WorldWideScience

Sample records for staging including assessment

  1. Extending Vulnerability Assessment to Include Life Stages Considerations.

    Science.gov (United States)

    Hodgson, Emma E; Essington, Timothy E; Kaplan, Isaac C

    2016-01-01

    Species are experiencing a suite of novel stressors from anthropogenic activities that have impacts at multiple scales. Vulnerability assessment is one tool to evaluate the likely impacts that these stressors pose to species so that high-vulnerability cases can be identified and prioritized for monitoring, protection, or mitigation. Commonly used semi-quantitative methods lack a framework to explicitly account for differences in exposure to stressors and organism responses across life stages. Here we propose a modification to commonly used spatial vulnerability assessment methods that includes such an approach, using ocean acidification in the California Current as an illustrative case study. Life stage considerations were included by assessing vulnerability of each life stage to ocean acidification and were used to estimate population vulnerability in two ways. We set population vulnerability equal to: (1) the maximum stage vulnerability and (2) a weighted mean across all stages, with weights calculated using Lefkovitch matrix models. Vulnerability was found to vary across life stages for the six species explored in this case study: two krill-Euphausia pacifica and Thysanoessa spinifera, pteropod-Limacina helicina, pink shrimp-Pandalus jordani, Dungeness crab-Metacarcinus magister and Pacific hake-Merluccius productus. The maximum vulnerability estimates ranged from larval to subadult and adult stages with no consistent stage having maximum vulnerability across species. Similarly, integrated vulnerability metrics varied greatly across species. A comparison showed that some species had vulnerabilities that were similar between the two metrics, while other species' vulnerabilities varied substantially between the two metrics. These differences primarily resulted from cases where the most vulnerable stage had a low relative weight. We compare these methods and explore circumstances where each method may be appropriate.

  2. Preliminary site description Laxemar stage 2.1. Feedback for completion of the site investigation including input from safety assessment and repository engineering

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-09-15

    The Laxemar subarea is the focus for the complete site investigations in the Simpevarp area. The south and southwestern parts of the subarea (the so-called 'focused area') have been designated for focused studies during the remainder of the site investigations. This area, some 5.3 square kilometres in size, is characterised on the surface by an arc shaped body of quartz monzodiorite gently dipping to the north, flanked in the north and south by Aevroe granite. The current report documents work conducted during stage 2.1 of the site-descriptive modelling of the Laxemar subarea. The primary objective of the work performed is to provide feedback to the site investigations at Laxemar to ensure that adequate and timely data and information are obtained during the remaining investigation stage. The work has been conducted in cooperation with the site investigation team at Laxemar and representatives from safety assessment and repository engineering. The principal aim of this joint effort has been to safeguard that adequate data are collected that resolve the remaining issues/uncertainties which are of importance for repository layout and long-term safety. The proposed additional works presented in this report should be regarded as recommended additions and/or modifications in relation to the CSI programme published early 2006. The overall conclusion of the discipline-wise review of critical issues is that the CSI programme overall satisfies the demands to resolve the remaining uncertainties. This is interpreted to be partly a result of the close interaction between the site modelling team, site investigation team and the repository engineering teams, which has been in operation since early 2005. In summary, the performed interpretations and modelling have overall confirmed the version 1.2 results. The exception being Hydrogeology where the new Laxemar 2.1 borehole data suggest more favourable conditions in the south and west parts of the focused area compared

  3. Preliminary site description Laxemar stage 2.1. Feedback for completion of the site investigation including input from safety assessment and repository engineering

    International Nuclear Information System (INIS)

    2006-09-01

    The Laxemar subarea is the focus for the complete site investigations in the Simpevarp area. The south and southwestern parts of the subarea (the so-called 'focused area') have been designated for focused studies during the remainder of the site investigations. This area, some 5.3 square kilometres in size, is characterised on the surface by an arc shaped body of quartz monzodiorite gently dipping to the north, flanked in the north and south by Aevroe granite. The current report documents work conducted during stage 2.1 of the site-descriptive modelling of the Laxemar subarea. The primary objective of the work performed is to provide feedback to the site investigations at Laxemar to ensure that adequate and timely data and information are obtained during the remaining investigation stage. The work has been conducted in cooperation with the site investigation team at Laxemar and representatives from safety assessment and repository engineering. The principal aim of this joint effort has been to safeguard that adequate data are collected that resolve the remaining issues/uncertainties which are of importance for repository layout and long-term safety. The proposed additional works presented in this report should be regarded as recommended additions and/or modifications in relation to the CSI programme published early 2006. The overall conclusion of the discipline-wise review of critical issues is that the CSI programme overall satisfies the demands to resolve the remaining uncertainties. This is interpreted to be partly a result of the close interaction between the site modelling team, site investigation team and the repository engineering teams, which has been in operation since early 2005. In summary, the performed interpretations and modelling have overall confirmed the version 1.2 results. The exception being Hydrogeology where the new Laxemar 2.1 borehole data suggest more favourable conditions in the south and west parts of the focused area compared with the

  4. Should abdominal sequences be included in prostate cancer MR staging studies?

    International Nuclear Information System (INIS)

    McEvoy, S.H.; Lavelle, L.P.; Purcell, Y.M.; Quinlan, D.M.; Skehan, S.J.; Collins, C.D.; McMahon, C.J.

    2015-01-01

    Highlights: • ESUR guideline that abdominal MR sequences are reserved for high-risk prostate cancer is tested. • Routine abdominal sequences are of low yield in prostate cancer MR staging. • Routine abdominal staging sequences frequently result in incidental findings. • Abdominal staging sequences should be reserved for high-risk prostate cancer cases. - Abstract: Objectives: Prostate cancer staging MR examinations commonly include abdominal sequences to assess for non-regional (common iliac or para-aortic) nodal metastasis. In our experience the diagnostic yield of this is limited, but incidental findings are frequent, often necessitating further investigations. The aim of this study is to assess the diagnostic utility of abdominal sequences in routine prostate cancer MR staging studies. Methods: Findings on abdominal sequences of consecutive MRI prostate studies performed for staging newly diagnosed prostate cancer between September 2011 and September 2013 were reviewed with respect to adenopathy and additional incidental findings. Results were correlated with Gleason grade and serum prostate-specific antigen (PSA) level in each case. Results: 355 MRI prostate examinations were reviewed. 4 (1.1%) showed enlarged non-regional lymph nodes. Incidental findings were found in 82(23.1%) cases, neccessitating further investigation in 45 (12.7%) cases. Enlarged non-regional nodes were associated with higher PSA level and Gleason grade (p = 0.007, p = 0.005 respectively). With a combined threshold of PSA > 20 ng/mL and/or Gleason grade ≥8 the sensitivity, specificity, PPV and NPV were 100, 60, 3 and 100% respectively for predicting the presence of non-regional adenopathy. Conclusions: Routine abdominal sequences are of very low yield in routine prostate cancer MR staging, frequently resulting in incidental findings requiring further work-up and should be reserved for high-risk cases. Our experience supports the use of an abdominal staging sequence in high

  5. Extending flood damage assessment methodology to include ...

    African Journals Online (AJOL)

    Optimal and sustainable flood plain management, including flood control, can only be achieved when the impacts of flood control measures are considered for both the man-made and natural environments, and the sociological aspects are fully considered. Until now, methods/models developed to determine the influences ...

  6. Skeletal maturity assessment using mandibular canine calcification stages

    Directory of Open Access Journals (Sweden)

    Vildana Džemidžić

    2016-11-01

    Full Text Available Objective. The aims of this study were: to investigate the relationship between mandibular canine calcification stages and skeletal maturity; and to evaluate whether the mandibular canine calcification stages may be used as a reliable diagnostic tool for skeletal maturity assessment. Materials and methods. This study included 151 subjects: 81 females and 70 males, with ages ranging from 9 to 16 years (mean age: 12.29±1.86 years. The inclusion criteria for subjects were as follows: age between 9 and 16 years; good general health without any hormonal, nutritional, growth or dental development problems. Subjects who were undergoing or had previously received orthodontic treatment were not included in this study. The calcification stages of the left permanent mandibular canine were assessed according to the method of Demirjian, on panoramic radiographs. Assessment of skeletal maturity was carried out using the cervical vertebral maturation index (CVMI, as proposed by the Hassel-Farman method, on lateral cephalograms. The correlation between the calcification stages of mandibular canine and skeletal maturity was estimated separately for male and female subjects. Results. Correlation coefficients between calcification stages of mandibular canine and skeletal maturity were 0.895 for male and 0.701 for female subjects. Conclusions. A significant correlation was found between the calcification stages of the mandibular canine and skeletal maturity. The calcification stages of the mandibular canine show a satisfactory diagnostic performance only for assessment of pre-pubertal growth phase.

  7. Reassessing the NTCTCS Staging Systems for Differentiated Thyroid Cancer, Including Age at Diagnosis.

    Science.gov (United States)

    McLeod, Donald S A; Jonklaas, Jacqueline; Brierley, James D; Ain, Kenneth B; Cooper, David S; Fein, Henry G; Haugen, Bryan R; Ladenson, Paul W; Magner, James; Ross, Douglas S; Skarulis, Monica C; Steward, David L; Xing, Mingzhao; Litofsky, Danielle R; Maxon, Harry R; Sherman, Steven I

    2015-10-01

    Thyroid cancer is unique for having age as a staging variable. Recently, the commonly used age cut-point of 45 years has been questioned. This study assessed alternate staging systems on the outcome of overall survival, and compared these with current National Thyroid Cancer Treatment Cooperative Study (NTCTCS) staging systems for papillary and follicular thyroid cancer. A total of 4721 patients with differentiated thyroid cancer were assessed. Five potential alternate staging systems were generated at age cut-points in five-year increments from 35 to 70 years, and tested for model discrimination (Harrell's C-statistic) and calibration (R(2)). The best five models for papillary and follicular cancer were further tested with bootstrap resampling and significance testing for discrimination. The best five alternate papillary cancer systems had age cut-points of 45-50 years, with the highest scoring model using 50 years. No significant difference in C-statistic was found between the best alternate and current NTCTCS systems (p = 0.200). The best five alternate follicular cancer systems had age cut-points of 50-55 years, with the highest scoring model using 50 years. All five best alternate staging systems performed better compared with the current system (p = 0.003-0.035). There was no significant difference in discrimination between the best alternate system (cut-point age 50 years) and the best system of cut-point age 45 years (p = 0.197). No alternate papillary cancer systems assessed were significantly better than the current system. New alternate staging systems for follicular cancer appear to be better than the current NTCTCS system, although they require external validation.

  8. Reassessing the NTCTCS Staging Systems for Differentiated Thyroid Cancer, Including Age at Diagnosis

    Science.gov (United States)

    McLeod, Donald S.A.; Jonklaas, Jacqueline; Brierley, James D.; Ain, Kenneth B.; Cooper, David S.; Fein, Henry G.; Haugen, Bryan R.; Ladenson, Paul W.; Magner, James; Ross, Douglas S.; Skarulis, Monica C.; Steward, David L.; Xing, Mingzhao; Litofsky, Danielle R.; Maxon, Harry R.

    2015-01-01

    Background: Thyroid cancer is unique for having age as a staging variable. Recently, the commonly used age cut-point of 45 years has been questioned. Objective: This study assessed alternate staging systems on the outcome of overall survival, and compared these with current National Thyroid Cancer Treatment Cooperative Study (NTCTCS) staging systems for papillary and follicular thyroid cancer. Methods: A total of 4721 patients with differentiated thyroid cancer were assessed. Five potential alternate staging systems were generated at age cut-points in five-year increments from 35 to 70 years, and tested for model discrimination (Harrell's C-statistic) and calibration (R2). The best five models for papillary and follicular cancer were further tested with bootstrap resampling and significance testing for discrimination. Results: The best five alternate papillary cancer systems had age cut-points of 45–50 years, with the highest scoring model using 50 years. No significant difference in C-statistic was found between the best alternate and current NTCTCS systems (p = 0.200). The best five alternate follicular cancer systems had age cut-points of 50–55 years, with the highest scoring model using 50 years. All five best alternate staging systems performed better compared with the current system (p = 0.003–0.035). There was no significant difference in discrimination between the best alternate system (cut-point age 50 years) and the best system of cut-point age 45 years (p = 0.197). Conclusions: No alternate papillary cancer systems assessed were significantly better than the current system. New alternate staging systems for follicular cancer appear to be better than the current NTCTCS system, although they require external validation. PMID:26203804

  9. Assessment and Verification of SLS Block 1-B Exploration Upper Stage and Stage Disposal Performance

    Science.gov (United States)

    Patrick, Sean; Oliver, T. Emerson; Anzalone, Evan J.

    2018-01-01

    Delta-v allocation to correct for insertion errors caused by state uncertainty is one of the key performance requirements imposed on the SLS Navigation System. Additionally, SLS mission requirements include the need for the Exploration Up-per Stage (EUS) to be disposed of successfully. To assess these requirements, the SLS navigation team has developed and implemented a series of analysis methods. Here the authors detail the Delta-Delta-V approach to assessing delta-v allocation as well as the EUS disposal optimization approach.

  10. Assessing Behavioral Stages From Social Media Data.

    Science.gov (United States)

    Liu, Jason; Weitzman, Elissa R; Chunara, Rumi

    2017-01-01

    Important work rooted in psychological theory posits that health behavior change occurs through a series of discrete stages. Our work builds on the field of social computing by identifying how social media data can be used to resolve behavior stages at high resolution (e.g. hourly/daily) for key population subgroups and times. In essence this approach opens new opportunities to advance psychological theories and better understand how our health is shaped based on the real, dynamic, and rapid actions we make every day. To do so, we bring together domain knowledge and machine learning methods to form a hierarchical classification of Twitter data that resolves different stages of behavior. We identify and examine temporal patterns of the identified stages, with alcohol as a use case (planning or looking to drink, currently drinking, and reflecting on drinking). Known seasonal trends are compared with findings from our methods. We discuss the potential health policy implications of detecting high frequency behavior stages.

  11. Sub-classification of Advanced-Stage Hepatocellular Carcinoma: A Cohort Study Including 612 Patients Treated with Sorafenib.

    Science.gov (United States)

    Yoo, Jeong-Ju; Chung, Goh Eun; Lee, Jeong-Hoon; Nam, Joon Yeul; Chang, Young; Lee, Jeong Min; Lee, Dong Ho; Kim, Hwi Young; Cho, Eun Ju; Yu, Su Jong; Kim, Yoon Jun; Yoon, Jung-Hwan

    2018-04-01

    Advanced hepatocellular carcinoma (HCC) is associated with various clinical conditions including major vessel invasion, metastasis, and poor performance status. The aim of this study was to establish a prognostic scoring system and to propose a sub-classification of the Barcelona-Clinic Liver Cancer (BCLC) stage C. This retrospective study included consecutive patientswho received sorafenib for BCLC stage C HCC at a single tertiary hospital in Korea. A Cox proportional hazard model was used to develop a scoring system, and internal validationwas performed by a 5-fold cross-validation. The performance of the model in predicting risk was assessed by the area under the curve and the Hosmer-Lemeshow test. A total of 612 BCLC stage C HCC patients were sub- classified into strata depending on their performance status. Five independent prognostic factors (Child-Pugh score, α-fetoprotein, tumor type, extrahepatic metastasis, and portal vein invasion) were identified and used in the prognostic scoring system. This scoring system showed good discrimination (area under the receiver operating characteristic curve, 0.734 to 0.818) and calibration functions (both p advanced HCC. A prognostic scoring system with five independent factors is useful in predicting the survival of patients with BCLC stage C HCC.

  12. Assessment of Growth Using Mandibular Canine Calcification Stages and Its Correlation with Modified MP3 Stages.

    Science.gov (United States)

    Nayak, Reshma; Nayak, Us Krishna; Hegde, Gautam

    2010-01-01

    Orthodontic diagnosis and treatment planning for growing children must involve growth prediction, especially in the treatment of skeletal problems. Studies have shown that a strong association exists between skeletal maturity and dental calcification stages. The present study was therefore taken up to provide a simple and practical method for assessing skeletal maturity using a dental periapical film and standard dental X-ray machine, to compare the developmental stages of the mandibular canine with that of developmental stages of modified MP3 and to find out if any correlation exists, to determine if the developmental stages of the mandibular canine alone can be used as a reliable indicator for assessment of skeletal maturity. A total of 160 periapical radiographs (80 males and 80 females), of the mandibular right canine and the MP3 region was taken and assessed according to the Dermirjian's stages of dental calcification and the modified MP3 stages. The correlation between the developmental stages of MP3 and the mandibular right canine in male and female groups, is of high statistical significance (p = 0.001). The correlation coefficient between MP3 stages and developmental stages of mandibular canine and chronological age in male and females was found to be not significant. The correlation between the mandibular canine calcification stages and MP3 stages was found to be significant. The developmental stages of the mandibular canine could be used very reliably as a sole indicator for assessment of skeletal maturity.

  13. Forsmark Bedrock mapping. Stage 1 (2002) - Outcrop data including fracture data

    International Nuclear Information System (INIS)

    Stephens, M.B.; Bergman, T.; Andersson, J.; Hermansson, T.; Wahlgren, C.H.; Albrecht, L.; Mikko, H.

    2003-02-01

    Infra-red aerial photographs over the study area, taken at a height of 2700 m, were interpreted in order to locate either the position of outcrops where the bedrock is exposed at the Earth's surface or sites where the bedrock lies beneath a thin (< 50 cm) cover of Quaternary deposits. These data were critical for the planning and execution of the field activities. It was aimed to map all the outcrops in the mainland part of the study area during stage 1 of the project. These data will be integrated with both bedrock analytical data and the interpretations obtained from the study of airborne geophysical data in order to produce a bedrock map over the study area. In order to gain some information on the regional variation in the frequency and orientation of fractures over the candidate area, a documentation of the position and strike and dip of fractures longer than 100 cm was carried out at 44 outcrops. This work will also help in the selection of outcrops where detailed fracture analysis will be carried out during a later stage of the site investigation programme. Field work associated with stage 1 of the project initiated in the candidate area during June 2002. Field activities then continued in the coastal area to the northeast, in the area north of 6700000 N to the northwest of the candidate area and in the inland area to the southwest. Field activities ceased during September 2002. Both descriptive and numerical data from the 1054 observation points have been included in an outcrop database. Primarily on account of the complexity of the outcrops visited and, as a consequence, the longer time required for the field activities, a large part of the area south of road 76 was not mapped during 2002

  14. Forsmark Bedrock mapping. Stage 1 (2002) - Outcrop data including fracture data

    Energy Technology Data Exchange (ETDEWEB)

    Stephens, M.B.; Bergman, T.; Andersson, J.; Hermansson, T.; Wahlgren, C.H.; Albrecht, L.; Mikko, H. [Geological Survey of Sweden, Uppsala (Sweden)

    2003-02-01

    Infra-red aerial photographs over the study area, taken at a height of 2700 m, were interpreted in order to locate either the position of outcrops where the bedrock is exposed at the Earth's surface or sites where the bedrock lies beneath a thin (< 50 cm) cover of Quaternary deposits. These data were critical for the planning and execution of the field activities. It was aimed to map all the outcrops in the mainland part of the study area during stage 1 of the project. These data will be integrated with both bedrock analytical data and the interpretations obtained from the study of airborne geophysical data in order to produce a bedrock map over the study area. In order to gain some information on the regional variation in the frequency and orientation of fractures over the candidate area, a documentation of the position and strike and dip of fractures longer than 100 cm was carried out at 44 outcrops. This work will also help in the selection of outcrops where detailed fracture analysis will be carried out during a later stage of the site investigation programme. Field work associated with stage 1 of the project initiated in the candidate area during June 2002. Field activities then continued in the coastal area to the northeast, in the area north of 6700000 N to the northwest of the candidate area and in the inland area to the southwest. Field activities ceased during September 2002. Both descriptive and numerical data from the 1054 observation points have been included in an outcrop database. Primarily on account of the complexity of the outcrops visited and, as a consequence, the longer time required for the field activities, a large part of the area south of road 76 was not mapped during 2002.

  15. Dental Age Estimation (DAE): Data management for tooth development stages including the third molar. Appropriate censoring of Stage H, the final stage of tooth development.

    Science.gov (United States)

    Roberts, Graham J; McDonald, Fraser; Andiappan, Manoharan; Lucas, Victoria S

    2015-11-01

    The final stage of dental development of third molars is usually helpful to indicate whether or not a subject is aged over 18 years. A complexity is that the final stage of development is unlimited in its upper border. Investigators usually select an inappropriate upper age limit or censor point for this tooth development stage. The literature was searched for appropriate data sets for dental age estimation and those that provided the count (n), the mean (x¯), and the standard deviation (sd) for each of the tooth development stages. The Demirjian G and Demirjian H were used for this study. Upper and lower limits of the Stage G and Stage H data were calculated limiting the data to plus or minus three standard deviations from the mean. The upper border of Stage H was limited by appropriate censoring at the maximum value for Stage G. The maximum age at attainment from published data, for Stage H, ranged from 22.60 years to 34.50 years. These data were explored to demonstrate how censoring provides an estimate for the correct maximum age for the final stage of Stage H as 21.64 years for UK Caucasians. This study shows that confining the data array of individual tooth developments stages to ± 3sd provides a reliable and logical way of censoring the data for tooth development stages with a Normal distribution of data. For Stage H this is inappropriate as it is unbounded in its upper limit. The use of a censored data array for Stage H using Percentile values is appropriate. This increases the reliability of using third molar Stage H alone to determine whether or not an individual is over 18 years old. For Stage H, individual ancestral groups should be censored using the same technique. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  16. Assessment of skeletal maturation using mandibular second molar maturation stages.

    Science.gov (United States)

    Goyal, S; Goyal, S; Gugnani, N

    2014-01-01

    To investigate the relationship between cervical vertebrae maturation and mandibular second molar calcification stages. The study was designed as a retrospective, descriptive and crosssectional research project. Pre-treatment lateral cephalograms and panoramic radiographs of 99 males and 110 females in the age range of 7 to 18 years 7 months were evaluated with Demirjian Index (DI) and cervical vertebrae maturation indicators (CVMI) of Hassel and Farman. A null hypothesis was proposed that there is no relation between CVMI and DI. A highly significant association (Pearson's contingency coefficient 0.713 for males and 0.863 for females) was found between DI and CVMI. In males, the DI stage E corresponded to stage 2 of CVMI (pre-peak of pubertal growth spurt) and DI stages F and G corresponded to stages 3 and 4 of CVMI (peak of pubertal growth spurt). DI stage H was associated with stages 5 and 6 of CVMI (end of pubertal growth spurt). In females, the DI stages C, D corresponded to CVMI stages 1, 2; DI stages E, F with CVMI stages 3, 4; DI stages G, H with CVMI stages 5, 6. Mandibular second molar calcification stages can be used as indicators for assessment of skeletal maturity.

  17. Property transfer assessments should include radon gas testing

    International Nuclear Information System (INIS)

    Nardi, M.A.

    1992-01-01

    There are two emerging influences that will require radon gas testing as part of many property transfers and most environmental assessments. These requirements come from lending regulators and state legislatures and affect single family, multifamily, and commercial properties. Fannie Mae and others have developed environmental investigation guidelines for protection from long term legal liabilities in the purchase of environmentally contaminated real estate. These guidelines include radon gas testing for many properties. Several states have enacted laws that require environmental disclosure forms be prepared to ensure that the parties involved in certain real estate transactions are aware of the environmental liabilities that may come with the transfer of property. Indiana has recently enacted legislation that would require the disclosure of the presence of radon gas on many commercial real estate transactions. With more banks and state governments following this trend, radon gas testing should be performed during all property transfers and environmental assessments to protect the parties involved from any long term legal liabilities

  18. Environmental site assessments should include radon gas testing

    International Nuclear Information System (INIS)

    Nardi, M.A.

    1991-01-01

    There are two emerging influences that will require radon gas testing as part of many property transfers and most site assessments. These requirements come from lending regulators and state legislatures. Fannie Mae and others have developed environmental investigation guidelines for the purchase of environmentally contaminated real estate. These guidelines include radon gas testing for many properties. Several states have enacted laws that require environmental disclosure forms be prepared to ensure that the parties involved in certain real estate transactions are aware of the environmental liabilities that may come with the transfer of property. Indiana has recently enacted legislation that would require the disclosure of the presence of radon gas on many commercial real estate transactions. With more lenders and state governments likely to follow this trend, radon gas testing should be performed during all property transfers and site assessment to protect the parties involved from any legal liabilities

  19. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    ORAU' s Oak Ridge Institute for Science Education (HCTT-CHE)

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

  20. [Helicobacter pylori gastritis: assessment of OLGA and OLGIM staging systems].

    Science.gov (United States)

    Ben Slama, Sana; Ben Ghachem, Dorra; Dhaoui, Amen; Jomni, Mohamed Taieb; Dougui, Mohamed Hédi; Bellil, Khadija

    2016-01-01

    Helicobacter pylori (H pylori) gastritis presents a risk of cancer related to atrophy and intestinal metaplasia. Two recent classifications OLGA (Operative Link on Gastritis Assessment) and OLGIM (Operative Link on Gastritic Intestinal Metaplasia assessment) have been proposed to identify high-risk forms (stages III and IV). The aim of this study is to evaluate the OLGA and OLGIM staging systems in H pylori gastritis. A descriptive study of 100 cases of chronic H pylori gastritis was performed. The revaluation of Sydney System parameters of atrophy and intestinal metaplasia, of gastric antrum and corpus, allowed identifying respectively the stages of OLGA and OLGIM systems. The progressive risk of our H pylori gastritis was 6% according to OLGA staging and 7% according to OLGIM staging. Significant correlation was revealed between age and OLGA staging. High-risk gastritis according to OLGIM staging was significantly associated with moderate to severe atrophy. High-risk forms according to OLGA staging were associated in 80% of the cases to intestinal metaplasia. OLGA and OLGIM systems showed a highly significant positive correlation between them with a mismatch at 5% for H pylori gastritis. The OLGA and OLGIM staging systems in addition to Sydney System, allow selection of high risk forms of chronic gastritis requiring accurate observation.

  1. TOOLS TO INCLUDE BLIND STUDENTS IN SCHOOL BUILDING PERFORMANCE ASSESSMENTS

    Directory of Open Access Journals (Sweden)

    Tania Pietzschke Abate

    2016-05-01

    Full Text Available This article discusses the design of data collection instruments that include the opinions of blind students, in accordance with the principles of Universal Design (UD. The aim of this study is to understand the importance of adapting data collection instruments for the inclusion of disabled persons in field research in Architecture and Design, among other fields. The data collection instruments developed were a play interview with a tactile map and a 3D survey with the use of tactile models. These instruments sought to assess the school environment experienced by blind students. The study involved students from the early years of a school for the blind who had not yet mastered the Braille system. The participation of these students was evaluated. A multidisciplinary team consisting of architects, designers, educators, and psychologists lent support to the study. The results showed that the data collection instruments adapted to blind students were successful in making the group of authors examine questions regarding UD. An analysis of the participatory phase showed that the limitations resulting from blindness determine the specificities in the adaptation and implementation process of the instruments in schools. Practical recommendations for future studies related to instruments in the UD thematic are presented. This approach is in line with the global trend of including disabled persons in society based on these users’ opinions concerning what was designed by architects and designers.

  2. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    HCTT-CHE

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

  3. Assessing bias in osteoarthritis trials included in Cochrane reviews

    DEFF Research Database (Denmark)

    Hansen, Julie Bolvig; Juhl, Carsten Bogh; Boutron, Isabelle

    2014-01-01

    the first appearing forest plot for overall pain in the Cochrane review. Treatment effect sizes will be expressed as standardised mean differences (SMDs), where the difference in mean values available from the forest plots is divided by the pooled SD. To empirically assess the risk of bias in treatment...

  4. Psychiatry in primary care using the three-stage assessment

    African Journals Online (AJOL)

    terms of the patient's readiness to change his/her behaviour and then use an agenda-setting technique to decide which risk factor to .... and occasionally uses cannabis. She is not using any family planning (besides ... require a long-term relationship with their primary care physician,. Table 1. The three-stage assessment.

  5. Expanding Health Technology Assessments to Include Effects on the Environment.

    Science.gov (United States)

    Marsh, Kevin; Ganz, Michael L; Hsu, John; Strandberg-Larsen, Martin; Gonzalez, Raquel Palomino; Lund, Niels

    2016-01-01

    There is growing awareness of the impact of human activity on the climate and the need to stem this impact. Public health care decision makers from Sweden and the United Kingdom have started examining environmental impacts when assessing new technologies. This article considers the case for incorporating environmental impacts into the health technology assessment (HTA) process and discusses the associated challenges. Two arguments favor incorporating environmental impacts into HTA: 1) environmental changes could directly affect people's health and 2) policy decision makers have broad mandates and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some of the value of environmental impacts, especially those generating health impacts, but might not be suitable for addressing broader concerns. Both cost-benefit and multicriteria decision analyses are potential methods for evaluating health and environmental outcomes, but are less familiar to health care decision makers. Health care is an important and sizable sector of the economy that could warrant closer policy attention to its impact on the environment. Considerable work is needed to track decision makers' demands, augment the environmental evidence base, and develop robust methods for capturing and incorporating environmental data as part of HTA. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  6. A new system for assessment of growth using mandibular canine calcification stages and its correlation with modified MP3 stages.

    Science.gov (United States)

    Hegde, Gautham; Hegde, Nanditha; Kumar, Anil; Keshavaraj

    2014-07-01

    Orthodontic diagnosis and treatment planning for growing children must involve growth prediction, especially in the treatment of skeletal problems. Studies have shown that a strong association exists between skeletal maturity and dental calcification stages. The present study was therefore taken up to provide a simple and practical method for assessing skeletal maturity using a dental periapical film and standard dental X-ray machine, to compare the developmental stages of the mandibular canine with that of developmental stages of modified MP3 and to find out if any correlation exists, to determine if the developmental stages of the mandibular canine alone can be used as a reliable indicator for assessment of skeletal maturity. A total of 160 periapical radiographs, of the mandibular right canine and the MP3 region was taken and assessed according to the Dermirjian's stages of dental calcification and the modified MP3 stages. The correlation coefficient between MP3 stages and developmental stages of mandibular canine was found to be significant in both male and female groups. When the canine calcification stages were compared with the MP3 stages it was found that with the exception of the D stage of canine calcification the remaining stages showed a very high correlation with the modified MP3 stages. The correlation between the mandibular canine calcification stages, and the MP3 stages was found to be significant. The canine calcification could be used as a sole indicator for assessment of skeletal maturity.

  7. Testing and assessment strategies, including alternative and new approaches

    DEFF Research Database (Denmark)

    Meyer, Otto A.

    2003-01-01

    The object of toxicological testing is to predict possible adverse effect in humans when exposed to chemicals whether used as industrial chemicals, pharmaceuticals or pesticides. Animal models are predominantly used in identifying potential hazards of chemicals. The use of laboratory animals raises...... ethical concern. However, irrespective of animal welfare it is an important aspect of the discipline of toxicology that the primary object is human health. The ideal testing and assessment strategy is simple to use all the available test methods and preferably more in laboratory animal species from which...... uses and of the absence of health problems involved with their use. Thus, the regulatory toxicology is a cocktail of science and pragmatism added a crucial concern for animal welfare. Test methods are most often used in a testing sequence as bricks in a testing strategy. The main key driving forces...

  8. Expanding Health Technology Assessments to Include Effects on the Environment

    DEFF Research Database (Denmark)

    Marsh, Kevin; Ganz, Michael Lee; Hsu, John

    2016-01-01

    decision makers. Health care is an important and sizable sector of the economy that could warrant closer policy attention to its impact on the environment. Considerable work is needed to track decision makers' demands, augment the environmental evidence base, and develop robust methods for capturing......There is growing awareness of the impact of human activity on the climate and the need to stem this impact. Public health care decision makers from Sweden and the United Kingdom have started examining environmental impacts when assessing new technologies. This article considers the case...... and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some...

  9. Reliability assessment of distribution power systems including distributed generations

    International Nuclear Information System (INIS)

    Megdiche, M.

    2004-12-01

    Nowadays, power systems have reached a good level of reliability. Nevertheless, considering the modifications induced by the connections of small independent producers to distribution networks, there's a need to assess the reliability of these new systems. Distribution networks present several functional characteristics, highlighted by the qualitative study of the failures, as dispersed loads at several places, variable topology and some electrotechnical phenomena which must be taken into account to model the events that can occur. The adopted reliability calculations method is Monte Carlo simulations, the probabilistic method most powerful and most flexible to model complex operating of the distribution system. We devoted a first part on the case of a 20 kV feeder to which a cogeneration unit is connected. The method was applied to a software of stochastic Petri nets simulations. Then a second part related to the study of a low voltage power system supplied by dispersed generations. Here, the complexity of the events required to code the method in an environment of programming allowing the use of power system calculations (load flow, short-circuit, load shedding, management of units powers) in order to analyse the system state for each new event. (author)

  10. Development of Constraint Force Equation Methodology for Application to Multi-Body Dynamics Including Launch Vehicle Stage Seperation

    Science.gov (United States)

    Pamadi, Bandu N.; Toniolo, Matthew D.; Tartabini, Paul V.; Roithmayr, Carlos M.; Albertson, Cindy W.; Karlgaard, Christopher D.

    2016-01-01

    The objective of this report is to develop and implement a physics based method for analysis and simulation of multi-body dynamics including launch vehicle stage separation. The constraint force equation (CFE) methodology discussed in this report provides such a framework for modeling constraint forces and moments acting at joints when the vehicles are still connected. Several stand-alone test cases involving various types of joints were developed to validate the CFE methodology. The results were compared with ADAMS(Registered Trademark) and Autolev, two different industry standard benchmark codes for multi-body dynamic analysis and simulations. However, these two codes are not designed for aerospace flight trajectory simulations. After this validation exercise, the CFE algorithm was implemented in Program to Optimize Simulated Trajectories II (POST2) to provide a capability to simulate end-to-end trajectories of launch vehicles including stage separation. The POST2/CFE methodology was applied to the STS-1 Space Shuttle solid rocket booster (SRB) separation and Hyper-X Research Vehicle (HXRV) separation from the Pegasus booster as a further test and validation for its application to launch vehicle stage separation problems. Finally, to demonstrate end-to-end simulation capability, POST2/CFE was applied to the ascent, orbit insertion, and booster return of a reusable two-stage-to-orbit (TSTO) vehicle concept. With these validation exercises, POST2/CFE software can be used for performing conceptual level end-to-end simulations, including launch vehicle stage separation, for problems similar to those discussed in this report.

  11. Assessment of Dual Life Stage Antiplasmodial Activity of British Seaweeds

    Directory of Open Access Journals (Sweden)

    Deniz Tasdemir

    2013-10-01

    Full Text Available Terrestrial plants have proven to be a prolific producer of clinically effective antimalarial drugs, but the antimalarial potential of seaweeds has been little explored. The main aim of this study was to assess the in vitro chemotherapeutical and prophylactic potential of the extracts of twenty-three seaweeds collected from the south coast of England against blood stage (BS and liver stage (LS Plasmodium parasites. The majority (14 of the extracts were active against BS of P. falciparum, with brown seaweeds Cystoseira tamariscifolia, C. baccata and the green seaweed Ulva lactuca being the most active (IC50s around 3 μg/mL. The extracts generally had high selectivity indices (>10. Eight seaweed extracts inhibited the growth of LS parasites of P. berghei without any obvious effect on the viability of the human hepatoma (Huh7 cells, and the highest potential was exerted by U. lactuca and red seaweeds Ceramium virgatum and Halopitys incurvus (IC50 values 14.9 to 28.8 μg/mL. The LS-active extracts inhibited one or more key enzymes of the malarial type-II fatty acid biosynthesis (FAS-II pathway, a drug target specific for LS. Except for the red seaweed Halopitys incurvus, all LS-active extracts showed dual activity versus both malarial intracellular stage parasites. This is the first report of LS antiplasmodial activity and dual stage inhibitory potential of seaweeds.

  12. Supplementing quantitative risk assessments with a stage addressing the risk understanding of the decision maker

    International Nuclear Information System (INIS)

    Aven, Terje

    2016-01-01

    A quantitative probabilistic risk assessment produces a conditional risk description given the knowledge of the analysts (formulated to a large extent through assumptions). However, important aspects of the risk may be concealed in the background knowledge of the analyst and the assumptions. This paper discusses this issue, the main purpose being to present a two-stage risk assessment approach where the second stage addresses the risk understanding of the decision maker. This second-stage is to a large extent qualitative. The approach is novel with its separation between the analysts' conditional risk descriptions using probability judgments, and the decision maker's risk understanding. The approach aims at improving the use of risk assessment in practical decision making by ensuring that the results of the risk assessments are properly interpreted and the key aspects of risk, uncertainty and knowledge are brought to attention for the decision makers. Examples are used to illustrate the approach. - Highlights: • A quantitative risk assessment produces a conditional risk description. • The decision maker (DM) needs to address risk beyond this description. • The paper presents a related two-stage process, covering analyst and DM judgments. • The second stage relates to the DM's risk understanding. • Strength of knowledge judgments are included in both stages.

  13. Food webs including parasites, biomass, body sizes, and life stages for three California/Baja California estuaries

    Science.gov (United States)

    Hechinger, Ryan F.; Lafferty, Kevin D.; McLaughlin, John P.; Fredensborg, Brian L.; Huspeni, Todd C.; Lorda, Julio; Sandhu, Parwant K.; Shaw, Jenny C.; Torchin, Mark E.; Whitney, Kathleen L.; Kuris, Armand M.

    2001-01-01

    This data set presents food webs for three North American Pacific coast estuaries and a “Metaweb” composed of the species/stages compiled from all three estuaries. The webs have four noteworthy attributes: (1) parasites (infectious agents), (2) body-size information, (3) biomass information, and (4) ontogenetic stages of many animals with complex life cycles. The estuaries are Carpinteria Salt Marsh, California (CSM); Estero de Punta Banda, Baja California (EPB); and Bahía Falsa in Bahía San Quintín, Baja California (BSQ). Most data on species assemblages and parasitism were gathered via consistent sampling that acquired body size and biomass information for plants and animals larger than ∼1 mm, and for many infectious agents (mostly metazoan parasites, but also some microbes). We augmented this with information from additional published sources and by sampling unrepresented groups (e.g., plankton). We estimated free-living consumer–resource links primarily by extending a previously published version of the CSM web (which the current CSM web supplants) and determined most parasite consumer–resource links from direct observation. We recognize 21 possible link types including four general interactions: predators consuming prey, parasites consuming hosts, predators consuming parasites, and parasites consuming parasites. While generally resolved to the species level, we report stage-specific nodes for many animals with complex life cycles. We include additional biological information for each node, such as taxonomy, lifestyle (free-living, infectious, commensal, mutualist), mobility, and residency. The Metaweb includes 500 nodes, 314 species, and 11 270 links projected to be present given appropriate species' co-occurrences. Of these, 9247 links were present in one or more of the estuarine webs. The remaining 2023 links were not present in the estuaries but are included here because they may occur in other places or times. Initial analyses have examined

  14. A new system for assessment of growth using mandibular canine calcification stages and its correlation with modified MP3 stages

    Directory of Open Access Journals (Sweden)

    Gautham Hegde

    2014-01-01

    Full Text Available Objective: Orthodontic diagnosis and treatment planning for growing children must involve growth prediction, especially in the treatment of skeletal problems. Studies have shown that a strong association exists between skeletal maturity and dental calcification stages. The present study was therefore taken up to provide a simple and practical method for assessing skeletal maturity using a dental periapical film and standard dental X-ray machine, to compare the developmental stages of the mandibular canine with that of developmental stages of modified MP3 and to find out if any correlation exists, to determine if the developmental stages of the mandibular canine alone can be used as a reliable indicator for assessment of skeletal maturity. Materials and Methods: A total of 160 periapical radiographs, of the mandibular right canine and the MP3 region was taken and assessed according to the Dermirjian′s stages of dental calcification and the modified MP3 stages. Results and Discussion: The correlation coefficient between MP3 stages and developmental stages of mandibular canine was found to be significant in both male and female groups. When the canine calcification stages were compared with the MP3 stages it was found that with the exception of the D stage of canine calcification the remaining stages showed a very high correlation with the modified MP3 stages. Conclusion: The correlation between the mandibular canine calcification stages, and the MP3 stages was found to be significant. The canine calcification could be used as a sole indicator for assessment of skeletal maturity.

  15. Life cycle assessment of nanoadsorbents at early stage technological development

    DEFF Research Database (Denmark)

    Kazemi, Ali; Bahramifar, Nader; Heydari, Akbar

    2018-01-01

    the process of the functionalization of nanoadsorbents leads to the increase of the adsorption capacity of nanoadsorbents, it is also paired with a significant enhancement of negative environmental impacts. The results of t-test comparing the cradle-to-use life cycle impacts of studied impact categories for 1...... in the control and removal of environmental pollutants. This application is still an emerging technology at the early stages of development. Hence, the heart of this study enables an environmental assessment of nanoadsorbents as an emerging product. In addition, the environmental impacts of synthesized...

  16. Stages of change in audiology: comparison of three self-assessment measures.

    Science.gov (United States)

    Ingo, Elisabeth; Brännström, K Jonas; Andersson, Gerhard; Lunner, Thomas; Laplante-Lévesque, Ariane

    2017-07-01

    In a clinical setting, theories of health behaviour change could help audiologists and other hearing health care professionals understand the barriers that prevent people with hearing problems to seek audiological help. The transtheoretical (stages of change) model of health behaviour change is one of these theories. It describes a person's journey towards health behaviour change (e.g. seeking help or taking up rehabilitation) in separate stages: precontemplation, contemplation, preparation, action, and, finally, maintenance. A short self-assessment measure of stages of change may guide the clinician and facilitate first appointments. This article describes correlations between three stages of change measures of different lengths, one 24-item and two one-item. Participants were recruited through an online hearing screening study. Adults who failed the speech-in-noise recognition screening test and who had never undergone a hearing aid fitting were invited to complete further questionnaires online, including the three stages of change measures. In total, 224 adults completed the three measures. A majority of the participants were categorised as being in one of the information- and help-seeking stage of change (contemplation or preparation). The three stages of change measures were significantly correlated. Conclusions Our results support further investigating the use of a one-item measure to determine stages of change in people with hearing impairment.

  17. Assessment and Verification of SLS Block 1-B Exploration Upper Stage State and Stage Disposal Performance

    Science.gov (United States)

    Patrick, Sean; Oliver, Emerson

    2018-01-01

    One of the SLS Navigation System's key performance requirements is a constraint on the payload system's delta-v allocation to correct for insertion errors due to vehicle state uncertainty at payload separation. The SLS navigation team has developed a Delta-Delta-V analysis approach to assess the effect on trajectory correction maneuver (TCM) design needed to correct for navigation errors. This approach differs from traditional covariance analysis based methods and makes no assumptions with regard to the propagation of the state dynamics. This allows for consideration of non-linearity in the propagation of state uncertainties. The Delta-Delta-V analysis approach re-optimizes perturbed SLS mission trajectories by varying key mission states in accordance with an assumed state error. The state error is developed from detailed vehicle 6-DOF Monte Carlo analysis or generated using covariance analysis. These perturbed trajectories are compared to a nominal trajectory to determine necessary TCM design. To implement this analysis approach, a tool set was developed which combines the functionality of a 3-DOF trajectory optimization tool, Copernicus, and a detailed 6-DOF vehicle simulation tool, Marshall Aerospace Vehicle Representation in C (MAVERIC). In addition to delta-v allocation constraints on SLS navigation performance, SLS mission requirement dictate successful upper stage disposal. Due to engine and propellant constraints, the SLS Exploration Upper Stage (EUS) must dispose into heliocentric space by means of a lunar fly-by maneuver. As with payload delta-v allocation, upper stage disposal maneuvers must place the EUS on a trajectory that maximizes the probability of achieving a heliocentric orbit post Lunar fly-by considering all sources of vehicle state uncertainty prior to the maneuver. To ensure disposal, the SLS navigation team has developed an analysis approach to derive optimal disposal guidance targets. This approach maximizes the state error covariance prior

  18. Including Health in Environmental Assessments of Major Transport Infrastructure Projects: A Documentary Analysis.

    Science.gov (United States)

    Riley, Emily; Harris, Patrick; Kent, Jennifer; Sainsbury, Peter; Lane, Anna; Baum, Fran

    2018-05-10

    Transport policy and practice impacts health. Environmental Impact Assessments (EIAs) are regulated public policy mechanisms that can be used to consider the health impacts of major transport projects before they are approved. The way health is considered in these environmental assessments (EAs) is not well known. This research asked: How and to what extent was human health considered in EAs of four major transport projects in Australia. We developed a comprehensive coding framework to analyse the Environmental Impact Statements (EISs) of four transport infrastructure projects: three road and one light rail. The coding framework was designed to capture how health was directly and indirectly included. We found that health was partially considered in all four EISs. In the three New South Wales (NSW) projects, but not the one South Australian project, this was influenced by the requirements issued to proponents by the government which directed the content of the EIS. Health was assessed using human health risk assessment (HHRA). We found this to be narrow in focus and revealed a need for a broader social determinants of health approach, using multiple methods. The road assessments emphasised air quality and noise risks, concluding these were minimal or predicted to improve. The South Australian project was the only road project not to include health data explicitly. The light rail EIS considered the health benefits of the project whereas the others focused on risk. Only one project considered mental health, although in less detail than air quality or noise. Our findings suggest EIAs lag behind the known evidence linking transport infrastructure to health. If health is to be comprehensively included, a more complete model of health is required, as well as a shift away from health risk assessment as the main method used. This needs to be mandatory for all significant developments. We also found that considering health only at the EIA stage may be a significant

  19. Operative link on gastritis assessment stage is an appropriate predictor of early gastric cancer.

    Science.gov (United States)

    Zhou, Ying; Li, Hai-Yan; Zhang, Jing-Jing; Chen, Xiao-Yu; Ge, Zhi-Zheng; Li, Xiao-Bo

    2016-04-07

    To assess the predictive value of Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) stages in gastric cancer. A prospective study was conducted with 71 patients with early gastric cancer (EGC) and 156 patients with non-EGC. All patients underwent endoscopic examination and systematic biopsy. Outcome measures were assessed and compared, including the Japanese endoscopic gastric atrophy (EGA) classification method and the modified OLGA method as well as the modified OLGIM method. Helicobacter pylori (H. pylori) status was determined for all study participants. Stepwise logistic regression modeling was performed to analyze correlations between EGC and the EGA, OLGA and OLGIM methods. For patients with EGC and patients with non-EGC, the proportions of moderate-to-severe EGA cases were 64.8% and 44.9%, respectively (P = 0.005), the proportions of OLGA stages III-IV cases were 52.1% and 22.4%, respectively (P cancer.

  20. Effects of Hot Streak and Phantom Cooling on Heat Transfer in a Cooled Turbine Stage Including Particulate Deposition

    Energy Technology Data Exchange (ETDEWEB)

    Bons, Jeffrey [The Ohio State Univ., Columbus, OH (United States); Ameri, Ali [The Ohio State Univ., Columbus, OH (United States)

    2016-01-08

    The objective of this research effort was to develop a validated computational modeling capability for the characterization of the effects of hot streaks and particulate deposition on the heat load of modern gas turbines. This was accomplished with a multi-faceted approach including analytical, experimental, and computational components. A 1-year no cost extension request was approved for this effort, so the total duration was 4 years. The research effort succeeded in its ultimate objective by leveraging extensive experimental deposition studies complemented by computational modeling. Experiments were conducted with hot streaks, vane cooling, and combinations of hot streaks with vane cooling. These studies contributed to a significant body of corporate knowledge of deposition, in combination with particle rebound and deposition studies funded by other agencies, to provide suitable conditions for the development of a new model. The model includes the following physical phenomena: elastic deformation, plastic deformation, adhesion, and shear removal. It also incorporates material property sensitivity to temperature and tangential-normal velocity rebound cross-dependencies observed in experiments. The model is well-suited for incorporation in CFD simulations of complex gas turbine flows due to its algebraic (explicit) formulation. This report contains model predictions compared to coefficient of restitution data available in the open literature as well as deposition results from two different high temperature turbine deposition facilities. While the model comparisons with experiments are in many cases promising, several key aspects of particle deposition remain elusive. The simple phenomenological nature of the model allows for parametric dependencies to be evaluated in a straightforward manner. This effort also included the first-ever full turbine stage deposition model published in the open literature. The simulations included hot streaks and simulated vane cooling

  1. Roentgenological criteria od assessment of stages of hydronephrosis in children

    International Nuclear Information System (INIS)

    Pavlova, M.K.

    1988-01-01

    A new parenchymatous index was proposed in order to raise the resolving power of excretory urography, and 3 stages of hydronephrosis were defined on the basis of quantitative indices. X-ray criteria were defined to prevent surgery in a group of children with the initial stage of disease. A group of patients with the terminal stage of hydronephrosis was subdivided into 2 groups: 1) sparing operation, 2) nephrectomy

  2. Environmental Assessment for Hazardous Waste Staging Facility, Pantex Plant, Amarillo, Texas

    International Nuclear Information System (INIS)

    1993-06-01

    This Environmental Assessment (EA) has been prepared pursuant to the implementing regulations to the National Environmental Policy Act (NEPA), which require federal agencies to assess the environmental impacts of a proposed action to determine whether that action requires the preparation of an Environmental Impact Statement (EIS) or if a Finding of No Significant Impact (FONSI) can be issued. The Pantex Plant does not possess permanent containerized waste staging facilities with integral secondary containment or freeze protection. Additional deficiencies associated with some existing staging facilities include: no protection from precipitation running across the staging pads; lack of protection against weathering; and facility foundations not capable of containing leaks, spills or accumulated precipitation. These shortcomings have raised concerns with respect to requirements under Section 3001 of the Resource Conservation and Recovery Act (RCRA). Deficiencies for these waste staging areas were also cited by a government audit team (Tiger Team) as Action Items. The provision for the staging of hazardous, mixed, and low level waste is part of the no-action altemative in the Programmatic Environmental Impact Statement for the integrated ER/WM program. Construction of this proposed project will not prejudice whether or not this integration will occur, or how

  3. Including Students with Disabilities in Common Non-Summative Assessments. NCEO Brief. Number 6

    Science.gov (United States)

    National Center on Educational Outcomes, 2012

    2012-01-01

    Inclusive large-scale assessments have become the norm in states across the U.S. Participation rates of students with disabilities in these assessments have increased dramatically since the mid-1990s. As consortia of states move toward the development and implementation of assessment systems that include both non-summative assessments and…

  4. Hierarchical structure of moral stages assessed by a sorting task

    NARCIS (Netherlands)

    Boom, J.; Brugman, D.; Van der Heijden, P.G.M.

    2001-01-01

    Following criticism of Kohlberg’s theory of moral judgment, an empirical re-examination of hierarchical stage structure was desirable. Utilizing Piaget’s concept of reflective abstraction as a basis, the hierarchical stage structure was investigated using a new method. Study participants (553 Dutch

  5. Environmental assessment for the National Conversion Pilot Project, Stage 3

    International Nuclear Information System (INIS)

    1997-01-01

    The purpose of the National Conversion Pilot Project (NCPP) is to explore and demonstrate, at the Rocky Flats Environmental Technology Site (RFETS), the feasibility of economic conversion at Department of Energy facilities. Economic conversion is the conversion of facilities and equipment owned by the Federal government to production of goods by private firms for profit. The NCPP mission is consistent with the RFETS current mission: to conduct site remediation, decontaminate and decommission site buildings and close the site in a manner that is safe, environmentally and socially responsible, physically secure, and cost effective. The NCPP is divided into three stages, with decision points at the ends of Stages 1 and 2 and periodically during Stage 3, to help ensure careful consideration of project effectiveness and to create an opportunity for regulators and stakeholders to provide comments to the DOE. At the end of each stage, the project can be reversed, authorized to proceed, or terminated

  6. Comparative assessment of single-stage and two-stage anaerobic digestion for the treatment of thin stillage.

    Science.gov (United States)

    Nasr, Noha; Elbeshbishy, Elsayed; Hafez, Hisham; Nakhla, George; El Naggar, M Hesham

    2012-05-01

    A comparative evaluation of single-stage and two-stage anaerobic digestion processes for biomethane and biohydrogen production using thin stillage was performed to assess the impact of separating the acidogenic and methanogenic stages on anaerobic digestion. Thin stillage, the main by-product from ethanol production, was characterized by high total chemical oxygen demand (TCOD) of 122 g/L and total volatile fatty acids (TVFAs) of 12 g/L. A maximum methane yield of 0.33 L CH(4)/gCOD(added) (STP) was achieved in the two-stage process while a single-stage process achieved a maximum yield of only 0.26 L CH(4)/gCOD(added) (STP). The separation of acidification stage increased the TVFAs to TCOD ratio from 10% in the raw thin stillage to 54% due to the conversion of carbohydrates into hydrogen and VFAs. Comparison of the two processes based on energy outcome revealed that an increase of 18.5% in the total energy yield was achieved using two-stage anaerobic digestion. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Acceleration of small, light projectiles (including hydrogen isotopes) to high speeds using a two-stage light gas gun

    International Nuclear Information System (INIS)

    Combs, S.K.; Foust, C.R.; Gouge, M.J.; Milora, S.L.

    1989-01-01

    Small, light projectiles have been accelerated to high speeds using a two-stage light gas gun at Oak Ridge National Laboratory. With 35-mg plastic projectiles (4 mm in diameter), speeds of up to 4.5 km/s have been recorded. The ''pipe gun'' technique for freezing hydrogen isotopes in situ in the gun barrel has been used to accelerate deuterium pellets (nominal diameter of 4 mm) to velocities of up to 2.85 km/s. The primary application of this technology is for plasma fueling of fusion devices via pellet injection of hydrogen isotopes. Conventional pellet injectors are limited to pellet speeds in the range 1-2 km/s. Higher velocities are desirable for plasma fueling applications, and the two-stage pneumatic technique offers performance in a higher velocity regime. However, experimental results indicate that the use of sabots to encase the cryogenic pellets and protect them for the high peak pressures will be required to reliably attain intact pellets at speeds of ∼3 km/s or greater. In some limited tests, lithium hydride pellets were accelerated to speeds of up to 4.2 km/s. Also, repetitive operation of the two-stage gun (four plastic pellets fired at ∼0.5 Hz) was demonstrated for the first time in preliminary tests. The equipment and operation are described, and experimental results and some comparisons with a theoretical model are presented. 17 refs., 6 figs., 2 tabs

  8. Hyperfractionated radiotherapy and simultaneous cisplatin for stage-III and -IV carcinomas of the head and neck. Long-term results including functional outcome

    International Nuclear Information System (INIS)

    Huguenin, P.; Glanzmann, C.; Taussky, D.; Luetolf, U.M.; Schmid, S.; Moe, K.

    1998-01-01

    Purpose: To assess the survival rate, the probability of local control, the patterns of relapse and late sequelae including self-reported quality of life in patients treated with hyperfractionated radiotherapy (RT) and simultaneous CDDP chemotherapy for stage-III to stage-IV carcinomas of the head and neck. Methods: From 1988 to 1994, 64 patients (median age 55.5 years) with carcinomas of different subsites, excluding the nasopharynx, were treated in a pilot study with 1.2 Gy bid (6 h interval; total dose 74.4 Gy) and simultaneous CDDP (20 mg/m 2 daily, 5 days in week 1 and 5) and followed at regular intervals. Overall survival and local control, as well as the rates of late toxicity, were estimated using the actuarial method. Median follow-up was 3.3 years for all and 5.2 years for surviving patients. To assess the quality of life, the EORTC QLQ-C 30 questionnaire and the H and N35 module questionnaire were sent to the patients surviving with no evidence of disease or second primary tumors; they were answered by 15/23 (67%). Results: Overall survival was 37% at 5 years, whereas disease-specific survival was 59%. Twenty-three patients died from uncontrolled head and neck cancer. Second primary tumors were observed in 13 patients, most frequently in the lung. Local control without salvage surgery was 74% at 5 years for all subsites and stages, and loco-regional disease-free survival was 72%. Eleven patients developed distant metastases, which was the only site of failure in 6 cases. Salvage surgery was successful in 2 cases. The actuarial estimates of ≥grade-3 late toxicity was 4% for the mandibular bone and 23% for dysphagia, and 50% of the patients experienced a permanent xerostomy. Self-reported global quality of life in surviving patients was good (mean 68 points on a scale 0 to 100); consequences of impaired salivary function had most impact on nutritional and social aspects. Conclusions: Hyperfractionated RT with concomitant CDDP is well tolerated and highly

  9. Dynamics of waterflooding massive oil deposits in the Chechen Ingush ASSR, including fissured reservoirs in the late stages of development

    Energy Technology Data Exchange (ETDEWEB)

    Tatashev, K.Kh.; Soboleva, G.N.; Tagunova, A.V.

    1979-01-01

    In 1956 in the Chechen Ingush ASSR a number of massive oil deposits located in fissured cavernous Upper Cretaceous limestone were developed. The deposits were developed by water-oil displacement from the edges and pericline toward the dome of the structure using the natural water pressure drive as well as artificial marginal flooding. The great oil-bearing capacity, the good hydrodynamic link with the deposit, the close magnitude of oil viscosity and water under the layer conditions and the significant difference in their density (0.4-0.5 g/cm/sup 3/) practically guarantees pistonlike oil displacement. Based on the deposit's geologic-physical characteristics, the late stage of development may be characterized by noncontinuous time and a sharp increase in well waterflooding to maintain full flooding. However, the data obtained from working the field suggest that a sharp increase in waterflooding will be substituted by a slow increase, by stabilization and possibly even a decrease in the percentage of water over the last 3-6 years. This occurred in a number of cases where measures were taken to limit the liquid flow, to periodically operate the well with isolated waterflooding and pereclinal perforation at intervals. This also occurred in a number of cases where the rate of fluid yield was naturally lowered by decreasing the number of producing wells due to waterflooding and disengagement. To more completely extract the oil from relatively low permeable areas of the deposits and to develop them in the later stages, it is useful to use a slow tempo once all wells have been brought to perclinal interval operation.

  10. Hepatosplenic volumetric assessment at MDCT for staging liver fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Pickhardt, Perry J.; Malecki, Kyle; Hunt, Oliver F.; Beaumont, Claire; Kloke, John; Ziemlewicz, Timothy J.; Lubner, Meghan G. [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States)

    2017-07-15

    To investigate hepatosplenic volumetry at MDCT for non-invasive prediction of hepatic fibrosis. Hepatosplenic volume analysis in 624 patients (mean age, 48.8 years; 311 M/313 F) at MDCT was performed using dedicated software and compared against pathological fibrosis stage (F0 = 374; F1 = 48; F2 = 40; F3 = 65; F4 = 97). The liver segmental volume ratio (LSVR) was defined by Couinaud segments I-III over segments IV-VIII. All pre-cirrhotic fibrosis stages (METAVIR F1-F3) were based on liver biopsy within 1 year of MDCT. LSVR and total splenic volumes increased with stage of fibrosis, with mean(±SD) values of: F0: 0.26 ± 0.06 and 215.1 ± 88.5 mm{sup 3}; F1: 0.25 ± 0.08 and 294.8 ± 153.4 mm{sup 3}; F2: 0.331 ± 0.12 and 291.6 ± 197.1 mm{sup 3}; F3: 0.39 ± 0.15 and 509.6 ± 402.6 mm{sup 3}; F4: 0.56 ± 0.30 and 790.7 ± 450.3 mm{sup 3}, respectively. Total hepatic volumes showed poor discrimination (F0: 1674 ± 320 mm{sup 3}; F4: 1631 ± 691 mm{sup 3}). For discriminating advanced fibrosis (≥F3), the ROC AUC values for LSVR, total liver volume, splenic volume and LSVR/spleen combined were 0.863, 0.506, 0.890 and 0.947, respectively. Relative changes in segmental liver volumes and total splenic volume allow for non-invasive staging of hepatic fibrosis, whereas total liver volume is a poor predictor. Unlike liver biopsy or elastography, these CT volumetric biomarkers can be obtained retrospectively on routine scans obtained for other indications. (orig.)

  11. Stages of change for physical activity and dietary habits in persons with type 2 diabetes included in a mobile health intervention: the Norwegian study in RENEWING HEALTH.

    Science.gov (United States)

    Holmen, Heidi; Wahl, Astrid; Torbjørnsen, Astrid; Jenum, Anne Karen; Småstuen, Milada Cvancarova; Ribu, Lis

    2016-01-01

    The aim of this study was to investigate stages of change for physical activity and dietary habits using baseline data from persons with type 2 diabetes included in a mobile health intervention. We examined the associations between stages of change for physical activity change and dietary change, and between stages of change for each behavior and individual characteristics, health-related quality of life, self-management, depressive symptoms, and lifestyle. We examined 151 persons with type 2 diabetes with an glycated hemoglobin (HbA1c) level ≥7.1%, aged ≥18 years at baseline of a randomized controlled trial, before testing a mobile app with or without health counseling. Stages of change were dichotomized into 'pre-action' and 'action'. Self-management was measured using the Health Education Impact Questionnaire (heiQ) where a higher score reflects increased self-management, and health-related quality of life was measured with the Short-Form-36 (SF-36). Logistic regression modeling was performed. The median HbA1c level was 7.9% (7.1-12.4), 90% were overweight or obese, and 20% had ≥3 comorbidities. 58% were in the preaction stage for physical activity change and 79% in the preaction stage for dietary change. Higher scores of self-management were associated with an increased chance of being in the action stage for both dietary change and physical activity change. Higher body mass index was associated with an 8% reduced chance of being in the action stage for physical activity change (OR 0.92, 95% CI 0.86 to 0.99). Being in the action stage was associated with higher scores of self-management, crucial for type 2 diabetes. Over half of the participants were in the preaction stage for physical activity and dietary change, and many had a high disease burden with comorbidities and overweight. NCT01315756.

  12. The role of competence assessment in the different stages of competence development

    NARCIS (Netherlands)

    Schoonenboom, J.; Tattersall, C.; Miao, Y.; Stefanov, K.; Aleksieva-Petrova, A.; Adelsberger, H.H.; Kinshuk,; Pawlowski, J.M.; Sampson, D.

    2008-01-01

    This chapter discusses the role of e-assessment in the process of competence development. Its basic claim is that competence development is a process with distinct stages, and that the assessment forms and the roles taken on by those involved in the process depend on the stage in which learning

  13. Risk Assessment Challenges in the Ares I Upper Stage

    Science.gov (United States)

    Stott, James E.; Ring, Robert W.; Elrada, Hassan A.; Hark, Frank

    2007-01-01

    NASA Marshall Space Flight Center (MSFC) is currently at work developing hardware and systems for the Ares I rocket that will send future astronauts into orbit. Built on cutting-edge launch technologies, evolved powerful Apollo and Space Shuttle propulsion elements, and decades of NASA spaceflight experience, Ares I is the essential core of a safe, reliable, cost-effective space transportation system -- one that will carry crewed missions back to the moon, on to Mars and out into the solar system. Ares I is an in-line, two-stage rocket configuration topped by the Orion crew vehicle and its launch abort system. In addition to the vehicle's primary mission -carrying crews of four to six astronauts to Earth orbit --Ares I may also use its 25-ton payload capacity to deliver resources and supplies to the International Space Station, or to "park" payloads in orbit for retrieval by other spacecraft bound for the moon or other destinations. Crew transportation to the International Space Station is planned to begin no later than 2014. The first lunar excursion is scheduled for the 2020 timeframe. This paper presents the challenges in designing the Ares I upper stage for reliability and safety while minimizing weight and maximizing performance.

  14. Psychiatry in primary care using the three-stage assessment

    African Journals Online (AJOL)

    psychiatrists working in psychiatric institutions. Therefore, the ... may be less dramatic, it would be a mistake to assume that assessing a patient with .... JB feels that the stress in .... flexible and adaptable to the unique needs of each patient.

  15. Temperature Assessment of Heating Stage for a Thermoforming Equipment

    International Nuclear Information System (INIS)

    Mohd Ghazali, F.A.; Ab Rahim, M.F.; Jaafar, A.A.; Ahmad, M.N.

    2016-01-01

    Thermoforming is a well-known manufacturing process in the productions of various plastic household and industrial solutions. The heating of a plastic sheet allows the plastic to soften and within its forming window temperature the sheet can replicate a required shape when pressed against a mould. Hence, the heating process is an important thermoforming stage that determine uniformity of the material distribution. This article proposed an experimental approach to investigate the thermal characteristics of the heating section of a low cost thermoforming equipment designed for teaching and research purposes. The temperatures of air and a model of a stretched heated plastic sheet were measured and analysed. The experimental data indicates that the spatial temperatures distribution was not localised and the temperature history of the infrared heating agrees well with those given by fast response thermocouples. The findings suggest that the spatial uniformity of temperature can be reasonably evaluated by using the proposed method. (paper)

  16. Radiographic assessment of skeletal maturation stages for orthodontic patients: hand-wrist bones or cervical vertebrae?

    Science.gov (United States)

    Lai, Eddie Hsiang-Hua; Liu, Jen-Pei; Chang, Jenny Zwei-Chieng; Tsai, Shih-Jaw; Yao, Chung-Chen Jane; Chen, Mu-Hsiung; Chen, Yi-Jane; Lin, Chun-Pin

    2008-04-01

    The skeletal maturation status of a growing patient can influence the selection of orthodontic treatment procedures. Either lateral cephalometric or hand-wrist radiography can be used to assess skeletal development. In this study, we examined the correlation between the maturation stages of cervical vertebrae and hand-wrist bones in Taiwanese individuals. The study group consisted of 330 male and 379 female subjects ranging in age from 8 to 18 years. A total of 709 hand-wrist and 709 lateral cephalometric radiographs were analyzed. Hand-wrist maturation stages were assessed using National Taiwan University Hospital Skeletal Maturation Index (NTUH-SMI). Cervical vertebral maturation stages were determined by the latest Cervical Vertebral Maturation Stage (CVMS) Index. Spearman's rank correlation was used to correlate the respective maturation stages assessed from the hand-wrist bones and the cervical vertebrae. The values of Spearman's rank correlation were 0.910 for males and 0.937 for females, respectively. These data confirmed a strong and significant correlation between CVMS and NTUH-SMI systems (p less than 0.001). After comparison of the mean ages of subjects in different stages of CVMS and NTU-SMI systems, we found that CVMS I corresponded to NTUH-SMI stages 1 and 2, CVMS II to NTUH-SMI stage 3, CVMS III to NTUHSMI stage 4, CVMS IV to NTUH-SMI stage 5, CVMS V to NTUH-SMI stages 6, 7 and 8, and CVMS VI to NTUH-SMI stage 9. Our results indicate that cervical vertebral maturation stages can be used to replace hand-wrist bone maturation stages for evaluation of skeletal maturity in Taiwanese individuals.

  17. Visual assessment of the cervical vertebral maturation stages: A study of diagnostic accuracy and repeatability.

    Science.gov (United States)

    Perinetti, Giuseppe; Caprioglio, Alberto; Contardo, Luca

    2014-11-01

    To evaluate the diagnostic accuracy and repeatability of the visual assessment of the cervical vertebral maturation (CVM) stages. Ten operators underwent training sessions in visual assessment of CVM staging. Subsequently, they were asked to stage 72 cases equally divided into the six stages. Such assessment was repeated twice in two sessions (T1 and T2) 4 weeks apart. A reference standard for each case was created according to a cephalometric analysis of both the concavities and shapes of the cervical vertebrae. The overall agreement with the reference standard was about 68% for both sessions and 76.9% for intrarater repeatability. The overall kappa coefficients with the reference standard were up to 0.86 for both sessions, and 0.88 for intrarater repeatability. Overall, disagreements one stage and twp stage apart were 23.5% (T1) and 5.1% (T2), respectively. Sensitivity ranged from 53.3% for CS5 (T1) to 99.9% for CS1 (T2), positive predictive values ranged from 52.4% for CS5 (T2) to 94.3% for CS6 (T1), and accuracy ranged from 83.6% for CS4 (T2) to 94.9% for CS1 (T1). Visual assessment of the CVM stages is accurate and repeatable to a satisfactory level. About one in three cases remain misclassified; disagreement is generally limited to one stage and is mostly seen in stages 4 and 5.

  18. Including biodiversity in life cycle assessment – State of the art, gaps and research needs

    International Nuclear Information System (INIS)

    Winter, Lisa; Lehmann, Annekatrin; Finogenova, Natalia; Finkbeiner, Matthias

    2017-01-01

    Purpose: For over 20 years the feasibility of including man-made impacts on biodiversity in the context of Life Cycle Assessment (LCA) has been explored. However, a comprehensive biodiversity impact assessment has so far not been performed. The aim of this study is to analyse how biodiversity is currently viewed in LCA, to highlight limitations and gaps and to provide recommendations for further research. Method: Firstly, biodiversity indicators are examined according to the level of biodiversity they assess (genetic, species, ecosystem) and to their usefulness for LCA. Secondly, relevant pressures on biodiversity that should be included in LCA are identified and available models (in and outside of an LCA context) for their assessment are discussed. Thirdly, existing impact assessment models are analysed in order to determine whether and how well pressures are already integrated into LCA. Finally, suggestions on how to include relevant pressures and impacts on biodiversity in LCA are provided and the necessary changes in each LCA phase that must follow are discussed. Results: The analysis of 119 indicators shows that 4% of indicators represent genetic diversity, 40% species diversity and 35% ecosystem diversity. 21% of the indicators consider further biodiversity-related topics. Out of the indicator sample, 42 indicators are deemed useful as impact indicators in LCA. Even though some identified pressures are already included in LCA with regard to their impacts on biodiversity (e.g. land use, carbon dioxide emissions etc.), other proven pressures on biodiversity have not yet been considered (e.g. noise, artificial light). Conclusion: Further research is required to devise new options (e.g. impact assessment models) for integrating biodiversity into LCA. The final goal is to cover all levels of biodiversity and include all missing pressures in LCA. Tentative approaches to achieve this goal are outlined. - Highlights: •Calculating man-made impacts highlights

  19. Including threat actor capability and motivation in risk assessment for Smart GRIDs

    NARCIS (Netherlands)

    Rossebo, J.E.Y.; Fransen, F.; Luiijf, H.A.M.

    2016-01-01

    The SEGRID (Security for Smart Electricity GRIDs) collaboration project, funded by the EU under the FP7 program investigates risk assessment methodologies and their possible need for enhancement. In this paper we discuss the need to include threat actor analysis in threat, vulnerability and risk

  20. What should be included in the assessment of laypersons' paediatric basic life support skills? Results from a Delphi consensus study.

    Science.gov (United States)

    Hasselager, Asbjørn Børch; Lauritsen, Torsten; Kristensen, Tim; Bohnstedt, Cathrine; Sønderskov, Claus; Østergaard, Doris; Tolsgaard, Martin Grønnebæk

    2018-01-18

    Assessment of laypersons' Paediatric Basic Life Support (PBLS) skills is important to ensure acquisition of effective PBLS competencies. However limited evidence exists on which PBLS skills are essential for laypersons. The same challenges exist with respect to the assessment of foreign body airway obstruction management (FBAOM) skills. We aimed to establish international consensus on how to assess laypersons' PBLS and FBAOM skills. A Delphi consensus survey was conducted. Out of a total of 84 invited experts, 28 agreed to participate. During the first Delphi round experts suggested items to assess laypersons' PBLS and FBAOM skills. In the second round, the suggested items received comments from and were rated by 26 experts (93%) on a 5-point scale (1 = not relevant to 5 = essential). Revised items were anonymously presented in a third round for comments and 23 (82%) experts completed a re-rating. Items with a score above 3 by more than 80% of the experts in the third round were included in an assessment instrument. In the first round, 19 and 15 items were identified to assess PBLS and FBAOM skills, respectively. The ratings and comments from the last two rounds resulted in nine and eight essential assessment items for PBLS and FBAOM skills, respectively. The PBLS items included: "Responsiveness"," Call for help", "Open airway"," Check breathing", "Rescue breaths", "Compressions", "Ventilations", "Time factor" and "Use of AED". The FBAOM items included: "Identify different stages of foreign body airway obstruction", "Identify consciousness", "Call for help", "Back blows", "Chest thrusts/abdominal thrusts according to age", "Identify loss of consciousness and change to CPR", "Assessment of breathing" and "Ventilation". For assessment of laypersons some PBLS and FBAOM skills described in guidelines are more important than others. Four out of nine of PBLS skills focus on airway and breathing skills, supporting the major importance of these skills for

  1. Simulation of a MR–PET protocol for staging of head-and-neck cancer including Dixon MR for attenuation correction

    Energy Technology Data Exchange (ETDEWEB)

    Eiber, Matthias, E-mail: matthias.eiber@tum.de [Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich (Germany); Souvatzoglou, Michael, E-mail: msouvatz@yahoo.de [Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich (Germany); Pickhard, Anja, E-mail: a.pickhard@lrz.tum.de [Department of Otorhinolaryngology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich (Germany); Loeffelbein, Denys J., E-mail: denys.loeffelbein@gmx.de [Department of Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich (Germany); Knopf, Andreas, E-mail: andreas.knopf@tum.de [Department of Otorhinolaryngology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich (Germany); Holzapfel, Konstantin, E-mail: holzapfel@roe.med.tum.de [Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich (Germany); Martinez-Möller, Axel, E-mail: a.martinez-moller@lrz.tu-muenchen.de [Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich (Germany); and others

    2012-10-15

    Purpose: To simulate and optimize a MR protocol for squamous cell cancer of the head and neck (HNSCC) patients for potential future use in an integrated whole-body MR–PET scanner. Materials and methods: On a clinical 3T scanner, which is the basis for a recently introduced fully integrated whole-body MR–PET, 20 patients with untreated HNSCC routinely staged with 18F-FDG PET/CT underwent a dedicated MR protocol for the neck. Moreover, a whole-body Dixon MR-sequence was applied, which is used for attenuation correction on a recently introduced hybrid MR–PET scanner. In a subset of patients volume-interpolated-breathhold (VIBE) T1w-sequences for lungs and liver were added. Total imaging time was analyzed for both groups. The quality of the delineation of the primary tumor (scale 0–3) and the presence or absence of lymph node metastases (scale 1–5) was evaluated for CT, MR, PET/CT and a combination of MR and PET to ensure that the MR–PET fusion does not cause a loss of diagnostic capability. PET was used to identify distant metastases. The PET dataset for simulated MR/PET was based on a segmentation of the CT data into 4 classes according to the approach of the Dixon MR-sequence for MR–PET. Standard of reference was histopathology in 19 cases. In one case no histopathological confirmation of a primary tumor could be achieved. Results: Mean imaging time was 35:17 min (range: 31:08–42:42 min) for the protocol including sequences for local staging and attenuation correction and 44:17 min (range: 35:44–54:58) for the extended protocol. Although not statistically significant a combination of MR and PET performed better in the delineation of the primary tumor (mean 2.20) compared to CT (mean 1.40), MR (1.95) and PET/CT (2.15) especially in patients with dental implants. PET/CT and combining MR and PET performed slightly better than CT and MR for the assessment of lymph node metastases. Two patients with distant metastases were only identified by PET

  2. Assessment of the effect of salinity on the early growth stage of the ...

    African Journals Online (AJOL)

    Assessment of the effect of salinity on the early growth stage of the common sunflower (Sanay cultivar) using spectral discrimination techniques. H Turhan, L Genc, SE Smith, YB Bostanci, OS Turkmen ...

