WorldWideScience

Sample records for surgical grand rounds

  1. Clinical physiology grand rounds.

    Science.gov (United States)

    Richards, Jeremy; Schwartzstein, Richard; Irish, Julie; Almeida, Jacqueline; Roberts, David

    2013-04-01

    Clinical Physiology Grand Rounds (CPGR) is an interactive, case-based conference for medical students designed to: (1) integrate preclinical and clinical learning; (2) promote inductive clinical reasoning; and (3) emphasise students as peer teachers. CPGR specifically encourages mixed learning level student interactions and emphasises the use of concept mapping. We describe the theoretical basis and logistical considerations for an interactive, integrative, mixed-learner environment such as CPGR. In addition, we report qualitative data regarding students' attitudes towards and perceptions of CPGR. Medical students from first to fourth year participate in a monthly, interactive conference. The CPGR was designed to bridge gaps and reinforce linkages between basic science and clinical concepts, and to incorporate interactive vertical integration between preclinical and clinical students. Medical education and content experts use Socratic, interactive teaching methods to develop real-time concept maps to emphasise the presence and importance of linkages across curricula. Student focus groups were held to assess attitudes towards and perceptions of the mixed-learner environment and concept maps in CPGR. Qualitative analyses of focus group transcripts were performed to develop themes and codes describing the students' impressions of CPGR. CPGR is a case-based, interactive conference designed to help students gain an increased appreciation of linkages between basic science and clinical medicine concepts, and an increased awareness of clinical reasoning thought processes. Success is dependent upon explicit attention being given to goals for students' integrated learning. © Blackwell Publishing Ltd 2013.

  2. Integrated telemedicine workstation for intercontinental grand rounds

    Science.gov (United States)

    Willis, Charles E.; Leckie, Robert G.; Brink, Linda; Goeringer, Fred

    1995-04-01

    The Telemedicine Spacebridge to Moscow was a series of intercontinental sessions sponsored jointly by NASA and the Moscow Academy of Medicine. To improve the quality of medical images presented, the MDIS Project developed a workstation for acquisition, storage, and interactive display of radiology and pathology images. The workstation was based on a Macintosh IIfx platform with a laser digitizer for radiographs and video capture capability for microscope images. Images were transmitted via the Russian Lyoutch Satellite which had only a single video channel available and no high speed data channels. Two workstations were configured -- one for use at the Uniformed Services University of Health Sciences in Bethesda, MD. and the other for use at the Hospital of the Interior in Moscow, Russia. The two workstations were used may times during 16 sessions. As clinicians used the systems, we modified the original configuration to improve interactive use. This project demonstrated that numerous acquisition and output devices could be brought together in a single interactive workstation. The video images were satisfactory for remote consultation in a grand rounds format.

  3. Clinical Immersion and Biomedical Engineering Design Education: "Engineering Grand Rounds".

    Science.gov (United States)

    Walker, Matthew; Churchwell, André L

    2016-03-01

    Grand Rounds is a ritual of medical education and inpatient care comprised of presenting the medical problems and treatment of a patient to an audience of physicians, residents, and medical students. Traditionally, the patient would be in attendance for the presentation and would answer questions. Grand Rounds has evolved considerably over the years with most sessions being didactic-rarely having a patient present (although, in some instances, an actor will portray the patient). Other members of the team, such as nurses, nurse practitioners, and biomedical engineers, are not traditionally involved in the formal teaching process. In this study we examine the rapid ideation in a clinical setting to forge a system of cross talk between engineers and physicians as a steady state at the praxis of ideation and implementation.

  4. A Nurse-Led Innovation in Education: Implementing a Collaborative Multidisciplinary Grand Rounds.

    Science.gov (United States)

    Matamoros, Lisa; Cook, Michelle

    2017-08-01

    Multidisciplinary grand rounds provides an opportunity to promote excellence in patient care through scholarly presentations and interdisciplinary collaboration with an innovative approach. In addition, multidisciplinary grand rounds serves to recognize expertise of staff, mentor and support professional development, and provide a collaborative environment across all clinical disciplines and support services. This article describes a process model developed by nurse educators for implementing a multidisciplinary grand rounds program. The components of the process model include topic submissions, coaching presenters, presentations, evaluations, and spreading the work. This model can be easily implemented at any organization. J Contin Educ Nurs. 2017;48(8):353-357. Copyright 2017, SLACK Incorporated.

  5. Reviving post-take surgical ward round teaching.

    Science.gov (United States)

    Force, Jade; Thomas, Ian; Buckley, Frances

    2014-04-01

    Learning in the clinical environment is an important feature of medical education. Ward-round teaching leads to relevant, applied and lasting learning of knowledge, skills and attitudes; however, on fast-paced ward rounds in specialties such as general surgery, the student experience is often suboptimal, and teaching can be overlooked. Clinical teaching fellows (CTFs) are postgraduate doctors ranging from foundation year-2 (FY2) level through to specialty trainees, who have elected to spend up to 2 years out of the programme to teach medical undergraduates. This article explores whether CTFs can successfully support the regular delivery of undergraduate medical teaching on the busy post-take surgical ward round (PTSWR). The CTFs at Raigmore Hospital, Inverness, planned and facilitated weekly, structured teaching sessions to accompany the PTSWR. This educational intervention was evaluated using pre- and post-intervention student questionnaires. The questionnaires focused on student enjoyment and depth of learning using Likert scales and free-text components. Students were also asked about barriers to learning on typical PTSWRs. The consultant surgeons leading on these rounds were issued separate questionnaires, to gauge their evaluation of CTF support. The main barrier to effective undergraduate ward round teaching was a lack of time on the part of clinical staff. Ward rounds accompanied by CTF support significantly increased student enjoyment (p student satisfaction, and was welcomed by clinical staff. CTF support could be widened to other busy ward rounds, e.g. acute medical takes, to enhance student learning and reduce the teaching burden on clinical faculty staff. © 2014 John Wiley & Sons Ltd.

  6. Multicultural Grand Rounds: Competency-Based Training Model for Clinical Psychology Graduate Students

    Science.gov (United States)

    Stites, Shana D.; Warholic, Christina L.

    2014-01-01

    Preparing students to enter the field of psychology as competent professionals requires that multicultural practices be infused into all areas of training. This article describes how the Grand Rounds model was adapted to a graduate clinical psychology training program to foster applied learning in multicultural competence. This extension of Grand…

  7. Learners' decisions for attending Pediatric Grand Rounds: a qualitative and quantitative study

    Directory of Open Access Journals (Sweden)

    Zuckerman Grace

    2006-04-01

    Full Text Available Abstract Background Although grand rounds plays a major educational role at academic medical centers, there has been little investigation into the factors influencing the learners' decision to attend. Greater awareness of attendees' expectations may allow grand rounds planners to better accommodate the learners' perspective, potentially making continuing education activities more attractive and inviting. Methods We used both qualitative (part A and quantitative (part B techniques to investigate the motivators and barriers to grand rounds attendance. Part A investigated contextual factors influencing attendance as expressed through attendee interviews. Transcripts of the interviews were analyzed using grounded theory techniques. We created a concept map linking key factors and their relationships. In part B we quantified the motivators and barriers identified during the initial interviews through a survey of the grand rounds audience. Results Sixteen persons voluntarily took part in the qualitative study (part A by participating in one of seven group interview sessions. Of the 14 themes that emerged from these sessions, the most frequent factors motivating attendance involved competent practice and the need to know. All sessions discussed intellectual stimulation, social interaction, time constraints and convenience, licensure, content and format, and absence of cost for attending sessions. The 59 respondents to the survey (part B identified clinically-useful topics (85%, continuing education credit (46%, cutting-edge research (27%, networking (22%, and refreshments (8% as motivators and non-relevant topics (44% and too busy to attend (56% as barriers. Conclusion Greater understanding of the consumers' perspective can allow planners to tailor the style, content, and logistics to make grand rounds more attractive and inviting.

  8. Robot Assisted Surgical Ward Rounds: Virtually Always There

    Directory of Open Access Journals (Sweden)

    Stefanie M. Croghan

    2018-05-01

    Full Text Available Background:  While an explosion in technological sophistication has revolutionized surgery within the operating theatre, delivery of surgical ward-based care has seen little innovation.  Use of telepresence allowing off-site clinicians communicate with patients has been largely restricted to outpatient settings or use of complex, expensive, static devices.  We designed a prospective study to ascertain feasibility and face validity of a remotely controlled mobile audiovisual drone (LUCY to access inpatients.  This device is, uniquely, lightweight, freely mobile and emulates ‘human’ interaction by swiveling and adjusting height to patients’ eye-level.     Methods: Robot-assisted ward rounds(RASWR were conducted over 3 months. A remotely located consultant surgeon communicated with patients/bedside teams via encrypted audiovisual telepresence robot (DoubleRoboticstm, California USA.  Likert-scale satisfaction questionnaires, incorporating free-text sections for mixed-methods data collection, were disseminated to patient and staff volunteers following RASWRs.  The same cohort completed a linked questionnaire following conventional (gold-standard rounds, acting as control group. Data were paired, and non-parametric analysis performed.     Results: RASWRs are feasible (>90% completed without technical difficulty. The RASWR(n=52 observations demonstrated face validity with strong correlations (r>0.7; Spearman, p-value <0.05 between robotic and conventional ward rounds among patients and staff on core themes, including dignity/confidentiality/communication/satisfaction with management plan. Patients (96.08%, n=25 agreed RASWR were a satisfactory alternative when consultant physical presence was not possible. There was acceptance of nursing/NCHD cohort (100% (n=11 willing to regularly partake in RASWR.    Conclusion: RASWRs receive high levels of patient and staff acceptance, and offer a valid alternative to conventional ward rounds

  9. Robot Assisted Surgical Ward Rounds: Virtually Always There.

    Science.gov (United States)

    Croghan, Stefanie M; Carroll, Paul; Reade, Sarah; Gillis, Amy E; Ridgway, Paul F

    2018-05-02

     While an explosion in technological sophistication has revolutionized surgery within the operating theatre, delivery of surgical ward-based care has seen little innovation.  Use of telepresence allowing off-site clinicians communicate with patients has been largely restricted to outpatient settings or use of complex, expensive, static devices.  We designed a prospective study to ascertain feasibility and face validity of a remotely controlled mobile audiovisual drone (LUCY) to access inpatients.  This device is, uniquely, lightweight, freely mobile and emulates 'human' interaction by swiveling and adjusting height to patients' eye-level.   METHODS: Robot-assisted ward rounds(RASWR) were conducted over 3 months. A remotely located consultant surgeon communicated with patients/bedside teams via encrypted audiovisual telepresence robot (DoubleRoboticstm, California USA).  Likert-scale satisfaction questionnaires, incorporating free-text sections for mixed-methods data collection, were disseminated to patient and staff volunteers following RASWRs.  The same cohort completed a linked questionnaire following conventional (gold-standard) rounds, acting as control group. Data were paired, and non-parametric analysis performed.  RESULTS: RASWRs are feasible (>90% completed without technical difficulty). The RASWR(n=52 observations) demonstrated face validity with strong correlations (r>0.7; Spearman, p-value <0.05) between robotic and conventional ward rounds among patients and staff on core themes, including dignity/confidentiality/communication/satisfaction with management plan. Patients (96.08%, n=25) agreed RASWR were a satisfactory alternative when consultant physical presence was not possible. There was acceptance of nursing/NCHD cohort (100% (n=11) willing to regularly partake in RASWR).  CONCLUSION: RASWRs receive high levels of patient and staff acceptance, and offer a valid alternative to conventional ward rounds when a consultant cannot be

  10. Does Self-Assessment Improve the Effectiveness of Grand Rounds Lectures in a Community-Based Teaching Hospital?

    Science.gov (United States)

    Winton, Lisa M; Ferguson, Elizabeth M N; Hsu, Chiu-Hsieh; Agee, Neal; Eubanks, Ryan D; O'Neill, Patrick J; Goldberg, Ross F; Kopelman, Tammy R; Nodora, Jesse N; Caruso, Daniel M; Komenaka, Ian K

    To determine whether use of self-assessment (SA) questions affects the effectiveness of weekly didactic grand rounds presentations. From 26 consecutive grand rounds presentations from August 2013 to April 2014, a 52-question multiple-choice test was administered based on 2 questions from each presentation. Community teaching institution. General surgery residents, students, and attending physicians. The test was administered to 66 participants. The mean score was 41.8%. There was no difference in test score based on experience with similar scores for junior residents, senior residents, and attending surgeons (43%, 46%, and 44%; p = 0.13). Most participants felt they would be most interested in presentations directly related to their surgical specialty. Participants, however, did not score differently on topics which were the focus of the program (40% vs. 42%; p = 0.85). Journal club presentations (39% vs. others 42%; p = 0.33) also did not affect the score. The Pearson correlation coefficient for attendance was 0.49 (p < 0.0001) demonstrated that attendance was very important. Participation in the weekly SA was significantly associated with improved score as those who participated in SA scored over 20% higher than those who did not (59% vs. 38%; p < 0.0001). Based on multiple linear regression for mean score, SA explained the variation in score more than attendance. The current study found that without preparation approximately 40% of material presented is retained after 10 months. Participation in weekly SA significantly improved retention of information from grand rounds presentations. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  11. Implementing Patient Family-Centered Care Grand Rounds Using Patient/Family Advisor Narratives

    Directory of Open Access Journals (Sweden)

    Maureen B Fagan DNP, MHA, FNP-BC

    2015-11-01

    Full Text Available With the emerging trend of patient family–centered care in health care, it is essential that physicians be exposed to patient and family perspectives of care during medical education and training. Grand Rounds provides an ideal format for physicians to learn about patient family–centered care. At Brigham and Women’s Hospital, we sought to bring the voice of the patient to Patient Family–Centered Grand Rounds in order to expose clinicians to rich narratives describing the medical care received by patients/families and to ultimately change physician practice to reflect patient family–centered principles. We conducted a clinician survey and found promising results indicating that patient/family narratives can be effective at educating physicians about patient family–centered care.

  12. Diagnostic grand rounds: A new teaching concept to train diagnostic reasoning

    International Nuclear Information System (INIS)

    Stieger, Stefan; Praschinger, Andrea; Kletter, Kurt; Kainberger, Franz

    2011-01-01

    Introduction: Diagnostic reasoning is a core skill in teaching and learning in undergraduate curricula. Diagnostic grand rounds (DGRs) as a subform of grand rounds are intended to train the students' skills in the selection of appropriate tests and in the interpretation of test results. The aim of this study was to test DGRs for their ability to improve diagnostic reasoning by using a pre-post-test design. Methods: During one winter term, all 398 fifth-year students (36.1% male, 63.9% female) solved 23 clinical cases presented in 8 DGRs. In an online questionnaire, a Diagnostic Thinking Inventory (DTI) with 41 items was evaluated for flexibility in thinking and structure of knowledge in memory. Results were correlated with those from a summative multiple-choice knowledge test and of the learning objectives in a logbook. Results: The students' DTI scores in the post-test were significantly higher than those reported in the pre-test. DTI scores at either testing time did not correlate with medical knowledge as assessed by a multiple-choice knowledge test. Abilities acquired during clinical clerkships as documented in a logbook could only account for a small proportion of the increase in the flexibility subscale score. This effect still remained significant after accounting for potential confounders. Conclusion: Establishing DGRs proofed to be an effective way of successfully improving both students' diagnostic reasoning and the ability to select the appropriate test method in routine clinical practice.

  13. Diagnostic grand rounds: A new teaching concept to train diagnostic reasoning

    Energy Technology Data Exchange (ETDEWEB)

    Stieger, Stefan, E-mail: stefan.stieger@univie.ac.at [Department of Basic Psychological Research, School of Psychology, University of Vienna, Liebiggasse 5, A-1010 Vienna (Austria); Praschinger, Andrea, E-mail: andrea.praschinger@meduniwien.ac.at [Core Unit for Medical Education (BEMAW), Medical University of Vienna, Spitalgasse 23, BT87, P.O. 10, A-1097 Vienna (Austria); Kletter, Kurt, E-mail: kurt.kletter@meduniwien.ac.at [Department of Nuclear Medicine, General Hospital of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Kainberger, Franz, E-mail: franz.kainberger@meduniwien.ac.at [Department of Radiology, General Hospital of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    2011-06-15

    Introduction: Diagnostic reasoning is a core skill in teaching and learning in undergraduate curricula. Diagnostic grand rounds (DGRs) as a subform of grand rounds are intended to train the students' skills in the selection of appropriate tests and in the interpretation of test results. The aim of this study was to test DGRs for their ability to improve diagnostic reasoning by using a pre-post-test design. Methods: During one winter term, all 398 fifth-year students (36.1% male, 63.9% female) solved 23 clinical cases presented in 8 DGRs. In an online questionnaire, a Diagnostic Thinking Inventory (DTI) with 41 items was evaluated for flexibility in thinking and structure of knowledge in memory. Results were correlated with those from a summative multiple-choice knowledge test and of the learning objectives in a logbook. Results: The students' DTI scores in the post-test were significantly higher than those reported in the pre-test. DTI scores at either testing time did not correlate with medical knowledge as assessed by a multiple-choice knowledge test. Abilities acquired during clinical clerkships as documented in a logbook could only account for a small proportion of the increase in the flexibility subscale score. This effect still remained significant after accounting for potential confounders. Conclusion: Establishing DGRs proofed to be an effective way of successfully improving both students' diagnostic reasoning and the ability to select the appropriate test method in routine clinical practice.

  14. Medical and surgical ward rounds in teaching hospitals of Kuwait University: students’ perceptions

    Directory of Open Access Journals (Sweden)

    AlMutar S

    2013-09-01

    Full Text Available Sara AlMutar,1 Lulwa AlTourah,1 Hussain Sadeq,2 Jumanah Karim,2 Yousef Marwan3 1Department of Medicine, 2Department of Pediatrics, Mubarak Al-Kabeer Hospital, 3Department of Orthopedic Surgery, Al-Razi Orthopedic Hospital, Kuwait City, Kuwait Background: Teaching sessions for medical students during ward rounds are an essential component of bedside teaching, providing students with the opportunity to regard patients as actual people, and to observe their physical conditions directly, allowing a better understanding of illnesses to be developed. We aim to explore medical students’ perceptions regarding medical and surgical ward rounds within the Faculty of Medicine at Kuwait University, and to evaluate whether this teaching activity is meeting the expectation of learners. Methods: A pretested questionnaire was used to collect data from 141 medical students during the 2012–2013 academic year. They were asked to provide their current and expected ratings about competencies that were supposed to be gained during ward rounds, on a scale from 1 (lowest to 5 (highest. Mean scores were calculated, and the Student t-test was used to compare results. P < 0.05 was the cut-off level for significance. Results: Only 17 students (12.1% declined to participate in the study. The students' current competency scores (for competencies taught within both disciplines – medical and surgical were significantly lower than the scores indicating students’ expectations (P < 0.001. The best-taught competency was bedside examination, in both medical (mean: 3.45 and surgical (mean: 3.05 ward rounds. However, medical ward rounds were better than surgical rounds in covering some competencies, especially the teaching of professional attitude and approach towards patients (P < 0.001. Conclusion: Both medical and surgical ward rounds were deficient in meeting the students’ expectations. Medical educators should utilize the available literature to improve the bedside

  15. Hosting an eConference: Interactive video conference grand rounds between two institutions

    Directory of Open Access Journals (Sweden)

    Jeffrey Rixe

    2018-01-01

    Full Text Available Audience: The eConference is an interactive video conference grand rounds innovation to augment the didactic curriculum provided for medical students, interns, residents, fellows, and attending physicians. Introduction: Formal education during emergency medicine (EM training has historically emphasized aspects of humanism and constructivism; the former through self-directed reading in books and journals, the latter through the content and discussion during resident didactics.1 However, some studies suggest that the current generation of EM learners are increasingly using digital and internet technologies to connect with online peer networks, a phenomenon known as connectivism.2 As such, contemporary EM learners are increasingly utilizing social media and Free Open Access Medical Education (FOAM to supplement traditional learning resources. The eConference was developed to be an interactive, virtual grand rounds that marries the merits of constructivism with connectivism; a new format of EM didactics that goes beyond the “typical lecture” model to incorporate the changing landscape in technology and medical education by combining classroom teaching at multiple institutions alongside digital learning tools. This manuscript outlines how to plan and execute a joint video conference with another institution. Objectives: Our objectives were to create and implement a novel virtual conference format through the integration of social media tools which allows for interdisciplinary and multi-site participation to enhance EM resident education. We wish to outline the steps required to reproduce this innovative session and share lessons learned. Conclusion: We designed and executed a multi-centered, novel form of virtual conference into the EM residency curriculum at two participating institutions. The virtual conference took place during a routine conference day for both programs, an hour in duration. The format utilized a hybrid of live and virtual

  16. Speaker Introductions at Internal Medicine Grand Rounds: Forms of Address Reveal Gender Bias.

    Science.gov (United States)

    Files, Julia A; Mayer, Anita P; Ko, Marcia G; Friedrich, Patricia; Jenkins, Marjorie; Bryan, Michael J; Vegunta, Suneela; Wittich, Christopher M; Lyle, Melissa A; Melikian, Ryan; Duston, Trevor; Chang, Yu-Hui H; Hayes, Sharonne N

    2017-05-01

    Gender bias has been identified as one of the drivers of gender disparity in academic medicine. Bias may be reinforced by gender subordinating language or differential use of formality in forms of address. Professional titles may influence the perceived expertise and authority of the referenced individual. The objective of this study is to examine how professional titles were used in the same and mixed-gender speaker introductions at Internal Medicine Grand Rounds (IMGR). A retrospective observational study of video-archived speaker introductions at consecutive IMGR was conducted at two different locations (Arizona, Minnesota) of an academic medical center. Introducers and speakers at IMGR were physician and scientist peers holding MD, PhD, or MD/PhD degrees. The primary outcome was whether or not a speaker's professional title was used during the first form of address during speaker introductions at IMGR. As secondary outcomes, we evaluated whether or not the speakers professional title was used in any form of address during the introduction. Three hundred twenty-one forms of address were analyzed. Female introducers were more likely to use professional titles when introducing any speaker during the first form of address compared with male introducers (96.2% [102/106] vs. 65.6% [141/215]; p form of address 97.8% (45/46) compared with male dyads who utilized a formal title 72.4% (110/152) of the time (p = 0.007). In mixed-gender dyads, where the introducer was female and speaker male, formal titles were used 95.0% (57/60) of the time. Male introducers of female speakers utilized professional titles 49.2% (31/63) of the time (p addressed by professional title than were men introduced by men. Differential formality in speaker introductions may amplify isolation, marginalization, and professional discomfiture expressed by women faculty in academic medicine.

  17. Development of an adhesive surgical ward round checklist: a technique to improve patient safety.

    LENUS (Irish Health Repository)

    Dhillon, P

    2012-02-01

    Checklists have been shown to improve patient outcomes. Checklist use is seen in the pre-operative to post-operative phases of the patient pathway. An adhesive checklist was developed for ward rounds due to the positive impact it could have on improving patient safety. Over an eight day period data were collected from five consultant-led teams that were randomly selected from the surgical department and divided into sticker groups and control groups. Across the board percentage adherence to the Good Surgical Practice Guidelines (GSPG) was markedly higher in the sticker study group, 1186 (91%) in comparison with the control group 718 (55%). There was significant improvement of documentation across all areas measured. An adhesive checklist for ward round note taking is a simple and cost-effective way to improve documentation, communication, hand-over, and patient safety. Successfully implemented in a tertiary level centre in Dublin, Ireland it is easily transferable to other surgical departments globally.

  18. Education Research: An exploration of case-based learning in neuroscience grand rounds using the Delphi technique.

    Science.gov (United States)

    Rigby, Heather; Schofield, Susie; Mann, Karen; Benstead, Timothy

    2012-07-17

    Neuroscience grand rounds (NSGR) is a key educational exercise in most academic medical centers. Despite its importance, there are few published studies evaluating the manner in which it is conducted. Our objective was to obtain consensus opinion from staff neurologists, neurosurgeons, neuroradiologists, and neuropathologists on the features that best characterize a highly educational NSGR. Using the Delphi technique, multiple rounds of questionnaires were presented to a panel of neurologists, neurosurgeons, neuropathologists, and neuroradiologists. The anonymous responses were analyzed and fed back to participants. Each round, the participants were given the opportunity to react to collective opinion by changing their response or by presenting arguments in favor or against the item in question. We found that support for NSGR in its present form is high and that particularly strong support exists for 1) case-based rounds, 2) high level of audience interaction, 3) resident participation in case presentation and analysis, 4) formal training for residents in leading case-based presentations, and 5) resident feedback and evaluation. Our results offer centers that use a case-based format for NSGR with guidance to maximize the important learning opportunity that it provides. We provide an organized evaluation of expert opinion on how this important educational exercise should be conducted. The results expose some fresh insights into traditional values in medical education.

  19. Statistical grand rounds: understanding the mechanism: mediation analysis in randomized and nonrandomized studies.

    Science.gov (United States)

    Mascha, Edward J; Dalton, Jarrod E; Kurz, Andrea; Saager, Leif

    2013-10-01

    In comparative clinical studies, a common goal is to assess whether an exposure, or intervention, affects the outcome of interest. However, just as important is to understand the mechanism(s) for how the intervention affects outcome. For example, if preoperative anemia was shown to increase the risk of postoperative complications by 15%, it would be important to quantify how much of that effect was due to patients receiving intraoperative transfusions. Mediation analysis attempts to quantify how much, if any, of the effect of an intervention on outcome goes though prespecified mediator, or "mechanism" variable(s), that is, variables sitting on the causal pathway between exposure and outcome. Effects of an exposure on outcome can thus be divided into direct and indirect, or mediated, effects. Mediation is claimed when 2 conditions are true: the exposure affects the mediator and the mediator (adjusting for the exposure) affects the outcome. Understanding how an intervention affects outcome can validate or invalidate one's original hypothesis and also facilitate further research to modify the responsible factors, and thus improve patient outcome. We discuss the proper design and analysis of studies investigating mediation, including the importance of distinguishing mediator variables from confounding variables, the challenge of identifying potential mediators when the exposure is chronic versus acute, and the requirements for claiming mediation. Simple designs are considered, as well as those containing multiple mediators, multiple outcomes, and mixed data types. Methods are illustrated with data collected by the National Surgical Quality Improvement Project (NSQIP) and utilized in a companion paper which assessed the effects of preoperative anemic status on postoperative outcomes.

  20. Information transfer and communication during the morning rounds in surgical departments: an observational study on the use of SBAR.

    NARCIS (Netherlands)

    Merten, H.; Langelaan, M.; Wagner, C.

    2013-01-01

    Objectives: To study the structure and completeness of the information transfer between nurses and physicians during the morning rounds on surgical wards after the implementation of the SBAR-communication tool. Methods: in collaboration with the care professionals, we adjusted the SBAR-tool

  1. Impact of near-peer teaching rounds on student satisfaction in the basic surgical clerkship.

    Science.gov (United States)

    Lin, Joseph A; Farrow, Norma; Lindeman, Brenessa M; Lidor, Anne O

    2017-06-01

    Teaching rounds are rarely featured in the surgery clerkship. Senior students interested in surgery are suited to precept teaching rounds. Near-peer teaching can provide benefits to both learners and preceptors. Near-peer teaching rounds consisted of senior student-precetors leading groups of 3 clerkship students on teaching rounds once during the clerkship. We prospectively surveyed student satisfaction before and after instituting near-peer teaching rounds. We retrospectively gathered qualitative narratives from student-preceptors. The survey response rate was 93% before near-peer teaching rounds were instituted and 85% after. Satisfaction with the learning environment and the quality and amount of small-group teaching were significantly higher after the institution of near-peer teaching rounds (P ≤ .001 for all 3). Satisfaction with the overall clerkship and baseline interest in surgery were not significantly different. Student-preceptors reported gaining valuable experience for future roles in academia as residents and attending surgeons. Student satisfaction with small-group teaching and the learning environment increased after the institution of near-peer teaching rounds in the surgery clerkship. Student-preceptors gained early experience for careers in academic surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. A report on the current status of grand rounds in radiology residency programs in the United States.

    Science.gov (United States)

    Yablon, Corrie M; Wu, Jim S; Slanetz, Priscilla J; Eisenberg, Ronald L

    2011-12-01

    A national needs assessment of radiology program directors was performed to characterize grand rounds (GR) programs, assess the perceived educational value of GR programs, and determine the impact of the recent economic downturn on GR. A 28-question survey was developed querying the organizational logistics of GR programs, types of speakers, content of talks, honoraria, types of speakers invited, response to the economic downturn, types of speaker interaction with residents, and perceived educational value of GR. Questions were in multiple-choice, yes-or-no, and five-point Likert-type formats. The survey was distributed to the program directors of all radiology residencies within the United States. Fifty-seven of 163 programs responded, resulting in a response rate of 36%. Thirty-eight programs (67%) were university residencies and 10 (18%) were university affiliated. Eighty-two percent of university and 60% of university-affiliated residencies had their own GR programs, while only 14% of community and no military residencies held GR. GR were held weekly in 18% of programs, biweekly in 8%, monthly in 42%, bimonthly in 16%, and less frequently than every 2 months in 16%. All 38 programs hosting GR reported a broad spectrum of presentations, including talks on medical education (66%), clinical and evidence-based medicine (55%), professionalism (45%), ethics (45%), quality assurance (34%), global health (26%), and resident presentations (26%). All programs invited speakers from outside the institution, but there was variability with regard to the frequency of visits and whether invited speakers were from out of town. As a result of recent economic events, one radiology residency (3%) completely canceled its GR program. Others decreased the number of speakers from outside their cities (40%) or decreased the number of speakers from within their own cities (16%). Honoraria were paid to speakers by 95% of responding programs. Most program directors (79%) who had their own

  3. Congenital oval or round window anomaly with or without abnormal facial nerve course: surgical results for 15 ears.

    Science.gov (United States)

    Thomeer, Henricus; Kunst, Henricus; Verbist, Berit; Cremers, Cor

    2012-07-01

    To describe the audiometric results in a consecutive series of patients with congenital ossicular aplasia (Class 4a) or dysplasia of the oval and/or round window (Class 4b), which might include a possible anomalous course of the facial nerve. Retrospective chart study. Tertiary referral center. A tertiary referral center study with a total of 14 patients with congenital minor ear anomalies as part of a consecutive series (n = 89) who underwent exploratory tympanotomies (15 ears). Audiometric results. In 8 of 15 ears, ossicular reconstruction was attempted. In the short term (1 mo), there was a serviceable hearing outcome (air-bone gap closure to within 25 dB) in 4 ears. However, the long-term results showed deterioration because of an increased air-bone gap in all but 1 ear. No facial nerve lesion was observed postoperatively. Congenital dysplasia or aplasia of the oval and/or round window is an uncommon congenital minor ear anomaly. Classical microsurgical opportunities are rare in this group of anomalies. Newer options for hearing rehabilitation, such as the osseointegrated passive bone conduction devices, have become viable alternatives for conventional air conduction hearing devices. In the near future, upcoming active bone conduction devices might become the most preferred surgical option. In cases in which the facial nerve is only partially overlying the oval window, a type of malleostapedotomy procedure might result in a serviceable postoperative hearing level.

  4. Peer-to-peer nursing rounds and hospital-acquired pressure ulcer prevalence in a surgical intensive care unit: a quality improvement project.

    Science.gov (United States)

    Kelleher, Alyson Dare; Moorer, Amanda; Makic, MaryBeth Flynn

    2012-01-01

    We conducted a quality improvement project in order to evaluate the effect of nurse-to-nurse bedside "rounding" as a strategy to decrease hospital-acquired pressure ulcers (HAPU) in a surgical intensive care unit. We instituted weekly peer-to-peer bedside skin rounds in a 17-bed surgical intensive care unit. Two nurses were identified as skin champions and trained by the hospital's certified WOC nurse to conduct skin rounds. The skin champion nurses conducted weekly peer-to-peer rounds that included discussions about key elements of our patients' skin status including current Braden Scale for Pressure Sore Risk score, and implementation of specific interventions related to subscale risk assessment. If a pressure ulcer was present, the current action plan was reevaluated for effectiveness. Quarterly HAPU prevalence studies were conducted from January 2008 to December 2010. Nineteen patients experienced a HAPU: 17 were located on the coccyx and 2 on the heel. Ten ulcers were classified as stage II, 3 PU were stage IV, 5 were deemed unstageable, and 1 was classified as a deep tissue injury. The frequency of preventive interventions rose during our quality improvement project. Specifically, the use of prevention surfaces increased 92%, repositioning increased 30%, nutrition interventions increased 77%, and moisture management increased 100%. Prior to focused nursing rounds, the highest HAPU prevalence rate was 27%. After implementing focused nursing rounds, HAPU rates trended down and were 0% for 3 consecutive quarters.

  5. The impact of round window vs cochleostomy surgical approaches on interscalar excursions in the cochlea: Preliminary results from a flat-panel computed tomography study

    Directory of Open Access Journals (Sweden)

    Nicole T. Jiam

    2016-09-01

    Full Text Available Objective: To evaluate incidence of interscalar excursions between round window (RW and cochleostomy approaches for cochlear implant (CI insertion. Methods: This was a retrospective case-comparison. Flat-panel CT (FPCT scans for 8 CI users with Med-El standard length electrode arrays were collected. Surgical technique was identified by a combination of operative notes and FPCT imaging. Four cochleae underwent round window insertion and 4 cochleae underwent cochleostomy approaches anterior and inferior to the round window. Results: In our pilot study, cochleostomy approaches were associated with a higher likelihood of interscalar excursion. Within the cochleostomy group, we found 29% of electrode contacts (14 of 48 electrodes to be outside the scala tympani. On the other hand, 8.5% of the electrode contacts (4 of 47 electrodes in the round window insertion group were extra-scalar to the scala tympani. These displacements occurred at a mean angle of occurrence of 364° ± 133°, near the apex of the cochlea. Round window electrode displacements tend to localize at angle of occurrences of 400° or greater. Cochleostomy electrodes occurred at an angle of occurrence of 19°–490°. Conclusions: Currently, the optimal surgical approach for standard CI electrode insertion is highly debated, to a certain extent due to a lack of post-operative assessment of intracochlear electrode contact. Based on our preliminary findings, cochleostomy approach is associated with an increased likelihood of interscalar excursions, and these findings should be further evaluated with future prospective studies. Keywords: Cochlear implantation, Round window insertion, Cochleostomy, Interscalar excursion, Electrode position, Flat-panel computed tomography, Surgical approach

  6. Grand Rounds in Pediatric Nephrology

    African Journals Online (AJOL)

    Centre for Kidney Research, The Children's Hospital at Westmead, Locked Bag 4001, ... Keywords nephrotic syndrome; infection; prednisolone; ... (urine protein on dipstick zero or trace) and cease. .... upper respiratory tract infection reduced the risk for relapse ... the most important predictor for kidney survival in SSNS is.

  7. Congenital oval or round window anomaly with or without abnormal facial nerve course: surgical results for 15 ears.

    NARCIS (Netherlands)

    Thomeer, H.G.; Kunst, H.P.; Verbist, B.M.; Cremers, C.W.R.J.

    2012-01-01

    OBJECTIVES: To describe the audiometric results in a consecutive series of patients with congenital ossicular aplasia (Class 4a) or dysplasia of the oval and/or round window (Class 4b), which might include a possible anomalous course of the facial nerve. STUDY DESIGN: Retrospective chart study.

  8. The Effect of Round Window vs Cochleostomy Surgical Approaches on Cochlear Implant Electrode Position: A Flat-Panel Computed Tomography Study.

    Science.gov (United States)

    Jiam, Nicole T; Jiradejvong, Patpong; Pearl, Monica S; Limb, Charles J

    2016-09-01

    The round window insertion (RWI) and cochleostomy approaches are the 2 most common surgical techniques used in cochlear implantation (CI). However, there is no consensus on which approach is ideal for electrode array insertion, in part because visualization of intracochlear electrode position is challenging, so postoperative assessment of intracochlear electrode contact is lacking. To measure and compare electrode array position between RWI and cochleostomy approaches for CI insertion. Retrospective case-comparison study of 17 CI users with Med-El standard-length electrode arrays who underwent flat-panel computed tomography scans after CI surgery at a tertiary referral center. The data was analyzed in October 2015. Flat-panel computed tomography scans were collected between January 1 and August 31, 2013, for 22 electrode arrays. The surgical technique was identified by a combination of operative notes and imaging. Eight cochleae underwent RWI and 14 cochleae underwent cochleostomy approaches anterior and inferior to the round window. Interscalar electrode position and electrode centroid distance to the osseous spiral lamina, lateral bony wall, and central axis of the modiolus. Nine participants were men, and 8, women; the mean age was 54.4 (range, 21-64) years. Electrode position was significantly closer to cochlear neural elements with RWI than cochleostomy approaches. Between the 2 surgical approaches, the RWI technique produced shorter distances between the electrode and the modiolus (mean difference, -0.33 [95% CI, -0.29 to -0.39] mm in the apical electrode; -1.42 [95% CI, -1.24 to -1.57] mm in the basal electrode). This difference, which was most prominent in the first third and latter third of the basal turn, decreased after the basal turn. The RWI approach was associated with an increased likelihood of perimodiolar placement. Opting to use RWI over cochleostomy approaches in CI candidates may position electrodes closer to cochlear neural substrates and

  9. Round atelectases

    International Nuclear Information System (INIS)

    Hanke, R.; Kretzschmar, R.

    1983-01-01

    a) For several reasons Sinner's paper calls for critical remarks: His term ''Pleuroma'' for a neither pleural nor tumorous but intrapulmonary and atelectatic mass lesion lacks any anatomical and histological basis and is misleading at that because it pretends a tumor of the pleura; his statement in the summary that atelectatic pseudotumors of the lung show a tumorcell-like cytoarchitecture is surprising without being further discussed by the author; he encourages risky invasive diagnostical procedures even in cases where the radiological diagnosis of round atelectasis is unmistakable; already known radiologic features of round atelectases are presented by him as hitherto undescribed; his conceptions of the formal development of round atelectases and of their most characteristic features can not be agreed with. b) The different forms of round atelectases and their residuals are presented with tomograms and with diagrams of their formal development from our point of view. (orig.) [de

  10. CDC Grand Rounds: global tobacco control.

    Science.gov (United States)

    Asma, Samira; Song, Yang; Cohen, Joanna; Eriksen, Michael; Pechacek, Terry; Cohen, Nicole; Iskander, John

    2014-04-04

    During the 20th century, use of tobacco products contributed to the deaths of 100 million persons worldwide. In 2011, approximately 6 million additional deaths were linked to tobacco use, the world's leading underlying cause of death, responsible for more deaths each year than human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), tuberculosis, and malaria combined. One third to one half of lifetime users die from tobacco products, and smokers die an average of 14 years earlier than nonsmokers. Manufactured cigarettes account for 96% of all tobacco sales worldwide. From 1880 to 2009, annual global consumption of cigarettes increased from an estimated 10 billion cigarettes to approximately 5.9 trillion cigarettes, with five countries accounting for 58% of the total consumption: China (38%), Russia (7%), the United States (5%), Indonesia (4%), and Japan (4%). Among the estimated 1 billion smokers worldwide, men outnumber women by four to one. In 14 countries, at least 50% of men smoke, whereas in more than half of these same countries, fewer than 10% of women smoke. If current trends persist, an estimated 500 million persons alive today will die from use of tobacco products. By 2030, tobacco use will result in the deaths of approximately 8 million persons worldwide each year. Yet, every death from tobacco products is preventable.

  11. Syndrome of round shadow

    International Nuclear Information System (INIS)

    Ginzburg, M.A.; Kinoshenko, Yu.T.

    1987-01-01

    Syndrome of round shadow is a traditional determination for a group of spherical, ovoid and similar volumetric formations of more than 1 cm. Differential roentgenodiagnosis of most typical diseases presented by a round shadow as well as dynamics of X-ray pattern of some round formations are presented. Radiological signs of the lung formations and similar ones in diaphragm and mediastinum thoracic wall are given. Ethiology, pathogenesis and pathomorphology of round formations, their clinical picture and investigation methods are discussed

  12. Grandes remolques

    Directory of Open Access Journals (Sweden)

    Editorial, Equipo

    1961-07-01

    Full Text Available El empleo creciente del material pesado auxiliar en la construcción de obras de ingeniería civil ha motivado la fabricación de grandes plataformas, capaces de transportar toda clase de maquinaria auxiliar. En general, este tipo de maquinaria requiere medios de transporte, pues su circulación por carreteras es lenta, obstructiva y cara, siempre que se trate de grandes distancias, caso presente en la mayoría de ocasiones en que se exige un traslado de esta maquinaria de una a otra obra.

  13. Round Ligament Varicosities During Pregnancy: Case Report

    International Nuclear Information System (INIS)

    Baek, Chang Kyu; Oh, Young Taik; Jung, Dae Chul

    2011-01-01

    There are various causes of a painful palpable mass in the groin during pregnancy. The differential diagnoses of an inguinal mass include hernia, lymphadenopathy, mesothelial cyst, cystic lymphangioma, neoplasms (lipoma, leiomyoma and sarcoma), endometriosis, embryonic remnants and round ligament varicosities. Among them, round ligament varicosities can be easily misdiagnosed as an inguinal hernia in a pregnant woman. These lesions should be managed conservatively because they resolve spontaneously during the postpartum period. Ultrasonography can help make the diagnosis of round ligament varicosities and so prevent unnecessary surgical intervention and the associated morbidity. Herein we report on a case of round ligament varicosities that presented during pregnancy and this condition was readily diagnosed via Doppler sonography

  14. Round Ligament Varicosities During Pregnancy: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Chang Kyu; Oh, Young Taik; Jung, Dae Chul [Yonsei University Health System, Seoul (Korea, Republic of)

    2011-12-15

    There are various causes of a painful palpable mass in the groin during pregnancy. The differential diagnoses of an inguinal mass include hernia, lymphadenopathy, mesothelial cyst, cystic lymphangioma, neoplasms (lipoma, leiomyoma and sarcoma), endometriosis, embryonic remnants and round ligament varicosities. Among them, round ligament varicosities can be easily misdiagnosed as an inguinal hernia in a pregnant woman. These lesions should be managed conservatively because they resolve spontaneously during the postpartum period. Ultrasonography can help make the diagnosis of round ligament varicosities and so prevent unnecessary surgical intervention and the associated morbidity. Herein we report on a case of round ligament varicosities that presented during pregnancy and this condition was readily diagnosed via Doppler sonography

  15. Grandes cocinas

    Directory of Open Access Journals (Sweden)

    García de Castro, Emilio

    1957-11-01

    Full Text Available Se describen en este artículo una serie de aparatos para grandes cocinas, vistos por los autores durante un rápido viaje por Alemania. Aprovechando los datos obtenidos se analizan brevemente las necesidades de una gran cocina moderna, comentando los planos de las instalaciones en varios hoteles o instituciones de todo el mundo. La mayoría de la información.

  16. Pediatric Round Pneumonia

    OpenAIRE

    Liu, Yen-Lin; Wu, Ping-Sheng; Tsai, Li-Ping; Tsai, Wen-Hsin

    2014-01-01

    Round pneumonia” or “spherical pneumonia” is a well-characterized clinical entity that seems to be less addressed by pediatricians in Taiwan. We herein report the case of a 7-year-old boy who presented with prolonged fever, cough, and chest X-rays showing a well-demarcated round mass measuring 5.9 × 5.6 × 4.3 cm in the left lower lung field, findings which were typical for round pneumonia. The urinary pneumococcal antigen test was positive, and serum anti-Mycoplasma pneumoniae antibody titer...

  17. Plutonium Round Robin Test

    International Nuclear Information System (INIS)

    Dudder, G.B.; Herbillon, G.H.

