Spare parts sharing with joint optimization of maintenance and inventory policies

DEFF Research Database (Denmark)

Larsen, Christian; Wong, Hartanto Wijaya; Nielsen, Lars Relund

We consider a collaborative arrangement where a number of companies are willing to share expensive spare parts, required for both failure replacement and preventive maintenance purposes. We develop a discrete-time Markov decision model for the joint optimization of maintenance and spare parts...

Stochastic model of forecasting spare parts demand

Directory of Open Access Journals (Sweden)

Ivan S. Milojević

2012-01-01

hypothesis of the existence of phenomenon change trends, the next step in the methodology of forecasting is the determination of a specific growth curve that describes the regularity of the development in time. These curves of growth are obtained by the analytical representation (expression of dynamic lines. There are two basic stages in the process of expression and they are: - The choice of the type of curve the shape of which corresponds to the character of the dynamic order variation - the determination of the number of values (evaluation of the curve parameters. The most widespread method of forecasting is the trend extrapolation. The basis of the trend extrapolation is the continuing of past trends in the future. The simplicity of the trend extrapolation process, on the one hand, and the absence of other information on the other hand, are the main reasons why the trend extrapolation is used for forecasting. The trend extrapolation is founded on the following assumptions: - The phenomenon development can be presented as an evolutionary trajectory or trend, - General conditions that influenced the trend development in the past will not undergo substantial changes in the future. Spare parts demand forecasting is constantly being done in all warehouses, workshops, and at all levels. Without demand forecasting, neither planning nor decision making can be done. Demand forecasting is the input for determining the level of reserve, size of the order, ordering cycles, etc. The question that arises is the one of the reliability and accuracy of a forecast and its effects. Forecasting 'by feeling' is not to be dismissed if there is nothing better, but in this case, one must be prepared for forecasting failures that cause unnecessary accumulation of certain spare parts, and also a chronic shortage of other spare parts. All this significantly increases costs and does not provide a satisfactory supply of spare parts. The main problem of the application of this model is that each

Sistem Pendukung Keputusan Pengalokasian Spare Part

Directory of Open Access Journals (Sweden)

Rita Wiryasaputra

2013-01-01

Full Text Available Abstrak Era informasi yang semakin berkembang mempengaruhi lingkungan bisnis. Pengaruhnya dapat dilihat pada proses pengambilan keputusan. Proses pengambilan keputusan terhadap sejumlah alternatif dan sejumlah tujuan diselesaikan dengan sebuah sistem. Sistem  yang bermodelkan Multi Attribute Decision Making (MADM dan Multi Objective Decision Making (MODM. Model MODM digunakan untuk menyelesaikan perancangan alternatif terbaik dan model MADM digunakan untuk menyelesaikan penyeleksian terhadap beberapa alternatif dalam jumlah yang terbatas. Salah satu pendekatan model MADM adalah TOPSIS (Technique for Order Preference by Similarity to Ideal Solution. Konsep utama TOPSIS adalah alternatif preferensi terbaik memiliki jarak terpendek dari solusi ideal positif dan memiliki jarak terjauh dari solusi ideal negatif. Hasil metode TOPSIS adalah perankingan terhadap sejumlah alternatif. Salah satu masukan dari metode TOPSIS adalah nilai pembobotan kriteria. Nilai pembobotan kriteria dapat diberikan secara langsung oleh pengambil keputusan atau dihitung melalui sebuah metode. Penelitian akan menghitung nilai pembobotan kriteria dengan metode Entropy. Tujuannya adalah untuk memberikan objektifitas pembobotan kriteria. Penelitian mengangkat kasus tentang pengalokasian spare part ke sejumlah store. Alternatif terbaik dengan sumber daya yang terbatas, beberapa tujuan yang saling bertentangan didekati dengan metode Goal programming. Pengambilan keputusan akan lebih terarah karena sistem menghasilkan perankingan store spare part, dan menampilkan  informasi alokasi spare part.   Kata kunci— Sistem Pendukung Keputusan, Entropy, TOPSIS, Goal Programming   Abstract The capabilities of computrized systems facilitate decision support in a number of ways, such as speed computations, increased productivity ,improved data management and others. Decisions are often made by individuals. There may be conflicting objectives even for a  decision maker. The conflicting

The spares provisioning problem with parts inventory

OpenAIRE

Abboud, Nadim E.

1990-01-01

In this research, we consider the spares provisioning problem, where a finite population of homogeneous machines are being deployed to meet a constant demand. While a machine is operating, it could become inoperable due to the failure of a critical built-in part in the machine. Before repairs on the machine can be initiated, however, a replacement part must be obtained. If a replacement part is available from stock, the machine is immediately transferred to the repair subsystem...

An improved method for forecasting spare parts demand using extreme value theory

NARCIS (Netherlands)

Zhu, S.; Dekker, R.; van Jaarsveld, W.; Renjie, R.W.; Koning, A.J.

2017-01-01

Inventory control for spare parts is essential for many organizations due to the trade-off between preventing high holding cost and stockouts. The lead time demand distribution plays a central role in inventory control. The estimation of this distribution is problematic as the spare part demand is

Optimal provisioning strategies for slow moving spare parts with small lead times

NARCIS (Netherlands)

Teunter, R.H.; Klein Haneveld, W.K.

When an expensive piece of equipment is bought, spare parts can often be bought at a reduced price. A decision must be made about the initial provisioning of spare parts. Furthermore, if at a certain time the stock drops to zero, because a number of failures have occurred, a decision must be made

Critical spare parts ordering decisions using conditional reliability and stochastic lead time

International Nuclear Information System (INIS)

Godoy, David R.; Pascual, Rodrigo; Knights, Peter

2013-01-01

Asset-intensive companies face great pressure to reduce operation costs and increase utilization. This scenario often leads to over-stress on critical equipment and its spare parts associated, affecting availability, reliability, and system performance. As these resources impact considerably on financial and operational structures, the opportunity is given by demand for decision-making methods for the management of spare parts processes. We proposed an ordering decision-aid technique which uses a measurement of spare performance, based on the stress–strength interference theory; which we have called Condition-Based Service Level (CBSL). We focus on Condition Managed Critical Spares (CMS), namely, spares which are expensive, highly reliable, with higher lead times, and are not available in store. As a mitigation measure, CMS are under condition monitoring. The aim of the paper is orienting the decision time for CMS ordering or just continuing the operation. The paper presents a graphic technique which considers a rule for decision based on both condition-based reliability function and a stochastic/fixed lead time. For the stochastic lead time case, results show that technique is effective to determine the time when the system operation is reliable and can withstand the lead time variability, satisfying a desired service level. Additionally, for the constant lead time case, the technique helps to define insurance spares. In conclusion, presented ordering decision rule is useful to asset managers for enhancing the operational continuity affected by spare parts

Spare-parts and perpetuity of equipment in French PWR plants

International Nuclear Information System (INIS)

Briolat, R.

1993-01-01

Supply of plants with new or repaired parts in strict quality conditions aids maintaining safety in operation and energy availability. Taking into account their expected life-time, a process of perpetuity in partnership with suppliers is necessary to ensure operation for the medium and long term. At EDF, the method involves a classification of mechanical and electrical spare parts in two levels of quality, responding to safety and availability imperatives and current available industrial practices. A diagram is presented to define optimal strategy for each equipment component, which gives choice between spare part storage, longevity agreement with the supplier, or a technology transfer agreement. 1 tab

Model of delivery consolidation of critical spare part : case study of an oil and gas company

Science.gov (United States)

Hartanto, D.; Agustinita, A.

2018-04-01

The availability of spare parts in oil and gas industry is very important to prevent the occurrence of very high opportunity cost, that is the loss caused by exploitation equipment which must stop because of unavailability of the spare part. This is done by providing safety stock with a very high service level that leads to high inventory costs. If the company wants to lower inventory costs, the choices are not to lower the service level but to lower the ordering cost. One of the components of ordering cost is the delivery cost. Exploitation facilities are usually located in remote areas so that the cost of delivery is high. In addition, many spare parts are supplied by the same supplier. Therefore, there is an opportunity to lower the cost of delivery of spare parts by consolidation. In this paper,mixed integer linear programming (MILP) model is developed to plan the procurement of spare parts so that inventory costs which include holding and ordering cost for spare parts can be minimized. The model has been verified and validated. Using this model the company can lower inventory costs of the spare part by 32%.

Multiobjective spare part allocation by means of genetic algorithms and Monte Carlo simulation

International Nuclear Information System (INIS)

Marseguerra, Marzio; Zio, Enrico; Podofillini, Luca

2005-01-01

The management of spare parts is a major concern for several industrial organizations, due to the significant amount of resources invested every year for holding spares inventories. In this paper, we explore the possibility of using genetic algorithms for the task of optimizing the number of spare parts required by a multi-component system. To address the question of how many spares should be kept in inventory for each component kind, the analyst is required to define objective functions with respect to which the optimization is sought. In our work we will look at multiple objectives such as, for example, the maximization of system revenues and the minimization of the total spares volume. The modeling of the system failure, repair and replacement stochastic processes is done by means of Monte Carlo simulation, whose flexibility allows a closer adherence to reality

Joint Optimization of Preventive Maintenance and Spare Parts Inventory with Appointment Policy

Directory of Open Access Journals (Sweden)

Jing Cai

2017-01-01

Full Text Available Under the background of the wide application of condition-based maintenance (CBM in maintenance practice, the joint optimization of maintenance and spare parts inventory is becoming a hot research to take full advantage of CBM and reduce the operational cost. In order to avoid both the high inventory level and the shortage of spare parts, an appointment policy of spare parts is first proposed based on the prediction of remaining useful lifetime, and then a corresponding joint optimization model of preventive maintenance and spare parts inventory is established. Due to the complexity of the model, the combination method of genetic algorithm and Monte Carlo is presented to get the optimal maximum inventory level, safety inventory level, potential failure threshold, and appointment threshold to minimize the cost rate. Finally, the proposed model is studied through a case study and compared with both the separate optimization and the joint optimization without appointment policy, and the results show that the proposed model is more effective. In addition, the sensitivity analysis shows that the proposed model is consistent with the actual situation of maintenance practices and inventory management.

A critical spare part inventory control based on hazard function approach: A case study in a garment company

Science.gov (United States)

Melinda, Intan Dewi; Jauhari, Wakhid Ahmad

2018-02-01

Spare part procurement is a complex issue and requires an accurate analysis. Stock outs of spare part can leads a great impact on production. Therefore, it is necessary to design the inventory control of spare parts that guarantee the availability of spare parts needed for supporting the maintenance activity. This paper studies the inventory policy for sewing machine spare part using hazard function to approximate the demand. Hazard function is the indicator of the effect of ageing on the reliability of the system. It quantifies the risk of failure as the age of the system increases. We use a continuous review policy based on Hadley Within Approach to calculate the optimum inventory level for critical spare parts. There are four spare parts categorized as critical spare parts, which are needle plate, feed dog, rotary and binder attachment. The optimal ordering quantity for needle plate, feed, rotary and binder attachment are 5 units, 17 units, 5 units, and 9 units, respectively and the reorder point are 2 units, 1 unit, 2 units and 1 unit, respectively. Finally, the service level achieved by the proposed policy is in a range of 95.91%-97.93%, which indicates that the inventory level of spare parts can be used to support the required parts in the maintenance activity.

Additive manufacturing technology in spare parts supply chain

DEFF Research Database (Denmark)

Li, Yao; Jia, Guozhu; Yang, Cheng

2017-01-01

Additive Manufacturing (AM) technology has the potential to significantly improve supply chain dynamics. The purpose of this paper is to investigate the impact of AM on spare parts supply chain. Three supply chain scenarios are investigated in this paper, namely conventional supply chain...

Spare parts inventory control under system availability constraints

NARCIS (Netherlands)

Houtum, van G.J.J.A.N.; Kranenburg, A.A.

2015-01-01

This book focuses on the tactical planning level for spare parts management. It describes a series of multi-item inventory models and presents exact and heuristic optimization methods, including greedy heuristics that work well for real, life-sized problems. The intended audience consists of

Linking the spare parts management with the total costs of ownership: An agenda for future research

Directory of Open Access Journals (Sweden)

Orlando Duran

2016-12-01

Full Text Available Purpose: This manuscript explores the link between Spare Parts Management and Total Costs of Ownership or Life Cycle Costs (LCC. Design/methodology/approach: First, this work enumerates the different managerial decisions instances in spare parts management that are present during the life cycle of a physical asset. Second, we analyse how those decision instances could affect the TCO of a physical asset (from the economic point of view. Finally, we propose a conceptual framework for incorporating the spare parts management into a TCO model. Findings: The recent literature lacks discussions on the integration of spare parts management with the Total Costs of Ownership (TCO. Based in an extensive literature revision we can declare that the computation of costs related to spare parts management has been neglected by TCO models. Originality/value: The contribution of this paper is twofold. First, a literature review and identification of a series of spare parts management decision instances and its relationship with TCOs is presented in this paper. Second, a conceptual framework is suggested for linking those decisions instances to a total cost of ownership perspective. Some research questions and future research challenges are presented at the end of this work.

Linking the spare parts management with the total costs of ownership: An agenda for future research

International Nuclear Information System (INIS)

Duran, O.; Roda, I.; Macchi, M.

2016-01-01

Purpose: This manuscript explores the link between Spare Parts Management and Total Costs of Ownership or Life Cycle Costs (LCC). Design/methodology/approach: First, this work enumerates the different managerial decisions instances in spare parts management that are present during the life cycle of a physical asset. Second, we analyse how those decision instances could affect the TCO of a physical asset (from the economic point of view). Finally, we propose a conceptual framework for incorporating the spare parts management into a TCO model. Findings: The recent literature lacks discussions on the integration of spare parts management with the Total Costs of Ownership (TCO). Based in an extensive literature revision we can declare that the computation of costs related to spare parts management has been neglected by TCO models. Originality/value: The contribution of this paper is twofold. First, a literature review and identification of a series of spare parts management decision instances and its relationship with TCOs is presented in this paper. Second, a conceptual framework is suggested for linking those decisions instances to a total cost of ownership perspective. Some research questions and future research challenges are presented at the end of this work.

Linking the spare parts management with the total costs of ownership: An agenda for future research

Energy Technology Data Exchange (ETDEWEB)

Duran, O.; Roda, I.; Macchi, M.

2016-07-01

Purpose: This manuscript explores the link between Spare Parts Management and Total Costs of Ownership or Life Cycle Costs (LCC). Design/methodology/approach: First, this work enumerates the different managerial decisions instances in spare parts management that are present during the life cycle of a physical asset. Second, we analyse how those decision instances could affect the TCO of a physical asset (from the economic point of view). Finally, we propose a conceptual framework for incorporating the spare parts management into a TCO model. Findings: The recent literature lacks discussions on the integration of spare parts management with the Total Costs of Ownership (TCO). Based in an extensive literature revision we can declare that the computation of costs related to spare parts management has been neglected by TCO models. Originality/value: The contribution of this paper is twofold. First, a literature review and identification of a series of spare parts management decision instances and its relationship with TCOs is presented in this paper. Second, a conceptual framework is suggested for linking those decisions instances to a total cost of ownership perspective. Some research questions and future research challenges are presented at the end of this work.

Spare parts management for nuclear power generation facilities

Science.gov (United States)

Scala, Natalie Michele

With deregulation, utilities in the power sector face a much more urgent imperative to emphasize cost efficiencies as compared to the days of regulation. One major opportunity for cost savings is through reductions in spare parts inventories. Most utilities are accustomed to carrying large volumes of expensive, relatively slow-moving parts because of a high degree of risk-averseness. This attitude towards risk is rooted in the days of regulation. Under regulation, companies recovered capital inventory costs by incorporating them into the base rate charged to their customers. In a deregulated environment, cost recovery is no longer guaranteed. Companies must therefore reexamine their risk profile and develop policies for spare parts inventory that are appropriate for a competitive business environment. This research studies the spare parts inventory management problem in the context of electric utilities, with a focus on nuclear power. It addresses three issues related to this problem: criticality, risk, and policy. With respect to criticality and risk, a methodology is presented that incorporates the use of influence diagrams and the Analytic Hierarchy Process (AHP). A new method is developed for group aggregation in the AHP when Saaty and Vargas' (2007) dispersion test fails and decision makers are unwilling or unable to revise their judgments. With respect to policy, a quantitative model that ranks the importance of keeping a part in inventory and recommends a corresponding stocking policy through the use of numerical simulation is developed. This methodology and its corresponding models will enable utilities that have transitioned from a regulated to a deregulated environment become more competitive in their operations while maintaining safety and reliability standards. Furthermore, the methodology developed is general enough so that other utility plants, especially those in the nuclear sector, will be able to use this approach. In addition to regulated

Management of spare parts in the obsolescence of equipment. Experiences of TECNATOM

Energy Technology Data Exchange (ETDEWEB)

Martin Frances, Antonio [Spares Engineering, TECNATOM, Ave. Montes de Oca 1, 28709, Madrid (Spain)

2010-07-01

Since 1957, Tecnatom is giving engineering specialized services to the Electric Power Generation Plants. These activities also extend to other industrial areas like aerospace sector. TECNATOM it's made up of highly qualified specialists with an extensive experience and dedicated spirit and a pool of young people who interact with them to ensure the continuity of the company as a great team. As an important part of our activities, the 'Spares Engineering', complements the reliability and guarantee of a committed company. Nowadays, because of different reasons, there is a growing problematic in the collection of safety equipment and its spares in the NPPs. Tecnatom has set several actions in motion directed to improve the availability of these equipment and spares, by means of life extension of equipment installed, by means of the development of equipment and spares alternatives to the originals, or by means of services in relation with the spare parts. The actions developed until now have provided satisfactory results in technical and economical terms for the Plants. We have developments at present in course, that we hope they will increase this contribution to solve the problems of obsolescence in NPP's. (authors)

CWT and RWT Metrics Measure the Performance of the Army's Logistics Chain for Spare Parts

National Research Council Canada - National Science Library

2003-01-01

.... Maintaining these weapon systems requires that spare parts be available where and when they are needed. Thus, the responsive functioning of the logistics chain for spare parts is critical to keeping equipment ready to operate...

ERVA - AREVAs Alternative Way for Spare Parts Management

Energy Technology Data Exchange (ETDEWEB)

Hoppe, H.

2014-07-01

The availability of equipment and systems in power plants throughout the life of the plant is a key challenge for plant operators. Therefore, the management of spare parts during the entire life cycle of a plant is of particular importance. In order to maintain the functionality of the equipment without retrofit or re-design it is important to have original parts available for use or to ensure there is adequate stock available for the future. (Author)

Initial Spare Parts of the A400M Aircraft

Science.gov (United States)

2012-03-08

inventory. Therefore, a balance has to be sought between inventory cost and customer service ( Heizer & Render , 2010:500-501). Nevertheless, spare part... Heizer , Jay H. and Barry Render . Principles of Operations Management. Boston: Pearson Education, 2011. Heuninckx, Baudouin. “Availability

Defense Acquisitions: Prices of Marine Corps Spare Parts Have Increased

National Research Council Canada - National Science Library

2000-01-01

...) examine spare part prices to determine whether these were increasing at a rate faster than inflation and the extent to which surcharges, suppliers' prices, and other factors contributed to price increases...

Optimal repairable spare-parts procurement policy under total business volume discount environment

International Nuclear Information System (INIS)

Pascual, Rodrigo; Santelices, Gabriel; Lüer-Villagra, Armin; Vera, Jorge; Cawley, Alejandro Mac

2017-01-01

In asset intensive fields, where components are expensive and high system availability is required, spare parts procurement is often a critical issue. To gain competitiveness and market share is common for vendors to offer Total Business Volume Discounts (TBVD). Accordingly, companies must define the procurement and stocking policy of their spare parts in order to reduce procurement costs and increase asset availability. In response to those needs, this work presents an optimization model that maximizes the availability of the equipment under a TBVD environment, subject to a budget constraint. The model uses a single-echelon structure where parts can be repaired. It determines the optimal number of repairable spare parts to be stocked, giving emphasis on asset availability, procurement costs and service levels as the main decision criteria. A heuristic procedure that achieves high quality solutions in a fast and time-consistent way was implemented to improve the time required to obtain the model solution. Results show that using an optimal procurement policy of spare parts and accounting for TBVD produces better overall results and yields a better availability performance. - Highlights: • We propose a model for procurement of repairable components in single-echelon and business volume discount environments. • We used a mathematical model to develop a competitive heuristic that provides high quality solutions in very short times. • Our model places emphasis on using system availability, procurement costs and service levels as leading decision criteria. • The model can be used as an engine for a multi-criteria Decision Support System.

Connecting inventory control and repair shop control : a differentiated control structure for repairable spare parts

NARCIS (Netherlands)

Driessen, M.A.; Rustenburg, W.D.; Houtum, van G.J.J.A.N.; Wiers, V.C.S.

2014-01-01

This paper presents a control structure for integrating decisions on spare parts inventory control and the control of repair shops for maintenance spare parts. A dierentiated control structure is proposed for the various repair shop types recognized in practice. Decisions functions are mapped and

Multi-echelon, multi-indenture spare parts inventory control subject to system availability and budget constraints

International Nuclear Information System (INIS)

Costantino, Francesco; Di Gravio, Giulio; Tronci, Massimo

2013-01-01

Inventory management of spare parts is one of the most critical issues in the aeronautical industry, given the required level of system availability related to the strategic importance and high stocking costs of the components. Even if a large number of spare parts increases warehousing costs, every single shortage have a greater impact: the adoption of best-in-class inventory management techniques becomes crucial. On these considerations, the paper presents an innovative model of spare parts allocation for the Italian Air Force with the aim of minimizing backorders and, at the same time, ensuring an availability of 99% depending on the actual flight plan. The model, solved by a marginal analysis, considers an original configuration of features combining different skills of maintenance centers in a hierarchical multi-echelon, multi-item, multi-indenture structure. A real case is provided in order to analyze the solving method and the results. -- Highlights: •We studied a problem of allocations for spare parts of aeronautical systems. •The model presents different repair capabilities of maintenance centers. •The model fits constraints on budget and on total operational availability. •The model is solved by a marginal analysis with a backorder/price ratio. •A numerical example shows a spare parts allocation with relative considerations

Service differentiation in spare parts supply through dedicated stocks

NARCIS (Netherlands)

Alvarez, Elisa; van der Heijden, Matthijs C.; Zijm, Willem H.M.

2012-01-01

We investigate keeping dedicated stocks at customer sites in addition to stock kept at some central location as a tool for applying service differentiation in spare parts supply. We study the resulting two-echelon system in a multi-item setting, both under backordering and under emergency shipments

Allotment of aircraft spare parts using genetic alorithms

Directory of Open Access Journals (Sweden)

Batchoun Pascale

2003-01-01

Full Text Available In this paper we attempt to determine the optimal allocation of aircraft parts used as spares for replacement of defective parts on-board of a departing flight. In order to minimize the cost of delay caused by unexpected failure, Genetic algorithms (GAs are used to allocate the initial quantity of parts among the airports. GAs are a class of adaptive search procedures, that distinguish themselves from other optimization techniques by the use of concepts from population genetics to guide the search. Problem-specific knowledge is incorporated into the problem and efficient parameters are identified and tested for the task of optimizing the allocation of parts. The approach is illustrated by numerical results.

Spare parts management for nuclear research reactors [Paper No.: I-14

International Nuclear Information System (INIS)

Kini, M.P.

1981-01-01

Most of the equipment installed at CIRUS and other reactors are imported units. CIRUS reactor is 20 years old and with present problems for obtaining spare parts for this equipment, indigenous effort in procurement has become imperative. In the absence of specifications and drawings for most of the components, the task of indigenous procurement has become quite demanding. The efforts put by Reactor Operations Division of the Bhabha Atomic Research Centre, Bombay in locating local manufacturers who are willing to fabricate in small quantities of spare parts to specifications and the difficulties involved is the theme of this paper. The paper also covers the efforts on equipment replacement, its success and failures. (author)

Ordering decision-making methods on spare parts for a new aircraft fleet based on a two-sample prediction

International Nuclear Information System (INIS)

Yongquan, Sun; Xi, Chen; He, Ren; Yingchao, Jin; Quanwu, Liu

2016-01-01

Ordering decision-making on spare parts is crucial in maximizing aircraft utilization and minimizing total operating cost. Extensive researches on spare parts inventory management and optimal allocation could be found based on the amount of historical operation data or condition-monitoring data. However, it is challengeable to make an ordering decision on spare parts under the case of establishment of a fleet by introducing new aircraft with little historical data. In this paper, spare parts supporting policy and ordering decision-making policy for new aircraft fleet are analyzed firstly. Then two-sample predictions for a Weibull distribution and a Weibull process are incorporated into forecast of the first failure time and failure number during certain time period using Bayesian and classical method respectively, according to which the ordering time and ordering quantity for spare parts are identified. Finally, a case study is presented to illustrate the methods of identifying the ordering time and ordering number of engine-driven pumps through forecasting the failure time and failure number, followed by a discussion on the impact of various fleet sizes on prediction results. This method has the potential to decide the ordering time and quantity of spare parts when a new aircraft fleet is established. - Highlights: • A modeling framework of ordering spare parts for a new fleet is proposed. • Models for ordering time and number are established based on two-sample prediction. • The computation of future failure time is simplified using Newtonian binomial law. • Comparison of the first failure time PDFs is used to identify process parameters. • Identification methods for spare parts are validated by Engine Driven Pump case study.

Spare part management of an electricity distribution network

Energy Technology Data Exchange (ETDEWEB)

Lauronen, J.

1998-07-01

Electricity distribution companies are required to improve their operational cost effectiveness. The storage systems of the companies have traditionally been based on the 'adequate' number of stores with plenty of different components. Therefore, they are potential objects for cost reduction. The effective operation of spare part management of an electricity distribution network requires that the spare components can be delivered at the fault site quickly in order to avoid excessive outage costs. In a fault situation the stores form a net structure. Currently the rural electricity distribution companies lack suitable methods for designing a spare part storage system. This thesis presents a suitable method for the designing problem. The models assume that faults of a distribution network are stochastic. Therefore, they are best suited for component types installed in large quantities. Improved methods for defining the outage, material and total costs for perpetual order quantity and periodic order-up-to-level storage control systems are described. The method for determining the control parameters of the stores is also presented and ways for finding the necessary initial parameter values are introduced. The developed method is tested in Haemeen Saehko Oy (HSOY). The results of the calculations are given. The key findings are: Small differences in the designing results can increase costs remarkably. For example, in HSOY too low stock levels can result in even eight folds higher outage costs than in the proper design. The best number of stores is not the same for all component types. For example, in HSOY the best number of stores is seven for the 50 kVA transformers and one for the 315 kVA transformers in a summer. If the stock levels are increased the protection against the demand variations is the better the shorter the duration of the review period and/or the replenishment lead time is. (orig.)

Spare part management of an electricity distribution network

Energy Technology Data Exchange (ETDEWEB)

Lauronen, J

1998-07-01

Electricity distribution companies are required to improve their operational cost effectiveness. The storage systems of the companies have traditionally been based on the 'adequate' number of stores with plenty of different components. Therefore, they are potential objects for cost reduction. The effective operation of spare part management of an electricity distribution network requires that the spare components can be delivered at the fault site quickly in order to avoid excessive outage costs. In a fault situation the stores form a net structure. Currently the rural electricity distribution companies lack suitable methods for designing a spare part storage system. This thesis presents a suitable method for the designing problem. The models assume that faults of a distribution network are stochastic. Therefore, they are best suited for component types installed in large quantities. Improved methods for defining the outage, material and total costs for perpetual order quantity and periodic order-up-to-level storage control systems are described. The method for determining the control parameters of the stores is also presented and ways for finding the necessary initial parameter values are introduced. The developed method is tested in Haemeen Saehko Oy (HSOY). The results of the calculations are given. The key findings are: Small differences in the designing results can increase costs remarkably. For example, in HSOY too low stock levels can result in even eight folds higher outage costs than in the proper design. The best number of stores is not the same for all component types. For example, in HSOY the best number of stores is seven for the 50 kVA transformers and one for the 315 kVA transformers in a summer. If the stock levels are increased the protection against the demand variations is the better the shorter the duration of the review period and/or the replenishment lead time is. (orig.)

Inventory-transportation integrated optimization for maintenance spare parts of high-speed trains

Science.gov (United States)

Wang, Jiaxi; Wang, Huasheng; Wang, Zhongkai; Li, Jian; Lin, Ruixi; Xiao, Jie; Wu, Jianping

2017-01-01

This paper presents a 0–1 programming model aimed at obtaining the optimal inventory policy and transportation mode for maintenance spare parts of high-speed trains. To obtain the model parameters for occasionally-replaced spare parts, a demand estimation method based on the maintenance strategies of China’s high-speed railway system is proposed. In addition, we analyse the shortage time using PERT, and then calculate the unit time shortage cost from the viewpoint of train operation revenue. Finally, a real-world case study from Shanghai Depot is conducted to demonstrate our method. Computational results offer an effective and efficient decision support for inventory managers. PMID:28472097

A joint spare part and maintenance inspection optimisation model using the Delay-Time concept

International Nuclear Information System (INIS)

Wang Wenbin

2011-01-01

Spare parts and maintenance are closely related logistics activities where maintenance generates the need for spare parts. When preventive maintenance is present, it may need more spare parts at one time because of the planned preventive maintenance activities. This paper considers the joint optimisation of three decision variables, e.g., the ordering quantity, ordering interval and inspection interval. The model is constructed using the well-known Delay-Time concept where the failure process is divided into a two-stage process. The objective function is the long run expected cost per unit time in terms of the three decision variables to be optimised. Here we use a block-based inspection policy where all components are inspected at the same time regardless of the ages of the components. This creates a situation that the time to failure since the immediate previous inspection is random and has to be modelled by a distribution. This time is called the forward time and a limiting but closed form of such distribution is obtained. We develop an algorithm for the optimal solution of the decision process using a combination of analytical and enumeration approaches. The model is demonstrated by a numerical example. - Highlights: → Joint optimisation of maintenance and spare part inventory. → The use of the Delay-Time concept. → Block-based inspection. → Fixed order interval but variable order quantity.

Deterministic and heuristic models of forecasting spare parts demand

Directory of Open Access Journals (Sweden)

Ivan S. Milojević

2012-04-01

Full Text Available Knowing the demand of spare parts is the basis for successful spare parts inventory management. Inventory management has two aspects. The first one is operational management: acting according to certain models and making decisions in specific situations which could not have been foreseen or have not been encompassed by models. The second aspect is optimization of the model parameters by means of inventory management. Supply items demand (asset demand is the expression of customers' needs in units in the desired time and it is one of the most important parameters in the inventory management. The basic task of the supply system is demand fulfillment. In practice, demand is expressed through requisition or request. Given the conditions in which inventory management is considered, demand can be: - deterministic or stochastic, - stationary or nonstationary, - continuous or discrete, - satisfied or unsatisfied. The application of the maintenance concept is determined by the technological level of development of the assets being maintained. For example, it is hard to imagine that the concept of self-maintenance can be applied to assets developed and put into use 50 or 60 years ago. Even less complex concepts cannot be applied to those vehicles that only have indicators of engine temperature - those that react only when the engine is overheated. This means that the maintenance concepts that can be applied are the traditional preventive maintenance and the corrective maintenance. In order to be applied in a real system, modeling and simulation methods require a completely regulated system and that is not the case with this spare parts supply system. Therefore, this method, which also enables the model development, cannot be applied. Deterministic models of forecasting are almost exclusively related to the concept of preventive maintenance. Maintenance procedures are planned in advance, in accordance with exploitation and time resources. Since the timing

Information system design of inventory control spare parts maintenance (valuation class 5000) (case study: plant kw)

Science.gov (United States)

Fitriana, Rina; Moengin, Parwadi; Riana, Mega

2016-02-01

Plat KW hadn't using optimal inventory level planning yet and hadn't have an information system that well computerized. The research objective is to be able to design an information system related inventory control of spare parts maintenance. The study focused on five types of spare parts with the highest application rate during February 2013- March 2015 and included in the classification of fast on FSN analysis Grinding stones Cut 4". Cable Tie 15". Welding RB 26-32MM. Ring Plat ½" and Ring Plate 5/8 ". Inventory calculation used Economic Order Quantity (EOQ). Safety Stock (SS) and Reorder Point (ROP) methods. System analysis conducted using the framework PIECES with the proposed inventory control system. the performance of the plant KW relating to the supply of spare parts maintenance needs can be more efficient as well as problems at the company can be answered and can perform inventory cost savings amounting Rp.267.066. A computerized information system of inventory control spare parts maintenance provides a menu that can be accessed by each departments as the user needed.

Joint optimisation of spare part inventory, maintenance frequency and repair capacity for k-out-of-N systems

NARCIS (Netherlands)

de Smidt-Destombes, Karin S.; van der Heijden, Matthijs C.; van Harten, Aart

2009-01-01

To achieve a high system availability at minimal costs, relevant decisions include the choice of preventive maintenance frequency, spare part inventory levels and spare part repair capacity. We develop heuristics for the joint optimisation of these variables for (a) a single k-out-of-N system under

Joint optimization of preventive maintenance and spare parts inventory for an optimal production plan with consideration of CO_2 emission

International Nuclear Information System (INIS)

Ba, Kader; Dellagi, Sofiene; Rezg, Nidhal; Erray, Walid

2016-01-01

This article presents a joint optimization of spare parts inventory and preventive maintenance. While minimizing CO_2 emissions, this approach is based on an optimal production plan achieved thanks to the HMMS model. The process which is studied in this paper only manufactures one type of product. The purpose of the paper is to determine for a random demand over a given period, a cost-effective production plan and a maintenance policy which integrates a spare parts strategy in accordance with environmental requirements and regulations. Our green spare parts management can be defined as a set of actions that are applied in order to decrease the spare parts footprint in its lifetime (Ba et al., 2015) [1]. Indeed, we take into account the spare parts characteristics (new or used) which will be used during maintenance actions (preventive or corrective) to preserve the environment. Consequently, we set up analytical models based on the effect of the production rate on the system deterioration so as to substantially cut the maintenance costs, production costs and CO_2 emissions. To evaluate the performance of our models, we give some illustrative examples. - Highlights: • Establishment of an optimal production plan for a manufacturing process. • Cost-effective maintenance strategy with a green spare parts strategy. • Possibility to choose between used and new spare parts to execute maintenance action.

Assessing End-Of-Supply Risk of Spare Parts Using the Proportional Hazard Model

NARCIS (Netherlands)

X. Li (Xishu); R. Dekker (Rommert); C. Heij (Christiaan); M. Hekimoğlu (Mustafa)

2016-01-01

textabstractOperators of long field-life systems like airplanes are faced with hazards in the supply of spare parts. If the original manufacturers or suppliers of parts end their supply, this may have large impacts on operating costs of firms needing these parts. Existing end-of-supply evaluation

Testing the Logistics Model of Supplying Military Vehicles with Spare Parts

Directory of Open Access Journals (Sweden)

Robert Spudić

2007-07-01

Full Text Available The use of advanced transport means understands alsotheir supply by spare and consumable parts. In order to solvethe problem of the required quantities, costs of purchase andstorage of the parts, it is necessary to solve the problem of stocksmanagement. The wear of tyres for military vehicles in extremeexploitation conditions is of random character. How fast thetyres will wear on the all-ten·ain and heavy motor vehicle dependson the driver's skill and the external conditions (weather,terrain. All the conditions are of random character and in orderto determine as accurately as possible the wear of tyres it isnecessary to monitor the wear of tyres within a certain time period,and to find the approximate probability of tyre wear in thefuture period of time. When the probability of tyre wear is determined,stochastic supply management model is used to calculatethe value of the stocks which allows optimal planning ofstocks of spare parts at minimal costs. The stochastic model allowsoptimal calculation for the purchase of consumable partsof transport means whose consumption depends on the randomconditions and events.

Optimization Policy of Inventory Spare Parts Stocking and Provisioning

International Nuclear Information System (INIS)

Yun, Tae Sik; Park, Jong Hyuk; Hwang, Eui Youp; Yoo, Sung Soo; Kim, In Hwan

2005-01-01

Spare parts, especially safety related items, being used in Korea Nuclear Power Plants are largely from the United States, Canada, France and the like, meaning the inventory policy, stocking and provision, should be influenced by those countries' nuclear industry situation in a direct or indirect manner. As a result of nuclear industry downturn practices, lots of spare supply corporations have gone broke, which gave immediate signals we have to resolve inventory purchases in need. It is known for that nuclear maintenance spare items are particularly composed of many kinds with small quantities, which makes matters worse to Korea nuclear operation company (KHNP) to purchase them. Hence, Korea nuclear business is trying to change its exinventory purchasing paradigm into innovative schemes it did not have to consider in the past. In order to implement a new stocking policy, it should be kept in mind the factors such as not only how much to stock for a smooth operation but also economic point of view. Even though it has done a lot of studies to optimize the inventory stocking level in an academic curiosity, it is not easy to apply the researches in a real world. Since it is so tough job to anticipate when and how large scale even occurs. Hence, it would be thought that the nuclear inventory should be dealt in a different manner from the general manufacturing industry

Inventory management of spare parts in an energy company

Energy Technology Data Exchange (ETDEWEB)

Guajardo, Mario; Roennqvist, Mikael; Halvorsen, Ann Mari; Kallevik, Svein Inge

2012-06-15

We address a problem of inventory management of spare parts in the context of a large energy company, producer of oil and gas. Spare parts are critical for assuring operational conditions in offshore platforms. About 200,000 different items are held in several inventory plants. The inventory system implemented at the company corresponds to a min-max system. The control parameters are decided based mainly on the expert judgment of the planners. Also, though the inventory plants can in practice be supplied from each other, the inventory planning is performed separately by the plant planners. This is because of different ownership structures where the studied company has the operative responsibility. The company is pursuing a system in which all planners conform to the same inventory management approach and evaluation, as well as being more cost efficient. Our work focuses on supporting this goal. We apply methods to decide the inventory control parameters for this system under a service level constraint. The methodology we use distinguishes unit-size and lot-size demand cases. We perform computational experiments to find control parameters for a sample of items. After the control parameters are found, we use them to explore the impact of risk pooling among the plants and inaccuracy arising from duplicate item codes.(Author)

Acquisition Pricing and Inventory Decisions on Dual-Source Spare-Part System with Final Production and Remanufacturing

Directory of Open Access Journals (Sweden)

Yancong Zhou

2016-01-01

Full Text Available The life spans of durable goods are longer than their warranty periods. To satisfy the service demand of spare parts and keep the market competition advantage, enterprises have to maintain the longer inventory planning of spare parts. However, how to obtain a valid number of spare parts is difficult for those enterprises. In this paper, we consider a spare-part inventory problem, where the inventory can be replenished by two ways including the final production order and the remanufacturing way. Especially for the remanufacturing way, we consider the acquisition management problem of used products concerning an acquisition pricing decision. In a multiperiod setting, we formulate the problem into a dynamic optimization problem, where the system decisions include the final production order and acquisition price of used products at each period. By stochastic dynamic programming, we obtain the optimal policy of the acquisition pricing at each period and give the optimal policy structure of the optimization problem at the first period. Then, a recursion algorithm is designed to calculate the optimal decisions and the critical points in the policy. Finally, the numerical analyses show the effects of demand information and customer’s sensitive degree on the related decisions and the optimal cost.

Spares management for improved maintenance

International Nuclear Information System (INIS)

Moncrief, E.C.; Schroder, R.M.

1987-01-01

A recent survey by the US Nuclear Regulatory Commission (NRC) of maintenance practices at US nuclear power plants confirms that spare parts availability is, to some extent, a problem at all but a few plants, and that 57% of the plants sometimes operated in a limiting condition for operation over the last year due to unavailability of spare parts. That's the bad news. The good news is that significant improvement is possible without ballooning inventory. The vast majority of total dollar value of spare parts inventory at power generation stations, whether nuclear or fossil, is rarely used (parts or components that are used 12 or less times per year including many with a history of no use for many years). Inventory Solutions of Akron, Ohio, has developed such a tool, called rarely used inventory stocking logic (RUSL) which is a user-friendly decision support tool for setting spare parts reorder points. Based on statistical computations enhanced to include the most advanced techniques developed for use in aerospace and military combat readiness, RUSL calculates the optimum stocking level to achieve the desired spare part availability at the station. In doing so, it considers the importance of the part in preventing an outage, as well as key economic ordering parameters, such as part cost, carrying cost, number of parts in service, historical observed usage, anticipated future usage, and lead time to replenish

Spare parts management at complex technology-based organizations: an agenda for research

NARCIS (Netherlands)

Rustenburg, W.D.; Houtum, van G.J.J.A.N.; Zijm, W.H.M.

2001-01-01

This paper explores the applicability of sophisticated models and techniques for spare parts inventory management within a highly technology-driven environment, viz. the Royal Netherlands Navy. In particular, we discuss the structure of the so-called VARI-METRIC models, a set of tools that has been

CWT and RWT Metrics Measure the Performance of the Army's Logistics Chain for Spare Parts

National Research Council Canada - National Science Library

2003-01-01

.... A responsive logistics chain for spare parts is also critical in deployments. When Army personnel know that parts can be quickly and dependably supplied through the logistics chain, units can deploy with fewer "just in case" supplies...

DBMS Development of Irradiated Materials and Spare parts on master-slave manipulator in IMEF

Energy Technology Data Exchange (ETDEWEB)

Choo, Y. S.; Kim, D. S.; Jung, Y. H.; Kim, H. M.; Yoo, B. O.; Baik, S. J.; Hong, K. P.; Ahn, S. B.; Ryu, W. S. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2008-12-15

The data of irradiated specimens(include nuclear fuel) which are transported from research reactor and commercial power reactor and the spare parts of the master-slave manipulator for the IMEF facility, which is operated since 1996, were controlled and managed through the Hangul and Excel software. But it is recommended to use a special program, which is developed for DBMS, for the beneficial control and systematic management of all irradiated specimens, especially assuming the increase of specimen's kind and amount by increasing customers in the near future. This report summarized the whole logical and physical processes and results about following items : - Management System of Irradiated Materials including nuclear fuel - Management System of spare parts for the master-slave manipulator.

Justification of evaluation criteria of the effectiveness of choice of spare parts stored in the warehouse of the transport company to maintain in good condition of its rolling stock

Directory of Open Access Journals (Sweden)

Antonyuk O.P.

2016-08-01

Full Text Available Support rolling stock of transport in good repair can be carried out using replacement parts that are stored on in the warehouses of transport enterprise and spare parts that are purchased as the need arises. For the uninterrupted transport services transport enterprise must have a certain amount of stock of spare parts at a given time. Rational organization of storage and inventory control of spare parts for motor plant affects the reducing operating costs and improving profitability of the transportation process. In the article the criteria for evaluating the effectiveness of choice of spare parts stored in the warehouse of the transport company to maintain in good condition of its rolling stock, taking into account the totality of the costs of purchase, transportation and storage of spare parts. Using these criteria allows to determine the advisability of keeping spare parts in stock of transport and procurement of necessary spare parts, provided the minimal costs of spare parts.

Locating spare part warehouses using the concept of gradual coverage - A case study

DEFF Research Database (Denmark)

Hansen, Klaus Reinholdt Nyhuus; Grunow, Martin

2009-01-01

for MAN Diesel SE is presented, where gradual coverage has been used for locating warehouses for spare parts. In particular it is described, how coverage decay functions are found, which identifies customers’ reaction to the offered ’speed of delivery’ and ’total order cost’. With these functions, demand...

Applying of neural networks in determination of replacement cycle of spare parts

International Nuclear Information System (INIS)

Saric, Tomislav; Majdandzic; Niko; Lujic, Roberto

2003-01-01

The article shows neural networks applicability to determine expected working time of equipment components before the damage. The results based on measure - simulated values of suggested model have been presented. Advantages of suggested model have been analyzed compared to traditional way of replacement of spare parts and components. Implementation possibility of suggested model in Management Information Maintenance System has been described. (author)

Qualified equipment for spare parts and modifications in Belgium

International Nuclear Information System (INIS)

Berthe, J.

1993-01-01

This paper describes the procedure followed for the procurement of components for spare parts and systems modifications, the legal and quality assurance environment and the specific measures taken to cope with various codes and standards. For pressure components, the regulation aspects of the American code used during the construction phase of plants had to be adapted to the Belgian context and to the actual industry situation. Obsolescence of products is treated either by qualification of a new product or by design modifications, or by replacement with an already qualified product. In these cases, the work is handled by the utility's engineering organization. 2 figs

Managing spares for improved availability

International Nuclear Information System (INIS)

Moncrief, E.C.; Schroder, R.M.

1987-01-01

A recent survey by the U.S. Nuclear Regulatory Commission of maintenance practices at U.S. nuclear power plants confirms that spare parts availability is, to some extent, a problem at all but a few plants. Fortunately, significant improvement is possible without ballooning inventory. The vast majority of total dollar value of spare parts inventory at power generation stations, whether nuclear or fossil, is rarely used (parts or components that are used 12 or less times per year including many with a history of no use for many years). Because rarely used inventory is not effectively managed with traditional inventory management techniques, opportunities exist both to increase availability and to reduce investment. But this requires a unique statistical tool that can recommend an unbiased, economic reorder point to be used in the materials management system. Inventory Solutions Inc. (ISI) of Akron, Ohio, has developed such a tool, rarely used inventory stocking logic (RUSL), which is a user friendly decision support tool for setting spare parts reorder points. RUSL, based on statistical computations enhanced to include the most advanced techniques developed for use in aerospace and military combat-readiness, calculates the optimum stocking level to achieve the desired spare part availability at the station

SUPPLIER EVALUATION AND SELECTION: CASE OF AN AUTOMOTIVE SPARE-PARTS SUPPLIER

OpenAIRE

Oflac, Bengu Sevil

2015-01-01

 The main aim of this study is to conduct a current state analysis for a leading original and spare parts producer operating in automobile industry. In the focused company, due to having some problems about purchasing process, there was a need for reviewing and restructuring supplier evaluation mechanism. In this perspective, based on the results of qualitative techniques conducted, reasons for poor evaluation systems were found. As a contribution to practice, in line with the needs of compan...

Fundiciones aleadas para piezas de repuesto. // Alloy foundries for spare parts.

Directory of Open Access Journals (Sweden)

J. Hernández de la Torre

2003-09-01

Full Text Available En el presente trabajo se aborda la concepción de mejorar las piezas mediante el análisis cuidadoso de las propiedades quelas mismas deben poseer, para responder a las severas exigencias del trabajo y en base a ello seleccionar la aleación y lasvías para mejorar sus cualidades y por ende su durabilidad. Como vías, en el caso de las fundiciones, se seleccionan laaleación en la carga y la modificación en la cazuela; en ambos casos con elementos aleantes que influyen sobre la matrizmetálica y la forma, tamaño y distribución del grafito. Se ejemplifica en base a piezas, como cuchillas centrales paramolinos azucareros.Palabras claves: fundición gris aleada, matriz metálica, grafito, cuchillas centrales._________________________________________________________________________________Abstract:This paper deals with the improvement of spare parts by means of a careful analysis of their properties, to face the hardexploitation conditions. Based on this analysis, the type of alloy and the ways to improve its properties and durability arefound. Two ways were applied for cast iron; the addition of alloy elements in the charge and the modification of moltenmetal in the ladle. In both cases, alloy elements are used to influence on the metallic matrix and the graphite distribution,size and form. The research is applied in spare parts such as central knives for sugar mills.Key words: alloy gray cast iron, metallic matrix, graphite, central knifes.

Policy design in closed-loop supply chains for the integrated management of component recycling and spare parts supply in the electronics industry

Science.gov (United States)

Schroeter, Marcus; Spengler, Thomas

2004-02-01

The strategy to recover components from discarded electrical and electronic equipment to obtain spare parts is promising, especially during the final service phase. In that phase, the original product is no longer produced and the sources of new parts are often limited. Controlling those closed-loop supply chains is challenging. Decision makers have to choose when to acquire discarded equipment, when to recover used parts, and when to produce new parts. We developed a generic system dynamics model that provides a test for various proposed policies to control closed-loop supply chains with parts recovery and spare-parts supply.

CWT and RWT Metrics Measure the Performance of the Army's Logistics Chain for Spare Parts

National Research Council Canada - National Science Library

2003-01-01

.... As part of its efforts to improve the logistics chain for spare parts, the Army must measure the performance of its supply system in filling orders for materiel. Velocity Management (VM) is a RAND-developed and Army implemented system that measures such performance and seeks ways to improve it through its Define-Measure- Improve (DMI) methodology. As the term DMI implies, measurement is central to this improvement approach.

Design of inventory pools in spare part support operation systems

Science.gov (United States)

Mo, Daniel Y.; Tseng, Mitchell M.; Cheung, Raymond K.

2014-06-01

The objective of a spare part support operation is to fulfill the part request order with different service contracts in the agreed response time. With this objective to achieve different service targets for multiple service contracts and the considerations of inventory investment, it is not only important to determine the inventory policy but also to design the structure of inventory pools and the order fulfilment strategies. In this research, we focused on two types of inventory pools: multiple inventory pool (MIP) and consolidated inventory pool (CIP). The idea of MIP is to maintain separated inventory pools based on the types of service contract, while CIP solely maintains a single inventory pool regardless of service contract. Our research aims to design the inventory pool analytically and propose reserve strategies to manage the order fulfilment risks in CIP. Mathematical models and simulation experiments would be applied for analysis and evaluation.

Spare Parts Inventory Management for the Next Generation Finnish Defense Force Fighter Fleet

Science.gov (United States)

2017-12-01

might benefit the end user most in high criticality or high cost classification classes: CrA, CrB, EA and EB. H. LEAD TIME EFFECTS Lead time is...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release. Distribution is unlimited. SPARE PARTS INVENTORY MANAGEMENT...Eddine Dahel THIS PAGE INTENTIONALLY LEFT BLANK i REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704–0188 Public reporting burden for this collection

An approximate approach for the joint problem of level of repair analysis and spare parts stocking

NARCIS (Netherlands)

Basten, R.J.I.; Heijden, van der M.C.; Schutten, J.M.J.

2011-01-01

For the spare parts stocking problem, generally metric type methods are used in the context of capital goods. Implicitly, a decision is assumed on which components to discard and which to repair upon failure, and where to perform repairs. In the military world, this decision is taken explicitly

An approximate approach for the joint problem of level of repair analysis and spare parts stocking.

NARCIS (Netherlands)

Basten, Robertus Johannes Ida; van der Heijden, Matthijs C.; Schutten, Johannes M.J.

2011-01-01

For the spare parts stocking problem, generally metric type methods are used in the context of capital goods. Implicitly, a decision is assumed on which components to discard and which to repair upon failure, and where to perform repairs. In the military world, this decision is taken explicitly

Preventive Maintenance Interval Prediction: a Spare Parts Inventory Cost and Lost Earning Based Model

Directory of Open Access Journals (Sweden)

O. A. Adebimpe

2015-06-01

Full Text Available In this paper, some preventive maintenance parameters in manufacturing firms were identified and used to develop cost based functions in terms of machine preventive maintenance. The proposed cost based model considers system’s reliability, cost of keeping spare parts inventory and lost earnings in deriving optimal maintenance interval. A case of a manufacturing firm in Nigeria was observed and the data was used to evaluate the model.

Second Line of Defense Spares Program

Energy Technology Data Exchange (ETDEWEB)

Henderson, Dale L.; Holmes, Aimee E.; Muller, George; Mercier, Theresa M.; Brigantic, Robert T.; Perkins, Casey J.; Cooley, Scott K.; Thorsen, Darlene E.

2012-11-20

During Fiscal Year 2012, a team from the Pacific Northwest National Laboratory (PNNL) conducted an assessment and analysis of the Second Line of Defense (SLD) Sustainability spare parts program. Spare parts management touches many aspects of the SLD Sustainability Program including contracting and integration of Local Maintenance Providers (LMP), equipment vendors, analyses and metrics on program performance, system state of health, and maintenance practices. Standardized spares management will provide better data for decisions during site transition phase and will facilitate transition to host country sustainability ownership. The effort was coordinated with related SLD Sustainability Program initiatives, including a configuration items baselining initiative, a metrics initiative, and a maintenance initiative. The spares study has also led to pilot programs for sourcing alternatives that include regional intermediate inventories and partnering agreements that leverage existing supply chains. Many partners from the SLD Sustainability program contributed to and were consulted in the course of the study. This document provides a description of the findings, recommendations, and implemented solutions that have resulted from the study.

Using TRIZ to Improve the Procurement Process of Spare Parts in the Taiwan Navy

Directory of Open Access Journals (Sweden)

Chia-Nan Wang

2017-10-01

Full Text Available Abstract: The Naval Maintenance and Repair Command Acquisition Management Unit (NMRC-AMU of the Taiwan Navy suffered from poor stock control of spare parts and inadequate modification of requested items and manufacturer/part codes during recent years. Therefore, the purpose of this study is to investigate core categorization, coordination, and procurement (CCP problems, to formulate feasible solutions and then to improve the CCP performances of spare parts in NMRC-AMU. The Teoriya Resheniya Izobreatatelskih Zadatch (TRIZ method was applied to solve this issue. A problem hierarchy analysis (PHA was first used to identify the core problems. Then, the 40 principles were used to determine the ideal improvement solution and formulate a solution strategy that simultaneously simplified CCP processed and enhanced the correctness of procurement tasks, thereby elevating CCP efficiency, supporting the Taiwan Navy repair missions, and satisfying fleet maintenance and servicing demands. The results indicated that total 6925 requests for coordination and procurement were submitted. Of these requests, 4366 requests had been completed (with total 102 cases, and the CCP efficiency is 63.0%. After improvement by this study, a total of 4529 items were submitted and 3592 executed items were completed (with a total of 172 cases, and the CCP efficiency is 79.3%. The improvement percentage of the CCP efficiency and completed cases are 30.6% and 68.6%, respectively. The performances are good and the TRIZ could be applied for other military forces.

Heuristics for multi-item two-echelon spare parts inventory control subject to aggregate and individual service measures

NARCIS (Netherlands)

Topan, E.; Bayindir, Z.P.; Tan, T.

2017-01-01

We consider a multi-item two-echelon spare parts inventory system in which the central warehouse operates under a (Q, R) policy and local warehouses implement (S−1,S) policy. The objective is to find the policy parameters minimizing expected system-wide inventory holding and fixed ordering subject

Reliability Based Spare Parts Management Using Genetic Algorithm

Directory of Open Access Journals (Sweden)

Rahul Upadhyay

2015-08-01

Full Text Available Effective and efficient inventory management is the key to the economic sustainability of capital intensive modern industries. Inventory grows exponentially with complexity and size of the equipment fleet. Substantial amount of capital is required for maintaining an inventory and therefore its optimization is beneficial for smooth operation of the project at minimum cost of inventory. The size and hence the cost of the inventory is influenced by a large no of factors. This makes the optimization problem complex. This work presents a model to solve the problem of optimization of spare parts inventory. The novelty of this study lies with the fact that the developed method could tackle not only the artificial test case but also a real-world industrial problem. Various investigators developed several methods and semi-analytical tools for obtaining optimum solutions for this problem. In this study non-traditional optimization tool namely genetic algorithms GA are utilized. Apart from this Coxs regression analysis is also used to incorporate the effect of some environmental factors on the demand of spares. It shows the efficacy of the applicability of non-traditional optimization tool like GA to solve these problems. This research illustrates the proposed model with the analysis of data taken from a fleet of dumper operated in a large surface coal mine. The optimum time schedules so suggested by this GA-based model are found to be cost effective. A sensitivity analysis is also conducted for this industrial problem. Objective function is developed and the factors like the effect of season and production pressure overloading towards financial year-ending is included in the equations. Statistical analysis of the collected operational and performance data were carried out with the help of Easy-Fit Ver-5.5.The analysis gives the shape and scale parameter of theoretical Weibull distribution. The Coxs regression coefficient corresponding to excessive loading

PRACTICE AND BUSINESS STRATEGIES FOR DECISION -MAKING IN THE AUTOMOTIVE SPARE PARTS SECTOR

Directory of Open Access Journals (Sweden)

Neyda Ibañez

2017-09-01

Full Text Available This paper aims to describe the practices and prospective strategies used by the Venezuelan automotive spare parts sector. The study was located in the post positivist paradigm using the descriptive method of scientist mode. The results showed that the industry uses more than 54.83 percent in qualitative prospective methods for constructing scenarios that enable their decision making, and 19,35 percent in quantitative forward-looking strategies, and the rest corresponding to a 25,82 percent in practices and prospective strategies that combine both. We conclude that made a new type of design with nine steps to build their scenarios.

Spare Items validation

International Nuclear Information System (INIS)

Fernandez Carratala, L.

1998-01-01

There is an increasing difficulty for purchasing safety related spare items, with certifications by manufacturers for maintaining the original qualifications of the equipment of destination. The main reasons are, on the top of the logical evolution of technology, applied to the new manufactured components, the quitting of nuclear specific production lines and the evolution of manufacturers quality systems, originally based on nuclear codes and standards, to conventional industry standards. To face this problem, for many years different Dedication processes have been implemented to verify whether a commercial grade element is acceptable to be used in safety related applications. In the same way, due to our particular position regarding the spare part supplies, mainly from markets others than the american, C.N. Trillo has developed a methodology called Spare Items Validation. This methodology, which is originally based on dedication processes, is not a single process but a group of coordinated processes involving engineering, quality and management activities. These are to be performed on the spare item itself, its design control, its fabrication and its supply for allowing its use in destinations with specific requirements. The scope of application is not only focussed on safety related items, but also to complex design, high cost or plant reliability related components. The implementation in C.N. Trillo has been mainly curried out by merging, modifying and making the most of processes and activities which were already being performed in the company. (Author)

Army Contracting Officials Could Have Purchased Husky Mounted Detection System Spare Parts at Lower Prices (Redacted)

Science.gov (United States)

2016-03-31

system mounted on an armored vehicle . It detects and marks landmines and other buried explosive hazards, and serves an important role in keeping...countries. Figure 1. HMDS Shown on a Husky Vehicle Source: Project Manager Close Combat Systems FOR OFFICIAL USE ONLY FOR OFFICIAL USE ONLY Introduction...Reasonable Prices From Meggitt Aircraft Braking Systems for Sole-Source Commercial Spare Parts,” May 8, 2015 Report No. DODIG-2015-103, “Summary of

NASA Parts Selection List (NPSL) WWW Site http://nepp.nasa.gov/npsl

Science.gov (United States)

Brusse, Jay

2000-01-01

The NASA Parts Selection List (NPSL) is an on-line resource for electronic parts selection tailored for use by spaceflight projects. The NPSL provides a list of commonly used electronic parts that have a history of satisfactory use in spaceflight applications. The objective of this www site is to provide NASA projects, contractors, university experimenters, et al with an easy to use resource that provides a baseline of electronic parts from which designers are encouraged to select. The NPSL is an ongoing resource produced by Code 562 in support of the NASA HQ funded NASA Electronic Parts and Packaging (NEPP) Program. The NPSL is produced as an electronic format deliverable made available via the referenced www site administered by Code 562. The NPSL does not provide information pertaining to patented or proprietary information. All of the information contained in the NPSL is available through various other public domain resources such as US Military procurement specifications for electronic parts, NASA GSFC's Preferred Parts List (PPL-21), and NASA's Standard Parts List (MIL-STD975).

From HTML to List of Words (part 2

Directory of Open Access Journals (Sweden)

William J. Turkel

2012-07-01

Full Text Available In this lesson, you will learn the Python commands needed to implement the second part of the algorithm begun in the From HTML to a List of Words (part 1. The first half of the algorithm gets the content of an HTML page and saves only the content that follows the tags. The second half of the algorithm does the following: Look at every character in the pageContents string, one character at a time If the character is a left angle bracket ( we are now leaving the tag; ignore the current character, but look at each following character If we’re not inside a tag, append the current character to a new variable: text Split the text string into a list of individual words that can later be manipulated further.

The Many Faces of Part-List Cuing—Evidence for the Interplay Between Detrimental and Beneficial Mechanisms

Directory of Open Access Journals (Sweden)

Eva-Maria Lehmer

2018-05-01

Full Text Available If participants study a list of items and, at test, receive a random selection of the studied items as retrieval cues, then such cuing often impairs recall of the remaining items. This effect, referred to as part-list cuing impairment, is a well-established finding in memory research that, over the years, has been attributed to quite different cognitive mechanisms. Here, we provide a review of more recent developments in research on part-list cuing. These developments (i suggest a new view on part-list cuing impairment and a critical role of encoding for the effect, (ii identify conditions in which part-list cuing impairment can turn into part-list cuing facilitation, and (iii relate research on part-list cuing to a phenomenon from social memory, known as collaborative inhibition. The recent developments also include a new multi-mechanisms account, which attributes the effects of cuing to the interplay between detrimental mechanisms—like blocking, inhibition, or strategy disruption—and beneficial mechanisms—like context reactivation. The account provides a useful theoretical framework to describe both older and newer findings. It may guide future work on part-list cuing and may also motivate new research on collaborative inhibition.

