Small Intestinal Bacterial Overgrowth: A Case-Based Review

Directory of Open Access Journals (Sweden)

Kristen H. Reynolds

2015-11-01

Full Text Available Small intestinal bacterial overgrowth (SIBO is a condition of increased microbial load in the small intestine. The microbes feed on dietary carbohydrates and starches via fermentation, leading to gas production, inflammation and damage to the lining of the small intestine. Clinical presentation is varied, including abdominal pain, bloating, malabsorption and systemic symptoms. SIBO is associated with many challenging and chronic conditions such as fibromyalgia, chronic fatigue and chronic pain syndromes, and has been shown to be a causative factor in two out of three cases of irritable bowel syndrome. Symptoms improve with antimicrobial treatment, but recurrence is common. Many providers may not be aware of SIBO. This narrative review highlights a clinical case and the most recent literature regarding SIBO, including history, clinical presentation, prevalence, pathophysiology, diagnostic workup, treatment and prevention. Integrative medicine approaches, including diet, supplements and manual therapies, are also reviewed. SIBO can be a challenging condition and requires an integrative, patient-centered approach. Further studies are needed to guide clinicians in the workup and treatment of SIBO.

Hypothyroidism among SLE patients: Case-control study.

Science.gov (United States)

Watad, Abdulla; Mahroum, Naim; Whitby, Aaron; Gertel, Smadar; Comaneshter, Doron; Cohen, Arnon D; Amital, Howard

2016-05-01

The prevalence of hypothyroidism in SLE patients varies considerably and early reports were mainly based on small cohorts. To investigate the association between SLE and hypothyroidism. Patients with SLE were compared with age and sex-matched controls regarding the proportion of hypothyroidism in a case-control study. Chi-square and t-tests were used for univariate analysis and a logistic regression model was used for multivariate analysis. The study was performed utilizing the medical database of Clalit Health Services. The study included 5018 patients with SLE and 25,090 age and sex-matched controls. The proportion of hypothyroidism in patients with SLE was increased compared with the prevalence in controls (15.58% and 5.75%, respectively, Phypothyroidism (odds ratio 2.644, 95% confidence interval 2.405-2.908). Patients with SLE have a greater proportion of hypothyroidism than matched controls. Therefore, physicians treating patients with SLE should be aware of the possibility of thyroid dysfunction. Copyright © 2016 Elsevier B.V. All rights reserved.

Propulsion Controls Modeling for a Small Turbofan Engine

Science.gov (United States)

Connolly, Joseph W.; Csank, Jeffrey T.; Chicatelli, Amy; Franco, Kevin

2017-01-01

A nonlinear dynamic model and propulsion controller are developed for a small-scale turbofan engine. The small-scale turbofan engine is based on the Price Induction company's DGEN 380, one of the few turbofan engines targeted for the personal light jet category. Comparisons of the nonlinear dynamic turbofan engine model to actual DGEN 380 engine test data and a Price Induction simulation are provided. During engine transients, the nonlinear model typically agrees within 10 percent error, even though the nonlinear model was developed from limited available engine data. A gain scheduled proportional integral low speed shaft controller with limiter safety logic is created to replicate the baseline DGEN 380 controller. The new controller provides desired gain and phase margins and is verified to meet Federal Aviation Administration transient propulsion system requirements. In understanding benefits, there is a need to move beyond simulation for the demonstration of advanced control architectures and technologies by using real-time systems and hardware. The small-scale DGEN 380 provides a cost effective means to accomplish advanced controls testing on a relevant turbofan engine platform.

Diaphragm disease of the small intestine: an interesting case report.

Science.gov (United States)

Ullah, Sana; Ajab, Shereen; Rao, Rajashekhar; Raghunathan, Girish; DaCosta, Philip

2015-06-01

Diaphragm disease of small intestine usually presents with nonspecific clinical features. Radiological investigations often fail to differentiate it from small intestinal tumors and inflammatory bowel disease. It is therefore diagnosed on final histology after surgical resection. We hereby report an interesting case of a suspected small bowel tumor later diagnosed as diaphragm disease on histology. © The Author(s) 2014.

Pollution control activities for waste-water treatment plants: planning, integrated approach, functionality controls and small plants

International Nuclear Information System (INIS)

Serena, F.; Tomiato, L.; Ostoich, M.; Falletti, L.

2009-01-01

The work presents the problem of the Wastewater Treatment Plants' (WWTPs) controls and the organization of the consequential activities with reference to the priorities of the Environmental Agencies through a hierarchy assessment according to the environmental importance of the pressure sources. The European Recommendation 2001/331/EC bases the environmental controls of industrial sites and also of WWTPs on an integrated approach overtaking the simple analytic control; the integrated approach requires documentary, technical, management and analytic controls. The Veneto Regional Environmental Prevention and Protection Agency (ARPAV) has recently developed and applied a check-list for the implementation of the European Recommendation for WWTPs. The check-list includes the functionality assessment of the WWTP in case of discharge control delegation to the plant manager as consented with Annex 5 third part Italian Decree 3/04/2006 n. 152. In the paper the general framework of environmental controls on public WWTPs in the Veneto region is described. Particular importance for the numerousness and for the required control typology is referred to the small WWTP ( [it

Reducing selection bias in case-control studies from rare disease registries.

Science.gov (United States)

Cole, J Alexander; Taylor, John S; Hangartner, Thomas N; Weinreb, Neal J; Mistry, Pramod K; Khan, Aneal

2011-09-12

In clinical research of rare diseases, where small patient numbers and disease heterogeneity limit study design options, registries are a valuable resource for demographic and outcome information. However, in contrast to prospective, randomized clinical trials, the observational design of registries is prone to introduce selection bias and negatively impact the validity of data analyses. The objective of the study was to demonstrate the utility of case-control matching and the risk-set method in order to control bias in data from a rare disease registry. Data from the International Collaborative Gaucher Group (ICGG) Gaucher Registry were used as an example. A case-control matching analysis using the risk-set method was conducted to identify two groups of patients with type 1 Gaucher disease in the ICGG Gaucher Registry: patients with avascular osteonecrosis (AVN) and those without AVN. The frequency distributions of gender, decade of birth, treatment status, and splenectomy status were presented for cases and controls before and after matching. Odds ratios (and 95% confidence intervals) were calculated for each variable before and after matching. The application of case-control matching methodology results in cohorts of cases (i.e., patients with AVN) and controls (i.e., patients without AVN) who have comparable distributions for four common parameters used in subject selection: gender, year of birth (age), treatment status, and splenectomy status. Matching resulted in odds ratios of approximately 1.00, indicating no bias. We demonstrated bias in case-control selection in subjects from a prototype rare disease registry and used case-control matching to minimize this bias. Therefore, this approach appears useful to study cohorts of heterogeneous patients in rare disease registries.

Small, microcomputer-based CAMAC controller

International Nuclear Information System (INIS)

Juras, R.C.

1979-01-01

The beam buncher necessary to condition the beam from the Oak Ridge National Laboratory 25 MV tandem accelerator for post-acceleration by the Oak Ridge Isochronous Cyclotron is CAMAC-based and will be controlled via one of the serial highways of the accelerator control system. However, prior to integration into the accelerator system, the buncher requires testing, including runs on the model EN tandem at Oak Ridge. In order to facilitate testing and initial operation of the buncher, a microcomputer-based controller was assembled. The controller consists of a CAMAC crate, several CAMAC modules, a touch panel display, a controller box, and software. The controller box contains one shaft encoder and two switches. One of the switches is a coarse/fine selector. The other switch is assignable via the touch panel display and is used, for example, to turn devices on and off. Operation of the controller is described. It can be quickly assembled to control any small CAMAC-based system. 2 figures

Selective serotonin reuptake inhibitors and gastrointestinal bleeding: a case-control study.

Directory of Open Access Journals (Sweden)

Alfonso Carvajal

Full Text Available BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs have been associated with upper gastrointestinal (GI bleeding. Given their worldwide use, even small risks account for a large number of cases. This study has been conducted with carefully collected information to further investigate the relationship between SSRIs and upper GI bleeding. METHODS: We conducted a case-control study in hospitals in Spain and in Italy. Cases were patients aged ≥18 years with a primary diagnosis of acute upper GI bleeding diagnosed by endoscopy; three controls were matched by sex, age, date of admission (within 3 months and hospital among patients who were admitted for elective surgery for non-painful disorders. Exposures to SSRIs, other antidepressants and other drugs were defined as any use of these drugs in the 7 days before the day on which upper gastrointestinal bleeding started (index day. RESULTS: 581 cases of upper GI bleeding and 1358 controls were considered eligible for the study; no differences in age or sex distribution were observed between cases and controls after matching. Overall, 4.0% of the cases and 3.3% of controls used an SSRI antidepressant in the week before the index day. No significant risk of upper GI bleeding was encountered for SSRI antidepressants (adjusted odds ratio, 1.06, 95% CI, 0.57-1.96 or for whichever other grouping of antidepressants. CONCLUSIONS: The results of this case-control study showed no significant increase in upper GI bleeding with SSRIs and provide good evidence that the magnitude of any increase in risk is not greater than 2.

A data acquisition controller for small to medium scale nuclear experiments

International Nuclear Information System (INIS)

Bohm, C.

1986-01-01

A data aquisition controller and related software for small to medium scaled nuclear experiments are described. The unit is designed to be connected (via a standard terminal connection) as a peripheral to a host computer (in our case a VAX). It is based on a standard eurobus Z-80 microprocessor to which specially designed multichannel analyzer subsystems are added for data aquisition. The multichannel analyzer, which consists of single width eurocard, uses the controller memory, via direct memory access, for data storage. To this it is possible to add standard eurobus interfaces for digital and analog supervision and for control of the experimental parameters. The unit uses the host computer to interpret a host command file defining the experimental procedure. It will log in to the host when it needs assistance, but stay logged out during periods of inactivity. (orig.)

Case-control studies in neurosurgery.

Science.gov (United States)

Nesvick, Cody L; Thompson, Clinton J; Boop, Frederick A; Klimo, Paul

2014-08-01

Observational studies, such as cohort and case-control studies, are valuable instruments in evidence-based medicine. Case-control studies, in particular, are becoming increasingly popular in the neurosurgical literature due to their low cost and relative ease of execution; however, no one has yet systematically assessed these types of studies for quality in methodology and reporting. The authors performed a literature search using PubMed/MEDLINE to identify all studies that explicitly identified themselves as "case-control" and were published in the JNS Publishing Group journals (Journal of Neurosurgery, Journal of Neurosurgery: Pediatrics, Journal of Neurosurgery: Spine, and Neurosurgical Focus) or Neurosurgery. Each paper was evaluated for 22 descriptive variables and then categorized as having either met or missed the basic definition of a case-control study. All studies that evaluated risk factors for a well-defined outcome were considered true case-control studies. The authors sought to identify key features or phrases that were or were not predictive of a true case-control study. Those papers that satisfied the definition were further evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. The search detected 67 papers that met the inclusion criteria, of which 32 (48%) represented true case-control studies. The frequency of true case-control studies has not changed with time. Use of odds ratios (ORs) and logistic regression (LR) analysis were strong positive predictors of true case-control studies (for odds ratios, OR 15.33 and 95% CI 4.52-51.97; for logistic regression analysis, OR 8.77 and 95% CI 2.69-28.56). Conversely, negative predictors included focus on a procedure/intervention (OR 0.35, 95% CI 0.13-0.998) and use of the word "outcome" in the Results section (OR 0.23, 95% CI 0.082-0.65). After exclusion of nested case-control studies, the negative correlation between focus on a procedure

Direct Torque Control of a Small Wind Turbine with a Sliding-Mode Speed Controller

Science.gov (United States)

Sri Lal Senanayaka, Jagath; Karimi, Hamid Reza; Robbersmyr, Kjell G.

2016-09-01

In this paper. the method of direct torque control in the presence of a sliding-mode speed controller is proposed for a small wind turbine being used in water heating applications. This concept and control system design can be expanded to grid connected or off-grid applications. Direct torque control of electrical machines has shown several advantages including very fast dynamics torque control over field-oriented control. Moreover. the torque and flux controllers in the direct torque control algorithms are based on hvsteretic controllers which are nonlinear. In the presence of a sliding-mode speed control. a nonlinear control system can be constructed which is matched for AC/DC conversion of the converter that gives fast responses with low overshoots. The main control objectives of the proposed small wind turbine can be maximum power point tracking and soft-stall power control. This small wind turbine consists of permanent magnet synchronous generator and external wind speed. and rotor speed measurements are not required for the system. However. a sensor is needed to detect the rated wind speed overpass events to activate proper speed references for the wind turbine. Based on the low-cost design requirement of small wind turbines. an available wind speed sensor can be modified. or a new sensor can be designed to get the required measurement. The simulation results will be provided to illustrate the excellent performance of the closed-loop control system in entire wind speed range (4-25 m/s).

Internal control activities in small Turkish companies

Directory of Open Access Journals (Sweden)

Ismail Bilgi

2017-01-01

Full Text Available The purpose of this paper is to present major outcomes from an empirical study concerning internal control activities in small Turkish companies, as to propose the improvement guidelines. Methods of analysis and synthesis, descriptive statistics, and statistical comparison were used. The collected data was processed with the help of the SPSS software. Тhe study is limited to organizations based in the European part of Turkey. Most of them operate in areas around large cities, such as Istanbul, Edirne, Kırklareli, and Tekirdağ. They employ on average 19-20 people and have a turnover of about TRY 3 million (≈€715,000, https://sdw.ecb.europa.eu on average. The survey concentrates mainly on small family businesses, which have been present on the market for more than ten years, with managers of good education and other characteristics that presuppose availability of internal control systems. The research results were used to compile main points of a SWOT analysis, as a part of the broader effort to help modernizing the internal control system in Turkish small businesses.

Power system small signal stability analysis and control

CERN Document Server

Mondal, Debasish; Sengupta, Aparajita

2014-01-01

Power System Small Signal Stability Analysis and Control presents a detailed analysis of the problem of severe outages due to the sustained growth of small signal oscillations in modern interconnected power systems. The ever-expanding nature of power systems and the rapid upgrade to smart grid technologies call for the implementation of robust and optimal controls. Power systems that are forced to operate close to their stability limit have resulted in the use of control devices by utility companies to improve the performance of the transmission system against commonly occurring power system

Reducing selection bias in case-control studies from rare disease registries

Directory of Open Access Journals (Sweden)

Mistry Pramod K

2011-09-01

Full Text Available Abstract Background In clinical research of rare diseases, where small patient numbers and disease heterogeneity limit study design options, registries are a valuable resource for demographic and outcome information. However, in contrast to prospective, randomized clinical trials, the observational design of registries is prone to introduce selection bias and negatively impact the validity of data analyses. The objective of the study was to demonstrate the utility of case-control matching and the risk-set method in order to control bias in data from a rare disease registry. Data from the International Collaborative Gaucher Group (ICGG Gaucher Registry were used as an example. Methods A case-control matching analysis using the risk-set method was conducted to identify two groups of patients with type 1 Gaucher disease in the ICGG Gaucher Registry: patients with avascular osteonecrosis (AVN and those without AVN. The frequency distributions of gender, decade of birth, treatment status, and splenectomy status were presented for cases and controls before and after matching. Odds ratios (and 95% confidence intervals were calculated for each variable before and after matching. Results The application of case-control matching methodology results in cohorts of cases (i.e., patients with AVN and controls (i.e., patients without AVN who have comparable distributions for four common parameters used in subject selection: gender, year of birth (age, treatment status, and splenectomy status. Matching resulted in odds ratios of approximately 1.00, indicating no bias. Conclusions We demonstrated bias in case-control selection in subjects from a prototype rare disease registry and used case-control matching to minimize this bias. Therefore, this approach appears useful to study cohorts of heterogeneous patients in rare disease registries.

On the Analysis of Case-Control Studies in Cluster-correlated Data Settings.

Science.gov (United States)

Haneuse, Sebastien; Rivera-Rodriguez, Claudia

2018-01-01

In resource-limited settings, long-term evaluation of national antiretroviral treatment (ART) programs often relies on aggregated data, the analysis of which may be subject to ecological bias. As researchers and policy makers consider evaluating individual-level outcomes such as treatment adherence or mortality, the well-known case-control design is appealing in that it provides efficiency gains over random sampling. In the context that motivates this article, valid estimation and inference requires acknowledging any clustering, although, to our knowledge, no statistical methods have been published for the analysis of case-control data for which the underlying population exhibits clustering. Furthermore, in the specific context of an ongoing collaboration in Malawi, rather than performing case-control sampling across all clinics, case-control sampling within clinics has been suggested as a more practical strategy. To our knowledge, although similar outcome-dependent sampling schemes have been described in the literature, a case-control design specific to correlated data settings is new. In this article, we describe this design, discuss balanced versus unbalanced sampling techniques, and provide a general approach to analyzing case-control studies in cluster-correlated settings based on inverse probability-weighted generalized estimating equations. Inference is based on a robust sandwich estimator with correlation parameters estimated to ensure appropriate accounting of the outcome-dependent sampling scheme. We conduct comprehensive simulations, based in part on real data on a sample of N = 78,155 program registrants in Malawi between 2005 and 2007, to evaluate small-sample operating characteristics and potential trade-offs associated with standard case-control sampling or when case-control sampling is performed within clusters.

Case-control studies in diabetes. Do they really use a case-control design?

Science.gov (United States)

Ramos, Analía; Mendoza, Lilian Cristina; Rabasa, Fernanda; Bolíbar, Ignasi; Puig, Teresa; Corcoy, Rosa

2017-07-01

Studies defined as case-control do not always use this design. We aimed to estimate the frequency of mislabelled case-control studies in published articles in the area of diabetes and to identify the predictors of incorrect labelling. We searched Medline and Web of Science for articles with "diabetes" and "case control" in title and filtered for language (English/Romance) and period (January 2010-December 2014). Inclusion criteria were: (1) statement to use a case-control design in title, (2) to be a final full-length publication and (3) to have original data in the area of diabetes. Three independent reviewers went through titles, looked for full texts and reviewed them. Discrepancies were settled with a fourth reviewer. Expert epidemiologist advice was requested in case of doubt. case-control mislabelling; addressed predictors: publication year, journal impact factor and journal subject. proportion of mislabelled CC articles and assessment of predictors by multivariate logistic regression analysis. We retrieved 362 articles, 251 of them fulfilling inclusion criteria. The proportion of mislabelled CC studies was 43.8% (confidence interval 95% 37.7-50.0%). Most mislabelled studies had a cross-sectional design (82.7%). Predictors of mislabelling were publication year, journal impact factor and journal area. A relevant subset of studies defined as case-control in the area of diabetes correspond to mislabelled cross-sectional studies. Incorrect labelling misleads readers regarding the interpretation of results and the cause-effect hypothesis. Researchers, reviewers and editors should be aware of and commit to settle this issue.

Small RNAs controlling outer membrane porins

DEFF Research Database (Denmark)

Valentin-Hansen, Poul; Johansen, Jesper; Rasmussen, Anders A

2007-01-01

are key regulators of environmental stress. Recent work has revealed an intimate interplay between small RNA regulation of outer membrane proteins and the stress-induced sigmaE-signalling system, which has an essential role in the maintenance of the integrity of the outer membrane.......Gene regulation by small non-coding RNAs has been recognized as an important post-transcriptional regulatory mechanism for several years. In Gram-negative bacteria such as Escherichia coli and Salmonella, these RNAs control stress response and translation of outer membrane proteins and therefore...

Social Media Marketing in a Small Business: A Case Study

OpenAIRE

Cox, Sarah

2012-01-01

In today’s social media driven environment, it is essential that small businesses understand Facebook, Twitter, and the strategies behind using social media for growing their business. Unfortunately, many small businesses do not have a strategy when they begin using social media. The purpose of this study is to understand how the owner of a small business, recognized for using social media to grow the business, uses social media to engage consumers. A case study is presented, followed by an i...

Ovarian Small Cell Carcinoma Hypercalcemic Type: A Case Report

LENUS (Irish Health Repository)

Rahma, M B.

2016-09-01

A 31-year-old female was diagnosed with small cell carcinoma of the ovary hypercalcaemic type (OSCCHT) post left oophorectomy. This is a rare aggressive ovarian tumour of which less than 300 cases were reported.

Small bowel obstruction complicating colonoscopy: a case report

Directory of Open Access Journals (Sweden)

Hunter Iain A

2008-05-01

Full Text Available Abstract Introduction This report describes a rare complication of colonoscopy and reviews the literature with regard to other rare causes of acute abdominal presentations following colonoscopy. Case presentation After a therapeutic colonoscopy a 60-year-old woman developed an acute abdomen. At laparotomy she was discovered to have small bowel obstruction secondary to incarceration through a congenital band adhesion. Conclusion Although there is no practical way in which such rare complications can be predicted, this case report emphasises the wide array of pathologies that can result in acute abdominal symptoms following colonoscopy.

Quadratic obstructions to small-time local controllability for scalar-input systems

Science.gov (United States)

Beauchard, Karine; Marbach, Frédéric

2018-03-01

We consider nonlinear finite-dimensional scalar-input control systems in the vicinity of an equilibrium. When the linearized system is controllable, the nonlinear system is smoothly small-time locally controllable: whatever m > 0 and T > 0, the state can reach a whole neighborhood of the equilibrium at time T with controls arbitrary small in Cm-norm. When the linearized system is not controllable, we prove that: either the state is constrained to live within a smooth strict manifold, up to a cubic residual, or the quadratic order adds a signed drift with respect to it. This drift holds along a Lie bracket of length (2 k + 1), is quantified in terms of an H-k-norm of the control, holds for controls small in W 2 k , ∞-norm and these spaces are optimal. Our proof requires only C3 regularity of the vector field. This work underlines the importance of the norm used in the smallness assumption on the control, even in finite dimension.

Agnosia for mirror stimuli: a new case report with a small parietal lesion.

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Martinaud, Olivier; Mirlink, Nicolas; Bioux, Sandrine; Bliaux, Evangéline; Lebas, Axel; Gerardin, Emmanuel; Hannequin, Didier

2014-11-01

Only seven cases of agnosia for mirror stimuli have been reported, always with an extensive lesion. We report a new case of an agnosia for mirror stimuli due to a circumscribed lesion. An extensive battery of neuropsychological tests and a new experimental procedure to assess visual object mirror and orientation discrimination were assessed 10 days after the onset of clinical symptoms, and 5 years later. The performances of our patient were compared with those of four healthy control subjects matched for age. This test revealed an agnosia for mirror stimuli. Brain imaging showed a small right occipitoparietal hematoma, encompassing the extrastriate cortex adjoining the inferior parietal lobe. This new case suggests that: (i) agnosia for mirror stimuli can persist for 5 years after onset and (ii) the posterior part of the right intraparietal sulcus could be critical in the cognitive process of mirror stimuli discrimination. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Small Cell Carcinoma of the Ovary of Hypercalcemic Type: A Case Report

Directory of Open Access Journals (Sweden)

S. Zaied

2012-01-01

Full Text Available Introduction. The small cell carcinoma of hypercalcemic type of ovary is a very aggressive tumor. It is associated with two-thirds of cases with hypercalcemia most often asymptomatic. It occurs mostly for young women. The treatment combines surgery, chemotherapy, and radiotherapy. Case Presentation. We report a case of small cell carcinoma of the ovary hypercalcemic type in a young Tunisian woman aged 25 years after a severe abdominal pain syndrome and a large ovarian mass discovered in scanner; a laparotomy was performed by radical surgery. The pathological examination of the specimen confirmed the diagnosis. The radiological assessment performed after surgery showed a continuing evolution. Palliative chemotherapy was established, and the patient had died two months after diagnosis. Conclusion. The hypercalcemic small cell carcinoma of the ovary is a rare disease of poor prognosis.

Case Report: Angiosarcoma of the small intestine | Mohammed ...

African Journals Online (AJOL)

Primary gastrointestinal angiosarcomas are very rare and those of the small bowel even more rare. We report a case which is the fi rst in the literature from this part of the world. It presented in a 25-year-old woman with multiple dissemination and rapid fatality. Diagnosis was based on histological morphology using ...

Case study of open-source enterprise resource planning implementation in a small business

Science.gov (United States)

Olson, David L.; Staley, Jesse

2012-02-01

Enterprise resource planning (ERP) systems have been recognised as offering great benefit to some organisations, although they are expensive and problematic to implement. The cost and risk make well-developed proprietorial systems unaffordable to small businesses. Open-source software (OSS) has become a viable means of producing ERP system products. The question this paper addresses is the feasibility of OSS ERP systems for small businesses. A case is reported involving two efforts to implement freely distributed ERP software products in a small US make-to-order engineering firm. The case emphasises the potential of freely distributed ERP systems, as well as some of the hurdles involved in their implementation. The paper briefly reviews highlights of OSS ERP systems, with the primary focus on reporting the case experiences for efforts to implement ERPLite software and xTuple software. While both systems worked from a technical perspective, both failed due to economic factors. While these economic conditions led to imperfect results, the case demonstrates the feasibility of OSS ERP for small businesses. Both experiences are evaluated in terms of risk dimension.

Individual and small group interactions in learning to teach with a hypermedia case

Science.gov (United States)

Chung, Mi-Lee Ahn

The purpose of this study was to investigate the similarities and differences of individual and small group preservice teachers' interactions with a hypermedia case. Preservice teachers' interactions with a hypermedia case were defined in terms of their (1) goals and perception of accomplishments of the goals, (2) use of features of the hypermedia case, and (3) types of questions and conflicts raised. Two individuals and two small groups of three preservice teachers participated by interacting with the hypermedia case which was developed to illustrate conceptual change science teaching in an elementary classroom. Most of the previous studies in this area have addressed large group use of hypermedia cases, and this study attempted to address the gap in the literature related to different social contexts, individuals and small groups, from the constructivist perspective. The assumptions of symbolic interactionism guided data collection from think-alouds and interviews. These multiple sources of data were used to understand the participants' construction of knowledge; data were analyzed and interpreted by a process of analytic induction. The major assertion was that the preservice teachers perceived the hypermedia case to be like a tool to link theory and practice of teaching. Three sub-assertions, and several supporting categories, also emerged from the data. These findings indicated that group learning experiences with the hypermedia case were more valuable than those of individuals. In general, preservice teachers benefited from learning how to teach with the hypermedia case in both settings. However, the individuals were not as satisfied as those in small groups, and the members of small groups interacted more actively with the hypermedia case as well as with the peers. The results of this study suggest that effective use of hypermedia cases takes place in a community of learners where the learners share the context and can draw upon the resources afforded by the

EXTRA SKELETAL EWINGS SARCOMA OF SMALL INTESTINE ORIGIN: A CASE REPORT

OpenAIRE

Satyavani; Sriharsha

2015-01-01

This is a case report of Ewing’s sarcoma/PNET arising from small intestine , a rare presentation of Ewing’s sarcoma. The case presented as a mass per abdomen with no other associated symptoms and after excision of the mass along with the adjacent mesentery , the histopathology and immunohistochemistry reported as Ewing’s/PNET with clear margins. Follow up of the case showed no recurrence. This case is reported for its rare occurrence , as only few cases ...

Small Satellite Passive Magnetic Attitude Control

Science.gov (United States)

Gerhardt, David T.

Passive Magnetic Attitude Control (PMAC) is capable of aligning a satellite within 5 degrees of the local magnetic field at low resource cost, making it ideal for a small satellite. However, simulation attempts to date have not been able to predict the attitude dynamics at a level sufficient for mission design. Also, some satellites have suffered from degraded performance due to an incomplete understanding of PMAC system design. This dissertation alleviates these issues by discussing the design, inputs, and validation of PMAC systems for small satellites. Design rules for a PMAC system are defined using the Colorado Student Space Weather Experiment (CSSWE) CubeSat as an example. A Multiplicative Extended Kalman Filter (MEKF) is defined for the attitude determination of a PMAC satellite without a rate gyro. After on-orbit calibration of the off-the-shelf magnetometer and photodiodes and an on-orbit fit to the satellite magnetic moment, the MEKF regularly achieves a three sigma attitude uncertainty of 4 degrees or less. CSSWE is found to settle to the magnetic field in seven days, verifying its attitude design requirement. A Helmholtz cage is constructed and used to characterize the CSSWE bar magnet and hysteresis rods both individually and in the flight configuration. Fitted parameters which govern the magnetic material behavior are used as input to a PMAC dynamics simulation. All components of this simulation are described and defined. Simulation-based dynamics analysis shows that certain initial conditions result in abnormally decreased settling times; these cases may be identified by their dynamic response. The simulation output is compared to the MEKF output; the true dynamics are well modeled and the predicted settling time is found to possess a 20 percent error, a significant improvement over prior simulation.

Occurrence of small intestinal volvulus in a terrier puppy-a case report

Science.gov (United States)

Golshahi, Hannaneh; Tavasoly, Abbas; Namjoo, Abdolrasol; Bahmani, Mahmoud

2014-01-01

Volvulus is the torsion of an organ around its root. In dogs, volvulus of the stomach is well known, but volvulus of the small intestine is rare. A dead 3-month-old female terrier puppy was presented for postmortem examination. According to owner statements, the puppy was depressed, lethargic and had abdominal pain, abdominal distension, severe diarrhea and vomiting a few hours before death. With gross and histopathologic studies, the death of this puppy was indorsed to small intestinal volvulus, subsequent infarction, peritonitis and likely acute toxaemia and/or septicaemia. The present case is going to be the first recorded case of small intestinal volvulus in dog in Iran.

Case-control study of fetal microchimerism and breast cancer.

Directory of Open Access Journals (Sweden)

Vijayakrishna K Gadi

2008-03-01

Full Text Available Prior pregnancy is known to protect against development of breast cancer. Recent studies have demonstrated that pregnancy has the capacity to establish small numbers of immunologically active fetal-derived cells in the mother, a phenomenon known as fetal microchimerism (FMc. We asked whether presence of FMc, routinely acquired during pregnancy, is a protective factor for breast cancer.DNA extracts from peripheral blood specimens were obtained from a population-based case-control study of risk factors for breast cancer in women 21 to 45 years old. Specimens were tested with quantitative PCR for presence and concentrations of male DNA presumed to derive from prior pregnancies with a male fetus. Odds ratios (OR and 95% confidence intervals (CI were estimated with consideration of multiple established reproductive and environmental risk factors for breast cancer. FMc results were generated on 99 parous women, 54 with primary invasive breast cancer and 45 general population controls. FMc prevalence was 56% (25/45 and 26% (14/54 in controls and cases, respectively. Women harboring FMc were less likely to have had breast cancer (OR = 0.29, 95% CI 0.11-0.83; p = 0.02, adjusting for age, number of children, birth of a son, history of miscarriage, and total DNA tested. In addition, FMc concentrations were higher in controls versus cases (p = 0.01. Median concentrations were 2 (0-78 and 0 (0-374 fetal genomes/10(6 maternal genomes in controls and cases, respectively.Results suggest that the enigma of why some parous women are not afforded protection from breast cancer by pregnancy might in part be explained by differences in FMc. Mechanistic studies of FMc-derived protection against breast cancer are warranted.

Small Bowel Obstruction Caused by Aloe vera Bezoars: A Case Report.

Science.gov (United States)

Hong, In Taik; Cha, Jae Myung; Ki, Hye Jin; Kwak, Min Seob; Yoon, Jin Young; Shin, Hyun Phil; Jeoun, Jung Won; Choi, Sung Il

2017-05-25

Small bowel obstruction is a clinical condition commonly caused by postoperative adhesion, volvulus, intussusceptions, and hernia. Small bowel obstruction due to bezoars is clinically uncommon, accounting for approximately 2-4% of all obstructions. Computed tomography (CT) is a useful method in diagnosing the cause of small bowel obstruction. However, small bowel obstruction caused by bezoars may not be detected by an abdominal CT examination. Herein, we report a rare case of small bowel obstruction by Aloe vera bezoars, which were undetected by an abdominal CT. Phytobezoars should be included in the differential diagnosis of small bowel obstruction in patients with predisposing factors, such as excessive consumption of high-fiber food and diabetes.

Analysis of Clinical Cohort Data Using Nested Case-control and Case-cohort Sampling Designs. A Powerful and Economical Tool.

Science.gov (United States)

Ohneberg, K; Wolkewitz, M; Beyersmann, J; Palomar-Martinez, M; Olaechea-Astigarraga, P; Alvarez-Lerma, F; Schumacher, M

2015-01-01

Sampling from a large cohort in order to derive a subsample that would be sufficient for statistical analysis is a frequently used method for handling large data sets in epidemiological studies with limited resources for exposure measurement. For clinical studies however, when interest is in the influence of a potential risk factor, cohort studies are often the first choice with all individuals entering the analysis. Our aim is to close the gap between epidemiological and clinical studies with respect to design and power considerations. Schoenfeld's formula for the number of events required for a Cox' proportional hazards model is fundamental. Our objective is to compare the power of analyzing the full cohort and the power of a nested case-control and a case-cohort design. We compare formulas for power for sampling designs and cohort studies. In our data example we simultaneously apply a nested case-control design with a varying number of controls matched to each case, a case cohort design with varying subcohort size, a random subsample and a full cohort analysis. For each design we calculate the standard error for estimated regression coefficients and the mean number of distinct persons, for whom covariate information is required. The formula for the power of a nested case-control design and the power of a case-cohort design is directly connected to the power of a cohort study using the well known Schoenfeld formula. The loss in precision of parameter estimates is relatively small compared to the saving in resources. Nested case-control and case-cohort studies, but not random subsamples yield an attractive alternative for analyzing clinical studies in the situation of a low event rate. Power calculations can be conducted straightforwardly to quantify the loss of power compared to the savings in the num-ber of patients using a sampling design instead of analyzing the full cohort.

High risk human papillomavirus in the periodontium : A case control study.

Science.gov (United States)

Shipilova, Anna; Dayakar, Manjunath Mundoor; Gupta, Dinesh

2017-01-01

Human papilloma viruses (HPVs) are small DNA viruses that have been identified in periodontal pocket as well as gingival sulcus. High risk HPVs are also associated with a subset of head and neck carcinomas. It is thought that the periodontium could be a reservoir for HPV. 1. Detection of Human Papilloma virus (HPV) in periodontal pocket as well as gingival of patients having localized chronic periodontitis and gingival sulcus of periodontally healthy subjects. 2. Quantitative estimation of E6 and E7 mRNA in subjects showing presence of HPV3. To assess whether periodontal pocket is a reservoir for HPV. This case-control study included 30 subjects with localized chronic Periodontitis (cases) and 30 periodontally healthy subjects (controls). Two samples were taken from cases, one from periodontal pocket and one from gingival sulcus and one sample was taken from controls. Samples were collected in the form of pocket scrapings and gingival sulcus scrapings from cases and controls respectively. These samples were sent in storage media for identification and estimation of E6/E7 mRNA of HPV using in situ hybridization and flow cytometry. Statistical analysis was done by using, mean, percentage and Chi Square test. A statistical package SPSS version 13.0 was used to analyze the data. P value oral cancer, periodontitis and HPV. However prospective studies are required to further explore this link.

Stability of the spreading in small-world network with predictive controller

International Nuclear Information System (INIS)

Bao, Z.J.; Jiang, Q.Y.; Yan, W.J.; Cao, Y.J.

2010-01-01

In this Letter, we apply the predictive control strategy to suppress the propagation of diseases or viruses in small-world network. The stability of small-world spreading model with predictive controller is investigated. The sufficient and necessary stability condition is given, which is closely related to the controller parameters and small-world rewiring probability p. Our simulations discover a phenomenon that, with the fixed predictive controller parameters, the spreading dynamics become more and more stable when p decreases from a larger value to a smaller one, and the suitable controller parameters can effectively suppress the spreading behaviors even when p varies within the whole spectrum, and the unsuitable controller parameters can lead to oscillation when p lies within a certain range.

(Azadirachta indica) seed extract for tick control in Small

African Journals Online (AJOL)

Dr. Matayo David

... extract for tick control in Small East African and Toggenburg female goat kids in Tanzania ... adoption rate by the local traditional small-scale resource poor farmers, etc.) (de Castro ..... SAS Institute Inc., Cary, North California. Saxena, R.C. ...

Fructose malabsorption in people with and without gout: A case-control study.

Science.gov (United States)

Batt, Caitlin; Fanning, Niamh; Drake, Jill; Frampton, Christopher; Gearry, Richard B; Stamp, Lisa K

2017-10-01

Higher fructose intake has been associated with hyperuricaemia and gout. Some individuals malabsorb fructose in the small intestine. The aims of this study were to determine the rate of fructose malabsorption and the effects of gout and fructose malabsorption on serum urate in people with and without gout. A total of 100 people with gout (cases) were age and gender matched with one control without gout. After a low fructose diet, fructose malabsorption was measured using a hydrogen and methane breath test with a 35g fructose load. In a subgroup of 35 cases and 35 controls, serum urate response to the fructose load over 240 minutes was measured. There was no significant difference in the rate of fructose malabsorption between cases and controls (48% vs. 52%; p = 0.67). Cases had a significantly lower mean (SEM) serum urate cumulative incremental concentration from baseline-240 minutes (iAUC 0-240 ) compared to controls 0.97 (0.56) vs. 4.78 (0.55); p gout. Allopurinol inhibits the increase in serum urate induced by a fructose load suggesting that people with gout receiving allopurinol may not need to restrict dietary intake of fructose. Copyright © 2017 Elsevier Inc. All rights reserved.

Cyber security for remote monitoring and control of small reactors

Energy Technology Data Exchange (ETDEWEB)

Trask, D., E-mail: dave.trask@cnl.ca [Atomic Energy of Canada Limited, Chalk River, ON (Canada); Jung, C. [Canadian Nuclear Safety Commission, Ottawa, ON (Canada); MacDonald, M., E-mail: marienna.macdonald@cnl.ca [Atomic Energy of Canada Limited, Chalk River, ON (Canada)

2014-07-01

There is growing international interest and activity in the development of small nuclear reactor technology with a number of vendors interested in building small reactors in Canada to serve remote locations. A common theme of small reactor designs proposed for remote Canadian locations is the concept of a centrally located main control centre operating several remotely located reactors via satellite communications. This theme was echoed at a recent IAEA conference where a recommendation was made to study I&C for remotely controlled small modular reactors, including satellite links and cyber security. This paper summarizes the results of an AECL-CNSC research project to analyze satellite communication technologies used for remote monitoring and control functions in order to provide cyber security regulatory considerations. The scope of this research included a basic survey of existing satellite communications technology and its use in industrial control applications, a brief history of satellite vulnerabilities and a broad review of over 50 standards, guidelines, and regulations from recognized institutions covering safety, cyber security, and industrial communication networks including wireless communications in general. This paper concludes that satellite communications should not be arbitrarily excluded by standards or regulation from use for the remote control and monitoring of small nuclear reactors. Instead, reliance should be placed on processes that are independent of any particular technology, such as reducing risks by applying control measures and demonstrating required reliability through good design practices and testing. Ultimately, it is compliance to well-developed standards that yields the evidence to conclude whether a particular application that uses satellite communications is safe and secure. (author)

Cyber security for remote monitoring and control of small reactors

International Nuclear Information System (INIS)

Trask, D.; Jung, C.; MacDonald, M.

2014-01-01

There is growing international interest and activity in the development of small nuclear reactor technology with a number of vendors interested in building small reactors in Canada to serve remote locations. A common theme of small reactor designs proposed for remote Canadian locations is the concept of a centrally located main control centre operating several remotely located reactors via satellite communications. This theme was echoed at a recent IAEA conference where a recommendation was made to study I&C for remotely controlled small modular reactors, including satellite links and cyber security. This paper summarizes the results of an AECL-CNSC research project to analyze satellite communication technologies used for remote monitoring and control functions in order to provide cyber security regulatory considerations. The scope of this research included a basic survey of existing satellite communications technology and its use in industrial control applications, a brief history of satellite vulnerabilities and a broad review of over 50 standards, guidelines, and regulations from recognized institutions covering safety, cyber security, and industrial communication networks including wireless communications in general. This paper concludes that satellite communications should not be arbitrarily excluded by standards or regulation from use for the remote control and monitoring of small nuclear reactors. Instead, reliance should be placed on processes that are independent of any particular technology, such as reducing risks by applying control measures and demonstrating required reliability through good design practices and testing. Ultimately, it is compliance to well-developed standards that yields the evidence to conclude whether a particular application that uses satellite communications is safe and secure. (author)

A clinical study of 68 cases of small intestinal perforation

International Nuclear Information System (INIS)

Ogura, Masaharu; Tanaka, Nobutaka; Furuya, Takatoshi; Nomura, Yukihiro; Nagai, Motoki; Takahashi, Michiro; Takayama, Toshio; Hirao, Hirofumi

2010-01-01

From January 2000 to September 2008 we analyzed the clinical features of 68 patients attending our hospital who had undergone surgery for small intestinal perforations. The nature of the rupture in 51 patients was endogenous, and endogenous in the other 17. Endogenous ruptures included ileus in 16 cases, tumors in 7 cases, of unknown origin in 5 cases, and blunt trauma in 23 cases. Exogenous rupture included iatrogenic in 5, foreign body digestion in 5, and penetrating trauma in 7. Postoperative complications occurred significantly more in the endogenous rupture cases than in the exogenous ones. There were 4 hospital deaths, which were in all endogenous cases. The high complication rate and a certain proportion of poor prognosis in cases of endogenous rupture necessitate imminent treatment as soon as an endogenous perforation is suspected. (author)

Imaging findings of hepatoid adenocarcinoma of the small bowel: A case report

Energy Technology Data Exchange (ETDEWEB)

Park, Jong Won; Kim, Kyoung Ah; Jung, Sang Geun [CHA Bundang Medical Center, CHA University College of Medicine, Seongnam (Korea, Republic of)

2016-12-15

Hepatoid adenocarcinoma is a rare extrahepatic tumor defined as having a morphologic and immunohistochemical similarity to hepatocellular carcinoma. In this case report, we describe a patient with hepatoid adenocarcinoma of the jejunum with multiple liver metastases that developed in the absence of risk factors. We describe the radiologic findings including those of dynamic computed tomography and small bowel follow-through. To the best of our knowledge, only two cases of hepatoid adenocarcinoma of the small bowel have been reported in patients with inflammatory bowel disease.

Capsule-Fixated Intraocular Lens Implantation in Small Pupil Cases.

Science.gov (United States)

Schojai, Merita; Schultz, Tim; Burkhard Dick, H

2017-08-01

To describe a new technique for implantation of capsule-fixated intraocular lenses (IOLs) (FEMTIS; Oculentis, Berlin, Germany) in patients with small pupils. In 4 eyes with small pupils, an anterior capsule-fixated IOL was implanted into the capsular bag after femtosecond laser treatment. The two large and two small flaps of the IOL were elevated to the front of the iris and the anterior capsule. Finally, the iris was flipped over the flaps to ensure a fixation of the capsule inside of the capsulotomy. In all cases, the implantation of anterior capsule-fixated IOLs was possible. No complications occurred during surgery or within the first months after surgery. With the described technique, capsulefixated IOLs can be implanted in eyes with small pupil easily and safely. This type of IOL has great potential to improve the refractive outcome by better prediction of the postoperative IOL position and eliminating IOL rotation after cataract surgery. [J Refract Surg. 2017;33(8):568-570.]. Copyright 2017, SLACK Incorporated.

Management of linear quadratic regulator optimal control with full-vehicle control case study

Directory of Open Access Journals (Sweden)

Rodrigue Tchamna

2016-09-01

Full Text Available Linear quadratic regulator is a powerful technique for dealing with the control design of any linear and nonlinear system after linearization of the system around an operating point. For small systems, which have fewer state variables, the transformation of the performance index from scalar to matrix form can be straightforward. On the other hand, as the system becomes large with many state variables and controllers, appropriate design and notations should be defined to make it easy to automatically implement the technique for any large system without the need to redesign from scratch every time one requires a new system. The main aim of this article was to deal with this issue. This article shows how to automatically obtain the matrix form of the performance index matrices from the scalar version of the performance index. Control of a full-vehicle in cornering was taken as a case study in this article.

WIND TUNNEL EVALUATION FOR CONTROL TRANSITION FROM ELEVATOR TO STABILATOR OF SMALL UAV

Directory of Open Access Journals (Sweden)

ZULHILMY SAHWEE

2017-06-01

Full Text Available Faulty control surface actuator in a small Unmanned Aerial Vehicles (sUAV could be overcome with a few techniques. Redundant actuators, analytical redundancy or combination of both are normally used as fault accommodation techniques. In this paper, the accommodation technique of faulty elevator actuator is presented. This technique uses a standby control surface as temporary control reallocation. Wind tunnel measurement facility is set up for the experimental validation and it is compared with FoilSim software. Flat plate airfoil which was used as horizontal stabilizer, is simulated using numerical model and it is validated using the wind tunnel test. Then, a flat airfoil is designed to be used as stabilator for the recovery of faulty elevator actuator. Results show the different deflection angle is needed when transferring from one control surface to another. From the analysis, the proposed method could be implemented without affecting the pitch stability during control surface transition. The alternate control surface accommodation technique proves to be promising for higher reliability sUAV in the case of a faulty on-board actuator.

How To Set Up Your Own Small Business. Service Company Case Study. Manufacturing Firm Case Study. Retail Store Case Study.

Science.gov (United States)

Fallek, Max

This collection of case studies is intended for use in a course in setting up a small business. The first, a case study of the process of setting up a service company, covers analyzing the pros and cons of starting one's own business, assessing the competition and local market, and selecting a site for and financing the business. The principal…

Framework for Small-Scale Experiments in Software Engineering: Guidance and Control Software Project: Software Engineering Case Study

Science.gov (United States)

Hayhurst, Kelly J.

1998-01-01

Software is becoming increasingly significant in today's critical avionics systems. To achieve safe, reliable software, government regulatory agencies such as the Federal Aviation Administration (FAA) and the Department of Defense mandate the use of certain software development methods. However, little scientific evidence exists to show a correlation between software development methods and product quality. Given this lack of evidence, a series of experiments has been conducted to understand why and how software fails. The Guidance and Control Software (GCS) project is the latest in this series. The GCS project is a case study of the Requirements and Technical Concepts for Aviation RTCA/DO-178B guidelines, Software Considerations in Airborne Systems and Equipment Certification. All civil transport airframe and equipment vendors are expected to comply with these guidelines in building systems to be certified by the FAA for use in commercial aircraft. For the case study, two implementations of a guidance and control application were developed to comply with the DO-178B guidelines for Level A (critical) software. The development included the requirements, design, coding, verification, configuration management, and quality assurance processes. This paper discusses the details of the GCS project and presents the results of the case study.

A versatile and light-weight slow control system for small-scale applications

Science.gov (United States)

Zappa, P.; Bütikofer, L.; Coderre, D.; Kaminsky, B.; Schumann, M.; von Sivers, M.

2016-09-01

We present an open source slow control system for small and medium scale projects. Thanks to its modular and flexible design, where the various instruments are read and controlled by independent plugins, Doberman (Detector OBsERving and Monitoring ApplicatioN) can be quickly adapted for many applications, also making use of existing code or proprietary components. The system uses a SQL database to store the data from the instruments and provides an online application to display and browse through the data. It allows the modification of device settings while the program is running and features a protocol to handle exceptions, including the automated distribution of alarm messages. We present two case studies from astroparticle physics, on which Doberman is successfully deployed: a low-background screening facility installed in a remote underground laboratory and a detector R&D platform using cryogenic liquid xenon.

Comparing U.S. Army suicide cases to a control sample: initial data and methodological lessons.

Science.gov (United States)

Alexander, Cynthia L; Reger, Mark A; Smolenski, Derek J; Fullerton, Nicole R

2014-10-01

Identification of risk and protective factors for suicide is a priority for the United States military, especially in light of the recent steady increase in military suicide rates. The Department of Defense Suicide Event Report contains comprehensive data on suicides for active duty military personnel, but no analogous control data is available to permit identification of factors that differentially determine suicide risk. This proof-of-concept study was conducted to determine the feasibility of collecting such control data. The study employed a prospective case-control design in which control cases were randomly selected from a large Army installation at a rate of four control participants for every qualifying Army suicide. Although 111 Army suicides were confirmed during the study period, just 27 control soldiers completed the study. Despite the small control sample, preliminary analyses comparing suicide cases to controls identified several factors more frequently reported for suicide cases, including recent failed intimate relationships, outpatient mental health history, mood disorder diagnosis, substance abuse history, and prior self-injury. No deployment-related risk factors were found. These data are consistent with existing literature and form a foundation for larger control studies. Methodological lessons learned regarding study design and recruitment are discussed to inform future studies. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Medical malpractice in the management of small bowel obstruction: A 33-year review of case law.

Science.gov (United States)

Choudhry, Asad J; Haddad, Nadeem N; Rivera, Mariela; Morris, David S; Zietlow, Scott P; Schiller, Henry J; Jenkins, Donald H; Chowdhury, Naadia M; Zielinski, Martin D

2016-10-01

Annually, 15% of practicing general surgeons face a malpractice claim. Small bowel obstruction accounts for 12-16% of all surgical admissions. Our objective was to analyze malpractice related to small bowel obstruction. Using the search terms "medical malpractice" and "small bowel obstruction," we searched through all jury verdicts and settlements for Westlaw. Information was collected on case demographics, alleged reasons for malpractice, and case outcomes. The search criteria yielded 359 initial case briefs; 156 met inclusion criteria. The most common reason for litigation was failure to diagnose and timely manage the small bowel obstruction (69%, n = 107). Overall, 54% (n = 84) of cases were decided in favor of the defendant (physician). Mortality was noted in 61% (n = 96) of cases. Eighty-six percent (42/49) of cases litigated as a result of failing to diagnose and manage the small bowel obstruction in a timely manner, resulting in patient mortality, had a verdict with an award payout for the plaintiff (patient). The median award payout was $1,136,220 (range, $29,575-$12,535,000). A majority of malpractice cases were decided in favor of the defendants; however, cases with an award payout were costly. Timely intervention may prevent a substantial number of medical malpractice lawsuits in small bowel obstruction, arguing in favor of small bowel obstruction management protocols. Copyright © 2016 Elsevier Inc. All rights reserved.

Accounting for control mislabeling in case-control biomarker studies.

Science.gov (United States)

Rantalainen, Mattias; Holmes, Chris C

2011-12-02

In biomarker discovery studies, uncertainty associated with case and control labels is often overlooked. By omitting to take into account label uncertainty, model parameters and the predictive risk can become biased, sometimes severely. The most common situation is when the control set contains an unknown number of undiagnosed, or future, cases. This has a marked impact in situations where the model needs to be well-calibrated, e.g., when the prediction performance of a biomarker panel is evaluated. Failing to account for class label uncertainty may lead to underestimation of classification performance and bias in parameter estimates. This can further impact on meta-analysis for combining evidence from multiple studies. Using a simulation study, we outline how conventional statistical models can be modified to address class label uncertainty leading to well-calibrated prediction performance estimates and reduced bias in meta-analysis. We focus on the problem of mislabeled control subjects in case-control studies, i.e., when some of the control subjects are undiagnosed cases, although the procedures we report are generic. The uncertainty in control status is a particular situation common in biomarker discovery studies in the context of genomic and molecular epidemiology, where control subjects are commonly sampled from the general population with an established expected disease incidence rate.

Environmental Displacements: The Case of Small Island States

Directory of Open Access Journals (Sweden)

Marina R. Martins Mattar

2012-09-01

Full Text Available The human displacement caused by adverse weather conditions is, and has been for a long time, a natural strategy to adapt to environmental changes. However, the frequency of natural disasters and the negative impact of climate change have increased significantly affecting a growing number of people. Internal and external tensions caused by large-scale displacements, conflicts generated by resource scarcity, increased spread of diseases and geopolitical reordering are among the consequences linked to this phenomenon. The case of the small island nations that will be submerged by the sea level rise is an extreme example that raises fascinating questions. This article aims at analyzing the links of climate change on the dynamics of migration and exploring legal and political implications and possible solutions, in particular, for the populations from small island nations.

Small invasive colon cancer with systemic metastasis: A case report

Directory of Open Access Journals (Sweden)

Sakamoto Taku

2011-05-01

Full Text Available ABSTRACT Background Recently, especially in Japan, several researchers have suggested that colorectal cancer can develop not only through an adenoma-carcinoma sequence but also from normal mucosa via a de novo pathway, and that these de novo cancers have more aggressive malignant potential. We report a case of aggressive colon cancer resulting in systemic metastasis despite small tumour size. Case Presentation A 35-year-old woman presented at the referring hospital with swelling of the left cervical lymph node. Biopsy of the lymph node revealed metastatic adenocarcinoma; however, CT scan and mammography were unable to identify the site of the primary lesion. She was diagnosed with unknown primary cancer and referred to our hospital for further examination. Immunohistochemical reevaluation showed the cervical lymph node biopsy specimen to be positive for CDX2 and CK20 and negative for CK7 expression, leading us to suspect the presence of a primary colorectal cancer. We performed a total colonoscopy, and detected a small protruding lesion in the transverse colon. The tumour was only 12 mm in diameter, with a central depressed component and a severely thickened stalk, which suggested direct cancer invasion of the deep submucosa. We concluded that this lesion was the site of origin of the metastasis despite the small tumour size, and performed diagnostic endoscopic mucosal resection. The lesion was found to have an intramucosal cancer component, demonstrating that this lesion represented primary colon cancer. The patient was referred to the gastrointestinal oncology division for systemic chemotherapy. Conclusions In this case, immunohistochemical findings strongly suggested the existence of a colorectal cancer. The non-polypoid gross appearance of the tumour suggested that it can originate de novo , thus providing a valuable case in support of the aggressive malignant potential of a de novo colorectal cancer pathway.

Development of Production Control in Small Batch Production

Directory of Open Access Journals (Sweden)

Németh Péter

2016-01-01

Full Text Available Our aim with this paper is to develop a new performance measurement and control system for small batch production in the automotive industry. For this reason, we present our previous research results for warehouse performance measurement and adopt its methodology to production control. The proposed method is based on artificial intelligence (neural networks.

High risk human papillomavirus in the periodontium : A case control study

Directory of Open Access Journals (Sweden)

Anna Shipilova

2017-01-01

Full Text Available Background: Human papilloma viruses (HPVs are small DNA viruses that have been identified in periodontal pocket as well as gingival sulcus. High risk HPVs are also associated with a subset of head and neck carcinomas. It is thought that the periodontium could be a reservoir for HPV. Aims: 1. Detection of Human Papilloma virus (HPV in periodontal pocket as well as gingival of patients having localized chronic periodontitis and gingival sulcus of periodontally healthy subjects. 2. Quantitative estimation of E6 and E7 mRNA in subjects showing presence of HPV3. To assess whether periodontal pocket is a reservoir for HPV. Settings and Design: This case-control study included 30 subjects with localized chronic Periodontitis (cases and 30 periodontally healthy subjects (controls. Two samples were taken from cases, one from periodontal pocket and one from gingival sulcus and one sample was taken from controls. Methods and Materials: Samples were collected in the form of pocket scrapings and gingival sulcus scrapings from cases and controls respectively. These samples were sent in storage media for identification and estimation of E6/E7 mRNA of HPV using in situ hybridization and flow cytometry. Statistical analysis: Statistical analysis was done by using, mean, percentage and Chi Square test. A statistical package SPSS version 13.0 was used to analyze the data. P value < 0.05 was considered as statistically significant. Results: pocket samples as well as sulcus samples for both cases and controls were found to contain HPV E6/E7 mRNAInterpretation and Conclusion: Presence of HPV E6/E7 mRNA in periodontium supports the hypothesis that periodontal tissues serve as a reservoir for latent HPV and there may be a synergy between oral cancer, periodontitis and HPV. However prospective studies are required to further explore this link.

