made women centred care difficult. Furthermore caring for high numbers of women, dependent on their help, resulted in reduced self-efficacy for providing effective breastfeeding support. interviewing both women and midwives specifically about initiation of breastfeeding has allowed for deeper insights into this critical period and enabled a comparison between the data obtained from mothers and midwives. The findings suggest that instinctive attachment is not an expectation of either mothers or midwives and results in a loss of breastfeeding confidence in both. to facilitate initiation there is a need for more research to develop appropriate maternal and midwifery skills, and make changes to the cultural environment in hospitals. Social Cognitive Theory could be used as a framework in both the antenatal and immediate postnatal period to develop strategies and materials to increase women's and

  18. Confronting hip resurfacing and big femoral head replacement gait analysis

    Directory of Open Access Journals (Sweden)

    Panagiotis K. Karampinas

    2014-03-01

    Full Text Available Improved hip kinematics and bone preservation have been reported after resurfacing total hip replacement (THRS. On the other hand, hip kinematics with standard total hip replacement (THR is optimized with large diameter femoral heads (BFH-THR. The purpose of this study is to evaluate the functional outcomes of THRS and BFH-THR and correlate these results to bone preservation or the large femoral heads. Thirty-one patients were included in the study. Gait speed, postural balance, proprioception and overall performance. Our results demonstrated a non-statistically significant improvement in gait, postural balance and proprioception in the THRS confronting to BFH-THR group. THRS provide identical outcomes to traditional BFH-THR. The THRS choice as bone preserving procedure in younger patients is still to be evaluated.

  19. Financial Analysis for Replacement of Construction Equipment in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Ali Shash

    2012-11-01

    Full Text Available This study report results of a survey conducted in the EasternProvince of Saudi Arabia to explore the procedures and financialtechniques that large-size contractors utilise in replacingequipment. The results indicated that contractors set severalreplacement alternatives that they evaluate by using a set ofvarious qualitative and quantitative factors. The contractors’business objectives, employee safety and morale, and, contractors’image in the industry were found to be the most influentialqualitative factors affecting the decision of equipment replacement.Inflation, downtime, obsolescence, salvage value, and depreciationare among the top quantitative factors that contractors considerwhile making a decision to replace equipment. Because of theirsimplicity and practicality, the net present value, payback period,and the economic life are the most popular techniques that areutilised for analysing the financial issues of proposed replacementalternatives.

  20. Institutional Strength in Depth

    International Nuclear Information System (INIS)

    Weightman, M.

    2016-01-01

    Much work has been undertaken in order to identify, learn and implement the lessons from the TEPCO Fukushima Daiichi nuclear accident. These have mainly targeted on engineering or operational lessons. Less attention has been paid to the institutional lessons, although there have been some measures to improve individual peer reviews, particularly by the World Association of Nuclear Operators, and the authoritative IAEA report published in 2015 brought forward several important lessons for regulators and advocated a system approach. The report noted that one of the contributing factors the accident was the tendency of stakeholders not to challenge. Additionally, it reported deficiencies in the regulatory authority and system. Earlier, the root cause of the accident was identified by a Japanese independent parliamentary report as being cultural and institutional. The sum total of the institutions, the safety system, was ineffective. While it is important to address the many technical and operational lessons these may not necessary address this more fundamental lesson, and may not serve to provide robust defences against human or institutional failings over a wide variety of possible events and combinations. The overall lesson is that we can have rigorous and comprehensive safety standards and other tools in place to deliver high levels of safety, but ultimately what is important is the ability of the nuclear safety system to ensure that the relevant institutions diligently and effectively apply those standards and tools — to be robust and resilient. This has led to the consideration of applying the principles of the strength in depth philosophy to a nuclear safety system as a way of providing a framework for developing, assessing, reviewing and improving the system. At an IAEA conference in October 2013, a model was presented for a robust national nuclear safety system based on strength in depth philosophy. The model highlighted three main layers: industry, the

  1. Quantitative in-depth state analysis by means of x-ray photoelectron spectroscopy and its application to surface Layer of SiC coatings

    International Nuclear Information System (INIS)

    Yabe, Katsumasa; Yamashina, Toshiro.

    1980-01-01

    An attempt of quantitative state analysis was made on the surface and the depth profile of inorganic compounds by X-ray photoelectron spectroscopy (XPS) which was combined by the sputter-etching with argon ions. A masking attachment was designed for an area of sample which is exposed to the non-uniform portion of the ion beam. Uniform sputter-etching could be attained, with the advantages on XPS observation of low background level and less impurity spectra from other origins than the sample. The photoelectron yields were examined for the quantitative analysis by XPS. The method established here was applied to analyze the surface and in-depth composition of SiC coatings onto carbon and molybdenum which are promising candidate materials as the first wall in a controlled thermonuclear reactor. (author)

  2. Circumferential electrocautery of the patella in primary total knee replacement without patellar replacement: a meta-analysis and systematic review

    Science.gov (United States)

    Fan, Lihong; Ge, Zhaogang; Zhang, Chen; Li, Jia; Yu, Zefeng; Dang, Xiaoqian; Wang, Kunzheng

    2015-03-01

    The purpose of this meta-analysis and systematic review was to identify and assess whether circumferential electrocautery is useful for improving outcomes after primary total knee replacement(TKR). We searched MEDLINE, EMBASE, PubMed, SpringerLink, Web of Knowledge, OVID CINAHL, OVID EBM and Google Scholar and included articles published through January 2014. A total of 6 articles met the inclusion criteria. Of the 776 cases included in the analysis, 388 cases involved patellar denervation, and 388 cases were designated as the control group. The meta-analysis revealed no significant difference in the incidence of anterior knee pain (AKP, p = 0.18) or in the visual analogue scale score (VAS, p = 0.23) between the two groups. In addition, AKSS Function Score indicated no significant difference between the two groups (p = 0.28). However, the OKS (p = 0.02), patellar score (p = 0.01), AKSS-Knee Score (p = 0.004), range of motion (ROM, p electrocautery. The results indicate that circumferential electrocautery of the patella does not significantly improve AKP compared with non-electrocautery techniques but that circumferential electrocautery significantly improves patients' knee function after surgery. Therefore, we believe that circumferential electrocautery is beneficial to the outcome of primary TKR surgery without patellar replacement.

  3. Being in control? A thematic content analysis of 14 in-depth interviews with 2,4-dinitrophenol users.

    Science.gov (United States)

    Ainsworth, Neha Prasad; Vargo, Elisabeth Julie; Petróczi, Andrea

    2018-02-01

    2,4-Dinitrophenol (2,4-DNP) is a compound with multiple industrial purposes. Currently unlicensed for human consumption, it is used by the gym-going population for drastic, short-term body fat loss. Nonetheless, physiological mechanisms can lead to potentially fatal hyperthermia. Reported fatal incidents have caused concern and highlighted the need for intervention. Understanding decision-making leading to 2,4-DNP use alongside the perceived outgroup attitudes is vital to forming effective harm minimisation policies targeting current and potential users. First-hand accounts from this elusive population are scarce. Fourteen novel and experienced users (13 male, 1 female) were recruited via "snowballing" techniques. Semi-structured interviews were conducted, comprising 28 questions. Thematic content analysis was conducted using 37 codes. Four characteristic themes emerged: 1. Users considered the Internet to be a crucial multifunctional resource directly impacting their 2,4-DNP use. 2. Users "respected" 2,4-DNP, proactively taking harm reduction measures. 3. Attitudinal polarisation towards 2,4-DNP within the gym-going community was consistent in all accounts. 4. Users perceived outgroup populations to have inherently negative attitudes towards their use. These themes fell under the all-encompassing theme of "being in control". For the first time, this study offers a rich detail of attitudes toward 2,4-DNP use by giving a collective voice to users. The element of control over every aspect of the users' life appears to be a significant contributor to the successful risk-management of 2,4-DNP use. In the absence of an established safe upper limit and effective regulatory control, education is critical to harm minimisation. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. An in-depth analysis of personality and other participant characteristics in a Web-based course for science teachers

    Science.gov (United States)

    Boyette, Todd Randall

    The purpose of this study was to analyze the role students' personality and other characteristics play in their experience and achievement in a web-based course for teachers. Participants in the study were 17 inservice teachers enrolled in Technology Tools for Science Teachers in the 2002 spring semester. "Tech Tools" is a web-based class designed to teach teachers how to use various technology such as digital cameras in the science classroom. As part of the class, students are required to attend four face-to-face sessions during the semester. Personality data was generated by the administering of three instruments: The Simmons Personal Survey, The Sixteen Personality Factor Questionnaire (16PF), and the Rosenberg Self-Esteem Inventory. Students also completed an entrance survey at the beginning of the course. All e-mails and Instant Messages sent to the instructors and all posts to the class listserv were collected for quantitative and qualitative analysis. Additional data was collected through Instant Message interviews with ten of the students conducted at the end of the course. Results indicated that characteristics such as assertiveness, courage, sociability, self-esteem, rule consciousness, and teaching experience, were strongly correlated with students' final grades. Traits such as anxiety, tension, apprehension and Privateness strongly correlated with students' amount of communication. Qualitative results indicated that students who are open and receptive to new ideas were better able to handle the rigor of the course, while students that enjoy change appreciated the content and format of the course. Self-esteem seems to impact the opinions of students regarding their experience in Tech Tools and Social Boldness seems to impact their opinions about the value of the face-to-face sessions. Other findings included how the amount of teaching experience of the students affected their perceptions of the workload involved in Tech Tools, how the requirements of

  5. In-depth analysis of protein inference algorithms using multiple search engines and well-defined metrics.

    Science.gov (United States)

    Audain, Enrique; Uszkoreit, Julian; Sachsenberg, Timo; Pfeuffer, Julianus; Liang, Xiao; Hermjakob, Henning; Sanchez, Aniel; Eisenacher, Martin; Reinert, Knut; Tabb, David L; Kohlbacher, Oliver; Perez-Riverol, Yasset

    2017-01-06

    inference is a crucial step in proteomics data analysis, a comprehensive evaluation of the many different inference methods has never been performed. Previously Journal of proteomics has published multiple studies about other benchmark of bioinformatics algorithms (PMID: 26585461; PMID: 22728601) in proteomics studies making clear the importance of those studies for the proteomics community and the journal audience. This manuscript presents a new bioinformatics solution based on the KNIME/OpenMS platform that aims at providing a fair comparison of protein inference algorithms (https://github.com/KNIME-OMICS). Six different algorithms - ProteinProphet, MSBayesPro, ProteinLP, Fido and PIA- were evaluated using the highly customizable workflow on four public datasets with varying complexities. Five popular database search engines Mascot, X!Tandem, MS-GF+ and combinations thereof were evaluated for every protein inference tool. In total >186 proteins lists were analyzed and carefully compare using three metrics for quality assessments of the protein inference results: 1) the numbers of reported proteins, 2) peptides per protein, and the 3) number of uniquely reported proteins per inference method, to address the quality of each inference method. We also examined how many proteins were reported by choosing each combination of search engines, protein inference algorithms and parameters on each dataset. The results show that using 1) PIA or Fido seems to be a good choice when studying the results of the analyzed workflow, regarding not only the reported proteins and the high-quality identifications, but also the required runtime. 2) Merging the identifications of multiple search engines gives almost always more confident results and increases the number of peptides per protein group. 3) The usage of databases containing not only the canonical, but also known isoforms of proteins has a small impact on the number of reported proteins. The detection of specific isoforms could

  6. In-depth investigation on the pyrolysis kinetics of raw biomass. Part I: kinetic analysis for the drying and devolatilization stages.

    Science.gov (United States)

    Chen, Dengyu; Zheng, Yan; Zhu, Xifeng

    2013-03-01

    An in-depth investigation was conducted on the kinetic analysis of raw biomass using thermogravimetric analysis (TGA), from which the activation energy distribution of the whole pyrolysis process was obtained. Two different stages, namely, drying stage (Stage I) and devolatilization stage (Stage II), were shown in the pyrolysis process in which the activation energy values changed with conversion. The activation energy at low conversions (below 0.15) in the drying stage ranged from 10 to 30 kJ/mol. Such energy was calculated using the nonisothermal Page model, known as the best model to describe the drying kinetics. Kinetic analysis was performed using the distributed activation energy model in a wide range of conversions (0.15-0.95) in the devolatilization stage. The activation energy first ranged from 178.23 to 245.58 kJ/mol and from 159.66 to 210.76 kJ/mol for corn straw and wheat straw, respectively, then increasing remarkably with an irregular trend. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. AN OXIDANT TO REPLACE NITROBENZENE IN LIGNIN ANALYSIS

    Directory of Open Access Journals (Sweden)

    Michael P. Masingale

    2009-08-01

    Full Text Available Four metal organic frameworks (MOFs are being evaluated as possible catalysts for alkaline lignin oxidation. One aspect of the screening process is the oxidation of in-situ hardwood lignin by a high mole ratio of Cu, Fe, or Cu + Fe contained in the MOFs. The MOF’s were prepared in a microwave-assisted synthesis. One of the MOFs, a benzenetricar-boxylic acid complex of Cu (II and Fe (III, converted the phenylpropane (C9 units in in-situ poplar lignin to approximately 50% monomers. The ratio of syringyl (S to guiacyl (G monomers was similar to the S:G ratio obtained from nitrobenzene oxidation (NBO. The S:G ratio from NBO was then compared to that from MOF oxidation (MOFO for two other poplars. The S:G ratios for the three poplars by MOFO were 1.20, 1.51 and 1.67, respectively while the corresponding NBO values were 1.25, 1.45 and 1.68. These initial results indicate that MOFO could be developed into a credible replacement for NBO, because it affords a higher yield of monomers when a large MOF dose is used. Some preliminary results are also presented for MOF acting as a catalyst (100 ppm Cu (II plus 81 ppm Fe (III in NaOH for oxygenation of the hardwoods. The products from O2 + MOF are identical to MOF only, but the ratios amongst them are different.

  8. Isoelectric point-based fractionation by HiRIEF coupled to LC-MS allows for in-depth quantitative analysis of the phosphoproteome.

    Science.gov (United States)

    Panizza, Elena; Branca, Rui M M; Oliviusson, Peter; Orre, Lukas M; Lehtiö, Janne

    2017-07-03

    Protein phosphorylation is involved in the regulation of most eukaryotic cells functions and mass spectrometry-based analysis has made major contributions to our understanding of this regulation. However, low abundance of phosphorylated species presents a major challenge in achieving comprehensive phosphoproteome coverage and robust quantification. In this study, we developed a workflow employing titanium dioxide phospho-enrichment coupled with isobaric labeling by Tandem Mass Tags (TMT) and high-resolution isoelectric focusing (HiRIEF) fractionation to perform in-depth quantitative phosphoproteomics starting with a low sample quantity. To benchmark the workflow, we analyzed HeLa cells upon pervanadate treatment or cell cycle arrest in mitosis. Analyzing 300 µg of peptides per sample, we identified 22,712 phosphorylation sites, of which 19,075 were localized with high confidence and 1,203 are phosphorylated tyrosine residues, representing 6.3% of all detected phospho-sites. HiRIEF fractions with the most acidic isoelectric points are enriched in multiply phosphorylated peptides, which represent 18% of all the phospho-peptides detected in the pH range 2.5-3.7. Cross-referencing with the PhosphoSitePlus database reveals 1,264 phosphorylation sites that have not been previously reported and kinase association analysis suggests that a subset of these may be functional during the mitotic phase.

  9. LCC analysis for the replacement of the dutch F-16

    NARCIS (Netherlands)

    Haas, R.C.T. de; Smit, M.C.; Zeeuw, M. de

    2001-01-01

    In the presentation we will first describe the way LCC-analysis are performed in the Netherlands in a general way. In the Netherlands LCC-studies are mainly used in the acquisition process of new military equipment. Inside the armed forces a project team is responsible for the acquisition process

  10. Thermal Analysis of Lampung Zeolite as Ion Cesium Replacement

    International Nuclear Information System (INIS)

    Aslina-Br-Ginting; Dian-Anggraini; Arif-Nugroho

    2007-01-01

    Zeolite have the cation can move freely and as exchangeable partly or totally with other cations. Therefore, it can serve the purpose of ion exchanger very selectively to ion cesium which is present in fuel waste. In this research analysis of pore surface area, radius pore, and adsorption have been done. After the characters of Lampung zeolite is known and then analysis of cation exchange capacity (CEC) toward ion 137 Cs is conducted, analysis of Lampung zeolite adsorption to ion 137 Cs in waste of fissile product and in research waste is subsequently done. Result of analysis show Lampung zeolite has surface area of 10,0478 m 2 , specific surface area of 47,0841 m 2 /g, pore radius of 19,3020 o A and adsorption of 24,500 cc/g. For application as a ion exchange, Lampung zeolite can adsorb ion 137 Cs reaching maximum at concentration of CsCl 0,5 N with the contact time 1 day and the optimum KTK value is 0,8360 m eq/g. While Lampung zeolite is able to adsorb 86,4 % ion Cs in waste of fission product. (author)

  11. Mass Measles Vaccination Campaign in Aila Cyclone-Affected Areas of West Bengal, India: An In-depth Analysis and Experiences

    Directory of Open Access Journals (Sweden)

    Sarmila Mallik

    2011-12-01

    Full Text Available Disaster-affected populations are highly vulnerable to outbreaks of measles. Therefore, a mass vaccination against measles was conducted in Aila cyclone-affected blocks of West Bengal, India in July 2009. The objectives of the present report were to conduct an in depth analysis of the campaign, and to discuss the major challenges. A block level micro-plan, which included mapping of the villages, health facilities, temporary settlements of disaster-affected population, communications available, formation of vaccination team, information education communication, vaccine storage, waste disposal, surveillance for adverse events following immunization, supervision and monitoring was developed. The rate of six months to five years old children, who were vaccinated by measles vaccine, was 70.7% and that of those who received one dose of vitamin A was 71.3%. Wastage factor for vaccine doses and auto-disable syringes were 1.09 and 1.07, respectively. Only 13 cases of adverse events following immunization were reported. An average of 0.91 puncture-proof containers per vaccination session was used. Despite the major challenges faced due to difficult to reach areas, inadequate infrastructure, manpower and communication, problems of vaccine storage and transport, the campaign achieved a remarkable success regarding measles vaccine coverage, improvements of cold chain infrastructure, formulating an efficient surveillance and reporting system for adverse events following immunization, building self-confidence of the stakeholders

  12. Mass Measles Vaccination Campaign in Aila Cyclone-Affected Areas of West Bengal, India: An In-depth Analysis and Experiences

    Science.gov (United States)

    Mallik, Sarmila; Mandal, Pankaj Kumar; Ghosh, Pramit; Manna, Nirmalya; Chatterjee, Chitra; Chakrabarty, Debadatta; Bagchi, Saumendra Nath; Dasgupta, Samir

    2011-01-01

    Disaster-affected populations are highly vulnerable to outbreaks of measles. Therefore, a mass vaccination against measles was conducted in Aila cyclone-affected blocks of West Bengal, India in July 2009. The objectives of the present report were to conduct an in depth analysis of the campaign, and to discuss the major challenges. A block level micro-plan, which included mapping of the villages, health facilities, temporary settlements of disaster-affected population, communications available, formation of vaccination team, information education communication, vaccine storage, waste disposal, surveillance for adverse events following immunization, supervision and monitoring was developed. The rate of six months to five years old children, who were vaccinated by measles vaccine, was 70.7% and that of those who received one dose of vitamin A was 71.3%. Wastage factor for vaccine doses and auto-disable syringes were 1.09 and 1.07, respectively. Only 13 cases of adverse events following immunization were reported. An average of 0.91 puncture-proof containers per vaccination session was used. Despite the major challenges faced due to difficult to reach areas, inadequate infrastructure, manpower and communication, problems of vaccine storage and transport, the campaign achieved a remarkable success regarding measles vaccine coverage, improvements of cold chain infrastructure, formulating an efficient surveillance and reporting system for adverse events following immunization, building self-confidence of the stakeholders, and developing a biomedical waste disposal system. PMID:23115416

  13. Energy efficiency of office equipment - Proposal for a policy mix for Germany with an in-depth analysis of labelling strategies

    International Nuclear Information System (INIS)

    Duscha, Markus; Seebach, Dominik

    2005-01-01

    Research under contract with the German Federal Environmental Agency (UBA) identified a considerable energy saving potential fielding the area of office equipment. In this paper, a proposal for a policy mix is presented with the goal to increase energy efficiency by market-transformation in this sector. This was worked out by order of the UBA. Pending EU legislation like the Procurement Directive and the proposal for Eco-Design Directive have been considered. An in-depth analysis for labelling schemes for office equipment is provided with respect to the future of the Energy Star process, specifically the continuation of the Energy Star-cooperation between the U.S.EPA and the EU. Preliminary results gained after literature enquiry and interviews of experts were discussed during a workshop at the German Federal Environmental Ministry in September 2004. Our proposal for a policy mix includes: public procurement, efficiency labelling, training and education, energy management in public and private institutions, mandatory minimum standards, marketing. The demand for high efficient appliances should initially be boosted by green procurement to trigger market transformation. In the field of efficiency labelling, we first analyse the shortcomings of previous strategies. On this basis, we propose a two level-strategy for Germany: 1. The Energy Star process with improved structures shall act as a widely compliable labelling minimum standard. 2. An information programme about high efficient appliances ('quality-programme') should be established basing on existing structures (Energy Star, GEEA, TopTen) to minimise transaction costs

  14. An in-depth analysis of the physico-mechanical properties imparted by agricultural fibers and food processing residues in polypropylene biocomposites

    International Nuclear Information System (INIS)

    Murdy, Rachel Campbell; Mak, Michelle; Misra, Manjusri; Mohanty, Amar K.

    2015-01-01

    The use of agricultural and food processing residues as potential reinforcements in plastics has been extensively studied. However, there is a large variation in the mechanical performance of agricultural fiber-based biocomposites due to different processing materials and parameters. An in-depth comparison of the resulting effect of the agricultural filler on the matrix is often not possible given the discrepancy in processing conditions. This study seeks to determine the intrinsic properties of agricultural fibers and food processing residues for their use in polypropylene biocomposites based on a standardization of experimental design. The effect of 25wt% loading of miscanthus, fall-and spring-harvest switchgrass, wheat straw, oat hull, soy hull, soy stalk, hemp and flax on the physico-mechanical properties of polypropylene biocomposites was investigated. The addition of fiber led to an improvement in flexural strength, flexural modulus, and tensile modulus, and a general decrease in tensile strength at yield, elongation at break and Izod impact strength. Scanning electron microscopy highlighted the interfacial adhesion, orientation and distribution of the fibers within the matrix, confirming that fiber length and dispersion within the matrix are positively correlated with mechanical properties. The crystallization of the polypropylene phase and a compositional analysis of the agricultural fibers and processing residues were also compared to offer insight into the effect of the filler’s intrinsic properties on the resulting material performance

  15. An in-depth analysis of the physico-mechanical properties imparted by agricultural fibers and food processing residues in polypropylene biocomposites

    Energy Technology Data Exchange (ETDEWEB)

    Murdy, Rachel Campbell; Mak, Michelle [Bioproducts Discovery and Development Centre, Department of Plant Agriculture, Crop Science Building, University of Guelph, Guelph, ON N1G 2W1 (Canada); Misra, Manjusri; Mohanty, Amar K. [Bioproducts Discovery and Development Centre, Department of Plant Agriculture, Crop Science Building, University of Guelph, Guelph, ON N1G 2W1 (Canada); School of Engineering, Thornbrough Building, University of Guelph, ON N1G 2W1 (Canada)

    2015-05-22

    The use of agricultural and food processing residues as potential reinforcements in plastics has been extensively studied. However, there is a large variation in the mechanical performance of agricultural fiber-based biocomposites due to different processing materials and parameters. An in-depth comparison of the resulting effect of the agricultural filler on the matrix is often not possible given the discrepancy in processing conditions. This study seeks to determine the intrinsic properties of agricultural fibers and food processing residues for their use in polypropylene biocomposites based on a standardization of experimental design. The effect of 25wt% loading of miscanthus, fall-and spring-harvest switchgrass, wheat straw, oat hull, soy hull, soy stalk, hemp and flax on the physico-mechanical properties of polypropylene biocomposites was investigated. The addition of fiber led to an improvement in flexural strength, flexural modulus, and tensile modulus, and a general decrease in tensile strength at yield, elongation at break and Izod impact strength. Scanning electron microscopy highlighted the interfacial adhesion, orientation and distribution of the fibers within the matrix, confirming that fiber length and dispersion within the matrix are positively correlated with mechanical properties. The crystallization of the polypropylene phase and a compositional analysis of the agricultural fibers and processing residues were also compared to offer insight into the effect of the filler’s intrinsic properties on the resulting material performance.

  16. An in-depth analysis of the physico-mechanical properties imparted by agricultural fibers and food processing residues in polypropylene biocomposites

    Science.gov (United States)

    Murdy, Rachel Campbell; Mak, Michelle; Misra, Manjusri; Mohanty, Amar K.

    2015-05-01

    The use of agricultural and food processing residues as potential reinforcements in plastics has been extensively studied. However, there is a large variation in the mechanical performance of agricultural fiber-based biocomposites due to different processing materials and parameters. An in-depth comparison of the resulting effect of the agricultural filler on the matrix is often not possible given the discrepancy in processing conditions. This study seeks to determine the intrinsic properties of agricultural fibers and food processing residues for their use in polypropylene biocomposites based on a standardization of experimental design. The effect of 25wt% loading of miscanthus, fall-and spring-harvest switchgrass, wheat straw, oat hull, soy hull, soy stalk, hemp and flax on the physico-mechanical properties of polypropylene biocomposites was investigated. The addition of fiber led to an improvement in flexural strength, flexural modulus, and tensile modulus, and a general decrease in tensile strength at yield, elongation at break and Izod impact strength. Scanning electron microscopy highlighted the interfacial adhesion, orientation and distribution of the fibers within the matrix, confirming that fiber length and dispersion within the matrix are positively correlated with mechanical properties. The crystallization of the polypropylene phase and a compositional analysis of the agricultural fibers and processing residues were also compared to offer insight into the effect of the filler's intrinsic properties on the resulting material performance.

  17. Mass Measles Vaccination Campaign in Aila Cyclone-Affected Areas of West Bengal, India: An In-depth Analysis and Experiences.

    Science.gov (United States)

    Mallik, Sarmila; Mandal, Pankaj Kumar; Ghosh, Pramit; Manna, Nirmalya; Chatterjee, Chitra; Chakrabarty, Debadatta; Bagchi, Saumendra Nath; Dasgupta, Samir

    2011-12-01

    Disaster-affected populations are highly vulnerable to outbreaks of measles. Therefore, a mass vaccination against measles was conducted in Aila cyclone-affected blocks of West Bengal, India in July 2009. The objectives of the present report were to conduct an in depth analysis of the campaign, and to discuss the major challenges. A block level micro-plan, which included mapping of the villages, health facilities, temporary settlements of disaster-affected population, communications available, formation of vaccination team, information education communication, vaccine storage, waste disposal, surveillance for adverse events following immunization, supervision and monitoring was developed. The rate of six months to five years old children, who were vaccinated by measles vaccine, was 70.7% and that of those who received one dose of vitamin A was 71.3%. Wastage factor for vaccine doses and auto-disable syringes were 1.09 and 1.07, respectively. Only 13 cases of adverse events following immunization were reported. An average of 0.91 puncture-proof containers per vaccination session was used. Despite the major challenges faced due to difficult to reach areas, inadequate infrastructure, manpower and communication, problems of vaccine storage and transport, the campaign achieved a remarkable success regarding measles vaccine coverage, improvements of cold chain infrastructure, formulating an efficient surveillance and reporting system for adverse events following immunization, building self-confidence of the stakeholders, and developing a biomedical waste disposal system.

  18. An in-depth analysis of the biological functional studies based on the NMR M2 channel structure of influenza A virus

    International Nuclear Information System (INIS)

    Huang Ribo; Du Qishi; Wang Chenghua; Chou, K.-C.

    2008-01-01

    The long-sought three-dimensional structure of the M2 proton channel of influenza A virus was successfully determined recently by the high-resolution NMR [J.R. Schnell, J.J. Chou, Structure and mechanism of the M2 proton channel of influenza A virus, Nature 451 (2008) 591-595]. Such a milestone work has provided a solid structural basis for studying drug-resistance problems. However, the action mechanism revealed from the NMR structure is completely different from the traditional view and hence prone to be misinterpreted as 'conflicting' with some previous biological functional studies. To clarify this kind of confusion, an in-depth analysis was performed for these functional studies, particularly for the mutations D44N, D44A and N44D on position 44, and the mutations on positions 27-38. The analyzed results have provided not only compelling evidences to further validate the NMR structure but also very useful clues for dealing with the drug-resistance problems and developing new effective drugs against H5N1 avian influenza virus, an impending threat to human beings.

  19. In-Depth Analysis of Exoproteomes from Marine Bacteria by Shotgun Liquid Chromatography-Tandem Mass Spectrometry: the Ruegeria pomeroyi DSS-3 Case-Study

    Directory of Open Access Journals (Sweden)

    Jean Armengaud

    2010-07-01

    Full Text Available Microorganisms secrete into their extracellular environment numerous compounds that are required for their survival. Many of these compounds could be of great interest for biotechnology applications and their genes used in synthetic biology design. The secreted proteins and the components of the translocation systems themselves can be scrutinized in-depth by the most recent proteomic tools. While the secretomes of pathogens are well-documented, those of non-pathogens remain largely to be established. Here, we present the analysis of the exoproteome from the marine bacterium Ruegeria pomeroyi DSS-3 grown in standard laboratory conditions. We used a shotgun approach consisting of trypsin digestion of the exoproteome, and identification of the resulting peptides by liquid chromatography coupled to tandem mass spectrometry. Three different proteins that have domains homologous to those observed in RTX toxins were uncovered and were semi-quantified as the most abundantly secreted proteins. One of these proteins clearly stands out from the catalogue, representing over half of the total exoproteome. We also listed many soluble proteins related to ABC and TRAP transporters implied in the uptake of nutrients. The Ruegeria pomeroyi DSS-3 case-study illustrates the power of the shotgun nano-LC-MS/MS strategy to decipher the exoproteome from marine bacteria and to contribute to environmental proteomics.

  20. The national psychological/personality profile of Romanians: An in depth analysis of the regional national psychological/personality profile of Romanians

    Directory of Open Access Journals (Sweden)

    David, D.

    2015-12-01

    Full Text Available In this article we perform an in depth analysis of the national psychological/personality profile of Romanians. Following recent developments in the field (see Rentfrow et al., 2013; 2015, we study the regional national psychological/personality profile of Romanians, based on the Big Five model (i.e., NEO PI/R. Using a representative sample (N1 = 1000, we performed a cluster analysis and identified two bipolar personality profiles in the population: cluster 1, called “Factor X-”, characterized by high neuroticism and low levels of extraversion, openness, agreeableness, and conscientiousness, and cluster 2, called “Factor X+”, characterized by the opposite configuration in personality traits, low neuroticism and high levels of extraversion, openness, agreeableness, and conscientiousness. The same two cluster pattern/solution emerged in other samples (N = 2200, with other Big Five-based instruments, and by using various methods of data (e.g., direct vs. reversed item score, controlling for item desirability and cluster (i.e., with and without “running means” analyses. These two profiles are quite evenly distributed in the overall population, but also across all geographical regions. Moreover, comparing the distribution of the five personality traits, we found just few small differences between the eight geographical divisions that we used for our analysis. These results suggest that the regional national psychological/personality profile of Romania is quite homogenous. Directions for harnessing the potential of both personality profiles are presented to the reader. Other implications based on the bipolar and fractal structure of the personality profile are discussed from an interdisciplinary perspective.

  1. Downstream processing from melt granulation towards tablets: In-depth analysis of a continuous twin-screw melt granulation process using polymeric binders.

    Science.gov (United States)

    Grymonpré, W; Verstraete, G; Vanhoorne, V; Remon, J P; De Beer, T; Vervaet, C

    2018-03-01

    The concept of twin-screw melt granulation (TSMG) has steadily (re)-gained interest in pharmaceutical formulation development as an intermediate step during tablet manufacturing. However, to be considered as a viable processing option for solid oral dosage forms there is a need to understand all critical sources of variability which could affect this granulation technique. The purpose of this study was to provide an in-depth analysis of the continuous TSMG process in order to expose the critical process parameters (CPP) and elucidate the impact of process and formulation parameters on the critical quality attributes (CQA) of granules and tablets during continuous TSMG. A first part of the study dealt with the screening of various amorphous polymers as binder for producing high-dosed melt granules of two model drug (i.e. acetaminophen and hydrochlorothiazide). The second part of this study described a quality-by-design (QbD) approach for melt granulation of hydrochlorothiazide in order to thoroughly evaluate TSMG, milling and tableting stage of the continuous TSMG line. Using amorphous polymeric binders resulted in melt granules with high milling efficiency due to their brittle behaviour without producing excessive amounts of fines, providing high granule yields with low friability. Therefore, it makes them extremely suitable for further downstream processing. One of the most important CPP during TSMG with polymeric binders was the granulation-torque, which - in case of polymers with high T g - increased during longer granulation runs to critical levels endangering the continuous process flow. However, by optimizing both screw speed and throughput or changing to polymeric binders with lower T g it was possible to significantly reduce this risk. This research paper highlighted that TSMG must be considered as a viable option during formulation development of solid oral dosage forms based on the robustness of the CQA of both melt granules and tablets. Copyright © 2017

  2. Preoperative widespread pain sensitization and chronic pain after hip and knee replacement: a cohort analysis

    Science.gov (United States)

    Wylde, Vikki; Sayers, Adrian; Lenguerrand, Erik; Gooberman-Hill, Rachael; Pyke, Mark; Beswick, Andrew D.; Dieppe, Paul; Blom, Ashley W.

    2015-01-01

    Abstract Chronic pain after joint replacement is common, affecting approximately 10% of patients after total hip replacement (THR) and 20% of patients after total knee replacement (TKR). Heightened generalized sensitivity to nociceptive input could be a risk factor for the development of this pain. The primary aim of this study was to investigate whether preoperative widespread pain sensitivity was associated with chronic pain after joint replacement. Data were analyzed from 254 patients receiving THR and 239 patients receiving TKR. Pain was assessed preoperatively and at 12 months after surgery using the Western Ontario and McMaster Universities Osteoarthritis Pain Scale. Preoperative widespread pain sensitivity was assessed through measurement of pressure pain thresholds (PPTs) at the forearm using an algometer. Statistical analysis was conducted using linear regression and linear mixed models, and adjustments were made for confounding variables. In both the THR and TKR cohort, lower PPTs (heightened widespread pain sensitivity) were significantly associated with higher preoperative pain severity. Lower PPTs were also significantly associated with higher pain severity at 12 months after surgery in the THR cohort. However, PPTs were not associated with the change in pain severity from preoperative to 12 months postoperative in either the TKR or THR cohort. These findings suggest that although preoperative widespread pressure pain sensitivity is associated with pain severity before and after joint replacement, it is not a predictor of the amount of pain relief that patients gain from joint replacement surgery, independent of preoperative pain severity. PMID:25599300

  3. Analysis of Mitral Valve Replacement Outcomes is Enhanced by Meaningful Clinical Use of Electronic Health Records

    Science.gov (United States)

    Chen, John C; Pfeffer, Thomas; Johnstone, Shelley; Chen, Yuexin; Kiley, Mary-Lou; Richter, Richard; Lee, Hon

    2013-01-01

    Objective: Cardiac surgical mortality has improved during the last decade despite the aging of the population. An integrated US health plan developed a heart valve registry to track outcomes and complications of heart valve operations. This database was used for longitudinal evaluation of mitral valve (MV) outcomes from 1999 to 2008 at four affiliated hospitals. Methods: We identified 3130 patients in the Apollo database who underwent 3180 initial MV procedures. Internal administrative and Social Security Administration databases were merged to determine survival rates. Electronic health records were searched to ascertain demographics, comorbidities, and postoperative complications. Cox regression was used to evaluate mean survival and identify risk factors. Results: The procedures included 1160 mechanical valve replacements, 1159 tissue valve replacements, and 861 annuloplasties. The mean age of patients undergoing these procedures was 58 ± 11 years, 69 ± 12 years, and 62 ± 12 years, respectively. Mean survival was 8.9 ± 0.1 years for mechanical valve replacement, 7.0 ± 0.1 years for tissue valve replacement, and 7.7 ± 0.1 years for annuloplasty. Early in the study, there was a preference for implanting mechanical MVs. Beginning in 2003, more patients received tissue valve replacements rather than mechanical valves. Over time, there was an increasing trend of annuloplasty. Cox regression analysis identified the following risk factors for increased ten-year mortality: tissue valve implantation; advanced age; female sex; nonelective, nonisolated procedure; diabetes; postoperative use of banked blood products; previous cardiovascular intervention; dialysis; and longer perfusion time. Hospital location, reoperation, preoperative anticoagulation, and cardiogenic shock were not statistically significant risk factors. Conclusions: When controlling for other risk factors, we observed a lower long-term survival rate for tissue valve replacement compared with

  4. A cost-effectiveness analysis of hormone replacement therapy in the menopause.

    Science.gov (United States)

    Cheung, A P; Wren, B G

    1992-03-02

    To evaluate the cost-effectiveness of hormone replacement therapy in the menopause with particular reference to osteoporotic fracture and myocardial infarction. The multiple-decrement form of the life table was the mathematical model used to follow women of age 50 through their lifetime under the "no hormone replacement" and "hormone replacement" assumptions. Standard demographic and health economic techniques were used to calculate the corresponding lifetime differences in direct health care costs (net costs in dollars) and health effects ("net effectiveness" in terms of life expectancy and quality, in "quality-adjusted life-years"). This was then expressed as a cost-effectiveness ratio or the cost ($) per quality-adjusted life-year (QALY) for each of the chosen hormone replacement regimens. All women of age 50 in New South Wales, Australia (n = 27,021). The analysis showed that the lifetime net increments in direct medical care costs were largely contributed by hormone drug and consultation costs. Hormone replacement was associated with increased quality-adjusted life expectancy, a large percentage of which was attributed to a relief of menopausal symptoms. Cost-effectiveness ratios ranged from under 10,000 to over a million dollars per QALY. Factors associated with improved cost-effectiveness were prolonged treatment duration, the presence of menopausal symptoms, minimum progestogen side effects (in the case of oestrogen with progestogen regimens), oestrogen use after hysterectomy and the inclusion of cardiac benefits in addition to fracture prevention. Hormone replacement therapy for symptomatic women is cost-effective when factors that enhance its efficiency are considered. Short-term treatment of asymptomatic women for prevention of osteoporotic fractures and myocardial infarction is an inefficient use of health resources. Cost-effectiveness of hormone replacement in asymptomatic women is dependent on the magnitude of cardiac benefits associated with hormone

  5. Valve-sparing and valve-replacing techniques for aortic root replacement in patients with Marfan syndrome: Analysis of early outcome.

    Science.gov (United States)

    Volguina, Irina V; Miller, D Craig; LeMaire, Scott A; Palmero, Laura C; Wang, Xing Li; Connolly, Heidi M; Sundt, Thoralf M; Bavaria, Joseph E; Dietz, Harry C; Milewicz, Dianna M; Coselli, Joseph S

    2009-05-01

    A prospective, international registry study was initiated to provide contemporary comparative data on short-term clinical outcomes after aortic valve-sparing and aortic valve-replacing root operations in patients with Marfan syndrome. The purpose of this initial report is to describe the study design and to compare early outcomes in the first 151 enrolled patients. We assessed 30-day outcomes in 151 patients who met strict Ghent diagnostic criteria for Marfan syndrome and underwent aortic root replacement with either valve-replacing (n = 46) or valve-sparing techniques (n = 105) at one of 18 participating centers. In the valve replacement group, a mechanical composite valve graft was used in 39 (85%) patients and a bioprosthetic valve in 7 (15%). In the valve-sparing group, David V procedures were performed in 57 (54%) patients, David I in 38 (36%), David IV in 8 (8%), Florida sleeve in 1 (1%), and Yacoub remodeling in 1 (1%). No in-hospital or 30-day deaths occurred. Despite longer crossclamp and cardiopulmonary bypass times in the valve-sparing group, there were no significant between-group differences in postoperative complications. Thirty-day valve-related complications occurred in 2 (4%) patients undergoing valve replacement and in 3 (3%) undergoing valve-sparing procedures (P = .6). The analysis of early outcomes revealed that valve-sparing techniques were the most common approach to root replacement in patients with Marfan syndrome in these centers. The complexity of valve-sparing root replacement did not translate into any demonstrable adverse early outcomes. Subsequent analysis will compare the 3-year durability of these two surgical approaches.

  6. In depth analysis of the role of the mountain gap south of the Valley of Mexico on the air quality in Mexico City.

    Science.gov (United States)

    Gerardo Ruiz Suarez, Luis

    2010-05-01

    38 days of air quality observations in Tenango del Aire (TENAI), south of Mexico City during MILAGRO were analyzed. That site was managed by FQA-CCA-UNAM's team with a mobile laboratory equipped with standard air quality monitors: O3, NOx, NOy, CO, SO2 and surface meteorological parameters. Hosted additional instruments were: CH2O, column NO2 (DOAS), backscatter (Lidar) and pilot balloons. Also, an ultra light plane from IMK-IFU, equipped with O3, PM10, CN, Dew Point monitors flew around the Popocatepetl and Iztaccihuatl volcanoes and above of TENAI some days during MILAGRO. Atop of TENAI, the ultra light descended in spiral until near ground and ascended to resume its path. In addition to these measurements, UNAM team ran air quality numerical simulations using the Mesoscale Climate and Chemistry Model (MCCM) and an online coupled Wind Erosion Processor to MCCM we call WEPS-MCCM. The combined observations on the ground, the ultra light plane and the models results enabled us to carry out an in depth analysis of air quality in such important region south of Mexico City. Comparison were made with the episodes classification proposed by De Foy; Ozone North and South, Convection North and South, Cold Surge and South Venting to characterize dynamics in the Valley of Mexico. The aim was to define how well connected is TENAI with the air quality network in the MCMA. The influence of the mountain gap on ozone and PM10 levels in Mexico City is analyzed by episode type. Also, the impact of the mega city of Mexico on the nearby region to the south can be understood by observations in TENAI. More polluted episode types in TENAI are those called: Cold Surge, Ozone South and South Venting due to a wind shift occurring in early afternoon that brings back polluted air that was drained south during the morning and returns back to TENAI rich in aged air parcels. March 17 was chosen to show the integrated analysis of all variables observed and modeled (MCCM) in TENAI. In that day

  7. Synthesis and in-depth analysis of highly ordered yttrium doped hydroxyapatite nanorods prepared by hydrothermal method and its mechanical analysis

    International Nuclear Information System (INIS)

    Nathanael, A. Joseph; Mangalaraj, D.; Hong, S.I.; Masuda, Y.

    2011-01-01

    In this study, undoped and yttrium (Y) doped nanocrystalline hydroxyapatite crystals were synthesized by the hydrothermal method at 180 °C for 24 h. Highly ordered and oriented hydroxyapatite (HAp) nanorods were prepared by yttrium doping and their nanostructure and physical properties were compared with those of undoped HAp rods. FESEM images showed that the doping with Y ions reduced the diameter (from 25 nm to 15 nm) and increased the length (from 95 nm to 115 nm) of the synthesized rods. The aspect ratio of the undoped and Y-doped nanorods were calculated to be 4.303 (SD = 0.0959) and 7.61 (SD = 0.0355), respectively. Specific surface area (SSA) analysis showed that SSA also increased from 66.74 m 2 /g to 68.57 m 2 /g with the addition of yttrium. Y-doped HAp nanorod reinforced HMWPE composites displayed the better mechanical performance than those reinforced with pure HAp nanorods. The possible strengthening of nanorods and the increase of SSA due to the reduction in the size of nanorods in the presence of yttrium may have contributed to the strengthening of Y-doped HAp/HMWPE composites. - Graphical Abstract: Highly ordered and oriented yttrium doped hydroxyapatite (HAp) nanorods were prepared by hydrothermal method. For undoped HAp the average length of the nanorod is 95 nm with mean diameter of 24 nm and for a Y doped nanorod the average length is ∼ 115 nm and the mean diameter is 15 nm. Mechanical analysis was carried out by polymer/nanoparticle composite method. Highlights: ► Yttrium doped hydroxyapatite nanorods were prepared by hydrothermal method. ► The nanorods have highly uniform size distribution. ► Yttrium substitution and nanostructure formation was confirmed by careful analysis. ► Mechanical strength was analyzed by polymer nanoparticle reinforcement method.

  8. Applicability and Efficiency of NGS in Routine Diagnosis: In-Depth Performance Analysis of a Complete Workflow for CFTR Mutation Analysis.

    Directory of Open Access Journals (Sweden)

    Adrien Pagin

    Full Text Available Actually, about 2000 sequence variations have been documented in the CFTR gene requiring extensive and multi-step genetic testing in the diagnosis of cystic fibrosis and CFTR-related disorders. We present a two phases study, with validation and performance monitoring, of a single experiment methodology based on multiplex PCR and high throughput sequencing that allows detection of all variants, including large rearrangements, affecting the coding regions plus three deep intronic loci.A total of 340 samples, including 257 patients and 83 previously characterized control samples, were sequenced in 17 MiSeq runs and analyzed with two bioinformatic pipelines in routine diagnostic conditions. We obtained 100% coverage for all the target regions in every tested sample.We correctly identified all the 87 known variants in the control samples and successfully confirmed the 62 variants identified among the patients without observing false positive results. Large rearrangements were identified in 18/18 control samples. Only 17 patient samples showed false positive signals (6.6%, 12 of which showed a borderline result for a single amplicon. We also demonstrated the ability of the assay to detect allele specific dropout of amplicons when a sequence variation occurs at a primer binding site thus limiting the risk for false negative results.We described here the first NGS workflow for CFTR routine analysis that demonstrated equivalent diagnostic performances compared to Sanger sequencing and multiplex ligation-dependent probe amplification. This study illustrates the advantages of NGS in term of scalability, workload reduction and cost-effectiveness in combination with an improvement of the overall data quality due to the simultaneous detection of SNVs and large rearrangements.

  9. Economic analysis of replacement regeneration and coppice regeneration in eucalyptus stands under risk conditions

    Directory of Open Access Journals (Sweden)

    Isabel Carolina de Lima Guedes

    2011-09-01

    Full Text Available Projects are by their very nature subject to conditions of uncertainty that obstruct the decision-making process. Uncertainties involving forestry projects are even greater, as they are combined with time of return on capital invested, being medium to long term. For successful forest planning, it is necessary to quantify uncertainties by converting them into risks. The decision on whether to adopt replacement regeneration or coppice regeneration in a forest stand is influenced by several factors, which include land availability for new forest crops, changes in project end use, oscillations in demand and technological advancement. This study analyzed the economic feasibility of replacement regeneration and coppice regeneration of eucalyptus stands, under deterministic and under risk conditions. Information was gathered about costs and revenues for charcoal production in order to structure the cash flow used in the economic analysis, adopting the Net Present Value method (VPL. Risk assessment was based on simulations running the Monte Carlo method. Results led to the following conclusions: replacement regeneration is economically viable, even if the future stand has the same productivity as the original stand; coppice regeneration is an economically viable option even if productivity is a mere 70% of the original stand (high-tree planted stand, the best risk-return ratio option is restocking the stand (replacement regeneration by one that is 20% more productive; the probabilistic analysis running the Monte Carlo method revealed that invariably there is economic viability for the various replacement and coppice regeneration options being studied, minimizing uncertainties and consequently increasing confidence in decision-making.

  10. Replacing penalties

    Directory of Open Access Journals (Sweden)

    Vitaly Stepashin

    2017-01-01

    Full Text Available УДК 343.24The subject. The article deals with the problem of the use of "substitute" penalties.The purpose of the article is to identify criminal and legal criteria for: selecting the replacement punishment; proportionality replacement leave punishment to others (the formalization of replacement; actually increasing the punishment (worsening of legal situation of the convicted.Methodology.The author uses the method of analysis and synthesis, formal legal method.Results. Replacing the punishment more severe as a result of malicious evasion from serving accused designated penalty requires the optimization of the following areas: 1 the selection of a substitute punishment; 2 replacement of proportionality is serving a sentence other (formalization of replacement; 3 ensuring the actual toughening penalties (deterioration of the legal status of the convict. It is important that the first two requirements pro-vide savings of repression in the implementation of the replacement of one form of punishment to others.Replacement of punishment on their own do not have any specifics. However, it is necessary to compare them with the contents of the punishment, which the convict from serving maliciously evaded. First, substitute the punishment should assume a more significant range of restrictions and deprivation of certain rights of the convict. Second, the perfor-mance characteristics of order substitute the punishment should assume guarantee imple-mentation of the new measures.With regard to replacing all forms of punishment are set significant limitations in the application that, in some cases, eliminates the possibility of replacement of the sentence, from serving where there has been willful evasion, a stricter measure of state coercion. It is important in the context of the topic and the possibility of a sentence of imprisonment as a substitute punishment in cases where the original purpose of the strict measures excluded. It is noteworthy that the

  11. Replacing the nucleus pulposus of the intervertebral disk: prediction of suitable properties of a replacement material using finite element analysis.

    Science.gov (United States)

    Meakin, J R

    2001-03-01

    An axisymmetric finite element model of a human lumbar disk was developed to investigate the properties required of an implant to replace the nucleus pulposus. In the intact disk, the nucleus was modeled as a fluid, and the annulus as an elastic solid. The Young's modulus of the annulus was determined empirically by matching model predictions to experimental results. The model was checked for sensitivity to the input parameter values and found to give reasonable behavior. The model predicted that removal of the nucleus would change the response of the annulus to compression. This prediction was consistent with experimental results, thus validating the model. Implants to fill the cavity produced by nucleus removal were modeled as elastic solids. The Poisson's ratio was fixed at 0.49, and the Young's modulus was varied from 0.5 to 100 MPa. Two sizes of implant were considered: full size (filling the cavity) and small size (smaller than the cavity). The model predicted that a full size implant would reverse the changes to annulus behavior, but a smaller implant would not. By comparing the stress distribution in the annulus, the ideal Young's modulus was predicted to be approximately 3 MPa. These predictions have implications for current nucleus implant designs. Copyright 2001 Kluwer Academic Publishers

  12. Gait analysis of patients with an off-the-shelf total knee replacement versus customized bi-compartmental knee replacement.

    Science.gov (United States)

    Wang, Henry; Foster, Jonathan; Franksen, Natasha; Estes, Jill; Rolston, Lindsey

    2018-04-01

    Newer TKR designs have been introduced to the market with the aim of overcoming common sizing problems with older TKR designs. Furthermore, since a sizable percentage of patients with OA present with disease limited to the medial/lateral knee compartment in addition to the patellofemoral joint, for whom, a customized bi-compartmental knee replacement (BKR) is available as a treatment option. To date, there is very little information regarding knee strength and mechanics during gait for patients implanted with these modern TKR and BKR designs. The purpose of the study was to evaluate knee strength and mechanics during walking for patients with either a modern off the shelf TKR or a customized BKR and compare these findings to a cohort of healthy controls. Twelve healthy controls, eight BKR, and nine TKR patients participated in the study. Maximal isometric knee strength was evaluated. 3D kinematic and kinetic analyses were conducted for level walking. The TKR knee exhibited less peak extensor torque when compared to, both the BKR and control limbs (p < 0.05). The TKR knee had less extensor moment at stance than both the BKR and control knees (p < 0.05). Both the BKR and control knees displayed larger internal rotation at stance than that of the TKR knee (p < 0.05). This study suggests that, for patients that exhibit isolated OA of the tibiofemoral joint, using a customized BKR implant is a viable treatment option and may contribute to superior mechanical advantages.

  13. The optimal growth hormone replacement dose in adults, derived from bioimpedance analysis.

    Science.gov (United States)

    de Boer, H; Blok, G J; Voerman, B; de Vries, P; Popp-Snijders, C; van der Veen, E

    1995-07-01

    The prevalence of clinical signs and symptoms related to fluid retention is high in most studies evaluating the efficacy of GH treatment in GH-deficient (GHD) adults. This may be a consequence of supraphysiological GH replacement. To examine whether fluid retention is a dose-related phenomenon, we evaluated the impact of various GH substitution doses on body fluid status in 46 GHD men participating in a 1-yr, double blind, and placebo-controlled study. The patients were randomized to receive either placebo (n = 13) or GH in a dose of 1 (n = 11), 2 (n = 10), or 3 (n = 12) IU/m2.day, respectively. Treatment was started at one third of the predetermined dose and was subsequently increased by another third every month until the maintenance dose was reached. Tissue hydration was assessed by means of electrical impedance measurements. Normal values were obtained from 128 age- and sex-matched controls. In the untreated GHD state, whole body resistance was abnormally high (observed, 642 +/- 82 omega; predicted, 550 +/- 31 omega; P Regression analysis of the pooled data showed that GH replacement in a dose of 1.10 IU/m2.day (95% confidence interval, 0.85-1.45 IU/m2.day) resulted in a normalization of whole body resistance. In conclusion, GH replacement therapy in adults rapidly corrects the preexisting deficit in ECW. This rehydration process is dose dependent and may result in a substantial weight gain.(ABSTRACT TRUNCATED AT 400 WORDS)

  14. Performance and economic analysis of broilers fed diets containing acerola meal in replacement of corn

    Directory of Open Access Journals (Sweden)

    Leonardo Henrique Zanetti

    2014-12-01

    Full Text Available It was aimed with this research to evaluate the performance of broiler chickens fed diets containing increasing levels of acerola meal in replacement of corn and analyze the economic viability of that production system. A total of 980 day-old male Cobb chicks were used, allotted in a completely randomized design, with four treatments - inclusion levels (0%, 5%, 10% and 15% of acerola meal in replacement of corn – and seven replications with 35 birds per experimental unit. The birds were weighed at 21 and 42 days of age to measure the performance data. In the period between 1 and 21 days of age, differences were observed in the feed intake and feed:gain only, in which the inclusion of acerola meal linearly decreased feed intake and improved feed:gain up to a level of 10.25%. For the total rearing period, the control treatment showed higher body weight. The feed:gain showed linear effect, worsening the results with increasing amounts of acerola meal in the diets. In the same period, there was no significant difference in feed intake and productive efficiency index. With regard to the economic analysis, it was found that the lowest final cost per broiler was observed in diets with 10% of acerola meal inclusion in replacement of corn.

  15. Economic Analysis of Diesel-Fuel Replacement by Crude Palm Oil in Indonesian Power Plants

    Directory of Open Access Journals (Sweden)

    Petr Procházka

    2018-02-01

    Full Text Available Indonesia needs to find an alternative fuel to substitute diesel in their power plants in order to reduce the use of nonrenewable energy sources. The Indonesian government has a target to reduce oil fuel consumption while improving the efficiency of energy utilization. Crude palm oil is proposed to be used for this substitution. In this paper, the authors conduct an economic analysis of the replacement of diesel by crude palm oil. To predict future prices, a time series analysis is conducted using AutoRegressive Integrated Moving-Average method. A financial analysis of a specific project (0.75-MW power plant is conducted using static financial indicators (payback period, return on investment. Results show that replacing diesel with crude palm oil may be profitable. This is especially true for the proposed prospects of diesel price evolution. Analysis shows that the price of crude oil, which is the main factor in the pricing of diesel, may go up. Also, recently Indonesian currency depreciated against the US dollar, which also implies a higher cost of diesel.

  16. Distribution in depth of quasars

    International Nuclear Information System (INIS)

    Schmidt, M.; Green, R.F.

    1980-01-01

    The authors discuss the distribution in depth of different kinds of quasars: quasi-stellar radio sources with steep radio spectrum, those with flat radio spectrum, and optically selected quasars. All exhibit an increase of space density with distance to a different degree. The optically selected quasars, in particular, show a steep increase of surface density with magnitude. The steepness of the increase is inconsistent with a uniform distribution of quasars in the local hypothesis. In the cosmological hypothesis the co-moving space density of optically selected quasars increases by a factor of 100,000 to a redshift of 2, and by factors of 1000 and 10 for steep-spectrum and flat-spectrum radio quasars, respectively. (Auth.)

  17. GNF Defense in Depth Update

    Energy Technology Data Exchange (ETDEWEB)

    Lingenfelter, Andrew A.; Schneider, Robert J.; Cantonwine, Paul E.; Moore, Brian; Rea, John; Crawford, Douglas C. [Global Nuclear Fuel, P.O. Box 780 M/C H25, Wilmington, NC 28402 (United States)

    2009-06-15

    Global Nuclear Fuel (GNF) has designed, fabricated, and placed into operation more than 9 million fuel rods in approximately 135 thousand assemblies. Customer satisfaction has always compelled GNF to reduce fuel rod failures (defined here as fuel rods that breach or leak in service), However, increasing success with and subsequent expectations for economic performance of nuclear reactor plants have raised broader Industry emphasis on fuel reliability. In 2005, GNF established its Defense-in-Depth (DID) Program for the purpose of focusing attention on the many aspects of fuel design, fabrication, performance, and utilization that affect fuel reliability as well as on the key methods that govern the utilization of GNF fuel. The Program is structured to address each of the identified in-service, fuel failure mechanisms. This paper provides a summary of GNF fuel performance, following previous updates. This paper will discuss recent GNF fuel reliability and channel performance, GNF2 introduction status, and methods. GNF's more recent fuel experience includes approximately 3.8 million GE11/13 (9x9) and GE12/14 (10x10) fuel rods, well over half of which are the GE12/14 design. (Those figures also include roughly 25,000 recently-introduced GNF2 fuel rods.) Reliability, expressed as annual, observed fuel failure rates (i.e., number of rods failed each year divided by the number of opportunities, or fuel rods in service), has improved for each year since 2005. The GNF fuel failure rate for years leading up to 2007 and 2008 has been on the order of 5 to 7 ppm (excluding the corrosion events of 2001-2003), and as of this writing (January 2009) the current in-service failure has decreased to around 1.5 ppm. Failures in GE14 fuel rod failures have been primarily due to debris-fretting (> 60%), with other failures being duty-related or yet undetermined. The only failure observed in GNF2 to date was a single, early-life debris failure in a bundle not equipped with GNF

  18. Airborne asbestos exposures associated with gasket and packing replacement: a simulation study and meta-analysis.

    Science.gov (United States)

    Madl, Amy K; Hollins, Dana M; Devlin, Kathryn D; Donovan, Ellen P; Dopart, Pamela J; Scott, Paul K; Perez, Angela L

    2014-08-01

    Exposures to airborne asbestos during the removal and installation of internal gaskets and packing associated with a valve overhaul were characterized and compared to published data according to different variables (e.g., product, equipment, task, tool, setting, duration). Personal breathing zone and area samples were collected during twelve events simulating gasket and packing replacement, clean-up and clothing handling. These samples were analyzed using PCM and TEM methods and PCM-equivalent (PCME) airborne asbestos concentrations were calculated. A meta-analysis was performed to compare these data with airborne asbestos concentrations measured in other studies involving gaskets and packing. Short-term mechanic and assistant airborne asbestos concentrations during valve work averaged 0.013f/cc and 0.008f/cc (PCME), respectively. Area samples averaged 0.008f/cc, 0.005f/cc, and 0.003f/cc (PCME) for center, bystander, and remote background, respectively. Assuming a tradesman conservatively performs 1-3 gasket and/or packing replacements daily, an average 8-h TWA was estimated to be 0.002-0.010f/cc (PCME). Combining these results in a meta-analysis of the published exposure data showed that the majority of airborne asbestos exposures during work with gaskets and packing fall within a consistent and low range. Significant differences in airborne concentrations were observed between power versus manual tools and removal versus installation tasks. Airborne asbestos concentrations resulting from gasket and packing work during a valve overhaul are consistent with historical exposure data on replacement of asbestos-containing gasket and packing materials involving multiple variables and, in nearly all plausible scenarios, result in average airborne asbestos concentrations below contemporaneous occupational exposure limits for asbestos. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Economic analysis for upgrade decision-making using a control system replacement example

    International Nuclear Information System (INIS)

    De Grosbois, J.; Wichman, R.; Hepburn, G.A.; Basso, R.; Kumar, V.; Deregowska, D.

    2006-01-01

    This paper (3rd in a CNS series) provides insight on how nuclear power plants can achieve better efficiencies and reduced operations and maintenance (O and M) costs by making well-informed equipment upgrade decisions. An investment decision in a plant system upgrade will have various technical options and associated performance outcomes. These can be modelled and evaluated using economic and financial analysis methods. The economic analysis usually involves a comparison of an investment scenario versus a no-investment scenario called difference case analysis. The investment may include several scenarios due to the existence of various options, different investment timings, or desired performance results. Classical approaches, using financial tools such as net present value and internal rate of return calculations, may be used to quantify the financial benefits of the difference cases when certainty about the outcomes is assumed. When making decisions under risk, the classical approaches may be augmented with methods that consider life-cycle costs and benefits, the cost consequences of and probability of equipment failure, the timing of the replacement, and the uncertainties in estimating costs and benefits. The use of expected value and Monte Carlo simulation, among others, allow the incorporation of financial and technical uncertainty into the analysis. Finally, sensitivity analysis enables better understanding of the problem and may improve the decision and clarify the level of confidence that should be put in the outcomes. This paper illustrates the use of financial decision analysis methods for equipment replacements using a control system upgrade example. These methods may easily be generalized for other types of plant upgrades. (author)

  20. In-depth research of domestic nuclear patent information

    International Nuclear Information System (INIS)

    Mo Dan; Gao Anna; Li Dongbin; Lu Yanjia; Ren Chao

    2014-01-01

    Based on the domestic patent information, combined with examples, this article makes an in-depth discussion on the domestic nuclear patent information. The author puts forward for the patent information research, the appropriate retrieval of patent documents is the basis,and the correct quantitative statistical analysis of patent documents is the key, and in-depth qualitative analysis of patent documents is the core. It is expected to provide information support and guarantee for the technical innovation and scientific research personnel in the nuclear field through in-depth study of domestic nuclear information. (authors)

  1. The reform of energy subsidies for the enhancement of marine sustainability: An empirical analysis of energy subsidies worldwide and an in-depth case study of South Korea's energy subsidy policies

    Science.gov (United States)

    Shim, Jae Hyun

    This dissertation seeks to raise awareness about harmful effects of fossil fuel and nuclear energy subsidies that have blocked transition from conventional energy to a decarbonized, renewable energy system. Today, humans face daunting challenges in the form of global warming, which results mainly from the burning of fossil fuels. To avoid catastrophe, the transition to a renewable energy regime should be an urgent priority; however, the reality is that the progress of renewable energy is very slow due to the various political and economic factors when compared to conventional energy resources. A chief factor is that the energy subsidy for fossil fuel and nuclear energy obstructs the "level playing field" for renewable energy. Energy subsidies for conventional energy can be understood in the context of the commodification paradigm, which regards nature as an object of conquest and supports the principle of more is better. Although fossil fuel energy damages the environment, economy, and social equity, all countries subsidize such energy, no matter the country's state of development. This holds true as much in the U.S. and the EU as in China, India and South Korea. The oceans, which cover 71% of the earth, are threatened by the activities of conventional energy, which are underpinned by subsidies. These subsidies have contributed to the destruction of the marine ecosystem through increased GHG emissions like CO2 and NOx which cause a sea temperature increase and coral bleaching. Subsidies also significantly affect fishery overexploitation, oil pollution, and thermal pollution. In-depth empirical analysis of South Korea showed how fossil fuel and nuclear energy activities have threatened marine sustainability through thermal pollution, algae bloom (red tides), overexploitation, and oil-related marine pollution. Reforming subsidies of fossil fuel and nuclear energy should be a global priority because of imminent of global warming. As strategies for energy subsidy

  2. Identification of bacteriology and risk factor analysis of asymptomatic bacterial colonization in pacemaker replacement patients.

