Surgical approach for systemic-pulmonary shunt in neonates with functionally univentricular heart: comparison between sternotomy and thoracotomy.

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Sasaki, Takashi; Takeda, Yuko; Ohnakatomi, Yasuko; Asou, Toshihide

2016-09-01

The preferred surgical approach for systemic-pulmonary shunts has changed from thoracotomy to sternotomy in our institution, to concomitantly manage the ductus arteriosus during surgery. The purpose of this study was to compare the outcomes of systemic-pulmonary shunts for neonates with functionally univentricular hearts based on surgical approach. Fifty-two neonates with functionally univentricular hearts underwent systemic-pulmonary shunt via sternotomy (n = 28) or thoracotomy (n = 24). Patient characteristics, achievement rates of right heart bypass, and survival rates were compared for the different approaches. Prenatal diagnosis was made more common in the sternotomy group (p = 0.006). The shunt was placed more centrally in the sternotomy group. The ductus arteriosus was ligated or banded in most patients in the sternotomy group (26/28) and in a few patients in the thoracotomy group (6/24). Frequency of ductal management in the early postoperative phase was not different between the groups (21 vs 25 %), but three new incisions had to be made in the thoracotomy group. No differences were seen in the achievement rates of bidirectional cavopulmonary shunts (86 vs 87 % at 10 months of age) and total cavopulmonary connection (81 vs 81 % at 2 years of age), or in the survival rates (92 vs 96 % at 8 years). There were no differences in short- and long-term outcomes between the groups. The sternotomy approach might be preferable in the current era of prenatal diagnosis, to allow simultaneous duct management during systemic-pulmonary shunt surgery, particularly in patients with large ducts associated with functionally univentricular hearts.

Simultaneous nephrectomy and coronary artery bypass grafting through extended sternotomy

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Budrikis Algimantas

2012-08-01

Full Text Available Abstract Background The advances in surgical techniques, resuscitation and anesthesiology support over the last years have allowed simultaneous thoracic and abdominal operations to be made for cancer and concomitant severe heart vessel disease relieving the patient from several diseases simultaneously and achieving long lasting remission or cure. Clinical case A simultaneous nephrectomy and coronary artery bypass grafting procedure through extended sternotomy is reported. A 63-year-old man with severe coronary artery disease was found to have renal carcinoma. Diagnosis Postoperative pathological investigation of the tumor revealed the presence of renal cell carcinoma pT3a N0 M0, G2. Coronarography revealed advanced three-vessel coronary artery disease. Treatment We successfully performed a simultaneous curative surgery for renal carcinoma and coronary artery bypass graft surgery under cardiopulmonary bypass using a novel technique of extended sternotomy. Simultaneous surgery thus appears to be a beneficial and safe approach for the treatment of coronary artery disease and resectable renal cancer in carefully selected patients.

Sternal plate fixation for sternal wound reconstruction: initial experience (Retrospective study

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Musgrave Melinda

2011-04-01

Full Text Available Abstract Background Median sternotomy infection and bony nonunion are two commonly described complications which occur in 0.4 - 5.1% of cardiac procedures. Although relatively infrequent, these complications can lead to significant morbidity and mortality. The aim of this retrospective study is to evaluate the initial experience of a transverse plate fixation system following wound complications associated with sternal dehiscence with or without infection following cardiac surgery. Methods A retrospective chart review of 40 consecutive patients who required sternal wound reconstruction post sternotomy was performed. Soft tissue debridement with removal of all compromised tissue was performed. Sternal debridement was carried using ronguers to healthy bleeding bone. All patients underwent sternal fixation using three rib plates combined with a single manubrial plate (Titanium Sternal Fixation System®, Synthes. Incisions were closed in a layered fashion with the pectoral muscles being advanced to the midline. Data were expressed as mean ± SD, Median (range or number (%. Statistical analyses were made by using Excel 2003 for Windows (Microsoft, Redmond, WA, USA. Results There were 40 consecutive patients, 31 males and 9 females. Twenty two patients (55% were diagnosed with sternal dehiscence alone and 18 patients (45% with associated wound discharge. Thirty eight patients went on to heal their wounds. Two patients developed recurrent wound infection and required VAC therapy. Both were immunocompromised. Median post-op ICU stay was one day with the median hospital stay of 18 days after plating. Conclusion Sternal plating appears to be an effective option for the treatment of sternal wound dehiscence associated with sternal instability. Long-term follow-up and further larger studies are needed to address the indications, benefits and complications of sternal plating.

Management of sternal precautions following median sternotomy by physical therapists in Australia: a web-based survey.

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Tuyl, Lara J; Mackney, Jennifer H; Johnston, Catherine L

2012-01-01

Sternal precautions are utilized within many hospitals with the aim of preventing the occurrence of sternal complications (eg, infection, wound breakdown) following midline sternotomy. The evidence base for sternal precaution protocols, however, has been questioned due to a paucity of research, unknown effect on patient outcomes, and possible discrepancies in pattern of use among institutions. The objective of this study was to investigate and document the use of sternal precautions by physical therapists in the treatment of patients following median sternotomy in hospitals throughout Australia, from immediately postsurgery to discharge from the hospital. A cross-sectional, observational design was used. An anonymous, Web-based survey was custom designed for use in the study. The questionnaire was content validated, and the online functionality was assessed. The senior cardiothoracic physical therapist from each hospital identified as currently performing cardiothoracic surgery (N=51) was invited to participate. The response rate was 58.8% (n=30). Both public (n=18) and private (n=12) hospitals in all states of Australia were represented. Management protocols reported by participants included wound support (n=22), restrictions on lifting and transfers (n=23), and restrictions on mobility aid use (n=15). Factors influencing clinical practice most commonly included "workplace practices/protocols" (n=27) and "clinical experience" (n=22). Limitations The study may be limited by response bias. Significant variation exists in the sternal precautions and protocols used in the treatment of patients following median sternotomy in Australian hospitals. Further research is needed to investigate whether the restrictions and precautions used are necessary and whether protocols have an impact on patient outcomes, including rates of recovery and length of stay.

A Randomized Trial to Assess the Contribution of a Novel Thorax Support Vest (Corset) in Preventing Mechanical Complications of Median Sternotomy.

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Caimmi, Philippe P; Sabbatini, Maurizio; Kapetanakis, Emmanouil I; Cantone, Silvia; Ferraz, Marcus V; Cannas, Mario; Tesler, Ugo F

2017-06-01

Mechanical complications of median sternotomy may cause significant morbidity and mortality in cardiac surgical patients. This study was aimed at assessing the role of Posthorax support vest (Epple, Inc., Vienna, Austria) in the prevention of sternal complications and the improvement of anatomical healing in patients at high risk for mechanical sternal dehiscence after cardiac surgery by mean of median sternotomy. A prospective, randomized, study was performed and 310 patients with predisposing factors for sternal dehiscence after sternotomy for cardiac surgery were included. The patients were divided into two groups: patients who received the Posthorax support vest after surgery, and patients who did not. Primary variables assessed included the incidence of mechanical sternal complications, the quality of sternal healing, the rate of re-operation, the duration of hospitalization, rate and duration of hospital, re-admission for sternal complications. Secondary variables assessed were the post-operative pain, the number of requests for supplemental analgesia and the quality of life measured by means of the EQ-5D format. Patients using vest demonstrated a lower incidence of mechanical sternal complications, a better anatomical sternum healing, lower hospital stay, no re-operations for sternal dehiscence before discharge and lower re-admissions for mechanical sternal complication. In addition, patients using a vest reported a better quality of life with better freedom from limitations in mobility, self-care, and pain. Our findings demonstrate that the use of the Posthorax vest reduces post-sternotomy mechanical complications and improves the healing of the sternotomy, the clinical course, and the post-operative quality of life.

Minimally Invasive Implantation of HeartWare Assist Device and Simultaneous Tricuspid Valve Reconstruction Through Partial Upper Sternotomy.

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Hillebrand, Julia; Hoffmeier, Andreas; Djie Tiong Tjan, Tonny; Sindermann, Juergen R; Schmidt, Christoph; Martens, Sven; Scherer, Mirela

2017-05-01

Left ventricular assist device (LVAD) implantation is a well-established therapy to support patients with end-stage heart failure. However, the operative procedure is associated with severe trauma. Third generation LVADs like the HeartWare assist device (HeartWare, Inc., Framingham, MA, USA) are characterized by enhanced technology despite smaller size. These devices offer new minimally invasive surgical options. Tricuspid regurgitation requiring valve repair is frequent in patients with the need for mechanical circulatory support as it is strongly associated with ischemic and nonischemic cardiomyopathy. We report on HeartWare LVAD implantation and simultaneous tricuspid valve reconstruction through minimally invasive access by partial upper sternotomy to the fifth left intercostal space. Four male patients (mean age 51.72 ± 11.95 years) suffering from chronic heart failure due to dilative (three patients) and ischemic (one patient) cardiomyopathy and also exhibiting concomitant tricuspid valve insufficiency due to annular dilation underwent VAD implantation and tricuspid valve annuloplasty. Extracorporeal circulation was established via the ascending aorta, superior vena cava, and right atrium. In all four cases the LVAD implantation and tricuspid valve repair via partial median sternotomy was successful. During the operative procedure, no conversion to full sternotomy was necessary. One patient needed postoperative re-exploration because of pericardial effusion. No postoperative focal neurologic injury was observed. New generation VADs are advantageous because of the possibility of minimally invasive implantation procedure which can therefore minimize surgical trauma. Concomitant tricuspid valve reconstruction can also be performed simultaneously through partial upper sternotomy. Nevertheless, minimally invasive LVAD implantation is a challenging operative technique. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals

Comparison of bolus and continuous infusion of esmolol on hemodynamic response to laryngoscopy, endotracheal intubation and sternotomy in coronary artery bypass graft

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Esra Mercanooglu Efe

2014-07-01

Full Text Available BACKGROUND AND OBJECTIVE: The aim of this randomized, prospective and double blinded study is to investigate effects of different esmolol use on hemodynamic response of laryngoscopy, endotracheal intubation and sternotomy in coronary artery bypass graft surgery. METHODS: After approval of local ethics committee and patients' written informed consent, 45 patients were randomized into three groups equally. In Infusion Group; from 10 min before intubation up to 5th minute after sternotomy, 0.5 mg/kg/min esmolol infusion, in Bolus Group; 2 min before intubation and sternotomy 1.5 mg/kg esmolol IV bolus and in Control Group; %0.9 NaCl was administered. All demographic parameters were recorded. Heart rate and blood pressure were recorded before infusion up to anesthesia induction in every minute, during endotracheal intubation, every minute for 10 minutes after endotracheal intubation and before, during and after sternotomy at first and fifth minutes. RESULTS: While area under curve (AUC (SAP × time was being found more in Group B and C than Group I, AUC (SAP × T int and T st and AUC (SAP × T2 was found more in Group B and C than Group I (p < 0.05. Moreover AUC (HR × T st was found less in Group B than Group C but no significant difference was found between Group B and Group I. CONCLUSION: This study highlights that esmolol infusion is more effective than esmolol bolus administration on controlling systolic arterial pressure during endotracheal intubation and sternotomy in CABG surgery.

Wound infection after median sternotomy during the war in Croatia.

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Jelić, I; Anić, D; Alfirević, I; Kalinić, S; Ugljen, R; Letica, D; Ante Korda, Z; Vucemilo, I; Bulat, C; Predrijevac, M; Corić, V; Husar, J; Jelic, M; Hulina, D; Depina, I; Dadić, D

1996-12-01

From 1990 to 1994 at Clinical Hospital Center, Zagreb, 1904 median sternotomies were performed for cardiac operations. Patients shared the same intensive care unit (ICU) with the wounded persons, admitted to the hospital from battlefield. Infection developed in 124 patients, an incidence of 6.51%. Methicillin resistant Staphylococcus aureus (MRSA) was isolated from 90, methicillin resistant Staphylococcus epidermidis (MRSE) from 19, and gram negative bacilli (GNB) from 56 patients, Pseudomonas aeruginosa in 2, and Clostridium pneumoniae in 1 case. Ninety-six patients (5.04%) developed superficial localized infection of subcutaneous tissues and they were treated with frequent dressing changes with antibiotic-soaked gauze in combination with systemic antibiotics. Twenty-eight patients (1.47%) developed mediastinitis and sternal dehiscence. They were treated by operative debridement followed by reclosure of the sternum with continuous antibiotic irrigation. We obtained satisfactory results with our method of closure of sternum which is a modification of Robicsek's technique. Nine of them required further operation. In seven cases we performed muscle flaps and in two omentoplasty. One hundred and twenty patients were discharged in satisfactory condition. The uncontrolled mediastinal sepsis caused death in 4 patients. Higher infection rate after median sternotomy during 1991 and 1992 could be possibly explained with the war circumstances in Croatia, and especially with MRSA strain becoming endemic in surgical ICU.

Wound infections after median sternotomy treated by VAC therapy, summary of results, and risk factor analysis.

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Hulman, M; Bezak, B; Artemiou, P; Cikrai, R

2017-01-01

The aim of this study is to summarize results and analyze risk factors for the development of wound infection in heart surgery patients after median sternotomy. In this retrospective analysis with assessment of multiple risk factors, we examined 143 patients with infection after median sternotomy treated with VAC therapy from total of 4,650 patients operated in our department from 2012 to 2015. Total of 143 patients developed significant SSI treated by VAC therapy following cardiac surgery. Of these, only 14 patients developed DSWI and one patient was diagnosed with suspected osteomyelitis. BMI, female gender, and use of BIMA proved to be statistically significant risk factors in our study (p infection (p infection proved to be a significant prognostic factor for patients' outcome (p infection (Tab. 3, Ref. 30).

Median sternotomy - gold standard incision for cardiac surgeons

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Radu Matache

2016-05-01

Full Text Available Sternotomy is the gold standard incision for cardiac surgeons but it is also used in thoracic surgery especially for mediastinal, tracheal and main stem bronchus surgery. The surgical technique is well established and identification of the correct anatomic landmarks, midline tissue preparation, osteotomy and bleeding control are important steps of the procedure. Correct sternal closure is vital for avoiding short- and long-term morbidity and mortality. The two sternal halves have to be well approximated to facilitate healing of the bone and to avoid instability, which is a risk factor for wound infection. New suture materials and techniques would be expected to be developed to further improve the patients evolution, in respect to both immediate postoperative period and long-term morbidity and mortality

In patients with post-sternotomy mediastinitis is vacuum-assisted closure superior to conventional therapy?

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Yu, Angela W; Rippel, Radoslaw A; Smock, Elliott; Jarral, Omar A

2013-11-01

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether vacuum-assisted closure therapy (VAC) is superior to conventional therapy for treating post-sternotomy mediastinitis. Altogether >261 papers were found using the reported search, of which 9 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Several studies indicate that VAC therapy is associated with shorter lengths of intensive care and in-hospital stay as well as faster rates of wound healing and fewer dressing changes. It has also been shown that VAC therapy is correlated with a statistically significant reduction in reinfection rates, particularly those that occur in the early postoperative period (at the 1-week follow-up). Patients can be discharged with the dressing in situ and managed in the community with a view to delayed closure or reconstruction. However, the studies comparing VAC with conventional therapy are all retrospective in nature and reinforce the need for randomized controlled trials in order to more accurately establish differences in outcomes between VAC and conventional therapy. Additionally, owing tło the variability of treatment protocols within the non-VAC arm, it is more challenging to draw definitive conclusions regarding the superiority of VAC therapy to every modality that is considered conventional treatment. We conclude that VAC therapy is a portable and an increasingly economical option for the treatment of post sternotomy mediastinitis. Although reductions in mortality rates were not reproduced in all studies, evidence suggests that VAC should still be considered as a first-line therapy for post-sternotomy mediastinitis and as a bridge therapy to musculocutaneous reconstruction or primary closure.

Omental Herniation: A Rare Complication of Vacuum-Assisted Closure of Infected Sternotomy Wound

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Philemon Gukop

2012-01-01

Full Text Available Vacuum-assisted closure (VAC has recently been adopted as an acceptable modality for management of sternotomy wound infections. Although generally efficacious, the use of negative pressure devices has been associated with complications such as bleeding, retention of sponge, and empyema. We report the first case of greater omental hernia as a rare complication of vacuum-assisted closure of sternal wound infection following coronary artery bypass grafting.

Median sternotomy and ventral stabilisation using pins and polymethylmethacrylate for a comminuted T5 vertebral fracture in a Miniature Schnauzer.

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Guiot, L P; Allman, D A

2011-01-01

A 2.9 kg Miniature Schnauzer was referred to our clinic, the Emergency & Critical Care Medicine Service at the Michigan State University Veterinary Teaching Hospital, following a dog fight. Physical examination findings upon admission included multiple thoracic wounds, absence of hindlimb deep pain, and marked Schiff-Sherrington syndrome. Computed tomography imaging revealed thoracic wall penetration and a comminuted T5 vertebral fracture. Thoracic exploration and thoracic wall repair were performed through a median sternotomy. The vertebral fracture was exposed and stabilised intra-thoracically through the same approach using pins and polymethylmethacrylate. The pins were placed percutaneously into the vertebral bodies of the adjacent vertebrae. Recovery was uncomplicated and fracture healing was documented eight weeks postoperatively. Spinal trauma secondary to dog fights is relatively common. The presence of concurrent penetrating thoracic injury negatively affects prognosis and necessitates thoracic exploration as soon as feasible. The approach should allow complete thoracic exploration to repair parietal and visceral damage, thus indicating the need for median sternotomy rather than an intercostal approach. The present case report suggested that median sternotomy can be used to safely apply stabilisation devices for the treatment of concurrent spinal trauma. Direct visualisation of the vertebral bodies permitted optimal implant anchorage as compared to potentially more hazardous techniques such as dorsal pinning.

Comparison between minimal right vertical infra-axillary thoracotomy and standard median sternotomy for repair of atrial septal defects

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Hafize Yaliniz

2015-10-01

Conclusion: Minimal right vertical infra-axillary thoracotomy can be performed with favorable cosmetic and clinical results for atrial septal defects closure. Infra-axillary thoracotomy provides a good alternative to standard median sternotomy for patients with atrial septal defects.

Ministernotomy: A preliminary experience in heart valve surgery

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Kovačević Pavle

2011-01-01

Full Text Available Background/Aim. The last decade of the 20th century brought up a significant development in the field of minimally invasive approaches to the valvular heart surgery. Potential benefits of this method are: good esthetic appearance, reduced pain, reduction of postoperative hemorrhage and incidence of surgical site infection, shorter postoperative intensive care units (ICU period and overall in-hospital period. Partial upper median sternotomy currently presents as a state-of-the art method for minimally invasive surgery of cardiac valves. The aim of this study was to report on initial experience in application of this surgical method in the surgery of mitral and aortic valves. Methods. The study was designed and conducted in a prospective manner and included all the patients who underwent minimally invasive cardiac valve surgery through the partial upper median sternotomy during the period November 2008 - August 2009. We analyzed the data on mean age of patients, mean extubation time, mean postoperative drainage, mean duration of hospital stay, as well as on occurance of postoperative complications (postoperative bleeding, surgical site infection and cerebrovascular insult. Results. During the observed period, in the Institute for Cardiovascular Diseases of Vojvodina, Clinic for Cardiovascular Surgery, 17 ministernotomies were performed, with 14 aortic valve replacements (82.35% and 3 mitral valve replacements (17.65%. Mean age of the patients was 60.78 ± 12.99 years (64.71% males, 35.29% females. Mean extubation time was 12.53 ± 8.87 hours with 23.5% of the patients extubated in less than 8 hours. Mean duration of hospital stay was 12.35 ± 10.17 days (in 29.4% of the patients less than 8 days. Mean postoperative drainage was 547.06 ± 335.2 mL. Postoperative complications included: bleeding (5.88% and cerebrovascular insult (5.88%. One patient (5.88% required conversion to full sternotomy. Conclusion. Partial upper median sternotomy represents

Prospective, randomized, controlled trial of polymer cable ties versus standard wire closure of midline sternotomy.

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Marasco, Silvana F; Fuller, Louise; Zimmet, Adam; McGiffin, David; Seitz, Michael; Ch'ng, Stephanie; Gangahanumaiah, Shivanand; Bailey, Michael

2018-04-16

Midline sternotomy remains the most common access incision for cardiac operations. Traditionally, the sternum is closed with stainless steel wires. Wires are well known to stretch and break, however, leading to pain, nonunion, and potential deep sternal wound infection. We hypothesized that biocompatible plastic cable ties would achieve a more rigid sternal fixation, reducing postoperative pain and analgesia requirements. A prospective, randomized study compared the ZIPFIX (De Puy Synthes, West Chester, Pa) sternal closure system (n = 58) with standard stainless steel wires (n = 60). Primary outcomes were pain and analgesia requirements in the early postoperative period. Secondary outcome was sternal movement, as assessed by ultrasound at the postoperative follow-up visit. Groups were well matched in demographic and operative variables. There were no significant differences between groups in postoperative pain, analgesia, or early ventilatory requirements. Patients in the ZIPFIX group had significantly more movement in the sternum and manubrium on ultrasound at 4 weeks. ZIPFIX sternal cable ties provide reliable closure but no demonstrable benefit in this study in pain or analgesic requirements relative to standard wire closure after median sternotomy. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Estudo comparativo entre a miniesternotomia em "L" invertido e esternotomia longitudinal total na correção cirúrgica da comunicação interatrial Comparative study between inverted "L" mini-sternotomy and complete sternotomy for the surgical treatment of the atrial septal defect (ASD

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Luiz Cláudio Nery Sampaio

2005-03-01

Full Text Available OBJETIVO: Comparar os resultados obtidos entre duas vias de acesso cirúrgico em pacientes submetidos à correção cirúrgica de comunicação interatrial (CIA. MÉTODO: Foram distribuídos 20 pacientes, com média de idade de 24,1±14,2 anos, em dois grupos. No grupo A, 10 pacientes (80% do sexo feminino, com média de idade de 20,9 ± 12,0 anos foram submetidos à correção da CIA por meio de uma esternotomia longitudinal total. No grupo B, 10 pacientes (80% do sexo feminino, com média de idade de 27,4 ± 16,1 anos foram submetidos à correção da CIA através de miniesternotomia em "L" invertido. Foi considerado significativo p OBJECTIVE: To compare the results obtained from two distinct surgical approaches in patients undergoing surgical correction of an atrial septal defect (ASD. METHOD: The study series consisted of 20 patients, with a mean age of 24.1±14.2 years, distributed in two groups. In group A, 10 patients (80% female, with a mean age of 20.9±12.0 years underwent surgical correction of ASD through a complete sternotomy. In group B, 10 patients (80% female, with mean age of 27.4±16.1 years, were operated through an inverted "L" mini-sternotomy. A p-value < 0.05 was considered statistically significant. RESULTS: There was no statistical significance for demographics variables, duration of surgery, cardiopulmonary bypass time, clamping time, amount of cardioplegia administered, thoracic drainage, ICU stay, duration of mechanical ventilatory support, amount of blood and its components transfused, arrhythmia or pacemaker usage. There was statistical significance (p= 0.00001 between incision size performed by complete sternotomy (group A and inverted "L" mini-sternotomy (group B, with mean incision size of 15.7±0.8 e 6.8±0.6cm, respectively. There was a difference in the mean hospital stay between the groups but without statistical significance (7.5±1.6 days in group A and 6.4±1.3 days in group B, with a p-value = 0.12. There

Left thoracotomy HeartWare implantation with outflow graft anastomosis to the descending aorta: a simplified bridge for patients with multiple previous sternotomies.

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Umakanthan, Ramanan; Haglund, Nicholas A; Stulak, John M; Joyce, Lyle D; Ahmad, Rashid; Keebler, Mary E; Maltais, Simon

2013-01-01

Advances in mechanical circulatory support have been critical in bridging patients awaiting heart transplantation. In addition, improvement in device durability has enabled left ventricular assist device therapy to be applied as destination therapy in those not felt to be transplant candidate. Because of the increasing complexity of patients, there continues to be a need for alternative strategies for device implantation to bridge high-risk patients awaiting heart transplantation, wherein the risks of numerous previous sternotomies may be prohibitive. We present a unique technique for placement of the HeartWare ventricular assist device via left anterior thoracotomy to the descending aorta in a patient awaiting heart transplantation with a history of multiple previous sternotomies.

Allergic reaction to stainless steel sternotomy wires requiring removal: A case report and literature review.

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Lopez, J; Sachithanandan, A; Leow, M

2016-06-01

Hypersensitivity to stainless steel sternal sutures are an uncommon occurrence. We present a case of such a patient who developed chronic tissue overgranulation over a sternotomy wound eight weeks post-operatively. Primary suspicion was infection, a more common complication however radiological and laboratory investigation showed otherwise. Conservative management provided limited ephemeral success. After ensuring adequate sternal bone healing, the sutures and granulation tissue were eventually surgically removed without complication and the reoperated wound healed well.

Presentation and management of keloid scarring following median sternotomy: a case study

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Javangula Kalyana C

2010-12-01

Full Text Available Abstract Introduction Keloid scars following median sternotomy are rare and occur more frequently in pigmented skin. Different management strategies have been described with variable success. We present a case of keloid scar formation following cardiac surgery including our management and the final aesthetic result. Case description A 64 year old female of fair complexion underwent mitral valve replacement. The procedure and postoperative recovery were uncomplicated, however, during the following year, thick keloid scars formed over the incision sites. Initial non surgical measures failed to relieve pain and did not offer any tangible aesthetic benefit. Eventually surgical excision was attempted. She presented to our clinic for nine months follow up with significant improvement in pain and aesthetic result. Discussion and Evaluation Several theories have attempted to explore the pathophysiology of keloid scar formation. A number of predisposing factors have been documented however none existed in this case. A variety of invasive and non invasive approaches have been described but significant differences in success rates and methodology of investigations still precludes a standardized management protocol. Conclusions In this case study a rare presentation of keloid scar has been presented. The variety of methods used to improve pain and aesthetic result demonstrates the propensity of keloid scars to recur and the therapeutic challenges that surgeons have to face in their quest for a satisfactory patient outcome.

Management of carotid Dacron patch infection: a case report using median sternotomy for proximal common carotid artery control and in situ polytetrafluoroethylene grafting.

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Illuminati, Giulio; Calio', Francesco G; D'Urso, Antonio; Ceccanei, Gianluca; Pacilè, Maria Antonietta

2009-01-01

We report on a 58-year-old male who presented with an enlarging cervical hematoma 3 months following carotid endarterectomy with Dacron patch repair, due to septic disruption of the Dacron patch secondary to presumed infection. The essential features of this case are the control of the proximal common carotid artery gained through a median sternotomy, because the patient was markedly obese with minimal thyromental distance, and the treatment consisting of in situ polytetrafluoroethylene bypass grafting, due to the absence of a suitable autogenous saphenous vein. Median sternotomy is rarely required in case of reintervention for septic false aneurysms and hematomas following carotid endarterectomy but should be considered whenever difficult control of the common carotid artery, when entering the previous cervicotomy, is anticipated. In situ polytetrafluoroethylene grafting can be considered if autogenous vein material is lacking.

Right miniparasternotomy may be a good minimally invasive alternative to full sternotomy for cardiac valve operations: a propensity-adjusted analysis.

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Chiu, Kuan M; Chen, Robert J; Lin, Tzu Y; Chen, Jer S; Huang, Jin H; Huang, Chun Y; Chu, Shu H

2016-02-01

Limited real-world data existed for mini-parasternotomy approach with good sample size in Asian cohorts and most previous studies were eclipsed by case heterogeneity. The goal of this study was to compare safety and quality outcomes of cardiac non-coronary valve operations by mini-parasternotomy and full sternotomy approaches on risk-adjusted basis. METHODS From our hospital database, we retrieved the cases of non-coronary valve operations from 1 January 2005 to 31 December 2012, including re-do, emergent, and combined procedures. Estimated EuroScore-II and propensity score for choosing mini-parasternotomy were adjusted for in the regression models on hospital mortality, complications (pneumonia, stroke, sepsis, etc.), and quality parameters (length of stay, ICU time, ventilator time, etc.). Non-complicated cases, defined as survival to discharge, ventilator use not over one week, and intensive care unit stay not over two weeks, were used for quality parameters. There were 283 mini-parasternotomy and 177 full sternotomy cases. EuroScore-II differed significantly (medians 2.1 vs. 4.7, P<0.001). Propensity scores for choosing mini-parasternotomy were higher with lower EuroScore-II (OR=0.91 per 1%, P<0.001), aortic regurgitation (OR=2.3, P=0.005), and aortic non-mitral valve disease (OR=3.9, P<0.001). Adjusted for propensity score and EuroScore-II, mini-parasternotomy group had less pneumonia (OR=0.32, P=0.043), less sepsis (OR=0.31, P=0.045), and shorter non-complicated length of stay (coefficient=-7.2 (day), P<0.001) than full sternotomy group, whereas Kaplan-Meier survival, non-complicated ICU time, non-complicated ventilator time, and 30-day mortality did not differ significantly. The propensity-adjusted analysis demonstrated encouraging safety and quality outcomes for mini-parasternotomy valve operation in carefully selected patients.

Right mini-parasternotomy may be a good minimally invasive alternative to full sternotomy for cardiac valve operations-a propensity-adjusted analysis.

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Chiu, K M; Chen, R J; Lin, T Y; Chen, J S; Huang, J H; Huang, C Y; Chu, S H

2014-03-26

Limited realworld data existed for miniparasternotomy approach with good sample size in Asian cohorts and most previous studies were eclipsed by case heterogeneity. The goal of this study was to compare safety and quality outcomes of cardiac noncoronary valve operations by miniparasternotomy and full sternotomy approaches on riskadjusted basis. From our hospital database, we retrieved the cases of non-coronary valve operations from 1 January 2005 to 31 December 2012, including re-do, emergent, and combined procedures. Estimated EuroScore-II and propensity score for choosing mini-parasternotomy were adjusted for in the regression models on hospital mortality, complications (pneumonia, stroke, sepsis, etc.), and quality parameters (length of stay, ICU time, ventilator time, etc.). Non-complicated cases, defined as survival to discharge, ventilator use not over one week, and intensive care unit stay not over two weeks, were used for quality parameters. There were 283 miniparasternotomy and 177 full sternotomy cases. EuroScore-II differed significantly (medians 2.1 vs. 4.7, p<0.001). Propensity scores for choosing miniparasternotomy were higher with lower EuroScore-II (OR=0.91 per 1%, p<0.001), aortic regurgitation (OR=2.3, p=0.005), and aortic non-mitral valve disease (OR=3.9, p<0.001). Adjusted for propensity score and EuroScore-II, mini-parasternotomy group had less pneumonia (OR=0.32, p=0.043), less sepsis (OR=0.31, p=0.045), and shorter non-complicated length of stay (coefficient=7.2 (day), p<0.001) than full sternotomy group, whereas Kaplan-Meier survival, non-complicated ICU time, non-complicated ventilator time, and 30-day mortality did not differ significantly. The propensity-adjusted analysis demonstrated encouraging safety and quality outcomes for mini-parasternotomy valve operation in carefully selected patients.

Standard restrictive sternal precautions and modified sternal precautions had similar effects in people after cardiac surgery via median sternotomy (‘SMART’ Trial: a randomised trial

Directory of Open Access Journals (Sweden)

Md Ali Katijjahbe

2018-04-01

Full Text Available Question: In people who have undergone cardiac surgery via median sternotomy, does modifying usual sternal precautions to make them less restrictive improve physical function, pain, kinesiophobia and health-related quality of life? Design: Two-centre, randomised, controlled trial with concealed allocation, blinded assessors and intention-to-treat analysis. Participants: Seventy-two adults who had undergone cardiac surgery via a median sternotomy were included. Intervention: Participants were randomly allocated to one of two groups at 4 (SD 1 days after surgery. The control group received the usual advice to restrict their upper limb use for 4 to 6 weeks (ie, restrictive sternal precautions. The experimental group received advice to use pain and discomfort as the safe limits for their upper limb use during daily activities (ie, less restrictive precautions for the same period. Both groups received postoperative individualised education in hospital and via weekly telephone calls for 6 weeks. Outcome measures: The primary outcome was physical function assessed by the Short Physical Performance Battery. Secondary outcomes included upper limb function, pain, kinesophobia, and health-related quality of life. Outcomes were measured before hospital discharge and at 4 and 12 weeks postoperatively. Adherence to sternal precautions was recorded. Results: There were no statistically significant differences in physical function between the groups at 4 weeks (MD 1.0, 95% CI –0.2 to 2.3 and 12 weeks (MD 0.4, 95% CI –0.9 to 1.6 postoperatively. There were no statistically significant between-group differences in secondary outcomes. Conclusion: Modified (ie, less restrictive sternal precautions for people following cardiac surgery had similar effects on physical recovery, pain and health-related quality of life as usual restrictive sternal precautions. Similar outcomes can be anticipated regardless of whether people following cardiac surgery are managed with

Trauma sternotomy for presumed haemopericardium with incidental coccidioidal pericarditis

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Seth I. Felder

2015-02-01

Full Text Available Background: Disseminated cocciodiomycosis with extrapulmonary disease occurs in less than 1% of infected patients, with few cases involving the pericardium reported in the literature. A subxiphoid window in a focussed assessment with sonography for trauma is a fast and reliable study for detecting haemopericardium in the haemodynamically unstable injured patient. Methods: Case report and literature review. Case report: A 50-year old man presented in extremis following a stab wound to the right thoracoabdominal region with a positive pericardial ultrasound. At the time of emergent sternotomy, the pericardial effusion appeared non-traumatic and not the cause of haemodynamic instability. Lung, diaphragm, liver and transverse colon lacerations were controlled by laparotomy. He was discovered to have extensive adenopathy within the mediastinum, porta hepatis, and lesser sac, which after histopathologic examination, demonstrated granulomatous lymphadenitis consistent with disseminated cocciodiomycosis. Conclusions: This case report describes the first reported “incidental” pericardial effusion in a haemodynamically unstable patient sustaining a thoracoabdominal stab wound discovered on a positive ultrasound study. Emergent operative exploration and subsequent workup determined the pericardial fluid to be of infectious origin, rather than traumatic. With the incidence of cocciodiomycosis within endemic geographic regions significantly rising, coccidioidal pericarditis may become an increasingly relevant cause of fluid detected on noninvasive pericardial examination. Keywords: Trauma, Infection, Focussed assessment with sonography for trauma (FAST

Perioperative outcomes in minimally invasive direct coronary artery bypass versus off-pump coronary artery bypass with sternotomy.

Science.gov (United States)

Tekin, Ali İhsan; Arslan, Ümit

2017-09-01

Surgical treatment of isolated left anterior descending coronary artery disease can be performed with either minimally invasive direct coronary artery bypass via a left anterior thoracotomy (MIDCAB) or off-pump coronary artery bypass via a median sternotomy (OPCAB). To compare the perioperative outcomes of patients undergoing MIDCAB or OPCAB surgery. Patients who underwent either MIDCAB or OPCAB for isolated left anterior descending (LAD) coronary artery disease between October 2013 and December 2015 were retrospectively evaluated. Operations were carried out by the same surgical team. Preoperative, intraoperative and postoperative data of the patients were recorded for analyses. Twenty-three patients (7 females, 16 males) underwent MIDCAB surgery, and 24 patients (4 female, 20 males) underwent OPCAB surgery. The two groups were comparable regarding preoperative patient characteristics. Duration of mechanical ventilation (5.1 ±0.7 h vs. 6.6 ±0.9 h), intensive care unit stay (19.4 ±2.5 h vs. 45.8 ±5.4 h) and hospital stay (4.3 ±0.4 days vs. 5.6 ±0.8 days) were significantly shorter in the MIDCAB group (p < 0.01). Patients in the OPCAB group required significantly more blood transfusions (1.83 ±0.38 units vs. 0.17 ±0.38 units) and fresh frozen plasma use (2.33 ±0.96 units vs. 0.69 ±0.76 units) (p < 0.01). Conversion to sternotomy was not required in the MIDCAB group. There was no mortality, conversion to cardiopulmonary bypass or serious complication in either group. We believe that the MIDCAB technique is more advantageous than the OPCAB technique in the treatment of patients with a critical LAD lesion.

EXPERIENCES WITH IDEA PROMOTING INITIATIVES

DEFF Research Database (Denmark)

Gish, Liv

2011-01-01

In new product development a central activity is to provide new ideas. Over the last decades experiences with stimulating employee creativity and establishing idea promoting initiatives have been made in industrial practice. Such initiatives are often labeled Idea Management – a research field...... with a growing interest. In this paper I examine three different idea promoting initiatives carried out in Grundfos, a leading pump manufacturer. In the analysis I address what understandings of idea work are inscribed in the initiatives and what role these initiatives play in the organization with respect...... understandings of idea work are inscribed in the idea promoting initiatives as they to some degree have to fit with the understandings embedded in practice in order to work....

Initial conditions of radiative shock experiments

International Nuclear Information System (INIS)

Kuranz, C. C.; Drake, R. P.; Krauland, C. M.; Marion, D. C.; Grosskopf, M. J.; Rutter, E.; Torralva, B.; Holloway, J. P.; Bingham, D.; Goh, J.; Boehly, T. R.; Sorce, A. T.

2013-01-01

We performed experiments at the Omega Laser Facility to characterize the initial, laser-driven state of a radiative shock experiment. These experiments aimed to measure the shock breakout time from a thin, laser-irradiated Be disk. The data are then used to inform a range of valid model parameters, such as electron flux limiter and polytropic γ, used when simulating radiative shock experiments using radiation hydrodynamics codes. The characterization experiment and the radiative shock experiment use a laser irradiance of ∼7 × 10 14 W cm −2 to launch a shock in the Be disk. A velocity interferometer and a streaked optical pyrometer were used to infer the amount of time for the shock to move through the Be disk. The experimental results were compared with simulation results from the Hyades code, which can be used to model the initial conditions of a radiative shock system using the CRASH code

Anterolateral minithoracotomy versus median sternotomy for the treatment of congenital heart defects: a meta-analysis and systematic review

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Ding Chao

2012-05-01

Full Text Available Abstract Background Anterolateral Minithoracotomy (ALMT for the radical correction of Congenital Heart Defects is an alternative to Median Sternotomy (MS due to reduce operative trauma accelerating recovery and yield a better cosmetic outcome after surgery. Our purpose is to conduct whether ALMT would bring more short-term benefits to patients than conventional Median Sternotomy by using a meta-analysis of case–control study in the published English Journal. Methods 6 case control studies published in English from 1997 to 2011 were identified and synthesized to compare the short-term postoperative outcomes between ALMT and MS. These outcomes were cardiopulmonary bypass time, aortic cross-clamp time, intubation time, intensive care unit stay time, and postoperative hospital stay time. Results ALMT had significantly longer cardiopulmonary bypass times (8.00 min more, 95% CI 0.36 to 15.64 min, p = 0.04. Some evidence proved that aortic cross-clamp time of ALMT was longer, yet not significantly (2.38 min more, 95% CI −0.15 to 4.91 min, p = 0.06. In addition, ALMT had significantly shorter intubation time (1.66 hrs less, 95% CI −3.05 to −0.27 hrs, p = 0.02. Postoperative hospital stay time was significantly shorter with ALMT (1.52 days less, 95% CI −2.71 to −0.33 days, p = 0.01. Some evidence suggested a reduction in ICU stay time in the ALMT group. However, this did not prove to be statistically significant (0.88 days less, 95% CI −0.81 to 0.04 days, p = 0.08. Conclusion ALMT can bring more benefits to patients with Congenital Heart Defects by reducing intubation time and postoperative hospital stay time, though ALMT has longer CPB time and aortic cross-clamp time.

Anterolateral minithoracotomy versus median sternotomy for the treatment of congenital heart defects: a meta-analysis and systematic review.

Science.gov (United States)

Ding, Chao; Wang, Chunmao; Dong, Aiqiang; Kong, Minjian; Jiang, Daming; Tao, Kaiyu; Shen, Zhonghua

2012-05-04

Anterolateral Minithoracotomy (ALMT) for the radical correction of Congenital Heart Defects is an alternative to Median Sternotomy (MS) due to reduce operative trauma accelerating recovery and yield a better cosmetic outcome after surgery. Our purpose is to conduct whether ALMT would bring more short-term benefits to patients than conventional Median Sternotomy by using a meta-analysis of case-control study in the published English Journal. 6 case control studies published in English from 1997 to 2011 were identified and synthesized to compare the short-term postoperative outcomes between ALMT and MS. These outcomes were cardiopulmonary bypass time, aortic cross-clamp time, intubation time, intensive care unit stay time, and postoperative hospital stay time. ALMT had significantly longer cardiopulmonary bypass times (8.00 min more, 95% CI 0.36 to 15.64 min, p = 0.04). Some evidence proved that aortic cross-clamp time of ALMT was longer, yet not significantly (2.38 min more, 95% CI -0.15 to 4.91 min, p = 0.06). In addition, ALMT had significantly shorter intubation time (1.66 hrs less, 95% CI -3.05 to -0.27 hrs, p = 0.02). Postoperative hospital stay time was significantly shorter with ALMT (1.52 days less, 95% CI -2.71 to -0.33 days, p = 0.01). Some evidence suggested a reduction in ICU stay time in the ALMT group. However, this did not prove to be statistically significant (0.88 days less, 95% CI -0.81 to 0.04 days, p = 0.08). ALMT can bring more benefits to patients with Congenital Heart Defects by reducing intubation time and postoperative hospital stay time, though ALMT has longer CPB time and aortic cross-clamp time.

Efficacy of gabapentin versus diclofenac in the treatment of chest pain and paresthesia in patients with sternotomy.

Science.gov (United States)

Biyik, Ismail; Gülcüler, Metin; Karabiga, Murat; Ergene, Oktay; Tayyar, Nezih

2009-10-01

Chronic post-sternotomy chest pain and paresthesia (PCPP) are frequently seen and reduce the quality of life. We aimed to demonstrate the efficacy and safety of gabapentin compared with diclofenac in the treatment of PCPP and to elucidate the similarities of PCPP to neuropathic pain syndromes. The prospective, randomized, open-label, blinded end-point design of study was used. One hundred and ten patients having PCPP lasting three months or more were randomized to receive 800 mg/daily gabapentin (n=55) and 75 mg/daily diclofenac (n=55) for thirty days. All patients have undergone cardiac surgery and median sternotomy. The perception of pain or paresthesia was evaluated as 0--Normal (no pain or paresthesia), 1--Mild, 2--Moderate, 3--Severe at baseline and after thirty days of treatment. Recurrences were questioned after three months. Statistical analyses were performed using independent samples t, Chi-square, continuity correction, Fisher's exact, Mann Whitney U and Kruskal Wallis tests. In gabapentin group, mean pain and paresthesia scores regressed from 2.12+/- 0.76 to 0.54+/- 0.83 (pparesthesia scores regressed in diclofenac group from 1.93+/- 0.8 to 1.0+/- 1.13 (p<0.001) and from 1.76+/- 0.74 to 1.24+/- 0.96 (p=0.002), respectively. Although, both gabapentin and diclofenac were found to be effective without obvious side effects in the treatment of PCPP (p<0.001), gabapentin was found to be superior to diclofenac (p=0.001 and p<0.001, respectively). Adverse effects were seen in 7% of patients on gabapentin and 4% of patients on diclofenac. Results also showed that symptomatic relief with gabapentin lasts longer than diclofenac (p<0.001). Both gabapentin and diclofenac are effective in the treatment of chronic PCPP, without obvious side effects. However, gabapentin is found to be superior to diclofenac and its effects sustain longer. The results show that there may be some evidence in PCPP as a kind of neuropathic pain.

[Plastic surgery of the thoracic wall as a method of thoracic wall reconstruction after complete surgical wound disintegration after sternotomy].

Science.gov (United States)

Hájek, T; Jirásek, K; Urban, M; Straka, Z

1998-12-01

During the period between January 1996 and July 1998 in our department 1920 patients were operated on account of heart disease from median sternotomy. In 17 patients, i.e. in 0.9% during the early postoperative period the surgical wound disintegrated incl. dehiscence of the sternum and the development of postoperative mediastinitis. In 14 of these patients the authors reconstructed the defect of the thoracic wall by their own modification of Jurkiewicz plastic operation using the pectoral muscles. One patient from this group died, in the remaining 13 patients the wound healed without deformity of the chest and without signs of instability, without restriction of movement and function.

Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis.

Science.gov (United States)

Ding, Chao; Jiang, Da-ming; Tao, Kai-yu; Duan, Qun-jun; Li, Jie; Kong, Min-jian; Shen, Zhong-hua; Dong, Ai-qiang

2014-06-01

Mitral valve disease tends to be treated with anterolateral minithoracotomy (ALMT) rather than median sternotomy (MS), as ALMT uses progressively smaller incisions to promote better cosmetic outcomes. This meta-analysis quantifies the effects of ALMT on surgical parameters and post-operative outcomes compared with MS. One randomized controlled study and four case-control studies, published in English from January 1996 to January 2013, were identified and evaluated. ALMT showed a significantly longer cardiopulmonary bypass time (P=0.001) and aortic cross-clamp time (P=0.05) compared with MS. However, the benefits of ALMT were evident as demonstrated by a shorter length of hospital stay (PALMT decreased significantly as compared with MS (P=0.05); however, the incidence of peri-operative mortality (P=0.62), re-operation for bleeding (P=0.37), neurologic events (P=0.77), myocardial infarction (P=0.84), gastrointestinal complications (P=0.89), and renal insufficiency (P=0.67) were similar to these of MS. Long-term follow-up data were also examined, and revealed equivalent survival and freedom from mitral valve events. Current clinical data suggest that ALMT is a safe and effective alternative to the conventional approach and is associated with better short-term outcomes and a trend towards longer survival.

Return to Experience and Initial Wage Level

DEFF Research Database (Denmark)

Sørensen, Kenneth Lykke; Vejlin, Rune Majlund

This paper estimates the relationship between initial wage and return to experience. We use a Mincer-like wage model to nonparametrically estimate this relationship allowing for an unobservable individual permanent effect in wages and unobservable individual return to experience. The relationship...

Return to experience and initial wage level

DEFF Research Database (Denmark)

Sørensen, K.L.; Vejlin, R.

2014-01-01

This paper estimates the relationship between initial wage and return to experience. We use a Mincer-like wage model to non-parametrically estimate this relationship allowing for an unobservable individual permanent effect in wages and unobservable individual return to experience. The relationshi...

Initial state radiation experiment at MAMI

Energy Technology Data Exchange (ETDEWEB)

Mihovilovič, M.; Merkel, H. [Institut für Kernphysik, Johannes Gutenberg-Universität Mainz, Johann-Joachim-Becher-Weg 45, 55128 Mainz (Germany); Collaboration: A1-Collaboration

2013-11-07

In an attempt to contribute further insight into the discrepancy between the Lamb shift and elastic scattering determinations of the proton charge radius, a new experiment at MAMI is underway, aimed at measuring proton form-factors at very low momentum transfers by using a new technique based on initial state radiation. This paper reports on first findings of the pilot measurement performed in 2010, whose main goal was to check the feasibility of the proposed experiment and to recognize and overcome potential obstacles before running the full experiment in 2013.

Photobiomodulation of surgical wound dehiscence in a diabetic individual by low-level laser therapy following median sternotomy

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Snehil Dixit

2013-01-01

Full Text Available In this single case study, we attempt to outline the possible effect of low-level laser therapy (LLLT on delayed wound healing and pain in chronic dehiscent sternotomy of a diabetic individual. The methods that were employed to evaluate changes pre and post irradiation were wound photography, wound area measurement, pressure ulcer scale of healing (PUSH, and visual analogue scale (VAS for pain. After irradiation, proliferation of healthy granulation tissue was observed with decrease in scores of PUSH for sternal dehiscence and VAS for bilateral shoulders and sternal dehiscence. We found that LLLT irradiation could be a novel method of treatment for chronic sternal dehiscence following coronary artery bypass grafting, as it augments wound healing with an early closure of the wound deficit. Hence, this might be translated into an early functional rehabilitation and decreased pain perception of an individual following surgical complication.

Initial Educational Experiences of Tertiary Students. LSAY Briefing Number 14

Science.gov (United States)

Hillman, Kylie

2008-01-01

This "Briefing" presents information about the initial tertiary education experiences, such as satisfaction with aspects of student life and changes to initial enrolments, of two groups of young people, based on two recent Longitudinal Surveys of Australian Youth (LSAY) research reports. One study focused on the first year experiences of…

Initial deuterium pellet experiments on FTU

International Nuclear Information System (INIS)

Snipes, J.A.

1993-01-01

Initial experiments have been performed with the Single Pellet INjector (SPIN) on FTU. SPIN is a two-stage cryogenic deuterium pellet injector capable of injection,a pellets with velocities up to 2.5 km/s. The nominal pellet mass for these experiments was approximately 1 x 10 20 atoms. These initial pellet experiments concentrated on studying pellet penetration under a variety of plasma conditions to compare with code predictions and to examine toroidal particle transport. The principal diagnostics used were two fast (∼1 μsec) photomultiplier tubes at nearly opposite toroidal locations with H α (D α ) interference filters (λ = 656 nm), a microwave cavity for pellet mass and velocity, a vertical array of soft x ray diodes without filters looking down onto the pellet, a DCN interferometer for electron density profiles, and a Michelson ECE system for electron temperature profiles. The time integral of the absolutely calibrated fast H α signal appears to give reasonable agreement with the expected pellet mass. Toroidal transport of deuterium ions from the pellet to nearly the opposite side of the tokamak agrees with calculated thermal deuterium velocities near the plasma edge. Comparison of the experimental results with code calculations using the Neutral Gas Shielding model show good agreement for the post-pellet electron temperature and density profiles and the H α profiles in some cases. Calculated penetration distances agree within 20%

Emergent Median Sternotomy for Mediastinal Hematoma: A Rare Complication following Internal Jugular Vein Catheterization for Chemoport Insertion—A Case Report and Review of Relevant Literature

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Saptarshi Biswas

2014-01-01

Full Text Available Mediastinal hematoma is a rare complication following insertion of a central venous catheter with only few cases reported in the English literature. We report a case of a 71-year-old female who was admitted for elective chemoport placement. USG guided right internal jugular access was attempted using the Seldinger technique. Resistance was met while threading the guidewire. USG showed a chronic clot burden in the RIJ. A microvascular access was established under fluoroscopic guidance. Rest of the procedure was completed without any further issues. Following extubation, the patient complained of right-sided chest pain radiating to the back. Chest X-ray revealed a contained white out in the right upper lung field. She became hemodynamically unstable. Repeated X-ray showed progression of the hematoma. Median Sternotomy showed posterior mediastinal hematoma tracking into right pleural cavity. Active bleeding from the puncture site at RIJ-SCL junction was repaired. Patient had an uneventful recovery. Injury to the central venous system is the result of either penetrating trauma or iatrogenic causes as in our case. A possible explanation of our complication may be attributed to the forced manipulation of the dilator or guidewire against resistance. Clavicle and sternum offer bony protection to the underlying vital venous structures and injuries often need sternotomy with or without neck extension. Division of the clavicle and disarticulation of the sternoclavicular joint may be required for optimum exposure. Meticulous surgical technique, knowledge of the possible complications, and close monitoring in the postprocedural period are of utmost importance. Chest X-ray showed to be routinely done to detect any complication early.

Initial Results from Coaxial Helicity Injection Experiments in NSTX

International Nuclear Information System (INIS)

Raman, R.; Jarboe, T.R.; Mueller, D.; Schaffer, M.J.; Maqueda, R.; Nelson, B.A.; Sabbagh, S.; Bell, M.; Ewig, R.; Fredrickson, E.; Gates, D.; Hosea, J.; Ji, H.; Kaita, R.; Kaye, S.M.; Kugel, H.; Maingi, R.; Menard, J.; Ono, M.; Orvis, D.; Paolette, F.; Paul, S.; Peng, M.; Skinner, C.H.; Wilgen, W.; Zweben, S.

2001-01-01

Coaxial Helicity Injection (CHI) has been investigated on the National Spherical Torus Experiment (NSTX). Initial experiments produced 130 kA of toroidal current without the use of the central solenoid. The corresponding injector current was 20 kA. Discharges with pulse lengths up to 130 ms have been produced

Magnetohydrodynamic simulation of solid-deuterium-initiated Z-pinch experiments

International Nuclear Information System (INIS)

Sheehey, P.T.

1994-02-01

Solid-deuterium-initiated Z-pinch experiments are numerically simulated using a two-dimensional resistive magnetohydrodynamic model, which includes many important experimental details, such as ''cold-start'' initial conditions, thermal conduction, radiative energy loss, actual discharge current vs. time, and grids of sufficient size and resolution to allow realistic development of the plasma. The alternating-direction-implicit numerical technique used meets the substantial demands presented by such a computational task. Simulations of fiber-initiated experiments show that when the fiber becomes fully ionized rapidly developing m=0 instabilities, which originated in the coronal plasma generated from the ablating fiber, drive intense non-uniform heating and rapid expansion of the plasma column. The possibility that inclusion of additional physical effects would improve stability is explored. Finite-Larmor-radius-ordered Hall and diamagnetic pressure terms in the magnetic field evolution equation, corresponding energy equation terms, and separate ion and electron energy equations are included; these do not change the basic results. Model diagnostics, such as shadowgrams and interferograms, generated from simulation results, are in good agreement with experiment. Two alternative experimental approaches are explored: high-current magnetic implosion of hollow cylindrical deuterium shells, and ''plasma-on-wire'' (POW) implosion of low-density plasma onto a central deuterium fiber. By minimizing instability problems, these techniques may allow attainment of higher temperatures and densities than possible with bare fiber-initiated Z-pinches. Conditions for significant D-D or D-T fusion neutron production may be realizable with these implosion-based approaches

The experiences of employees participating in organisational corporate social responsibility initiatives

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Gretha Cook

2018-04-01

Full Text Available Orientation: This article is about the experiences of employees who actively participate in organisational corporate social responsibility (CSR initiatives.   Research purpose: The general aim of this study was to explore the experiences of employees who participate in CSR initiatives within an organisation where a well-developed framework exists.   Motivation for the study: Whilst an emergent number of studies have considered the various dimensions of CSR initiatives, the focus appears to be on stakeholders such as the recipients of CSR, organisations, consumers and shareholders but not the perspective of the employees who actively participate in CSR initiatives.   Research design, approach and method: A qualitative research approach was employed with the intent of exploring the experiences of employees participating in organisational CSR initiatives. Data were collected and analysed from a purposive sample of 12 employees, by means of interactive qualitative analysis.   Main findings: The study revealed that the primary driver that motivates employees to participate in CSR is love. Love sparks a sense of compassion. Compassion, coupled with an enabling environment, stimulates generosity. By being generous, a feeling of hope and inspiration is induced in both the givers and receivers of generosity. A secondary outcome of generosity and hope and inspiration is bringing about change to others, and whilst going through this journey and making a difference in the lives of others, participants experience a progressive change within themselves. This change evokes a feeling of fulfilment, and ultimately a feeling of complete joy.   Contributions or value-add: This research complements existing CSR literature by focussing and reporting on the experiences of the employee as an important stakeholder.

Limited access atrial septal defect closure and the evolution of minimally invasive surgery.

Science.gov (United States)

Izzat, M B; Yim, A P; El-Zufari, M H

1998-04-01

While minimizing the "invasiveness" in general surgery has been equated with minimizing "access", what constitutes minimally invasive intra-cardiac surgery remains controversial. Many surgeons doubt the benefits of minimizing access when the need for cardiopulmonary bypass cannot be waived. Recognizing that median sternotomy itself does entail significant morbidity, we investigated the value of alternative approaches to median sternotomy using atrial septal defect closure as our investigative model. We believe that some, but not all minimal access approaches are associated with reduced postoperative morbidity and enhanced recovery. Our current strategy is to use a mini-sternotomy approach in adult patients, whereas conventional median sternotomy remains our standard approach in the pediatric population. Considerable clinical experiences coupled with documented clinical benefits are fundamental before a certain approach is adopted in routine practice.

Reliability of sternal instability scale (SIS) for transverse sternotomy in lung transplantation (LTX).

Science.gov (United States)

Fuller, Louise M; El-Ansary, Doa; Button, Brenda; Bondarenko, Janet; Marasco, Silvana; Snell, Greg; Holland, Anne E

2018-01-25

A surgical incision for bilateral sequential lung transplantation (BSLTX) is the "clam shell" (CSI) approach via bilateral anterior thoracotomies and a transverse sternotomy to allow for sequential replacement of the lungs. This can be associated with significant post-operative pain, bony overriding or sternal instability. The sternal instability scale (SIS) is a non-invasive manual assessment tool that can be used to detect early bony non-union or instability following CSI; however, its reliability is unknown. This prospective blinded reliability study aimed to assess intra-rater and inter-rater reliability of the SIS following lung transplantation. Participants post BSLTX aged older than 18 years underwent sternal assessment utilizing the SIS. Two assessors examined the sternum using a standardized protocol at two separate time points with a test-re-test time of 48 hours. The outcome measure was SIS tool using four categories from 0 (clinically stable) to 3 (separated sternum with overriding). In total, 20 participants (75% female) with a mean age of 48 years (SD 17) and mean pain score of 3 out of 10 were included, 60% having well healed wounds and 25% reporting symptoms of sternal clicking. The most painful self-reported painful activity was coughing. The SIS demonstrated excellent reliability with a kappa = 0.91 by different assessors on the same day, and kappa = 0.83 for assessments by the same assessor on different days. The SIS is a reliable manual assessment tool for evaluation of sternal instability after CSI following BSLTX and may facilitate the timely detection and management of sternal instability.

Initially curved microplates under electrostatic actuation: theory and experiment

KAUST Repository

Saghir, Shahid; Bellaredj, Mohammed Lamine Faycal; Ramini, Abdallah; Younis, Mohammad I.

2016-01-01

Microplates are the building blocks of many micro-electro-mechanical systems. It is common for them to experience initial curvature imperfection due to residual stresses caused by the micro fabrication process. Such plates are essentially different

Scintigraphic imaging with technetium-99M-labelled ceftizoxime is a reliable technique for the diagnosis of deep sternal wound infection in rats

Energy Technology Data Exchange (ETDEWEB)

Costa, Paulo Henrique Nogueira; Diniz, Simone Odilia Fernandes; Cardoso, Valbert Nascimento; Tarabal, Bernardo; Takenaka, Isabella; Braga, Otavio; Vidigal, Paula Vieira Teixeira; Gelape, Claudio Leo; Araujo, Ivana Duval, E-mail: phnc@uol.com.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil)

2015-07-01

Purpose: to evaluate whether scintigraphy with technetium-99m-labeled ceftizoxime ({sup 99m}Tc-CFT) can differentiate mediastinitis from aseptic inflammation associated with sternotomy. Methods: twenty female Wistar rats were randomly distributed into four groups: S (control) -partial upper median sternotomy with no treatment; SW (control) - sternotomy and treatment of sternal wounds with bone wax; SB - sternotomy and infection with Staphylococcus aureus; SWB - sternotomy with bone wax treatment and bacterial infection. Scintigraphy with {sup 99m}Tc-CFT was performed eight days after surgery and images were collected 210 and 360 min after infusion of the radiopharmaceutical. Results: no animals exhibited clinical signs of wound infection at the end of the experiment, although histological data verified acute inflammatory response in those experimentally infected with bacteria. Scintigraphic images revealed that tropism of {sup 99m}Tc-CFT to infected sternums was greater than to their non-infected counterparts. Mean counts of radioactivity in bacteria-infected sternal regions (SB and SWB) were significantly higher (p = 0.0007) than those of the respective controls (S and SW).Conclusion: scintigraphy with technetium-99m-labeled ceftizoxime is a method that can potentially detect infection post sternotomy and differentiate from aseptic inflammation in animals experimentally inoculated with S. aureus (author)

Initial experiences of family caregivers of survivors of a traumatic brain injury

Directory of Open Access Journals (Sweden)

Mandi Broodryk

2015-08-01

Full Text Available Background: There seems to be a paucity of research on the initial subjective experiences of family caregivers of survivors of a traumatic brain injury (TBI. Objective: To explore the challenges that family caregivers face during the initial stages of recovery of a relative who has sustained a TBI. Methods: Thematic analysis was used to explore the findings from semi-structured interviews that were conducted with 12 female family caregivers of relatives who had sustained a TBI. Results: Family caregivers recalled their initial experiences of the shock at hearing the news about their relative’s TBI, negative experiences in hospital and frustrating interactions with healthcare professionals as particularly challenging. Conclusion: The findings of this study emphasise caregivers’ need for support, information and psycho-education, especially from healthcare professionals, from the very beginning stages of recovery from a TBI. Practical and physical needs with regard to admission to and care in the hospital were also highlighted. This research will hopefully contribute to creating awareness amongst healthcare professionals on how they can contribute to improvement of the services provided by the healthcare system based on the experiences of the caregivers who participated in this study.

British Isles Field Experience: An Initiative in International Education.

Science.gov (United States)

Martin, William J.

The British Isles Field Experience (BIFE) program was initiated at Williamsport Area Community College (WACC) to provide a group of WACC faculty and staff members with individual and group activities of a personal, professional, and cultural nature in order to promote an international perspective that can be infused into student, collegiate, and…

Clinical outcomes of CO2-less single-port video-assisted thoracoscopic thymectomy versus open thymectomy: comparative study.

Science.gov (United States)

Aragón, Javier; Pérez Méndez, Itzell; Gutiérrez Pérez, Alexia

2016-01-01

results regarding thymectomy for the treatment of MG were established by the MG post-intervention status [complete stable remission (CSR), pharmacologic remission, minimal manifestations, improved, unchanged and worse exacerbation, and died of MG] and reflected similar results in both approaches. CO 2 -less VATS single-port thymectomy is a feasible and safe procedure. Oncologic outcomes are similar to open approaches. Complications, surgical time and hospital stay are shorter compared with sternotomy. This is an initial experience, further work is required to evaluate long-term results.

The initial experience of trans-rectal ultrasound and biopsy in ...

African Journals Online (AJOL)

The initial experience of trans-rectal ultrasound and biopsy in diagnosis of carcinoma prostate in Gezira Hospital for Renal Disease and Surgery (GHRDS). Walaa Eldin Ibraheem, Sami Mahjoub Taha, Mustafa Omran Mansour, Mohammed El Imam Mohamed Ahmed ...

Initial experience with the NRC significance determination process

International Nuclear Information System (INIS)

Madison, A.L.

2001-01-01

The U.S. Nuclear Regulatory Commission (NRC) has revamped its inspection, assessment, and enforcement programs for commercial nuclear power plants. The new oversight process uses more objective, timely, and safety-significant criteria in assessing performance, while seeking to more effectively and efficiently regulate the industry. The NRC tested the new process at thirteen reactors at nine sites across the country on a pilot basis in 1999 to identify what things worked well and what improvements were called for before beginning Initial Implementation at all US nuclear power plants on April 2, 2000. After a year of experience has been gained with the new oversight process at all US plants, the NRC anticipates making further improvements based on this wider experience. (author)

Initial experience with the NRC significance determination process

Energy Technology Data Exchange (ETDEWEB)

Madison, A.L. [Office of Nuclear Reactor Regulation, US Nuclear Regulatory Commission (United States)

2001-07-01

The U.S. Nuclear Regulatory Commission (NRC) has revamped its inspection, assessment, and enforcement programs for commercial nuclear power plants. The new oversight process uses more objective, timely, and safety-significant criteria in assessing performance, while seeking to more effectively and efficiently regulate the industry. The NRC tested the new process at thirteen reactors at nine sites across the country on a pilot basis in 1999 to identify what things worked well and what improvements were called for before beginning Initial Implementation at all US nuclear power plants on April 2, 2000. After a year of experience has been gained with the new oversight process at all US plants, the NRC anticipates making further improvements based on this wider experience. (author)

Robotic mitral valve operations by experienced surgeons are cost-neutral and durable at 1 year.

Science.gov (United States)

Coyan, Garrett; Wei, Lawrence M; Althouse, Andrew; Roberts, Harold G; Schauble, Drew; Murashita, Takashi; Cook, Chris C; Rankin, J Scott; Badhwar, Vinay

2018-04-12

Robotic mitral valve surgery has potential advantages in patient satisfaction and 30-day outcome. Cost concerns and repair durability limit wider adoption of robotic technology. This study examined detailed cost differences between robotic and sternotomy techniques in relation to outcomes and durability following robotic mitral program initiation. Between April 2013 and October 2015, 30-day and 1-year outcomes of 328 consecutive patients undergoing robotic or sternotomy mitral valve repair or replacement by experienced surgeons were examined. Multivariable logistic regression informed propensity matching to derive a cohort of 182 patients. Echocardiographic follow-up was completed at 1 year in all robotic patients. Detailed activity-based cost accounting was applied to include direct, semidirect, and indirect costs with special respect to robotic depreciation, maintenance, and supplies. A quantitative analysis of all hospital costs was applied directly to each patient encounter for comparative financial analyses. Mean predicted risk of mortality was similar in both the robotic (n = 91) and sternotomy (n = 91) groups (0.9% vs 0.8%; P > .431). The total costs of robotic mitral operations were similar to those of sternotomy ($27,662 vs $28,241; P = .273). Early direct costs were higher in the robotic group. There was a marked increase in late indirect cost with the sternotomy cohort related to increased length of stay, transfusion requirements, and readmission rates. Robotic repair technique was associated with no echocardiographic recurrence greater than trace to only mild regurgitation at 1 year. Experienced mitral surgeons can initiate a robotic program in a cost-neutral manner that maintains clinical outcome integrity as well as repair durability. Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Minimally invasive or interventional repair of atrial septal defects in children: experience in 171 cases and comparison with conventional strategies.

Science.gov (United States)

Formigari, R; Di Donato, R M; Mazzera, E; Carotti, A; Rinelli, G; Parisi, F; Pasquini, L; Ballerini, L

2001-05-01

The goal of this study was to evaluate percutaneous interventional and minimally invasive surgical closure of secundum atrial septal defect (ASD) in children. Concern has surrounded abandoning conventional midline sternotomy in favor of the less invasive approaches pursuing a better cosmetic result and a more rational resource utilization. A retrospective analysis was performed on the patients treated from June 1996 to December 1998. One hundred seventy-one children (median age 5.8 years, median weight 22.1 kg) underwent 52 device implants, 72 minimally invasive surgical operations and 50 conventional sternotomy operations. There were no deaths and no residual left to right shunt in any of the groups. The overall complication rate causing delayed discharge was 12.6% for minimally invasive surgery, 12.0% for midline sternotomy and 3.8% for transcatheter device closure (p appeal of the percutaneous and minimally invasive approaches must be weighed against their greater exposure to technical pitfalls. Adequate training is needed if a strategy of surgical or percutaneous minimally invasive closure of ASD in children is planned in place of conventional surgery.

Preliminary results from initial in-pile debris bed experiments

International Nuclear Information System (INIS)

Rivard, J.B.

1977-01-01

An accident in a liquid metal fast breeder reactor (LMFBR) in which molten core material is suddenly quenched with subcooled liquid sodium could result in extensive fragmentation and dispersal of fuel as subcritical beds of frozen particulate debris within the reactor vessel. Since this debris will continue to generate power due to decay of retained fission products, containment of the debris is threatened if the generated heat is not removed. Therefore, the initial safety question is the capacity which debris beds may have for transfer of the decay heat to overlying liquid sodium by natural processes--i.e., without the aid of forced circulation of the coolant. Up to the present time, all experiments on debris bed behavior either have used substitute materials (e.g., sand and water) or have employed actual materials, but atypical heating methods. Increased confidence in the applicability of debris bed simulations is afforded if the heat is generated within the fuel component of the appropriate fast reactor materials. The initial series of in-pile tests reported on herein constitutes the first experiments in which the internal heating mode has been produced in particulate oxide fuel immersed in liquid sodium. Fission heating of the fully-enriched UO 2 in the experiment while it is contained within Sandia Laboratories Annular Core Pulse Reactor (ACPR), operating in its steady-state mode, approximates the decay heating of debris. Preliminary results are discussed

Analysis of molten fuel-coolant interaction during a reactivity-initiated accident experiment

International Nuclear Information System (INIS)

El-Genk, M.S.; Hobbins, R.R.

1981-01-01

The results of a reactivity-initiated accident experiment, designated RIA-ST-4, are discussed and analyzed with regard to molten fuel-coolant interaction (MFCI). In this experiment, extensive amounts of molten UO 2 fuel and zircaloy cladding were produced and fragmented upon mixing with the coolant. Coolant pressurization up to 35 MPa and coolant overheating in excess of 940 K occurred after fuel rod failure. The initial coolant conditions were similar to those in boiling water reactors during a hot startup (that is, coolant pressure of 6.45 MPa, coolant temperature of 538 K, and coolant flow rate of 85 cm 3 /s). It is concluded that the high coolant pressure recorded in the RIA-ST-4 experiment was caused by an energetic MFCI and was not due to gas release from the test rod at failure, Zr/water reaction, or to UO 2 fuel vapor pressure. The high coolant temperature indicated the presence of superheated steam, which may have formed during the expansion of the working fluid back to the initial coolant pressure; yet, the thermal-to-mechanical energy conversion ratio is estimated to be only 0.3%

Initial acceptance test experience with FFTF plant equipment

International Nuclear Information System (INIS)

Brown, R.K.; Coleman, K.A.; Mahaffey, M.K.; McCargar, C.G.; Young, M.W.

1978-09-01

The purpose of this paper is to examine the initial acceptance test experience of certain pieces of auxiliary equipment of the Fast Flux Test Facility (FFTF). The scope focuses on the DHX blowers and drive train, inert gas blowers, H and V containment isolation valves, and the Surveillance and In-service Inspection (SISI) transporter and trolley. For each type of equipment, the discussion includes a summary of the design and system function, installation history, preoperational acceptance testing procedures and results, and unusual events and resolutions

The Community Reclaims Control? Learning Experiences from Rural Broadband Initiatives in the Netherlands

NARCIS (Netherlands)

Salemink, Koen; Strijker, Dirk; Bosworth, Gary

2017-01-01

Based on four illustrative case studies from the Netherlands, this article discusses learning experiences gained from rural broadband initiatives. As an example of the big society' (or participatiesamenleving' in Dutch), initiatives try to step in where the market and the government fail. The main

"Elite" Career-Changers and Their Experience of Initial Teacher Education

Science.gov (United States)

Wilkins, Chris

2017-01-01

This study explores the motivation of "high-status" professionals to change career and enter teaching, and their experience of undertaking initial teacher education (ITE) programmes in England. The study builds on previous research which found that career-changers are disproportionately more likely to fail to complete their ITE studies,…

Dynamic crack initiation toughness : experiments and peridynamic modeling.