76 FR 71468 - Defense Federal Acquisition Regulation Supplement: Accelerate Small Business Payments (DFARS Case...

Science.gov (United States)

2011-11-18

... all small business concerns. In combination with the change to the regulations, DoD immediately began... Federal Acquisition Regulation Supplement: Accelerate Small Business Payments (DFARS Case 2011-D008... Regulation Supplement to accelerate payments to all small business concerns. DATES: Effective Date: November...

Content Marketing for Small/Medium Online Re-tailers: Case Lamnia

OpenAIRE

Ngo, Mai

2015-01-01

The aim of the study was to acquire a deeper knowledge of content marketing, its relevance to small and medium online retailing businesses, and to examine the implementation of content marketing strategy by the case company. The research is done in parallel with the case company’s marketing development activities, thus it also determines the effectiveness of different content marketing tactics that were used. The data for the theoretical part of this thesis was collected from secondary da...

European multi-centre case-control study on risk factors for rare cancers of unknown aetiology

DEFF Research Database (Denmark)

Lynge, Elsebeth; Afonso, Noemia; Kaerlev, Linda

2005-01-01

To search for occupational risk factors, we conducted a case-control study in nine European countries of cancers of the small intestine, male gall bladder, thymus, bone, male breast, melanoma of the eye, and mycosis fungoides. Recruitment was population based in Denmark, Latvia, France, Germany...... recruited 3374 population (61% interviewed) and 1284 colon cancer controls (86% interviewed). It was possible to undertake this complicated study across Europe, but we encountered three main problems. It was difficult to ensure complete case ascertainment, for population controls, we found a clear divide......, Italy, and Sweden, from hospital areas in Spain and Portugal, and from one United Kingdom (UK) hospital. We recruited 1457 cases (84% interviewed). Numbers identified corresponded to those in the EUROCIM database for Denmark, but were below those observed for France, Italy and Sweden in the database. We...

Methodology Series Module 2: Case-control Studies.

Science.gov (United States)

Setia, Maninder Singh

2016-01-01

Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same 'study base' as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive - particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases - selection bias and recall bias.

Growing magma chambers control the distribution of small-scale flood basalts.

Science.gov (United States)

Yu, Xun; Chen, Li-Hui; Zeng, Gang

2015-11-19

Small-scale continental flood basalts are a global phenomenon characterized by regular spatio-temporal distributions. However, no genetic mechanism has been proposed to explain the visible but overlooked distribution patterns of these continental basaltic volcanism. Here we present a case study from eastern China, combining major and trace element analyses with Ar-Ar and K-Ar dating to show that the spatio-temporal distribution of small-scale flood basalts is controlled by the growth of long-lived magma chambers. Evolved basalts (SiO2 > 47.5 wt.%) from Xinchang-Shengzhou, a small-scale Cenozoic flood basalt field in Zhejiang province, eastern China, show a northward younging trend over the period 9.4-3.0 Ma. With northward migration, the magmas evolved only slightly ((Na2O + K2O)/MgO = 0.40-0.66; TiO2/MgO = 0.23-0.35) during about 6 Myr (9.4-3.3 Ma). When the flood basalts reached the northern end of the province, the magmas evolved rapidly (3.3-3.0 Ma) through a broad range of compositions ((Na2O + K2O)/MgO = 0.60-1.28; TiO2/MgO = 0.30-0.57). The distribution and two-stage compositional evolution of the migrating flood basalts record continuous magma replenishment that buffered against magmatic evolution and induced magma chamber growth. Our results demonstrate that the magma replenishment-magma chamber growth model explains the spatio-temporal distribution of small-scale flood basalts.

A Survey of Control Issues in PMSG-Based Small Wind-Turbine Systems

DEFF Research Database (Denmark)

Orlando, Natalia Angela; Liserre, Marco; Mastromauro, Rosa Anna

2013-01-01

/position estimation, pitch control, braking chopper control, dc/dc converter control, and grid converter control. Specific issues for small wind-turbines arise in the wind energy extraction optimization and limitation and in the innovative concept of “universal” wind-turbine operation, that leads these system...... generators directly connected to the grid, while recently permanent magnet synchronous generators (PMSG) with power converter, either partially or fully controlled, became popular. This paper reviews the control issues related to these small wind-turbine systems: generator torque control, speed...

Familial colorectal cancer, can it be identified by microsatellite instability and chromosomal instability? - A case-control study

DEFF Research Database (Denmark)

Sunde, Lone; Bisgaard, Marie Luise; Soll-Johanning, Helle

2009-01-01

(Chromosome INstability=LOH (loss of heterozygosity) and/or DNA-aneuploidy (abnormal nuclear DNA contents)) could be used as predictors of familial CRC. Formalin-fixed tissue from 97 patients with CRC (29 patients with 2 or more affected first-degree relatives (="cases"), 29 matched CRC controls without......Colonoscopy is recommended for persons with a familial risk of colorectal cancer (CRC). A familial risk is identified by a family history with CRC and/or predisposing mutation(s). However, such information may not be available. We analysed whether MSI (MicroSatellite Instability) and/or CIN...... a family history, and 39 relatives to cases) were analysed for MSI and CIN. In this small case-control study, no significant differences in the frequencies of MSI and CIN were observed between cases with a family history and their controls without a family history. MSI+;CIN- was observed in 6/29 cases...

ECONOMIC PROMOTION OF A SMALL COUNTRY – THE CASE OF SLOVENIA

OpenAIRE

Dejan Romih

2014-01-01

This paper examines the economic promotion of a small country in the case of Slovenia. It also examines the economic diplomacy, whose main activity is the promotion of an economy, in the same case. For Slovenia, economic promotion, especially trade and investment promotion, is particularly important. One of the reasons for this is the importance of foreign trade and investment for its economic growth and development.

Plasma exchange in small intestinal transplantation between ABO-incompatible individuals: A case report

OpenAIRE

ZHANG, QIUHUI; HU, XINGBIN; XIA, AIJUN; YI, JING; AN, QUNXING; ZHANG, XIANQING

2013-01-01

The aim of this study was to investigate the application of plasma exchange in small intestinal transplantation between ABO blood type-incompatible patients. A small intestinal transplantation case between ABO-incompatible individuals is hereby presented and analyzed. The main treatment included plasma exchange, splenectomy and immunosuppression. The patient undergoing small intestinal transplantation exhibited stable vital signs. A mild acute rejection reaction developed ~2 weeks after the s...

Stable Hovering Flight for a Small Unmanned Helicopter Using Fuzzy Control

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Arbab Nighat Khizer

2014-01-01

Full Text Available Stable hover flight control for small unmanned helicopter under light air turbulent environment is presented. Intelligent fuzzy logic is chosen because it is a nonlinear control technique based on expert knowledge and is capable of handling sensor created noise and contradictory inputs commonly encountered in flight control. The fuzzy nonlinear control utilizes these distinct qualities for attitude, height, and position control. These multiple controls are developed using two-loop control structure by first designing an inner-loop controller for attitude angles and height and then by establishing outer-loop controller for helicopter position. The nonlinear small unmanned helicopter model used comes from X-Plane simulator. A simulation platform consisting of MATLAB/Simulink and X-Plane© flight simulator was introduced to implement the proposed controls. The main objective of this research is to design computationally intelligent control laws for hovering and to test and analyze this autopilot for small unmanned helicopter model on X-Plane under ideal and mild turbulent condition. Proposed fuzzy flight controls are validated using an X-Plane helicopter model before being embedded on actual helicopter. To show the effectiveness of the proposed fuzzy control method and its ability to cope with the external uncertainties, results are compared with a classical PD controller. Simulated results show that two-loop fuzzy controllers have a good ability to establish stable hovering for a class of unmanned rotorcraft in the presence of light turbulent environment.

The effect of control parameters to the quality of small-scale wood pellet combustion

Energy Technology Data Exchange (ETDEWEB)

Ruusunen, M. (Oulu Univ. (Finland). Contol Engineering Lab.), Email: mika.ruusunen@oulu.fi; Korpela, T.; Bjoerkqvist, T. (Tampere Univ. of Technology (Finland). Dept. of Automation Science and Engineering), Email: timo.korpela@tut.fi, Email: tomas.bjorqvist@tut.fi

2009-07-01

The target is to clear out control variables and requirements for clean small-scale wood pellet combustion (<100 kW{sub th}). Experimental runs were carried out in the form of design of experiments (DOE) with two commercial 15 kW pellet burners, namely a horizontal gas-burner and a conventional horizontal burner in a 20 kW commercial pellet boiler. Analysed variables were fuel power, draught, air flows, and fuel feed period, and research variables were CO, O{sub 2} and efficiency. The target was to identify and characterise separately the magnitude and direction of the effect of each factor. After process identification and variable optimisation, the results show strong influence of the studied control parameters on the efficiency and the emissions. The effects and interactions between different process variables were rather similar with both burners. The major effects for CO levels were fuel feed and additionally draught affected in case of wood gas combustion. Additionally, the effects on combustion efficiency is described by draught, air feed and fuel feed period. Furthermore, the fuel feed period affected the excess air level in case of direct combustion principle. It was noticed, however, that the combustion properties and optimal parameter values vary significantly between the two cases. (orig.)

Current trends in small vocabulary speech recognition for equipment control

Science.gov (United States)

Doukas, Nikolaos; Bardis, Nikolaos G.

2017-09-01

Speech recognition systems allow human - machine communication to acquire an intuitive nature that approaches the simplicity of inter - human communication. Small vocabulary speech recognition is a subset of the overall speech recognition problem, where only a small number of words need to be recognized. Speaker independent small vocabulary recognition can find significant applications in field equipment used by military personnel. Such equipment may typically be controlled by a small number of commands that need to be given quickly and accurately, under conditions where delicate manual operations are difficult to achieve. This type of application could hence significantly benefit by the use of robust voice operated control components, as they would facilitate the interaction with their users and render it much more reliable in times of crisis. This paper presents current challenges involved in attaining efficient and robust small vocabulary speech recognition. These challenges concern feature selection, classification techniques, speaker diversity and noise effects. A state machine approach is presented that facilitates the voice guidance of different equipment in a variety of situations.

Small bowel perforation due to fish bone: A case report

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Huseyin Pulat

2015-09-01

Full Text Available Accidental ingestion of foreign bodies are a common condition in clinical practice. However, small bowel perforation which dues to ingestion foreign bodies has been rarely seen. In this article, we report a case of small bowel perforation which dues to ingestion foreign body. A 80-year-old female patient, presenting with complaints of acute abdomen, was admitted to the emergency department. She denied abdominal pain, nausea and vomiting. The patient had tenderness and defense on the right lower quadrant. Contrast enhanced abdominal computed tomography has been used on the patient's diagnosis. This revealed small bowel perforation due to the ingestion of foreign body. The patient was operated emergency. A microperforation due to fish bone was detected on the terminal ileum. The patient underwent debridement and primary repair. The patient was discharged postoperative 7th day without problem. Bowel perforation due to the ingestion of foreign bodies should be considered in the differential diagnosis of acute abdomen. Keywords: Foreign body, Small intestine, Perforation

Association between bullous pemphigoid and neurologic diseases: a case-control study.

Science.gov (United States)

Casas-de-la-Asunción, E; Ruano-Ruiz, J; Rodríguez-Martín, A M; Vélez García-Nieto, A; Moreno-Giménez, J C

2014-11-01

In the past 10 years, bullous pemphigoid has been associated with other comorbidities and neurologic and psychiatric conditions in particular. Case series, small case-control studies, and large population-based studies in different Asian populations, mainland Europe, and the United Kingdom have confirmed this association. However, no data are available for the Spanish population. This was an observational, retrospective, case-control study with 1:2 matching. Fifty-four patients with bullous pemphigoid were selected. We compared the percentage of patients in each group with concurrent neurologic conditions, ischemic heart disease, diabetes, chronic obstructive pulmonary disease, and solid tumors using univariate logistic regression. An association model was constructed with conditional multiple logistic regression. The case group had a significantly higher percentage of patients with cerebrovascular accident and/or transient ischemic attack (odds ratio [OR], 3.06; 95% CI, 1.19-7.87], dementia (OR, 5.52; 95% CI, 2.19-13.93), and Parkinson disease (OR, 5; 95% CI, 1.57-15.94). A significantly higher percentage of cases had neurologic conditions (OR, 6.34; 95% CI, 2.89-13.91). Dementia and Parkinson disease were independently associated with bullous pemphigoid in the multivariate analysis. Patients with bullous pemphigoid have a higher frequency of neurologic conditions. Copyright © 2013 Elsevier España, S.L.U. and AEDV. All rights reserved.

Four cases of small, traumatic hemorrhage in the deep midline portion of the brain

International Nuclear Information System (INIS)

Kim, Suho; Tsukahara, Tetsuya; Iwama, Mitsuru; Nishikawa, Michio

1981-01-01

Four cases recently encountered are presented in which computerized tomography (CT) demonstrated a small, traumatic hemorrhage in the deep midline portion of the brain. The lesions of hemorrhage revealed by CT were: Case 1, in the septum pellucidum and left lateral ventricle; Case 2, in the Monro's foramen and right lateral ventricle and Case 3, midbrain. These three cases had no other abnormal findings. In addition, a hemorrhage of the corpus callosum and diffuse brain damage were seen in Case 4. These small hemorrhages might be caused not only by the direct damage, but also by a local tendency to bleed due to hystoiogical fragility or the existence of a vascular anomaly, such as AVM or cryptic angioma. The prognoses quod vitam of our cases were relatively better than the previous reports of these hemorrhages, but the prognoses quod functionem were poor. The patients have shown prolonged psychoneurological disorder; these symptoms might be caused by damage to the limbic system. (author)

Small Bowel Volvulus Induced by Mesenteric Lymphangioma in an Adult: a Case Report

Energy Technology Data Exchange (ETDEWEB)

Jang, Jin Hee; Lee, Su Lim; Ku, Young Mi; An, Chang Hyeok; Chang, Eun Deok [Uijeongbu St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu (Korea, Republic of)

2009-06-15

Mesenteric lymphangiomas are rare abdominal masses that are seldom associated with small bowel volvulus, and especially in adult patients. We report here on an unusual case of small bowel volvulus that was induced by a mesenteric lymphangioma in a 43-year-old man who suffered from repeated bouts of abdominal pain. At multidetector CT, we noticed whirling of the cystic mesenteric mass and the adjacent small bowel around the superior mesenteric artery. Small bowel volvulus induced by the rotation of the mesenteric lymphangioma was found on exploratory laparotomy. Lymphangioma should be considered as a rare cause of small bowel volvulus in adult patients.

Risk-oriented internal control: The essence, management methods at small enterprises

OpenAIRE

Piskunov, V. A.; Manyayeva, V. A.; Tatarovskaya, T. E.; Bychkova, E. Y.

2016-01-01

The research topic relevance is inspired by necessity to develop theoretical and methodical provisions on the internal control system, risk-based management at small enterprises and to prove application feasibility, using economic-mathematical methods its implementation. The purpose of this research is to develop theoretical and methodical approaches to internal control system formation in small businesses, generating reliable and relevant information on the commercial organization activities...

The 'grey area' between small cell and non-small cell lung carcinomas. Light and electron microscopy versus clinical data in 14 cases

NARCIS (Netherlands)

Mooi, W. J.; van Zandwijk, N.; Dingemans, K. P.; Koolen, M. G.; Wagenvoort, C. A.

1986-01-01

We studied 14 lung tumours which on light microscopy had posed difficulties on classification as either small cell or non-small cell carcinomas. The light and electron microscopical features were compared with patient follow-up data. Electron microscopy showed neuroendocrine granules in 12 cases,

Analgesics use and ESRD in younger age: a case-control study

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Moehner Sabine

2007-12-01

1365 controls showed a significantly decreased risk, a tiny subgroup of extreme users with over 3.5 kg lifetime use (19 cases and 11 controls showed a significant risk increase. The detailed evaluation of 22 cases and 19 controls with over 2.5 kg lifetime use recommended by the regulatory advisors showed an impressive excess of other conditions than analgesics triggering the evolution of ESRD in cases compared with controls. Conclusion We found no clinically meaningful evidence for an increased risk of ESRD associated with use of phenacetin-free analgesics in single or combined formulation. The apparent risk increase shown in a small subgroup with extreme lifetime dose of analgesics is most likely an indirect, non-causal association. This hypothesis, however, cannot be confirmed or refuted within our case-control study. Overall, our results lend support to the mounting evidence that phenacetin-free analgesics do not induce ESRD and that the notion of "analgesic nephropathy" needs to be re-evaluated.

Case report 331: Small cell osteosarcoma of the tibia with diffuse metastatic disease

International Nuclear Information System (INIS)

Roessner, A.; Miebs, T.; Grundmann, E.; Immenkamp, M.; Hiddemann, W.; Althoff, J.

1985-01-01

In summary, the case is presented of a 29-year-old woman who developed a sclerosing small-cell osteosarcoma in the upper end of the tibia. The unique features in this case are reflected both in its morphology and protracted clinical course, while its histological pattern resembles in some features a small cell variant of the highly malignant osteosarcoma described by Sim and Martin. In addition to the unusual clinical course, the failure in response to chemotherapy underscores that this tumor differed in its biological behavior from other highly malignant types of osteosarcoma. The importance of DNA analysis is stressed. (orig./WU)

Model Predictive Control for a Small Scale Unmanned Helicopter

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Jianfu Du

2008-11-01

Full Text Available Kinematical and dynamical equations of a small scale unmanned helicoper are presented in the paper. Based on these equations a model predictive control (MPC method is proposed for controlling the helicopter. This novel method allows the direct accounting for the existing time delays which are used to model the dynamics of actuators and aerodynamics of the main rotor. Also the limits of the actuators are taken into the considerations during the controller design. The proposed control algorithm was verified in real flight experiments where good perfomance was shown in postion control mode.

Small bowel obstruction secondary to migration of a fragment of lithobezoar: a case report.

LENUS (Irish Health Repository)

Medani, Mekki

2009-01-01

INTRODUCTION: Small bowel obstruction is a common world-wide condition that has a range of etiological factors. The management is largely dependent on the cause of the obstruction. Small bowel obstruction caused by foreign body ingestion is rare; many items have been reported as responsible, but there are no reports implicating polyurethane foam. CASE PRESENTATION: We report the case of a 44-year-old Irish male who presented following ingestion of polyurethane foam. He was asymptomatic on presentation but developed a small bowel obstruction shortly thereafter. CONCLUSION: Patients presenting following ingestion of polyurethane foam should be scheduled for elective laparotomy, gastrotomy, and retrieval of the cast on the next available theatre list - given that they are suitable for surgery.

Hospital visitors as controls in case-control studies

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Gulnar Azevedo S Mendonça

2001-10-01

Full Text Available OBJECTIVE: Selecting controls is one of the most difficult tasks in the design of case-control studies. Hospital controls may be inadequate and random controls drawn from the base population may be unavailable. The aim was to assess the use of hospital visitors as controls in a case-control study on the association of organochlorinated compounds and other risk factors for breast cancer conducted in the main hospital of the "Instituto Nacional de Câncer" -- INCA (National Cancer Institute in Rio de Janeiro (Brazil. METHODS: The study included 177 incident cases and 377 controls recruited among female visitors. Three different models of control group composition were compared: Model 1, with all selected visitors; Model 2, excluding women visiting relatives with breast cancer; and Model 3, excluding all women visiting relatives with any type of cancer. Odds ratios (OR and 95% confidence intervals were calculated to test the associations. RESULTS: Age-adjusted OR for breast cancer associated with risk factors other than family history of cancer, except smoking and breast size, were similar in the three models. Regarding family history of all cancers, except for breast cancer, there was a decreased risk in Models 1 and 2, while in Model 3 there was an increased risk, but not statistically significant. Family history of breast cancer was a risk factor in Models 2 and 3, but no association was found in Model 1. In multivariate analysis a significant risk of breast cancer was found when there was a family history of breast cancer in Models 2 and 3 but not in Model 1. CONCLUSIONS: These results indicate that while investigating risk factors unrelated to family history of cancer, the use of hospital visitors as controls may be a valid and feasible alternative.

Colon cancer risk and different HRT formulations: a case-control study

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Thai Do

2007-05-01

Full Text Available Abstract Background Most studies have found no increased risk of colon cancer associated with hormone replacement therapy (HRT, or even a decreased risk. But information about the effects of different HRT preparations is lacking. Methods A case-control study was performed within Germany in collaboration with regional cancer registries and tumor centers. Up to 5 controls were matched to each case of colon cancer. Conditional logistic regression analysis was applied to estimate crude and adjusted odds ratios (OR and 95% confidence intervals (95% CI. Stratified analyses were performed to get an impression of the risk associated with different estrogens and progestins. Results A total of 354 cases of colon cancer were compared with 1422 matched controls. The adjusted overall risk estimate for colon cancer (ColC associated with ever-use of HRT was 0.97 (0.71 – 1.32. No clinically relevant trends for ColC risk were observed with increasing duration of HRT use, or increasing time since first or last HRT use in aggregate. Whereas the overall risk estimates were stable, the numbers in many of the sub-analyses of HRT preparation groups (estrogens and progestins were too small for conclusions. Nevertheless, if the ColC risk estimates are taken at face value, most seemed to be reduced compared with never-use of HRT, but did not vary much across HRT formulation subgroups. In particular, no substantial difference in ColC risk was observed between HRT-containing conjugated equine estrogens (CEE or medroxyprogesterone acetate (MPA and other formulations more common in Europe. Conclusion Ever-use of HRT was not associated with an increased risk of colon cancer. In contrary, most risk estimates pointed non-significantly toward a lower ColC risk in HRT ever user. They did not vary markedly among different HRT formulations (estrogens, progestins. However, the small numbers and the overlapping nature of the subgroups suggest cautious interpretation.

A very rare case of a small bowel leiomyosarcoma leading to ileocaecal intussusception treated with a laparoscopic resection: a case report and a literature review.

Science.gov (United States)

Guzel, Tomasz; Mech, Katarzyna; Mazurkiewicz, Michał; Dąbrowski, Bohdan; Lech, Gustaw; Chaber, Andrzej; Słodkowski, Maciej

2016-02-24

Small bowel tumours are rare and comprise less than 2% of all primary gastrointestinal neoplasms. Among these tumours, a leiomyosarcoma belonging to soft tissue sarcomas is extremely rare and accounts for about 1 % of malignant mesenchymal lesions in the gastrointestinal tract. Due to its aggressive nature and slow growth, it is often diagnosed at the late stage when curative treatment is impossible. Authors report a first case of leiomyosarcoma with chronic recurrent ileocaecal intussusception and literature review to analyse diagnosis and treatment features of the ileum mesenchymal tumours. We present a case of an 87-year-old Caucasian man suffering from cramp-like abdominal pain for months. Due to lack of clinical signs and unspecific complaints, a diagnosis was delayed. Despite a detailed in-hospital examination, a proper diagnosis was established as late as during an operation. The patient was treated by surgery with good results. An uncommon laparoscopic resection of the small bowel with a tumour was performed. A histopathological investigation confirmed a very rare mesenchymal lesion of the distal ileum. The patient is under control with no recurrence for 1 year of the follow-up period. Reported case indicates that a usually asymptomatic tumour can cause uncommon chronic recurrent ileus signs. CT and MRI scans are investigation of choice in such cases, but they are sometimes inconclusive. It might be worth highlighting the good results of laparoscopic leiomyosarcoma lesion resection with a very good outcome.

A small intestine volvulus caused by strangulation of a mesenteric lipoma: a case report.

Science.gov (United States)

Kakiuchi, Yoshihiko; Mashima, Hiroaki; Hori, Naoto; Takashima, Hirotoshi

2017-03-13

An emergency department encounters a variety of cases, including rare cases of the strangulation of a mesenteric lipoma by the greater omentum band. A 67-year-old Japanese man presented with nausea, vomiting, and upper abdominal pain. There were no abnormalities detected by routine blood tests other than a slight rise in his white cell count. A contrast-enhanced computed tomography scan of his abdomen revealed a dilated intestine, a small intestine volvulus, and a well-capsulated homogeneous mass. He was suspected of having a small intestine volvulus that was affected by a mesenteric lipoma; therefore, single-port laparoscopic surgery was performed. Laparoscopy revealed a small intestine volvulus secondary to the strangulation of a mesenteric lipoma. The band and tumor were removed. He had no postoperative complications and was discharged on postoperative day 6. Although this case was an emergency, it showed that single-port laparoscopic surgery can be a safe, useful, and efficacious procedure.

Seismicity Controlled by a Frictional Afterslip During a Small-Magnitude Seismic Sequence (ML Taiwan

Science.gov (United States)

Canitano, Alexandre; Godano, Maxime; Hsu, Ya-Ju; Lee, Hsin-Ming; Linde, Alan T.; Sacks, Selwyn

2018-02-01

We report evidence for frictional afterslip at shallow depths (about 5 to 7 km) during a small-magnitude seismic sequence (with MLTaiwan. The afterslip, which was recorded by a nearby borehole dilatometer, lasted about a month with a cumulative geodetic moment magnitude of 4.8 ± 0.2. The afterslip comprised two stages and controlled the aftershock sequence. The first postseismic stage, which followed a ML 4.6 earthquake, lasted about 6 h and mostly controlled the ruptures of neighboring asperities (e.g., multiplets) near the hypocenter. Then, a 4 week duration large afterslip event following a ML 4.9 earthquake controlled the rate of aftershocks during its first 2 days through brittle creep. The study presents a rare case of simultaneous seismological and geodetic observations for afterslip following earthquakes with magnitude lower than 5. Furthermore, the geodetic moment of the postseismic phase is at least equivalent to the coseismic moment of the sequence.

Vitamin D Status in Small Vessel and Large Vessel Ischemic Stroke Patients: A Case–control Study

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Navid Manouchehri

2017-01-01

Full Text Available Background: Vitamin D insufficiency is a globally widespread issue. Recent studies have reported a high prevalence of Vitamin D deficiency in Middle-East countries. Studies have shown negative effects of Vitamin D deficiency on endothelium and related diseases such as ischemic brain stroke. Here, we assessed Vitamin D status in patients with different types of ischemic brain stroke and control group. Materials and Methods: Seventy-five patients (49.3% small vessel, 50.7% large vessel and 75 controls, matched for age (68.01 ± 10.94 vs. 67.64 ± 10.24 and sex (42 male and 33 female were recruited. 25(OH D levels were measured by Chemiluminescence immunoassay. 25(OH D status was considered as severely, moderately, or mildly deficient and normal with 25(OH D levels of less than 5, 5-10, 10-16, and> 16 ng/ml, respectively. Results: Mean ± standard error concentration of 25(OH D in cases and controls were 17.7 ± 1.5 and 26.9 ± 1.6 (P = 0.0001, respectively. Mild, moderate, and severe Vitamin D deficiency were observed in 10.8%, 32.4%, 8.1% vs. 34.3%, 31.5%, 9.5% of small vessel and large vessel group, respectively. 21.7% of the controls were Vitamin D deficient. Vitamin D deficiency was significantly associated with higher risk for ischemic stroke, (P = 0.000, OR = 7.17, 95% confidence interval: 3.36–15.29. 25(OH D levels were significantly higher in control group comparing to small vessel (26.9 ± 1.6 vs. 20.59 ± 2.6 P < 0.05 and large vessel (26.9 ± 1.6 vs. 13.4 ± 1.3 P < 0.001 stroke patients. Small vessel group had significantly higher levels of Vitamin D than large vessel (P < 0.05. Conclusion: Vitamin D deficiency significantly increases the risk of ischemic stroke, favoring the types with the pathogenesis of large vessel strokes.

Erlotinib in previously treated non-small-cell lung cancer

International Nuclear Information System (INIS)

Smrdel, U.; Kovac, V.

2006-01-01

Background. Erlotinib is a novel biological anti-tumour agent in the treatment of advanced non small cell lung cancer. It represents the molecularly-targeted therapy which has been studied extensively. Case report. We present a case of a patient who suffered from advanced non-small-cell lung cancer. After the progress of disease following a prior chemotherapy he was treated with erlotinib with remarkable effect which was shown at chest x ray and symptoms were quite reduced. Conclusions. In selected patients with advanced non-small-cell lung cancer Erlotinib improves survival and symptom control as it results in presented case. (author)

Nostalgia, Commodification of Emotions and Small-town Tourism: The Case of Vintage Vila

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Pavlakovič Barbara

2016-12-01

Full Text Available Small urban environments face many issues in tourism; for example, how to position themselves in contrast to the larger cities and how to provide adequate tourist facilities for their guests. In the case of positioning, they have to choose something different and attractive. And in the case of infrastructure, small cities are primarily meant for their residents and have plenty residential buildings but lack of tourist accommodation buildings. The article attempts to reflect on specific contemporary form of “consumed nostalgia” (Cross, 2015 that is characteristic of the era of modern consumer society and offer an example of how its potential could be employed in tourism, particular in small urban environments with significant implications of preserving abandoned properties and thus existing architectural and cultural heritage. An analysis of Vintage Vila accommodation facility that is located in small city of Brežice, Slovenia, was conducted in order to acquaint the potential of a specific form of nostalgia tourism. After an interview with Vintage Vila founder, a review of their Facebook site and the responses of the visitors was made. Additionally the study of media coverage of Vintage Vila was completed to understand the discursive construction of a unique narrative of the place. The basic objective of this paper is to describe this innovative solution for the preservation of architectural and cultural heritage of small urban environments. With the case study of Vintage Vila accommodation facility we hope to encourage other small cities to recognise their potential in abandoned buildings. Restoration of such facilities can open up new possibilities in tourism and may, together with thoughtfully chosen narratives that emotionally bound people to their material environment, contribute to a revitalization of small cities. What is more, tourism development grounded in vintage and nostalgia appeals should be considered as part of a call for

Effects of casing treatment on a small, transonic axial-flow compressor

Science.gov (United States)

Holman, F. F.; Kidwell, J. R.

1975-01-01

Improved axial compressor surge margin through effective rotor casing treatment has been identified from test results on large axial compressors. A modified scale of a large compressor was built and tested to determine if similar improvements in surge margin could be duplicated in small-size turbomachinery. In addition, the effects of rotor radial running clearance, both with and without casing treatment, were investigated and are discussed. Test results of the scale configuration are presented and compared to the parent compressor.

Obstacles to Small Innovative Companies’ Development: Case Study of Nizhny Novgorod Region

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Nadezhda Butryumova

2015-12-01

Full Text Available The article presents the survey results of obstacles to small innovative companies as a case study of Nizhny Novgorod region of Russia as an area with high innovative potential and great level of socio-economic indicators. Based on the semi-structural personal interviews with 19 experts - the management of support infrastructure, results shows some typical for this region impediments: bureaucracy; lack of trust, poor collaboration within the innovation system; poor information support; legislative obstacles to innovations and intellectual property protection; low interest of large companies in collaboration with small ones. The findings and recommendations can help policy-makers to meet the needs of small innovative companies, and increase the innovative activity of small firms through the improvement of the assistance programs.

Organohalogen body burdens in a breast cancer case-control study

Energy Technology Data Exchange (ETDEWEB)

Petreas, M.; She, J.; Visita, P.; Winkler, J. [Hazardous Materials Lab., California Dept. of Toxic Substances Control, Berkeley, CA (United States); Hurley, S.; Smith, D.; Reynolds, P. [Environmental Health Investigations Branch, California Dept. of Health Services, Oakland, CA (United States); Jeffrey, S.; Mahoney, E. [Dept. of Surgery, Stanford Univ. School of Medicine, Stanford, CA (United States)

2004-09-15

Due to their lipophilic properties, dioxins (PCDD/PCDFs) and other organohalogen compounds bioaccumulate in the food chain, with diet accounting for over 90% of non-occupational exposures. To date, few epidemiologic studies have examined the relationship between dioxins and breast cancer in human populations. Most have examined risks in occupational cohorts or in populations exposed to dioxins from the Seveso accident6-8. Results from these studies have been conflicting and have largely been limited by a lack of individual-level measures of exposure, small numbers of cases, and inability to account for established breast cancer risk factors. Very little is known about the potential health effects of low-level environmental dioxin contamination. We present data on PCDD/PCDFs, organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDEs) in adipose tissues of women participating in a breast cancer case-control study centered in the San Francisco Bay Area. In addition, we examine distributions of these chemicals in breast and abdominal adipose of women undergoing mastectomies with concurrent breast reconstruction. If concentrations were equivalent, use of abdominal adipose would greatly enhance the pool for controls for future epidemiological studies.

Case-Control Study of Risk Factors Associated with Feline and Canine Chronic Kidney Disease

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Paul C. Bartlett

2010-01-01

Full Text Available An age-matched case-control study was initiated to determine the major risk factors associated with CKD in cats and dogs and to determine what clinical signs cat and dog owners observed before their veterinarian diagnosed their pet with CKD. When compared to controls, the feline cases were more likely to have had polydipsia and polyuria in the year before the owners' cats were diagnosed with CKD. In the dogs, increased water intake, increased urination, small size and a recent history of weight loss and bad breath were noticed by the dog owners before veterinary CKD diagnosis. Dog owners recognized abnormal drinking and urination behavior over half a year before their pet's veterinary diagnosis with CKD, and they recognized weight loss almost 4 months before CKD diagnosis. Bad breath was noticed 1.2 years before recognition of CKD by a veterinarian. Given that earlier CKD diagnosis should have been possible in most cases, clinical trials should proceed to measure the efficacy of early interventions.

Electronic Control Of Small Hydro-Generators Part II

International Nuclear Information System (INIS)

Diaz B, Pedro; Torres M, Carlos A.

1994-01-01

The present project arises for the Colombian population's necessity to overcome the underdevelopment, the poverty, the education and the level of life in rural areas of difficult access, for an economic rural electrification. The UIS, by means of the advisory committee of investigations of the ability of Physical-mechanical Sciences and the ability of Electricity and Electronic, it begins the process of developing in 1991 a study of economic and reliable control for the handling of small micro-centrals. Providing from electric power to the rural sector is a world problem, and have more than enough this some countries (China, Nepal, Peru, The islands of Papua, New Guinea), they have made investigations, outlining and building central micro controlled by microprocessor. The present study is developed with the objective of carrying out a load control that acts reliable and quickly. Traditionally they have been come using mechanical governors, which are those in charge of making the load control by means of valves that regulate the flow of water in the turbines, involving this way big retards characteristic of any mechanical control. In summary, the electronic governor of load presents on the mechanical governor, the advantage of acting to more speed and consequently to maintain stable the frequency of the system. To continue with the study, the objective that this project must develop, is an electronic control of load which presents to a small hydro generator, a relatively constant and independent electric load that the demanded consumption for the user varies from none to full load, given as initial parameters a constant flow in the turbine and a control in the line tension. This way it seeks to improve the energy quality given by isolated generators

Small bowel perforation without tumor recurrence after radiotherapy for cervical carcinoma: report of seven cases.

Science.gov (United States)

Yamashita, Hideomi; Nakagawa, Keiichi; Tago, Masao; Igaki, Hiroshi; Shiraishi, Kenshirou; Nakamura, Naoki; Sasano, Nakashi; Yamakawa, Sen; Ohtomo, Kuni

2006-04-01

We describe the clinical presentation, evaluation, management and outcome of patients experiencing small bowel perforation following radiation therapy for cervical cancer. A database consisting of 95 Japanese women with stage 0-4 A cervix cancer treated between 1991 and 2004 contained seven patients (7.4%) with small bowel perforation. The median age at the time of perforation was 72.5 years (range 62-78). The median time from completion of radiotherapy to perforation was 6 months (range 2-58). Surgery (one small bowel resection and anastomosis with diversion; six small bowel resection and anastomosis) was performed immediately in all seven patients. One of seven patients died of small bowel perforation (i.e. mortality rate was 14%). Bowel adhesion was detected during the operation in only three cases (43%). Signs of peritonitis were absent in six cases (86%). Severe abdominal pain was seen in all seven patients. The perforation site was ileum in all seven cases. In all patients, pathological changes were compatible with postirradiation injury of the gastrointestinal tract. The presenting complaints of patients with bowel perforation following radiotherapy vary, and signs of peritonitis may be absent. Emergency physicians must be alert for these complications in patients who have been treated with radiotherapy.

Segmental small bowel necrosis associated with antiphospholipid syndrome: a case report.

Science.gov (United States)

Wang, Qun-Ying; Ye, Xiao-Hua; Ding, Jin; Wu, Xiao-Kang

2015-04-07

Antiphospholipid syndrome is a multi-system disease characterized by the formation of thromboembolic complications and/or pregnancy morbidity, and with persistently increased titers of antiphospholipid antibodies. We report the case of a 50-year-old, previously healthy man who presented with fever and new-onset, dull abdominal pain. A contrast-enhanced computed tomography scan showed segmental small bowel obstruction, for which an emergency laparotomy was performed. Histopathologic examination of resected tissues revealed multiple intestinal and mesenteric thromboses of small vessels. Laboratory tests for serum antiphospholipid (anticardiolipin IgM) and anti-β2-glycoprotein I antibodies were positive. Despite proactive implementation of anticoagulation, steroid, and antibiotic therapies, the patient's condition rapidly deteriorated, and he died 22 d after admission. This case highlights that antiphospholipid syndrome should be suspected in patients with unexplainable ischemic bowel and intestinal necrosis presenting with insidious clinical features that may be secondary to the disease, as early diagnosis is critical to implement timely treatments in order to ameliorate the disease course.

Small bowel obstruction and perforation after Essure sterilization: a case report.

Science.gov (United States)

Mantel, Hendrik T J; Wijma, Jacobus; Stael, Adrianus P M

2013-01-01

We present a rare but serious complication of Essure microinsert sterilization. Case report. A 42-year-old woman presented with nausea, vomiting, abdominal pain and abdominal distension 1 month after uncomplicated Essure sterilization. Abdominal X-ray showed small bowel obstruction. At subsequent laparotomy, a stretched Essure device was found ensnaring the terminal ileum. It had caused strangulation and local perforation of the bowel wall. The device was removed and an ileocecal resection with side-to-side ileocolostomy was performed. In retrospect, the aberrant location of the right Essure device near the ileocecal junction was noticed on the abdominal X-ray. This case illustrates that perforation of an Essure device can result in a serious complication leading to ileocecal resection. An abdominal X-ray with specific attention to the correct location of the Essure coils is advisable for patients presenting with small bowel obstruction after Essure sterilization. Copyright © 2013 Elsevier Inc. All rights reserved.

A Case-Control Study of Risk Factors for Salivary Gland Cancer in Canada

Directory of Open Access Journals (Sweden)

Sai Yi Pan

2017-01-01

Full Text Available Aim. To assess the effect of various lifestyle risk factors on the risk of salivary gland cancer in Canada using data from a population-based case-control study. Methods. Data from a population-based case-control study of 132 incident cases of salivary gland cancer and 3076 population controls were collected through self-administered questionnaire and analysed using unconditional logistic regression. Results. Four or more servings/week of processed meat product was associated with an adjusted odds ratio (OR and corresponding 95% confidence interval (CI of 1.62 (1.02–2.58. Nonsignificantly increased ORs were also related to obesity, >7 drinks/week of alcohol consumption, and occupational exposure to radiation. Furthermore, nonsignificantly decreased ORs were found to be associated with high education level (>12 years (OR=0.65, high consumption of spinach/squash (OR=0.62 and all vegetables/vegetable juices (OR=0.75, and >30 sessions/month of recreational physical activity (OR=0.78. Conclusions. This study suggests positive associations with consumption of processed meat, smoking, obesity, alcohol drinking, and occupational exposure to radiation as well as negative associations with higher education, consumption of spinach/squash, and physical activity, which suggest a role of lifestyle factors in the etiology of salivary gland cancer. However, these findings were based on small number of cases and were nonsignificant. Further larger studies are warranted to confirm our findings.

Importance of woodlots to local communities, small scale entrepreneurs and indigenous forest conservation – A case study

CSIR Research Space (South Africa)

Ham, C

2000-01-01

Full Text Available forestry, South Africa The Importance of Woodlots to Local Communities, Small-scale Entrepreneurs and Indigenous Forest Conservation A case study Cori Ham ii The Importance of Woodlots to Local Communities, Small Scale Entrepreneurs... by the financial support of the UK Department for International Development and the European Commission iii Citation: Ham, C. 2000. The importance of woodlots to local communities, small scale entrepreneurs and indigenous forest conservation– A case study...

"Clean, green and ethical" animal production. Case study: reproductive efficiency in small ruminants.

Science.gov (United States)

Martin, Graeme B; Kadokawa, Hiroya

2006-02-01

In response to changes in society and thus the marketplace, we need a vision for the future of our animal industries, including both on-farm and off-farm activities, that is "clean, green and ethical". Using small ruminants as a case study, we describe three "clean, green and ethical" strategies that farmers could use to improve reproductive performance. The first allows control of the timing of reproductive events by using socio-sexual signals (the "male effect") to induce synchronised ovulation in females. The second strategy, "focus feeding", is based on using short periods of nutritional supplements that are precisely timed and specifically designed for each event in the reproductive process (eg, gamete production, embryo survival, fetal programming, colostrum production). The third strategy aims to maximize offspring survival by a combination of management, nutrition and genetic selection for behaviour (temperament). All of these approaches involve non-pharmacological manipulation of the endogenous control systems of the animals and complement the detailed information from ultrasound that is now becoming available. Importantly, these approaches all have a solid foundation in reproductive biology. In several cases, they are currently used in commercial practice, but there is still room for improvement through both basic and applied research. Ultimately, these "clean, green and ethical" tools can be cost-effective, increase productivity and, at the same time, greatly improve the image of meat and milk industries in society and the marketplace.

Simple Neuron-Fuzzy Tool for Small Control Devices

DEFF Research Database (Denmark)

Madsen, Per Printz

2008-01-01

Small control computers, running a kind of Fuzzy controller, are more and more used in many systems from household machines to large industrial systems. The purpose of this paper is firstly to describe a tool that is easy to use for implementing self learning Fuzzy systems, that can be executed...... can be described by four different kinds of membership functions. The output fuzzyfication is based on singletons. The rule base can be written in a natural language. The result of the learning is a new version of the Fuzzy system described in the FuNNy language. A simple shower control example...... is shown.  This example shows that FuNNy is able to control the shower and that the learning is able to optimize the Fuzzy system....

Parental and perinatal risk factors for sexual offending in men: a nationwide case-control study.

Science.gov (United States)

Babchishin, K M; Seto, M C; Sariaslan, A; Lichtenstein, P; Fazel, S; Långström, N

2017-01-01

Prior studies suggest parental and perinatal risk factors are associated with later offending. It remains uncertain, however, if such risk factors are similarly related to sexual offending. We linked socio-demographic, family relations, and perinatal (obtained at birth) data from the nationwide Swedish registers from 1973 to 2009 with information on criminal convictions of cases and control subjects. Male sex offenders (n = 13 773) were matched 1:5 on birth year and county of birth in Sweden to male controls without sexual or non-sexual violent convictions. To examine risk-factor specificity for sexual offending, we also compared male violent, non-sexual offenders (n = 135 953) to controls without sexual or non-sexual violent convictions. Predictors included parental (young maternal or paternal age at son's birth, educational attainment, violent crime, psychiatric disorder, substance misuse, suicide attempt) and perinatal (number of older brothers, low Apgar score, low birth weight, being small for gestational age, congenital malformations, small head size) variables. Conditional logistic regression models found consistent patterns of statistically significant, small to moderate independent associations of parental risk factors with sons' sexual offending and non-sexual violent offending. For perinatal risk factors, patterns varied more; small for gestational age and small head size exhibited similar risk effects for both offence types whereas a higher number of older biological brothers and any congenital malformation were small, independent risk factors only for non-sexual violence. This nationwide study suggests substantial commonalities in parental and perinatal risk factors for the onset of sexual and non-sexual violent offending.

Radiation exposure and central nervous system cancers: A case-control study among workers at two nuclear facilities

International Nuclear Information System (INIS)

Carpenter, A.V.; Flanders, W.D.; Frome, E.L.; Crawford-Brown, D.J.; Fry, S.A.

1987-03-01

A nested case-control study was conducted among workers employed between 1943 and 1977 at two nuclear facilities to investigate the possible association of primary malignant neoplasms of the central nervous system (CNS) with occupational exposure to ionizing radiation from external and internal sources. Eighty-nine white male and female workers, who according to the information on death certificates dies of primary CNS cancers, were identified as cases. Four matched controls were selected for each case. External radiation exposure data were available from film badge readings for individual workers, whereas radiation dose to lung from internally deposited radionuclides, mainly uranium, was estimated from area and personnel monitoring data and was used in analyses in lieu of the dose to the brain. Matched sets were included in the analyses only if information was available for the case and at least one of the corresponding controls. Thus, the analyses of external radiation included 27 cases and 90 matched controls, and 47 cases and 120 matched controls were analyzed for the effects of radiation from internally deposited uranium. No association was observed between deaths fron CNS cancers and occupational exposure to ionizing radiation from external or internal sources. However, due to the small number of monitored subjects and low doses, a weak association could not be ruled out. 43 refs., 1 fig., 15 tabs

Welding and lung cancer in a pooled analysis of case-control studies.

Science.gov (United States)

Kendzia, Benjamin; Behrens, Thomas; Jöckel, Karl-Heinz; Siemiatycki, Jack; Kromhout, Hans; Vermeulen, Roel; Peters, Susan; Van Gelder, Rainer; Olsson, Ann; Brüske, Irene; Wichmann, H-Erich; Stücker, Isabelle; Guida, Florence; Tardón, Adonina; Merletti, Franco; Mirabelli, Dario; Richiardi, Lorenzo; Pohlabeln, Hermann; Ahrens, Wolfgang; Landi, Maria Teresa; Caporaso, Neil; Consonni, Dario; Zaridze, David; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Gustavsson, Per; Marcus, Michael; Fabianova, Eleonora; 't Mannetje, Andrea; Pearce, Neil; Tse, Lap Ah; Yu, Ignatius Tak-Sun; Rudnai, Peter; Bencko, Vladimir; Janout, Vladimir; Mates, Dana; Foretova, Lenka; Forastiere, Francesco; McLaughlin, John; Demers, Paul; Bueno-de-Mesquita, Bas; Boffetta, Paolo; Schüz, Joachim; Straif, Kurt; Pesch, Beate; Brüning, Thomas

2013-11-15

Several epidemiologic studies have indicated an increased risk of lung cancer among welders. We used the SYNERGY project database to assess welding as a risk factor for developing lung cancer. The database includes data on 15,483 male lung cancer cases and 18,388 male controls from 16 studies in Europe, Canada, China, and New Zealand conducted between 1985 and 2010. Odds ratios and 95% confidence intervals between regular or occasional welding and lung cancer were estimated, with adjustment for smoking, age, study center, and employment in other occupations associated with lung cancer risk. Overall, 568 cases and 427 controls had ever worked as welders and had an odds ratio of developing lung cancer of 1.44 (95% confidence interval: 1.25, 1.67) with the odds ratio increasing for longer duration of welding. In never and light smokers, the odds ratio was 1.96 (95% confidence interval: 1.37, 2.79). The odds ratios were somewhat higher for squamous and small cell lung cancers than for adenocarcinoma. Another 1,994 cases and 1,930 controls had ever worked in occupations with occasional welding. Work in any of these occupations was associated with some elevation of risk, though not as much as observed in regular welders. Our findings lend further support to the hypothesis that welding is associated with an increased risk of lung cancer.

Sensitive detection of a small parathyroid adenoma using fluorocholine PET/CT: A case report

Energy Technology Data Exchange (ETDEWEB)

Padinhare-Keloth, Thanseer N. T. K.; Bhadada, Sanjay K.; Sood, Ashwani; Kumar, Rajender; Behera, Arunanshu; Radotra, Bishan D.; Mittal, Bhagwant R. [PGIMER, Chandigarh (India)

2017-06-15

Primary hyperparathyroidism is caused by parathyroid adenoma in the majority of cases and diagnosis is usually made biochemically. Pre-surgical localization of parathyroid adenoma is essential to limit the extent of surgery and avoid missing them at ectopic sites. Anatomical and functional imaging are used for the localization, but may fail to identify the small and ectopic parathyroid adenoma. We present a case of small sized ectopic parathyroid adenoma at unusual location detected by F-18 fluorocholine (FCH) PET/CT, where other imaging modalities failed. The post-operative histopathology confirmed the diagnosis of ectopic parathyroid adenoma.

Extramedullary plasmacytoma of small bowel mesentery in associated with cecal cancer: a case report

International Nuclear Information System (INIS)

Kim, Sung Kyu; Kim, Yong Soo; Kim, Young Sun; Cho, On Koo; Koh, Byung Hee; Rhim, Hyun Chul; Park, Choog Ki; Park, Dong Woo; Park, Yong Wook; Oh, Young Ha

2005-01-01

Extramedullary plasmacytoma is a rare disease that is histopathologically defined as a solitary tumor composed of a monoclonal proliferation of cells with plasmacytic differentiation in an extramedullary site. Most of these tumors occur in the submucosa of the upper aerodigestive tract, and they rarely occur in the small bowel mesentery. We report here on a case of extramedullary plasmacytoma of the small bowel mesentery that was in association with a cecal cancer. Abdominal ultrasound and CT revealed a lobulated soft tissue mass with a cystic portion and peripheral calcification. In this case, the preoperative radiological diagnosis was difficult due to accompanying cecal cancer

Extramedullary plasmacytoma of small bowel mesentery in associated with cecal cancer: a case report

Energy Technology Data Exchange (ETDEWEB)

Kim, Sung Kyu; Kim, Yong Soo; Kim, Young Sun; Cho, On Koo; Koh, Byung Hee; Rhim, Hyun Chul; Park, Choog Ki; Park, Dong Woo [Hanyang University College of Medicine, Seoul (Korea, Republic of); Park, Yong Wook; Oh, Young Ha [Hanyang University Guri Hospital, Guri (Korea, Republic of)

2005-07-15

Extramedullary plasmacytoma is a rare disease that is histopathologically defined as a solitary tumor composed of a monoclonal proliferation of cells with plasmacytic differentiation in an extramedullary site. Most of these tumors occur in the submucosa of the upper aerodigestive tract, and they rarely occur in the small bowel mesentery. We report here on a case of extramedullary plasmacytoma of the small bowel mesentery that was in association with a cecal cancer. Abdominal ultrasound and CT revealed a lobulated soft tissue mass with a cystic portion and peripheral calcification. In this case, the preoperative radiological diagnosis was difficult due to accompanying cecal cancer.

Primitive neuroectodermal tumor or small cell carcinoma of the kidney, arare neoplasm: Case Report

International Nuclear Information System (INIS)

Radhi, A.; Ratnakar, K.S.; Al-Durazi, M.; Khalifa, F.

2002-01-01

Small cell carcinoma is a malignancy primarily recognized in thebronchopulmonary region. Extrapulmonary locations are extremely uncommon. Wereport here a case of renal tumor encountered in a 34-year-old female, withextensive metastases in liver, lung and bone. Histological examination wasmost compatible with primitive neuroectodermal tumor (PNET) small cellcarcinoma. There were negative immunohistochemical markers for cytokeratin,any hormonal peptides and epithelial membrane antigens, which is consistentwith the designation of neoplasm as PNET. Previously reported cases have allbeen in the elderly and, to the best of our knowledge, this is the first caseof proven PNET of the kidney described in a young female. (author)

Comparing a single case to a control group - Applying linear mixed effects models to repeated measures data.

Science.gov (United States)

Huber, Stefan; Klein, Elise; Moeller, Korbinian; Willmes, Klaus

2015-10-01

In neuropsychological research, single-cases are often compared with a small control sample. Crawford and colleagues developed inferential methods (i.e., the modified t-test) for such a research design. In the present article, we suggest an extension of the methods of Crawford and colleagues employing linear mixed models (LMM). We first show that a t-test for the significance of a dummy coded predictor variable in a linear regression is equivalent to the modified t-test of Crawford and colleagues. As an extension to this idea, we then generalized the modified t-test to repeated measures data by using LMMs to compare the performance difference in two conditions observed in a single participant to that of a small control group. The performance of LMMs regarding Type I error rates and statistical power were tested based on Monte-Carlo simulations. We found that starting with about 15-20 participants in the control sample Type I error rates were close to the nominal Type I error rate using the Satterthwaite approximation for the degrees of freedom. Moreover, statistical power was acceptable. Therefore, we conclude that LMMs can be applied successfully to statistically evaluate performance differences between a single-case and a control sample. Copyright © 2015 Elsevier Ltd. All rights reserved.

First Japanese case of infectious endocarditis due to Enterococcus faecalis small-colony variants.

Science.gov (United States)

Ogihara, Shinji; Saito, Ryoichi; Sawabe, Etsuko; Hagihara, Michio; Tohda, Shuji

2016-10-01

A male patient was admitted to our hospital due to infectious endocarditis. He had been treated with levofloxacin for 6 weeks, sulbactam/cefoperazone for 4 weeks, and benzylpenicillin for 2 days prior to valve replacement surgery. Gram-positive cocci, with morphology consistent with γ-Streptococcus, were detected in blood cultures obtained at admission, as well as in vegetation obtained from the aortic valve. However, the strain could not be identified using biochemical methods. Sequencing of the 16S rRNA gene indicated that the culture was a small-colony variant of Enterococcus faecalis. This is the first case in Japan of infectious endocarditis due to E. faecalis small-colony variants. Small-colony variants are subpopulations of bacteria with slow growth, reduced sugar fermentation, and unstable phenotype. As a result, these strains tend to be misidentified. Further, small-colony variants are associated with recurrent and persistent infections such as prosthetic joint infection and infectious endocarditis. These strains are found in various bacterial species, including Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Pseudomonas aeruginosa, but rarely in Enterococcus species. The case highlights the need to be vigilant of E. faecalis small-colony variants, especially in patients who received long-term courses of antibiotics. Copyright © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Case-control Studies on the Effectiveness of Breast Cancer Screening: Insights from the UK Age Trial.

Science.gov (United States)

van der Waal, Daniëlle; Broeders, Mireille J M; Verbeek, André L M; Duffy, Stephen W; Moss, Sue M

2015-07-01

Ongoing breast cancer screening programs can only be evaluated using observational study designs. Most studies have observed a reduction in breast cancer mortality, but design differences appear to have resulted in different estimates. Direct comparison of case-control and trial analyses gives more insight into this variation. Here, we performed case-control analyses within the randomized UK Age Trial. The Age Trial assessed the effect of screening on breast cancer mortality in women ages 40-49 years. In our approach, case subjects were defined as breast cancer deaths between trial entry (1991-1997) and 2004. Women were ages 39-41 years at entry. For every case subject, five control subjects were selected. All case subjects were included in analyses of screening invitation (356 case subjects, 1,780 controls), whereas analyses of attendance were restricted to women invited to screening (105 case subjects, 525 age-matched controls). Odds ratios (OR) were estimated with conditional logistic regression. We used and compared two methods to correct for self-selection bias. Screening invitation resulted in a breast cancer mortality reduction of 17% (95% confidence interval [CI]: -36%, +6%), similar to trial results. Different exposure definitions and self-selection adjustments influenced the observed breast cancer mortality reduction. Depending on the method, "ever screened" appeared to be associated with a small reduction (OR: 0.86, 95% CI: 0.40, 1.89) or no reduction (OR: 1.02, 95% CI: 0.48, 2.14) using the two methods of correction. Recent attendance resulted in an adjusted mortality reduction of 36% (95% CI: -69%, +31%) or 45% (95% CI: -71%, +5%). Observational studies, and particularly case-control studies, are an important monitoring tool for breast cancer screening programs. The focus should be on diminishing bias in observational studies and gaining a better understanding of the influence of study design on estimates of mortality reduction.