    Directory of Open Access Journals (Sweden)

    Xian-Ming Chu

    Full Text Available Recent researches revealed that asymptomatic bacterial colonization on PMs might be ubiquitous and increase the risk of clinical PM infection. Early diagnosis of patients with asymptomatic bacterial colonization could provide opportunity for targeted preventive measures.The present study explores the incidence of bacterial colonization of generator pockets in pacemaker replacement patients without signs of infection, and to analyze risk factors for asymptomatic bacterial colonization.From June 2011 to December 2013, 118 patients underwent pacemaker replacement or upgrade. Identification of bacteria was carried out by bacterial culture and 16S rRNA sequencing. Clinical risk characteristics were analyzed.The total bacterial positive rate was 37.3% (44 cases, and the coagulase-negative Staphylococcus aureus detection rate was the highest. Twenty two (18.6% patients had positive bacterial culture results, of which 50% had coagulase-negative staphylococcus. The bacterial DNA detection rate was 36.4 % (43 cases. Positive bacterial DNA results from pocket tissues and the surface of the devices were 22.0% and 29.7%, respectively. During follow-up (median, 27.0 months, three patients (6.8%, 3/44 became symptomatic with the same genus of microorganism, S. aureus (n=2 and S. epidermidis (n=1. Multivariable logistic regression analysis showed that history of bacterial infection, use of antibiotics, application of antiplatelet drugs, replacement frequency were independent risk factors for asymptomatic bacterial colonization.There was a high incidence of asymptomatic bacterial colonization in pacemaker patients with independent risk factors. Bacterial culture combined genetic testing could improve the detection rate.

  3. Discontinuation of continuous renal replacement therapy: A post hoc analysis of a prospective multicenter observational study

    NARCIS (Netherlands)

    Uchino, Shigehiko; Bellomo, Rinaldo; Morimatsu, Hiroshi; Morgera, Stanislao; Schetz, Miet; Tan, Ian; Bouman, Catherine; Macedo, Ettiene; Gibney, Noel; Tolwani, Ashita; Oudemans-van Straaten, Heleen; Ronco, Claudio; Kellum, John A.

    2009-01-01

    Objectives: To describe current practice for the discontinuation of continuous renal replacement therapy in a multinational setting and to identify variables associated with successful discontinuation. The approach to discontinue continuous renal replacement therapy may affect patient outcomes.

  4. Effects of clinical pathways in the joint replacement: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Faggiano F

    2009-07-01

    Full Text Available Abstract Background A meta-analysis was performed to evaluate the use of clinical pathways for hip and knee joint replacements when compared with standard medical care. The impact of clinical pathways was evaluated assessing the major outcomes of in-hospital hip and knee joint replacement processes: postoperative complications, number of patients discharged at home, length of in-hospital stay and direct costs. Methods Medline, Cinahl, Embase and the Cochrane Central Register of Controlled Trials were searched. The search was performed from 1975 to 2007. Each study was assessed independently by two reviewers. The assessment of methodological quality of the included studies was based on the Jadad methodological approach and on the New Castle Ottawa Scale. Data analysis abided by the guidelines set out by The Cochrane Collaboration regarding statistical methods. Meta-analyses were performed using RevMan software, version 4.2. Results Twenty-two studies met the study inclusion criteria and were included in the meta-analysis for a total sample of 6,316 patients. The aggregate overall results showed significantly fewer patients suffering postoperative complications in the clinical pathways group when compared with the standard care group. A shorter length of stay in the clinical pathway group was also observed and lower costs during hospital stay were associated with the use of the clinical pathways. No significant differences were found in the rates of discharge to home. Conclusion The results of this meta-analysis show that clinical pathways can significantly improve the quality of care even if it is not possible to conclude that the implementation of clinical pathways is a cost-effective process, because none of the included studies analysed the cost of the development and implementation of the pathways. Based on the results we assume that pathways have impact on the organisation of care if the care process is structured in a standardised way

  5. Growth versus metabolic tissue replacement in mouse tissues determined by stable carbon and nitrogen isotope analysis

    Science.gov (United States)

    Macavoy, S. E.; Jamil, T.; Macko, S. A.; Arneson, L. S.

    2003-12-01

    Stable isotope analysis is becoming an extensively used tool in animal ecology. The isotopes most commonly used for analysis in terrestrial systems are those of carbon and nitrogen, due to differential carbon fractionation in C3 and C4 plants, and the approximately 3‰ enrichment in 15N per trophic level. Although isotope signatures in animal tissues presumably reflect the local food web, analysis is often complicated by differential nutrient routing and fractionation by tissues, and by the possibility that large organisms are not in isotopic equilibrium with the foods available in their immediate environment. Additionally, the rate at which organisms incorporate the isotope signature of a food through both growth and metabolic tissue replacement is largely unknown. In this study we have assessed the rate of carbon and nitrogen isotopic turnover in liver, muscle and blood in mice following a diet change. By determining growth rates, we were able to determine the proportion of tissue turnover caused by growth versus that caused by metabolic tissue replacement. Growth was found to account for approximately 10% of observed tissue turnover in sexually mature mice (Mus musculus). Blood carbon was found to have the shortest half-life (16.9 days), followed by muscle (24.7 days). Liver carbon turnover was not as well described by the exponential decay equations as other tissues. However, substantial liver carbon turnover was observed by the 28th day after diet switch. Surprisingly, these tissues primarily reflect the carbon signature of the protein, rather than carbohydrate, source in their diet. The nitrogen signature in all tissues was enriched by 3 - 5‰ over their dietary protein source, depending on tissue type, and the isotopic turnover rates were comparable to those observed in carbon.

  6. 'This is my story, how I remember it': In-depth analysis of Dignity Therapy documents from a study of Dignity Therapy for people with early stage dementia.

    Science.gov (United States)

    Johnston, Bridget; Lawton, Sally; Pringle, Jan

    2017-07-01

    Dementia is a progressive condition that impacts on individuals, families and care professionals. Maintaining quality of life through engagement with the person with dementia is an important part of their care. Dignity Therapy is an interactive, psychotherapeutic intervention that uses a trained dignity therapist to guide the person with dementia through an interview that then creates a written legacy called a generativity document. This can provide knowledge to inform care, as the condition progresses. Generativity documents were analysed using framework analysis. Main themes from the analysis were origin of values, essence and affirmation of self, forgiveness and resolution and existentialism/ meaning of life. These themes provide evidence of the type, scope and contribution that information generated from Dignity Therapy can make to the care and support of people with dementia. They provide information about the values, self-identity and the people and events that have been important to them and influenced their lives.

  7. A nationwide analysis of socioeconomic outcomes after hip and knee replacement

    DEFF Research Database (Denmark)

    Kjellberg, Jakob; Kehlet, Henrik

    2016-01-01

    INTRODUCTION: Total hip and knee replacement (THA and TKA) are successful operations based on patient-reported outcomes and short-term socioeconomic evaluations. However, other data have shown problems regarding persistent pain and function. No detailed large-scale, long-term socioeconomic data...... exist on income and total health expenses before and after THA and TKA compared with a matched reference population (RP). METHODS: From the unique nationwide Danish registers, a total of 128,109 patients undergoing primary THA and TKA were followed from up to 12 years before to up to 12 years after...... surgery. The economic analysis of the total costs before and after surgery were divided into annual healthcare costs (outpatient services, inpatient admissions, prescription drugs and physician office visits), home care and loss of income and compared with a matched RP. RESULTS: Healthcare costs increased...

  8. Can renewable energy replace nuclear power in Korea? An economic valuation analysis

    International Nuclear Information System (INIS)

    Park, Soo Ho; Jung, Woo Jin; Kim, Tae Hwan; Lee, Sang Yong Tom

    2016-01-01

    This paper studies the feasibility of renewable energy as a substitute for nuclear and energy by considering Korean customers' willingness to pay (WTP). For this analysis, we use the contingent valuation method to estimate the WTP of renewable energy, and then estimate its value using ordered logistic regression. To replace nuclear power and fossil energy with renewable energy in Korea, an average household is willing to pay an additional 102,388 Korean Won (KRW) per month (approx. US $85). Therefore, the yearly economic value of renewable energy in Korea is about 19.3 trillion KRW (approx. US $16.1 billion). Considering that power generation with only renewable energy would cost an additional 35 trillion KRW per year, it is economically infeasible for renewable energy to be the sole method of low-carbon energy generation in Korea

  9. Can Renewable Energy Replace Nuclear Power in Korea? An Economic Valuation Analysis

    Directory of Open Access Journals (Sweden)

    Soo-Ho Park

    2016-04-01

    Full Text Available This paper studies the feasibility of renewable energy as a substitute for nuclear and energy by considering Korean customers' willingness to pay (WTP. For this analysis, we use the contingent valuation method to estimate the WTP of renewable energy, and then estimate its value using ordered logistic regression. To replace nuclear power and fossil energy with renewable energy in Korea, an average household is willing to pay an additional 102,388 Korean Won (KRW per month (approx. US $85. Therefore, the yearly economic value of renewable energy in Korea is about 19.3 trillion KRW (approx. US $16.1 billion. Considering that power generation with only renewable energy would cost an additional 35 trillion KRW per year, it is economically infeasible for renewable energy to be the sole method of low-carbon energy generation in Korea.

  10. Can renewable energy replace nuclear power in Korea? An economic valuation analysis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Soo Ho [Korea Institute for Advancement of Technology, Korea Technology Center, Seoul (Korea, Republic of); Jung, Woo Jin [Graduate School of Information, Yonsei University, Seoul (Korea, Republic of); Kim, Tae Hwan; Lee, Sang Yong Tom [School of Business, Hanyang University, Seoul (Korea, Republic of)

    2016-04-15

    This paper studies the feasibility of renewable energy as a substitute for nuclear and energy by considering Korean customers' willingness to pay (WTP). For this analysis, we use the contingent valuation method to estimate the WTP of renewable energy, and then estimate its value using ordered logistic regression. To replace nuclear power and fossil energy with renewable energy in Korea, an average household is willing to pay an additional 102,388 Korean Won (KRW) per month (approx. US $85). Therefore, the yearly economic value of renewable energy in Korea is about 19.3 trillion KRW (approx. US $16.1 billion). Considering that power generation with only renewable energy would cost an additional 35 trillion KRW per year, it is economically infeasible for renewable energy to be the sole method of low-carbon energy generation in Korea.

  11. Effects of Growth Hormone Replacement Therapy on Bone Mineral Density in Growth Hormone Deficient Adults: A Meta-Analysis

    OpenAIRE

    Xue, Peng; Wang, Yan; Yang, Jie; Li, Yukun

    2013-01-01

    Objectives. Growth hormone deficiency patients exhibited reduced bone mineral density compared with healthy controls, but previous researches demonstrated uncertainty about the effect of growth hormone replacement therapy on bone in growth hormone deficient adults. The aim of this study was to determine whether the growth hormone replacement therapy could elevate bone mineral density in growth hormone deficient adults. Methods. In this meta-analysis, searches of Medline, Embase, and The Cochr...

  12. Clearing the fog of anticancer patents from 1993-2013: through an in-depth technology landscape & target analysis from pioneer research institutes and universities worldwide.

    Directory of Open Access Journals (Sweden)

    Ajay Dara

    Full Text Available BACKGROUND: In a search for an effective anticancer therapy the R&D units from leading universities and institutes reveal numerous technologies in the form of patent documents. The article addressed comparative anticancer patent landscape and technology assessment of Council of Scientific and Industrial Research (CSIR: India's largest R&D organisation with top twenty international public funded universities and institutes from eight different countries. METHODOLOGY/PRINCIPAL FINDINGS: The methodology include quantitative and qualitative assessment based on the bibliometric parameters and manual technology categorisation to understand the changing patent trends and recent novel technologies. The research finding analysed 25,254 patent documents from the year 1993 to 2013 and reported the insights of latest anticancer technologies and targets through categorisation studies at the level of drug discovery, development and treatment & diagnosis. The article has reported the technology correlation matrix of twelve secondary class technologies with 34 tertiary sub-class research area to identify the leading technologies and scope of future research through whitespaces analysis. In addition, the results have also addressed the target analysis, leading inventor, assignee, collaboration network, geographical distribution, patent trend analysis, citation maps and technology assessment with respect to international patent classification systems such as CPC, IPC and CPI codes. CONCLUSIONS/SIGNIFICANCE: The result suggested peptide technology as the dominating research area next to gene therapy, vaccine and medical preparation containing organic compounds. The Indian CSIR has ranked itself at seventh position among the top 20 universities. Globally, the anticancer research was focused in the area of genetics and immunology, whereas Indian CSIR reported more patents related to plant extract and organic preparation. The article provided a glimpse of two decade

  13. Clearing the fog of anticancer patents from 1993-2013: through an in-depth technology landscape & target analysis from pioneer research institutes and universities worldwide.

    Science.gov (United States)

    Dara, Ajay; Sangamwar, Abhay T

    2014-01-01

    In a search for an effective anticancer therapy the R&D units from leading universities and institutes reveal numerous technologies in the form of patent documents. The article addressed comparative anticancer patent landscape and technology assessment of Council of Scientific and Industrial Research (CSIR): India's largest R&D organisation with top twenty international public funded universities and institutes from eight different countries. The methodology include quantitative and qualitative assessment based on the bibliometric parameters and manual technology categorisation to understand the changing patent trends and recent novel technologies. The research finding analysed 25,254 patent documents from the year 1993 to 2013 and reported the insights of latest anticancer technologies and targets through categorisation studies at the level of drug discovery, development and treatment & diagnosis. The article has reported the technology correlation matrix of twelve secondary class technologies with 34 tertiary sub-class research area to identify the leading technologies and scope of future research through whitespaces analysis. In addition, the results have also addressed the target analysis, leading inventor, assignee, collaboration network, geographical distribution, patent trend analysis, citation maps and technology assessment with respect to international patent classification systems such as CPC, IPC and CPI codes. The result suggested peptide technology as the dominating research area next to gene therapy, vaccine and medical preparation containing organic compounds. The Indian CSIR has ranked itself at seventh position among the top 20 universities. Globally, the anticancer research was focused in the area of genetics and immunology, whereas Indian CSIR reported more patents related to plant extract and organic preparation. The article provided a glimpse of two decade anticancer scenario with respect to top public funded universities worldwide.

  14. Clearing the Fog of Anticancer Patents from 1993–2013: Through an In-Depth Technology Landscape & Target Analysis from Pioneer Research Institutes and Universities Worldwide

    Science.gov (United States)

    Dara, Ajay; Sangamwar, Abhay T.

    2014-01-01

    Background In a search for an effective anticancer therapy the R&D units from leading universities and institutes reveal numerous technologies in the form of patent documents. The article addressed comparative anticancer patent landscape and technology assessment of Council of Scientific and Industrial Research (CSIR): India’s largest R&D organisation with top twenty international public funded universities and institutes from eight different countries. Methodology/Principal Findings The methodology include quantitative and qualitative assessment based on the bibliometric parameters and manual technology categorisation to understand the changing patent trends and recent novel technologies. The research finding analysed 25,254 patent documents from the year 1993 to 2013 and reported the insights of latest anticancer technologies and targets through categorisation studies at the level of drug discovery, development and treatment & diagnosis. The article has reported the technology correlation matrix of twelve secondary class technologies with 34 tertiary sub-class research area to identify the leading technologies and scope of future research through whitespaces analysis. In addition, the results have also addressed the target analysis, leading inventor, assignee, collaboration network, geographical distribution, patent trend analysis, citation maps and technology assessment with respect to international patent classification systems such as CPC, IPC and CPI codes. Conclusions/Significance The result suggested peptide technology as the dominating research area next to gene therapy, vaccine and medical preparation containing organic compounds. The Indian CSIR has ranked itself at seventh position among the top 20 universities. Globally, the anticancer research was focused in the area of genetics and immunology, whereas Indian CSIR reported more patents related to plant extract and organic preparation. The article provided a glimpse of two decade anticancer scenario

  15. What methods do reviews of normative ethics literature use for search, selection, analysis, and synthesis? In-depth results from a systematic review of reviews.

    Science.gov (United States)

    Mertz, Marcel; Strech, Daniel; Kahrass, Hannes

    2017-12-19

    (Semi-)systematic approaches to finding, analysing, and synthesising ethics literature on medical topics are still in their infancy. However, our recent systematic review showed that the rate of publication of such (semi-)systematic reviews has increased in the last two decades. This is not only true for reviews of empirical ethics literature, but also for reviews of normative ethics literature. In the latter case, there is currently little in the way of standards and guidance available. Therefore, the methods and reporting strategies of such reviews vary greatly. The purpose of the follow-up study we present was to obtain deeper methodological insight into the ways reviews of normative literature are actually conducted and to analyse the methods used. Our search in the PubMed, PhilPapers, and Google Scholar databases led to the identification of 183 reviews of ethics literature published between 1997 and 2015, of which 84 were identified as reviews of normative and mixed literature. Qualitative content analysis was used to extract and synthesise descriptions of search, selection, quality appraisal, analysis, and synthesis methods. We further assessed quantitatively how often certain methods (e.g. search strategies, data analysis procedures) were used by the reviews. The overall reporting quality varies among the analysed reviews and was generally poor even for major criteria regarding the search and selection of literature. For example, only 24 (29%) used a PRISMA flowchart. Also, only 55 (66%) reviews mentioned the information unit they sought to extract, and 12 (14%) stated an ethical approach as the theoretical basis for the analysis. Interpretable information on the synthesis method was given by 47 (60%); the most common methods applied were qualitative methods commonly used in social science research (83%). Reviews which fail to provide sufficient relevant information to readers have reduced methodological transparency regardless of actual methodological

  16. Shear capacity of ASR damaged structures – in-depth analysis of some in-situ shear tests on bridge slabs

    DEFF Research Database (Denmark)

    Hansen, Søren Gustenhoff; Barbosa, Ricardo Antonio; Hoang, Linh Cao

    2016-01-01

    This paper deals with the influence of alkali-silica reaction (ASR) on the shear capacity for concrete slabs without shear reinforcement. An experimental full-scale in-situ program consisting of four slabs from a bridge (Vosnæsvej) has been carried out and the results have been published in ref. [1......] with the principal author of this paper as co-author. After the experiments, a detailed measurement of the test specimens was conducted. Based on these measurements a thorough analysis of the experimental results was carried out and evaluated by a plastic model for shear capacity, Crack Sliding Model (CSM...

  17. Ankle replacement

    Science.gov (United States)

    Ankle arthroplasty - total; Total ankle arthroplasty; Endoprosthetic ankle replacement; Ankle surgery ... Ankle replacement surgery is most often done while you are under general anesthesia. This means you will ...

  18. In depth analysis of genes and pathways of the mammary gland involved in the pathogenesis of bovine Escherichia coli-mastitis

    DEFF Research Database (Denmark)

    Buitenhuis, Albert Johannes; Rontved, Christine M.; Edwards, Stefan McKinnon

    2011-01-01

    Background Bovine mastitis is one of the most costly and prevalent diseases affecting dairy cows worldwide. In order to develop new strategies to prevent Escherichia coli-induced mastitis, a detailed understanding of the molecular mechanisms underlying the host immune response to an E. coli.......i. to represent the acute phase response (APR) and chronic stage, respectively. Differentially expressed (DE) genes for each stage were analyzed and the DE genes detected at T=24h were also compared to data collected from two previous E. coli mastitis studies that were carried out on post mortem tissue. Results...... of the up-regulated transcripts were associated with tissue healing processes. Comparison of T=24h DE genes detected in the three E. coli mastitis studies revealed 248 were common and mainly involved immune response functions. KEGG pathway analysis indicated these genes were involved in 12 pathways related...

  19. In-depth comparative analysis of malaria parasite genomes reveals protein-coding genes linked to human disease in Plasmodium falciparum genome.

    Science.gov (United States)

    Liu, Xuewu; Wang, Yuanyuan; Liang, Jiao; Wang, Luojun; Qin, Na; Zhao, Ya; Zhao, Gang

    2018-05-02

    Plasmodium falciparum is the most virulent malaria parasite capable of parasitizing human erythrocytes. The identification of genes related to this capability can enhance our understanding of the molecular mechanisms underlying human malaria and lead to the development of new therapeutic strategies for malaria control. With the availability of several malaria parasite genome sequences, performing computational analysis is now a practical strategy to identify genes contributing to this disease. Here, we developed and used a virtual genome method to assign 33,314 genes from three human malaria parasites, namely, P. falciparum, P. knowlesi and P. vivax, and three rodent malaria parasites, namely, P. berghei, P. chabaudi and P. yoelii, to 4605 clusters. Each cluster consisted of genes whose protein sequences were significantly similar and was considered as a virtual gene. Comparing the enriched values of all clusters in human malaria parasites with those in rodent malaria parasites revealed 115 P. falciparum genes putatively responsible for parasitizing human erythrocytes. These genes are mainly located in the chromosome internal regions and participate in many biological processes, including membrane protein trafficking and thiamine biosynthesis. Meanwhile, 289 P. berghei genes were included in the rodent parasite-enriched clusters. Most are located in subtelomeric regions and encode erythrocyte surface proteins. Comparing cluster values in P. falciparum with those in P. vivax and P. knowlesi revealed 493 candidate genes linked to virulence. Some of them encode proteins present on the erythrocyte surface and participate in cytoadhesion, virulence factor trafficking, or erythrocyte invasion, but many genes with unknown function were also identified. Cerebral malaria is characterized by accumulation of infected erythrocytes at trophozoite stage in brain microvascular. To discover cerebral malaria-related genes, fast Fourier transformation (FFT) was introduced to extract

  20. In-Depth Global Analysis of Transcript Abundance Levels in Porcine Alveolar Macrophages Following Infection with Porcine Reproductive and Respiratory Syndrome Virus

    Directory of Open Access Journals (Sweden)

    Laura C. Miller

    2010-01-01

    Full Text Available Porcine reproductive and respiratory syndrome virus (PRRSV is a major pathogen of swine worldwide and causes considerable economic loss. Identifying specific cell signaling or activation pathways that associate with variation in PRRSV replication and macrophage function may lead to identification of novel gene targets for the control of PRRSV infection. Serial Analysis of Gene Expression (SAGE was used to create and survey the transcriptome of in vitro mock-infected and PRRSV strain VR-2332-infected porcine alveolar macrophages (PAM at 0, 6, 12, 16, and 24 hours after infection. The transcriptome data indicated changes in transcript abundance occurring in PRRSV-infected PAMs over time after infection with more than 590 unique tags with significantly altered transcript abundance levels identified (P<.01. Strikingly, innate immune genes (whose transcript abundances are typically altered in response to other pathogens or insults including IL-8, CCL4, and IL-1β showed no or very little change at any time point following infection.

  1. Life Cycle Water Consumption and Water Resource Assessment for Utility-Scale Geothermal Systems: An In-Depth Analysis of Historical and Forthcoming EGS Projects

    Energy Technology Data Exchange (ETDEWEB)

    Clark, Corrie E. [Argonne National Lab. (ANL), Argonne, IL (United States); Harto, Christopher B. [Argonne National Lab. (ANL), Argonne, IL (United States); Schroeder, Jenna N. [Argonne National Lab. (ANL), Argonne, IL (United States); Martino, Louis E. [Argonne National Lab. (ANL), Argonne, IL (United States); Horner, Robert M. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2013-08-01

    This report is the third in a series of reports sponsored by the U.S. Department of Energy Geothermal Technologies Program in which a range of water-related issues surrounding geothermal power production are evaluated. The first report made an initial attempt at quantifying the life cycle fresh water requirements of geothermal power-generating systems and explored operational and environmental concerns related to the geochemical composition of geothermal fluids. The initial analysis of life cycle fresh water consumption of geothermal power-generating systems identified that operational water requirements consumed the vast majority of water across the life cycle. However, it relied upon limited operational water consumption data and did not account for belowground operational losses for enhanced geothermal systems (EGSs). A second report presented an initial assessment of fresh water demand for future growth in utility-scale geothermal power generation. The current analysis builds upon this work to improve life cycle fresh water consumption estimates and incorporates regional water availability into the resource assessment to improve the identification of areas where future growth in geothermal electricity generation may encounter water challenges. This report is divided into nine chapters. Chapter 1 gives the background of the project and its purpose, which is to assess the water consumption of geothermal technologies and identify areas where water availability may present a challenge to utility-scale geothermal development. Water consumption refers to the water that is withdrawn from a resource such as a river, lake, or nongeothermal aquifer that is not returned to that resource. The geothermal electricity generation technologies evaluated in this study include conventional hydrothermal flash and binary systems, as well as EGSs that rely on engineering a productive reservoir where heat exists, but where water availability or permeability may be limited. Chapter 2

  2. An in-depth analysis identifies two new independent signals in 11q23.3 associated with vitiligo in the Chinese Han population.

    Science.gov (United States)

    Zhao, Suli; Fang, Fang; Tang, Xianfa; Dou, Jinfa; Wang, Wenjun; Zheng, Xiaodong; Sun, Liangdan; Zhang, Anping

    2017-10-01

    Vitiligo is an autoimmune disease, characterized by progressive loss of skin pigmentation, which is caused by the interactions of multiple factors, such as heredity, immunity and environment. Recently, a single nucleotide polymorphism (SNP) rs638893 at 11q23.3 region was identified as a risk factor for vitiligo in genome-wide association studies and multiple SNPs in this region have been associated with other autoimmune diseases. This study aims to identify additional susceptibility variants associated with vitiligo at 11q23.3 in the Chinese Han population. We selected and genotyped 26 SNPs at 11q23.3 in an independent cohort including 2924 cases and 4048 controls using the Sequenom MassArray iPLEX ® system. Bonferroni adjustment was used for multiple comparisons and P value vitiligo (OR=1.21, 95% CI: 1.11-1.31, P=1.20×10 -5 ; OR=1.14, 95% CI: 1.07-1.23, P=1.90×10 -4 , respectively). The C allele of rs638893 (a previously reported one) located upstream of DDX6 was also significantly associated with vitiligo (OR=1.25, 95% CI: 1.12-1.38, P=3.04×10 -5 ). The genotypes distribution of 3 SNPs also showed significant differences between case and control (rs613791: P=7.00×10 -6 , rs523604: P=4.00×10 -3 , rs638893: P=1.20×10 -5 , respectively). The two newly identified SNPs (rs613791 and rs523604) showed independent associations with vitiligo by linkage disequilibrium analysis and conditional logistic regression. The study identified two new independent signals in the associated locus 11q23.3 for vitiligo. The presence of multiple independent variants emphasizes an important role of this region in disease susceptibility. Copyright © 2017 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.

  3. In-depth Analysis of Pattern of Occupational Injuries and Utilization of Safety Measures among Workers of Railway Wagon Repair Workshop in Jhansi (U.P.).

    Science.gov (United States)

    Gupta, Shubhanshu; Malhotra, Anil K; Verma, Santosh K; Yadav, Rashmi

    2017-01-01

    Occupational injuries constitute a global health challenge, yet they receive comparatively modest scientific attention. Pattern of occupational injuries and its safety precautions among wagon repair workers is an important health issue, especially in developing countries like India. To assess the pattern of occupational injuries and utilization of safety measures among railway wagon repair workshop workers in Jhansi (U.P.). Railway wagon repair workshop urban area, Jhansi (U.P). Occupation-based cross-sectional study. A cross-sectional study was conducted among 309 workers of railway workshop in Jhansi (U.P.) who were all injured during the study period of 1 year from July 2015 to June 2016. Baseline characteristics, pattern of occupational injuries, safety measures, and their availability to and utilization by the participants were assessed using a pretested structured questionnaire. Data obtained were collected and analyzed statistically by simple proportions and Chi-square test. The majority of studied workers aged between 38 and 47 years ( n = 93, 30.6%) followed by 28-37 years ( n = 79, 26%). Among the pattern of occupational injuries, laceration (28.7%) was most common followed by abrasion/scratch (21%). Safety shoes and hat were utilized 100% by all workers. Many of them had more than 5 years of experience ( n = 237, 78%). Age group, education level, and utilization of safety measures were significantly associated with pattern of occupational injuries in univariate analysis ( P safety measures is low among workers on railway wagon repair workshop, which highlights the importance of strengthening safety regulatory services toward this group of workers. Younger age group workers show a significant association with open wounds and surface wounds. As the education level of workers increases, the incidence of injuries decreases. Apart from shoes, hat, and gloves, regular utilization of other personal protective equipment was not seen.

  4. Physiotherapy rehabilitation after total knee or hip replacement: an evidence-based analysis.

    Science.gov (United States)

    2005-01-01

    The objective of this health technology policy analysis was to determine, where, how, and when physiotherapy services are best delivered to optimize functional outcomes for patients after they undergo primary (first-time) total hip replacement or total knee replacement, and to determine the Ontario-specific economic impact of the best delivery strategy. The objectives of the systematic review were as follows: To determine the effectiveness of inpatient physiotherapy after discharge from an acute care hospital compared with outpatient physiotherapy delivered in either a clinic-based or home-based setting for primary total joint replacement patientsTo determine the effectiveness of outpatient physiotherapy delivered by a physiotherapist in either a clinic-based or home-based setting in addition to a home exercise program compared with a home exercise program alone for primary total joint replacement patientsTo determine the effectiveness of preoperative exercise for people who are scheduled to receive primary total knee or hip replacement surgery Total hip replacements and total knee replacements are among the most commonly performed surgical procedures in Ontario. Physiotherapy rehabilitation after first-time total hip or knee replacement surgery is accepted as the standard and essential treatment. The aim is to maximize a person's functionality and independence and minimize complications such as hip dislocation (for hip replacements), wound infection, deep vein thrombosis, and pulmonary embolism. THE THERAPY: The physiotherapy rehabilitation routine has 4 components: therapeutic exercise, transfer training, gait training, and instruction in the activities of daily living. Physiotherapy rehabilitation for people who have had total joint replacement surgery varies in where, how, and when it is delivered. In Ontario, after discharge from an acute care hospital, people who have had a primary total knee or hip replacement may receive inpatient or outpatient

  5. Foundation Year 2 doctors' reasons for leaving UK medicine: an in-depth analysis of decision-making using semistructured interviews.

    Science.gov (United States)

    Smith, Samantha E; Tallentire, Victoria R; Pope, Lindsey M; Laidlaw, Anita H; Morrison, Jill

    2018-03-02

    To explore the reasons that doctors choose to leave UK medicine after their foundation year two posts. All four regions of Scotland. Foundation year two doctors (F2s) working throughout Scotland who were considering leaving UK medicine after foundation training were recruited on a volunteer basis. Maximum variation between participants was sought. Semistructured interviews were coded using template analysis. Six perspectives, described by Feldman and Ng, were used as the initial coding template. The codes were then configured to form a framework that explores the interplay of factors influencing Foundation Year 2 (F2) doctors' decisions to leave UK medicine. Seventeen participants were interviewed. Six perspectives were explored. Structural influences (countrywide and worldwide issues) included visas, economic and political considerations, structure of healthcare systems and availability of junior doctor jobs worldwide. Organisational influences (the National Health Service (NHS) and other healthcare providers) included staffing and compensation policies, the working environment and the learning environment. Occupational influences (specific to being a junior doctor) comprised the junior doctor contract, role and workload, pursuit of career interests and the structure of training. Work group influences (relationships with colleagues) included support at work, task interdependence and use of locums. Personal life influences consisted of work-life balance, and support in resolving work-life conflict. The underlying theme of 'taking a break' recurred through multiple narratives. F2s give reasons similar to those given by any professional considering a change in their job. However, working within the NHS as an F2 doctor brought specific challenges, such as a need to make a choice of specialty within the F2 year, exposure to workplace bullying and difficulties in raising concerns. Despite these challenges, most F2s did not view their decision to leave as a permanent job

  6. In-depth analysis of patient-clinician cell phone communication during the WelTel Kenya1 antiretroviral adherence trial.

    Directory of Open Access Journals (Sweden)

    Mia L van der Kop

    Full Text Available The WelTel Kenya1 trial demonstrated that text message support improved adherence to antiretroviral therapy (ART and suppression of HIV-1 RNA load. The intervention involved sending weekly messages to patients inquiring how they were doing; participants were required to respond either that they were well or that there was a problem.1 Describe problems participants identified through mobile phone support and reasons why participants did not respond to the messages; 2 investigate factors associated with indicating a problem and not responding; and 3 examine participant perceptions of the intervention.Secondary analysis of WelTel Kenya1 trial data.Reasons participants indicated a problem or did not respond were extracted from the study log. Negative binomial regression was used to determine participant characteristics associated with indicating a problem and non-response. Data from follow-up questionnaires were used to describe participant perceptions of the intervention.Between 2007 and 2009, 271 participants generated 11,873 responses; 377 of which indicated a problem. Health issues were the primary reason for problem responses (72%. Rural residence (adjusted incidence rate ratio [IRR] 1.96; 95%CI 1.19-3.25; p=0.009 and age were associated with indicating a problem (adjusted IRR 0.63 per increase in age group category; 95%CI 0.50-0.80; p<0.001. Higher educational level was associated with a decreased rate of non-response (adjusted IRR 0.81; 95%CI 0.69-0.94; p=0.005. Of participants interviewed, 62% (n=129 stated there were no barriers to the intervention; cell phone issues were the most common barrier. Benefits included reminding patients to take medication and promoting a feeling that "someone cares".The WelTel intervention enabled frequent communication between clinicians and patients during the WelTel Kenya1 trial. Many patients valued the service for the support it provided, with health-related concerns comprising the majority of problems

  7. Causes of Death Following Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Xiong, Tian-Yuan; Liao, Yan-Biao; Zhao, Zhen-Gang; Xu, Yuan-Ning; Wei, Xin; Zuo, Zhi-Liang; Li, Yi-Jian; Cao, Jia-Yu; Tang, Hong; Jilaihawi, Hasan; Feng, Yuan; Chen, Mao

    2015-09-21

    Transcatheter aortic valve replacement (TAVR) is an effective alternative to surgical aortic valve replacement in patients at high surgical risk. However, there is little published literature on the exact causes of death. The PubMed database was systematically searched for studies reporting causes of death within and after 30 days following TAVR. Twenty-eight studies out of 3934 results retrieved were identified. In the overall analysis, 46.4% and 51.6% of deaths were related to noncardiovascular causes within and after the first 30 days, respectively. Within 30 days of TAVR, infection/sepsis (18.5%), heart failure (14.7%), and multiorgan failure (13.2%) were the top 3 causes of death. Beyond 30 days, infection/sepsis (14.3%), heart failure (14.1%), and sudden death (10.8%) were the most common causes. All possible subgroup analyses were made. No significant differences were seen for proportions of cardiovascular deaths except the comparison between moderate (mean STS score 4 to 8) and high (mean STS score >8) -risk patients after 30 days post-TAVR (56.0% versus 33.5%, P=0.005). Cardiovascular and noncardiovascular causes of death are evenly balanced both in the perioperative period and at long-term follow-up after TAVR. Infection/sepsis and heart failure were the most frequent noncardiovascular and cardiovascular causes of death. This study highlights important areas of clinical focus that could further improve outcomes after TAVR. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  8. Flued head replacement alternatives

    International Nuclear Information System (INIS)

    Smetters, J.L.

    1987-01-01

    This paper discusses flued head replacement options. Section 2 discusses complete flued head replacement with a design that eliminates the inaccessible welds. Section 3 discusses alternate flued head support designs that can drastically reduce flued head installation costs. Section 4 describes partial flued head replacement designs. Finally, Section 5 discusses flued head analysis methods. (orig./GL)

  9. Comparative analysis of pain in patients who underwent total knee replacement regarding the tourniquet pressure

    Directory of Open Access Journals (Sweden)

    Marcos George de Souza Leão

    Full Text Available ABSTRACT OBJECTIVES: To evaluate through the visual analog scale (VAS the pain in patients undergoing total knee replacement (TKR with different pressures of the pneumatic tourniquet. METHODS: An observational, randomized, descriptive study on an analytical basis, with 60 patients who underwent TKR, divided into two groups, which were matched: a group where TKR was performed with tourniquet pressures of 350 mmHg (standard and the other with systolic blood pressure plus 100 mmHg (P + 100. These patients had their pain assessed by VAS at 48 h, and at the 5th and 15th days after procedure. Secondarily, the following were also measured: range of motion (ROM, complications, and blood drainage volume in each group; the data were subjected to statistical analysis. RESULTS: After data analysis, there was no statistical difference regarding the incidence of complications (p = 0.612, ROM (p = 0.202, bleeding after 24 and 48 h (p = 0.432 and p = 0.254 or in relation to VAS. No correlation was observed between time of ischemia compared to VAS and bleeding. CONCLUSIONS: The use of the pneumatic tourniquet pressure at 350 mmHg or systolic blood pressure plus 100 mmHg did not influence the pain, blood loss, ROM, and complications. Therefore the pressures at these levels are safe and do not change the surgery outcomes; the time of ischemia must be closely observed to avoid major complications.

  10. Analysis of growth and tissue replacement rates by stable sulfur isotope turnover.

    Science.gov (United States)

    Arneson, L. S.; Macko, S. A.; Macavoy, S. E.

    2003-12-01

    Stable isotope analysis has become a powerful tool to study animal ecology. Analysis of stable isotope ratios of elements such as carbon, nitrogen, sulfur, hydrogen, oxygen and others have been used to trace migratory routes, reconstruct dietary sources and determine the physiological condition of individual animals. The isotopes most commonly used are carbon, due to differential carbon fractionation in C3 and C4 plants, and nitrogen, due to the approximately 3% enrichment in 15N per trophic level. Although all cells express sulfur-containing compounds, such as cysteine, methionine, and coenzyme A, the turnover rate of sulfur in tissues has not been examined in most studies, owing to the difficulty in determining the δ 34S signature. In this study, we have assessed the rate of sulfur isotopic turnover in mouse tissues following a diet change from terrestrial (7%) to marine (19%) source. Turnover models reflecting both growth rate and metabolic tissue replacement will be developed for blood, liver, fat and muscle tissues.

  11. Mitral valve repair versus replacement in elderly patients: a systematic review and meta-analysis.

    Science.gov (United States)

    Shang, Xiaoke; Lu, Rong; Liu, Mei; Xiao, Shuna; Dong, Nianguo

    2017-09-01

    Although mitral valve repair (MVP) is generally accepted as the standard treatment for mitral valve disease, in older patients, there is increasing debate about whether MVP is superior to mitral valve replacement (MVR). We, therefore, performed a meta-analysis to compare MVP vs. MVR in the elderly population. We systematically searched PubMed, the Cochrane Library, and Scopus up to February 2017 and scrutinized the references of relevant literatures. Only studies of MVP vs. MVR in the elderly patients (aged 70 years or older) that were published after 2000 were included. The retrieval process yielded seven observational clinical studies with 1,809 patients. Compared with MVR, MVP was associated with a significantly reduced 30-day mortality [risk ratio (RR): 0.40, 95% confidence interval (CI): 0.25-0.64], with shorter duration of postoperative hospital stay (days) (weighted mean difference: -1.47, 95% CI: -2.47--0.48) and less postoperative complications (RR: 0.69, 95% CI: 0.56-0.86). In addition, our study also demonstrated improved 1-year (RR: 1.16, 95% CI: 1.08-1.24) and 5-year (RR: 1.26, 95% CI: 1.13-1.41) survival rates following MVP. There was no difference in reoperations between these two surgery approaches. The present meta-analysis indicates that elderly patients who receive MVP have better early and late outcomes than those undergoing MVR. MVP may be the preferred strategy for mitral valve surgery in the elderly population.

  12. Safety analysis program for steam generators replacement and power uprate at Tihange 2 nuclear power plant

    International Nuclear Information System (INIS)

    Delhaye, X.; Charlier, A.; Damas, Ph.; Druenne, H.; Mandy, C.; Parmentier, F.; Pirson, J.; Zhang, J.

    2002-01-01

    The Belgian Tihange 2 nuclear power plant went into commercial operation in 1983 producing a thermal power of 2785 MW. Since the commissioning of the plant the steam generators U-tubes have been affected by primary stress corrosion cracking. In order to avoid further degradation of the performance and an increase in repair costs, Electrabel, the owner of the plant, decided in 1997 to replace the 3 steam generators. This decision was supported by the feasibility study performed by Tractebel Energy Engineering which demonstrated that an increase of 10% of the initial power together with a fuel cycle length of 18 months was achieved. Tractebel Energy Engineering was entrusted by Electrabel as the owner's engineer to manage the project. This paper presents the role of Tractebel Energy Engineering in this project and the safety analysis program necessary to justify the new operation point and the fuel cycle extension to 18 months re-analysis of FSAR chapter 15 accidents and verification of the capacity of the safety and auxiliary systems. The FSAR chapter 15 accidents were reanalyzed jointly by Framatome and Tractebel Energy Engineering while the systems verifications were carried out by Tractebel Energy Engineering. (author)

  13. Do modern total knee replacements offer better value for money? A health economic analysis.

    Science.gov (United States)

    Hamilton, David F; Clement, Nicholas D; Burnett, Richard; Patton, James T; Moran, Mathew; Howie, Colin R; Simpson, A H R W; Gaston, Paul

    2013-11-01

    Cost effectiveness is an increasingly important factor in today's healthcare environment, and selection of arthroplasty implant is not exempt from such concerns. Quality adjusted life years (QALYs) are the typical tool for this type of evaluation. Using this methodology, joint arthroplasty has been shown to be cost effective; however, studies directly comparing differing prostheses are lacking. Data was gathered in a single-centre prospective double-blind randomised controlled trial comparing the outcome of modern and traditional knee implants, using the Short Form 6 dimensional (SF-6D) score and quality adjusted life year (QALY) methodology. There was significant improvement in the SF-6D score for both groups at one year (p traditional design at one year (0.141 versus 0.143, p = 0.94). This difference resulted in the modern implant costing £298 less per QALY at one year. This study demonstrates that modern implant technology does not influence the cost-effectiveness of TKA using the SF-6D and QALY methodology. This type of analysis however assesses health status, and is not sensitive to joint specific function. Evolutionary design changes in implant technology are thus unlikely to influence QALY analysis following joint replacement, which has important implications for implant procurement.

  14. Nicotine replacement therapy decision based on fuzzy multi-criteria analysis

    Science.gov (United States)

    Tarmudi, Zamali; Matmali, Norfazillah; Abdullah, Mohd Lazim

    2017-08-01

    It has been observed that Nicotine Replacement Therapy (NRT) is one of the alternatives to control and reduce smoking addiction among smokers. Since the decision to choose the best NRT alternative involves uncertainty, ambiguity factors and diverse input datasets, thus, this paper proposes a fuzzy multi-criteria analysis (FMA) to overcome these issues. It focuses on how the fuzzy approach can unify the diversity of datasets based on NRT's decision-making problem. The analysis done employed the advantage of the cost-benefit criterion to unify the mixture of dataset input. The performance matrix was utilised to derive the performance scores. An empirical example regarding the NRT's decision-making problem was employed to illustrate the proposed approach. Based on the calculations, this analytical approach was found to be highly beneficial in terms of usability. It was also very applicable and efficient in dealing with the mixture of input datasets. Hence, the decision-making process can easily be used by experts and patients who are interested to join the therapy/cessation program.

  15. Molecular-dynamics simulation of displacement cascades in Cu: analysis of replacement sequences

    International Nuclear Information System (INIS)

    King, W.E.; Benedek, R.

    1981-01-01

    Molecular-dynamics computer simulations of displacement cascades in copper have been performed for recoil energies up to 450 eV. Statistical analyses of the atomic replacements are presented. Linear replacement sequence lengths are extremely short on the average. The effect of the cooling phase of the cascade is discussed

  16. In Depth Analysis of Food Structures

    DEFF Research Database (Denmark)

    Nielsen, Otto Højager Attermann; Dahl, Anders Lindbjerg; Larsen, Rasmus

    2011-01-01

    over time. In this paper we demonstrate the use- fulness of our SLS system for characterizing food items. We use a laser source that can be tuned to any wavelength in the range of 455 nm - 1020 nm by applying an AOTF (Acousto-Optical Tunable Filter) to an optical beam generated by a Super......In this paper we describe a computer vision system based on SLS (Subsurface Laser Scattering) for industrial food inspection. To ob- tain high and uniform quality, in for example dairy products like yoghurt and cheese, it is important to monitor the change in size and shape of microscopic particles......K (supercontinuum) laser system. In our experiments we show how the system can be used for discriminating dairy products with dierent structure and how the structural change of a foam can be monitored over time. Time stability of the system is essential for measurements over several hours, and we demonstrate...

  17. Radial Force: An Underestimated Parameter in Oversizing Transcatheter Aortic Valve Replacement Prostheses: In Vitro Analysis with Five Commercialized Valves.

    Science.gov (United States)

    Egron, Sandrine; Fujita, Buntaro; Gullón, Lucía; Désirée, Pott; Schmitz-Rode, Thomas; Ensminger, Stephan; Steinseifer, Ulrich

    2017-09-05

    The goal is to inform in depth on transcatheter aortic valve replacement (TAVR) prosthesis mechanical behavior, depending on frame type, design, and size, and how it crucially impacts the oversizing issue in clinical use, and ultimately the procedure outcome. Transcatheter aortic valve replacement is an established therapy for high-risk patients suffering from aortic stenosis, and the indication for TAVR is progressively expanding to intermediate-risk patients. Choosing the optimal oversizing degree is crucial to safely anchor the TAVR valve-which involves limiting the risks for embolism, aortic regurgitation, conductance disturbance, or annulus rupture-and to increase the valve prosthesis performance. The radial force (RF) profiles of five TAVR prostheses were measured in vitro: the CoreValve 23 and 26 (Medtronic, MN), the Acurate neo S (Symetis, Switzerland), and the SAPIEN XT 23 and 26 (Edwards Lifesciences, CA). Measurements were run with the RX Machine equipment (Machine Solutions Inc., AZ), which is used in ISO standard tests for intravascular stents. Test protocols were adapted for TAVR prostheses. With the prostheses RF profiles' results, mechanical behavior differences could be described and discussed in terms of oversizing strategy and clinical impact for all five valves. Besides, crossing the prostheses' RF profiles with their recommended size windows made the assessment of borderline size cases possible and helped analyze the risks when accurate measurement of patient aortic annulus proves difficult. The prostheses' RF profiles bring new support in clinical decision-making for valve type and size in patients.

  18. Efficacy of pancreatic enzyme replacement therapy in chronic pancreatitis: systematic review and meta-analysis.

    Science.gov (United States)

    de la Iglesia-García, Daniel; Huang, Wei; Szatmary, Peter; Baston-Rey, Iria; Gonzalez-Lopez, Jaime; Prada-Ramallal, Guillermo; Mukherjee, Rajarshi; Nunes, Quentin M; Domínguez-Muñoz, J Enrique; Sutton, Robert

    2017-08-01

    The benefits of pancreatic enzyme replacement therapy (PERT) in chronic pancreatitis (CP) are inadequately defined. We have undertaken a systematic review and meta-analysis of randomised controlled trials of PERT to determine the efficacy of PERT in exocrine pancreatic insufficiency (EPI) from CP. Major databases were searched from 1966 to 2015 inclusive. The primary outcome was coefficient of fat absorption (CFA). Effects of PERT versus baseline and versus placebo, and of different doses, formulations and schedules were determined. A total of 17 studies (511 patients with CP) were included and assessed qualitatively (Jadad score). Quantitative data were synthesised from 14 studies. PERT improved CFA compared with baseline (83.7±6.0 vs 63.1±15.0, pregression analyses revealed that sample size, CP diagnostic criteria, study design and enzyme dose contributed to heterogeneity; data on health inequalities were lacking. PERT is indicated to correct EPI and malnutrition in CP and may be improved by higher doses, enteric coating, administration during food and acid suppression. Further studies are required to determine optimal regimens, the impact of health inequalities and long-term effects on nutrition. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Performance analysis of the electric vehicle air conditioner by replacing hydrocarbon refrigerant

    Science.gov (United States)

    Santoso, Budi; Tjahjana, D. D. D. P.

    2017-01-01

    The thermal comfort in passenger cabins needs an automotive air-conditioning system. The electric vehicle air conditioner system is driven by an electric compressor which includes a compressor and an electric motor. Almost air-conditioning system uses CFC-12, CFC-22 and HFC-134a as refrigerant. However, CFC-12 and CFC-22 will damage the ozone layer. The extreme huge global warming potentials (GWP) values of CFC-12, CFC-22, and HFC-134a represent the serious greenhouse effect of Earth. This article shows new experimental measurements and analysis by using a mixture of HC-134 to replace HFC-134a. The result is a refrigerating effect, the coefficient of performance and energy factor increase along with cooling capacity, both for HFC-134a and HC-134. The refrigerating effect of HC-134 is almost twice higher than HFC-134a. The coefficient of performance value of HC-134 is also 36.42% greater than HFC-134a. Then, the energy factor value of HC-134 is 3.78% greater than HFC-134a.

  20. Blood management in total hip replacement: an analysis of factors associated with allogenic blood transfusion.

    Science.gov (United States)

    Wong, Samuel; Tang, Howard; de Steiger, Richard

    2015-06-01

    The aim of this study was to audit the blood transfusion practice throughout the Epworth Healthcare Hospitals for patients undergoing primary total hip replacement (THR). We determined if blood-saving techniques were having an impact on the risk of allogenic blood transfusion and which patients were at risk of receiving allogenic blood transfusion. This study uses a retrospective audit of 787 patients who had undergone primary THR surgery at three Melbourne hospitals: Epworth Richmond, Epworth Eastern and Epworth Freemasons in 2010. Patient demographics, transfusion requirements and blood-conserving techniques were recorded. One hundred and eighty (23%) patients received allogenic blood transfusion and 18 (2.3%) patients received autologous blood transfusion. On multivariate analysis, preoperative anaemia (odds ratio (OR) 4.7, P blood transfusion. Use of spinal anaesthetic was found to be associated with lower risk of transfusion (OR 0.6, P = 0.0180) compared with general anaesthetic alone. Cell saver, acute normovolaemic haemodilution and re-infusion drain tube usage did not have a significant impact on reducing the risk of allogenic blood transfusion. Identification of patients at risk of blood transfusion, correction of preoperative anaemia and a restrictive transfusion policy are important factors to consider in effective perioperative blood management. © 2015 Royal Australasian College of Surgeons.

  1. Upper gastrointestinal bleeding following transcatheter aortic valve replacement: A retrospective analysis.

    Science.gov (United States)

    Stanger, Dylan E; Abdulla, Alym H; Wong, Frank T; Alipour, Sina; Bressler, Brian L; Wood, David A; Webb, John G

    2017-08-01

    The aim of this study was to identify the incidence of upper gastrointestinal bleeding (UGIB) in the postprocedural period following transcatheter aortic valve replacement (TAVR). As TAVR moves into intermediate- and low-risk patients, it has become increasingly important to understand its extracardiac complications. The patient population undergoing TAVR have clinical and demographic characteristics that place them at significant risk of UGIB. Practical aspects of TAVR, including use of antithrombotic therapy, further increase risk of UGIB. A retrospective single-center evaluation of 841 patients who underwent TAVR between January 2005 and August 2014 was performed in conjunction with analysis of referral patterns to the gastroenterology service for UGIB at the same site. The overall risk of UGIB following TAVR was found to be 2.0% (n = 17/841). Additionally, the risk of UGIB in patients receiving triple antithrombotic therapy was found to be 10-fold greater than patients not receiving triple antithrombotic therapy (11.8% vs 1.0%). Endoscopy findings demonstrated five high-risk esophageal lesions including erosive esophageal ulcers, visible vessels at the GE junction, erosions at distal esophagus, and an actively bleeding esophageal ring that had been intubated through by the transesophageal echocardiography (TEE) probe. This large cohort study demonstrates that TAVR is associated with a moderate risk of severe UGIB. The results of this study suggest that patients on triple antithrombotic therapy are at highest risk for severe UGIB. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  2. Knee Replacement

    Science.gov (United States)

    Knee replacement is surgery for people with severe knee damage. Knee replacement can relieve pain and allow you to ... Your doctor may recommend it if you have knee pain and medicine and other treatments are not ...

  3. Cost Analysis Of Replacement And Bearing Trailer Maintenance In Sugar Group Companies

    OpenAIRE

    Mastur, Mastur; Masyhuri, Masyhuri; Waluyati, Lestari Rahayu

    2017-01-01

    The purpose of this study are to understand (i) the costs and periods optimal of grease used for the replacement and maintenance bearing trailer in Sugar Group Companies (SGC), and (ii) the effect of a period and frequency of grease, lifetime bearing, frequency of replacement bearing in a year, unit trailer, brand bearing, and location of plant. The basic method used is descriptive and analytical. The location determined were in Workshop Division PT. ILP, PT. SIL, and PT. GPM. The analytical ...

  4. Comparison of IAS 39 and IFRS 9: The Analysis of Replacement

    Directory of Open Access Journals (Sweden)

    Mojca Gornjak

    2017-06-01

    Full Text Available The financial crisis had an impact on international financial reporting standards. The International Accounting Standards Board (IASB prepared a new standard for financial instruments. The replacement changes the view to accounting data in financial statements and changes the view to data in organizations, especially banks, and financial institutions. Historical prices are replaced with expectation in the future, which is not anymore a decision of the managers but has its basis on business operations.

  5. Choice of implant combinations in total hip replacement: systematic review and network meta-analysis.

    Science.gov (United States)

    López-López, José A; Humphriss, Rachel L; Beswick, Andrew D; Thom, Howard H Z; Hunt, Linda P; Burston, Amanda; Fawsitt, Christopher G; Hollingworth, William; Higgins, Julian P T; Welton, Nicky J; Blom, Ashley W; Marques, Elsa M R

    2017-11-02

    Objective  To compare the survival of different implant combinations for primary total hip replacement (THR). Design  Systematic review and network meta-analysis. Data sources  Medline, Embase, The Cochrane Library, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, and the EU Clinical Trials Register. Review methods  Published randomised controlled trials comparing different implant combinations. Implant combinations were defined by bearing surface materials (metal-on-polyethylene, ceramic-on-polyethylene, ceramic-on-ceramic, or metal-on-metal), head size (large ≥36 mm or small meta-analysis for revision. There was no evidence that the risk of revision surgery was reduced by other implant combinations compared with the reference implant combination. Although estimates are imprecise, metal-on-metal, small head, cemented implants (hazard ratio 4.4, 95% credible interval 1.6 to 16.6) and resurfacing (12.1, 2.1 to 120.3) increase the risk of revision at 0-2 years after primary THR compared with the reference implant combination. Similar results were observed for the 2-10 years period. 31 studies (2888 patients) were included in the analysis of Harris hip score. No implant combination had a better score than the reference implant combination. Conclusions  Newer implant combinations were not found to be better than the reference implant combination (metal-on-polyethylene (not highly cross linked), small head, cemented) in terms of risk of revision surgery or Harris hip score. Metal-on-metal, small head, cemented implants and resurfacing increased the risk of revision surgery compared with the reference implant combination. The results were consistent with observational evidence and were replicated in sensitivity analysis but were limited by poor reporting across studies. Systematic review registration  PROSPERO CRD42015019435. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

  6. The Effect on Long-Term Survivorship of Surgeon Preference for Posterior-Stabilized or Minimally Stabilized Total Knee Replacement: An Analysis of 63,416 Prostheses from the Australian Orthopaedic Association National Joint Replacement Registry.

    Science.gov (United States)

    Vertullo, Christopher J; Lewis, Peter L; Lorimer, Michelle; Graves, Stephen E

    2017-07-05

    Controversy still exists as to the optimum management of the posterior cruciate ligament (PCL) in total knee arthroplasty. Surgeons can choose to kinematically substitute the PCL with a posterior-stabilized total knee replacement or alternatively to utilize a cruciate-retaining, also known as minimally stabilized, total knee replacement. Proponents of posterior-stabilized total knee replacement propose that the reported lower survivorship in registries when directly compared with minimally stabilized total knee replacement is due to confounders such as selection bias because of the preferential usage of posterior-stabilized total knee replacement in more complex or severe cases. In this study, we aimed to eliminate these possible confounders by performing an instrumental variable analysis based on surgeon preference to choose either posterior-stabilized or minimally stabilized total knee replacement, rather than the actual prosthesis received. Cumulative percent revision, hazard ratio (HR), and revision diagnosis data were obtained from the Australian Orthopaedic Association National Joint Replacement Registry from September 1, 1999, to December 31, 2014, for 2 cohorts of patients, those treated by high-volume surgeons who preferred minimally stabilized replacements and those treated by high-volume surgeons who preferred posterior-stabilized replacements. All patients had a diagnosis of osteoarthritis and underwent fixed-bearing total knee replacement with patellar resurfacing. At 13 years, the cumulative percent revision was 5.0% (95% confidence interval [CI], 4.0% to 6.2%) for the surgeons who preferred the minimally stabilized replacements compared with 6.0% (95% CI, 4.2% to 8.5%) for the surgeons who preferred the posterior-stabilized replacements. The revision risk for the surgeons who preferred posterior-stabilized replacements was significantly higher for all causes (HR = 1.45 [95% CI, 1.30 to 1.63]; p total knee replacement compared with the patients of

  7. Physiologic Growth Hormone-Replacement Therapy and Craniopharyngioma Recurrence in Pediatric Patients: A Meta-Analysis.

    Science.gov (United States)

    Alotaibi, Nawaf M; Noormohamed, Nadia; Cote, David J; Alharthi, Salman; Doucette, Joanne; Zaidi, Hasan A; Mekary, Rania A; Smith, Timothy R

    2018-01-01

    A systematic review and meta-analysis were conducted to examine the effect of growth hormone-replacement therapy (GHRT) on the recurrence of craniopharyngioma in children. PubMed, Embase, and Cochrane databases were searched through April 2017 for studies that evaluated the effect of GHRT on the recurrence of pediatric craniopharyngioma. Pooled effect estimates were calculated with fixed- and random-effects models. Ten studies (n = 3487 patients) met all inclusion criteria, including 2 retrospective cohorts and 8 case series. Overall, 3436 pediatric patients were treated with GHRT after surgery and 51 were not. Using the fixed effect model, we found that the overall craniopharyngioma recurrence rate was lower among children who were treated by GHRT (10.9%; 95% confidence interval 9.80%-12.1%; I 2  = 89.1%; P for heterogeneity <0.01; n = 10 groups) compared with those who were not (35.2%; 95% confidence interval 23.1%-49.6%; I 2  = 61.7%; P for heterogeneity = 0.11; n = 3); the P value comparing the 2 groups was <0.01. Among patients who were treated with GHRT, subgroup analysis revealed that there was a greater prevalence of craniopharyngioma recurrence among studies conducted outside the United States (P < 0.01), single-center studies (P < 0.01), lower impact factor studies (P = 0.03), or studies with a lower quality rating (P = 0.01). Using the random-effects model, we found that the results were not materially different except for when stratifying by GHRT, impact factor, or study quality; this led to nonsignificant differences. Both Begg's rank correlation test (P = 0.7) and Egger's linear regression test (P = 0.06) indicated no publication bias. This meta-analysis demonstrated a lower recurrence rate of craniopharyngioma among children treated with GHRT than those who were not. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Comparison of total disc replacement with lumbar fusion: a meta-analysis of randomized controlled trials

    International Nuclear Information System (INIS)

    Nie, H.

    2015-01-01

    A meta-analysis was performed to evaluate whether a beneficial clinical effect of the Total Disc Replacement (TDR) over lumbar fusion for the treatment of patients with Degenerative Disc Disease (DDD). An electronic search of PubMed, Cochrane Central Register of Controlled Trials, and EMBASE from their inception to 2012 was completed, and we assessed risk bias and retrieved relevant data, and meta-analysis was performed, if appropriate. Oswestry Disability Index (ODI), Visual Analog Score (VAS), patient satisfaction or VAS patient satisfaction, narcotic use, overall success rate, reoperation rate, work status, surgery again, complications and radiographic outcomes were evaluated. Six RCTs were included in this meta-analysis. At 2 years, TDR was demonstrated to be more beneficial for patients compared to lumbar fusion in the following outcomes, including ODI scores (MD: -4.87, 95% CI: -7.77 to -1.97, p=0.001), patient satisfaction (OR:1.91, 95% CI: 1.27 to 2.86, p=0.002) and VAS patient satisfaction (MD:9.10, 95% CI: 3.20 to 14.99, p=0.002), the percentage of using narcotics (OR=0.54, 95%CI: 0.31 to 0.96, p=0.03), overall success rate (OR:1.68, 95% CI: 1.26 to 2.25, p=0.005), the rate of patients to chose the same surgical treatment again (OR:2.38, 95% CI: 1.72 to 3.28, p < 0.001), and complications (OR=0.50, 95% CI: 0.29 to 0.84, p=0.008). Other outcomes, including re-operation rate (OR:0.62, 95% CI: 0.36 to 1.06, p=0.08) and work status (OR=1.05, 95% CI: 0.75 to 1.47, p=0.80), were demonstrated to be no differences between the two groups. In a long-term of follow-up (2 years), TDR shows a significant superiority for the treatment of lumbar DDD compared with fusion. (author)

  9. Is testosterone replacement therapy in males with hypogonadism cost-effective? An analysis in Sweden.

    Science.gov (United States)

    Arver, Stefan; Luong, Ba; Fraschke, Anina; Ghatnekar, Ola; Stanisic, Sanja; Gultyev, Dmitry; Müller, Elvira

    2014-01-01

    Testosterone replacement therapy (TRT) has been recommended for the treatment of primary and secondary hypogonadism. However, long-term implications of TRT have not been investigated extensively. The aim of this analysis was to evaluate health outcomes and costs associated with life-long TRT in patients suffering from Klinefelter syndrome and late-onset hypogonadism (LOH). A Markov model was developed to assess cost-effectiveness of testosterone undecanoate (TU) depot injection treatment compared with no treatment. Health outcomes and associated costs were modeled in monthly cycles per patient individually along a lifetime horizon. Modeled health outcomes included development of type 2 diabetes, depression, cardiovascular and cerebrovascular complications, and fractures. Analysis was performed for the Swedish health-care setting from health-care payer's and societal perspective. One-way sensitivity analyses evaluated the robustness of results. The main outcome measures were quality-adjusted life-years (QALYs) and total cost in TU depot injection treatment and no treatment cohorts. In addition, outcomes were also expressed as incremental cost per QALY gained for TU depot injection therapy compared with no treatment (incremental cost-effectiveness ratio [ICER]). TU depot injection compared to no-treatment yielded a gain of 1.67 QALYs at an incremental cost of 28,176 EUR (37,192 USD) in the Klinefelter population. The ICER was 16,884 EUR (22,287 USD) per QALY gained. Outcomes in LOH population estimated benefits of TRT at 19,719 EUR (26,029 USD) per QALY gained. Results showed to be considerably robust when tested in sensitivity analyses. Variation of relative risk to develop type 2 diabetes had the highest impact on long-term outcomes in both patient groups. This analysis suggests that lifelong TU depot injection therapy of patients with hypogonadism is a cost-effective treatment in Sweden. Hence, it can support clinicians in decision making when considering

  10. Knee Kinematic Improvement After Total Knee Replacement Using a Simplified Quantitative Gait Analysis Method

    Directory of Open Access Journals (Sweden)

    Hassan Sarailoo

    2013-10-01

    Full Text Available Objectives: The aim of this study was to extract suitable spatiotemporal and kinematic parameters to determine how Total Knee Replacement (TKR alters patients’ knee kinematics during gait, using a rapid and simplified quantitative two-dimensional gait analysis procedure. Methods: Two-dimensional kinematic gait pattern of 10 participants were collected before and after the TKR surgery, using a 60 Hz camcorder in sagittal plane. Then, the kinematic parameters were extracted using the gait data. A student t-test was used to compare the group-average of spatiotemporal and peak kinematic characteristics in the sagittal plane. The knee condition was also evaluated using the Oxford Knee Score (OKS Questionnaire to ensure thateach subject was placed in the right group. Results: The results showed a significant improvement in knee flexion during stance and swing phases after TKR surgery. The walking speed was increased as a result of stride length and cadence improvement, but this increment was not statistically significant. Both post-TKR and control groups showed an increment in spatiotemporal and peak kinematic characteristics between comfortable and fast walking speeds. Discussion: The objective kinematic parameters extracted from 2D gait data were able to show significant improvements of the knee joint after TKR surgery. The patients with TKR surgery were also able to improve their knee kinematics during fast walking speed equal to the control group. These results provide a good insight into the capabilities of the presented method to evaluate knee functionality before and after TKR surgery and to define a more effective rehabilitation program.