  3. Life cycle assessment of sewage sludge management options including long-term impacts after land application

    DEFF Research Database (Denmark)

    Yoshida, Hiroko; ten Hoeve, Marieke; Christensen, Thomas Højlund

    2018-01-01

    -toxic impact categories other than freshwater eutrophication. The sensitivity analysis showed that the results were sensitive to soil and precipitation conditions. The ranking of scenarios was affected by local conditions for marine eutrophication. Overall, the present study highlighted the importance...... of including all sludge treatment stages and conducting a detailed N flow analysis, since the emission of reactive N into the environment is the major driver for almost all non-toxic impact categories....... happened. In general, the INC scenario performed better than or comparably to the scenarios with land application of the sludge. Human toxicity (non-carcinogenic) and eco-toxicity showed the highest normalised impact potentials for all the scenarios with land application. In both categories, impacts were...

  4. Rectal cancer staging: Multidetector-row computed tomography diagnostic accuracy in assessment of mesorectal fascia invasion

    Science.gov (United States)

    Ippolito, Davide; Drago, Silvia Girolama; Franzesi, Cammillo Talei; Fior, Davide; Sironi, Sandro

    2016-01-01

    AIM: To assess the diagnostic accuracy of multidetector-row computed tomography (MDCT) as compared with conventional magnetic resonance imaging (MRI), in identifying mesorectal fascia (MRF) invasion in rectal cancer patients. METHODS: Ninety-one patients with biopsy proven rectal adenocarcinoma referred for thoracic and abdominal CT staging were enrolled in this study. The contrast-enhanced MDCT scans were performed on a 256 row scanner (ICT, Philips) with the following acquisition parameters: tube voltage 120 KV, tube current 150-300 mAs. Imaging data were reviewed as axial and as multiplanar reconstructions (MPRs) images along the rectal tumor axis. MRI study, performed on 1.5 T with dedicated phased array multicoil, included multiplanar T2 and axial T1 sequences and diffusion weighted images (DWI). Axial and MPR CT images independently were compared to MRI and MRF involvement was determined. Diagnostic accuracy of both modalities was compared and statistically analyzed. RESULTS: According to MRI, the MRF was involved in 51 patients and not involved in 40 patients. DWI allowed to recognize the tumor as a focal mass with high signal intensity on high b-value images, compared with the signal of the normal adjacent rectal wall or with the lower tissue signal intensity background. The number of patients correctly staged by the native axial CT images was 71 out of 91 (41 with involved MRF; 30 with not involved MRF), while by using the MPR 80 patients were correctly staged (45 with involved MRF; 35 with not involved MRF). Local tumor staging suggested by MDCT agreed with those of MRI, obtaining for CT axial images sensitivity and specificity of 80.4% and 75%, positive predictive value (PPV) 80.4%, negative predictive value (NPV) 75% and accuracy 78%; while performing MPR the sensitivity and specificity increased to 88% and 87.5%, PPV was 90%, NPV 85.36% and accuracy 88%. MPR images showed higher diagnostic accuracy, in terms of MRF involvement, than native axial images

  5. A new instrument to assess physician skill at thoracic ultrasound, including pleural effusion markup.

    Science.gov (United States)

    Salamonsen, Matthew; McGrath, David; Steiler, Geoff; Ware, Robert; Colt, Henri; Fielding, David

    2013-09-01

    To reduce complications and increase success, thoracic ultrasound is recommended to guide all chest drainage procedures. Despite this, no tools currently exist to assess proceduralist training or competence. This study aims to validate an instrument to assess physician skill at performing thoracic ultrasound, including effusion markup, and examine its validity. We developed an 11-domain, 100-point assessment sheet in line with British Thoracic Society guidelines: the Ultrasound-Guided Thoracentesis Skills and Tasks Assessment Test (UGSTAT). The test was used to assess 22 participants (eight novices, seven intermediates, seven advanced) on two occasions while performing thoracic ultrasound on a pleural effusion phantom. Each test was scored by two blinded expert examiners. Validity was examined by assessing the ability of the test to stratify participants according to expected skill level (analysis of variance) and demonstrating test-retest and intertester reproducibility by comparison of repeated scores (mean difference [95% CI] and paired t test) and the intraclass correlation coefficient. Mean scores for the novice, intermediate, and advanced groups were 49.3, 73.0, and 91.5 respectively, which were all significantly different (P < .0001). There were no significant differences between repeated scores. Procedural training on mannequins prior to unsupervised performance on patients is rapidly becoming the standard in medical education. This study has validated the UGSTAT, which can now be used to determine the adequacy of thoracic ultrasound training prior to clinical practice. It is likely that its role could be extended to live patients, providing a way to document ongoing procedural competence.

  6. Invasive cervical carcinoma (stage IB-IIB): assessment with MR imaging

    International Nuclear Information System (INIS)

    Sironi, S.; Del Maschio, A.; Belloni, C.; Taccagni, L.

    1990-01-01

    In patients with cervical carcinoma the selection of the optimal therapy depends on the precise preoperative assessment of the extent of disease. Currently, decisions regarding the management of these patients are made on the basis of clinical (FIGO) staging that has 50% mean error rate. To investigate the value of MR imaging in staging patients with invasive cervical cancer, we performed 25 MR examinations on 23 patients with histologic diagnosis of cervical cancer. All patients were clinically considered as having stage IB or IIB disease and underwent radical hysterectomy, providing specimens for pathologic correlation. The overall accuracy of MR imaging in staging cervical carcinoma (stage IB-IIB) was 78.1%. MR imaging seems to be the most reliable preoperative modality for staging invasive cervical cancer

  7. A Cyber Security Risk Assessment of Hospital Infrastructure including TLS/SSL and other Threats

    OpenAIRE

    Millar, Stuart

    2016-01-01

    Cyber threats traditionally target governments, financial institutions and businesses. However, of growing concern is the threat to healthcare organizations. This study conducts a cyber security risk assessment of a theoretical hospital environment, to include TLS/SSL, which is an encryption protocol for network communications, plus other physical, logical and human threats. Despite significant budgets in the UK for the NHS, the spend on cyber security appears worryingly low and many hospital...

  8. Assessment of liver fibrosis stage influence on clinical course of periodontal diseases in patients with chronic hepatitis C

    Directory of Open Access Journals (Sweden)

    О. М. Slaba

    2017-08-01

    Full Text Available The aim. To assess the influence of liver fibrosis stage on the clinical course of periodontal diseases in patients with chronic hepatitis C. Material and Methods. 122 patients with chronic hepatitis C, treated at the 7th department ofLvivRegionalInfectiousDiseasesHospital during 2013 – 2015 were included into dental investigation. The periodontal disease was diagnosed in accordance with the classification of M. F. Danilevsky (1994. The clinical condition of periodontium was assessed by the papillary marginal alveolar index (PMA in the modification ofParma, by the periodontal index – PI (AL Russel, 1956, by the Muhlemann and Son index – the degree of bleeding in the region of the gingival papilla (PBI. The stage of liver fibrosis was determined according to the medical history. The significance of the difference between two or more relative indicators was calculated using the Fisher test with the Metropolis algorithm. The correlation dependence between the clinical condition of periodontal tissues and the stage of liver fibrosis in patients with viral hepatitis C was studied using the Spearman rank correlation coefficient. Results. The highest percentage of patients with stage of liver fibrosis F0 (70.00 ± 15.28 % was registered in patients with healthy periodont, the lowest - in patients with generalized periodontitis of the third stage (7.89 ± 4.37 %. The highest frequency of patients with the stage of liver fibrosis F3 (73.68 ± 7.14 % was also observed in persons suffering from generalized periodontitis stage III (73.68 ± 7.14 %. Conclusions. The distribution of periodontal lesion severity statistically significant (p < 0.001 depended on the stage of liver fibrosis in patients with chronic hepatitis C. Direct (R = 0.70; p < 0.001 strong correlation between the clinical state of periodontal tissues and the stage of liver fibrosis in patients with chronic hepatitis C (using the Spearman rank correlation coefficient has been determined

  9. Neglect of lactation stage leads to naive assessment of residual feed intake in dairy cattle

    DEFF Research Database (Denmark)

    Li, Bingjie; Berglund, B.; Fikse, W.F.

    2017-01-01

    Residual feed intake (RFI) is a candidate trait for feed efficiency in dairy cattle. We investigated the influence of lactation stage on the effect of energy sinks in defining RFI and the genetic parameters for RFI across lactation stages for primiparous dairy cattle. Our analysis included 747 pr...

  10. Risk assessment of titanium dioxide nanoparticles via oral exposure, including toxicokinetic considerations.

    Science.gov (United States)

    Heringa, Minne B; Geraets, Liesbeth; van Eijkeren, Jan C H; Vandebriel, Rob J; de Jong, Wim H; Oomen, Agnes G

    2016-12-01

    Titanium dioxide white pigment consists of particles of various sizes, from which a fraction is in the nano range (food as additive E 171 as well as in other products, such as food supplements and toothpaste. Here, we assessed whether a human health risk can be expected from oral ingestion of these titanium dioxide nanoparticles (TiO 2 NPs), based on currently available information. Human health risks were assessed using two different approaches: Approach 1, based on intake, i.e. external doses, and Approach 2, based on internal organ concentrations using a kinetic model in order to account for accumulation over time (the preferred approach). Results showed that with Approach 1, a human health risk is not expected for effects in liver and spleen, but a human health risk cannot be excluded for effects on the ovaries. When based on organ concentrations by including the toxicokinetics of TiO 2 NPs (Approach 2), a potential risk for liver, ovaries and testes is found. This difference between the two approaches shows the importance of including toxicokinetic information. The currently estimated risk can be influenced by factors such as absorption, form of TiO 2 , particle fraction, particle size and physico-chemical properties in relation to toxicity, among others. Analysis of actual particle concentrations in human organs, as well as organ concentrations and effects in liver and the reproductive system after chronic exposure to well-characterized TiO 2 (NPs) in animals are recommended to refine this assessment.

  11. Assessment of capabilities in persons with advanced stage of dementia: Validation of The Montessori Assessment System (MAS).

    Science.gov (United States)

    Erkes, Jérôme; Camp, Cameron J; Raffard, Stéphane; Gély-Nargeot And, Marie-Christine; Bayard, Sophie

    2017-01-01

    This study evaluated the validity and reliability of the Montessori Assessment System. The Montessori Assessment System assesses preserved abilities in persons with moderate to severe dementia. In this respect, this instrument provides crucial information for the development of effective person-centered care plans. A total of 196 persons with a diagnosis of dementia in the moderate to severe stages of dementia were recruited in 10 long-term care facilities in France. All participants completed the Montessori Assessment System, the Clinical Dementia Rating Scale and/or the Mini Mental State Examination and the Severe Impairment Battery-short form. The internal consistency and temporal stability of the Montessori Assessment System were high. Additionally, good construct and divergent validity were demonstrated. Factor analysis showed a one-factor structure. The Montessori Assessment System demonstrated satisfactory psychometric properties while being a useful instrument to assess capabilities in persons with advanced stages of dementia and hence to develop person-centered plans of care.

  12. Assessing CO2 Mitigation Options Utilizing Detailed Electricity Characteristics and Including Renewable Generation

    Science.gov (United States)

    Bensaida, K.; Alie, Colin; Elkamel, A.; Almansoori, A.

    2017-08-01

    This paper presents a novel techno-economic optimization model for assessing the effectiveness of CO2 mitigation options for the electricity generation sub-sector that includes renewable energy generation. The optimization problem was formulated as a MINLP model using the GAMS modeling system. The model seeks the minimization of the power generation costs under CO2 emission constraints by dispatching power from low CO2 emission-intensity units. The model considers the detailed operation of the electricity system to effectively assess the performance of GHG mitigation strategies and integrates load balancing, carbon capture and carbon taxes as methods for reducing CO2 emissions. Two case studies are discussed to analyze the benefits and challenges of the CO2 reduction methods in the electricity system. The proposed mitigations options would not only benefit the environment, but they will as well improve the marginal cost of producing energy which represents an advantage for stakeholders.

  13. Fix my child: The importance of including siblings in clinical assessments.

    Science.gov (United States)

    Farnfield, Steve

    2017-07-01

    This study examined concordance in the attachment strategies of school-aged siblings with reference to environmental risk in terms of poverty and maltreatment. It also investigated the effect of child maltreatment and maternal mental illness on children's psychosocial functioning in terms of the Dynamic-Maturational Model of Attachment and Adaptation (DMM) including unresolved trauma and the DMM Depressed modifier. The attachment strategies of 30 sibling pairs, aged 5-14 years, were assessed using the School-age Assessment of Attachment (SAA). Unlike most previous studies, this study included siblings from large families of two to six children. The main finding was that as environmental risk increases, the diversity of sibling attachment strategies decreases with greater recourse to the DMM Type A3-6 and A/C strategies. Unlike previous studies, the highest level of concordance was found in sibling pairs with the opposite gender. Boys whose mothers had a history of mental illness were significantly more likely than girls to be assessed with the DMM-depression modifier. As danger increases, children in the same family experience more of the same childhood. Further research should focus on single case, intra-familial studies to build a systemic model of the shared environment. Research should also evaluate the effects of environmental risk compared with size of the sibling group on children's attachment strategies. The clinical implications point to the importance of assessing all children in the family using a model built around functional formulation rather than diagnosing the symptoms of a particular child.

  14. Computer Based Assessment of Cervical Vertebral Maturation Stages Using Digital Lateral Cephalograms.

    Science.gov (United States)

    Dzemidzic, Vildana; Sokic, Emir; Tiro, Alisa; Nakas, Enita

    2015-12-01

    This study was aimed to investigate the reliability of a computer application for assessment of the stages of cervical vertebra maturation in order to determine the stage of skeletal maturity. For this study, digital lateral cephalograms of 99 subjects (52 females and 47 males) were examined. The following selection criteria were used during the sample composition: age between 9 and 16 years, absence of anomalies of the vertebrae, good general health, no history of trauma at the cervical region. Subjects with lateral cephalograms of low quality were excluded from the study. For the purpose of this study a computer application Cephalometar HF V1 was developed. This application was used to mark the contours of the second, third and fourth cervical vertebrae on the digital lateral cephalograms, which enabled a computer to determine the stage of cervical vertebral maturation. The assessment of the stages of cervical vertebral maturation was carried out by an experienced orthodontist. The assessment was conducted according to the principles of the method proposed by authors Hassel and Farman. The degree of the agreement between the computer application and the researcher was analyzed using by statistical Cohen Kappa test. The results of this study showed the agreement between the computer assessment and the researcher assessment of the cervical vertebral maturation stages, where the value of the Cohen Kappa coefficient was 0.985. The computer application Cephalometar HF V1 proved to be a reliable method for assessing the stages of cervical vertebral maturation. This program could help the orthodontists to identify the stage of cervical vertebral maturation when planning the orthodontic treatment for the patients with skeletal disharmonies.

  15. QMRAcatch: Microbial Quality Simulation of Water Resources including Infection Risk Assessment.

    Science.gov (United States)

    Schijven, Jack; Derx, Julia; de Roda Husman, Ana Maria; Blaschke, Alfred Paul; Farnleitner, Andreas H

    2015-09-01

    Given the complex hydrologic dynamics of water catchments and conflicts between nature protection and public water supply, models may help to understand catchment dynamics and evaluate contamination scenarios and may support best environmental practices and water safety management. A catchment model can be an educative tool for investigating water quality and for communication between parties with different interests in the catchment. This article introduces an interactive computational tool, QMRAcatch, that was developed to simulate concentrations in water resources of , a human-associated microbial source tracking (MST) marker, enterovirus, norovirus, , and as target microorganisms and viruses (TMVs). The model domain encompasses a main river with wastewater discharges and a floodplain with a floodplain river. Diffuse agricultural sources of TMVs that discharge into the main river are not included in this stage of development. The floodplain river is fed by the main river and may flood the plain. Discharged TMVs in the river are subject to dilution and temperature-dependent degradation. River travel times are calculated using the Manning-Gauckler-Strickler formula. Fecal deposits from wildlife, birds, and visitors in the floodplain are resuspended in flood water, runoff to the floodplain river, or infiltrate groundwater. Fecal indicator and MST marker data facilitate calibration. Infection risks from exposure to the pathogenic TMVs by swimming or drinking water consumption are calculated, and the required pathogen removal by treatment to meet a health-based quality target can be determined. Applicability of QMRAcatch is demonstrated by calibrating the tool for a study site at the River Danube near Vienna, Austria, using field TMV data, including a sensitivity analysis and evaluation of the model outcomes. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  16. Hyperfractionated radiotherapy and simultaneous cisplatin for stage-III and -IV carcinomas of the head and neck. Long-term results including functional outcome

    Energy Technology Data Exchange (ETDEWEB)

    Huguenin, P.; Glanzmann, C.; Taussky, D.; Luetolf, U.M. [Univ. Hospital Zurich (Switzerland). Radiation Oncology Dept.; Schmid, S.; Moe, K. [Univ. Hospital Zurich (Switzerland). Dept. of Head and Neck Surgery

    1998-08-01

    Purpose: To assess the survival rate, the probability of local control, the patterns of relapse and late sequelae including self-reported quality of life in patients treated with hyperfractionated radiotherapy (RT) and simultaneous CDDP chemotherapy for stage-III to stage-IV carcinomas of the head and neck. Methods: From 1988 to 1994, 64 patients (median age 55.5 years) with carcinomas of different subsites, excluding the nasopharynx, were treated in a pilot study with 1.2 Gy bid (6 h interval; total dose 74.4 Gy) and simultaneous CDDP (20 mg/m{sup 2} daily, 5 days in week 1 and 5) and followed at regular intervals. Overall survival and local control, as well as the rates of late toxicity, were estimated using the actuarial method. Median follow-up was 3.3 years for all and 5.2 years for surviving patients. To assess the quality of life, the EORTC QLQ-C 30 questionnaire and the H and N35 module questionnaire were sent to the patients surviving with no evidence of disease or second primary tumors; they were answered by 15/23 (67%). Results: Overall survival was 37% at 5 years, whereas disease-specific survival was 59%. Twenty-three patients died from uncontrolled head and neck cancer. Second primary tumors were observed in 13 patients, most frequently in the lung. Local control without salvage surgery was 74% at 5 years for all subsites and stages, and loco-regional disease-free survival was 72%. Eleven patients developed distant metastases, which was the only site of failure in 6 cases. Salvage surgery was successful in 2 cases. The actuarial estimates of {>=}grade-3 late toxicity was 4% for the mandibular bone and 23% for dysphagia, and 50% of the patients experienced a permanent xerostomy. Self-reported global quality of life in surviving patients was good (mean 68 points on a scale 0 to 100); consequences of impaired salivary function had most impact on nutritional and social aspects. Conclusions: Hyperfractionated RT with concomitant CDDP is well tolerated and

  17. Immunological Assays as an Opportunity of Assessment of Health Risks of Airborne Particle Mixture Including Nanoparticles

    International Nuclear Information System (INIS)

    Brzicová, Tána; Danihelka, Pavel; Micka, Vladimír; Lochman, Ivo; Lach, Karel; Lochmanová, Alexandra

    2013-01-01

    The aim of this pilot study was to evaluate perspectives of the assessment of nonspecific biological effects of airborne particulate matter including nanoparticles using appropriate immunological assays. We have selected various in vitro immunological assays to establish an array allowing us to monitor activation of the cell-mediated and humoral response of both the innate and adaptive immunity. To assess comprehensive interactions and effects, the assays were performed in whole blood cultures from healthy volunteers and we used an original airborne particle mixture from high pollution period in Ostrava region representing areas with one of the most polluted air in Europe. Even if certain effects were observed, the results of the immunological assays did not prove significant effects of airborne particles on immune cells' functions of healthy persons. However, obtained data do not exclude health risks of long-term exposure to airborne particles, especially in case of individuals with genetic predisposition to certain diseases or already existing disease. This study emphasizes the in vitro assessment of complex effects of airborne particles in conditions similar to actual ones in an organism exposed to particle mixture present in the polluted air.

  18. Computer Based Assessment of Cervical Vertebral Maturation Stages Using Digital Lateral Cephalograms

    OpenAIRE

    Dzemidzic, Vildana; Sokic, Emir; Tiro, Alisa; Nakas, Enita

    2015-01-01

    Objective: This study was aimed to investigate the reliability of a computer application for assessment of the stages of cervical vertebra maturation in order to determine the stage of skeletal maturity. Material and methods: For this study, digital lateral cephalograms of 99 subjects (52 females and 47 males) were examined. The following selection criteria were used during the sample composition: age between 9 and 16 years, absence of anomalies of the vertebrae, good general health, no histo...

  19. Economic assessment of S-prism including development and generating costs

    Energy Technology Data Exchange (ETDEWEB)

    Boardman, Ch.E. [GE Nuclear Energy San Jose (United States)

    2001-07-01

    S-PRISM is an advanced Fast Reactor plant design that utilizes compact modular pool-type reactors sized to enable factory fabrication and an affordable prototype test of a single Nuclear Steam Supply System (NSSS) for design certification at minimum cost and risk. S-PRISM retains all of the key ALMR (advanced liquid metal reactor) design features including passive reactor shutdown, passive shutdown heat removal, and passive reactor cavity cooling that were developed under an earlier DOE program. Key factors that make S-PRISM competitive include: 1) The use of passive safety systems that eliminate the need for diesel generators and hardened active heat sinks to assure that sufficient heat is removed from the core, reactor, and containment systems following design and beyond design basis events. 2) A seven point advantage in the plant capacity factor (93 versus 86%) over a single large plant. 3) A much shorter construction schedule (45%) made possible by a modular design that allows near parallel (sequenced) construction of three relatively small, simple factory fabricated NSSSs instead of one large complex NSSS. This paper describes the approach, methods, and results of an in-depth economic assessment of S-PRISM. The assessment found that the generation cost from an NOAK plant would be less than 3 cents/kW-hr and that a design certification could be obtained in less than 15 years at a cost of 2.1 billion dollars. (authors)

  20. Economic assessment of S-prism including development and generating costs

    International Nuclear Information System (INIS)

    Boardman, Ch.E.

    2001-01-01

    S-PRISM is an advanced Fast Reactor plant design that utilizes compact modular pool-type reactors sized to enable factory fabrication and an affordable prototype test of a single Nuclear Steam Supply System (NSSS) for design certification at minimum cost and risk. S-PRISM retains all of the key ALMR (advanced liquid metal reactor) design features including passive reactor shutdown, passive shutdown heat removal, and passive reactor cavity cooling that were developed under an earlier DOE program. Key factors that make S-PRISM competitive include: 1) The use of passive safety systems that eliminate the need for diesel generators and hardened active heat sinks to assure that sufficient heat is removed from the core, reactor, and containment systems following design and beyond design basis events. 2) A seven point advantage in the plant capacity factor (93 versus 86%) over a single large plant. 3) A much shorter construction schedule (45%) made possible by a modular design that allows near parallel (sequenced) construction of three relatively small, simple factory fabricated NSSSs instead of one large complex NSSS. This paper describes the approach, methods, and results of an in-depth economic assessment of S-PRISM. The assessment found that the generation cost from an NOAK plant would be less than 3 cents/kW-hr and that a design certification could be obtained in less than 15 years at a cost of 2.1 billion dollars. (authors)

  1. A global call for action to include gender in research impact assessment.

    Science.gov (United States)

    Ovseiko, Pavel V; Greenhalgh, Trisha; Adam, Paula; Grant, Jonathan; Hinrichs-Krapels, Saba; Graham, Kathryn E; Valentine, Pamela A; Sued, Omar; Boukhris, Omar F; Al Olaqi, Nada M; Al Rahbi, Idrees S; Dowd, Anne-Maree; Bice, Sara; Heiden, Tamika L; Fischer, Michael D; Dopson, Sue; Norton, Robyn; Pollitt, Alexandra; Wooding, Steven; Balling, Gert V; Jakobsen, Ulla; Kuhlmann, Ellen; Klinge, Ineke; Pololi, Linda H; Jagsi, Reshma; Smith, Helen Lawton; Etzkowitz, Henry; Nielsen, Mathias W; Carrion, Carme; Solans-Domènech, Maite; Vizcaino, Esther; Naing, Lin; Cheok, Quentin H N; Eckelmann, Baerbel; Simuyemba, Moses C; Msiska, Temwa; Declich, Giovanna; Edmunds, Laurel D; Kiparoglou, Vasiliki; Buchan, Alison M J; Williamson, Catherine; Lord, Graham M; Channon, Keith M; Surender, Rebecca; Buchan, Alastair M

    2016-07-19

    Global investment in biomedical research has grown significantly over the last decades, reaching approximately a quarter of a trillion US dollars in 2010. However, not all of this investment is distributed evenly by gender. It follows, arguably, that scarce research resources may not be optimally invested (by either not supporting the best science or by failing to investigate topics that benefit women and men equitably). Women across the world tend to be significantly underrepresented in research both as researchers and research participants, receive less research funding, and appear less frequently than men as authors on research publications. There is also some evidence that women are relatively disadvantaged as the beneficiaries of research, in terms of its health, societal and economic impacts. Historical gender biases may have created a path dependency that means that the research system and the impacts of research are biased towards male researchers and male beneficiaries, making it inherently difficult (though not impossible) to eliminate gender bias. In this commentary, we - a group of scholars and practitioners from Africa, America, Asia and Europe - argue that gender-sensitive research impact assessment could become a force for good in moving science policy and practice towards gender equity. Research impact assessment is the multidisciplinary field of scientific inquiry that examines the research process to maximise scientific, societal and economic returns on investment in research. It encompasses many theoretical and methodological approaches that can be used to investigate gender bias and recommend actions for change to maximise research impact. We offer a set of recommendations to research funders, research institutions and research evaluators who conduct impact assessment on how to include and strengthen analysis of gender equity in research impact assessment and issue a global call for action.

  2. Description and Codification of Miscanthus × giganteus Growth Stages for Phenological Assessment

    Directory of Open Access Journals (Sweden)

    Mauricio D. Tejera

    2017-10-01

    Full Text Available Triploid Miscanthus × giganteus (Greef et Deu. ex Hodkinson et Renvoize is a sterile, perennial grass used for biomass production in temperate environments. While M. × giganteus has been intensively researched, a scale standardizing description of M. × giganteus morphological stages has not been developed. Here we provide such a scale by adapting the widely-used Biologische Bundesanstalt, Bundessortenamt, CHemische Industrie (BBCH scale and its corresponding numerical code to describe stages of morphological development in M. × giganteus using observations of the “Freedom” and “Illinois” clone in Iowa, USA. Descriptive keys with images are also presented. Because M. × giganteus plants overlap in the field, the scale was first applied to individual stems and then scaled up to assess plants or communities. Of the 10 principal growth stages in the BBCH system, eight were observed in M. × giganteus. Each principal stage was subdivided into secondary stages to enable a detailed description of developmental progression. While M. × giganteus does not have seed development stages, descriptions of those stages are provided to extend the scale to other Miscanthus genotypes. We present methods to use morphological development data to assess phenology by calculating the onset, duration, and abundance of each developmental stage. This scale has potential to harmonize previously described study-specific scales and standardize results across studies. Use of the precise staging presented here should more tightly constrain estimates of developmental parameters in crop models and increase the efficacy of timing-sensitive crop management practices like pest control and harvest.

  3. The need to include Health Impact Assessment at the International Monetary Fund.

    Science.gov (United States)

    Cave, Ben; Birley, Martin

    2010-01-01

    The lending and technical support provided by the International Monetary Fund affect the determinants of health and healthy equity. Most health determinants lie outside the control of the health sector, and thus non-health-sector policies have profound positive and negative effects on population health. Health Impact Assessment (HIA) is an instrument for identifying the effect of policies, plans, programs, and projects on population health and health equity. It is a feasible, cost-effective, and transparent process that has been adopted by several financial institutions, including members of the World Bank Group. Adopting HIA would assist the IMF in ensuring that the potential health consequences of its policies are identified and addressed.

  4. A comparative assessment of the economics of plutonium disposition including comparison with other nuclear fuel cycles

    International Nuclear Information System (INIS)

    Williams, K.A.; Miller, J.W.; Reid, R.L.

    1997-01-01

    DOE has been evaluating three technologies for the disposition of approximately 50 metric tons of surplus plutonium from defense-related programs: reactors, immobilization, and deep boreholes. As part of the process supporting an early CY 1997 Record of Decision (ROD), a comprehensive assessment of technical viability, cost, and schedule has been conducted. Oak Ridge National Laboratory has managed and coordinated the life-cycle cost (LCC) assessment effort for this program. This paper discusses the economic analysis methodology and the results prior to ROD. Other objectives of the paper are to discuss major technical and economic issues that impact plutonium disposition cost and schedule. Also to compare the economics of a once-through weapons-derived MOX nuclear fuel cycle to other fuel cycles, such as those utilizing spent fuel reprocessing. To evaluate the economics of these technologies on an equitable basis, a set of cost estimating guidelines and a common cost-estimating format were utilized by all three technology teams. This paper also includes the major economic analysis assumptions and the comparative constant-dollar and discounted-dollar LCCs

  5. A technique of including the effect of aging of passive components in probabilistic risk assessments

    International Nuclear Information System (INIS)

    Phillips, J.H.; Weidenhamer, G.H.

    1992-01-01

    The probabilistic risk assessments (PRAS) being developed at most nuclear power plants to calculate the risk of core damage generally focus on the possible failure of active components. The possible failure of passive components is given little consideration. We are developing methods for selecting risk-significant passive components and including them in PRAS. These methods provide effective ways to prioritize passive components for inspection, and where inspection reveals aging damage, mitigation or repair can be employed to reduce the likelihood of component failure. We demonstrated a method by selecting a weld in the auxiliary feedwater (AFW) system, basing our selection on expert judgement of the likelihood of failure and on an estimate of the consequence of component failure to plant safety. We then modified and used the Piping Reliability Analysis Including Seismic Events (PRAISE) computer code to perform a probabilistic structural analysis to calculate the probability that crack growth due to aging would cause the weld to fail. The PRAISE code was modified to include the effects of changing design material properties with age and changing stress cycles. The calculation included the effects of mechanical loads and thermal transients typical of the service loads for this piping design and the effects of thermal cycling caused by a leaking check valve. However, this particular calculation showed little change in low component failure probability and plant risk for 48 years of service. However, sensitivity studies showed that if the probability of component failure is high, the effect on plant risk is significant. The success of this demonstration shows that this method could be applied to nuclear power plants. The demonstration showed the method is too involved (PRAISE takes a long time to perform the calculation and the input information is extensive) for handling a large number of passive components and therefore simpler methods are needed

  6. [Assessment of antibacterial efficacy of ozone therapy in treatment of caries at the white spot stage].

    Science.gov (United States)

    Makeeva, I M; Turkina, A Yu; Margaryan, E G; Paramonov, Yu O; Polyakova, M A

    Effect on cariogenic flora is the key toremineralizing therapy efficacy in treatment of initial caries (at the white spot stage). Ozone in dentistry is used as a highly effective antibacterial agent. Treatment of white spot lesions with the ozone-air mixture leads to significant increase of efficacy in non-invasive treatment of initial caries. clinical and microbiological assessment of antibacterial efficacy of ozone therapy in treatment of caries at the white spot stage. The trial recruited 86 patients for non-invasive treatment of caries at the white spot stage which included the complex of professional oral hygiene, medicamental treatment of white spot lesions with hydrogen peroxide 3% and chlorhexidinedigluconate 0,2%, treatment with the ozone-air mixture and application of hydroxyapatite Са2+. Material for microbiological study was received before the treatment, after the complex of professional oral hygiene and medicamental treatment of white spot lesions conducted as well as after the treatment with the ozone-air mixture. Before the treatment up to 16 kinds of microorganisms on the surface of white spot lesion were detected with the following shares: S. mutans (19.9%), S. salivarius (15.1%), S. epidermidis (8.7%), S. mitis (6.5%), Lactobacillus (6.5%) and different kinds of staphylococci (10.8%). After the complex of professional oral hygiene and medicamental treatment conducted decrease in number of cariogenic microorganisms was indicated as follows: S. mutans - from 1·105 to 1·104, S. salivarius - from 1·107 to 1·106, S. epidermidis - from 1·105 to 1·104, S. mitis - from 1·104 to 1·103, Lactobacillus - from 1·104 tо 1·103. After the treatment of tooth enamel with the ozone-air mixture increase in microorganisms was not observed. The efficacy of ozone on cariogenic microorganisms exceeds significantly the efficacy of 3% hydrogen peroxide and 0,2% chlorhexidinedigluconate. It is strongly advisable to include ozone in protocol of non

  7. Four Models Including Fish, Seafood, Red Meat and Enriched Foods to Achieve Australian Dietary Recommendations for n-3 LCPUFA for All Life-Stages

    Directory of Open Access Journals (Sweden)

    Flavia Fayet-Moore

    2015-10-01

    Full Text Available Populations are not meeting recommended intakes of omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA. The aim was (i to develop a database on n-3 LCPUFA enriched products; (ii to undertake dietary modelling exercise using four dietary approaches to meet the recommendations and (iii to determine the cost of the models. Six n-3 LCPUFA enriched foods were identified. Fish was categorised by n-3 LCPUFA content (mg/100 g categories as “excellent” “good” and “moderate”. The four models to meet recommended n-3 LCPUFA intakes were (i fish only; (ii moderate fish (with red meat and enriched foods; (iii fish avoiders (red meat and enriched foods only; and (iv lacto-ovo vegetarian diet (enriched foods only. Diets were modelled using the NUTTAB2010 database and n-3 LCPUFA were calculated and compared to the Suggested Dietary Targets (SDT. The cost of meeting these recommendations was calculated per 100 mg n-3 LCPUFA. The SDT were achieved for all life-stages with all four models. The weekly food intake in number of serves to meet the n-3 LCPUFA SDT for all life-stages for each dietary model were: (i 2 “excellent” fish; (ii 1 “excellent” and 1 “good” fish, and depending on life-stage, 3–4 lean red meat, 0–2 eggs and 3–26 enriched foods; (iii 4 lean red meat, and 20–59 enriched foods; (iv 37–66 enriched foods. Recommended intakes of n-3 LCPUFA were easily met by the consumption of fish, which was the cheapest source of n-3 LCPUFA. Other strategies may be required to achieve the recommendations including modifying the current food supply through feeding practices, novel plant sources and more enriched foods.

  8. Etiopathophysiological assessment of cases with chronic daily headache: A functional magnetic resonance imaging included investigation

    Science.gov (United States)

    Hashemi, Akram; Nami, Mohammad Torabi; Oghabian, Mohammad Ali; Ganjgahi, Habib; Vahabi, Zahra

    2012-01-01

    Background Chronic daily headache (CDH) has gained little attention in functional neuro-imaging. When no structural abnormality is found in CDH, defining functional correlates between activated brain regions during headache bouts may provide unique insights towards understanding the pathophysiology of this type of headache. Methods We recruited four CDH cases for comprehensive assessments, including history taking, physical examinations and neuropsychological evaluations (The Addenbrooke's Cognitive Evaluation, Beck's Anxiety and Depression Inventories, Pittsburg Sleep Quality Index and Epworth Sleepiness Scale). Visual analogue scale (VAS) was used to self-rate the intensity of headache. Patients then underwent electroencephalography (EEG), transcranial Doppler (TCD) and functional magnetic resonance imaging (fMRI) evaluations during maximal (VAS = 8-10/10) and off-headache (VAS = 0-3/10) conditions. Data were used to compare in both conditions. We also used BOLD (blood oxygen level dependent) -group level activation map fMRI to possibly locate headache-related activated brain regions. Results General and neurological examinations as well as conventional MRIs were unremarkable. Neuropsychological assessments showed moderate anxiety and depression in one patient and minimal in others. Unlike three patients, maximal and off-headache TCD evaluation in one revealed increased middle cerebral artery blood flow velocity, at the maximal pain area. Although with no seizure history, the same patient's EEG showed paroxysmal epileptic discharges during maximal headache intensity, respectively. Group level activation map fMRI showed activated classical pain matrix regions upon headache bouts (periaqueductal grey, substantia nigra and raphe nucleus), and markedly bilateral occipital lobes activation. Conclusion The EEG changes were of note. Furthermore, the increased BOLD signals in areas outside the classical pain matrix (i.e. occipital lobes) during maximal headaches may

  9. Gender, renal function, and outcomes on the liver transplant waiting list: assessment of revised MELD including estimated glomerular filtration rate.

    Science.gov (United States)

    Myers, Robert P; Shaheen, Abdel Aziz M; Aspinall, Alexander I; Quinn, Robert R; Burak, Kelly W

    2011-03-01

    The Model for End-Stage Liver Disease (MELD) allocation system for liver transplantation (LT) may present a disadvantage for women by including serum creatinine, which is typically lower in females. Our objectives were to investigate gender disparities in outcomes among LT candidates and to assess a revised MELD, including estimated glomerular filtration rate (eGFR), for predicting waiting list mortality. Adults registered for LT between 2002 and 2007 were identified using the UNOS database. We compared components of MELD, MDRD-derived eGFR, and the 3-month probability of LT and death between genders. Discrimination of MELD, MELDNa, and revised models including eGFR for mortality were compared using c-statistics. A total of 40,393 patients (36% female) met the inclusion criteria; 9% died and 24% underwent LT within 3 months of listing. Compared with men, women had lower median serum creatinine (0.9 vs. 1.0 mg/dl), eGFR (72 vs. 83 ml/min/1.73 m(2)), and mean MELD (16.5 vs. 17.2; all p discrimination for 3-month mortality (c-statistics: MELD 0.896, MELD-eGFR 0.894, MELDNa 0.911, MELDNa-eGFR 0.905). Women are disadvantaged under MELD potentially due to its inclusion of creatinine. However, since including eGFR in MELD does not improve mortality prediction, alternative refinements are necessary. Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  10. A Two-Stage Multi-Agent Based Assessment Approach to Enhance Students' Learning Motivation through Negotiated Skills Assessment

    Science.gov (United States)

    Chadli, Abdelhafid; Bendella, Fatima; Tranvouez, Erwan

    2015-01-01

    In this paper we present an Agent-based evaluation approach in a context of Multi-agent simulation learning systems. Our evaluation model is based on a two stage assessment approach: (1) a Distributed skill evaluation combining agents and fuzzy sets theory; and (2) a Negotiation based evaluation of students' performance during a training…

  11. Learning from experience: development of a cognitive task-list to assess the second stage of labour for operative delivery.

    Science.gov (United States)

    Hodges, Ryan; Simpson, Andrea; Gurau, David; Secter, Michael; Mocarski, Eva; Pittini, Richard; Snelgrove, John; Windrim, Rory; Higgins, Mary

    2015-04-01

    Ensuring the availability of operative vaginal delivery is one strategy for reducing the rising Caesarean section rate. However, current training programs appear inadequate. We sought to systematically identify the core steps in assessing women in the second stage of labour for safe operative delivery, and to produce an expert task-list to assist residents and obstetricians in deciding on the safest mode of delivery for their patients. Labour and delivery nursing staff of three large university-associated hospitals identified clinicians they considered to be skilled in operative vaginal deliveries. Obstetricians who were identified consistently were invited to participate in the study. Participants were filmed performing their normal assessment of the second stage of labour on a model. Two clinicians reviewed all videos and documented all verbal and non-verbal components of the assessment; these components were grouped into overarching themes and combined into an integrated expert task-list. The task-list was then circulated to all participants for additional comments, checked against SOGC guidelines, and redrafted, allowing production of a final expert task-list. Thirty clinicians were identified by this process and 20 agreed to participate. Themes identified were assessment of suitability, focused history, physical examination including importance of an abdominal examination, strategies to accurately assess fetal position, station, and the likelihood of success, cautionary signs to prompt reassessment in the operating room, and warning signs to abandon operative delivery for Caesarean section. Communication strategies were emphasized. Having expert clinicians teach assessment in the second stage of labour is an important step in the education of residents and junior obstetricians to improve confidence in managing the second stage of labour.

  12. Risk assessment considerations for plant protection products and terrestrial life-stages of amphibians.

    Science.gov (United States)

    Weltje, Lennart; Ufer, Andreas; Hamer, Mick; Sowig, Peter; Demmig, Sandra; Dechet, Friedrich

    2018-04-28

    Some amphibians occur in agricultural landscapes during certain periods of their life cycle and consequently might be exposed to plant protection products (PPPs). While the sensitivity of aquatic life-stages is considered to be covered by the standard assessment for aquatic organisms (especially fish), the situation is less clear for terrestrial amphibian life-stages. In this paper, considerations are presented on how a risk assessment for PPPs and terrestrial life-stages of amphibians could be conducted. It discusses available information concerning the toxicity of PPPs to terrestrial amphibians, and their potential exposure to PPPs in consideration of aspects of amphibian biology. The emphasis is on avoiding additional vertebrate testing as much as possible by using exposure-driven approaches and by making use of existing vertebrate toxicity data, where appropriate. Options for toxicity testing and risk assessment are presented in a flowchart as a tiered approach, progressing from a non-testing approach, to simple worst-case laboratory testing, to extended laboratory testing, to semi-field enclosure tests and ultimately to full-scale field testing and monitoring. Suggestions are made for triggers to progress to higher tiers. Also, mitigation options to reduce the potential for exposure of terrestrial life-stages of amphibians to PPPs, if a risk were identified, are discussed. Finally, remaining uncertainties and research needs are considered by proposing a way forward (road map) for generating additional information to inform terrestrial amphibian risk assessment. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Issues in Moderation of National Curriculum Assessment at Key Stage 3.

    Science.gov (United States)

    Cowling, Les

    1994-01-01

    Highlights the issues of moderation of teacher judgments for accountability and moderation for achieving consistent assessments. Discusses the meaning of moderation, the need for moderating teacher judgments, approaches to moderation, methods of moderation, and most appropriate methods of moderation at Key Stage 3. Presents an approach to…

  14. A comparison between cervical vertebrae and modified MP3 stages for the assessment of skeletal maturity.

    Science.gov (United States)

    Prasad, Mandava; Ganji, Venkata Suresh Kumar; George, Suja Ani; Talapaneni, Ashok Kumar; Shetty, Sharath Kumar

    2013-01-01

    Evaluation of skeletal maturity in human individuals is an important aspect in orthodontics and dentofacial orthopedics because, growth guidance and fundamental structural changes are essential for treatment of skeletal discrepancies in all the three planes. Among various growth assessment methods, cervical vertebra maturation stages and hand wrist have been correlated with the individual growth changes during puberty. The purpose of this study is to determine correlation of the CVM index with the modified median phalanx index (MP3) as described by Rajagopal and Kansal. 200 subjects (100 males and 100 females) of Nellore, Indian origin boys aged between 10 to 19 years and girls of 8 to 16 years were selected for the study. The subjects are selected randomly from patients visiting the Departments of Orthodontics and Dentofacial Orthopedics, Pediatric dentistry and Oral medicine and Radiology at Narayana Dental College and Hospital. Nellore. Radiographs of left hand MP3 and lateral cephalogram were taken. Cohen's kappa statistic was used to assess the agreement between the two measurements based on categorical variables. There was a good concordance between 6 stages of CVMI (Hassel and Farman) and the 6 stages of MP3 (Rajagopal and Kansal). Physiological maturity was earlier in females than in males when compared to the individuals of opposite sex of same chronological age. Chronological age was not a valid predictor of assessing the skeletal maturity because of significant variations in the distribution of CVMI and MP3 stages with respect to individual chronological age distribution.

  15. Clinical assessment, staging, and epidemiology of chronic obstructive pulmonary disease exacerbations

    DEFF Research Database (Denmark)

    Vestbo, Jørgen

    2006-01-01

    Patients presenting with an exacerbation of chronic obstructive pulmonary disease (COPD) are initially assessed to ensure that a proper diagnosis has been made and that relevant differential diagnoses are excluded. Although guidelines provide indicators for use, very little systematic research has...... been done in initial assessment of COPD exacerbations. Next, the assessment should aim at stratifying patients for risk of poor outcome. For this, predictors of poor prognosis as well as knowledge of favorable treatments can be used. However, no formal and validated staging system exists today. Given...... the frequency and impact of COPD exacerbations, there seems to be a need for systematic research in this area....

  16. Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes

    Science.gov (United States)

    Bittermann, Dirk; Janssen, Laura; Bittermann, Gerhard Koendert Pieter; Boonacker, Chantal; Haverkamp, Sarah; de Wilde, Hester; Van Der Heul, Marise; Specken, Tom FJMC; Koole, Ron; Kon, Moshe; Breugem, Corstiaan Cornelis; Mink van der Molen, Aebele Barber

    2017-01-01

    Background No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). Methods This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ≥17 years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Results Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001). In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%–17% of the patients exhibited increased nasalance scores, assessed through nasometry. Conclusions The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence. PMID:28573094

  17. Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes

    Directory of Open Access Journals (Sweden)

    Isabelle Francisca Petronella Maria Kappen

    2017-05-01

    Full Text Available BackgroundNo consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP.MethodsThis was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ≥17 years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation.ResultsForty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years. Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001. In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%–17% of the patients exhibited increased nasalance scores, assessed through nasometry.ConclusionsThe present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.

  18. Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes.

    Science.gov (United States)

    Kappen, Isabelle Francisca Petronella Maria; Bittermann, Dirk; Janssen, Laura; Bittermann, Gerhard Koendert Pieter; Boonacker, Chantal; Haverkamp, Sarah; de Wilde, Hester; Van Der Heul, Marise; Specken, Tom Fjmc; Koole, Ron; Kon, Moshe; Breugem, Corstiaan Cornelis; Mink van der Molen, Aebele Barber

    2017-05-01

    No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ≥17 years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (Pspeech assessment, and 11%-17% of the patients exhibited increased nasalance scores, assessed through nasometry. The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.

  19. Toxicity assessment of water at different stages of treatment using Microtox assay

    Directory of Open Access Journals (Sweden)

    Pogorzelec Marta

    2017-01-01

    Full Text Available Number of potentially toxic hydrophobic organic contaminants e.g. polycyclic aromatic hydrocarbons, pesticides, polychlorinated biphenyls and dioxins having entered aquatic environment, including potential sources of drinking water. Unfortunately, not all micropollutants can be removed during water treatment processes. What is more, disinfectants can react with some organic compounds already present in the water, and form disinfection by-products which also can be toxic. The aim of this study was to assess toxicity of water at different stages of water treatment and to verify usefulness semipermeable membrane devices in monitoring of drinking water. For this purpose, semipermeable membrane devices (SPMDs were deployed in a surface water treatment plant. To determine the effect of water treatment on the presence of toxic micropollutants, study was conducted for a period of 5 months. Three sampling places were chosen: raw water input, stream of water just before disinfection and treated water output. After sampling dialysis in organic solvent was carried out and extracts were then analyzed with the Microtox acute toxicity test. The study has indicated the utility as well as some limitations of combining SPMDs with bioluminescence assay in the monitoring of biological effects of bioavailable hydrophobic pollutants in drinking water.

  20. Including Performance Assessments in Accountability Systems: A Review of Scale-Up Efforts

    Science.gov (United States)

    Tung, Rosann

    2010-01-01

    The purpose of this literature and field review is to understand previous efforts at scaling up performance assessments for use across districts and states. Performance assessments benefit students and teachers by providing more opportunities for students to demonstrate their knowledge and complex skills, by providing teachers with better…

  1. A multi-stage process including transient polyploidization and EMT precedes the emergence of chemoresistent ovarian carcinoma cells with a dedifferentiated and pro-inflammatory secretory phenotype.

    Science.gov (United States)

    Rohnalter, Verena; Roth, Katrin; Finkernagel, Florian; Adhikary, Till; Obert, Julia; Dorzweiler, Kristina; Bensberg, Maike; Müller-Brüsselbach, Sabine; Müller, Rolf

    2015-11-24

    DNA-damaging drugs induce a plethora of molecular and cellular alterations in tumor cells, but their interrelationship is largely obscure. Here, we show that carboplatin treatment of human ovarian carcinoma SKOV3 cells triggers an ordered sequence of events, which precedes the emergence of mitotic chemoresistant cells. The initial phase of cell death after initiation of carboplatin treatment is followed around day 14 by the emergence of a mixed cell population consisting of cycling, cell cycle-arrested and senescent cells. At this stage, giant cells make up >80% of the cell population, p21 (CDKN1A) in strongly induced, and cell numbers remain nearly static. Subsequently, cell death decreases, p21 expression drops to a low level and cell divisions increase, including regular mitoses of giant cells and depolyploidization by multi-daughter divisions. These events are accompanied by the upregulation of stemness markers and a pro-inflammatory secretory phenotype, peaking after approximately 14 days of treatment. At the same time the cells initiate epithelial to mesenchymal transition, which over the subsequent weeks continuously increases, concomitantly with the emergence of highly proliferative, migratory, dedifferentiated, pro-inflammatory and chemoresistant cells (SKOV3-R). These cells are anchorage-independent and grow in a 3D collagen matrix, while cells on day 14 do not survive under these conditions, indicating that SKOV3-R cells were generated thereafter by the multi-stage process described above. This process was essentially recapitulated with the ovarian carcinoma cell line IGROV-1. Our observations suggest that transitory cells characterized by polyploidy, features of stemness and a pro-inflammatory secretory phenotype contribute to the acquisition of chemoresistance.

  2. Characterizing Forest Succession Stages for Wildlife Habitat Assessment Using Multispectral Airborne Imagery

    Directory of Open Access Journals (Sweden)

    Wen Zhang

    2017-06-01

    Full Text Available In this study, we demonstrate the potential of using high spatial resolution airborne imagery to characterize the structural development stages of forest canopies. Four forest succession stages were adopted: stand initiation, young multistory, understory reinitiation, and old growth. Remote sensing metrics describing the spatial patterns of forest structures were derived and a Random Forest learning algorithm was used to classify forest succession stages. These metrics included texture variables from Gray Level Co-occurrence Measures (GLCM, range and sill from the semi-variogram, and the fraction of shadow and its spatial distribution. Among all the derived variables, shadow fractions and the GLCM variables of contrast, mean, and dissimilarity were the most important for characterizing the forest succession stages (classification accuracy of 89%. In addition, a LiDAR (Light Detection and Ranging derived forest structural index (predicted Lorey’s height was employed to validate the classification result. The classification using imagery spatial variables was shown to be consistent with the LiDAR derived variable (R2 = 0.68 and Root Mean Square Error (RMSE = 2.39. This study demonstrates that high spatial resolution imagery was able to characterize forest succession stages with promising accuracy and may be considered an alternative to LiDAR data for this kind of application. Also, the results of stand development stages build a framework for future wildlife habitat mapping.

  3. What should be included in the assessment of laypersons' paediatric basic life support skills?

    DEFF Research Database (Denmark)

    Hasselager, Asbjørn Børch; Lauritsen, Torsten; Kristensen, Tim

    2018-01-01

    BACKGROUND: Assessment of laypersons' Paediatric Basic Life Support (PBLS) skills is important to ensure acquisition of effective PBLS competencies. However limited evidence exists on which PBLS skills are essential for laypersons. The same challenges exist with respect to the assessment of foreign...... body airway obstruction management (FBAOM) skills. We aimed to establish international consensus on how to assess laypersons' PBLS and FBAOM skills. METHODS: A Delphi consensus survey was conducted. Out of a total of 84 invited experts, 28 agreed to participate. During the first Delphi round experts...... suggested items to assess laypersons' PBLS and FBAOM skills. In the second round, the suggested items received comments from and were rated by 26 experts (93%) on a 5-point scale (1 = not relevant to 5 = essential). Revised items were anonymously presented in a third round for comments and 23 (82%) experts...

  4. Which Book and Why: Using Book Bands and Book Levels for Guided Reading in Key Stage 1 [Includes CD-ROM

    Science.gov (United States)

    Bodman, Sue, Ed.; Franklin, Glen, Ed.

    2014-01-01

    We want all children to love reading, and Which Book and Why demonstrates how effective guided reading for children in Foundation Stage and Key Stage 1 can help teachers make this happen. Balancing theory and practice, this book explores how schools and teachers can implement guided reading more confidently and more effectively. Which Book and Why…

  5. New assessment of feed water piping in GKN I including optimisation of piping supports

    International Nuclear Information System (INIS)

    Zaiss, W.; Heil, C.; Baier, B.; Manke, A.

    2003-01-01

    The quality of nuclear power plant components and piping is specified according to the then current state of knowledge. In operation, the quality can be reduced by ageing phenomena, so in-service quality assessment is constantly required. The contribution discusses the individual aspects of reassessment and its technical procedure, using the example of a feedwater pipe in the GKN I containment. (orig.) [de

  6. Role of imaging in the staging and response assessment of lymphoma

    DEFF Research Database (Denmark)

    Barrington, Sally F; Mikhaeel, N George; Kostakoglu, Lale

    2014-01-01

    emission tomography (PET)–computed tomography (CT). Progress in imaging is influencing trial design and affecting clinical practice. In particular, a five-point scale to grade response using PET-CT, which can be adapted to suit requirements for early- and late-response assessment with good interobserver....... CONCLUSION: This article comprises the consensus reached to update guidance on the use of PET-CT for staging and response assessment for [18F]fluorodeoxyglucose-avid lymphomas in clinical practice and late-phase trials....

  7. Including Life Cycle Assessment for decision-making in controlling wastewater nutrient removal systems

    DEFF Research Database (Denmark)

    Corominas, Lluís; Larsen, Henrik Fred; Flores-Alsina, Xavier

    2013-01-01

    This paper focuses on the use of Life Cycle Assessment (LCA) to evaluate the performance of seventeen control strategies in wastewater treatment plants (WWTPs). It tackles the importance of using site-specific factors for nutrient enrichment when decision-makers have to select best operating....../or energy savings present an environmental benefit for N&P and P-deficient systems. This is not the case when addressing N-deficient systems for which the use of chemicals (even for improving N removal efficiencies) is not always beneficial for the environment. A sensitivity analysis on using weighting...... of the impact categories is conducted to assess how value choices (policy decisions) may affect the management of WWTPs. For the scenarios with only N-limitation, the LCA-based ranking of the control strategies is sensitive to the choice of weighting factors, whereas this is not the case for N&P or P...

  8. Comparative life cycle assessment of wastewater treatment in Denmark including sensitivity and uncertainty analysis

    DEFF Research Database (Denmark)

    Niero, Monia; Pizzol, Massimo; Gundorph Bruun, Henrik

    2014-01-01

    Wastewater treatment has nowadays multiple functions and produces both clean effluents and sludge, which is increasingly seen as a resource rather than a waste product. Technological as well as management choices influence the performance of wastewater treatment plants (WWTPs) on the multiple...... functions. In this context, Life Cycle Assessment (LCA) can determine what choices provide the best environmental performance. However, the assessment is not straightforward due to the intrinsic space and time-related variability of the wastewater treatment process. These challenges were addressed...... in a comparative LCA of four types of WWTPs, representative of mainstream treatment options in Denmark. The four plant types differ regarding size and treatment technology: aerobic versus anaerobic, chemical vs. combined chemical and biological. Trade-offs in their environmental performance were identified...

  9. Development of a quantitative safety assessment method for nuclear I and C systems including human operators

    International Nuclear Information System (INIS)

    Kim, Man Cheol

    2004-02-01

    Conventional PSA (probabilistic safety analysis) is performed in the framework of event tree analysis and fault tree analysis. In conventional PSA, I and C systems and human operators are assumed to be independent for simplicity. But, the dependency of human operators on I and C systems and the dependency of I and C systems on human operators are gradually recognized to be significant. I believe that it is time to consider the interdependency between I and C systems and human operators in the framework of PSA. But, unfortunately it seems that we do not have appropriate methods for incorporating the interdependency between I and C systems and human operators in the framework of Pasa. Conventional human reliability analysis (HRA) methods are not developed to consider the interdependecy, and the modeling of the interdependency using conventional event tree analysis and fault tree analysis seem to be, event though is does not seem to be impossible, quite complex. To incorporate the interdependency between I and C systems and human operators, we need a new method for HRA and a new method for modeling the I and C systems, man-machine interface (MMI), and human operators for quantitative safety assessment. As a new method for modeling the I and C systems, MMI and human operators, I develop a new system reliability analysis method, reliability graph with general gates (RGGG), which can substitute conventional fault tree analysis. RGGG is an intuitive and easy-to-use method for system reliability analysis, while as powerful as conventional fault tree analysis. To demonstrate the usefulness of the RGGG method, it is applied to the reliability analysis of Digital Plant Protection System (DPPS), which is the actual plant protection system of Ulchin 5 and 6 nuclear power plants located in Republic of Korea. The latest version of the fault tree for DPPS, which is developed by the Integrated Safety Assessment team in Korea Atomic Energy Research Institute (KAERI), consists of 64

  10. An assessment of PCB degradation by microogransims including methods for measuring mineralization

    Energy Technology Data Exchange (ETDEWEB)

    Hadden, C.; Edenborn, H.; Osborne, T.; Holdsworth, G.; Revis, N.

    1990-12-31

    These studies sought to isolate and identify organism(s) from PCB contaminated soil and sediment that degrade PCB; to provide information on the potential of organisms in soil samples taken from a PCB-contaminated area to mineralize or dechlorinate PCB congeners; to assess potential enhancement of PCB biodegradation as a result of nutritional amendment of the samples; and to carry out analyses of successive lysimeter samples to determine whether field treatments have had an effect on the capacity of soil microbes to mineralize PCBS. We have expended considerable effort to validate the fractionation procedure used to assess mineralization and conversion of PCB substrates. The assessment relies on the ability to measure [{sup 14}C]-labeled CO{sub 2} in the presence of potentially volatile [{sup 14}C]-labeled PCB and degradation products to differentiate between volatile and non-volatile [{sup 14}C]-labeled compounds between water-soluble products of metabolism and a mixture of unchanged substrate and other water-insoluble products and between metabolism and loss or non-extractability of the substrate.

  11. An assessment of PCB degradation by microogransims including methods for measuring mineralization

    International Nuclear Information System (INIS)

    Hadden, C.; Edenborn, H.; Osborne, T.; Holdsworth, G.; Revis, N.

    1990-01-01

    These studies sought to isolate and identify organism(s) from PCB contaminated soil and sediment that degrade PCB; to provide information on the potential of organisms in soil samples taken from a PCB-contaminated area to mineralize or dechlorinate PCB congeners; to assess potential enhancement of PCB biodegradation as a result of nutritional amendment of the samples; and to carry out analyses of successive lysimeter samples to determine whether field treatments have had an effect on the capacity of soil microbes to mineralize PCBS. We have expended considerable effort to validate the fractionation procedure used to assess mineralization and conversion of PCB substrates. The assessment relies on the ability to measure [ 14 C]-labeled CO 2 in the presence of potentially volatile [ 14 C]-labeled PCB and degradation products to differentiate between volatile and non-volatile [ 14 C]-labeled compounds between water-soluble products of metabolism and a mixture of unchanged substrate and other water-insoluble products and between metabolism and loss or non-extractability of the substrate

  12. Final environmental assessment: TRU waste drum staging building, Technical Area 55, Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    1996-01-01

    Much of the US Department of Energy's (DOE's) research on plutonium metallurgy and plutonium processing is performed at Los Alamos National Laboratory (LANL), in Los Alamos, New Mexico. LANL's main facility for plutonium research is the Plutonium Facility, also referred to as Technical Area 55 (TA-55). The main laboratory building for plutonium work within the Plutonium Facility (TA-55) is the Plutonium Facility Building 4, or PF-4. This Environmental Assessment (EA) analyzes the potential environmental effects that would be expected to occur if DOE were to stage sealed containers of transuranic (TRU) and TRU mixed waste in a support building at the Plutonium Facility (TA-55) that is adjacent to PF-4. At present, the waste containers are staged in the basement of PF-4. The proposed project is to convert an existing support structure (Building 185), a prefabricated metal building on a concrete foundation, and operate it as a temporary staging facility for sealed containers of solid TRU and TRU mixed waste. The TRU and TRU mixed wastes would be contained in sealed 55-gallon drums and standard waste boxes as they await approval to be transported to TA-54. The containers would then be transported to a longer term TRU waste storage area at TA-54. The TRU wastes are generated from plutonium operations carried out in PF-4. The drum staging building would also be used to store and prepare for use new, empty TRU waste containers

  13. EXPLOSION POTENTIAL ASSESSMENT OF HEAT EXCHANGER NETWORK AT THE PRELIMINARY DESIGN STAGE

    Directory of Open Access Journals (Sweden)

    MOHSIN PASHA

    2016-07-01

    Full Text Available The failure of Shell and Tube Heat Exchangers (STHE is being extensively observed in the chemical process industries. This failure can cause enormous production loss and have a potential of dangerous consequences such as an explosion, fire and toxic release scenarios. There is an urgent need for assessing the explosion potential of shell and tube heat exchanger at the preliminary design stage. In current work, inherent safety index based approach is used to resolve the highlighted issue. Inherent Safety Index for Shell and Tube Heat Exchanger (ISISTHE is a newly developed index for assessing the inherent safety level of a STHE at the preliminary design stage. This index is composed of preliminary design variables and integrated with the process design simulator (Aspen HYSYS. Process information can easily be transferred from process design simulator to MS Excel spreadsheet owing to this integration. This index could potentially facilitate the design engineer to analyse the worst heat exchanger in the heat exchanger network. Typical heat exchanger network of the steam reforming process is presented as a case study and the worst heat exchanger of this network has been identified. It is inferred from this analysis that shell and tube heat exchangers possess high operating pressure, corrected mean temperature difference (CMTD and flammability and reactive potential needs to be critically analysed at the preliminary design stage.

  14. Assessments of plasma ghrelin levels in the early stages of parkinson's disease.

    Science.gov (United States)

    Song, Ning; Wang, Weiwei; Jia, Fengjv; Du, Xixun; Xie, Anmu; He, Qing; Shen, Xiaoli; Zhang, Jing; Rogers, Jack T; Xie, Junxia; Jiang, Hong

    2017-10-01

    Gastrointestinal symptoms are early events in Parkinson's disease (PD). The gastrointestinal hormone ghrelin was neuroprotective in the nigrostriatal dopamine system. The objective of this study was to assess ghrelin levels in the early stages of PD. Plasma was collected in the fasting state in 291 PD patients in stages 1-3 and 303 age- and sex-matched healthy controls. Additional samples were taken in the glucose response test to assess nutrition-related ghrelin levels in 20 PD patients and 20 healthy controls. The enzyme-linked immunosorbent assay was used to measure total and active plasma ghrelin levels. We reported that total and active plasma ghrelin levels were decreased in PD, although there was no difference across progressive PD stages. Postprandial ghrelin suppression and preprandial peak responses were both attenuated in PD. Plasma ghrelin levels were decreased in PD; however, this event might be irrelevant to PD progression. Ghrelin responses to meals were also impaired in PD. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

  15. 77 FR 61012 - Expansion of Importer Self-Assessment Program To Include Qualified Importers of Focused...

    Science.gov (United States)

    2012-10-05

    ... of International Trade, has determined that the company represents an acceptable risk to CBP, if the... Executive Director, Trade Policy and Programs, Office of International Trade, at [email protected] benefits: Entitled to receive entry summary trade data, including analysis support, from CBP. Consultation...

  16. Including ecosystem dynamics in risk assessment of radioactive waste in coastal regions

    International Nuclear Information System (INIS)

    Kumblad, L.; Kautsky, U.; Gilek, M.

    2000-01-01

    Radiation protection has mainly focused on assessing and minimising risks of negative effects on human health. Although some efforts have been made to estimate effects on non-human populations, modelling of radiation risks to other components of the ecosystem have often lead to more or less disappointing results. In this paper an ecosystem approach is suggested and exemplified with a preliminary 14 C model of a coastal Baltic ecosystem. Advantages with the proposed ecosystem approach are for example the possibility to detect important but previously neglected pathways to humans since the whole ecosystem is analysed. The results from the model indicate that a rather small share of hypothetical released 14 C would accumulate in biota due to large water exchange in the modelled area. However, modelled future scenarios imply opposite results, i.e. relatively high doses in biota, due to changes of the physical properties in the area that makes a larger accumulation possible. (author)

  17. Probabilistic assessment of fatigue life including statistical uncertainties in the S-N curve

    International Nuclear Information System (INIS)

    Sudret, B.; Hornet, P.; Stephan, J.-M.; Guede, Z.; Lemaire, M.

    2003-01-01

    A probabilistic framework is set up to assess the fatigue life of components of nuclear power plants. It intends to incorporate all kinds of uncertainties such as those appearing in the specimen fatigue life, design sub-factor, mechanical model and applied loading. This paper details the first step, which corresponds to the statistical treatment of the fatigue specimen test data. The specimen fatigue life at stress amplitude S is represented by a lognormal random variable whose mean and standard deviation depend on S. This characterization is then used to compute the random fatigue life of a component submitted to a single kind of cycles. Precisely the mean and coefficient of variation of this quantity are studied, as well as the reliability associated with the (deterministic) design value. (author)

  18. ECETOC Florence workshop on risk assessment of endocrine substances, including the potency concept.

    Science.gov (United States)

    Fegert, Ivana

    2013-12-16

    The European regulation on plant protection products (1107/2009) and the Biocidal Products Regulation (EC Regulation 528/2012) only support the marketing and use of chemicals if they do not cause endocrine disruption in humans or wildlife species. Also, substances with endocrine properties are subject to authorization under the European regulation on the registration, evaluation, authorization and restriction of chemicals (REACH; 1907/2006). Therefore, the regulatory consequences of identifying a substance as an endocrine disrupting chemical are severe. In contrast to that, basic scientific criteria, necessary to define endocrine disrupting properties, are not described in any of these legislative documents. Thus, the European Center for Ecotoxicology and Toxicology of Chemicals (ECETOC) established a task force to provide scientific criteria for the identification and assessment of chemicals with endocrine disrupting properties that may be used within the context of these three legislative texts (ECETOC, 2009a). In 2009, ECETOC introduced a scientific framework as a possible concept for identifying endocrine disrupting properties within a regulatory context (ECETOC, 2009b; Bars et al., 2011a,b). The proposed scientific criteria integrated, in a weight of evidence approach, information from regulatory (eco)toxicity studies and mechanistic/screening studies by combining evidence for adverse effects detected in apical whole-organism studies with an understanding of the mode of action (MoA) of endocrine toxicity. However, since not all chemicals with endocrine disrupting properties are of equal hazard, an adequate concept should also be able to differentiate between chemicals with endocrine properties of low concern from those of higher concern (for regulatory purposes). For this purpose, the task force refined this part of their concept. Following an investigation of the key factors at a second workshop of invited regulatory, academic and industry scientists, the

  19. Environmental impact assessment including indirect effects--a case study using input-output analysis

    International Nuclear Information System (INIS)

    Lenzen, Manfred; Murray, Shauna A.; Korte, Britta; Dey, Christopher J.

    2003-01-01

    Environmental impact assessment (EIA) is a process covered by several international standards, dictating that as many environmental aspects as possible should be identified in a project appraisal. While the ISO 14011 standard stipulates a broad-ranging study, off-site, indirect impacts are not specifically required for an Environmental Impact Statement (EIS). The reasons for this may relate to the perceived difficulty of measuring off-site impacts, or the assumption that these are a relatively insignificant component of the total impact. In this work, we describe a method that uses input-output analysis to calculate the indirect effects of a development proposal in terms of several indicator variables. The results of our case study of a Second Sydney Airport show that the total impacts are considerably higher than the on-site impacts for the indicators land disturbance, greenhouse gas emissions, water use, emissions of NO x and SO 2 , and employment. We conclude that employing input-output analysis enhances conventional EIA, as it allows for national and international effects to be taken into account in the decision-making process

  20. Evaluation of the Treatment of Congenital Penile Curvature Including Psychosexual Assessment.

    Science.gov (United States)

    Zachalski, Wojciech; Krajka, Kazimierz; Matuszewski, Marcin

    2015-08-01

    Penile corporoplasty is a well-established treatment method of congenital penile deviation (CPD). Anatomical results are good with only slight differences between surgical procedures used. The disease however has huge influence on young male quality of life. This issue is not well analyzed in the literature. The aim of the study was to evaluate quality of life of the patients affected with CPD before and after the surgical treatment Study population consisted of 107 patients with CPD referred for surgical management. Patients were evaluated with not only clinical assessment, but also by four questionnaires measuring various aspects of quality of life. They were: Short-Form Medical Outcomes, Sexual Quality of Life Questionnaire for Man, Beck Depression Inventory, and International Index of Erectile Function. Quality of life measurements showed deep decrease in the general quality of life, sexual performance, depression scale, as well as in physical and mental health in men with CPD. All these parameters were restored to normal after the successful surgical treatment with any method. CPD deeply decreases the quality of life of the affected men in many aspects. Surgical treatment is able to repair the anatomical deformity and as well as significantly restore the patients' psychosocial well-being. © 2015 International Society for Sexual Medicine.

  1. 45 CFR 287.130 - Can NEW Program activities include job market assessments, job creation and economic development...

    Science.gov (United States)

    2010-10-01

    ... assessments, job creation and economic development activities? 287.130 Section 287.130 Public Welfare... creation and economic development activities? (a) A Tribe may conduct job market assessments within its NEW Program. These might include the following: (1) Consultation with the Tribe's economic development staff...

  2. Environmental assessment of passenger transportation should include infrastructure and supply chains

    International Nuclear Information System (INIS)

    Chester, Mikhail V; Horvath, Arpad

    2009-01-01

    To appropriately mitigate environmental impacts from transportation, it is necessary for decision makers to consider the life-cycle energy use and emissions. Most current decision-making relies on analysis at the tailpipe, ignoring vehicle production, infrastructure provision, and fuel production required for support. We present results of a comprehensive life-cycle energy, greenhouse gas emissions, and selected criteria air pollutant emissions inventory for automobiles, buses, trains, and airplanes in the US, including vehicles, infrastructure, fuel production, and supply chains. We find that total life-cycle energy inputs and greenhouse gas emissions contribute an additional 63% for onroad, 155% for rail, and 31% for air systems over vehicle tailpipe operation. Inventorying criteria air pollutants shows that vehicle non-operational components often dominate total emissions. Life-cycle criteria air pollutant emissions are between 1.1 and 800 times larger than vehicle operation. Ranges in passenger occupancy can easily change the relative performance of modes.

  3. An approach to include soil carbon changes in life cycle assessments

    DEFF Research Database (Denmark)

    Petersen, Bjorn Molt; Knudsen, Marie Trydeman; Hermansen, John Erik

    2013-01-01

    to estimate carbon sequestration to be included in LCA is suggested and applied to two examples where the inclusion of carbon sequestration is especially relevant: 1) Bioenergy: removal of straw from a Danish soil for energy purposes and 2) Organic versus conventional farming: comparative study of soybean...... comparable to the IPCC 2006 tier I approach in a time perspective of 20 year, where after the suggested methodology showed a continued soil carbon change toward a new steady state. The suggested method estimated a carbon sequestration for the first example when storing straw in the soil instead of using...... it for bioenergy of 54, 97 and 213 kg C t(-1) straw C in a 200, 100 and 20 years perspective, respectively. For the conversion from conventional to organic soybean production, a difference of 32, 60 or 143 kg soil C ha(-1) yr(-1) in a 200,100 or 20 years perspective, respectively was found. The study indicated...

  4. FDG PET/CT in initial staging and early response to chemotherapy assessment of paediatric rhabdomyosarcomas

    International Nuclear Information System (INIS)

    Eugene, T.; Ansquer, C.; Oudoux, A.; Carlier, T.; Kraeber-Bodere, T.; Bodet-Milin, C.; Corradini, N.; Thomas, C.; Dupas, B.

    2010-01-01

    Purpose: The objective of this study was to retrospectively evaluate the impact of positron emission tomography/computed tomography (PET/CT) using fluorine-18-fluorodeoxyglucose (FDG), in comparison with conventional imaging modalities (CIM), for initial staging and early therapy assessment in paediatric rhabdomyosarcoma. Patients and methods: Prior to treatment, 18 patients (age range, 9 months to 18 years) with histologically proven rhabdomyosarcoma underwent FDG PET/CT in addition to CIM (magnetic resonance imaging of primary site, whole body CT and bone scintigraphy). After three courses of chemotherapy, 12 patients underwent FDG PET/CT in addition to CIM. RECIST criteria and visual analysis of FDG uptake were used for assessment of response. The standard of reference was determined by an interdisciplinary tumor board based on imaging material, histopathology and follow-up data (median = 5 years). Results: PET/CT sensitivity was superior to CIM's concerning lymph node involvement (100% versus 83%, respectively) and metastases detection (100% versus 50%, respectively). PET/CT results changed therapeutic management in 11% of cases. After three courses of chemotherapy, the rate of complete response was 66% with PET/CT versus 8% with CIM. Five percent of patients relapsed during follow-up (median = 5 years). Conclusion: This study confirms that PET/CT depicts important additional information in initial staging of paediatric rhabdomyosarcomas and suggests a superior prognostic value of PET/CT in early response to chemotherapy assessment. (authors)

  5. Efficacy of a combined oral formulation of derquantel-abamectin against the adult and larval stages of nematodes in sheep, including anthelmintic-resistant strains.