SMGE: strategic challenges and performance measurement in a small-sized company (case)

NARCIS (Netherlands)

MBA R. Vieveen; PhD B. Pesalj

2015-01-01

Case portrays the Superior Manufacturing Group Europe (SMGE), Barendrecht (Netherlands), a small-sized company doing business in the matting industry; facing challenges of how to sustain and improve its performance, by balancing between entrepreneurial initiative, and a need for strategic planning

Challenges for remote monitoring and control of small reactors

Energy Technology Data Exchange (ETDEWEB)

Trask, D., E-mail: traskd@aecl.ca [Atomic Energy of Canada Limited, Fredericton, New Brunswick (Canada)

2013-07-01

This paper considers a model for small, unmanned, remotely located reactors and discusses the ensuing cyber security and operational challenges for monitoring and control and how these challenges might be overcome through some of AECL's research initiatives and experience. (author)

Primary Volvulus of the Small Intestine Exhibiting Chylous Ascites: A Case Report.

Science.gov (United States)

Hayama, Tamuro; Shioya, Takeshi; Hankyo, Meishi; Shimizu, Takao; Shibuya, Hajime; Komine, Osamu; Watanabe, Yoshimasa; Nanbu, Kotaro; Yamada, Taro

2017-01-01

Primary volvulus of the small intestine associated with chylous ascites is very rare, with only four reported cases. In this paper, we report a new case of primary volvulus associated with chylous ascites. The patient was a 70-year-old man. After experiencing bloating and abdominal pain for several hours, he called an ambulance and underwent an emergency examination at our hospital. Abdominal distension, pressure pain, and rebound tenderness were observed throughout his entire abdomen. The patient had a history of hypertension for which he was receiving oral treatment. Abdominal contrast-enhanced computed tomography (CT) revealed an edematous change in the intestinal membrane and volvulus of the small intestine. As findings suggestive of ischemia were observed in part of the intestines, emergency surgery was performed on the day of admission. Open surgery revealed approximately 500 mL of chylous ascites in the abdominal cavity. The small intestine had twisted 180° in a counter-clockwise direction at the root of the superior mesenteric artery, and the mesentery appeared milky white with edematous changes extending 75 to 240 cm from the ligament of Treitz. There was no evidence of intestinal necrosis; therefore intestinal resection was not performed. The volvulus of the small intestine was corrected. Moreover, because there was no other underlying disease observed, surgery was completed. The ascites collected during surgery revealed high levels of triglycerides at 332 mg/dL, and chylous ascites was diagnosed. An abdominal CT performed on the third day after surgery showed an improvement in intestinal edema, and primary volvulus of the small intestine associated with chylous ascites was diagnosed. Postoperative progress was good, and the patient was discharged on hospital day 10.

Estimating time-varying exposure-outcome associations using case-control data: logistic and case-cohort analyses.

Science.gov (United States)

Keogh, Ruth H; Mangtani, Punam; Rodrigues, Laura; Nguipdop Djomo, Patrick

2016-01-05

Traditional analyses of standard case-control studies using logistic regression do not allow estimation of time-varying associations between exposures and the outcome. We present two approaches which allow this. The motivation is a study of vaccine efficacy as a function of time since vaccination. Our first approach is to estimate time-varying exposure-outcome associations by fitting a series of logistic regressions within successive time periods, reusing controls across periods. Our second approach treats the case-control sample as a case-cohort study, with the controls forming the subcohort. In the case-cohort analysis, controls contribute information at all times they are at risk. Extensions allow left truncation, frequency matching and, using the case-cohort analysis, time-varying exposures. Simulations are used to investigate the methods. The simulation results show that both methods give correct estimates of time-varying effects of exposures using standard case-control data. Using the logistic approach there are efficiency gains by reusing controls over time and care should be taken over the definition of controls within time periods. However, using the case-cohort analysis there is no ambiguity over the definition of controls. The performance of the two analyses is very similar when controls are used most efficiently under the logistic approach. Using our methods, case-control studies can be used to estimate time-varying exposure-outcome associations where they may not previously have been considered. The case-cohort analysis has several advantages, including that it allows estimation of time-varying associations as a continuous function of time, while the logistic regression approach is restricted to assuming a step function form for the time-varying association.

The value of RI scintigraphy and angiography in small intestinal bleeding; Report of eight cases

Energy Technology Data Exchange (ETDEWEB)

Kurosawa, Susumu; Kuwata, Hajime; Kushibiki, Kyoko; Akimoto, Kimihiko; Hashimoto, Toshiyuki; Kojima, Toshiya (Showa General Hospital, Kodaira, Tokyo (Japan))

1991-07-01

We retrospectively reviewed eight cases of small intestinal bleeding and assessed the value of RI scintigraphy and angiography in diagnosing the bleeding site. The patients' average age was 56.2 years. Chief complaint was melena of variable degree. In most cases neither upper endoscopy nor colonoscopy was diagnostic. RI scientigraphy (Tc-99 labeled human serum albumin) showed 75% of positive rate whereas angiography showed 66.7% (4/6) of positive rate. All four cases of leiomyosarcoma and leiomyoma demonstrated hypervascular stain and/or extra-vasation in angiography whereas RI scintigraphy failed to detect active gastrointestinal bleeding in 2 of the 4 cases. Therefore angiography was considered useful for the detection of bleeding from leiomyoma and leiomyosarcoma which are often hypervascular. Scintigraphy is thought of most value in the demonstration of small amount of bleeding with minimum vascular abnormality. (author).

APPLIED KNOWLEDGE MANAGEMENT IN SMALL DESIGN FIRMS: CASE STUDY

Directory of Open Access Journals (Sweden)

Christian Donin

2016-09-01

Full Text Available Knowledge is the new strategic imperative of organizations. The ability to manage knowledge is a crucial part of any organizations operational processes. The creation and diffusion of knowledge have become ever more important factors in competitiveness. This paper investigates the Knowledge Management and flow information and in small design firms. It is divided into three main parts. The first part of this paper describes the importance of Knowledge Management for organizations are described together with responsibilities needed to ensure successful Knowledge Management implementations and the Spiral of Organizational Knowledge Creation conception. The second part approaches literature available about process and organizational structure and information flow related to Brazilian design firms. Finally, this paper presents a case study of small design office of Civil Engineering identifying organizational process, verifying the types of communication practices and identifying the types of dynamic process of The Spiral of Organizational Knowledge Creation, KM strategy and dynamic through Knowledge Transfer.

Lung and bladder cancer among Danish urban bus drivers and tramway employees: a nested case-control study.

Science.gov (United States)

Soll-Johanning, Helle; Bach, Elsa; Jensen, Steen S

2003-02-01

The combustion of fossil fuels produces small amounts of mutagenic and carcinogenic compounds. We investigated the association between employment and lung and bladder cancer in Danish bus drivers and tramway employees. We carried out a nested case-control study of 153 lung and 84 bladder cancer cases, and 606 controls sampled in a cohort of 18 174 bus drivers or tramway employees employed in Copenhagen during the period 1900-1994. The cases and controls or their next of kin were interviewed about smoking, along with occupational and residential history. An exposure index based on which bus routes the bus drivers had mainly been driving was established. Relative risks (RRs) were estimated by conditional logistic regression. The analysis showed decreasing risk for lung cancer with increasing years of employment as a bus driver (RR = 0.97 for each added year, 95% confidence interval = 0.96-0.99). The air pollution index based on main bus for the bus drivers showed no positive correlation with risk.

Effect of automatic control technologies on emission reduction in small-scale combustion

Energy Technology Data Exchange (ETDEWEB)

Ruusunen, M. [Control Engineering Laboratory, University of Oulu (Finland)

2007-07-01

Automatic control can be regarded as a primary measure for preventing combustion emissions. In this view, the control technology covers broadly the control methods, sensors and actuators for monitoring and controlling combustion. In addition to direct control of combustion process, it can also give tools for condition monitoring and optimisation of total heat consumption by system integration thus reducing the need for excess conversion of energy. Automatic control has already shown its potential in small-scale combustion. The potential, but still unrealised advantages of automatic control in this scale are the adaptation to changes in combustion conditions (fuel, environment, device, user) and the continuous optimisation of the air/fuel ratio. Modem control technology also covers combustion condition monitoring, diagnostics, and the higher level optimisation of the energy consumption with system integration. In theory, these primary measures maximise the overall efficiency, enabling a significant reduction in fuel consumption and thus total emissions per small-scale combustion unit, specifically at the annual level.

Axial torsion of meckel's diverticulum causing small bowel obstruction in adult: A case report

Energy Technology Data Exchange (ETDEWEB)

Youn, In Kyung; Lee, Su Lim; Ku, Young Mi [Dept. of Radiology, Uijeongbu St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu (Korea, Republic of)

2016-02-15

Meckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract that is prevalent in 2–3% of the population. The lifetime risk of complications is estimated at 4%. Small bowel obstruction is the second most common complication of MD. Among the causes of bowel obstruction, axial torsion of MD is the rarest complication. Urgent surgical treatment is needed in cases of small bowel obstruction associated with torsion of MD. Pre-operative diagnosis of MD as a cause of small bowel obstruction is difficult, because the diagnosis can be made only if the diverticulum is delineated at the site of obstruction. We reported a case of axial torsion of MD with necrosis that caused proximal small bowel perforation in a 21 year old male.

Primary fibrosarcoma im small intestine of dog - Case report

OpenAIRE

Geórgia Modé Magalhães; Juliana Santilli; Sabryna Gouveia Calazans; Lilian Toshiko Nishimura; Sofia de Amorim Cerejo; Fernanda Gosuen Gonçalves Dias

2015-01-01

ABSTRACT. Magalhães G.M., Santilli J., Calazans S.G., Nishimura L.T., Cerejo S.A. & Dias F.G.G. [Primary fibrosarcoma im small intestine of dog - Case report.] Fibrossarcoma primário em intestino delgado de cão - Relato de caso. Revista Brasileira de Medicina Veterinária, 37(2):145-148, 2015. Programa de Pós-Graduação em Medicina Veterinária de Pequenos Animais, Universidade de Franca, Av. Dr. Armando Salles Oliveira, 201, Cx postal 82, Parque Universitá- rio, Franca, SP 14404-600, Brasil. E-...

Adhesive small bowel obstruction due to pelvic inflammatory disease: A case report

Directory of Open Access Journals (Sweden)

Razan A Al-Ghassab

2018-01-01

Full Text Available We report a rare case of a 32-year-old woman with adhesive small bowel obstruction due to pelvic inflammatory disease. She had no history of abdominal surgery, gynecological complaints or constitutional symptoms of chronic illness. The diagnosis was based on the laparoscopic findings of small bowel adhesions, free peritoneal fluid, “violin string” adhesions of Fitz-Hugh–Curtis syndrome and left hydrosalpinx. Laparoscopic adhesiolysis was performed successfully, and the patient had an uneventful postoperative course. The authors conclude that pelvic inflammatory disease should be included as a cause of adhesive small bowel obstruction in sexually active young women with no history of abdominal surgery or constitutional symptoms of chronic disease. When performed by experienced surgeons, laparoscopy in such patients is feasible and safe.

Chronic autoimmune disorders are increased in coeliac disease: A case-control study.

Science.gov (United States)

Bibbò, Stefano; Pes, Giovanni Mario; Usai-Satta, Paolo; Salis, Roberta; Soro, Sara; Quarta Colosso, Bianca Maria; Dore, Maria Pina

2017-11-01

Coeliac disease (CD) is an autoimmune disorder of the small bowel associated with increased risk of additional autoimmune diseases (ADs).To investigate the prevalence of ADs in a population of adult coeliac patients.This was a retrospective case-control study. Data from coeliac patients and controls referred to a tertiary center between 2013 and 2016 were collected. The frequency of ADs and the unadjusted and adjusted odds ratios (ORs) for age, gender, disease duration, and body mass index with their 95% confidence intervals (CIs) were evaluated.Two hundred fifty-five patients with CD (median age 37.1 years; 206 women) were matched with 250 controls. ADs were more frequent (35.3%) in coeliac patients than in controls (15.2%). Adjusted ORs for the presence of only 1, at least 1, and more than 1 AD were 3.13 (95% CI 1.81-5.42, P disease. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Fault tolerant attitude control for small unmanned aircraft systems equipped with an airflow sensor array.

Science.gov (United States)

Shen, H; Xu, Y; Dickinson, B T

2014-11-18

Inspired by sensing strategies observed in birds and bats, a new attitude control concept of directly using real-time pressure and shear stresses has recently been studied. It was shown that with an array of onboard airflow sensors, small unmanned aircraft systems can promptly respond to airflow changes and improve flight performances. In this paper, a mapping function is proposed to compute aerodynamic moments from the real-time pressure and shear data in a practical and computationally tractable formulation. Since many microscale airflow sensors are embedded on the small unmanned aircraft system surface, it is highly possible that certain sensors may fail. Here, an adaptive control system is developed that is robust to sensor failure as well as other numerical mismatches in calculating real-time aerodynamic moments. The advantages of the proposed method are shown in the following simulation cases: (i) feedback pressure and wall shear data from a distributed array of 45 airflow sensors; (ii) 50% failure of the symmetrically distributed airflow sensor array; and (iii) failure of all the airflow sensors on one wing. It is shown that even if 50% of the airflow sensors have failures, the aircraft is still stable and able to track the attitude commands.

Estimating time-varying exposure-outcome associations using case-control data: logistic and case-cohort analyses

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Ruth H. Keogh

2016-01-01

Full Text Available Abstract Background Traditional analyses of standard case-control studies using logistic regression do not allow estimation of time-varying associations between exposures and the outcome. We present two approaches which allow this. The motivation is a study of vaccine efficacy as a function of time since vaccination. Methods Our first approach is to estimate time-varying exposure-outcome associations by fitting a series of logistic regressions within successive time periods, reusing controls across periods. Our second approach treats the case-control sample as a case-cohort study, with the controls forming the subcohort. In the case-cohort analysis, controls contribute information at all times they are at risk. Extensions allow left truncation, frequency matching and, using the case-cohort analysis, time-varying exposures. Simulations are used to investigate the methods. Results The simulation results show that both methods give correct estimates of time-varying effects of exposures using standard case-control data. Using the logistic approach there are efficiency gains by reusing controls over time and care should be taken over the definition of controls within time periods. However, using the case-cohort analysis there is no ambiguity over the definition of controls. The performance of the two analyses is very similar when controls are used most efficiently under the logistic approach. Conclusions Using our methods, case-control studies can be used to estimate time-varying exposure-outcome associations where they may not previously have been considered. The case-cohort analysis has several advantages, including that it allows estimation of time-varying associations as a continuous function of time, while the logistic regression approach is restricted to assuming a step function form for the time-varying association.

Metastatic Small Cell Carcinoma of the Breast from Cancer of the Uterine Cervix: A Case Report

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Beom Seok Kwak

2018-01-01

Full Text Available We report here on a case of 51-year-old woman with metastatic small cell carcinoma of the breast that came from her cancer of the uterine cervix. She underwent radical hysterectomy with bilateral salpingo-oophorectomy due to small cell carcinoma of the uterine cervix, and adjuvant radiotherapy was administered to the pelvis. Breast metastasis with a palpable mass then occurred 3 months after the primary surgery. Simple mastectomy and adjuvant chemotherapy were performed. She initially showed a good response to the therapy, yet she ultimately died of multiple metastases with a fulminating disease course. This is an extremely rare case, and only 1 similar case has been reported earlier, so we report on this case along with a review of the relevant literature.

A Case of Primary Gastric Small-Cell Carcinoma in an Elderly Patient

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Fa-Chang Yu

2012-03-01

Full Text Available We report a case of primary small-cell carcinoma of the stomach in a 75-year-old man. The patient was admitted to our hospital with a 1-week history of intermittent tarry stool. An upper gastrointestinal examination revealed a large stage A2 ulcer in the greater curvature of the body of the stomach, and pathological findings from biopsy specimens revealed small-cell carcinoma. The tumor cells were small-sized, composed of hyperchromatic nuclei with scant cytoplasm, and stained positive for cytokeratin, synaptophysin, and chromogranin A. The patient was diagnosed with primary small-cell carcinoma of the stomach. He declined further evaluation and received palliative management. This is a rare carcinoma of the stomach, with aggressive manifestations and a poor prognosis. The mean survival of patients with primary gastric small-cell carcinoma is reported to be 7 months. The choice of treatment for this disease is still controversial. This rare gastric tumor should be listed in the differential diagnosis of gastric carcinoma in the elderly.

MRI findings of small cell neuroendocrime carcinoma of the uterine cervix: A case report

Energy Technology Data Exchange (ETDEWEB)

Won, You Sun; Yi, Boem Ha; Lee, Hae Kyung; Lee, Min Hee; Choi, Seo Youn; Kwak, Jeong Ja [Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

2015-10-15

Small cell neuroendocrine carcinoma of the uterine cervix is a rare primary neoplasm, accounting for less than 5% of all uterine cervical cancers. The tumor is known to have an aggressive behavior and poor prognosis. In this article, we present the MRI findings of 5 cases of pathologically-proven small cell neuroendocrine carcinoma of the uterine cervix, including diffusion-weighted images.

Mobile phone base stations and early childhood cancers: case-control study.

Science.gov (United States)

Elliott, Paul; Toledano, Mireille B; Bennett, J; Beale, L; de Hoogh, K; Best, N; Briggs, D J

2010-06-22

To investigate the risk of early childhood cancers associated with the mother's exposure to radiofrequency from and proximity to macrocell mobile phone base stations (masts) during pregnancy. Case-control study. Cancer registry and national birth register data in Great Britain. 1397 cases of cancer in children aged 0-4 from national cancer registry 1999-2001 and 5588 birth controls from national birth register, individually matched by sex and date of birth (four controls per case). Incidence of cancers of the brain and central nervous system, leukaemia, and non-Hodgkin's lymphomas, and all cancers combined, adjusted for small area measures of education level, socioeconomic deprivation, population density, and population mixing. Mean distance of registered address at birth from a macrocell base station, based on a national database of 76,890 base station antennas in 1996-2001, was similar for cases and controls (1107 (SD 1131) m v 1073 (SD 1130) m, P=0.31), as was total power output of base stations within 700 m of the address (2.89 (SD 5.9) kW v 3.00 (SD 6.0) kW, P=0.54) and modelled power density (-30.3 (SD 21.7) dBm v -29.7 (SD 21.5) dBm, P=0.41). For modelled power density at the address at birth, compared with the lowest exposure category the adjusted odds ratios were 1.01 (95% confidence interval 0.87 to 1.18) in the intermediate and 1.02 (0.88 to 1.20) in the highest exposure category for all cancers (P=0.79 for trend), 0.97 (0.69 to 1.37) and 0.76 (0.51 to 1.12), respectively, for brain and central nervous system cancers (P=0.33 for trend), and 1.16 (0.90 to 1.48) and 1.03 (0.79 to 1.34) for leukaemia and non-Hodgkin's lymphoma (P=0.51 for trend). There is no association between risk of early childhood cancers and estimates of the mother's exposure to mobile phone base stations during pregnancy.

Investigation of Practical Flight Control Systems for Small Aircraft

NARCIS (Netherlands)

Falkena, W.

2012-01-01

Personal air transportation utilizing small aircraft is a market that is expected to grow significantly in the near future. However, seventy times more accidents occur in this segment as compared with the commercial aviation sector. The majority of these accidents is related to handling and control

Surgical Treatment of Small Pulmonary Nodules Under Video-assisted Thoracoscopy 
(A Report of 129 Cases

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Tong WANG

2017-01-01

Full Text Available Background and objective The development of image technology has led to increasing detection of pulmonary small nodules year by year, but the determination of their nature before operation is difficult. This clinical study aimed to investigate the necessity and feasibility of surgical resection of pulmonary small nodules through a minimally invasive approach and the operational manner of non-small cell lung cancer (NSCLC. Methods The clinical data of 129 cases with pulmonary small nodule of 10 mm or less in diameter were retrospectively analyzed in our hospital from December 2013 to November 2016. Thin-section computed tomography (CT was performed on all cases with 129 pulmonary small nodules. CT-guided hook-wire precise localization was performed on 21 cases. Lobectomy, wedge resection, and segmentectomy with lymph node dissection might be performed in patients according to physical condition. Results Results of the pathological examination of 37 solid pulmonary nodules (SPNs revealed 3 primary squamous cell lung cancers, 3 invasive adenocarcinomas (IAs, 2 metastatic cancers, 2 small cell lung cancers (SCLCs, 16 hamartomas, and 12 nonspecific chronic inflammations. The results of pathological examination of 49 mixed ground glass opacities revealed 19 IAs, 6 micro invasive adenocarcinomas (MIAs, 4 adenocarcinomas in situ (AIS, 1 atypical adenomatous hyperplasia (AAH, 1 SCLC, and 18 nonspecific chronic inflammations. The results of pathological examination of 43 pure ground glass opacities revealed 19 AIS, 6 MIAs, 6 IA, 6 AAHs, and 6 nonspecific chronic inflammations. Wedge resection under video-assisted thoracoscopic surgery (VATS was performed in patients with 52 benign pulmonary small nodules. Lobectomy and systematic lymph node dissection under VATS were performed in 33 patients with NSCLC. Segmentectomy with selective lymph node dissection, wedge resection, and selective lymph node dissection under VATS were performed in six patients with

Pituitary tumor risk in relation to mobile phone use: A case-control study.

Science.gov (United States)

Shrestha, Mithila; Raitanen, Jani; Salminen, Tiina; Lahkola, Anna; Auvinen, Anssi

2015-01-01

The number of mobile phone users has grown rapidly, which has generated mounting public concern regarding possible health hazards. This study aims to assess pituitary tumor risk, as it has rarely been investigated. A case-control study was conducted with 80 eligible cases identified from all five university hospitals in Finland and frequency-matched 240 controls from the national population register. Controls were matched to cases by age, sex, region of residence and date of interview. A detailed history of mobile phone use was obtained using a structured interview. Several indicators of mobile phone use were assessed using conditional logistic regression. A reduced odds ratio was seen among regular mobile phone users [OR 0.39, 95% confidence interval (CI) 0.21, 0.72] relative to never/non-regular users, possibly reflecting methodological limitations. Pituitary tumor risk was not increased after 10 or more years since first use (OR 0.69, 95% CI 0.25, 1.89). The risk was not increased in relation to duration, cumulative hours of use, or cumulative number of calls. The results were similar for analog and digital phones. We found no excess risk associated with self-reported short- or medium-term use of mobile phones. This is consistent with most of the published studies. However, uncertainties remained for longer duration of use, as a very small proportion of study participants reported use beyond 10 years.

The Practical Application of Minor Element Control in Small Scale Melts

Science.gov (United States)

Jablonski, P. D.; Hawk, J. A.

Many times small scale melts are made for the purposes of alloy development, component evaluation, or simply economic concerns when "commercial" alloys are unavailable in small quantities. Not only is it critical that the major alloy elements meet the desired levels, but "tramp" elements or trace element additions must also be controlled. Control of tramp and trace elements on the small scale is often done differently simply due to the scale of the melt or the equipment available. In this paper several approaches will be presented that have been used at NETL in manufacturing alloys for in-house research, including, for example, vacuum refining. Also, the relative effectiveness of various gettering elements will be explored. The successes achieved as well as the failures of the various approaches will be discussed in terms of thermodynamic and kinetic considerations. The presentation will conclude with practical alloy examples.

Residential radon exposure and lung cancer risk in Misasa, Japan. A case-control study

International Nuclear Information System (INIS)

Sobue, Tomotaka; Lee, Valerie S.; Ye, Weimin; Tanooka, Hiroshi; Mifune, Masaaki; Suyama, Akihiko; Koga, Taeko; Morishima, Hiroshige; Kondo, Sohei

2000-01-01

In order to investigate an association between residential radon exposure and risk of lung cancer, a case-control study was conducted in Misasa Town, Tottori Prefecture, Japan. The case series consisted of 28 people who had died of lung cancer in the years 1976-96 and 36 controls chosen randomly from the residents in 1976, matched by sex and year of birth. Individual residential radon concentrations were measured for 1 year with alpha track detectors. The average radon concentration was 46 Bq/m 3 for cases and 51 Bq/m 3 for controls. Compared to the level of 24 or less Bq/m 3 , the adjusted odds ratios of lung cancer associated with radon levels of 25-49, 50-99 and 100 or more Bq/m 3 , were 1.13 (95% confidence interval; 0.29-4.40), 1.23 (0.16-9.39) and 0.25 (0.03-2.33), respectively. None of the estimates showed statistical significance, due to small sample size. When the subjects were limited to only include residents of more than 30 years, the estimates did not change substantially. This study did not find that the risk pattern of lung cancer, possibly associated with residential radon exposure, in Misasa Town differed from patterns observed in other countries. (author)

Goblet Cell Carcinoid Tumor of the Appendix with Small Bowel Obstruction: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Hwang, Su Yeon; Jang, Kyung Mi; Kim, Min Jeong; Koh, Sung Hye; Jeon, Eui Yong; Min, Kwang Seon; Seo, Jin Won; Park, Hyoung Chul [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)

2009-09-15

Goblet cell carcinoid tumor of the appendix (GCTA) is a tumor with histological features of both adenocarcinoma and carcinoid tumors. The most common clinical presentation of GCTA is acute appendicitis, although small bowel obstruction has been reported as a rare clinical symptom of GCTA. However, to the best of our knowledge, the CT feature of small bowel obstructions in patients with GCTA has not been reported to date. Here, we present a case of small bowel obstruction in a patient with GCTA caused by extensive tumor infiltration at the terminal ileum and distal ileum.

Population versus hospital controls for case-control studies on cancers in Chinese hospitals.

Science.gov (United States)

Li, Lin; Zhang, Min; Holman, D'Arcy

2011-12-15

Correct control selection is crucial to the internal validity of case-control studies. Little information exists on differences between population and hospital controls in case-control studies on cancers in Chinese hospital setting. We conducted three parallel case-control studies on leukemia, breast and colorectal cancers in China between 2009 and 2010, using population and hospital controls to separately match 540 incident cases by age, gender and residency at a 1:1 ratio. Demographic and lifestyle factors were measured using a validated questionnaire in face-to-face interview. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using conditional logistic regression analyses. The two control groups had closely similar exposure distributions of 15 out of 16 factors, with the only exception being that hospital controls were less likely to have a BMI ≥ 25 (OR = 0.71, 95% CI: 0.54, 0.93). For exposure of green tea drinking, the adjusted ORs (95% CIs) comparing green tealeaves intake ≥ 1000 grams annually with non-drinkers were 0.51 (0.31, 0.83) and 0.21 (0.27, 0.74) for three cancers combined, 0.06 (0.01, 0.61) and 0.07 (0.01, 0.47) for breast cancer, 0.52 (0.29, 0.94) and 0.45 (0.25, 0.82) for colorectal cancer, 0.65 (0.08, 5.63) and 0.57 (0.07, 4.79) for leukemia using hospital and population controls respectively. The study found that hospital controls were comparable with population controls for most demographic characteristics and lifestyle factors measured, but there was a slight difference between the two control groups. Hospital outpatients provide a satisfactory control group in hospital-based case-control study in the Chinese hospital setting.

Population versus hospital controls for case-control studies on cancers in Chinese hospitals

Directory of Open Access Journals (Sweden)

Li Lin

2011-12-01

Full Text Available Abstract Background Correct control selection is crucial to the internal validity of case-control studies. Little information exists on differences between population and hospital controls in case-control studies on cancers in Chinese hospital setting. Methods We conducted three parallel case-control studies on leukemia, breast and colorectal cancers in China between 2009 and 2010, using population and hospital controls to separately match 540 incident cases by age, gender and residency at a 1:1 ratio. Demographic and lifestyle factors were measured using a validated questionnaire in face-to-face interview. Odds ratios (ORs and 95% confidence intervals (CIs were obtained using conditional logistic regression analyses. Results The two control groups had closely similar exposure distributions of 15 out of 16 factors, with the only exception being that hospital controls were less likely to have a BMI ≥ 25 (OR = 0.71, 95% CI: 0.54, 0.93. For exposure of green tea drinking, the adjusted ORs (95% CIs comparing green tealeaves intake ≥ 1000 grams annually with non-drinkers were 0.51 (0.31, 0.83 and 0.21 (0.27, 0.74 for three cancers combined, 0.06 (0.01, 0.61 and 0.07 (0.01, 0.47 for breast cancer, 0.52 (0.29, 0.94 and 0.45 (0.25, 0.82 for colorectal cancer, 0.65 (0.08, 5.63 and 0.57 (0.07, 4.79 for leukemia using hospital and population controls respectively. Conclusions The study found that hospital controls were comparable with population controls for most demographic characteristics and lifestyle factors measured, but there was a slight difference between the two control groups. Hospital outpatients provide a satisfactory control group in hospital-based case-control study in the Chinese hospital setting.

Small functional groups for controlled differentiation of hydrogel-encapsulated human mesenchymal stem cells

Science.gov (United States)

Benoit, Danielle S. W.; Schwartz, Michael P.; Durney, Andrew R.; Anseth, Kristi S.

2008-10-01

Cell-matrix interactions have critical roles in regeneration, development and disease. The work presented here demonstrates that encapsulated human mesenchymal stem cells (hMSCs) can be induced to differentiate down osteogenic and adipogenic pathways by controlling their three-dimensional environment using tethered small-molecule chemical functional groups. Hydrogels were formed using sufficiently low concentrations of tether molecules to maintain constant physical characteristics, encapsulation of hMSCs in three dimensions prevented changes in cell morphology, and hMSCs were shown to differentiate in normal growth media, indicating that the small-molecule functional groups induced differentiation. To our knowledge, this is the first example where synthetic matrices are shown to control induction of multiple hMSC lineages purely through interactions with small-molecule chemical functional groups tethered to the hydrogel material. Strategies using simple chemistry to control complex biological processes would be particularly powerful as they could make production of therapeutic materials simpler, cheaper and more easily controlled.

osDesign: An R Package for the Analysis, Evaluation, and Design of Two-Phase and Case-Control Studies

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Sebastien Haneuse

2011-08-01

Full Text Available The two-phase design has recently received attention in the statistical literature as an extension to the traditional case-control study for settings where a predictor of interest is rare or subject to missclassification. Despite a thorough methodological treatment and the potential for substantial efficiency gains, the two-phase design has not been widely adopted. This may be due, in part, to a lack of general-purpose, readily-available software. The osDesign package for R provides a suite of functions for analyzing data from a two-phase and/or case-control design, as well as evaluating operating characteristics, including bias, efficiency and power. The evaluation is simulation-based, permitting flexible application of the package to a broad range of scientific settings. Using lung cancer mortality data from Ohio, the package is illustrated with a detailed case-study in which two statistical goals are considered: (i the evaluation of small-sample operating characteristics for two-phase and case-control designs and (ii the planning and design of a future two-phase study.

Case Studies in Modelling, Control in Food Processes.

Science.gov (United States)

Glassey, J; Barone, A; Montague, G A; Sabou, V

This chapter discusses the importance of modelling and control in increasing food process efficiency and ensuring product quality. Various approaches to both modelling and control in food processing are set in the context of the specific challenges in this industrial sector and latest developments in each area are discussed. Three industrial case studies are used to demonstrate the benefits of advanced measurement, modelling and control in food processes. The first case study illustrates the use of knowledge elicitation from expert operators in the process for the manufacture of potato chips (French fries) and the consequent improvements in process control to increase the consistency of the resulting product. The second case study highlights the economic benefits of tighter control of an important process parameter, moisture content, in potato crisp (chips) manufacture. The final case study describes the use of NIR spectroscopy in ensuring effective mixing of dry multicomponent mixtures and pastes. Practical implementation tips and infrastructure requirements are also discussed.

Control, Co-generation, and Sensor Placement Strategy for Integral Small Modular Reactors

International Nuclear Information System (INIS)

Upadhyaya, Belle-R.; Fan, Li; Hines, J.-Wesley; Perillo, Sergio-R. P.

2011-01-01

The development of Small Modular Reactors (SMR) has multiple applications for electricity generation, process heat, hydrogen production, and others. The results of research, development, and demonstration (RD and D) of load-following control design for multiple modules, nuclear desalination, and sensor placement strategy for enhanced fault detection and isolation, are presented in this paper. The technologies are demonstrated with application to an integral pressurized water reactor (IPWR) such as the IRIS reactor. The outcomes of this RD and D include the development of a complete dynamic model of the IRIS system, load following control under dual-module steam mixing, nuclear desalination with a multi-stage flash (MSF) desalination plant, and automated technique for sensor allocation in a combined reactor and balance-of-plant system. The dynamic performance of a nuclear power station comprised of two IRIS reactor modules, operating simultaneously with a common steam header with steam mixing, was evaluated. The control problem addressed 'load-following' scenarios, such as varying load during the day or reduced consumption during the weekend. To solve this problem, a single-module IRIS MATLAB-Simulink model was developed and used to quantify the responses from both modules. The resulting model was subjected to eight different perturbation cases to analyze its capability of detecting small perturbations, therefore testing its robustness and sensitivity. The prospects of using nuclear energy for seawater desalination on a large scale can be very attractive since desalination is an energy intensive process that can utilize the heat from a nuclear reactor and/or the electricity produced by such plants. Small modular reactors, ranging from 50 MWe to 300 MWe, offer the largest potential as coupling options to nuclear desalination systems. However, coupling a nuclear plant and a desalination plant involves a number of issues that have to be addressed. Among these issues

Control, Co-generation, and Sensor Placement Strategy for Integral Small Modular Reactors

Energy Technology Data Exchange (ETDEWEB)

Upadhyaya, Belle-R.; Fan, Li; Hines, J.-Wesley [University of Tennessee, Knoxville (United States); Perillo, Sergio-R. P. [Instituto de Pesquisas Energeticas e Nucleares, Sao Paulo (Brazil)

2011-08-15

The development of Small Modular Reactors (SMR) has multiple applications for electricity generation, process heat, hydrogen production, and others. The results of research, development, and demonstration (RD and D) of load-following control design for multiple modules, nuclear desalination, and sensor placement strategy for enhanced fault detection and isolation, are presented in this paper. The technologies are demonstrated with application to an integral pressurized water reactor (IPWR) such as the IRIS reactor. The outcomes of this RD and D include the development of a complete dynamic model of the IRIS system, load following control under dual-module steam mixing, nuclear desalination with a multi-stage flash (MSF) desalination plant, and automated technique for sensor allocation in a combined reactor and balance-of-plant system. The dynamic performance of a nuclear power station comprised of two IRIS reactor modules, operating simultaneously with a common steam header with steam mixing, was evaluated. The control problem addressed 'load-following' scenarios, such as varying load during the day or reduced consumption during the weekend. To solve this problem, a single-module IRIS MATLAB-Simulink model was developed and used to quantify the responses from both modules. The resulting model was subjected to eight different perturbation cases to analyze its capability of detecting small perturbations, therefore testing its robustness and sensitivity. The prospects of using nuclear energy for seawater desalination on a large scale can be very attractive since desalination is an energy intensive process that can utilize the heat from a nuclear reactor and/or the electricity produced by such plants. Small modular reactors, ranging from 50 MWe to 300 MWe, offer the largest potential as coupling options to nuclear desalination systems. However, coupling a nuclear plant and a desalination plant involves a number of issues that have to be addressed. Among these

Survived case of tardive small bowel injury resulting from radiotherapy for ovarial tumor

Energy Technology Data Exchange (ETDEWEB)

Haruyama, H; Hattori, K; Okubo, H; Ishizaki, Y; Kanemoto, T [National Hospital of Sapporo (Japan)

1981-07-01

In a patient who underwent surgical excision of recurrent tumor of ovarian disgerminoma, small bowel injury following radiotherapy was treated by extensive excision of the small intestine followed by intravenous hyperalimentation (I.V.H.) and hyperbaric oxygen therapy. From its clinical course and treatment, we concluded that 1) In small bowel complication due to radiation injury, especially perforation of the small bowel, radical excision of the diseased segment is most promising, if the general and local conditions permit. 2) I.V.H. is effective for protecting and improving postoperative malnutrition after extensive excision of the small bowel. 3) Hyperbaric oxygen therapy is very effective for postoperative paralytic ileus in the case in which surgical operation cannot be performed. 4) Zinc deficiency as a complication of prolonged I.V.H. therapy must be protected. 5) It is necessary to study pathophysiology of short bowel syndrome following the extensive excision and to continue treatment and careful long-term follow-up.

Blood Pressure Control in Aging Predicts Cerebral Atrophy Related to Small-Vessel White Matter Lesions

Directory of Open Access Journals (Sweden)

Kyle C. Kern

2017-05-01

Full Text Available Cerebral small-vessel damage manifests as white matter hyperintensities and cerebral atrophy on brain MRI and is associated with aging, cognitive decline and dementia. We sought to examine the interrelationship of these imaging biomarkers and the influence of hypertension in older individuals. We used a multivariate spatial covariance neuroimaging technique to localize the effects of white matter lesion load on regional gray matter volume and assessed the role of blood pressure control, age and education on this relationship. Using a case-control design matching for age, gender, and educational attainment we selected 64 participants with normal blood pressure, controlled hypertension or uncontrolled hypertension from the Northern Manhattan Study cohort. We applied gray matter voxel-based morphometry with the scaled subprofile model to (1 identify regional covariance patterns of gray matter volume differences associated with white matter lesion load, (2 compare this relationship across blood pressure groups, and (3 relate it to cognitive performance. In this group of participants aged 60–86 years, we identified a pattern of reduced gray matter volume associated with white matter lesion load in bilateral temporal-parietal regions with relative preservation of volume in the basal forebrain, thalami and cingulate cortex. This pattern was expressed most in the uncontrolled hypertension group and least in the normotensives, but was also more evident in older and more educated individuals. Expression of this pattern was associated with worse performance in executive function and memory. In summary, white matter lesions from small-vessel disease are associated with a regional pattern of gray matter atrophy that is mitigated by blood pressure control, exacerbated by aging, and associated with cognitive performance.

Psychogenic fever in a patient with small cell lung cancer: a case report

International Nuclear Information System (INIS)

Xu, Mengdan; Zhang, Xiaoye; Xu, Zhaoguo; Cui, Guoyuan; Yu, Li; Qi, Xiaoying; Lin, Jia; Liu, Yan

2015-01-01

Fever is common in malignant tumors. We report an exceptional case of psychogenic fever in a patient with small cell lung cancer. This is the first case report of psychogenic fever in a patient with small cell lung cancer. A 61-year-old Chinese man diagnosed with small cell carcinoma on June 30, 2012, came to our department with a complaint of fever lasting more than 1 month. He had undergone chemoradiotherapy for lung cancer 6 months previously. After admission, his body temperature fluctuated in the range of 37 °C to 39 °C. Somatic symptoms associated with anxiety were obvious. A 24-item Hamilton Anxiety Scale was used to assess the patient’s condition. A score of 32 confirmed a diagnosis of severe anxiety. After a week of antianxiety treatment, the patient’s temperature returned to normal. Psychogenic fever is common in cancer patients and deserves more attention. Patients with psychogenic fever must be distinguished from patients with infectious fever (including neutropenic fever), and tumor fever. Additionally, antianxiety or antidepression treatment should be provided. A concern is that continual anxiety may adversely affect anticancer therapy

Case-control study of radon and lung cancer in New Jersey

International Nuclear Information System (INIS)

Wilcox, H. B.; Al-Zoughool, M.; Garner, M. J.; Jiang, H.; Klotz, J. B.; Krewski, D.; Nicholson, W. J.; Schoenberg, J. B.; Villeneuve, P. J.; Zielinski, J. M.

2008-01-01

Radon is known to cause lung cancer in humans; however, there remain uncertainties about the effects associated with residential exposures. This case-control study of residential radon and lung cancer was conducted in five counties in New Jersey and involved 561 cases and 740 controls. A yearlong α-track detector measurement of radon was completed for ∼93% of all residences lived in at the time of interview (a total of 2063). While the odds ratios (ORs) for whole data were suggestive of an increased risk for exposures >75 Bq m -3 , these associations were not statistically significant. The adjusted excess OR (EOR) per 100 Bq m -3 was -0.13 (95% CI: -0.30 to 0.44) for males, 0.29 (95% CI: -0.12 to 1.70) for females and 0.05 (95% CI: -0.14 to 0.56) for all subjects combined. An analysis of radon effects by histological type of lung cancer showed that the OR was strongest for small/oat cell carcinomas in both males and females. There was no statistical heterogeneity of radon effects by demographic factors (age at disease occurrence, education level and type of respondent). Analysis by categories of smoking status, frequency or duration did not modify the risk estimates of radon on lung cancer. The findings of this study are consistent with an earlier population-based study of radon and lung cancer among New Jersey women, and with the North American pooling of case control radon seven studies, including the previous New Jersey study. Several uncertainties regarding radon measurements and assumptions of exposure history may have resulted in underestimation of a true exposure-response relationship. (authors)

Small bowel obstruction subsequent to Essure microinsert sterilization: a case report.

Science.gov (United States)

Belotte, Jimmy; Shavell, Valerie I; Awonuga, Awoniyi O; Diamond, Michael P; Berman, Jay M; Yancy, Amanda F

2011-07-01

To report a case of small bowel obstruction (SBO) subsequent to Essure microinsert sterilization. Case report. University teaching hospital. A 38-year-old woman, gravida 1, para 1, with a history of pelvic pain, vaginal spotting, nausea, vomiting, and constipation 1 month after Essure hysteroscopic sterilization. Radiologic investigation, including a computed tomography scan of the abdomen and pelvis, followed by operative laparoscopy. Alleviation of the SBO. Radiologic investigation suggested a distal SBO, with the left Essure microinsert noted in the left lower pelvis. These findings, including an inflamed appendix, were confirmed at operative laparoscopy. Lysis of adhesions, removal of the Essure microinsert, appendectomy, and left salpingectomy were performed. This case is reported to increase awareness that SBO is a potential complication of Essure microinsert placement. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Controller for a small induction-generator based wind-turbine

Energy Technology Data Exchange (ETDEWEB)

Ahshan, R.; Iqbal, M.T.; Mann, George K.I. [Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John' s, Newfoundland (Canada)

2008-04-15

Design of a low-cost micro-controller for a small induction-generator based grid-connected wind-turbine is presented in this paper. The controller senses the parameters of the wind-turbine generator and the grid, and makes decisions about grid connection and disconnection. Low-cost instrumentation circuitry has been developed to measure the generator and grid parameters. Based on the measurement of voltage and frequency of the wind-turbine generator and the grid side, a control decision is taken to connect the system to the grid. The controller makes decision to disconnect the system from the grid based on the power flow measurement between the wind turbine and the grid. The power flow between wind turbine and the grid depends upon the availability of the wind. The prototype controller has been developed based on a micro-controller PIC16F877 and has been tested in the laboratory. (author)

ECONOMIC PROMOTION OF A SMALL COUNTRY – THE CASE OF SLOVENIA

Directory of Open Access Journals (Sweden)

Dejan ROMIH

2014-06-01

Full Text Available This paper examines the economic promotion of a small country in the case of Slovenia, which is facing certain economic and social problems. One reason for this is the current financial and economic crisis, which is continuing to affect the country’s economy. Economic promotion is therefore very important for Slovenia and its economic performance in both the short and long run.

Intra-abdominal desmoplastic small round cell tumors: CT findings and clinicopathological correlations in 13 cases

Energy Technology Data Exchange (ETDEWEB)

Chouli, Malik [Department of Radiology, Institute Gustave Roussy, 39 Rue Camille Desmoulines, 94805 Villejuif Cedex (France); Viala, Juliette [Department of Radiology, Institute Gustave Roussy, 39 Rue Camille Desmoulines, 94805 Villejuif Cedex (France); Dromain, Clarisse [Department of Radiology, Institute Gustave Roussy, 39 Rue Camille Desmoulines, 94805 Villejuif Cedex (France); Fizazi, Karim [Department of Medicine, Institute Gustave Roussy, 39 Rue Camille Desmoulines, 94805 Villejuif Cedex (France); Duvillard, Pierre [Department of Histopathology, Institute Gustave Roussy, 39 Rue Camille Desmoulines, 94805 Villejuif Cedex (France); Vanel, Daniel [Department of Radiology, Institute Gustave Roussy, 39 Rue Camille Desmoulines, 94805 Villejuif Cedex (France)]. E-mail: vanel@igr.fr

2005-06-01

Purpose: We report computed tomography (CT) findings in 13 patients with a primary abdominal desmoplastic small round cell tumor. Materials and methods: 13 cases (12 men, 1 woman, mean age = 24.8 years) were found in our hospital database between 1991 and 2003. Clinical, CT and histopathological features were studied retrospectively. Results: Peritoneal involvement was the most common feature. In 10 cases, several lobulated peritoneal soft tissue masses (with a mean of four masses per patient) were seen. Two patients had diffused irregular peritoneal carcinomatosis without any distinct peritoneal masses. One patient had a solitary mass in the pelvic space. The main sites of peritoneal involvement were the pelvic space (n 7), omentum (n = 5), retroperitoneal space (n = 4), small bowel mesentery (n = 3), paracolic gutter (n = 2 on the right and n = 1 on the left), transverse colon mesentery (n = 1), peri-splenic space (n = 1), peri-hepatic space (n 1). The soft tissue masses were often bulky (mean 6 cm, range 1-28 cm), lobulated and heterogeneous with hypodense areas (in 73% of cases). In six cases, moderate ascites was seen. In one case of pelvic involvement, unilateral hydronephrosis was seen. Adenopathies were present in seven cases at the time of the diagnosis (at intraperitoneal, retroperitoneal and pelvic sites in six patients and in the groin in one patient). Five patients had liver metastases (four lesions per case excepted one patient with 30 metastases). Associated thoracic metastases were seen in three patients. The diagnosis was confirmed with four CT-guided percutaneous biopsies. Conclusion: Although CT features are nonspecific, the diagnosis of desmoplastic small round cell tumor may be suspected in young men with multiple bulky heterogeneous peritoneal soft tissue masses. Imaging is useful for staging and also to guide biopsies.

Optimization of the central automatic control of a small Dutch sewer system

Science.gov (United States)

Kolechkina, A. G.; Hoes, O. A. C.

2012-04-01

A sewer control system was developed in the context of a subsidized project aiming at improvement of surface water quality by control of sewer systems and surface water systems. The project was coordinated by the local water board, "Waterschap Hollandse Delta". Other participants were Delft University of Technology, Deltares and the municipalities Strijen, Cromstrijen, Westmaas, Oud Beijerland and Piershil. As part of the project there were two pilot implementations where a central automatic controller was coupled to the existing SCADA system. For these two pilots the system is now operational. A Dutch urban area in the western part of the Netherlands is usually part of a polder, which is effectively an artificially drained catchment. The urban area itself is split into small subcatchments that manage runoff in different ways. In all cases a large fraction goes into the natural hydrological cycle, but, depending on the design of the local sewer system, a larger or smaller part finds its way into the sewer system. Proper control of this flow is necessary to control surface water quality and to avoid health risks from flow from the sewer into the streets. At each time step the controller switches pumps to distribute the remaining water in the system at the end of the time step over the different subcatchments. The distribution is created based on expert judgment of the relative vulnerability and subcatchment sewer system water quality. It is implemented in terms curves of total system stored volume versus subcatchment stored volume. We describe the process of the adaptation of a controller to two different sewer systems and the understanding of the artificial part of the catchment we gained during this process. In the process of adaptation the type of sewer system (combined foul water and storm water transport or separate foul water and storm water transport) played a major role.

Pilot case-control study of paediatric falls from windows.

Science.gov (United States)

Johnston, Brian D; Quistberg, D Alexander; Shandro, Jamie R; Partridge, Rebecca L; Song, Hyun Rae; Ebel, Beth E

2011-12-01

Unintentional falls from windows are an important cause of paediatric morbidity. There have been no controlled studies to identify modifiable environmental risk factors for window falls in young children. The authors have piloted a case-control study to test procedures for case identification, subject enrolment, and environmental data collection. Case windows were identified when a child 0-9 years old presented for care after a fall from that window. Control windows were identified (1) from the child's home and (2) from the home of an age- and gender-matched child seeking care for an injury diagnosis not related to a window fall. Study staff visited enrolled homes to collect window measurements and conduct window screen performance tests. The authors enrolled and collected data on 18 case windows, 18 in-home controls, and 14 matched community controls. Six potential community controls were contacted for every one enrolled. Families who completed the home visit viewed study procedures positively. Case windows were more likely than community controls to be horizontal sliders (100% vs 50%), to have deeper sills (6.28 vs 4.31 inches), to be higher above the exterior surface (183 vs 82 inches), and to have screens that failed below a threshold derived from the static pressure of a 3-year-old leaning against the mesh (60.0% vs 16.7%). Case windows varied very little from in-home controls. Case-control methodology can be used to study risk factors for paediatric falls from windows. Recruitment of community controls is challenging but essential, because in-home controls tend to be over-matched on important variables. A home visit allows direct measurement of window type, height, sill depth, and screen performance. These variables should all be investigated in subsequent, larger studies covering major housing markets.

Risk factors for near-fatal asthma. A case-control study in hospitalized patients with asthma.

Science.gov (United States)

Turner, M O; Noertjojo, K; Vedal, S; Bai, T; Crump, S; Fitzgerald, J M

1998-06-01

We prospectively recruited patients admitted to the hospital with severe asthma to comprehensively evaluate the association of historical and physiologic features with the risk of near-fatal asthma (NFA). A case-control study design was used. All patients admitted with NFA (cases) were identified prospectively and compared with asthma patients admitted during the same period without respiratory failure (controls). Nineteen cases (age: 40.2 +/- 12.0 yr) (mean +/- SD) and 80 controls (age: 36 +/- 13.5 yr) were enrolled. Duration of asthma, gender, smoking status, ethnicity, and prevalence of atopy were similar in the case and control groups. More than 80% of patients in both groups reported worsening symptoms for more than 48 h before admission, and more than 50% were worse for longer than 7 d. There was no difference in degree of airways obstruction or bronchial hyperresponsiveness (PC20). Perception of dyspnea was similar in the cases and controls, but among cases the males had greater impairment than the females (Borg score: 1.9 +/- 1. 4 versus 3.9 +/- 1.2: p = 0.05). Univariate analysis identified a history of previous mechanical ventilation (OR: 27.5; 95% CI: 6.60 to 113.7), admission to the intensive care unit (ICU) (OR: 9.9; 95% CI: 3.0 to 32.9), history of worse asthma during January and February (OR: 3.5; 95% CI: 1.0 to 11.8), and use of air-conditioning (OR: 15.0; 95% CI: 1.3 to 166) as risk factors for NFA. Of concern was the dependence of most patients (59.8%) on the emergency department (ED) for initial care, and the small number of cases (16%) in which patients visited a physician before admission to the hospital. We have confirmed risk factors identified previously in retrospective studies of fatal and NFA, and have also shown that hospitalized patients with asthma, irrespective of severity of their asthma, share several characteristics, especially in terms of their failure to respond to worsening asthma.

Fraud and Corruption Control at Education System Level: A Case Study of the Victorian Department of Education and Early Childhood Development in Australia

Science.gov (United States)

Bandaranayake, Bandara

2014-01-01

This case describes the implementation of a fraud and corruption control policy initiative within the Victorian Department of Education and Early Childhood Development (the Department) in Australia. The policy initiative was administered and carried out by a small team of fraud control officials, including the author of this article, in the…

Maternal characteristics and birth outcomes of pregnant women who had offspring with congenital ear abnormalities - a population-based case-control study.

Science.gov (United States)

Paput, László; Bánhidy, Ferenc; Czeizel, Andrew E

2011-09-01

To describe the maternal characteristics and birth outcomes of newborn infants affected with isolated ear congenital abnormalities (IECA), mainly isolated anotia/microtia and unclassified multiple congenital abnormalities (CAs) including anotia/microtia (UMAM). Cases with IECA and UMAM were compared with their matched controls and all controls without any defect and malformed controls affected with other defects in the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities. The mothers of 354 cases with IECA did not show significant difference in age, but their mean birth order was higher while their socio-economic status based on the maternal employment status was lower compared to the figures of their matched controls. There was a male excess among cases with microtia and mainly with UMAM. The evaluation of birth outcomes of newborns affected with IECA indicated intrauterine fetal growth retardation. Newborn infants with isolated microtia had intrauterine growth retardation and the association of this developmental defect localized for a small region of head with the general fetal development raises interesting theoretical question.

Analyses on the Performance and Interaction Between the Impeller and Casing in a Small-Size Turbo-Compressor

Science.gov (United States)

Kim, Youn-Jea; Kim, Dong-Won

The effects of casing shapes on the performance and the interaction between an impeller and a casing in a small-size turbo-compressor are investigated. Numerical analysis is conducted for the turbo-compressor with circular and single volute casings from the inlet to a discharge nozzle. The optimum design for each element is important to develop the small-size turbo-compressor using alternative refrigerant as a working fluid. Typically, the rotating speed of the compressor is in the range of 40000-45000rpm because of the small size of an impeller diameter. A blade of an impeller has backswept two-dimensional shape due to tip clearance and a vane diffuser has wedge type. In order to predict the flow pattern inside the entire impeller, the vaneless diffuser and the casing, calculations with multiple frames of reference method between the rotating and stationery parts of the domain are carried out. For compressible turbulent flow fields, the continuity and time-averaged three-dimensional Navier-Stokes equations are employed. To evaluate the performance of two types of casings, the static pressure recovery and loss coefficients are obtained with various flow rates. Also, static pressure distributions around casings are studied for different casing shapes, which are very important to predict the distribution of radial load. To prove the accuracy of numerical results, measurements of static pressure around the casing and pressure difference between the inlet and the outlet of the compressor are performed for the circular casing. The comparison of experimental and numerical results is conducted, and reasonable agreement is obtained.

DFIG turbine representation for small signal voltage control studies

DEFF Research Database (Denmark)

Garcia, Jorge Martinez; Kjær, Philip Carne; Teodorescu, Remus

2010-01-01

This paper addresses the representation of a wind power plant, based on wound rotor asynchronous generators, with a centralized voltage controller, by an equivalent transfer function, valid for small signal voltage control studies. This representation allows to investigate the influence...... introduced recently by several grid codes from around the world, making important to analyze this control when applied to wind power plants. The performance of the equivalent transfer function has been evaluated and compared using an equivalent grid with different short circuit ratios and active power...... of the centralized plant control gain and short circuit ratio on the system stability, for instance, by analyzing the zero-pole placement. Larger percentages of wind power penetration translate to more demanding requirements coming from the grid codes, for example voltage support at the point of connection has been...