Energy Technology Data Exchange (ETDEWEB)

Foster, John T.

2009-10-01

This is a dissertation on research conducted studying the dynamic crack initiation toughness of a 4340 steel. Researchers have been conducting experimental testing of dynamic crack initiation toughness, K{sub Ic}, for many years, using many experimental techniques with vastly different trends in the results when reporting K{sub Ic} as a function of loading rate. The dissertation describes a novel experimental technique for measuring K{sub Ic} in metals using the Kolsky bar. The method borrows from improvements made in recent years in traditional Kolsky bar testing by using pulse shaping techniques to ensure a constant loading rate applied to the sample before crack initiation. Dynamic crack initiation measurements were reported on a 4340 steel at two different loading rates. The steel was shown to exhibit a rate dependence, with the recorded values of K{sub Ic} being much higher at the higher loading rate. Using the knowledge of this rate dependence as a motivation in attempting to model the fracture events, a viscoplastic constitutive model was implemented into a peridynamic computational mechanics code. Peridynamics is a newly developed theory in solid mechanics that replaces the classical partial differential equations of motion with integral-differential equations which do not require the existence of spatial derivatives in the displacement field. This allows for the straightforward modeling of unguided crack initiation and growth. To date, peridynamic implementations have used severely restricted constitutive models. This research represents the first implementation of a complex material model and its validation. After showing results comparing deformations to experimental Taylor anvil impact for the viscoplastic material model, a novel failure criterion is introduced to model the dynamic crack initiation toughness experiments. The failure model is based on an energy criterion and uses the K{sub Ic} values recorded experimentally as an input. The failure model

Blast experiments for the derivation of initial cloud dimensions after a ''Dirty Bomb'' event

International Nuclear Information System (INIS)

Thielen, H.; Schroedl, E.

2004-01-01

Basis for the assessment of potential consequences of a ''dirty bomb'' event is the calculation of the atmospheric dispersion of airborne particles. The empirical derivation of parameters for the estimation of the initial pollutant cloud dimensions was the principal purpose for blast experiments performed in the training area Munster in summer 2003 with the participation of several highly engaged German organisations and institutions. The experiments were performed under variation of parameters like mass and kind of explosive, subsurface characteristics or meteorological conditions and were documented by digital video recording. The blasting experiments supplied significant results under reproducible conditions. The initial cloud dimension was primarily influenced by the explosive mass. The influence of other parameters was relatively small and within the range of the experimental uncertainties. Based on these experimental results a new correlation was determined for the empirical estimation of the initial cloud dimensions as a function of explosive mass. The observed initial cloud volumes were more than an order of magnitude smaller than those calculated with other widely-used formulas (e.g. HOTSPOT). As a smaller volume of the initial cloud leads to higher near-ground concentration maxima, our results support an appropriate adjustment of currently employed calculation methods. (orig.)

Disseminating Adamantinoma of the Tibia

Directory of Open Access Journals (Sweden)

Albert N. Van Geel

1997-01-01

19 years after the initial treatment. Lung metastasectomy by sternotomy was carried out twice in a period of over 312 years. The patient is currently alive without evidence of other metastatic disease.

Comparison of the initial ETA gas propagation experiments with theoretical models

Energy Technology Data Exchange (ETDEWEB)

Chambers, F.W.; Clark, J.C.; Fessenden, T.J.

1982-04-20

This report contains a description of the initial ETA propagation experiments in air at a beam current of 4.5 kA. The beam was observed to propagate at the pressures anticipated on the basis of previous theory and experiment. A comparison of measured net current waveforms with predictions of the PHOENIX code showed good agreement over the pressure range 0.1 to 200 torr. However, the beam was observed to expand with Z at a faster rate than theory predicts. Excessive transverse beam modulation at injection complicated the experiments and limited their comparison with theory.

Comparison of the initial ETA gas propagation experiments with theoretical models

International Nuclear Information System (INIS)

Chambers, F.W.; Clark, J.C.; Fessenden, T.J.

1982-01-01

This report contains a description of the initial ETA propagation experiments in air at a beam current of 4.5 kA. The beam was observed to propagate at the pressures anticipated on the basis of previous theory and experiment. A comparison of measured net current waveforms with predictions of the PHOENIX code showed good agreement over the pressure range 0.1 to 200 torr. However, the beam was observed to expand with Z at a faster rate than theory predicts. Excessive transverse beam modulation at injection complicated the experiments and limited their comparison with theory

Shock initiation experiments on ratchet grown PBX 9502

Energy Technology Data Exchange (ETDEWEB)

Gustavsen, Richard L [Los Alamos National Laboratory; Thompson, Darla G [Los Alamos National Laboratory; Olinger, Barton W [Los Alamos National Laboratory; Deluca, Racci [Los Alamos National Laboratory; Bartram, Brian D [Los Alamos National Laboratory; Pierce, Timothy H [Los Alamos National Laboratory; Sanchez, Nathaniel J [Los Alamos National Laboratory

2010-01-01

This study compares the shock initiation behavior of PBX 9502 pressed to less than nominal density (nominal density is 1.890 {+-} 0.005 g/cm{sup 3}) with PBX 9502 pressed to nominal density and then ''ratchet grown'' to low density. PBX 9502 is an insensitive plastic bonded explosive consisting of 95 weight % dry-aminated tri-amino-tri-nitro-benzene (TATB) and 5 weight % Kel-F 800 plastic binder. ''Ratchet growth'' - an irreversible increase in specific volume - occurs when an explosive based on TATB is temperature cycled. The design of our study is as follows: PBX 9502, all from the same lot, received the following four treatments. Samples in the first group were pressed to less than nominal density. These were not ratchet grown and used as a baseline. Samples in the second group were pressed to nominal density and then ratchet grown by temperature cycling 30 times between -54 C and +80 C. Samples in the final group were pressed to nominal density and cut into 100 mm by 25.4 mm diameter cylinders. During thermal cycling the cylinders were axially constrained by a 100 psi load. Samples for shock initiation experiments were cut perpendicular (disks) and parallel (slabs) to the axial load. The four sample groups can be summarized with the terms pressed low, ratchet grown/no load, axial load/disks, and axial load/slabs. All samples were shock initiated with nearly identical inputs in plate impact experiments carried out on a gas gun. Wave profiles were measured after propagation through 3, 4, 5, and 6 mm of explosive. Side by side comparison of wave profiles from different samples is used as a measure of relative sensitivity. All reduced density samples were more shock sensitive than nominal density PBX 9502. Differences in shock sensitivity between ratchet grown and pressed to low density PBX 9502 were small, but the low density pressings are slightly more sensitive than the ratchet grown samples.

HDR brachytherapy in carcinoma of cervix: initial experience at AWARE hospitals

International Nuclear Information System (INIS)

Rajendran, M.; Reddy, K.D.; Reddy, R.M.; Reddy, J.M.; Reddy, B.V.N.; Kiran Kumar; Gopi, S.; Dharaniraj; Janardhanan

2002-01-01

High dose rate (HDR) brachytherapy is well established in the management of gynaecological malignancies. A report on the initial results of one and half year experience with a consistent dose/fractionation schedule and procedure of planning with delivery of treatment schedule is presented

Commissioning and initial experimental program of the BGO-OD experiment at ELSA

Science.gov (United States)

Alef, S.; Bauer, P.; Bayadilov, D.; Beck, R.; Becker, M.; Bella, A.; Bielefeldt, P.; Böse, S.; Braghieri, A.; Brinkmann, K.; Cole, P.; Di Salvo, R.; Dutz, H.; Elsner, D.; Fantini, A.; Freyermuth, O.; Friedrich, S.; Frommberger, F.; Ganenko, V.; Geffers, D.; Gervino, G.; Ghio, F.; Görtz, S.; Gridnev, A.; Gutz, E.; Hammann, D.; Hannappel, J.; Hillert, W.; Ignatov, A.; Jahn, R.; Joosten, R.; Jude, T. C.; Klein, F.; Knaust, J.; Kohl, K.; Koop, K.; Krusche, B.; Lapik, A.; Levi Sandri, P.; Lopatin, I. V.; Mandaglio, G.; Messi, F.; Messi, R.; Metag, V.; Moricciani, D.; Mushkarenkov, A.; Nanova, M.; Nedorezov, V.; Novinskiy, D.; Pedroni, P.; Reitz, B.; Romaniuk, M.; Rostomyan, T.; Rudnev, N.; Schaerf, C.; Scheluchin, G.; Schmieden, H.; Stugelev, A.; Sumachev, V.; Tarakanov, V.; Vegna, V.; Walther, D.; Watts, D.; Zaunick, H.; Zimmermann, T.

2016-11-01

BGO-OD is a new meson photoproduction experiment at the ELSA facility of Bonn University. It aims at the investigation of non strange and strange baryon excitations, and is especially designed to be able to detect weekly bound meson-baryon type structures. The setup for the BGO-OD experiment is presented, the characteristics of the photon beam and the detector performances are shown and the initial experimental program is discussed.

Initial experience of tritium exposure control at JET

International Nuclear Information System (INIS)

Patel, B.; Campling, D.C.; Schofield, P.A.; Macheta, P.; Sandland, K.

1998-01-01

Some of the safety procedures and controls in place for work with tritium are described, and initial operational experience of handling tritium is discussed. A description is given of work to rectify a water leak in a JET neutral beam heating component, which involved man-access to a confined volume to perform repairs, at tritium levels about 100 DAC (80 MBq/m 3 . HTO). Control measures involving use of purge and extract ventilation, and of personal protection using air-fed pressurized suits are described. Results are given of the internal doses to project staff and of atmospheric discharges of tritium during the repair outage. (P.A.)

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

Science.gov (United States)

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

2018-05-24

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

Early outcome of mini aortic valve replacement surgery

Directory of Open Access Journals (Sweden)

Shawky Fareed

2018-03-01

appearance, and more cost effective. Conclusions: Limited upper sternotomy minimally invasive technique for aortic valve replacement provides excellent exposure of the aortic valve and offers a better cosmetic scar. In addition, minimally invasive limited upper sternotomy is as safe as full median sternotomy for aortic valve surgery, with fewer complications and postoperative pain, less ICU and hospital stay, fast recovery to work with limited movement restriction after surgery. It is better to use the limited upper sternotomy incision as an initial approach for aortic valve surgery. Keywords: Minimally invasive limited upper sternotomy, Aortic valve surgery, Median sternotomy

A randomized multicenter trial of minimally invasive rapid deployment versus conventional full sternotomy aortic valve replacement.

Science.gov (United States)

Borger, Michael A; Moustafine, Vadim; Conradi, Lenard; Knosalla, Christoph; Richter, Markus; Merk, Denis R; Doenst, Torsten; Hammerschmidt, Robert; Treede, Hendrik; Dohmen, Pascal; Strauch, Justus T

2015-01-01

Minimally invasive surgical procedures (MIS) may offer several advantages over conventional full sternotomy (FS) aortic valve replacement (AVR). A novel class of aortic valve prostheses has been developed for rapid-deployment AVR (RDAVR). We report a randomized, multicenter trial comparing the outcomes for MIS-RDAVR with those of conventional FS-AVR. A total of 100 patients with aortic stenosis were enrolled in a prospective, multicenter, randomized comparison trial (CADENCE-MIS). Exclusion criteria included ejection fraction below 25%, AVR requiring concomitant procedures, and recent myocardial infarction or stroke. Patients were randomized to undergo MIS-RDAVR through an upper hemisternotomy (n = 51) or AVR by FS with a conventional stented bioprosthesis (n = 49). Three patients were excluded before the procedure, and 3 more patients who were randomized to undergo RDAVR were excluded because of their anatomy. Procedural, early clinical outcomes, and functional outcomes were assessed for the remaining 94 patients. Hemodynamic performance was assessed by an echocardiography core laboratory. Implanted valve sizes were similar between groups (22.9 ± 2.1 vs 23.0 ± 2.1 mm, p = 0.9). MIS-RDAVR was associated with significantly reduced aortic cross-clamp times compared with FS-AVR (41.3 ± 20.3 vs 54.0 ± 20.3 minutes, p quality of life measures. The RDAVR patients had a significantly lower mean transvalvular gradient (8.5 vs 10.3 mm Hg, p = 0.044) and a lower prevalence of patient-prosthesis mismatch (0% vs 15.0%, p = 0.013) 3 months postoperatively compared with the FS-AVR patients. RDAVR by the MIS approach is associated with significantly reduced myocardial ischemic time and better valvular hemodynamic function than FS-AVR with a conventional stented bioprosthesis. Rapid deployment valves may facilitate the performance of MIS-AVR. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

The Relationship of a Pilot's Educational Background, Aeronautical Experience and Recency of Experience to Performance In Initial Training at a Regional Airline

Science.gov (United States)

Shane, Nancy R.

The purpose of this study was to determine how a pilot's educational background, aeronautical experience and recency of experience relate to their performance during initial training at a regional airline. Results show that variables in pilots' educational background, aeronautical experience and recency of experience do predict performance in training. The most significant predictors include years since graduation from college, multi-engine time, total time and whether or not a pilot had military flying experience. Due to the pilot shortage, the pilots entering regional airline training classes since August 2013 have varied backgrounds, aeronautical experience and recency of experience. As explained by Edward Thorndike's law of exercise and the law of recency, pilots who are actively using their aeronautical knowledge and exercising their flying skills should exhibit strong performance in those areas and pilots who have not been actively using their aeronautical knowledge and exercising their flying skills should exhibit degraded performance in those areas. Through correlation, chi-square and multiple regression analysis, this study tests this theory as it relates to performance in initial training at a regional airline.

Initially curved microplates under electrostatic actuation: theory and experiment

KAUST Repository

Saghir, Shahid

2016-07-01

Microplates are the building blocks of many micro-electro-mechanical systems. It is common for them to experience initial curvature imperfection due to residual stresses caused by the micro fabrication process. Such plates are essentially different from perfectly flat ones and cannot be modeled using flat plate models. In this paper, we adopt a dynamic analog of the von Karman governing equations of imperfect plates. These equations are then used to develop a reduced order model based on the Galerkin procedure, to simulate the static and dynamic behavior of the microplate under electrostatic actuation. To validate the simulation results, an initially curved imperfect microplate made of silicon nitride is fabricated and tested. The static behaviour of the microplate is investigated when applying a DC voltage Vdc. Then, the dynamic behaviour of the microplate is examined under the application of a harmonic AC voltage, Vac, superimposed to Vdc. The simulation results show good agreement with the experimentally measured responses. © 2016 IOP Publishing Ltd.

[Evaluation of the influence of humidity and temperature on the drug stability by initial average rate experiment].

Science.gov (United States)

He, Ning; Sun, Hechun; Dai, Miaomiao

2014-05-01

To evaluate the influence of temperature and humidity on the drug stability by initial average rate experiment, and to obtained the kinetic parameters. The effect of concentration error, drug degradation extent, humidity and temperature numbers, humidity and temperature range, and average humidity and temperature on the accuracy and precision of kinetic parameters in the initial average rate experiment was explored. The stability of vitamin C, as a solid state model, was investigated by an initial average rate experiment. Under the same experimental conditions, the kinetic parameters obtained from this proposed method were comparable to those from classical isothermal experiment at constant humidity. The estimates were more accurate and precise by controlling the extent of drug degradation, changing humidity and temperature range, or by setting the average temperature closer to room temperature. Compared with isothermal experiments at constant humidity, our proposed method saves time, labor, and materials.

African American women's experiences with the initial discovery, diagnosis, and treatment of breast cancer.

Science.gov (United States)

Lackey, N R; Gates, M F; Brown, G

2001-04-01

To describe the experiences of African American women living with breast cancer following the primary diagnosis and while undergoing initial treatment. Phenomenologic. 13 African American women (ages 30-66) purposefully selected from two oncology clinics in the mid-South. Phenomenologic interviews (transcribed verbatim) and field notes were analyzed using Colaizzi's method of phenomenologic description and analysis. Experience Trajectory, Femininity, and Spirituality were the three major themes. The Experience Trajectory subthemes were finding the lump, getting the diagnosis, undergoing surgery and adjuvant treatment. The Femininity subthemes were loss of all or part of the breast, loss of hair, and sexual attractiveness to a man. Spirituality was reflected as a reliance on God. Telling the story of their experience trajectory during their breast cancer experience is valuable in assessing African American women's feelings, emotions, and fears of body changes that occur during surgery and treatment. Their spirituality helps them through this experience. Research involving both African American women and their partners would provide greater insight into specific relationship patterns and communication related to sexuality during this experience. Nurses need to listen to the stories of African American women about the initial experience of discovery, diagnosis, and treatment of breast cancer so they can be more informed advocates for these women. African American women need more information from healthcare providers regarding the whole experience trajectory.

Initial experiences of simultaneous laparoscopic resection of colorectal cancer and liver metastases

NARCIS (Netherlands)

Hoekstra, L. T.; Busch, O. R. C.; Bemelman, W. A.; van Gulik, T. M.; Tanis, P. J.

2012-01-01

Introduction. Simultaneous resection of primary colorectal carcinoma (CRC) and synchronous liver metastases (SLMs) is subject of debate with respect to morbidity in comparison to staged resection. The aim of this study was to evaluate our initial experience with this approach. Methods. Five patients

Barrier experiment: Shock initiation under complex loading

Energy Technology Data Exchange (ETDEWEB)

Menikoff, Ralph [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-01-12

The barrier experiments are a variant of the gap test; a detonation wave in a donor HE impacts a barrier and drives a shock wave into an acceptor HE. The question we ask is: What is the trade-off between the barrier material and threshold barrier thickness to prevent the acceptor from detonating. This can be viewed from the perspective of shock initiation of the acceptor subject to a complex pressure drive condition. Here we consider key factors which affect whether or not the acceptor undergoes a shock-to-detonation transition. These include the following: shock impedance matches for the donor detonation wave into the barrier and then the barrier shock into the acceptor, the pressure gradient behind the donor detonation wave, and the curvature of detonation front in the donor. Numerical simulations are used to illustrate how these factors affect the reaction in the acceptor.

Early in vivo experience with the pediatric continuous-flow total artificial heart.

Science.gov (United States)

Karimov, Jamshid H; Horvath, David J; Byram, Nicole; Sunagawa, Gengo; Kuban, Barry D; Gao, Shengqiang; Dessoffy, Raymond; Fukamachi, Kiyotaka

2018-03-30

Heart transplantation in infants and children is an accepted therapy for end-stage heart failure, but donor organ availability is low and always uncertain. Mechanical circulatory support is another standard option, but there is a lack of intracorporeal devices due to size and functional range. The purpose of this study was to evaluate the in vivo performance of our initial prototype of a pediatric continuous-flow total artificial heart (P-CFTAH), comprising a dual pump with one motor and one rotating assembly, supported by a hydrodynamic bearing. In acute studies, the P-CFTAH was implanted in 4 lambs (average weight: 28.7 ± 2.3 kg) via a median sternotomy under cardiopulmonary bypass. Pulmonary and systemic pump performance parameters were recorded. The experiments showed good anatomical fit and easy implantation, with an average aortic cross-clamp time of 98 ± 18 minutes. Baseline hemodynamics were stable in all 4 animals (pump speed: 3.4 ± 0.2 krpm; pump flow: 2.1 ± 0.9 liters/min; power: 3.0 ± 0.8 W; arterial pressure: 68 ± 10 mm Hg; left and right atrial pressures: 6 ± 1 mm Hg, for both). Any differences between left and right atrial pressures were maintained within the intended limit of ±5 mm Hg over a wide range of ratios of systemic-to-pulmonary vascular resistance (0.7 to 12), with and without pump-speed modulation. Pump-speed modulation was successfully performed to create arterial pulsation. This initial P-CFTAH prototype met the proposed requirements for self-regulation, performance, and pulse modulation. Copyright © 2018 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Experimental test accelerator: description and results of initial experiments

International Nuclear Information System (INIS)

Fessenden, T.; Birx, D.; Briggs, R.

1980-01-01

The ETA is a high current (10,000 Amp) linear induction accelerator that produces short (30 ns) pulses of electrons at 5 MeV twice per second or in bursts of 5 pulses separated by as little as one millisecond. At this time the machine has operated at 65% of its design current and 90% of the design voltage. This report contains a description of the accelerator and its diagnostics; the results of the initial year of operation; a comparison of design codes with experiments on beam transport; and a discussion of some of the special problems and their status

Discharge initiation experiments in the Tokapole II tokamak

International Nuclear Information System (INIS)

Shepard, D.A.

1984-01-01

Experiments in the Tokapole II tokamak demonstrate the benefits of high density (n/sub e//n/sub o/ greater than or equal to 0.01) preionization by reducing four quantities at startup: necessary toroidal loop voltage (V 1 ) (50%), volt-second consumption (40-50%), impurity radiation (25-50%), and runaway electron production (approx. 80-100%). A zero-dimensional code models the loop voltage reduction dependence on preionization density and predicts a similar result for reactor scale devices. The code shows low initial resistivity and a high resistivity time derivative contribute to loop voltage reduction. Microwaves at the electron cyclotron resonance (ECR) frequency and plasma gun injection produce high density preionization, which reduces the initial V 1 , volt-second consumption, and runaways. The ECR preionization also reduces impurity radiation by shortening the time from voltage application to current channel formation. This, evidently, reduces the total plasma-wall interaction at startup. The power balance of the ECR plasma in a toroidal-field-only case was studied using Langmuir probes and impurity doping. The vertical electric field and current, which result from curvature drift, were measured as approx. 10 V/cm and 50 amps, respectively, and exceeded expected values for the bulk electron temperature (approx. 10 eV)

Initial resident refractive surgical experience: outcomes of PRK and LASIK for myopia.

Science.gov (United States)

Wagoner, Michael D; Wickard, Joseph C; Wandling, George R; Milder, Lisa C; Rauen, Matthew P; Kitzmann, Anna S; Sutphin, John E; Goins, Kenneth M

2011-03-01

To evaluate and compare the outcome of initial resident surgical experience with photorefractive keratectomy (PRK) and LASIK. Retrospective review of all cases performed with the VISX Star S4 platform (Abbott Medical Optics) between July 1, 2003 and June 30, 2007. Inclusion criteria were spherical equivalent of -0.50 to -10.00 diopters (D), refractive astigmatic error of ≤3.00 D, intention to provide full distance correction, and minimum 3-month postoperative follow-up after initial ablation or retreatment (if performed). A total of 153 cases performed by 20 different residents met the inclusion criteria; 38 eyes underwent PRK and 115 eyes had LASIK. After initial treatment, mean Snellen uncorrected distance visual acuity (UDVA) after PRK was 20/17.3 and after LASIK was 20/19.5. Photorefractive keratectomy was associated with a significantly better approximation between preoperative corrected distance visual acuity (CDVA) and postoperative UDVA (ΔlogMAR 0.009 vs 0.091; P=.004) and a greater percentage of eyes that achieved UDVA of 20/20 or better (94.7% vs 78.3%; P=.02) or 20/30 or better (100% vs 87.8%; P=.02). There was a higher prevalence of retreatment in eyes that underwent LASIK (7.0% vs 0%; P=.20). One (0.9%) eye lost 2 lines of CDVA after LASIK. Supervised refractive surgery residents can achieve excellent visual outcomes in patients operated during their initial refractive experience. Photorefractive keratectomy was associated with better visual outcome than LASIK. Copyright 2011, SLACK Incorporated.

Energy efficiency initiatives: Indian experience

Energy Technology Data Exchange (ETDEWEB)

Dey, Dipankar [ICFAI Business School, Kolkata, (IBS-K) (India)

2007-07-01

India, with a population of over 1.10 billion is one of the fastest growing economies of the world. As domestic sources of different conventional commercial energy are drying up, dependence on foreign energy sources is increasing. There exists a huge potential for saving energy in India. After the first 'oil shock' (1973), the government of India realized the need for conservation of energy and a 'Petroleum Conservation Action Group' was formed in 1976. Since then many initiatives aiming at energy conservation and improving energy efficiency, have been undertaken (the establishment of Petroleum Conservation Research Association in 1978; the notification of Eco labelling scheme in 1991; the formation of Bureau of Energy Efficiency in 2002). But no such initiative was successful. In this paper an attempt has been made to analyze the changing importance of energy conservation/efficiency measures which have been initiated in India between 1970 and 2005.The present study tries to analyze the limitations and the reasons of failure of those initiatives. The probable reasons are: fuel pricing mechanism (including subsidies), political factors, corruption and unethical practices, influence of oil and related industry lobbies - both internal and external, the economic situation and the prolonged protection of domestic industries. Further, as India is opening its economy, the study explores the opportunities that the globally competitive market would offer to improve the overall energy efficiency of the economy. The study suggests that the Bureau of Energy Efficiency (BEE) - the newly formed nodal agency for improving energy efficiency of the economy may be made an autonomous institution where intervention from the politicians would be very low. For proper implementation of different initiatives to improve energy efficiency, BEE should involve more the civil societies (NGO) from the inception to the implementation stage of the programs. The paper also

Initial cathode processing experiences and results for the treatment of spent fuel

International Nuclear Information System (INIS)

Westphal, B.R.; Laug, D.V.; Brunsvold, A.R.; Roach, P.D.

1996-01-01

As part of the spent fuel treatment demonstration at Argonne National Laboratory, a vacuum distillation process is being employed for the recovery of uranium following an electrorefining process. Distillation of a salt electrolyte, primarily consisting of a eutectic mixture of lithium and potassium chlorides, from uranium is achieved by a batch operation termed ''cathode processing.'' Cathode processing is performed in a retort furnace which enables the production of a stable uranium product that can be isotopically diluted and stored. To date, experiments have been performed with two distillation units; one for prototypical testing and the other for actual spent fuel treatment operations. The results and experiences from these initial experiments with both units will be discussed as well as problems encountered and their resolution

Discharge initiation experiments in the Tokapole II tokamak

International Nuclear Information System (INIS)

Shepard, D.A.

1984-06-01

Experiments in the Tokapole II tokamak demonstrate the benefits of high density (n/sub e//n 0 greater than or equal to 0.01) preionization by reducing four quantities at startup: necessary toroidal loop voltage (V 1 ) (50%), volt-second consumption (40 to 50%), impurity radiation (25 to 50%), and runaway electron production (approx. 80 to 100%). A zero-dimensional code models the loop voltage reduction dependence on preionization density and predicts a similar result for reactor scale devices. The code shows low initial resistivity and a high resistivity time derivative contribute to loop voltage reduction. The power balance of the ECR plasma in a toroidal-field-only case was studied. Langmuir probes and impurity doping were used. The vertical electric field (E/sub v/) and current (I/sub v/), which result from curvature drift, were measured (E/sub v/ approx. 10 V/cm and I/sub v/ approx. 50 Amps) and exceeded expected values for the bulk electron temperature (approx. 10 eV). A series of experiments with external windings to simulate field errors perpendicular to the toroidal field was done. The results imply that an error field of 0.1% of the toroidal field is deleterious to ECR plasma density

High/Scope Preschool Key Experiences: Initiative and Social Relations. [with] Curriculum Videotape.

Science.gov (United States)

Graves, Michelle

As preschoolers develop the ability to carry out their ideas and play alone and with others, they are developing the foundation for social competence. This booklet and a companion videotape help teachers and parents recognize and support nine High/Scope key experiences in initiative and social relations: (1) making and expressing choices, plans,…

[Characterization of photochemical smog chamber and initial experiments].

Science.gov (United States)

Jia, Long; Xu, Yong-Fu; Shi, Yu-Zhen

2011-02-01

A self-made new indoor environmental chamber facility for the study of atmospheric processes leading to the formation of ozone and secondary organic aerosols has been introduced and characterized. The characterization experiments include the measurements of wall effects for reactive species and the determination of chamber dependent * OH radical sources by CO-NO(x) irradiation experiments. Preliminary ethene-NO(x) and benzene-NO(x) experiments were conducted as well. The results of characterization experiments show that the wall effects for O3 and NO2 in a new reactor are not obvious. Relative humidity has a great effect on the wall losses in the old reactor, especially for O3. In the old reactor, the rate constant for O3 wall losses is obtained to be 1.0 x 10(-5) s(-1) (RH = 5%) and 4.0 x10(-5) s(-1) (RH = 91%), whereas for NO2, it is 1.0 x 10(-6) s(-1) (RH = 5%) and 0.6 x 10(-6) s(-1) (RH = 75%). The value for k(NO2 --> HONO) determined by CO-NO(x) irradiation experiments is (4.2-5.2) x 10(-5) s(-1) and (2.3-2.5) x 10(-5) s(-1) at RH = 5% and RH 75% -77%, respectively. The average *OH concentration is estimated to be (2.1 +/- 0.4) x 10(6) molecules/cm3 by using a reaction rate coefficient of CO and * OH. The sensitivity of chamber dependent auxiliary reactions to the O3 formation is discussed. Results show that NO2 --> HONO has the greatest impact on the O3 formation during the initial stage, N2O5 + H2O --> 2HNO3 has a minus effect to maximum O3 concentration, and that the wall losses of both O3 and NO2 have little impact on the O3 formation. The results from the ethene-NO(x) and benzene-NO(x) experiments are in good agreement with those from the MCM simulation, which reflects that the facility for the study of the formation of secondary pollution of ozone and secondary organic aerosols is reliable. This demonstrates that our facility can be further used in the deep-going study of chemical processes in the atmosphere.

Experience of Initial Symptoms of Breast Cancer and Triggers for Action in Ethiopia

International Nuclear Information System (INIS)

Dye, T.D.; Hobden, C.; Reeler, A.; Dye, T.D.; Bogale, S.; Tilahun, Y.; Deressa, T.

2012-01-01

Objective. This study assessed the initial experiences, symptoms, and actions of patients in Ethiopia ultimately determined to have breast cancer. Methods. 69 participants in a comprehensive breast cancer treatment program at the main national cancer hospital in Ethiopia were interviewed using mixed qualitative and quantitative approaches. Participants narratives of their initial cancer experience were coded and analyzed for themes around their symptoms, time to seeking advice, triggers for action, and contextual factors. The assessment was approved by the Addis Ababa University Faculty of Medicine Institutional Review Board. Results. Nearly all women first noticed lumps, though few sought medical advice within the first year (average time to action: 1.5 years). Eventually, changes in their symptoms motivated most participants to seek advice. Most participants did not think the initial lump would be cancer, nor was a lump of any particular concern until symptoms changed. Conclusion. Given the frequency with which lumps are the first symptom noticed, raising awareness among participants that lumps should trigger medical consultation could contribute significantly to more rapid medical advice-seeking among women in Ethiopia. Primary care sites should be trained and equipped to offer evaluation of lumps so that women can be referred appropriately for assessment if needed

[Initiation, promotion, initiation experiments with radon and cigarette smoke: Lung tumors in rats]. Progress report

International Nuclear Information System (INIS)

Moolgavkar, S.H.

1994-01-01

During the past several years, the authors have made considerable progress in modeling carcinogenesis in general, and in modeling radiation carcinogenesis, in particular. They present an overview of their progress in developing stochastic carcinogenesis models and applying them to experimental and epidemiologic data sets. Traditionally, cancer models have been used for the analysis of incidence (or prevalence) data in epidemiology and time to tumor data in experimental studies. The relevant quantities for the analysis of these data are the hazard function and the probability of tumor. The derivation of these quantities is briefly described here. More recently, the authors began to use these models for the analysis of data on intermediate lesions on the pathway to cancer. Such data are available in experimental carcinogenesis studies, in particular in initiation and promotion studies on the mouse skin and the rat liver. If however, quantitative information on intermediate lesions on the pathway to lung cancer were to be come available at some future date, the methods that they have developed for the analysis of initiation-promotion experiments could easily be applied to the analysis of these lesions. The mathematical derivations here are couched in terms of a particular two-mutation model of carcinogenesis. Extension to models postulating more than two mutations is not always straightforward

Mapping patients' experiences from initial symptoms to gout diagnosis: a qualitative exploration.

Science.gov (United States)

Liddle, Jennifer; Roddy, Edward; Mallen, Christian D; Hider, Samantha L; Prinjha, Suman; Ziebland, Sue; Richardson, Jane C

2015-09-14

To explore patients' experiences from initial symptoms to receiving a diagnosis of gout. Data from in-depth semistructured interviews were used to construct themes to describe key features of patients' experiences of gout diagnosis. A maximum variation sample of 43 UK patients with gout (29 men; 14 women; age range 32-87 years) were recruited from general practices, rheumatology clinics, gout support groups and through online advertising. Severe joint pain, combined with no obvious signs of physical trauma or knowledge of injury, caused confusion for patients attempting to interpret their symptoms. Reasons for delayed consultation included self-diagnosis and/or self-medication, reluctance to seek medical attention, and financial/work pressures. Factors potentially contributing to delayed diagnosis after consultation included reported misdiagnosis, attacks in joints other than the first metatarsophalangeal joint, and female gender. The limitations in using serum uric acid (SUA) levels for diagnostic purposes were not always communicated effectively to patients, and led to uncertainty and lack of confidence in the accuracy of the diagnosis. Resistance to the diagnosis occurred in response to patients' beliefs about the causes of gout and characteristics of the people likely to be affected. Diagnosis prompted actions, such as changes in diet, and evidence was found of self-monitoring of SUA levels. This study is the first to report data specifically about patients' pathways to initial consultation and subsequent experiences of gout diagnosis. A more targeted approach to information provision at diagnosis would improve patients' experiences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Sternal reconstruction after post-sternotomy mediastinitis

Directory of Open Access Journals (Sweden)

Pankaj Kaul

2017-11-01

Full Text Available Abstract Background Deep sternal wound complications are uncommon after cardiac surgery. They comprise sternal dehiscence, deep sternal wound infections and mediastinitis, which will be treated as varying expressions of a singular pathology for reasons explained in the text. Methodology and review This article reviews the definition, prevalence, risk factors, prevention, diagnosis, microbiology and management of deep sternal wound infections and mediastinitis after cardiac surgery. The role of negative pressure wound therapy and initial and delayed surgical management is discussed with special emphasis on plastic techniques with muscle and omental flaps. Recent advances in reconstructive surgery are presented. Conclusions Deep sternal wound complications no longer spell debilitating morbidity and high mortality. Better understanding of risk factors that predispose to deep sternal wound complications and general improvement in theatre protocols for asepsis have dramatically reduced the incidence of deep sternal wound complications. Negative pressure wound therapy and appropriately timed and staged muscle or omental flap reconstruction have transformed the outcomes once these complications occur.

Initiation process of a thrust fault revealed by analog experiments

Science.gov (United States)

Yamada, Yasuhiro; Dotare, Tatsuya; Adam, Juergen; Hori, Takane; Sakaguchi, Hide

2016-04-01

We conducted 2D (cross-sectional) analog experiments with dry sand using a high resolution digital image correlation (DIC) technique to reveal initiation process of a thrust fault in detail, and identified a number of "weak shear bands" and minor uplift prior to the thrust initiation. The observations suggest that the process can be divided into three stages. Stage 1: characterized by a series of abrupt and short-lived weak shear bands at the location where the thrust will be generated later. Before initiation of the fault, the area to be the hanging wall starts to uplift. Stage 2: defined by the generation of the new thrust and its active displacement. The location of the new thrust seems to be constrained by its associated back-thrust, produced at the foot of the surface slope (by the previous thrust). The activity of the previous thrust turns to zero once the new thrust is generated, but the timing of these two events is not the same. Stage 3: characterized by a constant displacement along the (new) thrust. Similar minor shear bands can be seen in the toe area of the Nankai accretionary prism, SW Japan and we can correlate the along-strike variations in seismic profiles to the model results that show the characteristic features in each thrust development stage.

SPINAL CORD STIMULATION IN TREATMENT OF THE NEUROPATHIC PAIN SYNDROMES: INITIAL EXPERIENCE

Directory of Open Access Journals (Sweden)

D. A. Rzaev

2010-01-01

Full Text Available In the article initial experience of spinal cord stimulation for chronic pain syndromes is described. The trial was done for 62 patients, in 52 cases trial was successful and subcutaneous pulse generator were implanated. Maximal follow-up is 26 months. The level of pain evaluates at VAS. Permanent pain-relieve results were achieved in 46 patients (74,2%. These results correspond to literature data.

The concept of negative pressure wound therapy (NPWT) after poststernotomy mediastinitis--a single center experience with 54 patients.

Science.gov (United States)

Ennker, Ina C; Malkoc, Anita; Pietrowski, Detlef; Vogt, Peter M; Ennker, Juergen; Albert, Alexander

2009-01-12

Deep sternal infections, also known as poststernotomy mediastinitis, are a rare but often fatal complication in cardiac surgery. They are a cause of increased morbidity and mortality and have a significant socioeconomic aspect concerning the health system. Negative pressure wound therapy (NPWT) followed by muscular pectoralis plasty is a quite new technique for the treatment of mediastinitis after sternotomy. Although it could be demonstrated that this technique is at least as safe and reliable as other techniques for the therapy of deep sternal infections, complications are not absent. We report about our experiences and complications using this therapy in a set of 54 patients out of 3668 patients undergoing cardiac surgery in our institution between January 2005 and April 2007.

The experience of initiating injection drug use and its social context: a qualitative systematic review and thematic synthesis.

Science.gov (United States)

Guise, Andy; Horyniak, Danielle; Melo, Jason; McNeil, Ryan; Werb, Dan

2017-12-01

Understanding the experience of initiating injection drug use and its social contexts is crucial to inform efforts to prevent transitions into this mode of drug consumption and support harm reduction. We reviewed and synthesized existing qualitative scientific literature systematically to identify the socio-structural contexts for, and experiences of, the initiation of injection drug use. We searched six databases (Medline, Embase, PsychINFO, CINAHL, IBSS and SSCI) systematically, along with a manual search, including key journals and subject experts. Peer-reviewed studies were included if they qualitatively explored experiences of or socio-structural contexts for injection drug use initiation. A thematic synthesis approach was used to identify descriptive and analytical themes throughout studies. From 1731 initial results, 41 studies reporting data from 1996 participants were included. We developed eight descriptive themes and two analytical (higher-order) themes. The first analytical theme focused on injecting initiation resulting from a social process enabled and constrained by socio-structural factors: social networks and individual interactions, socialization into drug-using identities and choices enabled and constrained by social context all combine to produce processes of injection initiation. The second analytical theme addressed pathways that explore varying meanings attached to injection initiation and how they link to social context: seeking pleasure, responses to increasing tolerance to drugs, securing belonging and identity and coping with pain and trauma. Qualitative research shows that injection drug use initiation has varying and distinct meanings for individuals involved and is a dynamic process shaped by social and structural factors. Interventions should therefore respond to the socio-structural influences on injecting drug use initiation by seeking to modify the contexts for initiation, rather than solely prioritizing the reduction of individual

Initial experiment of focusing wiggler of MM wave Free Electron Laser on LAX-1

International Nuclear Information System (INIS)

Sakamoto, Keishi; Maebara, Sunao; Watanabe, Akihiko; Kishimoto, Yasuaki; Nagashima, Takashi; Maeda, Hikosuke; Shiho, Makoto; Oda, Hisako; Kawasaki, Sunao.

1991-03-01

Initial results of Free Electron laser (FEL) Experiment in the mm wave region are presented. The experiment is carried out using a induction linac system (LAX-1: Large current Accelerator Experiment) of E b = 1 MeV, Ib = 1 ∼ 3 kA. The wiggler of FEL is composed of the curved surface magnets arrays (focusing wiggler), which is found to be effective for a transport of low energy and high current beam through the wiggler. The superradiance of the mm wave region (30 GHz ∼ 40 GHz) is observed. The growth rate of this radiation is 0.42 dB/cm. (author)

Patients' Experiences of Performing Self-care of Stomas in the Initial Postoperative Period.

Science.gov (United States)

Lim, Siew Hoon; Chan, Sally Wai Chi; He, Hong-Gu

2015-01-01

With the loss of an important bodily function and the distortion in body image, a stoma patient experiences physical, psychological, and social changes. With limited current studies exploring experiences of patients in the management of their stoma, there is a need to explore their experiences, their needs, and factors that influence their self-management. The aim of this study was to investigate patients' experiences of performing self-care of stomas in the initial postoperative period. This study adopted a descriptive qualitative approach from the interpretive paradigm. Semistructured interviews were conducted with 12 patients 1 month postoperatively in a colorectal ward in a hospital in Singapore. Thematic analysis was applied to the interview data. Five themes were identified: process of acceptance and self-management of stoma, physical limitations, psychological reactions, social support, and need for timely and sufficient stoma preparation and education. This study highlights the importance of health professionals' role in helping patients adjust preoperatively and postoperatively and accept the presence of a stoma. Health professionals need to be aware of the physical, psychological, and social impact of stoma on patients in the initial 30-day postoperative period. Research findings informed the type and level of assistance and support to be offered to patients by nurses and the importance of encouraging patients to be involved in stoma care at an early stage, which will ultimately contribute to effective and independent self-management. Patients can be prepared preoperatively to reduce the psychological and social impact of stoma after creation of their stoma.

Prostate brachytherapy in Ghana: our initial experience

Directory of Open Access Journals (Sweden)

James Edward Mensah

2016-10-01

Full Text Available Purpose: This study presents the experience of a brachytherapy team in Ghana with a focus on technology transfer and outcome. The team was initially proctored by experienced physicians from Europe and South Africa. Material and methods : A total of 90 consecutive patients underwent either brachytherapy alone or brachytherapy in combination with external beam radiotherapy for prostate carcinoma between July 2008 and February 2014 at Korle Bu Teaching Hospital, Accra, Ghana. Patients were classified as low-risk, intermediate, and high-risk according to the National Comprehensive Cancer Network (NCCN criteria. All low-risk and some intermediate risk group patients were treated with seed implantation alone. Some intermediate and all high-risk group patients received brachytherapy combined with external beam radiotherapy. Results: The median patient age was 64.0 years (range 46-78 years. The median follow-up was 58 months (range 18-74 months. Twelve patients experienced biochemical failure including one patient who had evidence of metastatic disease and died of prostate cancer. Freedom from biochemical failure rates for low, intermediate, and high-risk cases were 95.4%, 90.9%, and 70.8%, respectively. Clinical parameters predictive of biochemical outcome included: clinical stage, Gleason score, and risk group. Pre-treatment prostate specific antigen (PSA was not a statistically significant predictor of biochemical failure. Sixty-nine patients (76.6% experienced grade 1 urinary symptoms in the form of frequency, urgency, and poor stream. These symptoms were mostly self-limiting. Four patients needed catheterization for urinary retention (grade 2. One patient developed a recto urethral fistula (grade 3 following banding for hemorrhoids. Conclusions : Our results compare favorably with those reported by other institutions with more extensive experience. We believe therefore that, interstitial permanent brachytherapy can be safely and effectively

The concept of negative pressure wound therapy (NPWT after poststernotomy mediastinitis – a single center experience with 54 patients

Directory of Open Access Journals (Sweden)

Vogt Peter M

2009-01-01

Full Text Available Abstract Deep sternal infections, also known as poststernotomy mediastinitis, are a rare but often fatal complication in cardiac surgery. They are a cause of increased morbidity and mortality and have a significant socioeconomic aspect concerning the health system. Negative pressure wound therapy (NPWT followed by muscular pectoralis plasty is a quite new technique for the treatment of mediastinitis after sternotomy. Although it could be demonstrated that this technique is at least as safe and reliable as other techniques for the therapy of deep sternal infections, complications are not absent. We report about our experiences and complications using this therapy in a set of 54 patients out of 3668 patients undergoing cardiac surgery in our institution between January 2005 and April 2007.

Initial Scaling Studies and Conceptual Thermal Fluids Experiments for the Prismatic NGNP Point Design

Energy Technology Data Exchange (ETDEWEB)

D. M. McEligot; G. E. McCreery

2004-09-01

The objective of this report is to document the initial high temperature gas reactor scaling studies and conceptual experiment design for gas flow and heat transfer. The general approach of the project is to develop new benchmark experiments for assessment in parallel with CFD and coupled CFD/ATHENA/RELAP5-3D calculations for the same geometry. Two aspects of the complex flow in an NGNP are being addressed: (1) flow and thermal mixing in the lower plenum ("hot streaking" issue) and (2) turbulence and resulting temperature distributions in reactor cooling channels ("hot channel" issue). Current prismatic NGNP concepts are being examined to identify their proposed flow conditions and geometries over the range from normal operation to decay heat removal in a pressurized cooldown. Approximate analyses are being applied to determine key non-dimensional parameters and their magnitudes over this operating range. For normal operation, the flow in the coolant channels can be considered to be dominant forced convection with slight transverse property variation. The flow in the lower plenum can locally be considered to be a situation of multiple buoyant jets into a confined density-stratified crossflow -- with obstructions. Experiments are needed for the combined features of the lower plenum flows. Missing from the typical jet experiments are interactions with nearby circular posts and with vertical posts in the vicinity of vertical walls - with near stagnant surroundings at one extreme and significant crossflow at the other. Two heat transfer experiments are being considered. One addresses the "hot channel" problem, if necessary. The second experiment will treat heated jets entering a model plenum. Unheated MIR (Matched-Index-of-Refraction) experiments are first steps when the geometry is complicated. One does not want to use a computational technique which will not even handle constant properties properly. The MIR experiment will simulate flow features of the paths of jets

Liver transplantations in Bulgaria--initial experience.

Science.gov (United States)

Vladov, N; Mihaylov, V; Takorov, I; Vasilevski, I; Lukanova, T; Odisseeva, E; Katzarov, K; Simonova, M; Tomova, D; Konakchieva, M; Petrov, N; Mladenov, N; Sergeev, S; Mutafchiiski, V

2014-01-01

The filed of liver transplantation (LT) continues to evolve and is highly effective therapy for many patients with acute and chronic liver failure resulting from a variety of causes. Improvement of perioperative care, surgical technique and immunosuppression in recent years has led to its transformation into a safe and routine procedure with steadily improving results. The aim of this paper is to present the initial experience of the transplant team at Military Medical Academy - Sofia, Bulgaria. For the period of April 2007 - August 2014 the team performed 38 liver transplants in 37 patients (one retransplantation). Patients were followed up prospectively and retrospectively. In 36 (95%) patients a graft from a cadaveric donor was used and in two cases--a right liver grafts from live donor. The mean MELD score of the transplanted patients was 17 (9-40). The preferred surgical technique was "piggyback" with preservation of inferior vena cava in 33 (86%) of the cases and classical technique in 3 (8%) patients. The overall complication rate was 48%. Early mortality rate was 13% (5 patients). The overall 1- and 5-year survival is 81% and 77% respectivelly. The setting of a new LT program is a complex process which requires the effort and effective colaboration of a wide range of speciacialists (hepatologists, surgeons, anesthesiologists, psychologists, therapists, coordinators, etc.) and institutions. The good results are function of a proper selection of the donors and the recipients. Living donation is an alternative in the shortage of cadaveric donors.

Thermophysical Property Estimation by Transient Experiments: The Effect of a Biased Initial Temperature Distribution

Directory of Open Access Journals (Sweden)

Federico Scarpa

2015-01-01

Full Text Available The identification of thermophysical properties of materials in dynamic experiments can be conveniently performed by the inverse solution of the associated heat conduction problem (IHCP. The inverse technique demands the knowledge of the initial temperature distribution within the material. As only a limited number of temperature sensors (or no sensor at all are arranged inside the test specimen, the knowledge of the initial temperature distribution is affected by some uncertainty. This uncertainty, together with other possible sources of bias in the experimental procedure, will propagate in the estimation process and the accuracy of the reconstructed thermophysical property values could deteriorate. In this work the effect on the estimated thermophysical properties due to errors in the initial temperature distribution is investigated along with a practical method to quantify this effect. Furthermore, a technique for compensating this kind of bias is proposed. The method consists in including the initial temperature distribution among the unknown functions to be estimated. In this way the effect of the initial bias is removed and the accuracy of the identified thermophysical property values is highly improved.

Minimally invasive right lateral thoracotomy without aortic cross-clamping: an attractive alternative to repeat sternotomy for reoperative mitral valve surgery.

Science.gov (United States)

Umakanthan, Ramanan; Petracek, Michael R; Leacche, Marzia; Solenkova, Nataliya V; Eagle, Susan S; Thompson, Annemarie; Ahmad, Rashid M; Greelish, James P; Ball, Stephen K; Hoff, Steven J; Absi, Tarek S; Balaguer, Jorge M; Byrne, John G

2010-03-01

The study aim was to determine the safety and benefits of minimally invasive mitral valve surgery without aortic cross-clamping for mitral valve surgery after previous cardiac surgery. Between January 2006 and August 2008, a total of 90 consecutive patients (38 females, 52 males; mean age 66 +/- 9 years) underwent minimally invasive mitral valve surgery after having undergone previous cardiac surgery. Of these patients, 80 (89%) underwent mitral valve replacement and 10 (11%) mitral valve repair utilizing a small (5 cm) right lateral thoracotomy along the 4th or 5th intercostal space under fibrillatory arrest (mean temperature 28 +/- 2 degrees C). The predicted mortality, calculated using the Society of Thoracic Surgeons (STS) algorithm, was compared to the observed mortality. The mean ejection fraction was 45 +/- 13%, mean NYHA class 3 +/- 1, while 66 patients (73%) had previous coronary artery bypass grafting and 37 (41%) had previous valve surgery. Twenty-six patients (29%) underwent non-elective surgery. Cardiopulmonary bypass was instituted through axillary (n = 19), femoral (n = 70) or direct use aortic (n = 1) cannulation. Operative mortality was 2% (2/90), lower than the STS-predicted mortality of 7%. Three patients (3%) developed acute renal failure postoperatively, one patient (1%) required new-onset hemodialysis, and one (1%) developed postoperative stroke. No patients developed postoperative myocardial infarction. The mean postoperative packed red blood cell transfusion requirement at 48 h was 2 +/- 3 units. Minimally invasive right thoracotomy without aortic cross-clamping is an excellent alternative to conventional redo-sternotomy for reoperative mitral valve surgery. The present study confirmed that this technique is safe and effective in reducing operative mortality in high-risk patients undergoing reoperative cardiac surgery.

Prototype radiographic system for emergency and intensive care units: Initial experience

International Nuclear Information System (INIS)

Mirvis, S.

1986-01-01

A prototype radiographic system has been developed for use in bedside examinations in multibed trauma or intensive care units and emergency rooms. The system features a single-phase, high-frequency 30-kW ceiling-mounted generator with an x-ray tube extending from a long counterbalanced arm. All movements are servo-assisted for ease of operation. Based on initial experience, the unit allows easier access to the patient around resuscitation and monitoring equipment, occupies less floor space, and yields better quality images than do standard mobile radiographic units

Initial Experiences of Simultaneous Laparoscopic Resection of Colorectal Cancer and Liver Metastases

Directory of Open Access Journals (Sweden)

L. T. Hoekstra

2012-01-01

Full Text Available Introduction. Simultaneous resection of primary colorectal carcinoma (CRC and synchronous liver metastases (SLMs is subject of debate with respect to morbidity in comparison to staged resection. The aim of this study was to evaluate our initial experience with this approach. Methods. Five patients with primary CRC and a clinical diagnosis of SLM underwent combined laparoscopic colorectal and liver surgery. Patient and tumor characteristics, operative variables, and postoperative outcomes were evaluated retrospectively. Results. The primary tumor was located in the colon in two patients and in the rectum in three patients. The SLM was solitary in four patients and multiple in the remaining patient. Surgical approach was total laparoscopic (2 patients or hand-assisted laparoscopic (3 patients. The midline umbilical or transverse suprapubic incision created for the hand port and/or extraction of the specimen varied between 5 and 10 cm. Median operation time was 303 (range 151–384 minutes with a total blood loss of 700 (range 200–850 mL. Postoperative hospital stay was 5, 5, 9, 14, and 30 days. An R0 resection was achieved in all patients. Conclusions. From this initial single-center experience, simultaneous laparoscopic colorectal and liver resection appears to be feasible in selected patients with CRC and SLM, with satisfying short-term results.

Preparing beginning reading teachers: An experimental comparison of initial early literacy field experiences

OpenAIRE

Al Otaiba, Stephanie; Lake, Vickie E.; Greulich, Luana; Folsom, Jessica S.; Guidry, Lisa

2012-01-01

This randomized-control trial examined the learning of preservice teachers taking an initial Early Literacy course in an early childhood education program and of the kindergarten or first grade students they tutored in their field experience. Preservice teachers were randomly assigned to one of two tutoring programs: Book Buddies and Tutor Assisted Intensive Learning Strategies (TAILS), which provided identical meaning-focused instruction (shared book reading), but differed ...

Medical student perceptions of an initial collaborative immersion experience.

Science.gov (United States)

House, Joseph B; Cedarbaum, Jacob; Haque, Fatema; Wheaton, Michael; Vredeveld, Jennifer; Purkiss, Joel; Moore, Laurel; Santen, Sally A; Daniel, Michelle

2018-03-01

Recent reviews of interprofessional education (IPE) highlight the need for innovative curricula focused on longitudinal clinical learning. We describe the development and early outcomes of the initial clinical experience (ICE), a longitudinal practice-based course for first-year medical students. While IPE courses focus on student-to-student interaction, ICE focuses on introducing students to interprofessional collaboration. Students attend 14 sessions at one of 18 different clinical sites. They work directly with different health professionals from among 17 possible professions, including nurses, pharmacists, social workers, and respiratory, occupational, and physical therapists. Between 2015 and 2016, 167 students completed the course, and 81 completed the end-of-course evaluation. Students agreed or strongly agreed that ICE meaningfully contributed to their understanding of healthcare teams and different professional roles (86%), improved their understanding of healthcare systems (84%), improved their ability to communicate with healthcare professionals (61%), and improved their ability to work on interprofessional teams (65%). Select themes from narrative comments suggest that clinical immersion improves understanding of professional roles, helps students understand their own future roles in healthcare teams, and increases awareness of and respect for other professionals, with the potential to change future practice. ICE may be a template for other schools wishing to expand their current educational offerings, by engaging learners in more authentic, longitudinal clinical experiences with practicing healthcare professionals.

Cardiac 82rubidium PET/CT: initial European experience

International Nuclear Information System (INIS)

Groves, Ashley M.; Dickson, John C.; Kayani, Irfan; Endozo, Raymondo; Blanchard, Patty; Shastry, Manu; Prvulovich, Elizabeth; Waddington, Wendy A.; Ben-Haim, Simona; Bomanji, Jamshed B.; Ell, Peter J.; Speechly-Dick, Marie-Elsya; McEwan, Jean R.

2007-01-01

Myocardial perfusion with PET/CT has advantages over conventional SPECT. We describe our initial European experience using 82 Rubidium-PET/CT, as part of a clinical myocardial perfusion service. We studied the first 100 patients (64 male; 36 female, mean age = 60: SD +/-12.5y, mean body mass index = 30: SD +/-6.9kg/m 2 ) who underwent 82 Rubidium cardiac PET/CT in our institution. Thirty patients had recently undergone coronary angiography. Patients underwent imaging during adenosine infusion and at rest. Images were acquired over 5 minutes using a GE-PET/CT instrument. Image quality was described as good, adequate or inadequate. Images were reported patient-by-patient by a minimum of five nuclear medicine physicians. A segment-by-segment analysis (17-segment model) was also performed. Image quality was good in 77%, adequate 23% and inadequate 0%. There was no statistical difference in image quality between obese and non-obese patients (Fisher's exact test, p = 0.2864). 59% had normal perfusion studies, 29% had inducible ischaemia, 12% had myocardial infarction (11% with super added ischaemia). There was reduced 82 Rubidium uptake in 132/1700 segments during stress. There was reduced 82 Rubidium uptake at rest in 42/1700 segments. The 82 Rubidium PET/CT findings were consistent with the angiographic findings in 28/30 cases. We show that, even from initial use of 82 Rubidium, it is possible to perform myocardial perfusion studies quickly with good image quality, even in the obese. The PET findings correlated well in the third of the cases where angiography was available. As such, 82 Rubidium cardiac PET/CT is likely to be an exciting addition to the European nuclear physician/ cardiologist's radionuclide imaging arsenal. (orig.)

Simulation of rod drop experiments in the initial cores of Loviisa and Mochovce

International Nuclear Information System (INIS)

Kaloinen, E.; Kyrki-Rajamaeki, R.; Wasastjerna, F.

1999-01-01

Interpretation of rod drop measurements during startup tests of the Loviisa reactors has earlier been studied with two-dimensional core calculations using a spatial prompt jump approximation. In these calculations the prediction for the reactivity meter reading was lower than the measured values by 25%. Another approach to solve the problem is simulation of the rod drop experiment with dynamic core calculations coupled with out of core calculations to estimate the response of ex-core ionization chambers for the reactivity meter. This report described the calculations performed with the three-dimensional dynamic code HEXTRAN for prediction of the reactivity meter readings in rod drop experiments in initial cores of the WWER-440 reactors. (Authors)

Resection of parathyroid tumor in the aorticopulmonary window without prior neck exploration

International Nuclear Information System (INIS)

McHenry, C.; Walsh, M.; Jarosz, H.; Henkin, R.; Tope, J.; Lawrence, A.M.; Paloyan, E.

1988-01-01

Of 522 patients with hyperparathyroidism operated on from 1973 to 1987 at our institution, there were seven (1.3%), each with an ectopic, hyperfunctioning mediastinal parathyroid adenoma, who required median sternotomy. In three of these seven patients, the tumor was located in the aorticopulmonary window. A 61-year-old woman with primary hyperparathyroidism had a preoperative thallium-technetium subtraction scan that showed thallium uptake at the base of the heart without any uptake in the neck. After further workup and without prior neck exploration, a parathyroid adenoma was found in the aorticopulmonary window through a median sternotomy. Six months later, serum calcium, phosphorus, and parathyroid hormone values remain normal. Two other cases of parathyroid adenoma in the aorticopulmonary window are presented. Of these two patients, the thallium scan was a key element in the immediate mediastinal exploration of one, who was transferred from another hospital comatose and intubated, in acute hypercalcemic crisis. Since mediastinal parathyroid tumors that necessitate median sternotomy occur in less than 2% of patients with primary hyperparathyroidism, we do not advocate routine preoperative localization studies before an initial cervical operation; localization, however, may be justified in selected cases, such as in critically ill patients or in instances of acute hyperparathyroidism, when the first operation needs to be curative

Intraoperative 3-tesla MRI in the management of paediatric cranial tumours - initial experience

International Nuclear Information System (INIS)

Avula, Shivaram; Garlick, Deborah; Abernethy, Laurence J.; Mallucci, Connor L.; Pizer, Barry; Crooks, Daniel

2012-01-01

Intraoperative MRI (ioMRI) has been gaining recognition because of its value in the neurosurgical management of cranial tumours. There is limited documentation of its value in children. To review the initial experience of a paediatric 3-Tesla ioMRI unit in the management of cranial tumours. Thirty-eight children underwent ioMRI during 40 cranial tumour resections using a 3-Tesla MR scanner co-located with the neurosurgical operating theatre. IoMRI was performed to assess the extent of tumour resection and/or to update neuronavigation. The intraoperative and follow-up scans, and the clinical records were reviewed. In 27/40 operations, complete resection was intended. IoMRI confirmed complete resection in 15/27 (56%). As a consequence, surgical resection was extended in 5/27 (19%). In 6/27 (22%), ioMRI was equivocal for residual tumour. In 13/40 (33%) operations, the surgical aim was to partially resect the tumour. In 7 of the 13 (54%), surgical resection was extended following ioMRI. In our initial experience, ioMRI has increased the rate of complete resection, with intraoperative surgical strategy being modified in 30% of procedures. Collaborative analysis of ioMRI by the radiologist and neurosurgeon is vital to avoid errors in interpretation. (orig.)

Intraoperative 3-tesla MRI in the management of paediatric cranial tumours - initial experience

Energy Technology Data Exchange (ETDEWEB)

Avula, Shivaram; Garlick, Deborah; Abernethy, Laurence J. [Alder Hey Children' s NHS Foundation Trust, Department of Radiology, Liverpool (United Kingdom); Mallucci, Connor L. [Alder Hey Children' s Hospital, Department of Neurosurgery, Liverpool (United Kingdom); Pizer, Barry [Alder Hey Children' s Hospital, Department of Oncology, Liverpool (United Kingdom); Crooks, Daniel [Walton Centre for Neurology and Neurosurgery, Department of Pathology, Liverpool (United Kingdom)

2012-02-15

Intraoperative MRI (ioMRI) has been gaining recognition because of its value in the neurosurgical management of cranial tumours. There is limited documentation of its value in children. To review the initial experience of a paediatric 3-Tesla ioMRI unit in the management of cranial tumours. Thirty-eight children underwent ioMRI during 40 cranial tumour resections using a 3-Tesla MR scanner co-located with the neurosurgical operating theatre. IoMRI was performed to assess the extent of tumour resection and/or to update neuronavigation. The intraoperative and follow-up scans, and the clinical records were reviewed. In 27/40 operations, complete resection was intended. IoMRI confirmed complete resection in 15/27 (56%). As a consequence, surgical resection was extended in 5/27 (19%). In 6/27 (22%), ioMRI was equivocal for residual tumour. In 13/40 (33%) operations, the surgical aim was to partially resect the tumour. In 7 of the 13 (54%), surgical resection was extended following ioMRI. In our initial experience, ioMRI has increased the rate of complete resection, with intraoperative surgical strategy being modified in 30% of procedures. Collaborative analysis of ioMRI by the radiologist and neurosurgeon is vital to avoid errors in interpretation. (orig.)

Initial clinical experience with a sac-anchoring endoprosthesis for aortic aneurysm repair.

Science.gov (United States)

Donayre, Carlos E; Zarins, Christopher K; Krievins, Dainis K; Holden, Andrew; Hill, Andrew; Calderas, Carlos; Velez, Jaime; White, Rodney A

2011-03-01

All current aortic endografts depend on proximal and distal fixation to prevent migration. However, migration and rupture can occur, particularly in patients with aortic necks that are short or angulated, or both. We present our initial clinical experience with a new sac-anchoring endoprosthesis designed to anchor and seal the device within the aneurysm sac. The initial worldwide experience using a new endoprosthesis for the treatment of aortic aneurysms (Nellix Endovascular, Palo Alto, Calif) was reviewed. The endoprosthesis consists of dual balloon-expandable endoframes surrounded by polymer-filled endobags designed to obliterate the aneurysm sac and maintain endograft position. Clinical results and follow-up contrast computed tomography (CT) scans at 30 days and 6 and 12 months were reviewed. The endograft was successfully deployed in 21 patients with infrarenal aortic aneurysms measuring 5.7 ± 0.7 cm (range, 4.3-7.4 cm). Two patients with common iliac aneurysms were treated with sac-anchoring extenders that maintained patency of the internal iliac artery. Infusion of 71 ± 37 mL of polymer (range, 19-158 mL) into the aortic endobags resulted in complete aneurysm exclusion in all patients. Mean implant time was 76 ± 35 minutes, with 33 ± 17 minutes of fluoroscopy time and 180 ± 81 mL of contrast; estimated blood loss was 174 ± 116 mL. One patient died during the postoperative period (30-day mortality, 4.8%), and one died at 10 months from non-device-related causes. During a mean follow-up of 8.7 ± 3.1 months and a median of 6.3 months, there were no late aneurysm- or device-related adverse events and no secondary procedures. CT imaging studies at 6 months and 1 year revealed no increase in aneurysm size, no device migration, and no new endoleaks. One patient had a limited proximal type I endoleak at 30 days that resolved at 60 days and remained sealed. One patient has an ongoing distal type I endoleak near the iliac bifurcation, with no change in aneurysm

Experience in initial training required for the recognition of the qualified RP expert in Spain

International Nuclear Information System (INIS)

Rodriguez Suarez, M.; Marco Arboli, M.; Menarguez, J.

2003-01-01

An important point of the actions inside the European framework to achieve the harmonisation of the training programmes and recognition was included in the European directive 96/29/Euratom which includes definition and specific tasks of the European Qualified Expert on Radiation Protection (RP). Basic syllabus for training of those experts was developed in the communication 98/C 133/03 concerning BSS applications. Although, in the Spanish education system, the training and recognition requirements of the high level qualified experts on RP was defined since 1977, until 2001, the figure of the Technical Qualified Expert on RP does not appear in the legal framework. In December 2002, a new regulation of the Spanish Regulatory Body, CSN, about qualifications to obtain the recognition of RP Expert in Spain (both high qualified and technical RP experts) was published. Concerning the qualified expert on RP, (RP Officer), responsible of the RP Service, which takes charge of the effective protection and advise radioactive and nuclear facilities in Rp aspects,has to be authorised by the regulatory body. to obtain the RP officer diploma, conceded by the CSN, an initial training of 300 hours and a three-year minimum experience are required (for X-ray installation a 6-month experience is enough). The technical qualified expert on RP is the worker who carried out the tasks in the a RP Service under the supervision of the RP officer. A Technician Qualified Expert on RP does not need an specific accreditation of the Regulatory Body, but an initial RP training and a three-month minimum experience are required and has hold a certificate by the RP officer. Continuous training is also required and as well has to receive a certificate from the RP officer. Since 1977, The Institute for energy Studies has been implementing specific training courses for those professionals who want to obtain the diploma of RP officer (high degree qualified RP expert), conceded by the CSN. Since then

Modifying mixing and instability growth through the adjustment of initial conditions in a high-energy-density counter-propagating shear experiment on OMEGA

International Nuclear Information System (INIS)

Merritt, E. C.; Doss, F. W.; Loomis, E. N.; Flippo, K. A.; Kline, J. L.

2015-01-01

Counter-propagating shear experiments conducted at the OMEGA Laser Facility have been evaluating the effect of target initial conditions, specifically the characteristics of a tracer foil located at the shear boundary, on Kelvin-Helmholtz instability evolution and experiment transition toward nonlinearity and turbulence in the high-energy-density (HED) regime. Experiments are focused on both identifying and uncoupling the dependence of the model initial turbulent length scale in variable-density turbulence models of k-ϵ type on competing physical instability seed lengths as well as developing a path toward fully developed turbulent HED experiments. We present results from a series of experiments controllably and independently varying two initial types of scale lengths in the experiment: the thickness and surface roughness (surface perturbation scale spectrum) of a tracer layer at the shear interface. We show that decreasing the layer thickness and increasing the surface roughness both have the ability to increase the relative mixing in the system, and thus theoretically decrease the time required to begin transitioning to turbulence in the system. We also show that we can connect a change in observed mix width growth due to increased foil surface roughness to an analytically predicted change in model initial turbulent scale lengths

Initial Experience with the Machine Protection System for LHC

CERN Document Server

Schmidt, Ruediger; Dehning, Bernd; Ferro-Luzzi, Massimiliano; Goddard, Brennan; Lamont, Mike; Siemko, Andrzej; Uythoven, Jan; Wenninger, Jorg; Zerlauth, Markus

2010-01-01

For nominal beam parameters at 7 TeV/c each proton beam with a stored energy of 362 MJ threatens to damage accelerator equipment in case of uncontrolled beam loss. These parameters will only be reached after some years of operation, however, a small fraction of this energy is already sufficient to damage accelerator equipment or experiments. The correct functioning of the machine protection systems is vital during the different operational phases already for initial operation. When operating the complex magnet system, with and without beam, safe operation relies on the protection and interlock systems for the superconducting circuits. For safe injection and transfer of the beams from SPS to LHC, transfer line parameters are monitored, beam absorbers must be in the correct position and the LHC must be ready to accept beam. At the end of a fill and in case of failures beams must be properly extracted onto the dump blocks, for some types of failure within less than few hundred microseconds. Safe operation requir...

Operation of the tokamak fusion test reactor tritium systems during initial tritium experiments

International Nuclear Information System (INIS)

Anderson, J.L.; Gentile, C.; Kalish, M.; Kamperschroer, J.; Kozub, T.; LaMarche, P.; Murray, H.; Nagy, A.; Raftopoulos, S.; Rossmassler, R.; Sissingh, R.; Swanson, J.; Tulipano, F.; Viola, M.; Voorhees, D.; Walters, R.T.

1995-01-01

The high power D-T experiments on the tokamak fusion test reactor (TFTR) at the Princeton Plasma Physics Laboratory commenced in November 1993. During initial operation of the tritium systems a number of start-up problems surfaced and had to be corrected. These were corrected through a series of system modifications and upgrades and by repair of failed or inadequate components. Even as these operational concerns were being addressed, the tritium systems continued to support D-T operations on the tokamak. During the first six months of D-T operations more than 107kCi of tritium were processed successfully by the tritium systems. D-T experiments conducted at TFTR during this period provided significant new data. Fusion power in excess of 9MW was achieved in May 1994. This paper describes some of the early start-up issues, and reports on the operation of the tritium system and the tritium tracking and accounting system during the early phase of TFTR D-T experiments. (orig.)

LWR aerosol containment experiments (LACE) program and initial test results

International Nuclear Information System (INIS)

Muhlestein, L.D.; Hilliard, R.K.; Bloom, G.R.; McCormack, J.D.; Rahn, F.J.

1985-01-01

The LWR aerosol containment experiments (LACE) program is described. The LACE program is being performed at the Hanford Engineer Development Laboratory (operated by Westinghouse Hanford Company) and the initial tests are sponsored by EPRI. The objectives of the LACE program are: to demonstrate, at large-scale, inherent radioactive aerosol retention behavior for postulated high consequence LWR accident situations; and to provide a data base to be used for aerosol behavior . Test results from the first phase of the LACE program are presented and discussed. Three large-scale scoping tests, simulating a containment bypass accident sequence, demonstrated the extent of agglomeration and deposition of aerosols occurring in the pipe pathway and vented auxiliary building under realistic accident conditions. Parameters varied during the scoping tests were aerosol type and steam condensation

Pain locations in the postoperative period after cardiac surgery: Chronology of pain and response to treatment.