The importance of ships and spare parts in LCAs of offshore wind power.

Science.gov (United States)

Arvesen, Anders; Birkeland, Christine; Hertwich, Edgar G

2013-03-19

We develop and assess life cycle inventories of a conceptual offshore wind farm using a hybrid life cycle assessment (LCA) methodology. Special emphasis is placed on aspects of installation, operation, and maintenance, as these stages have been given only cursory consideration in previous LCAs. The results indicate that previous studies have underestimated the impacts caused by offshore operations and (though less important) exchange of parts. Offshore installation and maintenance activities cause 28% (10 g CO(2)-Eq/kWh) of total greenhouse gas emissions and 31-45% of total impact indicator values at the most (marine eutrophication, acidification, particulates, photochemical ozone). Transport and dumping of rock in installation phase and maintenance of wind turbines in use phase are major contributory activities. Manufacturing of spare parts is responsible for 6% (2 g CO2-Eq/kWh) of greenhouse gas emissions and up to 13% of total impact indicator values (freshwater ecotoxicity). Assumptions on lifetimes, work times for offshore activities and implementation of NOx abatement on vessels are shown to have a significant influence on results. Another source of uncertainty is assumed operating mode data for vessels determining fuel consumption rates.

Incorporating single-side sparing in models for predicting parotid dose sparing in head and neck IMRT

International Nuclear Information System (INIS)

Yuan, Lulin; Wu, Q. Jackie; Yin, Fang-Fang; Yoo, David; Jiang, Yuliang; Ge, Yaorong

2014-01-01

Purpose: Sparing of single-side parotid gland is a common practice in head-and-neck (HN) intensity modulated radiation therapy (IMRT) planning. It is a special case of dose sparing tradeoff between different organs-at-risk. The authors describe an improved mathematical model for predicting achievable dose sparing in parotid glands in HN IMRT planning that incorporates single-side sparing considerations based on patient anatomy and learning from prior plan data. Methods: Among 68 HN cases analyzed retrospectively, 35 cases had physician prescribed single-side parotid sparing preferences. The single-side sparing model was trained with cases which had single-side sparing preferences, while the standard model was trained with the remainder of cases. A receiver operating characteristics (ROC) analysis was performed to determine the best criterion that separates the two case groups using the physician's single-side sparing prescription as ground truth. The final predictive model (combined model) takes into account the single-side sparing by switching between the standard and single-side sparing models according to the single-side sparing criterion. The models were tested with 20 additional cases. The significance of the improvement of prediction accuracy by the combined model over the standard model was evaluated using the Wilcoxon rank-sum test. Results: Using the ROC analysis, the best single-side sparing criterion is (1) the predicted median dose of one parotid is higher than 24 Gy; and (2) that of the other is higher than 7 Gy. This criterion gives a true positive rate of 0.82 and a false positive rate of 0.19, respectively. For the bilateral sparing cases, the combined and the standard models performed equally well, with the median of the prediction errors for parotid median dose being 0.34 Gy by both models (p = 0.81). For the single-side sparing cases, the standard model overestimates the median dose by 7.8 Gy on average, while the predictions by the combined

ANALISIS KLASIFIKASI PERSEDIAAN SUKU CADANG MENGGUNAKAN MUSIC-3D VIEW OF SPARES (Studi Kasus Perusahaan Farmasi di PT. XYZ

Directory of Open Access Journals (Sweden)

Yuli Dwi Astanti

2015-04-01

Full Text Available PT. XYZ is a pharmaceutical company that manufactures both pharmaceuticals and herbal medicinal chemistry. The drug is a vital necessity to society, therefore, the drug production process must be maintained so that its performance can be met drug availability. One way to maintain smooth production process is to maintain engine performance. An engine production facility that is vital and requires periodic maintenance or at any time in case of damage. Each performed maintenance or repairs due to damage, an engine needs replacement parts for the machine to run as before. To support the maintenance activities, PT. XYZ has a warehouse used to store spare parts. During this time, parts storage system in PT. XYZ is not based on consideration of the appropriate classification of its characteristics, but each part has different characteristics, both in terms of price, suppliers, materials, usage, and so on. Due to the large number of stocks and the importance of spare parts, the supply system must be considered in order not to cause any harm to the company. The present study will attempt to analyze the system parts inventory in the warehouse by using MUSIC-3D View of Spares. MUSIC-3D View of spares in the analysis using a 3-dimensional approach that values consumption, availability and critically. The third dimension is represented by the three approaches, namely System ABC, VED, and SDE. Based on the results of the analysis of MUSIC-3D Views of Spares in mind that parts each having a different classification, so it requires a different treatment according to their classification.   Keywords : spare parts, supplies, MUSIC-3D View of Spares

Sparing land for biodiversity at multiple spatial scales

Directory of Open Access Journals (Sweden)

Johan eEkroos

2016-01-01

Full Text Available A common approach to the conservation of farmland biodiversity and the promotion of multifunctional landscapes, particularly in landscapes containing only small remnants of non-crop habitats, has been to maintain landscape heterogeneity and reduce land-use intensity. In contrast, it has recently been shown that devoting specific areas of non-crop habitats to conservation, segregated from high-yielding farmland (‘land sparing’, can more effectively conserve biodiversity than promoting low-yielding, less intensively managed farmland occupying larger areas (‘land sharing’. In the present paper we suggest that the debate over the relative merits of land sparing or land sharing is partly blurred by the differing spatial scales at which it is suggested that land sparing should be applied. We argue that there is no single correct spatial scale for segregating biodiversity protection and commodity production in multifunctional landscapes. Instead we propose an alternative conceptual construct, which we call ‘multiple-scale land sparing’, targeting biodiversity and ecosystem services in transformed landscapes. We discuss how multiple-scale land sparing may overcome the apparent dichotomy between land sharing and land sparing and help to find acceptable compromises that conserve biodiversity and landscape multifunctionality.

Administrative and legal factors of customs clearance for components and spare parts imported for repair of ships in Ukraine

Directory of Open Access Journals (Sweden)

Едуард Борисович Хачатуров

2015-11-01

Full Text Available It is investigated an influence of administrative and legal factors of customs clearance when moving goods across customs borders for repair of marine ships in Ukraine. It is studied the existing regulatory base of legal acts governing order implementation of the customs procedures in the supply completing and spare parts for the shipbuilding industry. It is proposed an application of the customs regime of temporary import for goods to these groups, and, if necessary, use loyalty measures with the aim of ensuring timely production

A decision-making framework to integrate maintenance contract conditions with critical spares management

International Nuclear Information System (INIS)

Godoy, David R.; Pascual, Rodrigo; Knights, Peter

2014-01-01

Maintenance outsourcing is a strategic driver for asset intensive industries pursuing to enhance supply chain performance. Spare parts management plays a relevant role in this premise since its significant impact on equipment availability, and hence on business success. Designing critical spares policies might therefore seriously affect maintenance contracts profitability, yet service receivers and external providers traditionally attempt to benefit separately. To coordinate both chain parties, we investigated whether the spare components pool should be managed in-house or contracted out. This paper provides a decision-making framework to efficiently integrate contractual conditions with critical spares stockholding. Using an imperfect maintenance strategy over a finite horizon, the scheme maximizes chain returns whilst evaluating the impact of an additional part to stock. As result, an original joint value – preventive interval and stock level – sets the optimal agreement to profitably allocate the components pool within the service contract. Subsidization bonuses on preventive interventions and pooling costs are also estimated to induce the service provider to adjust its policy when needed. The proposed contractual conditions motivate stakeholders to continuously improve maintenance performance and supply practices, thus obtaining higher joint benefits

SISTEM PENJUALAN SPARE PART TOKO AJM MOTOR MENGGUNAKAN CI BERBASIS ARSITEKTUR MVC

Directory of Open Access Journals (Sweden)

Ade Setiadi

2016-11-01

Full Text Available Saat ini penggunaan komputer dan perangkat lunak semakin banyak hingga ke berbagai kehidupan, bahkan sampai pada bidang ekonomi. Sistem Informasi merupakan peranan sangat penting dalam kegiatan bisnis di suatu perusahaan. Toko AJM Motor bergerak dalam bidang penjualan spare part mobil dan masih menggunakan cara yang konvensional dalam mengolah data tentang transaksi penjualan, untuk itu Toko AJM Motor membutuhkan sistem informasi yang dapat menunjang kelancaran dalam melakukan transaksi penjualannya. Dalam dunia teknologi khususnya pemrograman saat ini, baik itu desktop maupun web base semakin marak pengerjaannya menggunakan framework dan salah satu framework berbasis PHP yang banyak digunakan yaitu CodeIgniter (CI. Framework CI memang dikembangkan untuk memudahkan dalam developing aplikasi dengan struktur file source code-nya menggunakan pendekatan arsitektur Models-Views-Controller (MVC dan pemrograman berorientasi objek. Oleh sebab itu, kami menggunakan CI dalam developing aplikasi ini dengan metode Object Oriented Analysis and Design sebagai metode pengembangan system. Dengan dirancangnya sistem ini telah mempermudah pemilik toko dalam mengelola data pelanggan, supplier dan barang yang di beli dan di jual serta pembuatan laporan yang diperlukan untuk perhitungan penjualan dan dapat memberikan informasi yang berguna bagi pemilik toko secara up to date. Kata kunci: codeigniter (CI, models-views-controller (MVC, object oriented, penjualan.

Cultural activities in primary school students' spare time

Directory of Open Access Journals (Sweden)

Mikanović Brane

2014-01-01

Full Text Available Culture is a form of creative expression of a human being through which he reshapes the world, acts on it adding it value and creating new, cultural values. A human being is able to create a product of culture only when he is free and able to express himself. A contemporary man can incorporate various cultural activities into his spare time. They are especially important when they concern children and young people: regardless of whether they are used in institutional settings or in spare time. The authors conducted an empirical research of students' assumptions and beliefs concerning cultural activities in their free time. The sample comprised 233 fifth grade students. The findings show that in their spare time fifth graders: engage in various cultural activities; that students who live in urban areas attend more cultural events; that students have the opportunity to engage in extra-curricular activities in the area of culture - join cultural and artistic groups and associations and engage in various creative pursuits at different levels of participation (as consumers, full participants; and that students' attitudes concerning the influence of parents and teachers on the selection of cultural activities to be pursued do not vary greatly by gender, location or school achievement. Cultural activities do play a significant part in the free time of primary school students. This is why it is important that guidance provided in school and in spare time should be brought in greaer harmony.

Erlotinib-induced rash spares previously irradiated skin

International Nuclear Information System (INIS)

Lips, Irene M.; Vonk, Ernest J.A.; Koster, Mariska E.Y.; Houwing, Ronald H.

2011-01-01

Erlotinib is an epidermal growth factor receptor inhibitor prescribed to patients with locally advanced or metastasized non-small cell lung carcinoma after failure of at least one earlier chemotherapy treatment. Approximately 75% of the patients treated with erlotinib develop acneiform skin rashes. A patient treated with erlotinib 3 months after finishing concomitant treatment with chemotherapy and radiotherapy for non-small cell lung cancer is presented. Unexpectedly, the part of the skin that had been included in his previously radiotherapy field was completely spared from the erlotinib-induced acneiform skin rash. The exact mechanism of erlotinib-induced rash sparing in previously irradiated skin is unclear. The underlying mechanism of this phenomenon needs to be explored further, because the number of patients being treated with a combination of both therapeutic modalities is increasing. The therapeutic effect of erlotinib in the area of the previously irradiated lesion should be assessed. (orig.)

Neural stem cell sparing by linac based intensity modulated stereotactic radiotherapy in intracranial tumors

International Nuclear Information System (INIS)

Oehler, Julia; Brachwitz, Tim; Wendt, Thomas G; Banz, Nico; Walther, Mario; Wiezorek, Tilo

2013-01-01

Neurocognitive decline observed after radiotherapy (RT) for brain tumors in long time survivors is attributed to radiation exposure of the hippocampus and the subventricular zone (SVZ). The potential of sparing capabilities for both structures by optimized intensity modulated stereotactic radiotherapy (IMSRT) is investigated. Brain tumors were irradiated by stereotactic 3D conformal RT or IMSRT using m3 collimator optimized for PTV and for sparing of the conventional OARs (lens, retina, optic nerve, chiasm, cochlea, brain stem and the medulla oblongata). Retrospectively both hippocampi and SVZ were added to the list of OAR and their dose volume histograms were compared to those from two newly generated IMSRT plans using 7 or 14 beamlets (IMSRT-7, IMSRT-14) dedicated for optimized additional sparing of these structures. Conventional OAR constraints were kept constant. Impact of plan complexity and planning target volume (PTV) topography on sparing of both hippocampi and SVZ, conformity index (CI), the homogeneity index (HI) and quality of coverage (QoC) were analyzed. Limits of agreement were used to compare sparing of stem cell niches with either IMSRT-7 or IMSRT-14. The influence of treatment technique related to the topography ratio between PTV and OARs, realized in group A-D, was assessed by a mixed model. In 47 patients CI (p ≤ 0.003) and HI (p < 0.001) improved by IMSRT-7, IMSRT-14, QoC remained stable (p ≥ 0.50) indicating no compromise in radiotherapy. 90% of normal brain was exposed to a significantly higher dose using IMSRT. IMSRT-7 plans resulted in significantly lower biologically effective doses at all four neural stem cell structures, while contralateral neural stem cells are better spared compared to ipsilateral. A further increase of the number of beamlets (IMSRT-14) did not improve sparing significantly, so IMSRT-7 and IMSRT-14 can be used interchangeable. Patients with tumors contacting neither the subventricular zone nor the cortex benefit

A single - item replacement decision model for repairable spare ...

African Journals Online (AJOL)

In this paper, we present an analytical method for determining spare parts replacement over an infinite planning horizon. (The objective is to minimize the total system cost). We develop an exact and simple method for determining the time for equipment replacement or making decision about when to replace equipments, ...

Valve-sparing aortic root replacement†

NARCIS (Netherlands)

Koolbergen, David R.; Manshanden, Johan S. J.; Bouma, Berto J.; Blom, Nico A.; Mulder, Barbara J. M.; de Mol, Bas A. J. M.; Hazekamp, Mark G.

2015-01-01

To evaluate our results of valve-sparing aortic root replacement and associated (multiple) valve repair. From September 2003 to September 2013, 97 patients had valve-sparing aortic root replacement procedures. Patient records and preoperative, postoperative and recent echocardiograms were reviewed.

46 CFR Table I to Part 150 - Alphabetical List of Cargoes

Science.gov (United States)

2010-10-01

... cargo name), see Caustic potash solution 5 2 CPS Potassium oleate 34 POE Potassium salt of polyolefin... Sodium polyacrylate solution 43 2 Sodium salt of Ferric hydroxyethylethylenediaminetriacetic acid... 46 Shipping 5 2010-10-01 2010-10-01 false Alphabetical List of Cargoes I Table I to Part 150...

49 CFR Appendix A to Part 604 - Listing of Human Service Federal Financial Assistance Programs

Science.gov (United States)

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Listing of Human Service Federal Financial... (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CHARTER SERVICE Pt. 604, App. A Appendix A to Part 604—Listing of Human Service Federal Financial Assistance Programs Federal Programs...

Diuretics in the treatment of hypertension. Part 2: loop diuretics and potassium-sparing agents.

Science.gov (United States)

Tamargo, Juan; Segura, Julian; Ruilope, Luis M

2014-04-01

Diuretics enhance the renal excretion of Na(+) and water due to a direct action at different tubular sites of the nephron where solute re-absorption occurs. This paper focuses on the mechanism of action, pharmacodynamics, antihypertensive effects, adverse effects, interactions and contraindications of loop diuretics and potassium-sparing agents (including mineralocorticoid receptor antagonists (MRAs) and epithelial Na(+) channel blockers). Loop diuretics are less effective than thiazide diuretics in lowering blood pressure, so that their major use is in edematous patients with congestive heart failure (HF), cirrhosis with ascites and nephritic edema. MRAs represent a major advance in the treatment of resistant hypertension, primary and secondary hyperaldosteronism and in patients with systolic HF to reduce the risks of hospitalization and of premature death. Potassium-sparing diuretics when coadministered with diuretics (thiazides and loop diuretics) working at more proximal nephron locations reduce the risk of hypokalemia and hypomagnesemia and the risk of cardiac arrhythmias. At the end of the article, the basis for the combination of diuretics with other antihypertensive drugs to achieve blood pressure targets is presented.

CPM Pairs from LSPM so Far Not WDS Listed – Part IV

Science.gov (United States)

Knapp, Wilfried; Nanson, John

2018-04-01

The LSPM catalog (Lepine and Shara 2005) is a rich source for CPM pairs we thought already exhausted – but as we found during research for our report "A New Concept for Counter-Checking of Assumed CPM Pairs" (Knapp and Nanson 2017), there are still many potential CPM pairs indicated in LSPM not listed in the WDS catalog. After our first three reports on about 100 such objects (Knapp and Nanson 2017 - CPM pairs from LSPM so far not WDS listed – Part I/II/III), this report with 30 additional potential common proper motion pairs is presented here.

Spare parts classification and procurement program

International Nuclear Information System (INIS)

Adlon, K.L.; Hassaballa, M.M.

1986-01-01

The cost benefits have been demonstrated for an integrated program, which is currently being implemented for two PWR stations with two 1100-MW units each. The component classification efforts reduced the number of safety-related components in several systems. Furthermore, the knowledge of the component specific function has contributed to the reduction of many safety-related parts per component, in addition to ensuring the procurement of parts to the correct safety level. The use of qualified commercial grade parts and components with their lower cost and reasonable procurement lead time compared to their 10 CFR 21 counterparts has a pronounced economic effect on the utility balance sheets

Positive surgical margins in nephron-sparing surgery; the great unknown

Directory of Open Access Journals (Sweden)

Dan Spinu

2018-04-01

Full Text Available There is a currently a general trend towards organ-preserving surgery, and urology is no exception. Specifically, nephron-sparing surgery (NSS has gained general acceptance for T1a renal cell carcinoma (guidelines recommendations. Moreover T1b, T2 and even T3 stage tumors have been included on the nephron sparing list at some centers. An unresolved issue is that of positive surgical margins (PSM, not only their detection but also the implications for follow up and treatment. This paper highlights data available on risk factors for PSM, their clinical relevance, and possible therapeutic consequences. From the surgeon’s viewpoint, NSS is a daring and risky surgical procedure. Urological guidelines stress the importance of NSS, and thus the trend is moving in that direction. Unresolved, however, is the problem of PSM. Trifecta, MIC, and pentafecta are applicable concepts which attempt to define the optimal endpoint of NSS, but further elaboration is necessary. Specifically, research needs to focus less on the concept of definitive margins and more on their identification and avoidance. Although some studies suggest that PSMs do not influence overall survival rate, the basic idea of preserving tissue that is not cancerous leads to further medical, social, and psychological considerations.

UHV testing of spare straight section chambers of Indus-2

International Nuclear Information System (INIS)

Tiwari, S.K.; Ratnakala, K.C.; Sridhar, R.; Bhange, N.J.; Netram; Shukla, S.K.

2015-01-01

The vacuum system of Synchrotron Radiation Source, Indus-2, in RRCAT has been functioning up to the mark, continuously for last 10 years. To continue the same trouble-free functioning, it was planned to procure spares for all critical vacuum components, test for UHV performance and keep ready for installation, in case of requirement. As a part of this planning, fifteen chambers made of Aluminium alloy (6063 T6), procured as spare straight section chambers for Indus-2, and were tested for UHV performance. They were tested in batches of 2 or 3 chambers, depending upon their length, and the similar testing-procedure was followed. This paper narrates the tests carried out, and the results obtained. Ultimate vacuum in the range (2 to 9) x 10 -10 mbar was achieved. (author)

Last Time Buy and repair decisions for fast moving parts

NARCIS (Netherlands)

Behfard, S.; Al Hanbali, A.; van der Heijden, M. C.; Zijm, W. H.M.

2018-01-01

Spare part availability is essential for advanced capital goods with a long service period. Sourcing becomes challenging once the production of spare parts ceases, while the remaining service period is still long. In this paper, we focus on fast moving parts with repair of failed parts as an

Clinic-radiology findings at limp-sparing surgery of alveolar sarcoma

International Nuclear Information System (INIS)

Tzekov, A.; Penchev, V.; Niagolova, S.; Kovachev, V.

2007-01-01

Soft-tissue sarcomas are a rare and heterogeneous group of tumors. Alveolar soft part sarcoma is a rare sarcoma of an unclear cause. It is representing 0.2-1 percent of soft tissue sarcomas. Unique biologic behaviors of soft-tissue sarcomas features include formation of a reactive zone, intra-compartmental growth, and, rarely, the presence of skip metastases. Although the soft-tissue sarcomas have a unique morphology, biological behavior, and prognosis, they share biological characteristics and are treated in a similar fashion. The concept of limb-sparing surgery, or limb salvage, has gradually evolved over the past 25 years. Prior to this the basic principles of surgical oncology for the extremities consisted solely of determining the correct level at which to perform an amputation. The three stages of a limb-sparing procedure are as follows: tumor resection skeletal reconstruction and soft-tissue coverage and muscle transfers to restore function. Imaging diagnostic is a key step in the limp-sparing surgery of a soft tissue sarcomas at relation of: preoperatively - the diagnosis of lesion, the decision for biopsy, about location of the lesion and what is the safest anatomic route to that location, possibly lung and bone metastases; postoperative - checking the position of the prosthesis, inflammatory, mechanic and oncology complications. (authors)

Results of revision of the data base of the State list of particularly protected parts of nature and landscape in sequence on the collection of letters of the state list

International Nuclear Information System (INIS)

Ambroz, L.; Sykora, J.

2005-01-01

The State list of particularly protected parts of nature and landscape (Stat list) is official account of protected territories and protected trees and their protected zones on the territory of the Slovak Republic. The State list was delimited from the State protection of nature of the Slovak Republic on the Museum of Nature Protection and Speleology. The content of the State list and structure of data base of protected territories and protected territories are presented

Second Line of Defense Spares Program Assessment

Energy Technology Data Exchange (ETDEWEB)

Henderson, Dale L.; Muller, George; Mercier, Theresa M.; Brigantic, Robert T.; Perkins, Casey J.; Cooley, Scott K.

2012-11-20

The Office of the Second Line of Defense (SLD) is part of the Department of Energy‘s (DOE) National Nuclear Security Administration (NNSA). The SLD Program accomplishes its critical global security mission by forming cooperative relationships with partner countries to install passive radiation detection systems that augment traditional inspection and law enforcement measures by alerting border officials to the presence of special nuclear or other radiological materials in cross-border traffic. An important tenet of the program is to work collaboratively with these countries to establish the necessary processes, procedures, infrastructure and conditions that will enable them to fully assume the financial and technical responsibilities for operating the equipment. As the number of operational deployments grows, the SLD Program faces an increasingly complex logistics process to promote the timely and efficient supply of spare parts.

36 CFR Appendix E to Part 1191 - List of Figures and Index

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false List of Figures and Index E Appendix E to Part 1191 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS... Figures and Index ER23JY04.289 ER23JY04.290 ER23JY04.291 ER23JY04.292 ER23JY04.293 ER23JY04.294 ER23JY04...

Conserving the birds of Uganda's banana-coffee arc: land sparing and land sharing compared.

Directory of Open Access Journals (Sweden)

Mark F Hulme

Full Text Available Reconciling the aims of feeding an ever more demanding human population and conserving biodiversity is a difficult challenge. Here, we explore potential solutions by assessing whether land sparing (farming for high yield, potentially enabling the protection of non-farmland habitat, land sharing (lower yielding farming with more biodiversity within farmland or a mixed strategy would result in better bird conservation outcomes for a specified level of agricultural production. We surveyed forest and farmland study areas in southern Uganda, measuring the population density of 256 bird species and agricultural yield: food energy and gross income. Parametric non-linear functions relating density to yield were fitted. Species were identified as "winners" (total population size always at least as great with agriculture present as without it or "losers" (total population sometimes or always reduced with agriculture present for a range of targets for total agricultural production. For each target we determined whether each species would be predicted to have a higher total population with land sparing, land sharing or with any intermediate level of sparing at an intermediate yield. We found that most species were expected to have their highest total populations with land sparing, particularly loser species and species with small global range sizes. Hence, more species would benefit from high-yield farming if used as part of a strategy to reduce forest loss than from low-yield farming and land sharing, as has been found in Ghana and India in a previous study. We caution against advocacy for high-yield farming alone as a means to deliver land sparing if it is done without strong protection for natural habitats, other ecosystem services and social welfare. Instead, we suggest that conservationists explore how conservation and agricultural policies can be better integrated to deliver land sparing by, for example, combining land-use planning and agronomic

[Aortic valve-sparing root reconstruction in Marfan syndrome].

Science.gov (United States)

Ogino, H; Sasaki, H; Hanafusa, Y; Hirata, M; Numata, S; Ando, M; Yagihara, T; Kitamura, S

2002-07-01

The outcome of aortic valve-sparing root reconstruction in Marfan syndrome was reviewed. Thirteen patients with Marfan syndrome underwent aortic valve-sparing root reconstruction for annuloaortic ectasia or aortic root dissection between 1994 and 1999. The grade of preoperative aortic regurgitation was I in 4, II in 2, III in 5, IV in 2 patients. The procedures of aortic valve-sparing were reimplantation in 7 and remodeling in 5 patients. There was no hospital and late death. Recurrence of aortic regurgitation greater than moderate grade developed in 1 patient immediately after the surgery and in the other 4 patients in the late stage. One patient of them required aortic valve replacement for it. Aortic valve-sparing root reconstruction is applicable in Marfan patients, although the indication should be cautious. Close observation is needed for recurrence of aortic regurgitation.

A Dynamic Model of the Initial Spares Support List Development Process

Science.gov (United States)

1979-06-01

S117Z1NOTE NREI -NOT READI END ITERS IIT7INOTE GPEI -QUANTITY OF PARTS M. END ITER 11775NOTE FUSERF -PARTS USE RATE FACTOR U8WOTE OP U -OTHER PARTS USE...FAILURES ’I 1675R PtJER.L=(NREI.K) (QPEI) (PUSERF.K)+OPUR II7HNOTE PUSER -PARTS USE RATE II7t5NOTE NREI -NOT READY END ITEMS II756NOTE GPEI -QUANTITY

Strategic provisioning of replacement parts for CANDU power plants

International Nuclear Information System (INIS)

Mizuno, G.; Tume, P.; Prentice, J.

2000-01-01

Provisioning of replacement parts and management of critical spares are key factors in optimizing maintenance programs for CANDU power plants. With a view to supply assurance, Atomic Energy Canada Limited (AECL) has created a Spare Parts Branch (SPB) to provide a clear pipeline from the client to the delivered replacement part(s). SPB provides the client with assured access to a qualified supplier database, computer aided design, engineering and manufacturing services and material upgrades and design registration through the authorized inspection agency. The AECL spare parts strategic provisioning service plan that has four thrusts: 1) the efficient delivery of cost-effective replacement parts; 2) obsolete parts resolution; 3) a website that will provide our clients with real-time access to replacement part data; and 4) inventory recovery opportunities. Thrusts one and two are actively ensuring plant maintenance for on-shore and off-shore CANDU clients. Thrusts three and four are longer-term commitments. This paper will explore these thrusts in the context of our CANDU business practices. (author)

Sparing bilateral neck level IB in oropharyngeal carcinoma and xerostomia outcomes.

Science.gov (United States)

Tam, Moses; Riaz, Nadeem; Kannarunimit, Danita; Peña, Angela P; Schupak, Karen D; Gelblum, Daphna Y; Wolden, Suzanne L; Rao, Shyam; Lee, Nancy Y

2015-08-01

To assess whether sparing neck-level IB in target delineation of node-positive (N+) oropharyngeal carcinoma (OPC) can improve xerostomia outcomes without compromising locoregional control (LRC). A total of 125 N+ OPC patients with a median age of 57 years underwent chemoradiation between May 2010 and December 2011. A total of 74% of patients had T1-T2 disease, 26% T3-T4, 16% N1, 8% N2A, 48% N2B, 28% N2C; 53% base of tongue, 41% tonsil, and 6% other. Patients were divided into those who had target delineation sparing of bilateral level IB (the spared cohort) versus no sparing (the treated cohort). Sparing of contralateral high-level II nodes was also performed more consistently in the spared cohort. A prospective xerostomia questionnaire (patient reported) was given at each patient follow-up visit to this cohort of patients to assess late xerostomia. Clinical assessment (observer rated) at each patient follow-up visit was also recorded. The 2-year LRC for the spared and treated cohorts was 97.5% and 93.8%, respectively (median follow-up, 23.2 mo). No locoregional failures occurred outside of treatment fields. The spared cohort experienced significant benefits in patient-reported xerostomia summary scores (P=0.021) and observer-rated xerostomia scores (P=0.006). In addition, there were significant reductions in mean doses to the ipsilateral submandibular gland (63.9 vs. 70.5 Gy; Pxerostomia outcomes.

Immediate Breast Reconstruction with Expander Assisted Latissimus Dorsi Flap after Skin Sparing Mastectomy

International Nuclear Information System (INIS)

Abdalla, H.M.; Shallan, M.A.; Fouad, F.A.; Elsayed, A.A.

2006-01-01

Background and Purpose: The latissimus dorsi my-ocutaneous flap (LDMF) used to. be the standard practice far breast reconstruction; haw ever, with the increased use of tissue expanders and the development of the transverse rectus-abdomen's myocutaneaus flap for autologous tissue breast reconstruction, its use has decreased. To. reassess the role of the LDMF in breast reconstruction, a prospective study was performed to. evaluate women who. had a skin sparing mastectomy followed by immediate reconstruction with a latissimus dorsi flap and tissue expander implant. Patients and Methods: Twenty-five women with early breast cancer underwent immediate latissimus dorsi my-ocutaneaus flaps with tissue expander after skin sparing mastectamy. The ancalagic safety at skin sparing mastectamy, the pastaperative aesthetic results and camplicatians were evaluated. Results: Between May 2003 and April 2005, 25 can-secutive wamen diagnased with breast cancer underwent skin sparing mas tecta my and expander assisted immediate latissimus darsi breast recanstructian. Their median age was 42 years, ranging fram 34 to 48 years. The pracedure duratian ranged fram 2.5 to. 6 haurs, with a median at 3.9 haurs, hawever, expansian was campleted by 4 manths (range I to. 8 manths). Patients were discharged 7 days after surgery with a range af 5 to. 15 days. The camplicatian rate was law, manifesting with skin flap necrosis in 12%, waund infectian in 4%, and part site extrusian in 4%. There was no. flap lass. With the exceptian af serama farmatian, the danar site marbidity was law (seroma 40%, hematama 4%, back pain 8%, and limited arm mavement 4%). No. lacal recurrence was recorded. The aesthetic result af surgery was rated as excellent in 20%, gaad in 60%, fair in 24%, and paar in 4% af cases. The duratian af past-aperative fallaw up was 14.7 manths, ranging fram 6 to 24 manths. Conclusions: Skin sparing mastectamy and immediate breast recanstructian is an ancalagically safe technique. The use

Nipple-Sparing Mastectomy Improves Long-Term Nipple But Not Skin Sensation After Breast Reconstruction: Quantification of Long-Term Sensation in Nipple Sparing Versus Non-nipple Sparing Mastectomy.

Science.gov (United States)

Rodriguez-Unda, Nelson A; Bello, Ricardo J; Clarke-Pearson, Emily M; Sanyal, Abanti; Cooney, Carisa M; Manahan, Michele A; Rosson, Gedge D

2017-06-01

Changes in breast sensation after reconstruction are expected. Return of breast sensation after reconstruction and whether nipple-sparing mastectomy offers a substantial benefit in terms of sensation has been inconsistently documented in the literature. We conducted the current study using the pressure-specified sensory device to quantify postoperative breast sensation in patients undergoing nipple-sparing versus non-nipple-sparing mastectomy. Consecutive adult women who underwent nipple-sparing (NSM) and non-NSM (NNSM) and were at least 18 months postreconstruction were included. Breast measurements were taken in 4 quadrants (upper/lower lateral, upper/lower medial) and nipple. Averaged skin cutaneous thresholds [(UL+LL+UM+LM)/4] and nipple sensation between NSM and NNSM were compared as the primary outcome measure. A generalized estimating equations model was used; univariate and multivariate variable analyses were done when appropriate. Forty-four patients (74 breasts) were examined (53 NNSM vs 21 NSM). The groups were further subdivided into autologous versus implant-based reconstruction. Averaged cutaneous skin thresholds for quadrants were better for the NSM, 51.8(±24.5) g/mm versus NNSM, 56.5(±25.7) g/mm, although this difference was not statistically significant. However, NSM breasts measured higher nipple or nipple area sensitivity, 44.5(±30.8) g/mm versus NNSM, 83.8(±27.4) g/mm (P sensation was the number of revision surgeries, especially after third revision. Breast sensation is decreased after reconstruction in both NSM and NNSM, but nipple sensation or nipple area is better preserved in NSM breasts. Number of revision surgeries (>3) was a predictor of decreased sensation.

A hot-spare injector for the APS linac

International Nuclear Information System (INIS)

Lewellen, J. W.

1999-01-01

Last year a second-generation SSRL-type thermionic cathode rf gun was installed in the Advanced Photon Source (APS) linac. This gun (referred to as ''gun2'') has been successfully commissioned and now serves as the main injector for the APS linac, essentially replacing the Koontz-type DC gun. To help ensure injector availability, particularly with the advent of top-up mode operation at the APS, a second thermionic-cathode rf gun will be installed in the APS linac to act as a hot-spare beam source. The hot-spare installation includes several unique design features, including a deep-orbit Panofsky-style alpha magnet. Details of the hot-spare beamline design and projected performance are presented, along with some plans for future performance upgrades

Graft-Sparing Strategy for Thoracic Prosthetic Graft Infection.

Science.gov (United States)

Uchino, Gaku; Yoshida, Takeshi; Kakii, Bunpachi; Furui, Masato

2018-04-01

 Thoracic prosthetic graft infection is a rare but serious complication with no standard management. We reported our surgical experience on graft-sparing strategy for thoracic prosthetic graft infection.  This study included patients who underwent graft-sparing surgery for thoracic prosthetic graft infection at Matsubara Tokushukai Hospital in Japan from January 2000 to October 2017.  There were 17 patients included in the analyses, with a mean age at surgery of 71.0 ± 10.5 years; 11 were men. In-hospital mortality was observed in five patients (29.4%).  Graft-sparing surgery for thoracic prosthetic graft infection is an alternative option particularly for early graft infection after hemiarch replacement. Georg Thieme Verlag KG Stuttgart · New York.

Valve-sparing aortic root replacement†.

Science.gov (United States)

Koolbergen, David R; Manshanden, Johan S J; Bouma, Berto J; Blom, Nico A; Mulder, Barbara J M; de Mol, Bas A J M; Hazekamp, Mark G

2015-02-01

To evaluate our results of valve-sparing aortic root replacement and associated (multiple) valve repair. From September 2003 to September 2013, 97 patients had valve-sparing aortic root replacement procedures. Patient records and preoperative, postoperative and recent echocardiograms were reviewed. Median age was 40.3 (range: 13.4-68.6) years and 67 (69.1%) were male. Seven (7.2%) patients were younger than 18 years, the youngest being 13.4 years. Fifty-four (55.7%) had Marfan syndrome, 2 (2.1%) other fibrous tissue diseases, 15 (15.5%) bicuspid aortic valve and 3 (3.1%) had earlier Fallot repair. The reimplantation technique was used in all, with a straight vascular prosthesis in 11 (26-34 mm) and the Valsalva prosthesis in 86 (26-32 mm). Concomitant aortic valve repair was performed in 43 (44.3%), mitral valve repair in 10 (10.3%), tricuspid valve repair in 5 (5.2%) and aortic arch replacement in 3 (3.1%). Mean follow-up was 4.2 ± 2.4 years. Follow-up was complete in all. One 14-year old patient died 1.3 years post-surgery presumably of ventricular arrhythmia. One patient underwent reoperation for aneurysm of the proximal right coronary artery after 4.9 years and 4 patients required aortic valve replacement, 3 of which because of endocarditis after 0.1, 0.8 and 1.3 years and 1 because of cusp prolapse after 3.8 years. No thrombo-embolic complications occurred. Mortality, root reoperation and aortic regurgitation were absent in 88.0 ± 0.5% at 5-year follow-up. Results of valve-sparing root replacement are good, even in association with a high incidence of concomitant valve repair. Valve-sparing aortic root replacement can be performed at a very young age as long as an adult size prosthesis can be implanted. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Second Line of Defense Master Spares Catalog

Energy Technology Data Exchange (ETDEWEB)

Henderson, Dale L.; Muller, George; Mercier, Theresa M.; Brigantic, Robert T.; Perkins, Casey J.; Cooley, Scott K.

2012-11-20

This catalog is intended to be a comprehensive listing of repair parts, components, kits, and consumable items used on the equipment deployed at SLD sites worldwide. The catalog covers detection, CAS, network, ancillary equipment, and tools. The catalog is backed by a Master Parts Database which is used to generate the standard report views of the catalog. The master parts database is a relational database containing a record for every part in the master parts catalog along with supporting tables for normalizing fields in the records. The database also includes supporting queries, database maintenance forms, and reports.

Active patient decision making regarding nerve sparing during radical prostatectomy: a novel approach.

Science.gov (United States)

Lavery, Hugh J; Prall, David N; Abaza, Ronney

2011-08-01

The motivation to preserve sexual function can vary widely among patients before prostatectomy. Increasing patient involvement may allow a more personalized experience and may improve satisfaction. We assessed a strategy of surgeon deference to patient choice in regard to nerve sparing to determine to what degree patients are rational actors and capable of active decision making. A total of 150 patients treated with prostatectomy participated in a standardized preoperative discussion regarding the concept of nerve sparing, extracapsular extension and the potential need for adjuvant radiation in the event of local recurrence. Each patient was given his nomogram predicted risk of extracapsular extension and then elected nerve sparing or nonnerve sparing. The corresponding procedure was performed unless grossly invasive disease was encountered. Of the 150 patients 109 chose nerve sparing (73%) and 41 chose nonnerve sparing (27%). In patients with a nomogram predicted risk of extracapsular extension less than 20%, 20% to 50% and greater than 50%, nerve sparing was elected by 88%, 41% and 25%, respectively. Patients with lower risks of extracapsular extension electing nonnerve sparing were older and had higher rates of erectile dysfunction. Empowering patients to decide on their nerve sparing status is a reasonable strategy that did not lead to a high rate of patients with a high risk of extracapsular extension electing nerve sparing. With proper counseling informed patients made reasonable decisions, and appeared to be conservative, prioritizing cancer control in the majority of instances where extracapsular extension risk was high. In addition, they may have been overly conservative in electing nonnerve sparing when the risk was low. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

[Valve-sparing Replacement in Patients with Aortic Root Dilatation].

Science.gov (United States)

Yamazaki, Kazuhiro; Minatoya, Kenji; Ueda, Ryoma; Takehara, Masato; Sakamoto, Kazuhisa; Ide, Yujiro; Kanemitsu, Hideo; Ueyama, Koji; Ikeda, Tadashi

2018-01-01

Valve-sparing root replacement is increasingly used to overcome drawbacks associated with valvular prostheses. In our institution, 7 patients underwent valve-sparing root replacement from August 2016 to July 2017. The mean age was 45 years (range, 14~69 years). Three patients had Marfan syndrome and 1 had Loeys-Dietz syndrome with acute aortic dissection. All patients underwent surgery with reimplantation technique using a Valsalva graft. Two patients required repair of aortic valve leaflet prolapse. All patients had an excellent clinical course, with mild or no aortic regurgitation and a decrease in end-diastolic volume on echocardiography. These results support the continued use of valve-sparing root replacement in selected patients.

Analysis of Reliability Estimations and Spares Protection Levels on Life Cycle Costs of the Marine Corps H-1 Upgrades Program

National Research Council Canada - National Science Library

Thompson, David

2004-01-01

.... This will be accomplished through the integration of factors impacting spare parts levels and Life Cycle Costs into a spreadsheet model that will establish the appropriate relationship between the factors...

46 CFR 131.545 - Maintenance in general.

Science.gov (United States)

2010-10-01

... points with the recommended lubricants. (5) A list of replaceable parts. (6) A list of sources of spare parts. (7) A log for records of inspections, maintenance, and repair. (b) The master shall ensure that... test in subchapter Q of this chapter. (g) The master shall report each emergency repair or alteration...

10 CFR Appendix H to Part 110 - Illustrative List of Electromagnetic Enrichment Plant Equipment and Components Under NRC Export...

Science.gov (United States)

2010-01-01

... Equipment and Components Under NRC Export Licensing Authority H Appendix H to Part 110 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) EXPORT AND IMPORT OF NUCLEAR EQUIPMENT AND MATERIAL Pt. 110, App. H Appendix H to Part 110—Illustrative List of Electromagnetic Enrichment Plant Equipment and Components Under...

10 CFR Appendix N to Part 110 - Illustrative List of Lithium Isotope Separation Facilities, Plants and Equipment Under NRC's...

Science.gov (United States)

2010-01-01

..., Plants and Equipment Under NRC's Export Licensing Authority N Appendix N to Part 110 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) EXPORT AND IMPORT OF NUCLEAR EQUIPMENT AND MATERIAL Pt. 110, App. N Appendix N to Part 110—Illustrative List of Lithium Isotope Separation Facilities, Plants and Equipment...

20 CFR 416.969 - Listing of Medical-Vocational Guidelines in appendix 2 of subpart P of part 404 of this chapter.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Listing of Medical-Vocational Guidelines in... Disability and Blindness Vocational Considerations § 416.969 Listing of Medical-Vocational Guidelines in appendix 2 of subpart P of part 404 of this chapter. The Dictionary of Occupational Titles includes...

Pathological confirmation of nerve-sparing types performed during robot-assisted radical prostatectomy (RARP).

Science.gov (United States)

Ko, Woo Jin; Hruby, Gregory W; Turk, Andrew T; Landman, Jaime; Badani, Ketan K

2013-03-01

WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Incremental nerve-sparing techniques (NSTs) improve postoperative erectile function after robot-assisted radical prostatectomy (RARP). However, there are no studies to date that histologically confirm the surgeon intended NST. Thus, in the present study, we histologically confirmed that the surgeon performed the nerve preservation as his intended NSTs during RARP. Also, we found that there was more variability in fascia width outcome on the left side compared with the right. Therefore, when performing nerve preservation on the surgeon's non-dominant side, we need to pay more close attention. To confirm that the surgeon achieved true intended histological nerve sparing during robot-assisted radical prostatectomy (RARP) by studying RP specimens. To aid the novice robotic surgeon to develop the skills of RARP. Between June 2008 and May 2009, 122 consecutive patients underwent RARP by a single surgeon (K.K.B.). The degree of nerve sparing (wide resection [WR], interfascial nerve sparing [ITE-NS], intrafascial nerve sparing [ITR-NS]) on both sides was recorded. The posterior sectors of RP specimens from distal, mid, and proximal parts were evaluated. Fascia width (FW) of each position in RP specimens were compared across nerve-sparing types (NSTs). FW was recorded at 15 ° intervals (3-9 o'clock position), measured as the distance between the outermost prostate gland and surgical margin. The slides were reviewed by an experienced uropathologist who was 'blinded' to the NST. In all, 93 men were included. The overall mean (sd) FW was the greatest in the order of WR, ITE-NS, and ITR-NS, at 2.42 (1.62), 1.71 (1.40) and 1.16 (1.08) mm, respectively (P ITE-NS, bilateral ITE-NS, ITE-NS/WR, and bilateral WR, respectively. To further validate and confirm these preliminary findings, additional studies involving multicentre cohorts would be required. The surgeon intended dissection and FW correlate, with ITR

Intrafascial nerve-sparing endoscopic extraperitoneal radical prostatectomy.

Science.gov (United States)

Stolzenburg, Jens-Uwe; Rabenalt, Robert; Do, Minh; Schwalenberg, Thilo; Winkler, Mathias; Dietel, Anja; Liatsikos, Evangelos

2008-05-01

Based on our recently published anatomic studies, we present the most recent refinement of the endoscopic extraperitoneal radical prostatectomy (EERPE), the intrafascial nerve-sparing EERPE (nsEERPE). As part of the intrafascial technique, the dissection plane is directly on the prostatic capsule, freeing the prostate laterally from its thin surrounding fascia that contains small vessels and nerves. The technique enables puboprostatic ligament preservation, leaving intact endopelvic fascia, periprostatic fascia, and neurovascular bundles. The operation was performed in 150 patients with indications for nerve-sparing procedure. The mean operative time was 131 min (range: 50-210 min) and the mean catheterization time was 5.9 d (range: 4-20 d). Twelve months postoperatively, 94.3% of the patients were continent (no need for pads), 4.6% had minimal stress incontinence, and one patient required >2 pads/d. At the 12-mo follow-up, the potency rates (erections sufficient for intercourse with or without the use of phosphodiesterase 5 [PDE5] inhibitors) of the patients who underwent bilateral intrafascial nsEERPE were 89.7% (age: 44-55 yr), 81.1% (age: 56-65 yr), and 61.9% (age: >65 yr). Positive surgical margins in pT2 and pT3 tumors were 4.5% and 29.4%, respectively. The intrafascial nsEERPE enables the dissection of the prostate with limited trauma to the surrounding fascias and the enclosed neurovascular bundles. We propose that the preserved neurovascular bundles with intrafascial nsEERPE are more viable. The results advocate this proposition.

Configuration model of partial repairable spares under batch ordering policy based on inventory state

Institute of Scientific and Technical Information of China (English)

Ruan Minzhi; Luo Yi; Li Hua

2014-01-01

Rational planning of spares configuration project is an effective approach to improve equipment availability as well as reduce life cycle cost (LCC). With an analysis of various impacts on support system, the spares demand rate forecast model is constructed. According to systemic analysis method, spares support effectiveness evaluation indicators system is built, and then, initial spares configuration and optimization method is researched. To the issue of discarding and con-sumption for incomplete repairable items, its expected backorders function is approximated by Laplace demand distribution. Combining the (s-1, s) and (R, Q) inventory policy, the spares resup-ply model is established under the batch ordering policy based on inventory state, and the optimi-zation analysis flow for spares configuration is proposed. Through application on shipborne equipment spares configuration, the given scenarios are analyzed under two constraint targets:one is the support effectiveness, and the other is the spares cost. Analysis reveals that the result is consistent with practical regulation;therefore, the model’s correctness, method’s validity as well as optimization project’s rationality are proved to a certain extent.

Modelagem da gestão de estoques de peças de reposição através de cadeias de Markov A model for spare parts stock management using Markov chains

Directory of Open Access Journals (Sweden)

Antonio Vinicius Pimpão Gomes

2008-04-01

Full Text Available Nessa pesquisa é apresentada uma abordagem para gestão de estoques de peças de reposição com base em cadeias de Markov. É feita uma comparação com a simulação convencional, a fim de validar esta abordagem, bem como é apresentada uma heurística para determinação dos parâmetros da política (S, s de gestão de estoques, dado um conjunto de itens de custo (falta, excesso e ressuprimento e de demanda com distribuição Poisson. A análise dos gráficos desses itens de custo em função dos parâmetros da política (S, s fornece os trade-offs básicos para a formulação da heurística.In this study, we propose a model for a management stock system of spare parts using Markov chains. We compare this method with a conventional simulation showing that both methods are equivalent. In addition, we propose heuristics to find the system parameters based on the properties of Markov Chains and graphics related to the costs implied in the stock management of spare parts.

Nipple- and areola-sparing mastectomy for the treatment of breast cancer.

Science.gov (United States)

Mota, Bruna S; Riera, Rachel; Ricci, Marcos Desidério; Barrett, Jessica; de Castria, Tiago B; Atallah, Álvaro N; Bevilacqua, Jose Luiz B

2016-11-29

The efficacy and safety of nipple-sparing mastectomy and areola-sparing mastectomy for the treatment of breast cancer are still questionable. It is estimated that the local recurrence rates following nipple-sparing mastectomy are very similar to breast-conserving surgery followed by radiotherapy. To assess the efficacy and safety of nipple-sparing mastectomy and areola-sparing mastectomy for the treatment of ductal carcinoma in situ and invasive breast cancer in women. We searched the Cochrane Breast Cancer Group's Specialized Register, the Cochrane Center Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed), Embase (via OVID) and LILACS (via Biblioteca Virtual em Saúde [BVS]) using the search terms "nipple sparing mastectomy" and "areola-sparing mastectomy". Also, we searched the World Health Organization's International Clinical Trials Registry Platform and ClinicalTrials.gov. All searches were conducted on 30th September 2014 and we did not apply any language restrictions. Randomised controlled trials (RCTs) however if there were no RCTs, we expanded our criteria to include non-randomised comparative studies (cohort and case-control studies). Studies evaluated nipple-sparing and areola-sparing mastectomy compared to modified radical mastectomy or skin-sparing mastectomy for the treatment of ductal carcinoma in situ or invasive breast cancer. Two review authors (BS and RR) performed data extraction and resolved disagreements. We performed descriptive analyses and meta-analyses of the data using Review Manager software. We used Cochrane's risk of bias tool to assess studies, and adapted it for non-randomised studies, and we evaluated the quality of the evidence using GRADE criteria. We included 11 cohort studies, evaluating a total of 6502 participants undergoing 7018 procedures: 2529 underwent a nipple-sparing mastectomy (NSM), 818 underwent skin-sparing mastectomy (SSM) and 3671 underwent traditional mastectomy, also known as modified radical

Foveal sparing in stargardt disease

NARCIS (Netherlands)

Huet, R.A.C. van; Bax, N.M.; Westeneng-van Haaften, S.C.; Muhamad, M.; Zonneveld-Vrieling, M.N.; Hoefsloot, L.H.; Cremers, F.P.M.; Boon, C.J.F.; Klevering, B.J.; Hoyng, C.B.

2014-01-01

PURPOSE: To provide a clinical and genetic description of a patient cohort with Stargardt disease (STGD1) with identifiable foveal sparing. METHODS: Patients with retinal atrophy (defined as an absence of autofluorescence) that surrounded the fovea by at least 180 degrees and did not include the

Simulation of an integrated age replacement and spare provisioning policy using SLAM

International Nuclear Information System (INIS)

Zohrul Kabir, A.B.M.; Farrash, S.H.A.

1996-01-01

This paper presents a SLAM simulation model for determining a jointly optimal age replacement and spare part provisioning policy. The policy, referred to as a stocking policy, is formulated by combining age replacement policy with a continuous review (s, S) type inventory policy, where s is the stock reorder level and S is the maximum stock level. The optimal values of the decision variables are obtained by minimizing the total cost of replacement and inventory. The simulation procedure outlined in the paper can be used to model any operating situation having either a single item or a number of identical items. Results from a number of case problems specifically constructed by 5-factor second order rotatory design have been presented and the effects of different cost elements, item failure characteristics and lead time characteristics have been highlighted. For all case problems, optimal (s, S) policies to support the Barlow-Proschan age policy have also been determined. Simulation results clearly indicate the separate optimizations of replacement and spare provisioning policies do not ensure global optimality when total system cost has to be minimized

Reframing the land-sparing/land-sharing debate for biodiversity conservation.

Science.gov (United States)

Kremen, Claire

2015-10-01

Conservation biologists are devoting an increasing amount of energy to debating whether land sparing (high-yielding agriculture on a small land footprint) or land sharing (low-yielding, wildlife-friendly agriculture on a larger land footprint) will promote better outcomes for local and global biodiversity. In turn, concerns are mounting about how to feed the world, given increasing demands for food. In this review, I evaluate the land-sparing/land-sharing framework--does the framework stimulate research and policy that can reconcile agricultural land use with biodiversity conservation, or is a revised framing needed? I review (1) the ecological evidence in favor of sparing versus sharing; (2) the evidence from land-use change studies that assesses whether a relationship exists between agricultural intensification and land sparing; and (3) how that relationship may be affected by socioeconomic and political factors. To address the trade-off between biodiversity conservation and food production, I then ask which forms of agricultural intensification can best feed the world now and in the future. On the basis of my review, I suggest that the dichotomy of the land-sparing/land-sharing framework limits the realm of future possibilities to two, largely undesirable, options for conservation. Both large, protected regions and favorable surrounding matrices are needed to promote biodiversity conservation; they work synergistically and are not mutually exclusive. A "both-and" framing of large protected areas surrounded by a wildlife-friendly matrix suggests different research priorities from the "either-or" framing of sparing versus sharing. Furthermore, wildlife-friendly farming methods such as agroecology may be best adapted to provide food for the world's hungry people. © 2015 New York Academy of Sciences.

Geometric factors influencing dosimetric sparing of the parotid glands using IMRT

International Nuclear Information System (INIS)

Hunt, Margie A.; Jackson, Andrew; Narayana, Ashwatha; Lee, Nancy

2006-01-01

Purpose/Objective: To determine the relationship between the parotid volume, parotid-planning target volume (PTV) overlap, and dosimetric sparing of the parotid with intensity-modulated radiation therapy (IMRT). Methods and Materials: Parotid data were collected retrospectively for 51 patients treated with simultaneous boost IMRT. Unresectable patients received 54 or 59.4 Gy to subclinical disease, 70 Gy to gross disease. Patients treated postoperatively received 54, 60, and 66 Gy to low-risk, high-risk, and tumor bed regions. Volume and mean dose of each gland and gland segments outside of and overlapping the PTV were collected. Proximity of each gland to each PTV was recorded. Results: Dosimetric sparing (mean dose ≤26.5 Gy) was achieved in 66 of 71 glands with ≤21% parotid-PTV overlap and 8 of 23 glands with >21% overlap (p = 21%. Median mean dose was 25.9 Gy to glands overlapping PTV 54 or PTV 59 alone and 30.0 Gy to those abutting PTV 7 (p 7 was associated with higher parotid dose, satisfactory sparing was achieved in 24 of 43 ipsilateral glands. Conclusions: Dosimetric sparing of the parotid is feasible when the parotid-PTV overlap is less than approximately 20%. With more overlap, sparing may result in low doses within the overlap region, possibly leading to inadequate PTV coverage. Gland proximity to the high-dose PTV is associated with higher mean dose but does not always preclude dosimetric sparing

All-Cause Mortality After Fertility-Sparing Surgery for Stage I Epithelial Ovarian Cancer.

Science.gov (United States)

Melamed, Alexander; Rizzo, Anthony E; Nitecki, Roni; Gockley, Allison A; Bregar, Amy J; Schorge, John O; Del Carmen, Marcela G; Rauh-Hain, J Alejandro

2017-07-01

To compare all-cause mortality between women who underwent fertility-sparing surgery with those who underwent conventional surgery for stage I ovarian cancer. In a cohort study using the National Cancer Database, we identified women younger than 40 years diagnosed with stage IA and unilateral IC epithelial ovarian cancer between 2004 and 2012. Fertility-sparing surgery was defined as conservation of one ovary and the uterus. The primary outcome was time from diagnosis to death. We used propensity score methods to assemble a cohort of women who underwent fertility-sparing or conventional surgery but were otherwise similar on observed covariates and conducted survival analyses using the Kaplan-Meier method and Cox proportional hazard models. We identified 1,726 women with stage IA and unilateral IC epithelial ovarian cancer of whom 825 (47.8%) underwent fertility-sparing surgery. Fertility-sparing surgery was associated with younger age, residence in the northeastern and western United States, and serous or mucinous histology (Pfertility-sparing surgery and 37 deaths among propensity-matched women who underwent conventional surgery after a median follow-up of 63 months. Fertility-sparing surgery was not associated with hazard of death (hazard ratio 0.80, 95% confidence interval [CI] 0.49-1.29, P=.36). The probability of survival 10 years after diagnosis was 88.5% (95% CI 82.4-92.6) in the fertility-sparing group and 88.9% (95% CI 84.9-92.0) in the conventional surgery group. In patients with high-risk features such as clear cell histology, grade 3, or stage IC, 10-year survival was 80.5% (95% CI 68.5-88.3) among women who underwent fertility-sparing surgery and 83.4% (95% 76.0-88.7) among those who had conventional surgery (hazard ratio 0.86, 95% CI 0.49-1.53, P=.61). Compared with conventional surgery, fertility-sparing surgery was not associated with increased risk of death in young women with stage I epithelial ovarian cancer.

Primary Buttonhole Mastopexy and Nipple-Sparing Mastectomy: A Preliminary Report.

Science.gov (United States)

Salibian, Arthur H; Harness, Jay K; Mowlds, Donald S

2016-10-01

Patients undergoing nipple-sparing mastectomy and immediate-implant based reconstruction occasionally require a mastopexy based on their breast size and degree of ptosis. Previous reports have shown the feasibility of mastopexy-nipple-sparing mastectomy in selected patients to raise the nipple up to 5 cm. Major mastopexy with nipple transposition more than 6 cm in conjunction with nipple-sparing mastectomy for therapeutic indications has not been described. The authors review their experience with primary buttonhole mastopexy performed in conjunction with nipple-sparing mastectomy. Between 2008 and 2014, 16 patients (32 breasts) underwent bilateral primary mastopexy and nipple-sparing mastectomy with immediate staged implant-based reconstruction. The Passot buttonhole technique was used for the mastopexy in all patients, raising the nipple from 7 to 12 cm. Tumor-related data, risk factors, breast size, degree of ptosis, expander size, fill volume, selection criteria, and complications are discussed. The average follow-up period was 33 months (range, 14 to 80 months). There were no tumor recurrences, and all patients completed their reconstruction. Two patients required removal of the expander and delayed reconstruction because of infection and implant exposure due to nipple-areola loss. The reasons for nipple-areola loss and technical modifications to enhance skin viability by retaining a thin layer of subareolar breast tissue for removal during the second-stage implant exchange are discussed. Primary mastopexy using the buttonhole technique performed together with nipple-sparing mastectomy is a safe procedure with predictable results in patients with very large or ptotic breasts requiring lifts greater than 6 cm. The success of the combined procedure depends on preserving a thin layer of subareolar breast tissue and removing it at the time of implant exchange.

Muscle sparing lateral thoracotomy: the standard incision for thoracic procedures

Directory of Open Access Journals (Sweden)

Mihai Dumitrescu

2017-05-01

Full Text Available Lateral thoracotomy is a versatile approach with many variations and is currently the most widely used incision in thoracic surgery. In the current article we are presenting the muscle-sparing lateral thoracotomy in the lateral decubitus position which we consider to be the “standard” for lateral thoracotomies. Indications, surgical technique and pitfalls are described alongside our experience with thoracic drainage. Although there is no consensus regarding the name of this incision, some authors call it “axillary thoracotomy” while others call it a “modified lateral thoracotomy”, they all agree on one aspect – the importance of muscle sparing – which makes it the go-to thoracotomy for both small and large procedures involving the lung. Lateral muscle sparing thoracotomy allows for good exposure of the pulmonary hilum, fissures, apex and diaphragm. The approach is easy and quick to perform while at the same time ensuring faster postoperative recovery by sparing the latissimus dorsi muscle, better cosmetics and lower postoperative pain score when compared to the posterolateral or classical lateral thoracotomies.

SNS Central Helium Liquefier spare Carbon Bed installation and commissioning

Energy Technology Data Exchange (ETDEWEB)

Degraff, Brian D. [ORNL; Howell, Matthew P. [ORNL; Kim, Sang-Ho [ORNL; Neustadt, Thomas S. [ORNL

2017-07-01

The Spallation Neutron Source (SNS) Central Helium Liquefier (CHL) at Oak Ridge National Laboratory (ORNL) has been without major operations downtime since operations were started back in 2006. This system utilizes a vessel filled with activated carbon as the final major component to remove oil vapor from the compressed helium circuit prior to insertion into the system's cryogenic cold box. The need for a spare carbon bed at SNS due to the variability of carbon media lifetime calculation to adsorption efficiency will be discussed. The fabrication, installation and commissioning of this spare carbon vessel will be presented. The novel plan for connecting the spare carbon vessel piping to the existing infrastructure will be presented.