    2001-01-01

    Full text: The goal of nuclear forensics is to develop a preferred approach to illicit trafficking investigations. This approach must be widely understood and acceptable as credible. The principle objectives of the Round Robin Test are to prioritize the forensic techniques and methods, evaluate attribution capabilities, and examine the utility of database. The Plutonium Round Robin has made a tremendous contribution to fulfilling these goals through a collaborative learning experience that resulted from the outstanding efforts of the six participating international laboratories. A prioritize list of techniques and methods has been developed based on this exercise. Future work will focus on a Highly Enriched Round Robin and extent to which the techniques and methods can be generalized. The Plutonium Round Robin demonstrated a rather high level of capability to determine the important characteristics of the materials and processes using analytical methods. When this capability to was combined with the appropriate knowledge and database, it resulted in a demonstrated capability to attribute the source of the materials to a specific nuclear fuel, reactor, and reprocessing facility. A number of shortfalls were also identified in our current capabilities. These included alternative dating techniques. Light Water Reactor discrimination techniques, and the lack of a comprehensive network of data/knowledge bases. The result of the Round Robin will be used to develop guidelines or a 'recommended protocol' to be made available to the interested authorities and countries to use in real cases. The poster will present a summary of the results of the Plutonium Round Robin and describe the plans the subsequent Highly Enriched Uranium Round Robin Test. (author)

  18. Rounding errors in weighing

    International Nuclear Information System (INIS)

    Jeach, J.L.

    1976-01-01

    When rounding error is large relative to weighing error, it cannot be ignored when estimating scale precision and bias from calibration data. Further, if the data grouping is coarse, rounding error is correlated with weighing error and may also have a mean quite different from zero. These facts are taken into account in a moment estimation method. A copy of the program listing for the MERDA program that provides moment estimates is available from the author. Experience suggests that if the data fall into four or more cells or groups, it is not necessary to apply the moment estimation method. Rather, the estimate given by equation (3) is valid in this instance. 5 tables

  19. Boarding ICU patients: Are our rounding practices subpar?

    Science.gov (United States)

    Nunn, Andrew M; Hatchimonji, Justin S; Holena, Daniel N; Seamon, Mark J; Smith, Brian P; Kaplan, Lewis J; Martin, Niels D; Reilly, Patrick M; Schwab, C William; Pascual, Jose L

    2018-04-01

    Surgical Intensive Care Unit (SICU) patients "boarding" in ICUs other than the designated home unit have been shown to suffer increased rates of complications. We hypothesized that ICU rounding practices are different when SICU patients are housed in home vs. boarding ICUs. SICU rounds were observed at an academic quaternary medical center. Individual patient rounding time and order seen on rounds along with patient data and demographics were recorded. Multivariable regression analysis was used for comparison between patients. Non-boarders were older, observed on a later post ICU admission day and were more likely to be mechanically ventilated. Boarded patients were often seen at the end of rounds and for less time. Not being a boarder, age, APACHE II score on admission, vasopressor use, and positive pressure ventilation all predicted increased rounding time. Surgical ICU patients boarding in non-preferred units are often seen at the end of rounds, result in a greater reliance upon telephone communication, and receive less bedside attention from ICU provider teams. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Resultados da correção cirúrgica de esotropias de grande ângulo, em portadores de baixa de acuidade visual unilateral Results of surgical treatment of large angle esotropia in patients with low visual acuity

    Directory of Open Access Journals (Sweden)

    Jorge Antonio Meireles-Teixeira

    2000-10-01

    Full Text Available Objetivo: Avaliar os resultados cirúrgicos de esotropias de grande ângulo (no mínimo 60 dioptrias prismáticas - dp, associadas à baixa de acuidade visual (BAV unilateral, cuja cirurgia foi planejada com o intuito de não se operar o olho de melhor visão. Casuística e Métodos: Foram selecionados 17 casos de esotropias não-acomodativas, associadas à BAV (AV 15 dp ou rotações de ± 4. Resultados: 13 (76,4% tinham AV de conta-dedos no olho não-fixador, 2 (11,7% atingiam 0,1 e outros 2 (11,7% 0,4. Em 3 havia alta miopia (equivalente esférico > ou = -6,00 dioptrias esféricas em ambos os olhos. Entre os 17 pacientes, 12 (70,5% obtiveram bom resultado cirúrgico, 3 (17,6% foram regulares e 2 (11,7% ruins. Conclusão: A cirurgia de estrabismo sob anestesia tópica mostrou ser eficaz e segura nestes casos especiais de BAV em um dos olhos, sendo que na maioria das vezes consegue-se não operar o olho de melhor visão; o que a nosso ver, só se tornou possível pelo uso da anestesia tópica.Purpose: To evaluate the surgical outcome of large angle esotropia (minimum of 60 prism diopters -- pd associated with unilateral low visual acuity (LVA in which the surgical strategy was applied in order to operate only the non-fixating eye. Patients and Methods: We selected 17 patients with non-accommodative esotropia, LVA (VA<= 0,4 in the non-fixating eye with the better visual correction and no previous treatment. Patients were classified as good result if they had a postoperative deviation of maximally 10 pd with binocular rotations of up to --2 of medial rectus and +2 of lateral rectus. Exotropia/esotropia between 10 and 15 pd or binocular rotations of ±3 were considered as a regular outcome. Deviations greater than 15 pd or binocular rotations of ±4 were included regarded as poor results. Results: Thirteen (76.4% patients had counts fingers VA in the non-fixating eye, 2 (11.7% achieved 0.1 and another two had 0.4. Three of them were also highly

  1. Piping inspection round robin

    International Nuclear Information System (INIS)

    Heasler, P.G.; Doctor, S.R.

    1996-04-01

    The piping inspection round robin was conducted in 1981 at the Pacific Northwest National Laboratory (PNNL) to quantify the capability of ultrasonics for inservice inspection and to address some aspects of reliability for this type of nondestructive evaluation (NDE). The round robin measured the crack detection capabilities of seven field inspection teams who employed procedures that met or exceeded the 1977 edition through the 1978 addenda of the American Society of Mechanical Engineers (ASME) Section 11 Code requirements. Three different types of materials were employed in the study (cast stainless steel, clad ferritic, and wrought stainless steel), and two different types of flaws were implanted into the specimens (intergranular stress corrosion cracks (IGSCCs) and thermal fatigue cracks (TFCs)). When considering near-side inspection, far-side inspection, and false call rate, the overall performance was found to be best in clad ferritic, less effective in wrought stainless steel and the worst in cast stainless steel. Depth sizing performance showed little correlation with the true crack depths

  2. Association Between ICU Admission During Morning Rounds and Mortality

    Science.gov (United States)

    Gajic, Ognjen; Morales, Ian J.; Keegan, Mark T.; Peters, Steve G.; Hubmayr, Rolf D.

    2009-01-01

    Background: No previous study has evaluated the association between admission to ICUs during round time and patient outcome. The objective of this study was to determine the association between round-time ICU admission and patient outcome. Methods: This retrospective study included 49,844 patients admitted from October 1994 to December 2007 to four ICUs (two surgical, one medical, and one multispecialty) of an academic medical center. Of these patients, 3,580 were admitted to the ICU during round time (8:00 am to 10:59 am) and 46,264 were admitted during nonround time (from 1:00 pm to 6:00 am). The medical ICU had 24-h/7-day per week intensivist coverage during the last 2 years of the study. We compared the baseline characteristics and outcome of patients admitted to the ICU between the two groups. Data were abstracted from the acute physiology and chronic health evaluation (APACHE) III database. Results: The round-time and non-round-groups were similar in gender, ethnicity, and age. The predicted hospital mortality rate of the round time group was higher (17.4% vs 12.3% predicted, respectively; p < 0.001). The hospital length of stay was similar between the two groups. The round-time group had a higher hospital mortality rate (16.2% vs 8.8%, respectively; p < 0.001). Most of the round-time ICU admissions and deaths occurred in the medical ICU. Round-time admission was an independent risk factor for hospital death (odds ratio, 1.321; 95% CI, 1.178 to 1.481). This independent association was present for the whole study period except for the last 2 years. Conclusions: Patients admitted to the ICU during morning rounds have higher severity of illness and mortality rates. PMID:19505985

  3. The Wheels of Stress Go 'Round and 'Round

    Science.gov (United States)

    Brey, Rebecca A.; Clark, Susan E.

    2012-01-01

    "The Wheels of Stress Go Round and Round" teaching idea uses three activity wheels to reinforce stress-related content and concepts. After presenting a definition of stress, the instructor assists students in identifying stressors, and aids in formulating a list of negative, reactive behaviors and a list of positive coping mechanisms. Using…

  4. Round Earthen Towers in Zhangzhou

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    The round earthen towers inZhangzhou,Fujifan Province,have long been famous a-round the world.Built of rammedearth,each tower consists uf four tofive stories and Is nearly 100 metersin diameter and 17 to 18meters high.Scatteredaround the mountains,valleys and plains insouthwestern Fujian,thetowers look very muchlike round castles.SomeChinese and foreign ar-chitercts,historians andfolk-custom researcherscall them“flyng sau-cers”from outer spaceor“mushrooms”fromearth.They represent,indeed,a unique archi-tectural style in theworld.

  5. Algeria schedules onshore licensing round

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This paper reports that Algeria's Sonatrach will conduct its first international onshore exploration licensing round in a move designed to triple drilling activity in the country. A second round will follow next April. Sonatrach plans to drill 200 wells during 1991-95, which will require the current level of 37/year to be almost trebled toward the end of the period. To this end foreign operators are being courted in an open exploration bidding round. Deadline for bid submittal in Nov. 30. Companies may enter singly or in groups to form partnerships with Sonatrach. Foreign licensees will be able to take a maximum 49% of production under Algerian law

  6. Improving surgical weekend handover.

    Science.gov (United States)

    Culwick, Caroline; Devine, Chris; Coombs, Catherine

    2014-01-01

    Effective handovers are vital to patient safety and continuity of care, and this is recognised by several national bodies including the GMC. The existing model at Great Western Hospital (GWH) involved three general surgical teams and a urology team placing their printed patient lists, complete with weekend jobs, in a folder for the on-call team to collect at the weekend. We recognised a need to reduce time searching for patients, jobs and reviews, and to streamline weekend ward rounds. A unified weekend list ordering all surgical patients by ward and bed number was introduced. Discrepancies in the layout of each team's weekday list necessitated the design of a new weekday list to match the weekend list to facilitate the easy transfer of information between the two lists. A colour coding system was also used to highlight specific jobs. Prior to this improvement project only 7.1% of those polled were satisfied with the existing system, after a series of interventions satisfaction increased to 85.7%. The significant increase in overall satisfaction with surgical handover following the introduction of the unified weekend list is promising. Locating patients and identifying jobs is easier and weekend ward rounds can conducted in a more logical and timely fashion. It has also helped facilitate the transition to consultant ward rounds of all surgical inpatients at the weekends with promising feedback from a recent consultants meeting.

  7. Anatomy of the ward round.

    LENUS (Irish Health Repository)

    O'Hare, James A

    2008-07-01

    The ward round has been a central activity of hospital life for hundreds of years. It is hardly mentioned in textbooks. The ward round is a parade through the hospital of professionals where most decision making concerning patient care is made. However the traditional format may be intimidating for patients and inadequate for communication. The round provides an opportunity for the multi-disciplinary team to listen to the patient\\'s narrative and jointly interpret his concerns. From this unfolds diagnosis, management plans, prognosis formation and the opportunity to explore social, psychological, rehabilitation and placement issues. Physical examination of the patient at the bedside still remains important. It has been a tradition to discuss the patient at the bedside but sensitive matters especially of uncertainty may better be discussed elsewhere. The senior doctor as round leader must seek the input of nursing whose observations may be under-appreciated due to traditional professional hierarchy. Reductions in the working hours of junior doctors and shortened length of stay have reduced continuity of patient care. This increases the importance of senior staff in ensuring continuity of care and the need for the joint round as the focus of optimal decision making. The traditional round incorporates teaching but patient\\'s right to privacy and their preferences must be respected. The quality and form of the clinical note is underreported but the electronic record is slow to being accepted. The traditional multi-disciplinary round is disappearing in some centres. This may be regrettable. The anatomy and optimal functioning of the ward round deserves scientific scrutiny and experimentation.

  8. A Survey of Rounding Practices in Canadian Adult Intensive Care Units.

    Directory of Open Access Journals (Sweden)

    Jessalyn K Holodinsky

    Full Text Available To describe rounding practices in Canadian adult Intensive Care Units (ICU and identify opportunities for improvement.Mixed methods design. Cross sectional survey of Canadian Adult ICUs (n = 180 with purposefully sampled follow-up interviews (n = 7.Medical directors representing 111 ICUs (62% participated in the survey. Rounding practices varied across ICUs with the majority reporting the use of interprofessional rounds (81% that employed an open (94% and collaborative (86% approach, occurred at the patient's bedside (82%, and started at a standard time (79% and standard location (56%. Most participants reported that patients (83% and family members (67% were welcome to attend rounds. Approximately half of ICUs (48% used tools to facilitate rounds. Interruptions during rounds were reported to be common (i.e., ≥ 1 interruption for ≥ 50% of patients in 46% of ICUs. Four themes were identified from qualitative analysis of participant responses to open-ended survey questions and interviews: multidisciplinarity, patient and family involvement, factors influencing productivity, and teaching and learning.There is considerable variation in current rounding practices in Canadian medical/surgical ICUs. Opportunities exist to improve ICU rounds including ensuring the engagement of essential participants, clearly defining participant roles, establishing a standardized approach to the rounding process, minimizing interruptions, modifying the role of teaching, utilizing a structured rounding tool, and developing a metric for measuring rounding quality.

  9. Improving surgical weekend handover

    OpenAIRE

    Culwick, Caroline; Devine, Chris; Coombs, Catherine

    2014-01-01

    Effective handovers are vital to patient safety and continuity of care, and this is recognised by several national bodies including the GMC. The existing model at Great Western Hospital (GWH) involved three general surgical teams and a urology team placing their printed patient lists, complete with weekend jobs, in a folder for the on-call team to collect at the weekend. We recognised a need to reduce time searching for patients, jobs and reviews, and to streamline weekend ward rounds. A unif...

  10. Retained surgical sponge

    International Nuclear Information System (INIS)

    Koyama, Masashi; Kurono, Kenji; Iida, Akihiko; Suzuki, Hirochika; Hara, Masaki; Mizutani, Hirokazu; Ohba, Satoru; Mizutani, Masaru; Nakajima, Yoichiro.

    1993-01-01

    The CT, US, and MRI findings of confirmed retained surgical sponges were reviewed. The CT examinations in eight lesions demonstrated round or oval masses with heterogeneous internal structures. The US examinations in 5 lesions demonstrated low echogenic masses with high echogenic internal structures, which suggested retained surgical sponges. MR imagings in three lesions showed slightly high intensity comparable to that of muscles on T1-weighted images and high signal intensity on T2-weighted images, suggesting fluid collections of high protein concentration. (author)

  11. Surgical Assisting

    Science.gov (United States)

    ... instruction, including: Microbiology Pathophysiology Pharmacology Anatomy and physiology Medical terminology Curriculum . Course content includes: Advanced surgical anatomy Surgical microbiology Surgical pharmacology Anesthesia methods and agents Bioscience Ethical ...

  12. Ward Round - Crocodile bites in Malawi: microbiology and surgical ...

    African Journals Online (AJOL)

    We present a case series of 5 patients admitted over 5 months to Queen Elizabeth Central Hospital who had sustained injuries from a crocodile bite. Three patients required amputation of a limb. The severe soft tissue injury associated with a crocodile bite and the unusual normal oral flora of the crocodile create challenges ...

  13. India and the Tokyo round

    OpenAIRE

    André Sapir; Robert Baldwin

    1983-01-01

    The paper attempts to quantify the gains and the losses for India from the changes in import tariffs decided during the Tokyo Round of Multilateral Trade Negotiations. The study focuses on exports to the ECCC, Japan, and the US. It is conducted at the tariff line level and uses the actual tariffs resulting from the Tokyo Round. The evaluation is in terms of the static effect of the tariff changes. The results indicate that the gains for India from most-favoured nation tariff cuts far outweigh...

  14. Round window stimulation for conductive and mixed hearing loss.

    Science.gov (United States)

    Dillon, Margaret T; Tubbs, Rhonda S; Adunka, Marcia C; King, English R; Hillman, Todd A; Adunka, Oliver F; Chen, Douglas A; Buchman, Craig A

    2014-10-01

    Assess surgical complications, postoperative residual hearing, and speech perception outcomes of placement of a middle ear implant on the round window in conductive and mixed hearing loss cases. Single-subject, repeated-measures design where each subject served as his or her own control. Tertiary referral medical systems. Eighteen subjects with either conductive or mixed hearing loss who could not benefit from conventional amplification were enrolled in a clinical trial investigating vibratory stimulation of the round window. The floating mass transducer (FMT) was positioned in the round window niche. Unaided residual hearing, and aided sound field thresholds and speech perception abilities were evaluated preoperatively, and at 1, 3, 6, and 10 months post-activation of the external speech processor. Six subjects experienced complications that either required further medical management or resolved on their own. There was no difference in residual bone conduction thresholds or unaided word discrimination over time. All subjects experienced a significant improvement in aided speech perception abilities as compared to preoperative performance. Subjects with conductive and mixed hearing loss with placement of the FMT in the round window niche experienced improved sound field thresholds and speech perception, without compromising residual hearing thresholds. Vibratory stimulation of the round window via a middle ear implant may be an appropriate treatment option for patients with conductive and mixed hearing loss. Additional research is needed on the preferred placement of the FMT, improvement of functional gain, and methods to limit postoperative complications and need for revision surgery.

  15. Grand Hotel prijutil hudozhnikov

    Index Scriptorium Estoniae

    2004-01-01

    Raadioajakirjanik Lea Veelmaa lindistas "Kunstikanali" 2004. a. esimese saate Grand Hotel Viljandis. Saatekülaliseks oli maalikunstnik Andres Tolts. Toltsi kaheksa akrüülmaali on eksponeeritud hotelli fuajees ja restoranis

  16. Grand Mal Seizure

    Science.gov (United States)

    ... grand mal seizures include: A family history of seizure disorders Any injury to the brain from trauma, a ... the risk of birth defects. If you have epilepsy and plan to become pregnant, work with your ...

  17. Abortion - surgical

    Science.gov (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  18. Technology round and management of technology

    International Nuclear Information System (INIS)

    Park, Yong Tae

    1994-04-01

    This book deals with beginning of technology round with background of it, change of scientific technique paradigm with economy, management and policy, change of international political environment globalization of technical and economic environment, formation of strategic alliance, intensifying regionalism, new GATT system, UR and technology round, new international technique regulation and technology round of OECD, feature and meaning of technology round, assignment and scientific technique of Korea, past and present of scientific technology in Korea, correspondence for technology round.

  19. New developments in iterated rounding

    NARCIS (Netherlands)

    Bansal, N.; Raman, V.; Suresh, S.P.

    2014-01-01

    Iterated rounding is a relatively recent technique in algorithm design, that despite its simplicity has led to several remarkable new results and also simpler proofs of many previous results. We will briefly survey some applications of the method, including some recent developments and giving a high

  20. Round robin scheduling - a survey

    DEFF Research Database (Denmark)

    Rasmussen, Rasmus Vinther; Trick, Michael A.

    2008-01-01

    This paper presents a comprehensive survey on the literature considering round robin tournaments. The terminology used within the area has been modified over time and today it is highly inconsistent. By presenting a coherent explanation of the various notions we hope that this paper will help to ...

  1. Storing biomass in round bales

    Energy Technology Data Exchange (ETDEWEB)

    Summer, H.R.; Hellwig, R.E.; Monroe, G.E.

    1984-09-01

    Biomass fuels, in the form of crop residues, were stored outside in large round bales. The influence of rainfall on bale mass and the change in apparent average moisture content (A.A.M.C) was studied. Covering the bales with large sheets of polyethylene was found to be the most effective way of reducing moisture penetration.

  2. Mastery of innovation risk in deep sea developments (part 1) - Drilling and well - round table no.4; Maitrise du risque de l'innovation dans le developpement en grand fond (1. partie) - le forage et le puits - table ronde no.4

    Energy Technology Data Exchange (ETDEWEB)

    Charlez, Ph.A.; Lassus Dessus, J.; Gazaniol, D. [TotalFinaElf, La Defense, 92 - Courbevoie (France); Guesnon, J. [Institut Francais du Petrole (IFP), 92 - Rueil-Malmaison (France); Hudson, W. [DORIS Engineering, 75 - Paris (France); Chauvin, H. [Geoservices S.A., 93 - Le Blanc Mesnil (France)

    2003-02-01

    This round table comprises 5 articles dealing with: 1) - the specific problems and drilling risks in very deep waters: risers (diameter, length, volume and weight), sea bottom conditions (high pressure and low temperature), and management of drilling mud weight (pore and fracturing pressures window, mud hydrates formation); 2) - the implementation of risers in very deep waters: risers mechanical properties (tension, weight), stresses on connected and non-connected risers, possible improvements (reduction of mud and riser weights), steel/composite technology for safety lines, lack of knowledge in the implementation of risers (vibrations, fatigue sources, simulation codes, optimization), instrumentation system for risers; 3) - drilling with surface BOP (blow out preventers): advantages and domains of use, risk management; 4) - safety using gas measurement in very deep drilling: detection of gas events (H{sub 2}S, alkanes, CO{sub 2}, benzene, toluene, xylene) during well drilling, improvement of detectors, implementation, reliability; 5) - Girassol field drillings and completions: contractual strategy, wells design, productivity, drilling and completion, underwater systems. (J.S.)

  3. Ankle Sprains. A Round Table.

    Science.gov (United States)

    Physician and Sportsmedicine, 1986

    1986-01-01

    Types of ankle sprains, surgical versus nonsurgical treatment, tape versus brace for support, rehabilitation, exercise, and prevention of ankle sprains are discussed by a panel of experts. An acute ankle taping technique is illustrated. (MT)

  4. Democracy and "Grand" Corruption.

    Science.gov (United States)

    Rose-Ackerman, Susan

    1996-01-01

    Defines "grand" corruption as that occurring at the higher levels of a political system and involving large sums of money. Discusses the impact and incentives for this level of corruption as well as various government responses. Identifies multinational corporations as the major malefactors. (MJP)

  5. The GRANDE detector

    International Nuclear Information System (INIS)

    Adams, A.; Bond, R.; Coleman, L.; Rollefson, A.; Wold, D.; Bratton, C.B.; Gurr, H.; Kropp, W.; Nelson, M.; Price, L.R.; Reines, F.; Schultz, J.; Sobel, H.; Svoboda, R.; Yodh, G.; Burnett, T.; Chaloupka, V.; Wilkes, R.J.; Cherry, M.; Ellison, S.B.; Guzik, T.G.; Wefel, J.; Gaidos, J.; Loeffler, F.; Sembroski, G.; Wilson, C.; Goodman, J.; Haines, T.J.; Kielczewska, D.; Lane, C.; Steinberg, R.; Lieber, M.; Nagle, D.; Potter, M.; Tripp, R.

    1990-01-01

    In this paper we present a detector facility which meets the requirements outlined above for a next-generation instrument. GRANDE (Gamma Ray and Neutrino DEtector) is an imaging, water Cerenkov detector, which combines in one facility an extensive air shower array and a high-energy neutrino detector. (orig.)

  6. Triggering the GRANDE array

    International Nuclear Information System (INIS)

    Wilson, C.L.; Bratton, C.B.; Gurr, J.; Kropp, W.; Nelson, M.; Sobel, H.; Svoboda, R.; Yodh, G.; Burnett, T.; Chaloupka, V.; Wilkes, R.J.; Cherry, M.; Ellison, S.B.; Guzik, T.G.; Wefel, J.; Gaidos, J.; Loeffler, F.; Sembroski, G.; Goodman, J.; Haines, T.J.; Kielczewska, D.; Lane, C.; Steinberg, R.; Lieber, M.; Nagle, D.; Potter, M.; Tripp, R.

    1990-01-01

    A brief description of the Gamma Ray And Neutrino Detector Experiment (GRANDE) is presented. The detector elements and electronics are described. The trigger logic for the array is then examined. The triggers for the Gamma Ray and the Neutrino portions of the array are treated separately. (orig.)

  7. Grand-Bassam

    African Journals Online (AJOL)

    Geo

    l'estuaire du fleuve Comoé (Grand-Bassam, Côte d'Ivoire). Kouassi Laurent ADOPO1*, Apie Colette AKOBE1, Etche Mireille AMANI2,. Sylvain MONDE3 et Kouamé AKA3. (1)Laboratoire de Géologie Marine, Sédimentologie et Environnement, Centre de Recherche en Ecologie,. Université Felix Houphouet Boigny Abidjan, ...

  8. Evolving practices in augmentation operative technique with Sientra HSC round implants.

    Science.gov (United States)

    Calobrace, M Bradley; Kaufman, David L; Gordon, Ashley E; Reid, Dustin L

    2014-07-01

    As of 2012, breast augmentation surgery continues to be the most commonly performed aesthetic surgical procedure in the United States. Surgeons consider a multitude of factors when choosing the type and style of breast implant for a patient. With the continuous evolution of breast implant designs, there are a variety of breast implant options for plastic surgeons to choose from; however, round implants remain the implant of choice for breast augmentation. This article discusses preoperative planning, implant selection, surgical techniques, and postoperative management using Sientra's Silimed brand smooth and textured round implants.

  9. Doha Round: the endless beginning

    OpenAIRE

    Popa, Diana

    2011-01-01

    This paper aims to research existing literature on the collapse of the Doha Round and its causes. The first part is a review of significant paper in the vast literature on the history of international trade from the end of the Second World War until the present, focusing especially, on the beginning of the Doha Ministerial Conference as part of World Trade Organization, but also, the results of the negotiations that followed it. The second part illustrated, briefly, some of the causes that le...

  10. Surgical lighting

    NARCIS (Netherlands)

    Knulst, A.J.

    2017-01-01

    The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago,

  11. Grand unified theories

    International Nuclear Information System (INIS)

    Langacker, P.

    1981-01-01

    In this talk I discuss the present status of these theories and of their observational and experimental implications. In section II, I briefly review the standard SU 3 sup(c) x SU 2 x U 1 model of the strong and electroweak interactions. Although phenomenologically successful, the standard model leaves many questions unanswered. Some of these questions are addressed by grand unified theories, which are defined and discussed in Section III. The Georgi-Glashow SU 5 model is described, as are theories based on larger groups such as SO 10 , E 6 , or SO 16 . It is emphasized that there are many possible grand unified theories and that it is an experimental problem not only to test the basic ideas but to discriminate between models. (orig./HSI)

  12. Asymptotically safe grand unification

    Energy Technology Data Exchange (ETDEWEB)

    Bajc, Borut [J. Stefan Institute,1000 Ljubljana (Slovenia); Sannino, Francesco [CP-Origins & the Danish IAS, University of Southern Denmark,Campusvej 55, DK-5230 Odense M (Denmark); Université de Lyon, France, Université Lyon 1, CNRS/IN2P3, UMR5822 IPNL,F-69622 Villeurbanne Cedex (France)

    2016-12-28

    Phenomenologically appealing supersymmetric grand unified theories have large gauge representations and thus are not asymptotically free. Their ultraviolet validity is limited by the appearance of a Landau pole well before the Planck scale. One could hope that these theories save themselves, before the inclusion of gravity, by generating an interacting ultraviolet fixed point, similar to the one recently discovered in non-supersymmetric gauge-Yukawa theories. Employing a-maximization, a-theorem, unitarity bounds, as well as positivity of other central charges we nonperturbatively rule out this possibility for a broad class of prime candidates of phenomenologically relevant supersymmetric grand unified theories. We also uncover candidates passing these tests, which have either exotic matter or contain one field decoupled from the superpotential. The latter class of theories contains a model with the minimal matter content required by phenomenology.

  13. LA GRANDE DESCENTE

    CERN Multimedia

    The first endcap disc of CMS being lowered slowly and carefully 100 m underground into the experimental cavern. The disc is one of 15 large pieces to make the grand descent.  The uniquely shaped slice, 16 m high, about 50 cm thick weighs 400 tonnes. The two HF that were lowered earlier in November can also be seen in the foreground and background.  

  14. A TXRF round robin study

    International Nuclear Information System (INIS)

    Roberts, R.F.; Holmes, R.J.; Florimonte, M.C. De

    2000-01-01

    Total reflection x-ray fluorescence spectroscopy (TXRF) is used extensively to measure the quantity of ultra trace metal contamination on wafer surfaces for manufacture monitoring, tool and material qualification and process development in the semiconductor industry. It has been noted, however, that issues with TXRF instrument calibration using reference wafers may lead to difficulty in comparison of TXRF areal density results from different laboratories. In order to cross-calibrate TXRF instruments within Lucent Technologies, a set of reference wafers was produced and characterized. The reference wafers were then measured, in round robin fashion, on various TXRF instruments, internal and external to Lucent Technologies, and the results compared. The results will be discussed as well as implications for instances where TXRF data from different facilities must be compared in a meaningful manner. (author)

  15. Why Might the Doha Round Fail?

    OpenAIRE

    Gifford, Michael N.; McCalla, Alex F.

    2008-01-01

    There are a number of factors working against a successful Doha Round conclusion. Several of these affect the linkages and trade-offs between the main elements of the Doha Round negotiating agenda, particularly agriculture, non-agricultural market access (NAMA), services, and rules. For most of the past six years, the negotiating difficulties in agriculture were regarded as the main constraint to concluding the Doha Round. However, in recent months, as the shape of the agricultural package be...

  16. Surgical smoke.

    Science.gov (United States)

    Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man

    2009-10-01

    Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown.

  17. Grande do Sul, Brasil

    Directory of Open Access Journals (Sweden)

    Denis Alcides-Rezende

    2008-01-01

    Full Text Available The objective of this work is to analyse the integration of information systems and information technology resources in the municipal planning of 14 small cities of Rio Grande do Sul (Brazil. The research methodology consisted of a multiple case study together with a convenient non-probabilistic sample chosen through a research protocol. The results demonstrate the difficulties of these cities to organise the municipal data as well as their struggle for accessibility of information and planning for management and control.

  18. INTRODUCTION Outline of Round Tables Outline of Round Tables

    Science.gov (United States)

    Abarzhi, Snezhana I.; Sreenivasan, Katepalli R.

    2010-12-01

    The Second International Conference and Advanced School 'Turbulent Mixing and Beyond', TMB-2009, was held at the Abdus Salam International Centre for Theoretical Physics, (ICTP), Trieste, Italy on 27 July-7 August 2009. TMB-2009 united over 180 participants ranging from students to members of the National Academies of Sciences and Engineering, and including researchers at experienced and early stages of their carriers from leading scientific institutions in academia, national laboratories, corporations and industry worldwide. Responding to the community's inquiry and reaffirming the practices established at TMB-2007, two Round Tables were organized for the participants of TMB-2009 on 30 July 2009 and 6 August 2009 in the Oppenheimer Room at the Centre. The goals of the Round Tables were to encourage the information exchange among the members of the interdisciplinary and international TMB community, promote discussions regarding the state-of-the-art in TMB-related scientific areas, identify directions for frontier research, and articulate recommendations for future developments. This article is a summary of the collective work of the Round Table participants (listed alphabetically below by their last names), whose contributions form its substance and, as such, are greatly appreciated. Abarzhi, Snezhana I (University of Chicago, USA) Andrews, Malcolm (Los Alamos National Laboratory, USA) Belotserkovskii, Oleg (Institute for Computer Aided Design of the Russian Academy of Sciences, Russia) Bershadskii, Alexander (ICAR, Israel) Brandenburg, Axel (Nordita, Denmark) Chumakov, Sergei (Stanford University, USA) Desai, Tara (University of Milano-Bicocca, Italy) Galperin, Boris (University of South Florida, USA) Gauthier, Serge (Commissariat à l'Energie Atomique, France) Gekelman, Walter (University of California at Los Angeles, USA) Gibson, Carl (University of California at San Diego, USA) Goddard III, William A (California Institute of Technology, USA) Grinstein, Fernando

  19. Discretization vs. Rounding Error in Euler's Method

    Science.gov (United States)

    Borges, Carlos F.

    2011-01-01

    Euler's method for solving initial value problems is an excellent vehicle for observing the relationship between discretization error and rounding error in numerical computation. Reductions in stepsize, in order to decrease discretization error, necessarily increase the number of steps and so introduce additional rounding error. The problem is…

  20. 40 CFR 73.12 - Rounding Procedures.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Rounding Procedures. 73.12 Section 73.12 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) SULFUR DIOXIDE ALLOWANCE SYSTEM Allowance Allocations § 73.12 Rounding Procedures. (a) Calculation...

  1. Ball mounting fixture for a roundness gage

    Science.gov (United States)

    Gauler, Allen L.; Pasieka, Donald F.

    1983-01-01

    A ball mounting fixture for a roundness gage is disclosed. The fixture includes a pair of chuck assemblies oriented substantially transversely with respect to one another and mounted on a common base. Each chuck assembly preferably includes a rotary stage and a wobble plate affixed thereto. A ball chuck affixed to each wobble plate is operable to selectively support a ball to be measured for roundness, with the wobble plate permitting the ball chuck to be tilted to center the ball on the axis of rotation of the rotary stage. In a preferred embodiment, each chuck assembly includes a vacuum chuck operable to selectively support the ball to be measured for roundness. The mounting fixture enables a series of roundness measurements to be taken with a conventional rotating gagehead roundness instrument, which measurements can be utilized to determine the sphericity of the ball.

  2. Cassini's Grand Finale Overview

    Science.gov (United States)

    Spilker, L. J.

    2017-12-01

    After 13 years in orbit, the Cassini-Huygens Mission to Saturn ended in a science-rich blaze of glory. Cassini sent back its final bits of unique science data on September 15, 2017, as it plunged into Saturn's atmosphere, vaporizing and satisfying planetary protection requirements. Cassini's final phase covered roughly ten months and ended with the first time exploration of the region between the rings and planet. In late 2016 Cassini transitioned to a series of 20 Ring Grazing orbits with peripases just outside Saturn's F ring, providing close flybys of tiny ring moons, including Pan, Daphnis and Atlas, and high-resolution views of Saturn's A and F rings. A final Titan flyby in late April 2017 propelled Cassini across Saturn's main rings and into its Grand Finale orbits. Comprised of 22 orbits, Cassini repeatedly dove between Saturn's innermost rings and upper atmosphere to answer fundamental questions unattainable earlier in the mission. The last orbit turned the spacecraft into the first Saturn atmosphere probe. The Grand Finale orbits provided highest resolution observations of both the rings and Saturn, and in-situ sampling of the ring particle composition, Saturn's atmosphere, plasma, and innermost radiation belts. The gravitational field was measured to unprecedented accuracy, providing information on the interior structure of the planet, winds in the deeper atmosphere, and mass of the rings. The magnetic field provided insight into the physical nature of the magnetic dynamo and structure of the internal magnetic field. The ion and neutral mass spectrometer sampled the upper atmosphere for molecules that escape the atmosphere in addition to molecules originating from the rings. The cosmic dust analyzer directly sampled the composition from different parts of the main rings for the first time. Fields and particles instruments directly measured the plasma environment between the rings and planet. Science highlights and new mysteries collected in the Grand

  3. Grand unification and supergravity

    International Nuclear Information System (INIS)

    Nanopoulos, D.V.

    Grand Unified Theories (GUTs) are very successful, but they suffer from fine-tuning or hierarchy problems. It seems that more symmetry beyond the gauge symmetry is needed and indeed supersymmetric GUTs may provide the correct framework in solving the hierarchy problems. These are reviewed. From the results discussed, it is seen that for the first time in particle physics, gravity seems to play a dominant role. It may be responsible for GUT breaking, SU(2) x U(1) breaking, fermion masses, proton decay and a consistent cosmological picture. Supergravity seems to offer a consistent, effective theory for energies below the Planck scale to N=1 local SUSY but also, in the context of N=8 extended supergravity with a dynamically realized SU(8), there may be a consistent fundamental unified theory of all interactions. (U.K.)

  4. Grand unification: status report

    International Nuclear Information System (INIS)

    Georgi, H.

    1983-01-01

    Grand unification is reviewed with regard to the flavor puzzle and the hierarchy puzzle. Progress in CP and the PQWWKDFS axion is reviewed. The neutrino mass and B-L research, the understanding and assimilation of the language of effective theories (which divide the momentum scale up into regions), with focus on the models, are surveyed. Various unified models are organized according to whether they address the hierarchy puzzle or the flavor puzzle. SU(5), SO(10), E6, and Higgs are considered simple and explicit models. Global symmetry addresses hierarchy puzzle, but the rules are unclear. In SO (18), with regard to hierarchy, perturbation theory breaks down. SO (14) fails for hierarchy because of GIM, b and t problems. Supersymmetry and technicolor with regard to flavor puzzle are questioned. The CP solution of ETC and Composite C models (addressing both flavor and hierarchy) is a minus. Composite A model has no evident virtues, and the basic idea of ETC model needs checking

  5. Grand unified theories. Pt. 2

    International Nuclear Information System (INIS)

    Ellis, J.

    1982-01-01

    The author gives an introduction to the construction of grand unified theories on the base of the SU(3)xSU(2)xU(1) model of the strong, weak, and electromagnetic interactions. Especially he discusses the proton decay, neutrino masses and oscillations, and cosmological implications in connection with grand unified theories. (orig./HSI)

  6. La importancia de ser grande

    OpenAIRE

    Baisre, J. A.

    2007-01-01

    Se responde a las preguntas ¿por qué los mamíferos marinos son los animales más grandes del planeta?, ¿Por qué los peces no pueden ser más grandes?. Éstas y otras interrogantes son respondidas de forma sencilla y clara.

  7. Grand Rounds: An Outbreak of Toxic Hepatitis among Industrial Waste Disposal Workers

    OpenAIRE

    Cheong, Hae-Kwan; Kim, Eun A; Choi, Jung-Keun; Choi, Sung-Bong; Suh, Jeong-Ill; Choi, Dae Seob; Kim, Jung Ran

    2006-01-01

    Context Industrial waste (which is composed of various toxic chemicals), changes to the disposal process, and addition of chemicals should all be monitored and controlled carefully in the industrial waste industry to reduce the health hazard to workers. Case presentation Five workers in an industrial waste plant developed acute toxic hepatitis, one of whom died after 3 months due to fulminant hepatitis. In the plant, we detected several chemicals with hepatotoxic potential, including pyridine...

  8. Neurobehavioral Grand Rounds introduction: Does near drowning in ice water prevent anoxic induced brain injury?

    Science.gov (United States)

    Hopkins, Ramona O

    2008-07-01

    Cold water near-drowning is often thought to be neuroprotective in individuals with anoxia of a longer duration than that usually required to produce irreversible neurologic damage. There is a paucity of data in adults with cold water near-drowning that assess neuropsychological outcomes. Information regarding long-term effects of near cold water near-drowning on neuropathology, neuropsychological and neurobehavioral outcomes are uncommon. This paper provides an introduction to two cases of cold water near-drowning reported in this issue of JINS by Sameulson and colleagues and provides background information for interpretation of the findings of these cases in the context of outcomes following anoxia.

  9. CDC Grand Rounds: Improving Medication Adherence for Chronic Disease Management - Innovations and Opportunities.

    Science.gov (United States)

    Neiman, Andrea B; Ruppar, Todd; Ho, Michael; Garber, Larry; Weidle, Paul J; Hong, Yuling; George, Mary G; Thorpe, Phoebe G

    2017-11-17

    Adherence to prescribed medications is associated with improved clinical outcomes for chronic disease management and reduced mortality from chronic conditions (1). Conversely, nonadherence is associated with higher rates of hospital admissions, suboptimal health outcomes, increased morbidity and mortality, and increased health care costs (2). In the United States, 3.8 billion prescriptions are written annually (3). Approximately one in five new prescriptions are never filled, and among those filled, approximately 50% are taken incorrectly, particularly with regard to timing, dosage, frequency, and duration (4). Whereas rates of nonadherence across the United States have remained relatively stable, direct health care costs associated with nonadherence have grown to approximately $100-$300 billion of U.S. health care dollars spent annually (5,6). Improving medication adherence is a public health priority and could reduce the economic and health burdens of many diseases and chronic conditions (7).

  10. CDC Grand Rounds: a public health approach to prevention of intimate partner violence.

    Science.gov (United States)

    Spivak, Howard R; Jenkins, Lynn; VanAudenhove, Kristi; Lee, Debbie; Kelly, Mim; Iskander, John

    2014-01-17

    Intimate partner violence (IPV) is a serious, and preventable, public health problem in the United States. IPV can involve physical and sexual violence, threats of physical or sexual violence, and psychological abuse, including stalking. It can occur within opposite-sex or same-sex couples and can range from one incident to an ongoing pattern of violence. On average, 24 persons per minute are victims of rape, physical violence, or stalking by an intimate partner in the United States. These numbers underestimate the problem because many victims do not report IPV to police, friends, or families. In 2010, IPV contributed to 1,295 deaths, accounting for 10% of all homicides for that year. The combined medical, mental health, and lost productivity costs of IPV against women are estimated to exceed $8.3 billion per year. In addition to the economic burden of IPV, victims are more likely to experience adverse health outcomes, such as depression, anxiety, posttraumatic stress disorder symptoms, suicidal behavior, sexually transmitted infections, and unintended pregnancy.

  11. Should This Patient Receive Aspirin?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

    Science.gov (United States)

    Burns, Risa B; Graham, Kelly; Sawhney, Mandeep S; Reynolds, Eileen E

    2017-12-05

    Aspirin exerts antiplatelet effects through irreversible inhibition of cyclooxygenase-1, whereas its anticancer effects may be due to inhibition of cyclooxygenase-2 and other pathways. In 2009, the U.S. Preventive Services Task Force endorsed aspirin for primary prevention of cardiovascular disease. However, aspirin's role in cancer prevention is still emerging, and no groups currently recommend its use for this purpose. To help physicians balance the benefits and harms of aspirin in primary disease prevention, the Task Force issued a guideline titled, "Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer" in 2016. In the evidence review conducted for the guideline, cardiovascular disease mortality and colorectal cancer mortality were significantly reduced among persons taking aspirin. However, there was no difference in nonfatal stroke, cardiovascular disease mortality, or all-cause mortality, nor in total cancer mortality, among those taking aspirin. Aspirin users were found to be at increased risk for major gastrointestinal bleeding. In this Beyond the Guidelines, the guideline is reviewed and 2 experts discuss how they would apply it to a 57-year-old man considering starting aspirin for primary prevention. Our experts review the data on which the guideline is based, discuss how they would balance the benefits and harms of aspirin therapy, and explain how they would incorporate shared decision making into clinical practice.

  12. Beyond Grand Rounds: A Comprehensive and Sequential Intervention to Improve Identification of Delirium

    Science.gov (United States)

    Ramaswamy, Ravishankar; Dix, Edward F.; Drew, Janet E.; Diamond, James J.; Inouye, Sharon K.; Roehl, Barbara J. O.

    2011-01-01

    Purpose of the Study: Delirium is a widespread concern for hospitalized seniors, yet is often unrecognized. A comprehensive and sequential intervention (CSI) aiming to effect change in clinician behavior by improving knowledge about delirium was tested. Design and Methods: A 2-day CSI program that consisted of progressive 4-part didactic series,…

  13. CDC Grand Rounds: Improving the Lives of Persons with Sickle Cell Disease.

    Science.gov (United States)

    Hulihan, Mary; Hassell, Kathryn L; Raphael, Jean L; Smith-Whitley, Kim; Thorpe, Phoebe

    2017-11-24

    Approximately 100,000 Americans have sickle cell disease (SCD), a group of recessively inherited red blood cell disorders characterized by abnormal hemoglobin, called hemoglobin S or sickle hemoglobin, in the red blood cells. Persons with hemoglobin SS or hemoglobin Sß 0 thalassemia, also known as sickle cell anemia (SCA), have the most severe form of SCD. Hemoglobin SC disease and hemoglobin Sß + thalassemia are other common forms of SCD. Red blood cells that contain sickle hemoglobin are inflexible and can stick to vessel walls, causing a blockage that slows or stops blood flow. When this happens, oxygen cannot reach nearby tissues, leading to attacks of sudden, severe pain, called pain crises, which are the clinical hallmark of SCD. The red cell sickling and poor oxygen delivery can also cause damage to the brain, spleen, eyes, lungs, liver, and multiple other organs and organ systems. These chronic complications can lead to increased morbidity, early mortality, or both. Tremendous strides in treating and preventing the complications of SCD have extended life expectancy. Now, nearly 95% of persons born with SCD in the United States reach age 18 years (1); however, adults with the most severe forms of SCD have a life span that is 20-30 years shorter than that of persons without SCD (2).