    Science.gov (United States)

    Little, Peter R; Hodge, Andrew; Maeder, Steven J; Wirtherle, Nicole C; Nicholas, David R; Cox, George G; Conder, George A

    2011-09-27

    Derquantel (DQL), a semi-synthetic member of a novel anthelmintic class, the spiroindoles, in combination with abamectin (ABA) [as the combination product STARTECT(®)] is a new entry for the treatment and control of parasites in sheep. The 19 studies reported herein were conducted in Australia, New Zealand, South Africa and the United Kingdom to demonstrate the efficacy of derquantel-abamectin (DQL-ABA) against a broad spectrum of gastrointestinal and respiratory nematodes of sheep, and to support registration of the combination product. Eleven studies were conducted using natural or experimental parasite infections with unknown or unconfirmed resistance, while eight studies utilised isolates/strains with confirmed or well characterised resistance to one or more currently available anthelmintics, including macrocyclic lactones. All studies included DQL-ABA and negative control groups, and in selected studies one or more reference anthelmintic groups were included. In all studies the commercial formulation of DQL-ABA was administered orally at 2mg/kg DQL and 0.2mg/kg ABA; placebo was administered in the same volume as DQL-ABA; and reference anthelmintics were administered as per label recommendations, except in one instance where levamisole was administered at twice the label dose. Infection, necropsy, worm collection and worm counting procedures were performed using standard techniques. Efficacy was calculated based on the percentage reduction in geometric mean worm count relative to negative control for each nematode species and lifecycle stage targeted. Twenty-two isolates/strains used in the eight studies targeting resistant worms had proven resistance: three to one anthelmintic class, eleven to two classes and eight to three or more classes; of these resistant strains, 16 demonstrated resistance to a macrocyclic lactone anthelmintic. Regardless of resistance status in the 19 studies, DQL-ABA controlled a broad range of economically important gastrointestinal

  6. Implementing the IA stage and developing an instrument to assess the fidelity of critical time interventional: task shifting

    Directory of Open Access Journals (Sweden)

    Tatiana Fernandes Carpinteiro Silva

    2014-10-01

    Full Text Available One strategy that has been used for treat patients with mental health disorder is the implementation of psychosocial interventions. Like the development of a new drug, which requires safety studies before efficacy assessment, the psychosocial interventions should be implemented following defined stages, with the objective of increase the validity and reliability of such interventions. These stages are IA (pre-pilot, IB (pilot study, II (randomized clinical trial and III (additional studies. This study proposes a description of all activities carried out in implementation of the pre-pilot (IA Critical Time Intervention – Task Shifting (CTI-TS, including the development of manuals and the development of an instrument to assess fidelity to the original protocol. As a result, were performed the adaptation of instruments to be used in the pilot study, the adaptation of CTI-TS manual to Brazilian context, the adaptation of the agents CTI-TS training manual, as well the development of the CTI-TS assessment scale fidelity and its instruction manual. This allows multicentric studies conducted in different contexts could be performed avoiding biases. Considering that Brazil is a country that lacks resources allocated to mental care, it is expected that more psychosocial interventions can be implemented, since it was possible to develop the implementation process according to the methods recommended by the international scientific literature.

  7. Metal coordination by sterically hindered heterocyclic ligands, including 2-vinylpyridine, assessed by investigation of cobaloximes.

    Science.gov (United States)

    Siega, Patrizia; Randaccio, Lucio; Marzilli, Patricia A; Marzilli, Luigi G

    2006-04-17

    Structural and 1H NMR data have been obtained for cobaloximes with the bulkiest substituted pyridines reported so far. We have isolated in noncoordinating solvents the complexes CH3Co(DH)2L (methylcobaloxime, where DH = the monoanion of dimethylglyoxime) with L = sterically hindered N-donor ligands: quinoline, 4-CH3quinoline, 2,4-(CH3)2pyridine, and 2-R-pyridine (R = CH3, OCH3, CH2CH3, CH=CH2). We have found that the Co-N(ax) bond is very long in the structurally characterized complexes. In particular, CH3Co(DH)2(4-CH3quinoline) has a longer Co-N(ax) bond (2.193(3) A) than any reported for methylcobaloximes. The main cause of the long bonds is unambiguously identified as the steric bulk of L by the fairly linear relationship found for Co-N(ax) distance vs CCA (calculated cone angle, CCA, a computed measure of bulk) over an extensive series of methylcobaloximes. The linear relationship improves if L basicity (quantified by pKa) is taken into account. In anhydrous CDCl3 at 25 degrees C, all complexes except the 2-aminopyridine adduct exhibit 1H NMR spectra consistent with partial dissociation of L to form the methylcobaloxime dimer. 1H NMR experiments at -20 degrees C allowed us to assess qualitatively the relative binding ability of L as follows: 2,4-(CH3)2pyridine > 4-CH3quinoline approximately = quinoline approximately = 2-CH3pyridine > 2-CH3Opyridine > 2-CH3CH2pyridine > 2-CH2=CHpyridine. The broadness of the 1H NMR signals at 25 degrees C suggests a similar order for the ligand exchange rate. The lack of dissociation by 2-aminopyridine is attributed to an intramolecular hydrogen bond between the NH2 group and an oxime O atom. The weaker than expected binding of 2-vinylpyridine relative to the Co-N(ax) bond length is attributed to rotation of the 2-vinyl group required for this bulky ligand to bind to the metal center, a conclusion supported by pronounced changes in 2-vinylpyridine signals upon coordination.

  8. Biomechanical Assessment of the Strength of Volleyball Players in Different Stages of the Training Macrocycle

    Directory of Open Access Journals (Sweden)

    Śliwa Marcin

    2015-09-01

    Full Text Available Introduction. In order to help volleyball players achieve superior results, their coaches are constantly seeking new training methods. One of the methods used to improve the effectiveness of the training that is being implemented is conducting tests which make it possible to assess the player’s locomotor system in terms of its motor and biomechanical functions. The aim of the study was to determine the torque of the knee flexor and extensor muscles of volleyball players in three stages of the annual macrocycle.

  9. Provision of financial transmission rights including assessment of maximum volumes of obligations and options

    International Nuclear Information System (INIS)

    Kristiansen, Tarjei

    2007-01-01

    This paper studies the risks faced by the providers of financial transmission rights (FTRs). The introduction of FTRs in different systems in the USA must be viewed in relationship to the organization of the market. Often, private players own the central grid, while an independent system operator (ISO) operates the grid. The revenues from transmission congestion collected in the day-ahead and balancing markets should give the ISO sufficient revenues to cover the costs associated with providing FTRs. This can be ensured if the issued FTRs fulfill the simultaneous feasibility test described by Hogan. This test on a three-node network is studied under different assumptions to find the maximum volumes, which can be sold, including contingency constraints. Next the feasibility test is analyzed when taking into account the proceeds from the FTR auction, and demonstrates that a higher volume might be issued. We introduce uncertainty under different scenarios for locational prices and calculate the maximum provided volumes. As a tool for risk management, the provider of the FTRs can use the Value at Risk approach. Finally, the provision of FTRs by private parties is discussed. (author)

  10. Evaluation of the Supraglottic and Subglottic Activities Including Acoustic Assessment of the Opera-Chant Singers.

    Science.gov (United States)

    Petekkaya, Emine; Yücel, Ahmet Hilmi; Sürmelioğlu, Özgür

    2017-12-28

    Opera and chant singers learn to effectively use aerodynamic components by breathing exercises during their education. Aerodynamic components, including subglottic air pressure and airflow, deteriorate in voice disorders. This study aimed to evaluate the changes in aerodynamic parameters and supraglottic structures of men and women with different vocal registers who are in an opera and chant education program. Vocal acoustic characteristics, aerodynamic components, and supraglottic structures were evaluated in 40 opera and chant art branch students. The majority of female students were sopranos, and the male students were baritone or tenor vocalists. The acoustic analyses revealed that the mean fundamental frequency was 152.33 Hz in the males and 218.77 Hz in the females. The estimated mean subglottal pressures were similar in females (14.99 cmH 2 O) and in males (14.48 cmH 2 O). Estimated mean airflow rates were also similar in both groups. The supraglottic structure compression analyses revealed partial anterior-posterior compressions in 2 tenors and 2 sopranos, and false vocal fold compression in 2 sopranos. Opera music is sung in high-pitched sounds. Attempts to sing high-pitched notes and frequently using register transitions overstrain the vocal structures. This intense muscular effort eventually traumatizes the vocal structures and causes supraglottic activity. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  11. Micro-mechanical modelling of ductile failure in 6005A aluminium using a physics based strain hardening larw including stage IV

    DEFF Research Database (Denmark)

    Simar, Aude; Nielsen, Kim Lau; de Meester, Bruno

    2010-01-01

    The strain hardening and damage behaviour of isothermally heat treated 6005A aluminium is investigated in order to link the thermal treatment conditions, microstructure and fracture strain. The need for a plastic flow rule involving a stage IV hardening at large strain was found essential to gene...

  12. Treatment outcome and prognostic factor analysis in transplant-eligible Chinese myeloma patients receiving bortezomib-based induction regimens including the staged approach, PAD or VTD

    Directory of Open Access Journals (Sweden)

    Chim Chor

    2012-06-01

    Full Text Available Abstract Background We have reported promising outcomes using a staged approach, in which bortezomib/thalidomide/dexamethasone was used only in 14 patients with suboptimal response to VAD (vincristine/adriamycin/dexamethasone before autologous stem cell transplantation (ASCT. Here we compared the outcomes of the staged approach with frontline PAD (bortezomib/doxorubicin/dexamethasone or VTD (bortezomib/thalidomide/dexamethasone induction, and analysed prognostic factors for outcome. Patients and methods Ninety-one transplant-eligible Chinese patients received three induction regimens prior to ASCT [staged approach (N = 25, PAD (N = 31, VTD (N = 35]. and received thalidomide maintenance for 2 years post-ASCT. Results 43 (47.3% patients had International Staging System (ISS III disease. By an intention-to-treat analysis, the overall CR/nCR rate were 37.4% post-induction, and 62.6% post-ASCT. Five-year overall (OS and event-free (EFS survivals were 66% and 45.1%. There was no difference of the post-induction CR/nCR rate, EFS or OS between patients induced by these three regimens. Moreover, ISS III disease did not affect CR/nCR rates. Multivariate analysis showed that ISS and post-ASCT CR/nCR impacted OS while ISS and post-induction CR/nCR impacted EFS. Conclusions These three induction regimens produced comparable and favorable outcomes in myeloma. The unfavorable outcome of ISS stage III persisted despite upfront/early use of bortezomib. CR/nCR predicted favorable survivals.

  13. An approach to quantitative sustainability assessment in the early stages of process design.

    Science.gov (United States)

    Tugnoli, Alessandro; Santarelli, Francesco; Cozzani, Valerio

    2008-06-15

    A procedure was developed for the quantitative assessment of key performance indicators suitable for the sustainability analysis of alternative processes, mainly addressing the early stages of process design. The methodology was based on the calculation of a set of normalized impact indices allowing a direct comparison of the additional burden of each process alternative on a selected reference area. Innovative reference criteria were developed to compare and aggregate the impact indicators on the basis of the site-specific impact burden and sustainability policy. An aggregation procedure also allows the calculation of overall sustainability performance indicators and of an "impact fingerprint" of each process alternative. The final aim of the method is to support the decision making process during process development, providing a straightforward assessment of the expected sustainability performances. The application of the methodology to case studies concerning alternative waste disposal processes allowed a preliminary screening of the expected critical sustainability impacts of each process. The methodology was shown to provide useful results to address sustainability issues in the early stages of process design.

  14. Risk assessment framework on time impact: Infrastructure projects in soft soil during construction stage

    Science.gov (United States)

    Low, W. W.; Wong, K. S.; Lee, J. L.

    2018-04-01

    With the growth of economy and population, there is an increase in infrastructure construction projects. As such, it is unavoidable to have construction projects on soft soil. Without proper risk management plan, construction projects are vulnerable to different types of risks which will have negative impact on project’s time, cost and quality. Literature review showed that little or none of the research is focused on the risk assessment on the infrastructure project in soft soil. Hence, the aim of this research is to propose a risk assessment framework in infrastructure projects in soft soil during the construction stage. This research was focused on the impact of risks on project time and internal risk factors. The research method was Analytical Hierarchy Process and the sample population was experienced industry experts who have experience in infrastructure projects. Analysis was completed and result showed that for internal factors, the five most significant risks on time element are lack of special equipment, potential contractual disputes and claims, shortage of skilled workers, delay/lack of materials supply, and insolvency of contractor/sub-contractor. Results indicated that resources risk factor play a critical role on project time frame in infrastructure projects in soft soil during the construction stage.

  15. The reliability of dental x-ray film in assessment of MP3 stages of the pubertal growth spurt.

    Science.gov (United States)

    Abdel-Kader, H M

    1998-10-01

    The main object of this clinical study is to provide a simple and practical method to assess the pubertal growth spurt stages of a subject by recording MP3 stages with the dental periapical radiograph and the standard dental x-ray machine.

  16. Micro-X-ray diffraction assessment of shock stage in enstatite chondrites

    Science.gov (United States)

    Izawa, Matthew R. M.; Flemming, Roberta L.; Banerjee, Neil R.; McCausland, Philip J. A.

    2011-05-01

    A new method for assessing the shock stage of enstatite chondrites has been developed, using in situ micro-X-ray diffraction (μXRD) to measure the full width at half maximum (FWHMχ) of peak intensity distributed along the direction of the Debye rings, or chi angle (χ), corresponding to individual lattice reflections in two-dimensional XRD patterns. This μXRD technique differs from previous XRD shock characterization methods: it does not require single crystals or powders. In situ μXRD has been applied to polished thin sections and whole-rock meteorite samples. Three frequently observed orthoenstatite reflections were measured: (020), (610), and (131); these were selected as they did not overlap with diffraction lines from other phases. Enstatite chondrites are commonly fine grained, stained or darkened by weathering, shock-induced oxidation, and metal/sulfide inclusions; furthermore, most E chondrites have little olivine or plagioclase. These characteristics inhibit transmitted-light petrography, nevertheless, shock stages have been assigned MacAlpine Hills (MAC) 02837 (EL3) S3, Pecora Escarpment (PCA) 91020 (EL3) S5, MAC 02747 (EL4) S4, Thiel Mountains (TIL) 91714 (EL5) S2, Allan Hills (ALHA) 81021 (EL6) S2, Elephant Moraine (EET) 87746 (EH3) S3, Meteorite Hills (MET) 00783 (EH4) S4, EET 96135 (EH4-5) S2, Lewis Cliff (LEW) 88180 (EH5) S2, Queen Alexandra Range (QUE) 94204 (EH7) S2, LaPaz Icefield (LAP) 02225 (EH impact melt) S1; for the six with published shock stages, there is agreement with the published classification. FWHMχ plotted against petrographic shock stage demonstrates positive linear correlation. FWHMχ ranges corresponding to shock stages were assigned as follows: S1 3.5°, S6—not measured. Slabs of Abee (EH impact-melt breccia), and Northwest Africa (NWA) 2212 (EL6) were examined using μXRD alone; FWHMχ values place both in the S2 range, consistent with literature values. Micro-XRD analysis may be applicable to other shocked orthopyroxene

  17. Remote Sensing Based Two-Stage Sampling for Accuracy Assessment and Area Estimation of Land Cover Changes

    Directory of Open Access Journals (Sweden)

    Heinz Gallaun

    2015-09-01

    Full Text Available Land cover change processes are accelerating at the regional to global level. The remote sensing community has developed reliable and robust methods for wall-to-wall mapping of land cover changes; however, land cover changes often occur at rates below the mapping errors. In the current publication, we propose a cost-effective approach to complement wall-to-wall land cover change maps with a sampling approach, which is used for accuracy assessment and accurate estimation of areas undergoing land cover changes, including provision of confidence intervals. We propose a two-stage sampling approach in order to keep accuracy, efficiency, and effort of the estimations in balance. Stratification is applied in both stages in order to gain control over the sample size allocated to rare land cover change classes on the one hand and the cost constraints for very high resolution reference imagery on the other. Bootstrapping is used to complement the accuracy measures and the area estimates with confidence intervals. The area estimates and verification estimations rely on a high quality visual interpretation of the sampling units based on time series of satellite imagery. To demonstrate the cost-effective operational applicability of the approach we applied it for assessment of deforestation in an area characterized by frequent cloud cover and very low change rate in the Republic of Congo, which makes accurate deforestation monitoring particularly challenging.

  18. Efficiency assessment of wind farms in China using two-stage data envelopment analysis

    International Nuclear Information System (INIS)

    Wu, Yunna; Hu, Yong; Xiao, Xinli; Mao, Chunyu

    2016-01-01

    Highlights: • The efficiency of China’s wind farms is assessed by data envelopment analysis. • Tobit model is used to analyze the impact of uncontrollable factors on efficiency. • Sensitivity analysis is conducted to verify the stability of evaluation results. • Efficiency levels of Chinese wind farms are relatively high in general. • Age and wind curtailment rate negatively affect the productive efficiency. - Abstract: China has been the world’s leader in wind power capacity due to the promotion of favorable policies. Given the rare research on the efficiency of China’s wind farms, this study analyzes the productive efficiency of 42 large-scale wind farms in China using a two-stage analysis. In the first stage, efficiency scores of wind farms are determined with data envelopment analysis and the sensitivity analysis is conducted to verify the robustness of efficiency calculation results. In the second stage, the Tobit regression is employed to explore the relationship between the efficiency scores and the environment variables that are beyond the control of wind farms. According to the results, all wind farms studied operate at an acceptable level. However, 50% of them overinvest in the installed capacity and about 48% have the electricity-saving potential. The most important factors affecting the efficiency of wind farms are the installed capacity and the wind power density. In addition, the age of the wind farm and the wind curtailment rate have a negative effect on productive efficiency, whereas the ownership of the wind farm has no significant effect. Findings from this study may be helpful for stakeholders in the wind industry to select wind power projects, optimize operational strategies and make related policies.

  19. Radiation therapy for stage IIA and IIB testicular seminoma: peripheral dose calculations and risk assessments

    Science.gov (United States)

    Mazonakis, Michalis; Berris, Theocharris; Lyraraki, Efrossyni; Damilakis, John

    2015-03-01

    This study was conducted to calculate the peripheral dose to critical structures and assess the radiation risks from modern radiotherapy for stage IIA/IIB testicular seminoma. A Monte Carlo code was used for treatment simulation on a computational phantom representing an average adult. The initial treatment phase involved anteroposterior and posteroanaterior modified dog-leg fields exposing para-aortic and ipsilateral iliac lymph nodes followed by a cone-down phase for nodal mass irradiation. Peripheral doses were calculated using different modified dog-leg field dimensions and an extended conventional dog-leg portal. The risk models of the BEIR-VII report and ICRP-103 were combined with dosimetric calculations to estimate the probability of developing stochastic effects. Radiotherapy for stage IIA seminoma with a target dose of 30 Gy resulted in a range of 23.0-603.7 mGy to non-targeted peripheral tissues and organs. The corresponding range for treatment of stage IIB disease to a cumulative dose of 36 Gy was 24.2-633.9 mGy. A dose variation of less than 13% was found by altering the field dimensions. Radiotherapy with the conventional instead of the modern modified dog-leg field increased the peripheral dose up to 8.2 times. The calculated heart doses of 589.0-632.9 mGy may increase the risk for developing cardiovascular diseases whereas the testicular dose of more than 231.9 mGy may lead to a temporary infertility. The probability of birth abnormalities in the offspring of cancer survivors was below 0.13% which is much lower than the spontaneous mutation rate. Abdominoplevic irradiation may increase the lifetime intrinsic risk for the induction of secondary malignancies by 0.6-3.9% depending upon the site of interest, patient’s age and tumor dose. Radiotherapy for stage IIA/IIB seminoma with restricted fields and low doses is associated with an increased morbidity. These data may allow the definition of a risk-adapted follow-up scheme for long

  20. The Assessment of Early Stage Computed Tomography Findings in Acute Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Nebahat Taşdemir

    2008-01-01

    Full Text Available The imaging techniques have become important tools during diagnostic stage of acute ischemic stroke during the last 30 years. The improvement in these techniques further increased the clinical areas that these tools could be used. As computerized brain tomography (CT is a rapid, cheap, non-invasive and highly available imaging tool in most hospitals, it remains to be the primary scanning method for all acute patients.The aim of this study was to evaluate the early stage CT findings in the ischemic stroke patients which have been scanned in the first 8 to 12 hours after the incidence. Sixty four cases (26 male, 38 female who had clinical symptoms of ischemic stroke have been included in this study. CT scan was performed twice to these patients; first in the first 8 to 12 hours, and second in between 24 hours and 48 hours after the stroke. The middle cerebral artery perfused area was the most common arterial area affected among cases who had CT findings in early scans. Hypodense lesions were most common lesions encountered in CT findings. Hyperdense middle cerebral artery sign in early CT findings could be an indicator of ischemia due to arterial occlusion. We determined that the CT images obtained at the beginning of developing stroke appeared to show the lesions smaller than what they really were. There were significant differences between the emergency room evaluation and detailed clinical evaluation of CT scans. More findings have been observed in late CT scans performed between 24 hours and 48 hours than the ones performed in the first 8 hours and 12 hours. There was no correlation between the presence of CT findings in early scans and severity of clinical features of ischemia. CT appears to be an important tool in diagnosing ischemic strokes even at early stages. Developments in diagnostic precision of CT tools will further increase our understanding of ischemic strokes and their clinical progress.

  1. Assessment of skeletal maturation with permanent mandibular second molar calcification stages among a group of Nepalese orthodontic patients

    Directory of Open Access Journals (Sweden)

    Giri J

    2016-03-01

    Full Text Available Jamal Giri,1 Basanta Kumar Shrestha,2 Rajiv Yadav,2 Tika Ram Ghimire21Department of Orthodontics, BP Koirala Institute of Health Sciences, Dharan, 2Department of Dentistry, Institute of Medicine, Kathmandu, Nepal Background: Assessment of growth status of a patient is a key component in orthodontic diagnosis and treatment planning for growing patients with skeletal discrepancy. Skeletal maturation based on hand-wrist radiograph and cervical vertebral maturation (CVM are commonly used methods of growth assessment. Studies have shown that stages of dental calcification can also be used to assess skeletal maturation status of an individual, whereas other studies have suggested that the relationship between dental calcification and skeletal maturation should be interpreted with caution owing to racial variation. Objective: To evaluate the relationship between permanent mandibular second molar calcification stages and skeletal maturity assessed by CVM among a group of Nepalese orthodontic patients. Materials and methods: One hundred and sixty-eight digital radiographs (84 orthopantomograms and 84 lateral cephalograms were obtained from the records of 84 patients who sought orthodontic treatment in Orthodontic and Dentofacial Orthopaedic Unit, Department of Dentistry, Institute of Medicine, Kathmandu. Two parameters were used in this study, namely, CVM stages from lateral cephalogram and Demirjian index (DI stages from orthopantomogram. The evaluation of digital radiographs was carried out on a computer screen with a resolution of 1,280×800 pixels. The association between DI stages of permanent mandibular second molar and CVM stages was assessed. Results: A statistically significant association was found between DI and CVM stages for both male and female subjects with Pearson's contingency coefficient value of 0.751 and 0.766 for male and female subjects, respectively. Conclusion: Skeletal maturation can be reliably assessed with dental calcification

  2. [Carcinoma of the uterine cervical canal. Staging and biometric assessment with magnetic resonance].

    Science.gov (United States)

    Fischetti, S G; Politi, G; Lomeo, E; Garozzo, G; Di Leo, S; Nuciforo, G

    1994-10-01

    In uterine cervical canal carcinoma, the current clinical FIGO criteria often fail not only to differentiate stage IA2 from stage IB but also to demonstrate possible parametrial involvement. Moreover, the analysis of tumor volume and of the depth of neoplastic stromal invasion is not very reliable. The authors investigated MR accuracy in the definition of such variables: to this purpose, 24 patients with histologically confirmed endocervical adenocarcinoma were submitted to MRI, which was performed with an 0.5-T superconductive magnet. Sagittal and oblique transverse or sometimes coronal SE images, oriented so as to be perpendicular to longitudinal cervical major axis were obtained with T2 weighting (TR 1800 ms, TE 25-90 ms). MR data were correlated with pathologic findings. MR accuracy in demonstrating parametrial involvement was 92%, its sensitivity was 86% and specificity 97%. Volumetric MR data showed a high correlation (r = 0.970) with those derived from pathologic findings. In 92% of cases stromal invasion exceeded 5 mm. MRI, thanks to its high accuracy, should be included in diagnostic pretreatment protocols, even though FIGO criteria do not require it yet, especially in the presence of an endocervical adenocarcinoma. Moreover, the accurate definition of tumor volume can allow less extensive surgery with the same survival rates and fewer complications, which are frequently observed after radical hysterectomy.

  3. Contrast-enhanced dynamic and diffusion-weighted magnetic resonance imaging at 3.0 T to assess early-stage nasopharyngeal carcinoma.

    Science.gov (United States)

    Ni, Liangping; Liu, Ying

    2018-04-01

    The present study aimed to assess early-stage nasopharyngeal carcinoma (NPC) with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) at 3.0 T. A total of 44 patients newly diagnosed with NPC were included in the present study. All patients underwent MR examination at 3.0 T using DCE-MRI and DWI. The volume transfer constant ( K trans ), flux rate constant between extravascular extracellular space and plasma ( K ep ), the volume of extravascular extracellular space per unit volume of tissue ( V e ) and the apparent diffusion coefficient (ADC) of tumours were investigated. Furthermore, the correlation between clinical stages and ADC value and K trans were analysed. The diagnostic accuracy of K trans and ADC were estimated using receiver operating characteristic curves. NPC stage correlated positively with K trans and negatively with ADC values. Additionally, tumour K trans negatively correlated with ADC value. The sensitivity and accuracy of combined K trans and ADC in distinguishing between stage II and stage III and stage III and IV were higher than the values of either measurement used separately. The present study suggested that K trans and ADC derived from DCE-MRI and DWI may be useful to detect stage early NPC accurately. K trans and ADC in combination were superior than either alone.

  4. Stage of readiness of patients with behavioral dysphonia in pre and post-group voice therapy assessments.

    Science.gov (United States)

    Costa, Bianca Oliveira Ismael da; Silva, Priscila Oliveira Costa; Pinheiro, Renata Serrano de Andrade; Silva, Hêmmylly Farias da; Almeida, Anna Alice Figueirêdo de

    2017-08-10

    To verify the efficacy of group voice therapy in the stage of readiness and identify which items of the URICA-Voice range are more sensitive to post-therapy change in patients with behavioral dysphonia. An intervention study was conducted on 49 patients with behavioral dysphonia. An eclectic approach to group therapy was implemented over eight sessions, the first and last sessions consisting of assessments. The URICA-Voice range was used to evaluate the stage of readiness at pre- and post-therapy assessments. A descriptive and inferential statistical analysis was implemented for the results. Most participants were female, did not make professional use of voice, and had membranous vocal fold lesions. Most of them were in the Contemplation stage at in both moments, pre- and post-therapy. There was no significant change in the comparison of pre- and post-therapy scores. The majority of patients showed a reduction in the stage of readiness and some advanced to a higher stage. In the comparison of URICA-V range items, seven questions had equal or inferior responses in the post-therapy assessment. There was no statistical difference when comparing the pre- and post-therapy total average score of the URICA-Voice range. There were significant changes in the stage of readiness of patients in pre- and post-group speech therapy assessments.

  5. Integrated toxic evaluation of sulfamethazine on zebrafish: Including two lifespan stages (embryo-larval and adult) and three exposure periods (exposure, post-exposure and re-exposure).

    Science.gov (United States)

    Yan, Zhengyu; Yang, Qiulian; Jiang, Weili; Lu, Jilai; Xiang, Zhongrun; Guo, Ruixin; Chen, Jianqiu

    2018-03-01

    Persistence of antibiotics in aquatic environment may pose a risk to the non-target aquatic organisms. This study provided an integrated evaluation to analyze the toxic stress of sulfamethazine (SMZ) on zebrafish in two lifespan stages (embryo-larval and adult) and three exposure periods (exposure, post-exposure and re-exposure). Zebrafish embryos and adult zebrafish were exposed to SMZ at 0.2, 20 and 2000 μg/L, respectively. The results showed that SMZ at any given concentration inhibited the hatching of embryos at 58-96 hpf (hours post-fertilization). Our result also indicated that two major kinds of the malformation, which was induced by the antibiotic, were edema and spinal curvature. Additionally, the antibiotic stimulated the heartbeat while reduced the body length of the embryo at 72 hpf. Superoxide dismutase (SOD) activities and malondialdehyde (MDA) contents significantly increased at 120 hpf when the embryos were exposed to the lowest concentration (0.2 μg/L) of the antibiotic. On the other hand, the antibiotic induced SOD activities and MDA contents in adult zebrafish in the exposure and re-exposure periods. The MDA contents could recover while SOD activities still increased in 2 d after the exposure. Both SOD activities and MDA contents could recover in 7 d after the exposure. Levels of SOD and MDA in the re-exposure were higher than those in the first exposure. Our results suggested that SMZ had toxic effects on both embryos and adult zebrafish, and provided an integrated evaluation of the toxic effects of SMZ on zebrafish at a new perspective. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Radiochemotherapy including cisplatin alone versus cisplatin + 5-fluorouracil for locally advanced unresectable stage IV squamous cell carcinoma of the head and neck

    Energy Technology Data Exchange (ETDEWEB)

    Tribius, Silke; Kilic, Yasemin [Dept. of Radiation Oncology, Univ. Medical Center Hamburg-Eppendorf, Hamburg (Germany); Kronemann, Stefanie [Dept. of Radiation Oncology, Univ. Hospital Schleswig-Holstein, Campus Luebeck (Germany); Schroeder, Ursula [Dept. of Head and Neck Surgery, Univ. Hospital Schleswig-Holstein, Campus Luebeck (Germany); Hakim, Samer [Dept. of Oro-Maxillo-Facial Surgery, Univ. Hospital Schleswig-Holstein, Campus Luebeck (Germany); Schild, Steven E. [Dept. of Radiation Oncology, Mayo Clinic, Scottsdale, AZ (United States); Rades, Dirk [Dept. of Radiation Oncology, Univ. Medical Center Hamburg-Eppendorf, Hamburg (Germany); Dept. of Radiation Oncology, Univ. Hospital Schleswig-Holstein, Campus Luebeck (Germany)

    2009-10-15

    Background and purpose: the optimal radiochemotherapy regimen for advanced head-and-neck cancer is still debated. This nonrandomized study compares two cisplatin-based radiochemotherapy regimens in 128 patients with locally advanced unresectable stage IV squamous cell carcinoma of the head and neck (SCCHN). Patients and methods: concurrent chemotherapy consisted of either two courses cisplatin (20 mg/m{sup 2}/d1-5 + 29-33; n = 54) or two courses cisplatin (20 mg/m{sup 2}/d1-5 + 29-33) + 5-fluorouracil (5-FU; 600 mg/m{sup 2}/d1-5 + 29-33; n = 74). Results: at least one grade 3 toxicity occurred in 25 of 54 patients (46%) receiving cisplatin alone and in 52 of 74 patients (70%) receiving cisplatin + 5-FU. The latter regimen was particularly associated with increased rates of mucositis (p = 0.027) and acute skin toxicity (p = 0.001). Seven of 54 (13%) and 20 of 74 patients (27%) received only one chemotherapy course due to treatment-related acute toxicity. Late toxicity in terms of xerostomia, neck fibrosis, skin toxicity, and lymphedema was not significantly different. The 2-year locoregional control rates were 67% after cisplatin alone and 52% after cisplatin + 5-FU (p = 0.35). The metastases-free survival rates were 79% and 69%, respectively (p = 0.65), and the overall survival rates 70% and 51%, respectively (p = 0.10). On multivariate analysis, outcome was significantly associated with performance status, T-category, N-category, hemoglobin level prior to radiotherapy, and radiotherapy break > 1 week. Conclusion: two courses of fractionated cisplatin (20 mg/m{sup 2}/day) alone appear preferable, as this regimen resulted in similar outcome and late toxicity as two courses of cisplatin + 5-FU, but in significantly less acute toxicity. (orig.)

  7. Functional and morphological assessment of ocular structures and follow-up of patients with early-stage Parkinson's disease.

    Science.gov (United States)

    Hasanov, Samir; Demirkilinc Biler, Elif; Acarer, Ahmet; Akkın, Cezmi; Colakoglu, Zafer; Uretmen, Onder

    2018-05-09

    To evaluate and follow-up of functional and morphological changes of the optic nerve and ocular structures prospectively in patients with early-stage Parkinson's disease. Nineteen patients with a diagnosis of early-stage Parkinson's disease and 19 age-matched healthy controls were included in the study. All participants were examined minimum three times at the intervals of at least 6 month following initial examination. Pattern visually evoked potentials (VEP), contrast sensitivity assessments at photopic conditions, color vision tests with Ishihara cards and full-field visual field tests were performed in addition to measurement of retinal nerve fiber layer (RNFL) thickness of four quadrants (top, bottom, nasal, temporal), central and mean macular thickness and macular volumes. Best corrected visual acuity was observed significantly lower in study group within all three examinations. Contrast sensitivity values of the patient group were significantly lower in all spatial frequencies. P100 wave latency of VEP was significantly longer, and amplitude was lower in patient group; however, significant deterioration was not observed during the follow-up. Although average peripapillary RNFL thickness was not significant between groups, RNFL thickness in the upper quadrant was thinner in the patient group. While there was no difference in terms of mean macular thickness and total macular volume values between the groups initially, a significant decrease occurred in the patient group during the follow-up. During the initial and follow-up process, a significant deterioration in visual field was observed in the patient group. Structural and functional disorders shown as electro-physiologically and morphologically exist in different parts of visual pathways in early-stage Parkinson's disease.

  8. Cachexia Stage, Patient-Generated Subjective Global Assessment, Phase Angle, and Handgrip Strength in Patients with Gastrointestinal Cancer.

    Science.gov (United States)

    Ozorio, Gislaine Aparecida; Barão, Katia; Forones, Nora Manoukian

    2017-07-01

    The aim of this study was to correlate patients with gastrointestinal cancer, classified according to different stages of cancer cachexia (SCC) as proposed by Fearon, with nutritional assessment tools such as PG-SGA, phase angle (PA), and handgrip strength. One hundred one patients with a mean age of 61.8 ± 12.8 yr, with 58.4% being men were included. 32.6% were malnourished according to the body mass index (BMI). A severe or moderate malnutrition had been diagnosed in 63.3% when assessed using the PG-SGA, 60.4% had decreased handgrip strength, and 57.4% had lower grades of PA. Among the patients in the study, 26% did not have cachexia, 11% had precachexia, 56% cachexia, and 8% refractory cachexia. The PG-SGA, PA, and handgrip strength were associated with cachexia (P ≤ 0.001). An increased risk of death was found in patients with cachexia [RR: 9.1; confidence interval (CI) 95%: 0.1-90.2, P = 0.039], refractory cachexia (RR: 69.4, CI 95%: 4.5-1073.8, P = 0.002), and increased serum C-reactive protein (CRP) levels (P cachexia or refractory cachexia in the first nutritional assessment. Nutritional risk, as determined by PG-SGA, was correlated with PA and handgrip strength. High CRP levels, cachexia, and refractory cachexia were prognostic factors for cancer patients.

  9. The assessment of cyberstalking: an expanded examination including social networking, attachment, jealousy, and anger in relation to violence and abuse.

    Science.gov (United States)

    Strawhun, Jenna; Adams, Natasha; Huss, Matthew T

    2013-01-01

    Because the first antistalking statute was enacted in California in 1990, stalking research has been expanded immensely, yet been largely confined to exploring traditional pursuit tactics. This study instead examined the prevalence and correlates of cyberstalking behaviors while examining the phenomenon in a more inclusive manner than previous studies focusing on cyberstalking by including social networking avenues. In addition to a measure assessing cyberstalking-related behaviors, questionnaires assessing pathological aspects of personality, including attachment style, interpersonal jealousy, interpersonal violence, and anger were also provided to participants. Results indicate that, given preliminary evidence, cyberstalking-related behaviors are related to past measures of traditional stalking and cyberstalking, although prior attachment, jealousy, and violence issues within relationships are significant predictors of cyberstalking-related behaviors. In addition, unexpected gender differences emerged. For example, women admitted greater frequencies of cyberstalking perpetration than males, signaling that further research on frequency and motivation for cyberstalking among the sexes is necessary.

  10. Selecting postoperative adjuvant systemic therapy for early stage breast cancer: A critical assessment of commercially available gene expression assays

    Science.gov (United States)

    Schuur, Eric; Angel Aristizabal, Javier; Bargallo Rocha, Juan Enrique; Cabello, Cesar; Elizalde, Roberto; García‐Estévez, Laura; Gomez, Henry L.; Katz, Artur; Nuñez De Pierro, Aníbal

    2017-01-01

    Risk stratification of patients with early stage breast cancer may support adjuvant chemotherapy decision‐making. This review details the development and validation of six multi‐gene classifiers, each of which claims to provide useful prognostic and possibly predictive information for early stage breast cancer patients. A careful assessment is presented of each test's analytical validity, clinical validity, and clinical utility, as well as the quality of evidence supporting its use. PMID:28211064

  11. Expression patterns of DLK1 and INSL3 identify stages of Leydig cell differentiation during normal development and in testicular pathologies, including testicular cancer and Klinefelter syndrome

    DEFF Research Database (Denmark)

    Lottrup, G; Nielsen, J E; Maroun, L L

    2014-01-01

    , and in the majority of LCs, it was mutually exclusive of DLK1. LIMITATIONS, REASONS FOR CAUTION: The number of samples was relatively small and no true normal adult controls were available. True stereology was not used for LC counting, instead LCs were counted in three fields of 0.5 µm(2) surface for each sample...... in adult men with testicular pathologies including testis cancer and Klinefelter syndrome. STUDY FUNDING/COMPETING INTERESTS: This work was funded by Rigshospitalet's research funds, the Danish Cancer Society and Kirsten and Freddy Johansen's foundation. The authors have no conflicts of interest....

  12. Development of a two-stage inspection process for the assessment of deteriorating infrastructure

    International Nuclear Information System (INIS)

    Sheils, Emma; O'Connor, Alan; Breysse, Denys; Schoefs, Franck; Yotte, Sylvie

    2010-01-01

    Inspection-based maintenance strategies can provide an efficient tool for the management of ageing infrastructure subjected to deterioration. Many of these methods rely on quantitative data from inspections, rather than qualitative and subjective data. The focus of this paper is on the development of an inspection-based decision scheme, incorporating analysis on the effect of the cost and quality of NDT tools to assess the condition of infrastructure elements/networks during their lifetime. For the first time the two aspects of an inspection are considered, i.e. detection and sizing. Since each stage of an inspection is carried out for a distinct purpose, different parameters are used to represent each procedure and both have been incorporated into a maintenance management model. The separation of these procedures allows the interaction between the two inspection techniques to be studied. The inspection for detection process acts as a screening exercise to determine which defects require further inspection for sizing. A decision tool is developed that allows the owner/manager of the infrastructural element/network to choose the most cost-efficient maintenance management plan based on his/her specific requirements.

  13. Quantitative Resilience Assessment under a Tri-Stage Framework for Power Systems

    Directory of Open Access Journals (Sweden)

    Han Zhang

    2018-06-01

    Full Text Available The frequent occurrence of natural disasters and malicious attacks has exerted unprecedented disturbances on power systems, accounting for the extensive attention paid to power system resilience. Combined with the evolving nature of general disasters, this paper proposes resilience assessment approaches for power systems under a tri-stage framework. The pre-disaster toughness is proposed to quantify the robustness of power systems against potential disasters, where the thinking of area division and partitioned multi-objective risk method (PMRM is introduced. In the case of information deficiency caused by disasters, the during-disaster resistance to disturbance is calculated to reflect the real-time system running state by state estimation (SE. The post-disaster restoration ability consists of response ability, restoration efficiency and restoration economy, which is evaluated by Sequential Monte-Carlo Simulation to simulate the system restoration process. Further, a synthetic metric system is presented to quantify the resilience performance of power systems from the above three aspects. The proposed approaches and framework are validated on the IEEE RTS 79 system, and helpful conclusions are drawn from extensive case studies.

  14. MR arthrography including abduction and external rotation images in the assessment of atraumatic multidirectional instability of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Schaeffeler, Christoph [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Kantonsspital Graubuenden, Musculoskeletal Imaging, Chur (Switzerland); Waldt, Simone; Bauer, Jan S.; Rummeny, Ernst J.; Woertler, Klaus [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Kirchhoff, Chlodwig [Technische Universitaet Muenchen, Department of Traumatology, Munich (Germany); Haller, Bernhard [Technische Universitaet Muenchen, Institute for Medical Statistics and Epidemiology, Munich (Germany); Schroeder, Michael [Center for Sports Orthopedics and Medicine, Orthosportiv, Munich (Germany); Imhoff, Andreas B. [Technische Universitaet Muenchen, Department of Orthopedic Sports Medicine, Munich (Germany)

    2014-06-15

    To evaluate diagnostic signs and measurements in the assessment of capsular redundancy in atraumatic multidirectional instability (MDI) of the shoulder on MR arthrography (MR-A) including abduction/external rotation (ABER) images. Twenty-one MR-A including ABER position of 20 patients with clinically diagnosed MDI and 17 patients without instability were assessed by three radiologists. On ABER images, presence of a layer of contrast between the humeral head (HH) and the anteroinferior glenohumeral ligament (AIGHL) (crescent sign) and a triangular-shaped space between the HH, AIGHL and glenoid (triangle sign) were evaluated; centring of the HH was measured. Anterosuperior herniation of the rotator interval (RI) capsule and glenoid version were determined on standard imaging planes. The crescent sign had a sensitivity of 57 %/62 %/48 % (observers 1/2/3) and specificity of 100 %/100 %/94 % in the diagnosis of MDI. The triangle sign had a sensitivity of 48 %/57 %/48 % and specificity of 94 %/94 %/100 %. The combination of both signs had a sensitivity of 86 %/90 %/81 % and specificity of 94 %/94 %/94 %. A positive triangle sign was significantly associated with decentring of the HH. Measurements of RI herniation, RI width and glenoid were not significantly different between both groups. Combined assessment of redundancy signs on ABER position MR-A allows for accurate differentiation between patients with atraumatic MDI and patients with clinically stable shoulders; measurements on standard imaging planes appear inappropriate. (orig.)

  15. Including pathogen risk in life cycle assessment of wastewater management. 1. Estimating the burden of disease associated with pathogens.

    Science.gov (United States)

    Harder, Robin; Heimersson, Sara; Svanström, Magdalena; Peters, Gregory M

    2014-08-19

    The environmental performance of wastewater and sewage sludge management is commonly assessed using life cycle assessment (LCA), whereas pathogen risk is evaluated with quantitative microbial risk assessment (QMRA). This study explored the application of QMRA methodology with intent to include pathogen risk in LCA and facilitate a comparison with other potential impacts on human health considered in LCA. Pathogen risk was estimated for a model wastewater treatment system (WWTS) located in an industrialized country and consisting of primary, secondary, and tertiary wastewater treatment, anaerobic sludge digestion, and land application of sewage sludge. The estimation was based on eight previous QMRA studies as well as parameter values taken from the literature. A total pathogen risk (expressed as burden of disease) on the order of 0.2-9 disability-adjusted life years (DALY) per year of operation was estimated for the model WWTS serving 28,600 persons and for the pathogens and exposure pathways included in this study. The comparison of pathogen risk with other potential impacts on human health considered in LCA is detailed in part 2 of this article series.

  16. The correlation between histological gastritis staging- 'OLGA/OLGIM' and serum pepsinogen test in assessment of gastric atrophy/intestinal metaplasia in China.

    Science.gov (United States)

    Wang, Xiaoteng; Lu, Bin; Meng, Lina; Fan, Yihong; Zhang, Shuo; Li, Meng

    2017-08-01

    Serum pepsinogen (PG) test, as an indicator of gastric mucosal atrophy, reflects the functional and morphologic status of gastric mucosal and it is suggested to serve as a useful predictive marker for patients with gastric cancer (GC). The available classifications of gastritis, known as the Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastritis Intestinal Metaplasia (OLGIM), integrating the severity and topography of atrophy/intestinal metaplasia (IM), have been gradually accepted and used in screening for GC in recent years. To assess whether serum pepsinogen test, including PGI, PGII, PGI/PGII and gastrin-17 (G-17) could reflect the extent and topography of gastric mucosal atrophy/IM. Furthermore, to discuss the relationship between OLGA/OLGIM staging system and serum pepsinogen test in assessment of gastric atrophy/IM. The OLGA/OLGIM ranks the gastric staging according to both the topography and the severity of gastric atrophy/IM. A retrospective study was conducted with 331 patients who underwent endoscopy with consecutive biopsy sampling and reassessed according to OLGA/OLGIM staging system. Serum pepsinogen test, including PGI, PGII, PGI/PGII and G-17, as well as serological Helicobacter pylori (Hp) antibody were also measured. Results were presented as gastritis stage, serum pepsinogen level and Hp status. Baseline characteristics were compared using analysis of variance (ANOVA) test for continuous data and Pearson's χ 2 test for categorical data. A logistic regression model was used for the correlation analysis between OLGA/OLGIM and serological pepsinogen test. A total of 177 non-atrophic gastritis and 154 atrophic gastritis were analyzed, among which 40 were antrum atrophy, 32 were corpus atrophy and 82 were pan-atrophy. All patients were assessed applying the OLGA/OLGIM criteria with a mean age of 54.7 ± 10.8 years. Patients among OLGA/OLGIM Stage III-IV were presented with a lower level of serum PGI and PGI/PGII (p  15

  17. Long-lasting complete response status of advanced stage IV gall bladder cancer and colon cancer after combined treatment including autologous formalin-fixed tumor vaccine: two case reports.

    Science.gov (United States)

    Imaoka, Yuki; Kuranishi, Fumito; Miyazaki, Tsubasa; Yasuda, Hiroko; Ohno, Tadao

    2017-09-11

    The prognosis of advanced (stage IV) cancer of the digestive organs is very poor. We have previously reported a case of advanced breast cancer with bone metastasis that was successfully treated with combined treatments including autologous formalin-fixed tumor vaccine (AFTV). Herein, we report the success of this approach in advanced stage IV (heavily metastasized) cases of gall bladder cancer and colon cancer. Case 1: A 61-year-old woman with stage IV gall bladder cancer (liver metastasis and lymph node metastasis) underwent surgery in May 2011, including partial resection of the liver. She was treated with AFTV as the first-line adjuvant therapy, followed by conventional chemotherapy. This patient is still alive without any recurrence, as confirmed with computed tomography, for more than 5 years. Case 2: A 64-year-old man with stage IV colon cancer (multiple para-aortic lymph node metastases and direct abdominal wall invasion) underwent non-curative surgery in May 2006. Following conventional chemotherapy, two courses of AFTV and radiation therapy were administered sequentially. This patient has had no recurrence for more than 5 years. We report the success of combination therapy including AFTV in cases of liver-metastasized gall bladder cancer and abdominal wall-metastasized colon cancer. Both patients experienced long-lasting, complete remission. Therefore, combination therapies including AFTV should be considered in patients with advanced cancer of the digestive organs.

  18. The role of whole-body FDG-PET in preoperative assessment of tumor staging in oral cancers

    Energy Technology Data Exchange (ETDEWEB)

    Nakasone, Yoshiki; Inoue, Tomio; Oriuchi, Noboru; Negishi, Akihide; Endo, Keigo; Mogi, Kenji [Gunma Univ., Maebashi (Japan). School of Medicine; Takeuchi, Kazuo

    2001-12-01

    The aim of this study is to clarify the clinical utility of 2-deoxy-2-[{sup 18}F]fluoro-D-glucose (FDG) positron emission tomography (PET) in determining the TNM classification in patients with oral cancer. Twenty-five consecutive patients (14 male and 11 female; age range, 40 yr to 86 yr) with oral cancer were included in this study. The diagnostic accuracy for detecting cervical lymph nodes was investigated by comparing the results of CT and/or MRI and physical findings. For the semi-quantitative analysis, the tumor standardized uptake value (SUV) and tumor to background SUV ratio (T/B ratio) were assessed in primary tumors and cervical lymph nodes. All primary lesions were visualized on FDG-PET images. Even though artifacts from dental materials near the lesion hampered the delineation of primary tumors on CT/MRI, the extent of primary tumors was accurately assessed by FDG-PET. The SUV and T/B ratio in the primary tumor classified in higher T grade (T3 and T4) was significantly higher than that in lower T grade (T1 and T2) (mean{+-}SD of SUV; 8.32{+-}2.99 vs. 5.15{+-}3.77, p<0.01, mean {+-}SD of T/B ratio; 6.96{+-}3.23 vs. 3.61{+-}2.76, p<0.01). The SUV and T/B ratio of metastatic lymph nodes were also significantly higher than those of normal lymph nodes (mean {+-}SD of SUV; 3.39{+-}1.69 vs. 1.55{+-}0.57, p<0.001, mean {+-}SD of T/B ratio; 2.46{+-}1.08 vs. 1.03{+-}0.22, p<0.001). Among these three methods, FDG-PET in conjunction with CT/MRI showed the highest accuracy of 92%, but there were no significant differences in diagnostic accuracy among the three methods. For the semi-quantitative analysis, a threshold SUV of 2.0 provided 100% sensitivity, 82% specificity, and 88% accuracy. Furthermore, a threshold T/B ratio of 1.5 provided 100% sensitivity, 100% specificity, and 100% accuracy. Regarding the detection of distant metastasis, there was one positive result in FDG-PET showing distant pulmonary metastasis. Whole-body FDG-PET is an effective and convenient

  19. Including impacts of particulate emissions on marine ecosystems in life cycle assessment: the case of offshore oil and gas production.

    Science.gov (United States)

    Veltman, Karin; Huijbregts, Mark A J; Rye, Henrik; Hertwich, Edgar G

    2011-10-01

    Life cycle assessment is increasingly used to assess the environmental performance of fossil energy systems. Two of the dominant emissions of offshore oil and gas production to the marine environment are the discharge of produced water and drilling waste. Although environmental impacts of produced water are predominantly due to chemical stressors, a major concern regarding drilling waste discharge is the potential physical impact due to particles. At present, impact indicators for particulate emissions are not yet available in life cycle assessment. Here, we develop characterization factors for 2 distinct impacts of particulate emissions: an increased turbidity zone in the water column and physical burial of benthic communities. The characterization factor for turbidity is developed analogous to characterization factors for toxic impacts, and ranges from 1.4 PAF (potentially affected fraction) · m(3) /d/kg(p) (kilogram particulate) to 7.0 x 10³ [corrected] for drilling mud particles discharged from the rig. The characterization factor for burial describes the volume of sediment that is impacted by particle deposition on the seafloor and equals 2.0 × 10(-1) PAF · m(3) /d/kg(p) for cutting particles. This characterization factor is quantified on the basis of initial deposition layer characteristics, such as height and surface area, the initial benthic response, and the recovery rate. We assessed the relevance of including particulate emissions in an impact assessment of offshore oil and gas production. Accordingly, the total impact on the water column and on the sediment was quantified based on emission data of produced water and drilling waste for all oil and gas fields on the Norwegian continental shelf in 2008. Our results show that cutting particles contribute substantially to the total impact of offshore oil and gas production on marine sediments, with a relative contribution of 55% and 31% on the regional and global scale, respectively. In contrast, the

  20. Irradiation of rainbow trout at early life stages results in trans-generational effects including the induction of a bystander effect in non-irradiated fish.

    Science.gov (United States)

    Smith, Richard W; Seymour, Colin B; Moccia, Richard D; Mothersill, Carmel E

    2016-02-01

    The bystander effect, a non-targeted effect (NTE) of radiation, which describes the response by non-irradiated organisms to signals emitted by irradiated organisms, has been documented in a number of fish species. However transgenerational effects of radiation (including NTE) have yet to be studied in fish. Therefore rainbow trout, which were irradiated as eggs at 48h after fertilisation, eyed eggs, yolk sac larvae or first feeders, were bred to generate a F1 generation and these F1 fish were bred to generate a F2 generation. F1 and F2 fish were swam with non-irradiated bystander fish. Media from explants of F1 eyed eggs, F1 one year old fish gill and F1 two year old fish gill and spleen samples, and F2 two year old gill and spleen samples, as well as from bystander eggs/fish, was used to treat a reporter cell line, which was then assayed for changes in cellular survival/growth. The results were complex and dependent on irradiation history, age (in the case of the F1 generation), and were tissue specific. For example, irradiation of one parent often resulted in effects not seen with irradiation of both parents. This suggests that, unlike mammals, in certain circumstances maternal and paternal irradiation may be equally important. This study also showed that trout can induce a bystander effect 2 generations after irradiation, which further emphasises the importance of the bystander effect in aquatic radiobiology. Given the complex community structure in aquatic ecosystems, these results may have significant implications for environmental radiological protection. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Development of several data bases related to reactor safety research including probabilistic safety assessment and incident analysis at JAERI

    International Nuclear Information System (INIS)

    Kobayashi, Kensuke; Oikawa, Tetsukuni; Watanabe, Norio; Izumi, Fumio; Higuchi, Suminori

    1986-01-01

    Presented are several databases developed at JAERI for reactor safety research including probabilistic safety assessment and incident analysis. First described are the recent developments of the databases such as 1) the component failure rate database, 2) the OECD/NEA/IRS information retrieval system, 3) the nuclear power plant database and so on. Then several issues are discussed referring mostly to the operation of the database (data input and transcoding) and to the retrieval and utilization of the information. Finally, emphasis is given to the increasing role which artifitial intelligence techniques such as natural language treatment and expert systems may play in improving the future capabilities of the databases. (author)

  2. Setting the Stage for Harmonized Risk Assessment by Seismic Hazard Harmonization in Europe (SHARE)

    Science.gov (United States)

    Woessner, Jochen; Giardini, Domenico; SHARE Consortium

    2010-05-01

    Maghreb countries in the Southern Mediterranean and Turkey in the Eastern Mediterranean. By strongly including the seismic engineering community, the project maintains a direct connection to the Eurocode 8 applications and the definition of the Nationally Determined Parameters, through the participation of the CEN/TC250/SC8 committee in the definition of the output specification requirements and in the hazard validation. SHARE will thus produce direct outputs for risk assessment. With this contribution, we focus on providing an overview of the goals and current achievement of the project.

  3. Irradiation of rainbow trout at early life stages results in trans-generational effects including the induction of a bystander effect in non-irradiated fish

    International Nuclear Information System (INIS)

    Smith, Richard W.; Seymour, Colin B.; Moccia, Richard D.; Mothersill, Carmel E.

    2016-01-01

    The bystander effect, a non-targeted effect (NTE) of radiation, which describes the response by non-irradiated organisms to signals emitted by irradiated organisms, has been documented in a number of fish species. However transgenerational effects of radiation (including NTE) have yet to be studied in fish. Therefore rainbow trout, which were irradiated as eggs at 48 h after fertilisation, eyed eggs, yolk sac larvae or first feeders, were bred to generate a F1 generation and these F1 fish were bred to generate a F2 generation. F1 and F2 fish were swam with non-irradiated bystander fish. Media from explants of F1 eyed eggs, F1 one year old fish gill and F1 two year old fish gill and spleen samples, and F2 two year old gill and spleen samples, as well as from bystander eggs/fish, was used to treat a reporter cell line, which was then assayed for changes in cellular survival/growth. The results were complex and dependent on irradiation history, age (in the case of the F1 generation), and were tissue specific. For example, irradiation of one parent often resulted in effects not seen with irradiation of both parents. This suggests that, unlike mammals, in certain circumstances maternal and paternal irradiation may be equally important. This study also showed that trout can induce a bystander effect 2 generations after irradiation, which further emphasises the importance of the bystander effect in aquatic radiobiology. Given the complex community structure in aquatic ecosystems, these results may have significant implications for environmental radiological protection. - Highlights: • We evaluated the transgenerational effect of early life irradiation in rainbow trout. • Trout irradiated as eggs, yolk sac larvae or first feeders were crossed. • A transgenerational effect was evident in two generations after irradiation. • F1 and F2 generation fish induced a bystander effect in non-irradiated fish. • The precise effects were tissue specific and dependent on

  4. Irradiation of rainbow trout at early life stages results in trans-generational effects including the induction of a bystander effect in non-irradiated fish

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Richard W., E-mail: rich.wilson.smith@gmail.com [Department of Animal Biosciences, University of Guelph, Guelph, Ontario (Canada); Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario (Canada); Seymour, Colin B. [Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario (Canada); Moccia, Richard D. [Department of Animal Biosciences, University of Guelph, Guelph, Ontario (Canada); Mothersill, Carmel E. [Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario (Canada)

    2016-02-15

    The bystander effect, a non-targeted effect (NTE) of radiation, which describes the response by non-irradiated organisms to signals emitted by irradiated organisms, has been documented in a number of fish species. However transgenerational effects of radiation (including NTE) have yet to be studied in fish. Therefore rainbow trout, which were irradiated as eggs at 48 h after fertilisation, eyed eggs, yolk sac larvae or first feeders, were bred to generate a F1 generation and these F1 fish were bred to generate a F2 generation. F1 and F2 fish were swam with non-irradiated bystander fish. Media from explants of F1 eyed eggs, F1 one year old fish gill and F1 two year old fish gill and spleen samples, and F2 two year old gill and spleen samples, as well as from bystander eggs/fish, was used to treat a reporter cell line, which was then assayed for changes in cellular survival/growth. The results were complex and dependent on irradiation history, age (in the case of the F1 generation), and were tissue specific. For example, irradiation of one parent often resulted in effects not seen with irradiation of both parents. This suggests that, unlike mammals, in certain circumstances maternal and paternal irradiation may be equally important. This study also showed that trout can induce a bystander effect 2 generations after irradiation, which further emphasises the importance of the bystander effect in aquatic radiobiology. Given the complex community structure in aquatic ecosystems, these results may have significant implications for environmental radiological protection. - Highlights: • We evaluated the transgenerational effect of early life irradiation in rainbow trout. • Trout irradiated as eggs, yolk sac larvae or first feeders were crossed. • A transgenerational effect was evident in two generations after irradiation. • F1 and F2 generation fish induced a bystander effect in non-irradiated fish. • The precise effects were tissue specific and dependent on

  5. Development of an international schedule for the assessment and staging of care for dementia

    NARCIS (Netherlands)

    Semrau, M.; Burns, A.; Djukic-Dejanovic, S.; Eraslan, D.; Han, C.; Lecic-Tosevski, D.; Lobo, A.; Mihai, A.; Morris, J.; Palumbo, C.; Robert, P.; Stiens, G.; Stoppe, G.; Volpe, U.; Olde Rikkert, M.G.M.; Sartorius, N.

    2015-01-01

    BACKGROUND: A reliable and valid global staging scale has been lacking within dementia care. OBJECTIVE: To develop an easy-to-use multi-dimensional clinical staging schedule for dementia. METHODS: The schedule was developed through: i) Two series of focus groups (40 and 48 participants,

  6. Staging of lung cancer.

    Science.gov (United States)

    de Groot, Patricia M; Carter, Brett W; Betancourt Cuellar, Sonia L; Erasmus, Jeremy J

    2015-06-01

    Primary lung cancer is the leading cause of cancer mortality in the world. Thorough clinical staging of patients with lung cancer is important, because therapeutic options and management are to a considerable degree dependent on stage at presentation. Radiologic imaging is an essential component of clinical staging, including chest radiography in some cases, computed tomography, MRI, and PET. Multiplanar imaging modalities allow assessment of features that are important for surgical, oncologic, and radiation therapy planning, including size of the primary tumor, location and relationship to normal anatomic structures in the thorax, and existence of nodal and/or metastatic disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Affordable Development and Demonstration of a Small NTR Engine and Stage: A Preliminary NASA, DOE, and Industry Assessment

    Science.gov (United States)

    Borowski, Stanley K.; Sefcik, Robert J.; Fittje, James E.; McCurdy, David R.; Qualls, Arthur L.; Schnitzler, Bruce G.; Werner, James E.; Weitzberg, Abraham; Joyner, Claude R.

    2015-01-01

    maximizing the use of existing and flight proven liquid rocket and stage hardware (e.g., from the RL10-B2 engine and Delta Cryogenic Second Stage) to further ensure affordability. This paper provides a preliminary NASA, DOE and industry assessment of what is required - the key DDT&E activities, development options, and the associated schedule - to affordably build, ground test and fly a small NTR engine and stage within a 10-year timeframe.

  8. Assessment of renal function during various stages of pregnancy in women

    International Nuclear Information System (INIS)

    Iqbal, S.A.; Ansari, A.K.; Akhtar, M.S.

    2003-01-01

    A study was conducted to investigate changes in renal functions during different trimesters of pregnancy in Pakistani women. For this purpose, 26 non-pregnant women (Group 1) and 63 women in different stages of pregnancy (18 in first trimester, Group II; 22 in the second trimester, Group III and 23 in the third trimester, Group IV), were selected. Blood samples were taken from all subjects for determination of serum glucose, albumin, creatinine, urea and uric acid. Similarly, urine samples were analysed for creatinine and other urinary parameters including GFR (glomerular filtration rate). Significant increase (P<0.05) was observed in urinary level of creatinine in Group 1only, while differences among women of other groups were non-significant. There was a significant rise in the rate of GFR in pregnant as compared to non-pregnant women as determined on the basis of endogenous creatinine clearance. Urine volume also increased significantly as pregnancy progressed. Serum urea decreased significantly in Groups II and IV, while creatinine remained unchanged. Serum uric acid also showed significant decrease in the first trimester but returned to control level in the 3rd trimester. Serum glucose level increased, while serum albumin decreased during pregnancy. (author)

  9. Assessment of heavy metals in Averrhoa bilimbi and A. carambola fruit samples at two developmental stages.

    Science.gov (United States)

    Soumya, S L; Nair, Bindu R

    2016-05-01

    Though the fruits of Averrhoa bilimbi and A. carambola are economically and medicinally important, they remain underutilized. The present study reports heavy metal quantitation in the fruit samples of A. bilimbi and A. carambola (Oxalidaceae), collected at two stages of maturity. Heavy metals are known to interfere with the functioning of vital cellular components. Although toxic, some elements are considered essential for human health, in trace quantities. Heavy metals such as Cr, Mn, Co, Cu, Zn, As, Se, Pb, and Cd were analyzed by atomic absorption spectroscopy (AAS). The samples under investigation included, A. bilimbi unripe (BU) and ripe (BR), A. carambola sour unripe (CSU) and ripe (CSR), and A. carambola sweet unripe (CTU) and ripe (CTR). Heavy metal analysis showed that relatively higher level of heavy metals was present in BR samples compared to the rest of the samples. The highest amount of As and Se were recorded in BU samples while Mn content was highest in CSU samples and Co in CSR. Least amounts of Cr, Zn, Se, Cd, and Pb were noted in CTU while, Mn, Cu, and As were least in CTR. Thus, the sweet types of A. carambola (CTU, CTR) had comparatively lower heavy metal content. There appears to be no reason for concern since different fruit samples of Averrhoa studied presently showed the presence of various heavy metals in trace quantities.

  10. Financial impact of improved pressure ulcer staging in the acute hospital with use of a new tool, the NE1 Wound Assessment Tool.

    Science.gov (United States)

    Young, Daniel L; Shen, Jay J; Estocado, Nancy; Landers, Merrill R

    2012-04-01

    The NE1 Wound Assessment Tool (NE1 WAT; Medline Industries, Inc, Mundelein, Illinois), previously called the N.E. One Can Stage, was shown to significantly improve accuracy of pressure ulcer (PrU) staging. Improved PrU staging has many potential benefits, including improved care for the patient and better reimbursement. Medicare has incentivized good care and accurate identification of PrUs in the acute care hospital through an additional payment, the Medicare Severity-Diagnosis Related Group (MS-DRG). This article examines the financial impact of NE1 WAT use on the acute care hospital relative to MS-DRG reimbursement. PrU staging accuracy with and without use of the NE1 WAT from previous data was compared with acute care hospital PrU rates obtained from the 2006 National Inpatient Sample. Hill-Rom International Pressure Ulcer Prevalence Survey data were used to estimate the number of MS-DRG-eligible PrUs. There are between 390,000 and 130,000 MS-DRG-eligible PrUs annually. Given current PrU staging accuracy, approximately $209 million in MS-DRG money is being collected. With the improved staging afforded by the NE1 WAT, this figure is approximately $763.9 million. Subtracting the 2 reveals $554.9 million in additional reimbursement that could be generated by using the NE1 WAT. There is a tremendous financial incentive to improve PrU staging. The NE1 WAT has been shown to improve PrU staging accuracy significantly. This improvement has the potential to improve the financial health of acute care hospitals caring for patients with PrUs.

  11. Molecular Classification Substitutes for the Prognostic Variables Stage, Age, and MYCN Status in Neuroblastoma Risk Assessment

    Directory of Open Access Journals (Sweden)

    Carolina Rosswog

    2017-12-01

    Full Text Available BACKGROUND: Current risk stratification systems for neuroblastoma patients consider clinical, histopathological, and genetic variables, and additional prognostic markers have been proposed in recent years. We here sought to select highly informative covariates in a multistep strategy based on consecutive Cox regression models, resulting in a risk score that integrates hazard ratios of prognostic variables. METHODS: A cohort of 695 neuroblastoma patients was divided into a discovery set (n = 75 for multigene predictor generation, a training set (n = 411 for risk score development, and a validation set (n = 209. Relevant prognostic variables were identified by stepwise multivariable L1-penalized least absolute shrinkage and selection operator (LASSO Cox regression, followed by backward selection in multivariable Cox regression, and then integrated into a novel risk score. RESULTS: The variables stage, age, MYCN status, and two multigene predictors, NB-th24 and NB-th44, were selected as independent prognostic markers by LASSO Cox regression analysis. Following backward selection, only the multigene predictors were retained in the final model. Integration of these classifiers in a risk scoring system distinguished three patient subgroups that differed substantially in their outcome. The scoring system discriminated patients with diverging outcome in the validation cohort (5-year event-free survival, 84.9 ± 3.4 vs 63.6 ± 14.5 vs 31.0 ± 5.4; P < .001, and its prognostic value was validated by multivariable analysis. CONCLUSION: We here propose a translational strategy for developing risk assessment systems based on hazard ratios of relevant prognostic variables. Our final neuroblastoma risk score comprised two multigene predictors only, supporting the notion that molecular properties of the tumor cells strongly impact clinical courses of neuroblastoma patients.

  12. Molecular Classification Substitutes for the Prognostic Variables Stage, Age, and MYCN Status in Neuroblastoma Risk Assessment.

    Science.gov (United States)

    Rosswog, Carolina; Schmidt, Rene; Oberthuer, André; Juraeva, Dilafruz; Brors, Benedikt; Engesser, Anne; Kahlert, Yvonne; Volland, Ruth; Bartenhagen, Christoph; Simon, Thorsten; Berthold, Frank; Hero, Barbara; Faldum, Andreas; Fischer, Matthias

    2017-12-01

    Current risk stratification systems for neuroblastoma patients consider clinical, histopathological, and genetic variables, and additional prognostic markers have been proposed in recent years. We here sought to select highly informative covariates in a multistep strategy based on consecutive Cox regression models, resulting in a risk score that integrates hazard ratios of prognostic variables. A cohort of 695 neuroblastoma patients was divided into a discovery set (n=75) for multigene predictor generation, a training set (n=411) for risk score development, and a validation set (n=209). Relevant prognostic variables were identified by stepwise multivariable L1-penalized least absolute shrinkage and selection operator (LASSO) Cox regression, followed by backward selection in multivariable Cox regression, and then integrated into a novel risk score. The variables stage, age, MYCN status, and two multigene predictors, NB-th24 and NB-th44, were selected as independent prognostic markers by LASSO Cox regression analysis. Following backward selection, only the multigene predictors were retained in the final model. Integration of these classifiers in a risk scoring system distinguished three patient subgroups that differed substantially in their outcome. The scoring system discriminated patients with diverging outcome in the validation cohort (5-year event-free survival, 84.9±3.4 vs 63.6±14.5 vs 31.0±5.4; P<.001), and its prognostic value was validated by multivariable analysis. We here propose a translational strategy for developing risk assessment systems based on hazard ratios of relevant prognostic variables. Our final neuroblastoma risk score comprised two multigene predictors only, supporting the notion that molecular properties of the tumor cells strongly impact clinical courses of neuroblastoma patients. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  13. MODARIA WG5: Towards a practical guidance for including uncertainties in the results of dose assessment of routine releases

    Energy Technology Data Exchange (ETDEWEB)

    Mora, Juan C. [Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas - CIEMAT (Spain); Telleria, Diego [International Atomic Energy Agency - IAEA (Austria); Al Neaimi, Ahmed [Emirates Nuclear Energy Corporation - ENEC (United Arab Emirates); Blixt Buhr, Anna Ma [Vattenfall AB (Sweden); Bonchuk, Iurii [Radiation Protection Institute - RPI (Ukraine); Chouhan, Sohan [Atomic Energy of Canada Limited - AECL (Canada); Chyly, Pavol [SE-VYZ (Slovakia); Curti, Adriana R. [Autoridad Regulatoria Nuclear - ARN (Argentina); Da Costa, Dejanira [Instituto de Radioprotecao e Dosimetria - IRD (Brazil); Duran, Juraj [VUJE Inc (Slovakia); Galeriu, Dan [Horia Hulubei National Institute of Physics and Nuclear Engineering - IFIN-HH (Romania); Haegg, Ann- Christin; Lager, Charlotte [Swedish Radiation Safety Authority - SSM (Sweden); Heling, Rudie [Nuclear Research and Consultancy Group - NRG (Netherlands); Ivanis, Goran; Shen, Jige [Ecometrix Incorporated (Canada); Iosjpe, Mikhail [Norwegian Radiation Protection Authority - NRPA (Norway); Krajewski, Pawel M. [Central Laboratory for Radiological Protection - CLOR (Poland); Marang, Laura; Vermorel, Fabien [Electricite de France - EdF (France); Mourlon, Christophe [Institut de Radioprotection et de Surete Nucleaire - IRSN (France); Perez, Fabricio F. [Belgian Nuclear Research Centre - SCK (Belgium); Woodruffe, Andrew [Federal Authority for Nuclear Regulation - FANR (United Arab Emirates); Zorko, Benjamin [Jozef Stefan Institute (Slovenia)

    2014-07-01

    MODARIA (Modelling and Data for Radiological Impact Assessments) project was launched in 2012 with the aim of improving the capabilities in radiation dose assessment by means of acquisition of improved data for model testing, model testing and comparison, reaching consensus on modelling philosophies, approaches and parameter values, development of improved methods and exchange of information. The project focuses on areas where uncertainties remain in the predictive capability of environmental models, emphasizing in reducing associated uncertainties or developing new approaches to strengthen the evaluation of the radiological impact. Within MODARIA, four main areas were defined, one of them devoted to Uncertainty and Variability. In this area four working groups were included, Working Group 5 dealing with the 'uncertainty and variability analysis for assessments of radiological impacts arising from routine discharges of radionuclides'. Whether doses are estimated by using measurement data, by applying models, or through a combination of measurements and calculations, the variability and uncertainty contribute to a distribution of possible values. The degree of variability and uncertainty is represented by the shape and extent of that distribution. The main objective of WG5 is to explore how to consider uncertainties and variabilities in the results of assessment of doses in planned situations for controlling the impact of routine releases from radioactive and nuclear installations to the environment. The final aim is to produce guidance for the calculation of uncertainties in these exposure situations and for the presentation of such results to the different stakeholders. To achieve that objective the main tasks identified were: to find tools and methods for uncertainty and variability analysis applicable to dose assessments in routine radioactive discharges, to define scenarios where information on uncertainty and variability of parameters is available

  14. Myometrial invasion and overall staging of endometrial carcinoma: assessment using fusion of T2-weighted magnetic resonance imaging and diffusion-weighted magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Guo Y

    2017-12-01

    Full Text Available Yu Guo,1,2 Ping Wang,2 Penghui Wang,2 Wei Gao,1 Fenge Li,3 Xueling Yang,1 Hongyan Ni,2 Wen Shen,2 Zhi Guo1 1Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin’s Clinical Research Center for Cancer, Tianjin, 2Department of Radiology, Tianjin First Center Hospital, The First Central Clinical College of Tianjin Medical University, Tianjin, 3Department of Gynecology, Tianjin First Center Hospital, Tianjin, People’s Republic of China Background: The age of onset of endometrial carcinoma has been decreasing in recent years. In endometrial carcinoma, it is important to accurately assess invasion depth and preoperative staging. Fusion of T2-weighted magnetic resonance imaging (T2WI and diffusion-weighted magnetic resonance imaging (DWI may contribute to the improvement of anatomical localization of lesions.Materials and methods: In our study, a total of 58 endometrial carcinoma cases were included. Based on the revised 2009 International Federation of Gynecology and Obstetrics staging system, a fusion of T2WI and DWI was utilized for the evaluation of invasion depth and determination of the overall stage. Postoperative pathologic assessment was considered as the reference standard. The consistency of T2WI image staging and pathologic staging, and the consistency of fused T2WI and DWI and pathologic staging were all analyzed using Kappa statistics.Results: Compared with the T2WI group, a significantly higher diagnostic accuracy was observed for myometrial invasion with fusion of T2WI and DWI (77.6% for T2WI; 94.8% for T2WI-DWI. For the identification of deep invasion, we calculated values for diagnostic sensitivity (69.2% for T2WI; 92.3% for T2WI-DWI, specificity (80% for T2WI; 95.6% for T2WI-DWI, positive predictive value (50% for T2WI; 85.7% for T2WI-DWI, and negative predictive value (90% for

  15. Identifying Stages in a Learning Hierarchy for Use in Formative Assessment--The Example of Line Graphs

    Science.gov (United States)

    Stacey, Kaye; Price, Beth; Steinle, Vicki

    2012-01-01

    This paper discusses issues arising in the design of questions to use in an on-line computer-based formative assessment system, focussing on how best to identify the stages of a learning hierarchy for reporting to teachers. Data from several hundred students is used to illustrate how design decisions have been made for a test on interpreting line…

  16. The significance of OLGA and OLGIM staging systems in the risk assessment of gastric cancer: a systematic review and meta-analysis.

    Science.gov (United States)

    Yue, Hu; Shan, Liu; Bin, Lv

    2018-02-19

    Despite extensive research on the criteria for the assessment of gastric cancer risk using the Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastritis/Intestinal-Metaplasia Assessment (OLGIM) systems, no comprehensive overview or systematic summary on their use is currently available. To perform a systematic review and meta-analysis to assess the efficacy of the OLGA and OLGIM staging systems in evaluating gastric cancer risk. We searched various databases, including PubMed, EMBASE, Medline, and Cochrane's library, for articles published before March 2017 on the association between OLGA/OLGIM stages and risk of gastric cancer. Statistical analysis was performed using RevMan 5.30 and Stata 14.0, with the odds ratio, risk ratio, and 95% confidence interval as the effect measures. A meta-analysis of six case-control studies and two cohort studies, comprising 2700 subjects, was performed. The meta-analysis of prospective case-control studies demonstrated a significant association between the OLGA/OLGIM stages III/IV and gastric cancer. The Newcastle-Ottawa Scale (NOS) score reflected heterogeneity in the case-control studies on OLGA. Subgroup analysis of high-quality (NOS score ≥ 5) studies showed an association between OLGA stage III/IV and increased risk of gastric cancer; the association was also high in the remaining study with low NOS score. The association between higher stages of gastritis defined by OLGA and risk of gastric cancer was significant. This correlation implies that close and frequent monitoring of such high-risk patients is necessary to facilitate timely diagnosis of gastric cancer.