Comparison of Spares Logistics Analysis Techniques for Long Duration Human Spaceflight

Science.gov (United States)

Owens, Andrew; de Weck, Olivier; Mattfeld, Bryan; Stromgren, Chel; Cirillo, William

2015-01-01

As the durations and distances involved in human exploration missions increase, the logistics associated with the repair and maintenance becomes more challenging. Whereas the operation of the International Space Station (ISS) depends upon regular resupply from the Earth, this paradigm may not be feasible for future missions. Longer mission durations result in higher probabilities of component failures as well as higher uncertainty regarding which components may fail, and longer distances from Earth increase the cost of resupply as well as the speed at which the crew can abort to Earth in the event of an emergency. As such, mission development efforts must take into account the logistics requirements associated with maintenance and spares. Accurate prediction of the spare parts demand for a given mission plan and how that demand changes as a result of changes to the system architecture enables full consideration of the lifecycle cost associated with different options. In this paper, we utilize a range of analysis techniques - Monte Carlo, semi-Markov, binomial, and heuristic - to examine the relationship between the mass of spares and probability of loss of function related to the Carbon Dioxide Removal System (CRS) for a notional, simplified mission profile. The Exploration Maintainability Analysis Tool (EMAT), developed at NASA Langley Research Center, is utilized for the Monte Carlo analysis. We discuss the implications of these results and the features and drawbacks of each method. In particular, we identify the limitations of heuristic methods for logistics analysis, and the additional insights provided by more in-depth techniques. We discuss the potential impact of system complexity on each technique, as well as their respective abilities to examine dynamic events. This work is the first step in an effort that will quantitatively examine how well these techniques handle increasingly more complex systems by gradually expanding the system boundary.

29 CFR (non - mandatory) Appendix C to Subpart L of Part 1926-List of National Consensus Standards

Science.gov (United States)

2010-07-01

... 29 Labor 8 2010-07-01 2010-07-01 false mandatory) Appendix C to Subpart L of Part 1926-List of National Consensus Standards (Non Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND... Consensus Standards ANSI/SIA A92.2-1990Vehicle-Mounted Elevating and Rotating Aerial Devices ANSI/SIA A92.3...

Homonymous Hemianopia with Macular Sparing: Clinical and ...

African Journals Online (AJOL)

Dr. Osoba

peripheral vision function in the cerebral cortex is located. Sparing ... Key words: brain, magnetic resonance imaging, macula, occipital lobe, vision ... luminance right homonymous hemianopia affecting inferior and superior ... infarction in left.

Macula-Sparing rhegmatogenous retinal detachment: Is emergent surgery necessary?

Directory of Open Access Journals (Sweden)

Sasan Mahmoudi

2016-01-01

Full Text Available The status of the macula is a significant factor in determining final visual outcomes in rhegmatogenous retinal detachment (RRD and should be considered in the timing of surgical repair. Several studies have shown that macula-involving RRDs attain similar visual and anatomic outcomes when surgery is performed within seven days as compared to emergent surgery (within 24 hours. In contrast, surgery prior to macular detachment in macula-sparing RRDs generally yields the best visual outcomes. In the case of macula-sparing RRDs, it is not clear how long the macula may remain attached, therefore, standard practice dictates emergent surgery. Timing of presentation, examination findings, case complexity, co-existing medical conditions, surgeon expertise, and timing and quality of access to operating facilities and staff, however, should all be considered in determining whether a macula-sparing RRD requires immediate intervention or if equivalent visual and possibly better overall outcomes can be achieved with scheduled surgery within an appropriate time frame.

WRENDA 76/77. World request list for nuclear data

International Nuclear Information System (INIS)

Lessler, R.M.

1976-08-01

The nuclear data request lists for fission reactors, fusion reactors and nuclear safeguards development appear in Parts II, III and IV, respectively, of this document. Supporting information which is pertinent to only one of the request lists has been collected in sections immediately preceding the relevant request list. Information applicable to all the request lists appears in Part I. Expansions of codes used in the request lists can be found in the appendices at the end of the document

Clinical outcomes of fertility-sparing treatments in young patients with epithelial ovarian carcinoma.

Science.gov (United States)

Hu, Jun; Zhu, Li-rong; Liang, Zhi-qing; Meng, Yuan-guang; Guo, Hong-yan; Qu, Peng-peng; Ma, Cai-ling; Xu, Cong-jian; Yuan, Bi-bo

2011-10-01

To assess the clinical outcomes of fertility-sparing treatments in young patients with epithelial ovarian carcinoma (EOC). A retrospective study of young EOC inpatients (≤40 years old) was performed during January 1994 and December 2010 in eight institutions. Data were analyzed from 94 patients treated with fertility-sparing surgery with a median follow-up time of 58.7 months. As histologic grade increased, overall survival (OS) and disease-free survival (DFS) of patients receiving fertility-sparing surgery declined. Neither staging surgery nor laparoscopy of early stage EOC with conservative surgery had a significant effect on OS or DFS. Normal menstruation recommenced after chemotherapy in 89% of the fertility-sparing group. Seventeen pregnancies among twelve patients were achieved by the end of the follow-ups. Fertility-sparing treatment for patients with EOC Stage I Grade 1 could be cautiously considered for young patients. The surgical procedure and surgical route might not significantly influence the prognosis. Standard chemotherapy is not likely to have an evident impact on ovarian function or fertility in young patients.

CPM Pairs from LSPM so far not WDS Listed – Part II

Science.gov (United States)

Knapp, Wilfried; Nanson, John

2017-10-01

The LSPM catalog (Lepine and Shara 2005) is a rich source for CPM pairs we thought already exhausted – but as we found during research for our report “A new concept for counter-checking of assumed CPM pairs” (Knapp and Nanson 2017) there are still many poten-tial CPM pairs indicated in LSPM which as of the end of 2016 are not listed in the WDS cata-log. After our first part on about 40 such objects (Knapp and Nanson 2017) the next report with about 30 additional common proper motion pairs is presented here.

ADAPTIVE OPTICS IMAGING OF FOVEAL SPARING IN GEOGRAPHIC ATROPHY SECONDARY TO AGE-RELATED MACULAR DEGENERATION.

Science.gov (United States)

Querques, Giuseppe; Kamami-Levy, Cynthia; Georges, Anouk; Pedinielli, Alexandre; Capuano, Vittorio; Blanco-Garavito, Rocio; Poulon, Fanny; Souied, Eric H

2016-02-01

To describe adaptive optics (AO) imaging of foveal sparing in geographic atrophy (GA) secondary to age-related macular degeneration. Flood-illumination AO infrared (IR) fundus images were obtained in four consecutive patients with GA using an AO retinal camera (rtx1; Imagine Eyes). Adaptive optics IR images were overlaid with confocal scanning laser ophthalmoscope near-IR autofluorescence images to allow direct correlation of en face AO features with areas of foveal sparing. Adaptive optics appearance of GA and foveal sparing, preservation of functional photoreceptors, and cone densities in areas of foveal sparing were investigated. In 5 eyes of 4 patients (all female; mean age 74.2 ± 11.9 years), a total of 5 images, sized 4° × 4°, of foveal sparing visualized on confocal scanning laser ophthalmoscope near-IR autofluorescence were investigated by AO imaging. En face AO images revealed GA as regions of inhomogeneous hyperreflectivity with irregularly dispersed hyporeflective clumps. By direct comparison with adjacent regions of GA, foveal sparing appeared as well-demarcated areas of reduced reflectivity with less hyporeflective clumps (mean 14.2 vs. 3.2; P = 0.03). Of note, in these areas, en face AO IR images revealed cone photoreceptors as hyperreflective dots over the background reflectivity (mean cone density 3,271 ± 1,109 cones per square millimeter). Microperimetry demonstrated residual function in areas of foveal sparing detected by confocal scanning laser ophthalmoscope near-IR autofluorescence. Adaptive optics allows the appreciation of differences in reflectivity between regions of GA and foveal sparing. Preservation of functional cone photoreceptors was demonstrated on en face AO IR images in areas of foveal sparing detected by confocal scanning laser ophthalmoscope near-IR autofluorescence.

Preventing Mitochondrial Diseases: Embryo-Sparing Donor-Independent Options.

Science.gov (United States)

Adashi, Eli Y; Cohen, I Glenn

2018-05-01

Mutant mitochondrial DNA gives rise to a broad range of incurable inborn maladies. Prevention may now be possible by replacing the mutation-carrying mitochondria of zygotes or oocytes at risk with donated unaffected counterparts. However, mitochondrial replacement therapy is being held back by theological, ethical, and safety concerns over the loss of human zygotes and the involvement of a donor. These concerns make it plain that the identification, validation, and regulatory adjudication of novel embryo-sparing donor-independent technologies remains a pressing imperative. This Opinion highlights three emerging embryo-sparing donor-independent options that stand to markedly allay theological, ethical, and safety concerns raised by mitochondrial replacement therapy. Copyright © 2018 Elsevier Ltd. All rights reserved.

76 FR 81793 - The Commerce Control List

Science.gov (United States)

2011-12-29

... DEPARTMENT OF COMMERCE Bureau of Industry and Security 15 CFR Part 774 The Commerce Control List CFR Correction In Title 15 of the Code of Federal Regulations, Parts 300 to 799, revised as of Jan. 1... Commerce Control List), Category 9 Aerospace and Propulsion, Product Group E is amended by revising the...

Aortic valve-sparing surgery in Marfan syndrome.

Science.gov (United States)

Nachum, Eyal; Shinfeld, Amichay; Kogan, Alexander; Preisman, Sergey; Levin, Shany; Raanani, Ehud

2013-08-01

Patients with Marfan syndrome are referred for cardiac surgery due to root aneurysm with or without aortic valve regurgitation. Because these patients are young and frequently present with normal-appearing aortic cusps, valve sparing is often recommended. However, due to the genetic nature of the disease, the durability of such surgery remains uncertain. Between February 2004 and June 2012, 100 patients in our department suffering from aortic aneurysm with aortic valve regurgitation underwent elective aortic valve-sparing surgery. Of them, 30 had Marfan syndrome, were significantly younger (30 +/- 13 vs. 53 +/- 16 years), and had a higher percentage of root aneurysm, compared with ascending aorta aneurysm in their non-Marfan counterparts. We evaluated the safety, durability, clinical and echocardiographic mid-term results of these patients. While no early deaths were reported in either group, there were a few major early complications in both groups. At follow-up (reaching 8 years with a mean of 34 +/- 26 months) there were no late deaths, and few major late complications in the Marfan group. Altogether, 96% and 78% of the patients were in New York Heart Association functional class I-II in the Marfan and non-Marfan groups respectively. None of the Marfan patients needed reoperation on the aortic valve. Freedom from recurrent aortic valve regurgitation > 3+ was 94% in the Marfan patients. Aortic valve-sparing surgery in Marfan symdrome patients is safe and yields good mid-term clinical outcomes.

Pancreas-sparing duodenectomy for an obstructive adenocarcinoma of the duodenum

OpenAIRE

Lam, D; Croome, KP; Hernandez-Alejandro, R

2012-01-01

A duodenal adenocarcinoma arising from the junction of the second and third portion of the duodenum, which was resected by pancreas-sparing duodenectomy, is reported. The completely obstructing tumour was circumferential and measured 6.5cm x 3.5cm x 1.0 cm. There was no evidence of pancreas invasion, nor any lymph node metastasis. Pancreas-sparing duodenectomy was performed, with dissection of the pancreaticoduodenal lymph nodes. The proximal duodenum was transected just distal to the ampula ...

A new model for Assessment and Optimization of Number of Spare Transformers and their Locations in Distribution Systems

Directory of Open Access Journals (Sweden)

M Sedaghati

2015-12-01

Full Text Available In this paper, a new model has been presented to determine the number of spare transformers and their locations for distribution stations. The number of spare transformers must be so that they need minimum investment. Furthermore, they must be sufficient for replacing with transformers that have been damaged. For this reason, in this paper a new purpose function has been presented to maximize profit in distribution company’s budgeting and planning. For determining the number of spares that must be available in a stock room, this paper considers the number of spares and transformer’s fault at the same time. The number of spare transformers is determined so that at least one spare transformer will be available for replacing with the failed transformers. This paper considers time required for purchasing or repairing a failed transformer to determine the number of required spare transformers. Furthermore, whatever the number of spare equipment are increased, cost of maintenance will be increased, so an economic comparison must be done between reduced costs from reducing of outage time and increased costs from spare transformers existence.

SOME SIMPLE APPROACHES TO PLANNING THE INVENTORY OF SPARE COMPONENTS OF AN INDUSTRIAL SYSTEM

Directory of Open Access Journals (Sweden)

Alenka Brezavšek

2016-02-01

Full Text Available Two variants of a simple stochastic model for planning the inventory of spare components supporting maintenance of an industrial system are developed. In both variants, the aim is to determine how many spare components are needed at the beginning of a planning interval to fulfil demand for corrective replacements during this interval. Under the first variant, the acceptable probability of spare shortage during the planning interval is chosen as a decision variable while in the second variant, the adequate spare inventory level is assessed taking into account the expected number of component failures within the planning interval. Calculation of the number of spare components needed depends on the form of the probability density function of component failure times. Different statistical density functions that are useful to describe this function are presented. Advantages and disadvantages of using a particular density function in our model are discussed. The applicability of the model is given through illustrative numerical examples.

19 CFR 4.50 - Passenger lists.

Science.gov (United States)

2010-04-01

... VESSELS IN FOREIGN AND DOMESTIC TRADES Passengers on Vessels § 4.50 Passenger lists. (a) The master of... passenger and crew lists, as required by § 4.7(a) of this part. If the vessel is arriving from noncontiguous... 19 Customs Duties 1 2010-04-01 2010-04-01 false Passenger lists. 4.50 Section 4.50 Customs Duties...

Post-nerve-sparing prostatectomy, dose-escalated intensity-modulated radiotherapy: effect on erectile function

International Nuclear Information System (INIS)

Bastasch, Michael D.; Teh, Bin S.; Mai, W.-Y.; Carpenter, L. Steven; Lu, Hsin H.; Chiu, J. Kam; Woo, Shiao Y.; Grant, Walter H.; Miles, Brian J.; Kadmon, Dov; Butler, E. Brian

2002-01-01

Purpose: The advent of widespread prostate-specific antigen screening has resulted in more younger, potent men being diagnosed with early-stage, organ-confined prostate cancer amenable to definitive surgery. Nerve-sparing prostatectomy is a relatively new surgical advance in the treatment of prostate cancer. Very few data exist on the effect of postoperative radiotherapy (RT) on erectile function after nerve-sparing prostatectomy. They are based on conventional techniques using moderate doses of radiation, 45-54 Gy. Intensity-modulated RT (IMRT) is becoming more widespread because it allows dose escalation with increased sparing of the surrounding normal tissue. We investigated the effect of postprostatectomy, high-dose IMRT on patients' erectile function. Methods and Materials: A review of patient records found 51 patients treated between April 1998 and December 2000 with IMRT after unilateral or bilateral nerve-sparing prostatectomy. The pathologic disease stage in these patients was T2 in 47.4% and T3 in 52.6%. Postoperatively, 4 patients received hormonal ablation consisting of one injection of Lupron Depot (30 mg) 2 months before RT. The median age was 65 years (range 46-77) at the time of RT. The prescribed dose was 64 Gy (range 60-66). The mean dose was 69.6 Gy (range 64.0-72.3). Erectile function was assessed before and after RT by questionnaires. Sexual potency was defined as erectile rigidity adequate for vaginal penetration. Results: Of the 51 patients, 18 (35.3%) maintained their potency and 33 (64.7%) became impotent after nerve-sparing prostatectomy. Patients who underwent bilateral nerve-sparing prostatectomy had higher rates of postoperative potency than did those who underwent unilateral nerve-sparing surgery (72.2% vs. 27.8%; p=0.025). The follow-up for the entire group was 19.5 months. All 18 patients (100%) who were potent postoperatively remained potent after RT. The median follow-up for the 18 potent patients was 27.2 months, significantly

Cognitive Spare Capacity and Speech Communication: A Narrative Overview

Directory of Open Access Journals (Sweden)

Mary Rudner

2014-01-01

Full Text Available Background noise can make speech communication tiring and cognitively taxing, especially for individuals with hearing impairment. It is now well established that better working memory capacity is associated with better ability to understand speech under adverse conditions as well as better ability to benefit from the advanced signal processing in modern hearing aids. Recent work has shown that although such processing cannot overcome hearing handicap, it can increase cognitive spare capacity, that is, the ability to engage in higher level processing of speech. This paper surveys recent work on cognitive spare capacity and suggests new avenues of investigation.

76 FR 38533 - Alphabetical Listings: Specially Designated Nationals and Blocked Persons; Blocked Vessels...

Science.gov (United States)

2011-06-30

.... * * * * * PART 546--DARFUR SANCTIONS REGULATIONS 0 22. The authority citation for part 546 continues to read as... Nationals and Blocked Persons List (``SDN List'') with the identifier ``[DARFUR].'' The SDN List is... Federal Register and incorporated into the SDN List with the identifier ``[BPI-DARFUR].'' * * * * * PART...

Pancreas-sparing duodenectomy for an obstructive adenocarcinoma of the duodenum.

Science.gov (United States)

Lam, D; Croome, Kp; Hernandez-Alejandro, R

2012-08-01

A duodenal adenocarcinoma arising from the junction of the second and third portion of the duodenum, which was resected by pancreas-sparing duodenectomy, is reported. The completely obstructing tumour was circumferential and measured 6.5cm x 3.5cm x 1.0 cm. There was no evidence of pancreas invasion, nor any lymph node metastasis. Pancreas-sparing duodenectomy was performed, with dissection of the pancreaticoduodenal lymph nodes. The proximal duodenum was transected just distal to the ampula of Vater and jejunum was transected just distal to the ligament of Treitz. A hand-sewn side-to-side anastomosis for the duodenojejunostomy was performed. There were no postoperative complications. Pathology reported a duodenal adenocarcinoma resected with negative margins. Pancreaticoduodenectomy is the treatment of choice for a duodenal adenocarcinoma, however, pancreas-sparing duodenectomy may be a safe alternative for duodenal tumours not involving the 2(nd) portion, especially in elderly patients with multiple medical comorbidities. © JSCR.

Hippocampus sparing in whole-brain radiotherapy. A review

International Nuclear Information System (INIS)

Oskan, F.; Ganswindt, U.; Schwarz, S.B.; Manapov, F.; Belka, C.; Niyazi, M.

2014-01-01

Radiation treatment techniques for whole-brain radiation therapy (WBRT) have not changed significantly since development of the procedure. However, the recent development of novel techniques such as intensity-modulated radiation therapy (IMRT), volumetric-modulated arc therapy (VMAT) and helical tomotherapy, as well as an increasing body of evidence concerning neural stem cells (NSCs) have altered the conventional WBRT treatment paradigm. In this regard, hippocampus-sparing WBRT is a novel technique that aims to spare critical hippocampus regions without compromising tumour control. Published data on this new technique are limited to planning and feasibility studies; data on patient outcome are still lacking. However, several prospective trials to analyse the feasibility of this technique and to document clinical outcome in terms of reduced neurotoxicity are ongoing. (orig.) [de

Can sparing of the superficial contralateral parotid lobe reduce xerostomia following radiotherapy for head and neck cancer?

Science.gov (United States)

Nevens, Daan; Nuyts, Sandra

2017-12-01

The purpose of this study is to see whether sparing the superficial contralateral parotid lobe can help limiting xerostomia following radiotherapy for head and neck cancer. 88 patients that were included in two prospective randomized studies were analysed in the current study. Using the dosimetry of both the parotid glands, we divided our patients in four groups. Group 1 includes patients where we were able to reduce the radiation dose below the threshold in order to spare both the ipsilateral and contralateral parotid glands, Group 2 consists of patients where only the contralateral parotid gland could be spared. Group 3 consists of patients where only the contralateral superficial parotid lobe could be spared, while in Group 4 not even the contralateral superficial lobe could be spared. When we compared Group 1 and Group 2, we did not observe a significant difference between both groups in terms of xerostomia scores at 6 or 12 months. When we compared these groups with Group 3, we observed significant differences with more xerostomia in Group 3 where only the contralateral superficial lobe was spared. A significant difference was also observed between Group 3 and Group 4 with more xerostomia in Group 4. Sparing of just one superficial parotid lobe results in less xerostomia when compared to not sparing any lobe of both parotid glands. Advances in knowledge: When sparing of the whole contralateral parotid gland is not possible, delineating both the superficial parotid glands and trying to spare at least one of them can mean a way forward in limiting xerostomia in head and neck cancer patients treated with radiotherapy.

NASA directives: Master list and index

Science.gov (United States)

1994-01-01

This Handbook sets forth in two parts the following information for the guidance of users of the NASA Management Directives System. Chapter 1 contains introductory information material on how to use this Handbook. Chapter 2 is a complete master list of Agency-wide management directives, describing each directive by type, number, effective date, expiration date, title, and organization code of the office responsible for the directive. Chapter 3 includes a consolidated numerical list of all delegations of authority and a breakdown of such delegation by the office of Installation to which special authority is assigned. Chapter 4 sets forth a consolidated list of all NASA Handbooks (NHB's) and important footnotes covering the control and ordering of such documents. Chapter 5 is a consolidated list of NASA management directives applicable to the Jet Propulsion Laboratory. Chapter 6 is a consolidated list of NASA management directives published in the code of Federal Regulations. Complementary manuals to the NASA Management Directives System are described in Chapter 7. Part B contains an in-depth alphabetical index to all NASA management directives other than Handbooks.

Hippocampal dosimetry correlates with the change in neurocognitive function after hippocampal sparing during whole brain radiotherapy: a prospective study

International Nuclear Information System (INIS)

Tsai, Ping-Fang; Yang, Chi-Cheng; Chuang, Chi-Cheng; Huang, Ting-Yi; Wu, Yi-Ming; Pai, Ping-Ching; Tseng, Chen-Kan; Wu, Tung-Ho; Shen, Yi-Liang; Lin, Shinn-Yn

2015-01-01

Whole brain radiotherapy (WBRT) has been the treatment of choice for patients with brain metastases. However, change/decline of neurocognitive functions (NCFs) resulting from impaired hippocampal neurogenesis might occur after WBRT. It is reported that conformal hippocampal sparing would provide the preservation of NCFs. Our study aims to investigate the hippocampal dosimetry and to demonstrate the correlation between hippocampal dosimetry and neurocognitive outcomes in patients receiving hippocampal sparing during WBRT (HS-WBRT). Forty prospectively recruited cancer patients underwent HS-WBRT for therapeutic or prophylactic purposes. Before receiving HS-WBRT, all participants received a battery of baseline neurocognitive assessment, including memory, executive functions and psychomotor speed. The follow-up neurocognitive assessment at 4 months after HS-WBRT was also performed. For the delivery of HS-WBRT, Volumetric Modulated Arc Therapy (VMAT) with two full arcs and two non-coplanar partial arcs was employed. For each treatment planning, dose volume histograms were generated for left hippocampus, right hippocampus, and the composite hippocampal structure respectively. Biologically equivalent doses in 2-Gy fractions (EQD 2 ) assuming an alpha/beta ratio of 2 Gy were computed. To perform analyses addressing the correlation between hippocampal dosimetry and the change in scores of NCFs, pre- and post-HS-WBRT neurocognitive assessments were available in 24 patients in this study. Scores of NCFs were quite stable before and after HS-WBRT in terms of hippocampus-dependent memory. Regarding verbal memory, the corresponding EQD 2 values of 0, 10, 50, 80 % irradiating the composite hippocampal structure with <12.60 Gy, <8.81, <7.45 Gy and <5.83 Gy respectively were significantly associated with neurocognitive preservation indicated by the immediate recall of Word List Test of Wechsler Memory Scale-III. According to logistic regression analyses, it was noted that

Shoulder complaints after nerve sparing neck dissections

NARCIS (Netherlands)

van Wilgen, CP; Dijkstra, PU; van der Laan, BFAM; Plukker, JTM; Roodenburg, JLN

The purpose of the study was to analyse the prevalence of shoulder complaints after nerve sparing neck dissection at least I year after surgery, and to analyse the influence of radiation therapy on shoulder complaints. Patients were interviewed for shoulder complaints, and patients filled out the

Model Development for Auto Spare Parts Inventory Control and ...

African Journals Online (AJOL)

2012-12-01

Dec 1, 2012 ... essential motivating factors for providing control in manufacturing companies has never showed any sign ... The management of these parts can only be done with the aid of a computer; ... perform a discrete event simulation of.

Psoriasis sparing the polio-affected limb: Is it merely the koebner phenomenon?

Directory of Open Access Journals (Sweden)

B C Ravikumar

2014-01-01

Full Text Available Psoriasis being a common skin condition, atypical forms and unusual localizations of this disease are quite frequently seen. However, psoriasis sparing a polio-affected limb is extremely rare. We report a case of an adult male, who presented with psoriasis distributed all over the body but with almost complete sparing of the polio-affected left lower limb.

76 FR 25782 - Financial Management Service; Proposed Collection of Information: List of Data (A) and List of...

Science.gov (United States)

2011-05-05

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of Information: List of Data (A) and List of Data (B) AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and Request for comments. SUMMARY: The Financial Management Service, as part of...

NASA directives master list and index

Science.gov (United States)

1995-01-01

This handbook sets forth in two parts, Master List of Management Directives and Index to NASA Management Directives, the following information for the guidance of users of the NASA Management Directives System. Chapter 1 contains introductory information material on how to use this handbook. Chapter 2 is a complete master list of agencywide management directives, describing each directive by type, number, effective date, expiration date, title, and organization code of the office responsible for the directive. Chapter 3 includes a consolidated numerical list of all delegations of authority and a breakdown of such delegation by the office or center to which special authority is assigned. Chapter 4 sets forth a consolidated list of all NASA handbooks (NHB's) and important footnotes covering the control and ordering of such documents. Chapter 5 is a consolidated list of NASA management directives applicable to the Jet Propulsion Laboratory. Chapter 6 is a consolidated list of NASA regulations published in the Code of Federal Regulations. Chapter 7 is a consolidated list of NASA regulations published in Title 14 of the Code of Federal Regulations. Complementary manuals to the NASA Management Directives System are described in Chapter 8. The second part contains an in depth alphabetical index to all NASA management directives other than handbooks, most of which are indexed by titles only.

Submandibular gland-sparing radiation therapy for locally advanced oropharyngeal squamous cell carcinoma: patterns of failure and xerostomia outcomes

International Nuclear Information System (INIS)

Gensheimer, Michael F; Liao, Jay J; Garden, Adam S; Laramore, George E; Parvathaneni, Upendra

2014-01-01

Saliva from submandibular glands (SMG) is necessary to minimize xerostomia. It is unclear whether SMG can be safely spared in patients undergoing bilateral neck radiotherapy for locally advanced oropharyngeal cancer without increasing the risk of marginal recurrence. We evaluated the outcomes of contralateral submandibular gland (cSMG) sparing intensity-modulated radiation therapy (IMRT). All patients with stage III/IV oropharyngeal squamous cell carcinoma treated with bilateral neck IMRT from 2006–2012 at our institution were included. Appropriately selected patients with favorable primary tumor characteristics and no definite contralateral neck disease were treated with cSMG-sparing IMRT. Patterns of failure and xerostomia outcomes were retrospectively analyzed. 114 patients were treated. 89% had stage IV disease and 89% received definitive radiation therapy. 76 patients (67%) received cSMG sparing IMRT. With a median follow-up of 30 months, there were 10 local, 9 regional, and 10 distant recurrences. 2-year overall survival was 86% and 2-year loco-regional control was 87%. In cSMG spared patients, the mean cSMG dose was 30.7 Gy. Late grade 2+ xerostomia was significantly reduced in the cSMG spared group compared to those without SMG sparing (6 months: 23% vs. 72%, 12 months: 6% vs. 41%, 24 months: 3% vs. 36%, all p < 0.0007). There were no peri-SMG marginal recurrences in the cSMG-spared cohort. cSMG sparing IMRT did not increase marginal failures in this series of locally advanced oropharyngeal SCC patients. Xerostomia was significantly reduced in cSMG spared patients

MANAGEMENT OF ENDOCRINE DISEASE: Outcome of adrenal sparing surgery in heritable pheochromocytoma.

Science.gov (United States)

Castinetti, F; Taieb, D; Henry, J F; Walz, M; Guerin, C; Brue, T; Conte-Devolx, B; Neumann, H P H; Sebag, F

2016-01-01

The management of hereditary pheochromocytoma has drastically evolved in the last 20 years. Bilateral pheochromocytoma does not increase mortality in MEN2 or von Hippel-Lindau (VHL) mutation carriers who are followed regularly, but these mutations induce major morbidities if total bilateral adrenalectomy is performed. Cortical sparing adrenal surgery may be proposed to avoid definitive adrenal insufficiency. The surgical goal is to leave sufficient cortical tissue to avoid glucocorticoid replacement therapy. This approach was achieved by the progressive experience of minimally invasive surgery via the transperitoneal or retroperitoneal route. Cortical sparing adrenal surgery exhibits management of all patients with MEN2 or VHL hereditary pheochromocytoma. Hereditary pheochromocytoma is a rare disease, and a randomized trial comparing cortical sparing vs classical adrenalectomy is probably not possible. This lack of data most likely explains why cortical sparing surgery has not been adopted in most expert centers that perform at least 20 procedures per year for the treatment of this disease. This review examined recent data to provide insight into the technique, its indications, and the results and subsequent follow-up in the management of patients with hereditary pheochromocytoma with a special emphasis on MEN2. © 2016 European Society of Endocrinology.

78 FR 40727 - Procurement List; Proposed Additions

Science.gov (United States)

2013-07-08

... for addition to the Procurement List for production by the nonprofit agencies listed: Products Towel.... 12/BX Cleaner, Brake Parts NSN: 6850-01-167-0678--17 oz. NPA: The Lighthouse for the Blind, St. Louis...

Analysis of Critical Parts and Materials

Science.gov (United States)

1980-12-01

1 1 1% 1% 1% 1% Large Orders Manual Ordering of Some Critical Parts Order Spares with Original Order Incentives Belter Capital Investment...demand 23 Large orders 24 Long lead procurement funding (including raw materials, facility funding) 25 Manpower analysis and training 26 Manual ... ordering of some critical parts 27 More active role in schedule negotiation 28 Multiple source procurements 29 Multi-year program funding 30 Order

Impact of shelf life on measured prompt fraction of spare Inconel in-core flux detectors

Energy Technology Data Exchange (ETDEWEB)

Mohindra, VK; Sadeghi, S. [Atomic Energy of Canada Limited, Mississauga, Ontario (Canada); Crouse, B. [Darlington Nuclear Generating Station, Bowmanville, Ontario (Canada)

2008-07-01

Prompt fraction measurements associated with spare self-powered Inconel In-Core Flux Detectors (ICFDs) carried out a few years after installation on Shut Down System number 1 (SDS1) and Reactor Regulating System (RRS) at Darlington Nuclear Generating Station (DNGS), were found to be lower than those of the original detectors. These detectors, spares and originals, were manufactured in the late 80s, however, the former were kept at manufacturer's warehouse and latter were installed in the reactor core within a few years after manufacturing. Although the prompt fractions of the spare detectors were relatively low, the electronic/electrical behavior of the spare detectors was intact. The first batch of the original detectors performed as per the design requirements. Therefore, it is suspected that during shelf life, spare Inconel in-core flux detectors underwent changes that lowered their measured values of prompt fraction, which were taken within a few years after installation in the reactor. Detailed study of detectors' material composition and impurity concentrations revealed no association with the lower prompt fraction measurements. The evaluation of the limited data of the original and spare Inconel ICFDs installed at Darlington showed: 1. The reduction in prompt fraction was roughly proportional to the shelf life of the detectors; and 2. The rate of reduction in prompt fraction during storage was about double the rate of reduction during operation in the reactor. Above observations were based on the data provided by DNGS for a few detectors. The purpose of this paper is two fold, firstly to present the results of the complete study carried out to investigate the cause of relatively low prompt fractions measured on spare SDS1 and RRS Inconel ICFDs at DNGS, and secondly to generate interest/awareness within other CANDU utilities to add to the database of prompt fractions of spare Inconel ICFDs measured after installation. The data will help to improve

Morphine sparing effect of low dose ketamine during patient ...

African Journals Online (AJOL)

Adele

2003-09-12

Sep 12, 2003 ... KEY WORDS: Ketamine, morphine sparing effect, patient controlled intravenous analgesia. ... Measurements: Morphine consumption, visual analogue pain score (VAPS), pulse ..... Brain Research, 1990; 518: 218-222. 7.

Controle de estoque de peças de reposição em local único: uma revisão da literatura Single location spare parts inventory control: the state of the art

Directory of Open Access Journals (Sweden)

José Roberto do Rego

2011-01-01

Full Text Available Estoques de peças de reposição atendem necessidades de manutenção e reparo de produtos de consumo, veículos, máquinas e equipamentos industriais, acarretando frequentemente altos custos de capital e forte impacto no nível de serviço aos clientes. A grande multiplicidade de componentes, com ciclos de vida mais curtos e baixas demandas dificultam a gestão destes estoques. Este artigo apresenta revisão da literatura sobre modelos de controle de estoques de peças de reposição em local único, abordando tanto a previsão de demanda quanto o controle de estoques nos diferentes estágios do ciclo de vida das peças. A partir do levantamento bibliográfico, identificam-se algumas lacunas referentes à decisão de estocagem ou não de um item, elaboração de pedidos iniciais e finais, na integração de modelos de previsão de demanda com o controle de estoque e também de estudos de caso na aplicação prática dos modelos.Spare parts inventory are needed for maintenance and repair of final products, vehicles, industrial machines and equipments, frequently requiring high investments and significantly affecting customer satisfaction. Inventory management is complex due to the large number of different items and low demands. This article presents a literature review on single location spare parts inventory control, embracing both demand forecasting techniques and inventory control decisions on the different life cycle stages. Overall, the literature review identified the following research opportunities on inventory management: criteria to decide to stock or not an item, how many to order in the first and the last batch, demand forecasting and inventory control models integration and case studies on real applications.

European red list of habitats. Part 1: Marine habitats

NARCIS (Netherlands)

Gubbay, S.; Sanders, N.; Haynes, T.; Janssen, J.A.M.; Rodwell, J.R.; Nieto, A.; Garcia Criado, M.; Beal, S.; Borg, J.

2016-01-01

The European Red List of Habitats provides an overview of the risk
of collapse (degree of endangerment) of marine, terrestrial and
freshwater habitats in the European Union (EU28) and adjacent
regions (EU28+), based on a consistent set of categories and
criteria, and detailed data

Land Sparing and Land Sharing Policies in Developing Countries - Drivers and Linkages to Scientific Debates

DEFF Research Database (Denmark)

Mertz, Ole; Mertens, Charlotte Filt

2017-01-01

The need for developing land sparing or land sharing policies for protecting the environment has been a polarized debate in the scientific literature. Some studies show that "spared" landscapes with clearly separated intensive agriculture and pristine forest are better for biodiversity and other...... ecosystem services, whereas others demonstrate the benefits of "shared" mosaic landscapes composed of a mix of forest types, agricultural fields, grassland, and plantations. Increasingly, these scientific views have been depolarized, recognizing that both shared and spared landscapes have a role to play......, depending on the context. However, it is less clear from the literature what drives actual policy-making related to land sparing and land sharing in developing countries and what the outcomes of these policies are. We therefore reviewed the international peer-reviewed literature for evidence of policies...

Imaging of hepatic steatosis and fatty sparing

Energy Technology Data Exchange (ETDEWEB)

Karcaaltincaba, Musturay [Department of Radiology, Hacettepe University School of Medicine, Ankara 06100 (Turkey)]. E-mail: musturayk@yahoo.com; Akhan, Okan [Department of Radiology, Hacettepe University School of Medicine, Ankara 06100 (Turkey)

2007-01-15

Radiology has gained importance in the non-invasive diagnosis of hepatic steatosis. Ultrasonography is usually the first imaging modality for the evaluation of hepatic steatosis. Unenhanced CT with or without dual kVp measurement and MRI with in and out of phase sequence can allow objective evaluation of hepatic steatosis. However, none of the imaging modalities can differentiate non-alcoholic steatohepatitis/fatty liver disease from simple steatosis. Evaluation of hepatic steatosis is important in donor evaluation before orthotopic liver transplantation and hepatic surgery. Recently, one-stop shop evaluation of potential liver donors has become possible by CT and MRI integrating vascular, parenchymal, volume and steatosis evaluation. Moreover hepatic steatosis (diffuse, multinodular, focal, subcortical, perilesional, intralesional, periportal and perivenular), hypersteatosis and sparing (geographic, nodular and perilesional or peritumoral) can cause diagnostic problems as a pseudotumor particularly in the evaluation of oncology patients. Liver MRI is used as a problem-solving tool in these patients. In this review, we discuss the current role of radiology in diagnosing, quantifying hepatic steatosis and solutions for diagnostic problems associated with fatty infiltration and sparing.

Imaging of hepatic steatosis and fatty sparing

International Nuclear Information System (INIS)

Karcaaltincaba, Musturay; Akhan, Okan

2007-01-01

Radiology has gained importance in the non-invasive diagnosis of hepatic steatosis. Ultrasonography is usually the first imaging modality for the evaluation of hepatic steatosis. Unenhanced CT with or without dual kVp measurement and MRI with in and out of phase sequence can allow objective evaluation of hepatic steatosis. However, none of the imaging modalities can differentiate non-alcoholic steatohepatitis/fatty liver disease from simple steatosis. Evaluation of hepatic steatosis is important in donor evaluation before orthotopic liver transplantation and hepatic surgery. Recently, one-stop shop evaluation of potential liver donors has become possible by CT and MRI integrating vascular, parenchymal, volume and steatosis evaluation. Moreover hepatic steatosis (diffuse, multinodular, focal, subcortical, perilesional, intralesional, periportal and perivenular), hypersteatosis and sparing (geographic, nodular and perilesional or peritumoral) can cause diagnostic problems as a pseudotumor particularly in the evaluation of oncology patients. Liver MRI is used as a problem-solving tool in these patients. In this review, we discuss the current role of radiology in diagnosing, quantifying hepatic steatosis and solutions for diagnostic problems associated with fatty infiltration and sparing

Reducing Xerostomia After Chemo-IMRT for Head and Neck Cancer: Beyond Sparing the Parotid Glands

Science.gov (United States)

Little, Michael; Schipper, Matthew; Feng, Felix Y.; Vineberg, Karen; Cornwall, Craig; Murdoch-Kinch, Carol-Anne; Eisbruch, Avraham

2011-01-01

Purpose To assess whether in addition to sparing parotid glands (PGs), xerostomia after chemo-IMRT of head and neck cancer is affected by reducing doses to other salivary glands. Methods Prospective study: 78 patients with stages III/IV oropharynx/nasopharynx cancers received chemo-IMRT aiming to spare the parts outside the targets of bilateral PGs, oral cavity (OC) containing the minor salivary glands, and contralateral submandibular gland (SMG) (when contralateral level I was not a target). Pretherapy and periodically through 24 months, validated patient-reported xerostomia questionnaires (XQ) scores and observer-graded xerostomia were recorded, and stimulated and unstimulated saliva measured selectively from each of the PGs and SMGs. Mean OC doses served as surrogates of minor salivary glands dysfunction. Regression models assessed XQ and observer-graded xerostomia predictors. Results Statistically significant predictors of the XQ score in univariate analysis included OC, PG, and SMG mean doses, as well as baseline XQ score, time since RT, and both stimulated and unstimulated PG saliva flow rates. Similar factors were statistically significant predictors of observer-graded xerostomia. OC, PG and SMG mean doses were moderately inter-correlated (r=0.47–0.55). In multivariate analyses, after adjusting for PG and SMG doses, OC mean dose (p xerostomia. While scatter plots showed no thresholds, OC mean doses xerostomia at almost all post-therapy time points. Conclusion PG, SMG and OC mean doses were significant predictors of both patient-reported and observer-rated xerostomia after chemo-IMRT, with OC doses remaining significant after adjusting for PG and SMG doses. These results support efforts to spare all salivary glands by IMRT, beyond the PGs alone. PMID:22056067

5 CFR Appendix B to Part 581 - List of Agents Designated To Facilitate the Service of Legal Process on Federal Employees

Science.gov (United States)

2010-01-01

... garnishment of the remuneration for employment due from the United States are listed in appendix A to part 581..., (Civilian Personnel Policy/Director of Civilian Personnel), 111 Army Pentagon, Washington, DC 20310-0111... Management Director, 6508 Dogwood Parkway, Suite E, Jackson, MS 39213, (601) 965-4140 Human Resources...

Opioid-sparing effects of the thoracic interfascial plane blocks: A meta-analysis of randomized controlled trials

Directory of Open Access Journals (Sweden)

Preet Mohinder Singh

2018-01-01

Conclusions: Use of PECS block and its modifications with general anesthesia for breast surgery has significant opioid-sparing effect intraoperatively and during the first 24 h after surgery. It also has higher intraoperative opioid-sparing effect when compared to PVB. During the 1st postoperative day, PVB has slightly more morphine sparing potential that may however be associated with higher complication rates. The present PECS block techniques show marked interstudy variations and need standardization.

Quality of the spare triple-GEM detectors

CERN Document Server

Lenci, Rosario; Paoletti, Emiliano; Pasquali, Luigi; Pinci, Davide; Piscitelli, Carmelo; Poli Lener, Marco; Sciubba, Adalberto; Tskhadadze, Edisher

2017-01-01

Triple-GEM chambers equip the inner region of the M1 muon station. In order to provide spare detectors in case of problems in the operating ones, new chambers have been assembled at the Frascati National Laboratories of the INFN. This note summarizes the results of the quality tests performed at the end of the production procedure.

Outcomes of Aortic Valve-Sparing Operations in Marfan Syndrome.

Science.gov (United States)

David, Tirone E; David, Carolyn M; Manlhiot, Cedric; Colman, Jack; Crean, Andrew M; Bradley, Timothy

2015-09-29

In many cardiac units, aortic valve-sparing operations have become the preferred surgical procedure to treat aortic root aneurysm in patients with Marfan syndrome, based on relatively short-term outcomes. This study examined the long-term outcomes of aortic valve-sparing operations in patients with Marfan syndrome. All patients with Marfan syndrome operated on for aortic root aneurysm from 1988 through 2012 were followed prospectively for a median of 10 years. Follow-up was 100% complete. Time-to-event analyses were calculated using the Kaplan-Meier method with log-rank test for comparisons. A total of 146 patients with Marfan syndrome had aortic valve-sparing operations. Reimplantation of the aortic valve was performed in 121 and remodeling of the aortic root was performed in 25 patients. Mean age was 35.7 ± 11.4 years and two-thirds were men. Nine patients had acute, 2 had chronic type A, and 3 had chronic type B aortic dissections before surgery. There were 1 operative and 6 late deaths, 5 caused by complications of dissections. Mortality rate at 15 years was 6.8 ± 2.9%, higher than the general population matched for age and sex. Five patients required reoperation on the aortic valve: 2 for endocarditis and 3 for aortic insufficiency. Three patients developed severe, 4 moderate, and 3 mild-to-moderate aortic insufficiency. Rate of aortic insufficiency at 15 years was 7.9 ± 3.3%, lower after reimplantation than remodeling. Nine patients developed new distal aortic dissections during follow-up. Rate of dissection at 15 years was 16.5 ± 3.4%. Aortic valve-sparing operations in patients with Marfan syndrome were associated with low rates of valve-related complications in long-term follow-up. Residual and new aortic dissections were the leading cause of death. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Tissue sparing, behavioral recovery, supraspinal axonal sparing/regeneration following sub-acute glial transplantation in a model of spinal cord contusion.

Science.gov (United States)

Barbour, Helen R; Plant, Christine D; Harvey, Alan R; Plant, Giles W

2013-09-27

It has been shown that olfactory ensheathing glia (OEG) and Schwann cell (SCs) transplantation are beneficial as cellular treatments for spinal cord injury (SCI), especially acute and sub-acute time points. In this study, we transplanted DsRED transduced adult OEG and SCs sub-acutely (14 days) following a T10 moderate spinal cord contusion injury in the rat. Behaviour was measured by open field (BBB) and horizontal ladder walking tests to ascertain improvements in locomotor function. Fluorogold staining was injected into the distal spinal cord to determine the extent of supraspinal and propriospinal axonal sparing/regeneration at 4 months post injection time point. The purpose of this study was to investigate if OEG and SCs cells injected sub acutely (14 days after injury) could: (i) improve behavioral outcomes, (ii) induce sparing/regeneration of propriospinal and supraspinal projections, and (iii) reduce tissue loss. OEG and SCs transplanted rats showed significant increased locomotion when compared to control injury only in the open field tests (BBB). However, the ladder walk test did not show statistically significant differences between treatment and control groups. Fluorogold retrograde tracing showed a statistically significant increase in the number of supraspinal nuclei projecting into the distal spinal cord in both OEG and SCs transplanted rats. These included the raphe, reticular and vestibular systems. Further pairwise multiple comparison tests also showed a statistically significant increase in raphe projecting neurons in OEG transplanted rats when compared to SCs transplanted animals. Immunohistochemistry of spinal cord sections short term (2 weeks) and long term (4 months) showed differences in host glial activity, migration and proteoglycan deposits between the two cell types. Histochemical staining revealed that the volume of tissue remaining at the lesion site had increased in all OEG and SCs treated groups. Significant tissue sparing was

Survival Following Kidney Sparing Management of Upper Urinary ...

African Journals Online (AJOL)

Survival Following Kidney Sparing Management of Upper Urinary Tract Transitional Cell Carcinoma is Adversely Affected By Prior History of Bladder Cancer. ... The tumor biology rather than the surgical approach dictates prognosis. Patients with higher stage and grade disease may be better served with a more aggressive ...

Focal sparing around the gallbladder in fatty liver

International Nuclear Information System (INIS)

Chen, Kemin; Hiramatsu, Yoshihiro; Yunoki, Masanori; Hirano, Yoko

1989-01-01

In evaluating fatty liver with CT, the residual normal liver tissues without fat deposits are occasionally detected on CT as high attenuation regions, especially surrounding the gallbladder. This study examined the incidence of this phenomenon in terms of the diagnostic value of CT in fatty liver. Fifty-seven patients with fatty liver were examined with CT. The incidence of focal sparing area was the highest in the gallbladder bed (42/57, 74%), followed by the interlobar fissure or subcapsular area (13, 23%), quadrate lobe (8, 14%), caudate lobe (2, 4%), and right lobe (one, 1.8%). These CT appearances were of spot, band, ring, and the mixed type. In 38 patients, fatty liver was too moderate to be detected without CT attenuation numbers. Among them, 27 patients (71%) had focal sparing area surrounding the gallbladder. This CT appearance seemed to be of significance in preventing the missing of moderate fatty liver. (Namekawa, K)

Carotid sparing intensity modulated radiotherapy on early glottic cancer: Preliminary study

Energy Technology Data Exchange (ETDEWEB)

Choi, Hoon Sik; Jeong, Bae Kwon; Jeong, Ho Jin; Song, Jin Ho; Kim, Jin Pyeong; Park, Jung Je; Woo, Seung Hoon; Kang, Ki Mun [Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju (Korea, Republic of)

2016-03-15

To compare the dose distribution between carotid sparing intensity modulated radiotherapy (IMRT) and opposed lateral field technique (LAFT), and to determine the effects of carotid sparing IMRT in early glottic cancer patients who have risk factors for atherosclerosis. Ten early glottic cancer patients were treated with carotid sparing IMRT. For each patient, the conventional LAFT plan was developed for comparison. IMRT and LAFT plans were compared in terms of planning target volume (PTV) coverage, conformity index, homogeneity index, and the doses to planning organ at risk volume (PRV) for carotid arteries, spinal cord and pharyngeal constrictor muscle. Recurrence was not observed in any patients during the follow-up period. V95% for PTV showed no significant difference between IMRT and LAFT plans, while V100% was significantly higher in the IMRT plan (95.5% vs. 94.6%, p = 0.005). The homogeneity index (11.6%) and conformity index (1.4) in the IMRT plan were significantly better than those in the LAFT plans (8.5% and 5.1, respectively) (p = 0.005). The median V5Gy (90.0%), V25Gy (13.5%), and V50Gy (0%) for carotid artery PRV in the IMRT plan were significantly lower than those in the LAFT plan (99.1%, 89.0%, and 77.3%, respectively) (p = 0.005). Our study suggests that carotid sparing IMRT can significantly decrease the dose to carotid arteries compared to LAFT, and it would be considered for early glottic cancer patient with high risk of atherosclerosis.

40 CFR Appendix to Subpart Eee of... - Quality Assurance Procedures for Continuous Emissions Monitors Used for Hazardous Waste Combustors

Science.gov (United States)

2010-07-01

..., the source must immediately stop burning hazardous waste. The CEM data control effort must be.... 5. Preventive Maintenance of CEMS (including spare parts inventory). 6. Data recording, calculations... reports). 2. Schedules for the daily checks, periodic audits, and preventive maintenance. 3. Check lists...

Usulan Indikator Evaluasi Pemasok dalam Penetapan Bidder List: Studi Kasus Pengadaan Jasa PT. Semen Padang

Directory of Open Access Journals (Sweden)

Pri Gustari Akbar

2016-04-01

Full Text Available Each company will seek to improve performance in order to obtain the optimal results and customer satisfaction. One of the factors that affect the performance of the company is the supplier or vendor, which acts as a supplier of the operational needs of the company consisting of raw materials and spare parts manufacturing equipment. The existence of suppliers is crucial for the production process and the product to be produced. Therefore, it is necessary to a proper selection of suppliers so as to eliminate all risks that would result in losses for the company. PT. Semen Padang is one of the companies involved in the cement industry is one of the members of PT. Cement Indonesia as the Holding Company. Until now both PT. Semen Padang and PT. Cement Indonesia does not have yet a standard method in the selection of suppliers for the procurement process of goods and services. This study aims to design the proposed indicator in the evaluation of suppliers to determine the bidder's list on a tender for the procurement of services in PT. Semen Padang. Based on the literature study, it obtained six criteria i.e: quality, delivery, performance history, price, technical capability, and procedural compliance, which are divided into 13 indicators of performance evaluation. These indicators will be validated by the cement industry. Future studies will design a model of evaluation of suppliers using Analytic Hierarchy Process (AHP method to determine the bidder's list on a tender for the procurement of services in PT. Semen Padang.

40 CFR Table 8 to Part 455 - List of Pollution Prevention Alternative Practices

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false List of Pollution Prevention... of Pollution Prevention Alternative Practices A modification to the list of practices on this table that an individual facility must comply with to be eligible for the pollution prevention alternative is...

Posterior Pole Sparing Laser Photocoagulation Combined with Intravitreal Bevacizumab Injection in Posterior Retinopathy of Prematurity

Directory of Open Access Journals (Sweden)

Rebecca Kim

2014-01-01

Full Text Available Purpose. To report the results of the posterior pole sparing laser photocoagulation combined with intravitreal bevacizumab injection (IVB in retinopathy of prematurity (ROP. Methods. A retrospective chart review of premature babies with ROP, all of whom received laser photocoagulation with IVB. Eleven eyes of 6 infants with advanced zone I ROP underwent laser ablation sparing posterior pole with concurrent IVB. The results were compared with those of full-laser treatment combined with IVB to 8 eyes of 5 infants with advanced ROP without involvement of the posterior pole. Results. The posterior pole sparing laser with IVB was performed with zone I, stage 3+ ROP at the mean postmenstrual age of 36 weeks and 5 days. The plus sign decreased significantly at postoperative day 1, the neovascular proliferation regressed by postoperative week 1, and the normal vascularization started at postoperative day 32 on the average. Two months after treatment, vascularization of the spared avascular area was completed. There was no macular dragging, tractional retinal detachment, foveal destruction by laser scars, or any other adverse event. No significant anatomical differences were identified from those of full-laser ablation combined with IVB. Conclusions. Posterior pole sparing laser with IVB can give favorable results without destruction of posterior pole retina.

Raman spectroscopic detection of peripheral nerves towards nerve-sparing surgery

Science.gov (United States)

Minamikawa, Takeo; Harada, Yoshinori; Takamatsu, Tetsuro

2017-02-01

The peripheral nervous system plays an important role in motility, sensory, and autonomic functions of the human body. Preservation of peripheral nerves in surgery, namely nerve-sparing surgery, is now promising technique to avoid functional deficits of the limbs and organs following surgery as an aspect of the improvement of quality of life of patients. Detection of peripheral nerves including myelinated and unmyelinated nerves is required for the nerve-sparing surgery; however, conventional nerve identification scheme is sometimes difficult to identify peripheral nerves due to similarity of shape and color to non-nerve tissues or its limited application to only motor peripheral nerves. To overcome these issues, we proposed a label-free detection technique of peripheral nerves by means of Raman spectroscopy. We found several fingerprints of peripheral myelinated and unmyelinated nerves by employing a modified principal component analysis of typical spectra including myelinated nerve, unmyelinated nerve, and adjacent tissues. We finally realized the sensitivity of 94.2% and the selectivity of 92.0% for peripheral nerves including myelinated and unmyelinated nerves against adjacent tissues. Although further development of an intraoperative Raman spectroscopy system is required for clinical use, our proposed approach will serve as a unique and powerful tool for peripheral nerve detection for nerve-sparing surgery in the future.

Current Status of Nephron-Sparing Surgery (NSS) in the Management of Renal Tumours.

Science.gov (United States)

Venkatramani, Vivek; Swain, Sanjaya; Satyanarayana, Ramgopal; Parekh, Dipen J

2017-06-01

Nephron-sparing surgery has emerged as the surgical treatment of choice for small renal masses over the past two decades, replacing the traditional teaching of radical nephrectomy for renal cell carcinoma. With time, there has been an evolution in the techniques and indications for partial nephrectomy. This review summarizes the current status of nephron-sparing surgery for renal carcinoma and also deals with the future of this procedure.

Land sharing not sparing in the “green economy”

NARCIS (Netherlands)

Dressler, Wolfram; Koning, de Jessica; Montefrio, Marvin; Firn, Jennifer

2016-01-01

In Southeast Asia's green economy, conservation interventions intensify the production of resources as commodities through land sparing activities and zoning in extensively used landscapes. Such initiatives encounter problems where poor resource users diversify livelihoods in multi-functional

75 FR 73972 - Hazardous Waste Management System; Identification and Listing of Hazardous Waste; Removal of...

Science.gov (United States)

2010-11-30

... Waste Management System; Identification and Listing of Hazardous Waste; Removal of Direct Final.... Lists of Subjects in 40 CFR Part 261 Environmental Protection, Hazardous waste, Recycling, Reporting and... follows: PART 261--IDENTIFICATION AND LISTING OF HAZARDOUS WASTE 0 1. The authority citation for part 261...

Esophagus and contralateral lung-sparing IMRT for locally advanced lung cancer in the community hospital setting

Directory of Open Access Journals (Sweden)

Johnny eKao

2015-06-01

Full Text Available Background: The optimal technique for performing lung IMRT remains poorly defined. We hypothesize that improved dose distributions associated with normal tissue sparing IMRT can allow for safe dose escalation resulting in decreased acute and late toxicity. Methods: We performed a retrospective analysis of 82 consecutive lung cancer patients treated with curative intent from 1/10 to 9/14. From 1/10 to 4/12, 44 patients were treated with the community standard of 3-dimensional conformal radiotherapy or IMRT without specific esophagus or contralateral lung constraints (standard RT. From 5/12 to 9/14, 38 patients were treated with normal tissue-sparing IMRT with selective sparing of contralateral lung and esophagus. The study endpoints were dosimetry, toxicity and overall survival.Results: Despite higher mean prescribed radiation doses in the normal tissue-sparing IMRT cohort (64.5 Gy vs. 60.8 Gy, p=0.04, patients treated with normal tissue-sparing IMRT had significantly lower lung V20, V10, V5, mean lung, maximum esophagus and mean esophagus doses compared to patients treated with standard RT (p≤0.001. Patients in the normal tissue-sparing IMRT group had reduced acute grade ≥3 esophagitis (0% vs. 11%, p<0.001, acute grade ≥2 weight loss (2% vs. 16%, p=0.04, late grade ≥2 pneumonitis (7% vs. 21%, p=0.02. The 2-year overall survival was 52% with normal tissue-sparing IMRT arm compared to 28% for standard RT (p=0.015.Conclusion: These data provide proof of principle that suboptimal radiation dose distributions are associated with significant acute and late lung and esophageal toxicity that may result in hospitalization or even premature mortality. Strict attention to contralateral lung and esophageal dose volume constraints are feasible in the community hospital setting without sacrificing disease control.

INIS: Authority list for journal titles

Energy Technology Data Exchange (ETDEWEB)

NONE

2003-03-01

This is the twenty-ninth revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). It lists the titles of 12 990 journals which have contained articles within the scope of INIS. The purpose of this report is to provide descriptive cataloguers with a standard entry for the full title of a journal. In addition to the full journal title, the ISSN (International Standard Serial Number), administered by the ISSN International Centre, Paris, France, and/or CODEN, assigned by Chemical Abstracts Service, USA, are given in this manual. In order to help the reader to find titles easily, the list is divided into two parts. In Part I, the full journal titles are grouped by country or international organization responsible for coverage and ordered alphabetically. In Part II, the full journal titles of all countries or international organizations are arranged alphabetically. The country name or the international organization name responsible for coverage of the journal title to INIS is entered in parentheses. Journal titles marked with an asterisk are regularly scanned by INIS. Titles that have been identified by INIS Centres as 'Key Journals' are marked with the hash sign.

INIS: Authority list for journal titles

International Nuclear Information System (INIS)

2003-01-01

This is the twenty-ninth revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). It lists the titles of 12 990 journals which have contained articles within the scope of INIS. The purpose of this report is to provide descriptive cataloguers with a standard entry for the full title of a journal. In addition to the full journal title, the ISSN (International Standard Serial Number), administered by the ISSN International Centre, Paris, France, and/or CODEN, assigned by Chemical Abstracts Service, USA, are given in this manual. In order to help the reader to find titles easily, the list is divided into two parts. In Part I, the full journal titles are grouped by country or international organization responsible for coverage and ordered alphabetically. In Part II, the full journal titles of all countries or international organizations are arranged alphabetically. The country name or the international organization name responsible for coverage of the journal title to INIS is entered in parentheses. Journal titles marked with an asterisk are regularly scanned by INIS. Titles that have been identified by INIS Centres as 'Key Journals' are marked with the hash sign

LT COL F.F. PIENAAR'S BOER WAR DIARY

African Journals Online (AJOL)

LT COL F.F. PIENAAR'S BOER WAR DIARY. (PART II). Brig J.H. Picard, SM*. FREE STATE TO ..... bing up and down on his master's spare horse. ... Jantjie and his master turned out of the road, and ..... on a list which burghers could afford to.

Tackling Fragmented Last Mile Deliveries to Nanostores by Utilizing Spare Transportation Capacity—A Simulation Study

Directory of Open Access Journals (Sweden)

Bram Kin

2018-02-01

Full Text Available Last mile deliveries in urban areas cause a disproportionate unsustainable impact, while it is also the most expensive part of the supply chain. This is particularly true for freight flows that are characterized by fragmentation. Logistically, this becomes apparent in vehicles that are driving around with a low vehicle fill rate, leading to the unnecessary presence of freight vehicles in our cities. This study focuses on the operational feasibility of utilizing the spare transportation capacity of a service-driven company as a potential solution to supply small independent retailers, or nanostores. The aim is to reduce inefficient vehicle movement. Based on a real-life implementation, we use SYnchronization Model for Belgian Inland Transport (SYMBIT, an agent-based model, to simulate various bundling scenarios. Results show the total vehicle kilometers and lead times to supply nanostores for the service-driven company to serve its customers. There is a potential to utilize spare capacity to supply nanostores while maintaining a decent service level. The number of vehicle kilometers driven highly depends on the location of the distribution center where the service-driven company operates. Based on these results, the conditions that have to be met to replicate this solution in other urban areas are discussed.

Free recall of word lists under total sleep deprivation and after recovery sleep.