  11. A Life Cycle Cost Analysis of the Proposed Replacement of Pope Air Force Base's C-130E Fleet Using a Fleet Replacement Model

    National Research Council Canada - National Science Library

    French, Lance

    2002-01-01

    .... However, after conducting sensitivity analyses on the input parameters, the research shows the replace now option becomes the least cost solution when any one of the following occur: the C-130J...

  12. Approaches for Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Vinayak Nagaraja

    2014-02-01

    Full Text Available Introduction: Retrograde transfemoral and antegrade transapical approaches are mostly used for transcatheter aortic valve replacement. This meta-analysis is designed to assess the performance of the transfemoral and transapical approach. Methods: A systematic search was conducted using MEDLINE, PubMed, EMBASE, Current Contents Connect, Cochrane library, Google Scholar, Science Direct, and Web of Science. Original data was abstracted from each study and used to calculate a pooled odd ratio (OR and 95% confidence interval (95% CI. Results: Only 14 studies comprising of 6965 patients met full criteria for analysis. The mean duration of hospitalisation and procedure duration were similar among the 2 cohorts. The 30 days mortality (OR: 0.70, 95% CI: 0.531-0.921, the need for haemodialysis (OR: 0.29, 95% CI: 0.157-0.525 and one year mortality (OR: 0.72, 95% CI: 0.564-0.927 were lower in the transfemoral cohort. The frequency of stroke at 30 days and new pacemaker insertion were comparable. However, the prevalence of vascular complication (OR: 2.88, 95% CI: 1.821-4.563 was higher in the transfemoral group. The incidence of aortic regurgitation (OR: 1.25, 95% CI: 0.844-1.855, valve embolization (OR: 2.00, 95% CI: 0.622-6.448, major bleeding incidence rates (OR:0.77, 95% CI: 0.488-1.225, coronary obstruction (OR:0.74, 95% CI:0.234-2.311, myocardial infarction (OR: 0.75, 95% CI: 0.28-2.00, conversion to open cardiac surgery (OR: 0.29, 95% CI: 0.062-1.343 and successful implantation (OR: 0.67, 95% CI: 0.394-1.149 were comparable in the two cohorts. Conclusions: In the absence of a randomized controlled study, the ability to discriminate true differences is challenging. Even though the complications rate was much lower in transfemoral group as compared to transapical group, the current literature does not support a clear superiority of one approach to TAVR over the other.

  13. Repair or Replacement for Isolated Tricuspid Valve Pathology? Insights from a Surgical Analysis on Long-Term Survival

    Science.gov (United States)

    Farag, Mina; Arif, Rawa; Sabashnikov, Anton; Zeriouh, Mohamed; Popov, Aron-Frederik; Ruhparwar, Arjang; Schmack, Bastian; Dohmen, Pascal M.; Szabó, Gábor; Karck, Matthias; Weymann, Alexander

    2017-01-01

    Background Long-term follow-up data concerning isolated tricuspid valve pathology after replacement or reconstruction is limited. Current American Heart Association guidelines equally recommend repair and replacement when surgical intervention is indicated. Our aim was to investigate and compare operative mortality and long-term survival in patients undergoing isolated tricuspid valve repair surgery versus replacement. Material/Methods Between 1995 and 2011, 109 consecutive patients underwent surgical correction of tricuspid valve pathology at our institution for varying structural pathologies. A total of 41 (37.6%) patients underwent tricuspid annuloplasty/repair (TAP) with or without ring implantation, while 68 (62.3%) patients received tricuspid valve replacement (TVR) of whom 36 (53%) were mechanical and 32 (47%) were biological prostheses. Results Early survival at 30 days after surgery was 97.6% in the TAP group and 91.1% in the TVR group. After 6 months, 89.1% in the TAP group and 87.8% in the TVR group were alive. In terms of long-term survival, there was no further mortality observed after one year post surgery in both groups (Log Rank p=0.919, Breslow p=0.834, Tarone-Ware p=0.880) in the Kaplan-Meier Survival analysis. The 1-, 5-, and 8-year survival rates were 85.8% for TAP and 87.8% for TVR group. Conclusions Surgical repair of the tricuspid valve does not show survival benefit when compared to replacement. Hence valve replacement should be considered generously in patients with reasonable suspicion that regurgitation after repair will reoccur. PMID:28236633

  14. An analysis of the cost effectiveness of replacing maize with wheat ...

    African Journals Online (AJOL)

    Increasing the level of inclusion of agro-industrial by-products in poultry diets formulation that will not adversely affect growth performance but enhancing feed cost reduction have been the major concern of researchers. In this study the cost effectiveness of using wheat offal to replace maize at 0, 5, 10, 15, 20 and 25 percent ...

  15. Replacing Maladaptive Speech with Verbal Labeling Responses: An Analysis of Generalized Responding.

    Science.gov (United States)

    Foxx, R. M.; And Others

    1988-01-01

    Three mentally handicapped students (aged 13, 36, and 40) with maladaptive speech received training to answer questions with verbal labels. The results of their cues-pause-point training showed that the students replaced their maladaptive speech with correct labels (answers) to questions in the training setting and three generalization settings.…

  16. Analysis of human protein replacement stable cell lines established using snoMEN-PR vector.

    Directory of Open Access Journals (Sweden)

    Motoharu Ono

    Full Text Available The study of the function of many human proteins is often hampered by technical limitations, such as cytotoxicity and phenotypes that result from overexpression of the protein of interest together with the endogenous version. Here we present the snoMEN (snoRNA Modulator of gene ExpressioN vector technology for generating stable cell lines where expression of the endogenous protein can be reduced and replaced by an exogenous protein, such as a fluorescent protein (FP-tagged version. SnoMEN are snoRNAs engineered to contain complementary sequences that can promote knock-down of targeted RNAs. We have established and characterised two such partial protein replacement human cell lines (snoMEN-PR. Quantitative mass spectrometry was used to analyse the specificity of knock-down and replacement at the protein level and also showed an increased pull-down efficiency of protein complexes containing exogenous, tagged proteins in the protein replacement cell lines, as compared with conventional co-expression strategies. The snoMEN approach facilitates the study of mammalian proteins, particularly those that have so far been difficult to investigate by exogenous expression and has wide applications in basic and applied gene-expression research.

  17. Hemiarch versus total aortic arch replacement in acute type A dissection: a systematic review and meta-analysis.

    Science.gov (United States)

    Poon, Shi Sum; Theologou, Thomas; Harrington, Deborah; Kuduvalli, Manoj; Oo, Aung; Field, Mark

    2016-05-01

    Despite recent advances in aortic surgery, acute type A aortic dissection remains a surgical emergency associated with high mortality and morbidity. Appropriate management is crucial to achieve satisfactory outcomes but the optimal surgical approach is controversial. The present systematic review and meta-analysis sought to access cumulative data from comparative studies between hemiarch and total aortic arch replacement in patients with acute type A aortic dissection. A systematic review of the literature using six databases. Eligible studies include comparative studies on hemiarch versus total arch replacement reporting short, medium and long term outcomes. A meta-analysis was performed on eligible studies reporting outcome of interest to quantify the effects of hemiarch replacement on mortality and morbidity risk compared to total arch replacement. Fourteen retrospective studies met the inclusion criteria and 2,221 patients were included in the final analysis. Pooled analysis showed that hemiarch replacement was associated with a lower risk of post-operative renal dialysis [risk ratio (RR) =0.72; 95% confidence interval (CI): 0.56-0.94; P=0.02; I(2)=0%]. There was no significant difference in terms of in-hospital mortality between the two groups (RR =0.84; 95% CI: 0.65-1.09; P=0.20; I(2)=0%). Cardiopulmonary bypass, aortic cross clamp and circulatory arrest times were significantly longer in total arch replacement. During follow up, no significant difference was reported from current studies between the two operative approaches in terms of aortic re-intervention and freedom from aortic reoperation. Within the context of publication bias by high volume aortic centres and non-randomized data sets, there was no difference in mortality outcomes between the two groups. This analysis serves to demonstrate that for those centers doing sufficient total aortic arch activity to allow for publication, excellent and equivalent outcomes are achievable. Conclusions on

  18. Effect of replacement of tin doped indium oxide (ITO) by ZnO: analysis of environmental impact categories

    Science.gov (United States)

    Ziemińska-Stolarska, Aleksandra; Barecka, Magda; Zbiciński, Ireneusz

    2017-10-01

    Abundant use of natural resources is doubtlessly one of the greatest challenges of sustainable development. Process alternatives, which enable sustainable manufacturing of valuable products from more accessible resources, are consequently required. One of examples of limited resources is Indium, currently broadly used for tin doped indium oxide (ITO) for production of transparent conductive films (TCO) in electronics industry. Therefore, candidates for Indium replacement, which would offer as good performance as the industrial state-of-the-art technology based on ITO are widely studied. However, the environmental impact of new layers remains unknown. Hence, this paper studies the environmental effect of ITO replacement by zinc oxide (ZnO) by means life cycle assessment (LCA) methodology. The analysis enables to quantify the environmental impact over the entire period of life cycle of products—during manufacturing, use phase and waste generation. The analysis was based on experimental data for deposition process. Further, analysis of different impact categories was performed in order to determine specific environmental effects related to technology change. What results from the analysis, is that ZnO is a robust alternative material for ITO replacement regarding environmental load and energy efficiency of deposition process which is also crucial for sustainable TCO layer production.

  19. Supra regional ground water modelling - in-depth analysis of the groundwater flow patterns in eastern Smaaland. Comparison with different conceptual descriptions; Storregional grundvattenmodellering - foerdjupad analys av floedesfoerhaallanden i oestra Smaaland. Jaemfoerelse av olika konceptuella beskrivningar

    Energy Technology Data Exchange (ETDEWEB)

    Ericsson, Lars O. [Lars O Ericsson Consulting AB, Stockholm (Sweden); Holmen, Johan [Golder Associates, Uppsala (Sweden); Rhen, Ingvar; Blomquist, Niklas [SWECO VIAK, Stockholm (Sweden)

    2006-05-15

    One of many geoscientific questions in connection with the siting of a final repository for spent nuclear fuel in Sweden has to do with understanding the large-scale flow patterns of the naturally circulating groundwater. The recharge and discharge of the groundwater is therefore a subject for both SKB's research activities and the interest of the regulatory authorities. This report aims at providing an in-depth scientific analysis of the groundwater flow pattern based on the criteria and suitability indicators which SKB has previously presented with respect to recharge and discharge aspects in a supra regional perspective. The analysis was conducted within the framework of a project whose goals were to: evaluate conceptual simplifications and model uncertainties in supra regional groundwater modelling, and to carry out an in-depth and comprehensive analysis of regional flow conditions in eastern Smaaland. Achieving these goals has required an approach based on the use of available geoscientific data on the Smaaland region combined with an analysis of different conceptual assumptions and system descriptions. The following general conclusions can be drawn from the study and the applied methodology: The factor of greatest importance for the regional flow pattern (from repository depth) is the topography. The discharge areas are mainly found in the low-lying parts of the topography, along valleys, and the recharge areas occur on the heights. The topographic undulation is of greater importance than the properties of the conductivity field. Different lithological units, regional deformation zones, local heterogeneity, Quaternary deposits etc are of less importance than the undulation of the topography. For areas described and analyzed with the most realistic assumptions, the groundwater flow pattern can be described as a primarily local flow process. The median flow path length in the study is on the order of 2 km, and the fraction of supra regional flow paths

  20. Replacement tunnelled dialysis catheters for haemodialysis access: Same site, new site, or exchange — A multivariate analysis and risk score

    International Nuclear Information System (INIS)

    Tapping, C.R.; Scott, P.M.; Lakshminarayan, R.; Ettles, D.F.; Robinson, G.J.

    2012-01-01

    Aim: To identify variables related to complications following tunnelled dialysis catheter (TDC) replacement and stratifying the risk to reduce morbidity in patients with end-stage renal disease. Materials and methods: One hundred and forty TDCs (Split Cath, medCOMP) were replaced in 140 patients over a 5 year period. Multiple variables were retrospectively collected and analysed to stratify the risk and to predict patients who were more likely to suffer from complications. Multivariate regression analysis was used to identify variables predictive of complications. Results: There were six immediate complications, 42 early complications, and 37 late complications. Multivariate analysis revealed that variables significantly associated to complications were: female sex (p = 0.003; OR 2.9); previous TDC in the same anatomical position in the past (p = 0.014; OR 4.1); catheter exchange (p = 0.038; OR 3.8); haemoglobin 15 s (p = 0.002; OR 4.1); and C-reactive protein >50 mg/l (p = 0.007; OR 4.6). A high-risk score, which used the values from the multivariate analysis, predicted 100% of the immediate complications, 95% of the early complications, and 68% of the late complications. Conclusion: Patients can now be scored prior to TDC replacement. A patient with a high-risk score can be optimized to reduce the chance of complications. Further prospective studies to confirm that rotating the site of TDC reduces complications are warranted as this has implications for current guidelines.

  1. Effects of Growth Hormone Replacement Therapy on Bone Mineral Density in Growth Hormone Deficient Adults: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Peng Xue

    2013-01-01

    Full Text Available Objectives. Growth hormone deficiency patients exhibited reduced bone mineral density compared with healthy controls, but previous researches demonstrated uncertainty about the effect of growth hormone replacement therapy on bone in growth hormone deficient adults. The aim of this study was to determine whether the growth hormone replacement therapy could elevate bone mineral density in growth hormone deficient adults. Methods. In this meta-analysis, searches of Medline, Embase, and The Cochrane Library were undertaken to identify studies in humans of the association between growth hormone treatment and bone mineral density in growth hormone deficient adults. Random effects model was used for this meta-analysis. Results. A total of 20 studies (including one outlier study with 936 subjects were included in our research. We detected significant overall association of growth hormone treatment with increased bone mineral density of spine, femoral neck, and total body, but some results of subgroup analyses were not consistent with the overall analyses. Conclusions. Our meta-analysis suggested that growth hormone replacement therapy could have beneficial influence on bone mineral density in growth hormone deficient adults, but, in some subject populations, the influence was not evident.

  2. Joint Replacement Surgery: Health Information Basics for You and Your Family

    Science.gov (United States)

    ... Initiative Breadcrumb Home Health Topics English Español Joint Replacement Surgery Basics In-Depth Download Download EPUB Download ... What is it? Points To Remember About Joint Replacement Surgery Joint replacement surgery removes damaged or diseased ...

  3. Thermodynamic analysis of refrigerant mixtures for possible replacements for CFCs by an algorithm compiling property data

    International Nuclear Information System (INIS)

    Arcaklioglu, Erol; Cavusoglu, Abdullah; Erisen, Ali

    2006-01-01

    In this study, we formed an algorithm to find refrigerant mixtures of equal volumetric cooling capacity (VCC) when compared to CFC based refrigerants in vapor compression refrigeration systems. To achieve this aim the point properties of the refrigerants are obtained from REFPROP where appropriate. We used replacement mixture ratios-of varying mass percentages-suggested by various authors along with our newly formed mixture ratios. In other words, we tried to see the effect of changing mass percentages of the suggested (i.e. in the literature) replacement refrigerants on the VCC of the cooling system. Secondly, we used this algorithm to calculate the coefficient of performance (COP) of the same refrigeration system. This mechanism has provided us the ability to compare the COP of the suggested refrigerant mixtures and our newly formed mixture ratios with the conventional CFC based ones. According to our results, for R12 R290/R600a (56/44) mixture, for R22 R32/R125/R134a (32.5/5/62.5) mixture, and for R502 R32/R125/R134a (43/5/52) mixture are appropriate and can be used as replacements

  4. High phenobarbital clearance during continuous renal replacement therapy: a case report and pharmacokinetic analysis.

    Science.gov (United States)

    Rosenborg, Staffan; Saraste, Lars; Wide, Katarina

    2014-08-01

    Phenobarbital is an old antiepileptic drug used in severe epilepsy. Despite this, little is written about the need for dose adjustments in renal replacement therapy. Most sources recommend a moderately increased dose guided by therapeutic drug monitoring.A 14 year old boy with nonketotic hyperglycinemia, a rare inborn error of metabolism, characterized by high levels of glycine, epilepsy, spasticity, and cognitive impairment, was admitted to the emergency department with respiratory failure after a few days of fever and cough. The boy was unconscious at admittance and had acute renal and hepatic failure.Due to the acute respiratory infection, hypoxic hepatic and renal failure occurred and the patient had a status epilepticus.The patient was intubated and mechanically ventilated. Continuous renal replacement therapy was initiated. Despite increased phenobarbital doses, therapeutic levels were not reached until the dose was increased to 500 mg twice daily. Therapeutic drug monitoring was performed in plasma and dialysate. Calculations revealed that phenobarbital was almost freely dialyzed.Correct dosing of drugs in patients on renal replacement therapy may need a multidisciplinary approach and guidance by therapeutic drug monitoring.

  5. The Analysis of Height System Definition and the High Precision GNSS Replacing Leveling Method

    Directory of Open Access Journals (Sweden)

    ZHANG Chuanyin

    2017-08-01

    Full Text Available Based on the definition of height system, the gravitational equipotential property of height datum surface is discussed in this paper, differences of the heights at ground points that defined in different height systems are tested and analyzed as well. A new method for replacing leveling using GNSS is proposed to ensure the consistency between GNSS replacing leveling and spirit leveling at mm accuracy level. The main conclusions include:①For determining normal height at centimeter accuracy level, the datum surface of normal height should be the geoid. The 1985 national height datum of China adopts normal height system, its datum surface is the geoid passing the Qingdao zero point.②The surface of equi-orthometric height in the near earth space is parallel to the geoid. The combination of GNSS precise positioning and geoid model can be directly used for orthometric height determination. However, the normal height system is more advantageous for describing the terrain and relief.③Based on the proposed method of GNSS replacing leveling, the errors in geodetic height affect more on normal height result than the errors of geoid model, the former is about 1.5 times of the latter.

  6. Defence in depth in nuclear safety

    International Nuclear Information System (INIS)

    Jayakumar, J.S.

    2016-01-01

    Nuclear energy is clean and can prevent global warming and hence it has a lot of importance in the current world. In order for the safe and reliable operation of the NPP, a defence in depth concept has been practised, so that even one level of protection fails the subsequent one will contain the hazardous situation. Various levels, both from consideration of the physical barriers and implementation are described in this paper. Three major accidents happened in nuclear reactors are analysed from the defence in depth concept and shortcomings are discussed. (author)

  7. Muscular responses to testosterone replacement vary by administration route: a systematic review and meta-analysis.

    Science.gov (United States)

    Skinner, Jared W; Otzel, Dana M; Bowser, Andrew; Nargi, Daniel; Agarwal, Sanjay; Peterson, Mark D; Zou, Baiming; Borst, Stephen E; Yarrow, Joshua F

    2018-06-01

    Inconsistent fat-free mass (FFM) and muscle strength responses have been reported in randomized clinical trials (RCTs) administering testosterone replacement therapy (TRT) to middle-aged and older men. Our objective was to conduct a meta-analysis to determine whether TRT improves FFM and muscle strength in middle-aged and older men and whether the muscular responses vary by TRT administration route. Systematic literature searches of MEDLINE/PubMed and the Cochrane Library were conducted from inception through 31 March 2017 to identify double-blind RCTs that compared intramuscular or transdermal TRT vs. placebo and that reported assessments of FFM or upper-extremity or lower-extremity strength. Studies were identified, and data were extracted and validated by three investigators, with disagreement resolved by consensus. Using a random effects model, individual effect sizes (ESs) were determined from 31 RCTs reporting FFM (sample size: n = 1213 TRT, n = 1168 placebo) and 17 reporting upper-extremity or lower-extremity strength (n = 2572 TRT, n = 2523 placebo). Heterogeneity was examined, and sensitivity analyses were performed. When administration routes were collectively assessed, TRT was associated with increases in FFM [ES = 1.20 ± 0.15 (95% CI: 0.91, 1.49)], total body strength [ES = 0.90 ± 0.12 (0.67, 1.14)], lower-extremity strength [ES = 0.77 ± 0.16 (0.45, 1.08)], and upper-extremity strength [ES = 1.13 ± 0.18 (0.78, 1.47)] (P FFM [ES = 1.49 ± 0.18 (1.13, 1.84)] and 10-13% increases in total body strength [ES = 1.39 ± 0.12 (1.15, 1.63)], lower-extremity strength [ES = 1.39 ± 0.17 (1.07, 1.72)], and upper-extremity strength [ES = 1.37 ± 0.17 (1.03, 1.70)] (P FFM [ES = 0.98 ± 0.21 (0.58, 1.39)] and only 2-5% increases in total body [ES = 0.55 ± 0.17 (0.22, 0.88)] and upper-extremity strength [ES = 0.97 ± 0.24 (0.50, 1.45)] (P < 0.001). Interestingly, transdermal TRT produced no change in lower

  8. Muscular responses to testosterone replacement vary by administration route: a systematic review and meta‐analysis

    Science.gov (United States)

    Skinner, Jared W.; Otzel, Dana M.; Bowser, Andrew; Nargi, Daniel; Agarwal, Sanjay; Peterson, Mark D.; Zou, Baiming; Borst, Stephen E.

    2018-01-01

    Abstract Background Inconsistent fat‐free mass (FFM) and muscle strength responses have been reported in randomized clinical trials (RCTs) administering testosterone replacement therapy (TRT) to middle‐aged and older men. Our objective was to conduct a meta‐analysis to determine whether TRT improves FFM and muscle strength in middle‐aged and older men and whether the muscular responses vary by TRT administration route. Methods Systematic literature searches of MEDLINE/PubMed and the Cochrane Library were conducted from inception through 31 March 2017 to identify double‐blind RCTs that compared intramuscular or transdermal TRT vs. placebo and that reported assessments of FFM or upper‐extremity or lower‐extremity strength. Studies were identified, and data were extracted and validated by three investigators, with disagreement resolved by consensus. Using a random effects model, individual effect sizes (ESs) were determined from 31 RCTs reporting FFM (sample size: n = 1213 TRT, n = 1168 placebo) and 17 reporting upper‐extremity or lower‐extremity strength (n = 2572 TRT, n = 2523 placebo). Heterogeneity was examined, and sensitivity analyses were performed. Results When administration routes were collectively assessed, TRT was associated with increases in FFM [ES = 1.20 ± 0.15 (95% CI: 0.91, 1.49)], total body strength [ES = 0.90 ± 0.12 (0.67, 1.14)], lower‐extremity strength [ES = 0.77 ± 0.16 (0.45, 1.08)], and upper‐extremity strength [ES = 1.13 ± 0.18 (0.78, 1.47)] (P FFM [ES = 1.49 ± 0.18 (1.13, 1.84)] and 10–13% increases in total body strength [ES = 1.39 ± 0.12 (1.15, 1.63)], lower‐extremity strength [ES = 1.39 ± 0.17 (1.07, 1.72)], and upper‐extremity strength [ES = 1.37 ± 0.17 (1.03, 1.70)] (P FFM [ES = 0.98 ± 0.21 (0.58, 1.39)] and only 2–5% increases in total body [ES = 0.55 ± 0.17 (0.22, 0.88)] and upper‐extremity strength [ES = 0.97 ± 0.24 (0.50, 1.45)] (P < 0

  9. [Efficacy analysis on hip replacement for hip-joint diseases with Parkinson disease].

    Science.gov (United States)

    Sun, Qi-Cai; Ru, Xuan-Liang; Xia, Yan-Fei; Liu, Xiao-Li; Song, Bai-Shan; Qiao, Song; Yan, Shi-Gui; Wang, Xiang-Hua

    2017-12-25

    To explore clinical efficacy of hip replacement for hip-joint diseases with Parkinson disease. From December 2011 to December 2016, 18 patients with hip-joint diseases with Parkinson disease treated by hip replacement, including 8 males and 10 females aged from 59 to 87 years old with an average of 71 years old. Among them, 3 cases were developmental dysplasia of hip, 3 cases were femoral head necrosis and 12 cases were femoral neck fracture. All patients manifested with obvious pain and limitation of stepping ability. Postoperative complications were observed and Harris score were used to compare hip joint function after operation. The incision were healed well, and pain were alleviated or disappeared, and hip joint function were improved. Eighteen patients were followed up from 1 to 3 years with an average of 2.3 years. At the latest follow up, 14 cases recovered freedom-walk, 2 cases could walk with walking stick, 1 case could walk with walking aid and 1 case was died. Among 18 patients, 2 cases were occurred dislocation, and 1 case were died for cardiac disease at 3 months after operation. Four patients were occurred slight pain. There were significant differences in Harris scores among preoperative (41.7±1.4), 6 months after operation(80.1±5.4) and the final follow-up (83.4±2.1), and 10 cases got excellent result, 4 good, 1 fair and 2 poor. Application of hip replacement for hip-joint diseases with Parkinson disease is a safe and effective clinical therapy, and has advantages of less complications and rapid recovery of hip joint function.

  10. Subgroup analysis of continuous renal replacement therapy in severely burned patients.

    Directory of Open Access Journals (Sweden)

    Jaechul Yoon

    Full Text Available Continuous renal replacement therapy (CRRT is administered to critically ill patients with renal injuries as renal replacement or renal support. We aimed to identify predictors of mortality among burn patients receiving CRRT, and to investigate clinical differences according to acute kidney injury (AKI status. This retrospective observational study evaluated 216 Korean burn patients who received CRRT at a burn intensive care unit. Patients were categorized by AKI status. Data were collected regarding arterial pH, laboratory results, ratio of arterial oxygen partial pressure to fractional inspired oxygen (PF ratio, and urine production. Among surviving patients, CRRT duration and the sequential organ failure assessment score were 6.5 days and 4.7 in the non-AKI group and 23.4 days and 7.4 in the AKI group, respectively (p = 0.003 and p = 0.008. On logistic regression analyses, mortality was significantly associated with a pH of 5.0 mEg/L (p = 0.045, creatinine levels of >2.0 mg/dL (p = 0.011, lactate levels of >2 mmol/L (p2 mmol/L, and a platelet count of 2 mg/dL. In the non-AKI group, poor outcomes were associated with lactate levels of >1.5 mmol/L, a PF ratio of 1.2 mg/dL. Duration of the CRRT application and the requirement for either renal replacement or renal support at the initiation of CRRT application are important considerations depending on its application.

  11. Time-based analysis of total cost of patient episodes: a case study of hip replacement.

    Science.gov (United States)

    Peltokorpi, Antti; Kujala, Jaakko

    2006-01-01

    Healthcare in the public and private sectors is facing increasing pressure to become more cost-effective. Time-based competition and work-in-progress have been used successfully to measure and improve the efficiency of industrial manufacturing. Seeks to address this issue. Presents a framework for time based management of the total cost of a patient episode and apply it to the six sigma DMAIC-process development approach. The framework is used to analyse hip replacement patient episodes in Päijät-Häme Hospital District in Finland, which has a catchment area of 210,000 inhabitants and performs an average of 230 hip replacements per year. The work-in-progress concept is applicable to healthcare--notably that the DMAIC-process development approach can be used to analyse the total cost of patient episodes. Concludes that a framework, which combines the patient-in-process and the DMAIC development approach, can be used not only to analyse the total cost of patient episode but also to improve patient process efficiency. Presents a framework that combines patient-in-process and DMAIC-process development approaches, which can be used to analyse the total cost of a patient episode in order to improve patient process efficiency.

  12. Health-related quality of life effects of enzalutamide in patients with metastatic castration-resistant prostate cancer: an in-depth post hoc analysis of EQ-5D data from the PREVAIL trial.

    Science.gov (United States)

    Devlin, Nancy; Herdman, Michael; Pavesi, Marco; Phung, De; Naidoo, Shevani; Beer, Tomasz M; Tombal, Bertrand; Loriot, Yohann; Ivanescu, Cristina; Parli, Teresa; Balk, Mark; Holmstrom, Stefan

    2017-06-23

    The effect of enzalutamide on health-related quality of life (HRQoL) in the PREVAIL trial in chemotherapy-naïve men with metastatic castration-resistant prostate cancer was analyzed using the generic EQ-5D instrument. Patients received oral enzalutamide 160 mg/day (n = 872) or placebo (n = 845). EQ-5D index and EQ-5D visual analogue scale (EQ-5D VAS) scores were evaluated at baseline, week 13, and every 12 weeks until week 61 due to sample size reduction thereafter. Changes on individual dimensions were assessed, and Paretian Classification of Health Change (PCHC) and time-to-event analyses were conducted. With enzalutamide, EQ-5D index and EQ-5D VAS scores declined more slowly versus placebo and time to diverge from full health was prolonged. Average decline in EQ-5D index (-0.042 vs. -0.070; P < .0001) and EQ-5D VAS (-1.3 vs. -4.4; P < .0001) was significantly smaller with enzalutamide. There were significant (P < .05) between-group differences favoring enzalutamide in Pain/Discomfort to week 37, Anxiety/Depression at week 13, and Usual Activities at week 25, but no significant differences for Mobility and Self-care. The PCHC analysis showed more enzalutamide patients reporting improvement than placebo patients at weeks 13, 25, and 49 (all P < .05) and week 37 (P = .0512). Enzalutamide was superior (P ≤ .0003) to placebo for time to diverge from full health and time to first deterioration on Pain/Discomfort and Anxiety/Depression dimensions. This in-depth post hoc analysis showed that enzalutamide delayed HRQoL deterioration and had beneficial effects on several HRQoL domains, including Pain/Discomfort and the proportion of patients in full health, compared with placebo, and may help to support future analyses of this type. NCT01212991.

  13. Clinical and Echocardiographic Outcomes Following Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement: Meta-Analysis and Meta-Regression.

    Science.gov (United States)

    Mohananey, Divyanshu; Jobanputra, Yash; Kumar, Arnav; Krishnaswamy, Amar; Mick, Stephanie; White, Jonathon M; Kapadia, Samir R

    2017-07-01

    Transcatheter aortic valve replacement has become the procedure of choice for inoperable, high-risk, and many intermediate-risk patients with aortic stenosis. Conduction abnormalities are a common finding after transcatheter aortic valve replacement and often result in permanent pacemaker (PPM) implantation. Data pertaining to the clinical impact of PPM implantation are controversial. We used meta-analysis techniques to summarize the effect of PPM implantation on clinical and echocardiographic outcomes after transcatheter aortic valve replacement. Data were summarized as Mantel-Haenszel relative risk (RR) and 95% confidence intervals (CIs) for dichotomous variables and as standardized mean difference and 95% CI for continuous variables We used the Higgins I 2 statistic to evaluate heterogeneity. We found that patients with and without PPM have similar all-cause mortality (RR, 0.85; 95% CI, 0.70-1.03), cardiovascular mortality (RR, 0.84; 95% CI, 0.59-1.18), myocardial infarction (RR, 0.47; 95% CI, 0.20-1.11), and stroke (RR, 1.26; 95% CI, 0.70-2.26) at 30 days. The groups were also comparable in all-cause mortality (RR, 1.03; 95% CI, 0.92-1.16), cardiovascular mortality (RR, 0.69; 95% CI, 0.39-1.24), myocardial infarction (RR, 0.58; 95% CI, 0.30-1.13), and stroke (RR, 0.70; 95% CI, 0.47-1.04) at 1 year. We observed that the improvement in left ventricular ejection fraction was significantly greater in the patients without PPM (standardized mean difference, 0.22; 95% CI, 0.12-0.32). PPM implantation is not associated with increased risk of all-cause mortality, cardiovascular mortality, stroke, or myocardial infarction both at short- and long-term follow-up. However, PPM is associated with impaired left ventricular ejection fraction recovery post-transcatheter aortic valve replacement. © 2017 American Heart Association, Inc.

  14. Nucleation theory - Is replacement free energy needed?. [error analysis of capillary approximation

    Science.gov (United States)

    Doremus, R. H.

    1982-01-01

    It has been suggested that the classical theory of nucleation of liquid from its vapor as developed by Volmer and Weber (1926) needs modification with a factor referred to as the replacement free energy and that the capillary approximation underlying the classical theory is in error. Here, the classical nucleation equation is derived from fluctuation theory, Gibb's result for the reversible work to form a critical nucleus, and the rate of collision of gas molecules with a surface. The capillary approximation is not used in the derivation. The chemical potential of small drops is then considered, and it is shown that the capillary approximation can be derived from thermodynamic equations. The results show that no corrections to Volmer's equation are needed.

  15. Comparative evaluation of left ventricular mass regression after aortic valve replacement: a prospective randomized analysis

    Directory of Open Access Journals (Sweden)

    Kiessling Arndt H

    2011-10-01

    Full Text Available Abstract Background We assessed the hemodynamic performance of various prostheses and the clinical outcomes after aortic valve replacement, in different age groups. Methods One-hundred-and-twenty patients with isolated aortic valve stenosis were included in this prospective randomized randomised trial and allocated in three age-groups to receive either pulmonary autograft (PA, n = 20 or mechanical prosthesis (MP, Edwards Mira n = 20 in group 1 (age 75. Clinical outcomes and hemodynamic performance were evaluated at discharge, six months and one year. Results In group 1, patients with PA had significantly lower mean gradients than the MP (2.6 vs. 10.9 mmHg, p = 0.0005 with comparable left ventricular mass regression (LVMR. Morbidity included 1 stroke in the PA population and 1 gastrointestinal bleeding in the MP subgroup. In group 2, mean gradients did not differ significantly between both populations (7.0 vs. 8.9 mmHg, p = 0.81. The rate of LVMR and EF were comparable at 12 months; each group with one mortality. Morbidity included 1 stroke and 1 gastrointestinal bleeding in the stentless and 3 bleeding complications in the MP group. In group 3, mean gradients did not differ significantly (7.8 vs 6.5 mmHg, p = 0.06. Postoperative EF and LVMR were comparable. There were 3 deaths in the stented group and no mortality in the stentless group. Morbidity included 1 endocarditis and 1 stroke in the stentless compared to 1 endocarditis, 1 stroke and one pulmonary embolism in the stented group. Conclusions Clinical outcomes justify valve replacement with either valve substitute in the respective age groups. The PA hemodynamically outperformed the MPs. Stentless valves however, did not demonstrate significantly superior hemodynamics or outcomes in comparison to stented bioprosthesis or MPs.

  16. Contemporary Costs Associated With Transcatheter Aortic Valve Replacement: A Propensity-Matched Cost Analysis.

    Science.gov (United States)

    Ailawadi, Gorav; LaPar, Damien J; Speir, Alan M; Ghanta, Ravi K; Yarboro, Leora T; Crosby, Ivan K; Lim, D Scott; Quader, Mohammed A; Rich, Jeffrey B

    2016-01-01

    The Placement of Aortic Transcatheter Valve (PARTNER) trial suggested an economic advantage for transcatheter aortic valve replacement (TAVR) for high-risk patients. The purpose of this study was to evaluate the cost effectiveness of TAVR in the "real world" by comparing TAVR with surgical aortic valve replacement (SAVR) in intermediate-risk and high-risk patients. A multiinstitutional database of The Society of Thoracic Surgeons (STS) (2011 to 2013) linked with estimated cost data was evaluated for isolated TAVR and SAVR operations (n = 5,578). TAVR-treated patients (n = 340) were 1:1 propensity matched with SAVR-treated patients (n = 340). Patients undergoing SAVR were further stratified into intermediate-risk (SAVR-IR: predicted risk of mortality [PROM] 4% to 8%) and high-risk (SAVR-HR: PROM >8%) cohorts. Median STS PROM for TAVR was 6.32% compared with 6.30% for SAVR (SAVR-IR 4.6% and SAVR-HR 12.4%). A transfemoral TAVR approach was most common (61%). Mortality was higher for TAVR (10%) compared with SAVR (6%, p costs compared with SAVR ($69,921 vs $33,598, p cost of TAVR was largely driven by the cost of the valve (all p cost savings versus TAVR. TAVR was associated with greater total costs and mortality compared with SAVR in intermediate-risk and high-risk patients while conferring lower major morbidity and improved resource use. Increased cost of TAVR appears largely related to the cost of the valve. Until the price of TAVR valves decreases, these data suggest that TAVR may not provide the most cost-effective strategy, particularly for intermediate-risk patients. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Penile Prosthesis First and Replacement Surgeries: Analysis of Patient and Partner Satisfaction.

    Science.gov (United States)

    Lledó-García, Enrique; Jara-Rascón, José; Moncada Iribarren, Ignacio; Piñero-Sánchez, Javier; Aragón-Chamizo, Juan; Hernández-Fernández, Carlos

    2015-07-01

    Among the many treatments for erectile dysfunction, implantation of a penile prosthesis has been associated with high patient satisfaction rates. Prosthesis replacement has become an accepted procedure in the event of device malfunction or complications, but to our knowledge, there are no data regarding the impact of implant replacement on patients and partner satisfaction. The aim of our study was to assess and to compare the level of satisfaction, with a first or second penile prosthesis implantation (PPI), in men with refractory erectile dysfunction and their partners. A survey study based on a five-item questionnaire was carried out at our center between January 1999 and January 2012. The main outcome measure used was the level of patient and partner satisfaction with sexual intercourse after PPI. Of the 190 eligible patients, 149 (78%) completed the survey (110 underwent a first implant and 39 a reimplant). Seventy-nine percent of first-time implanted patients and 80% of the reimplanted patients (P > 0.05; not significant [ns]) reported satisfactory sexual intercourse (very or moderately satisfied), while 74% and 80% of their partners reported satisfactory intercourses, respectively (P > 0.05; ns). Overall, 73.7% of first implants and 70% of second implants reported that they would undergo the procedure again if the PPI failed (P > 0.05; ns). With regards to cosmetic aspects, 13% of the first implants' and 15% of second implants' partners reported either penile shortness or soft glans as the main causes of their dissatisfaction. Only 2.4% of first implants and 1% of reimplanted patients expressed difficulty in manipulating the device. PPI is successful in returning the ability for satisfactory sexual intercourse to both first implant and reimplanted patients and their respective partners. © 2015 International Society for Sexual Medicine.

  18. Coding In-depth Semistructured Interviews

    DEFF Research Database (Denmark)

    Campbell, John L.; Quincy, Charles; Osserman, Jordan

    2013-01-01

    Many social science studies are based on coded in-depth semistructured interview transcripts. But researchers rarely report or discuss coding reliability in this work. Nor is there much literature on the subject for this type of data. This article presents a procedure for developing coding schemes...... useful for situations where a single knowledgeable coder will code all the transcripts once the coding scheme has been established. This approach can also be used with other types of qualitative data and in other circumstances....

  19. The effect of growth hormone (GH) replacement on muscle strength in patients with GH-deficiency: a meta-analysis.

    LENUS (Irish Health Repository)

    Widdowson, W Matthew

    2012-02-01

    CONTEXT\\/OBJECTIVES: GH replacement increases muscle mass and reduces body fat in growth hormone deficiency (GHD) adults. A recent meta-analysis has demonstrated that this improvement in body composition is associated with improved exercise performance. The current meta-analysis was carried out to determine whether high-quality evidence exists to support a beneficial effect of GH replacement on strength. DESIGN\\/METHODS: An extensive Medline search\\/literature review identified eight studies with utilizable, robust data, involving 231 patients in nine cohorts. Previously unpublished data were sought from authors and obtained in two cases. All studies included were randomized, double-blind, placebo-controlled, of parallel or cross-over design and of an average 6.7 months duration. Information was retrieved in uniform format, with data pertaining to patient numbers, study-design, GH-dose, mean age, IGF-I levels and muscle strength measurements (isometric or isokinetic quadriceps strength) recorded. Data were analysed using a fixed-effects model, utilizing continuous data measured on different scales. A summary effect measure (d(s)) was derived for individual strength variables, whereas an overall summary effect was derived from the sum of all studies incorporating different variables; 95% CIs were calculated from the weighted variances of individual study effects. RESULTS: Analysis revealed no significant improvement, neither when all studies were combined (d(s) = +0.01 +\\/- 0.26) nor when measured individually (isometric quadriceps strength, d(s) = +0.02 +\\/- 0.32 and isokinetic quadriceps strength, d(s) = 0.00 +\\/- 0.45). CONCLUSIONS: Evidence from short-term controlled studies fails to support a benefit on muscle strength of GH replacement in GHD patients, which is likely to occur over a longer time-course, as seen in open-label studies.

  20. Analysis of in vitro and in vivo function of total knee replacements using dynamic contact models

    Science.gov (United States)

    Zhao, Dong

    Despite the high incidence of osteoarthritis in human knee joint, its causes remain unknown. Total knee replacement (TKR) has been shown clinically to be effective in restoring the knee function. However, wear of ultra-high molecular weight polyethylene has limited the longevity of TKRs. To address these important issues, it is necessary to investigate the in vitro and in vivo function of total knee replacements using dynamic contact models. A multibody dynamic model of an AMTI knee simulator was developed. Incorporating a wear prediction model into the contact model based on elastic foundation theory enables the contact surface to take into account creep and wear during the dynamic simulation. Comparisons of the predicted damage depth, area, and volume lost with worn retrievals from a physical machine were made to validate the model. In vivo tibial force distributions during dynamic and high flexion activities were investigated using the dynamic contact model. In vivo medial and lateral contact forces experienced by a well-aligned instrumented knee implant, as well as upper and lower bounds on contact pressures for a variety of activities were studied. For all activities, the predicted medial and lateral contact forces were insensitive to the selected material model. For this patient, the load split during the mid-stance phase of gait and during stair is more equal than anticipated. The external knee adduction torque has been proposed as a surrogate measure for medial compartment load during gait. However, a direct link between these two quantities has not been demonstrated using in vivo measurement of medial compartment load. In vivo data collected from a subject with an instrumented knee implant were analyzed to evaluate this link. The subject performed five different overground gait motions (normal, fast, slow, wide, and toe out) while instrumented implant, video motion, and ground reaction data were simultaneously collected. The high correlation coefficient

  1. Intermediate and long-term quality of life after total knee replacement: a systematic review and meta-analysis.

    Science.gov (United States)

    Shan, Leonard; Shan, Bernard; Suzuki, Arnold; Nouh, Fred; Saxena, Akshat

    2015-01-21

    Total knee replacement is a highly successful and frequently performed operation. Technical outcomes of surgery are excellent, with favorable early postoperative health-related quality of life. This study reviews intermediate and long-term quality of life after surgery. A systematic review and meta-analysis of all studies published from January 2000 onward was performed to evaluate health-related quality of life after primary total knee replacement for osteoarthritis in patients with at least three years of follow-up. Key outcomes were postoperative quality of life, function, and satisfaction compared with the preoperative status. Strict inclusion and exclusion criteria were applied. Quality appraisal and data tabulation were performed with use of predefined criteria. Data were synthesized by narrative review and random-effects meta-analysis utilizing standardized mean differences. Heterogeneity was assessed with the tau(2) and I(2) statistics. Nineteen studies were included in the review. Intermediate and long-term postoperative quality of life was superior to the preoperative level in qualitative and quantitative analyses. The pooled effect in combined WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and KSS (Knee Society Score) outcomes was a marked improvement from baseline with respect to the total score (2.17; 95% CI [confidence interval], 1.13 to 3.22; p Total knee replacement confers significant intermediate and long-term benefits with respect to both disease-specific and generic health-related quality of life, especially pain and function, leading to positive patient satisfaction. Recommendations for necessary future studies are provided. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

  2. Toward the Replacement of Animal Experiments through the Bioinformatics-driven Analysis of 'Omics' Data from Human Cell Cultures.

    Science.gov (United States)

    Grafström, Roland C; Nymark, Penny; Hongisto, Vesa; Spjuth, Ola; Ceder, Rebecca; Willighagen, Egon; Hardy, Barry; Kaski, Samuel; Kohonen, Pekka

    2015-11-01

    This paper outlines the work for which Roland Grafström and Pekka Kohonen were awarded the 2014 Lush Science Prize. The research activities of the Grafström laboratory have, for many years, covered cancer biology studies, as well as the development and application of toxicity-predictive in vitro models to determine chemical safety. Through the integration of in silico analyses of diverse types of genomics data (transcriptomic and proteomic), their efforts have proved to fit well into the recently-developed Adverse Outcome Pathway paradigm. Genomics analysis within state-of-the-art cancer biology research and Toxicology in the 21st Century concepts share many technological tools. A key category within the Three Rs paradigm is the Replacement of animals in toxicity testing with alternative methods, such as bioinformatics-driven analyses of data obtained from human cell cultures exposed to diverse toxicants. This work was recently expanded within the pan-European SEURAT-1 project (Safety Evaluation Ultimately Replacing Animal Testing), to replace repeat-dose toxicity testing with data-rich analyses of sophisticated cell culture models. The aims and objectives of the SEURAT project have been to guide the application, analysis, interpretation and storage of 'omics' technology-derived data within the service-oriented sub-project, ToxBank. Particularly addressing the Lush Science Prize focus on the relevance of toxicity pathways, a 'data warehouse' that is under continuous expansion, coupled with the development of novel data storage and management methods for toxicology, serve to address data integration across multiple 'omics' technologies. The prize winners' guiding principles and concepts for modern knowledge management of toxicological data are summarised. The translation of basic discovery results ranged from chemical-testing and material-testing data, to information relevant to human health and environmental safety. 2015 FRAME.

  3. Ancient DNA and morphometric analysis reveal extinction and replacement of New Zealand's unique black swans.

    Science.gov (United States)

    Rawlence, Nicolas J; Kardamaki, Afroditi; Easton, Luke J; Tennyson, Alan J D; Scofield, R Paul; Waters, Jonathan M

    2017-07-26

    Prehistoric human impacts on megafaunal populations have dramatically reshaped ecosystems worldwide. However, the effects of human exploitation on smaller species, such as anatids (ducks, geese, and swans) are less clear. In this study we apply ancient DNA and osteological approaches to reassess the history of Australasia's iconic black swans ( Cygnus atratus ) including the palaeo-behaviour of prehistoric populations. Our study shows that at the time of human colonization, New Zealand housed a genetically, morphologically, and potentially ecologically distinct swan lineage ( C. sumnerensis , Poūwa), divergent from modern (Australian) C. atratus Morphological analyses indicate C. sumnerensis exhibited classic signs of the 'island rule' effect, being larger, and likely flight-reduced compared to C. atratus Our research reveals sudden extinction and replacement events within this anatid species complex, coinciding with recent human colonization of New Zealand. This research highlights the role of anthropogenic processes in rapidly reshaping island ecosystems and raises new questions for avian conservation, ecosystem re-wilding, and de-extinction. © 2017 The Author(s).

  4. [Analysis on replacement of traditional Chinese medicine bear bile with bile acids based on drug properties].

    Science.gov (United States)

    Yuan, Bin; Ren, Ying-Long; Ma, Li; Gu, Hao; Wang, Yun; Qiao, Yan-Jiang

    2014-02-01

    To discuss the rationality of the clinical replacement of traditional Chinese medicine (TCM) bear bile with bile acid constituents, and analyze the difference between these constituents and bear bile in drug properties. Summarizing the drug properties of bear bile by reference to medical literatures for drug properties of TCM bear bile and Science of Traditional Chinese Medicine (China Press of Traditional Chinese Medicine, 2007). Analyzing and summarizing the pharmacological effects of main bile acid constituents according to relevant literatures for studies on pharmacological effects of main bile acid constituents in CNKI database. Predicating the drug properties of these bile acid constituents by using the drug property predication model established by the study group according the pharmacological effects of main bile acid constituents in the paper, and compare the prediction results with the drug properties of bear bile. Bile acid constituents in bear bile were mostly cold in property, bitter in taste, and the combination of their drug properties could reflect the combined drug properties of bear bile. All of these bile acid constituents in bear bile could show part of effects of bear bile. Attention shall be given to regulate the medication scheme in clinical application according to actual conditions.

  5. Knee Replacement

    Science.gov (United States)

    ... days. Medications prescribed by your doctor should help control pain. During the hospital stay, you'll be encouraged to move your ... exercise your new knee. After you leave the hospital, you'll continue physical ... mobility and a better quality of life. And most knee replacements can be ...

  6. Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006–7: Australian Orthopaedic Association National Joint Replacement Registry

    Directory of Open Access Journals (Sweden)

    Brennan Sharon L

    2012-04-01

    Full Text Available Abstract Background The utilization of total hip replacement (THR surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD of Victoria, Australia. Methods Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006–7, primary THR with a diagnosis of osteoarthritis (OA among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. Results Females accounted for 46.9% of the 642 primary THR performed during 2006–7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70–79 years (males 6.1, and females 5.4 per 1,000 person years. Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. Conclusions Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.

  7. Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006-7: Australian Orthopaedic Association National Joint Replacement Registry.

    Science.gov (United States)

    Brennan, Sharon L; Stanford, Tyman; Wluka, Anita E; Henry, Margaret J; Page, Richard S; Graves, Stephen E; Kotowicz, Mark A; Nicholson, Geoffrey C; Pasco, Julie A

    2012-04-30

    The utilization of total hip replacement (THR) surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES) within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD) of Victoria, Australia. Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006-7, primary THR with a diagnosis of osteoarthritis (OA) among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. Females accounted for 46.9% of the 642 primary THR performed during 2006-7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70-79 years (males 6.1, and females 5.4 per 1,000 person years). Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.

  8. Parametric analysis of electromechanical and fatigue performance of total knee replacement bearing with embedded piezoelectric transducers

    Science.gov (United States)

    Safaei, Mohsen; Meneghini, R. Michael; Anton, Steven R.

    2017-09-01

    Total knee arthroplasty is a common procedure in the United States; it has been estimated that about 4 million people are currently living with primary knee replacement in this country. Despite huge improvements in material properties, implant design, and surgical techniques, some implants fail a few years after surgery. A lack of information about in vivo kinetics of the knee prevents the establishment of a correlated intra- and postoperative loading pattern in knee implants. In this study, a conceptual design of an ultra high molecular weight (UHMW) knee bearing with embedded piezoelectric transducers is proposed, which is able to measure the reaction forces from knee motion as well as harvest energy to power embedded electronics. A simplified geometry consisting of a disk of UHMW with a single embedded piezoelectric ceramic is used in this work to study the general parametric trends of an instrumented knee bearing. A combined finite element and electromechanical modeling framework is employed to investigate the fatigue behavior of the instrumented bearing and the electromechanical performance of the embedded piezoelectric. The model is validated through experimental testing and utilized for further parametric studies. Parametric studies consist of the investigation of the effects of several dimensional and piezoelectric material parameters on the durability of the bearing and electrical output of the transducers. Among all the parameters, it is shown that adding large fillet radii results in noticeable improvement in the fatigue life of the bearing. Additionally, the design is highly sensitive to the depth of piezoelectric pocket. Finally, using PZT-5H piezoceramics, higher voltage and slightly enhanced fatigue life is achieved.

  9. Dacron graft as replacement to dissected aorta: A three-dimensional fluid-structure-interaction analysis.

    Science.gov (United States)

    Jayendiran, R; Nour, B M; Ruimi, A

    2018-02-01

    Aortic dissection (AD) is a serious medical condition characterized by a tear in the intima, the inner layer of the aortic walls. In such occurrence, blood is being diverted to the media (middle) layer and may result in patient death if not quickly attended. In the case where the diseased portion of the aorta needs to be replaced, one common surgical technique is to use a graft made of Dacron, a synthetic fabric. We investigate the response of a composite human aortic segment-Dacron graft structure subjected to blood flow using the three-dimensional fluid-structure-interaction (FSI) capability in Abaqus. We obtain stress and strain profiles in each of the three layers of the aortic walls as well as in the Dacron graft. Results are compared when elastic and hyperelastic models are used and when isotropy vs. anisotropy is assumed. The more complex case (hyperelastic-anisotropy) is represented by the Holzapfel-Gasser-Ogden (HGO) model which also accounts for the orientation of the fibers present in the tissues. The fluid flow is taken as Newtonian, incompressible, pulsatile and turbulent. The simulation show that for all the cases, the von Mises stress distribution at aorta-Dacron interface is well below the ultimate strength of the aorta. No significant change in radial displacement at the interface of the two materials due to blood flow is observed. Computation cost is also addressed and results show that the hyperelastic-anisotropic model takes about three times longer to run than the elastic isotropic case. Trade-off between accuracy and computational cost has to be weighted. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Physician referral patterns and racial disparities in total hip replacement: A network analysis approach.

    Directory of Open Access Journals (Sweden)

    Hassan M K Ghomrawi

    Full Text Available Efforts to reduce racial disparities in total hip replacement (THR have focused mainly on patient behaviors. While these efforts are no doubt important, they ignore the potentially important role of provider- and system-level factors, which may be easier to modify. We aimed to determine whether the patterns of interaction among physicians around THR episodes differ in communities with low versus high concentrations of black residents.We analyzed national Medicare claims from 2008 to 2011, identifying all fee-for-service beneficiaries who underwent THR. Based on physician encounter data, we then mapped the physician referral networks at the hospitals where beneficiaries' procedures were performed. Next, we measured two structural properties of these networks that could affect care coordination and information sharing: clustering, and the number of external ties. Finally, we estimated multivariate regression models to determine the relationship between the concentration of black residents in the community [as measured by the hospital service area (HSA] served by a given network and each of these 2 network properties.Our sample included 336,506 beneficiaries (mean age 76.3 ± SD, 63.1% of whom were women. HSAs with higher concentrations of black residents tended to be more impoverished than those with lower concentrations. While HSAs with higher concentrations of black residents had, on average, more acute care beds and medical specialists, they had fewer surgeons per capita than those with lower concentrations. After adjusting for these differences, we found that HSAs with higher concentrations of black residents were served by physician referral networks that had significantly higher within-network clustering but fewer external ties.We observed differences in the patterns of interaction among physicians around THR episodes in communities with low versus high concentrations of black residents. Studies investigating the impact of these differences

  11. Defence-in-depth and new reactors

    International Nuclear Information System (INIS)

    Bonaca, M.

    2002-01-01

    Defense-in-Depth (DID) is the structured approach to nuclear reactor safety that is at the basis of the safety features of the current generation of operating plants. This approach developed as a means of compensating for uncertainties in equipment and human performance, and it has evolved since the 1950's from its early use as a reactor safety guiding principle to its current broad, systematic application as an overall safety philosophy incorporating lessons learned from the current generation of operating reactors. The NRC white paper on risk-informed and performance based regulation defines DID as ''...an element of the NRC's Safety Philosophy that employs successive compensatory measures to prevent accidents or mitigate damage if a malfunction, accident, or naturally caused event occurs at a nuclear facility. This philosophy ensures that safety will not be wholly dependent on any single element...The net effect of incorporating defense-in-depth...is that the facility...tends to be more tolerant of failures and external challenges''. In practical terms, DID results from the implementation of multiple measures to prevent and mitigate accidents, to contain their consequences, and to establish an acceptable balance between prevention and mitigation. Its pervasive application in reactor safety design and regulation is translated into many precepts and technical requirements of the current body of regulation. (author)

  12. Physical activity, hormone replacement therapy and breast cancer risk: A meta-analysis of prospective studies.

    Science.gov (United States)

    Pizot, Cécile; Boniol, Mathieu; Mullie, Patrick; Koechlin, Alice; Boniol, Magali; Boyle, Peter; Autier, Philippe

    2016-01-01

    Lower risk of breast cancer has been reported among physically active women, but the risk in women using hormone replacement therapy (HRT) appears to be higher. We quantified the association between physical activity and breast cancer, and we examined the influence that HRT use and other risk factors had on this association. After a systematic literature search, prospective studies were meta-analysed using random-effect models applied on highest versus lowest level of physical activity. Dose-response analyses were conducted with studies reporting physical activity either in hours per week or in hours of metabolic equivalent per week (MET-h/week). The literature search identified 38 independent prospective studies published between 1987 and 2014 that included 116,304 breast cancer cases. Compared to the lowest level of physical activity, the highest level was associated with a summary relative risk (SRR) of 0.88 (95% confidence interval [CI] 0.85, 0.90) for all breast cancer, 0.89 (95% CI 0.83, 0.95) for ER+/PR+ breast cancer and 0.80 (95% CI 0.69, 0.92) for ER-/PR- breast cancer. Risk reductions were not influenced by the type of physical activity (occupational or non-occupational), adiposity, and menopausal status. Risk reductions increased with increasing amounts of physical activity without threshold effect. In six studies, the SRR was 0.78 (95% CI 0.70, 0.87) in women who never used HRT and 0.97 (95% CI 0.88, 1.07) in women who ever used HRT, without heterogeneity in results. Findings indicate that a physically inactive women engaging in at least 150 min per week of vigorous physical activity would reduce their lifetime risk of breast cancer by 9%, a reduction that might be two times greater in women who never used HRT. Increasing physical activity is associated with meaningful reductions in the risk of breast cancer, but in women who ever used HRT, the preventative effect of physical activity seems to be cancelled out. Copyright © 2015 Elsevier Ltd. All

  13. Abnormal imaging findings of the breast related to hormone replacement therapy: analysis of surgically excised cases

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Woo Kyung; Cha, Joo Hee; Cho, Kyung Soo; Choi, Een Wan; Lee, Yu Jin; Im, Jung Gi [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of); Kim, Hyung Seok [Wooridul Spine Hospital, Seoul (Korea, Republic of); Chung, Sun Yang [Bundang CHA General Hospital, Sungnam (Korea, Republic of); Cho, Nariya [Gil Medical Center, Incheon (Korea, Republic of)

    2004-02-01

    To correlate the mammographic and ultrasonographic findings with the pathologic results in women undergoing hormone replacement therapy (HRT), and to determine the characteristic clinical, mammographic or histologic findings of breast cancer in these patients. Twenty-five breast lesions in 25 patients aged 44-65 (mean, 55.5) years undergoing HRT were surgically removed due to abnormal mammographic findings or the presence of palpable masses. Mammograms in all patients and ultrasonograms in 23 were retrospectively analyzed in terms of the shape and margin of the mass, and microcalcifications, and the imaging findings were correlated with the pathologic results. As a control group, 45 cancer patients not undergoing HRT were selected. Using the student t test, detection methods, tumor size, mammographic findings, and the proportion of intraductal cancers were compared between to two groups. Surgical excision revealed ten benign lesions (four fibroadenomas and six cases of fibrocystic change) and 15 cancers (three intraductal and twelve invasive ductal cancers). Abnormal findings at mammography were a mass in 16 cases, clustered microcalcifications in seven, and a mass with microcalcifications in two. Mammography showed that all four circumscribed masses were benign. Five of seven ill-defined masses (71%) and all six spiculated masses were malignant. Three of seven cases (43%) with microcalcifications, and both with a mass and microcalcification, were malignant. In two cases in which ultrasonography revealed cystic lesions, histologic examination showed that fibrocystic change had occurred. Compared to non-HRT-related cancers, HRT-related cancers were more often detected by mammography (60% vs 16%; p<0.001), smaller (17 mm vs 24 mm, p<0.01), showed microcalcification only (20% vs 13%; p<0.05), and were intraductal (20% vs 7%; p<0.01). In patients with HRT, mammographic findings of an ill-defined or spiculated mass, or one with microcalcifications, were associated with

  14. Abnormal imaging findings of the breast related to hormone replacement therapy: analysis of surgically excised cases

    International Nuclear Information System (INIS)

    Moon, Woo Kyung; Cha, Joo Hee; Cho, Kyung Soo; Choi, Een Wan; Lee, Yu Jin; Im, Jung Gi; Kim, Hyung Seok; Chung, Sun Yang; Cho, Nariya

    2004-01-01

    To correlate the mammographic and ultrasonographic findings with the pathologic results in women undergoing hormone replacement therapy (HRT), and to determine the characteristic clinical, mammographic or histologic findings of breast cancer in these patients. Twenty-five breast lesions in 25 patients aged 44-65 (mean, 55.5) years undergoing HRT were surgically removed due to abnormal mammographic findings or the presence of palpable masses. Mammograms in all patients and ultrasonograms in 23 were retrospectively analyzed in terms of the shape and margin of the mass, and microcalcifications, and the imaging findings were correlated with the pathologic results. As a control group, 45 cancer patients not undergoing HRT were selected. Using the student t test, detection methods, tumor size, mammographic findings, and the proportion of intraductal cancers were compared between to two groups. Surgical excision revealed ten benign lesions (four fibroadenomas and six cases of fibrocystic change) and 15 cancers (three intraductal and twelve invasive ductal cancers). Abnormal findings at mammography were a mass in 16 cases, clustered microcalcifications in seven, and a mass with microcalcifications in two. Mammography showed that all four circumscribed masses were benign. Five of seven ill-defined masses (71%) and all six spiculated masses were malignant. Three of seven cases (43%) with microcalcifications, and both with a mass and microcalcification, were malignant. In two cases in which ultrasonography revealed cystic lesions, histologic examination showed that fibrocystic change had occurred. Compared to non-HRT-related cancers, HRT-related cancers were more often detected by mammography (60% vs 16%; p<0.001), smaller (17 mm vs 24 mm, p<0.01), showed microcalcification only (20% vs 13%; p<0.05), and were intraductal (20% vs 7%; p<0.01). In patients with HRT, mammographic findings of an ill-defined or spiculated mass, or one with microcalcifications, were associated with

  15. Compensation for Expropriated Community Farmland in Nigeria: An In-Depth Analysis of the Laws and Practices Related to Land Expropriation for the Lekki Free Trade Zone in Lagos

    Directory of Open Access Journals (Sweden)

    Nicholas K. Tagliarino

    2018-02-01

    Full Text Available In Nigeria, the recurring impoverishment and other negative socioeconomic impacts endured by landholders affected by expropriation are well-documented and call into question the Land Use Act’s (LUA effectiveness in protecting local land rights. The World Bank’s Land Governance Assessment Framework found that, in Nigeria, “a large number of acquisitions occurs without prompt and adequate compensation, thus leaving those losing land worse off, with no mechanism for independent appeal even though the land is often not utilized for a public purpose”. Such negative outcomes may be due to a number of factors, including corruption, limited capacity, and insufficient financing as well as Nigeria’s weak legal framework. According to a recent study of compensation procedures established in national laws of 50 countries, Nigeria’s compensation procedure lags behind many of the countries assessed because the LUA mostly fails to adopt international standards on the valuation of compensation. This article examines Nigerian expropriation and compensation procedures in more detail by combining both an in-depth legal analysis of Nigeria’s expropriation laws as well as survey and qualitative research that indicates, to some extent, how expropriation laws function in practice in Nigeria. Based on our legal assessment, surveys, and interviews with both government and private sector officials involved in the LFTZ, we found that the Nigerian government failed to comply with international standards on expropriation and compensation, both in terms of its laws and its practices in the LFTZ case. This article expands our conference paper written for UN Economic Commission of Africa Conference on Land Policy in Africa, which took place in Addis Ababa, Ethiopia in November of 2017. Under Nigeria’s LUA, affected landholders are not granted the right to participate in expropriation and compensation decision-making or otherwise be consulted on matters

  16. Assessment of the Capability of the NGDS Prototype to Replace the JBAIDS for Environmental Sample Analysis

    Science.gov (United States)

    2016-11-01

    Diagnostic System (JBAIDS) for environmental sample analysis. JUPITR ATD and USAF members analyzed environmental samples using the FilmArray...requires 60+ min for sample preparation, whereas the FilmArray system (right) uses highly multiplexed assay pouches that require ᝺ min for sample...supported the evaluation of the BDCoE by analyzing spiked DFU samples using the Joint Biological Agent Identification and Diagnostic System (JBAIDS) and the

  17. Discovering bin-Laden’s Replacement in al-Qaeda, using Social Network Analysis: A Methodological Investigation

    Directory of Open Access Journals (Sweden)

    Edith Wu

    2014-02-01

    Full Text Available The removal of Osama bin-Laden created a leadership void within al-Qaeda. Despite the group’s autonomous cell structure, an authorative figure remains essential for promoting and disseminating al-Qaeda’s ideology. An appropriate replacement should exhibit traits comparable to bin-Laden and have similar positioning within the structure of the group. Using a media-based sample and social network analysis, this study attempts to uncover the most probable successor for bin-Laden by examining the dynamics within al-Qaeda. The results indicate how the differential embeddedness of al-Qaeda members affects social capital, which in turn provides insights for leadership potiential.