CT Findings of Small Bowel Anisakiasis: Analysis of Four Cases

International Nuclear Information System (INIS)

Kim, Wee Kyoung; Song, Soon Young; Cho, On Koo; Koh, Byung Hee; Kim, Yong Soo; Jung, Woo Kyoung; Kim, Min Yeong

2011-01-01

We wanted to describe the CT findings of small bowel anisakiasis with the pathologic correlation. Four patients with surgically and pathologically proven small bowel anisakiasis were included in this retrospective study. They were three men and one woman and their ages ranged from 28 to 43 years (mean age: 38 years). We evaluated their clinical, CT and histological findings. All the patients had a history of ingesting raw fish within 24 hours from the time of symptom onset. They complained of abdominal pain (n=4), nausea (n=4), vomiting (n=2) and diarrhea (n=1). Physical examination revealed tenderness (n=4), rebound tenderness (n=4) and increased bowel sounds (n=3). Leukocytosis was noted in all the patients on the laboratory examination. None of the patients showed eosinophilia. The CT findings were segmental small bowel wall thickening with preserved layering (n=4), focal segmental luminal narrowing with proximal dilatation (n=4), peritoneal thickening (n=3), mesenteric or omental infiltration (n=4) and varying degrees of ascites (n=4). On the histopathologic examination, they revealed an infiltration of eosinophils (n=4) in all layers of the bowel wall with severe edema. The larvae were found on surgico-pathologic examination in all the cases. The CT findings may be helpful to make the specific diagnosis of small bowel anisakiasis in a patient with the clinical findings of an acute abdomen and a history of eating raw fish

CT Findings of Small Bowel Anisakiasis: Analysis of Four Cases

Energy Technology Data Exchange (ETDEWEB)

Kim, Wee Kyoung; Song, Soon Young; Cho, On Koo; Koh, Byung Hee [Hanyang University College of Medicine, Seoul (Korea, Republic of); Kim, Yong Soo; Jung, Woo Kyoung; Kim, Min Yeong [Hanyang University Guri Hospital, College of Medicine, Guri (Korea, Republic of)

2011-02-15

We wanted to describe the CT findings of small bowel anisakiasis with the pathologic correlation. Four patients with surgically and pathologically proven small bowel anisakiasis were included in this retrospective study. They were three men and one woman and their ages ranged from 28 to 43 years (mean age: 38 years). We evaluated their clinical, CT and histological findings. All the patients had a history of ingesting raw fish within 24 hours from the time of symptom onset. They complained of abdominal pain (n=4), nausea (n=4), vomiting (n=2) and diarrhea (n=1). Physical examination revealed tenderness (n=4), rebound tenderness (n=4) and increased bowel sounds (n=3). Leukocytosis was noted in all the patients on the laboratory examination. None of the patients showed eosinophilia. The CT findings were segmental small bowel wall thickening with preserved layering (n=4), focal segmental luminal narrowing with proximal dilatation (n=4), peritoneal thickening (n=3), mesenteric or omental infiltration (n=4) and varying degrees of ascites (n=4). On the histopathologic examination, they revealed an infiltration of eosinophils (n=4) in all layers of the bowel wall with severe edema. The larvae were found on surgico-pathologic examination in all the cases. The CT findings may be helpful to make the specific diagnosis of small bowel anisakiasis in a patient with the clinical findings of an acute abdomen and a history of eating raw fish

Bias correction of risk estimates in vaccine safety studies with rare adverse events using a self-controlled case series design.

Science.gov (United States)

Zeng, Chan; Newcomer, Sophia R; Glanz, Jason M; Shoup, Jo Ann; Daley, Matthew F; Hambidge, Simon J; Xu, Stanley

2013-12-15

The self-controlled case series (SCCS) method is often used to examine the temporal association between vaccination and adverse events using only data from patients who experienced such events. Conditional Poisson regression models are used to estimate incidence rate ratios, and these models perform well with large or medium-sized case samples. However, in some vaccine safety studies, the adverse events studied are rare and the maximum likelihood estimates may be biased. Several bias correction methods have been examined in case-control studies using conditional logistic regression, but none of these methods have been evaluated in studies using the SCCS design. In this study, we used simulations to evaluate 2 bias correction approaches-the Firth penalized maximum likelihood method and Cordeiro and McCullagh's bias reduction after maximum likelihood estimation-with small sample sizes in studies using the SCCS design. The simulations showed that the bias under the SCCS design with a small number of cases can be large and is also sensitive to a short risk period. The Firth correction method provides finite and less biased estimates than the maximum likelihood method and Cordeiro and McCullagh's method. However, limitations still exist when the risk period in the SCCS design is short relative to the entire observation period.

Is case-chaos methodology an appropriate alternative to conventional case-control studies for investigating outbreaks?

Science.gov (United States)

Edelstein, Michael; Wallensten, Anders; Kühlmann-Berenzon, Sharon

2014-08-15

Case-chaos methodology is a proposed alternative to case-control studies that simulates controls by randomly reshuffling the exposures of cases. We evaluated the method using data on outbreaks in Sweden. We identified 5 case-control studies from foodborne illness outbreaks that occurred between 2005 and 2012. Using case-chaos methodology, we calculated odds ratios 1,000 times for each exposure. We used the median as the point estimate and the 2.5th and 97.5th percentiles as the confidence interval. We compared case-chaos matched odds ratios with their respective case-control odds ratios in terms of statistical significance. Using Spearman's correlation, we estimated the correlation between matched odds ratios and the proportion of cases exposed to each exposure and quantified the relationship between the 2 using a normal linear mixed model. Each case-control study identified an outbreak vehicle (odds ratios = 4.9-45). Case-chaos methodology identified the outbreak vehicle 3 out of 5 times. It identified significant associations in 22 of 113 exposures that were not associated with outcome and 5 of 18 exposures that were significantly associated with outcome. Log matched odds ratios correlated with their respective proportion of cases exposed (Spearman ρ = 0.91) and increased significantly with the proportion of cases exposed (b = 0.054). Case-chaos methodology missed the outbreak source 2 of 5 times and identified spurious associations between a number of exposures and outcome. Measures of association correlated with the proportion of cases exposed. We recommended against using case-chaos analysis during outbreak investigations. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Small- and Medium-Sized Commercial Building Monitoring and Controls Needs: A Scoping Study

Energy Technology Data Exchange (ETDEWEB)

Katipamula, Srinivas; Underhill, Ronald M.; Goddard, James K.; Taasevigen, Danny J.; Piette, M. A.; Granderson, J.; Brown, Rich E.; Lanzisera, Steven M.; Kuruganti, T.

2012-10-31

Buildings consume over 40% of the total energy consumption in the U.S. A significant portion of the energy consumed in buildings is wasted because of the lack of controls or the inability to use existing building automation systems (BASs) properly. Much of the waste occurs because of our inability to manage and controls buildings efficiently. Over 90% of the buildings are either small-size (<5,000 sf) or medium-size (between 5,000 sf and 50,000 sf); these buildings currently do not use BASs to monitor and control their building systems from a central location. According to Commercial Building Energy Consumption Survey (CBECS), about 10% of the buildings in the U.S. use BASs or central controls to manage their building system operations. Buildings that use BASs are typically large (>100,000 sf). Lawrence Berkeley National Laboratory (LBNL), Oak Ridge National Laboratory (ORNL) and Pacific Northwest National Laboratory (PNNL) were asked by the U.S. Department of Energy’s (DOE’s) Building Technologies Program (BTP) to identify monitoring and control needs for small- and medium-sized commercial buildings and recommend possible solutions. This study documents the needs and solutions for small- and medium-sized buildings.

Primary Gastric Small Cell Carcinoma in Elderly Patients: A Case Report and Review of the Literature

Directory of Open Access Journals (Sweden)

Jian-Han Lai

2017-03-01

Full Text Available We report the case of an 86-year-old man with primary gastric small cell carcinoma (SmCC. He was admitted to our hospital owing to gastrointestinal bleeding complicated by anemia. An upper gastrointestinal endoscopic examination revealed a large, irregularly ulcerated tumor on the upper to middle body of the stomach. Small cell carcinoma was diagnosed based on the results of histologic and immunohistochemical studies of an endoscopic biopsy specimen. According to previous reports of gastric SmCC, only one-sixth of cases have been correctly diagnosed preoperatively. In our case, it was an aggressive malignancy that had an extremely poor prognosis. We believe that careful endoscopic examination including immunohistochemical investigation is necessary to accurately diagnose gastric SmCC in clinical practice.

Counseling a Student Presenting Borderline Personality Disorder in the Small College Context: Case Study and Implications

Science.gov (United States)

Draper, Matthew R.; Faulkner, Ginger E.

2009-01-01

This case study examines the dynamics and challenges associated with counseling a client experiencing borderline personality disorder in the small college institutional context. The work of counseling centers at small private institutions has been relatively unexplored in the extant college counseling literature. To help fill this gap, the current…

[Volvulus of the small bowel due to ascaris lumbricoides package: about a case].

Science.gov (United States)

Diouf, Cheikh; Kane, Ahmed; Ndoye, Ndeye Aby; Ndour, Oumar; Faye-Fall, Aimé Lakh; Fall, Mbaye; Alumeti, Désiré Munyali; Ngom, Gabriel

2016-01-01

We report an exceptional case of a 7 year-old patient with necrotic small bowel volvulus due to adult ascaris lumbricoides. At the admission, the child had intestinal obstruction evolving since two days with alteration of general state. Abdominal radiography without preparation showed small bowel air-fluid levels and tiger-stripe appearance evoking the diagnosis of acute intestinal obstruction associated with abdominal mass. After resuscitation, the surgical treatment consisted of laparotomy which showed necrotic volvulus of the terminal ileum containing adult ascaris lumbricoides. The patient underwent small bowel resection, approximately one meter of affected section was removed and then an ileostomy was performed. The evolution was favorable. The patient underwent ileorectal anastomosis four weeks later. After a 2 year follow-up period the child had no symptoms.

A pulse-width modulated, high reliability charge controller for small photovoltaic systems

Energy Technology Data Exchange (ETDEWEB)

Gerken, K. [Morningstar Corp., Olney, MD (United States); Welsh, D. [Morningstar Corp., Encinitas, CA (United States)

1997-02-01

This report presents the results of a development effort to design, test and begin production of a new class of small photovoltaic (PV) charge controllers. Sandia National Laboratories provided technical support, test data and financial support through a Balance-of-System Development contract. One of the objectives of the development was to increase user confidence in small PV systems by improving the reliability and operating life of the system controllers. Another equally important objective was to improve the economics of small PV systems by extending the battery lifetimes. Using new technology and advanced manufacturing techniques, these objectives were accomplished. Because small stand-alone PV systems account for over one third of all PV modules shipped, the positive impact of improving the reliability and economics of PV systems in this market segment will be felt throughout the industry. The results of verification testing of the new product are also included in this report. The initial design goals and specifications were very aggressive, but the extensive testing demonstrates that all the goals were achieved. Production of the product started in May at a rate of 2,000 units per month. Over 40 Morningstar distributors (5 US and 35 overseas) have taken delivery in the first 2 months of shipments. Initial customer reactions to the new controller have been very favorable.

Pain control in small animalsControle da dor em pequenos animais

Directory of Open Access Journals (Sweden)

Julia Duarte Penter

2011-12-01

Full Text Available Pain is an unpleasant sensory or emotional experience that follows the application of a noxious stimulus. Can be experienced with or without the concomitant occurrence of physical stress signs, which occurs frequently in animals caused by trauma, systemic disease or surgical procedures. The control depends on length, where there are painful impulses and mental status of the animal. It is an important clinical condition, resulting in suffer that will affect quality life. This paper is a review of pathophysiology and pain control in small animals.A dor é uma experiência sensorial ou emocional desagradável que se segue à aplicação de um estímulo nocivo. Pode ser vivenciada com ou sem o acontecimento concomitante de sinais físicos de estresse, trauma, doença sistêmica ou procedimento cirúrgico. Seu controle depende de sua duração, de onde surgem os impulsos dolorosos e do estado de consciência do animal. É uma condição clinicamente importante, que resulta em sofrimento e afeta a qualidade de vida dos animais. O objetivo deste trabalho é a revisão da fisiopatologia e controle da dor em pequenos animais.

Impacts of the Implementation of a Project Management Information System – a Case Study of a Small R

Directory of Open Access Journals (Sweden)

Borštnar Mirjana Kljajić

2014-02-01

Full Text Available Background: The problems of resources management (human, financial, time in multi-project companies are inherently complex and need to be addressed systematically, in both small and large organizations. Furthermore, there is a need for transparent communication and collaboration within the organization as well as with partnering organizations. There are many methodologies and tools supporting project management, which are themselves complex and are therefore not widely adopted, especially among small companies. Objectives: The aim of this paper is to analyse impact of the implementation of a flexible cloud-based project management information system (PMIS from the human resources, financial management, and collaboration points of view. Method: We have conducted a case study in a small Slovenian research and development company, that has implemented the 4PM PMIS. Results: The findings imply the importance of keeping the balance of the creative processes that are unstructured, rule free and even chaotic, with structured processes monitor and control. Conclusions: The results of the study suggest that the use of “4PM” in support of multi-project management improves human resources and financial management in a collaborative and transparent way when implemented in an open and highly motivated environment

Small Business Tax Evasion, is There a Case of Internal Finance?

Directory of Open Access Journals (Sweden)

Ilirjan Lipi

2017-04-01

Full Text Available As long as there are taxes, the incentive for evasion will exist as well. Studies for tax evasion are of interest in different fields like that of economics, public finance, personal finance, business administration, business finance, financial accounting, in the banking system etc. However, there are only a few studies about the internal causes and financial incentives that oblige decision-makers of small firms towards tax evasion. When we refer to business tax evasion, always brings to mind sensational cases of large businesses that evade taxes, but business tax evasion is a widespread phenomenon even to small firms. To be more competitive, small business must have a consistently entrepreneurial orientation, but limited financing prevents this, therefore the business savings from tax evasion is believed to be an internally funding path. The restrictions on small firms financing often make them orientate more toward internal generation of funds, which also has few alternatives. As a way to internal saving, firms often find tax evasion, which is not only a deviant and unethical behavior, but also puts firms into many difficulties in the long run. Consequently, the study aims to discuss the phenomenon of tax evasion in the managerial practice of small business in an Albanian region, as well as its financial cause as is perceived by the small business. The study findings report that the deviant behavior of businesses from taxes considers the need for internal financing as an important reason. The study concluded that savings from tax evasion is an alternative of internal financing primarily for small and early-staged firms, and that if entrepreneurs are capable of a good business model and competitive strategy, they will not need to make evasion.

Governance of ecosystem services on small islands: three contrasting cases for St. Eustatius in the Dutch Caribbean

Directory of Open Access Journals (Sweden)

Nico Polman

2016-05-01

Full Text Available Natural ecosystems provide an attractive focus for tourism on small islands. But at the same time tourism and other human actions can be detrimental to these ecosystems especially because governance of the ecosystem may be difficult due to the limited resilience of small island ecosystems. In this paper, we focus on which conditions self-governance will be the appropriate governance mechanism of ecosystem services on small islands. We apply the Ostrom (2009 framework for common-pool resources in a social-ecological system, and select the relevant indicators for small islands. We scored these indicators for three cases (environmental issues in St. Eustatius. These cases show that self-organization of ecosystem services is not an outcome easily achieved. The unevenly distributed benefits of potential measures are found to decrease community support of measures that could reinforce these ecosystem services.

Optimizing the Attitude Control of Small Satellite Constellations for Rapid Response Imaging

Science.gov (United States)

Nag, S.; Li, A.

2016-12-01

Distributed Space Missions (DSMs) such as formation flight and constellations, are being recognized as important solutions to increase measurement samples over space and time. Given the increasingly accurate attitude control systems emerging in the commercial market, small spacecraft now have the ability to slew and point within few minutes of notice. In spite of hardware development in CubeSats at the payload (e.g. NASA InVEST) and subsystems (e.g. Blue Canyon Technologies), software development for tradespace analysis in constellation design (e.g. Goddard's TAT-C), planning and scheduling development in single spacecraft (e.g. GEO-CAPE) and aerial flight path optimizations for UAVs (e.g. NASA Sensor Web), there is a gap in open-source, open-access software tools for planning and scheduling distributed satellite operations in terms of pointing and observing targets. This paper will demonstrate results from a tool being developed for scheduling pointing operations of narrow field-of-view (FOV) sensors over mission lifetime to maximize metrics such as global coverage and revisit statistics. Past research has shown the need for at least fourteen satellites to cover the Earth globally everyday using a LandSat-like sensor. Increasing the FOV three times reduces the need to four satellites, however adds image distortion and BRDF complexities to the observed reflectance. If narrow FOV sensors on a small satellite constellation were commanded using robust algorithms to slew their sensor dynamically, they would be able to coordinately cover the global landmass much faster without compensating for spatial resolution or BRDF effects. Our algorithm to optimize constellation satellite pointing is based on a dynamic programming approach under the constraints of orbital mechanics and existing attitude control systems for small satellites. As a case study for our algorithm, we minimize the time required to cover the 17000 Landsat images with maximum signal to noise ratio fall

Assessment of small versus large hydro-power developments - a Norwegian case study

Energy Technology Data Exchange (ETDEWEB)

Bakken, Tor Haakon; Harby, Atle

2010-07-01

Full text: The era of new, large hydro-power development projects seems to be over in Norway. Partly as a response to this, a large number of applications for the development of smallscale hydro power projects up to 10 MW overflow the Water Resources and Energy Directorate, resulting in an extensive development of small tributaries and water courses in Norway. This study has developed a framework for the assessment and comparison of several small versus many large hydro-power projects based on a multi-criteria analysis (MCA) approach, and further tested this approach on planned or developed projects in the Helgeland region, Norway. Multi-criteria analysis is a decision-support tool aimed at providing a systematic approach for the comparison of various alternatives with often non-commensurable and conflicting attributes. At the same time, the technique enables complex problems and various alternatives to be assessed in a transparent and simple way. The MCA-software was in our case equipped with 2 overall criteria (objectives) with a number of sub criteria; Production with sub-criteria like volume of energy production, installed effect, storage capacity and economical profit; Environmental impacts with sub-criteria like fishing interests, biodiversity, protection of unexploited nature The data used in the case study is based on the planned development of Vefsna (large project) with the energy/effect production estimated and the environmental impacts identified as part of the feasibility studies (the project never reached the authorities' licensing system with a formal EIA). The small-scale hydro-power projects used for comparison are based on realized projects in the Helgeland region and a number of proposed projects, up scaled to the size of the proposed Vefsna-development. The results from the study indicate that a large number of small-scale hydro-power projects need to be implemented in order to balance the volume of produced electricity/effect from one

Risk factors for small airway obstruction among Chinese island residents: a case-control study.

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Yu-sheng Chen

Full Text Available BACKGROUND: We investigated the prevalence of and risk factors for small airway obstruction (SAO among Chinese island residents to establish means to prevent and treat SAO. METHODS: From October 17, 2011 to November 1, 2011, a total of 2,873 residents aged >20 years who lived on the Huangqi Peninsula of Fujian were recruited by random cluster sampling. They were asked to complete a Burden of Obstructive Lung Disease (BOLD questionnaire and underwent physical examinations and lung function evaluations. SAO was defined as a forced expiratory flow at 50% of vital capacity, Vmax50%, of less than 70% of predicted. Risk factors for SAO were assessed from among demographic and anthropometric variables, blood chemistry results, and questionnaire response items. RESULTS: A total of 216 (7.52% Chinese island residents were identified as having SAO (95 males; 121 females. Their survey and test results were compared with 432 age and sex-matched healthy controls (192 males; 240 females for SAO risk factors. Among numerous factors investigated, only diabetes mellitus (p = 0.039, smoking index (SI, p600, second hand smoke (p = 0.002, and lack of regular exercise (p<0.001 were significant risk factors for SAO. CONCLUSIONS: The risk factors for SAO among Chinese island residents appeared to be similar to those among people who live in high-density urban environments and impoverished rural areas. Public health policies and medical practices directed toward improving respiratory health for island residents should be comparable to those used for urban and rural dwellers.

The need to use elements of controlling system by entities of small and microenterprises

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K.O. Buzhymska

2017-08-01

Full Text Available The entities of small and microenterprise are the basis of an effectively functioning market economy. The development of small business in Ukraine is hindered by a number of negative factors, one of them is the imperfection of the management system. An effective method of improving the management system is the use of controlling as one of the newest technologies for coordinating managerial and economic processes towards achieving the general goals of the business entity. The article is devoted to the substantiation of the need to use elements of the controlling system at microenterpreneurship enterprises, to identify elements that are subject to urgent implementation and to determine effective approaches to the practical implementation of selected elements. The controlling system is primarily used to coordinate the management process in complex organizational structures that are characteristic of large and medium-sized enterprises, but some of its elements can be effectively used by small and microenterprises. The authors substantiate the necessity of introducing the following elements of the controlling system by small business entities: management accounting, monitoring, cost-benefit analysis, the information support for management decisions. The introduction of these elements is appropriate with the use of outsourcing or co-sourcing. The consultative and professional support of these processes should be provided by local government authorities as one of the directions of the state program for supporting small business.

Risk of Prostate Cancer after Trans Urethral Resection of BPH: A Cohort and Nested Case-Control Study

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Beatrice Melin

2011-11-01

Full Text Available Epidemiological and experimental evidence suggests that inflammation plays a role in both prostate cancer (PCa and benign prostate hyperplasia (BPH. This study evaluates the risk of PC after transurethral resection (TURP for BPH and estimates the PCa risk related to presence of inflammation in the resected material. The Pathology Department at the University Hospital of Umeå (Umeå, Sweden identified BPH cases (n = 7,901 that underwent TURP between 1982 and 1997. Using these pathological specimens, we compared the incidence of PCa in the cohort to the population and calculated the standardized incidence and mortality ratios (SIR and SMR. Inflammation, the androgen receptor (AR, and p53 were evaluated in a nested case-control study of 201 cases and controls. Inflammation was graded severe or mild-moderate. In the follow-up period after TURP, cases developed prostate cancer and the controls did not. After TURP, SIR for prostate cancer increased [1.26, CI 95% (1.17–1.35], whereas SMR decreased [0.59, CI 95% (0.47–0.73]. Presence of inflammation at the time of TURP did not differ between cases and controls nor were there differences in p53 or AR staining. The data suggest a small increased risk of PCa after TURP and decreased PCa mortality. Inflammation at the time of TURP is not associated with PCa risk in this material. The increased PCa risk may be attributed to increased surveillance and PSA screening.

Risk of Prostate Cancer after Trans Urethral Resection of BPH: A Cohort and Nested Case-Control Study

International Nuclear Information System (INIS)

Karlsson, Camilla T.; Wiklund, Fredrik; Grönberg, Henrik; Bergh, Anders; Melin, Beatrice

2011-01-01

Epidemiological and experimental evidence suggests that inflammation plays a role in both prostate cancer (PCa) and benign prostate hyperplasia (BPH). This study evaluates the risk of PC after transurethral resection (TURP) for BPH and estimates the PCa risk related to presence of inflammation in the resected material. The Pathology Department at the University Hospital of Umeå (Umeå, Sweden) identified BPH cases (n = 7,901) that underwent TURP between 1982 and 1997. Using these pathological specimens, we compared the incidence of PCa in the cohort to the population and calculated the standardized incidence and mortality ratios (SIR and SMR). Inflammation, the androgen receptor (AR), and p53 were evaluated in a nested case-control study of 201 cases and controls. Inflammation was graded severe or mild-moderate. In the follow-up period after TURP, cases developed prostate cancer and the controls did not. After TURP, SIR for prostate cancer increased [1.26, CI 95% (1.17–1.35) ], whereas SMR decreased [0.59, CI 95% (0.47–0.73) ]. Presence of inflammation at the time of TURP did not differ between cases and controls nor were there differences in p53 or AR staining. The data suggest a small increased risk of PCa after TURP and decreased PCa mortality. Inflammation at the time of TURP is not associated with PCa risk in this material. The increased PCa risk may be attributed to increased surveillance and PSA screening

Risk of Prostate Cancer after Trans Urethral Resection of BPH: A Cohort and Nested Case-Control Study

Energy Technology Data Exchange (ETDEWEB)

Karlsson, Camilla T., E-mail: Camilla.thellenberg@onkologi.umu.se [Department of Radiation Sciences, Oncology, Umeå University, SE-901 87 Umeå (Sweden); Wiklund, Fredrik; Grönberg, Henrik [Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm SE-171 77 (Sweden); Bergh, Anders [Department of Medical Biosciences, Pathology, Umeå University, SE-901 87 Umeå (Sweden); Melin, Beatrice [Department of Radiation Sciences, Oncology, Umeå University, SE-901 87 Umeå (Sweden)

2011-11-08

Epidemiological and experimental evidence suggests that inflammation plays a role in both prostate cancer (PCa) and benign prostate hyperplasia (BPH). This study evaluates the risk of PC after transurethral resection (TURP) for BPH and estimates the PCa risk related to presence of inflammation in the resected material. The Pathology Department at the University Hospital of Umeå (Umeå, Sweden) identified BPH cases (n = 7,901) that underwent TURP between 1982 and 1997. Using these pathological specimens, we compared the incidence of PCa in the cohort to the population and calculated the standardized incidence and mortality ratios (SIR and SMR). Inflammation, the androgen receptor (AR), and p53 were evaluated in a nested case-control study of 201 cases and controls. Inflammation was graded severe or mild-moderate. In the follow-up period after TURP, cases developed prostate cancer and the controls did not. After TURP, SIR for prostate cancer increased [1.26, CI 95% (1.17–1.35) ], whereas SMR decreased [0.59, CI 95% (0.47–0.73) ]. Presence of inflammation at the time of TURP did not differ between cases and controls nor were there differences in p53 or AR staining. The data suggest a small increased risk of PCa after TURP and decreased PCa mortality. Inflammation at the time of TURP is not associated with PCa risk in this material. The increased PCa risk may be attributed to increased surveillance and PSA screening.

Case Studies of Leading Edge Small Urban High Schools. Relevance Strategic Designs: 4. Boston Arts Academy

Science.gov (United States)

Shields, Regis Anne; Ireland, Nicole; City, Elizabeth; Derderian, Julie; Miles, Karen Hawley

2008-01-01

This report is one of nine detailed case studies of small urban high schools that served as the foundation for the Education Resource Strategies (ERS) report "Strategic Designs: Lessons from Leading Edge Small Urban High Schools." These nine schools were dubbed "Leading Edge Schools" because they stand apart from other high…

Case Studies of Leading Edge Small Urban High Schools. Relevance Strategic Designs: 6. Perspectives Charter School

Science.gov (United States)

Shields, Regis Anne; Ireland, Nicole; City, Elizabeth; Derderian, Julie; Miles, Karen Hawley

2008-01-01

This report is one of nine detailed case studies of small urban high schools that served as the foundation for the Education Resource Strategies (ERS) report "Strategic Designs: Lessons from Leading Edge Small Urban High Schools." These nine schools were dubbed "Leading Edge Schools" because they stand apart from other high…

Case Studies of Leading Edge Small Urban High Schools. Relevance Strategic Designs: 7. TechBoston Academy

Science.gov (United States)

Shields, Regis Anne; Ireland, Nicole; City, Elizabeth; Derderian, Julie; Miles, Karen Hawley

2008-01-01

This report is one of nine detailed case studies of small urban high schools that served as the foundation for the Education Resource Strategies (ERS) report "Strategic Designs: Lessons from Leading Edge Small Urban High Schools." These nine schools were dubbed "Leading Edge Schools" because they stand apart from other high…

Organo-axial volvulus of the small intestine: radiological case report and consideration for its mechanism.

Science.gov (United States)

Ishiguro, Toshitaka; Hiyama, Takashi; Nasu, Katsuhiro; Akashi, Yoshimasa; Minami, Manabu

2017-07-01

Gastrointestinal volvulus is mainly classified into two subtypes, mesentero-axial volvulus and organo-axial volvulus. The detailed imaging findings of organo-axial volvulus of the small intestine have never been reported as far as we know. In this article, we report a case of organo-axial volvulus of the small intestine, focusing on the computed tomography (CT) findings. An 80-year-old man was radiologically diagnosed as having organo-axial volvulus of the terminal ileum and it was confirmed by open surgery without adhesion or any other anatomical abnormalities. CT showed two specific findings, split-bowel sign and rotating-C sign, which we think reflect pathophysiologic features of organo-axial volvulus. We think the pathogenic mechanism of organo-axial volvulus can be explained by the convergence of the reversed-rotational twist following the formation of a twisted but non-obstructive circular loop, even if there is no adhesion. Radiologists should be aware that organo-axial volvulus can occur even in the small intestine, and in the case of small bowel obstruction with single transition point, the two pathophysiologic signs mentioned above must be looked for to diagnose the possibility of organo-axial volvulus.

Control Strategy for Small Molecule Impurities in Antibody-Drug Conjugates.

Science.gov (United States)

Gong, Hai H; Ihle, Nathan; Jones, Michael T; Kelly, Kathleen; Kott, Laila; Raglione, Thomas; Whitlock, Scott; Zhang, Qunying; Zheng, Jie

2018-04-01

Antibody-drug conjugates (ADCs) are an emerging class of biopharmaceuticals. As such, there are no specific guidelines addressing impurity limits and qualification requirements. The current ICH guidelines on impurities, Q3A (Impurities in New Drug Substances), Q3B (Impurities in New Drug Products), and Q6B (Specifications: Test Procedures and Acceptance Criteria for Biotechnological/Biological Products) do not adequately address how to assess small molecule impurities in ADCs. The International Consortium for Innovation and Quality in Pharmaceutical Development (IQ) formed an impurities working group (IWG) to discuss this issue. This white paper presents a strategy for evaluating the impact of small molecule impurities in ADCs. This strategy suggests a science-based approach that can be applied to the design of control systems for ADC therapeutics. The key principles that form the basis for this strategy include the significant difference in molecular weights between small molecule impurities and the ADC, the conjugation potential of the small molecule impurities, and the typical dosing concentrations and dosing schedule. The result is that exposure to small impurities in ADCs is so low as to often pose little or no significant safety risk.

The case for small-scale domestic cannabis cultivation.

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Decorte, Tom

2010-07-01

The shift to (inter)regional production, trade and domestic cultivation has become an irreversible international trend. Until now, the focus of most empirical work has been on large-scale, commercially oriented and professionally organized segments of the cannabis industry, often based on police data and on the perspective of law enforcement agencies. This paper offers a review of recent Dutch-language research that focuses on cannabis cultivation. Empirical studies were identified through literature searches using relevant search terms and Web of Science, Elin, Social Science Research Network and Elsevier ScienceDirect. The paper presents the main findings of Dutch and Belgian empirical work on the factors that stimulated the import substitution process on the cannabis market, aspects related to quality and potency issues, typologies of cannabis growers, and (unintended) effects of pursued policies. In the light of this (selective) review the author offers some commentary and analysis concerning the claims made by different stakeholders, and concludes with some reflections on future research and on policy implications. The author outlines the importance of small-scale, independent or ideologically oriented cannabis cultivation as an under-researched market segment. The author also makes a case for greater toleration of small-scale cannabis cultivation, to secure the least worst of cannabis markets. Copyright (c) 2010 Elsevier B.V. All rights reserved.

Patterned genital injury in cases of rape - A case-control study

DEFF Research Database (Denmark)

Astrup, Birgitte Schmidt; Ravn, Pernille; Thomsen, Jørgen Lange

2013-01-01

A pattern of genital injury that separates trauma seen in sexual assault cases from trauma seen following consensual sexual intercourse has been a matter of debate. This study aimed at clarifying the question by eliminating as many confounders as possible in a prospective, case-control setup. A t...

Effectiveness of malaria control interventions in Madagascar: a nationwide case-control survey.

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Kesteman, Thomas; Randrianarivelojosia, Milijaona; Raharimanga, Vaomalala; Randrianasolo, Laurence; Piola, Patrice; Rogier, Christophe

2016-02-11

Madagascar, as other malaria endemic countries, depends mainly on international funding for the implementation of malaria control interventions (MCI). As these funds no longer increase, policy makers need to know whether these MCI actually provide the expected protection. This study aimed at measuring the effectiveness of MCI deployed in all transmission patterns of Madagascar in 2012-2013 against the occurrence of clinical malaria cases. From September 2012 to August 2013, patients consulting for non-complicated malaria in 31 sentinel health centres (SHC) were asked to answer a short questionnaire about long-lasting insecticidal nets (LLIN) use, indoor residual spraying (IRS) in the household and intermittent preventive treatment of pregnant women (IPTp) intake. Controls were healthy all-ages individuals sampled from a concurrent cross-sectional survey conducted in areas surrounding the SHC. Cases and controls were retained in the database if they were resident of the same communes. The association between Plasmodium infection and exposure to MCI was calculated by multivariate multilevel models, and the protective effectiveness (PE) of an intervention was defined as 1 minus the odds ratio of this association. Data about 841 cases (out of 6760 cases observed in SHC) and 8284 controls was collected. The regular use of LLIN provided a significant 51 % PE (95 % CI [16-71]) in multivariate analysis, excluding in one transmission pattern where PE was -11 % (95 % CI [-251 to 65]) in univariate analysis. The PE of IRS was 51 % (95 % CI [31-65]), and the PE of exposure to both regular use of LLIN and IRS was 72 % (95 % CI [28-89]) in multivariate analyses. Vector control interventions avoided yearly over 100,000 clinical cases of malaria in Madagascar. The maternal PE of IPTp was 73 %. In Madagascar, LLIN and IRS had good PE against clinical malaria. These results may apply to other countries with similar transmission profiles, but such case-control surveys could be

Diaphragmatic rupture with right colon and small intestine herniation after blunt trauma: a case report

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Muroni Mirko

2010-08-01

Full Text Available Abstract Introduction Traumatic diaphragmatic hernias are an unusual presentation of trauma, and are observed in about 10% of diaphragmatic injuries. The diagnosis is often missed because of non-specific clinical signs, and the absence of additional intra-abdominal and thoracic injuries. Case presentation We report a case of a 59-year-old Italian man hospitalized for abdominal pain and vomiting. His medical history included a blunt trauma seven years previously. A chest X-ray showed right diaphragm elevation, and computed tomography revealed that the greater omentum, a portion of the colon and the small intestine had been transposed in the hemithorax through a diaphragm rupture. The patient underwent laparotomy, at which time the colon and small intestine were reduced back into the abdomen and the diaphragm was repaired. Conclusions This was a unusual case of traumatic right-sided diaphragmatic hernia. Diaphragmatic ruptures may be revealed many years after the initial trauma. The suspicion of diaphragmatic rupture in a patient with multiple traumas contributes to early diagnosis. Surgical repair remains the only curative treatment for diaphragmatic hernias. Prosthetic patches may be a good solution when the diaphragmatic defect is severe and too large for primary closure, whereas primary repair remains the gold standard for the closure of small to moderate sized diaphragmatic defects.

The role of independent intermediaries. The case of small and medium-sized exporters

DEFF Research Database (Denmark)

Madsen, Tage Koed; Moen, Øystein; Hammervold, Randi

2012-01-01

and participation rather than just discrete types of intermediary modes (agents, importers, dealers, etc.). Associations with performance as well as the role of product and distributor characteristics are analyzed. Empirical data based on a sample of product-market ventures in 227 small and medium-sized Norwegian...... export firms are analysed by a structural equation modelling approach. The article provides empirical evidence that managers keep control of decision making to an extent that may have a negative impact on export performance. The empirical study indicates that firms should participate more in task......The article examines how small and medium-sized exporters collaborate with intermediaries in foreign markets by studying the level of control, i.e. the delegation of decisions rights and task solution. It goes one step further than previous research, since it examines degrees of control...

Small cell carcinoma arising in Barrett's esophagus: a case report and review of the literature

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Markogiannakis Haridimos

2008-01-01

Full Text Available Abstract Introduction Gastrointestinal tract small cell carcinoma is an infrequent and aggressive neoplasm that represents 0.1–1% of gastrointestinal malignancies. Very few cases of small cell esophageal carcinoma arising in Barrett's esophagus have been reported in the literature. An extremely rare case of primary small cell carcinoma of the distal third of the esophagus arising from dysplastic Barrett's esophagus is herein presented. Case presentation A 62-year-old man with gastroesophageal reflux history presented with epigastric pain, epigastric fullness, dysphagia, anorexia, and weight loss. Esophagogastroscopy revealed an ulceroproliferative, intraluminar mass in the distal esophagus obstructing the esophageal lumen. Biopsy showed small cell esophageal carcinoma. Contrast-enhanced chest and abdominal computed tomography demonstrated a large tumor of the distal third of the esophagus without any lymphadenopathy or distant metastasis. Preoperative chemotherapy with cisplatine and etoposide for 3 months resulted in a significant reduction of the tumor. After en block esophagectomy with two field lymph node dissection, proximal gastrectomy, and cervical esophagogastric anastomosis, the patient was discharged on the 14th postoperative day. Histopathology revealed a primary small cell carcinoma of the distal third of the esophagus arising from dysplastic Barrett's esophagus. The patient received another 3 month course of postoperative chemotherapy with the same agents and remained free of disease at 12 month review. Conclusion Although small cell esophageal carcinoma is rare and its association with dysplastic Barrett's esophagus is extremely infrequent, the high carcinogenic risk of Barrett's epithelium should be kept in mind. Prognosis is quite unfavorable; a better prognosis might be possible with early diagnosis and treatment strategies incorporating chemotherapy along with oncological radical surgery and/or radiotherapy as part of a

Advantages of the nested case-control design in diagnostic research

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Hoes Arno W

2008-07-01

Full Text Available Abstract Background Despite its benefits, it is uncommon to apply the nested case-control design in diagnostic research. We aim to show advantages of this design for diagnostic accuracy studies. Methods We used data from a full cross-sectional diagnostic study comprising a cohort of 1295 consecutive patients who were selected on their suspicion of having deep vein thrombosis (DVT. We draw nested case-control samples from the full study population with case:control ratios of 1:1, 1:2, 1:3 and 1:4 (per ratio 100 samples were taken. We calculated diagnostic accuracy estimates for two tests that are used to detect DVT in clinical practice. Results Estimates of diagnostic accuracy in the nested case-control samples were very similar to those in the full study population. For example, for each case:control ratio, the positive predictive value of the D-dimer test was 0.30 in the full study population and 0.30 in the nested case-control samples (median of the 100 samples. As expected, variability of the estimates decreased with increasing sample size. Conclusion Our findings support the view that the nested case-control study is a valid and efficient design for diagnostic studies and should also be (reappraised in current guidelines on diagnostic accuracy research.

Intra-abdominal desmoplastic small cell tumor in a girl : a case report

International Nuclear Information System (INIS)

Lee, Young Seok

1998-01-01

Desmoplastic small cell tumor is a rare primary intra-abdominal disease with a predilection for the adolescent boy. This aggressive tumor involved multiple intraperitoneal organs, peritoneal, mesentery and omental seedings, and sometimes retroperitoneal extension. The author reports a case of this rare tumor, demonstrated by CT, MRI and US, in a 14-year-old girl. (author). 9 refs., 2 figs

Six Degrees-of-Freedom Ascent Control for Small-Body Touch and Go

Science.gov (United States)

Blackmore, Lars James C.

2011-01-01

A document discusses a method of controlling touch and go (TAG) of a spacecraft to correct attitude, while ensuring a safe ascent. TAG is a concept whereby a spacecraft is in contact with the surface of a small body, such as a comet or asteroid, for a few seconds or less before ascending to a safe location away from the small body. The report describes a controller that corrects attitude and ensures that the spacecraft ascends to a safe state as quickly as possible. The approach allocates a certain amount of control authority to attitude control, and uses the rest to accelerate the spacecraft as quickly as possible in the ascent direction. The relative allocation to attitude and position is a parameter whose optimal value is determined using a ground software tool. This new approach makes use of the full control authority of the spacecraft to correct the errors imparted by the contact, and ascend as quickly as possible. This is in contrast to prior approaches, which do not optimize the ascent acceleration.

Metastatic Extrapulmonary Small Cell Carcinoma to the Cerebellopontine Angle: A Case Report and Review of the Literature

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Debebe Theodros

2015-01-01

Full Text Available Extrapulmonary small cell carcinomas (EPSCC are rare malignancies with poor patient prognoses. We present the case of a 63-year-old male who underwent surgical resection of a poorly differentiated small cell carcinoma, likely from a small intestinal primary tumor that metastasized to the cerebellopontine angle (CPA. A 63-year-old male presented with mild left facial paralysis, hearing loss, and balance instability. MRI revealed a 15 mm mass in the left CPA involving the internal auditory canal consistent with a vestibular schwannoma. Preoperative MRI eight weeks later demonstrated marked enlargement to 35 mm. The patient underwent a suboccipital craniectomy and the mass was grossly different visually and in consistency from a standard vestibular schwannoma. The final pathology revealed a poorly differentiated small cell carcinoma. Postoperative PET scan identified avid uptake in the small intestine suggestive of either a small intestinal primary tumor or additional metastatic disease. The patient underwent whole brain radiation therapy and chemotherapy and at last follow-up demonstrated improvement in his symptoms. Surgical resection and radiotherapy are potential treatment options to improve survival in patients diagnosed with NET brain metastases. We present the first documented case of skull base metastasis of a poorly differentiated small cell carcinoma involving the CPA.

Supervisory Control System Architecture for Advanced Small Modular Reactors

Energy Technology Data Exchange (ETDEWEB)

Cetiner, Sacit M [ORNL; Cole, Daniel L [University of Pittsburgh; Fugate, David L [ORNL; Kisner, Roger A [ORNL; Melin, Alexander M [ORNL; Muhlheim, Michael David [ORNL; Rao, Nageswara S [ORNL; Wood, Richard Thomas [ORNL

2013-08-01

This technical report was generated as a product of the Supervisory Control for Multi-Modular SMR Plants project within the Instrumentation, Control and Human-Machine Interface technology area under the Advanced Small Modular Reactor (SMR) Research and Development Program of the U.S. Department of Energy. The report documents the definition of strategies, functional elements, and the structural architecture of a supervisory control system for multi-modular advanced SMR (AdvSMR) plants. This research activity advances the state-of-the art by incorporating decision making into the supervisory control system architectural layers through the introduction of a tiered-plant system approach. The report provides a brief history of hierarchical functional architectures and the current state-of-the-art, describes a reference AdvSMR to show the dependencies between systems, presents a hierarchical structure for supervisory control, indicates the importance of understanding trip setpoints, applies a new theoretic approach for comparing architectures, identifies cyber security controls that should be addressed early in system design, and describes ongoing work to develop system requirements and hardware/software configurations.

SMALL INVESTORS: CHALLENGES AND BENEFITS OF IPO - A CASE STUDY IN A SMALL BUSINESS IN THE REGION OF THE CAPÃO REDONDO - SP

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Loide Priscila Cacheche

2015-03-01

Full Text Available The purpose of this paper is to analyze the importance of knowledge of managers about market capitals (in terms of benefits and challenges and the relevance of the inclusion of small business context in this market. A case study was conducted by open questions interview with a CEO of a small business in Sao Paulo. Results showed that despite the CEO has knowledge about the capital market; the company was not structurally prepared to accept the challenges of capital markets.

Nonlinear control techniques of a controllable rectifier/inverter-motor drive system with a small dc-link capacitor

International Nuclear Information System (INIS)

Liutanakul, Pisit; Pierfederici, Serge; Meibody-Tabar, Farid

2008-01-01

The necessity of the converters compactness in many applications imposes the reduction of their different components size when it is possible. In this paper, a control method allowing the use of a small size dc-link capacitor for the cascade of voltage controlled-rectifier/inverter-motor drive system is proposed. This is achieved by adding the power balance equation in the system's model and the application of an exact input/output feedback linearization technique in a way that the rectifier controller compensates any sudden change in the inverter load, which is here an induction motor. Since the exact input/output feedback linearization technique is sensitive to the uncertainties over system parameters, a robust control strategy based on sliding mode controller is proposed. By this approach, the dc-link voltage becomes almost insensitive to the load variations. As a result, the level of the dc-link voltage could be stabilized with a small size dc-link capacitor. Without any considerations of the RMS current stress on this dc-link capacitor, a calculation method of a minimum value of this capacitor based on its storage energy is proposed. All the investigations are shown by computer simulations and the performance of controlled system is verified by experimentation results

Regional recurrence of oropharyngeal cancer after definitive radiotherapy: a case control study

International Nuclear Information System (INIS)

Söderström, Karin; Nilsson, Per; Dalianis, Tina; Kjellén, Elisabeth; Zackrisson, Björn

2015-01-01

Elective treatment of lymph nodes in oropharyngeal cancer (OPC) has impact on both regional recurrences (RR) and risk of late side effects. This study was performed to quantify the dose-dependent impact on RR and overall survival (OS) in a prospectively collected cohort of OPC from the ARTSCAN study with emphasis on elective treatment. ARTSCAN is a previously published prospective, randomized, multicentre study of altered radiotherapy (RT) fractionation in head and neck cancer. In ARTSCAN the elective treatment volume for node positive OPC varied significantly between centres due to local treatment principles. All patients with OPC in complete response after primary treatment were eligible for the present case–control study. Cases were patients with RR during five years follow-up. Patients with no recurrence were eligible as controls. Four controls per case were matched according to T- and N-stage. Mean (D mean ) and median (D 50% ) dose for the lymph node level (LNL) of RR in the cases and the corresponding LNL in the controls were analysed with conditional logistic regression. OS was estimated with the Kaplan-Meier method and evaluated by multivariate Cox regression analysis. There was a dose-dependent risk reduction for D 50% in the interval that represented elective treatment (40–50 Gy) (OR = 0.18, p < 0.05) and a trend in the same dose interval for D mean (OR = 0.19, p = 0.07). OS rates at five years were 0.39 (0.24-0.65) for cases and 0.70 (0.62–0.81) for controls (p < 0.001). The Kaplan-Meier and the Cox regression analysis for cases categorised by delivered dose showed an inverse relationship between dose and survival. The cases with RR in a LNL outside planning target volume (PTV) (D mean < 40 Gy) had an OS rate comparable to that of all patients, and those with RR in a LNL in PTV elective (D mean 40–60 Gy) or PTV tumour (D mean >60 Gy) did significantly worse (p < 0.05). The same inverse relationship was also shown for a small subset of patient

Lung cancer - small cell

Science.gov (United States)

Cancer - lung - small cell; Small cell lung cancer; SCLC ... About 15% of all lung cancer cases are SCLC. Small cell lung cancer is slightly more common in men than women. Almost all cases of SCLC are ...

Thrusting maneuver control of a small spacecraft via only gimbaled-thruster scheme

Science.gov (United States)

Kabganian, Mansour; Kouhi, Hamed; Shahravi, Morteza; Fani Saberi, Farhad

2018-05-01

The thrust vector control (TVC) scheme is a powerful method in spacecraft attitude control. Since the control of a small spacecraft is being studied here, a solid rocket motor (SRM) should be used instead of a liquid propellant motor. Among the TVC methods, gimbaled-TVC as an efficient method is employed in this paper. The spacecraft structure is composed of a body and a gimbaled-SRM where common attitude control systems such as reaction control system (RCS) and spin-stabilization are not presented. A nonlinear two-body model is considered for the characterization of the gimbaled-thruster spacecraft where, the only control input is provided by a gimbal actuator. The attitude of the spacecraft is affected by a large exogenous disturbance torque which is generated by a thrust vector misalignment from the center of mass (C.M). A linear control law is designed to stabilize the spacecraft attitude while rejecting the mentioned disturbance torque. A semi-analytical formulation of the region of attraction (RoA) is developed to ensure the local stability and fast convergence of the nonlinear closed-loop system. Simulation results of the 3D maneuvers are included to show the applicability of this method for use in a small spacecraft.

Space-Time Analysis of Testicular Cancer Clusters Using Residential Histories: A Case-Control Study in Denmark

Science.gov (United States)

Sloan, Chantel D.; Nordsborg, Rikke B.; Jacquez, Geoffrey M.; Raaschou-Nielsen, Ole; Meliker, Jaymie R.

2015-01-01

Though the etiology is largely unknown, testicular cancer incidence has seen recent significant increases in northern Europe and throughout many Western regions. The most common cancer in males under age 40, age period cohort models have posited exposures in the in utero environment or in early childhood as possible causes of increased risk of testicular cancer. Some of these factors may be tied to geography through being associated with behavioral, cultural, sociodemographic or built environment characteristics. If so, this could result in detectable geographic clusters of cases that could lead to hypotheses regarding environmental targets for intervention. Given a latency period between exposure to an environmental carcinogen and testicular cancer diagnosis, mobility histories are beneficial for spatial cluster analyses. Nearest-neighbor based Q-statistics allow for the incorporation of changes in residency in spatial disease cluster detection. Using these methods, a space-time cluster analysis was conducted on a population-wide case-control population selected from the Danish Cancer Registry with mobility histories since 1971 extracted from the Danish Civil Registration System. Cases (N=3297) were diagnosed between 1991 and 2003, and two sets of controls (N=3297 for each set) matched on sex and date of birth were included in the study. We also examined spatial patterns in maternal residential history for those cases and controls born in 1971 or later (N= 589 case-control pairs). Several small clusters were detected when aligning individuals by year prior to diagnosis, age at diagnosis and calendar year of diagnosis. However, the largest of these clusters contained only 2 statistically significant individuals at their center, and were not replicated in SaTScan spatial-only analyses which are less susceptible to multiple testing bias. We found little evidence of local clusters in residential histories of testicular cancer cases in this Danish population. PMID

Space-time analysis of testicular cancer clusters using residential histories: a case-control study in Denmark.

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Chantel D Sloan

Full Text Available Though the etiology is largely unknown, testicular cancer incidence has seen recent significant increases in northern Europe and throughout many Western regions. The most common cancer in males under age 40, age period cohort models have posited exposures in the in utero environment or in early childhood as possible causes of increased risk of testicular cancer. Some of these factors may be tied to geography through being associated with behavioral, cultural, sociodemographic or built environment characteristics. If so, this could result in detectable geographic clusters of cases that could lead to hypotheses regarding environmental targets for intervention. Given a latency period between exposure to an environmental carcinogen and testicular cancer diagnosis, mobility histories are beneficial for spatial cluster analyses. Nearest-neighbor based Q-statistics allow for the incorporation of changes in residency in spatial disease cluster detection. Using these methods, a space-time cluster analysis was conducted on a population-wide case-control population selected from the Danish Cancer Registry with mobility histories since 1971 extracted from the Danish Civil Registration System. Cases (N=3297 were diagnosed between 1991 and 2003, and two sets of controls (N=3297 for each set matched on sex and date of birth were included in the study. We also examined spatial patterns in maternal residential history for those cases and controls born in 1971 or later (N= 589 case-control pairs. Several small clusters were detected when aligning individuals by year prior to diagnosis, age at diagnosis and calendar year of diagnosis. However, the largest of these clusters contained only 2 statistically significant individuals at their center, and were not replicated in SaTScan spatial-only analyses which are less susceptible to multiple testing bias. We found little evidence of local clusters in residential histories of testicular cancer cases in this Danish

Space-time analysis of testicular cancer clusters using residential histories: a case-control study in Denmark.

Science.gov (United States)

Sloan, Chantel D; Nordsborg, Rikke B; Jacquez, Geoffrey M; Raaschou-Nielsen, Ole; Meliker, Jaymie R

2015-01-01

Though the etiology is largely unknown, testicular cancer incidence has seen recent significant increases in northern Europe and throughout many Western regions. The most common cancer in males under age 40, age period cohort models have posited exposures in the in utero environment or in early childhood as possible causes of increased risk of testicular cancer. Some of these factors may be tied to geography through being associated with behavioral, cultural, sociodemographic or built environment characteristics. If so, this could result in detectable geographic clusters of cases that could lead to hypotheses regarding environmental targets for intervention. Given a latency period between exposure to an environmental carcinogen and testicular cancer diagnosis, mobility histories are beneficial for spatial cluster analyses. Nearest-neighbor based Q-statistics allow for the incorporation of changes in residency in spatial disease cluster detection. Using these methods, a space-time cluster analysis was conducted on a population-wide case-control population selected from the Danish Cancer Registry with mobility histories since 1971 extracted from the Danish Civil Registration System. Cases (N=3297) were diagnosed between 1991 and 2003, and two sets of controls (N=3297 for each set) matched on sex and date of birth were included in the study. We also examined spatial patterns in maternal residential history for those cases and controls born in 1971 or later (N= 589 case-control pairs). Several small clusters were detected when aligning individuals by year prior to diagnosis, age at diagnosis and calendar year of diagnosis. However, the largest of these clusters contained only 2 statistically significant individuals at their center, and were not replicated in SaTScan spatial-only analyses which are less susceptible to multiple testing bias. We found little evidence of local clusters in residential histories of testicular cancer cases in this Danish population.

Control for small-speed lateral flight in a model insect

International Nuclear Information System (INIS)

Zhang Yanlai; Sun Mao

2011-01-01

Controls required for small-speed lateral flight of a model insect were studied using techniques based on the linear theories of stability and control (the stability and control derivatives were computed by the method of computational fluid dynamics). The main results are as follows. (1) Two steady-state lateral motions can exist: one is a horizontal side translation with the body rolling to the same side of the translation by a small angle, and the other is a constant-rate yaw rotation (rotation about the vertical axis). (2) The side translation requires an anti-symmetrical change in the stroke amplitudes of the contralateral wings, and/or an anti-symmetrical change in the angles of attack of the contralateral wings, with the down- and upstroke angles of attack of a wing having equal change. The constant-rate yaw rotation requires an anti-symmetrical change in the angles of attack of the contralateral wings, with the down- and upstroke angles of attack of a wing having differential change. (3) For the control of the horizontal side translation, control input required for the steady-state motion has an opposite sign to that needed for initiating the motion. For example, to have a steady-state left side-translation, the insect needs to increase the stroke amplitude of the left wing and decrease that of the right wing to maintain the steady-state flight, but it needs an opposite change in stroke amplitude (decreasing the stroke amplitude of the left wing and increasing that of the right wing) to enter the flight.

Control for small-speed lateral flight in a model insect.

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Zhang, Yan Lai; Sun, Mao

2011-09-01

Controls required for small-speed lateral flight of a model insect were studied using techniques based on the linear theories of stability and control (the stability and control derivatives were computed by the method of computational fluid dynamics). The main results are as follows. (1) Two steady-state lateral motions can exist: one is a horizontal side translation with the body rolling to the same side of the translation by a small angle, and the other is a constant-rate yaw rotation (rotation about the vertical axis). (2) The side translation requires an anti-symmetrical change in the stroke amplitudes of the contralateral wings, and/or an anti-symmetrical change in the angles of attack of the contralateral wings, with the down- and upstroke angles of attack of a wing having equal change. The constant-rate yaw rotation requires an anti-symmetrical change in the angles of attack of the contralateral wings, with the down- and upstroke angles of attack of a wing having differential change. (3) For the control of the horizontal side translation, control input required for the steady-state motion has an opposite sign to that needed for initiating the motion. For example, to have a steady-state left side-translation, the insect needs to increase the stroke amplitude of the left wing and decrease that of the right wing to maintain the steady-state flight, but it needs an opposite change in stroke amplitude (decreasing the stroke amplitude of the left wing and increasing that of the right wing) to enter the flight.

Symptomatic regrowth of a small intracranial aneurysm that had ruptured and completely thrombosed: a case report

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Hidetoshi Ooigawa

2015-06-01

Full Text Available We report a case of small internal carotid–posterior communication artery (IC–PC aneurysm that was completely thrombosed after initial bleeding, but subsequently became symptomatic, causing a mass effect. A 54-year-old woman initially presented with grade-five subarachnoid hemorrhage from a small right IC–PC aneurysm. The aneurysm was treated conservatively and completely thrombosed within 35 days. The patient slowly recovered and remained well until 4 years later, when she developed right oculomotor nerve palsy. Imaging revealed relapse of the aneurysm, and repair led to symptom resolution. This case offers a reminder that totally thrombosed aneurysms carry a risk of regrowth if left untreated.