Science.gov (United States)

Roca, J; Valero, R; Gomar, C

Postoperative pain after cardiac surgery (CS) can be generated at several foci besides the sternotomy. Prospective descriptive longitudinal study on the chronological evolution of pain in 11 sites after CS including consecutive patients submitted to elective CS through sternotomy. The primary endpoints were to establish the main origins of pain, and to describe its chronological evolution during the first postoperative week. Secondary endpoints were to describe pain characteristics in the sternotomy area and to correlate pain intensity with other variables. Numerical Pain Rating Scale from 0 to 10 at rest and at movement on postoperative days 1, 2, 4 and 6. Numerical Pain Rating Scale>3 was considered moderate pain. Statistical analysis consisted in Mann-Whitney U-test, a Chi-squared, a Fisher exact text and Pearson's correlations. Forty-seven patients were enrolled. In 4 of 11 locations pain was reported as Numerical Pain Rating Scale>3 (sternotomy, oropharynx, saphenectomy and musculoskeletal pain in the back and shoulders). Maximum intensity of pain on postoperative days 1 and 2 was reported in the sternotomy area, while on postoperative days 4 and 6 it was reported at the saphenectomy. Pain at rest and at movement differed considerably in the sternotomy, saphenectomy and oropharynx. Pain at back and shoulders and at central venous catheter entry were not influenced by movement. Pain in the sternotomy was mainly described as oppressive. Patients with arthrosis and younger patients presented higher intensity of pain (P=.004; P=.049, respectively). Four locations were identified as the main sources of pain after CS: sternotomy, oropharynx, saphenectomy, and back and shoulders. Pain in different focuses presented differences in chronologic evolution and was differently influenced by movement. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Initial TMX central-cell ICRH experiments

International Nuclear Information System (INIS)

Molvik, A.W.; Coffield, F.E.; Falabella, S.; Griffin, D.; McVey, B.; Pickles, W.; P.

1980-01-01

Four topics are discussed in this report: the feasibility of applying ion cyclotron resonance heating (ICRH) in the TMX central cell, some applications of heating, the results of preliminary experiments, and plans for further ICRH experiments

Initial Egyptian ECMO experience

Directory of Open Access Journals (Sweden)

Akram Abdelbary

2016-04-01

Results: A total of twelve patients received ECMO between January 2014 and June 2015. The mean age was 35.9 years. (range 13–65 years, 8 males, with VV ECMO in 10 patients, and VA ECMO in 2 patients. Out of ten patients of VV ECMO, one had H1N1 pneumonia, one had advanced vasculitic lung, four had bacterial pneumonia, two traumatic lung contusions and one with organophosphorus poisoning, and one undiagnosed etiology leading to severe ARDS. Lung injury score range was 3–3.8, PaO2/FiO2 (20–76 mechanical ventilation duration before ECMO 1–14 days, Femoro-jugular cannulation in 7 patients and femoro-femoral in 2 patients and femoro-subclavian in 1 patient; all patients were initially sedated and paralyzed for (2–4 days and ventilated on pressure controlled ventilation with Pmax of 25 cm H2O and PEEP of 10 cm H2O. In VA ECMO patients were cannulated percutaneously using femoro-femoral approach. One patient showed no neurologic recovery and died after 24 h, the other had CABG on ECMO however the heart didn’t recover and died after 9 days. Heparin intravenous infusion was used initially in all patients and changed to Bivalirudin in 2 patients due to possible HIT. Pump flow ranged from 2.6 to 6.5 L/min. Average support time was 12 days (range 2–24 days. Seven patients (63.3% were successfully separated from ECMO and survived to hospital discharge. Hospital length of stay ranged from 3 to 42 days, tracheostomy was done percutaneously in 5 patients and surgically in 3. Gastrointestinal bleeding occurred in 6 patients, VAP in 7 patients, neurologic complications in 1 patient with complete recovery, cardiac arrhythmias in 3 patients, pneumothorax in 9 patients, and deep venous thrombosis in 2 patients.

Student Experiences: the 2013 Cascadia Initiative Expedition Team's Apply to Sail Program

Science.gov (United States)

Mejia, H.; Hooft, E. E.; Fattaruso, L.

2013-12-01

During the summer of 2013, the Cascadia Initiative Expedition Team led six oceanographic expeditions to recover and redeploy ocean bottom seismometers (OBSs) across the Cascadia subduction zone and Juan de Fuca plate. The Cascadia Initiative (CI) is an onshore/offshore seismic and geodetic experiment to study questions ranging from megathrust earthquakes to volcanic arc structure to the formation, deformation and hydration of the Juan de Fuca and Gorda plates with the overarching goal of understanding the entire subduction zone system. The Cascadia Initiative Expedition Team is a team of scientists charged with leading the oceanographic expeditions to deploy and recover CI OBSs and developing the associated Education and Outreach effort. Students and early career scientists were encouraged to apply to join the cruises via the Cascadia Initiative Expedition Team's Apply to Sail Program. The goal of this call for open participation was to help expand the user base of OBS data by providing opportunities for students and scientists to directly experience at-sea acquisition of OBS data. Participants were required to have a strong interest in learning field techniques, be willing to work long hours at sea assisting in OBS deployment, recovery and preliminary data processing and have an interest in working with the data collected. In total, there were 51 applicants to the Apply to Sail Program from the US and 4 other countries; 21 graduate students as well as a few undergraduate students, postdocs and young scientists from the US and Canada were chosen to join the crew. The cruises lasted from 6 to 14 days in length. OBS retrievals comprised the three first legs, of which the first two were aboard the Research Vessel Oceanus. During each of the retrievals, multiple acoustic signals were sent while the vessel completed a semi-circle around the OBS to accurately determine its position, a final signal was sent to drop the seismometer's anchor, and finally the ship and crew

Initial experience of using an active beam delivery technique at PSI

International Nuclear Information System (INIS)

Pedroni, E.; Boehringer, T.; Coray, A.; Egger, E.; Grossmann, M.; Lin Shixiong; Lomax, A.; Goitein, G.; Roser, W.; Schaffner, B.

1999-01-01

At PSI a new proton therapy facility has been assembled and commissioned. The major features of the facility are the spot scanning technique and the very compact gantry. The operation of the facility was started in 1997 and the feasibility of the spot scanning technique has been demonstrated in practice with patient treatments. In this report we discuss the usual initial difficulties encountered in the commissioning of a new technology, the very positive preliminary experience with the system and the optimistic expectations for the future. The long range goal of this project is to parallel the recent developments regarding inverse planning for photons with a similar advanced technology optimized for a proton beam. (orig.)

Measuring health systems strength and its impact: experiences from the African Health Initiative.

Science.gov (United States)

Sherr, Kenneth; Fernandes, Quinhas; Kanté, Almamy M; Bawah, Ayaga; Condo, Jeanine; Mutale, Wilbroad

2017-12-21

Health systems are essential platforms for accessible, quality health services, and population health improvements. Global health initiatives have dramatically increased health resources; however, funding to strengthen health systems has not increased commensurately, partially due to concerns about health system complexity and evidence gaps demonstrating health outcome improvements. In 2009, the African Health Initiative of the Doris Duke Charitable Foundation began supporting Population Health Implementation and Training Partnership projects in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze significant advances in strengthening health systems. This manuscript reflects on the experience of establishing an evaluation framework to measure health systems strength, and associate measures with health outcomes, as part of this Initiative. Using the World Health Organization's health systems building block framework, the Partnerships present novel approaches to measure health systems building blocks and summarize data across and within building blocks to facilitate analytic procedures. Three Partnerships developed summary measures spanning the building blocks using principal component analysis (Ghana and Tanzania) or the balanced scorecard (Zambia). Other Partnerships developed summary measures to simplify multiple indicators within individual building blocks, including health information systems (Mozambique), and service delivery (Rwanda). At the end of the project intervention period, one to two key informants from each Partnership's leadership team were asked to list - in rank order - the importance of the six building blocks in relation to their intervention. Though there were differences across Partnerships, service delivery and information systems were reported to be the most common focus of interventions, followed by health workforce and leadership and governance. Medical products, vaccines and technologies, and

Comportamento da dor e da função pulmonar em pacientes submetidos à cirurgia cardíaca via esternotomia Pain and pulmonary function in patients submitted to heart surgery via sternotomy

Directory of Open Access Journals (Sweden)

Maria Cristina dos Santos Baumgarten

2009-12-01

Full Text Available OBJETIVO: Avaliar o comportamento da função pulmonar e da dor em pacientes adultos submetidos à cirurgia cardíaca por esternotomia. Além de verificar possíveis correlações e comparações dessas variáveis com as características do procedimento cirúrgico e o tempo de internação hospitalar. MÉTODOS: Foi realizado estudo de coorte composto de 70 indivíduos, nos quais foi avaliada a função pulmonar préoperatória por espirometria e inspirometria de incentivo. Os pacientes foram acompanhados no pós-operatório, por meio de protocolo com informações da cirurgia, função pulmonar e um protocolo de avaliação álgica (escala análoga visual e desenho do corpo humano. RESULTADOS: Os valores de função pulmonar do período pós-operatório apresentaram diminuição significativa em relação ao pré-operatório (POBJECTIVE: To investigate the pulmonary function and pain in adult patients undergoing heart surgery via sternotomy and to verify possible correlations of these variables with the characteristics of the surgical procedure and hospital stay. METHODS: A cross-sectional study was carried out of 70 individuals undergoing heart surgery. The lung function was assessed before and after surgery by spirometry and incentive spirometry. Details of the surgical procedure were studied and patients were followed up postoperatively using a visual analogue scale and design of the human body to evaluate pain. RESULTS: The pulmonary function was significantly impaired in the postoperative compared to preoperative period (P <0.01. The pain was centered in the region of the sternotomy and persisted until at least the 5th postoperative day. There was a correlation between pain and the parameters of pulmonary function (forced expiratory volume in 1 second - percentage: r = -0.271, P <0.047; peak expiratory flow: r = 0.357, P <0.008; and maximum inspiratory volume: r = -0.293, P <0.032. There was no significant correlation between pain and other

[Initial experience in robot-assisted colorectal surgery in Mexico].

Science.gov (United States)

Villanueva-Sáenz, Eduardo; Ramírez-Ramírez, Moisés Marino; Zubieta-O'Farrill, Gregorio; García-Hernández, Luis

Colorectal surgery has advanced notably since the introduction of the mechanical suture and the minimally invasive approach. Robotic surgery began in order to satisfy the needs of the patient-doctor relationship, and migrated to the area of colorectal surgery. An initial report is presented on the experience of managing colorectal disease using robot-assisted surgery, as well as an analysis of the current role of this platform. A retrospective study was conducted in order to review five patients with colorectal disease operated using a robot-assisted technique over one year in the initial phase of the learning curve. Gender, age, diagnosis and surgical indication, surgery performed, surgical time, conversion, bleeding, post-operative complications, and hospital stay, were analysed and described. A literature review was performed on the role of robotic assisted surgery in colorectal disease and cancer. The study included 5 patients, 3 men and 2 women, with a mean age of 62.2 years. Two of them were low anterior resections with colorectal primary anastomoses, one of them extended with a loop protection ileostomy, a Frykman-Goldberg procedure, and two left hemicolectomies with primary anastomoses. The mean operating time was 6hours and robot-assisted 4hours 20minutes. There were no conversions and the mean hospital stay was 5 days. This technology is currently being used worldwide in different surgical centres because of its advantages that have been clinically demonstrated by various studies. We report the first colorectal surgical cases in Mexico, with promising results. There is enough evidence to support and recommend the use of this technology as a viable and safe option. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

Using Controlled Landslide Initiation Experiments to Test Limit-Equilibrium Analyses of Slope Stability

Science.gov (United States)

Reid, M. E.; Iverson, R. M.; Brien, D. L.; Iverson, N. R.; Lahusen, R. G.; Logan, M.

2004-12-01

Most studies of landslide initiation employ limit equilibrium analyses of slope stability. Owing to a lack of detailed data, however, few studies have tested limit-equilibrium predictions against physical measurements of slope failure. We have conducted a series of field-scale, highly controlled landslide initiation experiments at the USGS debris-flow flume in Oregon; these experiments provide exceptional data to test limit equilibrium methods. In each of seven experiments, we attempted to induce failure in a 0.65m thick, 2m wide, 6m3 prism of loamy sand placed behind a retaining wall in the 31° sloping flume. We systematically investigated triggering of sliding by groundwater injection, by prolonged moderate-intensity sprinkling, and by bursts of high intensity sprinkling. We also used vibratory compaction to control soil porosity and thereby investigate differences in failure behavior of dense and loose soils. About 50 sensors were monitored at 20 Hz during the experiments, including nests of tiltmeters buried at 7 cm spacing to define subsurface failure geometry, and nests of tensiometers and pore-pressure sensors to define evolving pore-pressure fields. In addition, we performed ancillary laboratory tests to measure soil porosity, shear strength, hydraulic conductivity, and compressibility. In loose soils (porosity of 0.52 to 0.55), abrupt failure typically occurred along the flume bed after substantial soil deformation. In denser soils (porosity of 0.41 to 0.44), gradual failure occurred within the soil prism. All failure surfaces had a maximum length to depth ratio of about 7. In even denser soil (porosity of 0.39), we could not induce failure by sprinkling. The internal friction angle of the soils varied from 28° to 40° with decreasing porosity. We analyzed stability at failure, given the observed pore-pressure conditions just prior to large movement, using a 1-D infinite-slope method and a more complete 2-D Janbu method. Each method provides a static

The AGING Initiative experience: a call for sustained support for team science networks.

Science.gov (United States)

Garg, Tullika; Anzuoni, Kathryn; Landyn, Valentina; Hajduk, Alexandra; Waring, Stephen; Hanson, Leah R; Whitson, Heather E

2018-05-18

Team science, defined as collaborative research efforts that leverage the expertise of diverse disciplines, is recognised as a critical means to address complex healthcare challenges, but the practical implementation of team science can be difficult. Our objective is to describe the barriers, solutions and lessons learned from our team science experience as applied to the complex and growing challenge of multiple chronic conditions (MCC). MCC is the presence of two or more chronic conditions that have a collective adverse effect on health status, function or quality of life, and that require complex healthcare management, decision-making or coordination. Due to the increasing impact on the United States society, MCC research has been identified as a high priority research area by multiple federal agencies. In response to this need, two national research entities, the Healthcare Systems Research Network (HCSRN) and the Claude D. Pepper Older Americans Independence Centers (OAIC), formed the Advancing Geriatrics Infrastructure and Network Growth (AGING) Initiative to build nationwide capacity for MCC team science. This article describes the structure, lessons learned and initial outcomes of the AGING Initiative. We call for funding mechanisms to sustain infrastructures that have demonstrated success in fostering team science and innovation in translating findings to policy change necessary to solve complex problems in healthcare.

Prevalence of Sexual Experience and Initiation of Sexual Intercourse Among Adolescents, Rakai District, Uganda, 1994-2011

DEFF Research Database (Denmark)

Santelli, John S; Song, Xiaoyu; Larsen Holden, Inge Kristine

2015-01-01

: Sexual experience was more common among adolescent women than men. The prevalence of sexual experience rose for most age-gender groups after 1994 and then declined after 2002. Factors associated with higher prevalence of sexual experience (without adjustment for other factors) included age, not enrolled......PURPOSE: The purpose of the study was to identify risk factors and time trends for sexual experience and sexual debut in rural Uganda. METHODS: Using population-based, longitudinal data from 15- to 19-year olds in Rakai, Uganda, we examined temporal trends in the prevalence of sexual experience...... and potential risk factors for sexual experience (n = 31,517 person-round observations) using logistic regression. We then identified factors associated with initiation of sex between survey rounds, using Poisson regression to estimate incidence rate ratios (IRR; n = 5,126 person-year observations). RESULTS...

Multi-detector CT knee arthrography - initial experience

International Nuclear Information System (INIS)

Thomson, J.M.Z.; Fallon, M.; Breidahl, W.H.

2002-01-01

Full text: Traditional plain film arthrography can achieve reasonable accuracy and is an accepted method of investigation of patients with knee pain and possible meniscal tear. Multi-detector CT can potentially provide a more detailed and accurate examination due to its high-resolution crosssectional and multi-planar capabilities. The aim of this study was to assess the accuracy of our technique. All patients who underwent a multi-detector CT knee arthrogram in an initial 8 month period were identified. Initially the referring clinician was contacted. If the patient was referred to an orthopaedic surgeon the outcome of orthopaedic review was recorded using clinical, arthroscopic and / or MRI follow-up of the patient population. One hundred and twelve patients had a Multi-detector CT knee arthrogram performed within and 8 month period. Follow-up information was received in 69.7% of patients. Of these 68.9% had orthopaedic assessment - of which 69.2% underwent a knee arthroscopy.There was total agreement of findings in 67%, agreement of meniscal findings in 67% and chondral findings in 100%. Overall, orthopaedic opinion agreed with CT findings in 76.9%. At this stage, all meniscal tears not described in the initial CT arthrogram report have in retrospect been visible. Multi-detector CT knee arthrography is an accurate and elegant technique for investigation of knee pain, providing information in a format familiar to those reporting knee MRI. There is an initial learning curve. The technique is particularly useful in chondral assessment. It is accurate for meniscal pathology, although caution and recognition of potential pitfalls is required. Copyright (2002) Blackwell Science Pty Ltd

Initial experience with AcQsim CT simulator

International Nuclear Information System (INIS)

Michalski, Jeff M.; Gerber, Russell; Bosch, Walter R.; Harms, William; Matthews, John W.; Purdy, James A.; Perez, Carlos A.

1995-01-01

Purpose: We recently replaced our university developed CT simulator prototype with a commercial grade spiral CT simulator (Picker AcQsim) that is networked with three independent virtual simulation workstations and our 3D radiation therapy planning (3D-RTP) system multiple workstations. This presentation will report our initial experience with this CT simulation device and define criteria for optimum clinical use as well as describe some potential drawbacks of the current system. Methods and Materials: Over a 10 month period, 210 patients underwent CT simulation using the AcQsim. An additional 127 patients had a volumetric CT scan done on the device with their CT data and target and normal tissue contours ultimately transferred to our 3D-RTP system. We currently perform the initial patient localization and immobilization in the CT simulation suite by using CT topograms and a fiducial laser marking system. Immobilization devices, required for all patients undergoing CT simulation, are constructed and registered to a device that defines the treatment table coordinates. Orthogonal anterior and lateral CT topograms document patient alignment and the position of a reference coordinate center. The volumetric CT scan with appropriate CT contrast materials administered is obtained while the patient is in the immobilization device. On average, more than 100 CT slices are obtained per study. Contours defining tumor, target, and normal tissues are drawn on a slice by slice basis. Isocenter definition can be automatically defined within the target volume and marked on the patient and immobilization device before leaving the initial CT simulation session. Virtual simulation is then performed on the patient data set with the assistance of predefined target volumes and normal tissue contours displayed on rapidly computed digital reconstructed radiographs (DRRs) in a manner similar to a conventional fluoroscopic radiotherapy simulator. Lastly, a verification simulation is

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

Science.gov (United States)

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

2017-06-01

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

[Aortic valve preservation in Marfan syndrome. Initial experience].

Science.gov (United States)

Forteza, Alberto; Cortina, Jose M; Sánchez, Violeta; Centeno, Jorge; López, M Jesús; Pérez de la Sota, Enrique; Rufilanchas, Juan J

2007-05-01

Preservation of the aortic valve using the technique described by David has been shown to be as effective as the Bentall-De Bono procedure. It avoids both the need for long-term anticoagulation and the complications associated with mechanical prostheses. We report our initial experience using this technique in patients with Marfan syndrome. Between April 2004 and April 2006, we used the David reimplantation technique in 40 patients with an aortic root aneurysm. Eighteen patients had Marfan syndrome. Their median age was 29 years (13-55 years). Echocardiography showed that the median diameter of the aortic sinus was 53 mm (46-59 mm). In 17 patients, aortic valve preservation was possible. No patient died during hospitalization and there were no significant complications. On echocardiography at discharge, no patient had greater than grade-II aortic regurgitation. During a median follow-up period of 8 months (1-24 months), one patient died due to rupture of an abdominal aneurysm. The others are all in New York Heart Association class I. Preservation of the aortic valve by means of valve reimplantation produced excellent results. It avoided both the thromboembolic and hemorrhagic complications associated with prostheses and the need for long-term anticoagulation. If reimplanted valves continue to function adequately over the long term, this technique should become the treatment of choice for aneurysms of the ascending aorta in patients with Marfan syndrome.

Initiation of Addiction Treatment and Access to Services: Young Adults' Accounts of Their Help-Seeking Experiences.

Science.gov (United States)

Wagner, Vincent; Bertrand, Karine; Flores-Aranda, Jorge; Acier, Didier; Brunelle, Natacha; Landry, Michel; Brochu, Serge

2017-09-01

Substance addiction in young adults is particularly problematic. Yet, much remain at stake in understanding the specifics of this population's access to services. The objective of this study is to explore young adults' initiation of substance misuse treatment. Our study sample was composed of 35 individuals aged 18 to 30 with problematic psychoactive substance use who have been identified in criminal courts, hospital emergency departments, and Health and Social Services Centers in Québec (Canada). A thematic analysis was performed on the 62 semi-structured interviews conducted with participants. Three components emerged. First, personal elements-expectations, individual motivations, perceptions of use, and capacity to control it-influence initiation of substance misuse treatment. Second, family and peers have noticeable influences. Finally, system characteristics and prior care experiences also shape the process. Consideration should be given to tailor interventions that can reach young adults and encourage them to initiate appropriate care.

Ultrasound-guided Breast Biopsy in the Resource-limited Setting: An Initial Experience in Rural Uganda

Directory of Open Access Journals (Sweden)

Christopher R. Stark

2017-06-01

Full Text Available Purpose: To describe the methodology and initial experience behind creation of an ultrasoundguided percutaneous breast core biopsy program in rural Uganda. Methods and Materials: Imaging the World Africa (ITWA is the registered non-governmental organization division of Imaging the World (ITW, a not-for-profit organization whose primary aim is the integration of affordable high-quality ultrasound into rural health centers. In 2013, ITWA began the pilot phase of an IRB-approved breast care protocol at a rural health center in Uganda. As part of the protocol’s diagnostic arm, an ultrasound-guided percutaneous breast core biopsy training curriculum was implemented in tandem with creation of regionally supplied biopsy kits. Results: A surgeon at a rural regional referral hospital was successfully trained and certified to perform ultrasound-guided percutaneous breast core biopsies. Affordable and safe biopsy kits were created using locally available medical supplies with the cost of each kit totaling $10.62 USD. Conclusion: Successful implementation of an ultrasound-guided percutaneous breast core biopsy program in the resource-limited setting is possible and can be made sustainable through incorporation of local health care personnel and regionally supplied biopsy materials. Our hope is that ITWA’s initial experience in rural Uganda can serve as a model for similar programs in the future.

Carcinoma Showing Thymus-Like Differentiation (CASTLE of Thyroid: A Case Report and Literature Review

Directory of Open Access Journals (Sweden)

Leong-Perng Chan

2008-11-01

Full Text Available Carcinoma showing thymus-like differentiation (CASTLE is a rare malignant neoplasm that occurs in the thyroid gland, or head and neck. This tumor arises from either ectopic thymus tissue or remnants of branchial pouches, which retain the potential to differentiate along the thymus line. Clinical presentation and imaging can be consistent with a malignant lesion such as thyroid cancer or thymic carcinoma. Immunohistochemical staining with CD5 can differentiate CASTLE from other malignant thyroid neoplasms. A 54-year-old male had initially presented with a painless, left neck mass for 3 months. He underwent left thyroid lobectomy via a median sternotomy approach. Carcinoma showing thymus-like differentiation was the final histopathologic diagnosis. After 36 months of follow-up, no evidence of recurrence was observed. A median sternotomy is an excellent approach for CASTLE with anterior mediastinum involvement. Complete resection is important to improve the long-term survival rate and the locoregional recurrence rate.

[Ministernotomy: a preliminary experience in heart valve surgery].

Science.gov (United States)

Kovarević, Pavle; Mihajlović, Bogoljub; Velicki, Lazar; Redzek, Aleksandar; Ivanović, Vladimir; Komazec, Nikola

2011-05-01

The last decade of the 20th century brought up a significant development in the field of minimally invasive approaches to the valvular heart surgery. Potential benefits of this method are: good esthetic appearance, reduced pain, reduction of postoperative hemorrhage and incidence of surgical site infection, shorter postoperative intensive care units (ICU) period and overall in-hospital period. Partial upper median stemotomy currently presents as a state-of-the art method for minimally invasive surgery of cardiac valves. The aim of this study was to report on initial experience in application of this surgical method in the surgery of mitral and aortic valves. The study was designed and conducted in a prospective manner and included all the patients who underwent minimally invasive cardiac valve surgery through the partial upper median stemotomy during the period November 2008 - August 2009. We analyzed the data on mean age of patients, mean extubation time, mean postoperative drainage, mean duration of hospital stay, as well as on occurance of postoperative complications (postoperative bleeding, surgical site infection and cerebrovascular insult). During the observed period, in the Institute for Cardiovascular Diseases of Vojvodina, Clinic for Cardiovascular Surgery, 17 ministernotomies were performed, with 14 aortic valve replacements (82.35%) and 3 mitral valve replacements (17.65%). Mean age of the patients was 60.78 +/- 12.99 years (64.71% males, 35.29% females). Mean extubation time was 12.53 +/- 8.87 hours with 23.5% of the patients extubated in less than 8 hours. Mean duration of hospital stay was 12.35 +/- 10.17 days (in 29.4% of the patients less than 8 days). Mean postoperative drainage was 547.06 +/- 335.2 mL. Postoperative complications included: bleeding (5.88%) and cerebrovascular insult (5.88%). One patient (5.88%) required conversion to full stemotomy. Partial upper median sternotomy represents the optimal surgical method for the interventions on the

Initiation of simian virus 40 DNA replication in vitro: Pulse-chase experiments identify the first labeled species as topologically unwound

International Nuclear Information System (INIS)

Bullock, P.A.; Seo, Yeon Soo; Hurwitz, J.

1989-01-01

A distinct unwound form of DNA containing the simian virus 40 (SV40) origin is produced in replication reactions carried out in mixtures containing crude fractions prepared from HeLa cells. This species, termed form U R , comigrates on chloroquine-containing agarose gels with the upper part of the previously described heterogeneous highly unwound circular DNA, form U. As with form U, formation of form U R is dependent upon the SV40 tumor (T) antigen. Pulse-chase experiments demonstrate that the first species to incorporate labeled deoxyribonucleotides comigrates with form U R . Restriction analyses of the products of the pulse-chase experiments show that initiation occurs at the SV40 origin and then proceeds outward in a bidirectional manner. These experiments establish form U R as the earliest detectable substrate for SV40 DNA replication and suggest that SV40 DNA replication initiates on an unwound species

Revascularização do miocárdio sem circulação extracorpórea: experiência e resultados iniciais Myocardial revascularization without cardiopulmonary bypass: experience and initial results

Directory of Open Access Journals (Sweden)

Luiz Antônio BRASIL

2000-03-01

insufficiency. OBJECTIVE: To present our experience with this procedure describing the technique used and our initial results. MATERIAL AND METHODS: Twenty-three patients were submitted to myocardial revascularization without CPB. The patients selected for this study had lesions in the coronary arteries of the anterodiaphragmatic cardiac region. The main surgical indication was chronic coronary insufficiency (78.3%. 65% of the patients were male, with age between 44-80 (mean - 59.6 years. The surgical approach in all patients was through median sternotomy. He grafts used were internal thoracic arteries, saphenous vein and radial artery. RESULTS: Mean surgical time was 3:15 hours. There were no intra-operative occurences. The number of grafts was 1 to 3 in each patient (mean 1.56 graft/patient out of a total of 36 grafts. The left internal thoracic artery was the most used graft (41.7%. The most frequently revascularized coronary arteries were the anterior interventricular branch (52.8% and the right coronary (30.5%. Hospital mortality and post-operative infarct were 4.3%. There were no neurological, pulmonary, renal, hemorragic or infectious complications. The mean hospital stay was 7 days. CONCLUSION: Myocardial revascularization without cardiopulmonary bypass is an effective and safe technique that can be utilized in selected cases with low morbidity and mortality, reducing costs and hospital stay.

[Management of recurrent urethrocutaneous fistula after hypospadias surgery in pediatric patients: initial experience with dermal regeneration sheet Integra].

Science.gov (United States)

Casal-Beloy, I; Somoza Argibay, I; García-González, M; García-Novoa, A M; Míguez Fortes, L; Blanco, C; Dargallo Carbonell, T

2017-10-25

To present our initial experience using a dermal regeneration sheet as an urethral cover in the repair of recurrent urethrocutaneous fistulae in pediatric patients. Since May 2016 to March a total of 8 fistulaes were repaired using this new technique. We performed the ddissection of the fistulous tract and posterior closure of the urethral defect. A dermal regeneration sheet was used to cover the urethral suture. Finally a rotational flap was performed to avoid overlap sutures. During the follow-up (average 6 months), one patient presented in the immediate postoperative period infection of the surgical wound. This patient presented recurrence of the fistula. 88% of the patients included presented a good evolution with no other complications. In our initial experience the new technique seems easy, safe and effective in the management of the recurrent urethrocutaneous fistulae in pediatric patients. More studies are needed to prove these results.

Crossing the gender boundaries: The gender experiences of male nursing students in initial nursing clinical practice in Taiwan.

Science.gov (United States)

Liu, Hsing-Yuan; Li, Yun Ling

2017-11-01

The initial nursing clinical practice is the necessary practicum required for nursing students. Because of the changing learning style, many of them are under great pressure for environmental change and therefore their daily routine is severe affected. Interacting directly with patients in a female-dominated occupation, along with the general gender stereotypes, the impact is especially significant to male nursing students than to female nursing students. The purpose of this preliminary qualitative study is to explore the gendered experiences of male nursing students during their first initial nursing clinical practice. Both focus group interviews and individual interviews are conducted with twenty-two sophomore nursing students from a university of technology in northern Taiwan, with ten male students and twelve female students. Two main themes emerge from the gendered experiences shared by the nursing students: Gender consciousness awakening and thus maintaining masculinity, and male advantage in the learning environments. The results identify the specific gendered experiences of nursing students, providing implications for future nursing education and counseling service. Further, this study may serve to promote an active yet gender-sensitive nursing education for training nursing professionals. Published by Elsevier Ltd.

Characterizing Design Cognition of High School Students: Initial Analyses Comparing Those with and without Pre-Engineering Experiences

Science.gov (United States)

Wells, John; Lammi, Matthew; Gero, John; Grubbs, Michael E.; Paretti, Marie; Williams, Christopher

2016-01-01

Reported in this article are initial results from of a longitudinal study to characterize the design cognition and cognitive design styles of high school students with and without pre-engineering course experience over a 2-year period, and to compare them with undergraduate engineering students. The research followed a verbal protocol analysis…

Initial performance of the COSINE-100 experiment

Energy Technology Data Exchange (ETDEWEB)

Adhikari, G.; Adhikari, P. [Sejong University, Department of Physics, Seoul (Korea, Republic of); Souza, E.B. de; Jo, J.H.; Lim, K.E.; Maruyama, R.H.; Pierpoint, Z.P.; Thompson, W.G. [Yale University, Department of Physics, New Haven, CT (United States); Carlin, N. [University of Sao Paulo, Physics Institute, Sao Paulo (Brazil); Choi, S.; Joo, H.W.; Kim, S.K. [Seoul National University, Department of Physics and Astronomy, Seoul (Korea, Republic of); Choi, W.Q. [Korea Institute of Science and Technology Information, Daejeon (Korea, Republic of); Karlsruher Institut fuer Technologie (KIT), Institut fuer Experimentelle Kernphysik, Eggenstein-Leopoldshafen (Germany); Djamal, M.; Prihtiadi, H. [Bandung Institute of Technology, Department of Physics, Bandung (Indonesia); Ezeribe, A.C.; Kudryavtsev, V.A.; Lynch, W.A.; Mouton, F.; Spooner, N.J.C. [University of Sheffield, Department of Physics and Astronomy, Sheffield (United Kingdom); Ha, C.; Jeon, E.J.; Kang, W.G.; Kim, B.H.; Kim, H.; Kim, K.W.; Kim, N.Y.; Lee, H.S.; Lee, J.; Lee, M.H.; Leonard, D.S.; Olsen, S.L.; Park, H.K.; Park, K.S.; Ra, S.; Yong, S.H. [Institute for Basic Science (IBS), Center for Underground Physics, Daejeon (Korea, Republic of); Hahn, I.S. [Ewha Womans University, Department of Science Education, Seoul (Korea, Republic of); Hubbard, A.J.F. [Yale University, Department of Physics, New Haven, CT (United States); Northwestern University, Department of Physics and Astronomy, Evanston, IL (United States); Kang, W.; Rott, C. [Sungkyunkwan University, Department of Physics, Seoul (Korea, Republic of); Kauer, M. [University of Wisconsin-Madison, Department of Physics and Wisconsin IceCube Particle Astrophysics Center, Madison, WI (United States); Kim, H.J.; Lee, J.Y. [Kyungpook National University, Department of Physics, Daegu (Korea, Republic of); Kim, M.C. [Sungkyunkwan University, Department of Physics, Seoul (Korea, Republic of); Chiba University, Department of Physics, Chiba (Japan); Kim, Y.D. [Sejong University, Department of Physics, Seoul (Korea, Republic of); Institute for Basic Science (IBS), Center for Underground Physics, Daejeon (Korea, Republic of); Kim, Y.H. [Institute for Basic Science (IBS), Center for Underground Physics, Daejeon (Korea, Republic of); Korea Research Institute of Standards and Science, Daejeon (Korea, Republic of); Park, H.S. [Korea Research Institute of Standards and Science, Daejeon (Korea, Republic of); Park, J.S. [Institute for Basic Science (IBS), Center for Underground Physics, Daejeon (Korea, Republic of); High Energy Accelerator Research Organization (KEK), Ibaraki (Japan); Pettus, W. [Yale University, Department of Physics, New Haven, CT (United States); University of Washington, Department of Physics, Center for Experimental Nuclear Physics and Astrophysics, Seattle, WA (United States); Rogers, F.R. [Yale University, Department of Physics, New Haven, CT (United States); Massachusetts Institute of Technology, Department of Physics, Cambridge, MA (United States); Scarff, A. [University of Sheffield, Department of Physics and Astronomy, Sheffield (United Kingdom); University of British Columbia, Department of Physics and Astronomy, Vancouver, BC (Canada); Yang, L. [University of Illinois at Urbana-Champaign, Department of Physics, Urbana, IL (United States)

2018-02-15

COSINE is a dark matter search experiment based on an array of low background NaI(Tl) crystals located at the Yangyang underground laboratory. The assembly of COSINE-100 was completed in the summer of 2016 and the detector is currently collecting physics quality data aimed at reproducing the DAMA/LIBRA experiment that reported an annual modulation signal. Stable operation has been achieved and will continue for at least 2 years. Here, we describe the design of COSINE-100, including the shielding arrangement, the configuration of the NaI(Tl) crystal detection elements, the veto systems, and the associated operational systems, and we show the current performance of the experiment. (orig.)

Our experience with implantation of VentrAssist left ventricular assist device

Directory of Open Access Journals (Sweden)

Hiriyur Shivalingappa Jayanthkumar

2013-01-01

Full Text Available Perioperative anaesthetic management of the VentrAssist TM left ventricular assist device (LVAD is a challenge for anaesthesiologists because patients presenting for this operation have long-standing cardiac failure and often have associated hepatic and renal impairment, which may significantly alter the pharmacokinetics of administered drugs and render the patients coagulopathic. The VentrAssist is implanted by midline sternotomy. A brief period of cardiopulmonary bypass (CPB for apical cannulation of left ventricle is needed. The centrifugal pump, which produces non-pulsatile, continuous flow, is positioned in the left sub-diaphragmatic pocket. This LVAD is preload dependent and afterload sensitive. Transoesophageal echocardiography is an essential tool to rule out contraindications and to ensure proper inflow cannula position, and following the implantation of LVAD, to ensure right ventricular (RV function. The anaesthesiologist should be prepared to manage cardiac decompensation and acute desaturation before initiation of CPB, as well as RV failure and severe coagulopathic bleeding after CPB. Three patients had undergone implantation of VentrAssist in our hospital. This pump provides flow of 5 l/min depending on preload, afterload and pump speed. All the patients were discharged after an average of 30 days. There was no perioperative mortality.

Assessment of crown fire initiation and spread models in Mediterranean conifer forests by using data from field and laboratory experiments

Energy Technology Data Exchange (ETDEWEB)

Rodríguez y Silva, F.; Guijarro, M.; Madrigal, J.; Jiménez, E.; Molina, J.R.; Hernando, C.; Vélez, R.; Vega, J.A.

2017-11-01

Aims of study: To conduct the first full-scale crown fire experiment carried out in a Mediterranean conifer stand in Spain; to use different data sources to assess crown fire initiation and spread models, and to evaluate the role of convection in crown fire initiation. Area of study: The Sierra Morena mountains (Coordinates ETRS89 30N: X: 284793-285038; Y: 4218650-4218766), southern Spain, and the outdoor facilities of the Lourizán Forest Research Centre, northwestern Spain. Material and methods: The full-scale crown fire experiment was conducted in a young Pinus pinea stand. Field data were compared with data predicted using the most used crown fire spread models. A small-scale experiment was developed with Pinus pinaster trees to evaluate the role of convection in crown fire initiation. Mass loss calorimeter tests were conducted with P. pinea needles to estimate residence time of the flame, which was used to validate the crown fire spread model. Main results: The commonly used crown fire models underestimated the crown fire spread rate observed in the full-scale experiment, but the proposed new integrated approach yielded better fits. Without wind-forced convection, tree crowns did not ignite until flames from an intense surface fire contacted tree foliage. Bench-scale tests based on radiation heat flux therefore offer a limited insight to full-scale phenomena. Research highlights: Existing crown fire behaviour models may underestimate the rate of spread of crown fires in many Mediterranean ecosystems. New bench-scale methods based on flame buoyancy and more crown field experiments allowing detailed measurements of fire behaviour are needed.

Assessment of crown fire initiation and spread models in Mediterranean conifer forests by using data from field and laboratory experiments

International Nuclear Information System (INIS)

Rodríguez y Silva, F.; Guijarro, M.; Madrigal, J.; Jiménez, E.; Molina, J.R.; Hernando, C.; Vélez, R.; Vega, J.A.

2017-01-01

Aims of study: To conduct the first full-scale crown fire experiment carried out in a Mediterranean conifer stand in Spain; to use different data sources to assess crown fire initiation and spread models, and to evaluate the role of convection in crown fire initiation. Area of study: The Sierra Morena mountains (Coordinates ETRS89 30N: X: 284793-285038; Y: 4218650-4218766), southern Spain, and the outdoor facilities of the Lourizán Forest Research Centre, northwestern Spain. Material and methods: The full-scale crown fire experiment was conducted in a young Pinus pinea stand. Field data were compared with data predicted using the most used crown fire spread models. A small-scale experiment was developed with Pinus pinaster trees to evaluate the role of convection in crown fire initiation. Mass loss calorimeter tests were conducted with P. pinea needles to estimate residence time of the flame, which was used to validate the crown fire spread model. Main results: The commonly used crown fire models underestimated the crown fire spread rate observed in the full-scale experiment, but the proposed new integrated approach yielded better fits. Without wind-forced convection, tree crowns did not ignite until flames from an intense surface fire contacted tree foliage. Bench-scale tests based on radiation heat flux therefore offer a limited insight to full-scale phenomena. Research highlights: Existing crown fire behaviour models may underestimate the rate of spread of crown fires in many Mediterranean ecosystems. New bench-scale methods based on flame buoyancy and more crown field experiments allowing detailed measurements of fire behaviour are needed.

Second chance for a totally thoracoscopic video-assisted pulmonary vein isolation for atrial fibrillation.

Science.gov (United States)

Driessen, Antoine H G; Krul, Sébastien P J; de Mol, Bas A J M; de Groot, Joris R

2012-06-01

Thoracoscopic surgery for atrial fibrillation (AF) is an attractive and emerging treatment modality. However, when a bleeding occurs access for hemostasis is limited. Therefore, a sternotomy might be necessary to stop the bleeding and continue the operation. We report 2 patients with a periprocedural bleeding in whom sternotomy could be prevented by tamponading the bleeding, interrupting the operation and resuming 3 weeks later. Our cases show that sternotomies can be prevented and that there is a second chance for thoracoscopic surgery for AF. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Independence and Interdependence: An Analysis of Pre-Service Candidates' Use of Focused Assignments on an Electronic Discussion Forum during the Initial Field Experience

Science.gov (United States)

Fisch, Audrey A.; Bennett, Deborah J.

2011-01-01

This article describes a case study using an electronic learning platform for creating an interactive learning community through asynchronous discussion to enhance the initial field experience of secondary math and English teacher candidates enrolled in Field Experience. We identified three problems with the field experience course--lack of…

Initial measurements of two- and three-dimensional ordering, waves, and plasma filamentation in the Magnetized Dusty Plasma Experiment

Energy Technology Data Exchange (ETDEWEB)

Thomas, Edward, E-mail: etjr@auburn.edu; Konopka, Uwe [Physics Department, Auburn University, Auburn, Alabama 36849 (United States); Merlino, Robert L. [Department of Physics and Astronomy, The University of Iowa, Iowa City, Iowa 52242 (United States); Rosenberg, Marlene [Department of Electrical and Computer Engineering, University of California, San Diego, La Jolla, California 92093 (United States)

2016-05-15

The Magnetized Dusty Plasma Experiment at Auburn University has been operational for over one year. In that time, a number of experiments have been performed at magnetic fields up to B = 2.5 T to explore the interaction between magnetized plasmas and charged, micron-sized dust particles. This paper reports on the initial results from studies of: (a) the formation of imposed, ordered structures, (b) the properties of dust wave waves in a rotating frame, and (c) the generation of plasma filaments.

Evaluating the influence of initial magnetization conditions on extracted exchange parameters in NMR relaxation experiments: applications to CPMG and CEST

Energy Technology Data Exchange (ETDEWEB)

Yuwen, Tairan; Sekhar, Ashok; Kay, Lewis E., E-mail: kay@pound.med.utoronto.ca [The University of Toronto, Departments of Molecular Genetics, Biochemistry and Chemistry (Canada)

2016-08-15

Transient excursions of native protein states to functionally relevant higher energy conformations often occur on the μs–ms timescale. NMR spectroscopy has emerged as an important tool to probe such processes using techniques such as Carr–Purcell–Meiboom–Gill (CPMG) relaxation dispersion and Chemical Exchange Saturation Transfer (CEST). The extraction of kinetic and structural parameters from these measurements is predicated upon mathematical modeling of the resulting relaxation profiles, which in turn relies on knowledge of the initial magnetization conditions at the start of the CPMG/CEST relaxation elements in these experiments. Most fitting programs simply assume initial magnetization conditions that are given by equilibrium populations, which may be incorrect in certain implementations of experiments. In this study we have quantified the systematic errors in extracted parameters that are generated from analyses of CPMG and CEST experiments using incorrect initial boundary conditions. We find that the errors in exchange rates (k{sub ex}) and populations (p{sub E}) are typically small (<10 %) and thus can be safely ignored in most cases. However, errors become larger and cannot be fully neglected (20–40 %) as k{sub ex} falls near the lower limit of each method or when short CPMG/CEST relaxation elements are used in these experiments. The source of the errors can be rationalized and their magnitude given by a simple functional form. Despite the fact that errors tend to be small, it is recommended that the correct boundary conditions be implemented in fitting programs so as to obtain as robust estimates of exchange parameters as possible.

Initial Encounters : The Lived Experiences of Buyers

NARCIS (Netherlands)

G. Wright; J.J. Dekker

2012-01-01

The initial encounter between a buyer and a seller has received much attention among practitioners. The first time a buyer interacts with a seller is thought to be highly influential. The premise is that buyers form an opinion during this first encounter, or even the first minutes of this encounter.

Pore Formation and Mobility Investigation (PFMI): Concept, Hardware Development and Initial Analysis of Experiments

Science.gov (United States)

Grugel, Richard N.

2004-01-01

Porosity in the form of "bubbles and pipes" can occur during controlled directional solidification processing of metal alloys. This is a consequence that 1) precludes obtaining any meaningful scientific results and 2) is detrimental to desired material properties. Unfortunately, several Microgravity experiments have been compromised by porosity. The intent of the PFMI investigation is to conduct a systematic effort directed towards understanding porosity formation and mobility during controlled directional solidification (DS) in a microgravity environment. PFMI uses a pure transparent material, succinonitrile (SCN), as well as SCN "alloyed" with water, in conjunction with a translating temperature gradient stage so that direct observation and recording of pore generation and mobility can be made. PFMI is investigating the role of thermocapillary forces and temperature gradients in affecting bubble dynamics as well as other solidification processes in a microgravity Environment. This presentation will cover the concept, hardware development, operations, and the initial results from experiments conducted aboard the International Space Station. .

Initial clinical experience with frameless radiosurgery for patients with intracranial metastases

International Nuclear Information System (INIS)

Kamath, Reena; Ryken, Timothy C.; Meeks, Sanford L.; Pennington, Edward C.; Ritchie, Justine; Buatti, John M.

2005-01-01

Purpose: To review the initial clinical experience with frameless stereotactic radiosurgery (SRS) for treating intracranial metastatic disease. Methods and Materials: Sixty-four patients received frameless SRS for intracranial metastatic disease. Minimum follow-up was 6 months with none lost to follow-up. Patients had a median of 2 metastases and a maximum of 4. The median number of isocenters was 2 with median arcs of 10 and median dose of 17.5 Gy. Thirteen patients were treated for progressive/recurrent disease after surgical resection or whole brain radiotherapy (WBRT). Fifty-one patients were treated with frameless SRS as an an adjunct to initial treatment. Of the total treated, 17 were treated with SRS alone, 20 were treated with WBRT plus SRS, 16 were treated with surgical resection plus SRS, and the remaining 11 were treated with surgical resection plus WBRT plus SRS. Results: With a median actuarial follow-up period of 8.2 months, ultimate local control was 88%. The median time to progression was 8.1 months. The median overall survival was 8.7 months. Of the 17 patients treated with SRS alone, 86% had ultimate local control with mean overall survival of 7.1 months. Of the 13 patients who received surgical resection plus SRS without WBRT as primary treatment, there was 85% ultimate local control with an overall survival of 10.3 months. Three patients treated with initial surgery alone had recurrence treated with SRS 2-3 months after resection. All these patients obtained local control and median survival was >10 months. Of the 13 patients who received WBRT followed by SRS as boost treatment, 92% had local control and mean overall survival was 7.3 months. Of 7 patients who received SRS after recurrence after WBRT, 100% had local control with median survival of 8.2 months. For 8 patients who received surgery followed by WBRT and SRS, local control was 50%; however, ultimate intracranial control was achieved in 7 of 8 patients with repeat SRS and surgical

Preliminary experiments using light-initiated high explosive for driving thin flyer plates

International Nuclear Information System (INIS)

Benham, R.A.

1980-02-01

Light-initiated high explosive, silver acelytide - silver-nitrate (SASN), has been used to produce simulated x ray blow-off impulse loading on reentry vehicles to study the system structural response. SASN can be used to accelerate thin flyer plates to high terminal velocities which, in turn, can deliver a pressure pulse that can be tailored to the target material. This process is important for impulse tests where both structural and material response is desired. The theories used to calculate the dynamic state of the flyer plate prior to impact are summarized. Data from several experiments are presented which indicate that thin flyer plates can be properly accelerated and that there are predictive techniques available which are adequate to calculate the motion of the flyer plate. Recommendations are made for future study that must be undertaken to make the SASN flyer plate technique usable

F-18 FDG PET with coincidence detection, dual-head gamma camera, initial experience in oncology

Energy Technology Data Exchange (ETDEWEB)

Chu, J.M.G.; Pocock, N.; Quach, T.; Camden, B.M.C. [Liverpool Health Services, Liverpool, NSW (Australia). Department of Nuclear Medicine and Clinical Ultrasound

1998-06-01

Full text: The development of Co-incidence Detection (CD) in gamma camera technology has allowed the use of positron radiopharmaceuticals in clinical practice without dedicated PET facilities. We report our initial experience of this technology in Oncological applications. All patients were administered 200 MBq of F- 18 FDG intravenously in a fasting state, with serum glucose below 8.9 mmol/L., and hydration well maintained. Tomography was performed using an ADAC Solus Molecular Co-incidence Detection (MCD) dual-head gamma camera, 60 minutes after administration and immediately after voiding. Tomography of the torso required up to three collections depending on the length of the patient, with each collection requiring 32 steps of 40 second duration, and a 50% overlap. Tomography of the brain required a single collection with 32 steps of 80 seconds. Patients were scanned in the supine position. An iterative reconstruction algorithm was employed without attenuation correction. All patients had histologically confirmed malignancy. Scan findings were correlated with results of all conventional diagnostic imaging procedures that were pertinent to the evaluation and management of each individual patient`s disease. Correlation with tumour type and treatment status was also undertaken. F-18 FDG uptake as demonstrated by CD-PET was increased in tumour bearing sites. The degree of increased uptake varied with tumour type and with treatment status. Our initial experience with CD-PET has been very encouraging, and has led us to undertake prospective short and long term studies to define its role in oncology

Bile Duct Anastomosis Supplied With Biodegradable Stent in Liver Transplantation: The Initial Experience.

Science.gov (United States)

Janousek, L; Maly, S; Oliverius, M; Kocik, M; Kucera, M; Fronek, J

2016-12-01

The most common biliary complications after orthotopic liver transplantation are bile leaks, anastomotic and intrahepatic strictures, stones, and ampullary dysfunction. These complications can occur in up to 10% to 30% of liver transplant recipients. Leaks occur early in the posttransplant period; the stricture formation typically graduates over time. Ten patients underwent transplantation in our preliminary study: 5 were randomized to the group with stent placement and 5 to the control group. We investigated the role of an absorbable biliary stent with the goal of proving patency of duct-to-duct biliary anastomosis. The stents are made of machine-knitted polydioxanone monofilaments. Our initial results show that duct-to-duct biliary reconstruction using an absorbable internal stent had good patency in all 5 patients. There were no signs of biliary leakage accompanying the anastomoses in any of the cases, and there was no stone formation observed after liver transplantation. The biliary stent was completely absorbed, with no adverse effects. Based on our initial experience and data, we concluded that biodegradable stents can be successfully and safely used in clinical practice. Further large prospective randomized studies are needed to estimate the efficacy of the bioabsorbable stents. Copyright © 2016 Elsevier Inc. All rights reserved.

Initial experience gained with the balance-group system of the Swiss power supply legislation

International Nuclear Information System (INIS)

Waldner, M.; Rechsteiner, S.

2010-01-01

This article takes a look at the initial experience gained with the Swiss balance-group system. This system was introduced within the framework of Swiss power supply legislation (StromVG - Stromversorgungsgesetz). The balance-group system was considered to be an essential precondition for the implementation of an energy trading business in a liberalised power market. The associated rights and responsibilities and the economic risks involved are discussed in detail. The partners and structures involved in such a balance-group are looked at and basic models for the associated contracts are examined. The relationship between balance-groups and the national power grid Swissgrid are discussed

Transient debris freezing and potential wall melting during a severe reactivity initiated accident experiment

International Nuclear Information System (INIS)

El-Genk, M.S.; Moore, R.L.

1981-01-01

It is important to light water reactor (LWR) safety analysis to understand the transient freezing of molten core debris on cold structures following a hypothetical core meltdown accident. The purpose of this paper is to (a) present the results of a severe reactivity initiated accident (RIA) in-pile experiment with regard to molten debris distribution and freezing following test fuel rod failure, (b) analyze the transient freezing of molten debris (primarily a mixture of UO/sub 2/ fuel and Zircaloy cladding) deposited on the inner surface of the test shroud wall upon rod failure, and (c) assess the potential for wall melting upon being contacted by the molten debris. 26 refs

Initial Experience with ABO-incompatible Live Donor Renal Transplantation

Directory of Open Access Journals (Sweden)

Meng-Kun Tsai

2006-01-01

Full Text Available The serious shortage of cadaveric organs has prompted the development of ABO-incompatible live donor renal transplantation. We report our experience of the initial two live donor ABO incompatible renal transplants at our hospital. The first patient was a 55-year-old type A female who received a kidney from her AB type husband. The second patient was a 27-year-old type O male who received renal transplantation from his type A father. Preconditioning immunosuppressive therapy in the two patients with tacrolimus, mycophenolate mofetil and methylprednisolone was started 7 days before transplantation. During the period of preconditioning, double filtration plasmapheresis (DFPP was employed to remove anti-A and -B antibodies. Laparoscopic splenectomy and renal transplantation were performed after the anti-donor ABO antibodies were reduced to a titer of 1:4. Rituximab, a humanized monoclonal anti-CD20 antibody, was administered to the second patient due to a rebound in the anti-A antibody titer during the preconditioning period. Under a tacrolimus-based immunosuppressive regimen, both patients recovered very well without any evidence of rejection. Serum creatinine levels were 1.0 and 1.4 mg/dL at 6 and 3 months after transplantation, respectively. These cases illustrate that with new immunosuppressive agents, DFPP and splenectomy, ABO-incompatible renal transplantation can be successfully conducted in end-stage renal disease patients whose only available live donors are blood group incompatible.

Percutaneous MR-guided cryoablation of prostate cancer: initial experience

International Nuclear Information System (INIS)

Gangi, Afshin; Tsoumakidou, Georgia; Abdelli, Omar; Buy, Xavier; Mathelin, Michel de; Jacqmin, Didier; Lang, Herve

2012-01-01

We report our initial experience and the technical feasibility of transperineal prostate cryoablation under MR guidance. Percutaneous MR-guided cryoablation was performed in 11 patients with prostatic adenocarcinoma contraindicated for surgery (mean age: 72 years, mean Gleason score: 6.45, mean prostate-specific antigen (PSA): 6.21 ng/ml, T1-2c/N0/M0, mean: prostate volume 36.44 ml). Free-hand probe positioning was performed under real-time MR imaging. Four to seven cryoprobes were inserted into the prostate, depending on gland volume. The ice ball was monitored using real-time and high-resolution BLADE multi-planar imaging. Patients were followed at 1, 3, 6, 9 and 12 months after the procedure with serum PSA level and post-ablation MRI. Prostate cryoablation was technically feasible in 10/11 patients. The ice ball was clearly and sharply visualised in all cases as a signal-void area. Mean ice-ball volume was 53.3 ml. Mean follow-up was 15 months (range: 1-25). Mean PSA nadir was 0.33 ng/ml (range: 0.02-0.94 ng/ml). Mean hospitalisation was 5 days (range: 3-13). Complications included a urethro-rectal fistula, urinary infection, transient dysuria and scrotal pain. MR-guided prostate cryoablation is feasible and promising, with excellent monitoring of the ice ball. Future perspectives could include the use of MR guidance for focal prostate cancer cryotherapy. (orig.)

Percutaneous MR-guided cryoablation of prostate cancer: initial experience

Energy Technology Data Exchange (ETDEWEB)

Gangi, Afshin; Tsoumakidou, Georgia; Abdelli, Omar; Buy, Xavier [University Hospital of Strasbourg, Department of Interventional Radiology, Strasbourg (France); Mathelin, Michel de [University of Strasbourg, Lsiit, Strasbourg (France); Jacqmin, Didier; Lang, Herve [University Hospital of Strasbourg, Department of Urology, Strasbourg (France)

2012-08-15

We report our initial experience and the technical feasibility of transperineal prostate cryoablation under MR guidance. Percutaneous MR-guided cryoablation was performed in 11 patients with prostatic adenocarcinoma contraindicated for surgery (mean age: 72 years, mean Gleason score: 6.45, mean prostate-specific antigen (PSA): 6.21 ng/ml, T1-2c/N0/M0, mean: prostate volume 36.44 ml). Free-hand probe positioning was performed under real-time MR imaging. Four to seven cryoprobes were inserted into the prostate, depending on gland volume. The ice ball was monitored using real-time and high-resolution BLADE multi-planar imaging. Patients were followed at 1, 3, 6, 9 and 12 months after the procedure with serum PSA level and post-ablation MRI. Prostate cryoablation was technically feasible in 10/11 patients. The ice ball was clearly and sharply visualised in all cases as a signal-void area. Mean ice-ball volume was 53.3 ml. Mean follow-up was 15 months (range: 1-25). Mean PSA nadir was 0.33 ng/ml (range: 0.02-0.94 ng/ml). Mean hospitalisation was 5 days (range: 3-13). Complications included a urethro-rectal fistula, urinary infection, transient dysuria and scrotal pain. MR-guided prostate cryoablation is feasible and promising, with excellent monitoring of the ice ball. Future perspectives could include the use of MR guidance for focal prostate cancer cryotherapy. (orig.)

The Lusi seismic experiment: An initial study to understand the effect of seismic activity to Lusi

Energy Technology Data Exchange (ETDEWEB)

Karyono, E-mail: karyonosu@gmail.com [Agency for Meteorology, Climatology and Geophysics (BMKG), Jakarta (Indonesia); OSLO University (Norway); Padjadjaran University (UNPAD), Bandung (Indonesia); Mazzini, Adriano; Sugiharto, Anton [OSLO University (Norway); Lupi, Matteo [ETH Zurich (Switzerland); Syafri, Ildrem [Padjadjaran University (UNPAD), Bandung (Indonesia); Masturyono,; Rudiyanto, Ariska; Pranata, Bayu; Muzli,; Widodo, Handi Sulistyo; Sudrajat, Ajat [Agency for Meteorology, Climatology and Geophysics (BMKG), Jakarta (Indonesia)

2015-04-24

The spectacular Lumpur Sidoarjo (Lusi) eruption started in northeast Java on the 29 of May 2006 following a M6.3 earthquake striking the island [1,2]. Initially, several gas and mud eruption sites appeared along the reactivated strike-slip Watukosek fault system [3] and within weeks several villages were submerged by boiling mud. The most prominent eruption site was named Lusi. The Lusi seismic experiment is a project aims to begin a detailed study of seismicity around the Lusi area. In this initial phase we deploy 30 seismometers strategically distributed in the area around Lusi and along the Watukosek fault zone that stretches between Lusi and the Arjuno Welirang (AW) complex. The purpose of the initial monitoring is to conduct a preliminary seismic campaign aiming to identify the occurrence and the location of local seismic events in east Java particularly beneath Lusi.This network will locate small event that may not be captured by the existing BMKG network. It will be crucial to design the second phase of the seismic experiment that will consist of a local earthquake tomography of the Lusi-AW region and spatial and temporal variations of vp/vs ratios. The goal of this study is to understand how the seismicity occurring along the Sunda subduction zone affects to the behavior of the Lusi eruption. Our study will also provide a large dataset for a qualitative analysis of earthquake triggering studies, earthquake-volcano and earthquake-earthquake interactions. In this study, we will extract Green’s functions from ambient seismic noise data in order to image the shallow subsurface structure beneath LUSI area. The waveform cross-correlation technique will be apply to all of recordings of ambient seismic noise at 30 seismographic stations around the LUSI area. We use the dispersive behaviour of the retrieved Rayleigh waves to infer velocity structures in the shallow subsurface.

Transanal minimally-invasive surgery (TAMIS: Technique and results from an initial experience

Directory of Open Access Journals (Sweden)

Carlos Ramon Silveira Mendes

2013-10-01

Full Text Available Transanal endoscopic microsurgery is a minimally-invasive approach for rectal lesions. Superior exposure and access to the entire rectum result in lesser risk of compromised margins and lower recurrence rates, when compared to conventional transanal excision. The aim of this study was to describe a single institution's initial experience with transanal minimally invasive surgery (TAMIS. This was a prospective review of our database. Elev- en procedures from January 2012 to June 2013 were analyzed. Results: eleven operations were completed. Five men were evaluated. Mean age was 62.9 (40-86. Mean follow-up was 9.3 (2-17 months. Average tumor size was 3.8 (1.8-8 cm. Mean distance from anal verge was 6.3 (3-12 cm. Mean operating time was 53.73 (28-118 min. Postoperative complica- tion rate was 9.1%. There were no readmissions. Mortality was null. Operative pathology disclosed the presence of adenoma in four patients, invasive adenocarcinoma in two, neu- roendocrine carcinoma in three, and no residual lesion in one case. TAMIS is a minimally- invasive procedure with low postoperative morbidity at the initial experience. TAMIS is a curative procedure for benign lesions and for selected early cancers. It is useful after neoadjuvant therapy for strictly selected cancers, pending the results of multi-institutional trials. Resumo: Microcirurgia endoscópica transanal é uma abordagem minimamente invasiva para lesões retais. Apresenta menor risco de margem comprometida e menores taxas de recorrência em comparação com excisão transanal convencional. Objetivou-se descrever a experiência inicial, de uma única instituição, com cirurgia minimamente invasiva transanal (TAMIS. Avaliação prospectiva de nosso banco de dados. Onze procedimentos de janeiro de 2012 a junho de 2013, foram analisados. Resultados: onze operações foram concluídas. Havia cinco homens. A média de idade foi de 62,9 (40-86. O acompanhamento médio foi de ww9,3 (2-17 meses. O

Personality Traits and Training Initiation Process: Intention, Planning, and Action Initiation.

Science.gov (United States)

Laguna, Mariola; Purc, Ewelina

2016-01-01

The article aims at investigating the role of personality traits in relation to training initiation. Training initiation is conceptualized as a goal realization process, and explained using goal theories. There are three stages of the process analyzed: intention to undertake training, plan formulation, and actual training undertaking. Two studies tested the relationships between five personality traits, defined according to the five factor model, and the stages of the goal realization process. In Study 1, which explains training intention and training plans' formulation, 155 employees participated. In Study 2, which was time-lagged with two measurement points, and which explains intention, plans, and training actions undertaken, the data from 176 employees was collected at 3 month intervals. The results of these studies show that personality traits, mainly openness to experience, predict the training initiation process to some degree: intention, plans, and actual action initiation. The findings allow us to provide recommendations for practitioners responsible for human resource development. The assessment of openness to experience in employees helps predict their motivation to participate in training activities. To increase training motivation it is vital to strengthen intentions to undertake training, and to encourage training action planning.

Improved Approach With Subcostal Exchange of the HeartMate II Left Ventricular Assist Device: Difference in On and Off Pump?

Science.gov (United States)

Gaffey, Ann C; Chen, Carol W; Chung, Jennifer J; Phillips, Emily; Wald, Joyce; Williams, Matthew L; Low, David W; Acker, Michael A; Atluri, Pavan

2017-11-01

The HeartMate II (St. Jude Medical, Inc, St. Paul, MN [previously Thoratec]) left ventricular assist device (LVAD) exchange has traditionally involved a redo sternotomy. Alternate minimally invasive subcostal approaches have the advantage of avoiding sternal reentry, excessive bleeding, and prolonged recovery. This retrospective review included patients who underwent an exchange from May 2009 to March 2016. The patients were divided into three cohorts: (1) redo sternotomy, (2) subcostal approach involving cardiopulmonary bypass (CPB) (ON-CPB SC), and (3) subcostal approach off the CPB pump (OFF-CPB SC). Data pertaining to patients' baseline characteristics and outcomes were collected and analyzed. From May 1, 2009 to July 31, 2016, 33 HeartMate II LVAD exchanges were performed. There were 11 redo sternotomies and 22 subcostal exchanges, 12 of which were in the OFF-CPB SC group. There was no significant difference among the groups in terms of age (p = 0.75), sex (p = 0.95), and indication for exchange (p = 0.94). There was a higher red blood cell transfusion requirement within the sternotomy cohort (p rates were equivalent among the cohorts. Exchange of the HeartMate II LVAD can be accomplished with significantly improved recovery time and transfusion requirement through a less invasive subcostal approach when compared with sternotomy. The subcostal approach can be performed safely both on and off cardiopulmonary bypass. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Hawadith Street Initiative: A unique Sudanese childhood charity experience.

Science.gov (United States)

Ahmed, Awad Mohamed; A-Rahman, Nada Hassan Ahmed

2015-01-01

Due to escalating conflicts and resultant economic constraints, different social services in low income and low-middle income countries have witnessed a decline in its standards, and increase in the costs. This situation has led to emergence of large numbers of patients and their families who cannot afford the costs of health services provided by public hospitals. On this background, and the old heritage of the Sudanese to help the needy, the Hawadith Street Initiative (HSI) was established. Named after the street on which it was founded - which translates indirectly to "Accidents Lane", HSI was established in 2012 by a group of youths, most of them in their twenties of age, and recently graduated. The main activity of the initiative is helping the needy hospital patients, especially with regards to their treatment costs, in Khartoum and other cities in Sudan. Starting with recreational programs for cancer patients, and public campaigns for donation of blood, the initiative's youths changed their activities. Using the social media, Facebook, they adopted the strategy of communication with potential donors, after sending posts containing brief anonymous presentations and call of help for needy cases. Currently HSI includes more than 2000 volunteers in Khartoum and 17 other cities. The most important achievement of HSI is the establishment of an intensive care unit at a children hospital in Omdurman city costing 435,880 US dollars. HSI demonstrates the possibility of delivering great services with minimum resources, and constitutes a unique organization, worldwide, in a new wave of Internet-based initiatives.

First-Year Students’ Initial Motivational Beliefs at University: Predicted by Motivational Beliefs Derived from Within and Out-of-School Experience and Malleable Regardless of the Extent of Students’ Out-of-School Experience

Science.gov (United States)

Gorges, Julia

2017-01-01

The present study tested how academic self-concept of ability (ASC) and intrinsic task value (ITV) transpose onto novel university programs that depart from traditional subject areas within the framework of expectancy-value theory. The study focused on two potential sources of information used to anticipate one’s ASC and ITV regarding new learning content (here: business administration). First, students’ experiences from secondary school, especially their ASCs and ITVs established in a school subject they consider similar to business administration—mathematics—should predict their business administration-specific ASC and ITV. Second, students may have gained relevant experience in out-of-school settings such as internships with business companies or commercial vocational training prior to entering higher education. ASC and ITV developed from out-of-school experiences was hypothesized to predict students’ business administration-specific ASC and ITV as well. However, the likely mismatch between anticipated and actual experience with new contents should lead to revisions of ASC and ITV after entering university reflected in a presumably lower stability compared to secondary school settings. In addition, the extent of students’ out-of-school experience might act as a moderator. Data were collected from 341 first-year students in higher education in Germany before they began their study program and again 3–4 months later. Confirmatory factor analyses support the discriminant validity of the measures used in the study. Results from structural equation modeling show that students’ ASC/ITV derived from relevant out-of-school experience make an important contribution to their initial business administration-specific ASC and ITV beyond their mathematics-specific ASC/ITV. Furthermore, both business administration-specific ASC and ITV showed significantly lower stability coefficients over the initial study phase than research from secondary school indicating

First-Year Students' Initial Motivational Beliefs at University: Predicted by Motivational Beliefs Derived from Within and Out-of-School Experience and Malleable Regardless of the Extent of Students' Out-of-School Experience.

Science.gov (United States)

Gorges, Julia

2017-01-01

The present study tested how academic self-concept of ability (ASC) and intrinsic task value (ITV) transpose onto novel university programs that depart from traditional subject areas within the framework of expectancy-value theory. The study focused on two potential sources of information used to anticipate one's ASC and ITV regarding new learning content (here: business administration). First, students' experiences from secondary school, especially their ASCs and ITVs established in a school subject they consider similar to business administration-mathematics-should predict their business administration-specific ASC and ITV. Second, students may have gained relevant experience in out-of-school settings such as internships with business companies or commercial vocational training prior to entering higher education. ASC and ITV developed from out-of-school experiences was hypothesized to predict students' business administration-specific ASC and ITV as well. However, the likely mismatch between anticipated and actual experience with new contents should lead to revisions of ASC and ITV after entering university reflected in a presumably lower stability compared to secondary school settings. In addition, the extent of students' out-of-school experience might act as a moderator. Data were collected from 341 first-year students in higher education in Germany before they began their study program and again 3-4 months later. Confirmatory factor analyses support the discriminant validity of the measures used in the study. Results from structural equation modeling show that students' ASC/ITV derived from relevant out-of-school experience make an important contribution to their initial business administration-specific ASC and ITV beyond their mathematics-specific ASC/ITV. Furthermore, both business administration-specific ASC and ITV showed significantly lower stability coefficients over the initial study phase than research from secondary school indicating revisions to them

Complete fabrication of target experimental chamber and implement initial target diagnostics to be used for the first target experiments in NDCX-1

International Nuclear Information System (INIS)

Bieniosek, F.M.; Bieniosek, F.M.; Dickinson, M.R.; Henestroza, E.; Katayanagi, T.; Jung, J.Y.; Lee, C.W.; Leitner, M.; Ni, P.; Roy, P.; Seidl, P.; Waldron, W.; Welch, D.

2008-01-01

The Heavy Ion Fusion Science Virtual National Laboratory (HIFS-VNL) has completed the fabrication of a new experimental target chamber facility for future Warm Dense Matter (WDM) experiments, and implemented initial target diagnostics to be used for the first target experiments in NDCX-1. The target chamber has been installed on the NDCX-I beamline. This achievement provides to the HIFS-VNL unique and state-of-the-art experimental capabilities in preparation for the planned target heating experiments using intense heavy ion beams

Initial experiments with the Nevis Cyclotron, the Brookhaven Cosmotron, the Brookhaven AGS and their effects on high energy physics

International Nuclear Information System (INIS)

Lindenbaum, S.J.

1988-01-01

The first experiment at the Nevis Cyclotron by Bernardini, Booth and Lindenbaum demonstrated that nuclear stars are produced by a nucleon-nucleon cascade within the nucleon. This solved a long standing problem in Cosmic rays and made it clear that where they overlap cosmic ray investigation would not be competitive with accelerator investigations. The initial experiments at the Brookhaven Cosmotron by Lindenbaum and Yuan demonstrated that low energy pion nucleon scattering and pion production were unexpectedly mostly due to excitation of the isotopic spin = angular momentum = 3/2 isobaric state of the nucleon. This contradicted the Fermi statistical theory and led to the Isobar model proposed by the author and a collaborator. The initial experiments at the AGS by the author and collaborators demonstrated that the Pomeronchuck Theorem would not come true till at least several hundred GeV. These scattering experiments led to the development of the ''On-line Computer Technique'' by the author and collaborators which is now the almost universal technique in high energy physics. The first accomplishment which flowed from this technique led to contradiction of the Regge pole theory as a dynamical asymptotic theory, by the author and collaborators. The first critical experimental proof of the forward dispersion relation in strong interactions was accomplished by the author and collaborators. They were then used as a crystal ball to predict that ''Asymptopia''---the theoretically promised land where all asymptotic theorems come true---would not be reached till at least 25,000 BeV and probably not before 1,000,000 BeV. 26 refs., 11 figs., 2 tabs

Pain experience during initial alignment with a self-ligating and a conventional fixed orthodontic appliance system. A randomized controlled clinical trial.

