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Sample records for single institute experience

  1. Initial experience with robotic pancreatic surgery in Singapore: single institution experience with 30 consecutive cases.

    Science.gov (United States)

    Goh, Brian K P; Low, Tze-Yi; Lee, Ser-Yee; Chan, Chung-Yip; Chung, Alexander Y F; Ooi, London L P J

    2018-05-24

    Presently, the worldwide experience with robotic pancreatic surgery (RPS) is increasing although widespread adoption remains limited. In this study, we report our initial experience with RPS. This is a retrospective review of a single institution prospective database of 72 consecutive robotic hepatopancreatobiliary surgeries performed between 2013 and 2017. Of these, 30 patients who underwent RPS were included in this study of which 25 were performed by a single surgeon. The most common procedure was robotic distal pancreatectomy (RDP) which was performed in 20 patients. This included eight subtotal pancreatectomies, two extended pancreatecto-splenectomies (en bloc gastric resection) and 10 spleen-saving-RDP. Splenic preservation was successful in 10/11 attempted spleen-saving-RDP. Eight patients underwent pancreaticoduodenectomies (five hybrid with open reconstruction), one patient underwent a modified Puestow procedure and one enucleation of uncinate tumour. Four patients had extended resections including two RDP with gastric resection and two pancreaticoduodenectomies with vascular resection. There was one (3.3%) open conversion and seven (23.3%) major (>Grade II) morbidities. Overall, there were four (13.3%) clinically significant (Grade B) pancreatic fistulas of which three required percutaneous drainage. These occurred after three RDP and one robotic enucleation. There was one reoperation for port-site hernia and no 30-day/in-hospital mortalities. The median post-operative stay was 6.5 (range: 3-36) days and there were six (20%) 30-day readmissions. Our initial experience showed that RPS can be adopted safely with a low open conversion rate for a wide variety of procedures including pancreaticoduodenectomy. © 2018 Royal Australasian College of Surgeons.

  2. Pediatric colonic volvulus: A single-institution experience and review.

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    Tannouri, Sami; Hendi, Aditi; Gilje, Elizabeth; Grissom, Leslie; Katz, Douglas

    2017-06-01

    Pediatric colonic volvulus is both rare and underreported. Existing literature consists only of case reports and small series. We present an analysis of cases (n=11) over 15 years at a single institution, focusing on workup and diagnosis. This was an institutional review board approved single-institution retrospective chart review of 11 cases of large bowel volvulus occurring over 15 years (2000-2015). In our series, the most common presenting symptoms were abdominal pain and distention. Afflicted patients often had prior abdominal surgery, a neurodevelopmental disorder or chronic constipation. Of the imaging modalities utilized in the 11 patients studied, colonic volvulus was correctly diagnosed by barium enema in 100% of both cases, CT in 55.6% of cases and by plain radiography of the abdomen in only 22.2%of cases. Colonic volvulus was confirmed by laparotomy in all cases. The cecum (n=5) was the most often affected colonic segment, followed by the sigmoid (n=3). Operative treatment mainly consisted of resection (63.6%) and ostomy creation (36.4%). Colopexy was performed in 18.2% of cases. Plain abdominal radiography may be performed as an initial diagnostic study, however, it should be followed CT or air or contrast enema in children where there is high clinical suspicion and who do not have indications for immediate laparotomy. CT may be the most specific and useful test in diagnosis of colonic volvulus and has the added advantage of detection of complications including bowel ischemia. We demonstrate a range of diagnostic and therapeutic modalities for pediatric colonic volvulus. This underscores the need for further study to draft standard best practices for this life-threatening condition. Prognosis Study: Level IV. Study of a Diagnostic Test: Level III. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Merkel Cell Carcinoma of the Head and Neck: A Single Institutional Experience

    International Nuclear Information System (INIS)

    Morand, G.; Vital, D.; Pezier, T.; Holzmann, D.; Huber, G.F.; Roessle, M.; Cozzio, A.

    2013-01-01

    Merkel cell carcinoma (MCC) is a rare cutaneous malignancy occurring mostly in older immunocompromised Caucasian males. A growing incidence of MCC has been reported in epidemiological studies. Treatment of MCC usually consists of surgical excision, pathological lymph node evaluation, and adjuvant radiotherapy. This paper reports the experience of a single tertiary center institution with 17 head and neck Merkel cell carcinoma patients. Median followup for the cohort was 37.5 months. After five years, recurrence-free survival, disease specific survival, and overall survival were 85%, 90%, and 83%, respectively. Our limited data support the use of adjuvant radiotherapy. We also report two cases of MCC located at the vestibule of the nose and two cases of spontaneous regression after diagnostic biopsy. About 40% of our patients were referred to our center for surgical revision and pathological lymph node evaluation. Increased awareness of MCC and an interdisciplinary approach are essential in the management of MCC.

  4. Postoperative urinary retention after inguinal hernia repair: a single institution experience.

    Science.gov (United States)

    Blair, A B; Dwarakanath, A; Mehta, A; Liang, H; Hui, X; Wyman, C; Ouanes, J P P; Nguyen, H T

    2017-12-01

    Inguinal hernia repair is a common general surgery procedure with low morbidity. However, postoperative urinary retention (PUR) occurs in up to 22% of patients, resulting in further extraneous treatments.This single institution series investigates whether patient comorbidities, surgical approaches, and anesthesia methods are associated with developing PUR after inguinal hernia repairs. This is a single institution retrospective review of inguinal hernia from 2012 to 2015. PUR was defined as patients without a postoperative urinary catheter who subsequently required bladder decompression due to an inability to void. Univariate and multivariate logistic regressions were performed to quantify the associations between patient, surgical, and anesthetic factors with PUR. Stratification analysis was conducted at age of 50 years. 445 patients were included (42.9% laparoscopic and 57.1% open). Overall rate of PUR was 11.2% (12% laparoscopic, 10.6% open, and p = 0.64). In univariate analysis, PUR was significantly associated with patient age >50 and history of benign prostatic hyperplasia (BPH). Risk stratification for age >50 revealed in this cohort a 2.49 times increased PUR risk with lack of intraoperative bladder decompression (p = 0.013). At our institution, we found that patient age, history of BPH, and bilateral repair were associated with PUR after inguinal hernia repair. No association was found with PUR and laparoscopic vs open approach. Older males may be at higher risk without intraoperative bladder decompression, and therefore, catheter placement should be considered in this population, regardless of surgical approach.

  5. Demographics of Head and Neck Cancer Patients: A Single Institution Experience

    Science.gov (United States)

    Kitanova, Martina; Dzhenkov, Deyan L; Ghenev, Peter; Sapundzhiev, Nikolay

    2017-01-01

    Introduction Head and neck cancer (HNC) comprises a diverse group of oncological entities, originating from various tissue types and organ localizations, situated in the topographical regions of the head and neck (H&N). This single institution retrospective study was aimed at establishing the HNC patient demographics and categorizing the individual incidence of H&N malignancies, regarding their organ of origin and main histopathological type. Materials and methods All histologically verified cases of HNC from a single tertiary referral center were reviewed in a descriptive retrospective manner. Data sampling period was 47 months. Results Male to female ratio of the registered HNC cases was 3.24:1. The mean age of diagnosis was 63.84 ± 12.65 years, median 65 years. The most common HNC locations include the larynx 30.37% (n = 188), lips and oral cavity 29.08% (n = 180), pharynx 20.03% (n = 124) and salivary glands 10.94% (n = 68), with other locations such as the external nose, nasal cavity and sinuses and auricle and external ear canal harboring a minority of the cases. The main histopathological groups include squamous cell carcinoma 76.74% (n = 475) and adenocarcinoma 6.14% (n = 38), with other malignant entries such as other epithelial malignancies, primary tonsillar, mucosa-associated lymphoid tissue or parenchymal lymphomas, connective tissue neoplasias, neuroendocrine and vascular malignancies diagnosed in a minority of cases. Conclusion Considered to be relatively rare, HNC represents a diverse group of oncological entities with individual and specific demographic characteristics. The reported single institution results appear representative of the national incidence and characteristics of HNC. PMID:28875091

  6. [Definitive contraception with Essure device: Single institutional experience on 517 procedures].

    Science.gov (United States)

    Aparicio-Rodríguez-Miñón, Pablo; de la Fuente-Valero, Jesús; Martínez-Laral, Ana; Alonso-García, Ana; Sobrino-Mota, Verónica; Zapardiel-Gutiérrez, Ignacio; Hernández-Aguado, Juan J

    2015-01-01

    To analyse the outcomes of patients undergoing Essure sterilization in a single institution, interns of complications and technique failure. Retrospective descriptive study of 517 patients underwent definitive contraception with Essure device in outpatient hysteroscopy office without anesthesia and controlled at 3 months with abdominal radiography, ultrasonography and hysterosalpingography in selected cases. The success rates of the insertion of Essure was 96.8%, similar to data reported in the literature with 3.7% of vagal reactions, as most prevalent complication. 7 (1.35%) unintended pregnancies were observed. Essure is a permanent birth control device, with high rate of successful insertion and a low rate of complications. Unintended pregnancies in our study are high and we must change the protocols of placement and monitoring, considering hysterosalpingography as a routine control test.

  7. Single-port laparoscopy in gynecologic oncology: seven years of experience at a single institution.

    Science.gov (United States)

    Moulton, Laura; Jernigan, Amelia M; Carr, Caitlin; Freeman, Lindsey; Escobar, Pedro F; Michener, Chad M

    2017-11-01

    Single-port laparoscopy has gained popularity within minimally invasive gynecologic surgery for its feasibility, cosmetic outcomes, and safety. However, within gynecologic oncology, there are limited data regarding short-term adverse outcomes and long-term hernia risk in patients undergoing single-port laparoscopic surgery. The objective of the study was to describe short-term outcomes and hernia rates in patients after single-port laparoscopy in a gynecologic oncology practice. A retrospective, single-institution study was performed for patients who underwent single-port laparoscopy from 2009 to 2015. A univariate analysis was performed with χ 2 tests and Student t tests; Kaplan-Meier and Cox proportional hazards determined time to hernia development. A total of 898 patients underwent 908 surgeries with a median follow-up of 37.2 months. The mean age and body mass index were 55.7 years and 29.6 kg/m 2 , respectively. The majority were white (87.9%) and American Society of Anesthesiologists class II/III (95.5%). The majority of patients underwent surgery for adnexal masses (36.9%) and endometrial hyperplasia/cancer (37.3%). Most women underwent hysterectomy (62.7%) and removal of 1 or both fallopian tubes and/or ovaries (86%). Rate of adverse outcomes within 30 days, including reoperation (0.1%), intraoperative injury (1.4%), intensive care unit admission (0.4%), venous thromboembolism (0.3%), and blood transfusion, were low (0.8%). The rate of urinary tract infection was 2.8%; higher body mass index (P = .02), longer operative time (P = .02), smoking (P = .01), hysterectomy (P = .01), and cystoscopy (P = .02) increased the risk. The rate of incisional cellulitis was 3.5%. Increased estimated blood loss (P = .03) and endometrial cancer (P = .02) were independent predictors of incisional cellulitis. The rate for surgical readmissions was 3.4%; higher estimated blood loss (P = .03), longer operative time (P = .02), chemotherapy alone (P = .03), and

  8. Retrograde Ureteroscopic Management of Large Renal Calculi: A Single Institutional Experience and Concise Literature Review.

    Science.gov (United States)

    Scotland, Kymora B; Rudnick, Benjamin; Healy, Kelly A; Hubosky, Scott G; Bagley, Demetrius H

    2018-06-06

    Advances in flexible ureteroscope design and accessory instrumentation have allowed for more challenging cases to be treated ureteroscopically. Here, we evaluate our experience with ureteroscopy (URS) for the management of large renal calculi (≥2 cm) and provide a concise review of recent reports. A retrospective review was undertaken of all URS cases between 2004 and 2014 performed by the endourologic team at a single academic tertiary care institution. We identified patients with at least one stone ≥2 cm managed with retrograde URS. Stone size was defined as the largest linear diameter of the index stone. Small diameter flexible ureteroscopes were used primarily with holmium laser. Patient demographics, intraoperative data, and postoperative outcomes were evaluated. We evaluated 167 consecutive patients who underwent URS for large renal stones ≥2 cm. The initial reason for choosing URS included patient preference (29.5%), failure of other therapies (8.2%), anatomic considerations/body habitus (30.3%), and comorbidities (28.8%). Mean patient age was 55.5 years (22-84). The mean stone size was 2.75 cm with mean number of procedures per patient of 1.65 (1-6). The single session stone-free rate was 57.1%, two-stage procedure stone-free rate was 90.2% and three-stage stone-free rate was 94.0%. Access sheaths were used in 47% of patients. An association was identified between stone size and patient outcomes; smaller stones correlated with decreased number of procedures. Postoperative complications were minor. Single or multi-stage retrograde ureteroscopic lithotripsy is a safe and effective mode of surgical management of large renal calculi. Total stone burden is a reliable predictor of the need for a staged procedure and of stone-free rate.

  9. Outcome of postoperative radiotherapy following radical prostatectomy: a single institutional experience

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    Lee, Sea Won; Chung, Mi Joo; Jeong, Song Mi; Kim, Sung Hwan; Lee, Jong Hoon [Dept.of Radiation Oncology, St. Vincent' s Hospital, The Catholic University of Korea College of Medicine, Suwon (Korea, Republic of); Hwang, Tae Kon; Hong, Sung Hoo; Lee, Ji Youl; Jang, Hong Seok [Seoul St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of); Yoon, Sei Chul [Dept.of Radiation Oncology, Bucheon St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Bucheon (Korea, Republic of)

    2014-09-15

    This single institutional study is aimed to observe the outcome of patients who received postoperative radiotherapy after radical prostatectomy. A total of 59 men with histologically identified prostate adenocarcinoma who had received postoperative radiation after radical prostatectomy from August 2005 to July 2011 in Seoul St. Mary's Hospital of the Catholic University of Korea, was included. They received 45-50 Gy to the pelvis and boost on the prostate bed was given up to total dose of 63-72 Gy (median, 64.8 Gy) in conventional fractionation. The proportion of patients given hormonal therapy and the pattern in which it was given were analyzed. Primary endpoint was biochemical relapse-free survival (bRFS) after radiotherapy completion. Secondary endpoint was overall survival (OS). Biochemical relapse was defined as a prostate-specific antigen level above 0.2 ng/mL. After median follow-up of 53 months (range, 0 to 104 months), the 5-year bRFS of all patients was estimated 80.4%. The 5-year OS was estimated 96.6%. Patients who were given androgen deprivation therapy had a 5-year bRFS of 95.1% while the ones who were not given any had that of 40.0% (p < 0.01). However, the statistical significance in survival difference did not persist in multivariate analysis. The 3-year actuarial grade 3 chronic toxicity was 1.7% and no grade 3 acute toxicity was observed. The biochemical and toxicity outcome of post-radical prostatectomy radiotherapy in our institution is favorable and comparable to those of other studies.

  10. POOR HEMOPOIETIC STEM CELL MOBILIZERS IN MULTIPLE MYELOMA : A SINGLE INSTITUTION EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Guillermo Jose Ruiz-Delgado

    2010-06-01

    Full Text Available In a single institution, in a group of 28 myeloma patients deemed eligible for autologous transplant, stem cell mobilization was attempted using filgrastim: 26 individuals were given 31 autografts employing 1-4 (median three apheresis sessions, to obtain a target stem cell dose of 1 x 106 CD34 viable cells / Kg of the recipient. The median number of grafted CD34 cells was 7.56 x 106  / Kg of the recipient; the range being 0.92 to 14.8.  By defining as poor mobilizers individuals in which a cell collection of 1 x 106 CD34 viable cells / Kg was better (80% at 80 months than those grafted with < 1 x 106 CD34 viable cells / Kg (67% at 76 months. Methods to improve stem cell mobilization are needed and may result in obtaining better results when autografting multiple myeloma patients.

  11. A contemporary, single-institutional experience of surgical versus expectant management of congenital heart disease in trisomy 13 and 18 patients.

    Science.gov (United States)

    Costello, John P; Weiderhold, Allison; Louis, Clauden; Shaughnessy, Conner; Peer, Syed M; Zurakowski, David; Jonas, Richard A; Nath, Dilip S

    2015-06-01

    The objective of this study was to examine a large institutional experience of patients with trisomy 13 and trisomy 18 in the setting of comorbid congenital heart disease and present the outcomes of surgical versus expectant management. It is a retrospective single-institution cohort study. Institutional review board approved this study. Thirteen consecutive trisomy 18 patients and three consecutive trisomy 13 patients (sixteen patients in total) with comorbid congenital heart disease who were evaluated by our institution's Division of Cardiovascular Surgery between January 2008 and December 2013 were included in the study. The primary outcome measures evaluated were operative mortality (for patients who received surgical management), overall mortality (for patients who received expectant management), and total length of survival during follow-up. Of the thirteen trisomy 18 patients, seven underwent surgical management and six received expectant management. With surgical management, operative mortality was 29 %, and 80 % of patients were alive after a median follow-up of 116 days. With expectant management, 50 % of patients died before hospital discharge. Of the three patients with trisomy 13, one patient underwent surgical management and two received expectant management. The patient who received surgical management with complete repair was alive at last follow-up over 2 years after surgery; both patients managed expectantly died before hospital discharge. Trisomy 13 and trisomy 18 patients with comorbid congenital heart disease can undergo successful cardiac surgical intervention. In this population, we advocate that nearly all patients with cardiovascular indications for operative congenital heart disease intervention should be offered complete surgical repair over palliative approaches for moderately complex congenital cardiac anomalies.

  12. Single Fraction Versus Fractionated Linac-Based Stereotactic Radiotherapy for Vestibular Schwannoma: A Single-Institution Experience

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    Collen, Christine, E-mail: ccollen@uzbrussel.be [Department of Radiation Oncology, UZ Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels (Belgium); Ampe, Ben [Department of Neurosurgery, UZ Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels (Belgium); Gevaert, Thierry [Department of Radiation Oncology, UZ Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels (Belgium); Moens, Maarten [Department of Neurosurgery, UZ Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels (Belgium); Linthout, Nadine; De Ridder, Mark; Verellen, Dirk [Department of Radiation Oncology, UZ Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels (Belgium); D' Haens, Jean [Department of Neurosurgery, UZ Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels (Belgium); Storme, Guy [Department of Radiation Oncology, UZ Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels (Belgium)

    2011-11-15

    Purpose: To evaluate and compare outcomes for patients with vestibular schwannoma (VS) treated in a single institution with linac-based stereotactic radiosurgery (SRS) or by fractionated stereotactic radiotherapy (SRT). Methods and Materials: One hundred and nineteen patients (SRS = 78, SRT = 41) were treated. For both SRS and SRT, beam shaping is performed by a mini-multileaf collimator. For SRS, a median single dose of 12.5 Gy (range, 11-14 Gy), prescribed to the 80% isodose line encompassing the target, was applied. Of the 42 SRT treatments, 32 treatments consisted of 10 fractions of 3-4 Gy, and 10 patients received 25 sessions of 2 Gy, prescribed to the 100% with the 95% isodose line encompassing the planning target volume. Mean largest tumor diameter was 16.6 mm in the SRS and 24.6 mm in the SRT group. Local tumor control, cranial nerve toxicity, and preservation of useful hearing were recorded. Any new treatment-induced cranial nerve neuropathy was scored as a complication. Results: Median follow-up was 62 months (range, 6-136 months), 5 patients progressed, resulting in an overall 5-year local tumor control of 95%. The overall 5-year facial nerve preservation probability was 88% and facial nerve neuropathy was statistically significantly higher after SRS, after prior surgery, for larger tumors, and in Koos Grade {>=}3. The overall 5-year trigeminal nerve preservation probability was 96%, not significantly influenced by any of the risk factors. The overall 4-year probability of preservation of useful hearing (Gardner-Robertson score 1 or 2) was 68%, not significantly different between SRS or SRT (59% vs. 82%, p = 0.089, log rank). Conclusion: Linac-based RT results in good local control and acceptable clinical outcome in small to medium-sized vestibular schwannomas (VSs). Radiosurgery for large VSs (Koos Grade {>=}3) remains a challenge because of increased facial nerve neuropathy.

  13. ECONOMIC EXPERIENCES OF SINGLE MOTHERS IN BHAMBAYI, KWAZULU-NATAL, SOUTH AFRICA

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    Raniga, Tanusha

    2014-10-01

    Full Text Available Women living in low-income communities often initiate livelihood activities as a means to support themselves and their families. Even though these small-scale livelihood activities supplement the household income, they are insufficient to lift single mothers out of poverty. This study explores the economic experiences of 25 single mothers who embarked on individual livelihood activities. Using feminist theory, the paper presents their biographical profile and discusses two key themes, namely institutional barriers leading to economic insecurities, and the strengths and limitations of social networks. The paper concludes with some considerations for harnessing the valuable contributions made by single mothers.

  14. Pancreatic pseudocyst in children: a single-institute experience

    African Journals Online (AJOL)

    Background and objectives Pancreatic pseudocysts are rare in children, with most series describing not more than. 24 patients. At Zagazig University Hospital we have managed a range of cases of this disorder and feel this experience should add to the existing experience with children. This study aimed to analyze the ...

  15. Evolving Management of Symptomatic Chronic Subdural Hematoma: Experience of a Single Institution and Review of the Literature

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    Balser, David; Rodgers, Shaun D.; Johnson, Blair; Shi, Chen; Tabak, Esteban; Samadani, Uzma

    2015-01-01

    Objective Chronic subdural hematoma has an increasing incidence and results in high morbidity and mortality. We review here the ten-year experience of a single institution and the literature regarding the treatment and major associations of chronic subdural hematoma (cSDH). Methods We retrospectively reviewed all cSDHs surgically treated from 2000 to 2010 at our institution to evaluate duration from admission to treatment, type of treatment, length of stay in critical care, length of stay in the hospital and recurrence. The literature was reviewed with regards to incidence, associations and treatment of cSDH. Results From 2000–2008, 44 patients were treated with burr holes. From 2008 to 2010, 29 patients were treated with twist drill evacuation (SEPS). 4 patients from each group were readmitted for reoperation (9% vs. 14%; p=.53). The average time to intervention for SEPS (11.2±15.3 hrs) was faster than for burr holes (40.3±69.1 hrs) (p=.02). The total hospital LOS was shorter for SEPS (9.3±6.8 days) versus burr holes (13.4±10.2 days) (p=.04); both were significantly longer than for a brain tumor patient undergoing craniotomy (7.0±0.5 days, n=94, P<.01). Conclusion Despite decreasing lengths of stay over time as treatment for cSDH evolved from burr holes to SEPS, the length of stay for a cSDH is still greater than that of a patient undergoing craniotomy for brain tumor. We noted 11% recurrence in our series of patients, which included individuals who recurred as late as 3 years after initial diagnosis. PMID:23485050

  16. Cavernous sinus hemangioma: a fourteen year single institution experience.

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    Bansal, Sumit; Suri, Ashish; Singh, Manmohan; Kale, Shashank Sharad; Agarwal, Deepak; Sharma, Manish Singh; Mahapatra, Ashok Kumar; Sharma, Bhawani Shankar

    2014-06-01

    Cavernous sinus hemangioma (CSH) is a rare extra-axial vascular neoplasm that accounts for 2% to 3% of all cavernous sinus tumors. Their location, propensity for profuse bleeding during surgery, and relationship to complex neurovascular structures are factors which present difficulty in excising these lesions. The authors describe their experience of 22 patients with CSH over 14 years at a tertiary care center. Patients were managed with microsurgical resection using a purely extradural transcavernous approach (13 patients) and with Gamma Knife radiosurgery (GKRS; Elekta AB, Stockholm, Sweden) (nine patients). Retrospective data analysis found headache and visual impairment were the most common presenting complaints, followed by facial hypesthesia and diplopia. All but one patient had complete tumor excision in the surgical series. Transient ophthalmoparesis (complete resolution in 6-8 weeks) was the most common surgical complication. In the GKRS group, marked tumor shrinkage (>50% tumor volume reduction) was achieved in two patients, slight shrinkage in five and no change in two patients, with symptom improvement in the majority of patients. To our knowledge, we describe one of the largest series of CSH managed at a single center. Although microsurgical resection using an extradural transcavernous approach is considered the treatment of choice in CSH and allows complete excision with minimal mortality and long-term morbidity, GKRS is an additional tool for treating residual symptomatic lesions or in patients with associated comorbidities making surgical resection unsuitable. Copyright © 2013. Published by Elsevier Ltd.

  17. Single-fraction vs. fractionated linac-based stereotactic radiosurgery for vestibular schwannoma: a single-institution study

    NARCIS (Netherlands)

    Meijer, O. W. M.; Vandertop, W. P.; Baayen, J. C.; Slotman, B. J.

    2003-01-01

    PURPOSE: In this single-institution trial, we investigated whether fractionated stereotactic radiation therapy is superior to single-fraction linac-based radiosurgery with respect to treatment-related toxicity and local control in patients with vestibular schwannoma. METHODS AND MATERIALS: All 129

  18. Milestone experiments for single pass UV/X-ray FELs

    Science.gov (United States)

    Ben-Zvi, Ilan

    1995-04-01

    In the past decade, significant advances have been made in the theory and technology of high brightness electron beams and single pass FELs. These developments facilitate the construction of practical UV and X-ray FELs and has prompted proposals to the DOE for the construction of such facilities. There are several important experiments to be performed before committing to the construction of dedicated user facilities. Two experiments are under construction in the IR, the UCLA self-amplified spontaneous emission experiment and the BNL laser seeded harmonic generation experiment. A multi-institution collaboration is being organized about a 210 MeV electron linac available at BNL and the 10 m long NISUS wiggler. This experiment will be done in the UV and will test various experimental aspects of electron beam dynamics, FEL exponential regime with gain guiding, start-up from noise, seeding and harmonic generation. These experiments will advance the state of FEL research and lead towards future dedicated users' facilities.

  19. Milestone experiments for single pass UV/X-ray FELs

    International Nuclear Information System (INIS)

    Ben-Zvi, I.

    1994-01-01

    In the past decade, significant advances have been made in the theory and technology of high brightness electron beams and single pass FELS. These developments facilitate the construction of practical UV and X-ray FELs and has prompted proposals to the DOE for the construction of such facilities. There are several important experiments to be performed before committing to the construction of dedicated user facilities. Two experiments are under construction in the IR, the UCLA Self Amplified Spontaneous Emission experiment and the BNL laser seeded Harmonic Generation experiment. A multi-institution collaboration is being organized about a 210 MeV electron linac available at BNL and the 10 meter tong NISUS wiggler. This experiment will be done in the UV and will test various experimental aspects of electron beam dynamics, FEL exponential regime with gain guiding, start up from noise, seeding and harmonic generation. These experiments will advance the state of FEL research and lead towards future dedicated users' facilities

  20. Recent Experiments at the Gottingen Aerodynamic Institute

    Science.gov (United States)

    Ackeret, J

    1925-01-01

    This report presents the results of various experiments carried out at the Gottingen Aerodynamic Institute. These include: experiments with Joukowski wing profiles; experiments on an airplane model with a built-in motor and functioning propeller; and the rotating cylinder (Magnus Effect).

  1. Celiac Artery Compression Syndrome: An Experience in a Single Institution in Taiwan

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    Jen-Wei Chou

    2012-01-01

    Full Text Available Celiac artery compression syndrome (CACS or median arcuate ligament (MAL syndrome is a rare vascular disease. The clinical manifestations of CACS include the triad of postprandial pain, vomiting, and weight loss. The pathogenesis of CACS is the external compression of celiac artery by the MAL or celiac ganglion. Moreover, some authors also reported the compression with different etiologies, such as neoplasms of pancreatic head, adjacent duodenal carcinoma, vascular aneurysms, aortic dissection, or sarcoidosis. In the literature, most cases of CACS were reported from Western countries. In contrast, this disease was seldom reported in Oriental countries or regions, including Taiwan. Superior mesenteric artery syndrome (SMAS is also a rare disease characterized by compression of the third portion of the duodenum by the SMA. The clinical features of SMAS are postprandial pain, vomiting, and weight loss. To date, there are no guidelines to ensure the proper treatment of patients with CACS because of its low incidence. Thus, tailored therapy for patients with CACS remains a challenge as well as the prediction of clinical response and prognosis. The aim of our present study was to investigate the clinical features, the association with SMAS, treatments, and outcomes of patients with CACS in a single institution in Taiwan.

  2. Thoracic and diaphragmatic endometriosis: Single-institution experience using a novel broadened diagnostic criteria

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    Larraín, Demetrio; Suárez, Francisco; Braun, Hernán; Chapochnick, Javier; Diaz, Lidia; Rojas, Iván

    2018-06-05

    To describe our experience with the multidisciplinary management of both thoracic/diaphragmatic endometriosis (TED), applying a broadened definition of the “thoracic endometriosis syndrome (TES)” to define cases. We present a retrospective series of consecutive patients affected by pathology-proven TED, treated at our institution, during a period of 7 years. Five women were included. Two cases were referred due to catamenial chest/shoulder pain, one due to recurrent catamenial pneumothorax, one due to new-onset diaphragmatic hernia. One patient had not thoracic symptoms, and diaphragmatic endometriosis was found during gynecologic laparoscopy for pelvic endometriosis. Endometriosis was histologically confirmed in all cases. After follow-up all patients remain asymptomatic. Broadened TES criteria could increase the incidence of TED and determine better knowledge of this condition. Multidisciplinary, minimally invasive surgery is effective and safe, but should be reserved to tertiary referral centers.

  3. Nasopharyngeal carcinoma treated by radical radiotherapy alone: Ten-year experience of a single institution

    International Nuclear Information System (INIS)

    Yi Junlin; Gao Li; Huang Xiaodong; Li Suyan; Luo Jinwei; Cai Weiming; Xiao Jianping; Xu Guozhen

    2006-01-01

    Purpose: To report on our experience in the treatment of nasopharyngeal carcinoma (NPC) by radical radiotherapy alone in our institution during the last decade. Methods and Materials: From January 1990 to May 1999, 905 NPC patients were treated and were studied retrospectively. Radical radiotherapy was given to this cohort by conventional technique in a routine dose of 70-72 Gy to the primary tumor and metastatic lymph nodes. In case of residual primary lesion, a boost dose of 8-24 Gy was delivered by either 192 Ir afterloading brachytherapy, fractionated stereotactic radiotherapy, conformal radiotherapy, or small external-beam fields. Results: The 5-year and 10-year local-regional control, overall survival, and disease-free survival rates were 81.7% and 76.7%, 76.1% and 66.5%, 58.4% and 52.1%, respectively. In case of residual primary lesions after a dose of 70-72 Gy of conventional external-beam radiotherapy (EBRT), an additional boost was able to achieve a local control of 80.8%, similar to that obtained with primary lesions that completely disappeared at 70-72 Gy (82.6%, p = 0.892). Conclusions: The treatment results of radical EBRT followed by a boost dose to the residual primary tumor for nasopharyngeal carcinoma in our institution are promising

  4. Sharp Central Venous Recanalization in Hemodialysis Patients: A Single-Institution Experience

    Energy Technology Data Exchange (ETDEWEB)

    Arabi, Mohammad, E-mail: marabi2004@hotmail.com; Ahmed, Ishtiaq; Mat’hami, Abdulaziz [Prince Sultan Military Medical City (PSMMC), Division of Endovascular Interventional Radiology, Department of Medical Imaging (Saudi Arabia); Ahmed, Dildar; Aslam, Naveed [Prince Sultan Military Medical City (PSMMC), Department of Nephrology (Saudi Arabia)

    2016-06-15

    PurposeWe report our institutional experience with sharp central venous recanalization in chronic hemodialysis patients who failed standard techniques.Materials and MethodsSince January 2014, a series of seven consecutive patients (four males and three females), mean age 35 years (18–65 years), underwent sharp central venous recanalization. Indications included obtaining hemodialysis access (n = 6) and restoration of superior vena cava (SVC) patency to alleviate occlusion symptoms and restore fistula function (n = 1). The transseptal needle was used for sharp recanalization in six patients, while it could not be introduced in one patient due to total occlusion of the inferior vena cava. Instead, transmediastinal SVC access using Chiba needle was obtained.ResultsTechnical success was achieved in all cases. SVC recanalization achieved symptoms’ relief and restored fistula function in the symptomatic patient. One patient underwent arteriovenous fistula creation on the recanalized side 3 months after the procedure. The remaining catheters were functional at median follow-up time of 9 months (1–14 months). Two major complications occurred including a right hemothorax and a small hemopericardium, which were managed by covered stent placement across the perforated SVC.ConclusionSharp central venous recanalization using the transseptal needle is feasible technique in patients who failed standard recanalization procedures. The potential high risk of complications necessitates thorough awareness of anatomy and proper technical preparedness.

  5. Sharp Central Venous Recanalization in Hemodialysis Patients: A Single-Institution Experience

    International Nuclear Information System (INIS)

    Arabi, Mohammad; Ahmed, Ishtiaq; Mat’hami, Abdulaziz; Ahmed, Dildar; Aslam, Naveed

    2016-01-01

    PurposeWe report our institutional experience with sharp central venous recanalization in chronic hemodialysis patients who failed standard techniques.Materials and MethodsSince January 2014, a series of seven consecutive patients (four males and three females), mean age 35 years (18–65 years), underwent sharp central venous recanalization. Indications included obtaining hemodialysis access (n = 6) and restoration of superior vena cava (SVC) patency to alleviate occlusion symptoms and restore fistula function (n = 1). The transseptal needle was used for sharp recanalization in six patients, while it could not be introduced in one patient due to total occlusion of the inferior vena cava. Instead, transmediastinal SVC access using Chiba needle was obtained.ResultsTechnical success was achieved in all cases. SVC recanalization achieved symptoms’ relief and restored fistula function in the symptomatic patient. One patient underwent arteriovenous fistula creation on the recanalized side 3 months after the procedure. The remaining catheters were functional at median follow-up time of 9 months (1–14 months). Two major complications occurred including a right hemothorax and a small hemopericardium, which were managed by covered stent placement across the perforated SVC.ConclusionSharp central venous recanalization using the transseptal needle is feasible technique in patients who failed standard recanalization procedures. The potential high risk of complications necessitates thorough awareness of anatomy and proper technical preparedness.

  6. Operative interventions for failed heller myotomy: a single institution experience.

    Science.gov (United States)

    Pallati, Pradeep K; Mittal, Sumeet K

    2011-03-01

    Recurrent dysphagia and/or gastroesophageal reflux (GER) are failures of treatment after Heller myotomy for achalasia. We present our single center experience with surgical interventions for these failures. We did a retrospective analysis of a prospectively collected database. Based on preoperative symptoms and endoscopy, esophagogram, and manometry results, patients were divided into three groups to guide management. Telephone follow-up was done using a structured foregut questionnaire. Between December 2003 and June 2009, 16 patients underwent operative interventions for disabling symptoms after previous Heller myotomy. Eight patients presented primarily with recurrent dysphagia and underwent transabdominal Heller myotomy with partial fundoplication. Seven patients reported good to excellent symptom relief at mean follow-up of 42 months. One patient reported no relief and eventually required esophageal bypass with retrosternal gastric pull-up. Four patients presented with uncontrolled GER. Two patients who underwent redo partial fundoplication reported poor symptomatic outcome and one patient has since undergone short limb Roux-en-y gastric bypass (SLRNYGB) with excellent symptom relief. The other two patients underwent SLRNYGB with excellent relief at 10 months. Four patients had end stage achalasia and underwent esophageal resection with reconstruction. All reported excellent symptom relief at mean follow-up of 36 months. Transabdominal redo Heller myotomy for dysphagia has good outcomes. Redo fundoplication for GER after previous myotomy has poor results and SLRNYGB is an effective option in these patients. Esophageal resection remains an effective, albeit morbid, option for end-stage achalasia.

  7. Gender difference in utilization willingness of institutional care among the single seniors: evidence from rural Shandong, China.

    Science.gov (United States)

    Qian, Yangyang; Chu, Jie; Ge, Dandan; Zhang, Li; Sun, Long; Zhou, Chengchao

    2017-05-12

    Institutional care has become an urgent issue in rural China. Rural single seniors, compared with their counterparts, have lower income and are more vulnerable. Gender is also a significant factor determining long-term institutional care. This study is designed to examine the gender difference towards utilization willingness of institutional care among rural single seniors. A total of 505 rural single seniors were included in the analysis. Binary logistic regression model was used to examine the gender difference towards utilization willingness for institutional care, and also to identify the determinants of the utilization willingness for institutional care among rural single male and female seniors. Our study found that about 5.7% rural single seniors had willingness for institutional care in Shandong, China. Single females were found to be less willing for institutional care than single males in rural areas (OR = 0.19; 95 CI 0.06-0.57). It's also found that psychological stress was associated with institutionalization willingness in both single males (P = 0.045) and single females (P = 0.013) in rural China. The rural single seniors who lived alone were found to be more willing for institutional care both in males (P = 0.032) and females (P = 0.002) compared with those who lived with children or others. This study found that there was a gender difference towards utilization willingness for institutional care among single seniors in rural China. Factors including psychological stress and living arrangements were determinants of institutionalization willingness both in single males and females. Targeted policies should be made for rural single seniors of different gender.

  8. Outcome and treatment strategy in female lung cancer: a single institution experience

    International Nuclear Information System (INIS)

    Cicenas, S.; Kurtinaitis, J.; Smailyte, G.

    2010-01-01

    Purpose: To assess the survival rate of female lung cancer treated at the Institute of Oncology of the Vilnius University, Lithuania during the period between 1996-2005. Materials and Methods: During the period between 1996-2005, 471 women diagnosed with lung cancer were treated at the Department of Thoracic Surgery and Oncology of the Institute of Oncology, Vilnius University. Data on morphology, stage and treatment was collected from the medical records. All lung cancer cases by histology were classified in two groups: non-small cell lung cancer (includes squamous cell carcinoma, large cell carcinoma, adenocarcinoma and other less common types) and small cell lung cancer. The vital status of the study group was assessed as of December 31, 2007, by passive follow-up, using data from the population registry. It was found that 411 (87.3%) of the patients had died. Survival was estimated according to the Kaplan-Meier method. Results: The median survival of female lung cancer diagnosed during 1996-2005 in Lithuania show to be 8.7 months (8.4 (95% CI 7.2-10.8) months with non-small cell lung cancer and 9.3 (95% CI 6.3-13.0) months with small-cell lung cancer). Survival was more than 20 months in resectable non-small cell lung cancer (stages I, II, IIIA). Non-small cell lung cancer survival in advanced stages was less than 7 months. Small-cell lung cancer patients median survival at limited and extended stages of the disease were 9.5 (95% CI 2.9-18.4) compared to 9.2 (95% CI 6.2-13.7) months. Non-small cell lung cancer patients most frequently were treated by surgery (27.0%), surgery and chemotherapy or radiotherapy (19.6%). Small cell lung cancer patient treatment included chemo and radiotherapy (27.0%), chemotherapy (19.0%), radiotherapy (17.5%), surgery (27.9%). Conclusions: The single center study of female lung cancer diagnosed during 1996-2005 in Lithuania show a significantly better chance of survival in resectable non-small cell lung cancer. Advanced stages of

  9. Patterns of use of medical cannabis among Israeli cancer patients: a single institution experience.

    Science.gov (United States)

    Waissengrin, Barliz; Urban, Damien; Leshem, Yasmin; Garty, Meital; Wolf, Ido

    2015-02-01

    The use of the cannabis plant (Cannabis sativa L.) for the palliative treatment of cancer patients has been legalized in multiple jurisdictions including Israel. Yet, not much is currently known regarding the efficacy and patterns of use of cannabis in this setting. To analyze the indications for the administration of cannabis among adult Israeli cancer patients and evaluate its efficacy. Efficacy and patterns of use of cannabis were evaluated using physician-completed application forms, medical files, and a detailed questionnaire in adult cancer patients treated at a single institution. Of approximately 17,000 cancer patients seen, 279 (cannabis from an authorized institutional oncologist. The median age of cannabis users was 60 years (range 19-93 years), 160 (57%) were female, and 234 (84%) had metastatic disease. Of 151 (54%) patients alive at six months, 70 (46%) renewed their cannabis permit. Renewal was more common among younger patients and those with metastatic disease. Of 113 patients alive and using cannabis at one month, 69 (61%) responded to the detailed questionnaire. Improvement in pain, general well-being, appetite, and nausea were reported by 70%, 70%, 60%, and 50%, respectively. Side effects were mild and consisted mostly of fatigue and dizziness. Cannabis use is perceived as highly effective by some patients with advanced cancer and its administration can be regulated, even by local authorities. Additional studies are required to evaluate the efficacy of cannabis as part of the palliative treatment of cancer patients. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  10. Pediatric glioblastoma multiforme: A single-institution experience.

    Science.gov (United States)

    Ansari, Mansour; Nasrolahi, Hamid; Kani, Amir-Abbas; Mohammadianpanah, Mohammad; Ahmadloo, Niloofar; Omidvari, Shapour; Mosalaei, Ahmad

    2012-07-01

    Glioblastoma multiforme (GBM) is the most common astrocytoma in adults and has a poor prognosis, with a median survival of about 12 months. But, it is rare in children. We report our experience on the pediatric population (20 years or younger) with GBM. Twenty-three patients with GBM who were treated at our hospital during 1990-2008 were evaluated. The mean age was 15.2 years, and the majority of them (14/23) were male. All had received radiotherapy and some had also received chemotherapy. The mean survival was 16.0 months. Two cases survived more than 5 years. Age, radiation dose and performance status were significantly related to survival. GBM in pediatric patients were not very common in our center, and prognosis was unfavorable.

  11. Locally advanced cervix cancer: chemotherapy prior to definitive surgery or radiotherapy. A single institutional experience

    International Nuclear Information System (INIS)

    MacLeod, C.; O'Donnell, A.; Tattersall, M.H.N.; Dalrymple, C.; Firth, I.

    2001-01-01

    Primary or neoadjuvant chemotherapy prior to definitive local therapy has potential advantages for locally advanced cervix cancer. It can down stage a cancer and allow definitive local therapy to be technically possible (surgery), or potentially more effective (radiotherapy). It can also eradicate subclinical systemic metastases. This report reviews a single institution's experience of neoadjuvant chemotherapy prior to definitive local therapy for cervix cancer over a 13-year period. One hundred and six patients were treated with this intent. The patients were analysed for their response to chemotherapy, treatment received, survival, relapse and toxicity. The chemotherapy was feasible and the majority of patients had a complete or partial response (58.5%). Eight patients did not proceed to local treatment. Forty-six patients had definitive surgery and 52 had definitive radiotherapy. The 5-year overall survival was 27% and the majority of patients died with disease. The first site of relapse was usually in the pelvis (46.2%). Late complications that required ongoing medical therapy (n = 6) or surgical intervention (n = 2) were recorded in eight patients (7.5%). On univariate analysis stage (P= 0.04), tumour size (P = 0.01), lymph node status (P=0.003), response to chemotherapy (P = 0.045) and treatment (P = 0.003) were all significant predictors of survival. On multivariate analysis, tumour size (P < 0.0001) and nodal status (P = 0.02) were significant predictors of survival. Despite the impressive responses to chemotherapy of advanced cervix cancer, there is evidence from randomized trials that it does not improve or compromise survival prior to radiotherapy. As its role prior to surgery remains unclear, it should not be used in this setting outside a prospective randomized trial. Copyright (2001) Blackwell Science Pty Ltd

  12. The Ross Procedure in Pediatric Patients: A 20-Year Experience of Ross Procedure in a Single Institution.

    Science.gov (United States)

    Yoon, Dong Woog; Yang, Ji-Hyuk; Jun, Tae-Gook; Park, Pyo Won

    2017-08-01

    The Ross/Ross-Konno procedure is considered a good option for irreparable aortic valve disease in pediatric patients because of its hemodynamic performance and potential for growth of the pulmonary autograft. This study is a review of the long-term results of our 20-year experience with the Ross and Ross-Konno operations in a single institution. Between June 1995 and January 2016, 16 consecutive patients (mean age, 6.0±5.9 years; range, 16 days to 17.4 years) underwent either a Ross operation (n=9) or a Ross-Konno operation (n=7). The study included 12 males and 4 females, with a median follow-up period of 47 months (range, 6 to 256 months). There were no cases of in-hospital or late mortality. Six reoperations were performed in 5 patients. Four patients underwent right ventricular-pulmonary artery (RV-PA) conduit replacement. Two patients underwent concomitant replacement of the pulmonary autograft and RV-PA conduit 10 years and 8 years after the Ross operation, respectively. The rate of freedom from adverse outcomes of the pulmonary autograft was 88% and 70% at 5 and 10 years, respectively. The rate of freedom from valve-related reoperations was 79% and 63% at 5 and 10 years, respectively. Pulmonary autografts demonstrated good durability with low mortality. The Ross/Ross-Konno procedure is a good option that can be performed safely in pediatric patients with aortic valve disease, even in a small-volume center.

  13. Extracting Models in Single Molecule Experiments

    Science.gov (United States)

    Presse, Steve

    2013-03-01

    Single molecule experiments can now monitor the journey of a protein from its assembly near a ribosome to its proteolytic demise. Ideally all single molecule data should be self-explanatory. However data originating from single molecule experiments is particularly challenging to interpret on account of fluctuations and noise at such small scales. Realistically, basic understanding comes from models carefully extracted from the noisy data. Statistical mechanics, and maximum entropy in particular, provide a powerful framework for accomplishing this task in a principled fashion. Here I will discuss our work in extracting conformational memory from single molecule force spectroscopy experiments on large biomolecules. One clear advantage of this method is that we let the data tend towards the correct model, we do not fit the data. I will show that the dynamical model of the single molecule dynamics which emerges from this analysis is often more textured and complex than could otherwise come from fitting the data to a pre-conceived model.

  14. Surgical Excision with Forehead Flap as Single Modality Treatment for Basal Cell Cancer of Central Face: Single Institutional Experience of 50 Cases

    Directory of Open Access Journals (Sweden)

    Jagdeep Rao

    2014-01-01

    Full Text Available Basal cell carcinoma (BCC is the most common skin cancer worldwide. The WHO has defined it as “a locally invasive, slowly spreading tumor which rarely metastasizes, arising in the epidermis or hair follicles and in which the peripheral cells usually simulate the basal cells of the epidermis.” Here we discuss the management of BCCs of central face with surgical excision and reconstruction with forehead flap as single modality treatment. Material and Methods. This is a retrospective review of 50 patients who underwent surgical excision of BCC involving the facial region followed by primary reconstruction using forehead flaps at a single institution. There were 20 males and 30 females, mean age of 59 years. Results. No recurrence at primary site was observed during the follow-up of 1–4 yrs. There was no ectropion or exposure sequela. However, epiphora was evident. Size of lesions ranged from 2 to 6 cm. Keloid formation was seen in 2 (4% patients. Functional and cosmetic outcomes were satisfactory. Conclusion. For the face, the best reconstructive effort eventually fails in the face of tumor recurrence. The forehead flap represents one of the best methods for repair of extensive facial defects. Complete tumor extirpation, the primary event, is the key.

  15. Long-term Outcome of Chondrosarcoma: A Single Institutional Experience.

    Science.gov (United States)

    Bindiganavile, Srimanth; Han, Ilkyu; Yun, Ji Yeon; Kim, Han-Soo

    2015-10-01

    The prognostic factors of chondrosarcoma remain uncertain as only a few large studies with long-term follow-up have been reported. The aim of this study was to analyze oncological outcomes and prognostic factors. A retrospective review of oncological outcomes and prognostic factors was performed on 125 consecutive chondrosarcoma patients who underwent surgery at our institution. Overall survival was 91.6%±2.5%, 84.1%±3.8%, and 84.1%±3.8% at 5, 10, and 15 years respectively. Among the histological types, dedifferentiated type showed the worst survival (p chondrosarcoma, histologic grade and anatomical location predicted outcome, with high-grade with axial location having the worst outcome (p chondrosarcoma of appendicular skeleton could be treated safely by intralesional curettage. Histological type was significantly associated with the outcome of chondrosarcoma. For the conventional type, histologic grade and anatomical location predicted outcome, with high-grade with axial location having the worst outcome.

  16. Gender difference in utilization willingness of institutional care among the single seniors: evidence from rural Shandong, China

    OpenAIRE

    Qian, Yangyang; Chu, Jie; Ge, Dandan; Zhang, Li; Sun, Long; Zhou, Chengchao

    2017-01-01

    Background Institutional care has become an urgent issue in rural China. Rural single seniors, compared with their counterparts, have lower income and are more vulnerable. Gender is also a significant factor determining long-term institutional care. This study is designed to examine the gender difference towards utilization willingness of institutional care among rural single seniors. Methods A total of 505 rural single seniors were included in the analysis. Binary logistic regression model w...

  17. Meeting the Challenge: The National Cancer Institute's Central Institutional Review Board for Multi-Site Research.

    Science.gov (United States)

    Massett, Holly A; Hampp, Sharon L; Goldberg, Jacquelyn L; Mooney, Margaret; Parreco, Linda K; Minasian, Lori; Montello, Mike; Mishkin, Grace E; Davis, Catasha; Abrams, Jeffrey S

    2018-03-10

    The National Institutes of Health (NIH) issued a new policy that requires a single institutional review board (IRB) of record be used for all protocols funded by the NIH that are carried out at more than one site in the United States, effective January 2018. This policy affects several hundred clinical trials opened annually across the NIH. Limited data exist to compare the use of a single IRB to that of multiple local IRBs, so some institutions are resistant to or distrustful of single IRBs. Since 2001, the National Cancer Institute (NCI) has funded a central IRB (CIRB) that provides human patient reviews for its extensive national cancer clinical trials program. This paper presents data to show the adoption, efficiencies gained, and satisfaction of the CIRB among NCI trial networks and reviews key lessons gleaned from 16 years of experience that may be informative for others charged with implementation of the new NIH single-IRB policy.

  18. Severe neutropenia in children: a single institutional experience.

    Science.gov (United States)

    Yilmaz, Deniz; Ritchey, Arthur Kim

    2007-08-01

    Severe neutropenia (SN) is a rare disorder in childhood. This study aimed to document the approach to diagnosis and treatment of children with SN in a single university-based children's hospital, determine the types of SN seen in a 4-year period, and determine outcomes of the subtypes of SN. Forty-five children with SN were identified between 2000 and 2004. Two patients had autoimmune, 3 congenital, 3 familial, 6 cyclic, and 31 idiopathic SN. The median age of the patients with idiopathic SN was 15 months (3 mo to 17 y). Thirteen patients with idiopathic SN received filgrastim and 18 were observed. The history of severe infection and hospitalization at presentation was significantly more common among the patients who received filgrastim than those observed, but was not different between the 2 groups during the follow-up period. SN resolved in 16 patients and persisted in 14 patients. One patient with idiopathic SN did not respond to filgrastim and died of sepsis while she was still neutropenic. In summary, the majority of patients with SN had idiopathic SN, the infection risk was variable, treatment was based on clinical judgment rather than absolute neutrophil count, and approximately half of the patients had complete recovery.

  19. A single institution's experience with more than 500 laparoscopic Heller myotomies for achalasia.

    Science.gov (United States)

    Rosemurgy, Alexander S; Morton, Connor A; Rosas, Melissa; Albrink, Michael; Ross, Sharona B

    2010-05-01

    Long-term symptom relief and patient satisfaction after Heller myotomy are being reported. Herein, we report the largest experience of laparoscopic Heller myotomy for the treatment of achalasia. Since 1992, 505 patients have been prospectively followed after laparoscopic Heller myotomy. Until 2004, concomitant fundoplication was undertaken for a patulous hiatus, a large hiatal hernia, or to buttress the repair of an esophagotomy, then concomitant fundoplication became routinely applied. More recently, laparo-endoscopic single site (LESS) Heller myotomy has been performed when possible to improve cosmesis. Before and after myotomy, patients scored their symptoms. Before myotomy, 60% of patients underwent endoscopic therapy; of these patients, 27% had Botox (Allergan) therapy alone, 52% underwent dilation therapy alone, and 21% had both. Esophagotomy occurred in 7% of patients. Concomitant diverticulectomy was undertaken in 7%, fundoplication was performed in 59%, and LESS Heller myotomy was done in 12%. Median length of stay was 1 day. With mean follow-up at 31 months, the severity of all symptoms improved significantly. After myotomy, 95% experienced symptoms less than once per week, 86% believed their outcome is satisfying or better, and 92% would undergo myotomy again, if necessary. Symptoms after myotomy are similar with or without fundoplication and regardless of the laparoscopic approach used. Laparoscopic Heller myotomy safely and durably relieves symptoms of dysphagia. Confinement is short and satisfaction is very high. Relief of esophageal obstruction is paramount; the approach used or the application of a fundoplication has a lesser impact. Laparoscopic Heller myotomy, preferably with anterior fundoplication using a single site laparoscopic approach, is strongly encouraged for patients with symptomatic achalasia and is efficacious even after failures of dilation and/or Botox therapy. Copyright 2010 American College of Surgeons. Published by Elsevier Inc

  20. Experiments on cooperation, institutions, and social preferences

    NARCIS (Netherlands)

    Xu, Xue

    2018-01-01

    This thesis consists of three chapters in experimental economics. It involves various dimensions in which laboratory experiments can play a role: testing the validity of a game theory, helping understand institutions, and measuring (the change in) social preferences. It relates to the effects of

  1. Interactive Screen Experiments with Single Photons

    Science.gov (United States)

    Bronner, Patrick; Strunz, Andreas; Silberhorn, Christine; Meyn, Jan-Peter

    2009-01-01

    Single photons are used for fundamental quantum physics experiments as well as for applications. Originally being a topic of advance courses, such experiments are increasingly a subject of undergraduate courses. We provide interactive screen experiments (ISE) for supporting the work in a real laboratory, and for students who do not have access to…

  2. Rationalizing Neglect: An Institutional Response to Transfer Students

    Science.gov (United States)

    Tobolowsky, Barbara F.; Cox, Bradley E.

    2012-01-01

    This qualitative study focuses on institutional efforts affecting the transfer student experience at a single research institution. Findings based on interviews with institutional representatives, both faculty and staff, using the rational, natural, and open system perspectives of organizational theory, provide insights into the institutional…

  3. Validation of the 2012 Fukuoka Consensus Guideline for Intraductal Papillary Mucinous Neoplasm of the Pancreas From a Single Institution Experience.

    Science.gov (United States)

    Yu, Songfeng; Takasu, Naoki; Watanabe, Toshihiro; Fukumoto, Tsuyoshi; Okazaki, Shinji; Tezuka, Koji; Sugawara, Shuichiro; Hirai, Ichiro; Kimura, Wataru

    2017-08-01

    The 2012 Fukuoka consensus guideline has stratified the risks of malignant intraductal papillary mucinous neoplasm (IPMN) of the pancreas into "high-risk stigmata" (HRS) and "worrisome feature" (WF). This study aimed to evaluate its clinical validity based on a single institution experience. Eighty-nine patients who underwent surgical resection with pathological diagnosis of IPMN were retrospectively studied. High-risk stigmata was significantly correlated with the prevalence of malignant IPMN as compared with WF. The positive predictive values of HRS and WF were 66.7% and 35.7% for branch duct IPMN and 80% and 38.1% for main duct IPMN, respectively. Univariate analysis indicated that all the factors in HRS and WF had statistical significance. Whereas multivariate analysis revealed only enhanced solid component (odds ratio [OR], 50.01; P = 0.008), presence of mural nodule (OR, 73.83; P < 0.001) and lymphadenopathy (OR, 20.85; P = 0.03) were independent predictors. Scoring HRS and WF by different numbers of positive factors resulted in improved predictive value. The area under the curve of HRS score was significantly lower than that of WF or HRS + WF score (0.680 vs 0.900 or 0.902, respectively; P < 0.001). As supplementary to the 2012 Fukuoka guideline, we suggest that calculating scores of WF and HRS may have superior diagnostic accuracy in predicting malignant IPMN.

  4. Hydroxyapatite ceramic implants for cranioplasty in children: a single-center experience.

    Science.gov (United States)

    Zaccaria, Laura; Tharakan, Sasha Job; Altermatt, Stefan

    2017-02-01

    The use of hydroxyapatite ceramic (HAC) implants for the treatment of skull defects in pediatric patients started 2010 at our institution. Ceramic implants facilitate osteoblast migration and therefore optimize osteointegration with the host bone. The purpose of this study is to report a single-center experience with this treatment modality. A retrospective review of all patients from July 2010 through June 2014 undergoing a cranioplasty using hydroxyapatite ceramic implant and managed at a single institution was performed. Indication for cranioplasty, the hospital course, and follow-up were reviewed. Bone density was measured in Hounsfield Units (HU) and osteointegration was calculated using Mimics Software® (Mimics Innovation Suite v17.0 Medical, Materialize, Leuven, Belgium). Over the 4-year period, six patients met criteria for the study. Five patients had an osteointegration of nearly 100%. One patient had an incomplete osteointegration with a total bone-implant contact area of 69%. The mean bone density was 2800 HU (2300-3000 HU). Bone density alone is estimated to have a Hounsfield value between 400 and 2000 HU depending on the body region and bone quality. There were no major complications, and the patients were highly satisfied with the esthetical result. Hydroxyapatite ceramic implants for cranioplasty in pediatric patients are a good choice for different indications. The implants show excellent osteointegration and esthetical results.

  5. One-Step Nucleic Acid Amplification in Breast Cancer Sentinel Lymph Node: A Single Institutional Experience and a Short Review

    OpenAIRE

    Brambilla, Tatiana; Fiamengo, Barbara; Tinterri, Corrado; Testori, Alberto; Grassi, Massimo Maria; Sciarra, Amedeo; Abbate, Tommaso; Gatzemeier, Wolfgang; Roncalli, Massimo; Di Tommaso, Luca

    2015-01-01

    Sentinel lymph node (SLN) examination is a standard in breast cancer patients, with several methods employed along its 20 years history, the last one represented by one-step nucleic acid amplification (OSNA). The latter is a intra-operative molecular assay searching for CK19 mRNA as a surrogate of metastatic cells. Our 3 years experience with OSNA (1122 patients) showed results overlapping those recorded in the same institution with a morphological evaluation (930 patients) of SLN. In detail,...

  6. Leiomyosarcoma of the head and neck: A 17-year single institution experience and review of the National Cancer Data Base.

    Science.gov (United States)

    Workman, Alan D; Farquhar, Douglas R; Brody, Robert M; Parasher, Arjun K; Carey, Ryan M; Purkey, Michael T; Nagda, Danish A; Brooks, John S; Hartner, Lee P; Brant, Jason A; Newman, Jason G

    2018-04-01

    Leiomyosarcoma is a rare neoplasm of the head and neck. The purpose of this study was to present our single-institution case series of head and neck leiomyosarcoma and a review of cases in the National Cancer Data Base (NCDB). Patients with head and neck leiomyosarcoma at the University of Pennsylvania and in the NCDB were identified. Demographic characteristics, tumor factors, treatment paradigms, and outcomes were evaluated for prognostic significance. Nine patients with head and neck leiomyosarcoma from the institution were identified; a majority had high-grade disease and cutaneous leiomyosarcoma, with a 5-year survival rate of 50%. Two hundred fifty-nine patients with leiomyosarcoma were found in the NCDB; macroscopic positive margins and high-grade disease were associated with poor prognosis (P < .01), and positive surgical margins were related to adjuvant radiation (P < .001). Head and neck leiomyosarcoma presents at a high grade and is preferentially treated with surgery. Several demographic and tumor-specific factors are associated with outcomes and prognosis. © 2017 Wiley Periodicals, Inc.

  7. Practice of knowledge management for institutes--take the construction of experience feedback system as the example

    International Nuclear Information System (INIS)

    Wu Kaiping

    2014-01-01

    The construction of experience feedback system is an important part and breakthrough point of institutes' knowledge management. It is significant for institutes' design, management, development and innovation. This article introduces the concept of experience feedback for institutes. It also goes details of the content of experience feedback system construction for institutes, including the founding of experience feedback organizational mechanism, the development of experience feedback system, construction of knowledge database system, the construction of knowledge resources, and the appraisal of experience feedback's performance. Furthermore, the recognition and support of leaders, understanding and cooperation of relative departments, and corporation's culture of encouraging knowledge sharing, also are the important guarantees for the good effects of institutes' experience feedback work. (author)

  8. What happens if you single out? An experiment

    OpenAIRE

    Galeotti, Fabio; Zizzo, Daniel John

    2014-01-01

    We present an experiment investigating the effects of singling out an individual on trust and trustworthiness. We find that (a) trustworthiness falls if there is a singled out subject; (b) non-singled out subjects discriminate against the singled out subject when they are not responsible of the distinct status of this person; (c) under a negative frame, the singled out subject returns significantly less; (d) under a positive frame, the singled out subject behaves bimodally, either selecting v...

  9. INSTITUTIONAL TRANSFORMATION IN COUNTRIES OF CEE: EXPERIENCE FOR UKRAINE

    Directory of Open Access Journals (Sweden)

    Galyna\tPOCHENCHUK

    2015-12-01

    Full Text Available In the article the experience of post-socialist countries of Central and Eastern Europe on the transformational changes that have been implemented in the political, socio-economic and ideological spheres is considered. The unprecedentness is determined by the scope and timing of reform. The author reviews the main conceptual models of realization of market transformations. The features of centrally-planned or command economy and main stages of market reforms with regard to processes that took place in the reformed countries are characterized. It is determined that the first phase concerned the dismantling of the previous social system and its institutions, so that it was not only started the formation of market structures and the introduction of democratic principles, but also significant negative trends in the economy and social sphere. The second stage of reforms in CEE related to the acquisition of the membership in Member States and relevant preparatory and adaptational measures. Critical importance of institutional reforms to establish an effective functioning of democratic market economy is explained. Based on the analysis of institutional transformations that took place in the reform process in Central and Eastern Europe the main institutional changes in various fields are summarized. With the experience of CEE countries the narrow places of transformation processes in Ukraine are identified and necessary directions for further transformation are reasonably grounded.

  10. Definitive and adjuvant radiotherapy for sinonasal squamous cell carcinomas: a single institutional experience

    International Nuclear Information System (INIS)

    Duru Birgi, Sumerya; Teo, Mark; Dyker, Karen E.; Sen, Mehmet; Prestwich, Robin J D

    2015-01-01

    The aim of this study was to evaluate the disease outcomes of patients treated with definitive and adjuvant radiotherapy for squamous cell carcinomas of the nasal cavity and paranasal sinuses in a single institution. Between 2007–2012 patients were retrospectively identified from electronic databases who had undergone surgery and adjuvant radiotherapy or definitive radiotherapy for sinonasal squamous cell carcinomas with curative intent. Fourty three patients with sinonasal squamous cell carcinoma were identified (22 nasal cavity, 21 paranasal sinuses). 31/43 (72 %) had T3 or T4 disease; nodal stage was N0 in 38, N1 in 4, Na/b in 0 and N2c in 1 patient. Median age was 67 years (range 41–86). 18 (42 %) received definitive and 25 (58 %) adjuvant radiotherapy. Radiotherapy was delivered using either conventional radiotherapy (n = 39) or intensity modulated radiotherapy (n = 4). Elective neck radiotherapy was delivered to two patients. Chemotherapy was delivered to 6/43 (14 %) of patients. Two-year local control, regional control, distant metastases free survival, progression free survival, cause specific survival and overall survival were 81 %, 90 %, 95 %, 71 %, 84 % and 80 % respectively. There was no significant difference in outcome comparing patients who underwent surgery and adjuvant radiotherapy with patients receiving definitive radiotherapy (2 year locoregional disease free survival 75 % and 70 % respectively, p = 0.98). Pooly differentiated tumours were significantly associated with inferior disease outcomes. Local, regional, combined local and regional, and distant failure occurred in 7 (16 %), 3 (7 %), 1 (2 %) and 2 (5 %) of patients; all 3 regional recurrences were in patients with nasal cavity squamous cell carcinomas who had not undergone elective neck treatment. Definitive or adjuvant radiotherapy provides an effective treatment for sinonasal malignancies. The main pattern of failure remains local, suggesting the need for investigation of

  11. A short review of critical experiments performed at the Kurchatov Institute

    International Nuclear Information System (INIS)

    Gagarinski, A.Yu.; Glushkov, Y.S.; Ponomarev-Stepnoi, N.N.

    1997-01-01

    Since the 1950s, the Institute of Atomic Energy (now the Russian Research Center Kurchatov Institute) has investigated nuclear reactors intended for various purposes. A summary of the present state of these assemblies is given in an attachment to the paper. A second attachment provides a brief description of critical experiments for small nuclear power systems intended for decentralized power generation. The critical assemblies for these experiments were moderated by water and zirconium hydride, and fuel elements ranged in enrichment from 5% to 95% uranium 235. 7 refs

  12. A short review of critical experiments performed at the Kurchatov Institute

    Energy Technology Data Exchange (ETDEWEB)

    Gagarinski, A.Yu.; Glushkov, Y.S.; Ponomarev-Stepnoi, N.N. [Kurchatov Institute (Russian Federation)

    1997-06-01

    Since the 1950s, the Institute of Atomic Energy (now the Russian Research Center Kurchatov Institute) has investigated nuclear reactors intended for various purposes. A summary of the present state of these assemblies is given in an attachment to the paper. A second attachment provides a brief description of critical experiments for small nuclear power systems intended for decentralized power generation. The critical assemblies for these experiments were moderated by water and zirconium hydride, and fuel elements ranged in enrichment from 5% to 95% uranium 235. 7 refs.

  13. SILC for SILC: Single Institution Learning Curve for Single-Incision Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    Chee Wei Tay

    2013-01-01

    Full Text Available Objectives. We report the single-incision laparoscopic cholecystectomy (SILC learning experience of 2 hepatobiliary surgeons and the factors that could influence the learning curve of SILC. Methods. Patients who underwent SILC by Surgeons A and B were studied retrospectively. Operating time, conversion rate, reason for conversion, identity of first assistants, and their experience with previous laparoscopic cholecystectomy (LC were analysed. CUSUM analysis is used to identify learning curve. Results. Hundred and nineteen SILC cases were performed by Surgeons A and B, respectively. Eight cases required additional port. In CUSUM analysis, most conversion occurred during the first 19 cases. Operating time was significantly lower (62.5 versus 90.6 min, P = 0.04 after the learning curve has been overcome. Operating time decreases as the experience increases, especially Surgeon B. Most conversions are due to adhesion at Calot’s triangle. Acute cholecystitis, patients’ BMI, and previous surgery do not seem to influence conversion rate. Mean operating times of cases assisted by first assistant with and without LC experience were 48 and 74 minutes, respectively (P = 0.004. Conclusion. Nineteen cases are needed to overcome the learning curve of SILC. Team work, assistant with CLC experience, and appropriate equipment and technique are the important factors in performing SILC.

  14. Single-Institution Experience With Component Separation for Ventral Hernia Repair: A Retrospective Review.

    Science.gov (United States)

    Hill, Brian; Kambeyanda, Rohan; Fewell, Donna; Bryant, Stewart; Delaney, Kevin O; Herrera, Fernando A

    2018-06-01

    In this study, we reviewed our institution's experience using component separation for repair of ventral hernias. This was a retrospective review of all component separations for ventral hernia between July 2009 and December 2015. Recorded data included body mass index (BMI), preoperative albumin, smoking history, comorbidities, additional procedures, length of surgery, hospitalization, recurrence, and postoperative complications. One hundred ninety-six component separations were performed in the study period. The average patient age was 56 years, and 65.3% of patients were female. The average BMI was 32.6 kg/m; preoperative albumin was 3.59; 18.4% were current smokers; 28.1% were diabetic; and 14.3% had heart disease. Postoperative complications developed in 16.8% of patients. Recurrence developed in 8.7% of patients. Patients who developed a postoperative complication had a higher BMI (P = 0.025) and lower albumin (P = 0.047) compared with patients who did not develop complications. Current smokers were more likely to develop complications (P = 0.008). More than one third of patients had additional procedures at the time of the ventral hernia repair. The addition of a plastic surgery procedure was not associated with an increased risk of developing a complication (P = 0.25). Patients who developed complications had a significantly longer hospital course (P < 0.001) but no difference in total operative time (P = 0.975). Increased number of comorbidities did not statistically correlate with an increased complication rate (P = 0.65) or length of hospital stay (P = 0.43). We identified risk factors that increase the likelihood of postoperative complications and length of hospital stay. In addition, this study suggests that more comorbidities and additional procedures at the time of the hernia repair may not have as large of impact on complication risk as previously thought.

  15. Ignition experiment in a single-turn-coil tokamak

    International Nuclear Information System (INIS)

    Carrera, R.; Driga, M.; Gully, J.H.

    1989-01-01

    A novel concept for a fusion ignition experiment, IGNITEX proposed along the lines of previous ideas for a compact thermonuclear device is analyzed. A single-turn-coil tokamak is analyzed. A single-turn-coil tokamak supplied by homopolar generators can ohmically heat a DT plasma to ignition conditions and maintain a thermally stable ignited phase for about ten energy confinement times. The IGNITEX experiment can provide a simple and relatively inexpensive way to produce and control ignited plasmas for scientific study

  16. Outcomes of allogeneic hematopoietic stem cell transplantation for lymphomas: a single-institution experience

    Directory of Open Access Journals (Sweden)

    Mira Romany Massoud

    Full Text Available ABSTRACT Introduction: Allogeneic hematopoietic stem cell transplantation offers the opportunity for extended survival in patients with Hodgkin's and non-Hodgkin lymphomas who relapsed after, or were deemed ineligible for, autologous transplantation. This study reports the cumulative experience of a single center over the past 14 years aiming to define the impact of patient, disease, and transplant-related characteristics on outcomes. Methods: All patients with histologically confirmed diagnosis of Hodgkin's or non-Hodgkin lymphomas who received allogeneic transplantation from 2000 to 2014 were retrospectively studied. Results: Forty-one patients were reviewed: 10 (24% had Hodgkin's and 31 (76% had non-Hodgkin lymphomas. The median age was 50 years and 23 (56% were male. The majority of patients (68% had had a prior autologous transplantation. At the time of allogeneic transplantation, 18 (43% patients were in complete and seven (17% were in partial remission. Most (95% patients received reduced-intensity conditioning, 49% received matched sibling donor grafts, 24% matched-unrelated donor grafts, and 27% received double umbilical cord blood grafts. The 100-day treatment-related mortality rate was 12%. After a median duration of follow up of 17.1 months, the median progression-free and overall survival was 40.5 and 95.8 months, respectively. On multivariate analysis, patients who had active disease at the time of transplant had inferior survival. Conclusions: Allogeneic transplantation results extend survival in selected patients with relapsed/refractory Hodgkin's and non-Hodgkin lymphomas with low treatment-related mortality. Patients who have active disease at the time of allogeneic transplantation have poor outcomes.

  17. THE FIRST LADY INSTITUTE IN THE EXPERIENCE OF THE EASTERN SLAVIA

    Directory of Open Access Journals (Sweden)

    Inna Kalita

    2016-10-01

    Full Text Available The article analyzes the First Lady Institute experience in modern eastern Slavia. The examples of gender representation from the late Soviet era and the highest level gender “defeat” in some post-Soviet states are compared. The First Lady’s presentation and self-presentation are seen as an indicator of democratic changes in the state. The accumulated experience reflects the real condition of gender issue unpopularity among some leaders of Eastern Slavonic states, so it proves the immaturity of governmental democratic systems in Russia, Belarus and Ukraine. The analyzed paradigm also reflects the decline of the family institution prestige.

  18. Single Molecule Biophysics Experiments and Theory

    CERN Document Server

    Komatsuzaki, Tamiki; Takahashi, Satoshi; Yang, Haw; Silbey, Robert J; Rice, Stuart A; Dinner, Aaron R

    2011-01-01

    Discover the experimental and theoretical developments in optical single-molecule spectroscopy that are changing the ways we think about molecules and atoms The Advances in Chemical Physics series provides the chemical physics field with a forum for critical, authoritative evaluations of advances in every area of the discipline. This latest volume explores the advent of optical single-molecule spectroscopy, and how atomic force microscopy has empowered novel experiments on individual biomolecules, opening up new frontiers in molecular and cell biology and leading to new theoretical approaches

  19. Stereotactic radiosurgery for the treatment of brain metastases; results from a single institution experience.

    LENUS (Irish Health Repository)

    Burke, D

    2013-09-01

    Stereotactic radiosurgery is frequently used for the treatment of brain metastases. This study provides a retrospective evaluation of patients with secondary lesions of the brain treated with stereotactic radiosurgery (SRS) at our institution.

  20. Institutional Repositories: The Experience of Master's and Baccalaureate Institutions

    Science.gov (United States)

    Markey, Karen; St. Jean, Beth; Soo, Young Rieh; Yakel, Elizabeth; Kim, Jihyun

    2008-01-01

    In 2006, MIRACLE Project investigators censused library directors at all U.S. academic institutions about their activities planning, pilot testing, and implementing the institutional repositories on their campuses. Out of 446 respondents, 289 (64.8 percent) were from master's and baccalaureate institutions (M&BIs) where few operational…

  1. Division III Student-Athletes' Experiences of Institutional Social and Academic Systems

    Science.gov (United States)

    Becht, Louis A., Jr.

    2017-01-01

    The purpose of this qualitative study was to expand the literature on Division III student-athletes by examining their integration into the social and academic systems at one institution located in northeastern United States. This study examined participants' experiences within institutional social and academic systems designed for…

  2. Nuclear engineering experiments at experimental facilities of JNC in graduate course of Tokyo Institute of Technology

    International Nuclear Information System (INIS)

    Hayashizaki, Noriyosu; Takahashi, Minoru; Aoyama, Takafumi; Onose, Shoji

    2005-01-01

    Nuclear engineering experiments using outside facilities of the campus have been offered for graduate students in the nuclear engineering course in Tokyo Institute of Technology (Tokyo Tech.). The experiments are managed with the collaboration of Japan Nuclear Cycle Development Institute (JNC), Japan Atomic Energy Research Institute (JAERI) and Research Reactor Institute, Kyoto University (KUR). This report presents the new curriculum of the nuclear engineering experiments at JNC since 2002. The change is due to the shutdown of Deuterium Criticality Assembly Facility (DCA) that was used as an experimental facility until 2001. Reactor physics experiment using the training simulator of the experimental fast reactor JOYO is continued from the previous curriculum with the addition of the criticality approach experiment and control rods calibration. A new experimental subject is an irradiated material experiment at the Material Monitoring Facility (MMF). As a result, both are acceptable as the student experiments on the fast reactor. (author)

  3. Experiments and modeling of single plastic particle conversion in suspension

    DEFF Research Database (Denmark)

    Nakhaei, Mohammadhadi; Wu, Hao; Grévain, Damien

    2018-01-01

    Conversion of single high density polyethylene (PE) particles has been studied by experiments and modeling. The experiments were carried out in a single particle combustor for five different shapes and masses of particles at temperature conditions of 900 and 1100°C. Each experiment was recorded...... against the experiments as well as literature data. Furthermore, a simplified isothermal model appropriate for CFD applications was developed, in order to model the combustion of plastic particles in cement calciners. By comparing predictions with the isothermal and the non–isothermal models under typical...

  4. [Ethic review on clinical experiments of medical devices in medical institutions].

    Science.gov (United States)

    Shuai, Wanjun; Chao, Yong; Wang, Ning; Xu, Shining

    2011-07-01

    Clinical experiments are always used to evaluate the safety and validity of medical devices. The experiments have two types of clinical trying and testing. Ethic review must be done by the ethics committee of the medical department with the qualification of clinical research, and the approval must be made before the experiments. In order to ensure the safety and validity of clinical experiments of medical devices in medical institutions, the contents, process and approval criterions of the ethic review were analyzed and discussed.

  5. IgM MGUS associated with anti-MAG neuropathy: a single institution experience.

    Science.gov (United States)

    Talamo, Giampaolo; Mir, Muhammad A; Pandey, Manoj K; Sivik, Jeffrey K; Raheja, Divisha

    2015-06-01

    Anti-MAG neuropathy is a very rare form of acquired polyneuropathy associated with IgM monoclonal gammopathy of undetermined significance (MGUS). We conducted a retrospective review of 194 consecutive MGUS patients seen at the Penn State Hershey Cancer Institute. We identified six patients among 37 (16 %) with IgM MGUS with anti-MAG neuropathy. Interestingly, an additional patient had anti-MAG neuropathy without MGUS. Common clinical manifestations were numbness and paresthesias of the extremities and gait imbalance. All four patients treated with rituximab and none of the three untreated ones had a subjective improvement of their symptoms. We conclude that all patients with IgM MGUS and neuropathy should be screened for anti-MAG antibodies and, if positive, they should be offered treatment with rituximab.