Science.gov (United States)

de Almeida Valverde Zanini, Gislaine; Tufik, Sérgio; Andersen, Monica Levy; da Silva, Raquel Cristina Martins; Bueno, Orlando Francisco Amodeo; Rodrigues, Camila Cruz; Pompéia, Sabine

2012-02-01

One task that has been used to assess memory effects of prior total sleep deprivation (TSD) is the immediate free recall of word lists; however, results have been mixed. A possible explanation for this is task impurity, since recall of words from different serial positions reflects use of distinct types of memory (last words: short-term memory; first and intermediate words: episodic memory). Here we studied the effects of 2 nights of TSD on immediate free recall of semantically unrelated word lists considering the serial position curve. Random allocation to a 2-night TSD protocol followed by one night of recovery sleep or to a control group. Study conducted under continuous behavioral monitoring. 24 young, healthy male volunteers. 2 nights of total sleep deprivation (TSD) and one night of recovery sleep. Participants were shown five 15 unrelated word-lists at baseline, after one and 2 nights of TSD, and after one night of recovery sleep. We also investigated the development of recall strategies (learning) and susceptibility to interference from previous lists. No free recall impairment occurred during TSD, irrespective of serial position. Interference was unchanged. Both groups developed recall strategies, but task learning occurred earlier in controls and was evident in the TSD group only after sleep recovery. Prior TSD spared episodic memory, short-term phonological memory, and interference, allowed the development of recall strategies, but may have decreased the advantage of using these strategies, which returned to normal after recovery sleep.

Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer

International Nuclear Information System (INIS)

Eisbruch, Avraham; Kim, Hyungjin M.; Terrell, Jeffrey E.; Marsh, Lon H.C.; Dawson, Laura A.; Ship, Jonathan A.

2001-01-01

Purpose: To assess long-term xerostomia in patients receiving parotid-sparing radiation therapy (RT) for head-and-neck cancer, and to find the patient and therapy-related factors that affect its severity. Patients and Methods: From March 1994 through January 2000, 84 patients received comprehensive bilateral neck RT using conformal and multisegmental intensity-modulated RT (IMRT) aiming to spare the major salivary glands. Before RT and periodically through 2 years after the completion of RT, salivary flow rates from each of the major salivary glands were selectively measured. At the same time intervals, each patient completed an 8-item self-reported xerostomia-specific questionnaire (XQ). To gain a relative measure of the effect of RT on the minor salivary glands, whose output could not be measured, the surfaces of the oral cavity (extending to include the surface of the base of tongue) were outlined in the planning CT scans. The mean doses to the new organ ('oral cavity') were recorded. Forty-eight patients receiving unilateral neck RT were similarly studied and served as a benchmark for comparison. Factors predicting the XQ scores were analyzed using a random-effects model. Results: The XQ was found to be reliable and valid in measuring patient-reported xerostomia. The spared salivary glands which had received moderate doses in the bilateral RT group recovered to their baseline salivary flow rates during the second year after RT, and the spared glands in the unilateral RT group, which had received very low doses, demonstrated increased salivary production beyond their pre-RT levels. The increase in the salivary flow rates during the second year after RT paralleled an improvement in xerostomia in both patient groups. The improvement in xerostomia was faster in the unilateral compared with the bilateral RT group, but the difference narrowed at 2 years. The major salivary gland flow rates had only a weak correlation with the xerostomia scores. Factors found to be

Listed waste determination report

International Nuclear Information System (INIS)

1993-06-01

On September 23, 1988, the US Environmental Protection Agency (EPA) published a notice clarifying interim status requirements for the management of radioactive mixed waste thereby subjecting the Idaho National Engineering Laboratory (INEL) and other applicable Department of Energy (DOE) sites to regulation under the Resource Conservation and Recovery Act (RCRA). Therefore, the DOE was required to submit a Part A Permit application for each treatment, storage, and disposal (TSD) unit within the INEL, defining the waste codes and processes to be regulated under RCRA. The September 1990 revised Part A Permit application, that was approved by the State of Idaho identified 101 potential acute and toxic hazardous waste codes (F-, P-, and U- listed wastes according to 40 CFR 261.31 and 40 CFR 261.33) for some TSD units at the Idaho Chemical Processing Plant. Most of these waste were assumed to have been introduced into the High-level Liquid Waste TSD units via laboratory drains connected to the Process Equipment Waste (PEW) evaporator (PEW system). At that time, a detailed and systematic evaluation of hazardous chemical use and disposal practices had not been conducted to determine if F-, P-, or Unlisted waste had been disposed to the PEW system. The purpose of this investigation was to perform a systematic and detailed evaluation of the use and disposal of the 101 F-, P-, and Unlisted chemicals found in the approved September 1990 Part A Permit application. This investigation was aimed at determining which listed wastes, as defined in 40 CFR 261.31 (F-listed) and 261.33 (P ampersand Unlisted) were discharged to the PEW system. Results of this investigation will be used to support revisions to the RCRA Part A Permit application

INIS: Authority list for journal titles

International Nuclear Information System (INIS)

2005-01-01

This is the 31st revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). This list is published annually and includes the titles of all journals which have contained articles submitted to INIS at the time of publication. The current list contains 13,104 journal titles, 2,078 regularly scanned journals and 561 key journals. It was last updated in February 2005. The purpose of this report is to provide descriptive cataloguers with a standard entry for the full title of a journal. In addition to the full journal title, the ISSN (International Standard Serial Number), administered by the ISSN International Centre, Paris, France, and/or CODEN, assigned by Chemical Abstracts Service, USA, are given in this manual. In order to help the user find titles easily, the list is arranged in six parts, followed by summary statistics: In Part I, all key journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part II, all key journals are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. In Part III, all journals that are regularly scanned by INIS Centers are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part IV, all journals that are regularly scanned by INIS Centers are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. In Part V, all journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part VI, all journals are sorted alphabetically under their title. The name of the

INIS: Authority list for journal titles

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-03-01

This is the 31st revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). This list is published annually and includes the titles of all journals which have contained articles submitted to INIS at the time of publication. The current list contains 13,104 journal titles, 2,078 regularly scanned journals and 561 key journals. It was last updated in February 2005. The purpose of this report is to provide descriptive cataloguers with a standard entry for the full title of a journal. In addition to the full journal title, the ISSN (International Standard Serial Number), administered by the ISSN International Centre, Paris, France, and/or CODEN, assigned by Chemical Abstracts Service, USA, are given in this manual. In order to help the user find titles easily, the list is arranged in six parts, followed by summary statistics: In Part I, all key journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part II, all key journals are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. In Part III, all journals that are regularly scanned by INIS Centers are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part IV, all journals that are regularly scanned by INIS Centers are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. In Part V, all journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part VI, all journals are sorted alphabetically under their title. The name of the

INIS: Authority list for journal titles

International Nuclear Information System (INIS)

2006-01-01

This is the 32nd revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). This list is published annually and includes the titles of all journals which have contained articles submitted to INIS at the time of publication. The current list contains 13,231 journal titles, 2,125 regularly scanned journals and 555 key journals. It was last updated in February 2006. The purpose of this report is to provide descriptive cataloguers with a standard entry for the full title of a journal. In addition to the full journal title, the ISSN (International Standard Serial Number), administered by the ISSN International Centre, Paris, France, and/or CODEN, assigned by Chemical Abstracts Service, USA, are given in this manual. In order to help the user find titles easily, the list is arranged in six parts, followed by summary statistics: In Part I, all key journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part II, all key journals are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. In Part III, all journals that are regularly scanned by INIS Centres are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part IV, all journals that are regularly scanned by INIS Centres are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. In Part V, all journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. In Part VI, all journals are sorted alphabetically under their title. The name of the

Sparing of the submandibular glands by intensity modulated radiotherapy in the treatment of head and neck cancer

International Nuclear Information System (INIS)

Saarilahti, Kauko; Kouri, Mauri; Collan, Juhani; Kangasmaeki, Aki; Atula, Timo; Joensuu, Heikki; Tenhunen, Mikko

2006-01-01

Background and purpose: The submandibular glands produce most of the unstimulated saliva output and are the key in prevention of radiation-related xerostomia. We investigated whether sparing of the submandibular function is feasible with intensity modulated radiotherapy (IMRT). Patients and methods: Thirty-six patients diagnosed with head and neck cancer were treated with IMRT and had at least one parotid gland excluded from the planning target volume. In a subset, of these patients (n=18) where the risk of cancer recurrence in the contralateral submandibular region was judged low, the contralateral submandibular gland was spared from full-dose irradiation. The total unstimulated and stimulated salivary flow rates and adverse effects were monitored. Results: Twelve months following IMRT mean unstimulated saliva flow was 60% of the baseline value among patients who had one submandibular gland spared and 25% among those who did not (P=0.006). Patients whose contralateral submandibular was spared reported less grade two or three xerostomia (4 vs. 11; P=0.018), and used less saliva substitutes. No cancer recurrences were detected at the vicinity of the spared glands during a median follow-up time of 31 months. Conclusions: Submandibular gland sparing with IMRT is safe in selected patients treated for head and neck cancer. It is effective in prevention of radiation-associated xerostomia

A Controlled Study on Vaginal Blood Flow During Sexual Arousal Among Early-Stage Cervical Cancer Survivors Treated With Conventional Radical or Nerve-Sparing Surgery With or Without Radiotherapy

NARCIS (Netherlands)

Bakker, Rinske Maria; Pieterse, Quirine D.; van Lonkhuijzen, Luc R. C. W.; Trimbos, Baptist J. B. M. Z.; Creutzberg, Carien L.; Kenter, Gemma G.; de Kroon, Cor D.; ter Kuile, Moniek M.

2017-01-01

Objective: Sexual problems among cervical cancer survivors may in part be caused by reduced vaginal blood flow due to damaged hypogastric nerves during radical hysterectomy with pelvic lymphadenectomy and/or by radiation-induced vaginal changes after pelvic radiotherapy. A nerve-sparing modification

Evolution in Monitoring of Free Flap Autologous Breast Reconstruction after Nipple-Sparing Mastectomy: Is There a Best Way?

Science.gov (United States)

Frey, Jordan D; Stranix, John T; Chiodo, Michael V; Alperovich, Michael; Ahn, Christina Y; Allen, Robert J; Choi, Mihye; Karp, Nolan S; Levine, Jamie P

2018-05-01

Free flap monitoring in autologous reconstruction after nipple-sparing mastectomy remains controversial. The authors therefore examined outcomes in nipple-sparing mastectomy with buried free flap reconstruction versus free flap reconstruction incorporating a monitoring skin paddle. Autologous free flap reconstructions with nipple-sparing mastectomy performed from 2006 to 2015 were identified. Demographics and operative results were analyzed and compared between buried flaps and those with a skin paddle for monitoring. Two hundred twenty-one free flaps for nipple-sparing mastectomy reconstruction were identified: 50 buried flaps and 171 flaps incorporating a skin paddle. The most common flaps used were deep inferior epigastric perforator (64 percent), profunda artery perforator (12.1 percent), and muscle-sparing transverse rectus abdominis myocutaneous flaps (10.4 percent). Patients undergoing autologous reconstructions with a skin paddle had a significantly greater body mass index (p = 0.006). Mastectomy weight (p = 0.017) and flap weight (p < 0.0001) were significantly greater in flaps incorporating a skin paddle. Comparing outcomes, there were no significant differences in flap failure (2.0 percent versus 2.3 percent; p = 1.000) or percentage of flaps requiring return to the operating room (6.0 percent versus 4.7 percent; p = 0.715) between groups. Buried flaps had an absolute greater mean number of revision procedures per nipple-sparing mastectomy (0.82) compared with the skin paddle group (0.44); however, rates of revision procedures per nipple-sparing mastectomy were statistically equivalent between the groups (p = 0.296). Although buried free flap reconstruction in nipple-sparing mastectomy has been shown to be safe and effective, the authors' technique has evolved to favor incorporating a skin paddle, which allows for clinical monitoring and can be removed at the time of secondary revision. Therapeutic, III.

7 CFR 1755.98 - List of telecommunications specifications included in other 7 CFR parts.

Science.gov (United States)

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false List of telecommunications specifications included in... (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE TELECOMMUNICATIONS POLICIES ON SPECIFICATIONS, ACCEPTABLE MATERIALS, AND STANDARD CONTRACT FORMS § 1755.98 List of telecommunications specifications...

Part 1: Notch-sparing γ-secretase inhibitors: The identification of novel naphthyl and benzofuranyl amide analogs.

Science.gov (United States)

Lu, Dai; Wei, Han-Xun; Zhang, Jing; Gu, Yongli; Osenkowski, Pamela; Ye, Wenjuan; Selkoe, Dennis J; Wolfe, Michael S; Augelli-Szafran, Corinne E

2016-05-01

γ-Secretase is one of two proteases directly involved in the production of the amyloid β-peptide (Aβ), which is pathogenic in Alzheimer's disease. Inhibition of γ-secretase to suppress the production of Aβ should not block processing of one of its alternative substrates, Notch1 receptors, as interference with Notch1 signaling leads to severe toxic effects. In the course of our studies to identify γ-secretase inhibitors with selectivity for APP over Notch, 1 [3-(benzyl(isopropyl)amino)-1-(naphthalen-2-yl)propan-1-one] was found to inhibit γ-secretase-mediated Aβ production without interfering with γ-secretase-mediated Notch processing in purified enzyme assays. As 1 is chemically unstable, efforts to increase the stability of this compound led to the identification of 2 [naphthalene-2-carboxylic acid benzyl-isopropyl-amide] which showed similar biological activity to compound 1. Synthesis and evaluation of a series of amide analogs resulted in benzofuranyl amide analogs that showed promising Notch-sparing γ-secretase inhibitory effects. This class of compounds may serve as a novel lead series for further study in the development of γ-secretase inhibitors. Copyright © 2016 Elsevier Ltd. All rights reserved.

Feasibility of MRI-guided Focused Ultrasound as Organ-Sparing Treatment for Testicular Cancer

Science.gov (United States)

Staruch, Robert; Curiel, Laura; Chopra, Rajiv; Hynynen, Kullervo

2009-04-01

High cure rates for testicular cancer have prompted interest in organ-sparing surgery for patients with bilateral disease or single testis. Focused ultrasound (FUS) ablation could offer a noninvasive approach to organ-sparing surgery. The objective of this study was to determine the feasibility of using MR thermometry to guide organ-sparing focused ultrasound surgery in the testis. The testes of anesthetized rabbits were sonicated in several discrete locations using a single-element focused transducer operating at 2.787MHz. Focal heating was visualized with MR thermometry, using a measured PRF thermal coefficient of -0.0089±0.0003 ppm/° C. Sonications at 3.5-14 acoustic watts applied for 30 seconds produced maximum temperature elevations of 10-80° C, with coagulation verified by histology. Coagulation of precise volumes in the testicle is feasible with MRI-guided focused ultrasound. Variability in peak temperature for given sonication parameters suggests the need for online temperature feedback control.

Analysis of aortic root surgery with composite mechanical aortic valve conduit and valve-sparing reconstruction.

Science.gov (United States)

Dias, Ricardo Ribeiro; Mejia, Omar Asdrubal Vilca; Fiorelli, Alfredo Inácio; Pomerantzeff, Pablo Maria Alberto; Dias, Altamiro Ribeiro; Mady, Charles; Stolf, Noedir Antonio Groppo

2010-01-01

Comparative analysis of early and late results of aortic root reconstruction with aortic valve sparing operations and the composite mechanical valve conduit replacement. From November 2002 to September 2009, 164 consecutive patients with mean age 54 ± 15 years, 115 male, underwent the aortic root reconstruction (125 mechanical valve conduit replacements and 39 valve sparing operations). Sixteen percent of patients had Marfan syndrome and 4.3% had bicuspid aortic valve. One hundred and forty-four patients (88%) were followed for a mean period of 41.1 ± 20.8 months. The hospital mortality was 4.9%, 5.6% in operations with valved conduits and 2.6% in the valve sparing procedures (P valve sparing operations, respectively (95% CI = 70% - 95%, P = 0.001), (95% CI = 82% - 95% P = 0.03) and (95% CI = 81% - 95%, P = 0.03). Multivariate analysis showed that creatinine greater than 1.4 mg/dl, Cabrol operation and renal dialysis were predictors of mortality, respectively, with occurrence chance of 6 (95% CI = 1.8 - 19.5, P = 0.003), 12 (95% CI = 3 - 49.7, P = 0.0004) and 16 (95% CI = 3.6 - 71.3, P = 0.0002). The aortic root reconstruction has a low early and late mortality, high survival free of complications and low need for reoperation. During the late follow-up, valve sparing aortic root reconstructions presented fewer incidences of bleeding, thromboembolic events and endocarditis.

Optimized lens-sparing treatment of retinoblastoma with electron beams

NARCIS (Netherlands)

Steenbakkers, RJHM; Altschuler, MD; DAngio, GJ; Goldwein, JW; Kassaee, A

1997-01-01

Purpose: The ideal lens-sparing radiotherapy technique for retinoblastoma calls for 100% dose to the entire retina including the ora serrata and zero dose to the lens, Published techniques, most of which use photons, have not accomplished this ideal treatment. We describe here a technique that

Nephron-sparing surgery for bilateral Wilms' tumours: A single ...

African Journals Online (AJOL)

All three with unfavourable histology are alive. Four of the five metachronous presentations are alive, as are eight of 12 patients with synchronous bilateral tumours who presented since 2000. Conclusions: Appropriate chemotherapy and nephron-sparing surgery can achieve good results with preservation of adequate renal ...

Automation of a problem list using natural language processing

OpenAIRE

Meystre, Stephane; Haug, Peter J

2005-01-01

Abstract Background The medical problem list is an important part of the electronic medical record in development in our institution. To serve the functions it is designed for, the problem list has to be as accurate and timely as possible. However, the current problem list is usually incomplete and inaccurate, and is often totally unused. To alleviate this issue, we are building an environment where the problem list can be easily and effectively maintained. Methods For this project, 80 medica...

Procurement and control of spare and replacement parts - a regulatory perspective

International Nuclear Information System (INIS)

Baker, E.T.; Grimes, B.K.; Merschoff, E.W.

1987-01-01

As the nuclear industry shifts from a construction to an operations orientation, a number of fundamental changes have occurred in the type of safety-related procurements and the manner in which the utilities accomplish these procurements. Specifically, procurements have shifted from the purchase of large systems and components by architect-engineers, and nuclear steam supply system (NSSS) suppliers to the procurement by utilities of subassemblies, individual pieces of equipment (e.g., breakers, relays), and small parts for repairing individual pieces of equipment. To ensure that equipment will continue to perform its intended function and to satisfy regulatory requirements utilities must consider several things: (1) does the equipment perform a safety function; (2) does the replacement part affect the safety function; and (3) does the replacement part affect the seismic or environmental qualification. If the answer to any of these questions is yes, the purchaser has two alternatives. He may procure the item as safety-related and require the supplier or manufacturer to comply with all the applicable technical and quality requirements or he may purchase the item commercial grade and perform the necessary inspections and tests to ensure the item meets the requirements, i.e., dedicate the item

Low GDP Solution and Glucose-Sparing Strategies for Peritoneal Dialysis.

Science.gov (United States)

Szeto, Cheuk Chun; Johnson, David W

2017-01-01

Long-term exposure to a high glucose concentration in conventional peritoneal dialysis (PD) solution has a number of direct and indirect (via glucose degradation products [GDP]) detrimental effects on the peritoneal membrane, as well as systemic metabolism. Glucose- or GDP-sparing strategies often are hypothesized to confer clinical benefits to PD patients. Icodextrin (glucose polymer) solution improves peritoneal ultrafiltration and reduces the risk of fluid overload, but these beneficial effects are probably the result of better fluid removal rather than being glucose sparing. Although frequently used for glucose sparing, the role of amino acid-based solution in this regard has not been tested thoroughly. When glucose-free solutions are used in a combination regimen, published studies showed that glycemic control was improved significantly in diabetic PD patients, and there probably are beneficial effects on peritoneal function. However, the long-term effects of glucose-free solutions, used either alone or as a combination regimen, require further studies. On the other hand, neutral pH-low GDP fluids have been shown convincingly to preserve residual renal function and urine volume. The cost effectiveness of these solutions supports the regular use of neutral pH-low GDP solutions. Nevertheless, further studies are required to determine whether neutral pH-low GDP solutions exert beneficial effects on patient-level outcomes, such as peritonitis, technique survival, and patient survival. Copyright © 2017 Elsevier Inc. All rights reserved.

8 CFR 251.1 - Arrival manifests and lists.

Science.gov (United States)

2010-01-01

... List, in accordance with the instructions contained thereon. (2) Longshore work notations. The master... master, captain, or agent shall prepare as a part of the manifest, when one is required for presentation... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Arrival manifests and lists. 251.1 Section...

Hippocampal sparing radiotherapy for pediatric medulloblastoma: impact of treatment margins and treatment technique.

Science.gov (United States)

Brodin, N Patrik; Munck af Rosenschöld, Per; Blomstrand, Malin; Kiil-Berthlesen, Anne; Hollensen, Christian; Vogelius, Ivan R; Lannering, Birgitta; Bentzen, Søren M; Björk-Eriksson, Thomas

2014-04-01

We investigated how varying the treatment margin and applying hippocampal sparing and proton therapy impact the risk of neurocognitive impairment in pediatric medulloblastoma patients compared with current standard 3D conformal radiotherapy. We included 17 pediatric medulloblastoma patients to represent the variability in tumor location relative to the hippocampal region. Treatment plans were generated using 3D conformal radiotherapy, hippocampal sparing intensity-modulated radiotherapy, and spot-scanned proton therapy, using 3 different treatment margins for the conformal tumor boost. Neurocognitive impairment risk was estimated based on dose-response models from pediatric CNS malignancy survivors and compared among different margins and treatment techniques. Mean hippocampal dose and corresponding risk of cognitive impairment were decreased with decreasing treatment margins (P < .05). The largest risk reduction, however, was seen when applying hippocampal sparing proton therapy-the estimated risk of impaired task efficiency (95% confidence interval) was 92% (66%-98%), 81% (51%-95%), and 50% (30%-70%) for 3D conformal radiotherapy, intensity-modulated radiotherapy, and proton therapy, respectively, for the smallest boost margin and 98% (78%-100%), 90% (60%-98%), and 70% (39%-90%) if boosting the whole posterior fossa. Also, the distance between the closest point of the planning target volume and the center of the hippocampus can be used to predict mean hippocampal dose for a given treatment technique. We estimate a considerable clinical benefit of hippocampal sparing radiotherapy. In choosing treatment margins, the tradeoff between margin size and risk of neurocognitive impairment quantified here should be considered.

Is the stripping technique a tissue-sparing procedure in large simple ovarian cysts in children?

Science.gov (United States)

Arena, Francesco; Romeo, Carmelo; Castagnetti, Marco; Scalfari, GianFranco; Cimador, Marcello; Impellizzeri, Pietro; Villari, Daniela; Zimbaro, Fabrizio; DeGrazia, Enrico

2008-07-01

Stripping of the cystic wall is performed by gynecologists to treat large ovarian cysts. Information in the pediatric population is poor. We prospectively evaluated the pathologic specimens of large ovarian cyst to determine whether the stripping technique is a tissue-sparing procedure even in this age. We evaluated 5 patients. Samples were taken from the intermediate part of the cystic wall and from the layer covering the cyst during excision. The presence of ovarian tissue adjacent to the cyst wall, and the morphological features of the surrounding tissue were both evaluated. Pelvic ultrasound follow-up was also performed. Patients' mean age was 4.5 years (7 days to 12 years). All cysts were removed because all were symptomatic. The mean diameter was 86.6 mm (74-100 mm). Cysts were follicular in 2 cases, serous in other two, and endometriotic in 1 case. Adjacent ovarian tissue was present in 1 of 5 specimens and was approximately 1 to 2 mm in thickness. The layer adjacent to the cystic wall always appeared as normal ovarian tissue. Ultrasound scans at follow-up revealed presence of ovarian tissue. The stripping procedure for large ovarian cyst excision allows to spare the adjacent normal ovarian tissue even in pediatric age because ovarian tissue is rarely excised with the cyst wall during the procedure.

Revitalization of the damaged machine parts by hard facing as a way of saving funds

Directory of Open Access Journals (Sweden)

Vukić Lazić

2016-09-01

Full Text Available The objective of the research, presented in this paper, was to demonstrate the superiority of the hard facing as the revitalization technology of various damaged machine parts. The analysis of the two different revitalization methods of the damaged machine parts is presented – the replacement of the damaged part by the new – spare part and reparation by hard facing. The comparison is done on the example of hard facing and replacing of damaged loader's teeth. The paper presents a method for calculating costs of the two revitalization technologies based on their profitability and their comparison. That method could be applied for similar calculations for any machine part, with smallest or no adjustments. The paper presents a verification of advantage of applying the hard facing as the machine parts reparatory technology with respect to the other revitalization technology. The savings realized by application of hard facing reparation of the loader's teeth reach 73.5 % for one set of teeth and 82.40per annum of the costs for purchasing the new spare parts. The analysis was conducted under an assumption that organization of the maintenance function is at the exceptionally high level so that the purchasing of the new part/repairing of the damaged one is always done in time. This idealized approach was adopted since in that way one obtains the least economic effects of the reparatory technology application with respect to replacing the part with the spare one. In any other case the economic effects would be significantly higher, namely even more positive in favor of the hard facing revitalization technology.

Protein Sparing Effects of Lipids in The Practical Diets of ...

African Journals Online (AJOL)

ABSTRACT: A feeding trial was conducted to establish the protein sparing effects of various lipid sources in ... reported to utilize vegetable oil that is high in omega 6 .... origin up to 15 % without any negative effects on ..... Committee on Animal.

Radiation therapy for retinoblastoma: comparison of results with lens-sparing versus lateral beam techniques

International Nuclear Information System (INIS)

McCormick, B.; Ellsworth, R.; Abramson, D.; Haik, B.; Tome, M.; Grabowski, E.; LoSasso, T.

1988-01-01

From 1979 through 1986, 170 children were seen at our institution diagnosed with retinoblastoma. Sixty-six of the children with involvement of 121 eyes, were referred for definitive external beam radiation to one or both eyes. During the study period, two distinct radiation techniques were used. From 1980 through mid-1984, a lens-sparing technique included an anterior electron beam with a contact lens mounted lead shield, combined with a lateral field, was used. Since mid-1984, a modified lateral beam technique has been used, mixing lateral electrons and superior and inferior lateral oblique split beam wedged photons. Doses prescribed were similar for both techniques, ranging from 3,850 to 5,000 cGy in 4 to 5 weeks. The lens-sparing and the modified lateral techniques are compared for local control. For eyes with Group I through III disease, the lens-sparing technique resulted in local control in 33% of the eyes treated, where the modified lateral technique controlled 83% of the eyes treated (p = .006). Mean time to relapse was identical in both groups, that is 24 and 26 months respectively. Most relapses were successfully treated with further local therapy, including laser or cryosurgery, or 60Co plaques. Five eyes required enucleation following initial treatment with the lens-sparing technique, but none thus far with the lateral beam technique. For eyes with Group IV and V disease, no significant differences were found between the two techniques in terms of local control or eventual need for enucleation. With a mean follow-up time of 33 months for the entire group, the 4-year survival is 93%. Two of the 4 deaths are due to second primary tumor, and all 4 have occurred in the lens-sparing group. Because follow-up time is more limited in the lateral beam group, this is not statistically significant and direct survival comparisons are premature

Species List of Alaskan Birds, Mammals, Fish, Amphibians, Reptiles, and Invertebrates. Alaska Region Report Number 82.

Science.gov (United States)

Taylor, Tamra Faris

This publication contains a detailed list of the birds, mammals, fish, amphibians, reptiles, and invertebrates found in Alaska. Part I lists the species by geographical regions. Part II lists the species by the ecological regions of the state. (CO)

CACS: Master Textbook List Helps Solve On-Going Problem.

Science.gov (United States)

Anderson, Robert

1979-01-01

The use of a master textbook list developed by the Southern California Association of College Stores (CACS) is described. The three-part program is explained and the information assimilation process, format for revising lists, procedures for implementation, and general guidelines are among areas covered. (PHR)

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

Science.gov (United States)

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

2009-05-01

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

Sparingly Solvating Electrolytes for High Energy Density Lithium-Sulfur Batteries

Energy Technology Data Exchange (ETDEWEB)

Cheng, Lei; Curtiss, Larry A.; Zavadil, Kevin R.; Gewirth, Andrew A.; Shao, Yuyan; Gallagher, Kevin

2016-07-11

Moving to lighter and less expensive battery chemistries compared to lithium-ion requires the control of energy storage mechanisms based on chemical transformations rather than intercalation. Lithium sulfur (Li/S) has tremendous theoretical specific energy, but contemporary approaches to control this solution-mediated, precipitation-dissolution chemistry requires using large excesses of electrolyte to fully solubilize the polysulfide intermediate. Achieving reversible electrochemistry under lean electrolyte operation is the only path for Li/S to move beyond niche applications to potentially transformational performance. An emerging topic for Li/S research is the use of sparingly solvating electrolytes and the creation of design rules for discovering new electrolyte systems that fundamentally decouple electrolyte volume from reaction mechanism. This perspective presents an outlook for sparingly solvating electrolytes as the key path forward for longer-lived, high-energy density Li/S batteries including an overview of this promising new concept and some strategies for accomplishing it.

Valve-sparing aortic root replacement in Loeys-Dietz syndrome.

Science.gov (United States)

Patel, Nishant D; Arnaoutakis, George J; George, Timothy J; Allen, Jeremiah G; Alejo, Diane E; Dietz, Harry C; Cameron, Duke E; Vricella, Luca A

2011-08-01

Loeys-Dietz syndrome (LDS) is a recently recognized aggressive aortic disorder characterized by root aneurysm, arterial tortuosity, hypertelorism, and bifid uvula or cleft palate. The results of prophylactic root replacement using valve-sparing procedures (valve-sparing root replacement [VSRR]) in patients with LDS is not known. We reviewed all patients with clinical and genetic (transforming growth factor-β receptor mutations) evidence of LDS who underwent VSRR at our institution. Echocardiographic and clinical data were obtained from hospital and follow-up clinic records. From 2002 to 2009, 31 patients with a firm diagnosis of LDS underwent VSRR for aortic root aneurysm. Mean age was 15 years, and 24 (77%) were children. One (3%) patient had a bicuspid aortic valve. Preoperative sinus diameter was 3.9±0.8 cm (z score 7.0±2.9) and 2 (6%) had greater than 2+ aortic insufficiency. Thirty patients (97%) underwent reimplantation procedures using a Valsalva graft. There were no operative deaths. Mean follow-up was 3.6 years (range, 0 to 7 years). One patient required late repair of a pseudoaneurysm at the distal aortic anastomosis, and 1 had a conversion to a David reimplantation procedure after a Florida sleeve operation. No patient suffered thromboembolism or endocarditis, and 1 (3%) patient experienced greater than 2+ late aortic insufficiency. No patient required late aortic valve repair or replacement. Loeys-Dietz syndrome is an aggressive aortic aneurysm syndrome that can be addressed by prophylactic aortic root replacement with low operative risk. Valve-sparing procedures have encouraging early and midterm results, similar to those in Marfan syndrome, and are an attractive option for young patients. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Radical prostatectomy, sparing of the seminal vesicles, and painful orgasm.

Science.gov (United States)

Mogorovich, Andrea; Nilsson, Andreas E; Tyritzis, Stavros I; Carlsson, Stefan; Jonsson, Martin; Haendler, Leif; Nyberg, Tommy; Steineck, Gunnar; Wiklund, N Peter

2013-05-01

Erectile dysfunction has been widely investigated as the major factor responsible for sexual bother in patients after radical prostatectomy (RP); painful orgasm (PO) is one element of this bother, but little is known about its prevalence and its effects on sexual health. This study aims to investigate the prevalence of PO and to identify potential risk factors. A total of 1,411 consecutive patients underwent open (radical retropubic prostatectomy) or robot-assisted laparoscopic RP between 2002 and 2006. The patients were asked to complete a study-specific questionnaire. Of a total of 145 questions, 5 dealt with the orgasmic characteristics. The questionnaire was also administered to a comparison group of 442 persons, matched for age and area of residency. The response rate was 91% (1,288 patients). A total of 143 (11%) patients reported PO. Among the 834 men being able to have an orgasm, the prevalence was 18% vs. 6% in the comparison group (relative risk [RR] 2.8, 95% confidence interval [CI] 1.7-4.5). When analyzed as independent variables, bilateral seminal vesicle (SV)-sparing approach (RR 2.33, 95% CI 1.0-5.3, P = 0.045) and age <60 years were significantly related to the presence of PO (95% CI 0.5-0.9, P = 0.019). After adjustment for age, bilateral SV-sparing still remained a significant predictor for occurrence of PO. We found that PO occurs significantly more often in patients undergoing bilateral SV-sparing RP when compared with age-matched comparison population. © 2013 International Society for Sexual Medicine.

Comparison of quadriceps-sparing minimally invasive and medial parapatellar total knee arthroplasty: A 2-year follow-up study

Directory of Open Access Journals (Sweden)

Hongsen Chiang

2012-12-01

Conclusions: Patients undergoing quadriceps-sparing and standard medial parapatellar TKA had comparable outcomes for quadriceps muscle strength, hamstring–quadriceps balance, and knee function; however, the quadriceps-sparing TKA was more time consuming surgically and resulted in a less accurate prosthesis position.

IAHR List of Sea Parameters

DEFF Research Database (Denmark)

Frigaard, Peter; Helm-Petersen, J; Klopman, G.

1997-01-01

A Working Group on multidirectional waves formed by the International Association for Hydraulic Research has proposed an update of the IAHR List of Sea State Parameters from 1986 in the part concerning directional. Especially wave structure interaction with reflection of the waves have been treated....

LazySorted: A Lazily, Partially Sorted Python List

Directory of Open Access Journals (Sweden)

Naftali Harris

2015-06-01

Full Text Available LazySorted is a Python C extension implementing a partially and lazily sorted list data structure. It solves a common problem faced by programmers, in which they need just part of a sorted list, like its middle element (the median, but sort the entire list to get it. LazySorted presents them with the abstraction that they are working with a fully sorted list, while actually only sorting the list partially with quicksort partitions to return the requested sub-elements. This enables programmers to use naive "sort first" algorithms but nonetheless attain linear run-times when possible. LazySorted may serve as a drop-in replacement for the built-in sorted function in most cases, and can sometimes achieve run-times more than 7 times faster.

Executive Summary: Parts on Demand Project (CATT Phase II) - Volume 1 of 2

National Research Council Canada - National Science Library

Gates, Robert

1996-01-01

.... The GAO has profiled DoD challenges in: maintaining an aging aircraft fleet, reducing response time and cost of providing the spare parts, implementing commercial inventory management practices, reinventing buying and contracting practices...

Valve-sparing operation for aortic root aneurysm in patients with Marfan syndrome.

Science.gov (United States)

Wang, R; Ma, W G; Tian, L X; Sun, L Z; Chang, Q

2010-03-01

We report our experience with aortic valve-sparing procedures in patients with Marfan syndrome and aortic root aneurysm. Between August 2003 and July 2007, we performed aortic valve-sparing procedures in 20 patients with aortic root aneurysm resulting from Marfan syndrome. Mean age was 28 +/- 10 years (range, 10 to 57 years), and there were 9 females and 11 males. A reimplantation technique was used in 9 cases, a remodeling technique in 8 and a patch technique in 3 cases. Additional procedures included total aorta replacement in 1 patient, and aortic arch replacement plus stented elephant trunk in 2 patients. The mean follow-up time was 46 +/- 16 months (range, 17 to 64 months). No in-hospital or late death occurred. Reexploration for bleeding was required in one case on postoperative day 1. No valve-related complications occurred during the follow-up period. At the end of follow-up, trivial or no aortic regurgitation was demonstrated in 14 patients, mild in 4 patients, moderate in 1 and severe in 1. Two patients with moderate and severe aortic regurgitation required reoperation. The early and mid-term results of the valve-sparing operations were favorable, and the durability of the preserved valve should encourage use of this technique in patients with Marfan syndrome.

21 CFR 1300.02 - Definitions relating to listed chemicals.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Definitions relating to listed chemicals. 1300.02 Section 1300.02 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE DEFINITIONS § 1300.02 Definitions relating to listed chemicals. (a) Any term not defined in this part shall have the...

QTL list - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

Lifescience Database Archive (English)

Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ...Policy | Contact Us QTL list - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

Marker list - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

Lifescience Database Archive (English)

Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ...Database Site Policy | Contact Us Marker list - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

Cost Comparison of B-1B Non-Mission-Capable Drivers Using Finite Source Queueing with Spares

Science.gov (United States)

2012-09-06

COMPARISON OF B-1B NON-MISSION-CAPABLE DRIVERS USING FINITE SOURCE QUEUEING WITH SPARES GRADUATE RESEARCH PAPER Presented to the Faculty...step into the lineup making large-number approximations unusable. Instead, a finite source queueing model including spares is incorporated...were reported as flying time accrued since last occurrence. Service time was given in both start-stop format and MX man-hours utilized. Service time was

A bi-objective model for optimizing replacement time of age and block policies with consideration of spare parts’ availability

Science.gov (United States)

Alsyouf, Imad

2018-05-01

Reliability and availability of critical systems play an important role in achieving the stated objectives of engineering assets. Preventive replacement time affects the reliability of the components, thus the number of system failures encountered and its downtime expenses. On the other hand, spare parts inventory level is a very critical factor that affects the availability of the system. Usually, the decision maker has many conflicting objectives that should be considered simultaneously for the selection of the optimal maintenance policy. The purpose of this research was to develop a bi-objective model that will be used to determine the preventive replacement time for three maintenance policies (age, block good as new, block bad as old) with consideration of spare parts’ availability. It was suggested to use a weighted comprehensive criterion method with two objectives, i.e. cost and availability. The model was tested with a typical numerical example. The results of the model demonstrated its effectiveness in enabling the decision maker to select the optimal maintenance policy under different scenarios and taking into account preferences with respect to contradicting objectives such as cost and availability.

IT3T/2 - Creating, managingand using distribution lists with Simba2

CERN Multimedia

CERN. Geneva; Vitè, Davide F; Wagner, Andreas

2005-01-01

CERN Technical Training 2005: IT3T - IT Technical Training Tutorials (Summer 2005) The new Listbox service interface SIMBA2 is a tool browsed everyday by a big amount of Listbox users. The different views for owners or members of the lists and the settings saved by them is capital for the correct function of the list. In this presentation we will introduce the Listbox Platform and the web interfaces and services that support it. How to deal with external accounts, creation of mailing lists and their classification in Human Resources, External or Normal Lists. How to operate with lists in Bulk and the importance of the archiving permissions. A special part of the presentation will show the criteria that listbox is using for authentication of mails against mail bombing, worms and spammers. The different ways to subscribe and unsubscribe to mailing lists and what are the main differences with the old platform. We will also dedicate a high level technical part for those who are administrators of mailing lists and...

A prenatally detected adrenal cyst treated by adrenal-sparing surgery

African Journals Online (AJOL)

A neonatal case of left adrenal cyst detected in utero and successfully treated by adrenal-sparing surgery is presented and discussed with review of the literature. Incidentally discovered prenatal adrenal masses present a diagnostic dilemma. Benign and malignant conditions can present as a fetal suprarenal mass. There is ...

Effect of Nerve-Sparing Radical Prostatectomy on Urinary Continence in Patients With Preoperative Erectile Dysfunction

Directory of Open Access Journals (Sweden)

Yong Hyun Park

2016-03-01

Full Text Available Purpose: We aimed to assess whether nerve-sparing radical prostatectomy (nsRP is associated with improved recovery of urinary continence compared to non–nerve-sparing radical prostatectomy (nnsRP in patients with localized prostate cancer and preoperative erectile dysfunction. Methods: A total of 360 patients with organ-confined prostate cancer and an International Index of Erectile Function score of less than 17 were treated with nsRP or nnsRP in Seoul St. Mary’s Hospital. Patients who received neoadjuvant or adjuvant androgen deprivation therapy or had a history of prostate-related surgery were excluded. Recovery of urinary continence was assessed at 0, 1, 3, 6, and 12 months. Postoperative recovery of continence was defined as zero pad usage. The association between nerve-sparing status and urinary continence was assessed by using univariate and multivariate Cox regression analyses after controlling for known predictive factors. Results: Urinary continence recovered in 279 patients (77.5% within the mean follow-up period of 22.5 months (range, 6–123 months. Recovery of urinary continence was reported in 74.6% and 86.4% of patients after nnsRP and nsRP, respectively, at 12 months (P=0.022. All groups had comparable perioperative criteria and had no significant preoperative morbidities. Age, American Society of Anesthesiologists score, and nerve-sparing status were significantly associated with recovery of urinary continence on univariate analysis. On multivariate analysis, age (hazard ratio [HR], 1.254; 95% confidence interval [CI], 1.002–1.478; P=0.026 and nerve-sparing status (HR, 0.713; 95% CI, 0.548–0.929; P=0.012 were independently associated with recovery of urinary continence. Conclusions: nsRP, as compared to nnsRP, improves recovery rates of urinary incontinence and decreases surgical morbidity without compromising pathologic outcomes.

Systematic Review of Studies Reporting Positive Surgical Margins After Bladder Neck Sparing Radical Prostatectomy.

Science.gov (United States)

Bellangino, Mariangela; Verrill, Clare; Leslie, Tom; Bell, Richard W; Hamdy, Freddie C; Lamb, Alastair D

2017-11-07

Bladder neck preservation (BNP) during radical prostatectomy (RP) has been proposed as a method to improve early recovery of urinary continence after radical prostatectomy. However, there is concern over a possible increase in the risk of positive surgical margins and prostate cancer recurrence rate. A recent systematic review and meta-analysis reported improved early recovery and overall long-term urinary continence without compromising oncologic control. The aim of our study was to perform a critical review of the literature to assess the impact on bladder neck and base margins after bladder neck sparing radical prostatectomy. We carried out a systematic review of the literature using Pubmed, Scopus and Cochrane library databases in May 2017 using medical subject headings and free-text protocol according to PRISMA guidelines. We used the following search terms: bladder neck preservation, prostate cancer, radical prostatectomy and surgical margins. Studies focusing on positive surgical margins (PSM) in bladder neck sparing RP pertinent to the objective of this review were included. Overall, we found 15 relevant studies reporting overall and site-specific positive surgical margins rate after bladder neck sparing radical prostatectomy. This included two RCTs, seven prospective comparative studies, two retrospective comparative studies and four case series. All studies were published between 1993 and 2015 with sample sizes ranging between 50 and 1067. Surgical approaches included open, laparoscopic and robot-assisted radical prostatectomy. The overall and base-specific PSM rates ranged between 7-36% and 0-16.3%, respectively. Mean base PSM was 4.9% in those patients where bladder neck sparing was performed, but only 1.85% in those without sparing. Bladder neck preservation during radical prostatectomy may increase base-positive margins. Further studies are needed to better investigate the impact of this technique on oncological outcomes. A future paradigm could

Recurrence in Region of Spared Parotid Gland After Definitive Intensity-Modulated Radiotherapy for Head and Neck Cancer

International Nuclear Information System (INIS)

Cannon, Donald M.; Lee, Nancy Y.

2008-01-01

Purpose: To discuss the implications of three examples of periparotid recurrence after definitive intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC). Methods and Materials: We present 3 patients with HNC who underwent definitive IMRT with concurrent chemotherapy and later had treatment failure in or near a spared parotid gland. Two patients had bilateral multilevel nodal disease, and all had Level II nodal disease ipsilateral to the site of recurrence. The patients were treated using dose-painting IMRT with a dose of 70 Gy to the gross tumor volume and 59.4 Gy or 54 Gy to the high-risk or low-risk clinical tumor volume, respectively. The parotid glands were spared bilaterally. The patients had not undergone any surgical treatment for HNC before radiotherapy. Results: All patients had treatment failure in the region of a spared parotid gland. Failure in the 2 patients with bilateral multilevel nodal involvement occurred in the periparotid lymph nodes. The third patient developed a dermal metastasis near the tail of a spared parotid gland. On pretreatment imaging, the 2 patients with nodal failure had small nonspecific periparotid nodules that showed no hypermetabolic activity on positron emission tomography. Conclusion: For HNC patients receiving definitive IMRT, nonspecific positron emission tomography-negative periparotid nodules on pretreatment imaging should raise the index of suspicion for subclinical disease in the presence of multilevel or Level II nodal metastases. Additional evaluation of such nodules might be indicated before sparing the ipsilateral parotid gland

Laryngeal Muscles Are Spared in the Dystrophin Deficient "mdx" Mouse

Science.gov (United States)

Thomas, Lisa B.; Joseph, Gayle L.; Adkins, Tracey D.; Andrade, Francisco H.; Stemple, Joseph C.

2008-01-01

Purpose: "Duchenne muscular dystrophy (DMD)" is caused by the loss of the cytoskeletal protein, dystrophin. The disease leads to severe and progressive skeletal muscle wasting. Interestingly, the disease spares some muscles. The purpose of the study was to determine the effects of dystrophin deficiency on 2 intrinsic laryngeal muscles, the…

Critical structure sparing in stereotactic ablative radiotherapy for central lung lesions: helical tomotherapy vs. volumetric modulated arc therapy.

Directory of Open Access Journals (Sweden)

Alexander Chi

Full Text Available BACKGROUND: Helical tomotherapy (HT and volumetric modulated arc therapy (VMAT are both advanced techniques of delivering intensity-modulated radiotherapy (IMRT. Here, we conduct a study to compare HT and partial-arc VMAT in their ability to spare organs at risk (OARs when stereotactic ablative radiotherapy (SABR is delivered to treat centrally located early stage non-small-cell lung cancer or lung metastases. METHODS: 12 patients with centrally located lung lesions were randomly chosen. HT, 2 & 8 arc (Smart Arc, Pinnacle v9.0 plans were generated to deliver 70 Gy in 10 fractions to the planning target volume (PTV. Target and OAR dose parameters were compared. Each technique's ability to meet dose constraints was further investigated. RESULTS: HT and VMAT plans generated essentially equivalent PTV coverage and dose conformality indices, while a trend for improved dose homogeneity by increasing from 2 to 8 arcs was observed with VMAT. Increasing the number of arcs with VMAT also led to some improvement in OAR sparing. After normalizing to OAR dose constraints, HT was found to be superior to 2 or 8-arc VMAT for optimal OAR sparing (meeting all the dose constraints (p = 0.0004. All dose constraints were met in HT plans. Increasing from 2 to 8 arcs could not help achieve optimal OAR sparing for 4 patients. 2/4 of them had 3 immediately adjacent structures. CONCLUSION: HT appears to be superior to VMAT in OAR sparing mainly in cases which require conformal dose avoidance of multiple immediately adjacent OARs. For such cases, increasing the number of arcs in VMAT cannot significantly improve OAR sparing.

Comparing organic farming and land sparing: optimizing yield and butterfly populations at a landscape scale.

Science.gov (United States)

Hodgson, Jenny A; Kunin, William E; Thomas, Chris D; Benton, Tim G; Gabriel, Doreen

2010-11-01

Organic farming aims to be wildlife-friendly, but it may not benefit wildlife overall if much greater areas are needed to produce a given quantity of food. We measured the density and species richness of butterflies on organic farms, conventional farms and grassland nature reserves in 16 landscapes. Organic farms supported a higher density of butterflies than conventional farms, but a lower density than reserves. Using our data, we predict the optimal land-use strategy to maintain yield whilst maximizing butterfly abundance under different scenarios. Farming conventionally and sparing land as nature reserves is better for butterflies when the organic yield per hectare falls below 87% of conventional yield. However, if the spared land is simply extra field margins, organic farming is optimal whenever organic yields are over 35% of conventional yields. The optimal balance of land sparing and wildlife-friendly farming to maintain production and biodiversity will differ between landscapes. © 2010 Blackwell Publishing Ltd/CNRS.

Sparing of descending axons rescues interneuron plasticity in the lumbar cord to allow adaptive learning after thoracic spinal cord injury

Directory of Open Access Journals (Sweden)

Christopher Nelson Hansen

2016-03-01

Full Text Available This study evaluated the role of spared axons on structural and behavioral neuroplasticity in the lumbar enlargement after a thoracic spinal cord injury (SCI. Previous work has demonstrated that recovery in the presence of spared axons after an incomplete lesion increases behavioral output after a subsequent complete spinal cord transection (TX. This suggests that spared axons direct adaptive changes in below-level neuronal networks of the lumbar cord. In response to spared fibers, we postulate that lumbar neuron networks support behavioral gains by preventing aberrant plasticity. As such, the present study measured histological and functional changes in the isolated lumbar cord after complete TX or incomplete contusion (SCI. To measure functional plasticity in the lumbar cord, we used an established instrumental learning paradigm. In this paradigm, neural circuits within isolated lumbar segments demonstrate learning by an increase in flexion duration that reduces exposure to a noxious leg shock. We employed this model using a proof-of-principle design to evaluate the role of sparing on lumbar learning and plasticity early (7 days or late (42 days after midthoracic SCI in a rodent model. Early after SCI or TX at 7d, spinal learning was unattainable regardless of whether the animal recovered with or without axonal substrate. Failed learning occurred alongside measures of cell soma atrophy and aberrant dendritic spine expression within interneuron populations responsible for sensorimotor integration and learning. Alternatively, exposure of the lumbar cord to a small amount of spared axons for 6 weeks produced near-normal learning late after SCI. This coincided with greater cell soma volume and fewer aberrant dendritic spines on interneurons. Thus, an opportunity to influence activity-based learning in locomotor networks depends on spared axons limiting maladaptive plasticity. Together, this work identifies a time dependent interaction between

Skin-Sparing Radiation Using Intensity-Modulated Radiotherapy After Conservative Surgery in Early-Stage Breast Cancer: A Planning Study

International Nuclear Information System (INIS)

Saibishkumar, Elantholi P.; MacKenzie, Marc A.; Severin, Diane; Mihai, Alina; Hanson, John M.Sc.; Daly, Helene; Fallone, Gino; Parliament, Matthew B.; Abdulkarim, Bassam S.

2008-01-01

Purpose: To evaluate the feasibility of skin-sparing by configuring it as an organ-at-risk (OAR) while delivering whole-breast intensity-modulated radiotherapy (IMRT) in early breast cancer. Methods and Materials: Archival computed tomography scan images of 14 left-sided early-breast tumor patients who had undergone lumpectomy were selected for this study. Skin was contoured as a 4- to 5-mm strip extending from the patient outline to anterior margin of the breast planning target volume (PTV). Two IMRT plans were generated by the helical tomotherapy approach to deliver 50 Gy in 25 fractions to the breast alone: one with skin dose constraints (skin-sparing plan) and the other without (non-skin-sparing plan). Comparison of the plans was done using a two-sided paired Student t test. Results: The mean skin dose and volume of skin receiving 50 Gy were significantly less with the skin-sparing plan compared with non-skin-sparing plan (42.3 Gy vs. 47.7 Gy and 12.2% vs. 57.8% respectively; p < 0.001). The reduction in skin dose was confirmed by TLD measurements in anthropomorphic phantom using the same plans. Dose-volume analyses for other OARs were similar in both plans. Conclusions: By configuring the skin as an OAR, it is possible to achieve skin dose reduction while delivering whole-breast IMRT without compromising dose profiles to PTV and OARs

Split-field vs extended-field intensity-modulated radiation therapy plans for oropharyngeal cancer: Which spares the larynx? Which spares the thyroid?

Energy Technology Data Exchange (ETDEWEB)

Yu, Yao; Chen, Josephine [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Leary, Celeste I. [Department of Radiation Medicine, Oregon Health Sciences University, Portland, OR (United States); Shugard, Erin [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Yom, Sue S., E-mail: yoms@radonc.ucsf.edu [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Department of Otolaryngology—Head and Neck Surgery, University of California, San Francisco, San Francisco, CA (United States)

2016-07-01

Radiation of the low neck can be accomplished using split-field intensity-modulated radiation therapy (sf-IMRT) or extended-field intensity-modulated radiation therapy (ef-IMRT). We evaluated the effect of these treatment choices on target coverage and thyroid and larynx doses. Using data from 14 patients with cancers of the oropharynx, we compared the following 3 strategies for radiating the low neck: (1) extended-field IMRT, (2) traditional split-field IMRT with an initial cord-junction block to 40 Gy, followed by a full-cord block to 50 Gy, and (3) split-field IMRT with a full-cord block to 50 Gy. Patients were planned using each of these 3 techniques. To facilitate comparison, extended-field plans were normalized to deliver 50 Gy to 95% of the neck volume. Target coverage was assessed using the dose to 95% of the neck volume (D{sub 95}). Mean thyroid and larynx doses were computed. Extended-field IMRT was used as the reference arm; the mean larynx dose was 25.7 ± 7.4 Gy, and the mean thyroid dose was 28.6 ± 2.4 Gy. Split-field IMRT with 2-step blocking reduced laryngeal dose (mean larynx dose 15.2 ± 5.1 Gy) at the cost of a moderate reduction in target coverage (D{sub 95} 41.4 ± 14 Gy) and much higher thyroid dose (mean thyroid dose 44.7 ± 3.7 Gy). Split-field IMRT with initial full-cord block resulted in greater laryngeal sparing (mean larynx dose 14.2 ± 5.1 Gy) and only a moderately higher thyroid dose (mean thyroid dose 31 ± 8 Gy) but resulted in a significant reduction in target coverage (D{sub 95} 34.4 ± 15 Gy). Extended-field IMRT comprehensively covers the low neck and achieves acceptable thyroid and laryngeal sparing. Split-field IMRT with a full-cord block reduces laryngeal doses to less than 20 Gy and spares the thyroid, at the cost of substantially reduced coverage of the low neck. Traditional 2-step split-field IMRT similarly reduces the laryngeal dose but also reduces low-neck coverage and delivers very high doses to the thyroid.

INIS: Authority list for journal titles

International Nuclear Information System (INIS)

2009-01-01

This is the 35th revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). This list is published annually and includes the titles of all journals which have contained articles submitted to INIS at the time of publication. The current list contains 13 750 journal titles, 1 965 regularly scanned journals and 593 key journals. It was last updated in March 2009. A journal - or periodical - is a continuing publication issued in a succession of discrete parts, usually bearing numbering and/or chronological designations and intended to be continued indefinitely. It is generally published within a defined, fixed interval between issues and normally appears more than once per year. It includes a mixture of articles, letters, summaries, etc. Within this definition, annuals such as the Annual Review of Nuclear Science are included, but series titles such as the McGraw-Hill Series in Nuclear Engineering are not. The purpose of this document is to provide descriptive cataloguers with standard elements to include in bibliographic level 'S' of the INIS record. These elements include field (tag) 229 (Full Journal Title), 320 (ISSN) and 321 (CODEN). The full journal title is mandatory, and either the ISSN or the CODEN must be included (both may appear). Instructions on how to use this and other elements of the INIS record format are found in INIS: Guide to Bibliographic Description (IAEA-INIS-1). In order to help the user find titles easily, the list is arranged in six parts, followed by summary statistics: - In Part I, all key journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. - In Part II, all key journals are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. - In Part III, all journals that are regularly scanned by the

Skin sparing mastectomy: Technique and suggested methods of reconstruction

Directory of Open Access Journals (Sweden)

Ahmed M. Farahat

2014-09-01

Conclusions: Skin Sparing mastectomy through a circum-areolar incision has proven to be a safe and feasible option for the management of breast cancer in Egyptian women, offering them adequate oncologic control and optimum cosmetic outcome through preservation of the skin envelope of the breast when ever indicated. Our patients can benefit from safe surgery and have good cosmetic outcomeby applying different reconstructive techniques.

Factors influencing bowel sparing in intensity modulated whole pelvic radiotherapy for gynaecological malignancies

International Nuclear Information System (INIS)

Georg, Petra; Georg, Dietmar; Hillbrand, Martin; Kirisits, Christian; Poetter, Richard

2006-01-01

Background and purpose: To evaluate the influence of uterus and bladder size on large and small bowel sparing with intensity modulated whole pelvic radiotherapy (IM-WPRT) in gynecologic patients. Patients and methods: Twenty patients were selected; 10 women with cervical cancer treated with definitive radiotherapy (group 'DEF') and 10 endometrial cancer patients treated postoperatively (group 'POST'). Bladder, rectal wall, small (SB) and large bowel (LB) were delineated as organs at risk. A conformal four field technique and a seven field IMRT plan (prescription dose 50.4 Gy) were compared in terms of DVH and various target parameters. Results: At doses between 40 and 50.4 Gy statistically significant improvements (P<0.05) were observed for IM-WPRT for irradiated volume of rectal wall and bladder. In both patient groups, with IMRT the average irradiated volume of SB was reduced by a factor of 6 at 50.4 Gy. This ratio was 2 for LB. In the DEF group the effect of SB-sparing with IMRT correlated with bladder size (correlation coefficient 0.70) while it did not correlate in the postoperative group. The effect of LB-sparing decreased with increasing bladder size in both groups but the impact of IMRT was larger for postoperative patients. Conclusions: IMRT significantly reduced the absolute volume of rectal wall, bladder and bowel irradiated at the prescribed dose level in gynaecologic patients. Main differences between POST and DEF patients receiving IM-WPRT were absolute volumes of LB irradiated to doses between 35 and 50 Gy, suggesting an impact of intact uterus on LB volume in the pelvis. POST patients seem to benefit most from elective nodal IMRT. Bladder filling is an important co-factor influencing the benefit of IMRT with respect to OAR sparing

Hippocampal-Sparing Whole-Brain Radiotherapy: A 'How-To' Technique Using Helical Tomotherapy and Linear Accelerator-Based Intensity-Modulated Radiotherapy

International Nuclear Information System (INIS)

Gondi, Vinai; Tolakanahalli, Ranjini; Mehta, Minesh P.; Tewatia, Dinesh; Rowley, Howard; Kuo, John S.; Khuntia, Deepak; Tome, Wolfgang A.

2010-01-01

Purpose: Sparing the hippocampus during cranial irradiation poses important technical challenges with respect to contouring and treatment planning. Herein we report our preliminary experience with whole-brain radiotherapy using hippocampal sparing for patients with brain metastases. Methods and Materials: Five anonymous patients previously treated with whole-brain radiotherapy with hippocampal sparing were reviewed. The hippocampus was contoured, and hippocampal avoidance regions were created using a 5-mm volumetric expansion around the hippocampus. Helical tomotherapy and linear accelerator (LINAC)-based intensity-modulated radiotherapy (IMRT) treatment plans were generated for a prescription dose of 30 Gy in 10 fractions. Results: On average, the hippocampal avoidance volume was 3.3 cm 3 , occupying 2.1% of the whole-brain planned target volume. Helical tomotherapy spared the hippocampus, with a median dose of 5.5 Gy and maximum dose of 12.8 Gy. LINAC-based IMRT spared the hippocampus, with a median dose of 7.8 Gy and maximum dose of 15.3 Gy. On a per-fraction basis, mean dose to the hippocampus (normalized to 2-Gy fractions) was reduced by 87% to 0.49 Gy 2 using helical tomotherapy and by 81% to 0.73 Gy 2 using LINAC-based IMRT. Target coverage and homogeneity was acceptable with both IMRT modalities, with differences largely attributed to more rapid dose fall-off with helical tomotherapy. Conclusion: Modern IMRT techniques allow for sparing of the hippocampus with acceptable target coverage and homogeneity. Based on compelling preclinical evidence, a Phase II cooperative group trial has been developed to test the postulated neurocognitive benefit.

Astronomy Books of 1985: The Technical List.

Science.gov (United States)

Fraknoi, Andrew

1986-01-01

Consists of the second part of the 1985 annotated review of technical books done by the Astronomical Society of the Pacific. This listing was primarily designed for graduate students or research scientists. (TW)

Part C and Part D Compliance Actions

Data.gov (United States)

U.S. Department of Health & Human Services — This page includes results from CMSs Past Performance Review. The report called Spring 2014 Past Performance Review Outlier Results lists MA organizations and Part D...