Science.gov (United States)

Fleming, P S; Dibiase, A T; Sarri, G; Lee, R T

2009-01-01

To test the hypotheses that (1) there is no difference in the pain experience during the week following initial placement of two orthodontic appliances (SmartClip and Victory; 3M Unitek, Monrovia, Calif); and (2) there is no difference in the pain experience during removal and insertion of orthodontic archwires with these brackets. Sixty-six consecutive patients were treated with a self-ligating bracket system (SmartClip) or a conventional appliance (Victory) on the basis of computer-generated random allocation. After appliance placement and engagement of a 0.016'' nickel-titanium archwire, pain experience was recorded after 4, 24, and 72 hours and after 7 days with the use of a visual analog system (VAS) questionnaire. At a subsequent visit, participants documented pain experiences during removal and insertion of 0.019 x 0.025'' archwires on an additional 100 mm VAS questionnaire. Independent t-tests and analyses of covariance were used to analyze normally distributed data; the Mann-Whitney U-test was used for skewed distributions. Forty-eight (72.2%) and fifty-one (77.3%) subjects completed the first and second parts of the study, respectively. Bracket type had no influence on pain experience at 4 hours (P = .958), 24 hours (P = .289), 72 hours (P = .569), and 7 days (P = .756) following appliance placement. However, bracket type significantly influenced pain experience during archwire removal (P = .001) and insertion (P = .013). Hypothesis 1 cannot be rejected. The bracket type had no effect on subjective pain experience during the first week after initial placement of two preadjusted orthodontic appliances. Hypothesis 2 was rejected. Significantly greater discomfort was experienced during archwire insertion and removal with the SmartClip appliance.

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

Science.gov (United States)

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

2014-11-01

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

Use of Simulation in Nursing Education: Initial Experiences on a European Union Lifelong Learning Programme--Leonardo Da Vinci Project

Science.gov (United States)

Terzioglu, Fusun; Tuna, Zahide; Duygulu, Sergul; Boztepe, Handan; Kapucu, Sevgisun; Ozdemir, Leyla; Akdemir, Nuran; Kocoglu, Deniz; Alinier, Guillaume; Festini, Filippo

2013-01-01

Aim: The aim of this paper is to share the initial experiences on a European Union (EU) Lifelong Learning Programme Leonardo Da Vinci Transfer of Innovation Project related to the use of simulation-based learning with nursing students from Turkey. The project started at the end of the 2010 involving 7 partners from 3 different countries including…

Analysis of results from a loss-of-offsite-power-initiated ATWS experiment in the LOFT Facility

International Nuclear Information System (INIS)

Varacalle, D.J.; Giri, A.M.; Koizumi, Y.; Koske, J.E.

1983-01-01

An anticipated transient without scram (ATWS), initiated by loss-of-offsite power, was experimentally simulated in the Loss-of-Fluid Test (LOFT) pressurized water reactor (PWR). Primary system pressure was controlled using a scaled safety relief valve (SRV) representative of those in a commercial PWR, while reactor power was reduced by moderator reactivity feedback in a natural circulation mode. The experiment showed that reactor power decreases more rapidly when the primary pumps are tripped in a loss-of-offsite-power ATWS than in a loss-of-feedwater induced ATWS when the primary pumps are left on. During the experiment, the SRV had sufficient relief capacity to control primary system pressure. Natural circulation was effective in removing core heat at high temperature, pressure, and core power. The system transient response predicted using the RELAPS/MOD1 computer code showed good agreement with the experimental data

Charging conditions research to increase the initial projected velocity at different initial charge temperatures

Science.gov (United States)

Ishchenko, Aleksandr; Burkin, Viktor; Kasimov, Vladimir; Samorokova, Nina; Zykova, Angelica; Diachkovskii, Alexei

2017-11-01

The problems of the defense industry occupy the most important place in the constantly developing modern world. The daily development of defense technology does not stop, nor do studies on internal ballistics. The scientists of the whole world are faced with the task of managing the main characteristics of a ballistic experiment. The main characteristics of the ballistic experiment are the maximum pressure in the combustion chamber Pmax and the projected velocity at the time of barrel leaving UM. During the work the combustion law of the new high-energy fuel was determined in a ballistic experiment for different initial temperatures. This combustion law was used for a parametric study of depending Pmax and UM from a powder charge mass and a traveling charge was carried out. The optimal conditions for loading were obtained for improving the initial velocity at pressures up to 600 MPa for different initial temperatures. In this paper, one of the most promising schemes of throwing is considered, as well as a method for increasing the muzzle velocity of a projected element to 3317 m/s.

Initiating events frequency determination

International Nuclear Information System (INIS)

Simic, Z.; Mikulicic, V.; Vukovic, I.

2004-01-01

The paper describes work performed for the Nuclear Power Station (NPS). Work is related to the periodic initiating events frequency update for the Probabilistic Safety Assessment (PSA). Data for all relevant NPS initiating events (IE) were reviewed. The main focus was on events occurring during most recent operating history (i.e., last four years). The final IE frequencies were estimated by incorporating both NPS experience and nuclear industry experience. Each event was categorized according to NPS individual plant examination (IPE) initiating events grouping approach. For the majority of the IE groups, few, or no events have occurred at the NPS. For those IE groups with few or no NPS events, the final estimate was made by means of a Bayesian update with general nuclear industry values. Exceptions are rare loss-of-coolant-accidents (LOCA) events, where evaluation of engineering aspects is used in order to determine frequency.(author)

Initial experiments with Multiple Musical Gestures

DEFF Research Database (Denmark)

Jensen, Kristoffer; Graugaard, Lars

2005-01-01

The classic orchestra has a diminishing role in society, while hard-disc recorded music plays a predominant role today. A simple to use pointer interface in 2D for producing music is presented as a means for playing in a social situation. The sounds of the music are produced by a low-level...... synthesizer, and the music is produced by simple gestures that are repeated easily. The gestures include left-to-right and right-to-left motion shapes for spectral envelope and temporal envelope of the sounds, with optional backwards motion for the addition of noise; downward motion for note onset and several...... other manipulation gestures. The initial position controls which parameter is being affected, the notes intensity is controlled by the downward gesture speed, and a sequence is finalized instantly with one upward gesture. The synthesis employs a novel interface structure, the multiple musical gesture...

Initiation Processes of the Tropical Intraseasonal Variability Simulated in an Aqua-Planet Experiment: What is the Intrinsic Mechanism for MJO Onset?

Science.gov (United States)

Takasuka, Daisuke; Satoh, Masaki; Miyakawa, Tomoki; Miura, Hiroaki

2018-04-01

To understand the intrinsic onset mechanism of the Madden-Julian Oscillation (MJO), we simulated a set of initiation processes of MJO-like disturbances in 10 year aqua-planet experiments using a global atmospheric model with a 56 km horizontal mesh and an explicit cloud scheme. Under a condition with a zonally nonuniform sea surface temperature (SST) in the tropics, we reproduced MJO-like disturbances over the western warm pool region. The lagged-composite analysis of detected MJO-like disturbances clarifies the time sequence of three-dimensional dynamic and moisture fields prior to the onset. We found that midtropospheric moistening, a condition that is favorable for deep convection, is particularly obvious in the initiation region 5-9 days before onset. The moistening is caused by two-dimensional horizontal advection due to cross-equatorial shallow circulations associated with mixed Rossby-gravity waves, as well as anomalous poleward flows of a negative Rossby response to suppressed convection. When the midtroposphere is sufficiently moistened, lower tropospheric signals of circumnavigating Kelvin waves trigger active convection. The surface latent heat flux (LHF) feedback contributes to the initial stages of convective organization, while the cloud-radiation feedback contributes to later stages. Sensitivity experiments suggest that circumnavigating Kelvin waves regulate the period of MJO-like disturbances because of efficient convective triggering and that the LHF feedback contributes to rapid convective organization. However, the experiments also reveal that both conditions are not necessary for the existence of MJO-like disturbances. Implications for the relevance of these mechanisms for MJO onset are also discussed.

First-Year Students’ Initial Motivational Beliefs at University: Predicted by Motivational Beliefs Derived from Within and Out-of-School Experience and Malleable Regardless of the Extent of Students’ Out-of-School Experience

Directory of Open Access Journals (Sweden)

Julia Gorges

2017-07-01

Full Text Available The present study tested how academic self-concept of ability (ASC and intrinsic task value (ITV transpose onto novel university programs that depart from traditional subject areas within the framework of expectancy-value theory. The study focused on two potential sources of information used to anticipate one’s ASC and ITV regarding new learning content (here: business administration. First, students’ experiences from secondary school, especially their ASCs and ITVs established in a school subject they consider similar to business administration—mathematics—should predict their business administration-specific ASC and ITV. Second, students may have gained relevant experience in out-of-school settings such as internships with business companies or commercial vocational training prior to entering higher education. ASC and ITV developed from out-of-school experiences was hypothesized to predict students’ business administration-specific ASC and ITV as well. However, the likely mismatch between anticipated and actual experience with new contents should lead to revisions of ASC and ITV after entering university reflected in a presumably lower stability compared to secondary school settings. In addition, the extent of students’ out-of-school experience might act as a moderator. Data were collected from 341 first-year students in higher education in Germany before they began their study program and again 3–4 months later. Confirmatory factor analyses support the discriminant validity of the measures used in the study. Results from structural equation modeling show that students’ ASC/ITV derived from relevant out-of-school experience make an important contribution to their initial business administration-specific ASC and ITV beyond their mathematics-specific ASC/ITV. Furthermore, both business administration-specific ASC and ITV showed significantly lower stability coefficients over the initial study phase than research from secondary

MR imaging-guided percutaneous cryotherapy for lung tumors: initial experience.

Science.gov (United States)

Liu, Shangang; Ren, Ruimei; Liu, Ming; Lv, Yubo; Li, Bin; Li, Chengli

2014-09-01

To evaluate prospectively the initial clinical experience of magnetic resonance (MR) imaging-guided percutaneous cryotherapy of lung tumors. MR imaging-guided percutaneous cryotherapy was performed in 21 patients with biopsy-proven lung tumors (12 men, 9 women; age range, 39-79 y). Follow-up consisted of contrast-enhanced chest computed tomography (CT) scan performed at 3-month intervals to assess tumor control; CT scanning was carried out for 12 months or until death. Cryotherapy procedures were successfully completed in all 21 patients. Pneumothorax occurred in 7 (33.3%) of 21 patients. Chest tube placement was required in one (4.8%) case. Hemoptysis was exhibited by 11 (52.4%) patients, and pleural effusion occurred in 6 (28.6%) patients. Other complications were observed in 14 (66.7%) patients. The mean follow-up period was 10.5 months (range, 9-12 mo) in patients who died. At month 12 of follow-up, 7 (33.3%) patients had a complete response to therapy, and 10 (47.6%) patients showed a partial response. In addition, two patients had stable disease, and two patients developed progressive disease; one patient developed a tumor in the liver, and the other developed a tumor in the brain. The 1-year local control rate was 81%, and 1-year survival rate was 90.5%. MR imaging-guided percutaneous cryotherapy appears feasible, effective, and minimally invasive for lung tumors. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

CT-guided spinal injection: initial experience with Sprotte tip needles

Energy Technology Data Exchange (ETDEWEB)

Pua, Uei [Tan Tock Seng Hospital, Department of Diagnostic Radiology, Singapore (Singapore)

2010-09-15

The purpose of this paper is to describe our initial experience and to illustrate the potential benefits of using small caliber (25 and 27 G), noncutting pencil point needles (Sprotte) with single puncture coaxial technique in CT-guided spinal intervention (CTSI). From January 2009 to June 2009, Sprotte needles with single puncture coaxial technique were used in a total of ten patients for selective nerve root block (SNRB), facet joint block, and pars block under CT fluoroscopy (total of 16 target structures). All procedures were performed without conscious sedation, and visual analog scale (VAS) scores were recorded to determine pain related to needle placement. Total CT fluoroscopy time and out-of-plane needle deviation were obtained. Final needle position was documented by contrast injection for SNRBs and image capture for joint space cannulation. Sixteen out of the 16 structures were successfully targeted. No increase in VAS scores associated with needle placement was recorded, after infiltration of local anesthesia. Optimal peri-neurograms were obtained in all cases of SNRB, despite the side-hole opening in the Sprotte needles. Mean CT fluoroscopy time was 2 s (range 2-8 s per structure), and there was no case of out-of-plane needle deviation that required adjustment of the CT gantry. The use of small caliber Sprotte needles in CTSI is technically feasible and represents a potential refinement to current techniques in the management of chronic spinal pain. (orig.)

Laparoendoscopic single-site extraperitoneal inguinal hernia repair: initial experience in 10 patients.

Science.gov (United States)

Do, Minh; Liatsikos, Evangelos; Beatty, John; Haefner, Tim; Dunn, Ian; Kallidonis, Panagiotis; Stolzenburg, Jens-Uwe

2011-06-01

Recent technical advances and a trend toward laparoscopic single incision surgery have led us to explore the feasibility of laparoendoscopic single-site (LESS) hernia repair. We present our technique and initial experience with LESS extraperitoneal inguinal hernia repair in 10 consecutive men with unilateral inguinal hernias. Age range was 43.7 (28-64) years. Mean body mass index was 28 (range 24-30). Six were left inguinal hernias. There were six indirect and four direct hernias. Three patients had undergone previous open appendectomy. Incarcerated or bilateral hernias were excluded from our initial series. All cases were performed by three surgeons who were experienced in conventional totally extraperitoneal laparoscopic hernia repair as well as experienced in LESS. A literature review of current single-port inguinal hernia repair data is also presented. The mean operative time was 53 minutes (range 45-65  min). The average length of skin incision was 2.8  cm (range 2.3-3.2  cm). No drain was necessary in any of the patients, while no recordable bleeding was observed. There were no intraoperative or immediate postoperative complications. Hospitalization period was 2 days for all patients. After a limited follow-up of 1 month, there have been no recurrences and no complaints of testicular pain. The results of the current series compare favorably with those found in a literature review. LESS extraperitoneal inguinal hernia repair is both feasible and safe, although more technically demanding than its conventional laparoscopic counterpart. Although the cosmetic result with the former approach may prove superior, there are standing questions regarding the complications and long-term outcome. Randomized and if possible blinded trials that compare conventional and single-incision laparoscopic hernia repair may help to distinguish the most advantageous technique.

Modelling Reactivity-Initiated-Accident Experiments With Falcon And SCANAIR: A Comparison Exercise

International Nuclear Information System (INIS)

Romano, A.; Wallin, H.; Zimmermann, M.A.

2005-01-01

A critical assessment is made of the state-of-the-art fuel performance code FALCON in the context of selected Reactivity Initiated Accident (RIA) experiments from the CABRI REP Na series, and contrasts its predictions against those of the extensively benchmarked SCANAIR (Version 3.2) code. The thermal fields in the fuel and cladding, the clad mechanical deformation, and the Fission Gas Release (FGR) are adopted as 'Figures of Merit' by which to judge code performance. Particular attention is paid to the importance of fission-gas-induced clad deformation (which is modelled in SCANAIR, but not in FALCON), relative to that driven by the fuel thermal expansion (which is modelled by both codes). The thermal fields calculated by the codes are in good agreement with each other, especially during the initial stages of the transients --- the adiabatic phase. Larger discrepancies are observed at later times, and are due to the different models applied to calculate the gap conductance. FALCON predicts clad permanent deformations at the end of the transients with a maximum deviation from the experimental measurements of about 20%. Generally, the code always tends to underpredict the measurements. SCANAIR performs similarly, but grossly overpredicts the permanent clad strain for the case involving a very energetic pulse. The fission-gas-driven clad deformation is only relevant for very fast pulse energy injection cases, which are not prototypical of the RIA transients expected in PWRs. The FGR models in FALCON do not capture the mechanism of 'burst-release' in the RIA transients, having been developed for steady-state irradiation conditions. This also explains why they performed poorly when applied to the fast-transient cases analyzed here. In contrast, the FGR results from SCANAIR are in satisfactory agreement with the experimental results. (author)

Treatment of gram-positive deep sternal wound infections in cardiac surgery -experiences with daptomycin-

Directory of Open Access Journals (Sweden)

Coskun Kasim O

2011-09-01

Full Text Available Abstract The reported incidence of deep sternal wound infection (DSWI after cardiac surgery is 0.4-5% with Staphylococcus aureus being the most common pathogen isolated from infected wound sternotomies and bacteraemic blood cultures. This infection is associated with a higher morbidity and mortality than other known aetiologies. Little is reported about the optimal antibiotic management. The aim of the study is to quantify the application of daptomycin treatment of DSWI due to gram-positive organisms post cardiac surgery. We performed an observational analysis in 23 cases of post sternotomy DSWI with gram-positive organisms February 2009 and September 2010. When the wound appeared viable and the microbiological cultures were negative, the technique of chest closure was individualised to the patient. The incidence of DSWI was 1.46%. The mean dose of daptomycin application was 4.4 ± 0.9 mg/kg/d and the average duration of the daptomycin application was 14.47 ± 7.33 days. In 89% of the patients VAC therapy was used. The duration from daptomycin application to sternal closure was 18 ± 13.9 days. The parameters of infection including, fibrinogen (p = 0.03, white blood cell count (p = 0.001 and C-reactive protein (p = 0.0001 were significantly reduced after daptomycin application. We had no mortality and wound healing was successfully achieved in all patients. Treatment of DSWI due to gram-positive organisms with a daptomycin-containing antibiotic regimen is safe, effective and promotes immediate improvement of local wound conditions. Based on these observations, daptomycin may offer a new treatment option for expediting surgical management of DSWI after cardiac surgery.

Robotic repair of vesicovaginal fistula - initial experience

Directory of Open Access Journals (Sweden)

Ankush Jairath

2016-02-01

Full Text Available ABSTRACT Objective The most common acquired fistula of the urinary tract is Vesicovaginal fistulae (VVF (1 posing social stigmata for the patient as well as a surgical challenge for the urologist. Here we present our initial experience with Robotic assisted laparoscopic repair of VVF, its safety and efficacy. Materials and Methods Seven out of eight fistulas were post hysterectomy; five had undergone abdominal while two had laparoscopic hysterectomy while one was due to prolonged labour. Two had associated ureteric injury. All underwent robotic assisted laparoscopic trans abdominal extravesical approach. Three 8 mm ports for robotic arms, one 12 mm port for camera and another 12 mm for assistant were used in a fan shaped manner. All had preoperative ureteric catheter placed. Bladder was closed in two layers and vagina in one layer. Omental flap placed in all cases except two where it was not possible. Drain and per urethral catheter placed in all cases. Double J stents were placed in two cases requiring ureteric implantation additionally. Results The mean age of presentation was 39.25 years (26-47 range with mean BMI being 26.25 kg/m2 (21-32 range. Mean duration between insult and repair was 9.37 months (3-24 months. Only in single case there was history of previous repair attempt. On cystoscopy four had supratrigonal VVF and four were trigonal with mean size of 13.37 mm (7-20 mm. Mean operative time was 117.5 minutes (90-150. There were no intraoperative/postoperative complications or need for open conversion. Mean haemoglobin drop was 1.4 gm/dL (0.3-2 gm. Drain was removed once 24-48 hours output is negligible. One patient had post-operative urinary leak at 2 weeks which ceased with continuation of catheterisation for another 2 weeks. Catheter was removed after voiding cystourethrogram showed no leak at 2-3 weeks postoperatively. Mean duration of drain was 3.75 days (3-5 and per urethral catheterisation (which was removed after voiding

Cirurgia valvar mitral e da comunicação interatrial: abordagem minimamente invasiva ou por esternotomia Mitral valve and atrial septal defect surgery: minimally invasive or sternotomy approach

Directory of Open Access Journals (Sweden)

Josué V. Castro Neto

2012-08-01

Full Text Available FUNDAMENTO: Para diminuir o trauma cirúrgico em procedimentos cardiovasculares, técnicas Minimamente Invasivas (MI foram alternativamente introduzidas. OBJETIVO: Comparar o acesso cirúrgico MI com a Esternotomia Mediana (EM para tratar a cardiopatia valvar mitral (VM e a Comunicação Interatrial (CIA. MÉTODOS: Estudo prospectivo onde quarenta pacientes foram submetidos a cirurgia para correção de cardiopatia VM ou CIA. Foram divididos em: grupo A (GA (n = 20, de acesso por minitoracotomia direita com videoassistência, e grupo B (GB (n = 20, de acesso por EM. Comparamos: tempo de pinçamento aórtico e circulação extracorpórea, tempo de permanência na Unidade de Terapia Intensiva (UTI, tempo de hospitalização e morbidade. RESULTADOS: Quinze pacientes foram submetidos a procedimento VM e 5 a correção de CIA, em cada grupo. Houve nove trocas mitrais (sete bioprotéticas e duas mecânicas e seis reconstruções no GA, e 10 trocas (todas bioprotéticas e cinco reconstruções no GB. As médias de tempo de pinçamento aórtico e circulação extracorpórea, em minutos, foram 65,1 ± 29,3 no GA, e 50,2 ± 21,4 no GB (p = 0,074; e 91,8 ± 35 no GA, e 63,7 ± 27,3 no GB (p = 0,008. As médias de tempo de UTI, em horas, foram 51,7 ± 16,3 no GA, e 55,8 ± 17,5 no GB (p = 0,45. Os tempos de hospitalização, em dias, foram 5,2 ± 1 no GA, e 6,4 ± 1,5 no GB (p = 0,009. CONCLUSÃO: O acesso MI para correção da cardiopatia VM e da CIA implicaram em maior tempo de circulação extracorpórea para a finalização do procedimento principal sem, no entanto, afetar a recuperação do paciente. Os pacientes tratados de forma MI tiveram alta hospitalar mais cedo que os pacientes tratados com esternotomia.BACKGROUND: To decrease the surgical trauma in heart procedures, minimally invasive (MI techniques were alternatively introduced. OBJECTIVE: To compare MI surgical access with median sternotomy (MS for the treatment of mitral valve (MV disease and

[A unit for emergency psychiatry and crisis intervention--concepts, structure and initial experiences].

Science.gov (United States)

Feuerlein, W; Bronisch, T; Fürmaier, A

1983-03-01

The article reports on a ward with 12 beds which has been set up for emergency cases in psychiatry or for immediate intervention in case of a crisis experienced by a patient. In the theoretical part of this article, it is explained that crisis situations are present in most of the psychiatric emergency patients. The article then goes briefly into the fundamentals of therapeutic strategy in such patients: A therapy which helps to uncover hidden conflicts, the pros and cons of therapy focussed on conflict and on supportive measures; as well as a therapy which supports and promotes the ego. This is followed by a comparison of the ward with corresponding facilities in Germany and abroad and a description of their structure, their patients and their function within a psychiatric care system. The concluding part of the article is devoted to a description of the authors' initial experiences and impressions gained during their work with the ward patients, quoting several examples.

Initiatives on early detection and intervention to proactively identify health and social problems in older people: experiences from the Netherlands.

Science.gov (United States)

Lette, Manon; Baan, Caroline A; van den Berg, Matthijs; de Bruin, Simone R

2015-10-30

Over the last years, several initiatives on early detection and intervention have been put in place to proactively identify health and social problems in (frail) older people. An overview of the initiatives currently available in the Netherlands is lacking, and it is unknown whether they meet the preferences and needs of older people. Therefore, the objectives of this study were threefold: 1. To identify initiatives on early detection and intervention for older people in the Netherlands and compare their characteristics; 2. To explore the experiences of professionals with these initiatives; and 3. To explore to what extent existing initiatives meet the preferences and needs of older people. We performed a qualitative descriptive study in which we conducted semi-structured interviews with seventeen experts in preventive elderly care and three group interviews with volunteer elderly advisors. Data were analysed using the framework analysis method. We identified eight categories of initiatives based on the setting (e.g. general practitioner practice, hospital, municipality) in which they were offered. Initiatives differed in their aims and target groups. The utilization of peers to identify problems and risks, as was done by some initiatives, was seen as a strength. Difficulties were experienced with identifying the target group that would benefit from proactive delivery of care and support most, and with addressing prevalent issues among older people (e.g. psychosocial issues, self-reliance issues). Although there is a broad array of initiatives available, there is a discrepancy between supply and demand. Current initiatives insufficiently address needs of (frail) older people. More insight is needed in "what should be done by whom, for which target group and at what moment", in order to improve current practice in preventive elderly care.

Initial Results from the STEM Student Experiences Aboard Ships (STEMSEAS) Program

Science.gov (United States)

Lewis, J. C.; Cooper, S. K.; Thomson, K.; Rabin, B.; Alberts, J.

2016-12-01

The Science Technology Engineering and Math Student Experiences Aboard Ships (STEMSEAS) program was created as a response to NSF's call (through GEOPATHS) for improving undergraduate STEM education and enhancing diversity in the geosciences. It takes advantage of unused berths on UNOLS ships during transits between expeditions. During its 2016 pilot year - which consisted of three transits on three different research vessels in different parts of the country, each with a slightly different focus - the program has gained significant insights into how best to create and structure these opportunities and create impact on individual students. A call for applications resulted in nearly 900 applicants for 30 available spots. Of these applicants, 32% are from minority groups underrepresented in the geosciences (Black, Hispanic, or American Indian) and 20% attend community colleges. The program was able to sail socioeconomically diverse cohorts and include women, veterans, and students with disabilities and from two- and four-year colleges. Twenty-three are underrepresented minorities, 6 attend community colleges, 5 attend an HBCU or tribal college, and many are at HSIs or other MSIs. While longer term impact assessment will have to wait, initial results and 6-month tracking for the first cohort indicate that these kinds of relatively short but intense experiences can indeed achieve significant impacts on students' perception of the geosciences, in their understanding of STEM career opportunities, their desire to work in a geoscience lab setting, and to incorporate geosciences into non-STEM careers. Insights were also gained into the successful makeup of mentor/leader groups, factors to consider in student selection, necessary pre- and post-cruise logistics management, follow-up activities, structure of activities during daily life at sea, increasing student networks and access to mentorships, and leveraging of pre-existing resources and ship-based opportunities

European Community initiatives and experience in scientific and technical information

International Nuclear Information System (INIS)

Steven, G.

1990-05-01

Scientific and technical information (STI) is an increasingly important resource for R and D and industrial development. The rapid development of the market for electronic information and the increasing potential offered through new information technologies require new approaches for the collection and dissemination of STI. Activities of the Commission of the European Communities (CEC) in this area are reviewed. More recent CEC initiatives in the areas of biotechnology information and factual materials data banks have proved the need for international collaboration and for the implementation of infrastructural measures as a basis for such collaboration. The implementation of the EC Demonstrator Programme on materials property data systems has evaluated the potential of eleven European materials data banks against the market requirements and has helped to launch wide international collaboration. The concluding European workshop on materials data systems has developed a set of recommendations for future initiatives. These are shortly reviewed together with initial findings of a study aimed at developing a business plan for the establishment of a biotechnology information infrastructure for the bio-industries and research base in Europe. (author). 3 refs

European Community initiatives and experience in scientific and technical information

Energy Technology Data Exchange (ETDEWEB)

Steven, G [Commission of the European Communities, Luxembourg (Luxembourg)

1990-05-01

Scientific and technical information (STI) is an increasingly important resource for R and D and industrial development. The rapid development of the market for electronic information and the increasing potential offered through new information technologies require new approaches for the collection and dissemination of STI. Activities of the Commission of the European Communities (CEC) in this area are reviewed. More recent CEC initiatives in the areas of biotechnology information and factual materials data banks have proved the need for international collaboration and for the implementation of infrastructural measures as a basis for such collaboration. The implementation of the EC Demonstrator Programme on materials property data systems has evaluated the potential of eleven European materials data banks against the market requirements and has helped to launch wide international collaboration. The concluding European workshop on materials data systems has developed a set of recommendations for future initiatives. These are shortly reviewed together with initial findings of a study aimed at developing a business plan for the establishment of a biotechnology information infrastructure for the bio-industries and research base in Europe. (author). 3 refs.

Large-Scale Laboratory Experiments of Initiation of Motion and Burial of Objects under Currents and Waves

Science.gov (United States)

Landry, B. J.; Wu, H.; Wenzel, S. P.; Gates, S. J.; Fytanidis, D. K.; Garcia, M. H.

2017-12-01

Unexploded ordnances (UXOs) can be found at the bottom of coastal areas as the residue of military wartime activities, training or accidents. These underwater objects are hazards for humans and the coastal environment increasing the need for addressing the knowledge gaps regarding the initiation of motion, fate and transport of UXOs under currents and wave conditions. Extensive experimental analysis was conducted for the initiation of motion of UXOs under various rigid bed roughness conditions (smooth PVC, pitted steel, marbles, gravels and bed of spherical particles) for both unidirectional and oscillatory flows. Particle image velocimetry measurements were conducted under both flow conditions to resolve the flow structure estimate the critical flow conditions for initiation of motion of UXOs. Analysis of the experimental observations shows that the geometrical characteristics of the UXOs, their properties (i.e. volume, mass) and their orientation with respect to the mean flow play an important role on the reorientation and mobility of the examined objects. A novel unified initiation of motion diagram is proposed using an effective/unified hydrodynamic roughness and a new length scale which includes the effect of the projected area and the bed-UXO contact area. Both unidirectional and oscillatory critical flow conditions collapsed into a single dimensionless diagram highlighting the importance and practical applicability of the proposed work. In addition to the rigid bed experiments, the burial dynamics of proud UXOs on a mobile sand bed were also examined. The complex flow-bedform-UXOs interactions were evaluated which highlighted the effect of munition density on burial rate and final burial depth. Burial dynamics and mechanisms for motion were examined for various UXOs types, and results show that, for the case of the low density UXOs under energetic conditions, lateral transport coexists with burial. Prior to burial, UXO re-orientation was also observed

The PIOTRON: initial performance, preparation and experience with pion therapy

International Nuclear Information System (INIS)

Von Essen, C.F.; Blattmann, H.; Crawford, J.F.; Fessenden, P.; Pedroni, E.; Perret, C.; Salzmann, M.; Shortt, K.; Walder, E.

1982-01-01

The PIOTRON is a large solid angle superconducting channel built for the use of negative pi-mesons in radiotherapy. The pions are produced by protons of 590 MeV striking a target of molybdenum or beryllium. The pions are divided into 60 channels and deflected twice to enter the treatment volume radially. The momentum and the momentum band for all 60 channels can be chosen and the beam spot of Bragg peak pions at the isocenter of the applicator is a few centimeters in each direction. Dynamic scanning can thus achieve 3-dimensionally shaped treatment volumes. Two different methods are available: the ring scan, using changes of pion range; and the spot scan, involving translation of the patient through the fixed beam spot. Dose distributions of individual and multiple beams were plotted in a cylindrical water phantom. Radiobiological experiments with mammalian cells in gel and with mouse feet were performed. A special beam geometry using a sector of 15 beams was selected for the first treatments of patients with metastatic skin nodules. Six patients were treated. Acute skin reactions were scored and compared with those from orthovoltage therapy with comparable beam geometry. The RBE for 10 fractions is between 1.4 and 1.5. The next step involved treatment of patients inside water-bolus rings in preparation for dynamic therapy. Patients were then treated with the spot scan dynamic mode in the water bolus. The initial responses and reactions are favorable and confirm the feasibility and accuracy of dynamic pion therapy

Reduction of initial shock in decadal predictions using a new initialization strategy

Science.gov (United States)

He, Yujun; Wang, Bin; Liu, Mimi; Liu, Li; Yu, Yongqiang; Liu, Juanjuan; Li, Ruizhe; Zhang, Cheng; Xu, Shiming; Huang, Wenyu; Liu, Qun; Wang, Yong; Li, Feifei

2017-08-01

A novel full-field initialization strategy based on the dimension-reduced projection four-dimensional variational data assimilation (DRP-4DVar) is proposed to alleviate the well-known initial shock occurring in the early years of decadal predictions. It generates consistent initial conditions, which best fit the monthly mean oceanic analysis data along the coupled model trajectory in 1 month windows. Three indices to measure the initial shock intensity are also proposed. Results indicate that this method does reduce the initial shock in decadal predictions by Flexible Global Ocean-Atmosphere-Land System model, Grid-point version 2 (FGOALS-g2) compared with the three-dimensional variational data assimilation-based nudging full-field initialization for the same model and is comparable to or even better than the different initialization strategies for other fifth phase of the Coupled Model Intercomparison Project (CMIP5) models. Better hindcasts of global mean surface air temperature anomalies can be obtained than in other FGOALS-g2 experiments. Due to the good model response to external forcing and the reduction of initial shock, higher decadal prediction skill is achieved than in other CMIP5 models.

Initial operating experience and recent development on the TRIUMF optically pumped polarized H- ion source

International Nuclear Information System (INIS)

Schmor, P.W.; Law, W.M.; Levy, C.D.P.; McDonald, M.

1988-01-01

A polarized H - ion source using optical pumping techniques has been developed at TRIUMF. This source was used to demonstrate (on an ion source test stand) the feasibility of producing 10- μA of ∼ 60% polarized H - ion beam in a dc mode suitable for injection into the TRIUMF cyclotron. The source has been installed in a 300 kV high voltage terminal connected to the cyclotron via a recently constructed beam transport line. A polarization of 80% is anticipated near the end of 1988 after the installation of a superconducting solenoid to the source. In this paper the authors describe the initial operating experience, recent developments, and the future plans for the TRIUMF optically pumped polarized ion source

Transluminal Angioplasty of Peroneal Artery Branches in Diabetics: Initial Technical Experience

International Nuclear Information System (INIS)

Graziani, Lanfroi; Silvestro, Antonio; Monge, Luca; Boffano, Gian Mario; Kokaly, Francesco; Casadidio, Ilaria; Giannini, Francesco

2008-01-01

The present study aimed to report the technical feasibility of percutaneous transluminal angioplasty (PTA) of obstructed or insufficient collateral branches (anterior and posterior perforating branches) from distal peroneal to foot arteries in diabetic patients with chronic critical limb ischemia (CLI) and chronic noncrossable occlusion of the anterior and posterior tibial arteries. Twenty-four diabetic CLI patients (age, 67 ± 8 years; 87% males) undergoing collateral PTA were included. Baseline clinical angiographic and follow-up data were retrospectively reviewed. Collateral PTA was associated with a concomitant PTA of other sites in 21 (83%) cases. In 15 cases the treated collateral linked the peroneal with the plantaris communis; in 9 cases, the peroneal with the dorsalis pedis. Angiographic results of collateral PTA were good in 13 cases (<30% residual stenosis), whereas the result was considered moderate (30%-49% residual stenosis) in the remaining cases. Neither perforation nor acute occlusion of the treated collaterals or other relevant complications were observed. Mean follow-up was 32 ± 17 months. Major amputation was necessary for two (8.3%) patients. Cumulative limb salvage rates at 2 and 4 years were 96% and 87%, respectively. In conclusion, this initial experience shows that PTA of the collateral branches from distal peroneal to foot arteries is a feasible technique. Future studies are required to define the clinical role of this novel approach

Myocardial delayed-enhancement CT: initial experience in children and young adults

Energy Technology Data Exchange (ETDEWEB)

Goo, Hyun Woo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea, Republic of)

2017-10-15

Clinical utility of myocardial delayed enhancement CT has not been reported in children and young adults. To describe initial experience of myocardial delayed enhancement CT regarding image quality, radiation dose and identification of myocardial lesions in children and young adults. Between August 2013 and November 2016, 29 consecutive children and young adults (median age 16 months) with suspected coronary artery or myocardial abnormality underwent arterial- and delayed-phase cardiac CT at our institution. We measured CT densities in normal myocardium, left ventricular cavity, and arterial and delayed hypo-enhancing and delayed hyperenhancing myocardial lesions. We then compared the extent of delayed hyperenhancing lesions with delayed-enhancement MRI or thallium single-photon emission CT. Normal myocardium and left ventricular cavity showed significantly higher CT numbers on arterial-phase CT than on delayed-phase CT (t-test, P<0.0001). Contrast-to-noise ratios of the arterial and delayed hypo-enhancing and delayed hyperenhancing lesions on CT were 26.7, 17.6 and 18.7, respectively. Delayed-phase CT findings were equivalent to those of delayed-enhancement MRI in all cases (7/7) and to those of thallium single-photon emission CT in 70% (7/10). Myocardial delayed-enhancement CT can be added to evaluate myocardial lesions in select children and young adults with suspected coronary artery or myocardial abnormality. (orig.)

Myocardial delayed-enhancement CT: initial experience in children and young adults

International Nuclear Information System (INIS)

Goo, Hyun Woo

2017-01-01

Clinical utility of myocardial delayed enhancement CT has not been reported in children and young adults. To describe initial experience of myocardial delayed enhancement CT regarding image quality, radiation dose and identification of myocardial lesions in children and young adults. Between August 2013 and November 2016, 29 consecutive children and young adults (median age 16 months) with suspected coronary artery or myocardial abnormality underwent arterial- and delayed-phase cardiac CT at our institution. We measured CT densities in normal myocardium, left ventricular cavity, and arterial and delayed hypo-enhancing and delayed hyperenhancing myocardial lesions. We then compared the extent of delayed hyperenhancing lesions with delayed-enhancement MRI or thallium single-photon emission CT. Normal myocardium and left ventricular cavity showed significantly higher CT numbers on arterial-phase CT than on delayed-phase CT (t-test, P<0.0001). Contrast-to-noise ratios of the arterial and delayed hypo-enhancing and delayed hyperenhancing lesions on CT were 26.7, 17.6 and 18.7, respectively. Delayed-phase CT findings were equivalent to those of delayed-enhancement MRI in all cases (7/7) and to those of thallium single-photon emission CT in 70% (7/10). Myocardial delayed-enhancement CT can be added to evaluate myocardial lesions in select children and young adults with suspected coronary artery or myocardial abnormality. (orig.)

Heidelberg Ion Therapy Center (HIT): Initial clinical experience in the first 80 patients

Energy Technology Data Exchange (ETDEWEB)

Combs, Stephanie E. (Univ. Hospital of Heidelberg, Dept. of Radiation Oncology, Heidelberg (Germany)), E-mail: Stephanie.Combs@med.uni-heidelberg.de; Ellerbrock, Malte; Haberer, Thomas (Heidelberger Ionenstrahl Therapiezentrum (HIT), Im Neuenheimer Feld 450, 69120 Heidelberg (Germany)) (and others)

2010-10-15

The Heidelberg Ion Therapy Center (HIT) started clinical operation in November 2009. In this report we present the first 80 patients treated with proton and carbon ion radiotherapy and describe patient selection, treatment planning and daily treatment for different indications. Patients and methods. Between November 15, 2009 and April 15, 2010, 80 patients were treated at the Heidelberg Ion Therapy Center (HIT) with carbon ion and proton radiotherapy. Main treated indications consisted of skull base chordoma (n = 9) and chondrosarcoma (n = 18), malignant salivary gland tumors (n=29), chordomas of the sacrum (n = 5), low grade glioma (n=3), primary and recurrent malignant astrocytoma and glioblastoma (n=7) and well as osteosarcoma (n = 3). Of these patients, four pediatric patients aged under 18 years were treated. Results. All patients were treated using the intensity-modulated rasterscanning technique. Seventy-six patients were treated with carbon ions (95%), and four patients were treated with protons. In all patients x-ray imaging was performed prior to each fraction. Treatment concepts were based on the initial experiences with carbon ion therapy at the Gesellschaft fuer Schwerionenforschung (GSI) including carbon-only treatments and carbon-boost treatments with photon-IMRT. The average time per fraction in the treatment room per patient was 29 minutes; for irradiation only, the mean time including all patients was 16 minutes. Position verification was performed prior to every treatment fraction with orthogonal x-ray imaging. Conclusion. Particle therapy could be included successfully into the clinical routine at the Dept. of Radiation Oncology in Heidelberg. Numerous clinical trials will subsequently be initiated to precisely define the role of proton and carbon ion radiotherapy in radiation oncology.

Initiation precursors and initiators in laser-induced copolymerization of styrene and maleic anhydride in acetone

Science.gov (United States)

Miner, Gilda A.; Meador, Willard E.; Chang, C. Ken

1990-01-01

The initiation step of photopolymerized styrene/maleic anhydride copolymer was investigated at 365 nm. UV absorption measurements provide decisive evidence that the styrene/maleic anhydride charge transfer complex is the sole absorbing species; however, key laser experiments suggest intermediate reactions lead to a monoradical initiating species. A mechanism for the photoinitiation step of the copolymer is proposed.

In Their Own Words: Young Adults' Menthol Cigarette Initiation, Perceptions, Experiences and Regulation Perspectives.

Science.gov (United States)

Wackowski, Olivia A; Evans, Kiameesha R; Harrell, Melissa B; Loukas, Alexandra; Lewis, M Jane; Delnevo, Cristine D; Perry, Cheryl L

2017-02-17

Menthol cigarettes are disproportionately used by young people and have been called smoking starter products. However, limited qualitative research exists on young adults' perceptions of and experiences with these products, with much of it based on document reviews of the tobacco industry's research. We conducted six focus groups with young adult (ages 18-24) menthol smokers in New Jersey (half with black smokers) between December 2014 and March 2015. Participants were asked open-ended questions about their menthol smoking initiation, preference reasons, substitution behaviors, and perceptions of menthol cigarette risks and regulation. Participants' menthol cigarette initiation and preference were influenced by their perceived popularity, brand recognition, taste, smoothness, satisfaction and access (including as "loosies," typically available for Newport). Some believed menthol cigarettes were less harmful than non-menthol cigarettes when initiating smoking. Many currently believed menthol cigarettes were more harmful because they contained extra "additives," were stronger (ie, requiring fewer cigarettes to feel satisfied), and/or based on hearsay. Many had tried new brand Camel Crush, which was perceived to be especially minty, fun, and attractive for newer smokers. While some used non-menthol cigarettes when menthols were unavailable, many said they would never or almost never substitute. Many acknowledged a menthol cigarettes ban would likely help them quit smoking, even though they did not support the idea. Menthol cigarette initiation is influenced by an interplay of multiple factors including their sensory properties, marketing, perceived popularity and availability. The FDA should continue to pursue closing this flavored cigarette loophole. In this first qualitative study of menthol cigarette use among young adults, we found further evidence that menthol cigarettes can act as starter products because they are perceived as easier to smoke and taste and smell

How to start a minimal access mitral valve program.

Science.gov (United States)

Hunter, Steven

2013-11-01

The seven pillars of governance established by the National Health Service in the United Kingdom provide a useful framework for the process of introducing new procedures to a hospital. Drawing from local experience, the author present guidance for institutions considering establishing a minimal access mitral valve program. The seven pillars of governance apply to the practice of minimally invasive mitral valve surgery, based on the principle of patient-centred practice. The author delineate the benefits of minimally invasive mitral valve surgery in terms of: "clinical effectiveness", including reduced length of hospital stay, "risk management effectiveness", including conversion to sternotomy and aortic dissection, "patient experience" including improved cosmesis and quicker recovery, and the effectiveness of communication, resources and strategies in the implementation of minimally invasive mitral valve surgery. Finally, the author have identified seven learning curves experienced by surgeons involved in introducing a minimal access mitral valve program. The learning curves are defined as: techniques of mitral valve repair, Transoesophageal Echocardiography-guided cannulation, incisions, instruments, visualization, aortic occlusion and cardiopulmonary bypass strategies. From local experience, the author provide advice on how to reduce the learning curves, such as practising with the specialised instruments and visualization techniques during sternotomy cases. Underpinning the NHS pillars are the principles of systems awareness, teamwork, communication, ownership and leadership, all of which are paramount to performing any surgery but more so with minimal access surgery, as will be highlighted throughout this paper.

Catalyzing Collaboration: Wisconsin's Agency-Initiated Basin Partnerships

Science.gov (United States)

Genskow, Kenneth D.

2009-03-01

Experience with collaborative approaches to natural resource and environmental management has grown substantially over the past 20 years, and multi-interest, shared-resources initiatives have become prevalent in the United States and internationally. Although often viewed as “grass-roots” and locally initiated, governmental participants are crucial to the success of collaborative efforts, and important questions remain regarding their appropriate roles, including roles in partnership initiation. In the midst of growing governmental support for collaborative approaches in the mid-1990s, the primary natural resource and environmental management agency in Wisconsin (USA) attempted to generate a statewide system of self-sustaining, collaborative partnerships, organized around the state’s river basin boundaries. The agency expected the partnerships to enhance participation by stakeholders, leverage additional resources, and help move the agency toward more integrated and ecosystem-based resource management initiatives. Most of the basin partnerships did form and function, but ten years after this initiative, the agency has moved away from these partnerships and half have disbanded. Those that remain active have changed, but continue to work closely with agency staff. Those no longer functioning lacked clear focus, were dependent upon agency leadership, or could not overcome issues of scale. This article outlines the context for state support of collaborative initiatives and explores Wisconsin’s experience with basin partnerships by discussing their formation and reviewing governmental roles in partnerships’ emergence and change. Wisconsin’s experience suggests benefits from agency support and agency responsiveness to partnership opportunities, but cautions about expectations for initiating general-purpose partnerships.

Gamma Imaging-Guided Minimally Invasive Breast Biopsy: Initial Clinical Experience.

Science.gov (United States)

Brem, Rachel F; Mehta, Anita K; Rapelyea, Jocelyn A; Akin, Esma A; Bazoberry, Adriana M; Velasco, Christel D

2018-03-01

The purpose of this study was to evaluate our initial experience with gamma imaging-guided vacuum-assisted breast biopsy in women with abnormal findings. A retrospective review of patients undergoing breast-specific gamma imaging (BSGI), also known as molecular breast imaging (MBI), between April 2011 and October 2015 found 117 nonpalpable mammographically and sonographically occult lesions for which gamma imaging-guided biopsies were recommended. Biopsy was performed with a 9-gauge vacuum-assisted device with subsequent placement of a titanium biopsy site marker. Medical records and pathologic findings were evaluated. Of the 117 biopsies recommended, 104 were successful and 13 were canceled. Of the 104 performed biopsies, 32 (30.8%) had abnormal pathologic findings. Of those 32 biopsies, nine (28.1%) found invasive cancers, six (18.8%) found ductal carcinoma in situ (DCIS), and 17 (53.1%) found high-risk lesions. Of the 17 high-risk lesions, there were three (17.6%) lobular carcinomas in situ, five (29.4%) atypical ductal hyperplasias, two (11.8%) atypical lobular hyperplasias, one (5.9%) flat epithelial atypia, and six (35.3%) papillomas. Two cases of atypical ductal hyperplasia were upgraded to DCIS at surgery. The overall cancer detection rate for gamma imaging-guided biopsy was 16.3%. In this study, gamma imaging-guided biopsy had a positive predictive value of total successful biopsies of 16.3% for cancer and 30.8% for cancer and high-risk lesions. Gamma imaging-guided biopsy is a viable approach to sampling BSGI-MBI-detected lesions without sonographic or mammographic correlate. Our results compare favorably to those reported for MRI-guided biopsy.

Necrotizing infection of the heart.

Science.gov (United States)

Ballard, David H; Pennington, George Patton; Pennington, George P; Johnson, Joe; Bhalla, Sanjeev; Raptis, Constantine

2018-02-06

A case of necrotizing infection of the heart is presented. A 70-year-old woman presented with vague chest and abdominal pain. CT of the abdomen and pelvis was initially obtained, which demonstrated gas in the myocardium of the left ventricle. Subsequent chest CT, endoscopy, and abdominal surgical exploration did not reveal perforated viscus or diaphragm compromise. At median sternotomy, the inferior wall of the heart was found to be necrotic. Culture of the excised tissue grew E. coli. The patient expired shortly after surgical exploration. Copyright © 2018 Elsevier Inc. All rights reserved.

Comparative study for surgical management of thymectomy for non-thymomatous myasthenia gravis from the French national database EPITHOR.

Science.gov (United States)

Orsini, Bastien; Santelmo, Nicola; Pages, Pierre Benoit; Baste, Jean Marc; Dahan, Marcel; Bernard, Alain; Thomas, Pascal Alexandre

2016-09-01

Thymectomy may be part of the therapeutic strategy in patients with myasthenia gravis (MG) without thymoma. Median sternotomy is still considered as the gold standard, but during the last 15 years, several groups have demonstrated the non-inferiority of cervicotomy with upper sternotomy and minimally invasive techniques. To date, there is no consensus on surgical procedure choice. The aim of our study was to compare the morbidity and mortality of three techniques [cervicotomy with upper sternotomy versus sternotomy versus video-assisted thoracic surgery (VATS)/robotic-assisted thoracic surgery (RATS)] from the national database EPITHOR and to analyse French epidemiology. From the national thoracic surgery database EPITHOR, we have extracted all the details regarding thymectomies performed for non-thymomatous MG. We have divided thymectomy into three groups: A-sternotomy; B-cervicotomy with upper sternotomy; C-VATS/RATS. We investigated the postoperative morbidity and mortality without analysis of the long-term evolution of the disease not available on EPITHOR. From 2005 to 2013, 278 patients were included: 131 (47%) in Group A, 31 (11%) in Group B and 116 (42%) in Group C. The sex ratio F/M was 2.3. The mean age was, respectively, 42 ± 17, 42 ± 16, 35 ± 14 years old (P < 0.01). The number of patients without comorbidities was 63 (48%), 25 (81%) and 78 (65%), respectively (P < 0.01). The operative time was 94 ± 37, 79 ± 42 and 112 ± 59 min, respectively (P < 0.01). The number of patients who presented at least one postoperative complication was 12 (14%), 0 and 3 (9%) (P= 0.03), respectively. The postoperative lengths of stay were 7.7 ± 4.5, 5 ± 1.7 and 4.5 ± 2 days, respectively (P < 0.01). There was no death. In our study, we were unable to prove the superiority of minimally invasive techniques due to the important differences between the groups. However, this study shows us major changes in French surgical procedures during the last decade with an

Low-dose CT colonography in children: initial experience, technical feasibility and utility

International Nuclear Information System (INIS)

Anupindi, Sudha; Perumpillichira, James; Zalis, Michael E.; Jaramillo, Diego; Israel, Esther J.

2005-01-01

CT colonography (CTC) is utilized as a diagnostic tool in the detection of colon polyps and early colorectal cancer in adults. Large studies in the literature, although focused on adult populations, have shown CTC to be a safe, accurate, non-invasive technique. We evaluated the technical feasibility of CTC in children using a low-dose technique. From November 2001 to April 2004 we evaluated eight patients (3-17 years) with non-contrast CTC. Seven of the patients had CTC, followed by standard colonoscopy (SC) the same day; in one patient, CTC followed a failed SC. CTC results were compared to results of SC. The estimated effective dose from each CTC was calculated and compared to that of standard barium enema. CTC results were consistent with those of SC. Sensitivity for polyps 5-10 mm was 100%, and sensitivity for polyps 10 mm and larger was 66.7%. The estimated mean effective dose was 2.17 mSv for CTC, compared to the 5-6 mSv for a standard air-contrast barium enema in a small child. Our initial experience shows CTC in children is well-tolerated, safe, and useful. The procedure can be performed successfully with a low radiation dose, and preliminary results compare well with SC. (orig.)

Initial experience of two national centers in transcatheter aortic prosthesis implantation.

Science.gov (United States)

Lluberas, Sebastián; Abizaid, Alexandre; Siqueira, Dimytri; Ramos, Auristela; Costa, J Ribamar; Arrais, Magaly; Kambara, Antônio; Bihan, David Le; Sousa, Amanda; Sousa, J Eduardo

2014-04-01

Transcatheter aortic valve implantation is an effective alternative to surgical treatment of severe aortic stenosis in patients who are inoperable or at high surgical risk. To report the immediate and follow-up clinical and echocardiographic results of the initial experience of transcatheter aortic valve implantation. From 2009 June to 2013 February, 112 patients underwent transcatheter aortic valve implantation. Mean age was 82.5 ± 6.5 years, and the logistic EuroSCORE was 23.6 ± 13.5. Procedural success was 84%. After the intervention, a reduction in the mean systolic gradient was observed (pre: 54.7 ± 15.3 vs. post: 11.7 ± 4.0 mmHg; p < 0.01). Cerebrovascular accidents occurred in 3.6%, vascular complications in 19% and permanent pacemaker was required by 13% of the patients. Thirty-day mortality and at follow-up of 16 ± 11 months was 14% and 8.9% respectively. The presence of chronic obstructive pulmonary disease was the only predictor of mortality at 30 days and at follow-up. During follow up, aortic valve area and mean systolic gradient did not change significantly. Transcatheter aortic valve implantation is an effective and safe procedure for the treatment of aortic stenosis in high-surgical risk or inoperable patients. The presence of chronic obstructive pulmonary disease was the only independent predictor of mortality identified both in the first month post-intervention and at follow-up.

Robotic resections in hepatobiliary oncology - initial experience with Xi da Vinci system in India.

Science.gov (United States)

Chandarana, M; Patkar, S; Tamhankar, A; Garg, S; Bhandare, M; Goel, M

2017-01-01

Minimal invasive surgery has proven its advantages over open surgeries in the perioperative period. Food and Drug Administration approved da Vinci robot in 2000. The latest version, da Vinci Xi system has a mobile tower-based robot with several modifications to improve the functionality, versatility, and operative ease. None of the centers have reported exclusively on hepatobiliary oncology using the da Vinci Xi system. We report our initial experience. To study the feasibility, advantages, and discuss the operative technique of da Vinci Xi system in hepatobiliary oncology. Data were analyzed retrospectively from a prospectively maintained database from June 2015 to October 2016. Twenty-five patients with suspected or proven hepatobiliary malignancies were operated. Total robotic technique using da Vinci Xi system was used. Demographic details and perioperative outcomes were noted. Of the 25 surgeries, 14 patients had a suspected gallbladder malignancy, 11 patients had primary or metastatic liver tumor. Median age was 53 years. The average duration of surgery was 225 min with a median blood loss 150 ml. The median postoperative stay was 4 days. The median nodal yield for radical cholecystectomy was seven. Five patients required conversion. Two of these developed postoperative morbidity. Robotic surgery for hepatobiliary oncology is feasible and can be performed safely in experienced hands. Increasing experience in this field may equal or even prove advantageous over conventional or laparoscopic approach in future. A cautious approach with judicious patient selection is the key to establishing robotic surgery as a standard surgical approach.

Cardiac biplane strain imaging: initial in vivo experience

Science.gov (United States)

Lopata, R. G. P.; Nillesen, M. M.; Verrijp, C. N.; Singh, S. K.; Lammens, M. M. Y.; van der Laak, J. A. W. M.; van Wetten, H. B.; Thijssen, J. M.; Kapusta, L.; de Korte, C. L.

2010-02-01

In this study, first we propose a biplane strain imaging method using a commercial ultrasound system, yielding estimation of the strain in three orthogonal directions. Secondly, an animal model of a child's heart was introduced that is suitable to simulate congenital heart disease and was used to test the method in vivo. The proposed approach can serve as a framework to monitor the development of cardiac hypertrophy and fibrosis. A 2D strain estimation technique using radio frequency (RF) ultrasound data was applied. Biplane image acquisition was performed at a relatively low frame rate (dogs with an aortic stenosis. Initial results reveal the feasibility of measuring large radial, circumferential and longitudinal cumulative strain (up to 70%) at a frame rate of 100 Hz. Mean radial strain curves of a manually segmented region-of-interest in the infero-lateral wall show excellent correlation between the measured strain curves acquired in two perpendicular planes. Furthermore, the results show the feasibility and reproducibility of assessing radial, circumferential and longitudinal strains simultaneously. In this preliminary study, three beagles developed an elevated pressure gradient over the aortic valve (Δp: 100-200 mmHg) and myocardial hypertrophy. One dog did not develop any sign of hypertrophy (Δp = 20 mmHg). Initial strain (rate) results showed that the maximum strain (rate) decreased with increasing valvular stenosis (-50%), which is in accordance with previous studies. Histological findings corroborated these results and showed an increase in fibrotic tissue for the hearts with larger pressure gradients (100, 200 mmHg), as well as lower strain and strain rate values.

Cascadia Initiative Ocean Bottom Seismograph Performance

Science.gov (United States)

Evers, B.; Aderhold, K.

2017-12-01

The Ocean Bottom Seismograph Instrument Pool (OBSIP) provided instrumentation and operations support for the Cascadia Initiative community experiment. This experiment investigated geophysical processes across the Cascadia subduction zone through a combination of onshore and offshore seismic data. The recovery of Year 4 instruments in September 2015 marked the conclusion of a multi-year experiment that utilized 60 ocean-bottom seismographs (OBSs) specifically designed for the subduction zone boundary, including shallow/deep water deployments and active fisheries. The new instruments featured trawl-resistant enclosures designed by Lamont-Doherty Earth Observatory (LDEO) and Scripps Institution of Oceanography (SIO) for shallow deployment [water depth ≤ 500 m], as well as new deep-water instruments designed by Woods Hole Oceanographic Institute (WHOI). Existing OBSIP instruments were also deployed along the Blanco Transform Fault and on the Gorda Plate through complementary experiments. Station instrumentation included weak and strong motion seismometers, differential pressure gauges (DPG) and absolute pressure gauges (APG). All data collected from the Cascadia, Blanco, and Gorda deployments is available through the Incorporated Research Institutions for Seismology (IRIS) Data Management Center (DMC). The Cascadia Initiative is the largest amphibious seismic experiment undertaken to date, encompassing a diverse technical implementation and demonstrating an effective structure for community experiments. Thus, the results from Cascadia serve as both a technical and operational resource for the development of future community experiments, such as might be contemplated as part of the SZ4D Initiative. To guide future efforts, we investigate and summarize the quality of the Cascadia OBS data using basic metrics such as instrument recovery and more advanced metrics such as noise characteristics through power spectral density analysis. We also use this broad and diverse

Accelerated partial-breast irradiation using proton beams: Initial clinical experience

International Nuclear Information System (INIS)

Kozak, Kevin R.; Smith, Barbara L.; Adams, Judith C.; Kornmehl, Ellen; Katz, Angela; Gadd, Michele; Specht, Michelle; Hughes, Kevin; Gioioso, Valeria; Lu, H.-M.; Braaten, Kristina; Recht, Abram; Powell, Simon N.; DeLaney, Thomas F.; Taghian, Alphonse G.

2006-01-01

Purpose: We present our initial clinical experience with proton, three-dimensional, conformal, external beam, partial-breast irradiation (3D-CPBI). Methods and Materials: Twenty patients with Stage I breast cancer were treated with proton 3D-CPBI in a Phase I/II clinical trial. Patients were followed at 3 to 4 weeks, 6 to 8 weeks, 6 months, and every 6 months thereafter for recurrent disease, cosmetic outcome, toxicity, and patient satisfaction. Results: With a median follow-up of 12 months (range, 8-22 months), no recurrent disease has been detected. Global breast cosmesis was judged by physicians to be good or excellent in 89% and 100% of cases at 6 months and 12 months, respectively. Patients rated global breast cosmesis as good or excellent in 100% of cases at both 6 and 12 months. Proton 3D-CPBI produced significant acute skin toxicity with moderate to severe skin color changes in 79% of patients at 3 to 4 weeks and moderate to severe moist desquamation in 22% of patients at 6 to 8 weeks. Telangiectasia was noted in 3 patients. Three patients reported rib tenderness in the treated area, and one rib fracture was documented. At last follow-up, 95% of patients reported total satisfaction with proton 3D-CPBI. Conclusions: Based on our study results, proton 3D-CPBI offers good-to-excellent cosmetic outcomes in 89% to 100% of patients at 6-month and 12-month follow-up and nearly universal patient satisfaction. However, proton 3D-CPBI, as used in this study, does result in significant acute skin toxicity and may potentially be associated with late skin (telangiectasia) and rib toxicity. Because of the dosimetric advantages of proton 3D-CPBI, technique modifications are being explored to improve acute skin tolerance

Laparoscopic hand-assisted pancreaticoduodenectomy: initial UK experience.

Science.gov (United States)

Ammori, B J

2004-04-01

By and large, the limited world experience with laparoscopic pancreaticoduodenectomy (PD) has been unfavorable, but the laparoscopic hand-assisted approach to PD has recently shown promising results. We report the first successful UK experience with laparoscopic hand-assisted PD (LHAPD). A 62-year-old man who presented with painless obstructive jaundice was found at endoscopy, to have an ampullary tumor. Preoperative biopsy specimens confirmed the diagnosis of an adenocarcinoma, and CT showed no evidence of either vascular involvement or metastatic disease. A staging laparoscopy showed no intraabdominal metastases, and an LHAPD was performed using a Gelport. The intraoperative course was uneventful. Two units of blood were transfused intraoperatively, but no postoperative blood transfusion was required. The operative time was 11 h (plus a 30-min break). The patients postoperative recovery was uneventful except for superficial pressure sores over the buttocks and elbows. The patient resumed oral fluid and dietary intake on the 1st and 3rd postoperative days, respectively, and was discharged from hospital on the 9th postoperative day. Histology demonstrated an ampullary adenocarcinoma with clear resection margins and involvement of two of the 13 lymph nodes examined. At 2-month follow-up, the patient remains well and is receiving adjuvant chemotherapy. LHAPD achieves good oncological clearance and can be performed safely in selected patients. The early promising results with this approach will undoubtedly encourage wider adoption of this procedure and are likely to widen the selection criteria.

'Crisis' and 'everyday' initiators: A qualitative study of coercion and agency in the context of methadone maintenance treatment initiation.

Science.gov (United States)

Damon, Will; Small, Will; Anderson, Solanna; Maher, Lisa; Wood, Evan; Kerr, Thomas; McNeil, Ryan

2017-03-01

Patient attrition is common among people enrolled in methadone maintenance treatment (MMT) programs and most pronounced during the first year of treatment. However, the experiences of patients initiating MMT have been overlooked in the literature. This study explores experiences of MMT initiation among MMT patients, focusing on contextual influences on MMT initiation and perceptions of MMT and their subsequent influence on treatment retention. Semi-structured qualitative interviews were conducted with 39 MMT patients in Vancouver, Canada. Individuals reporting enrolment in MMT were recruited from within two ongoing cohort studies comprised of people who use drugs. Interview transcripts were analysed using an inductive and iterative approach. Two groups of MMT initiators were identified: (i) 'crisis initiators' prescribed methadone following critical transition events, such as incarceration or pregnancy; and (ii) 'everyday initiators' enrolled in MMT as part of routine healthcare utilisation. While most 'crisis initiators' and some 'everyday initiators' described experiencing coercion during MMT initiation, 'crisis initiators' were further subjected to the coercive leveraging of their vulnerability to motivate 'consent' for MMT. 'Crisis initiators' developed negative views towards MMT and were more likely to discontinue treatment. Long-standing patient-provider relationships and open dialogue were associated with more positive views regarding MMT, regardless of the circumstances of initiation. Findings underscore the need for clear and effective communication regarding treatment regimens and expectations during MMT initiation. Furthermore, training in trauma-informed care may help reduce perceptions of coercion and rates of early treatment termination. [Damon W, Small W, Anderson S, Maher L, Wood E, Kerr T, McNeil R. Crisis' and 'everyday' initiators: A qualitative study of coercion and agency in the context of methadone maintenance treatment initiation. Drug

Radiolysis of Fricke solution: initial experiments with the pelletron facility

International Nuclear Information System (INIS)

Sharma, S.B.; Rao, B.S.M.

1994-01-01

Experimental details of heavy ion irradiation of aqueous solutions using the Nuclear Science Centre (NSC) pelletron facility and the initial results from the radiolysis of Fricke solution using oxygen-16 ions are reported. (author). 4 refs., 1 fig

Informal Science: Family Education, Experiences, and Initial Interest in Science

Science.gov (United States)

Dabney, Katherine P.; Tai, Robert H.; Scott, Michael R.

2016-01-01

Recent research and public policy have indicated the need for increasing the physical science workforce through development of interest and engagement with informal and formal science, technology, engineering, and mathematics experiences. This study examines the association of family education and physical scientists' informal experiences in…

The effect of residual ventricular septal defects on early clinical outcome: initial experience

International Nuclear Information System (INIS)

Zaman, H.; Cheema, M.A.; Jalal, A.

2000-01-01

Residual ventricular septal defect (VSD)after repair of isolated VSD or Fallot's tetralogy is one of the main causes of morbidity and re-operations. In this paper we have presented the results of out initial experience regarding the management of this problem. The data consists of 71 patients (22 isolated VSD and 29 fallout's tetralogy) operate during January 1991 to July, 1993. The incidence of residual VSD as shown by color doppler study at the time of discharge from hospital and at three month's follow-up was 3 out of 60 patients(73%) and 12 out of to (20%) respectively. Six out of these 12 patients were NYHA class III-IV who underwent cardiac catheterization which revealed patch dehiscence in two patients and residual right ventricular outflow tract obstruction in four patients. The two patients, with patch dehiscence were reported successfully with very good outcome. Simple color doppler mapping tends to over-diagnose residual VSDs since it can pick up small haemodynamically insignificant leaks around stitches and needle holes which seal off in due course. The findings of color doppler should, therefore, be correlated with actual clinical outcome in order to proceed with further investigation and re-operation. (author)

MR imaging-guided cryoablation of metastatic brain tumours: initial experience in six patients

International Nuclear Information System (INIS)

Li, Chengli; Wu, Lebin; Song, Jiqing; Liu, Ming; Lv, Yubo; Sequeiros, Roberto Blanco

2010-01-01

The objective was to evaluate the initial experience and safety of magnetic resonance imaging (MRI)-guided transcranial cryoablation in cystic metastatic brain tumours. Seven cystic metastatic brain tumours in six patients were treated with cryoablation. The approval from the local ethics committee and individual patient consent were acquired before the study. Before the procedure the tumours were detected with conventional CT or MRI. The procedure was performed under local anaesthesia and conscious sedation. A 0.23-T open MRI system with optical tracking was used for procedural planning, instrument guidance and procedural monitoring of the ice ball formation. An MR-compatible, argon-based cryoablation system was used. The schedule of follow-up imaging ranged from 12 days to 12 months. Seven treatment sessions were performed. All the cryoprobes were successfully inserted into the target with one pass. All the patients tolerated the procedure well without experiencing any neurological deficits during the treatment phase or during the immediate post-treatment period. One patient died 12 days after cryoablation. MR-guided and monitored metastasis brain tumour cryoablation is technically feasible and may represent an alternative treatment in selected patients. (orig.)

Preparing beginning reading teachers: An experimental comparison of initial early literacy field experiences.

Science.gov (United States)

Al Otaiba, Stephanie; Lake, Vickie E; Greulich, Luana; Folsom, Jessica S; Guidry, Lisa

2012-01-01

This randomized-control trial examined the learning of preservice teachers taking an initial Early Literacy course in an early childhood education program and of the kindergarten or first grade students they tutored in their field experience. Preservice teachers were randomly assigned to one of two tutoring programs: Book Buddies and Tutor Assisted Intensive Learning Strategies (TAILS), which provided identical meaning-focused instruction (shared book reading), but differed in the presentation of code-focused skills. TAILS used explicit, scripted lessons, and the Book Buddies required that code-focused instruction take place during shared book reading. Our research goal was to understand which tutoring program would be most effective in improving knowledge about reading, lead to broad and deep language and preparedness of the novice preservice teachers, and yield the most successful student reading outcomes. Findings indicate that all pre-service teachers demonstrated similar gains in knowledge, but preservice teachers in the TAILS program demonstrated broader and deeper application of knowledge and higher self-ratings of preparedness to teach reading. Students in both conditions made similar comprehension gains, but students tutored with TAILS showed significantly stronger decoding gains.

Initial clinical experience with the heartstring

International Nuclear Information System (INIS)

Kazui, Toshinobu; Doi, Hirosato; Suzuki, Masato; Okamoto, Takashi; Koshima, Ryuji; Sugiki, Kenji; Ohno, Takemi

2006-01-01

The Heartstring is one of the devices that enable proximal anastomosis without clamping the aorta. We have applied the device not only to low-risk patients with normal aortas but also to high-risk patients with diseased aortas. The purpose of this study was to investigate the initial outcomes of using this device. The Heartstring was used on 87 patients between January and December 2004. The patients comprised 62 men and 25 women 48-86 years old (mean 68.4±8.4 years). The ascending aorta was evaluated by computed tomography (CT) scanning before surgery. If a patient's aorta was severely calcified, epiaortic echocardiography was performed. The aortas were ranked into four grades, and the preoperative patient's status were evaluated by the EuroSCORE. Angiography was performed on the third postoperative day. CT scanning revealed that 74 patients had no calcification in the ascending aorta, 10 patients had scattered calcification, and 3 patients had plate-like calcification. The EuroSCORE was 6.86±1.03. We performed 93 proximal anastomoses and 149 distal anastomoses. The average distal anastomosis was 1.6±0.6 sites per graft. Of the distal anastomoses, 74.2% were to the circumflex artery territory. Postoperative coronary angiography revealed that all grafts were patent. The Heartstring facilitates safe proximal anastomosis, even in high-risk patients. Their short-term outcome was good. The device assists in bypassing circumflex artery territory. Long-term follow-up is necessary. (author)

Prioritising integrated care initiatives on a national level. Experiences from Austria

Directory of Open Access Journals (Sweden)

Karin Eger

2009-09-01

Full Text Available Introduction and background: Based on a policy initiative and the foundation of the Competence Centre for Integrated Care by the Austrian Social Security Institutions in 2006, the aim of the project was to identify and prioritise potential diseases and target groups for which integrated care models should be developed and implemented within the Austrian health system. The project was conducted as a cooperation between the Competence Centre for Integrated Care of the Viennese Health Insurance Fund and the Institute of Social Medicine of the Medical University Vienna to ensure the involvement of both, theory and practice. Project report: The focus of the project was to develop an evidence-based process for the identification and prioritisation of diseases and target groups for integrated care measures. As there was no evidence of similar projects elsewhere, the team set out to design the prioritisation process and formulate the selection criteria based on the work in a focus group, literature reviews and a scientific council of national and international experts. The method and criteria were evaluated by an expert workshop. Discussion: The active involvement of all stakeholders from the beginning was crucial for the success. The time constraint proved also beneficial since it allowed the project team to demand focus and cooperation from all experts and stakeholders included. Conclusion: Our experience demonstrates that, with a clear concept and model, an evidence-based prioritisation including all stakeholders can be achieved. Ultimately however, the prioritisation is a political discussion and decision. Our model can only help base these decisions on sound and reasonable assumptions.