  17. RUSVISK: DOMESTICALLY DEVELOPED PRODUCT OF HYALURONIC ACID: ASSESSMENT OF EFFICACY AND SAFETY IN EARLY STAGES OF THE KNEE OSTEOARTHRITIS

    Directory of Open Access Journals (Sweden)

    N. V. Vas'kova

    2014-01-01

    Full Text Available Objective: to compare the efficacy and safety of intra-articular therapy with Rusvisk (hyaluronic acid product and Ostenil in early stages of knee osteoarthritis.Subjects and methods. 50 patients with II–III stage of the knee osteoarthritis were included in the randomized double blinded controlled study. They had pain at movement of more than 40 mm by visual analogue scale (VAS and Lequesne index of 4–12. All patients received a course of three intra-articular injections with products of hyaluronic acid at the interval of 7 days. Rusvisk (molecular weight 3500 kDa was administered to 25 patients, whereas other 25 received Ostenil (molecular weight 1200–1400 kDa. In 1, 2, 3 weeks after the first injection following criteria were registered: changes of WOMAC index, pain at movement and at rest by VAS, general assessment of therapy efficacy by doctor and patient, assessment of efficacy according to OMERACTOARSI.Results. In three weeks after the first injection a significant decrease of pain at movement (by 69% in Rusvisk group and by 55% in Ostenil group and of WOMAC index (by 63% in Rusvsik group and by 60% in Ostenil group was achieved in both groups without any differences between them. Significant decrease of pain at rest was observed at all visits only in Rusvisk group. When assessing the general efficacy, patients found more advantagesin the  domestic product, whereas the therapist did not see the differences between groups. Response to the therapy by OMERACT-OARSI criteria was observed in 88% of patients in Rusvisk group and in 64% in Ostenil group. Short-term pain in the site of injection was mentioned by 64% of patients from Rusvisk group and by 72% from Ostenil group.Conclusion. Intra-articular therapy with the products of hyaluronic acid «Rusvisk», «Ostenil» provides comparable decrease of pain and improvement of functional parameters in patients with knee osteoarthritis.

  18. Carbon Footprint of Inbound Tourism to Iceland: A Consumption-Based Life-Cycle Assessment including Direct and Indirect Emissions

    Directory of Open Access Journals (Sweden)

    Hannah Sharp

    2016-11-01

    Full Text Available The greenhouse gas (GHG emissions caused by tourism have been studied from several perspectives, but few studies exist that include all direct and indirect emissions, particularly those from aviation. In this study, an input/output-based hybrid life-cycle assessment (LCA method is developed to assess the consumption-based carbon footprint of the average tourist including direct and indirect emissions. The total inbound tourism-related GHG emissions are also calculated within a certain region. As a demonstration of the method, the full carbon footprint of an average tourist is assessed as well as the total GHG emissions induced by tourism to Iceland over the period of 2010–2015, with the presented approach applicable in other contexts as well. Iceland provides an interesting case due to three features: (1 the tourism sector in Iceland is the fastest-growing industry in the country with an annual growth rate of over 20% over the past five years; (2 almost all tourists arrive by air; and (3 the country has an almost emissions-free energy industry and an import-dominated economy, which emphasise the role of the indirect emissions. According to the assessment, the carbon footprint for the average tourist is 1.35 tons of CO2-eq, but ranges from 1.1 to 3.2 tons of CO2-eq depending on the distance travelled by air. Furthermore, this footprint is increasing due to the rise in average flight distances travelled to reach the country. The total GHG emissions caused by tourism in Iceland have tripled from approximately 600,000 tons of CO2-eq in 2010 to 1,800,000 tons in 2015. Aviation accounts for 50%–82% of this impact (depending on the flight distance underlining the importance of air travel, especially as tourism-related aviation is forecasted to grow significantly in the near future. From a method perspective, the carbon footprinting application presented in the study would seem to provide an efficient way to study both the direct and indirect

  19. In search of future earths: assessing the possibility of finding Earth analogues in the later stages of their habitable lifetimes.

    Science.gov (United States)

    O'Malley-James, Jack T; Greaves, Jane S; Raven, John A; Cockell, Charles S

    2015-05-01

    Earth will become uninhabitable within 2-3 Gyr as a result of the increasing luminosity of the Sun changing the boundaries of the habitable zone (HZ). Predictions about the future of habitable conditions on Earth include declining species diversity and habitat extent, ocean loss, and changes to geochemical cycles. Testing these predictions is difficult, but the discovery of a planet that is an analogue to future Earth could provide the means to test them. This planet would need to have an Earth-like biosphere history and to be approaching the inner edge of the HZ at present. Here, we assess the possibility of finding such a planet and discuss the benefits of analyzing older Earths. Finding an old-Earth analogue in nearby star systems would be ideal, because this would allow for atmospheric characterization. Hence, as an illustrative example, G stars within 10 pc of the Sun are assessed as potential old-Earth-analog hosts. Six of these represent good potential hosts. For each system, a hypothetical Earth analogue is placed at locations within the continuously habitable zone (CHZ) that would allow enough time for Earth-like biosphere development. Surface temperature evolution over the host star's main sequence lifetime (assessed by using a simple climate model) is used to determine whether the planet would be in the right stage of its late-habitable lifetime to exhibit detectable biosignatures. The best candidate, in terms of the chances of planet formation in the CHZ and of biosignature detection, is 61 Virginis. However, planet formation studies suggest that only a small fraction (0.36%) of G stars in the solar neighborhood could host an old-Earth analogue. If the development of Earth-like biospheres is rare, requiring a sequence of low-probability events to occur, biosphere evolution models suggest they are rarer still, with only thousands being present in the Galaxy as a whole.

  20. SOFTWARE IMPLEMENTATION OF FORMING OF COLOR-BASED CARDS FOR ASSESSMENT OF EARLY STAGES INNOVATION PROJECTS

    Directory of Open Access Journals (Sweden)

    Ekaterina I. Bragina

    2015-01-01

    Full Text Available The article deals with functional program that allows to generate a visualrepresentation of the shareholder tothe innovative project early stage ofdevelopment, formed a color-based cards.

  1. Assessment of Itakura Distance as a valuable feature for computer-aided classification of sleep stages.

    Science.gov (United States)

    Ebrahimi, F; Mikaili, M; Estrada, E; Nazeran, H

    2007-01-01

    Staging and detection of various states of sleep derived from EEG and other biomedical signals have proven to be very helpful in diagnosis, prognosis and remedy of various sleep related disorders. The time consuming and costly process of visual scoring of sleep stages by a specialist has always motivated researchers to develop an automatic sleep scoring system and the first step toward achieving this task is finding discriminating characteristics (or features) for each stage. A vast variety of these features and methods have been investigated in the sleep literature with different degrees of success. In this study, we investigated the performance of a newly introduced measure: the Itakura Distance (ID), as a similarity measure between EEG and EOG signals. This work demonstrated and further confirmed the outcomes of our previous research that the Itakura Distance serves as a valuable similarity measure to differentiate between different sleep stages.

  2. A Danish reference chart for assessment of psychomotor development based on the Ages & Stages Questionnaire

    DEFF Research Database (Denmark)

    Østergaard, Katrine Kure; Lando, Ane Vibeke; Hansen, Bo Mølholm

    2012-01-01

    The aim of this study was to obtain Ages and Stages Questionnaire (ASQ) scores from the background population so that these may be used as a reference group to extremely preterm children at nine and 18 months of corrected age....

  3. Histogram analysis of apparent diffusion coefficient maps for assessing thymic epithelial tumours: correlation with world health organization classification and clinical staging.

    Science.gov (United States)

    Kong, Ling-Yan; Zhang, Wei; Zhou, Yue; Xu, Hai; Shi, Hai-Bin; Feng, Qing; Xu, Xiao-Quan; Yu, Tong-Fu

    2018-04-01

    To investigate the value of apparent diffusion coefficients (ADCs) histogram analysis for assessing World Health Organization (WHO) pathological classification and Masaoka clinical stages of thymic epithelial tumours. 37 patients with histologically confirmed thymic epithelial tumours were enrolled. ADC measurements were performed using hot-spot ROI (ADC HS-ROI ) and histogram-based approach. ADC histogram parameters included mean ADC (ADC mean ), median ADC (ADC median ), 10 and 90 percentile of ADC (ADC 10 and ADC 90 ), kurtosis and skewness. One-way ANOVA, independent-sample t-test, and receiver operating characteristic were used for statistical analyses. There were significant differences in ADC mean , ADC median , ADC 10 , ADC 90 and ADC HS-ROI among low-risk thymoma (type A, AB, B1; n = 14), high-risk thymoma (type B2, B3; n = 9) and thymic carcinoma (type C, n = 14) groups (all p-values histogram analysis may assist in assessing the WHO pathological classification and Masaoka clinical stages of thymic epithelial tumours. Advances in knowledge: 1. ADC histogram analysis could help to assess WHO pathological classification of thymic epithelial tumours. 2. ADC histogram analysis could help to evaluate Masaoka clinical stages of thymic epithelial tumours. 3. ADC 10 might be a promising imaging biomarker for assessing and characterizing thymic epithelial tumours.

  4. Performance assessment and microbial diversity of two pilot scale multi-stage sub-surface flow constructed wetland systems.

    Science.gov (United States)

    Babatunde, A O; Miranda-CasoLuengo, Raul; Imtiaz, Mehreen; Zhao, Y Q; Meijer, Wim G

    2016-08-01

    This study assessed the performance and diversity of microbial communities in multi-stage sub-surface flow constructed wetland systems (CWs). Our aim was to assess the impact of configuration on treatment performance and microbial diversity in the systems. Results indicate that at loading rates up to 100gBOD5/(m(2)·day), similar treatment performances can be achieved using either a 3 or 4 stage configuration. In the case of phosphorus (P), the impact of configuration was less obvious and a minimum of 80% P removal can be expected for loadings up to 10gP/(m(2)·day) based on the performance results obtained within the first 16months of operation. Microbial analysis showed an increased bacterial diversity in stage four compared to the first stage. These results indicate that the design and configuration of multi-stage constructed wetland systems may have an impact on the treatment performance and the composition of the microbial community in the systems, and such knowledge can be used to improve their design and performance. Copyright © 2016. Published by Elsevier B.V.

  5. Assessment of phytochemical content in human milk during different stages of lactation.

    Science.gov (United States)

    Song, Brian J; Jouni, Zeina E; Ferruzzi, Mario G

    2013-01-01

    The present study reports the presence of several carotenoids and flavonoids in human milk samples. Samples were collected from 17 women who delivered healthy term babies (≥ 37 wk of gestation) at 1-, 4-, and 13-wk postpartum intervals. Epicatechin (63.7-828.5 nmol/L), epicatechin gallate (55.7-645.6 nmol/L), epigallocatechin gallate (215.1-2364.7 nmol/L), naringenin (64.1-722.0 nmol/L), kaempferol (7.8-71.4 nmol/L), hesperetin (74.8-1603.1 nmol/L), and quercetin (32.5-108.6 nmol/L) were present in human milk samples with high inter-/intraindividual variability. With the exception of kaempferol, the mean flavonoid content in human milk was not statistically different among lactation stages. In contrast, carotenoids α-carotene (59.0-23.2 nmol/L), β-carotene (164.3-88.0 nmol/L), α-cryptoxanthin (30.6-13.5 nmol/L), β-cryptoxanthin (57.4-24.8 nmol/L), zeaxanthin (46.3-21.4 nmol/L), lutein (121.2-56.4 nmol/L), and lycopene (119.9-49.5 nmol/L) significantly decreased from weeks 1 to 13 of lactation. The observed differences in the relative concentrations of the two phytochemical classes in human milk may be a result of several factors, including dietary exposure, stability in the milk matrix, efficiency of absorption/metabolism, and transfer from plasma to human milk. These data support the notion that flavonoids, as with carotenoids, are dietary phytochemicals present in human milk and potentially available to breast-fed infants. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Whole-body MRI versus 18F-FDG PET/CT for pretherapeutic assessment and staging of lymphoma: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Wang D

    2018-06-01

    Full Text Available Danyang Wang,1 Yanlei Huo,1 Suyun Chen,1 Hui Wang,1 Yingli Ding,2 Xiaochun Zhu,3 Chao Ma1,4 1Department of Nuclear Medicine, Affiliated XinHua Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China; 2Department of Nuclear Medicine, Affiliated Third People’s Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China; 3Department of Nuclear Medicine, Affiliated Ninth People’s Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China; 4Department of Nuclear Medicine, Tenth People’s Hospital of Tongji University, Shanghai, China Purpose: 18F-fluorodeoxyglucose (18F-FDG positron emission tomography/computed tomography (PET/CT is the reference standard in staging of 18F-FDG-avid lymphomas; however, there is no recommended functional imaging modality for indolent lymphomas. Therefore, we aimed to compare the performance of whole-body magnetic resonance imaging (WB-MRI with that of 18F-FDG PET/CT for lesion detection and initial staging in patients with aggressive or indolent lymphoma. Materials and methods: We searched the MEDLINE, EMBASE, and CENTRAL databases for studies that compared WB-MRI with 18F-FDG PET/CT for lymphoma staging or lesion detection. The methodological quality of the studies was assessed using version 2 of the “Quality Assessment of Diagnostic Accuracy Studies” tool. The pooled staging accuracy (µ of WB-MRI and 18F-FDG PET/CT for initial staging and for assessing possible heterogeneity (χ2 across studies were calculated using commercially available software. Results: Eight studies comprising 338 patients were included. In terms of staging, the meta-analytic staging accuracies of WB-MRI and 18F-FDG PET/CT for Hodgkin lymphoma and aggressive non-Hodgkin lymphoma (NHL were 98% (95% CI, 94%–100% and 98% (95% CI, 94%–100%, respectively. The pooled staging accuracy of 18F-FDG PET/CT dropped to 87% (95% CI, 72%–97% for staging in patients with indolent lymphoma

  7. The Value of High-Resolution MRI Technique in Patients with Rectal Carcinoma: Pre-Operative Assessment of Mesorectal Fascia Involvement, Circumferential Resection Margin and Local Staging

    International Nuclear Information System (INIS)

    Algebally, Ahmed Mohamed; Mohey, Nesreen; Szmigielski, Wojciech; Yousef, Reda Ramadan Hussein; Kohla, Samah

    2015-01-01

    The purpose of the study was to identify the accuracy of high-resolution MRI in the pre-operative assessment of mesorectal fascia involvement, circumfrential resection margin (CRM) and local staging in patients with rectal carcinoma. The study included 56 patients: 32 male and 24 female. All patients underwent high-resolution MRI and had confirmed histopathological diagnosis of rectal cancer located within 15 cm from the anal verge, followed by surgery. MRI findings were compared with pathological and surgical results. The overall accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI-based T-staging were 92.8, 88.8%, 96.5%, 96%, and 90.3%, respectively. The accuracy, sensitivity, specificity, PPV, and NPV of MRI-based assessment of CRM were 94.6%, 84.6%, 97.6%, 91.4, and 94.6%, respectively. The accuracy, sensitivity, specificity, PPV, and NPV of MRI-based N-staging were 82.1%, 75%, 67.3%, 60%, and 86.1%, respectively. Preoperative high-resolution rectal MRI is accurate in predicting tumor stage and CRM involvement. MRI is a precise diagnostic tool to select patients who may benefit from neo-adjuvant therapy and to avoid overtreatment in those patients who can proceed directly to surgery

  8. A 4-year sequential assessment of the Families First Edmonton partnership: challenges to synergy in the implementation stage.

    Science.gov (United States)

    Gray, Erin; Mayan, Maria; Lo, Sanchia; Jhangri, Gian; Wilson, Douglas

    2012-03-01

    This article assesses the partnership functioning of Families First Edmonton, a multisectored collaborative effort formed to determine the best health and recreation service delivery model for families with low income. Partners' evaluations of the collaborative process are examined across the formation, implementation, and maintenance stages of development. Statistical analyses of questionnaire data reveal a significant decrease in the partnership's capacity to maximize synergy-a main indicator of a successful collaborative process-in the implementation stage of the partnership. Implications for partnership practice are addressed.

  9. Oxygen-enhanced MRI vs. quantitatively assessed thin-section CT: Pulmonary functional loss assessment and clinical stage classification of asthmatics

    International Nuclear Information System (INIS)

    Ohno, Yoshiharu; Koyama, Hisanobu; Matsumoto, Keiko; Onishi, Yumiko; Nogami, Munenobu; Takenaka, Daisuke; Matsumoto, Sumiaki; Sugimura, Kazuro

    2011-01-01

    Purpose: The purpose of this study was to prospectively compare the efficacy of oxygen-enhanced MR imaging (O 2 -enhanced MRI) and CT for pulmonary functional loss assessment and clinical stage classification of asthmatics. Materials and methods: O 2 -enhanced MRI, CT and %FEV 1 measurement were used 34 consecutive asthmatics classified into four stages ('Mild Intermittent [n = 7]', 'Mild Persistent [n = 8], 'Moderate Persistent [n = 14]' and 'Severe Persistent [n = 5]'). Relative enhancement ratio maps for every subject were generated, and determine mean relative enhancement ratios (MRERs). Mean lung density (MLD) and the airway wall area (WA) corrected by body surface area (WA/BSA) were also measured on CT. To compare the efficacy of the two methods for pulmonary functional loss assessment, all indexes were correlated with %FEV 1 . To determine the efficacy of the two methods for clinical stage classification, all parameters for the four clinical stages were statistically compared. Results: %FEV 1 showed fair or moderate correlation with all parameters (0.15 ≤ r 2 ≤ 0.30, p 2 -enhanced MRI is as effective as CT for pulmonary functional loss assessment and clinical stage classification of asthmatics.

  10. Use of positron emission tomography for staging, preoperative response assessment and posttherapeutic evaluation in children with Wilms tumour

    International Nuclear Information System (INIS)

    Misch, Daniel; Steffen, Ingo G.; Furth, Christian; Stoever, Brigitte; Amthauer, Holger; Denecke, Timm; Schoenberger, Stefan; Voelker, Thomas; Henze, Guenter; Hautzel, Hubertus

    2008-01-01

    To evaluate FDG-PET for staging, grading, preoperative response assessment and posttherapeutic evaluation in children with Wilms tumour (WT). In this study, 23 FDG-PET examinations in 12 paediatric patients (female, n=5; male, n=7; age, 1-19 years) with WT (primary, n=9; relapsed, n=3) were analysed. All patients were examined with conventional imaging methods (CIM) according to the SIOP2001/GPOH trial protocol. Additionally, FDG-PET/PET-CT was performed for staging (n = 12), preoperative response assessment (n=6) and posttherapeutic evaluation (n=5). Imaging results of FDG-PET and CIM were analysed regarding the accuracy in tumour visualisation, impact on therapeutic management and preoperative response assessment, with clinical follow-up and histopathology as the standard of reference. FDG-PET and CIM showed concordant results for staging of primary WT, whereas FDG-PET was superior in 1/3 cases with recurrent WT. Concerning histological differentiation, one case with anaplastic WT had an standard uptake value (SUV) of 12.3, which was remarkably higher than the average SUV in the eight cases with intermediate risk histology. No parameter analysed for PET or CIM was reliably predictive for histological regression or clinical outcome. After completion of therapy, FDG-PET was superior to CIM in 2/5 cases in detecting residual disease with therapeutic relevance. FDG-PET does not provide additional information to the traditional imaging work-up for staging WT patients, preoperative response assessment and clinical outcome. FDG-PET was advantageous in ruling out residual disease after completion of first line treatment and in pretherapeutic staging of relapse patients. Furthermore, there seems to be a good correlation of initial SUV and histological differentiation. (orig.)

  11. An Integrated Simulation, Inference and Optimization Approach for Groundwater Remediation with Two-stage Health-Risk Assessment

    Directory of Open Access Journals (Sweden)

    Aili Yang

    2018-05-01

    Full Text Available In this study, an integrated simulation, inference and optimization approach with two-stage health risk assessment (i.e., ISIO-THRA is developed for supporting groundwater remediation for a petroleum-contaminated site in western Canada. Both environmental standards and health risk are considered as the constraints in the ISIO-THRA model. The health risk includes two parts: (1 the health risk during the remediation process and (2 the health risk in the natural attenuation period after remediation. In the ISIO-THRA framework, the relationship between contaminant concentrations and time is expressed through first-order decay models. The results demonstrate that: (1 stricter environmental standards and health risk would require larger pumping rates for the same remediation duration; (2 higher health risk may happen in the period of the remediation process; (3 for the same environmental standard and acceptable health-risk level, the remediation techniques that take the shortest time would be chosen. ISIO-THRA can help to systematically analyze interaction among contaminant transport, remediation duration, and environmental and health concerns, and further provide useful supportive information for decision makers.

  12. Assessing the risk of pelvic and para-aortic nodal involvement in apparent early-stage ovarian cancer: A predictors- and nomogram-based analyses.

    Science.gov (United States)

    Bogani, Giorgio; Tagliabue, Elena; Ditto, Antonino; Signorelli, Mauro; Martinelli, Fabio; Casarin, Jvan; Chiappa, Valentina; Dondi, Giulia; Leone Roberti Maggiore, Umberto; Scaffa, Cono; Borghi, Chiara; Montanelli, Luca; Lorusso, Domenica; Raspagliesi, Francesco

    2017-10-01

    To estimate the prevalence of lymph node involvement in early-stage epithelial ovarian cancer in order to assess the prognostic value of lymph node dissection. Data of consecutive patients undergoing staging for early-stage epithelial ovarian cancer were retrospectively evaluated. Logistic regression and a nomogram-based analysis were used to assess the risk of lymph node involvement. Overall, 290 patients were included. All patients had lymph node dissection including pelvic and para-aortic lymphadenectomy. Forty-two (14.5%) patients were upstaged due to lymph node metastatic disease. Pelvic and para-aortic nodal metastases were observed in 22 (7.6%) and 42 (14.5%) patients. Lymph node involvement was observed in 18/95 (18.9%), 1/37 (2.7%), 4/29 (13.8%), 11/63 (17.4%), 3/41 (7.3%) and 5/24 (20.8%) patients with high-grade serous, low-grade-serous, endometrioid G1, endometrioid G2&3, clear cell and undifferentiated, histology, respectively (p=0.12, Chi-square test). We observed that high-grade serous histology was associated with an increased risk of pelvic node involvement; while, histology rather than low-grade serous and bilateral tumors were independently associated with para-aortic lymph node involvement (p<0.05). Nomograms displaying the risk of nodal involvement in the pelvic and para-aortic areas were built. High-grade serous histology and bilateral tumors are the main characteristics suggesting lymph node positivity. Our data suggested that high-grade serous and bilateral early-stage epithelial ovarian cancer are at high risk of having disease harboring in the lymphatic tissues of both pelvic and para-aortic area. After receiving external validation, our data will help to identify patients deserving comprehensive retroperitoneal staging. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Assessment of Early Stage Non-Motor Symptoms in Parkinson’sDisease

    Directory of Open Access Journals (Sweden)

    Haluk Gümüş

    2013-09-01

    Full Text Available OBJECTIVE: In this study, our purpose is, in the early stage of PD, examining the frequency of occurrence of non-motor symptoms and discussing the effects of morbidity of disease. METHODS: Selcuk University, Meram Faculty of Medicine, Neurology outpatient clinic in the study, which is followed by the United Kingdom Brain Bank criteria for Parkinson's Disease Parkinson's Disease diagnosis and clinical staging according to Hoehn Yahr stages 1 and 2 of the 80 patients were studied. RESULTS: Cases, an increase in UPDRS scores were significantly higher non-motor symptoms. CONCLUSION: Non-motor symptoms in Parkinson's disease can often go unnoticed. Symptomatic treatment is an important part of the success. Therefore, PH and the non-motor symptoms, early detection is important to treat them in accordance with

  14. Can Australian radiographers assess screening mammograms accurately? First stage results from a four year prospective study

    International Nuclear Information System (INIS)

    Moran, S.; Warren-Forward, H.

    2016-01-01

    Introduction: Globally, the role of the radiographer is changing; some countries have developed advanced roles with specific scopes of practice. Other countries, like Australia, are in the process of this change. The aim of this research is to assess the diagnostic outcomes reported by the radiographers and compare them to those reported by current screen readers. Method: Six experienced radiographers were invited to participate in a prospective study conducted between 2010 and 2011. They were required to read 2000 mammograms each. Their results were compared with those of the radiologists. Statistical analysis of the results included overall cancer detection rates, recall rates, levels of agreement, kappa, sensitivity, specificity, accuracy, positive predictive value and negative predictive value. Results: A total of 9348 women were included in the study. The percentage of cancers detected by the radiographers ranged from 53% to 100% of the cancers detected by the radiologists. Radiologist recall rate ranged between 3.4% and 5.5% and the radiographers' range was 2.9%–9.8%. Level of agreement of the radiographers with the radiologists ranged from 90 to 96%. Conclusion: The potential for accuracy in screen reading by Australian radiographers is supported by the results of this study. Implementation of formal training is likely to result in an increase in the diagnostic accuracy of radiographers. - Highlights: • Radiographers prospectively read 2000 screening mammograms each. • These results support potential for accuracy in screen reading by radiographers. • Will advanced practice be introduced within BreastScreen Australia?.

  15. Probabilistic Safety Assessment (PSA) of Natural External Hazards Including Earthquakes. Workshop Proceedings, Prague, Czech Republic, 17-20 June 2013

    International Nuclear Information System (INIS)

    2014-01-01

    The Fukushima Dai-ichi accident triggered discussions about the significance of external hazards and their treatment in safety analyses. In addition, stress tests results have shown vulnerabilities and potential of cliff-edge effects in plant responses to external hazards and have identified possibilities and priorities for improvements and safety measures' implementation at specific sites and designs. In order to address these issues and provide relevant conclusions and recommendations to CSNI and CNRA, the CSNI Working Group on Risk Assessment (WGRISK) directed, in cooperation with the CSNI Working Group on Integrity and Ageing of Components and Structures (WGIAGE), a workshop hosted by UJV Rez. The key objectives of the workshop were to collect information from the OECD member states on methods and approaches being used, and experience gained in probabilistic safety assessment of natural external hazards, as well as to support the fulfillment of the CSNI task on 'PSA of natural external hazards including earthquakes'. These objectives are described more in detail in the introduction in Chapter 1 of this report. The WGRISK activities preceding the workshop and leading to the decision to organize it are described in Chapter 2 of this report. The focus of the workshop was on external events PSA for nuclear power plants, including all modes of operation. The workshop scope was generally limited to external, natural hazards, including those hazards where the distinction between natural and man-made hazards is not sharp. The detailed information about the presentations, discussions, and results of the workshop is presented in Chapter 3 of this report. Some general conclusions were agreed on during the workshop, which are presented in the following paragraphs. - The lessons learned from the Fukushima Dai-ichi reactor accidents and related actions at the national, regional, and global level have emphasized the importance to assess risks associated (authors) with

  16. The Role of Arsenic Speciation in Dietary Exposure Assessment and the Need to Include Bioaccessibility and Biotransformation

    Science.gov (United States)

    Chemical form specific exposure assessment for arsenic has long been identified as a source of uncertainty in estimating the risk associated with the aggregate exposure for a population. Some speciation based assessments document occurrence within an exposure route; however, the...

  17. Assessment of a respiratory face mask for capturing air pollutants and pathogens including human influenza and rhinoviruses.

    Science.gov (United States)

    Zhou, S Steve; Lukula, Salimatu; Chiossone, Cory; Nims, Raymond W; Suchmann, Donna B; Ijaz, M Khalid

    2018-03-01

    Prevention of infection with airborne pathogens and exposure to airborne particulates and aerosols (environmental pollutants and allergens) can be facilitated through use of disposable face masks. The effectiveness of such masks for excluding pathogens and pollutants is dependent on the intrinsic ability of the masks to resist penetration by airborne contaminants. This study evaluated the relative contributions of a mask, valve, and Micro Ventilator on aerosol filtration efficiency of a new N95 respiratory face mask. The test mask was challenged, using standardized methods, with influenza A and rhinovirus type 14, bacteriophage ΦΧ174, Staphylococcus aureus ( S . aureus ), and model pollutants. The statistical significance of results obtained for different challenge microbial agents and for different mask configurations (masks with operational or nonoperational ventilation fans and masks with sealed Smart Valves) was assessed. The results demonstrate >99.7% efficiency of each test mask configuration for exclusion of influenza A virus, rhinovirus 14, and S . aureus and >99.3% efficiency for paraffin oil and sodium chloride (surrogates for PM 2.5 ). Statistically significant differences in effectiveness of the different mask configurations were not identified. The efficiencies of the masks for excluding smaller-size (i.e., rhinovirus and bacteriophage ΦΧ174) vs. larger-size microbial agents (influenza virus, S . aureus ) were not significantly different. The masks, with or without features intended for enhancing comfort, provide protection against both small- and large-size pathogens. Importantly, the mask appears to be highly efficient for filtration of pathogens, including influenza and rhinoviruses, as well as the fine particulates (PM 2.5 ) present in aerosols that represent a greater challenge for many types of dental and surgical masks. This renders this individual-use N95 respiratory mask an improvement over the former types of masks for protection against

  18. Assessing efficiency and effectiveness of Malaysian Islamic banks: A two stage DEA analysis

    Science.gov (United States)

    Kamarudin, Norbaizura; Ismail, Wan Rosmanira; Mohd, Muhammad Azri

    2014-06-01

    Islamic banks in Malaysia are indispensable players in the financial industry with the growing needs for syariah compliance system. In the banking industry, most recent studies concerned only on operational efficiency. However rarely on the operational effectiveness. Since the production process of banking industry can be described as a two-stage process, two-stage Data Envelopment Analysis (DEA) can be applied to measure the bank performance. This study was designed to measure the overall performance in terms of efficiency and effectiveness of Islamic banks in Malaysia using Two-Stage DEA approach. This paper presents analysis of a DEA model which split the efficiency and effectiveness in order to evaluate the performance of ten selected Islamic Banks in Malaysia for the financial year period ended 2011. The analysis shows average efficient score is more than average effectiveness score thus we can say that Malaysian Islamic banks were more efficient rather than effective. Furthermore, none of the bank exhibit best practice in both stages as we can say that a bank with better efficiency does not always mean having better effectiveness at the same time.

  19. How reassuring is a normal breast ultrasound in assessment of a screen-detected mammographic abnormality? A review of interval cancers after assessment that included ultrasound evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, M.L. [Breastscreen WA, Perth (Australia); Department of Diagnostic and Interventional Radiology, Royal Perth Hospital, Perth (Australia); Welman, C.J. [Breastscreen WA, Perth (Australia); Department of Diagnostic and Interventional Radiology, Royal Perth Hospital, Perth (Australia); Department of Radiology, Fremantle Hospital and Health Service, Fremantle (Australia); Celliers, L.M., E-mail: liesl.celliers@health.wa.gov.au [Department of Diagnostic and Interventional Radiology, Royal Perth Hospital, Perth (Australia); Department of Radiology, Fremantle Hospital and Health Service, Fremantle (Australia)

    2011-10-15

    Aim: To review factors resulting in a false-negative outcome or delayed cancer diagnosis in women recalled for further evaluation, including ultrasound, after an abnormal screening mammogram. Materials and methods: Of 646,692 screening mammograms performed between 1 January 1995 and 31 December 2004, 34,533 women were recalled for further assessment. Nine hundred and sixty-four interval cancers were reported in this period. Forty-six of these women had been recalled for further assessment, which specifically included ultrasound evaluation in the preceding 24 months, and therefore, met the inclusion criteria for this study. Screening mammograms, further mammographic views, ultrasound scans, clinical findings, and histopathology results were retrospectively reviewed by two consultant breast radiologists. Results: The interval cancer developed in the contralateral breast (n = 9), ipsilateral breast, but different site (n = 6), and ipsilateral breast at the same site (n = 31) as the abnormality for which they had recently been recalled. In the latter group, 10 were retrospectively classified as a false-negative outcome, nine had a delay in obtaining a biopsy, and 12 had a delay due to a non-diagnostic initial biopsy. Various factors relating to these outcomes are discussed. Conclusion: Out of 34,533 women who attended for an assessment visit and the 46 women who subsequently developed an interval breast cancer, 15 were true interval cancers, 10 had a false-negative assessment outcome, and 21 had a delay to cancer diagnosis on the basis of a number of factors. When there is discrepancy between the imaging and histopathology results, a repeat biopsy rather than early follow-up would have avoided a delay in some cases. A normal ultrasound examination should not deter the radiologist from proceeding to stereotactic biopsy, if the index mammographic lesion is suspicious of malignancy.

  20. Reliability and validity of the international dementia alliance schedule for the assessment and staging of care in China.

    Science.gov (United States)

    Wang, Xiao; Sun, Zhenghai; Xiong, Lingchuan; Semrau, Maya; He, Jianhua; Li, Yang; Zhu, Jianzhong; Zhang, Nan; Wang, Aimin; Jiang, Qinpu; Mu, Nan; Zhao, Yuping; Chen, Wei; Wu, Donghui; Zheng, Zhanjie; Sun, Yongan; Zhang, Jing; Xu, Jun; Meng, Xue; Zhao, Mei; Zhang, Haifeng; Lv, Xiaozhen; Sartorius, Norman; Li, Tao; Yu, Xin; Wang, Huali

    2017-11-21

    Clinical and social services both are important for dementia care. The International Dementia Alliance (IDEAL) Schedule for the Assessment and Staging of Care was developed to guide clinical and social care for dementia. Our study aimed to assess the validity and reliability of the IDEAL schedule in China. Two hundred eighty-two dementia patients and their caregivers were recruited from 15 hospitals in China. Each patient-caregiver dyad was assessed with the IDEAL schedule by a rater and an observer simultaneously. The Clinical Dementia Rating (CDR), Mini-Mental Status Examination (MMSE), and Caregiver Burden Inventory (CBI) were assessed for criterion validity. IDEAL repeated assessment was conducted 7-10 days after the initial interview for 62 dyads. Two hundred seventy-seven patient-caregiver dyads completed the IDEAL assessment. Inter-rater reliability for the total score of the IDEAL schedule was 0.93 (95%CI = 0.92-0.95). The inter-class coefficient for the total score of IDEAL was 0.95 for the interviewers and 0.93 for the silent raters. The IDEAL total score correlated with the global CDR score (ρ = 0.72, p valid and reliable tool for the staging of care for dementia in the Chinese population.

  1. Reversal of the decision for caesarean section in the second stage of labour on the basis of consultant vaginal assessment.

    Science.gov (United States)

    Oláh, K S

    2005-02-01

    During a 5-year period there were 32 cases where the vaginal assessment performed by a specialist registrar in the second stage of labour was re-assessed within 15 minutes by a consultant obstetrician. The examination was prompted by a request for permission to perform a caesarean section in the second stage of labour. The results suggest a significant discrepancy between the consultants and the specialist registrar's findings, with 44% of the cases indicating a difference in the position of the head, and 81% a difference in the station of the head. No comment was made about caput or moulding in the majority of cases (94%). The study findings suggest that vaginal examination, like instrumental delivery, is a skill that is being eroded and will require formal instruction to address this problem.

  2. Using the Dynamic Model to Identify Stages of Teacher Skills in Assessment

    Science.gov (United States)

    Christoforidou, Margarita; Xirafidou, Elisavet

    2014-01-01

    The article presents the results of two cross-sectional studies that investigate teachers' skills in using various techniques of assessment in mathematics by taking into account the four phases of assessment. The five dimensions of the dynamic model are also taken into account in proposing a framework for measuring teacher skills in assessment.…

  3. The role of whole-body FDG-PET in preoperative assessment of tumor staging in oral cancers

    International Nuclear Information System (INIS)

    Nakasone, Yoshiki; Inoue, Tomio; Oriuchi, Noboru; Negishi, Akihide; Endo, Keigo; Mogi, Kenji; Takeuchi, Kazuo

    2001-01-01

    The aim of this study is to clarify the clinical utility of 2-deoxy-2-[ 18 F]fluoro-D-glucose (FDG) positron emission tomography (PET) in determining the TNM classification in patients with oral cancer. Twenty-five consecutive patients (14 male and 11 female; age range, 40 yr to 86 yr) with oral cancer were included in this study. The diagnostic accuracy for detecting cervical lymph nodes was investigated by comparing the results of CT and/or MRI and physical findings. For the semi-quantitative analysis, the tumor standardized uptake value (SUV) and tumor to background SUV ratio (T/B ratio) were assessed in primary tumors and cervical lymph nodes. All primary lesions were visualized on FDG-PET images. Even though artifacts from dental materials near the lesion hampered the delineation of primary tumors on CT/MRI, the extent of primary tumors was accurately assessed by FDG-PET. The SUV and T/B ratio in the primary tumor classified in higher T grade (T3 and T4) was significantly higher than that in lower T grade (T1 and T2) (mean±SD of SUV; 8.32±2.99 vs. 5.15±3.77, p<0.01, mean ±SD of T/B ratio; 6.96±3.23 vs. 3.61±2.76, p<0.01). The SUV and T/B ratio of metastatic lymph nodes were also significantly higher than those of normal lymph nodes (mean ±SD of SUV; 3.39±1.69 vs. 1.55±0.57, p<0.001, mean ±SD of T/B ratio; 2.46±1.08 vs. 1.03±0.22, p<0.001). Among these three methods, FDG-PET in conjunction with CT/MRI showed the highest accuracy of 92%, but there were no significant differences in diagnostic accuracy among the three methods. For the semi-quantitative analysis, a threshold SUV of 2.0 provided 100% sensitivity, 82% specificity, and 88% accuracy. Furthermore, a threshold T/B ratio of 1.5 provided 100% sensitivity, 100% specificity, and 100% accuracy. Regarding the detection of distant metastasis, there was one positive result in FDG-PET showing distant pulmonary metastasis. Whole-body FDG-PET is an effective and convenient diagnostic tool for the

  4. Assessment of implant stability during various stages of healing placed immediately following extraction in an overdenture situation

    OpenAIRE

    Ashwin Thomas Koshy; T Aby Mathew; Nicholas Mathew; Angel Mary Joseph

    2017-01-01

    To assess the implant stability during different stages of healing in an immediate loaded implant soon after extraction. A 73-year-old female came with a chief complaint of bad smell and irritation in her lower front gum region. On examination, she was found to be completely edentulous in the maxillary arch and partially edentulous in the mandibular arch with only the canines present bilaterally. The posterior mandibular ridge was severely resorbed and hence could not be treated with a conven...

  5. System-level Reliability Assessment of Power Stage in Fuel Cell Application

    DEFF Research Database (Denmark)

    Zhou, Dao; Wang, Huai; Blaabjerg, Frede

    2016-01-01

    reliability. In a case study of a 5 kW fuel cell power stage, the parameter variations of the lifetime model prove that the exponential factor of the junction temperature fluctuation is the most sensitive parameter. Besides, if a 5-out-of-6 redundancy is used, it is concluded both the B10 and the B1 system......High efficient and less pollutant fuel cell stacks are emerging and strong candidates of the power solution used for mobile base stations. In the application of the backup power, the availability and reliability hold the highest priority. This paper considers the reliability metrics from...... the component-level to the system-level for the power stage used in a fuel cell application. It starts with an estimation of the annual accumulated damage for the key power electronic components according to the real mission profile of the fuel cell system. Then, considering the parameter variations in both...

  6. Microbiological quality assessment of milk at different stages of the dairy value chain in a developing country setting.

    Science.gov (United States)

    Islam, Mohammad Aminul; Roy, Subarna; Nabi, Ashikun; Solaiman, Sultana; Rahman, Mahdia; Huq, Mohsina; Siddiquee, Nurul Amin; Ahmed, Niyaz

    2018-08-02

    The main objective of the study was to assess the microbiological quality of milk at different stages of the dairy value chain from farm to the factory in Bangladesh. A total of 438 raw milk samples (387 from primary producers, 32 from collectors, 15 from chilling plants, 4 from local restaurants) and 95 commercially processed milk samples were collected from northern part of Bangladesh. Almost 72% (n = 280) of samples at producer level and 100% from both collectors (n = 32) and chilling plants (n = 15) were contaminated with coliforms while 57% (n = 220) of samples from producers, 91% (n = 29) of samples from collectors and 100% (n = 15) from chilling plants were contaminated with fecal coliforms. Around 31% (n = 119) of samples from producers were positive for E. coli whereas >60% (n = 20) and 100% (n = 15) samples from collectors and chilling plants, respectively were positive for E. coli. One quarter of samples from collectors were positive for B. cereus and coagulase positive staphylococci and 33% (n = 5) of samples from chilling plants were positive for both of these microorganisms. In case of commercially processed milk, 77% (n = 46) and 37% (n = 22) of pasteurized milk samples had a high aerobic plate count (APC) (10 4  CFU/ml) and coliform count (>10 CFU/ml), respectively. None of the samples was positive for Shigella spp., Salmonella spp., and Campylobacter spp. Among 158 E. coli positive raw milk samples, 9% (n = 14) contained pathogenic E. coli, and enteroaggregative E. coli (EAEC) and Shiga-toxin producing E. coli (STEC) were found to be the predominant pathotypes. Of the 23 pathogenic E. coli identified from 14 samples based on their gene contents, >95% (n = 22) were resistant to at least one antibiotic and 13% (n = 3) of isolates were resistant to ≥3 classes of antibiotics. Several factors including the time of milking, hygiene practices of the producers, cow breed and amount of milk

  7. CFD modeling of two-stage ignition in a rapid compression machine: Assessment of zero-dimensional approach

    Energy Technology Data Exchange (ETDEWEB)

    Mittal, Gaurav [Department of Mechanical Engineering, The University of Akron, Akron, OH 44325 (United States); Raju, Mandhapati P. [General Motor R and D Tech Center, Warren, MI 48090 (United States); Sung, Chih-Jen [Department of Mechanical Engineering, University of Connecticut, Storrs, CT 06269 (United States)

    2010-07-15

    In modeling rapid compression machine (RCM) experiments, zero-dimensional approach is commonly used along with an associated heat loss model. The adequacy of such approach has not been validated for hydrocarbon fuels. The existence of multi-dimensional effects inside an RCM due to the boundary layer, roll-up vortex, non-uniform heat release, and piston crevice could result in deviation from the zero-dimensional assumption, particularly for hydrocarbons exhibiting two-stage ignition and strong thermokinetic interactions. The objective of this investigation is to assess the adequacy of zero-dimensional approach in modeling RCM experiments under conditions of two-stage ignition and negative temperature coefficient (NTC) response. Computational fluid dynamics simulations are conducted for n-heptane ignition in an RCM and the validity of zero-dimensional approach is assessed through comparisons over the entire NTC region. Results show that the zero-dimensional model based on the approach of 'adiabatic volume expansion' performs very well in adequately predicting the first-stage ignition delays, although quantitative discrepancy for the prediction of the total ignition delays and pressure rise in the first-stage ignition is noted even when the roll-up vortex is suppressed and a well-defined homogeneous core is retained within an RCM. Furthermore, the discrepancy is pressure dependent and decreases as compressed pressure is increased. Also, as ignition response becomes single-stage at higher compressed temperatures, discrepancy from the zero-dimensional simulations reduces. Despite of some quantitative discrepancy, the zero-dimensional modeling approach is deemed satisfactory from the viewpoint of the ignition delay simulation. (author)

  8. Condition-specific Quality of Life Assessment at Each Stage of Class III Surgical Orthodontic Treatment -A Prospective Study.

    Science.gov (United States)

    Tachiki, Chie; Nishii, Yasushi; Takaki, Takashi; Sueishi, Kenji

    2018-01-01

    Surgical orthodontic treatment has been reported to improve oral health-related quality of life (OHRQL). Such treatment comprises three stages: pre-surgical orthodontic treatment; orthognathic surgery; and post-surgical orthodontic treatment. Most studies have focused on change in OHRQL between before and after surgery. However, it is also necessary to evaluate OHRQL at the pre-surgical orthodontic treatment stage, as it may be negatively affected by dental decompensation compared with at pre-treatment. The purpose of this prospective study was to investigate the influence of surgical orthodontic treatment on QOL by assessing change in condition-specific QOL at each stage of treatment in skeletal class III cases. Twenty skeletal class III patients requiring surgical orthodontic treatment were enrolled in the study. Each patient completed the Orthognathic Quality of Life Questionnaire (OQLQ), which was developed for patients with dentofacial deformity. Its items are grouped into 4 domains: "social aspects of dentofacial deformity"; "facial esthetics"; "oral function"; and "awareness of dentofacial esthetics". The questionnaire was completed at the pre-treatment, pre-surgical orthodontic treatment, and post-surgical orthodontic treatment stages. The results revealed a significant worsening in scores between at pre-treatment and pre-surgical orthodontic treatment in the domains of facial esthetics and oral function (ppre-surgical orthodontic and post-surgical orthodontic treatment in all domains except awareness of dentofacial esthetics (ppre-surgical orthodontic treatment stage. Significant correlations were also observed between improvement in upper and lower lip difference, soft tissue pogonion protrusion, and ANB angle and improvement in OQLQ scores at the post-surgical orthodontic treatment stage. These results indicate that morphologic change influences OHRQL in patients undergoing surgical orthodontic treatment not only after surgery, but also during pre

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

    Directory of Open Access Journals (Sweden)

    Makita Masujiro

    2006-05-01

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

  10. Improving the accuracy of self-assessment of practical clinical skills using video feedback--the importance of including benchmarks.

    Science.gov (United States)

    Hawkins, S C; Osborne, A; Schofield, S J; Pournaras, D J; Chester, J F

    2012-01-01

    Isolated video recording has not been demonstrated to improve self-assessment accuracy. This study examines if the inclusion of a defined standard benchmark performance in association with video feedback of a student's own performance improves the accuracy of student self-assessment of clinical skills. Final year medical students were video recorded performing a standardised suturing task in a simulated environment. After the exercise, the students self-assessed their performance using global rating scales (GRSs). An identical self-assessment process was repeated following video review of their performance. Students were then shown a video-recorded 'benchmark performance', which was specifically developed for the study. This demonstrated the competency levels required to score full marks (30 points). A further self-assessment task was then completed. Students' scores were correlated against expert assessor scores. A total of 31 final year medical students participated. Student self-assessment scores before video feedback demonstrated moderate positive correlation with expert assessor scores (r = 0.48, p benchmark performance demonstration, self-assessment scores demonstrated a very strong positive correlation with expert scores (r = 0.83, p benchmark performance in combination with video feedback may significantly improve the accuracy of students' self-assessments.

  11. Criteria of assessment of short track runners’ prospects as mean of promising sportsmen losses’ prevention at selection stage

    Directory of Open Access Journals (Sweden)

    S.A. Kugayevskiy

    2015-12-01

    Full Text Available Purpose: to offer main criteria for assessment of short track runners’ prospects. Material: 8 sportsmen of short track Ukrainian national team participated in the research. Influence of training means’ volume on result, shown on competition distance, was determined. Both organism’s functional and reserve potentials were assessed with the help of computer program D&K-test. Results: we have determined priority of functional indicators in selection of short track runners and for assessment of their prospects. Sportsman’s potentials shall be assessed on the base of functional fitness indicators, analysis of competition practice and training process data of pervious stage of sport perfection. Conclusions: individualization of training process, considering physiological characteristics of definite sportsman, will permit to completely open the embedded potential. Absence of sportsman’s progress with prominent functional system’s characteristics points at demand in correction of training program for his sportsman.

  12. Including cetaceans in multi-species assessment models using strandings data: why, how and what can we do about it?

    Directory of Open Access Journals (Sweden)

    Camilo Saavedra

    2014-07-01

    Full Text Available Single-species models have been commonly used to assess fish stocks in the past. Since these models have relatively simple data requirements, they sometimes provide the only tool available to assess the status of a stock when data are not enough to develop more complex models. However, these models have been criticized for several reasons since they provide reference points independently for each species assessed ignoring their interactions. For example, several studies suggest that even more substantial reductions in fishing mortality may be necessary to ensure MSY is reached when taking into consideration multiespecies interactions. Therefore, and as Pauly et al. (1998 stated, single-species analysis may mislead researchers and managers into neglecting the gear and trophic interactions which ultimately determine stocks long-term yields and ecosystem health. Ecosystem or multispecies models offer a number of advantages over single-species models. As stated in the workshop “Incorporating ecosystem considerations into stock assessments and management advice” (Mace, 2000 two general improvements are: a better appreciation of the fishing on ecosystem structure and function, and a better appreciation of the need to consider de value of marine ecosystems for functions other than harvesting fish. As disadvantages, multispecies models are statistically complex and include trophic relationships requiring more information (e.g. good estimations of biological parameters of each species and generally a full quantification of the diet sometimes available though the analysis of stomach contents. To reduce the number of species and therefore the amount of information needed, Minimum Realistic Models (MRMs represent an intermediate level of complexity, where only the subset of the ecosystem, important for the issue under consideration, is modeled. This approach offers the advantage of allowing a refinement of our estimates and can help answer more targeted

  13. 18F-FDG-PET/CT in staging, restaging, and treatment response assessment of male breast cancer

    International Nuclear Information System (INIS)

    Groheux, David; Hindié, Elif; Marty, Michel; Espié, Marc; Rubello, Domenico; Vercellino, Laetitia; Bousquet, Guilhem; Ohnona, Jessica; Toubert, Marie-Elisabeth; Merlet, Pascal; Misset, Jean-Louis

    2014-01-01

    Purpose: Male breast cancer (BC) is a rare disease, with patterns different from those found in women. Most tumors are detected at more advanced stages than in women. The aim of this study was to analyze the performance of [18F]fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) in staging, restaging, and therapy response assessment. Methods: We performed a systematic analysis in the database of Saint-Louis Hospital to identify male patients with BC referred for PET/CT. 18 F-FDG-PET/CT findings considered suspicious for malignancy were compared to biopsy results, further work-up and/or patient follow-up of at least 6 months. Performances of 18 F-FDG-PET/CT were compared to that of conventional imaging (CI) using the McNemar test. The impact of PET/CT on management was evaluated. Results: During 6 consecutive years, among 12,692 18 F-FDG-PET/CT oncology studies, 30 were performed in 15 men with BC: 7 examinations for initial staging, 11 for restaging, and 12 for response assessment. Tumors profile was ER+ and one had HER2 overexpression. PET/CT sensitivity, specificity, positive predictive value, negative predictive value and accuracy to detect distant metastases were 100%, 67%, 86%, 100% and 89%, respectively. PET/CT was more informative than CI in 40% of studies (p = 0.03; 95% confidence interval: 3.26 – 40%). Findings from 18 F-FDG-PET/CT led to modification in the planned treatment in 13/30 cases (43%). Conclusion: Although all the tumors were ER+, primary lesions and metastases were diagnosed with high sensitivity. 18 F-FDG-PET/CT seems to be a powerful imaging method to perform staging, restaging and treatment response assessment in male patients with BC

  14. {sup 18}F-FDG-PET/CT in staging, restaging, and treatment response assessment of male breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Groheux, David, E-mail: dgroheux@yahoo.fr [Department of Nuclear Medicine, Saint-Louis Hospital, Paris (France); Doctoral School of Biology and Biotechnology, University Institute of Hematology, University of Paris VII, Paris (France); Hindié, Elif [Department of Nuclear Medicine, Haut-Lévêque Hospital, CHU Bordeaux, University Bordeaux-Segalen, Bordeaux (France); Marty, Michel [Breast Diseases Unit and Department of Medical Oncology, Saint-Louis Hospital, Paris (France); Centre for Therapeutic Innovation, Saint-Louis Hospital, Paris (France); Espié, Marc [Breast Diseases Unit and Department of Medical Oncology, Saint-Louis Hospital, Paris (France); Rubello, Domenico [Department of Nuclear Medicine, Santa Maria della Misericordia, Rovigo Hospital, Rovigo (Italy); Vercellino, Laetitia [Department of Nuclear Medicine, Saint-Louis Hospital, Paris (France); Doctoral School of Biology and Biotechnology, University Institute of Hematology, University of Paris VII, Paris (France); Bousquet, Guilhem [Breast Diseases Unit and Department of Medical Oncology, Saint-Louis Hospital, Paris (France); INSERM U728, University Institute of Hematology, University of Paris VII, Paris (France); Ohnona, Jessica; Toubert, Marie-Elisabeth [Department of Nuclear Medicine, Saint-Louis Hospital, Paris (France); Merlet, Pascal [Department of Nuclear Medicine, Saint-Louis Hospital, Paris (France); Doctoral School of Biology and Biotechnology, University Institute of Hematology, University of Paris VII, Paris (France); Misset, Jean-Louis [Breast Diseases Unit and Department of Medical Oncology, Saint-Louis Hospital, Paris (France)

    2014-10-15

    Purpose: Male breast cancer (BC) is a rare disease, with patterns different from those found in women. Most tumors are detected at more advanced stages than in women. The aim of this study was to analyze the performance of [18F]fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG-PET/CT) in staging, restaging, and therapy response assessment. Methods: We performed a systematic analysis in the database of Saint-Louis Hospital to identify male patients with BC referred for PET/CT. {sup 18}F-FDG-PET/CT findings considered suspicious for malignancy were compared to biopsy results, further work-up and/or patient follow-up of at least 6 months. Performances of {sup 18}F-FDG-PET/CT were compared to that of conventional imaging (CI) using the McNemar test. The impact of PET/CT on management was evaluated. Results: During 6 consecutive years, among 12,692 {sup 18}F-FDG-PET/CT oncology studies, 30 were performed in 15 men with BC: 7 examinations for initial staging, 11 for restaging, and 12 for response assessment. Tumors profile was ER+ and one had HER2 overexpression. PET/CT sensitivity, specificity, positive predictive value, negative predictive value and accuracy to detect distant metastases were 100%, 67%, 86%, 100% and 89%, respectively. PET/CT was more informative than CI in 40% of studies (p = 0.03; 95% confidence interval: 3.26 – 40%). Findings from {sup 18}F-FDG-PET/CT led to modification in the planned treatment in 13/30 cases (43%). Conclusion: Although all the tumors were ER+, primary lesions and metastases were diagnosed with high sensitivity. {sup 18}F-FDG-PET/CT seems to be a powerful imaging method to perform staging, restaging and treatment response assessment in male patients with BC.

  15. A TIERED APPROACH TO LIFE STAGES TESTING FOR AGRICULTURAL CHEMICAL SAFERY ASSESSMENT

    Science.gov (United States)

    A proposal has been developed by the Agricultural Chemical Safety Assessment (ACSA) Technical Committee of the ILSI Health and Environmental Sciences Institute (HESI) for an improved approach to assessing the safety of crop protection chemicals. The goal is to ensure that studie...

  16. Using DEWIS and R for Multi-Staged Statistics e-Assessments

    Science.gov (United States)

    Gwynllyw, D. Rhys; Weir, Iain S.; Henderson, Karen L.

    2016-01-01

    We demonstrate how the DEWIS e-Assessment system may use embedded R code to facilitate the assessment of students' ability to perform involved statistical analyses. The R code has been written to emulate SPSS output and thus the statistical results for each bespoke data set can be generated efficiently and accurately using standard R routines.…

  17. Assessment methods for comfort of consumer products at early stages of the development process

    DEFF Research Database (Denmark)

    Stavrakos, Stavros-Konstantinos

    Design engineers who are involved in the early conceptual phase of the development of products such as seats, headphones and domestic appliances stress the increasing importance of comfort. Comfort is taken into account in the purchasing decisions of buying a chair, a bed, and when driving a car...... stages of the design process and, to investigate the factors that influence the different dimensions of comfort (physical, physiological and psychological). The investigation has been conducted in strong collaboration with an industrial partner working with ear-worn devices, providing access to data...

  18. Oxygen-enhanced MRI vs. quantitatively assessed thin-section CT: Pulmonary functional loss assessment and clinical stage classification of asthmatics

    Energy Technology Data Exchange (ETDEWEB)

    Ohno, Yoshiharu, E-mail: yosirad@kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Koyama, Hisanobu [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Matsumoto, Keiko [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Department of Radiology, University of Yamanashi, 1100, Shimogatou, Chuo, Yamanashi, 409-3898 (Japan); Onishi, Yumiko [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Nogami, Munenobu [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Division of Image-Based Medicine, Institute of Biomedical Research and Innovation, 2-2 Minatojima Minamimachi Chuo-ku, Kobe, Hyogo, 650-0047 (Japan); Takenaka, Daisuke; Matsumoto, Sumiaki; Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan)

    2011-01-15

    Purpose: The purpose of this study was to prospectively compare the efficacy of oxygen-enhanced MR imaging (O{sub 2}-enhanced MRI) and CT for pulmonary functional loss assessment and clinical stage classification of asthmatics. Materials and methods: O{sub 2}-enhanced MRI, CT and %FEV{sub 1} measurement were used 34 consecutive asthmatics classified into four stages ('Mild Intermittent [n = 7]', 'Mild Persistent [n = 8], 'Moderate Persistent [n = 14]' and 'Severe Persistent [n = 5]'). Relative enhancement ratio maps for every subject were generated, and determine mean relative enhancement ratios (MRERs). Mean lung density (MLD) and the airway wall area (WA) corrected by body surface area (WA/BSA) were also measured on CT. To compare the efficacy of the two methods for pulmonary functional loss assessment, all indexes were correlated with %FEV{sub 1}. To determine the efficacy of the two methods for clinical stage classification, all parameters for the four clinical stages were statistically compared. Results: %FEV{sub 1} showed fair or moderate correlation with all parameters (0.15 {<=} r{sup 2} {<=} 0.30, p < 0.05). WA, WA/BSA and MRER of the 'Severe Persistent' group were significantly larger than those of 'Mild Intermittent' and 'Mild Persistent' groups (p < 0.05), and MRER of the 'Moderate Persistent' group significantly lower than that of the 'Mild Intermittent' group (p < 0.05). Conclusion: O{sub 2}-enhanced MRI is as effective as CT for pulmonary functional loss assessment and clinical stage classification of asthmatics.

  19. Assessment of Estimation Methods ForStage-Discharge Rating Curve in Rippled Bed Rivers

    Directory of Open Access Journals (Sweden)

    P. Maleki

    2016-02-01

    Full Text Available Introduction: Interactionbetweenwater flow characteristics andthe bed erodibilityplays an important role in sediment transport process. In order to reach stability, rivers with deposition or bottom erosion make a different bed form in the riverbed. One way to identify thebehavior of therivers is to study the structure and formation of bed forms within them. Ripples are the smallest of the bed forms. The longitudinal cross section of ripples are usually not symmetrical. The upstream face is long and has a gentle slope, and the downstream face is short and steep. The height of ripples is usually between 0.5 cm and 2 cm; the height ripple is not more than 5 cm. The wave lengths normally do not exceed 30cm, and they are usually within the range of 1 cm to 15 cm. Their occurrence is the result of the unstable viscous layer near the boundary. They can form in both shallow and deep water.With an increase of the flow velocity, the plan form of the ripples gradually develops form straight line to curves and then to a pattern like fish scales, symmetrical or unsymmetrical, as shown in Fig 1. Figure1-The patterndevelopment oftheripple Raudkivi (1966 was the first person that, the flow structure over ripples was investigated experimentally.Hethenestablishseveraldifferent conditionsonthemovingsandbedinanlaboratorychannelconsisted of a rectangular cross-section with base width of 70cm, wasable toform arow ofripples , he wassucceed toform arow ofripples.JafariMianaei and Keshavarzi(2008,studied the turbulentflow betweentwoartificialripples for investigate the change of kinetic energyandshearstress on overripples. The stage- discharge rating curve is one of the most important tools in the hydraulic studies. In alluvial rivers,bed rippled are formed and significantly affect the stage- discharge rating curve. In this research, the effects of two different type of ripples (parallel and flakeshape onthe hydraulic characteristicsof flow were experimentally studied

  20. Assessment of the effect of salinity on the early growth stage of the ...

    African Journals Online (AJOL)

    SERVER

    2008-03-18

    Mar 18, 2008 ... The results showed that plant growth decreased proportionally with increasing ... Therefore, agriculturalists can assess growth rate changes caused by salinity using remote .... pH of all solutions was adjusted to 6. De-ionized ...

  1. Seismic reliability assessment of RC structures including soil–structure interaction using wavelet weighted least squares support vector machine

    International Nuclear Information System (INIS)

    Khatibinia, Mohsen; Javad Fadaee, Mohammad; Salajegheh, Javad; Salajegheh, Eysa

    2013-01-01

    An efficient metamodeling framework in conjunction with the Monte-Carlo Simulation (MCS) is introduced to reduce the computational cost in seismic reliability assessment of existing RC structures. In order to achieve this purpose, the metamodel is designed by combining weighted least squares support vector machine (WLS-SVM) and a wavelet kernel function, called wavelet weighted least squares support vector machine (WWLS-SVM). In this study, the seismic reliability assessment of existing RC structures with consideration of soil–structure interaction (SSI) effects is investigated in accordance with Performance-Based Design (PBD). This study aims to incorporate the acceptable performance levels of PBD into reliability theory for comparing the obtained annual probability of non-performance with the target values for each performance level. The MCS method as the most reliable method is utilized to estimate the annual probability of failure associated with a given performance level in this study. In WWLS-SVM-based MCS, the structural seismic responses are accurately predicted by WWLS-SVM for reducing the computational cost. To show the efficiency and robustness of the proposed metamodel, two RC structures are studied. Numerical results demonstrate the efficiency and computational advantages of the proposed metamodel for the seismic reliability assessment of structures. Furthermore, the consideration of the SSI effects in the seismic reliability assessment of existing RC structures is compared to the fixed base model. It shows which SSI has the significant influence on the seismic reliability assessment of structures.

  2. Preoperatively Assessable Clinical and Pathological Risk Factors for Parametrial Involvement in Surgically Treated FIGO Stage IB-IIA Cervical Cancer.

    Science.gov (United States)

    Canaz, Emel; Ozyurek, Eser Sefik; Erdem, Baki; Aldikactioglu Talmac, Merve; Yildiz Ozaydin, Ipek; Akbayir, Ozgur; Numanoglu, Ceyhun; Ulker, Volkan

    2017-10-01

    Determining the risk factors associated with parametrial involvement (PMI) is of paramount importance to decrease the multimodality treatment in early-stage cervical cancer. We investigated the preoperatively assessable clinical and pathological risk factors associated with PMI in surgically treated stage IB1-IIA2 cervical cancer. A retrospective cohort study of women underwent Querleu-Morrow type C hysterectomy for cervical cancer stage IB1-IIA2 from 2001 to 2015. All patients underwent clinical staging examination under anesthesia by the same gynecological oncologists during the study period. Evaluated variables were age, menopausal status, body mass index, smoking status, FIGO (International Federation of Obstetrics and Gynecology) stage, clinically measured maximal tumor diameter, clinical presentation (exophytic or endophytic tumor), histological type, tumor grade, lymphovascular space invasion, clinical and pathological vaginal invasion, and uterine body involvement. Endophytic clinical presentation was defined for ulcerative tumors and barrel-shaped morphology. Two-dimensional transvaginal ultrasonography was used to measure tumor dimensions. Of 127 eligible women, 37 (29.1%) had PMI. On univariate analysis, endophytic clinical presentation (P = 0.01), larger tumor size (P PMI. In multivariate analysis endophytic clinical presentation (odds ratio, 11.34; 95% confidence interval, 1.34-95.85; P = 0.02) and larger tumor size (odds ratio, 32.31; 95% confidence interval, 2.46-423.83; P = 0.008) were the independent risk factors for PMI. Threshold of 31 mm in tumor size predicted PMI with 71% sensitivity and 75% specificity. We identified 18 patients with tumor size of more than 30 mm and endophytic presentation; 14 (77.7%) of these had PMI. Endophytic clinical presentation and larger clinical tumor size (>3 cm) are independent risk factors for PMI in stage IB-IIA cervical cancer. Approximately 78% of the patients with a tumor size of more than 3 cm and endophytic

  3. Assessment of persistent organic pollutants accumulation and lipid peroxidation in two reproductive stages of wild silverside (Odontesthes bonariensis).

    Science.gov (United States)

    Barni, María Florencia Silva; Gonzalez, Mariana; Miglioranza, Karina S B

    2014-01-01

    Persistent organic pollutants (POPs) in streamwater can sometimes exceed the guidelines values reported for biota and human protection in watersheds with intensive agriculture. Oxidative stress and cytotoxicity are some of the markers of exposure to POPs in fish. Accumulation of organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) as well as lipid peroxidation (LPO) was assessed in wild silverside (Odontesthes bonariensis) from maturation and pre-spawning stages sampled in a typical soybean growing area. Pollutants were quantified by gas chromatography with electron capture detection and LPO by the method of thiobarbituric acid reactive substances. Concentrations of POPs were in the following order: OCPs>PCBs>PBDEs in all organs and stages. Liver, gills and gonads had the highest OCP concentrations in both sexes and stages with a predominance of endosulfan in all samples. Matured individuals, sampled after endosulfan application period, showed higher endosulfan concentrations than pre-spawning individuals. The predominance of endosulfan sulfate could be due to direct uptake from diet and water column, as well as to the metabolism of the parent compounds in fish. The prevalence of p,p'-DDE in liver would also reflect both the direct uptake and the metabolic transformation of p,p'-DDT to p,p'-DDE by fish. The highest levels of PBDEs and PCBs were found in gills and brain of both stages of growth. The pattern BDE-47>BDE-100 in all samples corresponds to pentaBDE exposure. In the case of PCBs, penta (#101 and 110) and hexa-CB congeners (#153 and 138) dominated in the maturation stages and tri (#18) and tetra-CB (#44 and 52) in pre-spawning stages, suggesting biotransformation or preferential accumulation of heavier congeners during gonadal development. Differences in LPO levels in ovaries were associated with growth dilution and reproductive stage. Differences in LPO levels in gills were related with pesticide

  4. Bioeconomy with algae - Life cycle sustainability assessment including biophysical climate impacts (ALBEDO) of an algae-based biorefinery

    NARCIS (Netherlands)

    Hingsamer, Maria; Bird, Neil; Kaltenegger, Ingrid; Jungmeier, Gerfried; Kleinegris, Dorinde; Lamers, Packo; Boussiba, Sammy; Rodolfi, Liliana; Norsker, Niels Henrik; Jacobs, Fons; Fenton, Marcus; Ranjbar, Reza; Hujanen, Mervi; Sanz, Macarena

    2017-01-01

    The viability of using microalgae for energy production depends on the overall sustainability (environmental, economic, social). The project FUEL4ME applies a life cycle sustainability assessment (LCSA) providing scientific indicators for economic (e.g. operational costs, investment cost, trade

  5. Including a Service Learning Educational Research Project in a Biology Course-I: Assessing Community Awareness of Childhood Lead Poisoning

    Science.gov (United States)

    Abu-Shakra, Amal; Saliim, Eric

    2012-01-01

    A university course project was developed and implemented in a biology course, focusing on environmental problems, to assess community awareness of childhood lead poisoning. A set of 385 questionnaires was generated and distributed in an urban community in North Carolina, USA. The completed questionnaires were sorted first into yes and no sets…

  6. A manufacturing quality assessment model based-on two stages interval type-2 fuzzy logic

    Science.gov (United States)

    Purnomo, Muhammad Ridwan Andi; Helmi Shintya Dewi, Intan

    2016-01-01

    This paper presents the development of an assessment models for manufacturing quality using Interval Type-2 Fuzzy Logic (IT2-FL). The proposed model is developed based on one of building block in sustainable supply chain management (SSCM), which is benefit of SCM, and focuses more on quality. The proposed model can be used to predict the quality level of production chain in a company. The quality of production will affect to the quality of product. Practically, quality of production is unique for every type of production system. Hence, experts opinion will play major role in developing the assessment model. The model will become more complicated when the data contains ambiguity and uncertainty. In this study, IT2-FL is used to model the ambiguity and uncertainty. A case study taken from a company in Yogyakarta shows that the proposed manufacturing quality assessment model can work well in determining the quality level of production.

  7. In Situ Estuarine and Marine Toxicity Testing: A Review, Including Recommendations for Future Use in Ecological Risk Assessment

    Science.gov (United States)

    2009-09-01

    field and microcosms than they do under laboratory test conditions. In the case of tributyltin ( TBT ) exposures in San Diego Bay, he found that...TECHNICAL REPORT 1986 September 2009 In Situ Estuarine and Marine Toxicity Testing A Review, Including Recommendations for Future Use in...Pacific TECHNICAL REPORT 1986 September 2009 In Situ Estuarine and Marine Toxicity Testing A Review, Including Recommendations for Future Use in

  8. Bioenergy from crops and biomass residues: a consequential life-cycle assessment including land-use changes

    DEFF Research Database (Denmark)

    Tonini, Davide; Astrup, Thomas Fruergaard

    Biofuels are promising means to reduce fossil fuel depletion and mitigate greenhouse-gas (GHG) emissions. However, recent studies questioned the environmental benefits earlier attributed to biofuels, when these involve land-use changes (direct/indirect, i.e., dLUC/iLUC) (1-5). Yet, second...... to represent the actual environmental impacts. This study quantified the GHG emissions associated with a number of scenarios involving bioenergy production (as combined-heat-and-power, heating, and transport biofuel) from energy crops, industrial/agricultural residues, algae, and the organic fraction...... of municipal solid waste. Four conversion pathways were considered: combustion, fermentation-to-ethanol, fermentation-to-biogas, and thermal gasification. A total of 80 bioenergy scenarios were assessed. Consequential life-cycle assessment (CLCA) was used to quantify the environmental impacts. CLCA aimed...

  9. High water-stressed population estimated by world water resources assessment including human activities under SRES scenarios

    Science.gov (United States)

    Kiguchi, M.; Shen, Y.; Kanae, S.; Oki, T.

    2009-04-01

    In an argument of the reduction and the adaptation for the climate change, the evaluation of the influence by the climate change is important. When we argue in adaptation plan from a damage scale and balance with the cost, it is particularly important. Parry et al (2001) evaluated the risks in shortage of water, malaria, food, the risk of the coast flood by temperature function and clarified the level of critical climate change. According to their evaluation, the population to be affected by the shortage of water suddenly increases in the range where temperature increases from 1.5 to 2.0 degree in 2080s. They showed how much we need to reduce emissions in order to draw-down significantly the number at risk. This evaluation of critical climate change threats and targets of water shortage did not include the water withdrawal divided by water availability. Shen et al (2008a) estimated the water withdrawal of projection of future world water resources according to socio-economic driving factors predicted for scenarios A1b, A2, B1, and B2 of the Special Report on Emission Scenarios (SRES). However, these results were in function of not temperature but time. The assessment of the highly water-stressed population considered the socioeconomic development is necessary for a function of the temperature. Because of it is easy to understand to need to reduce emission. We present a multi-GCM analysis of the global and regional populations lived in highly water-stressed basin for a function of the temperature using the socioeconomic data and the outputs of GCMs. In scenario A2, the population increases gradually with warming. On the other hand, the future projection population in scenario A1b and B1 increase gradually until the temperature anomaly exceeds around from +1 to +1.5 degree. After that the population is almost constant. From Shen et al (2008b), we evaluated the HWSP and its ratio in the world with temperature function for scenarios A1B, A2, and B1 by the index of W

  10. Including the effects of filamentous bulking sludge during the simulation of wastewater treatment plants using a risk assessment model

    DEFF Research Database (Denmark)

    Flores Alsina, Xavier; Comas, J.; Rodriquez-Roda, I.

    2009-01-01

    The main objective of this paper is to demonstrate how including the occurrence of filamentous bulking sludge in a secondary clarifier model will affect the predicted process performance during the simulation of WWTPs. The IWA Benchmark Simulation Model No. 2 (BSM2) is hereby used as a simulation...... are automatically changed during the simulation by modifying the settling model parameters to mimic the effect of growth of filamentous bacteria. The simulation results demonstrate that including effects of filamentous bulking in the secondary clarifier model results in a more realistic plant performance...

  11. Social Values for Ecosystem Services (SolVES): using GIS to include social values information in ecosystem services assessments

    Science.gov (United States)

    Sherrouse, B.C.; Semmens, D.J.

    2010-01-01

    Ecosystem services can be defined in various ways; simply put, they are the benefits provided by nature, which contribute to human well-being. These benefits can range from tangible products such as food and fresh water to cultural services such as recreation and esthetics. As the use of these benefits continues to increase, additional pressures are placed on the natural ecosystems providing them. This makes it all the more important when assessing possible tradeoffs among ecosystem services to consider the human attitudes and preferences that express underlying social values associated with their benefits. While some of these values can be accounted for through economic markets, other values can be more difficult to quantify, and attaching dollar amounts to them may not be very useful in all cases. Regardless of the processes or units used for quantifying such values, the ability to map them across the landscape and relate them to the ecosystem services to which they are attributed is necessary for effective assessments. To address some of the needs associated with quantifying and mapping social values for inclusion in ecosystem services assessments, scientists at the Rocky Mountain Geographic Science Center (RMGSC), in collaboration with Colorado State University, have developed a public domain tool, Social Values for Ecosystem Services (SolVES). SolVES is a geographic information system (GIS) application designed to use data from public attitude and preference surveys to assess, map, and quantify social values for ecosystem services. SolVES calculates and maps a 10-point Value Index representing the relative perceived social values of ecosystem services such as recreation and biodiversity for various groups of ecosystem stakeholders. SolVES output can also be used to identify and model relationships between social values and physical characteristics of the underlying landscape. These relationships can then be used to generate predicted Value Index maps for areas

  12. Assessment of emerging contaminants including organophosphate esters and pyrethroids during DISCOVER-AQ in Houston, Texas, United States.

    Science.gov (United States)

    Usenko, Sascha; Clark, Addie; Sheesley, Rebecca

    2015-04-01

    DISCOVER-AQ (Deriving Information on Surface conditions from Column and Vertically Resolved Observations Relevant to Air Quality) is a NASA-funded air quality research program that focused on Houston, Texas, United States in September 2013. In conjunction with DISCOVER-AQ, particulate matter was collected for the month of September from four ground-based sampling sites across the Houston metropolitan area. The Houston metropolitan area is one of the most populous cities in the United States. Sampling sites included an upwind and downwind site as well as an urban (i.e. downtown) and industrial/port areas (i.e. Houston Ship Channel). Particulate matter samples were collected to examine both spatial and temporal trends (including day versus night). Particulate matter was collected on quartz fiber filters, which were analyzed for emerging classes of concern including organophosphate esters (OPEs; including flame retardants) and pyrethroids. OPEs have in recent years increased in both use and production as they replaced polybrominated diphenyl ethers flame retardants. Permethrin is one of the most commonly used mosquito adulticides in the United States.

  13. Method for assessment of stormwater treatment facilities - Synthetic road runoff addition including micro-pollutants and tracer.

    Science.gov (United States)

    Cederkvist, Karin; Jensen, Marina B; Holm, Peter E

    2017-08-01

    Stormwater treatment facilities (STFs) are becoming increasingly widespread but knowledge on their performance is limited. This is due to difficulties in obtaining representative samples during storm events and documenting removal of the broad range of contaminants found in stormwater runoff. This paper presents a method to evaluate STFs by addition of synthetic runoff with representative concentrations of contaminant species, including the use of tracer for correction of removal rates for losses not caused by the STF. A list of organic and inorganic contaminant species, including trace elements representative of runoff from roads is suggested, as well as relevant concentration ranges. The method was used for adding contaminants to three different STFs including a curbstone extension with filter soil, a dual porosity filter, and six different permeable pavements. Evaluation of the method showed that it is possible to add a well-defined mixture of contaminants despite different field conditions by having a flexibly system, mixing different stock-solutions on site, and use bromide tracer for correction of outlet concentrations. Bromide recovery ranged from only 12% in one of the permeable pavements to 97% in the dual porosity filter, stressing the importance of including a conservative tracer for correction of contaminant retention values. The method is considered useful in future treatment performance testing of STFs. The observed performance of the STFs is presented in coming papers. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Vulnerability assessment including tangible and intangible components in the index composition: An Amazon case study of flooding and flash flooding.