Registered plant list - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

Lifescience Database Archive (English)

Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ...the Plant DB link list in simple search page) Genome analysis methods Presence or... absence of Genome analysis methods information in this DB (link to the Genome analysis methods information ...base Site Policy | Contact Us Registered plant list - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

Listed waste determination report. Environmental characterization

Energy Technology Data Exchange (ETDEWEB)

1993-06-01

On September 23, 1988, the US Environmental Protection Agency (EPA) published a notice clarifying interim status requirements for the management of radioactive mixed waste thereby subjecting the Idaho National Engineering Laboratory (INEL) and other applicable Department of Energy (DOE) sites to regulation under the Resource Conservation and Recovery Act (RCRA). Therefore, the DOE was required to submit a Part A Permit application for each treatment, storage, and disposal (TSD) unit within the INEL, defining the waste codes and processes to be regulated under RCRA. The September 1990 revised Part A Permit application, that was approved by the State of Idaho identified 101 potential acute and toxic hazardous waste codes (F-, P-, and U- listed wastes according to 40 CFR 261.31 and 40 CFR 261.33) for some TSD units at the Idaho Chemical Processing Plant. Most of these waste were assumed to have been introduced into the High-level Liquid Waste TSD units via laboratory drains connected to the Process Equipment Waste (PEW) evaporator (PEW system). At that time, a detailed and systematic evaluation of hazardous chemical use and disposal practices had not been conducted to determine if F-, P-, or Unlisted waste had been disposed to the PEW system. The purpose of this investigation was to perform a systematic and detailed evaluation of the use and disposal of the 101 F-, P-, and Unlisted chemicals found in the approved September 1990 Part A Permit application. This investigation was aimed at determining which listed wastes, as defined in 40 CFR 261.31 (F-listed) and 261.33 (P & Unlisted) were discharged to the PEW system. Results of this investigation will be used to support revisions to the RCRA Part A Permit application.

Reference List About Implicit and Unconscious Bias

DEFF Research Database (Denmark)

Munar, Ana Maria; Villeseche, Florence; Wiedemann, Cecilie Dam

to publications accessible through the CBS library website and/or specifications of where and how to access each publication. In addition, as part of this effort and in line with the task list of the Council for Diversity and Inclusion, the report “Gender and Leadership Practices at Copenhagen Business School......The compilation of this reference list is one of the initiatives of the action plan developed by the Council for Diversity and Inclusion at Copenhagen Business School (CBS). This reference list is the first in a series of efforts initiated by this Council to develop an academic resource pool......, everyday human thought and activity” (Hardin and Banaji, 2013, pp. 13-14). Research also indicates that it is possible to implement procedures and strategic actions that help reduce implicit biases (Devine, Forscher, Austin, & Cox, 2012). Although extensive, this list does not include all existing academic...

Reducing Xerostomia After Chemo-IMRT for Head-and-Neck Cancer: Beyond Sparing the Parotid Glands

Energy Technology Data Exchange (ETDEWEB)

Little, Michael [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Schipper, Matthew [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Cancer Center Biostatistics Core, University of Michigan, Ann Arbor, MI (United States); Feng, Felix Y.; Vineberg, Karen [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Cornwall, Craig; Murdoch-Kinch, Carol-Anne [Hospital Dentistry, University of Michigan, Ann Arbor, MI (United States); Eisbruch, Avraham, E-mail: eisbruch@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States)

2012-07-01

Purpose: To assess whether, in addition to sparing the parotid glands (PGs), xerostomia after chemotherapy plus intensity-modulated radiotherapy (chemo-IMRT) for head-and-neck cancer is affected by reducing the dose to the other salivary glands. Patients and Methods: In a prospective study, 78 patients with Stage III-IV oropharynx/nasopharynx cancer underwent chemo-IMRT, with the aim of sparing the parts of the bilateral PGs, oral cavity (OC) containing the minor salivary glands, and contralateral submandibular gland (SMG) outside the target (when contralateral level I was not a target). Before therapy and periodically for 24 months, validated patient-reported xerostomia questionnaire (XQ) scores and observer-graded xerostomia scores were recorded. Also, the stimulated and unstimulated saliva was measured selectively from each of the PGs and SMGs. The mean OC doses served as surrogates of minor salivary gland dysfunction. Regression models assessed the XQ and observer-graded xerostomia predictors. Results: Statistically significant predictors of the XQ score on univariate analysis included the OC, PG, and SMG mean doses and the baseline XQ score, time since RT, and both stimulated and unstimulated PG saliva flow rates. Similar factors were statistically significant predictors of observer-graded xerostomia. The OC, PG, and SMG mean doses were moderately intercorrelated (r = 0.47-0.55). On multivariate analyses, after adjusting for the PG and SMG doses, the OC mean dose (p < .0001), interval from RT (p < .0001), and stimulated PG saliva (p < .0025) were significant predictors of the XQ scores and the OC mean dose and time for observer-graded xerostomia. Although scatter plots showed no thresholds, an OC mean dose of <40 Gy and contralateral SMG mean dose of <50 Gy were each associated with low patient-reported and observer-rated xerostomia at almost all post-therapy points. Conclusion: The PG, SMG, and OC mean doses were significant predictors of both patient

Reducing Xerostomia After Chemo-IMRT for Head-and-Neck Cancer: Beyond Sparing the Parotid Glands

International Nuclear Information System (INIS)

Little, Michael; Schipper, Matthew; Feng, Felix Y.; Vineberg, Karen; Cornwall, Craig; Murdoch-Kinch, Carol-Anne; Eisbruch, Avraham

2012-01-01

Purpose: To assess whether, in addition to sparing the parotid glands (PGs), xerostomia after chemotherapy plus intensity-modulated radiotherapy (chemo-IMRT) for head-and-neck cancer is affected by reducing the dose to the other salivary glands. Patients and Methods: In a prospective study, 78 patients with Stage III-IV oropharynx/nasopharynx cancer underwent chemo-IMRT, with the aim of sparing the parts of the bilateral PGs, oral cavity (OC) containing the minor salivary glands, and contralateral submandibular gland (SMG) outside the target (when contralateral level I was not a target). Before therapy and periodically for 24 months, validated patient-reported xerostomia questionnaire (XQ) scores and observer-graded xerostomia scores were recorded. Also, the stimulated and unstimulated saliva was measured selectively from each of the PGs and SMGs. The mean OC doses served as surrogates of minor salivary gland dysfunction. Regression models assessed the XQ and observer-graded xerostomia predictors. Results: Statistically significant predictors of the XQ score on univariate analysis included the OC, PG, and SMG mean doses and the baseline XQ score, time since RT, and both stimulated and unstimulated PG saliva flow rates. Similar factors were statistically significant predictors of observer-graded xerostomia. The OC, PG, and SMG mean doses were moderately intercorrelated (r = 0.47–0.55). On multivariate analyses, after adjusting for the PG and SMG doses, the OC mean dose (p < .0001), interval from RT (p < .0001), and stimulated PG saliva (p < .0025) were significant predictors of the XQ scores and the OC mean dose and time for observer-graded xerostomia. Although scatter plots showed no thresholds, an OC mean dose of <40 Gy and contralateral SMG mean dose of <50 Gy were each associated with low patient-reported and observer-rated xerostomia at almost all post-therapy points. Conclusion: The PG, SMG, and OC mean doses were significant predictors of both patient

THE COURSE IN TESTING THE WEARING OUT OF MUD PUMPS PARTS

Directory of Open Access Journals (Sweden)

Davorin Matanović

1989-12-01

Full Text Available Piston and cylinder are such parts in the mud pumps which cause the greatest expences due to the work stoppage of drilling rig. To reduce so caused expences it is necessary to produce spare parts of better quality. In determining the abrasion wear resistance for chosen materials, so called dry sand/rubber wheel abrasion test as an ASTM standard has been used (the paper is published in Croatian.

Safety of long-term subcutaneous free flap skin banking after skin-sparing mastectomy.

Science.gov (United States)

Verstappen, Ralph; Djedovic, Gabriel; Morandi, Evi Maria; Heiser, Dietmar; Rieger, Ulrich Michael; Bauer, Thomas

2018-03-01

A persistent problem in autologous breast reconstruction in skin-sparing mastectomies is skin restoration after skin necrosis or secondary oncological resection. As a solution to facilitate reconstruction, skin banking of free-flap skin has been proposed in cases where the overlying skin envelope must be resected, as this technique spares the patient an additional donor site. Herein, we present the largest series to date in which this method was used. We investigated its safety and the possibility of skin banking for prolonged periods of time. All skin-sparing mastectomies and immediate autologous breast reconstructions from December 2009 until June 2013 at our institution were analysed. We identified 31 patients who underwent 33 free flap reconstructions in which skin banking was performed. Our median skin banking period was 7 days, with a maximum duration of 171 days. In 22.5% of cases, the banked skin was used to reconstruct overlying skin defects, and in 9.6% of cases to reconstruct the nipple-areolar complex. Microbiological and histological investigations of the banked skin revealed neither clinical infections nor malignancies. In situ skin banking, even for prolonged periods of time, is a safe and cost-effective method to ensure that skin defects due to necrosis or secondary oncological resection can be easily reconstructed.

Age Disparities in the Use of Steroid-sparing Therapy for Inflammatory Bowel Disease.

Science.gov (United States)

Govani, Shail M; Wiitala, Wyndy L; Stidham, Ryan W; Saini, Sameer D; Hou, Jason K; Feagins, Linda A; Sussman, Jeremy B; Higgins, Peter D R; Waljee, Akbar K

2016-08-01

Corticosteroids are effective rescue therapies for patients with inflammatory bowel disease (IBD), but have significant side effects, which may be amplified in the growing population of elderly patients with IBD. We aimed to compare the use of steroids and steroid-sparing therapies (immunomodulators and biologics) and rates of complications among elderly (≥65) and younger patients in a national cohort of veterans with IBD. We used national Veterans Health Administrative data to conduct a retrospective study of veterans with IBD between 2002 and 2010. Medications and the incidence of complications were obtained from the Veterans Health Administrative Decision Support Systems. Multivariate logistic regression accounting for facility-level clustering was used to identify predictors of use of steroid-sparing medications. We identified 30,456 veterans with IBD. Of these, 94% were men and 40% were more than 65, and 32% were given steroids. Elderly veterans were less likely to receive steroids (23.8% versus 38.3%, P fracture rates increased in the elderly patients with IBD, whereas increases in venous thromboembolism and infections after starting steroids affected both age groups. Elderly veterans are less likely to receive steroids and steroid-sparing medications than younger veterans; elderly patients exposed to steroids were more likely to have fractures than the younger population.

Relationship between plasma analytes and SPARE-AD defined brain atrophy patterns in ADNI.

Directory of Open Access Journals (Sweden)

Jon B Toledo

Full Text Available Different inflammatory and metabolic pathways have been associated with Alzheimeŕs disease (AD. However, only recently multi-analyte panels to study a large number of molecules in well characterized cohorts have been made available. These panels could help identify molecules that point to the affected pathways. We studied the relationship between a panel of plasma biomarkers (Human DiscoveryMAP and presence of AD-like brain atrophy patterns defined by a previously published index (SPARE-AD at baseline in subjects of the ADNI cohort. 818 subjects had MRI-derived SPARE-AD scores, of these subjects 69% had plasma biomarkers and 51% had CSF tau and Aβ measurements. Significant analyte-SPARE-AD and analytes correlations were studied in adjusted models. Plasma cortisol and chromogranin A showed a significant association that did not remain significant in the CSF signature adjusted model. Plasma macrophage inhibitory protein-1α and insulin-like growth factor binding protein 2 showed a significant association with brain atrophy in the adjusted model. Cortisol levels showed an inverse association with tests measuring processing speed. Our results indicate that stress and insulin responses and cytokines associated with recruitment of inflammatory cells in MCI-AD are associated with its characteristic AD-like brain atrophy pattern and correlate with clinical changes or CSF biomarkers.

INIS: Authority list for journal titles

International Nuclear Information System (INIS)

2007-01-01

This is the 33rd revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). This list is published annually and includes the titles of all journals which have contained articles submitted to INIS at the time of publication. The current list contains 13 396 journal titles, 2 170 regularly scanned journals and 578 key journals. It was last updated in February 2007. A journal - or periodical - is a continuing publication issued in a succession of discrete parts, usually bearing numbering and/or chronological designations and intended to be continued indefinitely. It is generally published within a defined, fixed interval between issues and normally appears more than once per year. It includes a mixture of articles, letters, summaries, etc. Within this definition, annuals such as the Annual Review of Nuclear Science are included, but series titles such as the McGraw-Hill Series in Nuclear Engineering are not. The purpose of this document is to provide descriptive cataloguers with standard elements to include in bibliographic level 'S' of the INIS record. These elements include field (tag) 229 (Full Journal Title), 320 (ISSN) and 321 (CODEN). The full journal title is mandatory, and either the ISSN or the CODEN must be included (both may appear). Instructions on how to use this and other elements of the INIS record format are found in INIS: Guide to Bibliographic Description (IAEA-INIS-1). In order to help the user find titles easily, the list is arranged in six parts, followed by summary statistics: - In Part I, all key journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. - In Part II, all key journals are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. - In Part III, all journals that are regularly scanned by

Modified Sleeve Technique in Aortic Valve-Sparing Operation for Marfan Syndrome.

Science.gov (United States)

Wu, Yung-Szu; Hsieh, Shih-Rong; Wang, Chung-Chi; Tsai, Chung-Lin

2018-03-22

We devised a simple modification of the Florida Sleeve procedure to perform aortic valve-sparing surgery. This technique is simple, quick, effective, and safe. We used this technique in operations performed on two young patients with Marfan syndrome. The initial and short-term results were satisfactory.

Rare presentation of a testicular angiofibroma treated with testis sparing surgery.

Science.gov (United States)

Leone, Luca; Fulvi, Paola; Sbrollini, Giulia; Filosa, Alessandra; Caraceni, Enrico; Marronaro, Angelo; Galosi, Andrea B

2016-12-30

Testicular benign tumors are very rare (< 5%). Testicular Angiofibroma (AF) is one of those, however the gold standard of treatment and follow-up is still unclear. A 47 years-old man with only one functioning testis was referred to our clinic for a palpable right testicular mass and atrophic contralateral testis. Patient underwent testis-sparing surgery with inguinal approach and intraoperative frozen sections examination with diagnosis of AF. Final histology confirmed AF. Post-operative follow-up was uneventful. Clinical and ultrasonographic follow-up was negative after 8 months. We report a conservative surgery in a patient with AF of the solitary testis. AF is a benign para-testicular fibrous neoplasm that could be misinterpreted as malignant tumor and treated with orchiectomy. Testis-sparing surgery is recommended in this case with intraoperative pathological examination. The excision of the mass is enough but in front of a possible recurrence a long follow-up is advisable.

Rare presentation of a testicular angiofibroma treated with testis sparing surgery

Directory of Open Access Journals (Sweden)

Luca Leone

2016-12-01

Full Text Available Introduction: Testicular benign tumors are very rare (< 5%. Testicular Angiofibroma (AF is one of those, however the gold standard of treatment and follow-up is still unclear. Case report: A 47 years-old man with only one functioning testis was referred to our clinic for a palpable right testicular mass and atrophic contralateral testis. Patient underwent testis-sparing surgery with inguinal approach and intraoperative frozen sections examination with diagnosis of AF. Final histology confirmed AF. Post-operative follow-up was uneventful. Clinical and ultrasonographic follow-up was negative after 8 months. Conclusion: We report a conservative surgery in a patient with AF of the solitary testis. AF is a benign para-testicular fibrous neoplasm that could be misinterpreted as malignant tumor and treated with orchiectomy. Testis-sparing surgery is recommended in this case with intraoperative pathological examination. The excision of the mass is enough but in front of a possible recurrence a long follow-up is advisable.

Management of acetabular fractures with modified posterior approach to spare external hip rotators.

Science.gov (United States)

Sarlak, Ahmet Y; Selek, Ozgur; Inanir, Murat; Musaoglu, Resul; Baran, Tuncay

2014-04-01

In the present study the quality of reduction and incidence of complications in hip external rotator sparing modified posterior approach was assessed in both simple and complex acetabular fractures. This retrospective study includes 37 patients (38 hips) with a mean age of 42.1 years (range 21-60), that had been treated for displaced acetabular fractures from June 2007 through May 2011. They were reviewed at a mean of 3 years (20-67 months). The fractures were classified according to the Letournel-Judet classification. Anatomic reduction and stable fixation of the fracture with less than 2mm residual displacement was achieved in 28 of 38 hips. At the final follow up the patients were evaluated clinically according to Merle d'Aubigne and Postel scoring system which had been modified by Matta and radiologically based on the criteria described by Matta. The clinical results were excellent in 20, good in 8, fair in 8, and poor 2 hips. Complications included two superficial local wound infection and 10 heterotopic ossification with 7 of the cases having grade I heterotopic ossification. Avascular necrosis of the femoral head was not seen in any of the 38 hips. One patient with preoperative sciatic nerve palsy had complete recovery of neurologic function. There were no cases of deep vein thrombosis or pulmonary embolism. The functional outcome was satisfactory in most of the cases and comparable with other larger series. Using the limited part of Henry's sciatic nerve exposure skin incision - working in the plane between gluteus maximus and the tensor fascia lata as in the classical Gibson approach and two portal external rotator hip sparing approach resulted in good fracture reduction without approach related complications. Copyright © 2013 Elsevier Ltd. All rights reserved.

Cattle ranching intensification in Brazil can reduce global greenhouse gas emissions by sparing land from deforestation.

Science.gov (United States)

Cohn, Avery S; Mosnier, Aline; Havlík, Petr; Valin, Hugo; Herrero, Mario; Schmid, Erwin; O'Hare, Michael; Obersteiner, Michael

2014-05-20

This study examines whether policies to encourage cattle ranching intensification in Brazil can abate global greenhouse gas (GHG) emissions by sparing land from deforestation. We use an economic model of global land use to investigate, from 2010 to 2030, the global agricultural outcomes, land use changes, and GHG abatement resulting from two potential Brazilian policies: a tax on cattle from conventional pasture and a subsidy for cattle from semi-intensive pasture. We find that under either policy, Brazil could achieve considerable sparing of forests and abatement of GHGs, in line with its national policy targets. The land spared, particularly under the tax, is far less than proportional to the productivity increased. However, the tax, despite prompting less adoption of semi-intensive ranching, delivers slightly more forest sparing and GHG abatement than the subsidy. This difference is explained by increased deforestation associated with increased beef consumption under the subsidy and reduced deforestation associated with reduced beef consumption under the tax. Complementary policies to directly limit deforestation could help limit these effects. GHG abatement from either the tax or subsidy appears inexpensive but, over time, the tax would become cheaper than the subsidy. A revenue-neutral combination of the policies could be an element of a sustainable development strategy for Brazil and other emerging economies seeking to balance agricultural development and forest protection.

Quality assurance in a cask fleet parts control system

International Nuclear Information System (INIS)

Fernandez, C.; McCreery, P.N.; Shappert, L.B.

1991-01-01

Applicable portions of the eighteen Quality Assurance criteria of Subpart H, 10 CFR 71 are incorporated into a relational data base system which has been designed to manage the spare parts control system for a fleet of spent nuclear fuel casks. The system includes not only parts in warehouse storage but parts in use in the field plus casks, ancillary equipment, test equipment, support devices, and even personnel. It provides a high degree of assurance that any device for which a condition for certification has expired will be flagged for recertification testing or removal from service well before the critical date

Nipple-sparing mastectomy with immediate implant reconstruction: cosmetic outcomes and technical refinements.

Science.gov (United States)

Salgarello, Marzia; Visconti, Giuseppe; Barone-Adesi, Liliana

2010-11-01

Nipple-sparing mastectomy is gaining widespread popularity, as it could allow improved aesthetic outcome without increasing oncologic risk. To investigate the reconstructive issues experienced with immediate implant reconstruction, the authors reviewed the cosmetic outcomes of their series. The authors retrospectively analyzed the data on 33 cases of nipple-sparing mastectomy for both cancer and prophylaxis with immediate implant reconstruction using the submusculo-subfascial pocket. Cosmetic evaluation methods were clinical and photography-based assessments and a patient-satisfaction survey. The average follow-up period was 26.8 months. No nipple-areola complex cancer involvement was registered. The reconstructive outcomes ranged from good to excellent in 83 percent of the cases. Patients' satisfaction was high to very high, except in one patient who experienced total nipple-areola complex loss (one breast, 2.4 percent). Overall, early minor complications were registered in four breasts (9.5 percent) and late minor complications in five cases (12 percent). The authors' series suggest that nipple-sparing mastectomy is an option for carefully selected and screened patients. Larger studies with longer follow-up are needed, however. On the whole, the immediate one-stage implant reconstruction with hyperprojected anatomical gel implants represents a valid option. The skin incision algorithm proposed, which is based on the breast size, shape, and previous scars, might aid in the decision-making process to achieve satisfying results using this procedure. The radial approaches represent a good compromise between the oncologic and reconstructive procedures.

40 CFR Table 2 to Subpart Jj of... - List of Volatile Hazardous Air Pollutants

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 10 2010-07-01 2010-07-01 false List of Volatile Hazardous Air Pollutants 2 Table 2 to Subpart JJ of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY.... JJ, Table 2 Table 2 to Subpart JJ of Part 63—List of Volatile Hazardous Air Pollutants Chemical name...

Publication list concerning LMFBR-work of KFK from 1976 until 1978

International Nuclear Information System (INIS)

Hueper, R.

1979-04-01

This list is a continuation of the lists of the Karlsruhe Fast Breeder Project publications given in the earlier reports KFK-Ext. 25/7-1 and 25/76-1. Corresponding to the present organisation of the project in the framework of the cooperation between Germany, Belgium, the Netherlands and France, the list is subdivided into the fields of the working groups of the 'Arbeitsausschuss F+E-Programme des SNR-300'. In the last part of the list general surveys of the project work and its objectives are quoted. (orig.) [de

Probability and Confidence Trade-space (PACT) Evaluation: Accounting for Uncertainty in Sparing Assessments

Science.gov (United States)

Anderson, Leif; Box, Neil; Carter, Katrina; DiFilippo, Denise; Harrington, Sean; Jackson, David; Lutomski, Michael

2012-01-01

There are two general shortcomings to the current annual sparing assessment: 1. The vehicle functions are currently assessed according to confidence targets, which can be misleading- overly conservative or optimistic. 2. The current confidence levels are arbitrarily determined and do not account for epistemic uncertainty (lack of knowledge) in the ORU failure rate. There are two major categories of uncertainty that impact Sparing Assessment: (a) Aleatory Uncertainty: Natural variability in distribution of actual failures around an Mean Time Between Failure (MTBF) (b) Epistemic Uncertainty : Lack of knowledge about the true value of an Orbital Replacement Unit's (ORU) MTBF We propose an approach to revise confidence targets and account for both categories of uncertainty, an approach we call Probability and Confidence Trade-space (PACT) evaluation.

Lean spare parts delivery chain

OpenAIRE

Sjöstrand, Niklas; Larsson, Mona-Liza

2015-01-01

AbstractWhen a product has been sold to a customer a new market arises for the company to earn profit from and to differentiate itself within. According to Bartwal, et al. (2010) the after sales market generally does not provide great revenues but good profits of the total revenue. In order to gain competiveness and live up to customer’s expectations a company needs to be efficient (Atkinson, 2004). He continuous that this can be accomplished if companies implement Lean. Lean is different too...

14 CFR Appendix to Part 331 - Application Form for Reimbursement Under Section 185 of Public Law 109-115

Science.gov (United States)

2010-01-01

... entities than larger airports at which scheduled service is provided, the Department believes that this... flight and ground equipment; provisions for obsolescence and deterioration of spare parts; insurance...

The effect of setup uncertainty on normal tissue sparing with IMRT for head-and-neck cancer

International Nuclear Information System (INIS)

Manning, Matthew A.; Wu Quiwen; Cardinale, Robert M.; Mohan, Radhe; Lauve, Andrew D.; Kavanagh, Brian D.; Morris, Monica M.; Schmidt-Ullrich, Rupert K.

2001-01-01

Purpose: Intensity-modulated radiotherapy (IMRT) is being evaluated in the management of head-and-neck cancers at several institutions, and a Radiation Therapy Oncology Group study of its utility in parotid sparing is under development. There is an inherent risk that the sharper dose gradients generated by IMRT amplify the potentially detrimental impact of setup uncertainty. The International Commission on Radiation Units and Measurements Report 62 (ICRU-62) defined planning organ-at-risk volume (PRV) to account for positional uncertainties for normal tissues. The purpose of this study is to quantify the dosimetric effect of employing PRV for the parotid gland and to evaluate the use of PRV on normal-tissue sparing in the setting of small clinical setup errors. Methods and Materials: The optimized nine-beam IMRT plans for three head-and-neck cancer patients participating in an institutional review board approved parotid-sparing protocol were used as reference plans. A second optimized plan was generated for each patient by adding a PRV of 5 mm for the contralateral parotid gland. The effect of these additions on the quality of the plans was quantified, in terms of both target coverage and normal-tissue sparing. To test the value of PRV in a worst-case scenario, systematic translational setup uncertainties were simulated by shifting the treatment isocenter 5 mm superiorly, inferiorly, left, right, anteriorly, and posteriorly, without altering optimized beam profiles. At each shifted isocenter, dose distributions were recalculated, producing a total of six shifted plans without PRV and six shifted plans with PRV for each patient. The effect of setup uncertainty on parotid sparing and the value of PRV in compensating for the uncertainty were evaluated. Results: The addition of the PRV and reoptimization did not significantly affect the dose to gross tumor volume, spinal cord, or brainstem. In contrast, without any shift, the PRV did increase parotid sparing and reduce

Safety of long-term subcutaneous free flap skin banking after skin-sparing mastectomy

Directory of Open Access Journals (Sweden)

Ralph Verstappen

2018-03-01

Full Text Available Background A persistent problem in autologous breast reconstruction in skin-sparing mastectomies is skin restoration after skin necrosis or secondary oncological resection. As a solution to facilitate reconstruction, skin banking of free-flap skin has been proposed in cases where the overlying skin envelope must be resected, as this technique spares the patient an additional donor site. Herein, we present the largest series to date in which this method was used. We investigated its safety and the possibility of skin banking for prolonged periods of time. Methods All skin-sparing mastectomies and immediate autologous breast reconstructions from December 2009 until June 2013 at our institution were analysed. Results We identified 31 patients who underwent 33 free flap reconstructions in which skin banking was performed. Our median skin banking period was 7 days, with a maximum duration of 171 days. In 22.5% of cases, the banked skin was used to reconstruct overlying skin defects, and in 9.6% of cases to reconstruct the nipple-areolar complex. Microbiological and histological investigations of the banked skin revealed neither clinical infections nor malignancies. Conclusions In situ skin banking, even for prolonged periods of time, is a safe and cost-effective method to ensure that skin defects due to necrosis or secondary oncological resection can be easily reconstructed.

INIS: Authority List for Journal Titles

International Nuclear Information System (INIS)

1992-01-01

This is the nineteenth revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). It lists 10,797 journal titles which have contained articles within the scope of INIS. The purpose of this Authority List is to provide descriptive cataloguers with a standard abbreviation for journal titles and to assist users of INIS products with a tool for verifying the full title of a journal. A journal, or periodical, is generally published within a defined, fixed interval between issues, which usually has more than one issue a year, and which usually includes a mixture of articles, letters, summaries, etc. Within this definition, annuals such as Annual Review of Nuclear Science are included. Series titles as, for example the McGraw-Hill Series in Nuclear Engineering, are not included in this Authority. Entries: Each entry consists of: - the full journal title (highlighted); - the abbreviated title; - ISSN, if available; - CODEN, if available; - additional information related to the journal title. Arrangement: In Part I, the full journal titles are grouped by country or international organization name and ordered alphabetically, followed by the ISSN, the CODEN in square brackets if available, and then the abbreviated title. The abbreviated title is based on the rules of ISO 4: Documentation - International Code for the Abbreviation of Titles of Periodicals. The abbreviations of the words are taken from the ISDS List of Periodical Title Word Abbreviation. In Part II, the order of the citations is reversed: the abbreviated journal titles are arranged alphabetically, followed by country code. Then the full journal titles are followed by the country of publication, and if available, ISSN and CODEN. Additional Information: There is important information related to the journal titles which are fundamental for tracing the history of the title and the present status. They are listed below and are entered whenever applicable: - Ceased publication; - Superseded by

Dosimetric analysis of the alopecia preventing effect of hippocampus sparing whole brain radiation therapy

International Nuclear Information System (INIS)

Mahadevan, Anand; Sampson, Carrie; LaRosa, Salvatore; Floyd, Scott R.; Wong, Eric T.; Uhlmann, Erik J.; Sengupta, Soma; Kasper, Ekkehard M.

2015-01-01

Whole brain radiation therapy (WBRT) is widely used for the treatment of brain metastases. Cognitive decline and alopecia are recognized adverse effects of WBRT. Recently hippocampus sparing whole brain radiation therapy (HS-WBRT) has been shown to reduce the incidence of memory loss. In this study, we found that multi-field intensity modulated radiation therapy (IMRT), with strict constraints to the brain parenchyma and to the hippocampus, reduces follicular scalp dose and prevents alopecia. Suitable patients befitting the inclusion criteria of the RTOG 0933 trial received Hippocampus sparing whole brain radiation. On follow up, they were noticed to have full scalp hair preservation. 5 mm thickness of follicle bearing scalp in the radiation field was outlined in the planning CT scans. Conventional opposed lateral WBRT radiation fields were applied to these patient-specific image sets and planned with the same nominal dose of 30 Gy in 10 fractions. The mean and maximum dose to follicle bearing skin and Dose Volume Histogram (DVH) data were analyzed for conventional and HS-WBRT. Paired t-test was used to compare the means. All six patients had fully preserved scalp hair and remained clinically cognitively intact 1–3 months after HS-WBRT. Compared to conventional WBRT, in addition to the intended sparing of the Hippocampus, HS-WBRT delivered significantly lower mean dose (22.42 cGy vs. 16.33 cGy, p < 0.0001), V 24 (9 cc vs. 44 cc, p < 0.0000) and V 30 (9 cc vs. 0.096 cc, p = 0.0106) to follicle hair bearing scalp and prevented alopecia. There were no recurrences in the Hippocampus area. HS-WBRT, with an 11-field set up as described, while attempting to conserve hippocampus radiation and maintain radiation dose to brain inadvertently spares follicle-bearing scalp and prevents alopecia

INIS: Authority list for journal titles

International Nuclear Information System (INIS)

2008-01-01

This is the 34th revision of the INIS: Authority List for Journal Titles (IAEA-INIS-11). This list is published annually and includes the titles of all journals which have contained articles submitted to INIS at the time of publication. The current list contains 13 538 journal titles, 2 106 regularly scanned journals and 613 key journals. It was last updated in February 2008. A journal - or periodical - is a continuing publication issued in a succession of discrete parts, usually bearing numbering and/or chronological designations and intended to be continued indefinitely. It is generally published within a defined, fixed interval between issues and normally appears more than once per year. It includes a mixture of articles, letters, summaries, etc. Within this definition, annuals such as the Annual Review of Nuclear Science are included, but series titles such as the McGraw-Hill Series in Nuclear Engineering are not. The purpose of this document is to provide descriptive cataloguers with standard elements to include in bibliographic level 'S' of the INIS record. These elements include field (tag) 229 (Full Journal Title), 320 (ISSN) and 321 (CODEN). The full journal title is mandatory, and either the ISSN or the CODEN must be included (both may appear). Instructions on how to use this and other elements of the INIS record format are found in INIS: Guide to Bibliographic Description (IAEA-INIS-1). In order to help the user find titles easily, the list is arranged in six parts, followed by summary statistics: - In Part I, all key journals are grouped under the name of the country or international organization responsible for their input in INIS, then sorted alphabetically under their title. - In Part II, all key journals are sorted alphabetically under their title. The name of the country or international organization responsible for their input in INIS is entered in parentheses within the body of the entry. - In Part III, all journals that are regularly scanned by

SU-E-J-125: A Novel IMRT Planning Technique to Spare Sacral Bone Marrow in Pelvic Cancer Patients

Energy Technology Data Exchange (ETDEWEB)

McGuire, S; Bhatia, S; Sun, W; Menda, Y; Ponto, L; Gross, B; Buatti, J [University Of Iowa, Iowa City, IA (United States)

2015-06-15

Purpose: Develop an IMRT planning technique that can preferentially spare sacral bone marrow for pelvic cancer patients. Methods: Six pelvic cancer patients (two each with anal, cervical, and rectal cancer) were enrolled in an IRB approved protocol to obtain FLT PET images at simulation, during, and post chemoradiation therapy. Initially, conventional IMRT plans were created to maintain target coverage and reduce dose to OARs such as bladder, bowel, rectum, and femoral heads. Simulation FLT PET images were used to create IMRT plans to spare bone marrow identified as regions with SUV of 2 or greater (IMRT-BMS) within the pelvic bones from top of L3 to 5mm below the greater trochanter without compromising PTV coverage or OAR sparing when compared to the initial IMRT plan. IMRT-BMS plans used 8–10 beam angles that surrounded the subject. These plans were used for treatment. Retrospectively, the same simulation FLT PET images were used to create IMRT plans that spared bone marrow located in the sacral pelvic bone region (IMRT-FAN) also without compromising PTV coverage or OAR sparing. IMRT-FAN plans used 16 beam angles every 12° anteriorly from 90° – 270°. Optimization objectives for the sacral bone marrow avoidance region were weighted to reduce ≥V10. Results: IMRT-FAN reduced dose to the sacral bone marrow for all six subjects. The average V5, V10, V20, and V30 differences from the IMRT-BMS plan were −2.2 ± 1.7%, −11.4 ± 3.6%, −17.6 ± 5.1%, and −19.1 ± 8.1% respectively. Average PTV coverage change was 0.5% ± 0.8% from the conventional IMRT plan. Conclusion: An IMRT planning technique that uses beams from the anterior and lateral directions reduced the volume of sacral bone marrow that receives ≤10Gy while maintaining PTV coverage and OAR sparing. Additionally, the volume of sacral bone marrow that received 20 or 30 Gy was also reduced.

Cardiac dose sparing and avoidance techniques in breast cancer radiotherapy

International Nuclear Information System (INIS)

Shah, Chirag; Badiyan, Shahed; Berry, Sameer; Khan, Atif J.; Goyal, Sharad; Schulte, Kevin; Nanavati, Anish; Lynch, Melanie; Vicini, Frank A.

2014-01-01

Breast cancer radiotherapy represents an essential component in the overall management of both early stage and locally advanced breast cancer. As the number of breast cancer survivors has increased, chronic sequelae of breast cancer radiotherapy become more important. While recently published data suggest a potential for an increase in cardiac events with radiotherapy, these studies do not consider the impact of newer radiotherapy techniques commonly utilized. Therefore, the purpose of this review is to evaluate cardiac dose sparing techniques in breast cancer radiotherapy. Current options for cardiac protection/avoidance include (1) maneuvers that displace the heart from the field such as coordinating the breathing cycle or through prone patient positioning, (2) technological advances such as intensity modulated radiation therapy (IMRT) or proton beam therapy (PBT), and (3) techniques that treat a smaller volume around the lumpectomy cavity such as accelerated partial breast irradiation (APBI), or intraoperative radiotherapy (IORT). While these techniques have shown promise dosimetrically, limited data on late cardiac events exist due to the difficulties of long-term follow up. Future studies are required to validate the efficacy of cardiac dose sparing techniques and may use surrogates for cardiac events such as biomarkers or perfusion imaging

Conserving the birds of Uganda's Banana-Coffee Arc: Land Sparing and Land Sharing Compared

DEFF Research Database (Denmark)

Hulme, Mark F.; Vickery, Juliet A.; Green, Rhys E.

2013-01-01

Reconciling the aims of feeding an ever more demanding human population and conserving biodiversity is a difficult challenge. Here, we explore potential solutions by assessing whether land sparing (farming for high yield, potentially enabling the protection of non-farmland habitat), land sharing...... (lower yielding farming with more biodiversity within farmland) or a mixed strategy would result in better bird conservation outcomes for a specified level of agricultural production. We surveyed forest and farmland study areas in southern Uganda, measuring the population density of 256 bird species...... explore how conservation and agricultural policies can be better integrated to deliver land sparing by, for example, combining land-use planning and agronomic support for small farmers....

[Valve-sparing aortic root replacement for young female patients with Marfan syndrome].

Science.gov (United States)

Nawata, Kan; Morota, T

2009-10-01

Annuloaortic ectasia is frequently related with Marfan syndrome, and Bentall procedure or aortic root replacement with valved conduit has been the conventional standard operation for this disease. Recently, some institutes have adopted valve-sparing aortic root replacement (VSARR) instead of Bentall procedure. Young female patients with Marfan syndrome who wishes for childbearing seem to be a group of good candidates of this type of operation, because it let them free from morbidities after artificial valve implantation. Valve-sparing operation should be taken into consideration when the size of Valsalva sinus reaches 45 mm for patients with Marfan syndrome and when it reaches 40 mm for patients with past histories or family histories of aortic dissection or aortic rupture. Since pregnancy is one of the most serious risk factors for aortic events, Valsalva sinus of 40 mm or larger could be the new standard for surgical indication if VSARR is applicable.

Renal-sparing strategies in cardiac transplantation

DEFF Research Database (Denmark)

Gustafsson, Finn; Ross, Heather J

2009-01-01

PURPOSE OF REVIEW: Renal dysfunction due to calcineurin inhibitor (CNI) toxicity is a major clinical problem in cardiac transplantation. The aim of the article is to review the efficacy and safety of various renal sparing strategies in cardiac transplantation. RECENT FINDINGS: Small studies have...... reduction in terms of preserving renal function. Patients with longstanding CNI treatment or proteinuria are less likely to respond favourably to a switch from a CNI-based regimen to a proliferation signal inhibitor-based regimen. SUMMARY: Each cardiac transplant recipient with renal dysfunction must...... documented that late initiation of CNI is safe in patients treated with induction therapy at the time of transplantation. Use of mycophenolate is superior when compared with azathioprine to allow for CNI reduction. More substantial reduction in CNI levels is safe and effective with the introduction...

[Long-term outcome of aortic valve sparing procedures in connective tissue disorders].

Science.gov (United States)

Tanaka, Hiroshi; Ogino, H; Matsuda, H; Minatoya, K; Sasaki, N

2009-10-01

The aim of this study is to determine the long-term outcome of aortic valve sparing procedures for patients having connective tissue disorder. Between 1993 and 2008, the aortic valve sparing surgery was performed in 94 patients having aortic root dilatation. Eighty patients of them (37.2 +/- 13.4 years, 50 male) had cystic medial necrosis in the aortic wall, which was confirmed the pathological examination. We reviewed these patients. Sixty percent (48/80) had Marfan syndrome, 5% (4/80) had Loeyz-Dietz syndrome, 2% (2/80) had bicuspid aortic valve, and 11% (9/80) had aortic dissection. Our reimplantation procedure has been refined as followed: with a tube graft in 41, a tube graft with creation of neo-sinuses in 11, and a Valsalva graft in 14. Fourteen patients underwent the remodeling procedure. The follow-up rate was 100% with the duration of 3.7+/- 3.4 years. There were no operative death but six late deaths. Seventeen (21.3%) patients required aortic valve replacement, for recurrent aortic insufficiency in 13 and infection in 4. Freedom from reoperation was 80%, 43%, and freedom from moderate or severe aortic insufficiency was 80%, 54%, at 5 and 10 years, respectively. Pathological findings of the aortic valve obtained in the reoperations showed elongation and prolapse of the aortic valve due to myxomatous degeneration and fibrous thickening caused by aortic insufficiency. Even in connective tissue disorders, aortic valve sparing operation is associated with acceptable long-term durability, although cusp degeneration resulting in recurrent aortic insufficiency might be progressive.

Autopsy-confirmed hippocampal-sparing Alzheimer's disease with delusional jealousy as initial manifestation.

Science.gov (United States)

Fujishiro, Hiroshige; Iritani, Shuji; Hattori, Miho; Sekiguchi, Hirotaka; Matsunaga, Shinji; Habuchi, Chikako; Torii, Youta; Umeda, Kentaro; Ozaki, Norio; Yoshida, Mari; Fujita, Kiyoshi

2015-09-01

Alzheimer's disease (AD) is clinically characterized by gradual onset over years with worsening of cognition. The initial and most prominent cognitive deficit is commonly memory dysfunction. However, a subset of AD cases has less hippocampal atrophy than would be expected relative to the predominance of cortical atrophy. These hippocampal-sparing cases have distinctive clinical features, including the presence of focal cortical clinical syndromes. Given that previous studies have indicated that severe hippocampal atrophy corresponds to prominent loss of episodic memory, it is likely that memory impairment is initially absent in hippocampal-sparing AD cases. Here, we report on a patient with an 8-year history of delusional jealousy with insidious onset who was clinically diagnosed as possible AD and pathologically confirmed to have AD with relatively preserved neurons in the hippocampus. This patient had delusional jealousy with a long pre-dementia stage, which initially was characterized by lack of memory impairment. Head magnetic resonance imaging findings showed preserved hippocampal volume with bilateral enlarged ventricles and mild-to-moderate cortical atrophy. Head single-photon emission computed tomography revealed severely decreased regional cerebral blood flow in the right temporal lobe. The resolution of the delusion was attributed to pharmacotherapy by an acetylcholinesterase inhibitor, suggesting that the occurrence of delusional jealousy was due to the disease process of AD. Although the neural basis of delusional jealousy remains unclear, this hippocampal-sparing AD case may be classified as an atypical presentation of AD. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

Why and how to spare the hippocampus during brain radiotherapy: the developing role of hippocampal avoidance in cranial radiotherapy

International Nuclear Information System (INIS)

Kazda, Tomas; Slampa, Pavel; Laack, Nadia N; Jancalek, Radim; Pospisil, Petr; Sevela, Ondrej; Prochazka, Tomas; Vrzal, Miroslav; Burkon, Petr; Slavik, Marek; Hynkova, Ludmila

2014-01-01

The goal of this review is to summarize the rationale for and feasibility of hippocampal sparing techniques during brain irradiation. Radiotherapy is the most effective non-surgical treatment of brain tumors and with the improvement in overall survival for these patients over the last few decades, there is an effort to minimize potential adverse effects leading to possible worsening in quality of life, especially worsening of neurocognitive function. The hippocampus and associated limbic system have long been known to be important in memory formation and pre-clinical models show loss of hippocampal stem cells with radiation as well as changes in architecture and function of mature neurons. Cognitive outcomes in clinical studies are beginning to provide evidence of cognitive effects associated with hippocampal dose and the cognitive benefits of hippocampal sparing. Numerous feasibility planning studies support the feasibility of using modern radiotherapy systems for hippocampal sparing during brain irradiation. Although results of the ongoing phase II and phase III studies are needed to confirm the benefit of hippocampal sparing brain radiotherapy on neurocognitive function, it is now technically and dosimetrically feasible to create hippocampal sparing treatment plans with appropriate irradiation of target volumes. The purpose of this review is to provide a brief overview of studies that provide a rationale for hippocampal avoidance and provide summary of published feasibility studies in order to help clinicians prepare for clinical usage of these complex and challenging techniques

76 FR 63184 - Addition of Certain Persons on the Entity List; Implementation of Entity List Annual Review...

Science.gov (United States)

2011-10-12

... Road, Tsuen Wan, Hong Kong; and 2. Hang Tat Electronics Enterprises Co., Room 2608, Technology Plaza, 29-35 Sha Tsui Road, Tsuen Wan, Hong Kong. Removals From the Entity List This rule removes four... to part 732 of the EAR, ``BIS's `Know Your Customer' Guidance and Red Flags,'' when persons are...

In Situ Manufacturing is a Necessary Part of Any Planetary Architecture

Science.gov (United States)

Edmunson, Jennifer E.; McLemore, Carole A.

2012-01-01

The key to any sustainable presence in space is the ability to manufacture necessary tools, parts, structures, spares, etc. in situ and on demand. Cost, volume, and up-mass constraints prohibit launching everything needed for long-duration or long-distance missions from Earth, including spare parts and replacement systems. There are many benefits to building items as-needed in situ using computer aided drafting (CAD) models and additive manufacturing technology: (1) Cost, up-mass, and volume savings for launch due to the ability to manufacture specific parts when needed. (2) CAD models can be generated on Earth and transmitted to the station or spacecraft, or they can be designed in situ for any task. Thus, multiple people in many locations can work on a single problem. (3) Items can be produced that will enhance the safety of crew and vehicles (e.g., latches or guards). (4) Items can be produced on-demand in a small amount of time (i.e., hours or days) compared to traditional manufacturing methods and, therefore, would not require the lengthy amount of time needed to machine the part from a solid block of material nor the wait time required if the part had to be launched from Earth. (5) Used and obsolete parts can be recycled into powder or wire feedstock for use in later manufacturing. (6) Ultimately, the ability to produce items as-needed will reduce mission risk, as one will have everything they need to fix a broken system or fashion a new part making it available on a more timely basis.

Aortic regurgitation after valve-sparing aortic root replacement: modes of failure.

Science.gov (United States)

Oka, Takanori; Okita, Yutaka; Matsumori, Masamichi; Okada, Kenji; Minami, Hitoshi; Munakata, Hiroshi; Inoue, Takeshi; Tanaka, Akiko; Sakamoto, Toshihito; Omura, Atsushi; Nomura, Takuo

2011-11-01

Despite the positive clinical results of valve-sparing aortic root replacement, little is known about the causes of reoperations and the modes of failure. From October 1999 to June 2010, 101 patients underwent valve-sparing aortic root replacement using the David reimplantation technique. The definition of aortic root repair failure included the following: (1) intraoperative conversion to the Bentall procedure; (2) reoperation performed because of aortic regurgitation; and (3) aortic regurgitation equal to or greater than a moderate degree at the follow-up. Sixteen patients were considered to have repair failure. Three patients required intraoperative conversion to valve replacement, 3 required reoperation within 3 months, and another 8 required reoperation during postoperative follow-up. At initial surgery 5 patients had moderate to severe aortic regurgitation, 6 patients had acute aortic dissections, 3 had Marfan syndrome, 2 had status post Ross operations, 3 had bicuspid aortic valves, and 1 had aortitis. Five patients had undergone cusp repair, including Arantius plication in 3 and plication at the commissure in 2. The causes of early failure in 6 patients included cusp perforation (3), cusp prolapse (3), and severe hemolysis (1). The causes of late failure in 10 patients included cusp prolapse (4), commissure dehiscence (3), torn cusp (2), and cusp retraction (1). Patients had valve replacements at a mean of 23 ± 20.9 months after reimplantation and survived. Causes of early failure after valve-sparing root replacement included technical failure, cusp lesions, and steep learning curve. Late failure was caused by aortic root wall degeneration due to gelatin-resorcin-formalin glue, cusp degeneration, or progression of cusp prolapse. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Task Lists for Home Economics Occupations, 1988: Cluster Matrices for Home Economics Occupations. Education for Employment Task Lists.

Science.gov (United States)

Below, Virginia

This document contains information for home economics occupations in Illinois in seven sections. The first part provides lists of employability skills for the following: food preparation and service worker, fashion designer, dietetic technician, and service coordinator/consumer assistant/concierge. The second section contains task analyses for the…

Quality assurance in a cask fleet parts control system

International Nuclear Information System (INIS)

Fernandez, C.; Shappert, L.B.

1992-01-01

This paper discusses applicable portions of the eighteen Quality Assurance criteria of Subpart H, 10 CFR 71 which are incorporated into a relational data base system which has been designed to manage the spare parts control system for a fleet of spent nuclear fuel casks. The system includes not only parts in warehouse storage but parts in use in the field plus casks, ancillary equipment, test equipment, support devices, and even personnel. It provides a high degree of assurance that any device for which a condition for certification has expired will be flagged for recertification testing or removal from service well before the critical date

Weight-sparing effect of insulin detemir: a consequence of central nervous system-mediated reduced energy intake?

Science.gov (United States)

Russell-Jones, D; Danne, T; Hermansen, K; Niswender, K; Robertson, K; Thalange, N; Vasselli, J R; Yildiz, B; Häring, H U

2015-10-01

Insulin therapy is often associated with adverse weight gain. This is attributable, at least in part, to changes in energy balance and insulin's anabolic effects. Adverse weight gain increases the risk of poor macrovascular outcomes in people with diabetes and should therefore be mitigated if possible. Clinical studies have shown that insulin detemir, a basal insulin analogue, exerts a unique weight-sparing effect compared with other basal insulins. To understand this property, several hypotheses have been proposed. These explore the interplay of efferent and afferent signals between the muscles, brain, liver, renal and adipose tissues in response to insulin detemir and comparator basal insulins. The following models have been proposed: insulin detemir may reduce food intake through direct or indirect effects on the central nervous system (CNS); it may have favourable actions on hepatic glucose metabolism through a selective effect on the liver, or it may influence fluid homeostasis through renal effects. Studies have consistently shown that insulin detemir reduces energy intake, and moreover, it is clear that this shift in energy balance is not a consequence of reduced hypoglycaemia. CNS effects may be mediated by direct action, by indirect stimulation by peripheral mediators and/or via a more physiological counter-regulatory response to insulin through restoration of the hepatic-peripheral insulin gradient. Although the precise mechanism remains unclear, it is likely that the weight-sparing effect of insulin detemir can be explained by a combination of mechanisms. The evidence for each hypothesis is considered in this review. © 2015 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

Impact of penile rehabilitation with low-dose vardenafil on recovery of erectile function in Japanese men following nerve-sparing radical prostatectomy

Directory of Open Access Journals (Sweden)

Yuzo Nakano

2014-12-01

Full Text Available Erectile dysfunction (ED is a major complication after radical prostatectomy (RP; however, debate continues regarding the efficacy of penile rehabilitation in the recovery of the postoperative erectile function (EF. This study included a total of 103 consecutive sexually active Japanese men with localized prostate cancer undergoing nerve-sparing RP, and analyzed the postoperative EF, focusing on the significance of penile rehabilitation. In this series, 24 and 79 patients underwent bilateral and unilateral nerve-sparing RPs, respectively, and 10 or 20 mg of vardenafil was administered to 35 patients at least once weekly, who agreed to undergo penile rehabilitation. Twelve months after RP, 48 (46.6% of the 103 patients were judged to have recovered EF sufficient for sexual intercourse without any assistance. The proportion of patients who recovered EF in those undergoing penile rehabilitation (60.0% was significantly greater than that in those without penile rehabilitation (38.2%. Of several parameters examined, the preoperative International Index of Erectile Function-5 (IIEF-5 score and nerve-sparing procedure were significantly associated with the postoperative EF recovery rates in patients with and without management by penile rehabilitation, respectively. Furthermore, univariate analysis identified the preoperative IIEF-5 score, nerve-sparing procedure and penile rehabilitation as significant predictors of EF recovery, among which the preoperative IIEF-5 score and nerve-sparing procedure appeared to be independently associated with EF recovery. Considering these findings, despite the lack of independent significance, penile rehabilitation with low-dose vardenafil could exert a beneficial effect on EF recovery in Japanese men following nerve-sparing RP.

40 CFR Appendix: Table 1 to... - List of Hazardous Air Pollutants (HAP) for Subpart HHH

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 11 2010-07-01 2010-07-01 true List of Hazardous Air Pollutants (HAP) for Subpart HHH Table Appendix: Table 1 to Subpart HHH of Part 63 Protection of Environment... HHH of Part 63—List of Hazardous Air Pollutants (HAP) for Subpart HHH CAS Number a Chemical name 75070...

Hippocampus sparing in whole-brain radiotherapy. A review

Energy Technology Data Exchange (ETDEWEB)

Oskan, F. [University of Munich, Department of Radiation Oncology and CCC Neuro-Oncology, Munich (Germany); Saarland University Medical Center, Department of Radiation Oncology, Homburg/Saar (Germany); Ganswindt, U.; Schwarz, S.B.; Manapov, F.; Belka, C.; Niyazi, M. [University of Munich, Department of Radiation Oncology and CCC Neuro-Oncology, Munich (Germany)

2014-04-15

Radiation treatment techniques for whole-brain radiation therapy (WBRT) have not changed significantly since development of the procedure. However, the recent development of novel techniques such as intensity-modulated radiation therapy (IMRT), volumetric-modulated arc therapy (VMAT) and helical tomotherapy, as well as an increasing body of evidence concerning neural stem cells (NSCs) have altered the conventional WBRT treatment paradigm. In this regard, hippocampus-sparing WBRT is a novel technique that aims to spare critical hippocampus regions without compromising tumour control. Published data on this new technique are limited to planning and feasibility studies; data on patient outcome are still lacking. However, several prospective trials to analyse the feasibility of this technique and to document clinical outcome in terms of reduced neurotoxicity are ongoing. (orig.) [German] Die Technik der Ganzhirnbestrahlung (''whole-brain radiation therapy'', WBRT) hat sich seit der Entwicklung nicht wesentlich veraendert. Allerdings stellten die Neuentwicklung von Techniken wie die intensitaetsmodulierte Strahlentherapie (IMRT), die volumenmodulierte Arc-Therapie (VMAT) oder die helikale Tomotherapie sowie immer groesseres Wissen ueber das neurale Stammzellkompartiment (NSCs) das herkoemmliche Ganzhirn-Paradigma in Frage. Die hippocampusschonende Ganzhirnbestrahlung ist eine neuartige Technik, welche die kritische Region des Hippocampus schont, ohne die Tumorkontrolle zu gefaehrden. Ueber diese Technik gibt es bisher nur eine begrenzte Datenlage im Sinne von Planungs- und Machbarkeitsstudien. Klinische Daten bzgl. der Behandlungsergebnisse fehlen nach wie vor, aber einige prospektive Studien sind im Gange, um nicht nur die Machbarkeit zu belegen, sondern auch das klinische Outcome im Sinne einer verringerten Neurotoxizitaet nachzuweisen. (orig.)

Development and validation of a bowel-routine-based self-report questionnaire for sacral sparing after spinal cord injury

DEFF Research Database (Denmark)

Liu, N; Xing, H; Zhou, M-W

2017-01-01

-report questionnaire was developed based on several events that most patients might experience during bowel routine. 102 participants who sustained SCI within 12 months were asked to complete the questionnaire followed by an anorectal examination. Agreements of answers to the questionnaire and the physical examination......STUDY DESIGN: An observational study. OBJECTIVE: To develop a self-administered tool for assessment of sacral sparing after spinal cord injury (SCI) and to test its validity in individuals with SCI. SETTING: Peking University Third Hospital, Beijing, China. METHODS: A 5-item SCI sacral sparing self......: The validity of this questionnaire for the assessment of sacral sparing in up to 12 months post injury is good except for the motor function when there was increased AST. In some situations it could be considered as an alternative tool for digital rectal examination, especially when repeated examinations...

308 Building electrical load list and panel schedules

International Nuclear Information System (INIS)

Giamberardini, S.J.

1994-01-01

This report contains two lists. The first lists equipment, load location, source of power, and breaker identification. The second compiles the same information but in a different format, namely, for each power source, the breaker, equipment, and location is given. Building 308 is part of the Fuels and Materials Examination Facility which houses the Secure Automated Fabrication process line for fabrication of reactor fuels and the Breeder Processing Engineering Test for processing Fast Flux Test Facility fuel to demonstrate closure of the fuel cycle

Successful pregnancy outcome after fertility-sparing surgery and chemotherapy for dysgerminoma.

Science.gov (United States)

Shamim, Muhammad

2010-09-01

Ovarian dysgerminoma is a rare malignancy of the ovary. This is a case report of a 30-year-old female, presenting with a huge ovarian mass along with multiple gallstones; she was treated by fertility-sparing excision of the mass and cholecystectomy, followed by chemotherapy. She later had an uneventful pregnancy and delivered a healthy baby.

List of Pests of Significant Public Health Importance

Science.gov (United States)

This list is derived in large part from review of the pesticide/pest combinations for which efficacy (product performance) data are submitted and reviewed before registration. Pests that spread disease include cockroaches, lice, mosquitoes, and rodents.

Verification of protein sparing by feeding carbohydrate to common carp Cyprinus carpio

Science.gov (United States)

Cheng, Zhenyan; Li, Jinghui; Zhang, Baolong; Fang, Zhenzhen; Sun, Jinhui; Bai, Dongqing; Sun, Jinsheng; Qiao, Xiuting

2017-03-01

A 9-week feeding trial in floating freshwater cages (1.0 m×1.0 m×2.0 m) was conducted to study the effects of different dietary levels of protein and starch on growth, body composition, and gene expression of enzymes in common carp, Cyprinus carpio (mean body weight, 36.12±1.18 g) to evaluate the protein-sparing effect of dietary carbohydrate. Four diets were formulated with corn starch as the carbohydrate source to obtain corn starch levels of 6.5%, 13%, 19.5%, or 26% and protein levels of 30.5%, 28.2%, 26.4%, and 24.2%. The results showed no differences in growth performance of fish fed the diets with different protein and corn starch levels, but body composition and glucose metabolic enzyme activity of carp were significantly affected by the different diets ( P 0.05). In summary, the results indicate a protein-sparing effect by substituting carbohydrate in the diet of common carp.

Loose part monitoring device

International Nuclear Information System (INIS)

Nomura, Hiroshi.

1992-01-01

The device of the present invention estimates a place where loose parts occur and structural components as the loose parts in a fluid flow channel of a reactor device, to provide information thereof to a plant operator. That is, the device of the present invention comprises (1) a plurality of detectors disposed to each of equipments constituting fluid channels, (2) an abnormal sound sensing device for sensing signals from the detectors, (3) an estimation section for estimating the place where the loose parts occur and the structural components thereof based on the signals sensed by the abnormal sound sensing section, (4) a memory section for storing data of the plant structure necessary for the estimation, and (5) a display section for displaying the result of the estimation. In such a device, the position where the loose parts collide against the plant structural component and the energy thereof are estimated. The dropping path of the loose parts is estimated from the estimation position. Parts to be loose parts in the path are listed up. The parts on the list is selected based on the estimated energy thereby enabling to determine the loose parts. (I.S.)

Benefits from Funding the MSD Engineering List: A Fiscal Year 1999 Case Study

National Research Council Canada - National Science Library

Gehrich, David

2004-01-01

Every year the Air Force Material Command (AFMC) funds the MSD Engineering list. The projects on the list are submitted by the Air Logistic Centers in order to address problems with the maintainability or reliability of a reparable part...

Evaluation of Hemodynamics in Focal Steatosis and Focal Spared Lesion of the Liver Using Contrast-Enhanced Ultrasonography with Sonazoid

International Nuclear Information System (INIS)

Shiozawa, K.; Watanabe, M.; Ikehara, T.; Kogame, M.; Shinohara, M.; Shinohara, M.; Ishii, K.; Igarashi, Y.; Sumino, Y.; Shiozawa, K.; Makino, H.

2014-01-01

We aim to investigate the hemodynamics in focal steatosis and focal spared lesion of the liver using contrast-enhanced ultrasonography (CEUS) with Sonazoid. The subjects were 47 patients with focal steatosis and focal spared lesion. We evaluated enhancement patterns (hyper enhancement, iso enhancement, and hypo enhancement) in the vascular phase and the presence or absence of a hypoechoic area in the post vascular phase for these lesions using CEUS. Of the 24 patients with focal steatosis, the enhancement pattern was iso enhancement in 19 and hypo enhancement in 5. Hypoechoic areas were noted in the post vascular phase in 3 patients. Of the 23 patients with focal spared lesions, the enhancement pattern was iso enhancement in 18 and hyper enhancement in 5. No hypoechoic areas were noted in the post vascular phase in any patient. The hemodynamics in focal steatosis and focal spared lesions in non diffuse fatty liver can be observed using low-invasive procedures in real-time by CEUS. It was suggested that differences in the dynamics of enhancement in the vascular phase of CEUS were influenced by the fat deposits in the target lesion, the surrounding liver parenchyma, and the third inflow.

31 CFR 596.404 - Financial transactions transferred through a bank of a Terrorism List Government.

Science.gov (United States)

2010-07-01

... through a bank of a Terrorism List Government. 596.404 Section 596.404 Money and Finance: Treasury... TREASURY TERRORISM LIST GOVERNMENTS SANCTIONS REGULATIONS Interpretations § 596.404 Financial transactions transferred through a bank of a Terrorism List Government. For the purposes of this part only, a financial...

Hippocampal sparing radiotherapy for pediatric medulloblastoma: impact of treatment margins and treatment technique

DEFF Research Database (Denmark)

Brodin, N. Patrik; af Rosenschold, Per Munck; Blomstrand, Malin

2014-01-01

BackgroundWe investigated how varying the treatment margin and applying hippocampal sparing and proton therapy impact the risk of neurocognitive impairment in pediatric medulloblastoma patients compared with current standard 3D conformal radiotherapy.MethodsWe included 17 pediatric medulloblastoma...

Listings.

Science.gov (United States)

1994-12-07

Nursing Standard regrets that it is no longer able to take listings over the telephone because of unprecedented demand. Readers are reminded that the listings section is for the use of charitable and professional organisations, unions and health authorities to publicise forthcoming events. Listings should contain all relevant details and be posted or faxed to Susan Blood-worth, Nursing Standard, Viking House, 17-19 Peterborough Road, Harrotc. Middlesex HA 1 2AX. Fax: 081-423 3867.