Effect of Initial Conditions on Reproducibility of Scientific Research

Science.gov (United States)

Djulbegovic, Benjamin; Hozo, Iztok

2014-01-01

Background: It is estimated that about half of currently published research cannot be reproduced. Many reasons have been offered as explanations for failure to reproduce scientific research findings- from fraud to the issues related to design, conduct, analysis, or publishing scientific research. We also postulate a sensitive dependency on initial conditions by which small changes can result in the large differences in the research findings when attempted to be reproduced at later times. Methods: We employed a simple logistic regression equation to model the effect of covariates on the initial study findings. We then fed the input from the logistic equation into a logistic map function to model stability of the results in repeated experiments over time. We illustrate the approach by modeling effects of different factors on the choice of correct treatment. Results: We found that reproducibility of the study findings depended both on the initial values of all independent variables and the rate of change in the baseline conditions, the latter being more important. When the changes in the baseline conditions vary by about 3.5 to about 4 in between experiments, no research findings could be reproduced. However, when the rate of change between the experiments is ≤2.5 the results become highly predictable between the experiments. Conclusions: Many results cannot be reproduced because of the changes in the initial conditions between the experiments. Better control of the baseline conditions in-between the experiments may help improve reproducibility of scientific findings. PMID:25132705

Cardiac biplane strain imaging: initial in vivo experience

Energy Technology Data Exchange (ETDEWEB)

Lopata, R G P; Nillesen, M M; Thijssen, J M; De Korte, C L [Clinical Physics Laboratory, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Verrijp, C N; Lammens, M M Y; Van der Laak, J A W M [Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Singh, S K; Van Wetten, H B [Department of Cardiothoracic Surgery, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Kapusta, L [Pediatric Cardiology, Department of Pediatrics, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)], E-mail: R.Lopata@cukz.umcn.nl

2010-02-21

In this study, first we propose a biplane strain imaging method using a commercial ultrasound system, yielding estimation of the strain in three orthogonal directions. Secondly, an animal model of a child's heart was introduced that is suitable to simulate congenital heart disease and was used to test the method in vivo. The proposed approach can serve as a framework to monitor the development of cardiac hypertrophy and fibrosis. A 2D strain estimation technique using radio frequency (RF) ultrasound data was applied. Biplane image acquisition was performed at a relatively low frame rate (<100 Hz) using a commercial platform with an RF interface. For testing the method in vivo, biplane image sequences of the heart were recorded during the cardiac cycle in four dogs with an aortic stenosis. Initial results reveal the feasibility of measuring large radial, circumferential and longitudinal cumulative strain (up to 70%) at a frame rate of 100 Hz. Mean radial strain curves of a manually segmented region-of-interest in the infero-lateral wall show excellent correlation between the measured strain curves acquired in two perpendicular planes. Furthermore, the results show the feasibility and reproducibility of assessing radial, circumferential and longitudinal strains simultaneously. In this preliminary study, three beagles developed an elevated pressure gradient over the aortic valve ({delta}p: 100-200 mmHg) and myocardial hypertrophy. One dog did not develop any sign of hypertrophy ({delta}p = 20 mmHg). Initial strain (rate) results showed that the maximum strain (rate) decreased with increasing valvular stenosis (-50%), which is in accordance with previous studies. Histological findings corroborated these results and showed an increase in fibrotic tissue for the hearts with larger pressure gradients (100, 200 mmHg), as well as lower strain and strain rate values.

Cardiac biplane strain imaging: initial in vivo experience

International Nuclear Information System (INIS)

Lopata, R G P; Nillesen, M M; Thijssen, J M; De Korte, C L; Verrijp, C N; Lammens, M M Y; Van der Laak, J A W M; Singh, S K; Van Wetten, H B; Kapusta, L

2010-01-01

In this study, first we propose a biplane strain imaging method using a commercial ultrasound system, yielding estimation of the strain in three orthogonal directions. Secondly, an animal model of a child's heart was introduced that is suitable to simulate congenital heart disease and was used to test the method in vivo. The proposed approach can serve as a framework to monitor the development of cardiac hypertrophy and fibrosis. A 2D strain estimation technique using radio frequency (RF) ultrasound data was applied. Biplane image acquisition was performed at a relatively low frame rate (<100 Hz) using a commercial platform with an RF interface. For testing the method in vivo, biplane image sequences of the heart were recorded during the cardiac cycle in four dogs with an aortic stenosis. Initial results reveal the feasibility of measuring large radial, circumferential and longitudinal cumulative strain (up to 70%) at a frame rate of 100 Hz. Mean radial strain curves of a manually segmented region-of-interest in the infero-lateral wall show excellent correlation between the measured strain curves acquired in two perpendicular planes. Furthermore, the results show the feasibility and reproducibility of assessing radial, circumferential and longitudinal strains simultaneously. In this preliminary study, three beagles developed an elevated pressure gradient over the aortic valve (Δp: 100-200 mmHg) and myocardial hypertrophy. One dog did not develop any sign of hypertrophy (Δp = 20 mmHg). Initial strain (rate) results showed that the maximum strain (rate) decreased with increasing valvular stenosis (-50%), which is in accordance with previous studies. Histological findings corroborated these results and showed an increase in fibrotic tissue for the hearts with larger pressure gradients (100, 200 mmHg), as well as lower strain and strain rate values.

Highlight report local initiatives. Experiences with electric transport; Highlight report lokale initiatieven. Ervaringen met elektrisch vervoer

Energy Technology Data Exchange (ETDEWEB)

NONE

2013-06-15

In March 2013 Linkingreen and XTNT started a survey on local electric transportation initiatives. The aim is to learn from the experiences, problems and obstacles of business users of electric vehicles: cars, vans or trucks, scooters, boats and special vehicles (e.g. garbage trucks) that are all-electric or plug-in (with plug). In this brief report, the main results are presented [Dutch] In maart 2013 is door Linkingreen en XTNT in opdracht van Agentschap NL een enquete uitgezet naar lokale initiatieven elektrisch vervoer. Doel is te leren wat de ervaringen, knelpunten en belemmeringen zijn van zakelijke gebruikers van elektrisch vervoer: personenauto's, bestel- of vrachtauto's, scooters, vaartuigen en bijzondere voertuigen (vuilniswagens etc.) die volledig elektrische of plug in (met stekker) zijn. In dit korte verslag zijn de belangrijkste resultaten opgenomen.

Evaluating the experiences and support needs of people living with chronic cancer: development and initial validation of the Chronic Cancer Experiences Questionnaire (CCEQ).

Science.gov (United States)

Harley, Clare; Pini, Simon; Kenyon, Lucille; Daffu-O'Reilly, Amrit; Velikova, Galina

2016-08-10

Many advanced cancers are managed as chronic diseases, yet there are currently no international guidelines for the support of patients living with chronic cancer. It is important to understand whether care and service arrangements meet the needs of this rapidly growing patient group. This study aimed to develop and validate a questionnaire to capture patients' experiences of living with chronic cancer and their views of clinical and support services. The research was carried out between 1 July 2010 and 21 February 2013. A conceptual framework and initial item bank were derived from prior interviews with 56 patients with chronic cancer. Items were reviewed by 4 oncologists and 1 clinical nurse specialist and during 2 focus groups with 9 patients. Pilot questionnaires were completed by 416 patients across 5 cancer units. Item selection and scale reliability was explored using descriptive data, exploratory factor analysis, internal consistency analyses, multitrait scaling analyses and known-groups comparisons. The final Chronic Cancer Experiences Questionnaire (CCEQ) includes 75 items. 62 items contribute to 14 subscales with internal consistency between α 0·68-0·88 and minimal scaling errors. Known-groups comparisons confirmed subscale utility in distinguishing between patient groups. Subscales were labelled: managing appointments, coordination of care, general practitioner involvement, clinical trials, information and questions, making treatment decisions, symptom non-reporting, key worker, limitations, sustaining normality, financial advice, worries and anxieties, sharing feelings with others, and accessing support. 13 items assessing symptom experiences were retained as single items. The CCEQ has the potential to be used as a clinical instrument to assess patient experiences of chronic cancer or to screen for patient needs. It may also be used as an outcome measure for evaluating programmes and models of care and may identify areas for service development that

Academics and Learners’ Perceptions on Blended Learning as a Strategic Initiative to Improve Student Learning Experience

Directory of Open Access Journals (Sweden)

Ying Adeline Ng Ling

2017-01-01

Full Text Available The increasingly tighter shift of socio-economic constraints on higher education sectors in the recent years has called for greater flexibilities in student learning experience both locally and abroad. To this end, we have recently implemented a Blended Learning Initiative in an attempt to provide better learning support and greater flexibility to our students. This initiative is also in line with the University’s aim of having 50% of our learning and teaching delivered on-line by 2020. In this report, we present our findings on academics and learners’ perceptions on the approach which were obtained through surveys. Results showed that blended learning approach was new to the academics and the factors for successful blended learning implementation were identified. Results also showed that learners appreciated the approach as it made learning more accessible and flexible. Furthermore, they also enjoyed the interesting online activities incorporated into their units. In addition, learners were also able to review and pace their own learning. They also perceived that they have the access to the resources and technical ability to cope with online learning materials and activities. Nonetheless, the survey also revealed that learners still prefer to have academics delivering information to them directly rather than a flipped classroom model. In conclusion, findings from this study provide insights that blended learning could be effective to supplement courses offered by the faculty.

Probability of crack-initiation and application to NDE

Energy Technology Data Exchange (ETDEWEB)

Prantl, G [Nuclear Safety Inspectorate HSK, (Switzerland)

1988-12-31

Fracture toughness is a property with a certain variability. When a statistical distribution is assumed, the probability of crack initiation may be calculated for a given problem defined by its geometry and the applied stress. Experiments have shown, that cracks which experience a certain small amount of ductile growth can reliably be detected by acoustic emission measurements. The probability of crack detection by AE-techniques may be estimated using this experimental finding and the calculated probability of crack initiation. (author).

Initial Results from On-Orbit Testing of the Fram Memory Test Experiment on the Fastsat Micro-Satellite

Science.gov (United States)

MacLeond, Todd C.; Sims, W. Herb; Varnavas,Kosta A.; Ho, Fat D.

2011-01-01

The Memory Test Experiment is a space test of a ferroelectric memory device on a low Earth orbit satellite that launched in November 2010. The memory device being tested is a commercial Ramtron Inc. 512K memory device. The circuit was designed into the satellite avionics and is not used to control the satellite. The test consists of writing and reading data with the ferroelectric based memory device. Any errors are detected and are stored on board the satellite. The data is sent to the ground through telemetry once a day. Analysis of the data can determine the kind of error that was found and will lead to a better understanding of the effects of space radiation on memory systems. The test is one of the first flight demonstrations of ferroelectric memory in a near polar orbit which allows testing in a varied radiation environment. The initial data from the test is presented. This paper details the goals and purpose of this experiment as well as the development process. The process for analyzing the data to gain the maximum understanding of the performance of the ferroelectric memory device is detailed.

Is sternal rewiring mandatory in surgical treatment of deep sternal wound infections?

Science.gov (United States)

Rashed, Aref; Gombocz, Karoly; Alotti, Nasri; Verzar, Zsofia

2018-04-01

Deep sternal wound infections (DSWIs) are a rare but serious complication after median sternotomy, and treatment success depends mainly on surgical experience. We compared treatment outcomes after conventional sternal rewiring and reconstruction with no sternal rewiring in patients with a sternal wound infection. We retrospectively enrolled patients who developed a DSWI after an open-heart procedure with median sternotomy at the Department of Cardiac Surgery, at the St. Rafael Hospital, Zalaegerszeg, Hungary, between 2012 and 2016. All patients received negative pressure wound and antibiotic therapy before surgical reconstruction. Patients were divided into groups determined by the reconstruction technique and compared. Subjects were followed up for 12 months, and the primary end-points were readmission and 90-day mortality. Among 3,177 median sternotomy cases, 60 patients developed a DSWI, 4 of whom died of sepsis before surgical treatment. Fifty-six patients underwent surgical reconstruction with conventional sternal rewiring (23 cases, 41%) or another interventions with no sternal refixation (33 cases, 59%). Eighty-one percent of sternal wound infections followed coronary bypass surgery (alone or combinated with another procedures), and 60% were diagnosed after hospital discharge. Staphylococcus aureus was cultured in 30% of all wounds and, 56.5% of cases reconstructed by sternal rewiring vs. 26.5% with no sternal rewiring, (P=0.022). Hospital readmission occurred in 63.6% of the sternal rewiring group vs. 14.7% of the no sternal rewiring group. The rate of death before wound healing or the 90 th postoperative day was 21.7% in the sternal rewiring group vs. 0% in the no sternal rewiring group. The median hospital stay was longer in the sternal rewiring group than in the other group (51 vs. 30 days, P=0.006). Sternal rewiring may be associated with a higher rate of treatment failure than other forms of treatment for sternal wound infections.

Robot-Assisted Laparoendoscopic Single-Site Partial Nephrectomy With the Novel Da Vinci Single-Site Platform: Initial Experience

Science.gov (United States)

Komninos, Christos; Tuliao, Patrick; Kim, Dae Keun; Choi, Young Deuk; Chung, Byung Ha

2014-01-01

Purpose To report our initial clinical cases of robotic laparoendoscopic single-site (R-LESS) partial nephrectomy (PN) performed with the use of the novel Da Vinci R-LESS platform. Materials and Methods Three patients underwent R-LESS PN from November 2013 through February 2014. Perioperative and postoperative outcomes were collected and intraoperative difficulties were noted. Results Operative time and estimated blood loss volume ranged between 100 and 110 minutes and between 50 and 500 mL, respectively. None of the patients was transfused. All cases were completed with the off-clamp technique, whereas one case required conversion to the conventional (multiport) approach because of difficulty in creating the appropriate scope for safe tumor resection. No major postoperative complications occurred, and all tumors were resected in safe margins. Length of hospital stay ranged between 3 and 7 days. The lack of EndoWrist movements, the external collisions, and the bed assistant's limited working space were noticed to be the main drawbacks of this surgical method. Conclusions Our initial experience with R-LESS PN with the novel Da Vinci platform shows that even though the procedure is feasible, it should be applied in only appropriately selected patients. However, further improvement is needed to overcome the existing limitations. PMID:24955221

The Planeterrella experiment: from individual initiative to networking

Science.gov (United States)

Lilensten, J.; Provan, G.; Barthelemy, M.; Simon Wedlund, C.; Gronoff, G.; Vanlommel, P.; Brekke, A.; Garnier, P.; Grimald Rochel, S.

2013-12-01

Space weather is a relatively new discipline, which is still largely unknown amongst the wider public despite its increasing importance in all of our daily lives. Outreach activities can promote awareness of space weather. In particular the visual beauty and excitement of the aurora make these lights a wonderful inspirational hook to enhance understanding of space weather in a general audience. A century ago, the Norwegian experimental physicist Kristian Birkeland, one of the founding fathers of modern space science, demonstrated with his Terrella experiment the formation of the aurora. Recently, a modernized version of the Terrella has been designed in France. This ';';Planeterrella'' experiment allows the visualization of many phenomena that occur in our space environment. Although the Planeterrella was originally a local project, it has developed to become a very successful international public outreach experiment. We believe that its success is due to mainly two factors (i) the Planeterrella is not patented and the plans are free to any public institute and (ii) the project is widely advertised using national and scientific networks, as well as press releases, books and web sites. Today, nine Planeterrellas are in operation, six more are under construction in five different countries including in the US and several more are being planned. During the last five years, about 55 000 people in Europe have attended live Planeterrella demonstration on the formation of auroral light, the space environment and space weather. Many more have seen the Planeterrella being demonstrated on TV. It is now used for education, outreach, scientific, and artistic purposes. We will describes this process and discuss how the Planeterrella project developed to become an international public outreach phenomenon. We also examine some of the lessons learnt along the way such as patented or not, big or small, automatized or hand-operated, and the cost of the overall project. A star (close

The Planeterrella experiment: from individual initiative to networking

Directory of Open Access Journals (Sweden)

Garnier Pierre

2013-02-01

Full Text Available Space weather is a relatively new discipline, which is still largely unknown amongst the wider public despite its increasing importance in all of our daily lives. Outreach activities can promote awareness of space weather. In particular the visual beauty and excitement of the aurora make these lights a wonderful inspirational hook to enhance understanding of space weather in a general audience. A century ago, the Norwegian experimental physicist Kristian Birkeland, one of the founding fathers of modern space science, demonstrated with his Terrella experiment the formation of the aurora. Recently, a modernized version of the Terrella has been designed. This “Planeterrella” experiment allows the visualization of many phenomena that occur in our space environment. Although the Planeterrella was originally a local project, it has developed to become a very successful international public outreach experiment. We believe that its success is due to mainly two factors (i the Planeterrella is not patented and the plans are free to any public institute and (ii the project is widely advertised using national and European scientific networks such as COST ES 0803, as well as press releases, books and web sites. Today, seven Planeterrellas are in operation, four more are under construction in four different countries and several more are being planned. During the last five years, about 50 000 people in Europe have attended live Planeterrella demonstration on the formation of auroral light, the space environment and space weather. Many more have seen the Planeterrella being demonstrated on TV. The Planeterrella received the first international prize for outreach activities from the Europlanet Framework 7 program in 2010 and the French Ministry of Science outreach prize “Le goût des sciences” in November 2012. This paper describes the process that led to the construction of the first Planeterrella and discusses how the Planeterrella project developed

Neonatal extracorporeal membrane oxygenation: Initial experience of Hospital de São João

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G. Rocha

2014-11-01

Full Text Available The purpose of this series is to report the initial ECMO experience of the Neonatal Intensive Care Unit of Hospital de São João. The first three clinical cases are reported. Case report 1: a 39 weeks gestational age girl with severe lung hypoplasia secondary to a bilateral congenital diaphragmatic hernia. Case report 2: a 39 weeks gestational age girl with a right congenital diaphragmatic hernia and a tracheal stenosis. Case report 3: a 34 weeks gestational age boy, with 61 days of life, with a Bordetella pertussis pneumonia, severe pulmonary hypertension, shock, hyperleukocytosis and seizures. Resumo: O objetivo desta série é apresentar a experiência inicial da Unidade de Cuidados Intensivos Neonatais do Hospital de São João com ECMO no recém-nascido. São apresentados os 3 primeiros casos. Caso 1: recém-nascido de 39 semanas de idade gestacional, com hipoplasia pulmonar severa secundária a hérnia diafragmática congénita bilateral. Caso 2: recém-nascido de 39 semanas de idade gestacional, com hérnia diafragmática congénita direita e estenose traqueal. Caso 3: pré-termo de 34 semanas de idade gestacional, sexo masculino, com 61 dias de vida, com pneumonia por Bordetella pertussis, hipertensão pulmonar severa, choque, hiperleucocitose e convulsões. Keywords: Extracorporeal membrane oxygenation, Newborn, Congenital diaphragmatic hernia, Tracheal stenosis, Bordetella pertussis infection, Palavras-chave: Oxigenação por membrana extracorporal, Recém-nascido, Hérnia diafragmática congénita, Estenose traqueal, Infeção por Bordetella pertussis

An Initial Approach for Learning Objects from Experience

Science.gov (United States)

2018-05-02

algorithm to delineate objects which are then fed to a simple feed-forward neural network without any other processes in the pipeline. Our neural network...These are the basic requirements for the pipeline and are discussed in more detail below. Additionally, we are interested in testing various parts...that continuously learning objects from experience requires mechanisms to do the following: 1) Focus attention on things and stuff of interest . 2

Management support to e-business initiatives: The Croatian experience

Directory of Open Access Journals (Sweden)

Mario Spremić

2003-01-01

Full Text Available After defining e-business and explaining why an evolutionary aspect of moving to e-business is required, the dimensions of e-business is defined with respect to differences between traditional business, partial, or pure e-business. Also, a model for moving to e-business is illustrated. The e-business evolving model is divided into six stages and represents an evolutionary aspect of migrating to e-business. Finally, the results of the research study on current practices in evolving e-business in the most successful Croatian companies are given. In this research, some aspects of business process innovation and e-business usage have been investigated (general e-business issues with levels of e-business usage, key objectives of participating in e-business, alignment of business strategy with e-business initiatives, initiation of e-business projects and e-business planning issues, especially e-business funding. The questionnaire was sent to 400 CEOs or CIOs in Croatian companies selected from the Register of the ‘400 Biggest’ Croatian companies which were ranked according to their 2001 annual revenue and which were most likely to represent the structure of the Croatian economy. Although they represent less than 1% of the total number of registered companies in Croatia, the sampled companies hold 73% of the equity capital of the whole Croatian economy, they contribute with 65% in the total Croatian economy’s export balance and they employ 37% of the total number of people employed in Croatia.

Plans for longitudinal and transverse neutralized beam compression experiments, and initial results from solenoid transport experiments

International Nuclear Information System (INIS)

Seidl, P.A.; Armijo, J.; Baca, D.; Bieniosek, F.M.; Coleman, J.; Davidson, R.C.; Efthimion, P.C.; Friedman, A.; Gilson, E.P.; Grote, D.; Haber, I.; Henestroza, E.; Kaganovich, I.; Leitner, M.; Logan, B.G.; Molvik, A.W.; Rose, D.V.; Roy, P.K.; Sefkow, A.B.; Sharp, W.M.; Vay, J.L.; Waldron, W.L.; Welch, D.R.; Yu, S.S.

2007-01-01

This paper presents plans for neutralized drift compression experiments, precursors to future target heating experiments. The target-physics objective is to study warm dense matter (WDM) using short-duration (∼1 ns) ion beams that enter the targets at energies just above that at which dE/dx is maximal. High intensity on target is to be achieved by a combination of longitudinal compression and transverse focusing. This work will build upon recent success in longitudinal compression, where the ion beam was compressed lengthwise by a factor of more than 50 by first applying a linear head-to-tail velocity tilt to the beam, and then allowing the beam to drift through a dense, neutralizing background plasma. Studies on a novel pulse line ion accelerator were also carried out. It is planned to demonstrate simultaneous transverse focusing and longitudinal compression in a series of future experiments, thereby achieving conditions suitable for future WDM target experiments. Future experiments may use solenoids for transverse focusing of un-neutralized ion beams during acceleration. Recent results are reported in the transport of a high-perveance heavy ion beam in a solenoid transport channel. The principal objectives of this solenoid transport experiment are to match and transport a space-charge-dominated ion beam, and to study associated electron-cloud and gas effects that may limit the beam quality in a solenoid transport system. Ideally, the beam will establish a Brillouin-flow condition (rotation at one-half the cyclotron frequency). Other mechanisms that potentially degrade beam quality are being studied, such as focusing-field aberrations, beam halo, and separation of lattice focusing elements

In-pile observations of fuel and clad relocation during LMFBR initiation phase accident experiments - the STAR experiments

International Nuclear Information System (INIS)

Wright, S.A.; Schumacher, G.; Henkel, P.R.; Royl, P.

1987-01-01

A series of seven in-pile experiments (the STAR experiments) were performed in which clad motion and fuel dispersal were observed in small pin bundles with high-speed cinematography. The experimental heating conditions reproduced a range of Loss of Flow (LOF) accident scenarios for the lead subassemblies in LMFBRs. The experiments show strong tendencies for limited clad motion in multiple pin bundles, early fuel disruption and dispersal (prior to fuel melting) in moderate power transients having simultaneous clad melting and fuel disruption. The more recent experiments indicate a possibility of steel vapor driven fuel dispersal after fuel breakup and intimate fuel/steel mixing. (author)

Off-Pump Repair of a Post Myocardial Infarction Ventricular Septal Defect

Directory of Open Access Journals (Sweden)

Feridoun Sabzi

2014-01-01

Full Text Available Refractory cardiogenic shock meant that traditional patch repairs requiring cardiopulmonary bypass would be poorly tolerated and external sandwich closure of post myocardial ventricular septal defect (VSD appears to be simple and effective after initial myocardial infarction (MI. The three cases presented with a VSD after of acute MI with or without thrombolysed with streptokinase during patient admission. The general condition of the three patients was poor with pulmonary edema, low cardiac output and renal failure. The heart was approached through a median sternotomy. Off-pump coronary artery bypass grafting of the coronary artery lesion was done first using octopus and beating heart surgery method and latero - lateral septal plication was performed using sandwich technique. Low cardiac output managed with intra-aortic balloon pump in these patients accompanied with inotropic drugs. Post-operative transesophageal echocardiography revealed that VSD was closed completely in one patient and in two patients small residual VSD remained. More experience is required to ascertain whether this technique will become an accepted alternative to patch repairs.

Transcatheter closure of patent ductus arteriosus in children weighing 10 kg or less: Initial experience at Sohag University Hospital.

Science.gov (United States)

Ali, Safaa; El Sisi, Amel

2016-04-01

To assess the challenges, feasibility, and efficacy of device closure of patent ductus arteriosus (PDA) in small children weighing ⩽10 kg for different types of devices used in an initial experience at Sohag University hospital. Between March 2011 and September 2014, 91 patients with PDA underwent transcatheter closure in our institute, among whom 54 weighed ⩽10 kg. All of these patients underwent transcatheter closure of PDA using either a Cook Detachable Coil, PFM Nit-Occlud, or Amplatzer duct occluder. A retrospective review of the treatment results and adverse events was performed. Successful device placement was achieved in 53/54 small children (98.1%). The median minimum PDA diameter was 2.4 mm [interquartile range (IQR, 1.8-3.5 mm), median weight 8 kg (IQR, 7-10 kg), and median age 10 months (IQR, 8-17 months)]. Mild aortic obstruction occurred in one case (1.9%), as the device became displaced towards the aorta after release. The device embolized in one case (1.9%) and no retrieval attempt was made. Five cases (9.3%) had minor vascular complications. With the current availability of devices for PDA closure, transcatheter closure of PDA is considered safe and efficacious in small children weighing ⩽10 kg with good mid-term outcome. The procedure had a low rate of high-severity adverse events even with the initial experience of the catheterization laboratory.

Initial experiments on the effectiveness of telephone access to government services

CSIR Research Space (South Africa)

Cloete, Jacob PL

2004-08-01

Full Text Available ) claim process [2]. Dual Tone Multi Frequency (DTMF) and Wizard of Oz [3] based voice recognition system versions of the system were implemented in English and two in- digenous local languages: IsiZulu and Setswana. Each experiment consisted of pre... experiments based on a government application. 2 Experimental approach and results The objectives of the experiments were to improve theory on the use of user ex- periments, develop design guidelines and develop an ability to predict the success...

Ramp-up of CHI Initiated Plasmas on NSTX

International Nuclear Information System (INIS)

Mueller, D.; Bell, M.G.; Bell, R.E.; LeBlanc, B.; Roquemore, A.L.; Raman, R.; Jarboe, T.R.; Nelson, B.A.; Soukhanovskii, V.

2009-01-01

Experiments on the National Spherical Torus (NSTX) have now demonstrated flux savings using transient coaxial helicity injection (CHI). In these discharges, the discharges initiated by CHI are ramped up with an inductive transformer and exhibit higher plasma current than discharges without the benefit of CHI initiation.

Initializing decadal climate predictions over the North Atlantic region

Science.gov (United States)

Matei, Daniela Mihaela; Pohlmann, Holger; Jungclaus, Johann; Müller, Wolfgang; Haak, Helmuth; Marotzke, Jochem

2010-05-01

Decadal climate prediction aims to predict the internally-generated decadal climate variability in addition to externally-forced climate change signal. In order to achieve this it is necessary to start the predictions from the current climate state. In this study we investigate the forecast skill of the North Atlantic decadal climate predictions using two different ocean initialization strategies. First we apply an assimilation of ocean synthesis data provided by the GECCO project (Köhl and Stammer, 2008) as initial conditions for the coupled model ECHAM5/MPI-OM. Hindcast experiments are then performed over the period 1952-2001. An alternative approach is one in which the subsurface ocean temperature and salinity are diagnosed from an ensemble of ocean model runs forced by the NCEP-NCAR atmospheric reanalyzes for the period 1948-2007, then nudge into the coupled model to produce initial conditions for the hindcast experiments. An anomaly coupling scheme is used in both approaches to avoid the hindcast drift and the associated initial shock. Differences between the two assimilation approaches are discussed by comparing them with the observational data in key regions and processes. We asses the skill of the initialized decadal hindcast experiments against the prediction skill of the non-initialized hindcasts simulation. We obtain an overview of the regions with the highest predictability from the regional distribution of the anomaly correlation coefficients and RMSE for the SAT. For the first year the hindcast skill is increased over almost all ocean regions in the NCEP-forced approach. This increase in the hindcast skill for the 1 year lead time is somewhat reduced in the GECCO approach. At lead time 5yr and 10yr, the skill enhancement is still found over the North Atlantic and North Pacific regions. We also consider the potential predictability of the Atlantic Meridional Overturning Circulation (AMOC) and Nordic Seas Overflow by comparing the predicted values to

Initial ionization stage of FRC formation

International Nuclear Information System (INIS)

Commisso, R.J.; Armstrong, W.T.; Cochrane, J.C.; Ekdahl, C.A.; Lipson, J.; Linford, R.K.; Sherwood, E.G.; Siemon, R.E.; Tuszewski, M.

1980-01-01

A Field-Reversed Configuration (FRC) is a prolate compact torus that is confined by poloidal fields only. Theta-pinch formation of an FRC employs an initial bias field, B 1 , whose direction is opposite to that of the main theta-pinch field. Some fraction of the flux associated with this bias field eventually constitutes the closed-field-line flux of the FRC. Experimental and theoretical evidence suggest that the longest-lived FRC's are obtained when the closed flux is maximized. Because the initial ionization is done in the presence of the bias field, the actual bias flux available at the time of application of the main theta-pinch field depends strongly on the initial ionization, or preionization, technique used. In this paper we report on experiments characterizing the previously used theta-pinch preionization technique that employed a net field (bias plus preionization) null, or zero-crossing, of the axial component of the magnetic field to break down the gas. We also discuss results of experiments designed to develop preionization techniques in which the gas breakdown is not accomplished by a zero-crossing

Negative Interest Rates: Central Banks Initiated an Experiment

OpenAIRE

Aleksey N. Burenin

2016-01-01

Negative interest rates appeared as a consequence of economic problems that countries with market economy came across after the crises of2007-2008. The attempts of monetary authorities to stimulate economies with the help of quantitative easing didn't bring the desired result. That's why the central banks once again resorted to a traditional tool of their monetary policy of changing interest rates. But this time they launched an experiment, they used negative interest rates. The European Cent...

Lateral Transorbital Endoscopic Access to the Hippocampus, Amygdala, and Entorhinal Cortex: Initial Clinical Experience.

Science.gov (United States)

Chen, H Isaac; Bohman, Leif-Erik; Emery, Lyndsey; Martinez-Lage, Maria; Richardson, Andrew G; Davis, Kathryn A; Pollard, John R; Litt, Brian; Gausas, Roberta E; Lucas, Timothy H

2015-01-01

Transorbital approaches traditionally have focused on skull base and cavernous sinus lesions medial to the globe. Lateral orbital approaches to the temporal lobe have not been widely explored despite several theoretical advantages compared to open craniotomy. Recently, we demonstrated the feasibility of the lateral transorbital technique in cadaveric specimens with endoscopic visualization. We describe our initial clinical experience with the endoscope-assisted lateral transorbital approach to lesions in the temporal lobe. Two patients with mesial temporal lobe pathology presenting with seizures underwent surgery. The use of a transpalpebral or Stallard-Wright eyebrow incision enabled access to the intraorbital compartment, and a lateral orbital wall 'keyhole' opening permitted visualization of the anterior temporal pole. This approach afforded adequate access to the surgical target and surrounding structures and was well tolerated by the patients. To the best of our knowledge, this report constitutes the first case series describing the endoscope-assisted lateral transorbital approach to the temporal lobe. We discuss the limits of exposure, the nuances of opening and closing, and comparisons to open craniotomy. Further prospective investigation of this approach is warranted for comparison to traditional approaches to the mesial temporal lobe. © 2015 S. Karger AG, Basel.

Minimizing complications of ultrasound-assisted lipoplasty: an initial experience with no related complications.

Science.gov (United States)

Tebbetts, J B

1998-10-01

Numerous complications and increased operating times were reported with ultrasonically assisted lipoplasty in the first several months after introduction of the technology in the United States. The purpose of this study was to review early reported complications and management regimens, evaluate possible causes of problems, and apply indications and techniques to attempt to minimize complications during an initial experience with this technique beginning in January of 1997. Seven specific indications and modifications of existing techniques were developed and applied to an initial clinical series of 70 consecutive patients who underwent ultrasound-assisted suction lipoplasty between January 10, 1997, and August 1, 1997. Follow-up ranged from 1 to 7 months. No perioperative or postoperative complication occurred in any patient in this series. In this series of ultrasound-assisted lipoplasty cases, application of the following criteria resulted in a series of 70 patients with 1 to 7-month follow-up without complications: (1) selecting patients with well localized fat deposits who were no more than 20 percent above their ideal body weight; (2) infusing a solution of Ringer's Lactate containing 1 cc of 1:1000 epinephrine per 1000 cc into the area of fat removal, stopping infusion when the tissues first become firm, not infusing to marked tissue turgor or skin induration; (3) restricting the level of energy application to a minimum of 1 cm from the undersurface of the dermis; (4) limiting ultrasonic energy application in each area to approximately 1 minute per estimated 100 cc of total aspirate in a wet to superwet environment; (5) not performing ultrasound-assisted lipoplasty in the same area as another procedure that could potentially compromise tissue vascularity; (6) using a Lysonix 2000 generator and 5-mm golf tee tip probe at a power setting of 8 to apply ultrasonic energy to the area of fat removal, ceasing energy application when tissue resistance to the passage

Using the modern Silverhawk™ atherectomy catheter to characterize biliary structures that appear malignant: review of initial experience

Science.gov (United States)

Schwartz, Jason J; Thiesset, Heather F; Clayton, Frederic; Adler, Douglas G; Hutson, William R; Carlisle, James G

2011-01-01

Background Diagnosis of a biliary stricture often hinges on cytological interpretation. In the absence of accompanying stroma, these results can often be equivocal. In theory, advanced shave biopsy techniques would allow for the preservation of tissue architecture and a more accurate definition of biliary pathology. Objectives We sought to determine the initial diagnostic utility of the modern Silverhawk™ atherectomy (SA) catheter in the evaluation of biliary strictures that appear to be malignant. Methods A total of 141 patients with biliary pathology were identified during a retrospective review of medical records for the years 2006–2011. The SA catheter was employed 12 times in seven patients for whom a tissue diagnosis was otherwise lacking. Results Neoplasia was definitively excluded in seven specimens from four patients. These four individuals were followed for 1–5 years to exclude the development of cholangiocarcinoma (CC). Samples were positive for CC in three patients, one of whom became eligible for neoadjuvant therapy and orthotopic liver transplantation. Conclusions The SA catheter appears to be a useful adjunct in diagnosing patients with biliary pathology. The existence of this technique, predicated on tissue architecture, may impact therapy, allow more timely diagnosis, and exclude cases of equivocal cytology. Although the initial results of SA use are promising, more experience is required to effectively determine its clinical accuracy. PMID:21999597

Eating at worksites in Nordic countries: national experiences and policy initiatives

DEFF Research Database (Denmark)

Jørgensen, Michael Søgaard; Arsky, Gunn Helene; Brandhøj, Mia

2010-01-01

of dietary habits of the employees and some experiments with healthier worksite eating schemes. Blue-collar employees, employees with working hours outside normal working hours and employees with shifting worksites are likely to be offered less organised and less healthy food schemes. Worksites experiments...

Initial experience in hybrid PET-MRI for evaluation of refractory focal onset epilepsy.

Science.gov (United States)

Shin, Hae W; Jewells, Valerie; Sheikh, Arif; Zhang, Jingwen; Zhu, Hongtu; An, Hongyu; Gao, Wei; Shen, Dinggang; Hadar, Eldad; Lin, Weili

2015-09-01

We aim to evaluate the utility/improved accuracy of hybrid PET/MR compared to current practice separate 3T MRI and PET-CT imaging for localization of seizure foci. In a pilot study, twenty-nine patients undergoing epilepsy surgery evaluation were imaged using PET/MR. This subject group had 29 previous clinical 3T MRI as well as 12 PET-CT studies. Prior clinical PET and MR images were read sequentially while the hybrid PET/MR was concurrently read. The median interval between hybrid PET/MR and prior imaging studies was 5 months (range 1-77 months). In 24 patients, there was no change in the read between the clinical exams and hybrid PET/MR while new anatomical or functional lesions were identified by hybrid PET/MR in 5 patients without significant clinical change. Four new anatomical MR lesions were seen with concordant PET findings. The remaining patient revealed a new abnormal PET lesion without an MR abnormality. All new PET/MR lesions were clinically significant with concordant EEG and/or SPECT results as potential epileptic foci. Our initial hybrid PET-MRI experience increased diagnostic yields for detection of potential epileptic lesions. This may be due to the unique advantage of improved co-registration and simultaneous review of both structural and functional data. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Pathways to multidrug-resistant tuberculosis diagnosis and treatment initiation: a qualitative comparison of patients' experiences in the era of rapid molecular diagnostic tests.

Science.gov (United States)

Naidoo, Pren; van Niekerk, Margaret; du Toit, Elizabeth; Beyers, Nulda; Leon, Natalie

2015-10-28

Although new molecular diagnostic tests such as GenoType MTBDRplus and Xpert® MTB/RIF have reduced multidrug-resistant tuberculosis (MDR-TB) treatment initiation times, patients' experiences of diagnosis and treatment initiation are not known. This study aimed to explore and compare MDR-TB patients' experiences of their diagnostic and treatment initiation pathway in GenoType MTBDRplus and Xpert® MTB/RIF-based diagnostic algorithms. The study was undertaken in Cape Town, South Africa where primary health-care services provided free TB diagnosis and treatment. A smear, culture and GenoType MTBDRplus diagnostic algorithm was used in 2010, with Xpert® MTB/RIF phased in from 2011-2013. Participants diagnosed in each algorithm at four facilities were purposively sampled, stratifying by age, gender and MDR-TB risk profiles. We conducted in-depth qualitative interviews using a semi-structured interview guide. Through constant comparative analysis we induced common and divergent themes related to symptom recognition, health-care access, testing for MDR-TB and treatment initiation within and between groups. Data were triangulated with clinical information and health visit data from a structured questionnaire. We identified both enablers and barriers to early MDR-TB diagnosis and treatment. Half the patients had previously been treated for TB; most recognised recurring symptoms and reported early health-seeking. Those who attributed symptoms to other causes delayed health-seeking. Perceptions of poor public sector services were prevalent and may have contributed both to deferred health-seeking and to patient's use of the private sector, contributing to delays. However, once on treatment, most patients expressed satisfaction with public sector care. Two patients in the Xpert® MTB/RIF-based algorithm exemplified its potential to reduce delays, commencing MDR-TB treatment within a week of their first health contact. However, most patients in both algorithms experienced

Intraoperative closure of infant multiple muscular ventricular septal defects with Amplatzer occluder

International Nuclear Information System (INIS)

Liu Jinfen; Gao Wei; Zhu Zhongqun; Chen Huiwen; Zhang Yuqi

2005-01-01

Objective: To report the preliminary experience of intraoperative hybrid therapy for closure of multiple muscular ventricular septal defects (VSD) in a small infant. Methods: After median sternotomy, a AGA Amplatzer occluder was introduced through right ventricular surface to close 2 muscular ventricular septal defects under transesophageal echocardiographic guidance. Results: The infant survived after the treatment without residual shunting, and rehabilitated rapidly. Conclusions: Intraoperative hybrid therapy with combined surgical technique and interventional procedure for closure of multiple muscular VSD in small infant is a safe and effective method. (authors)

Experiment prediction for LOFT nuclear experiments L5-1/L8-2

International Nuclear Information System (INIS)

Chen, T.H.; Modro, S.M.

1982-01-01

The LOFT Experiments L5-1 and L8-2 simulated intermediate break loss-of-coolant accidents with core uncovery. This paper compares the predictions with the measured data for these experiments. The RELAP5 code was used to perform best estimate double-blind and single-blind predictions. The double-blind calculations are performed prior to the experiment and use specified nominal initial and boundary conditions. The single-blind calculations are performed after the experiment and use measured initial and boundary conditions while maintaining all other parameters constant, including the code version. Comparisons of calculated results with experimental results are discussed; the possible causes of discrepancies are explored and explained. RELAP5 calculated system pressure, mass inventory, and fuel cladding temperature agree reasonably well with the experiment results, and only slight changes are noted between the double-blind and single-blind predictions

VIM: Initial ENDF/B-VI experience

International Nuclear Information System (INIS)

Blomquist, R.N.

1997-01-01

The VIM Monte Carlo particle transport code uses detailed continuous-energy cross sections produced from ENDF/B data by a set of specialized codes developed or adapted for use at Argonne National Laboratory. ENDF/B-IV data were used until about 1979, and Version V data since then. These VIM libraries were extensively benchmarked against the MC 2 -2 code and against ZPR and ZPPR criticals for fast spectrum calculations, as well as other fast and thermal experiments and calculations. Recently, the cross section processing codes have been upgraded to accommodate ENDF/B-VI files, and a small library has been tested. Several fundamental tasks comprise the construction of a faithful representation of ENDF data for VIM calculations: (1) The resolved resonance parameters are converted to Doppler-broadened continuous-energy cross sections with energy grids suitable for linear-linear interpolation. (2) The unresolved resonance parameter distributions are sampled to produce many (40-400) resonance ladders in each energy band. These are converted to Doppler-broadened continuous energy resonance cross sections that are then binned by cross section, accumulating ladders until statistical convergence, the result being probability tables of total cross sections and conditional mean scattering and fission cross sections. VIM samples these tables at run time, and File 3 back ground cross sections are added. (3) Anisotropic angular distribution data are converted to angular probability tables. All other ENDF data are unmodified, except for format

Parents' experiences with neonatal home care following initial care in the neonatal intensive care unit: a phenomenological hermeneutical interview study.

Science.gov (United States)

Dellenmark-Blom, Michaela; Wigert, Helena

2014-03-01

A descriptive study of parents' experiences with neonatal home care following initial care in the neonatal intensive care unit. As survival rates improve among premature and critically ill infants with an increased risk of morbidity, parents' responsibilities for neonatal care grow in scope and degree under the banner of family-centred care. Concurrent with medical advances, new questions arise about the role of parents and the experience of being provided neonatal care at home. An interview study with a phenomenological hermeneutic approach. Parents from a Swedish neonatal (n = 22) home care setting were extensively interviewed within one year of discharge. Data were collected during 2011-2012. The main theme of the findings is that parents experience neonatal home care as an inner emotional journey, from having a child to being a parent. This finding derives from three themes: the parents' experience of leaving the hospital milieu in favour of establishing independent parenthood, maturing as a parent and processing experiences during the period of neonatal intensive care. This study suggests that neonatal home care is experienced as a care structure adjusted to incorporate parents' needs following discharge from a neonatal intensive care unit. Neonatal home care appears to bridge the gap between hospital and home, supporting the family's adaptation to life in the home setting. Parents become empowered to be primary caregivers, having nurse consultants serving the needs of the whole family. Neonatal home care may therefore be understood as the implementation of family-centred care during the transition from NICU to home. © 2013 John Wiley & Sons Ltd.

Young Asian Women Experiences of the Summer Activities Initiative.

Science.gov (United States)

Kirby, Laura

2002-01-01

Interviews and observations focused on experiences of 15 young Asian women at a 5-day summer adventure program in southern England. Participants seemed bored with presentations about future career options, activities lost their challenge through repetition, and debriefing was weak. However, the women connected with the transferable skills of trust…

Self-initiated expatriates

DEFF Research Database (Denmark)

Selmer, Jan; Lauring, Jakob

2014-01-01

Purpose – As it has been suggested that adult third-culture kids may be more culturally adaptable than others, they have been labelled “the ideal” expatriates. In this article, we explore the adjustment of self-initiated expatriate academics in Hong Kong, comparing adult third-culture kids...... with adult mono-culture kids. Design/methodology/approach – We use survey results from 267 self-initiated expatriate academics in Hong Kong. Findings – Exploratory results show that adult third-culture kids had a higher extent of general adjustment. No significant results were found in relation...... to interaction adjustment and job adjustment. We also found that recent expatriate experiences generally had a positive association with the adjustment of adult mono-culture kids, but this association only existed in terms of general adjustment for adult third-culture kids. Originality/value – Once corroborated...

Pore Formation and Mobility Investigation (PFMI): Concept, Hardware Development, and Initial Analysis of Experiments Conducted Aboard the International Space Station

Science.gov (United States)

Grugel, Richard N.

2003-01-01

Porosity in the form of "bubbles and pipes" can occur during controlled directional solidification processing of metal alloys. This is a consequence that 1) precludes obtaining any meaningful scientific results and 2) is detrimental to desired material properties. Unfortunately, several Microgravity experiments have been compromised by porosity. The intent of the PFMl investigation is to conduct a systematic effort directed towards understanding porosity formation and mobility during controlled directional solidification (DS) in a microgravity environment. PFMl uses a pure transparent material, succinonitrile (SCN), as well as SCN "alloyed" with water, in conjunction with a translating temperature gradient stage so that direct observation and recording of pore generation and mobility can be made. PFMl is investigating the role of thermocapillary forces and temperature gradients in affecting bubble dynamics as well as other solidification processes in a microgravity environment. This presentation will cover the concept, hardware development, operations, and the initial results from experiments conducted aboard the International Space Station.

Sensitivity of a Simulated Derecho Event to Model Initial Conditions

Science.gov (United States)

Wang, Wei

2014-05-01

Since 2003, the MMM division at NCAR has been experimenting cloud-permitting scale weather forecasting using Weather Research and Forecasting (WRF) model. Over the years, we've tested different model physics, and tried different initial and boundary conditions. Not surprisingly, we found that the model's forecasts are more sensitive to the initial conditions than model physics. In 2012 real-time experiment, WRF-DART (Data Assimilation Research Testbed) at 15 km was employed to produce initial conditions for twice-a-day forecast at 3 km. On June 29, this forecast system captured one of the most destructive derecho event on record. In this presentation, we will examine forecast sensitivity to different model initial conditions, and try to understand the important features that may contribute to the success of the forecast.

Initial conditions and entanglement sudden death

International Nuclear Information System (INIS)

Qian, Xiao-Feng; Eberly, J.H.

2012-01-01

We report results bearing on the behavior of non-local decoherence and its potential for being managed or even controlled. The decoherence process known as entanglement sudden death (ESD) can drive prepared entanglement to zero at the same time that local coherences and fidelity remain non-zero. For a generic ESD-susceptible Bell superposition state, we provide rules restricting the occurrence and timing of ESD, amounting to management tools over a continuous variation of initial conditions. These depend on only three parameters: initial purity, entanglement and excitation. Knowledge or control of initial phases is not needed. -- Highlights: ► We study the possibility of managing disentanglement through initial conditions. ► The initial parameters are the amount of entanglement, excitation, and purity. ► Entanglement sudden death (ESD) free and ESD susceptible phases are identified. ► ESD onset time is also presented in the ESD susceptible phase. ► Our results may guide experiments to prepare ESD free or delayed ESD states.

Initial ionization stage of FRC formation

Energy Technology Data Exchange (ETDEWEB)

Commisso, R.J.; Armstrong, W.T.; Cochrane, J.C.; Ekdahl, C.A.; Lipson, J.; Linford, R.K.; Sherwood, E.G.; Siemon, R.E.; Tuszewski, M.

1980-01-01

A Field-Reversed Configuration (FRC) is a prolate compact torus that is confined by poloidal fields only. Theta-pinch formation of an FRC employs an initial bias field, B/sub 1/, whose direction is opposite to that of the main theta-pinch field. Some fraction of the flux associated with this bias field eventually constitutes the closed-field-line flux of the FRC. Experimental and theoretical evidence suggest that the longest-lived FRC's are obtained when the closed flux is maximized. Because the initial ionization is done in the presence of the bias field, the actual bias flux available at the time of application of the main theta-pinch field depends strongly on the initial ionization, or preionization, technique used. In this paper we report on experiments characterizing the previously used theta-pinch preionization technique that employed a net field (bias plus preionization) null, or zero-crossing, of the axial component of the magnetic field to break down the gas. We also discuss results of experiments designed to develop preionization techniques in which the gas breakdown is not accomplished by a zero-crossing.

Cooling of particulate debris beds: analysis of the initial D-series experiments

International Nuclear Information System (INIS)

Rivard, J.B.

1978-01-01

In an effort to provide basic data on the cooling of fast reactor debris, three in-pile experiments employing oxide fuel particulate in liquid sodium were completed in late 1977. Preliminary results from these experiments were reported shortly after their completion at the Third Post-Accident Heat Removal Information Exchange, at Argonne National Laboratory. In these experiments, a distribution of 100 μm to 1000 μm-sized particles of enriched UO 2 was fission-heated to simulate decay-heated debris. In each experiment, the UO 2 particles were contained in a closed, flat-bottomed vessel 012 mm in diameter which was insulated on the diameter and bottom. Sufficient sodium was included to saturate the bed of particles and to provide a volume of bulk sodium above the bed at a controlled temperature. Parameters of interest in the experiments are given

Experiência inicial com operações cardíacas minimamente invasivas Initial experience with minimally invasive cardiac operations

Directory of Open Access Journals (Sweden)

Francisco Costa

2012-09-01

initial experience with minimally invasive operations, with emphasis on technical aspects and the learning curve. METHODS: Between July 2009 and March 2012, 95 patients were operated using minimally invasive operations. Mean age was 55 ± 15 years and 53% were females. The operations performed were atrial septal defect closure (25, aortic valve replacement (32, mitral valve repair (23, mitral valve replacement (12, excision of atrial myxoma (2 and resection of subaortic membrane (1. The incision was a mini right thoracotomy in 87 cases and ministernotomy in 8. RESULTS: Early mortality was 4.2%. Mean size of the incision was 6.3 ±1.2 cm. Extension of the original thoracotomy was necessary in only one case. Two patients suffered a stroke, and the mean total blood loss was 470 ± 277 ml. There were no cases of incision infection and 67% the patients had no major morbidity. CONCLUSIONS: Our initial results with minimally invasive operations demonstrated that it was safe and with good clinical results. Patient satisfaction is quite high. After the learning phase has been transversed, minimally invasive operations may be an excellent alternative for many patients with congenital and acquired diseases.

Environmental Management Initiatives in Product Chains

DEFF Research Database (Denmark)

Forman, Marianne; Hansen, Anne Grethe; Jørgensen, Michael Søgaard

The Environmental Council for Cleaner Products in 2000-2001 initiated a collection of experience from the environmental co-operation in 25 product chains. This collection of experience was to elucidate the concrete co-operation between suppliers, enterprises and purchasers, to go through tools...... and to report on opportunities and barriers for environmental efforts in the entire product chain. This paper aims at giving a comprehensive analysis of the experiences, on the basis of the reporting of the 25 companies and their supply chains (reported by Ettrup and Bauer in 2002. The 25 case studies have been...

SISCOM imaging : an initial South African experience

International Nuclear Information System (INIS)

Warwick, J.; Rubow, S.; Van Heerden, B.; Ghoorun, S.; Butler, J.

2004-01-01

Full text: Subtraction ictal SPECT co-registered with MRI (SISCOM) is a new technique utilized for the detection and localization of epileptogenic foci in patients with refractory focal epilepsy who are candidates for surgical resection. The technique requires many challenges to be overcome, in particular in relation to the administration of the radiopharmaceutical, acquisition of brain SPECT and the conversion, co-registration and fusion of brain SPECT and MRI studies. Furthermore the interpretation of the studies is complex and is ideally performed in a multidisciplinary context in cooperation with disciplines such as neurology, radiology, psychiatry and neurosurgery. Materials and methods: Two brain SPECT studies are performed using 99m Tc-ethylene cystinate dimer (ECD). An ictal study is performed after the administration of the 99m Tc-ECD during a seizure. An interictal SPECT, performed between seizures is then subtracted from the ictal SPECT, and the difference image fused with an MRI study to optimise localization of the epileptogenic focus. Image conversion, co-registration and fusion was performed using MRlcro and SPM software. Results: To date the Departments of Neurology and Nuclear Medicine have completed over 10 SISCOM studies. Conclusion: During this presentation this initial work will be presented. The methodology as well as the challenges involved in performing and interpreting these studies will be discussed. Individual cases will be used to illustrate the impact of this powerful technique on future patient management. (author)

Nondestructive test for assembly relationship of initiating explosive device

International Nuclear Information System (INIS)

Wang Xiangang; Zhang Chaozong; Guo Zhiping

2009-01-01

A 3D computed tomography (CT) method to inspect assembly relationship of initiating explosive device and to nondestructively evaluate assembly relationship by building geometric model from CT images was described. The experiment result proves that this method accurately inspects assembly relationship of initiating explosive device. (authors)

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

Science.gov (United States)

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

2016-01-01

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

Early outcome of minimally invasive mitral valve surgery

Directory of Open Access Journals (Sweden)

Shawky Fareed

2016-08-01

Conclusion: Right anterolateral mini-thoracotomy minimally invasive technique provides excellent exposure of the mitral valve, even with a small atrium and offers a better cosmetic lateral scar which is less prone to keloid formation. In addition, minimally invasive right anterolateral mini-thoracotomy is as safe as median sternotomy for mitral valve surgery, with fewer complications and postoperative pain, less ICU and hospital stay, fast recovery to work with no movement restriction after surgery. It should be used as an initial approach for mitral valve surgery. Furthermore, it was believed that less spreading of the incision, no interference with the diaphragm and less tissue dissection might improve outcomes, particularly respiratory function.

INITIATION EFFICIENCY f OF METHYL METHACRYLATE BULK RADICAL POLYMERIZATION

Institute of Scientific and Technical Information of China (English)

沈家骢; 田元; 王国斌; 杨梅林

1990-01-01

The values of the initiation efficiency f at various conversions in the bulk polymerization of MMA initiated by AIBME have first been determined according to a strict unsteady-state formula and based on the data of radical concentration and the termination rate constant determined using ESR method. A model of diffusion control initiation is proposed. The theory is well in agreement with the experiments during the whole process of polymerization.

Experiment prediction for LOFT nuclear experiments L5-1 and L8-2

International Nuclear Information System (INIS)

Chen, T.H.; Modro, S.M.

1983-01-01

The LOFT Experiments L5-1 and L8-2 simulated intermediate break loss-of-coolant accidents with core uncovery. This paper compares the predictions with the measured data for these experiments. The RELAP5 code was used to perform best estimate double-blind and single-blind predictions. The double-blind calculations are performed prior to the experiment and use specified nominal initial and boundary conditions. The single-blind calculations are performed after the experiment and use measured initial and boundary conditions while maintaining all other parameters constant, including the code version. Comparisons of calculated results with experimental results are discussed; the possible causes of discrepancies are explored and explained. RELAP5 calculated system pressure, mass inventory, and fuel cladding temperature agree reasonably well with the experiment results, and only slight changes are noted between the double-blind and single-blind predictions

Selection of initial events of accelerator driven subcritical system

International Nuclear Information System (INIS)

Wang Qianglong; Hu Liqin; Wang Jiaqun; Li Yazhou; Yang Zhiyi

2013-01-01

The Probabilistic Safety Assessment (PSA) is an important tool in reactor safety analysis and a significant reference to the design and operation of reactor. It is the origin and foundation of the PSA for a reactor to select the initial events. Accelerator Driven Subcritical System (ADS) has advanced design characteristics, complicated subsystems and little engineering and operating experience, which makes it much more difficult to identify the initial events of ADS. Based on the current design project of ADS, the system's safety characteristics and special issues were analyzed in this article. After a series of deductions with Master Logic Diagram (MLD) and considering the relating experience of other advanced research reactors, a preliminary initial events was listed finally, which provided the foundation for the next safety assessment. (authors)

Laparoscopic nephrectomy: initial experience with 120 cases.

LENUS (Irish Health Repository)

Cheema, I A

2010-02-01

Laparoscopic nephrectomy for both benign and malignant diseases of kidney is increasingly being performed. We report our experience with the first 120 consecutive laparoscopic nephrectomy performed in our hospital. It is the retrospective analysis of a prospectively maintained database of 4 years period. The parameters examined included age, gender, indications, operative time, blood loss, intraoperative and post operative complications. Mean age of surgery was 59 years (rang 19-84years). The indications for surgery included solid renal masses (71 patients), non-functioning kidneys (43), and collecting system tumours (6). The mean operating time was 132 minutes (range 75-270), average blood loss was 209 ml (range 0-1090) and average hospital stay was 4.7days (range 2-20). Bleeding, bowel injury and poor progression of laparoscopic procedure were the reasons in 7 (5.8%) cases converted to open surgery. There was 1 (0.8%) perioperative mortality. Eight (6.6%) patients developed post operative complications. Laparoscopic nephrectomy has inherent benefits and may be considered an alternate therapeutic option for kidney diseases with acceptable morbidity

Laparoscopic nephrectomy: initial experience with 120 cases.

LENUS (Irish Health Repository)

Cheema, I A

2012-02-01

Laparoscopic nephrectomy for both benign and malignant diseases of kidney is increasingly being performed. We report our experience with the first 120 consecutive laparoscopic nephrectomy performed in our hospital. It is the retrospective analysis of a prospectively maintained database of 4 years period. The parameters examined included age, gender, indications, operative time, blood loss, intraoperative and post operative complications. Mean age of surgery was 59 years (rang 19-84years). The indications for surgery included solid renal masses (71 patients), non-functioning kidneys (43), and collecting system tumours (6). The mean operating time was 132 minutes (range 75-270), average blood loss was 209 ml (range 0-1090) and average hospital stay was 4.7days (range 2-20). Bleeding, bowel injury and poor progression of laparoscopic procedure were the reasons in 7 (5.8%) cases converted to open surgery. There was 1 (0.8%) perioperative mortality. Eight (6.6%) patients developed post operative complications. Laparoscopic nephrectomy has inherent benefits and may be considered an alternate therapeutic option for kidney diseases with acceptable morbidity

EXPERIENCES INITIATING SOFTWARE PRODUCT LINE ENGINEERING IN SMALL TEAMS WITH PULSE

DEFF Research Database (Denmark)

Mærsk-Møller, Hans Martin; Jørgensen, Bo Nørregaard

2010-01-01

Small teams of software engineers are represented both in small companies and semi-independent fractions in medium and large companies. Even though some results and experience papers have been published in the context of Small- and Medium-Sized Enterprises (SMEs), there is a lack of experience pa...... an existing methodology, PuLSETM, drew advantages of NetBeans Rich Client Platform, and based the product line on the existing application....

Commissioning and initial experience with the ALICE on-line

International Nuclear Information System (INIS)

Altini, V; Anticic, T; Carena, F; Carena, W; Chapeland, S; Barroso, V Chibante; Costa, F; Divia, R; Fuchs, U; Makhlyueva, I; Roukoutakis, F; Schossmaier, K; Soos, C; Vyvre, P Vande; Haller, B von; Denes, E; Kiss, T

2010-01-01

ALICE (A Large Ion Collider Experiment) is the heavy-ion detector designed to study the physics of strongly interacting matter and the quark-gluon plasma at the CERN Large Hadron Collider (LHC). A large bandwidth and flexible Data Acquisition System (DAQ) has been designed and deployed to collect sufficient statistics in the short running time available per year for heavy ions and to accommodate very different requirements originated from the 18 sub-detectors. This paper will present the large scale tests conducted to assess the standalone DAQ performances, the interfaces with the other online systems and the extensive commissioning performed in order to be fully prepared for physics data taking. It will review the experience accumulated since May 2007 during the standalone commissioning of the main detectors and the global cosmic runs and the lessons learned from this exposure on the b attle field . It will also discuss the test protocol followed to integrate and validate each sub-detector with the online systems and it will conclude with the first results of the LHC injection tests and startup in September 2008. Several papers of the same conference present in more details some elements of the ALICE DAQ system.

Commissioning and initial experience with the ALICE on-line

Science.gov (United States)

Altini, V.; Anticic, T.; Carena, F.; Carena, W.; Chapeland, S.; Chibante Barroso, V.; Costa, F.; Dénes, E.; Divià, R.; Fuchs, U.; Kiss, T.; Makhlyueva, I.; Roukoutakis, F.; Schossmaier, K.; Soós, C.; Vande Vyvre, P.; von Haller, B.; ALICE Collaboration

2010-04-01

ALICE (A Large Ion Collider Experiment) is the heavy-ion detector designed to study the physics of strongly interacting matter and the quark-gluon plasma at the CERN Large Hadron Collider (LHC). A large bandwidth and flexible Data Acquisition System (DAQ) has been designed and deployed to collect sufficient statistics in the short running time available per year for heavy ions and to accommodate very different requirements originated from the 18 sub-detectors. This paper will present the large scale tests conducted to assess the standalone DAQ performances, the interfaces with the other online systems and the extensive commissioning performed in order to be fully prepared for physics data taking. It will review the experience accumulated since May 2007 during the standalone commissioning of the main detectors and the global cosmic runs and the lessons learned from this exposure on the "battle field". It will also discuss the test protocol followed to integrate and validate each sub-detector with the online systems and it will conclude with the first results of the LHC injection tests and startup in September 2008. Several papers of the same conference present in more details some elements of the ALICE DAQ system.

Depersonalisation and schizophrenia: Comparative study of initial and multiple episodes of schizophrenia.

Science.gov (United States)

Luque-Luque, Rogelio; Chauca-Chauca, Geli Marie; Alonso-Lobato, Pablo; Jaen-Moreno, M Jose

2016-01-01

The phenomena of depersonalisation/derealisation have classically been associated with the initial phases of psychosis, and it is assumed that they would precede (even by years) the onset of clinical psychosis, being much more common in the prodromal and acute phases of the illness. The aims of the present study are to analyse the differences in depersonalisation/derealisation between patients with initial and multiple episodes and the factors that could influence this. A descriptive, controlled and cross-sectional study of 48 patients diagnosed with paranoid schizophrenia (20 with an initial episode and 28 with multiple episodes). These patients were assessed using scales such as the Cambridge Depersonalization Scale, the Positive and Negative Symptom Scale, and the Dissociative Experiences Scale. Participants with initial episodes score higher on both the Cambridge Depersonalisation Scale, and the subscale of the Dissociative Experiences Scale that evaluates such experiences. There were no associations between these types of experience and the positive symptoms subscale of the Positive and Negative Symptom Scale. Depersonalisation/derealisation experiences appear with greater frequency, duration and intensity in patients in the early stages of the illnesses, gradually decreasing as they become chronic. Copyright © 2016 SEP y SEPB. Published by Elsevier España. All rights reserved.

LOSP-initiated event tree analysis for BWR

International Nuclear Information System (INIS)

Watanabe, Norio; Kondo, Masaaki; Uno, Kiyotaka; Chigusa, Takeshi; Harami, Taikan

1989-03-01

As a preliminary study of 'Japanese Model Plant PSA', a LOSP (loss of off-site power)-initiated Event Tree Analysis for a Japanese typical BWR was carried out solely based on the open documents such as 'Safety Analysis Report'. The objectives of this analysis are as follows; - to delineate core-melt accident sequences initiated by LOSP, - to evaluate the importance of core-melt accident sequences in terms of occurrence frequency, and - to develop a foundation of plant information and analytical procedures for efficiently performing further 'Japanese Model Plant PSA'. This report describes the procedure and results of the LOSP-initiated Event Tree Analysis. In this analysis, two types of event trees, Functional Event Tree and Systemic Event Tree, were developed to delineate core-melt accident sequences and to quantify their frequencies. Front-line System Event Tree was prepared as well to provide core-melt sequence delineation for accident progression analysis of Level 2 PSA which will be followed in a future. Applying U.S. operational experience data such as component failure rates and a LOSP frequency, we obtained the following results; - The total frequency of core-melt accident sequences initiated by LOSP is estimated at 5 x 10 -4 per reactor-year. - The dominant sequences are 'Loss of Decay Heat Removal' and 'Loss of Emergency Electric Power Supply', which account for more than 90% of the total core-melt frequency. In this analysis, a higher value of 0.13/R·Y was used for the LOSP frequency than experiences in Japan and any recovery action was not considered. In fact, however, there has been no experience of LOSP event in Japanese nuclear power plants so far and it is also expected that offsite power and/or PCS would be recovered before core melt. Considering Japanese operating experience and recovery factors will reduce the total core-melt frequency to less than 10 -6 per reactor-year. (J.P.N.)

Fostering of Less Commonly Taught Language Initiatives — The Minnesota Experience

Directory of Open Access Journals (Sweden)

Leonard Anthony Polakiewicz

2007-01-01

Full Text Available First, let me express my sincere gratitude to NCOLCTL for awarding me this prestigious recognition bearing the name of a man who was responsible for many important initiatives and contributions relating to the promotion of the interests of LCTLs. Although for the past 36 years I have been teaching Russian and Polish, in my discussion today I will focus mainly on Polish, the less common of my less commonly taught languages. We can view the future of LCTLs in two ways: paraphrasing Anton Chekhov—one is the view that everything passes and nothing matters; the other view is that nothing passes and everything matters. If we are guided by the first outlook in assessing the present and future status of LCTLs we will conclude that despite all of our initiatives to promote and safeguard the interests of LCTLs, in the final analysis developments beyond our control will threaten the survival of LCTLs as part of institutionalized curriculum at many institutions. Thus, all of our efforts will prove to be in vain.

Study of plasma start-up initiated by second harmonic electron cyclotron resonance heating on WEGA experiment

International Nuclear Information System (INIS)

Preynas, M.; Laqua, H. P.; Otte, M.; Stange, T.; Aßmus, D.; Wauters, T.

2014-01-01

Although both 1st harmonic ordinary mode (O1) and 2nd harmonic extra-ordinary mode (X2) have been successfully used to initiate pre-ionization and breakdown in many devices, a complete theoretical model is still missing to explain the success of this method. Moreover, some experimental observations are not completely understood, such as what occurs during the delay time between the turn-on of ECRH power and first signals of density or light measurements. Since during this free period the ECRH power has to be absorbed by in-vessel components, it is of prime importance to know what governs this delay time. Recently, dedicated start-up experiments have been performed on WEGA, using a 28 GHz ECRH system in X2-mode. This machine has the interesting capability to be run also as a tokamak allowing comparative experiments between stellarator (ι/2π > 0) and tokamak (ι/2π = 0) configurations. Different scans in heating power, neutral gas pressure, and rotational transform (ι) show clearly that the start-up is a two step process. A first step following the turn-on of the ECRH power during which no measurable electron density (or just above the noise level in some cases), ECE and radiated power is detected. Its duration depends strongly on the level of injected power. The second step corresponds to the gas ionization and plasma expansion phase, with a velocity of density build-up and filling-up of the vessel volume depending mainly on pressure, gas and rotational transform. Moreover, an interesting scenario of ECRH pre-ionization without loop voltage in tokamak configuration by applying a small optimal vertical field is relevant for start-up assistance on future experiments like ITER. The results from this experimental parametric study are useful for the modeling of the start-up assisted by the second harmonic electron cyclotron resonance heating. The aim of this work is to establish predictive scenarios for both ITER and W7-X operation

Study of plasma start-up initiated by second harmonic electron cyclotron resonance heating on WEGA experiment

Energy Technology Data Exchange (ETDEWEB)

Preynas, M.; Laqua, H. P.; Otte, M.; Stange, T.; Aßmus, D. [Max Planck Institut für Plasmaphysik, EURATOM Association, D-17491 Greifswald (Germany); Wauters, T. [Association Euratom-Belgian State, LPP-ERM/KMS, 1000 Brussels (Belgium)

2014-02-12

Although both 1st harmonic ordinary mode (O1) and 2nd harmonic extra-ordinary mode (X2) have been successfully used to initiate pre-ionization and breakdown in many devices, a complete theoretical model is still missing to explain the success of this method. Moreover, some experimental observations are not completely understood, such as what occurs during the delay time between the turn-on of ECRH power and first signals of density or light measurements. Since during this free period the ECRH power has to be absorbed by in-vessel components, it is of prime importance to know what governs this delay time. Recently, dedicated start-up experiments have been performed on WEGA, using a 28 GHz ECRH system in X2-mode. This machine has the interesting capability to be run also as a tokamak allowing comparative experiments between stellarator (ι/2π > 0) and tokamak (ι/2π = 0) configurations. Different scans in heating power, neutral gas pressure, and rotational transform (ι) show clearly that the start-up is a two step process. A first step following the turn-on of the ECRH power during which no measurable electron density (or just above the noise level in some cases), ECE and radiated power is detected. Its duration depends strongly on the level of injected power. The second step corresponds to the gas ionization and plasma expansion phase, with a velocity of density build-up and filling-up of the vessel volume depending mainly on pressure, gas and rotational transform. Moreover, an interesting scenario of ECRH pre-ionization without loop voltage in tokamak configuration by applying a small optimal vertical field is relevant for start-up assistance on future experiments like ITER. The results from this experimental parametric study are useful for the modeling of the start-up assisted by the second harmonic electron cyclotron resonance heating. The aim of this work is to establish predictive scenarios for both ITER and W7-X operation.

76 FR 76173 - Notice of Submission of Proposed Information Collection to OMB; Transformation Initiative...

Science.gov (United States)

2011-12-06

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5480-N-118] Notice of Submission of Proposed Information Collection to OMB; Transformation Initiative: Natural Experiment Grant Program AGENCY...: Transformation Initiative: Natural Experiment Grant Program. OMB Approval Number: 2528-New. Form Numbers: HUD...

Short pulse duration shock initiation experiments plus ignition and growth modeling on Composition B

International Nuclear Information System (INIS)

May, Chadd M; Tarver, Craig M

2014-01-01

Composition B (63% RDX, 36% TNT, 1% wax) is still a widely used energetic material whose shock initiation characteristics are necessary to understand. It is now possible to shock initiate Composition B and other secondary explosives at diameters well below their characteristic failure diameters for unconfined self-sustaining detonation. This is done using very high velocity, very thin, small diameter flyer plates accelerated by electric or laser power sources. Recently experimental detonation versus failure to detonate threshold flyer velocity curves for Composition B using several Kapton TM flyer thicknesses and diameters were measured. Flyer plates with diameters of 2 mm successfully detonated Composition B, which has a nominal failure diameter of 4.3 mm. The shock pressures required for these initiations are greater than the Chapman-Jouguet (C-J) pressure in self-sustaining Composition B detonation waves. The initiation process is two-dimensional, because both rear and side rarefactions can affect the shocked Composition B reaction rates. The Ignition and Growth reactive flow model for Composition B is extended to yield accurate simulations of this new threshold velocity data for various flyer thicknesses.