    Science.gov (United States)

    Andrade, Milena Marília Nogueira de; Szlafsztein, Claudio Fabian

    2018-07-15

    The vulnerability of cities and communities in the Amazon to flooding and flash flooding is increasing. The effects of extreme events on populations vary across landscapes, causing vulnerability to differ spatially. Traditional vulnerability studies in Brazil and across the world have used the vulnerability index for the country and, more recently, municipality scales. The vulnerability dimensions are exposure, sensitivity, and adaptive capacity. For each of these dimensions, there is a group of indicators that constitutes a vulnerability index using quantitative data. Several vulnerability assessments have used sensitivity and exposure analyses and, recently, adaptive capacity has been considered. The Geographical Information Systems (GIS) analysis allows spatial regional modeling using quantitative vulnerability indicators. This paper presents a local-scale vulnerability assessment in an urban Amazonian area, Santarém City, using interdisciplinary methods. Data for exposure and sensitivity were gathered by remote sensing and census data, respectively. However, adaptive capacity refers to local capacities, whether infrastructural or not, and the latter were gathered by qualitative participatory methods. For the mixed data used to study adaptive capacity, we consider tangible components for countable infrastructure that can cope with hazards, and intangible components that reflect social activities based on risk perceptions and collective action. The results indicate that over 80% of the area is highly or moderately vulnerable to flooding and flash flooding. Exposure and adaptive capacity were determinants of the results. Lower values of adaptive capacity play a significant role in vulnerability enhancement. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. The utility of PET/CT in staging and assessment of treatment response of naso pharyngeal cancer

    International Nuclear Information System (INIS)

    Law, Alastair; Peters, L.J.; Dutu, Gaelle; Rischin, Danny; Lau, Eddie; Drummond, Elizabeth; Corry, June

    2011-01-01

    Full text: The aim of this study was to evaluate the impact of positron emission tomography/computerised tomography (PET/CT) as an adjunct to conventional imaging (CI) in the management of nasopharyngeal cancer (NPC) both for initial staging and assessment of post-treatment response. Methods: All NPC cases referred to the Peter MacCallum Centre for Metabolic Imaging between January 2002 and December 2007 were identified, In patients undergoing initial staging, any differences between the pre PET/CT management plan based on CI and that following performance of the PET/CT scan were noted. Clinical impact was scored using the Centre's published criteria: 'high' if PET /CT changed the primary treatment modality or intent, 'medium' if treatment modality was unchanged but the radiotherapy technique or dose was altered, and 'low' if there was no change in treatment modality or intent. Patients undergoing PET/CT following definitive treatment were scored according to whether or not they achieved a complete metabolic response. Results: Forty-eight patients underwent a staging PET/CT. The clinical impact was high in 8%, medium in 25% and low in 66% of patients. Twenty-one patients were scanned for post-treatment response. PET/CT was less frequently equivocal than MRI (3 vs 8/21). A complete metabolic response on PET /CT was associated with a 93% negative predictive value for subsequent recurrence. Conclusion: PET /CT is a valuable staging tool for the detection of occult metastatic disease and defining the extent of neck nodal disease, Pos treatment, a complete metabolic response on PET /CT has a very high negative predictive value with fewer equivocal results than MRI.

  16. Assessing the dream-lag effect for REM and NREM stage 2 dreams.

    Science.gov (United States)

    Blagrove, Mark; Fouquet, Nathalie C; Henley-Einion, Josephine A; Pace-Schott, Edward F; Davies, Anna C; Neuschaffer, Jennifer L; Turnbull, Oliver H

    2011-01-01

    This study investigates evidence, from dream reports, for memory consolidation during sleep. It is well-known that events and memories from waking life can be incorporated into dreams. These incorporations can be a literal replication of what occurred in waking life, or, more often, they can be partial or indirect. Two types of temporal relationship have been found to characterize the time of occurrence of a daytime event and the reappearance or incorporation of its features in a dream. These temporal relationships are referred to as the day-residue or immediate incorporation effect, where there is the reappearance of features from events occurring on the immediately preceding day, and the dream-lag effect, where there is the reappearance of features from events occurring 5-7 days prior to the dream. Previous work on the dream-lag effect has used spontaneous home recalled dream reports, which can be from Rapid Eye Movement Sleep (REM) and from non-Rapid Eye Movement Sleep (NREM). This study addresses whether the dream-lag effect occurs only for REM sleep dreams, or for both REM and NREM stage 2 (N2) dreams. 20 participants kept a daily diary for over a week before sleeping in the sleep laboratory for 2 nights. REM and N2 dreams collected in the laboratory were transcribed and each participant rated the level of correspondence between every dream report and every diary record. The dream-lag effect was found for REM but not N2 dreams. Further analysis indicated that this result was not due to N2 dream reports being shorter, in terms of number of words, than the REM dream reports. These results provide evidence for a 7-day sleep-dependent non-linear memory consolidation process that is specific to REM sleep, and accord with proposals for the importance of REM sleep to emotional memory consolidation.

  17. Assessing the Dream-Lag Effect for REM and NREM Stage 2 Dreams

    Science.gov (United States)

    Blagrove, Mark; Fouquet, Nathalie C.; Henley-Einion, Josephine A.; Pace-Schott, Edward F.; Davies, Anna C.; Neuschaffer, Jennifer L.; Turnbull, Oliver H.

    2011-01-01

    This study investigates evidence, from dream reports, for memory consolidation during sleep. It is well-known that events and memories from waking life can be incorporated into dreams. These incorporations can be a literal replication of what occurred in waking life, or, more often, they can be partial or indirect. Two types of temporal relationship have been found to characterize the time of occurrence of a daytime event and the reappearance or incorporation of its features in a dream. These temporal relationships are referred to as the day-residue or immediate incorporation effect, where there is the reappearance of features from events occurring on the immediately preceding day, and the dream-lag effect, where there is the reappearance of features from events occurring 5–7 days prior to the dream. Previous work on the dream-lag effect has used spontaneous home recalled dream reports, which can be from Rapid Eye Movement Sleep (REM) and from non-Rapid Eye Movement Sleep (NREM). This study addresses whether the dream-lag effect occurs only for REM sleep dreams, or for both REM and NREM stage 2 (N2) dreams. 20 participants kept a daily diary for over a week before sleeping in the sleep laboratory for 2 nights. REM and N2 dreams collected in the laboratory were transcribed and each participant rated the level of correspondence between every dream report and every diary record. The dream-lag effect was found for REM but not N2 dreams. Further analysis indicated that this result was not due to N2 dream reports being shorter, in terms of number of words, than the REM dream reports. These results provide evidence for a 7-day sleep-dependent non-linear memory consolidation process that is specific to REM sleep, and accord with proposals for the importance of REM sleep to emotional memory consolidation. PMID:22046336

  18. Assessing the dream-lag effect for REM and NREM stage 2 dreams.

    Directory of Open Access Journals (Sweden)

    Mark Blagrove

    Full Text Available This study investigates evidence, from dream reports, for memory consolidation during sleep. It is well-known that events and memories from waking life can be incorporated into dreams. These incorporations can be a literal replication of what occurred in waking life, or, more often, they can be partial or indirect. Two types of temporal relationship have been found to characterize the time of occurrence of a daytime event and the reappearance or incorporation of its features in a dream. These temporal relationships are referred to as the day-residue or immediate incorporation effect, where there is the reappearance of features from events occurring on the immediately preceding day, and the dream-lag effect, where there is the reappearance of features from events occurring 5-7 days prior to the dream. Previous work on the dream-lag effect has used spontaneous home recalled dream reports, which can be from Rapid Eye Movement Sleep (REM and from non-Rapid Eye Movement Sleep (NREM. This study addresses whether the dream-lag effect occurs only for REM sleep dreams, or for both REM and NREM stage 2 (N2 dreams. 20 participants kept a daily diary for over a week before sleeping in the sleep laboratory for 2 nights. REM and N2 dreams collected in the laboratory were transcribed and each participant rated the level of correspondence between every dream report and every diary record. The dream-lag effect was found for REM but not N2 dreams. Further analysis indicated that this result was not due to N2 dream reports being shorter, in terms of number of words, than the REM dream reports. These results provide evidence for a 7-day sleep-dependent non-linear memory consolidation process that is specific to REM sleep, and accord with proposals for the importance of REM sleep to emotional memory consolidation.

  19. A pilot study of dentists' assessment of caries detection and staging systems applied to early caries: PEARL Network findings.

    Science.gov (United States)

    Thompson, Van P; Schenkel, Andrew B; Penugonda, Bapanaiah; Wolff, Mark S; Zeller, Gregory G; Wu, Hongyu; Vena, Don; Grill, Ashley C; Curro, Frederick A

    2016-01-01

    The International Caries Detection and Assessment System (ICDAS II) and the Caries Classification System (CCS) are caries stage description systems proposed for adoption into clinical practice. This pilot study investigated clinicians' training in and use of these systems for detection of early caries and recommendations for individual tooth treatment. Patient participants (N = 8) with a range of noncavitated lesions (CCS ranks 2 and 4 and ICDAS II ranks 2-4) identified by a team of calibrated examiners were recruited from the New York University College of Dentistry clinic. Eighteen dentists-8 from the Practitioners Engaged in Applied Research and Learning (PEARL) Network and 10 recruited from the Academy of General Dentistry-were randomly assigned to 1 of 3 groups: 5 dentists used only visual-tactile (VT) examination, 7 were trained in the ICDAS II, and 6 were trained in the CCS. Lesion stage for each tooth was determined by the ICDAS II and CCS groups, and recommended treatment was decided by all groups. Teeth were assessed both with and without radiographs. Caries was detected in 92.7% (95% CI, 88%-96%) of the teeth by dentists with CCS training, 88.8% (95% CI, 84%-92%) of the teeth by those with ICDAS II training, and 62.3% (95% CI, 55%-69%) of teeth by the VT group. Web-based training was acceptable to all dentists in the CCS group (6 of 6) but fewer of the dentists in the ICDAS II group (5 of 7). The modified CCS translated clinically to more accurate caries detection, particularly compared to detection by untrained dentists (VT group). Moreover, the CCS was more accepted than was the ICDAS II, but dentists in both groups were open to the application of these systems. Agreement on caries staging requires additional training prior to a larger validation study.

  20. Quality assessment of delineation and dose planning of early breast cancer patients included in the randomized Skagen Trial 1

    DEFF Research Database (Denmark)

    Francolini, Giulio; Thomsen, Mette S; Yates, Esben S

    2017-01-01

    , Dmax, D98%, D95% and D2%) from randomly selected dose plans were assessed. Target volume delineation according to ESTRO guidelines was obtained through atlas based automated segmentation and centrally approved as gold standard (GS). Dice similarity scores (DSC) with original delineations were measured....... No deviations in the dosimetric outcome were found in 76% of the patients, 82% and 95% of the patients had successful coverage of breast/chestwall and CTVn_L2-4-interpectoral. Dosimetric outcomes of original delineation and GS were comparable. CONCLUSIONS: QA showed high protocol compliance and adequate dose...... coverage in most patients. Inter-observer variability in contouring was low. Dose parameters were in harmony with protocol regardless original or GS segmentation....

  1. A study of fish and shellfish consumers near Sellafield: assessment of the critical groups including consideration of children

    International Nuclear Information System (INIS)

    Leonard, D.R.P.; Hunt, G.J.

    1985-01-01

    A survey of people's consumption rates in 1981 and 1982, of fish and shellfish caught near the British Nuclear Fuels plc (BNFL) Sellafield site is described. Particular emphasis has been given to mollusc eaters and consumption rates of children because of the potentially higher radiation doses they may receive. Appropriate critical groups have been selected for dose assessment purposes using principles recommended by the International Commission on Radiological Protection (ICRP). Methods for consideration of children in critical groups are suggested and a comparison of these methods using the present data shows similar results. Combination of seafood consumption pathways is also considered, and it is shown that a simple additive approach is not excessively conservative. (author)

  2. Probabilistic seismic safety assessment of a CANDU 6 nuclear power plant including ambient vibration tests: Case study

    Energy Technology Data Exchange (ETDEWEB)

    Nour, Ali [Hydro Québec, Montréal, Québec H2L4P5 (Canada); École Polytechnique de Montréal, Montréal, Québec H3C3A7 (Canada); Cherfaoui, Abdelhalim; Gocevski, Vladimir [Hydro Québec, Montréal, Québec H2L4P5 (Canada); Léger, Pierre [École Polytechnique de Montréal, Montréal, Québec H3C3A7 (Canada)

    2016-08-01

    Highlights: • In this case study, the seismic PSA methodology adopted for a CANDU 6 is presented. • Ambient vibrations testing to calibrate a 3D FEM and to reduce uncertainties is performed. • Procedure for the development of FRS for the RB considering wave incoherency effect is proposed. • Seismic fragility analysis for the RB is presented. - Abstract: Following the 2011 Fukushima Daiichi nuclear accident in Japan there is a worldwide interest in reducing uncertainties in seismic safety assessment of existing nuclear power plant (NPP). Within the scope of a Canadian refurbishment project of a CANDU 6 (NPP) put in service in 1983, structures and equipment must sustain a new seismic demand characterised by the uniform hazard spectrum (UHS) obtained from a site specific study defined for a return period of 1/10,000 years. This UHS exhibits larger spectral ordinates in the high-frequency range than those used in design. To reduce modeling uncertainties as part of a seismic probabilistic safety assessment (PSA), Hydro-Québec developed a procedure using ambient vibrations testing to calibrate a detailed 3D finite element model (FEM) of the containment and reactor building (RB). This calibrated FE model is then used for generating floor response spectra (FRS) based on ground motion time histories compatible with the UHS. Seismic fragility analyses of the reactor building (RB) and structural components are also performed in the context of a case study. Because the RB is founded on a large circular raft, it is possible to consider the effect of the seismic wave incoherency to filter out the high-frequency content, mainly above 10 Hz, using the incoherency transfer function (ITF) method. This allows reducing significantly the non-necessary conservatism in resulting FRS, an important issue for an existing NPP. The proposed case study, and related methodology using ambient vibration testing, is particularly useful to engineers involved in seismic re-evaluation of

  3. [Training of residents in obstetrics and gynecology: Assessment of an educational program including formal lectures and practical sessions using simulators].

    Science.gov (United States)

    Jordan, A; El Haloui, O; Breaud, J; Chevalier, D; Antomarchi, J; Bongain, A; Boucoiran, I; Delotte, J

    2015-01-01

    Evaluate an educational program in the training of residents in gynecology-obstetrics (GO) with a theory session and a practical session on simulators and analyze their learning curve. Single-center prospective study, at the university hospital (CHU). Two-day sessions were leaded in April and July 2013. An evaluation on obstetric and gynecological surgery simulator was available to all residents. Theoretical knowledge principles of obstetrics were evaluated early in the session and after formal lectures was taught to them. At the end of the first session, a satisfaction questionnaire was distributed to all participants. Twenty residents agreed to participate to the training sessions. Evaluation of theoretical knowledge: at the end of the session, the residents obtained a significant improvement in their score on 20 testing knowledge. Obstetrical simulator: a statistically significant improvement in scores on assessments simulator vaginal delivery between the first and second session. Subjectively, a larger increase feeling was seen after breech delivery simulation than for the cephalic vaginal delivery. However, the confidence level of the resident after breech delivery simulation has not been improved at the end of the second session. Simulation in gynecological surgery: a trend towards improvement in the time realized on the peg-transfer between the two sessions was noted. In the virtual simulation, no statistically significant differences showed, no improvement for in salpingectomy's time. Subjectively, the residents felt an increase in the precision of their gesture. Satisfaction: All residents have tried the whole program. They considered the pursuit of these sessions on simulators was necessary and even mandatory. The approach chosen by this structured educational program allowed a progression for the residents, both objectively and subjectively. This simulation program type for the resident's training would use this tool in assessing their skills and develop

  4. Raman Spectral Characteristics of Oil-Paper Insulation and Its Application to Ageing Stage Assessment of Oil-Immersed Transformers

    Directory of Open Access Journals (Sweden)

    Jingxin Zou

    2016-11-01

    Full Text Available The aging of oil-paper insulation in power transformers may cause serious power failures. Thus, effective monitoring of the condition of the transformer insulation is the key to prevent major accidents. The purpose of this study was to explore the feasibility of confocal laser Raman spectroscopy (CLRS for assessing the aging condition of oil-paper insulation. Oil-paper insulation samples were subjected to thermal accelerated ageing at 120 °C for up to 160 days according to the procedure described in the IEEE Guide. Meanwhile, the dimension of the Raman spectrum of the insulation oil was reduced by principal component analysis (PCA. The 160 oil-paper insulation samples were divided into five aging stages as training samples by clustering analysis and with the use of the degree of polymerization of the insulating papers. In addition, the features of the Raman spectrum were used as the inputs of a multi-classification support vector machine. Finally, 105 oil-paper insulation testing samples aged at a temperature of 130 °C were used to further test the diagnostic capability and universality of the established algorithm. Results demonstrated that CLRS in conjunction with the PCA-SVM technique provides a new way for aging stage assessment of oil-paper insulation equipment in the field.

  5. Biomarkers as a tool to assess effects of chromium (VI): comparison of responses in zebrafish early life stages and adults.

    Science.gov (United States)

    Domingues, Inês; Oliveira, Rhaul; Lourenço, Joana; Grisolia, Cesar Koppe; Mendo, Sónia; Soares, A M V M

    2010-09-01

    The present work aims to compare the sensitivity of embryos and adult zebrafish to chromium (VI) (as potassium dichromate) focusing on biomarkers (cholinesterase, glutathione S-transferase and lactate dehydrogenase) as endpoints. Zebrafish eggs showed less sensitivity to Cr (VI) (96 h-LC50=145.7 mg/L) than adults (96 h-LC50=39.4 mg/L) probably due to the protective action of the chorion. However, biomarkers were much more responsive in larvae than in adults and gave clear indications about Cr (VI) mode of action: it seems to be neurotoxic (inhibited cholinesterase), to inhibit glutathione S-transferase activity and to interfere with cellular metabolic activity (changes in lactate dehydrogenase activity) in larvae. In adults, only glutathione S-transferase was responsive, showing a clear inhibition. The responsiveness of the analyzed biomarkers in larvae reinforces the idea of the usefulness of early life stage assays in the assessment of chemicals effects. Moreover, early life stage assays also contributed with relevant information regarding anomalies in larvae development and behavior. Further research should focus on the use of biomarkers to assess long term effects which are ecologically more relevant. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  6. Older Adults' Perceptions of and Preferences for a Fall Risk Assessment System: Exploring Stages of Acceptance Model.

    Science.gov (United States)

    Galambos, Colleen; Rantz, Marilyn; Back, Jessie; Jun, Jung Sim; Skubic, Marjorie; Miller, Steven J

    2017-07-01

    Aging in place is a preferred and cost-effective living option for older adults. Research indicates that technology can assist with this goal. Information on consumer preferences will help in technology development to assist older adults to age in place. The study aim was to explore the perceptions and preferences of older adults and their family members about a fall risk assessment system. Using a qualitative approach, this study examined the perceptions, attitudes, and preferences of 13 older adults and five family members about their experience living with the fall risk assessment system during five points in time. Themes emerged in relation to preferences and expectations about the technology and how it fits into daily routines. We were able to capture changes that occurred over time for older adult participants. Results indicated that there was acceptance of the technology as participants adapted to it. Two themes were present across the five points in time-safety and usefulness. Five stages of acceptance emerged from the data from preinstallation to 2 years postinstallation. Identified themes, stages of acceptance, and design and development considerations are discussed.

  7. Agency Leaders' Assessments of Feasibility and Desirability of Implementation of Evidence-Based Practices in Youth-Serving Organizations Using the Stages of Implementation Completion.

    Science.gov (United States)

    Palinkas, Lawrence A; Campbell, Mark; Saldana, Lisa

    2018-01-01

    Background: This study examined influences on the decisions of administrators of youth-serving organizations to initiate and proceed with implementation of an evidence-based practice (EBP). Methods: Semi-structured interviews, developed using the Stages of Implementation Completion (SIC) as a framework, were conducted with 19 agency chief executive officers and program directors of 15 organizations serving children and adolescents. Results: Agency leaders' self-assessments of implementation feasibility and desirability prior to implementation (Pre-implementation) were influenced by intervention affordability, feasibility, requirements, validity, reliability, relevance, cost savings, positive outcomes, and adequacy of information; availability of funding, support from sources external to the agency, and adequacy of technical assistance; and staff availability and attitudes toward innovation in general and EBPs in particular, organizational capacity, fit between the EBP and agency mission and capacity, prior experience with implementation, experience with seeking evidence, and developing consensus. Assessments during the Implementation phase included intervention flexibility and requirements; availability of funding, adequacy of training and technical assistance, and getting sufficient and appropriate referrals; and staffing and implementing with fidelity. Assessments during the Sustainment phase included intervention costs and benefits; availability of funding, support from sources outside of the agency, and need for the EBP; and the fit between the EBP and the agency mission. Discussion: The results point to opportunities for using agency leader models to develop strategies to facilitate implementation of evidence-based and innovative practices for children and adolescents. The SIC provides a standardized framework for guiding agency leader self-assessments of implementation.

  8. Environmental assessment of bioenergy technologies application in Russia, including their impact on the balance of greenhouse gases

    Science.gov (United States)

    Andreeva, Irina; Vasenev, Ivan

    2017-04-01

    In recent years, Russia adopted a policy towards increasing of the share of renewable energy in total amount of used energy, albeit with some delay comparing to the EU countries and the USA. It was expected that the use of biofuels over time will reduce significantly the dependency of Russian economy on fossil fuels, increase its competitiveness, and increase Russian contribution to the prevention of global climate changes. Russia has significant bio-energy potential and resources which are characterized by great diversity due to the large extent of the territory, which require systematic studies and environmental assessment of used bio-energy technologies. Results of research carried at the Laboratory of agroecological monitoring, modeling and prediction of ecosystems RSAU-MTAA demonstrated significant differences in the assessment of the environmental, economic and social effects of biofuel production and use, depending on the species of bio-energy crops, regional soil-ecological and agro-climatic characteristics, applied farming systems and production processes. The total area of temporarily unused and fallow land, which could be allocated to the active agricultural use in Russia, according to various estimates, ranges from 20 to 33 million hectares, which removes the problem, typical of most European countries, of adverse agro-ecological changes in land use connected with the expansion of bio-energy crops cultivation. However, the expansion of biofuel production through the use of fallow land and conversion of natural lands has as a consequence the problem of greenhouse gas emissions due to land use changes, which, according to FAO, could be even higher than CO2 emission from fossil fuels for some of bio-energy raw materials and production systems. Assessment of the total impacts of biofuels on greenhouse gas emissions in the Russian conditions should be based on regionally adapted calculations of flows throughout the entire life cycle of production, taking

  9. Multicriteria two-stage model of assessment of museums' business strategies

    Directory of Open Access Journals (Sweden)

    Mimović Predrag

    2017-01-01

    Full Text Available This paper analyzes and evaluates the museum activities in the current social, economic and political context, in order to prove the need for the identification and evaluation of business strategy for the cultural sector in general. In addition, the paper also studies methodological issues related to the model of evaluation and assessment of the strategy in the case of The 'Kragujevački Oktobar' Memorial Park. By applying the SWOT analysis and Analytic network process (ANP as an expert method for the support to decision making, critical success factors have been identified and their evaluation performed, in order to create optimum conditions for formulating business strategies and sustainable development of the Memorial Park.

  10. Improving ecological risk assessment by including bioavailability into species sensitivity distributions: An example for plants exposed to nickel in soil

    International Nuclear Information System (INIS)

    Semenzin, Elena; Temminghoff, Erwin J.M.; Marcomini, Antonio

    2007-01-01

    The variability of species sensitivity distribution (SSD) due to contaminant bioavailability in soil was explored by using nickel as metal of concern. SSDs of toxicity test results of Avena sativa L. originating from different soils and expressed as total content and available (0.01 M CaCl 2 ) extractable concentration were compared to SSDs for terrestrial plants derived from literature toxicity data. Also the 'free' nickel (Ni 2+ ) concentration was calculated and compared. The results demonstrated that SSDs based on total nickel content highly depend on the experimental conditions set up for toxicity testing (i.e. selected soil and pH value) and thus on metal bioavailability in soil, resulting in an unacceptable uncertainty for ecological risk estimation. The use in SSDs of plant toxicity data expressed as 0.01 M CaCl 2 extractable metal strongly reduced the uncertainty in the SSD curve and thus can improve the ERA procedure remarkably by taking bioavailability into account. - The use of bioavailability toxicity data can improve species sensitivity distribution (SSD) curves and thus ecological risk assessment (ERA)

  11. Threat Assessment and Targeted Violence at Institutions of Higher Education: Implications for Policy and Practice Including Unique Considerations for Community Colleges

    Science.gov (United States)

    Bennett, Laura; Bates, Michael

    2015-01-01

    This article provides an overview of the research on targeted violence, including campus violence, and the implications for policy and practice at institutions of higher education. Unique challenges of threat assessment in the community college setting are explored, and an overview of an effective threat assessment policy and team at William…

  12. Optimal Control as a method for Diesel engine efficiency assessment including pressure and NO_x constraints

    International Nuclear Information System (INIS)

    Guardiola, Carlos; Climent, Héctor; Pla, Benjamín; Reig, Alberto

    2017-01-01

    Highlights: • Optimal Control is applied for heat release shaping in internal combustion engines. • Optimal Control allows to assess the engine performance with a realistic reference. • The proposed method gives a target heat release law to define control strategies. - Abstract: The present paper studies the optimal heat release law in a Diesel engine to maximise the indicated efficiency subject to different constraints, namely: maximum cylinder pressure, maximum cylinder pressure derivative, and NO_x emission restrictions. With this objective, a simple but also representative model of the combustion process has been implemented. The model consists of a 0D energy balance model aimed to provide the pressure and temperature evolutions in the high pressure loop of the engine thermodynamic cycle from the gas conditions at the intake valve closing and the heat release law. The gas pressure and temperature evolutions allow to compute the engine efficiency and NO_x emissions. The comparison between model and experimental results shows that despite the model simplicity, it is able to reproduce the engine efficiency and NO_x emissions. After the model identification and validation, the optimal control problem is posed and solved by means of Dynamic Programming (DP). Also, if only pressure constraints are considered, the paper proposes a solution that reduces the computation cost of the DP strategy in two orders of magnitude for the case being analysed. The solution provides a target heat release law to define injection strategies but also a more realistic maximum efficiency boundary than the ideal thermodynamic cycles usually employed to estimate the maximum engine efficiency.

  13. Multiscale approach including microfibril scale to assess elastic constants of cortical bone based on neural network computation and homogenization method.

    Science.gov (United States)

    Barkaoui, Abdelwahed; Chamekh, Abdessalem; Merzouki, Tarek; Hambli, Ridha; Mkaddem, Ali

    2014-03-01

    The complexity and heterogeneity of bone tissue require a multiscale modeling to understand its mechanical behavior and its remodeling mechanisms. In this paper, a novel multiscale hierarchical approach including microfibril scale based on hybrid neural network (NN) computation and homogenization equations was developed to link nanoscopic and macroscopic scales to estimate the elastic properties of human cortical bone. The multiscale model is divided into three main phases: (i) in step 0, the elastic constants of collagen-water and mineral-water composites are calculated by averaging the upper and lower Hill bounds; (ii) in step 1, the elastic properties of the collagen microfibril are computed using a trained NN simulation. Finite element calculation is performed at nanoscopic levels to provide a database to train an in-house NN program; and (iii) in steps 2-10 from fibril to continuum cortical bone tissue, homogenization equations are used to perform the computation at the higher scales. The NN outputs (elastic properties of the microfibril) are used as inputs for the homogenization computation to determine the properties of mineralized collagen fibril. The mechanical and geometrical properties of bone constituents (mineral, collagen, and cross-links) as well as the porosity were taken in consideration. This paper aims to predict analytically the effective elastic constants of cortical bone by modeling its elastic response at these different scales, ranging from the nanostructural to mesostructural levels. Our findings of the lowest scale's output were well integrated with the other higher levels and serve as inputs for the next higher scale modeling. Good agreement was obtained between our predicted results and literature data. Copyright © 2013 John Wiley & Sons, Ltd.

  14. A luciferase-based assay for rapid assessment of drug activity against Mycobacterium tuberculosis including monitoring of macrophage viability.

    Science.gov (United States)

    Larsson, Marie C; Lerm, Maria; Ängeby, Kristian; Nordvall, Michaela; Juréen, Pontus; Schön, Thomas

    2014-11-01

    The intracellular (IC) effect of drugs against Mycobacterium tuberculosis (Mtb) is not well established but increasingly important to consider when combining current and future multidrug regimens into the best possible treatment strategies. For this purpose, we developed an IC model based on a genetically modified Mtb H37Rv strain, expressing the Vibrio harvei luciferase (H37Rv-lux) infecting the human macrophage like cell line THP-1. Cells were infected at a low multiplicity of infection (1:1) and subsequently exposed to isoniazid (INH), ethambutol (EMB), amikacin (AMI) or levofloxacin (LEV) for 5days in a 96-well format. Cell viability was evaluated by Calcein AM and was maintained throughout the experiment. The number of viable H37Rv-lux was determined by luminescence and verified by a colony forming unit analysis. The results were compared to the effects of the same drugs in broth cultures. AMI, EMB and LEV were significantly less effective intracellularly (MIC90: >4mg/L, 8mg/L and 2mg/L, respectively) compared to extracellularly (MIC90: 0.5mg/L for AMI and EMB; 0.25mg/L for LEV). The reverse was the case for INH (IC: 0.064mg/L vs EC: 0.25mg/L). In conclusion, this luciferase based method, in which monitoring of cell viability is included, has the potential to become a useful tool while evaluating the intracellular effects of anti-mycobacterial drugs. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. All this grassroots, real life knowledge: Comparing perceived with realised concerns of including non-academic evaluators in societal impact assessment

    Energy Technology Data Exchange (ETDEWEB)

    Derrick, G.E.; Samuel, G.S.

    2016-07-01

    New research assessment frameworks that include societal impact criteria, also require the inclusion on non-academic evaluators (users) as part of the assessment panels. Little research has been conducted on how these user evaluators are received by traditionally academic-led panels, and how their presence influences evaluation outcomes. This is especially the case for evaluations including societal impact criteria. This article uses a mixed-methods approach to explore academic-evaluator concerns about the inclusion of user-evaluators in the assessment process. In addition, it explores how their involvement, influenced the outcomes of the evaluation process. (Author)

  16. Probabilistic risk assessment of the effect of acidified seawater on development stages of sea urchin (Strongylocentrotus droebachiensis).

    Science.gov (United States)

    Chen, Wei-Yu; Lin, Hsing-Chieh

    2018-05-01

    Growing evidence indicates that ocean acidification has a significant impact on calcifying marine organisms. However, there is a lack of exposure risk assessments for aquatic organisms under future environmentally relevant ocean acidification scenarios. The objective of this study was to investigate the probabilistic effects of acidified seawater on the life-stage response dynamics of fertilization, larvae growth, and larvae mortality of the green sea urchin (Strongylocentrotus droebachiensis). We incorporated the regulation of primary body cavity (PBC) pH in response to seawater pH into the assessment by constructing an explicit model to assess effective life-stage response dynamics to seawater or PBC pH levels. The likelihood of exposure to ocean acidification was also evaluated by addressing the uncertainties of the risk characterization. For unsuccessful fertilization, the estimated 50% effect level of seawater acidification (EC50 SW ) was 0.55 ± 0.014 (mean ± SE) pH units. This life stage was more sensitive than growth inhibition and mortality, for which the EC50 values were 1.13 and 1.03 pH units, respectively. The estimated 50% effect levels of PBC pH (EC50 PBC ) were 0.99 ± 0.05 and 0.88 ± 0.006 pH units for growth inhibition and mortality, respectively. We also predicted the probability distributions for seawater and PBC pH levels in 2100. The level of unsuccessful fertilization had 50 and 90% probability risks of 5.07-24.51 (95% CI) and 0-6.95%, respectively. We conclude that this probabilistic risk analysis model is parsimonious enough to quantify the multiple vulnerabilities of the green sea urchin while addressing the systemic effects of ocean acidification. This study found a high potential risk of acidification affecting the fertilization of the green sea urchin, whereas there was no evidence for adverse effects on growth and mortality resulting from exposure to the predicted acidified environment.

  17. Assessment of commercially available energy-efficient room air conditioners including models with low global warming potential (GWP) refrigerants

    Energy Technology Data Exchange (ETDEWEB)

    Shah, N. K. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Park, W. Y. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Gerke, B. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-08-30

    , the highest-efficiency RAC models employ the low-GWP refrigerants R-32 or R-290. • RACs are available in most regions and worldwide that surpass the highest efficiency levels recognized by labeling programs. • Fixed-speed RACs using high-GWP and ozone-depleting R-22 refrigerant still dominate the market in many emerging economies. There is significant scope to improve RAC efficiency and transition to low-GWP refrigerants using commercially available technology and to design market-transformation programs for high-efficiency, low-GWP equipment including standards, labeling, procurement, and incentive programs.

  18. Eco-efficient production of spring barley in a changed climate: A Life Cycle Assessment including primary data from future climate scenarios

    DEFF Research Database (Denmark)

    Niero, Monia; Ingvordsen, Cathrine Heinz; Peltonen-Sainio, Pirjo

    2015-01-01

    The paper has two main objectives: (i) to assess the eco-efficiency of spring barley cultivation for malting in Denmark in a future changed climate (700 ppm [CO2] and +5 °C) through Life Cycle Assessment (LCA) and (ii) to compare alternative future cultivation scenarios, both excluding and includ......The paper has two main objectives: (i) to assess the eco-efficiency of spring barley cultivation for malting in Denmark in a future changed climate (700 ppm [CO2] and +5 °C) through Life Cycle Assessment (LCA) and (ii) to compare alternative future cultivation scenarios, both excluding...

  19. Ultrasound assessment of the meniscus complex formation in health children and with the 1st stage of longitudinal platypodia ones

    Directory of Open Access Journals (Sweden)

    Alexei Ivantsov

    2013-04-01

    Full Text Available Objectives: Foot arch reduces the exposure of weight and buf load due to its bufer function. in longitudinal platypodia foot looses this function and articular menisci have to take the role of the bufers (shock absorbers. Materials and Methods: Ultrasound assessment of meniscus thickness was performed on the joint space level. Results: varus type (43.4% of the meniscus complex adaptation was dominant in 5-7 years old patients with the 1st stage longitudinal platypodia; symmetric type (51.9% – in 8-12 years old patients; valgus type (56% – in 13-17 years old ones. Healthy children showed the valgus type in all age periods. Conclusions: in our opinion the dominance of the varus type of the meniscus complex in 5-7 aged children and its further conversion into the valgus type in case of the 1st stage longitudinal platypodia refects the reduction of the lower extremities transformation processes from the varus into the most functional convenient valgus position at the age of 13-17. Keywords: meniscus, children, ultrasound investigation.

  20. Assessment of cobalt 57 tagged bleomycin as a clinical aid in staging of head and neck carcinoma

    International Nuclear Information System (INIS)

    Cummings, C.W.; Larson, S.M.; Dobie, R.A.; Weymuller, E.A. Jr.; Rudd, T.G.; Merello, A.

    1981-01-01

    Critical assessment of head and neck cancer with respect to staging has, on occasion, been disappointingly ineffective. We have attempted to correlate the incidence of measureable uptake of cobalt 57 tagged bleomycin by primary squamous cell carcinoma and metastatic cervical lymph nodes. Forty-six cases have been evaluated with respect to histopathological confirmation of the suspected metastatic disease. We have found that this diagnostic measure increases our acumen in staging of head and neck cancer. The relevance of the Co-Bleo scans as a diagnostic aid is reported in 46 cases. Malignant tumors greater than 2 cm in size appear to demonstrate active uptake of the imaging agent. Small tumor size and excess background radioactivity contribute to the false-negatives (17%). Inflammatory conditions or benign tumors of the salivary apparatus may result in minimal uptake, thus, a false-positive result (10%). An increase in the radioactivity of the Co-Bleo may enhance the benefits of this procedure in the search for an undiagnosed primary, as well as undiagnosed local or distant metastases

  1. Assessment of cobalt 57 tagged bleomycin as a clinical aid in staging of head and neck carcinoma

    International Nuclear Information System (INIS)

    Cummings, C.W.; Larson, S.M.; Dobie, R.A.; Weymuller, E.A. Jr.; Rudd, T.G.; Merello, A.

    1981-01-01

    Critical assessment of head and neck cancer with respect to staging has, on occasion, been disappointingly ineffective. The incidence of measurable uptake of cobalt 57 tagged bleomycin by primary squamous cell carcinoma and metastatic cervical lymph nodes has been correlated. Forty-six cases have been evaluated with respect to histopathological confirmation of the suspected metastatic disease. We have found that this diagnostic measure increases our acumen in staging of head and neck cancer. The relevance of the Co-Bleo scans as a diagnostic aid is reported in 46 cases. Malignant tumors greater than 2 cm in size appear to demonstrate active uptake of the imaging agent. Small tumor size and excess background radioactivity contribute to the false-negatives (17%). Inflammatory conditions or benign tumors of the salivary apparatus may result in minimal uptake, thus, a false-positive result (10%). An increase in the radioactivity of the Co-Bleo may enhance the benefits of this procedure in the search for an undiagnosed primary, as well as undiagnosed local or distant metastases

  2. Can cognitive assessment really discriminate early stages of Alzheimer's and behavioural variant frontotemporal dementia at initial clinical presentation?

    Science.gov (United States)

    Reul, Sophia; Lohmann, Hubertus; Wiendl, Heinz; Duning, Thomas; Johnen, Andreas

    2017-08-09

    Neuropsychological testing is considered crucial for differential diagnosis of Alzheimer's disease (AD) and behavioural variant frontotemporal dementia (bvFTD). In-depth neuropsychological assessment revealed specific dysfunctions in the two dementia syndromes. However, a significant overlap of cognitive impairments exists in early disease stages. We questioned whether a standard neuropsychological assessment at initial clinical presentation can delineate patients with AD versus bvFTD. In a retrospective approach, we evaluated and compared how cognitive profiles assessed at initial clinical presentation predicted the diagnosis of later verified AD (n = 43) and bvFTD (n = 26). Additionally, the neuropsychological standard domains memory, language, visuospatial skills, executive functions, praxis and social cognition were subjected to stepwise discriminant analysis to compare their differential contribution to diagnosis. Regardless of diagnosis, a percentage of patients presented with major deterioration in a wide range of cognitive domains when compared with age-matched normative data. Only few significant differences were detected on the group level: Patients with AD were relatively more impaired in the verbal recall, verbal recognition, figure copy, and surprisingly in the executive subdomains, set shifting and processing speed whereas bvFTD was characterised by more deficits in imitation of face postures. A combination of tests for verbal recall, imitation of limb and face postures, and figure copy showed the greatest discriminatory power. Our results imply that the contribution of a standard neuropsychological assessment is limited for differential diagnosis of AD and bvFTD at initial presentation. In contrast to current clinical guidelines, executive functions are neither particularly nor exclusively impaired in patients with bvFTD when assessed within a standard clinical neuropsychological test battery. The significant overlap of bvFTD and AD

  3. Initial risk assessment for a single stage to orbit nuclear thermal rocket

    Energy Technology Data Exchange (ETDEWEB)

    Labib, Satira, E-mail: Satira.Labib@duke-energy.com; King, Jeffrey, E-mail: kingjc@mines.edu

    2015-06-15

    Highlights: • The risks posed by the surface launch of a nuclear thermal rocket are considered. • Radiation exposure at the public viewing distance is insignificant. • Production of fission products and actinides during launch is limited. • The production of activated argon around the rocket may be a significant concern. - Abstract: In order to consider the possibility of a nuclear thermal rocket (NTR) ground launch, it is necessary to evaluate the risks from such a launch. This includes analysis of the radiation dose rate around the rocket, determining the rate of activation of the materials near the launch, and considering the radionuclides present in the core after the launch. This paper evaluates the potential risk of the NTR ground launch for a range of payloads from 1 to 15 metric tons (MT) using three NTR reactor cores (40, 80, and 120 cm in length) designed in a previous study, based on data produced by MCNP5 and MCNPX models. At the same power level, the 40 cm core length reactor results in the lowest radiation dose rate of the three reactors. Radiation dose rates decrease to background levels 3.5 km from the launch site. After a 1-year decay time, all of the activated materials produced by an NTR launch would be classified as Class A low-level waste. The activation of air produces significant amounts of argon-41 and nitrogen-16 within 100 m of the launch. The derived air concentration (DAC) ratio of the activation products decays to less than unity within 2 days, with only argon-41 remaining. After 10 min of full power operation, the 120 cm core for a 15 MT payload contains 2.5 × 10{sup 13}, 1.4 × 10{sup 12} and 1.5 × 10{sup 12} Bq of {sup 131}I, {sup 137}Cs, and {sup 90}Sr, respectively. The decay heat after shutdown increases with increasing reactor power with a maximum decay heat of 108 kW immediately after shutdown for the 15 MT payload.

  4. Role of specific DNA mutations in the peripheral blood of colorectal cancer patients for the assessment of tumor stage and residual disease following tumor resection

    Science.gov (United States)

    Norcic, Gregor; Jelenc, Franc; Cerkovnik, Petra; Stegel, Vida; Novakovic, Srdjan

    2016-01-01

    In the present study, the detection of tumor-specific KRAS proto-oncogene, GTPase (KRAS) and B-Raf proto-oncogene, serine/threonine kinase (BRAF) mutations in the peripheral blood of colorectal cancer (CRC) patients at all stages and adenomas was used for the estimation of disease stage prior to surgery and for residual disease following surgery. A total of 65 CRC patients were enrolled. The primary tumor tested positive for the specific mutations (KRAS mutations in codons 12, 13, 61, 117 or 146 and BRAF mutations in codon 600) in 35 patients. In all these patients, the specimen of normal bowel resected with the tumor was also tested for the presence of the same mutations in order to exclude the germ-line mutations. Only patients who tested positive for the specific mutation in the primary tumor were included in further analysis for the presence of tumor-specific mutation in the peripheral blood. No statistically significant differences were found between the detection rates of tumor mutations in the blood and different tumor stages (P=0.491). However, statistically significant differences in the proportions of patients with detected tumor-specific DNA mutations in the peripheral blood were found when comparing the groups of patients with R0 and R2 resections (P=0.038). Tumor-specific DNA mutations in the peripheral blood were more frequently detected in the patients with an incomplete surgical clearance of the tumor due to macroscopic residual disease (R2 resections). Therefore, the study concludes that the follow-up of somatic KRAS- and BRAF-mutated DNA in the peripheral blood of CRC patients may be useful in assessing the surgical clearance of the disease. PMID:27900004

  5. Improved assessment of mediastinal and pulmonary pathologies in combined staging CT examinations using a fast-speed acquisition dual-source CT protocol

    Energy Technology Data Exchange (ETDEWEB)

    Braun, Franziska M.; Holzner, Veronica; Meinel, Felix G.; Armbruster, Marco; Brandlhuber, Martina; Ertl-Wagner, Birgit; Sommer, Wieland H. [University Hospital Munich, Institute for Clinical Radiology, Munich (Germany)

    2017-12-15

    To demonstrate the feasibility of fast Dual-Source CT (DSCT) and to evaluate the clinical utility in chest/abdomen/pelvis staging CT studies. 45 cancer patients with two follow-up combined chest/abdomen/pelvis staging CT examinations (maximally ±10 kV difference in tube potential) were included. The first scan had to be performed with our standard protocol (fixed pitch 0.6), the second one using a novel fast-speed DSCT protocol (fixed pitch 1.55). Effective doses (ED) were calculated, noise measurements performed. Scan times were compared, motion artefacts and the diagnostic confidence rated in consensus reading. ED for the standard and fast-speed scans was 9.1 (7.0-11.1) mSv and 9.2 (7.4-12.8) mSv, respectively (P = 0.075). Image noise was comparable (abdomen; all P > 0.05) or reduced for fast-speed CTs (trachea, P = 0.001; ascending aorta, P < 0.001). Motion artefacts of the heart/the ascending aorta (all P < 0.001) and breathing artefacts (P < 0.031) were reduced in fast DSCT. The diagnostic confidence for the evaluation of mediastinal (P < 0.001) and pulmonary (P = 0.008) pathologies was improved for fast DSCT. Fast DSCT for chest/abdomen/pelvis staging CT examinations is performed within 2 seconds scan time and eliminates relevant intrathoracic motion/breathing artefacts. Mediastinal/pulmonary pathologies can thus be assessed with high diagnostic confidence. Abdominal image quality remains excellent. (orig.)

  6. Agency Leaders' Assessments of Feasibility and Desirability of Implementation of Evidence-Based Practices in Youth-Serving Organizations Using the Stages of Implementation Completion

    Directory of Open Access Journals (Sweden)

    Lawrence A. Palinkas

    2018-05-01

    Full Text Available Background: This study examined influences on the decisions of administrators of youth-serving organizations to initiate and proceed with implementation of an evidence-based practice (EBP.Methods: Semi-structured interviews, developed using the Stages of Implementation Completion (SIC as a framework, were conducted with 19 agency chief executive officers and program directors of 15 organizations serving children and adolescents.Results: Agency leaders' self-assessments of implementation feasibility and desirability prior to implementation (Pre-implementation were influenced by intervention affordability, feasibility, requirements, validity, reliability, relevance, cost savings, positive outcomes, and adequacy of information; availability of funding, support from sources external to the agency, and adequacy of technical assistance; and staff availability and attitudes toward innovation in general and EBPs in particular, organizational capacity, fit between the EBP and agency mission and capacity, prior experience with implementation, experience with seeking evidence, and developing consensus. Assessments during the Implementation phase included intervention flexibility and requirements; availability of funding, adequacy of training and technical assistance, and getting sufficient and appropriate referrals; and staffing and implementing with fidelity. Assessments during the Sustainment phase included intervention costs and benefits; availability of funding, support from sources outside of the agency, and need for the EBP; and the fit between the EBP and the agency mission.Discussion: The results point to opportunities for using agency leader models to develop strategies to facilitate implementation of evidence-based and innovative practices for children and adolescents. The SIC provides a standardized framework for guiding agency leader self-assessments of implementation.

  7. Towards a more sustainable transport infrastructure: how spatial geological data can be utilized to improve early stage Life cycle assessment of road infrastructure

    Science.gov (United States)

    Karlsson, Caroline; Miliutenko, Sofiia; Björklund, Anna; Mörtberg, Ulla; Olofsson, Bo; Toller, Susanna

    2017-04-01

    Environmental impacts during the life cycle stages of transport infrastructure are substantial, including among other greenhouse gas (GHG) emissions, as well as resource and energy use. For transport infrastructure to be sustainable, such issues need to be integrated in the planning process. Environmental Impact Assessment (EIA) is required by the European Union (EU) in order to ensure that all environmental aspects are considered during planning of road infrastructure projects. As a part of this process, the European Commission has suggested the use of the tool life cycle assessment (LCA) for assessing life cycle energy use and GHG emissions. When analyzing life cycle impacts of the road infrastructure itself, it was shown that earthworks and materials used for the road construction have a big share in the total energy use and GHG emissions. Those aspects are largely determined by the geological conditions at the site of construction: parameters such as soil thickness, slope, bedrock quality and soil type. The geological parameters determine the amounts of earthworks (i.e. volumes of soil and rock that will be excavated and blasted), transportation need for excavated materials as well as the availability of building materials. The study presents a new geographic information system (GIS)-based approach for utilizing spatial geological data in three dimensions (i.e. length, width and depth) in order to improve estimates on earthworks during the early stages of road infrastructure planning. Three main methodological steps were undertaken: mass balance calculation, life cycle inventory analysis and spatial mapping of greenhouse gas (GHG) emissions and energy use. The proposed GIS-based approach was later evaluated by comparing with the actual values of extracted material of a real road construction project. The results showed that the estimate of filling material was the most accurate, while the estimate for excavated soil and blasted rock had a wide variation from

  8. Demonstrating an Approach for Including Pesticide Use in Life Cycle Assessment: Estimating Human and Ecosystem Toxicity of Pesticide Use in Midwest Corn Farming

    Science.gov (United States)

    Purpose This study demonstrates an approach to assess human health and ecotoxicity impacts of pesticide use by including multiple environmental pathways and various exposure routes using the case of corn grown for bio-based fuel or chemical production in US Midwestern states.Meth...

  9. Demonstrating an approach for including pesticide use in life-cycle assessment: Estimating human and ecosystem toxicity of pesticide use in Midwest corn farming

    Science.gov (United States)

    PurposeThis study demonstrates an approach to assess human health and ecotoxicity impacts of pesticide use by including multiple environmental pathways and various exposure routes using the case of corn grown for bio-based fuel or chemical production in US Midwestern states.Metho...

  10. Reliable and valid assessment of competence in endoscopic ultrasonography and fine-needle aspiration for mediastinal staging of non-small cell lung cancer

    DEFF Research Database (Denmark)

    Konge, Lars; Vilmann, P; Clementsen, P

    2012-01-01

    Fine-needle aspiration (FNA) guided by endoscopic ultrasonography (EUS) is important in mediastinal staging of non-small cell lung cancer (NSCLC). Training standards and implementation strategies of this technique are currently under discussion. The aim of this study was to explore the reliabilit...... and validity of a newly developed EUS Assessment Tool (EUSAT) designed to measure competence in EUS - FNA for mediastinal staging of NSCLC....

  11. A Comparative Study between SVM and Fuzzy Inference System for the Automatic Prediction of Sleep Stages and the Assessment of Sleep Quality

    Directory of Open Access Journals (Sweden)

    John Gialelis

    2015-11-01

    Full Text Available This paper compares two supervised learning algorithms for predicting the sleep stages based on the human brain activity. The first step of the presented work regards feature extraction from real human electroencephalography (EEG data together with its corresponding sleep stages that are utilized for training a support vector machine (SVM, and a fuzzy inference system (FIS algorithm. Then, the trained algorithms are used to predict the sleep stages of real human patients. Extended comparison results are demonstrated which indicate that both classifiers could be utilized as a basis for an unobtrusive sleep quality assessment.

  12. ENSI's view on NTB-10-01 'Evaluation of the geological documents for the provisional safety assessment in SGT Stage 2' - Sectoral Plan 'Deep Geological Disposal'

    International Nuclear Information System (INIS)

    2011-03-01

    As a preliminary action ahead of Stage 2 in the Sectoral Plan 'Deep Geological Disposal' ('Sachplan Geologische Tiefenlager': SGT) the bodies in charge of the management of the radioactive wastes have to determine, together with the Swiss Federal Nuclear Safety Inspectorate (ENSI), which complementary investigations are needed for the provisional safety assessment of the foreseen repositories. In particular, comparisons between the different sites must be possible. If some doubts remain, new investigations have to be conducted. In SGT Stage 1 the National Cooperative for the Disposal of Radioactive Waste (NAGRA) stated that a time period of 100'000 years shall be considered for the storage of low- and intermediate-level radioactive wastes (SMA) and of 1 million years for the storage of high-level wastes (HAA). In SGT Stage 2, considerations about possible modifications of the biosphere during the considered time periods for SMA as well as for HAA have to be included. In what regards the host rock, ENSI declares that the dataset describing the Opalinus clay is sufficient for the site-specific safety analyses. What regards the Wellenberg site for a SMA repository, ENSI has earlier analysed the license request of the NAGRA. For the Mergel formations of the Helveticum, NAGRA conducted a complete safety analysis. ENSI considers the knowledge acquired for these rock types as sufficient for the technical safety comparisons in SGT Stage 2. The knowledge of the rock 'Brauner Dogger' is correct but some more information about the lithostratigraphy and the biostratigraphy is requested. The understanding of the effect of the rock density reduction on the hydraulic conductibility of Opalinus clay and Mergel formations is accurate enough for the comparisons in SGT Stage 2. For the 'Brauner Dogger', comparable data are missing, but the proposed thickness of 300 m of the host rock offers a sufficient protection against density reduction effects. Concerning the behaviour of the

  13. Summary Stage 2018 - SEER

    Science.gov (United States)

    Access this manual of codes and coding instructions for the summary stage field for cases diagnosed January 1, 2018 and forward. 2018 version applies to every site and/or histology combination, including lymphomas and leukemias. Historically, also called General Staging, California Staging, and SEER Staging.

  14. The value of sub-stages and thin slices for the assessment of the medial clavicular epiphysis: a prospective multi-center CT study.

    Science.gov (United States)

    Wittschieber, Daniel; Schulz, Ronald; Vieth, Volker; Küppers, Martin; Bajanowski, Thomas; Ramsthaler, Frank; Püschel, Klaus; Pfeiffer, Heidi; Schmidt, Sven; Schmeling, Andreas

    2014-06-01

    The clavicle plays an important role for forensic age estimation in living individuals, particularly with regard to the age of majority. The present prospective study aims to evaluate the age-dependent ossification process of the medial clavicular epiphysis in order to establish the clavicular sub-stages introduced in 2010 as well as the advantages and possibilities of thin-slice computed tomography (CT). For this purpose, 0.6 mm thin-slice CT scans of sternoclavicular joints of 572 bodies aged between 10 and 40 years were evaluated by means of two complementary classification systems: a five-stage system and a sub-staging system for the main stages 2 and 3. Assessment was possible in 493 cases. The results for stages 4 and 5 are in line with previous studies that found the ages of 21 years and 26 years, respectively, as minimum ages for these stages. Sub-stage 3c was first found at the age of 19 years in both sexes, thereby corroborating the value of this sub-stage as to statements about the age of majority. In comparison to other CT studies, stage 3a was first observed ~1 year earlier (16.4 years in males and 15.5 years in females). Stage 2c only occurred in 3 cases. In conclusion, the data corroborate the significance of diagnosing sub-stages as well as the value of thin-slice CT. For forensic practice, the concomitant and complementary use of both classification systems applied in this study can be recommended.

  15. Assessment of staging, prognosis and mortality of colorectal cancer by tumor markers: receptor erbB-2 and cadherins

    Directory of Open Access Journals (Sweden)

    Jesus Eliane C.

    2005-01-01

    Full Text Available PURPOSE: To evaluate the prognostic significance and correlation with staging and degree of cell differentiation of the tumoral expression of the proteins c-erbB-2 and E-cadherin, in patients with colorectal adenocarcinoma. METHODS: The study included 117 patients with an average age of 63.1 years and an average follow-up duration of 28.1 months. The disease-free interval, survival, incidence of recurrence and specific mortality were evaluated. c-erbB-2 anti-oncoprotein antibodies (Dako were utilized via the streptavidin-biotin technique. Samples were considered to be positive for c-erbB-2 if 10% or more of the tumor cell membranes were stained.The anti-E-cadherin antibodies (Dako, evaluated this protein and is considered positive, if 50% or more of the cell membranes were stained. Statistical analysis was performed using Pearson's chi-squared test, Fisher's exact test, Kaplan-Meier's estimator, the log-rank test and Wilcoxon's test (Breslow version, setting the level of statistical significance at 5% (p<0.05. RESULTS: 52 of 108 patients studied for c-erbB-2 were positive (48,1%, 47 of 93 patients studied for E-cadherin were negative (50,5%. These data do not express any correlation with TNM (tumor, node and metastasis staging and the degree of cell differentiation or with the tumor recurrence rate. The disease-free interval among patients who were positive for c-erbB-2 and negative for E-cadherin was 68.0 months and did not differ from those with c-erbB-2 negative and E-cadherin positive ( 55.0 months - p = 0.5510. The average survival among patients positive for c-erbB-2 and negative for E-cadherin was 75 months without statistical significance difference with the other group ( 61 months - p = 0.5256. Specific mortality occurred in 20.0% of the cases and did not correlate with the expression of c-erbB-2 (p=0,446, E-cadherin (p=0,883. CONCLUSION: The tumoral expression of c-erbB-2 and E-cadherin did not demonstrate a correlation with the

  16. Assessment of implant stability during various stages of healing placed immediately following extraction in an overdenture situation

    Directory of Open Access Journals (Sweden)

    Ashwin Thomas Koshy

    2017-01-01

    Full Text Available To assess the implant stability during different stages of healing in an immediate loaded implant soon after extraction. A 73-year-old female came with a chief complaint of bad smell and irritation in her lower front gum region. On examination, she was found to be completely edentulous in the maxillary arch and partially edentulous in the mandibular arch with only the canines present bilaterally. The posterior mandibular ridge was severely resorbed and hence could not be treated with a conventional mandibular complete denture. Considering the age of the patient and the preference of only a single surgical visit, we decided to plan for a conventional maxillary denture against an implant supported mandibular overdenture with two implants placed immediately after extraction of canines. The stability of these implants was assessed during the early phases of healing with the help of a resonance frequency analysis method (RFA using Osstell ISQ™. During the healing phase, implant stability quotient (ISQ values decrease by 4–5 values after installation with the lowest values at the 1st week postplacement. Following this, the ISQ values increased steadily for all implants up to 16 weeks. No significant differences were noted over time. At placement, the mean ISQ values at 33 and 43 regions were 74 and 75.2, respectively. The mean lowest ISQ values recorded at the 1st week were 58.8 and 65.4, respectively. At 16 weeks, the mean ISQ values were 70.5 and 67.9, respectively. The survival of such immediately placed implants, which are later used as overdenture supported implants, are highly predictable when the surgical and prosthetic part is done meticulously. However, there needs future studies oriented to understand better the healing pattern of immediately placed implants in extraction sockets, which would guide the clinician with the optimal loading time.

  17. The association between histological, macroscopic and magnetic resonance imaging assessed synovitis in end-stage knee osteoarthritis

    DEFF Research Database (Denmark)

    Riis, R G C; Gudbergsen, H; Simonsen, O

    2017-01-01

    the DCE-MRI variable MExNvoxel (surrogate of the volume and degree of synovitis) and the macroscopic score showed correlations above the pre-specified threshold for acceptance with histological inflammation. The maximum R2-value obtained in Model 1 was R2 = 0.39. In Model 2, where the CE......-MRI-variables were added, the highest R2 = 0.52. In Model 3, a four-variable model consisting of the gender, one CE-MRI and two DCE-MRI-variables yielded a R2 = 0.71. CONCLUSION: DCE-MRI is correlated with histological synovitis in end-stage KOA and the combination of CE and DCE-MRI may be a useful, non......-enhanced magnetic resonance imaging (CE-MRI) and dynamic contrast-enhanced (DCE)-MRI prior to (TKR) and correlated with microscopic and macroscopic assessments of synovitis obtained intraoperatively. Multiple bivariate correlations were used with a pre-specified threshold of 0.70 for significance. Also, multiple...

  18. The AEROPATH project targeting Pseudomonas aeruginosa: crystallographic studies for assessment of potential targets in early-stage drug discovery

    International Nuclear Information System (INIS)

    Moynie, Lucille; Schnell, Robert; McMahon, Stephen A.; Sandalova, Tatyana; Boulkerou, Wassila Abdelli; Schmidberger, Jason W.; Alphey, Magnus; Cukier, Cyprian; Duthie, Fraser; Kopec, Jolanta; Liu, Huanting; Jacewicz, Agata; Hunter, William N.; Naismith, James H.; Schneider, Gunter

    2012-01-01

    A focused strategy has been directed towards the structural characterization of selected proteins from the bacterial pathogen P. aeruginosa. The objective is to exploit the resulting structural data, in combination with ligand-binding studies, and to assess the potential of these proteins for early-stage antimicrobial drug discovery. Bacterial infections are increasingly difficult to treat owing to the spread of antibiotic resistance. A major concern is Gram-negative bacteria, for which the discovery of new antimicrobial drugs has been particularly scarce. In an effort to accelerate early steps in drug discovery, the EU-funded AEROPATH project aims to identify novel targets in the opportunistic pathogen Pseudomonas aeruginosa by applying a multidisciplinary approach encompassing target validation, structural characterization, assay development and hit identification from small-molecule libraries. Here, the strategies used for target selection are described and progress in protein production and structure analysis is reported. Of the 102 selected targets, 84 could be produced in soluble form and the de novo structures of 39 proteins have been determined. The crystal structures of eight of these targets, ranging from hypothetical unknown proteins to metabolic enzymes from different functional classes (PA1645, PA1648, PA2169, PA3770, PA4098, PA4485, PA4992 and PA5259), are reported here. The structural information is expected to provide a firm basis for the improvement of hit compounds identified from fragment-based and high-throughput screening campaigns

  19. A 3-stage model for assessing the probable economic effects of direct-to-consumer advertising of pharmaceuticals.

    Science.gov (United States)

    Vogel, Ronald J; Ramachandran, Sulabha; Zachry, Woodie M

    2003-01-01

    The pharmaceutical industry employs a variety of marketing strategies that have previously been directed primarily toward physicians. However, mass media direct-to-consumer (DTC) advertising of prescription drugs has emerged as a ubiquitous promotional strategy. This article explores the economics of DTC advertising in greater depth than has been done in the past by using a 3-stage economic model to assess the pertinent literature and to show the probable effects of DTC advertising in the United States. Economics literature on the subject was searched using the Journal of Economic Literature. Health services literature was searched using computer callback devices. Spending on DTC advertising in the United States increased from $17 million in 1985 to $2.5 billion in 2000. Proponents of DTC advertising claim that it provides valuable product-related information to health care professionals and patients, may contribute to better use of medications, and helps patients take charge of their own health care. Opponents argue that DTC advertising provides misleading messages rather than well-balanced, evidence-based information. The literature is replete with opinions about the effects of prescription drug advertising on pharmaceutical drug prices and physician-prescribing patterns, but few studies have addressed the issues beyond opinion surveys. The economic literature on advertising effects in other markets, however, may provide insight. DTC advertising indirectly affects the price and the quantity of production of pharmaceuticals via its effect on changes in consumer demand.

  20. Maximum likelihood estimation of signal detection model parameters for the assessment of two-stage diagnostic strategies.

    Science.gov (United States)

    Lirio, R B; Dondériz, I C; Pérez Abalo, M C

    1992-08-01

    The methodology of Receiver Operating Characteristic curves based on the signal detection model is extended to evaluate the accuracy of two-stage diagnostic strategies. A computer program is developed for the maximum likelihood estimation of parameters that characterize the sensitivity and specificity of two-stage classifiers according to this extended methodology. Its use is briefly illustrated with data collected in a two-stage screening for auditory defects.

  1. The effectiveness of formative assessment with understanding by design (UbD) stages in forming habits of mind in prospective teachers

    Science.gov (United States)

    Gloria, R. Y.; Sudarmin, S.; Wiyanto; Indriyanti, D. R.

    2018-03-01

    Habits of mind are intelligent thinking dispositions that every individual needs to have, and it needs an effort to form them as expected. A behavior can be formed by continuous practice; therefore the student's habits of mind can also be formed and trained. One effort that can be used to encourage the formation of habits of mind is a formative assessment strategy with the stages of UbD (Understanding by Design), and a study needs to be done to prove it. This study aims to determine the contribution of formative assessment to the value of habits of mind owned by prospective teachers. The method used is a quantitative method with a quasi-experimental design. To determine the effectiveness of formative assessment with Ubd stages on the formation of habits of mind, correlation test and regression analysis were conducted in the formative assessment questionnaire consisting of three components, i.e. feed back, peer assessment and self assessment, and habits of mind. The result of the research shows that from the three components of Formative Assessment, only Feedback component does not show correlation to students’ habits of mind (r = 0.323). While peer assessment component (r = 0. 732) and self assessment component (r = 0.625), both indicate correlation. From the regression test the overall component of the formative assessment contributed to the habits of mind at 57.1%. From the result of the research, it can be concluded that the formative assessment with Ubd stages is effective and contributes in forming the student's habits of mind; the formative assessment components that contributed the most are the peer assessment and self assessment. The greatest contribution goes to the Thinking interdependently category.

  2. Do psychopathic traits assessed in mid-adolescence predict mental health, psychosocial, and antisocial, including criminal outcomes, over the subsequent 5 years?

    Science.gov (United States)

    Hemphälä, Malin; Hodgins, Sheilagh

    2014-01-01

    To determine whether psychopathic traits assessed in mid-adolescence predicted mental health, psychosocial, and antisocial (including criminal) outcomes 5 years later and would thereby provide advantages over diagnosing conduct disorder (CD). Eighty-six women and 61 men were assessed in mid-adolescence when they first contacted a clinic for substance misuse and were reassessed 5 years later. Assessments in adolescence include the Psychopathy Checklist-Youth Version (PCL-YV), and depending on their age, either the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Aged Children or the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). Assessments in early adulthood included the SCID, self-reports of psychosocial functioning, aggressive behaviour, and criminality and official criminal records. The antisocial facet score positively predicted the number of anxiety symptoms and likelihood of receiving treatment for substance use disorders (SUDs). Lifestyle and antisocial facet scores negatively predicted Global Assessment of Functioning scores. By contrast, the interpersonal score and male sex independently and positively predicted the number of months worked or studied, as did the interaction of Lifestyle × Sex indicating that among men, but not women, an increase in lifestyle facet score was associated with less time worked or studied. Interpersonal and antisocial scores positively predicted school drop-out. Antisocial facet scores predicted the number of symptoms of antisocial personality disorder, alcohol and SUDs, and violent and nonviolent criminality but much more strongly among males than females. Predictions from numbers of CD symptoms were similar. Psychopathic traits among adolescents who misuse substances predict an array of outcomes over the subsequent 5 years. Information on the levels of these traits may be useful for planning treatment.

  3. Regional brain activity during early-stage intense romantic love predicted relationship outcomes after 40 months: an fMRI assessment.

    Science.gov (United States)

    Xu, Xiaomeng; Brown, Lucy; Aron, Arthur; Cao, Guikang; Feng, Tingyong; Acevedo, Bianca; Weng, Xuchu

    2012-09-20

    Early-stage romantic love is associated with activation in reward and motivation systems of the brain. Can these localized activations, or others, predict long-term relationship stability? We contacted participants from a previous fMRI study of early-stage love by Xu et al. [34] after 40 months from initial assessments. We compared brain activation during the initial assessment at early-stage love for those who were still together at 40 months and those who were apart, and surveyed those still together about their relationship happiness and commitment at 40 months. Six participants who were still with their partners at 40 months (compared to six who had broken up) showed less activation during early-stage love in the medial orbitofrontal cortex, right subcallosal cingulate and right accumbens, regions implicated in long-term love and relationship satisfaction [1,2]. These regions of deactivation at the early stage of love were also negatively correlated with relationship happiness scores collected at 40 months. Other areas involved were the caudate tail, and temporal and parietal lobes. These data are preliminary evidence that neural responses in the early stages of romantic love can predict relationship stability and quality up to 40 months later in the relationship. The brain regions involved suggest that forebrain reward functions may be predictive for relationship stability, as well as regions involved in social evaluation, emotional regulation, and mood. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  4. Role of preoperative PET-CT in assessing mediastinal and hilar lymph node status in early stage lung cancer

    Directory of Open Access Journals (Sweden)

    Wei-Yang Lin

    2012-05-01

    Conclusion: Integrated PET-CT is a useful tool for predicting the negativity of mediastinal LN status pre-operatively in clinically early stage (Stages I and II lung cancer but may be relatively inaccurate in predicting hilar LN status and largely confounded by false positives caused by inflammatory process.

  5. Assessment of early-stage optic nerve invasion in retinoblastoma using high-resolution 1.5 Tesla MRI with surface coils: a multicentre, prospective accuracy study with histopathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Brisse, Herve J. [Institut Curie, Department of Radiology, Paris (France); Institut CURIE, Imaging Department, Paris (France); Graaf, Pim de; Rodjan, Firazia; Jong, Marcus C. de; Castelijns, Jonas A. [VU University Medical Center, Department of Radiology, Amsterdam (Netherlands); Galluzzi, Paolo [Neuroimaging and Neurointerventional Unit (NINT) Azienda Ospedaliera e Universitaria Senese, Siena (Italy); Cosker, Kristel; Savignoni, Alexia [Institut Curie, Department of Biostatistics, Paris (France); Maeder, Philippe [Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Department of Radiology, Lausanne (Switzerland); Goericke, Sophia [University Hospital Essen, Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Aerts, Isabelle [Institut Curie, Department of Pediatric Oncology, Paris (France); Desjardins, Laurence [Institut Curie, Department of Ophthalmology, Paris (France); Moll, Annette C. [VU University Medical Center, Department of Ophthalmology, Amsterdam (Netherlands); Hadjistilianou, Theodora [Azienda Ospedaliera Universitaria Senese, Department of Ophthalmology, Siena (Italy); Toti, Paolo [University of Siena, Department of Medical Biotechnologies, Pathology Unit, Siena (Italy); Valk, Paul van der [VU University Medical Center, Department of Pathology, Amsterdam (Netherlands); Sastre-Garau, Xavier [Institut Curie, Department of Biopathology, Paris (France); Collaboration: European Retinoblastoma Imaging Collaboration (ERIC)

    2015-05-01

    To assess the accuracy of high-resolution (HR) magnetic resonance imaging (MRI) in diagnosing early-stage optic nerve (ON) invasion in a retinoblastoma cohort. This IRB-approved, prospective multicenter study included 95 patients (55 boys, 40 girls; mean age, 29 months). 1.5-T MRI was performed using surface coils before enucleation, including spin-echo unenhanced and contrast-enhanced (CE) T1-weighted sequences (slice thickness, 2 mm; pixel size <0.3 x 0.3 mm{sup 2}). Images were read by five neuroradiologists blinded to histopathologic findings. ROC curves were constructed with AUC assessment using a bootstrap method. Histopathology identified 41 eyes without ON invasion and 25 with prelaminar, 18 with intralaminar and 12 with postlaminar invasion. All but one were postoperatively classified as stage I by the International Retinoblastoma Staging System. The accuracy of CE-T1 sequences in identifying ON invasion was limited (AUC = 0.64; 95 % CI, 0.55 - 0.72) and not confirmed for postlaminar invasion diagnosis (AUC = 0.64; 95 % CI, 0.47 - 0.82); high specificities (range, 0.64 - 1) and negative predictive values (range, 0.81 - 0.97) were confirmed. HR-MRI with surface coils is recommended to appropriately select retinoblastoma patients eligible for primary enucleation without the risk of IRSS stage II but cannot substitute for pathology in differentiating the first degrees of ON invasion. (orig.)

  6. Strong Prognostic Value of Tumor-infiltrating Neutrophils and Lymphocytes Assessed by Automated Digital Image Analysis in Early Stage Cervical Cancer

    DEFF Research Database (Denmark)

    Carus, Andreas; Donskov, Frede; Switten Nielsen, Patricia

    2014-01-01

    INTRODUCTION Manual observer-assisted stereological (OAS) assessments of tumor-infiltrating neutrophils and lymphocytes are prognostic, accurate, but cumbersome. We assessed the applicability of automated digital image analysis (DIA). METHODS Visiomorph software was used to obtain DIA densities...... with the prognostically strongest manual OAS assessments in the peritumoral compartment. In multivariate analysis, CD66b and CD8 densities, assessed by DIA, and regional lymph node metastases were independent predictors of RFS, while CD163 density and FIGO stage were not. The CD66b/CD8 tumorassociated neutrophil...

  7. Reliable and valid assessment of competence in endoscopic ultrasonography and fine-needle aspiration for mediastinal staging of non-small cell lung cancer.

    Science.gov (United States)

    Konge, L; Vilmann, P; Clementsen, P; Annema, J T; Ringsted, C

    2012-10-01

    Fine-needle aspiration (FNA) guided by endoscopic ultrasonography (EUS) is important in mediastinal staging of non-small cell lung cancer (NSCLC). Training standards and implementation strategies of this technique are currently under discussion. The aim of this study was to explore the reliability and validity of a newly developed EUS Assessment Tool (EUSAT) designed to measure competence in EUS - FNA for mediastinal staging of NSCLC. A total of 30 patients with proven or suspected NSCLC underwent EUS - FNA for mediastinal staging by three trainees and three experienced physicians. Their performances were assessed prospectively by three experts in EUS under direct observation and again 2 months later in a blinded fashion using digital video-recordings. Based on the assessments, intra-rater reliability, inter-rater reliability, and construct validity were explored. The intra-rater reliability was good (Cronbach's α = 0.80), but comparison of results based on direct observations and blinded video-recordings indicated a significant bias favoring consultants (P = 0.022). Inter-rater reliability was very good (Cronbach's α = 0.93). However, one rater assessing five procedures or two raters each assessing four procedures were necessary to secure a generalizability coefficient of 0.80. The assessment tool demonstrated construct validity by discriminating between trainees and experienced physicians (P = 0.034). Competency in mediastinal staging of NSCLC using EUS and EUS - FNA can be assessed in a reliable and valid way using the EUSAT assessment tool. Measuring and defining competency and training requirements could improve EUS quality and benefit patient care. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Assessment of Physical Activity, Exercise Self-Efficacy, and Stages of Change in College Students Using a Street-Based Survey Method.

    Science.gov (United States)

    Leenders, Nicole Y. J. M.; Silver, Lorraine Wallace; White, Susan L.; Buckworth, Janet; Sherman, W. Michael

    2002-01-01

    Used a street-based survey to assess college students' physical activity level, exercise self-efficacy, and stages of change for exercise behavior. A large proportion of respondents were not regularly active. Exercise self-efficacy was an important variable in exercise behavior. The low cost, ease of data collection, and short turnaround for…

  9. Techno-environmental assessment of the green biorefinery concept: Combining process simulation and life cycle assessment at an early design stage.