  18. Efficacy and safety of transcatheter aortic valve replacement in aortic stenosis patients at low to moderate surgical risk: a comprehensive meta-analysis

    OpenAIRE

    Elmaraezy, Ahmed; Ismail, Ammar; Abushouk, Abdelrahman Ibrahim; Eltoomy, Moutaz; Saad, Soha; Negida, Ahmed; Abdelaty, Osama Mahmoud; Abdallah, Ahmed Ramadan; Aboelfotoh, Ahmed Magdy; Hassan, Hossam Mahmoud; Elmaraezy, Aya Gamal; Morsi, Mahmoud; Althaher, Farah; Althaher, Moath; AlSafadi, Ammar M.

    2017-01-01

    Background Recently, transcatheter aortic valve replacement (TAVR) has become the procedure of choice in high surgical risk patients with aortic stenosis (AS). However, its value is still debated in operable AS cases. We performed this meta-analysis to compare the safety and efficacy of TAVR to surgical aortic valve replacement (SAVR) in low-to-moderate surgical risk patients with AS. Methods A systematic search of five authentic databases retrieved 11 eligible studies (20,056 patients). Rele...

  19. Contact stresses, pressure and area in a fixed-bearing total ankle replacement: a finite element analysis.

    Science.gov (United States)

    Martinelli, Nicolo; Baretta, Silvia; Pagano, Jenny; Bianchi, Alberto; Villa, Tomaso; Casaroli, Gloria; Galbusera, Fabio

    2017-11-25

    Mobile-bearing ankle implants with good clinical results continued to increase the popularity of total ankle arthroplasty to address endstage ankle osteoarthritis preserving joint movement. Alternative solutions used fixed-bearing designs, which increase stability and reduce the risk of bearing dislocation, but with a theoretical increase of contact stresses leading to a higher polyethylene wear. The purpose of this study was to investigate the contact stresses, pressure and area in the polyethylene component of a new total ankle replacement with a fixed-bearing design, using 3D finite element analysis. A three-dimensional finite element model of the Zimmer Trabecular Metal Total Ankle was developed and assembled based on computed tomography images. Three different sizes of the polyethylene insert were modeled, and a finite element analysis was conducted to investigate the contact pressure, the von Mises stresses and the contact area of the polyethylene component during the stance phase of the gait cycle. The peak value of pressure was found in the anterior region of the articulating surface, where it reached 19.8 MPa at 40% of the gait cycle. The average contact pressure during the stance phase was 6.9 MPa. The maximum von Mises stress of 14.1 MPa was reached at 40% of the gait cycle in the anterior section. In the central section, the maximum von Mises stress of 10.8 MPa was reached at 37% of the gait cycle, whereas in the posterior section the maximum stress of 5.4 MPa was reached at the end of the stance phase. The new fixed-bearing total ankle replacement showed a safe mechanical behavior and many clinical advantages. However, advanced models to quantitatively estimate the wear are need. To the light of the clinical advantages, we conclude that the presented prosthesis is a good alternative to the other products present in the market.

  20. Fire hazards analysis for the replacement cross-site transfer system, project W-058

    International Nuclear Information System (INIS)

    Sepahpur, J.B.

    1996-01-01

    The fire hazards analysis assess the risk from fire and determines compliance with the applicable criteria of DOE 5480.7A, DOE 6430.1A, and RLID 5480.7. (Project W-058 will provide encased pipelines to connect the SY Tank Farms in 200 West Area with the tank farms in 200 East Area via an interface with the 244-A lift station. Function of the cross-site transfer system will be to transfer radioactive waste from the SY Tank Farm to treatment, storage, and disposal facilities in 200 East Area.)

  1. Replacement rod

    International Nuclear Information System (INIS)

    Hatfield, S.C.

    1989-01-01

    This patent describes in an elongated replacement rod for use with fuel assemblies of the type having two end fittings connected by guide tubes with a plurality of rod and guide tube cell defining spacer grids containing rod support features and mixing vanes. The grids secured to the guide tubes in register between the end fittings at spaced intervals. The fuel rod comprising: an asymmetrically beveled tip; a shank portion having a straight centerline; and a permanently diverging portion between the tip and the shank portion

  2. A nationwide analysis of socioeconomic outcomes after hip and knee replacement

    DEFF Research Database (Denmark)

    Kjellberg, Jakob; Kehlet, Henrik

    2016-01-01

    surgery. The economic analysis of the total costs before and after surgery were divided into annual healthcare costs (outpatient services, inpatient admissions, prescription drugs and physician office visits), home care and loss of income and compared with a matched RP. RESULTS: Healthcare costs increased......-morbidities have only a limited role in explaining the increased costs. CONCLUSIONS: The healthcare costs and income of patients undergoing THA and TKA are comparable to those of their matched RP until three years before the operation, but TKA and THA patients continuously have higher healthcare costs and lower...... income levels than the RP after surgery. These data should be taken into account in future studies of patient expectations and strategies for enhanced rehabilitation. FUNDING: none. TRIAL REGISTRATION: none....

  3. Does replacing coal with wood lower CO2 emissions? Dynamic lifecycle analysis of wood bioenergy

    Science.gov (United States)

    Sterman, John D.; Siegel, Lori; Rooney-Varga, Juliette N.

    2018-01-01

    Bioenergy is booming as nations seek to cut their greenhouse gas emissions. The European Union declared biofuels to be carbon-neutral, triggering a surge in wood use. But do biofuels actually reduce emissions? A molecule of CO2 emitted today has the same impact on radiative forcing whether it comes from coal or biomass. Biofuels can only reduce atmospheric CO2 over time through post-harvest increases in net primary production (NPP). The climate impact of biofuels therefore depends on CO2 emissions from combustion of biofuels versus fossil fuels, the fate of the harvested land and dynamics of NPP. Here we develop a model for dynamic bioenergy lifecycle analysis. The model tracks carbon stocks and fluxes among the atmosphere, biomass, and soils, is extensible to multiple land types and regions, and runs in ≈1s, enabling rapid, interactive policy design and sensitivity testing. We simulate substitution of wood for coal in power generation, estimating the parameters governing NPP and other fluxes using data for forests in the eastern US and using published estimates for supply chain emissions. Because combustion and processing efficiencies for wood are less than coal, the immediate impact of substituting wood for coal is an increase in atmospheric CO2 relative to coal. The payback time for this carbon debt ranges from 44-104 years after clearcut, depending on forest type—assuming the land remains forest. Surprisingly, replanting hardwood forests with fast-growing pine plantations raises the CO2 impact of wood because the equilibrium carbon density of plantations is lower than natural forests. Further, projected growth in wood harvest for bioenergy would increase atmospheric CO2 for at least a century because new carbon debt continuously exceeds NPP. Assuming biofuels are carbon neutral may worsen irreversible impacts of climate change before benefits accrue. Instead, explicit dynamic models should be used to assess the climate impacts of biofuels.

  4. Support for total hip replacement surgery: Structures modeling, Gait Data Analysis and Report system

    Directory of Open Access Journals (Sweden)

    Gianluca Mario Izzo

    2012-03-01

    Full Text Available For the treatment of advanced damages of hip joints, Total Hip Arthroplasty is well proven. Due to the different mechanical properties of the prosthesis material and the bone tissue, a partial unloading of the periprosthetic bone occurs. The bone cement causes reduction in bone density as a result of removal of normal stress from the bone, leading to weakening of the bone in that area and the fracture risk increases. Bone loss is identified as one of the main reasons for loosening of the stem. Otherwise, thanks to the press-fit of the non-cemented stem achieved by surgery, the bone layers immediately adjacent to the stem are preloaded, thus encouraged growing, and the bone getting stronger. The non-cemented stem would be the better choice for every patient, but the question remains if the femur can handle the press- fitting surgery. This studies aim to develop a monitoring techniques based on Gait analysis and bone density changes to assess patient recovery after Total Hip Arthroplasty. Furthermore, to validate computational processes based on 3D modeling and Finite Element Methods for optimizing decision making in the operation process and selecting the suited surgical procedure. A vision could be minimizing risk of periprosthetic fracture during and after surgery. Patients: The sample presents 11 patients receiving cemented implant and 13 for the uncemented. Patients are grouped by type of implant. Three checkpoints were considered: before, after operation and one year later. CT scans, gaitrite and kinepro measurements have been realized. Main outcome measures: Fracture risk probability is higher in bone with low bone mineral density; therefore bones are more fragile in elderly people. BMD is indeed one parameter considered among all the observations. Periprosthetic fracture of the femur is a rare but complex complication of THA, and requires demanding surgery. As such, they result in considerable morbidity and dysfunction. Thus, tests of

  5. Defence in Depth and Ageing Management

    Energy Technology Data Exchange (ETDEWEB)

    Fabbri, S.; Vega, G.; Diluch, A.; Versaci, R., E-mail: versaci@cnea.gov.ar [Comisión Nacional de Energía Atómica, Buenos Aires (Argentina)

    2014-10-15

    Accident prevention is the first safety priority of both designers and operators. It is achieved through the use of reliable structures, components, systems and procedures in a plant operated by personnel who are committed to a strong safety culture. For future nuclear power plants, consideration of multiple failures and severe accidents will be achieved in a more systematic and complete way from the design stage. Defence in depth (DID) consists of a hierarchical deployment of different levels of equipment and procedures in order to maintain the effectiveness of physical barriers placed between radioactive materials and workers, the public or the environment, in normal operation, anticipated operational occurrences and, for some barriers, in accidents at the plant. The primary way of preventing accidents is to achieve a high quality in design, construction and operation of the plant, and thereby to ensure that deviations from normal operation are infrequent. The best way to meet these premises of effectiveness of the barriers and the Systems, Structures and Components (SSCs) is to develop an ageing management programme to prevent potential failures and accidents. In this work we will refer to the ageing management programme for Atucha I and Atucha II power plants and to the Atucha I spent fuel storage. (author)

  6. Is nicotine replacement therapy overvalued in smoking cessation? Analysis of smokers' and quitters' communication in social media.

    Science.gov (United States)

    Kurko, Terhi; Linden, Kari; Kolstela, Maija; Pietilä, Kirsi; Airaksinen, Marja

    2015-12-01

    Internet discussion forums provide new, albeit less used data sources for exploring personal experiences of illness and treatment strategies. To gain an understanding of how discussion forum participants value nicotine replacement therapy (NRT) in smoking cessation (SC). Finnish national Internet-based discussion forum, STUMPPI, supporting SC and consisting of ten free discussion areas, each with a different focus. The analysis was based on STUMPPI forum participants' postings (n = 24 481) in five discussion areas during January 2007-January 2012. Inductive content analysis of the postings concerning NRT use or comparing NRT to other SC methods. Three major themes related to NRT in SC emerged from the discussions. These were as follows: (I) distrust and negative attitude towards NRT; (II) neutral acceptance of NRT as a useful SC method; and (III) trust on the crucial role of NRT and other SC medicines. The negative attitude was related to following perceptions: NRT use maintains tobacco dependence, fear of NRT dependence or experience of not gaining help from NRT use. NRT was perceived to be useful particularly in the initiation of SC attempts and in dealing with physiological dependence. The most highlighted factors of successful quitting were quitters' own psychological empowerment and peer support from the discussion community. The majority of STUMPPI forum participants had low or balanced expectations towards the role of NRT in SC. More research from the smokers' and quitters' perspective is needed to assess the real value of NRT compared to other methods in SC. © 2014 John Wiley & Sons Ltd.

  7. The role of surface chemical analysis in a study to select replacement processes for TCA vapor degreasing

    Science.gov (United States)

    Lesley, Michael W.; Davis, Lawrence E.; Moulder, John F.; Carlson, Brad A.

    1995-01-01

    The role of surface-sensitive chemical analysis (ESCA, AES, and SIMS) in a study to select a process to replace 1, 1, 1-trichloroethane (TCA) vapor degreasing as a steel and aluminum bonding surface preparation method is described. The effort was primarily concerned with spray-in-air cleaning processes involving aqueous alkaline and semi-aqueous cleaners and a contamination sensitive epoxy-to-metal bondline. While all five cleaners tested produced bonding strength results equal to or better than those produced by vapor degreasing, the aqueous alkaline cleaners yielded results which were superior to those produced by the semi-aqueous cleaners. The main reason for the enhanced performance appears to be a silicate layer left behind by the aqueous alkaline cleaners. The silicate layer increases the polarity of the surface and enhances epoxy-to-metal bonding. On the other hand, one of the semi-aqueous cleaners left a nonpolar carbonaceous residue which appeared to have a negative effect on epoxy-to-metal bonding. Differences in cleaning efficiency between cleaners/processes were also identified. These differences in surface chemistry, which were sufficient to affect bonding, were not detected by conventional chemical analysis techniques.

  8. Shoulder replacement - discharge

    Science.gov (United States)

    Total shoulder arthroplasty - discharge; Endoprosthetic shoulder replacement - discharge; Partial shoulder replacement - discharge; Partial shoulder arthroplasty - discharge; Replacement - shoulder - discharge; Arthroplasty - shoulder - discharge

  9. Rates of hip and knee joint replacement amongst different ethnic groups in England: an analysis of National Joint Registry data.

    Science.gov (United States)

    Smith, M C; Ben-Shlomo, Y; Dieppe, P; Beswick, A D; Adebajo, A O; Wilkinson, J M; Blom, A W

    2017-04-01

    Despite a health care system that is free at the point of delivery, ethnic minorities may not always get care equitable to that of White patients in England. We examined whether ethnic differences exist in joint replacement rates and surgical practice in England. 373,613 hip and 428,936 knee National Joint Registry (NJR) primary replacement patients had coded ethnicity in Hospital Episode Statistics (HES). Age and gender adjusted observed/expected ratios of hip and knee replacements amongst ethnic groups were compared using indirect standardisation. Associations between ethnic group and type of procedure were explored and effects of demographic, clinical and hospital-related factors examined using multivariable logistic regression. Adjusted standardised observed/expected ratios were substantially lower in Blacks and Asians than Whites for hip replacement (Blacks 0.33 [95% CI, 0.31-0.35], Asians 0.20 [CI, 0.19-0.21]) and knee replacement (Blacks 0.64 [CI, 0.61-0.67], Asians 0.86 % [CI, 0.84-0.88]). Blacks were more likely to receive uncemented hip replacements (Blacks 52%, Whites 37%, Asians 44%; P replacements than Whites (men 10% vs 15%, P = 0.001; women 6% vs 14%, P replacement (OR 1.43 [CI, 1.11-1.84]). In England, hip and knee replacement rates and prosthesis type given differ amongst ethnic groups. Whether these reflect differences in clinical need or differential access to treatment requires urgent investigation. Copyright © 2017. Published by Elsevier Ltd.

  10. The optimal time of initiation of renal replacement therapy in acute kidney injury: A meta-analysis.

    Science.gov (United States)

    Luo, Kaiping; Fu, Shufang; Fang, Weidong; Xu, Gaosi

    2017-09-15

    The impact on the timing of renal replacement therapy (RRT) initiation on clinical outcomes for patients with acute kidney injury (AKI) remains controversial. We searched the Cochrane Library, EMBASE, Global Health, MEDLINE, PubMed, the International Clinical Trials Registry Platform, and Web of Science. We included 49 studies involving 9698 patients. Pooled analysis of 5408 critically ill patients with AKI showed that early RRT was significantly associated with reduced mortality compared to late RRT [odds ratio (OR), 0.40; 95% confidential intervals (CI), 0.32 - 0.48; I 2 , 50.2%]. For 4290 non-critically ill patients with AKI, there was no statistically significant difference in the risk of mortality between early and late RRT (OR, 1.07; 95% CI, 0.79 - 1.45; I 2 , 73.0%). Early RRT was markedly associated with shortened intensive care units (ICU) length of stay (LOS) and hospital LOS compared to late RRT in both critically ill and non-critically ill patients with AKI. Early RRT probably reduce the mortality, ICU and hospital LOS in critically ill patients with AKI. Inversely, early RRT in non-critically ill patients with AKI did not decrease the mortality, but shortened the ICU and hospital LOS.

  11. Analysis of Outcomes of the Nutritional Status in Patients Qualified for Aortic Valve Replacement in Comparison to Healthy Elderly

    Directory of Open Access Journals (Sweden)

    Edyta Wernio

    2018-03-01

    Full Text Available Severe aortic stenosis (AS is associated with the reduction of muscle mass and may be associated with deterioration of nutritional status. Furthermore, malnourished cardiac patients are characterized by a higher risk of postoperative complications and mortality. The aim of this study was the evaluation and comparison of nutritional status, appetite and body composition in older people with severe aortic stenosis before aortic valve replacement and healthy elderly volunteers. One hundred and one patients, aged >65 years old with severe AS were included in the study. Nutritional status was assessed. Body composition was estimated using bioelectrical impedance analysis. Concentrations of albumin, prealbumin, triglycerides, total cholesterol and C-reactive protein were measured, and a complete blood count was done. About 40% of AS patients were at risk of malnutrition. They had decreased hand grip strength and they lost more body mass than the control group. Malnourished AS patients were older, had lower body mass indexes (BMIs and lower aortic valve areas in comparison to well-nourished patients. Older AS patients, like their peers, show excessive body mass and, at the same time, the features of malnutrition. They have additional factors such as unintentional weight lost and decreased muscle strength which may be associated with worse outcomes.

  12. Analysis of Mechanical Properties of Self Compacted Concrete by Partial Replacement of Cement with Industrial Wastes under Elevated Temperature

    Directory of Open Access Journals (Sweden)

    Junaid Mansoor

    2018-03-01

    Full Text Available Self-Compacting Concrete (SCC differs from the normal concrete as it has the basic capacity to consolidate under its own weight. The increased awareness regarding environmental disturbances and its hazardous effects caused by blasting and crushing procedures of stone, it becomes a delicate and obvious issue for construction industry to develop an alternative remedy as material which can reduce the environmental hazards and enable high-performance strength to the concrete, which would make it durable and efficient for work. A growing trend is being established all over the world to use industrial byproducts and domestic wastes as a useful raw material in construction, as it provides an eco-friendly edge to the construction process and especially for concrete. This study aims to enlighten the use and comparative analysis for the performance of concrete with added industrial byproducts such as Ground Granulated Blast Furnace Slag (GGBFS, Silica fumes (SF and Marble Powder (MP in the preparation of SCC. This paper deals with the prediction of mechanical properties (i.e., compressive, tensile and flexural Strength of self-compacting concrete by considering four major factors such as type of additive, percentage additive replaced, curing days and temperature using Artificial Neural Networks (ANNs.

  13. An Analysis of Differences in Terms of Professional Interests Based on the Project to Replace IAS 39

    Directory of Open Access Journals (Sweden)

    Cláudia Daniela Ferreira da Mota Carvalho

    2015-08-01

    Full Text Available The professional interests of the various stakeholders groups are often seen as obstacles to full accounting harmonization. Studying different professional interests in the accounting domain is significant for organizations involved in the international accounting harmonization process, insofar as it enables them to identify the main obstacles to face in order to achieve full harmonization. Thus, this article is aimed at analyzing the differences in terms of professional interests by addressing the participation of various stakeholders groups in the process of issuing/modifying standards of the International Accounting Standards Board (IASB. Based on content analysis, we examined the comment letters sent to the IASB in the context of the first part of the first phase of the project to replace the International Accounting Standard (IAS 39, entitled "Financial Instruments - Recognition and Measurement", by the International Financial Reporting Standard (IFRS 9, on its turn entitled "Financial Instruments". Respondents were identified according to the stakeholders group, and, later, the collected data underwent a nonparametric chi-square test. The results of this study indicate there are significant differences between the answers obtained from the various stakeholders groups involved in the process of issuing or reviewing a standard of the IASB, above all made clear between the group of financial preparers and the regulatory and/or standard-setting agencies and the professional associations related to accounting.

  14. Hemodynamic outcomes of the Ross procedure versus other aortic valve replacement: a systematic review and meta-analysis.

    Science.gov (United States)

    Um, Kevin J; McCLURE, Graham R; Belley-Cote, Emilie P; Gupta, Saurabh; Bouhout, Ismail; Lortie, Hugo; Alraddadi, Hatim; Alsagheir, Ali; Bossard, Matthias; McINTYRE, William F; Lengyel, Alexandra; Eikelboom, John W; Ouzounian, Maral; Chu, Michael W; Parry, Dominic; El-Hamamsy, Ismail; Whitlock, Richard P

    2018-01-09

    Life expectancy in young adults undergoing mechanical or bioprosthetic aortic valve replacement (AVR) may be reduced by up to 20 years compared to age matched controls. The Ross procedure is a durable, anticoagulation-sparing alternative. We performed a systematic review and meta-analysis to compare the valve hemodynamics of the Ross procedure versus other AVR. We searched Cochrane CENTRAL, MEDLINE and EMBASE from inception to February 2017 for randomized controlled trials (RCTs) and observational studies (n≥10 Ross). Independently and in duplicate, we performed title and abstract screening, full-text eligibility assessment, and data collection. We evaluated the risk of bias with the Cochrane and CLARITY tools, and the quality of evidence with the GRADE framework. We identified 2 RCTs and 13 observational studies that met eligibility criteria (n=1,412). In observational studies, the Ross procedure was associated with a lower mean aortic gradient at discharge (MD -9 mmHg, 95% CI [-13, -5], pRoss procedure was associated with a lower mean gradient at latest follow-up (MD -15 mmHg, 95% CI [-32, 2], p=0.08, I2=99%). The mean pulmonic gradient for the Ross procedure was 18.0 mmHg (95% CI [16, 20], pRoss procedure was associated with better aortic valve hemodynamics. Future studies should evaluate the impact of the Ross procedure on exercise capacity and quality of life.

  15. Relationship between intraoperative regional cerebral oxygen saturation trends and cognitive decline after total knee replacement: a post-hoc analysis.

    Science.gov (United States)

    Salazar, Fátima; Doñate, Marta; Boget, Teresa; Bogdanovich, Ana; Basora, Misericordia; Torres, Ferran; Gracia, Isabel; Fàbregas, Neus

    2014-01-01

    Bilateral regional brain oxygen saturation (rSO2) trends, reflecting intraoperative brain oxygen imbalance, could warn of brain dysfunction. Various types of cognitive impairment, such as memory decline, alterations in executive function or subjective complaints, have been described three months after surgery. Our aim was to explore the potential utility of rSO2 values as a warning sign for the development of different types of decline in postoperative psychological function. Observational post-hoc analysis of data for the patient sample (n = 125) of a previously conducted clinical trial in patients over the age of 65 years undergoing total knee replacement under spinal anesthesia. Demographic, hemodynamic and bilateral rSO2 intraoperative values were recorded. An absolute rSO2 value of 20% or >25% below baseline were chosen as relevant cutoffs. Composite function test scores were created from baseline to three months for each patient and adjusted for the mean (SD) score changes for a control group (n = 55). Tests were used to assess visual-motor coordination and executive function (VM-EF) (Wechsler Digit Symbol-Coding and Visual Reproduction, Trail Making Test) and memory (Auditory Verbal Learning, Wechsler Memory Scale); scales were used to assess psychological symptoms. We observed no differences in baseline rSO2 values; rSO2 decreased significantly in all patients during surgery (P Left and right rSO2 values were asymmetric in patients who had memory decline (mean [SD] left-right ratio of 95.03 [8.51] vs 101.29 [6.7] for patients with no changes, P = 0.0012). The mean right-left difference in rSO2 was also significant in these patients (-2.87% [4.73%], lower on the right, P = 0.0034). Detection of a trend to asymmetry in rSO2 values can warn of possible postoperative onset of memory decline. Psychological symptoms and memory decline were common three months after knee replacement in our patients over the age of 65 years.

  16. A Meta-Analysis of Total Arch Replacement With Frozen Elephant Trunk in Acute Type A Aortic Dissection.

    Science.gov (United States)

    Takagi, Hisato; Umemoto, Takuya

    2016-01-01

    To assess the safety and efficacy, we performed a meta-analysis of total arch replacement with frozen elephant trunk in exclusive acute type A (neither chronic nor type B) aortic dissection. Databases including MEDLINE and EMBASE were searched through March 2015 using Web-based search engines (PubMed and OVID). Eligible studies were case series of frozen elephant trunk enrolling patients with acute type A (neither chronic nor type B) aortic dissection reporting at least early (in-hospital or 30-day) all-cause mortality. Study-specific estimates were combined in both fixed- and random-effect models. Fifteen studies enrolling 1279 patients were identified and included. Pooled analyses demonstrated the cardiopulmonary bypass time of 207.1 (95% confidence interval [CI], 186.1-228.1) minutes, aortic cross-clamp time of 123.3 (95% CI, 113.1-133.5) minutes, selective antegrade cerebral perfusion time of 49.3 (95% CI, 37.6-61.0) minutes, hypothermic circulatory arrest time of 39.0 (95% CI, 30.7-47.2) minutes, early mortality of 9.2% (95% CI, 7.7-11.0%), stroke of 4.8% (95% CI, 2.5-9.0%), spinal cord injury of 3.5% (95% CI, 1.9-6.6%), mid- to long-term (≥1-year) overall mortality of 13.0% (95% CI, 10.4-16.0%), reintervention of 9.6% (95% CI, 5.6-15.8%), and false lumen thrombosis of 96.8% (95% CI, 90.7-98.9%). Total arch replacement with frozen elephant trunk provides a safe alternative to that with conventional elephant trunk in patients with acute type A aortic dissection, with acceptable early mortality and morbidity. The rates of mid- to long-term reintervention and false lumen non-thrombosis may be lower in patients undergoing the frozen than conventional elephant trunk procedure. © The Author(s) 2016.

  17. Hip joint replacement

    Science.gov (United States)

    Hip arthroplasty; Total hip replacement; Hip hemiarthroplasty; Arthritis - hip replacement; Osteoarthritis - hip replacement ... Your hip joint is made up of 2 major parts. One or both parts may be replaced during surgery: ...

  18. Evaluation of Adverse Events in Total Disc Replacement: A Meta-Analysis of FDA Summary of Safety and Effectiveness Data.

    Science.gov (United States)

    Anderson, Paul A; Nassr, Ahmad; Currier, Bradford L; Sebastian, Arjun S; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel

    2017-04-01

    Systematic review and meta-analysis. The safety of new technology such as cervical total disc replacement (TDR) is of paramount importance and is best evaluated in randomized clinical trials (RCT). We compared complication risks of TDR to fusion using data from Investigational Device Exemptions. A systematic review of FDA Summary of Safety and Effectiveness reports of the 8 approved cervical TDRs was performed. These were all randomized controlled trials comparing anterior cervical discectomy and fusion (ACDF) to TDR. Important outcome variables were dysphagia, wound infection, neurologic injuries, heterotopic ossification, death, and secondary surgeries. A random effects model was selected a priori. Data on adverse events was abstracted and analyzed by calculating relative risk of ACDF to TDR by meta-analysis techniques. The study included 3027 patients with 1377 randomized to ACDF and 1652 to TDR. No statistical differences were present between the 2 groups in dysphagia/dysphonia, hardware related, heterotopic ossification, death, and overall neurologic adverse events and incidence of neurologic deterioration. The relative risk of wound-related problems ACDF to TDR was 0.76 (95% confidence interval [CI] = 0.59, 0.98) favoring ACDF, which was statistically significant, but these were minor and never required a second surgical procedure for deep wound infection. The relative risk of ACDF to TDR in surgical-related neurologic events and secondary surgeries was 1.62 (95% CI = 1.04, 2.53) and 1.79 (95% CI = 1.17, 2.74), both favoring TDR. Cervical TDR appears to be as safe as or safer than ACDF at 2-year follow-up.

  19. Deconvolution analysis of 24-h serum cortisol profiles informs the amount and distribution of hydrocortisone replacement therapy.

    Science.gov (United States)

    Peters, Catherine J; Hill, Nathan; Dattani, Mehul T; Charmandari, Evangelia; Matthews, David R; Hindmarsh, Peter C

    2013-03-01

    Hydrocortisone therapy is based on a dosing regimen derived from estimates of cortisol secretion, but little is known of how the dose should be distributed throughout the 24 h. We have used deconvolution analysis of 24-h serum cortisol profiles to determine 24-h cortisol secretion and distribution to inform hydrocortisone dosing schedules in young children and older adults. Twenty four hour serum cortisol profiles from 80 adults (41 men, aged 60-74 years) and 29 children (24 boys, aged 5-9 years) were subject to deconvolution analysis using an 80-min half-life to ascertain total cortisol secretion and distribution throughout the 24-h period. Mean daily cortisol secretion was similar between adults (6.3 mg/m(2) body surface area/day, range 5.1-9.3) and children (8.0 mg/m(2) body surface area/day, range 5.3-12.0). Peak serum cortisol concentration was higher in children compared with adults, whereas nadir serum cortisol concentrations were similar. Timing of the peak serum cortisol concentration was similar (07.05-07.25), whereas that of the nadir concentration occurred later in adults (midnight) compared with children (22.48) (P = 0.003). Children had the highest percentage of cortisol secretion between 06.00 and 12.00 (38.4%), whereas in adults this took place between midnight and 06.00 (45.2%). These observations suggest that the daily hydrocortisone replacement dose should be equivalent on average to 6.3 mg/m(2) body surface area/day in adults and 8.0 mg/m(2) body surface area/day in children. Differences in distribution of the total daily dose between older adults and young children need to be taken into account when using a three or four times per day dosing regimen. © 2012 Blackwell Publishing Ltd.

  20. Replacement of quartz in cementitious composites using PET particles:A statistical analysis of the physical and mechanical properties

    OpenAIRE

    Detomi, Anine Cristina; Filho, Sergio Luiz Moni Ribeiro; Panzera, Túlio H C; Schiavon, Marco Antonio; Silva, Vania R V; Scarpa, Fabrizio

    2016-01-01

    This work investigates the mechanical behavior of cementitious composites (mortar) when quartz inclusions are totally or partially replaced with polyethylene terephthalate (PET) particles. A full factorial design is performed to identify the effect of the water/cement ratio and the range of quartz particles size used in the replacement on the different mechanical and physical parameters (bulk density, apparent porosity, water absorption, oxygen permeability, compressive strength, and modulus ...

  1. Simulation based assembly and alignment process ability analysis for line replaceable units of the high power solid state laser facility

    International Nuclear Information System (INIS)

    Wang, Junfeng; Lu, Cong; Li, Shiqi

    2016-01-01

    Highlights: • Discrete event simulation is applied to analyze the assembly and alignment process ability of LRUs in SG-III facility. • The overall assembly and alignment process of LRUs with specific characteristics is described. • An extended-directed graph is proposed to express the assembly and alignment process of LRUs. • Different scenarios have been simulated to evaluate assembling process ability of LRUs and decision making is supported to ensure the construction millstone. - Abstract: Line replaceable units (LRUs) are important components of the very large high power solid state laser facilities. The assembly and alignment process ability of LRUs will impact the construction milestone of facilities. This paper describes the use of discrete event simulation method for assembly and alignment process analysis of LRUs in such facilities. The overall assembly and alignment process for LRUs is presented based on the layout of the optics assembly laboratory and the process characteristics are analyzed. An extended-directed graph is proposed to express the assembly and alignment process of LRUs. Taking the LRUs of disk amplifier system in Shen Guang-III (SG-III) facility as the example, some process simulation models are built based on the Quest simulation platform. The constraints, such as duration, equipment, technician and part supply, are considered in the simulation models. Different simulation scenarios have been carried out to evaluate the assembling process ability of LRUs. The simulation method can provide a valuable decision making and process optimization tool for the optics assembly laboratory layout and the process working out of such facilities.

  2. Dose-response analysis of testosterone replacement therapy in patients with female to male gender identity disorder.

    Science.gov (United States)

    Nakamura, Aya; Watanabe, Masami; Sugimoto, Morito; Sako, Tomoko; Mahmood, Sabina; Kaku, Haruki; Nasu, Yasutomo; Ishii, Kazushi; Nagai, Atsushi; Kumon, Hiromi

    2013-01-01

    Gender identity disorder (GID) is a conflict between a person's actual physical gender and the one they identify him or herself with. Testosterone is the key agent in the medical treatment of female to male GID patients. We conducted a dose-response analysis of testosterone replacement therapy (TRT) in 138 patients to determine the onset of the therapeutic effects. The TRT consisted of intramuscular injection of testosterone enanthate and patients were divided into three groups; 250 mg every two weeks, 250 mg every three weeks and 125 mg every two weeks. The onset of deepening of voice, increase in facial hair and cessation of menses was evaluated in each group. At one month after the start of TRT, the onset of these physical changes was more prevalent in the group receiving the higher dose of testosterone, and there were dose-dependent effects observed between the three treatment groups. On the other hand, at six months after the start of TRT, most of the patients had achieved treatment responses and there were no dose-dependent effects with regard to the percentage of patients with therapeutic effects. No significant side effects were observed in any of the treatment groups. We demonstrated that the early onset of the treatment effects of TRT is dose-dependent, but within six months of starting TRT, all three doses were highly effective. Current study provides useful information to determine the initial dose of TRT and to suggest possible changes that should be made in the continuous dosage for long term TRT.

  3. Simulation based assembly and alignment process ability analysis for line replaceable units of the high power solid state laser facility

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Junfeng; Lu, Cong; Li, Shiqi, E-mail: sqli@hust.edu.cn

    2016-11-15

    Highlights: • Discrete event simulation is applied to analyze the assembly and alignment process ability of LRUs in SG-III facility. • The overall assembly and alignment process of LRUs with specific characteristics is described. • An extended-directed graph is proposed to express the assembly and alignment process of LRUs. • Different scenarios have been simulated to evaluate assembling process ability of LRUs and decision making is supported to ensure the construction millstone. - Abstract: Line replaceable units (LRUs) are important components of the very large high power solid state laser facilities. The assembly and alignment process ability of LRUs will impact the construction milestone of facilities. This paper describes the use of discrete event simulation method for assembly and alignment process analysis of LRUs in such facilities. The overall assembly and alignment process for LRUs is presented based on the layout of the optics assembly laboratory and the process characteristics are analyzed. An extended-directed graph is proposed to express the assembly and alignment process of LRUs. Taking the LRUs of disk amplifier system in Shen Guang-III (SG-III) facility as the example, some process simulation models are built based on the Quest simulation platform. The constraints, such as duration, equipment, technician and part supply, are considered in the simulation models. Different simulation scenarios have been carried out to evaluate the assembling process ability of LRUs. The simulation method can provide a valuable decision making and process optimization tool for the optics assembly laboratory layout and the process working out of such facilities.

  4. Analysis of adverse events and predisposing factors in voluntary and replacement whole blood donors: A study from north India

    Directory of Open Access Journals (Sweden)

    Naveen Agnihotri

    2012-01-01

    Full Text Available Background: Lack of awareness and community motivation, compounded with fragmented blood transfusion services in our country, Often leads to shortage of blood. Donor recruitment and retention are essential for ensuring adequate blood supply. However, adverse events (AEs in donors have a negative impact on donor return. Aims and Objectives: The present study was aimed to assess the frequency of AEs in whole blood donors and analyze the predisposing factors for AEs. Material and Methods: The study was conducted on allogeneic whole blood donors over a period of 14 months, i.e., from January 2002 to February 2003. A total of 37,896 donors were monitored for any AEs: 22587 (59.6% were voluntary donors (VD and 15,309 (40.4% were replacement donors (RD. Results: Overall reaction rate was 2.5% with vasovagal reactions constituting 63.5% and hematomas 35.0% of all reactions. Vasovagal reactions showed a significant association with young age, lower weight, first time donation status, female gender, and nature of blood donation camps. Amongst male donors, RDs had more reactions (P=0.03 than VDs. Majority of donors (85% with vasovagal reactions admitted to some fear or anxiety prior to donation. Hematoma formation occurred significantly more when less trained staff performed phlebotomy. Conclusion: Donor safety is an essential prerequisite to increase voluntary blood donation. AE analysis helps in identifying the blood donors at risk of donor reactions and adopting appropriate donor motivational strategies, pre-donation counseling, and care during and after donation.

  5. Cost effectiveness of transcatheter aortic valve replacement compared to medical management in inoperable patients with severe aortic stenosis: Canadian analysis based on the PARTNER Trial Cohort B findings.

    Science.gov (United States)

    Hancock-Howard, Rebecca L; Feindel, Christopher M; Rodes-Cabau, Josep; Webb, John G; Thompson, Ann K; Banz, Kurt

    2013-01-01

    The only effective treatment for severe aortic stenosis (AS) is valve replacement. However, many patients with co-existing conditions are ineligible for surgical valve replacement, historically leaving medical management (MM) as the only option which has a poor prognosis. Transcatheter Aortic Valve Replacement (TAVR) is a less invasive replacement method. The objective was to estimate cost-effectiveness of TAVR via transfemoral access vs MM in surgically inoperable patients with severe AS from the Canadian public healthcare system perspective. A cost-effectiveness analysis of TAVR vs MM was conducted using a deterministic decision analytic model over a 3-year time horizon. The PARTNER randomized controlled trial results were used to estimate survival, utilities, and some resource utilization. Costs included the valve replacement procedure, complications, hospitalization, outpatient visits/tests, and home/nursing care. Resources were valued (2009 Canadian dollars) using costs from the Ontario Case Costing Initiative (OCCI), Ontario Ministry of Health and Long-Term Care and Ontario Drug Benefits Formulary, or were estimated using relative costs from a French economic evaluation or clinical experts. Costs and outcomes were discounted 5% annually. The effect of uncertainty in model parameters was explored in deterministic and probabilistic sensitivity analysis. The incremental cost-effectiveness ratio (ICER) was $32,170 per quality-adjusted life year (QALY) gained for TAVR vs MM. When the time horizon was shortened to 24 and 12 months, the ICER increased to $52,848 and $157,429, respectively. All other sensitivity analysis returned an ICER of less than $50,000/QALY gained. A limitation was lack of availability of Canadian-specific resource and cost data for all resources, leaving one to rely on clinical experts and data from France to inform certain parameters. Based on the results of this analysis, it can be concluded that TAVR is cost-effective compared to MM for the

  6. Modular titanium alloy neck adapter failures in hip replacement - failure mode analysis and influence of implant material

    Directory of Open Access Journals (Sweden)

    Bloemer Wilhelm

    2010-01-01

    Full Text Available Abstract Background Modular neck adapters for hip arthroplasty stems allow the surgeon to modify CCD angle, offset and femoral anteversion intraoperatively. Fretting or crevice corrosion may lead to failure of such a modular device due to high loads or surface contamination inside the modular coupling. Unfortunately we have experienced such a failure of implants and now report our clinical experience with the failures in order to advance orthopaedic material research and joint replacement surgery. The failed neck adapters were implanted between August 2004 and November 2006 a total of about 5000 devices. After this period, the titanium neck adapters were replaced by adapters out of cobalt-chromium. Until the end of 2008 in total 1.4% (n = 68 of the implanted titanium alloy neck adapters failed with an average time of 2.0 years (0.7 to 4.0 years postoperatively. All, but one, patients were male, their average age being 57.4 years (36 to 75 years and the average weight 102.3 kg (75 to 130 kg. The failures of neck adapters were divided into 66% with small CCD of 130° and 60% with head lengths of L or larger. Assuming an average time to failure of 2.8 years, the cumulative failure rate was calculated with 2.4%. Methods A series of adapter failures of titanium alloy modular neck adapters in combination with a titanium alloy modular short hip stem was investigated. For patients having received this particular implant combination risk factors were identified which were associated with the occurence of implant failure. A Kaplan-Meier survival-failure-analysis was conducted. The retrieved implants were analysed using microscopic and chemical methods. Modes of failure were simulated in biomechanical tests. Comparative tests included modular neck adapters made of titanium alloy and cobalt chrome alloy material. Results Retrieval examinations and biomechanical simulation revealed that primary micromotions initiated fretting within the modular tapered neck

  7. Can photovoltaic replace nuclear?

    International Nuclear Information System (INIS)

    2017-01-01

    As the French law on energy transition for a green growth predicts that one third of nuclear energy production is to be replaced by renewable energies (wind and solar) by 2025, and while the ADEME proposes a 100 per cent renewable scenario for 2050, this paper proposes a brief analysis of the replacement of nuclear energy by solar photovoltaic energy. It presents and discusses some characteristics of photovoltaic production: production level during a typical day for each month (a noticeable lower production in December), evolution of monthly production during a year, evolution of the rate between nuclear and photovoltaic production. A cost assessment is then proposed for energy storage and for energy production, and a minimum cost of replacement of nuclear by photovoltaic is assessed. The seasonal effect is outlined, as well as the latitude effect. Finally, the authors outline the huge cost of such a replacement, and consider that public support to new photovoltaic installations without an at least daily storage mean should be cancelled

  8. Report on the ANSTO application for a licence to construct a Replacement Research Reactor, addressing seismic analysis and seismic design accident analysis, spent fuel and radioactive wastes

    International Nuclear Information System (INIS)

    2002-02-01

    The Report of the Nuclear Safety Committee (NSC) covers specific terms of reference as requested by the Chief Executive Officer of ARPANSA. The primary issue for the Working Group(WG) consideration was whether ANSTO had demonstrated: (i) that the overall approach to seismic analysis and its implementation in the design is both conservative and consistent with the international best practice; (ii) whether the full accident analysis in the Probabilistic Safety Assesment Report (PSAR) satisfies the radiation dose/frequency criteria specified in ARPANSA's regulatory assessment principle 28 and the assumptions used in the Reference Accident for the siting assessment have been accounted for in the PSAR; and (iii) the adequacy of the strategies for managing the spent fuel as proposed to be used in the Replacement Research Reactor and other radioactive waste (including emissions, taking into account the ALARA criterion) arising from the operation of the proposed replacement reactor and radioisotope production. The report includes a series of questions that were asked of the Applicant in the course of working group deliberations, to illustrate the breadth of inquiries that were made. The Committee noted that replies to some questions remain outstanding at the date of this document. The NSC makes a number of recommendations that appear in each section of the document, which has been compiled in three parts representing the work of each group. The NSC notes some lack of clarity in what was needed to be considered at this approval stage of the project, as against information that would be required at a later stage. While not in the original work plan, recent events of September 11, 2001 also necessitated some exploration of issues relating to construction security. Copyright (2002) Commonwealth of Australia

  9. Radiometric dating and quantitative analysis of elements in depth profiles of sediments by means of nuclear physical as well as X-ray fluorescence and atomic emission spectroscopic methods

    International Nuclear Information System (INIS)

    Schoenburg, M.

    1987-01-01

    The measurement of heavy metal concentration in sediments is of great importance for the assessment of water quality. If dating of the different layers of sediment cores is possible, informations about the history of pollution can be inferred. This paper describes the development and practical test of a procedure suitable for the investigation of sediment cores. Both the element analysis and the dating are based on physical methods. For element concentration determination inductively coupled plasma atomic emission spectrometry (ICP), total-reflection X-ray fluorescence analysis (TXRF) and neutron activation analysis (NAA) are used. The techniques are described and compared. For dating radiometric measurements of 210 Pb and 137 Cs are carried out with a coaxial well-type germanium γ-ray detector in a special low-level arrangement. Results of the systematic investigations are presented and a few individual depth profiles are discussed. (orig.) With 34 figs., 20 tabs [de

  10. RESULTS OF IN-DEPTH ANALYSIS OF PARAMETRIC INDICES OF TELEVISION ADVERTISING OF MEDICINES, PARAPHARMACY, ALCOHOLIC DRINKS - EVIDENCE BASE FOR THE DEVELOPMENT OF NORMATIVE AND LEGAL PRINCIPLES OF THE EFFECTIVE STATE REGULATION OF ITS ACTIVITY

    Directory of Open Access Journals (Sweden)

    M. S. Ponomarenko

    2015-05-01

    Full Text Available There was conducted the analysis of parametric indices of monitoring of television advertising of medicines, parapharmaceutical production and alcoholic drinks in 2011 on the main Ukrainian television channels. There were determined key differences and mechanisms of the development of television advertising business.

  11. Therapeutic validity and effectiveness of preoperative exercise on functional recovery after joint replacement: a systematic review and meta-analysis.

    NARCIS (Netherlands)

    Hoogeboom, T.J.; Oosting, E.; Vriezekolk, J.E.; Veenhof, C.; Siemonsma, P.C.; Bie, R.A. de; Ende, C.H.M. van den; Meeteren, N.L.U. van

    2012-01-01

    Background: Our aim was to develop a rating scale to assess the therapeutic validity of therapeutic exercise programmes. By use of this rating scale we investigated the therapeutic validity of therapeutic exercise in patients awaiting primary total joint replacement (TJR). Finally, we studied the

  12. Periodical test program in depth revision

    International Nuclear Information System (INIS)

    Feltin, C.; Zermizoglou, R.

    1987-11-01

    Inspection visits made to different sites during 1980 and 1981 evidenced the need to extend and define more precisely the periodical tests performed on safety related systems; thus Electricite de France was requested by the Safety Authorities to re-examine the periodical test program for all safety related systems. This paper presents the methodology adopted by Electricite de France in order to perform an exhaustive analysis of the periodical test program for the 900 and 1300 MWe plants, and the organization set up at the IPSN at one hand and Electricite de France on the other hand for the purpose of elaborating a periodical test program which would be ratified by the Safety Authorities

  13. Do intra-articular hyaluronic acid injections delay total knee replacement in patients with osteoarthritis - A Cox model analysis.

    Science.gov (United States)

    Delbarre, Angélique; Amor, Bernard; Bardoulat, Isabelle; Tetafort, Aymeric; Pelletier-Fleury, Nathalie

    2017-01-01

    This study aimed to describe patients treated for knee osteoarthritis between 2006 and 2013 in France and to compare the delay from diagnosis to total knee replacement between patients who received intra-articular hyaluronic acid injections and those who did not receive the injections. A second objective was to compare direct medical costs for ambulatory care between treatment groups. Patients were selected from a representative sample of the real world administrative claims database using an algorithm developed by experts from the scientific committee of the study. Data were matched with the medico-administrative database for hospital care. A Cox proportional hazards model was stratified for the treatment group and adjusted for available socio-demographic and medical covariates to compare restricted mean survival times at different time points (1, 3, 5 and 7.5 years) between groups. Costs were expressed in 2013 euros. A total of 14,782 patients were treated for knee osteoarthritis (67% women; mean age = 68 years). Among this population, 1,662 patients had total knee replacement (11.2%). At each time point, restricted mean survival time without total knee replacement was significantly higher (p-valueshyaluronic acid group, from +51 to +217 days at 1 and 7.5 years, respectively. For the year preceding total knee replacement, the means for total direct medical costs were similar between groups, €744 vs €805 for treatment and control groups, respectively, (p-value = 0.104). Intra-articular injections accounted for less than 10% of the total costs. This is the first retrospective longitudinal study involving knee osteoarthritis patients using medico-administrative databases in France. The results support the effectiveness of hyaluronic acid injections in delaying total knee replacement and show that patients treated with hyaluronic acid have similar direct medical costs for ambulatory care compared to patients treated with corticosteroids only.

  14. Mortality risk disparities in children receiving chronic renal replacement therapy for the treatment of end-stage renal disease across Europe: an ESPN-ERA/EDTA registry analysis.

    Science.gov (United States)

    Chesnaye, Nicholas C; Schaefer, Franz; Bonthuis, Marjolein; Holman, Rebecca; Baiko, Sergey; Baskın, Esra; Bjerre, Anna; Cloarec, Sylvie; Cornelissen, Elisabeth A M; Espinosa, Laura; Heaf, James; Stone, Rosário; Shtiza, Diamant; Zagozdzon, Ilona; Harambat, Jérôme; Jager, Kitty J; Groothoff, Jaap W; van Stralen, Karlijn J

    2017-05-27

    We explored the variation in country mortality rates in the paediatric population receiving renal replacement therapy across Europe, and estimated how much of this variation could be explained by patient-level and country-level factors. In this registry analysis, we extracted patient data from the European Society for Paediatric Nephrology/European Renal Association-European Dialysis and Transplant Association (ESPN/ERA-EDTA) Registry for 32 European countries. We included incident patients younger than 19 years receiving renal replacement therapy. Adjusted hazard ratios (aHR) and the explained variation were modelled for patient-level and country-level factors with multilevel Cox regression. The primary outcome studied was all-cause mortality while on renal replacement therapy. Between Jan 1, 2000, and Dec 31, 2013, the overall 5 year renal replacement therapy mortality rate was 15·8 deaths per 1000 patient-years (IQR 6·4-16·4). France had a mortality rate (9·2) of more than 3 SDs better, and Russia (35·2), Poland (39·9), Romania (47·4), and Bulgaria (68·6) had mortality rates more than 3 SDs worse than the European average. Public health expenditure was inversely associated with mortality risk (per SD increase, aHR 0·69, 95% CI 0·52-0·91) and explained 67% of the variation in renal replacement therapy mortality rates between countries. Child mortality rates showed a significant association with renal replacement therapy mortality, albeit mediated by macroeconomics (eg, neonatal mortality reduced from 1·31 [95% CI 1·13-1·53], p=0·0005, to 1·21 [0·97-1·51], p=0·10). After accounting for country distributions of patient age, the variation in renal replacement therapy mortality rates between countries increased by 21%. Substantial international variation exists in paediatric renal replacement therapy mortality rates across Europe, most of which was explained by disparities in public health expenditure, which seems to limit the availability and

  15. Surface and in-depth characterization of lithium-ion battery cathodes at different cycle states using confocal micro-X-ray fluorescence-X-ray absorption near edge structure analysis

    International Nuclear Information System (INIS)

    Menzel, Magnus; Schlifke, Annalena; Falk, Mareike; Janek, Jürgen; Fröba, Michael; Fittschen, Ursula Elisabeth Adriane

    2013-01-01

    The cathode material LiNi 0.5 Mn 1.5 O 4 for lithium-ion batteries has been studied with confocal micro-X-ray fluorescence (CMXRF) combined with X-ray absorption near edge structure (XANES) at the Mn-K edge and the Ni-K edge. This technique allows for a non-destructive, spatially resolved (x, y and z) investigation of the oxidation states of surface areas and to some extent of deeper layers of the electrode. Until now CMXRF-XANES has been applied to a limited number of applications, mainly geo-science. Here, we introduce this technique to material science applications and show its performance to study a part of a working system. A novel mesoporous LiNi 0.5 Mn 1.5 O 4 material was cycled (charged and discharged) to investigate the effects on the oxidation states at the cathode/electrolyte interface. With this approach the degradation of Mn 3+ to Mn 4+ only observable at the surface of the electrode could be directly shown. The spatially resolved non-destructive analysis provides knowledge helpful for further understanding of deterioration and the development of high voltage battery materials, because of its nondestructive nature it will be also suitable to monitor processes during battery cycling. - Highlights: • The potential of confocal micro-XRF-XANES for spatial resolved species analysis in a part of a working system is shown. • The spatial resolution enables differentiation of the oxidized interface from deeper layers. • With the analytical technique confocal micro-XRF-XANES 3D in-situ analyses of working systems are feasible. • The multidimensional and nondestructive analysis of Li-ion battery cathodes is shown. • The analysis will allow for a deeper understanding of processes at interfaces in battery science and others

  16. Surface and in-depth characterization of lithium-ion battery cathodes at different cycle states using confocal micro-X-ray fluorescence-X-ray absorption near edge structure analysis

    Energy Technology Data Exchange (ETDEWEB)

    Menzel, Magnus; Schlifke, Annalena [Institut für Anorganische und Angewandte Chemie, Universität Hamburg, Martin-Luther-King-Platz 6, 20146 Hamburg (Germany); Falk, Mareike; Janek, Jürgen [Physikalisch-Chemisches Institut, Justus-Liebig-Universität Gießen, Heinrich-Buff-Ring 58, 35392 Gießen (Germany); Fröba, Michael, E-mail: froeba@chemie.uni-hamburg.de [Institut für Anorganische und Angewandte Chemie, Universität Hamburg, Martin-Luther-King-Platz 6, 20146 Hamburg (Germany); Fittschen, Ursula Elisabeth Adriane, E-mail: ursula.fittschen@chemie.uni-hamburg.de [Institut für Anorganische und Angewandte Chemie, Universität Hamburg, Martin-Luther-King-Platz 6, 20146 Hamburg (Germany)

    2013-07-01

    The cathode material LiNi{sub 0.5}Mn{sub 1.5}O{sub 4} for lithium-ion batteries has been studied with confocal micro-X-ray fluorescence (CMXRF) combined with X-ray absorption near edge structure (XANES) at the Mn-K edge and the Ni-K edge. This technique allows for a non-destructive, spatially resolved (x, y and z) investigation of the oxidation states of surface areas and to some extent of deeper layers of the electrode. Until now CMXRF-XANES has been applied to a limited number of applications, mainly geo-science. Here, we introduce this technique to material science applications and show its performance to study a part of a working system. A novel mesoporous LiNi{sub 0.5}Mn{sub 1.5}O{sub 4} material was cycled (charged and discharged) to investigate the effects on the oxidation states at the cathode/electrolyte interface. With this approach the degradation of Mn{sup 3+} to Mn{sup 4+} only observable at the surface of the electrode could be directly shown. The spatially resolved non-destructive analysis provides knowledge helpful for further understanding of deterioration and the development of high voltage battery materials, because of its nondestructive nature it will be also suitable to monitor processes during battery cycling. - Highlights: • The potential of confocal micro-XRF-XANES for spatial resolved species analysis in a part of a working system is shown. • The spatial resolution enables differentiation of the oxidized interface from deeper layers. • With the analytical technique confocal micro-XRF-XANES 3D in-situ analyses of working systems are feasible. • The multidimensional and nondestructive analysis of Li-ion battery cathodes is shown. • The analysis will allow for a deeper understanding of processes at interfaces in battery science and others.

  17. The effects of contrast media volume on acute kidney injury after transcatheter aortic valve replacement: a systematic review and meta-analysis.

    Science.gov (United States)

    Thongprayoon, Charat; Cheungpasitporn, Wisit; Podboy, Alexander J; Gillaspie, Erin A; Greason, Kevin L; Kashani, Kianoush B

    2016-11-01

    The goal of this systematic review was to assess the effects of contrast media volume on transcatheter aortic valve replacement-related acute kidney injury. A literature search was performed using Medline, EMbase, the Cochrane Database of Systematic Reviews, and clinicaltrials.gov from the inception of these databases through December 2015. Studies that reported relative risk, odds ratio, or hazard ratio comparing the risks of acute kidney injury following transcatheter aortic valve replacement in patients who received high contrast media volume were included. Pooled risk ratio (RR) and 95% confidence intervals (95% CI) were calculated using a random-effect, generic inverse variance method. Four cohort studies composed of 891 patients were included in the analyses to assess the risk of acute kidney injury after transcatheter aortic valve replacement in patients who received high contrast media volume. The pooled RR of acute kidney injury after transcatheter aortic valve replacement in patients who received a large volume of contrast media was 1.41 (95% CI, 0.87 to 2.28) compared with low contrast media volume. The meta-analysis was limited to studies using standard acute kidney injury definitions, and the pooled RR of acute kidney injury in patients who received high contrast media volume is 1.12 (95% CI, 0.78 to 1.62). Our meta-analysis shows no significant association between contrast media volume and risk of acute kidney injury after transcatheter aortic valve replacement. © 2016 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

  18. Transcatheter aortic valve replacement

    Science.gov (United States)

    ... gov/ency/article/007684.htm Transcatheter aortic valve replacement To use the sharing features on this page, please enable JavaScript. Transcatheter aortic valve replacement (TAVR) is surgery to replace the aortic valve. ...

  19. Nicotine replacement therapy

    Science.gov (United States)

    Smoking cessation - nicotine replacement; Tobacco - nicotine replacement therapy ... Before you start using a nicotine replacement product, here are some things to know: The more cigarettes you smoke, the higher the dose you may need to ...

  20. The use of clinical analysis of movements in evaluation of motor functional status of patients after total hip replacement

    Directory of Open Access Journals (Sweden)

    Romakina N.A.

    2016-06-01

    Full Text Available Aim: to estimate functional status of coxarthrosis in patients requiring total hip replacement of the two hip joints. Material and methods. The biomechanical examination of 94 patients with bilateral primary coxarthrosis before and after total hip replacement was performed using clinical stabilometric software complex. The ability to perceive the mechanical load during standing and walking was evaluated at different stages of the treatment. The difference between the samples was estimated with the use of Mann — Whitney U-test. The rank correlation of biomechanical parameters was measured by Spearman coefficient. Results. It was revealed that the most responsive indicators are the transfer period, the first and second periods of double support and the deviation of the center of pressure relative to the average position in the frontal plane. Conclusion. After surgical treatment there was observed some improvement: the-left-and-right-step asymmetry decrease, rhythm rate increase, improved ability to maintain body balance, jog reactions increase.

  1. Effects of balance and proprioceptive training on total hip and knee replacement rehabilitation: A systematic review and meta-analysis.

    Science.gov (United States)

    Domínguez-Navarro, Fernando; Igual-Camacho, Celedonia; Silvestre-Muñoz, Antonio; Roig-Casasús, Sergio; Blasco, José María

    2018-05-01

    Balance and proprioceptive deficits are frequently persistent after total joint replacement, limiting functionality and involving altered movement patterns and difficulties in walking and maintaining postural control among patients. The goal of this systematic review was to evaluate the short- and mid-term effects of proprioceptive and balance training for patients undergoing total knee and hip replacement. This is a systematic review of literature. MEDLINE, Embase, Cochrane Library, PEDro, and Scopus were the databases searched. The review included randomized clinical trials in which the experimental groups underwent a training aimed at improving balance and proprioception, in addition to conventional care. The studies had to assess at least one of the following outcomes: self-reported functionality or balance (primary outcomes), knee function, pain, falls, or quality of life. Eight trials were included, involving 567 participants. The quantitative synthesis found a moderate to high significant effect of balance and proprioceptive trainings on self-reported functionality and balance after total knee replacement. The effects were maintained at mid-term in terms of balance alone. Conversely, preoperative training did not enhance outcomes after total hip arthroplasty. The synthesis showed that, in clinical terms, balance trainings are a convenient complement to conventional physiotherapy care to produce an impact on balance and functionality after knee replacement. If outcomes such as improvement in pain, knee range of movement, or patient quality of life are to be promoted, it would be advisable to explore alternative proposals specifically targeting these goals. Further research is needed to confirm or discard the current evidence ultimately, predominantly in terms of the effects on the hips and those yielded by preoperative interventions. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Environmental systems analysis of biogas systems-Part II: The environmental impact of replacing various reference systems

    International Nuclear Information System (INIS)

    Boerjesson, Pal; Berglund, Maria

    2007-01-01

    This paper analyses the overall environmental impact when biogas systems are introduced and replace various reference systems for energy generation, waste management and agricultural production. The analyses are based on Swedish conditions using a life-cycle perspective. The biogas systems included are based on different combinations of raw materials and final use of the biogas produced (heat, power and transportation fuel). A general conclusion is that biogas systems normally lead to environmental improvements, which in some cases are considerable. This is often due to indirect environmental benefits of changed land use and handling of organic waste products (e.g. reduced nitrogen leaching, emissions of ammonia and methane), which often exceed the direct environmental benefits achieved when fossil fuels are replaced by biogas (e.g. reduced emissions of carbon dioxide and air pollutants). Such indirect benefits are seldom considered when biogas is evaluated from an environmental point of view. The environmental impact from different biogas systems can, however, vary significantly due to factors such as the raw materials utilised, energy service provided and reference system replaced

  3. Effect of Replacing Animal Protein with Plant Protein on Glycemic Control in Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Viguiliouk, Effie; Stewart, Sarah E; Jayalath, Viranda H; Ng, Alena Praneet; Mirrahimi, Arash; de Souza, Russell J; Hanley, Anthony J; Bazinet, Richard P; Blanco Mejia, Sonia; Leiter, Lawrence A; Josse, Robert G; Kendall, Cyril W C; Jenkins, David J A; Sievenpiper, John L

    2015-12-01

    Previous research on the effect of replacing sources of animal protein with plant protein on glycemic control has been inconsistent. We therefore conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the effect of this replacement on glycemic control in individuals with diabetes. We searched MEDLINE, EMBASE, and Cochrane databases through 26 August 2015. We included RCTs ≥ 3-weeks comparing the effect of replacing animal with plant protein on HbA1c, fasting glucose (FG), and fasting insulin (FI). Two independent reviewers extracted relevant data, assessed study quality and risk of bias. Data were pooled by the generic inverse variance method and expressed as mean differences (MD) with 95% confidence intervals (CIs). Heterogeneity was assessed (Cochran Q-statistic) and quantified (I²-statistic). Thirteen RCTs (n = 280) met the eligibility criteria. Diets emphasizing a replacement of animal with plant protein at a median level of ~35% of total protein per day significantly lowered HbA1c (MD = -0.15%; 95%-CI: -0.26, -0.05%), FG (MD = -0.53 mmol/L; 95%-CI: -0.92, -0.13 mmol/L) and FI (MD = -10.09 pmol/L; 95%-CI: -17.31, -2.86 pmol/L) compared with control arms. Overall, the results indicate that replacing sources of animal with plant protein leads to modest improvements in glycemic control in individuals with diabetes. Owing to uncertainties in our analyses there is a need for larger, longer, higher quality trials. ClinicalTrials.gov registration number: NCT02037321.