Peak Experience Project

Science.gov (United States)

Scott, Daniel G.; Evans, Jessica

2010-01-01

This paper emerges from the continued analysis of data collected in a series of international studies concerning Childhood Peak Experiences (CPEs) based on developments in understanding peak experiences in Maslow's hierarchy of needs initiated by Dr Edward Hoffman. Bridging from the series of studies, Canadian researchers explore collected…

Commissioning and initial experience with the ALICE on-line

Energy Technology Data Exchange (ETDEWEB)

Altini, V [INFN, Dipartimento di Fisica dell' Universita and Sezione INFN Bari (Italy); Anticic, T [Ruder Botkovic Institute, Zagreb (Croatia); Carena, F; Carena, W; Chapeland, S; Barroso, V Chibante; Costa, F; Divia, R; Fuchs, U; Makhlyueva, I; Roukoutakis, F; Schossmaier, K; Soos, C; Vyvre, P Vande; Haller, B von [CERN, Physics department, Geneva (Switzerland); Denes, E; Kiss, T, E-mail: pierre.vande.vyvre@cern.c [KFKI Research Institute for Particle and Nuclear Physics, Budapest (Hungary)

2010-04-01

ALICE (A Large Ion Collider Experiment) is the heavy-ion detector designed to study the physics of strongly interacting matter and the quark-gluon plasma at the CERN Large Hadron Collider (LHC). A large bandwidth and flexible Data Acquisition System (DAQ) has been designed and deployed to collect sufficient statistics in the short running time available per year for heavy ions and to accommodate very different requirements originated from the 18 sub-detectors. This paper will present the large scale tests conducted to assess the standalone DAQ performances, the interfaces with the other online systems and the extensive commissioning performed in order to be fully prepared for physics data taking. It will review the experience accumulated since May 2007 during the standalone commissioning of the main detectors and the global cosmic runs and the lessons learned from this exposure on the {sup b}attle field{sup .} It will also discuss the test protocol followed to integrate and validate each sub-detector with the online systems and it will conclude with the first results of the LHC injection tests and startup in September 2008. Several papers of the same conference present in more details some elements of the ALICE DAQ system.

Initial performance of the CUORE-0 experiment

Energy Technology Data Exchange (ETDEWEB)

Artusa, D.R. [University of South Carolina, Department of Physics and Astronomy, Columbia, SC (United States); INFN-Laboratori Nazionali del Gran Sasso, L' Aquila (Italy); Avignone, F.T.; Chott, N.; Creswick, R.J.; Farach, H.A.; Rosenfeld, C.; Wilson, J. [University of South Carolina, Department of Physics and Astronomy, Columbia, SC (United States); Azzolini, O.; Keppel, G.; Palmieri, V. [INFN-Laboratori Nazionali di Legnaro, Padua (Italy); Balata, M.; Bucci, C.; Canonica, L.; Casali, N.; Di Vacri, M.L.; Goett, J.; Gorla, P.; Nisi, S.; Orlandi, D.; Pattavina, L.; Pirro, S.; Zarra, C. [INFN-Laboratori Nazionali del Gran Sasso, L' Aquila (Italy); Banks, T.I. [INFN-Laboratori Nazionali del Gran Sasso, L' Aquila (Italy); University of California, Department of Physics, Berkeley, CA (United States); Lawrence Berkeley National Laboratory, Nuclear Science Division, Berkeley, CA (United States); Bari, G.; Deninno, M.M.; Moggi, N. [INFN-Sezione di Bologna, Bologna (Italy); Beeman, J. [Lawrence Berkeley National Laboratory, Materials Science Division, Berkeley, CA (United States); Bellini, F.; Cardani, L.; Cosmelli, C.; Ferroni, F.; Piperno, G. [Sapienza Universita di Roma, Dipartimento di Fisica, Rome (Italy); INFN-Sezione di Roma, Rome (Italy); Bersani, A. [INFN-Sezione di Genova, Genoa (Italy); Biassoni, M.; Brofferio, C.; Capelli, S.; Carrettoni, M.; Chiesa, D.; Clemenza, M.; Faverzani, M.; Ferri, E.; Fiorini, E.; Giachero, A.; Gironi, L.; Gotti, C.; Maiano, C.; Maino, M.; Nucciotti, A.; Pavan, M.; Sala, E.; Sisti, M.; Terranova, F.; Zanotti, L. [Universita di Milano-Bicocca, Dipartimento di Fisica, Milan (Italy); INFN-Sezione di Milano Bicocca, Milan (Italy); Cai, X.Z.; Cao, X.G.; Fang, D.Q.; Li, Y.L.; Ma, Y.G.; Tian, W.D.; Wang, H.W. [Shanghai Institute of Applied Physics (Chinese Academy of Sciences), Shanghai (China); Carbone, L.; Cremonesi, O.; Datskov, V.; Pessina, G.; Previtali, E.; Rusconi, C. [INFN-Sezione di Milano Bicocca, Milan (Italy); Dafinei, I.; Morganti, S.; Orio, F.; Pettinacci, V.; Tomei, C.; Vignati, M. [INFN-Sezione di Roma, Rome (Italy); Dally, A.; Ejzak, L.; Wielgus, L. [University of Wisconsin, Department of Physics, Madison, WI (United States); Di Domizio, S.; Fernandes, G.; Pallavicini, M. [INFN-Sezione di Genova, Genoa (Italy); Universita di Genova, Dipartimento di Fisica, Genoa (Italy); Freedman, S.J. [University of California, Department of Physics, Berkeley, CA (United States); Lawrence Berkeley National Laboratory, Nuclear Science Division, Berkeley, CA (United States); Fujikawa, B.K.; Han, K.; Mei, Y. [Lawrence Berkeley National Laboratory, Nuclear Science Division, Berkeley, CA (United States); Giuliani, A.; Tenconi, M. [Centre de Spectrometrie Nucleaire et de Spectrometrie de Masse, Orsay Campus (France); Gutierrez, T.D. [California Polytechnic State University, Physics Department, San Luis Obispo, CA (United States); Haller, E.E. [Lawrence Berkeley National Laboratory, Materials Science Division, Berkeley, CA (United States); University of California, Department of Materials Science and Engineering, Berkeley, CA (United States); Heeger, K.M.; Lim, K.E.; Maruyama, R.H. [Yale University, Department of Physics, New Haven, CT (United States); Hennings-Yeomans, R.; Ouellet, J.L. [University of California, Department of Physics, Berkeley, CA (United States); Lawrence Berkeley National Laboratory, Nuclear Science Division, Berkeley, CA (United States); Huang, H.Z.; Liu, X.; Trentalange, S.; Winslow, L.A.; Zhu, B.X. [University of California, Department of Physics and Astronomy, Los Angeles, CA (United States); Kadel, R. [Lawrence Berkeley National Laboratory, Physics Division, Berkeley, CA (United States); Kazkaz, K.; Pedretti, M.; Sangiorgio, S.; Scielzo, N.D. [Lawrence Livermore National Laboratory, Livermore, CA (United States); Kolomensky, Yu.G. [University of California, Department of Physics, Berkeley, CA (United States); Lawrence Berkeley National Laboratory, Physics Division, Berkeley, CA (United States); Martinez, M. [Universidad de Zaragoza, Laboratorio de Fisica Nuclear y Astroparticulas, Saragossa (Spain); Nones, C. [Service de Physique des Particules, CEA/Saclay, Gif-sur-Yvette (France); Norman, E.B.; Wang, B.S. [Lawrence Livermore National Laboratory, Livermore, CA (United States); University of California, Department of Nuclear Engineering, Berkeley, CA (United States); O' Donnell, T. [University of California, Department of Physics, Berkeley, CA (United States); Smith, A.R. [Lawrence Berkeley National Laboratory, EH and S Division, Berkeley, CA (United States); Taffarello, L. [INFN-Sezione di Padova, Padua (Italy); Ventura, G. [Universita di Firenze, Dipartimento di Fisica, Florence (Italy); INFN-Sezione di Firenze, Florence (Italy); Wise, T. [University of Wisconsin, Department of Physics, Madison, WI (United States); Yale University, Department of Physics, New Haven, CT (United States); Zucchelli, S. [INFN-Sezione di Bologna, Bologna (Italy); Universita di Bologna, Dipartimento di Fisica, Bologna (Italy)

2014-08-15

CUORE-0 is a cryogenic detector that uses an array of tellurium dioxide bolometers to search for neutrinoless double-beta decay of {sup 130}Te. We present the first data analysis with 7.1kg . y of total TeO{sub 2} exposure focusing on background measurements and energy resolution. The background rates in the neutrinoless double-beta decay region of interest (2.47 to 2.57MeV) and in the α backgrounddominated region (2.70 to 3.90 MeV) have been measured to be 0.071 ± 0.011 and 0.019 ± 0.002 counts/(keV . kg . y), respectively. The latter result represents a factor of 6 improvement from a predecessor experiment, Cuoricino. The results verify our understanding of the background sources in CUORE-0, which is the basis of extrapolations to the full CUORE detector. The obtained energy resolution (full width at half maximum) in the region of interest is 5.7 keV. Based on themeasured background rate and energy resolution in the region of interest, CUORE-0 half-life sensitivity is expected to surpass the observed lower bound of Cuoricino with one year of live time. (orig.)

Sox2 is translationally activated by eukaryotic initiation factor 4E in human glioma-initiating cells

Energy Technology Data Exchange (ETDEWEB)

Ge, Yuqing; Zhou, Fengbiao; Chen, Hong; Cui, Chunhong; Liu, Dan [Key Laboratory of Glycoconjuates Research, Ministry of Public Health and Gene Research Center, Shanghai Medical College of Fudan University, Shanghai 200032 (China); Li, Qiuping [Zhongshan Hospital of Fudan University, Shanghai 200032 (China); Yang, Zhiyuan; Wu, Guoqiang [Key Laboratory of Glycoconjuates Research, Ministry of Public Health and Gene Research Center, Shanghai Medical College of Fudan University, Shanghai 200032 (China); Sun, Shuhui [Key Laboratory of Medical Molecular Virology, Ministry of Education and Health, Shanghai Medical College of Fudan University, Shanghai 200032 (China); Gu, Jianxin [Key Laboratory of Glycoconjuates Research, Ministry of Public Health and Gene Research Center, Shanghai Medical College of Fudan University, Shanghai 200032 (China); Institutes of Biomedical Sciences of Fudan University, Shanghai 200032 (China); Wei, Yuanyan, E-mail: yywei@fudan.edu.cn [Key Laboratory of Glycoconjuates Research, Ministry of Public Health and Gene Research Center, Shanghai Medical College of Fudan University, Shanghai 200032 (China); Jiang, Jianhai, E-mail: jianhaijiang@fudan.edu.cn [Key Laboratory of Glycoconjuates Research, Ministry of Public Health and Gene Research Center, Shanghai Medical College of Fudan University, Shanghai 200032 (China)

2010-07-09

Sox2, a master transcription factor, contributes to the generation of induced pluripotent stem cells and plays significant roles in sustaining the self-renewal of neural stem cells and glioma-initiating cells. Understanding the functional differences of Sox2 between glioma-initiating cells and normal neural stem cells would contribute to therapeutic approach for treatment of brain tumors. Here, we first demonstrated that Sox2 could contribute to the self-renewal and proliferation of glioma-initiating cells. The following experiments showed that Sox2 was activated at translational level in a subset of human glioma-initiating cells compared with the normal neural stem cells. Further investigation revealed there was a positive correlation between Sox2 and eukaryotic initiation factor 4E (eIF4E) in glioma tissues. Down-regulation of eIF4E decreased Sox2 protein level without altering its mRNA level in glioma-initiating cells, indicating that Sox2 was activated by eIF4E at translational level. Furthermore, eIF4E was presumed to regulate the expression of Sox2 by its 5' untranslated region (5' UTR) sequence. Our results suggest that the eIF4E-Sox2 axis is a novel mechanism of unregulated self-renewal of glioma-initiating cells, providing a potential therapeutic target for glioma.

Sox2 is translationally activated by eukaryotic initiation factor 4E in human glioma-initiating cells

International Nuclear Information System (INIS)

Ge, Yuqing; Zhou, Fengbiao; Chen, Hong; Cui, Chunhong; Liu, Dan; Li, Qiuping; Yang, Zhiyuan; Wu, Guoqiang; Sun, Shuhui; Gu, Jianxin; Wei, Yuanyan; Jiang, Jianhai

2010-01-01

Sox2, a master transcription factor, contributes to the generation of induced pluripotent stem cells and plays significant roles in sustaining the self-renewal of neural stem cells and glioma-initiating cells. Understanding the functional differences of Sox2 between glioma-initiating cells and normal neural stem cells would contribute to therapeutic approach for treatment of brain tumors. Here, we first demonstrated that Sox2 could contribute to the self-renewal and proliferation of glioma-initiating cells. The following experiments showed that Sox2 was activated at translational level in a subset of human glioma-initiating cells compared with the normal neural stem cells. Further investigation revealed there was a positive correlation between Sox2 and eukaryotic initiation factor 4E (eIF4E) in glioma tissues. Down-regulation of eIF4E decreased Sox2 protein level without altering its mRNA level in glioma-initiating cells, indicating that Sox2 was activated by eIF4E at translational level. Furthermore, eIF4E was presumed to regulate the expression of Sox2 by its 5' untranslated region (5' UTR) sequence. Our results suggest that the eIF4E-Sox2 axis is a novel mechanism of unregulated self-renewal of glioma-initiating cells, providing a potential therapeutic target for glioma.

Initial Experience with Balloon-Occluded Trans-catheter Arterial Chemoembolization (B-TACE) for Hepatocellular Carcinoma

Energy Technology Data Exchange (ETDEWEB)

Maruyama, Mitsunari, E-mail: mitunari@med-shimane.u.ac.jp; Yoshizako, Takeshi, E-mail: yosizako@med.shimane-u.ac.jp; Nakamura, Tomonori, E-mail: t-naka@med.shimane-u.ac.jp; Nakamura, Megumi, E-mail: megumi@med.shimane-u.ac.jp; Yoshida, Rika, E-mail: yoshidar@med.shimane-u.ac.jp; Kitagaki, Hajime, E-mail: kitagaki@med.shimane-u.ac.jp [Shimane University Faculty of Medicine, Department of Radiology (Japan)

2016-03-15

PurposeThis study was performed to evaluate the accumulation of lipiodol emulsion (LE) and adverse events during our initial experience of balloon-occluded trans-catheter arterial chemoembolization (B-TACE) for hepatocellular carcinoma (HCC) compared with conventional TACE (C-TACE).MethodsB-TACE group (50 cases) was compared with C-TACE group (50 cases). The ratio of the LE concentration in the tumor to that in the surrounding embolized liver parenchyma (LE ratio) was calculated after each treatment. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Effects (CTCAE) version 4.0.ResultsThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). Only elevation of alanine aminotransferase was more frequent in the B-TACE group, showing a statistically significant difference (Mann–Whitney test: P < 0.05). While B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation, there was no statistically significant difference in incidence between the groups. Multivariate logistic regression analysis suggested that the significant risk factor for liver abscess/infarction was bile duct dilatation (P < 0.05).ConclusionThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation.

PWR water chemistry controls: a perspective on industry initiatives and trends relative to operating experience and the EPRI PWR water chemistry guidelines

International Nuclear Information System (INIS)

Fruzzetti, K.; Choi, S.; Haas, C.; Pender, M.; Perkins, D.

2010-01-01

An effective PWR water chemistry control program must address the following goals: Minimize materials degradation (e.g., PWSCC, corrosion of fuel, corrosion damage of steam generator (SG) tubes); Maintain fuel integrity and good performance; Minimize corrosion product transport (e.g., transport and deposition on the fuel, transport into the SGs where it can foul tube surfaces and create crevice environments for the concentration of corrosive impurities); Minimize dose rates. Water chemistry control must be optimized to provide overall improvement considering the sometimes variant constraints of the goals listed above. New technologies are developed for continued mitigation of materials degradation, continued fuel integrity and good performance, continued reduction of corrosion product transport, and continued minimization of plant dose rates. The EPRI chemistry program, in coordination with other EPRI programs, strives to improve these areas through application of chemistry initiatives, focusing on these goals. This paper highlights the major initiatives and issues with respect to PWR primary and secondary system chemistry and outlines the recent, on-going, and proposed work to effectively address them. These initiatives are presented in light of recent operating experience, as derived from EPRI's PWR chemistry monitoring and assessment program, and EPRI's water chemistry guidelines. (author)

Initiation devices, initiation systems including initiation devices and related methods

Energy Technology Data Exchange (ETDEWEB)

Daniels, Michael A.; Condit, Reston A.; Rasmussen, Nikki; Wallace, Ronald S.

2018-04-10

Initiation devices may include at least one substrate, an initiation element positioned on a first side of the at least one substrate, and a spark gap electrically coupled to the initiation element and positioned on a second side of the at least one substrate. Initiation devices may include a plurality of substrates where at least one substrate of the plurality of substrates is electrically connected to at least one adjacent substrate of the plurality of substrates with at least one via extending through the at least one substrate. Initiation systems may include such initiation devices. Methods of igniting energetic materials include passing a current through a spark gap formed on at least one substrate of the initiation device, passing the current through at least one via formed through the at least one substrate, and passing the current through an explosive bridge wire of the initiation device.

The initial phase of sudden releases of superheated liquid

International Nuclear Information System (INIS)

Schmidli, J.; Yadigaroglu, G.

1994-01-01

Series of experiments were conducted with refrigerants-114, -12, propane and butane to investigate the initial phase of sudden releases of superheated liquids due to the catastrophic failure of the vessel containing them. The experiments were initiated by shattering spherical flasks of 100 to 2000 ml containing the liquefied, pressurized gases. The variable parameters were the initial superheat, the filling level, the height of the flask above ground, and the relative humidity of the surrounding air. It was found that the initial flashing process is not determined by homogeneous nucleation, but rather by surface instabilities which lead to an evaporation wave traveling from the initial surface towards the center of the released mass. Cloud shape and expansion velocity could be determined from high speed recordings covering the initial stage of the release during which gravity has no influence. When the internal energy was sufficient, it was observed that the expanding droplet/vapor cloud initially propagated spherically with a constant expansion velocity, until Rayleigh-Taylor type instabilities appeared at its surface. Information about the pool which can be formed on the ground, the pressure decay within the flask, the droplet size, and the cloud temperature was collected. The experimental findings for the expansion velocity, as well as for the pool fraction, were the base for a nondimensional analysis leading to correlations which describe the initial phase of such releases and can be used to define the ''source term'' for turbulent dispersion models. (author) 5 figs., 1 tab., 15 refs

Rising from failure and learning from success: The role of past experience in radical initiative taking

NARCIS (Netherlands)

D. Deichmann (Dirk); J.C.M. van den Ende (Jan)

2014-01-01

markdownabstract__Abstract__ We investigate how the successes and failures of people who initiate radical ideas influence (a) the inclination to take new personal initiatives and (b) the outcome of those initiatives. Using the data of 1,792 radical ideas suggested by 908 employees in a

Rising from failure and learning from success: the role of past experience in radical initiative taking

NARCIS (Netherlands)

Deichmann, D.; van den Ende, J..

2014-01-01

We investigate how the successes and failures of people who initiate radical ideas influence (a) the inclination to take new personal initiatives and (b) the outcome of those initiatives. Using the data of 1,792 radical ideas suggested by 908 employees in a multinational firm's idea and innovation

Correlates of sexual initiation among European adolescents.

Directory of Open Access Journals (Sweden)

Pietro Gambadauro

Full Text Available Sexuality is a physiological component of adolescent development, though early initiation is associated with reproductive health risk. This study aimed at identifying correlates and predictors of sexual initiation in a large multinational cohort of European adolescents.A questionnaire addressing socio-demographics, behaviours, mental health and sexual activity, was delivered to 11,110 adolescents recruited from 168 randomly selected schools in 10 European countries between 2009 and 2011. A follow-up questionnaire was delivered after 12 months. The longitudinal association of baseline risk behaviors, psychological attributes and contextual vulnerabilities, with sexual initiation during follow-up was evaluated through simple and multivariable age/sex stratified logistic regression. Multinomial logistic regression measured the association between predictors and sexual initiation with or without coexisting reproductive risk factors, such as multiple partners or infrequent condom use.Baseline sexual experience was reported by 19.2% of 10,757 respondents (median age 15; IQR 14-15; females 59.6%. This was significantly more frequent among pupils older than 15 (41% and males (20.8%. Of 7,111 pupils without previous experience who were available at follow-up (response rate 81.8%, 17% reported sexual initiation, without differences between females and males. Baseline smoking (age/sex adjusted odds ratio [aOR] 3.63, alcohol use (aOR 2.95, illegal drugs use (aOR 2.72, and poor sleep (aOR 1.71 predicted sexual initiation. Stratified analyses showed a particularly strong association in case of younger and female pupils, and, among girls, when initiation was reported together with multiple partners and/or infrequent condom use. Externalizing (i.e. conduct and hyperactivity symptoms independently predicted sexual initiation. Internalizing difficulties (i.e. emotional and peer problems were negatively associated with early and risky sexual initiation among boys

Initiating Service Encounter-based Innovation by Word-of-Business

DEFF Research Database (Denmark)

Mattsson, Jan

2015-01-01

Purpose – This paper aims to set up a natural experiment as action research and to develop a framework of cognitive distance of informants to improve the initiation of service encounter-based innovation. Design/methodology/approach – Natural experiment as action research in one Scandinavian case...... transcriptions of interviews and transcriptions. Research limitations/implications – Only one Scandinavian company and a limited number of informants were activated. Also, the time period only included the initiation phase of service encounter-based innovation. Practical implications – Three different strategies...... in an emerging innovation field, open/user-driven innovation. Theory from business marketing, service encounter and innovation is also used....

Topology-optimized metasurfaces: impact of initial geometric layout.

Science.gov (United States)

Yang, Jianji; Fan, Jonathan A

2017-08-15

Topology optimization is a powerful iterative inverse design technique in metasurface engineering and can transform an initial layout into a high-performance device. With this method, devices are optimized within a local design phase space, making the identification of suitable initial geometries essential. In this Letter, we examine the impact of initial geometric layout on the performance of large-angle (75 deg) topology-optimized metagrating deflectors. We find that when conventional metasurface designs based on dielectric nanoposts are used as initial layouts for topology optimization, the final devices have efficiencies around 65%. In contrast, when random initial layouts are used, the final devices have ultra-high efficiencies that can reach 94%. Our numerical experiments suggest that device topologies based on conventional metasurface designs may not be suitable to produce ultra-high-efficiency, large-angle metasurfaces. Rather, initial geometric layouts with non-trivial topologies and shapes are required.

Improved results of the vacuum assisted closure and Nitinol clips sternal closure after postoperative deep sternal wound infection.

Science.gov (United States)

Tocco, Maria Pia; Costantino, Alberto; Ballardini, Milva; D'Andrea, Claudio; Masala, Marcello; Merico, Eusebio; Mosillo, Luigi; Sordini, Paolo

2009-05-01

Postoperative deep sternal wound infection is a severe complication of cardiac surgery, with a high mortality rate and a high morbidity rate. The objective of this prospective study is to report our experience with the vacuum assisted closure (VAC) system for the management of deep wound infection. We also devised an innovative closure technique post VAC therapy using thermo reactive clips. The advantage of this technique is that the posterior face of the sternum does not have to be separated from the mediastinal structures thus minimising the risk of damage. From October 2006 to October 2008, we prospectively evaluated 21 patients affected by mediastinitis after sternotomy. Nineteen patients had sternotomy for coronary artery bypass grafting (CABG), one patient for aortic valve replacement (AVR) and another one for ascending aortic replacement (AAR). All patients were treated with the VAC system at the time of infection diagnosis. When the wound tissue appeared viable and the microbiological cultures were negative, the chest was closed using the most suitable procedure for the patient in question; nine patients were closed using pectoralis flaps, nine patients using Nitinol clips, one patient with a combined technique (use of Nitinol clips and muscle flap), one patient with a direct wound closure and another patient, who needed AAR with a homograft performed in another institution, was closed using sternal wires. We had no mortality; wound healing was successfully achieved in all patients. In more than 50% of the patients, the VAC therapy allowed direct sternal resynthesis. The average duration of the vacuum therapy was 26 days (range 14-37 days). VAC is a safe and effective option in the treatment of post-sternotomy mediastinitis, with excellent survival and immediate improvement of local wound conditions; furthermore, the use of Nitinol clips after VAC therapy demonstrated to be a safe and non-invasive option for sternal resynthesis. After VAC therapy, a

Effect of flaming on Hydrocotyle ranunculoides L.f. survival. An initial experiment

NARCIS (Netherlands)

Burg, van der W.J.; Michielsen, J.G.P.

2010-01-01

The background of this pilot experiment was to find out if treatment in nature with hydrogen peroxide would be feasible as control measure. The experiment was designed to 1. try to raise plants in containers, and 2. to observe the effect of hydrogen spraying on the plants. This would allow to

Initial results for electrochemical dissolution of spent EBR-II fuel

International Nuclear Information System (INIS)

Li, S. X.

1998-01-01

Initial results are reported for the anode behavior of spent metallic nuclear fuel in an electrorefining process. The anode behavior has been characterized in terms of the initial spent fuel composition and the final composition of the residual cladding hulls. A variety of results have been obtained depending on the experimental conditions. Some of the process variables considered are average and maximum cell voltage, average and maximum anode voltage, amount of electrical charge passed (coulombs or amp-hours) during the experiment, and cell resistance. The main goal of the experiments has been the nearly complete dissolution of uranium with the retention of zirconium and noble metal fission products in the cladding hulls. Analysis has shown that the most indicative parameters for determining an endpoint to the process, recognizing the stated goal, are the maximum anode voltage and the amount of electrical charge passed. For the initial experiments reported here, the best result obtained is greater than 98% uranium dissolution with approximately 50% zirconium retention. Noble metal fission product retention appears to be correlated with zirconium retention

South American Field Experience: An Initiative in International Education. The Implementation Journal for the South American Field Experience.

Science.gov (United States)

Martin, William J.

A description is provided of Williamsport Area Community College's (WACC's) South American Field Experience program, a travel/study program for faculty and staff designed to provide a variety of learning experiences through a three week trip to Peru, Chile, Argentina, and Brazil. Chapter I presents an overview of the development of the project,…

Leverage of an Existing Cervical Cancer Prevention Service Platform to Initiate Breast Cancer Control Services in Zambia: Experiences and Early Outcomes

Directory of Open Access Journals (Sweden)

Leeya F. Pinder

2017-09-01

Full Text Available Purpose: In 2005, the Cervical Cancer Prevention Program in Zambia (CCPPZ was implemented and has since provided cervical cancer screen-and-treat services to more than 500,000 women. By leveraging the successes and experiences of the CCPPZ, we intended to build capacity for the early detection and surgical treatment of breast cancer. Methods: Our initiative sought to build capacity for breast cancer care through the (1 formation of a breast cancer advocacy alliance to raise awareness, (2 creation of resource-appropriate breast cancer care training curricula for mid- and high-level providers, and (3 implementation of early detection and treatment capacity within two major health care facilities. Results: Six months after the completion of the initiative, the following outcomes were documented: Breast health education and clinical breast examination (CBE services were successfully integrated into the service platforms of four CCPPZ clinics. Two new breast diagnostic centers were opened, which provided access to breast ultrasound, ultrasound-guided core needle biopsy, and needle aspiration. Breast health education and CBE were provided to 1,955 clients, 167 of whom were evaluated at the two diagnostic centers; 55 of those evaluated underwent core-needle biopsy, of which 17 were diagnosed with invasive cancer. Newly trained surgeons performed six sentinel lymph node mappings, eight sentinel lymph node dissections, and 10 breast conservation surgeries (lumpectomies. Conclusion: This initiative successfully established clinical services in Zambia that are critical for the early detection and surgical management of breast cancer.

Initial testing of the tritium systems at the Tokamak Fusion Test Reactor

International Nuclear Information System (INIS)

Anderson, J.L.; Sissingh, R.A.P.; Gentile, C.A.; Rossmassler, R.L.; Walters, R.T.; Voorhees, D.R.

1993-01-01

The Tokamak Fusion Test Reactor (TFTR) at Princeton will start its D-T experiments in late 1993, introducing and operating the tokamak with tritium in order to begin the study of burning plasma physics in D-T. Trace tritium injection experiments, using small amounts of tritium will begin in the fall of 1993. In preparation for these experiments, a series of tests with low concentrations of tritium inn deuterium have been performed as an initial qualification of the tritium systems. These tests began in April 1993. This paper describes the initial testing of the equipment in the TFTR tritium facility

Ocean Bottom Seismograph Performance during the Cascadia Initiative

Science.gov (United States)

Aderhold, K.; Evers, B.

2015-12-01

The Ocean Bottom Seismograph Instrument Pool (OBSIP) provides instrumentation and operations support for the Cascadia Initiative community experiment. This experiment investigates geophysical processes across the Cascadia subduction zone through a combination of onshore and offshore seismic data. The recovery of Year 4 instruments in September 2015 marks the conclusion of a multi-year experiment that utilized 60 ocean-bottom seismographs (OBSs) specifically designed for the subduction zone boundary, including shallow/deep water deployments and active fisheries. The new instruments feature trawl-resistant enclosures designed by Lamont-Doherty Earth Observatory (LDEO) and Scripps Institution of Oceanography (SIO) for shallow deployment [water depth ≤ 500 m], as well as new deep-water instruments designed by Woods Hole Oceanographic Institute (WHOI). Existing OBSIP instruments were also deployed along the Blanco Transform Fault and on the Gorda Plate through complementary experiments. Stations include differential pressure gauges (DPG) and absolute pressure gauges (APG). All data collected from the Cascadia, Blanco, and Gorda deployments will be freely available through the Incorporated Research Institutions for Seismology (IRIS) Data Management Center (DMC). The Cascadia Initiative is the largest amphibious seismic experiment undertaken to date and demonstrates an effective structure for community experiments through collaborative efforts from the Cascadia Initiative Expedition Team (CIET), OBSIP (institutional instrument contributors [LDEO, SIO, WHOI] and Management Office [IRIS]), and the IRIS DMC. The successes and lessons from Cascadia are a vital resource for the development of a Subduction Zone Observatory (SZO). To guide future efforts, we investigate the quality of the Cascadia OBS data using basic metrics such as instrument recovery and more advanced metrics such as noise characteristics through power spectral density analysis. We also use this broad and

Initial experience with purely laparoscopic living-donor right hepatectomy.

Science.gov (United States)

Hong, S K; Lee, K W; Choi, Y; Kim, H S; Ahn, S W; Yoon, K C; Kim, H; Yi, N J; Suh, K S

2018-05-01

There may be concerns about purely laparoscopic donor right hepatectomy (PLDRH) compared with open donor right hepatectomy, especially when performed by surgeons accustomed to open surgery. This study aimed to describe technical tips and pitfalls in PLDRH. Data from donors who underwent PLDRH at Seoul National University Hospital between December 2015 and July 2017 were analysed retrospectively. Endpoints analysed included intraoperative events and postoperative complications. All operations were performed by a single surgeon with considerable experience in open living donor hepatectomy. A total of 26 donors underwent purely laparoscopic right hepatectomy in the study interval. No donor required transfusion during surgery, whereas two underwent reoperation. In two donors, the dissection plane at the right upper deep portion of the midplane was not correct. One donor experienced portal vein injury during caudate lobe transection, and one developed remnant left hepatic duct stenosis. One donor experienced remnant portal vein angulation owing to a different approach angle, and one experienced arterial damage associated with the use of a laparoscopic energy device. One donor had postoperative bleeding due to masking of potential bleeding foci owing to intra-abdominal pressure during laparoscopy. Two donors experienced right liver surface damage caused by a xiphoid trocar. Purely laparoscopic donor hepatectomy differs from open donor hepatectomy in terms of angle and caudal view. Therefore, surgeons experienced in open donor hepatectomy must gain adequate experience in laparoscopic liver surgery and make adjustments when performing PLDRH. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.

Initiating an online asthma management program in urban emergency departments: the recruitment experience.

Science.gov (United States)

Joseph, Christine L M; Lu, Mei; Stokes-Bruzzelli, Stephanie; Johnson, Dayna A; Duffy, Elizabeth; Demers, Michele; Zhang, Talan; Ownby, Dennis R; Zoratti, Edward; Mahajan, Prashant

2016-01-01

The emergency department could represent a means of identifying patients with asthma who could benefit from asthma interventions. To assess the initiation of a Web-based tailored asthma intervention in the emergency department of 2 urban tertiary care hospitals. In addition to awareness strategies for emergency department staff (eg, attending nursing huddles, division meetings, etc), recruitment experiences are described for 2 strategies: (1) recruitment during an emergency department visit for acute asthma and (2) recruitment from patient listings (mail or telephone). Patient enrollment was defined as baseline completion, randomization, and completion of the first of 4 online sessions. Of 499 eligible patients 13 to 19 years old visiting the emergency department for asthma during the study period, 313 (63%) were contacted in the emergency department (n = 65) or by mail or telephone (n = 350). Of these, 121 (38.6%) were randomized. Mean age of the study sample was 15.4 years and 88.4% were African American. Refusal rates for emergency department recruitment and mail or telephone were 18.5% (12 of 65) and 16.6% (58 of 350), respectively. On average, emergency department enrollment took 44 to 67 minutes, including downtime. When surveyed, emergency department providers were more positive about awareness activities and emergency department recruitment than were research staff. Emergency department recruitment was feasible but labor intensive. Refusal rates were similar for the 2 strategies. Targeting patients with acute asthma in the emergency department is one way of connecting with youth at risk of future acute events. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Implementing a robotics curriculum at an academic general surgery training program: our initial experience.

Science.gov (United States)

Winder, Joshua S; Juza, Ryan M; Sasaki, Jennifer; Rogers, Ann M; Pauli, Eric M; Haluck, Randy S; Estes, Stephanie J; Lyn-Sue, Jerome R

2016-09-01

The robotic surgical platform is being utilized by a growing number of hospitals across the country, including academic medical centers. Training programs are tasked with teaching their residents how to utilize this technology. To this end, we have developed and implemented a robotic surgical curriculum, and share our initial experience here. Our curriculum was implemented for all General Surgical residents for the academic year 2014-2015. The curriculum consisted of online training, readings, bedside training, console simulation, participating in ten cases as bedside first assistant, and operating at the console. 20 surgical residents were included. Residents were provided the curriculum and notified the department upon completion. Bedside assistance and operative console training were completed in the operating room through a mix of biliary, foregut, and colorectal cases. During the fiscal years of 2014 and 2015, there were 164 and 263 robot-assisted surgeries performed within the General Surgery Department, respectively. All 20 residents completed the online and bedside instruction portions of the curriculum. Of the 20 residents trained, 13/20 (65 %) sat at the Surgeon console during at least one case. Utilizing this curriculum, we have trained and incorporated residents into robot-assisted cases in an efficient manner. A successful curriculum must be based on didactic learning, reading, bedside training, simulation, and training in the operating room. Each program must examine their caseload and resident class to ensure proper exposure to this platform.

Initial dosimetric experience using simple three-dimensional conformal external-beam accelerated partial-breast irradiation

International Nuclear Information System (INIS)

Taghian, Alphonse G.; Kozak, Kevin R.; Doppke, Karen P.; Katz, Angela; Smith, Barbara L.; Gadd, Michele; Specht, Michelle; Hughes, Kevin; Braaten, Kristina; Kachnic, Lisa A.; Recht, Abram; Powell, Simon N.

2006-01-01

Purpose: Several accelerated partial-breast irradiation (APBI) techniques are being investigated in patients with early-stage breast cancer. We present our initial experience using three-dimensional conformal radiation therapy (3D-CRT). Methods and Materials: Sixty-one patients with tumors of 2 cm or less and negative axillary nodes were treated with 3D-CRT accelerated partial-breast irradiation (APBI) between August 2003 and March 2005. The prescribed radiation dose was 32 Gy in 4-Gy fractions given twice daily. Efforts were made to minimize the number of beams required to achieve adequate planning target volume (PTV) coverage. Results: A combination of photons and electrons was used in 85% of patients. A three-field technique that consisted of opposed, conformal tangential photons and enface electrons was employed in 43 patients (70%). Nine patients (15%) were treated with a four-field arrangement, which consisted of three photon fields and enface electrons. Mean PTV volumes that received 100%, 95%, and 90% of the prescribed dose were 93% ± 7%, 97% ± 4%, and 98% ± 2%, respectively. Dose inhomogeneity exceeded 10% in only 7 patients (11%). Mean doses to the ipsilateral lung and heart were 1.8 Gy and 0.8 Gy, respectively. Conclusions: Simple 3D-CRT techniques of APBI can achieve appropriate PTV coverage while offering significant normal-tissue sparing. Therefore, this noninvasive approach may increase the availability of APBI to patients with early-stage breast cancer

Single and multiple transverse fracture initiation from horizontal wells

Energy Technology Data Exchange (ETDEWEB)

Crosby, D.G.; Rahman, M.M.; Rahman, M.K.; Rahman, S.S. [School of Petroleum Engineering, The University of New South Wales, 2052 Sydney (Australia)

2002-08-01

The results of an analytical and experimental study of the initiation of transverse fractures from horizontal wells are presented. Analytical criteria for the initiation of single hydraulic fracture are reviewed, and criterion for initiation of multiple hydraulic fractures was developed by modification of the existing Drucker and Prager criterion for single hydraulic fracture initiation. The developed criterion for multiple fracture initiation was validated by comparisons with actual hydraulic fracture initiation pressures, which were obtained from scaled laboratory experiments and numerical results from boundary element analysis. Other criteria are assessed against the experimental results. Experimentally obtained transverse fracture initiation pressures were found close to longitudinal fracture initiation pressures estimated from maximum tensile stress criterion and Hoek and Brown criterion. One possible explanation of this finding is presented. Results from Drucker and Prager criteria for single and multiple fracture initiation were, however, found closer to experimental values. Therefore, these criteria could be useful to engineers involved with hydraulic fracturing for predicting transverse fracture initiation pressures from horizontal wells drilled parallel to the minimum horizontal in-situ stress.

The views and experiences of nurses and midwives in the provision and management of provider-initiated HIV testing and counseling: a systematic review of qualitative evidence.

Science.gov (United States)

Evans, Catrin; Nalubega, Sylivia; McLuskey, John; Darlington, Nicola; Croston, Michelle; Bath-Hextall, Fiona

2016-01-15

Global progress towards HIV prevention and care is contingent upon increasing the number of those aware of their status through HIV testing. Provider-initiated HIV testing and counseling is recommended globally as a strategy to enhance uptake of HIV testing and is primarily conducted by nurses and midwives. Research shows that provider-initiated HIV testing and counseling implementation is sub-optimal. The reasons for this are unclear. The review aimed to explore nurses' and midwives' views and experiences of the provision and management of provider-initiated HIV testing and counseling. All cadres of nurses and midwives were considered, including those who undertake routine HIV testing as part of a diverse role and those who are specifically trained as HIV counselors. Types of phenomenon of interest: The review sought to understand the views and experiences of the provision and management of provider-initiated HIV testing and counseling (including perceptions, opinions, beliefs, practices and strategies related to HIV testing and its implementation in practice). The review included only provider-initiated HIV testing and counseling. It excluded all other models of HIV testing. The review included all countries and all healthcare settings. Types of studies: This review considered all forms of qualitative study design and methodology. Qualitative elements of a mixed method study were included if they were presented separately within the publication. A three-step search strategy was utilized. Eight databases were searched for papers published from 1996 to October 2014, followed by hand searching of reference lists. Only studies published in the English language were considered. Methodological quality was assessed using the Qualitative Assessment and Review Instrument developed by the Joanna Briggs Institute. Qualitative findings were extracted using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Qualitative research findings were pooled

CT guided percutaneous needle biopsy of the chest: initial experience

African Journals Online (AJOL)

The objective of this article is to report our first experience of CT guided percutaneous thoracic biopsy and to demonstrate the accuracy and safety of this procedure. This was a retrospective study of 28 CT-Guided Percutaneous Needle Biopsies of the Chest performed on 24 patients between November 2014 and April 2015.

Percutaneous transcatheter closure of patent ductus arteriosus: Initial experience of Sohag University

Directory of Open Access Journals (Sweden)

Safaa Husein Ali

2014-06-01

Conclusion: Our initial results show that transcatheter occlusion of PDA using different types of devices is safe and effective with good midterm outcome alternative to surgery. Complications occurred in those with unfavorable duct anatomy and presence of pulmonary hypertension. Surgical backup was not important for such interventional procedures.

Percutaneous fiducial marker placement prior to stereotactic body radiotherapy for malignant liver tumors: an initial experience

International Nuclear Information System (INIS)

Ohta, Kengo; Shimohira, Masashi; Murai, Taro; Nishimura, Junichi; Iwata, Hiromitsu; Ogino, Hiroyuki; Hashizume, Takuya; Shibamoto, Yuta

2016-01-01

The aim of this study was to describe our initial experience with a gold flexible linear fiducial marker and to evaluate the safety and technical and clinical efficacy of stereotactic body radiotherapy using this marker for malignant liver tumors. Between July 2012 and February 2015, 18 patients underwent percutaneous fiducial marker placement before stereotactic body radiotherapy for malignant liver tumors. We evaluated the technical and clinical success rates of the procedure and the associated complications. Technical success was defined as successful placement of the fiducial marker at the target site, and clinical success was defined as the completion of stereotactic body radiotherapy without the marker dropping out of position. All 18 fiducial markers were placed successfully, so the technical success rate was 100% (18/18). All 18 patients were able to undergo stereotactic body radiotherapy without marker migration. Thus, the clinical success rate was 100% (18/18). Slight pneumothorax occurred as a minor complication in one case. No major complications such as coil migration or bleeding were observed. The examined percutaneous fiducial marker was safely placed in the liver and appeared to be useful for stereotactic body radiotherapy for malignant liver tumors

If I Experience Formative Assessment Whilst Studying at University, Will I Put It into Practice Later as a Teacher? Formative and Shared Assessment in Initial Teacher Education (ITE)

Science.gov (United States)

Hamodi, Carolina; López-Pastor, Víctor Manuel; López-Pastor, Ana Teresa

2017-01-01

The aim of this article is to analyse whether having experience of formative assessment during their initial teacher education courses (ITE) influences graduates' subsequent practice as teachers. That is, if the assessment methods that university students are subject to during their learning process are then actually employed by them during their…

"I Did Think It Was a Bit Strange Taking Outdoor Education Online": Exploration of Initial Teacher Education Students' Online Learning Experiences in a Tertiary Outdoor Education Unit

Science.gov (United States)

Dyment, Janet; Downing, Jillian; Hill, Allen; Smith, Heidi

2018-01-01

With a view to attracting more students and offering flexible learning opportunities, online teaching and learning is becoming increasingly wide-spread across the higher education sector. This research reports on the experiences of eight initial teacher education students who studied an outdoor education unit in the online space. Using a…

Initial performance of the PIGMI prototype

International Nuclear Information System (INIS)

Stovall, J.E.

1979-01-01

The PIGMI (Pion Generator for Medical Irradiations) program at LASL is an accelerator development program aimed at completing the design of an accelerator suitable for use as a pion generator in a hospital-based radiotherapy program. The major thrust of the program has been the design of a 7 MeV prototype accelerator which emphasizes compactness, economy of construction, and operation and reliability. To achieve these goals the design of the prototype has exploited a number of innovations in proton linac technology. An overview of the program discussing the major innovative features of the prototype is presented. The initial operating experience is discussed and initial performance measurements are presented

Minimally invasive aortic valve replacement

DEFF Research Database (Denmark)

Foghsgaard, Signe; Schmidt, Thomas Andersen; Kjaergard, Henrik K

2009-01-01

In this descriptive prospective study, we evaluate the outcomes of surgery in 98 patients who were scheduled to undergo minimally invasive aortic valve replacement. These patients were compared with a group of 50 patients who underwent scheduled aortic valve replacement through a full sternotomy...... operations were completed as mini-sternotomies, 4 died later of noncardiac causes. The aortic cross-clamp and perfusion times were significantly different across all groups (P replacement...... is an excellent operation in selected patients, but its true advantages over conventional aortic valve replacement (other than a smaller scar) await evaluation by means of randomized clinical trial. The "extended mini-aortic valve replacement" operation, on the other hand, is a risky procedure that should...

Micro Vascular Plug (MVP)-assisted vessel occlusion in neurovascular pathologies: technical results and initial clinical experience.

Science.gov (United States)

Beaty, Narlin B; Jindal, Gaurav; Gandhi, Dheeraj

2015-10-01

Deconstructive approaches may be necessary to treat a variety of neurovascular pathologies. Recently, a new device has become available for endovascular arterial occlusion that may have unique applications in neurovascular disease. The Micro Vascular Plug (MVP, Reverse Medical, Irvine, California, USA) has been designed for vessel occlusion through targeted embolization. To report the results from our initial experience with eight consecutive patients in whom the MVP was used to achieve endovascular occlusion of an artery in the head and neck. Eight consecutive patients treated over a nine-month period were included. The patients' radiographic and electronic medical records were retrospectively reviewed. Specifically demographic information, clinical indication, site of arterial occlusion, size of MVP, time to vessel occlusion, clinical complications, use of other secondary embolic agents, and clinical outcome were recorded. Follow-up information when available is presented. The MVP was used in eight patients for the treatment of neurovascular disease. Indications for treatment included post-traumatic head/neck bleeding (n=3), carotid-cavernous fistula (1), vertebral-vertebral fistula (1), giant fusiform vertebral aneurysm (1), stump-emboli after carotid dissection (1), and iatrogenic vertebral artery penetrating injury (1). One device was used in five patients, two in two patients, and one patient with extensive vertebral-vertebral venous fistula required three plugs to effectively trap the fistula from proximal and distal aspects. Vessel occlusion was obtained in MVP in neurovascular disease. Use of this device may be associated with shorter procedural times and cost savings in comparison with the use of microcoils for vessel occlusion. Our experience shows that MVP can have unique applications in neurovascular pathologies and it complements other occlusive devices. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

Initial 10-year Experience of Sperm Cryopreservation Services for Cancer Patients

Directory of Open Access Journals (Sweden)

Hong-Chiang Chang

2006-01-01

Full Text Available Offering sperm cryopreservation to preserve the fertility of male cancer patients is a relatively recent service in Asia. This study analyzed the types of cancer, timing of collection, sperm quality, and utilization for reproductive services by patients during a 10-year period at a medical center in Taiwan. A total of 75 oncology patients elected to freeze sperm for fertility preservation at our medical center during the initial 10 years of the availability of this service. The mean age of the patients was 25.7 years. Storage was discontinued in 13 (17% patients and their survival duration was 13.1 ±11.1 months. The utilization rate of sperm cryo-preservation was 2.8% (75/2642. The types of cancer varied, with leukemia (35%, lymphoma (25%, and testicular cancer (13% comprising the largest groups. A significantly lower sperm count was found in patients with chronic myelogenous leukemia, suggesting the need for earlier sperm collection after initiation of cancer treatment. Only three (4% patients utilized their specimens for reproductive purposes. There was no clinical pregnancy during the study period, although one biochemical pregnancy was achieved. The low rates of sperm cryostorage for fertility preservation in cancer patients in this study suggest that there is a need for greater emphasis of this option for male oncology patients whose fertility is likely to be affected by chemotherapeutic treatment.

Determination and demarcation of fatigue crack initiation phase in rotating bending condition

International Nuclear Information System (INIS)

Pasha, R.A.; Rehman, K.; Shah, M.

2012-01-01

In engineering applications, components often experience cyclic loading and therefore, have crack initiation propagation phase. In this research work experimental demarcation of fatigue crack initiation has been investigated. Initiation phase of fatigue life of Aluminium was determined by using single and two step fatigue loading test on four point rotating bending fatigue testing machine. Experimental data is used to determine the distinction between the initiation and propagation phase. Initiation phase is determined at different stress levels. The obtained results demonstrate the effect of stress level on initiation phase and propagation phase. (author)

Can community change be measured for an outcomes-based initiative? A comparative case study of the success by 6 initiative.

Science.gov (United States)

Minich, Lisa; Howe, Steven; Langmeyer, Daniel; Corcoran, Kevin

2006-12-01

One of the challenges facing nonprofit organizations today is the demand for measurable results. Increasingly, these organizations are focusing less on program outputs and program outcomes in favor of community outcomes or changes demonstrated in the larger community. Success by 6(R) is a popular United Way initiative that emphasizes defining and measuring community outcomes. In this paper, we describe our work with 24 Success by 6(R) initiatives around the country. It is clear that not all of these initiatives are measuring community outcomes. Of those initiatives that are experiencing some success measuring community outcomes, similar measurement strategies are reported. Additionally, our experience suggests several United Way employees express dissatisfaction with the logic model as a framework for defining and measuring community outcomes although no preferred alternative model is identified. Evaluators working with community-wide initiatives must find ways to communicate the differences between program and community outcomes to key stakeholders and funders.

Oculomotor evidence for top-down control following the initial saccade.

Directory of Open Access Journals (Sweden)

Alisha Siebold

Full Text Available The goal of the current study was to investigate how salience-driven and goal-driven processes unfold during visual search over multiple eye movements. Eye movements were recorded while observers searched for a target, which was located on (Experiment 1 or defined as (Experiment 2 a specific orientation singleton. This singleton could either be the most, medium, or least salient element in the display. Results were analyzed as a function of response time separately for initial and second eye movements. Irrespective of the search task, initial saccades elicited shortly after the onset of the search display were primarily salience-driven whereas initial saccades elicited after approximately 250 ms were completely unaffected by salience. Initial saccades were increasingly guided in line with task requirements with increasing response times. Second saccades were completely unaffected by salience and were consistently goal-driven, irrespective of response time. These results suggest that stimulus-salience affects the visual system only briefly after a visual image enters the brain and has no effect thereafter.

Correlates of sexual initiation among European adolescents

Science.gov (United States)

Carli, Vladimir; Hadlaczky, Gergö; Sarchiapone, Marco; Apter, Alan; Balazs, Judit; Banzer, Raphaela; Bobes, Julio; Brunner, Romuald; Cosman, Doina; Farkas, Luca; Haring, Christian; Hoven, Christina W.; Kaess, Michael; Kahn, Jean Pierre; McMahon, Elaine; Postuvan, Vita; Sisask, Merike; Värnik, Airi; Zadravec Sedivy, Nusa; Wasserman, Danuta

2018-01-01

Background Sexuality is a physiological component of adolescent development, though early initiation is associated with reproductive health risk. This study aimed at identifying correlates and predictors of sexual initiation in a large multinational cohort of European adolescents. Methods A questionnaire addressing socio-demographics, behaviours, mental health and sexual activity, was delivered to 11,110 adolescents recruited from 168 randomly selected schools in 10 European countries between 2009 and 2011. A follow-up questionnaire was delivered after 12 months. The longitudinal association of baseline risk behaviors, psychological attributes and contextual vulnerabilities, with sexual initiation during follow-up was evaluated through simple and multivariable age/sex stratified logistic regression. Multinomial logistic regression measured the association between predictors and sexual initiation with or without coexisting reproductive risk factors, such as multiple partners or infrequent condom use. Results Baseline sexual experience was reported by 19.2% of 10,757 respondents (median age 15; IQR 14–15; females 59.6%). This was significantly more frequent among pupils older than 15 (41%) and males (20.8%). Of 7,111 pupils without previous experience who were available at follow-up (response rate 81.8%), 17% reported sexual initiation, without differences between females and males. Baseline smoking (age/sex adjusted odds ratio [aOR] 3.63), alcohol use (aOR 2.95), illegal drugs use (aOR 2.72), and poor sleep (aOR 1.71) predicted sexual initiation. Stratified analyses showed a particularly strong association in case of younger and female pupils, and, among girls, when initiation was reported together with multiple partners and/or infrequent condom use. Externalizing (i.e. conduct and hyperactivity) symptoms independently predicted sexual initiation. Internalizing difficulties (i.e. emotional and peer problems) were negatively associated with early and risky sexual

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

Directory of Open Access Journals (Sweden)

Sanoop K Zachariah

2013-01-01

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

Methicillin-resistant Staphylococcus aureus screening as a patient safety initiative: using patients' experiences to improve the quality of screening practices.

Science.gov (United States)

Currie, Kay; Knussen, Christina; Price, Lesley; Reilly, Jacqui

2014-01-01

while methicillin-resistant Staphylococcus aureus screening is generally acceptable to patients as a regular patient safety initiative, to enhance the quality of the patient experience, clinicians should consider the timing, content and effectiveness of information provision. © 2013 John Wiley & Sons Ltd.

Radioembolization using yttrium-90 microspheres as bridging and downstaging treatment for unresectable hepatocellular carcinoma before liver transplantation: initial single-center experience.

Science.gov (United States)

Abdelfattah, M R; Al-Sebayel, M; Broering, D; Alsuhaibani, H

2015-03-01

HCC is the sixth most common malignancy worldwide and is the third most common cause of cancer related mortality. Moreover, the incidence of HCC is increasing. Surgical treatments for HCC including resection and/or transplantation provide the best curative outcomes in early stages. Unfortunately, many patients present at an advanced stage. Currently, locoregional therapies have an emerging role in the management of HCC for bridging to liver transplantation and for downstaging the disease to within transplant criteria. Radioembolization is among commonly used locoregional therapies. To describe our initial experience with the use of Therasphere® as bridging or downstaging modality before liver transplantation, including our institutional indications, technique and outcome. We retrospectively examined our database for liver transplantation after the use of Therasphere®. Nine patients were identified and reported. They were 5 females and 4 males. Their current age range is 40-72 years with a mean of 53.8 ± 9.5 years. Three patients had Therasphere® as downstaging treatment to our institutional transplantation criteria. Our institution is using UCSF criteria as a cut off limit for liver transplantation as primary treatment modality. The other 6 patients had Therasphere® as bridging for liver transplantation especially when other modalities are not possible. None of these lesions were treated by any other locoregional treatment before or after Therasphere®. Follow-up after liver transplantation ranged between 3.7 and 60.1 months (mean of 15.8 ± 17.7 months). All patients are still living, no retransplantation was done and none of them showed evidence of disease recurrence (100% graft, patient and disease free survival). Our initial experience showed that Therasphere® is a promising therapeutic tool for both downstaging and bridging of HCC before liver transplant. Copyright © 2015 Elsevier Inc. All rights reserved.

Does the cerebellum initiate movement?

Science.gov (United States)

Thach, W T

2014-02-01

Opinion is divided on what the exact function of the cerebellum is. Experiments are summarized that support the following views: (1) the cerebellum is a combiner of multiple movement factors; (2) it contains anatomically fixed permanent focal representation of individual body parts (muscles and segments) and movement modes (e.g., vestibular driven vs. cognitive driven); (3) it contains flexible changing representations/memory of physical properties of the body parts including muscle strength, segment inertia, joint viscosity, and segmental interaction torques (dynamics); (4) it contains mechanisms for learning and storage of the properties in item no. 3 through trial-and-error practice; (5) it provides for linkage of body parts, motor modes, and motordynamics via the parallel fiber system; (6) it combines and integrates the many factors so as to initiate coordinated movements of the many body parts; (7) it is thus enabled to play the unique role of initiating coordinated movements; and (8) this unique causative role is evidenced by the fact that: (a) electrical stimulation of the cerebellum can initiate compound coordinated movements; (b) in naturally initiated compound movements, cerebellar discharge precedes that in downstream target structures such as motor cerebral cortex; and (c) cerebellar ablation abolishes the natural production of compound movements in the awake alert individuals.

Status of the new initiative task force work

International Nuclear Information System (INIS)

Sheffield, J.

1992-01-01

The proposal for a open-quotes New Initiatives Task Forceclose quotes emerged from discussions in the scientific community on how to proceed following the demise of the Burning Plasma Experiment (BPX). In particular, the action of the Secretary of Energy Advisory Board (SEAB), which made the following recommendation in 1991, prompted the initiative: open-quotes Concept exploration should begin to define a new experiment in the $500 million class for the purpose of scientific study of tokomak improvements (e.g., second stability, steady state, bootstrap current) that could suggest new operating modes for ITER and permit the design of more reactor-desirable follow-ons to ITER.close quotes A New Initiative Task force, was chartered by Princeton Plasma Physics Laboratory in October 1991 to provide oversight in the development of a new experimental initiative and to provide guidance to advocate groups in the following areas: programmatic mission and technical objectives, critical issues of physics, engineering, and technology, design criteria, costing, and modes of operation. The guidance was designed to be based on broad community involvement. In addition, the Task Force was asked to identify the preferred options which could proceed to the design stage. Three primary machine designs have emerged from the work of this group, and they are briefly described. 4 refs., 2 figs., 2 tabs

Atmospheric statistical dynamic models. Climate experiments: albedo experiments with a zonal atmospheric model

International Nuclear Information System (INIS)

Potter, G.L.; Ellsaesser, H.W.; MacCracken, M.C.; Luther, F.M.

1978-06-01

The zonal model experiments with modified surface boundary conditions suggest an initial chain of feedback processes that is largest at the site of the perturbation: deforestation and/or desertification → increased surface albedo → reduced surface absorption of solar radiation → surface cooling and reduced evaporation → reduced convective activity → reduced precipitation and latent heat release → cooling of upper troposphere and increased tropospheric lapse rates → general global cooling and reduced precipitation. As indicated above, although the two experiments give similar overall global results, the location of the perturbation plays an important role in determining the response of the global circulation. These two-dimensional model results are also consistent with three-dimensional model experiments. These results have tempted us to consider the possibility that self-induced growth of the subtropical deserts could serve as a possible mechanism to cause the initial global cooling that then initiates a glacial advance thus activating the positive feedback loop involving ice-albedo feedback (also self-perpetuating). Reversal of the cycle sets in when the advancing ice cover forces the wave-cyclone tracks far enough equatorward to quench (revegetate) the subtropical deserts

Initial experience with xenograft bioconduit for the treatment of complex prosthetic valve endocarditis.

Science.gov (United States)

Roubelakis, Apostolos; Karangelis, Dimos; Sadeque, Syed; Yanagawa, Bobby; Modi, Amit; Barlow, Clifford W; Livesey, Steven A; Ohri, Sunil K

2017-07-01

The treatment of complex prosthetic valve endocarditis (PVE) with aortic root abscess remains a surgical challenge. Several studies support the use of biological tissues to minimize the risk of recurrent infection. We present our initial surgical experience with the use of an aortic xenograft conduit for aortic valve and root replacement. Between October 2013 and August 2015, 15 xenograft bioconduits were implanted for complex PVE with abscess (13.3% female). In 6 patients, concomitant procedures were performed: coronary bypass (n=1), mitral valve replacement (n=5) and tricuspid annuloplasty (n=1). The mean age at operation was 60.3±15.5 years. The mean Logistic European system for cardiac operating risk evaluation (EuroSCORE) was 46.6±23.6. The median follow-up time was 607±328 days (range: 172-1074 days). There were two in-hospital deaths (14.3% mortality), two strokes (14.3%) and seven patients required permanent pacemaker insertion for conduction abnormalities (46.7%). The mean length of hospital stay was 26 days. At pre-discharge echocardiography, the conduit mean gradient was 9.3±3.3mmHg and there was either none (n=6), trace (n=6) or mild aortic insufficiency (n=1). There was no incidence of mid-term death, prosthesis-related complications or recurrent endocarditis. Xenograft bioconduits may be safe and effective for aortic valve and root replacement for complex PVE with aortic root abscess. Although excess early mortality reflects the complexity of the patient population, there was good valve hemodynamics, with no incidence of recurrent endocarditis or prosthesis failure in the mid-term. Our data support the continued use and evaluation of this biological prosthesis in this high-risk patient cohort.

Paediatric magnetic resonance enteroclysis under general anaesthesia - initial experience

International Nuclear Information System (INIS)

Sadigh, Sophie; Chopra, Mark; Olsen, Oeystein E.; Watson, Tom A.; Sury, Michael R.; Shah, Neil

2017-01-01

MR enterography is the accepted imaging reference standard for small bowel assessment in inflammatory bowel disease. There is an increasing cohort of children with inflammatory bowel disease presenting at an early age (<5 years) with severe disease. Younger children present a technical challenge for enterography because of the need for sedation/general anaesthesia to allow image optimisation and the need for oral contrast to allow adequate luminal assessment. Through our experiences, MR enteroclysis under general anaesthesia has proven to be a successful imaging technique for the work-up of these patients. In this paper, we present our institutional practice for performing MR enteroclysis under general anaesthesia. (orig.)

Paediatric magnetic resonance enteroclysis under general anaesthesia - initial experience

Energy Technology Data Exchange (ETDEWEB)

Sadigh, Sophie; Chopra, Mark; Olsen, Oeystein E.; Watson, Tom A. [Great Ormond Street Hospital NHS Foundation Trust, Department of Paediatric Radiology, London (United Kingdom); Sury, Michael R. [Great Ormond Street Hospital NHS Foundation Trust, Department of Paediatric Anaesthetics, London (United Kingdom); Shah, Neil [Great Ormond Street Hospital NHS Foundation Trust, Department of Paediatric Gastroenterology, London (United Kingdom)

2017-06-15

MR enterography is the accepted imaging reference standard for small bowel assessment in inflammatory bowel disease. There is an increasing cohort of children with inflammatory bowel disease presenting at an early age (<5 years) with severe disease. Younger children present a technical challenge for enterography because of the need for sedation/general anaesthesia to allow image optimisation and the need for oral contrast to allow adequate luminal assessment. Through our experiences, MR enteroclysis under general anaesthesia has proven to be a successful imaging technique for the work-up of these patients. In this paper, we present our institutional practice for performing MR enteroclysis under general anaesthesia. (orig.)

Augmented Reality Guidance for the Resection of Missing Colorectal Liver Metastases: An Initial Experience.

Science.gov (United States)

Ntourakis, Dimitrios; Memeo, Ricardo; Soler, Luc; Marescaux, Jacques; Mutter, Didier; Pessaux, Patrick

2016-02-01

Modern chemotherapy achieves the shrinking of colorectal cancer liver metastases (CRLM) to such extent that they may disappear from radiological imaging. Disappearing CRLM rarely represents a complete pathological remission and have an important risk of recurrence. Augmented reality (AR) consists in the fusion of real-time patient images with a computer-generated 3D virtual patient model created from pre-operative medical imaging. The aim of this prospective pilot study is to investigate the potential of AR navigation as a tool to help locate and surgically resect missing CRLM. A 3D virtual anatomical model was created from thoracoabdominal CT-scans using customary software (VR RENDER(®), IRCAD). The virtual model was superimposed to the operative field using an Exoscope (VITOM(®), Karl Storz, Tüttlingen, Germany). Virtual and real images were manually registered in real-time using a video mixer, based on external anatomical landmarks with an estimated accuracy of 5 mm. This modality was tested in three patients, with four missing CRLM that had sizes from 12 to 24 mm, undergoing laparotomy after receiving pre-operative oxaliplatin-based chemotherapy. AR display and fine registration was performed within 6 min. AR helped detect all four missing CRLM, and guided their resection. In all cases the planned security margin of 1 cm was clear and resections were confirmed to be R0 by pathology. There was no postoperative major morbidity or mortality. No local recurrence occurred in the follow-up period of 6-22 months. This initial experience suggests that AR may be a helpful navigation tool for the resection of missing CRLM.

Feedback stabilization initiative

International Nuclear Information System (INIS)

1997-06-01

Much progress has been made in attaining high confinement regimes in magnetic confinement devices. These operating modes tend to be transient, however, due to the onset of MHD instabilities, and their stabilization is critical for improved performance at steady state. This report describes the Feedback Stabilization Initiative (FSI), a broad-based, multi-institutional effort to develop and implement methods for raising the achievable plasma betas through active MHD feedback stabilization. A key element in this proposed effort is the Feedback Stabilization Experiment (FSX), a medium-sized, national facility that would be specifically dedicated to demonstrating beta improvement in reactor relevant plasmas by using a variety of MHD feedback stabilization schemes

Feedback stabilization initiative

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-06-01

Much progress has been made in attaining high confinement regimes in magnetic confinement devices. These operating modes tend to be transient, however, due to the onset of MHD instabilities, and their stabilization is critical for improved performance at steady state. This report describes the Feedback Stabilization Initiative (FSI), a broad-based, multi-institutional effort to develop and implement methods for raising the achievable plasma betas through active MHD feedback stabilization. A key element in this proposed effort is the Feedback Stabilization Experiment (FSX), a medium-sized, national facility that would be specifically dedicated to demonstrating beta improvement in reactor relevant plasmas by using a variety of MHD feedback stabilization schemes.

The initial magnetic susceptibility of polydisperse ferrofluids: A comparison between experiment and theory over a wide range of concentration

International Nuclear Information System (INIS)

Solovyova, Anna Y.; Goldina, Olga A.; Ivanov, Alexey O.; Elfimova, Ekaterina A.; Lebedev, Aleksandr V.

2016-01-01

Temperature dependencies of the static initial magnetic susceptibility for ferrofluids at various concentrations are studied using experiment and statistical-mechanical theories. Magnetic susceptibility measurements are carried out for twelve samples of magnetite-based fluids stabilized with oleic acid over a wide range of temperatures (210 K ≲T ≲ 390 K); all samples have the same granulometric composition but different volume ferroparticle concentrations (0.2 ≲ φ ≲ 0.5). Experimental results are analyzed using three theories: the second-order modified mean-field theory (MMF2) [A. O. Ivanov and O. B. Kuznetsova, Phys. Rev. E 64, 41405 (2001)]; its correction for polydisperse ferrofluids arising from Mayer-type cluster expansion and taking into account the first terms of the polydisperse second virial coefficient [A. O. Ivanov and E. A. Elfimova, J. Magn. Magn. Mater 374, 327 (2015)]; and a new theory based on MMF2 combined with the first terms of the polydisperse second and third virial contributions to susceptibility. It turns out that the applicability of each theory depends on the experimental sample density. If twelve ferrofluid samples are split into three groups of strong, moderate, and low concentrated fluids, the temperature dependences of the initial magnetic susceptibility in each group are very precisely described by one of the three theories mentioned above. The determination of a universal formula predicting a ferrofluid susceptibility over a broad range of concentrations and temperatures remains as a challenge.

Blowdown heat transfer experiment, (1)

International Nuclear Information System (INIS)

Soda, Kunihisa; Yamamoto, Nobuo; Osaki, Hideki; Shiba, Masayoshi

1976-09-01

Blowdown heat transfer experiment has been carried out with a transparent test section to observe phenomena in coolant behavior during blowdown process. Experimental parameters are discharge position, initial system pressure, initial coolant temperature, power supply to heater rods and number of heater rods. At initial pressure 7-12 ata and initial power 6-50 kw per one heater rod, the flow condition in the test section is a major factor in determining time of DNB occurrence and physical process to DNB during blowdown. (auth.)

Quality-improvement initiatives focused on enhancing customer service in the outpatient pharmacy.

Science.gov (United States)

Poulin, Tenley J; Bain, Kevin T; Balderose, Bonnie K

2015-09-01

The development and implementation of quality-improvement initiatives to enhance customer service in an outpatient pharmacy of a Veterans Affairs (VA) medical center are described. Historically low customer service satisfaction rates with the outpatient pharmacy at the Philadelphia Veterans Affairs Medical Center prompted this quality-improvement project. A three-question survey was designed to be easily and quickly administered to veterans in the outpatient pharmacy waiting area. Using 5-point Likert scale, veterans were asked to rate (1) their overall experience with the outpatient pharmacy service and (2) their satisfaction with the customer service provided by the pharmacy department. They were also asked how they thought the pharmacy department could improve its customer service. After receiving feedback from the survey, several quality-improvement initiatives were developed. The initiatives were categorized as environmental, personnel, communicative, and technological. For each initiative, one or more tasks were developed and the initiatives were subsequently implemented over eight months. After each task was completed, veterans were surveyed to measure the impact of the change. A total of 79 veterans were surveyed before the implementation of the quality-improvement initiatives, and 49% and 68% rated their experience with the outpatient pharmacy and customer service favorably, respectively. Twenty-five veterans were surveyed after the implementation of numerous quality-improvement interventions, with 44% and 72% rating their experience with the outpatient pharmacy and customer service favorably. Customer service satisfaction with an outpatient pharmacy service at a VA medical center was enhanced through the implementation of various quality-improvement initiatives. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Early Sex Work Initiation and Violence against Female Sex Workers in Mombasa, Kenya.

Science.gov (United States)

Parcesepe, Angela M; L'Engle, Kelly L; Martin, Sandra L; Green, Sherri; Suchindran, Chirayath; Mwarogo, Peter

2016-12-01

Between 20 and 40 % of female sex workers (FSWs) began sex work before age 18. Little is known concerning whether early initiation of sex work impacts later experiences in adulthood, including violence victimization. This paper examines the relationship between early initiation of sex work and violence victimization during adulthood. The sample included 816 FSWs in Mombasa, Kenya, recruited from HIV prevention drop-in centers who were 18 years or older and moderate-risk drinkers. Early initiation was defined as beginning sex work at 17 or younger. Logistic regression modeled recent violence as a function of early initiation, adjusting for drop-in center, age, education, HIV status, supporting others, and childhood abuse. Twenty percent of the sample reported early initiation of sex work. Although both early initiators and other FSWs reported commonly experiencing recent violence, early initiators were significantly more likely to experience recent physical and sexual violence and verbal abuse from paying partners. Early initiation was not associated with physical or sexual violence from non-paying partners. Many FSWs begin sex work before age 18. Effective interventions focused on preventing this are needed. In addition, interventions are needed to prevent violence against all FSWs, in particular, those who initiated sex work during childhood or adolescence.

Social Health Maintenance Organizations: assessing their initial experience.

Science.gov (United States)

Newcomer, R; Harrington, C; Friedlob, A

1990-08-01

The Social/Health Maintenance Organization (S/HMO) is a four-site national demonstration. This program combines Medicare Part A and B coverage, with various extended and chronic care benefits, into an integrated health plan. The provision of these services extends both the traditional roles of HMOs and that of long-term care community-service case management systems. During the initial 30 months of operation the four S/HMOs shared financial risk with the Health Care Financing Administration. This article reports on this developmental period. During this phase the S/HMOs had lower-than-expected enrollment levels due in part to market competition, underfunding of marketing efforts, the limited geographic area served, and an inability to differentiate the S/HMO product from that of other Medicare HMOs. The S/HMOs were allowed to conduct health screening of applicants prior to enrolling them. The number of nursing home-certifiable enrollees was controlled through this mechanism, but waiting lists were never very long. Persons joining S/HMOs and other Medicare HMOs during this period were generally aware of the alternatives available. S/HMO enrollees favored the more extensive benefits; HMO enrollees considerations of cost. The S/HMOs compare both newly formed HMOs and established HMOs. On the basis of administrator cost, it is more efficient to add chronic care benefits to an HMO than to add an HMO component to a community care provider. All plans had expenses greater than their revenues during the start-up period, but they were generally able to keep service expenditures within planned levels.

Underground science initiatives at Los Alamos

International Nuclear Information System (INIS)

Simmons, L.M. Jr.