    Science.gov (United States)

    Corona, Andrea; Ambye-Jensen, Morten; Vega, Giovanna Croxatto; Hauschild, Michael Zwicky; Birkved, Morten

    2018-09-01

    The Green biorefinery (GBR) is a biorefinery concept that converts fresh biomass into value-added products. The present study combines a Process Flowsheet Simulation (PFS) and Life Cycle Assessment (LCA) to evaluate the technical and environmental performance of different GBR configurations and the cascading utilization of the GBR output. The GBR configurations considered in this study, test alternatives in the three main steps of green-biorefining: fractionation, precipitation, and protein separation. The different cascade utilization alternatives analyse different options for press-pulp utilization, and the LCA results show that the environmental profile of the GBR is highly affected by the utilization of the press-pulp and thus by the choice of conventional product replaced by the press-pulp. Furthermore, scenario analysis of different GBR configurations shows that higher benefits can be achieved by increasing product yields rather than lowering energy consumption. Green biorefining is shown to be an interesting biorefining concept, especially in a Danish context. Biorefining of green biomass is technically feasible and can bring environmental savings, when compared to conventional production methods. However, the savings will be determined by the processing involved in each conversion stage and on the cascade utilization of the different platform products. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. {sup 11}C-Acetate as a new biomarker for PET/CT in patients with multiple myeloma: initial staging and postinduction response assessment

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Chieh; Tsai, Shu-Fan; Yen, Tzu-Chen [Chang Gung Memorial Hospital, Department of Nuclear Medicine and Molecular Imaging Center, Gueishan (China); Chang Gung University College of Medicine, Taoyuan (China); Ho, Chi-Lai [Hong Kong Sanatorium and Hospital, Department of Nuclear Medicine and Positron Emission Tomography, Hong Kong (China); Ng, Shu-Hang; Lin, Yu-Chun [Chang Gung University College of Medicine, Taoyuan (China); Chang Gung Memorial Hospital, Department of Diagnostic Radiology, Taoyuan (China); Wang, Po-Nan; Tang, Tzung-Chih [Chang Gung University College of Medicine, Taoyuan (China); Chang Gung Memorial Hospital, Department of Internal Medicine, Division of Hematology-Oncology, Taoyuan (China); Huang, Yenlin [Chang Gung University College of Medicine, Taoyuan (China); Chang Gung Memorial Hospital, Department of Anatomic Pathology, Taoyuan (China); Rahmouni, Alain [AP-HP, Groupe Henri-Mondor Albert-Chenevier, CHU Henri Mondor, Department of Radiology, Creteil (France)

    2014-01-15

    We investigated the potential value of {sup 11}C-acetate (ACT) PET/CT in characterizing multiple myeloma (MM) compared with {sup 18}F-FDG PET/CT. Bone marrow histological and whole-body (WB) MRI findings served as the reference standards. In this prospective study, 15 untreated MM patients (10 men and 5 women, age range 48-69 years) underwent dual-tracer {sup 11}C-ACT and {sup 18}F-FDG PET/CT and WB MRI for pretreatment staging, and 13 of them had repeated examinations after induction therapy. Diffuse and focal bone marrow uptake was assessed by visual and quantitative analyses, including measurement of the maximum standardized uptake value (SUV{sub max}). Between-group differences and correlations were assessed with the Mann-Whitney U test and the Pearson test. At staging, all 15 patients had diffuse myeloma involvement upon bone marrow examination with 30-90 % of plasma cell infiltrates. Diffuse infiltration was detected in all of them (100 %) using {sup 11}C-ACT with a positive correlation between bone marrow uptake values and percentages of plasma cell infiltrates (r = +0.63, p = 0.01). In contrast, a diagnosis of diffuse infiltration could be established using {sup 18}F-FDG in only six patients (40 %). Focal lesions were shown in 13 patients on both {sup 11}C-ACT PET/CT and WB MRI, and in 10 patients on {sup 18}F-FDG PET/CT. Focal lesions demonstrated {sup 11}C-ACT uptake with a mean SUV{sub max} of 11.4 ± 3.3 (range 4.6-19.6, n = 59), which was significantly higher than the {sup 18}F-FDG uptake (mean SUV{sub max} 6.6 ± 3.1, range 2.3-13.7, n = 29; p < 0.0001). After treatment, the diffuse bone marrow {sup 11}C-ACT uptake showed a mean SUV{sub max} reduction of 66 % in patients with at least a very good partial response versus 34 % in those with at most a partial response only (p = 0.01). PET/CT using {sup 11}C-ACT as a biomarker showed a higher detection rate for both diffuse and focal myeloma lesions at diagnosis than using {sup 18}F-FDG, and may be

  11. 11C-Acetate as a new biomarker for PET/CT in patients with multiple myeloma: initial staging and postinduction response assessment

    International Nuclear Information System (INIS)

    Lin, Chieh; Tsai, Shu-Fan; Yen, Tzu-Chen; Ho, Chi-Lai; Ng, Shu-Hang; Lin, Yu-Chun; Wang, Po-Nan; Tang, Tzung-Chih; Huang, Yenlin; Rahmouni, Alain

    2014-01-01

    We investigated the potential value of 11 C-acetate (ACT) PET/CT in characterizing multiple myeloma (MM) compared with 18 F-FDG PET/CT. Bone marrow histological and whole-body (WB) MRI findings served as the reference standards. In this prospective study, 15 untreated MM patients (10 men and 5 women, age range 48-69 years) underwent dual-tracer 11 C-ACT and 18 F-FDG PET/CT and WB MRI for pretreatment staging, and 13 of them had repeated examinations after induction therapy. Diffuse and focal bone marrow uptake was assessed by visual and quantitative analyses, including measurement of the maximum standardized uptake value (SUV max ). Between-group differences and correlations were assessed with the Mann-Whitney U test and the Pearson test. At staging, all 15 patients had diffuse myeloma involvement upon bone marrow examination with 30-90 % of plasma cell infiltrates. Diffuse infiltration was detected in all of them (100 %) using 11 C-ACT with a positive correlation between bone marrow uptake values and percentages of plasma cell infiltrates (r = +0.63, p = 0.01). In contrast, a diagnosis of diffuse infiltration could be established using 18 F-FDG in only six patients (40 %). Focal lesions were shown in 13 patients on both 11 C-ACT PET/CT and WB MRI, and in 10 patients on 18 F-FDG PET/CT. Focal lesions demonstrated 11 C-ACT uptake with a mean SUV max of 11.4 ± 3.3 (range 4.6-19.6, n = 59), which was significantly higher than the 18 F-FDG uptake (mean SUV max 6.6 ± 3.1, range 2.3-13.7, n = 29; p 11 C-ACT uptake showed a mean SUV max reduction of 66 % in patients with at least a very good partial response versus 34 % in those with at most a partial response only (p = 0.01). PET/CT using 11 C-ACT as a biomarker showed a higher detection rate for both diffuse and focal myeloma lesions at diagnosis than using 18 F-FDG, and may be valuable for response assessment. (orig.)

  12. Clinical usefulness of 18F–FDG PET/CT for initial staging and assessment of treatment efficacy in patients with lymph node tuberculosis

    International Nuclear Information System (INIS)

    Lefebvre, Nicolas; Argemi, Xavier; Meyer, Nicolas; Mootien, Joy; Douiri, Nawal; Sferrazza-Mandala, Stefania; Schramm, Frédéric; Weingertner, Noëlle; Christmann, Daniel; Hansmann, Yves; Imperiale, Alessio

    2017-01-01

    Introduction: Few studies have evaluated the promising role of 18 F–fluoro-2-deoxy-D-glucose positron emission tomography (PET) and PET/computed tomography FDG PET/CT in evaluating and monitoring treatment response in patients with lymph node tuberculosis (LNTB). The aim of this clinical investigation was to assess the clinical usefulness of FDG PET/CT for initial tuberculosis staging and to determine the prognostic value of the decrease of 18 F–FDG uptake during antibiotic treatment in LNTB patients. Methods: We retrospectively reviewed 18 cases of LNTB admitted at a single center from 2004 to 2014. Medical records of patients who underwent two FDG PET/CT (>6 months interval), at initial staging and at the end of therapy were reviewed to determine the impact of FDG PET/CT on initial management of LNTB and response to therapy. Statistical analysis was performed using linear mixed-effects model. Results: Thirteen cases of disseminated LNTB and five cases of localized LNTB were included in the study. Initial FDG PET/CT allowed guided biopsy for initial diagnosis in 5 patients and identified unknown extra-LN TB sites in 9 patients. Visual analysis follow-up of FDG PET/CT showed a complete metabolic response in 9/18 patients (all of whom were cured), a partial response in 7/18 (5 of whom were cured) and no response in 2/18 (all of whom were not cured). The semi-quantitative evaluation of 18F–FDG intensity decrease based on the maximum standardized uptake value (SUVmax), compared to targeted estimated decrease allowed to predict correctly a complete response to treatment in 14/18 cases. Conclusion: FDG PET/CT allows an accurate pre-therapeutic mapping of LNTB and helps for early TB confirmation. The SUVmax follow up is a potential tool for monitoring the treatment response.

  13. Inter-observer reliability of animal-based welfare indicators included in the Animal Welfare Indicators welfare assessment protocol for dairy goats.

    Science.gov (United States)

    Vieira, A; Battini, M; Can, E; Mattiello, S; Stilwell, G

    2018-01-08

    This study was conducted within the context of the Animal Welfare Indicators (AWIN) project and the underlying scientific motivation for the development of the study was the scarcity of data regarding inter-observer reliability (IOR) of welfare indicators, particularly given the importance of reliability as a further step for developing on-farm welfare assessment protocols. The objective of this study is therefore to evaluate IOR of animal-based indicators (at group and individual-level) of the AWIN welfare assessment protocol (prototype) for dairy goats. In the design of the study, two pairs of observers, one in Portugal and another in Italy, visited 10 farms each and applied the AWIN prototype protocol. Farms in both countries were visited between January and March 2014, and all the observers received the same training before the farm visits were initiated. Data collected during farm visits, and analysed in this study, include group-level and individual-level observations. The results of our study allow us to conclude that most of the group-level indicators presented the highest IOR level ('substantial', 0.85 to 0.99) in both field studies, pointing to a usable set of animal-based welfare indicators that were therefore included in the first level of the final AWIN welfare assessment protocol for dairy goats. Inter-observer reliability of individual-level indicators was lower, but the majority of them still reached 'fair to good' (0.41 to 0.75) and 'excellent' (0.76 to 1) levels. In the paper we explore reasons for the differences found in IOR between the group and individual-level indicators, including how the number of individual-level indicators to be assessed on each animal and the restraining method may have affected the results. Furthermore, we discuss the differences found in the IOR of individual-level indicators in both countries: the Portuguese pair of observers reached a higher level of IOR, when compared with the Italian observers. We argue how the

  14. Measurement properties of a novel survey to assess stages of organizational readiness for evidence-based interventions in community chronic disease prevention settings

    Directory of Open Access Journals (Sweden)

    Stamatakis Katherine A

    2012-07-01

    Full Text Available Abstract Background There is a great deal of variation in the existing capacity of primary prevention programs and policies addressing chronic disease to deliver evidence-based interventions (EBIs. In order to develop and evaluate implementation strategies that are tailored to the appropriate level of capacity, there is a need for an easy-to-administer tool to stage organizational readiness for EBIs. Methods Based on theoretical frameworks, including Rogers’ Diffusion of Innovations, we developed a survey instrument to measure four domains representing stages of readiness for EBI: awareness, adoption, implementation, and maintenance. A separate scale representing organizational climate as a potential mediator of readiness for EBIs was also included in the survey. Twenty-three questions comprised the four domains, with four to nine items each, using a seven-point response scale. Representatives from obesity, asthma, diabetes, and tobacco prevention programs serving diverse populations in the United States were surveyed (N = 243; test-retest reliability was assessed with 92 respondents. Results Confirmatory factor analysis (CFA was used to test and refine readiness scales. Test-retest reliability of the readiness scales, as measured by intraclass correlation, ranged from 0.47–0.71. CFA found good fit for the five-item adoption and implementation scales and resulted in revisions of the awareness and maintenance scales. The awareness scale was split into two two-item scales, representing community and agency awareness. The maintenance scale was split into five- and four-item scales, representing infrastructural maintenance and evaluation maintenance, respectively. Internal reliability of scales (Cronbach’s α ranged from 0.66–0.78. The model for the final revised scales approached good fit, with most factor loadings >0.6 and all >0.4. Conclusions The lack of adequate measurement tools hinders progress in dissemination and implementation

  15. The usefulness of I-131 MIBG scintigraphy in assessing the staging of neuroectodermal tumors in children - Our experience

    International Nuclear Information System (INIS)

    Budlewski, T.; Rogowski, F.; Luczynski, W.; Krawczuk-Rybak, M.

    2004-01-01

    Full text: Neuroendodermal tumors include pheochromocytoma, paraganglioma, medullary thyroid cancer and neuroblastoma. These malignant tumors derive from the primitive neural crest, which develops to sympathic nervous system. The tumors consist of cells that are capable of incorporating the amine precursors such as I-131 MIBG. The most common malignant tumor in childhood is neuroblastoma. The tested group included patients with neuroblastoma and one with pheochromocytoma treated in the Department of Oncology at the Paediatric University Hospital in Bialystok. There were 8 patients between the ages of 2 and 13. They have all undergone standard whole body scanning with a tomographic Nucline X-Ring camera made by Mediso, fitted with high-energy all purpose parallel hole collimator, a scan speed 5cm/ min and static images of 250,000 counts or 10 min per image. The study was performed 24-48 h after I-131 MIBG injection of 35 MBq activity. The results were obtained by antero-posterior and posterio-anterior projections (a whole body scan) and, if necessary, additional static images of chest and abdomen, skull, pelvis, and lower limbs. Clinical Characteristics of the Group: M.E. 12-year-old child with a right suprarenal tumor with morrow metastases. HP-neuroblastoma. The child was treated with a preoperative chemotherapy, operated and given postoperative chemotherapy (palliative therapy). The MIBG scintigraphy showed hypermetabolic focus in the pelvis and in the left vertex bone. Clinical test pointed to the progress of the disease. M.J. 6-year-old child with infiltrative retroperitoneal on both sides of celiac trunk with a metastases to mediastinum and bone marrow. HP-neuroblastoma. The first MIBG scintigraphy performed after Tsishidy operative procedure was negative. The second MIBG scintigraphy, one year later showed metastases to thigh bone, spine, and sacroiliac joint. Clinically proven progress of the disease. G.G. 2-year-old child with facial skeleton tumor and

  16. Performance assessment and transient optimization of air precooling in multi-stage solid desiccant air conditioning systems

    International Nuclear Information System (INIS)

    Gadalla, Mohamed; Saghafifar, Mohammad

    2016-01-01

    Highlights: • Studying three two-stage solid desiccant cooling systems using Maisotsenko cooler. • Proposing precooling to improve two-stage desiccant systems’ COP for humid climates. • Performing transient analysis for a two-stage solid desiccant cooler in UAE. • Optimizing daily performance of a two-stage solid desiccant cooler for UAE. - Abstract: Renewable energy is one of the most promising solutions to both energy and global warming crisis. Energy consumption can be minimized considerably by utilizing solar energy in air conditioning systems operation. One of the popular solar air conditioning technologies is desiccant air conditioning. Nonetheless, conventional desiccant air conditioning systems have a relatively low coefficient of performance (COP). In consequence, two-stage desiccant air-conditioning systems are proposed to improve desiccant air conditioning systems’ COP. Moreover, a recently commercialized cooling method named Maisotsenko cooling cycle which is capable of cooling air near to its dew point temperature is considered to be integrated within the proposed multi-stage desiccant cooling systems. In this paper, three new two-stage desiccant air conditioning systems incorporating Maisotsenko cooling cycle are proposed and investigated in details for hot and humid climates such as UAE. Furthermore, air precooling is considered to improve two stage desiccant air conditioning systems’ COP. Moreover, full transient analysis and optimization are carried out in UAE within June–October. The proposed system can minimize the required solar heating during noon time as the ambient air dry bulb temperature rises. Average COP of the system during electricity load peak hours (10:00–14:00) for all five considered and combined months is 1.77. Average rate of heat input required to operate the system and average building cooling load are determined to be 100.3 kW and 46.2 kW, respectively. Therefore, system average COP is computed to be 0.46.

  17. Intravenous streptokinase therapy in acute myocardial infarction: Assessment of therapy effects by quantitative 201Tl myocardial imaging (including SPECT) and radionuclide ventriculography

    International Nuclear Information System (INIS)

    Koehn, H.; Bialonczyk, C.; Mostbeck, A.; Frohner, K.; Unger, G.; Steinbach, K.

    1984-01-01

    To evaluate a potential beneficial effect of systemic streptokinase therapy in acute myocardial infarction, 36 patients treated with streptokinase intravenously were assessed by radionuclide ventriculography and quantitative 201 Tl myocardial imaging (including SPECT) in comparison with 18 conventionally treated patients. Patients after thrombolysis had significantly higher EF, PFR, and PER as well as fewer wall motion abnormalities compared with controls. These differences were also observed in the subset of patients with anterior wall infarction (AMI), but not in patients with inferior wall infarction (IMI). Quantitative 201 Tl imaging demonstrated significantly smaller percent myocardial defects and fewer pathological stress segments in patients with thrombolysis compared with controls. The same differences were also found in both AMI and IMI patients. Our data suggest a favorable effect of intravenous streptokinase on recovery of left ventricular function and myocardial salvage. Radionuclide ventriculography and quantitative 201 Tl myocardial imaging seem to be reliable tools for objective assessment of therapy effects. (orig.)

  18. Process performance assessment of advanced anaerobic digestion of sewage sludge including sequential ultrasound-thermal (55 °C) pre-treatment.

    Science.gov (United States)

    Neumann, Patricio; Barriga, Felipe; Álvarez, Claudia; González, Zenón; Vidal, Gladys

    2018-03-15

    The aim of this study was to evaluate the performance and digestate quality of advanced anaerobic digestion of sewage sludge including sequential ultrasound-thermal (55 °C) pre-treatment. Both stages of pre-treatment contributed to chemical oxygen demand (COD) solubilization, with an overall factor of 11.4 ± 2.2%. Pre-treatment led to 19.1, 24.0 and 29.9% increased methane yields at 30, 15 and 7.5 days solid retention times (SRT), respectively, without affecting process stability or accumulation of intermediates. Pre-treatment decreased up to 4.2% water recovery from the digestate, but SRT was a more relevant factor controlling dewatering. Advanced digestion showed 2.4-3.1 and 1.5 logarithmic removals of coliforms and coliphages, respectively, and up to a 58% increase in the concentration of inorganics in the digestate solids compared to conventional digestion. The COD balance of the process showed that the observed increase in methane production was proportional to the pre-treatment solubilization efficiency. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Assessment of Choroidal Microstructure and Subfoveal Thickness Change in Eyes With Different Stages of Age-Related Macular Degeneration.

    Science.gov (United States)

    Lu, Linna; Xu, Shiqiong; He, Fangling; Liu, Yan; Zhang, Yidan; Wang, Jing; Wang, Zhiliang; Fan, Xianqun

    2016-03-01

    Age-related macular degeneration (AMD) is a major cause of irreversible blindness. Choroidal structural changes seem to be inevitable in AMD pathogenesis. Our study revealed associated choroidal microstructural changes in AMD eyes.The aim of the study was to compare choroidal microstructural changes in eyes with AMD of different stages.The study was a retrospective, cross-sectional case series.The participants comprised of 32 age-matched normal eyes as controls, and 26 fellow uninvolved eyes of intermediate/late AMD, 29 of early AMD, 28 of intermediate AMD, and 39 of late AMD.All subjects underwent comprehensive ophthalmologic examination. The choroid images, including subfoveal choroidal thickness, percentage of Sattler layer area, and en face images of the choroid, were obtained using spectral-domain optical coherence tomography.The main outcome measures were subfoveal choroidal thickness changes, percentage of Sattler layer area changes, and en face images of the choroid in AMD eyes.One hundred fifty-four eyes of 96 individuals with mean age of 67.1±9.2 years were included. The mean subfoveal choroidal thickness was 295.4 ± 56.8 μm in age-matched normal eyes, 306.7 ± 68.4 μm in fellow uninvolved eyes with AMD, 293.8 ± 80.4 μm in early AMD, 215.6 ± 80.4 μm in intermediate AMD, and 200.4 ± 66.6 μm in late AMD (F = 14.2, all P < 0.001). Choroidal thickness was greater in early AMD eyes than in intermediate/late AMD eyes (P < 0.001). Mean percentage of Sattler layer area in each group showed a similar tendency. Microstructure of the choroid showed reduced vascular density of Sattler layer areas in late AMD eyes compared with normal eyes.Decreasing subfoveal choroidal thickness and percentage of Sattler layer area were demonstrated in the progression of AMD. The choroidal change was related to atrophy of the microstructural changes of underlying capillaries and medium-sized vessels.

  20. Introduction to the JPA special issue: Can the Psychodynamic Diagnostic Manual put the complex person back at the center-stage of personality assessment?

    Science.gov (United States)

    Huprich, Steven K; Meyer, Gregory J

    2011-03-01

    We briefly introduce this special issue, which focuses both on the Psychodynamic Diagnostic Manual (PDM) and the practice of idiographic, depth-oriented personality assessment. The 7 articles in this issue are diverse in scope but all address these 2 important topics. To set the stage, the special issue opens with a description of the history behind, the purposes of, and the steps taken to develop the PDM, and the next article provides a compelling illustration of depth-oriented personality assessment in the context of a long-term course of psychodynamic treatment. The third and fourth articles describe how the PDM model fosters attention to dynamic processes, not just overt symptoms, and they articulate the challenges and benefits of integrating this model into both the revitalized practice of assessment and diagnosis and the research avenues that will evaluate its validity and utility. The fifth article provides a broad overview of interesting experimental research on implicit processes from personality, social, and cognitive psychology, with implications for understanding and assessing dynamic processes. The sixth article illustrates how a PDM-based assessment of an adolescent boy helpfully contributed to his psychodynamic therapy. Finally, the issue closes with an illuminating article describing a PDM-based training model for the graduated development of assessment and diagnosis skills in a doctoral program. Overall, this special issue helps show how the PDM can invigorate multimethod personality assessment by placing the complex idiographic understanding of a person at the center-stage in the assessment process.

  1. Assessment of resource use and costs associated with parathyroidectomy for secondary hyperparathyroidism in end stage renal disease in the UK.

    Science.gov (United States)

    Pockett, Rhys D; Cevro, Emir; Chamberlain, George; Scott-Coombes, David; Baboolal, Kesh

    2014-03-01

    Secondary hyperparathyroidism (SHPT) is a major complication of end stage renal disease (ESRD). For the National Health Service (NHS) to make appropriate choices between medical and surgical management, it needs to understand the cost implications of each. A recent pilot study suggested that the current NHS healthcare resource group tariff for parathyroidectomy (PTX) (£2071 and £1859 in patients with and without complications, respectively) is not representative of the true costs of surgery in patients with SHPT. This study aims to provide an estimate of healthcare resources used to manage patients and estimate the cost of PTX in a UK tertiary care centre. Resource use was identified by combining data from the Proton renal database and routine hospital data for adults undergoing PTX for SHPT at the University Hospital of Wales, Cardiff, from 2000-2008. Data were supplemented by a questionnaire, completed by clinicians in six centres across the UK. Costs were obtained from NHS reference costs, British National Formulary and published literature. Costs were applied for the pre-surgical, surgical, peri-surgical, and post-surgical periods so as to calculate the total cost associated with PTX. One hundred and twenty-four patients (mean age=51.0 years) were identified in the database and 79 from the questionnaires. The main costs identified in the database were the surgical stay (mean=£4066, SD=£,130), the first month post-discharge (£465, SD=£176), and 3 months prior to surgery (£399, SD=£188); the average total cost was £4932 (SD=£4129). From the questionnaires the total cost was £5459 (SD=£943). It is possible that the study was limited due to missing data within the database, as well as the possibility of recall bias associated with the clinicians completing the questionnaires. This analysis suggests that the costs associated with PTX in SHPT exceed the current NHS tariffs for PTX. The cost implications associated with PTX need to be considered in the

  2. THE USE OF CARTOGRAPHIC MATTER FROM OPEN SOURCES FOR MASS ASSESSMENT AT THE PRE-STAGE STUDY OF HYDROPOWER CONSTRUCTION

    Directory of Open Access Journals (Sweden)

    A. A. Tesalovsky

    2016-01-01

    Full Text Available In the article the possibility of planning and cartographic materials and supplies to remote sensing of the Earth, which can get them open sources for mass valuation of land at the pre-stage study on developing a multi-purpose reservoirs on the plains and plateaus. Particular attention is given to the use of the service "Public cadastral map', available on the portal of the Federal Service for State Registration, Cadastre and Cartography: advantages and disadvantages of the use of undeveloped and sparsely populated areas of service information. Clarified what objects other than those required by regulatory and technical documents and regulations can be obtained by using the public cadastral map using its various functions: cadastral division maps, raster maps Russian and available on a portal of Earth Remote Sensing Data. In the article it is assumed that the accuracy of the image contour of the situation and the relief map material from open sources corresponds to map scale is larger than 1: 100 000 with the height of the relief section of not less than 20 meters. Mass assessment is based on the possibility of placing some or all of the seven species of water potential in the waters of hydroelectric complex. Potential benefits of each of the water users, attributable to the land plot is set on the basis of the cadastral value of land corresponding to each type of water. The area used by each of the water users, established in accordance with its requirements to the bottom topography, the provisions of water and nature protection legislation. Justification is made on the basis of the calculation of measurement error plot area used by water users in their economic activity, taking into account the errors in the image of the contour of the situation on these maps. It was found that the error introduced by cartographic materials used in certain methods of mass estimation of cost of land area, reserved for the construction of multi

  3. Intra- and interobserver analysis in the morphological assessment of early stage embryos during an IVF procedure: a multicentre study

    Directory of Open Access Journals (Sweden)

    Devroe Johanna

    2011-09-01

    Full Text Available Abstract Background Quality control programs are necessary to maintain good clinical practice. Embryo grading has been described as one of the external quality assurance schemes. Although the evaluation of embryos is based on the assessment of morphological characteristics, considerable intra- and inter-observer variability has been described. In this multicentre study, the variability in the embryo evaluation has been evaluated using morphological characteristics on day 1, day 2 and day 3 of embryo development. Methods Five embryologists of four different IVF centers participated in this study. Multilevel images of embryos were presented on a website at different time points to evaluate intra-and inter-observer agreement in the assessment of embryo morphology. The embryos were evaluated on day 1, day 2 and day 3 of their development and each embryologist had to decide if the embryo had to be transferred, cryopreserved or discarded. Results Both intra-observer agreement and inter-observer agreement were good to excellent for the position of the pronuclei on day 1, the number of blastomeres on day 2 and day 3 and the clinical decision (transfer, cryopreservation, discard. For all other characteristics (size of pronuclei, presence of cytoplasomic halo, degree of fragmentation and size of blastomeres the intra- and inter-observer agreement was moderate to very poor. Conclusions Mono- or multicentre quality control on embryo scoring by morphological assessment can easily be performed through the design of a simple website. In the future the website design can be adapted to generate statistical feedback upon scoring and can even include a training module.

  4. Assessing vanadium and arsenic exposure of people living near a petrochemical complex with two-stage dispersion models

    International Nuclear Information System (INIS)

    Chio, Chia-Pin; Yuan, Tzu-Hsuen; Shie, Ruei-Hao; Chan, Chang-Chuan

    2014-01-01

    Highlights: • Two-stage dispersion models can estimate exposures to hazardous air pollutants. • Spatial distribution of V levels is derived for sources without known emission rates. • A distance-to-source gradient is found for V levels from a petrochemical complex. • Two-stage dispersion is useful for modeling air pollution in resource-limited areas. - Abstract: The goal of this study is to demonstrate that it is possible to construct a two-stage dispersion model empirically for the purpose of estimating air pollution levels in the vicinity of petrochemical plants. We studied oil refineries and coal-fired power plants in the No. 6 Naphtha Cracking Complex, an area of 2,603-ha situated on the central west coast of Taiwan. The pollutants targeted were vanadium (V) from oil refineries and arsenic (As) from coal-fired power plants. We applied a backward fitting method to determine emission rates of V and As, with 192 PM 10 filters originally collected between 2009 and 2012. Our first-stage model estimated emission rates of V and As (median and 95% confidence intervals at 0.0202 (0.0040–0.1063) and 0.1368 (0.0398–0.4782) g/s, respectively. In our second stage model, the predicted zone-average concentrations showed a strong correlation with V, but a poor correlation with As. Our findings show that two-stage dispersion models are relatively precise for estimating V levels at residents’ addresses near the petrochemical complex, but they did not work as well for As levels. In conclusion, our model-based approach can be widely used for modeling exposure to air pollution from industrial areas in countries with limited resources

  5. Assessing the environmental sustainability of early stage design for bioprocesses under uncertainties: An analysis of glycerol bioconversion

    DEFF Research Database (Denmark)

    Loureiro da Costa Lira Gargalo, Carina; Cheali, Peam; Posada, John A.

    2016-01-01

    The development of a bio-based economy is seen as a key strategy towards a sustainable society in a world facing climate change, energy security and social distress. However, since substantial uncertainty is involved in early-stage design analyses, the ranking and identification of potential......; and lastly, (v) rank the alternatives within the design space. Finally, the methodology's applicability is highlighted by screening early-stage glycerol bioconversion routes to value-added chemicals for future biorefinery concepts. Through the proposed methodology, it was demonstrated that the statistical...

  6. Assessment of Liver Fibrosis by Transient Elastography Should Be Done After Hemodialysis in End Stage Renal Disease Patients with Liver Disease.

    Science.gov (United States)

    Taneja, Sunil; Borkakoty, Amritangsu; Rathi, Sahaj; Kumar, Vivek; Duseja, Ajay; Dhiman, Radha K; Gupta, Krishan L; Chawla, Yogesh

    2017-11-01

    The patients with end stage renal disease (ESRD) are at greater risk of acquiring chronic hepatitis B or C and subsequently development of liver disease. The aim of the study was to assess liver fibrosis by transient elastography (TE) and look for factors associated with change in liver stiffness measurement (LSM) with one session of hemodialysis (HD). Consecutive ESRD patients on maintenance hemodialysis (MHD) with suspected liver disease were enrolled. They underwent LSM by TE before and after one session of HD. Bioelectric impedance analysis was done to evaluate the volume status at the time of TE. Sixty-eight patients with mean age of 40 ± 14 years were included. There was a significant reduction in LSM after HD (18.5 [95% CI 14.8-23.1] vs. 11.2 [95% CI 8.8-13.7] kPa, p  or  2.5 L (8.6 [95% CI 5.7-11.5] vs. 5.1 [95% CI 2.9-7.5], p = 0.05). In 18 patients who underwent liver biopsy, LSM after HD performed better at detecting significant fibrosis, with area under receiver operating characteristics curve 0.71 [95% CI 0.46-0.97], versus 0.64 [95% CI 0.38-0.90], respectively. An LSM value of 12.2 kPa after HD was 71% sensitive and 74% specific for detection of significant fibrosis (≥ F2), while values less than 9 kPa ruled out significant fibrosis with a sensitivity and specificity of 37 and 100%, respectively. LSM by TE decreases significantly after HD in patients with ESRD on long-term MHD. Hence, TE should be done after HD for accurate assessment of liver fibrosis.

  7. Combined curative radiotherapy including HDR brachytherapy and androgen deprivation in localized prostate cancer: A prospective assessment of acute and late treatment toxicity

    International Nuclear Information System (INIS)

    Wahlgren, Thomas; Nilsson, Sten; Ryberg, Marianne; Brandberg, Yvonne; Lennernaes, Bo

    2005-01-01

    Self-reported symptoms including urinary, bowel and sexual side effects were investigated prospectively at multiple assessment points before and after combined radiotherapy of prostate cancer including HDR brachytherapy and neoadjuvant androgen deprivation therapy. Between April 2000 and June 2003, patients with predominantly advanced localized prostate tumours subjected to this treatment were asked before treatment and on follow-up visits to complete a questionnaire covering urinary, bowel and sexual problems. The mainly descriptive analyses included 525 patients, responding to at least one questionnaire before or during the period 2-34 months after radiotherapy. Adding androgen deprivation before radiotherapy significantly worsened sexual function. During radiotherapy, urinary, bowel and sexual problems increased and were reported at higher levels up to 34 months, although there seemed to be a general tendency to less pronounced irritative bowel and urinary tract symptoms over time. No side effects requiring surgery were reported. Classic late irradiation effects such as mucosal bleeding were demonstrated mainly during the second year after therapy, but appear less pronounced in comparison with dose escalated EBRT series. In conclusion, despite the high radiation dose given, the toxicity seemed comparable with that of other series but long term (5-10 years) symptom outcome has to be determined

  8. Assessment of cerebral microbleeds by susceptibility-weighted imaging at 3T in patients with end-stage organ failure.

    Science.gov (United States)

    Sparacia, Gianvincenzo; Cannella, Roberto; Lo Re, Vincenzina; Gambino, Angelo; Mamone, Giuseppe; Miraglia, Roberto

    2018-02-17

    Cerebral microbleeds (CMBs) are small rounded lesions representing cerebral hemosiderin deposits surrounded by macrophages that results from previous microhemorrhages. The aim of this study was to review the distribution of cerebral microbleeds in patients with end-stage organ failure and their association with specific end-stage organ failure risk factors. Between August 2015 and June 2017, we evaluated 15 patients, 9 males, and 6 females, (mean age 65.5 years). Patients population was subdivided into three groups according to the organ failure: (a) chronic kidney failure (n = 8), (b) restrictive cardiomyopathy undergoing heart transplantation (n = 1), and (c) end-stage liver failure undergoing liver transplantation (n = 6). The MR exams were performed on a 3T MR unit and the SWI sequence was used for the detection of CMBs. CMBs were subdivided in supratentorial lobar distributed, supratentorial non-lobar distributed, and infratentorial distributed. A total of 91 microbleeds were observed in 15 patients. Fifty-nine CMBs lesions (64.8%) had supratentorial lobar distribution, 17 CMBs lesions (18.8%) had supratentorial non-lobar distribution and the remaining 15 CMBs lesions (16.4%) were infratentorial distributed. An overall predominance of supratentorial multiple lobar localizations was found in all types of end-stage organ failure. The presence of CMBs was significantly correlated with age, hypertension, and specific end-stage organ failure risk factors (p failure. The improved detection of CMBs with SWI sequences may contribute to a more accurate identification of patients with cerebral risk factors to prevent complications during or after the organ transplantation.

  9. Technical support document: Energy efficiency standards for consumer products: Refrigerators, refrigerator-freezers, and freezers including draft environmental assessment, regulatory impact analysis

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-07-01

    The Energy Policy and Conservation Act (P.L. 94-163), as amended by the National Appliance Energy Conservation Act of 1987 (P.L. 100-12) and by the National Appliance Energy Conservation Amendments of 1988 (P.L. 100-357), and by the Energy Policy Act of 1992 (P.L. 102-486), provides energy conservation standards for 12 of the 13 types of consumer products` covered by the Act, and authorizes the Secretary of Energy to prescribe amended or new energy standards for each type (or class) of covered product. The assessment of the proposed standards for refrigerators, refrigerator-freezers, and freezers presented in this document is designed to evaluate their economic impacts according to the criteria in the Act. It includes an engineering analysis of the cost and performance of design options to improve the efficiency of the products; forecasts of the number and average efficiency of products sold, the amount of energy the products will consume, and their prices and operating expenses; a determination of change in investment, revenues, and costs to manufacturers of the products; a calculation of the costs and benefits to consumers, electric utilities, and the nation as a whole; and an assessment of the environmental impacts of the proposed standards.

  10. ASSESSMENT OF THE CHANGES IN BLOOD PRESSURE CIRCADIAN PROFILE AND VARIABILITY IN PATIENTS WITH CHRONIC HEART FAILURE AND ARTERIAL HYPERTENSION DURING COMBINED THERAPY INCLUDING IVABRADINE

    Directory of Open Access Journals (Sweden)

    M. V. Surovtseva

    2012-01-01

    Full Text Available Aim. To assess the changes in blood pressure (BP circadian profile and variability in patients with chronic heart failure (CHF of ischemic etiology and arterial hypertension (HT due to the complex therapy including ivabradine. Material and methods. Patients (n=90 with CHF class II–III NYHA associated with stable angina II-III class and HT were examined. The patients were randomized into 3 groups depending on received drugs: perindopril and ivabradine - group 1; perindopril, bisoprolol and ivabradine - group 2; perindopril and bisoprolol - group 3. The duration of therapy was 6 months. Ambulatory BP monitoring (ABPM was assessed at baseline and after treatment. Results. More significant reduction in average 24-hours systolic BP was found in groups 1 and 2 compared to group 3 (Δ%: -19.4±0,4; -21.1±0.4 and -11.8±0.6, respectively as well as diastolic BP (Δ%: -10.6±0.6; -12.9±0.4 and -4,3±0.3, respectively and other ABPM indicators. Improvement of BP circadian rhythm was found due to increase in the number of «Dipper» patients (p=0.016. More significant reduction in average daily and night systolic and diastolic BP (p=0.001, as well as daily and night BP variability (p=0.001 was also found in patients of group 2 compared to these of group 1. Conclusion. Moderate antihypertensive effect (in respect of both diastolic and systolic BP was shown when ivabradine was included into the complex therapy of patients with ischemic CHF and HT. The effect was more pronounced when ivabradine was combined with perindopril and bisoprolol. This was accompanied by reduction in high BP daily variability and improvement of the BP circadian rhythm. 

  11. ASSESSMENT OF THE CHANGES IN BLOOD PRESSURE CIRCADIAN PROFILE AND VARIABILITY IN PATIENTS WITH CHRONIC HEART FAILURE AND ARTERIAL HYPERTENSION DURING COMBINED THERAPY INCLUDING IVABRADINE

    Directory of Open Access Journals (Sweden)

    M. V. Surovtseva

    2015-12-01

    Full Text Available Aim. To assess the changes in blood pressure (BP circadian profile and variability in patients with chronic heart failure (CHF of ischemic etiology and arterial hypertension (HT due to the complex therapy including ivabradine. Material and methods. Patients (n=90 with CHF class II–III NYHA associated with stable angina II-III class and HT were examined. The patients were randomized into 3 groups depending on received drugs: perindopril and ivabradine - group 1; perindopril, bisoprolol and ivabradine - group 2; perindopril and bisoprolol - group 3. The duration of therapy was 6 months. Ambulatory BP monitoring (ABPM was assessed at baseline and after treatment. Results. More significant reduction in average 24-hours systolic BP was found in groups 1 and 2 compared to group 3 (Δ%: -19.4±0,4; -21.1±0.4 and -11.8±0.6, respectively as well as diastolic BP (Δ%: -10.6±0.6; -12.9±0.4 and -4,3±0.3, respectively and other ABPM indicators. Improvement of BP circadian rhythm was found due to increase in the number of «Dipper» patients (p=0.016. More significant reduction in average daily and night systolic and diastolic BP (p=0.001, as well as daily and night BP variability (p=0.001 was also found in patients of group 2 compared to these of group 1. Conclusion. Moderate antihypertensive effect (in respect of both diastolic and systolic BP was shown when ivabradine was included into the complex therapy of patients with ischemic CHF and HT. The effect was more pronounced when ivabradine was combined with perindopril and bisoprolol. This was accompanied by reduction in high BP daily variability and improvement of the BP circadian rhythm. 

  12. Stage design

    International Nuclear Information System (INIS)

    Shacter, J.

    1975-01-01

    A method is described of cycling gases through a plurality of diffusion stages comprising the steps of admitting the diffused gases from a first diffusion stage into an axial compressor, simultaneously admitting the undiffused gases from a second diffusion stage into an intermediate pressure zone of said compressor corresponding in pressure to the pressure of said undiffused gases, and then admitting the resulting compressed mixture of diffused and undiffused gases into a third diffusion stage

  13. Staging Mobilities

    DEFF Research Database (Denmark)

    Jensen, Ole B.

    and lived as people are “staging themselves” (from below). Staging mobilities is a dynamic process between “being staged” (for example, being stopped at traffic lights) and the “mobile staging” of interacting individuals (negotiating a passage on the pavement). Staging Mobilities is about the fact...

  14. A comparison of two-component and quadratic models to assess survival of irradiated stage-7 oocytes of Drosophila melanogaster

    International Nuclear Information System (INIS)

    Peres, C.A.; Koo, J.O.

    1981-01-01

    In this paper, the quadratic model to analyse data of this kind, i.e. S/S 0 = exp(-αD-bD 2 ), where S and Ssub(o) are defined as before is proposed is shown that the same biological interpretation can be given to the parameters α and A and to the parameters β and B. Furthermore it is shown that the quadratic model involves one probabilistic stage more than the two-component model, and therefore the quadratic model would perhaps be more appropriate as a dose-response model for survival of irradiated stage-7 oocytes of Drosophila melanogaster. In order to apply these results, the data presented by Sankaranarayanan and Sankaranarayanan and Volkers are reanalysed using the quadratic model. It is shown that the quadratic model fits better than the two-component model to the data in most situations. (orig./AJ)

  15. Including pathogen risk in life cycle assessment of wastewater management. 2. Quantitative comparison of pathogen risk to other impacts on human health.

    Science.gov (United States)

    Heimersson, Sara; Harder, Robin; Peters, Gregory M; Svanström, Magdalena

    2014-08-19

    Resource recovery from sewage sludge has the potential to save natural resources, but the potential risks connected to human exposure to heavy metals, organic micropollutants, and pathogenic microorganisms attract stakeholder concern. The purpose of the presented study was to include pathogen risks to human health in life cycle assessment (LCA) of wastewater and sludge management systems, as this is commonly omitted from LCAs due to methodological limitations. Part 1 of this article series estimated the overall pathogen risk for such a system with agricultural use of the sludge, in a way that enables the results to be integrated in LCA. This article (part 2) presents a full LCA for two model systems (with agricultural utilization or incineration of sludge) to reveal the relative importance of pathogen risk in relation to other potential impacts on human health. The study showed that, for both model systems, pathogen risk can constitute an important part (in this study up to 20%) of the total life cycle impacts on human health (expressed in disability adjusted life years) which include other important impacts such as human toxicity potential, global warming potential, and photochemical oxidant formation potential.

  16. Dental age assessment of adolescents and emerging adults in United Kingdom Caucasians using censored data for stage H of third molar roots.

    Science.gov (United States)

    Boonpitaksathit, Teelana; Hunt, Nigel; Roberts, Graham J; Petrie, Aviva; Lucas, Victoria S

    2011-10-01

    The root of the third permanent molar is the only dental structure that continues development after completion of growth of the second permanent molar. It is claimed that the lack of a clearly defined end point for completion of growth of the third permanent molar means that this tooth cannot be used for dental age assessment. The aim of this study was to estimate the mean age of attainment of the four stages (E, F, G, and H) of root development of the third molar. The way in which the end point of completion of stage H can be identified is described. A total of 1223 dental panoramic tomographs (DPTs) available in the archives of the Eastman Dental Hospital, London, were used for this study. The ages of the subjects ranged from 12.6 to 24.9 years with 63 per cent of the sample being female. Demirjan's tooth development stages (TDSs), for the first and second molars, were applied to the third molars by a single examiner. For each of stages E, F, and G and for stage H censored data, the mean ages of the males and females were compared, separately within each tooth morphology type using the two sample t-test (P ages of the upper and lower third molars on each side, separately for each gender. The mean age of attainment and the 99 per cent confidence interval (CI) for each TDS were calculated for each third molar. The final stage H data were appropriately censored to exclude data above the age of completion of root growth. The results showed that, for each gender, the age in years at which individuals attained each of the four TDSs was approximately normally distributed. The mean age for appropriately censored data was always lower than the corresponding mean age of the inappropriately censored data for stage H (male UR8 19.57, UL8 19.53, LL8 19.91, and LR8 20.02 and female UR8 20.08, UL8 20.13, LL8 20.78, and LR8 20.70). This inappropriately censored data overestimated the mean age for stage H. The appropriately censored data for the TDSs of the third molar may be

  17. Fluorine-18-fluorodeoxyglucose positron emission tomography for interim response assessment of advanced-stage Hodgkin's lymphoma and diffuse large B-cell lymphoma: a systematic review

    DEFF Research Database (Denmark)

    Terasawa, T.; Lau, J.; Bardet, S.

    2009-01-01

    . RESULTS: Thirteen studies involving 360 advanced-stage HL patients and 311 DLBCL patients met our inclusion criteria. Advanced-stage HL studies included few unfavorable-risk patients. DLBCL studies were heterogeneous. FDG-PET had an overall sensitivity of 0.81 (95% CI, 0.72 to 0.89) and a specificity of 0.......97 (95% CI, 0.94 to 0.99) for advanced-stage HL, and a sensitivity of 0.78 (95% CI, 0.64 to 0.87) and a specificity of 0.87 (95% CI, 0.75 to 0.93) for DLBCL. Meta-regression and subgroup analyses did not identify factors that affect prognostic accuracy. CONCLUSION: For low- to intermediate-risk advanced...

  18. Including pork in the Mediterranean diet for an Australian population: Protocol for a randomised controlled trial assessing cardiovascular risk and cognitive function.

    Science.gov (United States)

    Wade, Alexandra T; Davis, Courtney R; Dyer, Kathryn A; Hodgson, Jonathan M; Woodman, Richard J; Keage, Hannah A D; Murphy, Karen J

    2017-12-22

    The Mediterranean diet is characterised by the high consumption of extra virgin olive oil, fruits, vegetables, grains, legumes and nuts; moderate consumption of fish, poultry, eggs and dairy; and low consumption of red meat and sweets. Cross sectional, longitudinal and intervention studies indicate that a Mediterranean diet may be effective for the prevention of cardiovascular disease and dementia. However, previous research suggests that an Australian population may find red meat restrictions difficult, which could affect long term sustainability of the diet. This paper outlines the protocol for a randomised controlled trial that will assess the cardiovascular and cognitive benefits of a Mediterranean diet modified to include 2-3 weekly serves of fresh, lean pork. A 24-week cross-over design trial will compare a modified Mediterranean diet with a low-fat control diet in at-risk men and women. Participants will follow each of the two diets for 8 weeks, with an 8-week washout period separating interventions. Home measured systolic blood pressure will be the primary outcome measure. Secondary outcomes will include body mass index, body composition, fasting blood lipids, C-reactive protein, fasting plasma glucose, fasting serum insulin, erythrocyte fatty acids, cognitive function, psychological health and well-being, and dementia risk. To our knowledge this research is the first to investigate whether an alternate source of protein can be included in the Mediterranean diet to increase sustainability and feasibility for a non-Mediterranean population. Findings will be significant for the prevention of cardiovascular disease and age-related decline, and may inform individuals, clinicians and public health policy. ACTRN12616001046493 . Registered 5 August 2016.

  19. Assessment of the quality of medical care among patients with early stage prostate cancer undergoing expectant management in the United States.

    Science.gov (United States)

    Ritchey, Jamie; Gay, E Greer; Spencer, Benjamin A; Miller, David C; Wallner, Lauren P; Stewart, Andrew K; Dunn, Rodney L; Litwin, Mark S; Wei, John T

    2012-09-01

    Given the increased attention to the quality and cost of medical care, the Institute of Medicine and Centers for Medicare and Medicaid Services have called for performance measurement and reporting. The clinical management of prostate cancer has been outlined, yet is not intended to describe quality prostate cancer care. Therefore, RAND researchers developed quality indicators for early stage prostate cancer. The ACoS (American College of Surgeons) used these indicators to perform the first national assessment to our knowledge of the quality of care among men with early stage prostate cancer undergoing expectant management. Information from medical records was abstracted for evidence of compliance with the RAND indicators (structure and process). Weighted and stratified proportions were calculated to assess indicator compliance. Logistic regression models were fit and evaluated by hospital type and patient factors. A weighted and stratified total of 13,876 early stage prostate cancer cases on expectant management in 2000 to 2001 were investigated. Compliance with structural indicators was high (greater than 80%) and compliance with process indicators varied (19% to 87%). Differences in process indicators were observed from models by hospital type and comorbid conditions, but not for age, race or insurance status. Using the RAND quality indicators this study revealed several process areas for quality improvement among men with early stage prostate cancer on expectant management in the United States. Efforts to improve the quality of early stage prostate cancer care need to move beyond the paradigm of age, race and insurance status. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  20. Validation study of a quantitative multigene reverse transcriptase-polymerase chain reaction assay for assessment of recurrence risk in patients with stage II colon cancer.

    Science.gov (United States)

    Gray, Richard G; Quirke, Philip; Handley, Kelly; Lopatin, Margarita; Magill, Laura; Baehner, Frederick L; Beaumont, Claire; Clark-Langone, Kim M; Yoshizawa, Carl N; Lee, Mark; Watson, Drew; Shak, Steven; Kerr, David J

    2011-12-10

    We developed quantitative gene expression assays to assess recurrence risk and benefits from chemotherapy in patients with stage II colon cancer. We sought validation by using RNA extracted from fixed paraffin-embedded primary colon tumor blocks from 1,436 patients with stage II colon cancer in the QUASAR (Quick and Simple and Reliable) study of adjuvant fluoropyrimidine chemotherapy versus surgery alone. A recurrence score (RS) and a treatment score (TS) were calculated from gene expression levels of 13 cancer-related genes (n = 7 recurrence genes and n = 6 treatment benefit genes) and from five reference genes with prespecified algorithms. Cox proportional hazards regression models and log-rank methods were used to analyze the relationship between the RS and risk of recurrence in patients treated with surgery alone and between TS and benefits of chemotherapy. Risk of recurrence was significantly associated with RS (hazard ratio [HR] per interquartile range, 1.38; 95% CI, 1.11 to 1.74; P = .004). Recurrence risks at 3 years were 12%, 18%, and 22% for predefined low, intermediate, and high recurrence risk groups, respectively. T stage (HR, 1.94; P < .001) and mismatch repair (MMR) status (HR, 0.31; P < .001) were the strongest histopathologic prognostic factors. The continuous RS was associated with risk of recurrence (P = .006) beyond these and other covariates. There was no trend for increased benefit from chemotherapy at higher TS (P = .95). The continuous 12-gene RS has been validated in a prospective study for assessment of recurrence risk in patients with stage II colon cancer after surgery and provides prognostic value that complements T stage and MMR. The TS was not predictive of chemotherapy benefit.

  1. The developmental stages of the middle phalanx of the third finger (MP3): a sole indicator in assessing the skeletal maturity?

    Science.gov (United States)

    Madhu, S; Hegde, Amitha M; Munshi, A K

    2003-01-01

    Assessment of skeletal maturity is an integral part of interceptive diagnosis and treatment planning. The present day methods of skeletal maturity assessment like the hand-wrist radiographs or cervical vertebrae radiographs are expensive, require elaborate equipment and accounts for high radiation exposure, especially for growing children. The present study was thus undertaken to provide a simple and practical method of skeletal maturity assessment using the developmental stages of the middle phalanx of the third finger (MP3) as seen on an IOPA film taken using a standard dental x-ray machine. The results of the study showed that this simple method was highly reliable and could be used as an alternative method to assess the skeletal maturity of growing children.

  2. Environmental Impact Assessment of a School Building in Iceland Using LCA-Including the Effect of Long Distance Transport of Materials

    Directory of Open Access Journals (Sweden)

    Nargessadat Emami

    2016-11-01

    Full Text Available Buildings are the key components of urban areas and society as a complex system. A life cycle assessment was applied to estimate the environmental impacts of the resources applied in the building envelope, floor slabs, and interior walls of the Vættaskóli-Engi building in Reykjavik, Iceland. The scope of this study included four modules of extraction and transportation of raw material to the manufacturing site, production of the construction materials, and transport to the building site, as described in the standard EN 15804. The total environmental effects of the school building in terms of global warming potential, ozone depletion potential, human toxicity, acidification, and eutrophication were calculated. The total global warming potential impact was equal to 255 kg of CO2 eq/sqm, which was low compared to previous studies and was due to the limited system boundary of the current study. The effect of long-distance overseas transport of materials was noticeable in terms of acidification (25% and eutrophication (31% while it was negligible in other impact groups. The results also concluded that producing the cement in Iceland caused less environmental impact in all five impact categories compared to the case in which the cement was imported from Germany. The major contribution of this work is that the environmental impacts of different plans for domestic production or import of construction materials to Iceland can be precisely assessed in order to identify effective measures to move towards a sustainable built environment in Iceland, and also to provide consistent insights for stakeholders.

  3. Forensic age assessment by 3.0T MRI of the knee: proposal of a new MRI classification of ossification stages.

    Science.gov (United States)

    Vieth, Volker; Schulz, Ronald; Heindel, Walter; Pfeiffer, Heidi; Buerke, Boris; Schmeling, Andreas; Ottow, Christian

    2018-03-13

    To explore the possibility of determining majority via a morphology-based examination of the epiphyseal-diaphyseal fusion by 3.0 T magnetic resonance imaging (MRI), a prospective cross-sectional study developing and applying a new stage classification was conducted. 344 male and 350 female volunteers of German nationality between the ages of 12-24 years were scanned between May 2013 and June 2015. A 3.0 T MRI scanner was used, acquiring a T1-weighted (T1-w) turbo spin-echo sequence (TSE) and a T2-weighted (T2-w) TSE sequence with fat suppression by spectral pre-saturation with inversion recovery (SPIR). The gathered information was sifted and a five-stage classification was formulated as a hypothesis. The images were then assessed using this classification. The relevant statistics were defined, the intra- and interobserver agreements were determined, and the differences between the sexes were analysed. The application of the new classification made it possible to correctly assess majority in both sexes by the examination of the epiphyses of the knee joint. The intra- and interobserver agreement levels were very good (κ > 0.80). The Mann-Whitney-U Test implied significant sex-related differences for most stages. Applying the presented MRI classification, it is possible to determine the completion of the 18th year of life in either sex by 3.0 T MRI of the knee joint. • Based on prospective referential data a new MRI classification was formulated. • The setting allows assessment of the age of an individual's skeletal development. • The classification scheme allows the reliable determination of majority in both sexes. • The staging shows a high reproducibility for instructed and trained professional personnel. • The proposed classification is likely to be adaptable to other long bone epiphyses.

  4. Comparison of renal function assessment by cystatin c and creatinine based equations for e-gfr in type 2 diabetics in different stages of albuminuria

    International Nuclear Information System (INIS)

    Qamar, A.; Ahmad, T.M.; Hayat, A.; Khan, M.A.; Rehman, S. Z.

    2017-01-01

    To compare e-GFR estimated by creatinine or cystatin C based and combined creatinine and cystatin C based equations in type 2 diabetics in different stages of albuminuria. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Chemical Pathology, Army Medical College Rawalpindi in collaboration with endocrinology outpatient department Military Hospital Rawalpindi, from Nov 2015 to Nov 2016. Material and Methods: A total of 119 type 2 diabetic subjects of either gender, aged 30- 60 years were enrolled in the study with duration of diabetes less than 15 years and were divided into further sub groups on the basis of degree of albuminuria determined by spot urine albumin to creatinine ratio (uACR). Fifty age matched disease free controls with no history of any systemic disease were also included in the study. Known patients of type 1 diabetes, chronic inflammatory disorders, uncontrolled hypertension, thyroid disease, chronic kidney disease, on lipid lowering drugs, steroids, ACE inhibitors and pregnant ladies were excluded from the study. Serum creatinine serum cystatin C were assessed on fully automated chemistry analyzer selectra. E-GFR was calculated by online GFR calculator by National Kidney Foundation. Comparison of means of e-GFR calculated by various equations was carried out by one way ANOVA and post-hoc Tukey tests. Degree of agreement between various equations for the estimation of GFR was assessed by kappa statistics. A p-value less than 0.05 were considered statistically significant. Results: Mean e-GFR (ml/min/1.73m2) was lowest in cystatin C based CKD-EPI equation (89.56 +- 39.84) followed by combined cystatin C and creatinine based CKD-EPI (92.34 +- 37.88). Values of e-GFR by creatinine based CKD-EPI equation (95.84 +- 27.24), and by creatinine based MDRD equation (105.37 +- 64.98) were both higher. In creatinine based MDRD, equation normo albuminuria and micro albuminuria groups did not show statistically

  5. Brief cognitive assessment of Alzheimer's disease in advanced stages: Proposal for a Brazilian version of the Short Battery for Severe Impairment (SIB-8

    Directory of Open Access Journals (Sweden)

    José Roberto Wajman

    Full Text Available ABSTRACT The measurement of cognitive abilities of patients with severe dementia can serve a wide range of methodological and clinical needs. Objective: To validate a proposed severe impairment battery SIB-8 for a Brazilian population sample as part of the neuropsychological assessment of patients with Alzheimer's disease (AD in advanced stages. Methods: After a systematic process of translation and back-translation, the SIB-8 was applied to 95 patients with AD at different stages; moderate, moderately severe and severe according to FAST subdivisions (5, 6 and 7, with scores on the Mini-Mental State Examination (MMSE of between 5 and 15 and followed by the Division of Behavioral Neurology and the Center for Aging Brain of the Federal University of São Paulo - UNIFESP. Results: Inferential data revealed that the SIB-8 instrument behaved differently at each stage of the disease with a statistical value of sensitivity p<0.001, gradually reflecting the expected course of the dementia, inherent with the decline of cognitive functions. Conclusion: Findings indicated that the SIB-8 is a useful tool for the evaluation and prospective comparison of AD patients in advanced stages, retaining its original characteristics in our population.

  6. Brief cognitive assessment of Alzheimer's disease in advanced stages: Proposal for a Brazilian version of the Short Battery for Severe Impairment (SIB-8).

    Science.gov (United States)

    Wajman, José Roberto; Bertolucci, Paulo Henrique Ferreira

    2013-01-01

    The measurement of cognitive abilities of patients with severe dementia can serve a wide range of methodological and clinical needs. To validate a proposed severe impairment battery SIB-8 for a Brazilian population sample as part of the neuropsychological assessment of patients with Alzheimer's disease (AD) in advanced stages. After a systematic process of translation and back-translation, the SIB-8 was applied to 95 patients with AD at different stages; moderate, moderately severe and severe according to FAST subdivisions (5, 6 and 7), with scores on the Mini-Mental State Examination (MMSE) of between 5 and 15 and followed by the Division of Behavioral Neurology and the Center for Aging Brain of the Federal University of São Paulo - UNIFESP. Inferential data revealed that the SIB-8 instrument behaved differently at each stage of the disease with a statistical value of sensitivity p<0.001, gradually reflecting the expected course of the dementia, inherent with the decline of cognitive functions. Findings indicated that the SIB-8 is a useful tool for the evaluation and prospective comparison of AD patients in advanced stages, retaining its original characteristics in our population.

  7. Genetic modification of risk assessment based on staging of preclinical type 1 diabetes in siblings of affected children.

    Science.gov (United States)

    Mrena, S; Savola, K; Kulmala, P; Reijonen, H; Ilonen, J; Akerblom, H K; Knip, M

    2003-06-01

    We set out to study the association between human leukocyte antigen-defined genetic disease susceptibility and the stage of preclinical type 1 diabetes and whether genetic predisposition affects the natural course of preclinical diabetes in initially nondiabetic siblings of affected children. A total of 701 initially unaffected siblings were graded into four stages of preclinical type 1 diabetes based on the initial number of disease-associated autoantibodies detectable close to the time of diagnosis of the index case: no prediabetes (no antibodies), early (one antibody specificity), advanced (two antibodies), and late prediabetes (three or more antibodies). Another classification system covering 659 siblings was based on a combination of the initial number of antibodies and the first-phase insulin response (FPIR) to iv glucose: no prediabetes (no antibodies), early (one antibody specificity, normal FPIR), advanced (two or more antibodies, normal FPIR), and late prediabetes (at least one antibody, reduced FPIR). Genetic susceptibility to type 1 diabetes was defined by human leukocyte antigen identity and DR and DQ genotypes. There was a higher proportion of siblings with late prediabetes initially among those with strong genetic disease susceptibility than among those with decreased genetic predisposition (16.7% vs. 0.5%; P siblings with no signs of prediabetes among those with genotypes conferring decreased risk (91.2% vs. 70.4% among those with high-risk DQB1 genotypes; P siblings than when combined with genetic susceptibility. Genetic susceptibility played a role in whether the initial prediabetic stage progressed (progression in 29.6% of the high-risk siblings compared with 6.6% of the siblings with DQB1 genotypes conferring decreased risk; P siblings of affected children.

  8. Toxicity assessment of silver nanoparticles in Persian sturgeon (Acipenser persicus) and starry sturgeon (Acipenser stellatus) during early life stages.

    Science.gov (United States)

    Banan, Ashkan; Kalbassi Masjed Shahi, Mohammad Reza; Bahmani, Mahmoud; Yazdani Sadati, Mohammad Ali

    2016-05-01

    Silver nanoparticles (AgNPs) are widely used in consumer products mainly due to their antimicrobial action. The rapidly increasing use of nanoparticles (NPs) has driven more attention to their possible ecotoxicological effects. In this study, the acute toxicity of colloidal AgNPs was evaluated during the embryonic stage of Persian sturgeon (Acipenser persicus) and starry sturgeon (Acipenser stellatus) at concentrations of 0, 0.25, 0.5, 1, 2, 4, and 8 mg/L. Fertilized eggs (75 eggs per replicate) were exposed to aforementioned concentrations for 96 h in triplicate. 96-h LC50 values in Persian sturgeon and starry sturgeon were calculated as 0.163 and 0.158 mg/L, respectively. Furthermore, in starry sturgeon, the short-term effects of AgNPs on the hatching rate, survival rate, and Ag accumulation during early life stages (before active feeding commences) were also analyzed at concentrations of 0, 0.025, 0.05, and 0.1 mg/L of colloidal AgNPs. The highest silver accumulation occurred in larvae exposed to 0.1 mg/L AgNPs; however, the body burden of silver did not alter survival rate, and there were no significant differences among treatments. Based on the obtained results from the acute toxicity exposures, AgNPs induced a concentration-dependent toxicity in both species during early life stages, while complementary studies are suggested for investigating their short-term effects in detail.

  9. Uterine Tonus Assessment by Midwives versus Patient self-assessment in the active management of the third stage of labor (UTAMP) : study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Browne, Joyce L; Damale, Nelson K R; Raams, Tessa M; Van der Linden, Eva L; Maya, Ernest T; Doe, Roseline; Rijken, Marcus J; Adanu, Richard; Grobbee, Diederick E; Franx, Arie; Klipstein-Grobusch, Kerstin

    2015-01-01

    BACKGROUND: Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide and accounts for one third of maternal deaths in low-income and middle-income countries. PPH can be prevented by active management of the third stage of labor (AMTSL), a series of steps recommended by the

  10. Stage-specific adhesion of Leishmania promastigotes to sand fly midguts assessed using an improved comparative binding assay.

    Directory of Open Access Journals (Sweden)

    Raymond Wilson

    2010-09-01

    Full Text Available The binding of Leishmania promastigotes to the midgut epithelium is regarded as an essential part of the life-cycle in the sand fly vector, enabling the parasites to persist beyond the initial blood meal phase and establish the infection. However, the precise nature of the promastigote stage(s that mediate binding is not fully understood.To address this issue we have developed an in vitro gut binding assay in which two promastigote populations are labelled with different fluorescent dyes and compete for binding to dissected sand fly midguts. Binding of procyclic, nectomonad, leptomonad and metacyclic promastigotes of Leishmania infantum and L. mexicana to the midguts of blood-fed, female Lutzomyia longipalpis was investigated. The results show that procyclic and metacyclic promastigotes do not bind to the midgut epithelium in significant numbers, whereas nectomonad and leptomonad promastigotes both bind strongly and in similar numbers. The assay was then used to compare the binding of a range of different parasite species (L. infantum, L. mexicana, L. braziliensis, L. major, L. tropica to guts dissected from various sand flies (Lu. longipalpis, Phlebotomus papatasi, P. sergenti. The results of these comparisons were in many cases in line with expectations, the natural parasite binding most effectively to its natural vector, and no examples were found where a parasite was unable to bind to its natural vector. However, there were interesting exceptions: L. major and L. tropica being able to bind to Lu. longipalpis better than L. infantum; L. braziliensis was able to bind to P. papatasi as well as L. major; and significant binding of L. major to P. sergenti and L. tropica to P. papatasi was observed.The results demonstrate that Leishmania gut binding is strictly stage-dependent, is a property of those forms found in the middle phase of development (nectomonad and leptomonad forms, but is absent in the early blood meal and final stages (procyclic

  11. The second stage of long-term training in team games: experimental assessment of traditional training system

    Directory of Open Access Journals (Sweden)

    Maksimenko I.G

    2010-03-01

    Full Text Available The features of construction of the traditional system of preparation of young sportsmen are certain on the stage of the preliminary base training. In researches 200 players took part in age 12-15 years. The indexes of frequency of cardiac rhythm, expenses of energy, competition activity of young sportsmen are presented. Indexes are fixed during implementation of the different typical trainings programs, participating in bilateral and official games. The typical rations of feed are analysed. The results of deep medical inspection are rotined.

  12. Multistate matrix population model to assess the contributions and impacts on population abundance of domestic cats in urban areas including owned cats, unowned cats, and cats in shelters

    Science.gov (United States)

    Coe, Jason B.

    2018-01-01

    Concerns over cat homelessness, over-taxed animal shelters, public health risks, and environmental impacts has raised attention on urban-cat populations. To truly understand cat population dynamics, the collective population of owned cats, unowned cats, and cats in the shelter system must be considered simultaneously because each subpopulation contributes differently to the overall population of cats in a community (e.g., differences in neuter rates, differences in impacts on wildlife) and cats move among categories through human interventions (e.g., adoption, abandonment). To assess this complex socio-ecological system, we developed a multistate matrix model of cats in urban areas that include owned cats, unowned cats (free-roaming and feral), and cats that move through the shelter system. Our model requires three inputs—location, number of human dwellings, and urban area—to provide testable predictions of cat abundance for any city in North America. Model-predicted population size of unowned cats in seven Canadian cities were not significantly different than published estimates (p = 0.23). Model-predicted proportions of sterile feral cats did not match observed sterile cat proportions for six USA cities (p = 0.001). Using a case study from Guelph, Ontario, Canada, we compared model-predicted to empirical estimates of cat abundance in each subpopulation and used perturbation analysis to calculate relative sensitivity of vital rates to cat abundance to demonstrate how management or mismanagement in one portion of the population could have repercussions across all portions of the network. Our study provides a general framework to consider cat population abundance in urban areas and, with refinement that includes city-specific parameter estimates and modeling, could provide a better understanding of population dynamics of cats in our communities. PMID:29489854

  13. Multistate matrix population model to assess the contributions and impacts on population abundance of domestic cats in urban areas including owned cats, unowned cats, and cats in shelters.

    Science.gov (United States)

    Flockhart, D T Tyler; Coe, Jason B

    2018-01-01

    Concerns over cat homelessness, over-taxed animal shelters, public health risks, and environmental impacts has raised attention on urban-cat populations. To truly understand cat population dynamics, the collective population of owned cats, unowned cats, and cats in the shelter system must be considered simultaneously because each subpopulation contributes differently to the overall population of cats in a community (e.g., differences in neuter rates, differences in impacts on wildlife) and cats move among categories through human interventions (e.g., adoption, abandonment). To assess this complex socio-ecological system, we developed a multistate matrix model of cats in urban areas that include owned cats, unowned cats (free-roaming and feral), and cats that move through the shelter system. Our model requires three inputs-location, number of human dwellings, and urban area-to provide testable predictions of cat abundance for any city in North America. Model-predicted population size of unowned cats in seven Canadian cities were not significantly different than published estimates (p = 0.23). Model-predicted proportions of sterile feral cats did not match observed sterile cat proportions for six USA cities (p = 0.001). Using a case study from Guelph, Ontario, Canada, we compared model-predicted to empirical estimates of cat abundance in each subpopulation and used perturbation analysis to calculate relative sensitivity of vital rates to cat abundance to demonstrate how management or mismanagement in one portion of the population could have repercussions across all portions of the network. Our study provides a general framework to consider cat population abundance in urban areas and, with refinement that includes city-specific parameter estimates and modeling, could provide a better understanding of population dynamics of cats in our communities.

  14. Assessment of border control measures and community containment measures used in Japan during the early stages of Pandemic (H1N1 2009.

    Directory of Open Access Journals (Sweden)

    Hiroko Sakaguchi

    Full Text Available In the early stages of Pandemic (H1N1 2009, border control measures were taken by quarantine stations to block the entry of infected individuals into Japan and community containment measures were implemented to prevent the spreading. The objectives of this study were to describe these measures and the characteristics of infected individuals, and to assess the measures' effectiveness.Border control and community containment measures implemented from April to June (Period I: April 28-May 21, Period II: May 22-June 18 2009 were described. Number of individuals identified and disease characteristics were analyzed. For entry screening, a health declaration form and an infrared thermoscanner were used to detect symptomatic passengers. Passengers indicated for the rapid influenza test underwent the test followed by RT-PCR. Patients positive for H1N1 were isolated, and close contacts were quarantined. Entry cards were handed out to all asymptomatic passengers informing them about how to contact a health center in case they developed symptoms. Nine individuals were identified by entry screening and 1 during quarantine to have Pandemic (H1N1 2009. Health monitoring by health centers was performed in period I for passengers arriving from affected countries and in period II for those who had come into contact with the individuals identified by entry screening. Health monitoring identified 3 infected individuals among 129,546 in Period I and 5 among 746 in Period II. Enhanced surveillance, which included mandatory reporting of details of the infected individuals, identified 812 individuals, 141 (18% of whom had a history of international travel. Twenty-four of these 141 passengers picked up by enhanced surveillance had been developing symptoms on entry and were missed at screening.Symptomatic passengers were detected by the various entry screening measures put in place. Enhanced surveillance provided data for the improvement of public health measures in

  15. Is MRI helpful in assessing the distance of the tumour from the internal os in patients with cervical cancer below FIGO Stage IB2?

    International Nuclear Information System (INIS)

    Bhosale, P.R.; Iyer, R.B.; Ramalingam, P.; Schmeler, K.M.; Wei, W.; Bassett, R.L.; Ramirez, P.T.; Frumovitz, M.

    2016-01-01

    Aim: To determine the ability of magnetic resonance imaging (MRI) in detecting tumour-free margins from the internal os (IO). Materials and methods: A database search yielded 79 women with early-stage cervical cancer who underwent radical hysterectomy and preoperative MRI. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MRI in assessment of ≤5 and >5 mm IO involvement were calculated with histopathological surgical specimen findings considered to be the reference standard. A main and subset analysis was performed. The subset analysis included only those patients who would have been considered for radical trachelectomy. Results: For predicting a distance between the tumour and the IO of ≤5 mm, MRI had a sensitivity of 73%, a specificity of 98.3%, a PPV of 95%, a NPV of 88.1%, and an accuracy of 89.8% for the main analysis, and sensitivity of 81.8%, a specificity of 93.2% a PPV of 69.2% a NPV of 96.5% and an accuracy of 91.4% for the subset analysis. Conclusion: MRI has high specificity, NPV, and accuracy in detecting tumour from the IO, making MRI suitable for treatment planning in patients desiring trachelectomy to preserve fertility. - Highlights: • Cervical cancer patients who underwent hysterectomy were analyzed on MRI and pathology for involvement of the internal os. • Distance of the tumor from the internal-os was measured on MRI and Pathology and findings were tabulated as > and ≤ 5 mm from the internal os. • MRI has the ability to identify tumor involvement of the internal os. • MRI can help select patients who can undergo trachelectomy safely.

  16. Colombia Mi Pronostico Flood Application: Updating and Improving the Mi Pronostico Flood Web Application to Include an Assessment of Flood Risk

    Science.gov (United States)

    Rushley, Stephanie; Carter, Matthew; Chiou, Charles; Farmer, Richard; Haywood, Kevin; Pototzky, Anthony, Jr.; White, Adam; Winker, Daniel

    2014-01-01

    Colombia is a country with highly variable terrain, from the Andes Mountains to plains and coastal areas, many of these areas are prone to flooding disasters. To identify these risk areas NASA's Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) was used to construct a digital elevation model (DEM) for the study region. The preliminary risk assessment was applied to a pilot study area, the La Mosca River basin. Precipitation data from the National Aeronautics and Space Administration (NASA) Tropical Rainfall Measuring Mission (TRMM)'s near-real-time rainfall products as well as precipitation data from the Instituto de Hidrologia, Meteorologia y Estudios Ambientales (the Institute of Hydrology, Meteorology and Environmental Studies, IDEAM) and stations in the La Mosca River Basin were used to create rainfall distribution maps for the region. Using the precipitation data and the ASTER DEM, the web application, Mi Pronóstico, run by IDEAM, was updated to include an interactive map which currently allows users to search for a location and view the vulnerability and current weather and flooding conditions. The geospatial information was linked to an early warning system in Mi Pronóstico that can alert the public of flood warnings and identify locations of nearby shelters.

  17. Identifying important life stages for monitoring and assessing risks from exposures to environmental contaminants: results of a World Health Organization review.

    Science.gov (United States)

    Cohen Hubal, Elaine A; de Wet, Thea; Du Toit, Lilo; Firestone, Michael P; Ruchirawat, Mathuros; van Engelen, Jacqueline; Vickers, Carolyn

    2014-06-01

    In this paper, we summarize exposure-related issues to consider in determining the most appropriate age ranges and life stages for risk assessment. We then propose a harmonized set of age bins for monitoring and assessing risks from exposures to chemicals for global use. The focus is on preconception through adolescence, though the approach should be applicable to additional life stages. A two-tiered set of early life age groups is recommended. The first tier involves the adoption of guidance similar to the childhood age groups recommended by the U.S. Environmental Protection Agency, whereas the second tier consolidates some of those age groups to reduce the burden of developing age-specific exposure factors for different regions. While there is no single "correct" means of choosing a common set of age groups to use internationally in assessing early life exposure and risk, use of a set of defined age groups is recommended to facilitate comparisons of potential exposures and risks around the globe, the collection of data and analyses of aggregate exposure and cumulative risk. Application of these age groups for robust assessment of exposure and risk for specific populations will require region-specific exposure factors as well as local environmental monitoring data. Copyright © 2013 World Health Organization. Published by Elsevier Inc. All rights reserved.

  18. Description and assessment of a registration-based approach to include bones for attenuation correction of whole-body PET/MRI.

    Science.gov (United States)

    Marshall, Harry R; Patrick, John; Laidley, David; Prato, Frank S; Butler, John; Théberge, Jean; Thompson, R Terry; Stodilka, Robert Z

    2013-08-01

    Attenuation correction for whole-body PET/MRI is challenging. Most commercial systems compute the attenuation map from MRI using a four-tissue segmentation approach. Bones, the most electron-dense tissue, are neglected because they are difficult to segment. In this work, the authors build on this segmentation approach by adding bones using a registration technique and assessing its performance on human PET images. Twelve oncology patients were imaged with FDG PET/CT and MRI using a Turbo-FLASH pulse sequence. A database of 121 attenuation correction quality CT scans was also collected. Each patient MRI was compared to the CT database via weighted heuristic measures to find the "most similar" CT in terms of body geometry. The similar CT was aligned to the MRI with a deformable registration method. Two MRI-based attenuation maps were computed. One was a standard four-tissue segmentation (air, lung, fat, and lean tissue) using basic image processing techniques. The other was identical, except the bones from the aligned CT were added. The PET data were reconstructed with the patient's CT-based attenuation map (the silver standard) and both MRI-based attenuation maps. The relative errors of the MRI-based attenuation corrections were computed in 14 standardized volumes of interest, in lesions, and over whole tissues. The squared Pearson correlation coefficient was also calculated over whole tissues. Statistical testing was done with ANOVAs and paired t-tests. The MRI-based attenuation correction ignoring bone had relative errors ranging from -37% to -8% in volumes of interest containing bone. By including bone, the magnitude of the relative error was reduced in all cases (pbone was improved from a mean of -7.5% to 2% (pbone reduced the magnitude of relative error in three cases (pbone slightly increased relative error in lung from 7.7% to 8.0% (p=0.002), in fat from 8.5% to 9.2% (pbone from -14.6% to 1.3% (pbone was included or not. The approach to include bones in MRI

  19. Tumour heterogeneity in oesophageal cancer assessed by CT texture analysis: Preliminary evidence of an association with tumour metabolism, stage, and survival

    International Nuclear Information System (INIS)

    Ganeshan, B.; Skogen, K.; Pressney, I.; Coutroubis, D.; Miles, K.