  6. Prognostic factors in glioblastoma multiforme. 10 years experience of a single institution

    Energy Technology Data Exchange (ETDEWEB)

    Hulshof, M C.C.M.; Schimmel, E C; Gonzalez, D G [Amsterdam Univ. (Netherlands). Dept. of Radiotherapy; Koot, R W; Bosch, D A [Amsterdam Univ. (Netherlands). Dept. of Neurosurgery; Dekker, F [Amsterdam Univ. (Netherlands). Dept. of Epidemiology

    2001-06-01

    Background: To analyze prognostic factors in patients with a glioblastoma multiforme treated in an academic institute over the last 10 years. Patients and method: From 1988 to 1998, 198 patients with pathologically confirmed glioblastoma multiforme were analyzed. Five radiation schedules were used mainly based on pretreatment selection criteria: 1. 60 Gy in 30 fractions followed by an interstitial iridium-192 (Ir-192) boost for selected patients with a good performance and a small circumscribed tumor, 2. 66 Gy in 33 fractions for good performance patients, 3. 40 Gy in eight fractions or 4. 28 Gy in four fractions for poor prognostic patients and 5. no irradiation. Results: Median survival was 16 months, 7 months, 5.6 months, 6.6 months and 1.8 months for the groups treated with Ir-192, 66 Gy, 40 Gy, 28 Gy and the group without treatment, respectively. No significant improvement in survival was encountered over the last 10 years. At multivariate analysis patients treated with a hypofractionated scheme showed a similar survival probability and duration of palliative effect compared to the conventionally fractionated group. The poor prognostic groups receiving radiotherapy had a highly significant better survival compared to the no-treatment group. Patients treated with an Ir-192 boost had a better median survival compared to a historical group matched on selection criteria but without boost treatment (16 vs 9.7 months, n.s.). However, survival at 2 years was similar. Analysis on pretreatment characteristics at multivariate analysis revealed age, neurological performance, addition of radiotherapy, total resection, tumor size post surgery and deterioration before start of radiotherapy (borderline) as significant prognostic factors for survival. Conclusion: Despite technical developments in surgery and radiotherapy over the last 10 years, survival of patients with a glioblastoma multiforme has not improved in our institution. The analysis of prognostic factors

  7. Improved Dye Stability in Single-Molecule Fluorescence Experiments

    Science.gov (United States)

    EcheverrÍa Aitken, Colin; Marshall, R. Andrew; Pugi, Joseph D.

    Complex biological systems challenge existing single-molecule methods. In particular, dye stability limits observation time in singlemolecule fluorescence applications. Current approaches to improving dye performance involve the addition of enzymatic oxygen scavenging systems and small molecule additives. We present an enzymatic oxygen scavenging system that improves dye stability in single-molecule experiments. Compared to the currently-employed glucose-oxidase/catalase system, the protocatechuate-3,4-dioxygenase system achieves lower dissolved oxygen concentration and stabilizes single Cy3, Cy5, and Alexa488 fluorophores. Moreover, this system possesses none of the limitations associated with the glucose oxidase/catalase system. We also tested the effects of small molecule additives in this system. Biological reducing agents significantly destabilize the Cy5 fluorophore as a function of reducing potential. In contrast, anti-oxidants stabilize the Cy3 and Alexa488 fluorophores. We recommend use of the protocatechuate-3,4,-dioxygenase system with antioxidant additives, and in the absence of biological reducing agents. This system should have wide application to single-molecule fluorescence experiments.

  8. War-related penile injuries in Libya: Single-institution experience.

    Science.gov (United States)

    Etabbal, Abdalla M; Hussain, Fathi F; Benkhadoura, Mohamed O; Banni, Abdalla M

    2018-06-01

    To report on our initial experience in the management of war-related penile injuries; proper diagnosis and immediate treatment of penile injuries is essential to gain satisfactory results. Besides treating primary wounds and restoring penile function, the cosmetic result is also an important issue for the surgeon. The study was conducted in the Department of Urology at Benghazi Medical Center and comprised all patients who presented with a shotgun, gunshot or explosive penile injury between February 2011 and August 2017. The patient's age, cause of injury, site and severity of injuries, management, postoperative complications, and hospital stay, were recorded. In all, 29 males with war-related penile injuries were enrolled in the study. The mean (SD) age of these patients was 31.3 (10.5) years. The glans, urethra, and corporal bodies were involved in four (13.7%), 10 (34.4%), and 20 (68.9%) of the patients, respectively. According to the American Association for the Surgery of Trauma Penis Injury Scale, Grade III penile injuries were the most common (11 patients, 37.9%). The most common post-intervention complications were urethral stricture with or without proximal urethrocutaneous fistula (eight patients, 27.5%), followed by permanent erectile dysfunction (five patients, 17.2%). In patients who sustain war-related penile injuries the surgeon's efforts should not only be directed to restoring normal voiding and erectile function but also on the cosmetic appearance of the penis.

  9. Single Mothers' Experiences with Pregnancy and Child Rearing in Korea: Discrepancy between Social Services/Policies and Single Mothers' Needs.

    Science.gov (United States)

    Kim, Jung-Eun; Lee, Jin Yong; Lee, Sang Hyung

    2018-05-10

    This study aims to explore single mothers’ experiences with social services/policies for their independent living and to identify gaps between these experiences and the needs of single mothers. A focus group discussion was performed to collect data. Seven single mothers discussed their experiences in significant periods of their lives: pregnancy, childbirth, and parenting. Findings from the qualitative thematic analysis show discrepancies between the direction of social services/policies and single mothers’ needs, in terms of difficulties in healthcare, childcare, housing, employment, and income security. To the single mothers in this study, the social safety net is not inclusive, compared to that which is available to two-parent families or adoptive families. It is necessary to intervene in current blind spots of services/policies for single mothers, and to provide a social safety net to strengthen single mothers’ self-reliance and their children’s social security in the long term.

  10. How institutions matter for international business : Institutional distance effects vs institutional profile effects

    NARCIS (Netherlands)

    van Hoorn, Andre; Maseland, Robbert

    Extant institutional research has failed to make a distinction between the effects of institutional profile and institutional distance on MNEs. The problem stems from the fact that, due to the use of a single reference country, variation in institutional distance between the reference country and

  11. Single-photon interference experiment for high schools

    Science.gov (United States)

    Bondani, Maria

    2014-07-01

    We follow the reductio ad absurdum reasoning described in the book "Sneaking a Look at God's Cards" by Giancarlo Ghirardi to demonstrate the wave-particle duality of light in a Mach-Zehnder interferometric setup analog to the conventional Young double-slit experiment. We aim at showing the double nature of light by measuring the existence of interference fringes down to the single-photon level. The setup includes a strongly attenuated laser, polarizing beam splitters, half-waveplates, polarizers and single-photon detectors.

  12. Experiences with Learning Management Systems in 113 European Institutions

    Directory of Open Access Journals (Sweden)

    Morten Flate Paulsen

    2003-10-01

    Full Text Available This article presents the major findings from six regional analyses conducted within the framework of the European Web-edu project (http://www.nettskolen.com/in_english/webedusite/index.html. It analyses the experiences of European institutions with the Learning Management Systems that they have purchased or developed themselves. Data was collected from in-depth interviews with 113 European experts, usually the systems managers in the institutions, in 17 countries. The analyses of the interviews revealed as many as 52 different commercial and 35 self-developed LMS systems. The article presents the data from these interviews and includes a series of important findings from the study. One conclusion is that there is a host of commercial and self-developed systems that seem to work satisfactorily in various educational institutions throughout Europe. The systems are not able to handle all the functions the institutions want, and they can be improved in many ways. But most systems encountered in the analyses seem to be good enough for handling online education successfully. Another conclusion is that the European market is not dominated by the American LMS systems. In countries that do not use English as the first language, locally developed LMS systems have successfully ousted the American products. Remarkably, a large number of the LMS systems used in Europe are commercial systems developed locally, or self-developed systems built by the institutions.

  13. Single Photon Experiments and Quantum Complementarity

    Directory of Open Access Journals (Sweden)

    Georgiev D. D.

    2007-04-01

    Full Text Available Single photon experiments have been used as one of the most striking illustrations of the apparently nonclassical nature of the quantum world. In this review we examine the mathematical basis of the principle of complementarity and explain why the Englert-Greenberger duality relation is not violated in the configurations of Unruh and of Afshar.

  14. Long-Term Memory for a Single Infancy Experience.

    Science.gov (United States)

    Perris, Eve Emmanuel; And Others

    1990-01-01

    Children's memory of single infant experience was evaluated. At 6.5 months, infants participated in study of reaching in light and dark for sounding object. Children repeated dark procedure in laboratory when they were either one year or two years older. Older children with infant experience reached and grasped the sounding object significantly…

  15. The Experiment Method for Manufacturing Grid Development on Single Computer

    Institute of Scientific and Technical Information of China (English)

    XIAO Youan; ZHOU Zude

    2006-01-01

    In this paper, an experiment method for the Manufacturing Grid application system development in the single personal computer environment is proposed. The characteristic of the proposed method is constructing a full prototype Manufacturing Grid application system which is hosted on a single personal computer with the virtual machine technology. Firstly, it builds all the Manufacturing Grid physical resource nodes on an abstraction layer of a single personal computer with the virtual machine technology. Secondly, all the virtual Manufacturing Grid resource nodes will be connected with virtual network and the application software will be deployed on each Manufacturing Grid nodes. Then, we can obtain a prototype Manufacturing Grid application system which is working in the single personal computer, and can carry on the experiment on this foundation. Compared with the known experiment methods for the Manufacturing Grid application system development, the proposed method has the advantages of the known methods, such as cost inexpensively, operation simple, and can get the confidence experiment result easily. The Manufacturing Grid application system constructed with the proposed method has the high scalability, stability and reliability. It is can be migrated to the real application environment rapidly.

  16. Quantum contextual phenomena observed in single-neutron interferometer experiments

    International Nuclear Information System (INIS)

    Hasegawa, Yuji; Rauch, Helmut

    2006-01-01

    Neutron optical experiments are presented, which exhibit quantum contextual phenomena. Entanglement is achieved not between particles, but between degrees of freedom, in this case, for a single-particle. Appropriate combinations of the direction of spin analysis and the position of the phase shifter allow an experimental verification of the violation of a Bell-like inequality. Our experiments manifest the fact that manipulation of the wavefunction in one Hilbert space influences the result of the measurement in the other Hilbert space: manipulation without touch! Next, we report another experiment which exhibits other peculiarity of quantum contextuality, e.g., originally intended to show a Kochen-Specker-like phenomenon. We have introduced inequalities for quantitative analysis of the experiments. The value obtained in the experiments clearly showed violations of prediction by non-contextual theory. Finally, we have accomplished a tomographic determination of entangled quantum state in single-neutrons. There, characteristics of the Bell-sate are confirmed: four poles for the real part of the density matrix are clearly seen

  17. Prognostic factors in glioblastoma multiforme. 10 years experience of a single institution

    International Nuclear Information System (INIS)

    Hulshof, M.C.C.M.; Schimmel, E.C.; Gonzalez, D.G.; Koot, R.W.; Bosch, D.A.; Dekker, F.

    2001-01-01

    Background: To analyze prognostic factors in patients with a glioblastoma multiforme treated in an academic institute over the last 10 years. Patients and method: From 1988 to 1998, 198 patients with pathologically confirmed glioblastoma multiforme were analyzed. Five radiation schedules were used mainly based on pretreatment selection criteria: 1. 60 Gy in 30 fractions followed by an interstitial iridium-192 (Ir-192) boost for selected patients with a good performance and a small circumscribed tumor, 2. 66 Gy in 33 fractions for good performance patients, 3. 40 Gy in eight fractions or 4. 28 Gy in four fractions for poor prognostic patients and 5. no irradiation. Results: Median survival was 16 months, 7 months, 5.6 months, 6.6 months and 1.8 months for the groups treated with Ir-192, 66 Gy, 40 Gy, 28 Gy and the group without treatment, respectively. No significant improvement in survival was encountered over the last 10 years. At multivariate analysis patients treated with a hypofractionated scheme showed a similar survival probability and duration of palliative effect compared to the conventionally fractionated group. The poor prognostic groups receiving radiotherapy had a highly significant better survival compared to the no-treatment group. Patients treated with an Ir-192 boost had a better median survival compared to a historical group matched on selection criteria but without boost treatment (16 vs 9.7 months, n.s.). However, survival at 2 years was similar. Analysis on pretreatment characteristics at multivariate analysis revealed age, neurological performance, addition of radiotherapy, total resection, tumor size post surgery and deterioration before start of radiotherapy (borderline) as significant prognostic factors for survival. Conclusion: Despite technical developments in surgery and radiotherapy over the last 10 years, survival of patients with a glioblastoma multiforme has not improved in our institution. The analysis of prognostic factors

  18. U.S. Principals’ Attitudes About and Experiences with Single-Sex Schooling

    Science.gov (United States)

    Fabes, Richard A.; Pahlke, Erin; Galligan, Kathrine; Borders, Adrienne

    2015-01-01

    Despite a lack of scientific evidence supporting the use of single-sex education, the number of U.S. public schools offering single-sex education has increased. However, our understanding as to why decision-makers have implemented single-sex education is lacking. To address this gap, we surveyed U.S. public-school principals and assessed their attitudes about and experiences with single-sex schooling. Sixty-seven principals from single-sex schools and 193 from coeducational schools participated. The results indicated that principals who had experience with single-sex schooling tended to have more positive attitudes about single-sex schooling, viewed it as more effective, and more often evoked gender-essentialist rationales for the use of single-sex schooling than did coeducational principals. However, both single-sex and coeducational principals noted issues with single-sex schooling. It was concluded that single-sex schooling is not a silver bullet to educational reform and that when single-sex schooling is implemented, one set of issues and problems is substituted for another. PMID:26190887

  19. Lacunar strokes: a single institutional experience

    Directory of Open Access Journals (Sweden)

    Osama Shukir Muhammed Amin

    2013-08-01

    Full Text Available Abstract: Objective: Lacunar ischemic strokes comprise approximately 25% of all ischemic strokes. We compared the risk factors and clinical pattern of this type of stroke between males and females. Methods: This observational study involved 50 consecutive patients with their first-ever lacunar stroke and was conducted at the department of neurology of Sulaimaniya general teaching hospital, Iraq from December 1, 2010 to March 1, 2013. Patients’ risk factors, clinical presentation, and strokes’ patterns were noted and a comparison was made between males and females. Results: Males (64% outnumbered females (36% with a male to female ration of 1.7. The mean age of males was 63 years while it was 61 years in females. Although hypertension was more common in females than in males, diabetes and smoking were more common in the latter group; however, there were no statistically significant differences between the 2 genders in terms of hypertension (P-value <0.3 and diabetes (P-value < 0.07 while smoking was strongly associated with male gender (P-value<0.0001. Pure motor hemiparesis, ataxic hemiparesis, pure sensory stroke, and dysarthria-clumsy hand syndrome were more common in males; only senori-motor stroke revealed a statistically significant difference in favor males (P-value<0.0001; 95% CI -1.7 to 19.2. There was no statistically significant difference in terms of which side of the brain was infarcted between males and females (P-value<0.4. Conclusion: Males around the age of 63 years were the main target for these lacunar strokes. Cigarette smoking and sensorimotor strokes were significantly associated with male gender. [Cukurova Med J 2013; 38(4.000: 659-666

  20. Single Incision Laparoscopic Splenectomy: Our First Experiences

    Directory of Open Access Journals (Sweden)

    Umut Barbaros

    2011-06-01

    Full Text Available Objective: Most laparoscopic surgeons have attempted to reduce incisional morbidity and improve cosmetic outcomes by using less and smaller trocars. Single incision laparoscopic splenectomy is a new laparoscopic procedure. Herein we would like to present our experiences.Material and Methods: Between January 2009 and June 2009, data of the 7 patients who underwent single incision laparoscopic splenectomy were evaluated retrospectively.Results: There were 7 patients (5 females and 2 males with a mean age of 29.9 years. The most common splenectomy indication was idiopathic thrombocytopenic purpura. Single incision laparoscopic splenectomy was performed successfully in 6 patients. In one patient the operation was converted to an open procedure.Conclusion: With surgeons experienced in minimally invasive surgery, single incision laparoscopic splenectomy could be performed successfully. However, in order to demonstrate the differneces between standard laparoscopic splenectomy and SILS splenetomy, prospective randomized comparative studies are required.

  1. Intimate Partner Violence: The Lived Experience of Single Women.

    Science.gov (United States)

    Thomas, Laura; Scott-Tilley, Donna

    2017-03-01

    Research in intimate partner violence has focused on married, cohabiting, adolescents, or college aged women. The experience of intimate partner violence by single women has not been studied separately from other groups of women. An interpretive phenomenological approach was used with feminist inquiry to gain insight into the experience of intimate partner violence by single women. The overarching theme was control and manipulation by the abuser. Subthemes included not feeling safe, poor communication skills, and caretaking. Nurses need to be aware of the occurrence of intimate partner violence in male and female partnered relationships to provide comprehensive and nonjudgmental care.

  2. Nasopharyngeal carcinoma in children and adolescents - a single institution experience of 158 patients

    International Nuclear Information System (INIS)

    Liu, Weixin; Tang, Yuan; Gao, Li; Huang, Xiaodong; Luo, Jingwei; Zhang, Shiping; Wang, Kai; Qu, Yuan; Xiao, Jianping; Xu, Guozhen; Yi, Junlin

    2014-01-01

    To evaluate the clinical features, treatment results, prognostic factors and late toxicities of nasopharyngeal carcinoma in children and adolescents. Between January 1990 and January 2011, 158 NPC patients younger than 20 years old were treated in our institution, and the patient’s clinical characteristics, treatment modalities, outcomes and prognostic factors were retrospectively analyzed. There were 9 (5.7%) patients in stage II, 60 (38.0%) in stage III and 89 (56.3%) in stage IV according to the UICC2002 staging system. Neck mass (32.3%), headache (21.5%) and nasal obstruction (15.2%) were the most common chief complaints. With a median follow-up time of 62.5 months (range 2.0-225.0 months), the 5-year overall survival (OS) rate, local-regional control (LRC) rate and distant metastasis-free survival (DMFS) rate were 82.6%, 94.9% and 76.4%, respectively. There were 43 (27.2%) patients failed during the follow up, with seven local-regional recurrences and 38 distant metastases. In univariate analysis, the 5-year OS of T4 and T1-3 were 75% and 87.9%, p = 0.01, stage IV and stage II-III were 77.1% and 90%, p = 0.04, respectively. In multivariate analysis, T4 (p = 0.02) and stage IV (p = 0.04) were the independent adverse prognostic factors for OS. Significant reduction in trismus (27.3% v 3.6%, p = 0.03) and G2 xerostomia (37.9% v 10.3%, p = 0.02) was observed in patients treated by IMRT. Most childhood and adolescence nasopharyngeal carcinoma patients were locally advanced diseases at first diagnosed. The treatment results of radiotherapy, with or without chemotherapy, are excellent in our institution. Reducing distant metastasis with new strategies and late toxicities with intensity-modulated radiotherapy are the future directions for the treatment of adolescent nasopharyngeal carcinoma

  3. MANAGEMENT EXPERIMENTS ACCORDING TO THE INSTITUTIONAL PROSPECT OF THE JIU VALLEY MINING AFTER 1989

    Directory of Open Access Journals (Sweden)

    MARIANA ANGHEL

    2012-01-01

    Full Text Available The hereby paper approaches certain aspects regarding the present circumstances that regard management experiments in the context of the social, economic, and political changes after 1989. Institutionally, and having as a background such changes, mining activities are continuously transforming and adapting to the requirements of the European Union. Institutional social and economic performance is determined by the assertive potential of the institution as an authority in the field as well as by the competitiveness of the mining units or of subordinated units. Management experience has been both influenced by the restructuring, turning to good account, and endowing with new technologies of the mining units as well as by the process of transition towards a functional market economy.

  4. Institutional policy learning and public consultation: the Canadian xenotransplantation experience.

    Science.gov (United States)

    Jones, Mavis; Einsiedel, Edna

    2011-09-01

    Attempts to evaluate public consultations, participatory technology assessment, and deliberative democracy have typically considered impacts on either policy or participants. The determination of impacts on policy institutions has been limited due to the challenges of tracing effects through the policy process, or penetrating bureaucratic walls. This paper presents findings from a retrospective study exploring the institutional lessons learned from a 2001 Canadian national public consultation on xenotransplantation. The consultation was conducted through an arm's-length process and involved the use of citizen juries in six regional sites. We conducted in-depth interviews of regulatory and policy actors who were engaged in early policy discussions and the consultation process. We reviewed evaluations of this process, both internal and external, which gave us richer insights into what institutional actors saw as the impacts of this consultative experience on their policy environment. Participants in our research identified a broader shift toward openness in policy culture which they linked specifically to the innovative consultation process employed for xenotransplantation. We argue that beyond input into policy decisions, a consultation may have an impact in terms of its contribution to overall shifts in institutional culture (related to institutional learning), such as an "opening" of technological decision processes to a broader range of actors, knowledge, and values. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Pedagogical Practices and Students' Experiences in Eritrean Higher Education Institutions

    Science.gov (United States)

    Tsegay, Samson Maekele; Zegergish, Mulgeta Zemuy; Ashraf, Muhammad Azeem

    2018-01-01

    Using semi-structured interview and review of documents, this study analyzes the pedagogical practices and students' experiences in Eritrean Higher Education Institutions (HEIs). The study indicated that pedagogical practices are affected by instructors' pedagogical skills and perceptions, and the teaching-learning environment. Moreover, the…

  6. St. Joseph's Hospital Barrow Neurological Institute stereitatic radiotherapy experience comparison of Gamma Knife and CyberKnife

    International Nuclear Information System (INIS)

    Kresl, J.J.

    2006-01-01

    The clinical utilisation stereotactic radiotherapy continues to increase in breadth and scope within the medical community. However, no single standard treatment platform exists for the delivery of stereotactic radiotherapy treatments. This is because although there are several commercially available platforms capable of delivering stereotactic radiotherapy treatments, each platform has unique abilities and limitations. The most widely used stereotactic radiotherapy system for intracranial treatments is the Gamma Knife. The first image guided robotic stereotactic radiotherapy system enabling body stereotactic radiotherapy is the CyberKnife. Both are available at the Barrow Neurological Institute. We describe our experience with the complementary use of these two distinct treatment platforms. This permits us to make a meaningful comparison and to detail their contrasting advantages and disadvantages for state of the art for stereotactic radiotherapy. (author)

  7. Pathologic fracture in childhood and adolescent osteosarcoma: A single-institution experience.

    Science.gov (United States)

    Haynes, Lindsay; Kaste, Sue C; Ness, Kirsten K; Wu, Jianrong; Ortega-Laureano, Lucia; Bishop, Michael; Neel, Michael; Rao, Bhaskar; Fernandez-Pineda, Israel

    2017-04-01

    Pathologic fractures occur in 5-10% of pediatric osteosarcoma (OS) cases and have historically been considered a contraindication to limb salvage. Our purpose was to describe the radiographic features of pathologic fracture and examine its impact on local recurrence rates, functional outcomes, and overall survival. We retrospectively analyzed patients at our institution from 1990 to 2015 with pathologic fracture at diagnosis or during neoadjuvant chemotherapy. We selected a control group of 50 OS patients of similar age and gender without pathologic fracture from 1990 to 2015. Functional outcomes were scored using Musculoskeletal Tumor Society criteria. Chi-square test was used for comparative analysis of groups. Thirty-six patients with 37 pathologic fractures form the study cohort. Of patients who received surgery, 18 of 34 patients with fracture underwent amputation compared to 8 of 48 patients in the nonfracture group (P = 0.007). Indications for amputation in fracture patients were tumor size (n = 7), neurovascular involvement (n = 6), and tumor progression during neoadjuvant chemotherapy (n = 5). Only one patient (2.9%) in the fracture group who underwent limb salvage suffered local recurrence. Of patients who received neoadjuvant chemotherapy, 25 of 34 fracture patients showed poor histological response compared to 24 of 47 nonfracture patients (P = 0.044). There was no statistically significant difference in overall survival (P = 0.96). Functional outcomes were significantly lower in fracture patients (median = 17.5) than nonfracture patients (median = 24) (P = 0.023). Radiographic features of pathologic fractures were highly variable in this population. Limb salvage surgery can be performed without increased risk of local recurrence. Patients with pathologic fracture suffer worse functional outcomes but no decrease in overall survival. © 2016 Wiley Periodicals, Inc.

  8. Skin Sparing Mastectomy and Immediate Breast Reconstruction (SSMIR for early breast cancer: Eight years single institution experience

    Directory of Open Access Journals (Sweden)

    Bobin Jean

    2008-04-01

    Full Text Available Abstract Background Skin Sparing Mastectomy (SSM and immediate breast reconstruction has become increasingly popular as an effective treatment for patients with breast carcinoma. The aim of this study was to evaluate the clinical outcome of skin sparing mastectomy in early breast cancer at a single population-based institution. Methods Records of ninety-five consecutive patients with operable breast cancer who had skin-sparing mastectomy and immediate breast reconstructions between 1995 and 2003 were reviewed. Patient and tumor characteristic, type of reconstruction, postoperative complications, aesthetic results and incidence of recurrence were analyzed. Results Mean age of the patients was 51.6(range 33–72 years. The AJCC pathologic stages were 0 (n = 51, 53.7%, I (n = 20, 21.1%, and II (n = 2, 2.1%. Twenty of the patients had recurrent disease (21.1%. The immediate breast reconstructions were performed with autologus tissue including latissimus dorsi musculocutaneous flap in 63 (66.3% patients and transverse rectus abdominis myocutaneous (TRAM flap in 4 (4.2% patients. Implants were used in 28 (29.4% patients. The average hospital stay was 7.7 days. Flap complication occurred in seven (10.4% patients resulting in four (6% re-operations and there were no delay in accomplishing postoperative adjuvant therapy. At a median follow-up of 69 months (range 48 to 144, local recurrence was seen in one patient (1.1% and systemic recurrence was seen in two patients (2.1%. Conclusion Skin sparing mastectomy and immediate breast reconstruction for early breast cancer is associated with low morbidity and low rate of local recurrence.

  9. An experience in World Nuclear University-Summer Institute 2012

    International Nuclear Information System (INIS)

    Suzilawati Mohd Sarowi

    2013-01-01

    Full-text: World Nuclear University-Summer Institute (WNU-SI) has been held annually since 2005 in Cristchurh College, Oxford, London. This six weeks course is attended by 80-90 young professionals, or fellow from 20-25 countries across the world. The WNU-SI is designed not only to discuss the full spectrum of issues surrounding nuclear energy, but also emphasis on team building, cultural awareness and the development of leadership potential in multinational environment. Interestingly, the mentors play their role base on their experience in leading the nuclear industry throughout the globe. At the end of the course, the participant could understand the most important issues address in the industry with global perspective, experience and learn from practical teamwork internationally. Finally, this course is believed to be a step in developing a worldwide network among the fellows to support each other in their careers. This paper will discuss the experience gained in WNU-SI 2012. (author)

  10. Morbidity analysis in minimally invasive esophagectomy for oesophageal cancer versus conventional over the last 10 years, a single institution experience

    Directory of Open Access Journals (Sweden)

    Misbah Khan

    2017-01-01

    Full Text Available Background: There has been an increasing inclination towards minimally invasive esophagectomies (MIEs at our institute recently for resectable oesophageal cancer. Objectives: The purpose of the present study is to report peri-operative and long-term procedure specific outcomes of the two groups and analyse their changing pattern at our institute. Methods: All adult patients with a diagnosis of oesophageal cancer managed at our institute from 2005 to 2015 were included in this retrospective study. Patients' demographic and clinical characteristics were recorded through our hospital information system. The cohort of esophagectomies was allocated into two groups, conventional open esophagectomy (OE or total laparoscopic MIE; hybrid esophagectomies were taken as a separate group. The short-term outcome measures are an operative time in minutes, length of hospital and Intensive Care Unit (ICU stay in days, post-operative complications and 30 days in-hospital mortality. Complications are graded according to the Clavien-Dindo classification system. Long-term outcomes are long-term procedure related complications over a minimum follow-up of 1 year. Trends were analysed by visually inspecting the graphic plots for mean number of events in each group each year. Results: Our results showed no difference in mortality, length of hospital and ICU stays and incidence of major complications between three groups on uni- and multi-variate analysis (P > 0.05. The operative time was significantly longer in MIE group (odds ratio [OR]: 1.66, confidence interval [CI]: 2.4–11.5. The incidence of long-term complication was low for MIE (OR: 1.0, CI: 133–1.017. However, all post-operative surgical outcomes trended to improve in both groups over the course of this study and stayed better for MIE group except for the operative time. Conclusion: MIE has overall comparable surgical outcomes to its conventional counterpart. Furthermore, the peri-operative outcomes tend to

  11. SPORT EDUCATION INSTITUTIONS BOLOGNA PROCESS APPLICATION EXPERIENCES AND PROBLEMS ANALYSIS

    Directory of Open Access Journals (Sweden)

    Vladislav Ilić

    2008-08-01

    Full Text Available Current changes in education legislative and efforts in direction of aligning domestic educational system with European union legislative and Bologna declaration were broadly welcomed in scientific institutions as positive and necessary step towards educational system modernization. However, together with new Higher education law implementation, ac creditation process start and education system modification a few important problems came to an attention. Although the time frame from the beginning of the changes is relatively short, certain conclusions and experiences about current problems can be presented. According to current experiences, new legislation was inadequately precise and correct in proper sport categorization, considering its distinctions as multidisciplinary and specific scientific area. It also failed to recognize needs and differences of sport higher education institutions in connection with students and teaching staff profile and quality. Above-mentioned factors caused problems which occurred in process of accreditation, knowledge transfer process, finding and adequate teaching staff acquiring with danger of potential lowering of numbers and quality of future graduates. As a conclusion,it can be said that prompt improvements and changes of current legislative are needed in order to meet true needs of sport and sport education.

  12. Type distribution of lymphomas in Lebanon: five-year single institution experience.

    Science.gov (United States)

    Sader-Ghorra, Claude; Rassy, Marc; Naderi, Samah; Kourie, Hampig Raphael; Kattan, Joseph

    2014-01-01

    Lymphomas represent the fifth most frequent cancer in Lebanon. However, little is known concerning epidemiologic characteristics and distribution of lymphoid neoplasms according to the 2008 WHO classification. We conducted a retrospective study of lymphoma cases diagnosed from 2008 till 2012 at Hotel-Dieu de France University Hospital. A total of 502 new cases of lymphoma were diagnosed at our institution during a five year period: 119 cases (24%) were Hodgkin lymphomas (HL) and 383 cases (76%) were non-Hodgkin lymphomas (NHL). HLs were equally distributed in both sexes with a mean age at diagnosis of 30 years. Among NHL, 87% (332 cases) were B cell lymphomas, 9% (34 cases) were T cell lymphomas and 4%(17 cases) were classified as precursor lymphoid neoplasms. Among B cell lymphomas, 44% (147 cases) were diffuse large B cell lymphomas (DLBCL), 20% (65 cases) follicular lymphomas and 8% (27 cases) mantle cell lymphomas. DLBCL were equally distributed in both sexes with a mean age of 58 years. Follicular lymphomas were characterized by a male predominance (57%) and a mean age of 60 years. Mantle cell lymphomas showed a pronounced male predominance (85%) with a mean age of 60 years in men and 70 years in women. Some 72% of patients having T cell lymphomas were men, with a mean age of 57 years in men and 45 years in women, while 65% of patients having precursor lymphoid neoplasms were women with a mean age of 22 years in women and 30 years in men. The lymphoma subtype distribution in Lebanon is unique when compared to other countries from around the world. In fact, Hodgkin and follicular lymphomas are more frequent than in most Far Eastern, European and American countries, while T-cell lymphomas and DLBCL are less frequent.

  13. Primary localized stages I and II non-Hodgkin's lymphoma of the nasopharynx: a retrospective 17-year single institutional experience.

    Science.gov (United States)

    Mohammadianpanah, Mohammad; Ahmadloo, Niloofar; Mozaffari, Mohammad Amin Nazer; Mosleh-Shirazi, Mohammad Amin; Omidvari, Shapour; Mosalaei, Ahmad

    2009-05-01

    The aim of this retrospective study was to define the natural history, clinicopathological findings, prognostic factors, and treatment outcome of 43 patients with localized stages I and II primary non-Hodgkin's lymphoma (NHL) of the nasopharynx, followed up in a single institution over a 17-year period. Forty-three (13 women and 30 men) consecutive patients with localized stages I (N = 12) and II (N = 31) primary nasopharyngeal NHL were treated in our institution between 1990 and 2007. The pathologic reports were classified according to the International Working Formulation (N = 22) or Revised European-American Lymphoma classification (N = 21). The vast majority of patients (88%) were managed with a sequential combination of chemotherapy and radiation therapy. Chemotherapy mainly consisted of 4-8 (median 6) cycles of CHOP regimen (cyclophosphamide, doxorubicin, vincristine and prednisolone). Involved-field radiation therapy with a median dose of 44 Gy was delivered to the primary site and entire cervical lymph nodes. The median age of the patients was 53 years (range, 6 to 86 years). The majority of the patients (70%) had high-grade histology. B-cell types represented 67% of the cases, among which diffuse large B cell was the most common histological subtype. After a median follow-up of 70 months, the 5-year disease-free survival and overall survival were 58.8% and 70.6%, respectively. In multivariate analysis, age less than or equal to 30 years (hazard ratio (HR) = 5.32, 95% confidence interval (CI) = 1.69-16.76), elevated serum lactate dehydrogenase level (HR = 3.69, 95% CI = 1.43-9.51), and modified International Prognostic Index with more than or equal to two risk factors (HR = 17.99, 95% CI = 2.32-139.30) retained statistical significance. Our limited data suggest that primary nasopharyngeal NHL tends to have aggressive histology and unfavorable clinical course with poor outcome, despite a considerably localized disease at the time of presentation and high

  14. U.S. Principals’ Attitudes About and Experiences with Single-Sex Schooling

    OpenAIRE

    Fabes, Richard A.; Pahlke, Erin; Galligan, Kathrine; Borders, Adrienne

    2015-01-01

    Despite a lack of scientific evidence supporting the use of single-sex education, the number of U.S. public schools offering single-sex education has increased. However, our understanding as to why decision-makers have implemented single-sex education is lacking. To address this gap, we surveyed U.S. public-school principals and assessed their attitudes about and experiences with single-sex schooling. Sixty-seven principals from single-sex schools and 193 from coeducational schools participat...

  15. A Computational Experiment on Single-Walled Carbon Nanotubes

    Science.gov (United States)

    Simpson, Scott; Lonie, David C.; Chen, Jiechen; Zurek, Eva

    2013-01-01

    A computational experiment that investigates single-walled carbon nanotubes (SWNTs) has been developed and employed in an upper-level undergraduate physical chemistry laboratory course. Computations were carried out to determine the electronic structure, radial breathing modes, and the influence of the nanotube's diameter on the…

  16. Kasabach-Merritt phenomenon: a single centre experience.

    LENUS (Irish Health Repository)

    Ryan, Clodagh

    2012-01-31

    OBJECTIVE: Kasabach-Merritt phenomenon (KMP) can lead to life-threatening bleeding, and its optimum treatment has not been established. We review the experience of managing KMP in a single institution. METHODS: A retrospective chart review on all children with KMP treated at the Hospital for Sick Children, Toronto, over an 18 yr period was carried out. RESULTS: All 15 patients had profound thrombocytopenia and hypofibrinogenemia at presentation, half had bleeding symptoms, and three had cardiac failure. All patients received corticosteroids. Five responded to steroids alone, given for an average of 13 wk, increasing platelets to >20 x 10(9)\\/L at a mean of 6.2 d and fibrinogen >1 g\\/dL at 25.6 d. Ten patients received at least one other therapeutic modality in addition to steroids, including vincristine, interferon, anti-platelet agents and pentoxifylline. Five patients received vincristine, for a mean of 6 wk, with two patients responding. Eight patients received interferon, for a mean of 4 months, with two patients responding. Overall, the mean time to increasing platelets >20 x 10(9)\\/L was 56 d, to >150 x 10(9)\\/L was 88 d and fibrinogen >1 g\\/dL 49 d. Ten patients showed a partial response to embolisation, with a mean of 2.8 procedures performed. Thrombotic complications occurred in 7%. Twelve patients remain alive, with relapse in six patients, all treated successfully. One patient died, and two patients have been lost to follow-up. CONCLUSION: KMP is a rare condition, with significant morbidity and mortality. The therapeutic approach should include a multidisciplinary team and consensus on guidelines.

  17. One-Step Nucleic Acid Amplification in Breast Cancer Sentinel Lymph Node: A Single Institutional Experience and a Short Review.

    Science.gov (United States)

    Brambilla, Tatiana; Fiamengo, Barbara; Tinterri, Corrado; Testori, Alberto; Grassi, Massimo Maria; Sciarra, Amedeo; Abbate, Tommaso; Gatzemeier, Wolfgang; Roncalli, Massimo; Di Tommaso, Luca

    2015-01-01

    Sentinel lymph node (SLN) examination is a standard in breast cancer patients, with several methods employed along its 20 years history, the last one represented by one-step nucleic acid amplification (OSNA). The latter is a intra-operative molecular assay searching for CK19 mRNA as a surrogate of metastatic cells. Our 3 years experience with OSNA (1122 patients) showed results overlapping those recorded in the same institution with a morphological evaluation (930 patients) of SLN. In detail, the data of OSNA were almost identical to those observed with standard post-operative procedure in terms of patients with positive SLN (30%) and micrometastatic/macrometastatic involvement of SLN (respectively, 38-45 and 62-55%). By contrast, when OSNA was compared to the standard intraoperatory procedure, it was superior in terms of accuracy, prompting the use of this molecular assay as a very valid, and reproducible for intra-operative evaluation of SLN. Further possibilities prompting the use of OSNA range from adhesion to quality control programs, saving of medical time, ability to predict, during surgery, additional nodal metastasis, and molecular bio-banking.

  18. ONE STEP NUCLEIC ACID AMPLIFICATION IN BREAST CANCER SENTINEL LYMPH NODE.A SINGLE INSTITUTIONAL EXPERIENCE AND A SHORT REVIEW.

    Directory of Open Access Journals (Sweden)

    Tatiana eBrambilla

    2015-06-01

    Full Text Available Sentinel lymph node (SLN examination is a standard in breast cancer patients, with several methods employed along its 20-years history, the last one represented by OSNA. The latter is a intra-operative molecular assay searching for CK19 mRNA as a surrogate of metastatic cells. Our 3-years experience with OSNA (1122 patients showed results overlapping those recorded in the same Institution with a morphological evaluation (930 patients of SLN. In detail the data of OSNA were almost identical to those observed with standard post-operative procedure in terms of patients with positive SLN (30% and micrometastatic/macrometastatic involvement of SLN (respectively 38-45% and 62-55%. By contrast when OSNA was compared to the standard intra-operatory procedure it was superior in terms of accuracy, prompting the use of this molecular assay as a very valid and reproducible for intra-operative evaluation of SLN.Further possibilities prompting the use of OSNA range from adhesion to quality control programs, saving of medical time, ability to predict, during surgery, additional nodal metatastis and molecular bio-banking.

  19. Dr Julia King CBE FREng, Chief Executive Designate, Institute of Physics (United Kingdom), visiting the NA48 experiment.

    CERN Multimedia

    Patrice Loïez

    2002-01-01

    Photo 02: Visiting the NA48 experiment, Dr Julia King, Chief Executive Designate, Institute of Physics (Britain and Ireland) (right) with A. Ceccucci and K. Peach. Photo 05: Visiting the NA48 experiment, Dr Julia King, Chief Executive Designate, Institute of Physics (Britain and Ireland) (centre) with A. Ceccucci and C. Lazzeroni. Photo 08: Visiting the NA48 experiment, Dr Julia King, Chief Executive Designate, Institute of Physics (Britain and Ireland) (second from left) with (left to right) R. Barlow, J. Wood, N. McCubbin, K. Peach, A. Ceccucci, C. Lazzeroni, M. Patel and D. Munday.

  20. Extracorporeal circulatory systems in the interhospital transfer of critically ill patients: experience of a single institution

    International Nuclear Information System (INIS)

    Haneya, Assad; Philipp, Alois; Foltan, Maik; Camboni, Daniele; Rupprecht, Leopold; Puehler, Thomas; Hirt, Stephan; Hilker, Michael; Kobuch, Reinhard; Schmid, Christof; Arlt, Matthias; Mueller, Thomas

    2009-01-01

    Critically ill patients with acute circulatory failure cannot be moved to other institutions unless stabilized by mechanical support systems. Extracorporeal heart and lung assist systems are increasingly used as a bridge to end-organ recovery or transplantation, and as an ultimate rescue tool in cardiopulmonary resuscitation. From July 2001 to April 2008, we had 38 requests for extracorporeal support for interhospital transfer carried out by the air medical service. Respiratory failure was present in 29 patients, who were provided with pumpless extracorporeal lung assist (PECLA) or veno-venous extracorporeal membrane oxygenation (ECMO). Cardiac failure dominated in 9 patients, who underwent implantation of extracorporeal life support (ECLS). Underlying diseases were acute respiratory distress syndrome in 15 patients, pneumonia in 7, prior lung transplant status in 4, cardiogenic shock in 7, and septic shock in 4. All assist systems were connected via peripheral vessels by the Seldinger technique. Transport was uneventful in all cases with no technical failures. On arrival at the specialized care hospital, two patients had leg ischemia and underwent relocation of the arterial cannula. After a mean (SD) support of 5.1 (3.0) days for PECLA, 3.5 (2.9) days for ECLS, and 7.3 (5.8) days for ECMO, 60%, 66%, and 66% of patients, respectively, could be successfully weaned from the systems. Discharge rates were 45% for PECLA, 44% for ECLS, and 56% for ECMO. Our experience proves that minimized extracorporeal assist devices allow safe assistance of patients with isolated or combined heart and lung failure in need of interhospital transfer. Critically ill patients get a chance to reach a center of maximum medical care. (author)

  1. Quality Assurance and Its Impact from Higher Education Institutions' Perspectives: Methodological Approaches, Experiences and Expectations

    Science.gov (United States)

    Bejan, Stelian Andrei; Janatuinen, Tero; Jurvelin, Jouni; Klöpping, Susanne; Malinen, Heikki; Minke, Bernhard; Vacareanu, Radu

    2015-01-01

    This paper reports on methodological approaches, experiences and expectations referring to impact analysis of quality assurance from the perspective of three higher education institutions (students, teaching staff, quality managers) from Germany, Finland and Romania. The presentations of the three sample institutions focus on discussing the core…

  2. Hydrocephalus: an underrated long-term complication of microvascular decompression for trigeminal neuralgia. A single institute experience.

    Science.gov (United States)

    Muratorio, Francesco; Tringali, G; Levi, V; Ligarotti, G K I; Nazzi, V; Franzini, A A

    2016-11-01

    Hydrocephalus is a common complication of posterior fossa surgery, but its real incidence after microvascular decompression (MVD) for idiopathic trigeminal neuralgia (TN) still remains unclear. The aim of this study was to focus on the potential association between MVD and hydrocephalus as a surgery-related complication. All patients who underwent MVD procedure for idiopathic TN at our institute between 2009 and 2014 were reviewed to search for early or late postoperative hydrocephalus. There were 259 consecutive patients affected by idiopathic TN who underwent MVD procedure at our institution between 2009 and 2014 (113 men, 146 women; mean age 59 years, range 30-87 years; mean follow-up 40.92 months, range 8-48 months). Nine patients (3.47 %) developed communicating hydrocephalus after hospital discharge and underwent standard ventriculo-peritoneal shunt. No cases of acute hydrocephalus were noticed. Our study suggests that late communicating hydrocephalus may be an underrated potential long-term complication of MVD surgery.

  3. Blunt hepatic and splenic trauma. A single Center experience using a multidisciplinary protocol.

    Science.gov (United States)

    Ruscelli, Paolo; Buccoliero, Farncesco; Mazzocato, Susanna; Belfiori, Giulio; Rabuini, Claudio; Sperti, Pierluigi; Rimini, Massimiliano

    2017-01-01

    The aim of this retrospective study was to describe more than 10 years experience of a single Trauma Center about non operative management of abdominal organ injuries in hemodynamically stable patients MATERIAL OF STUDY: Between January 2001 and December 2014 ,732 consecutive patients were admitted with blunt abdominal trauma, involving liver and/or spleen and/or kidney, at the Bufalini Cesena Hospital .Management of patients included a specific institutional developed protocol :hemodynamic stability was evaluated in shock room according to the patients response to fluid challenge and the patients were classified into three categories A,B,and C. Form 732 Trauma, 356(48.6%) of patients were submitted to a surgical procedure, all the other patient 376(51.4%) underwent an non operative management .Overall mortality was 9.8% (72), mortality in the surgery group was 15.4% eheras in the non operative group was 4.5%; the relative risk of mortality, measured by the odds ratio waith a 95% confidence interval, was 3.417(2.023-5.772) for rhe surgery group; patient over 40 years old has a statistically significant higher mortality. In our series the overall mortality rate of non operative management group was 4.5%, instead in unstable patients, the surgery group, the mortality was 15.3%; the overall mortality mortality rate after the application of our protocol is 9.8%, Although surgery continues to be the standard for hemodically unstable patients with blunt hepatic and splenic trauma. In our experience AAST Organ Injury Scale was useless for the therapeutic decision making process after the CT scan if a source of bleeding was detected and immediate angiography was performed in order to control and solve it. In our experience the AAST Organ Injury Scale was useless for the therapeutic decision making process, The results suggest that the only criteria of choice for therapeutici strategy was the hemodynamic stability, Nonoperative managem,ent can be applied only following

  4. Corpuscular Model of Two-Beam Interference and Double-Slit Experiments with Single Photons

    NARCIS (Netherlands)

    Jin, Fengping; Yuan, Shengjun; De Raedt, Hans; Michielsen, Kristel; Miyashita, Seiji

    We introduce an event-based corpuscular simulation model that reproduces the wave mechanical results of single-photon double-slit and two-beam interference experiments and (of a one-to-one copy of an experimental realization) of a single-photon interference experiment with a Fresnel biprism. The

  5. Single molecule experiments challenge the strict wave-particle dualism of light.

    Science.gov (United States)

    Greulich, Karl Otto

    2010-01-21

    Single molecule techniques improve our understanding of the photon and light. If the single photon double slit experiment is performed at the "single photon limit" of a multi-atom light source, faint light pulses with more than one photon hamper the interpretation. Single molecules, quantum dots or defect centres in crystals should be used as light source. "Single photon detectors" do not meet their promise-only "photon number resolving single photon detectors" do so. Particularly, the accumulation time argument, the only safe basis for the postulate of a strictly particle like photon, has so far not yet been verified.

  6. Research at the Paul Scherrer Institut

    International Nuclear Information System (INIS)

    Walter, H.K.

    1996-01-01

    The Paul Scherrer Institut (PSI) is a multidisciplinary research institute for natural sciences and technology. In national and international collaboration with universities, other research institutes and industry, PSI is active in elementary particle physics, life sciences, solid-state physics, material sciences, nuclear and non-nuclear energy research, and energy-related ecology. PSI's priorities lie in research fields which are relevant to sustainable development, serve educational needs and are beyond the possibilities of a single university department. PSI develops and operates complex research installations open of the world's most powerful cyclotron, allowing to operate high intensity secondary pion and muon beams, a neutron spallation source and various applications in medicine and materials research. A short review on research at PSI is presented, with special concentration on particle physics experiments. (author)

  7. Pediatric Critical Care Telemedicine Program: A Single Institution Review.

    Science.gov (United States)

    Hernandez, Maria; Hojman, Nayla; Sadorra, Candace; Dharmar, Madan; Nesbitt, Thomas S; Litman, Rebecca; Marcin, James P

    2016-01-01

    Rural and community emergency departments (EDs) often receive and treat critically ill children despite limited access to pediatric expertise. Increasingly, pediatric critical care programs at children's hospitals are using telemedicine to provide consultations to these EDs with the goal of increasing the quality of care. We conducted a retrospective review of a pediatric critical care telemedicine program at a single university children's hospital. Between the years 2000 and 2014, we reviewed all telemedicine consultations provided to children in rural and community EDs, classified the visits using a comprehensive evidence-based set of chief complaints, and reported the consultations' impact on patient disposition. We also reviewed the total number of pediatric ED visits to calculate the relative frequency with which telemedicine consultations were provided. During the study period, there were 308 consultations provided to acutely ill and/or injured children for a variety of chief complaints, most commonly for respiratory illnesses, acute injury, and neurological conditions. Since inception, the number of consultations has been increasing, as has the number of participating EDs (n = 18). Telemedicine consultations were conducted on 8.6% of seriously ill children, the majority of which resulted in admission to the receiving hospital (n = 150, 49%), with a minority of patients requiring transport to the university children's hospital (n = 103, 33%). This single institutional, university children's hospital-based review demonstrates that a pediatric critical care telemedicine program used to provide consultations to seriously ill children in rural and community EDs is feasible, sustainable, and used relatively infrequently, most typically for the sickest pediatric patients.

  8. Nonmyeloablative allogeneic stem cell transplantation for chronic lymphocytic leukaemia offers the possibility of disease control with minimal morbidity and mortality--a single institution experience.

    Science.gov (United States)

    Chakupurakal, G; Leitzke, S; Langerbeins, P; Schiller, J; Schneider, P M; Holtick, U; Shimabukuro-Vornhagen, A; Theurich, S; Chemnitz, J; Hallek, M; von Bergwelt-Baildon, M; Scheid, C

    2015-10-01

    Allogeneic stem cell transplantation is a treatment option for patients with poor risk CLL. We conducted a retrospective analysis of all CLL patients allografted at our institution, the University Hospital of Cologne, Germany. Data was collected on 40 patients from 2004 to 2012. The mean age was 54, and the majority were male (75 %). On average, the patients were diagnosed 6 years (range 2-12) prior to transplant with an average of 4 years (range 1-8) from time of first-line therapy to transplant. The remission states at the time of transplant were complete remission (CR) (n = 4), stable disease (n = 10), partial remission (n = 20) and progressive disease (n = 6). Only reduced intensity conditioning regimens were employed. The average CD34(+) cell dose was 4.16 × 10(6)/kg. Neutrophil engraftment was seen by day +17 (range 10-23) post-transplant, and 88 % achieved 95-100 % donor chimerism by day 100. Overall survival, progression-free survival and non-relapse mortality at 2 years post-transplant were 65, 52.5 and 27.5 %, respectively. A total of 51 % of patients were found to be minimal residual disease (MRD)-negative at 1 year post-transplant. Our single-centre experience confirms the valuable role of allogeneic stem cell transplantation (allo-SCT) in the treatment of poor risk CLL patients with promising long-term survival and acceptable transplant-related mortality. The advent of newer therapeutic agents should not hinder the consideration of allo-SCT for this patient cohort as it remains the only curative option for these patients.

  9. Physical Activity Experiences and Beliefs among Single Mothers: A Qualitative Study

    Science.gov (United States)

    Dlugonski, Deirdre; Motl, Robert W.

    2016-01-01

    Purpose: Single motherhood has been associated with negative health consequences such as depression and cardiovascular disease. Physical activity might reduce these consequences, but little is known about physical activity experiences and beliefs that might inform interventions and programs for single mothers. The present study used…

  10. Prognostic factors and long-term outcomes of hilar cholangiocarcinoma: A single-institution experience in China

    Science.gov (United States)

    Hu, Hai-Jie; Mao, Hui; Shrestha, Anuj; Tan, Yong-Qiong; Ma, Wen-Jie; Yang, Qin; Wang, Jun-Ke; Cheng, Nan-Sheng; Li, Fu-Yu

    2016-01-01

    AIM: To evaluate the prognostic factors of hilar cholangiocarcinoma in a large series of patients in a single institution. METHODS: Eight hundred and fourteen patients with a diagnosis of hilar cholangiocarcinoma that were evaluated and treated between 1990 and 2014, of which 381 patients underwent curative surgery, were included in this study. Potential factors associated with overall survival (OS) and disease-free survival (DFS) were evaluated by univariate and multivariate analyses. RESULTS: Curative surgery provided the best long-term survival with a median OS of 26.3 mo. The median DFS was 18.1 mo. Multivariate analysis showed that patients with tumor size > 3 cm [hazard ratio (HR) = 1.482, 95%CI: 1.127-1.949; P = 0.005], positive nodal disease (HR = 1.701, 95%CI: 1.346-2.149; P < 0.001), poor differentiation (HR = 2.535, 95%CI: 1.839-3.493; P < 0.001), vascular invasion (HR = 1.542, 95%CI: 1.082-2.197; P = 0.017), and positive margins (HR = 1.798, 95%CI: 1.314-2.461; P < 0.001) had poor OS outcome. The independent factors for DFS were positive nodal disease (HR = 3.383, 95%CI: 2.633-4.348; P < 0.001), poor differentiation (HR = 2.774, 95%CI: 2.012-3.823; P < 0.001), vascular invasion (HR = 2.136, 95%CI: 1.658-3.236; P < 0.001), and positive margins (HR = 1.835, 95%CI: 1.256-2.679; P < 0.001). Multiple logistic regression analysis showed that caudate lobectomy [odds ratio (OR) = 9.771, 95%CI: 4.672-20.433; P < 0.001], tumor diameter (OR = 3.772, 95%CI: 1.914-7.434; P < 0.001), surgical procedures (OR = 10.236, 95%CI: 4.738-22.116; P < 0.001), American Joint Committee On Cancer T stage (OR = 2.010, 95%CI: 1.043-3.870; P = 0.037), and vascular invasion (OR = 2.278, 95%CI: 0.997-5.207; P = 0.051) were independently associated with tumor-free margin, and surgical procedures could indirectly affect survival outcome by influencing the tumor resection margin. CONCLUSION: Tumor margin, tumor differentiation, vascular invasion, and lymph node status were independent

  11. Teaching Business Classes Abroad: How International Experience Benefits Faculty, Students, and Institutions

    Science.gov (United States)

    Miglietti, Cynthia

    2015-01-01

    International educational experiences can provide benefits for faculty members as well as higher education institutions and their students. The opportunity to lecture and conduct research with colleagues at universities in other countries can foster the globalization or internationalization of academic teaching, the advancement of knowledge, and…

  12. Contemporary Management of Renal Transplant Recipients With De Novo Urolithiasis: A Single Institution Experience and Review of the Literature.

    Science.gov (United States)

    Harraz, Ahmed M; Zahran, Mohamed H; Kamal, Ahmed I; El-Hefnawy, Ahmed S; Osman, Yasser; Soliman, Shady A; Kamal, Mohamed M; Ali-El-Dein, Beder; Shokeir, Ahmed A

    2017-06-01

    We report on the long-term follow-up of managing allograft stones at a single tertiary referral institution and review the relevant literature. A retrospective analysis of renal allograft recipient charts was performed to identify patients who developed allograft lithiasis between 1974 and 2009. Patient and stone characteristics, diagnoses, treatments, and outcomes were described. Sixteen patients developed 22 stones after a median follow-up of 170 months (range, 51-351 mo). The mean (standard deviation) and median diameter of the stones were 13.8 (8.5) mm and 11 mm. Among these, 3 stones were treated conservatively, 3 by shock-wave lithotripsy, and 7 by cystolitholapaxy. Seven patients underwent percutaneous treatment in the form of percutaneous nephrostomy tube fixation and spontaneous passage of stone (1 stone), shock-wave lithotripsy (1 stone), antegrade stenting (1 stone), and percutaneous nephrolithotomy (6 stones). All patients were stone free after treatment, except for 2 patients whose stones were stable and peripheral on long-term follow-up. Allograft lithiasis requires a multimodal treatment tailored according to stone and graft characteristics. Protocols regarding spontaneous passage can be adopted if there is no harm to the graft and the patient is compliant. Careful attention to the anatomy during percutaneous nephrostomy tube placement is mandatory to avoid intestinal loop injury. A more attentive follow-up is required for early stone management.

  13. Single Molecule Experiments Challenge the Strict Wave-Particle Dualism of Light

    Directory of Open Access Journals (Sweden)

    Karl Otto Greulich

    2010-01-01

    Full Text Available Single molecule techniques improve our understanding of the photon and light. If the single photon double slit experiment is performed at the “single photon limit” of a multi-atom light source, faint light pulses with more than one photon hamper the interpretation. Single molecules, quantum dots or defect centres in crystals should be used as light source. “Single photon detectors” do not meet their promise―only “photon number resolving single photon detectors” do so. Particularly, the accumulation time argument, the only safe basis for the postulate of a strictly particle like photon, has so far not yet been verified.

  14. Quantum delayed-choice experiment with a single neutral atom.

    Science.gov (United States)

    Li, Gang; Zhang, Pengfei; Zhang, Tiancai

    2017-10-01

    We present a proposal to implement a quantum delayed-choice (QDC) experiment with a single neutral atom, such as a rubidium or cesium atom. In our proposal, a Ramsey interferometer is adopted to observe the wave-like or particle-like behaviors of a single atom depending on the existence or absence of the second π/2-rotation. A quantum-controlled π/2-rotation on target atom is realized through a Rydberg-Rydberg interaction by another ancilla atom. It shows that a heavy neutral atom can also have a morphing behavior between the particle and the wave. The realization of the QDC experiment with such heavy neutral atoms not only is significant to understand the Bohr's complementarity principle in matter-wave and matter-particle domains but also has great potential on the quantum information process with neutral atoms.

  15. A report from a single institute's 14-year experience in treatment of male-to-female transsexuals.

    Science.gov (United States)

    Imbimbo, Ciro; Verze, Paolo; Palmieri, Alessandro; Longo, Nicola; Fusco, Ferdinando; Arcaniolo, Davide; Mirone, Vincenzo

    2009-10-01

    Gender identity disorder or transsexualism is a complex clinical condition, and prevailing social context strongly impacts the form of its manifestations. Sex reassignment surgery (SRS) is the crucial step of a long and complex therapeutic process starting with preliminary psychiatric evaluation and culminating in definitive gender identity conversion. The aim of our study is to arrive at a clinical and psychosocial profile of male-to-female transsexuals in Italy through analysis of their personal and clinical experience and evaluation of their postsurgical satisfaction levels SRS. From January 1992 to September 2006, 163 male patients who had undergone gender-transforming surgery at our institution were requested to complete a patient satisfaction questionnaire. The questionnaire consisted of 38 questions covering nine main topics: general data, employment status, family status, personal relationships, social and cultural aspects, presurgical preparation, surgical procedure, and postsurgical sex life and overall satisfaction. Average age was 31 years old. Seventy-two percent had a high educational level, and 63% were steadily employed. Half of the patients had contemplated suicide at some time in their lives before surgery and 4% had actually attempted suicide. Family and colleague emotional support levels were satisfactory. All patients had been adequately informed of surgical procedure beforehand. Eighty-nine percent engaged in postsurgical sexual activities. Seventy-five percent had a more satisfactory sex life after SRS, with main complications being pain during intercourse and lack of lubrication. Seventy-eight percent were satisfied with their neovagina's esthetic appearance, whereas only 56% were satisfied with depth. Almost all of the patients were satisfied with their new sexual status and expressed no regrets. Our patients' high level of satisfaction was due to a combination of a well-conducted preoperative preparation program, competent surgical skills

  16. A Tragic Educational Experience: Academic Injustice in Higher Education Institutions in Yemen

    Science.gov (United States)

    Muthanna, Abdulghani

    2013-01-01

    This article outlines the tragic educational experience of one Yemeni scholar who has been oppressed by the education policy that Yemeni university administrators are accustomed to implementing while employing candidates. The institutions of higher education in Yemen, with the absence of justice, have experienced major ordeals in improving the…

  17. Artificial climate experiment facility in Institute for Environmental Sciences

    Energy Technology Data Exchange (ETDEWEB)

    Hisamatsu, Shunichi [Department of Radioecology, Institute for Environmental Sciences, Rokkasho, Aomori (Japan)

    1999-03-01

    The Institute for Environmental Sciences is now constructing the artificial climate experiment facility (ACEF) to research the effect of climate on movement of elements in the various environments. The ACEF will have one large, and five small artificial climate experiment chambers. The large chamber is designed to simulate climate conditions in all Japan. It will equip systems to simulate sunshine, rainfall (including acid rain), snowfall and fog (including acid fog). `Yamase` condition will also be reproduced in it. Yamase is a Japanese term describing the characteristic weather condition occurring mainly on the Pacific Ocean side at the northern Japan. While the small chamber will not have rainfall, snowfall and fog systems, radioisotopes will be used in the two small chambers which will be set up in a radioisotope facility. We describe here the outline of the ACEF and the preliminary research programs being undertaken using both kinds of chambers. (author)

  18. Artificial climate experiment facility in Institute for Environmental Sciences

    International Nuclear Information System (INIS)

    Hisamatsu, Shunichi

    1999-01-01

    The Institute for Environmental Sciences is now constructing the artificial climate experiment facility (ACEF) to research the effect of climate on movement of elements in the various environments. The ACEF will have one large, and five small artificial climate experiment chambers. The large chamber is designed to simulate climate conditions in all Japan. It will equip systems to simulate sunshine, rainfall (including acid rain), snowfall and fog (including acid fog). 'Yamase' condition will also be reproduced in it. Yamase is a Japanese term describing the characteristic weather condition occurring mainly on the Pacific Ocean side at the northern Japan. While the small chamber will not have rainfall, snowfall and fog systems, radioisotopes will be used in the two small chambers which will be set up in a radioisotope facility. We describe here the outline of the ACEF and the preliminary research programs being undertaken using both kinds of chambers. (author)

  19. Clinicopathologic features of hepatic neoplasms in explanted livers: a single institution experience

    International Nuclear Information System (INIS)

    Mourad, W.; Tulbah, A.; Al-Omari, M.; Al-Mana, H.; Khalaf, H.; Neiamatallah, M.

    2007-01-01

    Hepatic neoplasms can be the primary indication for hepatic transplantation. The tumors can also be incidentally identified in explanted livers. We explored the clinicopathologic features of hepatic neoplasms identified in explanted livers. All explanted livers resected between 2001 and 2006 were evaluated for the presence of neoplasms and their clinicopathologic features were examined. In 198 liver transplants, 15 neoplasms (15.3%) were identified. Patient ages ranged from 5 to 63 years (median, 56 years). The primary etiology of hepatic disease was hepatitis C virus in 12 cases, hepatitis B virus in 1 case, cryptogenic cirrhosis in 1 case and congenital hepatic fibrosis in 1 case. Serum alpha-fetoprotein was significantly elevated (>400 U/L) in only 2 cases. CA19-9 was not elevated in any of the cases. The tumors included hepatocellular carcinoma (HCC) in 13 cases, 1 case of cholangiocarcinoma and 1 case of combined HCC and hepatoblastoma. The tumors ranged in size from 0.5 to 5 cm (median 1.4 cm) and were multifocal in 5 of the cases (33%). Tissue alpha-fetoprotein expression was only seen in the cases associated with elevated serum levels. In our institution hepatic neoplasma are seen in more than 15% of explanted livers. They can be incidentally identified, are frequently not associated with elevated serum levels of alpha-fetoprotein and CA19-9, are commonly multifocal but small and are associated with good prognosis. Elevated serum alpha-fetoprotein, albeit specific, is not a very sensitive marker in the detection of hepatic neoplasms. (author)

  20. Transformational and Transactional Leadership: An Exploration of Gender, Experience, and Institution Type

    Science.gov (United States)

    Martin, Jason

    2015-01-01

    This exploratory study examined the rates of transformational, transactional, and laissez-faire leadership among academic library deans, directors, and university librarians to see if any differences in leadership styles existed by gender, age and experience of the leaders, and type of institution in which they worked. The study found no…

  1. Parental reports of behavioural outcome among paediatric leukaemia survivors in Malaysia: a single institution experience.

    Science.gov (United States)

    Hamidah, Alias; Sham Marina, Mohd; Tamil, Azmi M; Loh, C-Khai; Zarina, Latiff A; Jamal, Rahman; Tuti Iryani, Mohd Daud; Ratnam, Vijayalakshmi C

    2014-10-01

    To determine the behavioural impact of chemotherapy in survivors of acute lymphoblastic leukaemia (ALL) treated with chemotherapy only and to identify treatment-related or sociodemography-related factors that might be associated with behavioural outcome. We examined 57 survivors of childhood ALL, who were off treatment for at least 2 years and were in remission, aged 4-18 years, and 221 unrelated healthy controls. The Child Behaviour Checklist (CBCL) parent report was used either in English or in Bahasa Malaysia (the national language of Malaysia) to assess the behavioural outcome. Childhood ALL survivors had significantly higher scores on externalising behaviour on the CBCL parent report than did controls. Higher problem scores were found in ALL survivors with single parents on 'total problems' (P = 0.03) and subscales 'withdrawn' (P = 0.03), 'social problems' (P < 0.01) and 'delinquent behaviour' (P = 0.03) than in survivors with married parents. Significant associations were seen between a lower education level of the father and the variables representing internalising (withdrawn, anxious/depressed) and externalising (aggressive behaviour). We observed trends on higher scores in all scales in ALL survivors with single parents than in controls with single parents or with fathers with low education level, especially primary education only. Malaysian childhood ALL survivors had a significantly increased risk for externalising behavioural problems, and there was a trend towards increased risk of problems in many other behavioural scales. Understanding the sociocultural dimension of patients' health is important to be able to design the most appropriate remedy for problem behaviours detected in this multi-ethnic population. © 2014 John Wiley & Sons Ltd.

  2. Single-center experience in double kidney transplantation.

    Science.gov (United States)

    Fontana, I; Magoni Rossi, A; Gasloli, G; Santori, G; Giannone, A; Bertocchi, M; Piaggio, F; Bocci, E; Valente, Umberto

    2010-05-01

    Use of organs from marginal donors for transplantation is a current strategy to expand the organ donor pool. Its efficacy is universally accepted among data from multicenter studies. Herein, we have reviewed outcomes of double kidney transplantation (DKT) over an 9-year experience in our center. The aim of this study was to evaluate possible important differences between a monocenter versus multicenter studies. Between 1999 and 2008, we performed 59 DKT. Recipient mean age was 63 +/- 5 years. Mean HLA-A, -B, and -DR mismatches were 3.69 +/- 0.922. Donor mean age was 69 +/- 7 years and mean creatinine clearance was 69.8 +/- 30.8 mL/min. Proteinuria was detected in three donors (5%). Mean cold ischemia and warm ischemia times were 1130 +/- 216 and 48 +/- 11 minutes, respectively. The right and left kidney scores were 4.18 +/- 2 and 4.21 +/- 2, respectively. Thirty patients (51%) displayed good postoperative renal function; 22 (37%), acute tubular necrosis with postoperative dialysis; 3 (5%), acute rejection episodes; 4 (7%), single-graft transplantectomy due to vascular thrombosis; 1 (2%), a retransplantation; 5 (8%), a lymphocele; 3 (5%) vescicoureteral reflux or stenosis requiring surgical correction. Cytomegalovirus infection was detected in five patients (8%). In three patients (5%) displayed de novo neoplasia. Three patients showed chronic rejection (5%), whereas we observed a cyclosporine-related toxicity in 7 (12%). Nine patients (15%) developed iatrogenic diabetes. Patient and graft survivals after 3 years from DKT were 93% and 86.3%, respectively. In this study, we applied successfully a widespread score to allocate organs to single kidney transplantation or DKT. In our experience, the score is suitable for the organ allocation but it may be overprotective, excluding potentially suitable organs for a single transplantation. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  3. Robot-assisted laparoscopic dismembered pyeloplasty for ureteropelvic junction obstruction: a multi-institutional experience.

    Science.gov (United States)

    Sivaraman, Ananthakrishnan; Leveillee, Raymond J; Patel, Manoj B; Chauhan, Sanket; Bracho, Jorge E; Moore, Charles R; Coelho, Rafael F; Palmer, Kenneth J; Schatloff, Oscar; Bird, Vincent G; Munver, Ravi; Patel, Vipul R

    2012-02-01

    To report a 6-year multi-institutional experience and outcomes with robot-assisted laparoscopic pyeloplasty (RLP) for the repair of ureteropelvic junction obstruction (UPJO). Between June 2002 and October 2008, 168 adult patients from 3 institutions underwent RLP for UPJO. A retrospective analysis of prospectively collected data were performed after institutional review board approval. Diagnosis was by intravenous urogram or computed tomography scan and diuretic renogram. All patients underwent RLP through a 4-port laparoscopic technique. Demographic, preoperative, operative, and postoperative endpoints for primary and secondary repair of UPJO were measured. Success was defined as a T½ of <20 minutes on diuretic renogram and symptom resolution. Pain resolution was assessed by subjective patient reports. Of 168 patients, 147 (87.5%) had primary repairs and 21 (12.5%) had secondary repairs. Of the secondary repairs, 57% had a crossing vessel etiology. Mean operative time was 134.9 minutes, estimated blood loss was 49 mL, and length of stay was 1.5 days. Mean follow-up was 39 months. Overall, 97.6% of patients had a successful outcome, with a 6.6% overall complication rate. To our knowledge, this review represents the largest multi-institutional experience of RLP with intermediate-term follow-up. RLP is a safe, efficacious, and viable option for either primary or secondary repair of UPJO with reproducible outcomes, a high success rate, and a low incidence of complications. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Clinical characteristics and outcomes of placental site trophoblastic tumor: experience of single institution in Korea.

    Science.gov (United States)

    Lee, Hye-Joo; Shin, Wonkyo; Jang, Yun Jeong; Choi, Chel Hun; Lee, Jeong-Won; Bae, Duk-Soo; Kim, Byoung-Gie

    2018-05-01

    Placental site trophoblastic tumor (PSTT) is the rarest form of gestational trophoblastic disease (GTD) and the optimum management is still controversial. In this study, we analyzed the clinical features, treatment, and outcomes of 6 consecutive patients with PSTT treated in our institution. The electronic medical record database of Samsung Medical Center was screened to identify patients with PSTT from 1994 to 2017. Medical records for the details of each patient's clinical features and treatment were extracted and reviewed. This study was approved Institutional Review Board of our hospital. A total of 418 cases of GTD, 6 (1.4%) patients with PSTT were identified. The median age of the patients was 31 years. The antecedent pregnancy was term in all 5 cases with available antecedent pregnancy information and the median interval from pregnancy to diagnosis of PSTT was 8 months. The median titer of serum beta human chorionic gonadotropin (β-hCG) at diagnosis was 190.9 mIU/mL. Five (83.3%) patients presented with irregular vaginal bleeding and one (16.7%) had amenorrhea. All patients had disease confined to the uterus without metastasis at diagnosis and were successfully treated by hysterectomy alone. All of them were alive without disease during the follow-up period. In this study, we observed low level serum β-hCG titer and irregular vaginal bleeding with varying interval after antecedent term pregnancy were most common presenting features of PSTT. In addition, we demonstrated hysterectomy alone was successful for the treatment of stage I disease of PSTT.

  5. A single institution experience with the new bethesda system for reporting thyroid cytopathology: correlation with existing cytologic, clinical, and histological data.

    Science.gov (United States)

    McElroy, Michele K; Mahooti, Sepi; Hasteh, Farnaz

    2014-07-01

    Our goal was to evaluate the Bethesda system (TBS) in comparison to the previously used system at our institution. One hundred consecutive thyroid fine needle aspirations (FNAs) and 45 consecutive indeterminate FNAs were reviewed by two cytopathology-boarded pathologists, diagnosed based on TBS and correlated with management and follow-up. Re-evaluation led to a diagnosis change in 48% of cases. Thirty-nine percent of benign cases were unsatisfactory under TBS. For malignant diagnoses the positive predictive value (PPV) was unchanged, while the negative predictive value (NPV) was slightly improved using TBS. Both the PPV and NPV were improved for actionable diagnoses. Inter-observer variability across all categories was in moderate agreement. Clinical management of both follicular lesion (FL) and indeterminate cases ranged from none to immediate surgery. Repeat FNA resolved the diagnosis in 50% of indeterminate cases. Indeterminate cases had an overall malignancy rate of 27%; higher in pre- (46%) than post-TBS cases (8%). Inter-observer variability between the reviewing pathologists and the original pathologists for indeterminate cases was fair, and between the two reviewing pathologists was moderate. Using TBS criteria increased the unsatisfactory rate and led to improved prediction of malignancy and actionable diagnoses. The pre-Bethesda diagnosis of FL at our institution led to inconsistent clinical management. Clinical management of patients with indeterminate diagnoses was essentially unchanged following adoption of TBS. The moderate inter-observer agreement between the reviewing pathologists may be related to level of cytology experience, strict adherence to TBS, and the exclusive use of cytomorphology for diagnosis. © 2014 Wiley Periodicals, Inc.

  6. Single-polymer dynamics under constraints: scaling theory and computer experiment

    International Nuclear Information System (INIS)

    Milchev, Andrey

    2011-01-01

    The relaxation, diffusion and translocation dynamics of single linear polymer chains in confinement is briefly reviewed with emphasis on the comparison between theoretical scaling predictions and observations from experiment or, most frequently, from computer simulations. Besides cylindrical, spherical and slit-like constraints, related problems such as the chain dynamics in a random medium and the translocation dynamics through a nanopore are also considered. Another particular kind of confinement is imposed by polymer adsorption on attractive surfaces or selective interfaces-a short overview of single-chain dynamics is also contained in this survey. While both theory and numerical experiments consider predominantly coarse-grained models of self-avoiding linear chain molecules with typically Rouse dynamics, we also note some recent studies which examine the impact of hydrodynamic interactions on polymer dynamics in confinement. In all of the aforementioned cases we focus mainly on the consequences of imposed geometric restrictions on single-chain dynamics and try to check our degree of understanding by assessing the agreement between theoretical predictions and observations. (topical review)

  7. The evaluation of data from the MACRO tracer experiment. The report for Japan Nuclear Cycle Development Institute

    International Nuclear Information System (INIS)

    Watari, Shingo

    1999-12-01

    On understanding the radionuclide transport in Natural Barrier in radioactive waste isolation research, the macroscopic dispersion in heterogeneous permeability field in the underground rock is regarded as an important process. Therefore, Japan Nuclear Cycle Development Institute (JNC) developed the MACRO experiment with an artificial heterogeneous permeability field and has been conducted lots of tracer experiments. To estimate the effect of characteristics of field on the macroscopic dispersion using data from those tracer experiments, the evaluation of dispersion coefficient is required. In this report, the macroscopic dispersion coefficients were evaluated for the results of the tracer experiments using the MACRO facility with a single well. The coefficients for the experiments of 18 cases were evaluated by the fitting of analytical solution to the breakthrough curve measured in the well. In the evaluations, the correction of data measured in the experiments and of the accuracy in the evaluation were considered. The conclusions are as follows. The macroscopic dispersion coefficients for 18 cases were evaluated using Least Square Method by fitting the analytical evaluation to the result of experiment. Consequently, the coefficients for 7 cases were evaluated with not enough accurate fitting results. Therefore, another evaluations for those 7 cases were required to be with more accuracy. Then, those coefficients were evaluated with enough accuracy. It was verified that the macroscopic dispersion coefficient tend to be increased with increase of the average radius of tracer front. In some cases, however, the trend was not verified because of the limit of accuracy for data measured in the experiment and for the evaluation method of the coefficient. It was found that the macroscopic dispersion coefficients evaluated for the cases with heterogeneous permeability field type B tend to be higher than those with heterogeneous permeability field type A. (author)

  8. Replicable Interprofessional Competency Outcomes from High-Volume, Inter-Institutional, Interprofessional Simulation.

    Science.gov (United States)

    Bambini, Deborah; Emery, Matthew; de Voest, Margaret; Meny, Lisa; Shoemaker, Michael J

    2016-10-25

    There are significant limitations among the few prior studies that have examined the development and implementation of interprofessional education (IPE) experiences to accommodate a high volume of students from several disciplines and from different institutions. The present study addressed these gaps by seeking to determine the extent to which a single, large, inter-institutional, and IPE simulation event improves student perceptions of the importance and relevance of IPE and simulation as a learning modality, whether there is a difference in students' perceptions among disciplines, and whether the results are reproducible. A total of 290 medical, nursing, pharmacy, and physical therapy students participated in one of two large, inter-institutional, IPE simulation events. Measurements included student perceptions about their simulation experience using the Attitude Towards Teamwork in Training Undergoing Designed Educational Simulation (ATTITUDES) Questionnaire and open-ended questions related to teamwork and communication. Results demonstrated a statistically significant improvement across all ATTITUDES subscales, while time management, role confusion, collaboration, and mutual support emerged as significant themes. Results of the present study indicate that a single IPE simulation event can reproducibly result in significant and educationally meaningful improvements in student perceptions towards teamwork, IPE, and simulation as a learning modality.