1985-01-01

Recently, the Los Alamos National Laboratory has proposed two major new initiatives in underground science. Following the dissolution of the original gallium solar neutrino collaboration, Los Alamos has formed a new North American collaboration. We briefly review the rationale for solar neutrino research, outline the proposal and new Monte Carlo simulations, and describe the candidate locations for the experiment. Because there is no dedicated deep underground site in North America suitable for a wide range of experiments, Los Alamos has conducted a survey of possible sites and developed a proposal to create a new National Underground Science Facility. This paper also reviews that proposal

Initial Smoking Experiences and Current Smoking Behaviors and Perceptions among Current Smokers

Directory of Open Access Journals (Sweden)

Hugh Klein

2013-01-01

Full Text Available Purpose. We examine early-onset cigarette smoking and how, if at all, it is related to subsequent smoking practices. Methods. From 2004 to 2007, face-to-face interviews were conducted with 485 adult cigarette smokers residing in the Atlanta metropolitan area. Data analysis involved a multivariate analysis to determine whether age of smoking onset was related to current smoking practices when the effects of gender, age, race, marital/relationship status, income, and educational attainment were taken into account. Results. The mean age for smoking onset was 14.8, and more than one-half of all smokers had their first cigarette between the ages of 12 and 16. Most people reported an interval of less than one month between their first and second time using tobacco. Earlier onset cigarette smoking was related to more cigarette use and worse tobacco-related health outcomes in adulthood. Conclusions. Early prevention and intervention are needed to avoid early-onset smoking behaviors. Intervening after initial experimentation but before patterned smoking practices are established will be challenging, as the interval between initial and subsequent use tends to be short.

Conceptual design of initial opacity experiments on the national ignition facility

Science.gov (United States)

Heeter, R. F.; Bailey, J. E.; Craxton, R. S.; Devolder, B. G.; Dodd, E. S.; Garcia, E. M.; Huffman, E. J.; Iglesias, C. A.; King, J. A.; Kline, J. L.; Liedahl, D. A.; McKenty, P. W.; Opachich, Y. P.; Rochau, G. A.; Ross, P. W.; Schneider, M. B.; Sherrill, M. E.; Wilson, B. G.; Zhang, R.; Perry, T. S.

2017-02-01

Accurate models of X-ray absorption and re-emission in partly stripped ions are necessary to calculate the structure of stars, the performance of hohlraums for inertial confinement fusion and many other systems in high-energy-density plasma physics. Despite theoretical progress, a persistent discrepancy exists with recent experiments at the Sandia Z facility studying iron in conditions characteristic of the solar radiative-convective transition region. The increased iron opacity measured at Z could help resolve a longstanding issue with the standard solar model, but requires a radical departure for opacity theory. To replicate the Z measurements, an opacity experiment has been designed for the National Facility (NIF). The design uses established techniques scaled to NIF. A laser-heated hohlraum will produce X-ray-heated uniform iron plasmas in local thermodynamic equilibrium (LTE) at temperatures eV and electron densities 21~\\text{cm}-3$ . The iron will be probed using continuum X-rays emitted in a ps, diameter source from a 2 mm diameter polystyrene (CH) capsule implosion. In this design, of the NIF beams deliver 500 kJ to the mm diameter hohlraum, and the remaining directly drive the CH capsule with 200 kJ. Calculations indicate this capsule backlighter should outshine the iron sample, delivering a point-projection transmission opacity measurement to a time-integrated X-ray spectrometer viewing down the hohlraum axis. Preliminary experiments to develop the backlighter and hohlraum are underway, informing simulated measurements to guide the final design.

Catheter closure of patent foramen ovale in patients with cryptogenic cerebrovascular accidents: initial experiences in Japan.

Science.gov (United States)

Kijima, Yasufumi; Akagi, Teiji; Nakagawa, Koji; Taniguchi, Manabu; Ueoka, Akira; Deguchi, Kentaro; Toh, Norihisa; Oe, Hiroki; Kusano, Kengo; Sano, Shunji; Ito, Hiroshi

2014-01-01

Although numerous studies have shown an association between a patent foramen ovale (PFO) and cryptogenic cerebrovascular accidents (CVA), there has been no definitive control study that demonstrated the benefit of percutaneous device closure of a PFO compared to medical therapy in patients with CVA. Additionally, few clinical data exist for Japanese patients in this field. We demonstrate the initial experiences in catheter closure of a PFO as secondary prevention of CVA in Japan. Catheter closure of a PFO was attempted in 7 patients who were diagnosed with cryptogenic CVA. Mean age at the procedure was 54 ± 19 years. The presence of spontaneous interatrial right-to-left shunts was demonstrated by transesophageal contrast echocardiography without Valsalva maneuver in all of the patients. Amplatzer Cribriform device (n = 4) or Amplatzer PFO Occluder (n = 3) was used for the procedure and was successfully deployed. Device-related complications were not observed at the time of the procedure or during the follow-up period (mean period of 16 ± 9 months). Catheter closure of a PFO could be safely performed with Amplatzer Cribriform or Amplatzer PFO Occluder. This procedure may contribute to prevention of recurrent cryptogenic CVA in Japanese patients.

Design and initial performance of the Sandia Pulsed Reactor-III

International Nuclear Information System (INIS)

Reuscher, J.A.; Estes, B.F.

1976-01-01

The Sandia Pulsed Reactor-III (SPR-III) is a new fast pulsed reactor which has recently undergone initial testing at Sandia Laboratories. SPR-III is a uranium-10 weight percent molybdenum fuel assembly with a 17.78 cm irradiation cavity similar in design to SPR-II which has been in operation since 1967. The basic SPR-III design utilizes the same split-core configuration which has been proven with SPR-II; however, SPR-III uses external reflectors for control and external bolts to hold the fuel plates together. The core consists of sixteen fuel plates with an inside diameter of 17.78 cm, an outside diameter of 29.72 cm, and a core height of 31.9 cm. The fuel mass is about 227 kg of fully enriched uranium-10 weight percent molybdenum alloy. SPR III has completed the initial series of startup tests which included the critical experiment, zero and low-power tests, and pulse testing. The reactor design and results from the initial testing program are described in this paper. A portion of the startup experiments with SPR-III have been completed and this paper discusses the more important aspects of the initial testing program

Experiences from the anatomy track in the ontology alignment evaluation initiative.

Science.gov (United States)

Dragisic, Zlatan; Ivanova, Valentina; Li, Huanyu; Lambrix, Patrick

2017-12-04

One of the longest running tracks in the Ontology Alignment Evaluation Initiative is the Anatomy track which focuses on aligning two anatomy ontologies. The Anatomy track was started in 2005. In 2005 and 2006 the task in this track was to align the Foundational Model of Anatomy and the OpenGalen Anatomy Model. Since 2007 the ontologies used in the track are the Adult Mouse Anatomy and a part of the NCI Thesaurus. Since 2015 the data in the Anatomy track is also used in the Interactive track of the Ontology Alignment Evaluation Initiative. In this paper we focus on the Anatomy track in the years 2007-2016 and the Anatomy part of the Interactive track in 2015-2016. We describe the data set and the changes it went through during the years as well as the challenges it poses for ontology alignment systems. Further, we give an overview of all systems that participated in the track and the techniques they have used. We discuss the performance results of the systems and summarize the general trends. About 50 systems have participated in the Anatomy track. Many different techniques were used. The most popular matching techniques are string-based strategies and structure-based techniques. Many systems also use auxiliary information. The quality of the alignment has increased for the best performing systems since the beginning of the track and more and more systems check the coherence of the proposed alignment and implement a repair strategy. Further, interacting with an oracle is beneficial.

Model and experiences of initiating collaboration with traditional healers in validation of ethnomedicines for HIV/AIDS in Namibia

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Chinsembu Kazhila C

2009-10-01

Full Text Available Abstract Many people with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS in Namibia have access to antiretroviral drugs but some still use traditional medicines to treat opportunistic infections and offset side-effects from antiretroviral medication. Namibia has a rich biodiversity of indigenous plants that could contain novel anti-HIV agents. However, such medicinal plants have not been identified and properly documented. Various ethnomedicines used to treat HIV/AIDS opportunistic infections have not been scientifically validated for safety and efficacy. These limitations are mostly attributable to the lack of collaboration between biomedical scientists and traditional healers. This paper presents a five-step contextual model for initiating collaboration with Namibian traditional healers in order that candidate plants that may contain novel anti-HIV agents are identified, and traditional medicines used to treat HIV/AIDS opportunistic infections are subjected to scientific validation. The model includes key structures and processes used to initiate collaboration with traditional healers in Namibia; namely, the National Biosciences Forum, a steering committee with the University of Namibia (UNAM as the focal point, a study tour to Zambia and South Africa where other collaborative frameworks were examined, commemorations of the African Traditional Medicine Day (ATMD, and consultations with stakeholders in north-eastern Namibia. Experiences from these structures and processes are discussed. All traditional healers in north-eastern Namibia were willing to collaborate with UNAM in order that their traditional medicines could be subjected to scientific validation. The current study provides a framework for future collaboration with traditional healers and the selection of candidate anti-HIV medicinal plants and ethnomedicines for scientific testing in Namibia.

Assessment of pain experience in adults and children after bracket bonding and initial archwire insertion

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Marcio José da Silva Campos

2013-10-01

Full Text Available INTRODUCTION: Ninety five percent of orthodontic patients routinely report pain, due to alterations in the periodontal ligament and surrounding soft tissues, with intensity and prevalence varying according to age. OBJECTIVE: This study aimed to assess toothache and buccal mucosal pain in adults and children during two initial phases of the orthodontic treatment. METHODS: The intensity of toothache and buccal mucosal pain reported by 20 patients, 10 children (11-13 years and 10 adults (18-37 years was recorded with the aid of a Visual Analog Scale (VAS, during 14 days - 7 days with bonded brackets only and 7 days with the initial archwire inserted. RESULTS: There was no significant difference in pain intensity among adults and children. After bracket bonding, 50% of the children and 70% of the adults reported pain. 70% of both groups reported pain after initial archwire insertion. While adults reported constant, low intensity, buccal mucosal pain, the children showed great variation of pain intensity, but with a trend towards decreasing pain during the assessment period. After initial archwire insertion the peaks of toothache intensity and prevalence occurred 24 hours in children and 48 hours in adults. CONCLUSIONS: In general, children reported pain less frequently than adults did, though with greater intensity.

Factors determining outcomes in grown up patients operated for congenital heart diseases

Directory of Open Access Journals (Sweden)

Sachin Talwar

2016-01-01

Conclusion: GUCH can be safely operated when adequate caution is taken in the presence of independent predictors such as previous sternotomy, aortic clamp time >45 min, cyanosis, and emergency procedure.

Quantum control for initiation and detection of explosives

International Nuclear Information System (INIS)

Greenfield, Margo T.; McGrane, Shawn D.; Scharff, R. Jason; Moore, David S.

2010-01-01

We employ quantum control methods towards detection and quantum controlled initiation (QCI) of energetic materials. Ultrafast pulse shaping of broadband Infrared (∼750 nm to 850 run) and ultraviolet (266 nm, 400 nm) light is utilized for control. The underlying principals behind optimal control can be utilized to both detect and initiate explosives. In each case, time dependent phase shaped electric fields drive the chemical systems towards a desired state. For optimal dynamic detection of explosives (ODD-Ex) a phase specific broadband infrared pulse is created which increases not only the sensitivity of detection but also the selectivity of an explosive's spectral signatures in a background of interferents. QCI on the other hand, seeks to initiate explosives by employing shaped ultraviolet light. QCI is ideal for use with explosive detonators as it removes the possibility of unintentional initiation from an electrical source while adding an additional safety feature, initiation only with the proper pulse shape. Quantum control experiments require: (1) the ability to phase and amplitude shape the laser pulse and (2) the ability to effectively search for the pulse shape which controls the reaction. In these adaptive experiments we utilize both global and local optimization search routines such as genetic algorithm, differential evolution, and downhill simplex. Pulse shaping the broadband IR light, produced by focusing 800 nm light through a pressurized tube of Argon, is straightforward as commercial pulse shapers are available at and around 800 nm. Pulse shaping in the UV requires a home built shaper. Our system is an acoustic optical modulator (AOM) pulse shaper in which consists of a fused silica AOM crystal placed in the Fourier plane of a 4-f zero dispersion compressor.

Is the femoral cannulation for minimally invasive aortic valve replacement necessary?

Science.gov (United States)

Cuenca, J; Rodriguez-Delgadillo, M A; Valle, J V; Campos, V; Herrera, J M; Rodriguez, F; Portela, F; Sorribas, F; Juffe, A

1998-10-01

Minimally invasive cardiac surgery through a small transverse sternotomy is a new promising technique that can be considered an alternative in most cases to aortic valve replacement thus reducing surgical trauma and subsequent time of hospitalization. The need to avoid the risks associated with femoro-femoral bypass has lead to the interest in aortic valve replacement (AVR) operations without femoral vessels cannulation. We want to emphasize a few important points of our technique, which differs somewhat from the one applied by Cosgrove and associates. This study details the approach to the minimally invasive AVR as first described by. Cosgrove et al. without standard femoral cannulation and points out our preliminary clinical experience. From October 1996 to May 1997 we have operated on 25 patients using minimally invasive AVR (MI-AVR) In 23 cases, access through transverse sternotomy as described by Cosgrove et al., was performed. In two additional cases the chest is opened via a mini-median sternotomy with an 'L'-shape extending from the sternal notch to the superior edge of the third interspace. Twenty-three patients underwent AVR through transverse sternotomy. The male/female ratio was 13:10. The mean age was 67 years (range 45-78 years). Seventy-four percent of the patients were over 65. Predominantly, in 43% of cases aortic valve stenosis and in 25% of cases aortic valve regurgitation isolated is presented. In 19 cases, a 10-cm transverse incision is performed over the second interspace. Likewise, in four cases over the third interspace according to the thorax morphology and length of the ascending aorta assessed by chest X-ray films. By convention, cannulation of the ascending aorta and right atrial appendage was performed as usual. In contrast, in one patient (5.5%), cannulation was placed in the superior vena cava and right common femoral vein into the inferior vena cava. In the present series, 15 mechanical prostheses and eight bioprostheses whose used

TRACY transient experiment databook. 2) ramp withdrawal experiment

International Nuclear Information System (INIS)

Nakajima, Ken; Yamane, Yuichi; Ogawa, Kazuhiko; Aizawa, Eiju; Yanagisawa, Hiroshi; Miyoshi, Yoshinori

2002-03-01

This is a databook of TRACY ''ramp withdrawal'' experiments. TRACY is a reactor to perform supercritical experiments using low-enriched uranyl nitrate aqueous solution. The excess reactivity of TRACY is 3$ at maximum, and it is inserted by feeding the solution to a core tank or by withdrawing a control rod, which is called as the transient rod, from the core. In the ramp withdrawal experiment, the supercritical experiment is initiated by withdrawing the transient rod from the core in a constant speed using a motor drive system. The data in the present databook consist of datasheets and graphs. Experimental conditions and typical values of measured parameters are tabulated in the datasheet. In the graph, power and temperature profiles are plotted. Those data are useful for the investigation of criticality accidents with fissile solutions, and for validation of criticality accident analysis codes. (author)

Initial Results on Neutralized Drift Compression Experiments (NDCX-IA) for High Intensity Ion Beam

CERN Document Server

Roy, Prabir K; Baca, David; Bieniosek, Frank; Coleman, Joshua E; Davidson, Ronald C; Efthimion, Philip; Eylon, Shmuel; Gilson, Erik P; Grant Logan, B; Greenway, Wayne; Henestroza, Enrique; Kaganovich, Igor D; Leitner, Matthaeus; Rose, David; Sefkow, Adam; Sharp, William M; Shuman, Derek; Thoma, Carsten H; Vanecek, David; Waldron, William; Welch, Dale; Yu, Simon

2005-01-01

Ion beam neutralization and compression experiments are designed to determine the feasibility of using compressed high intensity ion beams for high energy density physics (HEDP) experiments and for inertial fusion power. To quantitatively ascertain the various mechanisms and methods for beam compression, the Neutralized Drift Compression Experiment (NDCX) facility is being constructed at Lawrence Berkeley National Laboratory (LBNL). In the first compression experiment, a 260 KeV, 25 mA, K+ ion beam of centimeters size is radially compressed to a mm size spot by neutralization in a meter-long plasma column and beam peak current is longitudinally compressed by an induction velocity tilt core. Instrumentation, preliminary results of the experiments, and practical limits of compression are presented. These include parameters such as emittance, degree of neutralization, velocity tilt time profile, and accuracy of measurements (fast and spatially high resolution diagnostic) are discussed.

Learning From Tests: Facilitation of Delayed Recall by Initial Recognition Alternatives.

Science.gov (United States)

Whitten, William B., II; Leonard, Janet Mauriello

1980-01-01

Two experiments were designed to determine the effects of multiple-choice recognition test alternatives on subsequent memory for the correct answers. Results of both experiments are interpreted as demonstrations of the principle that long-term retention is facilitated such that memory evaluation occurs during initial recognition tests. (Author/RD)

Implementation of a patient dose monitoring system in conventional digital X-ray imaging: initial experiences

Energy Technology Data Exchange (ETDEWEB)

Heilmaier, Christina; Zuber, Niklaus; Weishaupt, Dominik [Stadtspital Triemli Zurich, Department of Radiology and Nuclear Medicine, Zurich (Switzerland)

2017-03-15

The purpose was to report on the initial experience after implementation of a patient dose-monitoring system in conventional X-ray imaging. A dose-monitoring system collected dose data relating to different radiographs (one projection) and studies (two or more projections). Images were acquired on digital X-ray systems equipped with flat-panel detectors. During period 1, examinations were performed in a routine fashion in 12,614 patients. After period 1, technical modifications were performed and radiographers underwent training in radiation protection. During period 2, examinations were performed in 14,514 patients, and the radiographers were advised to read dose data after each radiograph/study. Dose data were compared by means of kerma area product (KAP, gray x centimetre squared) and entrance surface air kerma (ESAK, milligray). During period 1, 13,955 radiographs and 8,466 studies were performed, and in period 2 16,090 radiographs and 10,389 studies. In period 2, KAP values for radiographs were an average of 25 % lower and for studies 7 % lower, and ESAK values for radiographs were 24 % lower and for studies 5 % lower. The reduction in KAP was significant in 8/13 radiographs and in 6/14 studies, and the reduction in ESAK was significant in 6/13 radiographs and 5/14 studies. Implementation of a patient dose-monitoring system in conventional X-ray imaging allows easy data collection, supports dose reduction efforts, and may increase radiographers' dose awareness. (orig.)

The initial phase of sudden releases of superheated liquid

International Nuclear Information System (INIS)

Schmidli, J.

1994-04-01

The catastrophic failure of a pressure vessel containing a liquefied substance, leading to an instantaneous release of its whole contents is considered as one of the major technological hazards. Due to the rapid depressurization caused by vessel failure, the fluid becomes superheated and unstable. Part of the fluid will evaporate using its internal energy and the two-phase mixture forming will be accelerated. This flashing process can be very violent, as experiments and incidents actually happened have shown. In the past, a number of dispersion models were developed to predict the history of an instantaneous release. In most of these models the source term is considered to be a gas volume at rest and not a rapidly expanding aerosol, as could be observed. Furthermore, it is usually assumed that all of the remaining fluid is entrained into the expanding cloud and nothing is deposited on the ground to form a pool. This work concentrates on the initial phase of the sudden release of superheated liquids with the aim to gain a better understanding of the flashing process and of the physical mechanisms involved, leading to a reliable prediction of the source term. Therefore, more than 400 experiments with propane, butane, refrigerant 12 and 114 were conducted. The experiments were initiated by shattering spherical glass flasks of different sizes. The main parameters varied were the liquid superheat and the filling level of the vessel. Using high-speed video and movie recordings and very fast responding measurement devices, it was possible to study the initial phase of such releases during which gravity plays no role. For sufficiently large released internal energy, the initial evolution of the release was always spherical with a constant radial expansion velocity during he first milliseconds until instabilities appeared at the surface of the droplet/vapor cloud that was formed. For all the experimental conditions, the fraction of the initial liquid falling on the ground

Prosthetic vascular graft infection through a median sternotomy: a multicentre review †.

Science.gov (United States)

Oda, Tatsuya; Minatoya, Kenji; Kobayashi, Junjiro; Okita, Yutaka; Akashi, Hidetoshi; Tanaka, Hiroyuki; Kawaharada, Nobuyoshi; Saiki, Yoshikatsu; Kuniyoshi, Yukio; Nishimura, Kunihiro

2015-06-01

The aim of this study is to analyse the treatment outcomes of thoracic prosthetic graft infection. A retrospective chart review was conducted at six hospitals and included the records of 68 patients treated for postoperative prosthetic vascular graft infection (mean age: 62.3 ± 15.1, male 51) from January 2000 to December 2013. The number of patients and the locations of the treated infections were as follows: 13 for aortic root, 16 for ascending aorta, 35 for aortic arch and 4 for aortic root to arch. In-hospital infection occurred in 43 patients and after discharge in 25. The mean follow-up time was 2.0 ± 2.3 years. The follow-up rate was 94.1%. The most commonly isolated micro-organism was Staphylococcus aureus (72.1%). Rereplacement of infectious graft was performed in 18 patients (Dacron graft in 12, homograft in 4 and rifampicin-bonded Dacron graft in 2). The overall hospital mortality rate was 35.3% (24/68). The mortality rate among the patients with graft rereplacement was 33.3% (6/18), with pedicled muscle flaps or pedicled omental flaps to cover the graft 25.9% (7/27), with irrigation 55.0% (11/20) and on antibiotic therapy only 0% (0/3). Our multivariate analysis demonstrated that the risk factors of hospital death increased in the absence of pedicled flaps (muscle or omentum) to cover the graft (P = 0.001), age over 55 (P = 0.003), time from onset of initial operation prosthetic vascular graft infection have not been satisfactory. However, the use of pedicled muscle or omental flaps to cover the graft could improve the outcomes. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Experiment data report for Loft anticipated transient experiments 16-1, 16-2, and 16-3

International Nuclear Information System (INIS)

Batt, D.L.; Carpenter, J.M.

1980-12-01

This report presents uninterpreted experimental data from the second, third, and fourth anticipated transient experiments (Experiments L6-2, L6-1, and L6-3), conducted in the Loss-of-Fluid Test (LOFT) facility. Experiment L6-2 simulated a loss of forced primary coolant flow in a large PWR by tripping power to primary coolant pump motor generator sets, allowing the pumps to coast down under the influence of the flywheel system. Reactor scram initiated on indication of low flow in the primary coolant system (PCS). Experiment L6-1 simulated a loss of steam load in a large PWR by closing the steam flow control valve which reduced heat removal from the secondary coolant system and caused the PCS temperature and pressure to increase until reactor scram initiated on indication on high PCS pressure. Experiment L6-3 simulated an excessive load increase in a large PWR by opening the steam flow control valve at its maximum rate. PCS temperature and pressure decreased, causing the reactor to scram on indication of low PCS pressure. All experiments were complete when the plant was returned to a hot-standby condition

Initial experience with a new articulating energy device for laparoscopic liver resection.

Science.gov (United States)

Berber, Eren; Akyuz, Muhammet; Aucejo, Federico; Aliyev, Shamil; Aksoy, Erol; Birsen, Onur; Taskin, Eren

2014-03-01

Although significant advances have been made in laparoscopic liver resection (LLR), most techniques still rely on multiple energy devices and staplers, which increase operative costs. The aim of this study was to report the initial results of a new multifunctional energy device for hepatic parenchymal transection. Fourteen patients who underwent LLR using this new device were compared to 20 patients who had LLR using current laparoscopic techniques (CL). Data were collected prospectively. The groups were similar demographics and tumor type and size. Although the type of resection was similar between the groups, the parenchymal transection time was less in the Caiman group (32 ± 5 vs. 63 ± 4 min, respectively, p = 0.0001). The operative time was similar (194 ± 21 vs. 233 ± 16 min, respectively, p = 0.158). There was reduction of the number of advanced instrumentation used in the Caiman group, including the staplers. Estimated blood loss, size of surgical margin, and hospital stay were similar. There was no mortality, and morbidity was 7 % in the Caiman and 20 % in the CL group. This initial study shows that the new device is safe and efficient for LLR. Its main advantage is shortening of hepatic parenchymal transection time. This has implications for increasing efficiency and cost saving in LLR.

NMR imaging of the brain: initial impressions

International Nuclear Information System (INIS)

Spencer, D.H.; Bydder, G.M.

1983-01-01

An NMR imaging system designed and built by Thorn-EMI Ltd was installed at Hammersmith Hospital in March 1981. In the first year of operation 180 patients and 40 volunteers have had cranial examinations and initial impressions bases on this experience are presented. Patients with a wide variety of neurological diseases have been studied to provide a basis for diagnostic interpretation, to define distinctive features, and to evaluate different types of scanning sequences. NMR imaging appears to be of considerable value in neurological diagnosis and has a number of advantages over CT. The detailed evaluation of NMR imaging will require much more work but the initial results are very promising

Initial experience of robotic versus laparoscopic colectomy for transverse colon cancer: a matched case-control study.

Science.gov (United States)

de'Angelis, Nicola; Alghamdi, Salah; Renda, Andrea; Azoulay, Daniel; Brunetti, Francesco

2015-10-09

Robotic surgery for transverse colon cancer has rarely been described. This study reports our initial experience in robotic resection for transverse colon cancer, by comparing robotic transverse colectomy (RC) to laparoscopic transverse colectomy (LC) in terms of safety, feasibility, short-term outcomes, and the surgeon's psychological stress and physical pain. The study population included the first 22 consecutive patients who underwent RC between March 2013 and December 2014 for histologically confirmed transverse colon adenocarcinoma. These patients were compared with 22 matched patients undergoing LC between December 2010 and February 2013. Patients were matched based on age, gender, body mass index (BMI), American Society of Anesthesiology (ASA) score, American Joint Committee on Cancer (AJCC) tumor stage, and tumor location (ratio 1:1). Mortality, morbidity, operative, and short-term oncologic outcomes were compared between groups. The operating surgeon's stress and pain were assessed before and after surgery on a 0-100-mm visual analog scale. The demographic and preoperative characteristics were comparable between RC and LC patients. No group difference was observed for intraoperative complications, blood loss, postoperative pain, time to flatus, time to regular diet, and hospital stay. RC was associated with longer operative time than LC (260 min vs. 225 min; p = 0.014), but the overall operative and robotic time in the RC group decreased over time reflecting the increasing experience in performing this procedure. No conversion to laparotomy was observed in the RC group, while two LC patients were converted due to uncontrolled bleeding and technically difficult middle colic pedicle dissection. Postoperative complications (Dindo-Clavien grade I or II) occurred in 11.3 % of patients with no group difference. Mortality was nil. All resections were R0, with >12 lymph nodes harvested in 90.9 % of RC and 95.5 % of LC patients. The surgeon's stress was

Role of laser myringotomy in a pediatric otolaryngology practice: initial experience

Science.gov (United States)

Shah, Udayan K.

2001-05-01

A new technology (OtoLAM) to fenestrate the tympanic membrane with the carbon dioxide laser (CO2), in the office or the operating room, has been introduced over the last three years. While not new conceptually, this product offers the ability to easily create a precise window into the middle ear using a portable system. Controversy regarding the indications and benefits of this technique, amplified by the costs of the system and the marketing of the technology prior to extensive clinical testing, has plagued the clinical application of this technology. We report our experience over the past year with this system in a busy pediatric otolaryngology practice. Laser fenestration of the tympanic membrane has been useful for the insertion of tympanostomy tubes, and for the minimally invasive evaluation of the middle ear. Our small experience to date reveals that there is a limited role for laser tympanic membrane fenestration in a busy pediatric otolaryngology practice.

EPID-based in vivo dosimetry for stereotactic body radiotherapy of non-small cell lung tumors: Initial clinical experience.

Science.gov (United States)

Consorti, R; Fidanzio, A; Brainovich, V; Mangiacotti, F; De Spirito, M; Mirri, M A; Petrucci, A

2017-10-01

EPID-based in vivo dosimetry (IVD) has been implemented for stereotactic body radiotherapy treatments of non-small cell lung cancer to check both isocenter dose and the treatment reproducibility comparing EPID portal images. 15 patients with lung tumors of small dimensions and treated with volumetric modulated arc therapy were enrolled for this initial experience. IVD tests supplied ratios R between in vivo reconstructed and planned isocenter doses. Moreover a γ-like analysis between daily EPID portal images and a reference one, in terms of percentage of points with γ-value smaller than 1, P γlevels of 5% for R ratio, P γlevel, and an average P γ90%. Paradigmatic discrepancies were observed in three patients: a set-up error and a patient morphological change were identified thanks to CBCT image analysis whereas the third discrepancy was not fully justified. This procedure can provide improved patient safety as well as a first step to integrate IVD and CBCT dose recalculation. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Designing Technology for Active Spectator Experiences at Sporting Events

DEFF Research Database (Denmark)

Veerasawmy, Rune; Ludvigsen, Martin

2010-01-01

This paper explores the active spectator experience at sporting events, by presenting and reflecting upon a design experiment carried out at a number of football1 events. The initial hypothesis of the design process, leading to the design experiment has been that the spectator experience is not m......This paper explores the active spectator experience at sporting events, by presenting and reflecting upon a design experiment carried out at a number of football1 events. The initial hypothesis of the design process, leading to the design experiment has been that the spectator experience...... is not merely an experience of receiving and consuming entertainment. It is also heavily reliant on the active participation of the spectator in creating the atmosphere of the entire event. The BannerBattle experiment provides interactive technology in sport arenas with a form of interaction based on existing...

Experiment prediction for Loft Nonnuclear Experiment L1-4

International Nuclear Information System (INIS)

White, J.R.; Berta, V.T.; Holmstrom, H.L.O.

1977-04-01

A computer analysis, using the WHAM and RELAP4 computer codes, was performed to predict the LOFT system thermal-hydraulic response for Experiment L1-4 of the nonnuclear (isothermal) test series. Experiment L1-4 will simulate a 200 percent double-ended offset shear in the cold leg of a four-loop large pressurized water reactor. A core simulator will be used to provide a reactor vessel pressure drop representative of the LOFT nuclear core. Experiment L1-4 will be initiated with a nominal isothermal primary coolant temperature of 282.2 0 C, a pressurizer pressure of 15.51 MPa, and a primary coolant flow of 270.9 kg/s. In general, the predictions of saturated blowdown for Experiment Ll-4 are consistent with the expected system behavior, and predicted trends agree with results from Semiscale Test S-01-4A, which simulated the Ll-4 experiment conditions

Robotic-assisted partial Nephrectomy: initial experience in South America

Directory of Open Access Journals (Sweden)

Gustavo C. Lemos

2011-08-01

Full Text Available OBJECTIVE:To report the initial outcomes of robotic-assisted partial nephrectomy in a tertiary center in South America. MATERIAL AND METHODS: From 11/2008 to 12/2009, a total of 16 transperitoneal robotic-assisted partial nephrectomies were performed in 15 patients to treat 18 kidney tumors. One patient with bilateral tumor had two procedures, while two patients with two synchronous unilateral tumors had a single operation to remove them. Eleven (73% patients were male and the right kidney was affected in 7 (46% patients. The median patient age and tumor size were 57 years old and 30 mm, respectively. Five (28% tumors were hilar and/or centrally located. RESULTS: The median operative time, warm ischemia time and estimated blood loss was 140 min, 27 min and 120 mL, respectively. Blood transfusion was required in one patient with bilateral tumor, and one additional pyelolithotomy was performed due to a 15mm stone located in the renal pelvis. The histopathology analysis showed 15 (83% malignant tumors, which 10 (67% were clear cell carcinoma. The median hospital stay was 72 hrs and no major complication was observed. CONCLUSION: Robotic-assisted partial nephrectomy is safe and represents a valuable option to perform minimally invasive nephron-sparing surgery.

The initial representation in reasoning towards an interpretation of conditional sentences.

Science.gov (United States)

Schroyens, Walter; Braem, Senne

2011-02-01

All accounts of human reasoning (whether presented at the symbolic or subsymbolic level) have to reckon with the temporal organization of the human processing systems and the ephemeral nature of the representations it uses. We present three new empirical tests for the hypothesis that people commence the interpretational process by constructing a minimal initial representation. In the case of if A then C the initial representation captures the occurrence of the consequent, C, within the context of the antecedent, A. Conditional inference problems are created by a categorical premise that affirms or denies A or C. The initial representation allows an inference when the explicitly represented information matches (e.g., the categorical premise A affirms the antecedent "A") but not when it mismatches (e.g., "not-A" denies A). Experiments 1 and 2 confirmed that people tend to accept the conclusion that "nothing follows" for the denial problems, as indeed they do not have a determinate initial-model conclusion. Experiment 3 demonstrated the other way round that the effect of problem type (affirmation versus denial) is reduced when we impede the possibility of inferring a determinate conclusion on the basis of the initial representation of both the affirmation and the denial problems.

Late presentation of a deep sternal wound infection and left breast abscess.

Science.gov (United States)

Mustafa, A; Carr, C; Alkhafagi, S; Mughal, N; Omer, M; Alkhulaifi, A

2014-02-01

In this paper, we present a case review of a 58-year-old female who presented to our emergency department with pyrexia, dyspnoea, dehydration and pain in her left breast six months following coronary artery bypass grafting (CABG). Although her sternotomy wound had healed well, examination revealed fluctuance of the whole precordium and left breast. She underwent antibiotic treatment and subsequent surgical debridement, followed by the application of vacuum-assisted dressings. Surgical reconstruction was deemed unsuitable and therefore the patient continued to be managed with vacuum dressings followed by routine dressings to allow the wound to heal by secondary intention. The patient was discharged three months after initial presentation in a good condition. The wound had completely healed four months later.

Robotic Applications in Cardiac Surgery

Directory of Open Access Journals (Sweden)

Alan P. Kypson

2008-11-01

Full Text Available Traditionally, cardiac surgery has been performed through a median sternotomy, which allows the surgeon generous access to the heart and surrounding great vessels. As a paradigm shift in the size and location of incisions occurs in cardiac surgery, new methods have been developed to allow the surgeon the same amount of dexterity and accessibility to the heart in confined spaces and in a less invasive manner. Initially, long instruments without pivot points were used, however, more recent robotic telemanipulation systems have been applied that allow for improved dexterity, enabling the surgeon to perform cardiac surgery from a distance not previously possible. In this rapidly evolving field, we review the recent history and clinical results of using robotics in cardiac surgery.

Impact of a hospital improvement initiative in Bangladesh on patient experiences and satisfaction with services: two cross-sectional studies

Directory of Open Access Journals (Sweden)

Omer Khalid

2011-12-01

Full Text Available Abstract Background The Bangladesh government implemented a pilot Hospital Improvement Initiative (HII in five hospitals in Sylhet division between 1998 and 2003. This included management and behaviour change training for staff, waste disposal and procurement, and referral arrangements. Two linked cross-sectional surveys in 2000 and 2003 assessed the impact of the HII, assessing both patients' experience and satisfaction and public views and use of the hospitals. Methods In each survey we asked 300 consecutive outpatients and a stratified random sample of 300 inpatients in the five hospitals about waiting and consultation time, use of an agent for admission, and satisfaction with privacy, cleanliness, and staff behaviour. The field teams observed cleanliness and privacy arrangements, and visited a sample of households in communities near the hospitals to ask about their opinions and use of the hospital services. Analysis examined changes over time in patients' experience and views. Multivariate analysis took account of other variables potentially associated with the outcomes. Survey managers discussed the survey findings with gender stratified focus groups in each sample community. Results Compared with 2000, an outpatient in three of the hospitals in 2003 was more likely to be seen within 10 minutes and for at least five minutes by the doctor, but outpatients were less likely to report receiving all the prescribed medicines from the hospital. In 2003, inpatients were more likely to have secured admission without using an agent. Although patients’ satisfaction with several aspects of care improved, most changes were not statistically significant. Households in 2003 were significantly more likely to rate the hospitals as good than in 2000. Use of the hospitals did not change, except that more households used the medical college hospital for inpatient care in 2003. Focus groups confirmed criticisms of services and suggested improvements

Initial experience with transperitoneal laparoscopic nephrectomy in an Irish hospital setting.

LENUS (Irish Health Repository)

Forde, J C

2009-08-01

Laparoscopic nephrectomy has gained widespread acceptance as a treatment for both benign and malignant conditions and is becoming increasingly popular in Irish hospitals. We report a single surgeon, single centre experience with 20 consecutive laparoscopic nephrectomies comparing them to 20 open cases performed prior to the establishment of a laparoscopic service.

TRACY transient experiment databook. 3) Ramp feed experiment

Energy Technology Data Exchange (ETDEWEB)

Nakajima, Ken; Yamane, Yuichi; Ogawa, Kazuhiko; Aizawa, Eiju; Yanagisawa, Hiroshi; Miyoshi, Yoshinori [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

2002-03-01

This is a databook of TRACY ''ramp feed'' experiments. TRACY is a reactor to perform supercritical experiments using low-enriched uranyl nitrate aqueous solution. The excess reactivity of TRACY is 3$ at maximum, and it is inserted by feeding the solution to a core tank or by withdrawing a control rod, which is called as the transient rod, from the core. In the ramp feed experiment, the supercritical experiment is initiated by feeding the fuel solution to the core tank in a constant feed rate. The data in the present databook consist of datasheets and graphs. Experimental conditions and typical values of measured parameters are tabulated in the datasheet. In the graph, power and temperature profiles are plotted. Those data are useful for the investigation of criticality accidents with fissile solutions, and for validation of criticality accident analysis codes. (author)

Initial results from the Wisconsin Spherically Convergent Ion Focus experiment

International Nuclear Information System (INIS)

Thorson, T.A.; Durst, R.D.; Fonck, R.J.; Foucher, B.S.; Wainwright, L.P.

1995-01-01

The Spherically Convergent Ion Focus (SCIF) is an alternative plasma confinement scheme in which ions are electrostatically confined, accelerated, and concentrated at fusion-relevant energies. This concept has been recently promoted for various near-term applications including waste disposal, particle production, neutron radiography and tomography, plastic explosive detection, materials research, and medical isotope production. The Wisconsin SCIF experiments are designed to evaluate the practicality of the SCIF concept for given applications. In the experiment, a wire globe serves as a simple means of producing the trapping potential well and the ion source consists of a cold, uniform plasma at the edge. Hydrogen ions formed from the background neutral gas are typically accelerated to energies of 5--20 kV, and measured cathode grid currents approach the space-charge limit for concentric spheres. Core size measurements utilize spectrally-filtered CCD camera images of the visible emission from the core region, and the minimal observed core radius of 0.6 cm (HWHM) is within a factor of 2--3 of the theoretical convergence ratio for the device. Neutral particle interactions and potential asymmetries imposed by the grid lead to non-ideal convergence, as evidenced by measured potential asymmetries and core size dependence on cathode grid spacing. Floating probes with 30 kV isolation have allowed unique measurements of the density, electric potential and temperature in the converged core. The ratio of core to edge density is 10--20, which is in good agreement with scaling from radial flux conservation

Initial magnetic field decay of the superconducting magnet in persistent current mode

International Nuclear Information System (INIS)

Yamamoto, S.; Yanada, T.

1988-01-01

The initial magnetic field decay in the persistent current mode of a magnetic resonance imaging magnet has been studied experimentally. The field decay is greater than the steady field decay due to joint resistances of conductors. Imaging experiments cannot be carried out during the periods, which last ten or more hours. The current distribution in the multifilamentory conductor is non-uniform just after the energization. It is suggested that the change of the current distribution causes the initial magnetic field decay. A 6th order superconducting magnet was prepared for experiments (central field = 0.35 T, inner diameters = 1 m, length = 1.86 m). The steady state magnetic field decay was 7*10/sup -8//hr. The initial magnetic field decay was 3*10/sup -6//hr. Overshoot currents (101 and 105 percent of the rated current) were applied to the magnet and the current reduced to the rated current to improve the initial decay. The energizing and de-energizing rate of the field was 1.8 gauss/second. No initial decay was observed when 105 percent current pattern was applied to the magnet

Laser driven hydrodynamic instability experiments

International Nuclear Information System (INIS)

Remington, B.A.; Weber, S.V.; Haan, S.W.; Kilkenny, J.D.; Glendinning, S.G.; Wallace, R.J.; Goldstein, W.H.; Wilson, B.G.; Nash, J.K.

1993-01-01

An extensive series of experiments has been conducted on the Nova laser to measure hydrodynamic instabilities in planar foils accelerated by x-ray ablation. Single mode experiments allow a measurement of the fundamental growth rates from the linear well into the nonlinear regime. Two-mode foils allow a first direct observation of mode coupling. Surface-finish experiments allow a measurement of the evolution of a broad spectrum of random initial modes

[Sexual initiation, masculinity and health: narratives of young men].

Science.gov (United States)

Rebello, Lúcia Emilia Figueiredo de Sousa; Gomes, Romeu

2009-01-01

The main objective of this study was to analyze the narratives of young university students about the experience of sexual initiation. The theoretical and conceptual references used were the sexual scripts of our society that inform people about when, how, where and with whom they should have their sexual experiences, indicating how to act sexually and the reasons why they have to practice some kind of sexual activity. The method used was a qualitative study of narratives from the perspective of dialectic hermeneutics. The methodological design involves the comprehension of sceneries, contexts, environments and characters of the narratives about sexual initiation. The analysis refers to narratives of university students in the city of Rio de Janeiro. Among the meanings of sexual initiation, we emphasize sexual intercourse, the demarcation of a stage of life, the awakening to the opposite sex and the discovery of the body. We observed that the young men's narratives were coherent with what is considered masculine, present in the discourse of different generations. It is concluded that the young men should be encouraged to participate in actions combining health and education aimed at promotion of sexual and reproductive health.

Teachers’ perceptions of their own initiative: Collective initiative vs. personal initiative

Directory of Open Access Journals (Sweden)

Džinović Vladimir

2013-01-01

Full Text Available Current trends in education demand from teachers to exhibit proactive behaviour and assume responsibility for the implementation of changes in school practice. In that sense, it is important to study how teachers perceive their own initiative and to gain insight into the activities where such initiative is demonstrated. This study has been conceived as a mixed-methods research. The qualitative study implied forming four focus groups with subject teachers and class teachers (N=38, while the quantitative study entailed surveying 1441 teachers in forty primary schools in Serbia using the questionnaire constructed based on qualitative data. Data from focus groups were processed by qualitative thematic analysis, while the questionnaire data were processed by principal component analysis and univariate analysis of variance. The findings of the study have shown that teachers mostly demonstrate initiative through co­operative activities that include planning of joint teaching as well as conducting joint projects within school and with the local community actors. Teachers are least ready to demonstrate personal initiative and the initiative aimed at accomplishing considerable changes in school work. The concluding part includes the recommendations for encouraging teachers’ personal initiative and building organizational culture that would support such initiative. [Projekat Ministarstva nauke Republike Srbije, br. br. 47008: Unapređivanje kvaliteta i dostupnosti obrazovanja u procesima modernizacije Srbije i br. 179034: Od podsticanja inicijative, saradnje i stvaralaštva u obrazovanju do novih uloga i identiteta u društvu

Early initial clinical experience with intravitreal aflibercept for wet age-related macular degeneration.

Science.gov (United States)

Ferrone, Philip J; Anwar, Farihah; Naysan, Jonathan; Chaudhary, Khurram; Fastenberg, David; Graham, Kenneth; Deramo, Vincent

2014-06-01

Age-related macular degeneration (AMD) is a degenerative process that leads to severe vision loss. Wet AMD is defined by choroidal neovascularisation, leading to the accumulation of subretinal fluid (SRF), macular oedema (ME), and pigment epithelium detachments (PED). Purpose To evaluate the initial clinical experience of conversion from bevacizumab or ranibizumab to aflibercept in wet AMD patients. Records of 250 consecutive wet AMD patients were retrospectively reviewed. Of 250 patients, 29 were naive (with no previous treatment), and 221 were previously treated with bevacizumab (1/3) or ranibizumab (2/3). On average, converted patients received 14 injections every 6 weeks on a treat-and-extend regimen with Avastin or Lucentis before being converted to aflibercept every 7 weeks on average (no loading dose) for three doses. For the purposes of this study, we concentrated on the patients converted to aflibercept since the number of naive patients was too small to draw any conclusion from. Snellen (as logMar) visual acuities, and optical coherence tomography (OCT) were compared predrug and postdrug conversion. Converted patients did not show a significant difference in visual acuity or average OCT thickness from preconversion values; however, small improvements in ME (p=0.0001), SRF (p=0.0001), and PED (p=0.008) grading were noted on average after conversion to aflibercept. No significant difference in visual outcome or average OCT thickness was observed when switched from bevacizumab or ranibizumab q6 week to aflibercept 7-week dosing, on average. Mild anatomic improvements did occur in converted patients with regard to ME, SRF and PED improvement, on average, after conversion to aflibercept, and aflibercept was injected less frequently. No serious adverse reactions, including ocular infections or inflammation, as well as ocular and systemic effects were noted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

Experienced physicians benefit from analyzing initial diagnostic hypotheses

Directory of Open Access Journals (Sweden)

Adam Bass

2013-03-01

Full Text Available Background: Most incorrect diagnoses involve at least one cognitive error, of which premature closure is the most prevalent. While metacognitive strategies can mitigate premature closure in inexperienced learners, these are rarely studied in experienced physicians. Our objective here was to evaluate the effect of analytic information processing on diagnostic performance of nephrologists and nephrology residents. Methods: We asked nine nephrologists and six nephrology residents at the University of Calgary and Glasgow University to diagnose ten nephrology cases. We provided presenting features along with contextual information, after which we asked for an initial diagnosis. We then primed participants to use either hypothetico-deductive reasoning or scheme-inductive reasoning to analyze the remaining case data and generate a final diagnosis. Results: After analyzing initial hypotheses, both nephrologists and residents improved the accuracy of final diagnoses (31.1% vs. 65.6%, p < 0.001, and 40.0% vs. 70.0%, p < 0.001, respectively. We found a significant interaction between experience and analytic processing strategy (p = 0.002: nephrology residents had significantly increased odds of diagnostic success when using scheme-inductive reasoning (odds ratio [95% confidence interval] 5.69 [1.59, 20.33], p = 0.007, whereas the performance of experienced nephrologists did not differ between strategies (odds ratio 0.57 [0.23, 1.39], p = 0.2. Discussion: Experienced nephrologists and nephrology residents can improve their performance by analyzing initial diagnostic hypotheses. The explanation of the interaction between experience and the effect of different reasoning strategies is unclear, but may relate to preferences in reasoning strategy, or the changes in knowledge structure with experience.

Patients' perception of physician-initiated prayer prior to elective ophthalmologic surgery.

Science.gov (United States)

Siatkowski, R Michael; Cannon, Sterling L; Farris, Bradley K

2008-02-01

Prayer is an important part of many patients' and physicians' lives. There is little data in the literature regarding patients' perception of prayer from or with their doctors. To assess in a masked fashion patients' impression of prayer's role in a medical setting, and their perception of being offered and receiving prayer from their physician. Confidential survey of 567 consecutive patients who were offered prayer by their physician before elective eye surgery. Proportion of patients favoring physician-initiated prayer and weighted Likert responses to various positive and negative sentiments regarding their experience. Survey response rate was 53% (300 patients). Ninety-six percent of patients identified themselves as Christian. At least 90% of Christian patients responded favorably toward their prayer experience to each Likert question. Among the non-Christian patients, the proportion of negative impressions to the prayer experience ranged from 0 to 25%. Physician-initiated Christian-based prayer before surgery is well-received by a strong majority of Christian patients. Although the data are few, only a minority of non-Christians felt negatively regarding this experience.

Armor breakup and reformation in a degradational laboratory experiment

OpenAIRE

Orrú, Clara; Blom, Astrid; Uijttewaal, Wim S. J.

2016-01-01

Armor breakup and reformation was studied in a laboratory experiment using a trimodal mixture composed of a 1mm sand fraction and two gravel fractions (6 and 10mm). The initial bed was characterized by a stepwise downstream fining pattern (trimodal reach) and a downstream sand reach, and the experiment was conducted under conditions without sediment supply. In the initial stage of the experiment an armor formed over the trimodal reach. The formation of the armor under partial transport condit...

Clinical and technical considerations for head and neck cancers treated by IMRT: initial experience

International Nuclear Information System (INIS)

Chao, K.S. Clifford; Low, Daniel A.; Gerber, Russell L.; Perez, Carlos A.; Purdy, James A.

1997-01-01

Purpose/Objective Intensity modulated radiation therapy (IMRT) has the potential to deliver dose distributions that decrease normal tissue toxicity while allowing dose escalation to the tumor to improve local control. Methods have been developed to critically assess patient immobilization, treatment planning, dose prescription, and treatment verification in patients with head and neck cancer treated using a commercial IMRT system (Peacock, NOMOS Corp.). This report presents our initial experience with inverse planning optimization and patient setup and immobilization evaluations. Materials and Methods Patients are non-invasively immobilized using a reinforced thermoplastic mask and a custom head support. The treatment planning computed tomography scan is acquired using a dedicated scanner. Targets and normal structures are defined on the treatment planning system. Dose optimization requires the input for each structure of dose limits, spatial margin, and optimization algorithm weight (range from zero to two). The optimization algorithm allows each spatial location to be occupied by only one structure. Applying a spatial margin often causes target and normal structures to overlap, so a structure-by-structure decision is made to determine if the target or the structure occupies overlapping space (target priority). The effect on the dose distribution of modifying the optimization parameters was evaluated for the parotid gland (see Figure 1 for plan identification). Verification of treatment setup and immobilization was conducted by acquiring two portal images each treatment session, one prior to and one after treatment, and comparing the locations of visible bony landmarks on the portal film against positions on a digitally reconstructed radiograph. Both inter- and intra-treatment motion in the cranio-caudal (CC) and anterior-posterior (AP) directions were studied. Results Figure 2 summarizes the compromise made between target coverage and tissue sparing. The plan

Initiating Event Rates at U.S. Nuclear Power Plants. 1988 - 2013

International Nuclear Information System (INIS)

Schroeder, John A.; Bower, Gordon R.

2014-01-01

Analyzing initiating event rates is important because it indicates performance among plants and also provides inputs to several U.S. Nuclear Regulatory Commission (NRC) risk-informed regulatory activities. This report presents an analysis of initiating event frequencies at U.S. commercial nuclear power plants since each plant's low-power license date. The evaluation is based on the operating experience from fiscal year 1988 through 2013 as reported in licensee event reports. Engineers with nuclear power plant experience staff reviewed each event report since the last update to this report for the presence of valid scrams or reactor trips at power. To be included in the study, an event had to meet all of the following criteria: includes an unplanned reactor trip (not a scheduled reactor trip on the daily operations schedule), sequence of events starts when reactor is critical and at or above the point of adding heat, occurs at a U.S. commercial nuclear power plant (excluding Fort St. Vrain and LaCrosse), and is reported by a licensee event report. This report displays occurrence rates (baseline frequencies) for the categories of initiating events that contribute to the NRC's Industry Trends Program. Sixteen initiating event groupings are trended and displayed. Initiators are plotted separately for initiating events with different occurrence rates for boiling water reactors and pressurized water reactors. p-values are given for the possible presence of a trend over the most recent 10 years.

Initial state with shear in peripheral heavy ion collisions

Science.gov (United States)

Magas, V. K.; Gordillo, J.; Strottman, D.; Xie, Y. L.; Csernai, L. P.

2018-06-01

In the present work we propose a new way of constructing the initial state for further hydrodynamic simulation of relativistic heavy ion collisions based on Bjorken-like solution applied streak by streak in the transverse plane. Previous fluid dynamical calculations in Cartesian coordinates with an initial state based on a streak by streak Yang-Mills field led for peripheral higher energy collisions to large angular momentum, initial shear flow and significant local vorticity. Recent experiments verified the existence of this vorticity via the resulting polarization of emitted Λ and Λ ¯ particles. At the same time parton cascade models indicated the existence of more compact initial state configurations, which we are going to simulate in our approach. The proposed model satisfies all the conservation laws, including conservation of a strong initial angular momentum, which is present in noncentral collisions. As a consequence of this large initial angular momentum we observe the rotation of the whole system as well as the fluid shear in the initial state, which leads to large flow vorticity. Another advantage of the proposed model is that the initial state can be given in both [t,x,y,z] and [τ ,x ,y ,η ] coordinates and thus can be tested by all 3+1D hydrodynamical codes which exist in the field.

SU-E-J-181: Magnetic Resonance Image-Guided Radiation Therapy Workflow: Initial Clinical Experience

International Nuclear Information System (INIS)

Green, O; Kashani, R; Santanam, L; Wooten, H; Li, H; Rodriguez, V; Hu, Y; Mutic, S; Hand, T; Victoria, J; Steele, C

2014-01-01

Purpose: The aims of this work are to describe the workflow and initial clinical experience treating patients with an MRI-guided radiotherapy (MRIGRT) system. Methods: Patient treatments with a novel MR-IGRT system started at our institution in mid-January. The system consists of an on-board 0.35-T MRI, with IMRT-capable delivery via doubly-focused MLCs on three 60 Co heads. In addition to volumetric MR-imaging, real-time planar imaging is performed during treatment. So far, eleven patients started treatment (six finished), ranging from bladder to lung SBRT. While the system is capable of online adaptive radiotherapy and gating, a conventional workflow was used to start, consisting of volumetric imaging for patient setup using visible tumor, evaluation of tumor motion outside of PTV on cine images, and real-time imaging. Workflow times were collected and evaluated to increase efficiency and evaluate feasibility of adding the adaptive and gating features while maintaining a reasonable patient throughput. Results: For the first month, physicians attended every fraction to provide guidance on identifying the tumor and an acceptable level of positioning and anatomical deviation. Average total treatment times (including setup) were reduced from 55 to 45 min after physician presence was no longer required and the therapists had learned to align patients based on soft-tissue imaging. Presently, the source strengths were at half maximum (7.7K Ci each), therefore beam-on times will be reduced after source replacement. Current patient load is 10 per day, with increase to 25 anticipated in the near future. Conclusion: On-board, real-time MRI-guided RT has been incorporated into clinical use. Treatment times were kept to reasonable lengths while including volumetric imaging, previews of tumor movement, and physician evaluation. Workflow and timing is being continuously evaluated to increase efficiency. In near future, adaptive and gating capabilities of the system will be

Application of robotics in general surgery: initial experience.

Science.gov (United States)

Nguyen, Ninh T; Hinojosa, Marcelo W; Finley, David; Stevens, Melinda; Paya, Mahbod

2004-10-01

Robotic surgery was recently approved for clinical use in general abdominal surgery. The aim of this study was to review our experience with the da Vinci surgical system during laparoscopic general surgical procedures. Eighteen patients underwent robotically assisted laparoscopic abdominal surgery between June 2002 and March 2003. Main outcome measures were operative time, room setup time, robotic arm-positioning and surgical time, blood loss, conversion to laparoscopy, length of stay, and morbidity. The types of robotically assisted laparoscopic procedures were excision of gastric leiomyoma (n = 1), Heller myotomy (n = 1), cholecystectomy (n = 2), gastric banding (n = 2), Nissen fundoplication (n = 4), and gastric bypass (n = 8). The mean room setup time was 63 +/- 14 minutes, and the mean robotic arm-positioning time was 16 +/- 7 minutes. Conversion to laparoscopy occurred in two (11%) of 18 cases because of equipment difficulty (n = 1) and technical difficulty (n = 1). Estimated blood loss was 91 +/- 71 mL. The mean operative time was 156 +/- 42 minutes, and the robotic operative time was 27% of the total operative time. The mean length of hospital stay was 2.2 +/- 1.5 days. There was one postoperative wound infection and one anastomotic stricture. Robotically assisted laparoscopic abdominal surgery is feasible and safe; however, the theoretical advantages of the da Vinci surgical system were not clinically apparent.

Initial experience with a nuclear medicine viewing workstation

Science.gov (United States)

Witt, Robert M.; Burt, Robert W.

1992-07-01

Graphical User Interfaced (GUI) workstations are now available from commercial vendors. We recently installed a GUI workstation in our nuclear medicine reading room for exclusive use of staff and resident physicians. The system is built upon a Macintosh platform and has been available as a DELTAmanager from MedImage and more recently as an ICON V from Siemens Medical Systems. The workstation provides only display functions and connects to our existing nuclear medicine imaging system via ethernet. The system has some processing capabilities to create oblique, sagittal and coronal views from transverse tomographic views. Hard copy output is via a screen save device and a thermal color printer. The DELTAmanager replaced a MicroDELTA workstation which had both process and view functions. The mouse activated GUI has made remarkable changes to physicians'' use of the nuclear medicine viewing system. Training time to view and review studies has been reduced from hours to about 30-minutes. Generation of oblique views and display of brain and heart tomographic studies has been reduced from about 30-minutes of technician''s time to about 5-minutes of physician''s time. Overall operator functionality has been increased so that resident physicians with little prior computer experience can access all images on the image server and display pertinent patient images when consulting with other staff.

Space Experiment Module (SEM)

Science.gov (United States)

Brodell, Charles L.

1999-01-01

The Space Experiment Module (SEM) Program is an education initiative sponsored by the National Aeronautics and Space Administration (NASA) Shuttle Small Payloads Project. The program provides nationwide educational access to space for Kindergarten through University level students. The SEM program focuses on the science of zero-gravity and microgravity. Within the program, NASA provides small containers or "modules" for students to fly experiments on the Space Shuttle. The experiments are created, designed, built, and implemented by students with teacher and/or mentor guidance. Student experiment modules are flown in a "carrier" which resides in the cargo bay of the Space Shuttle. The carrier supplies power to, and the means to control and collect data from each experiment.

Exploring Career Agency during Self-Initiated Repatriation: A Study of Chinese Sea Turtles

Science.gov (United States)

Guo, Chun; Porschitz, Emily T.; Alves, Jose

2013-01-01

Purpose: Drawing on career and self-initiated expatriation/repatriation literatures, this paper aims to examine the career experiences of Chinese self-initiated repatriates after their return to China. Design/methodology/approach: The authors conducted an exploratory, qualitative study involving in-depth interviews with 20 Chinese individuals who…

HL-1 tokamak data acquisition system and its initial application in the physical experiment

International Nuclear Information System (INIS)

Deng Huichen; Fu Bo; Dong Jiafu

1989-11-01

A HL-1 tokamak data acquisition system has been developed and has been used in the physical experiment. The hardware and software configuration of the system, as well as the typical acquired data in the HL-1 experiment are introduced

Poetic Experience

Directory of Open Access Journals (Sweden)

Shahab Yar Khan

2014-01-01

Full Text Available Nature of poetic experience is hereby redefined. The present article initially deals with the perennial nature of true poetic experience and its essential relevance to the world. It attempts to elaborate the process through which a poet is uplifted in a creative moment beyond terrestrial boundaries and is aligned with the ‘state of Perfection'. The role of successive generations of audiences in rediscovering the meaning of a poetic image is defined as life principle of all great poetry. Shakespeare is discussed as the ultimate example of this principle since his popularity remains an irreversible phenomenon

Initial results from a charge exchange q-diagnostic on TEXT-U

International Nuclear Information System (INIS)

Valanju, P.M.; Duraiappah, L.; Bengtson, R.D.; Karzhavin, Y.; Nikitin, A.

1994-01-01

The authors present initial results from a new q-diagnostic for TEXT-Upgrade. This method is based on using a toroidal array of detectors to determine the plane in which beam-injected neutrals are emitted after two charge-exchange collisions. The potential advantages are low cost, full plasma accessibility, and good time resolution. Their initial series of experiments on TEXT-U established the feasibility of this technique

Report to DOE on the evaluation of initial trapping studies

International Nuclear Information System (INIS)

Breun, R.A.; Kesner, J.; Nonn, P.; Pian, T.; Post, R.S.; Scharer, J.; Smatlak, D.; Smith, D.; Yugo, J.; Yujiri, L.

1978-12-01

This report summarizes work up to Dec. 1, 1978 on the single mirror plug of Phaedrus. The design, construction and initial experiments proceeded without major problems. The results on RF trapping and heating steadily improved during the months of October and November with our best results being obtained during the last two weeks of November. These positive results are encouraging for RF heating in mirrors. The experiments to date have concentrated on heating stream gun plasmas. This plasma source has been well suited for our initial studies as it produces a hot, dense plasma over a long duration (approx. 1 msec). This has made diagnostics particularly straight forward. Because of the time scale we have carried out most of our work with the 200 kW source which is capable of running for long pulses

Numerical and Experimental Validation of a New Damage Initiation Criterion

Science.gov (United States)

Sadhinoch, M.; Atzema, E. H.; Perdahcioglu, E. S.; van den Boogaard, A. H.

2017-09-01

Most commercial finite element software packages, like Abaqus, have a built-in coupled damage model where a damage evolution needs to be defined in terms of a single fracture energy value for all stress states. The Johnson-Cook criterion has been modified to be Lode parameter dependent and this Modified Johnson-Cook (MJC) criterion is used as a Damage Initiation Surface (DIS) in combination with the built-in Abaqus ductile damage model. An exponential damage evolution law has been used with a single fracture energy value. Ultimately, the simulated force-displacement curves are compared with experiments to validate the MJC criterion. 7 out of 9 fracture experiments were predicted accurately. The limitations and accuracy of the failure predictions of the newly developed damage initiation criterion will be discussed shortly.

Hawaii Utility Integration Initiatives to Enable Wind (Wind HUI) Final Technical Report

Energy Technology Data Exchange (ETDEWEB)

Dora Nakafuji; Lisa Dangelmaier; Chris Reynolds

2012-07-15

To advance the state and nation toward clean energy, Hawaii is pursuing an aggressive Renewable Portfolio Standard (RPS), 40% renewable generation and 30% energy efficiency and transportation initiatives by 2030. Additionally, with support from federal, state and industry leadership, the Hawaii Clean Energy Initiative (HCEI) is focused on reducing Hawaii's carbon footprint and global warming impacts. To keep pace with the policy momentum and changing industry technologies, the Hawaiian Electric Companies are proactively pursuing a number of potential system upgrade initiatives to better manage variable resources like wind, solar and demand-side and distributed generation alternatives (i.e. DSM, DG). As variable technologies will continue to play a significant role in powering the future grid, practical strategies for utility integration are needed. Hawaiian utilities are already contending with some of the highest penetrations of renewables in the nation in both large-scale and distributed technologies. With island grids supporting a diverse renewable generation portfolio at penetration levels surpassing 40%, the Hawaiian utilities experiences can offer unique perspective on practical integration strategies. Efforts pursued in this industry and federal collaborative project tackled challenging issues facing the electric power industry around the world. Based on interactions with a number of western utilities and building on decades of national and international renewable integration experiences, three priority initiatives were targeted by Hawaiian utilities to accelerate integration and management of variable renewables for the islands. The three initiatives included: Initiative 1: Enabling reliable, real-time wind forecasting for operations by improving short-term wind forecasting and ramp event modeling capabilities with local site, field monitoring; Initiative 2: Improving operators situational awareness to variable resources via real-time grid condition

The Saudi Initiative for asthma

Directory of Open Access Journals (Sweden)

Al-Moamary Mohamed

2009-01-01

Full Text Available The Saudi Initiative for Asthma (SINA provides up-to-date guidelines for healthcare workers managing patients with asthma. SINA was developed by a panel of Saudi experts with respectable academic backgrounds and long-standing experience in the field. SINA is founded on the latest available evidence, local literature, and knowledge of the current setting in Saudi Arabia. Emphasis is placed on understanding the epidemiology, pathophysiology, medications, and clinical presentation. SINA elaborates on the development of patient-doctor partnership, self-management, and control of precipitating factors. Approaches to asthma treatment in SINA are based on disease control by the utilization of Asthma Control Test for the initiation and adjustment of asthma treatment. This guideline is established for the treatment of asthma in both children and adults, with special attention to children 5 years and younger. It is expected that the implementation of these guidelines for treating asthma will lead to better asthma control and decrease patient utilization of the health care system.

North by Northwestern: initial experience with PACS at Northwestern Memorial Hospital

Science.gov (United States)

Channin, David S.; Hawkins, Rodney C.; Enzmann, Dieter R.

2000-05-01

This paper describes the initial phases and configuration of the Picture Archive and Communication System (PACS) deployed at Northwestern Memorial Hospital. The primary goals of the project were to improve service to patients, improve service to referring physicians, and improve the process of radiology. Secondary goals were to enhance the academic mission, and modernize institutional information systems. The system consists of a large number of heterogeneous imaging modalities sending imaging studies via DICOM to a GE medical Systems PathSpeed PACS. The radiology department workflow is briefly described. The system is currently storing approximately 140,000 studies and over 5 million images, growing by approximately 600 studies and 25,000 images per day. Data reflecting use of the short term and long term storage is provided.

Experienced physicians benefit from analyzing initial diagnostic hypotheses

Science.gov (United States)

Bass, Adam; Geddes, Colin; Wright, Bruce; Coderre, Sylvain; Rikers, Remy; McLaughlin, Kevin

2013-01-01

Background Most incorrect diagnoses involve at least one cognitive error, of which premature closure is the most prevalent. While metacognitive strategies can mitigate premature closure in inexperienced learners, these are rarely studied in experienced physicians. Our objective here was to evaluate the effect of analytic information processing on diagnostic performance of nephrologists and nephrology residents. Methods We asked nine nephrologists and six nephrology residents at the University of Calgary and Glasgow University to diagnose ten nephrology cases. We provided presenting features along with contextual information, after which we asked for an initial diagnosis. We then primed participants to use either hypothetico-deductive reasoning or scheme-inductive reasoning to analyze the remaining case data and generate a final diagnosis. Results After analyzing initial hypotheses, both nephrologists and residents improved the accuracy of final diagnoses (31.1% vs. 65.6%, p inductive reasoning (odds ratio [95% confidence interval] 5.69 [1.59, 20.33], p = 0.07), whereas the performance of experienced nephrologists did not differ between strategies (odds ratio 0.57 [0.23, 1.39], p = 0.20). Discussion Experienced nephrologists and nephrology residents can improve their performance by analyzing initial diagnostic hypotheses. The explanation of the interaction between experience and the effect of different reasoning strategies is unclear, but may relate to preferences in reasoning strategy, or the changes in knowledge structure with experience. PMID:26451203

Further experience in simulation of rod drop experiments in the Loviisa and Mochovce reactors

International Nuclear Information System (INIS)

Siltanen, P.; Kaloinen, E.; Tanskanen, A.; Mattila, R.

2001-01-01

Simulations of reactor scram experiments using the 3-dimensional kinetics code HEXTRAN have been updated for the initial cores of Loviisa-1 and 2 Mochovce-1 and have been extended to burned cores of Loviisa-1. In these simulations, the entire experiment is simulated dynamically, including the behaviour of the core, the signal of the ionization chamber, and the inverse point kinetics of the reactivity meter. The predicted output of the reactivity meter is compared with the output observed during the experiment (Authors)

Initialization and Predictability of a Coupled ENSO Forecast Model

Science.gov (United States)

Chen, Dake; Zebiak, Stephen E.; Cane, Mark A.; Busalacchi, Antonio J.

1997-01-01

The skill of a coupled ocean-atmosphere model in predicting ENSO has recently been improved using a new initialization procedure in which initial conditions are obtained from the coupled model, nudged toward observations of wind stress. The previous procedure involved direct insertion of wind stress observations, ignoring model feedback from ocean to atmosphere. The success of the new scheme is attributed to its explicit consideration of ocean-atmosphere coupling and the associated reduction of "initialization shock" and random noise. The so-called spring predictability barrier is eliminated, suggesting that such a barrier is not intrinsic to the real climate system. Initial attempts to generalize the nudging procedure to include SST were not successful; possible explanations are offered. In all experiments forecast skill is found to be much higher for the 1980s than for the 1970s and 1990s, suggesting decadal variations in predictability.

Alpha Antihydrogen Experiment

CERN Document Server

Fujiwara, M C; Ashkezari, M D; Baquero-Ruiz, M; Bertsche, W; Bray, C C; Butler, E; Cesar, C L; Chapman, S; Charlton, M; Cesar, C L; Fajans, J; Friesen, T; Gill, D R; Hangst, J S; Hardy, W N; Hayano, R S; Hayden, M E; Humphries, A J; Hydomako, R; Jonsell, S; Kurchaninov, L; Lambo, R; Madsen, N; Menary, S; Nolan, P; Olchanski, K; Olin, A; Povilus, A; Pusa, P; Robicheaux, F; Sarid, E; Silveira, D M; So, C; Storey, J W; Thompson, R I; van der Werf, D P; Wilding, D; Wurtele, J S; Yamazaki, Y

2011-01-01

ALPHA is an experiment at CERN, whose ultimate goal is to perform a precise test of CPT symmetry with trapped antihydrogen atoms. After reviewing the motivations, we discuss our recent progress toward the initial goal of stable trapping of antihydrogen, with some emphasis on particle detection techniques.

Complications in paediatric craniofacial surgery: an initial four year experience.

Science.gov (United States)

Jones, B M; Jani, P; Bingham, R M; Mackersie, A M; Hayward, R

1992-04-01

107 children undergoing transcranial craniofacial surgery in a paediatric hospital have been reviewed to assess the incidence and type of complications which arose. This represents the first 4 years' experience of the craniofacial team. There were no deaths or permanent adverse sequelae of surgery. A total of 53 complications were seen in 42 patients. In 9.3% of patients they were potentially life-threatening, serious in 12.1% and of a minor nature in 28%. The more serious complications were related either to haemorrhage and/or vasovagal shock at operation or to infection post-operatively. Infants undergoing monoblock frontofacial advancements and those with tracheostomies were at particular risk.

Understanding the experience of initiating community-based physical activity and social support by people with serious mental illness: a systematic review using a meta-ethnographic approach

Directory of Open Access Journals (Sweden)

Helen Quirk

2017-10-01

Full Text Available Abstract Background People with long-term serious mental illness live with severe and debilitating symptoms that can negatively influence their health and quality of life, leading to outcomes such as premature mortality, morbidity and obesity. An interplay of social, behavioural, biological and psychological factors is likely to contribute to their poor physical health. Participating in regular physical activity could bring symptomatic improvements, weight loss benefits, enhanced wellbeing and when undertaken in a community-based group setting can yield additional, important social support benefits. Yet poor uptake of physical activity by people with serious mental illness is a problem. This review will systematically search, appraise and synthesise the existing evidence that has explored the experience of community-based physical activity initiation and key features of social support within these contexts by adults with schizophrenia, bipolar affective disorder, major depressive disorder or psychosis using the meta-ethnography approach. This new understanding may be key in designing more acceptable and effective community-based group PA programmes that meet patients’ need and expectations. Methods This will be a systematic review of qualitative studies using the meta-ethnography approach. The following databases will be searched: ASSIA, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, Health Technology Assessment Database, MEDLINE, PsycINFO, Sociological Abstracts, SPORTDiscus and Web of Science. Grey literature will also be sought. Eligible studies will use qualitative methodology; involve adults (≥18 years with schizophrenia, bipolar affective disorder, major depressive disorder or psychosis; will report community-based group physical activity; and capture the experience of physical activity initiation and key features of social support from the perspective of the participant. Study selection and assessment of quality will

Understanding the experience of initiating community-based physical activity and social support by people with serious mental illness: a systematic review using a meta-ethnographic approach.