  14. Rounding, work intensification and new public management.

    Science.gov (United States)

    Willis, Eileen; Toffoli, Luisa; Henderson, Julie; Couzner, Leah; Hamilton, Patricia; Verrall, Claire; Blackman, Ian

    2016-06-01

    In this study, we argue that contemporary nursing care has been overtaken by new public management strategies aimed at curtailing budgets in the public hospital sector in Australia. Drawing on qualitative interviews with 15 nurses from one public acute hospital with supporting documentary evidence, we demonstrate what happens to nursing work when management imposes rounding as a risk reduction strategy. In the case study outlined rounding was introduced across all wards in response to missed care, which in turn arose as a result of work intensification produced by efficiency, productivity, effectiveness and accountability demands. Rounding is a commercially sponsored practice consistent with new public management. Our study illustrates the impact that new public management strategies such as rounding have on how nurses work, both in terms of work intensity and in who controls their labour. © 2015 John Wiley & Sons Ltd.

  15. Choroidal Round Hyporeflectivities in Geographic Atrophy.

    Directory of Open Access Journals (Sweden)

    Eleonora Corbelli

    Full Text Available In geographic atrophy (GA, choroidal vessels typically appear on structural optical coherence tomography (OCT as hyperreflective round areas with highly reflective borders. We observed that some GA eyes show choroidal round hyporeflectivities with highly reflective borders beneath the atrophy, and futher investigated the charcteristcs by comparing structural OCT, indocyanine green angiography (ICGA and OCT angiography (OCT-A.Round hyporeflectivities were individuated from a pool of patients with GA secondary to non-neovascular age-related macular degeneration consecutively presenting between October 2015 and March 2016 at the Medical Retina & Imaging Unit of the University Vita-Salute San Raffaele. Patients underwent a complete ophthalmologic examination including ICGA, structural OCT and OCT-A. The correspondence between choroidal round hyporeflectivities beneath GA on structural OCT and ICGA and OCT-A imaging were analyzed.Fifty eyes of 26 consecutive patients (17 females and 9 males; mean age 76.8±6.2 years with GA were included. Twenty-nine round hyporeflectivities have been found by OCT in choroidal layers in 21 eyes of 21 patients (42.0%; estimated prevalence of 57.7%. All 29 round hyporeflectivities showed constantly a hyperreflective border and a backscattering on structural OCT, and appeared as hypofluorescent in late phase ICGA and as dark foci with non detectable flow in the choroidal segmentation of OCT-A. Interestingly, the GA area was greater in eyes with compared to eyes without round hyporeflectivities (9.30±5.74 and 5.57±4.48mm2, respectively; p = 0.01.Our results suggest that most round hyporeflectivities beneath GA may represent non-perfused or hypo-perfused choroidal vessels with non-detectable flow.

  16. Choroidal Round Hyporeflectivities in Geographic Atrophy.

    Science.gov (United States)

    Corbelli, Eleonora; Sacconi, Riccardo; De Vitis, Luigi Antonio; Carnevali, Adriano; Rabiolo, Alessandro; Querques, Lea; Bandello, Francesco; Querques, Giuseppe

    2016-01-01

    In geographic atrophy (GA), choroidal vessels typically appear on structural optical coherence tomography (OCT) as hyperreflective round areas with highly reflective borders. We observed that some GA eyes show choroidal round hyporeflectivities with highly reflective borders beneath the atrophy, and futher investigated the charcteristcs by comparing structural OCT, indocyanine green angiography (ICGA) and OCT angiography (OCT-A). Round hyporeflectivities were individuated from a pool of patients with GA secondary to non-neovascular age-related macular degeneration consecutively presenting between October 2015 and March 2016 at the Medical Retina & Imaging Unit of the University Vita-Salute San Raffaele. Patients underwent a complete ophthalmologic examination including ICGA, structural OCT and OCT-A. The correspondence between choroidal round hyporeflectivities beneath GA on structural OCT and ICGA and OCT-A imaging were analyzed. Fifty eyes of 26 consecutive patients (17 females and 9 males; mean age 76.8±6.2 years) with GA were included. Twenty-nine round hyporeflectivities have been found by OCT in choroidal layers in 21 eyes of 21 patients (42.0%; estimated prevalence of 57.7%). All 29 round hyporeflectivities showed constantly a hyperreflective border and a backscattering on structural OCT, and appeared as hypofluorescent in late phase ICGA and as dark foci with non detectable flow in the choroidal segmentation of OCT-A. Interestingly, the GA area was greater in eyes with compared to eyes without round hyporeflectivities (9.30±5.74 and 5.57±4.48mm2, respectively; p = 0.01). Our results suggest that most round hyporeflectivities beneath GA may represent non-perfused or hypo-perfused choroidal vessels with non-detectable flow.

  17. The Doha Round Impasse: A Graphical Account

    OpenAIRE

    Evenett, Simon J

    2013-01-01

    Several factors potentially responsible for the failure to conclude the Doha Round of multilateral trade negotiations are analysed. A two-stage negotiation and ratification game between the “North” (industrialised countries) and the “South” (developing countries) is employed and collapses into a single diagram. The choice of negotiating agenda, principles, and currency of the Doha Round interact with domestic political factors in leading WTO members, the fast growth of exports prior to 2007, ...

  18. Grand slam on cancer.

    Science.gov (United States)

    Gartrell, Nanette

    2014-01-01

    A winner of 59 Grand Slam championships including a record 9 Wimbledon singles titles, Martina Navratilova is the most successful woman tennis player of the modern era. Martina was inducted into the International Tennis Hall of Fame, named "Tour Player of the Year" seven times by the Women's Tennis Association, declared "Female Athlete of the Year" by the Associated Press, and ranked one of the "Top Forty Athletes of All-Time" by Sports Illustrated. Equally accomplished off the court, Martina is an author, philanthropist, TV commentator, and activist who has dedicated her life to educating people about prejudice and stereotypes. After coming out as a lesbian in 1981, Martina became a tireless advocate of equal rights for lesbian, gay, bisexual, and transgender (LGBT) people, and she has contributed generously to the LGBT community. Martina is the author of seven books, including most recently Shape Your Self: My 6-Step Diet and Fitness Plan to Achieve the Best Shape of your Life, an inspiring guide to healthy living and personal fitness. Martina was diagnosed with breast cancer in 2010.

  19. Magnetic spectrometer Grand Raiden

    International Nuclear Information System (INIS)

    Fujiwara, M.; Akimune, H.; Daito, I.; Fujimura, H.; Fujita, Y.; Hatanaka, K.; Ikegami, H.; Katayama, I.; Nagayama, K.; Matsuoka, N.; Morinobu, S.; Noro, T.; Yoshimura, M.; Sakaguchi, H.; Sakemi, Y.; Tamii, A.; Yosoi, M.

    1999-01-01

    A high-resolution magnetic spectrometer called 'Grand Raiden' is operated at the RCNP ring cyclotron facility in Osaka for nuclear physics studies at intermediate energies. This magnetic spectrometer has excellent ion-optical properties. In the design of the spectrometer, the second-order dispersion matching condition has been taken into account, and almost all the aberration terms such as (x vertical bar θ 3 ), (x vertical bar θφ 2 ), (x vertical bar θ 2 δ) and (x vertical bar θδ 2 ) in a third-order matrix calculation are optimized. A large magnetic rigidity of the spectrometer (K = 1400 MeV) gives a great advantage to measure the charge-exchange ( 3 He, t) reactions at 450 MeV. The ability of the high-resolution measurement has been demonstrated. Various coincidence measurements are performed to study the nuclear structures of highly excited states through decay properties of nuclear levels following nuclear reactions at intermediate energies

  20. Planetary Taxonomy: Label Round Bodies "Worlds"

    Science.gov (United States)

    Margot, Jean-Luc; Levison, H. F.

    2009-05-01

    The classification of planetary bodies is as important to Astronomy as taxonomy is to other sciences. The etymological, historical, and IAU definitions of planet rely on a dynamical criterion, but some authors prefer a geophysical criterion based on "roundness". Although the former criterion is superior when it comes to classifying newly discovered objects, the conflict need not exist if we agree to identify the subset of "round" planetary objects as "worlds". This addition to the taxonomy would conveniently recognize that "round" objects such as Earth, Europa, Titan, Triton, and Pluto share some common planetary-type processes regardless of their distance from the host star. Some of these worlds are planets, others are not. Defining how round is round and handling the inevitable transition objects are non-trivial tasks. Because images at sufficient resolution are not available for the overwhelming majority of newly discovered objects, the degree of roundness is not a directly observable property and is inherently problematic as a basis for classification. We can tolerate some uncertainty in establishing the "world" status of a newly discovered object, and still establish its planet or satellite status with existing dynamical criteria. Because orbital parameters are directly observable, and because mass can often be measured either from orbital perturbations or from the presence of companions, the dynamics provide a robust and practical planet classification scheme. It may also be possible to determine which bodies are dynamically dominant from observations of the population magnitude/size distribution.

  1. Anesthesiology leadership rounding: identifying opportunities for improvement.

    Science.gov (United States)

    Gravenstein, Dietrich; Ford, Susan; Enneking, F Kayser

    2012-01-01

    Rounding that includes participation of individuals with authority to implement changes has been advocated as important to the transformation of an institution into a high-quality and safe organization. We describe a Department of Anesthesiology's experience with leadership rounding. The Department Chair or other senior faculty designate, a quality coordinator, up to four residents, the ward charge nurse, and patient nurses participated in rounds at bedsides. During a 23-month period, 14 significant opportunities to improve care were identified. Nurses identified 5 of these opportunities, primary team physicians 2, the rounding team 4, and patients or their family members another 3. The anesthesiology service had sole or shared responsibility for 10 improvements. A variety of organizations track specific measures across all phases of the patient experience to gauge quality of care. Chart auditing tools for detecting threats to safety are often used. These measures and tools missed opportunities for improvement that were discovered only through rounding. We conclude that the introduction of leadership rounding by an anesthesiology service can identify opportunities for improving quality that are not captured by conventional efforts.

  2. Estratégia cirúrgica na transposição das grandes artérias associada à obstrução do arco aórtico Surgical strategy in transposition of the great arteries with aortic arch obstruction

    Directory of Open Access Journals (Sweden)

    Bayard Gontijo Filho

    2007-06-01

    Full Text Available OBJETIVO: Analisar nossa experiência no tratamento cirúrgico da transposição das grandes artérias (TGA associada à obstrução do arco aórtico. MÉTODO: Entre janeiro de 1998 e dezembro de 2005, realizamos 223 operações de Jatene para correção de TGA: 21 (9,4% pacientes apresentavam obstruções do arco aórtico. A anatomia do arco aórtico evidenciou: coarctação da aorta localizada (n=10; coarctação com hipoplasia tubular do arco aórtico (n=6; interrupção do arco aórtico (n=5. Comunicação interventricular (CIV: 19 pacientes (90,5%, sendo 11 do tipo Taussig-Bing. Desproporção importante entre aorta e artéria pulmonar e anomalias coronárias foram achados freqüentes. Houve 7 correções em dois estágios e 14 correções em um único estágio. A reconstrução do arco foi realizada por ressecção e anastomose término-terminal ampliada (13 ou por translocação da aorta ascendente (8. RESULTADO: Houve cinco (23,8% óbitos hospitalares; apenas um (11,1% nos últimos nove casos consecutivos. Reoperações no período hospitalar: revisão de hemostasia (5, CIV residual + coarctação não identificada (1, estenose residual de arco aórtico (1. Após a alta, houve dois óbitos e três pacientes foram submetidos a reintervenções para estenose da via de saída do ventrículo direito. CONCLUSÃO: O tratamento da transposição das grandes artérias associada à obstrução do arco aórtico apresenta alta complexidade e morbi-mortalidade. Empregamos as correções em um e em dois estágios, obtendo resultados comparáveis. Nossa preferência atual é pela correção precoce em um único estágio para todos os pacientes, independente de sua configuração anatômica.OBJECTIVE:To analyze our experience in the surgical correction of transposition of the great arteries associated with aortic arch obstruction. METHOD: From January 1998 to December 2005 we performed 223 arterial switch operations for transposition of the great

  3. Surgical orthodontics.

    Science.gov (United States)

    Strohl, Alexis M; Vitkus, Lauren

    2017-08-01

    The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.

  4. Simulation for ward processes of surgical care.

    Science.gov (United States)

    Pucher, Philip H; Darzi, Ara; Aggarwal, Rajesh

    2013-07-01

    The role of simulation in surgical education, initially confined to technical skills and procedural tasks, increasingly includes training nontechnical skills including communication, crisis management, and teamwork. Research suggests that many preventable adverse events can be attributed to nontechnical error occurring within a ward context. Ward rounds represent the primary point of interaction between patient and physician but take place without formalized training or assessment. The simulated ward should provide an environment in which processes of perioperative care can be performed safely and realistically, allowing multidisciplinary assessment and training of full ward rounds. We review existing literature and describe our experience in setting up our ward simulator. We examine the facilities, equipment, cost, and personnel required for establishing a surgical ward simulator and consider the scenario development, assessment, and feedback tools necessary to integrate it into a surgical curriculum. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Round Ligament of Uterus Leiomyoma: An Unusual Cause of Dyspareunia

    Directory of Open Access Journals (Sweden)

    Ozer Birge

    2015-01-01

    Full Text Available Round ligament of uterus leiomyoma is a rare, benign tumor of the vulva. Its incidence is not known exactly, and the mean age ranges from 13 to 70. Although clinical properties of benign and malignant diseases in the vulvar area are frequently similar, early diagnosis and treatment are essential. Local excision is recommended as definitive therapy. We present an 28-year-old female without any birth with a mass in anterior vaginal wall diagnosed as vulvar leiomyoma. In conclusion, a brief review of relevant literature emphasizes that leiomyomas are quite rare outside of the uterus but they might occur in any tissue or organ containing smooth muscle, spontaneously or parasitically after the spreading effect of an accident or surgical trauma. Clinicians should be alert especially for the diagnosis in a tissue with smooth muscle content.

  6. Assessment of teamwork during structured interdisciplinary rounds on medical units.

    Science.gov (United States)

    O'Leary, Kevin J; Boudreau, Yvonne N; Creden, Amanda J; Slade, Maureen E; Williams, Mark V

    2012-01-01

    Interdisciplinary rounds (IDR) provide a means to assemble hospital team members and improve collaboration. Little is known about teamwork during IDR. To evaluate and characterize teamwork during IDR. Cross-sectional observational study. Six medical units which had implemented structured interdisciplinary rounds (SIDR). We adapted the Observational Teamwork Assessment for Surgery (OTAS) tool, a behaviorally anchored rating scale shown to be reliable and valid in surgical settings. OTAS provides scores ranging from 0 to 6 (0 = problematic behavior; 6 = exemplary behavior) across 5 domains (communication, coordination, cooperation/backup behavior, leadership, and monitoring/situational awareness) and for prespecified subteams. Two researchers conducted direct observations using the adapted OTAS tool. We conducted 7-8 independent observations for each unit (total = 44) and 20 joint observations. Inter-rater reliability was excellent at the unit level (Spearman's rho = 0.75), and good across domains (rho = 0.53-0.68) and subteams (rho = 0.53-0.76) with the exception of the physician subteam, for which it was poor (rho = 0.35). Though teamwork scores were generally high, we found differences across units, with a median (interquartile range [IQR]) 4.5 (3.9-4.9) for the lowest and 5.4 (5.3-5.5) for the highest performing unit (P teamwork during SIDR across units, domains, and most subteams. Variation in performance suggests a need to improve consistency of teamwork and emphasizes the importance of leadership. Copyright © 2012 Society of Hospital Medicine.

  7. Facial sculpting: Comprehensive approach for aesthetic correction of round face

    Directory of Open Access Journals (Sweden)

    M K Thomas

    2012-01-01

    Full Text Available Context: Standards for an aesthetic face are dynamic. The current trend is towards a leaner looking face with preservation of the inverted triangle of youth. Procedures that have been reported to be employed for correction of a chubby face include buccal fat pad excision, facial liposuction and injection lipolysis. In addition to giving the face an aesthetic triangular cut, chin and malar augmentation may be performed. The rounded appearance at the angles may further be reduced by injection of Botulinum toxin into the masseter. Materials and Methods: Forty patients who presented to us for correction of chubby (round faces were analysed and treated by facial sculpting surgery, which included at least two of the procedures in combination. The procedures included facial liposuction, buccal fat pad excision, chin augmentation, malar augmentation and injection lipolysis. All cases were followed-up for a minimum of 6 months after surgery. Results: Aesthetic expectations of the patients were met in 39 cases, one patient complained of facial asymmetry following facial liposuction and was subjected to a touch-up injection lipolysis. Conclusions: A combination of procedures is necessary to give the face an attractive contour. All the individual procedures have stood the test of time and are safe, proven and are put in mainstream. However, a thorough analysis of the face preoperatively and then subjecting the patient to a combination of these procedures in a single surgical sitting has yielded good results as seen in this study.

  8. International Technical Working Group Round Robin Tests

    Energy Technology Data Exchange (ETDEWEB)

    Dudder, Gordon B.; Hanlen, Richard C.; Herbillion, Georges M.

    2003-02-01

    The goal of nuclear forensics is to develop a preferred approach to support illicit trafficking investigations. This approach must be widely understood and accepted as credible. The principal objectives of the Round Robin Tests are to prioritize forensic techniques and methods, evaluate attribution capabilities, and examine the utility of database. The HEU (Highly Enriched Uranium) Round Robin, and previous Plutonium Round Robin, have made tremendous contributions to fulfilling these goals through a collaborative learning experience that resulted from the outstanding efforts of the nine participating internal laboratories. A prioritized list of techniques and methods has been developed based on this exercise. Current work is focused on the extent to which the techniques and methods can be generalized. The HEU Round Robin demonstrated a rather high level of capability to determine the important characteristics of the materials and processes using analytical methods. When this capability is combined with the appropriate knowledge/database, it results in a significant capability to attribute the source of the materials to a specific process or facility. A number of shortfalls were also identified in the current capabilities including procedures for non-nuclear forensics and the lack of a comprehensive network of data/knowledge bases. The results of the Round Robin will be used to develop guidelines or a ''recommended protocol'' to be made available to the interested authorities and countries to use in real cases.

  9. International Technical Working Group Round Robin Tests

    International Nuclear Information System (INIS)

    Dudder, Gordon B.; Hanlen, Richard C.; Herbillion, Georges M.

    2003-01-01

    The goal of nuclear forensics is to develop a preferred approach to support illicit trafficking investigations. This approach must be widely understood and accepted as credible. The principal objectives of the Round Robin Tests are to prioritize forensic techniques and methods, evaluate attribution capabilities, and examine the utility of database. The HEU (Highly Enriched Uranium) Round Robin, and previous Plutonium Round Robin, have made tremendous contributions to fulfilling these goals through a collaborative learning experience that resulted from the outstanding efforts of the nine participating internal laboratories. A prioritized list of techniques and methods has been developed based on this exercise. Current work is focused on the extent to which the techniques and methods can be generalized. The HEU Round Robin demonstrated a rather high level of capability to determine the important characteristics of the materials and processes using analytical methods. When this capability is combined with the appropriate knowledge/database, it results in a significant capability to attribute the source of the materials to a specific process or facility. A number of shortfalls were also identified in the current capabilities including procedures for non-nuclear forensics and the lack of a comprehensive network of data/knowledge bases. The results of the Round Robin will be used to develop guidelines or a ''recommended protocol'' to be made available to the interested authorities and countries to use in real cases

  10. A time-motion study of inpatient rounds using a family-centered rounds model

    NARCIS (Netherlands)

    Bhansali, P.; Birch, S.; Campbell, J.K.; Agrawal, D.; Hoffner, W.; Manicone, P.; Shah, K.; Krieger, E.; Ottolini, M.

    2013-01-01

    OBJECTIVE: Family-centered rounds (FCR) have become increasingly prevalent in pediatric hospital settings. The objective of our study was to describe time use and discrete events during pediatric inpatient rounds by using a FCR model. METHODS: We conducted a prospective observational study at

  11. In the Round: Supporting Teachers' Authentic Professional Learning

    Science.gov (United States)

    Strand, Matt

    2013-01-01

    This is a study of teachers' authentic professional learning at a public school in Poudre School District in northern Colorado. At Polaris Expeditionary Learning School, teachers and administrators have developed a form of school-based instructional rounds referred to herein as PLC rounds (professional learning community rounds). In PLC rounds,…

  12. Does Negative Type Characterize the Round Sphere?

    DEFF Research Database (Denmark)

    Kokkendorff, Simon Lyngby

    2007-01-01

    We discuss the measure theoretic metric invariants extent, mean distance and symmetry ratio and their relation to the concept of negative type of a metric space. A conjecture stating that a compact Riemannian manifold with symmetry ratio 1 must be a round sphere, was put forward in a previous paper....... We resolve this conjecture in the class of Riemannian symmetric spaces by showing, that a Riemannian manifold with symmetry ratio 1 must be of negative type and that the only compact Riemannian symmetric spaces of negative type are the round spheres....

  13. Venezuela slates second oil field revival round

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This paper reports that Venezuela will accept bids under a second round next year from private foreign and domestic companies for production contracts to operate marginal active as well as inactive oil fields. The first such round came earlier this year, involving about 55 other marginal, inactive fields. It resulted in two contractors signed with domestic and foreign companies. It represented the first time since nationalization of the petroleum industry in Venezuela in 1976 that private companies were allowed to produce oil in the country. A public bid tender was expected at presstime last week

  14. Round Gating for Low Energy Block Ciphers

    DEFF Research Database (Denmark)

    Banik, Subhadeep; Bogdanov, Andrey; Regazzoni, Francesco

    2016-01-01

    design techniques for implementing block ciphers in a low energy fashion. We concentrate on round based implementation and we discuss how gating, applied at round level can affect and improve the energy consumption of the most common lightweight block cipher currently used in the internet of things....... Additionally, we discuss how to needed gating wave can be generated. Experimental results show that our technique is able to reduce the energy consumption in most block ciphers by over 60% while incurring only a minimal overhead in hardware....

  15. Surgical competence.

    Science.gov (United States)

    Patil, Nivritti G; Cheng, Stephen W K; Wong, John

    2003-08-01

    Recent high-profile cases have heightened the need for a formal structure to monitor achievement and maintenance of surgical competence. Logbooks, morbidity and mortality meetings, videos and direct observation of operations using a checklist, motion analysis devices, and virtual reality simulators are effective tools for teaching and evaluating surgical skills. As the operating theater is also a place for training, there must be protocols and guidelines, including mandatory standards for supervision, to ensure that patient care is not compromised. Patients appreciate frank communication and honesty from surgeons regarding their expertise and level of competence. To ensure that surgical competence is maintained and keeps pace with technologic advances, professional registration bodies have been promoting programs for recertification. They evaluate performance in practice, professional standing, and commitment to ongoing education.

  16. Round Two for Three ALICE Industrial Awards

    CERN Multimedia

    2004-01-01

    Excellency in industrial collaboration with the LHC experimental teams is one important contribution to the successful development and realization of the experiments. A few weeks ago the ALICE collaboration presented a second round of awards to industrial collaborators for their novel and remarkable contributions to major detector systems.

  17. Round-trip boat on hydrogen

    International Nuclear Information System (INIS)

    Berends, A.M.; Van der Laag, P.C.

    2005-08-01

    The results of a feasibility study on a PEM (polymer-electrolyte membrane) fuel cell (FC) driven electric round-trip boat are presented and discussed. The study concerns the specification of a PEMFC system design, including a list of components. Also technical and environmental aspects are dealt with and compared with traditional battery-driven electric boats and diesel-driven boats [nl

  18. Trade liberalization in the Doha development Round

    NARCIS (Netherlands)

    Francois, J.; Meijl, van H.; Tongeren, van F.W.

    2005-01-01

    The Doha Round faced a long series of launch-delays and a spectacular launch-failure in Seattle in 1999. While the talks did take off in 2001, the negotiating agenda is still ambiguous in a number of crucial areas. This paper argues that these ambiguities matter greatly. Such ambiguities include the

  19. Commercial lumber, round timbers, and ties

    Science.gov (United States)

    David E. Kretschmann

    2010-01-01

    When sawn, a log yields round timber, ties, or lumber of varying quality. This chapter presents a general discussion of grading, standards, and specifications for these commercial products. In a broad sense, commercial lumber is any lumber that is bought or sold in the normal channels of commerce. Commercial lumber may be found in a variety of forms, species, and types...

  20. Stabilization of flow past a rounded cylinder

    Science.gov (United States)

    Samtaney, Ravi; Zhang, Wei

    2016-11-01

    We perform global linear stability analysis on low-Re flow past a rounded cylinder. The cylinder corners are rounded with a radius R, normalized as R+ = R / D where D is the cylinder diameter, and its effect on the flow stability characteristics is investigated. We compute the critical Reynolds number (Recr) for the onset of first instability, and quantify the perturbation growth rate for the super-critical flows. It is found that the flow can be stabilized by partially rounding the cylinder. Compared with the square and circular cylinders, the partially rounded cylinder has a higher Recr , attaining a maximum at around R+ = 0 . 30 , and the perturbation growth rate of the super-critical flows is reduced for Re R+ -> 0 . 00), while only the near-wake backflow is crucial for circular-like cylinders (R+ -> 0 . 50). The stability analysis results are also verified with those of the direct simulations and very good agreement is achieved. Supported by the KAUST Office of Competitive Research Funds under Award No. URF/1/1394-01. The supercomputer Shaheen at KAUST was utilized for the simulations.

  1. Surgical Navigation

    DEFF Research Database (Denmark)

    Azarmehr, Iman; Stokbro, Kasper; Bell, R. Bryan

    2017-01-01

    Purpose: This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indicatio...

  2. Surgical Instrument

    NARCIS (Netherlands)

    Dankelman, J.; Horeman, T.

    2009-01-01

    The present invention relates to a surgical instrument for minimall-invasive surgery, comprising a handle, a shaft and an actuating part, characterised by a gastight cover surrounding the shaft, wherein the cover is provided with a coupler that has a feed- through opening with a loskable seal,

  3. Selected topics in grand unification

    International Nuclear Information System (INIS)

    Seckel, D.

    1983-01-01

    This dissertation is a collection of four pieces of research dealing with grand unification. The topics are neutron oscillation, CP violation, magnetic monopole abundance and distribution in neutron stars, and a proposal for an inflationary cosmology driven by stress-energy in domain walls

  4. Introduction to grand unification theories

    International Nuclear Information System (INIS)

    Kang, Kyungsik

    1980-01-01

    We introduce the Georgi-Glashow model based on the minimal gauge group SU(5) as a prototype grand unification theory of the electroweak and strong interactions. Simple estimation of sin 2 thetasub(W) in the symmetry limit and the renormalization corrections at the energy scale of Msub(W) are given along wich other successes of the SU(5) model

  5. Coordinated Exploration for Grand Challenges

    DEFF Research Database (Denmark)

    Ørding Olsen, Anders; Sofka, Wolfgang; Grimpe, Christoph

    2016-01-01

    Grand challenges are among the most complex problems for modern societies. Many governments and foundations provide substantial resources to encourage the search for solutions. Due to the significance of these problems, organizations often form partnerships in what we call search consortia to eng...

  6. All-Round Marketing Increases Hospital Popularity.

    Science.gov (United States)

    Ziqi, Tao

    2015-06-01

    Xuzhou Center Hospital is in a competing medical market in Xuzhou city. This hospital has been dedicating to improve the medical skills and provide professional and individualized service to the patients in order to improve the patient's experience and increase the patient's satisfaction. On the other side, this hospital has provided an all-round marketing campaign to build up the social influence and public reputation through public-praise marketing, web marketing, media marketing, and scholar marketing. Besides, this hospital has been cooperating with foreign medical institutions and inviting foreign medical specialists to academic communication. With the combined effects of improving medical service and all-round marketing, the hospital's economic performance has been enhanced significantly and laid a solid foundation for its ambition to become the first-class hospital in Huaihai Economic Zone.

  7. Round beams generated by vertical dispersion

    International Nuclear Information System (INIS)

    Bagley, P.

    1990-01-01

    Simulations suggest that in e + e - storage rings collisions of round beams (equal emittances and equal β*) can produce very large tune shifts and luminosities. We understand how to make equal β*s, but generating equal emittances is more difficult. We describe an equal emittance scheme that uses several skew quads to couple horizontal dispersion into vertical dispersion. These skew quads also produce a coupling bump. At the interaction point and at other points outside the coupling bump, the motion is not coupled, so that the 'A' normal mode corresponds to horizontal motion and the 'B' normal mode corresponds to vertical motion. We present a round beam lattice for CESR that incorporates this scheme

  8. ["Round back" in children and adolescents].

    Science.gov (United States)

    Garoflid, N; Fragnière, B; Dutoit, M

    2000-10-01

    The hyper-kyphosis or "the postural round back" is one of the most common complaints in orthopedic practice. In the majority of cases, the thoracic kyphosis are painless and flexible. The vertebral bodies are normal on radiograms. This is "the kyphotic attitude" or postural round-back. A medical treatment is not the necessary rule. Life hygiene, sports and simple supervision are needed. Nevertheless, there are still pathological fixed kyphosis, induced in the majority of cases by Scheuermann's disease. The other possible etiologies (congenital, paralytic, post-traumatic, Pott's disease, postradiation, or metabolic origin) are a lot rare ones and will be excluded by clinical examination and imaging studies. The structural hyper-kyphosis require treatment. We will approach successively steps of the diagnosis and treatment of the hyper-kyphosis of the adolescent.

  9. The Periodic Round Table (by Gary Katz)

    Science.gov (United States)

    Rodgers, Reviewed By Glen E.

    2000-02-01

    Unwrapping and lifting the Periodic Round Table out of its colorful box is an exciting experience for a professional chemist or a chemistry student. Touted as a "new way of looking at the elements", it is certainly thatat least at first blush. The "table" consists of four sets of two finely finished hardwood discs each with the following elemental symbols and their corresponding atomic numbers pleasingly and symmetrically wood-burned into their faces. The four sets of two discs are 1 1/2, 3, 4 1/2, and 6 in. in diameter, each disc is 3/4 in. thick, and therefore the entire "round table" stands 6 in. high and is 6 in. in diameter at its base. The eight beautifully polished discs (represented below) are held together by center dowels that allow each to be rotated separately.

  10. On the Computation of Correctly Rounded Sums

    DEFF Research Database (Denmark)

    Kornerup, Peter; Lefevre, Vincent; Louvet, Nicolas

    2012-01-01

    This paper presents a study of some basic blocks needed in the design of floating-point summation algorithms. In particular, in radix-2 floating-point arithmetic, we show that among the set of the algorithms with no comparisons performing only floating-point additions/subtractions, the 2Sum...... algorithm introduced by Knuth is minimal, both in terms of number of operations and depth of the dependency graph. We investigate the possible use of another algorithm, Dekker's Fast2Sum algorithm, in radix-10 arithmetic. We give methods for computing, in radix 10, the floating-point number nearest...... the average value of two floating-point numbers. We also prove that under reasonable conditions, an algorithm performing only round-to-nearest additions/subtractions cannot compute the round-to-nearest sum of at least three floating-point numbers. Starting from an algorithm due to Boldo and Melquiond, we also...

  11. Virtual radiology rounds: adding value in the digital era

    Energy Technology Data Exchange (ETDEWEB)

    Fefferman, Nancy R.; Strubel, Naomi A.; Prithiani, Chandan; Chakravarti, Sujata; Caprio, Martha; Recht, Michael P. [New York University School of Medicine, Department of Radiology, New York, NY (United States)

    2016-11-15

    To preserve radiology rounds in the changing health care environment, we have introduced virtual radiology rounds, an initiative enabling clinicians to remotely review imaging studies with the radiologist. We describe our initial experience with virtual radiology rounds and referring provider impressions. Virtual radiology rounds, a web-based conference, use remote sharing of radiology workstations. Participants discuss imaging studies by speakerphone. Virtual radiology rounds were piloted with the Neonatal Intensive Care Unit (NICU) and the Congenital Cardiovascular Care Unit (CCVCU). Providers completed a survey assessing the perceived impact and overall value of virtual radiology rounds on patient care using a 10-point scale. Pediatric radiologists participating in virtual radiology rounds completed a survey assessing technical, educational and clinical aspects of this methodology. Sixteen providers responded to the survey; 9 NICU and 7 CCVCU staff (physicians, nurse practitioners and fellows). Virtual radiology rounds occurred 4-5 sessions/week with an average of 6.4 studies. Clinicians rated confidence in their own image interpretation with a 7.4 average rating for NICU and 7.5 average rating for CCVCU. Clinicians unanimously rated virtual radiology rounds as adding value. NICU staff preferred virtual radiology rounds to traditional rounds and CCVCU staff supported their new participation in virtual radiology rounds. Four of the five pediatric radiologists participating in virtual radiology rounds responded to the survey reporting virtual radiology rounds to be easy to facilitate (average rating: 9.3), to moderately impact interpretation of imaging studies (average rating: 6), and to provide substantial educational value for radiologists (average rating: 8.3). All pediatric radiologists felt strongly that virtual radiology rounds enable increased integration of the radiologist into the clinical care team (average rating: 8.8). Virtual radiology rounds are a

  12. Virtual radiology rounds: adding value in the digital era

    International Nuclear Information System (INIS)

    Fefferman, Nancy R.; Strubel, Naomi A.; Prithiani, Chandan; Chakravarti, Sujata; Caprio, Martha; Recht, Michael P.

    2016-01-01

    To preserve radiology rounds in the changing health care environment, we have introduced virtual radiology rounds, an initiative enabling clinicians to remotely review imaging studies with the radiologist. We describe our initial experience with virtual radiology rounds and referring provider impressions. Virtual radiology rounds, a web-based conference, use remote sharing of radiology workstations. Participants discuss imaging studies by speakerphone. Virtual radiology rounds were piloted with the Neonatal Intensive Care Unit (NICU) and the Congenital Cardiovascular Care Unit (CCVCU). Providers completed a survey assessing the perceived impact and overall value of virtual radiology rounds on patient care using a 10-point scale. Pediatric radiologists participating in virtual radiology rounds completed a survey assessing technical, educational and clinical aspects of this methodology. Sixteen providers responded to the survey; 9 NICU and 7 CCVCU staff (physicians, nurse practitioners and fellows). Virtual radiology rounds occurred 4-5 sessions/week with an average of 6.4 studies. Clinicians rated confidence in their own image interpretation with a 7.4 average rating for NICU and 7.5 average rating for CCVCU. Clinicians unanimously rated virtual radiology rounds as adding value. NICU staff preferred virtual radiology rounds to traditional rounds and CCVCU staff supported their new participation in virtual radiology rounds. Four of the five pediatric radiologists participating in virtual radiology rounds responded to the survey reporting virtual radiology rounds to be easy to facilitate (average rating: 9.3), to moderately impact interpretation of imaging studies (average rating: 6), and to provide substantial educational value for radiologists (average rating: 8.3). All pediatric radiologists felt strongly that virtual radiology rounds enable increased integration of the radiologist into the clinical care team (average rating: 8.8). Virtual radiology rounds are a

  13. Agricultural Liberalization in the Doha Round

    OpenAIRE

    Messerlin , Patrick

    2005-01-01

    The analysis of agricultural liberalization reveals very large potential gains for both developed and developing countries that will come especially from own-country liberalization as well as from inter-country trade, significant benefits that may be realized by the poorest developing countries, and limited benefits from existing preferential agricultural arrangements. An ideal program for agricultural liberalization in the Doha Round would involve substantial reductions in the high tariffs t...

  14. Round table discussion during session 2

    International Nuclear Information System (INIS)

    Mays, C.

    2004-01-01

    The round table discussions of the second session of the FSC Belgium Workshop addressed the following questions: - Do local stakeholders have, internally or externally, all the expertise they need in order to address the issues raised by radioactive waste management projects? - Do institutional stakeholders have all the expertise they need to take local impacts into account? - What kinds of expert input are sought and attained by the different stakeholders? - Were any formal methods used to aid local partnerships perform technology assessments? Or other types of assessment? - How to maintain the knowledge and expertise achieved by the stakeholders? Discussion took place after the plenary presentations, at tables grouping Belgian stakeholders and FSC delegates. As in Session I, most of the round table discussion focussed specifically on the experience of the local partnerships. Many insights were shared about the nature and role of expertise in complex decision making. They are summarised below, on the basis of the feedback provided to the plenary by each round table. Some of these insights can be generalised to other contexts. All in all, a profile emerged of the local partnerships as a unique and effective tool to deal with knowledge issues in managing risk. (author)

  15. 16 CFR 460.11 - Rounding off R-values.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Rounding off R-values. 460.11 Section 460.11... INSULATION § 460.11 Rounding off R-values. R-values shown in labels, fact sheets, ads, or other promotional materials must be rounded to the nearest tenth. However, R-values of 10 or more may be rounded to the...

  16. Results from KASCADE–Grande

    International Nuclear Information System (INIS)

    Bertaina, M.; Apel, W.D.; Arteaga-Velázquez, J.C.; Bekk, K.; Blümer, J.; Bozdog, H.; Brancus, I.M.; Buchholz, P.; Cantoni, E.; Chiavassa, A.; Cossavella, F.

    2012-01-01

    The KASCADE–Grande experiment, located at Karlsruhe Institute of Technology (Germany) is a multi-component extensive air-shower experiment devoted to the study of cosmic rays and their interactions at primary energies 10 14 –10 18 eV. Main goals of the experiment are the measurement of the all-particle energy spectrum and mass composition in the 10 16 –10 18 eV range by sampling charged (N ch ) and muon (N μ ) components of the air shower. The method to derive the energy spectrum and its uncertainties, as well as the implications of the obtained result, is discussed. An overview of the analyses performed by KASCADE–Grande to derive the mass composition of the measured high-energy comic rays is presented as well.

  17. Results from KASCADE-Grande

    Energy Technology Data Exchange (ETDEWEB)

    Bertaina, M., E-mail: bertaina@to.infn.it [Dipartimento di Fisica Generale dell' Universita, Torino (Italy); Apel, W.D. [Institut fuer Kernphysik, KIT - Karlsruher Institut fuer Technologie (Germany); Arteaga-Velazquez, J.C. [Universidad Michoacana, Instituto de Fisica y Matematicas, Morelia (Mexico); Bekk, K. [Institut fuer Kernphysik, KIT - Karlsruher Institut fuer Technologie (Germany); Bluemer, J. [Institut fuer Kernphysik, KIT - Karlsruher Institut fuer Technologie (Germany); Institut fuer Experimentelle Kernphysik, KIT - Karlsruher Institut fuer Technologie (Germany); Bozdog, H. [Institut fuer Kernphysik, KIT - Karlsruher Institut fuer Technologie (Germany); Brancus, I.M. [National Institute of Physics and Nuclear Engineering, Bucharest (Romania); Buchholz, P. [Fachbereich Physik, Universitaet Siegen (Germany); Cantoni, E. [Dipartimento di Fisica Generale dell' Universita, Torino (Italy); Istituto di Fisica dello Spazio Interplanetario, INAF Torino (Italy); Chiavassa, A. [Dipartimento di Fisica Generale dell' Universita, Torino (Italy); Cossavella, F. [Institut fuer Experimentelle Kernphysik, KIT - Karlsruher Institut fuer Technologie (Germany); and others

    2012-11-11

    The KASCADE-Grande experiment, located at Karlsruhe Institute of Technology (Germany) is a multi-component extensive air-shower experiment devoted to the study of cosmic rays and their interactions at primary energies 10{sup 14}-10{sup 18} eV. Main goals of the experiment are the measurement of the all-particle energy spectrum and mass composition in the 10{sup 16}-10{sup 18} eV range by sampling charged (N{sub ch}) and muon (N{sub {mu}}) components of the air shower. The method to derive the energy spectrum and its uncertainties, as well as the implications of the obtained result, is discussed. An overview of the analyses performed by KASCADE-Grande to derive the mass composition of the measured high-energy comic rays is presented as well.

  18. Solitary Fibrous Tumor in the Round Ligament of the Liver: A Fortunate Intraoperative Discovery

    Directory of Open Access Journals (Sweden)

    Laura Beyer

    2012-04-01

    Full Text Available Solitary fibrous tumors (SFTs are mesenchymal neoplasms of fibroblastic origin, most commonly found in the pleura. Numerous extrathoracic locations have been reported during the last 2 decades. Herein, we report the first case of an SFT in the round ligament of the liver. A 46-year-old Caucasian man presented with a 12-month history of abdominal pain. An ultrasonography-guided microbiopsy first revealed a desmoid tumor. After failure of first- and second-line medical treatments (celecoxib and tamoxifen, then imatinib, histological reexamination was suspicious for a low-grade sarcoma. MRI was also suspicious for a malignant process. Hence, surgery was decided. Laparotomy found a huge and well-limited tumor that, unexpectedly, was appended to the round ligament of the liver and free from any other intra-abdominal contact. The tumor was easily removed. Excision was monobloc and macroscopically complete. Histological analysis diagnosed an SFT arising from the round ligament of the liver. No adjuvant treatment was given. Ten months after surgery, the patient is alive without any signs or symptoms of relapse. This is the first report of SFT arising from the round ligament of the liver. It illustrates the difficulty in diagnosing such tumors. Whilst diagnosis of SFT is rare, it should be kept in mind to allow early diagnosis and complete surgical resection, which provide the best chance for recovery.

  19. Solitary fibrous tumor in the round ligament of the liver: a fortunate intraoperative discovery.

    Science.gov (United States)

    Beyer, Laura; Delpero, Jean-Robert; Chetaille, Bruno; Sarran, Anthony; Perrot, Delphine; Moureau-Zabotto, Laurence; Guiramand, Jérôme; Bertucci, François

    2012-01-01

    Solitary fibrous tumors (SFTs) are mesenchymal neoplasms of fibroblastic origin, most commonly found in the pleura. Numerous extrathoracic locations have been reported during the last 2 decades. Herein, we report the first case of an SFT in the round ligament of the liver. A 46-year-old Caucasian man presented with a 12-month history of abdominal pain. An ultrasonography-guided microbiopsy first revealed a desmoid tumor. After failure of first- and second-line medical treatments (celecoxib and tamoxifen, then imatinib), histological reexamination was suspicious for a low-grade sarcoma. MRI was also suspicious for a malignant process. Hence, surgery was decided. Laparotomy found a huge and well-limited tumor that, unexpectedly, was appended to the round ligament of the liver and free from any other intra-abdominal contact. The tumor was easily removed. Excision was monobloc and macroscopically complete. Histological analysis diagnosed an SFT arising from the round ligament of the liver. No adjuvant treatment was given. Ten months after surgery, the patient is alive without any signs or symptoms of relapse. This is the first report of SFT arising from the round ligament of the liver. It illustrates the difficulty in diagnosing such tumors. Whilst diagnosis of SFT is rare, it should be kept in mind to allow early diagnosis and complete surgical resection, which provide the best chance for recovery.

  20. Round atrophic holes in lattice degeneration--an important cause of phakic retinal detachment.

    Science.gov (United States)

    Tillery, W V; Lucier, A C

    1976-01-01

    Round atrophic holes in lattice degeneration are an important cause of phakic retinal detachment. Detachments due solely to round holes in lattice accounted for almost 2.8% of all retinal detachments treated at Wills Eye Hospital from January 1970 to August 1973. These detachments had the following important characteristics: 1. One of the patients were under the age of 30 years. 2. Over 75% of the patients had refractive errors more myopic than -3 D spherical equivalent. 3. Inferior detachments were slightly more common than superior detachments. When located inferiorly, there was a tendency for slow progression as indicated by the frequent presence of pigmented demarcation lines. 4. Surgical repair with standard scleral buckling techniques was successful in 98% of these detachments. Young, moderate to highly myopic patients with round holes in areas of lattice degeneration seem to have a greater risk of developing this type of detachment. Patients with the triad of youth, myopia, and round holes in lattice degeneration deserve close observation.