  4. Effect of Replacing Animal Protein with Plant Protein on Glycemic Control in Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Effie Viguiliouk

    2015-12-01

    Full Text Available Previous research on the effect of replacing sources of animal protein with plant protein on glycemic control has been inconsistent. We therefore conducted a systematic review and meta-analysis of randomized controlled trials (RCTs to assess the effect of this replacement on glycemic control in individuals with diabetes. We searched MEDLINE, EMBASE, and Cochrane databases through 26 August 2015. We included RCTs ≥ 3-weeks comparing the effect of replacing animal with plant protein on HbA1c, fasting glucose (FG, and fasting insulin (FI. Two independent reviewers extracted relevant data, assessed study quality and risk of bias. Data were pooled by the generic inverse variance method and expressed as mean differences (MD with 95% confidence intervals (CIs. Heterogeneity was assessed (Cochran Q-statistic and quantified (I2-statistic. Thirteen RCTs (n = 280 met the eligibility criteria. Diets emphasizing a replacement of animal with plant protein at a median level of ~35% of total protein per day significantly lowered HbA1c (MD = −0.15%; 95%-CI: −0.26, −0.05%, FG (MD = −0.53 mmol/L; 95%-CI: −0.92, −0.13 mmol/L and FI (MD = −10.09 pmol/L; 95%-CI: −17.31, −2.86 pmol/L compared with control arms. Overall, the results indicate that replacing sources of animal with plant protein leads to modest improvements in glycemic control in individuals with diabetes. Owing to uncertainties in our analyses there is a need for larger, longer, higher quality trials. Trial Registration: ClinicalTrials.gov registration number: NCT02037321.

  5. Do intra-articular hyaluronic acid injections delay total knee replacement in patients with osteoarthritis – A Cox model analysis

    Science.gov (United States)

    Amor, Bernard; Bardoulat, Isabelle; Tetafort, Aymeric; Pelletier-Fleury, Nathalie

    2017-01-01

    Due to the growing worldwide prevalence of knee osteoarthritis, the optimal management of this issue is critical for reducing its burden. Objectives This study aimed to describe patients treated for knee osteoarthritis between 2006 and 2013 in France and to compare the delay from diagnosis to total knee replacement between patients who received intra-articular hyaluronic acid injections and those who did not receive the injections. A second objective was to compare direct medical costs for ambulatory care between treatment groups. Materials and methods Patients were selected from a representative sample of the real world administrative claims database using an algorithm developed by experts from the scientific committee of the study. Data were matched with the medico-administrative database for hospital care. A Cox proportional hazards model was stratified for the treatment group and adjusted for available socio-demographic and medical covariates to compare restricted mean survival times at different time points (1, 3, 5 and 7.5 years) between groups. Costs were expressed in 2013 euros. Results A total of 14,782 patients were treated for knee osteoarthritis (67% women; mean age = 68 years). Among this population, 1,662 patients had total knee replacement (11.2%). At each time point, restricted mean survival time without total knee replacement was significantly higher (p-valueshyaluronic acid group, from +51 to +217 days at 1 and 7.5 years, respectively. For the year preceding total knee replacement, the means for total direct medical costs were similar between groups, €744 vs €805 for treatment and control groups, respectively, (p-value = 0.104). Intra-articular injections accounted for less than 10% of the total costs. Conclusion This is the first retrospective longitudinal study involving knee osteoarthritis patients using medico-administrative databases in France. The results support the effectiveness of hyaluronic acid injections in delaying total knee

  6. Allergic contact dermatitis pattern in Kuwait: nickel leads the pack. In-depth analysis of nickel allergy based on the results from a large prospective patch test series report

    Science.gov (United States)

    Almutawa, Fahad

    2017-01-01

    Introduction Contact dermatitis is a relatively common dermatosis reported among several population groups from all around the globe. However, the data from Kuwait is unavailable. Patch tests are essential for the diagnosis of contact sensitization. Aim To determine a relative frequency and pattern of sensitizers to different allergens in patients of suspected contact dermatitis in Kuwait and, also to study the role of the commonest sensitizer in detail. Material and methods Patch tests were performed in 2461 consecutive patients with a clinical diagnosis of contact dermatitis seen at our hospital between September 1, 2014 and August 31, 2015. Out of the total of 1381 (56.1%) patients with positive patch test results to at least one allergen, 546 (22.2%) patients with a single positive reaction to nickel only (single largest sensitizer) were selected as the study population for further detailed analysis. Results At least one positive patch test reaction was found in 1381 (56.12%) patients. Nickel was found to be the most common sensitizer seen in 546 (40%) patients. The mean age was 37.3 ±13.8 years and the mean duration of disease was 27.3 ±13.8 months. Most (387/546) patients sensitized were females. The forearms/hands and wrists were the most prevalent sites (52.56% of the participants). In 58.91% of women, dermatitis was more often confined to other sites, mostly ears and the neck due to earrings and necklaces. Just more than half of the number (51.09%) of nickel allergic patients were found in the age group of 15–25 years. Hairdressers/beauticians were the most affected group followed by house workers (housewives, cleaners, housekeepers). Conclusions Nickel is the single most common sensitizer found in our patients, and female sex, young age, occupation with long hours of contact to nickel are high risk factors. We recommend that a directive, which limits the release of nickel from products with extended skin contact, be approved in Kuwait. PMID:28670248

  7. A comparative study on the stress distribution around dental implants in three arch form models for replacing six implants using finite element analysis.

    Science.gov (United States)

    Zarei, Maryam; Jahangirnezhad, Mahmoud; Yousefimanesh, Hojatollah; Robati, Maryam; Robati, Hossein

    2018-01-01

    Dental implant is a method to replacement of missing teeth. It is important for replacing the missed anterior teeth. In vitro method is a safe method for evaluation of stress distribution. Finite element analysis as an in vitro method evaluated stress distribution around replacement of six maxillary anterior teeth implants in three models of maxillary arch. In this in vitro study, using ABAQUS software (Simulia Corporation, Vélizy-Villacoublay, France), implant simulation was performed for reconstruction of six maxillary anterior teeth in three models. Two implants were placed on both sides of the canine tooth region (A model); two implants on both sides of the canine tooth region and another on one side of the central incisor region (B model); and two implants on both sides of the canine tooth region and two implants in the central incisor area (C model). All implants evaluated in three arch forms (tapered, ovoid, and square). Data were analyzed by finite analysis software. Von Mises stress by increasing of implant number was reduced. In a comparison of A model in each maxillary arch, the stress created in the cortical and cancellous bones in the square arch was less than ovoid and tapered arches. The stress created in implants and cortical and cancellous bones in C model was less than A and B models. The C model (four-implant) reduced the stress distribution in cortical and cancellous bones, but this pattern must be evaluated according to arch form and cost benefit of patients.

  8. Statistical analysis on finger replacement schemes for RAKE receivers in the soft handover region with multiple BSs over i.n.d. fading channels

    KAUST Repository

    Nam, Sung Sik

    2017-06-12

    A new finger replacement technique which is applicable for RAKE receivers in the soft handover region has been proposed and studied under the ideal assumption that the fading is both independent and identically distributed from path to path. To supplement our previous work, we present a general comprehensive framework for the performance assessment of the proposed finger replacement schemes operating over independent but non-identically distributed (i.n.d.) faded paths. To accomplish this object, we derive new closed-form expressions for the target key statistics which are composed of i.n.d. exponential random variables. With these new expressions, the performance analysis of various wireless communication systems over more practical channel environments can be possible.

  9. Defining line replaceable units

    NARCIS (Netherlands)

    Parada Puig, J. E.; Basten, R. J I

    2015-01-01

    Defective capital assets may be quickly restored to their operational condition by replacing the item that has failed. The item that is replaced is called the Line Replaceable Unit (LRU), and the so-called LRU definition problem is the problem of deciding on which item to replace upon each type of

  10. In-Depth Case Studies of Superfund Reuse

    Science.gov (United States)

    SRI’s in-depth case studies explore Superfund reuse stories from start to finish. Their purpose is to see what redevelopment strategies worked, acknowledge reuse barriers and understand how communities overcame the barriers to create new reuse outcomes.

  11. An In-depth Study on Semitransparent amorphous Silicon Sensors

    International Nuclear Information System (INIS)

    Fernandez, M. G.; Ferrando, A.; Josa, M. I.; Molinero, A.; Oller, J. C.; Arce, P.; Calvo, E.; Figueroa, C. F.; Garcia, N.; Rodrigo, T.; Vila, I.; Virto, A. L.

    1999-01-01

    Semitransparent amorphous silicon sensors have been proposed as the 2D positioning sensors for the link system of the CMS alignment: An in-depth study of the actual performance of these sensors is here reported. (Author) 8 refs

  12. Next Generation Nuclear Plant Defense-in-Depth Approach

    International Nuclear Information System (INIS)

    Wallace, Edward G.; Fleming, Karl N.; Burns, Edward M.

    2009-01-01

    The purpose of this paper is to (1) document the definition of defense-in-depth and the pproach that will be used to assure that its principles are satisfied for the NGNP project and (2) identify the specific questions proposed for preapplication discussions with the NRC. Defense-in-depth is a safety philosophy in which multiple lines of defense and conservative design and evaluation methods are applied to assure the safety of the public. The philosophy is also intended to deliver a design that is tolerant to uncertainties in knowledge of plant behavior, component reliability or operator performance that might compromise safety. This paper includes a review of the regulatory foundation for defense-in-depth, a definition of defense-in-depth that is appropriate for advanced reactor designs based on High Temperature Gas-cooled Reactor (HTGR) technology, and an explanation of how this safety philosophy is achieved in the NGNP.

  13. ANALYSIS OF DOSE RATES DURING REPLACEMENT OF MANIPULATORS IN THE FFTF INTERIM EXAMINATION and MAINTENANCE (IEM) CELL

    International Nuclear Information System (INIS)

    NELSON, J.V.

    2002-01-01

    Replacement of a master-slave manipulator in the Interim Examination and Maintenance Cell at the Fast Flux Test Facility was carried out in August 2001. This operation created a 178-mm opening in the thick concrete wall of the hot cell. To aid in radiological work planning, dose rates outside the penetration in the wall were predicted using MCNP(trademark) photon transport calculations. The predicted dose rate was 7.7 mrem/h, which was reasonably close to the value of 10.4 mrem/h inferred from measurements

  14. [Milk yield and environmental factors: Multiple regression analysis of the association between milk yield and udder health, fertility data and replacement rate].

    Science.gov (United States)

    Fölsche, C; Staufenbiel, R

    2014-01-01

    The relationship between milk yield and both fertility and general animal health in dairy herds is discussed from opposing viewpoints. The hypothesis (1) that raising the herd milk yield would decrease fertility results, the number of milk cells as an indicator for udder health and the replacement rate as a global indicator for animal health as well as increasing the occurrence of specific diseases as a herd problem was compared to the opposing hypotheses that there is no relationship (2) or that there is a differentiated and changing relationship (3). A total of 743 herd examinations, considered independent, were performed in 489 herds between 1995 and 2010. The milk yield, fertility rate, milk cell count, replacement rate, categorized herd problems and management information were recorded. The relationship between the milk yield and both the fertility data and animal health was evaluated using simple and multiple regression analyses. The period between calving and the first service displayed no significant relationship to the herd milk yield. Simple regression analysis showed that the period between calving and gestation, the calving interval and the insemination number were significantly positively associated with the herd milk yield. This positive correlation was lost in multiple regression analysis. The milk cell count and replacement rate using both the simple and multiple regression analyses displayed a significant negative relationship to the milk yield. The alternative hypothesis (3) was confirmed. A higher milk yield has no negative influence on the milk cell count and the replacement rate in terms of the udder and general health. When parameterizing the fertility, the herd milk yield should be considered. Extending the resting time may increase the milk yield while preventing a decline in the insemination index.

  15. Assessment of defence in depth for nuclear power plants

    International Nuclear Information System (INIS)

    2005-01-01

    Defence in depth is a comprehensive approach to safety that has been developed by nuclear power experts to ensure with high confidence that the public and the environment are protected from any hazards posed by the use of nuclear power for the generation of electricity. The concepts of defence in depth and safety culture have served the nuclear power industry well as a basic philosophy for the safe design and operation of nuclear power plants. Properly applied, defence in depth ensures that no single human error or equipment failure at one level of defence, nor even a combination of failures at more than one level of defence, propagates to jeopardize defence in depth at the subsequent level or leads to harm to the public or the environment. The importance of the concept of defence in depth is underlined in IAEA Safety Standards, in particular in the requirements set forth in the Safety Standards: Safety of Nuclear Power Plants: Design (NS-R-1) and Safety Assessment and Verification for Nuclear Power Plants (NS-G-1.2). A specific report, Defence in Depth in Nuclear Safety (INSAG-10), describes the objectives, strategy, implementation and future development in the area of defence in depth in nuclear and radiation safety. In the report Basic Safety Principles for Nuclear Power Plants (INSAG-12), defence in depth is recognized as one of the fundamental safety principles that underlie the safety of nuclear power plants. In consonance with those high level publications, this Safety Report provides more specific technical information on the implementation of this concept in the siting, design, construction and operation of nuclear power plants. It describes a method for comprehensive and balanced review of the provisions required for implementing defence in depth in existing plants. This publication is intended to provide guidance primarily for the self-assessment by plant operators of the comprehensiveness and quality of defence in depth provisions. It can be used

  16. Salivary proteomics of healthy dogs: An in depth catalog.

    Directory of Open Access Journals (Sweden)

    Sheila M F Torres

    Full Text Available To provide an in-depth catalog of the salivary proteome and endogenous peptidome of healthy dogs, evaluate proteins and peptides with antimicrobial properties, and compare the most common salivary proteins and peptides between different breed phylogeny groups.36 healthy dogs without evidence of periodontal disease representing four breed phylogeny groups, based upon single nucleotide polymorphism haplotypes (ancient, herding/sighthound, and two miscellaneous groups. Saliva collected from dogs was pooled by phylogeny group and analyzed using nanoscale liquid chromatography-tandem mass spectrometry. Resulting tandem mass spectra were compared to databases for identification of endogenous peptides and inferred proteins.2,491 proteins and endogenous peptides were found in the saliva of healthy dogs with no periodontal disease. All dog phylogeny groups' saliva was rich in proteins and peptides with antimicrobial functions. The ancient breeds group was distinct in that it contained unique proteins and was missing many proteins and peptides present in the other groups.Using a sophisticated nanoscale liquid chromatography-tandem mass spectrometry, we were able to identify 10-fold more salivary proteins than previously reported in dogs. Seven of the top 10 most abundant proteins or peptides serve immune functions and many more with various antimicrobial mechanisms were found. This is the most comprehensive analysis of healthy canine saliva to date, and will provide the groundwork for future studies analyzing salivary proteins and endogenous peptides in disease states.

  17. Salivary proteomics of healthy dogs: An in depth catalog.

    Science.gov (United States)

    Torres, Sheila M F; Furrow, Eva; Souza, Clarissa P; Granick, Jennifer L; de Jong, Ebbing P; Griffin, Timothy J; Wang, Xiong

    2018-01-01

    To provide an in-depth catalog of the salivary proteome and endogenous peptidome of healthy dogs, evaluate proteins and peptides with antimicrobial properties, and compare the most common salivary proteins and peptides between different breed phylogeny groups. 36 healthy dogs without evidence of periodontal disease representing four breed phylogeny groups, based upon single nucleotide polymorphism haplotypes (ancient, herding/sighthound, and two miscellaneous groups). Saliva collected from dogs was pooled by phylogeny group and analyzed using nanoscale liquid chromatography-tandem mass spectrometry. Resulting tandem mass spectra were compared to databases for identification of endogenous peptides and inferred proteins. 2,491 proteins and endogenous peptides were found in the saliva of healthy dogs with no periodontal disease. All dog phylogeny groups' saliva was rich in proteins and peptides with antimicrobial functions. The ancient breeds group was distinct in that it contained unique proteins and was missing many proteins and peptides present in the other groups. Using a sophisticated nanoscale liquid chromatography-tandem mass spectrometry, we were able to identify 10-fold more salivary proteins than previously reported in dogs. Seven of the top 10 most abundant proteins or peptides serve immune functions and many more with various antimicrobial mechanisms were found. This is the most comprehensive analysis of healthy canine saliva to date, and will provide the groundwork for future studies analyzing salivary proteins and endogenous peptides in disease states.

  18. Can field-in-field technique replace wedge filter in radiotherapy treatment planning: a comparative analysis in various treatment sites

    International Nuclear Information System (INIS)

    Prabhakar, R.; Julka, P.K.; Rath, G.K.

    2008-01-01

    The aim of the study was to show whether field-in-field (FIF) technique can be used to replace wedge filter in radiation treatment planning. The study was performed in cases where wedges are commonly used in radiotherapy treatment planning. Thirty patients with different malignancies who received radiotherapy were studied. This includes patients with malignancies of brain, head and neck, breast, upper and lower abdomen. All the patients underwent computed tomography scanning and the datasets were transferred to the treatment planning system. Initially, wedge based planning was performed to achieve the best possible dose distribution inside the target volume with multileaf collimators (Plan1). Wedges were removed from a copy of the same plan and FIF plan was generated (Plan2). The two plans were then evaluated and compared for mean dose, maximum dose, median dose, doses to 2% (D 2 ) and 98% (D 9 8) of the target volume, volume receiving greater than 107% of the prescribed dose (V>107%), volume receiving less than 95% of the prescribed dose (V 2 , V>107% and CI for more of the sites with statistically significant reduction in monitor units. FIF results in better dose distribution in terms of homogeneity in most of the sites. It is feasible to replace wedge filter with FIF in radiotherapy treatment planning.

  19. Improved Laser Manipulation for On-chip Fabricated Microstructures Based on Solution Replacement and Its Application in Single Cell Analysis

    Directory of Open Access Journals (Sweden)

    Tao Yue

    2014-02-01

    Full Text Available In this paper, we present the fabrication and assembly of microstructures inside a microfluidic device based on a photocrosslinkable resin and optical tweezers. We also report a method of solution replacement inside the microfluidic channel in order to improve the manipulation performance and apply the assembled microstructures for single cell cultivation. By the illumination of patterned ultraviolet (UV through a microscope, microstructures of arbitrary shape were fabricated by the photocrosslinkable resin inside a microfluidic channel. Based on the microfluidic channel with both glass and polydimethylsiloxane (PDMS surfaces, immovable and movable microstructures were fabricated and manipulated. The microstructures were fabricated at the desired places and manipulated by the optical tweezers. A rotational microstructure including a microgear and a rotation axis was assembled and rotated in demonstrating this technique. The improved laser manipulation of microstructures was achieved based on the on-chip solution replacement method. The manipulation speed of the microstructures increased when the viscosity of the solvent decreased. The movement efficiency of the fabricated microstructures inside the lower viscosity solvent was evaluated and compared with those microstructures inside the former high viscosity solvent. A novel cell cage was fabricated and the cultivation of a single yeast cell (w303 was demonstrated in the cell cage, inside the microfluidic device.

  20. Bone density and anisotropy affect periprosthetic cement and bone stresses after anatomical glenoid replacement: A micro finite element analysis.

    Science.gov (United States)

    Chevalier, Yan; Santos, Inês; Müller, Peter E; Pietschmann, Matthias F

    2016-06-14

    Glenoid loosening is still a main complication for shoulder arthroplasty. We hypothesize that cement and bone stresses potentially leading to fixation failure are related not only to glenohumeral conformity, fixation design or eccentric loading, but also to bone volume fraction, cortical thickness and degree of anisotropy in the glenoid. In this study, periprosthetic bone and cement stresses were computed with micro finite element models of the replaced glenoid depicting realistic bone microstructure. These models were used to quantify potential effects of bone microstructural parameters under loading conditions simulating different levels of glenohumeral conformity and eccentric loading simulating glenohumeral instability. Results show that peak cement stresses were achieved near the cement-bone interface in all loading schemes. Higher stresses within trabecular bone tissue and cement mantle were obtained within specimens of lower bone volume fraction and in regions of low anisotropy, increasing with decreasing glenohumeral conformity and reaching their maxima below the keeled design when the load is shifted superiorly. Our analyses confirm the combined influences of eccentric load shifts with reduced bone volume fraction and anisotropy on increasing periprosthetic stresses. They finally suggest that improving fixation of glenoid replacements must reduce internal cement and bone tissue stresses, in particular in glenoids of low bone density and heterogeneity. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. In-depth analysis of bicycle hydraulic disc brakes

    Science.gov (United States)

    Maier, Oliver; Györfi, Benedikt; Wrede, Jürgen; Arnold, Timo; Moia, Alessandro

    2017-10-01

    Hydraulic Disc Brakes (HDBs) represent the most recent and innovative bicycle braking system. Especially Electric Bicycles (EBs), which are becoming more and more popular, are equipped with this powerful, unaffected by environmental influences, and low-wear type of brakes. As a consequence of the high braking performance, typical bicycle braking errors lead to more serious accidents. This is the starting point for the development of a Braking Dynamics Assistance system (BDA) to prevent front wheel lockup and nose-over (falling over the handlebars). One of the essential prerequisites for the system design is a better understanding of bicycle HDBs' characteristics. A physical simulation model and a test bench have been built for this purpose. The results of the virtual and real experiments conducted show a high correlation and allow valuable insights into HDBs on bicycles, which have not been studied scientifically in any depth so far.

  2. Atypical Clinical Manifestations of Graves' Disease: An Analysis in Depth

    Science.gov (United States)

    Hegazi, Mohamed Osama; Ahmed, Sherif

    2012-01-01

    Over the past few decades, there has been an increase in the number of reports about newly recognized (atypical or unusual) manifestations of Graves' disease (GD), that are related to various body systems. One of these manifestations is sometimes the main presenting feature of GD. Some of the atypical manifestations are specifically related to GD, while others are also similarly seen in patients with other forms of hyperthyroidism. Lack of knowledge of the association between these findings and GD may lead to delay in diagnosis, misdiagnosis, or unnecessary investigations. The atypical clinical presentations of GD include anemia, vomiting, jaundice, and right heart failure. There is one type of anemia that is not explained by any of the known etiological factors and responds well to hyperthyroidism treatment. This type of anemia resembles anemia of chronic disease and may be termed GD anemia. Other forms of anemia that are associated with GD include pernicious anemia, iron deficiency anemia of celiac disease, and autoimmune hemolytic anemia. Vomiting has been reported as a presenting feature of Graves' disease. Some cases had the typical findings of hyperthyroidism initially masked, and the vomiting did not improve until hyperthyroidism has been detected and treated. Hyperthyroidism may present with jaundice, and on the other hand, deep jaundice may develop with the onset of overt hyperthyroidism in previously compensated chronic liver disease patients. Pulmonary hypertension is reported to be associated with GD and to respond to its treatment. GD-related pulmonary hypertension may be so severe to produce isolated right-sided heart failure that is occasionally found as the presenting manifestation of GD. PMID:22132347

  3. Nonlinear analysis of the electroencephalogram in depth of anesthesia

    Directory of Open Access Journals (Sweden)

    Oscar Leonardo Mosquera-Dussan

    2015-01-01

    Full Text Available El procesamiento digital de la señal de electroencefalograma (EEG ha tomado importancia en el monitoreo de profundidad anestésica, contribuyendo a una mejor técnica anestésica. El objetivo es realizar una revisión de métodos matemáticos no lineales aplicados recientemente al análisis de EEG la cual presenta características no lineales y no estacionarias. Una revisión fue desarrollada abarcando métodos matemáticos no lineales en el dominio del tiempo y frecuencia, los cuales han sido aplicados recientemente al análisis de EEG: Entropía Aproximada, Entropía Muestral, Entropía Espectral, Entropía Permutada, Transformada Wavelet, Entropía Wavelet, Bispectro, Bicoherencia y Transformada Hilbert Huang. Los algoritmos implementados fueron probados en un registro EEG de un paciente en la Clínica Universidad de La Sabana. Resultados publicados en la literatura a fin del tema son discutidos. Técnicas no lineales como el análisis de entropía, y la combinación con transformadas Wavelet y Hilbert Huang en el dominio de la frecuencia han presentado resultados prometedores en clasificación de estados de profundidad anestésica.

  4. Knowledge transfer in pair programming: An in-depth analysis

    DEFF Research Database (Denmark)

    Plonka, Laura; Sharp, Helen; van der Linden, Janet

    2015-01-01

    Whilst knowledge transfer is one of the most widely-claimed benefits of pair programming, little is known about how knowledge transfer is achieved in this setting. This is particularly pertinent for novice−expert constellations, but knowledge transfer takes place to some degree in all constellati...

  5. Global Tuition Pricing: An In-Depth Analysis

    Science.gov (United States)

    Cupp, Jason W.

    2012-01-01

    This study was conducted to determine if there is a relationship between select pricing schemes used throughout the world and positive social outcomes. The rising costs of college tuition and escalating student debt has raised the concern about how students should pay for financing their education and whether the current system is the most…

  6. AIDA - from Airborne Data Inversion to In-Depth Analysis

    Science.gov (United States)

    Meyer, U.; Goetze, H.; Schroeder, M.; Boerner, R.; Tezkan, B.; Winsemann, J.; Siemon, B.; Alvers, M.; Stoll, J. B.

    2011-12-01

    The rising competition in land use especially between water economy, agriculture, forestry, building material economy and other industries often leads to irreversible deterioration in the water and soil system (as salinization and degradation) which results in a long term damage of natural resources. A sustainable exploitation of the near subsurface by industry, economy and private households is a fundamental demand of a modern society. To fulfill this demand, a sound and comprehensive knowledge on structures and processes of the near subsurface is an important prerequisite. A spatial survey of the usable underground by aerogeophysical means and a subsequent ground geophysics survey targeted at special locations will deliver essential contributions within short time that make it possible to gain the needed additional knowledge. The complementary use of airborne and ground geophysics as well as the validation, assimilation and improvement of current findings by geological and hydrogeological investigations and plausibility tests leads to the following key questions: a) Which new and/or improved automatic algorithms (joint inversion, data assimilation and such) are useful to describe the structural setting of the usable subsurface by user specific characteristics as i.e. water volume, layer thicknesses, porosities etc.? b) What are the physical relations of the measured parameters (as electrical conductivities, magnetic susceptibilities, densities, etc.)? c) How can we deduce characteristics or parameters from the observations which describe near subsurface structures as ground water systems, their charge, discharge and recharge, vulnerabilities and other quantities? d) How plausible and realistic are the numerically obtained results in relation to user specific questions and parameters? e) Is it possible to compile material flux balances that describe spatial and time dependent impacts of environmental changes on aquifers and soils by repeated airborne surveys? In order to follow up these questions raised the project aims to achieve the following goals: a) Development of new and expansion of existent inversion strategies to improve structural parameter information on different space and time scales. b) Development, modification, and tests for a multi-parameter inversion (joint inversion). c) Development of new quantitative approaches in data assimilation and plausibility studies. d) Compilation of optimized work flows for fast employment by end users. e) Primary goal is to solve comparable society related problems (as salinization, erosion, contamination, degradation etc.) in regions within Germany and abroad by generalization of project results.

  7. Monetary policy implications of financial innovation: In-depth analysis

    OpenAIRE

    Bernoth, Kerstin; Gebauer, Stefan; Schäfer, Dorothea

    2017-01-01

    In this policy brief, we argue that the financial innovations triggered by the FinTech industry have the potential to affect the transmission of monetary policy as well as the informational content of important monetary indicators. The growing FinTech industry could contribute substantially to the emergence of nonbank finance as a substitute for traditional commercial bank finance. While the overall effect of nonbank finance on monetary policy transmission is not yet clear, we argue that regu...

  8. OBSERVABILITY-IN-DEPTH: AN ESSENTIAL COMPLEMENT TO THE DEFENSE-IN-DEPTH SAFETY STRATEGY IN THE NUCLEAR INDUSTRY1

    Directory of Open Access Journals (Sweden)

    FRANCESCA M. FAVARÒ

    2014-12-01

    We examine several “event reports” from the U.S. Nuclear Regulatory Commission database, which illustrate specific instances of violation of the observability-in-depth safety principle and the consequences that followed (e.g., unmonitored releases and loss of containments. We also revisit the Three Mile Island accident in light of the proposed principle, and identify causes and consequences of the lack of observability-in-depth related to this accident sequence. We illustrate both the benefits of adopting the observability-in-depth safety principle and the adverse consequences when this principle is violated or not implemented. This work constitutes a first step in the development of the observability-in-depth safety principle, and we hope this effort invites other researchers and safety professionals to further explore and develop this principle and its implementation.

  9. Off-Line High-pH Reversed-Phase Fractionation for In-Depth Phosphoproteomics

    DEFF Research Database (Denmark)

    Batth, Tanveer S; Francavilla, Chiara; Olsen, Jesper V

    2014-01-01

    thousands of phosphorylation sites. However, in-depth phosphoproteomics often require off-line enrichment and fractionation techniques. In this study, we provide a detailed analysis of the physicochemical characteristics of phosphopeptides, which have been fractionated by off-line high-pH chromatography (Hp...... phosphorylated peptides over that with SCX. Further optimizations in the pooling and concatenation strategy increased the total number of multiphosphorylated peptides detected after HpH fractionation. In conclusion, we provide a basic framework and resource for performing in-depth phosphoproteome studies...

  10. Isolated mitral valve replacement with the Kay-Shiley disc. valve. Acturial analysis of the long term results.

    Science.gov (United States)

    Wellons, H A; Strauch, R S; Nolan, S P; Muller, W H

    1975-11-01

    During a five-year period the Kay-Shiley (K and T series) prosthesis was used for 83 isolated mitral valve replacements. There were 14 early deaths, for a 17.28 per cent mortality rate. Survival determined by the actuarial method revealed a 6 year cumulative survival rate of 39.8 per cent. Thromboembolism was a significant problem in this series, with 33 patients experiencing a total of 55 embolic events. This represented a rate of 24.7 emboli per 1,000 patient months at risk. From our experience, it is concluded that the Kay-Shiley prosthesis is associated with a high incidence of thromboembolism and late death.

  11. Study of the voxel-based specific regional analysis system for Alzheimer's disease imaging sequence after magnetic resonance apparatus replacement

    International Nuclear Information System (INIS)

    Tsukagoshi, Yuki; Kanai, Yoshihiro; Yasui, Gou; Abe, Yuuji; Maemura, Keisuke; Nakazawa, Masaki; Yamaji, Yuugo; Mihara, Ban

    2012-01-01

    In our institute, an MR apparatus, MAGNETOM VISION (Siemens) was replaced by ECHELON Vega (HITACHI). Z-score data acquired by MPRAGE (VISION) was compared with those by radio frequency-spoiled steady-state acquisition with rewinded gradient echo (RSSG) and gradient echo inversion recovery (GEIR) (ECHELON). For this study, ten normal volunteers were recruited and their data ware obtained within two months using both apparatuses. In addition, the difference of the contrasts of the images of these apparatuses was compared. There was a significant difference between Z-scores of MPRAGE and RSSG while there was no difference between MPRAGE and GEIR. As for the contrast, data of MPRAGE were similar to those of GEIR. To compare Z-scores acquired with MAGNTOM VISION (Siemens), it seems appropriate to use GEIR in ECHELON Vega. (author)

  12. Analysis of rehabilitation activities within skilled nursing and inpatient rehabilitation facilities after hip replacement for acute hip fracture.

    Science.gov (United States)

    Munin, Michael C; Putman, Koen; Hsieh, Ching-Hui; Smout, Randall J; Tian, Wenqiang; DeJong, Gerben; Horn, Susan D

    2010-07-01

    To characterize rehabilitation services in two types of postacute facilities in patients who underwent hip replacement following a hip fracture. Multisite prospective observational cohort from 6 freestanding skilled nursing facilities and 11 inpatient rehabilitation facilities. Patients (n = 218) with hip fracture who had either hemiarthroplasty or total hip arthroplasty followed by rehabilitation at skilled nursing facilities or inpatient rehabilitation facilities were enrolled. Using a point-of-care methodology, we recorded data from actual physical therapy and occupational therapy sessions completed including functional outcomes during the postacute admission. Onset time from surgical repair to rehabilitation admission was not significantly different between sites. Average skilled nursing facilities length of stay was 24.7 +/- 13.6 days, whereas inpatient rehabilitation facilities was 13.0 +/- 5.7 days (P inpatient rehabilitation facilities. For weekdays only, these data changed to 1.6 in skilled nursing facilities and 2.6 hrs per patient in inpatient rehabilitation facilities (P inpatient rehabilitation facilities accrued more time for gait training and exercise in physical therapy, which was found to be 48% and 40% greater, respectively, through day 8. In occupational therapy, patients of inpatient rehabilitation facilities had more time allocated to lower body dressing and transfers. Significant differences in rehabilitation activities were observed, and intensity was notably different within the first 8 therapy days even though baseline demographics and medical complexity were comparable across facility types. Our data suggest that after more complex hip replacement surgery, hip fracture patients can tolerate more intensive therapy earlier within the rehabilitation program.

  13. The effect of tranexamic acid on blood coagulation in total hip replacement arthroplasty: rotational thromboelastographic (ROTEM®) analysis.

    Science.gov (United States)

    Na, H S; Shin, H J; Lee, Y J; Kim, J H; Koo, K H; Do, S H

    2016-01-01

    We evaluated changes in rotational thromboelastometry (ROTEM(®) ) parameters and clinical outcomes in patients undergoing total hip replacement arthroplasty, with concomitant infusions of tranexamic acid and of 6% hydroxyethyl starch 130/0.4. Fifty-five patients were randomly assigned to either the tranexamic acid (n = 29) or the control (n = 26) group. Hydroxyethyl starch was administered in the range of 10-15 ml.kg(-1) during the operation in both groups. In the control group, the clot formation time and maximum clot firmness of APTEM showed significant differences when compared with those of EXTEM at one hour postoperatively, suggestive of fibrinolysis. In the tranexamic acid group, there was no significant difference between each postoperative EXTEM and APTEM parameter. In the tranexamic acid and control group, postoperative blood loss was 308 ml (210-420 [106-745]) and 488 ml (375-620 [170-910], p = 0.002), respectively, and total blood loss was 1168 ml (922-1470 [663-2107]) and 1563 ml (1276-1708 [887-1494], p = 0.003). Haemoglobin concentration was higher in the tranexamic acid group on the second postoperative day (10.5 (9.4-12.1 [7.9-14.0]) vs. 9.6 (8.9-10.5[7.3-16.0]) g.dl(-1) , p = 0.027). In patients undergoing total hip replacement arthroplasty, postoperative fibrinolysis aggravated by hydroxyethyl starch was attenuated by co-administration of 10 mg.kg(-1) tranexamic acid, which may have led to less postoperative blood loss. © 2015 The Association of Anaesthetists of Great Britain and Ireland.

  14. Relative Expression of PBMC MicroRNA-133a Analysis in Patients Receiving Warfarin After Mechanical Heart Valve Replacement

    Science.gov (United States)

    Kabiri Rad, Hamid; Mazaheri, Mahta; Dehghani Firozabadi, Ali

    Background: MicroRNAs (miRNAs) are implicated in various biological processes including anticoagulation. However, the modulation of miRNA by pharmacological intervention such as warfarin treatment in patients receiving warfarin has not been disclosed yet. The aim of this study work was to assess the effect of warfarin drug on expression level of mir-133a-3p in patients with mechanical heart valve replacement. Methods: In this research, the expression level of miRNA-133a-3p was analyzed in Peripheral Blood Mononuclear Cells (PBMCs) from mechanical valve replacement patients who had received warfarin for at least 3 months continuously. Quantitative RT-PCR method was used for this assay. Results: Our findings indicated a significant diffrence between the rate of miR-133a-3p expression in individuals receiving warfarin and the control group (p<0.01). There was also a statistically significant difference in miR-133a-3p expression in patients with different ages (p<0.05) suggesting that the rate of miR-133a-3p expression in persons receiving warfarin is related to age. However, other variables like warfarin dose, International Normalized Ratio (INR), gender, and Body Mass Index (BMI) were not significantly effective on the miR-133a-3p experssion rate in individuals receving warfarin. Conclusion: Based on our results, it can be concluded that miR-133a-3p is involved in the coagulation pathway. The recent result indicates that warfarin affects the expression of miR-133a. This expression may be potentially important for treatment by anticoagulants. Awareness of the time course of miRNA expression profile can improve efficiency of response to warfarin. PMID:29296264

  15. Liquid L-thyroxine versus tablet L-thyroxine in patients on L- thyroxine replacement or suppressive therapy: a meta-analysis.

    Science.gov (United States)

    Laurent, Irakoze; Tang, Siying; Astère, Manirakiza; Wang, Kan Ran; Deng, Shuhua; Xiao, Ling; Li, Qi Fu

    2018-03-23

    To compare the effectiveness of liquid L-T4 (L-thyroxine) and tablet L-T4 in patients on L-T4 replacement or suppressive therapy. The Cochrane Library, PubMed, Embase, and Web of Science databases were searched to identify relevant articles. All prospective or randomized controlled studies (RCTs) comparing liquid L-T4 and tablet L-T4 in patients on L-T4 replacement or suppressive therapy were included in the analysis. Overall, the initial search of the four databases identified 1278 published studies; of these, eight studies were ultimately included in the meta-analysis. TSH (thyroid stimulating hormone) levels were significantly suppressed in patients on liquid L-T4 compared with those on tablet L-T4, in patients on L-T4 suppressive therapy with L-T4 malabsorption (Mean Difference (MD) = -2.26, 95% Confidence Interval (CI): -3.59, -0.93; P = 0.0009)). However, liquid L-T4 and tablet L-T4 did not show a statistically significant difference in patients on L-T4 suppressive therapy without malabsorption (MD = 0.08, 95% CI: -0.31, 0.47; P = 0.69). TSH levels were significantly normalized in patients on liquid L-T4 compared with those on tablet L-T4, in Patients on L-T4 replacement therapy with L-T4 malabsorption (MD = -3.20, 95% CI: -5.08, -1.32; P = 0.0009). However, liquid L-T4 and tablet L-T4 did not show a statistically significant difference in patients on L-T4 replacement therapy without malabsorption (MD = 0.91, 95% CI: -0.03, 1.86; P = 0.06). Liquid L-T4 is more efficient than tablet L-T4 in patients on L-T4 replacement or suppressive therapy with malabsorption. No significant differences were observed in patients without malabsorption. Further studies should be conducted to verify these findings.

  16. Observability-in-depth: An essential complement to the defense-in-depth safety strategy in the nuclear industry

    Energy Technology Data Exchange (ETDEWEB)

    Favaro, Francesca M.; Saleh, Joseph H. [Georgia Institute of Technology, Atlanta (United States)

    2014-12-15

    Defense-in-depth is a fundamental safety principle for the design and operation of nuclear power plants. Despite its general appeal, defense-in-depth is not without its drawbacks, which include its potential for concealing the occurrence of hazardous states in a system, and more generally rendering the latter more opaque for its operators and managers, thus resulting in safety blind spots. This in turn translates into a shrinking of the time window available for operators to identify an unfolding hazardous condition or situation and intervene to abate it. To prevent this drawback from materializing, we propose propose in this work a novel safety principle termed 'observability-in-depth'. We characterize it as the set of provisions technical, operational, and organizational designed to enable the monitoring and identification of emerging hazardous conditions and accident pathogens in real-time and over different time-scales. Observability-in-depth also requires the monitoring of conditions of all safety barriers that implement defense-in-depth; and in so doing it supports sense making of identified hazardous conditions, and the understanding of potential accident sequences that might follow (how they can propagate). Observability-in-depth is thus an information-centric principle, and its importance in accident prevention is in the value of the information it provides and actions or safety interventions it spurs. We examine several 'event reports' from the U.S. Nuclear Regulatory Commission database, which illustrate specific instances of violation of the observability-in-depth safety principle and the consequences that followed (e.g., unmonitored releases and loss of containments). We also revisit the Three Mile Island accident in light of the proposed principle, and identify causes and consequences of the lack of observability-in-depth related to this accident sequence. We illustrate both the benefits of adopting the observability-in-depth

  17. Cluster analysis as a method for determining size ranges for spinal implants: disc lumbar replacement prosthesis dimensions from magnetic resonance images.

    Science.gov (United States)

    Lei, Dang; Holder, Roger L; Smith, Francis W; Wardlaw, Douglas; Hukins, David W L

    2006-12-01

    Statistical analysis of clinical radiologic data. To develop an objective method for finding the number of sizes for a lumbar disc replacement. Cluster analysis is a well-established technique for sorting observations into clusters so that the "similarity level" is maximal if they belong to the same cluster and minimal otherwise. Magnetic resonance scans from 69 patients, with no abnormal discs, yielded 206 sagittal and transverse images of 206 discs (levels L3-L4-L5-S1). Anteroposterior and lateral dimensions were measured from vertebral margins on transverse images; disc heights were measured from sagittal images. Hierarchical cluster analysis was performed to determine the number of clusters followed by nonhierarchical (K-means) cluster analysis. Discriminant analysis was used to determine how well the clusters could be used to classify an observation. The most successful method of clustering the data involved the following parameters: anteroposterior dimension; lateral dimension (both were the mean of results from the superior and inferior margins of a vertebral body, measured on transverse images); and maximum disc height (from a midsagittal image). These were grouped into 7 clusters so that a discriminant analysis was capable of correctly classifying 97.1% of the observations. The mean and standard deviations for the parameter values in each cluster were determined. Cluster analysis has been successfully used to find the dimensions of the minimum number of prosthesis sizes required to replace L3-L4 to L5-S1 discs; the range of sizes would enable them to be used at higher lumbar levels in some patients.

  18. A feasibility analysis of replacing the standard ammonia refrigeration device with the cascade NH3/CO2 refrigeration device in the food industry

    Directory of Open Access Journals (Sweden)

    Jankovich Dennis

    2015-01-01

    Full Text Available The thermodynamic analysis demonstrates the feasibility of replacing the standard ammonia refrigeration device with the cascade NH3/CO2 refrigeration device in the food industry. The main reason for replacement is to reduce the total amount of ammonia in spaces like deep-freezing chambers, daily chambers, working rooms and technical passageways. An ammonia-contaminated area is hazardous to human health and the safety of food products. Therefore the preferred reduced amount of ammonia is accumulated in the Central Refrigeration Engine Room, where the cascade NH3/CO2 device is installed as well. Furthermore, the analysis discusses and compares two left Carnot¢s refrigeration cycles, one for the standard ammonia device and the other for the cascade NH3/CO2 device. Both cycles are processes with two-stage compression and two-stage throttling. The thermodynamic analysis demonstrates that the selected refrigeration cycle is the most cost-effective process because it provides the best numerical values for the total refrigeration factor with respect to the observed refrigeration cycle. The chief analyzed influential parameters of the cascade device are: total refrigeration load, total reactive power, mean temperature of the heat exchanger, evaporating and condensing temperature of the low-temperature part.

  19. 3D echocardiographic analysis of aortic annulus for transcatheter aortic valve replacement using novel aortic valve quantification software: Comparison with computed tomography.

    Science.gov (United States)

    Mediratta, Anuj; Addetia, Karima; Medvedofsky, Diego; Schneider, Robert J; Kruse, Eric; Shah, Atman P; Nathan, Sandeep; Paul, Jonathan D; Blair, John E; Ota, Takeyoshi; Balkhy, Husam H; Patel, Amit R; Mor-Avi, Victor; Lang, Roberto M

    2017-05-01

    With the increasing use of transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis (AS), computed tomography (CT) remains the standard for annulus sizing. However, 3D transesophageal echocardiography (TEE) has been an alternative in patients with contraindications to CT. We sought to (1) test the feasibility, accuracy, and reproducibility of prototype 3DTEE analysis software (Philips) for aortic annular measurements and (2) compare the new approach to the existing echocardiographic techniques. We prospectively studied 52 patients who underwent gated contrast CT, procedural 3DTEE, and TAVR. 3DTEE images were analyzed using novel semi-automated software designed for 3D measurements of the aortic root, which uses multiplanar reconstruction, similar to CT analysis. Aortic annulus measurements included area, perimeter, and diameter calculations from these measurements. The results were compared to CT-derived values. Additionally, 3D echocardiographic measurements (3D planimetry and mitral valve analysis software adapted for the aortic valve) were also compared to the CT reference values. 3DTEE image quality was sufficient in 90% of patients for aortic annulus measurements using the new software, which were in good agreement with CT (r-values: .89-.91) and small (software can accurately measure aortic annulus in patients with severe AS undergoing TAVR, in better agreement with CT than the existing methodology. Accordingly, intra-procedural TEE could potentially replace CT in patients where CT carries significant risk. © 2017, Wiley Periodicals, Inc.

  20. Quality of life among elderly patients undergoing transcatheter or surgical aortic valve replacement- a model-based longitudinal data analysis.

    Science.gov (United States)

    Kaier, Klaus; Gutmann, Anja; Baumbach, Hardy; von Zur Mühlen, Constantin; Hehn, Philip; Vach, Werner; Beyersdorf, Friedhelm; Zehender, Manfred; Bode, Christoph; Reinöhl, Jochen

    2016-07-26

    Quality of life (QoL) measurements reported in observational studies are often biased, since patients who failed to improve are more likely to be unable to respond due to death or impairment. In order to observe the development of QoL in patients close to death, we analyzed a set of monthly QoL measurements for a cohort of elderly patients treated for aortic valve stenosis (AS) with special consideration of the effect of distance to death. QoL in 169 elderly patients (age ≥ 75 years), treated either with transcatheter aortic valve replacement (TAVR; n = 92), surgical aortic-valve replacement (n = 70), or drug-based therapy (n = 7), was evaluated using the standardized EQ-5D questionnaire. Over a two-year period, patients were consulted using monthly telephone interviews or outpatient visits, leading to a total of 2463 time points at which QoL values, New York Heart Association (NYHA) Functional Classification and their status of assistance were assessed. Furthermore, post-procedural clinical events and complications were monitored. Linear and ordered logistic regression analyses with random intercept were carried out, taking into account overall trends and distance to death. QoL measures decreased slightly over time, were temporarily impaired at month 1 after the initial episode of hospitalization and decreased substantially at the end of life with a measurable effect starting at the sixth from last follow-up (month) before death. Many clinical complications (bleeding complications, stroke, acute kidney injury) showed an impairment of QoL measurements, but the inclusion of lagged variables demonstrated medium term (three months) QoL impairments for access site bleeding only. All other complications are associated with event-related impairments that decreased dramatically at the second and third follow-up interviews (month) after event. Distance to death shows clear effects on QoL and should be taken into account when analyzing QoL measures in the

  1. Ankle replacement - discharge

    Science.gov (United States)

    ... total - discharge; Total ankle arthroplasty - discharge; Endoprosthetic ankle replacement - discharge; Osteoarthritis - ankle ... You had an ankle replacement. Your surgeon removed and reshaped ... an artificial ankle joint. You received pain medicine and were ...

  2. Artificial Disc Replacement

    Science.gov (United States)

    ... Spondylolisthesis BLOG FIND A SPECIALIST Treatments Artificial Disc Replacement (ADR) Patient Education Committee Jamie Baisden The disc ... Disc An artificial disc (also called a disc replacement, disc prosthesis or spine arthroplasty device) is a ...

  3. Partial knee replacement - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100225.htm Partial knee replacement - series—Normal anatomy To use the sharing ... A.M. Editorial team. Related MedlinePlus Health Topics Knee Replacement A.D.A.M., Inc. is accredited ...

  4. Latent stereopsis for motion in depth in strabismic amblyopia.

    Science.gov (United States)

    Hess, Robert F; Mansouri, Behzad; Thompson, Benjamin; Gheorghiu, Elena

    2009-10-01

    To investigate the residual stereo function of a group of 15 patients with strabismic amblyopia, by using motion-in-depth stimuli that allow discrimination of contributions from local disparity as opposed to those from local velocity mechanisms as a function of the rate of depth change. The stereo performance (percentage correct) was measured as a function of the rate of depth change for dynamic random dot stimuli that were either temporally correlated or uncorrelated. Residual stereoscopic function was demonstrated for motion in depth based on local disparity information in 2 of the 15 observers with strabismic amblyopia. The use of a neutral-density (ND) filter in front of the fixing eye enhanced motion-in-depth performance in four subjects randomly selected from the group that originally displayed only chance performance. This finding was true across temporal rate and for correlated and uncorrelated stimuli, suggesting that it was disparity based. The opposite occurred in a group of normal subjects. In a separate experiment, the hypothesis was that the beneficial effect of the ND filter is due to its contrast and/or mean luminance-reducing effects rather than any interocular time delay that it may introduce and that it is specific to motion-in-depth performance, as similar improvements were not found for static stereopsis. A small proportion of observers with strabismic amblyopia exhibit residual performance for motion in depth, and it is disparity based. Furthermore, some observers with strabismic amblyopia who do not display any significant stereo performance for motion in depth under normal binocular viewing may display above-chance stereo performance if the degree of interocular suppression is reduced. The authors term this phenomenon latent stereopsis.

  5. 3D finite element analysis of immediate loading of single wide versus double implants for replacing mandibular molar

    Directory of Open Access Journals (Sweden)

    Shrikar R Desai

    2013-01-01

    Full Text Available Purpose: The purpose of this finite element study was to compare the stresses, strains, and displacements of double versus single implant in immediate loading for replacing mandibular molar. Materials and Methods: Two 3D FEM (finite element method models were made to simulate implant designs. The first model used 5-mm-wide diameter implant to support a single molar crown. The second model used 3.75-3.75 double implant design. Anisotropic properties were assigned to bone model. Each model was analyzed with single force magnitude (100 N in vertical axis. Results: This FEM study suggested that micromotion can be controlled better for double implants compared to single wide-diameter implants. The Von Mises stress for double implant showed 74.44% stress reduction compared to that of 5-mm implant. The Von Mises elastic strain was reduced by 61% for double implant compared to 5-mm implant. Conclusion: Within the limitations of the study, when the mesiodistal space for artificial tooth is more than 12.5 mm, under immediate loading, the double implant support should be considered.

  6. Cemented versus uncemented fixation in total hip replacement: a systematic review and meta-analysis of randomized controlled trials.

    LENUS (Irish Health Repository)

    Abdulkarim, Ali

    2013-02-22

    The optimal method of fixation for primary total hip replacements (THR), particularly fixation with or without the use of cement is still controversial. In a systematic review and metaanalysis of all randomized controlled trials comparing cemented versus uncemented THRS available in the published literature, we found that there is no significant difference between cemented and uncemented THRs in terms of implant survival as measured by the revision rate. Better short-term clinical outcome, particularly an improved pain score can be obtained with cemented fixation. However, the results are unclear for the long-term clinical and functional outcome between the two groups. No difference was evident in the mortality and the post operative complication rate. On the other hand, the radiographic findings were variable and do not seem to correlate with clinical findings as differences in the surgical technique and prosthesis design might be associated with the incidence of osteolysis. We concluded in our review that cemented THR is similar if not superior to uncemented THR, and provides better short term clinical outcomes. Further research, improved methodology and longer follow up are necessary to better define specific subgroups of patients in whom the relative benefits of cemented and uncemented implant fixation can be clearly demonstrated.

  7. Cemented versus uncemented fixation in total hip replacement: a systematic review and meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Ali Abdulkarim

    2013-03-01

    Full Text Available The optimal method of fixation for primary total hip replacements (THR, particularly fixation with or without the use of cement is still controversial. In a systematic review and metaanalysis of all randomized controlled trials comparing cemented versus uncemented THRS available in the published literature, we found that there is no significant difference between cemented and uncemented THRs in terms of implant survival as measured by the revision rate. Better short-term clinical outcome, particularly an improved pain score can be obtained with cemented fixation. However, the results are unclear for the long-term clinical and functional outcome between the two groups. No difference was evident in the mortality and the post operative complication rate. On the other hand, the radiographic findings were variable and do not seem to correlate with clinical findings as differences in the surgical technique and prosthesis design might be associated with the incidence of osteolysis. We concluded in our review that cemented THR is similar if not superior to uncemented THR, and provides better short term clinical outcomes. Further research, improved methodology and longer follow up are necessary to better define specific subgroups of patients in whom the relative benefits of cemented and uncemented implant fixation can be clearly demonstrated.

  8. Accident management-defence in depth in Indian PHWRS

    International Nuclear Information System (INIS)

    Jagannad, V.B.L.; Reddy, V.V.; Hajela, Sameer; Bhatia, C.M.; Nair, Suma

    2015-01-01

    Defence in Depth (DiD) is the established safety principle for the design of Nuclear Power Plants (NPPs). Accident at Fukushima Dai-ichi had highlighted the importance of provisions at Level-4 and 5 of DiD. Post Fukushima accident, on-site measures have been strengthened for Indian Nuclear Power Plants. On procedural front, Accident Management Guidelines have been introduced to handle events more severe than design basis accidents. This paper elaborates enhancement of Defence in Depth provisions for Indian Nuclear Power Plants. (author)

  9. In-Depth Study Of European Union Fiscal Approximation

    Directory of Open Access Journals (Sweden)

    Andreea Roxana TOMI

    2011-05-01

    Full Text Available The current study presents a viewpoint on the EU fiscal policy contents, advocating the need for an in-depth understanding and acceleration of the 27 national fiscal system components and the creation of the EU Tax System that would enable the Single Market operation and the enforcement of the four fundamental liberties within the European Union. In the author’s opinion, the extant common fiscal policy elements are only marginal, while the actions aimed at an in-depth understanding of a broad fiscal policy are essential to the extent they point at both direct and indirect taxation aspects whose approximation is a priority.

  10. Capital Equipment Replacement Decisions

    OpenAIRE

    Batterham, Robert L.; Fraser, K.I.

    1995-01-01

    This paper reviews the literature on the optimal replacement of capital equipment, especially farm machinery. It also considers the influence of taxation and capital rationing on replacement decisions. It concludes that special taxation provisions such as accelerated depreciation and investment allowances are unlikely to greatly influence farmers' capital equipment replacement decisions in Australia.

  11. Implementing Replacement Cost Accounting

    Science.gov (United States)

    1976-12-01

    cost accounting Clickener, John Ross Monterey, California. Naval Postgraduate School http://hdl.handle.net/10945/17810 Downloaded from NPS Archive...Calhoun IMPLEMENTING REPLACEMENT COST ACCOUNTING John Ross CHckener NAVAL POSTGRADUATE SCHOOL Monterey, California THESIS IMPLEMENTING REPLACEMENT COST ...Implementing Replacement Cost Accounting 7. AUTHORS John Ross Clickener READ INSTRUCTIONS BEFORE COMPLETING FORM 3. RECIPIENT’S CATALOG NUMBER 9. TYRE OF

  12. Advanced 3-D analysis, client-server systems, and cloud computing-Integration of cardiovascular imaging data into clinical workflows of transcatheter aortic valve replacement.

    Science.gov (United States)

    Schoenhagen, Paul; Zimmermann, Mathis; Falkner, Juergen

    2013-06-01

    Degenerative aortic stenosis is highly prevalent in the aging populations of industrialized countries and is associated with poor prognosis. Surgical valve replacement has been the only established treatment with documented improvement of long-term outcome. However, many of the older patients with aortic stenosis (AS) are high-risk or ineligible for surgery. For these patients, transcatheter aortic valve replacement (TAVR) has emerged as a treatment alternative. The TAVR procedure is characterized by a lack of visualization of the operative field. Therefore, pre- and intra-procedural imaging is critical for patient selection, pre-procedural planning, and intra-operative decision-making. Incremental to conventional angiography and 2-D echocardiography, multidetector computed tomography (CT) has assumed an important role before TAVR. The analysis of 3-D CT data requires extensive post-processing during direct interaction with the dataset, using advance analysis software. Organization and storage of the data according to complex clinical workflows and sharing of image information have become a critical part of these novel treatment approaches. Optimally, the data are integrated into a comprehensive image data file accessible to multiple groups of practitioners across the hospital. This creates new challenges for data management requiring a complex IT infrastructure, spanning across multiple locations, but is increasingly achieved with client-server solutions and private cloud technology. This article describes the challenges and opportunities created by the increased amount of patient-specific imaging data in the context of TAVR.

  13. Computer simulation of replacement sequences in copper

    International Nuclear Information System (INIS)

    Schiffgens, J.O.; Schwartz, D.W.; Ariyasu, R.G.; Cascadden, S.E.

    1978-01-01

    Results of computer simulations of , , and replacement sequences in copper are presented, including displacement thresholds, focusing energies, energy losses per replacement, and replacement sequence lengths. These parameters are tabulated for six interatomic potentials and shown to vary in a systematic way with potential stiffness and range. Comparisons of results from calculations made with ADDES, a quasi-dynamical code, and COMENT, a dynamical code, show excellent agreement, demonstrating that the former can be calibrated and used satisfactorily in the analysis of low energy displacement cascades. Upper limits on , , and replacement sequences were found to be approximately 10, approximately 30, and approximately 14 replacements, respectively. (author)

  14. Principles of Defense-in-depth philosophy applied in NPP engineering management

    International Nuclear Information System (INIS)

    Wu Guangwei

    2011-01-01

    Based on the Defense-in-depth Concept in nuclear and radiation safety, Defense-in-depth Concept for design management of Nuclear Power Plant (NPP) is developed in this paper to analyze the feasibility and importance of the application of the basic principle: Defense-in-depth concept in NPP systems performed during the design control of NPP. This paper focuses on the NPP engineering management process, and according to the analysis of such process, 5 principles of Defense-in-depth Concept applied in NPP design management are raised: (1) preventing the non-conformities of design via effective design quality management system; (2) discovering and correcting non-conformities of design quality in time via design checkup and design review meeting; (3) carrying out timely analysis and treatment against design non-conformities which have been transferred to construction phase; (4) Assessing and judging the severe non-conformities in construction phase, putting forward treatment opinions and remedies accordingly so as to avoid the existence of such non-conformities in physical construction of NPP; (5) Paying 'return-visit' and performing 'post-assessment' for NPP design to assess the designed functions and safety of NPP comprehensively. (author)

  15. Total joint replacement: A multiple risk factor analysis of physical activity level 1-2 years postoperatively.

    Science.gov (United States)

    Paxton, Elizabeth W; Torres, Andy; Love, Rebecca M; Barber, Thomas C; Sheth, Dhiren S; Inacio, Maria C S

    2016-07-01

    Background and purpose - The effect of total joint arthroplasty (TJA) on physical activity is not fully understood. We investigated the change in physical activity after TJA and patient factors associated with change. Patients and methods - Using a total joint replacement registry, primary total hip arthroplasty (THA) patients (n = 5,678) and knee arthroplasty (TKA) patients (n = 11,084) between January 1, 2010 and December 31, 2012 were identified. Median age at THA was 68 and median age at TKA was 67. Change in self-reported physical activity (minutes per week) from before TJA (within 1 year of surgery) to after TJA (1-2 years) was the outcome of interest. Patient demographics and comorbidities were evaluated as risk factors. Multiple linear regression was used. Results - Median physical activity before surgery was 50 min/week (IQR: 0-140) for THA patients and 58 (IQR: 3-143) for TKA patients. Median physical activity after surgery was 150 min/week (IQR: 60-280) for both THA patients and TKA patients. Following TJA, 50% of patients met CDC/WHO physical activity guideline criteria. Higher body mass index was associated with lower change in physical activity (THA: -7.1 min/week; TKA: -5.9 min/week). Females had lower change than males (THA: -11 min/week; TKA: -9.1 min/week). In TKA patients, renal failure was associated with lower change (-17 min/week), as were neurological disorders (-30 min/week). Interpretation - Self-reported minutes of physical activity increased from before to after TJA, but 50% of TJA patients did not meet recommended physical activity guideline criteria. Higher body mass index, female sex, and specific comorbidities were found to be associated with low change in physical activity. Patient education on the benefits of physical activity should concentrate on these subgroups of patients.

  16. Does the suction drain diameter matter? Bleeding analysis after total knee replacement comparing different suction drain gauges

    Directory of Open Access Journals (Sweden)

    Marcos George de Souza Leao

    Full Text Available ABSTRACT OBJECTIVES: To evaluate bleeding and the estimated blood loss in patients who underwent total knee replacement (TKR with different closed suction drains (3.2-mm and 4.8-mm gauge. METHODS: This was a randomized controlled trial with 22 patients who underwent TKR and were divided into two groups: Group I, with 11 patients in whom the 3.2-mm suction drain was used, and Group II, with 11 patients in whom the 4.8-mm suction drain was used. The hematocrit was measured after 24, 48 and 72 h after surgery in order to calculate the estimated blood loss. The drained volume was measured 3, 6, 12, 24, and 48 h after TKR, and thereafter both groups were compared. RESULTS: Regarding the hematocrit, there were no differences between groups in measured periods (24, 48, and 72 h after surgery. The total bleeding measured at the suction drains within 48 h was higher in Group II, with a statistically significant difference (p = 0.005; in the first 24 h, there was major bleeding in Group II (mean 893 mL, with a significant difference (p = 0.004. Between 24 and 48 h, there was no statistically significant difference in both groups (p = 0.710. The total estimated bleeding was higher in Group I, with mean of 463 mL, versus 409 mL in Group II, with no statistical significance (p = 0.394. CONCLUSIONS: Bleeding was higher in the group that used the 4.8 mm gauge suction drain, with no differences in hematocrit and estimated blood loss.

  17. Patients' perceptions of physical activity before and after joint replacement: a systematic review with meta-ethnographic analysis.