Science.gov (United States)

Quirk, Helen; Crank, Helen; Harrop, Deborah; Hock, Emma; Copeland, Robert

2017-10-25

People with long-term serious mental illness live with severe and debilitating symptoms that can negatively influence their health and quality of life, leading to outcomes such as premature mortality, morbidity and obesity. An interplay of social, behavioural, biological and psychological factors is likely to contribute to their poor physical health. Participating in regular physical activity could bring symptomatic improvements, weight loss benefits, enhanced wellbeing and when undertaken in a community-based group setting can yield additional, important social support benefits. Yet poor uptake of physical activity by people with serious mental illness is a problem. This review will systematically search, appraise and synthesise the existing evidence that has explored the experience of community-based physical activity initiation and key features of social support within these contexts by adults with schizophrenia, bipolar affective disorder, major depressive disorder or psychosis using the meta-ethnography approach. This new understanding may be key in designing more acceptable and effective community-based group PA programmes that meet patients' need and expectations. This will be a systematic review of qualitative studies using the meta-ethnography approach. The following databases will be searched: ASSIA, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, Health Technology Assessment Database, MEDLINE, PsycINFO, Sociological Abstracts, SPORTDiscus and Web of Science. Grey literature will also be sought. Eligible studies will use qualitative methodology; involve adults (≥18 years) with schizophrenia, bipolar affective disorder, major depressive disorder or psychosis; will report community-based group physical activity; and capture the experience of physical activity initiation and key features of social support from the perspective of the participant. Study selection and assessment of quality will be performed by two reviewers. Data will be

Anticipated transient without SCRAM experiments at LOFT

International Nuclear Information System (INIS)

Grush, W.H.; Harvego, E.A.; Koizumi, Y.; Varacalle, D.J.

1983-01-01

This paper discusses the experimental results for two anticipated transients without scram (ATWS) experiments, and compares computer code predictions with the experimental data. Experiment L9-3 simulated an ATWS in a commercial pressurized water reactor (PWR) initiated by a complete loss of feedwater and Experiment L9-4 simulated a loss-of-offsite-power-initiated (loss of feedwater and trip of the primary coolant pumps) ATWS. The LOFT facility is uniquely suited for ATWS experiments because it is a volumetrically scaled (1/44) experimental PWR designed to simulate the major components and system responses of larger commercial PWRs during both hypothesized loss-of-coolant accidents and anticipated transients. In both of the examined experiments, the primary system transient behavior was dominated by the interactions between the steam generator primary-to-secondary heat removal, the reactor kinetics, and the relief valve actuation. It is demonstrated that the discussed ATWS events can be controlled by properly sized automatic safety systems

Vascular rings and slings: A challenging diagnostic and therapeutic rare disease entity

Directory of Open Access Journals (Sweden)

Yasser Mohamed Menaissy

2017-12-01

Conclusions: In our series, Echocardiography and MSCT were essential for proper diagnosis and planing for surgery. Left thoracotomy or median sternotomy provided good exposure in the operated cases. Surgery was done with low mortality and morbidity.

Initial results of a high-power microwave sintering experiment at ORNL

International Nuclear Information System (INIS)

Kimrey, H.D.; White, T.L.; Bigelow, T.S.; Becher, P.F.

1986-01-01

Experiments have recently begun at Oak Ridge National Laboratory to develop microwave sintering techniques suitable for large ceramic parts. Microwave sintering offers the advantages of faster heating rates, more uniform heating, and greater energy efficiency than conventional sintering techniques. We are using 28-GHz, 200-kW cw gyrotrons as the heating source. An untuned cavity is used as the applicator to eliminate geometry sensitivity in coupling efficiency

Large-scale thermal-shock experiments with clad and unclad steel cylinders

International Nuclear Information System (INIS)

Cheverton, R.D.

1992-01-01

Flaw behavior trends associated with pressurized-thermal-shock (PTS) loading of pressurized-water-reactor pressure vessels have been under investigation at the Oak Ridge National Laboratory for nearly 20 years. During that time, twelve thermal-shock experiments with thick-walled (152 mm) steel cylinders were conducted as a part of the investigations. The first eight experiments were conducted with unclad cylinders initially containing shallow (8--19 mm) two-dimensional and semicircular inner-surface flaws. These experiments demonstrated, in good agreement with linear elastic fracture mechanics, crack initiation and arrest, a series of initiation/arrest events with deep penetration of the wall, long crack jumps, arrest with the stress intensity factor (K I ) increasing with crack depth, extensive surface extension of an initially short and shallow (semicircular) flaw, and warm prestressing with K I ≤ 0. The remaining four experiments were conducted with clad cylinders containing initially shallow (19--24 mm) semielliptical subclad and surface flaws at the inner surface. In the first of these experiments one of six equally spaced (60 degrees) open-quotes identicalclose quotes subclad flaws extended nearly the length of the cylinder (1,220 mm) beneath the cladding (no crack extension into the cladding) and nearly 50% of the wall, radially. For the final experiment, four of the semielliptical subclad flaws that had not propagated previously were converted to surface flaws, and they experienced extensive extension beneath the cladding with no cracking of the cladding. Information from this series of thermal-shock experiments is being used in the evaluation of the PTS issue

Development and initial porcine and cadaver experience with three-dimensional printing of endoscopic and laparoscopic equipment.

Science.gov (United States)

del Junco, Michael; Okhunov, Zhamshid; Yoon, Renai; Khanipour, Ramtin; Juncal, Samuel; Abedi, Garen; Lusch, Achim; Landman, Jaime

2015-01-01

Recent advances in three-dimensional (3D) printing technology have made it possible to print surgical devices. We report our initial experience with the printing and deployment of endoscopic and laparoscopic equipment. We created computer-aided designs for ureteral stents and laparoscopic trocars using SolidWorks. We developed three generations of stents, which were printed with an Objet500 Connex printer, and a fourth generation was printed with an EOSINT P395 printer. The trocars were printed with an Objet30 Pro printer. We deployed the printed stents and trocars in a female cadaver and in vivo porcine model. We compared the printed trocars to two standard trocars for defect area and length using a digital caliper. Paired T-tests and ANOVA were used to test for statistical difference. The first two generations of stents (7F and 9F) were functional failures as their diminutive inner lumen failed to allow the passage of a 0.035 guidewire. The third generation 12F stent allowed passage of a 0.035 guidewire. The 12F diameter limited its deployment, but it was introduced in a cadaver through a ureteral access sheath. The fourth-generation 9F stents were printed and deployed in a porcine model using the standard Seldinger technique. The printed trocars were functional for the maintenance of the pneumoperitoneum and instrument passage. The printed trocars had larger superficial defect areas (pcadaver models. Three-dimensional printing is rapidly advancing and may be clinically viable in the future.

The SPIRIT Telescope Initiative: six years on

Science.gov (United States)

Luckas, Paul

2017-06-01

Now in its sixth year of operation, the SPIRIT initiative remains unique in Australia, as a robust web-enabled robotic telescope initiative funded for education and outreach. With multiple modes of operation catering for a variety of usage scenarios and a fully supported education program, SPIRIT provides free access to contemporary astronomical tools for students and educators in Western Australia and beyond. The technical solution itself provides an excellent model for low cost robotic telescope installations, and the education program has evolved over time to include a broad range of student experiences-from engagement activities to authentic science. This paper details the robotic telescope solution, student interface and educational philosophy, summarises achievements and lessons learned and examines the possibilities for future enhancement including spectroscopy.

Acquired demographics and reasons to relocate among self-initiated expatriates

DEFF Research Database (Denmark)

Selmer, Jan; Lauring, Jakob

2011-01-01

Organizational expatriates, who have been assigned by their parent companies to the foreign location have been thoroughly investigated as compared to self-initiated expatriates, who themselves have decided to expatriate to work abroad. Consequently, much less is known about the latter type...... expatriate experience and seniority, as well as five individual reasons to expatriate: adventure/travel, career, family, financial incentives and life change/escape. The results indicated support for the research propositions, suggesting that self-initiated expatriates' (SIEs) reasons to expatriate differ...

Initial experience of percutaneous treatment of mitral regurgitation with MitraClip® therapy in Spain.

Science.gov (United States)

Carrasco-Chinchilla, Fernando; Arzamendi, Dabit; Romero, Miguel; Gimeno de Carlos, Federico; Alonso-Briales, Juan Horacio; Li, Chi-Hion; Mesa, Maria Dolores; Arnold, Roman; Serrador Frutos, Ana María; Pan, Manuel; Roig, Eulalia; Rodríguez-Bailón, Isabel; de la Fuente Galán, Luis; Hernández, José María; Serra, Antonio; Suárez de Lezo, José

2014-12-01

Symptomatic mitral regurgitation has an unfavorable prognosis unless treated by surgery. However, the European registry of valvular heart disease reports that 49% of patients with this condition do not undergo surgery. Percutaneous treatment of mitral regurgitation with MitraClip® has been proved a safe, efficient adjunct to medical treatment in patients with this profile. The objective of the present study is to describe initial experience of MitraClip® therapy in Spain. Retrospective observational study including all patients treated between November 2011 and July 2013 at the 4 Spanish hospitals recording the highest numbers of implantations. A total of 62 patients (77.4% men) were treated, mainly for restrictive functional mitral regurgitation (85.4%) of grade III (37%) or grade IV (63%), mean (standard deviation) ejection fraction 36% (14%), and New York Heart Association functional class III (37%) or IV (63%). Device implantation was successful in 98% of the patients. At 1 year, 81.2% had mitral regurgitation ≤ 2 and 90.9% were in New York Heart Association functional class ≤ II. One periprocedural death occurred (sepsis at 20 days post-implantation) and another 3 patients died during follow-up (mean, 9.1 months). Two patients needed a second implantation due to partial dehiscence of the first device and 2 others underwent heart transplantation. In Spain, MitraClip® therapy has principally been aimed at patients with functional mitral regurgitation, significant systolic ventricular dysfunction, and high surgical risk. It is considered a safe alternative treatment, which can reduce mitral regurgitation and improve functional capacity. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Laser driven hydrodynamic instability experiments

International Nuclear Information System (INIS)

Remington, B.A.; Weber, S.V.; Haan, S.W.; Kilkenny, J.D.; Glendinning, S.G.; Wallace, R.J.; Goldstein, W.H.; Wilson, B.G.; Nash, J.K.

1992-01-01

We have conducted an extensive series of experiments on the Nova laser to measure hydrodynamic instabilities in planar foils accelerated by x-ray ablation. Single mode experiments allow a measurement of the fundamental growth rates from the linear well into the nonlinear regime; multimode foils allow an assessment of the degree of mode coupling; and surface-finish experiments allow a measurement of the evolution of a broad spectrum of random initial modes. Experimental results and comparisons with theory and simulations are presented

Breast vibro-acoustography: initial experience in benign lesions

International Nuclear Information System (INIS)

Alizad, Azra; Mehrmohammadi, Mohammad; Ghosh, Karthik; Glazebrook, Katrina N; Carter, Rickey E; Karaberkmez, Leman Gunbery; Whaley, Dana H; Fatemi, Mostafa

2014-01-01

Vibro-acoustography (VA) is a newly developed imaging technology that is based on low-frequency vibrations induced in the object by the radiation force of ultrasound. VA is sensitive to the dynamic characteristics of tissue. Here, we evaluate the performance of VA in identifying benign lesions and compare the results to those of mammography. An integrated mammography-VA system designed for in vivo breast imaging was tested on a group of female volunteers, age ≥ 18 years, with suspected breast lesions based on clinical examination. A set of VA scans was acquired after each corresponding mammography. Most lesions were classified as benign based on their histological results. However, in 4 cases, initial diagnosis based on clinical imaging determined that the lesions were cysts. These cysts were aspirated with needle aspiration and disappeared completely under direct ultrasound visualization. Therefore, no biopsies were performed on these cases and lesions were classified as benign based on clinical findings per clinical standards. To define the VA characteristics of benign breast masses, we adopted the features that are normally attributed to such masses in mammography. In a blinded assessment, three radiologists evaluated the VA images independently. The diagnostic accuracy of VA for detection of benign lesions was assessed by comparing the reviewers’ evaluations with clinical data. Out of a total 29 benign lesions in the group, the reviewers were able to locate all lesions on VA images and mammography, 100% with (95% confidence interval (CI): 88% to 100%). Two reviewers were also able to correctly classify 83% (95% CI: 65% to 92%), and the third reviewer 86% (95% CI: 65% to 95%) of lesions, as benign on VA images and 86% (95% CI: 69% to 95%) on mammography. The results suggest that the mammographic characteristics of benign lesion may also be used to identify such lesions in VA. Furthermore, the results show the ability of VA to detect benign breast

Proposal for a United Nations Basic Space Technology Initiative

Science.gov (United States)

Balogh, Werner

Putting space technology and its applications to work for sustainable economic and social development is the primary objective of the United Nations Programme on Space Applications, launched in 1971. A specific goal for achieving this objective is to establish a sustainable national space capacity. The traditional line of thinking has supported a logical progression from building capacity in basic space science, to using space applications and finally - possibly - to establishing indigenous space technology capabilities. The experience in some countries suggests that such a strict line of progression does not necessarily hold true and that priority given to the establishment of early indigenous space technology capabilities may contribute to promoting the operational use of space applications in support of sustainable economic and social development. Based on these findings and on the experiences with the United Nations Basic Space Science Initiative (UNBSSI) as well as on a series of United Nations/International Academy of Astronautics Workshops on Small Satellites in the Service of Developing Countries, the United Nations Office for Outer Space Affairs (UNOOSA) is considering the launch of a dedicated United Nations Basic Space Technology Initiative (UNBSTI). The initiative would aim to contribute to capacity building in basic space technology and could include, among other relevant fields, activities related to the space and ground segments of small satellites and their applications. It would also provide an international framework for enhancing cooperation between all interested actors, facilitate the exchange of information on best practices, and contribute to standardization efforts. It is expected that these activities would advance the operational use of space technology and its applications in an increasing number of space-using countries and emerging space nations. The paper reports on these initial considerations and on the potential value-adding role

The initiation of environmentally-assisted cracking in semi-elliptical surface cracks

International Nuclear Information System (INIS)

James, L.A.

1997-01-01

A criterion to predict under what conditions EAC would Initiate In cracks In a high-sulfur steel in contact with low-oxygen water was recently proposed by Wire and U. This EAC Initiation Criterion was developed using transient analyses for the diffusion of sulfides plus experimental test results. The experiments were conducted mainly on compact tension-type specimens with initial crack depths of about 2.54 mm. The present paper expands upon the work of Wire and U by presenting results for significantly deeper initial semi-elliptical surface cracks. In addition, in one specimen, the surface crack penetrated weld-deposited cladding into the high-sulfur steel. The results for the semi-elliptical surface cracks agreed quite well with the EAC Initiation Criterion, and provide confirmation of the applicability of the criterion to crack configurations with more restricted access to water

The Majorana Experiment

Energy Technology Data Exchange (ETDEWEB)

Aalseth, Craig E.; Aguayo Navarrete, Estanislao; Amman, M.; Avignone, F. T.; Back, Henning O.; Bai, Xinhua; Barabash, Alexander S.; Barbeau, P. S.; Bergevin, M.; Bertrand, F.; Boswell, M.; Brudanin, V.; Bugg, William; Burritt, Tom H.; Busch, Matthew; Capps, Greg L.; Chan, Yuen-Dat; Collar, J. I.; Cooper, R. J.; Creswick, R.; Detwiler, Jason A.; Diaz, J.; Doe, Peter J.; Efremenko, Yuri; Egorov, Viatcheslav; Ejiri, H.; Elliott, S. R.; Ely, James H.; Esterline, James H.; Farach, H. A.; Fast, James E.; Fields, N.; Finnerty, P.; Fraenkle, Florian; Gehman, Victor M.; Giovanetti, G. K.; Green, M.; Guiseppe, Vincente; Gusey, K.; Hallin, A. L.; Harper, Gregory; Hazama, R.; Henning, Reyco; Hime, Andrew; Hong, H.; Hoppe, Eric W.; Hossbach, Todd W.; Howard, Stanley; Howe, M. A.; Johnson, R. A.; Keeter, K.; Keillor, Martin E.; Keller, C.; Kephart, Jeremy D.; Kidd, M. F.; Knecht, A.; Kochetov, Oleg; Konovalov, S.; Kouzes, Richard T.; LaRoque, B. H.; Leviner, L.; Loach, J. C.; Luke, P.; MacMullin, S.; Marino, Michael G.; Martin, R. D.; Medlin, D.; Mei, Dong-Ming; Miley, Harry S.; Miller, M. L.; Mizouni, Leila; Myers, Allan W.; Nomachi, Masaharu; Orrell, John L.; Peterson, David; Phillips, D.; Poon, Alan; Perevozchikov, O.; Perumpilly, Gopakumar; Prior, Gersende; Radford, D. C.; Reid, Douglas J.; Rielage, Keith; Robertson, R. G. H.; Rodriguez, Larry; Ronquest, M. C.; Salazar, Harold; Schubert, Alexis G.; Shima, T.; Shirchenko, M.; Sobolev, V.; Steele, David; Strain, J.; Swift, Gary; Thomas, K.; Timkin, V.; Tornow, W.; Van Wechel, T. D.; Vanyushin, I.; Varner, R. L.; Vetter, Kai; Vorren, Kris R.; Wilkerson, J. F.; Wolfe, B. A.; Xiang, W.; Yakushev, E.; Yaver, Harold; Young, A.; Yu, Chang-Hong; Yumatov, V.; Zhang, C.

2011-08-01

The Majorana Collaboration is assembling an array of HPGe detectors to search for neutrinoless double-beta decay in 76Ge. Initially, Majorana aims to construct a prototype module to demonstrate the potential of a future 1-tonne experiment. The design and potential reach of this prototype Demonstrator module are presented.

Initial operation of SSRL wiggler in spear

International Nuclear Information System (INIS)

Berndt, M.; Brunk, W.; Cronin, R.; Jensen, D.; Johnson, R.; King, A.; Spencer, J.; Taylor, T.; Winick, H.

1979-03-01

A 3 lambda planar, magnetic wiggler has been designed, built, installed and operated in the SPEAR storage ring. Its primary purpose is to provide tunable synchrotron radiation (SR) with a higher energy and intensity than previously available for a new SR beam line just commissioned at the Stanford Synchrotron Radiation Laboratory. Because the magnet operates from 0-18 kG, it should also produce undulator radiation (UR). Since the wiggler influences storage ring operation in both single beam and colliding beam modes, measurements were made of tune changes, emittance changes and energy spreads which are compared to predictions. Significant improvements in luminosity for high energy physics experiments were observed. The ability to do x-ray experiments easily that were not previously feasible at low electron beam energies and currents has also been demonstrated. The basic design, some interesting characteristics of the magnetic measurements and initial operating experience and results are discussed

Infidelity, initiation, and the emotional climate of divorce: are there implications for mental health?

Science.gov (United States)

Sweeney, M M; Horwitz, A V

2001-09-01

A large literature has examined the role of "secondary" stressors, such as problems with finances, social support, residential mobility, and children, in producing the well-documented association between divorce and a variety of psychopathological conditions. Much less attention, however, has been paid to variation in the "primary" disruption experience. We address this omission using data from the National Survey of Families and Households to investigate the interrelationships among depression, initiator status, and spousal infidelity. While we find little evidence of direct effects of initiator status or spousal infidelity on post-divorce depression, the importance of these characteristics emerges when they are considered in an interactive context. Specifically, while divorce initiation is associated with reduced depression among individuals with unfaithful spouses, initiation is associated with increased depression in the absence of spousal infidelity. Taken together, our findings suggest that characteristics of the divorce experience may interact in complex ways to produce variation in mental health outcomes.

Robust facial landmark detection based on initializing multiple poses

Directory of Open Access Journals (Sweden)

Xin Chai

2016-10-01

Full Text Available For robot systems, robust facial landmark detection is the first and critical step for face-based human identification and facial expression recognition. In recent years, the cascaded-regression-based method has achieved excellent performance in facial landmark detection. Nevertheless, it still has certain weakness, such as high sensitivity to the initialization. To address this problem, regression based on multiple initializations is established in a unified model; face shapes are then estimated independently according to these initializations. With a ranking strategy, the best estimate is selected as the final output. Moreover, a face shape model based on restricted Boltzmann machines is built as a constraint to improve the robustness of ranking. Experiments on three challenging datasets demonstrate the effectiveness of the proposed facial landmark detection method against state-of-the-art methods.

CEBAF SRF Performance during Initial 12 GeV Commissioning

International Nuclear Information System (INIS)

Bachimanchi, Ramakrishna; Allison, Trent; Daly, Edward; Drury, Michael; Hovater, J; Lahti, George; Mounts, Clyde; Nelson, Richard; Plawski, Tomasz

2015-09-01

The Continuous Electron Beam Accelerator Facility (CEBAF) energy upgrade from 6 GeV to 12 GeV includes the installation of eleven new 100 MV cryomodules (88 cavities). The superconducting RF cavities are designed to operate CW at an accelerating gradient of 19.3 MV/m with a Q L of 3x10 7 . Not all the cavities were operated at the minimum gradient of 19.3 MV/m with the beam. Though the initial 12 GeV milestones were achieved during the initial commissioning of CEBAF, there are still some issues to be addressed for long term reliable operation of these modules. This paper reports the operational experiences during the initial commissioning and the path forward to improve the performance of C100 (100 MV) modules.

Master Logic Diagram: An Approach to Identify Initiating Events of HTGRs

Science.gov (United States)

Purba, J. H.

2018-02-01

Initiating events of a nuclear power plant being evaluated need to be firstly identified prior to applying probabilistic safety assessment on that plant. Various types of master logic diagrams (MLDs) have been proposedforsearching initiating events of the next generation of nuclear power plants, which have limited data and operating experiences. Those MLDs are different in the number of steps or levels and different in the basis for developing them. This study proposed another type of MLD approach to find high temperature gas cooled reactor (HTGR) initiating events. It consists of five functional steps starting from the top event representing the final objective of the safety functions to the basic event representing the goal of the MLD development, which is an initiating event. The application of the proposed approach to search for two HTGR initiating events, i.e. power turbine generator trip and loss of offsite power, is provided. The results confirmed that the proposed MLD is feasiblefor finding HTGR initiating events.

Scoring system to guide decision making for the use of gentamicin-impregnated collagen sponge to prevent deep sternal wound infection.

Science.gov (United States)

Benedetto, Umberto; Raja, Shahzad G

2014-11-01

The effectiveness of the routine retrosternal placement of a gentamicin-impregnated collagen sponge (GICS) implant before sternotomy closure is currently a matter of some controversy. We aimed to develop a scoring system to guide decision making for the use of GICS to prevent deep sternal wound infection. Fast backward elimination on predictors, including GICS, was performed using the Lawless and Singhal method. The scoring system was reported as a partial nomogram that can be used to manually obtain predicted individual risk of deep sternal wound infection from the regression model. Bootstrapping validation of the regression models was performed. The final populations consisted of 8750 adult patients undergoing cardiac surgery through full sternotomy during the study period. A total of 329 patients (3.8%) received GICS implant. The overall incidence of deep sternal wound infection was lower among patients who received GICS implant (0.6%) than patients who did not (2.01%) (P=.02). A nomogram to predict the individual risk for deep sternal wound infection was developed that included the use of GICS. Bootstrapping validation confirmed a good discriminative power of the models. The scoring system provides an impartial assessment of the decision-making process for clinicians to establish if GICS implant is effective in reducing the risk for deep sternal wound infection in individual patients undergoing cardiac surgery through full sternotomy. Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

42 CFR 482.80 - Condition of participation: Data submission, clinical experience, and outcome requirements for...

Science.gov (United States)

2010-10-01

..., clinical experience, and outcome requirements for initial approval of transplant centers. 482.80 Section... Hospitals Transplant Center Data Submission, Clinical Experience, and Outcome Requirements § 482.80 Condition of participation: Data submission, clinical experience, and outcome requirements for initial...

Funding Initiatives | Women in Science | Initiatives | Indian Academy ...

Indian Academy of Sciences (India)

Home; Initiatives; Women in Science; Funding Initiatives ... The Fellowship Scheme for Women Scientists for societal programmes is initiative of the ... at a young age of 52, after a valiant battle with cancer, today on 29th March 2016 in Delhi.

Results of railgun experiments

International Nuclear Information System (INIS)

Hawke, R.S.; Brooks, A.L.; Fowler, C.M.; Peterson, D.R.

1983-04-01

During the 1979 Megagauss II conference the hypervelocity potential of railguns and the pulsed power technology needed to power them were discussed. Since then, many laboratories have initiated railgun R and D projects for a variety of potential applications. Los Alamos and Lawrence Livermore National Laboratories initiated a collaborative experimental railgun project which resulted in several successes in accelerating projectiles to high velocities, emphasized the limits on railgun operation, and indicated that the numerical modeling of railgun operation was in good agreement with the experiments

Initial Entry Training: Reducing First Term Attrition Through Effective Organizational Socialization

National Research Council Canada - National Science Library

Hayden, Thomas

2000-01-01

This paper examines Initial Entry Training (IET) from an organizational behavior perspective to identify if the Army's socialization experience can be enhanced to have a positive impact on first term attrition within the Army...

Single-Lung Ventilation with Contralateral Lung Deflation

Science.gov (United States)

Dallan, Luís Alberto O.; Lisboa, Luiz Augusto F.; Platania, Fernando; Oliveira, Sérgio A.; Stolf, Noedir A.

2007-01-01

There are many new alternative methods of minimally invasive myocardial revascularization that can be applied in selected patients who have multivessel coronary artery disease. However, these techniques often require new and expensive equipment. Most multivessel myocardial revascularization is performed via median sternotomy and involves the use of a conventional endotracheal tube. Both lungs are ventilated, and frequently the left pleural cavity is opened. In contrast, single-lung deflation naturally moves the mediastinum within the thorax toward the collapsed lung, without the need to open the pleural cavities. Herein, we describe a simple alternative procedure that facilitates off-pump multivessel coronary artery bypass grafting via complete median sternotomy: single-lung ventilation with contralateral lung deflation. This technique better exposes the more distal right and circumflex coronary artery branches with or without the opening of the pleural cavities. PMID:17622364

Minimally invasive surgical treatment of valvular heart disease.

Science.gov (United States)

Goldstone, Andrew B; Joseph Woo, Y

2014-01-01

Cardiac surgery is in the midst of a practice revolution. Traditionally, surgery for valvular heart disease consisted of valve replacement via conventional sternotomy using cardiopulmonary bypass. However, over the past 20 years, the increasing popularity of less-invasive procedures, accompanied by advancements in imaging, surgical instrumentation, and robotic technology, has motivated and enabled surgeons to develop and perform complex cardiac surgical procedures through small incisions, often eliminating the need for sternotomy or cardiopulmonary bypass. In addition to the benefits of improved cosmesis, minimally invasive mitral valve surgery was pioneered with the intent of reducing morbidity, postoperative pain, blood loss, hospital length of stay, and time to return to normal activity. This article reviews the current state-of-the-art of minimally invasive approaches to the surgical treatment of valvular heart disease. Copyright © 2014 Elsevier Inc. All rights reserved.

Teachers' Personal Learning Networks (PLNs): Exploring the Nature of Self-Initiated Professional Learning Online

Science.gov (United States)

Tour, Ekaterina

2017-01-01

In the field of Literacy Studies, online spaces have been recognised as providing many opportunities for spontaneous and self-initiated learning. While some progress has been made in understanding these important learning experiences, little attention has been paid to teachers' self-initiated professional learning. Contributing to the debates…

Microstability of TMX-U during initial thermal barrier operation

International Nuclear Information System (INIS)

Casper, T.A.; Berzins, L.V.; Ellis, R.F.; James, R.A.; Lasnier, C.

1984-03-01

During the initial thermal barrier experiments on the Tandem Mirror Experiment-Upgrade (TMX-U), we successfully demonstrated the principle of improved axial tandem mirror confinement achieved by establishment of both the thermal barrier and the ion confining potential peak. During this operation, we created both hot (100-keV) mirror-confined electron and hot (8-keV) mirror-confined ion populations in the end cells. In certain parameter ranges, we observed these species to be weakly unstable to various microinstabilities, but we did not observe clear evidence for an absolute limit to confinement

PET/MRI in head and neck cancer: initial experience

Energy Technology Data Exchange (ETDEWEB)

Platzek, Ivan; Laniado, Michael [Dresden University Hospital, Department of Radiology, Dresden (Germany); Beuthien-Baumann, Bettina [Dresden University Hospital, Department of Nuclear Medicine, Dresden (Germany); Schneider, Matthias [Dresden University Hospital, Oral and Maxillofacial Surgery, Dresden (Germany); Gudziol, Volker [Dresden University Hospital, Department of Otolaryngology, Dresden (Germany); Langner, Jens; Schramm, Georg; Hoff, Joerg van den [Institute of Bioinorganic and Radiopharmaceutical Chemistry, Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany); Kotzerke, Joerg [Dresden University Hospital, Nuclear Medicine, Dresden (Germany)

2013-01-15

To evaluate the feasibility of PET/MRI (positron emission tomography/magnetic resonance imaging) with FDG ({sup 18}F-fluorodeoxyglucose) for initial staging of head and neck cancer. The study group comprised 20 patients (16 men, 4 women) aged between 52 and 81 years (median 64 years) with histologically proven squamous cell carcinoma of the head and neck region. The patients underwent a PET scan on a conventional scanner and a subsequent PET/MRI examination on a whole-body hybrid system. FDG was administered intravenously prior to the conventional PET scan (267-395 MBq FDG, 348 MBq on average). The maximum standardized uptake values (SUV{sub max}) of the tumour and of both cerebellar hemispheres were determined for both PET datasets. The numbers of lymph nodes with increased FDG uptake were compared between the two PET datasets. No MRI-induced artefacts where observed in the PET images. The tumour was detected by PET/MRI in 17 of the 20 patients, by PET in 16 and by MRI in 14. The PET/MRI examination yielded significantly higher SUV{sub max} than the conventional PET scanner for both the tumour (p < 0.0001) and the cerebellum (p = 0.0009). The number of lymph nodes with increased FDG uptake detected using the PET dataset from the PET/MRI system was significantly higher the number detected by the stand-alone PET system (64 vs. 39, p = 0.001). The current study demonstrated that PET/MRI of the whole head and neck region is feasible with a whole-body PET/MRI system without impairment of PET or MR image quality. (orig.)

Magnetic resonance imaging of the female pelvis: initial experience

International Nuclear Information System (INIS)

Hricak, H.; Alpers, C.; Crooks, L.E.; Sheldon, P.E.

1983-01-01

The potential of magnetic resonance imaging (MRI) was evaluated in 21 female subjects: seven volunteers, 12 patients scanned for reasons unrelated to the lower genitourinary tract, and two patients referred with gynecologic disease. The uterus at several stages was examined; the premenarcheal uterus (one patient), the uterus of reproductive age (12 patients), the postmenopausal uterus (two patients), and in an 8 week pregnancy (one patient). The myometrium and cyclic endometrium in the reproductive age separated by a low-intensity line (probably stratum basale), which allows recognition of changes in thickness of the cyclic endometrium during the menstrual cycle. The corpus uteri can be distinguished from the cervix by the transitional zone of the isthmus. The anatomic relation of the uterus to bladder and rectum is easily outlined. The vagina can be distinguished from the cervix, and the anatomic display of the closely apposed bladder, vagina, and rectum is clear on axial and coronal images. The ovary is identified; the signal intensity from the ovary depends on the acquisition parameter used. Uterine leiomyoma, endometriosis, and dermoid cyst were depicted, but further experience is needed to ascertain the specificity of the findings

Guidelines Regarding §16 of the German Transplantation Act - Initial Experiences with Structured Reporting.

Science.gov (United States)

Pinto Dos Santos, Daniel; Arnhold, Gordon; Mildenberger, Peter; Düber, Christoph; Kloeckner, Roman

2017-12-01

the German Transplantation Act - Initial Experiences with Structured Reporting. Fortschr Röntgenstr 2017; 189: 1145 - 1151. © Georg Thieme Verlag KG Stuttgart · New York.

The POST trial: initial post-market experience of the Penumbra system: revascularization of large vessel occlusion in acute ischemic stroke in the United States and Europe.

Science.gov (United States)

Tarr, Robert; Hsu, Dan; Kulcsar, Zsolt; Bonvin, Christophe; Rufenacht, Daniel; Alfke, Karsten; Stingele, Robert; Jansen, Olav; Frei, Donald; Bellon, Richard; Madison, Michael; Struffert, Tobias; Dorfler, Arnd; Grunwald, Iris Q; Reith, Wolfgang; Haass, Anton

2010-12-01

The purpose of this study was to assess the initial post-market experience of the device and how it is compared with the Penumbra Pivotal trial used to support the 510k application. A retrospective case review of 157 consecutive patients treated with the Penumbra system at seven international centers was performed. Primary endpoints were revascularization of the target vessel (TIMI score of 2 or 3), good functional outcome as defined by a modified Rankin scale (mRS) score of ≤2 and incidence of procedural serious adverse events. Results were compared with those of the Penumbra pivotal trial. A total of 157 vessels were treated. Mean baseline values at enrollment were: age 65 years, NIHSS score 16. After use of the Penumbra system, 87% of the treated vessels were revascularized to TIMI 2 (54%) or 3 (33%) as compared with 82% reported in the Pivotal trial. Nine procedural serious adverse events were reported in 157 patients (5.7%). All-cause mortality was 20% (32/157), and 41% had a mRS of ≤2 at 90-day follow-up as compared with only 25% in the Pivotal trial. Patients who were successfully revascularized by the Penumbra system had significantly better outcomes than those who were not. Initial post-market experience of the Penumbra system revealed that the revascularization rate and safety profile of the device are comparable to those reported in the Pivotal trial. However, the proportion of patients who had good functional outcome was higher than expected.

Microrelief-Controlled Overland Flow Generation: Laboratory and Field Experiments

Directory of Open Access Journals (Sweden)

Xuefeng Chu

2015-01-01

Full Text Available Surface microrelief affects overland flow generation and the related hydrologic processes. However, such influences vary depending on other factors such as rainfall characteristics, soil properties, and initial soil moisture conditions. Thus, in-depth research is needed to better understand and evaluate the combined effects of these factors on overland flow dynamics. The objective of this experimental study was to examine how surface microrelief, in conjunction with the factors of rainfall, soil, and initial moisture conditions, impacts overland flow generation and runoff processes in both laboratory and field settings. A series of overland flow experiments were conducted for rough and smooth surfaces that represented distinct microtopographic characteristics and the experimental data were analyzed and compared. Across different soil types and initial moisture conditions, both laboratory and field experiments demonstrated that a rough soil surface experienced a delayed initiation of runoff and featured a stepwise threshold flow pattern due to the microrelief-controlled puddle filling-spilling-merging dynamics. It was found from the field experiments that a smooth plot surface was more responsive to rainfall variations especially during an initial rainfall event. However, enhanced capability of overland flow generation and faster puddle connectivity of a rough field plot occurred during the subsequent rain events.

The MEGAPIE Initiative

International Nuclear Information System (INIS)

Salvatores, M.; Bauer, G.S.; Heusener, G.

2000-10-01

MEGAPIE (Megawatt Pilot Experiment) is a joint initiative by Commissariat a l'Energie Atomique (CEA), France, Forschungszentrum Karlsruhe (FZK), Germany, and Paul Scherrer Institut (PSI), Switzerland, to design, build, operate and explore a liquid lead-bismuth spallation target for 1MW of beam power, taking advantage of the existing spallation neutron facility SINQ at PSI. Such a target based on an eutectic mixture with a melting point as low as 125 o C and a boiling point as high as 1670 o C is the preferred concept in several studies aiming at utilising accelerators to drive subcritical assemblies in order to transmute long lived nuclear waste into shorter lived isotopes in an effort to ease problems of long term storage and final disposal. MEGAPIE will be an essential step towards demonstrating the feasibility of the coupling of a high power accelerator, a spallation target and a subcritical assembly. It will specifically address one of the most critical issues, namely the behaviour of a liquid metal target under realistic operating conditions. As an intensely instrumented pilot experiment it will provide valuable data for benchmarking of frequently used computer codes and will allow to gain important experience in the safe handling of components that have been irradiated with PbBi. It will be installed at the ring cyclotron at PSI with 590 MeV proton energy and a continuous current of 1.8 mA. The basic concept of the MEGAPIE target as well as the definition of the project phases and of the supporting research and development activities at the participating laboratories are described in the present report

Experiment data report for LOFT Boron dilution Experiment L6-6

International Nuclear Information System (INIS)

Stitt, B.D.; Divine, J.M.

1982-06-01

Selected pertinent and uninterpreted data from the sixth anticipated transient experiment (Experiment L6-6) conducted in the Loss-of-Fluid Test (LOFT) facility are presented. Experiment L6-6 simulated a boron dilution accident by injecting demineralized water into the primary coolant system (PCS) at a rate of 0.47 L/s while the reactor was in a cold shutdown condition with the control rods withdrawn. System pressure was maintained at approximately 285 kPa throughout the experiment. The experiment was divided into two parts. In the first part, L6-6A, a recirculation flow of 4.7 L/s was maintained through the PCS and criticality was achieved 7416 +- 10 s after the initiation of the dilution flow. The second part, L6-6B, was identical to L6-6A except that a recirculation flow of 9.5 L/s was maintained and criticality occurred at 8058 +- 10 s

The experience turn of the Danish periphery

DEFF Research Database (Denmark)

Lorentzen, Anne

2013-01-01

strategic management, is more encompassing than the related notion of cultural economy, and its application in urban strategies aims to promote (1) new forms of business innovation, (2) the development of new industries and (3) the development of place as a factor of attraction. The article proceeds...... constructed by the initiatives of public, private and civic actors over more than a decade, until it finally became institutionalized in official municipal policy and organizations. The many initiatives materialized in a considerable enhancement of the local cultural and leisure supply, urban refurbishment......, business innovation and a change of urban image from industrial city to experience city. The experience economy mainly became institutionalized as a reinterpretation and development of welfare services from a consumer perspective. As a municipal strategy the experience economy concept is faced with two...

Hawaii Energy and Environmental Technologies (HEET) Initiative

Science.gov (United States)

2011-12-01

polymer electrolyte fuel cells ( PEMFCs ) performance. This work was performed to support the DOE manufacturing initiative for PEMFC production. The work...performed by exposing the MEA cathode to 10 ppm SO2 in N2 at certain potential and typical operating conditions of a PEMFC for certain time, then...adsorbate by analyzing the electrochemical reduction and oxidation potential and charge. As for the in-situ SO2 adsorption experiments, a PEMFC under

Melatonin delays clutch initiation in a wild songbird

Science.gov (United States)

Greives, Timothy J.; Kingma, Sjouke A.; Beltrami, Giulia; Hau, Michaela

2012-01-01

The hormone melatonin is known to play an important role in regulating many seasonal changes in physiology, morphology and behaviour. In birds, unlike in mammals, melatonin has thus far been thought to play little role in timing seasonal reproductive processes. This view is mainly derived from laboratory experiments on male birds. This study tests whether melatonin is capable of influencing the timing of clutch initiation in wild female songbirds. Free-living female great tits (Parus major) treated with melatonin-filled implants prior to the breeding season initiated their first clutch of the season significantly later than females carrying an empty implant. Melatonin treatment did not affect clutch size. Further, melatonin treatment did not delay the onset of daily activity in the wild nor adversely affect body mass in captivity compared with controls. These data suggest a previously unknown role for this hormone in regulating the timing of clutch initiation in the wild. PMID:22171024

Robotic-assisted laparoscopic partial nephrectomy: initial experience in Brazil and a review of the literature

Directory of Open Access Journals (Sweden)

Carlo Camargo Passerotti

2012-02-01

Full Text Available CONTEXT AND PURPOSE: Partial nephrectomy has become the standard of care for renal tumors less than 4 cm in diameter. Controversy still exists, however, regarding the best surgical approach, especially when minimally invasive techniques are taken into account. Robotic-assisted laparoscopic partial nephrectomy (RALPN has emerged as a promising technique that helps surgeons achieve the standards of open partial nephrectomy care while offering a minimally invasive approach. The objective of the present study was to describe our initial experience with robotic-assisted laparoscopic partial nephrectomy and extensively review the pertinent literature. MATERIALS AND METHODS: Between August 2009 and February 2010, eight consecutive selected patients with contrast enhancing renal masses observed by CT were submitted to RALPN in a private institution. In addition, we collected information on the patients' demographics, preoperative tumor characteristics and detailed operative, postoperative and pathological data. In addition, a PubMed search was performed to provide an extensive review of the robotic-assisted laparoscopic partial nephrectomy literature. RESULTS: Seven patients had RALPN on the left or right sides with no intraoperative complications. One patient was electively converted to a robotic-assisted radical nephrectomy. The operative time ranged from 120 to 300 min, estimated blood loss (EBL ranged from 75 to 400 mL and, in five cases, the warm ischemia time (WIT ranged from 18 to 32 min. Two patients did not require any clamping. Overall, no transfusions were necessary, and there were no intraoperative complications or adverse postoperative clinical events. All margins were negative, and all patients were disease-free at the 6-month follow-up. CONCLUSIONS: Robotic-assisted laparoscopic partial nephrectomy is a feasible and safe approach to small renal cortical masses.Further prospective studies are needed to compare open partial nephrectomy with

Copenhagen Sonic Experience Map

DEFF Research Database (Denmark)

Kreutzfeldt, Jacob

2011-01-01

In the wake of present European interest for mapping urban noise, it seems increasingly relevant to investigate the multiple ways in which sound intersects with the everyday experiences of urban citizens. Focusing on the polluting effects of infrastructural noise, the EU-initiated project of asse...

Authoring experience

DEFF Research Database (Denmark)

Knox, Jeanette Bresson Ladegaard; Svendsen, Mette Nordahl

2015-01-01

This article examines the storytelling aspect inphilosophizing with rehabilitating cancer patients in small Socratic dialogue groups (SDG). Recounting an experienceto illustrate a philosophical question chosen by the participantsis the traditional point of departure for the dialogicalexchange....... However, narrating is much more than abeginning point or the skeletal framework of events and itdeserves more scholarly attention than hitherto given. Storytelling pervades the whole Socratic process and impactsthe conceptual analysis in a SDG. In this article weshow how the narrative aspect became a rich...... an experiencethrough a collaborative effort, most participants hadtheir initial experience existentially refined and the chosenconcept of which the experience served as an illustrationtransformed into a moral compass to be used in self-orientationpost cancer....

SU-E-E-05: Initial Experience On Physics Rotation of Radiological Residents

International Nuclear Information System (INIS)

Zhang, J; Williams, D; DiSantis, D; Hardy, P; Oates, M

2014-01-01

Purpose: The new ABR core exam integrates physics into clinical teaching, with an emphasis on understanding image quality, image artifacts, radiation dose and patient safety for each modality and/or sub-specialty. Accordingly, physics training of radiological residents faces a challenge. A traditional teaching of physics through didactic lectures may not fully fulfill this goal. It is also difficult to incorporate physics teaching in clinical practice due to time constraints. A dedicated physics rotation may be a solution. This study is to evaluate a full week physics workshop developed for the first year radiological residents. Methods: The physics rotation took a full week. It included three major parts, introduction lectures, hand-on experiences and observation of technologist operation. An introduction of basic concepts was given to each modality at the beginning. Hand-on experiments were emphasized and took most of time. During hand-on experiments, residents performed radiation measurements, studied the relationship between patient dose and practice (i.e., fluoroscopy), investigated influence of acquisition parameters (i.g., kV, mAs) on image quality, and evaluated image quality using phantoms A physics test before and after the workshop was also given but not for comparison purpose. Results: The evaluation shows that the physics rotation during the first week of residency in radiology is preferred by all residents. The length of a full week of physics workshop is appropriate. All residents think that the intensive workshop can significantly benefit their coming clinical rotations. Residents become more comfortable regarding the use of radiation and counseling relevant questions such as a pregnant patient risk from a CE PE examination. Conclusion: A dedicated physics rotation, assisting with didactic lectures, may fulfill the requirements of physics of the new ABR core exam. It helps radiologists deeply understand the physics concepts and more efficiently use

SU-E-E-05: Initial Experience On Physics Rotation of Radiological Residents

Energy Technology Data Exchange (ETDEWEB)

Zhang, J; Williams, D; DiSantis, D; Hardy, P; Oates, M [University of Kentucky, Lexington, KY (United States)

2014-06-01

Purpose: The new ABR core exam integrates physics into clinical teaching, with an emphasis on understanding image quality, image artifacts, radiation dose and patient safety for each modality and/or sub-specialty. Accordingly, physics training of radiological residents faces a challenge. A traditional teaching of physics through didactic lectures may not fully fulfill this goal. It is also difficult to incorporate physics teaching in clinical practice due to time constraints. A dedicated physics rotation may be a solution. This study is to evaluate a full week physics workshop developed for the first year radiological residents. Methods: The physics rotation took a full week. It included three major parts, introduction lectures, hand-on experiences and observation of technologist operation. An introduction of basic concepts was given to each modality at the beginning. Hand-on experiments were emphasized and took most of time. During hand-on experiments, residents performed radiation measurements, studied the relationship between patient dose and practice (i.e., fluoroscopy), investigated influence of acquisition parameters (i.g., kV, mAs) on image quality, and evaluated image quality using phantoms A physics test before and after the workshop was also given but not for comparison purpose. Results: The evaluation shows that the physics rotation during the first week of residency in radiology is preferred by all residents. The length of a full week of physics workshop is appropriate. All residents think that the intensive workshop can significantly benefit their coming clinical rotations. Residents become more comfortable regarding the use of radiation and counseling relevant questions such as a pregnant patient risk from a CE PE examination. Conclusion: A dedicated physics rotation, assisting with didactic lectures, may fulfill the requirements of physics of the new ABR core exam. It helps radiologists deeply understand the physics concepts and more efficiently use

DRAMA IN SCHOOL. AN EDUCATIONAL INITIATIVE FOR THE FUTURE

Directory of Open Access Journals (Sweden)

Sylvia ROTTER

2017-12-01

Full Text Available The aim of this paper is to highlight experiences and benefits of drama in education that have been developed through the project „The National Educational Initiative – Drama in education”. The project was carried out in 2014 in Romanian secondary schools by the Vienna Theatre for Children Association. The initiative addressed to children, teens and teachers alike. The starting point of the project lies in the research and methodology that were developed within the “School for Life” initiative of the Vienna Theatre for Children in 2008. The focal point consists in exploring the impact of play in education and learning. The two projects that are mentioned in the paper identified and evaluated the skills of the children and youth who got involved in the drama activities. The results showed cognitive, emotional and interpersonal progress in acquisition.

With the Advent of Tomosynthesis in the Workup of Mammographic Abnormality, is Spot Compression Mammography Now Obsolete? An Initial Clinical Experience.

Science.gov (United States)

Ni Mhuircheartaigh, Neasa; Coffey, Louise; Fleming, Hannah; O' Doherty, Ann; McNally, Sorcha

2017-09-01

To determine if the routine use of spot compression mammography is now obsolete in the assessment of screen detected masses, asymmetries and architectural distortion since the availability of digital breast tomosynthesis. We introduced breast tomosynthesis in the workup of screen detected abnormalities in our screening center in January 2015. During an initial learning period with tomosynthesis standard spot compression views were also performed. Three consultant breast radiologists retrospectively reviewed all screening mammograms recalled for assessment over the first 6-month period. We assessed retrospectively whether there was any additional diagnostic information obtained from spot compression views not already apparent on tomography. All cases were also reviewed for any additional lesions detected by tomosynthesis, not detected on routine 2-view screening mammography. 548 women screened with standard 2-view digital screening mammography were recalled for assessment in the selected period and a total of 565 lesions were assessed. 341 lesions were assessed by both tomosynthesis and routine spot compression mammography. The spot compression view was considered more helpful than tomosynthesis in only one patient. This was because the breast was inadequately positioned for tomosynthesis and the area in question was not adequately imaged. Apart from this technical error there was no asymmetry, distortion or mass where spot compression provided more diagnostic information than tomosynthesis alone. We detected three additional cancers on tomosynthesis, not detected by routine screening mammography. From our initial experience with tomosynthesis we conclude that spot compression mammography is now obsolete in the assessment of screen detected masses, asymmetries and distortions where tomosynthesis is available. © 2017 Wiley Periodicals, Inc.

Initial operational experience with Gd-2M+ fuel at Dukovany NPP

International Nuclear Information System (INIS)

Borovička, M.; Zýbal, J.

2015-01-01

Trend of continuous development of nuclear fuel and fuel cycle can be observed from the very beginning of Dukovany NPP operation. The results of this development are documented on the one hand by extending the length of the cycle and on the other by significant reduction in the number of fresh FA’s which are loaded into reactor cores. As a continuation of this trend introduces Dukovany NPP evolutional change of nuclear fuel from the fuel Gd-2M to the Gd-2M + . (authors) Keywords: Gd-2M + , fuel assembly, operational experience

Digital library initiative in an Indian research library: an experience report

International Nuclear Information System (INIS)

Venkadesan, S.; Narayanan, A.

1999-01-01

Libraries all over the world are transiting from the traditional print only era to the electronic era. The migration to an electronic library involves the understanding of several issues and requirements at the planning stage itself. This paper describes the various aspects of building a digital library system. Experience of implementing certain strategies in the IGCAR library is discussed in detail. The components of the digital library and the various access levels are discussed with examples. Finally, samples of the IGCAR library web site and the Newsletter web site are shown. (author)

SUPERCOLLIDER: Preparing initial experiments

International Nuclear Information System (INIS)

Anon.

1991-01-01

The Superconducting Supercollider (SSC) Laboratory in Ellis County, Texas, has taken an important step toward its scientific programme. While three letters of intent for large detectors had been invited, only two could be considered due to funding limitations. Two letters were received from existing collaborations (SDC and L*) and one from a merger of (EMPACT and TEXAS)

Experimenting for resilience

DEFF Research Database (Denmark)

Hagedorn-Rasmussen, Peter; Dupret, Katia

Focusing on how an experimental approach to organizing may pave the way for organizational resilience, we explore opportunities and barriers of experimental organizing by following a concrete social experiment in civil society and discuss its adaptability in traditional organizations. The social ...... through balancing a strategic and anticipatory strategy with experimental setups inspired by civil society organizing initiatives....

Radiation safety without borders initiative

International Nuclear Information System (INIS)

Dibblee, Martha; Dickson, Howard; Krieger, Ken; Lopez, Jose; Waite, David; Weaver, Ken

2008-01-01

The Radiation Safety Without Borders (RSWB) initiative provides peer support to radiation safety professionals in developing countries, which bolsters the country's infrastructure and may lead the way for IRPA Associate membership. The Health Physics Society (HPS) recognizes that many nations do not possess the infrastructure to adequately control and beneficially use ionizing radiation. In a substantial number of countries, organized radiation protection programs are minimal. The RSWB initiative relies on HPS volunteers to assist their counterparts in developing countries with emerging health physics and radiation safety programs, but whose resources are limited, to provide tools that promote and support infrastructure and help these professionals help themselves. RSWB experience to date has shown that by providing refurbished instruments, promoting visits to a HPS venue, or visiting a country just to look provide valuable technical and social infrastructure experiences often missing in the developing nation's cadre of radiation safety professionals. HPS/RSWB with the assistance of the International Atomic Energy Agency (IAEA) pairs chapters with a country, with the expectation that the country's professional radiation safety personnel will form a foreign HPS chapter, and the country eventually will become an IRPA Associate. Although still in its formative stage, RSWB nonetheless has gotten valuable information in spite of the small number of missions. The RSWB initiative continues to have significant beneficial impacts, including: Improving the radiation safety infrastructure of the countries that participate; Assisting those countries without professional radiation safety societies to form one; Strengthening the humanitarian efforts of the United States; Enhancing Homeland Security efforts through improved control of radioactive material internationally. Developing countries, including those in Latin America, underwritten by IAEA, may take advantage of resources

Antares facility for inertial-fusion experiments: status and plans

International Nuclear Information System (INIS)

Goldstone, P.D.; Allen, G.; Jansen, H.; Saxman, A.; Singer, S.; Thuot, M.

1982-01-01

Antares is a large, 30 to 40 kJ CO 2 laser system which will provide a base for experiments to determine the efficiency with which 10 μm light can be used to drive target implosions while maintaining an acceptable level of preheat. Construction of the facility is in the final stages and diagnostics for initial experiments are being designed and constructed with operations scheduled to begin early in FY-84. After an initial shakedown period, we expect to perform a series of measurements to determine the energy scaling of hot electron temperature and target coupling efficiency in selected set of targets including simple spheres. We also expect to continue experiments, now planned for Helios, to determine whether CO 2 -produced ions are appropriate for driving inertial fusion targets with acceptable efficiency (Helios experiments have demonstrated that as much as 40% of the incident light can be converted to fast ions). Details of these experiments, as well as plans for further experiments, are still being defined

A Half-Day Workshop on ``Smarter Investment by Aligning SPI Initiatives, Capabilities and Stakeholder Values''

Science.gov (United States)

Selioukova, Yana; Frühwirth, Christian

Software companies who want to improve software process capabilities (SPCs)a systematic method to make informed investment decisions on software process improvement (SPI) initiatives. Such decisions should aim at creating maximum stakeholder values. To address this problem, we present a method with tool support that may help companies align stakeholder values with SPCs and SPI initiatives. The proposed method has been developed based on the well-established “Quality Function Deployment” (QFD) approach. The experience with the proposed method suggests that it particularly helps to reduce the risk of misalignment by identifying those SPI initiatives that are most beneficial to stakeholders. The tool support provided with the proposed method also generated positive experiences in increasing the usability of the method and helped companies in the elicitation and prioritization of stakeholder values. Therefore, we propose a workshop for the method work out named “Smarter Investment by Aligning SPI Initiatives, Capabilities and Stakeholder Values” in hypothetical case company.

ANIONIC POLYMERIZATION OF ALKYL METHACRYLATES INITIATED BY nBuCu(NCy2)Li

Institute of Scientific and Technical Information of China (English)

Bing-yong Han; Jian-guo Liang; Jian-min Lu; Feng An; Wan-tai Yang

2009-01-01

Anionic polymerization of methyl methacrylate (MMA), n-butyl methacrylate (nBMA) and glycidyl methacrylate (GMA) initiated by nBuCu(NCy2)Li (1) in tetrahydrofuran (THF) at -50℃ to -10℃ was investigated. It was found that the polymerization of MMA and nBMA initiated by 1 proceeded quantitatively in THF to afford PMMA and PBMA with polydispersity index 1.15-1.30 and nearly 100% initiator efficiencies at -10℃. The molecular weights increased linearly with the ratio of [monomer]/[1]. However, a post-polymerization experiment carried out on this system revealed a double polymer peak by GPC when fresh monomer was added after an interval of 10 rain. Polymerization of styrene could be initiated by 1, but the initiator efficiency was low.

Experiência inicial no fechamento percutâneo da comunicação interatrial com a prótese de Amplatzer Initial experience in percutaneous occlusion of atrial septal defects with the Amplatzer device

Directory of Open Access Journals (Sweden)

Valmir F. Fontes

1998-03-01

Full Text Available OBJETIVO: Analisar a experiência inicial no fechamento percutâneo da comunicação interatrial ostium secundum (CIA OS com a prótese de Amplatzer. MÉTODOS: Sete pacientes foram submetidos ao procedimento através da via venosa anterógrada, orientados pela ecocardiografia transesofágica (ETE e sob anestesia geral. Uma criança era portadora de 2 CIA e de canal arterial (CA. As CIA medidas pelo ETE variaram de 8,7 a 20mm. Um ecocardiograma transtorácico foi realizado na manhã seguinte do procedimento. RESULTADOS: Oito próteses foram implantadas nos 7 pacientes com sucesso. Em um paciente, o CA foi ocluído na mesma sessão com mola de Gianturco, tendo surgido taquicardia supraventricular durante a oclusão de uma das CIA, controlada com adenosina. Todos receberam alta hospitalar na manhã seguinte, com oclusão total dos defeitos. CONCLUSÃO: O procedimento mostrou-se seguro, eficaz e versátil, podendo ser considerado como uma alternativa terapêutica inicial em pacientes selecionados com CIA OS.PURPOSE: To evaluate our initial experience with percutaneous closure of secundum type atrial septal defects (ASD with the Amplatzer septal occluder. METHODS: Seven patients underwent occlusion by anterograde approach, under general anesthesia and transesophageal echocardiography (TEE guidance. One child had 2 ASD and a patent ductus arteriosus (PDA. The ASD size ranged from 8,7 to 20mm as measured by TEE. A transthoracic echocardiogram was performed in the morning after the procedure. RESULTS: Eight devices were successfully implanted in 7 patients and the PDA was occluded with a Gianturco coil at the same session. In this patient, there was an episode of supraventricular tachycardia during the occlusion of one ASD which was reverted with adenosin. All patients were discharged the day after, with complete occlusion of all defects. CONCLUSION: The procedure is safe, effective and versatile. It can be applied as an initial alternative to the

Shock timing on the National Ignition Facility: First Experiments

International Nuclear Information System (INIS)

Celliers, P.M.; Robey, H.F.; Boehly, T.R.; Alger, E.; Azevedo, S.; Berzins, L.V.; Bhandarkar, S.D.; Bowers, M.W.; Brereton, S.J.; Callahan, D.; Castro, C.; Chandrasekaran, H.; Choate, C.; Clark, D.; Coffee, K.R.; Datte, P.S.; Dewald, E.L.; DiNicola, P.; Dixit, S.; Doeppner, T.; Dzenitis, E.; Edwards, M.J.; Eggert, J.H.; Fair, J.; Farley, D.R.; Frieders, G.; Gibson, C.R.; Giraldez, E.; Haan, S.; Haid, B.; Hamza, A.V.; Haynam, C.; Hicks, D.G.; Holunga, D.M.; Horner, J.B.; Jancaitis, K.; Jones, O.S.; Kalantar, D.; Kline, J.L.; Krauter, K.G.; Kroll, J.J.; LaFortune, K.N.; Pape, S.L.; Malsbury, T.; Maypoles, E.R.; Milovich, J.L.; Moody, J.D.; Moreno, K.; Munro, D.H.; Nikroo, A.; Olson, R.E.; Parham, T.; Pollaine, S.; Radousky, H.B.; Ross, G.F.; Sater, J.; Schneider, M.B.; Shaw, M.; Smith, R.F.; Thomas, C.A.; Throop, A.; Town, R.J.; Trummer, D.; Van Wonterghem, B.M.; Walters, C.F.; Widmann, K.; Widmayer, C.; Young, B.K.; Atherton, L.J.; Collins, G.W.; Landen, O.L.; Lindl, J.D.; MacGowan, B.J.; Meyerhofer, D.D.; Moses, E.I.

2011-01-01

An experimental campaign to tune the initial shock compression sequence of capsule implosions on the National Ignition Facility (NIF) was initiated in late 2010. The experiments use a NIF ignition-scale hohlraum and capsule that employs a reentrant cone to provide optical access to the shocks as they propagate in the liquid deuterium-filled capsule interior. The strength and timing of the shock sequence is diagnosed with velocity interferometry that provides target performance data used to set the pulse shape for ignition capsule implosions that follow. From the start, these measurements yielded significant new information on target performance, leading to improvements in the target design. We describe the results and interpretation of the initial tuning experiments.

Multiple-shock initiation via statistical crack mechanics

Energy Technology Data Exchange (ETDEWEB)

Dienes, J.K.; Kershner, J.D.

1998-12-31

Statistical Crack Mechanics (SCRAM) is a theoretical approach to the behavior of brittle materials that accounts for the behavior of an ensemble of microcracks, including their opening, shear, growth, and coalescence. Mechanical parameters are based on measured strain-softening behavior. In applications to explosive and propellant sensitivity it is assumed that closed cracks act as hot spots, and that the heating due to interfacial friction initiates reactions which are modeled as one-dimensional heat flow with an Arrhenius source term, and computed in a subscale grid. Post-ignition behavior of hot spots is treated with the burn model of Ward, Son and Brewster. Numerical calculations using SCRAM-HYDROX are compared with the multiple-shock experiments of Mulford et al. in which the particle velocity in PBX 9501 is measured with embedded wires, and reactions are initiated and quenched.

Initial Operative Experience and Short-term Hearing Preservation Results With a Mid-scala Cochlear Implant Electrode Array.

Science.gov (United States)

Svrakic, Maja; Roland, J Thomas; McMenomey, Sean O; Svirsky, Mario A

2016-12-01

To describe our initial operative experience and hearing preservation results with the Advanced Bionics (AB) Mid Scala Electrode (MSE). Retrospective review. Tertiary referral center. Sixty-three MSE implants in pediatric and adult patients were compared with age- and sex-matched 1j electrode implants from the same manufacturer. All patients were severe to profoundly deaf. Cochlear implantation with either the AB 1j electrode or the AB MSE. The MSE and 1j electrodes were compared in their angular depth of insertion and pre to postoperative change in hearing thresholds. Hearing preservation was analyzed as a function of angular depth of insertion. Secondary outcome measures included operative time, incidence of abnormal intraoperative impedance and telemetry values, and incidence of postsurgical complications. Depth of insertion was similar for both electrodes, but was more consistent for the MSE array and more variable for the 1j array. Patients with MSE electrodes had better hearing preservation. Thresholds shifts at four audiometric frequencies ranging from 250 to 2000 Hz were 10, 7, 2, and 6 dB smaller for the MSE electrode than for the 1j (p < 0.05). Hearing preservation at low frequencies was worse with deeper insertion, regardless of array. Secondary outcome measures were similar for both electrodes. The MSE electrode resulted in more consistent insertion depth and somewhat better hearing preservation than the 1j electrode. Differences in other surgical outcome measures were small or unlikely to have a meaningful effect.

Insulin initiation status of primary care physicians in Turkey, barriers to insulin initiation and knowledge levels about insulin therapy: A multicenter cross-sectional study.

Science.gov (United States)

Ates, Elif; Set, Turan; Saglam, Zuhal; Tekin, Nil; Karatas Eray, Irep; Yavuz, Erdinc; Sahin, Mustafa Kursat; Selcuk, Engin Burak; Cadirci, Dursun; Cubukcu, Mahcube

2017-10-01

Our aim was to evaluate the insulin initiation status, barriers to insulin initiation and knowledge levels about treatment administered by primary care physicians (PCP). We conducted our study in accordance with a multicenter, cross-sectional design in Turkey, between July 2015 and July 2016. A questionnaire inquiring demographic features, status of insulin initiation, obstacles to insulin initiation and knowledge about therapy of the PCPs was administered during face-to-face interviews. 84 PCPs (19%) (n=446, mean age=41.5±8.4years, 62.9% male and 90.0% ministry certified family physicians) initiated insulin therapy in the past. Most of the stated primary barriers (51.9%, n=230) were due to the physicians. The most relevant barrier was "lack of clinical experience" with a rate of 19% (n=84 of the total). The average total knowledge score was 5.7±2.0 for the family medicine specialist, and 3.8±2.1 for the ministry certified family physicians (p=0.000, maximum knowledge score could be 10). The status of insulin initiation in Turkey by the primary care physicians is inadequate. Medical education programs and health care systems may require restructuring to facilitate insulin initiation in primary care. Copyright © 2017 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

The SPIRIT Telescope Initiative: Six Years On (Abstract)

Science.gov (United States)

Luckas, P.

2017-12-01

(Abstract only) Now in its sixth year of operation, the SPIRIT initiative remains unique in Australia, as a robust web-enabled robotic telescope initiative funded for education and outreach. With multiple modes of operation catering for a variety of usage scenarios and a fully supported education program, SPIRIT provides free access to contemporary astronomical tools for students and educators in Western Australia and beyond. The technical solution itself provides an excellent model for low cost robotic telescope installations, and the education program has evolved over time to include a broad range of student experiences - from engagement activities to authentic science. This paper details the robotic telescope solution, student interface, and educational philosophy, summarizes achievements and lessons learned, and examines the possibilities for future enhancement including spectroscopy.

Regulation of protein translation initiation in response to ionizing radiation

International Nuclear Information System (INIS)

Trivigno, Donatella; Bornes, Laura; Huber, Stephan M; Rudner, Justine

2013-01-01

Proliferating tumor cells require continuous protein synthesis. De novo synthesis of most proteins is regulated through cap-dependent translation. Cellular stress such as ionizing radiation (IR) blocks cap-dependent translation resulting in shut-down of global protein translation which saves resources and energy needed for the stress response. At the same time, levels of proteins required for stress response are maintained or even increased. The study aimed to analyze the regulation of signaling pathways controlling protein translation in response to IR and the impact on Mcl-1, an anti-apoptotic and radioprotective protein, which levels rapidly decline upon IR. Protein levels and processing were analyzed by Western blot. The assembly of the translational pre-initiation complex was examined by Immunoprecipitation and pull-down experiments with 7-methyl GTP agarose. To analyze IR-induced cell death, dissipation of the mitochondrial membrane potential and DNA fragmentation were determined by flow cytometry. Protein levels of the different initiation factors were down-regulated using RNA interference approach. IR induced caspase-dependent cleavage of the translational initiation factors eIF4G1, eIF3A, and eIF4B resulting in disassembly of the cap-dependent initiation complex. In addition, DAP5-dependent initiation complex that regulates IRES-dependent translation was disassembled in response to IR. Moreover, IR resulted in dephosphorylation of 4EBP1, an inhibitor of cap-dependent translation upstream of caspase activation. However, knock-down of eIF4G1, eIF4B, DAP5, or 4EBP1 did not affect IR-induced decline of the anti-apoptotic protein Mcl-1. Our data shows that cap-dependent translation is regulated at several levels in response to IR. However, the experiments indicate that IR-induced Mcl-1 decline is not a consequence of translational inhibition in Jurkat cells

Regulation of protein translation initiation in response to ionizing radiation

Directory of Open Access Journals (Sweden)

Trivigno Donatella

2013-02-01

Full Text Available Abstract Background Proliferating tumor cells require continuous protein synthesis. De novo synthesis of most proteins is regulated through cap-dependent translation. Cellular stress such as ionizing radiation (IR blocks cap-dependent translation resulting in shut-down of global protein translation which saves resources and energy needed for the stress response. At the same time, levels of proteins required for stress response are maintained or even increased. The study aimed to analyze the regulation of signaling pathways controlling protein translation in response to IR and the impact on Mcl-1, an anti-apoptotic and radioprotective protein, which levels rapidly decline upon IR. Methods Protein levels and processing were analyzed by Western blot. The assembly of the translational pre-initiation complex was examined by Immunoprecipitation and pull-down experiments with 7-methyl GTP agarose. To analyze IR-induced cell death, dissipation of the mitochondrial membrane potential and DNA fragmentation were determined by flow cytometry. Protein levels of the different initiation factors were down-regulated using RNA interference approach. Results IR induced caspase-dependent cleavage of the translational initiation factors eIF4G1, eIF3A, and eIF4B resulting in disassembly of the cap-dependent initiation complex. In addition, DAP5-dependent initiation complex that regulates IRES-dependent translation was disassembled in response to IR. Moreover, IR resulted in dephosphorylation of 4EBP1, an inhibitor of cap-dependent translation upstream of caspase activation. However, knock-down of eIF4G1, eIF4B, DAP5, or 4EBP1 did not affect IR-induced decline of the anti-apoptotic protein Mcl-1. Conclusion Our data shows that cap-dependent translation is regulated at several levels in response to IR. However, the experiments indicate that IR-induced Mcl-1 decline is not a consequence of translational inhibition in Jurkat cells.

Impact of initial pulse shape on the nonlinear spectral compression in optical fibre

Science.gov (United States)

Boscolo, Sonia; Chaussard, Frederic; Andresen, Esben; Rigneault, Hervé; Finot, Christophe

2018-02-01

We theoretically study the effects of the temporal intensity profile of the initial pulse on the nonlinear propagation spectral compression process arising from nonlinear propagation in an optical fibre. Various linearly chirped input pulse profiles are considered, and their dynamics is explained with the aid of time-frequency representations. While initially parabolic-shaped pulses show enhanced spectral compression compared to Gaussian pulses, no significant spectral narrowing occurs when initially super-Gaussian pulses are used. Triangular pulses lead to a spectral interference phenomenon similar to the Fresnel bi-prism experiment.

The effects of initial testing on false recall and false recognition in the social contagion of memory paradigm.

Science.gov (United States)

Huff, Mark J; Davis, Sara D; Meade, Michelle L

2013-08-01

In three experiments, participants studied photographs of common household scenes. Following study, participants completed a category-cued recall test without feedback (Exps. 1 and 3), a category-cued recall test with feedback (Exp. 2), or a filler task (no-test condition). Participants then viewed recall tests from fictitious previous participants that contained erroneous items presented either one or four times, and then completed final recall and source recognition tests. The participants in all conditions reported incorrect items during final testing (a social contagion effect), and across experiments, initial testing had no impact on false recall of erroneous items. However, on the final source-monitoring recognition test, initial testing had a protective effect against false source recognition: Participants who were initially tested with and without feedback on category-cued initial tests attributed fewer incorrect items to the original event on the final source-monitoring recognition test than did participants who were not initially tested. These data demonstrate that initial testing may protect individuals' memories from erroneous suggestions.

MINERvA - neutrino nucleus cross section experiment

CERN Multimedia

CERN. Geneva

2014-01-01

Recent results from MINERvA, a neutrino cross section experiment at Fermilab, are presented. MINERVA has the goal of providing precision results which will have important impact on oscillation experiments.  Initial data runs for muon neutrino and antineutrino beams of ~3.5 GeV have produced a large number of new results. This seminar will introduce the experiment and describe results for quasielastic, pion production, and inclusive cross sections.

Construction and Initial Validation of the Multiracial Experiences Measure (MEM)

Science.gov (United States)