  9. Resonator QED experiments with single 40Ca+ ions

    International Nuclear Information System (INIS)

    Lange, B.

    2006-01-01

    Combining an optical resonator with an ion trap provides the possibility for QED experiments with single or few particles interacting with a single mode of the electro-magnetic field (Cavity-QED). In the present setup, fluctuations in the count rate on a time scale below 30 seconds were purely determined by the photon statistics due to finite emission and detection efficiency, whereas a marginal drift of the system was noticeable above 200 seconds. To find methods to increase the efficiency of the photon source, investigations were conducted and experimental improvements of the setup implemented in the frame of this thesis. Damping of the resonator field and coupling of ion and field were considered as the most important factors. To reduce the damping of the resonator field, a resonator with a smaller transmissivity of the output mirror was set up. The linear trap used in the experiment allows for the interaction of multiple ions with the resonator field, so that more than one photon may be emitted per pump pulse. This was investigated in this thesis with two ions coupled to the resonator. The cross correlation of the emitted photons was measured with the Hanbury Brown-Twiss method. (orig.)

  10. Implications of the single supervisory mechanism on ECB's functions and on credit institutions' activity

    Directory of Open Access Journals (Sweden)

    Teodora Cristina BARBU

    2013-03-01

    Full Text Available The European Commission's proposal launched on September 12, 2012 for conferring the European Central Bank extended powers in the field of Euro zone banking supervision has become a hotly debated topic across EU member states. Until now, there is still strong resilience of the EU countries outside the single currency area.The prospects for its practical implementation raised, however, a series of questions related to its technical feasibility. Our paper intends to shed light on some issues concerning the implications of the single monitoring mechanism on the traditional functions of the ECB, on the coexistence between supranational supervision and the national one, and on various facets of the impact that the new architecture of European banking supervision will have on the business of credit institutions, in terms of performance indicators, efficiency, risk and competition.

  11. The Woman Engineering Academic: An Investigation of Departmental and Institutional Environments.

    Science.gov (United States)

    McKendall, Sherron Benson

    2000-01-01

    Interviewed women engineering faculty at two universities to determine their experiences and perceptions of departmental and institutional environments. Most participants had experienced some type of isolation or singling out due to gender. Some questioned whether they were overreacting. Many had difficulty balancing home and work lives.…

  12. Unrelated hematopoietic stem cell transplantation in the pediatric population: single institution experience

    Directory of Open Access Journals (Sweden)

    Daniela Hespanha Marinho

    2015-08-01

    Full Text Available OBJECTIVE: Hematopoietic stem cell transplantation has been successfully used to treat the pediatric population with malignant and non-malignant hematological diseases. This paper reports the results up to 180 days after the procedure of all unrelated hematopoietic stem cell transplantations in pediatric patients that were performed in one institution.METHODS: A retrospective review was performed of all under 18-year-old patients who received unrelated transplantations between 1995 and 2009. Data were analyzed using the log-rank test, Cox stepwise model, Kaplan-Meier method, Fine and Gray model and Fisher's exact test.RESULTS: This study included 118 patients (46.8% who received bone marrow and 134 (53.2% who received umbilical cord blood transplants. Engraftment occurred in 89.47% of the patients that received bone marrow and 65.83% of those that received umbilical cord blood (p-value < 0.001. Both neutrophil and platelet engraftments were faster in the bone marrow group. Acute graft-versus-host disease occurred in 48.6% of the patients without statistically significant differences between the two groups (p-value = 0.653. Chronic graft-versus-host disease occurred in 9.2% of the patients with a higher incidence in the bone marrow group (p-value = 0.007. Relapse occurred in 24% of the 96 patients with malignant disease with 2-year cumulative incidences of 45% in the bone marrow group and 25% in the umbilical cord blood group (p-value = 0.117. Five-year overall survival was 47%, with an average survival time of 1207 days, and no significant differences between the groups (p-value = 0.4666.CONCLUSION: Despite delayed engraftment in the umbilical cord blood group, graft-versus-host disease, relapse and survival were similar in both groups.

  13. Infectious complications in chronic lymphocytic leukemia- a retrospective analysis: single institution experience.

    Science.gov (United States)

    Demitrovicova, L; Mikuskova, E; Oravcova, I; Cingelova, S; Drgona, L; Mladosievicova, B

    2017-01-01

    The aim of this study was to evaluate the incidence of a variety of infectious complications in patients with CLL regarding the duration of CLL and the type of treatment. We present the retrospective analysis of patients with CLL treated at our institution in years 2004-2016. We collected data about the type of infection, pathogenes, treatment and severity of infections surpassed in connection with administration treatment. In the study one hundred and ten patients were evaluated. The average age of patients was 61.7 years (range 34.5-91.9 years). Fludarabine was the most widely used regimen, followed by bendamustine and alemtuzumab. We recorded 393 episodes of infections, of which 114 (29%) were severe and life threatening of degree 3-5, and 279 (71%) of degree 2. The most common infections were the upper respiratory tract infections together with sinusitis (45.03%), pneumonia (26.20%), CMV reactivation occured in 8.14%, infections of the skin was in 7.6 %. Most infections have occurred with the administration of monoclonal antibody alemtuzumab, these patients were at significantly higher risk of infection [RR 2.59 (1.30 to 5.17)] than patients receiving obinutuzumab [RR 0.63 (0.48 to 0.82)] (p = 0.0001). On the contrary, the safety profile of BCR signaling pathway inhibitors was very acceptable [RR 1.17 (0.70 - 1.96)]. The number of infections have decreased during the first 12 months of treatment with ibrutinib. In the study group we recorded 19 deaths, 8 (7.27%) of them were of infectious etiology. The risk of infectious complications is lifelong in patients with CLL, it can be minimized by early detection and aggressive management. Novel targeted agents used in therapy of CLL have a good safety profile, even the risk of infection is decreased during administration.

  14. Political Innovation and Institution-Building: The Experience of Decentralization Experiments.

    Science.gov (United States)

    Yates, Douglas

    The purpose of this paper is to resolve what determines the success or failure of innovations in participatory government; and, more precisely what are the dynamics of institution-building by which the ideas of participation and decentralization are implemented and enduring neighborhood institutions are established. To answer these questions, a…

  15. A Phenomenological Study of Middle Grade Female and Male Students' Single-Sex Mathematical Experiences

    Science.gov (United States)

    Simpson, Amber; Che, S. Megan

    2016-01-01

    Utilizing a descriptive phenomenological design, this study examines the lived experiences of seven middle grade students, four females and three males, enrolled in a single-sex mathematics classroom within a coeducational school setting. The intent of the study is to understand, from students themselves, about the experience of single-sex…

  16. Single-charge craters excavated during subsurface high-explosive experiments at Big Black Test Site, Mississippi

    International Nuclear Information System (INIS)

    Woodruff, W.R.; Bryan, J.B.

    1978-01-01

    Single-charge and row-charge subsurface cratering experiments were performed to learn how close-spacing enhances single-crater dimensions. Our first experimental phase established cratering curves for 60-lb charges of the chemical explosive. For the second phase, to be described in a subsequent report, the Row-cratering experiments were designed and executed. This data report contains excavated dimensions and auxiliary data for the single-charge cratering experiments. The dimensions for the row-charge experiments will be in the other report. Significant changes in the soil's water content appeared to cause a variability in the excavated dimensions. This variability clouded the interpretation and application of the cratering curves obtained

  17. Blood culture contamination in hospitalized pediatric patients: a single institution experience

    Science.gov (United States)

    Min, Hyewon; Park, Cheong Soo; Kim, Dong Soo

    2014-01-01

    Purpose Blood culture is the most important tool for detecting bacteremia in children with fever. However, blood culture contamination rates range from 0.6% to 6.0% in adults; rates for young children have been considered higher than these, although data are limited, especially in Korea. This study determined the contamination rate and risk factors in pediatric patients visiting the emergency room (ER) or being admitted to the ward. Methods We conducted a retrospective chart review of blood cultures obtained from children who visited Yonsei Severance Hospital, Korea between 2006 and 2010. Positive blood cultures were labeled as true bacteremia or contamination according to Centers for Disease Control and Prevention/National Healthcare Safety Network definitions for laboratory-confirmed bloodstream infection, after exclusion of cultures drawn from preexisting central lines only. Results Among 40,542 blood cultures, 610 were positive, of which 479 were contaminations and 131 were true bacteremia (overall contamination rate, 1.18%). The contamination rate in the ER was significantly higher than in the ward (1.32% vs. 0.66%, P6 years, respectively). Conclusion Overall, contamination rates were higher in younger children than in older children, given the difficulty of performing blood sampling in younger children. The contamination rates from the ER were higher than those from the ward, not accounted for only by overcrowding and lack of experience among personnel collecting samples. Further study to investigate other factors affecting contamination should be required. PMID:24868215

  18. Single atoms on demand for cavity QED experiments

    International Nuclear Information System (INIS)

    Dotsenko, I.

    2007-01-01

    Cavity quantum electrodynamics (cavity QED) describes electromagnetic fields in a confined space and the radiative properties of atoms in such fields. The simplest example of such system is a single atom interacting with one mode of a high-finesse resonator. Besides observation and exploration of fundamental quantum mechanical effects, this system bears a high potential for applications quantum information science such as, e.g., quantum logic gates, quantum communication and quantum teleportation. In this thesis I present an experiment on the deterministic coupling of a single neutral atom to the mode of a high-finesse optical resonator. In Chapter 1 I describe our basic techniques for trapping and observing single cesium atoms. As a source of single atoms we use a high-gradient magneto-optical trap, which captures the atoms from background gas in a vacuum chamber and cools them down to millikelvin temperatures. The atoms are then transferred without loss into a standing-wave dipole trap, which provides a conservative potential required for experiments on atomic coherence such as quantum information processing and metrology on trapped atoms. Moreover, shifting the standing-wave pattern allows us to deterministically transport the atoms (Chapter 2). In combination with nondestructive fluorescence imaging of individual trapped atoms, this enables us to control their position with submicrometer precision over several millimeters along the dipole trap. The cavity QED system can distinctly display quantum behaviour in the so-called strong coupling regime, i.e., when the coherent atom-cavity coupling rate dominates dissipation in the system. This sets the main requirements on the resonator's properties: small mode volume and high finesse. Chapter 3 is devoted to the manufacturing, assembling, and testing of an ultra-high finesse optical Fabry-Perot resonator, stabilized to the atomic transition. In Chapter 4 I present the transportation of single atoms into the cavity

  19. Single atoms on demand for cavity QED experiments

    Energy Technology Data Exchange (ETDEWEB)

    Dotsenko, I.

    2007-09-06

    Cavity quantum electrodynamics (cavity QED) describes electromagnetic fields in a confined space and the radiative properties of atoms in such fields. The simplest example of such system is a single atom interacting with one mode of a high-finesse resonator. Besides observation and exploration of fundamental quantum mechanical effects, this system bears a high potential for applications quantum information science such as, e.g., quantum logic gates, quantum communication and quantum teleportation. In this thesis I present an experiment on the deterministic coupling of a single neutral atom to the mode of a high-finesse optical resonator. In Chapter 1 I describe our basic techniques for trapping and observing single cesium atoms. As a source of single atoms we use a high-gradient magneto-optical trap, which captures the atoms from background gas in a vacuum chamber and cools them down to millikelvin temperatures. The atoms are then transferred without loss into a standing-wave dipole trap, which provides a conservative potential required for experiments on atomic coherence such as quantum information processing and metrology on trapped atoms. Moreover, shifting the standing-wave pattern allows us to deterministically transport the atoms (Chapter 2). In combination with nondestructive fluorescence imaging of individual trapped atoms, this enables us to control their position with submicrometer precision over several millimeters along the dipole trap. The cavity QED system can distinctly display quantum behaviour in the so-called strong coupling regime, i.e., when the coherent atom-cavity coupling rate dominates dissipation in the system. This sets the main requirements on the resonator's properties: small mode volume and high finesse. Chapter 3 is devoted to the manufacturing, assembling, and testing of an ultra-high finesse optical Fabry-Perot resonator, stabilized to the atomic transition. In Chapter 4 I present the transportation of single atoms into the

  20. A Critical Reflection: Foster Care Youth Experiences at a Four Year Postsecondary Institution

    Science.gov (United States)

    Greer, Renada D.

    2016-01-01

    Foster care youth face significant challenges to postsecondary educational success, especially while enrolled at four-year institutions. Foster care youth are absent of family support that their non-foster peers receive throughout the college experience. Without family support, foster care youth encounter greater challenges to persevere through…

  1. Role of surgical treatment in breast cancer liver metastases: a single center experience.

    Science.gov (United States)

    Bacalbasa, Nicolae; Dima, Simona Olimpia; Purtan-Purnichescu, Raluca; Herlea, Vlad; Popescu, Irinel

    2014-10-01

    The aim of the present study was to review a single hepatobiliary center experience, the benefit of hepatic metastasectomy in breast cancer liver metastases (BCLM) patients and to identify predictors of survival. Fifty-two female patients underwent surgery for BCLM between 2002 and 2013. Only patients with liver resections (n=43) were included in the analysis. The median survival of the 43 patients with liver resection was 32.2 months. The factors significantly associated with overall post-hepatectomy survival were estrogen/progesteron receptor (ER/PR) status (p=0.002), node involvement of the primary tumor (p=0.049), size (p=0.005) and number (p=0.006) of the metastatic lesions. The 1-, 3- and 5-year survival rates after curative liver resection were 93.02%, 74.42%, 58.14%, respectively. BCLM resection is a safe procedure and offers survival benefit, especially in patients with reduced liver metastatic burden (solitary metastases, diameter of the metastases <5 cm) and positive ER/PR status. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  2. Tunable single quantum dot nanocavities for cavity QED experiments

    International Nuclear Information System (INIS)

    Kaniber, M; Laucht, A; Neumann, A; Bichler, M; Amann, M-C; Finley, J J

    2008-01-01

    We present cavity quantum electrodynamics experiments performed on single quantum dots embedded in two-dimensional photonic crystal nanocavities. We begin by describing the structural and optical properties of the quantum dot sample and the photonic crystal nanocavities and compare the experimental results with three-dimensional calculations of the photonic properties. The influence of the tailored photonic environment on the quantum dot spontaneous emission dynamics is studied using spectrally and spatially dependent time-resolved spectroscopy. In ensemble and single dot measurements we show that the photonic crystals strongly enhance the photon extraction efficiency and, therefore, are a promising concept for realizing efficient single-photon sources. Furthermore, we demonstrate single-photon emission from an individual quantum dot that is spectrally detuned from the cavity mode. The need for controlling the spectral dot-cavity detuning is discussed on the basis of shifting either the quantum dot emission via temperature tuning or the cavity mode emission via a thin film deposition technique. Finally, we discuss the recently discovered non-resonant coupling mechanism between quantum dot emission and cavity mode for large detunings which drastically lowers the purity of single-photon emission from dots that are spectrally coupled to nanocavity modes.

  3. Information Networks and Integration: Institutional Influences on Experiences and Persistence of Beginning Students

    Science.gov (United States)

    Karp, Melinda Mechur; Hughes, Katherine L.

    2008-01-01

    This article uses data from a qualitative exploratory study at two urban community colleges to examine experiences of beginning students, paying close attention to the influence that institutional information networks have on students' perceptions and persistence. The authors find that students' reported integration, or sense of belonging in the…

  4. Injection molded nanofluidic chips: Fabrication method and functional tests using single-molecule DNA experiments

    DEFF Research Database (Denmark)

    Utko, Pawel; Persson, Karl Fredrik; Kristensen, Anders

    2011-01-01

    We demonstrate that fabrication of nanofluidic systems can be greatly simplified by injection molding of polymers. We functionally test our devices by single-molecule DNA experiments in nanochannels.......We demonstrate that fabrication of nanofluidic systems can be greatly simplified by injection molding of polymers. We functionally test our devices by single-molecule DNA experiments in nanochannels....

  5. [The influence of leadership experience on the style of resolving management decisions by executives of healthcare institutions].

    Science.gov (United States)

    Vezhnovets', T A

    2013-12-01

    The aim of our study was to examine the influence of age and management experience of executives in healthcare institutions at the style of decision-making. The psychological study of 144 executives was conducted. We found out that the age of executives in healthcare institutions does not affect the style of managerial decision making, while experience in leadership position does. Also it was established that the more experienced leader is, the more often he will make decision in authoritative, autonomous, marginal style and the less management experience is, the more likely is the usage of indulgent and situational style. Moreover, the authoritarian style is typical for younger executives, marginal and autonomous is typical for elder executives.

  6. Python and Roles of Variables in Introductory Programming: Experiences from Three Educational Institutions

    Science.gov (United States)

    Nikula, Uolevi; Sajaniemi, Jorma; Tedre, Matti; Wray, Stuart

    2007-01-01

    Students often find that learning to program is hard. Introductory programming courses have high drop-out rates and students do not learn to program well. This paper presents experiences from three educational institutions where introductory programming courses were improved by adopting Python as the first programming language and roles of…

  7. One- vs. Three-Fraction Pancreatic Stereotactic Body Radiation Therapy for Pancreatic Carcinoma: Single Institution Retrospective Review

    Directory of Open Access Journals (Sweden)

    Philip Anthony Sutera

    2017-11-01

    Full Text Available Background/introductionEarly reports of stereotactic body radiation therapy (SBRT for pancreatic ductal adenocarcinoma (PDAC used single fraction, but eventually shifted to multifraction regimens. We conducted a single institution review of our patients treated with single- or multifraction SBRT to determine whether any outcome differences existed.Methods and materialsPatients treated with SBRT in any setting for PDAC at our facility were included, from 2004 to 2014. Overall survival (OS, local control (LC, regional control (RC, distant metastasis (DM, and late grade 3 or greater radiation toxicities from the time of SBRT were calculated using Kaplan–Meier estimation to either the date of last follow-up/death or local/regional/distant failure.ResultsWe identified 289 patients (291 lesions with pathologically confirmed PDAC. Median age was 69 (range, 33–90 years. Median gross tumor volume was 12.3 (8.6–21.3 cm3 and planning target volume 17.9 (12–27 cm3. Single fraction was used in 90 (30.9% and multifraction in 201 (69.1% lesions. At a median follow-up of 17.3 months (IQR 10.1–29.3 months, the median survival for the entire cohort 17.8 months with a 2-year OS of 35.3%. Univariate analysis showed multifraction schemes to have a higher 2-year OS 30.5% vs. 37.5% (p = 0.019, it did not hold significance on MVA. Multifractionation schemes were found to have a higher LC on MVA (HR = 0.53, 95% CI, 0.33–0.85, p = 0.009. At 2 years, late grade 3+ toxicity was 2.5%. Post-SBRT CA19-9 was found on MVA to be a prognostic factor for OS (HR = 1.01, 95% CI, 1.01–1.01, p = 0.009, RC (HR = 1.01, 95% CI 1.01–1.01, p = 0.02, and DM (HR = 1.01, 95% CI, 1.01–1.01, p = 0.001.ConclusionOur single institution retrospective review is the largest to date comparing single and multifraction SBRT and the first to show multifraction regimen SBRT to have a higher LC than single fractionation. Additionally, we

  8. Double-slit experiment with single wave-driven particles and its relation to quantum mechanics.

    Science.gov (United States)

    Andersen, Anders; Madsen, Jacob; Reichelt, Christian; Rosenlund Ahl, Sonja; Lautrup, Benny; Ellegaard, Clive; Levinsen, Mogens T; Bohr, Tomas

    2015-07-01

    In a thought-provoking paper, Couder and Fort [Phys. Rev. Lett. 97, 154101 (2006)] describe a version of the famous double-slit experiment performed with droplets bouncing on a vertically vibrated fluid surface. In the experiment, an interference pattern in the single-particle statistics is found even though it is possible to determine unambiguously which slit the walking droplet passes. Here we argue, however, that the single-particle statistics in such an experiment will be fundamentally different from the single-particle statistics of quantum mechanics. Quantum mechanical interference takes place between different classical paths with precise amplitude and phase relations. In the double-slit experiment with walking droplets, these relations are lost since one of the paths is singled out by the droplet. To support our conclusions, we have carried out our own double-slit experiment, and our results, in particular the long and variable slit passage times of the droplets, cast strong doubt on the feasibility of the interference claimed by Couder and Fort. To understand theoretically the limitations of wave-driven particle systems as analogs to quantum mechanics, we introduce a Schrödinger equation with a source term originating from a localized particle that generates a wave while being simultaneously guided by it. We show that the ensuing particle-wave dynamics can capture some characteristics of quantum mechanics such as orbital quantization. However, the particle-wave dynamics can not reproduce quantum mechanics in general, and we show that the single-particle statistics for our model in a double-slit experiment with an additional splitter plate differs qualitatively from that of quantum mechanics.

  9. Double-slit experiment with single wave-driven particles and its relation to quantum mechanics

    Science.gov (United States)

    Andersen, Anders; Madsen, Jacob; Reichelt, Christian; Rosenlund Ahl, Sonja; Lautrup, Benny; Ellegaard, Clive; Levinsen, Mogens T.; Bohr, Tomas

    2015-07-01

    In a thought-provoking paper, Couder and Fort [Phys. Rev. Lett. 97, 154101 (2006), 10.1103/PhysRevLett.97.154101] describe a version of the famous double-slit experiment performed with droplets bouncing on a vertically vibrated fluid surface. In the experiment, an interference pattern in the single-particle statistics is found even though it is possible to determine unambiguously which slit the walking droplet passes. Here we argue, however, that the single-particle statistics in such an experiment will be fundamentally different from the single-particle statistics of quantum mechanics. Quantum mechanical interference takes place between different classical paths with precise amplitude and phase relations. In the double-slit experiment with walking droplets, these relations are lost since one of the paths is singled out by the droplet. To support our conclusions, we have carried out our own double-slit experiment, and our results, in particular the long and variable slit passage times of the droplets, cast strong doubt on the feasibility of the interference claimed by Couder and Fort. To understand theoretically the limitations of wave-driven particle systems as analogs to quantum mechanics, we introduce a Schrödinger equation with a source term originating from a localized particle that generates a wave while being simultaneously guided by it. We show that the ensuing particle-wave dynamics can capture some characteristics of quantum mechanics such as orbital quantization. However, the particle-wave dynamics can not reproduce quantum mechanics in general, and we show that the single-particle statistics for our model in a double-slit experiment with an additional splitter plate differs qualitatively from that of quantum mechanics.

  10. Valuing energy policy attributes for environmental management: Choice experiment evidence from a research institution

    International Nuclear Information System (INIS)

    Komarek, Timothy M.; Lupi, Frank; Kaplowitz, Michael D.

    2011-01-01

    Many governments, firms, institutions and individuals have become increasingly cognizant of their impact on the environment, most notably with respect to global climate change. Coupled with the possibility of future regulations aimed at curbing greenhouse gas emissions, firms and institutions have begun to critically evaluate their own carbon footprint. This paper examines the preferences of stakeholders within a large academic institution for attributes of alternative greenhouse gas (GHG) reduction strategies. The attributes considered by constituents include: the fuel portfolio mix, effort for conserving energy use, carbon emissions reduction, timeframe for emissions reduction to be achieved and cost. We use a choice experiment technique that enables the examination of greenhouse gas reduction program attribute preferences across three constituent groups. The results show that each of the constituent groups have a positive WTP for carbon emissions reductions and prefer investments in reductions in the shorter- rather than longer-term. The results also suggest differences between the constituent groups in their WTP for types of fuels in the fuel portfolio. Finally, we use the results to examine the welfare implications of different combinations of the policy attributes that coincide with alternative GHG program strategies. - Highlights: → We explore preferences for carbon footprint reduction at an academic institution. → Include several pertinent energy policy attributes in a choice experiment. → Find preference heterogeneity between constituent groups for policy attributes. → Find highest willingness to pay for 'green' energy and emissions reduction amount.

  11. Valuing energy policy attributes for environmental management: Choice experiment evidence from a research institution

    Energy Technology Data Exchange (ETDEWEB)

    Komarek, Timothy M., E-mail: komarekt@msu.edu [Department of Agricultural Food and Resource Economics, Michigan State University, 20 Cook Hall East Lansing, MI 48824 (United States); Lupi, Frank [Department of Agricultural Food and Resource Economics, Michigan State University, 301 B Agriculture Hall, East Lansing, MI 48824 (United States); Department of Fisheries and Wildlife, Michigan State University, 301 B Agriculture Hall, East Lansing, MI 48824 (United States); Kaplowitz, Michael D. [Department of Community, Agriculture, Recreation and Resource Studies, Michigan State University, 331 C Natural Resources, East Lansing, MI 48824 (United States)

    2011-09-15

    Many governments, firms, institutions and individuals have become increasingly cognizant of their impact on the environment, most notably with respect to global climate change. Coupled with the possibility of future regulations aimed at curbing greenhouse gas emissions, firms and institutions have begun to critically evaluate their own carbon footprint. This paper examines the preferences of stakeholders within a large academic institution for attributes of alternative greenhouse gas (GHG) reduction strategies. The attributes considered by constituents include: the fuel portfolio mix, effort for conserving energy use, carbon emissions reduction, timeframe for emissions reduction to be achieved and cost. We use a choice experiment technique that enables the examination of greenhouse gas reduction program attribute preferences across three constituent groups. The results show that each of the constituent groups have a positive WTP for carbon emissions reductions and prefer investments in reductions in the shorter- rather than longer-term. The results also suggest differences between the constituent groups in their WTP for types of fuels in the fuel portfolio. Finally, we use the results to examine the welfare implications of different combinations of the policy attributes that coincide with alternative GHG program strategies. - Highlights: > We explore preferences for carbon footprint reduction at an academic institution. > Include several pertinent energy policy attributes in a choice experiment. > Find preference heterogeneity between constituent groups for policy attributes. > Find highest willingness to pay for 'green' energy and emissions reduction amount.

  12. Twenty-years of lung transplantation in Taiwan: Effects of cumulative institutional experience on early outcomes

    Directory of Open Access Journals (Sweden)

    Shun-Mao Yang

    2017-11-01

    Conclusion: Although the results were undesirable in the first decade of the transplant program, the cumulative institutional experience led to significantly improved outcomes in the second decade of the transplant program.

  13. The data analysis of the single well injection-withdraw tracer experiment using the MACRO II

    International Nuclear Information System (INIS)

    Shirakawa, Toshihiko; Kanazawa, Yasuo; Hatanaka, Koichiro

    2001-04-01

    On understanding the radionuclide transport in natural barrier in radioactive waste isolation research, the macroscopic dispersion in heterogeneous permeability field in the underground rock is regarded as an important process. Therefore, we have conducted lots of tracer experiments by the MACRO II facility with an artificially constructed heterogeneous permeability field. In order to study the scale dependence of dispersion coefficients in case of laboratory experiments, we placed the flow cell horizontally, and conducted injection-withdraw tracer experiment with a single well. We have conducted 15 cases experiments. These cases were prepared by changing a position of single well and the injection-withdraw time. At each position we have conducted 9 cases and 6 cases experiments. In this report, we evaluated the macroscopic dispersion coefficients by the fitting of analytical solution to breakthrough curve measured by the 15 cases pumping tracer experiment. Consequently, we could evaluate the dispersion coefficients for 12 cases of 15 cases. Then, we discussed the relation between a injection-withdraw flow rate and a property of heterogeneous media and dispersion coefficient. The conclusions obtained from the results of the evaluation are summarized as follows, It was found that the macroscopic dispersion coefficients tend to be increased with increase of the average radius of tracer front spread around a single well. We have conducted any experiments with s single well settled at two positions. In case of that there is low permeability around a single well, we found dispersion coefficients are large. In case of that there is high permeability around a single well, we found dispersion coefficients are small. In three cases that we could not evaluate because of incorrect accuracy of fitting, we have found it possible that there is some points that dispersion coefficients were strikingly small in tracer front. (author)

  14. The Global Tracheostomy Collaborative: one institution's experience with a new quality improvement initiative.

    Science.gov (United States)

    Lavin, Jennifer; Shah, Rahul; Greenlick, Hannah; Gaudreau, Philip; Bedwell, Joshua

    2016-01-01

    Given the low frequency of adverse events after tracheostomy, individual institutions struggle to collect outcome data to generate effective quality improvement protocols. The Global Tracheostomy Collaborative (GTC) is a multi-institutional, multi-disciplinary organization that utilizes a prospective database to collect data on patients undergoing tracheostomy. We describe our institution's preliminary experience with this collaborative. It was hypothesized that entry into the database would be non-burdensome and could be easily and accurately initiated by skilled specialists at the time of tracheostomy placement and completed at time of patient discharge. Demographic, diagnostic, and outcome data on children undergoing tracheostomy at our institution from January 2013 to June 2015 were entered into the GTC database, a database collected and managed by REDCap (Research Electronic Data Capture). All data entry was performed by pediatric otolaryngology fellows and all post-operative updates were completed by a skilled tracheostomy nurse. Tracked outcomes included accidental decannulation, failed decannulation, tracheostomy tube obstruction, bleeding/tracheoinnominate fistula, and tracheocutaneous fistula. Data from 79 patients undergoing tracheostomy at our institution were recorded. Database entry was straightforward and entry of patient demographic information, medical comorbidities, surgical indications, and date of tracheostomy placement was completed in less than 5min per patient. The most common indication for surgery was facilitation of ventilation in 65 patients (82.3%). Average time from admission to tracheostomy was 62.6 days (range 0-246). Stomal breakdown was seen in 1 patient. A total of 72 patients were tracked to hospital discharge with 53 patients surviving (88.3%). No mortalities were tracheostomy-related. The Global Tracheostomy Collaborative is a multi-institutional, multi-disciplinary collaborative that collects data on patients undergoing

  15. Using Social Networks to Enhance Teaching and Learning Experiences in Higher Learning Institutions

    Science.gov (United States)

    Balakrishnan, Vimala

    2014-01-01

    The paper first explores the factors that affect the use of social networks to enhance teaching and learning experiences among students and lecturers, using structured questionnaires prepared based on the Push-Pull-Mooring framework. A total of 455 students and lecturers from higher learning institutions in Malaysia participated in this study.…

  16. Replicable Interprofessional Competency Outcomes from High-Volume, Inter-Institutional, Interprofessional Simulation

    Directory of Open Access Journals (Sweden)

    Deborah Bambini

    2016-10-01

    Full Text Available There are significant limitations among the few prior studies that have examined the development and implementation of interprofessional education (IPE experiences to accommodate a high volume of students from several disciplines and from different institutions. The present study addressed these gaps by seeking to determine the extent to which a single, large, inter-institutional, and IPE simulation event improves student perceptions of the importance and relevance of IPE and simulation as a learning modality, whether there is a difference in students’ perceptions among disciplines, and whether the results are reproducible. A total of 290 medical, nursing, pharmacy, and physical therapy students participated in one of two large, inter-institutional, IPE simulation events. Measurements included student perceptions about their simulation experience using the Attitude Towards Teamwork in Training Undergoing Designed Educational Simulation (ATTITUDES Questionnaire and open-ended questions related to teamwork and communication. Results demonstrated a statistically significant improvement across all ATTITUDES subscales, while time management, role confusion, collaboration, and mutual support emerged as significant themes. Results of the present study indicate that a single IPE simulation event can reproducibly result in significant and educationally meaningful improvements in student perceptions towards teamwork, IPE, and simulation as a learning modality.

  17. Mothering Experiences: How Single Parenthood and Employment Structure the Emotional Valence of Parenting.

    Science.gov (United States)

    Meier, Ann; Musick, Kelly; Flood, Sarah; Dunifon, Rachel

    2016-06-01

    Research studies and popular accounts of parenting have documented the joys and strains of raising children. Much of the literature comparing parents with those without children indicates a happiness advantage for those without children, although recent studies have unpacked this general advantage to reveal differences by the dimension of well-being considered and important features in parents' lives and parenting experiences. We use unique data from the 2010, 2012, and 2013 American Time Use Survey to understand emotions in mothering experiences and how these vary by key demographic factors: employment and partnership status. Assessing mothers' emotions in a broad set of parenting activities while controlling for a rich set of person- and activity-level factors, we find that mothering experiences are generally associated with high levels of emotional well-being, although single parenthood is associated with differences in the emotional valence. Single mothers report less happiness and more sadness, stress, and fatigue in parenting than partnered mothers, and these reports are concentrated among those single mothers who are not employed. Employed single mothers are happier and less sad and stressed when parenting than single mothers who are not employed. Contrary to common assumptions about maternal employment, we find overall few negative associations between employment and mothers' feelings regarding time with children, with the exception that employed mothers report more fatigue in parenting than those who are not employed.

  18. Reconstructing an icosahedral virus from single-particle diffraction experiments

    Science.gov (United States)

    Saldin, D. K.; Poon, H.-C.; Schwander, P.; Uddin, M.; Schmidt, M.

    2011-08-01

    The first experimental data from single-particle scattering experiments from free electron lasers (FELs) are now becoming available. The first such experiments are being performed on relatively large objects such as viruses, which produce relatively low-resolution, low-noise diffraction patterns in so-called ``diffract-and-destroy'' experiments. We describe a very simple test on the angular correlations of measured diffraction data to determine if the scattering is from an icosahedral particle. If this is confirmed, the efficient algorithm proposed can then combine diffraction data from multiple shots of particles in random unknown orientations to generate a full 3D image of the icosahedral particle. We demonstrate this with a simulation for the satellite tobacco necrosis virus (STNV), the atomic coordinates of whose asymmetric unit is given in Protein Data Bank entry 2BUK.

  19. RadioImmunotherapy for adenoid cystic carcinoma: a single-institution series of combined treatment with cetuximab

    Science.gov (United States)

    2010-01-01

    Background Local control in adjuvant/definitive RT of adenoid cystic carcinoma (ACC) is largely dose-dependent. However, some clinical situations do not allow application of tumouricidal doses (i.e. re-irradiation) hence radiation sensitization by exploitation of high endothelial growth factor receptor (EGFR)-expression in ACC seems beneficial. This is a single-institution experience of combined radioimmunotherapy (RIT) with the EGFR-inhibitor cetuximab. Methods Between 2006 and 2010, 9 pts received RIT for advanced/recurrent ACC, 5/9 pts as re-irradiation. Baseline characteristics as well as treatment parameters were retrieved to evaluate efficacy and toxicity of the combination regimen were evaluated. Control rates (local/distant) and overall survival were calculated using Kaplan-Meier estimation. Results Median dose was 65 Gy, pts received a median of 6 cycles cetuximab. RIT was tolerated well with only one °III mucositis/dysphagia. Overall response/remission rates were high (77,8%); 2-year estimate of local control was 80% hence reaching local control levels comparable to high-dose RT. Progression-free survival (PFS) at 2 years and median overall survival were only 62,5% and 22,2 mo respectively. Conclusion While local control and treatment response in RIT seems promising, PFS and overall survival are still hampered by distant failure. The potential benefit of RIT with cetuximab warrants exploration in a prospective controlled clinical trial. PMID:21047402

  20. RadioImmunotherapy for adenoid cystic carcinoma: a single-institution series of combined treatment with cetuximab

    Directory of Open Access Journals (Sweden)

    Weichert Wilko

    2010-11-01

    Full Text Available Abstract Background Local control in adjuvant/definitive RT of adenoid cystic carcinoma (ACC is largely dose-dependent. However, some clinical situations do not allow application of tumouricidal doses (i.e. re-irradiation hence radiation sensitization by exploitation of high endothelial growth factor receptor (EGFR-expression in ACC seems beneficial. This is a single-institution experience of combined radioimmunotherapy (RIT with the EGFR-inhibitor cetuximab. Methods Between 2006 and 2010, 9 pts received RIT for advanced/recurrent ACC, 5/9 pts as re-irradiation. Baseline characteristics as well as treatment parameters were retrieved to evaluate efficacy and toxicity of the combination regimen were evaluated. Control rates (local/distant and overall survival were calculated using Kaplan-Meier estimation. Results Median dose was 65 Gy, pts received a median of 6 cycles cetuximab. RIT was tolerated well with only one °III mucositis/dysphagia. Overall response/remission rates were high (77,8%; 2-year estimate of local control was 80% hence reaching local control levels comparable to high-dose RT. Progression-free survival (PFS at 2 years and median overall survival were only 62,5% and 22,2 mo respectively. Conclusion While local control and treatment response in RIT seems promising, PFS and overall survival are still hampered by distant failure. The potential benefit of RIT with cetuximab warrants exploration in a prospective controlled clinical trial.

  1. Recurrence in Benign Paroxysmal Positional Vertigo: A Large, Single-Institution Study.

    Science.gov (United States)

    Luryi, Alexander L; Lawrence, Juliana; Bojrab, Dennis I; LaRouere, Michael; Babu, Seilesh; Zappia, John; Sargent, Eric W; Chan, Eleanor; Naumann, Ilka; Hong, Robert S; Schutt, Christopher A

    2018-04-11

    To report rates of recurrence in benign paroxysmal positional vertigo (BPPV) and associated patient and disease factors. Retrospective chart review. Single high-volume otology practice. Patients diagnosed with BPPV from 2007 to 2016 with documented resolution of symptoms. Diagnostic and particle repositioning maneuvers for BPPV. BPPV recurrence, time to recurrence, and ear(s) affected at recurrence. A total of 1,105 patients meeting criteria were identified. Of this population, 37% had recurrence of BPPV in either ear or both ears. Overall same-ear recurrence rate was 28%; 76% of recurrences involved the same ear(s) as initial presentation. Recurrences that occurred after longer disease-free intervals were more likely to involve the opposite ear than early recurrences (p = 0.02). Female sex (40.4% versus 32.7%, p = 0.01) and history of previous BPPV (57.5% versus 32.4%, p diabetes mellitus, and traumatic etiology were not. Approximately, half (56%) of recurrences occurred within 1 year of resolution. A large single-institution study of recurrence in BPPV is presented along with Kaplan-Meier disease-free survival curves. Female sex and history of previous BPPV were associated with increased recurrence, while previously suspected risk factors for recurrence including history of Menière's disease, diabetes, and trauma were not. Remote recurrence is more likely to involve the contralateral ear than early recurrence. These data solidify the expected course of treated BPPV allowing for improved clinical care and patient counseling.

  2. Overview of quasi single helicity experiments in reversed field pinches

    International Nuclear Information System (INIS)

    Martin, P.; Marrelli, L.; Spizzo, G.

    2003-01-01

    We report the results of an experimental and theoretical project dedicated to the study of Quasi Single Helicity Reversed Field Pinch plasmas. The project has involved several RFP devices and numerical codes. It appears that QSH spectra are a feature common to all the experiments. (author)

  3. Single column and two-column H-D-T distillation experiments at TSTA

    International Nuclear Information System (INIS)

    Yamanishi, T.; Yoshida, H.; Hirata, S.; Naito, T.; Naruse, Y.; Sherman, R.H.; Bartlit, J.R.; Anderson, J.L.

    1988-01-01

    Cryogenic distillation experiments were peformed at TSTA with H-D-T system by using a single column and a two-column cascade. In the single column experiment, fundamental engineering data such as the liquid holdup and the HETP were measured under a variety of operational condtions. The liquid holdup in the packed section was about 10 /approximately/ 15% of its superficial volume. The HETP values were from 4 to 6 cm, and increased slightly with the vapor velocity. The reflux ratio had no effect on the HETP. For the wo-colunn experiemnt, dynamic behavior of the cascade was observed. 8 refs., 7 figs., 2 tabs

  4. Treatment results of nasopharyngeal carcinoma: a 15-year single institutional experience.

    Science.gov (United States)

    Khademi, Bijan; Mahmoodi, Jalal; Omidvari, Shapour; Mohammadianpanah, Mohammad

    2006-06-01

    Nasopharyngeal Carcinoma (NPC) is a common malignant neoplasm of the head and neck that occurs most commonly in people in the South Eastern Asia but its condition in Iran is not much clear. In this retrospective study, we evaluated the treatment characteristics determining the outcome in patients with NPC. In this retrospective study, we reviewed the records of one hundred and seven patients with biopsy proven diagnosis of NPC who were referred to the radiation oncology department, Nemazee Hospital, Shiraz University of Medical Sciences, Iran, during the time period from January 1985 to December 2000. Eightyfive patients (79.4%) received 60-70Gy radiation (1.8- 2Gy/fraction, one fraction per day, and 5 fractions per week). Sixty-two patients (57.5%) received radiotherapy combined with adjuvant chemotherapy which consisted of cisplatin and 5-fluorouracil. Eighty-six patients (80.4%) had WHO II-III histopathologic diagnosis. According to the AJCC 1997 staging system, 4 (3.6%), 3 (2.7%), 33 (30.8%) and 67 (62%) patients were in stages I, II, III and IV, respectively. With a median follow-up of 12 months, the 2-year overall and disease-free survival rates were 35% and 21%, respectively. According to the multivariate analysis for overall survival, patients under 40 years had a better prognosis (p=0.041). Node stage and stage of disease were significant prognostic factors (p=0.0001). On multivariate analysis for disease-free survival, age and node stage were significant prognostic factors. The patients who received more than 60Gy radiation had a better prognosis (p=0.02), however; sequential adjuvant chemotherapy had no impact on survival and response (p=0.6). Our experience confirmed earlier reports showing poor outcomes for locoregionally advanced nasopharyngeal carcinomas. This study failed to demonstrate improvement in the outcome regarding overall and disease-free survival by adding sequential adjuvant chemotherapy after radiotherapy for patients with advanced NPC.

  5. Treatment Results of Nasopharyngeal Carcinoma: A 15- Year Single Institutional Experience

    International Nuclear Information System (INIS)

    Khademi, B.; Mahmoodi, J.; Omidvari, S.; Anpanah, M.M.

    2006-01-01

    Background: Nasopharyngeal Carcinoma (NPC) is a common malignant neoplasm of the head and neck that occurs most commonly in people in the South Eastern Asia but its condition in Iran is not much clear. Objective: In this retrospective study, we evaluated the treatment characteristics determining the outcome in patients with NPC. Patients and Methods: In this retrospective study, we reviewed the records of one hundred and seven patients with biopsy proven diagnosis of NPC who were referred to the radiation oncology department, Nemazee Hospital, Shiraz University of Medical Sciences, Iran, during the time period from January 1985 to December 2000. Eighty five patients (79.4%) received 60-70 Gy radiation (1.82 Gy/fraction, one fraction per day, and 5 fractions per week). Sixty-two patients (57.5%) received radiotherapy combined with adjuvant chemotherapy which consisted of cisplatin and 5-fluorouracil. Eighty-six patients (80.4%) had WHO II-III histopathologic diagnosis. According to the AlCC 1997 staging system, 4 (3.6%), 3 (2.7%), 33 (30.8%) and 67 (62%) patients were in stages I, II, III and IV, respectively. Results: With a median follow-up of 12 months, the 2-year overall and disease-free survival rates were 35% and 21%, respectively. According to the multivariate analysis for overall survival, patients under 40 years had a better prognosis (p=0.041). Node stage and stage of disease were significant prognostic factors (p=0.0001. On multivariate analysis for disease-free survival, age and node stage were significant prognostic factors. The patients who received more than 60 Gy radiation had a better prognosis (p=0.02), however; sequential adjuvant chemotherapy had no impact on survival and response (p=0.6). Conclusion: Our experience confirmed earlier reports showing poor outcomes for locoregionally advanced nasopharyngeal carcinomas. This study failed to demonstrate improvement in the outcome regarding overall and disease-free survival by adding sequential

  6. Head and neck paragangliomas: A two-decade institutional experience and algorithm for management.

    Science.gov (United States)

    Smith, Joshua D; Harvey, Rachel N; Darr, Owen A; Prince, Mark E; Bradford, Carol R; Wolf, Gregory T; Else, Tobias; Basura, Gregory J

    2017-12-01

    Paragangliomas of the head and neck and cranial base are typically benign, slow-growing tumors arising within the jugular foramen, middle ear, carotid bifurcation, or vagus nerve proper. The objective of this study was to provide a comprehensive characterization of our institutional experience with clinical management of these tumors and posit an algorithm for diagnostic evaluation and treatment. This was a retrospective cohort study of patients undergoing treatment for paragangliomas of the head and neck and cranial base at our institution from 2000-2017. Data on tumor location, catecholamine levels, and specific imaging modalities employed in diagnostic work-up, pre-treatment cranial nerve palsy, treatment modality, utilization of preoperative angiographic embolization, complications of treatment, tumor control and recurrence, and hereditary status (ie, succinate dehydrogenase mutations) were collected and summarized. The mean (SD) age of our cohort was 51.8 (±16.1) years with 123 (63.4%) female patients and 71 (36.6%) male patients. Catecholamine-secreting lesions were found in nine (4.6%) patients. Fifty-one patients underwent genetic testing, with mutations identified in 43 (20 SDHD , 13 SDHB, 7 SDHD , 1 SDHA, SDHAF2, and NF1 ). Observation with serial imaging, surgical extirpation, radiation, and stereotactic radiosurgery were variably employed as treatment approaches across anatomic subsites. An algorithmic approach to clinical management of these tumors, derived from our longitudinal institutional experience and current empiric evidence, may assist otolaryngologists, radiation oncologists, and geneticists in the care of these complex neoplasms. 4.

  7. All black swans? : showcasing three U.S. postsecondary institution's disability support services for students with learning disabilities

    OpenAIRE

    Rice, Travis A.

    2010-01-01

    The main purpose of this study was to investigate the disability support service (DSS) office designs at three varying U.S. postsecondary institutions and their relationship to the experiences of students with a learning disability. The three postsecondary institutions represent a community college, a medium sized university and a large research university all-residing in a single bellwether state. Selection of the cases and postsecondary institutions was carefully done in order to investig...

  8. Creation of the Financial Ombudsman Institute: International Experience and Prospects for Ukraine

    Directory of Open Access Journals (Sweden)

    Britchenko Igor G.

    2017-03-01

    Full Text Available The article is dedicated to the problems of introduction of the institute of financial ombudsman in Ukraine on the basis of studying international experience. The modern development of the banking system of Ukraine is characterized by the presence of significant losses, the outflow of deposit funds of individuals, the growth of inflationary pressures, the reduction in the number of banking institutions, and the decrease in the level of confidence in them among the population. These factors among others have led to a considerable number of litigations between banks and their clients. This situation forces the banks to find effective ways to solve the problem. In the world practice the institute of financial ombudsman serves this purpose. The conclusion is made that the activity of the institute of the financial ombudsman occurs within the framework of a clearly defined legislative field, which in a generalized form is represented by the British and German models. The main difference between these models of the financial ombudsman lies in the status of this institute in different countries. But their common characteristics are the respect for clients, the possibility of voluntary appeal to the ombudsman, a short period of considering the matter, the lack of payment for ombudsman services. The necessity of establishment of the institute of alternative resolution of disputes in the sphere of financial services in the form of financial ombudsman in Ukraine is justified. Its creation will improve the quality of financial market regulation, increase the level of public confidence in financial institutions, strengthen financial discipline, reduce the load on law courts, increase the transparency and openness of the financial market. The financial ombudsman should complement the work of other financial market regulators but at the same time remain an independent and free-standing body. In modern realities of development of Ukraine, a necessary task is

  9. Double-slit experiment with single wave-driven particles and its relation to quantum mechanics

    DEFF Research Database (Denmark)

    Andersen, Anders Peter; Madsen, Jacob; Reichelt, Christian Günther

    2015-01-01

    even though it is possible to determine unambiguously which slit the walking droplet passes. Here we argue, however, that the single-particle statistics in such an experiment will be fundamentally different from the single-particle statistics of quantum mechanics. Quantum mechanical interference takes...... place between different classical paths with precise amplitude and phase relations. In the double-slit experiment with walking droplets, these relations are lost since one of the paths is singled out by the droplet. To support our conclusions, we have carried out our own double-slit experiment, and our...... results, in particular the long and variable slit passage times of the droplets, cast strong doubt on the feasibility of the interference claimed by Couder and Fort. To understand theoretically the limitations of wave-driven particle systems as analogs to quantum mechanics, we introduce a Schro...

  10. Definitive Radiotherapy for T1–2 Hypopharyngeal Cancer: A Single-Institution Experience

    International Nuclear Information System (INIS)

    Nakajima, Aya; Nishiyama, Kinji; Morimoto, Masahiro; Nakamura, Satoaki; Suzuki, Osamu; Kawaguchi, Yoshifumi; Miyagi, Ken; Fujii, Takashi; Yoshino, Kunitoshi

    2012-01-01

    Purpose: To analyze the outcome in T1–2 hypopharyngeal cancer (HPC) patients treated with definitive radiotherapy (RT). Patients and Methods: A total of 103 patients with T1–2 hypopharyngeal squamous cell carcinoma treated with radical RT between March 2000 and June 2008 at our institution were analyzed. Pre-RT neck dissection (ND) was performed in 26 patients with advanced neck disease. Chemotherapy was used concurrently with RT in 14 patients. Sixty patients were associated with synchronous or metachronous malignancies. The median follow-up for surviving patients was 41 months. Results: The 3-year overall and cause-specific survival rates were 70% and 79%, respectively. The 3-year local control rates were 87% for T1 and 83% for T2 disease. The ultimate local control rate was 89%, including 7 patients in whom salvage was successful. The ultimate local control rate with laryngeal preservation was 82%. Tumors of the medial wall of the pyriform sinus tended to have lower control rates compared with tumors of the lateral or posterior pharyngeal wall. Among patients with N2b–3 disease, the 3-year regional control rates were 74% for patients with pre-RT ND and 40% for patients without ND. The 3-year locoregional control rates were as follows: Stage I, 100%; Stage II, 84%; Stage III, 67%; Stage IVA, 43%; Stage IVB, 67%. Forty-two patients developed disease recurrence, with 29 (70%) patients developing recurrence within the first year. Of the 103 patients, 6 developed late complications higher than or equal to Grade 3. Conclusions: Definitive RT accomplished a satisfactory local control rate and contributed to organ preservation.

  11. What factors are associated with unplanned return following transurethral resection of bladder tumor? An analysis of a large single institution's experience.

    Science.gov (United States)

    Ghali, Fady; Moses, Rachel A; Raffin, Eric; Hyams, Elias S

    2016-10-01

    This study sought to evaluate factors associated with unplanned hospital return (UR) following transurethral resection of bladder tumor (TURBT), the largest source of readmission among ambulatory urological procedures. A retrospective review of TURBTs at a single academic institution between April 2011 and August 2014 was performed. Demographics, comorbidities, length of stay, tumor size and multiple other factors were recorded. UR was recorded within 30 days of surgery. Bivariate and multivariable analyses were performed to determine factors associated with UR. Among 708 patients undergoing TURBT, 23.9% were female with a mean age of 70 years. The rate of UR was 10.9%. The most common cause of UR was gross hematuria, accounting for 70%. On bivariate analysis, Foley catheter placement in the operating room, non-aspirin anticoagulation and index length of stay longer than 24 h were associated with hematuria-related UR (p hematuria-related UR (p  0.05). On multivariable analysis, only Foley placement in the operating room remained associated with higher rates of hematuria-related UR, while preoperative antibiotics, female gender and aspirin therapy remained associated with a lower likelihood of this event. UR following TURBT is common and typically results from gross hematuria. Patients with postoperative Foley catheterization in the operating room may require additional counseling or supervision before discharge, and should be considered for discharge with a Foley rather than having a prompt voiding trial.

  12. Progress of the nEDM experiment at the Paul Scherrer Institute

    Energy Technology Data Exchange (ETDEWEB)

    Kasprzak, Małgorzata, E-mail: malgorzata.kasprzak@fys.kuleuven.be [University of Leuven, Institute for Nuclear and Radiation Physics (Belgium)

    2016-12-15

    Advances in experimental searches for a neutron Electric Dipole Moment (nEDM, d{sub n}) are motivated by the potential discovery of a new source of CP violation beyond the Standard Model of particle physics. The nEDM experiment at the Paul Scherrer Institute (PSI), which with accumulated sensitivity of 1.09 × 10{sup −26}e⋅cm (September 2016) is currently the most sensitive nEDM experiment worldwide, uses the Ramsey technique of separated oscillatory fields applied to stored ultracold neutrons. The nEDM measurements depend upon precise information about the magnetic field, which is monitored by a {sup 199}Hg co-magnetometer and an array of {sup 133}Cs magnetometers. The principle of the magnetic field measurement is based on the optical detection of the Larmor precession frequency of atoms polarized by optical pumping. In this article we present the recent progress of the nEDM experiment as well as details of a magnetic field measurements with special focus on the laser-operated array of high-sensitivity {sup 133}Cs magnetometers.

  13. Infantile hypertrophic pyloric stenosis: a single institution's experience

    African Journals Online (AJOL)

    western world, but its incidence in the Kingdom of Saudi. Arabia is ... IHPS in this region of the world. Seasonal .... (Sweden), which might reflect the effect of ethnic variations [15]. ... IHPS and seasonal variations in previous studies [12], but.

  14. Pancreatic pseudocyst in children: a single-institute experience ...

    African Journals Online (AJOL)

    The pseudocysts were acute in 11 patients, chronic in seven patients, and only ... and post-traumatic cysts, the surgical treatment of pancreatic pseudocyst is a ... Keywords: children, drainage, conservative treatment, pancreatic pseudocyst, ...

  15. A single-institution experience with hydrostatic reduction for ...

    African Journals Online (AJOL)

    Background/purpose Hydrostatic reduction for intussusception has the benefit ... The v2-test was used to compare categorical variables, and a P value of 0.05 was ... Conclusion Although less than half of the patients presenting with childhood ...

  16. First Danish single-institution experience with radical prostatectomy

    DEFF Research Database (Denmark)

    Vrang, Marie-Louise; Røder, Martin Andreas; Vainer, Ben

    2012-01-01

    OBJECTIVE: This study aimed to investigate the impact of positive surgical margins (PSMs), stratified by location and extension, on biochemical outcome after radical retropubic prostatectomy (RRP). MATERIAL AND METHODS: The study included data from 605 consecutive patients treated with RRP for lo...

  17. Institutional Power: Identity, Politics, and Lived Experiences in the Dance License via Portfolio Process

    Science.gov (United States)

    Maloney, Betsy

    2015-01-01

    In this research study, I examined how institutional power affected the experiences of two dance educators attempting to gain their K-12 dance teaching license in Minnesota. My research analyzed the ways in which candidates applying for the portfolio review process constructed, amended, or abandoned their identities as teachers/artists/individuals…

  18. Life in the Universe - Astronomy and Planetary Science Research Experience for Undergraduates at the SETI Institute

    Science.gov (United States)

    Chiar, J.; Phillips, C. B.; Rudolph, A.; Bonaccorsi, R.; Tarter, J.; Harp, G.; Caldwell, D. A.; DeVore, E. K.

    2016-12-01

    The SETI Institute hosts an Astrobiology Research Experience for Undergraduates (REU) program. Beginning in 2013, we partnered with the Physics and Astronomy Dept. at Cal Poly Pomona, a Hispanic-serving university, to recruit underserved students. Over 11 years, we have served 155 students. We focus on Astrobiology since the Institute's mission is to explore, understand and explain the origin, nature and prevalence of life in the universe. Our REU students work with mentors at the Institute - a non-profit organization located in California's Silicon Valley-and at the nearby NASA Ames Research Center. Projects span research on survival of microbes under extreme conditions, planetary geology, astronomy, the Search for Extraterrestrial Intelligence (SETI), extrasolar planets and more. The REU program begins with an introductory lectures by Institute scientists covering the diverse astrobiology subfields. A week-long field trip to the SETI Institute's Allen Telescope Array (Hat Creek Radio Astronomy Observatory in Northern California) and field experiences at hydrothermal systems at nearby Lassen Volcanic National Park immerses students in radio astronomy and SETI, and extremophile environments that are research sites for astrobiologists. Field trips expose students to diverse environments and allow them to investigate planetary analogs as our scientists do. Students also participate in local trips to the California Academy of Sciences and other nearby locations of scientific interest, and attend the weekly scientific colloquium hosted by the SETI Institute at Microsoft, other seminars and lectures at SETI Institute and NASA Ames. The students meet and present at a weekly journal club where they hone their presentation skills, as well as share their research progress. At the end of the summer, the REU interns present their research projects at a session of the Institute's colloquium. As a final project, students prepare a 2-page formal abstract and 15-minute

  19. Single-dose radiosurgical treatment for hepatic metastases - therapeutic outcome of 138 treated lesions from a single institution

    International Nuclear Information System (INIS)

    Habermehl, Daniel; Herfarth, Klaus K; Bermejo, Justo Lorenzo; Hof, Holger; Rieken, Stefan; Kuhn, Sabine; Welzel, Thomas; Debus, Jürgen; Combs, Stephanie E

    2013-01-01

    Local ablative therapies such as stereotactically guided single-dose radiotherapy or helical intensity-modulated radiotherapy (tomotherapy) with high single-doses are successfully applied in many centers in patients with liver metastasis not suitable for surgical resection. This study presents results from more than 10 years of clinical experience and evaluates long-term outcome and efficacy of this therapeutic approach. From 1997 to 2009 a total of 138 intrahepatic tumors of 90 patients were irradiated with single doses of 17 to 30 Gy (median dose 24 Gy). Median age of the patients was 64 years (range 31–89 years). Most frequent underlying tumor histologies were colorectal adenocarcinoma (70 lesions) and breast cancer (27 lesions). In 35 treatment sessions multiple targets were simultaneously irradiated (up to four lesions at once). Local progression-free (PFS) and overall survival (OS) after treatment were investigated using uni- and multiple survival regression models. Median overall survival of all patients was 24.3 months. Local PFS was 87%, 70% and 59% after 6, 12 and 18 months, respectively. Median time to local progression was 25.5 months. Patients with a single lesion and no further metastases at time of RT had a favorable median PFS of 43.1 months according to the Kaplan-Meier estimator. The type of tumor showed a statistical significant influence on local PFS, with a better prognosis for breast cancer histology than for colorectal carcinoma in uni- and multiple regression analysis (p = 0.05). Multiple regression analysis revealed no influence of planning target volume (PTV), patient age and radiation dose on local PFS. Treatment was well tolerated with no severe adverse events. This study confirms safety of SBRT in liver lesions, with 6- and 12 months local control of 87% and 70%. The dataset represents the clinical situation in a large oncology setting, with many competing treatment options and heterogeneous patient characteristics

  20. Exploring the Academic and Social Experiences of Latino Engineering Community College Transfer Students at a 4-Year Institution: A Qualitative Research Study

    Science.gov (United States)

    Hagler, LaTesha R.

    As the number of historically underrepresented populations transfer from community college to university to pursue baccalaureate degrees in science, technology, engineering, and mathematics (STEM), little research exists about the challenges and successes Latino students experience as they transition from 2-year colleges to 4-year universities. Thus, institutions of higher education have limited insight to inform their policies, practices, and strategic planning in developing effective sources of support, services, and programs for underrepresented students in STEM disciplines. This qualitative research study explored the academic and social experiences of 14 Latino engineering community college transfer students at one university. Specifically, this study examined the lived experiences of minority community college transfer students' transition into and persistence at a 4-year institution. The conceptual framework applied to this study was Schlossberg's Transition Theory, which analyzed the participant's social and academic experiences that led to their successful transition from community college to university. Three themes emerged from the narrative data analysis: (a) Academic Experiences, (b) Social Experiences, and (c) Sources of Support. The findings indicate that engineering community college transfer students experience many challenges in their transition into and persistence at 4-year institutions. Some of the challenges include lack of academic preparedness, environmental challenges, lack of time management skills and faculty serving the role as institutional agents.

  1. Does the Unemployement Benefit Institution Affect the Productivity of Workers? Evidence from a Field Experiment

    NARCIS (Netherlands)

    Blanco, M.; Dalton, P.S.; Vargas, J.F.

    2013-01-01

    Abstract: We investigate whether and how the type of unemployment bene t institution affects productivity. We designed a field experiment to compare workers' productivity under a welfare system, where the unemployed receive an unconditional monetary transfer, with their productivity under a workfare

  2. Single-Pass Percutaneous Liver Biopsy for Diffuse Liver Disease Using an Automated Device: Experience in 154 Procedures

    International Nuclear Information System (INIS)

    Rivera-Sanfeliz, Gerant; Kinney, Thomas B.; Rose, Steven C.; Agha, Ayad K.M.; Valji, Karim; Miller, Franklin J.; Roberts, Anne C.

    2005-01-01

    Purpose: To describe our experience with ultrasound (US)-guided percutaneous liver biopsies using the INRAD 18G Express core needle biopsy system.Methods: One hundred and fifty-four consecutive percutaneous core liver biopsy procedures were performed in 153 men in a single institution over 37 months. The medical charts, pathology reports, and radiology files were retrospectively reviewed. The number of needle passes, type of guidance, change in hematocrit level, and adequacy of specimens for histologic analysis were evaluated.Results: All biopsies were performed for histologic staging of chronic liver diseases. The majority of patients had hepatitis C (134/153, 90.2%). All patients were discharged to home after 4 hr of postprocedural observation. In 145 of 154 (94%) biopsies, a single needle pass was sufficient for diagnosis. US guidance was utilized in all but one of the procedures (153/154, 99.4%). The mean hematocrit decrease was 1.2% (44.1-42.9%). Pain requiring narcotic analgesia, the most frequent complication, occurred in 28 of 154 procedures (18.2%). No major complications occurred. The specimens were diagnostic in 152 of 154 procedures (98.7%).Conclusions: Single-pass percutaneous US-guided liver biopsy with the INRAD 18G Express core needle biopsy system is safe and provides definitive pathologic diagnosis of chronic liver disease. It can be performed on an outpatient basis. Routine post-biopsy monitoring of hematocrit level in stable, asymptomatic patients is probably not warranted

  3. Epidermal Growth Factor Receptor Is Related to Poor Survival in Glioblastomas: Single-Institution Experience

    Science.gov (United States)

    Choi, Youngmin; Lee, Hyung-Sik; Hur, Won-Joo; Sung, Ki-Han; Kim, Ki-Uk; Choi, Sun-Seob; Kim, Su-Jin; Kim, Dae-Cheol

    2013-01-01

    Purpose There are conflicting results surrounding the prognostic significance of epidermal growth factor receptor (EGFR) status in glioblastoma (GBM) patients. Accordingly, we attempted to assess the influence of EGFR expression on the survival of GBM patients receiving postoperative radiotherapy. Materials and Methods Thirty three GBM patients who had received surgery and postoperative radiotherapy at our institute, between March 1997 and February 2006, were included. The evaluation of EGFR expression with immunohistochemistry was available for 30 patients. Kaplan-Meier survival analysis and Cox regression were used for statistical analysis. Results EGFR was expressed in 23 patients (76.7%), and not expressed in seven (23.3%). Survival in EGFR expressing GBM patients was significantly less than that in non-expressing patients (median survival: 12.5 versus 17.5 months, p=0.013). Patients who received more than 60 Gy showed improved survival over those who received up to 60 Gy (median survival: 17.0 versus 9.0 months, p=0.000). Negative EGFR expression and a higher radiation dose were significantly correlated with improved survival on multivariate analysis. Survival rates showed no differences according to age, sex, and surgical extent. Conclusion The expression of EGFR demonstrated a significantly deleterious effect on the survival of GBM patients. Therefore, approaches targeting EGFR should be considered in potential treatment methods for GBM patients, in addition to current management strategies. PMID:23225805

  4. Single-port laparoscopic approach of the left liver: initial experience.

    Science.gov (United States)

    Camps Lasa, Judith; Cugat Andorrà, Esteban; Herrero Fonollosa, Eric; García Domingo, María Isabel; Sánchez Martínez, Raquel; Vargas Pierola, Harold; Rodríguez Campos, Aurora

    2014-11-01

    New technological advances have enabled the development of single-port laparoscopic surgery. This approach began with cholecystectomy and subsequently with other abdominal surgeries. However, few publications on laparoscopic liver surgery have described the use of complete single-port access. We present our initial experience of a single-port laparoscopic hepatectomy. Between May 2012 and December 2013, 5 single-port laparoscopic hepatectomies were performed: one for benign disease and four for colorectal liver metastases. The lesions were approached through a 3-5 cm right supraumbilical incision using a single-port access device. All the lesions were located in hepatic segments II or III. Four left lateral sectorectomies and one left hepatectomy were performed. Median operative time was 135 min. No cases were converted to conventional laparoscopic or open surgery. The oral intake began at 18 h. There were no postoperative complications and no patients required blood transfusion. The median hospital stay was 3 days. The degree of satisfaction was very good in 4 cases and good in one. Patients resumed their normal daily activities at 8 days. Single-port laparoscopic hepatectomy is safe and feasible in selected cases and may reduce surgical aggression and offer better cosmetic results. Comparative studies are needed to determine the real advantages of this approach. Copyright © 2014 AEC. Published by Elsevier Espana. All rights reserved.

  5. Nonlocality of a single photon: Paths to an Einstein-Podolsky-Rosen-steering experiment

    International Nuclear Information System (INIS)

    Jones, S. J.; Wiseman, H. M.

    2011-01-01

    A single-photon incident on a beam splitter produces an entangled field state, and in principle could be used to violate a Bell inequality, but such an experiment (without postselection) is beyond the reach of current experiments. Here we consider the somewhat simpler task of demonstrating Einstein-Podolsky-Rosen (EPR) steering with a single photon (also without postselection). We demonstrate that Alice's choice of measurement on her portion of the entangled state can affect Bob's portion of the entangled state in his laboratory, in a sense rigorously defined by us and Doherty [Phys. Rev. Lett. 98, 140402 (2007)]. Previous work by Lvovsky and coworkers [Phys. Rev. Lett. 92, 047903 (2004)] has addressed this phenomenon (which they called remote preparation) experimentally using homodyne measurements on a single photon. Here we show that, unfortunately, their experimental parameters do not meet the bounds necessary for a rigorous demonstration of EPR steering with a single photon. However, we also show that modest improvements in the experimental parameters, and the addition of photon counting to the arsenal of Alice's measurements, would be sufficient to allow such a demonstration.

  6. Use of incidentally encoded memory from a single experience in cats.

    Science.gov (United States)

    Takagi, Saho; Tsuzuki, Mana; Chijiiwa, Hitomi; Arahori, Minori; Watanabe, Arii; Saito, Atsuko; Fujita, Kazuo

    2017-08-01

    We examined whether cats could retrieve and utilize incidentally encoded information from a single past event in a simple food-exploration task previously used for dogs (Fujita et al., 2012). In Experiment 1, cats were led to four open, baited containers and allowed to eat from two of them (Exposure phase). After a 15-min delay during which the cats were absent and all containers were replaced with empty ones, the cats were unexpectedly returned to the room and allowed to explore the containers (Test phase). Although the cats' first choice of container to visit was random, they explored containers from which they had not previously eaten for longer than those from which they did previously eat. In the Exposure phase of Experiment 2, two containers held food, one held a nonedible object, and the fourth was empty. Cats were allowed to eat from one of them. In the post-delay Test phase, the cats first visited the remaining baited-uneaten container significantly more often than chance and they spent more time exploring this container. Because the cats' behavior in the Test phase cannot be explained by association of the container with a pleasant experience (eating), the results suggest that cats retrieved and utilized "what" and "where" information from an incidentally encoded memory from a single experience. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. How to stimulate single mothers on welfare to find a job : Evidence from a policy experiment

    NARCIS (Netherlands)

    Knoef, M.G.; van Ours, Jan

    2016-01-01

    We present the results from a policy experiment in which single mothers on welfare were stimulated to enter the labor market and increase their work experience. The aim of the policy was not per se for single mothers to leave welfare completely but to encourage them to find a job if only a part-time

  8. Sorafenib-Regorafenib Sequential Therapy in Advanced Hepatocellular Carcinoma: A Single-Institute Experience.

    Science.gov (United States)

    Ueshima, Kazuomi; Nishida, Naoshi; Kudo, Masatoshi

    2017-01-01

    Previously, no therapeutic agent has been known to improve the overall survival compared with placebo in patients with hepatocellular carcinoma (HCC), who have progressed after sorafenib. In this patient population, regorafenib was first demonstrated to confer a survival benefit in the RESORCE trial, and subsequently it was approved as a second-line treatment for patients with advanced HCC. An open-label expanded access program (EAP) of regorafenib was implemented for compassionate use. We investigated the efficacy and safety of regorafenib based on our experience of the RESORCE trial and the EAP. Data from 5 patients from the RESORCE trial and 6 from the EAP were analyzed retrospectively. All patients had tolerated prior sorafenib and were progressing during sorafenib treatment. The median progression-free survival was 9.2 months (95% CI 2.3-16.1). One patient achieved a partial response and 7 achieved stable disease. The objective response rate was 9.1%, and the disease control rate was 72.7%. No treatment-associated mortalities were observed. Grade 3 hypophosphatemia was observed in 2 patients, grade 2 anorexia was observed in 5 patients, and grade 3 neutropenia was observed in 2 patients. Grade 2 and grade 3 thrombocytopenia were observed in 2 and 3 patients, respectively. All treatment-related adverse events were improved by reduction or interruption of regorafenib. Five patients showed decreased serum albumin levels. Sorafenib and regorafenib sequential therapy presents a safe and effective treatment option for patients with advanced HCC. © 2017 S. Karger AG, Basel.

  9. Two-Year Institution Part-Time Nurse Faculty Experiences During Role Transition and Identity Development: A Phenomenological Study.

    Science.gov (United States)

    Owens, Rhoda A

    This study explored two-year institution part-time nurse faculty's perceptions of their experiences during their role transitions from nurses in clinical practice to part-time clinical instructors. Part-time nurse faculty enter academia as expert clinicians, but most have little or no training in the pedagogy of effective student learning. A phenomenological study was used to explore the faculty role transition experiences. Findings support the proposition that six participants transitioned from their expert clinician to instructor identities; however, two continue in the process. Critical to this process are relationships with individuals in their environments, past and present experiences, the incentive to learn to be better instructors, and the importance of support and training. A model emerged, Process of Role Transition and Professional Identity Formation for Part-Time Clinical Instructors at Two-Year Institutions, that is potentially useful for administrators in developing individualized orientation and professional development programs.

  10. Single-center experience using the Freedom SOLO aortic bioprosthesis.

    Science.gov (United States)

    Iliopoulos, Dimitrios C; Deveja, Aris Rezar; Androutsopoulou, Vasiliki; Filias, Vasilios; Kastelanos, Eleftherios; Satratzemis, Vasilios; Khalpey, Zain; Koudoumas, Dimitrios

    2013-07-01

    This study reviews a single institution experience with the Freedom SOLO (Sorin Group, Saluggia, Italy) aortic bioprosthesis. Between October 2006 and February 2010, 128 patients (64 men, 64 women; mean age, 75.8 ± 5.1 years) underwent aortic valve replacement using the Freedom SOLO stentless aortic valve. The follow-up time was 36.7 ± 1.2 months and 100% complete. Concomitant procedures were performed in 77 patients (60%). The mean standard European System for Cardiac Operative Risk Evaluation was 9 ± 2.7. Grade 3 aortic stenosis was present in 73% of patients, mixed aortic stenosis and regurgitation were present in 40% of patients, and mitral regurgitation was present in 46% of patients. The mean crossclamp time was 53 ± 12 minutes for isolated Freedom SOLO aortic valve implantation and 80 ± 28 minutes for concomitant procedures, and the mean cardiopulmonary bypass time was 103 ± 31 minutes. The mean implanted valve size was 22.6 ± 1.4 mm. The mean intensive care unit and hospital stays were 2.4 ± 1.1 days and 8.8 ± 2.6 days, respectively. Three patients underwent reoperation for bleeding. The 15-day, 30-day, and perioperative mortality were all 4.6%. The 36-month survival was 95.4% ± 1.6% for the cohort with a low European System for Cardiac Operative Risk Evaluation (9). Echocardiographic data preoperatively, immediately postoperatively, and at 3, 6, and 12 months postoperatively showed peak transvalvular gradients of 75 ± 23, 17 ± 6, 18 ± 6.5, 16 ± 6, and 16 ± 9 mm Hg, respectively (P SOLO stentless aortic valve has excellent early and intermediate-term results. Published by Mosby, Inc.

  11. Motivation and Prior Animal Experience of Newly Enrolled Veterinary Nursing Students at two Irish Third-Level Institutions.

    Science.gov (United States)

    Dunne, Karen; Brereton, Bernadette; Duggan, Vivienne; Campion, Deirdre

    2017-11-03

    Veterinary nurses report an intrinsic desire to work with animals. However, this motivation may be eroded by poor working conditions and low pay, resulting in the exit of experienced veterinary nurses from clinical practice. This study sought to quantify the level of animal-handling experience students possessed at the start of their training and to explore the factors motivating them to enter veterinary nurse training in two Irish third-level institutions. The authors had noted a tendency for veterinary nursing students to possess limited animal-handling skills, despite their obvious motivation to work with animals. The study explores possible reasons for this, as it mirrors previous reports in relation to students of veterinary medicine. First-year veterinary nursing students at Dundalk Institute of Technology and University College Dublin were surveyed and a focus group was held in each institution to explore student motivations for choosing this career and their prior animal-handling experience and workplace exposure. The results show that veterinary nursing students are highly intrinsically motivated to work with and care for animals. The majority had spent time in the veterinary workplace before starting their studies but they had limited animal-handling experience beyond that of family pets, primarily dogs. The study also revealed potential tensions between the veterinary nursing and veterinary medical students at University College Dublin: a hitherto unexposed aspect of the hidden curriculum in this institution. The results of this study highlight the need for ongoing investment in practical animal-handling training for veterinary nursing students.

  12. Combining p-values in replicated single-case experiments with multivariate outcome.

    Science.gov (United States)

    Solmi, Francesca; Onghena, Patrick

    2014-01-01

    Interest in combining probabilities has a long history in the global statistical community. The first steps in this direction were taken by Ronald Fisher, who introduced the idea of combining p-values of independent tests to provide a global decision rule when multiple aspects of a given problem were of interest. An interesting approach to this idea of combining p-values is the one based on permutation theory. The methods belonging to this particular approach exploit the permutation distributions of the tests to be combined, and use a simple function to combine probabilities. Combining p-values finds a very interesting application in the analysis of replicated single-case experiments. In this field the focus, while comparing different treatments effects, is more articulated than when just looking at the means of the different populations. Moreover, it is often of interest to combine the results obtained on the single patients in order to get more global information about the phenomenon under study. This paper gives an overview of how the concept of combining p-values was conceived, and how it can be easily handled via permutation techniques. Finally, the method of combining p-values is applied to a simulated replicated single-case experiment, and a numerical illustration is presented.

  13. Shock compression experiments on Lithium Deuteride (LiD) single crystals

    Science.gov (United States)

    Knudson, M. D.; Desjarlais, M. P.; Lemke, R. W.

    2016-12-01

    Shock compression experiments in the few hundred GPa (multi-Mbar) regime were performed on Lithium Deuteride single crystals. This study utilized the high velocity flyer plate capability of the Sandia Z Machine to perform impact experiments at flyer plate velocities in the range of 17-32 km/s. Measurements included pressure, density, and temperature between ˜190 and 570 GPa along the Principal Hugoniot—the locus of end states achievable through compression by large amplitude shock waves—as well as pressure and density of reshock states up to ˜920 GPa. The experimental measurements are compared with density functional theory calculations, tabular equation of state models, and legacy nuclear driven results that have been reanalyzed using modern equations of state for the shock wave standards used in the experiments.