    2012-01-01

    Aim: To undertake a pilot study assessing whether tumour heterogeneity evaluated using computed tomography texture analysis (CTTA) has the potential to provide a marker of tumour aggression and prognosis in oesophageal cancer. Materials and methods: In 21 patients, unenhanced CT images of the primary oesophageal lesion obtained using positron-emission tomography (PET)-CT examinations underwent CTTA. CTTA was carried out using a software algorithm that selectively filters and extracts textures at different anatomical scales between filter values 1.0 (fine detail) and 2.5 (coarse features) with quantification as entropy and uniformity (measures image heterogeneity). Texture parameters were correlated with average tumour 2-[ 18 F]-fluoro-2-deoxy-D-glucose (FDG) uptake [standardized uptake values (SUV mean and SUV max )] and clinical staging as determined by endoscopic ultrasound (nodal involvement) and PET-CT (distant metastases). The relationship between tumour stage, FDG uptake, and texture with survival was assessed using Kaplan–Meier analysis. Results: Tumour heterogeneity correlated with SUV max and SUV mean . The closest correlations were found for SUV mean measured as uniformity and entropy with coarse filtration (r = –0.754, p < 0.0001; and r = 0.748, p = 0.0001 respectively). Heterogeneity was also significantly greater in patients with clinical stage III or IV for filter values between 1.0 and 2.0 (maximum difference at filter value 1.5: entropy: p = 0.027; uniformity p = 0.032). The median (range) survival was 21 (4–34) months. Tumour heterogeneity assessed by CTTA (coarse uniformity) was an independent predictor of survival [odds ratio (OR)=4.45 (95% CI: 1.08, 18.37); p = 0.039]. Conclusion: CTTA assessment of tumour heterogeneity has the potential to identify oesophageal cancers with adverse biological features and provide a prognostic indicator of survival.

  20. Trading stages

    DEFF Research Database (Denmark)

    Steiner, Uli; Tuljapurkar, Shripad; Coulson, Tim

    2012-01-01

    Interest in stage-and age structured models has recently increased because they can describe quantitative traits such as size that are left out of age-only demography. Available methods for the analysis of effects of vital rates on lifespan in stage-structured models have not been widely applied ...... examples. Much of our approach relies on trading of time and mortality risk in one stage for time and risk in others. Our approach contributes to the new framework of the study of age- and stage-structured biodemography....

  1. The Bulgarian Emergency Response System for dose assessment in the early stage of accidental releases to the atmosphere

    International Nuclear Information System (INIS)

    Syrakov, D.; Veleva, B.; Prodanova, M.; Popova, T.; Kolarova, M.

    2009-01-01

    The Bulgarian Emergency Response System (BERS) is being developed in the Bulgarian National Institute of Meteorology and Hydrology since 1994. BERS is based on numerical weather forecast meteorological information and a numerical long-range dispersion model accounting for the transport, dispersion, chemical and radioactive transformations of pollutants. In the present paper, the further development of this system for a mixture of radioactive gaseous and aerosol pollutants is described. The basic module for the BERS, the numerical dispersion model EMAP, is upgraded with a 'dose calculation block'. Two scenarios for hypothetical accidental atmospheric releases from two NPPs, one in Western, and the other in Eastern Europe, are numerically simulated. The effective doses from external irradiation, from air submersion and ground shinning, effective dose from inhalation and absorbed dose by thyroid gland formed by 37 different radionuclides, significant for the early stage of a nuclear accident, are calculated as dose fields for both case studies and discussed

  2. Low-level waste drum staging building at Weapons Engineering Tritium Facility, TA-16, Los Alamos National Laboratory, Los Alamos, New Mexico. Environmental Assessment

    International Nuclear Information System (INIS)

    1994-08-01

    The proposed action is to place a 3 meter (m) by 4.5 m (10 ft x 15 ft) prefabricated storage building (transportainer) adjacent to the existing Weapons Engineering Tritium Facility (WETF) at Technical Area (TA-) 16, Los Alamos National Laboratory (LANL), and to use the building as a staging site for sealed 55 galllon drums of noncompactible waste contaminated with low levels of tritium (LLW). Up to eight drums of waste would be accumulated before the waste is moved by LANL Waste Management personnel to the existing on-site LLW disposal area at TA-54. The drum staging building would be placed on a bermed asphalt pad, near other existing accumulation structures for office trash and compactible LLW. The no-action alternative is to continue storing drums of LLW in the WETF laboratories where they occupy valuable work space, hamper movement of personnel and equipment, and require waste management personnel to enter those laboratories in order to remove filled drums. No new waste would be generated by implementing the proposed action; no changes or increases in WETF operations or waste production rate are anticipated as a result of staging drums of LLW outside the main laboratory building. The site for the LLW drum staging building would not impact any sensitive areas. Tritium emissions from the drums of LLW were included within the source term for normal operations at the WETF; the cumulative impacts would not be increased

  3. A randomised controlled multicentre trial of treatments for adolescent anorexia nervosa including assessment of cost-effectiveness and patient acceptability - the TOuCAN trial.

    Science.gov (United States)

    Gowers, S G; Clark, A F; Roberts, C; Byford, S; Barrett, B; Griffiths, A; Edwards, V; Bryan, C; Smethurst, N; Rowlands, L; Roots, P

    2010-03-01

    To evaluate the clinical effectiveness and cost-effectiveness of inpatient compared with outpatient treatment and general (routine) treatment in Child and Adolescent Mental Health Services (CAMHS) against specialist treatment for young people with anorexia nervosa. In addition, to determine young people's and their carers' satisfaction with these treatments. A population-based, pragmatic randomised controlled trial (RCT) was carried out on young people age 12 to 18 presenting to community CAMHS with anorexia nervosa. Thirty-five English CAMHS in the north-west of England co-ordinated through specialist centres in Manchester and Liverpool. Two hundred and fifteen young people (199 female) were identified, of whom 167 (mean age 14 years 11 months) were randomised and 48 were followed up as a preference group. Randomised patients were allocated to either inpatient treatment in one of four units with considerable experience in the treatment of anorexia nervosa, a specialist outpatient programme delivered in one of two centres, or treatment as usual in general community CAMHS. The outpatient programmes spanned 6 months of treatment. The length of inpatient treatment was determined on a case-by-case basis on clinical need with outpatient follow-up to a minimum of 6 months. Follow-up assessments were carried out at 1, 2 and 5 years. The primary outcome measure was the Morgan-Russell Average Outcome Scale (MRAOS) and associated categorical outcomes. Secondary outcome measures included physical measures of weight, height, body mass index (BMI) and % weight for height. Research ratings included the Health of the National Outcome Scale for Children and Adolescents (HoNOSCA). Self report measures comprised the user version of HoNOSCA (HoNOSCA-SR), the Eating Disorder Inventory 2 (EDI-2), the Family Assessment Device (FAD) and the recent Mood and Feelings Questionnaire (MFQ). Information on resource use was collected in interview at 1, 2 and 5 years using the Child and

  4. Empirical study of ill-supported activities in variation risk identification and assessment in early stage product development

    DEFF Research Database (Denmark)

    Bjarklev, Kristian; Mortensen, Niels Henrik; Ebro, Martin

    2017-01-01

    medical device company by interviewing six key employees that work in the variation risk identification and assessment process. It is found that there are several ill-supported activities, and that the project teams rely heavily on tolerance experts’ assistance and experience in order to identify...... and assess the variation risk. Ill-supported activities are found to be: Balancing hardness of requirements and the screening; communicating mechanism understanding; predicting user input and internal component movement; documenting and communicating tolerance analysis; implementing robustness in the early...

  5. Pyrosequencing analysis yields comprehensive assessment of microbial communities in pilot-scale two-stage membrane biofilm reactors.

    Science.gov (United States)

    Ontiveros-Valencia, Aura; Tang, Youneng; Zhao, He-Ping; Friese, David; Overstreet, Ryan; Smith, Jennifer; Evans, Patrick; Rittmann, Bruce E; Krajmalnik-Brown, Rosa

    2014-07-01

    We studied the microbial community structure of pilot two-stage membrane biofilm reactors (MBfRs) designed to reduce nitrate (NO3(-)) and perchlorate (ClO4(-)) in contaminated groundwater. The groundwater also contained oxygen (O2) and sulfate (SO4(2-)), which became important electron sinks that affected the NO3(-) and ClO4(-) removal rates. Using pyrosequencing, we elucidated how important phylotypes of each "primary" microbial group, i.e., denitrifying bacteria (DB), perchlorate-reducing bacteria (PRB), and sulfate-reducing bacteria (SRB), responded to changes in electron-acceptor loading. UniFrac, principal coordinate analysis (PCoA), and diversity analyses documented that the microbial community of biofilms sampled when the MBfRs had a high acceptor loading were phylogenetically distant from and less diverse than the microbial community of biofilm samples with lower acceptor loadings. Diminished acceptor loading led to SO4(2-) reduction in the lag MBfR, which allowed Desulfovibrionales (an SRB) and Thiothrichales (sulfur-oxidizers) to thrive through S cycling. As a result of this cooperative relationship, they competed effectively with DB/PRB phylotypes such as Xanthomonadales and Rhodobacterales. Thus, pyrosequencing illustrated that while DB, PRB, and SRB responded predictably to changes in acceptor loading, a decrease in total acceptor loading led to important shifts within the "primary" groups, the onset of other members (e.g., Thiothrichales), and overall greater diversity.

  6. Discussion on life cycle assessment on automobiles. 2. From a viewpoint of saving energy in the stage of their use; Jidosha no life cycle assessment ni kansuru ichikento. 2. Shiyo dankai no sho energy no shiten kara

    Energy Technology Data Exchange (ETDEWEB)

    Takeishi, T.; Kobayashi, N. [Nissan Motor Co. Ltd., Tokyo (Japan)

    1997-01-30

    Analysis was made by using the life cycle assessment method for the purpose of saving energy in the use stage of automobiles. Life cycle energy was calculated for cases of adopting direct fuel injection and non-stage transmission (CVT) in the currently used gasoline fueled cars. The calculation was performed with respect to each stage of raw material manufacturing, car fabrication, internal energy manufacturing, driving and disposal. Adoption of direct fuel injection and CVT technologies results in reducing the life cycle energy to about 30% in the use stage and little less than 30% on the whole. Stopping the idling operation will reduce the energy in the use stage by about 40%. Adoption of electric vehicles will result in energy reduction of 30% to 35% as compared with gasoline fueled cars. Since fuel consumption improves with increasing average car speed, energy consumption will be improved by about 30% if the current average car speed in the Tokyo Metropolitan area of 19 km/h is improved to the national average level. Improving the driving environments is important. Driving methods with less often quick starting and quick acceleration can save energy. Combinations of policies are desired, such as improvements in the currently used gasoline fueled vehicles, introduction of substitution fuel driven vehicles, and improvements in driving environments. 4 refs., 10 figs., 3 tabs.

  7. Stages of Plasma Cell Neoplasms (Including Multiple Myeloma)

    Science.gov (United States)

    ... cancer treatment is also called biotherapy or immunotherapy. Immunomodulators are a type of biologic therapy. Thalidomide , lenalidomide , and pomalidomide are immunomodulators used to treat multiple myeloma and other plasma ...

  8. VALIDATION OF THE RUSSIAN VERSION OF A QUESTIONNAIRE FOR THE ASSESSMENT OF UTILITARIAN INDICES IN PEDIATRIC PRACTICE. STAGE II

    Directory of Open Access Journals (Sweden)

    I. V. Vinyarskaya

    2014-01-01

    Full Text Available Aim: To create the Russian-language version of the standardized international questionnaire Health Utilities Index (HUI applicable for children's age, on the basis of the relevant international requirements to linguistic ratification and validation of tools. Patients and methods: 427 children of the first and 233 children of the second health group have taken part in the research. Average age of patients made10.8 ± 4.6 years. Criteria validity of the HUI questionnaire was assessed by comparison of patients' answers who had the different health status, a convergent validity — by comparison of the HUI attributes with scales of the PedsQL questionnaire, reliability — by calculation of Cronbach's alfa and the analysis of correlations between questions of the HUI classification. Results: Between the first and second health group there were significant distinctions on each attribute of the HUI questionnaire (p < 0.001. Average value of a number of the reduced attributes significantly differed depending on the state of health of patients: the worse the state of health is, the higher number of limited attributes is (p < 0.05. Significant correlations between the scales estimating similar concepts on questionnaires HUI and PedsQL are established. In assessment of the reliability Cronbach's according to the HUI3 and HUI2 system made 0.79 and 0.8, respectively. Significantcorrelations between the questions estimating identical attributes (sight, hearing, speech, cognitive abilities are shown. The validity and reliability assessment executed for children with various state of health, allowed to assess all attributes of the HUI2 and HUI3 systems. The received results showed satisfactory psychometric properties of the new language version of a questionnaire. Conclusion: The offeredRussian version of the international questionnaire HUI is a validated tool for the development of utility coefficients for various chronic diseases in children, creation of the

  9. An analytical method for assessing stage-specific drug activity in Plasmodium vivax malaria: implications for ex vivo drug susceptibility testing.

    Directory of Open Access Journals (Sweden)

    Douglas H Kerlin

    Full Text Available The emergence of highly chloroquine (CQ resistant P. vivax in Southeast Asia has created an urgent need for an improved understanding of the mechanisms of drug resistance in these parasites, the development of robust tools for defining the spread of resistance, and the discovery of new antimalarial agents. The ex vivo Schizont Maturation Test (SMT, originally developed for the study of P. falciparum, has been modified for P. vivax. We retrospectively analysed the results from 760 parasite isolates assessed by the modified SMT to investigate the relationship between parasite growth dynamics and parasite susceptibility to antimalarial drugs. Previous observations of the stage-specific activity of CQ against P. vivax were confirmed, and shown to have profound consequences for interpretation of the assay. Using a nonlinear model we show increased duration of the assay and a higher proportion of ring stages in the initial blood sample were associated with decreased effective concentration (EC(50 values of CQ, and identify a threshold where these associations no longer hold. Thus, starting composition of parasites in the SMT and duration of the assay can have a profound effect on the calculated EC(50 for CQ. Our findings indicate that EC(50 values from assays with a duration less than 34 hours do not truly reflect the sensitivity of the parasite to CQ, nor an assay where the proportion of ring stage parasites at the start of the assay does not exceed 66%. Application of this threshold modelling approach suggests that similar issues may occur for susceptibility testing of amodiaquine and mefloquine. The statistical methodology which has been developed also provides a novel means of detecting stage-specific drug activity for new antimalarials.

  10. Are stage IV vestibular schwannomas preoperatively different from other stages?

    Science.gov (United States)

    Tringali, Stéphane; Dubreuil, Christian; Zaouche, Sandra; Ferber-Viart, Chantal

    2008-01-01

    The aim of this study was to focus on the clinical and paraclinical symptoms of patients suffering from Stage IV vestibular schwannomas (VSs). In this prospective study, we included 734 patients who have VS and candidates for operation. Patients were classified as having Stage I, II, III, or IV tumors according to Tos criteria as evaluated by magnetic resonance imaging. PREOPERATIVE CLINICAL EVALUATION: We recorded the occurrence of complaints (%) and duration (yr) of hearing loss, tinnitus, and balance disorder. Preoperative paraclinical evaluation included pure-tone (PTA) and speech audiometry, auditory brainstem response (ABR) patterns, and vestibular deficit at videonystamography (VNG). Continuous variables were compared between Stage IV and other stages using analysis of variance. Qualitative variables expressed as a percentage of presence were compared between Stage IV and other stages using percentage comparison. Quantitative Parameters. Patients with Stage IV VS were significantly younger as compared with patients with other stages. Stage IV hearing loss was greater compared with other stages at 250 and 500 Hz but smaller at 2,000 and 8,000 Hz. We found no difference in the loss of PTA between Stage IV and the other stages. Speech discriminancy score was smaller in Stage IV. The durations of hearing loss, tinnitus, and balance disorders were similar whatever the tumor stage. Auditory brainstem response patterns showed no difference in Wave III latency between Stage IV VS and other stages, whereas Wave V latency and V-I interval were higher in Stage IV. Both ABR threshold and VNG caloric deficit were higher in Stage IV VS compared with other stages. Qualitative Parameters. The percentage of patients with Stage IV was lower than that with Stages II and III. The percentage of men and women was similar in all stages. The occurrence of hearing loss was similar in all stages, whereas that of tinnitus was lower in Stage IV compared with Stages I and II. In

  11. Staging atmospheres

    DEFF Research Database (Denmark)

    Bille, Mikkel; Bjerregaard, Peter; Sørensen, Tim Flohr

    2015-01-01

    The article introduces the special issue on staging atmospheres by surveying the philosophical, political and anthropological literature on atmosphere, and explores the relationship between atmosphere, material culture, subjectivity and affect. Atmosphere seems to occupy one of the classic...

  12. Internal consistency and content validity of a questionnaire aimed to assess the stages of behavioral lifestyle changes in Colombian schoolchildren: The Fuprecol study

    Directory of Open Access Journals (Sweden)

    Yasmira CARRILLO-BERNATE

    Full Text Available ABSTRACT Objective To assess internal consistency and content validity of a questionnaire aimed to assess the stages of Behavioural Lifestyle Changes in a sample of school-aged children and adolescents aged 9 to 17 years-old. Methods This validation study involved 675 schoolchildren from three official school in the city of Bogota, Colombia. A self-administered questionnaire called Behavioural Lifestyle Changes has been designed to explore stages of change regarding to physical activity/exercise, fruit and vegetable consumption, alcohol abuse, tobacco use, and drug abuse. Cronbach-α, Kappa index and exploratory factor analysis were used for evaluating the internal consistency and validity of content, respectively. Results The study population consisted of 51.1% males and the participants’ average age was 12.7±2.4 years-old. Behavioural Lifestyle Changes scored 0.720 (range 0.691 to 0.730 on the Cronbach α and intra-observer reproducibility was good (Kappa=0.71. Exploratory factor analysis determined two factors (factor 1: physical activity/exercise, fruit and vegetable consumption, and factor 2: alcohol abuse tobacco use and drug abuse, explaining 67.78% of variance by the items and six interactions χ2/gL=11649.833; p<0.001. Conclusion Behavioural Lifestyle Changes Questionnaire was seen to have suitable internal consistency and validity. This instrument can be recommended, mainly within the context of primary attention for studying the stages involved in the lifestyle behavioural changes model on a school-based population.

  13. Assessing the toxicity and risk of salt-impacted winter road runoff to the early life stages of freshwater mussels in the Canadian province of Ontario.

    Science.gov (United States)

    Prosser, R S; Rochfort, Q; McInnis, R; Exall, K; Gillis, P L

    2017-11-01

    In temperate urbanized areas where road salting is used for winter road maintenance, the level of chloride in surface waters has been increasing. While a number of studies have shown that the early-life stages of freshwater mussels are particularly sensitive to salt; few studies have examined the toxicity of salt-impacted winter road runoff to the early-life stages of freshwater mussels to confirm that chloride is the driver of toxicity in this mixture. This study examines the acute toxicity of field-collected winter road runoff to the glochidia of wavy-rayed lampmussels (Lampsilis fasciola) (48 h exposure) and newly released juvenile fatmucket mussels (Lampsilis siliquoidea) (road run-off created with moderately hard synthetic water (∼80 mg CaCO 3 /L) were 1177 (95% confidence interval (CI): 1011-1344 mg Cl - /L) and 2276 mg Cl - /L (95% CI: 1698-2854 mg Cl - /L), respectively. These effect concentrations correspond with the toxicity of chloride reported in other studies, indicating that chloride is likely the driver of toxicity in salt-impacted road-runoff, with other contaminants (e.g., metals, polycyclic aromatic hydrocarbons) playing a de minimis role. Toxicity data from the current study and literature and concentrations of chloride in the surface waters of Ontario were used to conduct a probabilistic risk assessment of chloride to early-life stage freshwater mussels. The assessment indicated that chronic exposure to elevated chloride levels could pose a risk to freshwater mussels; further investigation is warranted to ensure that the most sensitive organisms are protected. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  14. Assessment of channel changes, model of historical floods, and effects of backwater on flood stage, and flood mitigation alternatives for the Wichita River at Wichita Falls, Texas

    Science.gov (United States)

    Winters, Karl E.; Baldys, Stanley

    2011-01-01

    In cooperation with the City of Wichita Falls, the U.S. Geological Survey assessed channel changes on the Wichita River at Wichita Falls, Texas, and modeled historical floods to investigate possible causes and potential mitigation alternatives to higher flood stages in recent (2007 and 2008) floods. Extreme flooding occurred on the Wichita River on June 30, 2007, inundating 167 homes in Wichita Falls. Although a record flood stage was reached in June 2007, the peak discharge was much less than some historical floods at Wichita Falls. Streamflow and stage data from two gages on the Wichita River and one on Holliday Creek were used to assess the interaction of the two streams. Changes in the Wichita River channel were evaluated using historical aerial and ground photography, comparison of recent and historical cross sections, and comparison of channel roughness coefficients with those from earlier studies. The floods of 2007 and 2008 were modeled using a one-dimensional step-backwater model. Calibrated channel roughness was larger for the 2007 flood compared to the 2008 flood, and the 2007 flood peaked about 4 feet higher than the 2008 flood. Calibration of the 1941 flood yielded a channel roughness coefficient (Manning's n) of 0.030, which represents a fairly clean natural channel. The step-backwater model was also used to evaluate the following potential mitigation alternatives: (1) increasing the capacity of the bypass channel near River Road in Wichita Falls, Texas; (2) removal of obstructions near the Scott Avenue and Martin Luther King Junior Boulevard bridges in Wichita Falls, Texas; (3) widening of aggraded channel banks in the reach between Martin Luther King Junior Boulevard and River Road; and (4) reducing channel bank and overbank roughness. Reductions in water-surface elevations ranged from 0.1 foot to as much as 3.0 feet for the different mitigation alternatives. The effects of implementing a combination of different flood-mitigation alternatives were

  15. Assessing the Influences of a Flood Diversion Project on Mitigating River Stage, Inundation Extent and Economic Loss

    Directory of Open Access Journals (Sweden)

    Wei-Bo Chen

    2015-04-01

    Full Text Available Taiwan usually suffers severe inundation disasters during typhoons and strong rainstorms, and therefore flood mitigation is considered an important issue. To assess the effect of the Yuansantze flood diversion tunnel (YFDT on flood mitigation at the upstream reaches of the Keelung River, a three-dimensional, unstructured grid, Finite-Volume, primitive equation Community Ocean Model (FVCOM was used. The model was validated with observed data for water levels and inundation extent during different typhoon events. The simulated results show a good agreement with field measurements of water level with three historical typhoon events but underestimated the measured inundation extent with Typhoon Nari. The validated model was then applied to assess the flood mitigation and economic loss with the YFDT. The results demonstrated that the river level decreases approximately 3 m with the YFDT and that the inundation extent decreases by more than 50% in the Ruifang District with YFDT. The YDFT aims to not only mitigate hazards but also reduce economic losses. The average annual expected benefit after construction of the YFDT is approximately 184 million NTD in the Ruifang District.

  16. RELATIONSHIP OF ASSESS SELF-ESTEEM AND LOCUS OF CONTROL WITH QUALITY OF LIFE DURING TREATMENT STAGES IN PATIENTS REFERRING TO DRUG ADDICTION REHABILITATION CENTERS.

    Science.gov (United States)

    Heidari, Mohammad; Ghodusi, Mansureh

    2016-07-24

    Thus, the present research was carried out aimed at determining the relationship between self-esteem and locus of control and quality of life during treatment stages in the patients referring to drug addiction rehabilitation centers of Borujen city, Iran. The current study was a sectional research of descriptive correlation type. The research sample was 150 individuals of patients referring to addiction rehabilitation centers of Borujen city. For data gathering, Rosenberg Self-esteem Scale, Rotter's Locus of Control Scale, and SF36 Quality of Life Questionnaire were used. Following collection of questionnaires, the data were analyzed using SPSS/16 software. According to the results, in the 12 th day of treatment, 96 patients exhibited moderate self-esteem, 102 patients had internal locus of control, and the score of their overall quality of life was 40.43±12.71. Furthermore, Pearson's correlation coefficient indicated that a significant and positive relationship was observed between locus of control and quality of life during different treatment stages. It seems that quality of life improves during addiction treatment stages due to improvement of personality traits including locus of control and self-esteem. Therefore, consultation methods as a very crucial priority in addiction rehabilitation centers shall be taken into account by the health sector authorities and managers and can play an essential role in enhancing quality of life.

  17. RELATIONSHIP OF ASSESS SELF-ESTEEM AND LOCUS OF CONTROL WITH QUALITY OF LIFE DURING TREATMENT STAGES IN PATIENTS REFERRING TO DRUG ADDICTION REHABILITATION CENTERS

    Science.gov (United States)

    Heidari, Mohammad; Ghodusi, Mansureh

    2016-01-01

    Objective: Thus, the present research was carried out aimed at determining the relationship between self-esteem and locus of control and quality of life during treatment stages in the patients referring to drug addiction rehabilitation centers of Borujen city, Iran. Methods: The current study was a sectional research of descriptive correlation type. The research sample was 150 individuals of patients referring to addiction rehabilitation centers of Borujen city. For data gathering, Rosenberg Self-esteem Scale, Rotter’s Locus of Control Scale, and SF36 Quality of Life Questionnaire were used. Following collection of questionnaires, the data were analyzed using SPSS/16 software. Results: According to the results, in the 12th day of treatment, 96 patients exhibited moderate self-esteem, 102 patients had internal locus of control, and the score of their overall quality of life was 40.43±12.71. Furthermore, Pearson’s correlation coefficient indicated that a significant and positive relationship was observed between locus of control and quality of life during different treatment stages. Conclusion: It seems that quality of life improves during addiction treatment stages due to improvement of personality traits including locus of control and self-esteem. Therefore, consultation methods as a very crucial priority in addiction rehabilitation centers shall be taken into account by the health sector authorities and managers and can play an essential role in enhancing quality of life. PMID:27698598

  18. A cross-sectional study to assess the long-term health status of patients with lower respiratory tract infections, including Q-fever.

    NARCIS (Netherlands)

    Dam, A.S.G. van; Loenhout, J.A.F. van; Peters, J.B.; Rietveld, A.; Paget, W.J.; Akkermans, R.P.; Olde Loohuis, A.; Hautvast, J.L.A.; Velden, J. van der

    2015-01-01

    Patients with a lower respiratory tract infection (LRTI) might be at risk for long-term impaired health status. We assessed whether LRTI patients without Q fever are equally at risk for developing long-term symptoms compared to LRTI patients with Q fever. The study was a cross-sectional cohort

  19. Monitored Attenuation of Inorganic Contaminants in Ground Water Volume 2 – Assessment for Non-Radionuclides Including Arsenic, Cadmium, Chromium, Copper, Lead, Nickel, Nitrate, Perchlorate, and Selenium

    Science.gov (United States)

    This document represents the second volume of a set of three volumes that address the technical basis and requirements for assessing the potential applicability of MNA as part of a ground-water remedy for plumes with non-radionuclide and/or radionuclide inorganic contaminants. V...

  20. Characterization of the disposition of fostamatinib in Japanese subjects including pharmacokinetic assessment in dry blood spots: results from two phase I clinical studies.

    Science.gov (United States)

    Martin, Paul; Cheung, S Y Amy; Yen, Mark; Han, David; Gillen, Michael

    2016-01-01

    The aims of the present study were to characterize the pharmacokinetics of fostamatinib in two phase I studies in healthy Japanese subjects after single- and multiple-dose administration, and to evaluate the utility of dried blood spot (DBS) sampling. In study A, 40 Japanese and 16 white subjects were randomized in a double-blind parallel group study consisting of seven cohorts, which received either placebo or a fostamatinib dose between 50 and 200 mg after single and multiple dosing. Pharmacokinetics of R406 (active metabolite of fostamatinib) in plasma and urine was assessed, and safety was intensively monitored. Study B was an open-label study that assessed fostamatinib 100 and 200 mg in 24 Japanese subjects. In addition to plasma and urine sampling (as for study A), pharmacokinetics was also assessed in blood. Mean maximum plasma concentration (C max) and area under total plasma concentration–time curve (AUC) increased with increasing dose in Japanese subjects. Steady state was achieved in 5–7 days for all doses. C max and AUC were both higher in Japanese subjects administered a 150-mg single dose than in white subjects. This difference was maintained for steady state exposure by day 10. Overall, R406 blood concentrations were consistent and ∼2.5-fold higher than in plasma. Minimal (blood cells, and DBS sampling was a useful method for assessing R406 pharmacokinetics.

  1. A National Energy-Water System Assessment Framework (NEWS): Synopsis of Stage 1 Research Strategy and Results

    Science.gov (United States)

    Vorosmarty, C. J.; Miara, A.; Macknick, J.; Newmark, R. L.; Cohen, S.; Sun, Y.; Tidwell, V. C.; Corsi, F.; Melillo, J. M.; Fekete, B. M.; Proussevitch, A. A.; Glidden, S.; Suh, S.

    2017-12-01

    The focus of this talk is on climate adaptation and the reliability of power supply infrastructure when viewed through the lens of strategic water issues. Power supply is critically dependent upon water resources, particularly to cool thermoelectric plants, making the sector particularly sensitive to any shifts in the geography or seasonality of water supply. We report on results from an NSF-Funded Water Sustainability and Climate effort aimed at uncovering key energy and economic system vulnerabilities. We have developed the National Energy-Water System assessment framework (NEWS) to systematically evaluate: a) the performance of the nation's electricity sector under multiple climate scenarios; b) the feasibility of alternative pathways to improve climate adaptation; and, c) the impacts of energy technology and investment tradeoffs on the economic productivity, water availability and aquatic ecosystem condition. Our project combines core engineering and geophysical models (ReEDS [Regional Energy Deployment System], TP2M [Thermoelectric Power and Thermal Pollution], and WBM [Water Balance]) through unique digital "handshake" protocols that operate across different institutions and modeling platforms. Combined system outputs are fed into a regional-to-national scale economic input/output model to evaluate economic consequences of climate constraints, technology choices, and environmental regulation. The impact assessments in NEWS are carried out through a series of climate/energy policy scenario studies to 2050. We find that despite significant climate-water impacts on individual plants, the current US power supply infrastructure shows potential for adaptation to future climates by capitalizing on the size of regional power systems, grid configuration and improvements in thermal efficiencies. However, the magnitude and implications of climate-water impacts vary depending on the configuration of the future power sector. To evaluate future power supply performance, we

  2. Regional landslide susceptibility assessment using multi-stage remote sensing data along the coastal range highway in northeastern Taiwan

    Science.gov (United States)

    Lee, Ching-Fang; Huang, Wei-Kai; Chang, Yu-Lin; Chi, Shu-Yeong; Liao, Wu-Chang

    2018-01-01

    Typhoons Megi (2010) and Saola (2012) brought torrential rainfall which triggered regional landslides and flooding hazards along Provincial Highway No. 9 in northeastern Taiwan. To reduce property loss and saving lives, this study combines multi-hazard susceptibility assessment with environmental geology map a rock mass rating system (RMR), remote sensing analysis, and micro-topography interpretation to develop an integrated landslide hazard assessment approach and reflect the intrinsic state of slopeland from the past toward the future. First, the degree of hazard as indicated by historical landslides was used to determine many landslide regions in the past. Secondly, geo-mechanical classification of rock outcroppings was performed by in-situ investigation along the vulnerable road sections. Finally, a high-resolution digital elevation model was extracted from airborne LiDAR and multi-temporal remote sensing images which was analyzed to discover possible catastrophic landslide hotspot shortly. The results of the analysis showed that 37% of the road sections in the study area were highly susceptible to landslide hazards. The spatial distribution of the road sections revealed that those characterized by high susceptibility were located near the boundaries of fault zones and in areas of lithologic dissimilarity. Headward erosion of gullies and concave-shaped topographic features had an adverse effect and was the dominant factor triggering landslides. Regional landslide reactivation on this coastal highway are almost related to the past landslide region based on hazard statistics. The final results of field validation demonstrated that an accuracy of 91% could be achieved for forecasting geohazard followed by intense rainfall events and typhoons.

  3. Including the temporal change in PM{sub 2.5} concentration in the assessment of human health impact: Illustration with renewable energy scenarios to 2050

    Energy Technology Data Exchange (ETDEWEB)

    Gschwind, Benoit, E-mail: benoit.gschwind@mines-paristech.fr [Centre Observation, Impacts, Energy, MINES ParisTech, 1 rue Claude Daunesse, CS 10207, F-06904 Sophia Antipolis (France); Lefevre, Mireille, E-mail: mireille.lefevre@mines-paristech.fr [Centre Observation, Impacts, Energy, MINES ParisTech, 1 rue Claude Daunesse, CS 10207, F-06904 Sophia Antipolis (France); Blanc, Isabelle, E-mail: isabelle.blanc@mines-paristech.fr [Centre Observation, Impacts, Energy, MINES ParisTech, 1 rue Claude Daunesse, CS 10207, F-06904 Sophia Antipolis (France); Ranchin, Thierry, E-mail: thierry.ranchin@mines-paristech.fr [Centre Observation, Impacts, Energy, MINES ParisTech, 1 rue Claude Daunesse, CS 10207, F-06904 Sophia Antipolis (France); Wyrwa, Artur, E-mail: awyrwa@agh.edu.pl [AGH University of Science and Technology, Al. Mickiewicza 30, Krakow 30-059 (Poland); Drebszok, Kamila [AGH University of Science and Technology, Al. Mickiewicza 30, Krakow 30-059 (Poland); Cofala, Janusz, E-mail: cofala@iiasa.ac.at [International Institute for Applied Systems Analysis, Schlossplatz 1, 2067 Laxenburg (Austria); Fuss, Sabine, E-mail: fuss@mcc-berlin.net [International Institute for Applied Systems Analysis, Schlossplatz 1, 2067 Laxenburg (Austria); Mercator Research Institute on Global Commons and Climate Change, Torgauer Str. 12-15, 10829 Berlin (Germany)

    2015-04-15

    This article proposes a new method to assess the health impact of populations exposed to fine particles (PM{sub 2.5}) during their whole lifetime, which is suitable for comparative analysis of energy scenarios. The method takes into account the variation of particle concentrations over time as well as the evolution of population cohorts. Its capabilities are demonstrated for two pathways of European energy system development up to 2050: the Baseline (BL) and the Low Carbon, Maximum Renewable Power (LC-MRP). These pathways were combined with three sets of assumptions about emission control measures: Current Legislation (CLE), Fixed Emission Factors (FEFs), and the Maximum Technically Feasible Reductions (MTFRs). Analysis was carried out for 45 European countries. Average PM{sub 2.5} concentration over Europe in the LC-MRP/CLE scenario is reduced by 58% compared with the BL/FEF case. Health impacts (expressed in days of loss of life expectancy) decrease by 21%. For the LC-MRP/MTFR scenario the average PM{sub 2.5} concentration is reduced by 85% and the health impact by 34%. The methodology was developed within the framework of the EU's FP7 EnerGEO project and was implemented in the Platform of Integrated Assessment (PIA). The Platform enables performing health impact assessments for various energy scenarios. - Highlights: • A new method to assess health impact of PM{sub 2.5} for energy scenarios is proposed. • An algorithm to compute Loss of Life Expectancy attributable to exposure to PM{sub 2.5} is depicted. • Its capabilities are demonstrated for two pathways of European energy system development up to 2050. • Integrating the temporal evolution of PM{sub 2.5} is of great interest for assessing the potential impacts of energy scenarios.

  4. Enhancement MRI evaluation of neuroblastoma staging in children

    International Nuclear Information System (INIS)

    Li Xin; Wang Chunxiang; Zhao Bin; Liu Peifang

    2002-01-01

    Objective: To evaluate the value and limitation of Gd-DTPA enhanced MRI for neuroblastoma staging in children. Methods: Twelve cases of neuroblastoma proved by operation or bone marrow aspiration were examined by gadolinium-enhanced MRI. The age ranged from seven months to five years, mean 3.7 years. Eight tumors originated from adrenal, and four from posterior mediastinum. Conventional sequences, double dose gadolinium-enhanced MRI, and 3D CEMRA were used in all patients. Six cases were examined by CT in same time. Imaging staging on surgic-histopathological-based International Neuroblastoma Staging System (INSS) was performed. Results: Six patients were staged by CT, including stage I-II in 2 cases, stage III in 4 cases, and stage IV in none. Twelve patients were staged by conventional MRI, including stage I-II in 2 cases, stage III in 9 cases, and stage IV in 1 case. Twelve patients were staged by double dose gadolinium-enhanced MRI, including stage I-II in 1 case, stage III in 1 case, and stage IV in 10 cases. Conclusion: Gadolinium-enhanced MRI was a single best imaging modality for neuroblastoma, most useful for distal to diaphragm metastasis, dumbbell tumor intraspinal extension, and bone marrow metastasis that was not detected by aspirate examination. Enhancement MRI was important in evaluating the therapy and was also helpful in assessing the therapeutic efficacy and relapse. 3D CEMRA helps demonstrate large vascular encasement and tumor erosion into important organs, and it is useful in assessing the respectability. Long examination time and lack in showing the characteristic calcium were the limitations

  5. Role of FDG-PET scans in staging, response assessment, and follow-up care for non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cuaron, John [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Dunphy, Mark [Department of Nuclear Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Rimner, Andreas, E-mail: rimnera@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2013-01-03

    The integral role of positron-emission tomography (PET) using the glucose analog tracer fluorine-18 fluorodeoxyglucose (FDG) in the staging of non-small cell lung cancer (NSCLC) is well established. Evidence is emerging for the role of PET in response assessment to neoadjuvant therapy, combined-modality therapy, and early detection of recurrence. Here, we review the current literature on these aspects of PET in the management of NSCLC. FDG-PET, particularly integrated {sup 18}F-FDG-PET/CT, scans have become a standard test in the staging of local tumor extent, mediastinal lymph node involvement, and distant metastatic disease in NSCLC. {sup 18}F-FDG-PET sensitivity is generally superior to computed tomography (CT) scans alone. Local tumor extent and T stage can be more accurately determined with FDG-PET in certain cases, especially in areas of post-obstructive atelectasis or low CT density variation. FDG-PET sensitivity is decreased in tumors <1 cm, at least in part due to respiratory motion. False-negative results can occur in areas of low tumor burden, e.g., small lymph nodes or ground-glass opacities. {sup 18}F-FDG-PET-CT nodal staging is more accurate than CT alone, as hilar and mediastinal involvement is often detected first on {sup 18}F-FDG-PET scan when CT criteria for malignant involvement are not met. {sup 18}F-FDG-PET scans have widely replaced bone scintography for assessing distant metastases, except for the brain, which still warrants dedicated brain imaging. {sup 18}F-FDG uptake has also been shown to vary between histologies, with adenocarcinomas generally being less FDG avid than squamous cell carcinomas. {sup 18}F-FDG-PET scans are useful to detect recurrences, but are currently not recommended for routine follow-up. Typically, patients are followed with chest CT scans every 3–6 months, using {sup 18}F-FDG-PET to evaluate equivocal CT findings. As high {sup 18}F-FDG uptake can occur in infectious, inflammatory, and other non-neoplastic conditions

  6. The transillumination technique as a method for the assessment of spermatogenesis using medicinal plants: the effect of extracts of black maca (Lepidium meyenii) and camu camu (Myrciaria dubia) on stages of the spermatogenic cycle in male rats.

    Science.gov (United States)

    Gonzales, Gustavo F; Vasquez, Vanessa Bertha; Gasco, Manuel

    2013-10-01

    Transillumination technique for assessment of stages of spermatogenic cycle is a useful tool for toxicological studies. This study was designed to determine the effect of two medicinal plants on spermatogenesis in male rats using the transillumination technique. For this, the effect of the combination of a fruit with highest content of ascorbic acid (Myrciaria dubia, camu camu) and extract of black maca (Lepidium meyenii) on seminiferous tubule stages scored by transillumination on intact tubules in adult male rats was assessed. Animals were treated during seven days with vehicle, black maca, camu camu or a mixture of black maca + camu camu and assessed for daily sperm production (DSP), stages of spermatogenic cycle as well as antioxidant activity and levels of flavonoids and polyphenols. Black maca increased stages of spermiation (VII-VIII) and mitosis of germ cells (IX-XI), whereas camu camu increased stages of mitosis (IX-XI) and meiosis (XII). Mixture of maca + camu camu increased stages of spermiation, mitosis and meiosis. All treatments increased DSP (pmaca. In conclusion, M. dubia (camu camu) has potential effects improving spermatogenesis and co-administered with maca increase stages of mitosis, meiosis and spermiation of the spermatogenic cycle as assessed by the transillumination technique. This technique is becoming increasingly a useful tool for assessment spermatogenesis.

  7. Results of chemical analysis from the 2008-2009 National Rivers and Streams Assessment Survey, including persistent organic pollutants and pharmaceuticals

    Data.gov (United States)

    U.S. Environmental Protection Agency — In 2008-2009, fish are were collected from approximately 560 national streams, which included a representative subset of 154 urban river sites, which were in close...

  8. Strategic environmental assessment (SEA) as a means to include environmental knowledge in decision making in the case of an aluminium reduction plant in Greenland

    DEFF Research Database (Denmark)

    Hansen, Anne Merrild

    2011-01-01

    The purpose and means of strategic environmental assessment (SEA) can vary depending on the case investigated and interests of actors involved. Based on the objective for the SEA of a proposed aluminium reduction plant (ARP) in Greenland, this paper evaluates the SEA’s effectiveness in securing...... environmental knowledge in a decision-making process. It is concluded that the SEA secured inclusion of environmental knowledge in three out of four key decision arenas, which determined the direction and outcome of the process. The results from the SEA did not oppose the recommendations based on the economic...... assessments. As there was no conflict between economic and environmental recommendations, and hence no visible proof of SEA’s influence on the outcome of the decision, it is discussed whether environmental knowledge, in this decision making process, equals influence. The investigation was carried out...

  9. Assessment of humoral immune responses to blood-stage malaria antigens following ChAd63-MVA immunization, controlled human malaria infection and natural exposure.

    Science.gov (United States)

    Biswas, Sumi; Choudhary, Prateek; Elias, Sean C; Miura, Kazutoyo; Milne, Kathryn H; de Cassan, Simone C; Collins, Katharine A; Halstead, Fenella D; Bliss, Carly M; Ewer, Katie J; Osier, Faith H; Hodgson, Susanne H; Duncan, Christopher J A; O'Hara, Geraldine A; Long, Carole A; Hill, Adrian V S; Draper, Simon J

    2014-01-01

    The development of protective vaccines against many difficult infectious pathogens will necessitate the induction of effective antibody responses. Here we assess humoral immune responses against two antigens from the blood-stage merozoite of the Plasmodium falciparum human malaria parasite--MSP1 and AMA1. These antigens were delivered to healthy malaria-naïve adult volunteers in Phase Ia clinical trials using recombinant replication-deficient viral vectors--ChAd63 to prime the immune response and MVA to boost. In subsequent Phase IIa clinical trials, immunized volunteers underwent controlled human malaria infection (CHMI) with P. falciparum to assess vaccine efficacy, whereby all but one volunteer developed low-density blood-stage parasitemia. Here we assess serum antibody responses against both the MSP1 and AMA1 antigens following i) ChAd63-MVA immunization, ii) immunization and CHMI, and iii) primary malaria exposure in the context of CHMI in unimmunized control volunteers. Responses were also assessed in a cohort of naturally-immune Kenyan adults to provide comparison with those induced by a lifetime of natural malaria exposure. Serum antibody responses against MSP1 and AMA1 were characterized in terms of i) total IgG responses before and after CHMI, ii) responses to allelic variants of MSP1 and AMA1, iii) functional growth inhibitory activity (GIA), iv) IgG avidity, and v) isotype responses (IgG1-4, IgA and IgM). These data provide the first in-depth assessment of the quality of adenovirus-MVA vaccine-induced antibody responses in humans, along with assessment of how these responses are modulated by subsequent low-density parasite exposure. Notable differences were observed in qualitative aspects of the human antibody responses against these malaria antigens depending on the means of their induction and/or exposure of the host to the malaria parasite. Given the continued clinical development of viral vectored vaccines for malaria and a range of other diseases

  10. Assessment of humoral immune responses to blood-stage malaria antigens following ChAd63-MVA immunization, controlled human malaria infection and natural exposure.

    Directory of Open Access Journals (Sweden)

    Sumi Biswas

    Full Text Available The development of protective vaccines against many difficult infectious pathogens will necessitate the induction of effective antibody responses. Here we assess humoral immune responses against two antigens from the blood-stage merozoite of the Plasmodium falciparum human malaria parasite--MSP1 and AMA1. These antigens were delivered to healthy malaria-naïve adult volunteers in Phase Ia clinical trials using recombinant replication-deficient viral vectors--ChAd63 to prime the immune response and MVA to boost. In subsequent Phase IIa clinical trials, immunized volunteers underwent controlled human malaria infection (CHMI with P. falciparum to assess vaccine efficacy, whereby all but one volunteer developed low-density blood-stage parasitemia. Here we assess serum antibody responses against both the MSP1 and AMA1 antigens following i ChAd63-MVA immunization, ii immunization and CHMI, and iii primary malaria exposure in the context of CHMI in unimmunized control volunteers. Responses were also assessed in a cohort of naturally-immune Kenyan adults to provide comparison with those induced by a lifetime of natural malaria exposure. Serum antibody responses against MSP1 and AMA1 were characterized in terms of i total IgG responses before and after CHMI, ii responses to allelic variants of MSP1 and AMA1, iii functional growth inhibitory activity (GIA, iv IgG avidity, and v isotype responses (IgG1-4, IgA and IgM. These data provide the first in-depth assessment of the quality of adenovirus-MVA vaccine-induced antibody responses in humans, along with assessment of how these responses are modulated by subsequent low-density parasite exposure. Notable differences were observed in qualitative aspects of the human antibody responses against these malaria antigens depending on the means of their induction and/or exposure of the host to the malaria parasite. Given the continued clinical development of viral vectored vaccines for malaria and a range of other

  11. Preliminary steps towards assessing aerosol retention in the break stage of a dry steam generator during severe accident SGTR sequences

    International Nuclear Information System (INIS)

    Herranz, L.E.; Lopez del Pra, C.; Sanchez Velasco, F.J.

    2006-01-01

    Severe accidents SGTR sequences are identified as major contributors to risk of PWRs. Their relevance lies in the potential radioactive release from reactor coolant system to the environment. Lack of knowledge on the source term attenuation capability of the steam generator has avoided its consideration in probabilistic safety studies and severe accident management guidelines. This paper describes a research program presently under way on the aerosol retention in the nearby of the tube breach within the secondary side of the steam generation in the absence of water. Its development has been internationally framed within the EU-SGTR and the ARTIST program. Experimental activities are focused on setting up a reliable database in which the influence of gas mass flow rate, breach configuration and particle nature in the aerosol retention are properly considered. Theoretical activities are aimed at developing a predictive tool (ARISG) capable of assessing source term attenuation in the scenario with reasonable accuracy. Given the major importance of jet aerodynamics, 3D CFD analyses are being conducted to assist both test interpretation and model development. (author)

  12. WE-F-BRB-02: Setting the Stage for Incorporation of Toxicity Measures in Treatment Plan Assessments

    International Nuclear Information System (INIS)

    Mayo, C.

    2015-01-01

    Advancements in informatics in radiotherapy are opening up opportunities to improve our ability to assess treatment plans. Models on individualizing patient dose constraints from prior patient data and shape relationships have been extensively researched and are now making their way into commercial products. New developments in knowledge based treatment planning involve understanding the impact of the radiation dosimetry on the patient. Akin to radiobiology models that have driven intensity modulated radiotherapy optimization, toxicity and outcome predictions based on treatment plans and prior patient experiences may be the next step in knowledge based planning. In order to realize these predictions, it is necessary to understand how the clinical information can be captured, structured and organized with ontologies and databases designed for recall. Large databases containing radiation dosimetry and outcomes present the opportunity to evaluate treatment plans against predictions of toxicity and disease response. Such evaluations can be based on dose volume histogram or even the full 3-dimensional dose distribution and its relation to the critical anatomy. This session will provide an understanding of ontologies and standard terminologies used to capture clinical knowledge into structured databases; How data can be organized and accessed to utilize the knowledge in planning; and examples of research and clinical efforts to incorporate that clinical knowledge into planning for improved care for our patients. Learning Objectives: Understand the role of standard terminologies, ontologies and data organization in oncology Understand methods to capture clinical toxicity and outcomes in a clinical setting Understand opportunities to learn from clinical data and its application to treatment planning Todd McNutt receives funding from Philips, Elekta and Toshiba for some of the work presented

  13. An assessment of the government liquid hydrogen requirements for the 1995-2005 time frame including addendum, liquid hydrogen production and commercial demand in the United States

    Science.gov (United States)

    Bain, Addison

    1990-01-01

    Liquid hydrogen will continue to be an integral element in virtually every major space program, and it has also become a significant merchant product for certain commercial markets. Liquid hydrogen is not a universally available commodity, and the number of supply sources historically have been limited to regions having concentrated consumption patterns. With the increased space program activity it becomes necessary to assess all future programs on a collective and unified basis. An initial attempt to identify projected requirements on a long range basis is presented.

  14. Affordable Development and Demonstration of a Small NTR engine and Stage: A Preliminary NASA, DOE, and Industry Assessment

    Science.gov (United States)

    Borowski, S. K.; Sefcik, R. J.; Fittje, J. E.; McCurdy, D. R.; Qualls, A. L.; Schnitzler, B. G; Werner, J.; Weitzberg, A.; Joyner, C. R.

    2015-01-01

    In FY'11, Nuclear Thermal Propulsion (NTP) was identified as a key propulsion option under the Advanced In-Space Propulsion (AISP) component of NASA's Exploration Technology Development and Demonstration (ETDD) program A strategy was outlined by GRC and NASA HQ that included 2 key elements -"Foundational Technology Development" followed by specific "Technology Demonstration" projects. The "Technology Demonstration "element proposed ground technology demonstration (GTD) testing in the early 2020's, followed by a flight technology demonstration (FTD) mission by approx. 2025. In order to reduce development costs, the demonstration projects would focus on developing a small, low thrust (approx. 7.5 -16.5 klb(f)) engine that utilizes a "common" fuel element design scalable to the higher thrust (approx. 25 klb(f)) engines used in NASA's Mars DRA 5.0 study(NASA-SP-2009-566). Besides reducing development costs and allowing utilization of existing, flight proven engine hard-ware (e.g., hydrogen pumps and nozzles), small, lower thrust ground and flight demonstration engines can validate the technology and offer improved capability -increased payloads and decreased transit times -valued for robotic science missions identified in NASA's Decadal Study.

  15. Including Youth with Intellectual Disabilities in Health Promotion Research: Development and Reliability of a Structured Interview to Assess the Correlates of Physical Activity among Youth

    Science.gov (United States)

    Curtin, Carol; Bandini, Linda G.; Must, Aviva; Phillips, Sarah; Maslin, Melissa C. T.; Lo, Charmaine; Gleason, James M.; Fleming, Richard K.; Stanish, Heidi I.

    2016-01-01

    Background: The input of youth with intellectual disabilities in health promotion and health disparities research is essential for understanding their needs and preferences. Regular physical activity (PA) is vital for health and well-being, but levels are low in youth generally, including those with intellectual disabilities. Understanding the…

  16. Assessment of Serosal Invasion and Criteria for the Classification of Pathological (p) T4 Staging in Colorectal Carcinoma: Confusions, Controversies and Criticisms

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, Colin J. R., E-mail: colin.stewart@health.wa.gov.au; Hillery, Simon [Department of Histopathology, SJOG Hospital, Perth, Western Australia (Australia); Platell, Cameron [Colorectal Surgery Unit, SJOG Hospital, Perth, Western Australia and University of Western (Australia); Puppa, Giacomo [Division of Pathology, ‘G. Fracastoro’ City Hospital, Verona (Italy)

    2011-01-04

    Transmural spread by colorectal carcinoma can result in tumor invasion of the serosal surface and, hence, more likely dissemination within the peritoneal cavity and potentially to additional metastatic sites. The adverse prognostic significance of serosal invasion is widely accepted and its presence may be considered an indication for chemotherapy in patients with node negative disease. However, controversy persists regarding the most appropriate criteria for diagnosis and there are also practical difficulties associated with histological assessment in some cases. Therefore, serosal invasion may be under-diagnosed in a significant proportion of tumors, potentially leading to sub-optimal treatment of high-risk patients. The examination of multiple microscopic sections combined with ancillary studies such as cytology preparations, elastin stains, and immunohistochemistry may prove beneficial in selected problematic cases, but these are not used routinely. The relative prognostic significance of serosal invasion and of direct tumor spread to other organs, both of which are incorporated within the pT4 category of the AJCC/UICC TNM staging system, remains unclear. Further studies are required to demonstrate whether recent adjustments to the TNM staging of pT4 tumors are appropriate.

  17. Reliability of Schmeling's stages of ossification of medial clavicular epiphyses and its validity to assess 18 years of age in living subjects.

    Science.gov (United States)

    Cameriere, R; De Luca, S; De Angelis, D; Merelli, V; Giuliodori, A; Cingolani, M; Cattaneo, C; Ferrante, L

    2012-11-01

    Nowadays, due to the global increase in migration movements, forensic age estimation of living young adults has become an important focus of interest. Minors often have no identification documents providing their correct birth dates. Establishing the age of majority is therefore fundamental in order to determine whether juvenile penal systems or penal systems in force for adults are to be applied. Radiological examination of the clavicles is one of the methods recommended by the Study Group on Forensic Age Diagnostics. In this retrospective study, a sample of chest radiographs of 274 subjects, aged between 12 and 25 years, was studied according to Schmeling's method in order to examine the ossification of both medial clavicular epiphyses. All stage classifications were evaluated by five examiners. Intra- and inter-examiner reliability was analysed by Cohen's K statistic. Intra-examiner agreement was insufficient for two of the experts. Inter-examiner agreement, among the other three operators, was moderate (K = 0.509). Study of reliability highlighted difficulties in interpretation, the need to select qualified personnel and choice of the best radiographic image in order to reduce any anatomic overlaps. Although ossification of the medial clavicular epiphyses is recommended to assess whether an individual has already reached the age of majority or not, these results suggested that it is very difficult to clearly identify the five stages of ossification by using conventional chest radiography.

  18. A comparison of cervical vertebral maturation assessment of skeletal growth stages with chronological age in Thai between cleft lip and palate and non-cleft patients.

    Science.gov (United States)

    Pisek, Poonsak; Godfrey, Keith; Manosudprasit, Montian; Wangsrimongkol, Tasanee; Leelasinjaroen, Pornnapha

    2013-09-01

    (1) To search for any difference in chronological age related to stages of the cervical vertebral maturation index stages (CVMIs) comparing groups of cleft lip and palate (CLP) and non-cleft (non-CLP) subjects; (2) To investigate the relationship between chronological age and CVMIs in both groups of subjects. Cervical vertebrae C2, C3, C4 were assessed on 1,549 cephalometric films (503 CLP films, 1,046 non-CLP films of subjects aged 5 to 18 years) using Hassel and Farman's method. T-tests showed mean chronological ages of CVMIs 2, 3 and 6 were different at p = 0.001, 0.024 and 0.016, respectively. CVMIs 1, 4 and 5 showed no significant differences. The CLP group achieved each CVMI score one year ahead of the non-CLP group, except for CVMI 4. Spearman's rank order correlations were r = 0.80 (95% CI: 0.76-0.83) for CLP, and 0.77 (95% CI: 0.74-0.79) for non-CLP. CLP subjects tended to have a slightly advanced growth compared with non-CLP subjects. A high correlation coefficient was found between chronological age and cervical vertebral skeletal maturation.

  19. A two-stage model for in vivo assessment of brain tumor perfusion and abnormal vascular structure using arterial spin labeling.

    Directory of Open Access Journals (Sweden)

    Patrick W Hales

    Full Text Available The ability to assess brain tumor perfusion and abnormalities in the vascular structure in vivo could provide significant benefits in terms of lesion diagnosis and assessment of treatment response. Arterial spin labeling (ASL has emerged as an increasingly viable methodology for non-invasive assessment of perfusion. Although kinetic models have been developed to describe perfusion in healthy tissue, the dynamic behaviour of the ASL signal in the brain tumor environment has not been extensively studied. We show here that dynamic ASL data acquired in brain tumors displays an increased level of 'biphasic' behaviour, compared to that seen in healthy tissue. A new two-stage model is presented which more accurately describes this behaviour, and provides measurements of perfusion, pre-capillary blood volume fraction and transit time, and capillary bolus arrival time. These biomarkers offer a novel contrast in the tumor and surrounding tissue, and provide a means for measuring tumor perfusion and vascular structural abnormalities in a fully non-invasive manner.

  20. Potash: a global overview of evaporate-related potash resources, including spatial databases of deposits, occurrences, and permissive tracts: Chapter S in Global mineral resource assessment

    Science.gov (United States)

    Orris, Greta J.; Cocker, Mark D.; Dunlap, Pamela; Wynn, Jeff C.; Spanski, Gregory T.; Briggs, Deborah A.; Gass, Leila; Bliss, James D.; Bolm, Karen S.; Yang, Chao; Lipin, Bruce R.; Ludington, Stephen; Miller, Robert J.; Słowakiewicz, Mirosław

    2014-01-01

    Potash is mined worldwide to provide potassium, an essential nutrient for food crops. Evaporite-hosted potash deposits are the largest source of salts that contain potassium in water-soluble form, including potassium chloride, potassium-magnesium chloride, potassium sulfate, and potassium nitrate. Thick sections of evaporitic salt that form laterally continuous strata in sedimentary evaporite basins are the most common host for stratabound and halokinetic potash-bearing salt deposits. Potash-bearing basins may host tens of millions to more than 100 billion metric tons of potassium oxide (K2O). Examples of these deposits include those in the Elk Point Basin in Canada, the Pripyat Basin in Belarus, the Solikamsk Basin in Russia, and the Zechstein Basin in Germany.

  1. A comparative assessment of human exposure to tetrabromobisphenol A and eight bisphenols including bisphenol A via indoor dust ingestion in twelve countries.

    Science.gov (United States)

    Wang, Wei; Abualnaja, Khalid O; Asimakopoulos, Alexandros G; Covaci, Adrian; Gevao, Bondi; Johnson-Restrepo, Boris; Kumosani, Taha A; Malarvannan, Govindan; Minh, Tu Binh; Moon, Hyo-Bang; Nakata, Haruhiko; Sinha, Ravindra K; Kannan, Kurunthachalam

    2015-10-01

    Tetrabromobisphenol A (TBBPA) and eight bisphenol analogues (BPs) including bisphenol A (BPA) were determined in 388 indoor (including homes and microenvironments) dust samples collected from 12 countries (China, Colombia, Greece, India, Japan, Kuwait, Pakistan, Romania, Saudi Arabia, South Korea, U.S., and Vietnam). The concentrations of TBBPA and sum of eight bisphenols (ƩBPs) in dust samples ranged from exposure doses through diet, dust ingestion accounted for less than 10% of the total exposure doses in China and the U.S. For TBBPA, the EDI for infants and toddlers ranged from 0.01 to 3.4 ng/kg bw/day, and dust ingestion is an important pathway for exposure accounting for 3.8-35% (median) of exposure doses in China. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Use of geochemical signatures, including rare earth elements, in mosses and lichens to assess spatial integration and the influence of forest environment

    Science.gov (United States)

    Gandois, L.; Agnan, Y.; Leblond, S.; Séjalon-Delmas, N.; Le Roux, G.; Probst, A.

    2014-10-01

    In order to assess the influence of local environment and spatial integration of Trace Metals (TM) by biomonitors, Al, As, Cd, Cr, Cs, Cu, Fe, Mn, Ni, Pb, Sb, Sn, V and Zn and some rare earth element (REE) concentrations have been measured in lichens and mosses collected in three French forest sites located in three distinct mountainous areas, as well as in the local soil and bedrock, and in both bulk deposition (BD) and throughfall (TF). Similar enrichment factors (EF) were calculated using lichens and mosses and local bedrock for most elements, except for Cs, Mn, Ni, Pb, and Cu which were significantly (KW, p leaching (Mn), direct uptake (Ni), or dry deposition dissolution (Pb, Cu, Cs).

  3. [Effects of pathological assessment of endometrial tissue in fertility-sparing treatment with progestin for endometrial carcinoma of stage I a and complex atypical hyperplasia].

    Science.gov (United States)

    Gong, Qinglin; Chen, Xiaoduan; Xie, Xing

    2014-09-01

    To assess the efficacy and pathological change of fertility-sparing treatment with progestin for endometrial carcinoma (EC) of stage I a and complex atypical hyperplasia (CAH) and to observe the prognosis of the treatment. Nine EC patients of stage I a and 21 CAH patients aged under 40 years who desired childbearing and retaining their fertility were enrolled into this study. All patients were given a daily oral high-dose of progestin with duration of treatment ranging from 6 to 9 months. Diagnostic curettage was performed every 3 months as a modality for seeing the histologic change of neoplastic tissues and endometrial tissue. A careful and long- term follow- up is necessary for patients with complete response (CR). During the first period of fertility-sparing management, according to histologic change, 5 EC patients and 18 CAH patients showed CR with no evidence of endometrial adenocarcinoma or hyperplasia, 2 EC patients and 2 CAH patients showed partial response with a regression to complex or simple hyperplasia without atypia, 2 EC patients and 1 CAH patient showed stable disease or progressive disease. Accordingly, a total of 26 patients showed CR (26 of 30 patients). The median time to CR was 6 months (range, 3 to 21 months) of progestin treatment. The median follow-up time was 55.5 months (range, 24 to 104 months) and all patients were alive. During follow-up, among the 26 patients with CR, 3 of 6 EC patients achieved CR recurred disease after a median time interval of 10 months (range, 6 to 51 months), 7 of 20 CAH patients achieved CR had recurrent disease after a median time interval of 12 months (range, 6 to 55 months). Four of 7 CAH with recurrent disease achieved CR to progestin re-treatment. Eight of 26 patients achieved CR continued a further 3 or 6 months of consolidation therapy, 3 of them had recurrent disease, the remaining 18 stopped progesterone treatment after CR and 7 patients had recurrent disease; there was no significant statistical

  4. Development and Assessment of CFD Models Including a Supplemental Program Code for Analyzing Buoyancy-Driven Flows Through BWR Fuel Assemblies in SFP Complete LOCA Scenarios

    Science.gov (United States)

    Artnak, Edward Joseph, III

    This work seeks to illustrate the potential benefits afforded by implementing aspects of fluid dynamics, especially the latest computational fluid dynamics (CFD) modeling approach, through numerical experimentation and the traditional discipline of physical experimentation to improve the calibration of the severe reactor accident analysis code, MELCOR, in one of several spent fuel pool (SFP) complete loss-ofcoolant accident (LOCA) scenarios. While the scope of experimental work performed by Sandia National Laboratories (SNL) extends well beyond that which is reasonably addressed by our allotted resources and computational time in accordance with initial project allocations to complete the report, these simulated case trials produced a significant array of supplementary high-fidelity solutions and hydraulic flow-field data in support of SNL research objectives. Results contained herein show FLUENT CFD model representations of a 9x9 BWR fuel assembly in conditions corresponding to a complete loss-of-coolant accident scenario. In addition to the CFD model developments, a MATLAB based controlvolume model was constructed to independently assess the 9x9 BWR fuel assembly under similar accident scenarios. The data produced from this work show that FLUENT CFD models are capable of resolving complex flow fields within a BWR fuel assembly in the realm of buoyancy-induced mass flow rates and that characteristic hydraulic parameters from such CFD simulations (or physical experiments) are reasonably employed in corresponding constitutive correlations for developing simplified numerical models of comparable solution accuracy.

  5. [Assessment of the technology of care relations in the health services: perception of the elderly included in the family health strategy in Bambuí, Brazil].

    Science.gov (United States)

    Santos, Wagner Jorge dos; Giacomin, Karla Cristina; Firmo, Josélia Oliveira Araújo

    2014-08-01

    In the health field, technologies of care relations are in the scope of the worker-user encounter, implying intersubjectivity with the development of relationships between subjects, resulting in action. Evaluation studies synthesize knowledge produced on the consequences of using these technologies for society. This anthropological study aims to understand the perception of the elderly regarding the resolution capability and effectiveness of the acts produced in health care relationships in the context of the Family Health Strategy (ESF). The group studied consisted of 57 elderly residents in Bambui, State of Minas Gerais, Brazil. The model of signs, meanings and actions was used for collecting and analyzing data and the semi-structured interview was applied as a research technique. Elderly individuals assess resolution capability and effectiveness of the acts of care in the ESF as negative, with relation to the quality of user and professional interaction. The ESF is not effective and the desired change in the health care model has not occurred in practice. It repeats the centrality of the medical-drug-procedure model that treats the disease rather than the patient, perceiving old age as a disease and illness as being related to aging.

  6. Variability and accuracy of coronary CT angiography including use of iterative reconstruction algorithms for plaque burden assessment as compared with intravascular ultrasound - an ex vivo study

    Energy Technology Data Exchange (ETDEWEB)

    Stolzmann, Paul [Massachusetts General Hospital and Harvard Medical School, Cardiac MR PET CT Program, Boston, MA (United States); University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Schlett, Christopher L.; Maurovich-Horvat, Pal; Scheffel, Hans; Engel, Leif-Christopher; Karolyi, Mihaly; Hoffmann, Udo [Massachusetts General Hospital and Harvard Medical School, Cardiac MR PET CT Program, Boston, MA (United States); Maehara, Akiko; Ma, Shixin; Mintz, Gary S. [Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (United States)

    2012-10-15

    To systematically assess inter-technique and inter-/intra-reader variability of coronary CT angiography (CTA) to measure plaque burden compared with intravascular ultrasound (IVUS) and to determine whether iterative reconstruction algorithms affect variability. IVUS and CTA data were acquired from nine human coronary arteries ex vivo. CT images were reconstructed using filtered back projection (FBPR) and iterative reconstruction algorithms: adaptive-statistical (ASIR) and model-based (MBIR). After co-registration of 284 cross-sections between IVUS and CTA, two readers manually delineated the cross-sectional plaque area in all images presented in random order. Average plaque burden by IVUS was 63.7 {+-} 10.7% and correlated significantly with all CTA measurements (r = 0.45-0.52; P < 0.001), while CTA overestimated the burden by 10 {+-} 10%. There were no significant differences among FBPR, ASIR and MBIR (P > 0.05). Increased overestimation was associated with smaller plaques, eccentricity and calcification (P < 0.001). Reproducibility of plaque burden by CTA and IVUS datasets was excellent with a low mean intra-/inter-reader variability of <1/<4% for CTA and <0.5/<1% for IVUS respectively (P < 0.05) with no significant difference between CT reconstruction algorithms (P > 0.05). In ex vivo coronary arteries, plaque burden by coronary CTA had extremely low inter-/intra-reader variability and correlated significantly with IVUS measurements. Accuracy as well as reader reliability were independent of CT image reconstruction algorithm. (orig.)

  7. Assessment of anthropometric parameters including area of the psoas, area of the back muscle, and psoas-vertebra distance as indices for prediction of vertebral fracture

    International Nuclear Information System (INIS)

    Suzuki, Tamotsu; Morita, Masahumi; Mabuchi, Kiyoshi

    2005-01-01

    We assessed some anthropometric parameters as indices for the prediction of vertebral compression fracture. We measured the area of the total cross section, area of the back muscle, area of the psoas, area of subcutaneous fat tissue, ratio of the right and left area of the psoas, psoas-vertebra distance, the mediolateral length of the back muscle, anteroposterior length of the back muscle, the mediolateral length of the psoas, and anteroposterior length of the psoas, on computed tomography images. Logistic regression analysis was performed in order to test the correlation between each anthropometric parameter and the incidence of fracture. The odds ratio corresponding to one standard deviation of each parameter was calculated. The ratio of center and anterior vertebral heights and the ratio of center and posterior vertebral heights were measured from the positioning image. The smaller value of these was defined as the vertebral height ratio value. Vertebral height ratio was used as the parameter directly related to vertebral fracture. The subjects for research were 25 women with vertebral compression fracture and 36 women without fracture. Vertebral height ratio had a significant correlation with area of the psoas (correlation coefficient, r=0.609 p<0.001), area of the back muscle (r=0.547 p<0.001), and the psoas-vertebra distance (r=-0.523 p<0.001) in the anthropometric parameters. The odds ratios of the area of the psoas (odds ratio, OR:0.18, 95% confidence interval, CI:0.43 to 0.08), area of the back muscle (OR:0.13, 95% CI:0.37 to 0.05), and the psoas-vertebra distance (OR:3.01, 95% CI:6.22 to 1.46) were high. The odds ratio of the mediolateral length of the psoas (OR:0.34, 95% CI:0.67 to 0.18), and the left-to-right area ratio of the psoas (OR:0.41, 95% CI:0.76 to 0.22) were rather high. However, the vertebral height ratio had no significant correlation with the left-to-right area ratio of the psoas. It was considered that area of the psoas, area of the back

  8. Use of a unipedal standing test to assess the ambulation reacquisition time during the early postoperative stage after hip fracture in elderly Japanese: prospective study.

    Science.gov (United States)

    Murata, Koichi; Sugitani, Shigeki; Yoshioka, Hiroki; Noguchi, Takashi; Aoto, Toshiyuki; Nakamura, Takashi

    2010-01-01

    The aim of this study was to predict the ambulation reacquisition time after hip fracture in elderly people using the unipedal standing test during the early postoperative stage. Patients with an intertrochanteric fracture treated with internal fixation (n = 35) and patients with a femoral neck fracture treated with hemiarthroplasty (n = 22) were included. A unipedal standing test using the nonoperated leg was performed on days 3 and 7 after the operation. Among the patients with an intertrochanteric fracture, those with a positive result on the unipedal standing test on postoperative day (POD) 3 attained gait with parallel guide bars (BG) and walker-assisted gait (WG) significantly earlier than did patients with a negative result on the unipedal standing test. Patients with a positive result on the unipedal standing test on POD 7 attained BG, WG, and cane-assisted gait (CG) significantly earlier than did patients with a negative test. Among patients with a femoral neck fracture, those with a positive unipedal standing test result on POD 3 attained BG, WG, and CG significantly earlier than did patients with a negative test. Those with a positive test result on POD 7 attained BG, WG, and CG significantly earlier than did patients with a negative test. The unipedal standing test given during the early postoperative stage is a good test for predicting the ambulation reacquisition time. Moreover, it gives information that can help determine the need for subacute rehabilitation and about discharge planning and health service provision.

  9. HVDC-System-Interaction Assessment through Line-Flow Change-Distribution Factor and Transient-Stability Analysis at Planning Stage

    Directory of Open Access Journals (Sweden)

    Sungchul Hwang

    2016-12-01

    Full Text Available Many of the recent projects for new transmission line have considered the high-voltage direct current (HVDC system, owing to the many advantages of the direct current (DC system. The most noteworthy advantage is that a cable can serve as a substitute for the overhead transmission line in residential areas; therefore, the HVDC system application is increasing, and as the number of DC systems in the power system increases, the interaction assessment regarding the HVDC system gains importance. An index named multi-infeed interaction factor (MIIF is commonly used to estimate the interaction between power converters; however, the HVDC system is composed of two converters and a transmission line. The MIIF represents the interaction between the rectifiers and inverters, but not for the whole system. In this work, a method to assess the interaction of the whole system was therefore studied. To decide on the location of the new HVDC transmission system at the planning stage, in consideration of the interaction of the existing DC system, the line flow change distribution factor, according to the HVDC-transmission capacity change, was examined. Also, a power system transient -stability analysis was performed with different HVDC system locations, depending on the distribution factor. The simulation results indicate that when the factor is higher, two HVDC systems have a stronger interaction and are less stable in the transient state.

  10. The effect of pramipexole therapy on balance disorder and fall risk in Parkinson's disease at early stage: clinical and posturographic assessment.

    Science.gov (United States)

    Güler, Sibel; Bir, Levent Sinan; Akdag, Beyza; Ardıc, Fusun

    2012-01-01

    The aim of this study was to determine balance problems and severity and ratio of postural instability of newly diagnosed, early stage Parkinson's patients who did not receive any antiparkinson treatment before, to evaluate fall risk clinically and posturographically and to examine the effects of pramipexole on these signs and symptoms. Detailed posturographic assessments which involved central vestibular, visual, peripheric vestibular somatosensory field tests were applied to both patient and control subjects and fall risk was determined. There was not statistically significant difference between patients and control subjects before and after drug therapy in the assesment of fall risk in posturography and there was not any improvement with drug usage in the patient group. However, in the analysis of subsystems separately, only the involvement in central vestibular field was more severe and could appear at all positions in Parkinson's patients comparing with the control group, and pramipexole was partially effective in improving this disorder. Central vestibular field is the subsystem that should be examined with first priority. Posturography is relatively reliable in defining fall risk and postural instability ratio in Parkinson's disease. But it should be considered that clinical assessment tools can be more sensitive in the evaluation of balance and postural disorders and in the follow-up of the response to drug therapy.