  1. Cassini's Grand Finale Science Highlights

    Science.gov (United States)

    Spilker, Linda

    2017-10-01

    After 13 years in orbit, the Cassini-Huygens Mission to Saturn ended in a science-rich blaze of glory. Cassini returned its final bits of unique science data on September 15, 2017, as it plunged into Saturn's atmosphere satisfying planetary protection requirements. Cassini's Grand Finale covered a period of roughly five months and ended with the first time exploration of the region between the rings and planet.The final close flyby of Titan in late April 2017 propelled Cassini across Saturn’s main rings and into its Grand Finale orbits; 22 orbits that repeatedly dove between Saturn’s innermost rings and upper atmosphere making Cassini the first spacecraft to explore this region. The last orbit turned the spacecraft into the first Saturn upper atmospheric probe.The Grand Finale orbits provided highest resolution observations of both the rings and Saturn, and in-situ sampling of the ring particle composition, Saturn's atmosphere, plasma, and innermost radiation belts. The gravitational field was measured to unprecedented accuracy, providing information on the interior structure of the planet, winds in the deeper atmosphere, and mass of the rings. The magnetic field provided insight into the physical nature of the magnetic dynamo and structure of the internal magnetic field. The ion and neutral mass spectrometer sampled the upper atmosphere for molecules that escape the atmosphere in addition to molecules originating from the rings. The cosmic dust analyzer directly sampled the composition from different parts of the main rings for the first time. Fields and particles instruments directly measured the plasma environment between the rings and planet.Science highlights and new mysteries gleaned to date from the Grand Finale orbits will be discussed.The research described in this paper was carried out in part at the Jet Propulsion Laboratory, California Institute of Technology, under a contract with the National Aeronautics and Space Administration. Copyright 2017

  2. Grandes números primos

    OpenAIRE

    Bang, Thöger

    2012-01-01

    En las escuelas danesas la teoría de los números se ha ido restringiendo gradualmente hasta no incluir sino la demostración de la descomposición univoca de los números enteros en números primos y la demostración del teorema clásico de EUCLIDES sobre la existencia de un número primo arbitrariamente grande.

  3. Team Ward Rounds for Quality Improvement in Patient-Centred ...

    African Journals Online (AJOL)

    In this paper we describe a clinical practice change for evaluation and continuous quality improvement of in-patient services in our ACE unit, such as daily geriatrics (multi disciplinary) team ward rounds preceding traditional ward rounds by other managing teams. The geriatrics team rounds enabled the identification of ...

  4. Anatomic measurements of the posterior tympanum related to the round window vibroplasty in congenital aural atresia and stenosis patients.

    Science.gov (United States)

    Chen, Keguang; Yin, Dongming; Lyu, Huiying; Yang, Lin; Zhang, Tianyu; Dai, Peidong

    2016-01-01

    With the aggravation of the external auditory canal malformation, the size of extra-niche fossa became smaller, providing concrete data and valuable information for the better design, selecting and safer implantation of the transducer in the area of round window niche. Three-dimensional measurements and assessments before surgery might be helpful for a safer surgical approach and implantation of a vibrant soundbridge. The aim of this study was to investigate whether differences exist in the morphology of the posterior tympanum related to the round window vibroplasty among congenital aural atresia (CAA), congenital aural stenosis (CAS), and a normal control group, and to analyze its effect on the round window implantation of vibrant soundbridge. CT images of 10 normal subjects (20 ears), 27 CAS patients (30 ears), and 25 CAA patients (30 ears) were analyzed. The depth and the size of outside fossa of round window niche related to the round window vibroplasty (extra-niche fossa)and the distances between the center of round window niche and extra-niche fossa were calculated based on three-dimensional reconstruction using mimics software. Finally, the data were analyzed statistically. The size of extra-niche fossa in the atresia group was smaller than in the stenosis group (p < 0.05); furthermore, the size of extra-niche fossa in the stenosis group was smaller than that of the control group (p < 0.05). There was no statistically significant difference of the depth of extra-niche fossa among different groups.

  5. Grand unification theory and technicolor

    International Nuclear Information System (INIS)

    Rubakov, V.A.; Shaposhnikov, M.E.

    1983-01-01

    The lecture course can be considered as introduction to the problems concerning grand unification models. The course is incomplete. Such problems as CP-violations in strong interactions and the problem of gravitational interaction inclusion in the scheme of grand unification theory are not touched upon. Models of early unification, in which strong, weak and electromagnetic interactions are compared according to the ''strength'' at energies of about 10 5 -10 6 GeV, are not discussed. Models with horizontal symmetry, considering different generations of quarks and leptons from one viewpoint, are not analyzed. Cosmological applications of supersymmetric unified theories are not considered. Certain problems of standard elementary particle theory, philosophy of the great unification, general properties of the grand unification models and the main principles of the construction of models: the SU(5) model, models on the SO(10) groups, have been considered. The problem of supersymmetric unification hierarchies, supersymmetric generalization of the minimum SU(5) model, supersymmetry violation and the problem of hierarchies, phenomenology of the o.rand unification models, cosmological application and technicolour, are discussed

  6. Positioning a thin-wall round wrapper within a heavy wall out-of-round shell of a heat exchanger

    International Nuclear Information System (INIS)

    Hargrove, H.G.; Thompson, E.G.; Bayless, J.R.

    1983-01-01

    A thin-wall, generally round wrapper is installed within a heavy wall, rolled heat exchanger shell which has greater out-of-round tolerances than the wrapper and the wrapper is maintained in its round state by utilizing a plurality of jacks disposed adjacent spaced tube support plates within the wrapper. (author)

  7. Impact of regular nursing rounds on patient satisfaction with nursing care.

    Science.gov (United States)

    Negarandeh, Reza; Hooshmand Bahabadi, Abbas; Aliheydari Mamaghani, Jafar

    2014-12-01

    The purpose of the study was to determine the impact of regular nursing rounds on patient satisfaction with nursing care. This was a controlled clinical trial in which 100 hospitalized patients in a medical surgical ward were allocated to control and experimental groups through convenience sampling. The experimental group received regular nursing rounds every 1-2 hours. Routine care was performed for the control group. Patient satisfaction with the quality of nursing care was assessed on the second and fifth days of hospitalization in both groups using Patient Satisfaction with Nursing Care Quality Questionnaire. On the second day, patient satisfaction scores of the two groups had no significant difference (p = .499). However, the intervention was associated with statistically significant increased patient satisfaction in the experimental group compared to the control group (p patient satisfaction. This method may hence improve patient-nurse interactions and promote the quality of nursing care and patient satisfaction. Copyright © 2014. Published by Elsevier B.V.

  8. Precracking of round notched bars. Progress Report

    International Nuclear Information System (INIS)

    Scibetta, M.

    1996-02-01

    Precracking round notched bars is the first step before fracture mechanics testing. This report gives an overview of the different techniques described in the literature. Difficulties generally encountered are linked to the crack length determination and the creation of eccentric cracks. As the compliance technique is often used, a detailed study of the stress intensity factor and the compliance of the precracked bar under bending and tension is presented. Comparison with finite element calculations is made to validate the proposed analytical formulation. Finally a practical way for precracking is described

  9. Revisiting the round bottom flask rainbow experiment

    Science.gov (United States)

    Selmke, Markus; Selmke, Sarah

    2018-01-01

    A popular demonstration experiment in optics uses a round-bottom flask filled with water to project a circular rainbow on a screen with a hole through which the flask is illuminated. We show how the vessel's wall shifts the first- and second-order bows towards each other and consequently reduces the width of Alexander's dark band. We address the challenge this introduces in observing Alexander's dark band, and explain the importance of a sufficient distance between the flask and the screen. The wall-effect also introduces a splitting of the bows that can easily be misinterpreted.

  10. Efficacy of ONC201 in Desmoplastic Small Round Cell Tumor.

    Science.gov (United States)

    Hayes-Jordan, Andrea A; Ma, Xiao; Menegaz, Brian A; Lamhamedi-Cherradi, Salah-Eddine; Kingsley, Charles V; Benson, Jalen A; Camacho, Pamela E; Ludwig, Joseph A; Lockworth, Cynthia R; Garcia, Gloria E; Craig, Suzanne L

    2018-05-01

    Desmoplastic Small Round Cell Tumor (DSRCT) is a rare sarcoma tumor of adolescence and young adulthood, which harbors a recurrent chromosomal translocation between the Ewing's sarcoma gene (EWSR1) and the Wilms' tumor suppressor gene (WT1). Patients usually develop multiple abdominal tumors with liver and lymph node metastasis developing later. Survival is poor using a multimodal therapy that includes chemotherapy, radiation and surgical resection, new therapies are needed for better management of DSRCT. Triggering cell apoptosis is the scientific rationale of many cancer therapies. Here, we characterized for the first time the expression of pro-apoptotic receptors, tumor necrosis-related apoptosis-inducing ligand receptors (TRAILR1-4) within an established human DSRCT cell line and clinical samples. The molecular induction of TRAIL-mediated apoptosis using agonistic small molecule, ONC201 in vitro cell-based proliferation assay and in vivo novel orthotopic xenograft animal models of DSRCT, was able to inhibit cell proliferation that was associated with caspase activation, and tumor growth, indicating that a cell-based delivery of an apoptosis-inducing factor could be relevant therapeutic agent to control DSRCT. Copyright © 2018. Published by Elsevier Inc.

  11. Efficacy of ONC201 in Desmoplastic Small Round Cell Tumor

    Directory of Open Access Journals (Sweden)

    Andrea A. Hayes-Jordan

    2018-05-01

    Full Text Available Desmoplastic Small Round Cell Tumor (DSRCT is a rare sarcoma tumor of adolescence and young adulthood, which harbors a recurrent chromosomal translocation between the Ewing’s sarcoma gene (EWSR1 and the Wilms’ tumor suppressor gene (WT1. Patients usually develop multiple abdominal tumors with liver and lymph node metastasis developing later. Survival is poor using a multimodal therapy that includes chemotherapy, radiation and surgical resection, new therapies are needed for better management of DSRCT. Triggering cell apoptosis is the scientific rationale of many cancer therapies. Here, we characterized for the first time the expression of pro-apoptotic receptors, tumor necrosis-related apoptosis-inducing ligand receptors (TRAILR1-4 within an established human DSRCT cell line and clinical samples. The molecular induction of TRAIL-mediated apoptosis using agonistic small molecule, ONC201 in vitro cell-based proliferation assay and in vivo novel orthotopic xenograft animal models of DSRCT, was able to inhibit cell proliferation that was associated with caspase activation, and tumor growth, indicating that a cell-based delivery of an apoptosis-inducing factor could be relevant therapeutic agent to control DSRCT.

  12. Surgical Technology Integration with Tools for Cognitive Human Factors (STITCH)

    Science.gov (United States)

    2010-10-01

    Measurement Tool We conducted another round of data collection using the daVinci Surgical System at the University of Kentucky Hospital in May. In this...9 3. Tools and Display Technology...considering cognitive and environmental factors such as mental workload, stress, situation awareness, and level of comfort with complex tools . To

  13. Inguinal endometriosis attaching to the round ligament

    International Nuclear Information System (INIS)

    Hagiwara, Y.; Hatori, M.; Kokubun, S.; Moriya, T.; Terada, Y.; Yaegashi, N.; Ehara, S.

    2007-01-01

    We report a case of endometriosis in the right inguinal region, attached to the right round ligament in a 28-year-old woman. At the age of 20, laparoscopic left ovarian cystectomy and pelvic adhesiolysis for endometriosis was carried out. She noticed a right tender groin mass 7 months previously, and the tumour size fluctuated with the menstrual cycle. A poorly circumscribed elastic hard mass, measuring 3 cm in diameter, was palpated in her right inguinal region. Magnetic resonance imaging showed a 2.5 cm x 2.5 cm mass in the right inguinal canal and a 5.4 cm x 6.8 cm mass was seen in the left ovary. The mass enlarged during menstruation. The groin mass was removed, in addition to carrying out laparoscopic ovarian cystectomy. At operation, the groin mass was found to be in continuity with the round ligament of extraperitoneal portion. Histological diagnosis of endometriosis was made in both ovarian and inguinal tumours. After surgery, the pain disappeared completely. Worth mentioning is that MRI clearly showed the change of tumour size depending on the menstrual cycle, which aided in arriving at the correct diagnosis of endometriosis in an unusual location

  14. The EWGRD Round Robin Measurement Exercise

    Science.gov (United States)

    Thornton, D. A.; Wagemans, J.; Fernandes, A. C.; Girard, J. M.; Kis, D. P.; Klupák, V.; Mutnuru, R.; Philibert, H.; Rousseau, G.; Santos, J. P.; Serén, T.; Zsolnay, E. M.

    2016-02-01

    This paper presents the results of a round robin exercise carried out to compare specific activity measurements performed by eight European organisations on a set of ten neutron activation detectors containing the radio-nuclides 110mAg, 60Co, 54Mn, 46Sc and 94Nb. The purpose of the exercise was to demonstrate the level of consistency between the participating organisations in blind tests of measurements relevant to reactor metrology. The samples used were selected from a stock of pre-existing irradiated material held at SCK•CEN. Taking turns over a period of approximately 9 months, the participating organisations received the samples, measured them and provided their results to an independent referee who collated and compared the data. The inter-comparison has demonstrated good agreement between the participants with standard deviations for each dosimeter varying between 1.6% and 3.1%. The paper provides results of the EWGRD Round Robin in an anonymised form together with discussion and conclusions which may be drawn from the exercise.

  15. 1. round table. Information and knowledge sharing

    International Nuclear Information System (INIS)

    2005-01-01

    The law from December 30, 1991, precisely defines 3 axes of researches for the management of high level and long-lived radioactive wastes: separation/transmutation, surface storage and underground disposal. A global evaluation report about these researches is to be supplied in 2006 by the French government to the Parliament. A first synthesis of the knowledge gained after 14 years of research has led the national commission of the public debate (CNDP) to organize a national debate about the general options of management of high-level and long-lived radioactive wastes before the 2006 date line. The debate comprises 4 public hearings (September 2005: Bar-le-Duc, Saint-Dizier, Pont-du-Gard, Cherbourg), 12 round-tables (October and November 2005: Paris, Joinville, Caen, Nancy, Marseille), a synthesis meeting (December 2005, Dunkerque) and a closing meeting (January 2006, Lyon). This document is the synthesis of the first round table debates about the information dissemination and the sharing of knowledge which took place at Caen. The main discussions of this session concerns the political decisions and the information of the public, and the transparency of this information as it should be in a western democracy. (J.S.)

  16. Tickling a high speed round jet

    Science.gov (United States)

    Arakeri, Vijay; Krothapalli, Anjaneyulu; Siddavaram, Vikram; Alkislar, Mehmet

    2001-11-01

    We have experimentally studied the effect of tickling a Mach 0.9 round jet with a set of microjets.Two dimensional velocity field measurements with PIV show a significant reduction in the turbulent intensities in the developing region of the jet with the activation of the microjets.Quantitatively,the axial and normal turbulence intensities are reduced by about 15respectively;even a larger effect is found on the magnitude of the correlation of axial and normal fluctuation intensities with a reduction of almost 40possible with a mass flow rate of the microjets being only about one percent of the main jet mass flow rate and hence justifying the use of the term `tickling`.The above findings are difficult to explain on the basis of stability considerations since there is very little change in the mean profile.Physically,the observed effect could be due to the alteration of the large eddy structures,which are so natural to a round jet,by the presence of the microjets.Exact nature of this interaction may be clarified with three dimensional PIV studies.It is expected that the tickling of the jet done as presently could have a favourable reflection in the aeroacoustics characteristics of the main jet.

  17. Impact of floating mass transducer coupling and positioning in round window vibroplasty.

    Science.gov (United States)

    Rajan, Gunesh P; Lampacher, Peter; Ambett, Ranjeeta; Dittrich, Gregor; Kuthubutheen, Jafri; Wood, Bradley; McArthur, Anne; Marino, Roberta

    2011-02-01

    The round window application of the Vibrant Sound bridge, the so-called round window vibroplasty, is gaining increasing popularity for hearing rehabilitation of patients with mixed hearing loss or conductive hearing loss. In these patients, conventional hearing amplification and/or surgical restoration is either not possible or has failed because of chronic ear disease, extensive otosclerosis, or malformations. The exact mechanisms of direct cochlear stimulation via the round window membrane are not yet completely understood. It is unclear what kind and what degree of contact is required between the floating mass transducer (FMT) and the round window membrane (RWM) to elicit a functional hearing perception with the implant. We investigated the coupling efficiency between the FMT and the RWM and how the efficiency is altered by the FMT position, the degree of FMT-RWM contact, and the use of a soft tissue coupler. Prospective cohort study. Tertiary referral center in Western Australia. Patients undergoing round window vibroplasty for a mixed or conductive hearing loss otherwise not aidable. Patients underwent round window vibroplasty and received audiological and coupling analysis in the follow-up. These data were then correlated with FMT positioning and the extent of FMT-RWM interface as determined by postoperative high-resolution temporal bone computed tomography. Coupling and hearing levels in relation to FMT positioning and degree of FMT-RWM contact. Of 10 patients, 8 were available for vibroplasty behavioral threshold testing. In 2 patients, testing could not be done because of wound breakdown requiring device explantation in 1 case, and in the other case, the bone conduction thresholds dropped 2 months after implantation, thus falling out of the performance range of the device. Postoperative FMT migration occurred in 50% of the patients (3/6) with recurrent chronic ear disease and status after multiple previous ear operations. All patients, including the 3

  18. Grand unification: quo vadis domine

    International Nuclear Information System (INIS)

    Senjanovic, G.

    1985-01-01

    The present theoretical and experimental situation with grand unification is summarized. The issues of proton decay and the Weinberg angle are addressed, going through the predictions of both the standard SU(5) theory and its supersymmetric extension. The SO(10) theory, which provides a minimal one family model, is then studied. The gravitational characteristics of domain walls and strings are then discussed. It is argued that there is a need to go beyond SO(10) in order to incorporate a unified picture of families. This leads to the prediction of mirror fermions, whose physics is analyzed. 31 refs

  19. Graafikatriennaali grand prix Korea kunstnikule

    Index Scriptorium Estoniae

    1998-01-01

    Tallinna XI graafikatriennaali rahvusvaheline žürii andis grand prix korea kunstnikule Chung¡Sang-Gonile, kolm võrdset preemiat - soome kunstnikele Anita Jensenile ja Tapani Mikkonenile ning jaapani kunstnikule Estuko Obatale. Eesti Kunstimuuseumi preemia - Wendy Swallow. Tallinna linna preemia ja Ivar Luki sponsoripreemia - Walter Jule. Sponsoripreemiad : Paletti Eesti AS preemia - Inga Heamägi; Rannila Profiili preemia - Mojca Zlokarnik; UNDP preemia - Andrea Juan. Rotermanni soolalao arhitektuuri- ja kunstikeskuse diplom - Lis Ingram, Heli Päivikki Kurunsaari, Randi Strand, Wendy Swallow

  20. Grand Challenges of Enterprise Integration

    Energy Technology Data Exchange (ETDEWEB)

    Brosey, W.D; Neal, R.E.; Marks, D.

    2001-04-01

    Enterprise Integration connects and combines people, processes, systems, and technologies to ensure that the right people and the right processes have the right information and the right resources at the right time. A consensus roadmap for Technologies for Enterprise Integration was created as part of an industry/government/academia partnership in the Integrated Manufacturing Technology Initiative (IMTI). Two of the grand challenges identified by the roadmapping effort will be addressed here--Customer Responsive Enterprises and Totally Connected Enterprises. Each of these challenges is briefly discussed as to the current state of industry and the future vision as developed in the roadmap.

  1. Grand Challenges for Environmental Magnetism

    Science.gov (United States)

    Verosub, K. L.

    2009-05-01

    The development of new, inexpensive, and rapid geochemical methods for determining the ages of geologic materials, their elemental composition, and their isotopic ratios over a broad array of elements puts into sharp focus the question: What information can environmental magnetic methods provide that can't be obtained using these other methods? Because iron is ubiquitous in the Earth's crust and because it exists in so many different forms, a discipline that looks in detail at iron-bearing minerals does have the potential to make significant contributions to the study of surficial processes. However, to reach that potential requires the development of new environmental magnetic methods. I would like to put forward three Grand Challenges for environmental magnetism that have the potential to move the field forward to a new level of scientific sophistication and that will allow environmental magnetists to compete successfully in a world increasingly dominated by geochemists. The first Grand Challenge is the development of new techniques that lead to the direct and unambiguous identification of the full suite of magnetic minerals. For many environmental magnetic applications, the key magnetic minerals are not just magnetite and hematite but also iron oxy-hydroxides (goethite, lepidocrocite, akaganeite, ferrihydrite), carbonates (siderite) and sulfides (pyrrhotite and greigite) as well as compounds involving iron and other transition metals (cobalt and nickel). The second Grand Challenge is the development of new analytical methods that provide specific quantitative values for the amount of each magnetic mineral present in a sample. One promising approach to this problem is the application of two- or three-component multivariate analysis to arrays of downcore environmental magnetic parameters. The third Grand Challenge is the development of new ways of determining, not just the average values, but the actual distributions of grain sizes and coercivities of each mineral

  2. The Grand Challenges of Nanotechnology

    International Nuclear Information System (INIS)

    Lane, Neal

    2001-01-01

    Amazing breakthroughs and advances continue to be made in nanoscale science and engineering and the rapidly emerging field of nanotechnology, including near-commercial applications in biomedicine, computing and environmental protection. The National Nanotechnology Initiative, begun by the Clinton Administration has placed nanoscale research on a new funding trajectory. But, many 'grand challenges' must be overcome, technical ones as well as those related to funding, science and technology workforce, and the need for stronger collaboration across discipline, organizations, government agencies and with other countries

  3. Implementing iRound: A Computer-Based Auditing Tool.

    Science.gov (United States)

    Brady, Darcie

    Many hospitals use rounding or auditing as a tool to help identify gaps and needs in quality and process performance. Some hospitals are also using rounding to help improve patient experience. It is known that purposeful rounding helps improve Hospital Consumer Assessment of Healthcare Providers and Systems scores by helping manage patient expectations, provide service recovery, and recognize quality caregivers. Rounding works when a standard method is used across the facility, where data are comparable and trustworthy. This facility had a pen-and-paper process in place that made data reporting difficult, created a silo culture between departments, and most audits and rounds were completed differently on each unit. It was recognized that this facility needed to standardize the rounding and auditing process. The tool created by the Advisory Board called iRound was chosen as the tool this facility would use for patient experience rounds as well as process and quality rounding. The success of the iRound tool in this facility depended on several factors that started many months before implementation to current everyday usage.

  4. The Dual Rounding Model: Forging Therapeutic Alliances 
in Oncology and Palliative Care.

    Science.gov (United States)

    Baxley, Carey E

    2016-04-01

    Inpatients with solid tumors at Duke University Hospital in Durham, NC, are cared for in a dynamic integrated care model that incorporates medical oncology and palliative care. This has profound implications for patients, their loved ones, medical and surgical staff, and oncology nurses. As a nurse with less than three years of experience, my participation in a setting that uses the Dual Rounding Model has accelerated my professional and personal development. During a typical shift, I am an oncology nurse, a palliative care nurse, and a hospice nurse.
.

  5. Investors flock to Venezuelan bidding rounds

    International Nuclear Information System (INIS)

    Kielmas, M.

    1997-01-01

    The Venezuelan government has disproved the long-cherished oil industry mantra that low tax rates attract private sector investors. At a time when most company managements feel they need to collect balance sheet assets at any price. Venezuela is ensuring that it remains the upmarket not the bargain basement investor target. Despite offering some of the most punitive and complicated fiscal terms worldwide, a near certainty that taxes will rise in the future and state oil company control of the join ventures' operating committees, oil investors of all sizes cannot keep away. The third marginal field reactivation round, launched late last year attracted a staggering 259 companies, both foreign and local, which prequalified to bid. (Author)

  6. European Enlargement Across Rounds and Beyond Borders

    DEFF Research Database (Denmark)

    Enlargement has been an almost constant part of European integration history – going from an improvised exercise to the EU’s most developed foreign policy tool. However, neither the longevity nor the complexity of enlargement has been properly historicised. European Enlargement across Rounds...... and Beyond Borders offers three interdisciplinary, innovative, and indeed radical, new ways of understanding and analysing EC/EU enlargements: first, tracing Longue Durée developments; second, investigating enlargement Beyond the Road to Membership; and third, exploring the Entangled Exchanges and synergies...... scholars, should engage with it. This publication will be of key interest to scholars and students of modern European history and politics, the European integration process, EU studies, and more broadly multilateral international institutions, history, law and the social sciences....

  7. On Round-off Error for Adaptive Finite Element Methods

    KAUST Repository

    Alvarez-Aramberri, J.

    2012-06-02

    Round-off error analysis has been historically studied by analyzing the condition number of the associated matrix. By controlling the size of the condition number, it is possible to guarantee a prescribed round-off error tolerance. However, the opposite is not true, since it is possible to have a system of linear equations with an arbitrarily large condition number that still delivers a small round-off error. In this paper, we perform a round-off error analysis in context of 1D and 2D hp-adaptive Finite Element simulations for the case of Poisson equation. We conclude that boundary conditions play a fundamental role on the round-off error analysis, specially for the so-called ‘radical meshes’. Moreover, we illustrate the importance of the right-hand side when analyzing the round-off error, which is independent of the condition number of the matrix.

  8. On Round-off Error for Adaptive Finite Element Methods

    KAUST Repository

    Alvarez-Aramberri, J.; Pardo, David; Paszynski, Maciej; Collier, Nathan; Dalcin, Lisandro; Calo, Victor M.

    2012-01-01

    Round-off error analysis has been historically studied by analyzing the condition number of the associated matrix. By controlling the size of the condition number, it is possible to guarantee a prescribed round-off error tolerance. However, the opposite is not true, since it is possible to have a system of linear equations with an arbitrarily large condition number that still delivers a small round-off error. In this paper, we perform a round-off error analysis in context of 1D and 2D hp-adaptive Finite Element simulations for the case of Poisson equation. We conclude that boundary conditions play a fundamental role on the round-off error analysis, specially for the so-called ‘radical meshes’. Moreover, we illustrate the importance of the right-hand side when analyzing the round-off error, which is independent of the condition number of the matrix.

  9. Ethics rounds: An appreciated form of ethics support.

    Science.gov (United States)

    Silén, Marit; Ramklint, Mia; Hansson, Mats G; Haglund, Kristina

    2016-03-01

    Ethics rounds are one way to support healthcare personnel in handling ethically difficult situations. A previous study in the present project showed that ethics rounds did not result in significant changes in perceptions of how ethical issues were handled, that is, in the ethical climate. However, there was anecdotal evidence that the ethics rounds were viewed as a positive experience and that they stimulated ethical reflection. The aim of this study was to gain a deeper understanding of how the ethics rounds were experienced and why the intervention in the form of ethics rounds did not succeed in improving the ethical climate for the staff. An exploratory and descriptive design with a qualitative approach was adopted, using individual interviews. A total of 11 healthcare personnel, working in two different psychiatry outpatient clinics and with experience of participating in ethics rounds, were interviewed. The study was based on informed consent and was approved by one of the Swedish Regional Ethical Review Boards. The participants were generally positive about the ethics rounds. They had experienced changes by participating in the ethics rounds in the form of being able to see things from different perspectives as well as by gaining insight into ethical issues. However, these changes had not affected daily work. A crucial question is whether or not increased reflection ability among the participants is a good enough outcome of ethics rounds and whether this result could have been measured in patient-related outcomes. Ethics rounds might foster cooperation among the staff and this, in turn, could influence patient care. By listening to others during ethics rounds, a person can learn to see things from a new angle. Participation in ethics rounds can also lead to better insight concerning ethical issues. © The Author(s) 2014.

  10. Trade Issues in the Doha Round; Dispelling Some Misconceptions

    OpenAIRE

    Stephen Tokarick

    2006-01-01

    The current round of multilateral trade negotiations-the Doha Round-presents an opportunity for countries to reap the benefits of trade liberalization. Unfortunately, a number of misconceptions about the likely impact of trade reforms has, in part, impeded more rapid progress toward completion of the Round. This paper addresses some of the most egregious of these misconceptions and presents results from IMF research that sheds light on these issues. In particular, this paper argues that: (i) ...

  11. Agreement on Agriculture in the Uruguay Round of GATT, The

    OpenAIRE

    Zuhair A. Hassan

    1994-01-01

    The Uruguay Round is the eighth round of multilateral trade negotiations (MTN) under the General Agreement on Tariffs and Trade (GATT). The previous seven rounds produced significant reductions in tariffs on manufactured goods, but little or no progress was made in opening international markets for agricultural trade (see Appendix A0. However, the distortions in international agricultural trade and domestic agricultural production and the increasing budgetary outlays prompted trade ministers ...

  12. Imaging of round pneumonia and mimics in children

    Energy Technology Data Exchange (ETDEWEB)

    Restrepo, Ricardo; Palani, Rajaneeshankar; Matapathi, Uma M.; Wu, Yen-Ying [Miami Children' s Hospital, Department of Radiology, Miami, FL (United States)

    2010-12-15

    Various diseases in the pediatric age group can present as an intrathoracic rounded opacity on a chest radiograph. The purpose of this pictorial essay is to emphasize the imaging appearance of round pneumonia, an entity that occurs especially in the pediatric population. Additional pathologies with similar chest radiographic appearances are also presented. The diagnosis of round pneumonia should be made in children who have the typical clinical presentation along with chest radiographs demonstrating the characteristic findings. (orig.)

  13. Is the Doha Round Dead? What is the Way Forward?

    OpenAIRE

    Faizel Ismail

    2012-01-01

    The WTO Doha Round of negotiations has been at an impasse since December 2008. Several academics and opinion makers have argued recently that the Doha Round is ‘dead’. This paper discusses the US narrative on the reasons for the impasse in the Doha Round and the way forward. It contrasts this narrative with that of the major developing country alliances in the WTO and considers some underlying causes for the current impasse in the Doha Round. The paper concludes that the US narrative that...

  14. Use of electrical barriers to deter movement of round goby

    Science.gov (United States)

    Savino, Jacqueline F.; Jude, David J.; Kostich, Melissa J.; Coutant, Charles C.

    2001-01-01

    An electrical barrier was chosen as a possible means to deter movement of round goby Neogobius melanostomus. Feasibility studies in a 2.1-m donut-shaped tank determined the electrical parameters necessary to inhibit round goby from crossing the 1-m stretch of the benthic, electrical barrier. Increasing electrical pulse duration and voltage increased effectiveness of the barrier in deterring round goby movement through the barrier. Differences in activity of round goby during daytime and nocturnal tests did not change the effectiveness of the barrier. In field verification studies, an electrical barrier was placed between two blocking nets in the Shiawassee River, Michigan. The barrier consisted of a 6-m wide canvas on which were laid four cables carrying the electrical current. Seven experiments were conducted, wherein 25 latex paint-marked round goby were introduced upstream of the electrical barrier and recovered 24 h later upstream, on, and downstream of the barrier. During control studies, round goby moved across the barrier within 20 min from release upstream. With the barrier on and using the prescribed electrical settings shown to inhibit passage in the laboratory, the only marked round goby found below the barrier were dead. At reduced pulse durations, a few round goby (mean one/test) were found alive, but debilitated, below the barrier. The electrical barrier could be incorporated as part of a program in reducing movement of adult round goby through artificial connections between watersheds.

  15. U-value measurements on ISO round Robin window

    DEFF Research Database (Denmark)

    Duer, Karsten

    1997-01-01

    9 laboratories in 6 european and 2 north american countries have participated in a round robin U-value test of a standard facade window. The objective of the round robin test was to verify that the ISO/CEN proposals for U-value measurement standard is robust.......9 laboratories in 6 european and 2 north american countries have participated in a round robin U-value test of a standard facade window. The objective of the round robin test was to verify that the ISO/CEN proposals for U-value measurement standard is robust....

  16. Impact of surgical case order on perioperative outcomes for robotic-assisted radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Anil A Thomas

    2014-01-01

    Conclusions: Surgical case order may influence perioperative outcomes for RARP with decreased operative times and increased length of hospital stay associated with later cases. These findings indicate that select perioperative factors may improve with ascending case order as the surgical team "warms up" during the day. In addition, 3 rd round cases can increase hospital costs associated with increased lengths of hospital stay. Knowledge of these differences may assist in surgical planning to improve outcomes and limit costs.

  17. Google Earth Grand Tour Themes

    Science.gov (United States)

    De Paor, D. G.; Whitmeyer, S. J.; Bentley, C.; Dordevic, M. M.

    2014-12-01

    As part of an NSF TUES Type 3 project entitled "Google Earth for Onsite and Distance Education (GEODE)," we are assembling a "Grand Tour" of locations on Earth and other terrestrial bodies that every geoscience student should know about and visit at least in virtual reality. Based on feedback from colleagues at previous meetings, we have identified nine Grand Tour themes: "Plates and Plumes," "Rocks and Regions," "Geology Through Time," "The Mapping Challenge*," "U.S. National Parks*," "The Magical Mystery Tour*," "Resources and Hazards," "Planets and Moons," and "Top of the Pops." Themes marked with an asterisk are most developed at this stage and will be demonstrated in real time. The Mapping Challenge invites students to trace geological contacts, measure bedding strike and dip and the plunge, trend, and facing of a fold. There is an advanced tool for modeling periclinal folds. The challenge is presented in a game-like format with an emphasis on puzzle-solving that will appeal to students regardless of gender. For the tour of U.S. national parks, we divided the most geologically important parks into four groups—Western Pacific, West Coast, Rockies, and East Coast. We are combining our own team's GigaPan imagery with imagery already available on the Internet. There is a great deal of imagery just waiting to be annotated for geological education purposes. The Magical Mystery Tour takes students to Google Streetview locations selected by instructors. Students are presented with questions or tasks and are given automatic feedback. Other themes are under development. Within each theme, we are crowd-sourcing contributions from colleagues and inviting colleagues to vote for or against proposed locations and student interactions. The GEODE team includes the authors and: Heather Almquist, Stephen Burgin, Cinzia Cervato, Gene Cooper, Paul Karabinos, Terry Pavlis, Jen Piatek, Bill Richards, Jeff Ryan, Ron Schott, Kristen St. John, and Barb Tewksbury.

  18. Role of immunohistochemistry and fluorescence in-situ hybridization (FISH in the diagnosis of spindle and round cell tumors of the kidney

    Directory of Open Access Journals (Sweden)

    M. Abbas

    2015-09-01

    Conclusion: In summary we advise an immunohistochemical panel for round/spindle cell tumors of the kidney and for unclear cases we advise to add (FISH to get the correct diagnosis, as they are completely different regarding surgical approach and post-operative adjuvant therapy.

  19. Next Generation Innovation Policy and Grand Challenges

    NARCIS (Netherlands)

    Kuhlmann, Stefan; Rip, Arie

    2018-01-01

    The paper explores transformative ways to address Grand Challenges, while locating them in a broader diagnosis of ongoing changes. Coping with Grand Challenges is a challenge in its own right, for policy as well as for science, technology, and innovation actors. The paper presents building blocks

  20. Proton hexality in local grand unification

    Energy Technology Data Exchange (ETDEWEB)

    Foerste, Stefan; Nilles, Hans Peter [Bonn Univ. (Germany). Bethe Center for Theoretical Physics and Physikalisches Institut; Ramos-Sanchez, Saul [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Vaudrevange, Patrick K.S. [Muenchen Univ. (Germany). Arnold Sommerfeld Center for Theoretical Physics

    2010-07-15

    Proton hexality is a discrete symmetry that avoids the problem of too fast proton decay in the supersymmetric extension of the standard model. Unfortunately it is inconsistent with conventional grand unification. We show that proton hexality can be incorporated in the scheme of ''Local Grand Unification'' discussed in the framework of model building in (heterotic) string theory. (orig.)

  1. Reconstruction of Bile Duct Injury and Defect with the Round Ligament.

    Science.gov (United States)

    Dokmak, Safi; Aussilhou, Béatrice; Ragot, Emilia; Tantardini, Camille; Cauchy, François; Ponsot, Philippe; Belghiti, Jacques; Sauvanet, Alain; Soubrane, Olivier

    2017-09-01

    Lateral injury of the bile duct can occur after cholecystectomy, bile duct dissection, or exploration. If direct repair is not possible, conversion to bilioenteric anastomosis can be needed with the risk of long-term bile duct infections and associated complications. We developed a new surgical technique which consist of reconstructing the bile duct with the round ligament. The vascularized round ligament is completely mobilized until its origin and used for lateral reconstruction of the bile duct to cover the defect. T tube was inserted and removed after few months. Patency of the bile duct was assessed by cholangiography, the liver function test and magnetic resonance imaging (MRI). Two patients aged 33 and 59 years old underwent lateral reconstruction of the bile duct for defects secondary to choledocotomy for stone extraction or during dissection for Mirizzi syndrome. The defects measured 2 and 3 cm and occupied half of the bile duct circumference. The postoperative course was marked by low output biliary fistula resolved spontaneously. In one patient, the T tube was removed at 3 months after surgery and MRI at 9 months showed strictly normal aspect of the bile duct with normal liver function test. The second patient is going very well 2 months after surgery and the T tube is closed. Lateral reconstruction of the bile duct can be safely achieved with the vascularized round ligament. We will extend our indications to tubular reconstruction.

  2. Family participation during intensive care unit rounds: attitudes and experiences of parents and healthcare providers in a tertiary pediatric intensive care unit.

    Science.gov (United States)

    Stickney, Carolyn A; Ziniel, Sonja I; Brett, Molly S; Truog, Robert D

    2014-02-01

    To compare the experiences and attitudes of healthcare providers and parents regarding parental participation in morning rounds, in particular to evaluate for differences in perception of parental comprehension of rounds content and parental comfort with attendance, and to identify subgroups of parents who are more likely to report comfort with attending rounds. Cross-sectional survey of 100 parents and 131 healthcare providers in a tertiary care pediatric medical/surgical intensive care unit. Descriptive statistics were used to analyze survey responses; univariate and multivariate analyses were performed to compare parent and healthcare provider responses. Of parents, 92% reported a desire to attend rounds, and 54% of healthcare providers reported a preference for parental presence. There were significant discrepancies in perception of understanding between the 2 groups, with healthcare providers much less likely to perceive that parents understood both the format (30% vs 73%, P parents. Analysis of parent surveys did not reveal characteristics correlated with increased comfort or desire to attend rounds. A majority of parents wish to participate in morning rounds, whereas healthcare provider opinions are mixed. Important discrepancies exist between parent and healthcare provider perceptions of parental comfort and comprehension on rounds, which may be important in facilitating parental presence. Copyright © 2014 Mosby, Inc. All rights reserved.

  3. Whole abdominopelvic radiotherapy for desmoplastic small round-cell tumor

    International Nuclear Information System (INIS)

    Goodman, Karyn A.; Wolden, Suzanne L.; La Quaglia, Michael P.; Kushner, Brian H.

    2002-01-01

    Purpose: Desmoplastic small round-cell tumor (DSRCT) is a rare, recently described intraperitoneal malignancy occurring predominantly in adolescent boys. Our objective was to evaluate the feasibility and outcome of whole abdominopelvic irradiation (WAPI) as part of a combined modality protocol for patients with DSRCT. Methods and Materials: The records of all 21 patients treated with WAPI for DSRCT at our institution from 1992 to 2001 were retrospectively reviewed. Patients were treated on an institutional protocol with 7 cycles of an alkylator-based chemotherapy. After maximal surgical debulking, patients were treated with external beam radiotherapy to the whole abdomen and pelvis to a dose of 30 Gy. Results: All 21 patients completed the prescribed treatment. The median follow-up was 28 months. The overall survival and relapse-free survival rate at 3 years was 48% and 19%, respectively. The median survival was 32 months, and the median time to relapse was 19 months. Most relapses were intraperitoneal and/or hepatic. Acute toxicities included Radiation Therapy Oncology Group Grade 2 upper and lower gastrointestinal toxicity in 81% and 71% of patients, respectively. All patients experienced acute hematologic toxicity, with Grade 4 thrombocytopenia, leukopenia, and anemia in 76%, 29%, and 33%, respectively. The major long-term toxicity was small bowel obstruction, which occurred in 7 patients (33%) after surgery and WAPI. Conclusion: DSRCT is a rare and highly lethal disease, requiring aggressive multimodality therapy. WAPI is feasible in conjunction with intensive chemotherapy and surgery. Hematologic and gastrointestinal toxicities are expected but manageable with diligent supportive care. The long-term efficacy of this therapy remains disappointing, thus novel approaches are being investigated

  4. Evidence for predatory control of the invasive round goby

    Science.gov (United States)

    Madenjian, C.P.; Stapanian, M.A.; Witzel, L.D.; Einhouse, D.W.; Pothoven, S.A.; Whitford, H.L.

    2011-01-01

    We coupled bioenergetics modeling with bottom trawl survey results to evaluate the capacity of piscivorous fish in eastern Lake Erie to exert predatory control of the invading population of round goby Neogobius melanostomus. In the offshore (>20 m deep) waters of eastern Lake Erie, burbot Lota lota is a native top predator, feeding on a suite of prey fishes. The round goby invaded eastern Lake Erie during the late 1990s, and round goby population size increased dramatically during 1999–2004. According to annual bottom trawl survey results, round goby abundance in offshore waters peaked in 2004, but then declined during 2004–2008. Coincidentally, round goby became an important component of burbot diet beginning in 2003. Using bottom trawling and gill netting, we estimated adult burbot abundance and age structure in eastern Lake Erie during 2007. Diet composition and energy density of eastern Lake Erie burbot were also determined during 2007. This information, along with estimates of burbot growth, burbot mortality, burbot water temperature regime, and energy densities of prey fish from the literature, were incorporated into a bioenergetics model application to estimate annual consumption of round goby by the adult burbot population. Results indicated that the adult burbot population in eastern Lake Erie annually consumed 1,361 metric tons of round goby. Based on the results of bottom trawling, we estimated the biomass of yearling and older round goby in offshore waters eastern Lake Erie during 2007–2008 to be 2,232 metric tons. Thus, the adult burbot population was feeding on round goby at an annual rate equal to 61% of the estimated round goby standing stock. We concluded that the burbot population had high potential to exert predatory control on round goby in offshore waters of eastern Lake Erie.

  5. Clinical and epidemiological round: journal club

    Directory of Open Access Journals (Sweden)

    Galeano-Toro, José Alejandro

    2017-10-01

    Full Text Available In this edition of the clinical and epidemiological round, we analyzed four articles which we have considered relevant to the clinical practice. Spaite et al. studied for the first time in the medical literature the truly prognosis value of a hypotensive threshold in the reanimation of the patient with moderate to severe traumatic brain injury. Oluwalana et al. assessed the impact of oral administration of azithromycin during delivery on the risk of maternal and neonatal infections. On the other hand, Esplin et al. evaluated the accuracy of the transvaginal cervical length and serial fetal fibronectin, alone or in combination, to predict spontaneous preterm birth in nulliparous pregnant women. Finally, the FOURIER group’s study assessed the effect of the reduction on LDL cholesterol levels achieved through evolocumab administration, in patients with clinically-evident cardiovascular disease which have a statin optimized therapy, on the composite outcome of cardiovascular death, stroke, myocardial infarction and need of hospitalization due to unstable angina or coronary revascularization.

  6. WTO new round agreement and nuclear

    International Nuclear Information System (INIS)

    Lee, M. K.; Moon, L. H.; Kim, S. S.

    2002-01-01

    The start of new round of WTO could be recognized as a turning point shifting from bilateral or regional trade system to multilateral trade system worldwide. The changes in international trade system are expected to have some impact on the Korean nuclear industry. The purpose of this study is to understand the impact on prepare opening the market for the plant design and engineering. This market has been protected by Agreement on Government Procurement(AGP). However, this market will be eventually influenced by GATS(General Agreement on Trade in Services) with KEPCO's on going privatization being completed. There have been no impacts on R and D fund provided by the government as yet. However, in case of Government supported R and D for commercial purpose, there are much concerns to be discussed further within new WTO agreement. It is necessary to develop a strategy for maximizing national interests and promoting R and D in the negotiation for design and construction services related with nuclear industry, and energy services. Furthermore, to effectively explore new nuclear markets in developing countries including China, market analyses for their countries are required

  7. Desmoplastic Small Round Cell Tumor of Stomach

    Directory of Open Access Journals (Sweden)

    Ahmed Abu-Zaid

    2013-01-01

    Full Text Available Desmoplastic small round cell tumor (DSRCT is an extremely uncommon, highly aggressive, and malignant mesenchymal neoplasm of undetermined histogenesis. Less than 200 case reports have been documented in literature so far. Herein, we report a 26-year-old otherwise healthy female patient who presented with a 1-month history of epigastric pain. On physical examination, a palpable, slightly mobile, and tender epigastric mass was detected. All laboratory tests were normal. A chest, abdominal, and pelvic contrast-enhanced computed tomography (CT scans showed a 3.8 × 7.2 × 8.7 cm ill-defined mass, involving gastric fundus and extending into gastric cardia and lower gastroesophageal junction. It was associated with multiple enlarged gastrohepatic lymph nodes; the largest measured 1.2 cm. There was no evidence of ascites or retroperitoneal or mesenteric lymphatic metastases. Patient underwent total gastrectomy with D2 lymphadenectomy, splenectomy, and antecolic Roux-en-Y esophagojejunal anastomosis. Histopathological examination revealed coexpression of mesenchymal, epithelial, and neural markers. The characteristic chromosomal translocation (t(11; 22(p13; q12 was demonstrated on fluorescence in situ hybridization (FISH technique. Diagnosis of DSRCT of stomach was confirmed. Patient received no postoperative radiotherapy or chemotherapy. A postoperative 3-month followup failed to show any recurrence. In addition, a literature review on DSRCT is included.