Interim essential and support drawing list for K Basins

International Nuclear Information System (INIS)

Langevin, M.J.

1994-01-01

This document presents a list of essential and support drawings that have been identified as required to achieve the mission objectives of K Basin and are an integral part of the in-progress K Basins system baselining effort. The drawings listed in the appendix are those drawings required to safely operate K Basins. These drawings will be authenticated through the field verification and design reconstitution programs to ensure that these identified drawings are consistent with design requirements

Neurovascular bundle–sparing radiotherapy for prostate cancer using MRI-CT registration: A dosimetric feasibility study

Energy Technology Data Exchange (ETDEWEB)

Cassidy, R.J., E-mail: richardjcassidy@emory.edu [Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA (United States); Yang, X.; Liu, T.; Thomas, M. [Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA (United States); Nour, S.G. [Department of Radiology, Emory University, Atlanta, GA (United States); Jani, A.B. [Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA (United States)

2016-01-01

Purpose: Sexual dysfunction after radiotherapy for prostate cancer remains an important late adverse toxicity. The neurovascular bundles (NVB) that lie posterolaterally to the prostate are typically spared during prostatectomy, but in traditional radiotherapy planning they are not contoured as an organ-at-risk with dose constraints. Our goal was to determine the dosimetric feasibility of “NVB-sparing” prostate radiotherapy while still delivering adequate dose to the prostate. Methods: Twenty-five consecutive patients with prostate cancer (with no extraprostatic disease on pelvic magnetic resonance imaging [MRI]) who that were treated with external beam radiotherapy, with the same primary planning target volume margins, to a dose of 79.2 Gy were evaluated. Pelvic MRI and simulation computed tomography scans were registered using dedicated software to allow for bilateral NVB target delineation on T2-weighted MRI. A volumetric modulated arc therapy plan was generated using the NVB bilaterally with 2 mm margin as an organ to spare and compared to the patient’s previously delivered plan. Dose-volume histogram endpoints for NVB, rectum, bladder, and planning target volume 79.2 were compared between the 2 plans using a 2-tailed paired t-test. Results: The V70 for the NVB was significantly lower on the NVB-sparing plan (p <0.01), while rectum and bladder endpoints were similar. Target V100% was similar but V{sub 105%} was higher for the NVB-sparing plans (p <0.01). Conclusions: “NVB-sparing” radiotherapy is dosimetrically feasible using CT-MRI registration, and for volumetric modulated arc therapy technology — target coverage is acceptable without increased dose to other normal structures, but with higher target dose inhomogeneity. The clinical impact of “NVB-sparing” radiotherapy is currently under study at our institution.

Prospective Study of Functional Bone Marrow-Sparing Intensity Modulated Radiation Therapy With Concurrent Chemotherapy for Pelvic Malignancies

International Nuclear Information System (INIS)

Liang Yun; Bydder, Mark; Yashar, Catheryn M.; Rose, Brent S.; Cornell, Mariel; Hoh, Carl K.; Lawson, Joshua D.; Einck, John; Saenz, Cheryl; Fanta, Paul; Mundt, Arno J.; Bydder, Graeme M.

2013-01-01

Purpose: To test the hypothesis that intensity modulated radiation therapy (IMRT) can reduce radiation dose to functional bone marrow (BM) in patients with pelvic malignancies (phase IA) and estimate the clinical feasibility and acute toxicity associated with this technique (phase IB). Methods and Materials: We enrolled 31 subjects (19 with gynecologic cancer and 12 with anal cancer) in an institutional review board-approved prospective trial (6 in the pilot study, 10 in phase IA, and 15 in phase IB). The mean age was 52 years; 8 of 31 patients (26%) were men. Twenty-one subjects completed 18 F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) simulation and magnetic resonance imaging by use of quantitative IDEAL (IDEAL IQ; GE Healthcare, Waukesha, WI). The PET/CT and IDEAL IQ were registered, and BM subvolumes were segmented above the mean standardized uptake value and below the mean fat fraction within the pelvis and lumbar spine; their intersection was designated as functional BM for IMRT planning. Functional BM-sparing vs total BM-sparing IMRT plans were compared in 12 subjects; 10 were treated with functional BM-sparing pelvic IMRT per protocol. Results: In gynecologic cancer patients, the mean functional BM V 10 (volume receiving ≥10 Gy) and V 20 (volume receiving ≥20 Gy) were 85% vs 94% (P 18 F-fluorodeoxyglucose-PET/CT and IDEAL IQ. The efficacy of BM-sparing IMRT is being tested in a phase II trial.

Rectal dose sparing with a balloon catheter and ultrasound localization in conformal radiation therapy for prostate cancer

International Nuclear Information System (INIS)

Patel, Rakesh R.; Orton, Nigel; Tome, Wolfgang A.; Chappell, Rick; Ritter, Mark A.

2003-01-01

Background and purpose: To compare the rectal wall and bladder volume in the high dose region with or without the use of a balloon catheter with both three-dimensional (3D)-conformal and intensity modulated radiation therapy (CRT, IMRT) approaches in the treatment of prostate cancer. Material and methods: Five patients with a wide range of prostate volumes and treated with primary external beam radiation therapy for localized prostate cancer were selected for analysis. Pinnacle TM treatment plans were generated utilizing a 3D conformal six-field design and an IMRT seven coplanar-field plan with a novel, three-step optimization and with ultrasound localization. Separate plans were devised with a rectal balloon deflated or air inflated with and without inclusion of the seminal vesicles (SV) in the target volume. The prescription dose was 76 Gy in 38 fractions of 2 Gy each. Cumulative dose-volume histograms (DVHs) were analyzed for the planning target volume (PTV), rectal wall, and bladder with an inflated (60 cc air) or deflated balloon with and without SV included. The volumes of rectal wall and bladder above 60, 65, and 70 Gy with each treatment approach were evaluated. Results: Daily balloon placement was well-tolerated with good patient positional reproducibility. Inflation of the rectal balloon in all cases resulted in a significant decrease in the absolute volume of rectal wall receiving greater than 60, 65, or 70 Gy. The rectal sparing ratio (RSR), consisting of a structure's high dose volume with the catheter inflated, divided by the volume with the catheter deflated, was calculated for each patient with and without seminal vesicle inclusion for 3D-CRT and IMRT. For 3D-CRT, RSRs with SV included were 0.59, 0.59, and 0.56 and with SV excluded were 0.60, 0.58, and 0.54 at doses of greater than 60, 65, and 70 Gy, respectively. Similarly, for IMRT, the mean RSRs were 0.59, 0.59, and 0.63 including SV and 0.71, 0.66, and 0.67 excluding SV at these same dose levels

Nomenclatural studies toward a world list of Diptera genus-group names. Part V

DEFF Research Database (Denmark)

Evenhuis, Neal L.; Pape, Thomas; Pont, Adrian C.

and method of fixation, current status of the name, family placement, and a list of any emendations of it that have been found in the literature. Remarks are given to clarify nomenclatural or taxonomic information. In addition, an index to all the species-group names of Diptera proposed by Macquart (3...

License - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

Lifescience Database Archive (English)

Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ...t list, Marker list, QTL list, Plant DB link & Genome analysis methods © Satoshi ... Policy | Contact Us License - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

DisLexList

DEFF Research Database (Denmark)

2013-01-01

DisLexList is a simple analysis script for the generation of lists of lexemes in discourses, and may be used as a tool in discourse analysis (critical and otherwise). DisLexList is, in its current state, able to generate simple word lists and lexeme list based on output from VISL's flat structure...

Opioid-sparing effects of the thoracic interfascial plane blocks: A meta-analysis of randomized controlled trials.

Science.gov (United States)

Singh, Preet Mohinder; Borle, Anuradha; Kaur, Manpreet; Trikha, Anjan; Sinha, Ashish

2018-01-01

Thoracic interfascial plane blocks and modification (PECS) have recently gained popularity for analgesic potential during breast surgery. We evaluate/consolidate the evidence on opioid-sparing effect of PECS blocks in comparison with conventional intravenous analgesia (IVA) and paravertebral block (PVB). Prospective, randomized controlled trials comparing PECS block to conventional IVA or PVB in patients undergoing breast surgery published till June 2017 were searched in the medical database. Comparisons were made for 24-h postoperative morphine consumption and intraoperative fentanyl-equivalent consumption. Final analysis included nine trials (PECS vs. IVA 4 trials and PECS vs. PVB 5 trials). PECS block showed a decreased intraoperative fentanyl consumption over IVA by 49.20 mcg (95% confidence interval [CI] =42.67-55.74) ( I 2 = 98.47%, P consumption with PECS block was lower than IVA by 7.66 mg (95% CI being 6.23-9.10) ( I 2 = 63.15, P < 0.001) but was higher than PVB group by 1.26 mg (95% CI being 0.91-1.62) ( I 2 = 99.53%, P < 0.001). Two cases of pneumothorax were reported with PVB, and no complication was reported in any other group. Use of PECS block and its modifications with general anesthesia for breast surgery has significant opioid-sparing effect intraoperatively and during the first 24 h after surgery. It also has higher intraoperative opioid-sparing effect when compared to PVB. During the 1 st postoperative day, PVB has slightly more morphine sparing potential that may however be associated with higher complication rates. The present PECS block techniques show marked interstudy variations and need standardization.

Updates on the COPD gene list

Science.gov (United States)

Bossé, Yohan

2012-01-01

A genetic contribution to develop chronic obstructive pulmonary disease (COPD) is well established. However, the specific genes responsible for enhanced risk or host differences in susceptibility to smoke exposure remain poorly understood. The goal of this review is to provide a comprehensive literature overview on the genetics of COPD, highlight the most promising findings during the last few years, and ultimately provide an updated COPD gene list. Candidate gene studies on COPD and related phenotypes indexed in PubMed before January 5, 2012 are tabulated. An exhaustive list of publications for any given gene was looked for. This well-documented COPD candidate-gene list is expected to serve many purposes for future replication studies and meta-analyses as well as for reanalyzing collected genomic data in the field. In addition, this review summarizes recent genetic loci identified by genome-wide association studies on COPD, lung function, and related complications. Assembling resources, integrative genomic approaches, and large sample sizes of well-phenotyped subjects is part of the path forward to elucidate the genetic basis of this debilitating disease. PMID:23055711

Towards decision support for waiting lists: an operations management view.

Science.gov (United States)

Vissers, J M; Van Der Bij, J D; Kusters, R J

2001-06-01

This paper considers the phenomenon of waiting lists in a healthcare setting, which is characterised by limitations on the national expenditure, to explore the potentials of an operations management perspective. A reference framework for waiting list management is described, distinguishing different levels of planning in healthcare--national, regional, hospital and process--that each contributes to the existence of waiting lists through managerial decision making. In addition, different underlying mechanisms in demand and supply are distinguished, which together explain the development of waiting lists. It is our contention that within this framework a series of situation specific models should be designed to support communication and decision making. This is illustrated by the modelling of the demand for cataract treatment in a regional setting in the south-eastern part of the Netherlands. An input-output model was developed to support decisions regarding waiting lists. The model projects the demand for treatment at a regional level and makes it possible to evaluate waiting list impacts for different scenarios to meet this demand.

Nephron sparing surgery (NSS) for unilateral wilms tumor (UWT): the SIOP 2001 experience

NARCIS (Netherlands)

Wilde, Jim C. H.; Aronson, Daniel C.; Sznajder, Beata; van Tinteren, Harm; Powis, Mark; Okoye, Bruce; Cecchetto, Giovanni; Audry, Georges; Fuchs, Jörg; Schweinitz, Dietrich Von; Heij, Hugo; Graf, Norbert; Bergeron, Christophe; Pritchard-Jones, Kathy; van den Heuvel-Eibrink, Marry; Carli, Modesto; Oldenburger, Foppe; Sandstedt, Bengt; de Kraker, Jan; Godzinski, Jan

2014-01-01

Total nephrectomy (TN) remains the standard treatment of unilateral Wilms tumors (uWT). The SIOP WT-2001 protocol allowed Nephron Sparing Surgery (NSS) for polar or peripherally non-infiltrating tumors. Inventory of the current SIOP NSS-experience. 2,800 patients with a unilateral, localized or

Testicular sparing surgery in small testis masses: A multinstitutional experience

Directory of Open Access Journals (Sweden)

Andrea B. Galosi

2016-12-01

Full Text Available Introduction: The incidence of benign testicular tumors is increasing in particular in small lesion incidentally found at scrotal ultrasonography. Primary aim of this study was to perform radical surgery in malignant tumor. Secondary aim was to verify the efficacy of the diagnostic-therapeutic pathway recently adopted in management of small masses with testis sparing surgery in benign lesions. Materials and methods: In this multicenter study, we reviewed all patients with single testis lesion less than 15 mm at ultrasound as main diameter. We applied the diagnostic-therapeutic pathway described by Sbrollini et al. (Arch Ital Urol Androl 2014; 86:397 which comprises: 1 testicular tumor markers, 2 repeated scrotal ultrasound at the tertiary center, 3 surgical exploration with inguinal approach, intraoperative ultrasound, and intraoperative pathological examination. Definitive histology was reviewed by a dedicated uro-pathologist. Results: Twenty-eight patients completed this clinical flowchart. The mean lesion size was 9.3 mm (range 2.5-15. Testicular tumor markers were normal except in a case. Intraoperative ultrasound was necessary in 8/28 cases. We treated 11/28 (39.3% with immediate radical orchiectomy and 17/28 (60.7% with testis-sparing surgery. Definitive pathological results were: malignant tumor in 6 cases (seminoma, benign tumor in 10 cases (5 Leydig tumors, 2 Sertoli tumors, 1 epidermoid cyst, 1 adenomatoid tumor, 1 angiofibroma, benign disease in 11 (8 inflammation with haemorragic infiltration, 2 tubular atrophy, 1 fibrosis, and normal parenchyma in 1 case. We observed a good concordance between frozen section examination and definitive histology. Any malignant tumor was treated conservatively. Any delayed orchiectomy was necessary based on definitive histology. Conclusions: The incidence of benign lesions in 60% of small testis lesions with normal tumor markers makes orchiectomy an overtreatment. Testicular sparing surgery of single

Development of Availability and Sustainability Spares Optimization Models for Aircraft Reparables

Science.gov (United States)

2013-09-01

the integrated SAP ® Enterprise Resource Planning ( ERP ) information system of the RSAF. A more in-depth review of OPUS10 capabilities will be provided...Dynamic Multi-Echelon Technique for Recoverable Item Control EBO: Expected Backorder EOQ: Economic Order Quantity ERP : Enterprise Resource...particular, the propulsion sub-system was expanded to include SSRUs. Spares information are extracted from the RSAF ERP system and include: 22

Refractive changes after lens-sparing vitrectomy for macular hole and epiretinal membrane

Directory of Open Access Journals (Sweden)

Muto T

2017-08-01

Full Text Available Tetsuya Muto,1 Tomoharu Nishimura,1 Takefumi Yamaguchi,2 Makoto Chikuda,1 Shigeki Machida1 1Department of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan; 2Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan Purpose: Cataract progression after lens-sparing vitrectomy might differ according to original posterior segment diseases. Our objective was to analyze the refractive values after lens-sparing vitrectomy for macular hole (MH and epiretinal membrane (ERM. Materials and methods: We reviewed the medical records of 25 MH patients (25 eyes and 23 ERM patients (23 eyes who underwent lens-sparing vitrectomy. Refractive changes in both groups were compared. All patients underwent 20-gauge three-port pars plana vitrectomy. Fluid–air exchange was performed during vitrectomy only in the MH group. The results were analyzed using the unpaired t-test, chi-square test, or Fisher exact probability test, and multivariate analysis. Results: There were no significant differences in the patient’s age (P=0.45. The myopia progression rate (D/month was higher in the MH group after surgery than that in the ERM group (P=0.035. MH group had more females (P=0.043, longer surgical time (P<0.001, and higher frequencies of surgical adjuvants use (triamcinolone acetonide, P=0.019; brilliant blue G, P<0.001. The myopia progression rate in the MH group (R=0.568, P<0.001 correlated with female gender. However, no correlation was observed between longer surgical time and the use of surgical adjuvants. Conclusion: The rate of myopia progression was higher in the MH group. Fluid–air exchange and gender may affect the rate of myopia progression. Keywords: cataract, vitrectomy, macular hole, epiretinal membrane

Governance, agricultural intensification, and land sparing in tropical South America

OpenAIRE

CEDDIA Michele Graziano; BARDSLEY N. O.; GOMEZ Y PALOMA Sergio; SEDLACEK S

2014-01-01

In this paper we address two topical questions: How do the quality of governance and agricultural intensification impact on spatial expansion of agriculture? Which aspects of governance are more likely to ensure that agricultural intensification allows sparing land for nature? Using data from the Food and Agriculture Organization, the World Bank, the World Database on Protected Areas, and the Yale Center for Environmental Law and Policy, we estimate a panel data model for six South A...

Reduction in cardiolipin decreases mitochondrial spare respiratory capacity and increases glucose transport into and across human brain cerebral microvascular endothelial cells.

Science.gov (United States)

Nguyen, Hieu M; Mejia, Edgard M; Chang, Wenguang; Wang, Ying; Watson, Emily; On, Ngoc; Miller, Donald W; Hatch, Grant M

2016-10-01

Microvessel endothelial cells form part of the blood-brain barrier, a restrictively permeable interface that allows transport of only specific compounds into the brain. Cardiolipin is a mitochondrial phospholipid required for function of the electron transport chain and ATP generation. We examined the role of cardiolipin in maintaining mitochondrial function necessary to support barrier properties of brain microvessel endothelial cells. Knockdown of the terminal enzyme of cardiolipin synthesis, cardiolipin synthase, in hCMEC/D3 cells resulted in decreased cellular cardiolipin levels compared to controls. The reduction in cardiolipin resulted in decreased mitochondrial spare respiratory capacity, increased pyruvate kinase activity, and increased 2-deoxy-[(3) H]glucose uptake and glucose transporter-1 expression and localization to membranes in hCMEC/D3 cells compared to controls. The mechanism for the increase in glucose uptake was an increase in adenosine-5'-monophosphate kinase and protein kinase B activity and decreased glycogen synthase kinase 3 beta activity. Knockdown of cardiolipin synthase did not affect permeability of fluorescent dextran across confluent hCMEC/D3 monolayers grown on Transwell(®) inserts. In contrast, knockdown of cardiolipin synthase resulted in an increase in 2-deoxy-[(3) H]glucose transport across these monolayers compared to controls. The data indicate that in hCMEC/D3 cells, spare respiratory capacity is dependent on cardiolipin. In addition, reduction in cardiolipin in these cells alters their cellular energy status and this results in increased glucose transport into and across hCMEC/D3 monolayers. Microvessel endothelial cells form part of the blood-brain barrier, a restrictively permeable interface that allows transport of only specific compounds into the brain. In human adult brain endothelial cell hCMEC/D3 monolayers cultured on Transwell(®) plates, knockdown of cardiolipin synthase results in decrease in mitochondrial

The effect of part-time sick leave for employees with mental disorders

DEFF Research Database (Denmark)

Høgelund, Jan; Holm, Anders

reduces the duration until employees with mental disorders end their sick leave by reporting ready for returning to regular working hours. The programme allows fully sick-listed employees to resume work at reduced hours. When the sick-listed employee’s health improves, working hours are increased until...... the employee is able to work regular hours. We use combined survey and register data about 226 long-term sick-listed employees with mental disorders and 638 employees with physical disorders. Our analyses show that part-time sick-listing significantly reduces the duration until returning to regular working...... hours for employees with physical disorders. In contrast, we find that part-time sick-listing does not reduce durations for employees with mental disorders. The analyses also illustrate the importance of adjusting for unobserved differences between part-time sick-listed and full-time sick...

Favorable Outcome with Close Margins in Patients Undergoing Nipple/Skin Sparing Mastectomy with Immediate Breast Reconstruction: 5-year Follow-up

Directory of Open Access Journals (Sweden)

Enver Özkurt1

2018-02-01

Full Text Available Background: Implant-based breast reconstruction after mastectomy has recently been reported to be the preferred type of surgery among breast-specific surgeons and plastic surgeons. Aims: To explore the significant clinicopathological factors associated with long-term outcome related to local recurrences of the nipple among patients who underwent immediate breast reconstruction with tissue expander or implant after mastectomy. Study Design: Retrospective cohort. Methods: From January 2007 to January 2013, 51 breast cancer patients who underwent immediate breast reconstruction with tissue expander or implant were retrospectively analysed. Patients’ demographic data, clinicopathological characteristics, and clinical outcome by disease-free survival and disease-specific survival analyses were determined. Results: The median follow-up was 64 (31-114 months. Of the 57 mastectomies, 41 were skin sparing mastectomy (72% and 16 were nipple-areola sparing mastectomy (28%. Immediate breast reconstruction surgery included tissue expander (n=46, 81% or implant (n=11, 19% placement. The molecular subgroups of 47 invasive cancers were as follows: luminal A (n=23, 49%, luminal B (n=16, 34%, non-luminal HER2 (n=5, 10.6, triple negative breast cancer (n=3, 6.4%. The 5-years disease-specific survival, disease-free survival, and locoregional recurrence-free survival rates were 96.8%, 90%, and 97.6% respectively. Patients with luminal A cancer were found to have an improved 5-year disease-free survival time than other (luminal A; 100% vs. non-luminal A; 78%; p=0.028. Of the 14 nipple-areola sparing mastectomy, 13 had a close median tumour distance to nipple-areola complex (<20 mm with a 5-year locoregional recurrence free survival of 100%. Conclusion: Immediate breast reconstruction with implant or tissue expander can be safely applied in patients undergoing skin sparing mastectomy or nipple-areola sparing mastectomy. Patients with luminal-A type show the most

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

Directory of Open Access Journals (Sweden)

Bobin Jean

2008-04-01

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

Latissimus-sparing thoracotomy in the pediatric patient: a valuable asset for thoracic reconstruction.

Science.gov (United States)

Malczewski, M C; Colony, L; Cobb, L M

1994-03-01

The traditional posterolateral thoracotomy involves division of the latissimus dorsi muscle (LD). While the division results in no functional disability, it does negate the potential for possible future thoracic reconstruction if required in individual cases (eg, bronchopleural fistula, empyema, etc). A latissimus-sparing thoracotomy (LST) mobilizes the muscle dorsad and does not compromise the operation. Thus, the ipsilateral LD can be used when chest wall reconstruction is required. This option has been used frequently for adults; however, its use in children has not been extensively documented. Microvascular anastomoses for a contralateral LD free-flap may be tenuous in the small vessels of the child; thus, reconstruction using the ipsilateral LD could be beneficial and safer. The feasibility of LST has not been established with regard to the chest of the child. The authors present three pediatric thoracic cases that illustrate the value of this procedure, and discuss different situations in which latissimus-sparing thoracotomy is advantageous.

Neurology check list. 5. rev. and enl. ed.

International Nuclear Information System (INIS)

Grehl, Holger; Reinhardt, Frank

2013-01-01

The neurology check list covers the following issues, organized in four parts: Grey part - diagnostic fundamentals, therapeutic principles: clinical neurological examination, liquor puncture, specific laboratory diagnostics, neurophysical diagnostics, imaging techniques, therapeutic principles, legal aspects, neurological assessment. Green Part - leading syndromes and leading symptoms. Blue part - neurological disease appearance: pains in head and face, pain syndrome, congenital and development disturbances, liquor circulation disturbances, ZNS hemorrhages, tumors and neoplasm, paraneoplastic syndromes, inflammatory diseases of the nervous system, dementia diseases, metabolic and other encephalopathy, cerebellum diseases and system surmounting processes, movement degeneration, basal ganglion diseases, epilepsy, non-epileptic attacks, medulla diseases, brain nerve diseases, plexus lesions, radicular lesions, peripheric neuropathy, neuromuscular transfer disturbances, muscular diseases. Red part: neurological intensive medicine.

One-stage nipple and breast reconstruction following areola-sparing mastectomy.

Science.gov (United States)

Kim, Hye Ri; Lim, Jin Soo; Kim, Sue Min; Jung, Sung No; Yoo, Gyeol; Rha, Eun Young

2013-09-01

Skin-sparing mastectomy with immediate breast reconstruction is increasingly becoming a proven surgical option for early-stage breast cancer patients. Areola-sparing mastectomy (ASM) has also recently become a popular procedure. The purpose of this article is to investigate the reconstructive and aesthetic issues experienced with one-stage nipple and breast reconstruction using ASM. Among the patients who underwent mastectomy between March 2008 and March 2010, 5 women with a low probability of nipple-areolar complex malignant involvement underwent ASM and immediate breast reconstruction with simultaneous nipple reconstruction using the modified C-V flap. The cosmetic outcomes of this series were reviewed by plastic surgeons and patient self-assessment and satisfaction were assessed via telephone interview. During the average 11-month follow-up period, there were no cases of cancer recurrence, the aesthetic outcomes were graded as excellent to very good, and all of the patients were satisfied. Two patients developed a gutter-like depression around the reconstructed nipple, and one patient developed skin erosion in a small area of the areola, which healed with conservative dressing. The other complications, such as necrosis of the skin flap or areola, seroma, hematoma, or fat necrosis did not occur. Since one-stage nipple and breast reconstruction following ASM is an oncologically safe, cost-effective, and aesthetically satisfactory procedure, it is a good surgical option for early breast cancer patients.

Incidence and progression of mild aortic regurgitation after Tirone David reimplantation valve-sparing aortic root replacement.

Science.gov (United States)

Stephens, Elizabeth H; Liang, David H; Kvitting, John-Peder Escobar; Kari, Fabian A; Fischbein, Michael P; Mitchell, R Scott; Miller, D Craig

2014-01-01

The study objective was to determine whether recurrent or residual mild aortic regurgitation, which occurs after valve-sparing aortic root replacement, progresses over time. Between 2003 and 2008, 154 patients underwent Tirone David-V valve-sparing aortic root replacement; 96 patients (62%) had both 1-year (median, 12 ± 4 months) and mid-term (62 ± 22 months) transthoracic echocardiograms available for analysis. Age of patients averaged 38 ± 13 years, 71% were male, 31% had a bicuspid aortic valve, 41% had Marfan syndrome, and 51% underwent aortic valve repair, predominantly cusp free margin shortening. Forty-one patients (43%) had mild aortic regurgitation on 1-year echocardiogram. In 85% of patients (n = 35), mild aortic regurgitation remained stable on the most recent echocardiogram (median, 57 ± 20 months); progression to moderate aortic regurgitation occurred in 5 patients (12%) at a median of 28 ± 18 months and remained stable thereafter; severe aortic regurgitation developed in 1 patient, eventually requiring reoperation. Five patients (5%) had moderate aortic regurgitation at 1 year, which did not progress subsequently. Two patients (2%) had more than moderate aortic regurgitation at 1 year, and both ultimately required reoperation. Although mild aortic regurgitation occurs frequently after valve-sparing aortic root replacement, it is unlikely to progress over the next 5 years and should not be interpreted as failure of the valve-preservation concept. Further, we suggest that mild aortic regurgitation should not be considered nonstructural valve dysfunction, as the 2008 valve reporting guidelines would indicate. We need 10- to 15-year follow-up to learn the long-term clinical consequences of mild aortic regurgitation early after valve-sparing aortic root replacement. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Role of spared pathways in locomotor recovery after body-weight-supported treadmill training in contused rats.

Science.gov (United States)

Singh, Anita; Balasubramanian, Sriram; Murray, Marion; Lemay, Michel; Houle, John

2011-12-01

Body-weight-supported treadmill training (BWSTT)-related locomotor recovery has been shown in spinalized animals. Only a few animal studies have demonstrated locomotor recovery after BWSTT in an incomplete spinal cord injury (SCI) model, such as contusion injury. The contribution of spared descending pathways after BWSTT to behavioral recovery is unclear. Our goal was to evaluate locomotor recovery in contused rats after BWSTT, and to study the role of spared pathways in spinal plasticity after BWSTT. Forty-eight rats received a contusion, a transection, or a contusion followed at 9 weeks by a second transection injury. Half of the animals in the three injury groups were given BWSTT for up to 8 weeks. Kinematics and the Basso-Beattie-Bresnahan (BBB) test assessed behavioral improvements. Changes in Hoffmann-reflex (H-reflex) rate depression property, soleus muscle mass, and sprouting of primary afferent fibers were also evaluated. BWSTT-contused animals showed accelerated locomotor recovery, improved H-reflex properties, reduced muscle atrophy, and decreased sprouting of small caliber afferent fibers. BBB scores were not improved by BWSTT. Untrained contused rats that received a transection exhibited a decrease in kinematic parameters immediately after the transection; in contrast, trained contused rats did not show an immediate decrease in kinematic parameters after transection. This suggests that BWSTT with spared descending pathways leads to neuroplasticity at the lumbar spinal level that is capable of maintaining locomotor activity. Discontinuing training after the transection in the trained contused rats abolished the improved kinematics within 2 weeks and led to a reversal of the improved H-reflex response, increased muscle atrophy, and an increase in primary afferent fiber sprouting. Thus continued training may be required for maintenance of the recovery. Transected animals had no effect of BWSTT, indicating that in the absence of spared pathways this

Limbal Stem Cell-Sparing Corneoscleroplasty with Peripheral Intralamellar Tuck: A New Surgical Technique for Keratoglobus

Directory of Open Access Journals (Sweden)

Elias Jarade

2017-04-01

Full Text Available Purpose: To describe the technique of limbal stem cell-sparing corneoscleroplasty for the management of advanced keratoglobus. Methods: A patient with bilateral advanced keratoglobus, with best-corrected visual acuity of 20/400 in the right eye and 20/200 in the left eye, underwent limbal stem cell-sparing corneoscleroplasty of the right eye. Initially, a 360-degree limbal incision with 200-μm depth was created, followed by a sublimbal tunnel dissection into the sclera, in order to conserve stem cells. Next, a limbus-to-limbus lamellar keratectomy at 200-μm depth was performed. Meanwhile, a donor corneoscleral button with preserved endothelium of the central 8 mm was fashioned. Prior to suturing the donor corneoscleral graft using a modified suturing technique to cover its scleral component, a full-thickness trephination of 8-mm diameter was completed in the central host cornea. Results: Reepithelialization occurred within the first week. No episodes of rejection, intraocular pressure spikes, or epithelial breakdown were observed postoperatively. At the 6-month follow-up, the patient had 20/70 best-corrected vision and a smooth cornea with regular astigmatism on topography. Conclusion: Limbal stem cell-sparing corneoscleroplasty is a single-step technique for restoring the structural integrity of the cornea in advanced keratoglobus while preserving the host limbal stem cells.

The influence of parotid gland sparing on radiation damages of dental hard tissues.

Science.gov (United States)

Hey, Jeremias; Seidel, Johannes; Schweyen, Ramona; Paelecke-Habermann, Yvonne; Vordermark, Dirk; Gernhardt, Christian; Kuhnt, Thomas

2013-07-01

The aim of the present study was to evaluate whether radiation damage on dental hard tissue depends on the mean irradiation dose the spared parotid gland is subjected to or on stimulated whole salivary flow rate. Between June 2002 and October 2008, 70 patients with neck and cancer curatively irradiated were included in this study. All patients underwent dental treatment referring to the guidelines and recommendations of the German Society of Dental, Oral and Craniomandibular Sciences prior, during, and after radiotherapy (RT). During the follow-up period of 24 months, damages on dental hard tissues were classified according to the RTOG/EORTC guidelines. The mean doses (D(mean)) during spared parotid gland RT were determined. Stimulated whole saliva secretion flow rates (SFR) were measured before RT and 1, 6, 12, 24 months after RT. Thirty patients showed no carious lesions (group A), 18 patients developed sporadic carious lesions (group B), and 22 patients developed general carious lesions (group C). Group A patients received a D mean of 21.2 ± 11.04 Gy. Group B patients received a D(mean) of 26.5 ± 11.59 Gy and group C patients received a D(mean) of 33.9 ± 9.93 Gy, respectively. The D(mean) of group A was significantly lower than the D(mean) of group C (p dental hard tissue correlates with increased mean irradiation doses as well as decreased salivary flow rates. Parotid gland sparing resulting in a dose below 20 Gy reduces radiation damage on dental hard tissues, and therefore, the dose may act as a predictor for the damage to be expected.

Long-term results of aortic valve-sparing operations in patients with Marfan syndrome.

Science.gov (United States)

David, Tirone E; Armstrong, Sue; Maganti, Manjula; Colman, Jack; Bradley, Timothy J

2009-10-01

The appropriateness of aortic valve-sparing operations in patients with Marfan syndrome has been questioned. This study examines the long-term results of these operations in patients with Marfan syndrome. From 1988 to 2006, 103 consecutive patients with Marfan syndrome (mean age, 37 +/- 12 years) and aortic root aneurysm had aortic valve-sparing operations. Emergency surgery was performed in 11 patients: 8 for acute type A aortic dissection and 3 for unexplained persistent chest pain. Fourteen patients also had mitral valve surgery. The technique of aortic valve reimplantation was used in 77 patients, and aortic root remodeling was used in 26 patients. Patients were followed prospectively and underwent annual echocardiographic studies. The mean follow-up was 7.3 +/- 4.2 years and 100% complete. There was 1 operative death and 5 late deaths. Four of the 6 deaths were due to complications of aortic dissections. The patients' survival at 15 years was 87.2% compared with 95.6% for the general population of Ontario matched for age and sex. Seven patients had important aortic insufficiency: 4 mild to moderate, 2 moderate, and 1 moderate to severe. Freedom from greater than mild aortic insufficiency at 15 years was 79.2%. Three patients, all after aortic root remodeling, had aortic valve replacement, 2 for aortic insufficiency and 1 for endocarditis. At the most recent follow-up, 97 patients were alive: 86 were in functional class I, and 11 were in functional class II. Aortic valve-sparing operations provided excellent clinical outcomes in this series of patients with Marfan syndrome. Postoperatively, complications of aortic dissections were the leading cause of death.

40 CFR Table 5 to Subpart Jj of... - List of VHAP of Potential Concern Identified by Industry

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 10 2010-07-01 2010-07-01 false List of VHAP of Potential Concern Identified by Industry 5 Table 5 to Subpart JJ of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION.... 63, Subpt. JJ, Table 5 Table 5 to Subpart JJ of Part 63—List of VHAP of Potential Concern Identified...

Radiological aspects in hot-spot removal from spare LPRM location

International Nuclear Information System (INIS)

Nagarajan, V.; Raveendran, P.S.; Parashar, Vivek; Mharse, R.S.; Phadnis, P.S.

2012-01-01

TAPS 1 and 2 comprises of twin units of boiling water reactors with vertical core. Cruciform shaped control blades are driven from the bottom through the core using hydraulic Control Rod Drives (CRD). Neutron flux monitoring is carried out by in-core devices such as Source Range Monitors (SRM) and Intermediate Range Monitors (IRM) during the start up and later using Power Range Monitors located in the biological shield. In addition, Local Power Range Monitor (LPRM) assemblies located symmetrically in the core gives information about axial and radial neutron flux. There are 18 LPRM locations out of which 13 are used for mounting the LPRMs and rest are spare locations. The lower head of the reactor vessel has 120 nozzles for CRD housings, SRM, IRM, LPRMs, vessel drain etc. Maintenance work on CRDs, removal and installation of in-core monitoring devices etc are carried out from under vessel area in the primary containment known as CRD housing area. While conducting radiation survey of CRD housing area after shut down of unit no. 1 for the 21st refueling outage, hotspot was observed at spare LPRM 40-21 location showing radiation level of 10 Gy/h and general back ground of 30-50 mGy/h. An attempt is made to bring out the ALARA efforts taken during hot spot removal. Options like hotspot shielding were not feasible. After core unloading, efforts were made to remove the hotspot. To assess the change in radiation levels, a high range silicon semiconductor based gamma monitor's detector was mounted on a pole and fixed near hotspot. Radiation level at the detector was 6 Gy/h. In addition detector of another low range area monitor was fixed at the trolley in the CRD housing area and radiation level was 7 mGy/h. Monitors of both the detectors were kept outside the primary containment in low back ground area at reactor building 103' El. Hotspot removal was attempted initially by vacuuming from the top of reactor vessel using 1 inch dia tube from spare LPRM location. Vacuum

The state of the art in the technical performance of lung-sparing operations for malignant pleural mesothelioma.

Science.gov (United States)

Friedberg, Joseph S

2013-01-01

Malignant pleural mesothelioma remains an incurable disease for which the role of surgery remains controversial. Though not yet clearly defined there does appear to be a subset of patients who benefit from a surgery-based multimodal treatment plan, beyond what would be expected with current nonoperative therapies. As with other pleural cancers it is probably not possible to achieve a microscopic complete resection with any operation. The goal of surgery in this setting, therefore, is to remove all visible and palpable disease - a macroscopic complete resection. There are basically two surgical approaches to achieve a macroscopic complete resection, lung-sacrificing and lung-sparing. Lung-sacrificing surgery, which likely leaves behind the least amount of microscopic disease, is accomplished as an extrapleural pneumonectomy. This is a well established and standardized operation. Lung-sparing surgery for malignant pleural mesothelioma, on the other hand, does not currently enjoy any degree of consistency. Not only are the reported variations on the operation widely disparate, but even the nomenclature to describe the operation is highly variable. Often the selection of a lung-sparing approach is reported as an intraoperative decision that hinges on the bulk of the cancer and/or the degree of extension into the pulmonary fissures. This article describes the current evolution of a lung-sparing procedure, radical pleurectomy, which has been used to achieve a macroscopic complete resection in over a hundred patients. Many of these cases involved bulky cancers, some exceeding two liters in volume, and often with extensive invasion of the pulmonary fissures. With the described technique there has not yet been an instance where conversion to extrapleural pneumonectomy would have contributed to the ability to achieve a macroscopic complete resection. Whether or not radical pleurectomy is the optimal approach for any or all patients undergoing surgery-based multimodal

Non-potassium sparing diuretics and sudden cardiac death in hypertensive patients : a pharmacoepidemiologic approach

NARCIS (Netherlands)

A.W. Hoes (Arno)

1992-01-01

textabstractThe studies described in this thesis focus on the possible relationship between the use of non-potassium sparing diuretics and the occurrence of sudden cardiac death in hypertensive patients. To study this potential adverse drug reaction several methods were applied, including

Long-term outcomes of aortic root operations for Marfan syndrome: A comparison of Bentall versus aortic valve-sparing procedures.

Science.gov (United States)

Price, Joel; Magruder, J Trent; Young, Allen; Grimm, Joshua C; Patel, Nishant D; Alejo, Diane; Dietz, Harry C; Vricella, Luca A; Cameron, Duke E

2016-02-01

Prophylactic aortic root replacement improves survival in patients with Marfan syndrome with aortic root aneurysms, but the optimal procedure remains undefined. Adult patients with Marfan syndrome who had Bentall or aortic valve-sparing root replacement (VSRR) procedures between 1997 and 2013 were identified. Comprehensive follow-up information was obtained from hospital charts and telephone contact. One hundred sixty-five adult patients with Marfan syndrome (aged > 20 years) had either VSRR (n = 98; 69 reimplantation, 29 remodeling) or Bentall (n = 67) procedures. Patients undergoing Bentall procedure were older (median, 37 vs 36 years; P = .03), had larger median preoperative sinus diameter (5.5 cm vs 5.0 cm; P = .003), more aortic dissections (25.4% vs 4.1%; P Marfan syndrome, patients undergoing Bentall and valve-sparing procedures have similar late survival, freedom from root reoperation, and freedom from endocarditis. However, valve-sparing procedures result in significantly fewer thromboembolic and hemorrhagic events. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

75 FR 55479 - National Oil and Hazardous Substances Pollution Contingency Plan; National Priorities List...

Science.gov (United States)

2010-09-13

... and Hazardous Substances Pollution Contingency Plan; National Priorities List: Partial Deletion of the... . SUPPLEMENTARY INFORMATION: The portion of the site to be deleted from the NPL is the surface media (soil... further actions. List of Subjects in 40 CFR Part 300 Environmental protection, Air pollution control...

Download - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

Lifescience Database Archive (English)

Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ...t_db_link_en.zip (36.3 KB) - 6 Genome analysis methods pgdbj_dna_marker_linkage_map_genome_analysis_methods_... of This Database Site Policy | Contact Us Download - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

Open Maximal Mucosa-Sparing Functional Total Laryngectomy

Directory of Open Access Journals (Sweden)

Pavel Dulguerov

2017-10-01

Full Text Available BackgroundTotal laryngectomy after (chemoradiotherapy is associated with a high incidence of fistula and therefore flaps are advocated. The description of a transoral robotic total laryngectomy prompted us to develop similar minimally invasive open approaches for functional total laryngectomy.MethodsA retrospective study of consecutive unselected patients with a dysfunctional larynx after (chemoradiation that underwent open maximal mucosal-sparing functional total laryngectomy (MMSTL between 2014 and 2016 is presented. The surgical technique is described, and the complications and functional outcome are reviewed.ResultsThe cohorts included 10 patients who underwent open MMSTL. No pedicled flap was used. Only one postoperative fistula was noted (10%. All patients resumed oral diet and experienced a functional tracheo-esophageal voice.ConclusionMMSTL could be used to perform functional total laryngectomy without a robot and with minimal incidence of complications.

Optimal selection of Orbital Replacement Unit on-orbit spares - A Space Station system availability model

Science.gov (United States)

Schwaab, Douglas G.

1991-01-01

A mathematical programing model is presented to optimize the selection of Orbital Replacement Unit on-orbit spares for the Space Station. The model maximizes system availability under the constraints of logistics resupply-cargo weight and volume allocations.

Computer system design description for the spare pump mini-dacs data acquisition and control system

International Nuclear Information System (INIS)

Vargo, G.F. Jr.

1994-01-01

The attached document outlines the computer software design for the mini data acquisition and control system (DACS), that supports the testing of the spare pump for Tank 241-SY-101, at the maintenance and storage facility (MASF)

One-Stage Nipple and Breast Reconstruction Following Areola-Sparing Mastectomy

Directory of Open Access Journals (Sweden)

Hye Ri Kim

2013-09-01

Full Text Available BackgroundSkin-sparing mastectomy with immediate breast reconstruction is increasingly becoming a proven surgical option for early-stage breast cancer patients. Areola-sparing mastectomy (ASM has also recently become a popular procedure. The purpose of this article is to investigate the reconstructive and aesthetic issues experienced with one-stage nipple and breast reconstruction using ASM.MethodsAmong the patients who underwent mastectomy between March 2008 and March 2010, 5 women with a low probability of nipple-areolar complex malignant involvement underwent ASM and immediate breast reconstruction with simultaneous nipple reconstruction using the modified C-V flap. The cosmetic outcomes of this series were reviewed by plastic surgeons and patient self-assessment and satisfaction were assessed via telephone interview.ResultsDuring the average 11-month follow-up period, there were no cases of cancer recurrence, the aesthetic outcomes were graded as excellent to very good, and all of the patients were satisfied. Two patients developed a gutter-like depression around the reconstructed nipple, and one patient developed skin erosion in a small area of the areola, which healed with conservative dressing. The other complications, such as necrosis of the skin flap or areola, seroma, hematoma, or fat necrosis did not occur.ConclusionsSince one-stage nipple and breast reconstruction following ASM is an oncologically safe, cost-effective, and aesthetically satisfactory procedure, it is a good surgical option for early breast cancer patients.

Midterm outcome of valve-sparing aortic root replacement in inherited connective tissue disorders.

Science.gov (United States)

Tanaka, Hiroshi; Ogino, Hitoshi; Matsuda, Hitoshi; Minatoya, Kenji; Sasaki, Hiroaki; Iba, Yutaka

2011-11-01

This study determined the midterm outcome of valve-sparing aortic root replacement for patients with inherited connective tissue disorders. From 1993 to 2008, 94 patients underwent valve-sparing aortic root replacement. Sixty patients (64%), average age 33 years (range, 15 to 61 years), had inherited connective tissue disorders: Marfan syndrome, 54 (92%); Loeys-Dietz syndrome, 5 (8%); and smooth muscle α-actin (ACTA2) mutation in 1. Median preoperative sinus diameter was 52 mm (range, 42 to 76 mm), and moderate/severe aortic regurgitation was present in 14 (23%). Seven (12%, 1993 to 1999) underwent remodeling procedures, and 53 had reimplantation procedures. Cusp repair was performed in 4. Median follow-up was 55 months (range, 1 to 149 months). There were 15 patients in the early term (1993 to 2000) and 45 in the late term (2001 to 2008). Four late deaths occurred (cardiac, 3; aortic, 1), with 10-year survival of 86%. Rates of freedom from aortic valve replacement at 5 and 10 years were 85% and 58% in remodeling and 96% and 58% in reimplantation. Risk factors for reoperations were postprocedure intraoperative aortic insufficiency greater than mild (p = 0.046), remodeling procedure (p = 0.016), and early term (p = 0.0002). One patient (2%) with none/trivial postprocedure aortic insufficiency required aortic valve replacement. Freedom from reoperation in patients with none/trivial postprocedure aortic insufficiency at 5 and 10 years was 100% and 67%. Meticulous control of aortic insufficiency during operation would bring favorable midterm durability in valve-sparing aortic root replacement using a reimplantation technique, even in patients with inherited connective tissue disorders. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Database Description - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

Lifescience Database Archive (English)

Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ... QTL list, Plant DB link & Genome analysis methods Alternative name - DOI 10.18908/lsdba.nbdc01194-01-000 Cr...ers and QTLs are curated manually from the published literature. The marker information includes marker sequences, genotyping methods... Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

Table of 3D organ model IDs and organ names (PART-OF Tree) - BodyParts3D | LSDB Archive [Life Science Database Archive metadata

Lifescience Database Archive (English)

Full Text Available List Contact us BodyParts3D Table of 3D organ model IDs and organ names (PART-OF Tree) Data detail Data name Table of 3D org...an model IDs and organ names (PART-OF Tree) DOI 10.18908/lsdba.nbdc00837-002 Description of ...data contents List of downloadable 3D organ models in a tab-delimited text file format, describing the correspondence between 3D org...an model IDs and organ names available in PART-OF Tree. D...atabase Site Policy | Contact Us Table of 3D organ model IDs and organ names (PART-OF Tree) - BodyParts3D | LSDB Archive ...

Optimized lens-sparing treatment of retinoblastoma with electron beams

International Nuclear Information System (INIS)

Steenbakkers, Roel J.H.M.; Altschuler, Martin D.; D'Angio, Giulio J.; Goldwein, Joel W.; Kassaee, Alireza

1997-01-01

Purpose: The ideal lens-sparing radiotherapy technique for retinoblastoma calls for 100% dose to the entire retina including the ora serrata and zero dose to the lens. Published techniques, most of which use photons, have not accomplished this ideal treatment. We describe here a technique that approaches this ideal configuration using electron beam therapy. Methods and Materials: Dose-modeling calculations were made using a computer program built around a proprietary algorithm. This program calculates 3D dose distribution for electrons and photons and uses the Cimmino feasibility method for the inverse problem of beam weighting to achieve the prescribed dose. The algorithm has been verified in the ocular region by measurements in a RANDO phantom. To search for an ideal lens-sparing beam setup, a stylized phantom of an 8-month-old infant was generated with built-in inhomogeneities, and a phantom of a 5-year-old child was generated from a patient CT series. Results: Of more than 100 different beam setups tested, two 9 MeV electron beams at gantry angles plus and minus 26 degrees from the optic nerve axis achieved the best distribution. Both fields have a lens block and an isocenter between the globe and origin of the optic nerve. When equal doses are given to both fields, the entire extent of the retina (including ora serrata) received 100%, while the lens received 10% or less. Conclusion: The two-oblique-electron-beam technique here described appears to meet most of the stringent dosimetry needed to treat retinoblastoma. It is suitable for a range of ages, from infancy to early childhood years

List of selected publications from Risoe's Health Physics Department 1957-1989

International Nuclear Information System (INIS)

Heikel Vinther, F.

1991-01-01

This list includes scientific and technical papers written by staff members of the former Health Physics Department at Risoe National Laboratory. The first part includes papers in periodicals, proceedings etc. in order of chronology while the second and third part include Riso-R and Riso-M reports respectively arranged according to report numbers. (author)

Prophylactic Nipple-Sparing Mastectomy and Direct-to-Implant Reconstruction of the Large and Ptotic Breast

DEFF Research Database (Denmark)

Gunnarsson, Gudjon L; Bille, Camilla; Reitsma, Laurens C

2017-01-01

BACKGROUND: Nipple-sparing mastectomy with simultaneous hammock technique direct-to-implant reconstruction is increasingly offered to patients opting for risk-reducing mastectomy. Despite this promising method, patients with macromastia and ptotic breasts remain a challenging group to treat satis...

Crisis or Conference! Master List for Conference Planners.

Science.gov (United States)

Carey, Tony

This conference organizer's guide contains 42 lists of ideas, reminders, things to check, and questions to ask when a person is planning an event such as a conference, workshop, or training session. Written from a British point of view, the guide is organized into four parts in chronological order: preplanning, planning, onsite, and…

Plant DB link - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

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Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ...e Site Policy | Contact Us Plant DB link - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

Histomorphology of the Olfactory Mucosa and Spinal Tissue Sparing Following Transplantation in the Partial Spinal Cord Injury in Rats

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H Delaviz

2011-01-01

Full Text Available Introduction & Objective: Nowadays, cellular and tissues transplant has become the focus of attention for spinal cord injury. It has been shown olfactory nerve cells or olfactory mucosa whi have more efficient on nervous tissue repair and they have been more studied in experimental study. Furthermore, they were used in a few clinical centers for spinal defect. But mucosa tissue and spinal tissue have different structure and there is doubt about the integration of mucosa tissue in nervous tissue. Thus, in this research the morphology and the effect of the fetal olfactory mucosa (FOM on spinal tissue sparing were studied after transplanted into the spinal cord hemisection in rats. Materials & Methods: This experimental study was conducted at Iran University of Medical Sciences in 2008. Of thirty eight female Sprague-Dawley (200-250g rats twenty- eight were spinally hemisected at the L1 spinal level and were randomized into two groups of 14 animals. Treatment group received FOM graft and the control group received fetal respiratory mucosa graft (FRM. The other animals received surgical procedure without spinal cord injury as a sham group. The morphology of the transplant region and spinal tissue sparing was examined histological eight weeks after transplantation. The collected data was analyzed by the SPSS software using ANOVA and the morphology of the transplant region were studied by light microscope. Results: Histological study showed that the both mucosa tissues could not integrate with the parenchyma of the spinal tissue. Although the FOM were fused more than the FRM with the host tissue but clear boundary was seen at the graft–host interface. The mean spinal tissue sparing of the treatment group increased a little compare to the control but a significant difference was not apparent whereas, the spinal tissue sparing in treatment and control groups compare to the sham group decreased significantly (P < 0.05. Conclusion: Transplantation of

The incentives of different types of dual listing to Accounting Conservatism

Directory of Open Access Journals (Sweden)

Elizangela Lourdes de Castro

2016-05-01

Full Text Available There was an increase in the number of Brazilian companies, in the period 1998-2007, that have issued securities in other markets, especially in the USA. Because of that, this study aimed to examine that the option of Brazilian companies listed on the BM&FBOVESPA by dual listing in the US market has created incentives to increase the degree of conservatism of these companies. To accomplish this, three hypotheses were tested in the type of list: 1 - Adhere the dual listing encourages conservatism enterprises; 2 - Adhere the levels II and III encourages conservatism of the companies. 3 - Adhere the listing levels III and 144A encourages the degree of conservatism of the companies. To measure the degree of conservatism the models were used Basu (1997 and Ball and Shivakumar (2005, estimated at panel for the period 1998 to 2007. The results of the tests showed no change in the level of conservatism none of the types of dual listing of companies in the North American market. This allows us to infer that the dual listing has not encouraged a more conservative behavior on the part of those companies. Regarding the sample of all companies, only the model of Ball and Shivakumar (2005 indicated the presence of conservatism.

10 CFR Appendix B to Part 110 - Illustrative List of Gas Centrifuge Enrichment Plant Components Under NRC's Export Licensing...

Science.gov (United States)

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Illustrative List of Gas Centrifuge Enrichment Plant... 110—Illustrative List of Gas Centrifuge Enrichment Plant Components Under NRC's Export Licensing Authority 1. Assemblies and components especially designed or prepared for use in gas centrifuges. Note: The...

Automation of a problem list using natural language processing

Directory of Open Access Journals (Sweden)

Haug Peter J

2005-08-01

Full Text Available Abstract Background The medical problem list is an important part of the electronic medical record in development in our institution. To serve the functions it is designed for, the problem list has to be as accurate and timely as possible. However, the current problem list is usually incomplete and inaccurate, and is often totally unused. To alleviate this issue, we are building an environment where the problem list can be easily and effectively maintained. Methods For this project, 80 medical problems were selected for their frequency of use in our future clinical field of evaluation (cardiovascular. We have developed an Automated Problem List system composed of two main components: a background and a foreground application. The background application uses Natural Language Processing (NLP to harvest potential problem list entries from the list of 80 targeted problems detected in the multiple free-text electronic documents available in our electronic medical record. These proposed medical problems drive the foreground application designed for management of the problem list. Within this application, the extracted problems are proposed to the physicians for addition to the official problem list. Results The set of 80 targeted medical problems selected for this project covered about 5% of all possible diagnoses coded in ICD-9-CM in our study population (cardiovascular adult inpatients, but about 64% of all instances of these coded diagnoses. The system contains algorithms to detect first document sections, then sentences within these sections, and finally potential problems within the sentences. The initial evaluation of the section and sentence detection algorithms demonstrated a sensitivity and positive predictive value of 100% when detecting sections, and a sensitivity of 89% and a positive predictive value of 94% when detecting sentences. Conclusion The global aim of our project is to automate the process of creating and maintaining a problem

Transcatheter balloon dilation for recurrent right ventricular outflow tract obstruction following valve-sparing repair of tetralogy of Fallot.

Science.gov (United States)

Gellis, Laura; Banka, Puja; Marshall, Audrey; Emani, Sitaram; Porras, Diego

2015-10-01

Valve-sparing repair in patients with tetralogy of Fallot (TOF) carries the risk of residual or recurrent right ventricular outflow tract (RVOT) obstruction, which is often treated with transcatheter balloon dilation (BD). The outcomes and associated complications of BD of the RVOT in this scenario remain unknown. Retrospective review of the records of the Department of Cardiology at Boston Children's Hospital from 2000 to 2013 was performed. 34 patients had initial valve-sparing repair of tetralogy of Fallot followed by BD of the RVOT during the study period. Following BD, the RVOT gradient decreased from a median of 43 mm Hg (range 13 to 79 mm Hg) to 28 mm Hg (range 0 to 73 mm Hg) (P 1 and a final RVOT gradient of ≥40 post-BD were associated with shorter freedom from reintervention (P < 0.001). BD in patients with recurrent RVOT obstruction following valve-sparing repair of TOF acutely reduces the RVOT gradient, but commonly results in increased PR and is associated with a high reintervention rate. Patients with stenosis solely at the level of the valve had a better response to this type of intervention. © 2015 Wiley Periodicals, Inc.

Managing Renal Cell Carcinoma Associated Paraneoplastic Syndrome with Nephron-sparing Surgery in a Patient with von Hippel-Lindau

Directory of Open Access Journals (Sweden)

John M. DiBianco

2017-07-01

Full Text Available A patient with germline von Hippel-Lindau (VHL gene alteration and history of multiple tumors present with classical paraneoplastic syndrome (PNS associated with renal cell carcinoma (RCC. She underwent open nephron sparing surgery with resolution of symptoms. She remained without recurrence of RCC for the initial 2 years of her follow-up. To the best of our knowledge, this case represents the first in which PNS was specifically resolved using a partial nephrectomy in a patient with VHL. This case report provides initial evidence for the potential role of nephron sparing surgery in the management of paraneoplastic symptoms associated with hereditary RCC.

Programming list processes. SLIP: symmetric list processor - applications; Le traitement de listes en programmation. SLIP: langage de listes symetrique - applications

Energy Technology Data Exchange (ETDEWEB)

Broudin, Y [Commissariat a l' Energie Atomique, Centre d' Etudes Nucleaires de Saclay, 91 - Gif-sur-Yvette (France)

1966-06-01

Modern aspects of programming languages are essentially turned towards list processing. The ordinary methods of sequential treatment become inadequate and we must substitute list processes for them, where the cells of a group have no neighbourhood connection, but where the address of one cell is contained in the preceding one. These methods are required in 'time sharing' solving problems. They also allow us to treat new problems and to solve others in the shortest time. Many examples are presented after an abstract of the most usual list languages and a detailed study of one of them : SLIP. Among these examples one should note: locating of words in a dictionary or in a card index, treatment of non numerical symbols, formal derivation. The problems are treated in Fortran II on an IBM 7094 machine. The subroutines which make up the language are presented in an appendix. (author) [French] La programmation moderne ne se satisfait plus des methodes classiques de traitement sequentiel ni des tableaux a positions de memoire contigues. Elle tend a generaliser les methodes de listes ou les cellules d'un groupe n'ont pas de relation de voisinage, mais sont enchainees en listes, l'une donnant l'adresse machine de l'autre. Ces methodes sont indispensables en 'partage de temps' et dans les traitements en 'temps reel'. De plus, elles permettent de traiter des problemes nouveaux et d'optimiser le temps de traitement de nombreux autres. De nombreux exemples sont traites, apres un resume des langages les plus utilises et une etude plus precise d'un langage de listes: SLIP. Parmi les exemples traites signalons la recherche lexicographique, le traitement de symboles alphanumeriques, la derivation formelle. Probleme traite en Fortran II sur IBM 7094. Les sous-programmes constitutifs du langage sont fournis en annexe. (auteur)

NIH Toolbox Cognition Battery (NIHTB-CB): list sorting test to measure working memory.

Science.gov (United States)

Tulsky, David S; Carlozzi, Noelle; Chiaravalloti, Nancy D; Beaumont, Jennifer L; Kisala, Pamela A; Mungas, Dan; Conway, Kevin; Gershon, Richard

2014-07-01

The List Sorting Working Memory Test was designed to assess working memory (WM) as part of the NIH Toolbox Cognition Battery. List Sorting is a sequencing task requiring children and adults to sort and sequence stimuli that are presented visually and auditorily. Validation data are presented for 268 participants ages 20 to 85 years. A subset of participants (N=89) was retested 7 to 21 days later. As expected, the List Sorting Test had moderately high correlations with other measures of working memory and executive functioning (convergent validity) but a low correlation with a test of receptive vocabulary (discriminant validity). Furthermore, List Sorting demonstrates expected changes over the age span and has excellent test-retest reliability. Collectively, these results provide initial support for the construct validity of the List Sorting Working Memory Measure as a measure of working memory. However, the relationship between the List Sorting Test and general executive function has yet to be determined.

76 FR 59960 - Hazardous Waste Management System; Identification and Listing of Hazardous Waste; Withdrawal of...

Science.gov (United States)

2011-09-28

... Waste Management System; Identification and Listing of Hazardous Waste; Withdrawal of proposed rule... Permitting Division, Corrective Action and Waste Minimization Section (6PD-C), 1445 Ross Avenue, Dallas, TX... petition. A new petition will be required for this waste stream. List of Subjects in 40 CFR Part 261...

Retrofitting Listed Buildings

DEFF Research Database (Denmark)

Rasmussen, Torben Valdbjørn

2011-01-01

The paper presents a case study where the energy demand for a listed building constructed in 1900 is reduced. Many older buildings are listed and have restrictions that include the entire building or that include only its exterior. For the building presented, only its exterior facade is listed. T...

Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life

International Nuclear Information System (INIS)

Rij, CM van; Oughlane-Heemsbergen, WD; Ackerstaff, AH; Lamers, EA; Balm, AJM; Rasch, CRN

2008-01-01

To assess the impact of intensity modulated radiotherapy (IMRT) versus conventional radiation on late xerostomia and Quality of Life aspects in head and neck cancer patients. Questionnaires on xerostomia in rest and during meals were sent to all patients treated between January 1999 and December 2003 with a T1-4, N0-2 M0 head and neck cancer, with parotid gland sparing IMRT or conventional bilateral neck irradiation to a dose of at least 60 Gy, who were progression free and had no disseminated disease (n = 192). Overall response was 85% (n = 163); 97% in the IMRT group (n = 75) and 77% in the control group (n = 88) the median follow-up was 2.6 years. The prevalence of complaints was compared between the two groups, correcting for all relevant factors at multivariate ordinal regression analysis. Patients treated with IMRT reported significantly less difficulty transporting and swallowing their food and needed less water for a dry mouth during day, night and meals. They also experienced fewer problems with speech and eating in public. Laryngeal cancer patients in general had fewer complaints than oropharynx cancer patients but both groups benefited from IMRT. Within the IMRT group the xerostomia scores were better for those patients with a mean parotid dose to the 'spared' parotid below 26 Gy. Parotid gland sparing IMRT for head and neck cancer patients improves xerostomia related quality of life compared to conventional radiation both in rest and during meals. Laryngeal cancer patients had fewer complaints but benefited equally compared to oropharyngeal cancer patients from IMRT

Multifocal osteolysis following limb-sparing procedures: imaging findings and a review of the literature

International Nuclear Information System (INIS)

Kaste, S.C.; Rao, B.N.; Lynch, M.H.; Parham, D.M.; Meyer, W.H.

1996-01-01

Limb-sparing procedures utilizing endoprostheses improve both the quality of life and functional level of patients treated for primary bone sarcomas. Herein, we present the imaging findings of an uncommon cause of prosthetic failure, i. e., foreign body reaction, manifested by progressive multifocal osteolysis along the prosthetic femoral shaft. (orig.). With 3 figs

Update History of This Database - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

Lifescience Database Archive (English)

Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ...B link & Genome analysis methods English archive site is opened. 2012/08/08 PGDBj... Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods is opened. About This...ate History of This Database - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

Career listings.

Science.gov (United States)

1994-01-12

Nursing Standard regrets that it is no longer able to take listings over the telephone because of unprecedented demand. Readers are reminded that the listings section is for the use of charitable and professional organisations, unions and health authorities to publicise forthcoming events.

Preventative Valve-Sparing Aortic Root Replacement and Pregnancy Outcome in Marfan Syndrome

OpenAIRE

Sokol, Vesna; Zlopaša, Gordan; Herman, Mislav; Planinić, Pavao; Micevska, Ana

2012-01-01

In Marfan syndrome, with dilatation of the aortic root secondary to an underlying connective tissue defect, pregnancy can cause hemodynamic stress leading to the development of an aortic aneurysm and even a fatal aortic dissection. In the presence of existing aortic root enlargement and a family history of aortic dissection, preventative elective surgery is suggested. Aortic root replacement with or without a valve-sparing procedure is superior to total aortic root replacement with ...

MANAGEMENT PROCEDURE OF SUPPLIES OF UNITS, MATERIALS AND CONSTITUENT PARTS FOR REPAIR AND MAINTENANCE SUPPORT OF TRANSPORT AND PRODUCTION MACHINES

Directory of Open Access Journals (Sweden)

Victor Yurievich Stroganov

2017-05-01

Full Text Available This article considers a question of creation of schemes and sequence of passing of the main stages of process of execution of repair and maintenance works order taking into account formation of stocks of necessary spare parts, materials and constituent parts. Models of an input stream are offered for inventory control system, which are rather adequately described by autoregressive models of order two.

How new subscribers use cancer-related online mailing lists.

Science.gov (United States)

Rimer, Barbara K; Lyons, Elizabeth J; Ribisl, Kurt M; Bowling, J Michael; Golin, Carol E; Forlenza, Michael J; Meier, Andrea

2005-07-01

with cancer, 42% (n = 121) strongly agreed they used mailing lists for support, and 37% (n = 109) strongly agreed that they were on the mailing lists to help others. Smaller proportions of new subscribers strongly agreed that others on the mailing lists had similar cancer experiences (n = 23, 9%), that they could relate to the experiences of others on the lists (n = 66, 27%), and that others on the list gave them good ideas about how to cope with cancer (n = 66, 27%). Cancer-related online mailing lists appear to be an important resource, especially for information seeking but also for support of cancer survivors. These were the primary motivators most members reported for joining mailing lists. The modest proportion of subscribers who strongly agreed that they could relate to others' cancer experiences (as well as similar responses to other process questions) is undoubtedly due at least in part to the short duration that these subscribers were involved with the mailing lists. Emerging data, including our own, suggest that mailing lists are perhaps under-used by minority patients/survivors. These preliminary data add to a growing body of research on health-related online communities, of which online mailing lists are one variant.

Transparent meta-analysis: does aging spare prospective memory with focal vs. non-focal cues?

Directory of Open Access Journals (Sweden)

Bob Uttl

Full Text Available BACKGROUND: Prospective memory (ProM is the ability to become aware of a previously-formed plan at the right time and place. For over twenty years, researchers have been debating whether prospective memory declines with aging or whether it is spared by aging and, most recently, whether aging spares prospective memory with focal vs. non-focal cues. Two recent meta-analyses examining these claims did not include all relevant studies and ignored prevalent ceiling effects, age confounds, and did not distinguish between prospective memory subdomains (e.g., ProM proper, vigilance, habitual ProM (see Uttl, 2008, PLoS ONE. The present meta-analysis focuses on the following questions: Does prospective memory decline with aging? Does prospective memory with focal vs. non-focal cues decline with aging? Does the size of age-related declines with focal vs. non-focal cues vary across ProM subdomains? And are age-related declines in ProM smaller than age-related declines in retrospective memory? METHODS AND FINDINGS: A meta-analysis of event-cued ProM using data visualization and modeling, robust count methods, and conventional meta-analysis techniques revealed that first, the size of age-related declines in ProM with both focal and non-focal cues are large. Second, age-related declines in ProM with focal cues are larger in ProM proper and smaller in vigilance. Third, age-related declines in ProM proper with focal cues are as large as age-related declines in recall measures of retrospective memory. CONCLUSIONS: The results are consistent with Craik's (1983 proposal that age-related declines on ProM tasks are generally large, support the distinction between ProM proper vs. vigilance, and directly contradict widespread claims that ProM, with or without focal cues, is spared by aging.

78 FR 73456 - List of Approved Spent Fuel Storage Casks: HI-STORM 100 Cask System; Amendment No. 9

Science.gov (United States)

2013-12-06

...-2012-0052] RIN 3150-AJ12 List of Approved Spent Fuel Storage Casks: HI-STORM 100 Cask System; Amendment... International HI-STORM 100 Cask System listing within the ``List of Approved Spent Fuel Storage Casks'' to... requirements for the HI-STORM 100U part of the HI-STORM 100 Cask System and updates the thermal model and...

Retail Shopping Lists

DEFF Research Database (Denmark)

Schmidt, Marcus

2012-01-01

categories. An association between the frequency of a brand's appearance on lists and the amount of money spent on advertising the brand could not be found. A strong link between brands, prices and store names is revealed. Price in the majority of cases refers to brands rather than to product categories......The paper addresses consumers' shopping lists. The current study is based on a survey of 871 lists collected at retail grocery stores. Most items on shopping lists appear on the product category level rather than the brand level. The importance of the brand level varies considerably across product...

Sick-listed persons' experiences with taking part in an in-patient occupational rehabilitation program based on Acceptance and Commitment Therapy: a qualitative focus group interview study.

Science.gov (United States)

Rise, Marit B; Gismervik, Sigmund Ø; Johnsen, Roar; Fimland, Marius S

2015-11-27

Occupational medicine has shifted emphasis from disease treatment to disability rehabilitation and management. Hence, newly developed occupational rehabilitation programs are often generic and multicomponent, aiming to influence the sick-listed persons' perception on return to work, and thereby support the return to work process. The aim of this study was to explore sick-listed persons' experiences with taking part in an in-patient occupational rehabilitation program based on Acceptance and Commitment Therapy. Twenty-nine adults on sickness benefit or work assessment allowance due to musculoskeletal and/or common mental health disorders participated in this study. They were interviewed in focus groups at the beginning and at the end of a 3.5 week inpatient group-based occupational rehabilitation program in Central Norway. Key elements in the program were Acceptance and Commitment Therapy (ACT), physical exercise and creating a work-participation plan. The program was mainly group-based including participants with different diagnoses. Data was analyzed according to a phenomenological approach. At the start of the program most participants expressed frustration regarding being sick-listed, external anticipations as well as hindrances towards returning to work, and described hope that the program would provide them with the skills and techniques necessary to cope with health problems and being able to return to work. At the end of the program the participants described that they had embarked upon a long process of increased awareness. This process encompassed four areas; an increased awareness of what was important in life, realizing the strain from external expectations and demands, a need to balance different aspects of life, and return to work as part of a long and complex process. The occupational rehabilitation program induced a perceived meaningful reorientation encompassing several aspects of life. However, the return to work process was described as diffuse

Nephron-sparing surgery and percutaneous biopsies in renal-cell carcinoma: a global impression among endourologists

NARCIS (Netherlands)

Kummerlin, Intan P. E. D.; Borrego, Jaime; Wink, Margot H.; van Dijk, Marleen M.; Wijkstra, Hessel; de La Rosette, Jean J. M. C. H.; Laguna, M. Pilar

2007-01-01

BACKGROUND AND PURPOSE: On the one hand, nephron-sparing surgery (NSS) in small renal tumors is a safe and effective alternative to radical nephrectomy. On the other hand, the role of preoperative percutaneous needle biopsies (PNB) remains controversial. The purpose of this study was to evaluate the

Nephron-sparing surgery and percutaneous biopsies in renal-cell carcinoma : a global impression among endourologists

NARCIS (Netherlands)

Kummerlin, I.; Borrego, J.; Wink, M.H.; Dijk, van M.M.; Wijkstra, H.; Rosette, de la J.J.M.C.H.; Laguna, M.P.

2010-01-01

Background and Purpose: On the one hand, nephron-sparing surgery (NSS) in small renal tumors is a safe and effective alternative to radical nephrectomy. On the other hand, the role of preoperative percutaneous needle biopsies (PNB) remains controversial. The purpose of this study was to evaluate the

List of scientific and technical publications of the Karlsruhe Nuclear Research Centre, 1985

International Nuclear Information System (INIS)

1986-05-01

The report lists the titles and other bibliographic data of the publications released in 1985. Lectures not yet available in printed form are listed separately. The patent section gives information on patent rights granted or published in 1985. Technical lectures or material prepared for courses held by the SKT (Nuclear Engineering School) are not part of the list. The data are arranged by institutes, information on project activities is given referring to published project reports and other publications prepared by project staff. The list also presents R and D reports printed by KfK for informationn on the PFT project, fabrication technologies, which is a joint enterprise by KfK, several other institutes, and industry. Publications of the branch institute of the Federal Food Research Institute are also given, followed by a list of publications prepared by guest scientists of the KfK. (orig./PW) [de

Impact of Salivary Gland Dosimetry on Post-IMRT Recovery of Saliva Output and Xerostomia Grade for Head-and-Neck Cancer Patients Treated With or Without Contralateral Submandibular Gland Sparing: A Longitudinal Study

International Nuclear Information System (INIS)

Wang Zhonghe; Yan Chao; Zhang Zhiyuan; Zhang Chenping; Hu Haisheng; Tu Wenyong; Kirwan, Jessica; Mendenhall, William M.

2011-01-01

Purpose: To observe the recovery of saliva output and effect on xerostomia grade after intensity-modulated radiotherapy (IMRT) with or without contralateral submandibular gland (cSMG) sparing and to assess the impact of salivary gland dosimetry on this recovery among patients with head-and-neck cancer. Methods and Materials: Between May 2007 and May 2008, 52 patients with head-and-neck cancer received definitive (n = 5 patients) and postoperative (n = 47 patients) IMRT at our institution, with at least one parotid gland spared. Of these patients, 26 patients with a low risk of recurrence in the cSMG region underwent IMRT and had their cSMGs spared (cSMG-sparing group). The remaining 26 high-risk patients had no cSMGs spared (cSMG-unspared group). Xerostomia grades and salivary flow rates were monitored at five time points (before IMRT and at 2, 6, 12, and 18 months after IMRT). Results: Average mean doses and mean volumes receiving 30 Gy (V30) of the cSMGs were lower in the cSMG-sparing group than in the cSMG-unspared group (mean dose, 20.4 Gy vs. 57.4 Gy; mean V30, 14.7% vs. 99.8%, respectively). Xerostomia grades at 2 and 6 months post-IMRT were also significantly lower among patients in the cSMG-sparing group than in the cSMG-unspared group, but differences were not significant at 12 and 18 months after IMRT. Patients in the cSMG-sparing group had significantly better mean unstimulated salivary flow rates at each time point post- IMRT as well as better mean stimulated salivary flow rates at 2 months post-IMRT. Conclusions: Recovery of saliva output and grade of xerostomia post-IMRT in patients whose cSMGs were spared were much better than in patients whose cSMGs were not spared. The influence of the mean doses to the cSMG and parotid gland on the recovery of saliva output was equivalent to that of the mean V30 to the glands.

Impact of Salivary Gland Dosimetry on Post-IMRT Recovery of Saliva Output and Xerostomia Grade for Head-and-Neck Cancer Patients Treated With or Without Contralateral Submandibular Gland Sparing: A Longitudinal Study

Energy Technology Data Exchange (ETDEWEB)

Wang Zhonghe; Yan Chao [Division of Radiation Oncology, the Shanghai Ninth Peoples Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (China); Zhang Zhiyuan; Zhang Chenping [Department of Oral and Maxillofacial Surgery, the Shanghai Ninth Peoples Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (China); Hu Haisheng; Tu Wenyong [Division of Radiation Oncology, the Shanghai Ninth Peoples Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (China); Kirwan, Jessica [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States); Mendenhall, William M., E-mail: mendwm@shands.ufl.edu [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States)

2011-12-01

Purpose: To observe the recovery of saliva output and effect on xerostomia grade after intensity-modulated radiotherapy (IMRT) with or without contralateral submandibular gland (cSMG) sparing and to assess the impact of salivary gland dosimetry on this recovery among patients with head-and-neck cancer. Methods and Materials: Between May 2007 and May 2008, 52 patients with head-and-neck cancer received definitive (n = 5 patients) and postoperative (n = 47 patients) IMRT at our institution, with at least one parotid gland spared. Of these patients, 26 patients with a low risk of recurrence in the cSMG region underwent IMRT and had their cSMGs spared (cSMG-sparing group). The remaining 26 high-risk patients had no cSMGs spared (cSMG-unspared group). Xerostomia grades and salivary flow rates were monitored at five time points (before IMRT and at 2, 6, 12, and 18 months after IMRT). Results: Average mean doses and mean volumes receiving 30 Gy (V30) of the cSMGs were lower in the cSMG-sparing group than in the cSMG-unspared group (mean dose, 20.4 Gy vs. 57.4 Gy; mean V30, 14.7% vs. 99.8%, respectively). Xerostomia grades at 2 and 6 months post-IMRT were also significantly lower among patients in the cSMG-sparing group than in the cSMG-unspared group, but differences were not significant at 12 and 18 months after IMRT. Patients in the cSMG-sparing group had significantly better mean unstimulated salivary flow rates at each time point post- IMRT as well as better mean stimulated salivary flow rates at 2 months post-IMRT. Conclusions: Recovery of saliva output and grade of xerostomia post-IMRT in patients whose cSMGs were spared were much better than in patients whose cSMGs were not spared. The influence of the mean doses to the cSMG and parotid gland on the recovery of saliva output was equivalent to that of the mean V30 to the glands.

LLL DBASE glossary and parameter definitions, Part 1

International Nuclear Information System (INIS)

Rohrer, R.F.

1975-01-01

This report lists, defines, and updates parameters in DBASE, an LLL test effects data bank in which data is stored from experiments performed at NTS and other test sites. Parameters are listed by subject and by number. Part 2 of this report presents the same information for classified parameters

Effect of branched chain amino acid enrichment of total parenteral nutrition on nitrogen sparing and clinical outcome of sepsis and trauma: a prospective randomized double blind trial

NARCIS (Netherlands)

von Meyenfeldt, M. F.; Soeters, P. B.; Vente, J. P.; van Berlo, C. L.; Rouflart, M. M.; de Jong, K. P.; van der Linden, C. J.; Gouma, D. J.

1990-01-01

Administration of extra branched chain amino acids (BCAA) has been associated with a nitrogen sparing effect in septic and traumatized patients. Whether nitrogen sparing is associated with decreased morbidity and mortality rates is unknown. We therefore undertook a prospective, randomized, double

Ordinary and extraordinary prices in the Giolito Libri spirituali sales List

Directory of Open Access Journals (Sweden)

Giliola Barbero

2018-05-01

Full Text Available This article illustrates an early modern sales list of books, the Libri spirituali di stampa of the Venetian Giolito publishing house. This printed list, kept in the Biblioteca Comunale Augusta in Perugia, includes the descriptions of 81 devotional and religious sixteenth century books with their prices expressed in Venetian lire (an account money. The aim of the research is to illustrate the price policy of the Giolito firm between 1587 and 1592, and the segment of the market they intended to serve. For this purpose, on the basis of the books priced, the list has been dated and placed in chronological relation with other already known Giolito sales catalogues. In the second part of the article, average prices per printing sheet are calculated and the relationships between prices and dates, languages and formats are taken into consideration. In the end, the reasons why some few editions were proposed on the market at a higher price are discussed. The list is published in the Appendix.

Skin-sparing Helical Tomotherapy vs 3D-conformal Radiotherapy for Adjuvant Breast Radiotherapy: In Vivo Skin Dosimetry Study

International Nuclear Information System (INIS)

Capelle, Lisa; Warkentin, Heather; MacKenzie, Marc; Joseph, Kurian; Gabos, Zsolt; Pervez, Nadeem; Tankel, Keith; Chafe, Susan; Amanie, John; Ghosh, Sunita; Parliament, Matthew; Abdulkarim, Bassam

2012-01-01

Purpose: We investigated whether treatment-planning system (TPS)-calculated dose accurately reflects skin dose received for patients receiving adjuvant breast radiotherapy (RT) with standard three-dimensional conformal RT (3D-CRT) or skin-sparing helical tomotherapy (HT). Methods and Materials: Fifty patients enrolled in a randomized controlled trial investigating acute skin toxicity from adjuvant breast RT with 3D-CRT compared to skin-sparing HT, where a 5-mm strip of ipsilateral breast skin was spared. Thermoluminescent dosimetry or optically stimulated luminescence measurements were made in multiple locations and were compared to TPS-calculated doses. Skin dosimetric parameters and acute skin toxicity were recorded in these patients. Results: With HT there was a significant correlation between calculated and measured dose in the medial and lateral ipsilateral breast (r = 0.67, P V50 (1.4% vs 5.9%, respectively; P=.001) but higher skin V40 and skin V30 (71.7% vs 64.0%, P=.02; and 99.0% vs 93.8%, P=.001, respectively) than 3D-CRT plans. Conclusion: The 3D-CRT TPS more accurately reflected skin dose than the HT TPS, which tended to overestimate dose received by 14% in patients receiving adjuvant breast RT.

Neurology check list. 5. rev. and enl. ed.; Checkliste Neurologie

Energy Technology Data Exchange (ETDEWEB)

Grehl, Holger [Evangelisches und Johanniter Klinikum, Duisburg (Germany). Neurologische Klinik; Reinhardt, Frank

2013-02-01

The neurology check list covers the following issues, organized in four parts: Grey part - diagnostic fundamentals, therapeutic principles: clinical neurological examination, liquor puncture, specific laboratory diagnostics, neurophysical diagnostics, imaging techniques, therapeutic principles, legal aspects, neurological assessment. Green Part - leading syndromes and leading symptoms. Blue part - neurological disease appearance: pains in head and face, pain syndrome, congenital and development disturbances, liquor circulation disturbances, ZNS hemorrhages, tumors and neoplasm, paraneoplastic syndromes, inflammatory diseases of the nervous system, dementia diseases, metabolic and other encephalopathy, cerebellum diseases and system surmounting processes, movement degeneration, basal ganglion diseases, epilepsy, non-epileptic attacks, medulla diseases, brain nerve diseases, plexus lesions, radicular lesions, peripheric neuropathy, neuromuscular transfer disturbances, muscular diseases. Red part: neurological intensive medicine.

A quarter of a century of experience with aortic valve-sparing operations.

Science.gov (United States)

David, Tirone E; Feindel, Christopher M; David, Carolyn M; Manlhiot, Cedric

2014-09-01

To examine the late outcomes of aortic valve-sparing operations to treat patients with aortic root aneurysm with and without aortic insufficiency (AI) in a cohort of patients followed up prospectively since 1988. A total of 371 consecutive patients had undergone aortic valve-sparing surgery (mean age, 47 ± 15 years; 78% men) from 1988 through 2010. In addition to the aortic root aneurysm, 47% had moderate or severe AI, 35.5% had Marfan syndrome, 12.1% had type A aortic dissection, 9.2% had bicuspid aortic valve, 8.4% had mitral insufficiency, 16.1% had aortic arch aneurysm, and 10.2% had coronary artery disease. Reimplantation of the aortic valve was used in 296 patients and remodeling of the aortic root in 75. Cusp repair by plication of the free margin along the nodule of Arantius was used in 36.6% of patients, and reinforcement of the free margin with a double layer of fine Gore-Tex suture in 24.2%. The patients were followed up prospectively with images of the aortic root for a median follow-up of 8.9 ± 5.2 years. A total of 4 operative and 39 late deaths occurred. Survival at 18 years was 76.8% ± 4.31%, lower than that for the general population matched for age and gender. Age, type A aortic dissection, impaired ventricular function, and preoperative AI were associated with increased mortality on multivariable analysis. Reoperations on the aortic valve were performed in 8 patients for recurrent AI and in 2 for infective endocarditis. Freedom from reoperation on the aortic valve at 18 years was 94.8% ± 2.0%. No predictors of the need for reoperation were found on multivariable analysis. Eighteen patients developed AI greater than mild. Freedom from AI greater than mild at 18 years was 78.0% ± 4.8%. No predictors of recurrent AI were identified on multivariable analysis. Aortic valve-sparing operations continue to provide excellent clinical outcomes, although a slow but progressive deterioration of aortic valve function seems to occur during the first 2

Calcineurin inhibitor sparing with mycophenolate in kidney transplantation: a systematic review and meta-analysis.

LENUS (Irish Health Repository)

Moore, Jason

2009-02-27

Limiting the exposure of kidney transplant recipients to calcineurin inhibitors (CNIs) has potential merit, but there is no clear consensus on the utility of current strategies. In an attempt to aid clarification, we conducted a systematic review and meta-analysis of randomized trials that assessed CNI sparing (minimization or elimination) with mycophenolate as sole adjunctive immunosuppression.

Fetal Growth Restriction with Brain Sparing: Neurocognitive and Behavioral Outcomes at 12 Years of Age

NARCIS (Netherlands)

Beukers, Fenny; Aarnoudse-Moens, Cornelieke S. H.; van Weissenbruch, Mirjam M.; Ganzevoort, Wessel; van Goudoever, Johannes B.; van Wassenaer-Leemhuis, Aleid G.

2017-01-01

Objective To study neurocognitive functions and behavior in children with a history of fetal growth restriction (FGR) with brain sparing. We hypothesized that children with FGR would have poorer outcomes on these domains. Study design Subjects were 12-year-old children with a history of FGR born to

Mitral valve-sparing procedures and prosthetic heart valve failure: A case report

Science.gov (United States)

Khan, Nasir A; Butany, Jagdish; Leong, Shaun W; Rao, Vivek; Cusimano, Robert J; Ross, Heather J

2009-01-01

Prosthetic heart valve dysfunction due to thrombus or pannus formation can be a life-threatening complication. The present report describes a 47-year-old woman who developed valvular cardiomyopathy after chorda-sparing mitral valve replacement, and subsequently underwent heart transplantation for progressive heart failure. The explanted mitral valve prosthesis showed significant thrombus and pannus leading to reduced leaflet mobility and valvular stenosis. The present report illustrates the role of the subvalvular apparatus and pannus in prosthesis dysfunction. PMID:19279993

Painful orgasm in an adolescent after seminal-sparing cystoprostatectomy: a puzzling symptom.

Science.gov (United States)

Angelini, Lorenzo; Castagnetti, Marco; Rigamonti, Waifro

2015-01-01

An 18-year-old boy, followed up after seminal-sparing cystectomy for bladder rhabdomyosarcoma, presented complaining of recurrent episodes of left scrotal/inguinal pain arising after orgasms. Full work-up ruled out disease recurrence, but showed enlarged seminal vesicles. Ligation of the vas deferens was unsuccessful. The patient was started on α-blockers to reduce vas contractions with improvement of symptoms. The possible pathophysiology and treatments of this symptom are discussed. 2014 S. Karger AG, Basel

Oil and Gas field code master list 1995

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-12-01

This is the fourteenth annual edition of the Energy Information Administration`s (EIA) Oil and Gas Field Code Master List. It reflects data collected through October 1995 and provides standardized field name spellings and codes for all identified oil and/or gas fields in the US. The Field Code Index, a listing of all field names and the States in which they occur, ordered by field code, has been removed from this year`s publications to reduce printing and postage costs. Complete copies (including the Field Code Index) will be available on the EIA CD-ROM and the EIA World-Wide Web Site. Future editions of the complete Master List will be available on CD-ROM and other electronic media. There are 57,400 field records in this year`s Oil and Gas Field Code Master List. As it is maintained by EIA, the Master List includes the following: field records for each State and county in which a field resides; field records for each offshore area block in the Gulf of Mexico in which a field resides; field records for each alias field name (see definition of alias below); and fields crossing State boundaries that may be assigned different names by the respective State naming authorities. Taking into consideration the double-counting of fields under such circumstances, EIA identifies 46,312 distinct fields in the US as of October 1995. This count includes fields that no longer produce oil or gas, and 383 fields used in whole or in part for oil or gas Storage. 11 figs., 6 tabs.

Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life

Science.gov (United States)

van Rij, CM; Oughlane-Heemsbergen, WD; Ackerstaff, AH; Lamers, EA; Balm, AJM; Rasch, CRN

2008-01-01

Background and purpose To assess the impact of intensity modulated radiotherapy (IMRT) versus conventional radiation on late xerostomia and Quality of Life aspects in head and neck cancer patients. Patients and nethods Questionnaires on xerostomia in rest and during meals were sent to all patients treated between January 1999 and December 2003 with a T1-4, N0-2 M0 head and neck cancer, with parotid gland sparing IMRT or conventional bilateral neck irradiation to a dose of at least 60 Gy, who were progression free and had no disseminated disease (n = 192). Overall response was 85% (n = 163); 97% in the IMRT group (n = 75) and 77% in the control group (n = 88) the median follow-up was 2.6 years. The prevalence of complaints was compared between the two groups, correcting for all relevant factors at multivariate ordinal regression analysis. Results Patients treated with IMRT reported significantly less difficulty transporting and swallowing their food and needed less water for a dry mouth during day, night and meals. They also experienced fewer problems with speech and eating in public. Laryngeal cancer patients in general had fewer complaints than oropharynx cancer patients but both groups benefited from IMRT. Within the IMRT group the xerostomia scores were better for those patients with a mean parotid dose to the "spared" parotid below 26 Gy. Conclusion Parotid gland sparing IMRT for head and neck cancer patients improves xerostomia related quality of life compared to conventional radiation both in rest and during meals. Laryngeal cancer patients had fewer complaints but benefited equally compared to oropharyngeal cancer patients from IMRT. PMID:19068126

Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life

Directory of Open Access Journals (Sweden)

Balm AJM

2008-12-01

Full Text Available Abstract Background and purpose To assess the impact of intensity modulated radiotherapy (IMRT versus conventional radiation on late xerostomia and Quality of Life aspects in head and neck cancer patients. Patients and nethods Questionnaires on xerostomia in rest and during meals were sent to all patients treated between January 1999 and December 2003 with a T1-4, N0-2 M0 head and neck cancer, with parotid gland sparing IMRT or conventional bilateral neck irradiation to a dose of at least 60 Gy, who were progression free and had no disseminated disease (n = 192. Overall response was 85% (n = 163; 97% in the IMRT group (n = 75 and 77% in the control group (n = 88 the median follow-up was 2.6 years. The prevalence of complaints was compared between the two groups, correcting for all relevant factors at multivariate ordinal regression analysis. Results Patients treated with IMRT reported significantly less difficulty transporting and swallowing their food and needed less water for a dry mouth during day, night and meals. They also experienced fewer problems with speech and eating in public. Laryngeal cancer patients in general had fewer complaints than oropharynx cancer patients but both groups benefited from IMRT. Within the IMRT group the xerostomia scores were better for those patients with a mean parotid dose to the "spared" parotid below 26 Gy. Conclusion Parotid gland sparing IMRT for head and neck cancer patients improves xerostomia related quality of life compared to conventional radiation both in rest and during meals. Laryngeal cancer patients had fewer complaints but benefited equally compared to oropharyngeal cancer patients from IMRT.

Demarcation laser photocoagulation of selected macula-sparing rhegmatogenous retinal detachments.

Science.gov (United States)

Vrabec, T R; Baumal, C R

2000-06-01

To report a series of macula-sparing rhegmatogenous retinal detachments (MSRRDs) treated with demarcation laser photocoagulation (DLP). Retrospective, noncomparative case series. Thirty-one patients (34 eyes) with primary or recurrent MSRRDs without associated visual field loss, necrotizing retinitis, or proliferative vitreoretinopathy (PVR), managed with DLP from November 1992 through May 1999. Demarcation laser photocoagulation consisting of a triple row of confluent laser burns. Best corrected postoperative visual acuity and MSRRD progression or recurrence. Thirty-four primary and recurrent MSRRDs were treated by DLP, which consisted of a triple row of confluent laser burns. Macula-sparing rhegmatogenous retinal detachments were located in all quadrants and affected 10% to 45% of the retina. Findings associated with MSRRDs included lattice degeneration (12 eyes), vitreous hemorrhage (4 eyes), and demarcation line (9 eyes). Symptoms (photopsias or floaters) were associated with 14 MSRRDs. Eight eyes were myopic and 11 were pseudophakic. Thirty-two MSRRDs were shallow, two were dome shaped, and all were smooth without corrugations. Follow-up ranged from 1.5 to 80 months (mean, 15.8 months; median, 17 months). Thirty-three of 34 detachments remained stable after DLP. Three flattened spontaneously. One eye was managed with scleral buckle 6 weeks after DLP. Progression was attributed to incomplete laser treatment. Best corrected postoperative visual acuity was the same or improved in all but one eye, in which a cataract developed. Demarcation laser photocoagulation is an effective method to manage acute or chronic, primary or recurrent MSRRDs without associated PVR that are shallow and smooth without corrugations. Demarcation laser photocoagulation is an alternative to both observation and surgical repair for these select MSRRDs.

Fuel sparing: Control of industrial furnaces using process gas as supplemental fuel

International Nuclear Information System (INIS)

Boisvert, Patrick G.; Runstedtler, Allan

2014-01-01

Combustible gases from industrial processes can be used to spare purchased fuels such as natural gas and avoid wasteful flaring of the process gases. One of the challenges of incorporating these gases into other furnaces is their intermittent availability. In order to incorporate the gases into a continuously operating furnace, the furnace control system must be carefully designed so that the payload is not affected by the changing fuel. This paper presents a transient computational fluid dynamics (CFD) model of an industrial furnace that supplements natural gas with carbon monoxide during furnace operation. A realistic control system of the furnace is simulated as part of the CFD calculation. The time dependent changes in fuels and air injection on the furnace operation is observed. It is found that there is a trade-off between over-controlling the furnace, which results in too sensitive a response to normal flow oscillations, and under-controlling, which results in a lagged response to the fuel change. - Highlights: •Intermittently available process gases used in a continuously operating furnace. •Study shows a trade-off between over-controlling and under-controlling the furnace. •Over-controlling: response too sensitive to normal flow oscillations. •Under-controlling: lagged response to changing fuel composition. •Normal flow oscillations in furnace would not be apparent in steady-state model

76 FR 16531 - Technical Correction for Neurological Listing Cross-Reference

Science.gov (United States)

2011-03-24

... 1-800-325-0778, or visit our Internet site, Social Security Online, at http://www.socialsecurity.gov... SOCIAL SECURITY ADMINISTRATION 20 CFR Part 404 [Docket No. SSA-2011-0019] RIN 0960-AH33 Technical Correction for Neurological Listing Cross-Reference AGENCY: Social Security Administration. ACTION: Final...

Valve-sparing root and ascending aorta replacement after heart transplantation.

Science.gov (United States)

Elhenawy, Abdelsalam M; Feindel, Christopher M; Ross, Heather; Butany, Jagdish; Yau, Terrence M

2012-12-01

A 45-year-old female underwent heart transplantation 17 years ago, with a heart from a 15-year-old donor. Recently, she had developed an aneurysm of the donor aortic root and ascending aorta, with severe aortic insufficiency. Two surgical options were considered; retransplantation versus replacement of the aortic root and ascending aorta. A valve-sparing replacement of the aortic root and ascending aortic aneurysm was performed. The donor aorta showed pathologic changes typical of Marfan syndrome. Nineteen months postoperatively, the patient remains in functional class I, with trivial aortic insufficiency. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

The steroid-sparing effect of long-term plasmapheresis in pemphigus

DEFF Research Database (Denmark)

Søndergaard, Klaus; Carstens, Jan; Jørgensen, Jan

1995-01-01

Glucocorticoids and immunosuppressive agents can induce remission in most patients with pemphigus, but mortality remains at 5 to 15% due to complications from these drugs. We reviewed the adjunctive effect of long-term plasmapheresis in 8 patients with pemphigus. Four cases had been resistant to ...... where cyclosporine was introduced. This first report of long-term plasmapheresis demonstrates clinical efficacy in pemphigus and a considerable steroid-sparing effect.......Glucocorticoids and immunosuppressive agents can induce remission in most patients with pemphigus, but mortality remains at 5 to 15% due to complications from these drugs. We reviewed the adjunctive effect of long-term plasmapheresis in 8 patients with pemphigus. Four cases had been resistant...

Recipient vessel selection in immediate breast reconstruction with free abdominal tissue transfer after nipple-sparing mastectomy.

Science.gov (United States)

Yang, Sung Jun; Eom, Jin Sup; Lee, Taik Jong; Ahn, Sei Hyun; Son, Byung Ho

2012-05-01

Nipple-sparing mastectomy (NSM) is gaining popularity due to its superior aesthetic results. When reconstructing the breast with free abdominal tissue transfer, we must readdress the recipient vessel, because NSM can cause difficulty in access to the chest vessel. Between June 2006 and March 2011, a total of 92 women underwent NSM with free abdominal tissue transfer. A lateral oblique incision was used for the nipple-sparing mastectomy. For recipient vessels, the internal mammary vessels were chosen if the mastectomy flap did not block access to the vessels. If it did, the thoracodorsal vessels were used. Age, degree of breast ptosis, weight of the mastectomy specimen, and related complications of the internal mammary vessel group and the thoracodorsal vessel group were compared. Thoracodorsal vessels were used as recipient vessels in 59 cases, and internal mammary vessels in 33 cases including 4 cases with perforators of the internal mammary vessels. Breast reconstruction was successful in all cases except one case involving a total flap failure, which was replaced by a silicone gel implant. The internal mammary group and the thoracodorsal group were similar in terms of age, height, breast weight, and degree of ptosis. The flap related complications such as flap loss and take-back operation rates were not significantly different between the two groups. The rate of nipple necrosis was higher in the internal mammary group. The thoracodorsal vessels could produce comparable outcomes in breast reconstruction after nipple-sparing mastectomies. If access to internal mammary vessels is difficult, the thoracodorsal vessel can be a better choice.

Recipient Vessel Selection in Immediate Breast Reconstruction with Free Abdominal Tissue Transfer after Nipple-Sparing Mastectomy

Directory of Open Access Journals (Sweden)

Sung Jun Yang

2012-05-01

Full Text Available BackgroundNipple-sparing mastectomy (NSM is gaining popularity due to its superior aesthetic results. When reconstructing the breast with free abdominal tissue transfer, we must readdress the recipient vessel, because NSM can cause difficulty in access to the chest vessel.MethodsBetween June 2006 and March 2011, a total of 92 women underwent NSM with free abdominal tissue transfer. A lateral oblique incision was used for the nipple-sparing mastectomy. For recipient vessels, the internal mammary vessels were chosen if the mastectomy flap did not block access to the vessels. If it did, the thoracodorsal vessels were used. Age, degree of breast ptosis, weight of the mastectomy specimen, and related complications of the internal mammary vessel group and the thoracodorsal vessel group were compared.ResultsThoracodorsal vessels were used as recipient vessels in 59 cases, and internal mammary vessels in 33 cases including 4 cases with perforators of the internal mammary vessels. Breast reconstruction was successful in all cases except one case involving a total flap failure, which was replaced by a silicone gel implant. The internal mammary group and the thoracodorsal group were similar in terms of age, height, breast weight, and degree of ptosis. The flap related complications such as flap loss and take-back operation rates were not significantly different between the two groups. The rate of nipple necrosis was higher in the internal mammary group.ConclusionsThe thoracodorsal vessels could produce comparable outcomes in breast reconstruction after nipple-sparing mastectomies. If access to internal mammary vessels is difficult, the thoracodorsal vessel can be a better choice.

Perbaikan Pengelolaan Pergudangan Melalui Penerapan Sistem Informasi Pergudangan di CV. ABB

Directory of Open Access Journals (Sweden)

Hery Hamdi Azwir

2017-05-01

Full Text Available Warehousing management problems that exist in the CV. ABB is the management of warehouses that are susceptible to manipulation of data, methods of work are still very manual such as recording a spare part only handwritten by the warehouse, frequent loss of spare parts in the warehouse, the bon false, and the lack of supervision instruments for oversee the spare parts in the warehouse. To overcome these problems, then made improvements through the implementation of warehouse management information system. Improvements in the form of procurement supervision instruments using the application PHP7 and MySQL, because the existence of the application makes it easy to keep an eye on spare parts in the warehouse, ranging from spare part comes in, spare part out, anyone who requests a part, stock of spare parts of existing in the warehouse, stock outs are used to help finance the manufacture purchase order, reports the spare parts that go into the warehouse of the supplier and request a report part. Not only is it a system of warehousing information can facilitate in making purchase order finance and carry out the approval of the request part of the user. Thus the system becomes more transparent.

Preoperative Decision Making for Nephron-Sparing Procedure in the Renal Mass: Time for Using Standard Tools?

NARCIS (Netherlands)

Zondervan, Patricia J.; van Lienden, Krijn P.; van Delden, Otto M.; de La Rosette, Jean J. M. C. H.; Laguna, M. Pilar

2016-01-01

To determine if the application of using standard tools on tumor complexity and comorbidity indexes may replace the traditional choice of nephron-sparing procedure (NSP) based on clinical maximal tumor diameter (cMTD), age, and comorbidity. Anatomic complexity scores (PADUA and RENAL) and Charlson

Preventive sparing of spinal cord and brain stem in the initial irradiation of locally advanced head and neck cancers.

Science.gov (United States)

Farace, Paolo; Piras, Sara; Porru, Sergio; Massazza, Federica; Fadda, Giuseppina; Solla, Ignazio; Piras, Denise; Deidda, Maria Assunta; Amichetti, Maurizio; Possanzini, Marco

2014-01-06

Since reirradiation in recurrent head and neck patients is limited by previous treatment, a marked reduction of maximum doses to spinal cord and brain stem was investigated in the initial irradiation of stage III/IV head and neck cancers. Eighteen patients were planned by simultaneous integrated boost, prescribing 69.3 Gy to PTV1 and 56.1 Gy to PTV2. Nine 6 MV coplanar photon beams at equispaced gantry angles were chosen for each patient. Step-and-shoot IMRT was calculated by direct machine parameter optimization, with the maximum number of segments limited to 80. In the standard plan, optimization considered organs at risk (OAR), dose conformity, maximum dose < 45 Gy to spinal cord and < 50 Gy to brain stem. In the sparing plans, a marked reduction to spinal cord and brain stem were investigated, with/without changes in dose conformity. In the sparing plans, the maximum doses to spinal cord and brain stem were reduced from the initial values (43.5 ± 2.2 Gy and 36.7 ± 14.0 Gy), without significant changes on the other OARs. A marked difference (-15.9 ± 1.9 Gy and -10.1 ± 5.7 Gy) was obtained at the expense of a small difference (-1.3% ± 0.9%) from initial PTV195% coverage (96.6% ± 0.9%). Similar difference (-15.7 ± 2.2 Gy and -10.2 ± 6.1 Gy) was obtained compromising dose conformity, but unaffecting PTV195% and with negligible decrease in PTV295% (-0.3% ± 0.3% from the initial 98.3% ± 0.8%). A marked spinal cord and brain stem preventive sparing was feasible at the expense of a decrease in dose conformity or slightly compromising target coverage. A sparing should be recommended in highly recurrent tumors, to make potential reirradiation safer.

Joint optimization of LORA and spares stocks considering corrective maintenance time

Institute of Scientific and Technical Information of China (English)

Linhan Guo; Jiujiu Fan; Meilin Wen; Rui Kang

2015-01-01

Level of repair analysis (LORA) is an important method of maintenance decision for establishing systems of operation and maintenance in the equipment development period. Currently, the research on equipment of repair level focuses on economic analy-sis models which are used to optimize costs and rarely considers the maintenance time required by the implementation of the main-tenance program. In fact, as to the system requiring high mission complete success, the maintenance time is an important factor which has a great influence on the availability of equipment sys-tems. Considering the relationship between the maintenance time and the spares stocks level, it is obvious that there are contra-dictions between the maintenance time and the cost. In order to balance these two factors, it is necessary to build an optimization LORA model. To this end, the maintenance time representing per-formance characteristic is introduced, and on the basis of spares stocks which is traditional y regarded as a decision variable, a de-cision variable of repair level is added, and a multi-echelon multi-indenture (MEMI) optimization LORA model is built which takes the best cost-effectiveness ratio as the criterion, the expected num-ber of backorder (EBO) as the objective function and the cost as the constraint. Besides, the paper designs a convex programming algorithm of multi-variable for the optimization model, provides solutions to the non-convex objective function and methods for improving the efficiency of the algorithm. The method provided in this paper is proved to be credible and effective according to the numerical example and the simulation result.

Skin-Tissue-sparing Excision with Electrosurgical Peeling (STEEP): a surgical treatment option for severe hidradenitis suppurativa Hurley stage II/III.

Science.gov (United States)

Blok, J L; Spoo, J R; Leeman, F W J; Jonkman, M F; Horváth, B

2015-02-01

Surgery is the only curative treatment for removal of the persistent sinus tracts in the skin that are characteristic of severe hidradenitis suppurativa (HS). Complete resection of the affected tissue by wide excision is currently regarded as the preferred surgical technique in these cases. However, relatively large amounts of healthy tissue are removed with this method and suitable skin-tissue-saving techniques aiming at creating less-extensive surgical defects are therefore needed in severe HS. We describe a skin-tissue-saving surgical technique for HS Hurley stage II-III disease: the Skin-Tissue-sparing Excision with Electrosurgical Peeling (STEEP) procedure. In contrast to wide excisions that generally reach into the deep subcutaneous fat, the fat is maximally spared with the STEEP procedure by performing successive tangential excisions of lesional tissue until the epithelialized bottom of the sinus tracts has been reached. From here, secondary intention healing can occur. In addition, fibrotic tissue is completely removed in the same manner as this also serves as a source of recurrence. This tissue-sparing technique results in low recurrence rates, high patient satisfaction with relatively short healing times and favourable cosmetic outcomes without contractures. © 2014 European Academy of Dermatology and Venereology.

Spare capacity and phenotypic flexibility in the digestive system of a migratory bird: defining the limits of animal design.

Science.gov (United States)

McWilliams, Scott R; Karasov, William H

2014-05-22

Flexible phenotypes enable animals to live in environments that change over space and time, and knowing the limits to and the required time scale for this flexibility provides insights into constraints on energy and nutrient intake, diet diversity and niche width. We quantified the level of immediate and ultimate spare capacity, and thus the extent of phenotypic flexibility, in the digestive system of a migratory bird in response to increased energy demand, and identified the digestive constraints responsible for the limits on sustained energy intake. Immediate spare capacity decreased from approximately 50% for birds acclimated to relatively benign temperatures to less than 20% as birds approached their maximum sustainable energy intake. Ultimate spare capacity enabled an increase in feeding rate of approximately 126% as measured in birds acclimated for weeks at -29°C compared with +21°C. Increased gut size and not tissue-specific differences in nutrient uptake or changes in digestive efficiency or retention time were primarily responsible for this increase in capacity with energy demand, and this change required more than 1-2 days. Thus, the pace of change in digestive organ size may often constrain energy intake and, for birds, retard the pace of their migration.

A simple lens-sparing technique to treat hypotonic maculopathy secondary to large cyclodialysis

OpenAIRE

Masayo Kimura; Tsutomu Yasukawa; Yuichiro Ogura

2018-01-01

Purpose: Hypotonic maculopathy secondary to cyclodialysis often persists and causes irreversible visual loss despite a variety of treatments proposed. The purpose of this study is to report two cases with persistent hypotonic maculopathy due to a large cyclodialysis cleft treated with a simple, lens-sparing technique of external drainage, diathermy, and suturing under the placement of an infusion cannula. Observations: Both patients had sustained blunt trauma to one eye, causing persisting hy...

Early and medium term results of the sleeve valve-sparing procedure for aortic root ectasia.

Science.gov (United States)

Gamba, Amando; Tasca, Giordano; Giannico, Floriana; Lobiati, Elisabetta; Skouse, Douglas; Galanti, Andrea; Martino, Antonello Stefano; Triggiani, Michele

2015-04-01

The aim of this retrospective study was to evaluate our experience of using a simplified aortic valve sleeve procedure to treat aortic root ectasia and aneurysms with or without aortic regurgitation. In experienced hands, 2 aortic valve-sparing procedures, ie, Yacoub and David, have yielded excellent long-term results in the treatment of aortic root aneurysms, with or without aortic regurgitation. However, these techniques are demanding and not widely used. Recently, a new and simplified valve-sparing technique, named "sleeve procedure," has been proposed, and has yielded encouraging early results. Ninety consecutive patients with aortic root aneurysms underwent sleeve procedures from October 2006 to October 2012. Follow-up data (clinical 100% complete and echocardiographic 93% complete) were acquired from our outpatient clinic or from the referring cardiologist. The mean age of the patients was 61.5 ± 12.5 years, 79% were male, 16 (18%) had a bicuspid valve, 3 had Marfan syndrome, and 2 had aortic dissection. Over a mean clinical follow-up of 34 ± 19 months, 2 patients died from noncardiac causes and 1 was reoperated on for the recurrence of aortic regurgitation. On follow-up echocardiography after a mean of 18 ± 9 months, aortic regurgitation was absent/negligible, mild or moderate in 62%, 37%, and 1% of patients, respectively, and the diameters of the annulus, Valsalva sinuses, and sinotubular junction were 27.3 + 2.2, 37.0 + 3.4, and 30.6 + 3.1 mm, respectively. Our encouraging early and medium term results suggest that the sleeve procedure is a safe and effective aortic valve-sparing technique for the treatment of aortic root ectasia and aneurysm. However, longer follow-up is needed in order to draw definitive conclusions. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Normal liver tissue sparing by intensity-modulated proton stereotactic body radiotherapy for solitary liver tumours

International Nuclear Information System (INIS)

Petersen, Joergen B. B.; Hansen, Anders T.; Lassen, Yasmin; Grau, Cai; Hoeyer, Morten; Muren, Ludvig P.

2011-01-01

Background. Stereotactic body radiotherapy (SBRT) is often the preferred treatment for the advanced liver tumours which owing to tumour distribution, size and multi-focality are out of range of surgical resection or radiofrequency ablation. However, only a minority of patients with liver tumours may be candidates for conventional SBRT because of the limited radiation tolerance of normal liver, intestine and other normal tissues. Due to the favourable depth-dose characteristics of protons, intensity-modulated proton therapy (IMPT) may be a superior alternative to photon-based SBRT. The purpose of this treatment planning study was therefore to investigate the potential sparing of normal liver by IMPT compared to photon-based intensity-modulated radiotherapy (IMRT) for solitary liver tumours. Material and methods. Ten patients with solitary liver metastasis treated at our institution with multi-field SBRT were retrospectively re-planned with IMRT and proton pencil beam scanning techniques. For the proton plans, two to three coplanar fields were used in contrast to five to six coplanar and non-coplanar photon fields. The same planning objectives were used for both techniques. A risk adapted dose prescription to the PTV surface of 12.5-16.75 Gy x 3 was used. Results. The spared liver volume for IMPT was higher compared to IMRT in all 10 patients. At the highest prescription dose level, the median liver volume receiving less than 15 Gy was 1411 cm 3 for IMPT and 955 cm 3 for IMRT (p D 15 Gy > 700 cm 3 constraint. For the D mean = 15 Gy constraint, nine of 10 cases could be treated at the highest dose level using IMPT whereas with IMRT, only two cases met this constraint at the highest dose level and six at the lowest dose level. Conclusion. A considerable sparing of normal liver tissue can be obtained using proton-based SBRT for solitary liver tumours

The STAPL pList

KAUST Repository

Tanase, Gabriel

2010-01-01

We present the design and implementation of the stapl pList, a parallel container that has the properties of a sequential list, but allows for scalable concurrent access when used in a parallel program. The Standard Template Adaptive Parallel Library (stapl) is a parallel programming library that extends C++ with support for parallelism. stapl provides a collection of distributed data structures (pContainers) and parallel algorithms (pAlgorithms) and a generic methodology for extending them to provide customized functionality. stapl pContainers are thread-safe, concurrent objects, providing appropriate interfaces (e.g., views) that can be used by generic pAlgorithms. The pList provides stl equivalent methods, such as insert, erase, and splice, additional methods such as split, and efficient asynchronous (non-blocking) variants of some methods for improved parallel performance. We evaluate the performance of the stapl pList on an IBM Power 5 cluster and on a CRAY XT4 massively parallel processing system. Although lists are generally not considered good data structures for parallel processing, we show that pList methods and pAlgorithms (p-generate and p-partial-sum) operating on pLists provide good scalability on more than 103 processors and that pList compares favorably with other dynamic data structures such as the pVector. © 2010 Springer-Verlag.

Skin sparing mastectomy: Technique and suggested methods of reconstruction

International Nuclear Information System (INIS)

Farahat, A.M.; Hashim, T.; Soliman, H.O.; Manie, T.M.; Soliman, O.M.

2014-01-01

To demonstrate the feasibility and accessibility of performing adequate mastectomy to extirpate the breast tissue, along with en-block formal axillary dissection performed from within the same incision. We also compared different methods of immediate breast reconstruction used to fill the skin envelope to achieve the best aesthetic results. Methods: 38 patients with breast cancer underwent skin-sparing mastectomy with formal axillary clearance, through a circum-areolar incision. Immediate breast reconstruction was performed using different techniques to fill in the skin envelope. Two reconstruction groups were assigned; group 1: Autologus tissue transfer only (n= 24), and group 2: implant augmentation (n= 14). Autologus tissue transfer: The techniques used included filling in the skin envelope using Extended Latissimus Dorsi flap (18 patients) and Pedicled TRAM flap (6 patients). Augmentation with implants: Subpectoral implants(4 patients), a rounded implant placed under the pectoralis major muscle to augment an LD reconstructed breast. LD pocket (10 patients), an anatomical implant placed over the pectoralis major muscle within a pocket created by the LD flap. No contra-lateral procedure was performed in any of the cases to achieve symmetry. Results: All cases underwent adequate excision of the breast tissue along with en-block complete axillary clearance (when indicated), without the need for an additional axillary incision. Eighteen patients underwent reconstruction using extended LD flaps only, six had TRAM flaps, four had augmentation using implants placed below the pectoralis muscle along with LD flaps, and ten had implants placed within the LD pocket. Breast shape, volume and contour were successfully restored in all patients. Adequate degree of ptosis was achieved, to ensure maximal symmetry. Conclusions: Skin Sparing mastectomy through a circum-areolar incision has proven to be a safe and feasible option for the management of breast cancer in Egyptian

SU-F-J-122: Rectal Sparing Reproducibility in Prostate Cancer Patients Treated with Hydrogel Spacer and Proton Therapy

Energy Technology Data Exchange (ETDEWEB)

Hedrick, S; Robison, B; Blakey, M; Artz, M; Renegar, J; Schreuder, A; Fagundes, M [Provision Center for Proton Therapy, Knoxville, TN (United States); Case, S [Vanderbilt University, Nashville, TN (United States)

2016-06-15

Purpose: Rectal hydrogel spacer has been shown to improve rectal sparing in prostate radiotherapy. The purpose of this study was to determine the reproducibility of rectal sparing throughout treatment in patients undergoing proton therapy. Methods: At our facility, prostate cancer patients are treated with pencil beam scanning proton therapy, utilizing an endorectal balloon (ERB) or rectal spacer hydrogel (Gel) “SpaceOAR” implant. All patients were treated with a full bladder and empty rectum (low residue diet and stool softeners). A quality assurance CT (QACT) was performed periodically throughout treatment to ensure rectal filling consistency and sparing in 41 patients treated with Gel. The treatment planning (TP) dose was calculated on each QACT and the rectum V90%, V75%, V65%, V50%, and V40% were recorded. QACT scans were acquired on day 0, week 1, week 3, and week 5. Results: 144 QACT scans were analyzed, each patient receiving 3–4 QACTs. Rectum V90% was within +/−1% of the TP dose in 70% of the QACTs and within +/−5% in 95% of scans. From previous data analyses, our ERB rectum V90% average is 6%. This value was used as an upper threshold for the Gel QACT analysis. 5 of the 41 patients (12%), corresponding to 7 QACTs, had a rectum V90% that exceeded 6% on one or more QACTs. However, the average rectal V90% measured over multiple QACTs never exceeded 6%. 55% of the QACTs had a rectum volume within 5cc of the TPCT volume, 68% were within 10cc. Conclusion: In this study, we have shown that a majority of our prostate patients can maintain consistent rectal sparing when treated with a hydrogel spacer. QACT rectal V90% exceeding our threshold was most often related to increased rectal filling and gas, which was addressed with improved dietary compliance and the intensification of stool softeners or laxatives.

SU-F-J-122: Rectal Sparing Reproducibility in Prostate Cancer Patients Treated with Hydrogel Spacer and Proton Therapy

International Nuclear Information System (INIS)

Hedrick, S; Robison, B; Blakey, M; Artz, M; Renegar, J; Schreuder, A; Fagundes, M; Case, S

2016-01-01

Purpose: Rectal hydrogel spacer has been shown to improve rectal sparing in prostate radiotherapy. The purpose of this study was to determine the reproducibility of rectal sparing throughout treatment in patients undergoing proton therapy. Methods: At our facility, prostate cancer patients are treated with pencil beam scanning proton therapy, utilizing an endorectal balloon (ERB) or rectal spacer hydrogel (Gel) “SpaceOAR” implant. All patients were treated with a full bladder and empty rectum (low residue diet and stool softeners). A quality assurance CT (QACT) was performed periodically throughout treatment to ensure rectal filling consistency and sparing in 41 patients treated with Gel. The treatment planning (TP) dose was calculated on each QACT and the rectum V90%, V75%, V65%, V50%, and V40% were recorded. QACT scans were acquired on day 0, week 1, week 3, and week 5. Results: 144 QACT scans were analyzed, each patient receiving 3–4 QACTs. Rectum V90% was within +/−1% of the TP dose in 70% of the QACTs and within +/−5% in 95% of scans. From previous data analyses, our ERB rectum V90% average is 6%. This value was used as an upper threshold for the Gel QACT analysis. 5 of the 41 patients (12%), corresponding to 7 QACTs, had a rectum V90% that exceeded 6% on one or more QACTs. However, the average rectal V90% measured over multiple QACTs never exceeded 6%. 55% of the QACTs had a rectum volume within 5cc of the TPCT volume, 68% were within 10cc. Conclusion: In this study, we have shown that a majority of our prostate patients can maintain consistent rectal sparing when treated with a hydrogel spacer. QACT rectal V90% exceeding our threshold was most often related to increased rectal filling and gas, which was addressed with improved dietary compliance and the intensification of stool softeners or laxatives.

Long-term results after aortic valve-sparing operation (David I).

Science.gov (United States)

Shrestha, Malakh; Baraki, Hassina; Maeding, Ilona; Fitzner, Sebastian; Sarikouch, Samir; Khaladj, Nawid; Hagl, Christian; Haverich, Axel

2012-01-01

Aortic valve-sparing David procedure has gained broad acceptance. However, few long-term results have been published. We present our results. More than 450 David procedures have been performed in our institution so far. Of these, 126 patients were operated between July 1993 and December 2000. Median age was 57 (8-83) years and 46 (36.5%) were female. As many as 26 (20.6%) had Marfan syndrome, 21 (16.7%) had acute aortic dissection type A (AADA) and 67 (53.2%) had additional procedures. There were six (4.8%) deaths in 30 post-operative period (POD), four of whom had AADA. In the follow-up, there were 32 (25.4%) late deaths, 11 (34.4%) of these were caused by cardiac or underlying disease or op-related. As many as 15 (11.9%) patients were re-operated; six (40%) were Marfan patients and two (13.3%) had early endocarditis. Follow-up echocardiography of 76 (60.3%) event-free patients showed valve insufficiency (AI)≤AI I° in 68 (89.5%) and grade II in 7 (9.2%) patients. Leaflet degeneration due to proposed leaflet contact with the straight Dacron graft was not observed. A total of 36 (47.4%) patients were in New York Heart Association (NYHA) class I, 33 (43.4%) in NYHA II, and five (6.6%) were in class III. During the entire follow-up of 790 patient-years, there was no stroke or major bleeding. Survival at 1, 5 and 10 years was 93%, 85% and 70%, respectively. Freedom from valve replacement at 1, 5 and 10 years was 96%, 91% and 87%, respectively. Regardless of the underlying pathology, valve-sparing David I procedure has acceptable long-term results. Valve-related complications such as stroke or major bleeding is exceedingly low.

Ocean thermal energy conversion power system development-I. Preliminary design report. Volume 3. Appendixes D, E, and F. Phase I. Final report

Energy Technology Data Exchange (ETDEWEB)

1978-12-18

The conceptual design of a 40 to 50 MW closed cycle ammonia OTEC commercial plant, the preliminary design of a 10 MW OTEC module analogous to the 50 MW module, and the preliminary design of heat exchanger test articles (evaporator and condenser) representative of the 50 MW heat exchangers for testing in OTEC-1 are presented. This volume includes the appendices: D) system equipment (hardware breakdown structure; 10-MW hardware listing; list of support and maintenance equipment, tools and spare parts; sacrificial anodes; M.A.N. brush; and Alclad 3004 data); E) heat exchanger supporting data (analyses/configuration, contract tooling, manufacturing plan, specification, and evaporator ammonia liquid distribution system); and F) rotating machinery (performance characteristics, radial inflow turbine; item descriptions; weight calculation-rotor; producibility analysis; long lead-time items; spares; support equipment; non recurring costs; performance characteristics-axial flow turbine; Worthington pump data; and American M.A.N. Corporation data). Also included is attachment 1 to the phase I final report which presents details of the system modeling; design, materials considerations, and systems analysis of the baseline module; system cost analysis; and supporting data. (WHK)

COMPLETE RESOLUTION OF LARGE RETINAL FOLD AFTER TRANSECTION OF RETROLENTAL MEMBRANE DURING LENS-SPARING VITRECTOMY FOR RETINOPATHY OF PREMATURITY: A 15-YEAR FOLLOW-UP.

Science.gov (United States)

Thomas, Benjamin J; Yonekawa, Yoshihiro; Trese, Michael T

2016-01-01

To describe the long-term anatomical and visual outcomes of a patient with retinopathy of prematurity characterized by a prominent retinal fold adherent to the posterior lens capsule, treated by lens-sparing vitrectomy with surgical transection of the retrolental membrane. A premature infant was born at a gestational age of 25 weeks and birthweight of 636 g. She developed threshold retinopathy of prematurity bilaterally and was subsequently treated with laser ablative therapy. The left eye responded favorably, with regression of neovascularization; however, the right eye progressed to Stage 4A with a prominent retinal fold adherent to the posterior lens capsule. The patient underwent lens-sparing vitrectomy with dissection of the retrolental membrane at postmenstrual age of 44 weeks. At 15-year follow-up, the patient has maintained a best-corrected visual acuity of 20/60 and, of note, demonstrated complete resolution of the previous retinal fold. Surgical treatment for retinopathy of prematurity was considerably advanced by the introduction of lens-sparing vitrectomy techniques; however, cases developing retrolental membranes often persisted with poor visual outcomes, and lensectomy is conventionally performed. However, in select cases of Stage 4A retinopathy of prematurity, careful transection of retrolental membranes during lens-sparing vitrectomy using the appropriate technique may provide very good anatomical and visual outcomes.