Assessment of global phase uncertainty in case-control studies

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van Houwelingen Hans C

2009-09-01

Full Text Available Abstract Background In haplotype-based candidate gene studies a problem is that the genotype data are unphased, which results in haplotype ambiguity. The measure 1 quantifies haplotype predictability from genotype data. It is computed for each individual haplotype, and for a measure of global relative efficiency a minimum value is suggested. Alternatively, we developed methods directly based on the information content of haplotype frequency estimates to obtain global relative efficiency measures: and based on A- and D-optimality, respectively. All three methods are designed for single populations; they can be applied in cases only, controls only or the whole data. Therefore they are not necessarily optimal for haplotype testing in case-control studies. Results A new global relative efficiency measure was derived to maximize power of a simple test statistic that compares haplotype frequencies in cases and controls. Application to real data showed that our proposed method gave a clear and summarizing measure for the case-control study conducted. Additionally this measure might be used for selection of individuals, who have the highest potential for improving power by resolving phase ambiguity. Conclusion Instead of using relative efficiency measure for cases only, controls only or their combined data, we link uncertainty measure to case-control studies directly. Hence, our global efficiency measure might be useful to assess whether data are informative or have enough power for estimation of a specific haplotype risk.

Role of nutrition in pre-eclampsia and eclampsia cases, a case control study

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Punyatoya Bej

2014-12-01

Full Text Available Background: Preeclampsia and eclampsia during pregnancy contribute to maternal and fetal morbidity as well as mortality. The identification of the role of maternal nutrition during pregnancy will help in reducing morbidity and mortality. Aims & Objective: The objective of this study is to find out the role of nutrition, in the form of total calorie, protein, fruits, iron, folic acid and calcium intake in the development of preeclampsia and eclampsia among pregnant women in a tertiary level hospital. Material Methods: After ethical approval and informed consent, 122 women who delivered beyond 22 weeks of gestation and diagnosed as preeclampsia or eclampsia were selected. Simultaneously, 122 controls with no diagnosis of preeclampsia or eclampsia were selected from the post natal ward. Cases and controls were administered the same pre-tested questionnaire containing questions related to food and micronutrient intake by cases and control. Results: Logistic regression was applied in the statistical analysis. The factors that were found to be significant predictors of risk for development of preeclampsia and eclampsia were higher calorie intake (adjusted Odds Ratio (OR 14.12 [6.41-43.23] P < 0.001, less protein intake (adjusted OR 3.87 [1.97-8.01] P < 0.001 during pregnancy. Fruits intake in both cases and controls were similar. 77.9% of cases and 84.4% of controls had taken iron tablets during their antenatal period. 75.4% of cases and 82.8% of controls had taken calcium tablets during their antenatal period. Iron and calcium intake is not significantly associated with development of preeclampsia and eclampsia. Conclusion: Higher calorie intake and less protein intake during pregnancy were associated with development of preeclampsia and eclampsia. Fruits intake, iron and calcium intake were not associated with development of preeclampsia and eclampsia

Homocyst(e)ine and cardiovascular disease: a systematic review of the evidence with special emphasis on case-control studies and nested case-control studies.

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Ford, Earl S; Smith, S Jay; Stroup, Donna F; Steinberg, Karen K; Mueller, Patricia W; Thacker, Stephen B

2002-02-01

Elevated concentrations of homocyst(e)ine are thought to increase the risk of vascular diseases including coronary heart disease and cerebrovascular disease. We searched MEDLINE (1966-1999), EMBASE (1974-1999), SciSearch (1974- 1999), and Dissertation Abstracts (1999) for articles and theses about homocyst(e)ine concentration and coronary heart disease and cerebrovascular disease. We included 57 publications (3 cohort studies, 12 nested case-control studies, 42 case-control studies) that reported results on 5518 people with coronary heart disease (11,068 control subjects) and 1817 people with cerebrovascular disease (4787 control subjects) in our analysis. For coronary heart disease, the summary odds ratios (OR) for a 5-micromol/l increase in homocyst(e)ine concentration were 1.06 (95% CI : 0.99-1.13) for 2 publications of cohort studies, 1.23 (95% CI : 1.07-1.41) for 10 publications of nested case-control studies, and 1.70 (95% CI : 1.50-1.93) for 26 publications of case-control studies. For cerebrovascular disease, the summary OR for a 5-micromol/l increase in homocyst(e)ine concentration were 1.10 (95% CI : 0.94-1.28) for 2 publications of cohort studies, 1.58 (95% CI : 1.35-1.85) for 5 publications of nested case-control studies, and 2.16 (95% CI : 1.65-2.82) for 17 publications of case-control studies. Prospective studies offer weaker support than case-control studies for an association between homocyst(e)ine concentration and cardiovascular disease. Although other lines of evidence support a role for homocyst(e)ine in the pathogenesis of cardiovascular disease, more information from prospective epidemiological studies or clinical trials is needed to clarify this role.

Control of positive end-expiratory pressure (PEEP for small animal ventilators

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Leão Nunes Marcelo V

2010-07-01

Full Text Available Abstract Background The positive end-expiratory pressure (PEEP for the mechanical ventilation of small animals is frequently obtained with water seals or by using ventilators developed for human use. An alternative mechanism is the use of an on-off expiratory valve closing at the moment when the alveolar pressure is equal to the target PEEP. In this paper, a novel PEEP controller (PEEP-new and the PEEP system of a commercial small-animal ventilator, both based on switching an on-off valve, are evaluated. Methods The proposed PEEP controller is a discrete integrator monitoring the error between the target PEEP and the airways opening pressure prior to the onset of an inspiratory cycle. In vitro as well as in vivo experiments with rats were carried out and the PEEP accuracy, settling time and under/overshoot were considered as a measure of performance. Results The commercial PEEP controller did not pass the tests since it ignores the airways resistive pressure drop, resulting in a PEEP 5 cmH2O greater than the target in most conditions. The PEEP-new presented steady-state errors smaller than 0.5 cmH2O, with settling times below 10 s and under/overshoot smaller than 2 cmH2O. Conclusion The PEEP-new presented acceptable performance, considering accuracy and temporal response. This novel PEEP generator may prove useful in many applications for small animal ventilators.

Intelligent landing strategy for the small bodies: from passive bounce to active trajectory control

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Cui, Pingyuan; Liu, Yanjie; Yu, Zhengshi; Zhu, Shengying; Shao, Wei

2017-08-01

Landing exploration is an important way to improve the understanding of small bodies. Considering the weak gravity field as well as the strict attitude constraints which make bounce a common situation and a tough issue for safe landing on small bodies, a novel active trajectory control-based intelligent landing strategy is proposed to improve the safety and reliability of mission. The scenarios of intelligent landing strategy for both safe landing and hopping exploration are introduced in detail and a potential structure for autonomous navigation and control system is presented. Furthermore, a convex optimization-based control algorithm is developed, which is the key technology fulfilling the active trajectory control. Meanwhile a novel discretization method based on the fourth-order Runge-Kutta rule is proposed to improve the accuracy. A helpful adjustment process of time-to-landing is also introduced when the feasible trajectory does not exist. Comprehensive simulations about the proposed intelligent landing strategy are performed to demonstrate the improved safety and accuracy of both landing and hopping exploration on small bodies. Meanwhile, the performance and accuracy of the proposed convex optimization-based control algorithms is also compared and discussed thoroughly. Some useful conclusions for control system design are also obtained.

Effects of environmental factors on child survival in Bangladesh: a case control study.

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Hoque, B A; Chakraborty, J; Chowdhury, J T; Chowdhury, U K; Ali, M; el Arifeen, S; Sack, R B

1999-03-01

The need for further studies on relationships between deaths and environmental variables has been reported in the literature. This case-control study was, therefore, carried out to find out the associations between several social and environmental variables and deaths of children due to infectious diseases such as those leading to diarrhoea, acute respiratory infection, measles and other diseases. Six hundred and twenty-five deaths (cases) and an equal number of matched living children (controls) aged 1-59 months, were studied in rural Matlab. An analysis of crude and adjusted odds ratio showed differential associations. Sources of drinking water, amount of stored water, conditions of latrines, number of persons sleeping with the child and the type of cooking site were statistically significantly associated with deaths due to infectious diseases after controlling for breast feeding, immunization, and the family size. Significant associations were also observed between: (i) the sources of drinking water and deaths due to ARI, and (ii) conditions of latrines and deaths due to diarrhoeal diseases, after controlling for the confounding variables. Several other environmental factors also showed associations with these various death groups, but they were not statistically significant. The size of the samples in death groups (small) and the prevalence of more or less homogeneous environmental health conditions probably diminished the magnitude of the effects. The results of the study reconfirm the importance of environmental health intervention in child survival, irrespective of breast-feeding, immunization, and selected social variables.

Trace metals and over-expression of metallothioneins in bladder tumoral lesions: a case-control study

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Cymbron Teresa

2009-07-01

Full Text Available Abstract Background Previous studies have provided some evidence of a possible association between cancer and metallothioneins. Whether this relates to an exposure to carcinogenic metals remains unclear. Methods In order to examine the association between the expression of metallothioneins and bladder tumors, and to compare the levels of arsenic, cadmium, chromium, lead and nickel in animals with bladder tumors and animals without bladder tumors, 37 cases of bovine bladder tumors and 17 controls were collected. The detection and quantification of metallothioneins in bladder tissue of both cases and controls was performed by immunohistochemistry. And the quantification of metals in tissue and hair was assessed by inductively coupled plasma – mass spectrometry. Results Increased expression of metallothioneins was associated with bladder tumors when compared with non-tumoral bladder tissue (OR = 9.3, 95% CI: 1.0 – 480. The concentrations of cadmium, chromium, lead and nickel in hair of cases were significantly higher than those of controls. However, as for the concentration of metals in bladder tissue, the differences were not significant. Conclusion Though the sample size was small, the present study shows an association between bladder tumors and metallothioneins. Moreover, it shows that concentrations of metals such as cadmium, chromium, lead and nickel in hair may be used as a biomarker of exposure.

A hospital-randomized controlled trial of a formal quality improvement educational program in rural and small community Texas hospitals: one year results.

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Filardo, Giovanni; Nicewander, David; Herrin, Jeph; Edwards, Janine; Galimbertti, Percy; Tietze, Mari; McBride, Susan; Gunderson, Julie; Collinsworth, Ashley; Haydar, Ziad; Williams, Josie; Ballard, David J

2009-08-01

To investigate the effectiveness of a quality improvement educational program in rural hospitals. Hospital-randomized controlled trial. A total of 47 rural and small community hospitals in Texas that had previously received a web-based benchmarking and case-review tool. The 47 hospitals were randomized either to receive formal quality improvement educational program or to a control group. The educational program consisted of two 2-day didactic sessions on continuous quality improvement techniques, followed by the design, implementation and reporting of a local quality improvement project, with monthly coaching conference calls and annual follow-up conclaves. Performance on core measures for community-acquired pneumonia and congestive heart failure were compared between study groups to evaluate the impact of the educational program. No significant differences were observed between the study groups on any measures. Of the 23 hospitals in the intervention group, only 16 completed the didactic program and 6 the full training program. Similar results were obtained when these groups were compared with the control group. While the observed results suggest no incremental benefit of the quality improvement educational program following implementation of a web-based benchmarking and case-review tool in rural hospitals, given the small number of hospitals that completed the program, it is not conclusive that such programs are ineffective. Further research incorporating supporting infrastructure, such as physician champions, financial incentives and greater involvement of senior leadership, is needed to assess the value of quality improvement educational programs in rural hospitals.

Controlled AFM manipulation of small nanoparticles and assembly of hybrid nanostructures

International Nuclear Information System (INIS)

Kim, Suenne; Shafiei, Farbod; Ratchford, Daniel; Li Xiaoqin

2011-01-01

We demonstrate controlled manipulation of semiconductor and metallic nanoparticles (NPs) with 5-15 nm diameters and assemble these NPs into hybrid structures. The manipulation is accomplished under ambient environment using a commercial atomic force microscope (AFM). There are particular difficulties associated with manipulating NPs this small. In addition to spatial drift, the shape of an asymmetric AFM tip has to be taken into account in order to understand the intended and actual manipulation results. Furthermore, small NPs often attach to the tip via electrostatic interaction and modify the effective tip shape. We suggest a method for detaching the NPs by performing a pseudo-manipulation step. Finally, we show by example the ability to assemble these small NPs into prototypical hybrid nanostructures with well-defined composition and geometry.

Helicopter internal noise control: Three case histories

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Edwards, B. D.; Cox, C. R.

1978-01-01

Case histories are described in which measurable improvements in the cabin noise environments of the Bell 214B, 206B, and 222 were realized. These case histories trace the noise control efforts followed in each vehicle. Among the design approaches considered, the addition of a fluid pulsation damper in a hydraulic system and the installation of elastomeric engine mounts are highlighted. It is concluded that substantial weight savings result when the major interior noise sources are controlled by design, both in altering the noise producing mechanism and interrupting the sound transmission paths.

Case Studies of Leading Edge Small Urban High Schools. Relevance Strategic Designs: 8. High Tech High School

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Shields, Regis Anne; Ireland, Nicole; City, Elizabeth; Derderian, Julie; Miles, Karen Hawley

2008-01-01

This report is one of nine detailed case studies of small urban high schools that served as the foundation for the Education Resource Strategies (ERS) report "Strategic Designs: Lessons from Leading Edge Small Urban High Schools." These nine schools were dubbed "Leading Edge Schools" because they stand apart from other high…

Case Studies of Leading Edge Small Urban High Schools. Personalization Strategic Designs: 9. MetWest High School

Science.gov (United States)

Shields, Regis Anne; Ireland, Nicole; City, Elizabeth; Derderian, Julie; Miles, Karen Hawley

2008-01-01

This report is one of nine detailed case studies of small urban high schools that served as the foundation for the Education Resource Strategies (ERS) report "Strategic Designs: Lessons from Leading Edge Small Urban High Schools." These nine schools were dubbed "Leading Edge Schools" because they stand apart from other high…

Case-control study of congenital malformations and occupational exposure to low-level ionizing radiation

International Nuclear Information System (INIS)

Sever, L.E.; Gilbert, E.S.; Hessol, N.A.; McIntyre, J.M.

1988-01-01

In a case-control study, the authors investigated the association of parental occupational exposure to low-level external whole-body penetrating ionizing radiation and risk of congenital malformations in their offspring. Cases and controls were ascertained from births in two counties in southeastern Washington State, where the Hanford Site has been a major employer. A unique feature of this study was the linking of quantitative individual measurement of external whole-body penetrating ionizing radiation exposure of employees at the Hanford Site, using personal dosimeters, and the disease outcome, congenital malformations. The study population included 672 malformation cases and 977 matched controls from births occurring from 1957 through 1980. Twelve specific malformation types were analyzed for evidence of association with employment of the parents at Hanford and with occupational exposure to ionizing radiation. Two defects, congenital dislocation of the hip and tracheoesophageal fistula, showed statistically significant associations with employment of the parents at Hanford, but not with parental radiation exposure. Neural tube defects showed a significant association with parental preconception exposure, on the basis of a small number of cases. Eleven other defects, including Down syndrome, for which an association with radiation was considered most likely, showed no evidence of such an association. When all malformations were analyzed as a group, there was no evidence of an association with employment of the parents at Hanford, but the relation of parental exposure to radiation before conception was in the positive direction (one-tailed p value between 0.05 and 0.10). Given the number of statistical tests conducted, some or all of the observed positive correlations are likely to represent false positive findings. 30 references

Matched case-control studies: a review of reported statistical methodology

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Niven DJ

2012-04-01

Full Text Available Daniel J Niven1, Luc R Berthiaume2, Gordon H Fick1, Kevin B Laupland11Department of Critical Care Medicine, Peter Lougheed Centre, Calgary, 2Department of Community Health Sciences, University of Calgary, Calgary, Alberta, CanadaBackground: Case-control studies are a common and efficient means of studying rare diseases or illnesses with long latency periods. Matching of cases and controls is frequently employed to control the effects of known potential confounding variables. The analysis of matched data requires specific statistical methods.Methods: The objective of this study was to determine the proportion of published, peer reviewed matched case-control studies that used statistical methods appropriate for matched data. Using a comprehensive set of search criteria we identified 37 matched case-control studies for detailed analysis.Results: Among these 37 articles, only 16 studies were analyzed with proper statistical techniques (43%. Studies that were properly analyzed were more likely to have included case patients with cancer and cardiovascular disease compared to those that did not use proper statistics (10/16 or 63%, versus 5/21 or 24%, P = 0.02. They were also more likely to have matched multiple controls for each case (14/16 or 88%, versus 13/21 or 62%, P = 0.08. In addition, studies with properly analyzed data were more likely to have been published in a journal with an impact factor listed in the top 100 according to the Journal Citation Reports index (12/16 or 69%, versus 1/21 or 5%, P ≤ 0.0001.Conclusion: The findings of this study raise concern that the majority of matched case-control studies report results that are derived from improper statistical analyses. This may lead to errors in estimating the relationship between a disease and exposure, as well as the incorrect adaptation of emerging medical literature.Keywords: case-control, matched, dependent data, statistics

Research of pneumatic control transmission system for small irradiation samples

International Nuclear Information System (INIS)

Bai Zhongxiong; Zhang Haibing; Rong Ru; Zhang Tao

2008-01-01

In order to reduce the absorbed dose damage for the operator, pneumatic control has been adopted to realize the rapid transmission of small irradiation samples. On/off of pneumatic circuit and directions for the rapid transmission system are controlled by the electrical control part. The main program initializes the system and detects the location of the manual/automatic change-over switch, and call for the corresponding subprogram to achieve the automatic or manual operation. Automatic subprogram achieves the automatic sample transmission; Manual subprogram completes the deflation, and back and forth movement of the radiation samples. This paper introduces in detail the implementation of the system, in terms of both hardware and software design. (authors)

Making a business case for small medical practices to maintain quality while addressing racial healthcare disparities.

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Dunston, Frances J; Eisenberg, Andrew C; Lewis, Evelyn L; Montgomery, John M; Ramos, Diana; Elster, Arthur

2008-11-01

Various reports have documented variations in quality of care that occur among racial and ethnic populations, even after accounting for socioeconomic factors and health insurance status. Although quality improvement initiatives are often touted as the answer to healthcare disparities, researchers have questioned whether a business case exists that supports this notion. We assess various barriers and incentives for using quality improvement to address racial and ethnic healthcare disparities in small-to-medium-sized practices. We believe that although both indirect and direct cost incentives may exist, a favorable business case for small private practices cannot be made unless there are additional financial incentives. The business community can work with health plans to provide these incentives.

Small-Signal Modeling and Analysis of Grid-Connected Inverter with Power Differential Droop Control

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Xin Chen

2016-01-01

Full Text Available The conventional voltage and frequency droop control strategy in grid-connected inverter suffers a major setback in the presence of disturbance by producing oscillations. Adding a power differential term in droop controller is an effective way to address such drawback. In this paper, grid-connected inverter’s small-signal models of the conventional droop control and the power differential droop control are established. The eigenvalues of the models are then determined by system matrix. The eigenvalues analysis is presented which helps in identifying the relationship between the system stability and controller parameters. It is concluded that the damping ratio of dominant low-frequency eigenvalues increased and the oscillation caused by the disturbance is suppressed when a power differential term is added to the droop control method. The MATLAB/Simulink models of grid-connected inverter with both control strategies are also established to validate the results of small-signal analysis.

Remote control of therapeutic T cells through a small molecule-gated chimeric receptor

Science.gov (United States)

Wu, Chia-Yung; Roybal, Kole T.; Puchner, Elias M.; Onuffer, James; Lim, Wendell A.

2016-01-01

There is growing promise in using engineered cells as therapeutic agents. For example, synthetic Chimeric Antigen Receptors (CARs) can redirect T cells to recognize and eliminate tumor cells expressing specific antigens. Despite promising clinical results, excessive activity and poor control over such engineered T cells can cause severe toxicities. We present the design of “ON-switch” CARs that enable small molecule-control over T cell therapeutic functions, while still retaining antigen specificity. In these split receptors, antigen binding and intracellular signaling components only assemble in the presence of a heterodimerizing small molecule. This titratable pharmacologic regulation could allow physicians to precisely control the timing, location, and dosage of T cell activity, thereby mitigating toxicity. This work illustrates the potential of combining cellular engineering with orthogonal chemical tools to yield safer therapeutic cells that tightly integrate both cell autonomous recognition and user control. PMID:26405231

The role of small agribusiness in regional development: the case of Sumatera Utara province

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Subhilhar

2018-03-01

The agribusiness is an emerging sector in Indonesia and its potential needs to be fully explored. Its development can contribute to a development of regions or correct the discrepancy in welfare benefits between groups and regions. The development of small agribusiness is important and strategic. There are more than 32 million small agribusinesses with their working capital less than Rp. 2 billion per year. In Indonesia, out of this 90 percent (about 21.30 million business units) are household businesses which run business in the agriculture sector. The aim of this study is to identify the contributions of small agribusiness to regional development in Sumatera Utara. The method that used in this study is quantitative approach by using survey and case studies through an in-depth interview. The result shows that small agribusinesses do contribute significantly towards regional development in Sumatera Utara. This study found that annual business turnover significantly contributes toward regional development. The main contribution of small agribusinesses is in the utilization of labor force and local tax revenues.

Control-Oriented Modeling and System Identification for Nonlinear Trajectory Tracking Control of a Small-Scale Unmanned Helicopter

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Pourrezaei Khaligh, Sepehr

Model-based control design of small-scale helicopters involves considerable challenges due to their nonlinear and underactuated dynamics with strong couplings between the different degrees-of-freedom (DOFs). Most nonlinear model-based multi-input multi-output (MIMO) control approaches require the dynamic model of the system to be affine-in-control and fully actuated. Since the existing formulations for helicopter nonlinear dynamic model do not meet these requirements, these MIMO approaches cannot be applied for control of helicopters and control designs in the literature mostly use the linearized model of the helicopter dynamics around different trim conditions instead of directly using the nonlinear model. The purpose of this thesis is to derive the 6-DOF nonlinear model of the helicopter in an affine-in-control, non-iterative and square input-output formulation to enable many nonlinear control approaches, that require a control-affine and square model such as the sliding mode control (SMC), to be used for control design of small-scale helicopters. A combination of the first-principles approach and system identification is used to derive this model. To complete the nonlinear model of the helicopter required for the control design, the inverse kinematics of the actuating mechanisms of the main and tail rotors are also derived using an approach suitable for the real-time control applications. The parameters of the new control-oriented formulation are identified using a time-domain system identification strategy and the model is validated using flight test data. A robust sliding mode control (SMC) is then designed using the new formulation of the helicopter dynamics and its robustness to parameter uncertainties and wind disturbances is tested in simulations. Next, a hardware-in-the-loop (HIL) testbed is designed to allow for the control implementation and gain tuning as well as testing the robustness of the controller to external disturbances in a controlled

Small-town migration to metropolitan centres: a case in Peninsular Malaysia.

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Lee Boon Thong

1979-12-01

In Malaysia small towns are an important source of population gowth in metropolitan areas. To provide empirical evidence of the magnitude and roles of small urban centers as complementary sources of population growth in metropolitan areas, a small survey was conducted in 10 small towns in the State of Selangor. Criteria for the selection of these towns include a fair geographical spread over the State, and each area must characteristically possess a dominant urban center. The questionnaires were directed to the heads of 300 households with the intention of investigating the socioeconomic background of the households and the magnitude and characteristics of those members of the households who have migrated elsewhere. The total number of outmigrants from each area varied from 27-57, giving an overall average figure of 1.53 outmigrants/household. About 77% of the outmigrants had moved to the metropolitan centers. As the majority of the metropolitan migrants were more attracted to Kuala Lumpur, Klang, and Petaling Jaya, it may be assumed that the total outmigrants from small towns as derived would have consitituted about 39% of the population in the Klang Valley region. Based on this estimate, the role of small towns in metropolitan population growth is important. In the survey conducted, 2 broad categories of movements were involved: "economic movers," i.e., those who migrated to work or to establish businesses in the metropolitan areas; and "noneconomic movers," i.e., those who moved to continue their studies or to follow their spouses, and so forth. The economic mover stream made up 71% of the total metropolitan migrants. 2 variables--marital status and sex--were significantly related to the economic or noneconomic nature of the metropolitan migrants. The movement of males tended to be associated with economic motives whereas noneconomic reasons for movement tended to be the case among females migrants. The most important occupational group of the economically

Hyperthyroidism association with SLE, lessons from real-life data--A case-control study.

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Watad, Abdulla; Cohen, Arnon D; Comaneshter, Doron; Tekes-Manova, Dorit; Amital, Howard

2016-01-01

Despite the frequently encountered association between thyroid disease and systemic lupus erythematosus (SLE) is well known, it is of surprise that only several reports compromised of small population size support this observation. To investigate the association of comorbid SLE and hyperthyroidism. Using the database of the largest health maintenance organization (HMO) in Israel, the Clalit Health Services, we searched for the co-existence of SLE and hyperthyroidism. Patients with SLE were compared with age- and sex-matched controls regarding the prevalence of hyperthyroidism in a case-control study. Chi-square and t-tests were used for univariate analysis and a logistic regression model was used for multivariate analysis. The study included 5018 patients with SLE and 25,090 age- and sex- matched controls. The prevalence of hyperthyroidism in patients with SLE was increased compared with the prevalence in controls (2.59% and 0.91%, respectively, p hyperthyroidism (odds ratio 2.52, 95% confidence interval 2.028-3.137). Patients with SLE have a greater prevalence of hyperthyroidism than matched controls. Therefore, physicians treating patients with SLE should be aware of this possibility of this thyroid dysfunction.

Association Between Anemia and Cerebral Venous Thrombosis: Case-Control Study

NARCIS (Netherlands)

Coutinho, Jonathan M.; Zuurbier, Susanna M.; Gaartman, Aafke E.; Dikstaal, Arienne A.; Stam, Jan; Middeldorp, Saskia; Cannegieter, Suzanne C.

2015-01-01

Anemia is often considered to be a risk factor for cerebral venous thrombosis (CVT), but this assumption is mostly based on case reports. We investigated the association between anemia and CVT in a controlled study. Unmatched case-control study: cases were adult patients with CVT included in a

A dural metastatic small cell carcinoma of the gallbladder as the first manifestation: a case report.

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Tonomura, Shuichi; Kitaichi, Tomoko; Onishi, Rina; Kakehi, Yoshiaki; Shimizu, Hisao; Shimada, Keiji; Kanemasa, Kazuyuki; Fukusumi, Akio; Takahashi, Nobuyuki

2018-03-16

A dural metastasis is one of the essential differential diagnoses of meningioma. In general, carcinomas of the breast and lung in females and prostate in males have been the most commonly reported primary lesions of dural metastases. However, dural metastasis of gallbladder carcinoma is extremely rare. Here, we report a unique case of a dural matter metastasis of gallbladder carcinoma as the first manifestation, which was autopsy-defined as small cell carcinoma. A 78-year-old man came to our hospital complaining of left hemianopia. Brain computed tomography (CT) revealed a sizeable parasagittal dural-based extra-axial tumor. However, the findings for meningioma were atypical by magnetic resonance imaging, suggesting a meningioma mimic. A contrast-enhanced CT scan of the abdomen revealed a large gallbladder carcinoma. The patient opted for the best supportive care and died 2 months later. The post-mortem examination revealed small cell carcinoma in gallbladder carcinoma. Moreover, an immunologically similar carcinoma was detected in the dural metastasis. To the best of our knowledge, this is the first case of a dural metastasis of gallbladder small cell carcinoma. A systemic examination is essential for clinicians when atypical findings of meningioma are observed, suggesting a meningioma mimic. We present this rare case with a review of the literature.

Small simple hepatic cysts causing obstructive jaundice: a case report of sclerotherapy

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Kim, Hyun Ji; Song, Soon Young; Koh, Byung Hee; Cho, On Koo [Hanyang University College of Medicine, Hanyang University Hospital, Seoul (Korea, Republic of); Kim, Yong Soo [Hanyang University Guri Hospital, Guri (Korea, Republic of)

2007-10-15

A 62-year-old man visited our hospital for a regular follow-up of a known liver cirrhosis. Laboratory tests revealed recently elevated total and direct bilirubin levels. Imaging studies showed two small hepatic cysts (2.7 and 2.9 cm in the largest diameter) compressing both central intrahepatic ducts, respectively. Obstructive jaundice caused by the cysts was diagnosed. Sclerotherapy of the cysts was performed with 100% ethanol after aspiration of the cyst contents. An follow-up CT obtained after 3 months showed decreased cyst size and improved bile duct dilatation. It is known that obstructive jaundice due to a hepatic cyst is rare, and the cysts were unusually large and centrally located. We report a case of obstructive jaundice caused by very small hepatic cysts that was successfully treated with sclerotherapy.

Small simple hepatic cysts causing obstructive jaundice: a case report of sclerotherapy

International Nuclear Information System (INIS)

Kim, Hyun Ji; Song, Soon Young; Koh, Byung Hee; Cho, On Koo; Kim, Yong Soo

2007-01-01

A 62-year-old man visited our hospital for a regular follow-up of a known liver cirrhosis. Laboratory tests revealed recently elevated total and direct bilirubin levels. Imaging studies showed two small hepatic cysts (2.7 and 2.9 cm in the largest diameter) compressing both central intrahepatic ducts, respectively. Obstructive jaundice caused by the cysts was diagnosed. Sclerotherapy of the cysts was performed with 100% ethanol after aspiration of the cyst contents. An follow-up CT obtained after 3 months showed decreased cyst size and improved bile duct dilatation. It is known that obstructive jaundice due to a hepatic cyst is rare, and the cysts were unusually large and centrally located. We report a case of obstructive jaundice caused by very small hepatic cysts that was successfully treated with sclerotherapy

Primary Cutaneous CD4-Positive Small/Medium Pleomorphic T-cell Lymphoma – A Case Report

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Micković Milena

2016-12-01

Full Text Available Primary cutaneous CD4-positive small- to medium-sized pleomorphic T-cell lymphoma is a provisional entity in the 2005 WHO-EORTC classification for cutaneous lymphomas. It is a rare condition and, in most cases, it has a favorable clinical course and prognosis. Primary cutaneous CD4-positive small/medium pleomorphic T-cell lymphoma (PCSM-TCL is defined as a cutaneous T-cell lymphoma with predominantly small- to medium-sized CD4-positive pleomorphic T-cells without a history of patches and plaques typical of mycosis fungoides. PCSM-TCL usually presents as a solitary plaque or tumor on the head, neck, trunk or upper extremities and it is considered to have indolent clinical behavior. Histologically, it is characterized by a dense infiltration of small/medium-sized pleomorphic T-cells that involves the entire dermal thickness, often with nodular extension into the hypodermis. Using immunohistochemical staining, the majority of the reported cases proved to be CD3, CD4 positive and CD8, CD30 negative. However, due to the rarity and heterogeneity of the PCSM-TCL, precise clinicopathologic characteristics of PCSM-TCL have not been well characterized and the optimal treatment for this group of lymphomas is yet to be defined. Dermatologists and pathologists should be aware of this entity in order to avoid unnecessary aggressive treatments.

Phytobezoar in a jejunal diverticulum as a cause of small bowel obstruction: a case report

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Rauf Fozia

2011-09-01

Full Text Available Abstract Introduction Phytobezoars are concretions of poorly digested fruit and vegetable fibers found in the alimentary tract. Previous gastric resection, gastrojejunostomy, or pyloroplasty predispose people to bezoar formation. Small-bowel bezoars normally come from the stomach, and primary small-bowel bezoars are very rare. They are seen only in patients with underlying small-bowel diseases such as diverticula, strictures, or tumors. Primary small-bowel bezoars almost always present as intestinal obstructions, although it is a very rare cause, being responsible for less than 3% of all small-bowel obstructions in one series. Jejunal diverticula are rare, with an incidence of less than 0.5%. They are usually asymptomatic pseudodiverticula of pulsion type, and complications are reported in 10% to 30% of patients. A phytobezoar in a jejunal diverticulum is an extremely rare presentation. Case presentation A 78-year-old Pakistani man presented to our clinic with small-bowel obstruction. Upon exploration, we found a primary small-bowel bezoar originating in a jejunal diverticulum and causing jejunal obstruction. Resection and anastomosis of the jejunal segment harboring the diverticulum was performed, and our patient had an uneventful recovery. Conclusion Primary small-bowel bezoars are very rare but must be kept in mind as a possible cause of small-bowel obstruction.

Top Management Control Functions for Information Systems in Small and Medium Enterprises

OpenAIRE

Uma VIJAYAKUMAR

2009-01-01

This paper analyzes the Top Management Control functions for Information Systems (IS) in Small and Medium Enterprises (SMEs). SMEs extensively rely on information technology resources to enhance their competence in today’s global economy. They should have adequate top management control mechanisms in place for their efficient functioning. Top Management Controls determine how effectively the senior management manages the IS functions in a SME. The major tasks at this level consist of Planni...

LQG/LTR optimal attitude control of small flexible spacecraft using free-free boundary conditions

Science.gov (United States)

Fulton, Joseph M.

Due to the volume and power limitations of a small satellite, careful consideration must be taken while designing an attitude control system for 3-axis stabilization. Placing redundancy in the system proves difficult and utilizing power hungry, high accuracy, active actuators is not a viable option. Thus, it is customary to find dependable, passive actuators used in conjunction with small scale active control components. This document describes the application of Elastic Memory Composite materials in the construction of a flexible spacecraft appendage, such as a gravity gradient boom. Assumed modes methods are used with Finite Element Modeling information to obtain the equations of motion for the system while assuming free-free boundary conditions. A discussion is provided to illustrate how cantilever mode shapes are not always the best assumption when modeling small flexible spacecraft. A key point of interest is first resonant modes may be needed in the system design plant in spite of these modes being greater than one order of magnitude in frequency when compared to the crossover frequency of the controller. LQG/LTR optimal control techniques are implemented to compute attitude control gains while controller robustness considerations determine appropriate reduced order controllers and which flexible modes to include in the design model. Key satellite designer concerns in the areas of computer processor sizing, material uncertainty impacts on the system model, and system performance variations resulting from appendage length modifications are addressed.

Porous stainless steel hollow fibers with shrinkage-controlled small radial dimensions

NARCIS (Netherlands)

Luiten-Olieman, Maria W.J.; Raaijmakers, Michiel; Raaijmakers, Michiel J.T.; Winnubst, Aloysius J.A.; Wessling, Matthias; Nijmeijer, Arian; Benes, Nieck Edwin

2011-01-01

A method is presented for the preparation of thin (∼250 μm) porous stainless steel hollow fiber membranes based on dry–wet spinning of a particle-loaded polymer solution followed by heat treatment. Extraordinarily small radial dimensions were achieved by controlled shrinkage during thermal

Assessing the Effectiveness of Case-Based Collaborative Learning via Randomized Controlled Trial.

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Krupat, Edward; Richards, Jeremy B; Sullivan, Amy M; Fleenor, Thomas J; Schwartzstein, Richard M

2016-05-01

Case-based collaborative learning (CBCL) is a novel small-group approach that borrows from team-based learning principles and incorporates elements of problem-based learning (PBL) and case-based learning. CBCL includes a preclass readiness assurance process and case-based in-class activities in which students respond to focused, open-ended questions individually, discuss their answers in groups of 4, and then reach consensus in larger groups of 16. This study introduces CBCL and assesses its effectiveness in one course at Harvard Medical School. In a 2013 randomized controlled trial, 64 medical and dental student volunteers were assigned randomly to one of four 8-person PBL tutorial groups (control; n = 32) or one of two 16-person CBCL tutorial groups (experimental condition; n = 32) as part of a required first-year physiology course. Outcomes for the PBL and CBCL groups were compared using final exam scores, student responses to a postcourse survey, and behavioral coding of portions of video-recorded class sessions. Overall, the course final exam scores for CBCL and PBL students were not significantly different. However, CBCL students whose mean exam performance in prior courses was below the participant median scored significantly higher than their PBL counterparts on the physiology course final exam. The most common adjectives students used to describe CBCL were "engaging," "fun," and "thought-provoking." Coding of observed behaviors indicated that individual affect was significantly higher in the CBCL groups than in the PBL groups. CBCL is a viable, engaging, active learning method. It may particularly benefit students with lower academic performance.

Dengue infection and miscarriage: a prospective case control study.

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Peng Chiong Tan

Full Text Available BACKGROUND: Dengue is the most prevalent mosquito borne infection worldwide. Vertical transmissions after maternal dengue infection to the fetus and pregnancy losses in relation to dengue illness have been reported. The relationship of dengue to miscarriage is not known. METHOD: We aimed to establish the relationship of recent dengue infection and miscarriage. Women who presented with miscarriage (up to 22 weeks gestation to our hospital were approached to participate in the study. For each case of miscarriage, we recruited 3 controls with viable pregnancies at a similar gestation. A brief questionnaire on recent febrile illness and prior dengue infection was answered. Blood was drawn from participants, processed and the frozen serum was stored. Stored sera were thawed and then tested in batches with dengue specific IgM capture ELISA, dengue non-structural protein 1 (NS1 antigen and dengue specific IgG ELISA tests. Controls remained in the analysis if their pregnancies continued beyond 22 weeks gestation. Tests were run on 116 case and 341 control sera. One case (a misdiagnosed viable early pregnancy plus 45 controls (39 lost to follow up and six subsequent late miscarriages were excluded from analysis. FINDINGS: Dengue specific IgM or dengue NS1 antigen (indicating recent dengue infection was positive in 6/115 (5·2% cases and 5/296 (1·7% controls RR 3·1 (95% CI 1·0-10 P = 0·047. Maternal age, gestational age, parity and ethnicity were dissimilar between cases and controls. After adjustments for these factors, recent dengue infection remained significantly more frequently detected in cases than controls (AOR 4·2 95% CI 1·2-14 P = 0·023. INTERPRETATION: Recent dengue infections were more frequently detected in women presenting with miscarriage than in controls whose pregnancies were viable. After adjustments for confounders, the positive association remained.

[Hydrocephalus Associated with Small Clinoidal Meningioma that Resolved after Tumor Removal:A Case Report].

Science.gov (United States)

Fujiwara, Hidemoto; Aiba, Toyotaka; Watanabe, Toru; Hiraishi, Tetsuya; Fujii, Yukihiko

2016-12-01

Small meningiomas causing hydrocephalus without obstruction of the ventricular system are rare. Herein, we report a case of small clinoidal meningioma with communicating hydrocephalus, which resolved after tumor removal. A 70-year-old woman presented with a 1-month history of memory disturbance followed by gait disturbance. MR images revealed a right clinoidal meningioma, 2 cm in diameter, and dilatation of the ventricles suggesting communicating hydrocephalus. The cerebrospinal fluid(CSF)pressure was 130 mmH2O, as determined via a lumbar puncture. High concentrations of protein(65mg/dL)were detected in the lumbar CSF. The tumor was completely removed via a frontotemporal craniotomy. Higher protein concentrations(94mg/dL)were detected in the CSF obtained intraoperatively from the sylvian cistern. The histopathological diagnosis was meningothelial meningioma. The patient's symptoms improved markedly after surgery. Postoperative MR images revealed resolution of the hydrocephalus. The lumbar CSF protein concentration returned to normal(43mg/dL). Neither tumor recurrence nor progression of hydrocephalus has been observed for 4 years. Communicating hydrocephalus, associated with a small meningioma at the supratentorial region, has not been described. Previous studies have shown that patients with meningioma may develop communicating hydrocephalus after tumor removal or stereotactic radiosurgery. Thus, it is interesting that the small supratentorial meningioma in our case developed communicating hydrocephalus without any therapeutic intervention. Considering the CSF protein concentration, we speculate that the hydrocephalus was the result of CSF malabsorption associated with high CSF protein concentration and CSF pathway obstruction at the suprasellar cistern caused by the tumor.

Comparison of two control groups for estimation of oral cholera vaccine effectiveness using a case-control study design.

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Franke, Molly F; Jerome, J Gregory; Matias, Wilfredo R; Ternier, Ralph; Hilaire, Isabelle J; Harris, Jason B; Ivers, Louise C

2017-10-13

Case-control studies to quantify oral cholera vaccine effectiveness (VE) often rely on neighbors without diarrhea as community controls. Test-negative controls can be easily recruited and may minimize bias due to differential health-seeking behavior and recall. We compared VE estimates derived from community and test-negative controls and conducted bias-indicator analyses to assess potential bias with community controls. From October 2012 through November 2016, patients with acute watery diarrhea were recruited from cholera treatment centers in rural Haiti. Cholera cases had a positive stool culture. Non-cholera diarrhea cases (test-negative controls and non-cholera diarrhea cases for bias-indicator analyses) had a negative culture and rapid test. Up to four community controls were matched to diarrhea cases by age group, time, and neighborhood. Primary analyses included 181 cholera cases, 157 non-cholera diarrhea cases, 716 VE community controls and 625 bias-indicator community controls. VE for self-reported vaccination with two doses was consistent across the two control groups, with statistically significant VE estimates ranging from 72 to 74%. Sensitivity analyses revealed similar, though somewhat attenuated estimates for self-reported two dose VE. Bias-indicator estimates were consistently less than one, with VE estimates ranging from 19 to 43%, some of which were statistically significant. OCV estimates from case-control analyses using community and test-negative controls were similar. While bias-indicator analyses suggested possible over-estimation of VE estimates using community controls, test-negative analyses suggested this bias, if present, was minimal. Test-negative controls can be a valid low-cost and time-efficient alternative to community controls for OCV effectiveness estimation and may be especially relevant in emergency situations. Copyright © 2017. Published by Elsevier Ltd.

Adaptive Fuzzy Robust Control for a Class of Nonlinear Systems via Small Gain Theorem

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Xingjian Wang

2013-01-01

Full Text Available Practical nonlinear systems can usually be represented by partly linearizable models with unknown nonlinearities and external disturbances. Based on this consideration, we propose a novel adaptive fuzzy robust control (AFRC algorithm for such systems. The AFRC effectively combines techniques of adaptive control and fuzzy control, and it improves the performance by retaining the advantages of both methods. The linearizable part will be linearly parameterized with unknown but constant parameters, and the discontinuous-projection-based adaptive control law is used to compensate these parts. The Takagi-Sugeno fuzzy logic systems are used to approximate unknown nonlinearities. Robust control law ensures the robustness of closed-loop control system. A systematic design procedure of the AFRC algorithm by combining the backstepping technique and small-gain approach is presented. Then the closed-loop stability is studied by using small gain theorem, and the result indicates that the closed-loop system is semiglobally uniformly ultimately bounded.

Sporadic occurrence of completely lateralized vertex sharp transients of sleep is a normal phenomenon: a retrospective, blinded, case-control study.

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Brenton, J Nicholas; Mytinger, John R

2015-04-01

Vertex sharp transients (VSTs) of sleep often lateralize to the left or right frontocentral regions and can be mistaken as epileptiform. The aim of this study was to determine the prevalence of completely lateralized VSTs in pediatric-aged individuals and to assess their significance by comparing cohorts with and without epilepsy. The authors hypothesized that completely lateralized VSTs are normal and occur with similar frequencies in patients with and without epilepsy. The authors conducted a retrospective, blinded, case-control study comparing completely lateralized VSTs within a 5-minute EEG sleep epoch between cohorts of 100 patients with epilepsy and 100 age- and gender-matched controls. The number of patients with completely lateralized VSTs was not significantly different between cases (62%) and controls (65%) (P = 0.66). The median number of completely lateralized VSTs was small but not significantly different between cases (median 3) and controls (median 4) (P = 0.11). The presence of completely lateralized VSTs in cases (generalized vs. focal epilepsy) was not significantly different (P > 0.95). This is the first systematic study of the prevalence and significance of completely lateralized VSTs of sleep. This study provides class III evidence that completely lateralized VSTs, occurring in a sporadic fashion, are a normal phenomenon and should not be confused with epileptiform discharges.

Remote control of therapeutic T cells through a small molecule-gated chimeric receptor.

Science.gov (United States)

Wu, Chia-Yung; Roybal, Kole T; Puchner, Elias M; Onuffer, James; Lim, Wendell A

2015-10-16

There is growing interest in using engineered cells as therapeutic agents. For example, synthetic chimeric antigen receptors (CARs) can redirect T cells to recognize and eliminate tumor cells expressing specific antigens. Despite promising clinical results, these engineered T cells can exhibit excessive activity that is difficult to control and can cause severe toxicity. We designed "ON-switch" CARs that enable small-molecule control over T cell therapeutic functions while still retaining antigen specificity. In these split receptors, antigen-binding and intracellular signaling components assemble only in the presence of a heterodimerizing small molecule. This titratable pharmacologic regulation could allow physicians to precisely control the timing, location, and dosage of T cell activity, thereby mitigating toxicity. This work illustrates the potential of combining cellular engineering with orthogonal chemical tools to yield safer therapeutic cells that tightly integrate cell-autonomous recognition and user control. Copyright © 2015, American Association for the Advancement of Science.

Modern Spirometry Supports Anesthetic Management in Small Animal Clinical Practice: A Case Series.

Science.gov (United States)

Calice, Ivana; Moens, Yves

2016-01-01

Modern spirometry, like no other monitoring technique, allows insight into breath-to-breath respiratory mechanics. Spirometers continuously measure volume, airway pressure, and flow while calculating and continuously displaying respiratory system compliance and resistance in the form of loops. The aim of this case series is to show how observation of spirometric loops, similar to electrocardiogram or CO2 curve monitoring, can improve safety of anesthetic management in small animals. Spirometric monitoring cases described in this case series are based on use of the anaesthesia monitor Capnomac Ultima with a side stream spirometry sensor. The cases illustrate how recognition and understanding of spirometric loops allows for easy diagnosis of iatrogenic pneumothorax, incorrect ventilator settings, leaks in the system, kinked or partially obstructed endotracheal tube, and spontaneous breathing interfering with intermittent positive-pressure ventilation. The case series demonstrates the potential of spirometry to improve the quality and safety of anesthetic management, and, hence, its use can be recommended during intermittent positive-pressure ventilation and procedures in which interference with ventilation can be expected.

Night-shift work and hematological cancers: a population based case-control study in three Nordic countries.

Science.gov (United States)

Talibov, Madar; Pukkala, Eero; Martinsen, Jan Ivar; Tryggvadottir, Laufey; Weiderpass, Elisabete; Hansen, Johnni

2018-05-01

Objective The aim of this case-control study was to assess the effect of night-shift work on the risk of hematological cancers. Methods The study included 39 371 leukemia, 56 713 non-Hodgkin lymphoma, 9322 Hodgkin lymphoma, and 26 188 multiple myeloma cases diagnosed between 1961 and 2005 in Finland, Sweden, and Iceland. Five controls for each case were selected from the Nordic Occupational Cancer Study (NOCCA) cohort, matched by year of birth, sex and country. Night-shift exposure was assessed by using the NOCCA job-exposure matrix (JEM). Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated from conditional logistic regression models. Results Overall, night work was not associated with a risk of hematological cancers. We observed a small but non-significantly increased risk for leukemia (OR 1.07, 95% CI 0.99-1.16), especially for acute myeloid leukemia (OR 1.15, 95% CI 0.97-1.36) among workers exposed to a high level of cumulative night work exposure. Night work exposure was not associated with lymphatic cancers and multiple myeloma. Conclusion This study did not support associations between night-shift work and hematological cancers.

Case-control study on uveal melanoma (RIFA: rational and design

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Schmidt-Pokrzywniak Andrea

2004-08-01

Full Text Available Abstract Background Although a rare disease, uveal melanoma is the most common primary intraocular malignancy in adults, with an incidence rate of up to 1.0 per 100,000 persons per year in Europe. Only a few consistent risk factors have been identified for this disease. We present the study design of an ongoing incident case-control study on uveal melanoma (acronym: RIFA study that focuses on radiofrequency radiation as transmitted by radio sets and wireless telephones, occupational risk factors, phenotypical characteristics, and UV radiation. Methods/Design We conduct a case-control study to identify the role of different exposures in the development of uveal melanoma. The cases of uveal melanoma were identified at the Division of Ophthalmology, University of Essen, a referral centre for tumours of the eye. We recruit three control groups: population controls, controls sampled from those ophthalmologists who referred cases to the Division of Ophthalmology, University of Duisburg-Essen, and sibling controls. For each case the controls are matched on sex and age (five year groups, except for sibling controls. The data are collected from the study participants by short self-administered questionnaire and by telephone interview. During and at the end of the field phase, the data are quality-checked. To estimate the effect of exposures on uveal melanoma risk, we will use conditional logistic regression that accounts for the matching factors and allows to control for potential confounding.

Case-control vaccine effectiveness studies: Data collection, analysis and reporting results.

Science.gov (United States)

Verani, Jennifer R; Baqui, Abdullah H; Broome, Claire V; Cherian, Thomas; Cohen, Cheryl; Farrar, Jennifer L; Feikin, Daniel R; Groome, Michelle J; Hajjeh, Rana A; Johnson, Hope L; Madhi, Shabir A; Mulholland, Kim; O'Brien, Katherine L; Parashar, Umesh D; Patel, Manish M; Rodrigues, Laura C; Santosham, Mathuram; Scott, J Anthony; Smith, Peter G; Sommerfelt, Halvor; Tate, Jacqueline E; Victor, J Chris; Whitney, Cynthia G; Zaidi, Anita K; Zell, Elizabeth R

2017-06-05

The case-control methodology is frequently used to evaluate vaccine effectiveness post-licensure. The results of such studies provide important insight into the level of protection afforded by vaccines in a 'real world' context, and are commonly used to guide vaccine policy decisions. However, the potential for bias and confounding are important limitations to this method, and the results of a poorly conducted or incorrectly interpreted case-control study can mislead policies. In 2012, a group of experts met to review recent experience with case-control studies evaluating vaccine effectiveness; we summarize the recommendations of that group regarding best practices for data collection, analysis, and presentation of the results of case-control vaccine effectiveness studies. Vaccination status is the primary exposure of interest, but can be challenging to assess accurately and with minimal bias. Investigators should understand factors associated with vaccination as well as the availability of documented vaccination status in the study context; case-control studies may not be a valid method for evaluating vaccine effectiveness in settings where many children lack a documented immunization history. To avoid bias, it is essential to use the same methods and effort gathering vaccination data from cases and controls. Variables that may confound the association between illness and vaccination are also important to capture as completely as possible, and where relevant, adjust for in the analysis according to the analytic plan. In presenting results from case-control vaccine effectiveness studies, investigators should describe enrollment among eligible cases and controls as well as the proportion with no documented vaccine history. Emphasis should be placed on confidence intervals, rather than point estimates, of vaccine effectiveness. Case-control studies are a useful approach for evaluating vaccine effectiveness; however careful attention must be paid to the collection

Symptoms and sources of Yersinia enterocolitica-infection: a case-control study

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Siitonen Anja

2010-05-01

Full Text Available Abstract Background Yersinia enterocolitica (YE is the causative agent of yersiniosis. YE encompass strains of diverse pathogenicity: YE biotypes 1B and 2-5 are considered pathogenic, whereas biotype 1A is in general considered nonvirulent. Also YE-like species, which can sometimes be misidentified as YE, are considered nonvirulent. Methods In order to study differences in clinical picture caused by different YE types and their possible sources a case-control study was conducted in 2006. In this case-control study, 295 case-patients with YE or YE-like finding and their 758 controls responded to the questionnaire about symptoms and possible sources of infection. Results Strains of pathogenic YE bio/serotypes 3-4/O:3 or 2/O:9 were found in 18%, YE biotype 1A in 65% and YE -like strains of 17% of the patients. Patients infected with the strains of pathogenic YE bio/serotypes were younger and had fever more often than those with BT 1A who suffered more from vomiting. Symptoms of reactive arthritis were reported by 10% of pathogenic YE infections, 3% of YE BT 1A, and 0.3% of the controls. Eating or tasting raw or medium done pork was a significant risk factor for pathogenic YE bio/serotype infection (OR 6.6; 95% CI 1.7-24.9 as well as eating in a canteen (OR 3.5; 95% CI 1.6-7.9. Imported fruits and berries were associated with increased risk of YE BT 1A finding. Conclusions The symptoms of the patients with YE BT 1A differed from yersiniosis caused by the classic pathogenic YE bio/serotypes. In addition, the patients with YE BT 1A had more protracted gastrointestinal disorders and unspecific complaints. Small children were overrepresented in classic pathogenic bio/serotypes while in BT 1A or YE-like species were not found among children younger than two years. This suggests the lacking virulence of the BT 1A strains. We can not, however, rule out the possibility that some strains of genetically heterogeneous group of BT 1A may cause an illness.

Fuzzy Logic Based MPPT Controller for a Small Wind Turbine System

DEFF Research Database (Denmark)

Petrila, Diana; Blaabjerg, Frede; Muntean, Nicolae

2012-01-01

operation. Therefore, the mechanical power (Pm) is composed of the generator mechanical (input) power (Pg) plus the dynamic power, resulting in the dynamic power versus rotating speed curve. The controller is able to track the maximum power point for changing wind conditions, and is robust with respect....../Δω. The change of reference generator current (ΔI*) is the output variable. For small power applications, when the turbine inertia is relatively small, and the wind speed changes continuously, it is important to consider the transients in order to develop an accurate theoretical model and to attain optimal...

Composite microsphere-functionalized scaffold for the controlled release of small molecules in tissue engineering

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Laura Pandolfi

2016-01-01

Full Text Available Current tissue engineering strategies focus on restoring damaged tissue architectures using biologically active scaffolds. The ideal scaffold would mimic the extracellular matrix of any tissue of interest, promoting cell proliferation and de novo extracellular matrix deposition. A plethora of techniques have been evaluated to engineer scaffolds for the controlled and targeted release of bioactive molecules to provide a functional structure for tissue growth and remodeling, as well as enhance recruitment and proliferation of autologous cells within the implant. Recently, novel approaches using small molecules, instead of growth factors, have been exploited to regulate tissue regeneration. The use of small synthetic molecules could be very advantageous because of their stability, tunability, and low cost. Herein, we propose a chitosan–gelatin scaffold functionalized with composite microspheres consisting of mesoporous silicon microparticles and poly(dl-lactic-co-glycolic acid for the controlled release of sphingosine-1-phospate, a small molecule of interest. We characterized the platform with scanning electron microscopy, Fourier transform infrared spectroscopy, and confocal microscopy. Finally, the biocompatibility of this multiscale system was analyzed by culturing human mesenchymal stem cells onto the scaffold. The presented strategy establishes the basis of a versatile scaffold for the controlled release of small molecules and for culturing mesenchymal stem cells for regenerative medicine applications.