  8. Views of pharmacists on involvement in ward rounds in selected ...

    African Journals Online (AJOL)

    Background: Pharmacist participation in ward rounds is of increasing interest for better pharmaceutical care, yet most pharmacists do not engage in this activity. Objective: The objective was to obtain public sector pharmacistsf views and perceptions on their involvement in ward rounds. Method: A rapid assessment was ...

  9. Constant round group key agreement protocols: A comparative study

    NARCIS (Netherlands)

    Makri, E.; Konstantinou, Elisavet

    2011-01-01

    The scope of this paper is to review and evaluate all constant round Group Key Agreement (GKA) protocols proposed so far in the literature. We have gathered all GKA protocols that require 1,2,3,4 and 5 rounds and examined their efficiency. In particular, we calculated each protocol’s computation and

  10. Why Are So Many Things in the Solar System Round?

    Science.gov (United States)

    Heilig, Steven J.

    2010-01-01

    Several years ago a student asked why so many things in the solar system were round. He noted that many objects in the solar system, although not all, are round. The standard answer, which he knew, is that the mutual gravitational attraction of the molecules pulls them into the shape that gets them as close to each other as possible: a sphere.…

  11. 19 CFR 159.3 - Rounding of fractions.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Rounding of fractions. 159.3 Section 159.3 Customs... (CONTINUED) LIQUIDATION OF DUTIES General Provisions § 159.3 Rounding of fractions. (a) Value. In the... cents or more, the lower fractions shall be dropped, and if it is necessary to take up as whole dollars...

  12. Creating a Cycle of Continuous Improvement through Instructional Rounds

    Science.gov (United States)

    Meyer-Looze, Catherine L.

    2015-01-01

    Instructional Rounds is a continuous improvement strategy that focuses on the technical core of educational systems as well as educators collaborating side-by-side. Concentrating on collective learning, this process only makes sense within an overall strategy of improvement. This case study examined the Instructional Rounds process in a northern…

  13. Round pneumonia: imaging findings in a large series of children

    International Nuclear Information System (INIS)

    Kim, Yong-Woo; Donnelly, Lane F.

    2007-01-01

    Although round pneumonia is a well-known clinical entity, there have been no large case reviews, with most knowledge based on case reports and small series from the 1960s and 1970s. To review the imaging findings of a large series of children with round pneumonia. A retrospective review of radiographic and CT findings in all children reported to have round pneumonia at a large children's hospital from 2000 to 2006 was performed. Children with underlying medical conditions were excluded. Epidemiologic characteristics, radiographic and CT findings, and follow-up imaging were reviewed. The review identified 109 children (mean age 5 years, range 4 months to 19 years). Round pneumonias tended to be solitary 98% (107/109), have well-defined borders 70% (77/109), and be posteriorly located 83% (91/109), with the following lobar distribution: left lower lobe (36), right lower lobe (33), right upper lobe (28), left upper lobe (7), right middle lobe (4), and lingula (2). Round pneumonia tended to resolve on follow-up imaging (95%, 41/43) as compared to progression to lobar pneumonia (4.6%, 2/43). Three patients (2.6%, 3/112) originally suspected to have round pneumonia were later shown to have other diagnoses: cavitary necrosis in pneumonia (two) or pleural pseudocyst (one). Round pneumonia occurs in young children (mean age 5 years), tends to be a solitary lesion, and is most commonly posteriorly located. Misdiagnosis of other pathology as round pneumonia is uncommon. (orig.)

  14. La Grande: volver a empezar

    Directory of Open Access Journals (Sweden)

    Julio Premat

    2011-07-01

    Full Text Available Este texto, borrador de un trabajo más amplio, pretende despejar algunas pistas de lectura de La grande, en tanto que paradójico final de la producción de Saer. Digo “paradójico” porque puede tomársela como una novela de comienzo o de origen : de un volver a empezar, en todos los sentidos del término. En esa perspectiva podrían estudiarse algunos núcleos temáticos (como el retorno o el recuerdo de cara a la construcción del texto, a la relación planteada con la tradición y a la singular historia de su escritura (y al material genético que rodea y completa esta novela a la vez inacabada y póstuma. En esta intervención, la idea es la de comentar tres textos, escenas o frases del texto, y a partir de allí esbozar pistas para un estudio que está en ciernes.Première ébauche d’un travail de plus d’ampleur, ce texte vise à éclairer quelques pistes de lecture de La grande, en tant que fin paradoxale de la production de Saer. Je dis « paradoxale » parce que l’on peut considérer cette œuvre comme un roman des commencements ou des origines : comme un retour aux débuts, dans tous les sens du terme. Dans cette perspective, plusieurs nœuds thématiques (comme le retour ou le souvenir pourraient être étudiés en relation à la construction du texte, à la relation qui s’établit avec la tradition et à la singulière histoire de son écriture (et au matériau génétique qui entoure et complète ce roman, à la fois inachevé et posthume. Il sera question ici de commenter trois textes, scènes ou phrases du texte, et d’ébaucher à partir de là quelques pistes pour une étude à l’état naissant.The objective of this text, a draft for a broader work, is to outline some reading clues for La grande, inasmuch as it constitutes a paradoxical ending of Saer’s production. I say “paradoxical” because we can consider this work a novel of beginnings or of origins: a return to the beginning, in every meaning of the

  15. Rounded atelectasis of the lung: A pictorial review

    International Nuclear Information System (INIS)

    Sobocińska, Magdalena; Sobociński, Bartosz; Jarzemska, Agnieszka; Serafin, Zbigniew

    2014-01-01

    Rounded atelectasis of the lung is well described in medical literature, but still difficult to diagnose. Since lesions give no clinical symptoms in patients, radiologists are often the first to recognize the round lesion in an X-ray picture or a CT scan. Rounded atelectasis is an atypical form of lung collapse that usually occurs adjacent to scarred pleura and can be mistaken for lung cancer. Patients with rounded atelectasis have a history of asbestos exposure or pleural effusion due to various causes. When characteristic imaging findings are present, the diagnosis is rarely dubious and no further investigation is necessary. However, differential diagnosis of rounded atelectasis poses a challenge to pulmonary specialists and radiologists

  16. Rounded atelectasis of the lung: A pictorial review.

    Science.gov (United States)

    Sobocińska, Magdalena; Sobociński, Bartosz; Jarzemska, Agnieszka; Serafin, Zbigniew

    2014-01-01

    Rounded atelectasis of the lung is well described in medical literature, but still difficult to diagnose. Since lesions give no clinical symptoms in patients, radiologists are often the first to recognize the round lesion in an X-ray picture or a CT scan. Rounded atelectasis is an atypical form of lung collapse that usually occurs adjacent to scarred pleura and can be mistaken for lung cancer. Patients with rounded atelectasis have a history of asbestos exposure or pleural effusion due to various causes. When characteristic imaging findings are present, the diagnosis is rarely dubious and no further investigation is necessary. However, differential diagnosis of rounded atelectasis poses a challenge to pulmonary specialists and radiologists.

  17. A Grande Reportagem no contexto informativo SIC

    OpenAIRE

    Colaço, Vanessa Alexandra Francisco

    2014-01-01

    Os telespectadores querem ver grandes reportagens? Como evoluíram as audiências da Grande Reportagem SIC? É este o produto premium da estação? Terá este formato um investimento e continuidade garantidas? Estas são algumas das questões formuladas e às quais se procurou dar resposta neste Relatório de Estágio. Neste trabalho traça-se o perfil do programa Grande Reportagem SIC, clarificando a linha editorial que lhe serviu de base, procurando perceber as suas dinâmicas e passando em revista mome...

  18. Supersymmetry and supergravity: Phenomenology and grand unification

    International Nuclear Information System (INIS)

    Arnowitt, R.; Nath, P.

    1993-01-01

    A survey is given of supersymmetry and supergravity and their phenomenology. Some of the topics discussed are the basic ideas of global supersymmetry, the minimal supersymmetric Standard Model (MSSM) and its phenomenology, the basic ideas of local supersymmetry (supergravity), grand unification, supersymmetry breaking in supergravity grand unified models, radiative breaking of SU(2) x U(1), proton decay, cosmological constraints, and predictions of supergravity grand unified models. While the number of detailed derivations are necessarily limited, a sufficient number of results are given so that a reader can get a working knowledge of this field

  19. Software Engineering Support of the Third Round of Scientific Grand Challenge Investigations: Earth System Modeling Software Framework Survey

    Science.gov (United States)

    Talbot, Bryan; Zhou, Shu-Jia; Higgins, Glenn; Zukor, Dorothy (Technical Monitor)

    2002-01-01

    One of the most significant challenges in large-scale climate modeling, as well as in high-performance computing in other scientific fields, is that of effectively integrating many software models from multiple contributors. A software framework facilitates the integration task, both in the development and runtime stages of the simulation. Effective software frameworks reduce the programming burden for the investigators, freeing them to focus more on the science and less on the parallel communication implementation. while maintaining high performance across numerous supercomputer and workstation architectures. This document surveys numerous software frameworks for potential use in Earth science modeling. Several frameworks are evaluated in depth, including Parallel Object-Oriented Methods and Applications (POOMA), Cactus (from (he relativistic physics community), Overture, Goddard Earth Modeling System (GEMS), the National Center for Atmospheric Research Flux Coupler, and UCLA/UCB Distributed Data Broker (DDB). Frameworks evaluated in less detail include ROOT, Parallel Application Workspace (PAWS), and Advanced Large-Scale Integrated Computational Environment (ALICE). A host of other frameworks and related tools are referenced in this context. The frameworks are evaluated individually and also compared with each other.

  20. Should This Patient Receive Prophylactic Medication to Prevent Delirium?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

    Science.gov (United States)

    Tess, Anjala V; Mattison, Melissa L P; Leo, Joshua R; Reynolds, Eileen E

    2018-04-03

    In 2015, the American Geriatrics Society released recommendations for prevention and management of postoperative delirium, based on a systematic literature review and evaluation of nonpharmacologic and pharmacologic approaches by an expert panel. The guidelines recommend an interdisciplinary focus on nonpharmacologic measures (reorientation, medication management, early mobility, nutrition, and gastointestinal motility) for prevention and consideration of this strategy for acute management. They also recommend optimizing nonopioid medication as a means to manage pain and avoiding benzodiazepines other than to treat substance withdrawal. The authors concluded that evidence to recommend antipsychotics for prevention of delirium is insufficient but that these drugs may be considered for short-term treatment in the setting of imminent harm to the patient or caregivers or severe distress due to agitation. Patients should be given the lowest possible dose for the shortest duration when other nonpharmacologic measures have failed. In this Beyond the Guidelines, a psychiatrist and a geriatrician debate whether Mr. W, a 79-year-old man at high risk for postoperative delirium, should receive prophylactic antipsychotics with his next surgery. They review risk factors, appropriate evaluation, and potential benefits and harms of the various medications often used in this setting.

  1. Micro-surgical endodontics.

    Science.gov (United States)

    Eliyas, S; Vere, J; Ali, Z; Harris, I

    2014-02-01

    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  2. Round-table discussion on food irradiation

    International Nuclear Information System (INIS)

    1973-01-01

    The possibilities of using radiation for food preservation as a way of alleviating the food deficiency problem in a large part of the world has been studied for some 20 years. Since the idea was recognized as a viable one, scientists had to develop it along three levels: firstly, the technological problems and economic viability had to be faced; at the same time tests had to be initiated to prove the wholesomeness of the irradiated foodstuffs, and then public acceptance and confidence in the end product had to be established. Work is proceeding along these three lines and in some cases, success has been won on all fronts. In others, it is continuing. As a FLASHBACK to the situation TWO YEARS AGO, we thought it interesting to reprint excerpts from a round-table discussion at which scientists from five countries sat down to discuss the pros and cons of food irradiation. ost at the gathering was Dr. Rocco Basson, Director of Chemistry at Pelindaba, South Africa, and the man responsible for directing radiation processing in that country. With him were Dr. Lapidot, Head of the Radiation and Engineering and Processing Section of the Israel Atomic Energy Commission at Soreq; Dr. Saint-Lebe of the Radioagronomy Service, French Atomic Energy Commission, at Cadarache; Dr. Ulmann, then Director of the Food Irradiation Pilot Plant at Wageningen in Holland; and Mr. Roy Hickman, leader of the International Project in the Field of Irradiation, sponsored by the FAO, IAEA and the OECD Nuclear Energy Agency, centred at Karlsruhe in Germany. (author)

  3. Round table discussion during session 1

    International Nuclear Information System (INIS)

    Aebersold, M.

    2004-01-01

    The round table discussions of the first session of the Belgium Workshop addressed the following questions: - Accepting or refusing a person, an institution or a grouping as a legitimate Stakeholder who makes the decision and how? - How are the local partnerships built and organised? - How to obtain community support for the partnership's legitimate decisions/findings? - Experience teaches that no decision is reached solely by formal and legal processes. What role do informal processes play? - How can the informal procedures be accepted? Do they need to be made explicit? Discussion took place after the plenary presentations, at tables grouping Belgian stakeholders and FSC delegates. After the discussion, each table's findings were reported to the plenary. Most of the discussion concerned the local partnerships. Important findings were that the statutes for the partnerships were developed by the partnerships themselves and there were no legally binding rules handed down by the federal level. The partnerships are part of an informal process. A legally binding participation (i.e. within the EIA) will be initiated at a later stage. As the partnerships function outside of the formal legal procedure, they can function in a more flexible way. It was noted that the partnerships make recommendations, but it is not clear what the government will do with these recommendations. It was also argued that the process may cause conflicts between neighboring communities. As in other contexts visited by the FSC, the importance of the right of veto of the community was stressed, although this may cause a conflict between technical suitability and social acceptance. Access of the community to the local partnership is necessary. Finally it was accepted that time is needed to explain the recommendations to the broader community before any decisions are taken. (author)

  4. Dermatosurgery Rounds - The Island SKIN Infraorbital Flap

    Directory of Open Access Journals (Sweden)

    Georgi Tchernev

    2017-07-01

    Full Text Available The main objective in dermatologic surgery is complete excision of the tumour while achieving the best possible functional and cosmetic outcome. Also we must take into account age, sex, and tumour size and site. We should also consider the patient's expectations, the preservation of the different cosmetic units, and the final cosmetic outcome. Various reconstructive methods ranging from secondary healing to free flap applications are usedfor the reconstruction of perinasal or facial defects caused by trauma or tumour surgery. Herein, we describe the nasal infraorbital island skin flap for the reconstruction in a patient with basal cell carcinoma. No complications were observed in operation field. The infraorbital island skin flap which we describe for the perinasal area reconstruction is a safe, easily performed and versatile flap. The multidimensional use of this flap together with a relatively easy reconstruction plan and surgical procedure would be effective in flap choice.

  5. Las cinco grandes dimensiones de la personalidad

    Directory of Open Access Journals (Sweden)

    Jan ter Laak

    1996-12-01

    Full Text Available Este artículo revisa las distintas posiciones teóricas sobre las cinco grandes dimensiones de la personalidad, mostrando las semejanzas y diferencias entre las posturas teóricas. Esta contribución presenta lo siguiente: (a la génesis del contenido y la estructura de las cinco dimensiones; (b la fortaleza de las cinco dimensiones; (e la relación de las cinco grandes dimensiones con otros constructos de personalidad; (d discute el valor predictivo de las puntuaciones del perfil de las cinco dimensiones para criterios pertinentes; (e analiza el estatus teórico de las cinco dimensiones; (f discute críticas históricas sobre las cinco grandes dimensiones y se formulan respuestas a estas críticas; (g hace conjeturas para el futuro de las cinco grandes dimensiones; y (h concluye con algunas conclusiones y comentarios.

  6. Developing non-technical ward-round skills.

    Science.gov (United States)

    Harvey, Rachel; Mellanby, Edward; Dearden, Effie; Medjoub, Karima; Edgar, Simon

    2015-10-01

    Conducting clinical 'rounds' is one of the most onerous and important duties that every junior doctor is expected to perform. There is evidence that newly qualified doctors are not adequately prepared by their undergraduate experiences for this task. The aim of this study was to analyse the challenges pertaining to non-technical skills that students would face during ward rounds, and to create a model that facilitates the transition from medical student to doctor. A total of 217 final-year medical students completed a simulated ward round. Free-text responses were analysed using template analysis applying an a priori template developed from the literature by the research team. This drew on the generic categories of non-technical skills suggested by Flin et al. Ninety-seven per cent of students agreed or strongly agreed that the simulated ward round improved their insight into the challenges of ward rounds and their perceived ability to work efficiently as an active member of the ward round. The responding students (206) submitted written feedback describing the learning that they planned to use: 800 learning points were recorded, and all could be categorised into one of seven non-technical skills. Conducting clinical 'rounds' is one of the most onerous and important duties that every junior doctor is expected to perform We believe that improved task efficiency and insight into the challenges of the ward round gained by medical students will lead to an enhancement in performance during clinical rounds, and will have a positive impact on patient safety. We would suggest that undergraduate medical schools consider this model in the preparation for the clinical practice element of the curriculum. © 2015 John Wiley & Sons Ltd.

  7. Grand unification and gravity - selected topics

    International Nuclear Information System (INIS)

    Zee, A.

    1981-09-01

    The material given here was presented in lectures delivered at the 4th Kyoto Summer Institute on Grand Unification and Related Topics. It consists of six sections. The sections are: the family problem, fermion mass hierarchy, maximal local symmetry, operator analysis of new physics, dynamically generated gravity, and Kaluza theory and grand unification. The last section contains a (hopefully) pedagogical introduction to Kaluza theory. For pedagogical completeness, several appendices reviewing some elementary notions of differential geometry have been added

  8. Clinical and epidemiological round: journal club

    Directory of Open Access Journals (Sweden)

    Galeano-Toro, José Alejandro

    2017-04-01

    Full Text Available In this edition of Ronda Clínica y Epidemiológica four articles that we consider important for clinical practice are analyzed. The study by the SPIROMICS group wanted to rethink the use of spirometry for the diagnosis of chronic obstructive pulmonary disease (COPD, mainly in symptomatic patients with smoking history and preserved pulmonary function, but with outcomes similar to those developed in chronic pulmonary disease. Borja Gómez et al. aimed at validating a step-by-step approach for young febrile infants, in order to discard an invasive bacterial infection. The study by Talan et al. wanted to demonstrate that antibiotic therapy with trimethoprim-sulfamethoxazole, in addition to surgical drainage, was associated with a higher cure rate for cutaneous abscesses compared to placebo in a population with high prevalence of methicillinresistant Staphylococcus aureus (MRSA infection. Lastly, the EAT study analyzed the early introduction of allergenic foods in breast-fed infants, starting at the age of 3 months, as a strategy to protect them against the development of posterior food allergy.

  9. Unconventional fixation Thoracolumbar fractures using round hole boneplates and transpedicular screws

    International Nuclear Information System (INIS)

    Behairy, Yaser M.

    2001-01-01

    . It iseffective in the surgical treatment of unstable fractures around thethoracolumbar junction. Because of their low cost and ease of insertion,round hole bone plates are an excellent choice for short arthrodesis andinstrumentation of such fractures. (author)

  10. On security arguments of the second round SHA-3 candidates

    DEFF Research Database (Denmark)

    Andreeva, Elena; Bogdanov, Andrey; Mennink, Bart

    2012-01-01

    of which got accepted to the first round. 14 candidates were left in the second round, out of which five candidates have been recently chosen for the final round. An important criterion in the selection process is the SHA-3 hash function security. We identify two important classes of security arguments...... for the new designs: (1) the possible reductions of the hash function security to the security of its underlying building blocks and (2) arguments against differential attack on building blocks. In this paper, we compare the state of the art provable security reductions for the second round candidates...... and review arguments and bounds against classes of differential attacks.We discuss all the SHA-3 candidates at a high functional level, analyze, and summarize the security reduction results and bounds against differential attacks. Additionally, we generalize the well-known proof of collision resistance...

  11. Examination of the program to avoid round-off error

    International Nuclear Information System (INIS)

    Shiota, Y.; Kusunoki, T.; Tabushi, K.; Shimomura, K.; Kitou, S.

    2005-01-01

    The MACRO programs which express a simple shape such as PLANE, SPHERE, CYLINDER and CONE, are used to the formation of the geometry in EGS4. Each MACRO calculates the important value for the main code to recognize the configured geometry. This calculation process may generate the calculation error due to the effect of a round-off error. SPHERE, CYLINDER and CONE MACRO include the function to avoid the effect, but PLANE MACRO dose not include. The effect of the round-off error is small usually in case of PLANE MACRO, however a slant plane may cause the expansion of the effect. Therefore, we have configured the DELPLANE program with the function to avoid the effect of the round-off error. In this study, we examine the DELPLANE program using the simply geometry with slant plane. As a result, the normal PLANE MACRO generates the round-off error, however DELPLANE program dose not generates one. (author)

  12. Round robin performance testing of organic photovoltaic devices

    DEFF Research Database (Denmark)

    Gevorgyan, Suren; Zubillaga, Oihana; de Seoane, José María Vega

    2014-01-01

    This study addresses the issue of poor intercomparability of measurements of organic photovoltaic (OPV) devices among different laboratories. We present a round robin performance testing of novel OPV devices among 16 laboratories, organized within the framework of European Research Infrastructure...

  13. 7 CFR 1405.7 - Uruguay Round Agreements Act.

    Science.gov (United States)

    2010-01-01

    ... Uruguay Round Agreements Act. In the event the outlays by the United States for domestic support measures... level of domestic support provided by the United States complies with the commitments of the United...

  14. Bittersweet Findings: Round Cups Fail to Induce Sweeter Taste

    Directory of Open Access Journals (Sweden)

    Casparus J. A. Machiels

    2018-02-01

    Full Text Available An increasing body of literature demonstrates that consumers associate visual information with specific gustatory elements. This phenomenon is better known as cross-modal correspondence. A specific correspondence that has received attention of late is the one between round forms and sweet taste. Research indicates that roundness (as opposed to angularity is consistently associated with an increased sweetness perception. Focusing on two different cup forms (round versus angular, two studies tested this association for a butter milk drink and a mate-based soft drink. Results, however, were not able to corroborate the frequently suggested correspondence effect, but a correspondence was found between the angular cup and a more bitter taste for the soft drink. These results are discussed in light of previous findings matching sweetness with roundness and bitterness with angularity, hopefully aiding researchers in this field in conducting future experiments.

  15. Round-Table Meeting on China and Uzbekistan Strategic Partnership

    Institute of Scientific and Technical Information of China (English)

    Wen; Guangmei

    2013-01-01

    <正>Round-table meeting—"Strategic Partnership between China and Uzbekistan:experience,present condition and future"—jointly sponsored by the CPAFFC,China Foundation for International Studies(CFIS),the Center

  16. Promise Zone Round 2 Applicant Geography and Goal Data

    Data.gov (United States)

    Department of Housing and Urban Development — This dataset includes Promise Zone initiative round II applicant project data from 111 urban, rural, and tribal communities who consented to share their application...

  17. Improving nurse-physician teamwork through interprofessional bedside rounding.

    Science.gov (United States)

    Henkin, Stanislav; Chon, Tony Y; Christopherson, Marie L; Halvorsen, Andrew J; Worden, Lindsey M; Ratelle, John T

    2016-01-01

    Teamwork between physicians and nurses has a positive association with patient satisfaction and outcomes, but perceptions of physician-nurse teamwork are often suboptimal. To improve nurse-physician teamwork in a general medicine inpatient teaching unit by increasing face-to-face communication through interprofessional bedside rounds. From July 2013 through October 2013, physicians (attendings and residents) and nurses from four general medicine teams in a single nursing unit participated in bedside rounding, which involved the inclusion of nurses in morning rounds with the medicine teams at the patients' bedside. Based on stakeholder analysis and feedback, a checklist for key patient care issues was created and utilized during bedside rounds. To assess the effect of bedside rounding on nurse-physician teamwork, a survey of selected items from the Safety Attitudes Questionnaire (SAQ) was administered to participants before and after the implementation of bedside rounds. The number of pages to the general medicine teams was also measured as a marker of physician-nurse communication. Participation rate in bedside rounds across the four medicine teams was 58%. SAQ response rates for attendings, residents, and nurses were 36/36 (100%), 73/73 (100%), and 32/73 (44%) prior to implementation of bedside rounding and 36 attendings (100%), 72 residents (100%), and 14 (19%) nurses after the implementation of bedside rounding, respectively. Prior to bedside rounding, nurses provided lower teamwork ratings (percent agree) than residents and attendings on all SAQ items; but after the intervention, the difference remained significant only on SAQ item 2 ("In this clinical area, it is not difficult to speak up if I perceive a problem with patient care", 64% for nurses vs 79% for residents vs 94% for attendings, P=0.02). Also, resident responses improved on SAQ item 1 ("Nurse input is well received in this area", 62% vs 82%, P=0.01). Increasing face-to-face communication through

  18. Strategies for improving family engagement during family-centered rounds.

    Science.gov (United States)

    Kelly, Michelle M; Xie, Anping; Carayon, Pascale; DuBenske, Lori L; Ehlenbach, Mary L; Cox, Elizabeth D

    2013-04-01

    Family-centered rounds (FCR) are recommended as standard practice in the pediatric inpatient setting; however, limited data exist on best practices promoting family engagement during rounds. To identify strategies to enhance family engagement during FCR using a recognized systems engineering approach. In this qualitative study, stimulated recall interviews using video-recorded rounding sessions were conducted with participants representing the various stakeholders on rounds (15 parents/children and 22 healthcare team [HCT] members) from 4 inpatient services at a children's hospital in Wisconsin. On video review, participants were asked to provide strategies that would increase family engagement on FCR. Qualitative content analysis of interview transcripts was performed in an iterative process. We identified 21 categories of strategies corresponding to 2 themes related to the structure and process of FCR. Strategies related to the structure of FCR were associated with all five recognized work system elements: people (HCT composition), tasks (HCT roles), organization (scheduling of rounds and HCT training), environment (location of rounds and HCT positioning), and tools and technologies (computer use). Strategies related to the FCR process were associated with three rounding phases: before (HCT and family preparation), during (eg, introductions, presentation content, communication style), and after (follow-up) FCR. We identified a range of strategies to enhance family engagement during FCR. These strategies both confirm prior work on the importance of the content and style of communication on rounds and highlight other factors within the hospital work system, like scheduling and computer use, which may affect family engagement in care. Copyright © 2013 Society of Hospital Medicine.

  19. What if the Doha Round Fails? Implications for Canadian Agriculture

    OpenAIRE

    Gifford, Michael N.; McCalla, Alex F.; Meilke, Karl D.

    2008-01-01

    Many commentators assume that the WTO Doha Round negotiations have already failed and that this failure will not matter for Canadian agriculture. Neither view is correct. Most countries appear willing to make the effort needed to bring the negotiations to a make or break point in early 2008. If the Doha Round does eventually fail, an important opportunity to make the agricultural trading system significantly less distorted, more open and fair will have been lost. For Canadian agriculture, the...

  20. Round pneumonia: imaging findings in a large series of children

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong-Woo; Donnelly, Lane F. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2007-12-15

    Although round pneumonia is a well-known clinical entity, there have been no large case reviews, with most knowledge based on case reports and small series from the 1960s and 1970s. To review the imaging findings of a large series of children with round pneumonia. A retrospective review of radiographic and CT findings in all children reported to have round pneumonia at a large children's hospital from 2000 to 2006 was performed. Children with underlying medical conditions were excluded. Epidemiologic characteristics, radiographic and CT findings, and follow-up imaging were reviewed. The review identified 109 children (mean age 5 years, range 4 months to 19 years). Round pneumonias tended to be solitary 98% (107/109), have well-defined borders 70% (77/109), and be posteriorly located 83% (91/109), with the following lobar distribution: left lower lobe (36), right lower lobe (33), right upper lobe (28), left upper lobe (7), right middle lobe (4), and lingula (2). Round pneumonia tended to resolve on follow-up imaging (95%, 41/43) as compared to progression to lobar pneumonia (4.6%, 2/43). Three patients (2.6%, 3/112) originally suspected to have round pneumonia were later shown to have other diagnoses: cavitary necrosis in pneumonia (two) or pleural pseudocyst (one). Round pneumonia occurs in young children (mean age 5 years), tends to be a solitary lesion, and is most commonly posteriorly located. Misdiagnosis of other pathology as round pneumonia is uncommon. (orig.)

  1. Bundling the value of discharge telephone calls and leader rounding.

    Science.gov (United States)

    Setia, Nina; Meade, Christine

    2009-03-01

    Discharge telephone calls made by hospital staff provide invaluable opportunities to prevent adverse events, improve quality of care, and increase patient satisfaction. Similarly, the effect of rounding on patients can improve clinical quality and improve both patient and staff satisfaction. The author discusses how the combination of implementing both nurse leader rounding and discharge telephone calls simultaneously produced powerful positive outcomes in satisfaction and patient quality of care.

  2. American Pediatric Surgical Association

    Science.gov (United States)

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  3. Abortion - surgical - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  4. Urogynecologic Surgical Mesh Implants

    Science.gov (United States)

    ... procedures performed to treat pelvic floor disorders with surgical mesh: Transvaginal mesh to treat POP Transabdominal mesh to treat ... address safety risks Final Order for Reclassification of Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair Final Order for Effective ...

  5. Il regionalismo commerciale dopo l'Uruguay Round (Commercial regionalism after the Uruguay Round

    Directory of Open Access Journals (Sweden)

    E. GRILLI

    2013-10-01

    Full Text Available The attempts by a number of countries to partially or totally liberalise their trade on a discriminatory basis have long been documented. Despite the wide spread of the GATT in both geographical and temporal terms, regionalism has never easily co-existed with commercial multilateralism. The Uruguay Round has taken place in a period in which several key countries have radically changed trade policies. In this light, the search for a new balance between the multilateralism de jure and the regionalism de facto practiced by many members of the GATT took on importance as a test of their intentions to continue or not with the existing multilateral order or rather to modify it in a regional sense. This paper reviews the problems of coexistence between regionalism and multilateralism in the international trade order and demonstrates how few concrete conclusions can be drawn from an examination of both the theory and the empirical evidence.JEL: F13

  6. Leadership rounds to reduce health care-associated infections.

    Science.gov (United States)

    Knobloch, Mary Jo; Chewning, Betty; Musuuza, Jackson; Rees, Susan; Green, Christopher; Patterson, Erin; Safdar, Nasia

    2018-03-01

    Evidence-based guidelines exist to reduce health care-associated infections (HAIs). Leadership rounds are one tool leaders can use to ensure compliance with guidelines, but have not been studied specifically for the reduction of HAIs. This study examines HAI leadership rounds at one facility. We explored unit-based HAI leadership rounds led by 2 hospital leaders at a large academic hospital. Leadership rounds were observed on 19 units, recorded, and coded to identify themes. Themes were linked to the Consolidated Framework for Implementation Research and used to guide interviews with frontline staff members. Staff members disclosed unit-specific problems and readily engaged in problem-solving with top hospital leaders. These themes appeared over 350 times within 22 rounds. Findings revealed that leaders used words that demonstrated fallibility and modeled curiosity, 2 factors associated with learning climate and psychologic safety. These 2 themes appeared 115 and 142 times, respectively. The flexible nature of the rounds appeared to be conducive for reflection and evaluation, which was coded 161 times. Each interaction between leaders and frontline staff can foster psychologic safety, which can lead to open problem-solving to reduce barriers to implementation. Discovering specific communication and structural factors that contribute to psychologic safety may be powerful in reducing HAIs. Published by Elsevier Inc.

  7. 2010 Panel on the Biomaterials Grand Challenges

    Science.gov (United States)

    Reichert, William “Monty”; Ratner, Buddy D.; Anderson, James; Coury, Art; Hoffman, Allan S.; Laurencin, Cato T.; Tirrell, David

    2014-01-01

    In 2009, the National Academy for Engineering issued the Grand Challenges for Engineering in the 21st Century comprised of 14 technical challenges that must be addressed to build a healthy, profitable, sustainable, and secure global community (http://www.engineeringchallenges.org). Although crucial, none of the NEA Grand Challenges adequately addressed the challenges that face the biomaterials community. In response to the NAE Grand Challenges, Monty Reichert of Duke University organized a panel entitled Grand Challenges in Biomaterials at the at the 2010 Society for Biomaterials Annual Meeting in Seattle. Six members of the National Academies—Buddy Ratner, James Anderson, Allan Hoffman, Art Coury, Cato Laurencin, and David Tirrell—were asked to propose a grand challenge to the audience that, if met, would significantly impact the future of biomaterials and medical devices. Successfully meeting these challenges will speed the 60-plus year transition from commodity, off-the-shelf biomaterials to bioengineered chemistries, and biomaterial devices that will significantly advance our ability to address patient needs and also to create new market opportunities. PMID:21171147

  8. [A Case of an Abdominal Desmoplastic Small Round Cell Tumor with Metastasis in the Medulla Oblongata].

    Science.gov (United States)

    Azami, Ayaka; Takano, Yoshinao; Honda, Michitaka; Todate, Yukitoshi; Tada, Takeshi; Waragai, Mitsuru; Fukushima, Daizo; Suzuki, Nobuyasu; Sato, Atai; Abe, Tsuyoshi; Teranishi, Yasushi; Sakuma, Hideo

    2016-11-01

    A desmoplastic small round cell tumor(DSRCT)is a very rare malignant tumor that mainly occurs in the intra-abdominal cavity in young adults.This neoplasm has an extremely poor prognosis, with a clinical course characterized by rapid progression and metastasis.We present a 31-year-old man who presented with chief complaints of dysphagia, ataxic gait, and hoarseness.He first underwent surgical resection of a tumor in the medulla oblongata; however, the lesion was suspected to be a metastatic neoplasm.Following a thorough medical examination, the patient was diagnosed with retroperitoneal DSRCT with multiple metastatic lesions.He received multidisciplinary treatment including debulking surgery for the primary lesion; radiotherapy for metastatic lesions in the brain, abdomen, and cervical lymph nodes; hepatic artery embolization for liver metastasis; and systemic chemotherapy.The patient died of progressive disease 17 months after the initial diagnosis.

  9. The ward round--patient experiences and barriers to participation.

    Science.gov (United States)

    Swenne, Christine Leo; Skytt, Bernice

    2014-06-01

    Patients' participation is essential to their well-being and sense of coherence, as well as to their understanding of and adherence to prescribed treatments. Ward rounds serve as a forum for sharing information between patient and caregiver. The purpose of the ward round is to obtain information and plan medical and nursing care through staff-patient communication. The aim and objective of this study was to investigate patients' experiences during the ward round and their ability to participate in their care. The study was qualitative and descriptive in design. Fourteen inpatients at a cardiovascular ward were interviewed. Qualitative content analysis was used for the analysis. The ethics of scientific work were adhered to. Each study participant gave his/her informed consent based on verbal and written information. The study was approved by the Research Ethics Committee at Uppsala University. The analysis revealed one theme and three subthemes related to patients' experiences of ward rounds. The main theme was handling of information from the daily ward round while waiting for private consultation. The subthemes were making the best of the short time spent on ward rounds; encountering traditional roles and taking comfort in staff competency; and being able to choose the degree to which one participates in the decision-making process. Several aspects of traditional ward round routines could be improved in regard to the two-way information exchange process between caregivers and patient. Patients' and caregivers' ability to communicate their goals and the environment in which the communication occurs are of great importance. The information provided by nurses is easier to understand than that provided by physicians. The atmosphere must be open; the patient should be treated with empathy by staff; and patients' right to participate must be acknowledged by all healthcare professionals involved. © 2013 Nordic College of Caring Science.

  10. Comparison of student learning in the out-patient clinic and ward round.

    Science.gov (United States)

    Davis, M H; Dent, J A

    1994-05-01

    In undergraduate medical education there is a trend away from ward-based teaching towards out-patient and community-based teaching. To study the potential effects of this altered emphasis on student learning, a pilot group of final-year medical students at the University of Dundee was asked to keep individual structured log-books. These contained details of patients seen during their 3-week orthopaedic attachment in both a ward and out-patient setting. A comparison of perceived learning in the two settings showed that students learned more from attending an out-patient clinic than a ward round, but did not make full use of the learning potential of either. The setting did not particularly influence the balance of learning as categorized here but only the ward round supplied experience of surgical complications. The amount of learning taking place in an out-patient clinic was influenced by student ability, measured by examination performance, but not by clinic work-load. The implications of increased use of out-patient clinics and the advantages and disadvantages of the approach employed are discussed. It is concluded that in the situation studied student learning in the outpatient setting is as good as or superior to the ward setting but should not totally replace it.

  11. Effective Higgs theories in supersymmetric grand unification

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Sibo [Chongqing University, Department of Physics, Chongqing (China)

    2017-09-15

    The effective Higgs theories at the TeV scale in supersymmetric SU(5) grand unification models are systematically derived. Restricted to extensions on 5{sub H} containing the Higgs sector we show that only two types of real (vector-like) models and one type of chiral model are found to be consistent with perturbative grand unification. While the chiral model has been excluded by the LHC data, the fate of perturbative unification will be uniquely determined by the two classes of vector-like models. (orig.)

  12. Grand Tour: immaginario, territorio e culture digitali

    Directory of Open Access Journals (Sweden)

    Emiliano Ilardi

    2016-12-01

    Full Text Available Il Grand Tour può essere recuperato come asset narrativo utile per un intervento strategico di re-branding del viaggio in Italia? Il contributo analizza il contesto e le condizioni per una progettazione di questo livello nell’ambiente culturale dell’epoca digitale. Considerando gli archetipi moderni della mediazione dei luoghi come una grande riserva di senso, da riattivare sia nelle pratiche basate sui format seriali e transmediali che valorizzano i territori nella produzione creativa, sia nella costruzione di infrastrutture digitali e  transluoghi per la valorizzazione degli attrattori culturali.

  13. A Unified Grand Tour of Theoretical Physics

    CERN Document Server

    Lawrie, Ian D

    2002-01-01

    A unified account of the principles of theoretical physics, A Unified Grand Tour of Theoretical Physics, Second Edition stresses the inter-relationships between areas that are usually treated as independent. The profound unifying influence of geometrical ideas, the powerful formal similarities between statistical mechanics and quantum field theory, and the ubiquitous role of symmetries in determining the essential structure of physical theories are emphasized throughout.This second edition conducts a grand tour of the fundamental theories that shape our modern understanding of the physical wor

  14. Recommended Protocol for Round Robin Studies in Additive Manufacturing

    Science.gov (United States)

    Moylan, Shawn; Brown, Christopher U.; Slotwinski, John

    2016-01-01

    One way to improve confidence and encourage proliferation of additive manufacturing (AM) technologies and parts is by generating more high quality data describing the performance of AM processes and parts. Many in the AM community see round robin studies as a way to generate large data sets while distributing the cost among the participants, thereby reducing the cost to individual users. The National Institute of Standards and Technology (NIST) has conducted and participated in several of these AM round robin studies. While the results of these studies are interesting and informative, many of the lessons learned in conducting these studies concern the logistics and methods of the study and unique issues presented by AM. Existing standards for conducting interlaboratory studies of measurement methods, along with NIST’s experience, form the basis for recommended protocols for conducting AM round robin studies. The role of round robin studies in AM qualification, some of the limitations of round robin studies, and the potential benefit of less formal collaborative experiments where multiple factors, AM machine being only one, are varied simultaneously are also discussed. PMID:27274602

  15. Improved targeted immunization strategies based on two rounds of selection

    Science.gov (United States)

    Xia, Ling-Ling; Song, Yu-Rong; Li, Chan-Chan; Jiang, Guo-Ping

    2018-04-01

    In the case of high degree targeted immunization where the number of vaccine is limited, when more than one node associated with the same degree meets the requirement of high degree centrality, how can we choose a certain number of nodes from those nodes, so that the number of immunized nodes will not exceed the limit? In this paper, we introduce a new idea derived from the selection process of second-round exam to solve this problem and then propose three improved targeted immunization strategies. In these proposed strategies, the immunized nodes are selected through two rounds of selection, where we increase the quotas of first-round selection according the evaluation criterion of degree centrality and then consider another characteristic parameter of node, such as node's clustering coefficient, betweenness and closeness, to help choose targeted nodes in the second-round selection. To validate the effectiveness of the proposed strategies, we compare them with the degree immunizations including the high degree targeted and the high degree adaptive immunizations using two metrics: the size of the largest connected component of immunized network and the number of infected nodes. Simulation results demonstrate that the proposed strategies based on two rounds of sorting are effective for heterogeneous networks and their immunization effects are better than that of the degree immunizations.

  16. The 'Grand Paris' project: Tools and challenges

    OpenAIRE

    De Palma, André

    2011-01-01

    The purpose of this Round Table is to assess the economic effects of major transport infrastructure projects. The term major projects is used to designate qualitative leaps, be it the mapping out of new road or rail rings to link disparate radial penetration routes or the introduction of more-targeted innovations tackling frequency, speed or automation. (...)

  17. Optical properties of the human round window membrane

    Science.gov (United States)

    Höhl, Martin; DeTemple, Daphne; Lyutenski, Stefan; Leuteritz, Georg; Varkentin, Arthur; Schmitt, Heike Andrea; Lenarz, Thomas; Roth, Bernhard; Meinhardt-Wollweber, Merve; Morgner, Uwe

    2017-10-01

    Optical techniques are effective tools for diagnostic applications in medicine and are particularly attractive for the noninvasive analysis of biological tissues and fluids in vivo. Noninvasive examinations of substances via a fiber optic probe need to consider the optical properties of biological tissues obstructing the optical path. This applies to the analysis of the human perilymph, which is located behind the round window membrane. The composition of this inner ear liquid is directly correlated to inner ear hearing loss. In this work, experimental methods for studying the optical properties of the human round window membrane ex vivo are presented. For the first time, a comprehensive investigation of this tissue is performed, including optical transmission, forward scattering, and Raman scattering. The results obtained suggest the application of visible wavelengths (>400 nm) for investigating the perilymph behind the round window membrane in future.

  18. A calculational round robin in elastic-plastic fracture mechanics

    International Nuclear Information System (INIS)

    Larsson, L.H.

    Eighteen organizations participated in this round robin which treated the same three-point bend problem as an ASTM round robin four years earlier. Overall deformation, J, CTOD and crack profile were the main results required using plane strain elastic-plastic finite element analysis for a monotonically increasing load up to a maximum deformation which was far beyond the elastic regime. All elastic solutions were accurate to within a few percent. In the elastic-plastic regime, however, there was a large scatter of the results, increasing with increasing plastic deformation and roughly of the same order as in the ASTM round robin which contained ten solutions. Apparently no significant progress has taken place in the state of the art of numerical EPFM analysis in four years time. The paper discusses the reasons for this scatter and draws tentative conclusions on the most suitable numerical analysis methods in EPFM. (Auth.)

  19. How river rocks round: resolving the shape-size paradox.

    Directory of Open Access Journals (Sweden)

    Gabor Domokos

    Full Text Available River-bed sediments display two universal downstream trends: fining, in which particle size decreases; and rounding, where pebble shapes evolve toward ellipsoids. Rounding is known to result from transport-induced abrasion; however many researchers argue that the contribution of abrasion to downstream fining is negligible. This presents a paradox: downstream shape change indicates substantial abrasion, while size change apparently rules it out. Here we use laboratory experiments and numerical modeling to show quantitatively that pebble abrasion is a curvature-driven flow problem. As a consequence, abrasion occurs in two well-separated phases: first, pebble edges rapidly round without any change in axis dimensions until the shape becomes entirely convex; and second, axis dimensions are then slowly reduced while the particle remains convex. Explicit study of pebble shape evolution helps resolve the shape-size paradox by reconciling discrepancies between laboratory and field studies, and enhances our ability to decipher the transport history of a river rock.

  20. Round-Robin Test of Paraffin Phase-Change Material

    Science.gov (United States)

    Vidi, S.; Mehling, H.; Hemberger, F.; Haussmann, Th.; Laube, A.