    Science.gov (United States)

    Smith, Toby O; Latham, Sarah; Maskrey, Vivienne; Blyth, Annie

    2015-09-01

    It has been perceived that people following total hip arthroplasty (THA) or total knee arthroplasty (TKA) have the capability, with reduced pain, to increase their levels of physical activity. To determine the attitudes and perceptions of people awaiting or having undergone THA or TKA to physical activity post-arthroplasty and to identify potential facilitators or barriers to engage in active living and physical activity pursuits. Systematic review of published and unpublished databases was undertaken from their inception to November 2014. Studies exploring the attitudes and perceptions of people awaiting or having undergone THA or TKA to physical activity post-arthroplasty were included. Data were analysed through a meta-ethnography approach. From 528 citations, 13 papers were eligible, sampling 282 people post-THA or TKA. The literature was judged moderate to high quality. Following THA and TKA, people either wished to return to their pre-pathology level of physical activity or simply be able to engage in less physically demanding activities that are meaningful to them and their lifestyles. Barriers to engaging in higher levels of physical activity were largely related to limited information, which culminated in fear surrounding 'doing the right thing' both for individual's recovery and the longevity of the joint replacement. While many people post-THA or TKA wish to return to pre-pathological physical activity status, there is limited interest in actually undertaking greater levels of physical activity post-arthroplasty either for pleasure or health gains. Improvement in education and awareness of this may be key drivers to improve habitualisation of physical activity post-arthroplasty. CRD42014014995. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Analysis of the characteristics of DC nozzle arcs in air and guidance for the search of SF6 replacement gas

    Science.gov (United States)

    Liu, J.; Zhang, Q.; Yan, J. D.; Zhong, J.; Fang, M. T. C.

    2016-11-01

    It is shown that the arc model based on laminar flow cannot predict satisfactorily the voltage of an air arc burning in a supersonic nozzle. The Prandtl mixing length model (PML) and a modified k-epsilon turbulence model (MKE) are used to introduce turbulence enhanced momentum and energy transport. Arc voltages predicted by these two turbulence models are in good agreement with experiments at the stagnation pressure (P 0) of 10 bar. The predicted arc voltages by MKE for P 0  =  13 bar and 7 bar are in better agreement with experiments than those predicted by PML. MKE is therefore a preferred turbulence model for an air nozzle arc. There are two peaks in ρC P of air at 4000 K and 7000 K due, respectively, to the dissociation of oxygen and that of nitrogen. These peaks produce corresponding peaks in turbulent thermal conductivity, which results in very broad radial temperature profile and a large arc radius. Thus, turbulence indirectly enhances axial enthalpy transport, which becomes the dominant energy transport process for the overall energy balance of the arc column at high currents. When the current reduces, turbulent thermal conduction gradually becomes dominant. The temperature dependence of ρC P has a decisive influence on the radial temperature profile of a turbulent arc, thus the thermal interruption capability of a gas. Comparison between ρC P for air and SF6 shows that ρC P for SF6 has peaks below 4000 K. This renders a distinctive arc core and a small arc radius for turbulent SF6, thus superior arc quenching capability. It is suggested, for the first time, that ρC P provides guidance for the search of a replacement switching gas for SF6.

  19. Successive Evolutions of the Defence in Depth Concept

    Energy Technology Data Exchange (ETDEWEB)

    Poulat, B., E-mail: B.Poulat@iaea.org [International Atomic Energy Agency (IAEA), Department of Nuclear Safety and Security, Wagramer Strasse 5, P.O. Box 100, 1400 Vienna (Austria)

    2014-10-15

    Following Fukushima Daiichi accident, the Defence-in-depth concept, which is usually defined as a combination of a number of consecutive and independent levels of protection that would have to fail before harmful effects could be caused, has been confirmed as an essential element to be applied in the design of a nuclear facility to protect people and the environment. However, and although the implementation of the defence in depth concept had been required for long, the Fukushima Daiichi accident and the “stress tests” conducted in different countries have revealed deficiencies in its implementation. Consequently within the review of the IAEA safety requirements requested by Member states, it was important to check whether this concept was appropriately defined in order to be properly understood and fully implemented by vendors and operating organizations. By screening the successive definitions of the defence in depth principle and concept, this paper emphasizes the few issues which have been gradually clarified and enhanced to ensure effectiveness of the defence in depth as expressed from its original statement. (author)

  20. Defence in Depth - Applied to the Nuclear System

    Energy Technology Data Exchange (ETDEWEB)

    Weightman, M., E-mail: mike_weightman@hotmail.com

    2014-10-15

    Full text: Normally, the Defence in Depth concept is applied to the technical barriers that provide protection to the public and workers from nuclear accidents. This allows designers, operators and regulators to challenge (along with using other design principles such as independence, redundancy, diversity, single point failure, etc) the technical systems provided to see whether more needs to be done to provide adequate defence in depth to ensure risks are reduced so far as is reasonably practical. Post Fukushima, much thought has gone into reconsidering whether the effectiveness of the defence in depth concept can be enhanced by, for example, rebalancing the attention between prevention and mitigation or enhancing the independence of protective measures such as providing extremely robust standalone emergency cooling capability. This presentation argues that Fukushima teaches us a more fundamental lesson - that the defence in depth concept (along with other design principles') should be applied to the nuclear system to see whether more should be done to enhance the institutional barriers in any particular nuclear system. These barriers are at three main levels: industry, regulators and stakeholders each with sub-barriers. It reinforces the need for industry and regulators to be independent, open and transparent so that the nuclear system can work effectively. Examples are given where the application of the model identifies areas for improvement in existing systems. (author)

  1. Revisiting Sex Equality With Transcatheter Aortic Valve Replacement Outcomes: A Collaborative, Patient-Level Meta-Analysis of 11,310 Patients.

    Science.gov (United States)

    O'Connor, Stephen A; Morice, Marie-Claude; Gilard, Martine; Leon, Martin B; Webb, John G; Dvir, Danny; Rodés-Cabau, Josep; Tamburino, Corrado; Capodanno, Davide; D'Ascenzo, Fabrizio; Garot, Philippe; Chevalier, Bernard; Mikhail, Ghada W; Ludman, Peter F

    2015-07-21

    There has been conflicting clinical evidence as to the influence of female sex on outcomes after transcatheter aortic valve replacement. The aim of this study was to evaluate the impact of sex on early and late mortality and safety end points after transcatheter aortic valve replacement using a collaborative meta-analysis of patient-level data. From the MEDLINE, Embase, and the Cochrane Library databases, data were obtained from 5 studies, and a database containing individual patient-level time-to-event data was generated from the registry of each selected study. The primary outcome of interest was all-cause mortality. The safety end point was the combined 30-day safety end points of major vascular complications, bleeding events, and stroke, as defined by the Valve Academic Research Consortium when available. Five studies and their ongoing registry data, comprising 11,310 patients, were included. Women constituted 48.6% of the cohort and had fewer comorbidities than men. Women had a higher rate of major vascular complications (6.3% vs. 3.4%; p women and men (2.6 % vs. 2.2% [p = 0.24] and 6.5% vs. 6.5% [p = 0.93], respectively), but female sex was independently associated with improved survival at median follow-up of 387 days (interquartile range: 192 to 730 days) from the index procedure (adjusted hazard ratio: 0.79; 95% confidence interval: 0.73 to 0.86; p = 0.001). Although women experience more bleeding events, as well as vascular and stroke complications, female sex is an independent predictor of late survival after transcatheter aortic valve replacement. This should be taken into account during patient selection for this procedure. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  2. The 5-year cost-effectiveness of two-level anterior cervical discectomy and fusion or cervical disc replacement: a Markov analysis.

    Science.gov (United States)

    Overley, Samuel C; McAnany, Steven J; Brochin, Robert L; Kim, Jun S; Merrill, Robert K; Qureshi, Sheeraz A

    2018-01-01

    Anterior cervical discectomy and fusion (ACDF) and cervical disc replacement (CDR) are both acceptable surgical options for the treatment of cervical myelopathy and radiculopathy. To date, there are limited economic analyses assessing the relative cost-effectiveness of two-level ACDF versus CDR. The purpose of this study was to determine the 5-year cost-effectiveness of two-level ACDF versus CDR. The study design is a secondary analysis of prospectively collected data. Patients in the Prestige cervical disc investigational device exemption (IDE) study who underwent either a two-level CDR or a two-level ACDF were included in the study. The outcome measures were cost and quality-adjusted life years (QALYs). A Markov state-transition model was used to evaluate data from the two-level Prestige cervical disc IDE study. Data from the 36-item Short Form Health Survey were converted into utilities using the short form (SF)-6D algorithm. Costs were calculated from the payer perspective. QALYs were used to represent effectiveness. A probabilistic sensitivity analysis (PSA) was performed using a Monte Carlo simulation. The base-case analysis, assuming a 40-year-old person who failed appropriate conservative care, generated a 5-year cost of $130,417 for CDR and $116,717 for ACDF. Cervical disc replacement and ACDF generated 3.45 and 3.23 QALYs, respectively. The incremental cost-effectiveness ratio (ICER) was calculated to be $62,337/QALY for CDR. The Monte Carlo simulation validated the base-case scenario. Cervical disc replacement had an average cost of $130,445 (confidence interval [CI]: $108,395-$152,761) with an average effectiveness of 3.46 (CI: 3.05-3.83). Anterior cervical discectomy and fusion had an average cost of $116,595 (CI: $95,439-$137,937) and an average effectiveness of 3.23 (CI: 2.84-3.59). The ICER was calculated at $62,133/QALY with respect to CDR. Using a $100,000/QALY willingness to pay (WTP), CDR is the more cost-effective strategy and would be selected

  3. Optimization of station battery replacement

    International Nuclear Information System (INIS)

    Jancauskas, J.R.; Shook, D.A.

    1994-01-01

    During a loss of ac power at a nuclear generating station (including diesel generators), batteries provide the source of power which is required to operate safety-related components. Because traditional lead-acid batteries have a qualified life of 20 years, the batteries must be replaced a minimum of once during a station's lifetime, twice if license extension is pursued, and more often depending on actual in-service dates and the results of surveillance tests. Replacement of batteries often occurs prior to 20 years as a result of systems changes caused by factors such as Station Blackout Regulations, control system upgrades, incremental load growth, and changes in the operating times of existing equipment. Many of these replacement decisions are based on the predictive capabilities of manual design basis calculations. The inherent conservatism of manual calculations may result in battery replacements occurring before actually required. Computerized analysis of batteries can aid in optimizing the timing of replacements as well as in interpreting service test data. Computerized analysis also provides large benefits in maintaining the as-configured load profile and corresponding design margins, while also providing the capability of quickly analyze proposed modifications and response to internal and external audits

  4. Coupled RELAP5/PANTHER/COBRA steam line break accident analysis in support of licensing DOEL 2 power uprate and steam generator replacement

    International Nuclear Information System (INIS)

    Zhang, J.; Bosso, S.; Henno, X.; Ouliddren, K.; Schneidesch, C.R.; Hove, W. van

    2004-01-01

    The nuclear reactor accident analyses using best estimate codes provide a better understanding and more accurate modeling of the key physical phenomena, which allows a more realistic evaluation of the conservatism and margins in the final safety analysis report (FSAR) accident analysis. The use of the best estimate codes and methods is necessary to meet the increasing technical, licensing and regulatory requirements for major plant changes (e.g. steam generator replacement), power uprate, core design optimization (cycle extension), as well as Periodic Safety Review. Since 1992, Tractebel Engineering (TE) has developed and applied a deterministic bounding approach to FASR accident analysis using the best estimate system thermal hydraulic code RELAP5/MOD2.5 and the subchannel thermal hydraulic code COBRA-3C. This approach has been accepted by the Belgian Safety Authorities, and turned out to be cost effective for most of the non-LOCA transient analyses. Since this approach adapts a decoupled modeling of the core responses, the analysis results often involved too large un-quantified conservatisms, due to either simplistic approximations for asymmetric accidents with strong 3D core neutronics - plant thermal hydraulics interactions, or additional penalties introduced from 'incoherent' initial/boundary conditions for separate plant and core analyses. Therefore, an external dynamic coupling between the RELAP5/MOD2.5 code and the 3-D neutronic code PANTHER was implemented since 1997 via the transient analysis code linkage program TALINK. Furthermore, a static linkage between the PANTHER code and the COBRA-3C code was developed for on-line calculation of (Departure from Nucleate Boiling Ratio (DNBR). TE intends to use the coupled code package for licensing non-symmetric FSAR accident analysis. The TE coupled code package has been applied to develop a main steam line break (MSLB) accident analysis methodology [using the TE deterministic bounding approach. The methodology

  5. Pre-Columbian origins of Native American dog breeds, with only limited replacement by European dogs, confirmed by mtDNA analysis.

    Science.gov (United States)

    van Asch, Barbara; Zhang, Ai-bing; Oskarsson, Mattias C R; Klütsch, Cornelya F C; Amorim, António; Savolainen, Peter

    2013-09-07

    Dogs were present in pre-Columbian America, presumably brought by early human migrants from Asia. Studies of free-ranging village/street dogs have indicated almost total replacement of these original dogs by European dogs, but the extent to which Arctic, North and South American breeds are descendants of the original population remains to be assessed. Using a comprehensive phylogeographic analysis, we traced the origin of the mitochondrial DNA lineages for Inuit, Eskimo and Greenland dogs, Alaskan Malamute, Chihuahua, xoloitzcuintli and perro sín pelo del Peru, by comparing to extensive samples of East Asian (n = 984) and European dogs (n = 639), and previously published pre-Columbian sequences. Evidence for a pre-Columbian origin was found for all these breeds, except Alaskan Malamute for which results were ambigous. No European influence was indicated for the Arctic breeds Inuit, Eskimo and Greenland dog, and North/South American breeds had at most 30% European female lineages, suggesting marginal replacement by European dogs. Genetic continuity through time was shown by the sharing of a unique haplotype between the Mexican breed Chihuahua and ancient Mexican samples. We also analysed free-ranging dogs, confirming limited pre-Columbian ancestry overall, but also identifying pockets of remaining populations with high proportion of indigenous ancestry, and we provide the first DNA-based evidence that the Carolina dog, a free-ranging population in the USA, may have an ancient Asian origin.

  6. [In-depth interviews and the Kano model to determine user requirements in a burns unit].

    Science.gov (United States)

    González-Revaldería, J; Holguín-Holgado, P; Lumbreras-Marín, E; Núñez-López, G

    To determine the healthcare requirements of patients in a Burns Unit, using qualitative techniques, such us in-depth personal interviews and Kano's methodology. Qualitative methodology using in-depth personal interviews (12 patients), Kano's conceptual model, and the SERVQHOS questionnaire (24 patients). All patients had been hospitalised in the last 12 months in the Burns Unit. Using Kano's methodology, service attributes were grouped by affinity diagrams, and classified as follows: must-be, attractive (unexpected, great satisfaction), and one-dimensional (linked to the degree of functionality of the service). The outcomes were compared with those obtained with SERVQHOS questionnaire. From the analysis of in-depth interviews, 11 requirements were obtained, referring to hotel aspects, information, need for closer staff relationship, and organisational aspects. The attributes classified as must-be were free television and automatic TV disconnection at midnight. Those classified as attractive were: individual room for more privacy, information about dressing change times in order to avoid anxiety, and additional staff for in-patients. The results were complementary to those obtained with the SERVQHOS questionnaire. In-depth personal interviews provide extra knowledge about patient requirements, complementing the information obtained with questionnaires. With this methodology, a more active patient participation is achieved and the companion's opinion is also taken into account. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Experimental assessment of precision and accuracy of radiostereometric analysis for the determination of polyethylene wear in a total hip replacement model.

    Science.gov (United States)

    Bragdon, Charles R; Malchau, Henrik; Yuan, Xunhua; Perinchief, Rebecca; Kärrholm, Johan; Börlin, Niclas; Estok, Daniel M; Harris, William H

    2002-07-01

    The purpose of this study was to develop and test a phantom model based on actual total hip replacement (THR) components to simulate the true penetration of the femoral head resulting from polyethylene wear. This model was used to study both the accuracy and the precision of radiostereometric analysis, RSA, in measuring wear. We also used this model to evaluate optimum tantalum bead configuration for this particular cup design when used in a clinical setting. A physical model of a total hip replacement (a phantom) was constructed which could simulate progressive, three-dimensional (3-D) penetration of the femoral head into the polyethylene component of a THR. Using a coordinate measuring machine (CMM) the positioning of the femoral head using the phantom was measured to be accurate to within 7 microm. The accuracy and precision of an RSA analysis system was determined from five repeat examinations of the phantom using various experimental set-ups of the phantom. The accuracy of the radiostereometric analysis, in this optimal experimental set-up studied was 33 microm for the medial direction, 22 microm for the superior direction, 86 microm for the posterior direction and 55 microm for the resultant 3-D vector length. The corresponding precision at the 95% confidence interval of the test results for repositioning the phantom five times, measured 8.4 microm for the medial direction, 5.5 microm for the superior direction, 16.0 microm for the posterior direction, and 13.5 microm for the resultant 3-D vector length. This in vitro model is proposed as a useful tool for developing a standard for the evaluation of radiostereometric and other radiographic methods used to measure in vivo wear.

  8. Can a single pain rating replace a multiple pain rating in third molar surgery studies? Analysis of 220 patients

    NARCIS (Netherlands)

    Martin, W.J.J.M.; Heymans, M.W.; Skorpil, N.E.; Forouzanfar, T.

    2012-01-01

    This study describes the comparison of multiple and single pain ratings in patients after surgical removal of the third molar. Correlation and agreement analysis were performed between the average pain intensity measured three times a day over a period of 7 days and one single pain rating

  9. Aeronautical Information System Replacement -

    Data.gov (United States)

    Department of Transportation — Aeronautical Information System Replacement is a web-enabled, automation means for the collection and distribution of Service B messages, weather information, flight...

  10. Safety Management of a Clinical Process Using Failure Mode and Effect Analysis: Continuous Renal Replacement Therapies in Intensive Care Unit Patients.

    Science.gov (United States)

    Sanchez-Izquierdo-Riera, Jose Angel; Molano-Alvarez, Esteban; Saez-de la Fuente, Ignacio; Maynar-Moliner, Javier; Marín-Mateos, Helena; Chacón-Alves, Silvia

    2016-01-01

    The failure mode and effect analysis (FMEA) may improve the safety of the continuous renal replacement therapies (CRRT) in the intensive care unit. We use this tool in three phases: 1) Retrospective observational study. 2) A process FMEA, with implementation of the improvement measures identified. 3) Cohort study after FMEA. We included 54 patients in the pre-FMEA group and 72 patients in the post-FMEA group. Comparing the risks frequencies per patient in both groups, we got less cases of under 24 hours of filter survival time in the post-FMEA group (31 patients 57.4% vs. 21 patients 29.6%; p FMEA, there were several improvements in the management of intensive care unit patients receiving CRRT, and we consider it a useful tool for improving the safety of critically ill patients.

  11. Transcatheter vs. surgical aortic valve replacement and medical treatment : Systematic review and meta-analysis of randomized and non-randomized trials.

    Science.gov (United States)

    Ak, A; Porokhovnikov, I; Kuethe, F; Schulze, P C; Noutsias, M; Schlattmann, P

    2017-04-27

    Transcatheter aortic valve replacement (TAVR) has emerged as the procedure of choice for patients with severe aortic stenosis (AS) and high perioperative risk. We performed a meta-analysis to compare the mortality related to TAVR with medical therapy (MT) and surgical aortic valve replacement (SAVR). A systematic literature search was conducted by two independent investigators from the database inception to 30 December 2014. Relative risk (RR) and odds ratio (OR) were calculated and graphically displayed in forest plots. We used I 2 for heterogeneity (meta-regression) and Egger's regression test of asymmetry (funnel plots). We included 24 studies (n = 19 observational studies; n = 5 randomized controlled trials), with a total of 7356 patients in this meta-analysis. Mean age had a substantial negative impact on the long-term survival of AS patients (OR = 1.544; 95% CI: 1.25-1.90). Compared with MT, TAVR showed a statistically significant benefit for all-cause mortality at 12 months (OR = 0.68; 95% CI: 0.49-0.95). Both TAVR and SAVR were associated with better outcomes compared with MT. TAVR showed lower all-cause mortality over SAVR at 12 months (OR = 0.81; 95% CI: 0.68-0.97). The comparison between SAVR and TAVR at 2 years revealed no significant difference (OR = 1.09; 95% CI: 1.01-1.17). In AS, both TAVR and SAVR provide a superior prognosis to MT and, therefore, MT is not the preferred treatment option for AS. Furthermore, our data show that TAVR is associated with lower mortality at 12 months compared with SAVR. Further studies are warranted to compare the long-term outcome of TAVR versus SAVR beyond a 2-year follow-up period.

  12. Systematic review and meta-analysis of surgical outcomes in Marfan patients undergoing aortic root surgery by composite-valve graft or valve sparing root replacement.

    Science.gov (United States)

    Flynn, Campbell D; Tian, David H; Wilson-Smith, Ashley; David, Tirone; Matalanis, George; Misfeld, Martin; Mastrobuoni, Stefano; El Khoury, Gebrine; Yan, Tristan D

    2017-11-01

    A major, life-limiting feature of Marfan syndrome (MFS) is the presence of aneurysmal disease. Cardiovascular intervention has dramatically improved the life expectancy of Marfan patients. Traditionally, the management of aortic root disease has been undertaken with composite-valve graft replacing the aortic valve and proximal aorta; more recently, valve sparing procedures have been developed to avoid the need for anticoagulation. This meta-analysis assesses the important surgical outcomes of the two surgical techniques. A systematic review and meta-analysis of 23 studies reporting the outcomes of aortic root surgery in Marfan patients with data extracted for outcomes of early and late mortality, thromboembolic events, late bleeding complications and surgical reintervention rates. The outcomes of 2,976 Marfan patients undergoing aortic root surgery were analysed, 1,624 patients were treated with composite valve graft (CVG) and 1,352 patients were treated with valve sparing root replacement (VSRR). When compared against CVG, VSRR was associated with reduced risk of thromboembolism (OR =0.32; 95% CI, 0.16-0.62, P=0.0008), late hemorrhagic complications (OR =0.18; 95% CI, 0.07-0.45; P=0.0003) and endocarditis (OR =0.27; 95% CI, 0.10-0.68; P=0.006). Importantly there was no significant difference in reintervention rates between VSRR and CVG (OR =0.89; 95% CI, 0.35-2.24; P=0.80). There is an increasing body of evidence that VSRR can be reliably performed in Marfan patients, resulting in a durable repair with no increased risk of re-operation compared to CVG, thus avoiding the need for systemic anticoagulation in selected patients.

  13. Antegrade versus retrograde cerebral perfusion for hemiarch replacement with deep hypothermic circulatory arrest: does it matter? A propensity-matched analysis.

    Science.gov (United States)

    Ganapathi, Asvin M; Hanna, Jennifer M; Schechter, Matthew A; Englum, Brian R; Castleberry, Anthony W; Gaca, Jeffrey G; Hughes, G Chad

    2014-12-01

    The choice of cerebral perfusion strategy for aortic arch surgery has been debated, and the superiority of antegrade (ACP) or retrograde (RCP) cerebral perfusion has not been shown. We examined the early and late outcomes for ACP versus RCP in proximal (hemi-) arch replacement using deep hypothermic circulatory arrest (DHCA). A retrospective analysis of a prospectively maintained database was performed for all patients undergoing elective and nonelective hemiarch replacement at a single referral institution from June 2005 to February 2013. Total arch cases were excluded to limit the analysis to shorter DHCA times and a more uniform patient population for whom clinical equipoise regarding ACP versus RCP exists. A total of 440 procedures were identified, with 360 (82%) using ACP and 80 (18%) using RCP. The endpoints included 30-day/in-hospital and late outcomes. A propensity score with 1:1 matching of 40 pre- and intraoperative variables was used to adjust for differences between the 2 groups. All 80 RCP patients were propensity matched to a cohort of 80 similar ACP patients. The pre- and intraoperative characteristics were not significantly different between the 2 groups after matching. No differences were found in 30-day/in-hospital mortality or morbidity outcomes. The only significant difference between the 2 groups was a shorter mean operative time in the RCP cohort (P = .01). No significant differences were noted in late survival (P = .90). In proximal arch operations using DHCA, equivalent early and late outcomes can be achieved with RCP and ACP, although the mean operative time is significantly less with RCP, likely owing to avoidance of axillary cannulation. Questions remain regarding comparative outcomes with straight DHCA and lesser degrees of hypothermia. Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  14. Determination of in-depth contamination in concrete using a non-destructive technique

    International Nuclear Information System (INIS)

    Boden, S.; Cantrel, E.

    2007-01-01

    The decommissioning of the BR3 (Belgian Reactor 3) approaches its final phase, in which the building structures are being decontaminated and either denuclearized for possible reuse or demolished. Apart from the presence of naturally occurring radionuclides in building materials, other radionuclides might be present due to activation or contamination. The BR3 bioshield has been exposed to rather high neutron leakage fluxes during the reactor operation and is therefore activated. Building structure contamination usually results from leakages during reactor operation, releases due to maintenance works or even dismantling operations. In case of in-depth contamination in concrete it is important to know the exact in-depth profile before decontamination, in order to minimize the amount of radioactive waste that will be produced during the decontamination process and to optimize both the decontamination process and the final control measurements. Common non-destructive analyses used in decommissioning are usually based on the measurement of beta radiation, using e.g. hand-held plastic scintillators. This kind of measurement technique can not be used to determine in-depth contamination. Therefore, most of the decontamination specialists currently base themselves on the results of the radiological analysis of samples taken by core drilling. The use of such a destructive method implies a number of disadvantages: it is time consuming and therefore costly and the different sample preparation steps can conceivably lead to cross-contamination. Moreover, one only receives results of a limited number of points, while the in-depth contamination is usually very inhomogeneously distributed and the relationship between in-depth contamination and surface contamination and/or dose rate (hotspot detection) is generally rather poor.The objective therefore is to test the use of the ISOCS (In Situ Object Counting System) for the determination of contamination depth

  15. Manual vs. computer-assisted sperm analysis: can CASA replace manual assessment of human semen in clinical practice?

    Science.gov (United States)

    Talarczyk-Desole, Joanna; Berger, Anna; Taszarek-Hauke, Grażyna; Hauke, Jan; Pawelczyk, Leszek; Jedrzejczak, Piotr

    2017-01-01

    The aim of the study was to check the quality of computer-assisted sperm analysis (CASA) system in comparison to the reference manual method as well as standardization of the computer-assisted semen assessment. The study was conducted between January and June 2015 at the Andrology Laboratory of the Division of Infertility and Reproductive Endocrinology, Poznań University of Medical Sciences, Poland. The study group consisted of 230 men who gave sperm samples for the first time in our center as part of an infertility investigation. The samples underwent manual and computer-assisted assessment of concentration, motility and morphology. A total of 184 samples were examined twice: manually, according to the 2010 WHO recommendations, and with CASA, using the program set-tings provided by the manufacturer. Additionally, 46 samples underwent two manual analyses and two computer-assisted analyses. The p-value of p CASA and manually. In the group of patients where all analyses with each method were performed twice on the same sample we found no significant differences between both assessments of the same probe, neither in the samples analyzed manually nor with CASA, although standard deviation was higher in the CASA group. Our results suggest that computer-assisted sperm analysis requires further improvement for a wider application in clinical practice.

  16. Patients' journeys through total joint replacement: patterns of medication use.

    Science.gov (United States)

    Johnson, Emma C; Horwood, Jeremy; Gooberman-Hill, Rachael

    2014-06-01

    Medication is used to manage pain that results from both osteoarthritis and total joint replacement (TJR). Research has provided insight into how people living with osteoarthritis use pain relief medication. However, it is not known whether elective TJR affects existing attitudes and behaviours with regard to pain medications. Using qualitative methods, the present study explored patterns of pain relief use around the time of TJR. In-depth face-to-face qualitative interviews were carried out with 24 patients two to four weeks after they had undergone TJR for hip or knee osteoarthritis. Participants were asked to reflect on their use of pain medication pre-surgery, while in hospital and while recovering from their operation at home. Transcripts of the audio-recorded interviews were imported into Atlas.ti® and thematic analysis was used. Attitudes to pain relief medication and their use are not static. Many participants change their use of pain medication around the time of surgery. This shift was influenced by interactions with health professionals and changing views on the acceptability, necessity and value of pain relief in helping to manage an altered pain experience. Understanding reasons for medication-taking behaviour during the journey through joint replacement may be helpful to health professionals. Health professionals have a fundamental role to play in challenging or reinforcing different treatment beliefs, which is the basis for effective use of pain relief over the pre- to postoperative period. © 2013 John Wiley & Sons, Ltd.

  17. Reinforcing Defence in Depth: A Practical Systemic Approach

    International Nuclear Information System (INIS)

    Watts, G.; Misak, J.

    2016-01-01

    The concept of defence in depth for ensuring nuclear safety of nuclear installations is often oversimplified and interpreted as a set of physical barriers, whose integrity is ensured by safety provisions in the form of the plant systems implemented independently at various levels of defence. However, the provisions established at each level of defence should in general terms include not only hardware components (active and passive systems), but more comprehensively, also inherent safety characteristics, safety margins, operating procedures and guidelines, quality assurance, safety culture, staff training, and many other organizational measures as parts of management of safety. Many of the above mentioned provisions belong to the category of human and organizational factors. While various hardware components are typically specific for different levels of defence, human and organizational factors may have an impact on several levels of defence. These factors are associated with large uncertainties and can result in latent weaknesses. Their implementation can negatively affect several levels of defence at the same time. The proposed paper will underline the need for a more comprehensive view of the defence in depth concept in order to provide a practical and effective tool for a systemic approach to safety. The paper will consist of two main parts. The first part will introduce a screening method developed by the IAEA as a tool for facilitating the assessment of the comprehensiveness of defence in depth. The method uses screening of safety provisions at five levels of defence to ensure integrity of the physical barriers and achievement of safety objectives at each level of defence. The second part of the paper will focus on human and organizational factors considered as provisions for reliable performance of safety functions. It will explain the significant shift in the demands on the human system between levels 3 and 4 of the defence in depth framework, and will

  18. Magnesium replacement in formaldehyde: Theoretical rovibrational analysis of X ∼ 3B1 MgCH2

    Science.gov (United States)

    Bassett, Matthew K.; Fortenberry, Ryan C.

    2018-02-01

    A full, anharmonic set of fundamental vibrational frequencies as well as spectrosocpic constants are provided at high-level for X ∼ 3B1 MgCH2 for the first time. The present data are in line with previous computational and Ar-matrix results, but the anharmonic data show that two brightest frequencies, ν4 and ν5 , are nearly coincident with one another at 560 cm-1. Hence, this area is the best spectral region to search for signatures of this molecule. The rotational constants are also provided indicating a near-prolate rotational progression which should aid in microwave/millimeter-wave analysis of this molecule. Magnesium is known to be a significant component of the Earth, and molecules containing it may be more common in the interstellar medium/circumstellar media than previously thought. More spectral characterization of such molecules like MgCH2 should be undertaken, and this work is a step in that direction.

  19. Prioritization methodology for chemical replacement

    Science.gov (United States)

    Cruit, Wendy; Goldberg, Ben; Schutzenhofer, Scott

    1995-01-01

    to be quantitatively compared in several categories, and a QFD matrix which allows process/chemical pairs to be rated against one another for importance (using consistent categories). Depending on the need for application, one can choose the part(s) needed or have the methodology completed in its entirety. For example, if a program needs to show the risk of changing a process/chemical one may choose to use part of Matrix A and Matrix C. If a chemical is being used, and the process must be changed; one might use the Process Concerns part of Matrix D for the existing process and all possible replacement processes. If an overall analysis of a program is needed, one may request the QFD to be completed.

  20. Radiation Source Replacement Workshop

    Energy Technology Data Exchange (ETDEWEB)

    Griffin, Jeffrey W.; Moran, Traci L.; Bond, Leonard J.

    2010-12-01

    This report summarizes a Radiation Source Replacement Workshop in Houston Texas on October 27-28, 2010, which provided a forum for industry and researchers to exchange information and to discuss the issues relating to replacement of AmBe, and potentially other isotope sources used in well logging.

  1. Dual energy X-ray absorptiometry analysis of peri-prosthetic stress shielding in the Birmingham resurfacing hip replacement.

    LENUS (Irish Health Repository)

    Harty, J A

    2012-02-03

    INTRODUCTION: Numerous reports in the literature refer to the femoral neck fracture rate in hip resurfacing. The aim of this study was to determine the bone mineral density and evidence of stress shielding around the femoral component of the Birmingham resurfacing prosthesis. MATERIAL AND METHODS: Twenty-eight patients with primary unilateral osteoarthritis had a Birmingham resurfacing prosthesis. DEXA analysis of the proximal femur and femoral neck was performed and compared with the opposite unaffected side. RESULTS: Total periprosthetic bone mineral density was 0.49% greater than the control, but this did not achieve statistical significance. Although the BMD of the femoral neck was slightly increased on the prosthetic side (1.002 g\\/cm2) as opposed to the control side, this difference did not reach statistical significance. CONCLUSION: The Birmingham resurfacing prosthesis does not appear to reduce femoral neck bone mineral density in comparison to the normal femoral neck bone density. We conclude that femoral neck fractures are unlikely to be due to stress shielding related to the prosthesis.

  2. Intravenous versus topical tranexamic acid in primary total hip replacement: A systemic review and meta-analysis.

    Science.gov (United States)

    Sun, Xiang; Dong, Qiang; Zhang, Yin-Guang

    2016-08-01

    Total hip arthroplasty (THA) is associated with substantial blood loss. Tranexamic acid (TXA) could reduce perioperative blood loss. The optimal administration routine of TXA remains controversial. The objective of the present systemic review and meta-analysis was to compare the effectiveness and safety of various application methods of tranexamic acid in primary THA. Potential relevant literature was identified from electronic databases including Medline, PubMed, Embase, ScienceDirect, web of science and Cochrane Library. Grey academic studies were also identified from the references of the included literature. There was no language restriction. The pooling of data was carried out by using RevMan 5.1. Three randomized controlled trials (RCTs) and two non-RCTs involving 1614 patients met the inclusion criteria. Current meta-analysis indicated that there were no significant differences in terms of total blood loss (MD = -30.04, 95% CI: -114.67 to 54.59, P = 0.49), postoperative hemoglobin level (MD = -0.29, 95% CI: -0.68 to 0.10, P = 0.14), transfusion rate (RD = -0.02, 95% CI: -0.5 to -0.00, P = 0.09), length of stay ((MD = -0.14, 95% CI: -0.30 to 0.01, P = 0.07) or operation time ((MD = 1.00, 95% CI: -0.31 to 2.31, P = 0.14) between treatment groups. No significant differences were found regarding the incidence of adverse effects such as wound infection (RD = -0.01, 95% CI: -0.06 to 0.04, P = 0.66), myocardial infarction (MI) (RD = -0.01, 95% CI: -0.04 to 0.02, P = 0.61), deep venous thrombosis (DVT) (RD = 0.00, 95% CI: -0.01 to 0.01, P = 0.51) or pulmonary embolism (PE) (RD = RD = 0.00, 95% CI: -0.01 to 0.01, P = 0.63) between groups. The topical administration of TXA in THA carried similar hemostasis effects compared with intravenous use without an increased risk of thrombotic complications. No other adverse effect was identified. Topical TXA application was a simple, safe, effective and cost-effective adjunct for

  3. A novel multidimensional protein identification technology approach combining protein size exclusion prefractionation, peptide zwitterion-ion hydrophilic interaction chromatography, and nano-ultraperformance RP chromatography/nESI-MS2 for the in-depth analysis of the serum proteome and phosphoproteome: application to clinical sera derived from humans with benign prostate hyperplasia.

    Science.gov (United States)

    Garbis, Spiros D; Roumeliotis, Theodoros I; Tyritzis, Stavros I; Zorpas, Kostas M; Pavlakis, Kitty; Constantinides, Constantinos A

    2011-02-01

    The current proof-of-principle study was aimed toward development of a novel multidimensional protein identification technology (MudPIT) approach for the in-depth proteome analysis of human serum derived from patients with benign prostate hyperplasia (BPH) using rational chromatographic design principles. This study constituted an extension of our published work relating to the identification and relative quantification of potential clinical biomarkers in BPH and prostate cancer (PCa) tissue specimens. The proposed MudPIT approach encompassed the use of three distinct yet complementary liquid chromatographic chemistries. High-pressure size-exclusion chromatography (SEC) was used for the prefractionation of serum proteins followed by their dialysis exchange and solution phase trypsin proteolysis. The tryptic peptides were then subjected to offline zwitterion-ion hydrophilic interaction chromatography (ZIC-HILIC) fractionation followed by their online analysis with reversed-phase nano-ultraperformance chromatography (RP-nUPLC) hyphenated to nanoelectrospray ionization-tandem mass spectrometry using an ion trap mass analyzer. For the spectral processing, the sequential use of the SpectrumMill, Scaffold, and InsPecT software tools was applied for the tryptic peptide product ion MS(2) spectral processing, false discovery rate (FDR) assessment, validation, and protein identification. This milestone serum analysis study allowed the confident identification of over 1955 proteins (p ≤ 0.05; FDR ≤ 5%) with a broad spectrum of biological and physicochemical properties including secreted, tissue-specific proteins spanning approximately 12 orders of magnitude as they occur in their native abundance levels in the serum matrix. Also encompassed in this proteome was the confident identification of 375 phosphoproteins (p ≤ 0.05; FDR ≤ 5%) with potential importance to cancer biology. To demonstrate the performance characteristics of this novel MudPIT approach, a comparison

  4. A defence in depth approach to safety assessment of existing nuclear power plant

    International Nuclear Information System (INIS)

    Butcher, P.; Holloway, N.J.

    1998-01-01

    The safety assessment of plant built to earlier standards requires an approach to prioritisation of upgrades that is based on sound engineering and safety principles. The principles of defence in depth are universally accepted and can form the basis of a prioritisation scheme for safety issues, and hence for the upgrading required to address them. The described scheme includes criteria for acceptability and issue prioritisation that are based on the number of lines of defence and the consequences of their failure. They are thus equivalent in concept to risk criteria, but are based on deterministic principles. This scheme has been applied successfully to the RBMK plant at Ignalina in Lithuania, for which a Western-style Safety Analysis Report has recently been produced and reviewed by joint Western and Eastern teams. An extended Safety Improvement Programme (SIP2) has been developed and agreed, based on prioritisations from the defence in depth assessment. (author)

  5. Data for in-depth characterisation of the lamb meat proteome from longissimus lumborum

    Directory of Open Access Journals (Sweden)

    Tzer-Yang Yu

    2015-06-01

    Full Text Available This Data article provides Supplementary data related to the research article titled “In-depth characterisation of the lamb meat proteome from longissimus lumborum” by Yu et al. [1]. This research article reports the proteome catalogue of the 48 h post-mortem lamb longissimus lumborum. A list of 388 ovine-specific proteins were identified and characterised after separating the samples into sarcoplasmic, myofibrillar and insoluble fractions, followed by an in-depth shotgun proteomic evaluation and bioinformatic analysis. The detailed list of identified proteins, the annotated MS/MS spectra corresponding to the proteins identified by a single peptide-spectrum match, the raw Gene Ontology annotation data and other miscellaneous files, as will be described below, were contained in this Data article. We hope the data presented here will contribute to the current knowledge of the global protein composition of lamb skeletal muscle/meat.

  6. A useful framework for optimal replacement models

    International Nuclear Information System (INIS)

    Aven, Terje; Dekker, Rommert

    1997-01-01

    In this note we present a general framework for optimization of replacement times. It covers a number of models, including various age and block replacement models, and allows a uniform analysis for all these models. A relation to the marginal cost concept is described

  7. Venous thrombo-embolism (VTE prevention of patients undergoing total hip and knee replacement: budget impact analysis of apixaban in Italy

    Directory of Open Access Journals (Sweden)

    Lorenzo Giovanni Mantovani

    2013-09-01

    Full Text Available BACKGROUND: Venous thromboembolism (VTE is a common and burdensome cardiovascular condition, frequently leading to severe complications and requiring high-cost healthcare interventions. New oral anticoagulants (nOACs have demonstrated to be efficacious and safe in VTE prevention of patients undergoing total hip replacement (THR and total knee replacement (TKR, a condition that is typically associated to cardiovascular disease. The Italian Healthcare Service (SSN has recently approved the latest nOAC, apixaban. The present article aims to evaluate its economic impact in the perspective of the Italian SSN.METHODS: We conducted a budget impact analysis to estimate clinical outcomes and economic consequences associated to the reimbursement of apixaban, in the prevention of VTE as a consequence of major orthopedic surgery, over a three-year time horizon. In our analysis we compared two alternative scenarios, with apixaban either reimbursed (Scenario B or not reimbursed (Scenario A by the Italian SSN, and estimated the difference of healthcare costs between the two scenarios. Only direct healthcare costs have been considered.RESULTS: According to market assumptions, it is estimated that 1.2%, 3.7%, and 6.5% of THR patients, and 1.2%, 3.8% and 6.7% of TKR patients, would be treated with apixaban over the first three years since launch. At the estimated daily cost of apixaban (€2.48/die, this would translate into a budget impact of €14.3 mln, €45.5 mln, and €81.4 mln at years 1, 2 and 3 since launch, respectively. This expenditure would be more than offset by savings, due to: i reduction of prescriptions of alternative treatment options (other nOACs, low-molecular weight heparins, fondaparinux; ii reduction of the economic burden attributable of CV complications of VTE. Finally, Scenario B resulted slightly favourable compared to Scenario A, leading to economic savings for about €50 thousands over three years. Sensitivity analyses confirmed

  8. Could wind replace nuclear?

    International Nuclear Information System (INIS)

    2017-01-01

    This article aims at assessing the situation produced by a total replacement of nuclear energy by wind energy, while facing consumption demand at any moment, notably in December. The authors indicate the evolution of the French energy mix during December 2016, and the evolution of the rate between wind energy production and the sum of nuclear and wind energy production during the same month, and then give briefly some elements regarding necessary investments in wind energy to wholly replace nuclear energy. According to them, such a replacement would be ruinous

  9. Three-dimensional thoracic aorta principal strain analysis from routine ECG-gated computerized tomography: feasibility in patients undergoing transcatheter aortic valve replacement.

    Science.gov (United States)

    Satriano, Alessandro; Guenther, Zachary; White, James A; Merchant, Naeem; Di Martino, Elena S; Al-Qoofi, Faisal; Lydell, Carmen P; Fine, Nowell M

    2018-05-02

    Functional impairment of the aorta is a recognized complication of aortic and aortic valve disease. Aortic strain measurement provides effective quantification of mechanical aortic function, and 3-dimenional (3D) approaches may be desirable for serial evaluation. Computerized tomographic angiography (CTA) is routinely performed for various clinical indications, and offers the unique potential to study 3D aortic deformation. We sought to investigate the feasibility of performing 3D aortic strain analysis in a candidate population of patients undergoing transcatheter aortic valve replacement (TAVR). Twenty-one patients with severe aortic valve stenosis (AS) referred for TAVR underwent ECG-gated CTA and echocardiography. CTA images were analyzed using a 3D feature-tracking based technique to construct a dynamic aortic mesh model to perform peak principal strain amplitude (PPSA) analysis. Segmental strain values were correlated against clinical, hemodynamic and echocardiographic variables. Reproducibility analysis was performed. The mean patient age was 81±6 years. Mean left ventricular ejection fraction was 52±14%, aortic valve area (AVA) 0.6±0.3 cm 2 and mean AS pressure gradient (MG) 44±11 mmHg. CTA-based 3D PPSA analysis was feasible in all subjects. Mean PPSA values for the global thoracic aorta, ascending aorta, aortic arch and descending aorta segments were 6.5±3.0, 10.2±6.0, 6.1±2.9 and 3.3±1.7%, respectively. 3D PSSA values demonstrated significantly more impairment with measures of worsening AS severity, including AVA and MG for the global thoracic aorta and ascending segment (panalysis is clinically feasible from routine ECG-gated CTA. Appropriate reductions in PSSA were identified with increasing AS hemodynamic severity. Expanded study of 3D aortic PSSA for patients with various forms of aortic disease is warranted.

  10. Impaired Velocity Processing Reveals an Agnosia for Motion in Depth.

    Science.gov (United States)

    Barendregt, Martijn; Dumoulin, Serge O; Rokers, Bas

    2016-11-01

    Many individuals with normal visual acuity are unable to discriminate the direction of 3-D motion in a portion of their visual field, a deficit previously referred to as a stereomotion scotoma. The origin of this visual deficit has remained unclear. We hypothesized that the impairment is due to a failure in the processing of one of the two binocular cues to motion in depth: changes in binocular disparity over time or interocular velocity differences. We isolated the contributions of these two cues and found that sensitivity to interocular velocity differences, but not changes in binocular disparity, varied systematically with observers' ability to judge motion direction. We therefore conclude that the inability to interpret motion in depth is due to a failure in the neural mechanisms that combine velocity signals from the two eyes. Given these results, we argue that the deficit should be considered a prevalent but previously unrecognized agnosia specific to the perception of visual motion. © The Author(s) 2016.

  11. Defence in depth by 'Leittechnique' systems with graded intelligence

    International Nuclear Information System (INIS)

    Aleite, W.

    1983-01-01

    In the past, only two types of nuclear power plant instrumentation and control systems were in use in the Federal Republic of Germany (FRG): safety systems and operational systems. Present nuclear power plant 'Leittechnique' systems in the FRG have been expanded from this 'black-and-white' status to multiple-grade systems with respect to safety, qualification requirements and intelligence. The extensive experience of the past has encouraged the rule-making committees - representing all parties working in the nuclear field - to differentiate between the protection limitations and condition limitations of the reactor protection system on one hand and the information systems (including the accident monitoring and alarm system) of different safety importance on the other, assuming additional extensive application of non-safety-grade operational Leittechnique systems. These definitions of categories are in accordance with international practice and enable designers to apply 'echelons of defence', composed of equipment of all categories, in accordance with 'defence-in-depth' concepts. They also simplify the introduction of computerized equipment, especially in the lower safety categories. Status, background and reasons of the introduction, as well as typical defence-in-depth modes, of the first running Leittechnique system of this kind (in the Grafenrheinfeld nuclear power plant) and especially their different tasks in disturbance handling are described. The international situation and future developments are briefly characterized. (author)

  12. Slab replacement maturity guidelines.

    Science.gov (United States)

    2014-04-01

    This study investigated the use of maturity method to determine early age strength of concrete in slab : replacement application. Specific objectives were (1) to evaluate effects of various factors on the compressive : maturity-strength relationship ...

  13. Partial knee replacement

    Science.gov (United States)

    ... good range of motion in your knee. The ligaments in your knee are stable. However, most people with knee arthritis have a surgery called a total knee arthroplasty (TKA). Knee replacement is most often done in people age 60 ...

  14. Carbohydrates as Fat Replacers.

    Science.gov (United States)

    Peng, Xingyun; Yao, Yuan

    2017-02-28

    The overconsumption of dietary fat contributes to various chronic diseases, which encourages attempts to develop and consume low-fat foods. Simple fat reduction causes quality losses that impede the acceptance of foods. Fat replacers are utilized to minimize the quality deterioration after fat reduction or removal to achieve low-calorie, low-fat claims. In this review, the forms of fats and their functions in contributing to food textural and sensory qualities are discussed in various food systems. The connections between fat reduction and quality loss are described in order to clarify the rationales of fat replacement. Carbohydrate fat replacers usually have low calorie density and provide gelling, thickening, stabilizing, and other texture-modifying properties. In this review, carbohydrates, including starches, maltodextrins, polydextrose, gums, and fibers, are discussed with regard to their interactions with other components in foods as well as their performances as fat replacers in various systems.

  15. Hip joint replacement - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100006.htm Hip joint replacement - series—Normal anatomy To use the ... to slide 5 out of 5 Overview The hip joint is made up of two major parts: ...

  16. Tool Inventory and Replacement

    Science.gov (United States)

    Bear, W. Forrest

    1976-01-01

    Vocational agriculture teachers are encouraged to evaluate curriculum offerings, the new trends in business and industry, and develop a master tool purchase and replacement plan over a 3- to 5-year period. (HD)

  17. Knee joint replacement

    Science.gov (United States)

    ... to make everyday tasks easier. Practice using a cane, walker , crutches , or a wheelchair correctly. On the ... ask your doctor Knee joint replacement - discharge Preventing falls Preventing falls - what to ask your doctor Surgical ...

  18. Product Platform Replacements

    DEFF Research Database (Denmark)

    Sköld, Martin; Karlsson, Christer

    2012-01-01

    . To shed light on this unexplored and growing managerial concern, the purpose of this explorative study is to identify operational challenges to management when product platforms are replaced. Design/methodology/approach – The study uses a longitudinal field-study approach. Two companies, Gamma and Omega...... replacement was chosen in each company. Findings – The study shows that platform replacements primarily challenge managers' existing knowledge about platform architectures. A distinction can be made between “width” and “height” in platform replacements, and it is crucial that managers observe this in order...... to challenge their existing knowledge about platform architectures. Issues on technologies, architectures, components and processes as well as on segments, applications and functions are identified. Practical implications – Practical implications are summarized and discussed in relation to a framework...

  19. Efficacy and safety of transcatheter aortic valve replacement in aortic stenosis patients at low to moderate surgical risk: a comprehensive meta-analysis.

    Science.gov (United States)

    Elmaraezy, Ahmed; Ismail, Ammar; Abushouk, Abdelrahman Ibrahim; Eltoomy, Moutaz; Saad, Soha; Negida, Ahmed; Abdelaty, Osama Mahmoud; Abdallah, Ahmed Ramadan; Aboelfotoh, Ahmed Magdy; Hassan, Hossam Mahmoud; Elmaraezy, Aya Gamal; Morsi, Mahmoud; Althaher, Farah; Althaher, Moath; AlSafadi, Ammar M

    2017-08-24

    Recently, transcatheter aortic valve replacement (TAVR) has become the procedure of choice in high surgical risk patients with aortic stenosis (AS). However, its value is still debated in operable AS cases. We performed this meta-analysis to compare the safety and efficacy of TAVR to surgical aortic valve replacement (SAVR) in low-to-moderate surgical risk patients with AS. A systematic search of five authentic databases retrieved 11 eligible studies (20,056 patients). Relevant Data were pooled as risk ratios (RRs) or standardized mean differences (SMD), with their 95% confidence interval, using Comprehensive Meta-Analysis and RevMan software for windows. At one-year of follow-up, the pooled effect-estimates showed no significant difference between TAVR and SAVR groups in terms of all-cause mortality (RR 1.02, 95% CI [0.83, 1.26], stroke (RR 0.83, 95%CI [0.56, 1.21]), myocardial infarction (RR 0.82, 95% CI [0.57, 1.19]), and length of hospital stay (SMD -0.04, 95% CI [-0.34, 0.26]). The incidence of major bleeding (RR 0.45, 95% CI [0.24, 0.86]) and acute kidney injury (RR 0.52, 95% CI [0.30, 0.88]) was significantly lower in the TAVR group, compared to the SAVR group. However, TAVR was associated with a higher risk of permanent pacemaker implantation (RR 2.57, 95% CI [1.36, 4.86]), vascular-access complications at 1 year (RR 1.99, 95%CI [1.04, 3.80]), and paravalvular aortic regurgitation at 30 days (RR 3.90, 95% CI [1.25, 12.12]), compared to SAVR. Due to the comparable mortality rates in SAVR and TAVR groups and the lower risk of life-threatening complications in the TAVR group, TAVR can be an acceptable alternative to SAVR in low-to-moderate risk patients with AS. However, larger trials with longer follow-up periods are required to compare the long-term outcomes of both techniques.

  20. The replacement research reactor

    International Nuclear Information System (INIS)

    Cameron, R.

    1999-01-01

    As a consequences of the government decision in September 1997. ANSTO established a replacement research reactor project to manage the procurement of the replacement reactor through the necessary approval, tendering and contract management stages This paper provides an update of the status of the project including the completion of the Environmental Impact Statement. Prequalification and Public Works Committee processes. The aims of the project, management organisation, reactor type and expected capabilities are also described

  1. Reinforcement of Defence-in-Depth: Modification Practice After the Fukushima Nuclear Accident

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Y.; Tang, H.; Mao, Q., E-mail: wangyuhong@cgnpc.com.cn [China Nuclear Power Design Co., Ltd Xia Meilin, Futian District, Shenzhen, Guangdong Province (China)

    2014-10-15

    The Fukushima Daiichi nuclear accident revealed the importance and demand for further reinforcement of defence in- depth. CGN (China General Nuclear Power Group) has made a complete safety assessment on CPR1000 nuclear power plants under construction in China. Dozens of modifications have been implemented based on the assessment findings and lessons learned from Fukushima nuclear accident, taking into account of PSA (Probabilistic Safety Analysis) and comparison analysis of the latest regulations and standards. These modifications help to enhance nuclear safety significantly for nuclear power plants under construction in China, and provide helpful modification guidance for nuclear power plants in operation of the same type. (author)

  2. Metabolic effects of testosterone replacement therapy on hypogonadal men with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Xiang Cai

    2014-02-01

    Full Text Available This systematic review was aimed at assessing the metabolic effects of testosterone replacement therapy (TRT on hypogonadal men with type 2 diabetes mellitus (T2DM. A literature search was performed using the Cochrane Library, EMBASE and PubMed. Only randomized controlled trials (RCTs were included in the meta-analysis. Two reviewers retrieved articles and evaluated the study quality using an appropriate scoring method. Outcomes including glucose metabolism, lipid parameters, body fat and blood pressure were pooled using a random effects model and tested for heterogeneity. We used the Cochrane Collaboration's Review Manager 5.2 software for statistical analysis. Five RCTs including 351 participants with a mean follow-up time of 6.5-months were identified that strictly met our eligibility criteria. A meta-analysis of the extractable data showed that testosterone reduced fasting plasma glucose levels (mean difference (MD: −1.10; 95% confidence interval (CI (−1.88, −0.31, fasting serum insulin levels (MD: −2.73; 95% CI (−3.62, −1.84, HbA1c % (MD: −0.87; 95% CI (−1.32, −0.42 and triglyceride levels (MD: −0.35; 95% CI (−0.62, −0.07. The testosterone and control groups demonstrated no significant difference for other outcomes. In conclusion, we found that TRT can improve glycemic control and decrease triglyceride levels of hypogonadal men with T2DM. Considering the limited number of participants and the confounding factors in our systematic review; additional large, well-designed RCTs are needed to address the metabolic effects of TRT and its long-term influence on hypogonadal men with T2DM.

  3. Early assessment of the likely cost-effectiveness of a new technology: A Markov model with probabilistic sensitivity analysis of computer-assisted total knee replacement.

    Science.gov (United States)

    Dong, Hengjin; Buxton, Martin

    2006-01-01

    The objective of this study is to apply a Markov model to compare cost-effectiveness of total knee replacement (TKR) using computer-assisted surgery (CAS) with that of TKR using a conventional manual method in the absence of formal clinical trial evidence. A structured search was carried out to identify evidence relating to the clinical outcome, cost, and effectiveness of TKR. Nine Markov states were identified based on the progress of the disease after TKR. Effectiveness was expressed by quality-adjusted life years (QALYs). The simulation was carried out initially for 120 cycles of a month each, starting with 1,000 TKRs. A discount rate of 3.5 percent was used for both cost and effectiveness in the incremental cost-effectiveness analysis. Then, a probabilistic sensitivity analysis was carried out using a Monte Carlo approach with 10,000 iterations. Computer-assisted TKR was a long-term cost-effective technology, but the QALYs gained were small. After the first 2 years, the incremental cost per QALY of computer-assisted TKR was dominant because of cheaper and more QALYs. The incremental cost-effectiveness ratio (ICER) was sensitive to the "effect of CAS," to the CAS extra cost, and to the utility of the state "Normal health after primary TKR," but it was not sensitive to utilities of other Markov states. Both probabilistic and deterministic analyses produced similar cumulative serious or minor complication rates and complex or simple revision rates. They also produced similar ICERs. Compared with conventional TKR, computer-assisted TKR is a cost-saving technology in the long-term and may offer small additional QALYs. The "effect of CAS" is to reduce revision rates and complications through more accurate and precise alignment, and although the conclusions from the model, even when allowing for a full probabilistic analysis of uncertainty, are clear, the "effect of CAS" on the rate of revisions awaits long-term clinical evidence.

  4. Comparison of survival analysis and palliative care involvement in patients aged over 70 years choosing conservative management or renal replacement therapy in advanced chronic kidney disease.

    Science.gov (United States)

    Hussain, Jamilla A; Mooney, Andrew; Russon, Lynne

    2013-10-01

    There are limited data on the outcomes of elderly patients with chronic kidney disease undergoing renal replacement therapy or conservative management. We aimed to compare survival, hospital admissions and palliative care access of patients aged over 70 years with chronic kidney disease stage 5 according to whether they chose renal replacement therapy or conservative management. Retrospective observational study. Patients aged over 70 years attending pre-dialysis clinic. In total, 172 patients chose conservative management and 269 chose renal replacement therapy. The renal replacement therapy group survived for longer when survival was taken from the time estimated glomerular filtration rate management, in patients older than 80 years or with a World Health Organization performance score of 3 or more. There was also a significant reduction in the effect of renal replacement therapy on survival in patients with high Charlson's Comorbidity Index scores. The relative risk of an acute hospital admission (renal replacement therapy vs conservative management) was 1.6 (p management patients died in hospital, compared to 69% undergoing renal replacement therapy (Renal Registry data). Seventy-six percent of the conservative management group accessed community palliative care services compared to 0% of renal replacement therapy patients. For patients aged over 80 years, with a poor performance status or high co-morbidity scores, the survival advantage of renal replacement therapy over conservative management was lost at all levels of disease severity. Those accessing a conservative management pathway had greater access to palliative care services and were less likely to be admitted to or die in hospital.

  5. Impact of patient-prosthesis mismatch following aortic valve replacement on short-term survival: a retrospective single center analysis of 632 consecutive patients with isolated stented biological aortic valve replacement.

    Science.gov (United States)

    Hoffmann, Grischa; Ogbamicael, Selam Abraham; Jochens, Arne; Frank, Derk; Lutter, Georg; Cremer, Jochen; Petzina, Rainer

    2014-09-01

    The impact of patient-prosthesis mismatch (PPM) after aortic valve replacement (AVR) on short-term and long-term mortality remains controversial. The objective of this study was to evaluate the incidence and severity of PPM and its impact on short-term survival in a large cohort of patients treated with isolated stented biological AVR in a single institution. We analyzed retrospectively data of 632 consecutive patients with aortic stenosis undergoing isolated stented biological AVR between January 2007 and February 2012 at our institution. PPM was defined as an indexed effective orifice area ≤ 0.85 cm(2)/m(2). Statistical analyses were performed to identify influencing variables on valve size implanted. Of the 632 patients investigated, 46% were females and mean age was 71.9 ± 10.4 years. PPM was observed in 93.8% (593 of 632 patients). In 71% of the patients, moderate (0.65-0.85 cm(2)/m(2)) PPM was present and in 22.8% severe (body mass index, and body surface area as simultaneous predictors of the valve size implanted (R(2)= 0.39). PPM had no discernable impact on short-term survival, although it was present in 93.8% of our patients following isolated stented biological AVR. Georg Thieme Verlag KG Stuttgart · New York.

  6. A meta-analysis and meta-regression of long-term outcomes of transcatheter versus surgical aortic valve replacement for severe aortic stenosis.

    Science.gov (United States)

    Villablanca, Pedro A; Mathew, Verghese; Thourani, Vinod H; Rodés-Cabau, Josep; Bangalore, Sripal; Makkiya, Mohammed; Vlismas, Peter; Briceno, David F; Slovut, David P; Taub, Cynthia C; McCarthy, Patrick M; Augoustides, John G; Ramakrishna, Harish

    2016-12-15

    Transcatheter aortic valve replacement (TAVR) has emerged as an alternative to surgical aortic-valve replacement (SAVR) for patients with severe symptomatic aortic stenosis (AS) who are at high operative risk. We sought to determine the long-term (≥1year follow-up) safety and efficacy TAVR compared with SAVR in patients with severe AS. A comprehensive search of PubMed, EMBASE, Cochrane Central Register of Controlled Trials, conference proceedings, and relevant Web sites from inception through 10 April 2016. Fifty studies enrolling 44,247 patients met the inclusion criteria. The mean duration follow-up was 21.4months. No difference was found in long-term all-cause mortality (risk ratios (RR), 1.06; 95% confidence interval (CI) 0.91-1.22). There was a significant difference favoring TAVR in the incidence of stroke (RR, 0.82; 95% CI 0.71-0.94), atrial fibrillation (RR, 0.43; 95% CI 0.33-0.54), acute kidney injury (RR, 0.70; 95% CI 0.53-0.92), and major bleeding (RR, 0.57; 95% CI 0.40-0.81). TAVR had significant higher incidence of vascular complications (RR, 2.90; 95% CI 1.87-4.49), aortic regurgitation (RR, 7.00; 95% CI 5.27-9.30), and pacemaker implantation (PPM) (RR, 2.02; 95% CI 1.51-2.68). TAVR demonstrated significantly lower stroke risk compared to SAVR in high-risk patients (RR, 1.49; 95% CI 1.06-2.10); no differences in PPM implantation were observed in intermediate-risk patients (RR, 1.68; 95% CI 0.94-3.00). In a meta-regression analysis, the effect of TAVR baseline clinical features did not affect the long-term all-cause mortality outcome. TAVR and SAVR showed similar long-term survival in patients with severe AS; with important differences in treatment-associated morbidity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. The impact of TV mass media campaigns on calls to a National Quitline and the use of prescribed nicotine replacement therapy: a structural vector autoregression analysis.

    Science.gov (United States)

    Haghpanahan, Houra; Mackay, Daniel F; Pell, Jill P; Bell, David; Langley, Tessa; Haw, Sally

    2017-07-01

    To estimate (1) the immediate impact; (2) the cumulative impact; and (3) the duration of impact of Scottish tobacco control TV mass media campaigns (MMCs) on smoking cessation activity, as measured by calls to Smokeline and the volume of prescribed nicotine replacement therapy (NRT). Multivariate time-series analysis using secondary data on population level measures of exposure to TV MMCs broadcast and smoking cessation activity between 2003 and 2012. Population of Scotland. Adult television viewer ratings (TVRs) as a measure of exposure to Scottish mass media campaigns in the adult population; monthly calls to NHS Smokeline; and the monthly volume of prescribed NRT as measured by gross ingredient costs (GIC). Tobacco control TVRs were associated with an increase in calls to Smokeline but not an increase in the volume of prescribed NRT. A 1 standard deviation (SD) increase of 194 tobacco control TVRs led to an immediate and significant increase of 385.9 [95% confidence interval (CI) = 171.0, 600.7] calls to Smokeline (unadjusted model) within 1 month. When adjusted for seasonality the impact was reduced, but the increase in calls remained significant (226.3 calls, 95% CI = 37.3, 415.3). The cumulative impact on Smokeline calls remained significant for 6 months after broadcast in the unadjusted model and 18 months in the adjusted model. However, an increase in tobacco control TVRs of 194 failed to have a significant impact on the GIC of prescribed NRT in either the unadjusted (£1361.4, 95% CI = -£9138.0, £11860.9) or adjusted (£6297.1, 95% CI = -£2587.8, £15182.1) models. Tobacco control television mass media campaigns broadcast in Scotland between 2003 and 2012 were effective in triggering calls to Smokeline, but did not increase significantly the use of prescribed nicotine replacement therapy by adult smokers. The impact on calls to Smokeline occurred immediately within 1 month of broadcast and was sustained for at least 6 months. © 2017 The

  8. In-depth survey report of Scoular Elevator, Salina, Kansas

    Energy Technology Data Exchange (ETDEWEB)

    Zaebst, D.D.