  14. Transsphenoidal surgery for pituitary tumors from microsurgery to the endoscopic surgery. Single surgeon's experience

    International Nuclear Information System (INIS)

    Iwai, Yoshiyasu; Yoshimura, Masaki; Terada, Aiko; Yamanaka, Kazuhiro; Koshimo, Naomi

    2011-01-01

    We reviewed results of the surgical outcome of pituitary tumors treated via the transsphenoidal approach between January, 1994 and January, 2010 at our institution. This data included 100 patients (124 procedures) treated through the sublabial transsphenoidal approach and 45 patients (54 procedures) treated through the endoscopic endonasal (bilateral nostrils) transsphenoidal approach performed by a single surgeon. The extent of tumor removal was significantly improved with endoscopic surgery; adjuvant gamma knife radiosurgery was needed for 65% of patients undergoing microsurgery vs. 30% for patients who had endoscopic surgery (p<0.0001). Patients who underwent endoscopic surgery had less intraoperative blood loss (mean volume: 100 mL for microsurgery patients vs. 30 mL for endoscopic surgery patients, p<0.0001), less pain, and less need for postoperative hormone replacement therapy (19% for microsurgery patients vs. 6% for endoscopic surgery patients; p<0.05). Cerebrospinal fluid (CSF) leakage and meningitis were experienced in one microsurgery patient (1%) and one endoscopic surgery patient (2.2%). Endoscopic surgery is a reasonable alternative to microsurgery and our experience supports the concept that an otolaryngologist/neurosurgeon team skilled in endoscopic techniques and pituitary surgery can safely make the transition from microsurgery to endoscopic surgery. (author)

  15. Evaluation of Partial Breast Reirradiation with Intraoperative Radiotherapy after Prior Thoracic Radiation: A Single-Institution Report of Outcomes and Toxicity

    Directory of Open Access Journals (Sweden)

    Christine Chin

    2017-08-01

    Full Text Available IntroductionMastectomy is the current standard of care for ipsilateral breast tumor recurrences after prior whole breast irradiation (WBI. We report our single-institution experience with breast-conserving surgery (BCS followed by intraoperative radiotherapy (IORT as an alternative to salvage mastectomy for new or recurrent breast cancers that develop in the setting of prior thoracic radiation.MethodsWe performed an IRB-approved retrospective review of patients treated with breast IORT between September 2013 and November 2016. We identified 12 patients who declined salvage mastectomy for their breast cancer after prior thoracic radiation. IORT was delivered using the Intrabeam™ device (Carl Zeiss, Germany. A dose of 20 Gy was prescribed to the lumpectomy cavity surface using 50 kV X-rays. We graded both acute and late treatment-related breast toxicities using the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Local control, mastectomy-free survival, distant metastasis, and overall survival were determined.ResultsOur study included nine patients who developed a new or recurrent ipsilateral breast cancer after prior WBI for early-stage breast cancer, two patients with primary breast cancer after mantle-field radiation for Hodgkin’s lymphoma, and one patient with a synchronous stage III non-small cell lung cancer treated with definitive radiation to the ipsilateral lung and mediastinum. The median time from prior radiation to presentation was 18 years (range: 2 months to 46 years. All patients successfully underwent partial breast reirradiation with IORT and were able to preserve their breast. At a median follow-up of 14 months (4–25 months, there were no local or distant recurrences. There was a single non-cancer-related death. In the acute setting, we observed grade 1 toxicity in 58% (n = 7, grade 2 toxicity in 17% (n = 2, and no grade 3 or higher toxicity. In the late setting, at

  16. Theoretical interpretation of SCARABEE single pin in-pile boiling experiments

    International Nuclear Information System (INIS)

    Struwe, D.; Bottoni, M.; Fries, W.; Elbel, H.; Angerer, G.

    1977-01-01

    In the framework of LMFBR safety analysis a theoretical interpretation of some of the most representative of the single pin experiments of the in-pile SCARABEE project has been performed from both viewpoints of thermohydraulic and fuel behaviour using the computer codes CAPRI-2 and SATURN-1. The analysis is aimed at investigating the pin behavior from the preirradiation history, through the observed sequence of events following a coolant mass flow reduction from boiling inception up to pin breakdown. A comparison of theoretical results with experimentally recorded data has allowed a deeper insight into the peculiar features of the experiments and enabled a valuable code verification. (Auth.)

  17. Source of single photons and interferometry with one photon. From the Young's slit experiment to the delayed choice

    International Nuclear Information System (INIS)

    Jacques, V.

    2007-11-01

    This manuscript is divided in two independent parts. In the first part, we study the wave-particle duality for a single photon emitted by the triggered photoluminescence of a single NV color center in a diamond nano-crystal. We first present the realization of a single-photon interference experiment using a Fresnel's bi-prism, in a scheme equivalent to the standard Young's double-slit textbook experiment. We then discuss the complementarity between interference and which-path information in this two-path interferometer. We finally describe the experimental realization of Wheeler's delayed-choice Gedanken experiment, which is a fascinating and subtle illustration of wave-particle duality. The second part of the manuscript is devoted to the efficiency improvement of single-photon sources. We first describe the implementation of a new single-photon source based on the photoluminescence of a single nickel-related defect center in diamond. The photophysical properties of such defect make this single-photon source well adapted to open-air quantum cryptography. We finally demonstrate an original method that leads to an improvement of single-molecule photo stability at room temperature. (author)

  18. Laparoscopic isthmocele treatment - single center experience.

    Science.gov (United States)

    Ciebiera, Michał; Ciebiera, Magdalena; Czekańska-Rawska, Magdalena; Jakiel, Grzegorz

    2017-01-01

    A cesarean section is the most frequently performed surgery in modern obstetrics. In case of an incorrect wound healing process there is a risk of a persistent uterine wall defect. Nowadays, due to the high frequency of cesarean sections, obstetricians have to deal with the threat of uterine rupture due to pathological wound healing. It has been proven that isthmocele can cause abnormal uterine bleeding (AUB), pelvic pain (PP), and secondary infertility (SI), and can be a place of improper pregnancy placement. This article presents our experience with isthmocele treatment. We describe our diagnostic process scheme, method of corrective surgery and main therapeutic outcomes. In this manuscript we present a single center's experience in isthmocele therapy. We have operated on 16 patients who suffered from abnormal uterine bleeding, pain disorders or secondary infertility possibly due to a cesarean scar defect. The results obtained in our center are promising. In 9 of 11 (81.8%) women with abnormal bleeding we obtained complete resolution of symptoms. We had slightly worse results in the case of pelvic pain. In 4 (66.6%) of 6 patients the pain resolved completely. We have obtained 7 pregnancies in 11 (63.6%) patients operated on due to secondary infertility. In our opinion, laparoscopic treatment seems to be currently one of the most effective methods in isthmocele therapy. Further investigation is necessary to determine the indications for surgery, suitable treatment strategies and appropriate care.

  19. Evaluation and enhancement of medical knowledge competency by monthly tests: a single institution experience.

    Science.gov (United States)

    Khan, Abdur Rahman; Siddiqui, Nauman Saleem; Thotakura, Raja; Hasan, Syed Shafae; Luni, Faraz Khan; Sodeman, Thomas; Hinch, Bryan; Kaw, Dinkar; Hariri, Imad; Khuder, Sadik; Assaly, Ragheb

    2015-01-01

    In-training examination (ITE) has been used as a predictor of performance at the American Board of Internal Medicine (ABIM) certifying examination. ITE however may not be an ideal modality as it is held once a year and represents snapshots of performance as compared with a trend. We instituted monthly tests (MTs) to continually assess the performance of trainees throughout their residency. To determine the predictors of ABIM performance and to assess whether the MTs can be used as a tool to predict passing the ABIM examination. The MTs, core competencies, and ITE scores were analyzed for a cohort of graduates who appeared for the ABIM examination from 2010 to 2013. Logistic regression was performed to identify the predictors of a successful performance at the ABIM examination. Fifty-one residents appeared for the ABIM examination between 2010 and 2013 with a pass rate of 84%. The MT score for the first year (odds ratio [OR] =1.302, CI =1.004-1.687, P=0.04) and second year (OR =1.125, CI =1.004-1.261, P=0.04) were independent predictors of ABIM performance along with the second-year ITE scores (OR =1.248, CI =1.096-1.420, P=0.001). The MT is a valuable tool to predict the performance at the ABIM examination. Not only it helps in the assessment of likelihood of passing the certification examination, it also helps to identify those residents who may require more assistance earlier during their residency. It may also highlight the areas of weakness in program curriculum and guide curriculum development.

  20. A Study of Pacific Islander Scholarship Football Players and Their Institutional Experience in Higher Education

    Science.gov (United States)

    Morita, Monica K.

    2013-01-01

    This study applies the theories of social and cultural capital and introduces athletic capital in order to gain an understanding of Polynesian scholarship football players and their experiences at an institution of higher education. Additionally, theories of student identity development and student-athlete development are also utilized to gain a…

  1. Student Teachers' Experiences of Teaching Practice at Open and Distance Learning Institution in South Africa

    Science.gov (United States)

    Mokoena, Sello

    2017-01-01

    This small-scale study focused on the experiences of student teachers towards teaching practice in an open and distance learning (ODL) institution in South Africa. The sample consisted of 65 fourth year students enrolled for Bachelor of Education, specializing in secondary school teaching. The mixed-method research design consisting of…

  2. Spectrum of Childhood and Adolescent Ovarian Tumors in India: 25 Years Experience at a Single Institution

    Directory of Open Access Journals (Sweden)

    Ruchi Rathore

    2016-09-01

    Full Text Available BACKGROUND: Ovarian tumour in children and adolescent girls form an uncommon but important part of gynaecological malignancies. They account for 1% of all the childhood malignancies and 8% of all abdominal tumours in children. Since the ovarian cysts are thought to arise from mature follicles, these tumours were considered to be infrequent in the paediatric population. AIM: The rarity of this condition prompted us to conduct this study and share our experience on the incidence and clinicopathological features of different ovarian tumours in girls up to 20 years of age observed in last 25 years at a single tertiary care hospital. MATERIAL AND METHODS: This was a retrospective study conducted in the Department of Pathology at a tertiary hospital, Delhi. All ovarian tumours up to the age of 20 years in the past 25 years (1990-2014 were included for the purpose of studying the clinicopathological aspects of ovarian tumours in this age group. Descriptive statistics for prevalence and age-wise prevalence was done. Chi-square test, to find an association between the age, laterality and size with malignancy was performed. RESULTS: We received a total of 1102 cases of ovarian tumours over the period of 25 years  (1990 to 2014, of which 112 (10% cases were seen in girls up to 20 years of age. The mean age of the patients was 15.3 ± 4 years. The most common presenting complaint was pain abdomen (46.4 % There was a statistically significant correlation found between size and malignancy status of tumours in our study (p = 0.00. Of 112 cases of ovarian tumours, 39/112 (34.8% were malignant and 73/112 (65.2% were benign. Mature  cystic teratoma (27.6% was the most common type of benign tumour in this age group and immature teratomas were the most common type of malignant ovarian neoplasms. CONCLUSION: Premenarchal girls with ovarian masses may have varied presentations. Abdominal pain is the most common presenting complaint of young adolescent girls with

  3. Laparoscopic adrenalectomy: Single centre experience.

    LENUS (Irish Health Repository)

    O'Farrell, N J

    2012-02-01

    BACKGROUND: Laparoscopic adrenalectomy is an attractive alternative to the traditional open approach in the surgical excision of an adrenal gland. It has replaced open adrenalectomy in our institution and we review our experience to date. METHODS: All cases of laparoscopic adrenalectomies in our hospital over eight years (from 2001 to May 2009) were retrospectively reviewed. Patient demographics, diagnosis, length of hospital stay, histology and all operative and post-operative details were evaluated. RESULTS: Fifty-five laparoscopic adrenalectomies (LA) were performed on 51 patients over eight years. The mean age was 48 years (Range 16-86 years) with the male: female ratio 1:2. Twenty-three cases had a right adrenalectomy, 24 had a left adrenalectomy and the remaining four patients had bilateral adrenalectomies. 91% were successfully completed laparoscopically with five converted to an open approach. Adenomas (functional and non functional) were the leading indication for LA, followed by phaeochromocytomas. Other indications for LA included Cushing\\'s disease, adrenal malignancies and rarer pathologies. There was one mortality from necrotising pancreatitis following a left adrenalectomy for severe Cushing\\'s disease, with subsequent death 10 days later. CONCLUSION: Laparoscopic adrenalectomy is effective for the treatment of adrenal tumours, fulfilling the criteria for the ideal minimally invasive procedure. It has replaced the traditional open approach in our centre and is a safe and effective alternative. However, in the case of severe Cushing\\'s disease, laparoscopic adrenalectomy has the potential for significant adverse outcomes and mortality.

  4. Ground-facilities at the DLR Institute of Aerospace Medicine for preparation of flight experiments

    Science.gov (United States)

    Hemmersbach, Ruth; Hendrik Anken, Ralf; Hauslage, Jens; von der Wiesche, Melanie; Baerwalde, Sven; Schuber, Marianne

    In order to investigate the influence of altered gravity on biological systems and to identify gravisensitive processes, various experimental platforms have been developed, which are useful to simulate weightlessness or are able to produce hypergravity. At the Institute of Aerospace Medicine, DLR Cologne, a broad spectrum of applications is offered to scientists: clinostats with one rotation axis and variable rotation speeds for cultivation of small objects (including aquatic organisms) in simulated weightlessness conditions, for online microscopic observations and for online kinetic measurements. Own research concentrates on comparative studies with other kinds of methods to simulate weightlessness, also available at the institute: Rotating Wall Vessel (RWV) for aquatic studies, Random Positioning Machine (RPM; manufactured by Dutch Space, Leiden, The Netherlands). Correspondingly, various centrifuge devices are available to study different test objects under hypergravity conditions -such as NIZEMI, a slow rotating centrifuge microscope, and MUSIC, a multi-sample centrifuge. Mainly for experiments with human test subjects (artificial gravity), but also for biological systems or for testing various kinds of (flight-) hardware, the SAHC, a short arm human centrifuge -loaned by ESA -was installed in Cologne and completes our experimental scenario. Furthermore, due to our specific tasks such as providing laboratories during the German Parabolic Flight Experiments starting from Cologne and being the Facility Responsible Center for BIOLAB, a science rack in the Columbus module aboard the ISS, scientists have the possibility for an optimal preparation of their flight experiments.

  5. Gleason grading challenges in the diagnosis of prostate adenocarcinoma: experience of a single institution.

    Science.gov (United States)

    Chen, Sonja D; Fava, Joseph L; Amin, Ali

    2016-02-01

    Gleason score (GS) is an important factor in determining management and outcome of prostate adenocarcinoma. A standard GS scheme was introduced by ISUP 2005 consensus conference, but there is still significant discordance in grading prostate adenocarcinomas among pathologists, especially between genitourinary-trained (GU) and non-GU pathologists. All biopsies from outside institutions referred for definitive treatment in our hospital are reviewed by a GU pathologist for confirmation and quality assurance. From 2011 to 2013, 117 consecutive prostate consults were retrieved and compared with the initial outside reports as well as final radical prostatectomy (RP) results. Follow-up prostate specific antigen (PSA) was assessed pre- and post-RP, and the results were analyzed. The overall initial GS was higher for all specimens (p = 0.007) especially for the RP cases (p = 0.002). Overall, the modal GS on initial diagnosis was GS7(4 + 3) that was downgraded to the modal GS6(3 + 3) upon review. Despite an overall substantial agreement between the non-GU and GU pathologists [ICC = 0.66], GS by GU pathologist had higher correlation with the final GS in the RP specimen [ICC = 0.62] than non-GU pathologist [ICC = 0.48]. GS on all reviewed cases were found to correlate significantly with the pre-operative PSA (p = 0.002) but the same was not true for the initial report. A non-GU pathologist is more likely to assign a higher GS than a GU pathologist, with a trend to overcall Gleason pattern 4. Considering the implications on treatment, close attention must be paid to the ISUP 2005 consensus conference recommendations.

  6. Possibilities of paired comparison of receptor binding parameters obtained in a single experiment

    International Nuclear Information System (INIS)

    Mashilova, K.V.; Kiriakov, G.V.; Malin, K.M.; Rozhanets, V.V.

    1987-01-01

    The authors explore the use of comparing control and experimental groups on the basis of extrapolation parameters obtained from a single pair of experiments. One of the experiments study the parameters of specific binding of 3 H-D-ala-2-enkephelin-5-D-leucine in the striatum of different groups of rats. The analysis was done by the Cornish-Bowden method

  7. Single particle measurements and two particle interferometry results from CERN experiment NA44

    International Nuclear Information System (INIS)

    Simon-Gillo, J.

    1994-01-01

    CERN experiment NA44 is optimized for the study of identified single and multiple particle distributions to p T = 0 near mid-rapidity. We measure π +- , K +- , p, bar p, d and bar d, in p + A and A + A collisions at 450 and 20OGeV/u, respectively. Two-particle intensity interferometry results from π + π + , K + K + , and K - K - measurements and single particle distributions are presented

  8. Cost comparison of curative therapies for localized prostate cancer in Japan. A single-institution experience

    International Nuclear Information System (INIS)

    Satoh, Takefumi; Ishiyama, Hiromichi; Matsumoto, Kazumasa

    2009-01-01

    In addition to open surgery, curative therapies for prostate cancer now include endoscopic surgery and radiation therapies. Because of the expansion and subdivision of treatment methods for prostate cancer, the medical fee point schedule in Japan was revised in fiscal year 2006. We examined changes in medical income and expenditure after this revision of the medical fee system. We studied income and expenditure, after institution of the new medical fee schedule, for the five types of therapies for prostate cancer performed at our hospital: two surgical therapies (radical retropubic prostatectomy and laparoscopic prostatectomy) and three radiation therapies (three-dimensional conformal radiation therapy, 192 Ir high-dose-rate brachytherapy, and 125 I low-dose-rate brachytherapy). Low-dose-rate brachytherapy was found to be associated with a profit of 199 yen per patient. Laparoscopic prostatectomy, a highly advanced medical treatment that the fee revision changed from a partially insured to an insured procedure, yielded a profit of 75672 yen per patient. However, high-dose-rate brachytherapy was associated with a loss of 654016 yen per patient. Given the loss in hospital income per patient undergoing high-dose-rate brachytherapy, the medical fee point system for this procedure should be reassessed. (author)

  9. ESR Experiments on a Single Donor Electron in Isotopically Enriched Silicon

    Science.gov (United States)

    Tracy, Lisa; Luhman, Dwight; Carr, Stephen; Borchardt, John; Bishop, Nathaniel; Ten Eyck, Gregory; Pluym, Tammy; Wendt, Joel; Witzel, Wayne; Blume-Kohout, Robin; Nielsen, Erik; Lilly, Michael; Carroll, Malcolm

    In this talk we will discuss electron spin resonance experiments in single donor silicon qubit devices fabricated at Sandia National Labs. A self-aligned device structure consisting of a polysilicon gate SET located adjacent to the donor is used for donor electron spin readout. Using a cryogenic HEMT amplifier next to the silicon device, we demonstrate spin readout at 100 kHz bandwidth and Rabi oscillations with 0.96 visibility. Electron spin resonance measurements on these devices show a linewidth of 30 kHz and coherence times T2* = 10 us and T2 = 0.3 ms. We also discuss estimates of the fidelity of our donor electron spin qubit measurements using gate set tomography. This work was performed, in part, at the Center for Integrated Nanotechnologies, a U.S. DOE Office of Basic Energy Sciences user facility. Sandia National Laboratories is a multi-program laboratory operated by Sandia Corporation, a Lockheed-Martin Company, for the U. S. Department of Energy under Contract No. DE-AC04-94AL85000. ESR Experiments on a Single Donor Electron in Isotopically Enriched Silicon.

  10. Reliability of 3-Dimensional Measures of Single-Leg Cross Drop Landing Across 3 Different Institutions: Implications for Multicenter Biomechanical and Epidemiological Research on ACL Injury Prevention.

    Science.gov (United States)

    DiCesare, Christopher A; Bates, Nathaniel A; Barber Foss, Kim D; Thomas, Staci M; Wordeman, Samuel C; Sugimoto, Dai; Roewer, Benjamin D; Medina McKeon, Jennifer M; Di Stasi, Stephanie; Noehren, Brian W; Ford, Kevin R; Kiefer, Adam W; Hewett, Timothy E; Myer, Gregory D

    2015-12-01

    Anterior cruciate ligament (ACL) injuries are physically and financially devastating but affect a relatively small percentage of the population. Prospective identification of risk factors for ACL injury necessitates a large sample size; therefore, study of this injury would benefit from a multicenter approach. To determine the reliability of kinematic and kinetic measures of a single-leg cross drop task across 3 institutions. Controlled laboratory study. Twenty-five female high school volleyball players participated in this study. Three-dimensional motion data of each participant performing the single-leg cross drop were collected at 3 institutions over a period of 4 weeks. Coefficients of multiple correlation were calculated to assess the reliability of kinematic and kinetic measures during the landing phase of the movement. Between-centers reliability for kinematic waveforms in the frontal and sagittal planes was good, but moderate in the transverse plane. Between-centers reliability for kinetic waveforms was good in the sagittal, frontal, and transverse planes. Based on these findings, the single-leg cross drop task has moderate to good reliability of kinematic and kinetic measures across institutions after implementation of a standardized testing protocol. Multicenter collaborations can increase study numbers and generalize results, which is beneficial for studies of relatively rare phenomena, such as ACL injury. An important step is to determine the reliability of risk assessments across institutions before a multicenter collaboration can be initiated.

  11. Postoperative complications following intraoperative radiotherapy in abdominopelvic malignancy: A single institution analysis of 113 consecutive patients.

    Science.gov (United States)

    Abdelfatah, Eihab; Page, Andrew; Sacks, Justin; Pierorazio, Phillip; Bivalacqua, Trinity; Efron, Jonathan; Terezakis, Stephanie; Gearhart, Susan; Fang, Sandy; Safar, Bashar; Pawlik, Timothy M; Armour, Elwood; Hacker-Prietz, Amy; Herman, Joseph; Ahuja, Nita

    2017-06-01

    Intraoperative radiotherapy (IORT) has advantages over external beam radiation therapy (EBRT). Few studies have described side effects associated with its addition. We evaluated our institution's experience with abdominopelvic IORT to assess safety by postoperative complication rates. Prospectively collected IRB-approved database of all patients receiving abdominopelvic IORT (via high dose rate brachytherapy) at Johns Hopkins Hospital between November 2006 and May 2014 was reviewed. Patients were discussed in multidisciplinary conferences. Those selected for IORT were patients for whom curative intent resection was planned for which IORT could improve margin-negative resection and optimize locoregional control. Perioperative complications were classified via Clavien-Dindo scale for postoperative surgical complications. A total of 113 patients were evaluated. Most common diagnosis was sarcoma (50/113, 44%) followed by colorectal cancer (45/113, 40%), most of which were recurrent (84%). There were no perioperative deaths. A total of 57% of patients experienced a complication Grade II or higher: 24% (27/113) Grade II; 27% (30/113) Grade III; 7% (8/113) Grade IV. Wound complications were most common (38%), then gastrointestinal (25%). No radiotherapy variables were significantly associated with complications on uni/multi-variate analysis. Our institution's experience with IORT demonstrated historically expected postoperative complication rates. IORT is safe, with acceptable perioperative morbidity. © 2017 Wiley Periodicals, Inc.

  12. Extrapulmonary small-cell carcinoma series in a single-institution experience. With a case report of small cell carcinoma in the hypopharynx

    International Nuclear Information System (INIS)

    Monobe, Hiroko; Kagoya, Ryoji; Tojima, Hitoshi

    2010-01-01

    Extrapulmonary small-cell carcinoma (EPSCC) is clinically underrecognized and optimal management remains illusive. Although head and neck EPSCC tends to involve early widespread dissemination and poor prognosis, recently reported favorable outcomes have used concurrent chemoradiotherapy in limited-stage disease. We report an EPSCC case of arising in the hypopharynx successfully treated by induction chemotherapy followed by concurrent chemoradiotherapy. To clarify EPSCC clinically, we retrospectively reviewed clinical courses of all EPSCC records between 1999 and 2008 in a single-institution series. The 14 subjects identified had primary sites at the gastrointestinal tract in 5, uterine cervix in 3, genitourinary system in 2 and at the gallbladder, liver, hypopharynx, and an unidentified primary lymph node in one case each. Of the 14, 2 cases had stage I, 2 cases had stage II, 4 cases had stage III, 5 cases had stage IV in tumor-node-metastasis (TNM) classification. Stage IV subjects usually underwent platinum-based chemotherapy, to which 25% showed partial response (PR) and 75% progressive disease (PD) with median overall survival (OS) of 114.0 days, or 16 weeks. Of stage III or lower subjects, 75% underwent surgery and 62.5% chemotherapy. OS was 1244.0 days or 3.7 years and 2-year survival rates was estimated at 87.5%. Survival duration differed significantly between those in stage III or lower and those in group IV. Age significantly affected survival time in the Cox proportional hazard regression model. Brain metastasis was uncommon in this series, despite the absence of prophylactic cranial radiation. Further studies are needed to improve and clarify the clinical EPSCC course. (author)

  13. Dielectronic recombination experiments with tungsten ions at the test storage ring and development of a single-particle detector at the cryogenic storage ring

    International Nuclear Information System (INIS)

    Spruck, Kaija

    2015-05-01

    This work is about electron-ion collision experiments at the ion storage rings of the Max Planck Institute for Nuclear Physics in Heidelberg. Absolute recombination rate coefficients of highly-charged tungsten ions featuring an open 4-f-shell structure have been measured at the heavy-ion storage ring TSR. The resulting plasma rate coefficients have been used to probe the significance of newly developed theoretical approaches. Plasma rate coefficients of highly-charged tungsten ions are in particular interesting for the development of plasma models for nuclear fusion reactors, since tungsten is a foreseeable impurity in the fusion plasma. In the relevant temperature range, the experimental results exceed the theoretical data used so far by up to a factor of 10, showing the need for more reliable theoretical calculations. Furthermore, based on the design of the detectors which have been used in the experiments at TSR, a movable single-particle detector for electron-ion recombination studies at the cryogenic storage ring CSR has been developed and installed within the scope of this work. The device has been designed specifically to meet the requirements of the CSR regarding low ion energies and cryogenic ambient temperature conditions. In a series of experiments, the detector was carefully characterised and successfully tested for its compatibility with these requirements. The detector was part of the infrastructure used for the room-temperature commissioning of CSR (2014) and is currently operated as a single-particle counter during the first cryogenic operation of CSR in 2015.

  14. Dielectronic recombination experiments with tungsten ions at the test storage ring and development of a single-particle detector at the cryogenic storage ring

    Energy Technology Data Exchange (ETDEWEB)

    Spruck, Kaija

    2015-05-15

    This work is about electron-ion collision experiments at the ion storage rings of the Max Planck Institute for Nuclear Physics in Heidelberg. Absolute recombination rate coefficients of highly-charged tungsten ions featuring an open 4-f-shell structure have been measured at the heavy-ion storage ring TSR. The resulting plasma rate coefficients have been used to probe the significance of newly developed theoretical approaches. Plasma rate coefficients of highly-charged tungsten ions are in particular interesting for the development of plasma models for nuclear fusion reactors, since tungsten is a foreseeable impurity in the fusion plasma. In the relevant temperature range, the experimental results exceed the theoretical data used so far by up to a factor of 10, showing the need for more reliable theoretical calculations. Furthermore, based on the design of the detectors which have been used in the experiments at TSR, a movable single-particle detector for electron-ion recombination studies at the cryogenic storage ring CSR has been developed and installed within the scope of this work. The device has been designed specifically to meet the requirements of the CSR regarding low ion energies and cryogenic ambient temperature conditions. In a series of experiments, the detector was carefully characterised and successfully tested for its compatibility with these requirements. The detector was part of the infrastructure used for the room-temperature commissioning of CSR (2014) and is currently operated as a single-particle counter during the first cryogenic operation of CSR in 2015.

  15. Decommissioning project feedback experience in the Japan Atomic Energy Research Institut

    International Nuclear Information System (INIS)

    Yanagihara, S.; Tachibana, M.; Miyajima, K.

    2003-01-01

    Since starting the research and development program for peaceful use of nuclear energy in 1950's, various research and demonstration facilities have been constructed in research organizations, universities and commercial sectors in Japan. Some of the nuclear facilities constructed in the early stage of research and development have been retired to be decommissioned because of completion of the initial objectives in the Japan Atomic Energy Research Institute (JAERI). On the other hand, since the first commercial operation of nuclear power plant (1968), the number of nuclear power plants has increased up to 52 plants operating as of August 2003 in Japan. The shear of nuclear energy accounts approximately for 35% of electricity generation in total at present time. However, several nuclear power plants have been operated for more than 25 years and two nuclear power plants are expected to be finally shutdown by 2010 to be eventually decommissioned. The Tokai Power Station, the oldest Japanese nuclear power plant operated by the Japan Atomic Power Company, was permanently shutdown from March 1998 and it is in decommissioning stage at this time. The Fugen, which is advanced thermal reactor operated by the Japan Nuclear Cycle Development Institute (JNC), was finally shutdown on March, 2003 after 25 years operation to be decommissioned. In addition, relating to planned unification between JAERI and JNC in 2005, the studies have been in progress on decommissioning and radioactive waste treatment and disposal; the cost was estimated to be 10 to 30 billion Japanese yens per year during 80 years for decommissioning of nearly 200 nuclear facilities. Decommissioning of nuclear facilities is thus getting to be one of important issues in Japan. Decommissioning of nuclear facilities might be possible using conventional and/or partially improved technology. However, reviewing project feedback experience on decommissioning and decontamination might contribute to solve various issues

  16. Brachytherapy or Conformal External Radiotherapy for Prostate Cancer: A Single-Institution Matched-Pair Analysis

    International Nuclear Information System (INIS)

    Pickles, Tom; Keyes, Mira; Morris, W. James

    2010-01-01

    Purpose: In the absence of randomized study data, institutional case series have shown brachytherapy (BT) to produce excellent biochemical control (bNED) in patients with localized prostate cancer compared with alternative curative treatments. This study was designed to overcome some of the limitations of case series studies by using a matched-pair design in patients treated contemporaneously with BT and external beam radiation therapy (EBRT) at a single institution. Methods and Materials: Six hundred one eligible patients treated between 1998 and 2001 were prospectively followed up in our institutional databases and matched on a 1:1 basis for the following known prognostic variables: prostate-specific antigen (PSA) level, Gleason score, T stage, the use and duration of neoadjuvant androgen deprivation therapy, and the percentage of positive tissue core samples. Two hundred seventy-eight perfect matches of patients (139 in each group) with low- and intermediate-risk cancer were further analyzed. bNED (Phoenix definition) was the primary endpoint. Other endpoints were toxicity, PSA kinetics, and the secondary use of androgen deprivation therapy. Results: The 5-year bNED rates were 95% (BT) and 85% (EBRT) (p < 0.001). After 7 years, the BT bNED result was unchanged, but the rate in EBRT patients had fallen to 75%. The median posttreatment PSA nadirs were 0.04 ng/mL (BT) and 0.62 ng/mL (EBRT, p < 0.001), which predicted a higher ongoing treatment failure rate in association with EBRT use than with BT use. Late urinary toxicity and rectal/bowel toxicity were worse in patients treated with BT and EBRT, respectively. Conclusions: BT for both low-risk and selected intermediate-risk cancers achieves exceptional cure rates. Even with dose escalation, it will be difficult for EBRT to match the proven track record of BT seen over the past decade.

  17. A wireless centrifuge force microscope (CFM) enables multiplexed single-molecule experiments in a commercial centrifuge.

    Science.gov (United States)

    Hoang, Tony; Patel, Dhruv S; Halvorsen, Ken

    2016-08-01

    The centrifuge force microscope (CFM) was recently introduced as a platform for massively parallel single-molecule manipulation and analysis. Here we developed a low-cost and self-contained CFM module that works directly within a commercial centrifuge, greatly improving accessibility and ease of use. Our instrument incorporates research grade video microscopy, a power source, a computer, and wireless transmission capability to simultaneously monitor many individually tethered microspheres. We validated the instrument by performing single-molecule force shearing of short DNA duplexes. For a 7 bp duplex, we observed over 1000 dissociation events due to force dependent shearing from 2 pN to 12 pN with dissociation times in the range of 10-100 s. We extended the measurement to a 10 bp duplex, applying a 12 pN force clamp and directly observing single-molecule dissociation over an 85 min experiment. Our new CFM module facilitates simple and inexpensive experiments that dramatically improve access to single-molecule analysis.

  18. Stories from early-career women physicians who have left academic medicine: a qualitative study at a single institution.

    Science.gov (United States)

    Levine, Rachel B; Lin, Fenny; Kern, David E; Wright, Scott M; Carrese, Joseph

    2011-06-01

    The number of women in academic medicine has steadily increased, although gender parity still does not exist and women leave academics at somewhat higher rates than men. The authors investigated the reasons why women leave careers in academic medicine. Semistructured, one-on-one interviews were conducted in 2007-2008 with 20 women physicians who had left a single academic institution to explore their reasons for opting out of academic careers. Data analysis was iterative, and an editing analysis style was used to derive themes. A lack of role models for combining career and family responsibilities, frustrations with research (funding difficulties, poor mentorship, competition), work-life balance, and the institutional environment (described as noncollaborative and biased in favor of male faculty) emerged as key factors associated with a decision to leave academic medicine for respondents. Faced with these challenges, respondents reevaluated their priorities and concluded that a discrepancy existed between their own and institutional priorities. Many respondents expressed divergent views with the institutional norms on how to measure success and, as a consequence, felt that they were undervalued at work. Participants report a disconnection between their own priorities and those of the dominant culture in academic medicine. Efforts to retain women faculty in academic medicine may include exploring the aspects of an academic career that they value most and providing support and recognition accordingly.

  19. Refugee Immigrants' Experiences of Racism and Racial Discrimination at Australian TAFE Institutes: A Transformative Psychosocial Approach

    Science.gov (United States)

    Onsando, Gerald; Billett, Stephen

    2017-01-01

    This paper discusses experiences of racism and racial discrimination of seven refugee immigrants attending different courses at two Technical and Further Education (TAFE) institutes in South East Queensland, Australia. In doing so, the paper draws from two studies that focused on resettlement of refugee immigrants in Australia. A transformative…

  20. Retrocausation acting in the single-electron double-slit interference experiment

    Science.gov (United States)

    Hokkyo, Noboru

    The single electron double-slit interference experiment is given a time-symmetric interpretation and visualization in terms of the intermediate amplitude of transition between the particle source and the detection point. It is seen that the retarded (causal) amplitude of the electron wave expanding from the source shows an advanced (retrocausal) bifurcation and merging in passing through the double-slit and converges towards the detection point as if guided by the advanced (retrocausal) wave from the detected electron. An experiment is proposed to confirm the causation-retrocausation symmetry of the electron behavior by observing the insensitivity of the interference pattern to non-magnetic obstacles placed in the shadows of the retarded and advanced waves appearing on the rear and front sides of the double-slit.

  1. Transjugular Intrahepatic Portosystemic Shunt for Treatment of Cirrhosis-related Chylothorax and Chylous Ascites: Single-institution Retrospective Experience

    Energy Technology Data Exchange (ETDEWEB)

    Kikolski, Steven G., E-mail: skikolski@ucsd.edu; Aryafar, Hamed, E-mail: haryafar@ucsd.edu; Rose, Steven C., E-mail: scrose@ucsd.edu [University of California San Diego Health Sciences, Department of Radiology (United States); Roberts, Anne C., E-mail: acroberts@ucsd.edu [University of California San Diego Health Sciences, Department of Vascular and Interventional Radiology (United States); Kinney, Thomas B., E-mail: tbkinney@ucsd.edu [University of California San Diego Health Sciences, Department of Radiology (United States)

    2013-08-01

    PurposeTo investigate the efficacy and safety of the use of transjugular intrahepatic portosystemic shunt (TIPS) creation to treat cirrhosis-related chylous collections (chylothorax and chylous ascites).MethodsWe retrospectively reviewed data from four patients treated for refractory cirrhosis-related chylous collections with TIPS at our institution over an 8 year period.ResultsOne patient had chylothorax, and three patients had concomitant chylothorax and chylous ascites. There were no major complications, and the only procedure-related complications occurred in two patients who had mild, treatable hepatic encephalopathy. All patients had improvement as defined by decreased need for thoracentesis or paracentesis, with postprocedure follow-up ranging from 19 to 491 days.ConclusionTIPS is a safe procedure that is effective in the treatment of cirrhosis-related chylous collections.

  2. Extending the applicability of an open-ring trap to perform experiments with a single laser-cooled ion

    Energy Technology Data Exchange (ETDEWEB)

    Cornejo, J. M.; Colombano, M.; Doménech, J.; Rodríguez, D., E-mail: danielrodriguez@ugr.es [Departamento de Física Atómica, Molecular y Nuclear, Universidad de Granada, 18071 Granada (Spain); Block, M. [GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt (Germany); Helmholtz-Institut Mainz, 55099 Mainz (Germany); Institut für Kernchemie, University of Mainz, 55099 Mainz (Germany); Delahaye, P. [Grand Accélérateur National d’Ions Lourds, 14000 Caen (France)

    2015-10-15

    A special ion trap was initially built up to perform β-ν correlation experiments with radioactive ions. The trap geometry is also well suited to perform experiments with laser-cooled ions, serving for the development of a new type of Penning trap, in the framework of the project TRAPSENSOR at the University of Granada. The goal of this project is to use a single {sup 40}Ca{sup +} ion as detector for single-ion mass spectrometry. Within this project and without any modification to the initial electrode configuration, it was possible to perform Doppler cooling on {sup 40}Ca{sup +} ions, starting from large clouds and reaching single ion sensitivity. This new feature of the trap might be important also for other experiments with ions produced at radioactive ion beam facilities. In this publication, the trap and the laser system will be described, together with their performance with respect to laser cooling applied to large ion clouds down to a single ion.

  3. Nurses' Perceptions of Pediatric Intensive Care Unit Environment and Work Experience After Transition to Single-Patient Rooms.

    Science.gov (United States)

    Kudchadkar, Sapna R; Beers, M Claire; Ascenzi, Judith A; Jastaniah, Ebaa; Punjabi, Naresh M

    2016-09-01

    The architectural design of the pediatric intensive care unit may play a major role in optimizing the environment to promote patients' sleep while improving stress levels and the work experience of critical care nurses. To examine changes in nurses' perceptions of the environment of a pediatric critical care unit for promotion of patients' sleep and the nurses' work experience after a transition from multipatient rooms to single-patient rooms. A cross-sectional survey of nurses was conducted before and after the move to a new hospital building in which all rooms in the pediatric critical care unit were single-patient rooms. Nurses reported that compared with multipatient rooms, single-patient private rooms were more conducive to patients sleeping well at night and promoted a more normal sleep-wake cycle (P noise in single-patient rooms (33%) than in multipatient rooms (79%; P pediatric intensive care unit environment for promoting patients' sleep and the nurses' own work experience. ©2016 American Association of Critical-Care Nurses.

  4. Feasibility of single-incision laparoscopic surgery for appendicitis in abnormal anatomical locations: A single surgeon′s initial experience

    Directory of Open Access Journals (Sweden)

    Sanoop K Zachariah

    2013-01-01

    Full Text Available Background: Single-incision laparoscopic surgery is considered as a more technically demanding procedure than the standard laparoscopic surgery. Based on an initial and early experience, single-incision laparoscopic appendectomy (LA was found to be technically advantageous for dealing with appendicitis in unusual anatomical locations. This study aims to highlight the technical advantages of single-incision laparoscopic surgery in dealing with the abnormally located appendixes and furthermore report a case of acute appendicitis occurring in a sub-gastric position, which is probably the first such case to be reported in English literature. Materials and Methods: A retrospective analysis of the first 10 cases of single-incision LA which were performed by a single surgeon is presented here. Results: There were seven females and three males. The mean age of the patients was 30.6 (range 18-52 years, mean BMI was 22.7 (range 17-28 kg/m 2 and the mean operative time was 85.5 (range 45-150 min. The mean postoperative stay was 3.6 (range 1-7 days. The commonest position of the appendix was retro-caecal (50% followed by pelvic (30%. In three cases the appendix was found to be in abnormal locations namely sub-hepatic, sub-gastric and deep pelvic or para-vesical or para-rectal. All these cases could be managed with this technique without any conversions Conclusion: Single-incision laparoscopic surgery appears to be a feasible and safe technique for dealing with appendicitis in rare anatomical locations. Appendectomy may be a suitable procedure for the initial training in single-incision laparoscopic surgery.

  5. Event-by-event simulation of single-neutron experiments to test uncertainty relations

    International Nuclear Information System (INIS)

    Raedt, H De; Michielsen, K

    2014-01-01

    Results from a discrete-event simulation of a recent single-neutron experiment that tests Ozawa's generalization of Heisenberg's uncertainty relation are presented. The event-based simulation algorithm reproduces the results of the quantum theoretical description of the experiment but does not require the knowledge of the solution of a wave equation, nor does it rely on detailed concepts of quantum theory. In particular, the data from these non-quantum simulations satisfy uncertainty relations derived in the context of quantum theory. (paper)

  6. Laparoendoscopic single site surgery in urology: A single centre experience

    Directory of Open Access Journals (Sweden)

    Arvind P Ganpule

    2012-01-01

    Full Text Available Objective : To analyze our experience of 87 cases with single port surgery, which is also known as laparoendoscopic single site surgery (LESS. Materials and Methods: Case records of all LESS procedures performed between December 2007 and June 2010 were analysed. The procedures performed were donor nephrectomy (n=45, simple nephrectomy (n=27, radical nephrectomy (n=5, pyeloplasty (n=9, and ureteroneocystostomy (n=1. Parameters analysed were operating room (OR time, estimated blood loss (EBL, visual analogue score (VAS, and complications in all patients undergoing LESS procedure and additionally, warm ischaemia time (WIT and graft outcome in patients undergoing LESS donor nephrectomy. In reconstructive procedures, the functional assessment was performed with a diuretic renogram at 6 months. Results: In LESS donor nephrectomy, the mean WIT was 6.9 ± 1.9 min. Mean serum creatinine in recipients at 1 month was 0.96 ± 0.21 mg%. We encountered one instance each of renal artery injury, renal vein injury, large bowel injury, minor cortical laceration at the upper pole and two instances of diaphragmatic injury. In LESS simple nephrectomy, the average OR time was 148.7 ± 52.2 min and hospital stay was 3.7 ± 1.2 days. There was one instance of large bowel injury during specimen retrieval. In LESS radical nephrectomy, the average OR time was 202.5 ± 35.7 min and average hospital stay was 4.2 ± 1.3 days. 6 patients of LESS pyeloplasty completed follow up with a diuretic renogram showing a good drainage. LESS ureteroneocystostomy could also be performed successfully without any complications. Conclusion: LESS surgery can be accomplished safely in nephrectomy and reconstructive procedures such as pyeloplasty and ureteroneocystostomy with equivalent outcomes as standard laparoscopy and with added benefits of cosmesis and quicker convalescence. LESS donor nephrectomy is a technically feasible procedure; current status of procedure needs to be proved with

  7. Impact of Single-Case Pupil Descriptions on Student Teacher Attitudes towards Inclusive Education

    Science.gov (United States)

    Röhm, Alexander; Schnöring, Annika; Hastall, Matthias R.

    2018-01-01

    Institutional and individual stigmatization are still major barriers for children with disabilities to access education. Teacher attitudes towards inclusive education play a crucial role in this regard, and are shaped by single-case descriptions from mass media or other sources. Building on exemplification theory and priming, two experiments with…

  8. The lived experience of pregnancy complications in single older women.

    Science.gov (United States)

    Mandel, Deborah

    2010-01-01

    To explore the lived experience of single older women (35 years or older at time of birth) who experienced complications in their planned pregnancy. Phenomenology, using semistructured interviews with 11 women between the ages of 35 to 48 years. Six themes emerged: (a) motherhood now or never, (b) the known and unknown, (c) importance of support, (d) the stigma of single motherhood, (e) changing priorities, and (f) long-term concerns for themselves and child/children. Nurses who work with pregnant women should understand as much as possible about the issues affecting older single women who choose pregnancy; this offers the best opportunity to provide comprehensive care. These women can be at increased risk for many pregnancy complications, and should receive counseling about their risks for both fetal and maternal complications. Nurses should also conduct a thorough psychosocial assessment to determine what support systems are in place and what resources are available if complications arise. In the intrapartum and postpartum settings, nurses can offer not only appropriate physical caregiving but also a supportive and caring attitude with women in this circumstance. Helping women maintain a sense of control by helping them to participate in their care planning is essential.

  9. Hemostatic powder TC-325 in the management of upper and lower gastrointestinal bleeding: a two-year experience at a single institution.

    Science.gov (United States)

    Chen, Yen-I; Barkun, Alan; Nolan, Sabrina

    2015-02-01

    TC-325 is a novel endoscopic hemostatic powder. Our aim was to describe a single-center experience with the use of TC-325 in the upper and lower gastrointestinal tract, while for the first time attempting to determine how long the powder remains on a lesion. The charts of consecutive patients receiving TC-325 therapy between July 2011 and July 2013 were reviewed retrospectively. Primary endpoints included immediate hemostasis and early rebleeding (≤ 72 hours). Overall, 60 patients received 67 treatments with TC-325: 21 for nonmalignant nonvariceal upper gastrointestinal bleeding, 19 for malignant upper gastrointestinal bleeding, 11 for lower gastrointestinal bleeding, and 16 for intra-procedural bleeding. Immediate hemostasis was achieved in 66 cases (98.5 %), with 6 cases (9.5 %) of early rebleeding. No serious adverse events were noted. No TC-325 powder was identified in the 11 patients who underwent second-look endoscopy, performed within 24 hours in 4 patients. TC-325 appears safe and effective for managing bleeding in the upper and lower gastrointestinal tract with a variety of causes. The time during which the powder remains in the gastrointestinal tract is short, with complete elimination from the gastrointestinal tract as early as within 24 hours after use. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Transverse Single-Spin Asymmetries in Proton-Proton Collisions at the AFTER@LHC Experiment

    Directory of Open Access Journals (Sweden)

    K. Kanazawa

    2015-01-01

    Full Text Available We present results for transverse single-spin asymmetries in proton-proton collisions at kinematics relevant for AFTER, a proposed fixed-target experiment at the Large Hadron Collider. These include predictions for pion, jet, and direct photon production from analytical formulas already available in the literature. We also discuss specific measurements that will benefit from the higher luminosity of AFTER, which could help resolve an almost 40-year puzzle of what causes transverse single-spin asymmetries in proton-proton collisions.

  11. Spin-path entanglement in single-neutron interferometer experiments

    International Nuclear Information System (INIS)

    Hasegawa, Yuji; Erdoesi, Daniel

    2011-01-01

    There are two powerful arguments against the possibility of extending quantum mechanics (QM) into a more fundamental theory yielding a deterministic description of nature. One is the experimental violation of Bell inequalities, which discards local hidden-variable theories as a possible extension to QM. The other is the Kochen-Specker (KS) theorem, which stresses the incompatibility of QM with a larger class of hidden-variable theories, known as noncontextual hidden-variable theories. We performed experiments with neutron interferometer, which exploits spin-path entanglements in single neutrons. A Bell-like state is generated to demonstrate a violation of the Bell-like inequality and phenomena in accordance with KS theorem: both experiments study quantum contextuality and show clear evidence of the incompatibility of noncontextual hidden variable theories with QM. The value S = 2.202±0.007≰2 is obtained in the new measurement of the Bell-like inequality, which shows a larger violation than the previous measurement. For the study of KS theorem, the obtained violation 2.291±0.008≰1 clearly shows that quantum mechanical predictions cannot be reproduced by noncontextual hidden variable theories.

  12. Surgical management of adrenal cysts: a single-institution experience

    Directory of Open Access Journals (Sweden)

    Xiao Lyu

    2014-10-01

    Full Text Available Objective To analyze surgical methods and evaluate treatment efficacy and safety for managing adrenal cystic lesions. Materials and methods All patients presenting with adrenal lesions of the West China Hospital were reviewed retrospectively from January 2003 to April 2013 and 47 were diagnosed as adrenal cysts. Basic information, clinical history, physical examination, laboratory investigations, abdominal ultrasound and enhanced computed tomography were detailed noted. Cysts with different surgical management were analyzed and surgery option operative time, postoperative complications and after-surgery hospital stay were all noted. The final diagnosis was judged by histopathology. Patients were followed from 3 month to 10 years. Results All the 47 patients with a mean age of 43.8 years were managed by surgical intervention. Compared laparoscopic technology with open technology, the laparoscopic has the advantage of a shorter operation time, shorter hospital stay after surgery and enhanced cosmesis. The histopathologic result was: 23 (50% were endothelial cysts and 16 (35% were pseudocysts. One patient had evidence to recurrence at the followed-up stage. Conclusion Adrenal cysts are rare and with the development of imaging techniques many of these are diagnosed incidentally. CT has advantages in detecting the cysts with haemorrhage, intracystic debris, calcification and mixed adrenal mass. Minimally invasive surgery offers equivalent efficacy to traditional open procedures, while providing a shorter operation time, shorter convalescence and improved cosmesis. Patients after surgical resection should be followed up closely especially if functional cysts and histopathology of cystic tumor are present.

  13. Primary breast lymphoma: A single-institute experience in Taiwan

    Directory of Open Access Journals (Sweden)

    Che-Wei Ou

    2014-10-01

    Full Text Available Background: Breast is an uncommon location of lymphoma involvement. The most common type of primary breast lymphoma (PBL is diffuse large B-cell lymphoma (DLBCL. Rituximab is the widely used monoclonal antibody against CD20+ B-cell lymphoma, especially DLBCL. We aimed to analyze the clinical features, prognostic factors, and treatment outcome with or without rituximab in primary breast DLBCL. Methods: We retrospectively analyzed patients diagnosed with PBL from October 1987 to March 2012 in our hospital, excluding metastasis by whole-body computed tomography and bone marrow study. Results: Twenty-three patients were diagnosed with PBL. All were females. Eighteen patients were stage IE and five were stage IIE according to the Ann Arbor staging system. Two patients had lymphoma other than DLBCL. The median age of primary breast DLBCL patients was 48 years (range 27-79. Two were excluded from the analysis due to refusal or ineligibility for chemotherapy. No significant prognostic factor was found. Patients receiving chemotherapy with (RC or without (C rituximab were not significantly different in the 5-year overall survival (RC: 57.1%; C: 58.3%; p = 0.457 or progression-free survival (RC: 57.1%; C: 50.0%; p = 0.456. A high incidence of relapse in the central nervous system (CNS (17.6% was observed. Conclusions: In accordance with prior literature reports, our Taiwanese cohort of primary breast DLBCL seemed younger than those reported in Japan, Korea, and Western societies. Relapse in the CNS was not uncommon. The benefit of rituximab in addition to chemotherapy was not statistically significant. Treatment modality remained to be defined by further large-scale studies.

  14. A feasible quantum optical experiment capable of refuting noncontextuality for single photons

    International Nuclear Information System (INIS)

    Cereceda, Jose L

    2002-01-01

    Elaborating on a previous work by Simon et al (2000 Phys. Rev. Lett. 85 1783) we propose a realizable quantum optical single-photon experiment using standard present day technology, capable of discriminating maximally between the predictions of quantum mechanics (QM) and noncontextual hidden variable theories (NCHV). Quantum mechanics predicts a gross violation (up to a factor of 2) of the noncontextual Bell-like inequality associated with the proposed experiment. An actual maximal violation of this inequality would demonstrate (modulo fair sampling) an all-or-nothing type contradiction between QM and NCHV

  15. Shock compression experiments on Lithium Deuteride single crystals.

    Energy Technology Data Exchange (ETDEWEB)

    Knudson, Marcus D.; Desjarlais, Michael Paul; Lemke, Raymond W.

    2014-10-01

    S hock compression exper iments in the few hundred GPa (multi - Mabr) regime were performed on Lithium Deuteride (LiD) single crystals . This study utilized the high velocity flyer plate capability of the Sandia Z Machine to perform impact experiments at flyer plate velocities in the range of 17 - 32 km/s. Measurements included pressure, density, and temperature between %7E200 - 600 GPa along the Principal Hugoniot - the locus of end states achievable through compression by large amplitude shock waves - as well as pressure and density of re - shock states up to %7E900 GPa . The experimental measurements are compared with recent density functional theory calculations as well as a new tabular equation of state developed at Los Alamos National Labs.

  16. On the scalar electron mass limit from single photon experiments

    International Nuclear Information System (INIS)

    Grivaz, J.F.

    1987-03-01

    We discuss how the 90% C.L. lower limit on the mass of the scalar electron, as extracted from the single photon experiments, is affected by the way the background from radiative neutrino pair production is handled. We argue that some of the results presented at the Berkeley conference are overoptimistic, and that the mass lower limit is 65 GeV rather than the advertized value of 84 GeV, for the case of degenerate scalar electrons with massless photinos

  17. Implementation of the GFS physical package in the GRAPES regional model: single column experiment

    Science.gov (United States)

    Chen, Baode; Huang, Wei; Bao, Jian-wen

    2015-04-01

    There is a growing concern about coupling among physical components in NWP models. The Physics package of the NCEP Global Forecast System (GFS) has been considerably turned and connection among various components is well considered. Thus, the full GFS physical package was implemented into the GRAPES-MESO and its single column version as well. Using the data collected at ARM Southern Great Plain site during the summer 1997 Intensive Observing Period, several experiments of single-column model (SCM) were conducted to test performance of a set of original physical processes of GRAPES(CTL experiment) and the GFS physics package implemented(GFS experiment). Temperature, moisture, radiation, surface heat flux, surface air temperature and precipitation are evaluated. It is found that potential temperature and vapor mixing ratio simulated by GFS experiment is more accurate than that of CTL experiment. Errors of surface downward solar and long-wave radiation simulated by GFS experiment are less than that of CTL experiment and upward latent and sensible heat flux are also better agreeing with observation. The maximum and minimum 2-m air temperatures of the GFS experiment are close to observation compared with that of CTL experiment. Analysis of precipitation simulated shows that both sets of physical processes well reproduce heavy rainfall events. Failure and delay of moderate rainfall events and over predictions of drizzle events are commonly found for two sets of experiments. For the case of three rainfall events, the errors of potential temperature and vapor mixing ratio simulated by GFS experiment were smaller than that of CTL experiment. It is shown that the late occurrences of rainfall are resulted from a more stable temperature profile and lower moisture simulated in boundary layer than those from the observation prior to rainfall. When the simulated rainfall occurs, the simulated temperature and moisture become more favorable to the precipitation than observation.

  18. Evaluation acting: the experience of a public research institute

    International Nuclear Information System (INIS)

    Guimaraes, Regia Ruth Ramirez; Ferreira, Hudson Rubio; Filgueiras, Sergio A. Cunha

    2007-01-01

    Innovation and knowledge management are central questions of the modern world economy where the incorporation of new knowledge is determining for competition. In this context, there is a movement of pression under public research institutions for a more dynamic participation on the local innovation system. The institutions of C and T should prepare to help the companies to insert in the context of open economies and also to compete in the global market. The modernity requires flexibility and organizational changes in the research institutions. Redefinitions of their practices in relation to other aspects such as: financing sources; partnership with other organizations; definition and planning of the objectives; evaluation, diffusion and valorization of the results and the establishing of a measuring system and performance indicators. Aiming at having an effective institutional insertion on the national and regional systems of innovation, the Nuclear Technology Development Center - CDTN reformulated its strategical planning, incorporating the view of the researchers of the Center and external experts. As part of the evaluation process, CDTN organizes an annual seminar for evaluating its projects, focused on presenting the results and also on the analysis of the performance indicators. The result of this pairs review are widely informed to the Institution and is an important tool for the critical analysis of the institutional performance and for corrections to be made by the high direction. This paper presents the methodology for evaluating the results, as well as the difficulties and improvements incorporated to the process, which has been applied for three years. (author)

  19. Theoretical and experimental study of single particle tracking in extreme conditions: single photon imaging

    International Nuclear Information System (INIS)

    Cajgfinger, T.

    2012-10-01

    This manuscript presents my thesis on the high frame rate (500 frames / second) single-photon detector electron-bombarded CMOS (ebCMOS). The first section compares three ultra-sensitive detectors and their methods for improving photon sensitivity: the CMOS low noise (sCMOS), the electron-multiplying CCD (emCCD) with signal multiplication by pixel and the ebCMOS with amplification by applied electric field. The method developed to detect single photon impacts with intra-pixel resolution on the ebCMOS sensor is presented. The second section compares the localization accuracy of these detectors in extreme conditions of very low photon flux (<10 photons/frame). First the theoretical limit is calculated using the Cramer-Rao lower bound for significant parameter sets. An experimental comparison of the detectors is then described. The setup provides one or more point sources controlled in position, signal and background noise. The results allow a comparison of the experimental effectiveness, purity and localization accuracy. The last section describes two experiments with the ebCMOS camera. The first aims at tracking hundreds of quantum dots simultaneously at the Nanoptec center. The second focuses on the swimming of bacteria at the surface at the Joliot Curie Institute. The point sources tracking algorithm using single photons and the Kalman filter implementation developed for these experiments is also described. (author)

  20. One Hundred Twenty-One Resected Solid Pseudopapillary Tumors of the Pancreas: An 8-Year Single-Institution Experience at Zhongshan Hospital, Shanghai, China.

    Science.gov (United States)

    Xu, Yadong; Zhao, Guochao; Pu, Ning; Nuerxiati, Abulimiti; Ji, Yuan; Zhang, Lei; Rong, Yefei; Lou, Wenhui; Wang, Dansong; Kuang, Tiantao; Xu, Xuefeng; Wu, Wenchuan

    2017-09-01

    The aims of this study were to introduce our experience with treating patients with pancreatic solid pseudopapillary tumors (SPTs) and to investigate the clinical risk factors for recurrence of SPTs because no consensus has been established to date. One hundred twenty-one patients underwent surgical resection from January 2008 to December 2015 in our institution. Clinical data were collected from the standardized reports. Of the 121 patients, 93 (76.9%) were women, 28 (23.1%) were men, and the mean age at diagnosis was 33.7 years (range, 11-68 years). Sixty patients were subjected to short-term complications, and 8 patients experienced long-term complications, some of whom may require surgery. The tumor located in the distal pancreas (P = 0.02), and a Ki-67 index value > 1.5 (P = 0.01) indicated malignancy according to the World Health Organization 2000 classification. One hundred three patients responded to follow-up, and 3 cases (2.9%) were subject to liver metastases. Recurrence was more frequently observed in tumors classified as high-grade malignancies according to the World Health Organization 2010 classification (P = 0.013), synchronous metastases (P < 0.001), peripancreatic fat infiltration (P = 0.018), and lymphovascular invasion (P < 0.001). Evaluating the risk of the recurrence of SPTs still requires systematic and multicenter trials in the future, even some pathological features showed statistical differences.

  1. Radiotherapy as an effective treatment modality for follicular lymphoma: a single institution experience

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seo Hee; Cho, Jae Ho; Kim, Jin Seok; Cheong, June Won; Suh, Chang Ok [Dept. of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-12-15

    Follicular lymphoma (FL) is an indolent non-Hodgkin's lymphoma that is highly sensitive to radiotherapy (RT). However, the effectiveness of RT has not been well established. We reviewed our experiences to assess the role of RT for FL and analyze treatment results. Retrospective analysis was done on 29 patients who received first RT between January 2003 and August 2013. Of 23 early stage (stage I, II) patients, 16 received RT alone, four received chemotherapy followed by RT, two received RT postoperatively, and one received salvage RT for relapse after resection. Six advanced-stage (stage III, IV) patients received RT after chemotherapy: two received consolidation RT, three received salvage RT for residual lesions, and one received RT for progressive sites. Median RT dose was 30.6 Gy (range, 21.6 to 48.6 Gy). Median follow-up duration was 62 months (range, 6 to 141 months). All patients showed complete response in the radiation field. Eight outfield relapses were reported. Seven patients received salvage treatment (three chemotherapy, four RT). Four patients showed excellent responses, especially to RT. Estimated 5-year and 10-year relapse-free survivals were 72% and 60%. In the RT-alone group, 5-year relapse-free survival was 74.5%. All advanced-stage patients were disease-free with 100% 5-year overall survival. Disease-specific death was noted in only one patient; four others died of other unrelated causes. No significant toxicity was reported. RT resulted in excellent treatment outcomes for all FL stages when used as a primary treatment modality for early stage or salvage-treatment modality for advanced-stage disease.

  2. Implications of surgical intervention in the treatment of neuroblastomas. 20-year experience of a single institution

    International Nuclear Information System (INIS)

    Tajiri, Tatsuro; Souzaki, Ryota; Kinoshita, Yoshiaki; Koga, Yuhki; Suminoe, Aiko; Hara, Toshiro; Taguchi, Tomoaki

    2012-01-01

    The implications of surgical intervention for neuroblastomas were assessed in one institution. We analyzed the clinical characteristics and extension of resection in 123 pediatric patients with neuroblastoma diagnosed between 1985 and 2004. The 5-year survival rate of the 82 patients under 12 months of age, 59 of whom were treated with complete resection of the primary tumor, was 97%. The 5-year survival rate of the 41 patients over 12 months of age did not differ significantly according to whether complete (n=19) or incomplete resection (n=22) was performed (46 vs. 38%, respectively). No local recurrence was observed in ten patients over 12 months of age with stage 4 disease who underwent complete resection of the primary tumor; however, four of these ten patients died of metastatic recurrence. Considering that the majority of infantile neuroblastomas in this study had favorable biology, complete resection might be unnecessary for patients under 12 years of age. For advanced neuroblastomas in patients over 12 months of age, the main treatment for metastasis is systemic chemotherapy, although extirpation of the primary tumor without extensive surgery might prevent local recurrence when combined with radiation therapy. (author)

  3. The Religious and Spiritual Experiences of Undergraduate Gay Males Attending a Religiously Affiliated Institution of Higher Education

    Science.gov (United States)

    Adams, Melvin D., III

    2013-01-01

    This doctoral thesis studied the religious and spiritual experiences of undergraduate gay males at a Protestant affiliated higher education institution and how undergraduate gay males made sense of their personal journeys. Data was collected from four participants and analyzed using interpretative phenomenological analysis. Five themes emerged…

  4. Endogenous and costly institutional deterrence

    Science.gov (United States)

    David C. Kingsley; Thomas C. Brown

    2014-01-01

    Modern economies rely on central-authority institutions to regulate individual behaviour. Despite the importance of such institutions little is known about their formation within groups. In a public good experiment, groups selected the level of deterrence implemented by the institution, knowing that the administrative costs of the institution rose with the level of...

  5. Possible ramifications of introducing the institute of personal bankruptcy: The USA experience

    Directory of Open Access Journals (Sweden)

    Mizdraković Vule

    2016-01-01

    economic crisis and the role of personal bankruptcy as its most probable cause yields a conclusion that the adequate legal regulation of this process is paramount. The experiences of countries that have already introduced this legal institute are invaluable. The countries in the region which have set too rigorous rules for debt write-offs are currently facing the option of undertaking massive write-offs of debtors' claims, which are most unlikely to be objective. On the other hand, in the countries which have envisaged too flexible proceedings for debt write-offs, there is a negative selection of debtors and default of financial institutions. With this experience in mind, it is necessary to regulate and apply the institute of personal bankruptcy so that it provides for the maximum debt collection as well as for accomplishing the major social goals.

  6. Intrathecal trastuzumab in the management of HER2+ breast leptomeningeal disease: a single institution experience.

    Science.gov (United States)

    Figura, Nicholas B; Long, Wendy; Yu, Michael; Robinson, Timothy J; Mokhtari, Sepideh; Etame, Arnold B; Tran, Nam D; Diaz, Roberto; Soliman, Hatem; Han, Heather S; Sahebjam, Solmaz; Forsyth, Peter A; Ahmed, Kamran A

    2018-06-01

    Leptomeningeal disease is a rare and devastating presentation of advanced stage metastatic breast cancer with historically poor overall survival. We assessed the safety and feasibility of intrathecal (IT) trastuzumab in HER2+ leptomeningeal disease. A total of 13 patients were treated at our institution with IT trastuzumab beginning November 2012 and followed until November 2017. Outcomes including craniospinal progression as well as overall survival (OS) following initiation of IT trastuzumab were assessed from review of the clinical chart and radiologic examinations. The median age of patients was 48 (range 29-75). Median time from breast cancer diagnosis to development of brain metastases was 87.7 months with a median of 4.6 months from brain metastases diagnosis to the development of leptomeningeal disease. Previous whole brain radiotherapy was received by the majority of patients (92%) and prior surgery for brain metastases was performed in 23%. Median duration of IT trastuzumab treatment was 6.4 months. Median time from IT trastuzumab start to craniospinal progression was 5.7 months with 6- and 12-month Kaplan-Meier rates of 41 and 21%, respectively. Sustained responses > 6 months were achieved in 4 patients. Median survival from the start of IT trastuzumab was 10.6 months with 6- and 12-month OS rates of 68 and 47%, respectively. IT trastuzumab was well tolerated with one patient developing ventriculitis, which resolved with IV antibiotics. IT trastuzumab was well tolerated with prolongation of OS over historical controls. IT trastuzumab should be considered for management of HER2+ leptomeningeal disease patients.

  7. An inter-professional approach to personalized medicine education: one institution's experience.

    Science.gov (United States)

    Formea, Christine M; Nicholson, Wayne T; Vitek, Carolyn Rohrer

    2015-03-01

    Personalized medicine offers the promise of better diagnoses, targeted therapies and individualized treatment plans. Pharmacogenomics is an integral component of personalized medicine; it aids in the prediction of an individual's response to medications. Despite growing public acceptance and emerging clinical evidence, this rapidly expanding field of medicine is slow to be adopted and utilized by healthcare providers, although many believe that they should be knowledgeable and able to apply pharmacogenomics in clinical practice. Institutional infrastructure must be built to support pharmacogenomic implementation. Multidisciplinary education for healthcare providers is a critical component for pharmacogenomics to achieve its full potential to optimize patient care. We describe our recent experience at the Mayo Clinic implementing pharmacogenomics education in a large, academic healthcare system facilitated by the Mayo Clinic Center for Individualized Medicine.

  8. Initial experience with the new da Vinci single-port robot-assisted platform.

    Science.gov (United States)

    Ballestero Diego, R; Zubillaga Guerrero, S; Truan Cacho, D; Carrion Ballardo, C; Velilla Diez, G; Calleja Hermosa, P; Gutiérrez Baños, J L

    2017-06-01

    To describe our experience in the first cases of urological surgeries performed with the da Vinci single-port robot-assisted platform. We performed 5 single-port robot-assisted surgeries (R-LESS) between May and October 2014. We performed 3 ureteral reimplant surgeries, one ureteropyeloplasty in an inverted kidney and 1 partial nephrectomy. The perioperative and postoperative results were collected, as well as a report of the complications according to the Clavien classification system. Of the 5 procedures, 4 were performed completely by LESS, while 1 procedure was reconverted to multiport robot-assisted surgery. There were no intraoperative complications. We observed perioperative complications in 4 patients, all of which were grade 1 or 2. The mean surgical time was 262minutes (range, 230-300). In our initial experience with the da Vinci device, R-LESS surgery was feasible and safe. There are still a number of limitations in its use, which require new and improved R-LESS platforms. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Image-guided cryoablation for the treatment of painful musculoskeletal metastatic disease: a single-center experience

    Energy Technology Data Exchange (ETDEWEB)

    Prologo, J.D. [Emory University Hospital, Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Atlanta, GA (United States); Passalacqua, Matthew; Patel, Indravadan; Bohnert, Nathan [University Hospitals Case Medical Center, Department of Radiology, Cleveland, OH (United States); Corn, David J. [University Hospitals Case Medical Center, Departments of Radiology and Biomedical Engineering, Cleveland, OH (United States)

    2014-11-15

    The role of image-guided thermal ablation techniques for the nonoperative local management of painful osseous metastatic disease has expanded during recent years, and several advantages of cryoablation in this setting have emerged. The purpose of this study is to retrospectively evaluate and report a single-center experience of CT-guided percutaneous cryoablation in the setting of painful musculoskeletal metastatic disease. This study was approved by the institutional review board and is compliant with the Health Insurance Portability and Accountability Act. Electronic medical records of all patients who underwent percutaneous image-guided palliative cryoablation at our institution were reviewed (n = 61). An intent-to-treat analysis was performed. Records were reviewed for demographic data and anatomical data, primary tumor type, procedure details, and outcome - including change in analgesic requirements (expressed as morphine equivalent dosages), pain scores (utilizing the clinically implemented visual analog scale), subsequent therapies (including radiation and/or surgery), and complications during the 24 h following the procedure and at 3 months. Patients were excluded (n = 7) if data were not retrospectively identifiable at the defined time points. Fifty-four tumors were ablated in 50 patients. There were statistically significant decreases in the median VAS score and narcotic usage at both 24 h and 3 months (p < 0.000). Six patients (11 %) incurred complications related to their therapy. Two patients had no relief at 24 h, of which both reported worsened pain at 3 months. One patient had initial relief but symptom recurrence at 3 months. Four patients went on to have radiation therapy of the ablation site at some point following the procedure. CT-guided cryoablation is a safe, effective, reproducible procedural option for the nonoperative local treatment of painful musculoskeletal metastatic disease. (orig.)

  10. Image-guided cryoablation for the treatment of painful musculoskeletal metastatic disease: a single-center experience

    International Nuclear Information System (INIS)

    Prologo, J.D.; Passalacqua, Matthew; Patel, Indravadan; Bohnert, Nathan; Corn, David J.

    2014-01-01

    The role of image-guided thermal ablation techniques for the nonoperative local management of painful osseous metastatic disease has expanded during recent years, and several advantages of cryoablation in this setting have emerged. The purpose of this study is to retrospectively evaluate and report a single-center experience of CT-guided percutaneous cryoablation in the setting of painful musculoskeletal metastatic disease. This study was approved by the institutional review board and is compliant with the Health Insurance Portability and Accountability Act. Electronic medical records of all patients who underwent percutaneous image-guided palliative cryoablation at our institution were reviewed (n = 61). An intent-to-treat analysis was performed. Records were reviewed for demographic data and anatomical data, primary tumor type, procedure details, and outcome - including change in analgesic requirements (expressed as morphine equivalent dosages), pain scores (utilizing the clinically implemented visual analog scale), subsequent therapies (including radiation and/or surgery), and complications during the 24 h following the procedure and at 3 months. Patients were excluded (n = 7) if data were not retrospectively identifiable at the defined time points. Fifty-four tumors were ablated in 50 patients. There were statistically significant decreases in the median VAS score and narcotic usage at both 24 h and 3 months (p < 0.000). Six patients (11 %) incurred complications related to their therapy. Two patients had no relief at 24 h, of which both reported worsened pain at 3 months. One patient had initial relief but symptom recurrence at 3 months. Four patients went on to have radiation therapy of the ablation site at some point following the procedure. CT-guided cryoablation is a safe, effective, reproducible procedural option for the nonoperative local treatment of painful musculoskeletal metastatic disease. (orig.)

  11. Understanding Single-Thread Meandering Rivers with High Sinuosity on Mars through Chemical Precipitation Experiments

    Science.gov (United States)

    Lim, Y.; Kim, W.

    2015-12-01

    Meandering rivers are extremely ubiquitous on Earth, yet it is only recently that single-thread experimental channels with low sinuosity have been created. In these recent experiments, as well as in natural rivers, vegetation plays a crucial role in maintaining a meandering pattern by adding cohesion to the bank and inhibiting erosion. The ancient, highly sinuous channels found on Mars are enigmatic because presumably vegetation did not exist on ancient Mars. Under the hypothesis that Martian meandering rivers formed by chemical precipitation on levees and flood plain deposits, we conducted carbonate flume experiments to investigate the formation and evolution of a single-thread meander pattern without vegetation. The flow recirculating in the flume is designed to accelerate chemical reactions - dissolution of limestone using CO2 gas to produce artificial spring water and precipitation of carbonates to increase cohesion- with precise control of water discharge, sediment discharge, and temperature. Preliminary experiments successfully created a single-thread meandering pattern through chemical processes. Carbonate deposits focused along the channel sides improved the bank stability and made them resistant to erosion, which led to a stream confined in a narrow path. The experimental channels showed lateral migration of the bend through cut bank and point bar deposits; intermittent floods created overbank flow and encouraged cut bank erosion, which enhanced lateral migration of the channel, while increase in sediment supply improved lateral point bar deposition, which balanced erosion and deposition rates. This mechanism may be applied to terrestrial single-thread and/or meandering rivers with little to no vegetation or before its introduction to Earth and also provide the link between meandering river records on Mars to changes in Martian surface conditions.

  12. Why Public Comments Matter: The Case of the National Institutes of Health Policy on Single Institutional Review Board Review of Multicenter Studies.

    Science.gov (United States)

    Ervin, Ann-Margret; Taylor, Holly A; Ehrhardt, Stephan; Meinert, Curtis L

    2018-03-06

    In 2014, the National Institutes of Health (NIH) requested public comments on a draft policy requiring NIH-funded, U.S.-based investigators to use a single institutional review board (sIRB) for ethical review of multicenter studies. The authors conducted a directed content analysis and qualitative summary of the comments and discuss how they shaped the final policy. Two reviewers independently assessed support for the policy from a review of comments responding to the draft policy in 2016. A reviewer conducted an open text review to identify prespecified and additional comment themes. A second researcher reviewed 20% of the comments; discrepancies were resolved through discussion. The NIH received 167 comments: 65% (108/167) supportive of the policy, 23% (38/167) not supportive, and 12% (21/167) not indicating support. Clarifications or changes to the policy were suggested in 102/167 comments (61%). Criteria for selecting sIRBs were addressed in 32/102 comments (31%). Also addressed were IRB responsibilities (39/102; 38%), cost (27/102; 26%), the role of local IRBs (14/102; 14%), and allowable policy exceptions (19/102; 19%). The NIH further clarified or provided additional guidance for selection criteria, IRB responsibilities, and cost in the final policy (June 2016). Local IRB reviews and exemptions guidance were unchanged. In this case study, public comments were effective in shaping policy as the NIH modified provisions or planned supplemental guidance in response to comments. Yet critical knowledge gaps remain and empirical data are necessary. The NIH is considering mechanisms to support the establishment of best practices for sIRB implementation.

  13. DNA origami as biocompatible surface to match single-molecule and ensemble experiments

    Science.gov (United States)

    Gietl, Andreas; Holzmeister, Phil; Grohmann, Dina; Tinnefeld, Philip

    2012-01-01

    Single-molecule experiments on immobilized molecules allow unique insights into the dynamics of molecular machines and enzymes as well as their interactions. The immobilization, however, can invoke perturbation to the activity of biomolecules causing incongruities between single molecule and ensemble measurements. Here we introduce the recently developed DNA origami as a platform to transfer ensemble assays to the immobilized single molecule level without changing the nano-environment of the biomolecules. The idea is a stepwise transfer of common functional assays first to the surface of a DNA origami, which can be checked at the ensemble level, and then to the microscope glass slide for single-molecule inquiry using the DNA origami as a transfer platform. We studied the structural flexibility of a DNA Holliday junction and the TATA-binding protein (TBP)-induced bending of DNA both on freely diffusing molecules and attached to the origami structure by fluorescence resonance energy transfer. This resulted in highly congruent data sets demonstrating that the DNA origami does not influence the functionality of the biomolecule. Single-molecule data collected from surface-immobilized biomolecule-loaded DNA origami are in very good agreement with data from solution measurements supporting the fact that the DNA origami can be used as biocompatible surface in many fluorescence-based measurements. PMID:22523083

  14. Geothermal District Heating Institutional Factors: The Klamath Falls Experience

    Energy Technology Data Exchange (ETDEWEB)

    Lienau, Paul J

    1984-01-01

    The city of Klamath Falls Geothermal District Heating System started to provide heat to 10 government buildings on March 20, 1984. This startup was two and one-half years after construction of the system was completed and the operation is scheduled for only a four-month test period. The delay was the result of citizens objecting to pumping and injecting geothermal fluids in the reservoir and was legally enforced by means of a city ordinance passed by the voters. This Initiative Ordinance essentially regulates the resource by requiring any additional water pumped from a geothermal well be returned to that same well. The state of Oregon filed a lawsuit against the city, claiming that state regulation preempted city action. The issue currently is in the Court of Appeals, after Klamath County Circuit Court ruled that the state was not preempted and the ordinance was valid and enforceable. Historical description of development that led up to these institutional and legal problems are discussed. Citizens objections and third party mitigation measures by means of reservoir engineering studies and public meetings are described. Lessons learned from the Klamath Falls experience are pointed out so future developments in other communities may benefit.

  15. Photon-HDF5: An Open File Format for Timestamp-Based Single-Molecule Fluorescence Experiments

    OpenAIRE

    Ingargiola, Antonino; Laurence, Ted; Boutelle, Robert; Weiss, Shimon; Michalet, Xavier

    2016-01-01

    We introduce Photon-HDF5, an open and efficient file format to simplify exchange and long-term accessibility of data from single-molecule fluorescence experiments based on photon-counting detectors such as single-photon avalanche diode, photomultiplier tube, or arrays of such detectors. The format is based on HDF5, a widely used platform- and language-independent hierarchical file format for which user-friendly viewers are available. Photon-HDF5 can store raw photon data (timestamp, channel n...