    2015-11-01

    A round-robin test between three institutes was performed on a paraffin phase-change material (PCM) in the context of the German quality association for phase-change materials. The aim of the quality association is to define quality and test specifications for PCMs and to award certificates for successfully tested materials. To ensure the reproducibility and comparability of the measurements performed at different institutes using different measuring methods, a round-robin test was performed. The sample was unknown. The four methods used by the three participating institutes in the round-robin test were differential scanning calorimetry, Calvet calorimetry and three-layer calorimetry. Additionally, T-history measurements were made. The aim of the measurements was the determination of the enthalpy as a function of temperature. The results achieved following defined test specifications are in excellent agreement.

  1. Hilbert's Grand Hotel with a series twist

    Science.gov (United States)

    Wijeratne, Chanakya; Mamolo, Ami; Zazkis, Rina

    2014-08-01

    This paper presents a new twist on a familiar paradox, linking seemingly disparate ideas under one roof. Hilbert's Grand Hotel, a paradox which addresses infinite set comparisons is adapted and extended to incorporate ideas from calculus - namely infinite series. We present and resolve several variations, and invite the reader to explore his or her own variations.

  2. "Teine" võitis Prantsusmaal Grand Prix'

    Index Scriptorium Estoniae

    2006-01-01

    Prantsusmaal Essonne'is toimuval 8. Euroopa filmifestivalil Cinessonne sai üliõpilaste žürii grand prix rahvusvahelises ühistöös valminud tantsufilm "Teine" ("Another") : režissöör Rene Vilbre. Ka teistest festivalidest, kus film osalenud

  3. The Virtual Grand Tour as Educational Paradigm

    DEFF Research Database (Denmark)

    Hansen, Per Skafte; Mouritsen, Lars

    2001-01-01

    The Virtual Grand Tour as defined here bears some resemblance to its 18th century ancestor: a wide range of individual topics are treated as a whole; a tutor, whether real or simulated, present or remote, is provided; a set of problem solving tools forms an integrated part of the "traveller...

  4. Grand Prix Eurovision: Eine Fankultur im Medienzeitalter

    Directory of Open Access Journals (Sweden)

    Heinz Moser

    2017-06-01

    Full Text Available Der Grand Prix Eurovision ist seit Jahrzehnten eine der bekanntesten Unterhaltungssendungen im europäischen Raum. Dennoch erregte es Verwunderung, wenn der Schreibende Bekannten darüber berichtete, daß dies ein Forschungsgegenstand sei. Wurde von Interviews mit Grand Prix-Fans erzählt, so fielen schnell Aussagen wie: „Wie kann man sich nur für so etwas Abseitiges und Triviales wie den Grand Prix interessieren“. Dennoch bin ich der Meinung, daß Fankulturen für die entstehende Mediengesellschaft ein nicht unwichtiges Forschungsthema darstellen. Zwar geht es nicht um eine medienpädagogische Fragestellung im engeren Sinne; die Fans des Grand Prix Eurovision sind dem Jugendalter längst entwachsen. Dennoch handelt es sich bei Fangemeinschaften um Phänomene, die im Rahmen von Jugend- und Kinderkulturen von besonderer Relevanz sind. So meint Winter (1997, daß jugendliche Fanwelten eine bedeutende Rolle als Kristallisationspunkte kultureller Differenzierung spielen: ,Die Zugehörigkeit zu einer Fan weit ist Teil der jugendlichen Lebensbewältigung in der Postmoderne, denn in der Gemeinschaft der Fans können Jugendliche emotionale Allianzen eingehen, außeralltäglichen Beschäftigungen nachgehen, expressive Identitätsmuster gemeinschaftlich realisieren und sich mit ihrer Lebenssituation als Heranwachsende auseinandersetzen“ (Winter 1997, S. 51f..

  5. Grand Canyon Monitoring and Research Center

    Science.gov (United States)

    Hamill, John F.

    2009-01-01

    The Grand Canyon of the Colorado River, one of the world's most spectacular gorges, is a premier U.S. National Park and a World Heritage Site. The canyon supports a diverse array of distinctive plants and animals and contains cultural resources significant to the region's Native Americans. About 15 miles upstream of Grand Canyon National Park sits Glen Canyon Dam, completed in 1963, which created Lake Powell. The dam provides hydroelectric power for 200 wholesale customers in six western States, but it has also altered the Colorado River's flow, temperature, and sediment-carrying capacity. Over time this has resulted in beach erosion, invasion and expansion of nonnative species, and losses of native fish. Public concern about the effects of Glen Canyon Dam operations prompted the passage of the Grand Canyon Protection Act of 1992, which directs the Secretary of the Interior to operate the dam 'to protect, mitigate adverse impacts to, and improve values for which Grand Canyon National Park and Glen Canyon National Recreation Area were established...' This legislation also required the creation of a long-term monitoring and research program to provide information that could inform decisions related to dam operations and protection of downstream resources.

  6. Comprehensive District Reform: Philadelphia's Grand Experiment.

    Science.gov (United States)

    Useem, Elizabeth; Balfanz, Robert

    2002-01-01

    This report describes "Philadelphia's Grand Experiment" in comprehensive school district reform, from its conception through its initial months of implementation. In 2001, as part of the remedy for low student performance, the governor ordered the state to take over governance of the Philadelphia School District, with a substantial…

  7. Rio Branco, grand strategy and naval power

    Directory of Open Access Journals (Sweden)

    João Paulo Alsina Jr.

    2014-12-01

    Full Text Available This article addresses Baron of Rio Branco's grand strategy and the role played by the naval reorganization program (1904-1910 in this context. The ensuing case study determined the domestic and international constraints that affected the program, as well as the worldview of the patron of Brazilian diplomacy regarding military power's instrumentality to foreign policy.

  8. Reisipakkumine - Grand Tour Itaalias / Mai Levin

    Index Scriptorium Estoniae

    Levin, Mai, 1942-

    2009-01-01

    Tiina Abeli koostatud ja Urmas Viigi kujundatud näitus "Grand Tour. Eesti kunstnikud Itaalias" Kumu Kunstimuuseumis 05. aprillini. Loetletud eksponeeritud tööde autoreid. Näitus annab ülevaate, kes siinsetest kunstnikest 19. sajandi algusest kuni 1930ndate aastateni Itaalias käisid ja kuidas see nende loomingut mõjutas

  9. Middle Rio Grande Basin Research Report 2008

    Science.gov (United States)

    Deborah M. Finch; Catherine Dold

    2008-01-01

    An ecosystem is rarely static. A natural system composed of plants, animals, and microorganisms interacting with an area's physical factors, an ecosystem is always fluctuating and evolving. But sometimes, often at the hands of humans, ecosystems change too much. Such is the case with many of the ecosystems of the Middle Rio Grande Basin of New Mexico.

  10. Panel - Rio Grande restoration: Future directions

    Science.gov (United States)

    Deborah M. Finch; Pete V. Domenici; Jeffrey. C. Whitney; Steve Harris; Brian Shields; Clifford S. Crawford

    1996-01-01

    The purpose of this panel was to discuss historical and current changes to the Rio Grande system, focusing on the middle Basin, and to present and review different individual, organizational, and political perspectives on the future of the system. Invitations were made to panelists based on their past and current interests and activities pertaining to restoration of...

  11. Removal of an intra-abdominal desmoplastic small round cell tumor by repetitive debulking surgery: A case report and literature review

    OpenAIRE

    SHIMAZAKI, JIRO; MOTOHASHI, GYO; NISHIDA, KIYOTAKA; TABUCHI, TAKANOBU; UBUKATA, HIDEYUKI; TABUCHI, TAKAFUMI

    2014-01-01

    In the current study, a case of recurrent desmoplastic small round cell tumor (DSRCT) is presented, which was successfully treated by repetitive debulking surgery. In May 2010, a 39-year-old male, with a history of surgical resection of intra-abdominal DSRCT, visited the Ibaraki Medical Center, Tokyo Medical University Hospital (Ami, Japan) with severe lower abdominal discomfort. Abdominal computed tomography revealed a large tumor in the pouch of Douglas with a small number of nodules in the...

  12. Efficient, Robust and Constant-Round Distributed RSA Key Generation

    DEFF Research Database (Denmark)

    Damgård, Ivan Bjerre; Mikkelsen, Gert Læssøe

    2010-01-01

    We present the first protocol for distributed RSA key generation which is constant round, secure against malicious adversaries and has a negligibly small bound on the error probability, even using only one iteration of the underlying primality test on each candidate number.......We present the first protocol for distributed RSA key generation which is constant round, secure against malicious adversaries and has a negligibly small bound on the error probability, even using only one iteration of the underlying primality test on each candidate number....

  13. Cassini ISS Observation of Saturn from Grand Finale Orbits

    Science.gov (United States)

    Blalock, J. J.; Sayanagi, K. M.; Ingersoll, A. P.; Dyudina, U.; Ewald, S. P.; McCabe, R. M.; Garland, J.; Gunnarson, J.; Gallego, A.

    2017-12-01

    We present images captured during Cassini's Grand Finale orbits, and their preliminary analyses. During the final 22 orbits of the mission, the spacecraft is in orbits that have 6.5 day period at an inclination of 62 degrees, apoapsis altitude of about 1,272,000 km, and periapsis altitudes of about 2,500 km. Images captured during periapsis passes show Saturn's atmosphere at unprecedented spatial resolution. We present preliminary analyses of these images, including the final images captured before the end of the mission when the spacecraft enters Saturn's atmosphere on September 15th, 2017. Prominent features captured during the final orbits include the north polar vortex and other vortices as well as very detailed views of the "popcorn clouds" that reside between the Hexagon and the north pole. In the cloud field between zonal jets, clouds either resemble linear streaks suggestive of cirrus-like clouds or round shapes suggestive of vortices or cumulus anvil. The presence of linear streaks that follow lines of constant latitudes suggests that meridional mixing is inhibited at those latitudes. The size of vortices may reflect latitudinal variation in the atmospheric deformation radius. We also compare the new images to those captured earlier in the Cassini mission to characterize the temporal evolution such as changes in the zonal jet speeds, and prevalence and colors of vortices. A particular focus of our interest is the long-term change in the color of the hexagon, the evolution of the wind speeds in the jetstream that blows eastward at the boundary of the hexagon, and the morphology of the north polar vortex. Our work has been supported by NASA PATM NNX14AK07G, NSF AAG 1212216, and NASA NESSF NNX15AQ70H.

  14. Deriving DICOM surgical extensions from surgical workflows

    Science.gov (United States)

    Burgert, O.; Neumuth, T.; Gessat, M.; Jacobs, S.; Lemke, H. U.

    2007-03-01

    The generation, storage, transfer, and representation of image data in radiology are standardized by DICOM. To cover the needs of image guided surgery or computer assisted surgery in general one needs to handle patient information besides image data. A large number of objects must be defined in DICOM to address the needs of surgery. We propose an analysis process based on Surgical Workflows that helps to identify these objects together with use cases and requirements motivating for their specification. As the first result we confirmed the need for the specification of representation and transfer of geometric models. The analysis of Surgical Workflows has shown that geometric models are widely used to represent planned procedure steps, surgical tools, anatomical structures, or prosthesis in the context of surgical planning, image guided surgery, augmented reality, and simulation. By now, the models are stored and transferred in several file formats bare of contextual information. The standardization of data types including contextual information and specifications for handling of geometric models allows a broader usage of such models. This paper explains the specification process leading to Geometry Mesh Service Object Pair classes. This process can be a template for the definition of further DICOM classes.

  15. Recognizing surgical patterns

    NARCIS (Netherlands)

    Bouarfa, L.

    2012-01-01

    In the Netherlands, each year over 1700 patients die from preventable surgical errors. Numerous initiatives to improve surgical practice have had some impact, but problems persist. Despite the introduction of checklists and protocols, patient safety in surgery remains a continuing challenge. This is

  16. Surgical medical record

    DEFF Research Database (Denmark)

    Bulow, S.

    2008-01-01

    A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15......A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15...

  17. Distinguishing attack on five-round Feistel networks

    DEFF Research Database (Denmark)

    Knudsen, Lars Ramkilde; Raddum, H

    2003-01-01

    Recently it was shown (by J. Patarin) how to distinguish a general five-round Feistel network from a random permutation using O(2/sup 3n/2/) chosen plaintexts or O(2/sup 7n/4/) known plaintexts. The present authors report improvement of these results and a distinguisher is presented which uses ro...

  18. Pioneer round of translation occurs during serum starvation

    International Nuclear Information System (INIS)

    Oh, Nara; Kim, Kyoung Mi; Cho, Hana; Choe, Junho; Kim, Yoon Ki

    2007-01-01

    The pioneer round of translation plays a role in translation initiation of newly spliced and exon junction complex (EJC)-bound mRNAs. Nuclear cap-binding protein complex CBP80/20 binds to those mRNAs at the 5'-end, recruiting translation initiation complex. As a consequence of the pioneer round of translation, the bound EJCs are dissociated from mRNAs and CBP80/20 is replaced by the cytoplasmic cap-binding protein eIF4E. Steady-state translation directed by eIF4E allows for an immediate and rapid response to changes in physiological conditions. Here, we show that nonsense-mediated mRNA decay (NMD), which restricts only to the pioneer round of translation but not to steady-state translation, efficiently occurs even during serum starvation, in which steady-state translation is drastically abolished. Accordingly, CBP80 remains in the nucleus and processing bodies are unaffected in their abundance and number in serum-starved conditions. These results suggest that mRNAs enter the pioneer round of translation during serum starvation and are targeted for NMD if they contain premature termination codons

  19. Security proof for round robin differential phase shift QKD

    NARCIS (Netherlands)

    Leermakers, D.; Skoric, B.

    2017-01-01

    We give the first information-theoretic security proof of the `Round Robin Differential Phase Shift' Quantum Key Distribution scheme. Our proof consists of the following steps. We construct an EPR variant of the scheme. We identify Eve's optimal way of coupling an ancilla to an EPR qudit pair under

  20. Eating Disorders in Young Athletes. A Round Table.

    Science.gov (United States)

    Physician and Sportsmedicine, 1985

    1985-01-01

    A round table discussion by a physician, a psychiatrist, a dietitian, and 3 college coaches reviewed the problem of anorexia nervosa and bulimia in young athletes who are compulsive overachievers. Coaches need to know the symptoms and potential consequences of these illnesses in order to detect them and to counsel athletes properly. (MT)

  1. Lower antibiotic costs attributable to clinical microbiology rounds.

    Science.gov (United States)

    Huang, Richard S P; Guervil, David J; Hunter, Robert L; Wanger, Audrey

    2015-09-01

    At our institution, our microbiologist, pharmacist, and infectious disease (ID) team meet to discuss ID patients, and this meeting is referred to as microbiology rounds. We hypothesized that our microbiology rounds reduce antibiotic costs. The study involved a review of 80 patients with an ID consultation order at each of the 3 hospitals: hospital A (HA) (only HA has microbiology rounds), hospital B (HB), and hospital C (HC). Of this population, we included patients with a positive blood culture. Thirty-six patients who met the above criteria were included in the study. The average antibiotic cost/patient/day at HA, HB, and HC were $66.0, $123, and $109, respectively. Also, we found that change in antibiotics was appropriate when compared to the final microbiology results in 90%, 44%, and 40% of the time at HA, HB, and HC, respectively. Herein, we found an association between conducting microbiology rounds and reduction of antibiotic cost. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Psychiatry Morbidity and Mortality Rounds: Implementation and Impact

    Science.gov (United States)

    Goldman, Stuart; Demaso, David R.; Kemler, Beth

    2009-01-01

    Objective: This study assessed the implementation of psychiatry morbidity and mortality rounds (M&Ms) on the clinical and educational practice in a children's hospital. Methods: Attendees to monthly M&Ms between July 2005 and May 2007 included staff and trainees from psychiatry, psychology, nursing, and social work. Cases were selected based on a…

  3. Small round structured viruses (SRSVs) and transmission electron ...

    African Journals Online (AJOL)

    Administrator

    immune-electron microscopy (IEM) from patients' feces. They reported this virus particle as the causative agent of winter vomiting outbreaks in Norwalk (Kapikian et al.,. 1972). This is the remarkable landmark study of non- bacterial gastroenteritis viruses, especially for small round structured viruses (SRSVs). After that, many.

  4. Military Base Closures: Observations on Prior and Current BRAC Rounds

    Science.gov (United States)

    DOD indicates that recommendations from the previous BRAC rounds were implemented within the 6-year period mandated by law. As a result, DOD estimated that it reduced its domestic infrastructure by about 20 percent; about 90 percent of unneeded BRAC property is now available for reuse.

  5. THEORETICAL FLANGING PRINCIPLES IN ROUND BILLET WITH ITS LOCAL HEATING

    Directory of Open Access Journals (Sweden)

    L. A. Isaevich

    2010-01-01

    Full Text Available The paper considers wall thickness changes of a round billet in the pipe expansion process with subsequent flanging owing to thinning of this wall in the strain zone and bearing strain of an internal edge. Equations for calculation of thinning value are given in the paper. 

  6. Competitors' Perceptions of Questions in Individual Events Rounds.

    Science.gov (United States)

    Mills, Daniel; Pettus, Ann Burnett

    A study investigated student competitors' opinions of the practice of judges asking questions of competitors at the conclusion of speeches in the individual events competiton at forensic tournaments. Surveys were completed by 52 final round student competitors at a large midwestern university individual events invitational tournament. Results…

  7. Ward Round - a boy with multiple joint swellings | Tickell | Malawi ...

    African Journals Online (AJOL)

    Ward Round - a boy with multiple joint swellings. D Tickell. Abstract. No Abstract Malawi Medical Journal Vol. 20 (3) 2008: pp. 99-100. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/mmj.v20i3.10968 · AJOL African Journals Online.

  8. Medieval Round Churches and the Shape of the Earth.

    Science.gov (United States)

    Haagensen, Erling; Lind, Niels C

    2015-12-01

    There is a unique cluster of four medieval round churches, linked by a simple geometry, on Bornholm Island in the Baltic Sea. Why so many and why so close together? Immediate simple answers are "Just by chance" and "For no reason." Why are the churches round? "Defense." This essay proposes another hypothesis for this unique situation: the churches are astronomical observatories, meant to solve a scientific problem (Is the Earth really spherical?) and a practical problem (How far is it to sail west to the Orient?). The capacity and desire to find answers, together with other practical needs related to astronomy, can better explain these round churches' special architecture. The geometry that connects them fits the ideal pattern with an angular accuracy of 1 minute of a degree. The round churches may be the earliest astronomical observatories in Christian Europe; other hypotheses have been shown to be untenable. Their location provides for a good method to estimate the Earth's extent in the east-west direction, seemingly the earliest such measurements.

  9. Benign Multicystic Mesothelioma in the Left Round Ligament: Case Report

    International Nuclear Information System (INIS)

    Bae, So Young; Yi, Boem Ha; Lee, Hae Kyung; Park, Seong Jin; Cho, Gyu Seok; Kwak, Jeong Ja

    2010-01-01

    Benign multicystic mesothelioma is a rare mesothelial lesion that forms multicystic masses in the upper abdomen, pelvis, and retroperitoneum. Most cases have a benign course. We present the ultrasound and MR findings of benign multicystic mesothelioma in the left round ligament, which caused a left inguinal hernia in a 46-year-old woman

  10. Benign Multicystic Mesothelioma in the Left Round Ligament: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Bae, So Young; Yi, Boem Ha; Lee, Hae Kyung; Park, Seong Jin; Cho, Gyu Seok; Kwak, Jeong Ja [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2010-02-15

    Benign multicystic mesothelioma is a rare mesothelial lesion that forms multicystic masses in the upper abdomen, pelvis, and retroperitoneum. Most cases have a benign course. We present the ultrasound and MR findings of benign multicystic mesothelioma in the left round ligament, which caused a left inguinal hernia in a 46-year-old woman.

  11. Ward Round - Late Presentation of Acute Compartment Syndrome in ...

    African Journals Online (AJOL)

    following the course of ibuprofen mentioned. Twelve days after admission he started to complain of increasing pain and tightness in his left thigh. Sensation and motor function. Ward Round - Late Presentation of Acute. Compartment Syndrome in the Thigh. University of Malawi, College of Medicine, Department of Surgery,.

  12. Cosmological implications of grand unified theories

    International Nuclear Information System (INIS)

    Nanopoulos, D.V.

    1982-01-01

    These lectures, mainly devoted to the cosmological implications of GUTs, also include the essential ingredients of GUTs and some of their important applications to particle physics. Section 1 contains some basic points concerning the structure of the standard strong and electroweak interactions prior to grand unification. A detailed expose of GUTs is attempted in sect. 2, including their basci principles and their consequences for particle physics. The minimal, simplest GUT, SU 5 is analysed in some detail and it will be used throughout these lectures as the GUT prototype. Finally, sect. 3 contains the most important cosmological implications of GUTs, including baryon number generation in the early Universe (in rather lengthy detail), dissipative processes in the very early Universe, grand unified monopoles, etc. (orig./HSI)

  13. The geology of Piz Pian Grand

    International Nuclear Information System (INIS)

    Huber, M.; Staeuble, J.

    1987-01-01

    Nagra has identified four potential sites for a repository for low- and intermediate-level waste. Exploration work is already underway at Oberbauenstock (UR) and Piz Pian Grand (GR). As part of the investigations in the Piz Pian Grand area, geological surface mapping was carried out between 1984 and 1987. Since the data obtained is still being evaluated, it would be premature to draw any interpretative conclusions at this stage. On the other hand, some of the most significant observations of this work can be summarised here. As a first step, the geological framework in which these investigations are to be seen should be defined. Observations will then be made on the rock content (lithology) and geometric structure (structural geology) of the area. (author) 6 figs

  14. Grand Gulf-prioritization of regulatory requirements

    International Nuclear Information System (INIS)

    Meisner, M.J.

    1993-01-01

    As cost pressures mount, Grand Gulf nuclear station (GGNS) is relying increasingly on various prioritization approaches to implement, modify, eliminate, or defer regulatory requirements. Regulatory requirements can be prioritized through the use of three measures: (1) safety (or risk) significance; (2) cost; and (3) public policy (or political) significance. This paper summarizes GGNS' efforts to implement solutions to regulatory issues using these three prioritization schemes to preserve a balance between cost and safety benefit

  15. Between two evils: Investors prefer grand corruption!

    OpenAIRE

    Graf Lambsdorff, Johann

    2005-01-01

    Recent empirical studies claim that, in addition to levels of corruption, investors are deterred by its unpredictability. I claim instead that it is petty corruption that deters investors. I employ seven subcomponents of corruption for a sample of 102 countries that appear in the 2003 Global Competitiveness Report of the WEF. The second principal component of this data depicts a grand, political type, embracing corruption in government policymaking and in judicial decisions as opposed to corr...

  16. Grand Challenges in Music Information Research

    OpenAIRE

    Goto, Masataka

    2012-01-01

    This paper discusses some grand challenges in which music information research will impact our daily lives and our society in the future. Here, some fundamental questions are how to provide the best music for each person, how to predict music trends, how to enrich human-music relationships, how to evolve new music, and how to address environmental, energy issues by using music technologies. Our goal is to increase both attractiveness and social impacts of music information research in the fut...

  17. Meliponiculture in Rio Grande do Norte

    Directory of Open Access Journals (Sweden)

    Ulysses Madureira Maia

    2015-12-01

    Full Text Available ABSTRACT. Maia U.M., Jaffe R., Carvalho A.T. & Imperatriz-Fonseca V.L. [Meliponiculture in Rio Grande do Norte.] Meliponicultura no Rio Grande do Norte. Revista Brasileira de Medicina Veterinária, 37(4:327-333, 2015. Departamento de Biologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP 14040-901, Brasil. E-mail: ummaia@usp.br This study aimed to assess the current status of stingless bee beekeeping (meliponiculture in the State of Rio Grande do Norte, Brazil, with the aid of structured questionnaires made during visits to beekeepers. The results were compared with a previous census made in the state and with a similar study from Australia. Meliponiculture in Rio Grande do Norte is still informal and little standardized. The activity has grown in recent years considering the mean number of nests per beekeeper. Most apiaries are formed of up to 50 colonies, usually distributed in the backyards of homes. Twelve species of stingless bees were reared in the state, and the most common was the “Jandaíra” bee (Melipona subnitida, whose honey is considered medicinal. While many beekeepers already know the importance of bees as pollinators, stingless bees are still not used for crop pollination. Compared to a recent analysis of beekeeping in Australia, meliponiculture in Brazil is more traditional, honey is the main product and the number of colonies per beekeeper is much higher. Our results highlight the need to reinforce knowledge about bees and promote specific training aimed at improving and standardizing management practices.

  18. Neutrino mixing in a grand unified theory

    International Nuclear Information System (INIS)

    Milton, K.; Tanaka, K.

    1980-01-01

    Neutrino mixing in a grand unified theory in which the neutrino mass matrix is determined by the Gell-Mann-Ramond-Slansky mechanism was investigated. With an arbitrary real right-handed Majorana mass matrix which incorporates three neutrino mass scales, the effects of the up-quark mass matrix are found to be dominant and as a result no significant mixing of ν/sub e/ occurs, while ν/sub μ/ - ν/sub γ/ mixing can be substantial

  19. The Grand Strategy of Charles de Gaulle

    Science.gov (United States)

    1989-09-08

    4. TITLE AND SUBTITLE The Grand Startegy of Charles de Gaulle 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...dependent on French influence within NATO and the Common Market . De Gaulle frequently used these fora to veto British and American initiatives. As Cook...the reserve currency. Gold would be the basis of international finance and a French-dominated European Common Market would provide the framework

  20. Quality improvement of interdisciplinary rounds by leadership training based on essential quality indicators of the Interdisciplinary Rounds Assessment Scale

    NARCIS (Netherlands)

    Ten Have, Elsbeth C. M.; Nap, Raoul E.; Tulleken, Jaap E.

    2013-01-01

    The implementation of interdisciplinary teams in the intensive care unit (ICU) has focused attention on leadership behavior. Daily interdisciplinary rounds (IDRs) in ICUs integrate leadership behavior and interdisciplinary teamwork. The purpose of this intervention study was to measure the effect of

  1. [Grand Banks activity : updates and opportunities

    International Nuclear Information System (INIS)

    Bruce, G.

    1998-01-01

    An overview of the exploration and on-going activities by the petroleum industry on the Grand Banks of Newfoundland was presented. The two offshore oil developments underway are Hibernia and Terra Nova, both located in the Jeanne d'Arc Basin. Current production from Hibernia is 68,000 bopd, expected to rise to 130,000 bopd in 1999. The Terra Nova Field is still under development. Total recoverable reserves from the 17 discoveries made in the Jeanne d'Arc Basin are estimated at 1.6 billion barrels of oil and 4 trillion cubic feet of gas. Industry participants in the area include Amoco, Petro-Canada, Mobil, Chevron, Husky and Norsk Hydro. Petro-Canada believes the Grand Banks represent one of the best opportunities for oil anywhere in the world. There are currently 21 exploration licenses held on the Grand Banks. Major attractions of the area include the large reserve potential, the relatively low finding costs, the size of the pools being discovered, improvements in offshore technology that have substantially lowered development costs, and a profit-sensitive generic royalty regime that ensures reasonable rates of return for investors. figs

  2. Proton decay in grand unified theories

    International Nuclear Information System (INIS)

    Lucha, W.

    1984-01-01

    Interactions which violate the conservation of baryon and lepton number represent an intrinsic part of all grand unified theories (GUTs) of strong and electroweak interactions. These new interactions - predicted within the framework of GUTs - generate B and L violating four-fermion interactions via the exchange of superheavy particles which cannot be ascribed a well-defined baryon or lepton number. The effective coupling constant of these four-fermion interactions might be large enough to make the proton decay detectable by the present generation of experiments. In this review the basic concepts of conventional as well as supersymmetric GUTs relevant for proton decay are sketched. The baryon number violating sector of grand unified theories is discussed in more detail. Special emphasis is laid on the various selection rules arising as consequences of low-energy gauge invariance and supersymmetry for proton decay. These selection rules already determine the coarse pattern of the resulting decay modes and branching ratios without any reference to or detailed knowledge of the underlying grand unified theory. Finally the numerous theoretical predictions are summarized and confronted with experiment. (Author)

  3. Raptor Use of the Rio Grande Gorge

    Energy Technology Data Exchange (ETDEWEB)

    Ponton, David A. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-03-20

    The Rio Grande Gorge is a 115 km long river canyon located in Southern Colorado (15 km) and Northern New Mexico (100 km). The majority of the canyon is under the administration of the Bureau of Land Management {BLM), and 77 km of the canyon south of the Colorado/New Mexico border are designated Wild River under the National Wild and Scenic Rivers Act of 1968. Visits I have made to the Rio Grande Gorge over the past 15 .years disclosed some raptor utilization. As the Snake River Birds of Prey Natural Area gained publicity, its similarity to the Rio Grande Gorge became obvious, and I was intrigued by the possibility of a high raptor nesting density in the Gorge. A survey in 1979 of 20 km of the northern end of the canyon revealed a moderately high density of red-tailed hawks and prairie falcons. With the encouragement of that partial survey, and a need to assess the impact of river-running on nesting birds of prey, I made a more comprehensive survey in 1980. The results of my surveys, along with those of a 1978 helicopter survey by the BLM, are presented in this report, as well as general characterization of the area, winter use by raptors, and an assessment of factors influencing the raptor population.

  4. Differences by Ending Rounds and Other Rounds in Time-Motion Analysis of Mixed Martial Arts: Implications for Assessment and Training.

    Science.gov (United States)

    Miarka, Bianca; Brito, Ciro J; Moreira, Danilo G; Amtmann, John

    2018-02-01

    Miarka, B, Brito, CJ, Moreira, DG, and Amtmann, J. Differences by ending rounds and other rounds in time-motion analysis of mixed martial arts: implications for assessment and training. J Strength Cond Res 32(2): 534-544, 2018-This study aimed to support training program development through the comparison of performance analysis of professionals mixed martial art (MMA) athletes in the bouts that were not finished by points. Using digital recordings of each bout, we analyzed 1,564 rounds (678 bouts) which were separated by ending and other rounds. Our results indicated that knockout/technical knockout is the main outcome that defines the ending round (≈60%); however, there is a higher frequency of ending by submission on the first and second rounds (>30%). Bouts ending during the first or second rounds had shorter total time and standing combat with low intensity than ending in the third round (91.5 ± 71.4, 93.4 ± 67.5, and 143.2 ± 87.4; for low intensity in the first, second, and third rounds, respectively; p ≤ 0.05), whereas standing combat time with high intensity was longer in the last round in comparison to bouts that finished in the first or second rounds (7.4 ± 9.2, 9.7 ± 18.0, and 17.7 ± 29.1 for high intensity in the first, second, and third rounds, respectively; p ≤ 0.05). The lower time dedicated to low-intensity stand-up combat actions, regardless of round, and forcefulness of the actions in groundwork in the first and second rounds seem to be elements that increase the probability of success in professional MMA bouts; these factors have essential implications related to training program design.

  5. Surgical ethics: surgical virtue and more.

    Science.gov (United States)

    Vercler, Christian J

    2015-01-01

    The encounter between a patient and her surgeon is unique for several reasons. The surgeon inflicts pain upon a patient for the patient's own good. An operative intervention is irreducibly personal, such that the decisions about and performance of operations are inseparable from the idiosyncrasies of the individual surgeon. Furthermore, there is a chasm of knowledge between the patient and surgeon that is difficult to cross. Hence, training in the discipline of surgery includes the inculcation of certain virtues and practices to safeguard against abuses of this relationship and to make sure that the best interests of the patient are prioritized. The stories in this issue are evidence that in contemporary practice this is not quite enough, as surgeons reflect on instances they felt were ethically challenging. Common themes include the difficulty in communicating surgical uncertainty, patient-surgeon relationships, ethical issues in surgical training, and the impact of the technological imperative on caring for dying patients.

  6. Surgical site infections

    African Journals Online (AJOL)

    Decrease the inflammatory response Vasodilatation leads to better perfusion and ... Must NOT be allowed to come in contact with brain, meninges, eyes or .... project (SCIP): Evolution of National Quality Measure. Surgical. Infection 2008 ...

  7. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  8. Ambulatory Surgical Measures - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  9. Surgical Management of Hemorrhoids

    Science.gov (United States)

    Agbo, S. P.

    2011-01-01

    Hemorrhoids are common human afflictions known since the dawn of history. Surgical management of this condition has made tremendous progress from complex ligation and excision procedures in the past to simpler techniques that allow the patient to return to normal life within a short period. Newer techniques try to improve on the post-operative complications of older ones. The surgical options for the management of hemorrhoids today are many. Capturing all in a single article may be difficult if not impossible. The aim of this study therefore is to present in a concise form some of the common surgical options in current literature, highlighting some important post operative complications. Current literature is searched using MEDLINE, EMBASE and the Cochrane library. The conclusion is that even though there are many surgical options in the management of hemorrhoids today, most employ the ligature and excision technique with newer ones having reduced post operative pain and bleeding. PMID:22413048

  10. Surgical site infections

    African Journals Online (AJOL)

    Surgical site infections (SSIs) are a worldwide problem that has ... deep tissue is found on clinical examination, re-opening, histopathological or radiological investigation ..... Esposito S, Immune system and SSI, Journal of Chemotherapy, 2001.

  11. Surgical management of pain

    African Journals Online (AJOL)

    If these therapies fail, and with a thorough multidisciplinary approach involving carefully ... Generally, surgical pain management is divided into neuro- modulative .... 9 suggested. It is important to be sure that the underlying instability or.

  12. [Simulation in surgical training].

    Science.gov (United States)

    Nabavi, A; Schipper, J

    2017-01-01

    Patient safety during operations hinges on the surgeon's skills and abilities. However, surgical training has come under a variety of restrictions. To acquire dexterity with decreasingly "simple" cases, within the legislative time constraints and increasing expectations for surgical results is the future challenge. Are there alternatives to traditional master-apprentice learning? A literature review and analysis of the development, implementation, and evaluation of surgical simulation are presented. Simulation, using a variety of methods, most important physical and virtual (computer-generated) models, provides a safe environment to practice basic and advanced skills without endangering patients. These environments have specific strengths and weaknesses. Simulations can only serve to decrease the slope of learning curves, but cannot be a substitute for the real situation. Thus, they have to be an integral part of a comprehensive training curriculum. Our surgical societies have to take up that challenge to ensure the training of future generations.

  13. Reactor Pressure Vessel P-T Limit Curve Round Robin

    Energy Technology Data Exchange (ETDEWEB)

    Jang, C.H.; Moon, H.R.; Jeong, I.S. [Korea Electric Power Research Institute, Taejon (Korea)

    2002-07-01

    This report is the summary of the analysis results for the P-T Limit Curve construction which have been subjected to the round robin analysis. The purpose of the round robin is to compare the procedure and method used in various organizations to construct P-T limit curve to prevent brittle fracture of reactor pressure vessel of nuclear power plants. Each Participant used its own approach to construct the P-T limit curve and submitted the results, By analyzing the results, the reference procedure for the P-T limit curve could be established. This report include the results of the comparison of the procedure and method used by the participants, and sensitivity study of the key parameters. (author) 23 refs, 88 figs, 17 tabs.

  14. Higher Order Differential Attack on 6-Round MISTY1

    Science.gov (United States)

    Tsunoo, Yukiyasu; Saito, Teruo; Nakashima, Hiroki; Shigeri, Maki

    MISTY1 is a 64-bit block cipher that has provable security against differential and linear cryptanalysis. MISTY1 is one of the algorithms selected in the European NESSIE project, and it has been recommended for Japanese e-Government ciphers by the CRYPTREC project. This paper reports a previously unknown higher order differential characteristic of 4-round MISTY1 with the FL functions. It also shows that a higher order differential attack that utilizes this newly discovered characteristic is successful against 6-round MISTY1 with the FL functions. This attack can recover a partial subkey with a data complexity of 253.7 and a computational complexity of 264.4, which is better than any previous cryptanalysis of MISTY1.

  15. Response of round gobies, Neogobius melanostomus, to conspecific sounds

    Science.gov (United States)

    Isabella-Valenzi, Lisa

    A useful model group to examine reproductive plasticity in acoustic responsiveness is the family Gobiidae. Male round gobies Neogobius melanostomus emit calls and females respond to these calls with high specificity. The current study investigates differential attraction between reproductive morphologies of the goby to conspecific calls and explores the use of calls to develop a bioacoustic trap. Behavioural responsiveness to conspecific calls was tested using playback experiments in the lab and field. Females showed a strong attraction to the grunt call in both the lab and field, while nonreproductive and sneaker males preferred the drum call in the lab, but favoured the grunt call in the field. By determining the relationship between reproductive state and auditory responsiveness to conspecific calls, I am further elucidating the function of acoustic communication in the round goby and may be essential when creating control strategies to prevent the spread of the invasive species.

  16. Information and communication technologies - A new round of household electrification

    International Nuclear Information System (INIS)

    Ropke, Inge; Haunstrup Christensen, Toke; Ole Jensen, Jesper

    2010-01-01

    Information and communication technologies (ICTs) increasingly permeate everyday life in industrialized societies. The aim of this paper is to explore ICT-related transformations of everyday practices and discuss the implications, particularly for residential electricity consumption. The present socio-technical changes are seen in a historical perspective, and it is argued that the integration of ICT into everyday practices can be seen as a new round of household electrification, comparable to earlier rounds that also led to higher electricity consumption. A case study carried out in Denmark in 2007-2008 explores the present changes in everyday life. Based on qualitative interviews, the study focuses on people's ways of integrating ICTs into their everyday practices, on any significant changes in these practices, and on the influence of the changed practices on electricity consumption. The paper concludes with a discussion on the implications for energy policy.

  17. Information and communication technologies - A new round of household electrification

    DEFF Research Database (Denmark)

    Røpke, Inge; Christensen, Toke Haunstrup; Jensen, Jesper Ole

    2010-01-01

    Information and communication technologies (ICTs) increasingly permeate everyday life in industrialized societies. The aim of this paper is to explore ICT-related transformations of everyday practices and discuss the implications, particularly for residential electricity consumption. The present...... socio-technical changes are seen in a historical perspective, and it is argued that the integration of ICT into everyday practices can be seen as a new round of household electrification, comparable to earlier rounds that also led to higher electricity consumption. A case study carried out in Denmark...... in 2007–2008 explores the present changes in everyday life. Based on qualitative interviews, the study focuses on people’s ways of integrating ICTs into their everyday practices, on any significant changes in these practices, and on the influence of the changed practices on electricity consumption...

  18. The effectiveness of sharp end and rounded end bristle toothbrush

    OpenAIRE

    Paulus Januar; Anastasia Susetyo; Ratih Widyastuti

    2010-01-01

    Background: Numerous designs of manual toothbrush are available in the market with the claims of superiority in plaque removal. It often makes the public confuse which is the best design. The sharp end bristle toothbrush is a modification that commercially available in the market. Purpose: The objective of the study was to compare the effectiveness in plaque removal of the sharp end bristle toothbrush and the rounded end bristle toothbrush. Methods: This clinical trial was a double blind cros...

  19. The potential cost of a failed doha round:

    OpenAIRE

    Bouet, Antoine; Debucquet, David Laborde

    2009-01-01

    "In times of economic turmoil, countries might decide to increase current tariff rates to protect domestic industries or raise revenues in order to finance domestic programs. Using the highest applied or bound rate imposed by countries from 1995 to 2008 as an indicator, this study presents several scenarios regarding the economic costs of a failed Doha Round and a subsequent rush into protectionism. For example, in a scenario where the applied tariffs of major economies would go all the way u...

  20. Experimental and Numerical Analysis of Steel Joints in Round Wood

    Directory of Open Access Journals (Sweden)

    Mikolášek David

    2014-12-01

    Full Text Available The paper analyses a drawn steel joint in round logs for which several types of reinforcements have been proposed. The load-carrying capacity of the reinforcements have been tested in laboratories. At the same time, numerical modelling has been performed - it has focused, in particular, on rigidity of the joints during the loading process. Physical and geometrical nonlinearities have been taken into account. The Finite Element Method and 3D computation models have been used in the numerical calculations.

  1. CHF prediction in rod bundles using round tube data

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Wallen F.; Veloso, Maria A.F.; Pereira, Cláubia; Costa, Antonella L., E-mail: wallenfds@yahoo.com.br, E-mail: mdora@nuclear.ufmg.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear

    2017-07-01

    The present work concerns the use of 1995 CHF table for uniformly heated round tubes, developed jointly by Canadian and Russian researchers, for the prediction of critical heat fluxes in rod bundles geometries. Comparisons between measured and calculated critical heat fluxes indicate that this table could be applied to rod bundles provided that a suitable correction factor is employed. The tolerance limits associated with the departure from nucleate boiling ratio (DNBR) are evaluated by using statistical analysis. (author)

  2. Tight Network Topology Dependent Bounds on Rounds of Communication

    OpenAIRE

    Chattopadhyay, Arkadev; Langberg, Michael; Li, Shi; Rudra, Atri

    2016-01-01

    We prove tight network topology dependent bounds on the round complexity of computing well studied $k$-party functions such as set disjointness and element distinctness. Unlike the usual case in the CONGEST model in distributed computing, we fix the function and then vary the underlying network topology. This complements the recent such results on total communication that have received some attention. We also present some applications to distributed graph computation problems. Our main contri...

  3. A model for correlating burnout in round tubes

    International Nuclear Information System (INIS)

    Kirby, G.J.

    1966-09-01

    A model is presented which represents the film flow rate in the climbing film regime of boiling two phase flow. By calculating the dryout point burnout heat fluxes for round tubes both uniformly and non-uniformly heated axially have been predicted with accuracies as good as the best empirical correlations. The model is used to investigate the effect of varying flux profile as well as the other system describing parameters. (author)

  4. THE URUGUAY ROUND AGREEMENT ON AGRICULTURE: AN EVALUATION

    OpenAIRE

    Josling, Timothy E.; Honma, Masayoshi; Lee, Jaeok; MacLaren, Donald; Miner, William M.; Sumner, Daniel A.; Tangermann, Stefan; Valdes, Alberto

    1994-01-01

    Contact for this paper: Laura Bipes/University of Minnesota/Department of Applied Economics/ 1994 Buford Avenue./ St. Paul, MN 55108 USA. From the start, agriculture played a central role in the Uruguay Round of GATT trade negotiations. The Punta del Este Declaration called for a solution to the problems facing agricultural trade through modified trade rules and an agreement to lower protection levels. It was recognized that such an improvement implied negotiations on the national farm polici...

  5. Initiating round robins in the L2 classroom - preliminary observations

    DEFF Research Database (Denmark)

    Mortensen, Kristian; Hazel, Spencer

    2011-01-01

    Complementing recent interactional research on the contingent operation of online task accomplishment, this paper deals with a specific way of organizing and managing tasks in plenary L2 classrooms – namely the round robin. This may seem like a “traditional” and rigid form of classroom organizati...... and artefacts and graphic structures that are used not only as mediating tools in the (supposed) learning relevant activity, but also as structurally relevant features to organize the ongoing interaction, in which these activities emerge....

  6. The Doha Round, poverty, and regional inequality in Brazil

    OpenAIRE

    Filho, Joaquim Bento de Souza Ferreira; Horridge, Mark

    2005-01-01

    This paper addresses the potential effects of the Doha round of trade negotiations on poverty and income distribution in Brazil, using an applied general equilibrium (AGE) and micro-simulation model of Brazil tailored for income distribution and poverty analysis. Of particular importance is the fact that the representative household hypothesis is replaced by a detailed representation of households. The model distinguishes 10 different labor types and has 270 different household expenditure pa...

  7. OPENING GLOBAL MARKETS FOR AGRICULTURE: THE NEXT WTO ROUND

    OpenAIRE

    Sumner, Daniel A.

    2000-01-01

    More open international markets benefit the economy as a whole, as well as most U.S. agricultural producers. The Uruguay Round Agreement laid out a useful framework. Specifically addressed here is why the key to further liberalizing agricultural trade is reduction of tariffs as comprehensively and rapidly as politics will allow. Other issues such as export subsidies, tariff-rate quota quantities, and developing-country relationships are also important, especially while tariffs are coming down...