Control and Management of Small Quantity Nuclear Material (SQNM) on Safeguards

International Nuclear Information System (INIS)

Park, Jae Hwan; Shin, Byung Woo; Park, Jae Beom

2009-01-01

Small Quantity Nuclear Material (SQNM) is defined as the nuclear material that is below the amount approved in atomic energy act. SQNM generally lists depleted uranium (DU) used as a catalyst or shielding material in exposure devices in industries. The SQNM users have a duty to report information on possessing and using SQNM regularly to the government. All nuclear materials must be included in IAEA reporting lists according to safeguards agreement and additional protocol regardless of amount. However, it is difficult to investigate the status of nuclear material possessed in industries because SQNM is excepted regulation item list in atomic energy act. Most SQNM user industries are small companies so they have some problems like the loss of nuclear material after bankruptcy. Even though the damage of radiation leakage is very low, loss or careless management of nuclear material causes confusion. Thus, developing a control and management system for SQNM is essential. This paper discusses the present condition and prospect of control and management SQNM in Korea

CT findings of primary undifferentiated pleomorphic sarcoma in the small bowel: A case report

Energy Technology Data Exchange (ETDEWEB)

Kim, Youe Ree; Lee, Young Hwan; Yoon, Kwon Ha; Yun, Ki Jung [Wonkwang University School of Medicine and Hospital, Institute of Wonkwang Medical Science, Iksan (Korea, Republic of)

2015-11-15

Undifferentiated pleomorphic sarcoma (UPS), previously known as malignant fibrous histiocytoma, is a soft tissue sarcoma arising from mesenchymal tissue of the body. UPS of the gastrointestinal tract is known to be rare and only a few cases have been reported in the literature. Based on our case and review of the other relevant literature, the CT findings of primary UPS of the small bowel included nodular bowel wall thickening with homogeneous enhancement. It presents as a rapidly growing tumor without bowel obstruction, and it may be accompanied by distant metastasis.

Implementation of small field radiotherapy dosimetry for spinal metastase case

Science.gov (United States)

Rofikoh, Wibowo, W. E.; Pawiro, S. A.

2017-07-01

The main objective of this study was to know dose profile of small field radiotherapy in the spinal metastase case with source axis distance (SAD) techniques. In addition, we evaluated and compared the dose planning of stereotactic body radiation therapy (SBRT) and conventional techniques to measurements with Exradin A16 and Gafchromic EBT3 film dosimeters. The results showed that film EBT3 had a highest precision and accuracy with the average of the standard deviation of ±1.7 and maximum discrepancy of 2.6 %. In addition, the average value of Full Wave Half Maximum (FWHM) and its largest deviation in small field size of 0.8 x 0.8 cm2 are 0.82 cm and 16.3 % respectively, while it was found around 2.36 cm and 3 % for the field size of 2.4 x 2.4 cm2. The comparison between penumbra width and the collimation was around of 37.1 % for the field size of 0.8 x 0.8 cm2, while it was found of 12.4 % for the field size of 2.4 x 2.4 cm2.

Relating small airways to asthma control by using impulse oscillometry in children.

Science.gov (United States)

Shi, Yixin; Aledia, Anna S; Tatavoosian, Ahramahzd V; Vijayalakshmi, Shruthi; Galant, Stanley P; George, Steven C

2012-03-01

Previous reports suggest that the peripheral airways are associated with asthma control. Patient history, although subjective, is used largely to assess asthma control in children because spirometric results are many times normal values. Impulse oscillometry (IOS) is an objective and noninvasive measurement of lung function that has the potential to examine independently both small- and large-airway obstruction. We sought to determine the utility of IOS in assessing asthma control in children. Asthmatic and healthy children (6-17 years) were enrolled in the study. Spirometric and IOS (resistance of the respiratory system at 5 Hz [R5] and 20 Hz [R20], reactance of the respiratory system at 5 Hz [X5], resonant frequency of reactance [Fres], and area under the reactance curve between 5 Hz and Fres [reactance area {AX}]) values were collected in triplicate before and after a bronchodilator was administered. The physicians were blinded to the IOS measurements and assessed asthma control using American Thoracic Society guidelines. Small-airway IOS measurements, including the difference of R5 and R20 [R5-20], X5, Fres, and AX, of children with uncontrolled asthma (n = 44) were significantly different from those of children with controlled asthma (n = 57) and healthy children (n = 14), especially before the administration of a bronchodilator. However, there was no difference in large-airway IOS values (R20). No differences were found between children with controlled asthma and healthy children in any of the end points. Receiver operating characteristic analysis showed cut points for baseline R5-20 (1.5 cm H(2)O · L(-1) · s) and AX (9.5 cm H(2)O · L(-1)) that effectively discriminated controlled versus uncontrolled asthma (area under the curve, 0.86 and 0.84) and correctly classified more than 80% of the population. Uncontrolled asthma is associated with small-airways dysfunction, and IOS might be a reliable and noninvasive method to assess asthma control in children

Effectiveness of pneumococcal vaccination for elderly people in Catalonia, Spain: a case-control study.

Science.gov (United States)

Dominguez, Angela; Salleras, Lluis; Fedson, David S; Izquierdo, Conchita; Ruiz, Laura; Ciruela, Pilar; Fenoll, Asuncion; Casal, Julio

2005-05-01

Observational studies offer an approach to evaluating the effectiveness of vaccination programs. We evaluated the effectiveness of a 23-valent pneumococcal vaccination program for elderly people in Catalonia, Spain, in a matched-set case-control study. We identified 149 cases of invasive pneumococcal disease among patients aged > or =65 years who were hospitalized in 12 large hospitals in Catalonia during the period of 1 January 2001 through 31 March 2002. We selected 2 hospital control patients and 1 outpatient control subject for each case patient, matching on the basis of age and underlying medical conditions. We obtained their pneumococcal vaccination histories and used conditional logistic regression to determine effectiveness of vaccination. Among all 149 cases of invasive pneumococcal disease, 131 (87.9%) were caused by vaccine or vaccine-related serotypes. In the adjusted analysis, overall effectiveness of vaccination against infections due to all serotypes was 70% (95% confidence interval [CI], 48%-82%). Among immunocompetent subjects with or without high-risk conditions, effectiveness of vaccination was 76% (95% CI, 51%-88%), but among immunocompromised subjects it was 50% (95% CI, -44% to 82%). Among subjects with infections due to vaccine or vaccine-related serotypes, effectiveness of vaccination was 72% (95% CI, 50%-85%) overall and 78% (95% CI, 50%-90%) in those who were immunocompetent, but it was only 46% (95% CI, -54% to 81%) in those who were immunocompromised. Overall effectiveness of vaccination was 65% (95% CI, 35%-81%) during the noninfluenza period. Pneumococcal vaccination was effective in preventing invasive pneumococcal disease among all elderly persons in Catalonia. Effectiveness was greater in immunocompetent persons, most of whom had underlying high-risk conditions. The number of subjects was too small to determine whether vaccination was effective in those who were immunocompromised.

Case-control study of genetic and environmental influences on premature death of adult adoptees.

Science.gov (United States)

Petersen, Liselotte; Nielsen, Gert G; Andersen, Per Kragh; Sørensen, Thorkild I A

2002-08-01

Genetic and environmental influence on risk of premature death in adulthood was investigated by estimating the associations in total and cause-specific mortality of adult Danish adoptees and their biological and adoptive parents. Among all 14,427 nonfamilial adoptions formally granted in Denmark during the period 1923 through 1947, we identified 976 case families in which the adoptee died before a fixed date. As control families, we selected 976 families where the adoptees were alive on that date, and matched to the case adoptees with regard to gender and year and month of birth. The data were viewed as a cohort of case parents and a cohort of control parents, and lifetime distributions in the two cohorts were compared using a Cox regression, stratified with regard to the matching variables: gender and year of birth. In the main analyses, the sample was restricted with regard to birth year of the adoptees, and age of transfer to the adoptive parents, and age at death was restricted to the same range for parents and offspring (25-64 years) in order to consider a symmetric lifetime distribution. This reduces the sample to 459 case families and 738 control families. Various truncations, restrictions, and stratifications were used in order to examine the robustness of the results. The results showed a higher mortality among biological parents who had children dying in the age range 25 through 64 years, and this was significant for death from natural causes, infectious causes, vascular causes, and from all causes combined. There were no significant effects for the adoptive parents. This study supports that there are moderate genetic influences on the risk of dying prematurely in adulthood, and only a small, if any, effect of the family environment. Copyright 2002 Wiley-Liss, Inc.

Struggling doctors in specialist training: a case control study

DEFF Research Database (Denmark)

O'Neill, Lotte; Norberg, Karen; Thomsen, Maria

), or transferred (i.e. had unplanned changes in place of training/ward due to failure to thrive or due to inadequate development of competences), or dropped out (i.e. were dismissed from, had resigned from, or changed their speciality). Controls were a random sample of doctors in the source population, who were......Abstract summary The aim of this cummulative incidence case-control study was to examine: if struggling trainees in medical specialist training (cases) tended to struggle already in medical school or not compared to non-struggling controls, and which performance indicators during medical school...... seemed to predict struggling in postgraduate education if any. The study design is rooted in epidemiological methodology. Struggling doctors in specialist training: a case-control study. It has been reported in the international literature, that around 3-10% of doctors in post-garduate specialist...

Colon cancer controls versus population controls in case-control studies of occupational risk factors

DEFF Research Database (Denmark)

Kaerlev, Linda; Lynge, Elsebeth; Sabroe, Svend

2004-01-01

are interchangeable with the experience for population controls. Patient controls may even be preferable from population controls under certain conditions. In this study we examine if colon cancer patients can serve as surrogates for proper population controls in case-control studies of occupational risk factors...... about occupational, medical and life style conditions. RESULTS: No statistical significant difference for educational level, medical history or smoking status was seen between the two control groups. There was evidence of a higher alcohol intake, less frequent work as a farmer and less exposure...... to pesticides among colon cancer controls. CONCLUSIONS: Use of colon cancer controls may provide valid exposure estimates in studies of many occupational risk factors for cancer, but not for studies on exposure related to farming....

Pleural mesothelioma: Case-report of uncommon occupational asbestos exposure in a small furniture industry.

Science.gov (United States)

Oddone, Enrico; Imbriani, Marcello

2016-01-01

The relationship between asbestos exposure and malignant mesothelioma is no longer disputed, although it is not always easy to trace past occupational exposure. This report describes a case of uncommon asbestos exposure of a small furniture industry worker, who subsequently died of pleural malignant mesothelioma, to stress the crucial importance of a full reconstruction of the occupational history, both for legal and compensation purposes. Sarcomatoid pleural mesothelioma was diagnosed in a 70-year-old man, who was previously employed as a carpenter in a small furniture industry. He worked for about 6 years in the small factory, was exposed to asbestos during the assembly of the furniture inspired by classical architecture, in which asbestos cement tubes were used to reproduce classical columns. During this production process no specific work safety measures were applied, nor masks or local aspirators. No extra-professional exposure to asbestos was identified. This mesothelioma case was investigated by the Public Prosecutor's assignment that commissioned expert evidence on the legal accountability for the disease. Despite its uncommon expositive circumstance, the length of latency (about 30 years), the duration of exposure, the clinical and histochemical features are all consistent with literature evidence, accounting for the occupational origin of this malignancy. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Case Studies of Leading Edge Small Urban High Schools. Core Academic Strategic Designs: 3. University Park Campus School

Science.gov (United States)

Shields, Regis Anne; Ireland, Nicole; City, Elizabeth; Derderian, Julie; Miles, Karen Hawley

2008-01-01

This report is one of nine detailed case studies of small urban high schools that served as the foundation for the Education Resource Strategies (ERS) report "Strategic Designs: Lessons from Leading Edge Small Urban High Schools." These nine schools were dubbed "Leading Edge Schools" because they stand apart from other high…

Two case studies in river naturalization: planform migration and bank erosion control

Science.gov (United States)

Abad, J. D.; Guneralp, I.; Rhoads, B. L.; Garcia, M. H.

2005-05-01

streambank protection project using bendway weirs. In the State of Illinois, bendway weirs constructed of rock have been installed at hundreds of sites, especially on small streams, to control streambank erosion. Bendway weirs are low hard structures installed in the concave bank of a meander bend. Design criteria for these weirs are approximate and have not been rigorously evaluated for overall effectiveness at low-, medium- and high flows. This initial step of the study attempted to describe the hydrodynamics around the weirs and the influence of the hydrodynamic patterns on sediment transport (near-field and far-field). To do that, a state-of-the-art three-dimensional CFD model was used to simulate flow through meander bends where 3D velocity measurements have been obtained to validate model predictions at low stages. Results indicate that the weirs produce highly complex patterns of flow around the weirs, which in some cases may actually increase erosional potential near the outer bank. These two case studies represent components of an emerging initiative to develop predictive tools for naturalization over a range of spatial and temporal scales

Small bowel adenocarcinoma of the jejunum: a case report and literature review.

Science.gov (United States)

Li, Jie; Wang, Zhiliang; Liu, Na; Hao, Junfeng; Xu, Xin

2016-07-04

In practice, small bowel cancer is a rare entity. The most common histologic subtype is adenocarcinoma. Adenocarcinoma of the small bowel (SBA) is challenging to diagnose, often presents at a late stage and has a poor prognosis. The treatment of early-stage SBA is surgical resection. No standard protocol has been established for unresectable or metastatic disease. We report here on a 26-year-old man with SBA in the jejunum, lacking specific symptoms and with a delay of 6 months in diagnosis. The diagnosis was finally achieved with a combination of balloon-assisted enteroscopy, computed tomography scans, positron emission computed tomography scans and the values of carcino-embryonic antigen and carbohydrate antigen 19-9. The patient underwent segmental intestine with lymph node resection, followed by eight cycles of FOLFOX palliative chemotherapy with good tolerance. As of the 11-month postoperative follow-up, there has been no evidence of recurrent disease. This case is reported to arouse a clinical suspicion of SBA in patients with abdominal pain of unknown cause. We also provided evidence in this case of a response to palliative chemotherapy with FOLFOX. Because the incidence of SBA is very low, there is a need for further studies to evaluate the possible application of newer investigative agents and strategies to obtain a better outcome within the framework of international collaborations.

Suspected survivor bias in case-control studies: stratify on survival time and use a negative control.

Science.gov (United States)

van Rein, Nienke; Cannegieter, Suzanne C; Rosendaal, Frits R; Reitsma, Pieter H; Lijfering, Willem M

2014-02-01

Selection bias in case-control studies occurs when control selection is inappropriate. However, selection bias due to improper case sampling is less well recognized. We describe how to recognize survivor bias (i.e., selection on exposed cases) and illustrate this with an example study. A case-control study was used to analyze the effect of statins on major bleedings during treatment with vitamin K antagonists. A total of 110 patients who experienced such bleedings were included 18-1,018 days after the bleeding complication and matched to 220 controls. A protective association of major bleeding for exposure to statins (odds ratio [OR]: 0.56; 95% confidence interval: 0.29-1.08) was found, which did not become stronger after adjustment for confounding factors. These observations lead us to suspect survivor bias. To identify this bias, results were stratified on time between bleeding event and inclusion, and repeated for a negative control (an exposure not related to survival): blood group non-O. The ORs for exposure to statins increased gradually to 1.37 with shorter time between outcome and inclusion, whereas ORs for the negative control remained constant, confirming our hypothesis. We recommend the presented method to check for overoptimistic results, that is, survivor bias in case-control studies. Copyright © 2014 Elsevier Inc. All rights reserved.

A rare case of small bowel volvulus after jenjunoileal bariatric bypass requiring emergency surgery: a case report

Directory of Open Access Journals (Sweden)

Patel Pranav H

2012-03-01

Full Text Available Abstract Introduction Bariatric surgery is on the increase throughout the world. Jejunoileal bypass bariatric procedures have fallen out of favor in western surgical centers due to the high rate of associated complications. They are, however, performed routinely in other centers and as a consequence of health tourism, management of complications related to these procedures may still be encountered. Case presentation We describe a rare case of small bowel obstruction in a 45-year-old British Caucasian woman, secondary to a volvulus of the jejunoileal anastomosis following bariatric bypass surgery. The pre-operative diagnosis was confirmed by radiology. We describe a successful surgical technique for this rare complication. Conclusions Bariatric surgery may be complicated by bowel obstruction. Early imaging is vital for diagnosis and effective management. The use of our surgical technique provides a simple and effective approach for the successful management of this bariatric complication.

Effect of cryoablation sequential chemotherapy on patients with advanced non-small cell lung cancer

Directory of Open Access Journals (Sweden)

Shu-Hui Yao

2016-03-01

Full Text Available Objective: To evaluate the effect of cryoablation sequential chemotherapy on patients with advanced non-small cell lung cancer. Methods: A total of 39 cases with advanced non-small cell lung cancer who received cryoablation sequential chemotherapy and 39 cases with advanced non-small cell lung cancer who received chemotherapy alone were selected and enrolled in sequential group and control group, disease progression and survival of two groups were followed up, and contents of tumor markers and angiogenesis molecules in serum as well as contents of T-lymphocyte subsets in peripheral blood were detected. Results: Progressionfree survival and median overall survival (mOS of sequential group were longer than those of control group, and cumulative cases of tumor progression at various points in time were significantly less than those of control group (P<0.05; 1 month after treatment, serum tumor markers CEA, CYFRA21-1 and NSE contents, serum angiogenesis molecules PCDGF, VEGF and HDGF contents as well as CD3+CD4-CD8+CD28-T cell content in peripheral blood of sequential group were significantly lower than those of control group (P<0.05, and contents of CD3+CD4+CD8-T cell and CD3+CD4-CD8+CD28+T cell in peripheral blood were higher than those of control group (P<0.05. Conclusions: Cryoablation sequential chemotherapy can improve the prognosis of patients with advanced non-small cell lung cancer, delay disease progression, prolong survival time, inhibit angiogenesis and improve immune function.

[Small cell neuroendocrine tumour of the bladder: with reference to a case and bibliographical revision].

Science.gov (United States)

Lahoz Tornos, A; Marrón Penón, Maria C; Pardo López, Maria L; Nogueras Gimeno, M A; Pujol Obis, E; Del Villar Sordo, V

2006-09-01

The small cell neuroendocrine tumour is an infrecuent neoplasia, with inmunohistochemistry being the key to diagnosis. We present a new case making reference to treatment and its evolution there after. The clinic, diagnosis and treatment of this tumour is described. Bibliographical revision follours. The neuroendocrine tumour of small cell is an infrecuent neoplasia, in which the inmunohistochemistry study is key in the diagnosis. The differential diagnosis includes the high degree diferentiation transitionals cells carcinoma and primary and secondary linfoma. The standard treatment is based on chemotherapy plus surgery.

Control, Control, Complete Control!!! Neurotic Control Relationships and the Development of Dysfunctional Organizational Structures.

Science.gov (United States)

Kersten, Astrid

A case study illustrates the concept of the neurotic organization by describing the development of "Central Control College" over a period of 11 years. In this period of time, the college moved from a small, informal organization to a highly developed compulsive institution. The image of neurosis has been applied in the organizational…

Barriers to innovation in small-scale industries: case study from the briquetting industry in India

NARCIS (Netherlands)

Clancy, Joy S.

2001-01-01

This paper focuses on the innovation process in small- and medium-scale industries in developing countries, raking the briquetting (densification of biomass) as a case study. The technical efficiency was found to vary significantly between firms, which can be attributed to the lack of technological

D2D-Enabled Small Cell Network Control Scheme Based on the Dynamic Stackelberg Game

Directory of Open Access Journals (Sweden)

Sungwook Kim

2017-01-01

Full Text Available For current and future cellular networks, small cell structure with licensed and unlicensed bandwidth, caching content provisioning, and device-to-device (D2D communications is seen as a necessary architecture. Recently, a series of control methods have been developed to address a myriad of challenges in next-generation small cell networks. In this study, we focus on the design of novel D2D-enabled small cell network control scheme by allowing caching and unlicensed D2D communications. Motivated by game theory and learning algorithm, the proposed scheme adaptively selects caching contents and splits the available bandwidth for licensed and unlicensed communications. Under dynamically changing network environments, we capture the dynamics of the network system and design a new dynamic Stackelberg game model. Based on a hierarchical and feedback based control manner, small base stations and users can be leaders or followers dynamically while improving 5G network performance. Simulations and performance analysis verify the efficiency of the proposed scheme, showing that our approach can outperform existing schemes by about 5%~15% in terms of bandwidth utilization, cache hit ratio, and system throughput.

A rare case of retroperitoneal malignant triton tumor invading renal vein and small intestine

Directory of Open Access Journals (Sweden)

Mijović Žaklina

2013-01-01

Full Text Available Introduction. Malignant Triton tumor is a very rare malignant peripheral nerve sheath tumor with rhabdomyosarcomatous differentiation. Most of those tumors occur in patients with von Recklinghausen’s disease or as a late complication of irradiation and commonly seen in the head, neck, extremities and trunk. Case report. We reported retroperitoneal malignant Triton tumor in a 57-year-old female patient. Skin lesions were not present, and there was no family history of neurofibromatosis or previous irradiation. The presented case is one of a few recorded in the specialized literature that occurs in the retroperitoneal space in sporadic form. In this case, tumor consisted of a multilobular mass was in close relation with the abdominal aorta and inferior vena cava and involved the renal vein with gross invasion of the small intestine. The patient underwent total resection of the tumor and left nefrectomy was performed. The small intestine 10 cm in length was also resected and end-to-end anastomosis was conducted. The postoperative course was uneventful and the patient was discharged from the hospital ten days after the surgery. Conclusion. Diagnostically, it is crucial to recognize this uncommon histological variant because malignant Triton tumor has a worse prognosis than classic malignant peripheral nerve sheath tumor does. The use of the immunohistochemistry is essential in making the correct diagnosis. Only appropriate pathological evaluation supported by immunostaining with S-100 protein and desmin confirmed the diagnosis. Aggressive surgical management treatment improves the prognosis of such cases with adjuvant radiotherapy.

Development of the novel control algorithm for the small proton exchange membrane fuel cell stack without external humidification

Energy Technology Data Exchange (ETDEWEB)

Kim, Tae-Hoon; Kim, Sang-Hyun; Kim, Wook; Lee, Jong-Hak; Cho, Kwan-Seok; Choi, Woojin [Department of Electrical Engineering, Soongsil University, 1-1 Sangdo-dong, Dongjak-gu, Seoul 156-743 (Korea); Park, Kyung-Won [Department of Chemical/Environmental Engineering, Soongsil University, 1-1 Sangdo-dong, Dongjak-gu, Seoul 156-743 (Korea)

2010-09-15

Small PEM (proton exchange membrane) fuel cell systems do not require humidification and have great commercialization possibilities. However, methods for controlling small PEM fuel cell stacks have not been clearly established. In this paper, a control method for small PEM fuel cell systems using a dual closed loop with a static feed-forward structure is defined and realized using a microcontroller. The fundamental elements that need to be controlled in fuel cell systems include the supply of air and hydrogen, water management inside the stack, and heat management of the stack. For small PEM fuel cell stacks operated without a separate humidifier, fans are essential for air supply, heat management, and water management of the stack. A purge valve discharges surplus water from the stack. The proposed method controls the fan using a dual closed loop with a static feed-forward structure, thereby improving system efficiency and operation stability. The validity of the proposed method is confirmed by experiments using a 150-W PEM fuel cell stack. We expect the proposed algorithm to be widely used for controlling small PEM fuel cell stacks. (author)

Space-time clustering of non-hodgkin lymphoma using residential histories in a Danish case-control study.

Directory of Open Access Journals (Sweden)

Rikke Baastrup Nordsborg

Full Text Available Non-Hodgkin lymphoma (NHL is a frequent cancer and incidence rates have increased markedly during the second half of the 20(th century; however, the few established risk factors cannot explain this rise and still little is known about the aetiology of NHL. Spatial analyses have been applied in an attempt to identify environmental risk factors, but most studies do not take human mobility into account. The aim of this study was to identify clustering of NHL in space and time in Denmark, using 33 years of residential addresses. We utilised the nation-wide Danish registers and unique personal identification number that all Danish citizens have to conduct a register-based case-control study of 3210 NHL cases and two independent control groups of 3210 each. Cases were identified in the Danish Cancer Registry and controls were matched by age and sex and randomly selected from the Civil Registration System. Residential addresses of cases and controls from 1971 to 2003 were collected from the Civil Registration System and geocoded. Data on pervious hospital diagnoses and operations were obtained from the National Patient Register. We applied the methods of the newly developed Q-statistics to identify space-time clustering of NHL. All analyses were conducted with each of the two control groups, and we adjusted for previous history of autoimmune disease, HIV/AIDS or organ transplantation. Some areas with statistically significant clustering were identified; however, results were not consistent across the two control groups; thus we interpret the results as chance findings. We found no evidence for clustering of NHL in space and time using 33 years of residential histories, suggesting that if the rise in incidence of NHL is a result of risk factors that vary across space and time, the spatio-temporal variation of such factors in Denmark is too small to be detected with the applied method.

A case of limbic encephalitis presenting as a paraneoplastic manifestation of limited stage small cell lung cancer: a case report

Directory of Open Access Journals (Sweden)

Butt Mohammad

2010-12-01

Full Text Available Abstract Introduction The differential diagnosis of altered mental status and behavioral change is very extensive. Paraneoplastic limbic encephalitis is a rare cause of cognitive impairment, which should be considered in the differential diagnosis. Case presentation A 64-year-old British Caucasian woman presented to our hospital with a 12-week history of confusion and short-term memory loss. She was hyponatremic with a serum sodium level of 128mmol/L. Moreover, there was evidence of left hilar prominence on the chest radiograph. A thoracic computed tomography scan showed left hilar opacity with confluent lymphadenopathy. A percutaneous biopsy confirmed a diagnosis of small cell lung cancer. There was no radiological evidence of brain metastasis on the computed tomography scan. In view of continued cognitive impairment, which was felt to be disproportionate to hyponatremia, a magnetic resonance imaging scan of the brain was undertaken. It showed hyperintense signals from both hippocampi, highly suggestive of limbic encephalitis presenting as a paraneoplastic manifestation of small cell lung cancer. She had a significant radiological and clinical response following chemotherapy and radiotherapy. Conclusion This case highlights the importance of considering paraneoplastic syndromes in patients with neurological symptoms in the context of lung malignancy. If initial investigations fail to reveal the cause of cognitive impairment in a patient with malignancy, magnetic resonance imaging may be invaluable in the diagnosis of limbic encephalitis. The clinical presentation, diagnostic techniques and management of paraneoplastic limbic encephalitis are discussed in this case report.

A case-control study of risk factors for epithelial ovarian cancer

Directory of Open Access Journals (Sweden)

Ghaem Maghami Noori F

2001-09-01

Full Text Available Ovarian cancer is second prevalent cancer among gynecologic malignancies and the most common type of ovarian cancer is epithelial form (85-90 percent. To detect the risk factors for the epithelial ovarian cancer, a case-control study was conducted in Valieasr hospital in 1988. In this study, 118 cases with epithelial ovarian cancer (according histological records and 240 controls without any gynecological cancer in gynecologic clinic had been interviewed. For data analysis, T-test, Chi2 test and logistic regression have been used at a =0.05 as level of significance. The mean age in cases was 50±13 and in controls was 49.9±12 years, without significant different. The mean number of pregnancies and parity in cases was less than controls, significantly (P<0.03. The mean months of breast feeding in cases was less than controls (54.9±71.2 versus 82.4±62.7 (P<0.001. The cases had a lower mean age of menarch than controls (P=0.03. 58 percent of cases and 21.3 percent of controls hadn't used any contraception methods (P=0.00001. The mean years of contraception was significantly less in cases versus controls (P<0.001. The odds ratio for epithelial ovarian cancer was 0.24 (95 percent CI: 0.13-0.48 in OCP users, 0.47 (95 percent CI: 0.005-0.43 in TL method, and was 0.41 (95 percent CI: 0.22-0.76 in other contraception methods, relative to women who hadn't used any contraception methods. This study reveals that epithelial ovarian cancer risk increases significantly with earlier menarch, decreasing number of pregnancy, deliveries duration of breast feeding and use of contraception methods. Use of contraception pill and tubal ligation method decreases risk of epithelial ovarian cancer.

Small cell lung cancer transformation from EGFR-mutated lung adenocarcinoma: A case report and literatures review.

Science.gov (United States)

Liu, Yangyang

2018-06-03

Epithelial growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have markedly improved the response of non-small cell lung cancer (NSCLC) with EGFR-mutant patients. However, these patients inevitably come cross acquired resistance to EGFR-TKIs. The transformation of lung adenocarcinoma to small cell lung cancer (SCLC) following treatment with EGFR-TKIs is rare, which leads to resistance to EGFR-TKIs. The present case concerns a case of a 38-year-old man presenting with cough and dyspnea. Radical resection was performed and confirmed an EGFR exon 21 L858R lung adenocarcinoma. However, the patient suffered pleural metastasis after successful treatment with surgery and adjuvant treatment. So, erlotinib was administered with 18 months. Because of enlarged pleural nodule, repeat biopsy identified an SCLC and chemotherapy was started. However, despite the brief success of chemotherapy, our patient suffered brain metastasis. Our case emaphsizes both the profile of transformation from NSCLC to SCLC and the importance of repeat biopsy dealing with drug resistance. We also summarize the clinical characteristics, mechanisms, predictors of SCLC transformation, treatment after transformation and other types of transformation to SCLC.

Public choice in water resource management: two case studies of the small-scale hydroelectric controversy

Energy Technology Data Exchange (ETDEWEB)

Soden, D.L.

1985-01-01

Hydroelectric issues have a long history in the Pacific Northwest, and more recently have come to focus on developing environmentally less-obtrusive means of hydroelectric generation. Small-scale hydroelectric represents perhaps the most important of these means of developing new sources of renewable resources to lessen the nation's dependence on foreign sources of energy. Each potential small-scale hydroelectric project, however, manifests a unique history which provides a highly useful opportunity to study the process of collective social choice in the area of new energy uses of water resources. Utilizing the basic concepts of public choice theory, a highly developed and increasingly widely accepted approach in the social sciences, the politicalization of small-scale hydroelectric proposals is analyzed. Through the use of secondary analysis of archival public opinion data collected from residents of the State of Idaho, and through the development of the two case studies - one on the Palouse River in Eastern Washington and the other at Elk Creek Falls in Northern Idaho, the policy relevant behavior and influence of major actors is assessed. Results provide a useful test of the utility of public-choice theory for the study of cases of natural-resources development when public involvement is high.

Multichannel active control of random noise in a small reverberant room

DEFF Research Database (Denmark)

Laugesen, Søren; Elliott, Stephen J.

1993-01-01

An algorithm for multichannel adaptive IIR (infinite impulse response) filtering is presented and applied to the active control of broadband random noise in a small reverberant room. Assuming complete knowledge of the primary noise, the theoretically optimal reductions of acoustic energy are init...... with the primary noise field generated by a panel excited by a loudspeaker in an adjoining room. These results show that far better performances are provided by IIR and FIR filters when the primary source has a lightly damped dynamic behavior which the active controller must model...

The Misconception of Case-Control Studies in the Plastic Surgery Literature: A Literature Audit.

Science.gov (United States)

Hatchell, Alexandra C; Farrokhyar, Forough; Choi, Matthew

2017-06-01

Case-control study designs are commonly used. However, many published case-control studies are not true case-controls and are in fact mislabeled. The purpose of this study was to identify all case-control studies published in the top three plastic surgery journals over the past 10 years, assess which were truly case-control studies, clarify the actual design of the articles, and address common misconceptions. MEDLINE, Embase, and Web of Science databases were searched for case-control studies in the three highest-impact factor plastic surgery journals (2005 to 2015). Two independent reviewers screened the resulting titles, abstracts, and methods, if applicable, to identify articles labeled as case-control studies. These articles were appraised and classified as true case-control studies or non-case-control studies. The authors found 28 articles labeled as case-control studies. However, only six of these articles (21 percent) were truly case-control designs. Of the 22 incorrectly labeled studies, one (5 percent) was a randomized controlled trial, three (14 percent) were nonrandomized trials, two (9 percent) were prospective comparative cohort designs, 14 (64 percent) were retrospective comparative cohort designs, and two (9 percent) were cross-sectional designs. The mislabeling was worse in recent years, despite increases in evidence-based medicine awareness. The majority of published case-control studies are not in fact case-control studies. This misunderstanding is worsening with time. Most of these studies are actually comparative cohort designs. However, some studies are truly clinical trials and thus a higher level of evidence than originally proposed.

Primary Small-Cell Carcinoma of the Palate with Cushing’s Syndrome: A Case Report

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Yingqiu Song

2012-01-01

Full Text Available We report a 24-year-old woman presenting with a relapsed soy-bean-size tender mass at the junction of the soft and hard palate and a history of palatine tumor of small cell carcinoma. Reexcision surgery was performed and histopathological features were consistent. The patient was treated with six cycles of chemotherapy consisting of etoposide and cisplatin. After one year, the patient developed bone metastases and Cushing's syndrome, and successfully recovered with subsequent chemotherapy with irinotecan and cisplatin plus radiotherapy. There was no evidence of recurrence or metastasis for more than three years. Small cell carcinoma originating in the head and neck region has been reported to be highly aggressive and has a poor prognosis. This is the first case report of a patient with relapsed primary small cell carcinoma of the palate and successfully treated with second-line chemotherapy and local radiotherapy.

The use of CAMAC with small computers in the TRIUMF control system

International Nuclear Information System (INIS)

Gurd, D.P.; Heywood, D.R.; Johnson, R.R.

1975-08-01

The TRIUMF control system uses several small computers. This allows tasks to be partitioned in hardware rather than by a complex operating system. This flexibility was especially convenient during the developmental stages of TRIUMF. The multi-mini approach also improves mean time to repair. All control system computers are to be interfaced simultaneously to a single CAMAC system of 35 crates on seven branches. Other computers, belonging to separate systems, communicate with the control system via parallel CAMAC-to-CAMAC links. Modularity at both the computer and controller levels, combined with CAMAC multisourcing, has allowed the introduction of considerable redundancy, thereby increasing overall system reliability. (author)

Primary fibrosarcoma im small intestine of dog - Case report

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Geórgia Modé Magalhães

2015-06-01

Full Text Available ABSTRACT. Magalhães G.M., Santilli J., Calazans S.G., Nishimura L.T., Cerejo S.A. & Dias F.G.G. [Primary fibrosarcoma im small intestine of dog - Case report.] Fibrossarcoma primário em intestino delgado de cão - Relato de caso. Revista Brasileira de Medicina Veterinária, 37(2:145-148, 2015. Programa de Pós-Graduação em Medicina Veterinária de Pequenos Animais, Universidade de Franca, Av. Dr. Armando Salles Oliveira, 201, Cx postal 82, Parque Universitá- rio, Franca, SP 14404-600, Brasil. E-mail: georgiamode@hotmail.com Intestinal neoplasms are uncommon in dogs, and among the most frequently diagnosed are smooth muscle, lymphomas and carcinomas. The fibrosarcoma is extremely rare in the intestine of animals of this species therefore, little is known about the macroscopic and behavior of this tumor. Given this unusual intestinal disease in dogs, the present study aimed to report a case of intestinal fibrosarcoma in a poodle breed dog, 15 years old, with no apparent clinical signs. The mass was pedunculated, whitish and firm consistency. The diagnosis was made by histopathology. After four months of surgical excision, there was no recurrence and metastasis. We conclude that the intestinal fibrosarcoma has low aggressiveness, are rare and can present macroscopic pediculated.

Immuno-related polymorphisms and cervical cancer risk: The IARC multicentric case-control study.

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James McKay

Full Text Available A small proportion of women who are exposed to infection with human-papillomavirus (HPV develop cervical cancer (CC. Genetic factors may affect the risk of progression from HPV infection to cervical precancer and cancer. We used samples from the International Agency for Research on Cancer (IARC multicentric case-control study to evaluate the association of selected genetic variants with CC. Overall, 790 CC cases and 717 controls from Algeria, Morocco, India and Thailand were included. Cervical exfoliated cells were obtained from control women and cervical exfoliated cells or biopsy specimens from cases. HPV-positivity was determined using a general primer GP5+/6+ mediated PCR. Unconditional logistic regression was used to estimate odds ratios (OR and corresponding 95% confidence intervals (CI of host genotypes with CC risk, using the homozygous wild type genotype as the referent category and adjusting by age and study centre. The association of polymorphisms with the risk of high-risk HPV-positivity among controls was also evaluated. A statistically significant association was observed between single nucleotide polymorphism (SNP CHR6 rs2844511 and CC risk: the OR for carriers of the GA or GG genotypes was 0.70 (95% CI: 0.43-1.14 and 0.61 (95% CI: 0.38-0.98, respectively, relative to carriers of AA genotype (p-value for trend 0.03. We also observed associations of borderline significance with the TIPARP rs2665390 polymorphism, which was previously found to be associated with ovarian and breast cancer, and with the EXOC1 rs13117307 polymorphism, which has been linked to cervical cancer in a large study in a Chinese population. We confirmed the association between CC and the rs2844511 polymorphism previously identified in a GWAS study in a Swedish population. The major histocompatibility region of chromosome 6, or perhaps other SNPs in linkage disequilibrium, may be involved in CC onset.

Mucosa-associated Lymphoid Tissue Lymphoma Presenting with Bowel Obstruction of the Duodenum and Small Bowels: A Case Report

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Ryu, Guen Ho; Hong, Seong Sook; Kim, Jung Hoon; Chang, Yun Woo; Choi, Duek Lin; Hwang, Jung Hwa; Kwon, Kui Hyang [Soonchunhyang University Hospital, Seoul (Korea, Republic of)

2010-01-15

The occurrence of primary duodenal mucosa associated lymphoid tissue (MALT) lymphoma is extremely rare, and more so is the obstruction of the duodenum for the MALT lymphoma. We describe the small bowel follow through and CT findings in an uncommon case of MALT lymphoma presenting with bowel obstruction of the 2nd portion of the duodenum and small bowels.

Mucosa-associated Lymphoid Tissue Lymphoma Presenting with Bowel Obstruction of the Duodenum and Small Bowels: A Case Report

International Nuclear Information System (INIS)

Ryu, Guen Ho; Hong, Seong Sook; Kim, Jung Hoon; Chang, Yun Woo; Choi, Duek Lin; Hwang, Jung Hwa; Kwon, Kui Hyang

2010-01-01

The occurrence of primary duodenal mucosa associated lymphoid tissue (MALT) lymphoma is extremely rare, and more so is the obstruction of the duodenum for the MALT lymphoma. We describe the small bowel follow through and CT findings in an uncommon case of MALT lymphoma presenting with bowel obstruction of the 2nd portion of the duodenum and small bowels

Estimation and Control in Agile Methods for Software Development: a Case Study

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Mitre-Hernández Hugo A.

2014-07-01

Full Text Available The development of software (SW using agile methods is growing due to the productivity associated with these methodologies, in addition to the flexibility shown in small teams. However, these methods have clear weaknesses of software development in cost estimation and management, as well as the fact that project managers do not have enough evidence to verify the budget spending on a project due to the poor documentation generated and the lack of monitoring of resource spending. A proposal estimation and cost control in agile methods to solve these shortcomings. To this end, a case study was conducted in an agile software development company using the proposal for Software as a Service (SaaS and Web application projects. The results found were that the proposal generates a high degree of evidence for project managers, but it has shortcomings in the administration of the evidence for the control and decision making, which led to a definition of a decision making process to be coupled with the measurement proposal.

Four small supernumerary marker chromosomes derived from chromosomes 6, 8, 11 and 12 in a patient with minimal clinical abnormalities: a case report

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Hamid Ahmed B

2010-08-01

Full Text Available Abstract Introduction Small supernumerary marker chromosomes are still a problem in cytogenetic diagnostic and genetic counseling. This holds especially true for the rare cases with multiple small supernumerary marker chromosomes. Most such cases are reported to be clinically severely affected due to the chromosomal imbalances induced by the presence of small supernumerary marker chromosomes. Here we report the first case of a patient having four different small supernumerary marker chromosomes which, apart from slight developmental retardation in youth and non-malignant hyperpigmentation, presented no other clinical signs. Case presentation Our patient was a 30-year-old Caucasian man, delivered by caesarean section because of macrosomy. At birth he presented with bilateral cryptorchidism but no other birth defects. At age of around two years he showed psychomotor delay and a bilateral convergent strabismus. Later he had slight learning difficulties, with normal social behavior and now lives an independent life as an adult. Apart from hypogenitalism, he has multiple hyperpigmented nevi all over his body, short feet with pes cavus and claw toes. At age of 30 years, cytogenetic and molecular cytogenetic analysis revealed a karyotype of 50,XY,+min(6(:p11.1-> q11.1:,+min(8(:p11.1->q11.1:,+min(11(:p11.11->q11:,+min(12(:p11.2~12->q10:, leading overall to a small partial trisomy in 12p11.1~12.1. Conclusions Including this case, four single case reports are available in the literature with a karyotype 50,XN,+4mar. For prenatally detected multiple small supernumerary marker chromosomes in particular we learn from this case that such a cytogenetic condition may be correlated with a positive clinical outcome.

Risk Factors for Sporadic Domestically Acquired Campylobacter Infections in Norway 2010-2011: A National Prospective Case-Control Study.

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Emily MacDonald

Full Text Available Campylobacteriosis is the most frequently reported food- and waterborne infection in Norway. We investigated the risk factors for sporadic Campylobacter infections in Norway in order to identify areas where control and prevention measures could be improved.A national prospective case-control study of factors associated with Campylobacter infection was conducted from July 2010 to September 2011. Cases were recruited from the Norwegian Surveillance System of Communicable Diseases (MSIS. Controls were randomly selected from the Norwegian Population Registry. Cases and controls were mailed a paper questionnaire with a prepaid return envelope. Univariable analyses using logistic regression were conducted for all exposures. A final parsimonious multivariable model was developed using regularized/penalized logistic regression, and adjusted odds ratios were calculated.A total of 995 cases and 1501 controls were included in the study (response proportion 55% and 30%, respectively. Exposures that had significant increases in odds of Campylobacter infection in multivariable analysis were drinking water directly from river, stream, or lake (OR: 2.96, drinking purchased bottled water (OR: 1.78, eating chicken (1.69, eating meat that was undercooked (OR: 1.77, eating food made on a barbecue (OR: 1.55, living on a farm with livestock (OR: 1.74, having a dog in the household (OR: 1.39, and having household water supply serving fewer than 20 houses (OR: 1.92.Consumption of poultry and untreated water remain important sources of Campylobacter infection in Norway, despite ongoing control efforts. The results justify the need for strengthening education for consumers and food handlers about the risks of cross-contamination when preparing poultry and with consuming raw or undercooked chicken. The public should also be reminded to take precautions when drinking untreated water in nature and ensure continued vigilance in order to protect and maintain the quality of

Risk Factors for Sporadic Domestically Acquired Campylobacter Infections in Norway 2010-2011: A National Prospective Case-Control Study.

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MacDonald, Emily; White, Richard; Mexia, Ricardo; Bruun, Tone; Kapperud, Georg; Lange, Heidi; Nygård, Karin; Vold, Line

2015-01-01

Campylobacteriosis is the most frequently reported food- and waterborne infection in Norway. We investigated the risk factors for sporadic Campylobacter infections in Norway in order to identify areas where control and prevention measures could be improved. A national prospective case-control study of factors associated with Campylobacter infection was conducted from July 2010 to September 2011. Cases were recruited from the Norwegian Surveillance System of Communicable Diseases (MSIS). Controls were randomly selected from the Norwegian Population Registry. Cases and controls were mailed a paper questionnaire with a prepaid return envelope. Univariable analyses using logistic regression were conducted for all exposures. A final parsimonious multivariable model was developed using regularized/penalized logistic regression, and adjusted odds ratios were calculated. A total of 995 cases and 1501 controls were included in the study (response proportion 55% and 30%, respectively). Exposures that had significant increases in odds of Campylobacter infection in multivariable analysis were drinking water directly from river, stream, or lake (OR: 2.96), drinking purchased bottled water (OR: 1.78), eating chicken (1.69), eating meat that was undercooked (OR: 1.77), eating food made on a barbecue (OR: 1.55), living on a farm with livestock (OR: 1.74), having a dog in the household (OR: 1.39), and having household water supply serving fewer than 20 houses (OR: 1.92). Consumption of poultry and untreated water remain important sources of Campylobacter infection in Norway, despite ongoing control efforts. The results justify the need for strengthening education for consumers and food handlers about the risks of cross-contamination when preparing poultry and with consuming raw or undercooked chicken. The public should also be reminded to take precautions when drinking untreated water in nature and ensure continued vigilance in order to protect and maintain the quality of water

Case-control study of gadodiamide-related nephrogenic systemic fibrosis

DEFF Research Database (Denmark)

Marckmann, Peter; Skov, Lone; Rossen, Kristian

2007-01-01

exposed to gadodiamide develop nephrogenic systemic fibrosis. METHODS: We conducted a case-control study of 19 histologically verified cases and 19 sex- and age-matched controls. All subjects had chronic renal failure when exposed to gadodiamide. Clinical, biochemical and pharmacological data were.......02). CONCLUSIONS: Increasing cumulative gadodiamide exposure, high-dose epoietin-beta treatment, and higher serum concentrations of ionized calcium and phosphate increase the risk of gadodiamide-related nephrogenic systemic fibrosis in renal failure patients. Severe cases seem to develop primarily among patients......BACKGROUND: Nephrogenic systemic fibrosis may be caused by gadolinium (Gd)-containing magnetic resonance imaging contrast agents. Most reported cases were associated with one particular agent, gadodiamide. Yet, unidentified cofactors might explain why only a minority of renal failure patients...

Small-Signal Analysis of the Microgrid Secondary Control Considering a Communication Time Delay

DEFF Research Database (Denmark)

Coelho, Ernane Antônio Alves; Wu, Dan; Guerrero, Josep M.

2016-01-01

This paper presents a small-signal analysis of an islanded microgrid composed of two or more voltage-source inverters connected in parallel. The primary control of each inverter is integrated through an internal current and voltage loops using proportional resonant compensators, a virtual impedance......, and an external power controller based on frequency and voltage droops. The frequency restoration function is implemented at the secondary control level, which executes a consensus algorithm that consists of a load-frequency control and a single time delay communication network. The consensus network consists...... the behavior of the system considering control parameters and time delay variation....

Effects of Precommercial Thinning and Midstory Control on Avian and Small Mammal Communities during Longleaf Pine Savanna Restoration.

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Lane, Vanessa R [Abraham Baldwin Agricultural College; Kilgo, John C [USDA Forest Service, Southern Research Station

2015-01-01

Abstract - Restoring longleaf pine (Pinus palustris Mill.) savanna is a goal of many southern land managers, and longleaf plantations may provide a mechanism for savanna restoration. However, the effects of silvicultural treatments used in the management of longleaf pine plantations on wildlife communities are relatively unknown. Beginning in 1994, we examined effects of longleaf pine restoration with plantation silviculture on avian and small mammal communities using four treatments in four 8- to 11- year-old plantations within the Savannah River Site in South Carolina. Treatments included prescribed burning every 3 to 5 years, plus: (1) no additional treatment (burn-only control); (2) precommercial thinning; (3) non-pine woody control with herbicides; and (4) combined thinning and woody control. We surveyed birds (1996-2003) using 50-m point counts and small mammals with removal trapping. Thinning and woody control alone had short-lived effects on avian communities, and the combination treatment increased avian parameters over the burn-only control in all years. Small mammal abundance showed similar trends as avian abundance for all three treatments when compared with the burn-only control, but only for 2 years post-treatment. Both avian and small mammal communities were temporarily enhanced by controlling woody vegetation with chemicals in addition to prescribed fire and thinning. Therefore, precommercial thinning in longleaf plantations, particularly when combined with woody control and prescribed fire, may benefit early-successional avian and small mammal communities by developing stand conditions more typical of natural longleaf stands maintained by periodic fire.

Electronic Control Of Small Hydro-Generators Part 1

International Nuclear Information System (INIS)

Perez G, Alvaro; Romero A, Carlos E.

1993-01-01

This work is the beginning of several applied itineraries, to the government of micro-centrals, mainly directed to the control of electric variables of the generator with the desire of obtaining a system of electric generation to drop it climbs, economic, reliable and with great sense of use of the hydraulic resources guided to poor communities, isolated of the system of national interconnection. In all hydroelectric power station without caring their capacity is fundamental to govern the speed of the system turbine generator, to guarantee a constant frequency of 60 Hz, the stability of this parameter is a measure of the quality of the energy given to the user. The used regulation method is the mechanical governor, its action it is to control the flow of water that it enters to the turbine. For small generation power stations (smaller to 200 Kw), the mechanical governor's cost is comparable to the total cost of the plant, then it is economic to use an electronic load control. The project develops the load control whose function is to add external electric load to the generator to maintain the constant nominal active power and similar to the power nominal mechanics surrendered by the turbine. The microprocessor 8088 dedicated to the control of the system by the complexity of the process, the quantity of variables and the precision in the answer of the system is used. To carry out the investigation project a simulation program it was designed in computer that allows to know the answer of the load control ahead of time for different conditions of the user's operation. These results were answered with the obtained experimental values of the final tests of the team, throwing very near values to those calculated

Describing an Environment for a Self-Sustaining Technology Transfer Service in a Small Research Budget University: A Case Study

Science.gov (United States)

Nieb, Sharon Lynn

2014-01-01

This single-site qualitative study sought to identify the characteristics that contribute to the self sustainability of technology transfer services at universities with small research budgets through a case study analysis of a small research budget university that has been operating a financially self-sustainable technology transfer service for…

A case-control evaluation of fungiform papillae density in burning mouth syndrome.

Science.gov (United States)

Naud, Jason M; Benca, Laura; Drangsholt, Mark T; LeResche, Linda; Coldwell, Susan E

2018-04-01

It has been hypothesized that high fungiform papillae density may be a risk factor for developing the taste and pain alterations characteristic of burning mouth syndrome. Evaluate whether fungiform papillae density, taste sensitivity, and mechanical pain sensitivity differ between burning mouth syndrome cases and controls. This case-control study compared cases diagnosed with primary burning mouth syndrome with pain-free controls. Participants (17 female cases and 23 female controls) rated the intensity of sucrose, sodium chloride, citric acid, and quinine applied separately to each side of the anterior tongue and sampled whole mouth. Mechanical pain sensitivity was assessed separately for each side of the tongue using weighted pins. Digital photographs of participants' tongues were used to count fungiform papillae. Burning mouth syndrome cases had increased whole mouth taste intensity. Cases also had increased sensitivity to quinine on the anterior tongue, as well as increased mechanical pain sensitivity on the anterior tongue. Fungiform papillae density did not differ significantly between cases and controls. Fungiform papillae density on the left and right sides of the tongue were correlated in controls; however, there was no left/right side correlation in cases. Cases had increased pain and taste perception on the anterior tongue. The lack of correlation between left and right fungiform papillae density in cases may be an indication of asymmetrical lingual innervation in these patients. 3b. Laryngoscope, 128:841-846, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Investigation of longitudinal control system for a small hydrofoil boat

Science.gov (United States)

Phillips, W. H.; Shaughnessy, J. D.

1976-01-01

An analysis of a hydromechanical system for longitudinal control of a small hydrofoil boat is presented. The system incorporates height and acceleration sensors operating flaps on the foils through a mechanical linkage. Effects of some of the system parameters on the stability and response to waves are shown. The results indicate that the system is capable of providing adequate stability, but the response to stern waves at low frequencies is larger than desired.

Small Bowel Adenocarcinoma Complicating Coeliac Disease: A Report of Three Cases and the Literature Review

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Hafida Benhammane

2012-01-01

Full Text Available Coeliac disease is associated with an increased risk of malignancy, not only of intestinal lymphoma but also of small intestinal adenocarcinoma which is 82 times more common in patients with celiac disease than in the normal population. We report three additional cases of a small bowel adenocarcinoma in the setting of coeliac disease in order to underline the epidemiological features, clinicopathological findings, and therapeutic approaches of this entity based on a review of the literature. The three patients underwent a surgical treatment followed by adjuvant chemotherapy based on capecitabine/oxaliplatin regimen, and they have well recovered.

Top Management Control Functions for Information Systems in Small and Medium Enterprises

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Uma VIJAYAKUMAR

2009-01-01

Full Text Available This paper analyzes the Top Management Control functions for Information Systems (IS in Small and Medium Enterprises (SMEs. SMEs extensively rely on information technology resources to enhance their competence in today’s global economy. They should have adequate top management control mechanisms in place for their efficient functioning. Top Management Controls determine how effectively the senior management manages the IS functions in a SME. The major tasks at this level consist of Planning, Organizing, Leading and Controlling functions. A brief introduction to SMEs is given at the beginning followed by the different categories of Top Management Controls. The final section highlights on some good practices to be followed by Top Management to realize the vision for the IS project in SMEs.

Association between microcephaly, Zika virus infection, and other risk factors in Brazil: final report of a case-control study.

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de Araújo, Thalia Velho Barreto; Ximenes, Ricardo Arraes de Alencar; Miranda-Filho, Demócrito de Barros; Souza, Wayner Vieira; Montarroyos, Ulisses Ramos; de Melo, Ana Paula Lopes; Valongueiro, Sandra; de Albuquerque, Maria de Fátima Pessoa Militão; Braga, Cynthia; Filho, Sinval Pinto Brandão; Cordeiro, Marli Tenório; Vazquez, Enrique; Cruz, Danielle di Cavalcanti Souza; Henriques, Claudio Maierovitch Pessanha; Bezerra, Luciana Caroline Albuquerque; Castanha, Priscila Mayrelle da Silva; Dhalia, Rafael; Marques-Júnior, Ernesto Torres Azevedo; Martelli, Celina Maria Turchi; Rodrigues, Laura Cunha

2018-03-01

A Zika virus epidemic emerged in northeast Brazil in 2015 and was followed by a striking increase in congenital microcephaly cases, triggering a declaration of an international public health emergency. This is the final report of the first case-control study evaluating the potential causes of microcephaly: congenital Zika virus infection, vaccines, and larvicides. The published preliminary report suggested a strong association between microcephaly and congenital Zika virus infection. We did a case-control study in eight public maternity hospitals in Recife, Brazil. Cases were neonates born with microcephaly, defined as a head circumference of 2 SD below the mean. Two controls without microcephaly were matched to each case by expected date of delivery and area of residence. We tested the serum of cases and controls and the CSF of cases for detection of Zika virus genomes with quantitative RT-PCR and for detection of IgM antibodies with capture-IgM ELISA. We also tested maternal serum with plaque reduction neutralisation assays for Zika and dengue viruses. We estimated matched crude and adjusted odds ratios with exact conditional logistic regression to determine the association between microcephaly and Zika virus infection. We screened neonates born between Jan 15 and Nov 30, 2016, and prospectively recruited 91 cases and 173 controls. In 32 (35%) cases, congenital Zika virus infection was confirmed by laboratory tests and no controls had confirmed Zika virus infections. 69 (83%) of 83 cases with known birthweight were small for gestational age, compared with eight (5%) of 173 controls. The overall matched odds ratio was 73·1 (95% CI 13·0-∞) for microcephaly and Zika virus infection after adjustments. Neither vaccination during pregnancy or use of the larvicide pyriproxyfen was associated with microcephaly. Results of laboratory tests for Zika virus and brain imaging results were available for 79 (87%) cases; within these cases, ten were positive for Zika virus

13 CFR 107.865 - Control of a Small Business by a Licensee.

Science.gov (United States)

2010-01-01

... corporation, general partners of a limited partnership, or managers of a limited liability company, as... BUSINESS INVESTMENT COMPANIES Financing of Small Businesses by Licensees Structuring Licensee's Financing... of directors, or otherwise. The period of such Control will be limited to the seventh anniversary of...