  16. Observation and applications of single-electron charge signals in the XENON100 experiment

    NARCIS (Netherlands)

    Aprile, E.; et al., [Unknown; Alfonsi, M.; Colijn, A.P.; Decowski, M.P.

    2014-01-01

    The XENON100 dark matter experiment uses liquid xenon in a time projection chamber (TPC) to measure xenon nuclear recoils resulting from the scattering of dark matter weakly interacting massive particles (WIMPs). In this paper, we report the observation of single-electron charge signals which are

  17. The Challenge to Foster Foreign Students’ Experiences for Sustainable Higher Educational Institutions

    Directory of Open Access Journals (Sweden)

    Tomás M. Bañegil-Palacios

    2018-02-01

    Full Text Available While most companies are developing strategies that focus on responsibility and sustainability, recent discussions in higher educational institutions query the contribution of university social responsibility. Based on the theory of stakeholders and the new strategic paradigm of universities becoming sustainable corporations, the purpose of this paper is to determine Erasmus students’ opinions on their experiences abroad, as they relate to the importance they attribute to their emotions, and their relationship with and loyalty to their host university’s country as a tourism destination. The method inquired into Erasmus students’ impressions when studying in Spain through an ad hoc questionnaire based on academic literature and the Delphi technique. Survey data was analyzed through an exploratory factor analysis and partial least squares structural equation modeling. The study is a first attempt at analyzing experiential marketing in Erasmus students, who we considered tourists. The results support experiential marketing as a key approach for achieving sustainability in universities. The paper draws attention to the need for institutions to be more aware of the needs of foreign students as important stakeholders when designing mobility programs, as well as suggestions on how this awareness can be cultivated, in order to contribute to the consolidation of the selected country as a tourism destination.

  18. The interfacial strength of carbon nanofiber epoxy composite using single fiber pullout experiments.

    Science.gov (United States)

    Manoharan, M P; Sharma, A; Desai, A V; Haque, M A; Bakis, C E; Wang, K W

    2009-07-22

    Carbon nanotubes and nanofibers are extensively researched as reinforcing agents in nanocomposites for their multifunctionality, light weight and high strength. However, it is the interface between the nanofiber and the matrix that dictates the overall properties of the nanocomposite. The current trend is to measure elastic properties of the bulk nanocomposite and then compare them with theoretical models to extract the information on the interfacial strength. The ideal experiment is single fiber pullout from the matrix because it directly measures the interfacial strength. However, the technique is difficult to apply to nanocomposites because of the small size of the fibers and the requirement for high resolution force and displacement sensing. We present an experimental technique for measuring the interfacial strength of nanofiber-reinforced composites using the single fiber pullout technique and demonstrate the technique for a carbon nanofiber-reinforced epoxy composite. The experiment is performed in situ in a scanning electron microscope and the interfacial strength for the epoxy composite was measured to be 170 MPa.

  19. Observation of Electroweak Single Top-Quark Production with the CDF II Experiment

    International Nuclear Information System (INIS)

    Lueck, Jan

    2009-01-01

    The standard model of elementary particle physics (SM) predicts, besides the top-quark pair production via the strong interaction, also the electroweak production of single top-quarks (19). Up to now, the Fermilab Tevatron proton-antiproton-collider is the only place to produce and study top quarks emerging from hadron-hadron-collisions. Top quarks were directly observed in 1995 during the Tevatron Run I at a center-of-mass energy of √s = 1.8 TeV simultaneously by the CDF and D0 Collaborations via the strong production of top-quark pairs. Run II of the Tevatron data taking period started 2001 at √s = 1.96 TeV after a five year upgrade of the Tevatron accelerator complex and of both experiments. One main component of its physics program is the determination of the properties of the top quark including its electroweak production. Even though Run II is still ongoing, the study of the top quark is already a successful endeavor, confirmed by dozens of publications from both Tevatron experiments. A comprehensive review of top-quark physics can be found in reference. The reasons for searching for single top-quark production are compelling. As the electroweak top-quark production proceeds via a Wtb vertex, it provides the unique opportunity of the direct measurement of the CKM matrix element |V tb |, which is expected to be |V tb | ∼ 1 in the SM. Significant deviations from unity could be an indication of a fourth quark generation, a production mode via flavor-changing neutral currents, and other new phenomena, respectively. There are two dominating electroweak top-quark production modes at the Fermilab Tevatron: the t-channel exchange of a virtual W boson striking a b quark and the s-channel production of a timelike W boson via the fusion of two quarks. In proton-antiproton-collisions the third electroweak production mode, the associated Wt production of an on-shell W boson in conjunction with a top quark has a comparatively negligible small predicted cross section

  20. Observation of Electroweak Single Top-Quark Production with the CDF II Experiment

    Energy Technology Data Exchange (ETDEWEB)

    Lueck, Jan [Karlsruhe Inst. of Technology (Germany)

    2009-07-24

    The standard model of elementary particle physics (SM) predicts, besides the top-quark pair production via the strong interaction, also the electroweak production of single top-quarks [19]. Up to now, the Fermilab Tevatron proton-antiproton-collider is the only place to produce and study top quarks emerging from hadron-hadron-collisions. Top quarks were directly observed in 1995 during the Tevatron Run I at a center-of-mass energy of √s = 1.8 TeV simultaneously by the CDF and D0 Collaborations via the strong production of top-quark pairs. Run II of the Tevatron data taking period started 2001 at √s = 1.96 TeV after a five year upgrade of the Tevatron accelerator complex and of both experiments. One main component of its physics program is the determination of the properties of the top quark including its electroweak production. Even though Run II is still ongoing, the study of the top quark is already a successful endeavor, confirmed by dozens of publications from both Tevatron experiments. A comprehensive review of top-quark physics can be found in reference. The reasons for searching for single top-quark production are compelling. As the electroweak top-quark production proceeds via a Wtb vertex, it provides the unique opportunity of the direct measurement of the CKM matrix element |Vtb|, which is expected to be |Vtb| ~ 1 in the SM. Significant deviations from unity could be an indication of a fourth quark generation, a production mode via flavor-changing neutral currents, and other new phenomena, respectively. There are two dominating electroweak top-quark production modes at the Fermilab Tevatron: the t-channel exchange of a virtual W boson striking a b quark and the s-channel production of a timelike W boson via the fusion of two quarks. In proton-antiproton-collisions the third electroweak production mode, the associated Wt production of an on-shell W boson in conjunction with a top quark has a comparatively negligible small

  1. Parental experience of family resources in single-parent families having a child with cancer.

    Science.gov (United States)

    Huang, I-Chen; Mu, Pei-Fan; Chiou, Tzeon-Jye

    2008-10-01

    The purpose of this study was to explore the essence of family experiences in terms of family resources and how these assist a single-parent caring for a child with cancer. When families face stresses caused by cancer, they need to readjust their roles, interactive patterns and relationships, both inside and outside the family. During the adaptation process, family resources may assist recovery from stress and a return to equilibrium. Most research has emphasised the support resources available to two-parent families during the treatment process. There is a lack of information on the experiences of single-parent families and their available resources together with the functions and roles played by family resources during the adjustment process. Qualitative. Five major themes were identified: (i) facing the disease with courage; (ii) hope kindled by professionals; (iii) constructing parental role ability; (iv) assisting the children to live with the illness; and (v) family flexibility. The results of the current study demonstrate that single-parent families with a child suffering from cancer employ family resources to assist family adjustment and to maintain family function/equilibrium. These results explain the dynamic interactions between the multiple levels of resources available to the family. The study results provide evidence-based information that identifies the nature of family resources in single-parent families and describes how these resources can be applied to assist the families.

  2. Safety of cardiac magnetic resonance and contrast angiography for neonates and small infants: a 10-year single-institution experience

    Energy Technology Data Exchange (ETDEWEB)

    Rangamani, Sheela; Li, Ling; Harvey, Lisa; Fletcher, Scott E.; Danford, David A.; Kutty, Shelby [University of Nebraska College of Medicine/Creighton University School of Medicine, Joint Division of Pediatric Cardiology, Omaha, NE (United States); Varghese, Joby [Children' s Hospital and Medical Center, Division of Pediatric Cardiac Anesthesia, Omaha, NE (United States); Hammel, James M.; Duncan, Kim F. [Children' s Hospital and Medical Center, Division of Cardiothoracic Surgery, Omaha, NE (United States)

    2012-11-15

    With increasing applications of cardiac magnetic resonance (CMR) and magnetic resonance angiography (MRA) for evaluation of congenital heart disease (CHD), safety of this technology in the very young is of particular interest. We report our 10-year experience with CMR in neonates and small infants with particular focus on the safety profile and incidence of adverse events (AEs). We reviewed clinical, anesthesia and nursing records of all children {<=}120 days of age who underwent CMR. We recorded variables including cardiac diagnosis, study duration, anesthesia type and agents, prostaglandin E1 (PGE1) dependence and gadolinium (Gd) use. Serially recorded temperature, systemic saturation (SpO{sub 2}) and cardiac rhythm were analyzed. Primary outcome measure was any AE during or <24 h after the procedure, including minor AEs such as hypothermia (axillary temperature {<=}95 F), desaturation (SpO{sub 2} drop {>=}10% below baseline) and bradycardia (heart rate {<=}100 bpm). Secondary outcome measure was unplanned overnight hospitalization of outpatients. Children (n = 143; 74 boys, 69 girls) had a median age of 6 days (1-117), and 98 were {<=}30 days at the time of CMR. The median weight was 3.4 kg (1.4-6 kg) and body surface area 0.22 m{sup 2} (0.13-0.32 m{sup 2}). There were 118 (83%) inpatients (108 receiving intensive care) and 25 (17%) outpatients. Indications for CMR were assessment of aortic arch (n = 57), complex CHD (n = 41), pulmonary veins (n = 15), vascular ring (n = 8), intracardiac mass (n = 8), pulmonary artery (n = 7), ventricular volume (n = 4), and systemic veins (n = 3). CMR was performed using a 1.5-T scanner and a commercially available coil. CMR utilized general anesthesia (GA) in 86 children, deep sedation (DS) in 50 and comforting methods in seven. MRA was performed in 136 children. Fifty-nine children were PGE1-dependent and 39 had single-ventricle circulation. Among children on PGE1, 43 (73%) had GA and 10 (17%) had DS. Twelve children (9%) had

  3. Safety of cardiac magnetic resonance and contrast angiography for neonates and small infants: a 10-year single-institution experience

    International Nuclear Information System (INIS)

    Rangamani, Sheela; Li, Ling; Harvey, Lisa; Fletcher, Scott E.; Danford, David A.; Kutty, Shelby; Varghese, Joby; Hammel, James M.; Duncan, Kim F.

    2012-01-01

    With increasing applications of cardiac magnetic resonance (CMR) and magnetic resonance angiography (MRA) for evaluation of congenital heart disease (CHD), safety of this technology in the very young is of particular interest. We report our 10-year experience with CMR in neonates and small infants with particular focus on the safety profile and incidence of adverse events (AEs). We reviewed clinical, anesthesia and nursing records of all children ≤120 days of age who underwent CMR. We recorded variables including cardiac diagnosis, study duration, anesthesia type and agents, prostaglandin E1 (PGE1) dependence and gadolinium (Gd) use. Serially recorded temperature, systemic saturation (SpO 2 ) and cardiac rhythm were analyzed. Primary outcome measure was any AE during or 2 drop ≥10% below baseline) and bradycardia (heart rate ≤100 bpm). Secondary outcome measure was unplanned overnight hospitalization of outpatients. Children (n = 143; 74 boys, 69 girls) had a median age of 6 days (1-117), and 98 were ≤30 days at the time of CMR. The median weight was 3.4 kg (1.4-6 kg) and body surface area 0.22 m 2 (0.13-0.32 m 2 ). There were 118 (83%) inpatients (108 receiving intensive care) and 25 (17%) outpatients. Indications for CMR were assessment of aortic arch (n = 57), complex CHD (n = 41), pulmonary veins (n = 15), vascular ring (n = 8), intracardiac mass (n = 8), pulmonary artery (n = 7), ventricular volume (n = 4), and systemic veins (n = 3). CMR was performed using a 1.5-T scanner and a commercially available coil. CMR utilized general anesthesia (GA) in 86 children, deep sedation (DS) in 50 and comforting methods in seven. MRA was performed in 136 children. Fifty-nine children were PGE1-dependent and 39 had single-ventricle circulation. Among children on PGE1, 43 (73%) had GA and 10 (17%) had DS. Twelve children (9%) had adverse events (AEs) - one major and 11 minor. Of those 12, nine children had GA (10%) and three had DS (6%). The single major AE was

  4. Intensity modulated radiotherapy (IMRT in the treatment of children and Adolescents - a single institution's experience and a review of the literature

    Directory of Open Access Journals (Sweden)

    Huber Peter

    2009-09-01

    Full Text Available Abstract Background While IMRT is widely used in treating complex oncological cases in adults, it is not commonly used in pediatric radiation oncology for a variety of reasons. This report evaluates our 9 year experience using stereotactic-guided, inverse planned intensity-modulated radiotherapy (IMRT in children and adolescents in the context of the current literature. Methods Between 1999 and 2008 thirty-one children and adolescents with a mean age of 14.2 years (1.5 - 20.5 were treated with IMRT in our department. This heterogeneous group of patients consisted of 20 different tumor entities, with Ewing's sarcoma being the largest (5 patients, followed by juvenile nasopharyngeal fibroma, esthesioneuroblastoma and rhabdomyosarcoma (3 patients each. In addition a review of the available literature reporting on technology, quality, toxicity, outcome and concerns of IMRT was performed. Results With IMRT individualized dose distributions and excellent sparing of organs at risk were obtained in the most challenging cases. This was achieved at the cost of an increased volume of normal tissue receiving low radiation doses. Local control was achieved in 21 patients. 5 patients died due to progressive distant metastases. No severe acute or chronic toxicity was observed. Conclusion IMRT in the treatment of children and adolescents is feasible and was applied safely within the last 9 years at our institution. Several reports in literature show the excellent possibilities of IMRT in selective sparing of organs at risk and achieving local control. In selected cases the quality of IMRT plans increases the therapeutic ratio and outweighs the risk of potentially increased rates of secondary malignancies by the augmented low dose exposure.

  5. A 4096-pixel MAPS detector used to investigate the single-electron distribution in a Young–Feynman two-slit interference experiment

    Energy Technology Data Exchange (ETDEWEB)

    Gabrielli, A. [Istituto Nazionale di Fisica Nucleare, Bologna (Italy); Department of Physics, University of Bologna (Italy); Giorgi, F.M., E-mail: giorgi@bo.infn.it [Istituto Nazionale di Fisica Nucleare, Bologna (Italy); Semprini, N.; Villa, M.; Zoccoli, A. [Istituto Nazionale di Fisica Nucleare, Bologna (Italy); Department of Physics, University of Bologna (Italy); Matteucci, G.; Pozzi, G. [Department of Physics, University of Bologna (Italy); Frabboni, S. [Department of Physics, University of Modena and Reggio Emilia (Italy); CNR-Institute of Nanoscience-S3, Modena (Italy); Gazzadi, G.C. [CNR-Institute of Nanoscience-S3, Modena (Italy)

    2013-01-21

    A monolithic CMOS detector, made of 4096 active pixels developed for HEP collider experiments, has been used in the Young–Feynman two-slit experiment with single electrons. The experiment has been carried out by inserting two nanometric slits in a transmission electron microscope that provided the electron beam source and the electro-optical lenses for projecting and focusing the interference pattern on the sensor. The fast readout of the sensor, in principle capable to manage up to 10{sup 6} frames per second, allowed to record single-electron frames spaced by several empty frames. In this way, for the first time in a single-electron two-slit experiment, the time distribution of electron arrivals has been measured with a resolution of 165μs. In addition, high statistics samples of single-electron events were collected within a time interval short enough to be compatible with the stability of the system and coherence conditions of the illumination.

  6. How to Stimulate Single Mothers on Welfare to Find a Job : Evidence from a Natural Experiment

    NARCIS (Netherlands)

    Knoef, M.G.; van Ours, J.C.

    2014-01-01

    We present the results from a natural experiment in which single mothers on welfare were stimulated to find a job. Two policy instruments were introduced: an earnings disregard and job creation. The experiment was performed at the level of municipalities in The Netherlands, a country with relatively

  7. Mapping the Interrelationships between Self-Concept, Motivation and University Experience among Students of Self-Financing Higher Education Institutions in Hong Kong

    Science.gov (United States)

    Wong, Phoebe; Mak, Connie; Ng, Peggy M. L.; Zhao, Jessie

    2017-01-01

    This study explores the interrelationships between self-concept, motivation and academic and social experience among students from self-financing higher education institutions in Hong Kong. Although prior studies have investigated different aspects of self that drive various types of motivation in students' academic and social experience, most of…

  8. Comparison of ICEPEL predictions with single elbow flexible piping system experiment

    International Nuclear Information System (INIS)

    A-Moneim, M.T.; Chang, Y.W.

    1978-01-01

    The ICEPEL Code for coupled hydrodynamic-structural response analysis of piping systems is used to analyze an experiment on the response of flexible piping systems to internal pressure pulses. The piping system consisted of two flexible Nickel-200 pipes connected in series through a 90 0 thick-walled stainless steel elbow. A tailored pressure pulse generated by a calibrated pulse gun is stabilized in a long thick-walled stainless steel pipe leading to the flexible piping system which ended with a heavy blind flange. The analytical results of pressure and circumferential strain histories are discussed and compared against the experimental data obtained by Stanford Research Institute

  9. Congenital bronchopulmonary malformations: A single-center experience and a review of literature

    Directory of Open Access Journals (Sweden)

    Kumar Basant

    2008-01-01

    Full Text Available Purpose: To present a single-center experience with 25 cases of bronchopulmonary malformations and the review the literature. Materials and Methods: We conducted a retrospective analysis of the medical records of patients with congenital bronchopulmonary malformations who were operated between July 1997 and July 2007 in our institute; we examined the modes of presentations, management, and outcome. Outcome of all patients was assessed over a short follow-up period (average 1.8 months. Results: Out of 25 patients, 18 (72% were male and 7 (28% were female. Age of patients ranged from 1 day to 11 years. The histopathological diagnosis was congenital cystic adenomatoid malformations [CCAM; n = 14 (56%], congenital lobar emphysema [CLE; n = 5 (20%], pulmonary sequestrations [PS; n = 3 (12%], and bronchogenic cysts [BC; n = 3 (12%]. Antenatal diagnosis was available in only 2 (8% patients. The common presenting symptoms were respiratory distress and chest infections. Lobectomy was the procedure of choice . Mortality was 16% (n = 4; M: F = 3: 1. Two patients died because of overwhelming sepsis, one from compromised cardiac function, and one from aspiration which might possibly have been prevented. Conclusion: Patients with progressive respiratory distress due to these anomalies may require urgent surgical intervention regardless of age. The surgical outcome is favorable, with manageable complications. Plain x-ray chest and CT of thorax are usually sufficient for diagnosis and planning of treatment. Pathological diagnosis may differ from the imaging diagnosis. Mortality is found to be more in neonates. Apart from initial stabilization, resection of lesion and careful postoperative care is necessary to reduce mortality and morbidity.

  10. The long tail of molecular alterations in non-small cell lung cancer: a single-institution experience of next-generation sequencing in clinical molecular diagnostics.

    Science.gov (United States)

    Fumagalli, Caterina; Vacirca, Davide; Rappa, Alessandra; Passaro, Antonio; Guarize, Juliana; Rafaniello Raviele, Paola; de Marinis, Filippo; Spaggiari, Lorenzo; Casadio, Chiara; Viale, Giuseppe; Barberis, Massimo; Guerini-Rocco, Elena

    2018-03-13

    Molecular profiling of advanced non-small cell lung cancers (NSCLC) is essential to identify patients who may benefit from targeted treatments. In the last years, the number of potentially actionable molecular alterations has rapidly increased. Next-generation sequencing allows for the analysis of multiple genes simultaneously. To evaluate the feasibility and the throughput of next-generation sequencing in clinical molecular diagnostics of advanced NSCLC. A single-institution cohort of 535 non-squamous NSCLC was profiled using a next-generation sequencing panel targeting 22 actionable and cancer-related genes. 441 non-squamous NSCLC (82.4%) harboured at least one gene alteration, including 340 cases (63.6%) with clinically relevant molecular aberrations. Mutations have been detected in all but one gene ( FGFR1 ) of the panel. Recurrent alterations were observed in KRAS , TP53 , EGFR , STK11 and MET genes, whereas the remaining genes were mutated in <5% of the cases. Concurrent mutations were detected in 183 tumours (34.2%), mostly impairing KRAS or EGFR in association with TP53 alterations. The study highlights the feasibility of targeted next-generation sequencing in clinical setting. The majority of NSCLC harboured mutations in clinically relevant genes, thus identifying patients who might benefit from different targeted therapies. © 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.

  11. Multi-Institution Research Centers: Planning and Management Challenges

    Science.gov (United States)

    Spooner, Catherine; Lavey, Lisa; Mukuka, Chilandu; Eames-Brown, Rosslyn

    2016-01-01

    Funding multi-institution centers of research excellence (CREs) has become a common means of supporting collaborative partnerships to address specific research topics. However, there is little guidance for those planning or managing a multi-institution CRE, which faces specific challenges not faced by single-institution research centers. We…

  12. Cardiac transplantation: 15 years experience Cardiology Institute of Child

    International Nuclear Information System (INIS)

    Ceruti, B; Chiesa, P.; Tambasco, J.; Anzibar, R.; Gutierrez, C.; Barboza, S.; Manfredi, A.; Leone, R.

    2012-01-01

    The cardiac transplant is the treatment of choice for the cardiac insufficiency when there is not another therapeutic alternative that prolongs the life expectancy. On December 1996 The Cardiology Institute of child begin the program of Cardiac Insufficiency and Transplants of the Institute of Pediatric Cardiology, achieving the first cardiac transplant in a 14-year-old child in Uruguay. Three years later they put in practice the program of cardiac transplant in adults

  13. Use of Retrievable Compared to Permanent Inferior Vena Cava Filters: A Single-Institution Experience

    International Nuclear Information System (INIS)

    Ha, Thuong G. Van; Chien, Andy S.; Funaki, Brian S.; Lorenz, Jonathan; Piano, Giancarlo; Shen, Maxine; Leef, Jeffrey

    2008-01-01

    The purpose of this study was to review the use, safety, and efficacy of retrievable inferior vena cava (IVC) filters in their first 5 years of availability at our institution. Comparison was made with permanent filters placed in the same period. A retrospective review of IVC filter implantations was performed from September, 1999, to September, 2004, in our department. These included both retrievable and permanent filters. The Recovery nitinol and Guenther tulip filters were used as retrievable filters. The frequency of retrievable filter used was calculated. Clinical data and technical data related to filter placement were reviewed. Outcomes, including pulmonary embolism, complications associated with placement, retrieval, or indwelling, were calculated. During the study period, 604 IVC filters were placed. Of these, 97 retrievable filters (16%) were placed in 96 patients. There were 53 Recovery filter and 44 Tulip filter insertions. Subjects were 59 women and 37 men; the mean age was 52 years, with a range of from 18 to 97 years. The placement of retrievable filters increased from 2% in year 1 to 32% in year 5 of the study period. The total implantation time for the permanent group was 145,450 days, with an average of 288 days (range, 33-1811 days). For the retrievable group, the total implantation time was 21,671 days, with an average of 226 days (range, 2-1217 days). Of 29 patients who returned for filter retrieval, the filter was successfully removed in 28. There were 14 of 14 successful Tulip filter retrievals and 14 of 15 successful Recovery filter retrievals. In one patient, after an indwelling period of 39 days, a Recovery nitinol filter could not be removed secondary to a large clot burden within the filter. For the filters that were removed, the mean dwell time was 50 days for the Tulip type and 20 days for the Recovery type. Over the follow-up period there was an overall PE incidence of 1.4% for the permanent group and 1% for the retrieval group. In

  14. The lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution.

    Science.gov (United States)

    Bimenyimana, E; Poggenpoel, M; Myburgh, C; van Niekerk, V

    2009-09-01

    Caring for good people is difficult enough; to care for people who are either aggressive or violent is even more difficult. This is what psychiatric nurses working in the psychiatric institution in which research was done are exposed to on a daily basis. The aim of the research was to explore and describe the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. A qualitative, explorative, descriptive, and contextual study design was utilised. Data was collected by means of semi-structured interviews and naïve sketches. Tesch 's (Creswell, 2004: 256) method of open coding and an independent coder were utilised for data analysis. This study shed some light on the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. The findings show that the level of violence and aggression to which psychiatric nurses are exposed is overwhelming and the consequences are alarming. The contributing factors to this violence and aggression are: the mental status and the conditions in which patients are admitted; the staff shortage; the lack of support among the members of the multidisciplinary team (MDT); and the lack of structured and comprehensive orientation among newly appointed staff members. As a result, psychiatric nurses are emotionally, psychologically, and physically affected. They then respond with the following emotions and behaviour: fear, anger, frustration, despair, hopelessness and helplessness, substance abuse, absenteeism, retaliation and the development of an "I don't care" attitude.

  15. The loss of a shared lifetime: a qualitative study exploring spouses' experiences of losing couplehood with their partner with dementia living in institutional care.

    Science.gov (United States)

    Førsund, Linn Hege; Skovdahl, Kirsti; Kiik, Riina; Ytrehus, Siri

    2015-01-01

    To explore and describe spouses' experiences of losing couplehood with their dementia-afflicted partner living in institutional care. Despite the losses and experiences of discontinuity due to the cognitive decline caused by dementia, the feelings of belonging and reciprocity in close relationships are still crucial to many couples. However, these experiences of spouses with partners living in institutional care are not well documented and are thus the focus of this study. A constructivist grounded theory approach was used to capture the relational processes described by the spouses. Conversational interviews were conducted with n = 10 spouses of dementia-afflicted persons living in institutional care. Data were analysed using the constant comparative method. The spouses' experiences of losing couplehood were primarily connected to separation from the partner and the sense of being alone. They were also related to the loss of the shared past and future. However, these experiences did not seem to be constant; short glimpses of connectedness, reciprocity and interdependence contributed to a feeling of couplehood, although these were only momentary. The spouses' experiences of losing couplehood were dynamic and were related to the couple's entire life. The spouses wavered between senses of loss and belonging to couplehood, depending on the conditions characterising the moment. Healthcare personnel must recognise the severity of some spouses' experiences of losing couplehood and be aware of how these experiences can fluctuate and be situation dependent. © 2014 John Wiley & Sons Ltd.

  16. Single port VATS: recent developments in Asia.

    Science.gov (United States)

    Yu, Peter S Y; Capili, Freddie; Ng, Calvin S H

    2016-03-01

    Single port video-assisted thoracic surgery (VATS) is the most recent evolution in minimally invasive thoracic surgery. With increasing global popularity, the single port VATS approach has been adopted by experienced thoracic surgeons in many Asian countries. From initial experience of single port VATS lobectomy to the more complex sleeve resection procedures now forming part of daily practice in some Asia institutes, the region has been the proving ground for single port VATS approaches' feasibility and safety. In addition, certain technical refinements in single port VATS lung resection and lymph node dissection have also sprung from Asia. Novel equipment designed to facilitate single port VATS allowing further reduce access trauma are being realized by the partnership between surgeons and the industries. Advanced thoracoscopes and staplers that are narrower and more maneuverable are particularly important in the smaller habitus of patients from Asia. These and similar new generation equipment are being applied to single port VATS in novel ways. As dedicated thoracic surgeons in the region continue to striving for excellence, innovative ideas in single incision access including subxiphoid and embryonic natural-orifice transluminal endoscopic surgery (e-NOTES) have been explored. Adjunct techniques and technology used in association with single port VATS such as non-intubated surgery, hybrid operating room image guidance and electromagnetic navigational bronchoscopy are all in rapid development in Asia.

  17. Untangling reaction pathways through modern approaches to high-throughput single-molecule force-spectroscopy experiments

    NARCIS (Netherlands)

    Dulin, D.; Berghuis, B.A.; Depken, S.M.; Dekker, N.H.

    2015-01-01

    Single-molecule experiments provide a unique means for real-time observation of the activity of individual biomolecular machines. Through such techniques, insights into the mechanics of for example, polymerases, helicases, and packaging motors have been gleaned. Here we describe the recent advances

  18. Experience with single-layer rectal anastomosis.

    OpenAIRE

    Khubchandani, M; Upson, J

    1981-01-01

    Anastomotic dehiscence following resection of the large intestine is a serious complication. Satisfactory results of single-layer anastomosis depend upon meticulous technique and a scrupulously clean colon. Out of 65 single-layer anastomoses involving the rectum, significant leakage occurred in 4 patients. The results are reported in order to draw attention to the safety and efficacy of one-layer anastomosis.

  19. Pedagogical experiment of the first rector of the Ural state mining institute P.P. Von Weymarn as an effort to reform the higher education institution in 1917-1920

    Directory of Open Access Journals (Sweden)

    Н. Г. Валиев

    2017-12-01

    Full Text Available Based on sources recently discovered and included in the database of scientific publications, the article analyzes the pedagogical activity of the scientist-chemist, the first rector and founder of the Ural Mining Institute in Ekaterinburg Petr Petrovich von Weymarn, whose name is now almost forgotten. The article shows that this activity can be evaluated as a pedagogical experiment on reformation of the higher education institution system, which could have been adopted in Russia if Bolsheviks lost the Civil War. Pedagogical activity of von Weymarn has a theoretical basis that he developed under the influence of Wilhelm Ostwald, the Nobel Prize winner in chemistry and the idealist philosopher, as well as the example of the Petrograd (Petersburg Mining Institute, which for von Weymarn was not only an alma mater but an example of a reformist attitudes toward the scientific and pedagogical process in higher education.The article gives a detailed analysis of the currently available philosophical and pedagogical essays of P.P. von Weymarn, known as «Essays on the Energy of Culture», as well as the practical application of these theoretical works on the basis of the Ural Mining Institute in Ekaterinburg and in Vladivostok.With the advent of Soviet power, von Weymarn's pedagogical experiment was forcibly interrupted, and he became «persona non-grata» in the Soviet Union, but now his name is being restored. Unfortunately, he is known either as a chemist or as the founder and first rector of the current Ural State Mining University, but not as a teacher who offered his view of reforming the higher school system. This article fills this gap, revealing not only the work of von Weymarn, but also describing the difficult period of changing the old scientific school system, which could have taken a completely different development path.

  20. The experience of Occupational Therapy with storytelling in an educational institution

    Directory of Open Access Journals (Sweden)

    José Henrique da Silva Cunha

    2015-03-01

    Full Text Available Stories are important tools in the educational process and daily lives of children, because they contribute to the teaching practice in early education and to child development in many aspects, especially in learning. The purpose of this report is to present the experience of a storytelling group in an educational institution in the municipality of Uberaba, Minas Gerais state, during an internship supervised by the Occupational Therapy Course - Federal University of Triângulo Mineiro. The group developed strategies to improve psychomotor and cognitive aspects and expressive abilities of the students. Twelve one-hour weekly meetings were held during the morning, and the public were students aged 6 to 12 years old that stayed in school the whole day. In the workshop, entitled “Living the Story”, the group developed actions aimed at the creation and telling of stories, the confection of resources that were linked to the stories, and the concepts of experiences related to psychomotor aspects. As a result, it was possible to observe improvements in cognitive skills, emotional regulation, attention and concentration, problem solving, and general psychomotor aspects. Therefore, it is possible to point out that creating and listening to stories stimulate the imagination, educate, instruct, develop cognitive skills, facilitate the process of reading and writing, and enhance children’s communication skills

  1. Primary intracranial soft tissue sarcomas in children, adolescents, and young adults: single institution experience and review of the literature.

    Science.gov (United States)

    Maher, Ossama M; Khatua, Soumen; Mukherjee, Devashis; Olar, Adriana; Lazar, Alexander; Luthra, Raja; Liu, Diane; Wu, Jimin; Ketonen, Leena; Zaky, Wafik

    2016-03-01

    There is a paucity of literature reporting the outcome of intracranial sarcomas (IS) in children, adolescents, and young adults (CAYA). A multimodal therapeutic approach is commonly used, with no well-established treatment consensus. We conducted a retrospective review of CAYA with IS, treated at our institution, to determine their clinical findings, treatments, and outcomes. Immunohistochemistry (PDGFRA and EGFR) and DNA sequencing were performed on 5 tumor samples. A literature review of IS was also conducted. We reviewed 13 patients (median age, 7 years) with a primary diagnosis of IS between 1990 and 2015. Diagnoses included unclassified sarcoma (n = 9), chondrosarcoma (n = 2), and rhabdomyosarcoma (n = 2). Five patients underwent upfront gross total resection (GTR) of the tumor. The 5-drug regimen (vincristine, doxorubicin, cyclophosphamide, etoposide, and ifosfamide) was the most common treatment used. Nine patients died due to progression or recurrence (n = 8) or secondary malignancy (n = 1). The median follow-up period of the 4 surviving patients was 1.69 years (range 1.44-5.17 years). The 5-year progression-free survival and overall survival rates were 21 and 44 %, respectively. BRAF, TP53, KRAS, KIT, ERBB2, MET, RET, ATM, and EGFR mutations were detected in 4 of the 5 tissue samples. All 5 samples were immunopositive for PDGFRA, and only 2 were positive for EGFR. IS remain a therapeutic challenge due to high progression and recurrence rates. Collaborative multi-institutional studies are warranted to delineate a treatment consensus and investigate tumor biology to improve the disease outcome.

  2. Caudal dysgenesis and sirenomelia-single centre experience suggests common pathogenic basis.

    Science.gov (United States)

    Thottungal, Anjana D; Charles, Adrian K; Dickinson, Jan E; Bower, Carol

    2010-10-01

    Abnormally formed lower limbs with varying degrees of fusion are the major feature of sirenomelia whereas maldeveloped lower limbs without fusion are found in association with caudal dysgenesis (CD). The relationship between these two entities has been a topic of debate for many years. The presence of a single umbilical artery originating from the abdominal aorta was considered a major feature distinguishing sirenomelia from CD. Based on this finding, the vascular steal theory was put forward as the causative mechanism of sirenomelia. CD and sirenomelia were considered to be two entirely different entities with distinct pathogenic mechanisms. However, it is now clear that a single umbilical artery can be found in some patients of CD and normal umbilical arteries in some patients of sirenomelia. The hypothesis of primary deficiency of caudal mesoderm caused by early developmental disruption suggests that sirenomelia and CD are two ends of a spectrum of maldevelopment of caudal mesoderm. In this paper we report on the clinical and pathological features of 16 patients of CD and 9 patients of sirenomelia from our institution and review the literature. This series of cases is notable for the significant association with neural tube defects, refining the renal and urogenital pathology associated with these conditions, and supporting the concept of a continuum of the disease spectrum. Copyright © 2010 Wiley-Liss, Inc.

  3. Perceptions of safety culture vary across the intensive care units of a single institution.

    Science.gov (United States)

    Huang, David T; Clermont, Gilles; Sexton, J Bryan; Karlo, Crystal A; Miller, Rachel G; Weissfeld, Lisa A; Rowan, Kathy M; Angus, Derek C

    2007-01-01

    To determine whether safety culture factors varied across the intensive care units (ICUs) of a single hospital, between nurses and physicians, and to explore ICU nursing directors' perceptions of their personnel's attitudes. Cross-sectional surveys using the Safety Attitudes Questionnaire-ICU version, a validated, aviation industry-based safety culture survey instrument. It assesses culture across six factors: teamwork climate, perceptions of management, safety climate, stress recognition, job satisfaction, and work environment. Four ICUs in one tertiary care hospital. All ICU personnel. We conducted the survey from January 1 to April 1, 2003, and achieved a 70.2% response rate (318 of 453). We calculated safety culture factor mean and percent-positive scores (percentage of respondents with a mean score of > or =75 on a 0-100 scale for which 100 is best) for each ICU. We compared mean ICU scores by ANOVA and percent-positive scores by chi-square. Mean and percent-positive scores by job category were modeled using a generalized estimating equations approach and compared using Wald statistics. We asked ICU nursing directors to estimate their personnel's mean scores and generated ratios of their estimates to the actual scores.Overall, factor scores were low to moderate across all factors (range across ICUs: 43.4-74.9 mean scores, 8.6-69.4 percent positive). Mean and percent-positive scores differed significantly (p safety culture variation exists across ICUs of a single hospital. ICU nursing directors tend to overestimate their personnel's attitudes, particularly for teamwork. Culture assessments based on institutional level analysis or director opinion may be flawed.

  4. Photobiomodulation therapy for the management of radiation-induced dermatitis. A single-institution experience of adjuvant radiotherapy in breast cancer patients after breast conserving surgery

    Energy Technology Data Exchange (ETDEWEB)

    Strouthos, Iosif [Sana Klinikum Offenbach, Department of Radiation Oncology, Offenbach (Germany); Medical Center - Albert Ludwigs University of Freiburg, Department of Radiotherapy and Oncology, Freiburg (Germany); Chatzikonstantinou, Georgios; Tselis, Nikolaos [Sana Klinikum Offenbach, Department of Radiation Oncology, Offenbach (Germany); J.W. Goethe University, Department of Radiotherapy and Oncology, Frankfurt am Main (Germany); Bon, Dimitra [J.W. Goethe University, Institute of Biostatistics and Mathematical Modelling, Frankfurt am Main (Germany); Karagiannis, Efstratios [Sana Klinikum Offenbach, Department of Radiation Oncology, Offenbach (Germany); Otto von Guericke University, Department of Radiation Oncology, Magdeburg (Germany); Zoga, Eleni; Ferentinos, Konstantinos; Maximenko, Julia; Nikolettou-Fischer, Vassiliki; Zamboglou, Nikolaos [Sana Klinikum Offenbach, Department of Radiation Oncology, Offenbach (Germany)

    2017-06-15

    Radiation therapy (RT) comprises a key component in the treatment of breast cancer. Radiation-induced skin toxicity is the major adverse event experienced by patients; however, radiodermatitis (RD) prevention and management remains trivial. It is proven that photobiomodulation (PBM) therapy using light-emitting diode (LED) increases wound healing and depicts an anti-inflammatory effect. This single-institute study evaluates the beneficial role of PBM-LED in preventing/reducing RD during breast cancer RT. Of 70 consecutively treated patients, 25 patients were treated with PBM-LED twice a week prior to adjuvant 3D conformal RT after breast-conserving surgery. RD was reported using Common Toxicity Criteria for Adverse Events Version 4.0 and pain intensity using a visual analog scale (VAS). For comparison, a control group (n = 45) received RT without PBM-LED. In addition, a ''matched'' group (n = 25) was generated from the control group based on propensity for potentially confounding variables. In the PBM group, 22 patients (88%) presented grade 1 and 3 (12%) grade 2 RD. In the control group, 25 patients (55.6%) developed grade 1 reactions, 18 patients (40%) grade 2, and 2 (4.4%) patients grade 3 RD. Concerning pain intensity, 15 patients (60%) of the PBM treatment arm reported no pain, 5 patients (20%) VAS 2, and 5 (20%) VAS 3. In the control group, 13 patients (28.9%) reported no pain, 2 (4.4%) VAS 1, 7 (15.6%) VAS 2, 9 patients (20%) reported VAS 3, 12 (26.7%) patients VAS 4, and 2 (4.4%) patients VAS 5. PBM-LED therapy applied prior to RT might be effective in decreasing the incidence and sequelae of radiation-induced skin toxicity in breast cancer patients treated with breast-conserving surgery. (orig.) [German] Radiotherapie (RT) ist integrativer Bestandteil der multimodalen Therapie beim Mammakarzinom. Strahlentherapieinduzierte Hauttoxizitaet ist dabei das haeufigste unerwuenschte Ereignis; dennoch sind Praevention und Management der

  5. Long-Term Experience With World Health Organization Grade III (Malignant) Meningiomas at a Single Institution

    International Nuclear Information System (INIS)

    Rosenberg, Lewis A.; Prayson, Richard A.; Lee, Joung; Reddy, Chandana; Chao, Samuel T.; Barnett, Gene H.; Vogelbaum, Michael A.; Suh, John H.

    2009-01-01

    Purpose: To evaluate the outcomes for patients with Grade III meningiomas as defined by the 2007 World Health Organization standards. Methods and Materials: The slides from patients who had been treated at the Cleveland Clinic for malignant meningiomas were reviewed by a single neuropathologist. The data from 13 patients treated between 1984 and 2006 satisfied the World Health Organization 2007 definition of Grade III meningioma. A total of 24 surgeries were performed, including 13 primary, 7 salvage, and 4 second salvage. Also, 14 courses of radiotherapy (RT) were administered, including fractionated RT in 3 patients after primary surgery, fractionated RT in 4 patients after salvage surgery, salvage stereotactic radiosurgery to six separate areas in 3 patients, and salvage intensity-modulated RT in 1 patient. Results: From the primary surgery, the median survival was 3.4 years, the 5-year survival rate was 47.2%, and the 8-year survival rate was 12.2%. The median time to recurrence was 9.6 months. A trend was seen toward longer survival for patients who had received adjuvant RT after initial surgery compared with those treated with surgery alone. Two patients developed radiation necrosis, and three had surgical complications. Conclusion: This is one of the few studies reporting the outcomes for malignant meningioma patients according to recent definitions. Our results are consistent with existing reports of the overall poor outcomes for atypical and malignant meningioma patients. From the available data, surgical resection followed by RT and salvage therapy can lead to extended survival.

  6. Intraoperative radiation therapy in gynecologic cancer: update of the experience at a single institution

    International Nuclear Information System (INIS)

    Garton, Graciela R.; Gunderson, Leonard L.; Webb, Maurice J.; Wilson, Timothy O.; Cha, Stephen S.; Podratz, Karl C.

    1997-01-01

    Purpose: To update the Mayo Clinic experience with intraoperative radiation therapy (IORT) in patients with gynecologic cancer. Methods and Materials: Between January 1983 and June 1991, 39 patients with recurrent or locally advanced gynecologic malignancies received intraoperative radiation therapy with electrons. The anatomical area treated was pelvis (side walls or presacrum) or periaortic nodes or a combination of both. In addition to intraoperative radiation therapy, 28 patients received external beam irradiation (median dose, 45 Gy; range, 0.9 to 65.7 Gy), and 13 received chemotherapy preoperatively. At the time of intraoperative radiation therapy and after maximum debulking operation, 23 patients had microscopic residual disease and 16 had gross residual disease up to 5 cm in thickness. Median follow-up for surviving patients was 43.4 months (range, 27.1 to 125.4 months). Results: The 5-year actuarial local control with or without central control was 67.4%, and the control within the IORT field (central control) was 81%. The risk of distant metastases at 5 years was 52% (82% in patients with gross residual disease and 33% in patients with only microscopic disease postoperatively). Actuarial 5-year overall survival and disease-free survival was 31.5 and 40.5%, respectively. Patients with microscopic disease had 5-year disease-free and overall survival of 55 and 50%, respectively. Grade 3 toxicity was directly associated with IORT in six patients (15%). Conclusion: Patients with local, regionally recurrent gynecologic cancer may benefit from maximal surgical debulking and IORT with or without external beam irradiation, especially those with microscopic residual disease

  7. INSTITUTIONAL REPOSITORY: EMPLOYMENT IN EDUCATION

    Directory of Open Access Journals (Sweden)

    Vasyl P. Oleksyuk

    2012-11-01

    Full Text Available The article investigated the concept of «institutional repository» and determined the aspects of institutional repositories in higher education. Institutional Repositories are information systems that allow preserving, storing and disseminating scientific knowledge produced in higher education and scientific research institutions. This study presented the main aspects using institutional repositories in educational process (such as storage of scientific and educational information, means of organization activity of students, object of studying. This article produced the structure of communities and collections of the institutional. It is described the experience of implementing of DSpace in the learning process.

  8. Clinical and socio-demographic characteristics of college students exposed to traumatic experiences: a census of seven college institutions in Northeastern Brazil.

    Directory of Open Access Journals (Sweden)

    Liana R Netto

    Full Text Available BACKGROUND: Epidemiological studies show that most of the adult population will be exposed to at least one potentially traumatic event in the course of his/her life; adolescence and early adulthood are the most vulnerable periods of life for exposure to traumatic experiences (70% of their deaths are due to external causes. Posttraumatic Stress Disorder is characterized by the development of dysfunctional symptoms that cause distress or social, academic, or occupational impairment, as result of exposure to a traumatic event. The aim of this multicentric study is to establish the proportion of college students, within seven institutions in Northeastern Brazil, who were exposed to traumatic experience and met PTSD criteria. METHODS/DESIGN: A one-phase census protocol of seven college institutions in three metropolitan regions in Northeastern Brazil was performed (April to July 2011. All students aged 18 years or older, matriculated and attending their first or final semester were eligible. The self-applied protocol consisted of a socio-demographic questionnaire and the following scales adjusted to Brazilian Portuguese standards Trauma History Questionnaire (THQ, PTSD Checklist-Civilian (PCL-C, Impulsivity Scale (BIS-11. Data were entered into SPSS 17.0. RESULTS: 2213 (85.5% students consented to participate, and completely filled in the protocols. Of these, 66.1% were woman, mean age 23.9 (SD 6.3, 82.7% were single, and 57.3% attended university outside their native cities. The total PTSD prevalence was 14%, and the median for frequency of trauma exposure was 5 events. CONCLUSION: A high frequency of exposure to violence, as well as a high rate of PTSD, suicide attempts, and high-risk sexual behavior was found in Brazilian college students. This highlights the importance of effective public health actions in relation to the prevention and treatment of PTSD and other dysfunctional behaviors resulting from traumatic exposure in young individuals

  9. Underrepresented Racial/Ethnic Minority Graduate Students in Science, Technology, Engineering, and Math (STEM) Disciplines: A Cross Institutional Analysis of their Experiences

    Science.gov (United States)

    Figueroa, Tanya

    Considering the importance of a diverse science, technology, engineering, and math (STEM) research workforce for our country's future, it is troubling that many underrepresented racial minority (URM) students start graduate STEM programs, but do not finish. However, some institutional contexts better position students for degree completion than others. The purpose of this study was to uncover the academic and social experiences, power dynamics, and programmatic/institutional structures URM students face within their graduate STEM programs that hinder or support degree progression. Using a critical socialization framework applied in a cross-comparative qualitative study, I focused on how issues of race, ethnicity, and underrepresentation within the educational contexts shape students' experiences. Data was collected from focus group interviews involving 53 URM graduate students pursuing STEM disciplines across three institution types -- a Predominately White Institution, a Hispanic-Serving Institution, and a Historically Black University. Results demonstrate that when students' relationships with faculty advisors were characterized by benign neglect, students felt lost, wasted time and energy making avoidable mistakes, had less positive views of their experiences, and had more difficulty progressing through classes or research, which could cause them to delay time to degree completion or to leave with a master's degree. Conversely, faculty empowered students when they helped them navigate difficult processes/milestones with regular check-ins, but also allowed students room to make decisions and solve problems independently. Further, faculty set the tone for the overall interactional culture and helping behavior in the classroom and lab contexts; where faculty modeled collaboration and concern for students, peers were likely to do the same. International peers sometimes excluded domestic students both socially and academically, which had a negative affect on

  10. Single-experiment displacement assay for quantifying high-affinity binding by isothermal titration calorimetry.

    Science.gov (United States)

    Krainer, Georg; Keller, Sandro

    2015-04-01

    Isothermal titration calorimetry (ITC) is the gold standard for dissecting the thermodynamics of a biomolecular binding process within a single experiment. However, reliable determination of the dissociation constant (KD) from a single titration is typically limited to the range 100 μM>KD>1 nM. Interactions characterized by a lower KD can be assessed indirectly by so-called competition or displacement assays, provided that a suitable competitive ligand is available whose KD falls within the directly accessible window. However, this protocol is limited by the fact that it necessitates at least two titrations to characterize one high-affinity inhibitor, resulting in considerable consumption of both sample material and time. Here, we introduce a fast and efficient ITC displacement assay that allows for the simultaneous characterization of both a high-affinity ligand and a moderate-affinity ligand competing for the same binding site on a receptor within a single experiment. The protocol is based on a titration of the high-affinity ligand into a solution containing the moderate-affinity ligand bound to the receptor present in excess. The resulting biphasic binding isotherm enables accurate and precise determination of KD values and binding enthalpies (ΔH) of both ligands. We discuss the theoretical background underlying the approach, demonstrate its practical application to metal ion chelation, explore its potential and limitations with the aid of simulations and statistical analyses, and elaborate on potential applications to protein-inhibitor interactions. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Proposal for probing energy transfer pathway by single-molecule pump-dump experiment

    OpenAIRE

    Tao, Ming-Jie; Ai, Qing; Deng, Fu-Guo; Cheng, Yuan-Chung

    2016-01-01

    The structure of Fenna-Matthews-Olson (FMO) light-harvesting complex has long been recognized as containing seven bacteriochlorophyll (BChl) molecules. Recently, an additional BChl molecule was discovered in the crystal structure of the FMO complex, which may serve as a link between baseplate and the remaining seven molecules. Here, we investigate excitation energy transfer (EET) process by simulating single-molecule pump-dump experiment in the eight-molecules complex. We adopt the coherent m...

  12. Laparoscopic single port surgery in children using Triport: our early experience.

    Science.gov (United States)

    de Armas, Ismael A Salas; Garcia, Isabella; Pimpalwar, Ashwin

    2011-09-01

    Laparoscopy has become the gold standard technique for appendectomy and cholecystectomy. With the emergence of newer laparoscopic instruments which are roticulating and provide 7 degrees of freedom it is now possible to perform these operations through a single umbilical incision rather than the standard 3-4 incisions and thus lead to more desirable cosmetic results and less postoperative pain. The newer reticulating telescopes provide excellent exposure of the operating field and allow the operations to proceed routinely. Recently, ports [Triports (Olympus surgery)/SILS ports] especially designed for single incision laparoscopic surgery (SILS) have been developed. We herein describe our experience with laparoscopic single port appendectomies and cholecystectomies in children using the Triport. This is a retrospective cohort study of children who underwent single incision laparoscopic surgery between May 2009 and August 2010 at Texas Children's Hospital and Ben Taub General Hospital in Houston Texas by a single surgeon. Charts were reviewed for demographics, type of procedure, operative time, early or late complications, outcome and cosmetic results. Fifty-four patients underwent SILS. A total of 50 appendectomies (early or perforated) and 4 cholecystectomies were performed using this new minimally invasive approach. The average operative time for SILS/LESS appendectomy was 54 min with a range between 25 and 205 min, while operative time for SILS cholecystectomy was 156 min with a range of 75-196 min. Only small percentage (4%) of appendectomies (mostly complicated) were converted to standard laparoscopy, but none were converted to open procedure. All patients were followed up in the clinic after 3-4 weeks. No complications were noted and all patients had excellent cosmetic results. Parents were extremely satisfied with the cosmetic results. SILS/LESS is a safe, minimally invasive approach for appendectomy and cholecystectomy in children. This new approach is

  13. The lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution

    Directory of Open Access Journals (Sweden)

    E. Bimenyimana

    2009-09-01

    Full Text Available Caring for good people is difficult enough; to care for people who are either aggressive or violent is even more difficult. This is what psychiatric nurses working in the psychiatric institution in which research was done are exposed to on a daily basis. The aim of the research was to explore and describe the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. A qualitative, explorative, descriptive, and contextual study design was utilised. Data was collected by means of semi-structured interviews and naïve sketches. Tesch’s (Creswell, 2004:256 method of open coding and an independent coder were utilised for data analysis. This study shed some light on the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. The findings show that the level of violence and aggression to which psychiatric nurses are exposed is overwhelming and the consequences are alarming. The contributing factors to this violence and aggression are: the mental status and the conditions in which patients are admitted; the staff shortage; the lack of support among the members of the multidisciplinary team (MDT; and the lack of structured and comprehensive orientation among newly appointed staff members. As a result, psychiatric nurses are emotionally, psychologically, and physically affected. They then respond with the following emotions and behaviour: fear, anger, frustration, despair, hopelessness and helplessness, substance abuse, absenteeism, retaliation and the development of an “I don’t care” attitude.

  14. Entdeckung elektroschwacher Produktion einzelner Top-Quarks mit dem CDF II Experiment; Discovery electroweak production of single top quarks with the CDF II Experiment

    Energy Technology Data Exchange (ETDEWEB)

    Luck, Jan [Karlsruhe Inst. of Technology (KIT) (Germany)

    2009-01-01

    This thesis presents a neural network search for combined as well as separate s- and t-channel single top-quark production with the CDF II experiment at the Tevatron using 3.2 fb-1 of collision data. It is the twelfth thesis dealing with single top-quark production performed within the CDF Collaboration, whereas three have been done in Run I [53–55] and eight in Run II [23, 25, 28, 39, 56–59].

  15. Motivations and Paths to Becoming Faculty at Minority Serving Institutions

    Directory of Open Access Journals (Sweden)

    Daniel Blake

    2018-02-01

    Full Text Available Drawing upon 15 qualitative interviews with early- to mid-career faculty (seven men and eight women at Minority Serving Institutions (MSIs, this study examines the diverse motivations and paths those faculty members have taken to becoming professors at their respective institutions. The faculty come from a range of MSIs (Historically Black Colleges and Universities, Hispanic Serving Institutions, Asian American and Native American Pacific Islander Serving Institutions, and Predominantly Black Institutions across the country and represent a broad spectrum of disciplines. This study sheds light on factors that guide their choices of discipline and entrance into the faculty ranks at MSIs. Social cognitive career theory (SCCT was used as a lens during qualitative coding and analysis in order to develop the findings, which reveal that (1 teaching, activism, and community uplift were primary motivators to enter the professoriate; (2 supportive environmental factors, including single individuals, proved pivotal in influencing faculty to take these roles; and (3 career transitions into the academy were spurred by learning experiences that revealed disciplinary and teaching interests. The findings suggest that MSIs attract community-oriented individuals to their faculty positions, and that colleges and universities interested in diversifying their faculties should craft such roles in ways that are appealing to the populations that they are trying to recruit and retain.

  16. Light-ion irradiation experiments in National Research Institute for Metals

    International Nuclear Information System (INIS)

    Kishimoto, Naoki; Nagakawa, Johsei; Shiraishi, Haruki

    1987-01-01

    National Research Institute for Metals (NRIM) has primarily focused in the mechanical testings under ion bombardment. (creep, fatigue, and fracture toughness are planned). For the purpose of carrying out those objectives, light ion cyclotron is thought one of the most suitable as an accelerator. NRIM installed AVF-type cyclotron with some modification accomodating to the irradiation testing. From the characteristics of produced particles, NRIM's cyclotron is expected to simulate fusion irradiation environment properly. Irradiation creep experiment was started in 1986. An important and difficult point for the creep measurement is the control of specimen temperature under flucturing beam heating. The problem of this fluctuation was solved by employing forced convection of helium and DC. heating. Fe-25Ni-15Cr and 316 SS have been preliminarily investigated concerning mechanism of the phase stability and the post-helium-implantation creep, etc. Fe-25Ni-15Cr was made into platelets of 0.087 x 2.5 x 20 mm 3 and 316 SS was drawn into wire of 0.8 mm in diameter. Results of preliminary experiments are as follows. For Fe-25Ni-15Cr, 1) Ni of 25 % does not improve creep resistance, 2) Minor element like Ti is important in suppressing the creep, 3) SIPA and PAG model explain the stress dependence of creep qualitatively, and for 316 SS, 4) 0.025 dpa is required to reach steady-state creep, at 2.5 x 10 -7 dpa/s, 300 deg C and 50 MPa, 5) The evolution of irradiation creep is sensitive to the damage rate, particularly in the low dpa range. (Ishimitsu, A.)

  17. Single-stage Modified Duhamel procedure for Hirschsprung′s disease : Our experience

    Directory of Open Access Journals (Sweden)

    Paras R Kothari

    2012-01-01

    Full Text Available Introduction: Primary single-stage pull-through for Hirschsprung′s disease (HD has been reported to give comparable surgical outcomes to staged operations with less morbidity. Herein, we present our experience with single-stage Modified Duhamel procedure for management of HD. Patients and Methods: This was a review of 48 cases of HD who underwent single-stage Modified Duhamel procedure without a protective colostomy. Results: The age at surgery ranged from 6 months to 10 years (median - 9 months, mean - 2.3 years. The average weight of the child was 7.2 kg (range, 4.9-22 kg. 38 (79.2% patients had classical rectosigmoid HD, the rest being long segment HD (the proximal most level being the splenic flexure. The average duration of surgery was 175 minutes (range, 130-245 minutes. The average blood loss was 45 ml. The average hospital stay was 7.2 days (range: 6-10 days. The major postoperative complications (n=3 included postoperative adhesive intestinal obstruction, anastomotic leak and persistent constipation due to residual aganglionosis. Each required a re-exploration. Minor complications included surgical site infection (n=3 and post-operative enterocolitis (n=3, which were managed conservatively. Six patients had constipation for a limited period post-operatively. All patients have a satisfactory functional outcome and normal development and growth. Conclusions: For HD, we recommend that single-stage Modified Duhamel procedure should be the preferred approach in view of its low morbidity, satisfactory functional outcome and avoidance of stoma, multiple surgeries and economic benefit in view of decreased hospital stay.

  18. Epidemiology and management of breast carcinoma in Egyptian males: Experience of a single Cancer Institute

    International Nuclear Information System (INIS)

    Elshafiey, M.M.; Elsebai, H.I.; Attia, A.A.; Zeeneldin, A.A.; Moneer, M.; Mohamed, D.B.; Gouda, I.

    2011-01-01

    To assess the epidemiological and clinico-pathological features, surgical and reconstructive techniques, adjuvant treatments and clinical outcome of breast carcinoma in males (BCM) at the Egyptian National Cancer Institute (NCI). Patients and methods: Thirty-two males with breast carcinoma presented to NCI between January 2000 and December 2002. They were evaluated by complete history, physical examination, laboratory and radiological investigations. Results: Median age was 59 years. Left sided and retroareolar breast lumps were the commonest presentations. Grade 11 tumors positive for hormone receptors were very common. Stage I, II, 111 and IV disease were encountered in 6.2%, 34.4%, 34.4% and 25.0% of patients, respectively. Curative surgery was done in 22 patients; they received adjuvant hormonal therapy, chemotherapy and radiotherapy in 22,16 and 10 patients, respectively. Eight metastatic patients were treated with palliative measures. Surgery was done in 25 patients; the most common procedure was modified radical mastectomy (40.6%). Primary closure was feasible in 17 patients (68%), local flaps were needed in 4 cases (16%), while myocutaneous flap was done in 3 cases (12%). The commonest complication was development of seroma (9 cases). The overall survival (OS) at 5 years was 65.4%. The disease free survival (DPS) at 5 years was 53.9%. Stage and curative surgery significantly affected OS, while type of surgery was the only variable significantly affecting DPS. Conclusion: Male breast carcinoma occurs at older ages than females, usually in advanced stage. This necessitates directing attention of males and awareness on the prevalence and risk factors for this disease.needed in 4 cases (16%), while myocutaneous flap was done in 3 cases (12%). The commonest complication was development of seroma (9 cases). The overall survival (OS) at 5 years was 65.4%. The disease free survival (DPS) at 5 years was 53.9%. Stage and curative surgery significantly affected OS

  19. Fluoroscopy Learning Curve in Hip Arthroscopy-A Single Surgeon's Experience.

    Science.gov (United States)

    Smith, Kevin M; Duplantier, Neil L; Crump, Kimbelyn H; Delgado, Domenica A; Sullivan, Stephanie L; McCulloch, Patrick C; Harris, Joshua D

    2017-10-01

    To determine if (1) absorbed radiation dose and (2) fluoroscopy time decreased with experience over the first 100 cases of a single surgeon's hip arthroscopy practice. Subjects who underwent hip arthroscopy for symptomatic femoroacetabular impingement and labral injury were eligible for analysis. Inclusion criteria included the first 100 subjects who underwent hip arthroscopy by a single surgeon (December 2013 to December 2014). Subject demographics, procedure details, fluoroscopy absorbed dose (milligray [mGy]), and time were recorded. Subjects were categorized by date of surgery to one of 4 possible groups (25 per group). One-way analysis of variance was used to determine if a significant difference in dose (mGy) or time was present between groups. Simple linear regression analysis was performed to determine the relation between case number and both radiation dose and fluoroscopy time. Subjects underwent labral repair (n = 93), cam osteoplasty (n = 90), and pincer acetabuloplasty (n = 65). There was a significant (P arthroscopy practice learning curve. Level IV, therapeutic, retrospective, noncomparative case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  20. sRNAbench: profiling of small RNAs and its sequence variants in single or multi-species high-throughput experiments

    Czech Academy of Sciences Publication Activity Database

    Barturen, G.; Rueda, A.; Hamberg, M.; Alganza, A.; Lebron, R.; Kotsyfakis, Michalis; Shi, B.-J.; Koppers-Lalic, D.; Hackenberg, M.

    2014-01-01

    Roč. 1, SEP 30 2014 (2014), s. 21-31 ISSN 2084-7173 Institutional support: RVO:60077344 Keywords : microRNA * small RNA * isomiRs * expression profiling * multi-species experiment * webserver Subject RIV: EB - Genetics ; Molecular Biology

  1. Robot-assisted tubal reanastomosis: Initial experience in a single institution

    Directory of Open Access Journals (Sweden)

    Ahmet Göçmen

    2013-03-01

    Conclusion: Robot-assisted TLR is safe and feasible. This procedure may facilitate minimally invasive treatment for patients who want to regain their fertility without the aid of artificial reproductive techniques.

  2. Hypofractionated stereotactic radiation therapy for recurrent glioblastoma: single institutional experience

    International Nuclear Information System (INIS)

    Ciammella, Patrizia; Podgornii, Ala; Galeandro, Maria; D’Abbiero, Nunziata; Pisanello, Anna; Botti, Andrea; Cagni, Elisabetta; Iori, Mauro; Iotti, Cinzia

    2013-01-01

    Glioblastoma (GBM) is the most common malignant primary brain tumor in adults. Tumor control and survival have improved with the use of radiotherapy (RT) plus concomitant and adjuvant chemotherapy, but the prognosis remain poor. In most cases the recurrence occurs within 7–9 months after primary treatment. Currently, many approaches are available for the salvage treatment of patients with recurrent GBM, including resection, re-irradiation or systemic agents, but no standard of care exists. We analysed a cohort of patients with recurrent GBM treated with frame-less hypofractionated stereotactic radiation therapy with a total dose of 25 Gy in 5 fractions. Of 91 consecutive patients with newly diagnosed GBM treated between 2007 and 2012 with conventional adjuvant chemo-radiation therapy, 15 underwent salvage RT at recurrence. The median time interval between primary RT and salvage RT was 10.8 months (range, 6–54 months). Overall, patients undergoing salvage RT showed a longer survival, with a median survival of 33 vs. 9.9 months (p= 0.00149). Median overall survival (OS) from salvage RT was 9.5 months. No patients demonstrated clinically significant acute morbidity, and all patients were able to complete the prescribed radiation therapy without interruption. Our results suggest that hypofractionated stereotactic radiation therapy is effective and safe in recurrent GBM. However, until prospective randomized trials will confirm these results, the decision for salvage treatment should remain individual and based on a multidisciplinary evaluation of each patient

  3. Postoperative radiotherapy in salivary ductal carcinoma: a single institution experience

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Hyung; Kim, Mi Sun; Choi, Seo Hee; Suh, Yang Gun; Koh, Yoon Woo; Kim, Se Hun; Choi, Eun Chang; Keum, Ki Chang [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-09-15

    We reviewed treatment outcomes and prognostic factors for patients with salivary ductal carcinoma (SDC) treated with surgery and postoperative radiotherapy from 2005 to 2012. A total of 16 patients were identified and 15 eligible patients were included in analysis. Median age was 61 years (range, 40 to 71 years) and 12 patients (80%) were men. Twelve patients (80%) had a tumor in the parotid gland, 9 (60%) had T3 or T4 disease, and 9 (60%) had positive nodal disease. All patients underwent surgery and postoperative radiotherapy. Postoperative radiotherapy was delivered using 3-dimensional conformal radiotherapy or intensity-modulated radiotherapy. Locoregional failure-free survival (LRFFS), distant failure-free survival (DFFS), progression-free survival (PFS), and overall survival (OS) were calculated using the Kaplan-Meier method. Differences in survival based on risk factors were tested using a log-rank test. Median total radiotherapy dose was 60 Gy (range, 52.5 to 63.6 Gy). Four patients received concurrent weekly chemotherapy with cisplatin. Among 10 patients who underwent surgery with neck dissection, 7 received modified radical neck dissection. With a median follow-up time of 38 months (range, 24 to 105 months), 4-year rates were 86% for LRFFS, 51% for DFFS, 46% for PFS, and 93% for OS. Local failure was observed in 2 patients (13%), and distant failure was observed in 7 (47%). The lung was the most common involved site of distant metastasis. Surgery and postoperative radiotherapy in SDC patients resulted in good local control, but high distant metastasis remained a major challenge.

  4. Universality of Citation Distributions for Academic Institutions and Journals

    Science.gov (United States)

    Chatterjee, Arnab; Ghosh, Asim; Chakrabarti, Bikas K.

    2016-01-01

    Citations measure the importance of a publication, and may serve as a proxy for its popularity and quality of its contents. Here we study the distributions of citations to publications from individual academic institutions for a single year. The average number of citations have large variations between different institutions across the world, but the probability distributions of citations for individual institutions can be rescaled to a common form by scaling the citations by the average number of citations for that institution. We find this feature seems to be universal for a broad selection of institutions irrespective of the average number of citations per article. A similar analysis for citations to publications in a particular journal in a single year reveals similar results. We find high absolute inequality for both these sets, Gini coefficients being around 0.66 and 0.58 for institutions and journals respectively. We also find that the top 25% of the articles hold about 75% of the total citations for institutions and the top 29% of the articles hold about 71% of the total citations for journals. PMID:26751563

  5. Experiments with Mixtures Designs, Models, and the Analysis of Mixture Data

    CERN Document Server

    Cornell, John A

    2011-01-01

    The most comprehensive, single-volume guide to conducting experiments with mixtures"If one is involved, or heavily interested, in experiments on mixtures of ingredients, one must obtain this book. It is, as was the first edition, the definitive work."-Short Book Reviews (Publication of the International Statistical Institute)"The text contains many examples with worked solutions and with its extensive coverage of the subject matter will prove invaluable to those in the industrial and educational sectors whose work involves the design and analysis of mixture experiments."-Journal of the Royal S

  6. Building institutions for an effective health system: lessons from China's experience with rural health reform.

    Science.gov (United States)

    Bloom, Gerald

    2011-04-01

    This paper is concerned with the management of health system changes aimed at substantially increasing the access to safe and effective health services. It argues that an effective health sector relies on trust-based relationships between users, providers and funders of health services, and that one of the major challenges governments face is to construct institutional arrangements within which these relationships can be embedded. It presents the case of China, which is implementing an ambitious health reform, drawing on a series of visits to rural counties by the author over a 10-year period. It illustrates how the development of reform strategies has been a response both to the challenges arising from the transition to a market economy and the result of actions by different actors, which have led to the gradual creation of increasingly complex institutions. The overall direction of change has been strongly influenced by the efforts made by the political leadership to manage a transition to a modern economy which provides at least some basic benefits to all. The paper concludes that the key lessons for other countries from China's experience with health system reform are less about the detailed design of specific interventions than about its approach to the management of institution-building in a context of complexity and rapid change. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Meeting the Data Management Compliance Challenge: Funder Expectations and Institutional Reality

    Directory of Open Access Journals (Sweden)

    Catherine Pink

    2013-11-01

    Full Text Available In common with many global research funding agencies, in 2011 the UK Engineering and Physical Sciences Research Council (EPSRC published its Policy Framework on Research Data along with a mandate that institutions be fully compliant with the policy by May 2015. The University of Bath has a strong applied science and engineering research focus and, as such, the EPSRC is a major funder of the university’s research. In this paper, the Jisc-funded Research360 project shares its experience in developing the infrastructure required to enable a research-intensive institution to achieve full compliance with a particular funder’s policy, in such a way as to support the varied data management needs of both the University of Bath and its external stakeholders. A key feature of the Research360 project was to ensure that after the project’s completion in summer 2013 the newly developed data management infrastructure would be maintained up to and beyond the EPSRC’s 2015 deadline. Central to these plans was the ‘University of Bath Roadmap for EPSRC’, which was identified as an exemplar response by the EPSRC. This paper explores how a roadmap designed to meet a single funder’s requirements can be compatible with the strategic goals of an institution. Also discussed is how the project worked with Charles Beagrie Ltd to develop a supporting business case, thus ensuring implementation of these long-term objectives. This paper describes how two new data management roles, the Institutional Data Scientist and Technical Data Coordinator, have contributed to delivery of the Research360 project and the importance of these new types of cross-institutional roles for embedding a new data management infrastructure within an institution. Finally, the experience of developing a new institutional data policy is shared. This policy represents a particular example of the need to reconcile a funder’s expectations with the needs of individual researchers and their

  8. Recent results of μCF experiments at SIN [Swiss Institute For Nuclear Research

    International Nuclear Information System (INIS)

    Breunlich, W.H.; Cargnelli, M.; Bistirlich, J.

    1986-09-01

    Important topics concerning Muon Catalyzed Fusion were investigated in experiments at the Swiss Institute for Nuclear Research (SIN), including transient and steady state rates for the main dμt cycle as well as detailed information about the competing dμd and tμt fusion branches. The basic kinetic parameters were determined and striking features of the resonant dμt formation process were revealed (density effect, epithermal behavior). DT sticking was measured with independent techniques, i.e., detection of fusion neutrons as well as μHe x-rays after fusion. Fusion yields per muon of 113 +- 10 were observed at liquid conditions, yields exceeding 200 are anticipated for optimal conditions from our results. 43 refs., 8 figs., 3 tabs

  9. Social responsibility, international development, and institutional commitment: lessons from the Boston University experience.

    Science.gov (United States)

    Babich, Lauren P; Bicknell, William J; Culpepper, Larry; Jack, Brian W

    2008-02-01

    Boston University (BU) has a long history of a strong social mission and commitment to service. In August 2003, BU made an institutional commitment to work with the country of Lesotho to tackle the human capital implications of the HIV/AIDS epidemic. Surrounded by South Africa, and with a population of two million, Lesotho, a stable democracy, suffers the world's third-highest adult HIV prevalence rate of about 24%. The initiation of the program required a substantial initial institutional investment without any promise of payback. This allowed BU to begin work in Lesotho while searching for additional funds. The government of Lesotho and BU agreed to focus on preserving the lives of Lesotho's citizens, building the capacity of the country's workforce, and maximizing the efficiency of Lesotho's existing systems and resources. Initial activities were modest, beginning with workshops on problem solving, then the launch of a primary care clinic that offered HIV/AIDS treatment services at the nation's only teacher training college. With support from the W.K. Kellogg Foundation, the main focus is now on strengthening district-level primary care services, including the initiation of a family medicine residency training program in cooperation with the University of the Free State in Bloemfontein. The initial commitment has developed into a mutual partnership, with benefits to country and university alike. By combining the expertise from various schools and departments to focus on a single country, a university can significantly advance international development, strengthen its service mission, enrich teaching, and provide new opportunities for research.

  10. Analysis of photon count data from single-molecule fluorescence experiments

    Science.gov (United States)

    Burzykowski, T.; Szubiakowski, J.; Rydén, T.

    2003-03-01

    We consider single-molecule fluorescence experiments with data in the form of counts of photons registered over multiple time-intervals. Based on the observation schemes, linking back to works by Dehmelt [Bull. Am. Phys. Soc. 20 (1975) 60] and Cook and Kimble [Phys. Rev. Lett. 54 (1985) 1023], we propose an analytical approach to the data based on the theory of Markov-modulated Poisson processes (MMPP). In particular, we consider maximum-likelihood estimation. The method is illustrated using a real-life dataset. Additionally, the properties of the proposed method are investigated through simulations and compared to two other approaches developed by Yip et al. [J. Phys. Chem. A 102 (1998) 7564] and Molski [Chem. Phys. Lett. 324 (2000) 301].

  11. LEARNING CURVE IN SINGLE-LEVEL MINIMALLY INVASIVE TLIF: EXPERIENCE OF A NEUROSURGEON

    Directory of Open Access Journals (Sweden)

    Samuel Romano-Feinholz

    Full Text Available ABSTRACT Objective: To describe the learning curve that shows the progress of a single neurosurgeon when performing single-level MI-TLIF. Methods: We included 99 consecutive patients who underwent single-level MI-TLIF by the same neurosurgeon (JASS. Patient’s demographic characteristics were analyzed. In addition, surgical time, intraoperative blood loss and hospital stay were evaluated. The learning curves were calculated with a piecewise regression model. Results: The mean age was 54.6 years. The learning curves showed an inverse relationship between the surgical experience and the variable analyzed, reaching an inflection point for surgical time in case 43 and for blood loss in case 48. The mean surgical time was 203.3 minutes (interquartile range [IQR] 150-240 minutes, intraoperative bleeding was 97.4ml (IQR 40-100ml and hospital stay of four days (IQR 3-5 days. Conclusions: MI-TLIF is a very frequent surgical procedure due to its effectiveness and safety, which has shown similar results to open procedure. According to this study, the required learning curve is slightly higher than for open procedures, and is reached after about 45 cases.

  12. Cervical Lymph Node Metastases From Unknown Primary Cancer: A Single-Institution Experience With Intensity-Modulated Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Villeneuve, Hugo, E-mail: hugo.villeneuve@umontreal.ca [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Despres, Philippe; Fortin, Bernard; Filion, Edith; Donath, David [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Soulieres, Denis [Department of Medical Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Guertin, Louis; Ayad, Tarek; Christopoulos, Apostolos [Department of Head and Neck Surgery, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Nguyen-Tan, Phuc Felix [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada)

    2012-04-01

    Purpose: To determine the effectiveness and rate of complications of intensity-modulated radiotherapy (IMRT) in the treatment of cervical lymph node metastases from unknown primary cancer. Methods and Materials: Between February 2005 and November 2008, 25 patients with an unknown primary cancer underwent IMRT, with a median radiation dose of 70 Gy. The bilateral neck and ipsilateral putative pharyngeal mucosa were included in the target volume. All patients had squamous cell carcinoma, except for 1 patient who had adenosquamous differentiation. They were all treated with curative intent. Of the 25 included patients, 20 were men and 5 were women, with a median age of 54 years. Of these patients, 3 had Stage III, 18 had Stage IVa, and 4 had Stage IVb. Of the 25 patients, 18 (72%) received platinum-based chemotherapy in a combined-modality setting. Neck dissection was reserved for residual disease after definitive IMRT. Overall survival, disease-free survival, and locoregional control were calculated using the Kaplan-Meier method. Results: With a median follow-up of 38 months, the overall survival, disease-free survival, and locoregional control rates were all 100% at 3 years. No occurrence of primary cancer was observed during the follow-up period. The reported rates of xerostomia reduced with the interval from the completion of treatment. Nine patients (36%) reported Grade 2 or greater xerostomia at 6 months, and only 2 (8%) of them reported the same grade of salivary function toxicity after 24 months of follow-up. Conclusion: In our institution, IMRT for unknown primary cancer has provided good overall and disease-free survival in all the patients with an acceptable rate of complications. IMRT allowed us to address the bilateral neck and ipsilateral putative pharyngeal mucosa with minimal late salivary function toxicity. The use of concurrent chemotherapy and IMRT for more advanced disease led to good clinical results with reasonable toxicities.

  13. An Intersectional Social Capital Analysis of the Influence of Historically Black Sororities on African American Women's College Experiences at a Predominantly White Institution

    Science.gov (United States)

    Greyerbiehl, Lindsay; Mitchell, Donald, Jr.