  8. The Uruguay Round and Welfare in Some Distorted Agricultural Economies

    OpenAIRE

    James E. Anderson

    1997-01-01

    There is widespread concern that the Uruguay Round may reduce the welfare of developing countries through its effect on world agricultural prices. Reduced agricultural price distortions among major supplying nations are predicted to increase basic food prices and decrease some important export prices such as those for coffee and cotton. It appears that raising food prices paid by food importers must be bad for them, while reducing world coffee and cotton prices appears bad for exporters of th...

  9. Fracture toughness evaluation of circumferentially-cracked round bars

    International Nuclear Information System (INIS)

    Scibetta, M.

    1996-05-01

    The measure of the fracture toughness of a circumferentially-cracked round bar is generally performed through approximate formulae. Comparison of existing formulae to finite element results does not always show good agreement. Therefore an eta factor is introduced in order to improve the existing analytical formula. The axisymmetrical geometry is generally considered to be a high constrained geometry. Finite element calculations are performed to verify and quantify the constraint relative to the three point bending configuration (precracked Charpy)

  10. Manipulating Tournaments in Cup and Round Robin Competitions

    OpenAIRE

    Russell, Tyrel; Walsh, Toby

    2009-01-01

    In sports competitions, teams can manipulate the result by, for instance, throwing games. We show that we can decide how to manipulate round robin and cup competitions, two of the most popular types of sporting competitions in polynomial time. In addition, we show that finding the minimal number of games that need to be thrown to manipulate the result can also be determined in polynomial time. Finally, we show that there are several different variations of standard cup competitions where mani...

  11. Performances of One-Round Walks in Linear Congestion Games

    Science.gov (United States)

    Bilò, Vittorio; Fanelli, Angelo; Flammini, Michele; Moscardelli, Luca

    We investigate the approximation ratio of the solutions achieved after a one-round walk in linear congestion games. We consider the social functions {Stextsc{um}}, defined as the sum of the players’ costs, and {Mtextsc{ax}}, defined as the maximum cost per player, as a measure of the quality of a given solution. For the social function {Stextsc{um}} and one-round walks starting from the empty strategy profile, we close the gap between the upper bound of 2+sqrt{5}≈ 4.24 given in [8] and the lower bound of 4 derived in [4] by providing a matching lower bound whose construction and analysis require non-trivial arguments. For the social function {Mtextsc{ax}}, for which, to the best of our knowledge, no results were known prior to this work, we show an approximation ratio of Θ(sqrt[4]{n^3}) (resp. Θ(nsqrt{n})), where n is the number of players, for one-round walks starting from the empty (resp. an arbitrary) strategy profile.

  12. Desmoplastic small round cell tumour: Cytological and immunocytochemical features

    Directory of Open Access Journals (Sweden)

    Filho Adhemar

    2005-01-01

    Full Text Available Abstract Background Desmoplastic small round cell tumor (DSRCT is a rare and highly aggressive neoplasm. The cytological diagnosis of these tumors can be difficult because they show morphological features quite similar to other small round blue cells tumors. We described four cases of DSRCT with cytological sampling: one obtained by fine needle aspiration biopsy (FNAB and three from serous effusions. The corresponding immunocytochemical panel was also reviewed. Methods Papanicolaou stained samples from FNAB and effusions were morphologically described. Immunoreaction with WT1 antibody was performed in all cytological samples. An immunohistochemical panel including the following antibodies was performed in the corresponding biopsies: 34BE12, AE1/AE3, Chromogranin A, CK20, CK7, CK8, Desmin, EMA, NSE, Vimentin and WT1. Results The smears showed high cellularity with minor size alteration. Nuclei were round to oval, some of them with inconspicuous nucleoli. Tumor cells are clustered, showing rosette-like feature. Tumor cells in effusions and FNA were positive to WT1 in 3 of 4 cytology specimens (2 out 3 effusions and one FNA. Immunohistochemical reactions for vimentin, NSE, AE1/AE3 and WT1 were positive in all cases in tissue sections. Conclusion The use of an adjunct immunocytochemical panel coupled with the cytomorphological characteristics allows the diagnosis of DSRCT in cytological specimens.

  13. Trial manufacture of round mask for TV fluoroscopic unit

    International Nuclear Information System (INIS)

    Matsuoka, Shoji; Matsumoto, Yukio

    1977-01-01

    Demands for revision of existing medical law were described together with an introduction of TV fluoroscopic unit. Round mask, which does not always press out the bottom face of used x-ray beam from the effective primary fluorescent face of photomultiplier inspite of shifting of a spot in time of TV fluoroscopy, was manufactured for trial, and it was furnished with already established fluoroscopic stand. It is used in daily examination without any trouble. Round mask was divided into two parts, and opened upward and downward quickly by lod motor in time of photographing. Multiple iris was operated in order to fit to film size, and round mask was closed at the same time of the finishment of photographing and fluoroscopy was performed again. Item 3 of Para 2 of Art 30 of the existing medical low states that it is good not to press out, the distance between x-ray focus and fluorescent screen, and used x-ray beam from fluorescent screen. However, a regulation, which states that x-ray beam should not be pressed out from effective primary fluorescent face in x-ray fluoroscopy using photomultiplier, must be added. Improvement of the existing unit is expected, and decrease of unnecessary exposure even in small amount is proposed. (Tsunoda, M.)

  14. The Impact of the Uruguay Round on World Agriculture

    Directory of Open Access Journals (Sweden)

    Chung-Sil Kim

    2002-12-01

    Full Text Available This paper focuses on the impact of the Uruguay Round (UR implementation on world agriculture using a multi-regional general equilibrium model and the mapping function of the Geographic Information System (GIS. The results of this study show that the Uruguay Round has had a negative impact on world agriculture in the light of total food production and food distribution. For commodities such as grains, while grain production rises in exporting countries, the effect is not sufficient to cover the fall in production in importing countries. In particular, the impact is serious on food security in importing countries of agricultural products. The negative impact is almost concentrated in importing countries, particularly Japan, the European Union (EU and South Korea. As is clearly visible on the maps produced by the GIS function, the real state of world agriculture as well as the results evaluated by this Computable General Equilibrium (CGE model has changed negatively in major importing countries and particularly the Least Developed Countries (LDCs, Sub-Saharan Africa following the Uruguay Round.

  15. A calculational round robin in elastic-plastic fracture mechanics

    International Nuclear Information System (INIS)

    Larsson, L.H.

    1983-01-01

    Eighteen organisations participated in this elastic-plastic fracture mechanics (EPFM) numerical analysis round robin which treated the same three-point bend problem as a similar round robin conducted by ASTM four years earlier. The work involved the calculation of overall deformation, J, CTOD and crack profile using plane strain elastic-plastic finite element analysis for a monotonically increasing load up to a maximum deformation which was far beyond the elastic regime. It was found that all of the elastic solutions were accurate to within a few per cent. In the elastic-plastic regime, however, there was a large scatter of the results, increasing with increasing plastic deformation and roughly of the same order as in the ASTM round robin which contained ten solutions. No significant progress has taken place in the state of the art of numerical EPFM analysis over the four-year interval. The reasons for this scatter and tentative conclusions on the most suitable numerical analysis methods in EPFM are discussed. (author)

  16. Post surgical complications from students' large animal surgical ...

    African Journals Online (AJOL)

    A retrospective study of post surgical complications was conducted on records of students' Large Animal Surgical Laboratories in the Faculty of Veterinary Medicine (F.V.M.), Ahmadu Bello University (A.B.U), Zaria from 1989 to 1993. Three hundred and eleven surgical complications were recorded from five surgical ...

  17. Seasonal Alterations in Park Visitation, Amenity Use, and Physical Activity — Grand Forks, North Dakota, 2012–2013

    Science.gov (United States)

    Johnson, LuAnn

    2014-01-01

    Introduction Park amenities promote visitation and physical activity during summer. Physical activity declines during winter. Identifying park amenities that promote visitation during winter would increase year-round activity. The purpose of this study was to determine how park visitation, amenity choice, and physical activity intensity change across seasons. Methods Physical activity intensity of children and adults was assessed at 16 parks in Grand Forks, North Dakota, during summer and fall of 2012, and winter and spring of 2013. Results Park visitation was highest in spring and lowest in winter. Amenity use varied by season. Parks with water splash pads were visited more during summer, and playgrounds and open spaces were visited more during spring. Ice rinks were visited most in winter. Physical activity intensity was lowest in summer and highest in winter for each age group. The activity intensity observed for all young age groups ranged from 2.7 to 2.9 metabolic equivalents in summer and greater than 3 metabolic equivalents in all other seasons. Adults’ mean activity intensity was greater than 3 metabolic equivalents in winter. Conclusion Information on park visitation, amenity use, and activity intensity across seasons is valuable; it can be used when designing or redesigning parks in order to promote year-round physical activity. Redesigning parks in cold climates to include ice rinks, sledding hills, cross-country skiing, and indoor areas for physical activity would increase winter visitation and allow the park to serve as a year-round resource for physical activity. PMID:25211503

  18. Seasonal alterations in park visitation, amenity use, and physical activity--Grand Forks, North Dakota, 2012-2013.

    Science.gov (United States)

    Roemmich, James N; Johnson, LuAnn

    2014-09-11

    Park amenities promote visitation and physical activity during summer. Physical activity declines during winter. Identifying park amenities that promote visitation during winter would increase year-round activity. The purpose of this study was to determine how park visitation, amenity choice, and physical activity intensity change across seasons. Physical activity intensity of children and adults was assessed at 16 parks in Grand Forks, North Dakota, during summer and fall of 2012, and winter and spring of 2013. Park visitation was highest in spring and lowest in winter. Amenity use varied by season. Parks with water splash pads were visited more during summer, and playgrounds and open spaces were visited more during spring. Ice rinks were visited most in winter. Physical activity intensity was lowest in summer and highest in winter for each age group. The activity intensity observed for all young age groups ranged from 2.7 to 2.9 metabolic equivalents in summer and greater than 3 metabolic equivalents in all other seasons. Adults' mean activity intensity was greater than 3 metabolic equivalents in winter. Information on park visitation, amenity use, and activity intensity across seasons is valuable; it can be used when designing or redesigning parks in order to promote year-round physical activity. Redesigning parks in cold climates to include ice rinks, sledding hills, cross-country skiing, and indoor areas for physical activity would increase winter visitation and allow the park to serve as a year-round resource for physical activity.

  19. Effect of music on surgical skill during simulated intraocular surgery.

    Science.gov (United States)

    Kyrillos, Ralph; Caissie, Mathieu

    2017-12-01

    To evaluate the effect of Mozart music compared to silence on anterior segment surgical skill in the context of simulated intraocular surgery. Prospective stratified and randomized noninferiority trial. Fourteen ophthalmologists and 12 residents in ophthalmology. All participants were asked to perform 4 sets of predetermined tasks on the EyeSI surgical simulator (VRmagic, Mannheim, Germany). The participants completed 1 Capsulorhexis task and 1 Anti-Tremor task during 3 separate visits. The first 2 sets determined the basic level on day 1. Then, the participants were stratified by surgical experience and randomized to be exposed to music (Mozart sonata for 2 pianos in D-K448) during either the third or the fourth set of tasks (day 2 or 3). Surgical skill was evaluated using the parameters recorded by the simulator such as "Total score" and "Time" for both tasks and task-specific parameters such as "Out of tolerance percentage" for the Anti-Tremor task and "Deviation of rhexis radius from 2.5 mm," "Roundness," and "Centering" for the Capsulorhexis task. The data were analyzed using the Wilcoxon signed-rank test. No statistically significant differences were noted between exposure and nonexposure for all the Anti-Tremor task parameters as well as most parameters for the Capsulorhexis task. Two parameters for the Capsulorhexis task showed a strong trend for improvement with exposure to music ("Total score" +23.3%, p = 0.025; "Roundness" +33.0%, p = 0.037). Exposure to music did not negatively impact surgical skills. Moreover, a trend for improvement was shown while listening to Mozart music. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  20. Multicenter surgical experience evaluation on the Mid-Scala electrode and insertion tools.

    Science.gov (United States)

    Gazibegovic, Dzemal; Bero, Eva M

    2017-02-01

    The HiFocus Mid-Scala electrode is intended to improve hearing for individuals with severe-to-profound hearing loss by providing extended electrical coverage of the cochlea while minimizing trauma related to insertion. The electrode is appropriate for use with a wide range of surgical techniques, including either a cochleostomy or round window insertion, and the use of either a free-hand or tool-assisted approach. The objective of this survey was to evaluate how the HiFocus Mid-Scala electrode and insertion tools was used across a population of cochlear implant recipients of differing ages, audiologic profiles, and anatomical characteristics. The intent was to understand the type and frequency of surgical techniques applicable with the electrode, and to provide guidelines for clinical practice. Two questionnaires were completed by surgeons at implant centres located in the United States, Europe, and Asia. Before any surgeries were conducted, surgeons completed a questionnaire that assessed their overall cochlear implant surgical practice and preferences. Following each HiFocus Mid-Scala electrode insertion, surgeons completed a questionnaire that summarized their experience during that surgical procedure. Questionnaires were completed by 32 surgeons from 16 centres for a total of 143 surgeries (112 adults, 31 children). Most surgeons (62 %) preferred to insert the electrode via the round window or an extended round window compared with a cochleostomy (16 %), whereas the remaining 22 % indicated that they made an insertion choice based on presenting anatomy. Sixty-nine percent preferred a free-hand approach over using insertion tools. In 32 procedures, surgeons elected to deviate from an intended round window insertion to either an extended round window or cochleostomy approach.

  1. LEP constraints on grand unified theories

    International Nuclear Information System (INIS)

    Sarkar, Utpal

    1993-01-01

    Recent developments on grand unified theories (GUTs) in the context of the LEP measurements of the coupling constants are reviewed. The three coupling constants at the electroweak scale have been measured at LEP quite precisely. One can allow these couplings to evolve with energy following the renormalization group equations for the various groups and find out whether all the coupling constants meet at any energy. It was pointed out that the minimal SU(5) grand unified theory fails to satisfy this test. However, various extensions of the theory are still allowed. These extensions include (i) supersymmetric SU(5) GUT, with some arbitrariness in the susy breaking scale arising from the threshold corrections, (ii) non-susy SU(5) GUTs with additional fermions as well as Higgs multiplets, which has masses of the order of TeV, and (iii) non-renormalizable effect of gravity with a fine tuned relation among the coupling constants at the unification energy. The LEP results also constrain GUTs with an intermediate symmetry breaking scale. By adjusting the intermediate symmetry breaking scale, one usually can have unification, but these theories get constrained. For example, the left-right symmetric theories coming from GUTs can be broken only at energies higher than about ∼10 10 GeV. This implies that if right handed gauge bosons are found at energies lower than this scale, then that will rule out the possibility of grand unification. Another recent interesting development on the subject, namely, low energy unification, is discussed in this context. All the coupling constants are unified at energies of the order of ∼10 8 GeV when they are embedded in an SU(15)GUT, with some particular symmetry breaking pattern. But even in this case the results of the intermediate symmetry breaking scale remain unchanged. (author). 16 refs., 3 figs

  2. Maternal and fetal outcome in grand multipara

    International Nuclear Information System (INIS)

    Qamar, A.; Qamar, S.

    2015-01-01

    Study Design: Case control study. Place and Duration of Study: Gynecology and Obstetric Unit-I of the Jinnah Post Graduate and Medical Centre Karachi, from February 2009 to January 2010. Patients and Methods: One hundred (100) patients of grand multipara (GMP), (parity = 5) and 100 patients of multipara (MP) (parity 2-4) were included in the study. Pregnant women with known medical conditions including essential hypertension, diabetes mellitus, epilepsy, primigravidas, women with previous caesarean section and twin pregnancies were excluded. Patients were admitted through antenatal clinic and emergency. A detailed history was taken and a physical examination was done with special emphasis on obstetrical examination. Investigations like blood CP, Urine D/R, blood grouping and sonogram were done. During labour, mother and neonates were managed according to ward protocols. Maternal and fetal outcomes were compared among GMPs and MPs. Results: A high frequency of anaemia (81% vs 20%), pregnancy induced hypertension (45%, vs. 26%) and gestational diabetes (9%, vs1%) were seen in GMP as compared to MP group. Frequency of malpresentations (26% vs 15%), postpartum hemorrhage (15%, vs 10%) and intrauterine deaths (26%, vs 13%) were higher in GMP group along with a high caesarean delivery rate (GMP 21%, MP 14%). A higher maternal mortality (GMP 4%, MP 1%) and low APGAR score (GMP 12%, MP 4%) were observed among babies born to grand multipara group. Conclusion: Grand multiparity is associated with adverse outcome for both mother and fetus. Effort should be directed to reduce high parity in the community through effective family planning initiatives. Specialized antenatal and obstetrical care facilities should be available. (author)

  3. Finding and applying evidence during clinical rounds: the "evidence cart".

    Science.gov (United States)

    Sackett, D L; Straus, S E

    1998-10-21

    Physicians need easy access to evidence for clinical decisions while they care for patients but, to our knowledge, no investigators have assessed use of evidence during rounds with house staff. To determine if it was feasible to find and apply evidence during clinical rounds, using an "evidence cart" that contains multiple sources of evidence and the means for projecting and printing them. Descriptive feasibility study of use of evidence during 1 month (April 1997) and anonymous questionnaire (May 1997). General medicine inpatient service. Medical students, house staff, fellows, and attending consultant. Evidence cart that included 2 secondary sources developed by the department (critically appraised topics [CATs] and Redbook), Best Evidence, JAMA Rational Clinical Examination series, the Cochrane Library, MEDLINE, a physical examination textbook, a radiology anatomy textbook, and a Simulscope, which allows several people to listen simultaneously to the same signs on physical examination. Number of times sources were used, type of sources searched and success of searches, time needed to search, and whether the search affected patient care. The evidence cart was used 98 times, but could not be taken on bedside rounds because of its bulk; hard copies of several sources were taken instead. When the evidence cart was used during team rounds and student rounds, some sources could be accessed quickly enough (10.2-25.4 seconds) to be practical on our service. Of 98 searches, 79 (81%) sought evidence that could affect diagnostic and/or treatment decisions. Seventy-one (90%) of 79 searches regarding patient management were successful, and when assessed from the perspective of the most junior team members responsible for each patient's evaluation and management, 37 (52%) of the 71 successful searches confirmed their current or tentative diagnostic or treatment plans, 18 (25%) led to a new diagnostic skill, an additional test, or a new management decision, and 16 (23

  4. Studies of turbulent round jets through experimentation, simulation, and modeling

    Science.gov (United States)

    Keedy, Ryan

    This thesis studies the physics of the turbulent round jet. In particular, it focuses on three different problems that have the turbulent round jet as their base flow. The first part of this thesis examines a compressible turbulent round jet at its sonic condition. We investigate the shearing effect such a jet has when impinging on a solid surface that is perpendicular to the flow direction. We report on experiments to evaluate the jet's ability to remove different types of explosive particles from a glass surface. Theoretical analysis revealed trends and enabled modeling to improve the predictability of particle removal for various jet conditions. The second part of thesis aims at developing a non-intrusive measurement technique for free-shear turbulent flows in nature. Most turbulent jet investigations in the literature, both in the laboratory and in the field, required specialized intrusive instrumentation and/or complex optical setups. There are many situations in naturally-occurring flows where the environment may prove too hostile or remote for existing instrumentation. We have developed a methodology for analyzing video of the exterior of a naturally-occurring flow and calculating the flow velocity. We found that the presence of viscosity gradients affects the velocity analysis. While these effects produce consistent, predictable changes, we became interested in the mechanism by which the viscosity gradients affect the mixing and development of the turbulent round jet. We conducted a stability analysis of the axisymmetric jet when a viscosity gradient is present. Finally, the third problem addressed in this thesis is the growth of liquid droplets by condensation in a turbulent round jet. A vapor-saturated turbulent jet issues into a cold, dry environment. The resulting mixing produces highly inhomogeneous regions of supersaturation, where droplets grow and evaporate. Non-linear interactions between the droplet growth rate and the supersaturation field make

  5. Lie groups and grand unified theories

    International Nuclear Information System (INIS)

    Gubitoso, M.D.

    1987-01-01

    This work presents some concepts in group theory and Lie algebras and, at same time, shows a method to study and work with semisimple Lie groups, based on Dynkin diagrams. The aproach taken is not completely formal, but it presents the main points of the elaboration of the method, so its mathematical basis is designed with the purpose of making the reading not so cumbersome to those who are interested only in a general picture of the method and its usefulness. At the end it is shown a brief review of gauge theories and two grand-unification models based on SO(13) and E 7 gauge groups. (author) [pt

  6. Grand Canonical Ensembles in General Relativity

    International Nuclear Information System (INIS)

    Klein, David; Yang, Wei-Shih

    2012-01-01

    We develop a formalism for general relativistic, grand canonical ensembles in space-times with timelike Killing fields. Using that, we derive ideal gas laws, and show how they depend on the geometry of the particular space-times. A systematic method for calculating Newtonian limits is given for a class of these space-times, which is illustrated for Kerr space-time. In addition, we prove uniqueness of the infinite volume Gibbs measure, and absence of phase transitions for a class of interaction potentials in anti-de Sitter space.

  7. Produccion de plantas grandes usando minicontenedores

    Science.gov (United States)

    R. Kasten Dumroese; Thomas D. Landis

    2012-01-01

    En América del Norte hay cada vez más interés por la producción híbrida o mixta. La misma consiste en cultivar plantines en contenedores de pequeño volumen y luego trasplantarlos; el trasplante se puede realizar a canteros en el suelo como en la producción a raíz desnuda o bien a contenedores más grandes. Originalmente se llamaban plantines "plug+", "...

  8. 75 FR 21343 - Notice of Availability of the Final Environmental Impact Statement for the Round Mountain...

    Science.gov (United States)

    2010-04-23

    ... INFORMATION: The Round Mountain Gold Corporation, which is a joint venture of Kinross Gold Corporation and Barrick Gold Corporation, proposes to expand its Round Mountain Mine, an existing open-pit gold mining and... about 66.2 acres between the Round Mountain area and the Gold Hill area. The primary method of...

  9. Cryptanalysis of the 10-Round Hash and Full Compression Function of SHAvite-3-512

    DEFF Research Database (Denmark)

    Gauravaram, Praveen; Leurent, Gaëtan; Mendel, Florian

    2010-01-01

    In this paper, we analyze SHAvite-3-512 hash function, as proposed for round 2 of the SHA-3 competition. We present cryptanalytic results on 10 out of 14 rounds of the hash function SHAvite-3-512, and on the full 14 round compression function of SHAvite-3-512. We show a second preimage attack on ...

  10. The Grand Duchy on the Grand Tour: A Historical Study of Student Migration in Luxembourg

    Science.gov (United States)

    Rohstock, Anne; Schreiber, Catherina

    2013-01-01

    Since Luxembourg became independent in 1839, practically the entire political, economic and intellectual elite of the country has been socialised abroad. It was only in 2003 that the Grand Duchy set up its own university; before then, young Luxembourgers had to study in foreign countries. Over the past 150 years, Luxembourg has thus experienced…

  11. 3D Surgical Simulation

    Science.gov (United States)

    Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2009-01-01

    This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308

  12. 28 milliards d’euros, c’est grand comment ?

    OpenAIRE

    Ozer, Pierre; Salmon, Marc; Theunissen, Yannick

    2009-01-01

    J’ouvre mon quotidien. Fortis : 28 milliards d’euros de pertes en 2008. Ma fille de sept ans qui commence à lire et pose sans cesse des questions sur tout me lance : « Dis-moi, papa : 28 milliards d’euros, c’est grand comment ? ». Grande question… Je réfléchis et tente de trouver une parade parlante pour un enfant qui, in fine, se pose les mêmes questions que les grandes personnes.

  13. Gamma ray and neutrino detector facility (GRANDE), Task C

    International Nuclear Information System (INIS)

    Sobel, H.W.; Yodh, G.B.

    1991-08-01

    GRANDE is an imaging, water Cerenkov detector, which combines in one facility an extensive air shower array and a high-energy neutrino detector. We proposed that the detector be constructed in phases, beginning with an active detector area of 31,000 m 2 (GRANDE-I) 2 and expanding to a final size of 100,000--150,00 m 2 . Some of the characteristics of GRANDE-I are discussed in this paper

  14. Anxiety in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff

    2012-01-01

    The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p...

  15. SO(10) supersymmetric grand unified theories

    Science.gov (United States)

    Dermisek, Radovan

    The origin of the fermion mass hierarchy is one of the most challenging problems in elementary particle physics. In the standard model fermion masses and mixing angles are free parameters. Supersymmetric grand unified theories provide a beautiful framework for physics beyond the standard model. In addition to gauge coupling unification these theories provide relations between quark and lepton masses within families, and with additional family symmetry the hierarchy between families can be generated. We present a predictive SO(10) supersymmetric grand unified model with D 3 x U(1) family symmetry. The hierarchy in fermion masses is generated by the family symmetry breaking D 3 x U(1) → ZN → nothing. This model fits the low energy data in the charged fermion sector quite well. We discuss the prediction of this model for the proton lifetime in light of recent SuperKamiokande results and present a clear picture of the allowed spectra of supersymmetric particles. Finally, the detailed discussion of the Yukawa coupling unification of the third generation particles is provided. We find a narrow region is consistent with t, b, tau Yukawa unification for mu > 0 (suggested by b → sgamma and the anomalous magnetic moment of the muon) with A0 ˜ -1.9m16, m10 ˜ 1.4m16, m16 ≳ 1200 GeV and mu, M1/2 ˜ 100--500 GeV. Demanding Yukawa unification thus makes definite predictions for Higgs and sparticle masses.

  16. O conservadorismo patronal da grande imprensa brasileira

    Directory of Open Access Journals (Sweden)

    Fonseca Francisco

    2003-01-01

    Full Text Available Através da análise da opinião dos editoriais dos quatro principais periódicos diários da grande imprensa, isto é, o Jornal do Brasil, O Globo, a Folha de S. Paulo e O Estado de S. Paulo - aqui considerados "aparelhos privados de hegemonia" -, este artigo procura desvendar os posicionamentos adotados perante a ordem social na Constituinte de 1987/1988, que também contribuem para compreender a reação à Consolidação das Leis do Trabalho. Observa-se, além do mais, as estratégias utilizadas para sua consecução. Conclui-se que, por mecanismos diversos, a grande imprensa contribuiu decisivamente para a introdução da agenda ideológica neoliberal no país, pois atuou de forma a "divulgar e vulgarizar" as idéias pertinentes a este ideário e de forma militantemente conservadora e patronal.

  17. Aprovechamiento de Salto Grande Argentina – Uruguay

    Directory of Open Access Journals (Sweden)

    Bongiovanni, M.

    1979-12-01

    Full Text Available The power harnessing of Salto Grande will be the first common project carried out by two South American Countries and this will foster greater integration of both countries. The project involves the following: — One 39 m-high dam — Two hydroelectric power plants — One international bridge — One shipping canal The benefits to be obtained from the project include: increase and improvement of the waterway network; increase of electricity production; railways and highway tie-ups between both countries; industrial development; increased availability of irrigation water; new tourist resorts; increase of fishing resources.

    El aprovechamiento hidroeléctrico de Salto Grande será el primer aprovechamiento común a dos países sudamericanos, lo que permitirá una mayor integración entre ellos. Consta de las siguientes obras: _ una presa de 39 m de altura; _ dos centrales hidroeléctricas; _ un puente internacional; _ un canal de navegación, etc. Entre los beneficios que se obtendrán destacan: aumento y mejora de la red de navegación; aumento de la producción eléctrica; enlace de las vías de ferrocarril y carreteras entre los dos países; desarrollo industrial; aumento de la disponibilidad de agua de riego; creación de zonas de turismo, e incremento de la riqueza piscícola.

  18. SURGICAL SITE INFECTION: REVIEW

    Directory of Open Access Journals (Sweden)

    P. H. M. Bonai

    2016-07-01

    Full Text Available Nosocomial infection or nosocomial infection (NI is one of the factors that increase the cost of maintaining patients in the health system, even in processes that should safely occur, such as hospital patients and performing simple and routine surgical procedures surgical centers and clinics leading to complications resulting from these infections that prolong hospital stay and promote pain and suffering to the patient, resulting in the defense of the quality of services and influencing negatively the hospitals. Therefore, the aim of this study was to review the factors that result in surgical site infection, with the purpose of better understanding of the subject and the possibility of preventive actions to better treatment outcome of the patient.

  19. Ultrastructure and pathology of desmoplastic small round cell tumor

    International Nuclear Information System (INIS)

    Xu Bin; Wang Bo; Gu Junlian; Li Xin; Li Yang

    2010-01-01

    Objective: To observe the change of ultrastructure and pathology of desmoplastic small round cell tumor (DSRCT) and recognize the characteristics of DSRCT and improve the standard of diagnosis. Methods: One case of primary DSRCT in right leg was observed by light microscope, immunohistochemical method and electron microscope and analyzed with review of the literatures. Results: The size of tumor was 3.2 cm x 2.4 cm x 1.3 cm with gray-yellow on cross-section. Foci of hemorrhage and necrosis were noted. Under light microscope, the tumor was composed of sharply demarcated nests of small rounded or oval cells. The cellular aggregates were surrounded and separated by abundant fibrous connective tissue. The tumor cells were uniform in size and shape, and showed small to moderate amounts of pale cytoplasm with indistinct cell borders. The nuclei were round to oval, with clumped chromatin and marked hyperchromasia. Some cells had one or two indistinct nucleoli. Numerous mitotic figures and areas of necrosis were dentified. The immunohistochemical results showed that the tumor cells were strongly positive for CK, EMA and NSE. There was focal positive staining for desmin with a perinuclear dot-like pattern. However, the tumor cells were negative for CgA, Myogenin, Syn, LCA, SMA, S-100, NF, GFAP, HMB45, HHF-35, CD3, CD10, Actin, CD99, and CD20. Under electron microscope, the tumor cells showed paranuclear cytoplasmic intermediate filaments arranging in globular or whorl array. Conclusion: DSRCT occurs both in the abdomen and at other sites. The patients with DSRCT range widely in age. DSRCT has distinctive histopathologic and ultrastructural features. This tumor shows immunohistochemical feature of epithelial, mesenchymal as well as neural multidirectional differentiation. RT-PCR may be served as an important diagnostic adjunct for DSRAT. The prognosis of the patients with DSRCT is very poor. (authors)

  20. The Development Round: Main Outcomes, Challenges and Implementation Prospects

    Directory of Open Access Journals (Sweden)

    Volomymyr Vashchenko

    2004-04-01

    Full Text Available The article touches upon current issues in the development of a WTO-based multilateral trade system and the participation of the broadest possible range of nations in this system, with special attention to the agenda of the Fourth and Fifth Ministerial Conferences of WTO memberstates, progress on negotiations and their current status. Bottlenecks in specific areas of the negotiations that have arisen in the course of the discussions, the positions of groups and individual countries are also identified. The article outlines the possibilities of activating and accelerating efforts towards the completion of the liberalization of world trade as envisaged in the agenda of the Development Round.

  1. Influence Processes in Climate Change Negotiations. Modelling the Rounds

    Energy Technology Data Exchange (ETDEWEB)

    Courtois, P. [CIRED Centre international de recherches sur l' environnement et le developpement, CNRS/EHESS, Paris (France)

    2002-10-01

    An integrated framework for structuring and evaluating dynamic and sequential climate change decision making in the international arena is presented, taking into account influence processes occurring during negotiation rounds. The analysis integrates imitation, persuasion and dissuasion behaviours. The main innovation brought in the approach is the presentation of a stochastic model framework derived from thermodynamics. The so-called master equation is introduced in order to better understand strategic switch and influence games exerted. The model is illustrated toward a simulation of climate change conferences decision making processes. Characteristics of regions behaviours are derived from the simulations. In particular the bargain behaviours allowing for the emergence of an agreement are presented.

  2. A New Structural-Differential Property of 5-Round AES

    DEFF Research Database (Denmark)

    Grassi, Lorenzo; Rechberger, Christian; Ronjom, Sondre

    2017-01-01

    AES is probably the most widely studied and used block cipher. Also versions with a reduced number of rounds are used as a building block in many cryptographic schemes, e.g. several candidates of the SHA-3 and CAESAR competition are based on it.So far, non-random properties which are independent ...... a random permutation with only 2 32 chosen texts that has a computational cost of 2(35.6) look-ups into memory of size 2 36 bytes which has a success probability greater than 99%....

  3. Influence Processes in Climate Change Negotiations. Modelling the Rounds

    International Nuclear Information System (INIS)

    Courtois, P.

    2002-10-01

    An integrated framework for structuring and evaluating dynamic and sequential climate change decision making in the international arena is presented, taking into account influence processes occurring during negotiation rounds. The analysis integrates imitation, persuasion and dissuasion behaviours. The main innovation brought in the approach is the presentation of a stochastic model framework derived from thermodynamics. The so-called master equation is introduced in order to better understand strategic switch and influence games exerted. The model is illustrated toward a simulation of climate change conferences decision making processes. Characteristics of regions behaviours are derived from the simulations. In particular the bargain behaviours allowing for the emergence of an agreement are presented

  4. Impacts of the Doha Round framework agreements on dairy policies.

    Science.gov (United States)

    Suzuki, N; Kaiser, H M

    2005-05-01

    Dairy is highly regulated in many countries for several reasons. Perishability, seasonal imbalances, and inelastic supply and demand for milk can cause inherent market instability. Milk buyers typically have had more market power than dairy farmers. Comparative production advantages in some countries have led to regulations and policies to protect local dairy farmers by maintaining domestic prices higher than world prices. A worldwide consensus on reduction of border measures for protecting dairy products is unlikely, and dairy will probably be an exception in ongoing World Trade Organization (WTO) negotiations. Under the Doha Round framework agreements, countries may name some products such as dairy as "sensitive," thereby excluding them from further reforms. However, new Doha Round framework agreements depart from the current WTO rule and call for product-specific spending caps. Such caps will greatly affect the dairy sector because dairy accounts for much of the aggregate measure of support (AMS) in several countries, including the United States and Canada. Also, the amounts of dairy AMS in several countries may be recalculated relative to an international reference price. In addition, all export subsidies are targeted for elimination in the Doha Round, including export credit programs and state trading enterprises, which will limit options for disposing of surplus dairy products in foreign markets. Currently, with higher domestic prices, measures for cutting or disposing of surpluses have been used in many countries. Supply control, which is not regulated by WTO rules, remains as an option. Although explicit export subsidies are restricted by WTO rules, many countries use esoteric measures to promote dairy exports. If countries agree to eliminate "consumer financed" export subsidies using a theoretical definition and measurements proposed herein as Export Subsidy Equivalents (ESE), dairy exports in many countries may be affected. Although domestic supports and

  5. Assessing the potential cost of a failed Doha round

    OpenAIRE

    Antoine Bouet

    2010-01-01

    This study offers new conclusions on the economic cost of a failed Doha Development Agenda (DDA). We assess potential outcome of the Doha Round as well as four protectionist scenarios using the MIRAGE Computable General Equilibrium (CGE) model. In a scenario where applied tariffs of World Trade Organization (WTO) economies would go up to currently bound tariff rates, world trade would decrease by 7.7 % and world welfare by US$353 billion. The economic cost of a failed DDA is here evaluated by...

  6. The educational value of ward rounds for junior trainees

    Directory of Open Access Journals (Sweden)

    Faidon-Marios Laskaratos

    2015-04-01

    Full Text Available The ward round (WR is a complex task and medical teachers are often faced with the challenge of finding a balance between service provision and clinical development of learners. The educational value of WRs is an under-researched area. This short communication aims to evaluate the educational role of WRs for junior trainees and provides insight into current practices. It also identifies obstacles to effective teaching/training in this setting and provides suggestions for improving the quality of WR teaching.

  7. Features of round air jet flowing at low Reynolds numbers

    Science.gov (United States)

    Lemanov, V. V.; Sharov, K. A.; Gorinovich, N. V.

    2018-03-01

    The laminar-turbulent transition in a round jet flowing from a cylindrical channel with the diameter of 3.2 mm was studied experimentally. In experiments, the range of Reynolds numbers determined by the mean-flow velocity was Re = Ud/ν = 700-12000. The measurements were carried out using a PIV system and one-component hot-wire anemometer. The profiles of average velocities and their pulsations in the zone of laminar-turbulent transition were obtained along with axial distributions of longitudinal velocity and pulsations of longitudinal velocity.

  8. Investigating the round air jet dynamics at low Reynolds numbers

    Directory of Open Access Journals (Sweden)

    Lemanov Vadim

    2017-01-01

    Full Text Available The laminar-turbulent transition in a round jet flowing from a cylindrical channel with the diameter of 3.2 mm was studied experimentally. In experiments, the range of Reynolds numbers determined by the mean-flow velocity was Re = Ud/v = 700-12000. The measurements were carried out using a PIV system and one-component hot-wire anemometer. The profiles of average velocities and their pulsations in the zone of laminar-turbulent transition were obtained, as well as axial distributions of longitudinal velocity and pulsations of longitudinal velocity.

  9. Characterization of ASTM round-robin tungsten-powder samples

    International Nuclear Information System (INIS)

    Slettevold, C.A.; Biermann, A.H.

    1975-01-01

    The Lawrence Livermore Laboratory Particle Characterization Laboratory Group has participated in an industry-wide round-robin investigation on characterization of tungsten powder. sponsored by the ASTM Subcommittee on Refractory-Metal Powders (B-09.3). The analyses performed at the suggestion of the ASTM subcommittee included measurements of tap density, apparent density, true density, average particle size, and surface area. Determinations of particle-weight and size distributions were also performed and particle inspection conducted by microscopy. This report describes the equipment and procedures used and summarizes the results of these analyses. (9 tables, 17 fig) (U.S.)

  10. Proposed Grand Challenges in Geoscience Education Research: Articulating a Community Research Agenda

    Science.gov (United States)

    Semken, S. C.; St John, K. K.; Teasdale, R.; Ryker, K.; Riggs, E. M.; Pyle, E. J.; Petcovic, H. L.; McNeal, K.; McDaris, J. R.; Macdonald, H.; Kastens, K.; Cervato, C.

    2017-12-01

    Fourteen ago the Wingspread Project helped establish geoscience education research (GER) as an important research field and highlighted major research questions for GER at the time. More recently, the growth and interest in GER is evident from the increase in geoscience education research articles, the establishment of the NAGT GER Division, the creation of the GER Toolbox, an increase in GER graduate programs, and the growth of tenure-eligible GER faculty positions. As an emerging STEM education research field, the GER community is examining the current state of their research and considering the best course forward so that it can have the greatest collective impact on advancing teaching and learning in the geosciences. As part of an NSF-funded effort to meet this need, 45 researchers drafted priority research questions, or "Grand Challenges", that span 10 geoscience education research themes. These include research on: students' conceptual understanding of the solid and the fluid Earth, K-12 teacher preparation, teaching about Earth in the context of societal problems, access and success of underrepresented groups in the geosciences, spatial and temporal reasoning, quantitative reasoning and use of models, instructional strategies to improve geoscience learning, students' self-regulated learning, and faculty professional development and institutional change. For each theme, several Grand Challenges have been proposed; these have undergone one round of peer-review and are now ready for the AGU community to critically examine the proposed Grand Challenges and make suggestions on strategies for addressing them: http://nagt.org/nagt/geoedresearch/grand_challenges/feedback.html. We seek perspectives from geoscience education researchers, scholars, and reflective educators. It is our vision that the final outcomes of this community-grounded process will be a published guiding framework to (1) focus future GER on questions of high interest to the geoscience education

  11. La masa de los grandes impactores

    Science.gov (United States)

    Parisi, M. G.; Brunini, A.

    Los planetas han sido formados fundamentalmente acretando masa a través de colisiones con planetesimales sólidos. La masa más grande de la distribución de planetesimales y las masas máxima y mínima de los impactores, han sido calculadas usando los valores actuales del período y de la inclinación de los planetas (Lissauer & Safronov 1991; Parisi & Brunini 1996). Recientes investigaciones han mostrado, que las órbitas de los planetas gigantes no han sufrido variaciones con el tiempo, siendo su movimiento regular durante su evolución a partir de la finalización de la etapa de acreción (Laskar 1990, 1994). Por lo tanto, la eccentricidad actual de los planetas gigantes se puede utilizar para imponer una cota máxima a las masas y velocidades orbitales de los grandes impactores. Mediante un simple modelo dinámico, y considerando lo arriba mencionado, obtenemos la cota superior para la masa del planetesimal más grande que impactó a cada planeta gigante al final de su etapa de acreción. El resultado más importante de este trabajo es la estimación de la masa máxima permitida para impactar a Júpiter, la cúal es ~ 1.136 × 10 -1, siendo en el caso de Neptuno ~ 3.99 × 10 -2 (expresada en unidades de la masa final de cada planeta). Además, fue posible obtener la velocidad orbital máxima permitida para los impactores como una función de su masa, para cada planeta. Las cotas obtenidas para la masa y velocidad de los impactores de Saturno y Urano (en unidades de la masa y velocidad final de cada planeta respectivamente) son casi las mismas que las obtenidas para Júpiter debido a que estos tres planetas poseen similar eccentricidad actual. Nuestros resultados están en buen acuerdo con los obtenidos por Lissauer & Safronov (1991). Estas cotas podrían ser utilizadas para obtener la distribución de planetesimales en el Sistema Solar primitivo.

  12. Design of roundness measurement model with multi-systematic error for cylindrical components with large radius.

    Science.gov (United States)

    Sun, Chuanzhi; Wang, Lei; Tan, Jiubin; Zhao, Bo; Tang, Yangchao

    2016-02-01

    The paper designs a roundness measurement model with multi-systematic error, which takes eccentricity, probe offset, radius of tip head of probe, and tilt error into account for roundness measurement of cylindrical components. The effects of the systematic errors and radius of components are analysed in the roundness measurement. The proposed method is built on the instrument with a high precision rotating spindle. The effectiveness of the proposed method is verified by experiment with the standard cylindrical component, which is measured on a roundness measuring machine. Compared to the traditional limacon measurement model, the accuracy of roundness measurement can be increased by about 2.2 μm using the proposed roundness measurement model for the object with a large radius of around 37 mm. The proposed method can improve the accuracy of roundness measurement and can be used for error separation, calibration, and comparison, especially for cylindrical components with a large radius.

  13. Experimental Evaluation of Multi-Round Matrix Multiplication on MapReduce

    DEFF Research Database (Denmark)

    Ceccarello, Matteo; Silvestri, Francesco

    2015-01-01

    required by reduce functions. Then, we present an extensive study of this library on an in-house cluster and on Amazon Web Services aiming at showing its performance and at comparing monolithic and multi-round approaches. The experiments show that, even without a low level optimization, it is possible...... not be the best approach in cloud systems. Indeed, multi-round algorithms may exploit some features of cloud platforms by suitably setting the round number according to the execution context. In this paper we carry out an experimental study of multi-round MapReduce algorithms aiming at investigating...... the performance of the multi-round approach. We use matrix multiplication as a case study. We first propose a scalable Hadoop library, named M3, for matrix multiplication in the dense and sparse cases which allows to tradeoff round number with the amount of data shuffled in each round and the amount of memory...

  14. Surgical infections with Mycoplasma

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Prag, Jørgen Brorson; Jensen, J S

    1997-01-01

    Mycoplasma hominis and Ureaplasma urealyticum are common inhabitants of the human genital tract. Evidence for an aetiological role in pyelonephritis, pelvic inflammatory disease, post-abortion and post-partum fever has been presented. There are sporadic reports of Mycoplasma causing serious...... extragenital infection such as septicemia, septic arthritis, neonatal meningitis and encephalitis. We review 38 cases of surgical infections with Mycoplasma....

  15. [Surgical therapy of gynecomastia].

    Science.gov (United States)

    Heckmann, A; Leclère, F M; Vogt, P M; Steiert, A

    2011-09-01

    Nowadays surgical intervention is an essential part of the treatment of idiopathic gynecomastia. Choosing the right method is crucial and is based on the current status in the clinical and histological evaluation. Before finalizing the process of choosing a specific method a prior interdisciplinary evaluation of the patient is necessary to ascertain clear indications for a surgical intervention. Liposuction is one of the methods which have become popular in recent years. The advantages are the possible combination with traditional techniques, such as subcutaneous mastectomy or periareolar mastopexy. The main indication is for gynecomastia stage IIa/b and is justifiable due to the reduction in surgical complications and scarring. Furthermore this technique provides an excellent aesthetical outcome for the patient. A total of 162 patients suffering from gynecomastia stages I-III (according to Simon) were surgically treated between 2000 and 2010 and these cases were retrospectively evaluated. The results showed a decline in the use of a T-shaped incision in combination with subcutaneous mastectomy with periareolar tightening compared to an increase in the use of subcutaneous mastectomy in combination with liposuction. The excised tissue should always be sent for histological examination to make sure no malignant cells were present.