Cannabinoid 1 receptor knockout mice display cold allodynia, but enhanced recovery from spared-nerve injury-induced mechanical hypersensitivity.

Science.gov (United States)

Sideris, Alexandra; Piskoun, Boris; Russo, Lori; Norcini, Monica; Blanck, Thomas; Recio-Pinto, Esperanza

2016-01-01

The function of the Cannabinoid 1 receptor (CB1R) in the development of neuropathic pain is not clear. Mounting evidence suggest that CB1R expression and activation may contribute to pain. Cannabinoid 1 receptor knockout mice (CB1R-/-) generated on a C57Bl/6 background exhibit hypoalgesia in the hotplate assay and formalin test. These findings suggest that Cannabinoid 1 receptor expression mediates the responses to at least some types of painful stimuli. By using this mouse line, we sought to determine if the lack of Cannabinoid 1 receptor unveils a general hypoalgesic phenotype, including protection against the development of neuropathic pain. The acetone test was used to measure cold sensitivity, the electronic von Frey was used to measure mechanical thresholds before and after spared-nerve injury, and analysis of footprint patterns was conducted to determine if motor function is differentially affected after nerve-injury in mice with varying levels of Cannabinoid 1 receptor. At baseline, CB1R-/- mice were hypersensitive in the acetone test, and this phenotype was maintained after spared-nerve injury. Using calcium imaging of lumbar dorsal root ganglion (DRG) cultures, a higher percentage of neurons isolated from CB1R-/- mice were menthol sensitive relative to DRG isolated from wild-type (CB1R+/+) mice. Baseline mechanical thresholds did not differ among genotypes, and mechanical hypersensitivity developed similarly in the first two weeks following spared-nerve injury (SNI). At two weeks post-SNI, CB1R-/- mice recovered significantly from mechanical hypersensitivity, while the CB1R+/+ mice did not. Heterozygous knockouts (CB1R+/-) transiently developed cold allodynia only after injury, but recovered mechanical thresholds to a similar extent as the CB1R-/- mice. Sciatic functional indices, which reflect overall nerve health, and alternation coefficients, which indicate uniformity of strides, were not significantly different among genotypes. Cold allodynia and

Programming list processes. SLIP: symmetric list processor - applications

International Nuclear Information System (INIS)

Broudin, Y.

1966-06-01

Modern aspects of programming languages are essentially turned towards list processing. The ordinary methods of sequential treatment become inadequate and we must substitute list processes for them, where the cells of a group have no neighbourhood connection, but where the address of one cell is contained in the preceding one. These methods are required in 'time sharing' solving problems. They also allow us to treat new problems and to solve others in the shortest time. Many examples are presented after an abstract of the most usual list languages and a detailed study of one of them : SLIP. Among these examples one should note: locating of words in a dictionary or in a card index, treatment of non numerical symbols, formal derivation. The problems are treated in Fortran II on an IBM 7094 machine. The subroutines which make up the language are presented in an appendix. (author) [fr

Prognostic factors in invasive bladder carcinoma treated by combined modality protocol (organ-sparing approach)

International Nuclear Information System (INIS)

Matos, Tadeja; Cufer, Tanja; Cervek, Jozica; Borstnar, Simona; Kragelj, Borut; Zumer-Pregelj, Mirjana

2000-01-01

Purpose: The results of bladder sparing approach for the treatment of muscle-invasive bladder cancer, using a combination of transurethral resection (TUR), chemotherapy, and radiotherapy, are encouraging. The survival of patients treated by this method is similar to the survival of patients treated by radical cystectomy. The aim of our study was to find out which pretreatment characteristics influence the survival of patients treated by organ sparing approach that would enable us to identify the patients most suitable for this type of treatment. Methods and Materials: The prognostic value of different factors, such as age, gender, performance status, hemoglobin level, clinical stage, histologic grade, presence of obstructive uropathy, and completeness of TUR, has been studied in 105 patients with invasive bladder cancer, who received a bladder sparing treatment in the period from 1988 to 1995. They were treated with a combination of TUR, followed by 2-4 cycles of methotrexate, cisplatinum, and vinblastine polychemotherapy. In complete responders the treatment was completed by radiotherapy (50 Gy to the bladder and 40 Gy to the regional lymph nodes), whereas nonresponders underwent cystectomy whenever feasible. Results: Our study has confirmed an independent prognostic value of performance status, histologic grade, and obstructive uropathy, for the disease-specific survival (DSS) of bladder cancer patients treated by a conservative approach. We believe that performance status best reflects the extent of disease and exerts significant influence on the extent and course of treatment, while obstructive uropathy is a good indicator of local spread of the disease, better than clinical T-stage. Our finding that histologic grade is one of the strongest prognostic factors shows that tumor biology also is a very important prognostic factor in patients treated by conservative approach. Conclusion: Patients with muscle-invasive bladder cancer who are most likely to benefit

78 FR 31417 - National Priorities List, Final Rule No. 56

Science.gov (United States)

2013-05-24

... would be time-consuming or costly. In other cases, data for scoring some pathways are available, but... NPL as they are cleaned up? I. What is the Construction Completion List (CCL)? J. What is the sitewide... partly in response to CERCLA section 105(c), added by SARA. The revised HRS evaluates four pathways...

Technique for sparing previously irradiated critical normal structures in salvage proton craniospinal irradiation

International Nuclear Information System (INIS)

McDonald, Mark W; Wolanski, Mark R; Simmons, Joseph W; Buchsbaum, Jeffrey C

2013-01-01

Cranial reirradiation is clinically appropriate in some cases but cumulative radiation dose to critical normal structures remains a practical concern. The authors developed a simple technique in 3D conformal proton craniospinal irradiation (CSI) to block organs at risk (OAR) while minimizing underdosing of adjacent target brain tissue. Two clinical cases illustrate the use of proton therapy to provide salvage CSI when a previously irradiated OAR required sparing from additional radiation dose. The prior radiation plan was coregistered to the treatment planning CT to create a planning organ at risk volume (PRV) around the OAR. Right and left lateral cranial whole brain proton apertures were created with a small block over the PRV. Then right and left lateral “inverse apertures” were generated, creating an aperture opening in the shape of the area previously blocked and blocking the area previously open. The inverse aperture opening was made one millimeter smaller than the original block to minimize the risk of dose overlap. The inverse apertures were used to irradiate the target volume lateral to the PRV, selecting a proton beam range to abut the 50% isodose line against either lateral edge of the PRV. Together, the 4 cranial proton fields created a region of complete dose avoidance around the OAR. Comparative photon treatment plans were generated with opposed lateral X-ray fields with custom blocks and coplanar intensity modulated radiation therapy optimized to avoid the PRV. Cumulative dose volume histograms were evaluated. Treatment plans were developed and successfully implemented to provide sparing of previously irradiated critical normal structures while treating target brain lateral to these structures. The absence of dose overlapping during irradiation through the inverse apertures was confirmed by film. Compared to the lateral X-ray and IMRT treatment plans, the proton CSI technique improved coverage of target brain tissue while providing the least

CRNL library serials list

International Nuclear Information System (INIS)

Alburger, T.P.

1982-04-01

A list of 1900 serial publications (periodicals, society transactions and proceedings, annuals and directories, indexes, newspapers, etc.) is presented with volumes and years held by the Main Library. This library is the largest in AECL as well as one of the largest scientific and technical libraries in North America, and functions as a Canadian resource for nuclear information. A main alphabetical list is followed by broad subject field lists representing research interests, and lists of abstract and index serials, general bibliographic serials, conference indexes, press releases, English translations, and original language journals

Fifty Psychological and Psychiatric Terms to Avoid: A List of Inaccurate, Misleading, Misused, Ambiguous, and Logically Confused Words and Phrases

Directory of Open Access Journals (Sweden)

Scott O Lilienfeld

2015-08-01

Full Text Available The goal of this article is to promote clear thinking and clear writing among students and teachers of psychological science by curbing terminological misinformation and confusion. To this end, we present a provisional list of 50 commonly used terms in psychology, psychiatry, and allied fields that should be avoided, or at most used sparingly and with explicit caveats. We provide corrective information for students, instructors, and researchers regarding these terms, which we organize for expository purposes into five categories: inaccurate or misleading terms, frequently misused terms, ambiguous terms, oxymorons, and pleonasms. For each term, we (a explain why it is problematic, (b delineate one or more examples of its misuse, and (c when pertinent, offer recommendations for preferable terms. By being more judicious in their use of terminology, psychologists and psychiatrists can foster clearer thinking in their students and the field at large regarding mental phenomena.

Fifty psychological and psychiatric terms to avoid: a list of inaccurate, misleading, misused, ambiguous, and logically confused words and phrases.

Science.gov (United States)

Lilienfeld, Scott O; Sauvigné, Katheryn C; Lynn, Steven Jay; Cautin, Robin L; Latzman, Robert D; Waldman, Irwin D

2015-01-01

The goal of this article is to promote clear thinking and clear writing among students and teachers of psychological science by curbing terminological misinformation and confusion. To this end, we present a provisional list of 50 commonly used terms in psychology, psychiatry, and allied fields that should be avoided, or at most used sparingly and with explicit caveats. We provide corrective information for students, instructors, and researchers regarding these terms, which we organize for expository purposes into five categories: inaccurate or misleading terms, frequently misused terms, ambiguous terms, oxymorons, and pleonasms. For each term, we (a) explain why it is problematic, (b) delineate one or more examples of its misuse, and (c) when pertinent, offer recommendations for preferable terms. By being more judicious in their use of terminology, psychologists and psychiatrists can foster clearer thinking in their students and the field at large regarding mental phenomena.

Acronym master list

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-06-01

This document is a master list of acronyms and other abbreviations that are used by or could be useful to, the personnel at Los Alamos National Laboratory. Many specialized and well-known abbreviations are not included in this list.

Surgery of the aortic root: should we go for the valve-sparing root reconstruction or the composite graft-valve replacement is still the first choice of treatment for these patients?

Science.gov (United States)

Lamana, Fernando de Azevedo; Dias, Ricardo Ribeiro; Duncan, Jose Augusto; Faria, Leandro Batisti de; Malbouisson, Luiz Marcelo Sa; Borges, Luciano de Figueiredo; Mady, Charles; Jatene, Fábio Biscegli

2015-01-01

To compare the results of the root reconstruction with the aortic valve-sparing operation versus composite graft-valve replacement. From January 2002 to October 2013, 324 patients underwent aortic root reconstruction. They were 263 composite graft-valve replacement and 61 aortic valve-sparing operation (43 reimplantation and 18 remodeling). Twenty-six percent of the patients were NYHA functional class III and IV; 9.6% had Marfan syndrome, and 12% had bicuspid aortic valve. There was a predominance of aneurysms over dissections (81% vs. 19%), with 7% being acute dissections. The complete follow-up of 100% of the patients was performed with median follow-up time of 902 days for patients undergoing composite graft-valve replacement and 1492 for those undergoing aortic valve-sparing operation. In-hospital mortality was 6.7% and 4.9%, respectively for composite graft-valve replacement and aortic valve-sparing operation (ns). During the late follow-up period, there was 0% moderate and 15.4% severe aortic regurgitation, and NYHA functional class I and II were 89.4% and 94%, respectively for composite graft-valve replacement and aortic valve-sparing operation (ns). Root reconstruction with aortic valve-sparing operation showed lower late mortality (P=0.001) and lower bleeding complications (P=0.006). There was no difference for thromboembolism, endocarditis, and need of reoperation. The aortic root reconstruction with preservation of the valve should be the operation being performed for presenting lower late mortality and survival free of bleeding events.

Cleanups In My Community (CIMC) - Superfund National Priority List (NPL) Sites, National Layer

Data.gov (United States)

U.S. Environmental Protection Agency — This data layer provides access to Superfund National Priority List Sites as part of the CIMC web service. Superfund is a program administered by the EPA to locate,...

Preventative valve-sparing aortic root replacement and pregnancy outcome in Marfan syndrome.

Science.gov (United States)

Sokol, Vesna; Zlopasa, Gordan; Herman, Mislav; Planinić, Pavao; Micevska, Ana

2012-06-01

In Marfan syndrome, with dilatation of the aortic root secondary to an underlying connective tissue defect, pregnancy can cause hemodynamic stress leading to the development of an aortic aneurysm and even a fatal aortic dissection. In the presence of existing aortic root enlargement and a family history of aortic dissection, preventative elective surgery is suggested. Aortic root replacement with or without a valve-sparing procedure is superior to total aortic root replacement with prosthetic valve/tube graft. It provides excellent survival with low rates of aortic - valve related complications.

Whole-brain hippocampal sparing radiation therapy: Volume-modulated arc therapy vs intensity-modulated radiation therapy case study

Energy Technology Data Exchange (ETDEWEB)

Lee, Katrina, E-mail: Trinabena23@gmail.com; Lenards, Nishele; Holson, Janice

2016-04-01

The hippocampus is responsible for memory and cognitive function. An ongoing phase II clinical trial suggests that sparing dose to the hippocampus during whole-brain radiation therapy can help preserve a patient's neurocognitive function. Progressive research and advancements in treatment techniques have made treatment planning more sophisticated but beneficial for patients undergoing treatment. The aim of this study is to evaluate and compare hippocampal sparing whole-brain (HS-WB) radiation therapy treatment planning techniques using volume-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT). We randomly selected 3 patients to compare different treatment techniques that could be used for reducing dose to the hippocampal region. We created 2 treatment plans, a VMAT and an IMRT, from each patient's data set and planned on the Eclipse 11.0 treatment planning system (TPS). A total of 6 plans (3 IMRT and 3 VMAT) were created and evaluated for this case study. The physician contoured the hippocampus as per the Radiation Therapy Oncology Group (RTOG) 0933 protocol atlas. The organs at risk (OR) were contoured and evaluated for the plan comparison, which included the spinal cord, optic chiasm, the right and left eyes, lenses, and optic nerves. Both treatment plans produced adequate coverage on the planning target volume (PTV) while significantly reducing dose to the hippocampal region. The VMAT treatment plans produced a more homogenous dose distribution throughout the PTV while decreasing the maximum point dose to the target. However, both treatment techniques demonstrated hippocampal sparing when irradiating the whole brain.

Reimplantation valve-sparing aortic root replacement in Marfan syndrome using the Valsalva conduit: an intercontinental multicenter study.

Science.gov (United States)

Settepani, Fabrizio; Szeto, Wilson Y; Pacini, Davide; De Paulis, Ruggero; Chiariello, Luigi; Di Bartolomeo, Roberto; Gallotti, Roberto; Bavaria, Joseph E

2007-02-01

Introduced by DePaulis in 2000, the Gelweave Valsalva graft (Sulzer Vascutek, Refrewshire, Scotland) is a modified Dacron conduit (DuPont, Wilmington, DE), with prefashioned sinuses of Valsalva. The aim of this study was to evaluate the mid-term results of the reimplantation valve-sparing aortic root replacement using the Gelweave Valsalva prosthesis in Marfan syndrome patients. A retrospective review was performed of 35 patients with Marfan syndrome in four centers who underwent the reimplantation valve-sparing aortic root replacement using the Gelweave Valsalva prosthesis. The patients were predominantly men, with a mean age of 36.5 +/- 12.6 years (range, 14 to 62 years). Two patients presented with acute type A dissections and underwent emergent operations. Elective hemiarch reconstruction using hypothermic circulatory arrest was required in 11 patients. Aortic valve cusp repair was performed in 2 patients. There were no operative or hospital deaths, and no patients died during follow-up. The mean follow-up was 19 months (range, 1 to 60 months). Significant (>2+) aortic insufficiency (AI), requiring aortic valve replacement, developed in 3 patients during follow-up that requiring aortic valve replacement. The 5-year freedom from reoperation owing to structural valve deterioration was 88.9% +/- 8.1%. There were no episodes of clinically significant thromboembolism. Reimplantation valve-sparing aortic root replacement with the Gelweave Valsalva prosthesis in Marfan patients provides satisfactory mid-term results, thus encouraging further use of this type of repair. However, long-term results are needed in order to define the durability of this technique.

Whole-brain hippocampal sparing radiation therapy: Volume-modulated arc therapy vs intensity-modulated radiation therapy case study

International Nuclear Information System (INIS)

Lee, Katrina; Lenards, Nishele; Holson, Janice

2016-01-01

The hippocampus is responsible for memory and cognitive function. An ongoing phase II clinical trial suggests that sparing dose to the hippocampus during whole-brain radiation therapy can help preserve a patient's neurocognitive function. Progressive research and advancements in treatment techniques have made treatment planning more sophisticated but beneficial for patients undergoing treatment. The aim of this study is to evaluate and compare hippocampal sparing whole-brain (HS-WB) radiation therapy treatment planning techniques using volume-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT). We randomly selected 3 patients to compare different treatment techniques that could be used for reducing dose to the hippocampal region. We created 2 treatment plans, a VMAT and an IMRT, from each patient's data set and planned on the Eclipse 11.0 treatment planning system (TPS). A total of 6 plans (3 IMRT and 3 VMAT) were created and evaluated for this case study. The physician contoured the hippocampus as per the Radiation Therapy Oncology Group (RTOG) 0933 protocol atlas. The organs at risk (OR) were contoured and evaluated for the plan comparison, which included the spinal cord, optic chiasm, the right and left eyes, lenses, and optic nerves. Both treatment plans produced adequate coverage on the planning target volume (PTV) while significantly reducing dose to the hippocampal region. The VMAT treatment plans produced a more homogenous dose distribution throughout the PTV while decreasing the maximum point dose to the target. However, both treatment techniques demonstrated hippocampal sparing when irradiating the whole brain.

Stochastic model of forecasting spare parts demand

OpenAIRE

Ivan S. Milojević; Rade V. Guberinić

2012-01-01

If demand is known for the whole planning period (complete information), then this type of demand or a supply system is deterministic. In the simplest cases, the demand per time unit is constant. If demand levels change over time following a precisely determined and pre-known principle, this type of demand is also classified as deterministic. This quality of demand is very rare. In most cases demand is the product of a process, for example TMS maintenance, whose progression cannot be predicte...

Service differentiation in spare parts inventory management

NARCIS (Netherlands)

Kranenburg, A.A.; Houtum, van G.J.J.A.N.

2008-01-01

The contemporary after-sales market is of increasing importance. One of the features required by the market is to provide differentiated service levels to different groups of customers. We use critical levels as a means to offer differentiation. Critical level policies aim to exploit the differences

Cost Allocation and Overpricing of Spare Parts.

Science.gov (United States)

1986-09-01

traditional cost allocation process as reported in accounting literature. Horngren reported there are essen- tially three facets of cost allocation as...is for more than one unit of a product. Horngren reports cost accounting systems commonly have two major cost objectives: departments and products (8...Standards Board: Standards, Rules, and Regulations. Washington: Government Printing Office, 1985. 8. Horngren , Charles T. Cost Accounting : A Managerial

ExoMol molecular line lists - XXVI: spectra of SH and NS

Science.gov (United States)

Yurchenko, Sergei N.; Bond, Wesley; Gorman, Maire N.; Lodi, Lorenzo; McKemmish, Laura K.; Nunn, William; Shah, Rohan; Tennyson, Jonathan

2018-07-01

Line lists for the sulphur-containing molecules SH (the mercapto radical) and NS are computed as part of the ExoMol project. These line lists consider transitions within the X2Π ground state for 32SH, 33SH, 34SH,36SH and, 32SD, and 14N32S, 14N33S, 14N34S, 14N36S, and 15N32S. Ab initio potential energy (PEC) and spin-orbit coupling (SOC) curves are computed and then improved by fitting to experimentally observed transitions. Fully ab initio dipole moment curves (DMCs) computed at high level of theory are used to produce the final line lists. For SH, our fit gives a root-mean-square (rms) error of 0.03 cm-1 between the observed (vmax = 4, Jmax = 34.5) and calculated transitions wavenumbers; this is extrapolated such that all X2Π rotational-vibrational-electronic (rovibronic) bound states are considered. For 32SH the resulting line list contains about 81 000 transitions and 2300 rovibronic states, considering levels up to vmax = 14 and Jmax = 60.5. For NS the refinement used a combination of experimentally determined frequencies and energy levels and led to an rms-fitting error of 0.002 cm-1. Each NS-calculated line list includes around 2.8 million transitions and 31 000 rovibronic states with a vibrational range up to v = 53 and rotational range up to J = 235.5, which covers up to 23 000 cm-1. Both line lists should be complete for temperatures up to 5000 K. Example spectra simulated using this line list are shown and comparisons made to the existing data in the CDMS data base. The line lists are available from the CDS (http://cdsarc.u-strasbg.fr) and ExoMol (www.exomol.com) data bases.

ExoMol molecular line lists - XXVI: spectra of SH and NS

Science.gov (United States)

Yurchenko, Sergei N.; Bond, Wesley; Gorman, Maire N.; Lodi, Lorenzo; McKemmish, Laura K.; Nunn, William; Shah, Rohan; Tennyson, Jonathan

2018-04-01

Line lists for the sulphur-containing molecules SH (the mercapto radical) and NS are computed as part of the ExoMol project. These line lists consider transitions within the X 2Π ground state for 32SH, 33SH, 34SH and 32SD, and 14N32S, 14N33S, 14N34S, 14N36S and 15N32S. Ab initio potential energy (PEC) and spin-orbit coupling (SOC) curves are computed and then improved by fitting to experimentally observed transitions. Fully ab initio dipole moment curves (DMCs) computed at high level of theory are used to produce the final line lists. For SH, our fit gives a root-mean-square (rms) error of 0.03 cm-1 between the observed (vmax = 4, Jmax = 34.5) and calculated transitions wavenumbers; this is extrapolated such that all X 2Π rotational-vibrational-electronic (rovibronic) bound states are considered. For 32SH the resulting line list contains about 81 000 transitions and 2 300 rovibronic states, considering levels up to vmax = 14 and Jmax = 60.5. For NS the refinement used a combination of experimentally determined frequencies and energy levels and led to an rms fitting error of 0.002 cm-1. Each NS calculated line list includes around 2.8 million transitions and 31 000 rovibronic states with a vibrational range up to v = 53 and rotational range to J = 235.5, which covers up to 23 000 cm-1. Both line lists should be complete for temperatures up to 5000 K. Example spectra simulated using this line list are shown and comparisons made to the existing data in the CDMS database. The line lists are available from the CDS (http://cdsarc.u-strasbg.fr) and ExoMol (www.exomol.com) data bases.

Anal wall sparing effect of an endorectal balloon in 3D conformal and intensity-modulated prostate radiotherapy.

NARCIS (Netherlands)

Smeenk, R.J.; Lin, E.N.J.T. van; Kollenburg, P. van; Kunze-Busch, M.C.; Kaanders, J.H.A.M.

2009-01-01

BACKGROUND AND PURPOSE: To investigate the anal wall (Awall) sparing effect of an endorectal balloon (ERB) in 3D conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) for prostate cancer. MATERIALS AND METHODS: In 24 patients with localized prostate carcinoma, two planning

Retzus-sparing robotic-assisted laparoscopic radical prostatectomy: a step–by-step technique description of this first brazilian experience

Directory of Open Access Journals (Sweden)

Marcos Tobias-Machado

Full Text Available Abstract Introduction: Retzus-sparing robotic-assisted radical prostatectomy(RARP is a newly approach that preserve the Retzus structures and provide better recovery of continence and erectile function. In Brazil, this approach has not yet been previously reported. Objective: Our goal is to describe Step-by-Step the Retzus-sparing RARP surgical technique and report our first Brazilian experience. Methods: We present a case of a 60-year-old white man with low risk prostate cancer. Surgical materials were four arms Da Vinci robotic platform system, six transperitoneal portals, two prolene wires and Polymer Clips. This surgical technique was step-by-step described according to Galfano et al. One additional step was added as a modification of Galfano et al. Primary technique description: The closure of the Denovellier fascia. Results: We have operated one patient with this technique. The operative time was 180minutes, console time was135 min, the blood loss was 150ml, none perioperative or postoperative complications was found, hospital stay of 01 day. The anatomopathological classification revealed a pT2aN0M0 specimen with free surgical margins. The patient achieved continence immediately after bladder stent retrieval. Full erection reported after 30 days of surgery. Conclusion: Retzus-sparing RARP approach is feasible and reproducible. However, further comparative studies are necessary to demonstrate potential benefits in continence and sexual outcomes over the standard approaches.

Prophylactic Nipple-Sparing Mastectomy and Direct-to-Implant Reconstruction of the Large and Ptotic Breast: Is Preshaping of the Challenging Breast a Key to Success?

Science.gov (United States)

Gunnarsson, Gudjon L; Bille, Camilla; Reitsma, Laurens C; Wamberg, Peter; Thomsen, Jørn Bo

2017-09-01

Nipple-sparing mastectomy with simultaneous hammock technique direct-to-implant reconstruction is increasingly offered to patients opting for risk-reducing mastectomy. Despite this promising method, patients with macromastia and ptotic breasts remain a challenging group to treat satisfactorily and more often end up undergoing a difficult corrective procedure and experience an unacceptably high rate of failed reconstruction. The authors examined whether targeted preshaping mastopexy/reduction could prepare these patients for a successful nipple-sparing mastectomy/direct-to-implant reconstruction. Patients seeking risk-reducing nipple-sparing mastectomy/direct-to-implant reconstruction at the authors' institutions deemed unfit for a one-stage procedure based on their previous experience were offered a targeted two-stage, risk-reducing mastopexy/reduction followed by a delayed secondary nipple-sparing mastectomy and direct-to-implant reconstruction. Patients were followed up at 3 weeks and 6 or 12 months. Forty-four reconstructions were performed in 22 patients aged 43 years (range, 26 to 57 years). All 44 procedures were completed successfully without any failure or nipple-areola complex losses. Patients' median body mass index was 30 kg/m (range, 22 to 44 kg/m). Six patients were smokers and one had hypertension. Two patients underwent reoperation because of hematoma and fat necrosis. The authors' results demonstrate that a targeted preshaping mastopexy/reduction followed by nipple-sparing mastectomy/direct-to-implant reconstruction can be safely planned in women who opt for a risk-reducing mastectomy and can be performed successfully with a 3- to 4-month time span between operations. On the basis of these results and the superior cosmetic outcome, the two-stage approach has become the authors' standard of care in all such settings. Therapeutic, IV.

Spared pre-irradiated area in pustular lesions induced by icotinib showing decreased expressions of CD1a+ langerhans cells and FGFR2

International Nuclear Information System (INIS)

Zhao Qiong; Wang Yi Na; Wang Bo

2013-01-01

Icotinib hydrochloride, a novel inhibitor of epidermal growth factor receptor tyrosine kinase, has been approved by the State Food and Drug Administration for the treatment of advanced non-small-cell lung cancer. Up to date, cutaneous response to icotinib is largely unknown. Here we report an uncommon lesional phenomenon in a 56-year-old Chinese male with non-small-cell lung cancer, who received icotinib as a second-line treatment. Characteristic papulopustular rash on the chest and back was observed 4 days later. Interestingly, the rash completely spares a pre-irradiated area. The immunohistochemical study in the lesional skin area and spared skin area revealed a significant decrease in CD1a + Langerhans cells, Ki-67 as well as FGFR2 in the spared area than in the lesional area. Thus, the present case indicated that loss of the basal layer of proliferative cells and antigen-presenting cells (Langerhans cell), as well as the down-regulation of FGFR2 signaling in the pre-irradiated skin area, may join forces in inhibiting icotinib-associated cutaneous reactions. To our knowledge, this is the first report of both lesional area and lesion-spared area in a Chinese male receiving treatment with a new epidermal growth factor receptor-tyrosine kinase inhibitor (icotinib). The immunohistochemical reactions described here also provide new insight into the pathogenesis of epidermal growth factor receptor-tyrosine kinase inhibitor-related skin toxicities, and the role that other tyrosine kinase receptors (including FGFR) played in non-small-cell lung cancer. (author)

Spared pre-irradiated area in pustular lesions induced by icotinib showing decreased expressions of CD1a+ langerhans cells and FGFR2.

Science.gov (United States)

Zhao, Qiong; Wang, Yi Na; Wang, Bo

2013-02-01

Icotinib hydrochloride, a novel inhibitor of epidermal growth factor receptor tyrosine kinase, has been approved by the State Food and Drug Administration for the treatment of advanced non-small-cell lung cancer. Up to date, cutaneous response to icotinib is largely unknown. Here we report an uncommon lesional phenomenon in a 56-year-old Chinese male with non-small-cell lung cancer, who received icotinib as a second-line treatment. Characteristic papulopustular rash on the chest and back was observed 4 days later. Interestingly, the rash completely spares a pre-irradiated area. The immunohistochemical study in the lesional skin area and spared skin area revealed a significant decrease in CD1a(+) Langerhans cells, Ki-67 as well as FGFR2 in the spared area than in the lesional area. Thus, the present case indicated that loss of the basal layer of proliferative cells and antigen-presenting cells (Langerhans cell), as well as the down-regulation of FGFR2 signaling in the pre-irradiated skin area, may join forces in inhibiting icotinib-associated cutaneous reactions. To our knowledge, this is the first report of both lesional area and lesion-spared area in a Chinese male receiving treatment with a new epidermal growth factor receptor-tyrosine kinase inhibitor (icotinib). The immunohistochemical reactions described here also provide new insight into the pathogenesis of epidermal growth factor receptor-tyrosine kinase inhibitor-related skin toxicities, and the role that other tyrosine kinase receptors (including FGFR) played in non-small-cell lung cancer.

Amla Enhances Mitochondrial Spare Respiratory Capacity by Increasing Mitochondrial Biogenesis and Antioxidant Systems in a Murine Skeletal Muscle Cell Line

Directory of Open Access Journals (Sweden)

Hirotaka Yamamoto

2016-01-01

Full Text Available Amla is one of the most important plants in Indian traditional medicine and has been shown to improve various age-related disorders while decreasing oxidative stress. Mitochondrial dysfunction is a proposed cause of aging through elevated oxidative stress. In this study, we investigated the effects of Amla on mitochondrial function in C2C12 myotubes, a murine skeletal muscle cell model with abundant mitochondria. Based on cell flux analysis, treatment with an extract of Amla fruit enhanced mitochondrial spare respiratory capacity, which enables cells to overcome various stresses. To further explore the mechanisms underlying these effects on mitochondrial function, we analyzed mitochondrial biogenesis and antioxidant systems, both proposed regulators of mitochondrial spare respiratory capacity. We found that Amla treatment stimulated both systems accompanied by AMPK and Nrf2 activation. Furthermore, we found that Amla treatment exhibited cytoprotective effects and lowered reactive oxygen species (ROS levels in cells subjected to t-BHP-induced oxidative stress. These effects were accompanied by increased oxygen consumption, suggesting that Amla protected cells against oxidative stress by using enhanced spare respiratory capacity to produce more energy. Thus we identified protective effects of Amla, involving activation of mitochondrial function, which potentially explain its various effects on age-related disorders.

Patient- and therapy-related factors associated with the incidence of xerostomia in nasopharyngeal carcinoma patients receiving parotid-sparing helical tomotherapy.

Science.gov (United States)

Lee, Tsair-Fwu; Liou, Ming-Hsiang; Ting, Hui-Min; Chang, Liyun; Lee, Hsiao-Yi; Wan Leung, Stephen; Huang, Chih-Jen; Chao, Pei-Ju

2015-08-20

We investigated the incidence of moderate to severe patient-reported xerostomia among nasopharyngeal carcinoma (NPC) patients treated with helical tomotherapy (HT) and identified patient- and therapy-related factors associated with acute and chronic xerostomia toxicity. The least absolute shrinkage and selection operator (LASSO) normal tissue complication probability (NTCP) models were developed using quality-of-life questionnaire datasets from 67 patients with NPC. For acute toxicity, the dosimetric factors of the mean doses to the ipsilateral submandibular gland (Dis) and the contralateral submandibular gland (Dcs) were selected as the first two significant predictors. For chronic toxicity, four predictive factors were selected: age, mean dose to the oral cavity (Doc), education, and T stage. The substantial sparing data can be used to avoid xerostomia toxicity. We suggest that the tolerance values corresponded to a 20% incidence of complications (TD20) for Dis = 39.0 Gy, Dcs = 38.4 Gy, and Doc = 32.5 Gy, respectively, when mean doses to the parotid glands met the QUANTEC 25 Gy sparing guidelines. To avoid patient-reported xerostomia toxicity, the mean doses to the parotid gland, submandibular gland, and oral cavity have to meet the sparing tolerance, although there is also a need to take inherent patient characteristics into consideration.

77 FR 35264 - Extension of Expiration Dates for Several Body System Listings

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2012-06-13

..., Social Security Online, at http://www.socialsecurity.gov . SUPPLEMENTARY INFORMATION: Background We use... SOCIAL SECURITY ADMINISTRATION 20 CFR Part 404 [Docket No. SSA-2012-0024] RIN 0960-AH49 Extension of Expiration Dates for Several Body System Listings AGENCY: Social Security Administration. ACTION...

78 FR 54756 - Extension of Expiration Dates for Two Body System Listings

Science.gov (United States)

2013-09-06

... Security Online, at http://www.socialsecurity.gov . SUPPLEMENTARY INFORMATION: Background We use the... SOCIAL SECURITY ADMINISTRATION 20 CFR Part 404 [Docket No. SSA-2013-0039] RIN 0960-AH60 Extension of Expiration Dates for Two Body System Listings AGENCY: Social Security Administration. ACTION...

Robotic da Vinci Xi-assisted nipple-sparing mastectomy: First clinical report.

Science.gov (United States)

Sarfati, Benjamin; Honart, Jean-Francois; Leymarie, Nicolas; Rimareix, Francoise; Al Khashnam, Heba; Kolb, Frederic

2018-05-01

Nipple-sparing mastectomy (NSM) is increasingly popular for the treatment of selected breast cancers and prophylactic mastectomy. Surgical scarring and esthetic outcomes are important patient-related cosmetic considerations. Today, the concept of minimally invasive surgery has become popular, especially using robotic surgery. The authors report the first case of NSM using the latest version of the da Vinci Xi surgical system (Xi). The final incision used to remove the entire mammary gland was located behind the axillary line. In this position, hidden by the arm of the patient, the incision was not visible and was compatible with immediate breast reconstruction. © 2017 Wiley Periodicals, Inc.

The Christmas list

CERN Multimedia

James Gillies

2010-01-01

List making seems to be among mankind’s favourite activities, particularly as the old year draws to a close and the new one begins. It seems that we all want to know what the top 100 annoying pop songs are, who are the world’s most embarrassing people and what everyone’s been watching on TV. The transition from 2009 to 2010 was no different, but some of the latest batch of lists have a few surprising entries. According to the Global Language Monitor, ‘twitter’ was the top word of 2009. No surprises there, but ‘hadron’ came in at number 8 on the list. ‘King of pop’ was top phrase, according to the same source, but ‘god particle’ came in at number 10. And while ‘Barack Obama’ was the name of the year, ‘Large Hadron Collider’ came in at number four. The Global Language Monitor was not the only organization whose lists included particle physics references. &ls...

TARGETED DELETION OF INDUCIBLE HEAT SHOCK PROTEIN 70 ABROGATES THE LATE INFARCT-SPARING EFFECT OF MYOCARDIAL ISCHEMIC PRECONDITIONING

Science.gov (United States)

Abstract submitted for 82nd annual meeting of the American Association for Thoracic Surgery, May 4-8, 2002 in Washington D.C.Targeted Deletion of Inducible Heat Shock Protein 70 Abrogates the Late Infarct-Sparing Effect of Myocardial Ischemic PreconditioningCraig...

Efficacy of non-fovea-sparing ILM peeling for symptomatic myopic foveoschisis with and without macular hole.

Science.gov (United States)

Al-Badawi, Amer Hamad; Abdelhakim, Mohamad Amr Salah Eddin; Macky, Tamer Ahmed; Mortada, Hassan Aly

2018-04-30

To study anatomical and visual outcomes of pars plana vitrectomy (PPV) with non-fovea-sparing (entire) internal limiting membrane (ILM) peeling in eyes with myopic foveoschisis (MF). Prospective interventional case series of eyes undergoing PPV with entire ILM peeling for symptomatic MF. Preoperative spectral domain optical coherence tomography (SD - OCT) epiretinal membrane, anomalous posterior vitreous detachment, vitreoschisis and postoperative changes in SD-OCT central foveal thickness (CFT), ellipsoid zone defect, foveal detachment (FD), macular hole (MH) diameter (if present) and best-corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution (logMAR). This study included 21 eyes (21 patients) with mean age 60.4±13.1, 15 females (71.4%). All patients achieved complete postoperative reattachment by SD-OCT (no FD) 6 months post vitrectomy, with no iatrogenic intraoperative or postoperative MH, and with significant improvement in final BCVA from 1.6±0.30 to1.0±0.2 logMAR, and in CFT from 918.2±311.4 to182.3±33.1 µm. Patients were subdivided into subgroup A: 11 eyes without MH; and subgroup B: 10 eyes with MH, the latter had significant improvement in MH diameter (p=0.005). Preoperative BCVA was a significant risk factor for visual gain, while preoperative FD and CFT were significant for CFT change. Vitrectomy with non-fovea-sparing (entire) ILM peeling resulted in a significant functional and anatomical improvement in eyes with MF with/without MH with no reported complications. Results are comparable to fovea-sparing ILM peeling. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Surgery of the aortic root: should we go for the valve-sparing root reconstruction or the composite graft-valve replacement is still the first choice of treatment for these patients?

Directory of Open Access Journals (Sweden)

Fernando de Azevedo Lamana

2015-09-01

Full Text Available AbstractObjective:To compare the results of the root reconstruction with the aortic valve-sparing operation versus composite graftvalve replacement.Methods:From January 2002 to October 2013, 324 patients underwent aortic root reconstruction. They were 263 composite graft-valve replacement and 61 aortic valve-sparing operation (43 reimplantation and 18 remodeling. Twenty-six percent of the patients were NYHA functional class III and IV; 9.6% had Marfan syndrome, and 12% had bicuspid aortic valve. There was a predominance of aneurysms over dissections (81% vs. 19%, with 7% being acute dissections. The complete follow-up of 100% of the patients was performed with median follow-up time of 902 days for patients undergoing composite graft-valve replacement and 1492 for those undergoing aortic valve-sparing operation.Results:In-hospital mortality was 6.7% and 4.9%, respectively for composite graft-valve replacement and aortic valve-sparing operation (ns. During the late follow-up period, there was 0% moderate and 15.4% severe aortic regurgitation, and NYHA functional class I and II were 89.4% and 94%, respectively for composite graft-valve replacement and aortic valve-sparing operation (ns. Root reconstruction with aortic valve-sparing operation showed lower late mortality (P=0.001 and lower bleeding complications (P=0.006. There was no difference for thromboembolism, endocarditis, and need of reoperation.Conclusion:The aortic root reconstruction with preservation of the valve should be the operation being performed for presenting lower late mortality and survival free of bleeding events.

Web-Based Corporate Environmental Reporting in Nigeria: A Study of Listed Companies

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Uwalomwa UWUIGBE

2012-01-01

Full Text Available This paper basically examined the utilization of the Internet for communicating corporate environmental information by listed financial and non-financial companies in Nigeria. The sample for the study consists of 30 firms listed on the Nigerian stock exchange. While the content analysis technique was used as a basis for eliciting data from the corporate websites of the selected firms, the student t-test statistics was used to find out whether there is a significant difference in the level of web-based corporate environmental disclosure between financial and non-financial firms in Nigeria. In addition, the linear regression method of data analysis was employed to investigate whether there is a relationship between the financial performance of firms and the level of corporate environmental disclosures of the selected listed firms in Nigeria. The paper as part of its findings observed that there is no significant difference in the level of web-based corporate environmental disclosure between listed financial and non-financial firms in the Nigeria stock exchange

Parotid gland sparing effect by computed tomography-based modified lower field margin in whole brain radiotherapy

International Nuclear Information System (INIS)

Cho, Oyeon; Chun, Mi Son; Oh, Young Taek; Kim, Mi Hwa; Park, Hae Jin; Nam, Sang Soo; Heo, Jae Sung; Noh, O Kyu; Park, Sung Ho

2013-01-01

Parotid gland can be considered as a risk organ in whole brain radiotherapy (WBRT). The purpose of this study is to evaluate the parotid gland sparing effect of computed tomography (CT)-based WBRT compared to 2-dimensional plan with conventional field margin. From January 2008 to April 2011, 53 patients underwent WBRT using CT-based simulation. Bilateral two-field arrangement was used and the prescribed dose was 30 Gy in 10 fractions. We compared the parotid dose between 2 radiotherapy plans using different lower field margins: conventional field to the lower level of the atlas (CF) and modified field fitted to the brain tissue (MF). Averages of mean parotid dose of the 2 protocols with CF and MF were 17.4 Gy and 8.7 Gy, respectively (p 98% of prescribed dose were 99.7% for CF and 99.5% for MF. Compared to WBRT with CF, CT-based lower field margin modification is a simple and effective technique for sparing the parotid gland, while providing similar dose coverage of the whole brain.

Urethra sparing - potential of combined Nickel-Titanium stent and intensity modulated radiation therapy in prostate cancer.

Science.gov (United States)

Thomsen, Jakob Borup; Arp, Dennis Tideman; Carl, Jesper

2012-05-01

To investigate a novel method for sparing urethra in external beam radiotherapy of prostate cancer and to evaluate the efficacy of such a treatment in terms of tumour control using a mathematical model. This theoretical study includes 20 patients previously treated for prostate cancer using external beam radiotherapy. All patients had a Nickel-Titanium (Ni-Ti) stent inserted into the prostate part of urethra. The stent has been used during the treatment course as an internal marker for patient positioning prior to treatment. In this study the stent is used for delineating urethra while intensity modulated radiotherapy was used for lowering dose to urethra. Evaluation of the dose plans were performed using a tumour control probability model based on the concept of uniform equivalent dose. The feasibility of the urethra dose reduction method is validated and a reduction of about 17% is shown to be possible. Calculations suggest a nearly preserved tumour control probability. A new concept for urethra dose reduction is presented. The method relies on the use of a Ni-Ti stent as a fiducial marker combined with intensity modulated radiotherapy. Theoretical calculations suggest preserved tumour control. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Simulation of dynamics behaviors for shipping equipment support with system dynamics analysis approach

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Yang Song

2015-05-01

Full Text Available Purpose: The exactly and precisely supply of carrying spare parts has a crucial impact on support and could improve the performance of equipment. Spare parts support is the crux work which will be limited by spare parts allocation and support cost input. Reasonable support strategy can help in making good use of available resources and support the equipment in normal operational status. The purpose of this paper is to propose a dynamics model of spare parts support process based on considering the interaction of multiple factors, and explores the regulation of dynamics behavior in the system. In order to achieve the optimization strategy to improve the effect of support so that will enhance the relevant support parameters of equipment. Design/methodology/approach: Meditate the feedback relationship among some important factors of support that involve support cost, support time and maintenance ability. System dynamics theory is adopted to propose a dynamics model of spare parts support process, on the analysis of multiple factors and casual relationship to find some major ones which have crucial impact on spare parts support. Spare parts support cost and availability was regarded as the control objective, moreover, adjust the control paramours and improve the effect of cannibalization and lateral supply scheduling strategy for spares support. Findings: The factors of spare parts supply, demand and maintenance have relationship of control feedback, and adjust the value of some crucial factors can reduce the support cost and improve the availability value. The main finding is that adopting cannibalization strategy under condition of available materials can relieve the mission and operational availability decline caused by shortage of spare parts. Combining the lateral supply and cannibalization strategy can reduce the inventory of warship carrying spare parts. Practical implications: By controlling the value of key factors regarding aspect of spare

78 FR 8360 - Addition of South Sudan to the Restricted Destinations List

Science.gov (United States)

2013-02-06

...: Brooke G. Smith, Senior International Policy Analyst, Office of International Programs, U.S. Nuclear... NUCLEAR REGULATORY COMMISSION 10 CFR Part 110 [NRC-2012-0278] RIN 3150-AJ21 Addition of South Sudan to the Restricted Destinations List AGENCY: Nuclear Regulatory Commission. ACTION: Final rule...

Course Resource Lists.

Science.gov (United States)

England, Robert G.

The Mountain-Plains Course Resource List is presented by job title for 26 curriculum areas. For each area the printed materials, audiovisual aids, and equipment needed for the course are listed. The 26 curriculum areas are: mathematics skills, communication skills, office education, lodging services, food services, marketing and distribution,…

Effects of vertebral-body-sparing proton craniospinal irradiation on the spine of young pediatric patients with medulloblastoma

Directory of Open Access Journals (Sweden)

Iain MacEwan, MD

2017-04-01

Conclusion: Vertebral-body-sparing CSI with proton beam did not appear to cause increased severe spinal abnormalities in patients treated at our institution. This approach could be considered in future clinical trials in an effort to reduce toxicity and the risk of secondary malignancy and to improve adult height.

Novel Amalgams for In-Space Fabrication of Replacement Parts

Science.gov (United States)

Cochran, Calvin T.; Van Hoose, James R.; Grugel, R. N.

2012-01-01

Being able to fabricate replacement parts during extended space flight missions precludes the weight, storage volume, and speculation necessary to accommodate spares. Amalgams, widely used in dentistry, are potential candidates for fabricating parts in microgravity environments as they are moldable, do not require energy for melting, and do not pose fluid handling problems. Unfortunately, amalgams have poor tensile strength and the room temperature liquid component is mercury. To possibly resolve these issues a gallium-indium alloy was substituted for mercury and small steel fibers were mixed in with the commercial alloy powder. Subsequent microscopic examination of the novel amalgam revealed complete bonding of the components, and mechanical testing of comparable samples showed those containing steel fibers to have a significant improvement in strength. Experimental procedures, microstructures, and test results are presented and discussed in view of further improving properties.

Transgressors, victims, and cry babies: is basic moral judgment spared in autism?

Science.gov (United States)

Leslie, Alan M; Mallon, Ron; DiCorcia, Jennifer A

2006-01-01

Human social intelligence comprises a wide range of complex cognitive and affective processes that appear to be selectively impaired in autistic spectrum disorders. The study of these neuro-developmental disorders and the study of canonical social intelligence have advanced rapidly over the last twenty years by investigating the two together. Specifically, studies of autism have provided important insights into the nature of "theory of mind" abilities, their normal development and underlying neural systems. At the same time, the idea of impaired development of the neurocognitive mechanisms underlying "theory of mind" has shed new light on the nature of autistic disorders. This general approach is not restricted to the study of impairments but extends to mapping areas of social intelligence that are spared in autism. Here we investigate basic moral judgment and find that it appears to be substantially intact in children with autism who are severely impaired in "theory of mind". At the same time, we extend studies of moral reasoning in normal development by way of a new control task, the "cry baby" task. Cry baby scenarios, in which the distress of the victim is "unreasonable" or "unjustified," do not elicit moral condemnation from normally developing preschoolers or from children with autism. Judgments of moral transgressions in which the victim displays distress are therefore not likely the result of a simple automatic reaction to distress and more likely involve moral reasoning. Mapping the cognitive comorbidity patterns of disordered development must encompass both impairments and sparings because both are needed to make sense of the neural and genetic levels.

Whole-brain hippocampal sparing radiation therapy: Volume-modulated arc therapy vs intensity-modulated radiation therapy case study.

Science.gov (United States)

Lee, Katrina; Lenards, Nishele; Holson, Janice

2016-01-01

The hippocampus is responsible for memory and cognitive function. An ongoing phase II clinical trial suggests that sparing dose to the hippocampus during whole-brain radiation therapy can help preserve a patient׳s neurocognitive function. Progressive research and advancements in treatment techniques have made treatment planning more sophisticated but beneficial for patients undergoing treatment. The aim of this study is to evaluate and compare hippocampal sparing whole-brain (HS-WB) radiation therapy treatment planning techniques using volume-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT). We randomly selected 3 patients to compare different treatment techniques that could be used for reducing dose to the hippocampal region. We created 2 treatment plans, a VMAT and an IMRT, from each patient׳s data set and planned on the Eclipse 11.0 treatment planning system (TPS). A total of 6 plans (3 IMRT and 3 VMAT) were created and evaluated for this case study. The physician contoured the hippocampus as per the Radiation Therapy Oncology Group (RTOG) 0933 protocol atlas. The organs at risk (OR) were contoured and evaluated for the plan comparison, which included the spinal cord, optic chiasm, the right and left eyes, lenses, and optic nerves. Both treatment plans produced adequate coverage on the planning target volume (PTV) while significantly reducing dose to the hippocampal region. The VMAT treatment plans produced a more homogenous dose distribution throughout the PTV while decreasing the maximum point dose to the target. However, both treatment techniques demonstrated hippocampal sparing when irradiating the whole brain. Copyright © 2016 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

Internal hemipelvectomy with intraoperative and external beam radiotherapy in the limb-sparing treatment of a pelvic girdle chondrosarcoma

NARCIS (Netherlands)

Hoekstra, HJ; Szabo, BG

The case of a patient with an extensive pelvic girdle chondrosarcoma treated with internal hemipelvectomy and intraoperative radiotherapy, followed by adjuvant high-dose external beam radiotherapy, with a successful attempt in achieving long-term local tumor control and limb-sparing treatment is

Under what conditions is recognition spared relative to recall after selective hippocampal damage in humans?

Science.gov (United States)

Holdstock, J S; Mayes, A R; Roberts, N; Cezayirli, E; Isaac, C L; O'Reilly, R C; Norman, K A

2002-01-01

The claim that recognition memory is spared relative to recall after focal hippocampal damage has been disputed in the literature. We examined this claim by investigating object and object-location recall and recognition memory in a patient, YR, who has adult-onset selective hippocampal damage. Our aim was to identify the conditions under which recognition was spared relative to recall in this patient. She showed unimpaired forced-choice object recognition but clearly impaired recall, even when her control subjects found the object recognition task to be numerically harder than the object recall task. However, on two other recognition tests, YR's performance was not relatively spared. First, she was clearly impaired at an equivalently difficult yes/no object recognition task, but only when targets and foils were very similar. Second, YR was clearly impaired at forced-choice recognition of object-location associations. This impairment was also unrelated to difficulty because this task was no more difficult than the forced-choice object recognition task for control subjects. The clear impairment of yes/no, but not of forced-choice, object recognition after focal hippocampal damage, when targets and foils are very similar, is predicted by the neural network-based Complementary Learning Systems model of recognition. This model postulates that recognition is mediated by hippocampally dependent recollection and cortically dependent familiarity; thus hippocampal damage should not impair item familiarity. The model postulates that familiarity is ineffective when very similar targets and foils are shown one at a time and subjects have to identify which items are old (yes/no recognition). In contrast, familiarity is effective in discriminating which of similar targets and foils, seen together, is old (forced-choice recognition). Independent evidence from the remember/know procedure also indicates that YR's familiarity is normal. The Complementary Learning Systems model can

77 FR 11384 - Removal of Oman from the Restricted Destinations List

Science.gov (United States)

2012-02-27

... NUCLEAR REGULATORY COMMISSION 10 CFR Part 110 [NRC-2011-0264] RIN 3150-AJ06 Removal of Oman from... regulations by removing Oman from the list of restricted destinations. This amendment is necessary to conform... regard to U.S. Government law and policy on Oman. The Executive Branch recommended, in light of current...

[Effect of native aortic valve sparing aortic root reconstruction surgery on short- and long-term prognosis in Marfan syndrome patients:a meta-analysis].

Science.gov (United States)

Hu, Rui; Wang, Zhiwei; Hu, Xiaoping; Wu, Hongbing; Zhou, Zhen

2014-05-01

This meta-analysis was performed to analyze the effect of preserving the native aortic valve on short- and long-term prognosis post aortic root reconstruction surgery for patients with Marfan syndrome. Database including Pubmed,Embase, Cochrane library, CNKI, Wanfang,VIP and CBM were searched to collect studies comparing clinical results of valve sparing surgery with composite valve graft surgery for patients with Marfan syndrome. Study quality was assessed by Newcastle-Ottawa Scale and publication bias was assessed by visual inspection of the funnel plot together with Egger test. Clinical outcomes data was extracted from the manuscripts and analyzed with Revman 5.0 supplied by Cochrane collaboration. Seven clinical trials with 690 patients were included. Meta- analysis demonstrated that valve sparing surgery was associated with a lower incidence of re-exploration (RR = 0.51, 95%CI:0.29- 0.90, P 0.05). Valve sparing aortic root reconstruction surgery is a superior procedure to composite valve graft surgery in term of improving the short- and long-term prognosis for patients with Marfan syndrome.

SU-F-T-187: Quantifying Normal Tissue Sparing with 4D Robust Optimization of Intensity Modulated Proton Therapy

Energy Technology Data Exchange (ETDEWEB)

Newpower, M; Ge, S; Mohan, R [UT MD Anderson Cancer Center, Houston, TX (United States)

2016-06-15

Purpose: To report an approach to quantify the normal tissue sparing for 4D robustly-optimized versus PTV-optimized IMPT plans. Methods: We generated two sets of 90 DVHs from a patient’s 10-phase 4D CT set; one by conventional PTV-based optimization done in the Eclipse treatment planning system, and the other by an in-house robust optimization algorithm. The 90 DVHs were created for the following scenarios in each of the ten phases of the 4DCT: ± 5mm shift along x, y, z; ± 3.5% range uncertainty and a nominal scenario. A Matlab function written by Gay and Niemierko was modified to calculate EUD for each DVH for the following structures: esophagus, heart, ipsilateral lung and spinal cord. An F-test determined whether or not the variances of each structure’s DVHs were statistically different. Then a t-test determined if the average EUDs for each optimization algorithm were statistically significantly different. Results: T-test results showed each structure had a statistically significant difference in average EUD when comparing robust optimization versus PTV-based optimization. Under robust optimization all structures except the spinal cord received lower EUDs than PTV-based optimization. Using robust optimization the average EUDs decreased 1.45% for the esophagus, 1.54% for the heart and 5.45% for the ipsilateral lung. The average EUD to the spinal cord increased 24.86% but was still well below tolerance. Conclusion: This work has helped quantify a qualitative relationship noted earlier in our work: that robust optimization leads to plans with greater normal tissue sparing compared to PTV-based optimization. Except in the case of the spinal cord all structures received a lower EUD under robust optimization and these results are statistically significant. While the average EUD to the spinal cord increased to 25.06 Gy under robust optimization it is still well under the TD50 value of 66.5 Gy from Emami et al. Supported in part by the NCI U19 CA021239.

77 FR 64471 - Circular Welded Carbon-Quality Steel Pipe From the Socialist Republic of Vietnam: Final Negative...

Science.gov (United States)

2012-10-22

... To Produce Exported Goods Import Duty Exemptions for Imported Fixed Assets, Spare Parts and... Imported Fixed Assets, Spare Parts and Accessories for Encouraged Projects Comment 6 SeAH VINA's Failure to... of Fixed Assets, Spare Parts and Accessories Policy Loans Comment 8 Preferential Financing to the...

Music, memory, and Alzheimer's disease: is music recognition spared in dementia, and how can it be assessed?

Science.gov (United States)

Cuddy, Lola L; Duffin, Jacalyn

2005-01-01

Despite intriguing and suggestive clinical observations, no formal research has assessed the possible sparing of musical recognition and memory in Alzheimer's dementia (AD). A case study is presented of an 84-year old woman with severe cognitive impairment implicating AD, but for whom music recognition and memory, according to her caregivers, appeared to be spared. The hypotheses addressed were, first, that memory for familiar music may be spared in dementia, and second, that musical recognition and memory may be reliably assessed with existing tests if behavioral observation is employed to overcome the problem of verbal or written communication. Our hypotheses were stimulated by the patient EN, for whom diagnosis of AD became probable in 2000. With severe problems in memory, language, and cognition, she now has a mini-mental status score of 8 (out of 30) and is unable to understand or recall standard instructions. In order to assess her music recognition abilities, three tests from the previous literature were adapted for behavioral observation. Two tests involved the discrimination of familiar melodies from unfamiliar melodies. The third involved the detection of distortions ("wrong" notes) in familiar melodies and discrimination of distorted melodies from melodies correctly reproduced. Test melodies were presented to EN on a CD player and her responses were observed by two test administrators. EN responded to familiar melodies by singing along, usually with the words, and often continuing to sing after the stimulus had stopped. She never responded to the unfamiliar melodies. She responded to distorted melodies with facial expressions - surprise, laughter, a frown, or an exclamation, "Oh, dear!"; she never responded in this way to the undistorted melodies. Allowing these responses as indicators of detection, the results for EN were in the normal or near normal range of scores for elderly controls. As well, lyrics to familiar melodies, spoken in a conversational

Long-term results after aortic valve-sparing operation (David I)†

Science.gov (United States)

Shrestha, Malakh; Baraki, Hassina; Maeding, Ilona; Fitzner, Sebastian; Sarikouch, Samir; Khaladj, Nawid; Hagl, Christian; Haverich, Axel

2012-01-01

OBJECTIVE Aortic valve-sparing David procedure has gained broad acceptance. However, few long-term results have been published. We present our results. METHODS More than 450 David procedures have been performed in our institution so far. Of these, 126 patients were operated between July 1993 and December 2000. Median age was 57 (8–83) years and 46 (36.5%) were female. As many as 26 (20.6%) had Marfan syndrome, 21 (16.7%) had acute aortic dissection type A (AADA) and 67 (53.2%) had additional procedures. RESULTS There were six (4.8%) deaths in 30 post-operative period (POD), four of whom had AADA. In the follow-up, there were 32 (25.4%) late deaths, 11 (34.4%) of these were caused by cardiac or underlying disease or op-related. As many as 15 (11.9%) patients were re-operated; six (40%) were Marfan patients and two (13.3%) had early endocarditis. Follow-up echocardiography of 76 (60.3%) event-free patients showed valve insufficiency (AI) ≤ AI I° in 68 (89.5%) and grade II in 7 (9.2%) patients. Leaflet degeneration due to proposed leaflet contact with the straight Dacron graft was not observed. A total of 36 (47.4%) patients were in New York Heart Association (NYHA) class I, 33 (43.4%) in NYHA II, and five (6.6%) were in class III. During the entire follow-up of 790 patient-years, there was no stroke or major bleeding. Survival at 1, 5 and 10 years was 93%, 85% and 70%, respectively. Freedom from valve replacement at 1, 5 and 10 years was 96%, 91% and 87%, respectively. CONCLUSIONS: Regardless of the underlying pathology, valve-sparing David I procedure has acceptable long-term results. Valve-related complications such as stroke or major bleeding is exceedingly low. PMID:21632258

Simvastatin in the treatment of asthma: lack of steroid-sparing effect.

Science.gov (United States)

Cowan, Douglas C; Cowan, Jan O; Palmay, Rochelle; Williamson, Avis; Taylor, D Robin

2010-10-01

Statins have anti-inflammatory actions which in theory are potentially beneficial in asthma. Small trials have failed to show a significant benefit, but a systematic study to evaluate the steroid-sparing effect of statin treatment has not been carried out. A randomised, placebo-controlled, crossover trial was conducted of simvastatin 40 mg at night with simultaneous stepwise reduction of fluticasone propionate dose until loss of control occurred, followed by an increase until regain of control ('minimum' dose required) in 51 patients with asthma and sputum eosinophils (steroid-free) ≥ 2%. 43 patients completed the study. There was no significant difference in 'minimum' inhaled corticosteroid (ICS) dose requirement between simvastatin and placebo: (median (IQR) 50 μg daily (0-250) vs 100 μg daily (0-250), p=0.931). 'Minimum' dose distribution was similar (p=0.269). The fluticasone dose at which loss of control occurred did not differ significantly between simvastatin and placebo (p=0.404). In patients with loss of control in both treatment arms, fluticasone dose at loss of control was similar with simvastatin and placebo (median (IQR) 50 μg daily (0-100) for both, p=0.620). In those patients who reached 0 μg/day (n=18), Astma Control Questionnaire (ACQ) was lower (p=0.037), forced expiratory volume in 1 s (FEV(1)) higher (p<0.01) and sputum eosinophils lower with simvastatin compared with placebo (9.5% compared with 25.4%, p=0.033). Simvastatin does not have clinically important steroid-sparing effects in patients with eosinophilic asthma. In the absence of steroid, simvastatin is associated with minor improvements in symptoms and lung function, and a reduction in sputum eosinophils. Clinical trial number ACTRN12606000531516.