    2014-01-01

    Research exploring the college experiences of African American women at predominantly White institutions (PWI) continues to be a necessity as African American women graduate at lower rates than their racial/ethnic peers. This qualitative study explored the influence historically Black sororities had on the college experiences of African American…

  14. Chronological changes in lung cancer surgery in a single Japanese institution

    Science.gov (United States)

    Nakamura, Haruhiko; Sakai, Hiroki; Kimura, Hiroyuki; Miyazawa, Tomoyuki; Marushima, Hideki; Saji, Hisashi

    2017-01-01

    Background The aim of this study was to evaluate the chronological changes in epidemiological factors and surgical outcomes in patients with lung cancer who underwent surgery in a single Japanese institution. Patients and methods A clinicopathological database of patients with lung cancer who underwent surgery with curative intent from January 1974 to December 2014 was reviewed. The chronological changes in various factors, including patient’s age, sex, histological type, tumor size, pathological stage (p-stage), surgical method, operative time, intraoperative blood loss, 30-day mortality, and postoperative overall survival (OS), were evaluated. Results A total of 1,616 patients were included. The numbers of resected patients, females, adenocarcinomas, p-stage IA patients, and age at the time of surgery increased with time, but tumor size decreased (all P<0.0001). Concerning surgical methods, the number of sublobar resections increased, but that of pneumonectomies decreased (P<0.0001). The mean operative time, intraoperative blood loss, and the postoperative 30-day mortality rate decreased (all P<0.0001). When the patients were divided into two groups (1974–2004 and 2005–2014), the 5-year OS rates for all patients and for p-stage IA patients improved from 44% to 79% and from 73% to 89%, respectively (all P<0.0001). The best 5-year OS rate was obtained for sublobar resection (73%), followed by lobectomy (60%), combined resection (22%), and pneumonectomy (21%; P<0.0001). Conclusion Changes in epidemiological factors, a trend toward less invasive surgery, and a remarkably improved postoperative OS were confirmed, which demonstrated the increasingly important role of surgery in therapeutic strategies for lung cancer. PMID:28331339

  15. Test Facilities and Experience on Space Nuclear System Developments at the Kurchatov Institute

    International Nuclear Information System (INIS)

    Ponomarev-Stepnoi, Nikolai N.; Garin, Vladimir P.; Glushkov, Evgeny S.; Kompaniets, George V.; Kukharkin, Nikolai E.; Madeev, Vicktor G.; Papin, Vladimir K.; Polyakov, Dmitry N.; Stepennov, Boris S.; Tchuniyaev, Yevgeny I.; Tikhonov, Lev Ya.; Uksusov, Yevgeny I.

    2004-01-01

    The complexity of space fission systems and rigidity of requirement on minimization of weight and dimension characteristics along with the wish to decrease expenditures on their development demand implementation of experimental works which results shall be used in designing, safety substantiation, and licensing procedures. Experimental facilities are intended to solve the following tasks: obtainment of benchmark data for computer code validations, substantiation of design solutions when computational efforts are too expensive, quality control in a production process, and 'iron' substantiation of criticality safety design solutions for licensing and public relations. The NARCISS and ISKRA critical facilities and unique ORM facility on shielding investigations at the operating OR nuclear research reactor were created in the Kurchatov Institute to solve the mentioned tasks. The range of activities performed at these facilities within the implementation of the previous Russian nuclear power system programs is briefly described in the paper. This experience shall be analyzed in terms of methodological approach to development of future space nuclear systems (this analysis is beyond this paper). Because of the availability of these facilities for experiments, the brief description of their critical assemblies and characteristics is given in this paper

  16. DNA-cisplatin binding mechanism peculiarities studied with single molecule stretching experiments

    Science.gov (United States)

    Crisafuli, F. A. P.; Cesconetto, E. C.; Ramos, E. B.; Rocha, M. S.

    2012-02-01

    We propose a method to determine the DNA-cisplatin binding mechanism peculiarities by monitoring the mechanical properties of these complexes. To accomplish this task, we have performed single molecule stretching experiments by using optical tweezers, from which the persistence and contour lengths of the complexes can be promptly measured. The persistence length of the complexes as a function of the drug total concentration in the sample was used to deduce the binding data, from which we show that cisplatin binds cooperatively to the DNA molecule, a point which so far has not been stressed in binding equilibrium studies of this ligand.

  17. FZR Institute of Radiochemistry. Annual report 1991

    International Nuclear Information System (INIS)

    Bernhard, G.

    1992-04-01

    The Research Center Rossendorf Inc. was founded on 1 January 1992 as an Institute of the Blue List. It is financed in equal shares by the Free State of Saxony and the Federal Republic of Germany. The Research Center Rossendorf (FZR) carries out its scientific work in five institutes: Institute of Ion Beam Physics and Materials Research; Institute of Nuclear and Hadronic Physics; Institute of Safety Research; Institute of Bioanorganic and Radiopharmaceutical Chemistry; Institute of Radiochemistry. The presentation of the Institute of Radiochemistry is to be considered a description of working tasks from today's angle. In the course of the formation process up to the end of the year specifications and partly also substantial changes will have to be considered. Although the Research Center Rossendorf has been recently founded, its plans are based of course on the scientific experiences of its staff. The said experiences form the basis for the status report on the lines of work. The last part compiles abridged versions of individual results achieved in 1991, documenting for specialists the work done by the groups of scientists. (orig./BBR) [de

  18. Anaesthetic management and perioperative complications during deep brain stimulation surgery: Our institutional experience

    Directory of Open Access Journals (Sweden)

    Renu Bala

    2016-01-01

    Full Text Available Background: Deep brain stimulation (DBS surgery is an established therapeutic option for alleviating movement disorders. It represents unique challenges for anaesthesiologists. We retrospectively reviewed the patients, who underwent this surgery at our institution, to study anaesthetic management and perioperative complications. Materials and Methods: After taking approval from the Institutional Ethics Committee, medical, surgical and anaesthesia records of 67 patients who were admitted to undergo DBS surgery during 11 years period (January 2001 to December 2011 were retrieved and reviewed. Sixty-five patients underwent the procedure. Various anaesthetic events and perioperative complications were noted and appropriate statistical analysis was carried out to analyse the data. Results: Electrode placement under monitored anaesthesia care (MAC was the most commonly used technique (86% of patients. Intra-operative complications occurred in 16 patients (24% whereas post-operative complication occurred in 10 patients (15.4%. There was one mortality. Though age >60 years and American Society of Anesthesiologists status > II were found to be the risk factors for post-operative complications in the bivariate analysis; they were not significant in multivariate analysis. Conclusions: We report our experience of DBS surgery, which was performed using MAC in majority of patients, though general anaesthesia is also feasible. Further prospective randomised studies comprising large number of patients are warranted to corroborate our finding and to find out the most suitable sedative agent.

  19. Lived experiences of student nurses caring for intellectually disabled people in a public psychiatric institution

    Directory of Open Access Journals (Sweden)

    Annie Temane

    2016-06-01

    Full Text Available Background: Caring for intellectually disabled people can be demanding for student nurses who are novices in the nursing profession. To ensure that quality nursing care is provided, student nurses should have an understanding of and a positive attitude towards intellectually disabled people. Nursing intellectually disabled people can be a challenge for the student nurses. Therefore, student nurses need to be able to deal with challenges of caring for intellectually disabled people. Objective: This article aims to explore and describe experiences of student nurses caring for intellectually disabled people in a public psychiatric institution. Design and method: A qualitative, exploratory, descriptive and contextual research design was used. Data were collected through individual in-depth phenomenological interviews, naïve sketches and field notes. Thematic analysis was utilised to analyse the collected data. Results were contextualised within the literature and measures to ensure trustworthiness were adhered to. Ethical principals were also applied throughout the research process. Results: Five themes emerged from the data. Student nurses experienced a profoundly unsettling impact on their whole being when caring for intellectually disabled people; they developed a sense of compassion and a new way of looking at life, and experienced a need for certain physical, mental and spiritual needs to be met. Conclusion: From the results, it is evident that student nurses were challenged in caring for intellectually disabled people. However, they developed a sense of awareness that intellectually disabled people have a need to be cared for like any other person. Keywords: experiences, student nurses, caring, intellectually disabled people, public psychiatric institution

  20. Single-centre experience of retroperitoneoscopic approach in urology with tips to overcome the steep learning curve

    Directory of Open Access Journals (Sweden)

    Aneesh Srivastava

    2016-01-01

    Full Text Available Context: The retroperitoneoscopic or retroperitoneal (RP surgical approach has not become as popular as the transperitoneal (TP one due to the steeper learning curve. Aims: Our single-institution experience focuses on the feasibility, advantages and complications of retroperitoneoscopic surgeries (RS performed over the past 10 years. Tips and tricks have been discussed to overcome the steep learning curve and these are emphasised. Settings and Design: This study made a retrospective analysis of computerised hospital data of patients who underwent RP urological procedures from 2003 to 2013 at a tertiary care centre. Patients and Methods: Between 2003 and 2013, 314 cases of RS were performed for various urological procedures. We analysed the operative time, peri-operative complications, time to return of bowel sound, length of hospital stay, and advantages and difficulties involved. Post-operative complications were stratified into five grades using modified Clavien classification (MCC. Results: RS were successfully completed in 95.5% of patients, with 4% of the procedures electively performed by the combined approach (both RP and TP; 3.2% required open conversion and 1.3% were converted to the TP approach. The most common cause for conversion was bleeding. Mean hospital stay was 3.2 ± 1.2 days and the mean time for returning of bowel sounds was 16.5 ± 5.4 h. Of the patients, 1.4% required peri-operative blood transfusion. A total of 16 patients (5% had post-operative complications and the majority were grades I and II as per MCC. The rates of intra-operative and post-operative complications depended on the difficulty of the procedure, but the complications diminished over the years with the increasing experience of surgeons. Conclusion: Retroperitoneoscopy has proven an excellent approach, with certain advantages. The tips and tricks that have been provided and emphasised should definitely help to minimise the steep learning curve.

  1. The use of fund accounting and the need for single fund reporting by institutional healthcare providers. Principles and Practices Board Statement No. 8. Healthcare Financial Management Association.

    Science.gov (United States)

    1986-06-01

    For many years, hospitals and other institutional healthcare providers used fund accounting as a basis for presenting their financial statements. Recently, authoritative literature has placed less emphasis on separate fund reporting. This is evidenced by the reduction of fund classifications specified in the literature. This trend seems to follow the recognition that institutional healthcare activities should be reported in a manner comparable to other businesses. The Principles and Practices Board (P&P Board) of the Healthcare Financial management Association believes that general purpose financial statements of institutional healthcare providers should be comparable to reporting by other businesses. That is, all assets, liabilities, and equity are presented in a single aggregated balance sheet without differentiation by fund. This form of presentation, referred to in this statement as single fund reporting, should be used by all institutional healthcare providers including those that are part of HMOs, universities, municipalities, and other larger entities when separate reports of the provider are issued. The P&P Board is studying other significant issues concerning the reporting of revenues and components of equity and changes therein. The conclusion in this statement can be implemented even though conclusions on these related subjects are not yet complete. The P&P Board recognizes that certain circumstances may require detailed records and reports for special purposes. This statement deals only with those general purpose financial statements on which an independent accountant's opinion is expressed.

  2. Postpercutaneous Nephrolithotomy Nephrostogram: Is It Mandatory? A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Abdul Rouf Khawaja

    2014-01-01

    Full Text Available Aims and Objective. “Postpercutaneous nephrolithotomy nephrostogram” (PPNN is routinely performed in most of the centers. No published series could be found in the literature without post percutaneous nephrolithotomy nephrostogram. Hence, the aim of our study is to highlight that post percutaneous nephrolithotomy nephrostogram is not mandatory and it only adds to cost and morbidity without adding any information in the management of such patients. Methods. It was a prospective study from 2005 to 2012, conducted in our institute. It included 119 patients of renal stones who underwent percutaneous nephrolithotomy performed under the guidance of a single surgeon. Postoperative nephrostogram was not done in any of the patients. Results. Complete stone clearance was achieved in 97.5% of patients and 2.5% of patients needed two to three sessions of ESWL later on. None of the patients needed second look percutaneous nephrolithotomy or nephrostogram. Conclusion. Postpercutaneous nephrolithotomy nephrostogram increases chances of infection, inconvenience, contrast related complications, and cost, with no added advantage over plain X-ray KUB, and it should not be done as a routine investigation prior to the removal of PCN tube in patients with complete stone clearance.

  3. A P&T Committee's Transition to a Complete Electronic Meeting System-A Multisite Institution Experience.

    Science.gov (United States)

    Al-Jedai, Ahmed H; Algain, Roaa A; Alghamidi, Said A; Al-Jazairi, Abdulrazaq S; Amin, Rashid; Bin Hussain, Ibrahim Z

    2017-10-01

    In the last few decades, changes to formulary management processes have taken place in institutions with closed formulary systems. However, many P&T committees continued to operate using traditional paper-based systems. Paper-based systems have many limitations, including confidentiality, efficiency, open voting, and paper wastage. This becomes more challenging when dealing with a multisite P&T committee that handles formulary matters across the whole health care system. In this paper, we discuss the implementation of the first paperless, completely electronic, Web-based formulary management system across a large health care system in the Middle East. We describe the transitioning of a multisite P&T committee in a large tertiary care institution from a paper-based to an all-electronic system. The challenges and limitations of running a multisite P&T committee utilizing a paper system are discussed. The design and development of a Web-based committee floor management application that can be used from notebooks, tablets, and hand-held devices is described. Implementation of a flexible, interactive, easy-to-use, and efficient electronic formulary management system is explained in detail. The development of an electronic P&T committee meeting system that encompasses electronic document sharing, voting, and communication could help multisite health care systems unify their formularies across multiple sites. Our experience might not be generalizable to all institutions because this depends heavily on system features, existing processes and workflow, and implementation across different sites.

  4. Negotiating Worlds, Managing Subjectivities, and Redefining Selves: The Lived Experiences of African American Undergraduate Females at Predominately White Institutions

    Science.gov (United States)

    Allen, Ayana Ma-el

    2010-01-01

    A narrative analysis of the lived experiences of seven undergraduate African American females at Predominately White Institutions (PWIs) is presented in this study. The purpose of the study was to explore the ways the seven women constructed their identity and self-concept in the context of their PWI environment. Other key purposes of the study…

  5. Data Mining in Institutional Economics Tasks

    Science.gov (United States)

    Kirilyuk, Igor; Kuznetsova, Anna; Senko, Oleg

    2018-02-01

    The paper discusses problems associated with the use of data mining tools to study discrepancies between countries with different types of institutional matrices by variety of potential explanatory variables: climate, economic or infrastructure indicators. An approach is presented which is based on the search of statistically valid regularities describing the dependence of the institutional type on a single variable or a pair of variables. Examples of regularities are given.

  6. Hydrodynamic dispersion in a single fracture: final report on CRNL experiment

    International Nuclear Information System (INIS)

    Lever, D.A.; Evans, G.V.; Novakowski, K.S.; Raven, K.G.

    1988-01-01

    One of the options under consideration for the safe long-term disposal of radioactive waste is deep burial in stable fractured rock formations. The most probable way by which radionuclides from the waste could return to the biosphere is by leaching and dissolution of the waste-form, and then water-borne transport by the ground water. In-situ tracer experiments are an important element in developing an understanding of the physical processes that determine the migration of radionuclides through the rock. Unfortunately, there are few field studies presented in the literature to date, which corroborate existing laboratory studies and provide data for theoretical models of transport through fractured rock. The objective of this study was to design and conduct a tracer experiment in which a single fracture was isolated and tested under advective flow conditions with a conservative tracer. During the summer of 1983 a joint AECL-CEC field test was carried out at the Chalk River test site in Canada. Two experiments were conducted, using 82 Br as the conservative tracer, on a discrete fracture identified by hydraulic interference tests at approximately 100 m depth in moderately-fractured monzonitic gneiss. The selected fracture intersects two boreholes in a relatively horizontal attitude over a distance of about 10 m

  7. Management of radiation hazards in hospitals: plural rationalities in a single institution

    International Nuclear Information System (INIS)

    Rayner, S.

    1986-01-01

    This paper examines the perceptions of occupational radiological hazards in a small sample of American hospitals during an anthropological pilot study conducted in 1982. The results indicate that occupants of various occupational categories exhibit diverse behaviours toward medical radiation. These behaviours are consistent with grid/group classifications of each type of occupation. Various implications for risk management and institutional design are discussed in the context of different levels of trust in individual control and institutional procedures. (author)

  8. Therapeutic outcome of nasopharyngeal carcinoma with cranial nerve palsy: a single institution experience of 104 patients

    Directory of Open Access Journals (Sweden)

    Huang CC

    2017-04-01

    Full Text Available Chun-Chieh Huang,1,2 Fu-Min Fang,1 Hui-Chun Chen,1 Hsuan-Chih Hsu,1 Tai-Lin Huang,3 Yu-Li Su,3 Ya-Chun Chang4 1Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, 2Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, 3Department of Hematology and Oncology, 4Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China Purpose: Cranial nerve (CN palsy is the main symptom in patients with locally advanced nasopharyngeal carcinoma (NPC. This study aimed to evaluate the therapeutic outcome of NPC with CN palsy and to analyze the prognostic factors.Patients and methods: A total of 104 NPC patients with CN palsy curatively treated by conventional (n=44 or conformal (n=60 radiotherapy (RT were enrolled. Upper CN palsy was present in 81 patients, lower CN palsy in four patients, and both upper and lower CN palsy in 19 patients. Forty-one patients had CN palsy for >2 months before diagnosis.Results: Complete recovery of CN palsy was observed in 74 patients. The actuarial 5-year locoregional control (LRC, distant metastasis-free survival (DMFS, and overall survival (OS rates were 58.2%, 62.2%, and 38.4%, respectively. No significant difference was observed in CN recovery, LRC, DMFS, or OS for patients treated by conventional versus conformal technique. However, significant reduction of grade 3 or greater toxicities was found in those treated by the conformal technique (odds ratio =0.28.Conclusion: Patients with CN palsy presenting >2 months before diagnosis were hard to recover from palsy. The LRC, OS, and recovery from CN palsy did not significantly change with the treatment evolution. Patients with complete recovery from CN palsy had longer OS. Keywords: nasopharyngeal carcinoma, cranial nerve palsy, radiotherapy

  9. Chronological changes in lung cancer surgery in a single Japanese institution

    Directory of Open Access Journals (Sweden)

    Nakamura H

    2017-03-01

    Full Text Available Haruhiko Nakamura, Hiroki Sakai, Hiroyuki Kimura, Tomoyuki Miyazawa, Hideki Marushima, Hisashi Saji Department of Chest Surgery, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan Background: The aim of this study was to evaluate the chronological changes in epidemiological factors and surgical outcomes in patients with lung cancer who underwent surgery in a single Japanese institution.Patients and methods: A clinicopathological database of patients with lung cancer who underwent surgery with curative intent from January 1974 to December 2014 was reviewed. The chronological changes in various factors, including patient’s age, sex, histological type, tumor size, pathological stage (p-stage, surgical method, operative time, intraoperative blood loss, 30-day mortality, and postoperative overall survival (OS, were evaluated.Results: A total of 1,616 patients were included. The numbers of resected patients, females, adenocarcinomas, p-stage IA patients, and age at the time of surgery increased with time, but tumor size decreased (all P<0.0001. Concerning surgical methods, the number of sublobar resections increased, but that of pneumonectomies decreased (P<0.0001. The mean operative time, intraoperative blood loss, and the postoperative 30-day mortality rate decreased (all P<0.0001. When the patients were divided into two groups (1974–2004 and 2005–2014, the 5-year OS rates for all patients and for p-stage IA patients improved from 44% to 79% and from 73% to 89%, respectively (all P<0.0001. The best 5-year OS rate was obtained for sublobar resection (73%, followed by lobectomy (60%, combined resection (22%, and pneumonectomy (21%; P<0.0001.Conclusion: Changes in epidemiological factors, a trend toward less invasive surgery, and a remarkably improved postoperative OS were confirmed, which demonstrated the increasingly important role of surgery in therapeutic strategies for lung cancer. Keywords: lung cancer, surgery, sublobar

  10. Photobiomodulation therapy for the management of radiation-induced dermatitis. A single-institution experience of adjuvant radiotherapy in breast cancer patients after breast conserving surgery

    International Nuclear Information System (INIS)

    Strouthos, Iosif; Chatzikonstantinou, Georgios; Tselis, Nikolaos; Bon, Dimitra; Karagiannis, Efstratios; Zoga, Eleni; Ferentinos, Konstantinos; Maximenko, Julia; Nikolettou-Fischer, Vassiliki; Zamboglou, Nikolaos

    2017-01-01

    Radiation therapy (RT) comprises a key component in the treatment of breast cancer. Radiation-induced skin toxicity is the major adverse event experienced by patients; however, radiodermatitis (RD) prevention and management remains trivial. It is proven that photobiomodulation (PBM) therapy using light-emitting diode (LED) increases wound healing and depicts an anti-inflammatory effect. This single-institute study evaluates the beneficial role of PBM-LED in preventing/reducing RD during breast cancer RT. Of 70 consecutively treated patients, 25 patients were treated with PBM-LED twice a week prior to adjuvant 3D conformal RT after breast-conserving surgery. RD was reported using Common Toxicity Criteria for Adverse Events Version 4.0 and pain intensity using a visual analog scale (VAS). For comparison, a control group (n = 45) received RT without PBM-LED. In addition, a ''matched'' group (n = 25) was generated from the control group based on propensity for potentially confounding variables. In the PBM group, 22 patients (88%) presented grade 1 and 3 (12%) grade 2 RD. In the control group, 25 patients (55.6%) developed grade 1 reactions, 18 patients (40%) grade 2, and 2 (4.4%) patients grade 3 RD. Concerning pain intensity, 15 patients (60%) of the PBM treatment arm reported no pain, 5 patients (20%) VAS 2, and 5 (20%) VAS 3. In the control group, 13 patients (28.9%) reported no pain, 2 (4.4%) VAS 1, 7 (15.6%) VAS 2, 9 patients (20%) reported VAS 3, 12 (26.7%) patients VAS 4, and 2 (4.4%) patients VAS 5. PBM-LED therapy applied prior to RT might be effective in decreasing the incidence and sequelae of radiation-induced skin toxicity in breast cancer patients treated with breast-conserving surgery. (orig.) [de

  11. Particle imaging velocimetry experiments and lattice-Boltzmann simulations on a single sphere settling under gravity

    NARCIS (Netherlands)

    Ten Cate, A.; Nieuwstad, C.H.; Derksen, J.J.; Van den Akker, H.E.A.

    2002-01-01

    A comparison is made between experiments and simulations on a single sphere settling in silicon oil in a box. Cross-correlation particle imaging velocimetry measurements were carried out at particle Reynolds numbers ranging from 1.5 to 31.9. The particle Stokes number varied from 0.2 to 4 and at

  12. Market power and the sale of Ontario residential natural gas: An institutional analysis and a laboratory experiment

    Science.gov (United States)

    Bloemhof, Barbara Lynn

    2005-11-01

    The Ontario residential natural gas market underwent a significant institutional change in 1986, after the federal government decontrolled natural gas prices. Currently, consumers may sign up for fixed-cost natural gas from a broker, or they may continue to be served by the regulated distribution company. This thesis examines the economic effects on consumers of the institutional change, and particularly whether or not market power was enhanced by the change. In the thesis, I first present the industrial organization of the residential natural gas sector, and explain the institutional evolution using an institutional economic approach. I then construct a model of the market environment, with sellers acting as middlemen in a well-defined Bertrand oligopoly setting with no production constraints and single-unit consumer demands. In this model, the only Nash equilibrium in the one-period game is the joint profit maximizing price, and its likelihood of obtaining depends on the nature of the cost of signing up new customers. I then take a version of this model into the laboratory with human subject sellers and simulated buyers and run six replications each of a balanced treatment design under a unique information mechanism that parallels individual customer canvassing used by sellers in the naturally-occurring market. Treatment variables are: number of sellers, number of simulated at-cost sellers present, and presence of input cost uncertainty for sellers. I find that adding any seller to the market has about the same impact on market price, irrespective of whether it is a human subject or a simulated at-cost seller. Although increasing the number of sellers does decrease the market price somewhat, it does not bring about the competitive outcome predicted by the benchmark microeconomic model. This research contributes to the literature on policy making and energy market design, as well as to experimental methodology aimed at policy evaluation.

  13. Surgical treatment of secondary hyperparathyroidism in elderly patients: an institutional experience.

    Science.gov (United States)

    Polistena, Andrea; Sanguinetti, Alessandro; Lucchini, Roberta; Galasse, Segio; Avenia, Stefano; Monacelli, Massimo; Johnson, Louis Banka; Jeppsson, Bengt; Avenia, Nicola

    2017-02-01

    Secondary hyperparathyroidism in elderly fragile patients presents clinical difficulties due to severity of symptoms and related comorbidity. The optimal surgical approach for this group of patients is still debated. The aim of the study was to define the optimal technique of parathyroidectomy in elderly patients with secondary hyperparathyroidism. Retrospective analysis in a series of 253 patients including 35 elderly individuals at a single institution was carried out. Postoperative parathyroid hormone decrease, surgical complications and symptoms control were analyzed for all patients in relation to the types of parathyroidectomy performed. In elderly patients, total parathyroidectomy was the most used approach. Subtotal parathyroidectomy was mostly reserved for younger patients suitable for kidney transplantation. No elderly patients treated with total parathyroidectomy were autotransplanted. No significant difference in surgical complications was observed between younger and elderly patients and considering the different procedures. Adequate symptom control after surgery was achieved in almost 90% of patients. A limited rate of recurrence requiring repeat surgery was observed only after subtotal parathyroidectomy. Considering the features of all types of parathyroidectomy, very low recurrence rate, contained postoperative hypocalcemia and limited complications following total parathyroidectomy, might represent specific advantages for elderly patients. Total parathyroidectomy without parathyroid transplantation is safe for elderly patients with secondary hyperparathyroidism and a good alternative to the well-established total parathyroidectomy with autografting.

  14. Workplace Innovation as Institutional Entrepreneurship

    DEFF Research Database (Denmark)

    Hvid, Helge Søndergaard; Scheller, Vibeke Kristine

    2017-01-01

    Workplace Innovation (WPI) ascribes to the tradition of Sociotechnical Systems (STS) in organisational development. Experiences of promoting STS show that neither economic arguments nor arguments of humanising work are sufficient to get companies to implement WPI activities. This chapter therefore...... that institutional alliances and coalitions are an important part of institutional entrepreneurship that creates change in the direction of WPI. The case studies also indicate that the sustainability of the introduced WPI activities depends on the institutional alliances related to their activity....

  15. Risk models for mortality following elective open and endovascular abdominal aortic aneurysm repair: a single institution experience.

    Science.gov (United States)

    Choke, E; Lee, K; McCarthy, M; Nasim, A; Naylor, A R; Bown, M; Sayers, R

    2012-12-01

    To develop and validate an "in house" risk model for predicting perioperative mortality following elective AAA repair and to compare this with other models. Multivariate logistics regression analysis was used to identify risk factors for perioperative-day mortality from one tertiary institution's prospectively maintained database. Consecutive elective open (564) and endovascular (589) AAA repairs (2000-2010) were split randomly into development (810) and validation (343) data sets. The resultant model was compared to Glasgow Aneurysm Score (GAS), Modified Customised Probability Index (m-CPI), CPI, the Vascular Governance North West (VGNW) model and the Medicare model. Variables associated with perioperative mortality included: increasing age (P = 0.034), myocardial infarct within last 10 years (P = 0.0008), raised serum creatinine (P = 0.005) and open surgery (P = 0.0001). The areas under the receiver operating characteristic curve (AUC) for predicted probability of 30-day mortality in development and validation data sets were 0.79 and 0.82 respectively. AUCs for GAS, m-CPI and CPI were poor (0.63, 0.58 and 0.58 respectively), whilst VGNW and Medicare model were fair (0.73 and 0.79 respectively). In this study, an "in-house" developed and validated risk model has the most accurate discriminative value in predicting perioperative mortality after elective AAA repair. For purposes of comparative audit with case mix adjustments, national models such as the VGNW or Medicare models should be used. Copyright © 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  16. Shared Governance and Regional Accreditation: Institutional Processes and Perceptions

    Science.gov (United States)

    McGrane, Wendy L.

    2013-01-01

    This qualitative single-case research study was conducted to gain deeper understanding of the institutional processes to address shared governance accreditation criteria and to determine whether institutional processes altered stakeholder perceptions of shared governance. The data collection strategies were archival records and personal…

  17. INFLUENCE OF RELATIONS WITH INTERNATIONAL FINANCIAL INSTITUTIONS ON INSTITUTIONAL TRANSFORMATIONS OF ECONOMY

    Directory of Open Access Journals (Sweden)

    Galyna POCHENCHUK

    2014-12-01

    Full Text Available The article deals with the problem of the impact of transitional countries cooperation with international financial institutions on institutional changes which take place in emerging market economies, on the base of Ukraine. Research is carried out from the standpoint of institutional theory. The main reforms that took place in emerging market economy countries were based on the Washington Consensus strategy recommended by international financial institutions. The results of implementing this strategy are varied in different countries. In Ukraine strict adherence to requirements in the early stages of reforms without internal institutional conditions and characteristics led to a deep and protracted crisis of forming a "transformational stability." The general formal institutions of the market economy have been created according to the neoliberal concept which is provided by IFIs. However, experience of transitive economies including Ukraine, confirms the ineffectiveness of many established formal institutions borrowed from the developed countries. The author reviews the basic theory of institutional changes, argues that the terms of cooperation circulated by international financial institutions not only affect economic development strategy, but also determine the role of the national government in relations with markets. Under present conditions prevailing in Ukraine, it is impossible to manage without assistance of international financial institutions. But we need to pay more attention to technical and advisory cooperation in realization of institutional reforms, and credits – to take as a required time for receiving the results of reforms.

  18. Single atom oscillations

    International Nuclear Information System (INIS)

    Wiorkowski, P.; Walther, H.

    1990-01-01

    Modern methods of laser spectroscopy allow the study of single atoms or ions in an unperturbed environment. This has opened up interesting new experiments, among them the detailed study of radiation-atom coupling. In this paper, the following two experiments dealing with this problem are reviewed: the single-atom maser and the study of the resonance fluorescence of a single stored ion. The simplest and most fundamental system for studying radiation-matter coupling is a single two-level atom interacting with a single mode of an electromagnetic field in a cavity. This problem received a great deal of attention shortly after the maser was invented

  19. CFD Simulations of a Single-phase Mixing Experiment

    International Nuclear Information System (INIS)

    Bertolotto, Davide; Chawla, Rakesh; Manera, Annalisa; Prasser, Horst-Michael

    2008-01-01

    The current paper reports on an investigation of the capabilities of CFD codes to model multidimensional mixing phenomena in a loop. For the purpose, a test facility consisting of two loops connected by a double T-junction has been built at the Paul Scherrer Institut (PSI). Experiments were carried out, in which a tracer was injected in one loop and the tracer distribution before and after the T-junction was measured by means of wire-mesh sensors located at the outlets of the junction. The tracer distribution after the T-junction is strongly dependent on 3D mixing phenomena, which are dominant due to the particular geometry of the set-up. For the CFD analysis, a 3D model of the double T-junction was created, and different simulations were performed with ANSYS-CFX to study the sensitivity of the results with respect to parameters such as mesh refinement, integration time step, turbulence model, profiles for inlet velocity and injected tracer concentration. Thereafter, these results were compared with the experimental data. The comparisons have clearly pointed out that 3D modelling is able to reproduce (at least qualitatively) the experimental results. Moreover, it has been found that the CFD results are strongly influenced by the velocity profile assumptions at the inlets of the double T-junction. (authors)

  20. Fuel rod simulator effects in flooding experiments single rod tests

    International Nuclear Information System (INIS)

    Nishida, M.

    1984-09-01

    The influence of a gas filled gap between cladding and pellet on the quenching behavior of a PWR fuel rod during the reflood phase of a LOCA has been investigated. Flooding experiments were conducted with a short length electrically heated single fuel rod simulator surrounded by glass housing. The gap of 0.05 mm width between the Zircaloy cladding and the internal Al 2 O 3 pellets of the rod was filled either wit helium or with argon to vary the radial heat resistance across the gap. This report presents some typical data and an evaluation of the reflood behavior of the fuel rod simulator used. The results show that the quench front propagates faster for increasing heat resistance in the gap between cladding and heat source of the rod. (orig.) [de

  1. Single-Center Experience Using Marginal Liver Grafts in Korea.

    Science.gov (United States)

    Park, P-J; Yu, Y-D; Yoon, Y-I; Kim, S-R; Kim, D-S

    2018-05-01

    Liver transplantation (LT) is an established therapeutic modality for patients with end-stage liver disease. The use of marginal donors has become more common worldwide due to the sharp increase in recipients, with a consequent shortage of suitable organs. We analyzed our single-center experience over the last 8 years in LT to evaluate the outcomes of using so-called "marginal donors." We retrospectively analyzed the database of all LTs performed at our institution from 2009 to 2017. Only patients undergoing deceased-donor LTs were analyzed. Marginal grafts were defined as livers from donors >60 years of age, livers from donors with serum sodium levels >155 mEq, graft steatosis >30%, livers with cold ischemia time ≥12 hours, livers from donors who were hepatitis B or C virus positive, livers recovered from donation after cardiac death, and livers split between 2 recipients. Patients receiving marginal grafts (marginal group) were compared with patients receiving standard grafts (standard group). A total of 106 patients underwent deceased-donor LT. There were 55 patients in the standard group and 51 patients in the marginal group. There were no significant differences in terms of age, sex, Model for End-Stage Liver Disease score, underlying liver disease, presence of hepatocellular carcinoma, and hospital stay between the 2 groups. Although the incidence of acute cellular rejection, cytomegalovirus infection, and postoperative complications was similar between the 2 groups, the incidence of early allograft dysfunction was higher in the marginal group. With a median follow-up of 26 months, the 1-, 3-, and 5-year overall and graft (death-censored) survivals in the marginal group were 85.5%, 75%, and 69.2% and 85.9%, 83.6%, and 77.2%, respectively. Patient overall survival and graft survival (death-censored) were significantly lower in the marginal group (P = .023 and P = .048, respectively). On multivariate analysis, receiving a marginal graft (hazard ratio [HR

  2. The Type of Breast Reconstruction May Not Influence Patient Satisfaction in the Chinese Population: A Single Institutional Experience

    Science.gov (United States)

    Chen, Jiaying; Chen, Ying; Hu, Zhen; Liu, Guangyu; Shen, Zhenzhou; Shao, Zhimin; Wu, Jiong

    2015-01-01

    Background The goal of this study was to evaluate patient satisfaction with four common types of breast reconstruction performed at our institution: latissimus dorsi myocutaneous (LDM) flap reconstruction with or without implants, pedicled transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction, and free deep inferior epigastric perforator (DIEP) flap reconstruction. Methods A custom survey consisting of questions that assessed general and aesthetic satisfaction was sent to patients who had undergone breast reconstruction in the last 5 years. The clinical data and details of the surgery were also collected from the patients who returned the surveys. We compared satisfaction rates across the four breast reconstruction types and analyzed the effects of various factors on overall general and aesthetic satisfaction rates using a binary logistic regression model. Result A total of 207 (72%) patients completed the questionnaires. Overall, significant differences in general and aesthetic satisfaction among the four procedures were not observed. A multivariate analysis revealed that the factor “complications” (p = 0.001) played a significant role in general satisfaction and that the factors “> 2 years since reconstruction” (p = 0.043) and “age > 35 years” (p = 0.05) played significant roles in overall aesthetic satisfaction. Conclusion The present study demonstrated that the type of breast reconstruction might not influence satisfaction in Chinese patients. PMID:26562294

  3. MOOCs and their Effect on the Institution: Experiences in Course Design, Delivery and Evaluation; Research; Faculty Development; Unbundling and Credits for MOOCs

    Directory of Open Access Journals (Sweden)

    Janine Kiers

    2016-07-01

    Full Text Available Four years after the introduction of MOOCs – which were proclaimed to be «the end of education as we know it» in 2012 – the role and effect of these free, online courses is becoming clearer. The online means of delivery to the heterogeneous audiences of MOOCs have enabled and compelled instructors and course teams to develop innovative and flexible learning materials. We can analyse the data on the study behaviour of learners to identify which course elements are effective. In addition, the integration of elements of MOOCs in campus education has resulted in promising outcomes and positive reactions from both students and teachers. On the level of the institution, we also see the effect of MOOCs: ranging from new possibilities in communication and branding, to new needs for faculty development and the support organisation. Furthermore, MOOCs play a role in the unbundling of education, e.g. the learning experience and the assessment tasks now can be uncoupled and may be delivered by different institutions and by different means: the learning experience may be in the form of a MOOC and the assessment may be a written exam at an institution.

  4. Experimental Spaces and Institutional Innovation

    DEFF Research Database (Denmark)

    Cartel, Melodie; Boxenbaum, Eva

    and procedures that connect the prototype to the organizational field, hence increasing the likelihood of institutional innovation. We develop a process model of institutional institutionalization that, through temporal interactions between distancing work and anchoring work, enables the generation......This paper examines processes involved in designing experimental spaces for institutional innovation. Through a qualitative, process-oriented analysis of an experimental space related to the institutional innovation of carbon markets in Europe, we show how key actors in the European electricity...... sector deliberately designed an experimental space and engaged a range of stakeholders in experimenting incognito with a carbon market model. A mirror image of their prototype later appeared as European policy. Our findings show that the key actors engaged in two forms of institutional work, distancing...

  5. 2012 Summer Research Experiences for Undergraduates at Pisgah Astronomical Research Institute

    Science.gov (United States)

    Castelaz, Michael W.; Cline, J. D.; Whitworth, C.; Clavier, D.; Owen, L.

    2013-01-01

    Pisgah Astronomical Research Institute (PARI) offers research experiences for undergraduates (REU). PARI receives support for the internships from the NC Space Grant Consortium, NSF awards, private donations, and industry partner funding. The PARI REU program began in 2001 with 4 students and has averaged 6 students per year over the past 11 years. This year PARI hosted 8 funded REU students. Mentors for the interns include PARI’s Science, Education, and Information Technology staff and visiting faculty who are members of the PARI Research Faculty Affiliate program. Students work with mentors on radio and optical astronomy research, electrical engineering for robotic control of instruments, software development for instrument control and software for citizen science projects, and science education by developing curricula and multimedia and teaching high school students in summer programs at PARI. At the end of the summer interns write a paper about their research which is published in the annually published PARI Summer Student Proceedings. Several of the students have presented their results at AAS Meetings. We will present a summary of specific research conducted by the students with their mentors and the logistics for hosting the PARI undergraduate internship program.

  6. Laparoendoscopic single-site repair of bladder rupture using a home-made single-port device: initial experience of treatment for a traumatic intraperitoneal bladder rupture.

    Science.gov (United States)

    Lee, Joo Yong; Kang, Dong Hyuk; Lee, Seung Wook

    2012-06-01

    We report our initial experience with a laparoendoscopic single-site (LESS) repair of a bladder rupture using a home-made single-port device. A 37-year-old man presented to the emergency department with complaints of voiding difficulty and gross hematuria after blunt trauma. Cystography and computed tomography revealed an intraperitoneal bladder rupture. The patient underwent LESS repair of a bladder rupture using the Alexis wound retractor, which was inserted through the umbilical incision. A home-made single-port device was made by fixing 6½ surgical gloves to the outer rim of the retractor and securing the glove finger to the end of 3 trocars with a tie. Using the flexible laparoscopic instruments and rigid instruments, LESS surgery was performed using a procedure similar to conventional laparoscopic surgery. The patient did not have any voiding problem after removal of the urethral Foley catheter on the 10th postoperative day. To our knowledge, this is the first published report of LESS repair of a traumatic bladder rupture using a home-made single-port device in the literature.

  7. Listening to children: gaining a perspective of the experiences of poverty and social exclusion from children and young people of single-parent families.

    Science.gov (United States)

    Walker, Janet; Crawford, Karin; Taylor, Francesca

    2008-07-01

    This paper reports on the experiences and views of children and young people of single-parent families, as findings from a European Union-funded research project undertaken in England, Greece and Cyprus. The objectives of the research project were to investigate how children and young people of single-parent families understand and experience their worlds as members of these families: whether and to what extent they experience poverty and social exclusion and how they cope with the challenges that this confronts them with. Methodology was replicated in each of the countries; however, this paper draws on the English experiences. Semistructured interviews (40) and focus groups (four) were undertaken with children of single parents. In addition, focus groups were undertaken with children of two-parent families (four), focus groups with single parents, focus groups with two-parent families (four) and individual interviews with key professionals. Detailed discussion guides were followed, with open-ended questions to allow participants to express their feelings and ideas in their own words. The research sample included children from single-parent and two-parent families, aged 6 years to 16 years, balanced in terms of age, gender and geographical location. Findings demonstrate the children's and young people's understanding of the impact of poverty and social exclusion on their family life and their everyday experiences. The positive benefits of being in a single-parent family are highlighted, with 'time poverty' raised as a significant issue. Children and young people are aware of their poverty and how it influences exclusion from friendships, play, leisure and community activities. Policy needs to take account of the systematic reality of children's experiences; alliances with adults that support meaningful involvement and participation by children and young people will make a significant contribution to this.

  8. Engineering and management experience at Texas A&M Transportation Institute

    Science.gov (United States)

    Chowdhury, Arif Tahjibul

    This manuscript presents the author's engineering and management experience during his internship in the Materials and Pavements (M&P) Division at the Texas A&M Transportation Institute (TTI), and is a record of study for the Doctor of Engineering at Texas A&M University. Through this internship, he met his established internship objectives of gaining technical knowledge as well as knowledge and skills in project management, organizational communication, and quality management of pavement condition data, and of attaining professional development. In meeting these objectives, the author describes the history, mission, and organizational structure of his workplace. He also presents his experience of developing and delivering a two-week training course on pavement design and construction in Kosovo. Participating in a number of professional development training courses and other activities prepared him for working as an engineering manager. These activities include Delta-T leadership training, an instructor development course, a time management and organizational skills course, and the M&P Division lecture series. Leadership and skills learned through the Delta-T program were beneficial for the employee as well as the employer. For the class project, the author and his teammates performed a study dealing with improving TTI's deliverables. The Delta-T team composed a report summarizing their efforts of examining the current state of TTI's project deliverables, the deliverables' shortcomings, and potential enhancements to expand the deliverables' appeal to additional types of potential users outside the traditional research community. The team also developed a prototype web-based model of deliverables and presented some implementation recommendations. Participating in the Texas Department of Transportation's (TxDOT's) pavement surface distress data collection program enabled the author to become familiar with pavement distress data quality management and thus attain the

  9. Clinical results of stereotactic body radiotherapy for Stage I small-cell lung cancer. A single institutional experience

    International Nuclear Information System (INIS)

    Shioyama, Yoshiyuki; Nakamura, Katsumasa; Sasaki, Tomonari; Ohga, Saiji; Yoshitake, Tadamasa; Nonoshita, Takeshi; Asai, Kaori; Terashima, Koutarou; Matsumoto, Keiji; Hirata, Hideki; Honda, Hiroshi

    2013-01-01

    The purpose of this study was to evaluate the treatment outcomes of stereotactic body radiotherapy (SBRT) for Stage I small-cell lung cancer (SCLC). From April 2003 to September 2009, a total of eight patients with Stage I SCLC were treated with SBRT in our institution. In all patients, the lung tumors were proven as SCLC pathologically. The patients' ages were 58-84 years (median: 74). The T-stage of the primary tumor was T1a in two, T1b in two and T2a in four patients. Six of the patients were inoperable because of poor cardiac and/or pulmonary function, and two patients refused surgery. SBRT was given using 7-8 non-coplanar beams with 48 Gy in four fractions. Six of the eight patients received 3-4 cycles of chemotherapy using carboplatin (CBDCA) + etoposide (VP-16) or cisplatin (CDDP) + irinotecan (CPT-11). The follow-up period for all patients was 6-60 months (median: 32). Six patients were still alive without any recurrence. One patient died from this disease and one died from another disease. The overall and disease-specific survival rate at three years was 72% and 86%, respectively. There were no patients with local progression of the lesion targeted by SBRT. Only one patient had nodal recurrence in the mediastinum at 12 months after treatment. The progression-free survival rate was 71%. No Grade 2 or higher SBRT-related toxicities were observed. SBRT plus chemotherapy could be an alternative to surgery with chemotherapy for inoperable patients with Stage I small-cell lung cancer. However, further investigation is needed using a large series of patients. (author)

  10. Comparison of children versus adults undergoing mini-percutaneous nephrolithotomy: large-scale analysis of a single institution.

    Directory of Open Access Journals (Sweden)

    Guohua Zeng

    Full Text Available OBJECTIVE: As almost any version of percutaneous nephrolithotomy (PCNL was safely and efficiently applied for adults as well as children without age being a limiting risk factor, the aim of the study was to compare the different characteristics as well as the efficacy, outcome, and safety of the pediatric and adult patients who had undergone mini-PCNL (MPCNL in a single institution. METHODS: We retrospective reviewed 331 renal units in children and 8537 renal units in adults that had undergone MPCNL for upper urinary tract stones between the years of 2000-2012. The safety, efficacy, and outcome were analyzed and compared. RESULTS: The children had a smaller stone size (2.3 vs. 3.1 cm but had smilar stone distribution (number and locations. The children required fewer percutaneous accesses, smaller nephrostomy tract, shorter operative time and less hemoglobin drop. The children also had higher initial stone free rate (SFR (80.4% vs. 78.6% after single session of MPCNL (p0.05. Both groups had low rate of high grade Clavien complications. There was no grade III, IV, V complications and no angiographic embolization required in pediatric group. One important caveat, children who required multiple percutaneous nephrostomy tracts had significant higher transfusion rate than in adults (18.8% vs. 4.5%, p = 0.007. CONCLUSIONS: This contemporary largest-scale analysis confirms that the stone-free rate in pediatric patients is at least as good as in adults without an increase of complication rates. However, multiple percutaneous nephrostomy tracts should be practiced with caution in children.

  11. Single Policy Study

    DEFF Research Database (Denmark)

    Kronsell, Annica; Manners, Ian James

    2015-01-01

    Single policy studies are the most common form of European Union (EU) research. Single policy studies are widely used to understand the role of the EU in a wide variety of sectors, together with their development over time, and often offer public policy prescriptions. This chapter discusses...... the relevance of single policy studies in EU research and give examples of how such research can be designed and carried out. The chapter reviews three examples of single policy studies using different methods based on EU environmental policy, the EU biofuels directive, and the EU Common Security and Defence...... Policy (CSDP). The examples are illustrative of how single policy studies can be designed to use different approaches in the analysis: multiple streams approach to policy-making; a comparative hypothesis testing; and feminist institutional theory....

  12. institutional and resource constraints that inhibit contractor ...

    African Journals Online (AJOL)

    p2333147

    Keywords: Institutions; small-scale contractor performance; sugar industry. ABSTRACT ..... diverse cultural settings, women, specifically widowed or single women, have a .... constraints on business growth, such as the work limitations placed.

  13. Single-molecule experiments in biological physics: methods and applications.

    Science.gov (United States)

    Ritort, F

    2006-08-16

    I review single-molecule experiments (SMEs) in biological physics. Recent technological developments have provided the tools to design and build scientific instruments of high enough sensitivity and precision to manipulate and visualize individual molecules and measure microscopic forces. Using SMEs it is possible to manipulate molecules one at a time and measure distributions describing molecular properties, characterize the kinetics of biomolecular reactions and detect molecular intermediates. SMEs provide additional information about thermodynamics and kinetics of biomolecular processes. This complements information obtained in traditional bulk assays. In SMEs it is also possible to measure small energies and detect large Brownian deviations in biomolecular reactions, thereby offering new methods and systems to scrutinize the basic foundations of statistical mechanics. This review is written at a very introductory level, emphasizing the importance of SMEs to scientists interested in knowing the common playground of ideas and the interdisciplinary topics accessible by these techniques. The review discusses SMEs from an experimental perspective, first exposing the most common experimental methodologies and later presenting various molecular systems where such techniques have been applied. I briefly discuss experimental techniques such as atomic-force microscopy (AFM), laser optical tweezers (LOTs), magnetic tweezers (MTs), biomembrane force probes (BFPs) and single-molecule fluorescence (SMF). I then present several applications of SME to the study of nucleic acids (DNA, RNA and DNA condensation) and proteins (protein-protein interactions, protein folding and molecular motors). Finally, I discuss applications of SMEs to the study of the nonequilibrium thermodynamics of small systems and the experimental verification of fluctuation theorems. I conclude with a discussion of open questions and future perspectives.

  14. Single-molecule experiments in biological physics: methods and applications

    International Nuclear Information System (INIS)

    Ritort, F

    2006-01-01

    I review single-molecule experiments (SMEs) in biological physics. Recent technological developments have provided the tools to design and build scientific instruments of high enough sensitivity and precision to manipulate and visualize individual molecules and measure microscopic forces. Using SMEs it is possible to manipulate molecules one at a time and measure distributions describing molecular properties, characterize the kinetics of biomolecular reactions and detect molecular intermediates. SMEs provide additional information about thermodynamics and kinetics of biomolecular processes. This complements information obtained in traditional bulk assays. In SMEs it is also possible to measure small energies and detect large Brownian deviations in biomolecular reactions, thereby offering new methods and systems to scrutinize the basic foundations of statistical mechanics. This review is written at a very introductory level, emphasizing the importance of SMEs to scientists interested in knowing the common playground of ideas and the interdisciplinary topics accessible by these techniques. The review discusses SMEs from an experimental perspective, first exposing the most common experimental methodologies and later presenting various molecular systems where such techniques have been applied. I briefly discuss experimental techniques such as atomic-force microscopy (AFM), laser optical tweezers (LOTs), magnetic tweezers (MTs), biomembrane force probes (BFPs) and single-molecule fluorescence (SMF). I then present several applications of SME to the study of nucleic acids (DNA, RNA and DNA condensation) and proteins (protein-protein interactions, protein folding and molecular motors). Finally, I discuss applications of SMEs to the study of the nonequilibrium thermodynamics of small systems and the experimental verification of fluctuation theorems. I conclude with a discussion of open questions and future perspectives. (topical review)

  15. Single-tube condensation experiment in Passive Auxiliary Feedwater System of APR1400+

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Chang Wook; No, Hee Cheon; Yun, Bong Yo; Jeon, Byong Guk [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    2012-05-15

    Conventional Korean nuclear power plants, Advanced Power Reactors (APR), are characterized by an active cooling system. However, Active cooling system may not prevent significant damage without any AC power source available for its operation as vividly illustrated through the recent Fukushima incident. In the APR1400+ to be designed, an independent passive cooling system was added in order to overcome the aforementioned shortcomings. In the Passive Auxiliary Feedwater System (PAFS), gravity force and density difference between steam and water are used. The system comprises of 240 condensation tubes to efficiently remove decay heat. Before applying the PAFS to APR1400+, the system's safety and heat removal performance must be verified. The present study experimentally evaluates the heat removal performance of a single tube in the PAFS. The objectives of SCOP (Single-tube Condensation experiment facility of PAFS) are the evaluation of the heat removal performance in the tube of the PAFS and database construction under various tube designs and test conditions. Reaching these objectives, we developed advanced measurement techniques for the amount of moisture, heat flux, and water film thickness.

  16. Strength That Silences: Learning from the Experiences of Black Female College Students with Mental Health Concerns at a Predominantly White Institution

    Science.gov (United States)

    Caesar-Richardson, Nadia Monique

    2012-01-01

    This qualitative study examines first person accounts of college experiences provided by Black female college students with mental health concerns at a predominantly White institution. Utilizing the theoretical frameworks of disability studies and critical race feminism to develop the study and analyze the collected data, this study considers the…

  17. A review of experiment data processing method for uranium mining and metallurgy in BRICEM

    International Nuclear Information System (INIS)

    Ye Guoqiang; Lu Kehong; Wang Congying

    1997-01-01

    The authors investigates the methods of experiment data processing in Beijing Research Institute of Chemical Engineering and Metallurgy (BRICEM). It turns out that error analysis method is used to process experiment data, single-factor transformation and orthogonal test design method are adopted for arranging test, and regression analysis and mathematical process simulation are applied to process mathematical model for uranium mining and metallurgy. The methods above-mentioned lay a foundation for the utilization of mathematical statistics in our subject

  18. New experiment to gain unparalleled insight into antimatter

    CERN Multimedia

    Katarina Anthony

    2013-01-01

    At last week’s Research Board meeting, the Baryon Antibaryon Symmetry Experiment (BASE) was approved for installation at CERN. The experiment will be diving into the search for matter-antimatter asymmetry, as it aims to take ultra-high precision measurements of the antiproton magnetic moment.   CERN's AD Hall: the new home of the BASE double Penning trap set-up. The BASE collaboration will be setting up shop in the AD Hall this September with its first CERN-based experimental set-up. Using the novel double-Penning trap set-up developed at the University of Mainz, GSI Darmstadt and the Max Plank Institute for Nuclear Physics (Germany), the BASE team will be able to measure the antiproton magnetic moment with hitherto unreachable part-per-billion precision. “We constructed the first double-Penning trap at our companion facility in Germany, and made the first ever direct observations of single spin flips of a single proton,” explains Stefan Ulmer from RIKE...

  19. Paediatric percutaneous nephrolithotomy: single-centre 10-year experience.

    Science.gov (United States)

    Bhageria, Anand; Nayak, Brusabhanu; Seth, Amlesh; Dogra, Prem Nath; Kumar, Rajeev

    2013-08-01

    Percutaneous nephrolithotomy (PCNL) is a standard management option for complex and large renal calculi. In children, there is some concern over potential perioperative complications. We reviewed our 10 years of experience of PCNL in children and present our data. Data for paediatric patients who underwent PCNL at our centre in the last decade were retrieved. PCNL was performed in standard prone position under fluoroscopic guidance. Patient characteristics, outcomes and complications were reviewed. Complications were graded according to the modified Clavien system. A comparison was also made between supracostal and infracostal accesses. 95 children underwent PCNL in our institute in the last decade. 7 patients had bilateral PCNL. The most common presentation was flank pain (85%). 83% patients were stone-free after first PCNL and overall 94% were stone free after second-look PCNL and auxillary procedures. 6 cases had clinically insignificant residual fragments. Supracostal puncture was performed in 32 cases. Complications were higher in the supracostal puncture group (16 (50%)) and included fever in 11, sepsis in 2 and hydrothorax in 3 patients. There were 7 (10%) complications in the infracostal group: fever in 5 and perinephric collection in 2 patients. 16 patients had grade 1, 9 had grade 2 and another 2 cases developed grade 3 complications. PCNL is a safe and effective procedure in children. It enables excellent stone clearance with minimal number of interventions. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  20. Intractable trigeminal neuralgia: A single institution experience in 26 patients treated with stereotactic gamma knife radiosurgery

    International Nuclear Information System (INIS)

    Mark, Rufus J.; Duma, Christopher M.; Jacques, Dean B.; Kopyov, Oleg V.; Copcutt, Brian

    1996-01-01

    Purpose: In patients with trigeminal neuralgia, severe pain can persist, or recur despite aggressive medical management and open surgery. Recently, Gamma Knife radiosurgery has been used with promising results. We report on our series of 26 patients with intractable trigeminal neuralgia treated with stereotactic Gamma Knife radiosurgery. Materials and Methods: Between 1991 and 1995, 26 patients with intractable trigeminal neuralgia were treated at our institution using stereotactic Gamma Knife radiosurgery. Medical management had failed in all cases. In addition, 13 patients underwent a total of 20 open surgeries, with transient, or no pain relief. There were 19 females, and 7 males. Patient ages ranged from 37 to 87 years, with a median of 74 years. All patients were treated with a 201 source Cobalt-60 Gamma Knife unit. All patients underwent placement of the Leksell frame, followed by MRI scanning and computer treatment planning. The target in all patients was the fifth cranial nerve root entry zone into the brainstem. Twenty-five patients received between 64.3 to 70 Gy prescribed to Dmax in one shot. One patient received 120 Gy to Dmax in one shot. The 4 mm collimator was used in 22 cases, and the 8 mm in 4 cases. Follow-up ranged from 5 to 55 months, with a median of 19 months. Complete resolution (CR) of pain was scored when the patient reported being pain free off all medication. Partial resolution (PR) was scored when the patient reported > 50% pain reduction after Gamma Knife treatment. Results: At last follow-up, 84.6% ((22(26))) reported CR or PR of pain after Gamma Knife treatment. Forty-two percent ((11(26))) of patients reported CR, and 42%((11(26))) reported PR of pain. There was a dose response. In patients receiving < 70 Gy, 25% ((3(12))) reported CR, while 57% ((8(14))) of those receiving ≥ 70 Gy reported CR. Complications occurred in two (8%) patients. One patient developed transient numbness of the face after 70 Gy, and a second patient

  1. Single incision laparoscopic colorectal resection: Our experience

    Directory of Open Access Journals (Sweden)

    Chinnusamy Palanivelu

    2012-01-01

    Full Text Available Background: A prospective case series of single incision multiport laparoscopic colorectal resections for malignancy using conventional laparoscopic trocars and instruments is described. Materials and Methods: Eleven patients (seven men and four women with colonic or rectal pathology underwent single incision multiport laparoscopic colectomy/rectal resection from July till December 2010. Four trocars were placed in a single transumblical incision. The bowel was mobilized laparoscopically and vessels controlled intracorporeally with either intra or extracorporeal anastomosis. Results: Three patients had carcinoma in the caecum, one in the hepatic flexure, two in the rectosigmoid, one in the descending colon, two in the rectum and two had ulcerative pancolitis (one with high grade dysplasia and another with carcinoma rectum. There was no conversion to standard multiport laparoscopy or open surgery. The median age was 52 years (range 24-78 years. The average operating time was 130 min (range 90-210 min. The average incision length was 3.2 cm (2.5-4.0 cm. There were no postoperative complications. The average length of stay was 4.5 days (range 3-8 days. Histopathology showed adequate proximal and distal resection margins with an average lymph node yield of 25 nodes (range 16-30 nodes. Conclusion: Single incision multiport laparoscopic colorectal surgery for malignancy is feasible without extra cost or specialized ports/instrumentation. It does not compromise the oncological radicality of resection. Short-term results are encouraging. Long-term results are awaited.

  2. Postpartum tubal ligation: A retrospective review of anesthetic management at a single institution and a practice survey of academic institutions.

    Science.gov (United States)

    McKenzie, Christine; Akdagli, Seden; Abir, Gillian; Carvalho, Brendan

    2017-12-01

    The primary aim was to evaluate institutional anesthetic techniques utilized for postpartum tubal ligation (PPTL). Secondarily, academic institutions were surveyed on their clinical practice for PPTL. An institutional-specific retrospective review of patients with ICD-9 procedure codes for PPTL over a 2-year period was conducted. Obstetric anesthesia fellowship directors were surveyed on anesthetic management of PPTL. Labor and delivery unit. Internet survey. 202 PPTL procedures were reviewed. 47 institutions were surveyed; 26 responses were received. Timing of PPTL, anesthetic management, postoperative pain and length of stay. There was an epidural catheter reactivation failure rate of 26% (18/69 epidural catheter reactivation attempts). Time from epidural catheter insertion to PPTL was a significant factor associated with failure: median [IQR; range] time for successful versus failed epidural catheter reactivation was 17h [10-25; 3-55] and 28h [14-33; 5-42], respectively (P=0.028). Epidural catheter reactivation failure led to significantly longer times to provide surgical anesthesia than successful epidural catheter reactivation or primary spinal technique: median [IQR] 41min [33-54] versus 15min [12-21] and 19min [15-24], respectively (P8h and >24h post-delivery, respectively. Epidural catheter reactivation failure increases with longer intervals between catheter placement and PPTL. Failed epidural catheter reactivation increases anesthetic and operating room times. Our results and the significant variability in practice from our survey suggest recommendations on the timing and anesthetic management are needed to reduce unfulfilled PPTL procedures. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. [Being treated as a human being. Experiences of patients in a prenatal service of a philanthropic institution].

    Science.gov (United States)

    Bonadio, I C

    1998-04-01

    This paper reports a qualitative study conducted in an anthropological perspective using the ethnografic research methodology. It had has the objective of knowing and understanding the needs, antenatal care values and beliefs of pregnant women in the context of Prenatal Service of a Philanthropic Institution. The central theme "be treated as a Human Being", identified from the analysis of the cultural themes, revealed that, in the women experience, the most significant element is represented either by the effective interaction or by the establishment on bond of trust between them and nurse.

  4. Versatile single-chip event sequencer for atomic physics experiments

    Science.gov (United States)

    Eyler, Edward

    2010-03-01

    A very inexpensive dsPIC microcontroller with internal 32-bit counters is used to produce a flexible timing signal generator with up to 16 TTL-compatible digital outputs, with a time resolution and accuracy of 50 ns. This time resolution is easily sufficient for event sequencing in typical experiments involving cold atoms or laser spectroscopy. This single-chip device is capable of triggered operation and can also function as a sweeping delay generator. With one additional chip it can also concurrently produce accurately timed analog ramps, and another one-chip addition allows real-time control from an external computer. Compared to an FPGA-based digital pattern generator, this design is slower but simpler and more flexible, and it can be reprogrammed using ordinary `C' code without special knowledge. I will also describe the use of the same microcontroller with additional hardware to implement a digital lock-in amplifier and PID controller for laser locking, including a simple graphics-based control unit. This work is supported in part by the NSF.

  5. Imaging Live Cells at the Nanometer-Scale with Single-Molecule Microscopy: Obstacles and Achievements in Experiment Optimization for Microbiology

    Science.gov (United States)

    Haas, Beth L.; Matson, Jyl S.; DiRita, Victor J.; Biteen, Julie S.

    2015-01-01

    Single-molecule fluorescence microscopy enables biological investigations inside living cells to achieve millisecond- and nanometer-scale resolution. Although single-molecule-based methods are becoming increasingly accessible to non-experts, optimizing new single-molecule experiments can be challenging, in particular when super-resolution imaging and tracking are applied to live cells. In this review, we summarize common obstacles to live-cell single-molecule microscopy and describe the methods we have developed and applied to overcome these challenges in live bacteria. We examine the choice of fluorophore and labeling scheme, approaches to achieving single-molecule levels of fluorescence, considerations for maintaining cell viability, and strategies for detecting single-molecule signals in the presence of noise and sample drift. We also discuss methods for analyzing single-molecule trajectories and the challenges presented by the finite size of a bacterial cell and the curvature of the bacterial membrane. PMID:25123183

  6. Carcinoma of unknown primary: 35 years of a single institution's experience

    Directory of Open Access Journals (Sweden)

    Rana I Mahmood

    2016-01-01

    Conclusion: Our data confirm the heterogeneity of CUP cases and variable treatment courses. This highlights the importance of establishing a national registry for this subgroup of cancer patients. Moreover, there is a need to develop multidisciplinary specialist teams and protocols to manage this group of patients, and participation in clinical trials should be strongly encouraged.

  7. A single institution's 1-year experience with uterine fibroid embolization marketing.

    Science.gov (United States)

    Ciacci, Joseph; Taussig, Jacob; Kouri, Brian; Bettmann, Michael

    2011-09-01

    To assess the impact of various marketing techniques on the referral pattern for uterine fibroid embolization (UFE) at an academic interventional radiology practice over a 1-year period. All referrals to the interventional radiology clinic for UFE from January 1, 2009, to December 31, 2009, were retrospectively reviewed. A standard intake sheet was completed by the interventional clinic secretary at the time of initial patient contact that included the source of the referral (radio, television, newspaper, mailing, Internet, physician, friend, other). All patients who proceeded to consultation were seen in the interventional radiology clinic by attending interventional radiologists in a university-based academic center. The referral pattern was analyzed with respect to the number of patients who contacted the clinic, the number of actual clinic visits, the number of magnetic resonance (MR) imaging examinations performed before and after the procedure, the total number of embolization cases performed, and the subsequent downstream revenue. During the 1-year period, 344 patients contacted the interventional radiology clinic regarding UFE resulting in 171 consultations and 100 pelvic MR imaging examinations performed before the procedure. Sixty-two patients proceeded to UFE, and 32 patients underwent follow-up pelvic MR imaging. These results show a significant increase from eight cases the previous year and are presumably attributable almost entirely to the directed marketing campaign. The marketing initiative consisted primarily of print and radio advertisements, with the latter being the most effective. The total advertising cost for the year was approximately $24,706, of which $20,520 was for radio advertisements. The radio advertisements generated 69% (237 of 344) of the referrals and 69% (43 of 62) of the UFE procedures. Using Medicare reimbursement rates, the radio advertisements generated $281,994 in UFE technical fees and $50,329 in MR imaging technical fees. Direct patient marketing techniques can promote significant growth for a fibroid embolization practice. In our market, radio advertisements proved to be the most cost-effective strategy. Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

  8. Colon cancer modulation by a diabetic environment: A single institutional experience.

    Science.gov (United States)

    Prieto, Isabel; Del Puerto-Nevado, Laura; Gonzalez, Nieves; Portal-Nuñez, Sergio; Zazo, Sandra; Corton, Marta; Minguez, Pablo; Gomez-Guerrero, Carmen; Arce, Jose Miguel; Sanz, Ana Belen; Mas, Sebastian; Aguilera, Oscar; Alvarez-Llamas, Gloria; Esbrit, Pedro; Ortiz, Alberto; Ayuso, Carmen; Egido, Jesus; Rojo, Federico; Garcia-Foncillas, Jesus

    2017-01-01

    Multiple observational studies suggest an increased risk of colon cancer in patients with diabetes mellitus (DM). This can theoretically be the result of an influence of the diabetic environment on carcinogenesis or the tumor biologic behavior. To gain insight into the influence of a diabetic environment on colon cancer characteristics and outcomes. Retrospective analysis of clinical records in an academic tertiary care hospital with detailed analysis of 81 diabetic patients diagnosed of colon cancer matched with 79 non-diabetic colon cancer patients. The impact of streptozotocin-induced diabetes on the growth of colon cancer xenografts was studied in mice. The incidence of DM in 1,137 patients with colorectal cancer was 16%. The diabetic colon cancer cases and non-diabetic colon cancer controls were well matched for demographic and clinical variables. The ECOG Scale Performance Status was higher (worse) in diabetics (ECOG ≥1, 29.1% of controls vs 46.9% of diabetics, p = 0.02), but no significant differences were observed in tumor grade, adjuvant therapy, tumor site, lymphovascular invasion, stage, recurrence, death or cancer-related death. Moreover, no differences in tumor variables were observed between patients treated or not with metformin. In the xenograft model, tumor growth and histopathological characteristics did not differ between diabetic and nondiabetic animals. Our findings point towards a mild or negligible effect of the diabetes environment on colon cancer behavior, once cancer has already developed.

  9. Colon cancer modulation by a diabetic environment: A single institutional experience

    OpenAIRE

    Prieto, Isabel; del Puerto-Nevado, Laura; Gonzalez, Nieves; Portal-Nu?ez, Sergio; Zazo, Sandra; Corton, Marta; Minguez, Pablo; Gomez-Guerrero, Carmen; Arce, Jose Miguel; Sanz, Ana Belen; Mas, Sebastian; Aguilera, Oscar; Alvarez-Llamas, Gloria; Esbrit, Pedro; Ortiz, Alberto

    2017-01-01

    Background Multiple observational studies suggest an increased risk of colon cancer in patients with diabetes mellitus (DM). This can theoretically be the result of an influence of the diabetic environment on carcinogenesis or the tumor biologic behavior. Aim To gain insight into the influence of a diabetic environment on colon cancer characteristics and outcomes. Material and methods Retrospective analysis of clinical records in an academic tertiary care hospital with detailed analysis of 81...

  10. Meningiomas after cranial radiotherapy for childhood cancer: a single institution experience.

    Science.gov (United States)

    Felicetti, Francesco; Fortunati, Nicoletta; Garbossa, Diego; Biasin, Eleonora; Rudà, Roberta; Daniele, Dino; Arvat, Emanuela; Corrias, Andrea; Fagioli, Franca; Brignardello, Enrico

    2015-07-01

    Childhood cancer survivors (CCS) treated with cranial radiation therapy (CRT) are at risk of developing meningiomas. The aim of this study was to evaluate the cumulative incidence of meningiomas in a cohort of CCS who previously underwent CRT. We considered all CCS who received CRT and were followed up at the "Transition Unit for Childhood Cancer Survivors" in Turin. Even though asymptomatic, they had at least one brain computed tomography or magnetic resonance imaging performed at a minimum interval of 10 years after treatment for pediatric cancer. We identified 90 patients (median follow-up 24.6 years). Fifteen patients developed meningioma (median time from pediatric cancer, 22.5 years). In four patients, it was suspected on the basis of neurological symptoms (i.e., headache or seizures), whereas all other cases, including five giant meningiomas, were discovered in otherwise asymptomatic patients. Multiple meningiomas were discovered in four CCS. Ten patients underwent surgical resection. An atypical meningioma (grade II WHO) was reported in four patients. One patient with multiple meningiomas died for a rapid growth of the intracranial lesions. A second neoplasm (SN) other than meningioma was diagnosed in five out of the 15 patients with meningioma and in ten out of the 75 CCS without meningioma. Cox multivariate analysis showed that the occurrence of meningioma was associated with the development of other SNs, whereas age, sex, or CRT dose had no influence. CCS at risk of the development of meningioma deserve close clinical follow-up, especially those affected by other SNs.

  11. Laparoendoscopic single-site extraperitoneal inguinal hernia repair: initial experience in 10 patients.

    Science.gov (United States)

    Do, Minh; Liatsikos, Evangelos; Beatty, John; Haefner, Tim; Dunn, Ian; Kallidonis, Panagiotis; Stolzenburg, Jens-Uwe

    2011-06-01

    Recent technical advances and a trend toward laparoscopic single incision surgery have led us to explore the feasibility of laparoendoscopic single-site (LESS) hernia repair. We present our technique and initial experience with LESS extraperitoneal inguinal hernia repair in 10 consecutive men with unilateral inguinal hernias. Age range was 43.7 (28-64) years. Mean body mass index was 28 (range 24-30). Six were left inguinal hernias. There were six indirect and four direct hernias. Three patients had undergone previous open appendectomy. Incarcerated or bilateral hernias were excluded from our initial series. All cases were performed by three surgeons who were experienced in conventional totally extraperitoneal laparoscopic hernia repair as well as experienced in LESS. A literature review of current single-port inguinal hernia repair data is also presented. The mean operative time was 53 minutes (range 45-65  min). The average length of skin incision was 2.8  cm (range 2.3-3.2  cm). No drain was necessary in any of the patients, while no recordable bleeding was observed. There were no intraoperative or immediate postoperative complications. Hospitalization period was 2 days for all patients. After a limited follow-up of 1 month, there have been no recurrences and no complaints of testicular pain. The results of the current series compare favorably with those found in a literature review. LESS extraperitoneal inguinal hernia repair is both feasible and safe, although more technically demanding than its conventional laparoscopic counterpart. Although the cosmetic result with the former approach may prove superior, there are standing questions regarding the complications and long-term outcome. Randomized and if possible blinded trials that compare conventional and single-incision laparoscopic hernia repair may help to distinguish the most advantageous technique.

  12. Clinical features and outcomes of plasma cell leukemia: a single-institution experience in the era of novel agents

    Directory of Open Access Journals (Sweden)

    Giampaolo Talamo

    2012-08-01

    Full Text Available Plasma cell leukemia (PCL is a rare hematologic malignancy with aggressive clinical and biologic features. Data regarding its prognosis with the use of the novel agents, i.e., the immunomodulatory drugs thalidomide and lenalidomide, and the proteasome inhibitor bortezomib, are limited. We retrospectively reviewed clinical outcomes, response to therapy, and survival of 17 patients seen at the Penn State Hershey Cancer Institute since the availability of novel agents (2006-2011. Twelve patients had primary PCL (pPCL, and 5 second- ary PCL (sPCL. PCL was associated with aggressive clinicobiological features, such as high-risk cytogenetics, elevated serum beta-2-microglobulin and lactate dehydrogenase, International Staging System stage III, and rapid relapse after therapy. With the use of thalidomide, lenalidomide, and bortezomib in 53%, 53%, and 88% patients, respectively, median overall survival (OS was 18 months in the whole group (95% confidence interval, 11-21 months, and 21 and 4 months in pPCL and sPCL, respectively (P=0.015. OS was inferior to that of 313 consecutive patients with multiple myeloma (MM treated in the same period, even when compared with a subset of 47 MM with high-risk cytogenetics. Although our data are limited by the small sample size, we conclude that novel agents may modestly improve survival in patients with PCL, when compared to historical controls. Novel therapies do not seem to overcome the negative prognosis of PCL as compared with MM.

  13. Clinical features and outcomes of plasma cell leukemia: a single-institution experience in the era of novel agents.

    Science.gov (United States)

    Talamo, Giampaolo; Dolloff, Nathan G; Sharma, Kamal; Zhu, Junjia; Malysz, Jozef

    2012-06-26

    Plasma cell leukemia (PCL) is a rare hematologic malignancy with aggressive clinical and biologic features. Data regarding its prognosis with the use of the novel agents, i.e., the immunomodulatory drugs thalidomide and lenalidomide, and the proteasome inhibitor bortezomib, are limited. We retrospectively reviewed clinical outcomes, response to therapy, and survival of 17 patients seen at the Penn State Hershey Cancer Institute since the availability of novel agents (2006-2011). Twelve patients had primary PCL (pPCL), and 5 secondary PCL (sPCL). PCL was associated with aggressive clinicobiological features, such as high-risk cytogenetics, elevated serum beta-2-microglobulin and lactate dehydrogenase, International Staging System stage III, and rapid relapse after therapy. With the use of thalidomide, lenalidomide, and bortezomib in 53%, 53%, and 88% patients, respectively, median overall survival (OS) was 18 months in the whole group (95% confidence interval, 11-21 months), and 21 and 4 months in pPCL and sPCL, respectively (P=0.015). OS was inferior to that of 313 consecutive patients with multiple myeloma (MM) treated in the same period, even when compared with a subset of 47 MM with high-risk cytogenetics. Although our data are limited by the small sample size, we conclude that novel agents may modestly improve survival in patients with PCL, when compared to historical controls. Novel therapies do not seem to overcome the negative prognosis of PCL as compared with MM.

  14. Clinical characteristics and treatment outcomes of patients with colorectal cancer who develop brain metastasis: a single institution experience.

    Science.gov (United States)

    Fountzilas, Christos; Chang, Katherine; Hernandez, Brian; Michalek, Joel; Crownover, Richard; Floyd, John; Mahalingam, Devalingam

    2017-02-01

    The development of brain metastasis (BM) in patients with colorectal cancer (CRC) is a rare and late event. We sought to investigate the clinical characteristics, disease course and safety using biologic agents in our patients with CRC who develop brain metastases. A retrospective review of patients with CRC with brain metastases treated at our institution from 01/2005-01/2015 was performed. Survival analysis was performed using the Kaplan-Meier method. Forty patients were included in the analysis. Median age was 55.5 years, 67.5% were males, and 28% had a KRAS mutation. Twenty-four percent were treatment-naive at the time of BM diagnosis. Patients had a median of two brain lesions. Sixty-five percent of the patients were treated with radiotherapy alone, 22.5% had both surgical resection and brain radiotherapy. Median overall survival was 3.2 months after development of BM. Overall survival was longer in patients who received combined modality local therapy compared to patients treated with surgical resection or radiotherapy alone. Patients who received systemic treatment incorporating biologics following development of BM had a median overall survival of 18.6 months. Overall, the administration of biologic agents was safe and well tolerated. In summary, BM is an uncommon and late event in the natural history of metastatic CRC. The ability to deliver combined-modality local brain therapy as well as availability of more systemic therapy options appear to lead to improved outcomes.

  15. Laparoscopic Repair of Incisional Hernia Following Liver Transplantation-Early Experience of a Single Institution in Taiwan.

    Science.gov (United States)

    Kuo, S-C; Lin, C-C; Elsarawy, A; Lin, Y-H; Wang, S-H; Wu, Y-J; Chen, C-L

    2017-10-01

    Ventral incisional hernia (VIH) is not uncommon following liver transplantation. Open repair was traditionally adopted for its management. Laparoscopic repair of VIH has been performed successfully in nontransplant patients with evidence of reduced recurrence rates and hospital stay. However, the application of VIH in post-transplantation patients has not been well established. Herein, we provide our initial experience with laparoscopic repair of post-transplantation VIH. From March 2015 to March 2016, 18 cases of post-transplantation VIH were subjected to laparoscopic repair (laparoscopy group). A historical control group of 17 patients who underwent conventional open repair (open group) from January 2013 to January 2015 were identified for comparison. The demographics and clinical outcomes were retrospectively compared. There were no significant differences among basic demographics between the 2 groups. No conversion was recorded in the laparoscopy group. Recurrence of VIH up to the end of the study period was not noted. In the laparoscopy group, the minor complications were lower (16.7% vs 52.9%; P = .035), the length of hospital stay was shorter (3 d vs 7 d, P = .007), but the median operative time was longer (137.5 min vs 106 min; P = .003). Laparoscopic repair of post-transplantation VIH is a safe and feasible procedure with shorter length of hospital stay. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Fifty years experiences in nuclear engineering education at Tokyo Institute of Technology

    International Nuclear Information System (INIS)

    Fujii, Yasuhiko; Saito, Masaki; Aritomi, Masanori

    2008-01-01

    Nuclear engineering education has been initiated in 1957 at the graduate school of Tokyo Institute of Technology. Educational activities have been conducted for fifty years under the support of the Research Laboratory for Nuclear Reactors. In the past fifty years, about 1000 Master students and 200 Doctoral students and 200 Doctoral students graduated from our Nuclear Engineering Department at Tokyo Institute of Technology. Many of them found their jobs in nuclear industries and institutes. International course of nuclear engineering was initiated in 1994, and so far about 90 students from 15 overseas countries have graduated from our Master and Doctoral Programs. In 2003, our proposal of 'Innovative Nuclear Energy System for the Sustainable World' was adopted as the Center of Excellent Program sponsored by Ministry of Education, Science and Technology. Recently a collaborative education network has been developed among Kanazawa University, Fukui University, Ibaraki University, Okayama University, Tokyo Institute of Technology and Japan Atomic Energy Agency. (author)

  17. Rural-to-Urban Migrants' Experiences with Primary Care under Different Types of Medical Institutions in Guangzhou, China.