    1987-06-01

    An in/depth industrial hygiene survey of exposures to phosphine during the use of aluminum phosphide was conducted as part of a survey on exposure to grain fumigants. Area monitoring and breathing-zone sampling for phosphine were conducted during the addition of aluminum phosphide to grain during turning operations; source samples and peak personal exposures were also analyzed. Major sources of personal exposure included the escape of air from the bin headspace during filling with treated grain, filling and emptying of the phosphide pellet dispenser, and infiltration from the treated grain bin and from the pellet dispenser itself into adjacent air space. Relatively good dust control was indicated by the total dust samples collected during the survey. Measures recommended by the author are in the report.

  9. In-depth Cultural Studies in Multicultural Group

    Directory of Open Access Journals (Sweden)

    Siliņa-Jasjukeviča Gunta

    2016-12-01

    Full Text Available There is much research and educational practices at all levels of education on how to deal with promoting acceptance and understanding between different cultures. A cultural study forms an important part of shaping intercultural understanding. The aim of the research is to analyze an innovative way of incorporating cultural studies in teacher education program from the perspective of encouraging multinational students to reveal common values within diverse manifestations of different cultures. The present article describes a qualitative study of multinational students’ experiences in international project related to the learning about Nordic and Baltic cultural traditions. In the conclusion of the article, the efficiency of the structure of content and the process of in-depth cultural studies are analyzed. The discussion contains problems for further research of this topic.

  10. Defence-in-depth concept for the EU-ABWR

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Hiroshi; Fuchs, Steffen; Takada, Toshiaki; Kataoka, Kazuyoshi [Toshiba International Limited (Japan)

    2013-07-01

    The current defence-in-depth (DiD) concept has been established by the Reactor Harmonization Working Group (RHWG) of Western European Nuclear Regulators Association (WENRA). Principally the DiD concept was already part of the very early power reactor designs. However, additional considerations have been done in order to take plant conditions into account which are beyond the original design basis. The most recent advancements have been done based on major lessons learned from the Fukushima Dai-Ichi accident. Especially for new nuclear reactors it has to be demonstrated that DiD aspects have been considered in their design. Currently Toshiba is adapting its Advanced Boiling Water Reactor (ABWR) for the European market, at first in Finland. This presentation aims to describe how the new DiD concept has been applied to achieve the safety goals for a modern reactor type and to ensure a design that can be licensed in Western Europe. (orig.)

  11. Utility of Volume Assessment Using Bioelectrical Impedance Analysis in Critically Ill Patients Receiving Continuous Renal Replacement Therapy: A Prospective Observational Study

    Directory of Open Access Journals (Sweden)

    Ki Hyun Park

    2017-08-01

    Full Text Available Background Fluid overload prior to continuous renal replacement therapy (CRRT is an important prognostic factor. Thus, precise evaluation of fluid status is necessary to treat such patients. In this study, we investigated whether fluid assessment using bioelectrical impedance analysis (BIA can predict outcomes in critically ill patients requiring CRRT. Methods A prospective observational study was performed in patients who were admitted to the intensive care unit and who required CRRT. BIA was conducted before CRRT; then, the ratio of extracellular water to total body water (ECW/TBW was derived to estimate volume status. Results A total of 31 patients treated with CRRT were included. There were 18 men (58.1%, and the median age was 67 years (interquartile range, 51 to 78 years. Fourteen patients (45.2% died within 28 days after CRRT initiation. Patients were divided into 16 with ECW/TBW ≥0.41 and 15 with ECW/TBW <0.41. Survival rate within 28 days was different between the two groups (P = 0.044. Cox regression analysis revealed a relationship between ECW/TBW ≥0.41 and 28-day mortality, but it was not statistically significant (hazard ratio, 3.0; 95% confidence interval, 0.9 to 9.8; P = 0.061. Lastly, the area under the curve of ECW/TBW for 28-day mortality was analyzed. The area under the curve of ECW/TBW was 0.73 (95% confidence interval, 0.54 to 0.92, and this was significant (P = 0.037. Conclusions Fluid status can be assessed using BIA in critically ill patients requiring CRRT, and BIA can predict mortality. Further large trials are needed to confirm the usefulness of BIA in critically ill patients.

  12. Pulmonary valve replacement after operative repair of tetralogy of Fallot: meta-analysis and meta-regression of 3,118 patients from 48 studies.

    Science.gov (United States)

    Ferraz Cavalcanti, Paulo Ernando; Sá, Michel Pompeu Barros Oliveira; Santos, Cecília Andrade; Esmeraldo, Isaac Melo; de Escobar, Rodrigo Renda; de Menezes, Alexandre Motta; de Azevedo, Orlando Morais; de Vasconcelos Silva, Frederico Pires; Lins, Ricardo Felipe de Albuquerque; Lima, Ricardo de Carvalho

    2013-12-10

    Because the real benefit of pulmonary valve replacement (PVR) in patients with repaired tetralogy of Fallot who develop pulmonary insufficiency remains unclear, it is necessary to analyze the evidence published around the world. We performed a systematic review of studies that reported data about the effect of PVR in patients with repaired tetralogy of Fallot that developed pulmonary insufficiency, until December 2012. The variables chosen to represent the benefit were both right ventricular (RV) and left ventricular measures, QRS duration, and functional class. The principal summary measures were difference in means with 95% confidence interval and p values (considered statistically significant when p regression were completed with the software Comprehensive Meta-Analysis (version 2, Biostat, Inc., Englewood, New Jersey). Forty-eight studies involving 3,118 patients met the eligibility criteria. The pooled 30-day mortality was 0.87% (47 studies; 27 of 3,100 patients); the pooled 5-year mortality was 2.2% (24 studies; 49 of 2,231 patients); the pooled 5-year re-PVR was 4.9% (15 studies; 88 of 1,798 patients). The results of this meta-analysis demonstrate that after PVR: 1) the RV experiences improvement of its volumes and function; 2) the left ventricle experiences improvement of its function; 3) QRS duration decreases; 4) symptoms improve; 5) pre-operative RV geometry modulates the effect of PVR; and 6) there is important heterogeneity of the effects among the studies, and few publication biases. In conclusion, PVR seems to be a positive approach in the analyzed scenario. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. A Full Cost Analysis of the Replacement of Naval Base, Guantanamo Bay's Marine Ground Defense Force by the Fleet Antiterrorism Security Team

    National Research Council Canada - National Science Library

    Ordona, Placido

    2000-01-01

    ... of these diminishing resources. One such initiative is the restructuring of the Marine security presence at Naval Station, Guantanamo Bay, Cuba, through the replacement of the 350 man Marine Ground Defense Force with a smaller...

  14. Statistical analysis on finger replacement schemes for RAKE receivers in the soft handover region with multiple BSs over i.n.d. fading channels

    KAUST Repository

    Nam, Sung Sik; Ko, Young-Chai; Alouini, Mohamed-Slim; Choi, Seyeong

    2017-01-01

    . To supplement our previous work, we present a general comprehensive framework for the performance assessment of the proposed finger replacement schemes operating over independent but non-identically distributed (i.n.d.) faded paths. To accomplish this object, we

  15. Modifications to Replacement Costs System

    International Nuclear Information System (INIS)

    Godec, M.

    1989-01-01

    The purpose of this memorandum is to document the improvements and modifications made to the Replacement Costs of Crude Oil (REPCO) Supply Analysis System. While some of this work was performed under our previous support contract to DOE/ASFE, we are presenting all modifications and improvements are presented here for completeness. The memo primarily documents revisions made to the Lower-48 Onshore Model. Revisions and modifications made to other components and models in the REPCO system which are documented elsewhere are only highlighted in this memo. Generally, the modifications made to the Lower-48 Onshore Model reflect changes that have occurred in domestic drilling, oil field costs, and reserves since 1982, the date of the most recent available data used for the original Replacement Costs report, published in 1985

  16. Non anti-coagulant factors associated with filter life in continuous renal replacement therapy (CRRT): a systematic review and meta-analysis.

    Science.gov (United States)

    Brain, Matthew; Winson, Elizabeth; Roodenburg, Owen; McNeil, John

    2017-02-20

    Optimising filter life and performance efficiency in continuous renal replacement therapy has been a focus of considerable recent research. Larger high quality studies have predominantly focussed on optimal anticoagulation however CRRT is complex and filter life is also affected by vascular access, circuit and management factors. We performed a systematic search of the literature to identify and quantify the effect of vascular access, circuit and patient factors that affect filter life and presented the results as a meta-analysis. A systematic review and meta-analysis was performed by searching Pubmed (MEDLINE) and Ovid EMBASE libraries from inception to 29 th February 2016 for all studies with a comparator or independent variable relating to CRRT circuits and reporting filter life. Included studies documented filter life in hours with a comparator other than anti-coagulation intervention. All studies comparing anticoagulation interventions were searched for regression or hazard models pertaining to other sources of variation in filter life. Eight hundred nineteen abstracts were identified of which 364 were selected for full text analysis. 24 presented data on patient modifiers of circuit life, 14 on vascular access modifiers and 34 on circuit related factors. Risk of bias was high and findings are hypothesis generating. Ranking of vascular access site by filter longevity favours: tunnelled semi-permanent catheters, femoral, internal jugular and subclavian last. There is inconsistency in the difference reported between femoral and jugular catheters. Amongst published literature, modality of CRRT consistently favoured continuous veno-venous haemodiafiltration (CVVHD-F) with an associated 44% lower failure rate compared to CVVH. There was a trend favouring higher blood flow rates. There is insufficient data to determine advantages of haemofilter membranes. Patient factors associated with a statistically significant worsening of filter life included mechanical

  17. Defense-in-depth for common cause failure of nuclear power plant safety system software

    International Nuclear Information System (INIS)

    Tian Lu

    2012-01-01

    This paper briefly describes the development of digital I and C system in nuclear power plant, and analyses the viewpoints of NRC and other nuclear safety authorities on Software Common Cause Failure (SWCCF). In view of the SWCCF issue introduced by the digitized platform adopted in nuclear power plant safety system, this paper illustrated a diversified defence strategy for computer software and hardware. A diversified defence-in-depth solution is provided for digital safety system of nuclear power plant. Meanwhile, analysis on problems may be faced during application of nuclear safety license are analyzed, and direction of future nuclear safety I and C system development are put forward. (author)

  18. Integration technique of digital I and C replacement and its Critical Digital Review procedure

    International Nuclear Information System (INIS)

    Huang, Hui-Wen; Yang, Wen-Long

    2013-01-01

    Highlights: ► A digital I and C replacement integration technique have been developed. ► Establishment of Nuclear Power Plant Digital Replacement Integration Guideline. ► Preliminary Investigation on I and C System Digitalization. ► Evaluation on I and C System Digitalization. ► Establishment of I and C System Digitalization Architectures. -- Abstract: Institute of Nuclear Energy Research (INER) developed a digital Instrumentation and Control (I and C) replacement integration technique on the basis of requirement of the three existing nuclear power plants (NPPs), which are Chin–Shan (CS) NPP, Kuo–Sheng (KS) NPP, and Maanshan (MS) NPP, in Taiwan, and also developed the related Critical Digital Review (CDR) procedure. The digital I and C replacement integration technique includes: (1) Establishment of Nuclear Power Plant Digital Replacement Integration Guideline, (2) Preliminary Investigation on I and C System Digitalization, (3) Evaluation on I and C System Digitalization, and (4) Establishment of I and C System Digitalization Architectures. These works can be a reference for performing I and C system digital replacement integration of the three existing NPPs of Taiwan Power Company (TPC). A CDR is the review for a critical system digital I and C replacement. The major reference of this procedure is EPRI TR-1011710 (2005) “Handbook for Evaluating Critical Digital Equipment and Systems” which was published by the Electric Power Research Institute (EPRI). With this document, INER developed a TPC-specific CDR procedure. Currently, CDR becomes one of the policies for digital I and C replacement in TPC. The contents of this CDR procedure include: Scope, Responsibility, Operation Procedure, Operation Flow Chart, CDR review items. The CDR review items include the comparison of the design change, Software Verification and Validation (SV and V), Failure Mode and Effects Analysis (FMEA), Evaluation of Diversity and Defense-in-depth (D3), Evaluation of

  19. Enzyme replacement therapy for Anderson-Fabry disease: A complementary overview of a Cochrane publication through a linear regression and a pooled analysis of proportions from cohort studies.

    Science.gov (United States)

    El Dib, Regina; Gomaa, Huda; Ortiz, Alberto; Politei, Juan; Kapoor, Anil; Barreto, Fellype

    2017-01-01

    Anderson-Fabry disease (AFD) is an X-linked recessive inborn error of glycosphingolipid metabolism caused by a deficiency of alpha-galactosidase A. Renal failure, heart and cerebrovascular involvement reduce survival. A Cochrane review provided little evidence on the use of enzyme replacement therapy (ERT). We now complement this review through a linear regression and a pooled analysis of proportions from cohort studies. To evaluate the efficacy and safety of ERT for AFD. For the systematic review, a literature search was performed, from inception to March 2016, using Medline, EMBASE and LILACS. Inclusion criteria were cohort studies, patients with AFD on ERT or natural history, and at least one patient-important outcome (all-cause mortality, renal, cardiovascular or cerebrovascular events, and adverse events) reported. The pooled proportion and the confidence interval (CI) are shown for each outcome. Simple linear regressions for composite endpoints were performed. 77 cohort studies involving 15,305 participants proved eligible. The pooled proportions were as follows: a) for renal complications, agalsidase alfa 15.3% [95% CI 0.048, 0.303; I2 = 77.2%, p = 0.0005]; agalsidase beta 6% [95% CI 0.04, 0.07; I2 = not applicable]; and untreated patients 21.4% [95% CI 0.1522, 0.2835; I2 = 89.6%, plinear regression showed that Fabry patients receiving agalsidase alfa are more likely to have higher rates of composite endpoints compared to those receiving agalsidase beta. Agalsidase beta is associated to a significantly lower incidence of renal, cardiovascular and cerebrovascular events than no ERT, and to a significantly lower incidence of cerebrovascular events than agalsidase alfa. In view of these results, the use of agalsidase beta for preventing major organ complications related to AFD can be recommended.

  20. [Three-dimensional finite element analysis on mechanical behavior of the bone remodeling and bone integration between the bone-implant interface after hip replacement].

    Science.gov (United States)

    Li, Yong-Jiang; Zhang, Li-Cheng; Zhang, Mei-Chao; Yang, Guo-Jing; Lin, Rui-Xin; Cai, Chun-Yuan; Zhong, Shi-Zhen

    2014-04-01

    To discuss the primary stability of the fixed interface between the cementless prosthesis and femur, and its influence on bone ingrowth and secondary stability under the roughened surface and press fit of different prostheses by finite element analysis. :A three-dimensional finite element module of total hip arthroplasty (THA) was developed with Mimics software. There was a collection of data when simulating hip arthroplasty. The frictional coefficient between the fixed interface was 0,0.15,0.40 and 1.00 representing the roughness of prosthesis surface. The press fit was 0, 0.01,0.05 and 0.10 mm according to the operation. The Vion Mises stress distribution and the contact pressure,friction stress and relative sliding displacement between the interface were analysed and compared when simulating the maneuver of climbing stairs. At a fixed press fit of 0.05 mm,the contact pressure between the interface was 230 , 231, 222 and 275 MN under four different frictional coefficient (0,0. 15,0.40 and 1.00) with little change; the relative sliding displacement was 0.529, 0.129, 0.107 and 0.087 mm with a consistent and obvious decline. As the fixed frictional coefficient was 0.40,the contact pressure between the interface were 56.0,67.7 ,60.4 and 49.6 MN under four different press fit (0, 0.01, 0.05 and 0.10 mm) with a reduction; the relative sliding displacement was 0.064,0.062,0.043 and 0.042 mm with an obvious decline, and there was a maximal friction stress when press fit of 0.01 mm. There is a dynamic process of the bone remodeling and bone integration between the interface after hip replacement, determining the long-term outcome. The interface clearance and the frictional coefficient are the key factors of the bone integration.

  1. Stentless vs. stented bioprosthesis for aortic valve replacement: A case matched comparison of long-term follow-up and subgroup analysis of patients with native valve endocarditis.

    Science.gov (United States)

    Schaefer, Andreas; Dickow, Jannis; Schoen, Gerhard; Westhofen, Sumi; Kloss, Lisa; Al-Saydali, Tarik; Reichenspurner, Hermann; Philipp, Sebastian A; Detter, Christian

    2018-01-01

    Current retrospective evidence suggests similar clinical and superior hemodynamic outcomes of the Sorin Freedom Solo stentless aortic valve (SFS) (LivaNova PLC, London, UK) compared to the Carpentier Edwards Perimount stented aortic valve (CEP) (Edwards Lifesciences Inc., Irvine, California, USA). To date, no reports exist describing case-matched long-term outcomes and analysis for treatment of native valve endocarditis (NVE). From 2004 through 2014, 77 consecutive patients (study group, 59.7% male, 68.9 ± 12.5 years, logEuroSCORE II 7.6 ± 12.3%) received surgical aortic valve replacement (SAVR) with the SFS. A control group of patients after SAVR with the CEP was retrieved from our database and matched to the study group regarding 15 parameters including preoperative endocarditis. Acute perioperative outcomes and follow-up data (mean follow-up time 48.7±29.8 months, 95% complete) were retrospectively analyzed. No differences in early mortality occurred during 30-day follow up (3/77; 3.9% vs. 4/77; 5.2%; p = 0.699). Echocardiographic findings revealed lower postprocedural transvalvular pressure gradients (max. 17.0 ± 8.2 vs. 24.5 ± 9.2 mmHg, pendocarditis (PVE) (9.1% vs. 1.3%; p = 0.04) was more frequent in the SFS group. All-cause mortality during follow-up was 20.8% vs. 14.3% (p = 0.397). When patients were divided into subgroups of NVE and respective utilized bioprosthesis, the SFS presented impaired outcomes regarding mortality in NVE cases (p = 0.031). The hemodynamic superiority of the SFS was confirmed in this comparison. However, clinical outcomes in terms of SVD and PVE rates, as well as survival after NVE, were inferior in this study. Therefore, we are reluctant to recommend utilization of the SFS for treatment of NVE.

  2. A Pilot Analysis of the Association Between Types of Monitored Anesthesia Care Drugs and Outcomes in Transfemoral Aortic Valve Replacement Performed Without General Anesthesia.

    Science.gov (United States)

    Chen, Eric Y; Sukumar, Nitin; Dai, Feng; Akhtar, Shamsuddin; Schonberger, Robert B

    2018-04-01

    The types of agents used for monitored anesthesia care (MAC) and their possible differential effects on outcomes have received less study despite increased use over general anesthesia (GA) in transfemoral aortic valve replacements (TAVRs). In this pilot analysis of patients undergoing TAVR using MAC, the authors described the anesthetic agents used and sought to investigate the possible association of anesthetic agent choice with outcomes and the extent to which total weight and time-adjusted doses of anesthetics declined with increasing 10-year age increments. Retrospective observational study. Tertiary teaching hospital. Ninety-three participants scheduled to undergo TAVR, with a primary plan of conscious sedation between November 2014 and June 2016, were included. None. Types of MAC were divided into 4 primary groups, but 2 groups were focused: propofol (n = 39) and dexmedetomidine plus propofol (n = 34). Conversion to GA occurred in 6 participants (6.45%) and was not associated with the type of sedation received. The authors also compared patients who received dexmedetomidine with those who did not in accordance with their a priori analytic plan. There were no associations between the use of dexmedetomidine and postoperative delirium or intensive care unit/hospital length of stay. No significant trends in medication dose adjustments were seen across increasing 10-year age increments. A wide breadth of MAC medications is in use among TAVR patients and does not support differences in outcomes. Despite recommendations to reduce anesthetic drug dosing in the elderly, no significant trends in dose reduction with increasing age were noted. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Prioritizing equipment for replacement.

    Science.gov (United States)

    Capuano, Mike

    2010-01-01

    It is suggested that clinical engineers take the lead in formulating evaluation processes to recommend equipment replacement. Their skill, knowledge, and experience, combined with access to equipment databases, make them a logical choice. Based on ideas from Fennigkoh's scheme, elements such as age, vendor support, accumulated maintenance cost, and function/risk were used.6 Other more subjective criteria such as cost benefits and efficacy of newer technology were not used. The element of downtime was also omitted due to the data element not being available. The resulting Periop Master Equipment List and its rationale was presented to the Perioperative Services Program Council. They deemed the criteria to be robust and provided overwhelming acceptance of the list. It was quickly put to use to estimate required capital funding, justify items already thought to need replacement, and identify high-priority ranked items for replacement. Incorporating prioritization criteria into an existing equipment database would be ideal. Some commercially available systems do have the basic elements of this. Maintaining replacement data can be labor-intensive regardless of the method used. There is usually little time to perform the tasks necessary for prioritizing equipment. However, where appropriate, a clinical engineering department might be able to conduct such an exercise as shown in the following case study.

  4. Thyroid hormone replacement therapy

    NARCIS (Netherlands)

    Wiersinga, W. M.

    2001-01-01

    Thyroid hormone replacement has been used for more than 100 years in the treatment of hypothyroidism, and there is no doubt about its overall efficacy. Desiccated thyroid contains both thyroxine (T(4)) and triiodothyronine (T(3)); serum T(3) frequently rises to supranormal values in the absorption

  5. Fluorescent Lamp Replacement Study

    Science.gov (United States)

    2017-07-01

    not be cited for purposes of advertisement. DISPOSITION INSTRUCTIONS: Destroy this document when no longer needed. Do not return to the... recycling , and can be disposed safely in a landfill. (2) LEDs offer reduced maintenance costs and fewer bulb replacements, significantly reducing... recycling . Several fixtures, ballasts and energy efficient fluorescent bulbs that were determined to be in pristine condition were returned to ATC

  6. Replacing Recipe Realism

    OpenAIRE

    Saatsi, J

    2017-01-01

    Many realist writings exemplify the spirit of ‘recipe realism’. Here I characterise recipe realism, challenge it, and propose replacing it with ‘exemplar realism’. This alternative understanding of realism is more piecemeal, robust, and better in tune with scientists’ own attitude towards their best theories, and thus to be preferred.

  7. Fructose replacement of glucose or sucrose in food or beverages lowers postprandial glucose and insulin without raising triglycerides: a systematic review and meta-analysis.

    Science.gov (United States)

    Evans, Rebecca A; Frese, Michael; Romero, Julio; Cunningham, Judy H; Mills, Kerry E

    2017-08-01

    Background: Conflicting evidence exists on the effects of fructose consumption in people with type 1 and type 2 diabetes mellitus. No systematic review has addressed the effect of isoenergetic fructose replacement of glucose or sucrose on peak postprandial glucose, insulin, and triglyceride concentrations. Objective: The objective of this study was to review the evidence for postprandial glycemic and insulinemic responses after isoenergetic replacement of either glucose or sucrose in foods or beverages with fructose. Design: We searched the Cochrane Library, MEDLINE, EMBASE, the WHO International Clinical Trials Registry Platform Search Portal, and clinicaltrials.gov The date of the last search was 26 April 2016. We included randomized controlled trials measuring peak postprandial glycemia after isoenergetic replacement of glucose, sucrose, or both with fructose in healthy adults or children with or without diabetes. The main outcomes analyzed were peak postprandial blood glucose, insulin, and triglyceride concentrations. Results: Replacement of either glucose or sucrose by fructose resulted in significantly lowered peak postprandial blood glucose, particularly in people with prediabetes and type 1 and type 2 diabetes. Similar results were obtained for insulin. Peak postprandial blood triglyceride concentrations did not significantly increase. Conclusions: Strong evidence exists that substituting fructose for glucose or sucrose in food or beverages lowers peak postprandial blood glucose and insulin concentrations. Isoenergetic replacement does not result in a substantial increase in blood triglyceride concentrations. © 2017 American Society for Nutrition.

  8. In-depth characterization of silicon solar cells

    International Nuclear Information System (INIS)

    Verhoef, L.A.; Bisschop, F.J.; Stroom, J.C.; Sinke, W.C.

    1990-01-01

    The authors present an extension of the photo-current decay (PCD) method to enable determination of the minority-carrier diffusion length in Si solar cells in a depth-resolved fashion. From a single decay curve three observables (quantum efficiency, fundamental decay time, and intercept of the extrapolated decay curve with the time-zero axis) are determined. It is demonstrated how three transport parameters (back-surface recombination velocity, the average minority-carrier diffusion length, and a third parameter which describes the depth-dependence of the diffusion length) are extracted from these observables. Computer simulations of the time-dependent minority-carrier transport problem are performed to unravel the relations between the recombination parameters of the solar cell base and the three observables. With the authors' experimental set-up, comprising a Ti:Sapphire laser, light pulses of wavelength 1010 nm are used to perform PCD measurements. Measurements on a set of polycrystalline Si cells were performed showing that gettering treatments during cell production result in depth-dependent lifetimes

  9. The PSA assessment of Defense in Depth Memorandum and proposals

    International Nuclear Information System (INIS)

    Fiorini, Gian-Luigi; La Rovere, Stefano

    2016-01-01

    This report concerns the peculiar roles of the Defence-in-Depth (DiD) concept and the Probabilistic Safety Assessment (PSA) approach for the optimization of the safety performances of the nuclear installation. It proposes a conceptual framework and related process for the assessment of the 'safety architecture' implementing DiD, which is articulated in four main steps devoted to (1) the formulation of the safety objectives, (2) the identification of loads and environmental conditions, (3) the representation of the safety architecture and (4) the evaluation of the physical performance and reliability of the levels of DiD. A final additional step achieves the practical assessment of the safety architecture and the corresponding DiD with the support of the PSA. The comprehensive safety assessment of the implemented architecture needs its multi-dimensional representation, i.e. for given initiating event, sequence of possible failures, affected safety function and level of DiD. The risk space (frequency/probability of occurrence, versus consequences) is the framework for the integration between the DiD concept and the PSA approach. Additional qualitative key-notions are introduced in order to address the compliance of the safety architecture with a number of international safety requirements. In this context, the role of the PSA is no longer limited to the verification of the fulfilment of probabilistic targets but includes different contributions to the assessment of the DiD identified in this report. (authors)

  10. Shared Communications: Volume 2. In-Depth Systems Research

    Energy Technology Data Exchange (ETDEWEB)

    Truett, LF

    2004-09-22

    This report is the second of two documents that examine the literature for actual examples of organizations and agencies that share communications resources. While the primary emphasis is on rural, intelligent transportation system (ITS) communications involving transit, examples will not be limited to rural activities, nor to ITS implementation, nor even to transit. In addition, the term ''communication'' will be broadly applied to include all information resources. The first document of this series, ''Shared Communications: Volume I. A Summary and Literature Review'', defines the meaning of the term ''shared communication resources'' and provides many examples of agencies that share resources. This document, ''Shared Communications: Volume II. In-Depth Systems Research'', reviews attributes that contributed to successful applications of the sharing communication resources concept. A few examples of each type of communication sharing are provided. Based on the issues and best practice realworld examples, recommendations for potential usage and recommended approaches for field operational tests are provided.

  11. Evolution of System Safety at NASA as Related to Defense-in-Depth

    Science.gov (United States)

    Dezfuli, Homayoon

    2015-01-01

    Presentation given at the Defense-in-Depth Inter-Agency Workshop on August 26, 2015 in Rockville, MD by Homayoon Dezfuli. The presentation addresses the evolution of system safety at NASA as related to Defense-in-Depth.

  12. Effect of estrogen replacement therapy on bone and cardiovascular outcomes in women with turner syndrome: a systematic review and meta-analysis.

    Science.gov (United States)

    Cintron, Dahima; Rodriguez-Gutierrez, Rene; Serrano, Valentina; Latortue-Albino, Paula; Erwin, Patricia J; Murad, Mohammad Hassan

    2017-02-01

    Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency. Hence, long-term estrogen replacement therapy is the cornerstone treatment. The estimates of its effect and optimal use, however, remain uncertain. We aimed to summarize the benefits and harms of estrogen replacement therapy on bone, cardiovascular, vasomotor and quality of life outcomes in patients with Turner syndrome. A comprehensive search of four databases was performed from inception through January 2016. Randomized clinical trials and observational cohort studies studying the effect of estrogen replacement therapy in patients with Turner syndrome under the age of 40 were included. Independently and in duplicate reviewers selected studies, extracted data and assessed risk of bias. Subgroup analyses were based on route of administration and type of estrogen formulation. Twenty-five studies at moderate to high risk of bias (12 randomized trials, 13 cohort studies) with 771 patients were included. Using random-effects models, estrogen replacement therapy showed an increase in bone mineral density [weighted mean change from baseline 0.09 g/cm2 (0.04-0.14)] that differed by type of estrogen but not route of administration. Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [weighted mean difference 9.33 mg/dl (4.82-13.85)] with no significant effect on other lipid fractions. The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol. Whether this improvement translates into changes in patient important outcomes (cardiovascular events or fractures) remains uncertain. Larger randomized clinical trials with direct comparisons on patient important outcomes are necessary.

  13. Value-of-Information Analysis to Reduce Decision Uncertainty Associated with the Choice of Thromboprophylaxis after Total Hip Replacement in the Irish Healthcare Setting.

    LENUS (Irish Health Repository)

    McCullagh, Laura

    2012-06-05

    Background: The National Centre for Pharmacoeconomics, in collaboration with the Health Services Executive, considers the cost effectiveness of all new medicines introduced into Ireland. Health Technology Assessments (HTAs) are conducted in accordance with the existing agreed Irish HTA guidelines. These guidelines do not specify a formal analysis of value of information (VOI). Objective: The aim of this study was to demonstrate the benefits of using VOI analysis in decreasing decision uncertainty and to examine the viability of applying these techniques as part of the formal HTA process for reimbursement purposes within the Irish healthcare system. Method: The evaluation was conducted from the Irish health payer perspective. A lifetime model evaluated the cost effectiveness of rivaroxaban, dabigatran etexilate and enoxaparin sodium for the prophylaxis of venous thromboembolism after total hip replacement. The expected value of perfect information (EVPI) was determined directly from the probabilistic analysis (PSA). Population-level EVPI (PEVPI) was determined by scaling up the EVPI according to the decision incidence. The expected value of perfect parameter information (EVPPI) was calculated for the three model parameter subsets: probabilities, preference weights and direct medical costs. Results: In the base-case analysis, rivaroxaban dominated both dabigatran etexilate and enoxaparin sodium. PSA indicated that rivaroxaban had the highest probability of being the most cost-effective strategy over a threshold range of &U20AC;0-&U20AC;100 000 per QALY. At a threshold of &U20AC;45 000 per QALY, the probability that rivaroxaban was the most cost-effective strategy was 67%. At a threshold of &U20AC;45 000 per QALY, assuming a 10-year decision time horizon, the PEVPI was &U20AC;11.96 million and the direct medical costs subset had the highest EVPPI value (&U20AC;9.00 million at a population level). In order to decrease uncertainty, a more detailed costing

  14. Revisiting the Concept and Implementation of Defense-in-Depth

    International Nuclear Information System (INIS)

    Choi, Youngsung

    2013-01-01

    The subsequent tsunami, with its maximum wave height greater than the design basis, invalidated all layers of the Fukushima NPP. This raises the question on which of the philosophy or the implementation of DID fell short at Fukushima. This paper suggests several complements necessary to the concept of DID and new application practice in a wide variety of safety related objectives/areas/events. Since its conception, DID appears to have been successfully applied to the design and operation but less to the site, external events, resource requirements, the unexpected impacts of organization, etc. Thus, the horizontal as well as vertical application of DID is suggested. Here, the latter application means repeated questions of 'What if this fails?' and the former one means the application of DID to all the applicable objectives, which can be a real defense-in-width. It is widely accepted that defense-in-depth (DID) has been the core of safety philosophy in nuclear safety regulation. Its concept has been developed and refined over many years to go beyond physical barriers and design practices. The historical development of the concept led to a general structure of four physical barriers and five successive levels of defense. The accident at the Fukushima nuclear power plant (NPP) showed that multiple levels of defense could fail at the same time, demonstrated how these could work and how some were challenged, and gave the chance of the concept and implementation being improved. This paper examines the traditional concept and implementation strategies of DID, identifies some weaknesses in that, and suggest some complements and new approach to improving the application of DID

  15. Glaucoma after corneal replacement.

    Science.gov (United States)

    Baltaziak, Monika; Chew, Hall F; Podbielski, Dominik W; Ahmed, Iqbal Ike K

    Glaucoma is a well-known complication after corneal transplantation surgery. Traditional corneal transplantation surgery, specifically penetrating keratoplasty, has been slowly replaced by the advent of new corneal transplantation procedures: primarily lamellar keratoplasties. There has also been an emergence of keratoprosthesis implants for eyes that are high risk of failure with penetrating keratoplasty. Consequently, there are different rates of glaucoma, pathogenesis, and potential treatment in the form of medical, laser, or surgical therapy. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. The replacement research reactor

    International Nuclear Information System (INIS)

    Cameron, R.; Horlock, K.

    2001-01-01

    The contract for the design, construction and commissioning of the Replacement Research Reactor was signed in July 2000. This was followed by the completion of the detailed design and an application for a construction licence was made in May 2001. This paper will describe the main elements of the design and their relation to the proposed applications of the reactor. The future stages in the project leading to full operation are also described

  17. Apparatus for fuel replacement

    International Nuclear Information System (INIS)

    Imada, Takahiko.

    1974-01-01

    Object: To support a telescope mast such that no deforming load is applied to it even during massive vibration, it is held fixed at the time of fuel replacement to permit satisfactory remote control operation by automatic operation. Structure: The body of the fuel replacement apparatus is provided with telescope mast fixing means comprising a slide base supported for reciprocal movement with respect to a telescope mast, an operating arm pivoted at the slide base, a wrist member mounted on the free end of the operating arm and an engagement member for restricting the slide base and operating arm at the time of loading and unloading the fuel. When loading and unloading the fuel, the slide base and operating arm are restrained by the engagement member to reliably restrict the vibration of the telescope mast. When the fuel replacement apparatus is moved, the means provided on the operating arm is smoothly displaced to follow the swing (vibration) of the telescope mast to prevent the deforming load from being applied to the support portion or other areas. The wrist member supports the telescope mast such that it can be rotated while restraining movement in the axial direction, and it is provided with revolution drive means for rotating the telescope mast under remote control. (Kamimura, M.)

  18. Quality of life assessed with the medical outcomes study short form 36-item health survey of patients on renal replacement therapy: A systematic review and meta-analysis

    NARCIS (Netherlands)

    Y.S. Liem (Ylian Serina); J.L. Bosch (Johanna); L.R. Arends (Lidia); M.H. Heijenbrok-Kal (Majanka); M.G.M. Hunink (Myriam)

    2007-01-01

    textabstractObjectives: The Medical Outcomes Study Short Form 36-Item Health Survey (SF-36) is the most widely used generic instrument to estimate quality of life of patients on renal replacement therapy. Purpose of this study was to summarize and compare the published literature on quality of

  19. The influence of hormone replacement therapy on the aging-related change in cognitive performance. Analysis based on a Danish cohort study

    DEFF Research Database (Denmark)

    Løkkegaard, E; Pedersen, A T; Laursen, P

    2002-01-01

    A maintenance and/or improvement of cognitive performance with postmenopausal hormone replacement therapy (HRT) is biological plausible. The objectives of this study were to analyze the impact of HRT on aging-related changes in cognitive performances, and to assess whether women who choose HRT have...... better cognitive performance prior to HRT....

  20. Prospective analysis of a first MTP total joint replacement. Evaluation by bone mineral densitometry, pedobarography, and visual analogue score for pain

    DEFF Research Database (Denmark)

    Wetke, Eva; Zerahn, Bo; Kofoed, Hakon

    2012-01-01

    We hypothesized that a total replacement of the first metatarsophalangeal joint (MTP-1) would alter the walking pattern with medialisation of the ground reaction force (GRF) of the foot and subsequently cause an increase in bone mineral density (BMD) in the medial metatarsal bones and a decline o...

  1. Residual and Progressive Aortic Regurgitation After Valve-Sparing Root Replacement: A Propensity-Matched Multi-Institutional Analysis in 764 Patients.

    Science.gov (United States)

    Kari, Fabian A; Doll, Kai-Nicolas; Hemmer, Wolfgang; Liebrich, Markus; Sievers, Hans-Hinrich; Richardt, Doreen; Reichenspurner, Hermann; Detter, Christian; Siepe, Matthias; Czerny, Martin; Beyersdorf, Friedhelm

    2016-04-01

    Residual/progressive aortic regurgitation (rAR, pAR) after valve-sparing aortic root replacement (V-SARR) can lead to reoperations. We sought to characterize risk factors of mild rAR and pAR after V-SARR in a multicenter cohort. The effect of additional cusp repair on valve function was analyzed using propensity matching. A total of 1,015 patients after V-SARR were identified with (n = 288, 28%) or without additional cusp/commissure repair (n = 727, 72%) at four cardiac units in Germany. A total of 764 patients fulfilling transthoracic echocardiography follow-up-criteria comprised the study cohort. Logistic regression was used for risk factor analysis with endpoints rAR, new onset AR, and pAR. t tests and analyses of variance were used for between-group differences. The effects of additional cusp repair on valve function were studied comparing propensity-matched quintiles. The incidence of rAR was 29%, with influencing factors aneurysm size (p = 0.07) and preoperative aortic valve function (p = 0.08). It was found more often among nonsyndromic patients (34% vs. 14%; OR, 0.4; p < 0.001). Progression of rAR was detectable in 30% after a mean of 4.3 years. The progression rate of rAR ∼ 0.3 grades per patient-year within the first 5 years. When quintiles identified by propensity score were compared, additional cusp repair was linked to new onset AR (p = 0.016) while it was not linked to rAR (p = 0.14) or pAR (p = 0.5). The incidences of rAR and pAR are considerable after V-SARR. Patients should be operated on before large aneurysms are present. New onset AR after an initially good functional result is more likely after an additional cusp repair, while rAR and pAR are not influenced by cusp repair. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Incidence of hip and knee replacement in patients with rheumatoid arthritis following the introduction of biological DMARDs: an interrupted time-series analysis using nationwide Danish healthcare registers.

    Science.gov (United States)

    Cordtz, René Lindholm; Hawley, Samuel; Prieto-Alhambra, Daniel; Højgaard, Pil; Zobbe, Kristian; Overgaard, Søren; Odgaard, Anders; Kristensen, Lars Erik; Dreyer, Lene

    2018-05-01

    To study the impact of the introduction of biological disease-modifying anti-rheumatic drugs (bDMARDs) and associated rheumatoid arthritis (RA) management guidelines on the incidence of total hip (THR) and knee replacements (TKR) in Denmark. Nationwide register-based cohort and interrupted time-series analysis. Patients with incident RA between 1996 and 2011 were identified in the Danish National Patient Register. Patients with RA were matched on age, sex and municipality with up to 10 general population comparators (GPCs). Standardised 5-year incidence rates of THR and TKR per 1000 person-years were calculated for patients with RA and GPCs in 6-month periods. Levels and trends in the pre-bDMARD (1996-2001) were compared with the bDMARD era (2003-2016) using segmented linear regression interrupted by a 1-year lag period (2002). We identified 30 404 patients with incident RA and 297 916 GPCs. In 1996, the incidence rate of THR and TKR was 8.72 and 5.87, respectively, among patients with RA, and 2.89 and 0.42 in GPCs. From 1996 to 2016, the incidence rate of THR decreased among patients with RA, but increased among GPCs. Among patients with RA, the incidence rate of TKR increased from 1996 to 2001, but started to decrease from 2003 and throughout the bDMARD era. The incidence of TKR increased among GPCs from 1996 to 2016. We report that the incidence rate of THR and TKR was 3-fold and 14-fold higher, respectively among patients with RA compared with GPCs in 1996. In patients with RA, introduction of bDMARDs was associated with a decreasing incidence rate of TKR, whereas the incidence of THR had started to decrease before bDMARD introduction. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Design verification for reactor head replacement

    International Nuclear Information System (INIS)

    Dwivedy, K.K.; Whitt, M.S.; Lee, R.

    2005-01-01

    must be negotiated. This paper does not describe the massive efforts required by the NSSS and manufacturer's engineering groups nor does it include the challenges of construction in development of mechanical handling of heavy and large components, or the effort for providing adequate access for the head replacement and restoring the containment structure. The paper outlines the analysis and design efforts needed to support reactor head replacement. The paper concludes that the verification efforts performed by the utility design group not only provide increased assurance of design adequacy, but also serves as an important player on the strong team that is required for a successful head replacement. (authors)

  4. In-depth characterisation of the lamb meat proteome from longissimus lumborum

    Directory of Open Access Journals (Sweden)

    Tzer-Yang Yu

    2015-03-01

    Full Text Available Lamb is one of the major red meats consumed globally, both as a key component in the diet of some countries, and as a niche meat product in others. Despite this relatively wide consumption, an in-depth description of the global protein composition of lamb has not been reported. In this study, we investigated the proteome of the 48 h post-mortem lamb longissimus lumborum through separation of the samples into sarcoplasmic, myofibrillar and insoluble fractions, followed by an in-depth shotgun proteomic evaluation and bioinformatic analysis. As a result, 388 ovine-specific proteins were identified and characterised. The 207 proteins found in the sarcoplasmic fraction were dominated by glycolytic enzymes and mitochondrial proteins. This fraction also contained several sarcomeric proteins, e.g., myosin light chains and titin. Some of them might be the degradation products from the post-mortem proteolysis. Actin, myosin and tropomyosin were abundant in the myofibrillar fraction while nebulin and titin were also present. Collagen type I, III and IV were found in the insoluble fraction but there were also sequences from myosin and titin. The present study also confirms the existence of at least 300 predicted protein sequences obtained from the latest issue of the sheep genome (version 3 with high confidence.

  5. Toleration, Synthesis or Replacement?

    DEFF Research Database (Denmark)

    Holtermann, Jakob v. H.; Madsen, Mikael Rask

    2016-01-01

    , in order to answer is not yet another partisan suggestion, but rather an attempt at making intelligible both the oppositions and the possibilities of synthesis between normative and empirical approaches to law. Based on our assessment and rational reconstruction of current arguments and positions, we...... therefore outline a taxonomy consisting of the following three basic, ideal-types in terms of the epistemological understanding of the interface of law and empirical studies: toleration, synthesis and replacement. This tripartite model proves useful with a view to teasing out and better articulating...

  6. Upgrade, rebuild or replace?

    International Nuclear Information System (INIS)

    Forbes, C.A.

    1990-01-01

    Ageing reactor simulators present some tough decisions for utility managers. Although most utilities have chosen the cheaper, upgrading solution as the best compromise between costs and outage length, some US utilities have found that for them, replacement represents the best option. Simulators may be less than ten years old, but they have limited instructor systems, older low fidelity models that cannot reproduce important training scenarios, and out of date, difficult to maintain computers that do not permit much expansion of the models anyway. Perhaps worse than this is the possibility that the simulator may no longer be a faithful reproduction of the referenced plant, or have poor (or non-existent) documentation. (author)

  7. Clinical Outcomes of Dietary Replacement of Saturated Fatty Acids with Unsaturated Fat Sources in Adults with Overweight and Obesity: A Systematic Review and Meta-Analysis of Randomized Control Trials.

    Science.gov (United States)

    Hannon, Bridget A; Thompson, Sharon V; An, Ruopeng; Teran-Garcia, Margarita

    2017-01-01

    Obesity and dyslipidemia are frequently treated with dietary interventions before pharmacotherapy is given. Diets high in unsaturated fat have proven advantageous to disease treatment. The purpose of this systematic review and meta-analysis was to assess the evidence of the effect of saturated fatty acids (SFA) replacement with unsaturated fatty acids (UFA) in metabolically healthy adults with overweight and obesity on markers of dyslipidemia and body composition. Keyword search was performed in PubMed, CINAHL, and Cochrane Library for randomized controlled trials (RCTs) evaluating the effects of fatty acid substitution in adults with overweight and obesity. Meta-analysis was performed on interventions assessing lipoprotein levels and body composition. Publication bias was assessed by funnel plot inspection, Begg's, and Egger's test. Eight RCTs enrolling 663 participants were included in the review, with intervention durations between 4 and 28 weeks. Although nonsignificant (p = 0.06), meta-analysis found UFA replacement to reduce total cholesterol concentrations by 10.68 mg/dL (95%CI -21.90 to 0.53). Reductions in low-density lipoprotein cholesterol and triglycerides were statistically nonsignificant. Due to null results and a small number of studies included, there is no strong evidence that replacement of SFA with UFA may benefit lipid profiles in this population. © 2017 S. Karger AG, Basel.

  8. A full cost analysis of the replacement of Naval Base, Guantanamo Bay's Marine ground defense force by the fleet antiterrorism security team

    OpenAIRE

    Ordona, Placido C.

    2000-01-01

    Constrained defense budgets and manpower resources have motivated the United States Marine Corps and the United States Navy to seek initiatives that maximize the efficient use and allocation of these diminishing resources. One such initiative is the restructuring of the Marine security presence at Naval Station, Guantanamo Bay, Cuba, through the replacement of the 350 man Marine Ground Defense Force with a smaller, rotating unit consisting of two platoons from the Fleet Antiterrorism Security...

  9. Countrywise results of total hip replacement An analysis of 438,733 hips based on the Nordic Arthroplasty Register Association database

    DEFF Research Database (Denmark)

    Makela, K. T.; Matilainen, M.; Pulkkinen, P.

    2014-01-01

    Background and purpose An earlier Nordic Arthroplasty Register Association (NARA) report on 280,201 total hip replacements (THRs) based on data from 1995-2006, from Sweden, Norway, and Denmark, was published in 2009. The present study assessed THR survival according to country, based on the NARA.......36-0.98) year of follow-up. Interpretation The differences in THR survival rates were considerable, with inferior results in Finland. Brand-level comparison of THRs in Nordic countries will be required....

  10. Valuing Externalities of Watershed Restoration and Erosion Control Projects in Mediterranean Basins: A Comparative Analysis of the Contingent Valuation and Replacement Cost Methods

    OpenAIRE

    Saez, Maria Del Carmen Almansa; Calatrava-Requena, Javier

    2002-01-01

    The methodology used for Economic Valuation of the Externalities generated by the Watershead Restoration and Erosion Control Projects in the Hydrographic Basins of the Mediterranean Slope, is based on the Replacement Cost Method. Environmental Economics, however, today offer us other methodological possibilities, whose application to the valuation of this type of project may prove to be of interest. It is the case of the Contingent Valuation Method used for the evaluation of the effects of th...

  11. Gentilly 2 divider plate replacement

    International Nuclear Information System (INIS)

    Forest, J.; Klisel, E.; McClellan, G.; Schnelder, W.

    1995-01-01

    The steam generators at the Gentilly 2 Nuclear Plant in operation since 1983 were built with primary divider plates of a bolted panel configuration. During a routine outage inspection, it was noted that two bolts had dislodged from the divider and were located lying in the primary head. Subsequent inspections revealed erosion damage to a substantial number of divider plate bolts and to a lesser extent, to the divider plate itself. After further inspection and repair the units were returned to operation, however, it was determined that a permanent replacement of the primary divider plates was going to be necessary. After evaluation of various options, it was decided that the panel type dividers would be replaced with a single piece floating design. The divider itself was to be of a one piece all-welded arrangement to be constructed from individual panels to be brought in through the manways. In view of the strength limitations of the bolted attachment of the upper seat bar to the tubesheet, a new welded seat bar was provided. To counteract erosion concerns, the new divider is fitted with erosion resistant inserts or weld buildup and with improved sealing features in order to minimize leakage and erosion. At an advanced stage in the design and manufacture of the components, the issue of divider strength during LOCA conditions came into focus. Analysis was performed to determine the strength and/or failure characteristics of the divider to a variety of small and large LOCA conditions. The paper describes the diagnosis of the original divider plates and the design, manufacture, field mobilization, installation and subsequent operation of the replacement divider plates. (author)

  12. Power Plant Replacement Study

    Energy Technology Data Exchange (ETDEWEB)

    Reed, Gary

    2010-09-30

    This report represents the final report for the Eastern Illinois University power plant replacement study. It contains all related documentation from consideration of possible solutions to the final recommended option. Included are the economic justifications associated with the chosen solution along with application for environmental permitting for the selected project for construction. This final report will summarize the results of execution of an EPC (energy performance contract) investment grade audit (IGA) which lead to an energy services agreement (ESA). The project includes scope of work to design and install energy conservation measures which are guaranteed by the contractor to be self-funding over its twenty year contract duration. The cost recovery is derived from systems performance improvements leading to energy savings. The prime focus of this EPC effort is to provide a replacement solution for Eastern Illinois University's aging and failing circa 1925 central steam production plant. Twenty-three ECMs were considered viable whose net impact will provide sufficient savings to successfully support the overall project objectives.

  13. Cadmium plating replacements

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, M.J.; Groshart, E.C.

    1995-03-01

    The Boeing Company has been searching for replacements to cadmium plate. Two alloy plating systems seem close to meeting the needs of a cadmium replacement. The two alloys, zinc-nickel and tin-zinc are from alloy plating baths; both baths are neutral pH. The alloys meet the requirements for salt fog corrosion resistance, and both alloys excel as a paint base. Currently, tests are being performed on standard fasteners to compare zinc-nickel and tin-zinc on threaded hardware where cadmium is heavily used. The Hydrogen embrittlement propensity of the zinc-nickel bath has been tested, and just beginning for the tin-zinc bath. Another area of interest is the electrical properties on aluminum for tin-zinc and will be discussed. The zinc-nickel alloy plating bath is in production in Boeing Commercial Airplane Group for non-critical low strength steels. The outlook is promising that these two coatings will help The Boeing Company significantly reduce its dependence on cadmium plating.

  14. REPLACEMENT OF FRENCH CARDS

    CERN Multimedia

    Human Resources Division

    2001-01-01

    The French Ministry of Foreign Affairs has informed the Organization that it is shortly to replace all diplomatic cards, special cards and employment permits ('attestations de fonctions') now held by members of the personnel and their families. Between 2 July and 31 December 2001, these cards are to be replaced by secure, computerized equivalents. A 'personnel office' stamped photocopy of the old cards may continue to be used until 31 December 2001. For the purposes of the handover, members of the personnel must go personally to the cards office (33/1-015), between 8:30 and 12:30, in order to fill a 'fiche individuelle' form (in black ink only), which has to be personally signed by themselves and another separately signed by members of their family, taking the following documents for themselves and members of their families already in possession of a French card : A recent identity photograph in 4.5 cm x 3.5 cm format (signed on the back) The French card in their possession an A4 photocopy of the same Fre...

  15. Power Plant Replacement Study

    Energy Technology Data Exchange (ETDEWEB)

    Reed, Gary

    2010-09-30

    This report represents the final report for the Eastern Illinois University power plant replacement study. It contains all related documentation from consideration of possible solutions to the final recommended option. Included are the economic justifications associated with the chosen solution along with application for environmental permitting for the selected project for construction. This final report will summarize the results of execution of an EPC (energy performance contract) investment grade audit (IGA) which lead to an energy services agreement (ESA). The project includes scope of work to design and install energy conservation measures which are guaranteed by the contractor to be self-funding over its twenty year contract duration. The cost recovery is derived from systems performance improvements leading to energy savings. The prime focus of this EPC effort is to provide a replacement solution for Eastern Illinois University’s aging and failing circa 1925 central steam production plant. Twenty-three ECMs were considered viable whose net impact will provide sufficient savings to successfully support the overall project objectives.

  16. Strategic vehicle fleet management - the replacement problem

    Directory of Open Access Journals (Sweden)

    Adam Redmer

    2016-03-01

    Full Text Available Background: Fleets constitute the most important production means in transportation. Their appropriate management is crucial for all companies having transportation duties. The paper is the third one of a series of three papers that the author dedicates to the strategic vehicle fleet management topic. Material and methods: The paper discusses ways of building replacement strategies for companies' fleets of vehicles. It means deciding for how long to exploit particular vehicles in a fleet (the fleet replacement problem - FR. The essence of this problem lies in the minimization of vehicle / fleet exploitation costs by balancing ownership and utilization costs and taking into account budget limitations. In the paper an original mathematical model (an optimization method allowing for the FR analysis is proposed. Results: An application of the proposed optimization method in a real-life decision situation (the case study within the Polish environment and the obtained solution are presented. The solution shows that there exist optimal exploitation periods of particular vehicles in a fleet. However, combination of them gives a replacement plan for an entire fleet violating budget constraints. But it is possible to adjust individual age to replacement of particular vehicles to fulfill budget constraints without losing economical optimality of a developed replacement plan for an entire fleet. Conclusions: The paper is the last one of a series of three papers that the author dedicated to the strategic vehicle fleet management topic including the following managerial decision problems: MAKE-or-BUY, sizing / composition and replacement.

  17. Method for performing diversity and defense-in-depth analyses of reactor protection systems

    International Nuclear Information System (INIS)

    Preckshot, G.G.

    1994-12-01

    The purpose of this NUREG is to describe a method for analyzing computer-based nuclear reactor protection systems that discovers design vulnerabilities to common-mode failure. The potential for common-mode failure has become an important issue as the software content of protection systems has increased. This potential was not present in earlier analog protection systems because it could usually be assumed that common-mode failure, if it did occur, was due to slow processes such as corrosion or premature wear-out. This assumption is no longer true for systems containing software. It is the purpose of the analysis method described here to determine points of a design for which credible common-mode failures are uncompensated either by diversity or defense-in-depth

  18. Non-cognitive Characteristics of Gifted Students With Learning Disabilities: An In-depth Systematic Review.

    Science.gov (United States)

    Beckmann, Else; Minnaert, Alexander

    2018-01-01

    Gifted students who also have learning disabilities (G/LD) are often overlooked when students are assessed either for giftedness or specific learning disabilities. The cognitive and non-cognitive characteristics of these G/LD students are habitually discussed only briefly alongside identification and intervention issues and, beyond that, the relevance of non-cognitive characteristics is often left unconsidered. Accordingly, this study aims to conduct an in-depth review of the non-cognitive characteristics of these students for identification and intervention purposes. Detailed analysis was performed on 23 publications. High levels of negative emotions, low self-perception, and adverse interpersonal relationships, as well as high levels of motivation, coping skills and perseverance were found among these students. A common characteristic was a high degree of frustration with the academic situation. The study reveals that these students show considerably duality in their non-cognitive characteristics which requires tailored counseling skills to provide effective support for their learning needs.

  19. Replace with abstract title

    Science.gov (United States)

    Coho, Aleksander; Kioussis, Nicholas

    2003-03-01

    We use the semidiscrete variational generelized Peierls-Nabarro model to study the effect of Cu alloying on the dislocation properties of Al. First-principles density functional theory (DFT) is used to calculate the generalized-stacking-fault (GSF) energy surface when a plane, on which one in four Al atoms has been replaced with a Cu atom, slips over a pure Al plane. Various dislocation core properties (core width, energy, Peierls stress, dissociation tendency) are investigated and compared with the pure Al case. Cu alloying lowers the intrinsic stacking fault (ISF) energy, which makes dislocations more likely to dissociate into partials. We also try to understand the lowering of ISF energy in terms of Al-Cu and Al-Al bond formation and braking during shearing along the direction. From the above we draw conclusions about the effects of Cu alloying on the mechanical properties of Al.

  20. Iron replacement therapy

    DEFF Research Database (Denmark)

    Nielsen, Ole Haagen; Coskun, Mehmet; Weiss, Günter

    2016-01-01

    PURPOSE OF REVIEW: Approximately, one-third of the world's population suffers from anemia, and at least half of these cases are because of iron deficiency. With the introduction of new intravenous iron preparations over the last decade, uncertainty has arisen when these compounds should...... be administered and under which circumstances oral therapy is still an appropriate and effective treatment. RECENT FINDINGS: Numerous guidelines are available, but none go into detail about therapeutic start and end points or how iron-deficiency anemia should be best treated depending on the underlying cause...... of iron deficiency or in regard to concomitant underlying or additional diseases. SUMMARY: The study points to major issues to be considered in revisions of future guidelines for the true optimal iron replacement therapy, including how to assess the need for treatment, when to start and when to stop...

  1. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Seismic measures and defence in depth of nuclear power plant. Lessons learned from the great east Japan earthquake

    International Nuclear Information System (INIS)

    Ochiai, Kanehiro

    2011-01-01

    The Great East Japan Earthquake occurred in March 11, 2011 brought about severe accident at nuclear power plant, which gave significant lessons to nuclear experts concerned with safety measures. Concepts of defence in depth was basic philosophy to assure safety of nuclear power plant even against uncertainties exceeding design basis. This concept consisted of prevention, monitoring, and action to mitigate consequences of failures such as a series of physical barriers between the reactor core and the environment, which were called multiple safety systems, each with backup and designed to accommodate human error. As for natural disaster, depth of recognition of characteristic of natural phenomena and its effect and engineering judgment was of prime importance. Different waveforms of ground motion at Fukushima and Onagawa at the Great East Japan Earthquake showed that design ground motion should have large uncertainties. To cope with uncertainties of ground motion, robust seismic measures based on experience were such as design of static seismic intensity and rigid structure of natural period less than 0.1 sec. As for tsunami, defence in depth measures were prepared for the cooling of reactor core, spent fuel and related electric generation equipment with taking into account 1) time lag between tsunami generation and arrival, 2) tsunami affected area could be limited by coastal levee or anti-inundation measure, 3) system redundancy could be assured by different locations of equipments and 4) repair works could be done by shipment of replacement equipment from outside due to limitation of affected regional area. Success examples of Onagawa, Tokai unit 2, Fukushima Daiichi unit 6 and Fukushima Daini Nuclear Power Plants could suggest definite tsunami defence in depth measures. Containment vent system as final heat sink and emergency condenser as reactor core cooling at outage should be properly utilized for Fukushima Daiichi unit 1 Nuclear Power Plant. (T. Tanaka)

  3. Replacement of pneumatic and hydraulic drives with electrical drives - Analysis of potential; Ersatz von pneumatischen und hydraulischen Antrieben durch Elektroantriebe. Potentialanalyse

    Energy Technology Data Exchange (ETDEWEB)

    Berchten, S. [BEngineering, Bassersdorf (Switzerland); Ritz, Ch. [Schnyder Ingenieure AG, Steg (Switzerland)

    2006-07-01

    This final report for the Swiss Federal Office of Energy (SFOE) discusses the potential offered by modern technologies to save energy. The replacement of energy-intensive methods of providing physical movement - such as with pneumatic and hydraulic drives - with electrical drives is discussed. Based on existing installations in industry, an estimate of the potential for making savings is presented. This shows that large energy savings can be made by directly converting electrical into mechanical energy. Using real world examples, end-users and decision-makers are shown two profit-scenarios involving the purchase of a new system or retrofitting an existing system. The scenarios take investments, operating costs and system life-cycle into account. Extrapolations provide estimates of savings-potentials for the Swiss electricity market. Various market sectors are looked at, including the metal-working, chemical, foodstuffs and packaging sectors. Examples of installations actually implemented, where electro-mechanical systems have replaced pneumatic and hydraulic drives, are given.

  4. Diabetes mellitus is associated with increased acute kidney injury and 1-year mortality after transcatheter aortic valve replacement: A meta-analysis.

    Science.gov (United States)

    Mina, George S; Gill, Priyanka; Soliman, Demiana; Reddy, Pratap; Dominic, Paari

    2017-09-01

    Diabetes mellitus (DM) is associated with adverse outcomes after surgical aortic valve replacement. However, there are conflicting data on the impact of DM on outcomes of transcatheter aortic valve replacement (TAVR). DM is associated with poor outcomes after different cardiac procedures. Therefore, DM can also be associated with poor outcomes after TAVR. We searched PubMed and Cochrane Central Register of Controlled Trials for studies that evaluated outcomes after TAVR and stratified at least 1 of the studied endpoints by DM status. The primary endpoint was all-cause mortality at 1 year. Secondary endpoints were early (up to 30 days) mortality, acute kidney injury (AKI), cerebrovascular accident (CVA), major bleeding, and major vascular complications. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using random effects models. We included 64 studies with a total of 38 686 patients. DM was associated with significantly higher 1-year mortality (OR: 1.14, 95% CI: 1.04-1.26, P = 0.008) and periprocedural AKI (OR: 1.28, 95% CI: 1.08-1.52, P = 0.004). On the other hand, there were no significant differences between diabetics and nondiabetics in early mortality, CVAs, major bleeding, or major vascular complications. DM is associated with increased 1-year mortality and periprocedural AKI in patients undergoing TAVR. The results of this study suggest that DM is a predictor of adverse outcomes in patients undergoing TAVR. © 2017 Wiley Periodicals, Inc.

  5. NSAC: in-depth look at Three Mile Island

    International Nuclear Information System (INIS)

    Lihach, N.; Zebroski, E.

    1979-01-01

    The Nuclear Safety Analysis Center (NSAC) is hoping to learn what caused the reactor accident at Three Mile Island, what happened during the accident, and how to take advantage of what is learned to prevent future incidents. When the Electric Power Research Institute (EPRI) was asked to make an independent assessment, the NSAC was organized with a separate identity and funded by special contributions from the electric utilities. The Center has nearly completed the first phase of organization and data gathering on the sequence of events. This will be followed by a safety analysis to determine causes and to look for ways to improve nuclear power plant technology. The Center will also serve as a clearing house for studies on the effects of radiation, improvements in instrumentation, and emergency response systems

  6. The in-depth safety assessment (ISA) pilot projects in Ukraine

    International Nuclear Information System (INIS)

    Kot, C. A.