Candidate gene analysis of spontaneous preterm delivery: New insights from re-analysis of a case-control study using case-parent triads and control-mother dyads

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Myking Solveig

2011-12-01

Full Text Available Abstract Background Spontaneous preterm delivery (PTD has a multifactorial etiology with evidence of a genetic contribution to its pathogenesis. A number of candidate gene case-control studies have been performed on spontaneous PTD, but the results have been inconsistent, and do not fully assess the role of how two genotypes can impact outcome. To elucidate this latter point we re-analyzed data from a previously published case-control candidate gene study, using a case-parent triad design and a hybrid design combining case-parent triads and control-mother dyads. These methods offer a robust approach to genetic association studies for PTD compared to traditional case-control designs. Methods The study participants were obtained from the Norwegian Mother and Child Cohort Study (MoBa. A total of 196 case triads and 211 control dyads were selected for the analysis. A case-parent triad design as well as a hybrid design was used to analyze 1,326 SNPs from 159 candidate genes. We compared our results to those from a previous case-control study on the same samples. Haplotypes were analyzed using a sliding window of three SNPs and a pathway analysis was performed to gain biological insight into the pathophysiology of preterm delivery. Results The most consistent significant fetal gene across all analyses was COL5A2. The functionally similar COL5A1 was significant when combining fetal and maternal genotypes. PON1 was significant with analytical approaches for single locus association of fetal genes alone, but was possibly confounded by maternal effects. Focal adhesion (hsa04510, Cell Communication (hsa01430 and ECM receptor interaction (hsa04512 were the most constant significant pathways. Conclusion This study suggests a fetal association of COL5A2 and a combined fetal-maternal association of COL5A1 with spontaneous PTD. In addition, the pathway analysis implied interactions of genes affecting cell communication and extracellular matrix.

Mass tourism versus small form tourism case study: Perspective for the development of small form tourism in the municipality of Surčin

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Stanić-Jovanović Sara

2015-01-01

Full Text Available The phenomenon of mass tourism development in recent years has undergone certain transformations, in particular, with the appearance of small forms of tourism, having significant prospects for development in the future. Although mass tourism development has represented, for a long time, a successful example of the concept of development of various tourist destinations around the world, in time, it was getting more exposed to criticism. Numerous authors and tourism scholars emphasize negative impact of mass tourism, whereas World Tourism Organization's forecast is in favor of reducing the mass as opposed to small forms of tourism. The small forms of tourism are primarily characterized by individual tours or traveling within small groups, usually consisting of educated, experienced and responsible participants with greater purchasing power when compared to typical tourists, participants of mass tourism. This case study entails prospects for the development of small forms of tourism in Surčin, the youngest of seventeen Belgrade municipalities. Due to its favorable traffic and tourist position, natural resources, cultural heritage and built infrastructure, in recent years, Surčin has become more attractive for individuals and small groups of tourists, positioning itself as a tourist destination for excursions in the market capital. This paper investigated the possibilities for tourism development of small forms of tourism based on the natural environment, cultural heritage, events; adventure, sport and recreation; authentic offer and local tradition as well as the parts of a short city break tour and cruising programs in the area of the Surčin municipality.

Delayed sleep phase cases and controls

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Nievergelt Caroline M

2008-04-01

Full Text Available Abstract Background Delayed sleep phase disorder (DSPD is a condition in which patients have difficulty falling asleep before the early morning hours and commonly have trouble awakening before late morning or even early afternoon. Several studies have suggested that variations in habitual bedtime are 40–50% heritable. Methods We recruited a case series of 205 participants, along with 221 controls (DSPD-C with normal sleep, roughly matched for age, gender, and ancestry. A representative sample of San Diego adults recruited some years before was already available to confirm the control group. Both DSPD and DSPD-C provided blood or saliva samples for DNA and completed extensive questionnaires about sleep habits, sleep history, family history, sleep quality, morningness-eveningness traits, depression, mania, and seasonality of symptoms. The DSPD group wore wrist actigraphs for a median of 13.2 days. The representative sample collected previously had undergone actigraphic recordings, from which 48 hours of data were generally available. Results The DSPD and DSPD-C samples showed almost no overlap on morningness-eveningness scores. DSPD cases went to bed and arose about 3 hours later than the DSPD-C and the representative sample. DSPD cases reported more difficulties with sleep, poorer sleep quality, and more depression, but there was no significant difference in a history of mania. DSPD cases reported more family history of late bedtimes, but female DSPD reported that their fathers' bedtimes were later than the fathers of male DSPD. Conclusion These results indicate a DSPD phenotype is familial and associated with unipolar depression.

Primary Hepatic Small Cell Carcinoma: Two Case Reports, Molecular Characterization and Pooled Analysis of Known Clinical Data.

Science.gov (United States)

Shastri, Aditi; Msaouel, Pavlos; Montagna, Cristina; White, Sherry; Delio, Maria; Patel, Kunjan; Alexis, Karenza; Strakhan, Marianna; Elrafei, Tarek N; Reed, Louis Juden

2016-01-01

Primary hepatic small cell carcinoma (HSCC) is a rare malignancy that has previously been described in only few case reports. The clinicopathological course, natural history, molecular markers and ideal treatment strategy for this tumor have not been fully elucidated. Herein, we report on two cases of spontaneously arising, metastatic primary HSCC that were treated at our Institution. Both patients succumbed to their disease within two months of initial presentation. Both cases underwent postmortem examination and no evidence of a pulmonary or other non-hepatic small cell primary was found. Unlike pulmonary small cell tumors, these two hepatic primaries showed only locoregional spread and very few distant metastases. Formalin-fixed samples were obtained at autopsy and sequenced using single-nucleotide polymorphism arrays and whole-genome sequencing. Four mutations in the epidermal growth factor receptor (EGFR) gene known to be associated with response to tyrosine kinase inhibitors (TKIs) were detected in one of the two HSCC samples. A systematic review and pooled analysis of all previously reported cases of primary HSCCs was conducted. The median overall survival was estimated at 4 months. Surgical resection was significantly associated with longer overall survival (hazard ratio =0.13, 95% confidence interval=0.03-0.69). Although several case reports of primary HSCC have been reported prior to this publication, to our knowledge this is the first time that molecular and systematic analysis has been conducted in order to more fully characterize this rare disease. Our results indicate that surgical resection, when feasible, may be a valid option in primary HSCC, and that some tumors may respond to TKIs against EGFR. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

A case control study of fowl pox in southeastern Ontario.

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Alves, D M; Martin, S W

1990-06-01

An outbreak of fowl pox, which occurred in south-eastern Ontario between July 1988 and April 1989, was investigated in the spring of 1989 to determine factors associated with the spread of the disease. Clinical fowl pox was confirmed on five farms (cases). Twenty-seven farms, out of 35 egg producers with quota from Durham region to Northumberland county, provided information as controls. Bivariate analyses were performed on mail survey data using Fisher's exact test and odds ratios. Although the tests of hypotheses lacked statistical power because of the small number of case farms, and barns, a number of significant associations were found. At the farm level, fowl pox infection was associated with pullets purchased from a particular pullet grower. At the barn level, fowl pox infection was associated with pullets from a particular grower, mixing different groups of pullets, and a trend towards having birds early in the laying period, and higher numbers of birds placed. Fowl pox-infected barns had higher mortality and lower egg production postoutbreak. The results may indicate that the virus enters the laying barn at, or near, the time new birds are placed. Better communication among producers, catch-and-fill crews, and others associated with the egg industry, as well as more complete records of dates, sources, and persons involved with pullet placements, are recommended.

Factors associated with tuberculosis cases in Semarang District, Indonesia: case-control study performed in the area where case detection rate was extremely low.

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Rahayu, Sri Ratna; Katsuyama, Hironobu; Demura, Masashi; Katsuyama, Midori; Ota, Yoko; Tanii, Hideji; Higashi, Tomomi; Semadi, Ngakan Putu Djaja; Saijoh, Kiyofumi

2015-07-01

Indonesia is ranked as the 4th highest contributor to tuberculosis (TB) in the world. Semarang District in Central Java displays extremely low case detection rate (CDR), possibly contributing to the local prevalence of TB. A case-control study was performed to explore the factors that cause such low CDR. We recruited 129 TB cases and 83 controls that visited the same centers and were not diagnosed with TB. The cases had 7.5 ± 2.3 symptoms/person on average, indicating the delay in diagnosis because the controls only displayed 1.0 ± 1.7. The multiple logistic regression analysis comparing the cases/controls extracted following factors as a risk to have TB: farmer, close contact with TB patients, ignorance of whether Bacillus Calmette-Guérin (BCG) was accepted or no, smoking, low income, a lot of people living in the same room, irregular hand wash before meals, not wash hands after blow, soil floor, and no sunlight and no ventilation in the house. Neither the cases nor the controls knew the symptoms and how to avoid TB infection, which probably caused the delay in diagnosis. It is difficult to change the current living conditions. Thus, the amendment of the community-based education program of TB seems to be required.

Do new anesthesia ventilators deliver small tidal volumes accurately during volume-controlled ventilation?

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Bachiller, Patricia R; McDonough, Joseph M; Feldman, Jeffrey M

2008-05-01

During mechanical ventilation of infants and neonates, small changes in tidal volume may lead to hypo- or hyperventilation, barotrauma, or volutrauma. Partly because breathing circuit compliance and fresh gas flow affect tidal volume delivery by traditional anesthesia ventilators in volume-controlled ventilation (VCV) mode, pressure-controlled ventilation (PCV) using a circle breathing system has become a common approach to minimizing the risk of mechanical ventilation for small patients, although delivered tidal volume is not assured during PCV. A new generation of anesthesia machine ventilators addresses the problems of VCV by adjusting for fresh gas flow and for the compliance of the breathing circuit. In this study, we evaluated the accuracy of new anesthesia ventilators to deliver small tidal volumes. Four anesthesia ventilator systems were evaluated to determine the accuracy of volume delivery to the airway during VCV at tidal volume settings of 100, 200, and 500 mL under different conditions of breathing circuit compliance (fully extended and fully contracted circuits) and lung compliance. A mechanical test lung (adult and infant) was used to simulate lung compliances ranging from 0.0025 to 0.03 L/cm H(2)O. Volumes and pressures were measured using a calibrated screen pneumotachograph and custom software. We tested the Smartvent 7900, Avance, and Aisys anesthesia ventilator systems (GE Healthcare, Madison, WI) and the Apollo anesthesia ventilator (Draeger Medical, Telford, PA). The Smartvent 7900 and Avance ventilators use inspiratory flow sensors to control the volume delivered, whereas the Aisys and Apollo ventilators compensate for the compliance of the circuit. We found that the anesthesia ventilators that use compliance compensation (Aisys and Apollo) accurately delivered both large and small tidal volumes to the airway of the test lung under conditions of normal and low lung compliance during VCV (ranging from 95.5% to 106.2% of the set tidal volume

Risk factors for measles among adults in Tianjin, China: Who should be controls in a case-control study?

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Wagner, Abram L; Boulton, Matthew L; Gillespie, Brenda W; Zhang, Ying; Ding, Yaxing; Carlson, Bradley F; Luo, Xiaoyan; Montgomery, JoLynn P; Wang, Xiexiu

2017-01-01

Control groups in previous case-control studies of vaccine-preventable diseases have included people immune to disease. This study examines risk factors for measles acquisition among adults 20 to 49 years of age in Tianjin, China, and compares findings using measles IgG antibody-negative controls to all controls, both IgG-negative and IgG-positive. Measles cases were sampled from a disease registry, and controls were enrolled from community registries in Tianjin, China, 2011-2015. Through a best subsets selection procedure, we compared which variables were selected at different model sizes when using IgG-negative controls or all controls. We entered risk factors for measles in two separate logistic regression models: one with measles IgG-negative controls and the other with all controls. The study included 384 measles cases and 1,596 community controls (194 IgG-negative). Visiting a hospital was an important risk factor. For specialty hospitals, the odds ratio (OR) was 4.53 (95% confidence interval (CI): 1.28, 16.03) using IgG-negative controls, and OR = 5.27 (95% CI: 2.73, 10.18) using all controls. Variables, such as age or length of time in Tianjin, were differentially selected depending on the control group. Individuals living in Tianjin ≤3 years had 2.87 (95% CI: 1.46, 5.66) times greater odds of measles case status compared to all controls, but this relationship was not apparent for IgG-negative controls. We recommend that case-control studies examining risk factors for infectious diseases, particularly in the context of transmission dynamics, consider antibody-negative controls as the gold standard.

Diagnostic and therapeutic value of laparoscopy for small bowel blunt injuries: A case report.

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Addeo, Pietro; Calabrese, Daniela Paola

2011-01-01

Small bowel injuries after blunt abdominal trauma represent both a diagnostic and a therapeutic challenge. Early diagnosis and prompt treatment are necessary in order to avoid a dangerous diagnostic delay. Laparoscopy can represent a diagnostic and therapeutic tool in patients with uncertain clinical symptoms. We report the case of a 25-year-old man, haemodynamically stable, admitted for acute abdominal pain a few hours after a physical assault. Giving the persistence of the abdominal pain and the presence of free fluids at the computed tomography examination, an exploratory laparoscopy was performed. At the laparoscopic exploration, an isolated small bowel perforation was found, 60 cm distal from the ligament of Treitz. The injury was repaired by laparoscopic suturing and the patient was discharged home at postoperative day 3 after an uneventful postoperative course. Laparoscopy represents a valuable tool for patients with small bowel blunt injuries allowing a timely diagnosis and a prompt treatment.

Case Studies of Leading Edge Small Urban High Schools. Relevance Strategic Designs: 5. Life Academy of Health and Bioscience

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Shields, Regis Anne; Ireland, Nicole; City, Elizabeth; Derderian, Julie; Miles, Karen Hawley

2008-01-01

This report is one of nine detailed case studies of small urban high schools that served as the foundation for the Education Resource Strategies (ERS) report "Strategic Designs: Lessons from Leading Edge Small Urban High Schools." These nine schools were dubbed "Leading Edge Schools" because they stand apart from other high…

Case Studies of Leading Edge Small Urban High Schools. Core Academic Strategic Designs: 1. Academy of the Pacific Rim

Science.gov (United States)

Shields, Regis Anne; Ireland, Nicole; City, Elizabeth; Derderian, Julie; Miles, Karen Hawley

2008-01-01

This report is one of nine detailed case studies of small urban high schools that served as the foundation for the Education Resource Strategies (ERS) report "Strategic Designs: Lessons from Leading Edge Small Urban High Schools." These nine schools were dubbed "Leading Edge Schools" because they stand apart from other high…

Case Studies of Leading Edge Small Urban High Schools. Core Academic Strategic Designs: 2. Noble Street Charter High School

Science.gov (United States)

Shields, Regis Anne; Ireland, Nicole; City, Elizabeth; Derderian, Julie; Miles, Karen Hawley

2008-01-01

This report is one of nine detailed case studies of small urban high schools that served as the foundation for the Education Resource Strategies (ERS) report "Strategic Designs: Lessons from Leading Edge Small Urban High Schools." These nine schools were dubbed "Leading Edge Schools" because they stand apart from other high…

SMALL CELL VARIANT OF OSTEOSARCOMA AT DIAPHYSIS OF TIBIA : A RARE CASE REPORT WITH REVIEW OF LITERATURE

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Venkatalakshmi

2015-04-01

Full Text Available Osteosarcoma is the most common primary malignant tumor of bone involving predominantly metaphysis of the long bones. It accounts for 20% of primary bone cancers. Diaphyseal osteosarcoma is a rare form which accounts for approximately 10% of all cases of osteosarcomas. We present a case of Small cell variant of osteosarcoma in a 25 year old female presented in the diaphysis of left tibia

Validation of self-reported start year of mobile phone use in a Swedish case-control study on radiofrequency fields and acoustic neuroma risk.

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Pettersson, David; Bottai, Matteo; Mathiesen, Tiit; Prochazka, Michaela; Feychting, Maria

2015-01-01

The possible effect of radiofrequency exposure from mobile phones on tumor risk has been studied since the late 1990s. Yet, empirical information about recall of the start of mobile phone use among adult cases and controls has never been reported. Limited knowledge about recall errors hampers interpretations of the epidemiological evidence. We used network operator data to validate the self-reported start year of mobile phone use in a case-control study of mobile phone use and acoustic neuroma risk. The answers of 96 (29%) cases and 111 (22%) controls could be included in the validation. The larger proportion of cases reflects a more complete and detailed reporting of subscription history. Misclassification was substantial, with large random errors, small systematic errors, and no significant differences between cases and controls. The average difference between self-reported and operator start year was -0.62 (95% confidence interval: -1.42, 0.17) years for cases and -0.71 (-1.50, 0.07) years for controls, standard deviations were 3.92 and 4.17 years, respectively. Agreement between self-reported and operator-recorded data categorized into short, intermediate and long-term use was moderate (kappa statistic: 0.42). Should an association exist, dilution of risk estimates and distortion of exposure-response patterns for time since first mobile phone use could result from the large random errors in self-reported start year. Retrospective collection of operator data likely leads to a selection of "good reporters", with a higher proportion of cases. Thus, differential recall cannot be entirely excluded.

Identification and medical utilization of incident cases of alcohol dependence: A population-based case-control study.

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Pan, Chun-Hung; Li, Min-Shan; Yang, Tien-Wey; Huang, Ming-Chyi; Su, Sheng-Shiang; Hung, Yen-Ni; Chen, Chiao-Chicy; Kuo, Chian-Jue

2018-05-05

Patients with alcohol dependence (AD) often seek help from medical professionals due to alcohol-related diseases, but the overall distribution of medical specialties identifying new AD cases is unclear. We investigated how such cases were identified and how medical resources were utilized before the identification of AD in a nationwide cohort. We enrolled a population-based cohort (N = 1,000,000) using the National Health Insurance Research Database of Taiwan; 8181 cases with incident AD were retrieved between January 1, 2000, and December 31, 2010. For this nested case-control study, four controls were matched for age and sex with each case based on risk-set sampling. We measured various dimensions of medical utilization before AD was diagnosed, including department visited, physical comorbidity, and medication used. Conditional logistic regression was used for estimating the variables associated with AD. Patients living in less urbanized areas who were unemployed were more likely to develop AD. The highest proportions (34.2%) of AD cases were identified in the internal medicine department, followed by the emergency (22.3%) and psychiatry (18.7%) departments. AD patients had a higher risk of comorbid chronic hepatic disease (adjusted RR = 2.72, p identification of AD than controls. AD patients also had greater numbers of hospital admissions than controls, including non-psychiatric and psychiatric hospitalizations. Outpatient visit numbers were similar for AD patients and controls. The findings indicate that clinicians providing care in diverse medical settings should be prepared to screen for unhealthy alcohol use and to mitigate its detrimental effects. Copyright © 2018 Elsevier B.V. All rights reserved.

Use of medicinal plants to control Haemonchus contortus infection in small ruminants

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Sawleha Qadir1

Full Text Available Haemonchus contortus is singly the most important of all the gastrointestinal nematodes that constrain the survival and productivity of sheep and goats owned by rural poor farmers in the developing world. This haematophagus parasite is infamous throughout the humid tropics/subtropics, being responsible for acute disease outbreaks with high levels of mortalities, particularly in young animals. Costs associated with control of this parasite in India, have been estimated to be US$ 103 million. H. contortus is also prominent amongst the reports of anthelmintic resistance that has emerged in all countries of the world that produce small ruminants. This emergence of multiple anthelmintic resistances has provided a spur for research on alternative forms of control. Recent surveys in developing countries have identified many plants that are intended and have the potential to be used as anthelmintics. This paper reviews the use of some medicinal plants as anthelmintics against H. contortus infection in small ruminants. [Veterinary World 2010; 3(11.000: 515-518

Sarcomatoid Carcinoma of the lung: A rare case of three small intestinal intussusceptions and literature review

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Angela Romano

2015-01-01

Conclusion: There are rare reports of small intestinal intussusceptions caused by metastatic lung carcinosarcoma, this presentation shows the third case in literature. Physicians should be more alert to symptoms or signs indicating GI metastais in patients with a history of lung cancer.

Synchronous perforation of non-Hodgkin's lymphoma of the small intestine and colon: a case report

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Baidoun Fadi

2011-02-01

Full Text Available Abstract Introduction Primary non-Hodgkin's lymphoma of the small and large bowel presenting as a perforated viscus entity with peritonitis is extremely rare. A thorough literature review did not reveal any cases where primary lymphoma of the jejunum presented with perforation and peritonitis synchronously with primary lymphoma of the descending colon. Case presentation This report concerns a 64-year-old Caucasian woman admitted with severe abdominal pain and fever. An emergency laparotomy revealed a large mass with perforation in the proximal jejunum with intense mesenteric thickening and lymphadenopathy. The descending colon was edematous and covered with fibrinous exudate. Histopathological examination of the resected segment of jejunum revealed a T cell non-Hodgkin's lymphoma. On post-operative day 10, a computed tomography scan of our patient's abdomen and pelvis showed leakage of contrast into the pelvis. Re-exploration revealed perforation of the descending colon. The histopathology of the resected colon also showed T cell non-Hodgkin's lymphoma. Her post-operative course was complicated by acute renal and respiratory failure. The patient died on post-operative day 21. Conclusions Lymphoma of the small intestine has been reported to have a poor prognosis. The synchronous occurrence of lesions in the small intestine or colon is unusual, and impacts the prognosis adversely. Early diagnosis and treatment are important to improve the prognosis of bowel perforation in patients with non-Hodgkin's lymphoma.

Pregnancy-Associated Plasma Protein A Levels in Late First Trimester Pregnancies with Small-for-Gestational Age Neonates: A Prospective Case-Control Study.

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Agarwal, Rachna; Kumari, Radhika; Mehndiratta, Mohit; Radhakrishnan, Gita; Faridi, M M A; Chandra, Nilesh

2017-08-01

We aimed to investigate the association of pregnancy associated plasma protein A (PAPP-A) levels in late first trimester with small for gestational age (SGA) neonates and adverse pregnancy outcomes in a low-income setting. The inclusion criteria were late first trimester (11-13 + 6 weeks) women with singleton and non-anomalous pregnancy. Enrolled participants were sampled for PAPP-A and prospectively followed up for delivery outcome and antenatal complications. A multiple of median (MoM) was calculated and statistically compared between groups. Out of total 284 subjects, 14.54% delivered SGA babies and formed cases (Group A), 66.5% delivered appropriate for gestational age (AGA) neonates with uneventful antenatal period (controls, Group B), and 19.3% were AGA group with adverse pregnancy complications (Group C). The late first trimester median PAPP-A MoM was significantly lower (0.61) in Group A compared to Group B (1.47). Using receiver operating characteristic (ROC) curve for PAPP-A MoM, optimal cutoff value was found at 0.45 MoM, with positive predictive value of 56.2%, specificity of 92.6% and sensitivity of 45%. The median interquartile range (IQR) of PAPP-A MoM value in Group C in comparison with Group B was significantly lower except for abruption. At PAPP-A MoM cutoff value <1, <0.8, <0.6 and <0.4, the odds ratio for adverse pregnancy outcome was 8.30, 7.29, 10.97 and 10.60, respectively, indicating an inverse relationship. With 0.45 MoM cutoff of PAPP-A, the detection rate, specificity and positive predictive value for SGA were 45, 92.6 and 56.2%, respectively. As PAPP-A MoM values decreased, the odds ratio of having adverse pregnancy outcomes increased.

Electrical network capacity support from demand side response: Techno-economic assessment of potential business cases for small commercial and residential end-users

International Nuclear Information System (INIS)

Martínez Ceseña, Eduardo A.; Good, Nicholas; Mancarella, Pierluigi

2015-01-01

Demand Side Response (DSR) is recognised for its potential to bring economic benefits to various electricity sector actors, such as energy retailers, Transmission System Operators (TSOs) and Distribution Network Operators (DNOs). However, most DSR is provided by large industrial and commercial consumers, and little research has been directed to the quantification of the value that small (below 100 kW) commercial and residential end-users could accrue by providing DSR services. In particular, suitable models and studies are needed to quantify potential business cases for DSR from small commercial and residential end-users. Such models and studies should consider the technical and physical characteristics of the power system and demand resources, together with the economic conditions of the power market. In addition, the majority of research focuses on provision of energy arbitrage or ancillary services, with very little attention to DSR services for network capacity support. Accordingly, this paper presents comprehensive techno-economic methodologies for the quantification of three capacity-based business cases for DSR from small commercial and residential end-users. Case study results applied to a UK context indicate that, if the appropriate regulatory framework is put in place, services for capacity support to both DNOs and TSOs can result into potentially attractive business cases for DSR from small end-users with minimum impact on their comfort level. -- Highlights: •We present three business cases for DSR from domestic and commercial end-users. •A comprehensive techno-economic methodology is proposed for the quantification of each DSR business cases. •The regulatory implications associated with each business case are discussed

A case-control study assessing depression in patients with periodontitis

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Shiyamali Sundararajan

2017-01-01

Full Text Available Background: Chronic periodontitis is an inflammatory disease of the supporting structures of the tooth. One of the important non-oral risk factors for periodontitis is psychosocial stress and depression. Depression affects oral health by affecting the immune system through its effects on hypothalamic pituitary axis system. Periodontal inflammatory surface area (PISA is a system used to assess inflammatory burden in the periodontal tissue. Aim: The aim of this study is to assess the relationship between PISA and depression. Settings and Design: The design of the study is case-control study. Materials and Methods: The study design is a case-control study with forty patients each in case and control groups. The periodontal inflammatory level was assessed by PISA system and the levels of depression was assessed by using Beck's Depression Inventory (BDI. Statistical Analysis: Student's t-test was used to compare PISA and BDI scores. The BDI score (mean ± standard deviation [SD] for controls was 12.75 ± 6.82 compared to 22.73 ± 4.40 for the cases. The comparison (t = 7.78 was statistically significant at P < 0.0001. The PISA score (mean ± SD for controls was 210.47 ± 76.80 compared to the PISA score of 1069.50 ± 204.21 for cases which was statistically significant (t = 24.90; P < 0.0001. Results: Significantly higher BDI scores were observed in patients with chronic periodontitis than healthy controls. Conclusion: This study clearly reveals a significant association between the severity of depression and inflammatory burden.

Benchmarking of industrial control systems via case-based reasoning

International Nuclear Information System (INIS)

Hadjiiski, M.; Boshnakov, K.; Georgiev, Z.

2013-01-01

Full text: The recent development of information and communication technologies enables the establishment of virtual consultation centers related to the control of specific processes that are widely presented worldwide as the location of the installations does not have influence on the results. The centers can provide consultations regarding the quality of the process control and overall enterprise management as correction factors such as weather conditions, product or service and associated technology, production level, quality of feedstock used and others can be also taken into account. The benchmarking technique is chosen as a tool for analyzing and comparing the quality of the assessed control systems in individual plants. It is a process of gathering, analyzing and comparing data on the characteristics of comparable units to assess and compare these characteristics and improve the performance of the particular process, enterprise or organization. By comparing the different processes and the adoption of the best practices energy efficiency could be improved and hence the competitiveness of the participating organizations will increase. In the presented work algorithm for benchmarking and parametric optimization of a given control system is developed by applying the approaches of Case-Based Reasoning (CBR) and Data Envelopment Analysis (DEA). Expert knowledge and approaches for optimal tuning of control systems are combined. Two of the most common systems for automatic control of different variables in the case of biological wastewater treatment are presented and discussed. Based on analysis of the processes, different cases are defined. By using DEA analysis the relative efficiencies of 10 systems for automatic control of dissolved oxygen are estimated. The designed and implemented in the current work CBR and DEA are applicable for the purposed of virtual consultation centers. Key words: benchmarking technique, energy efficiency, Case-Based Reasoning (CBR

Propensity score matching for selection of local areas as controls for evaluation of effects of alcohol policies in case series and quasi case-control designs.

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de Vocht, F; Campbell, R; Brennan, A; Mooney, J; Angus, C; Hickman, M

2016-03-01

Area-level public health interventions can be difficult to evaluate using natural experiments. We describe the use of propensity score matching (PSM) to select control local authority areas (LAU) to evaluate the public health impact of alcohol policies for (1) prospective evaluation of alcohol policies using area-level data, and (2) a novel two-stage quasi case-control design. Ecological. Alcohol-related indicator data (Local Alcohol Profiles for England, PHE Health Profiles and ONS data) were linked at LAU level. Six LAUs (Blackpool, Bradford, Bristol, Ipswich, Islington, and Newcastle-upon-Tyne) as sample intervention or case areas were matched to two control LAUs each using PSM. For the quasi case-control study a second stage was added aimed at obtaining maximum contrast in outcomes based on propensity scores. Matching was evaluated based on average standardized absolute mean differences (ASAM) and variable-specific P-values after matching. The six LAUs were matched to suitable control areas (with ASAM 0.05 indicating good matching) for a prospective evaluation study that sought areas that were similar at baseline in order to assess whether a change in intervention exposure led to a change in the outcome (alcohol related harm). PSM also generated appropriate matches for a quasi case-control study--whereby the contrast in health outcomes between cases and control areas needed to be optimized in order to assess retrospectively whether differences in intervention exposure were associated with the outcome. The use of PSM for area-level alcohol policy evaluation, but also for other public health interventions, will improve the value of these evaluations by objective and quantitative selection of the most appropriate control areas. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Metastatic osteosarcoma to the small bowel with resultant intussusception: a case report and review of the literature

International Nuclear Information System (INIS)

Wootton-Gorges, Sandra L.; Stein-Wexler, Rebecca; West, Danel C.

2003-01-01

Intussusception resulting from osteosarcoma metastasis to the small bowel is a rare diagnosis. This case report describes a patient with this diagnosis, demonstrates the CT appearance of this lesion, and reviews the literature. (orig.)

The Challenge of Implementing an ERP System in a Small and Medium Enterprise--A Teaching Case of ERP Project Management

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Xu, Hongjiang; Rondeau, Patrick J.; Mahenthiran, Sakthi

2011-01-01

Enterprise Resource Planning (ERP) system implementation projects are notoriously risky. While large-scale ERP cases continue to be developed, relatively few new ERP cases have been published that further ERP implementation education in small to medium size firms. This case details the implementation of a new ERP system in a medium sized…

Retrospective exposure assessment and quality control in an international multi-centre case-control study

DEFF Research Database (Denmark)

Tinnerberg, H; Heikkilä, P; Huici-Montagud, A

2003-01-01

The paper presents the exposure assessment method and quality control procedure used in an international, multi-centre case-control study within a joint Nordic and Italian cohort. This study was conducted to evaluate whether occupational exposure to carcinogens influenced the predictivity of high...... was higher among the original assessors (the assessor from the same country as the subject) than the average prevalence assessed by the other four in the quality control round. The original assessors classified more job situations as exposed than the others. Several reasons for this are plausible: real...... country-specific differences, differences in information available to the home assessor and the others and misunderstandings or difficulties in translation of information. To ensure the consistency of exposure assessments in international retrospective case-control studies it is important to have a well...

Social capital and adverse treatment outcomes of tuberculosis: a case-control study.

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Deshmukh, P R; Mundra, A; Dawale, A

2017-08-01

'Social capital' refers to social norms, relationships, networks and values that affect the functioning and development of society. Social capital influences health positively, but its role in the treatment outcomes of tuberculosis (TB) is not known. To study the role of social capital in determining adverse TB treatment outcomes. Of 516 patients registered under the Revised National Tuberculosis Control Programme in 2014 in Wardha Tuberculosis Unit, Wardha, India, we included 88 patients with adverse treatment outcomes as cases and 187 controls from among those without adverse outcomes. Multiple logistic regression was used to compare standardised Z-scores. A greater proportion of controls than cases belonged to higher quartiles of social capital and its domains than cases, and the mean standardised Z-score was also consistently higher among controls than cases. Respectively 47% and 15% of cases and controls were in the poorest quartile of social capital, whereas respectively 10% and 33% of cases and controls were in the richest quartile. Each unit increase in Z-score of overall social capital reduced the odds of adverse treatment outcomes by 63.1%. Appropriate interventions for building social capital for TB patients and linking them with the programme would improve programme performance.

Evaluation of proxy tests for SFSN: evidence for mixed small and large fiber dysfunction.

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Hamid Ebadi

Full Text Available BACKGROUND: Though intra-epidermal nerve fiber density (IENFD is considered the gold standard for diagnosis of small fiber sensory neuropathy (SFSN, we aimed to determine if novel threshold values derived from standard tests of small or large fiber function could serve as diagnostic alternatives. METHODS: Seventy-four consecutive patients with painful polyneuropathy and normal nerve conduction studies (NCS were defined as SFSN cases or controls by distal IENFD <5.4 and ≥5.4 fibers/mm, respectively. Diagnostic performance of small fiber [cooling (CDT and heat perception (HP thresholds, axon reflex-mediated neurogenic vasodilatation] and large fiber function tests [vibration perception thresholds (VPT and sural nerve conduction parameters] were determined by receiver operating-characteristic (ROC curve analyses. RESULTS: The 26(35% SFSN cases had mean IENFD 3.3±1.7 fibers/mm and the 48(65% controls 9.9±2.9 fibers/mm. Male gender (p = 0.02 and older age (p = 0.02 were associated with SFSN cases compared to controls. VPT were higher and CDT lower in SFSN cases, but the largest magnitude of differences was observed for sural nerve amplitude. It had the greatest area under the ROC curve (0.75 compared to all other tests (p<0.001 for all comparisons and the optimal threshold value of ≤12 µV defined SFSN cases with 80% sensitivity and 72% specificity. CONCLUSION: In patients presenting with polyneuropathy manifestations and normal NCS, though small fiber function tests were intuitively considered the best alternative measures to predict reduced IENFD, their diagnostic performance was poor. Instead, novel threshold values within the normal range for large fiber tests should be considered as an alternative strategy to select subjects for skin biopsy in diagnostic protocols for SFSN.

Risk Factors for Anemia in Pregnancy: A Case Control Study

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Rutuja Pundkar

2017-12-01

Full Text Available Background: Aim of the study was to find the risk factors leading to Anemia in pregnancy. The main objective was to study the various sociodemographic factors leading to anemia. And to assess the knowledge about anemia among study participants. Material and methods: The present Case control study was carried out at Primary Health Centre, to determine the risk factors leading to anemia in pregnancy. A total of 308 pregnant females were registered. Among them two groups were made, group I cases and group II controls. Each group had 50 cases each. Laboratory test were done and females having hemoglobin less than 11mg/dl were considered anemic. Anemic females were considered cases and females having Hb >11mg/dl were considered controls. Data analysis was done using SPSS software. Results: The overall mean haemoglobin (Hb was 11.55g/dL in controls, whereas it was seen that among the cases it was 9.58g/dL.It would seem that diet, family size, education, social class, gravida and parity are associated with anemia in pregnancy. Conclusion: After adjusting for all the possible covariates there seems to be significant association between Hb levels and age group, education level, family size, diet, gravida and parity.

Small cell carcinoma of the urinary bladder without gross hematuria: a case report.

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Huang, Wanqiu; Luan, Yang; Jin, Lu; Wang, Tao; Chen, Ruibao; Liu, Zheng; Chen, Zhiqiang; Lan, Ruzhu

2015-09-01

Small cell carcinoma of the urinary bladder (SCCB) is a rare and aggressive form of bladder cancer with poor prognosis. Hematuria is the main symptom of this malignancy, and most patients have a history of smoking. The disease incidence of malignant bladder tumors in China is approximately 0.74%. Early and accurate diagnosis of SCCB can ensure timely and appropriate treatment of this malignant disease. Oncologic surgery is the standard treatment; however, it may not be a curative approach. Chemotherapy and/or radiotherapy should be performed following surgical removal. This case report describes a patient with a single neoplasm diagnosed as SCCB that arose because of recurrence of bladder cancer after bladder tumor resection. In contrast to previously reported cases, this patient had no gross hematuria and no history of smoking.

Does marriage protect against hospitalization with pneumonia? A population-based case-control study

Directory of Open Access Journals (Sweden)

Mor A

2013-10-01

Full Text Available Anil Mor, Sinna P Ulrichsen, Elisabeth Svensson, Klara Berencsi, Reimar W Thomsen Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark Background: To reduce the increasing burden of pneumonia hospitalizations, we need to understand their determinants. Being married may decrease the risk of severe infections, due to better social support and healthier lifestyle. Patients and methods: In this population-based case-control study, we identified all adult patients with a first-time pneumonia-related hospitalization between 1994 and 2008 in Northern Denmark. For each case, ten sex- and age-matched population controls were selected from Denmark's Civil Registration System. We performed conditional logistic regression analysis to estimate the odds ratios (ORs for pneumonia hospitalization among persons who were divorced, widowed, or never married, as compared with married persons, adjusting for age, sex, 19 different comorbidities, alcoholism-related conditions, immunosuppressant use, urbanization, and living with small children. Results: The study included 67,162 patients with a pneumonia-related hospitalization and 671,620 matched population controls. Compared with controls, the pneumonia patients were more likely to be divorced (10% versus 7% or never married (13% versus 11%. Divorced and never-married patients were much more likely to have previous diagnoses of alcoholism-related conditions (18% and 11%, respectively compared with married (3% and widowed (6% patients. The adjusted OR for pneumonia-related hospitalization was increased, at 1.29 (95% confidence interval [CI]: 1.25-1.33 among divorced; 1.15 (95% CI: 1.12-1.17 among widowed; and 1.33 (95% CI: 1.29-1.37 among never-married individuals as compared with those who were married. Conclusion: Married individuals have a decreased risk of being hospitalized with pneumonia compared with never-married, divorced, and widowed patients

Risk Factors for Sporadic Domestically Acquired Campylobacter Infections in Norway 2010–2011: A National Prospective Case-Control Study

Science.gov (United States)

Mexia, Ricardo; Bruun, Tone; Kapperud, Georg; Lange, Heidi; Nygård, Karin; Vold, Line

2015-01-01

Background Campylobacteriosis is the most frequently reported food- and waterborne infection in Norway. We investigated the risk factors for sporadic Campylobacter infections in Norway in order to identify areas where control and prevention measures could be improved. Methods A national prospective case-control study of factors associated with Campylobacter infection was conducted from July 2010 to September 2011. Cases were recruited from the Norwegian Surveillance System of Communicable Diseases (MSIS). Controls were randomly selected from the Norwegian Population Registry. Cases and controls were mailed a paper questionnaire with a prepaid return envelope. Univariable analyses using logistic regression were conducted for all exposures. A final parsimonious multivariable model was developed using regularized/penalized logistic regression, and adjusted odds ratios were calculated. Results A total of 995 cases and 1501 controls were included in the study (response proportion 55% and 30%, respectively). Exposures that had significant increases in odds of Campylobacter infection in multivariable analysis were drinking water directly from river, stream, or lake (OR: 2.96), drinking purchased bottled water (OR: 1.78), eating chicken (1.69), eating meat that was undercooked (OR: 1.77), eating food made on a barbecue (OR: 1.55), living on a farm with livestock (OR: 1.74), having a dog in the household (OR: 1.39), and having household water supply serving fewer than 20 houses (OR: 1.92). Conclusions Consumption of poultry and untreated water remain important sources of Campylobacter infection in Norway, despite ongoing control efforts. The results justify the need for strengthening education for consumers and food handlers about the risks of cross-contamination when preparing poultry and with consuming raw or undercooked chicken. The public should also be reminded to take precautions when drinking untreated water in nature and ensure continued vigilance in order to

Small RNA-Controlled Gene Regulatory Networks in Pseudomonas putida

DEFF Research Database (Denmark)

Bojanovic, Klara

evolved numerous mechanisms to controlgene expression in response to specific environmental signals. In addition to two-component systems, small regulatory RNAs (sRNAs) have emerged as major regulators of gene expression. The majority of sRNAs bind to mRNA and regulate their expression. They often have...... multiple targets and are incorporated into large regulatory networks and the RNA chaper one Hfq in many cases facilitates interactions between sRNAs and their targets. Some sRNAs also act by binding to protein targets and sequestering their function. In this PhD thesis we investigated the transcriptional....... Detailed insights into the mechanisms through which P. putida responds to different stress conditions and increased understanding of bacterial adaptation in natural and industrial settings were gained. Additionally, we identified genome-wide transcription start sites, andmany regulatory RNA elements...

Market-oriented Programming Using Small-world Networks for Controlling Building Environments

Science.gov (United States)

Shigei, Noritaka; Miyajima, Hiromi; Osako, Tsukasa

The market model, which is one of the economic activity models, is modeled as an agent system, and applying the model to the resource allocation problem has been studied. For air conditioning control of building, which is one of the resource allocation problems, an effective method based on the agent system using auction has been proposed for traditional PID controller. On the other hand, it has been considered that this method is performed by decentralized control. However, its decentralization is not perfect, and its performace is not enough. In this paper, firstly, we propose a perfectly decentralized agent model and show its performance. Secondly, in order to improve the model, we propose the agent model based on small-world model. The effectiveness of the proposed model is shown by simulation.

Hierarchical path planning and control of a small fixed-wing UAV: Theory and experimental validation

Science.gov (United States)

Jung, Dongwon

2007-12-01

Recently there has been a tremendous growth of research emphasizing control of unmanned aerial vehicles (UAVs) either in isolation or in teams. As a matter of fact, UAVs increasingly find their way into military and law enforcement applications (e.g., reconnaissance, remote delivery of urgent equipment/material, resource assessment, environmental monitoring, battlefield monitoring, ordnance delivery, etc.). This trend will continue in the future, as UAVs are poised to replace the human-in-the-loop during dangerous missions. Civilian applications of UAVs are also envisioned such as crop dusting, geological surveying, search and rescue operations, etc. In this thesis we propose a new online multiresolution path planning algorithm for a small UAV with limited on-board computational resources. The proposed approach assumes that the UAV has detailed information of the environment and the obstacles only in its vicinity. Information about far-away obstacles is also available, albeit less accurately. The proposed algorithm uses the fast lifting wavelet transform (FLWT) to get a multiresolution cell decomposition of the environment, whose dimension is commensurate to the on-board computational resources. A topological graph representation of the multiresolution cell decomposition is constructed efficiently, directly from the approximation and detail wavelet coefficients. Dynamic path planning is sequentially executed for an optimal path using the A* algorithm over the resulting graph. The proposed path planning algorithm is implemented on-line on a small autopilot. Comparisons with the standard D*-lite algorithm are also presented. We also investigate the problem of generating a smooth, planar reference path from a discrete optimal path. Upon the optimal path being represented as a sequence of cells in square geometry, we derive a smooth B-spline path that is constrained inside a channel that is induced by the geometry of the cells. To this end, a constrained optimization

A prevalence-based association test for case-control studies.

Science.gov (United States)

Ryckman, Kelli K; Jiang, Lan; Li, Chun; Bartlett, Jacquelaine; Haines, Jonathan L; Williams, Scott M

2008-11-01

Genetic association is often determined in case-control studies by the differential distribution of alleles or genotypes. Recent work has demonstrated that association can also be assessed by deviations from the expected distributions of alleles or genotypes. Specifically, multiple methods motivated by the principles of Hardy-Weinberg equilibrium (HWE) have been developed. However, these methods do not take into account many of the assumptions of HWE. Therefore, we have developed a prevalence-based association test (PRAT) as an alternative method for detecting association in case-control studies. This method, also motivated by the principles of HWE, uses an estimated population allele frequency to generate expected genotype frequencies instead of using the case and control frequencies separately. Our method often has greater power, under a wide variety of genetic models, to detect association than genotypic, allelic or Cochran-Armitage trend association tests. Therefore, we propose PRAT as a powerful alternative method of testing for association.

Systemic amyloidosis due to unknown multiple myeloma in small bowel pseudo-obstruction: case report

Directory of Open Access Journals (Sweden)

Giuseppe Caparrotti

2016-03-01

Full Text Available Amyloidosis is a pathologic diagnosis characterized by extracellular deposition of insoluble protein fibrils in various organs and tissues. There are two main forms of amyloidosis, primary amyloidosis, and secondary amyloidosis. Gastrointestinal involvement is common in both amyloidosis forms. We describe the case of a 78-year-old woman taken to the operating room for small bowel obstruction, found to have pseudo-obstruction and enteritis. Exploratory laparotomy revealed gastric mass and histological examen showed extensive amyloid deposition consistent with amyloidosis. Hematological evaluation revealed unknown multiple myeloma. This case report and literature data suggest to perform a hematological examination in patients with amyloidosis diagnosis to exclude a multiple myeloma or other plasma cell disorders

Case-Control Studies - An Efficient Observational Study Design

NARCIS (Netherlands)

van Stralen, Karlijn J.; Dekker, Friedo W.; Zoccali, Carmine; Jager, Kitty J.

2010-01-01

Case-control studies are an efficient research method for investigating risk factors of a disease. The method involves the comparison of the odds of exposure in a patient group with that of the odds of exposure in a control group. As only a minority of the population is included in the study, less

A fault-tolerant small world topology control model in ad hoc networks for search and rescue

Science.gov (United States)

Tan, Mian; Fang, Ling; Wu, Yue; Zhang, Bo; Chang, Bowen; Holme, Petter; Zhao, Jing

2018-02-01

Due to their self-organized, multi-hop and distributed characteristics, ad hoc networks are useful in search and rescue. Topology control models need to be designed for energy-efficient, robust and fast communication in ad hoc networks. This paper proposes a topology control model which specializes for search and rescue-Compensation Small World-Repeated Game (CSWRG)-which integrates mobility models, constructing small world networks and a game-theoretic approach to the allocation of resources. Simulation results show that our mobility models can enhance the communication performance of the constructed small-world networks. Our strategy, based on repeated game, can suppress selfish behavior and compensate agents that encounter selfish or faulty neighbors. This model could be useful for the design of ad hoc communication networks.

Network-based regularization for high dimensional SNP data in the case-control study of Type 2 diabetes.

Science.gov (United States)

Ren, Jie; He, Tao; Li, Ye; Liu, Sai; Du, Yinhao; Jiang, Yu; Wu, Cen

2017-05-16

Over the past decades, the prevalence of type 2 diabetes mellitus (T2D) has been steadily increasing around the world. Despite large efforts devoted to better understand the genetic basis of the disease, the identified susceptibility loci can only account for a small portion of the T2D heritability. Some of the existing approaches proposed for the high dimensional genetic data from the T2D case-control study are limited by analyzing a few number of SNPs at a time from a large pool of SNPs, by ignoring the correlations among SNPs and by adopting inefficient selection techniques. We propose a network constrained regularization method to select important SNPs by taking the linkage disequilibrium into account. To accomodate the case control study, an iteratively reweighted least square algorithm has been developed within the coordinate descent framework where optimization of the regularized logistic loss function is performed with respect to one parameter at a time and iteratively cycle through all the parameters until convergence. In this article, a novel approach is developed to identify important SNPs more effectively through incorporating the interconnections among them in the regularized selection. A coordinate descent based iteratively reweighed least squares (IRLS) algorithm has been proposed. Both the simulation study and the analysis of the Nurses's Health Study, a case-control study of type 2 diabetes data with high dimensional SNP measurements, demonstrate the advantage of the network based approach over the competing alternatives.

Analysis of new lactotransferrin gene variants in a case-control study related to periodontal disease in dog.

Science.gov (United States)

Morinha, Francisco; Albuquerque, Carlos; Requicha, João; Dias, Isabel; Leitão, José; Gut, Ivo; Guedes-Pinto, Henrique; Viegas, Carlos; Bastos, Estela

2012-04-01

The molecular and genetic research has contributed to a better understanding of the periodontal disease (PD) in humans and has shown that many genes play a role in the predisposition and progression of this complex disease. Variations in human lactotransferrin (LTF) gene appear to affect anti-microbial functions of this molecule, influencing the PD susceptibility. PD is also a major health problem in small animal practice, being the most common inflammatory disease found in dogs. Nevertheless, the research in genetic predisposition to PD is an unexplored subject in this species. This work aims to contribute to the characterization of the genetic basis of canine PD. In order to identify genetic variations and verify its association with PD, was performed a molecular analysis of LTF gene in a case-control approach, including 40 dogs in the PD cases group and 50 dogs in the control group. In this study were detected and characterized eight new single nucleotide variations in the dog LTF gene. Genotype and allele frequencies of these variations showed no statistically significant differences between the control and PD cases groups. Our data do not give evidence for the contribution of these LTF variations to the genetic background of canine PD. Nevertheless, the sequence variant L/15_g.411C > T leads to an aminoacid change (Proline to Leucine) and was predicted to be possibly damaging to the LTF protein. Further investigations would be of extreme value to clarify the biological importance of these new findings.

The case for moderate gun control.

Science.gov (United States)

DeGrazia, David

2014-03-01

In addressing the shape of appropriate gun policy, this essay assumes for the sake of discussion that there is a legal and moral right to private gun ownership. My thesis is that, against the background of this right, the most defensible policy approach in the United States would feature moderate gun control. The first section summarizes the American gun control status quo and characterizes what I call "moderate gun control." The next section states and rebuts six leading arguments against this general approach to gun policy. The section that follows presents a positive case for moderate gun control that emphasizes safety in the home and society as well as rights whose enforcement entails some limits or qualifications on the right to bear arms. A final section shows how the recommended gun regulations address legitimate purposes, rather than imposing arbitrary restrictions on gun rights, and offers concluding reflections.

Eighteen cases of small breast cancer: a comparative study of mammography, CT scan and pathology

International Nuclear Information System (INIS)

Wu Yaopan; Lin Haogao; Cai Peiqiang; Ouyang Yi; Zhang Weizhang; Lu Bingui

2003-01-01

Objective: To improve the early diagnosis of breast cancer through a study of the mammography and CT findings of small breast cancer. Methods: The mammography and CT findings of 18 cases of small breast cancer (φ≤2.0 cm in diameter) were studied and compared with pathological results. Results: The diagnostic accuracy of CT and mammography was 83% and 61%, respectively. There was a statistical difference between both modalities (P<0.05), CT scan was superior to mammography. However, there was no difference between them when assessing the lesion arising in F-type breast. In detecting breast fine cluster of calcification, the sensitivity of mammography was better than CT scan. Conclusion: The patient suspected of small breast cancer should take mammography as the first evaluation. CT scan is reserved for the further investigation. The mammography combined with CT scan can improve the early diagnostic rate of breast cancer

Association between selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: population based case-control study

Science.gov (United States)

de Abajo, Francisco José; Rodríguez, Luis Alberto García; Montero, Dolores

1999-01-01

Objective To examine the association between selective serotonin reuptake inhibitors and risk of upper gastrointestinal bleeding. Design Population based case-control study. Setting General practices included in the UK general practice research database. Subjects 1651 incident cases of upper gastrointestinal bleeding and 248 cases of ulcer perforation among patients aged 40 to 79 years between April 1993 and September 1997, and 10 000 controls matched for age, sex, and year that the case was identified. Interventions Review of computer profiles for all potential cases, and an internal validation study to confirm the accuracy of the diagnosis on the basis of the computerised information. Main outcome measures Current use of selective serotonin reuptake inhibitors or other antidepressants within 30 days before the index date. Results Current exposure to selective serotonin reuptake inhibitors was identified in 3.1% (52 of 1651) of patients with upper gastrointestinal bleeding but only 1.0% (95 of 10 000) of controls, giving an adjusted rate ratio of 3.0 (95% confidence interval 2.1 to 4.4). This effect measure was not modified by sex, age, dose, or treatment duration. A crude incidence of 1 case per 8000 prescriptions was estimated. A small association was found with non-selective serotonin reuptake inhibitors (relative risk 1.4, 1.1 to 1.9) but not with antidepressants lacking this inhibitory effect. None of the groups of antidepressants was associated with ulcer perforation. The concurrent use of selective serotonin reuptake inhibitors with non-steroidal anti-inflammatory drugs increased the risk of upper gastrointestinal bleeding beyond the sum of their independent effects (15.6, 6.6 to 36.6). A smaller interaction was also found between selective serotonin reuptake inhibitors and low dose aspirin (7.2, 3.1 to 17.1). Conclusions Selective serotonin reuptake inhibitors increase the risk of upper gastrointestinal bleeding. The absolute effect is, however

Mycobacteria in Terrestrial Small Mammals on Cattle Farms in Tanzania

DEFF Research Database (Denmark)

Durnez, Lies; Katakweba, Abdul; Sadiki, Harrison

2011-01-01

The control of bovine tuberculosis and atypical mycobacterioses in cattle in developing countries is important but difficult because of the existence of wildlife reservoirs. In cattle farms in Tanzania, mycobacteria were detected in 7.3% of 645 small mammals and in cow's milk. The cattle farms we....... However, because of the high prevalence of mycobacteria in some small mammal species, these infected animals can pose a risk to humans, especially in areas with a high HIV-prevalence as is the case in Tanzania.......The control of bovine tuberculosis and atypical mycobacterioses in cattle in developing countries is important but difficult because of the existence of wildlife reservoirs. In cattle farms in Tanzania, mycobacteria were detected in 7.3% of 645 small mammals and in cow's milk. The cattle farms were...... and PCR in the small mammals were atypical mycobacteria. Analysis of the presence of mycobacteria in relation to the reactor status of the cattle farms does not exclude transmission between small mammals and cattle but indicates that transmission to cattle from another source of infection is more likely...

Dermatitis in small-scale metal industries

Energy Technology Data Exchange (ETDEWEB)

Coenraads, P J; Foo, S C; Phoon, W O; Lun, K C

1985-03-01

A survey in 21 small metal factories in Singapore revealed that 6.6% of 751 workers (530 male, 221 female) had a skin disorder on their hands and arms. Dermatitis accounted for 4.5% (34 cases) and follicular rashes for 1% (8 cases). Positive patch tests were found in 23% (8 cases) of those with dermatitis and in 9.8% (21 workers) of a control group without any skin problem. Dermatitis was found to be associated with exposure to solvents. Simultaneous analysis of various exposure/risk factors by multiple logistic regression indicated a significant effect of combined exposure to oils and solvents (interaction). Being over 35 years of age was also a significant risk factor, whereas the role of contact allergy, detected by patch testing, was less pronounced.

Determinants of podoconiosis, a case control study | Feleke ...

African Journals Online (AJOL)

The sample size was calculated using Epi-info soft ware: 95% CI, 85% power, control to case ratio of 2:1, expected frequency of barefoot among controls 50%, odds ratio of 1.5 and non-response rate of 10% yielding 1148 study participants. Binary logistic regression was used to identify the determinants of Podoconiosis.

Is work organisation associated with work status 3 months after injury? Results from a case-control study of New Zealand workers.

Science.gov (United States)

Lilley, Rebbecca; Derrett, Sarah; Davie, Gabrielle

2015-01-01

Little empirical examination of the relationship between work organisational factors and return to work following injury has been undertaken despite the growing recognition of examining broader multi-dimensional contexts for recovery following injury. To explore relationships between pre-injury work organisational factors and work status (working/work absent) 3-month after injury among people employed prior to injury. Cases (work absent) and controls (working), selected from a larger study of injury outcomes according to reported work status 3-month after injury, completed a postal questionnaire. Work organisational factors were compared between cases and controls using univariate and multivariable analyses. One hundred and twelve participants completed the questionnaire (44 cases; 68 controls). Of 11 work organisation factors examined, organisational size was the only explanatory variable significantly associated with work status in the multivariable model. Higher odds of work absence were found in small ( 500 employees) (OR 7.2) workplaces, compared with medium-sized (50-500 employees) organisations. Variations in post-injury work patterns among those working pre-injury may be partly explained by organisation size. Future research examining work status following injury should examine the influence of work organisational factors in larger studies.

Sediment control - an appropriate solution for small irrigation channels

International Nuclear Information System (INIS)

Shoag, M.A.