    Directory of Open Access Journals (Sweden)

    Jiazhi Zeng

    Full Text Available China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Migrants are in a vulnerable state when they attempt to access to primary care services. This study was designed to explore rural-to-urban migrants' experiences in primary care, comparing their quality of primary care experiences under different types of medical institutions in Guangzhou, China.The study employed a cross-sectional survey of 736 rural-to-urban migrants in Guangzhou, China in 2014. A validated Chinese version of Primary Care Assessment Tool--Adult Short Version (PCAT-AS, representing 10 primary care domains was used to collect information on migrants' quality of primary care experiences. These domains include first contact (utilization, first contact (accessibility, ongoing care, coordination (referrals, coordination (information systems, comprehensiveness (services available, comprehensiveness (services provided, family-centeredness, community orientation and culturally competent. These measures were used to assess the quality of primary care performance as reported from patients' perspective. Analysis of covariance was conducted for comparison on PCAT scores among migrants accessing primary care in tertiary hospitals, municipal hospitals, community health centers/community health stations, and township health centers/rural health stations. Multiple linear regression models were used to explore factors associated with PCAT total scores.After adjustments were made, migrants accessing primary care in tertiary hospitals (25.49 reported the highest PCAT total scores, followed by municipal hospitals (25.02, community health centers/community health stations (24.24, and township health centers/rural health stations (24.18. Tertiary hospital users reported significantly better performance in first contact (utilization, first contact (accessibility, coordination (information system, comprehensiveness (service available, and cultural competence

  18. Integrating institutional bribery and behavioral measures of bribery

    OpenAIRE

    Rose, Richard; Peiffer, Caryn

    2016-01-01

    Bribery involves individuals exchanging material benefits for a service of a public institution. To understand the process of bribery we need to integrate measures of individual behaviour and institutional attributes rather than rely exclusively on surveys of individual perceptions and experience or macro-level corruption indexes of national institutions. This paper integrates institutional and behavioural measures to show that where you live and who you are have independent influence on whet...

  19. Thyroid cancer: experiences of Cancer Institute, Madras

    International Nuclear Information System (INIS)

    Kannan, R. Ravi; Mahajan, V.; Ganesh, M.S.; Ayyappan, S.; Suresh, V.; Suryasen, S.

    1999-01-01

    It has been long recognized that Thyroid Cancer (TC) envelopes under its umbrella a spectrum of cancers from the relatively indolent well differentiated papillary and follicular cancers to the aggressive and rapidly fatal anaplastic cancers. Medullary cancers fall in between the two extremes. Recently, poor prognostic variants of well-differentiated cancers have been described. There is also a move to define a group of poorly differentiated TC including the insular variants distinguishing them from anaplastic carcinomas. Of the 1168 patients with thyroid nodules seen at the Cancer Institute (WIA), Chennai between 1956 and 1996, 670 cases proved to be malignant either cytologically or histologically. This report is based on the follow-up of these patients which at 10 years was 75%

  20. Awake craniotomy for glioma resection: Technical aspects and initial results in a single institution.

    Science.gov (United States)

    Trimble, Gillian; McStravick, Clodagh; Farling, Peter; Megaw, Katie; McKinstry, Steven; Smyth, Graham; Law, Gillian; Courtney, Heather; Quigley, Gavin; Flannery, Thomas

    2015-01-01

    Although variations in the technique of awake craniotomy (AC) have been widely reported, a key member of this interdisciplinary procedure is the healthcare professional performing assessments of neurological function during resection. The expertise of the latter will depend on the neurological function to be tested and on available resources of the institution. This report details our initial experience of an AC service utilizing the expertise of a speech and language therapist (SLT) and an experienced neuro-physiotherapist (NP) to monitor patient function during glioma resection. Forty-five patients underwent 50 AC procedures for eloquently located gliomas over a 3-year period. Patients with a glioma involving speech or sensorimotor areas were assessed preoperatively by the SLT/NP respectively. The same therapist monitored the patient's neurological function intraoperatively and executed a rehabilitation program tailored to the needs of the patient in the postoperative period. Three patients underwent biopsy only, due to intraoperative seizures precluding intraoperative mapping (2 cases) or speech arrest on stimulation of a small recurrent tumor. The remaining 47 cases were suitable for repetitive neurological assessment "awake" during tumor debulking. One patient with a large sensorimotor tumor developed intraoperative hemiparesis due to outward brain herniation (which recovered postoperatively). Ten patients developed a new or worsened neurological deficit in the initial postoperative period (6 were detected intraoperatively), of which 5 eventually had resolution and returned to baseline function within 2 weeks. In our initial experience based anecdotally on a previous similar "non-awake" caseload, we have found AC with the input of the SLT/NP to be a key component in ensuring optimal functional outcomes for patients with gliomas in eloquently located areas.

  1. Analysis of the learning curve for peroral endoscopic myotomy for esophageal achalasia: Single-center, two-operator experience.

    Science.gov (United States)

    Lv, Houning; Zhao, Ningning; Zheng, Zhongqing; Wang, Tao; Yang, Fang; Jiang, Xihui; Lin, Lin; Sun, Chao; Wang, Bangmao

    2017-05-01

    Peroral endoscopic myotomy (POEM) has emerged as an advanced technique for the treatment of achalasia, and defining the learning curve is mandatory. From August 2011 to June 2014, two operators in our institution (A&B) carried out POEM on 35 and 33 consecutive patients, respectively. Moving average and cumulative sum (CUSUM) methods were used to analyze the POEM learning curve for corrected operative time (cOT), referring to duration of per centimeter myotomy. Additionally, perioperative outcomes were compared among distinct learning curve phases. Using the moving average method, cOT reached a plateau at the 29th case and at the 24th case for operators A and B, respectively. CUSUM analysis identified three phases: initial learning period (Phase 1), efficiency period (Phase 2) and mastery period (Phase 3). The relatively smooth state in the CUSUM graph occurred at the 26th case and at the 24th case for operators A and B, respectively. Mean cOT of distinct phases for operator A were 8.32, 5.20 and 3.97 min, whereas they were 5.99, 3.06 and 3.75 min for operator B, respectively. Eckardt score and lower esophageal sphincter pressure significantly decreased during the 1-year follow-up period. Data were comparable regarding patient characteristics and perioperative outcomes. This single-center study demonstrated that expert endoscopists with experience in esophageal endoscopic submucosal dissection reached a plateau in learning of POEM after approximately 25 cases. © 2016 Japan Gastroenterological Endoscopy Society.

  2. Programming Basics for Beginners. Experience of the Institute of Informatics at Tallinn University of Technology

    Directory of Open Access Journals (Sweden)

    Olga Mironova

    2017-11-01

    Full Text Available The present paper demonstrates the teaching approach in programming basics course for novices: schoolchildren of different ages and schoolteachers. This programming course was developed at the Institute of Informatics at Tallinn University of Technology in Tallinn, Estonia and it based on many years experience in teaching programming for non-IT first year students. The main aim of the chosen teaching approach in the course is to raise the motivation and keep the learners’ interest in programming field on the high level. The idea of developed teaching technique is the implementation of the visual programming before a serious textual coding. Furthermore, authors suggest readers some ways and methods to overcome learners’ difficulties in the first stage in a textual coding.

  3. Radiation treatment for medulloblastoma. A review of 64 cases at a single institute

    International Nuclear Information System (INIS)

    Liu Yueping; Gao Li; Xu Guozhen; Yi Junhin; Liu Xinfan; Li Yexiong

    2005-01-01

    Although the optimal treatment mode for medulloblastoma is frequently discussed, results based on large series of cases, especially those treated in Asia, have rarely been reported. Our purpose was to evaluate the efficacy of postoperative radiation therapy, and to identify prognostic factors, in a relatively large cohort of patients with limited-stage medulloblastoma treated at a single institute in China. Between January 1996 and April 2001, 69 patients with Chang stage M0/M1 medulloblastoma were referred to our hospital for radiation therapy after total or subtotal resection of the primary tumor. All patients received 30 Gy to the craniospinal axis followed by a 20-25 Gy boost to the posterior fossa (median fraction, 1.8 Gy). Sixty-four patients were followed for a median period of 38.5 months. The rates of 3-year and 5-year overall survival were 68.8% and 55.7%, respectively; corresponding disease-free survival were 57.8% and 51.4%, respectively. Patients who had received radiation treatment within 25 days after resection had a greater probability of 3-year survival (81.5% versus 59.5%; P=0.11) and 3-year disease-free survival (74.1% versus 46.0%; P=0.03) than patients who began radiation treatment later. No relationship was found between survival and age, sex or tumor size. This regimen was comparatively ineffective in preventing recurrence of postoperative medulloblastoma; however, we found that the interval between surgery and radiation is a significant prognostic factor for disease-free survival. (author)

  4. Achievements and experience in Laboratory for Low Level Measurements, Rudjer Boskovic Institute, Croatia, during the IAEA QA/QC program

    International Nuclear Information System (INIS)

    Obelic, B.; Horvatincic, N.; Krajcar Bronic, I.

    2002-01-01

    In this summary we explain our motivation for joining the IAEA Program on Quality Assurance and Quality Control in Nuclear Analytical Techniques, the situation in the Laboratory before joining the program, and achievements during this 2-year program. We also describe our experience and difficulties with implementation of the quality system in the Laboratory, as well as with the quality system at the Rudjer Boskovic Institute. Finally, we present our plans for the future

  5. Institutional games played by confined juveniles.

    Science.gov (United States)

    Bartollas, C; Sieverdes, C M

    1983-01-01

    This study examined the games played by 561 juvenile offenders confined in six coeducational correctional facilities in one state. The types of games these residents used against staff and peers within the confines of the institution varied considerably. The study documented nineteen games used by males and females, twelve to deal with staff and seven to deal with peers. The games were defined as therapeutic games, material games, psychological games, and physical games. Peer-oriented games included attention-seeking activities and a variety of dominance games. Additionally, these games were described and tabulated according to the sex and race of the residents. The conclusion was that game-playing behavior was no less frequent in coeducational institutions than it was in single-sex institutions.

  6. Error variation in OSL palaeodose estimates from single aliquots of quartz: a factorial experiment

    International Nuclear Information System (INIS)

    Galbraith, R.F.; Roberts, R.G.; Yoshida, H.

    2005-01-01

    We use a factorial experiment to study systematic and random differences between measured OSL palaeodoses for a variety of quartz samples. These include samples that have absorbed either a large or small natural or laboratory-induced radiation dose, either with or without prior heating or bleaching. The systematic factors studied are the size of the test dose, the preheat temperature and the number of quartz grains in each multi-grain aliquot. Palaeodoses were estimated using a single-aliquot regenerative-dose protocol. The main parameter of interest is the amount of random variation, over and above that due to photon counting statistics, to be expected between estimates from aliquots that have received the same radiation dose. This over-dispersion is generally larger for natural samples than for artificially bleached ones, and it varies from about 1% in the most favourable cases to about 18% for small aliquots of a sample that had received a natural dose of about 46 Gy. The latter is comparable to the over-dispersion reported for single grains of natural quartz that are thought to have been well-bleached at the time of deposition. The factorial experiment also revealed a number of systematic effects. In particular, measured palaeodoses using a preheat temperature of 260 deg. C were systematically lower than those using 180 deg. C, by up to about 5% in some cases

  7. DNA-psoralen interaction: a single molecule experiment.

    Science.gov (United States)

    Rocha, M S; Viana, N B; Mesquita, O N

    2004-11-15

    By attaching one end of a single lambda-DNA molecule to a microscope coverslip and the other end to a polystyrene microsphere trapped by an optical tweezers, we can study the entropic elasticity of the lambda-DNA by measuring force versus extension as we stretch the molecule. This powerful method permits single molecule studies. We are particularly interested in the effects of the photosensitive drug psoralen on the elasticity of the DNA molecule. We have illuminated the sample with different light sources, studying how the different wavelengths affect the psoralen-DNA linkage. To do this, we measure the persistence length of individual DNA-psoralen complexes.

  8. Observation of single top-quark production with the CDF II experiment

    International Nuclear Information System (INIS)

    Lueck, J.

    2010-01-01

    We present the observation of electroweak single top-quark production using up to 3.2 fb -1 of data collected by the CDF experiment. Lepton plus jets candidate events are classified by four parallel analysis techniques: one likelihood discriminant, one matrix-element discriminant, one decision-tree discriminant, and one neural-network discriminant. These outputs are combined with a super discriminant based on a neural-network analysis in order to improve the expected sensitivity. In conjunction with one neural-network discriminant using a complementary dataset of MET plus jets events with a veto on identified leptons we observe a signal consistent with the standard model but inconsistent with the background-only model by 5.0 standard deviations, with a median expected sensitivity in excess of 5.9 standard deviations.

  9. Observation of Single Top Quark production with the Cdf 2. Experiment

    International Nuclear Information System (INIS)

    Lueck, J.

    2010-01-01

    We present the observation of electroweak single top-quark production using up to 3.2 fb -1 of data collected by the Cdf experiment. Lepton plus jets candidate events are classified by four parallel analysis techniques: one likelihood discriminant, one matrix-element discriminant, one decision-tree discriminant, and one neural-network discriminant. These outputs are combined with a super discriminant based on a neural-network analysis in order to improve the expected sensitivity. In conjunction with one neural-network discriminant using a complementary dataset of Met plus jets events with a veto on identified leptons we observe a signal consistent with the standard model but inconsistent with the background-only model by 5.0 standard deviations, with a median expected sensitivity in excess of 5.9 standard deviations.

  10. The first preliminary experiments on an 84 GHz gyrotron with a single-stage depressed collector

    International Nuclear Information System (INIS)

    Shimozuma, T.; Sato, M.; Takita, Y.

    1997-10-01

    We fabricated and tested an 84GHz gyrotron with a single-stage depressed collector. The gyrotron has a high-voltage insulating section made of a low loss silicon nitride composite. In this preliminary experiment in the depressed collector configuration, we obtained 591kW, 41% operation with a depression voltage of 22.5kV. Access to the higher efficiency region was inhibited by an increase in anode current. (author)

  11. Proposal for probing energy transfer pathway by single-molecule pump-dump experiment

    Science.gov (United States)

    Tao, Ming-Jie; Ai, Qing; Deng, Fu-Guo; Cheng, Yuan-Chung

    2016-06-01

    The structure of Fenna-Matthews-Olson (FMO) light-harvesting complex had long been recognized as containing seven bacteriochlorophyll (BChl) molecules. Recently, an additional BChl molecule was discovered in the crystal structure of the FMO complex, which may serve as a link between baseplate and the remaining seven molecules. Here, we investigate excitation energy transfer (EET) process by simulating single-molecule pump-dump experiment in the eight-molecules complex. We adopt the coherent modified Redfield theory and non-Markovian quantum jump method to simulate EET dynamics. This scheme provides a practical approach of detecting the realistic EET pathway in BChl complexes with currently available experimental technology. And it may assist optimizing design of artificial light-harvesting devices.

  12. Loop Ileostomy Closure as an Overnight Procedure: Institutional Comparison With the National Surgical Quality Improvement Project Data Set.

    Science.gov (United States)

    Berger, Nicholas G; Chou, Raymond; Toy, Elliot S; Ludwig, Kirk A; Ridolfi, Timothy J; Peterson, Carrie Y

    2017-08-01

    Enhanced recovery pathways have decreased length of stay after colorectal surgery. Loop ileostomy closure remains a challenge, because patients experience high readmission rates, and validation of enhanced recovery pathways has not been demonstrated. This study examined a protocol whereby patients were discharged on the first postoperative day and instructed to advance their diet at home with close telephone follow-up. The hypothesis was that patients can be safely discharged the day after loop closure, leading to shorter length of stay without increased rates of readmission or complications. Patients undergoing loop ileostomy closure were queried from the American College of Surgeons National Surgical Quality Improvement Project and compared with a single institution (2012-2015). Length of stay, 30-day readmission, and 30-day morbidity data were analyzed. The study was conducted at a tertiary university department. The study includes 1602 patients: 1517 from the National Surgical Quality Improvement Project database and 85 from a single institution. Length of stay and readmission rates were measured. Median length of stay was less at the single institution compared with control (2 vs 4 d; p < 0.001). Thirty-day readmission (15.3% vs 10.4%; p = 0.15) and overall 30-day complications (15.3% vs 16.7%; p = 0.73) were similar between cohorts. Estimated adjusted length of stay was less in the single institution (2.93 vs 5.58 d; p < 0.0001). There was no difference in the odds of readmission (p = 0.22). The main limitations of this study include its retrospective nature and limitations of the National Surgical Quality Improvement Program database. Next-day discharge with protocoled diet advancement and telephone follow-up is acceptable after loop ileostomy closure. Patients can benefit from decreased length of stay without an increase in readmission or complications. This has the potential to change the practice of postoperative management of loop ileostomy closure, as

  13. Leadership in the Management Institutes: An Exploration of the ...

    African Journals Online (AJOL)

    Leadership in the Management Institutes: An Exploration of the Experiences of Women Directors. Rajib Lochan Dhar. Abstract. As leadership is a key component in meeting the challenges of educational institutes, this study was designed to examine the challenges faced by the female leaders of the management institutes ...

  14. Building Comprehensive and Sustainable Health Informatics Institutions in Developing Countries: Moi University Experience.

    Science.gov (United States)

    Were, Martin C; Siika, Abraham; Ayuo, Paul O; Atwoli, Lukoye; Esamai, Fabian

    2015-01-01

    Current approaches for capacity building in Health Informatics (HI) in developing countries mostly focus on training, and often rely on support from foreign entities. In this paper, we describe a comprehensive and multidimensional capacity-building framework by Lansang & Dennis, and its application for HI capacity building as implemented in a higher-education institution in Kenya. This framework incorporates training, learning-by-doing, partnerships, and centers of excellence. At Moi University (Kenya), the training dimensions include an accredited Masters in HI Program, PhD in HI, and HI short courses. Learning-by-doing occurs through work within MOH facilities at the AMPATH care and treatment program serving 3 million people. Moi University has formed strategic HI partnerships with Regenstrief Institute, Inc. (USA), University of Bergen (Norway), and Makerere University (Uganda), among others. The University has also created an Institute of Biomedical Informatics to serve as an HI Center of Excellence in the region. This Institute has divisions in Training, Research, Service and Administration. The HI capacity-building approach by Moi provides a model for adoption by other institutions in resource-limited settings.

  15. Experiment and density functional theory analyses of GdTaO4 single crystal

    Science.gov (United States)

    Ding, Shoujun; Kinross, Ashlie; Wang, Xiaofei; Yang, Huajun; Zhang, Qingli; Liu, Wenpeng; Sun, Dunlu

    2018-05-01

    GdTaO4 is a type of excellent materials that can be used as scintillation, laser matrix as well as self-activated phosphor has generated significant interest. Whereas its band structure, electronic structure and optical properties are still need elucidation. To solve this intriguing problem, high-quality GdTaO4 single crystal (M-type) was grown successfully using Czochralski method. Its structure as well as optical properties was determined in experiment. Moreover, a systematic theoretical calculation based on the density function theory methods were performed on M-type and M‧-type GdTaO4 and their band structure, density of state as well as optical properties were obtained. Combine with the performed experiment results, the calculated results were proved with high reliability. Hence, the calculated results obtained in this work could provide a deep understanding of GdTaO4 material, which also useful for the further investigation on GdTaO4 material.

  16. Coparenting experiences in African American families: an examination of single mothers and their nonmarital coparents.

    Science.gov (United States)

    Gonzalez, Michelle; Jones, Deborah; Parent, Justin

    2014-03-01

    African American youth from single-mother homes continue to be overrepresented in statistics on risk behavior and delinquency, a trend that many be attributed to father-absence, socioeconomic disadvantage, and compromises in parenting more typical of single than two-parent families. Yet, this risk-focused perspective ignores a long-standing strength of the African American community, the involvement and potential protective impact of extended family members in childrearing. This study describes the experiences of 95 African American single mothers and their nonmarital coparents who participated in a study of African American single-mother families with an 11-16-year-old child. Specifically, the study examines: (a) the extent to which nonmarital coparents are involved in childrearing; (b) the relative levels of risk (i.e., depression, mother-coparent conflict) and protective (i.e., parenting) associated with maternal and coparent involvement; and (c) how similarly and/or differently coparent and mother variables operate with regard to youth externalizing problems. Findings reveal that a range of family members and other adults actively participate in childrearing in African American single-mother families, coparents do not differ from mothers on certain study variables (i.e., depression and mother-coparent conflict) but do for others (parenting), and coparent involvement is associated with youth adjustment in ways that are similar to our more established understanding of maternal involvement. The potential clinical implications of the findings are discussed and future research directions are highlighted. © 2014 FPI, Inc.

  17. Danish Space Research Institute

    International Nuclear Information System (INIS)

    1991-01-01

    The present report presents a description of the activities and finances of the Danish Space Reserach Institute during 1989 and 1990. The research deals with infrared astronomy (ISOPHOT), X-ray astronomy (EXPECT/SODART), hard X-ray astronomy (WATCH), satellite projects and sounding rocket experiments. (CLS)

  18. Electron Spin Resonance Experiments on a Single Electron in Silicon Implanted with Phosphorous

    Science.gov (United States)

    Luhman, Dwight R.; Nguyen, K.; Tracy, L. A.; Carr, S.; Borchardt, J.; Bishop, N.; Ten Eyck, G.; Pluym, T.; Wendt, J.; Lilly, M. P.; Carroll, M. S.

    2015-03-01

    In this talk we will discuss the results of our ongoing experiments involving electron spin resonance (ESR) on a single electron in a natural silicon sample. The sample consists of an SET, defined by lithographic polysilicon gates, coupled to nearby phosphorous donors. The SET is used to detect charge transitions and readout the spin of the electron being investigated with ESR. The measurements were done with the sample at dilution refrigerator temperatures in the presence of a 1.3 T magnetic field. We will present data demonstrating Rabi oscillations of a single electron in this system as well as measurements of the coherence time, T2. We will also discuss our results using these and various other pulsing schemes in the context of a donor-SET system. This work was performed, in part, at the Center for Integrated Nanotechnologies, a U.S. DOE Office of Basic Energy Sciences user facility. Sandia National Laboratories is a multi-program laboratory operated by Sandia Corporation, a Lockheed-Martin Company, for the U. S. Department of Energy under Contract No. DE-AC04-94AL85000.

  19. The treatment of extensive scalp lesions using coplanar and non-coplanar photon IMRT: a single institution experience

    International Nuclear Information System (INIS)

    Ostheimer, Christian; Janich, Martin; Hübsch, Patrick; Gerlach, Reinhard; Vordermark, Dirk

    2014-01-01

    This clinical study compared four different cases of extensive scalp malignancies treated by intensity-modulated radiation therapy. The merits of coplanar and non-coplanar Step-and-shoot total scalp irradiation techniques were evaluated against the background of the literature. Four patients (angiosarcoma, n=2, cutaneous B-cell non-Hodgkin lymphoma, B-NHL, n=1, mycosis fungoides, n=1) treated between 2008 and 2012 at our institution were retrospectively analyzed. For every patient with executed coplanar plan, a non-coplanar plan and vice versa has been calculated additionally for direct comparison. Three patients underwent limited surgery before radiotherapy. Individual adapted bolus material was used for every patient (helmet). Total scalp dose was 30 Gy (B-NHL, mycosis fungoides) and 50 Gy (angiosarcoma) with fractional doses of 2.0-2.5 Gy (without sequential local boost in three patients). Conformity and homogeneity indexes and dose volume histograms were used for treatment plan comparison. Dose hot spots were higher in coplanar plans (110-128% Dmax). Non-coplanar plans showed a more homogeneous dose distribution (HI = .12 - .17) and superior PTV coverage (88 - 96%). Target dose coverage was 81-117% in non-coplanar and 30-128% in coplanar plans. Coplanar plans yielded a stronger dose gradient across the target (.7-1.6 Gy/mm) compared to non-coplanar plans (.8-1.3 Gy/mm). The most conformal plan was a non-coplanar plan (CI = .7). Mean and maximum brain doses were comparable and showed an almost linear decrease between min. and max. dose. The optic chiasm and brain stem was spared most with non-coplanar plans, mean doses to the lenses ranged between 4 and 8 Gy and were higher in non-coplanar plans as were doses to the optic nerves. Radiotherapy tolerance was acceptable and acute side effects included erythema, scalp pain, alopecia and radiodermatitis which all spontaneously resolved. Two patients accomplished partial response, two patients showed complete response

  20. Mesh Plug Repair of Inguinal Hernia; Single Surgeon Experience

    Directory of Open Access Journals (Sweden)

    Ahmet Serdar Karaca

    2013-10-01

    Full Text Available Aim: Mesh repair of inguinal hernia repairs are shown to be an effective and reliable method. In this study, a single surgeon%u2019s experience with plug-mesh method performs inguinal hernia repair have been reported. Material and Method: 587 patients with plug-mesh repair of inguinal hernia, preoperative age, body / mass index, comorbid disease were recorded in terms of form. All of the patients during the preoperative and postoperative hernia classification of information, duration of operation, antibiotics, perioperative complications, and later, the early and late postoperative complications, infection, recurrence rates and return to normal daily activity, verbal pain scales in terms of time and postoperative pain were evaluated. Added to this form of long-term pain ones. The presence of wound infection was assessed by the presence of purulent discharge from the incision. Visual analog scale pain status of the patients was measured. Results: 587 patients underwent repair of primary inguinal hernia mesh plug. One of the patients, 439 (74% of them have adapted follow-ups. Patients%u2019 ages ranged from 18-86. Was calculated as the mean of 47±18:07. Follow-up period of the patients was found to be a minimum of 3 months, maximum 55 months. Found an average of 28.2±13.4 months. Mean duration of surgery was 35.07±4.00 min (min:22mn-max:52mn, respectively. When complication rates of patients with recurrence in 2 patients (0.5%, hematoma development (1.4% in 6 patients, the development of infection in 11 patients (2.5% and long-term groin pain in 4 patients (0.9% appeared. Discussion: In our experience, the plug-mesh repair of primary inguinal hernia repair safe, effective low recurrence and complication rates can be used.

  1. A multi-institutional outcome and prognostic factor analysis of radiosurgery (RS) for resectable single brain metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Auchter, RM; Lamond, JP; Alexander, E; Buatti, JM; Chappell, RJ; Friedman, W; Kinsella, TJ; Levin, AB; Noyes, WR; Schultz, C; Loeffler, JS; Mehta, MP

    1995-07-01

    PURPOSE: Recent randomized trials comparing resection of single brain metastasis (BM) in selected patients (pts) followed by whole brain radiotherapy (WBRT) to WBRT alone demonstrated statistically significant survival advantage for surgery (Patchell, 1990 and Noordijk, 1994). This multi-institutional retrospective study was performed in similar pts who were treated with RS and WBRT to provide a baseline for comparison for a future randomized trial. MATERIALS AND METHODS: The RS databases of four institutions were reviewed to identify all pts who met the following criteria: single BM; age > 18; surgically resectable lesion; independently functional (KPS {>=} 70); non-radiosensitive histology (small cell, lymphoma, myeloma, germ cell excluded); no prior cranial surgery or WBRT. 122 of 533 pts with BM treated with RS met these criteria. Pts were categorized by: (a) status of the primary: 'absent' = complete resection, 26 pts; 'controlled' locally controlled with radiotherapy or chemotherapy, 70 pts; 'under treatment' = undergoing radiotherapy, 15 pts; 'active' = no definitive or successful treatment of the primary, 11 pts; (b) status of non-CNS metastasis: present=64 pts, absent=58 pts; (c) age: median=61, range 23-83; (d) KPS : KPS 70/80/90/100=20/26/44/32 pts; (e) histology: lung=58, melanoma=16, breast=13, renal=12,colon=9, other=10, unknown primary=4; (f) time from primary to BM: median=12 months, range=1-252 months; (g) gender: male=64, female=58; (h) tumor volume: median=2.68 cc, range=0.13-27.2 cc. RS was performed with a linear accelerator based technique (peripheral dose 10-27 Gy, median 17 Gy). WBRT was performed in all but 5 pts who refused it (range 25 - 40 Gy, median 37.5 Gy). RESULTS: The potential median follow-up for all pts is 123 weeks (wks). The overall local response rate is 59% (complete response = 25%, partial response = 34%). In field progression occurred in 17 patients (14%), with overall local control of 86%. Local control was highest for

  2. Instituting interaction: normative transformations in human communicative practices.

    Science.gov (United States)

    Elias, John Z; Tylén, Kristian

    2014-01-01

    Recent experiments in semiotics and linguistics demonstrate that groups tend to converge on a common set of signs or terms in response to presented problems, experiments which potentially bear on the emergence and establishment of institutional interactions. Taken together, these studies indicate a spectrum, ranging from the spontaneous convergence of communicative practices to their eventual conventionalization, a process which might be described as an implicit institutionalization of those practices. However, the emergence of such convergence and conventionalization does not in itself constitute an institution, in the strict sense of a social organization partly created and governed by explicit rules. A further step toward institutions proper may occur when others are instructed about a task. That is, given task situations which select for successful practices, instructions about such situations make explicit what was tacit practice, instructions which can then be followed correctly or incorrectly. This transition gives rise to the normative distinction between conditions of success versus conditions of correctness, a distinction which will be explored and complicated in the course of this paper. Using these experiments as a basis, then, the emergence of institutions will be characterized in evolutionary and normative terms, beginning with our adaptive responses to the selective pressures of certain situational environments, and continuing with our capacity to then shape, constrain, and institute those environments to further refine and streamline our problem-solving activity.

  3. Pleural space infections after image-guided percutaneous drainage of infected intraabdominal fluid collections: a retrospective single institution analysis.

    Science.gov (United States)

    Avella, Diego M; Toth, Jennifer W; Reed, Michael F; Gusani, Niraj J; Kimchi, Eric T; Mahraj, Rickeshvar P; Staveley-O'Carroll, Kevin F; Kaifi, Jussuf T

    2015-04-11

    Percutaneous drainage of infected intraabdominal fluid collections is preferred over surgical drainage due to lower morbidity and costs. However, it can be a challenging procedure and catheter insertion carries the potential to contaminate the pleural space from the abdomen. This retrospective analysis demonstrates the clinical and radiographic correlation between percutaneous drainage of infected intraabdominal collections and the development of iatrogenic pleural space infections. A retrospective single institution analysis of 550 consecutive percutaneous drainage procedures for intraabdominal fluid collections was performed over 24 months. Patient charts and imaging were reviewed with regard to pleural space infections that were attributed to percutaneous drain placements. Institutional review board approval was obtained for conduct of the study. 6/550 (1.1%) patients developed iatrogenic pleural space infections after percutaneous drainage of intraabdominal fluid collections. All 6 patients presented with respiratory symptoms and required pleural space drainage (either by needle aspiration or chest tube placement), 2 received intrapleural fibrinolytic therapy and 1 patient had to undergo surgical drainage. Pleural effusion cultures revealed same bacteria in both intraabdominal and pleural fluid in 3 (50%) cases. A video with a dynamic radiographic sequence demonstrating the contamination of the pleural space from percutaneous drainage of an infected intraabdominal collection is included. Iatrogenic pleural space infections after percutaneous drainage of intraabdominal fluid collections occur at a low incidence, but the pleural empyema can be progressive requiring prompt chest tube drainage, intrapleural fibrinolytic therapy or even surgery. Expertise in intraabdominal drain placements, awareness and early recognition of this complication is critical to minimize incidence, morbidity and mortality in these patients.

  4. RT-qPCR work-flow for single-cell data analysis

    Czech Academy of Sciences Publication Activity Database

    Stahlberg, A.; Rusňáková, Vendula; Forootan, A.; Anděrová, Miroslava; Kubista, Mikael

    2013-01-01

    Roč. 59, č. 1 (2013), s. 80-88 ISSN 1046-2023 R&D Projects: GA MŠk(CZ) ME10052; GA ČR GAP303/10/1338 Institutional research plan: CEZ:AV0Z50520701 Institutional support: RVO:68378041 Keywords : RT-qPCR * Single-cell biology * Single-cell data analysis Subject RIV: EB - Genetics ; Molecular Biology; FH - Neurology (UEM-P) Impact factor: 3.221, year: 2013

  5. Iodine-125 seed brachytherapy for early stage prostate cancer: a single-institution review

    International Nuclear Information System (INIS)

    Zuber, Simon; Weiß, Susan; Baaske, Dieter; Schöpe, Michael; Stevens, Simon; Bodis, Stephan; Zwahlen, Daniel R

    2015-01-01

    We are reporting the five-year biochemical control, toxicity profile and dosimetric parameters using iodine-125 low dose rate brachytherapy (BT) as monotherapy for early stage prostate cancer at a single institution. Between April 2006 and December 2010, 169 men with early stage prostate cancer were treated with BT. Biochemical failure was defined using the Phoenix definition (nadir + 2 ng/mL). Treatment-related morbidities, including urinary, rectal and sexual function, were measured, applying the International Prostate Symptom Score (IPSS), the 7-grade Quality of Life Scale (QoL) and medical status, the International Consultation on Incontinence Modular Questionnaire (ICIQ), the International Index of Erectile Function (IIEF-5) and the Common Terminology Criteria for Adverse Events (CTCAE v4.03). Seed migration and loss, dosimetric parameters and learning effects were also analyzed. Medium follow-up time was 50 months (range, 1–85 months). The five-year biochemical failure rate was 7%. Acute proctitis rates were 19% (grade 1) and 1% (grade 2), respectively. The overall incidence of incontinence was 19% (mild), 16% (moderate) and < 1% (severe). An increase in IPSS ≥ 5 points was detected in 59% of patients, with 38% regaining their baseline. Seed dislocation was found in 24% of patients and correlated with D90 and V100. A learning curve was found for seed migration, D90 and V100. QoL correlated with the general health condition of patient, incontinence symptoms and IPSS. BT for early stage prostate cancer offers excellent five-year biochemical control with low toxicities. QoL aspects are favorable. A learning curve was detected for procedural aspects but its impact on patient relevant endpoints remains inconclusive

  6. Treatment outcomes of female germ cell tumors: The Egyptian National Cancer Institute experience

    International Nuclear Information System (INIS)

    Saber, M.M.; Zeeneldin, A.A.; El Gammal, M.M.; Salem, S.E.; Darweesh, A.D.; Abdelaziz, A.A.; Monir, M.

    2014-01-01

    Introduction: Female germ cell tumors (GCTS) are rare tumors that carry a good prognosis. Aim: To report the experience of the Egyptian National Cancer Institute (ENCI) in managing female GCTs. Methods: This retrospective study included 19 females with ovarian GCTs presenting to the ENCI between 2006 and 2010. Results: The median age was 23 years. Ovaries were the primary site in all patients. Dysgerminoma and teratoma were the predominant pathologies followed by mixed GCT in females. Unilateral ovariectomy or ovarian tumorectomy were the classic surgical procedures with R0 resection being feasible in most cases. Surveillance was adopted in six patients with stage I disease. Chemotherapy was administered in 63% of ovarian GCTs with BEP being the commonest regimen with reasonable tolerability and good response rates. The median OS and EFS were not reached. The projected 5-year OS rate was 93.8%. Both OS and EFS were better in patients responding to chemotherapy than non-responders (p< 0.002). Stage of disease did not significantly affect OS or EFS. Conclusions: Female GCTs rarely affect Egyptian females. They have good prognosis.

  7. Living at home or in institution: adolescents' optimal experience and life theme building

    Directory of Open Access Journals (Sweden)

    Antonella Delle Fave

    2000-12-01

    Full Text Available The influence of family relationships on adolescents' behavior and development has been widely investigated. This study examines the relationship between family structure and a adolescents' quality of experience in daily activities and social contexts b adolescents' perceived life influences, challenges and goals. To achieve this aim, Flow Questionnaire and Life Theme Questionnaire were administered to 50 Italian girls (15-21 years of age, 25 living in two-parent families, 25 entrusted to Institutions for Custody of Minors. The findings suggest tha adolescents' perception of a positive and supportive family enviroment fosters the active search for challenges and enjoyment in daily activities, and the involvement in productive and social contexts. On the contrary , negative family perception is related to lack of engagement and motivation, and to the prevalence of low-challenge activities as sources of enjoyment and satisfaction. Although the sample size does not allow us to draw conclusions about causality, the results confirm the crucial role of family in influencing adolescents' psychological and behavioral development.

  8. Performance study of single undoped CsI crystals for the Mu2e experiment

    International Nuclear Information System (INIS)

    Donghia, R.

    2016-01-01

    The Mu2e experiment at Fermilab aims to measure the neutrinoless muon-to-electron conversion, which is a charged-lepton flavor-violating process. The goal of the experiment is to reach a single event sensitivity of 2.5 × 10"−"1"7, to set an upper limit on the muon conversion rate at 6.7 × 10"−"1"7 in a three-year run. For this purpose, the Mu2e detector is designed to identify electrons from muon conversion and reduce the background to a negligible level. It consists of a low-mass straw tracker and a pure CsI crystal calorimeter. In this paper, the performance of undoped CsI single crystal is reported. Crystals from many vendors have been characterized by determining their Light Yield (LY) and Longitudinal Response Uniformity (LRU), when read with a UV extended PMT, and their time resolution when coupled to a silicon photomultiplier. The crystals show a LY of ∼ 100 photoelectrons per MeV when wrapped with Tyvek and coupled to the PMT without optical grease. The LRU is well represented by a linear slope that is on average 0.6%/cm. Both measurements have been performed using a "2"2Na source. The timing performance has been evaluated exploiting cosmic rays, with MPPC readout. A timing resolution lower than 400 ps has been achieved (at ∼ 20 MeV, which is the energy released by a minimum ionizing particle in the crystal).

  9. 76 FR 66698 - Postsecondary Educational Institutions Invited To Participate in Experiments Under the...

    Science.gov (United States)

    2011-10-27

    ... typically need their student aid funds early to meet obligations for travel to the site of their upcoming... Education. ACTION: Notice. Overview Information: Federal Student Financial Assistance Programs under Title... invites postsecondary educational institutions (institutions) that participate in the student assistance...

  10. Characterization of photoactivated singlet oxygen damage in single-molecule optical trap experiments.

    Science.gov (United States)

    Landry, Markita P; McCall, Patrick M; Qi, Zhi; Chemla, Yann R

    2009-10-21

    Optical traps or "tweezers" use high-power, near-infrared laser beams to manipulate and apply forces to biological systems, ranging from individual molecules to cells. Although previous studies have established that optical tweezers induce photodamage in live cells, the effects of trap irradiation have yet to be examined in vitro, at the single-molecule level. In this study, we investigate trap-induced damage in a simple system consisting of DNA molecules tethered between optically trapped polystyrene microspheres. We show that exposure to the trapping light affects the lifetime of the tethers, the efficiency with which they can be formed, and their structure. Moreover, we establish that these irreversible effects are caused by oxidative damage from singlet oxygen. This reactive state of molecular oxygen is generated locally by the optical traps in the presence of a sensitizer, which we identify as the trapped polystyrene microspheres. Trap-induced oxidative damage can be reduced greatly by working under anaerobic conditions, using additives that quench singlet oxygen, or trapping microspheres lacking the sensitizers necessary for singlet state photoexcitation. Our findings are relevant to a broad range of trap-based single-molecule experiments-the most common biological application of optical tweezers-and may guide the development of more robust experimental protocols.

  11. High-quality single crystals for neutron experiments

    Indian Academy of Sciences (India)

    studies and our collaborative research projects with other UK and international groups will be discussed. Keywords. Crystal growth; floating zone method; neutron scattering. ... of single crystals of new materials is a highly competitive business.

  12. Mycophenolate mofetil in pediatric renal transplantation: A single center experience.

    LENUS (Irish Health Repository)

    Raheem, Omer A

    2011-05-01

    Raheem OA, Kamel MH, Daly PJ, Mohan P, Little DM, Awan A, Hickey DP. Mycophenolate mofetil in pediatric renal transplantation: A single center experience. Pediatr Transplantation 2011: 15:240-244. © 2009 John Wiley & Sons A\\/S. Abstract:  We assessed our long-term experience with regards to the safety and efficacy of MMF in our pediatric renal transplant population and compared it retrospectively to our previous non-MMF immunosuppressive regimen. Forty-seven pediatric renal transplants received MMF as part of their immunosuppressive protocol in the period from January 1997 till October 2006 (MMF group). A previously reported non-MMF group of 59 pediatric renal transplants was included for comparative analysis (non-MMF group). The MMF group comprised 29 boys and 18 girls, whereas the non-MMF group comprised 34 boys and 25 girls. Mean age was 11.7 and 12 yr in the MMF and non-MMF groups, respectively. The incidence of acute rejection episodes was 11 (23.4%) and 14 (24%) in the MMF and non-MMF group, respectively. Two (3.3%) grafts were lost in the non-MMF group compared with one (2.1%) in the MMF group. Twenty-one (44.68%) patients in the MMF group developed post-transplant infections compared with 12 (20.33%) in the non-MMF group (p < 0.0001). In conclusion, the use of MMF in pediatric renal transplantation was not associated with a lower rejection rate or immunological graft loss. It did, however, result in a significantly higher rate of viral infections.

  13. Long-term Dose Stability of OnabotulinumtoxinA Injection for Adductor Spasmodic Dysphonia: A 19-Year Single Institution Experience

    Directory of Open Access Journals (Sweden)

    Paul Paddle

    2017-11-01

    Full Text Available ObjectivesAdductor spasmodic dysphonia (AdSD is a focal dystonia predominantly involving the laryngeal adductor muscles. AdSD is reported to be a largely non-progressive neurological disorder, though fluctuations in symptom severity do occur. Repeated laryngeal onabotulinumtoxinA (BTX-A injections are the primary management for AdSD. A number of studies have demonstrated long-term dose stability as evidence of this long-term disease stability.MethodsA retrospective review was performed on all patients undergoing BTX-A injections for AdSD from April 1994 to September 2013 by a single laryngologist at a tertiary referral laryngology center. Patient demographics, injection doses, use of diazepam and/or lidocaine, and self-reported vocal function were recorded. Multiple linear regression analyses were performed.Results83 patients underwent a total of 1,168 injections over 19 years. The mean starting dose was 2.35 MU (0.79 SD. The mean long-term dose was 2.36 MU (0.79 SD. After adjusting for confounders, the change in the relative dose of BTX-A, with every year elapsed since initial dose was 0.13% (95% confidence interval −0.31 to 0.57%, p = 0.568.ConclusionBTX-A dose is stable over time in our large cohort of patients treated with bilateral thyroarytenoid injections for AdSD.

  14. The World Nuclear University Summer Institute

    International Nuclear Information System (INIS)

    Rivard, D.; McIntyre, M.

    2007-01-01

    The World Nuclear University (WNU) Summer Institute is a six weeks intensive training program aimed to develop a global leadership in the field of nuclear sciences and technologies. The topics covered include global setting, international regimes, technology innovation and nuclear industry operations. This event has been held annually since 2005. Mark McIntyre and Dominic Rivard attended this activity as a personal initiative. In this paper they will present the WNU and its Summer Institute, share their participation experience and discuss as well of some technical content covered during the Institute, highlighting the benefits this brought to their careers. (author)

  15. Percutaneous nephrolithotomy for staghorn calculi: a single center's experience over 15 years.

    Science.gov (United States)

    Soucy, Frédéric; Ko, Raymond; Duvdevani, Mordechai; Nott, Linda; Denstedt, John D; Razvi, Hassan

    2009-10-01

    Percutaneous nephrolithotomy (PCNL) for staghorn calculi is one of the more challenging endourologic procedures. Although excellent stone-free rates are universally reported in the literature, complication rates vary widely, especially related to the need for blood transfusion. The purpose of this study was to evaluate the outcomes of PCNL for patients with staghorn calculi in a large series of patients at a single, tertiary referral, endourologic stone center. Between July 1990 and December 2005, 1338 patients underwent PCNL for renal stone disease at our institution. Among this group, 509 procedures were performed for patients with a partial or complete staghorn calculus. Data analysis included procedure time, length of hospital stay, number of access tracts, transfusion rates, other early and late complications, and stone-free status. Mean patient age was 53.8 years (range 4-84 yrs). The average procedure time was 104 minutes. Sixteen percent of the cases needed multiple access tracts (range 2-5), with the lower calix being the most commonly used in 64.1%, followed by the upper calix in 18.5% and the middle calix in 17.4%. Various intracorporeal lithotriptors were used, including ultrasound, pneumatic, electrohydraulic, and holmium:yttrium-aluminium-garnet laser. The transfusion rate among this group was 0.8%. There was no statistically significant difference in transfusion rates (0.7%-1.2% P = 0.24) or other major complications in patients who were treated with either a single tract or among those needing multiple tracts. Stone-free rates at hospital discharge and at 3 months follow-up were 78% and 91%, respectively. PCNL is a safe and effective procedure in the management of staghorn calculi, with outcomes similar to those reported for percutaneous management of smaller volume nonstaghorn stones. Attention to accurate tract selection and placement as well as possession of the full array of endourologic equipment are essential to achieving an excellent outcome.

  16. The Young-Feynman two-slits experiment with single electrons: Build-up of the interference pattern and arrival-time distribution using a fast-readout pixel detector

    Energy Technology Data Exchange (ETDEWEB)

    Frabboni, Stefano [Department of Physics, University of Modena and Reggio Emilia, Via G. Campi 213/a, 41125 Modena (Italy); CNR-Institute of Nanoscience-S3, Via G. Campi 213/a, 41125 Modena (Italy); Gabrielli, Alessandro [Department of Physics, University of Bologna, Viale B. Pichat 6/2, 40127 Bologna (Italy); INFN, Viale B. Pichat 6/2, 40127 Bologna (Italy); Carlo Gazzadi, Gian [CNR-Institute of Nanoscience-S3, Via G. Campi 213/a, 41125 Modena (Italy); Giorgi, Filippo [Department of Physics, University of Bologna, Viale B. Pichat 6/2, 40127 Bologna (Italy); INFN, Viale B. Pichat 6/2, 40127 Bologna (Italy); Matteucci, Giorgio [Department of Physics, University of Bologna, Viale B. Pichat 6/2, 40127 Bologna (Italy); Pozzi, Giulio, E-mail: giulio.pozzi@unibo.it [Department of Physics, University of Bologna, Viale B. Pichat 6/2, 40127 Bologna (Italy); Cesari, Nicola Semprini; Villa, Mauro; Zoccoli, Antonio [Department of Physics, University of Bologna, Viale B. Pichat 6/2, 40127 Bologna (Italy); INFN, Viale B. Pichat 6/2, 40127 Bologna (Italy)

    2012-05-15

    The two-slits experiment for single electrons has been carried out by inserting in a conventional transmission electron microscope a thick sample with two nano-slits fabricated by Focused Ion Beam technique and a fast recording system able to measure the electron arrival-time. The detector, designed for experiments in future colliders, is based on a custom CMOS chip equipped with a fast readout chain able to manage up to 10{sup 6} frames per second. In this way, high statistic samples of single electron events can be collected within a time interval short enough to measure the distribution of the electron arrival-times and to observe the build-up of the interference pattern. -- Highlights: Black-Right-Pointing-Pointer We present the first results obtained regarding the two-slits Young-Feynman experiment with single electrons. Black-Right-Pointing-Pointer We use two nano-slits fabricated by Focused Ion Beam technique. Black-Right-Pointing-Pointer We insert in the transmission electron microscope a detector, designed for experiments in future colliders. Black-Right-Pointing-Pointer We record the build-up of high statistic single electron interference patterns. Black-Right-Pointing-Pointer We measure the time distribution of electron arrivals.

  17. Institutional Trajectories of Street Youth in Buenos Aires

    Directory of Open Access Journals (Sweden)

    Cecilia Litichever

    2012-07-01

    Full Text Available This article explores citizenship formation in institutional settings. Based on life stories and participant observation, it studies how street youth in Buenos Aires experience State institutions in charge of children and youth at risk. It analyzes the level of involvement, the demands, the expression of needs and negotiations that take place within various public institutions and explores how these interactions shape the process of citizenship formation. Results suggest three different institutional trajectories amongst street youth that lead to different processes of citizenship formation.

  18. Current experiments in elementary particle physics

    International Nuclear Information System (INIS)

    Galic, H.; Dodder, D.C.; Klyukhin, V.I.; Ryabov, Yu.G.; Illarionova, N.S.; Lehar, F.; Oyanagi, Y.; Frosch, R.

    1992-06-01

    This report contains summaries of 584 current and recent experiments in elementary particle physics. Experiments that finished taking data before 1986 are excluded. Included are experiments at Brookhaven, CERN, CESR, DESY, Fermilab, Tokyo Institute of Nuclear Studies, Moscow Institute of Theoretical and Experimental Physics, KEK, LAMPF, Novosibirsk, Paul Scherrer Institut (PSI), Saclay, Serpukhov, SLAC, SSCL, and TRIUMF, and also several underground and underwater experiments. Instructions are given for remote searching of the computer database (maintained under the SLAC/SPIRES system) that contains the summaries

  19. Exploring the experiences of female students in introductory project-based engineering courses at two- and four-year institutions

    Science.gov (United States)

    Swan, Amy K.

    2011-12-01

    This qualitative study explored the experiential and contextual factors that shaped female students' pathways into introductory project-based engineering classes at two community colleges and one four-year institution, as well as female students' experiences within and outside of these classes. The study was framed by Social Cognitive Career Theory (SCCT) (Lent, Brown & Hackett, 1996) and Bronfenbrenner's (1979) ecological systems theory. Findings were based on analyses of data gathered through multiple methods: observations; individual interviews with female students; focus group interviews with project teams; and document collection. The findings of this study revealed that while positive experiences with math or science were a likely pre-cursor to engineering interest, experiential learning appeared to be a more powerful force in fostering students' engineering interest. Specifically, participants developed an interest in engineering through academic, professional, and extracurricular engineering- and design-related activities that familiarized them with the tasks and skills involved in engineering work and helped them develop a sense of selfefficacy with regard to this work. Interest and self-efficacy, in turn, played a role in students' postsecondary educational decision-making processes, as did contextual factors including families and finances. This study's findings also showed that participants' project teams were a critically important microsystem within participants' ecological environments. Within this sometimes "chilly" microsystem, female students negotiated intrateam processes, which were in some cases affected by gender norms. Intrateam processes that influenced female students' project-based learning experiences included: interpersonal dynamics; leadership; and division of labor. This study also identified several ways in which the lived experiences of participants at the community colleges were different from, or similar to, those of participants

  20. Search for Electroweak Single-Top Quark Production with the CDF II Experiment

    Energy Technology Data Exchange (ETDEWEB)

    Buehler, Matthias; /Karlsruhe U., EKP

    2006-08-01

    The CDF II experiment and the Tevatron proton-antiproton collider are parts of the Fermi National Laboratories (Fermilab). The Fermilab is located in the vicinity of Chicago, USA. Today, the Tevatron is the only collider which is able to produce the heaviest known elementary particle, the top quark. The top quark was discovered at the Tevatron by the CDF and the D0 collaborations in 1995 [1]. So far, all the top quarks found are produced via the strong interaction as top-antitop pairs. The Standard Model of elementary particle physics also predicts single-top quark production via the electroweak interaction. This production mode has not yet been observed. The CDF and the D0 collaborations have set upper limits on the cross section for that process in Run I [2, 3] and improved those results in Run II [4, 5]. Single-top quark production is one of the major interests in Run II of the Tevatron as it offers several ways to test the Standard Model and to search for potential physics beyond the Standard Model. The measurement of the cross section of singly produced top quarks via the electroweak interaction offers the possibility to determine the Cabbibo-Kobayashi-Maskawa (CKM) matrix element V{sub tb} directly. The CKM matrix defines the transformation from the eigenstates of the electroweak interactions to the mass eigenstates of the quarks. V{sub tb} gives the strength of the coupling at the Wtb vertex. The single-top quark is produced at this vertex and therefore the cross section of the single-top quark production is directly proportional to |V{sub tb}|{sup 2}. In the Standard Model, three generations of quarks and the unitarity of the CKM matrix are predicted. This leads to V{sub tb} {approx} 1. Up to now, there is no possibility to measure V{sub tb} without using the assumption that there are a certain number of quark generations. Since the measurement of the cross section of single-top quark production is independent of this assumption it could verify another

  1. Low-order longitudinal modes of single-component plasmas

    International Nuclear Information System (INIS)

    Tinkle, M.D.; Greaves, R.G.; Surko, C.M.

    1995-01-01

    The low-order modes of spheroidal, pure electron plasmas have been studied experimentally, both in a cylindrical electrode structure and in a quadrupole trap. Comparison is made between measurements of mode frequencies, recent analytical theories, and numerical simulations. Effects considered include trap anharmonicity, image charges, and temperature. Quantitative agreement is obtained between the predictions and these measurements for spheroidal plasmas in the quadrupole trap. In many experiments on single-component plasmas, including antimatter plasmas, the standard diagnostic techniques used to measure the density and temperature are not appropriate. A new method is presented for determining the size, shape, average density, and temperature of a plasma confined in a Penning trap from measurements of the mode frequencies. copyright 1995 American Institute of Physics

  2. Imaging characteristics of supratentorial ependymomas: Study on a large single institutional cohort with histopathological correlation.

    Science.gov (United States)

    Mangalore, Sandhya; Aryan, Saritha; Prasad, Chandrajit; Santosh, Vani

    2015-01-01

    Supratentorial ependymoma (STE) is a tumor whose unique clinical and imaging characteristics have not been studied. Histopathologically, they resemble ependymoma elsewhere. We retrospectively reviewed the imaging findings with clinicopathological correlation in a large number of patients with STE to identify these characteristics. Computed tomography (CT) magnetic resonance images (MRI), pathology reports, and clinical information from 41 patients with pathology-confirmed STE from a single institution were retrospectively reviewed. CT and MRI findings including location, size, signal intensity, hemorrhage, and enhancement pattern were tabulated and described separately in intraventricular and intraparenchymal forms. STE was more common in pediatric age group and intraparenchymal was more common than intraventricular form. The most common presentation was features of raised intracranial tension. There were equal numbers of Grade II and Grade III tumors. The imaging characteristics in adult and pediatric age group were similar. The tumor was large and had both solid and cystic components. Advanced imaging such as diffusion, perfusion, and spectroscopy were suggestive of high-grade tumor. Only differentiating factor between Grade II and Grade III was the presence of calcification. 1234 rule and periwinkle sign which we have described in this article may help characterize this tumor on imaging. This series expands the clinical and imaging spectrum of STE and identifies characteristics that should suggest consideration of this uncommon diagnosis.

  3. Photon-HDF5: Open Data Format and Computational Tools for Timestamp-based Single-Molecule Experiments.

    Science.gov (United States)

    Ingargiola, Antonino; Laurence, Ted; Boutelle, Robert; Weiss, Shimon; Michalet, Xavier

    2016-02-13

    Archival of experimental data in public databases has increasingly become a requirement for most funding agencies and journals. These data-sharing policies have the potential to maximize data reuse, and to enable confirmatory as well as novel studies. However, the lack of standard data formats can severely hinder data reuse. In photon-counting-based single-molecule fluorescence experiments, data is stored in a variety of vendor-specific or even setup-specific (custom) file formats, making data interchange prohibitively laborious, unless the same hardware-software combination is used. Moreover, the number of available techniques and setup configurations make it difficult to find a common standard. To address this problem, we developed Photon-HDF5 (www.photon-hdf5.org), an open data format for timestamp-based single-molecule fluorescence experiments. Building on the solid foundation of HDF5, Photon-HDF5 provides a platform- and language-independent, easy-to-use file format that is self-describing and supports rich metadata. Photon-HDF5 supports different types of measurements by separating raw data (e.g. photon-timestamps, detectors, etc) from measurement metadata. This approach allows representing several measurement types and setup configurations within the same core structure and makes possible extending the format in backward-compatible way. Complementing the format specifications, we provide open source software to create and convert Photon-HDF5 files, together with code examples in multiple languages showing how to read Photon-HDF5 files. Photon-HDF5 allows sharing data in a format suitable for long term archival, avoiding the effort to document custom binary formats and increasing interoperability with different analysis software. We encourage participation of the single-molecule community to extend interoperability and to help defining future versions of Photon-HDF5.

  4. Proposed Treatment Protocol for Frostbite: A Retrospective Analysis of 17 Cases Based on a 3-Year Single-Institution Experience

    Directory of Open Access Journals (Sweden)

    Eun-Kyung Woo

    2013-09-01

    Full Text Available Background This paper discusses the treatment protocol for patients with frostbite.Methods We performed a retrospective analysis of a series of 17 patients with second- andhigher-degree frostbite who had been treated at our medical institution between 2010 and2012.Results Our clinical series of patients (n=17 included 13 men and four women, whosemean age was 42.4±11.6 years (range, 22-67 years. The sites of injury include the foot in sixpatients (35.3%, the hand in six patients (35.3% and the facial region in five patients (29.4%.Seven patients with second-degree frostbite were completely cured with only conservativetreatment during a mean period of 12.7±3.3 days (range, 8-16 days. Of the five patients withthird-degree frostbite, two underwent skin grafting following debridement, and the remainingthree achieved a complete cure with conservative treatment during a mean period of 35±4.3days (range, 29-39 days. Five patients with fourth-degree frostbite were treated with surgicalprocedures including amputation.Conclusions With the appropriate conservative management in the early stage of onset,surgeons should decide on surgery after waiting for a sufficient period of time until thedemarcation of the wound. Continuous management of patients is also needed to achievefunctional recovery after a complete cure has been achieved. This should also be accompaniedby patient education for the avoidance of re-exposure to cold environments.

  5. Proposed Treatment Protocol for Frostbite: A Retrospective Analysis of 17 Cases Based on a 3-Year Single-Institution Experience

    Directory of Open Access Journals (Sweden)

    Eun-Kyung Woo

    2013-09-01

    Full Text Available BackgroundThis paper discusses the treatment protocol for patients with frostbite.MethodsWe performed a retrospective analysis of a series of 17 patients with second- and higher-degree frostbite who had been treated at our medical institution between 2010 and 2012.ResultsOur clinical series of patients (n=17 included 13 men and four women, whose mean age was 42.4±11.6 years (range, 22-67 years. The sites of injury include the foot in six patients (35.3%, the hand in six patients (35.3% and the facial region in five patients (29.4%. Seven patients with second-degree frostbite were completely cured with only conservative treatment during a mean period of 12.7±3.3 days (range, 8-16 days. Of the five patients with third-degree frostbite, two underwent skin grafting following debridement, and the remaining three achieved a complete cure with conservative treatment during a mean period of 35±4.3 days (range, 29-39 days. Five patients with fourth-degree frostbite were treated with surgical procedures including amputation.ConclusionsWith the appropriate conservative management in the early stage of onset, surgeons should decide on surgery after waiting for a sufficient period of time until the demarcation of the wound. Continuous management of patients is also needed to achieve functional recovery after a complete cure has been achieved. This should also be accompanied by patient education for the avoidance of re-exposure to cold environments.

  6. Factors influencing the outcome of radiotherapy in malignant mesothelioma of the pleura - a single-institution experience with 189 patients

    International Nuclear Information System (INIS)

    Graaf-Strukowska, Lucyna de; Zee, Jacoba van der; Putten, Wim van; Senan, Suresh

    1999-01-01

    Purpose: To determine the factors influencing the response to palliative radiotherapy (RT) in malignant mesothelioma of the pleura (MM). Methods and Materials: A retrospective review was conducted of the records of all patients with mesothelioma who were referred to our institution between 1979 and 1996. A total of 227 RT series were administered to 189 patients with MM. Of these, 21 patients with chest wall nodules also received concomitant local hyperthermia. Results: The median survival was 5 months from the start of RT and only 17% of patients were alive at 1 year after treatment. Chest pain and painful chest wall metastases were the main indications for RT. A higher local response rate was seen for patients treated with a 4-Gy per fraction scheme, vs. those receiving fractions of less than 4 Gy (50% vs. 39%). Pain recurrence occurred predominantly within the previous RT field, and pain recurred after a median of 69 days (range 32-363) in the group treated using 4-Gy fractions. When compared with a matched group, patients treated with combined RT and hyperthermia had higher response rates and fewer in-field recurrences. Conclusions: RT provides local palliation in at least 50% of patients with MM who were treated using a 4-Gy/fraction scheme to a median dose of 36 Gy. The low response rates with RT alone suggest that combined RT and local hyperthemia should be further evaluated in MM

  7. Current experiments in elementary particle physics

    Energy Technology Data Exchange (ETDEWEB)

    Wohl, C.G.; Armstrong, F.E., Oyanagi, Y.; Dodder, D.C.; Ryabov, Yu.G.; Frosch, R.; Olin, A.; Lehar, F.; Moskalev, A.N.; Barkov, B.P.

    1987-03-01

    This report contains summaries of 720 recent and current experiments in elementary particle physics (experiments that finished taking data before 1980 are excluded). Included are experiments at Brookhaven, CERN, CESR, DESY, Fermilab, Moscow Institute of Theoretical and Experimental Physics, Tokyo Institute of Nuclear Studies, KEK, LAMPF, Leningrad Nuclear Physics Institute, Saclay, Serpukhov, SIN, SLAC, and TRIUMF, and also experiments on proton decay. Instructions are given for searching online the computer database (maintained under the SLAC/SPIRES system) that contains the summaries. Properties of the fixed-target beams at most of the laboratories are summarized.

  8. Current experiments in elementary particle physics

    International Nuclear Information System (INIS)

    Wohl, C.G.; Armstrong, F.E.; Oyanagi, Y.; Dodder, D.C.; Ryabov, Yu.G.; Frosch, R.; Olin, A.; Lehar, F.; Moskalev, A.N.; Barkov, B.P.

    1987-03-01

    This report contains summaries of 720 recent and current experiments in elementary particle physics (experiments that finished taking data before 1980 are excluded). Included are experiments at Brookhaven, CERN, CESR, DESY, Fermilab, Moscow Institute of Theoretical and Experimental Physics, Tokyo Institute of Nuclear Studies, KEK, LAMPF, Leningrad Nuclear Physics Institute, Saclay, Serpukhov, SIN, SLAC, and TRIUMF, and also experiments on proton decay. Instructions are given for searching online the computer database (maintained under the SLAC/SPIRES system) that contains the summaries. Properties of the fixed-target beams at most of the laboratories are summarized

  9. China’s Institutional Architecture: A New Institutional Economics and Organization Theory Perspective on the Links between Local Governance and Local Enterprises

    NARCIS (Netherlands)

    B. Krug (Barbara); H. Hendrischke (Hans)

    2008-01-01

    textabstractWe start our exploration of China’s institutional change by asking what the China experience can tell us about institutional economics and organization theory. We point to under-researched areas such as the formation of firms and the interplay between firms and local politics. Our

  10. Ventriculostomy-associated infection: a new, standardized reporting definition and institutional experience.

    Science.gov (United States)

    Gozal, Yair M; Farley, Chad W; Hanseman, Dennis J; Harwell, Daniel; Magner, Mark; Andaluz, Norberto; Shutter, Lori

    2014-08-01

    Shortcomings created by the lack of both a uniform definition of ventriculostomy-associated infection (VAI) and reporting standards have led to widely ranging infections rates (2-24%) whose significance is uncertain. We propose a standardized definition of VAI and a consistent reporting format compliant with Centers for Disease Control and Prevention (CDC) for device-related infections. Using those parameters to establish an infection-control surveillance program, we report our 4-year institutional VAI rates. In this prospective study covering ventriculostomy utilization (October 2006-December 2010), 498 patients had a total of 4,673 ventriculostomy days. By review of the literature and our institutional analysis, we defined VAI as a positive CSF culture in a patient with ventriculostomy catheter, plus one or more of the following (1) fever recorded >101.5 °F or (2) cerebrospinal fluid (CSF) glucose level, either definition and CDC format seems promising toward facilitating future study and guideline development. Given our strict protocol of sterile catheter placement and care, and our institution's low 2.0% infection rates, we propose an infection-rate target of ≤5 per 1,000 device days. Our results suggest that the use of antibiotics or antibiotic-impregnated catheters is unwarranted--a positive given concerns of evolving anti-microbial resistance.

  11. Institutional Betrayal as a Motivator for Campus Sexual Assault Activism

    Science.gov (United States)

    Linder, Chris; Myers, Jess S.

    2018-01-01

    Institutional betrayal, feelings of treason that occur when an institution fails to prevent or respond appropriately to wrongdoings committed within the context of an institution, contributes to exacerbated trauma for survivors of sexual violence (Smith & Freyd, 2014). Through a qualitative research study, we examine experiences of 10 sexual…

  12. Medical student storytelling on an institutional blog: a case study analysis.

    Science.gov (United States)

    Becker, Katherine A; Freberg, Karen

    2014-05-01

    Despite the proclivity and proliferation of blogs on the Internet, the use of blogs at medical institutions is not well documented. In examining the structured stories that medical students share with the digital community, we may better understand how students use institutional blogs to discuss their medical school experiences while maintaining their role as a medical student ambassador for the program. We conducted a case study to analyze the stories within 309 medical student blogs from one medical institution in the United States. In an attempt to communicate their experiences to different benefactors, student bloggers engaged in structured and personal storytelling. Structured stories offered medical school advice to prospective students, while personal stories embodied features of a personal diary where students recounted significant milestones, talked about personal relationships and engaged in emotional reflection and disclosure. Institutional blogs may provide social marketing for medical institutions, as students strategically framed their experiences to reflect a positive attitude about the medical institution and focused on providing advice to prospective students. Although these structured stories limit complete disclosure, students may still achieve benefits by engaging in emotional disclosure and personal reflection.

  13. SU-E-T-284: Dose Plan Optimization When Using Hydrogel Prostate-Rectum Spacer: A Single Institution Experience

    Energy Technology Data Exchange (ETDEWEB)

    Rajecki, M; Thurber, A; Catalfamo, F; Duff, M; Shah, D [Cancer Care of Western New York, Cheektowaga, NY (United States)

    2015-06-15

    Purpose: To describe rectal dose reduction achieved and techniques used to take advantage of the increased peri-rectal spacing provided by injected polyethylene-glycol. Methods: Thirty prostate cancer patents were 2:1 randomized during a clinical trial to evaluate the effectiveness of injected poly-ethylene glycol hydrogel (SpaceOAR System) in creating space between the prostate and the anterior rectal wall. All patients received a baseline CT/MR scan and baseline IMRT treatment plan. Patients were randomized to receive hydrogel injection (n=20) or Control (n=10), followed by another CT/MR scan and treatment plan (single arc VMAT, 6 MV photons, 79.2 Gy, 44 fractions). Additional optimization structures were employed to constrain the dose to the rectum; specifically an avoidance structure to limit V75 <15%, and a control structure to limit the maximum relative dose <105% in the interface region of the anterior rectal wall and the prostate planning target volume. Dose volumetric data was analyzed for rectal volumes receiving 60 through 80 Gy. Results: Rectal dose reduction was observed in all patients who received the hydrogel. Volumetric analysis indicates a median rectal volume and (reduction from baseline plan) following spacer application of 4.9% (8.9%) at V60Gy, 3.8% (8.1%) at V65Gy, 2.5% (7.2%) at V70Gy, 1.6% (5.8%) at V75Gy, and 0.5% (2.5%) at V80Gy. Conclusion: Relative to planning without spacers, rectal dose constraints of 5%, 4%, 3%, 2%, 1% for V60, V65, V70, V75, and V80, should be obtainable when peri-rectal spacers are used. The combined effect of increased peri-rectal space provided by the hydrogel, with strict optimization objectives, resulted in reduced dose to the rectum. To maximize benefit, strict optimization objectives and reduced rectal dose constraints should be employed when creating plans for patients with perirectal spacers. Clinical Trial for SpaceOAR product conducted by Augmenix,Inc. The research site was paid to be a participating site.

  14. SU-E-T-284: Dose Plan Optimization When Using Hydrogel Prostate-Rectum Spacer: A Single Institution Experience

    International Nuclear Information System (INIS)

    Rajecki, M; Thurber, A; Catalfamo, F; Duff, M; Shah, D

    2015-01-01

    Purpose: To describe rectal dose reduction achieved and techniques used to take advantage of the increased peri-rectal spacing provided by injected polyethylene-glycol. Methods: Thirty prostate cancer patents were 2:1 randomized during a clinical trial to evaluate the effectiveness of injected poly-ethylene glycol hydrogel (SpaceOAR System) in creating space between the prostate and the anterior rectal wall. All patients received a baseline CT/MR scan and baseline IMRT treatment plan. Patients were randomized to receive hydrogel injection (n=20) or Control (n=10), followed by another CT/MR scan and treatment plan (single arc VMAT, 6 MV photons, 79.2 Gy, 44 fractions). Additional optimization structures were employed to constrain the dose to the rectum; specifically an avoidance structure to limit V75 <15%, and a control structure to limit the maximum relative dose <105% in the interface region of the anterior rectal wall and the prostate planning target volume. Dose volumetric data was analyzed for rectal volumes receiving 60 through 80 Gy. Results: Rectal dose reduction was observed in all patients who received the hydrogel. Volumetric analysis indicates a median rectal volume and (reduction from baseline plan) following spacer application of 4.9% (8.9%) at V60Gy, 3.8% (8.1%) at V65Gy, 2.5% (7.2%) at V70Gy, 1.6% (5.8%) at V75Gy, and 0.5% (2.5%) at V80Gy. Conclusion: Relative to planning without spacers, rectal dose constraints of 5%, 4%, 3%, 2%, 1% for V60, V65, V70, V75, and V80, should be obtainable when peri-rectal spacers are used. The combined effect of increased peri-rectal space provided by the hydrogel, with strict optimization objectives, resulted in reduced dose to the rectum. To maximize benefit, strict optimization objectives and reduced rectal dose constraints should be employed when creating plans for patients with perirectal spacers. Clinical Trial for SpaceOAR product conducted by Augmenix,Inc. The research site was paid to be a participating site

  15. The Appalachian Tri-State Node Experiences with the National Institute on Drug Abuse Clinical Trials Network.

    Science.gov (United States)

    Kelly, Thomas M; Daley, Dennis C; Byrne, Mimmie; Demarzo, Larry; Smith, Doris; Madl, Stephanie

    2011-07-01

    The National Institute on Drug Abuse (NIDA)-sponsored Clinical Trial Network (CTN) recently celebrated 10 years of conducting "real world" research into the treatment of addiction. This article reviews the history and results of the most recent CTN studies and describes the experiences of one of the 13 participating research affiliates, the Appalachian Tri-State (ATS) Node. We discuss our "bidirectional" collaboration with multiple community treatment programs (CTPs) on research and dissemination activities and include their experiences as a member of our ATS Node.Results of CTN clinical trials have found unexpectedly that treatment as usual (TAU) is often almost as good as evidence-based interventions such as Motivational Interviewing (MI), possibly due to the difficulty in implementing evidence-based practices most effectively among divergent treatment sites and heterogeneous clinical populations. Some expected findings from the reviewed research are that severity of addiction and comorbidity moderate treatment outcomes and must be accounted for in future CTN-sponsored studies. Notwithstanding these results, much has been learned and recommendations are suggested for changes in CTN research designs that will address methodological limitations and increase treatment effectiveness in future CTN studies.

  16. US Principals' Attitudes about and Experiences with Single-Sex Schooling

    Science.gov (United States)

    Fabes, Richard A.; Pahlke, Erin; Borders, Adrienne Z.; Galligan, Kathrine

    2015-01-01

    Despite a lack of scientific evidence supporting the use of single-sex education, the number of US public schools offering single-sex education has increased. However, our understanding as to why decision-makers have implemented single-sex education is lacking. To address this gap, we surveyed US public school principals and assessed their…

  17. Impacted Mandibular Third Molars: A Retrospective Study of 1198 Cases to Assess Indications for Surgical Removal, and Correlation with Age, Sex and Type of Impaction-A Single Institutional Experience.

    Science.gov (United States)

    Patel, Shital; Mansuri, Saloni; Shaikh, Faizan; Shah, Taksh

    2017-03-01

    To study the incidence of mandibular third molar impaction in relation to type and side of impaction, age and sex of patients and indications for its surgical removal through data collected from a single institute over a period of 3 and half years. The records of 1198 patients who underwent the surgical removal of impacted mandibular third molars were reviewed retrospectively. Records were divided into groups according to sex, age, type and side of impaction. Radiographs were studied to determine angular position of impacted mandible third molar. We found that there was a high incidence of mesioangular lower third molar impaction (33.97 %), highest number of patients were found in 15-30 years of age group (48.33 %), a left side (56.93 %) was more commonly involved, female predominance (63.44 %) was observed and recurrent pericoronitis (33.81 %) was the most common indication. Awareness of the indications for surgical removal of impacted mandibular third molar to the patients will help to avoid future risk of complications and morbidity associated with the same. This will not only help in saving time and money but also prevents the psychological trauma associated with delayed treatment. Removal of only symptomatic IMTM seems to be the logical choice in view of financial constraint in developing countries like India but at the same time early removal offers freedom from future complications in selected cases. So surgeons should apply a meticulous approach in selecting the patients for SRIMTM.

  18. Data collection of patient outcomes: one institution's experience.

    Science.gov (United States)

    Whitaker, Thomas J; Mayo, Charles S; Ma, Daniel J; Haddock, Michael G; Miller, Robert C; Corbin, Kimberly S; Neben-Wittich, Michelle; Leenstra, James L; Laack, Nadia N; Fatyga, Mirek; Schild, Steven E; Vargas, Carlos E; Tzou, Katherine S; Hadley, Austin R; Buskirk, Steven J; Foote, Robert L

    2018-03-01

    Patient- and provider-reported outcomes are recognized as important in evaluating quality of care, guiding health care policy, comparative effectiveness research, and decision-making in radiation oncology. Combining patient and provider outcome data with a detailed description of disease and therapy is the basis for these analyses. We report on the combination of technical solutions and clinical process changes at our institution that were used in the collection and dissemination of this data. This initiative has resulted in the collection of treatment data for 23 541 patients, 20 465 patients with provider-based adverse event records, and patient-reported outcome surveys submitted by 5622 patients. All of the data is made accessible using a self-service web-based tool.

  19. 'Silk Road', the virtual drug marketplace: a single case study of user experiences.