    1998-01-01

    Ukraine operates pressurized water reactors of the Soviet-designed type, VVER. All Ukrainian plants are currently operating with annually renewable permits until they update their safety analysis reports (SARs). After approval of the SARS by the Ukrainian Nuclear Regulatory Authority, the plants will be granted longer-term operating licenses. In September 1995, the Nuclear Regulatory Authority and the Government Nuclear Power Coordinating Committee of Ukraine issued a new contents requirement for the safety analysis reports of VVERs in Ukraine. It contains requirements in three major areas: design basis accident (DBA) analysis, probabilistic risk assessment (PRA), and beyond design-basis accident (BDBA) analysis. The DBA requirements are an expanded version of the older SAR requirements. The last two requirements, on PRA and BDBA, are new. The US Department of Energy (USDOE), through the International Nuclear Safety Program (INSP), has initiated an assistance and technology transfer program to Ukraine to assist their nuclear power stations in developing a Western-type technical basis for the new SARS. USDOE sponsored In-Depth Safety Assessments (ISAs) have been initiated at three pilot nuclear reactor units in Ukraine, South Ukraine Unit 1, Zaporizhzhya Unit 5, and Rivne Unit 1. USDOE/INSP have structured the ISA program in such a way as to provide maximum assistance and technology transfer to Ukraine while encouraging and supporting the Ukrainian plants to take the responsibility and initiative and to perform the required assessments

  7. Estimation of fatality and injury risk by means of in-depth fatal accident investigation data.

    Science.gov (United States)

    Yannis, George; Papadimitriou, Eleonora; Dupont, Emmanuelle; Martensen, Heike

    2010-10-01

    In this article the factors affecting fatality and injury risk of road users involved in fatal accidents are analyzed by means of in-depth accident investigation data, with emphasis on parameters not extensively explored in previous research. A fatal accident investigation (FAI) database is used, which includes intermediate-level in-depth data for a harmonized representative sample of 1300 fatal accidents in 7 European countries. The FAI database offers improved potential for analysis, because it includes information on a number of variables that are seldom available, complete, or accurately recorded in road accident databases. However, the fact that only fatal accidents are examined requires for methodological adjustments, namely, the correction for two types of effects on a road user's baseline risk: "accident size" effects, and "relative vulnerability" effects. Fatality and injury risk can be then modeled through multilevel logistic regression models, which account for the hierarchical dependences of the road accident process. The results show that the baseline fatality risk of road users involved in fatal accidents decreases with accident size and increases with the vulnerability of the road user. On the contrary, accident size increases nonfatal injury risk of road users involved in fatal accidents. Other significant effects on fatality and injury risk in fatal accidents include road user age, vehicle type, speed limit, the chain of accident events, vehicle maneuver, and safety equipment. In particular, the presence and use of safety equipment such as seat belt, antilock braking system (ABS), and electronic stability program (ESP) are protection factors for car occupants, especially for those seated at the front seats. Although ABS and ESP systems are typically associated with positive effects on accident occurrence, the results of this research revealed significant related effects on accident severity as well. Moreover, accident consequences are more severe

  8. In-depth investigation of escalator riding accidents in heavy capacity MRT stations.

    Science.gov (United States)

    Chi, Chia-Fen; Chang, Tin-Chang; Tsou, Chi-Lin

    2006-07-01

    In 2000, the accident rate for escalator riding was about 0.815 accidents per million passenger trips through Taipei Metro Rapid Transit (MRT) heavy capacity stations. In order to reduce the probability and severity of escalator riding accidents and enhance the safety of passengers, the Drury and Brill model [Drury, C.G., Brill, M., 1983. Human factors in consumer product accident investigation. Hum. Factors 25 (3), 329-342] for in-depth investigation was adopted to analyze the 194 escalator riding accidents in terms of victim, task, product and environment. Prevention measures have been developed based on the major causes of accidents and other related contributing factors. The results from the analysis indicated that the majority of the escalator riding accidents was caused by passengers' carrying out other tasks (38 cases, including carrying luggage 24 cases, looking after accompany persons 9 cases, and 5 others), loss of balance (26 cases, 13.4%), not holding the handrail (20 cases, 10.3%), unhealthy passengers (18 cases, 9.3%), followed by people struck by other passenger (16 cases, 8.2%). For female passengers aged 15-64 years, their rushing for trains accidents could have been prevented by wearing safer footwear or by appropriate signing being provided indicating the location and traveling direction of escalators. Female passengers aged 65 years and above whose accidents were caused by loss of balance, should be encouraged to take the elevator instead. To prevent entrapment injuries, following a stricter design code can be most effective. Further in-depth accident investigation is suggested to cover the activity of the victim prior to the accident, any involved product, the location of the accident on the escalator, any medical treatment, what went wrong, opinion of the respondent on the causes of the accident, and personal characteristics of the passengers. Also, management must trade off productivity and safety appropriately to prevent "Organizational

  9. Multiple scattering effects in depth resolution of elastic recoil detection

    International Nuclear Information System (INIS)

    Wielunski, L.S.; Harding, G.L.

    1998-01-01

    Elastic Recoil Detection (ERD) is used to profile hydrogen and other low mass elements in thin films at surface and interfaces in a similar way that Rutherford Backscattering Spectroscopy (RBS) is used to detect and profile heavy elements. It is often assumed that the depth resolutions of these two techniques are similar. However, in contrast to typical RBS, the depth resolution of ERD is limited substantially by multiple scattering. In experimental data analysis and/or spectra simulations of a typical RBS measurement multiple scattering effects are often ignored. Computer programs used in IBA, such as RUMP, HYPRA or RBX do not include multiple scattering effects at all. In this paper, using practical thin metal structures with films containing intentionally introduced hydrogen, we demonstrate experimental ERD depth resolution and sensitivity limitations. The effects of sample material and scattering angle are also discussed. (authors)

  10. Multiple scattering effects in depth resolution of elastic recoil detection

    Energy Technology Data Exchange (ETDEWEB)

    Wielunski, L.S.; Harding, G.L. [Commonwealth Scientific and Industrial Research Organisation (CSIRO), Lindfield, NSW (Australia). Telecommunications and Industrial Physics; Szilagyi, E. [KFKI Research Institute for Particle and Nuclear Physics, Budapest, (Hungary)

    1998-06-01

    Elastic Recoil Detection (ERD) is used to profile hydrogen and other low mass elements in thin films at surface and interfaces in a similar way that Rutherford Backscattering Spectroscopy (RBS) is used to detect and profile heavy elements. It is often assumed that the depth resolutions of these two techniques are similar. However, in contrast to typical RBS, the depth resolution of ERD is limited substantially by multiple scattering. In experimental data analysis and/or spectra simulations of a typical RBS measurement multiple scattering effects are often ignored. Computer programs used in IBA, such as RUMP, HYPRA or RBX do not include multiple scattering effects at all. In this paper, using practical thin metal structures with films containing intentionally introduced hydrogen, we demonstrate experimental ERD depth resolution and sensitivity limitations. The effects of sample material and scattering angle are also discussed. (authors). 19 refs., 4 figs.

  11. Costs and outcomes associated with alternative discharge strategies following joint replacement surgery: analysis of an observational study using a propensity score.

    Science.gov (United States)

    Coyte, P C; Young, W; Croxford, R

    2000-11-01

    We estimated the impact of alternative discharge strategies, following joint replacement (JR) surgery, on acute care readmission rates and the total cost of a continuum of care. Following surgery, patients were discharged to one of four destinations. Propensity scores were used to adjust costs and outcomes for potential bias in the assignment of discharge destinations. We demonstrated that the use of rehabilitation hospitals may lower readmission rates, but at a prohibitive incremental cost of each saved readmission, that patients discharged with home care had longer acute care stays than other patients, that the provision of home care services increased health system costs, and that acute care readmission rates were greatest among patients discharged with home care. Our study should be seen as one important stepping stone towards a full economic evaluation of the continuum of care for patients.

  12. Regional citrate anticoagulation for continuous renal replacement therapy in severe burns-a retrospective analysis of a protocol-guided approach.

    Science.gov (United States)

    Gille, Jochen; Sablotzki, Armin; Malcharek, Michael; Raff, Thomas; Mogk, Martin; Parentin, Torsten

    2014-12-01

    For critically ill patients, the use of regional citrate anticoagulation as part of continuous renal replacement therapy (CRRT) has become increasingly common in recent years. However, there are scarce data on the use of this technique in patients with burns. The aim of this study was to examine the effectiveness, feasibility and complications of regional citrate anticoagulation for CRRT in burn patients, as well as the effects on coagulation and the electrolyte and acid-base balance. This retrospective study included all patients who received renal replacement therapy with citrate anticoagulation to treat acute kidney injury (AKI) between January 1, 2004 and December 31, 2009 at the burn unit of St. Georg Hospital GmbH in Leipzig. During the examination period, 18 patients were treated using CRRT with regional citrate anticoagulation (CVVHDF in the pre-dilution mode). The median patient age was 64 years (49.5; 71), with a median TBSA of 42.5% (33.25; 52.5) and a median ABSI score of 10 (9; 10). The CRRT was initiated on a median of 6 days (4; 8.75) after admission to the hospital and continued for a median duration of 7 days (5; 8). The median dialysis dose was 38.2mlkgBW(-1)h(-1) (31.8; 42.1). The median effective filter operation time was 67h (46; 72). No relevant disorders associated with acid-base balance, electrolytes or coagulation occurred, and there were no bleeding complications. In terms of bleeding risk and electrolyte and acid-base balance, regional citrate anticoagulation may be considered to be an effective, safe and user-friendly procedure for patients with severe burns and AKI. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  13. Fuzzy logic application for extruders replacement problem

    Directory of Open Access Journals (Sweden)

    Edison Conde Perez dos Santos

    2017-03-01

    Full Text Available In a scenario of uncertainty and imprecision, before taking the replacement analysis, a manager needs to consider the uncertain reality of a problem. In this scenario, the fuzzy logic makes an excellent option. Therefore, it is necessary to make a decision based on the fuzzy model. This study is based on the comparison of two methodologies used in the problem of asset replacement. The study, thus, was based on a comparison between two extruders for polypropylene yarn bibliopegy, comparing mainly the costs involved in maintaining the equipment.

  14. Cost justification of chiller replacement

    International Nuclear Information System (INIS)

    Baker, T.J.; Baumer, R.A.

    1993-01-01

    We often hear of products with paybacks that are too good to be true. Just a few weeks ago,a client received a recommendation from a national service company's local office. In the letter the company recommended that open-quotes due to the age and condition of the boiler ... that the school consider replacing the boiler... The cost for the new boiler can usually be recovered by lower fuel bills in 2 to 3 yearsclose quotes. This was for an installation in Southeast Texas where the boiler is only used 4 to 5 months per year. Analysis show the above claims to be nonsense. A new boiler would cost about $47,000 installed. Current total gas bills for the facility are $15,630 per year. They would have to shutoff the gas to the facility to have a three year payback. In fact, only two-thirds of the gas is used to heat the facility so we have only $10, 000 to write off against the new boiler. How much will the greater efficiency save? A 30% savings due to greater efficiency produces $3,000 per year in gas savings to offset the $47,000 cost, a 16 year payback. And much of the efficiency savings can be realized by adjusting the existing boiler. In another care a client wanted to investigate replacement of a twenty year old chiller plant with more efficient equipment. We investigated the project and determined that the payback would be greater than ten years. They did not operate the equipment during the summer and at less than 50% of capacity the balance of the year

  15. Uncovering Market Positioning Coordinates Using In-Depth Interviews. Evidence from the Romanian Modern Retail

    Directory of Open Access Journals (Sweden)

    Negricea Iliuta Costel

    2016-08-01

    Full Text Available Market positioning is not anymore just an outcome of the marketing endeavour but actually the essence of it. Organisations must develop and implement proper market positioning plans if they want to pursue an enduring existence. In this direction, an organisation must perform a brand situation analysis, its results being the starting point of a successful market positioning. This analysis entails collecting data about the brand and its competitors being performed through various qualitative and quantitative research methods. The current study focuses on the use of in-depth interviews, a very important qualitative research instrument, in collecting data necessary to build a market position in the form of inconspicuous consumer behaviour factors, such as perceptions, attitudes and motivations. The peculiarities and advantages of this tool are detailed in an analysis of the Romanian modern retail. The findings through their richness made possible configuring market positions for several companies under study. There is no doubt about the effectiveness of this tool in collecting essential data for an effective market positioning. However, in some instances an organisation might need data of quantitative nature in making market positioning decisions, situations in which the use of the indepth interview should be complemented with a survey.

  16. Antenna Controller Replacement Software

    Science.gov (United States)

    Chao, Roger Y.; Morgan, Scott C.; Strain, Martha M.; Rockwell, Stephen T.; Shimizu, Kenneth J.; Tehrani, Barzia J.; Kwok, Jaclyn H.; Tuazon-Wong, Michelle; Valtier, Henry; Nalbandi, Reza; hide

    2010-01-01

    The Antenna Controller Replacement (ACR) software accurately points and monitors the Deep Space Network (DSN) 70-m and 34-m high-efficiency (HEF) ground-based antennas that are used to track primarily spacecraft and, periodically, celestial targets. To track a spacecraft, or other targets, the antenna must be accurately pointed at the spacecraft, which can be very far away with very weak signals. ACR s conical scanning capability collects the signal in a circular pattern around the target, calculates the location of the strongest signal, and adjusts the antenna pointing to point directly at the spacecraft. A real-time, closed-loop servo control algorithm performed every 0.02 second allows accurate positioning of the antenna in order to track these distant spacecraft. Additionally, this advanced servo control algorithm provides better antenna pointing performance in windy conditions. The ACR software provides high-level commands that provide a very easy user interface for the DSN operator. The operator only needs to enter two commands to start the antenna and subreflector, and Master Equatorial tracking. The most accurate antenna pointing is accomplished by aligning the antenna to the Master Equatorial, which because of its small size and sheltered location, has the most stable pointing. The antenna has hundreds of digital and analog monitor points. The ACR software provides compact displays to summarize the status of the antenna, subreflector, and the Master Equatorial. The ACR software has two major functions. First, it performs all of the steps required to accurately point the antenna (and subreflector and Master Equatorial) at the spacecraft (or celestial target). This involves controlling the antenna/ subreflector/Master-Equatorial hardware, initiating and monitoring the correct sequence of operations, calculating the position of the spacecraft relative to the antenna, executing the real-time servo control algorithm to maintain the correct position, and

  17. Excellence in fleet combat replacement squadrons: predicting carrier qualification success

    OpenAIRE

    Smith, Martin P.

    1988-01-01

    This thesis presents a two-part analysis of excellence criteria for fleet combat replacement squadrons. Part one focuses on the qualitative issues and management techniques identified in outstanding fleet combat replacement squadrons. Part two develops and presents a regression model for predicting a fleet replacement squadron pilot's carrier qualification grade. The model was derived using standard linear regression techniques and the SPSSx software package of the Naval Postgraduate School. ...

  18. Evaluation of HPV type-replacement in unvaccinated and vaccinated adolescent females-Post-hoc analysis of a community-randomized clinical trial (II).

    Science.gov (United States)

    Gray, Penelope; Palmroth, Johanna; Luostarinen, Tapio; Apter, Dan; Dubin, Gary; Garnett, Geoff; Eriksson, Tiina; Natunen, Kari; Merikukka, Marko; Pimenoff, Ville; Söderlund-Strand, Anna; Vänskä, Simopekka; Paavonen, Jorma; Pukkala, Eero; Dillner, Joakim; Lehtinen, Matti

    2018-06-15

    Efficacy of human papillomavirus (HPV) vaccines promises to control HPV infections. However, HPV vaccination programs may lay bare an ecological niche for non-vaccine HPV types. We evaluated type-replacement by HPV type and vaccination strategy in a community-randomized trial executed in HPV vaccination naïve population. Thirty-three communities were randomized to gender-neutral vaccination with AS04-adjuvanted HPV16/18 vaccine (Arm A), HPV vaccination of girls and hepatitis B-virus (HBV) vaccination of boys (Arm B) and gender-neutral HBV vaccination (Arm C). Resident 1992-95 born boys (40,852) and girls (39,420) were invited. 11,662 boys and 20,513 girls were vaccinated with 20-30% and 45-48% coverage, respectively. HPV typing of 11,396 cervicovaginal samples was performed by high throughput PCR. Prevalence ratios (PR) between arms and ranked order of HPV types and odds ratio (OR) for having multiple HPV types in HPV16 or 18/45 positive individuals were calculated. The ranked order of HPV types did not significantly differ between arms or birth cohorts. For the non-HPV vaccinated 1992-1993 birth cohorts increased PR, between the gender-neutral intervention versus control arms for HPV39 (PR A 1.84, 95% CI 1.12-3.02) and HPV51 (PR A 1.56, 95% CI 1.11-2.19) were observed. In the gender-neutral arm, increased clustering between HPV39 and the vaccine-covered HPV types 16 or 18/45 (OR A16  = 5.1, OR A18/45  = 11.4) was observed in the non-HPV vaccinated 1994-1995 birth cohorts. Comparable clustering was seen between HPV51 and HPV16 or HPV18/45 (OR B16  = 4.7, OR B18/45  = 4.3), in the girls-only arm. In conclusion, definitively consistent postvaccination patterns of HPV type-replacement were not observed. Future occurrence of HPV39 and HPV51 warrant investigation. © 2018 UICC.

  19. Hip Replacement: MedlinePlus Health Topic

    Science.gov (United States)

    ... invasive hip replacement (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Hip Replacement updates ... replacement - precautions Minimally invasive hip replacement Related Health Topics Hip Injuries and Disorders National Institutes of Health ...

  20. Educating My Replacement

    Science.gov (United States)

    Tarter, Jill

    , in partnership with the dedicated teachers out there, I think I can help promote the critical thinking skills and scientific literacy of the next generation of voters. Hopefully, I can also help train my replacement to be a better scientist, capable of seizing all the opportunities generated by advances in technology and our improved understanding of the universe to craft search strategies with greater probability of success than those I have initiated.

  1. Transforming Normal Programs by Replacement

    NARCIS (Netherlands)

    Bossi, Annalisa; Pettorossi, A.; Cocco, Nicoletta; Etalle, Sandro

    1992-01-01

    The replacement transformation operation, already defined in [28], is studied wrt normal programs. We give applicability conditions able to ensure the correctness of the operation wrt Fitting's and Kunen's semantics. We show how replacement can mimic other transformation operations such as thinning,

  2. Minimally invasive aortic valve replacement

    DEFF Research Database (Denmark)

    Foghsgaard, Signe; Schmidt, Thomas Andersen; Kjaergard, Henrik K

    2009-01-01

    In this descriptive prospective study, we evaluate the outcomes of surgery in 98 patients who were scheduled to undergo minimally invasive aortic valve replacement. These patients were compared with a group of 50 patients who underwent scheduled aortic valve replacement through a full sternotomy...... operations were completed as mini-sternotomies, 4 died later of noncardiac causes. The aortic cross-clamp and perfusion times were significantly different across all groups (P replacement...... is an excellent operation in selected patients, but its true advantages over conventional aortic valve replacement (other than a smaller scar) await evaluation by means of randomized clinical trial. The "extended mini-aortic valve replacement" operation, on the other hand, is a risky procedure that should...

  3. [In-depth assessment of work-related stress in a major company undergoing restructuring].

    Science.gov (United States)

    Magrini, Andrea; Pelagalli, Maria Felicia; Pietroiusti, Antonio; Livigni, Lucilla; Guidi, Stefano; Moscatelli, Maurizia; Mascioli, Marco; D'Orsi, Fulvio; Zolla, Antonella; Bagnara, Sebastiano

    2015-07-08

    An in-depth assessment of work-related stress was conducted in a major national telecommunications company undergoing major changes. The assessment was made on three homogeneous groups of workers and covered a large representative sample of the corresponding populations. To identify the main sources of stress for the three populations of workers, stimulate a discussion on the possible corrective actions, and assess the impact of the on-going organizational changes on workers' health. The assessment started with an analysis of the objective stress indicators listed in the INAIL (National Insurance Institute for Occupational Diseases and Accidents) Checklist. This was followed by a combination of qualitative and quantitative investigations on work context and tasks and on the subjective perceptions of workers, which were carried out by using: semi-structured interviews with management, field observations of work tasks, focus groups and questionnaires (GHQ-12, HSE Indicator Tool, ad-hoc questionnaire). The assessment allowed identification of the critical areas to be addressed with specific interventions: relationship with the company, work performance, work organization, and equipment. the investigation allowed to identification of specific practical actions (improvement of technological tools; professional development through training courses) as well as strategic actions ( re-establish relationship of trust with the company) so as to mitigate the workers' level of stress. Analysis of the results also showed that the three targeted populations differed in the degree of acceptance and understanding of the organizational changes.

  4. Ion-beam-induced topography and compositional changes in depth profiling

    International Nuclear Information System (INIS)

    Carter, G.; Nobes, M.J.

    1992-01-01

    When energetic ions penetrate and stop in solids they not only add a new atomic constituent to the matrix but they also create atomic recoils and defects. The fluxes of these entities can give rise to spatial redistribution of atomic components, which may be partly or completely balanced by reordering and relaxation processes. These latter, in turn, may be influenced by fields and gradients induced by the primary relocation processes and by the energy deposited. These will include quasi-thermal, concentration (or chemical potential) and electrostatic gradients and may act to enhance or suppress atomic redistribution. Some, or all, of these processes will operate, depending upon the system under study, when energetic ions are employed to sputter erode a substrate for depth sectioning and, quite generally, can perturb the atomic depth profile that it is intended to evaluate. Theoretical and computational approaches to modelling such processes will be outlined and experimental examples shown which illustrate specific phenomena. In particular the accumulation of implant species and defect generation or redistribution can modify, with increasing ion fluence, the local sputtering mechanism and create further problems in depth profile analysis as a changing surface topography penetrates the solid. Examples of such topographic evolution and its influence on depth profiling analysis will be given and models to explain general and specific behaviour will be outlined. The commonality of models which examine both depth-dependent composition modification and surface topography evolution will be stressed. (author)

  5. Five-Year Survival of 20,946 Unicondylar Knee Replacements and Patient Risk Factors for Failure: An Analysis of German Insurance Data.

    Science.gov (United States)

    Jeschke, Elke; Gehrke, Thorsten; Günster, Christian; Hassenpflug, Joachim; Malzahn, Jürgen; Niethard, Fritz Uwe; Schräder, Peter; Zacher, Josef; Halder, Andreas

    2016-10-19

    Improvements in implant design and surgical technique of unicondylar knee arthroplasty have led to reduced revision rates, but patient selection seems to be crucial for success of such arthroplasties. The purpose of the present study was to analyze the 5-year implant survival rate of unicondylar knee replacements in Germany and to identify patient factors associated with an increased risk of revision, including >30 comorbid conditions. Using nationwide billing data of the largest German health-care insurance for inpatient hospital treatment, we identified patients who underwent unicondylar knee arthroplasty between 2006 and 2012. Kaplan-Meier survival curves with revision as the end point and log-rank tests were used to evaluate 5-year implant survival. A multivariable Cox regression model was used to determine factors associated with revision. The risk factors of age, sex, diagnosis, comorbidities, type of implant fixation, and hospital volume were analyzed. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated. During the study period, a total of 20,946 unicondylar knee arthroplasties were included. The number of unicondylar knee arthroplasties per year increased during the study period from 2,527 in 2006 to 4,036 in 2012. The median patient age was 64 years (interquartile range, 56 to 72 years), and 60.4% of patients were female. During the time evaluated, the 1-year revision rate decreased from 14.3% in 2006 to 8.7% in 2011. The 5-year survival rate was 87.8% (95% CI, 87.3% to 88.3%). Significant risk factors (p 74 years was used as the reference); female sex (HR, 1.18 [95% CI, 1.07 to 1.29]); complicated diabetes (HR, 1.47 [95% CI, 1.03 to 2.12]); depression (HR, 1.29 [95% CI, 1.06 to 1.57]); obesity, defined as a body mass index of ≥30 kg/m 2 (HR, 1.13 [95% CI, 1.02 to 1.26]); and low-volume hospitals, denoted as an annual hospital volume of ≤10 cases (HR, 1.60 [95% CI, 1.39 to 1.84]), 11 to 20 cases (HR, 1.47 [95% CI, 1.27 to 1

  6. Prosthetic alignment after total knee replacement is not associated with dissatisfaction or change in Oxford Knee Score: A multivariable regression analysis.

    Science.gov (United States)

    Huijbregts, Henricus J T A M; Khan, Riaz J K; Fick, Daniel P; Jarrett, Olivia M; Haebich, Samantha

    2016-06-01

    Approximately 18% of the patients are dissatisfied with the result of total knee replacement. However, the relation between dissatisfaction and prosthetic alignment has not been investigated before. We retrospectively analysed prospectively gathered data of all patients who had a primary TKR, preoperative and one-year postoperative Oxford Knee Scores (OKS) and postoperative computed tomography (CT). The CT protocol measures hip-knee-ankle (HKA) angle, and coronal, sagittal and axial component alignment. Satisfaction was defined using a five-item Likert scale. We dichotomised dissatisfaction by combining '(very) dissatisfied' and 'neutral/not sure'. Associations with dissatisfaction and change in OKS were calculated using multivariable logistic and linear regression models. 230 TKRs were implanted in 105 men and 106 women. At one year, 12% were (very) dissatisfied and 10% neutral. Coronal alignment of the femoral component was 0.5 degrees more accurate in patients who were satisfied at one year. The other alignment measurements were not different between satisfied and dissatisfied patients. All radiographic measurements had a P-value>0.10 on univariate analyses. At one year, dissatisfaction was associated with the three-months OKS. Change in OKS was associated with three-months OKS, preoperative physical SF-12, preoperative pain and cruciate retaining design. Neither mechanical axis, nor component alignment, is associated with dissatisfaction at one year following TKR. Patients get the best outcome when pain reduction and function improvement are optimal during the first three months and when the indication to embark on surgery is based on physical limitations rather than on a high pain score. 2. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. A multi-perspective cost-effectiveness analysis comparing rivaroxaban with enoxaparin sodium for thromboprophylaxis after total hip and knee replacement in the German healthcare setting

    Directory of Open Access Journals (Sweden)

    Zindel Sonja

    2012-07-01

    Full Text Available Abstract Background Patients undergoing major orthopaedic surgery (MOS, such as total hip (THR or total knee replacement (TKR, are at high risk of developing venous thromboembolism (VTE. For thromboembolism prophylaxis, the oral anticoagulant rivaroxaban has recently been included in the German diagnosis related group (DRG system. However, the cost-effectiveness of rivaroxaban is still unclear from both the German statutory health insurance (SHI and the German hospital perspective. Objectives To assess the cost-effectiveness of rivaroxaban from the German statutory health insurance (SHI perspective and to analyse financial incentives from the German hospital perspective. Methods Based on data from the RECORD trials and German cost data, a decision tree was built. The model was run for two settings (THR and TKR and two perspectives (SHI and hospital per setting. Results Prophylaxis with rivaroxaban reduces VTE events (0.02 events per person treated after TKR; 0.007 after THR compared with enoxaparin. From the SHI perspective, prophylaxis with rivaroxaban after TKR is cost saving (€27.3 saving per patient treated. However, the cost-effectiveness after THR (€17.8 cost per person remains unclear because of stochastic uncertainty. From the hospital perspective, for given DRGs, the hospital profit will decrease through the use of rivaroxaban by €20.6 (TKR and €31.8 (THR per case respectively. Conclusions Based on our findings, including rivaroxaban for reimbursement in the German DRG system seems reasonable. Yet, adequate incentives for German hospitals to use rivaroxaban are still lacking.

  8. THE REPLACEMENT-RENEWAL OF INDUSTRIAL EQUIPMENTS. THE MAPI FORMULAS

    Directory of Open Access Journals (Sweden)

    Meo Colombo Carlotta

    2010-07-01

    Full Text Available Since the production has been found to be an economical means for satisfying human wants, this process requires a complex industrial organization together with a large investment in equipments, plants and productive systems. These productive systems are employed to alter the physical environment and create consumer goods. As a result, they are consumed or become obsolete, inadequate, or otherwise candidates for replacement. When replacement is being considered, two assets must be evaluated: the present asset, the defender and its potential replacement, the challenger. Since the success of an industrial organization depends upon profit, replacement should generally occur if an economic advantage will result. Whatever the reason leading to the consideration of replacement, the analysis and decisions must be based upon estimates of what will occur in the future. In this paper we present the Mapi algorithm as a procedure for evaluating investments or for analyzing replacement opportunities.

  9. Opportunity-based age replacement: exponentially distributed times between opportunities

    NARCIS (Netherlands)

    R. Dekker (Rommert); M.C. Dijkstra (Matthijs)

    1992-01-01

    textabstractThis article gives a full analysis of a component-replacement model in which preventive replacements are only possible at maintenance opportunities. These oppertunities arise according to a Poisson process, independently of failures of the component. Conditions for the existence of a

  10. Patients Unicondylar Knee Replacement vs. Total Knee Replacement

    OpenAIRE

    Hedra Eskander

    2017-01-01

    The aim of this review article is to analyse the clinical effectiveness of total knee replacement (TKR) compared to unicondylar knee replacement (UKR) on patients. In terms of survival rates, revision rates and postoperative complications. The keywords used were: knee arthroplasty. Nearly three thousand articles were found on 25 August 2016. Of those, only twenty-five were selected and reviewed because they were strictly focused on the topic of this article. Compared with those who have TKR, ...

  11. Modeling and Analyzing Intrusion Attempts to a Computer Network Operating in a Defense in Depth Posture

    National Research Council Canada - National Science Library

    Givens, Mark

    2004-01-01

    In order to ensure the confidentially, integrity, and availability of networked resources operating on the Global Information Grid, the Department of Defense has incorporated a "Defense-in-Depth" posture...

  12. Aortic valve replacement

    DEFF Research Database (Denmark)

    Kapetanakis, Emmanouil I; Athanasiou, Thanos; Mestres, Carlos A

    2008-01-01

    mortality were collected. Group analysis by patient geographic distribution and by annular diameter of the prosthesis utilized was conducted. Patients with a manufacturer's labeled prosthesis size > or = 21 mm were assigned to the 'large' aortic size subset, while those with a prosthesis size ... differences in the distribution of either gender or BSA. In the multivariable model, south European patients were seven times more likely to receive a smaller-sized aortic valve (OR = 6.5, 95% CI = 4.82-8.83, p

  13. Defense-in-depth and diversity assessment of the RESAR-414 Integrated Protection System

    International Nuclear Information System (INIS)

    1979-01-01

    This report discusses the defense-in-depth and diversity principles as they apply to safety related instrumentation and presents guidelines which can be used to assess the degree to which the designs of complex, interconnected safety systems conform to these principles. These guidelines are based on the use of the block concept, an approach in which the components and modules of the system are aggregated into a small number of functional units, or blocks, to simplify the analysis. It is believed that the use of the block concept and the guidelines will result in a conservative assessment of the capability of such systems to function when subjected to postulated to common-mode failures. A preliminary assessment of the RESAR-414 Integrated Protection System by means of the guidelines is also presented. The results of this assessment support the conclusion that, for purposes of a preliminary design approval, the RESAR-414 Integrated Protection System is acceptable. However, the assessment, has also resulted in requirements for additional analyses and tests, the results of which must demonstrate conformance to the guidelines prior to the issuance of a Final Design Approval

  14. Defense-in-depth evaluation for the New Waste Transfer Facility

    International Nuclear Information System (INIS)

    Hayes, T.G.; Kelly, J.L.

    1995-01-01

    This report fulfills part of the requirements of References 2 and 3 by documenting a Defense-In-Depth evaluation for the New Waste Transfer Facility (NWTF). This evaluation was performed using methodology similar to that used in an evaluation for the Defense Waste Processing Facility (DWPF). It differs because the DWPF evaluation was based on an existing Process Hazards Analysis (PHA) while NWTF's is based on a Preoperational Process Hazards Review (PHR) (Ref. 1). The accidents in the Process Hazards Review (PHR) were reviewed to determine those that might have significant consequences. Significance was based on the findings of the PHR, The facility design was reviewed to determine the Structures, Systems, and Components (SSCs) and administrative controls available before and after each accident. From this was developed a list of the Lines of Defense (LODs) available to contain the hazard associated with the accident. A summary of these LODs is given in Appendix C. Items are tabulated that are suggested for consideration in the functional classification as worker protection items. The specific criteria used in the evaluation is given in the methodology section of this report. The results are documented in Appendices A, B, C, and D

  15. Eimeria atlapetesi nom. nov., a replacement name for Eimeria pileata Soriano-Vargas et al., 2015 (Apicomplexa: Eimeriidae), preoccupied by Eimeria pileata Straneva and Kelley, 1979 (Apicomplexa: Eimeriidae), with observations on histopathology and phylogenetic analysis.

    Science.gov (United States)

    Soriano-Vargas, Edgardo; Salgado-Miranda, Celene; Zepeda-Velázquez, Andrea Paloma; Medina, Juan Pablo; Janczur, Mariusz Krzysztof; González-Gómez, Maricruz; Flores-Valle, Izanami Tereira; Berto, Bruno Pereira; Lopes, Carlos Wilson Gomes

    2017-01-31

    Eimeria pileata Soriano-Vargas, Medina, Salgado-Miranda, García-Conejo, Galindo-Sánchez, Janczur, Berto and Lopes, 2015 is a junior homonym of Eimeria pileata Straneva and Kelley, 1979 and needs to be replaced. This coccidium was described from a rufous-capped brush finch Atlapetes pileatus Wagler in the Nevado de Toluca Natural Protected Area, Mexico. Thus, to maintain the original intent of the specific epithet derived from the scientific name of the type-host, the name Eimeria atlapetesi nom. nov. is proposed as a replacement name. Additionally, the current work reports another rufous-capped brush finch A. pileatus parasitized by E. atlapetesi in co-infection with an Isospora sp., providing observations of histopathology and phylogenetic analysis of 18S ribosomal RNA (rRNA) gene from E. atlapetesi. Endogenous forms of E. atlapetesi and Isospora sp. were observed in intestinal sections. Few oocysts of Isospora sp. were observed; therefore they were not morphologically or molecularly identified. In return, E. atlapetesi was identified and it was phylogenetically close to Eimeria dispersa Tyzzer, 1929 from the domestic turkey Meleagris gallopavo Linnaeus.

  16. Nuclear reactor fuel replacement system

    International Nuclear Information System (INIS)

    Kayano, Hiroyuki; Joge, Toshio.

    1976-01-01

    Object: To permit the direction in which a fuel replacement unit is moving to be monitored by the operator. Structure: When a fuel replacement unit approaches an intermediate goal position preset in the path of movement, renewal of data display on a goal position indicator is made every time the goal position is changed. With this renewal, the prevailing direction of movement of the fuel replacement unit can be monitored by the operator. When the control of movement is initiated, the co-ordinates of the intermediate goal point A are displayed on a goal position indicator. When the replacement unit reaches point A, the co-ordinates of the next intermediate point B are displayed, and upon reaching point B the co-ordinates of the (last) goal point C are displayed. (Nakamura, S.)

  17. Slab replacement maturity guidelines : [summary].

    Science.gov (United States)

    2014-04-01

    Concrete sets in hours at moderate temperatures, : but the bonds that make concrete strong continue : to mature over days to years. However, for : replacement concrete slabs on highways, it is : crucial that concrete develop enough strength : within ...

  18. Prolonged Intermittent Renal Replacement Therapy.

    Science.gov (United States)

    Edrees, Fahad; Li, Tingting; Vijayan, Anitha

    2016-05-01

    Prolonged intermittent renal replacement therapy (PIRRT) is becoming an increasingly popular alternative to continuous renal replacement therapy in critically ill patients with acute kidney injury. There are significant practice variations in the provision of PIRRT across institutions, with respect to prescription, technology, and delivery of therapy. Clinical trials have generally demonstrated that PIRRT is non-inferior to continuous renal replacement therapy regarding patient outcomes. PIRRT offers cost-effective renal replacement therapy along with other advantages such as early patient mobilization and decreased nursing time. However, due to lack of standardization of the procedure, PIRRT still poses significant challenges, especially pertaining to appropriate drug dosing. Future guidelines and clinical trials should work toward developing consensus definitions for PIRRT and ensure optimal delivery of therapy. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  19. Can we Replace Arterial Blood Gas Analysis by Pulse Oximetry in Neonates with Respiratory Distress Syndrome, who are Treated According to INSURE Protocol?

    Directory of Open Access Journals (Sweden)

    Pedram Niknafs

    2015-05-01

    Full Text Available Neonates with respiratory distress syndrome (RDS, who are treated according to INSURE protocol; require arterial blood gas (ABG analysis to decide on appropriate management. We conducted this study to investigate the validity of pulse oximetry instead of frequent ABG analysis in the evaluation of these patients. From a total of 193 blood samples obtained from 30 neonates <1500 grams with RDS, 7.2% were found to have one or more of the followings: acidosis, hypercapnia, or hypoxemia. We found that pulse oximetry in the detection of hyperoxemia had a good validity to appropriately manage patients without blood gas analysis. However, the validity of pulse oximetry was not good enough to detect acidosis, hypercapnia, and hypoxemia.

  20. Replacement of sub-systems

    International Nuclear Information System (INIS)

    Rosen, S.E.

    1992-01-01

    This paper describes a number of quality aspects related to replacement of important systems or components in a nuclear power station. Reference is given to the steam generator replacement and power uprating performed at Ringhals 2 in Sweden in 1989. Since quality is a wide concept there has been put special emphasis in this paper to the important aspects that traditionally are not connected to quality. (author) 1 fig

  1. Changing trends in total knee replacement

    OpenAIRE

    Goudie, Ewan; Robinson, Cal; Walmsley, Phil; Brenkel, Ivan

    2017-01-01

    Introduction:  This study evaluates a possible change in the demographics and surgical practice observed in a large cohort of patients undergoing total knee replacement (TKR). Patients and methods:  We performed a retrospective analysis of a prospectively collected data on two groups of consecutive patients undergoing primary TKR. Group one consisted of patients who underwent surgery between 1994 and 1998. Group two consisted of patients who had surgery between 2009 and 2012. Results:  The me...

  2. Feeder replacement tooling and processes

    International Nuclear Information System (INIS)

    Mallozzi, R.; Goslin, R.; Pink, D.; Askari, A.

    2008-01-01

    Primary heat transport system feeder integrity has become a concern at some CANDU nuclear plants as a result of thinning caused by flow accelerated corrosion (FAC). Feeder inspections are indicating that life-limiting wall thinning can occur in the region between the Grayloc hub weld and second elbow of some outlet feeders. In some cases it has become necessary to replace thinned sections of affected feeders to restore feeder integrity to planned end of life. Atomic Energy of Canada Limited (AECL) and Babcock and Wilcox Canada Ltd. (B and W) have developed a new capability for replacement of single feeders at any location on the reactor face without impacting or interrupting operation of neighbouring feeders. This new capability consists of deploying trained crews with specialized tools and procedures for feeder replacements during planned outages. As may be expected, performing single feeder replacement in the congested working environment of an operational CANDU reactor face involves overcoming many challenges with respect to access to feeders, available clearances for tooling, and tooling operation and performance. This paper describes some of the challenges encountered during single feeder replacements and actions being taken by AECL and B and W to promote continuous improvement of feeder replacement tooling and processes and ensure well-executed outages. (author)

  3. Using a symbolic process model as input for model-based fMRI analysis : Locating the neural correlates of problem state replacements

    NARCIS (Netherlands)

    Borst, J.P.; Taatgen, N.A.; Van Rijn, D.H.

    2011-01-01

    In this paper, a model-based analysis method for fMRI is used with a high-level symbolic process model. Participants performed a triple-task in which intermediate task information needs to be updated frequently. Previous work has shown that the associated resource - the problem state resource - acts

  4. Can the computer replace the adult for storybook reading? A meta-analysis on the effects of multimedia stories as compared to sharing print stories with an adult

    NARCIS (Netherlands)

    Takacs, Zsofia K.; Swart, Elise K.; Bus, Adriana G

    2014-01-01

    The present meta-analysis challenges the notion that young children necessarily need adult scaffolding in order to understand a narrative story and learn words as long as they encounter optimally designed multimedia stories. Including 29 studies and 1272 children, multimedia stories were found more

  5. Steam generator replacement from ALARA aspects

    International Nuclear Information System (INIS)

    Terry, I.; Breznik, B.

    2003-01-01

    This paper is going to consider radiological related parameters important for steam generator replacement (SGR) implementation. These parameters are identified as ALARA related parameters, owner-contractor relationship, planning, health physics with logistic services, and time required for the replacement. ALARA related parameters such as source or initial dose rate and plant system configuration define the initial conditions for the planning. There is room to optimise work planning. managerial procedures and also the staff during the implementation phase. The overview of these general considerations is based on the following background: using internationally available data and the experience of one of the vendors, i.e. Siemens-Framatome, and management experience of SG replacement which took place at Krsko NPP in the spring of 2000. Generally plant decisions on maintenance or repair procedures under radiation conditions take into account ALARA considerations. But in the main it is difficult to adjudge the results of an ALARA study, usually in the form of a collective dose estimate, because a comparison standard is missing. That is, very often the planned work is of a one-off nature so comparisons are not possible or the scopes are not the same. In such a case the collective doses for other types of work are looked at and a qualitative evaluation is made. In the case of steam generator replacement this is not the case. Over years of steam generator replacements world-wide a standard has been developed gradually. The first part of the following displays an overview of SGR and sets the Krsko SGR in perspective by applying dose analysis. The second part concentrates on the Krsko SGR itself and its ALARA aspects. (authors)

  6. Laboratory Evaluation of LED T8 Replacement Lamp Products

    Energy Technology Data Exchange (ETDEWEB)

    Richman, Eric E.; Kinzey, Bruce R.; Miller, Naomi J.

    2011-05-23

    A report on a lab setting analysis involving LED lamps intended to directly replace T8 fluorescent lamps (4') showing light output, power, and economic comparisons with other fluorescent options.

  7. Analysis

    DEFF Research Database (Denmark)

    Mathiesen, Brian Vad; Liu, Wen; Zhang, Xiliang

    2014-01-01

    three major technological changes: energy savings on the demand side, efficiency improvements in energy production, and the replacement of fossil fuels by various sources of renewable energy. Consequently, the analysis of these systems must include strategies for integrating renewable sources...

  8. Kinematic and kinetic analysis of the knee joint before and after a PCL retaining total knee replacement during gait and single step ascent.

    Science.gov (United States)

    Apostolopoulos, Alexandros; Lallos, Stergios; Mastrokalos, Dimitrios; Michos, Ioannis; Darras, Nikolaos; Tzomaki, Magda; Efstathopoulos, Nikolaos

    2011-01-01

    The objective of this study was to capture and analyze the kinetics and kinematics and determine the functional performance of the osteoarthritic knee after a posterior cruciate ligament (PCL) retaining total knee arthroplasty. Kinematic and kinetic gait analysis of level walking was performed in 20 subjects (12 female and 8 male) with knee ostoarthritis. These patients were free of any neurological diseases that could affect their normal gait. Mean age was 69.6 ± 6.6 years; mean height was 157.6 cm ± 7.6 cm; and mean weight was 77.2 ± 12.1 kg. Full body gait analyses were performed using the BIOKIN 3D motion analysis system before and 9 months after total knee arthroplasty procedures. Single-step ascending kinetic analyses and plantar pressure distribution analyses were also performed for all subjects. International Knee Society Scores (IKSSs) were also assessed pre- and postoperatively. Significant increases were noted postoperatively in average cadence (preoperative mean = 99.26, postoperative mean = 110.5; p knee adduction moment were also reported postoperatively. All patients showed a significant improvement of knee kinetics and kinematics after a PCL retaining total knee arthroplasty. Significant differences were found in the cadence, step length, stride length, and walk velocity postoperatively. IKSSs also significantly improved. Further research is warranted to determine the clinical relevance of these findings.

  9. Energy and exergy analysis of LPG (liquefied petroleum gas) as a drop in replacement for R134a in domestic refrigerators

    International Nuclear Information System (INIS)

    El-Morsi, Mohamed

    2015-01-01

    This study presents a comparison of energetic and exergetic performance of a vapour compression refrigeration system using pure HC (hydrocarbon) refrigerants. In this study, three different pure HCs propane (R290), butane (R600) and commercial LPG (liquefied petroleum gas) are used in the theoretical analysis. R134a is also used in the analysis as a reference refrigerant. The evaporator temperature ranges from −30 to 0 °C while the condenser ranges from 30 to 50 °C. MATLAB software is used for solving the thermodynamic equations, while the thermo-physical properties are calculated using REFPROP software. The results show that R600 has the highest COP c and exergetic efficiency, while LPG has the lowest. When compared to R134a, the COP c for R134a is higher than that for LPG by 10%. Also, the exergetic efficiency is higher by 5%. However, LPG has the advantage of being not expensive, available in large amounts and zero ozone depletion potential and low global warming potential. - Highlights: • The results show that R600 has the highest COP c & exergy efficiency, and the lowest irreversibility. • LPG has the lowest COP c & exergy efficiency, and the highest irreversibility. • Compared to R134a, LPG has a lower COP c and exergy efficiency by an average of 10% and 5%, respectively

  10. Can involved-field irradiation replace elective nodal irradiation in chemoradiotherapy for esophageal cancer? A systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Xiaoyue; Miao, Chuanwang; Chen, Zhen; Li, Wanhu; Yuan, Shuanghu; Yu, Jinming; Hu, Xudong

    2017-01-01

    Chemoradiotherapy is the most common treatment for inoperable esophageal cancer. However, there is no consensus on the delineation of the clinical target volume. Elective nodal irradiation (ENI) is recommended for inoperable esophageal cancer. A few studies have reported a decrease in the incidence of radiation-related toxicity of involved-field irradiation (IFI) for esophageal cancer. A systematic review and pooled analysis were performed to determine whether IFI in definitive chemoradiotherapy was more beneficial than ENI for esophageal cancer. The results showed no significant differences in the overall survival and local control rates between the IFI and ENI arms. Meanwhile, the incidences of esophageal and lung toxicities were significantly decreased in the IFI arm. These results suggest that IFI is a feasible treatment option for locally advanced esophageal cancer, especially to minimize irradiation-related toxicity.

  11. Can the computer replace the adult for storybook reading? A meta-analysis on the effects of multimedia stories as compared to sharing print stories with an adult.

    Science.gov (United States)

    Takacs, Zsofia K; Swart, Elise K; Bus, Adriana G

    2014-01-01

    The present meta-analysis challenges the notion that young children necessarily need adult scaffolding in order to understand a narrative story and learn words as long as they encounter optimally designed multimedia stories. Including 29 studies and 1272 children, multimedia stories were found more beneficial than encounters with traditional story materials that did not include the help of an adult for story comprehension (g+ = 0.40, k = 18) as well as vocabulary (g+ = 0.30, k = 11). However, no significant differences were found between the learning outcomes of multimedia stories and sharing traditional print-like stories with an adult. It is concluded that multimedia features like animated illustrations, background music and sound effects provide similar scaffolding of story comprehension and word learning as an adult.

  12. Can the computer replace the adult for storybook reading? A meta-analysis on the effects of multimedia stories as compared to sharing print stories with an adult.

    Directory of Open Access Journals (Sweden)

    Zsofia Katalin Takacs

    2014-12-01

    Full Text Available The present meta-analysis challenges the notion that young children necessarily need adult scaffolding in order to understand a narrative story and learn words as long as they encounter optimally designed multimedia stories. Including 29 studies and 1272 children, multimedia stories were found more beneficial than encounters with traditional story materials that did not include the help of an adult for story comprehension (g+ = 0.40, k = 18 as well as vocabulary (g+ = 0.30, k = 11. However, no significant differences were found between the learning outcomes of multimedia stories and sharing traditional print-like stories with an adult. It is concluded that multimedia features like animated illustrations, background music and sound effects provide similar scaffolding of story comprehension and word learning as an adult.

  13. Qualitative elastography can replace thyroid nodule fine-needle aspiration in patients with soft thyroid nodules. A systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Nell, Sjoerd; Kist, Jakob W. [Department of Surgery, University Medical Center Utrecht (Netherlands); Debray, Thomas P.A. [Julius Center for Health Sciences and Primary Care Utrecht (Netherlands); Keizer, Bart de [Department of Radiology and Nuclear Medicine, University Medical Center Utrecht (Netherlands); Oostenbrugge, Timotheus J. van; Borel Rinkes, Inne H.M. [Department of Surgery, University Medical Center Utrecht (Netherlands); Valk, Gerlof D. [Department of Endocrinology, University Medical Center Utrecht (Netherlands); Vriens, Menno R., E-mail: mvriens@umcutrecht.nl [Department of Surgery, University Medical Center Utrecht (Netherlands)

    2015-04-15

    Context: Only a minority of thyroid nodules is malignant; nevertheless, many invasive diagnostic procedures are performed to distinguish between benign and malignant nodules. Qualitative ultrasound elastography is a non-invasive technique to evaluate thyroid nodules. Objective: To investigate the diagnostic value of qualitative elastography in distinguishing benign from malignant thyroid nodules in patients referred for fine-needle aspiration (FNA). Data sources: A systematic literature search (PubMed, Embase and Cochrane Library) was performed. Study selection: Included studies reported thyroid nodule elastography color scores and the related cytologic or histologic findings in patients with a thyroid nodule referred for FNA. Data extraction: Two independent reviewers extracted study data and assessed study quality. Pooled sensitivities and specificities of different populations were calculated using a bivariate Bayesian framework. Data Synthesis: Twenty studies including thyroid nodules were analyzed. Pooled results of elastography indicate a summary sensitivity of 85% (95% confidence interval [CI], 79–90%) and specificity of 80% (95% CI, 73–86%). The respective pooled negative predictive and positive predictive values were 97% (95% CI, 94–98%) and 40% (95% CI, 34–48%). The pretest probability of a benign nodule was 82%. Only 3.7% of the false-negative nodules was a follicular thyroid carcinoma. A pooled negative predictive value of 99% (95% CI, 97–100%) was found when only complete soft nodules (Asteria elastography 1) were classified as benign, which included 14% of the studied population. Conclusions: Elastography has a fair specificity and sensitivity for diagnostic accuracy. Its major strength entails the detection of benignity, especially when only completely soft nodules are qualified as benign. The outcomes of our analysis show that FNA could safely be omitted in patients referred for analysis of their thyroid nodule when elastography shows it

  14. Replacement Power Facility site selection report

    Energy Technology Data Exchange (ETDEWEB)

    Wike, L.D.; Toole, G.L.; Specht, W.L.

    1992-06-01

    The Department of Energy (DOE) has proposed the construction and operation of a Replacement Power Facility (RPF) for supplementing and replacing existing sources of steam and possibly electricity at the Savannah River Site (SRS). DOE is preparing an Environmental Impact Statement (EIS) for this project As part of the impact analysis of the proposed action, the EIS will include a detailed description of the environment where the RPF will be constructed. This description must be specific to the recommended site at SRS, which contains more than 300 square miles of land including streams, lakes, impoundments, wetlands, and upland areas. A formal site-selection process was designed and implemented to identify the preferred RPF site.

  15. Replacement research reactor for Australia

    International Nuclear Information System (INIS)

    Miller, Ross

    1998-01-01

    In 1992, the Australian Government commissioned a review into the need for a replacement research reactor. That review concluded that in about years, if certain conditions were met, the Government could make a decision in favour of a replacement reactor. A major milestone was achieved when, on 3 September 1997, the Australian Government announced the construction of a replacement research reactor at the site of Australia's existing research reactor HIFAR, subject to the satisfactory outcome of an environmental assessment process. The reactor will be have the dual purpose of providing a first class facility for neutron beam research as well as providing irradiation facilities for both medical isotope production and commercial irradiations. The project is scheduled for completion before the end of 2005. (author)

  16. Joint replacement in Zambia: A review of Hip & Knee Replacement ...

    African Journals Online (AJOL)

    Methods: Data captured by the different variables entered into the Joint Register covering the pre-op, intra-op and post-op period of all total hip and knee replacement surgery done at the ZIOH from 1998 to 2010 was entered into a spreadsheet after verification with individual patient medical records. This was then imported ...

  17. REPLACEMENT CONTROL OF INNOVATION MANAGERS: ORGANIZATIONAL AND ECONOMIC ASPECTS

    Directory of Open Access Journals (Sweden)

    E. V. Gurina

    2011-01-01

    Full Text Available The paper substantiates phases of specialists’ replacement ensuring innovation development of the national economy in Belarus, i.e. managers of innovation activity. Realization of replacement phases is presented within the system consisting of four blocks – objective, managing, controllable and providing. Analysis results of the current state of the innovation activity managers replacement system reveal main problems in interaction of its basic agents. The paper considers solution of specified problems in the context of formation of organizational and economic approaches to managing the innovation activity managers replacement system which presupposes modernization of organizational interrelations between state- run public authorities in the managing block and micro-incentive structures in the controllable block as well as the usage of the process approach in every phase of the replacement process. 

  18. In-depth, high-accuracy proteomics of sea urchin tooth organic matrix

    Directory of Open Access Journals (Sweden)

    Mann Matthias

    2008-12-01

    Full Text Available Abstract Background The organic matrix contained in biominerals plays an important role in regulating mineralization and in determining biomineral properties. However, most components of biomineral matrices remain unknown at present. In sea urchin tooth, which is an important model for developmental biology and biomineralization, only few matrix components have been identified. The recent publication of the Strongylocentrotus purpuratus genome sequence rendered possible not only the identification of genes potentially coding for matrix proteins, but also the direct identification of proteins contained in matrices of skeletal elements by in-depth, high-accuracy proteomic analysis. Results We identified 138 proteins in the matrix of tooth powder. Only 56 of these proteins were previously identified in the matrices of test (shell and spine. Among the novel components was an interesting group of five proteins containing alanine- and proline-rich neutral or basic motifs separated by acidic glycine-rich motifs. In addition, four of the five proteins contained either one or two predicted Kazal protease inhibitor domains. The major components of tooth matrix were however largely identical to the set of spicule matrix proteins and MSP130-related proteins identified in test (shell and spine matrix. Comparison of the matrices of crushed teeth to intact teeth revealed a marked dilution of known intracrystalline matrix proteins and a concomitant increase in some intracellular proteins. Conclusion This report presents the most comprehensive list of sea urchin tooth matrix proteins available at present. The complex mixture of proteins identified may reflect many different aspects of the mineralization process. A comparison between intact tooth matrix, presumably containing odontoblast remnants, and crushed tooth matrix served to differentiate between matrix components and possible contributions of cellular remnants. Because LC-MS/MS-based methods directly

  19. Social capital and health during pregnancy; an in-depth exploration from rural Sri Lanka.

    Science.gov (United States)

    Agampodi, Thilini Chanchala; Rheinländer, Thilde; Agampodi, Suneth Buddhika; Glozier, Nicholas; Siribaddana, Sisira

    2017-07-27

    Dimensions of social capital relevant to health in pregnancy are sparsely described in the literature. This study explores dimensions of social capital and the mechanisms in which they could affect the health of rural Sri Lankan pregnant women. An exploratory qualitative study of solicited diaries written by pregnant women on their social relationships, diary interviews and in-depth interviews with key informants was conducted. A framework approach for qualitative data analysis was used. Pregnant women (41), from eight different communities completed diaries and 38 post-diary interviews. Sixteen key informant interviews were conducted with public health midwives and senior community dwellers. We identified ten cognitive and five structural constructs of social capital relevant to health in pregnancy. Domestic and neighborhood cohesion were the most commonly expressed constructs. Social support was limited to support from close family, friends and public health midwives. A high density of structural social capital was observed in the micro-communities. Membership in local community groups was not common. Four different pathways by which social capital could influence health in pregnancy were identified. These include micro-level cognitive social capital by promoting mental wellbeing; micro-level structural social capital by reducing minor ailments in pregnancy; micro-level social support mechanisms promoting physical and mental wellbeing through psychosocial resources and health systems at each level providing focused maternal care. Current tools available may not contain the relevant constructs to capture the unique dimensions of social capital in pregnancy. Social capital can influence health during pregnancy, mainly through improved psychosocial resources generated by social cohesion in micro-communities and by the embedded neighborhood public health services.

  20. Unbiased in-depth characterization of CEX fractions from a stressed monoclonal antibody by mass spectrometry.

    Science.gov (United States)

    Griaud, François; Denefeld, Blandine; Lang, Manuel; Hensinger, Héloïse; Haberl, Peter; Berg, Matthias

    2017-07-01

    Characterization of charge-based variants by mass spectrometry (MS) is required for the analytical development of a new biologic entity and its marketing approval by health authorities. However, standard peak-based data analysis approaches are time-consuming and biased toward the detection, identification, and quantification of main variants only. The aim of this study was to characterize in-depth acidic and basic species of a stressed IgG1 monoclonal antibody using comprehensive and unbiased MS data evaluation tools. Fractions collected from cation ion exchange (CEX) chromatography were analyzed as intact, after reduction of disulfide bridges, and after proteolytic cleavage using Lys-C. Data of both intact and reduced samples were evaluated consistently using a time-resolved deconvolution algorithm. Peptide mapping data were processed simultaneously, quantified and compared in a systematic manner for all MS signals and fractions. Differences observed between the fractions were then further characterized and assigned. Time-resolved deconvolution enhanced pattern visualization and data interpretation of main and minor modifications in 3-dimensional maps across CEX fractions. Relative quantification of all MS signals across CEX fractions before peptide assignment enabled the detection of fraction-specific chemical modifications at abundances below 1%. Acidic fractions were shown to be heterogeneous, containing antibody fragments, glycated as well as deamidated forms of the heavy and light chains. In contrast, the basic fractions contained mainly modifications of the C-terminus and pyroglutamate formation at the N-terminus of the heavy chain. Systematic data evaluation was performed to investigate multiple data sets and comprehensively extract main and minor differences between each CEX fraction in an unbiased manner.

  1. An in-depth examination into pharmacy technician worklife through an organizational behavior framework.

    Science.gov (United States)

    Desselle, Shane P

    2016-01-01

    Pharmacy technicians are a vital part of the health care workforce. Little is known about perceptions of their own work environment that would engender more effective recruitment, retention, and management strategies by pharmacists and employers. The purpose of this study was to gain a greater understanding of certified pharmacy technician worklife. Specific objectives included the identification of themes of worklife phenomena to assist with the development of appropriate responses by other pharmacy stakeholders and to ascertain the contribution of various factors engendering or discouraging career commitment of pharmacy technicians. Semi-structured in-depth interviews were carried out with a convenience sample of pharmacy technicians in one U.S. state, who varied by their work settings and level of experience. The interview guide and corresponding participant responses were framed from around an organizational cultural basis rooted in organizational behavior theory. Notes from the interviews were analyzed thematically using directed content analysis. Four primary themes emerged, including: career impetus, job responsibilities, quality of work life, and equitable partnership. The data revealed pharmacy technicians' need for self-actualization and recognition of the value they bring to the organization. The participants identified primary responsibilities that contribute to their sense of worth and those that if not managed adequately potentially detract from their well-being and effectiveness. Findings in regard to rate of pay corroborate previous work on wages as both an intrinsic and extrinsic motivator. Pharmacy technicians seek equity among each other (their peers) and in a mutually beneficial relationship with their employing organization. This study provides the impetus for interventions and further study that should serve to enhance pharmacy technician effectiveness, quality of work life, and longevity in an emerging profession. Copyright © 2015 Elsevier

  2. Enhanced defence in depth: a fundamental approach for innovative nuclear systems recommended by INPRO

    International Nuclear Information System (INIS)

    Kuczera, B.; Juhn, P.E.

    2004-01-01

    In May 2001, the IAEA initiated the 'International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO)'. Having in mind that nuclear power will be an important option for meeting future electricity needs, the scope of INPRO covers nuclear reactors expected to come into service in the next fifty years, together with their associated fuel cycles. This article deals with enhanced defence in depth (DID) strategy that is recommended by INPRO. This strategy is twofold: first, to prevent accidents and second, if prevention fails, to limit their potential consequences and prevent any evolution to more serious conditions. Accident prevention is the first priority. For innovative nuclear systems, the effectiveness of preventive measures should be enhanced compared with existing systems. DID is generally structured in 5 levels of protection, including successive barriers preventing the release of radioactive material to the environment. These levels are: 1) prevention of abnormal operation and failures, 2) control of abnormal operation and detection of failures, 3) control of accidents within the design basis, 4) control of severe plant conditions, including prevention and mitigation of the consequences of severe accidents, and 5) mitigation of radiological consequences of significant release of radioactive materials. In the area of nuclear safety, INPRO has set 5 principles: 1) incorporate DID as a part of the safety approach and make the 5 levels of DID more independent from each other than in current installations; 2) prevent, reduce or contain releases of radioactive or hazardous materials in any normal or abnormal plant operation; 3) incorporate increased emphasis on inherent safety characteristics and passive safety features; 4) include research and development work to bring the capability of computer codes used for the safety of innovative nuclear systems to the standard of codes used for the safety of current reactors; and 5) include a holistic life

  3. HST Replacement Battery Initial Performance

    Science.gov (United States)

    Krol, Stan; Waldo, Greg; Hollandsworth, Roger

    2009-01-01

    The Hubble Space Telescope (HST) original Nickel-Hydrogen (NiH2) batteries were replaced during the Servicing Mission 4 (SM4) after 19 years and one month on orbit.The purpose of this presentation is to highlight the findings from the assessment of the initial sm4 replacement battery performance. The batteries are described, the 0 C capacity is reviewed, descriptions, charts and tables reviewing the State Of Charge (SOC) Performance, the Battery Voltage Performance, the battery impedance, the minimum voltage performance, the thermal performance, the battery current, and the battery system recharge ratio,

  4. Insurance for replacement power costs

    International Nuclear Information System (INIS)

    Cleaver, A.

    1980-01-01

    Although careful consideration is given to insurance against physical damage to plant and equipment, little thought is given to the costs that will be incurred in replacing the power that is lost while a relatively efficient system is out of action. The results of an investigation carried out for a generating authority with an installed capacity of about 3000 MW is given. Replacement power costs for different cases of severity of damage range from Pound1.17m per month for damage to central services taking out all four units. (author)

  5. Replacing fuel alignment in Germany

    International Nuclear Information System (INIS)

    Poetz, F.; Kalthoff, W.

    1991-01-01

    Up to the end of 1989 varying numbers of broken fuel alignment pins were detected in several German PWRs (80 broken pins in all). The distribution of these broken pins over the core cross-section was more or less random. The problem was due to the stress corrosion cracking of the pin material and was restricted to individual pins. It was concluded that all fuel alignment pins made of Inconel X-750 should be replaced. The development of a new pin, more resistant to intergranular stress corrosion, and the replacement technique are outlined. (author)

  6. Design features to achieve defence-in-depth in small and medium sized reactors

    International Nuclear Information System (INIS)

    Kuznetsov, Vladimir

    2009-01-01

    Broader incorporation of inherent and passive safety design features has become a 'trademark' of many advanced reactor concepts, including several evolutionary designs and nearly all innovative small and medium sized design concepts. Ensuring adequate defence-in-depth is important for reactors of smaller output because many of them are being designed to allow more proximity to the user, specifically, when non-electrical energy products are targeted. Based on the activities recently performed by the International Atomic Energy Agency, the paper provides a summary description of the design features used to achieve defence in depth in the eleven representative concepts of small and medium sized reactors. (author)

  7. Western European Nuclear Regulators’ Association (WENRA) Views on Defence-in-Depth for New Reactors

    Energy Technology Data Exchange (ETDEWEB)

    Reiman, L.; Routamo, T. [STUK, Helsinki (Finland); Féron, F., E-mail: lasse.reiman@stuk.fi [ASN (France)

    2014-10-15

    WENRA published in 2010 a statement on safety objectives for new NPPs. Based on these objectives, WENRA decided to develop common positions, compiled in a booklet (available on www.wenra.org), on selected key safety issues for the design of new NPPs. One position presents WENRA’s Defence-in-Depth approach, describing WENRA’s expectation that multiple failure events and core melt accidents are considered in the original design of new nuclear power plants; another position presents expectations on the independence between different levels of Defence-in-Depth. (author)

  8. A comparison of minimally invasive and standard aortic valve replacement.

    Science.gov (United States)

    Stoliński, Jarosław; Plicner, Dariusz; Grudzień, Grzegorz; Wąsowicz, Marcin; Musiał, Robert; Andres, Janusz; Kapelak, Bogusław

    2016-10-01

    The study objective was to compare aortic valve replacement through a right anterior minithoracotomy with aortic valve replacement through a median sternotomy. With propensity score matching, we selected 211 patients after aortic valve replacement through a right anterior minithoracotomy and 211 patients after aortic v