2002-01-01

Sediment control is one of the key factors considered prior to the design of an irrigation channel. When the channel takes off from its headworks, its slope is usually smaller than that of the parent stream to obtain required head. If the sediment load is heavy then the channel can not maintain equilibrium since the high influx can not be transported fully due to its small gradient. This results in the deposition of part incoming sediment in the channel itself. A typical irrigation intake suitable for small schemes, which consists of a simple settling basin with double orifice: one at the inlet from the river and the other at the outlet to the canal. The basin is provided with a side spill weir near its downstream end, to discharge flows in excess of the maximum canal capacity. This paper deals with the experimental study of such an arrangement. Different flows were run covering a range of levels in the river, from minimum to flood flows to check the hydraulic performance of the layout and in particular to study its effectiveness in settling sediment at low flows and avoiding excessive sediment input to the canal during flood. (author)

A photocleavable rapamycin conjugate for spatiotemporal control of small GTPase activity.

Science.gov (United States)

Umeda, Nobuhiro; Ueno, Tasuku; Pohlmeyer, Christopher; Nagano, Tetsuo; Inoue, Takanari

2011-01-12

We developed a novel method to spatiotemporally control the activity of signaling molecules. A newly synthesized photocaged rapamycin derivative induced rapid dimerization of FKBP (FK-506 binding protein) and FRB (FKBP-rapamycin binding protein) upon UV irradiation. With this system and the spatially confined UV irradiation, we achieved subcellularly localized activation of Rac, a member of small GTPases. Our technique offers a powerful approach to studies of dynamic intracellular signaling events.

Flocking small smart machines: An experiment in cooperative, multi-machine control

International Nuclear Information System (INIS)

Klarer, P.R.

1998-03-01

The intent and purpose of this work was to investigate and demonstrate cooperative behavior among a group of mobile robot machines. The specific goal of this work was to build a small swarm of identical machines and control them in such a way as to show a coordinated movement of the group in a flocking manner, similar to that observed in nature. Control of the swarm's individual members and its overall configuration is available to the human user via a graphic man-machine interface running on a base station control computer. Any robot may be designated as the nominal leader through the interface tool, which then may be commanded to proceed to a particular geographic destination. The remainder of the flock follows the leader by maintaining their relative positions in formation, as specified by the human controller through the interface. The formation's configuration can be altered manually through an interactive graphic-based tool. An alternative mode of control allows for teleoperation of one robot, with the flock following along as described above

Control rod studies in small and medium sized fast reactors

International Nuclear Information System (INIS)

John, T.M.; Mohanakrishnan, P.; Mahalakshmi, B.; Singh, R.S.

1988-01-01

Control rods are the primary safety mechanism in the operation of fast reactors. Neutronic parameters associated with the control rods have to be evaluated precisely for studying the behaviour of the reactor under various operating conditions. Control rods are strong neutron absorbers discretely distributed in the reactor core. Accurate estimation of control rod parameters demand, in principle transport theory solutions in exact geometry. But computer codes for such evaluations usually consume exorbitantly large computer time and memory for even a single parameter evaluation. During the design of reactors, evaluation of these parameters will be required for many configurations of control rods. In this paper, the method used at Indira Gandhi Centre for Atomic Research for estimating the parameters associated with control rods is presented. Diffusion theory solutions were used for computations. A scheme using three dimensional geometry represented by triangular meshes and diffusion theory solutions in few energy groups for control rod parameter evaluation is presented. This scheme was employed in estimating the control rod parameters in a 500 Mw(e) fast reactor. Error due to group collapsing is estimated by comparing with 25 group calculations in three dimensions for typical cases. (author). 5 refs, 4 figs, 3 tabs

The business case for safety and health at work : cost-benefit analyses of interventions in small and medium-sized enterprises

NARCIS (Netherlands)

Targoutzidis, A.; Koukoulaki, T.; Schmitz-Felten, E.; Kuhl, K.; Oude Hengel, K.M.; Rijken, E.; Broek K. van den; Kluser, R.

2014-01-01

This report examines the economic aspects of occupational safety and health (OSH) interventions in small and medium-sized businesses (SMEs). First, case studies in the existing literature were identified and examined. Second, 13 new case studies on OSH initiatives in European SMEs were developed,

One Critical Case in Singularly Perturbed Control Problems

Science.gov (United States)

Sobolev, Vladimir

2017-02-01

The aim of the paper is to describe the special critical case in the theory of singularly perturbed optimal control problems. We reduce the original singularly perturbed problem to a regularized one such that the existence of slow integral manifolds can be established by means of the standard theory. We illustrate our approach by an example of control problem.

Risk Factors Profile of Shoulder Dystocia in Oman: A Case Control Study

OpenAIRE

Maha M. Al-Khaduri; Rania Mohammed Abudraz; Sayed G. Rizvi; Yahya M. Al-Farsi

2014-01-01

Objective: This study aimed to assess the risk factor profile of shoulder dystocia and associated neonatal complications in Oman, a developing Arab country. Methods: A retrospective case-control study was conducted among 111 cases with dystocia and 111 controls, identified during 1994-2006 period in a tertiary care hospital in Oman. Controls were randomly selected among women who did not have dystocia, and were matched to cases on the day of delivery. Data related to potential risk factor...

Small reactor operating mode

International Nuclear Information System (INIS)

Snell, V.G.

1997-01-01

There is a potential need for small reactors in the future for applications such as district heating, electricity production at remote sites, and desalination. Nuclear power can provide these at low cost and with insignificant pollution. The economies required by the small scale application, and/or the remote location, require a review of the size and location of the operating staff. Current concepts range all the way from reactors which are fully automatic, and need no local attention for days or weeks, to those with reduced local staff. In general the less dependent a reactor is on local human intervention, the greater its dependence on intrinsic safety features such as passive decay heat removal, low-stored energy and limited reactivity speed and depth in the control systems. A case study of the design and licensing of the SLOWPOKE Energy System heating reactor is presented. (author)

The Association Between Urban Tree Cover and Gun Assault: A Case-Control and Case-Crossover Study.

Science.gov (United States)

Kondo, Michelle C; South, Eugenia C; Branas, Charles C; Richmond, Therese S; Wiebe, Douglas J

2017-08-01

Green space and vegetation may play a protective role against urban violence. We investigated whether being near urban tree cover during outdoor activities was related to being assaulted with a gun. We conducted geographic information systems-assisted interviews with boys and men aged 10-24 years in Philadelphia, Pennsylvania, including 135 patients who had been shot with a firearm and 274 community controls, during 2008-2011. Each subject reported a step-by-step mapped account of where and with whom they traveled over a full day from waking until being assaulted or going to bed. Geocoded path points were overlaid on mapped layers representing tree locations and place-specific characteristics. Conditional logistic regressions were used to compare case subjects versus controls (case-control) and case subjects at the time of injury versus times earlier that day (case-crossover). When comparing cases at the time of assault to controls matched at the same time of day, being under tree cover was inversely associated with gunshot assault (odds ratio (OR) = 0.70, 95% confidence interval (CI): 0.55, 0.88), especially in low-income areas (OR = 0.69, 95% CI: 0.54, 0.87). Case-crossover models confirmed this inverse association overall (OR = 0.55, 95% CI: 0.34, 0.89) and in low-income areas (OR = 0.54, 95% CI: 0.33, 0.88). Urban greening and tree cover may hold promise as proactive strategies to decrease urban violence. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Design of Neutral-Point Voltage Controller of a Three-level NPC Inverter with Small DC-Link Capacitors

DEFF Research Database (Denmark)

Maheshwari, Ram Krishan; Munk-Nielsen, Stig; Busquets-Monge, S.

2013-01-01

A Neutral-Point-Clamped (NPC) three-level inverter with small dc-link capacitors is presented in this paper. The inverter requires zero average neutral-point current for stable neutral-point voltage. The small dc-link capacitors may not maintain capacitor voltage balance, even with zero neutral......-point voltage control on the basis of the continuous model. The design method for optimum performance is discussed. The implementation of the proposed modulation strategy and the controller is very simple. The controller is implemented in a 7.5 kW induction machine based drive with only 14 ìF dc-link capacitors...

Brain-relevant antibodies in first-episode psychosis: a matched case-control study.

Science.gov (United States)

Gaughran, Fiona; Lally, John; Beck, Katherine; McCormack, Ruaidhri; Gardner-Sood, Poonam; Coutinho, Ester; Jacobson, Leslie; Lang, Bethan; Sainz-Fuertes, Ricardo; Papanastasiou, Evangelos; Di Forti, Marta; Nicholson, Tim; Vincent, Angela; Murray, Robin M

2018-06-01

There has been much recent excitement about the possibility that some cases of psychosis may be wholly due to brain-reactive antibodies, with antibodies to N-methyl-D-aspartate receptor (NMDAR) and the voltage-gated potassium channel (VGKC)-complex reported in a few patients with first-episode psychosis (FEP). Participants were recruited from psychiatric services in South London, UK, from 2009 to 2011 as part of the Genetics and Psychosis study. We conducted a case-control study to examine NMDAR and VGKC-complex antibody levels and rates of antibody positivity in 96 patients presenting with FEP and 98 controls matched for age and sex. Leucine-rich glioma inactiviated-1 (LGI1) and contactin-associated protein (CASPR) antibodies were also measured. Notably, patients with suspicion of organic disease were excluded. VGKC-complex antibodies were found in both cases (n = 3) and controls (n = 2). NMDAR antibody positivity was seen in one case and one control. Either LGI1-Abs or CASPR2-Abs were found in three cases and three controls. Neuronal antibody staining, consistent with the above results or indicating potential novel antigens, was overall positive in four patients but also in six controls. Overall, antibody positivity was at low levels only and not higher in cases than in controls. This case-control study of the prevalence of antibodies in FEP does not provide evidence to support the hypothesis that FEP is associated with an immune-mediated process in a subgroup of patients. Nevertheless, as other bio-clinical factors may influence the effect of such antibodies in a given individual, and patients with organic neurological disease may be misdiagnosed as FEP, the field requires more research to put these findings in context.

Qat use and esophageal cancer in Ethiopia: A pilot case-control study.

Directory of Open Access Journals (Sweden)

Maria E Leon

Full Text Available Qat (Catha edulis chewing is reported to induce lesions in the buccal mucosa, irritation of the esophagus, and esophageal reflux. Case series suggest a possible etiological role in oral and esophageal cancers. This pilot study aimed to generate preliminary estimates of the magnitude and direction of the association between qat use and esophageal cancer (EC risk and to inform the logistics required to conduct a multi-center case-control study.Between May 2012 and May 2013, 73 EC cases (including 12 gastro-esophageal junction cases and 133 controls matched individually on sex, age, and residence were enrolled at two endoscopy clinics and a cancer treatment hospital in Addis Ababa. A face-to-face structured questionnaire was administered. Qat use was defined as ever having chewed qat once a week or more frequently for at least one year. Odds ratios were calculated using conditional logistic regression.Only 8% of cases resided in Addis Ababa. Qat use was more frequent in cases (36% than in controls (26%. A 2-fold elevation in EC risk was observed in ever qat chewers compared with never users in unadjusted conditional logistic regression (OR = 2.12; 95% CI = 0.94, 4.74, an association that disappeared after adjusting for differences in tobacco use, consumption of alcohol and green vegetables, education level, and religion (OR = 0.95; 0.22, 4.22. Among never tobacco users, however, a non-significant increase in EC risk was suggested in ever qat users also after adjustment. Increases in EC risk were observed with ever tobacco use, alcohol consumption, low consumption of green vegetables, a salty diet, illiteracy, and among Muslims; the four latter associations were significant.This pilot study generated EC risk estimates in association with a habit practiced by millions of people and never before studied in a case-control design. Results must be interpreted cautiously in light of possible selection bias, with some demographics such as education level

Strangulated small bowel gangrene due to torsioned gangrenous appendix in an old man: a case report

Directory of Open Access Journals (Sweden)

Ardavan Shahbazi

2016-11-01

Full Text Available Background: Torsion of the appendix is a rare entity and divided into two categories: primary and secondary. The primary mode is due to an abnormality in either appendix anatomy or its meso or both and is more common in children. The secondary forms happen in adults which can be associated with appendiceal tumor, appendiceal mucocele, fecal impaction, volvulus of ovarian cyctadenoma. Adynamic small bowel obstruction or ileus is seen frequently with all forms of peritoneal inflammation. However, Anatomical small intestinal obstruction or gangrene due to torsioned appendix is a rare condition and few cases reported in the literature. Method: Here we have a 83-year-old man patient with small bowel obstruction and localized right lower quadrant peritonitis who undergo emergency laparotomy to eliminate small bowel obstruction and peritonitis. Preoperative abdominal radiography showed multiple dilated small bowel loops with empty colon. Results: During exploration necrosis of the terminal 40cm of the ileum due to a twisted and gangrenous appendix was discovered. Other parts were normal. Conclusion: it may be useful to recommend early midline exploratory laparotomy for patients with small bowel obstruction even in the presence symptoms of local appendicitis. This operation can be both diagnostic and therapeutic.

Small School Reform

Directory of Open Access Journals (Sweden)

Carroll E. Bronson

2013-05-01

Full Text Available This qualitative ethnographic case study explored the evolution of a public urban high school in its 3rd year of small school reform. The study focused on how the high school proceeded from its initial concept, moving to a small school program, and emerging as a new small high school. Data collection included interviews, observations, and document review to develop a case study of one small high school sharing a multiplex building. The first key finding, “Too Many Pieces, Not Enough Glue,” revealed that the school had too many new programs starting at once and they lacked a clear understanding of their concept and vision for their new small school, training on the Montessori philosophies, teaching and learning in small schools, and how to operate within a teacher-cooperative model. The second key finding, “A Continuous Struggle,” revealed that the shared building space presented problems for teachers and students. District policies remain unchanged, resulting in staff and students resorting to activist approaches to get things done. These findings offer small school reform leaders suggestions for developing and sustaining a small school culture and cohesion despite the pressures to revert back to top-down, comprehensive high school norms.

Multivariable Super Twisting Based Robust Trajectory Tracking Control for Small Unmanned Helicopter

Directory of Open Access Journals (Sweden)

Xing Fang

2015-01-01

Full Text Available This paper presents a highly robust trajectory tracking controller for small unmanned helicopter with model uncertainties and external disturbances. First, a simplified dynamic model is developed, where the model uncertainties and external disturbances are treated as compounded disturbances. Then the system is divided into three interconnected subsystems: altitude subsystem, yaw subsystem, and horizontal subsystem. Second, a disturbance observer based controller (DOBC is designed based upon backstepping and multivariable super twisting control algorithm to obtain robust trajectory tracking property. A sliding mode observer works as an estimator of the compounded disturbances. In order to lessen calculative burden, a first-order exact differentiator is employed to estimate the time derivative of the virtual control. Moreover, proof of the stability of the closed-loop system based on Lyapunov method is given. Finally, simulation results are presented to illustrate the effectiveness and robustness of the proposed flight control scheme.

Assessment of the state administration effectiveness in the field of small business control in Slovakia

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Eleonóra Marišová

2013-01-01

Full Text Available The agenda of small business in Slovakia is administered by state administration - district offices which registry and also control the entrepreneurs. The control units in the period 2008–2011 and its evaluation in terms of efficiency were the objects of the research. A comparative analysis was focused on the number of inspections carried out by inspectors at registered enterprises and the number of fines imposed by law established methods (penalties in block proceedings and fines on the basis of a decision to impose fine. Comparison was made to the NUTS 3 level, and in different regions of Slovakia. The assessment was based on the number of inspections and fines imposed on the incumbent entrepreneur in the respective region and the number of controls per 1 inspector. The result of the research is to evaluate the effectiveness of control activities of units within the NUTS 3. The average proportion of registered enterprises inspections in 2012 was 3.98% (SR. The base index of the average share of inspected enterprises in the period between the year 2008 and 2012 shows a value 0.75, which indicates a decrease in the proportion of subjects controlled by 25%. The results of the research show that the control units should increase the proportion of screened subjects, revise the amount of the fines imposed and the ability to enforce compliance with the obligations under the Act on small business No. 455/1991 Coll. (Small business law and special rules. To achieve the increase of effectiveness of inspectors, its recommended to innovate their temporal and territorial flexibility.

A dual small-molecule rheostat for precise control of protein concentration in Mammalian cells.

Science.gov (United States)

Lin, Yu Hsuan; Pratt, Matthew R

2014-04-14

One of the most successful strategies for controlling protein concentrations in living cells relies on protein destabilization domains (DD). Under normal conditions, a DD will be rapidly degraded by the proteasome. However, the same DD can be stabilized or "shielded" in a stoichiometric complex with a small molecule, enabling dose-dependent control of its concentration. This process has been exploited by several labs to post-translationally control the expression levels of proteins in vitro as well as in vivo, although the previous technologies resulted in permanent fusion of the protein of interest to the DD, which can affect biological activity and complicate results. We previously reported a complementary strategy, termed traceless shielding (TShld), in which the protein of interest is released in its native form. Here, we describe an optimized protein concentration control system, TTShld, which retains the traceless features of TShld but utilizes two tiers of small molecule control to set protein concentrations in living cells. These experiments provide the first protein concentration control system that results in both a wide range of protein concentrations and proteins free from engineered fusion constructs. The TTShld system has a greatly improved dynamic range compared to our previously reported system, and the traceless feature is attractive for elucidation of the consequences of protein concentration in cell biology. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Malignant lymphoma incidentally diagnosed due to the perforation of the small intestine caused by a fish bone: A case report

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Masatsugu Hiraki

Full Text Available Introduction: The ingestion of a foreign body is relatively common. However, it rarely results in the perforation of gastrointestinal tract. We herein report an unusual case of malignant lymphoma incidentally diagnosed after the perforation of the small intestine by a fish bone. Presentation of case: A 90-year-old woman was admitted to our hospital because of abdominal pain and vomiting. Abdominal computed tomography demonstrated free air and ascites in the abdominal cavity. In the pelvic cavity, a radiopaque linear shadow about 35 mm in diameter was shown in the small intestine, and the stricture was exposed to the abdominal cavity. Therefore, a diagnosis of perforation of the small intestine due to ingestion of a foreign body and panperitonitis was made. Emergent laparotomy was performed. The intraoperative findings revealed perforation of the small intestine with a fish bone in the jejunum. Local inflammation at the perforation site was seen, and circulated wall thickness was observed at the distal side of the jejunum. Partial resection of the jejunum and anastomosis of jejuno-jejunostomy was performed. A pathological examination and immunohistochemical study of the resected specimen resulted in a diagnosis of malignant lymphoma of follicular lymphoma Grade 1. Discussion: It is very difficult to identify the existence malignancy accompanied with gastrointestinal perforation with ingestion of a foreign body. Conclusion: In cases suspected of involving malignancy, careful observation during surgery is needed in order to avoid missing the accompanying malignancy. Keywords: Fish bone, Perforation, Small intestine, Malignant lymphoma, Foreign body, Ingestion

Epilepsy and risk of suicide: a population-based case-control study

DEFF Research Database (Denmark)

Christensen, Jakob; Vestergaard, Mogens; Mortensen, Preben Bo

2007-01-01

by sex, birth year, and calendar date, were assigned to each suicide case. FINDINGS: We identified 21 169 cases of suicide and 423 128 controls. 492 (2.32%) individuals who committed suicide had epilepsy compared with 3140 (0.74%) controls, corresponding to a three times higher risk (rate ratio [RR] 3...

Modelling and adaptive control of small capacity chillers for HVAC applications

International Nuclear Information System (INIS)

Beghi, A.; Cecchinato, Luca

2011-01-01

An adaptive controller for single and uneven tandem scroll compressor, packaged air-cooled water chillers is described. The designed controller allows to substantially increase the energy performance of the system, as well as to achieve excellent regulation performances in process applications. The controller parameters are adapted on the basis of estimates of the plant thermal load, that are computed by using a Kalman filter. An ad hoc approach is used to define a relay control logic, which is based on a numerical optimization procedure. To support controller design, a detailed simulation environment is developed and validated on an experimental facility. Performance of the algorithm is described with both simulation and experimental data. At low part load ratio values the proposed algorithm grants a 0.6-0.7 K improvement in the regulation performance in terms of supply water temperature standard deviation and mean supply water temperature deviation. The unit energy efficiency improvement with respect to supply water temperature control varies from 7.3% to 3.0% while the experimental seasonal energy efficiency rating improvement is 9.1%. - Research highlights: → Design of an advanced control algorithms for small capacity chillers. → Matlab/Simulink simulation environment development and experimental validation. → Development of an adaptive control algorithm for scroll compressor chillers, which allows to increase both control accuracy and energy performance. → New load estimation scheme based on a Kalman filter.

Considerations on safeguards approach for small centrifuge enrichment facilities

International Nuclear Information System (INIS)

Vicens, Hugo E.; Marzo, Marco A.; Nunes, Vitorio E.

2004-01-01

The safeguards' objectives for enrichment facilities encompass the detection of the diversion of declared nuclear material and of facility misuse. The safeguard's approach presently applied for commercial centrifuge enrichment facilities is based on the Hexa partite Project and seems not to be directly applicable to cases of small plants. Since ABACC started its operation one of the main problems faced was the application of safeguards to small centrifuge enrichment plants for testing centrifuges in cascade mode or for small LEU production. These plants consist of a few fully independent cascades, does not operate in a routine basis and panels prevent visual access to the centrifuges and their surroundings for preserving sensitive information. For such plants misuse scenarios seems to dominate, particularly those associated with feeding the plant with undeclared LEU. This paper presents a concise analysis of misuse strategies in small centrifuge facility and alternative safeguard's approach, describing the main control elements to be applied. The particularities arising from the existence of panels or boxes covering the centrifuges are specifically addressed. Two alternatives approaches based on the application of a transitory perimeter control to increase the effectiveness of unannounced inspection and on the application of permanent perimeter control are presented. (author)

Gimbal system configurations and line-of-sight control techniques for small UAV applications

Science.gov (United States)

Miller, Rick; Mooty, Greg; Hilkert, J. M.

2013-05-01

The proliferation of small Unmanned Air Vehicles (UAVs) in the past decade has been driven, in part, by the diverse applications that various industries have found for these platforms. Originally, these applications were predominately military in nature but now include law enforcement/security, environmental monitoring/remote sensing, agricultural surveying, movie making and others. Many of these require sensors/payloads such as cameras, laser pointers/ illuminators/rangefinders and other systems that must be pointed and/or stabilized and therefore require a precision miniature gimbal or other means to control their line-of-sight (LOS). Until now, these markets have been served by traditional/larger gimbals; however, the latest class of small UAVs demands much smaller gimbals while maintaining high-performance. The limited size and weight of these gimbaled devices result in design challenges unique to the small-gimbal design field. In the past five years, Ascendant Engineering Solutions has engaged in designing, analyzing and building several small-gimbal systems to meet these challenges and has undertaken a number of trade studies to investigate techniques to achieve optimal performance within the inherent limitations mentioned above. These have included investigating various gimbal configurations, feedback sensors such as gyros, IMUs and encoders, drive train configurations, control system techniques, packaging and interconnect, as well as technology such as fast-steering mirrors and image-stabilization algorithms. This paper summarizes the results of these trade studies, attempts to identify inherent trends and limitations in the various design approaches and techniques, and discusses some practical issues such as test and verification.

Harnessing case isolation and ring vaccination to control Ebola.

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Chad Wells

2015-05-01

Full Text Available As a devastating Ebola outbreak in West Africa continues, non-pharmaceutical control measures including contact tracing, quarantine, and case isolation are being implemented. In addition, public health agencies are scaling up efforts to test and deploy candidate vaccines. Given the experimental nature and limited initial supplies of vaccines, a mass vaccination campaign might not be feasible. However, ring vaccination of likely case contacts could provide an effective alternative in distributing the vaccine. To evaluate ring vaccination as a strategy for eliminating Ebola, we developed a pair approximation model of Ebola transmission, parameterized by confirmed incidence data from June 2014 to January 2015 in Liberia and Sierra Leone. Our results suggest that if a combined intervention of case isolation and ring vaccination had been initiated in the early fall of 2014, up to an additional 126 cases in Liberia and 560 cases in Sierra Leone could have been averted beyond case isolation alone. The marginal benefit of ring vaccination is predicted to be greatest in settings where there are more contacts per individual, greater clustering among individuals, when contact tracing has low efficacy or vaccination confers post-exposure protection. In such settings, ring vaccination can avert up to an additional 8% of Ebola cases. Accordingly, ring vaccination is predicted to offer a moderately beneficial supplement to ongoing non-pharmaceutical Ebola control efforts.

Harnessing case isolation and ring vaccination to control Ebola.

Science.gov (United States)

Wells, Chad; Yamin, Dan; Ndeffo-Mbah, Martial L; Wenzel, Natasha; Gaffney, Stephen G; Townsend, Jeffrey P; Meyers, Lauren Ancel; Fallah, Mosoka; Nyenswah, Tolbert G; Altice, Frederick L; Atkins, Katherine E; Galvani, Alison P

2015-05-01

As a devastating Ebola outbreak in West Africa continues, non-pharmaceutical control measures including contact tracing, quarantine, and case isolation are being implemented. In addition, public health agencies are scaling up efforts to test and deploy candidate vaccines. Given the experimental nature and limited initial supplies of vaccines, a mass vaccination campaign might not be feasible. However, ring vaccination of likely case contacts could provide an effective alternative in distributing the vaccine. To evaluate ring vaccination as a strategy for eliminating Ebola, we developed a pair approximation model of Ebola transmission, parameterized by confirmed incidence data from June 2014 to January 2015 in Liberia and Sierra Leone. Our results suggest that if a combined intervention of case isolation and ring vaccination had been initiated in the early fall of 2014, up to an additional 126 cases in Liberia and 560 cases in Sierra Leone could have been averted beyond case isolation alone. The marginal benefit of ring vaccination is predicted to be greatest in settings where there are more contacts per individual, greater clustering among individuals, when contact tracing has low efficacy or vaccination confers post-exposure protection. In such settings, ring vaccination can avert up to an additional 8% of Ebola cases. Accordingly, ring vaccination is predicted to offer a moderately beneficial supplement to ongoing non-pharmaceutical Ebola control efforts.

Periodontal disease and spontaneous preterm birth: a case control study

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Eley Barry

2006-07-01

Full Text Available Abstract Background Several studies have suggested an association between periodontal disease and prematurity but this finding has not been consistently observed. Methods Case control study. Cases (n = 50 were women who had delivered after spontaneous preterm labor at Results There was no difference in the proportion of sites with significant attachment loss (≥3 mm: Cases-3.2%, Controls-2.2% p = 0.21. The gingival crevicular fluid concentrations of elastase and gingipain were elevated in cases vs. controls 238.8 uU/ul vs. 159.6 uU/ul p = .007 and 2.70 uU/ul vs. 1.56 uU/ul p = .001. On multivariate analysis, the mean log concentration of elastase, but not of gingipain, remained a significant predictor of preterm labor p = .0.015. Conclusion We found no evidence that clinical periodontal disease is associated with spontaneous preterm birth. Elevated gingival crevicular fluid levels of elastase were associated with preterm birth but further research is needed before this can be assumed to be a causal relationship.

Desmoplastic small round cell tumor: a case report and review of the literature

International Nuclear Information System (INIS)

Pinto, Luiz Gustavo Teixeira; Isberner, Rony Klaus; Scolaro, Bruno Lorenzo; Sezerino, Daniel Oseias; Almeida, Daniel da Silva

2006-01-01

Desmoplastic small round cell tumor is a rare and highly aggressive neoplasm that predominantly occurs in young adult males. Pain and abdominal distention are frequent, ascites could be observed. His histogenesis is uncertain and the most common location is the peritoneal cavity. This tumor is characterized by presenting a distinct morphology and polyphenotypic differentiation. We present in this report the case of an adolescent admitted in the service of Internal Medicine and Radiology of the Hospital and Maternity Marieta Konder Bornhausen, Itajai, SC, Brazil, in year 2005. (author)

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)

Use of benzodiazepines or benzodiazepine related drugs and the risk of cancer: a population-based case-control study

DEFF Research Database (Denmark)

Pottegård, Anton; Friis, Søren; Andersen, Morten

2013-01-01

AIM: Studies of the carcinogenic potential of benzodiazepines and related drugs (BZRD) have been equivocal. A recent study reported a 35% excess cancer risk among users of hypnotics, including benzodiazepines. METHOD: Using Danish nationwide registers, we conducted a matched case-control study...... of the association between BZRD and cancer risk. During 1 January 2002 and 31 December 2009, we identified 152 510 cases with a first time cancer who were matched (1:8) by age and gender to 1,220,317 cancer-free controls. A new-user design was applied by excluding all subjects who had used anxiolytics, hypnotics.......02), liver 1.81 (95% CI 1.18, 2.80), lung 1.38 (95% CI 1.23, 1.54), pancreas 1.35 (95% CI 1.02, 1.79) and kidney 1.39 (95% CI 1.01, 1.91). For tobacco-related cancers, the OR was 1.15 (95% CI 1.09, 1.22) and for the remaining cancer sites 1.01 (95% CI 0.94, 1.08). Sub-group analyses revealed only small...

Pseudolisthesis secondary to small L5

International Nuclear Information System (INIS)

Bagheri, Mohammad Hadi; Hosseini, Mehrdad Mohammad; Foroughi, Amin Aboulhassani

2011-01-01

Rationale and objective: Small AP diameter of L5 can mimic spondylolisthesis in lumbosacral MRI. The aim of the present study was to evaluate the prevalence of small L5 mimicking spondylolisthesis in lumbosacral MRI of the patients referred to an imaging center by any symptoms. Association between small anteroposterior diameter of L5 and presence and absence of unilateral or bilateral spondylolysis at L5 were also evaluated. Materials and methods: 2000 lumbosacral MRI of the patients referred to an imaging center for any reasons were evaluated. The posterior step of L5 was measured and the cases with posterior step of more than 2 mm were selected. These cases were evaluated for presence or absence of spondylolysis. Results: Small anteroposterior diameters of L5 were detected in 38 cases (2%), mimicking the spondylolisthesis in lumbosacral MRI. The prevalence of small L5 in lumbosacral MRI of the patients referred by any symptoms was about 2%. In these selected cases, 6 (15.8%) show unilateral spondylolysis and 5 (13.1%) show bilateral spondylolysis. Conclusion: Pseudospondylolisthesis secondary to small AP diameter of L5 has prevalence of about 2% in lumbosacral MRI of cases referred for any reasons and can be overlooked in reporting of LS MRI. There was an association between small anteroposterior diameter of L5 and presence of spondylolysis at L5.

Management Control in Inter-organizational Relationships: The Case of Franchises

OpenAIRE

Magdalena Cordobés Madueño; Pilar Soldevila García

2015-01-01

There is great interest in the role of management control on theoretical and practical developments within the field of Inter-organizational Relations. This research aims to contribute at verifying how relationships between firms affect the management control tools used, as illustrated in a specific case: the relationship between the franchisor and its franchisees, which has not received much attention to date. As indicated by previous research, case studies can be helpful to determine the...

Risk factors for inguinal hernia in women: a case-control study. The Coala Trial Group.

Science.gov (United States)

Liem, M S; van der Graaf, Y; Zwart, R C; Geurts, I; van Vroonhoven, T J

1997-11-01

Potential risk factors for inguinal hernia in women were investigated and the relative importance of these factors was quantified. In women, symptomatic but nonpalpable hernias often remain undiagnosed. However, knowledge on this subject only concerns hernia and operation characteristics, which have been obtained by review of case series. Virtually nothing is known about risk factors for inguinal hernia. The authors performed a hospital-based case-control study of 89 female patients with an incident inguinal hernia and 176 age-matched female controls. Activity since birth with two validated questionnaires was measured and smoking habits, medical and operation history, Quetelet index (kg/m2), and history of pregnancies and deliveries were recorded. Response for cases was 81% and for controls 73%. Total physical activity was not associated with inguinal hernia (univariate odds ratio (OR) = 0.8, 95% confidence interval (CI) 0.6-1.1), but high present sports activities was associated with less inguinal hernia (multivariate OR = 0.2, 95% CI 0.1-0.7). Obesity (Quetelet index > 30) was also protective for inguinal hernia (OR = 0.2, 95% CI 0.04-1.0). Independent risk factors were positive family history (OR = 4.3, 95% CI 1.9-9.7) and obstipation (OR = 2.5, 95% CI 1.0-6.7). In particular, smoking, appendectomy, other abdominal operations, and multiple deliveries were not associated with inguinal hernia in females. The protective effect of present sports activity may be explained by optimizing the resistance of the abdominal musculature protecting the relatively small inguinal weak spot in the female. The individual predisposition for inguinal hernia may be quantified by these risk factors, and, with this in mind, the authors advise that further evaluation might be needed for the patient with unexplained inguinal pain.

Intraabdominal desmoplastic small round cell tumor: Report of a case and literature review.

Science.gov (United States)

Koniari, Katerina; Mahera, Helen; Nikolaou, Marinos; Chatzis, Odysseas; Glezakou, Ourania; Magiasis, Vasilios; Kiratzis, Georgios

2011-01-01

Desmoplastic small round cell tumor is a rare malignancy with poor prognosis that predominantly affects young males. Its etiopathogenesis is still unknown and diagnosis can be achieved only by immunohistochemistry and cytogenetic studies. Due to our limited knowledge of the pathologic and clinical nature of this disease, there is no clear consensus regarding the optimal therapeutic procedures for treating this neoplasm. A high degree of care and improvements in diagnostic capabilities are required in order to identify this entity and avoid misdiagnosis. We report a new case of a 29-year-old male who proceeded to our Emergency Department complaining about non-specific abdominal pain. Physical examination revealed no abnormalities except for a palpable mass in the lower abdomen and a diffuse abdominal pain. Computed Tomography scan showed enlarged paraortic and mesenteric lymphadenopathy, thickness of the small bowel wall and dispersed masses intraperitoneally. He underwent an exploratory laparotomy and the resultant biopsy revealed desmoplastic small round cell tumor. Diagnosis of desmoplastic small round cell tumor can easily be missed because it presents with few early warning symptoms and signs, while the routine blood tests are within normal limits. A high degree of suspicion, a thorough physical examination, a full imaging check and an aggressive therapeutic approach are required in order to identify this disease and fight for a better quality of life for these patients. In addition we make a review of the literature in an effort to clarify the epidemiological, clinical and pathological aspects of this entity.

The clinical psychologist and the management of inpatient pain: a small case series

Directory of Open Access Journals (Sweden)

Childs SR

2014-12-01

Full Text Available Susan R Childs,1,* Emma M Casely,2,* Bianca M Kuehler,1 Stephen Ward,1 Charlotte L Halmshaw,1 Sarah E Thomas,1 Ian D Goodall,1 Carsten Bantel1,3 1Pain Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, 2Anaesthetic Department, Hillingdon Hospital, Uxbridge, 3Section of Anaesthetics, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital Campus, London, UK *These authors contributed equally to this manuscript Abstract: Recent research has confirmed that between 25% and 33% of all hospitalized patients experience unacceptable levels of pain. Studies further indicate that this reduces patient satisfaction levels, lengthens hospital stays, and increases cost. Hospitals are aiming to discharge patients earlier, and this can interfere with adequate pain management. Therefore, the pain service at Chelsea and Westminster Hospital has adapted to this changing model of care. An increasing body of evidence demonstrates that psychological factors are key components of patients’ pain experiences in both acute and chronic pain. Therefore, it is reasonable to suggest a clinical psychologist should be involved in inpatient pain management. This small study discusses three cases that highlight how patient care could be improved by including a clinical psychologist as part of the inpatient pain team. Two cases particularly highlight the active role of the psychologist in the diagnosis and management of common conditions such as fear and anxiety, along with other psychiatric comorbidities. The management therefore employed an eclectic approach adapted from chronic pain and comprising of behavioral, cognitive behavioral, and dialectical behavioral therapeutic techniques blended with brief counseling. The third case exemplifies the importance of nurse-patient interactions and the quality of nurse-patient relationships on patient outcomes. Here, the psychologist helped to optimize

Optimization and control of a small angle ion source using an adaptive neural network controller

Energy Technology Data Exchange (ETDEWEB)

Brown, S.K.; Mead, W.C.; Bowling, P.S.; Jones, R.D.; Barnes, C.W.

1993-09-01

This project developed an automated controller based on an artificial neural network and evaluated its applicability in a real-time environment. This capability was developed within the context of a small angle negative ion source on the Discharge Test Stand at Los Alamos. The controller processes information obtained from the beam current waveform, developing a figure of merit (fom) to determine the ion source operating conditions. The fom is composed of the magnitude of the beam current, the stability of operation, and the quietness of the beam. Using no knowledge of operating conditions, the controller begins by making of rough scan of the four-dimensional operating surface. This surface uses as independent variables the anode and cathode temperatures, the hydrogen flow rate, and the arc voltage. `Me dependent variable is the fom described above. Once the rough approximation of the surface has been determined, the network formulates a model from which it determines the best operating point. The controller takes the ion source to that operating point for a reality check. As real data is fed in, the model of the operating surface is updated until the neural network`s model agrees with reality. The controller then uses a gradient ascent method to optimize the operation of the ion source. Initial tests of the controller indicate that it is remarkably capable. It has optimized the operation of the ion source on six different occasions bringing the beam to excellent quality and stability.

Seatbelt injury causing small bowel devascularisation: case series and review of the literature.

LENUS (Irish Health Repository)

O'Dowd, Vincent

2012-01-31

The use of seatbelts has increased significantly in the last twenty years, leading to a decrease in mortality from road traffic accidents (RTA). However, this increase in seatbelt use has also led to a change in the spectrum of injuries from RTA; abdominal injuries, particularly intestinal injuries have dramatically increased with the routine use of seatbelts. Such intestinal injuries frequently result from improper placement of the "lap belt". We present 3 cases in which passengers wearing a seatbelt sustained significant devascularisation injuries to the small bowel requiring emergency surgical intervention. A high index of suspicion is crucial in such cases to prevent delays in diagnosis that can lead to severe complications and adverse outcomes. It is evident that while advocating seatbelt use, the importance of education in correct seatbelt placement should also be a focus of public health strategies to reduce RTA morbidity and mortality.

Violence against Women and Gastroschisis: A Case-Control Study

Directory of Open Access Journals (Sweden)

Daniel Ruiz

2013-10-01

Full Text Available Background: Gastroschisis, a birth defect characterized by herniated fetal abdominal wall, occurs more commonly in infants born to teenage and young mothers. Ischemia of the vascular vitelline vessels is the likely mechanism of pathogenesis. Given that chronic stress and violence against women are risk factors for cardiovascular disease we explored whether these may represent risk factors for gastroschisis, when they occur during pregnancy. A case-control study was conducted, with 15 incident cases of children born with gastroschisis in the Region of Murcia, Spain, from December 2007 to June 2013. Forty concurrent controls were recruited at gestation weeks 20–24 or post-partum. All mothers of cases and controls completed a comprehensive, in-person, ‘green sheet’ questionnaire on environmental exposures. Results: Mothers of children with gastroschisis were younger, smoked more cigarettes per week relative to controls, were exposed to higher amounts of illegal drugs, and suffered from domestic violence more frequently than the controls. Multivariable logistic regression analysis highlights periconceptional ‘gender-related violence’ (OR: 16.6, 95% CI 2.7 to 101.7 and younger maternal age (OR 1.1, 95% CI 1.0–1.3. Conclusions: Violence against pregnant women is associated with birth defects, and should be studied in more depth as a cause-effect teratogenic. Psychosocial risk factors, including gender-based violence, are important for insuring the health and safety of the pregnant mother and the fetus.

Functional Aspects of Gait in Essential Tremor: A Comparison with Age-Matched Parkinson's Disease Cases, Dystonia Cases, and Controls.

Science.gov (United States)

Louis, Elan D; Rao, Ashwini K

2015-01-01

An understanding of the functional aspects of gait and balance has wide ramifications. Individuals with balance disorders often restrict physical activity, travel, and social commitments to avoid falling, and loss of balance confidence, itself, is a source of disability. We studied the functional aspects of gait in patients with essential tremor (ET), placing their findings within the context of two other neurological disorders (Parkinson's disease [PD] and dystonia) and comparing them with age-matched controls. We administered the six-item Activities of Balance Confidence (ABC-6) Scale and collected data on number of falls and near-falls, and use of walking aids in 422 participants (126 ET, 77 PD, 46 dystonia, 173 controls). Balance confidence was lowest in PD, intermediate in ET, and relatively preserved in dystonia compared with controls. This ordering reoccurred for each of the six ABC-6 items. The number of near-falls and falls followed a similar ordering. Use of canes, walkers, and wheelchairs was elevated in ET and even greater in PD. Several measures of balance confidence (ABC-6 items 1, 4, 5, and 6) were lower in torticollis cases than in those with blepharospasm, although the two groups did not differ with respect to falls or use of walking aids. Lower balance confidence, increased falls, and greater need for walking aids are variably features of a range of movement disorder patients compared to age-matched controls. While most marked among PD patients, these issues affected ET patients as well and, to a small degree, some patients with dystonia.

Correlation between familial cancer history and epidermal growth factor receptor mutations in Taiwanese never smokers with non-small cell lung cancer: a case-control study.

Science.gov (United States)

Cheng, Po-Chung; Cheng, Yun-Chung

2015-03-01

Lung cancer is a leading cause of cancer deaths in the world. Cigarette smoking remains a prominent risk factor, but lung cancer incidence has been increasing in never smokers. Genetic abnormalities including epidermal growth factor receptor (EGFR) mutations predominate in never smoking lung cancer patients. Furthermore, familial aggregations of patients with these mutations reflect heritable susceptibility to lung cancer. The correlation between familial cancer history and EGFR mutations in never smokers with lung cancer requires investigation. This was a retrospective case-control study that evaluated the prevalence of EGFR mutations in lung cancer patients with familial cancer history. Never smokers with lung cancer treated at a hospital in Taiwan between April 2012 and May 2014 were evaluated. Inclusion criteria were never smokers with non-small cell lung cancer (NSCLC). Exclusion criteria involved patients without records of familial cancer history or tumor genotype. This study included 246 never smokers with lung cancer. The study population mainly involved never smoking women with a mean age of 60 years, and the predominant tumor histology was adenocarcinoma. Lung cancer patients with familial cancer history had an increased prevalence of EGFR mutations compared to patients without family history [odds ratio (OR): 5.9; 95% confidence interval (CI): 3.3-10.6; Pnon-pulmonary cancers (OR: 5.0; 95% CI: 2.5-10.0; Pnever smoking lung cancer patients with familial cancer history. Moreover, a sizable proportion of never smoking cancer patients harbored these mutations. These observations have implications for the treatment of lung cancer in never smokers.

[Three Cases of Unresectable, Advanced, and Recurrent Colorectal Cancer Associated with Gastrointestinal Obstruction That Were Treated with Small Intestine-Transverse Colon Bypass Surgery].

Science.gov (United States)

Ida, Arika; Miyaki, Akira; Miyauchi, Tatsuomi; Yamaguchi, Kentaro; Naritaka, Yoshihiko

2016-11-01

Herein, we report 3cases of unresectable, advanced, and recurrent colorectal cancer associated with gastrointestinal obstruction. The patients were treated with small intestine-transverse colon bypass surgery, which improved the quality of life (QOL)in all cases. Case 1 was an 80-year-old woman who presented with subileus due to ascending colon cancer. After surgery, her oral intake was reestablished, and she was discharged home. Case 2 was an 89-year-old woman whose ileus was caused by cecal cancer with multiple hepatic metastases. After surgery, the patient was discharged to a care facility. Case 3 was an 83-year-old man whose ileus was caused by a local recurrence and small intestine infiltration after surgery for rectosigmoid cancer. He underwent surgery after a colonic stent was inserted. His oral intake was re-established and he was discharged home. Small bowel-transverse colon bypass surgery can be used to manage various conditions rostral to the transverse colon. It is still possible to perform investigations in patients whose general condition is poorer than that of patients who undergo resection of the primary lesion. This avoids creating an artificial anus and allows continuation of oral intake, which are useful for improving QOL in terminal cases.

Marketing in Small Firms: The Case of Slovenia

Directory of Open Access Journals (Sweden)

Mateja Bodlaj

2014-09-01

Full Text Available The purpose of this paper is to obtain a better understanding of how marketing is understood and practised by Slovenian small companies. Semi-structured, in-depth interviews were conducted with 25 small firm owners/managers. The main findings of our exploratory study suggest that the marketing style of Slovenian small firms is presumably similar to that of their Western counterparts. Marketing tends to be narrowly understood as tactics/methods (most often as being synonymous with advertising, with no person particularly responsible for it. Marketing plans often exist only in the heads of the owners/managers and usually have a short-term focus with very broadly defined objectives.

Performance improvement of small-scale rotors by passive blade twist control

OpenAIRE

Lv, Peng; Prothin, Sebastien; Mohd Zawawi, Fazila; Bénard, Emmanuel; Morlier, Joseph; Moschetta, Jean-Marc

2015-01-01

A passive twist control is proposed as an adaptive way to maximize the overall efficiency of the small-scale rotor blade for multifunctional aircrafts. Incorporated into a database of airfoil characteristics, Blade Element Momentum Theory is implemented to obtain the blade optimum twist rates for hover and forward flight. In order to realize the required torsion of blade between hover and forward flight, glass/epoxy laminate blade is proposed based on Centrifugal Force Induced Twist concept. ...

A new controllable damper with neuro controller

International Nuclear Information System (INIS)

Kobayashi, N.; Kobayashi, H.; Saito, O.; Yokoi, R.; Morishita, S.

1993-01-01

A new controllable damper is proposed for suppressing the vibration of the piping system for wide frequency range. Electro-Rheological fluid (ER fluid) is enclosed in the damper casing in place of oil, and the apparent viscosity of ER fluid can be varied by applying electric field strength (E.F.S.), which is controlled by an adaptive neural network controller. The shaking test is conducted about a simplified L-shaped piping model with a prototype controllable damper. The test results show the effectiveness of the presented controllable damper for suppressing very small amplitude vibration of the piping system. Furthermore an application of neural network is discussed to control E.F.S. of the electrode. (author)

ICT as a new competitive advantage factor – case of small transitional hotel sector

Directory of Open Access Journals (Sweden)

Tanja Mihalic

2013-03-01

Full Text Available This paper studies the information and communication technology (ICT in a small hotel sector at a point in time when the transition towards a full market economy is coming to the end and competitiveness and ICT implementation is gaining on importance. Its main purpose is to study a business potential of this new competitive advantage resource and its productivity paradox. A competitive advantage factor model (CAF model has been proposed and the structural modelling (SEM has been performed on the case of a small transitional Slovenian hotel sector. The study contributes to knowledge on ICT competiveness and ICT productivity paradox in hotel sector. Further, its results hold practical implications for the strategy for hotels operating in small-sized hotel industries in transitional or ICT developing environments. In more concrete terms, research findings indicate that such hotel sectors need to speed the ICT implementation. ICT as such doesn’t directly increase the firm’s profitability, yet there is an indirect positive impact of factor ICT on a firm’s financial performance that emerges through other competitiveness factors, such as differentiation, quality or image, which helps firms to stay competitive on the tourism markets.

Small-Signal Modeling of the PVR-Based AD Scheme and Controller Design for Three-Phase Standalone DG System

DEFF Research Database (Denmark)

Shen, Pan; Han, Yang; Lu, Chang

2016-01-01

This paper presents the small-signal state-space modeling and a new multifunctional multi-loop control strategy for three-phase inverter-based islanded DG systems under unbalanced and/or nonlinear load conditions. The proposed control methodology utilizes the parallel virtual resistance (PVR...... controllers are based on an enhanced proportional resonant (PR) structure to achieve zero steady-state error, and multi-resonant harmonic compensator (MRHC) plus PR controller to prevent low-order load current harmonics to distort the output voltage. The proposed small-signal model of the islanded DG system...... with multi-loop control strategy in the stationary reference frame is presented. Moreover, an enhanced delay compensation (EDC) scheme based on two integrators of the discrete PR controller is presented to improve stability margins with a higher accuracy compared with the existing methods. Then, a detailed...

An optimization strategy for the control of small capacity heat pump integrated air-conditioning system

International Nuclear Information System (INIS)

Gao, Jiajia; Huang, Gongsheng; Xu, Xinhua

2016-01-01

Highlights: • An optimization strategy for a small-scale air-conditioning system is developed. • The optimization strategy aims at optimizing the overall system energy consumption. • The strategy may guarantee the robust control of the space air temperature. • The performance of the optimization strategy was tested on a simulation platform. - Abstract: This paper studies the optimization of a small-scale central air-conditioning system, in which the cooling is provided by a ground source heat pump (GSHP) equipped with an on/off capacity control. The optimization strategy aims to optimize the overall system energy consumption and simultaneously guarantee the robustness of the space air temperature control without violating the allowed GSHP maximum start-ups number per hour specified by customers. The set-point of the chilled water return temperature and the width of the water temperature control band are used as the decision variables for the optimization. The performance of the proposed strategy was tested on a simulation platform. Results show that the optimization strategy can save the energy consumption by 9.59% in a typical spring day and 2.97% in a typical summer day. Meanwhile it is able to enhance the space air temperature control robustness when compared with a basic control strategy without optimization.

Identifying risk factors for blindness from primary open-angle glaucoma by race: a case-control study.

Science.gov (United States)

Williams, Andrew M; Huang, Wei; Muir, Kelly W; Stinnett, Sandra S; Stone, Jordan S; Rosdahl, Jullia A

2018-01-01

To examine the factors associated with blindness from primary open-angle glaucoma (POAG) among black and white patients at our institution. For this retrospective, case-control study, patients legally blind from POAG ("cases") were matched on age, race, and gender with non-blind POAG patients ("controls"). Thirty-seven black case-control pairs and 19 white case-control pairs were included in this study. Clinical variables were compared at initial presentation and over the course of follow-up. Black case-control pairs and white case-control pairs had similar characteristics at presentation, including cup-to-disc ratio and number of glaucoma medications. However, over the course of follow-up, black cases underwent significantly more glaucoma surgeries than matched controls (2.4 versus 1.2, p =0.001), whereas white cases and controls had no significant difference in glaucoma operations (0.9 versus 0.6, p =0.139). Our analysis found that glaucoma surgery is associated with blindness in black patients (odds ratio [OR] 1.6, 95% CI 1.1-2.2) but not in white patients (OR 1.5, 95% CI 0.7-3.2). Black and white case-control pairs with POAG shared similar risk factors for blindness at presentation. However, over the follow-up period, black cases required significantly more glaucoma surgeries compared to black controls, whereas there was no significant difference in surgery between white cases and controls. There was no difference in medication changes in either case-control set.

External radiotherapy prior to thyroid cancer: A case-control study

International Nuclear Information System (INIS)

Hallquist, A.; Loefroth, P.O.; Hardell, L.

1993-01-01

The aim of this investigation was to study previous radiotherapy of malignant diseases as a risk factor for thyroid cancer. By using the Swedish Cancer Registry all cases of thyroid cancer with another malignant disease at least one year previously and living within the catchment area of the hospital were traced. During 1959-1989 a total of 1056 cases of thyroid cancer were identified. Of these, 37 had had another previous malignant disease and they constituted the cases in this study. As controls four persons with at least two malignant diseases, thyroid cancer excluded, were selected for each case from the same cancer registry. Ten (27.0%) of the 37 patients with thyroid cancer as a second tumor had earlier been irradiated with the treatment dose including the thyroid gland as compared with 34 (24.5%) of the 139 control patients. Eight of the ten cases with previous irradiation of the thyroid gland had papillary cancer. The median latency was 13 years. The estimated radiation dose in the thyroid varied between 3 and 40 Gy. External radiotherapy gave a crude odds ratio of 1.1 with 95% confidence interval = 0.5-2.8 for thyroid cancer. The weighted odds ratio was calculated to 2.3 with confidence interval = 0.5-8.9. This case-control study gave a nonsignificantly increased odds ratio for thyroid cancer in patients with external radiotherapy including the thyroid gland. 26 refs., 4 tabs

Risk Factors for DOTS Treatment Default Among New HIV-TB Coinfected Patients in Nalgonda (Dist.) Telangana (State): A Case Control Study.

Science.gov (United States)

Reddy Satti, Siva Balaji; Kondagunta, Nagaraj

2016-01-01

The therapeutic regimens as recommended by the Revised National TB Control Programme (RNTCP) have been shown to be highly effective for both preventing and treating tuberculosis, but poor adherence to medication is a major barrier to its global control. The study was conducted to assess the influence of patient related factors for DOTS Treatment Default among HIV-TB Co-infected cases. This was a case control study conducted in Nalgond, Telangana. All new HIV-TB coinfected and DOTS-defaulted patients registered under RNTCP for the period from January 2010 to December 2012 were selected. Of the 154 patients, 23 had died and 11 could not be traced, and these were excluded. Thus the total number of available cases were 120 for those age- and sex-matched controls (HIV-TB coinfected patients and those who had completed the DOTS regimen successfully) were selected. The mean age was 36.5 ± 9 years; the majority (23.3%) of patients defaulted during the second month of treatment. Significant risk factors associated with defaulting included unskilled occupation [adjusted odds ratio (AOR: 3.56; 95% confidence interval (CI): 1.1-11.56], lower middle class socioeconomic status (AOR: 17.16; 95% CI: 3.93-74.82), small family size (AOR: 21.3; 95% CI: 6.4-70.91), marital disharmony (AOR: 6.78; 95% CI: 1.93-23.76), not being satisfied with the conduct of health personnel (AOR: 7.38; 95% CI: 2.32-23.39), smoking (AOR: 8.5; 95% CI: 2.31-31.21), and side effects of drugs (AOR: 4.18; 95% CI: 1.35-12.9). Unskilled occupation, marital disharmony, small family size, lower middle class socioeconomic status, not being satisfied with the conduct of health personnel, smoking, and drug side effects were significantly associated with defaulting. Information on the pattern of tuberculosis (TB), the outcome of anti-tuberculosis treatment (ATT), and the factors associated with it will help in planning interventions to improve adherence to DOTS treatment.

Radon and Lung Cancer Case-Control Study in Middle Ural

International Nuclear Information System (INIS)

Kirdin, I.A.; Lezhnin, V.L.; Yarmoshenko, I.V.; Ekidin, A.

2001-01-01

Full text: The pilot phase of radon and lung cancer case-control study has been performed in Karpinsk and Pervouralsk towns of Middle Ural region of Russia. The case group consists of 341 persons with lung cancer and living in that towns at least five previous years. The lung cancer diagnoses were carefully verified by instrumental techniques and 70% of its were morphologically validated. The persons for the control group (448) were chosen from the population living in that towns at least five years taking into account the age and sex. The special epidemiological questionnaire was developed which includes the items by the groups of factors as follow: clinical data, social factors, chronic lung diseases, life habit, tobacco smoking, alcohol drinking, diet preference etc. The epidemiological questionnaires were fulfilled for each member of case and control groups. Radon gas concentration and thoron equilibrium equivalent concentration measurements had been performed using nuclear track detectors and grab sampling accordingly in the dwellings of case and control groups members. By preliminary estimation the odds ratios are 1, 0.91, 1.2, 1.1 in the ranges of radon and thoron equilibrium equivalent concentration 0-6, 3-13, 13-36 and 36-370 Bq/m 3 respectively. The deeper and more rigorous analysis as well as different independent approaches will be discussed in the paper.(author)

Exposure to pistachio pesticides and stillbirth: a case-control study.