    Science.gov (United States)

    Van Hout, Marie Claire; Bingham, Tim

    2013-09-01

    The online promotion of 'drug shopping' and user information networks is of increasing public health and law enforcement concern. An online drug marketplace called 'Silk Road' has been operating on the 'Deep Web' since February 2011 and was designed to revolutionise contemporary drug consumerism. A single case study approach explored a 'Silk Road' user's motives for online drug purchasing, experiences of accessing and using the website, drug information sourcing, decision making and purchasing, outcomes and settings for use, and perspectives around security. The participant was recruited following a lengthy relationship building phase on the 'Silk Road' chat forum. The male participant described his motives, experiences of purchasing processes and drugs used from 'Silk Road'. Consumer experiences on 'Silk Road' were described as 'euphoric' due to the wide choice of drugs available, relatively easy once navigating the Tor Browser (encryption software) and using 'Bitcoins' for transactions, and perceived as safer than negotiating illicit drug markets. Online researching of drug outcomes, particularly for new psychoactive substances was reported. Relationships between vendors and consumers were described as based on cyber levels of trust and professionalism, and supported by 'stealth modes', user feedback and resolution modes. The reality of his drug use was described as covert and solitary with psychonautic characteristics, which contrasted with his membership, participation and feelings of safety within the 'Silk Road' community. 'Silk Road' as online drug marketplace presents an interesting displacement away from 'traditional' online and street sources of drug supply. Member support and harm reduction ethos within this virtual community maximises consumer decision-making and positive drug experiences, and minimises potential harms and consumer perceived risks. Future research is necessary to explore experiences and backgrounds of other users. Copyright © 2013

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

    Science.gov (United States)

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

    2009-01-01

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

  1. Coparenting Experiences in African American Families: An Examination of Single Mothers and their Non-Marital Coparents

    Science.gov (United States)

    Gonzalez, Michelle; Jones, Deborah J.; Parent, Justin

    2015-01-01

    African American youth from single mother homes continue to be overrepresented in statistics on risk behavior and delinquency, a trend that many be attributed to father-absence, socioeconomic disadvantage, and compromises in parenting more typical of single than two-parent families. Yet, this risk-focused perspective ignores a long-standing strength of the African American community, the involvement and potential protective impact of extended family members in childrearing. This study describes the experiences of 95 African American single mothers and their non-marital coparents who participated in a study of African American single mother families with an 11 to 16 year old child. Specifically, the study examines: 1) the extent to which nonmarital coparents are involved in childrearing; 2) the relative levels of risk (i.e., depression, mother-coparent conflict) and protective (i.e., parenting) associated with maternal and coparent involvement; and 3) how similarly and/or differently coparent and mother variables operate with regard to youth externalizing problems. Findings reveal that a range of family members and other adults actively participate in childrearing in African American single mother families, coparents do not differ from mothers on certain study variables (i.e., depression and mother-coparent conflict) but do for others (parenting), and coparent involvement is associated with youth adjustment in ways that are similar to our more established understanding of maternal involvement. The potential clinical implications of the findings are discussed and future research directions are highlighted. PMID:24479612

  2. Safety Evaluation Report, related to the renewal of the operating license for the critical experiment facility of the Rensselaer Polytechnic Institute (Docket No. 50-225)

    International Nuclear Information System (INIS)

    1983-10-01

    This Safety Evaluation Report for the application filed by the Rensselaer Polytechnic Institute (RPI) for a renewal of operating license CX-22 to continue to operate a critical experiment facility has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by Rensselaer Polytechnic Institute and is located at a site in the city of Schenectady, New York. The staff concludes that this critical facility can continue to be operated by RPI without endangering the health and safety of the public

  3. Source of single photons and interferometry with one photon. From the Young's slit experiment to the delayed choice; Source de photons uniques et interferences a un seul photon. De l'experience des fentes d'Young au choix retarde

    Energy Technology Data Exchange (ETDEWEB)

    Jacques, V

    2007-11-15

    This manuscript is divided in two independent parts. In the first part, we study the wave-particle duality for a single photon emitted by the triggered photoluminescence of a single NV color center in a diamond nano-crystal. We first present the realization of a single-photon interference experiment using a Fresnel's bi-prism, in a scheme equivalent to the standard Young's double-slit textbook experiment. We then discuss the complementarity between interference and which-path information in this two-path interferometer. We finally describe the experimental realization of Wheeler's delayed-choice Gedanken experiment, which is a fascinating and subtle illustration of wave-particle duality. The second part of the manuscript is devoted to the efficiency improvement of single-photon sources. We first describe the implementation of a new single-photon source based on the photoluminescence of a single nickel-related defect center in diamond. The photophysical properties of such defect make this single-photon source well adapted to open-air quantum cryptography. We finally demonstrate an original method that leads to an improvement of single-molecule photo stability at room temperature. (author)

  4. Single incision laparoscopic surgery (SILS) inguinal hernia repair - recent clinical experiences of this novel technique.

    Science.gov (United States)

    Yussra, Y; Sutton, P A; Kosai, N R; Razman, J; Mishra, R K; Harunarashid, H; Das, S

    2013-01-01

    Inguinal hernia remains the most commonly encountered surgical problem. Various methods of repair have been described, and the most suitable one debated. Single port access (SPA) surgery is a rapidly evolving field, and has the advantage of affording 'scarless' surgery. Single incision laparoscopic surgery (SILS) for inguinal hernia repair is seen to be feasible in both total extraperitoneal (TEP) and transabdominal pre-peritoneal (TAPP) approaches. Data and peri-operative information on both of these however are limited. We aimed to review the clinical experience, feasibility and short term complications related to laparoscopic inguinal hernia repair via single port access. A literature search was performed using Google Scholar, Springerlink Library, Highwire Press, Surgical Endoscopy Journal, World Journal of Surgery and Medscape. The following search terms were used: laparoscopic hernia repair, TAPP, TEP, single incision laparoscopic surgery (SILS). Fourteen articles in English language related to SILS inguinal hernia repair were identified. Nine articles were related to TEP repair and the remaining 5 to TAPP. A total of 340 patients were reported within these studies: 294 patients having a TEP repair and 46 a TAPP. Only two cases of recurrence were reported. Various ports have been utilized, including the SILS port, Tri-Port and a custom- made port using conventional laparoscopic instruments. The duration of surgery was 40-100 minutes and the average length of hospital stay was one day. Early outcomes of this novel technique show it to be feasible, safe and with potentially better cosmetic outcome.

  5. Current experiments in elementary particle physics

    Energy Technology Data Exchange (ETDEWEB)

    Wohl, C.G.; Armstrong, F.E.; Trippe, T.G.; Yost, G.P. (Lawrence Berkeley Lab., CA (USA)); Oyanagi, Y. (Tsukuba Univ., Ibaraki (Japan)); Dodder, D.C. (Los Alamos National Lab., NM (USA)); Ryabov, Yu.G.; Slabospitsky, S.R. (Gosudarstvennyj Komitet po Ispol' zovaniyu Atomnoj Ehnergii SSSR, Serpukhov (USSR). Inst. Fiziki Vysokikh Ehnergij); Frosch, R. (Swiss Inst. for Nuclear Research, Villigen (Switzerla

    1989-09-01

    This report contains summaries of 736 current and recent experiments in elementary particle physics (experiments that finished taking data before 1982 are excluded). Included are experiments at Brookhaven, CERN, CESR, DESY, Fermilab, Tokyo Institute of Nuclear Studies, Moscow Institute of Theoretical and Experimental Physics, Joint Institute for Nuclear Research (Dubna), KEK, LAMPF, Novosibirsk, PSI/SIN, Saclay, Serpukhov, SLAC, and TRIUMF, and also several underground experiments. Also given are instructions for searching online the computer database (maintained under the SLAC/SPIRES system) that contains the summaries. Properties of the fixed-target beams at most of the laboratories are summarized.

  6. Current experiments in elementary particle physics

    International Nuclear Information System (INIS)

    Wohl, C.G.; Armstrong, F.E.; Trippe, T.G.; Yost, G.P.; Oyanagi, Y.; Dodder, D.C.; Ryabov, Yu.G.; Slabospitsky, S.R.; Olin, A.; Klumov, I.A.

    1989-09-01

    This report contains summaries of 736 current and recent experiments in elementary particle physics (experiments that finished taking data before 1982 are excluded). Included are experiments at Brookhaven, CERN, CESR, DESY, Fermilab, Tokyo Institute of Nuclear Studies, Moscow Institute of Theoretical and Experimental Physics, Joint Institute for Nuclear Research (Dubna), KEK, LAMPF, Novosibirsk, PSI/SIN, Saclay, Serpukhov, SLAC, and TRIUMF, and also several underground experiments. Also given are instructions for searching online the computer database (maintained under the SLAC/SPIRES system) that contains the summaries. Properties of the fixed-target beams at most of the laboratories are summarized

  7. Circulating hematopoietic progenitors and CD34(+) cells predicted successful hematopoietic stem cell harvest in myeloma and lymphoma patients: experiences from a single institution.

    Science.gov (United States)

    Yu, Jui-Ting; Cheng, Shao-Bin; Yang, Youngsen; Chang, Kuang-Hsi; Hwang, Wen-Li; Teng, Chieh-Lin Jerry

    2016-01-01

    Previous studies have shown that the numbers of both circulating hematopoietic progenitor cell (HPC) and CD34(+) cell are positively correlated with CD34(+) cell harvest yield. However, the minimal numbers of both circulating HPCs and CD34(+) cells required for performing an efficient hematopoietic stem cell (HSC) harvest in lymphoma and myeloma patients have not been defined in our institution. Medical records of 50 lymphoma and myeloma patients undergoing peripheral blood HSC harvest in our institution were retrospectively reviewed. The minimal and optimal HSC harvest yield required for the treatment was considered to be ≥2×10(6) CD34(+) cells/kg and ≥5×10(6) CD34(+) cells/kg, respectively. The minimally required or optimal HSC yield obtained was not influenced by age (≥60 years), sex, underlying malignancies, disease status, multiple rounds of chemotherapy, or history of radiotherapy. The numbers of both circulating HPC and CD34(+) cell were higher in patients with minimally required HSC yields (P=0.000 for HPC and P=0.000 for CD34(+) cell) and also in patients with optimal HSC yields (P=0.011 for HPC and P=0.006 for CD34(+) cell). The cell count cutoff for obtaining minimally required HSC harvest was determined to be 20/mm(3) for HPCs and 10/mm(3) for CD34(+) cells. Furthermore, the cell count cutoff for obtaining optimal HSC harvest was determined to be 60/mm(3) for HPCs and 35/mm(3) for CD34(+) cells. A total of 60/mm(3) of HPCs and 35/mm(3) of CD34(+) cells in peripheral blood predicted optimal HSC harvest in lymphoma and myeloma patients.

  8. Quengel Casting for the Management of Pediatric Knee Flexion Contractures: A 26-Year Single Institution Experience.

    Science.gov (United States)

    Wiley, Marcel R; Riccio, Anthony I; Felton, Kevin; Rodgers, Jennifer A; Wimberly, Robert L; Johnston, Charles E

    Quengel casting was introduced in 1922 for nonsurgical treatment of knee flexion contractures (KFC) associated with hemophilic arthropathy. It consists of an extension-desubluxation hinge fixed to a cast allowing for gradual correction of a flexion deformity while preventing posterior tibial subluxation. The purpose of this study is to report 1 center's experience with this technique for the treatment of pediatric KFC. A retrospective review was conducted over a 26-year period. All patients with KFC treated with Quengel casting were included. Demographic data, associated medical conditions, adjunctive soft tissue releases, complications, and the need for late surgical intervention were recorded. Tibiofemoral angle measurements in maximal extension were recorded at initiation and termination of casting, 1-year follow-up, and final follow-up. Success was defined as no symptomatic recurrence of KFC or need for subsequent surgery. Eighteen patients (26 knees) were treated for KFC with Quengel casting. Average age at initiation of casting was 8.1 years with average follow-up of 59.9 months. Fifteen knees (58%) underwent soft tissue releases before casting. An average of 1.5 casts per knee were applied over an average of 23.9 days. Average KFC before casting was 50.6 degrees (range, 15 to 100 degrees) which improved to 5.96 degrees (0 to 40 degrees) at cast removal (Pcasting before 1 year. Of these, 11 knees (50%) had a successful outcome. Residual KFC of those treated successfully was 6.8 degrees (range, 0 to 30 degrees) at 1 year and 8.2 degrees (range, 0 to 30 degrees) at final follow-up, averaging 71.4 months (P=0.81). Of the 11 knees deemed failures, all had recurrence of deformity within an average of 1 year from cast removal. Surgical release before Quengel casting did not improve the chances for success (P=0.09). Quengel casting can improve pediatric KFC an average of 44.2 degrees with minimal complications. Although 50% of treated patients will demonstrate

  9. Institute for Safety Research. Annual report 1992

    International Nuclear Information System (INIS)

    Weiss, F.P.; Boehmert, J.

    1993-11-01

    The Institute is concerned with evaluating the design based safety and increasing the operational safety of technical systems which include serious sources of danger. It is further occupied with methods of mitigating the effects of incidents and accidents. For all these goals the institute does research work in the following fields: modelling and simulation of thermofluid dynamics and neutron kinetics in cases of accidents; two-phase measuring techniques; safety-related analyses and characterizing of mechanical behaviours of material; measurements and calculations of radiation fields; process and plant diagnostics; development and application of methods of decision analysis. This annual report gives a survey of projects and scientific contributions (e.g. Single rod burst tests with ZrNb1 cladding), lists publications, institute seminars and workshops, names the personal staff and describes the organizational structure. (orig./HP)

  10. Helical Tomotherapy Versus Single-Arc Intensity-Modulated Arc Therapy: A Collaborative Dosimetric Comparison Between Two Institutions

    International Nuclear Information System (INIS)

    Rong Yi; Tang, Grace; Welsh, James S.; Mohiuddin, Majid M.; Paliwal, Bhudatt; Yu, Cedric X.

    2011-01-01

    Purpose: Both helical tomotherapy (HT) and single-arc intensity-modulated arc therapy (IMAT) deliver radiation using rotational beams with multileaf collimators. We report a dual-institution study comparing dosimetric aspects of these two modalities. Methods and Materials: Eight patients each were selected from the University of Maryland (UMM) and the University of Wisconsin Cancer Center Riverview (UWR), for a total of 16 cases. Four cancer sites including brain, head and neck (HN), lung, and prostate were selected. Single-arc IMAT plans were generated at UMM using Varian RapidArc (RA), and HT plans were generated at UWR using Hi-Art II TomoTherapy. All 16 cases were planned based on the identical anatomic contours, prescriptions, and planning objectives. All plans were swapped for analysis at the same time after final approval. Dose indices for targets and critical organs were compared based on dose-volume histograms, the beam-on time, monitor units, and estimated leakage dose. After the disclosure of comparison results, replanning was done for both techniques to minimize diversity in optimization focus from different operators. Results: For the 16 cases compared, the average beam-on time was 1.4 minutes for RA and 4.8 minutes for HT plans. HT provided better target dose homogeneity (7.6% for RA and 4.2% for HT) with a lower maximum dose (110% for RA and 105% for HT). Dose conformation numbers were comparable, with RA being superior to HT (0.67 vs. 0.60). The doses to normal tissues using these two techniques were comparable, with HT showing lower doses for more critical structures. After planning comparison results were exchanged, both techniques demonstrated improvements in dose distributions or treatment delivery times. Conclusions: Both techniques created highly conformal plans that met or exceeded the planning goals. The delivery time and total monitor units were lower in RA than in HT plans, whereas HT provided higher target dose uniformity.

  11. Peripheral nerve field stimulation for chronic neuropathic pain: a single institution experience.

    Science.gov (United States)

    D'Ammando, A; Messina, G; Franzini, A; Dones, I

    2016-04-01

    Peripheral nerve field stimulation (PNFS) is a novel neurosurgical procedure consisting of implantation of subcutaneous leads in specific painful areas in different types of painful, drug-resistant syndromes. The objective of this study was to evaluate the efficacy of PNFS in several patients affected by different chronic neuropathic pain syndromes, along with its risks, limits and possible correlation between the results achieved and the patients' main symptoms. Twenty-two patients affected by different types of chronic neuropathic pain were submitted to PNFS at the Department of Neurosurgery of the Istituto Neurologico "C. Besta" in Milan between July 2009 and July 2013. The visual analog scale (VAS) and variations in the use of analgesic drugs, along with complications, were considered to assess results. In 59 % of our patients, an average pain reduction of 5.50 points on the visual analog scale was observed (average pre-implant score 8.86 and average post-implant score 3.36). These patients reduced their analgesic drug use after PNFS. We observed no early or long-term complications after our last follow-up evaluation. PNFS can be considered an effective and safe option to treat carefully selected, drug-resistant and chronic neuropathic pain patients; the reversibility of the procedure and its lack, at least in our hands, of long-term complications may contribute to wider use of this procedure.

  12. Inclusion of non-English-speaking patients in research: A single institution experience.

    Science.gov (United States)

    Bernier, Rachel; Halpin, Erin; Staffa, Steven J; Benson, Lindsey; DiNardo, James A; Nasr, Viviane G

    2018-05-01

    Considering the recent increase in medical care provided to patients from foreign countries and the diversity of languages spoken by families living within the United States, it is important to determine whether non-English-speaking patients have access to participate in clinical research from which they may benefit. We aimed to determine the number of non-English-speaking patients presenting to Boston Children's Hospital for medical care between 2011 and 2016, the number of clinical research protocols active within the Department of Anesthesiology, Critical Care and Pain Medicine approved to enroll non-English-speaking patients, as well as the number of both non-English- and English-speaking patients approached and enrolled in these studies. Furthermore, we attempted to determine barriers that may have prevented non-English-speaking patients from inclusion in clinical research. We conducted a retrospective review of various data sources during a 5-year period. Data included the number of non-English-speaking patients presenting to Boston Children's Hospital for care as well as the number of English- and non-English-speaking patients approached for studies at the Department of Anesthesiology each year. Additionally, we reviewed data from the IRB which included the justification that research teams provided when opting to exclude non-English-speaking participants. In addition, we attempted to determine the barriers that may have prevented these patients from inclusion in research protocols. We found that the number of non-English-speaking patients presenting to Boston Children's Hospital increased over time. However, the number of studies approved to enroll non-English-speaking patients within the Department of Anesthesiology and the rate of enrollment of these patients did not increase at the same rate. In order to increase the number of non-English-speaking patients approached to participate in research, we must improve cultural awareness and provide investigators with resources for interpreter and translation services. © 2018 John Wiley & Sons Ltd.

  13. Prophylactic cranial irradiation in small cell lung cancer: a single institution experience.

    Science.gov (United States)

    Naidoo, J; Kehoe, M; Sasiadek, W; Hacking, D; Calvert, P

    2014-03-01

    Prophylactic cranial irradiation (PCI) is used to prevent the development of brain metastases in small cell lung carcinoma. PCI confers an overall survival (OS) benefit in both limited and extensive stage disease. We analyze the incidence of symptomatic brain metastases, progression-free survival (PFS) and OS in a cohort of patients who received PCI, in a 5-year period. A retrospective review of all patients who had received PCI between 2006 and 2011 at the Whitfield Clinic was completed. Patient- and disease-related characteristics, the number of patients who developed brain metastases, PFS and OS data were collected. 24 patients were identified. 14 (58.3 %) patients were male, 10 (41.7 %) were female, with a mean age of 62.5 years (range 31-78). All patients were smokers. 12 (50 %) patients had limited stage small cell lung cancer (SCLC), 12 (50 %) had extensive stage disease. 2 (8.2 %) patients developed brain metastases post PCI (p = 0.478.) The median PFS for limited stage SCLC was 13 months (range 3-20) and 10 months (range 5-18) for extensive stage SCLC. Median OS was 15 months (range 4-29) in limited stage SCLC, and 11 months (range 5-29) in extensive stage SCLC. Our study demonstrated a low incidence of symptomatic brain metastases and favourable median PFS and OS in the patients that received PCI, when compared to published phase III data.

  14. Diagnosis and treatment of polycythemia vera: Brazilian experience from a single institution

    Directory of Open Access Journals (Sweden)

    Camila da Cruz Gouveia Linardi

    Full Text Available CONTEXT AND OBJECTIVE: Polycythemia vera (PV is a chronic myeloproliferative disorder characterized by predominant proliferation of erythroid precursors. Few data are available concerning Brazilian patients with this condition. The aim of this study was to describe clinical and demographic characteristics of PV patients at diagnosis and analyze their long-term outcomes. DESIGN AND SETTING: Retrospective study at the Division of Hematology, Faculdade de Medicina da Universidade de São Paulo (FMUSP, São Paulo. METHODS: All consecutive patients with PV diagnosed according to World Health Organization criteria were eligible for this study. Clinical and demographic characteristics, thrombotic events, transformation to acute leukemia, myelofibrosis and survival were evaluated. RESULTS: Sixty-six patients were evaluated. Thirty-six (54.5% were females, with a median age at diagnosis of 61 years. At diagnosis, the median hemoglobin concentration was 18.8 mg/dl and the median platelet count was 593,000/mm³. Fifty-eight patients (88.0% were treated with hydroxyurea with or without phlebotomy. During a median follow-up of 77 months, 22 patients (33.3% had new thrombotic events, mainly of arterial type. The overall incidence of leukemia and myelofibrosis was 0.42% per patient-year and 1.06% per patient-year, respectively. Median overall survival was not reached and the seven-year survival rate was 77.8%. CONCLUSION: The PV patients described here had long survival and arterial thrombotic events were the most important and common complication among this population.

  15. Metallic stent in the treatment of ureteral obstruction: Experience of single institute

    Directory of Open Access Journals (Sweden)

    Chien-Chang Li

    2011-10-01

    Conclusion: Patients with ureteral obstructions can be treated sufficiently with the Resonance® metallic stent. Patients who had gynecological malignancies and received radiotherapy had a higher failure rate after Resonance® metallic stent insertion.

  16. Cyberinfrastructure for Open Science at the Montreal Neurological Institute.

    Science.gov (United States)

    Das, Samir; Glatard, Tristan; Rogers, Christine; Saigle, John; Paiva, Santiago; MacIntyre, Leigh; Safi-Harab, Mouna; Rousseau, Marc-Etienne; Stirling, Jordan; Khalili-Mahani, Najmeh; MacFarlane, David; Kostopoulos, Penelope; Rioux, Pierre; Madjar, Cecile; Lecours-Boucher, Xavier; Vanamala, Sandeep; Adalat, Reza; Mohaddes, Zia; Fonov, Vladimir S; Milot, Sylvain; Leppert, Ilana; Degroot, Clotilde; Durcan, Thomas M; Campbell, Tara; Moreau, Jeremy; Dagher, Alain; Collins, D Louis; Karamchandani, Jason; Bar-Or, Amit; Fon, Edward A; Hoge, Rick; Baillet, Sylvain; Rouleau, Guy; Evans, Alan C

    2016-01-01

    Data sharing is becoming more of a requirement as technologies mature and as global research and communications diversify. As a result, researchers are looking for practical solutions, not only to enhance scientific collaborations, but also to acquire larger amounts of data, and to access specialized datasets. In many cases, the realities of data acquisition present a significant burden, therefore gaining access to public datasets allows for more robust analyses and broadly enriched data exploration. To answer this demand, the Montreal Neurological Institute has announced its commitment to Open Science, harnessing the power of making both clinical and research data available to the world (Owens, 2016a,b). As such, the LORIS and CBRAIN (Das et al., 2016) platforms have been tasked with the technical challenges specific to the institutional-level implementation of open data sharing, including: Comprehensive linking of multimodal data (phenotypic, clinical, neuroimaging, biobanking, and genomics, etc.)Secure database encryption, specifically designed for institutional and multi-project data sharing, ensuring subject confidentiality (using multi-tiered identifiers).Querying capabilities with multiple levels of single study and institutional permissions, allowing public data sharing for all consented and de-identified subject data.Configurable pipelines and flags to facilitate acquisition and analysis, as well as access to High Performance Computing clusters for rapid data processing and sharing of software tools.Robust Workflows and Quality Control mechanisms ensuring transparency and consistency in best practices.Long term storage (and web access) of data, reducing loss of institutional data assets.Enhanced web-based visualization of imaging, genomic, and phenotypic data, allowing for real-time viewing and manipulation of data from anywhere in the world.Numerous modules for data filtering, summary statistics, and personalized and configurable dashboards. Implementing

  17. 40-Tesla pulsed-field cryomagnet for single crystal neutron diffraction

    Science.gov (United States)

    Duc, F.; Tonon, X.; Billette, J.; Rollet, B.; Knafo, W.; Bourdarot, F.; Béard, J.; Mantegazza, F.; Longuet, B.; Lorenzo, J. E.; Lelièvre-Berna, E.; Frings, P.; Regnault, L.-P.

    2018-05-01

    We present the first long-duration and high duty cycle 40-T pulsed-field cryomagnet addressed to single crystal neutron diffraction experiments at temperatures down to 2 K. The magnet produces a horizontal field in a bi-conical geometry, ±15° and ±30° upstream and downstream of the sample, respectively. Using a 1.15 MJ mobile generator, magnetic field pulses of 100 ms length are generated in the magnet, with a rise time of 23 ms and a repetition rate of 6-7 pulses per hour at 40 T. The setup was validated for neutron diffraction on the CEA-CRG three-axis spectrometer IN22 at the Institut Laue Langevin.

  18. Current experiments in elementary particle physics. Revised

    Energy Technology Data Exchange (ETDEWEB)

    Galic, H. [Stanford Univ., CA (United States). Stanford Linear Accelerator Center; Wohl, C.G.; Armstrong, B. [Lawrence Berkeley Lab., CA (United States); Dodder, D.C. [Los Alamos National Lab., NM (United States); Klyukhin, V.I.; Ryabov, Yu.G. [Inst. for High Energy Physics, Serpukhov (Russian Federation); Illarionova, N.S. [Inst. of Theoretical and Experimental Physics, Moscow (Russian Federation); Lehar, F. [CEN Saclay, Gif-sur-Yvette (France); Oyanagi, Y. [Univ. of Tokyo (Japan). Faculty of Sciences; Olin, A. [TRIUMF, Vancouver, BC (Canada); Frosch, R. [Paul Scherrer Inst., Villigen (Switzerland)

    1992-06-01

    This report contains summaries of 584 current and recent experiments in elementary particle physics. Experiments that finished taking data before 1986 are excluded. Included are experiments at Brookhaven, CERN, CESR, DESY, Fermilab, Tokyo Institute of Nuclear Studies, Moscow Institute of Theoretical and Experimental Physics, KEK, LAMPF, Novosibirsk, Paul Scherrer Institut (PSI), Saclay, Serpukhov, SLAC, SSCL, and TRIUMF, and also several underground and underwater experiments. Instructions are given for remote searching of the computer database (maintained under the SLAC/SPIRES system) that contains the summaries.

  19. Medulloblastoma in adults. A retrospective single institution analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hadi, Indrawati; Roengvoraphoj, Olarn; Niyazi, Maximilian; Nachbichler, Silke Birgit [LMU Munich, Department of Radiation Oncology, University Hospital, Munich (Germany); Roeder, Falk [LMU Munich, Department of Radiation Oncology, University Hospital, Munich (Germany); German Cancer Research Center (DKFZ), Molecular Radiation Oncology, Heidelberg (Germany); Schueller, Ulrich [University Medical Center, Institute of Neuropathology, Hamburg-Eppendorf (Germany); Research Institute Children' s Cancer Center, Hamburg (Germany); University Medical Center, Department of Pediatric Hematology and Oncology, Hamburg-Eppendorf (Germany); Belka, Claus [LMU Munich, Department of Radiation Oncology, University Hospital, Munich (Germany); German Cancer Consortium (DKTK), Munich (Germany)

    2018-03-15

    Adult medulloblastoma is a rare disease treated according to the current pediatric treatment guidelines. This retrospective analysis investigated the clinical outcomes and prognostic factors of adult medulloblastoma patients, who received multimodal therapy at our institution. Treatment charts of all patients over the age of 15 years of age with de novo medulloblastoma, who had been treated at our institution between 2001 and 2014, were retrospectively analyzed. Patients' demographic parameters, initial symptoms, treatment modalities, toxicities, and survival outcomes were investigated. In all, 21 patients with a median age of 30.2 years were identified. The most frequent histologies were desmoplastic and classic, and the most common molecular subtype was sonic hedgehog (SHH). After tumor resection, all patients received craniospinal irradiation (median dose 35.2 Gy) and a boost to the posterior fossa (median dose 19.8 Gy). Simultaneous chemotherapy with vincristine was given to 20 patients and sequential chemotherapy to 15 patients. The most common side effects were hematological toxicities. Median overall survival (OS) has not been reached after a median follow-up of 92 months. Estimated 5- and 10-year OS was 89 and 80%, respectively. Estimated 5- and 10-year progression-free survival (PFS) was 89 and 81%, respectively. In univariate analysis, a shorter interval between tumor resection and end of irradiation was significantly associated with improved OS and PFS, anaplastic histology with worse OS and PFS. The combined modality treatment showed a good outcome in adults with medulloblastoma. Treatment time was revealed to be prognostic and should be kept as short as possible. (orig.) [German] Das Medulloblastom des Erwachsenen ist eine seltene Erkrankung, die analog paediatrischer Behandlungsprotokolle therapiert wird. Diese retrospektive Analyse untersuchte die klinischen Ergebnisse und prognostischen Faktoren von erwachsenen Medulloblastompatienten, die eine

  20. Government regulation of business in a changing institutional barrier

    Directory of Open Access Journals (Sweden)

    Novikova I.

    2013-02-01

    Full Text Available The article examines the domestic experience in government regulation of business in a changing institutional barrier.Compared the degree of economic freedom in Ukraine. The emphasis is on the need to develop a national strategy of institutional development of domestic entrepreneurship.

  1. Single-centre experience of stereotactic radiosurgery and fractionated stereotactic radiotherapy for prolactinomas with the linear accelerator.

    Science.gov (United States)

    Wilson, Peter J; Williams, Janet Rosemary; Smee, Robert Ian

    2015-06-01

    Primary management of prolactinomas is usually medical, with surgery a secondary option where necessary. This study is a review of a single centre's experience with focused radiotherapy where benefit was not gained by medical or surgical approaches. Radiotherapy as an alternative and adjuvant treatment for prolactinomas has been performed at our institution with the linear accelerator since 1990. We present a retrospective review of 13 patients managed with stereotactic radiosurgery (SRS) and 5 managed with fractionated stereotactic radiotherapy (FSRT), as well as 5 managed with conventional radiotherapy, at the Prince of Wales Hospital. Patients with a histopathologically diagnosed prolactinoma were eligible. Those patients who had a confirmed pathological diagnosis of prolactinoma following surgical intervention, a prolactin level elevated above 500 μg/L, or a prolactin level persistently elevated above 200 μg/L with exclusion of other causes were represented in this review. At the end of documented follow-up (SRS median 6 years, FSRT median 2 years), no SRS patients showed an increase in tumour volume. After FSRT, 1 patient showed an increase in size, 2 showed a decrease in size and 2 patients showed no change. Prolactin levels trended towards improvement after SRS and FSRT, but no patients achieved the remission level of <20 μg/L. Seven of 13 patients in the SRS group achieved a level of <500 μg/L, whereas no patients reached this target after FSRT. A reduction in prolactin level is frequent after SRS and FSRT for prolactinomas; however, true biochemical remission is uncommon. Tumour volume control in this series was excellent, but this may be related to the natural history of the disease. Morbidity and mortality after stereotactic radiation were very low in this series. © 2014 The Royal Australian and New Zealand College of Radiologists.

  2. Investment Process in Romania and Institutional

    Directory of Open Access Journals (Sweden)

    Dan Marius VOICILAŞ

    2011-12-01

    Full Text Available The concepts set out and the macroeconomic policies implemented during the past twenty years have been different and controversial. They have aimed at creating an economic environment conducive to the infusion of foreign capital and development of sectors considered as a priority at that time, which can ensure a sound macro-economic stability, taking into account the fact that there is not enough domestic capital to participate in achieving these objectives. In this paper we will focus on foreign direct investment (FDI policies designed to promote them, their effects on national economy in general terms and features of investment in rural and agricultural sector, which we consider key elements of success in economic growth. Also, the institutional framework in which the investment process took place is thoroughly addressed given that most times the general investment climate of a certain market is influenced both by legislation and the institutions involved in economic life. The experience of transition and the experiences of other countries have shown how important are institutions created to coordinate, support and control of investment activity. We included in this analysis institutions and organizations in Romania with responsibilities in the investment field. Based on this analysis, and on the contributions of institutions to create the proper economic development, but also by investors' direct contribution to the creation of this framework by policy makers recommendations, it is obtained a profile of the business environment in Romania, including what is best but what is missing and it needs to be implemented. We consider that this approach is an important step in addressing the institutional investment process and it creates prerequisites of disseminating essential information and remedial implications to stakeholders.

  3. Elementary education in the correctional institution in Valjevo

    Directory of Open Access Journals (Sweden)

    Milak Siniša

    2015-01-01

    Full Text Available Education of the residents in correctional institutions for juveniles has not a long tradition in our country. That is the reason why many questions linked to the organization and forms of their education, especially elementary education, remain open. The scope of this article is to present the process of acquiring elementary education of the residents in the correctional institution for juveniles. Since the Correctional Institute in Valjevo is the only institution for juveniles in our country at the moment, in which juvenile offenders spend their time penalties, the question of their education in the institution is worth our attention. The paper presents the results of a qualitative research conducted in this institution. The exeminees were the teachers who teach the residents in the school which is within the Correctional Institute in Valjevo. The teachers evaluated the existing organization and education of residents mainly positively, and singled out only some financial, space, and technical problems. The research pointed out the importance and value of this form of education for the residents, especially for their subsequent resocialization and integration in the society after leaving the Institute, as well as the importance of pedagogy for solving the problems of educating residents of correctional instutions for juveniles.

  4. Treatment of Advanced Malignant Uterine Perivascular Epithelioid Cell Tumor with mTOR Inhibitors: Single-institution Experience and Review of the Literature.

    Science.gov (United States)

    Starbuck, Kristen D; Drake, Richard D; Budd, G Thomas; Rose, Peter G

    2016-11-01

    Uterine perivascular epithelioid cell tumors (PEComas) are rare mesenchymal tumors. Many have malignant behavior, and no successful treatment strategy has been established. Identification of mutations in the tuberous sclerosis 1 (TSC1) and TSC2 genes producing constitutive activation of the mammalian target of rapamycin (mTOR) pathway presents an opportunity for targeted therapy. Patients with advanced malignant uterine PEComa treated with mTOR inhibitors were identified and records were retrospectively reviewed for treatment response based on radiographic assessment. Three patients with advanced uterine PEComas underwent debulking surgery followed by mTOR inhibitor therapy; two had a complete response to therapy and disease in one patient progressed. Given the absence of effective therapies for malignant uterine PEComas, targeting the mTOR pathway is a logical strategy to pursue given the known pathobiology involving the Tuberous Sclerosis complex. Treatment of malignant uterine PEComas with mTOR inhibitors was effective in two out of three patients after surgical resection, with durable response. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  5. Using newspaper collections in information institutions for research purposes: experiences of historians and linguists

    Directory of Open Access Journals (Sweden)

    Maja Krtalić

    2015-04-01

    Full Text Available The aim of this paper is to present the opinions, experiences and needs of a sample of scientists in the field of the humanities – namely historians and philologists – and their use of newspaper collections in memory institutions during scientific research. A part of the results gathered in the research, which was conducted within the Newspapers as a source of scientific information in social sciences and humanities project, and is presented here. This project examined the extent and practices in the use of newspapers as a resource of information for scientific research in the social sciences and humanities field in Croatia. The quantitative and qualitative data about the methods and level of use of newspaper material as a resource in scientific research were gathered. The results of this project implied that the newspapers are recognised and used as an admissible resource in scientific work, especially in the fields of history and philology. The fact that scientists have specific information needs and search patterns should be considered in creating innovative and effective digital newspaper collections.

  6. ADS project in the Vinca Institute

    International Nuclear Information System (INIS)

    Pesic, M.; Neskovic, N.; Plecas, I.

    1999-01-01

    Among the six scientific programmes proposed for future research in the Vinca Institute, the nuclear one is connected to the nuclear reactors and waste management activities. One of the projects within the nuclear programme is associated to a proposal for designing a small modern subcritical research reactor driven by an accelerator beam. The idea of this Project is based on the facts that the construction of the Tesla accelerator installation is in the final phase and that a rich experience is gained in design, construction, operation and maintenance of both research reactors in the Institute in the last 40 years. Preliminary scope of the ADS project in the Vinca Institute, including some details and options, are given (author)

  7. The Analysis of the National Legal and Regulatory Grounds for the Institutional Autonomy of Higher Education Institutions

    Directory of Open Access Journals (Sweden)

    Andriichenko Zhanna O.

    2017-11-01

    Full Text Available The article identifies and systematizes the existing legal obstacles to the autonomy of higher education institution and develops recommendations to overcome them. The approaches to establishing the legal status of institutions of higher education in the current legislation of Ukraine are characterized. The impact of the legal status of higher education institution on its legal personality and the institutional autonomy has been determined. Views of scholars together with foreign experience of property titles in the imposition of property on higher education institution, were analyzed. Directions for the development of legal regulation of the system of public law legal entities in Ukraine have been defined. In order to ensure the development of the model of public administration in the sphere of higher education, it has been proposed that most of the higher education institutions should change the legal status of public legal entity – budgetary institution to the status of private legal entity – profitable or non-profitable higher education institution of the public / communal form of ownership, for which the founder would regularize property on the right of ownership. This will eliminate the conservatism, strict regulation on the part of the State, that is linked to the status of publicity, and, in order to develop the autonomy of higher education institution, will allow to take advantage of dispositivity inherent in private law entities in determining their legal personality.

  8. How Supervisor Experience Influences Trust, Supervision, and Trainee Learning: A Qualitative Study.

    Science.gov (United States)

    Sheu, Leslie; Kogan, Jennifer R; Hauer, Karen E

    2017-09-01

    Appropriate trust and supervision facilitate trainees' growth toward unsupervised practice. The authors investigated how supervisor experience influences trust, supervision, and subsequently trainee learning. In a two-phase qualitative inductive content analysis, phase one entailed reviewing 44 internal medicine resident and attending supervisor interviews from two institutions (July 2013 to September 2014) for themes on how supervisor experience influences trust and supervision. Three supervisor exemplars (early, developing, experienced) were developed and shared in phase two focus groups at a single institution, wherein 23 trainees validated the exemplars and discussed how each impacted learning (November 2015). Phase one: Four domains of trust and supervision varying with experience emerged: data, approach, perspective, clinical. Early supervisors were detail oriented and determined trust depending on task completion (data), were rule based (approach), drew on their experiences as trainees to guide supervision (perspective), and felt less confident clinically compared with more experienced supervisors (clinical). Experienced supervisors determined trust holistically (data), checked key aspects of patient care selectively and covertly (approach), reflected on individual experiences supervising (perspective), and felt comfortable managing clinical problems and gauging trainee abilities (clinical). Phase two: Trainees felt the exemplars reflected their experiences, described their preferences and learning needs shifting over time, and emphasized the importance of supervisor flexibility to match their learning needs. With experience, supervisors differ in their approach to trust and supervision. Supervisors need to trust themselves before being able to trust others. Trainees perceive these differences and seek supervision approaches that align with their learning needs.

  9. Proposal of Michelson-Morley experiment via single photon interferometer: Interpretation of Michelson-Morley experimental results using de Broglie-Bohm picture

    OpenAIRE

    Sato, Masanori

    2004-01-01

    The Michelson-Morley experiment is considered via a single photon interferometer and we propose the interpretation of the Michelson-Morley experimental results using de Broglie-Bohm picture. We point out that the Michelson-Morley experiment revealed the interference of photons, however, it did not reveal the photons simultaneous arrival at the beam splitter. According to the de Broglie-Bohm picture, the quantum potential nonlocally determines the interference of photons. The interference of t...

  10. Geothermal in situ experiments in the Asse salt-mine

    International Nuclear Information System (INIS)

    Kopietz, J.; Jung, R.

    1978-01-01

    The paper presents design and results of in situ experiments carried out by the Bundesanstat fuer Geowissenschaften und Rohstoffe (Federal Institute for Geosciences and Natural Resources, F.R. of Germany) in the Asse salt-mine. With reference to model calculations of the temperature field which is produced in salt formations by radioactive waste, temperature measurements in the area of electrical heating elements and in situ measurements of thermal conductivity have been performed. The measured temperatures are in good accordance with the theoretical prediction. Preliminary results of the thermal conductivity measurements correspond with the data of single NaCl crystals published by Birch and Clark. At present a heating experiment is being conducted in the Asse mine to investigate thermo-mechanical effects of a cylindrical heat source upon the surrounding rock salt. Possible thermal induced fractures monitored by permeability changes and seismoacoustical phenomena are the main objects of this experiment

  11. Patterns of care and treatment outcomes for primary thyroid lymphoma: A single institution study

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Hye Jung; Kim, Jun Won; Suh, Chang Ok; Kim, Jin Seok; Cheong, June Won; Lee, Jeong Shim; Keum, Ki Chang; Lee, Chang Geol; Cho, Jae Ho [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2013-12-15

    The aim of this study was to analyze the patterns of care and treatment outcomes in patients with primary thyroid lymphoma (PTL) in a single institution. Medical records of 29 patients with PTL treated between April 1994 and February 2012 were retrospectively reviewed. Diagnosis was confirmed by biopsy (n = 17) or thyroidectomy (n = 12). Treatment modality and outcome were analyzed according to lymphoma grade. The median follow-up was 43.2 months (range, 3.8 to 220.8 months). The median age at diagnosis was 57 years (range, 21 to 83 years) and 24 (82.8%) patients were female. Twenty-five (86.2%) patients had PTL with stage IEA and IIEA. There were 8 (27.6%) patients with mucosa-associated lymphoid tissue (MALT) lymphoma and the remaining patients had high-grade lymphoma. Patients were treated with surgery (n = 2), chemotherapy (n = 7), radiotherapy (n = 3) alone, or a combination of these methods (n = 17). Treatment modalities evolved over time and a combination of modalities was preferred, especially for the treatment of high-grade lymphoma in recent years. There was no death or relapse among MALT lymphoma patients. Among high-grade lymphoma patients, 5-year overall survival (OS) and 5-year progression-free survival (PFS) were 75.6% and 73.9%, respectively. Complete remission after initial treatment was the only significant prognostic factor for OS (p = 0.037) and PFS (p = 0.003). Patients with PTL showed a favorable outcome, especially with MALT lymphoma. Radiotherapy alone for MALT lymphoma and chemotherapy followed by radiotherapy for high-grade lymphoma can be effective treatment options for PTL.

  12. A clinical analysis of hypopharyngeal carcinoma. Single institution outcomes

    International Nuclear Information System (INIS)

    Furukawa, Tatsuya; Iwae, Shigemichi; Hirayama, Yuji; Teshima, Masanori; Soejima, Toshinori; Tsujino, Kayoko; Ota, Yosuke

    2013-01-01

    We report the treatment outcomes of 195 patients with hypopharyngeal carcinoma treated at our institute during the nine-year period between 2001 and 2009. The five-year overall survival rate and cause-specific survival rate of all patients except for M1 cases were 47.7% and 56.8%. The five-year cause-specific survival rates of patients with Stage I, II, III, IV A and IV B were 80.2%, 86.9%, 66.8%, 45.5 and 0.0%, respectively. We consider that TPLE and concurrent chemoradiotherapy (CCRT) are standard treatments. We select CCRT for patients of complete response (CR) or partial response (PR) after induction chemotherapy. The five-year cause-specific survival rate of the induction chemotherapy (ICT) good response (CCRT) group, good response (TPLE) group, poor response (CCRT) group, and poor response (TPLE) group were 68.7%, 65.6%, 53.6%, and 32.9%, respectively. Patients of the good response (CCRT) group had a good prognosis, but patients of the poor response (TPLE) group had a poor prognosis. (author)

  13. Patients come from populations and populations contain patients. A two-stage scientific and ethics review: The next adaptation for single institutional review boards.

    Science.gov (United States)

    Knopman, David; Alford, Eli; Tate, Kaitlin; Long, Mark; Khachaturian, Ara S

    2017-08-01

    For nearly 50 years, institutional review boards (IRB) and independent ethics committees have featured local oversight as a core function of research ethics reviews. However growing complexity in Alzheimer's clinical research suggests current approaches to research volunteer safety is hampering development of new therapeutics. As a partial response to this challenge, the NIH has mandated that all NIH-funded multi-site studies will use a single Institutional Review Board. The perspective describes a joint program to provide a single IRB of record (sIRB) for phases of multi-site studies. The approach follows two steps. One, an expert Scientific Review Committee (SRC) of senior researchers in the field will conduct the review principally of scientific merit, significance, feasibility, and the likelihood of meaningful results. The second step will be the IRB's regulatory and ethics review. The IRB will apply appropriate regulatory criteria for approval including minimization of risks to subjects and risks reasonable in relation to anticipated benefits, equitable subject selection, informed consent, protections for vulnerable populations, and application of local context considerations, among others. There is a steady demand for scientific, ethical and regulatory review of planned Alzheimer's studies. As of January 15, 2017, there are nearly 400 open studies, Phase II and III, industry and NIH sponsored trials on disease indications affecting memory, movement and mood in the US. The effort will initially accept protocols for studies of Alzheimer's disease, dementia, and related disorders effecting memory, movement and mood. Future aims will be to provide scientific review and, where applicable, regulatory and ethical review in an international context outside North America with sites possibly in Asia, Europe and Australia. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  14. Intraoperative Boost Radiotherapy during Targeted Oncoplastic Breast Surgery: Overview and Single Center Experiences

    Directory of Open Access Journals (Sweden)

    Wolfram Malter

    2014-01-01

    Full Text Available Breast-conserving surgery followed by whole-breast irradiation is the standard local therapy for early breast cancer. The international discussion of reduced importance of wider tumor-free resection margins than “tumor not touching ink” leads to the development of five principles in targeted oncoplastic breast surgery. IORT improves local recurrence risk and diminishes toxicity since there is less irradiation of healthy tissue. Intraoperative radiotherapy (IORT can be delivered in two settings: an IORT boost followed by a conventional regimen of external beam radiotherapy or a single IORT dose. The data from TARGIT-A and ELIOT reinforce the conviction that intraoperative radiotherapy during breast-conserving surgery is a reliable alternative to conventional postoperative fractionated irradiation, but only in a carefully selected population at low risk of local recurrence. We describe our experiences with IORT boost (50 kV energy X-rays; 20 Gy in combination with targeted oncoplastic breast surgery in a routine clinical setting. Our experiences demonstrate the applicability and reliability of combining IORT boost with targeted oncoplastic breast surgery in breast-conserving therapy of early breast cancer.

  15. Nursing Intervention in adolescence: an institution experience in Public Secondary School

    Directory of Open Access Journals (Sweden)

    Daniel Martínez Esquivel

    2013-04-01

    Full Text Available Adolescence is a key stage of life to the empowerment that must have health, but it has many needs that healthteams still have not resolved. This article presents an analysis of the health situation of a group of teenagersattending a public institution of higher education and intervention by nursing students, focused on creatingconditions for health promotion and disease prevention. This research was conducted from a quantitative,descriptive and was performed in an institution of secondary education in the period from September toNovember 2012. We worked with students and students of eighth and ninth year with a convenience sample. Themain results indicated needs in sexuality, healthy lifestyles and conflict resolution. To address these issuesevolved different strategies planned, organized, directed and controlled by the individual. We conclude that healtheducation in adolescents is a public health problem and that nurses must meet.

  16. Developing SoTL through Organized Scholarship Institutes

    Directory of Open Access Journals (Sweden)

    Elizabeth Marquis

    2015-12-01

    Full Text Available The need to further integrate SoTL into college and university cultures has been discussed relatively frequently in recent teaching and learning literature. While a number of useful strategies to assist in this task have been advanced, one especially promising suggestion is the development of organized, institutionally-recognized scholarship institutes. Centres or units of this sort have been created at higher education institutions in a number of countries, but little published information currently exists about the design of these institutes or the experiences of individuals affiliated with them. To that end, the present study sought to examine the perceived benefits, challenges and design features of teaching and learning scholarship institutes at research-intensive universities worldwide. A website scan and a survey of individuals affiliated with these units were used to collect qualitative and quantitative data of relevance to the research questions. Based on the findings, and on ideas from the existing research institute and scholarship of teaching and learning literatures, a series of recommendations for individuals and campuses interested in developing effective SoTL institutes are provided.

  17. Tatar Virtual Institute of Kayum Nasyri

    Directory of Open Access Journals (Sweden)

    Liliia Shaiakhmetova

    2017-12-01

    Full Text Available The article is devoted to the study of structure and activity of the network of centers of Tatar virtual Institute of Kayum Nasyri, created on the basis of Institute of Philology and Intercultural Communication after Leo Tolstoy of Kazan Federal University. The aim of the Institute of Kayum Nasyri is the desire to become a world brand in its field. In this context, the Institute relies on the experience of such world-known educational centers as the British Council, the Institute named after Goethe, Cervantes Institute, Confucius Institute and Institute by Yunus Emre. The Institute's activities are associated with the development of collaboration in the field of education, support, promotion and development of the Tatar language and culture in the regions of the Russian Federation, countries of near and far abroad. There are 7 educational-cultural centers in the Institute at this moment. Each center is supplied with educational, informative literature and fiction, as well as the video-conferencing system for training, conferences and events online. The Institute of Kayum Nasyri is named after the famous Tatar educator. As a fervent supporter of friendship between Russian and Tatar people, he was the first of the educators to acquaintance the Tatars with the Russian history and culture in their native language, translated into the Tatar language many textbooks on geography, physics, mathematics, etc. Kayum Nasyri at the time, made the Russian-Tatar dictionary, was the author of a textbook of Russian grammar for the Tatars, as well as of the significant works in the field of the Tatar linguistics.

  18. PITUITARY GIGANTISM--EXPERIENCE OF A SINGLE CENTER FROM WESTERN INDIA.

    Science.gov (United States)

    Patt, Hiren P; Bothra, Nikita; Goel, Atul H; Kasaliwal, Rajeev; Lila, Anurag R; Bandgar, Tushar R; Shah, Nalini S

    2015-06-01

    Limited data are available on pituitary gigantism, as it is a rare disorder. This study was carried out to assess the clinical, hormonal, and radiologic profiles and management outcomes of patients with pituitary gigantism. We conduced a retrospective analysis of 14 patients with pituitary gigantism who presented to a single tertiary care institute from 1990 to 2014. Thirteen patients were male, and 1 was female. The mean age at diagnosis was 21.9 ± 6.1 years, with a mean lag period of 6.5 ± 5.6 years. The mean height SD score at the time of diagnosis was 3.2 ± 0.6. Symptoms of tumor mass effect were the chief presenting complaint in the majority (50%) of patients, while 2 patients were asymptomatic. Six patients had hyperprolactinemia. At presentation, the nadir PGGH (postglucose GH) and insulin-like growth factor (IGF 1)-ULN (× upper limit of normal) were 63.2 ± 94.9 ng/mL and 1.98 ± 0.5, respectively. All (except 1 with mild pituitary hyperplasia) had pituitary macroadenoma. Six patients had invasive pituitary adenoma. Transsphenoidal surgery (TSS) was the primary modality of treatment in 13/14 patients, and it achieved remission in 4/13 (30.76%) patients without recurrence over a median follow-up of 7 years. Post-TSS radiotherapy (RT) achieved remission in 3/5 (60%) patients over a median follow-up of 3.5 years. None of the patients received medical management at any point of time. Gigantism is more common in males, and remission can be achieved in the majority of the patients with the help of multimodality treatment (TSS and RT).

  19. TOPICAL REVIEW: Single-molecule experiments in biological physics: methods and applications

    Science.gov (United States)

    Ritort, F.

    2006-08-01

    I review single-molecule experiments (SMEs) in biological physics. Recent technological developments have provided the tools to design and build scientific instruments of high enough sensitivity and precision to manipulate and visualize individual molecules and measure microscopic forces. Using SMEs it is possible to manipulate molecules one at a time and measure distributions describing molecular properties, characterize the kinetics of biomolecular reactions and detect molecular intermediates. SMEs provide additional information about thermodynamics and kinetics of biomolecular processes. This complements information obtained in traditional bulk assays. In SMEs it is also possible to measure small energies and detect large Brownian deviations in biomolecular reactions, thereby offering new methods and systems to scrutinize the basic foundations of statistical mechanics. This review is written at a very introductory level, emphasizing the importance of SMEs to scientists interested in knowing the common playground of ideas and the interdisciplinary topics accessible by these techniques. The review discusses SMEs from an experimental perspective, first exposing the most common experimental methodologies and later presenting various molecular systems where such techniques have been applied. I briefly discuss experimental techniques such as atomic-force microscopy (AFM), laser optical tweezers (LOTs), magnetic tweezers (MTs), biomembrane force probes (BFPs) and single-molecule fluorescence (SMF). I then present several applications of SME to the study of nucleic acids (DNA, RNA and DNA condensation) and proteins (protein-protein interactions, protein folding and molecular motors). Finally, I discuss applications of SMEs to the study of the nonequilibrium thermodynamics of small systems and the experimental verification of fluctuation theorems. I conclude with a discussion of open questions and future perspectives.

  20. The Minneapolis Heart Institute Foundation Summer Research Internship Program: the benefits of preprofessional experience for prospective physicians.

    Science.gov (United States)

    Willenbring, Benjamin D; McKee, Katherine C; Wilson, Betsy V; Henry, Timothy D

    2008-08-01

    There is a distinct shortage of preprofessional opportunities for undergraduate premedical students. During the last 7 summers, the Minneapolis Heart Institute Foundation Summer Research Internship Program has exposed interested students to cardiology and clinical research. The goals of the internship program are threefold: to bring students in contact with the medical profession, to offer experiences in the various disciplines of cardiology, and to introduce students to clinical research. The success of the program can be measured by its influence on participants' academic pursuits and scholarly contributions. Of the 65 internship alumni, 52 are studying to become physicians and most of the others are in health-related fields. Interns have also contributed abstracts and manuscripts to peer-reviewed journals and presented their research at major conferences.

  1. Human resources development: capabilities and experience of CNEA and its institutes in Argentina

    International Nuclear Information System (INIS)

    Sbaffoni, M.M.; Soler, S.G.; Harriague, S.

    2007-01-01

    under and postgraduate studies in nuclear and mechanical engineering, and in various areas o f physics, including medical, as well as training in nuclear applications. More than 250 nuclear engineers have been formed there, as well as an important number of physicists. b) Jorge Sabato Technology Institute: offers undergraduate and postgraduate studies in materials science and engineering. Around 200 professionals have been formed there. c) Dan Beninson Institute for Nuclear Studies: offers one year postgraduate programmes in nuclear reactors and its fuel cycle, and in radiochemistry and nuclear applications. They are mainly aimed to people directly involved in the nuclear field. There are also courses to fulfil specific needs, e.g. welding, radiological protection, non destructive testing, radioisotope use and dosimetry, etc. Since its very beginning, CNEA's efforts in education have been opened to fellows from other countries, mainly from the Latin American region, sponsored by CNEA itself, by IAEA, by the Organization of American States (OAS) or by bilateral cooperation agreements. At present, Argentina has significant means to provide the qualified personnel necessary for the growing of nuclear activities in the country, with capacities that can be offered to international projects on nuclear education. Based on our 50-year experience of international cooperation in this field, CNEA is willing to contribute to the worldwide effort in developing human resources for the nuclear future. (author)

  2. Summer Institute in Engineering and Computer Applications: Learning Through Experience

    Science.gov (United States)

    Langdon, Joan S.

    1995-01-01

    The document describing the Summer Institute project is made up of the following information: Administrative procedures; Seminars/Special Courses/Tours/College fair; Facilities/ Transportation; Staff and Administration; Collaboration; Participant/Project monitoring and evaluation; Fiscal and developmental activities; Job readiness/Job internship development and placement; and Student Follow-up/Tracking. Appendices include presentations, self-evaluations; abstracts and papers developed by the students during their participation in the program.

  3. CAS at the Cockcroft Institute

    CERN Multimedia

    2007-01-01

    The CERN Accelerator School (CAS) and the UK’s new centre for accelerator science, the Cockcroft Institute, jointly organised a course on General Accelerator Physics, at intermediate level, at the Cockcroft Institute, Daresbury, UK, from 16 to 28 September 2007. The venue took advantage of the excellent new facilities in the Institute and the existing infrastructure of the adjacent Daresbury Laboratory. The intermediate level course followed established practice, with lectures on core topics in the mornings and specialised courses in the afternoons. The latter provided "hands-on" education and experience in the three selected topics: "RF Measurements Techniques", "Beam Instrumentation and Diagnostics" and "Optics Design and Correction". These proved to be highly successful, with participants choosing one course and following the topic throughout the school. Guided studies, tutorials, seminars and a poster session completed the prog...

  4. Overcoming institutional challenges through continuous professionalism improvement: the University of Washington experience.

    Science.gov (United States)

    Fryer-Edwards, Kelly; Van Eaton, Erik; Goldstein, Erika A; Kimball, Harry R; Veith, Richard C; Pellegrini, Carlos A; Ramsey, Paul G

    2007-11-01

    The University of Washington (UW) School of Medicine is in the midst of an emerging ecology of professionalism. This initiative builds on prior work focusing on professionalism at the student level and moves toward the complete integration of a culture of professionalism within the UW medical community of including staff, faculty, residents, and students. The platform for initiating professionalism as institutional culture is the Committee on Continuous Professionalism Improvement, established in November 2006. This article reviews three approaches to organizational development used within and outside medicine and highlights features that are useful for enhancing an institutional culture of professionalism: organizational culture, safety culture, and appreciative inquiry. UW Medicine has defined professional development as a continuous process, built on concrete expectations, using mechanisms to facilitate learning from missteps and highlighting strengths. To this end, the school of medicine is working toward improvements in feedback, evaluation, and reward structures at all levels (student, resident, faculty, and staff) as well as creating opportunities for community dialogues on professionalism issues within the institution. Throughout all the Continuous Professionalism Improvement activities, a two-pronged approach to cultivating a culture of professionalism is taken: celebration of excellence and attention to accountability.

  5. Electronic properties of single crystal CVD diamond and its suitability for particle detection in hadron physics experiments

    Energy Technology Data Exchange (ETDEWEB)

    Pomorski, Michal

    2008-08-07

    This work presents the study on the suitability of single-crystal CVD diamond for particle-detection systems in present and future hadron physics experiments. Different characterization methods of the electrical and the structural properties were applied to gain a deeper understanding of the crystal quality and the charge transport properties of this novel semiconductor material. First measurements regarding the radiation tolerance of diamond were performed with sensors heavily irradiated with protons and neutrons. Finally, detector prototypes were fabricated and successfully tested in various experiments as time detectors for minimum ionizing particles as well as for spectroscopy of heavy ions at the energy ranges available at the SIS and the UNILAC facilities of GSI. (orig.)

  6. Electronic properties of single crystal CVD diamond and its suitability for particle detection in hadron physics experiments

    International Nuclear Information System (INIS)

    Pomorski, Michal

    2008-01-01

    This work presents the study on the suitability of single-crystal CVD diamond for particle-detection systems in present and future hadron physics experiments. Different characterization methods of the electrical and the structural properties were applied to gain a deeper understanding of the crystal quality and the charge transport properties of this novel semiconductor material. First measurements regarding the radiation tolerance of diamond were performed with sensors heavily irradiated with protons and neutrons. Finally, detector prototypes were fabricated and successfully tested in various experiments as time detectors for minimum ionizing particles as well as for spectroscopy of heavy ions at the energy ranges available at the SIS and the UNILAC facilities of GSI. (orig.)

  7. Lessons learned from a single institution's retrospective analysis of emergent cesarean delivery following external cephalic version with and without neuraxial anesthesia.

    Science.gov (United States)

    Ainsworth, A; Sviggum, H P; Tolcher, M C; Weaver, A L; Holman, M A; Arendt, K W

    2017-05-01

    To evaluate the risk of emergent cesarean delivery with the use of neuraxial anesthesia for external cephalic version in a single practice. Randomized trials have shown increased external cephalic version success when neuraxial anesthesia is used, without additional risk. We hypothesized that in our actual clinical practice, outside the confines of randomized trials, neuraxial anesthesia could be associated with an increased risk of emergent cesarean delivery. This retrospective cohort study included all women who underwent external cephalic version at a single institution with and without neuraxial anesthesia. The primary outcome was the incidence of emergent cesarean delivery (defined as delivery within 4hours of version). Secondary outcomes were version success and ultimate mode of delivery. A total of 135 women underwent external cephalic version procedures; 58 with neuraxial anesthesia (43.0%) and 77 without (57.0%). Location of the procedure, tocolytic therapy, and gestational age were different between groups. An increased rate of emergent cesarean delivery was found in procedures with neuraxial anesthesia compared to procedures without (5/58 (8.6%) compared to 0/77 (0.0%); 95% CI for difference, 1.4 to 15.8%; P=0.013). In this single hospital's practice, patients who may be at higher risk of complications and have a lesser likelihood of success were provided NA for ECV. As a result, the use of neuraxial anesthesia for external cephalic version was associated with a higher rate of emergent cesarean delivery. Obstetric and anesthetic practices should evaluate their patient selection and procedure protocol for external cephalic version under neuraxial anesthesia. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Dual-energy CT workflow: multi-institutional consensus on standardization of abdominopelvic MDCT protocols.

    Science.gov (United States)

    Patel, Bhavik N; Alexander, Lauren; Allen, Brian; Berland, Lincoln; Borhani, Amir; Mileto, Achille; Moreno, Courtney; Morgan, Desiree; Sahani, Dushyant; Shuman, William; Tamm, Eric; Tublin, Mitchell; Yeh, Benjamin; Marin, Daniele

    2017-03-01

    To standardize workflow for dual-energy computed tomography (DECT) involving common abdominopelvic exam protocols. 9 institutions (4 rsDECT, 1 dsDECT, 4 both) with 32 participants [average # years (range) in practice and DECT experience, 12.3 (1-35) and 4.6 (1-14), respectively] filled out a single survey (n = 9). A five-point agreement scale (0, 1, 2, 3, 4-contra-, not, mildly, moderately, strongly indicated, respectively) and utilization scale (0-not performing and shouldn't; 1-performing but not clinically useful; 2-performing but not sure if clinically useful; 3-not performing it but would like to; 4-performing and clinically useful) were used. Consensus was considered with a score of ≥2.5. Survey results were discussed over three separate live webinar sessions. 5/9 (56%) institutions exclude large patients from DECT. 2 (40%) use weight, 2 (40%) use transverse dimension, and 1 (20%) uses both. 7/9 (78%) use 50 keV for low and 70 keV for medium monochromatic reconstructed images. DECT is indicated for dual liver [agreement score (AS) 3.78; utilization score (US) 3.22] and dual pancreas in the arterial phase (AS 3.78; US 3.11), mesenteric ischemia/gastrointestinal bleeding in both the arterial and venous phases (AS 2.89; US 2.79), RCC exams in the arterial phase (AS 3.33; US 2.78), and CT urography in the nephrographic phase (AS 3.11; US 2.89). DECT for renal stone and certain single-phase exams is indicated (AS 3.00). DECT is indicated during the arterial phase for multiphasic abdominal exams, nephrographic phase for CTU, and for certain single-phase and renal stone exams.

  9. Axial lumbar interbody fusion: a 6-year single-center experience

    Directory of Open Access Journals (Sweden)

    Zeilstra DJ

    2013-08-01

    Full Text Available Dick J Zeilstra,1 Larry E Miller,2,3 Jon E Block3 1Bergman Clinics, Naarden and NedSpine, Ede, The Netherlands; 2Miller Scientific Consulting, Inc, Arden, NC, USA; 3The Jon Block Group, San Francisco, CA, USA Introduction: The aim of this study is to report our 6-year single-center experience with L5–S1 axial lumbar interbody fusion (AxiaLIF. Methods: A total of 131 patients with symptomatic degenerative disc disease refractory to nonsurgical treatment were treated with AxiaLIF at L5–S1, and were followed for a minimum of 1 year (mean: 21 months. Main outcomes included back and leg pain severity, Oswestry Disability Index score, working status, analgesic medication use, patient satisfaction, and complications. Computed tomography was used to determine postoperative fusion status. Results: No intraoperative complications, including vascular, neural, urologic, or bowel injuries, were reported. Back and leg pain severity decreased by 51% and 42%, respectively, during the follow-up period (both P < 0.001. Back function scores improved 50% compared to baseline. Clinical success, defined as improvement ≥30%, was 67% for back pain severity, 65% for leg pain severity, and 71% for back function. The employment rate increased from 47% before surgery to 64% at final follow-up (P < 0.001. Less than one in four patients regularly used analgesic medications postsurgery. Patient satisfaction with the AxiaLIF procedure was 83%. The fusion rate was 87.8% at final follow-up. During follow-up, 17 (13.0% patients underwent 18 reoperations on the lumbar spine, including pedicle screw fixation (n = 10, total disc replacement of an uninvolved level (n = 3, facet screw fixation (n = 3, facet screw removal (n = 1, and interbody fusion at L4–L5 (n = 1. Eight (6.1% reoperations were at the index level. Conclusion: Single-level AxiaLIF is a safe and effective means to achieve lumbosacral fusion in patients with symptomatic degenerative disc disease. Keywords: Axia

  10. Is a single dose of meningococcal serogroup C conjugate vaccine sufficient for protection? experience from the Netherlands

    Directory of Open Access Journals (Sweden)

    Kaaijk Patricia

    2012-02-01

    Full Text Available Abstract Background The first meningococcal serogroup C (MenC conjugate vaccine was licensed in 1999 and introduced in the United Kingdom. Countries that have implemented the MenC vaccine since then in their national immunisation programmes use different schedules. Nevertheless, all involved countries seem to experience substantial declines in the incidence of MenC disease. Discussion Since 2001, the MenC conjugate vaccine has been implemented in the Netherlands by offering a single dose to all children aged 14 months. Prior to the introduction of the vaccine into the national immunisation programme, a catch-up vaccination campaign was initiated in which a single dose of the MenC conjugate vaccine was offered to all children aged from 14 months up to and including 18 years. Since then, there has been no report of any case of MenC disease among immunocompetent vaccinees. Administration of a single dose of MenC conjugate vaccine after infancy could be beneficial considering the already complex immunisation schedules with large numbers of vaccinations in the first year of life. The present paper deals with the advantages and critical aspects of a single dose of the MenC conjugate vaccine. Summary A single dose of MenC conjugate vaccine at the age of 14 months in combination with a catch up vaccine campaign appeared to be a successful strategy to prevent MenC disease in the Netherlands, thereby confirming that a single dose of the vaccine could sufficiently protect against disease. Nevertheless, this approach can only be justified in countries with a relatively low incidence of serogroup C meningococcal disease in the first year of life. Furthermore, a good surveillance programme is recommended for timely detection of vaccine breakthroughs and outbreaks among non-vaccinees, since long-term protection after a single dose in the second year of life cannot currently be guaranteed.

  11. Handcuffing Institutional Research and Quality Assurance to the Student Experience: 50 Shades of Grey?

    Science.gov (United States)

    Schofield, Mark

    2014-01-01

    Institutional Research (IR), as a concept, has been gaining traction in the UK and across the world, as evidenced by the growing number of European, African, Australasian and North American associations, communities, conferences and publications. This paper stresses the need for high-quality (Institutional) research behaviours, aligned with and…

  12. Distributed deep learning networks among institutions for medical imaging.

    Science.gov (United States)

    Chang, Ken; Balachandar, Niranjan; Lam, Carson; Yi, Darvin; Brown, James; Beers, Andrew; Rosen, Bruce; Rubin, Daniel L; Kalpathy-Cramer, Jayashree

    2018-03-29

    Deep learning has become a promising approach for automated support for clinical diagnosis. When medical data samples are limited, collaboration among multiple institutions is necessary to achieve high algorithm performance. However, sharing patient data often has limitations due to technical, legal, or ethical concerns. In this study, we propose methods of distributing deep learning models as an attractive alternative to sharing patient data. We simulate the distribution of deep learning models across 4 institutions using various training heuristics and compare the results with a deep learning model trained on centrally hosted patient data. The training heuristics investigated include ensembling single institution models, single weight transfer, and cyclical weight transfer. We evaluated these approaches for image classification in 3 independent image collections (retinal fundus photos, mammography, and ImageNet). We find that cyclical weight transfer resulted in a performance that was comparable to that of centrally hosted patient data. We also found that there is an improvement in the performance of cyclical weight transfer heuristic with a high frequency of weight transfer. We show that distributing deep learning models is an effective alternative to sharing patient data. This finding has implications for any collaborative deep learning study.

  13. Photon-HDF5: An Open File Format for Timestamp-Based Single-Molecule Fluorescence Experiments.

    Science.gov (United States)

    Ingargiola, Antonino; Laurence, Ted; Boutelle, Robert; Weiss, Shimon; Michalet, Xavier

    2016-01-05

    We introduce Photon-HDF5, an open and efficient file format to simplify exchange and long-term accessibility of data from single-molecule fluorescence experiments based on photon-counting detectors such as single-photon avalanche diode, photomultiplier tube, or arrays of such detectors. The format is based on HDF5, a widely used platform- and language-independent hierarchical file format for which user-friendly viewers are available. Photon-HDF5 can store raw photon data (timestamp, channel number, etc.) from any acquisition hardware, but also setup and sample description, information on provenance, authorship and other metadata, and is flexible enough to include any kind of custom data. The format specifications are hosted on a public website, which is open to contributions by the biophysics community. As an initial resource, the website provides code examples to read Photon-HDF5 files in several programming languages and a reference Python library (phconvert), to create new Photon-HDF5 files and convert several existing file formats into Photon-HDF5. To encourage adoption by the academic and commercial communities, all software is released under the MIT open source license. Copyright © 2016 Biophysical Society. Published by Elsevier Inc. All rights reserved.

  14. Facilitating institutional change in West Africa: the CoS–SIS experience

    NARCIS (Netherlands)

    Adjei-Nsiah, S.; Sakyi-Dawson, O.; Klerkx, L.W.A.

    2014-01-01

    The Convergence of Sciences–Strengthening Innovation Systems (CoS–SIS) programme is based on the premise that the livelihood of the African smallholder farmer is constrained by the existence and/or performance of formal and informal institutions that are not conducive to small-farm development.

  15. Rehabilitation between institutional and non-institutional forensic psychiatric care: important influences on the transition process.

    Science.gov (United States)

    Gustafsson, E; Holm, M; Flensner, G

    2012-10-01

    All patients cared for in forensic psychiatric care (FPC) have some kind of psychiatric disorder and most of them have committed one or more criminal acts. One part of the patient's rehabilitation is the transition from institutional to non-institutional FPC, but a number of patients do not succeed. The aim of this study was to elucidate different caregivers' experiences of aspects that influence the patients' ability to manage this rehabilitation. A qualitative approach was chosen. Data were collected by interviews in two focus groups, each group comprising of six caregivers representing both institutional and non-institutional FPC. The transcribed interviews were analysed using a qualitative content analysis. Important aspects influencing the patients' transition described were a well-planned care plan, together with a suitable non-institutional dwelling and a tailored occupation. Other important areas were having a well-functioning and trusting social network and a good relationship with a contact person/advocate. A major barrier to a successful transition was whether the patients managed their own finances or not. It was stated that it is important that the patients participate in the care and that different authorities create individual conditions and flexible solutions. All of these factors are important to focus on when caring for patients during their stay in the institutional FPC. © 2011 Blackwell Publishing.

  16. Migrating a professional field of study in a multi-institutional partnership: facilitators’ experience in the competence-based curriculum development process

    Directory of Open Access Journals (Sweden)

    Proscovia Namubiru Ssentamu

    2014-07-01

    Full Text Available With the urge to Africanise the curriculum following colonisation, many African countries are still wary of the educational initiatives from the developed countries. However, with the clear curriculum design and development guidelines provided by various national Quality Assurance bodies, African countries need not fear migrating curricula from developed countries. Drawing from the workshop experiences, authors of this paper illustrate the steps involved in migrating, contextualising and adapting a professional field of study in a multi-institutional partnership, with particular focus on the competence-based curriculum design and development process. The process of migrating higher education (HE Administration, Leadership and Management curriculum taught at the University of Tampere (Finland to a Postgraduate Diploma in Higher Education Leadership and Management (PGDHELM curriculum at Uganda Management Institute (UMI in partnership with the Makerere University and the University of Helsinki involved undertaking a needs assessment, training of trainers and adapting the programme to the UMI context. The training of trainers provided opportunity for the trainees to reflect and generate information on the status of HE leadership and management in Uganda. The curriculum was institutionalised by aligning it to the vision, mission and profile of UMI in the context of the existing internal and external Quality Assurance frameworks. This paper underscores the importance of involving stakeholders, taking into account national and institutional requirements in all the steps when migrating an academic curriculum.

  17. Trends in the Management of Patients With Left Ventricular Assist Devices Presenting for Noncardiac Surgery: A 10-Year Institutional Experience.

    Science.gov (United States)

    Stone, Marc; Hinchey, Joseph; Sattler, Christopher; Evans, Adam

    2016-09-01

    In our institution, the vast majority of patients presenting for noncardiac surgery (NCS) while supported by a left ventricular assist device (LVAD) are now cared for by noncardiac-trained anesthesiologists as the result of a decade of educational intervention to effect this transition. This represents a significant departure from the published experiences of other institutions. With institutional review board approval, we queried the database of our anesthesia record keeping system (CompuRecord) to determine various aspects of the perioperative management of these patients from July 1, 2003, through June 30, 2013, during which time 271 NCS procedures were performed on adult patients supported by LVADs. Over the entire study period (2003-2013), anesthetic care was provided by a cardiac anesthesiologist 47% of the time and by a noncardiac anesthesiologist 53% of the time. However, by the time period 2012-2013, 88% of the NCS procedures were staffed by a noncardiac anesthesiologist. Despite the prevalence of continuous flow devices in this series, the use of invasive blood pressure monitoring decreased dramatically by the later years of the study. Vasoactive and inotropic medications were rarely required intraoperatively. No intraoperative cardiac arrests, thromboembolic complications, or device malfunctions occurred. Our conclusion is that NCS procedures on LVAD-supported patients can be safely managed by educated noncardiac anesthesiologists. © The Author(s) 2015.

  18. Imaging-Guided Percutaneous Radiofrequency Ablation of Adrenal Metastases: Preliminary Results at a Single Institution with a Single Device

    International Nuclear Information System (INIS)

    Carrafiello, G.; Lagana, D.; Recaldini, C.; Giorgianni, A.; Ianniello, A.; Lumia, D.; D'Ambrosio, A.; Petulla, M.; Dionigi, G.; Fugazzola, C.

    2008-01-01

    The aim of this study was to show the feasibility, safety, imaging appearance, and short-term efficacy of image-guided percutaneous radiofrequency ablation (RFA) of adrenal metastases (AM). Seven imaging-guided percutaneous RFA treatments were performed in six patients (two men and four women; mean age, 67.2 years; range, 55-74 years) with six AM who were referred to our institution from 2003 to 2006. One patient was treated twice for recurrence after first treatment. The average diameter of the treated AM was 29 mm (range, 15-40 mm). In all patients, the diagnosis was obtained with CT current protocols in use at our institution and confirmed by pathology with an image-guided biopsy. No major complications occurred. In one patient shortly after initiation of the procedure, severe hypertension was noted; another patient developed post-RFA syndrome. In five of six lesions, there was no residual enhancement of the treated tumor. In one patient CT examination showed areas of residual enhancement of the tumor after treatment. Our preliminary results suggest that imaging-guided percutaneous RFA is effective for local control of AM, without major complications and with a low morbidity rate related to the procedure. Long-term follow-up will need to be performed and appropriate patient selection criteria will need to be determined in future randomized trials.

  19. “... And Gladly Teach”: The American Hospital Association's Experience in Conducting Institutes on Hospital Librarianship

    Science.gov (United States)

    Yast, Helen

    1964-01-01

    As part of its overall educational program, the American Hospital Association has since 1959 conducted three institutes on hospital librarianship to meet the demand for more competent librarians in medical, nursing school, and patients' libraries. The purpose of such institutes is to teach the basic elements of library science to untrained personnel in hospital libraries. Discussed are steps in initiating an institute; factors determining length, date, and place; financing; publicity; choice and responsibility of local advisory committee; program content; qualifications of instructors; characteristics of registrants; materials for distribution; evaluations. Details of the most recent institute are outlined. A summary of problems still facing this type of educational program and suggestions for future improvements conclude the paper. PMID:14119309

  20. The Antitumor Effect of Single-domain Antibodies Directed Towards Membrane-associated Catalase and Superoxide Dismutase.

    Science.gov (United States)

    Bauer, Georg; Motz, Manfred

    2016-11-01

    Neutralizing single-domain antibodies directed towards catalase or superoxide dismutase (SOD) caused efficient reactivation of intercellular reactive oxygen species/reactive nitrogen species (ROS/RNS)-dependent apoptosis-inducing signaling specifically in human tumor cells. Single-domain antibodies targeted tumor cell-specific membrane-associated SOD and catalase, but not the corresponding intracellular enzymes. They were shown to be about 200-fold more effective than corresponding classical recombinant antigen-binding fragments and more than four log steps more efficient than monoclonal antibodies. Combined addition of single-domain antibodies against catalase and SOD caused a remarkable synergistic effect. Proof-of-concept experiments in immunocompromised mice using human tumor xenografts and single-domain antibodies directed towards SOD showed an inhibition of tumor growth. Neutralizing single-domain antibodies directed to catalase and SOD also caused a very strong synergistic effect with the established chemotherapeutic agent taxol, indicating an overlap of signaling pathways. This effect might also be useful in order to avoid unwanted side-effects and to drastically lower the costs for taxol-based therapy. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.