  11. CT volumetry for gastric carcinoma: association with TNM stage

    Energy Technology Data Exchange (ETDEWEB)

    Hallinan, James T.P.D.; Peter, Luke; Makmur, Andrew [National University Health System (NUHS), Diagnostic Radiology, Singapore (Singapore); Venkatesh, Sudhakar K. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Yong, Wei Peng [NUHS, Hematology and Oncology, Singapore (Singapore); So, Jimmy B.Y. [NUHS, Surgery, Singapore (Singapore)

    2014-12-15

    We evaluated the feasibility of performing CT volumetry of gastric carcinoma (GC) and its correlation with TNM stage. This institutional review board-approved retrospective study was performed on 153 patients who underwent a staging CT study for histologically confirmed GC. CT volumetry was performed by drawing regions of interest including abnormal thickening of the stomach wall. Reproducibility of tumour volume (Tvol) between two readers was assessed. Correlation between Tvol and TNM/peritoneal staging derived from histology/surgical findings was evaluated using ROC analysis and compared with CT evaluation of TNM/peritoneal staging. Tvol was successfully performed in all patients. Reproducibility among readers was excellent (r = 0.97; P = 0.0001). The median Tvol of GC showed an incremental trend with T-stage (T1 = 27 ml; T2 = 32 ml; T3 = 53 ml and T4 = 121 ml, P < 0.01). Tvol predicted with good accuracy T-stage (≥T2:0.95; ≥T3:0.89 and T4:0.83, P = 0.0001), M-stage (0.87, P = 0.0001), peritoneal metastases (0.87, P = 0.0001) and final stage (≥stage 2:0.89; ≥stage 3:0.86 and stage 4:0.87, P = 0.0001), with moderate accuracy for N-stage (≥N1:0.75; ≥N2:0.74 and N3:0.75, P = 0.0001). Tvol was significantly (P < 0.05) more accurate than standard CT staging for prediction of T-stage, N3-stage, M-stage and peritoneal metastases. CT volumetry may provide useful adjunct information for preoperative staging of GC. (orig.)

  12. CT volumetry for gastric carcinoma: association with TNM stage

    International Nuclear Information System (INIS)

    Hallinan, James T.P.D.; Peter, Luke; Makmur, Andrew; Venkatesh, Sudhakar K.; Yong, Wei Peng; So, Jimmy B.Y.

    2014-01-01

    We evaluated the feasibility of performing CT volumetry of gastric carcinoma (GC) and its correlation with TNM stage. This institutional review board-approved retrospective study was performed on 153 patients who underwent a staging CT study for histologically confirmed GC. CT volumetry was performed by drawing regions of interest including abnormal thickening of the stomach wall. Reproducibility of tumour volume (Tvol) between two readers was assessed. Correlation between Tvol and TNM/peritoneal staging derived from histology/surgical findings was evaluated using ROC analysis and compared with CT evaluation of TNM/peritoneal staging. Tvol was successfully performed in all patients. Reproducibility among readers was excellent (r = 0.97; P = 0.0001). The median Tvol of GC showed an incremental trend with T-stage (T1 = 27 ml; T2 = 32 ml; T3 = 53 ml and T4 = 121 ml, P < 0.01). Tvol predicted with good accuracy T-stage (≥T2:0.95; ≥T3:0.89 and T4:0.83, P = 0.0001), M-stage (0.87, P = 0.0001), peritoneal metastases (0.87, P = 0.0001) and final stage (≥stage 2:0.89; ≥stage 3:0.86 and stage 4:0.87, P = 0.0001), with moderate accuracy for N-stage (≥N1:0.75; ≥N2:0.74 and N3:0.75, P = 0.0001). Tvol was significantly (P < 0.05) more accurate than standard CT staging for prediction of T-stage, N3-stage, M-stage and peritoneal metastases. CT volumetry may provide useful adjunct information for preoperative staging of GC. (orig.)

  13. Assessment of five different guideline indication criteria for spirometry, including modified GOLD criteria, in order to detect COPD: data from 5,315 subjects in the PLATINO study.

    Science.gov (United States)

    Luize, Ana P; Menezes, Ana Maria B; Perez-Padilla, Rogelio; Muiño, Adriana; López, Maria Victorina; Valdivia, Gonzalo; Lisboa, Carmem; Montes de Oca, Maria; Tálamo, Carlos; Celli, Bartolomé; Nascimento, Oliver A; Gazzotti, Mariana R; Jardim, José R

    2014-10-30

    Spirometry is the gold standard for diagnosing chronic obstructive pulmonary disease (COPD). Although there are a number of different guideline criteria for deciding who should be selected for spirometric screening, to date it is not known which criteria are the best based on sensitivity and specificity. Firstly, to evaluate the proportion of subjects in the PLATINO Study that would be recommended for spirometry testing according to Global initiative for Obstructive Lung Disease (GOLD)-modified, American College of Chest Physicians (ACCP), National Lung Health Education Program (NLHEP), GOLD and American Thoracic Society/European Respiratory Society (ATS/ERS) criteria. Secondly, we aimed to compare the sensitivity, specificity, and positive predictive and negative predictive values, of these five different criteria. Data from the PLATINO study included information on respiratory symptoms, smoking and previous spirometry testing. The GOLD-modified spirometry indication criteria are based on three positive answers out of five questions: the presence of cough, phlegm in the morning, dyspnoea, age over 40 years and smoking status. Data from 5,315 subjects were reviewed. Fewer people had an indication for spirometry (41.3%) according to the GOLD-modified criteria, and more people had an indication for spirometry (80.4%) by the GOLD and ATS/ERS criteria. A low percentage had previously had spirometry performed: GOLD-modified (14.5%); ACCP (13.2%); NLHEP (12.6%); and GOLD and ATS/ERS (12.3%). The GOLD-modified criteria showed the least sensitivity (54.9) and the highest specificity (61.0) for detecting COPD, whereas GOLD and ATS/ERS criteria showed the highest sensitivity (87.9) and the least specificity (20.8). There is a considerable difference in the indication for spirometry according to the five different guideline criteria. The GOLD-modified criteria recruit less people with the greatest sum of sensitivity and specificity.

  14. Fertility in Namibia. Changes in fertility levels in North-Central Namibia 1960-2001, including an assessment of the impact of HIV

    Directory of Open Access Journals (Sweden)

    Riikka Shemeikka

    2006-01-01

    Full Text Available The aim of this study was to estimate the development of fertility in North-Central Namibia, former Ovamboland, from 1960 to 2001. Special attention was given to the onset of fertility decline and to the impact of the HIV epidemic on fertility. An additional aim was to introduce parish registers as a source of data for fertility research in Africa.  Data used consisted of parish registers from Evangelical Lutheran congregations, the 1991 and 2001 Population and Housing Censuses, the 1992 and 2000 Namibia Demographic and Health Surveys, and the HIV sentinel surveillances of 1992-2004. Both period and cohort fertility were analysed. The P/F ratio method was used when analysing census data. The impact of HIV infection on fertility was estimated indirectly by comparing the fertility histories of women who died at an age of less than 50 years with the fertility of other women. The impact of the HIV epidemic on fertility was assessed both among infected women and in the general population.  Fertility in the study population began to decline in 1980. The decline was rapid during the 1980s, levelled off in the early 1990s at the end of war of independence and then continued to decline until the end of the study period. According to parish registers, total fertility was 6.4 in the 1960s and 6.5 in the 1970s, and declined to 5.1 in the 1980s and 4.2 in the 1990s. Adjustment of these total fertility rates to correspond to levels of fertility based on data from the 1991 and 2001 censuses resulted in total fertility declining from 7.6 in 1960-79 to 6.0 in 1980-89, and to 4.9 in 1990-99. The decline was associated with increased age at first marriage, declining marital fertility and increasing premarital fertility. Fertility among adolescents increased, whereas the fertility of women in all other age groups declined.  During the 1980s, the war of independence contributed to declining fertility through spousal separation and delayed marriages. Contraception

  15. Assessing the Sensitivity of Different Life Stages for Sexual Disruption in Roach (Rutilus rutilus) Exposed to Effluents from Wastewater Treatment Works

    Science.gov (United States)

    Liney, Katherine E.; Jobling, Susan; Shears, Jan A.; Simpson, Peter; Tyler, Charles R.

    2005-01-01

    Surveys of U.K. rivers have shown a high incidence of sexual disruption in populations of wild roach (Rutilus rutilus) living downstream from wastewater treatment works (WwTW), and the degree of intersex (gonads containing both male and female structural characteristics) has been correlated with the concentration of effluent in those rivers. In this study, we investigated feminized responses to two estrogenic WwTWs in roach exposed for periods during life stages of germ cell division (early life and the postspawning period). Roach were exposed as embryos from fertilization up to 300 days posthatch (dph; to include the period of gonadal sex differentiation) or as postspawning adult males, and including fish that had received previous estrogen exposure, for either 60 or 120 days when the annual event of germ cell proliferation occurs. Both effluents induced vitellogenin synthesis in both life stages studied, and the magnitude of the vitellogenic responses paralleled the effluent content of steroid estrogens. Feminization of the reproductive ducts occurred in male fish in a concentration-dependent manner when the exposure occurred during early life, but we found no effects on the reproductive ducts in adult males. Depuration studies (maintenance of fish in clean water after exposure to WwTW effluent) confirmed that the feminization of the reproductive duct was permanent. We found no evidence of ovotestis development in fish that had no previous estrogen exposure for any of the treatments. In wild adult roach that had previously received exposure to estrogen and were intersex, the degree of intersex increased during the study period, but this was not related to the immediate effluent exposure, suggesting a previously determined programming of ovotestis formation. PMID:16203238

  16. Patient-Generated Subjective Global Assessment in relation to site, stage of the illness, reason for hospital admission, and mortality in patients with gynecological tumors.

    Science.gov (United States)

    Rodrigues, Camila Santos; Chaves, Gabriela Villaça

    2015-03-01

    This study aimed to identify factors related to the illness and to oncological treatment as determinants of the nutritional status of patients with gynecological tumors. This is a retrospective study; the group was composed of 146 women histopathologically shown to have gynecological tumors, at different stages of treatment, and hospitalized at the foremost centers for the prevention and treatment of cancer in Rio de Janeiro. To obtain a nutritional diagnosis, we used the Patient-Generated Subjective Global Assessment (PG-SGA). We did multiple comparisons of the numeric variables between the three PG-SGA nutritional status-classification groups by performing Kruskal-Wallis analysis of variance. We used the Mann-Whitney test to compare numerical variables between two groups. We analyzed the associations between categorical variables by using either the chi-squared (χ (2)) test or Fisher's exact test. Of the women, 62.4 % were found to be at nutritional risk or to have some level of malnourishment, being more associated with the reason for hospital admission and stage disease that properly to the tumor site. The median PG-SGA score was points, with 62.3 % of the group returning 9 or more points. Women diagnosed with endometrial cancer were found to be predominantly well nourished, and those with tumors in the ovary were more frequently diagnosed as being severely malnourished. Our findings support early nutritional intervention in the population identified as being at greater nutritional risk, aiming to minimize the loss of muscle mass and body weight, as well as to improve symptoms management, thus helping to achieve better clinical results.

  17. The newly proposed clinical and post-neoadjuvant treatment staging classifications for gastric adenocarcinoma for the American Joint Committee on Cancer (AJCC) staging.

    Science.gov (United States)

    In, Haejin; Ravetch, Ethan; Langdon-Embry, Marisa; Palis, Bryan; Ajani, Jaffer A; Hofstetter, Wayne L; Kelsen, David P; Sano, Takeshi

    2018-01-01

    New stage grouping classifications for clinical (cStage) and post-neoadjuvant treatment (ypStage) stage for gastric adenocarcinoma have been proposed for the eighth edition of the AJCC manual. This article summarizes the analysis for these stages. Gastric adenocarcinoma patients diagnosed in 2004-2009 were identified from the National Cancer Database (NCDB). The cStage cohort included both surgical and nonsurgical cases, and the ypStage cohort included only patients who had chemotherapy or radiation therapy before surgery. Survival differences between the stage groups were determined by the log-rank test and prognostic accuracy was assessed by concordance index. Analysis was performed using SAS 9.4 (SAS, Cary, NC, USA). Five strata for cStage and four strata for ypStage were developed. The 5-year survival rates for cStages were 56.77%, 47.39%, 33.1%, 25.9%, and 5.0% for stages I, IIa, IIb, III, and IV, respectively, and the rates for ypStage were 74.2%, 46.3%, 19.2%, and 11.6% for stages I, II, III, and IV, respectively. The log-rank test showed that survival differences were well stratified and stage groupings were ordered and distinct (p < 0.0001). The proposed cStage and ypStage classification was sensitive and specific and had high prognostic accuracy (cStage: c index = 0.81, 95% CI, 0.79-0.83; ypStage: c index = 0.80, 95% CI, 0.73-0.87). The proposed eighth edition establishes two new staging schemata that provide essential prognostic data for patients before treatment and for patients who have undergone surgery following neoadjuvant therapy. These additions are a significant advance to the AJCC staging manual and will provide critical guidance to clinicians in making informed decisions throughout the treatment course.

  18. Staging for vulvar cancer.

    Science.gov (United States)

    Hacker, Neville F; Barlow, Ellen L

    2015-08-01

    Vulvar cancer has been staged by the International Federation of Gynaecology and Obstetrics (FIGO) since 1969, and the original staging system was based on clinical findings only. This system provided a very good spread of prognostic groupings. Because vulvar cancer is virtually always treated surgically, the status of the lymph nodes is the most important prognostic factor and this can only be determined with certainty by histological examination of resected lymph nodes, FIGO introduced a surgical staging system in 1988. This was modified in 1994 to include a category of microinvasive vulvar cancer (stage IA), because such patients have virtually no risk of lymph node metastases. This system did not give a reasonably even spread of prognostic groupings. In addition, patients with stage III disease were shown to be a heterogeneous group prognostically, and the number of positive nodes and the morphology of those nodes were not taken into account. A new surgical staging system for vulvar cancer was introduced by FIGO in 2009. Initial retrospective analyses have suggested that this new staging system has overcome the major deficiencies in the 1994 system. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  19. Staged residential post-acute rehabilitation for adults following acquired brain injury: A comparison of functional gains rated on the UK Functional Assessment Measure (UK FIM+FAM) and the Mayo-Portland Adaptability Inventory (MPAI-4).

    Science.gov (United States)

    Jackson, Diana; Seaman, Karla; Sharp, Kristylee; Singer, Rachel; Wagland, Janet; Turner-Stokes, Lynne

    2017-01-01

    To compare the UK Functional Assessment Measure (UK FIM+FAM) and Mayo-Portland Adaptability Inventory (MPAI-4) as measures of functional change in patients with brain injury receiving a staged residential post-acute community-based rehabilitation programme. Longitudinal cohort study of consecutive admissions (N = 42) over 3 years. Patients were assessed at admission and discharge/annual review. We examined groups according to stage of independence on admission: Maximum support (stages 1 and 2: N = 17); moderate/maximum self-care/household support (stage 3: N = 15); minimal self-care and moderate household/community support (stages 4-6: N = 10). Median (IQR) age: 50 (37-56) years. Male:female ratio: (71%:29%). Aetiology: stroke (50%), traumatic (36%) and other brain injuries (14%). Both tools demonstrated significant gains in overall scores and all subscales (p MPAI-4 was more sensitive to changes in adjustment and participation for clients admitted in the later stages (4-6). The UK FIM+FAM and MPAI-4 provide complementary evaluation across functional tasks ranging from self-care to participation. This study supports their use for longitudinal outcome evaluation in community residential rehabilitation services that take patients at different stages of recovery.

  20. [18F]FDG PET/CT-based response assessment of stage IV non-small cell lung cancer treated with paclitaxel-carboplatin-bevacizumab with or without nitroglycerin patches

    Energy Technology Data Exchange (ETDEWEB)

    Jong, Evelyn E.C. de; Elmpt, Wouter van; Leijenaar, Ralph T.H.; Lambin, Philippe [Maastricht University Medical Centre, Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht (Netherlands); Hoekstra, Otto S. [VU University Medical Center, Department of Nuclear Medicine and PET Research, Amsterdam (Netherlands); Groen, Harry J.M. [University of Groningen and University Medical Center Groningen, Department of Pulmonary Diseases, Groningen (Netherlands); Smit, Egbert F. [VU University Medical Center, Department of Pulmonary Diseases, Amsterdam (Netherlands); The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Thoracic Oncology, Amsterdam (Netherlands); Boellaard, Ronald [University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen (Netherlands); Noort, Vincent van der [The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Biometrics, Amsterdam (Netherlands); Troost, Esther G.C. [Maastricht University Medical Centre, Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht (Netherlands); Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology, Dresden (Germany); Medical Faculty and University Hospital Carl Gustav Carus of Technische Universitaet Dresden, Department of Radiotherapy and Radiation Oncology, Dresden (Germany); Dingemans, Anne-Marie C. [Maastricht University Medical Centre, Department of Pulmonology, GROW-School for Oncology and Developmental Biology, Maastricht (Netherlands)

    2017-01-15

    Nitroglycerin (NTG) is a vasodilating drug, which increases tumor blood flow and consequently decreases hypoxia. Therefore, changes in [18F] fluorodeoxyglucose positron emission tomography ([18F]FDG PET) uptake pattern may occur. In this analysis, we investigated the feasibility of [18F]FDG PET for response assessment to paclitaxel-carboplatin-bevacizumab (PCB) treatment with and without NTG patches. And we compared the [18F]FDG PET response assessment to RECIST response assessment and survival. A total of 223 stage IV non-small cell lung cancer (NSCLC) patients were included in a phase II study (NCT01171170) randomizing between PCB treatment with or without NTG patches. For 60 participating patients, a baseline and a second [18F]FDG PET/computed tomography (CT) scan, performed between day 22 and 24 after the start of treatment, were available. Tumor response was defined as a 30 % decrease in CT and PET parameters, and was compared to RECIST response at week 6. The predictive value of these assessments for progression free survival (PFS) and overall survival (OS) was assessed with and without NTG. A 30 % decrease in SUVpeak assessment identified more patients as responders compared to a 30 % decrease in CT diameter assessment (73 % vs. 18 %), however, this was not correlated to OS (SUVpeak30 p = 0.833; CTdiameter30 p = 0.557). Changes in PET parameters between the baseline and the second scan were not significantly different for the NTG group compared to the control group (p value range 0.159-0.634). The CT-based (part of the [18F]FDG PET/CT) parameters showed a significant difference between the baseline and the second scan for the NTG group compared to the control group (CT diameter decrease of 7 ± 23 % vs. 19 ± 14 %, p = 0.016, respectively). The decrease in tumoral FDG uptake in advanced NSCLC patients treated with chemotherapy with and without NTG did not differ between both treatment arms. Early PET-based response assessment showed more tumor responders

  1. DNA Topoisomerase I Gene Copy Number and mRNA Expression Assessed as Predictive Biomarkers for Adjuvant Irinotecan in Stage II/III Colon Cancer

    DEFF Research Database (Denmark)

    Nygård, Sune Boris; Vainer, Ben; Nielsen, Signe L

    2016-01-01

    FISH and follow-up data were obtained from 534 patients. TOP1 gain was identified in 27 % using a single-probe enumeration strategy (≥ 4 TOP1 signals per cell), and in 31 % when defined by a TOP1/CEN20 ratio ≥ 1.5. The effect of additional irinotecan was not dependent on TOP1 FISH status. TOP1 m......PURPOSE: Prospective-retrospective assessment of the TOP1 gene copy number and TOP1 mRNA expression as predictive biomarkers for adjuvant irinotecan in stage II/III colon cancer (CC). EXPERIMENTAL DESIGN: Formalin-fixed, paraffin-embedded tissue microarrays were obtained from an adjuvant CC trial...... (PETACC3) where patients were randomized to 5-fluorouracil/folinic acid with or without additional irinotecan. TOP1 copy number status was analyzed by fluorescence in situ hybridization (FISH) using a TOP1/CEN20 dual-probe combination. TOP1 mRNA data were available from previous analyses. RESULTS: TOP1...

  2. Methods for Assessing the Impact of Fog Oil Smoke on Availability, Palatability, & Food Quality of Relevant Life Stages of Insects for Threatened and Endangered Species

    Energy Technology Data Exchange (ETDEWEB)

    Driver, Crystal J.; Strenge, Dennis L.; Su, Yin-Fong; Cullinan, Valerie I.; Herrington, Ricky S.; Saunders, Danielle L.; Rogers, Lee E.

    2007-04-01

    A methodology for quantifying population dynamics and food source value of insect fauna in areas subjected to fog oil smoke was developed. Our approach employed an environmentally controlled re-circulating wind tunnel outfitted with a high-heat vaporization and re-condensation fog oil generator that has been shown to produce aerosols of comparable chemistry and droplet-size distribution as those of field releases of the smoke. This method provides reproducible exposures of insects under realistic climatic and environmental conditions to fog oil aerosols that duplicate chemical and droplet-size characteristics of field releases of the smoke. The responses measured take into account reduction in food sources due to death and to changes in availability of relevant life stages of insects that form the prey base for the listed Threatened and Endangered Species. The influence of key environmental factors, wind speed and canopy structure on these responses were characterized. Data generated using this method was used to develop response functions related to particle size, concentration, wind speed, and canopy structure that will allow military personnel to assess and manage impacts to endangered species from fog oil smoke used in military training.

  3. Objectively Assessed Exercise Behavior in Chinese Patients with Early-Stage Cancer: A Predictor of Perceived Benefits, Communication with Doctors, Medical Coping Modes, Depression and Quality of Life.

    Science.gov (United States)

    Liu, Zhunzhun; Zhang, Lanfeng; Shi, Songsong; Xia, Wenkai

    2017-01-01

    This study sought to identify factors associated with objectively assessed exercise behavior in Chinese patients with early-stage cancer. Three hundred and fifty one cancer patients were recruited from the Affiliated Jiangyin Hospital of Southeast University Medical College and the Nantong Tumor Hospital. One-way ANOVA, Pearson Chi-square tests and regression analysis were employed to identify the correlations between physical exercise and the measured factors. The results showed that occupation type (χ2 = 14.065; p = 0.029), monthly individual monthly income level (χ2 = 24.795; p = 0.003), BMI (χ2 = 15.709; p = 0.015) and diagnosis (χ2 = 42.442; p exercise with different frequency per week. Differences in the frequency of exercise were associated with different degrees of reported Benefit Finding (BF) (F = 24.651; p exercise. Our results indicated that benefit finding, medical coping modes, communication with doctors, social support, depression and quality of life were significantly correlated with exercise. The variance in several psychosocial factors (benefit finding, medical coping modes, the communication with doctors, depression and quality of life) could be explained by exercise. Psychosocial factors should be addressed and examined over time when evaluating the effect of physical exercise that is prescribed as a clinically relevant treatment.

  4. Testing lagoonal sediments with early life stages of the copepod Acartia tonsa (Dana): An approach to assess sediment toxicity in the Venice Lagoon.

    Science.gov (United States)

    Picone, Marco; Bergamin, Martina; Delaney, Eugenia; Ghirardini, Annamaria Volpi; Kusk, Kresten Ole

    2018-01-01

    The early-life stages of development of the calanoid copepod Acartia tonsa from egg to copepodite I is proposed as an endpoint for assessing sediment toxicity by exposing newly released eggs directly onto the sediment-water interface. A preliminary study of 5 sediment samples collected in the lagoon of Venice highlighted that the larval development rate (LDR) and the early-life stages (ELS) mortality endpoints with A. tonsa are more sensitive than the standard amphipod mortality test; moreover LDR resulted in a more reliable endpoint than ELS mortality, due to the interference of the sediment with the recovery of unhatched eggs and dead larvae. The LDR data collected in a definitive study of 48 sediment samples from the Venice Lagoon has been analysed together with the preliminary data to evaluate the statistical performances of the bioassay (among replicate variance and minimum significant difference between samples and control) and to investigate the possible correlation with sediment chemistry and physical properties. The results showed that statistical performances of the LDR test with A. tonsa correspond with the outcomes of other tests applied to the sediment-water interface (Strongylocentrotus purpuratus embryotoxicity test), sediments (Neanthes arenaceodentata survival and growth test) and porewater (S. purpuratus); the LDR endpoint did, however, show a slightly higher variance as compared with other tests used in the Lagoon of Venice, such as 10-d amphipod lethality test and larval development with sea urchin and bivalves embryos. Sediment toxicity data highlighted the high sensitivity and the clear ability of the larval development to discriminate among sediments characterized by different levels of contamination. The data of the definitive study evidenced that inhibition of the larval development was not affected by grain-size and the organic carbon content of the sediment; in contrast, a strong correlation between inhibition of the larval development

  5. Assessing viability and infectivity of foodborne and waterborne stages (cysts/oocysts of Giardia duodenalis, Cryptosporidium spp., and Toxoplasma gondii: a review of methods

    Directory of Open Access Journals (Sweden)

    Rousseau Angélique

    2018-01-01

    Full Text Available Giardia duodenalis, Cryptosporidium spp. and Toxoplasma gondii are protozoan parasites that have been highlighted as emerging foodborne pathogens by the Food and Agriculture Organization of the United Nations and the World Health Organization. According to the European Food Safety Authority, 4786 foodborne and waterborne outbreaks were reported in Europe in 2016, of which 0.4% were attributed to parasites including Cryptosporidium, Giardia and Trichinella. Until 2016, no standardized methods were available to detect Giardia, Cryptosporidium and Toxoplasma (oocysts in food. Therefore, no regulation exists regarding these biohazards. Nevertheless, considering their low infective dose, ingestion of foodstuffs contaminated by low quantities of these three parasites can lead to human infection. To evaluate the risk of protozoan parasites in food, efforts must be made towards exposure assessment to estimate the contamination along the food chain, from raw products to consumers. This requires determining: (i the occurrence of infective protozoan (oocysts in foods, and (ii the efficacy of control measures to eliminate this contamination. In order to conduct such assessments, methods for identification of viable (i.e. live and infective parasites are required. This review describes the methods currently available to evaluate infectivity and viability of G. duodenalis cysts, Cryptosporidium spp. and T. gondii oocysts, and their potential for application in exposure assessment to determine the presence of the infective protozoa and/or to characterize the efficacy of control measures. Advantages and limits of each method are highlighted and an analytical strategy is proposed to assess exposure to these protozoa.

  6. Optic disc boundary segmentation from diffeomorphic demons registration of monocular fundus image sequences versus 3D visualization of stereo fundus image pairs for automated early stage glaucoma assessment

    Science.gov (United States)

    Gatti, Vijay; Hill, Jason; Mitra, Sunanda; Nutter, Brian

    2014-03-01

    Despite the current availability in resource-rich regions of advanced technologies in scanning and 3-D imaging in current ophthalmology practice, world-wide screening tests for early detection and progression of glaucoma still consist of a variety of simple tools, including fundus image-based parameters such as CDR (cup to disc diameter ratio) and CAR (cup to disc area ratio), especially in resource -poor regions. Reliable automated computation of the relevant parameters from fundus image sequences requires robust non-rigid registration and segmentation techniques. Recent research work demonstrated that proper non-rigid registration of multi-view monocular fundus image sequences could result in acceptable segmentation of cup boundaries for automated computation of CAR and CDR. This research work introduces a composite diffeomorphic demons registration algorithm for segmentation of cup boundaries from a sequence of monocular images and compares the resulting CAR and CDR values with those computed manually by experts and from 3-D visualization of stereo pairs. Our preliminary results show that the automated computation of CDR and CAR from composite diffeomorphic segmentation of monocular image sequences yield values comparable with those from the other two techniques and thus may provide global healthcare with a cost-effective yet accurate tool for management of glaucoma in its early stage.

  7. Lernpunkt Deutsch--Stage 1.

    Science.gov (United States)

    Theil, Elvira

    1997-01-01

    Evaluates the first stage of "Lernpunkt Deutsch," a new three-stage German course designed for upper elementary and early secondary school. Describes the publisher's package of materials and the appropriateness of the course, utility of the different package elements, format of the materials, and assesses whether the course provides pedagogically…

  8. Experimental assessment of the water quality influence on the phosphorus uptake of an invasive aquatic plant: biological responses throughout its phenological stage.

    Science.gov (United States)

    Baldy, Virginie; Thiebaut, Gabrielle; Fernandez, Catherine; Sagova-Mareckova, Marketa; Korboulewsky, Nathalie; Monnier, Yogan; Perez, Thierry; Tremolieres, Michele

    2015-01-01

    Understanding how an invasive plant can colonize a large range of environments is still a great challenge in freshwater ecology. For the first time, we assessed the relative importance of four factors on the phosphorus uptake and growth of an invasive macrophyte Elodea nuttallii (Planch.) St. John. This study provided data on its phenotypic plasticity, which is frequently suggested as an important mechanism but remains poorly investigated. The phosphorus uptake of two Elodea nuttallii subpopulations was experimentally studied under contrasting environmental conditions. Plants were sampled in the Rhine floodplain and in the Northern Vosges mountains, and then maintained in aquaria in hard (Rhine) or soft (Vosges) water. Under these conditions, we tested the influence of two trophic states (eutrophic state, 100 μg x l(-1) P-PO4(3-) and hypertrophic state, 300 μg x l(-1) P-PO4(3-)) on the P metabolism of plant subpopulations collected at three seasons (winter, spring and summer). Elodea nuttallii was able to absorb high levels of phosphorus through its shoots and enhance its phosphorus uptake, continually, after an increase of the resource availability (hypertrophic > eutrophic). The lowest efficiency in nutrient use was observed in winter, whereas the highest was recorded in spring, what revealed thus a storage strategy which can be beneficial to new shoots. This experiment provided evidence that generally, the water trophic state is the main factor governing P uptake, and the mineral status (softwater > hardwater) of the stream water is the second main factor. The phenological stage appeared to be a confounding factor to P level in water. Nonetheless, phenology played a role in P turnover in the plant. Finally, phenotypic plasticity allows both subpopulations to adapt to a changing environment.

  9. Experimental assessment of the water quality influence on the phosphorus uptake of an invasive aquatic plant: biological responses throughout its phenological stage.

    Directory of Open Access Journals (Sweden)

    Virginie Baldy

    Full Text Available Understanding how an invasive plant can colonize a large range of environments is still a great challenge in freshwater ecology. For the first time, we assessed the relative importance of four factors on the phosphorus uptake and growth of an invasive macrophyte Elodea nuttallii (Planch. St. John. This study provided data on its phenotypic plasticity, which is frequently suggested as an important mechanism but remains poorly investigated. The phosphorus uptake of two Elodea nuttallii subpopulations was experimentally studied under contrasting environmental conditions. Plants were sampled in the Rhine floodplain and in the Northern Vosges mountains, and then maintained in aquaria in hard (Rhine or soft (Vosges water. Under these conditions, we tested the influence of two trophic states (eutrophic state, 100 μg x l(-1 P-PO4(3- and hypertrophic state, 300 μg x l(-1 P-PO4(3- on the P metabolism of plant subpopulations collected at three seasons (winter, spring and summer. Elodea nuttallii was able to absorb high levels of phosphorus through its shoots and enhance its phosphorus uptake, continually, after an increase of the resource availability (hypertrophic > eutrophic. The lowest efficiency in nutrient use was observed in winter, whereas the highest was recorded in spring, what revealed thus a storage strategy which can be beneficial to new shoots. This experiment provided evidence that generally, the water trophic state is the main factor governing P uptake, and the mineral status (softwater > hardwater of the stream water is the second main factor. The phenological stage appeared to be a confounding factor to P level in water. Nonetheless, phenology played a role in P turnover in the plant. Finally, phenotypic plasticity allows both subpopulations to adapt to a changing environment.

  10. In Vitro Assessment of Anthelmintic Activities of Rauwolfia vomitoria (Apocynaceae Stem Bark and Roots against Parasitic Stages of Schistosoma mansoni and Cytotoxic Study

    Directory of Open Access Journals (Sweden)

    Emmanuel Mouafo Tekwu

    2017-01-01

    Full Text Available Schistosomiasis is a Neglected Tropical Diseases which can be prevented with mass deworming chemotherapy. The reliance on a single drug, praziquantel, is a motivation for the search of novel antischistosomal compounds. This study investigated the anthelmintic activity of the stem bark and roots of Rauwolfia vomitoria against two life stages of Schistosoma mansoni. Both plant parts were found to be active against cercariae and adult worms. Within 2 h of exposure all cercariae were killed at a concentration range of 62.5–1000 µg/mL and 250–1000 µg/mL of R. vomitoria stem bark and roots, respectively. The LC50 values determined for the stem bark after 1 and 2 h of exposure were 207.4 and 61.18 µg/mL, respectively. All adult worms exposed to the concentrations range of 250–1000 µg/mL for both plant parts died within 120 h of incubation. The cytotoxic effects against HepG2 and Chang liver cell assessed using MTT assay method indicated that both plant extracts which were inhibitory to the proliferation of cell lines with IC50 > 20 μg/mL appear to be safe. This report provides the first evidence of in vitro schistosomicidal potency of R. vomitoria with the stem bark being moderately, but relatively, more active and selective against schistosome parasites. This suggests the presence of promising medicinal constituent(s.

  11. Staging of intestinal- and diffuse-type gastric cancers with the OLGA and OLGIM staging systems.

    Science.gov (United States)

    Cho, S-J; Choi, I J; Kook, M-C; Nam, B-H; Kim, C G; Lee, J Y; Ryu, K W; Kim, Y-W

    2013-11-01

    Operative link on gastritis assessment (OLGA) and Operative link on gastric intestinal metaplasia assessment (OLGIM) staging systems have been proposed for gastric cancer (GC) risk estimation. To validate the OLGA and OLGIM staging systems in a region with high risk of GC. This retrospective study included 474 GC patients and age- and sex-matched health screening control persons in a cancer centre hospital. We classified gastritis patterns according to the OLGA and OLGIM systems using the histological database that a pathologist prospectively evaluated using the updated Sydney system. GC risk according to the OLGA and OLGIM stages was evaluated using logistic regression analysis. More GC patients had OLGA stages III-IV (46.2%) than controls (26.6%, P diffuse-type GCs (30.9%). OLGA stages III and IV were significantly associated with increased risk of GC [odds ratios (ORs), 2.09; P = 0.008 and 2.04; P = 0.014 respectively] in multivariate analysis. The association was more significant for intestinal-type (ORs, 4.76; P = 0.001 and 4.19; P = 0.002 respectively), but not diffuse-type GC. OLGIM stages from I to IV were significantly associated with increased risk of both intestinal-type (ORs, 3.64, 5.15, 7.89 and 13.20 respectively) and diffuse-type GC (ORs, 1.84, 2.59, 5.08 and 6.32 respectively) with a significantly increasing trend. As high OLGA and OLGIM stages are independent risk factors for gastric cancer, the staging systems may be useful for risk assessment in high-risk regions, especially for intestinal-type gastric cancer. © 2013 John Wiley & Sons Ltd.

  12. Using Human Life Stage PBPK/PD Model Predictions of Perchlorate-Induced Iodide Inhibition to Inform Risk Assessment in Sensitive Populations

    National Research Council Canada - National Science Library

    Mattie, David R; Sterner, Teresa R; Merrill, Elaine A; Clewell, Rebecca A

    2006-01-01

    .... Recently, existing physiologically based pharmacokinetics/pharmacodynamic (PBPK/PD) models across life-stages in rat and in adult human were expanded to describe inhibition kinetics during-perinatal development in humans...

  13. Adjuvant radiotherapy for stage I endometrial cancer.

    Science.gov (United States)

    Kong, A; Johnson, N; Cornes, P; Simera, I; Collingwood, M; Williams, C; Kitchener, H

    2007-04-18

    The role of adjuvant radiotherapy (both pelvic external beam radiotherapy and vaginal intracavity brachytherapy) in stage I endometrial cancer following total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH and BSO) remains unclear. To assess the efficacy of adjuvant radiotherapy following surgery for stage I endometrial cancer. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CancerLit, Physician Data Query (PDQ) of National Cancer Institute. Handsearching was also carried out where appropriate. Randomised controlled trials (RCTs) which compared adjuvant radiotherapy versus no radiotherapy following surgery for patients with stage I endometrial cancer were included. Quality of the studies was assessed and data collected using a predefined data collection form. The primary endpoint was overall survival. Secondary endpoints were locoregional recurrence, distant recurrence and endometrial cancer death. Data on quality of life (QOL) and morbidity were also collected. A meta-analysis on included trials was performed using the Cochrane Collaboration Review Manager Software 4.2. The meta-analysis was performed on four trials (1770 patients). The addition of pelvic external beam radiotherapy to surgery reduced locoregional recurrence, a relative risk (RR) of 0.28 (95% confidence interval (CI) 0.17 to 0.44, p ASTEC; Lukka) are awaited. External beam radiotherapy carries a risk of toxicity and should be avoided in stage 1 endometrial cancer patients with no high risk factors.

  14. Clinical and endorectal ultrasound staging of circumferential rectal cancers

    International Nuclear Information System (INIS)

    Smith, A.; Farmer, K.C.; Chapple, K.

    2008-01-01

    Full text: Circumferential rectal cancers present at a more advanced stage than those located in a single quadrant. Although accurate staging is an important aspect of the preoperative management of the patient with a rectal cancer, the clinical and radiological staging of this subgroup of rectal cancer patients has been poorly studied. All patients with a rectal cancer were assessed clinically (by digital rectal examination and rigid sigmoidoscopy) before the radiological assessment by endorectal ultrasound (ERUS). Data collected included tumour height (distance from anal verge in centimetre) and tumour type (circumferential or non-circumferential). Radiological tumour staging was with the TNM system. Fifty-nine subjects (33 men, 26 women; median age 65 years (range 38-86 years)) were identified with a circumferential rectal cancer. Mean height of the cancer was 8 - 0.4 cm (standard error of the mean; range 2-13 cm). Forty-two cancers were palpable, and 17 cancers were impalpable. All cancers assessed clinically as circumferential were confirmed as circumferential on ERUS scanning. Tumour stage as assessed by ERUS was either T3 (n = 57) or T4 (n = 2). Nodal status was NO (n = 29) and N1 (n = 30). All rectal cancers assessed as circumferential on clinical examination have an ERUS stage of T3 or greater.

  15. The histologic risk model is a useful and inexpensive tool to assess risk of recurrence and death in stage I or II squamous cell carcinoma of tongue and floor of mouth.

    Science.gov (United States)

    Sinha, Namita; Rigby, Matthew H; McNeil, Michael L; Taylor, S Mark; Trites, Jonathan Rb; Hart, Robert D; Bullock, Martin J

    2018-02-02

    Surgery is the mainstay of treatment for low-stage (stage I/II, ie, T1N0/T2N0) squamous cell carcinoma of oral cavity. However, a significant percentage of low-stage squamous cell carcinoma of oral cavity will develop local recurrence and disease-related mortality. In this study, we stratified 64 patients with low-stage of oral tongue and floor of mouth patients into high-, intermediate- and low-risk categories based on existing histologic risk model. The classification of these risk categories was based on presence or absence of perineural invasion and evaluation of tumor-host junction for worst pattern of invasion and lymphocytic host response. We correlated risk category and other variables with recurrence and death. In a univariate model, high-risk category tumors had a significantly higher rate of recurrence and death due to recurrence compared with low/intermediate-risk categories (P=0.000 and P=0.047, respectively). Controlling for margin status and T-stage, high-risk category had a 12.4 odds ratio of later recurrence when compared with low/intermediate-risk categories, with a P-value of 0.001. In conclusion, we found low-stage oral cavity squamous cell carcinoma patients with high-risk category have a significantly higher risk for recurrence when compared with patients in the low- or intermediate-risk category, even when controlling for margin status and T-stage. These patients may be suitable candidates for adjuvant treatment to decrease morbidity and mortality associated with a recurrence. Our results indicate that the histologic risk model is a useful and simple tool to assess risk of recurrence in stage I or II squamous cell carcinoma of oral cavity.Modern Pathology advance online publication, 2 February 2018; doi:10.1038/modpathol.2017.183.

  16. Uganda; Financial System Stability Assessment, including Reports on the Observance of Standards and Codes on the following topics: Monetary and Financial Policy Transparency, Banking Supervision, Securities Regulation, and Payment Systems

    OpenAIRE

    International Monetary Fund

    2003-01-01

    This paper presents findings of Uganda’s Financial System Stability Assessment, including Reports on the Observance of Standards and Codes on Monetary and Financial Policy Transparency, Banking Supervision, Securities Regulation, Insurance Regulation, Corporate Governance, and Payment Systems. The banking system in Uganda, which dominates the financial system, is fundamentally sound, more resilient than in the past, and currently poses no threat to macroeconomic stability. A major disruption ...

  17. Assessing risk of fibrosis progression and liver-related clinical outcomes among patients with both early stage and advanced chronic hepatitis C.

    Directory of Open Access Journals (Sweden)

    Monica A Konerman

    Full Text Available Assessing risk of adverse outcomes among patients with chronic liver disease has been challenging due to non-linear disease progression. We previously developed accurate prediction models for fibrosis progression and clinical outcomes among patients with advanced chronic hepatitis C (CHC. The primary aim of this study was to validate fibrosis progression and clinical outcomes models among a heterogeneous patient cohort.Adults with CHC with ≥3 years follow-up and without hepatic decompensation, hepatocellular carcinoma (HCC, liver transplant (LT, HBV or HIV co-infection at presentation were analyzed (N = 1007. Outcomes included: 1 fibrosis progression 2 hepatic decompensation 3 HCC and 4 LT-free survival. Predictors included longitudinal clinical and laboratory data. Machine learning methods were used to predict outcomes in 1 and 3 years.The external cohort had a median age of 49.4 years (IQR 44.3-54.3; 61% were male, 80% white, and 79% had genotype 1. At presentation, 73% were treatment naïve and 31% had cirrhosis. Fibrosis progression occurred in 34% over a median of 4.9 years (IQR 3.2-7.6. Clinical outcomes occurred in 22% over a median of 4.4 years (IQR 3.2-7.6. Model performance for fibrosis progression was limited due to small sample size. The area under the receiver operating characteristic curve (AUROC for 1 and 3-year risk of clinical outcomes was 0.78 (95% CI 0.73-0.83 and 0.76 (95% CI 0.69-0.81.Accurate assessments for risk of clinical outcomes can be obtained using routinely collected data across a heterogeneous cohort of patients with CHC. These methods can be applied to predict risk of progression in other chronic liver diseases.

  18. ChAd63-MVA-vectored blood-stage malaria vaccines targeting MSP1 and AMA1: assessment of efficacy against mosquito bite challenge in humans.

    Science.gov (United States)

    Sheehy, Susanne H; Duncan, Christopher J A; Elias, Sean C; Choudhary, Prateek; Biswas, Sumi; Halstead, Fenella D; Collins, Katharine A; Edwards, Nick J; Douglas, Alexander D; Anagnostou, Nicholas A; Ewer, Katie J; Havelock, Tom; Mahungu, Tabitha; Bliss, Carly M; Miura, Kazutoyo; Poulton, Ian D; Lillie, Patrick J; Antrobus, Richard D; Berrie, Eleanor; Moyle, Sarah; Gantlett, Katherine; Colloca, Stefano; Cortese, Riccardo; Long, Carole A; Sinden, Robert E; Gilbert, Sarah C; Lawrie, Alison M; Doherty, Tom; Faust, Saul N; Nicosia, Alfredo; Hill, Adrian V S; Draper, Simon J

    2012-12-01

    The induction of cellular immunity, in conjunction with antibodies, may be essential for vaccines to protect against blood-stage infection with the human malaria parasite Plasmodium falciparum. We have shown that prime-boost delivery of P. falciparum blood-stage antigens by chimpanzee adenovirus 63 (ChAd63) followed by the attenuated orthopoxvirus MVA is safe and immunogenic in healthy adults. Here, we report on vaccine efficacy against controlled human malaria infection delivered by mosquito bites. The blood-stage malaria vaccines were administered alone, or together (MSP1+AMA1), or with a pre-erythrocytic malaria vaccine candidate (MSP1+ME-TRAP). In this first human use of coadministered ChAd63-MVA regimes, we demonstrate immune interference whereby responses against merozoite surface protein 1 (MSP1) are dominant over apical membrane antigen 1 (AMA1) and ME-TRAP. We also show that induction of strong cellular immunity against MSP1 and AMA1 is safe, but does not impact on parasite growth rates in the blood. In a subset of vaccinated volunteers, a delay in time to diagnosis was observed and sterilizing protection was observed in one volunteer coimmunized with MSP1+AMA1-results consistent with vaccine-induced pre-erythrocytic, rather than blood-stage, immunity. These data call into question the utility of T cell-inducing blood-stage malaria vaccines and suggest that the focus should remain on high-titer antibody induction against susceptible antigen targets.

  19. Operation of staged membrane oxidation reactor systems

    Science.gov (United States)

    Repasky, John Michael

    2012-10-16

    A method of operating a multi-stage ion transport membrane oxidation system. The method comprises providing a multi-stage ion transport membrane oxidation system with at least a first membrane oxidation stage and a second membrane oxidation stage, operating the ion transport membrane oxidation system at operating conditions including a characteristic temperature of the first membrane oxidation stage and a characteristic temperature of the second membrane oxidation stage; and controlling the production capacity and/or the product quality by changing the characteristic temperature of the first membrane oxidation stage and/or changing the characteristic temperature of the second membrane oxidation stage.

  20. New seismograph includes filters

    Energy Technology Data Exchange (ETDEWEB)

    1979-11-02

    The new Nimbus ES-1210 multichannel signal enhancement seismograph from EG and G geometrics has recently been redesigned to include multimode signal fillers on each amplifier. The ES-1210F is a shallow exploration seismograph for near subsurface exploration such as in depth-to-bedrock, geological hazard location, mineral exploration, and landslide investigations.

  1. Enhancement of the methodology of repository design and post-closure performance assessment for preliminary investigation stage (3). Progress report on NUMO-JAEA collaborative research in FY2013 (Joint research)

    International Nuclear Information System (INIS)

    Shibata, Masahiro; Sawada, Atsushi; Tachi, Yukio; Makino, Hitoshi; Wakasugi, Keiichiro; Mitsui, Seiichiro; Kitamura, Akira; Oda, Chie; Ishidera, Takamitsu; Suyama, Tadahiro; Hatanaka, Koichiro; Kamei, Gento; Yoshikawa, Hideki; Senba, Takeshi; Seo, Toshihiro; Kurosawa, Susumu; Goto, Junichi; Shibutani, Sanae; Goto, Takahiro; Kubota, Shigeru; Inagaki, Manabu; Moriya, Toshifumi; Suzuki, Satoru; Ishida, Keisuke; Nishio, Hikaru; Makiuchi, Akie; Fujihara, Hiroshi

    2015-03-01

    JAEA and NUMO have conducted a collaborative research work which is designed to enhance the methodology of repository design and post-closure performance assessment in preliminary investigation stage. With regard to (1) study on host rock suitability in terms of hydrology, based on some examples of developing method of hydro-geological structure model, acquired knowledge are arranged using the tree diagram, and model uncertainty and its influence on the evaluation items were discussed. With regard to (2) study on scenario development, the developed approach for “defining conditions” has been reevaluated and improved from practical viewpoints. In addition, the uncertainty evaluation for the effect of use of cementitious material, as well as glass dissolution model, was conducted with analytical evaluation. With regard to (3) study on setting radionuclide migration parameters, based on survey of precedent procedures, multiple-approach for distribution coefficient of rocks was established, and the adequacy of the approach was confirmed through its application to sedimentary rock and granitic rock. Besides, an approach for solubility setting was developed including the procedure of selection of solubility limiting solid phase. The adequacy of the approach was confirmed through its application to key radionuclides. (author)

  2. MR imaging for staging of cervical carcinoma: Update

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Seong Kuk; Kim, Dong Won [Dong A University Hospital, Busan(Korea, Republic of)

    2017-08-15

    Uterine cervical cancer is globally the third most common cancer among women, and shows high mortality with invasive cervical carcinoma. Early detection of the disease, its correct staging, and treatment are therefore of great importance. The staging system updated in 2009 by the International Federation of Gynecology and Obstetrics (FIGO), is commonly used for planning the treatment. However, there are significant inaccuracies in the FIGO staging system. Accurate tumor staging is very important to decide the treatment strategy. Although not included in the staging system, magnetic resonance (MR) imaging is a valuable tool for local staging of the disease, and is useful in assessing the spread of the tumor and metastatic lymph nodes, thereby becoming a more accurate substitute for clinical staging of cervical carcinoma. In addition, it is capable of assessing the disease response to surgery or chemoradiation. This review briefly describes the role of MR imaging and the basic MR scanning protocol in evaluating cervical carcinoma. The MR findings with staging, and MR evaluation of treatment response, are further addressed.

  3. Functioning in early and late stages of schizophrenia

    Directory of Open Access Journals (Sweden)

    Leonardo Gazzi Costa

    2014-12-01

    Full Text Available INTRODUCTION: Schizophrenia is frequently associated with a debilitating course and prominent impairment in social and occupational functioning. Although the criteria for classification into stages have not been defined in the literature, illness duration and functioning seem to be good candidates.OBJECTIVE:To compare functioning of patients with schizophrenia at different stages of the disease (early vs. late and healthy sex- and age-matched controls.METHODS: This double-blinded, case-controlled study included 79 individuals: 23 patients with schizophrenia diagnosed up to 5 years earlier; 19 patients with schizophrenia diagnosed at least 20 years earlier; and healthy matched controls. Diagnoses were established using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV Axis I Disorder. Functioning was assessed using the Functioning Assessment Short Test (FAST.RESULTS: Patients in the early stage had significantly higher scores than healthy controls in total FAST and in autonomy, occupational functioning, cognitive functioning and interpersonal relationships. Individuals in the late stage had significantly poorer functioning than controls in all domains. The comparison of functioning between the two groups of patients revealed no significant differences, except in occupational functioning, in which late stage patients had a poorer performance.CONCLUSION: Functioning impairment in schizophrenia tends to remain stable despite illness duration. Therefore, functioning should be effectively assessed at an early stage, as illness duration alone may not be the most reliable criterion to stage patients with schizophrenia.

  4. Analytic device including nanostructures

    KAUST Repository

    Di Fabrizio, Enzo M.; Fratalocchi, Andrea; Totero Gongora, Juan Sebastian; Coluccio, Maria Laura; Candeloro, Patrizio; Cuda, Gianni

    2015-01-01

    A device for detecting an analyte in a sample comprising: an array including a plurality of pixels, each pixel including a nanochain comprising: a first nanostructure, a second nanostructure, and a third nanostructure, wherein size of the first nanostructure is larger than that of the second nanostructure, and size of the second nanostructure is larger than that of the third nanostructure, and wherein the first nanostructure, the second nanostructure, and the third nanostructure are positioned on a substrate such that when the nanochain is excited by an energy, an optical field between the second nanostructure and the third nanostructure is stronger than an optical field between the first nanostructure and the second nanostructure, wherein the array is configured to receive a sample; and a detector arranged to collect spectral data from a plurality of pixels of the array.

  5. Saskatchewan resources. [including uranium

    Energy Technology Data Exchange (ETDEWEB)

    1979-09-01

    The production of chemicals and minerals for the chemical industry in Saskatchewan are featured, with some discussion of resource taxation. The commodities mentioned include potash, fatty amines, uranium, heavy oil, sodium sulfate, chlorine, sodium hydroxide, sodium chlorate and bentonite. Following the successful outcome of the Cluff Lake inquiry, the uranium industry is booming. Some developments and production figures for Gulf Minerals, Amok, Cenex and Eldorado are mentioned.

  6. Assessing the Effect of Potential Reductions in Non-Hepatic Mortality on the Estimated Cost-Effectiveness of Hepatitis C Treatment in Early Stages of Liver Disease

    Science.gov (United States)

    Chesson, Harrell W.; Spradling, Philip R.; Holmberg, Scott D.

    2018-01-01

    Background Most cost-effectiveness analyses of hepatitis C (HCV) therapy focus on the benefits of reducing liver-related morbidity and mortality. Objectives Our objective was to assess how cost-effectiveness estimates of HCV therapy can vary depending on assumptions regarding the potential impact of HCV therapy on non-hepatic mortality. Methods We adapted a state-transition model to include potential effects of HCV therapy on non-hepatic mortality. We assumed successful treatment could reduce non-hepatic mortality by as little as 0 % to as much as 100 %. Incremental cost-effectiveness ratios were computed comparing immediate treatment versus delayed treatment and comparing immediate treatment versus non-treatment. Results Comparing immediate treatment versus delayed treatment, when we included a 44 % reduction in nonhepatic mortality following successful HCV treatment, the incremental cost per quality-adjusted life year (QALY) gained by HCV treatment fell by 76 % (from US$314,100 to US$76,900) for patients with no fibrosis and by 43 % (from US$62,500 to US$35,800) for patients with moderate fibrosis. Comparing immediate treatment versus non-treatment, assuming a 44 % reduction in non-hepatic mortality following successful HCV treatment, the incremental cost per QALY gained by HCV treatment fell by 64 % (from US$186,700 to US$67,300) for patients with no fibrosis and by 27 % (from US$35,000 to US$25,500) for patients with moderate fibrosis. Conclusion Including reductions in non-hepatic mortality from HCV treatment can have substantial effects on the estimated cost-effectiveness of treatment. PMID:27480538

  7. Assessing variability in chemical acute toxicity of unionid mussels: Influence of intra- and inter-laboratory testing, life stage, and species - SETAC Abstract

    Science.gov (United States)

    We developed a toxicity database for unionid mussels to examine the extent of intra- and inter-laboratory variability in acute toxicity tests with mussel larvae (glochidia) and juveniles; the extent of differential sensitivity of the two life stages; and the variation in sensitiv...

  8. Assessing variability in chemical acute toxicity of unionid mussels: Influence of intra- and inter-laboratory testing, life stage, and species

    Science.gov (United States)

    The authors developed a toxicity database for unionid mussels to examine the extent of intra- and interlaboratory variability in acute toxicity tests with mussel larvae (glochidia) and juveniles; the extent of differential sensitivity of the 2 life stages; and the variation in se...

  9. Reliable and valid assessment of competence in endoscopic ultrasonography and fine-needle aspiration for mediastinal staging of non-small cell lung cancer

    NARCIS (Netherlands)

    Konge, L.; Vilmann, P.; Clementsen, P.; Annema, J. T.; Ringsted, C.

    2012-01-01

    Background and study aims: Fine-needle aspiration (FNA) guided by endoscopic ultrasonography (EUS) is important in mediastinal staging of non-small cell lung cancer (NSCLC). Training standards and implementation strategies of this technique are currently under discussion. The aim of this study was

  10. Assessment of phthalates/phthalate alternatives in children's toys and childcare articles: Review of the report including conclusions and recommendation of the Chronic Hazard Advisory Panel of the Consumer Product Safety Commission.

    Science.gov (United States)

    Lioy, Paul J; Hauser, Russ; Gennings, Chris; Koch, Holger M; Mirkes, Philip E; Schwetz, Bernard A; Kortenkamp, Andreas

    2015-01-01

    The Consumer Product Safety Commission (CPSC) convened a Chronic Hazard Advisory Panel (CHAP) on Phthalates found in children's toys, and childcare products, and in products used by women of childbearing age. The CHAP conducted a risk assessment on phthalates and phthalate substitutes, and made recommendations to either ban, impose an interim ban, or allow the continued use of phthalates and phthalate substitutes in the above products. After a review of the literature, the evaluation included toxic end points of primary concern, biomonitoring results, extant exposure reconstruction, and epidemiological results. The health end points chosen were associated with the rat phthalate syndrome, which is characterized by malformations of the epididymis, vas deferens, seminal vesicles, prostate, external genitalia (hypospadias), and by cryptorchidism (undescended testes), retention of nipples/areolae, and demasculinization (~incomplete masculinization) of the perineum, resulting in reduced anogenital distance. Risk assessment demonstrated that some phthalates should be permanently banned, removed from the banned list, or remain interim banned. Biomonitoring and toxicology data provided the strongest basis for a mixture risk assessment. In contrast, external exposure data were the weakest and need to be upgraded for epidemiological studies and risk assessments. Such studies would focus on routes and sources. The review presents recommendations and uncertainties.

  11. Neutrophil to lymphocyte ratio (NLR) improves the risk assessment of ISS staging in newly diagnosed MM patients treated upfront with novel agents.

    Science.gov (United States)

    Romano, A; Parrinello, N L; Consoli, M L; Marchionni, L; Forte, S; Conticello, C; Pompa, A; Corso, A; Milone, G; Di Raimondo, F; Borrello, I

    2015-11-01

    Recent reports identify the ratio between absolute neutrophil count (ANC) and absolute lymphocyte count (ALC), called neutrophil to lymphocyte ratio (NLR), as a predictor of progression-free survival (PFS) and overall survival (OS) in various malignancies. We retrospectively examined the NLR in a cohort of 309 newly diagnosed multiple myeloma (MM) patients treated upfront with novel agents. NLR was calculated using data obtained from the complete blood count (CBC) at diagnosis and subsequently correlated with PFS and OS. The median NLR was 1.9 (range 0.4-15.9). Higher NLR was independent of international staging system (ISS) stage, plasma cell infiltration or cytogenetics. The 5-year PFS and OS estimates were, respectively, 18.2 and 36.4 % for patients with NLR ≥ 2 versus 25.5 and 66.6 % in patients with NLR < 2. Among younger patients (age <65 years, N = 179), NLR ≥ 2 had a negative prognostic impact on both PFS and OS, in all ISS stages. By combining ISS stage and NLR in a model limited to young patients, we found that 19 % of the patients were classified as very low risk, 70 % standard risk and 11 % very high risk. The 5-year estimates were 39.3, 19.4 and 10.9 % for PFS and 95.8, 50.9 and 23.6 % for OS for very low, standard-risk and very high-risk groups. We found NLR to be a predictor of PFS and OS in MM patients treated upfront with novel agents. NLR can be combined with ISS staging system to identify patients with dismal outcome. However, larger cohorts and prospective studies are needed to use NLR as additional parameter to personalise MM therapy in the era of novel agents.

  12. Stage-dependency of apoptosis and the blood-testis barrier in the dogfish shark (Squalus acanthias): cadmium-induced changes as assessed by vital fluorescence techniques.

    Science.gov (United States)

    McClusky, Leon M

    2006-09-01

    Naturally occurring heavy metals and synthetic compounds are potentially harmful for testicular function but evidence linking heavy metal exposure to reduced semen parameters is inconclusive. Elucidation of the exact stage at which the toxicant interferes with spermatogenesis is difficult because the various germ cell stages may have different sensitivities to any given toxicant, germ cell development is influenced by supporting testicular somatic cells and the presence of inter-Sertoli cell tight junctions create a blood-testis barrier, sequestering meiotic and postmeiotic germ cells in a special microenvironment. Sharks such as Squalus acanthias provide a suitable model for studying aspects of vertebrate spermatogenosis because of their unique features: spermatogenesis takes place within spermatocysts and relies mainly on Sertoli cells for somatic cell support; spermatocysts are linearly arranged in a maturational order across the diameter of the elongated testis; spermatocysts containing germ cells at different stages of development are topographically separated, resulting in visible zonation in testicular cross sections. We have used the vital dye acridine orange and a novel fluorescence staining technique to study this model to determine (1) the efficacy of these methods in assays of apoptosis and blood-testis barrier function, (2) the sensitivity of the various spermatogonial generations in Squalus to cadmium (as an illustrative spermatotoxicant) and (3) the way that cadmium might affect more mature spermatogenic stages and other physiological processes in the testis. Our results show that cadmium targets early spermatogenic stages, where it specifically activates a cell death program in susceptible (mature) spermatogonial clones, and negatively affects blood-testis barrier function. Since other parameters are relatively unaffected by cadmium, the effects of this toxicant on apoptosis are presumably process-specific and not attributable to general toxicity.

  13. Being Included and Excluded

    DEFF Research Database (Denmark)

    Korzenevica, Marina

    2016-01-01

    Following the civil war of 1996–2006, there was a dramatic increase in the labor mobility of young men and the inclusion of young women in formal education, which led to the transformation of the political landscape of rural Nepal. Mobility and schooling represent a level of prestige that rural...... politics. It analyzes how formal education and mobility either challenge or reinforce traditional gendered norms which dictate a lowly position for young married women in the household and their absence from community politics. The article concludes that women are simultaneously excluded and included from...... community politics. On the one hand, their mobility and decision-making powers decrease with the increase in the labor mobility of men and their newly gained education is politically devalued when compared to the informal education that men gain through mobility, but on the other hand, schooling strengthens...

  14. RAPP, a systematic e-assessment of postoperative recovery in patients undergoing day surgery: study protocol for a mixed-methods study design including a multicentre, two-group, parallel, single-blind randomised controlled trial and qualitative interview studies.

    Science.gov (United States)

    Nilsson, U; Jaensson, M; Dahlberg, K; Odencrants, S; Grönlund, Å; Hagberg, L; Eriksson, M

    2016-01-13

    Day surgery is a well-established practice in many European countries, but only limited information is available regarding postoperative recovery at home though there is a current lack of a standard procedure regarding postoperative follow-up. Furthermore, there is also a need for improvement of modern technology in assessing patient-related outcomes such as mobile applications. This article describes the Recovery Assessment by Phone Points (RAPP) study protocol, a mixed-methods study to evaluate if a systematic e-assessment follow-up in patients undergoing day surgery is cost-effective and improves postoperative recovery, health and quality of life. This study has a mixed-methods study design that includes a multicentre, two-group, parallel, single-blind randomised controlled trial and qualitative interview studies. 1000 patients >17 years of age who are undergoing day surgery will be randomly assigned to either e-assessed postoperative recovery follow-up daily in 14 days measured via smartphone app including the Swedish web-version of Quality of Recovery (SwQoR) or to standard care (ie, no follow-up). The primary aim is cost-effectiveness. Secondary aims are (A) to explore whether a systematic e-assessment follow-up after day surgery has a positive effect on postoperative recovery, health-related quality of life (QoL) and overall health; (B) to determine whether differences in postoperative recovery have an association with patient characteristic, type of surgery and anaesthesia; (C) to determine whether differences in health literacy have a substantial and distinct effect on postoperative recovery, health and QoL; and (D) to describe day surgery patient and staff experiences with a systematic e-assessment follow-up after day surgery.The primary aim will be measured at 2 weeks postoperatively and secondary outcomes (A-C) at 1 and 2 weeks and (D) at 1 and 4 months. NCT02492191; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use

  15. Is knowledge translation adequate? A quality assurance study of staging investigations in early stage breast cancer patients.

    Science.gov (United States)

    Han, Dolly; Hogeveen, Sophie; Sweet Goldstein, Miriam; George, Ralph; Brezden-Masley, Christine; Hoch, Jeffrey; Haq, Rashida; Simmons, Christine E

    2012-02-01

    After primary surgery, patients diagnosed with early stage breast cancer undergo radiological investigations based on pathologic stage of disease to rule out distant metastases. Published guidelines can aid clinicians in determining which tests are appropriate based on stage of disease. We wished to assess the consistency of radiological staging in an academic community oncology setting with standard guidelines and to determine the overall impact of non-adherence to these guidelines. A retrospective cohort study was conducted for new breast cancer patients seen at a single institution between January 2009 and April 2010. Patients were included if initial diagnosis and primary surgery was at this institution. Pathologic stage and radiological tests completed were recorded. A literature review was performed and the results were compared with those from this study to determine overall adherence rates. Subsequently, a cost analysis was performed to determine the financial impact at this centre. 231 patients met eligibility criteria for inclusion in this study. A large proportion of patients were over-staged with 129 patients (55%) undergoing unnecessary investigations according to guidelines. Specifically, 59% of stage I patients and 58% of stage II patients were over-investigated. Distant metastases at the time of diagnosis were found in three patients, all of whom had stage III disease (1.3%). The literature reviewed revealed similar non-adherence rates in other centres. The estimated cost of such non-adherence is in the range of $78 (CDN) per new early stage breast cancer patient seen at this centre. This oncology centre has a low adherence to practice guidelines for staging investigations in breast cancer patients, with 55% of patients undergoing unnecessary tests. Very few patients had metastases at diagnosis, and all had pathological stage III disease. Efforts may need to focus on improving knowledge translation across clinical oncology settings to increase

  16. Second stage gasifier in staged gasification and integrated process

    Science.gov (United States)

    Liu, Guohai; Vimalchand, Pannalal; Peng, Wan Wang

    2015-10-06

    A second stage gasification unit in a staged gasification integrated process flow scheme and operating methods are disclosed to gasify a wide range of low reactivity fuels. The inclusion of second stage gasification unit operating at high temperatures closer to ash fusion temperatures in the bed provides sufficient flexibility in unit configurations, operating conditions and methods to achieve an overall carbon conversion of over 95% for low reactivity materials such as bituminous and anthracite coals, petroleum residues and coke. The second stage gasification unit includes a stationary fluidized bed gasifier operating with a sufficiently turbulent bed of predefined inert bed material with lean char carbon content. The second stage gasifier fluidized bed is operated at relatively high temperatures up to 1400.degree. C. Steam and oxidant mixture can be injected to further increase the freeboard region operating temperature in the range of approximately from 50 to 100.degree. C. above the bed temperature.

  17. Dynamic Contrast-Enhanced Perfusion Area-Detector CT: Preliminary Comparison of Diagnostic Performance for N Stage Assessment With FDG PET/CT in Non-Small Cell Lung Cancer.

    Science.gov (United States)

    Ohno, Yoshiharu; Fujisawa, Yasuko; Sugihara, Naoki; Kishida, Yuji; Seki, Shinichiro; Koyama, Hisanobu; Yoshikawa, Takeshi

    2017-11-01

    The objective of our study was to directly compare the capability of dynamic first-pass contrast-enhanced (CE) perfusion area-detector CT (ADCT) and FDG PET/CT for differentiation of metastatic from nonmetastatic lymph nodes and assessment of N stage in patients with non-small cell lung carcinoma (NSCLC). Seventy-seven consecutive patients, 45 men (mean age ± SD, 70.4 ± 5.9 years) and 32 women (71.2 ± 7.7 years), underwent dynamic first-pass CE-perfusion ADCT at two or three different positions for covering the entire thorax, FDG PET/CT, surgical treatment, and pathologic examination. From all ADCT data for each of the subjects, a whole-chest perfusion map was computationally generated using the dual- and single-input maximum slope and Patlak plot methods. For quantitative N stage assessment, perfusion parameters and the maximum standardized uptake value (SUV max ) for each lymph node were determined by measuring the relevant ROI. ROC curve analyses were performed for comparing the diagnostic capability of each of the methods on a per-node basis. N stages evaluated by each of the indexes were then statistically compared with the final pathologic diagnosis by means of chi-square and kappa statistics. The area under the ROC curve (A z ) values of systemic arterial perfusion (A z = 0.89), permeability surface (A z = 0.78), and SUV max (A z = 0.85) were significantly larger than the A z values of total perfusion (A z = 0.70, p Dynamic first-pass CE-perfusion ADCT is as useful as FDG PET/CT for the differentiation of metastatic from nonmetastatic lymph nodes and assessment of N stage in patients with NSCLC.

  18. Development of measures to assess the safety of existing NPPs and the effectiveness of regulations and regulatory actions (including 'prescriptive' and 'performance based' approaches). Peer discussions on regulatory practices

    International Nuclear Information System (INIS)

    1996-09-01

    This report arises from the fourth series of peer discussions on regulatory practices entitled D evelopment of measures to assess the safety of existing nuclear power plants and the effectiveness of regulations and regulatory actions (including 'prescriptive' and 'performance based' approaches) . Senior regulators from 23 Member States participated in four peer group discussions during 1995-1996. This report presents the outcome of these meetings and recommendations of good practices identified by these senior regulators. The purpose of this report is to disseminate the views which the senior regulators presented at the meetings relating to measures used for assessing the safety of existing nuclear power plants and evaluating the effectiveness of regulators and regulatory actions. The intention in doing this is to assist Member States in the enhancement of their regulatory practices by identifying commonly accepted good practices. This report is structured so that it covers the subject matter under the following main headings: 'Prescriptive and Performance Based' Approaches to Regulation; Common Features of Regulatory Approaches; Effectiveness of the Regulator and Regulatory Actions; Recommendations of Good Practice. It is important to note that recommendations of good practice are included if they have been identified by at least one of the groups. It does not follow that all of the groups or individual Member States would necessarily endorse all of the recommendations. However, it is considered that if a single group of senior regulators judge that a particular practice is worthy of recommendation then it should be included for serious consideration. In some cases the same recommendations arise from all of the Groups

  19. Prostate cancer staging

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000397.htm Prostate cancer staging To use the sharing features on this ... trials you may be able to join How Prostate Cancer Staging is Done Initial staging is based on ...

  20. Staged Repository Development Programmes

    International Nuclear Information System (INIS)

    Isaacs, T

    2003-01-01

    Programs to manage and ultimately dispose of high-level radioactive wastes are unique from scientific and technological as well as socio-political aspects. From a scientific and technological perspective, high-level radioactive wastes remain potentially hazardous for geological time periods-many millennia-and scientific and technological programs must be put in place that result in a system that provides high confidence that the wastes will be isolated from the accessible environment for these many thousands of years. Of course, ''proof'' in the classical sense is not possible at the outset, since the performance of the system can only be known with assurance, if ever, after the waste has been emplaced for those geological time periods. Adding to this challenge, many uncertainties exist in both the natural and engineered systems that are intended to isolate the wastes, and some of the uncertainties will remain regardless of the time and expense in attempting to characterize the system and assess its performance. What was perhaps underappreciated in the early days of waste management and repository program development were the unique and intense reactions that the institutional, political, and public bodies would have to repository program development, particularly in programs attempting to identify and then select sites for characterization, design, licensing, and ultimate development. Reactions in most nations were strong, focused, unrelenting, and often successful in hindering, derailing, and even stopping national repository programs. The reasons for such reactions and the measures to successfully respond to them are still evolving and continue to be the focus of many national program and political leaders. Adaptive Staging suggests an approach to repository program development that reflects the unique challenges associated with the disposal of high-level radioactive waste. The step-wise, incremental, learn-as-you-go approach is intended to maximize the

  1. Should Student Evaluation of Teaching Play a Significant Role in the Formal Assessment of Dental Faculty? Two Viewpoints: Viewpoint 1: Formal Faculty Assessment Should Include Student Evaluation of Teaching and Viewpoint 2: Student Evaluation of Teaching Should Not Be Part of Formal Faculty Assessment.

    Science.gov (United States)

    Rowan, Susan; Newness, Elmer J; Tetradis, Sotirios; Prasad, Joanne L; Ko, Ching-Chang; Sanchez, Arlene

    2017-11-01

    Student evaluation of teaching (SET) is often used in the assessment of faculty members' job performance and promotion and tenure decisions, but debate over this use of student evaluations has centered on the validity, reliability, and application of the data in assessing teaching performance. Additionally, the fear of student criticism has the potential of influencing course content delivery and testing measures. This Point/Counterpoint article reviews the potential utility of and controversy surrounding the use of SETs in the formal assessment of dental school faculty. Viewpoint 1 supports the view that SETs are reliable and should be included in those formal assessments. Proponents of this opinion contend that SETs serve to measure a school's effectiveness in support of its core mission, are valid measures based on feedback from the recipients of educational delivery, and provide formative feedback to improve faculty accountability to the institution. Viewpoint 2 argues that SETs should not be used for promotion and tenure decisions, asserting that higher SET ratings do not correlate with improved student learning. The advocates of this viewpoint contend that faculty members may be influenced to focus on student satisfaction rather than pedagogy, resulting in grade inflation. They also argue that SETs are prone to gender and racial biases and that SET results are frequently misinterpreted by administrators. Low response rates and monotonic response patterns are other factors that compromise the reliability of SETs.

  2. Life stage-specific effects of the fungicide pyrimethanil and temperature on the snail Physella acuta (Draparnaud, 1805) disclose the pitfalls for the aquatic risk assessment under global climate change

    International Nuclear Information System (INIS)

    Seeland, Anne; Albrand, Jennifer; Oehlmann, Jörg; Müller, Ruth

    2013-01-01

    It can be suggested that the combined stress of pesticide pollution and suboptimal temperature influences the sensitivity of life stages of aquatic invertebrates differently. The embryo, juvenile, half- and full-life-cycle toxicity tests performed with the snail Physella acuta at different concentrations (0.06–0.5 or 1.0 mg L −1 ) of the model fungicide pyrimethanil at 15, 20 and 25 °C revealed, that pyrimethanil caused concentration-dependent effects at all test temperatures. Interestingly, the ecotoxicity of pyrimethanil was higher at lower (suboptimal) temperature for embryo hatching and F 1 reproduction, but its ecotoxicity for juvenile growth and F 0 reproduction increased with increasing temperature. The life-stage specific temperature-dependent ecotoxicity of pyrimethanil and the high fungicide susceptibility of the invasive snail clearly demonstrate the complexity of pesticide–temperature interactions and the challenge to draw conclusions for the risk of pesticides under the impact of global climate change. -- Highlights: ► Physella acuta reacts highly sensitively to exposure to pyrimethanil. ► The ecotoxicity of pyrimethanil is life-stage specific. ► Pyrimethanil and temperature stress influenced the development interactively. -- The aquatic risk of pesticides under climate change cannot be adequately assessed by recent strategies for the regular risk assessment of agrochemicals

  3. A pilot randomized trial assessing the effects of autogenic training in early stage cancer patients in relation to psychological status and immune system responses.

    Science.gov (United States)

    Hidderley, Margaret; Holt, Martin

    2004-03-01

    Autogenic training (AT) is a type of meditation usually used for reducing stress. This pilot study describes how AT was used on a group of early stage cancer patients and the observed effect on stress-related behaviours and immune system responses. This was a randomized trial with 31 early stage breast cancer women, having received a lumpectomy and adjuvant radiotherapy. The women were randomized into two groups. Group 1 received a home visit only. Group 2 received a home visit and 2 months' weekly Autogenic training. At the beginning and end of the 2 monthly periods, the Hospital Anxiety and Depression Scale (HADS) and T and B cell markers were measured to give an indication of changes in immune system responses and measurement of anxiety and depression. At the end of the study, HADS scores and T and B cell markers remained similar in the women who did not receive AT. The women receiving AT showed a strong statistical difference for an improvement in their HADS scores and those women observed in a meditative state as opposed to a relaxed state were found to have an increase in their immune responses. This study suggests AT as a powerful self-help therapy.

  4. The value of different vegetative indices (NDVI, GAI for the assessment of yield potential of pea (Pisum sativum L. at different growth stages and under varying management practices

    Directory of Open Access Journals (Sweden)

    Agnieszka Klimek-Kopyra

    2018-03-01

    Full Text Available This research evaluated the NDVI (normalized difference vegetation index and GAI (green area index in order to indicate the productivity and developmental effects of Rhizobium inoculants and microelement foliar fertilizer on pea crops. Two inoculants, Nitragina (a commercial inoculant and IUNG (a noncommercial inoculant gel and a foliar fertilizer (Photrel were studied over a 4-year period, 2009–2012. The cultivars chosen for the studies were characterized by different foliage types, namely a semileafless pea ‘Tarchalska’ and one with regular foliage, ‘Klif’. Foliar fertilizer significantly increased the length of the generative shoots and the number of fruiting nodes in comparison to the control, which in turn had a negative impact on the harvest index. Pea seed yield was highly dependent on the interaction between the years of growth and the microbial inoculant, and was greater for ‘Tarchalska’ (4.33 t ha−1. Presowing inoculation of seeds and foliar fertilization resulted in a significantly higher value of GAI at the flowering (3.91 and 3.81, respectively and maturity stages (4.82 and 4.77, respectively, whereas the value of NDVI was higher for these treatments only at the maturity stage (0.67 and 0.79, respectively. A significantly greater yield (5.0–5.4 t ha−1 was obtained after inoculation with IUNG during the dry years.