  16. Surgical manifestations of filariasis

    Directory of Open Access Journals (Sweden)

    Subrahmanyam M

    1978-01-01

    Full Text Available Surgical manifestations of filariasis as seen in 150 cases over a period of three years in the department of Surgery, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha are reviewed. The genital manifestations are more common than the elephantiasis in this endemic zone.

  17. [Surgical complications of colostomies].

    Science.gov (United States)

    Ben Ameur, Hazem; Affes, Nejmeddine; Rejab, Haitham; Abid, Bassem; Boujelbene, Salah; Mzali, Rafik; Beyrouti, Mohamed Issam

    2014-07-01

    The colostomy may be terminal or lateral, temporary or permanent. It may have psychological, medical or surgical complications. reporting the incidence of surgical complications of colostomies, their therapeutic management and trying to identify risk factors for their occurrence. A retrospective study for a period of 5 years in general surgery department, Habib Bourguiba hospital, Sfax, including all patients operated with confection of a colostomy. Were then studied patients reoperated for stoma complication. Among the 268 patients who have had a colostomy, 19 patients (7%) developed surgical stoma complications. They had a mean age of 59 years, a sex ratio of 5.3 and a 1-ASA score in 42% of cases. It was a prolapse in 9 cases (reconfection of the colostomy: 6 cases, restoration of digestive continuity: 3 cases), a necrosis in 5 cases (reconfection of the colostomy), a plicature in 2 cases (reconfection of the colostomy) a peristomal abscess in 2 cases (reconfection of the colostomy: 1 case, restoration of digestive continuity: 1 case) and a strangulated parastomal hernia in 1 case (herniorrhaphy). The elective incision and the perineal disease were risk factors for the occurrence of prolapse stomial. Surgical complications of colostomies remain a rare event. Prolapse is the most common complication, and it is mainly related to elective approach. Reoperation is often required especially in cases of early complications, with usually uneventful postoperative course.

  18. Transient Three-Dimensional Side Load Analysis of Out-of-Round Film Cooled Nozzles

    Science.gov (United States)

    Wang, Ten-See; Lin, Jeff; Ruf, Joe; Guidos, Mike

    2010-01-01

    The objective of this study is to investigate the effect of nozzle out-of-roundness on the transient startup side loads at a high altitude, with an anchored computational methodology. The out-of-roundness could be the result of asymmetric loads induced by hardware attached to the nozzle, asymmetric internal stresses induced by previous tests, and deformation, such as creep, from previous tests. The rocket engine studied encompasses a regeneratively cooled thrust chamber and a film cooled nozzle extension with film coolant distributed from a turbine exhaust manifold. The computational methodology is based on an unstructured-grid, pressure-based computational fluid dynamics formulation, and a transient inlet history based on an engine system simulation. Transient startup computations were performed with the out-of-roundness achieved by four different degrees of ovalization: one perfectly round, one slightly out-of-round, one more out-of-round, and one significantly out-of-round. The results show that the separation-line-jump is the peak side load physics for the round, slightly our-of-round, and more out-of-round cases, and the peak side load increases as the degree of out-of-roundness increases. For the significantly out-of-round nozzle, however, the peak side load reduces to comparable to that of the round nozzle and the separation line jump is not the peak side load physics. The counter-intuitive result of the significantly out-of-round case is found to be related to a side force reduction mechanism that splits the effect of the separation-line-jump into two parts, not only in the circumferential direction and most importantly in time.

  19. [da Vinci surgical system].

    Science.gov (United States)

    Watanabe, Gou; Ishikawa, Norihiro

    2014-07-01

    The da Vinci surgical system was developed by Intuitive Surgical Inc. in the United States as an endoscopic surgical device to assist remote control surgeries. In 1998, the Da Vinci system was first used for cardiothoracic procedures. Currently a combination of robot-assisted internal thoracic artery harvest together with coronary artery bypass grafting (CABG) through a mini-incision (ThoraCAB) or totally endoscopic procedures including anastomoses under robotic assistance (TECAB) are being conducted for the treatment of coronary artery diseases. With the recent advances in catheter interventions, hybrid procedures combining catheter intervention with ThoraCAB or TECAB are anticipated in the future.On the other hand, with the decrease in number of coronary artery bypass surgeries, the share of valvular surgeries is expected to increase in the future. Among them, mitral valvuloplasty for mitral regurgitation is anticipated to be conducted mainly by low-invasive procedures, represented by minimally invasive cardiac surgery( MICS) and robot-assisted surgery. Apart from the intrinsic good surgical view, robotic-assisted systems offer additional advantages of the availability of an amplified view and the easy to observe the mitral valve in the physiological position. Thus, robotic surgical surgeries that make complicated procedures easier are expected to accomplish further developments in the future. Furthermore, while the number of surgeries for atrial septal defects has decreased dramatically following the widespread use of Amplatzer septal occluder, robotic surgery may become a good indication for cases in which the Amplatzer device is not indicated. In Japan, clinical trial of the da Vinci robotic system for heart surgeries has been completed. Statutory approval of the da Vinci system for mitral regurgitation and atrial septal defects is anticipated in the next few years.

  20. Local grand unification and string theory

    International Nuclear Information System (INIS)

    Nilles, Hans Peter; Vaudrevange, Patrick K.S.

    2009-09-01

    The low energy effective action of string theory depends strongly on the process of compactification and the localization of fields in extra dimensions. Explicit string constructions towards the minimal supersymmetric standard model (MSSM) reveal interesting results leading to the concept of local grand unification. Properties of the MSSM indicate that we might live at a special location close to an orbifold fixed point rather than a generic point in Calabi-Yau moduli space. We observe an enhancement of (discrete) symmetries that have various implications for the properties of the MSSM such as proton stability as well as solutions to the flavor problem, the m-problem and the strong CP-problem. (orig.)

  1. A unified grand tour of theoretical physics

    CERN Document Server

    Lawrie, Ian D

    2013-01-01

    A Unified Grand Tour of Theoretical Physics invites its readers to a guided exploration of the theoretical ideas that shape our contemporary understanding of the physical world at the fundamental level. Its central themes, comprising space-time geometry and the general relativistic account of gravity, quantum field theory and the gauge theories of fundamental forces, and statistical mechanics and the theory of phase transitions, are developed in explicit mathematical detail, with an emphasis on conceptual understanding. Straightforward treatments of the standard models of particle physics and cosmology are supplemented with introductory accounts of more speculative theories, including supersymmetry and string theory. This third edition of the Tour includes a new chapter on quantum gravity, focusing on the approach known as Loop Quantum Gravity, while new sections provide extended discussions of topics that have become prominent in recent years, such as the Higgs boson, massive neutrinos, cosmological perturba...

  2. Introduction to Grand Unified Theories. 12

    International Nuclear Information System (INIS)

    Wali, K.C.

    1989-01-01

    This chapter presents an introduction into Grand Unified Theories. After a discussion of the general features to be expected in any such theory, and of the motivations for them, a detailed presentation of SU(5) theory is given. The group structures, particle multiplets, gauge and Higgs bosons are explained. The two stages of spontaneous symmetry breaking via the Higgs model, are calculated individually and in combination. Fermion mass matrices and relations between quark and lepton masses are derived. predictions of SU(5) theory, calculated using renormalization group methods, are derived. The chapter ends with discussions that bring together particle physics and cosmology, including the baryon asymmetry problem, phase transitions in the very early universe, and singularities like domain walls, vortex lines and monopoles. (author). 9 refs.; 4 figs.; 5 tabs

  3. Supersymmetric grand unified theories and cosmology

    International Nuclear Information System (INIS)

    Lazarides, G.; Shafi, Q.

    1983-01-01

    By examining the behavior of supersymmetric grand unified theories (GUT's) in the very early universe we find two classes of realistic models. In one of them supersymmetry is broken at or near superheavy GUT scale. The cosmological implications of such models are expected to be similar to those of nonsupersymmetric GUT's. In the second class of models, the superheavy GUT scale is related to the supersymmetry-breaking scale in the manner of Witten. Two types of cosmological scenarios appear possible in this case, either with or without an intermediate (new) inflationary phase. They can be experimentally distinguished, since the former predicts an absence and the latter an observable number density of superheavy monopoles. A mechanism for generating baryon asymmetry in such models is pointed out

  4. Pitié pour les grandes villes !

    Directory of Open Access Journals (Sweden)

    Jérôme Monnet

    1997-02-01

    Full Text Available Roger Caillois disait, en 1938, qu´il existe "une représentation de la grande ville, assez puissante sur les imaginations pour que jamais en pratique ne soit posée la question de son exactitude, créée de toute pièce par le livre, assez répandue néanmoins pour faire partie de l´atmosphère mentale collective et posséder par suite une certaine force de contrainte"(Le mythe et l´homme, p.156 [c´est lui qui souligne]. En 1996, la presse française a consacré dossiers et articles à "Habitat II...

  5. Preface to a GUT (Grand Unified Theory)

    International Nuclear Information System (INIS)

    Honig, W.

    1982-01-01

    A Grand Unified Theory (GUT) is proposed exhibiting relativistic invariance and based on a physical model for vacuum space consisting of the superposition of oppositely charged continuous fluids. Models for the photon, electron, neutrino, proton, etc., consist of separate unique variations in the relative densities of the fluids and their flow patterns. This GUT is also based on the use of transfinite axiomatic number forms and on a concept of metrical relativity which hopefully reconciles the many logical dichotomies in and between Special Relativity and Quantum Mechanics. These ideas result in a number of experimental proposals and predicted results which appear to be underivable from present paradigms, first among which is a physical model for the hidden variable of Quantum Mechanics. It is on these features that attention should rest. (Auth.)

  6. Higgsless grand unified theory breaking and trinification

    International Nuclear Information System (INIS)

    Carone, Christopher D.; Conroy, Justin M.

    2004-01-01

    Boundary conditions on an extra dimensional interval can be chosen to break bulk gauge symmetries and to reduce the rank of the gauge group. We consider this mechanism in models with gauge trinification. We determine the boundary conditions necessary to break the trinified gauge group directly down to that of the standard model. Working in an effective theory for the gauge-symmetry-breaking parameters on a boundary, we examine the limit in which the grand-unified theory-breaking-sector is Higgsless and show how one may obtain the low-energy particle content of the minimal supersymmetric standard model. We find that gauge unification is preserved in this scenario, and that the differential gauge coupling running is logarithmic above the scale of compactification. We compare the phenomenology of our model to that of four dimensional 'trinified' theories

  7. Grand unified models including extra Z bosons

    International Nuclear Information System (INIS)

    Li Tiezhong

    1989-01-01

    The grand unified theories (GUT) of the simple Lie groups including extra Z bosons are discussed. Under authors's hypothesis there are only SU 5+m SO 6+4n and E 6 groups. The general discussion of SU 5+m is given, then the SU 6 and SU 7 are considered. In SU 6 the 15+6 * +6 * fermion representations are used, which are not same as others in fermion content, Yukawa coupling and broken scales. A conception of clans of particles, which are not families, is suggested. These clans consist of extra Z bosons and the corresponding fermions of the scale. The all of fermions in the clans are down quarks except for the standard model which consists of Z bosons and 15 fermions, therefore, the spectrum of the hadrons which are composed of these down quarks are different from hadrons at present

  8. submitter Electromagnetic Study of a Round Coil Superferric Magnet

    CERN Document Server

    Volpini, Giovanni; Statera, Marco

    2016-01-01

    A novel type of superferric magnets suitable to arbitrary multipole orders was proposed by I. F. Malyshev and later by V. Kashikhin. This new topology, which we refer to as round coil superferric magnets (RCSM), allows a great simplification of the superconducting part, which in the simplest case may be composed by a single round coil, which has intrinsically a rather large bending radius allowing the use of strain-sensitive superconductors. INFN is designing and building a prototype of a multipolar corrector magnet based on this geometry and using MgB2 tapes. In this paper, we investigate a number of issues pertaining to the electromagnetic characteristics of RCSM. The RCSM magnetic has inherently even harmonics, in addition to usual odd ones and a solenoidal component. Either (but not both) disappears when integrated using a one-coil or a two-coil specular design. We investigate the effect of saturation on the multipolar components and on the load line, since in RCSM, saturation plays a role that differs bo...

  9. Medical academia clinical experiences of Ward Round Teaching curriculum.

    Science.gov (United States)

    Haghani, Fariba; Arabshahi, Seyed Kamran Soltani; Bigdeli, Shoaleh; Alavi, Mousa; Omid, Athar

    2014-01-01

    Medical students spend most of their time in hospital wards and it is necessary to study clinical educational opportunities. This study was aimed to explore faculty members' experience on Ward Round Teaching content. This qualitative study was conducted by purposive sampling with the maximum variation of major clinical departments faculty members in Isfahan University of Medical Sciences (n = 9). Data gathering was based on deep and semi-structured interviews. Data gathering continued till data saturation. Data was analyzed through the Collaizzi method and validated. Strategies to ensure trustworthiness of data (credibility, dependability, conformability, transferability) were employed (Guba and Lincoln). Basic codes extracted from the analyzed data were categorized into two main themes and related subthemes, including (1) tangible teachings (analytic intelligence, technical intelligence, legal duties) and (2) implied teachings (professionalism, professional discipline, professional difficulties). Ward round teaching is a valuable opportunity for learners to learn not only patient care aspects but also ethical values. By appropriate planning, opportunities can be used to teach capabilities that are expected of general practitioners.

  10. Medical academia clinical experiences of Ward Round Teaching curriculum

    Directory of Open Access Journals (Sweden)

    Fariba Haghani

    2014-01-01

    Full Text Available Background: Medical students spend most of their time in hospital wards and it is necessary to study clinical educational opportunities. This study was aimed to explore faculty members′ experience on Ward Round Teaching content. Methods and Materials: This qualitative study was conducted by purposive sampling with the maximum variation of major clinical departments faculty members in Isfahan University of Medical Sciences (n = 9. Data gathering was based on deep and semi-structured interviews. Data gathering continued till data saturation.Data was analyzed through the Collaizzi method and validated. Strategies to ensure trustworthiness of data (credibility, dependability, conformability, transferability were employed (Guba and Lincoln. Results: Basic codes extracted from the analyzed data were categorized into two main themes and related subthemes, including (1 tangible teachings (analytic intelligence, technical intelligence, legal duties and (2 implied teachings (professionalism, professional discipline, professional difficulties. Conclusion: Ward round teaching is a valuable opportunity for learners to learn not only patient care aspects but also ethical values. By appropriate planning, opportunities can be used to teach capabilities that are expected of general practitioners.

  11. Japanese round robin analysis for probabilistic fracture mechanics

    International Nuclear Information System (INIS)

    Yagawa, G.; Yoshimura, S.; Handa, N.

    1991-01-01

    Recently attention is focused on the probabilistic fracture mechanics, a branch of fracture mechanics with probability theory for a rational mean to assess the strength of components and structures. In particular, the probabilistic fracture mechanics is recognized as the powerful means for quantitative investigation of significance of factors and rational evaluation of life on problems involving a number of uncertainties, such as degradation of material strength, accuracy and frequency of inspection. Comparison with reference experiments are generally employed to assure the analytical accuracy. However, accuracy and reliability of analytical methods in the probabilistic fracture mechanics are hardly verified by experiments. Therefore, it is strongly needed to verify the probabilistic fracture mechanics through the round robin analysis. This paper describes results from the round robin analysis of flat plate with semi-elliptic cracks on the surface, conducted by the PFM Working Group of LE Subcommittee of the Japan Welding Society under the contract of the Japan Atomic Energy Research Institute and participated by Tokyo University, Yokohama National University, the Power Reactor and Nuclear Fuel Corporation, Tokyo Electric Power Co. Central Research Institute of Electric Power Industry, Toshiba Corporation, Kawasaki Heavy Industry Co. and Mitsubishi Heavy Industry Co. (author)

  12. International Round-Robin Testing of Bulk Thermoelectrics

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Hsin [ORNL; Porter, Wallace D [ORNL; Bottner, Harold [Fraunhofer-Institute, Freiburg, Germany; Konig, Jan [Fraunhofer-Institute, Freiburg, Germany; Chen, Lidong [Chinese Academy of Sciences; Bai, Shengqiang [Chinese Academy of Sciences; Tritt, Terry M. [Clemson University; Mayolett, Alex [Corning, Inc; Smith, Charlene [Corning, Inc; Harris, Fred [ZT-Plus; Sharp, Jeff [Marlow Industries, Inc; Lo, Jason [CANMET - Materials Technology Laboratory, Natural Resources of Canada; Keinke, Holger [University of Waterloo, Canada; Kiss, Laszlo I. [University of Quebec at Chicoutimi

    2011-11-01

    Two international round-robin studies were conducted on transport properties measurements of bulk thermoelectric materials. The study discovered current measurement problems. In order to get ZT of a material four separate transport measurements must be taken. The round-robin study showed that among the four properties Seebeck coefficient is the one can be measured consistently. Electrical resistivity has +4-9% scatter. Thermal diffusivity has similar +5-10% scatter. The reliability of the above three properties can be improved by standardizing test procedures and enforcing system calibrations. The worst problem was found in specific heat measurements using DSC. The probability of making measurement error is great due to the fact three separate runs must be taken to determine Cp and the baseline shift is always an issue for commercial DSC. It is suggest the Dulong Petit limit be always used as a guide line for Cp. Procedures have been developed to eliminate operator and system errors. The IEA-AMT annex is developing standard procedures for transport properties testing.

  13. An assessment of ninth round; Nona: uma avaliacao da rodada

    Energy Technology Data Exchange (ETDEWEB)

    Assumpcao, Eduardo; Andrade, Leila; Fontana, Raphaela [Agencia Nacional do Petroleo, Gas Natural e Biocombustiveis (ANP), Rio de Janeiro, RJ (Brazil)

    2008-07-01

    Accomplished on November, 27{sup th}, 2007, 271 exploratory blocks were offered in Round 9, distributed within 14 sectors, totalling an area of 73 thousand km{sup 2}. The following basins were included: Campos, Espirito Santo, Para- Maranhao, Parnaiba, Pernambuco-Paraiba, Potiguar, Santos, Reconcavo and Rio do Peixe. From the original lot of 67 companies qualified (31 Brazilian and 36 of foreign origin), 42 offered bids individually or in partnerships. 117 blocks were allocated to 24 winning operator companies. Other 12 enterprises won acreage as non-operator participants of joint bids. A record of R$ 2,1 billion were offered as signature bonuses along with 169.436 units of the so called minimum exploratory programs. These units may be converted to an estimated R$ 1,4 billion. The objective of this paper is to evaluate the results obtained in Round 9, analyzing collected data through three different perspectives of aggregate results: bidding companies, offered areas and exploratory models. (author)

  14. Dynamic eccentricity fault diagnosis in round rotor synchronous motors

    International Nuclear Information System (INIS)

    Ebrahimi, Bashir Mahdi; Etemadrezaei, Mohammad; Faiz, Jawad

    2011-01-01

    Research highlights: → We have presented a novel approach to detect dynamic eccentricity in round rotor synchronous motors. → We have introduced an efficient index based on processing torque using time series data mining method. → The stator current spectrum of the motor under different levels of fault and load are computed. → Winding function method has been employed to model healthy and faulty synchronous motors. -- Abstract: In this paper, a novel approach is presented to detect dynamic eccentricity in round rotor synchronous motors. For this, an efficient index is introduced based on processing developed torque using time series data mining (TSDM) method. This index can be utilized to diagnose eccentricity fault and its degree. The capability of this index to predict dynamic eccentricity is illustrated by investigation of load variation impacts on the nominated index. Stator current spectrum of the faulty synchronous motor under different loads and dynamic eccentricity degrees are computed. Effects of the dynamic eccentricity and load variation simultaneously are scrutinized on the magnitude of 17th and 19th harmonic components as traditional indices for eccentricity fault diagnosis in synchronous motors. Necessity signals and parameters for processing and feature extraction are evaluated by winding function method which is employed to model healthy and faulty synchronous motors.

  15. Fracture Toughness Round Robin Test International in pressure tube materials

    International Nuclear Information System (INIS)

    Villagarcia, M.P.; Liendo, M.F.

    1993-01-01

    Part of the pressure tubes surveillance program of CANDU type reactors is to determine the fracture toughness using a special fracture specimen and test procedure. Atomic Energy of Canada Limited decided to hold a Round Robin Test International and 9 laboratories participated worldwide in which several pressure tube materials were selected: Zircaloy-2, Zr-2.5%Nb cold worked and Zr-2.5%Nb heat treated. The small specimens used held back the thickness and curvature of the tube. J-R curves at room temperature were obtained and the crack extension values were determined by electrical potential drop techniques. These values were compared with results generated from other laboratories and a bid scatter was founded. It could be due to slight variations in the test method or inhomogeneity of the materials and a statistical study must be done to see if there is any pattern. The next step for the Round Robin Test would be to make some modifications in the test method in order to reduce the scatter. (Author)

  16. Review of freeboard: Grand Rapids Generating Station

    Energy Technology Data Exchange (ETDEWEB)

    Groeneveld, J.L.; Harding, W.B.; Bonin, D.V.; Fuchs, D.M. [Acres Manitoba Ltd., Winnipeg, MB (Canada); Warner, B.J. [Manitoba Hydro, Winnipeg, MB (Canada)

    2001-10-01

    Constructed during the period 1960-1965, the Grand Rapids Generating Station is a 472 MW hydroelectric station located approximately 400 kilometres northwest of Winnipeg, Manitoba, on the Saskatchewan River. An intake structure, four penstocks, a four-unit plus house unit powerhouse, wing walls, extensive dyke structures and a four-bay spillway are the components of the generating station. A little over ten years ago, the Manitoba Hydro Dam Safety Program was initiated. The program included a detailed dam safety review of the Grand rapids Generating Station. A potential deficiency in the freeboard allowance for several of the earthen dykes was revealed by the review process. The dam safety guidelines sponsored by the Canadian Dam Association were not met. The occurrence of a 1:1000 year wind event from the critical direction when the reservoir was at or near its full supply level was compounded by the analysis. The establishment of a wind and wave monitoring program was included in the deficiency studies commissioned. The objective was to confirm the empirical estimates concerning wave height, the development and usage of a two dimensional numerical wave model, and additional freeboard analyses to refine estimates of the recurrence interval of the current level of protection. A statistical Monte Carlo analysis was performed in the case of the estimates of the recurrence interval to determine the joint probabilities of seasonal variations in wind direction, wind speed, and reservoir level. The estimate of the actual risk of overtopping was therefore refined, and the details pertaining to the methodology and the conclusions of the analysis are all included in the paper. 15 refs., 4 tabs., 9 figs.

  17. Perspective view over the Grand Canyon, Arizona

    Science.gov (United States)

    2001-01-01

    This simulated true color perspective view over the Grand Canyon was created from Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) data acquired on May 12, 2000. The Grand Canyon Village is in the lower foreground; the Bright Angel Trail crosses the Tonto Platform, before dropping down to the Colorado Village and then to the Phantom Ranch (green area across the river). Bright Angel Canyon and the North Rim dominate the view. At the top center of the image the dark blue area with light blue haze is an active forest fire. ASTER is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra satellite. The instrument was built by Japan's Ministry of Economy, Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products. The broad spectral coverage and high spectral resolution of ASTER provides scientists in numerous disciplines with critical information for surface mapping, and monitoring of dynamic conditions and temporal change. Example applications are: monitoring glacial advances and retreats; monitoring potentially active volcanoes; identifying crop stress; determining cloud morphology and physical properties; wetlands evaluation; thermal pollution monitoring; coral reef degradation; surface temperature mapping of soils and geology; and measuring surface heat balance. The U.S. science team is located at NASA's Jet Propulsion Laboratory, Pasadena, Calif. The Terra mission is part of NASA's Science Mission Directorate. Size: 5 km in foreground to 40 km Location: 36.3 degrees north latitude, 112 degrees west longitude Orientation: North-northeast at top Original Data Resolution: ASTER 15 meters Dates Acquired: May 12, 2000

  18. Phase transitions at finite chemical potential in grand unified theories

    International Nuclear Information System (INIS)

    Bailin, D.; Love, A.

    1984-01-01

    We discuss the circumstances in which non-zero chemical potentials might prevent symmetry restoration in phase transitions in the early universe at grand unification or partial unification scales. The general arguments are illustrated by consideration of SO(10) and SU(5) grand unified theories. (orig.)

  19. Fetal Outcomes among Grand Multiparous and Multiparous Women ...

    African Journals Online (AJOL)

    Objective: To compare fetal outcomes among grand multiparous (para 5-9) and multiparous (para 2-4) delivering in Mulago hospital, Uganda. Design: Prospective cohort study. Setting: Mulago hospital, Uganda. Subjects: One hundred and fifty six grand multiparous and multiparous women were recruited on admission in ...

  20. First report of Phytophthora ramorum infecting grand fir in California

    Science.gov (United States)

    K.L. Riley; G.A. Chastagner

    2011-01-01

    Phytophthora ramorum was detected on grand fir in 2003 and 2005 in a Christmas tree plantation near Los Gatos, CA, in association with infected California bay laurel. Isolates derived from stem lesions were used to inoculate grand fir seedlings in two tests. Isolations from lesions on inoculated plants were positive for P. ramorum...

  1. Plants, arthropods, and birds of the Rio Grande [chapter 7

    Science.gov (United States)

    Deborah M. Finch; Gale L. Wolters; Wang Yong; Mary Jean Mund

    1995-01-01

    Human populations have increased dramatically along the Rio Grande since European settlement. Human use of water for irrigation and consumption, and human use of land for agriculture, urban centers, livestock grazing, and recreation have changed Rio Grande ecosystems by altering flood cycles, channel geomorphology, upslope processes, and water quality and quantity....

  2. Research of the Rio Grande Ecosystem Management Program

    Science.gov (United States)

    Deborah M. Finch

    2000-01-01

    This paper describes the mission, objectives, and preliminary results of the Middle Rio Grande Ecosystem Management Research Program managed at the Rocky Mountain Research Station's Albuquerque laboratory. This program was initiated in 1994 to address growing pressures to effectively manage the limited resources of the middle Rio Grande Basin. The program is...

  3. Use of an autologous liver round ligament flap zeros postoperative bile leak after curative resection of hilar cholangiocarcinoma.

    Science.gov (United States)

    Sun, Da-Xin; Tan, Xiao-Dong; Gao, Feng; Xu, Jin; Cui, Dong-Xu; Dai, Xian-Wei

    2015-01-01

    Postoperative bile leak is a major surgical morbidity after curative resection with hepaticojejunostomy for hilar cholangiocarcinoma, especially in Bismuth-Corlette types III and IV. This retrospective study assessed the effectiveness and safety of an autologous hepatic round ligament flap (AHRLF) for reducing bile leak after hilar hepaticojejunostomy. Nine type III and IV hilar cholangiocarcinoma patients were consecutively hospitalized for elective perihilar partial hepatectomy with hilar hepaticojejunostomy using an AHRLF between October 2009 and September 2013. The AHRLF was harvested to reinforce the perihilar hepaticojejunostomy. Main outcome measures included operative time, blood loss, postoperative recovery times, morbidity, bile leak, R0 resection rate, and overall survival. All patients underwent uneventful R0 resection with hilar hepaticojejunostomy. No patient experienced postoperative bile leak. The AHRLF was associated with lack of bile leak after curative perihilar hepatectomy with hepaticojejunostomy for hilar cholangiocarcinoma, without compromising oncologic safety, and is recommended in selected patients.

  4. Elastoplasticidad anisotropa de metales en grandes deformaciones

    Science.gov (United States)

    Caminero Torija, Miguel Angel

    El objetivo de este trabajo es el desarrollo de modelos y algoritmos numericos que simulen el comportamiento del material bajo estas condiciones en el contexto de programas de elementos finitos, dando como resultado predicciones mas precisas de los procesos de conformado y deformacion plastica en general. Para lograr este objetivo se han desarrollado diversas tareas destinadas a mejorar las predicciones en tres aspectos fundamentales. El primer aspecto consiste en la mejora de la descripcion del endurecimiento cinematico anisotropo en pequenas deformaciones, lo cual se ha realizado a traves de modelos y algoritmos implicitos de superficies multiples. Ha sido estudiada la consistencia de este tipo de modelos tanto si estan basados en una regla implicita similar a la de Mroz o en la regla de Prager. Ademas se han simulado los ensayos de Lamba y Sidebottom, obteniendo, en contra de la creencia general, muy buenas predicciones con la regla de Prager. Dichos modelos podrian ser extendidos de forma relativamente facil para considerar grandes deformaciones a traves de procedimientos en deformaciones logaritmicas, similares a los desarrollados en esta tesis y detallados a continuacion. El segundo aspecto consiste en la descripcion de la anisotropia elastoplastica inicial. Esto se ha conseguido mediante el desarrollo de modelos y algoritmos para plasticidad anisotropa en grandes deformaciones, bien ignorando la posible anisotropia elastica, bien considerandola simultaneamente con la anisotropia plastica. Para ello ha sido necesario desarrollar primero un nuevo algoritmo de elastoplasticidad anisotropa en pequenas deformaciones consistentemente linealizado y sin despreciar ningun termino, de tal forma que se conserve la convergencia cuadratica de los metodos de Newton. Este algoritmo en pequenas deformaciones ha servido para realizar la correccion plastica de dos algoritmos en grandes deformaciones. El primero de estos algoritmos es una variacion del clasico algoritmo de

  5. Paediatric Abdominal Surgical Emergencies in a General Surgical ...

    African Journals Online (AJOL)

    ... organized for general surgeons undertaking paediatric surgical emergencies. More paediatric surgeons should be trained and more paediatric surgical units should established in the country. Key Words: Paediatric Abdominal Surgical Emergencies; Paediatric Surgeons, General Surgeons. Journal of College of Medicine ...

  6. The Effect of Family Presence on Rounding Duration in the PICU.

    Science.gov (United States)

    Gupta, Priya R; Perkins, R Serene; Hascall, Rebecca L; Shelak, Carolyn F; Demirel, Shaban; Buchholz, Mark T

    2017-02-01

    The incorporation of family-centered rounds has become standard in PICUs across the United States. We compared rounding times in our institution, with and without family members present, to determine the effect on total rounding time and work flow. This observational study of a convenience sample was conducted over a 17-month period (May 2014-October 2015), accounting for typical seasonal variation in the PICU. The individual patient rounding times for 2657 encounters were recorded. The presence of family members, intubation status, physician assistant participation, interruptions during rounds, attending physician's full- or part-time status, and patient census were documented. The effect of family presence on per-patient rounding time was analyzed, while controlling for influential variables. Family members were present during 1743 of 2657 (66%) rounding encounters. The average per-patient rounding time with and without family members present was 8.6 minutes and 7.3 minutes, respectively, a difference of 1.3 minutes per patient. In statistical models that accounted for other influential variables, the presence of family members was associated with a highly significant (20.4%, P family members increases per-patient rounding times in the PICU. Family presence on rounds may have benefits that outweigh the additional time required to complete each patient interaction. Copyright © 2017 by the American Academy of Pediatrics.

  7. Occurrence and food habits of the round goby in the profundal zone of southwestern Lake Ontario

    Science.gov (United States)

    Walsh, M.G.; Dittman, D.E.; O'Gorman, R.

    2007-01-01

    Little is known about the ecology of round goby (Neogobius melanostomus), an invasive benthic fish, in the profundal zone of the Great Lakes. In April 2002–2005 we caught increasing numbers of round gobies with a bottom trawl in the 45–150 m depth range of southwestern Lake Ontario. In 2005, we examined gut contents of 30 round gobies from each of three depths, 55, 95, and 130 m, and qualitatively compared gut contents with density of benthic invertebrates determined by Ponar grabs. Round goby guts contained mostly Dreissena spp. and opposum shrimp, Mysis relicta (Mysis); the frequency of occurrence of dreissenids in guts decreased with depth, whereas the frequency of occurrence of Mysis in guts increased with depth. Abundance of these invertebrates in the environment followed the same pattern, although dreissenids of optimum edible size (3–12 mm) were still abundant (1,373/m2) at 130 m, where round gobies primarily consumed Mysis, suggesting that round gobies may switch from dreissenids to more profitable prey when it is available. Other food items were ostracods and fish, with ostracods generally eaten by smaller round gobies and fish eaten by larger round gobies. Occurrence and increasing abundance of round gobies in the profundal zone and predation on Mysis by round goby could have far-reaching consequences for the Lake Ontario fish community.

  8. Surgical camps: the Ugandan experience

    African Journals Online (AJOL)

    . The planned visits were advertised locally and in the national media. Screening of the patients was done first by the local medical teams and later by the visiting surgical teams. The surgical teams were comprised of the following personnel:.

  9. Acquiring minimally invasive surgical skills

    OpenAIRE

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room. This thesis has led to an enlarged insight in the organization of surgical skills training during residency training of surgical medical specialists.

  10. Robotic surgical training.

    Science.gov (United States)

    Ben-Or, Sharon; Nifong, L Wiley; Chitwood, W Randolph

    2013-01-01

    In July 2000, the da Vinci Surgical System (Intuitive Surgical, Inc) received Food and Drug Administration approval for intracardiac applications, and the first mitral valve repair was done at the East Carolina Heart Institute in May 2000. The system is now approved and used in many surgical specialties. With this disruptive technology and accepted use, surgeons and hospitals are seeking the most efficacious training pathway leading to safe use and responsible credentialing.One of the most important issues related to safe use is assembling the appropriate team of professionals involved with patient care. Moreover, proper patient selection and setting obtainable goals are also important.Creation and maintenance of a successful program are discussed in the article focusing on realistic goals. This begins with a partnership between surgeon leaders, hospital administrators, and industry support. Through this partnership, an appropriate training pathway and clinical pathway for success can be outlined. A timeline can then be created with periods of data analysis and adjustments as necessary. A successful program is attainable by following this pathway and attending to every detail along the journey.

  11. Surgical experts: born or made?

    Science.gov (United States)

    Sadideen, Hazim; Alvand, Abtin; Saadeddin, Munir; Kneebone, Roger

    2013-01-01

    The concept of surgical expertise and the processes involved in its development are topical, and there is a constant drive to identify reliable measures of expert performance in surgery. This review explores the notion of whether surgical experts are "born" or "made", with reference to educational theory and pertinent literature. Peer-reviewed publications, books, and online resources on surgical education, expertise and training were reviewed. Important themes and aspects of expertise acquisition were identified in order to better understand the concept of a surgical expert. The definition of surgical expertise and several important aspects of its development are highlighted. Innate talent plays an important role, but is insufficient on its own to produce a surgical expert. Multiple theories that explore motor skill acquisition and memory are relevant, and Ericsson's theory of the development of competence followed by deliberate self-practice has been especially influential. Psychomotor and non-technical skills are necessary for progression in the current climate in light of our training curricula; surgical experts are adaptive experts who excel in these. The literature suggests that surgical expertise is reached through practice; surgical experts are made, not born. A deeper understanding of the nature of expert performance and its development will ensure that surgical education training programmes are of the highest possible quality. Surgical educators should aim to develop an expertise-based approach, with expert performance as the benchmark. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  12. Surgical navigation with QR codes

    Directory of Open Access Journals (Sweden)

    Katanacho Manuel

    2016-09-01

    Full Text Available The presented work is an alternative to established measurement systems in surgical navigation. The system is based on camera based tracking of QR code markers. The application uses a single video camera, integrated in a surgical lamp, that captures the QR markers attached to surgical instruments and to the patient.

  13. Nigerian Journal of Surgical Research

    African Journals Online (AJOL)

    The Nigerian Journal of Surgical Research is a publication of the Surgical Research Society with main office in Zaria, Nigeria. Zaria is home to Ahmadu Bello University (ABU), a premier university in Nigeria. The aim of The Nigerian Journal of Surgical Research is to cover developments and advances in the broad field of ...

  14. Multilateral market-access reforms of the Doha Round

    DEFF Research Database (Denmark)

    Yu, Wusheng; Jensen, Hans Grinsted

    members such as the US. This paper provides a preliminary assessment of the likely impact of the tiered-formula reform approach on EU agricultural sectors. Numerical simulations of a multilateral market-access reform scenario show that such cuts would lead to across-the-board decreases in intra-EU trade...... external trade surpluses in many EU agricultural products. Further, the resulting adjustments in member states’ production and net trade positions are not equal: the new member states would generally lose part of their export shares in the EU market to external competitors, as highlighted in the cases......The July package of the Doha Round of trade negotiations stipulates that a tiered-formula approach should be used to significantly reduce market access barriers across countries, implying that the EU would have to make larger cuts to its high external tariffs, in comparison with many other WTO...

  15. Primary desmoplastic small round cell tumor of the femur

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Akihiko; Garcia, Joaquin [Memorial Sloan-Kettering Cancer Center, Department of Pathology, New York, NY (United States); Edgar, Mark A. [Memorial Sloan-Kettering Cancer Center, Department of Pathology, New York, NY (United States); Weill Medical College of Cornell University, New York, NY (United States); Meyers, Paul A. [Weill Medical College of Cornell University, New York, NY (United States); Memorial Sloan-Kettering Cancer Center, Department of Pediatrics, New York, NY (United States); Morris, Carol D. [Weill Medical College of Cornell University, New York, NY (United States); Memorial Sloan-Kettering Cancer Center, Department of Surgery, Orthopaedic Service, New York, NY (United States); Panicek, David M. [Weill Medical College of Cornell University, New York, NY (United States); Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States)

    2008-09-15

    Desmoplastic small round cell tumor (DSRCT) is a rare malignant neoplasm typically involving the abdominal cavity of a young male. Extra-abdominal occurrence of this tumor is very rare. We report a 10-year-old girl with primary DSRCT arising within the left femur. The patient presented with knee pain, and radiological findings were strongly suggestive of osteogenic sarcoma. In addition to the typical microscopic appearance and immunophenotype, RT-PCR demonstrated the chimeric transcript of EWS-WT1, which is diagnostic of DSRCT. Pulmonary metastases were present at initial staging studies, but no abdominal or pelvic lesion was present. Despite chemotherapy and complete tumor excision, the patient developed progressive lung and bone metastases and died 3 years after initial presentation. This is the second reported case of primary DSRCT of bone with genetic confirmation. (orig.)

  16. NUFACT11 round table discussion questions and answers

    CERN Document Server

    Blondel, A

    2013-01-01

    This presents the response to questions formulated by a round table discussion panel to the NUFACT11 participants. The main points made were as follows. Neutrino mass is physics beyond the Standard Model, it presents a very deep puzzle to solve, with the answers to several fundamental questions as potential reward. Precision measurement of oscillation parameters is one essential way to access information needed to solve this puzzle and there is a relatively clear (but not easy) way forward. Large θ(13) makes the appearance signals larger, but does not allow to relax the requirements on high beam intensity and large detector masses, it creates a difficult challenge on systematic errors, which will require dedicated ancillary experiments. Of particular interest is a low intensity muon storage ring for required cross-section measurements. There exist already extended bottom-up international collaboration in both physics and R&D experiments. All three main regions have plans for upgraded super-beams and asso...

  17. Round window electrode insertion potentiates retention in the scala tympani.

    Science.gov (United States)

    Connor, Stephen E J; Holland, N Julian; Agger, Andreas; Leong, Annabelle C; Varghese, Re Ajay; Jiang, Dan; Fitzgerald O'Connor, Alec

    2012-09-01

    The round window membrane (RWM)-intentioned approach is superior to the traditional bony cochleostomy (BC) approach in obtaining electrode placement within the scala tympani (ST). Cochlear implant outcome is influenced by several factors, including optimal placement and retention of the electrode array within the ST. The present study aimed to assess whether the RWM route is superior to a traditional BC for placement and retention of the electrode array in the ST. This was a prospective consecutive non-randomized comparison study. All patients were implanted with the Advanced Bionics 1J electrode array. The RWM approach (n = 32) was compared with a traditional BC group (n = 33). The outcome measure was the electrode position as judged within the scalar chambers at four points along the basal turn using postoperative computed tomography (CT). When the mean position scores were compared, the RWM-intentioned group had significantly more electrodes directed towards the ST compartment than the BC group (p scala vestibuli.

  18. Method for wrapping a wire round a nuclear fuel rod

    International Nuclear Information System (INIS)

    Nakayasu, Fumio.

    1974-01-01

    Object: To provide a method for winding a wire round a nuclear fuel rod with accurate pitches without imparting any local strain or torsion to the wire. Structure: A wire is fixed on one end of the fuel rod, and the other end of the wire is secured to a universal joint leaving a winding allowance to the fuel rod. The wire is linearly stretched by a predetermined tension through the universal joint so as to provide an angle of development theta corresponding to the desired winding pitch, and then, the fuel rod may be rotated so that the end of the wire on the side of the universal joint is moved towards the fuel rod so as to render the angle of development theta constant in proportion to said rotation of the fuel rod. (Kamimura, M.)

  19. Year-Round Use Of Thermography In House Doctoring

    Science.gov (United States)

    Gadsby, Kenneth J.; Harrje, David T.; Dutt, Gautam S.

    1983-03-01

    There have been many presentations of thermographic residential building analyses at the past ThermosInse conferences. A number of these papers have dealt with evaluation of insulation voids and more recently a few have described air leakage detection 2,3 during the colder winter months. This paper will focus on the thermographic application in the House Doctor instrumented energy analysis approach as developed by Princeton University. The central theme will be the application to a year-round research or commercial activity. Some of the conditions that could create thermographic problems, as well as techniques that may be used to lessen these difficulties, thereby extending the thermographic "season" is discussed. Our experiences in summer thermography with and without the use of a building pressurization system is also covered.

  20. Primary desmoplastic small round cell tumor of the femur

    International Nuclear Information System (INIS)

    Yoshida, Akihiko; Garcia, Joaquin; Edgar, Mark A.; Meyers, Paul A.; Morris, Carol D.; Panicek, David M.

    2008-01-01

    Desmoplastic small round cell tumor (DSRCT) is a rare malignant neoplasm typically involving the abdominal cavity of a young male. Extra-abdominal occurrence of this tumor is very rare. We report a 10-year-old girl with primary DSRCT arising within the left femur. The patient presented with knee pain, and radiological findings were strongly suggestive of osteogenic sarcoma. In addition to the typical microscopic appearance and immunophenotype, RT-PCR demonstrated the chimeric transcript of EWS-WT1, which is diagnostic of DSRCT. Pulmonary metastases were present at initial staging studies, but no abdominal or pelvic lesion was present. Despite chemotherapy and complete tumor excision, the patient developed progressive lung and bone metastases and died 3 years after initial presentation. This is the second reported case of primary DSRCT of bone with genetic confirmation. (orig.)

  1. Implementing interprofessional bedside rounding at the prequalification stage

    Directory of Open Access Journals (Sweden)

    Tuite DR

    2016-10-01

    Full Text Available Daniel R Tuite,1 David Healy,1 Thomas S MacKinnon2 1Faculty of Medicine, Brighton and Sussex Medical School, Brighton, 2School of Medicine, Imperial College London, London, UKWe read with great interest the paper by Henkin et al,1 demonstrating that the use of interprofessional bedside rounding (IBR significantly improved nurse–physician teamwork, particularly from the nurses’ point of view. This finding is relevant when one takes into account the importance of interdisciplinary teamwork; a review conducted by Epstein concluded that effective interprofessional teamwork both maximizes patient safety and increases job satisfaction and efficiency.2 We, as medical students, believe that inadequate emphasis is placed on interprofessional collaboration at the prequalification phase, and therefore, we suggest that implementing IBR at the university level could represent a method to improve teamwork between the nurses and doctors of the future.  View the original paper by Henkin et al.  

  2. Achieving Agreement in Three Rounds with Bounded-Byzantine Faults

    Science.gov (United States)

    Malekpour, Mahyar, R.

    2017-01-01

    A three-round algorithm is presented that guarantees agreement in a system of K greater than or equal to 3F+1 nodes provided each faulty node induces no more than F faults and each good node experiences no more than F faults, where, F is the maximum number of simultaneous faults in the network. The algorithm is based on the Oral Message algorithm of Lamport, Shostak, and Pease and is scalable with respect to the number of nodes in the system and applies equally to traditional node-fault model as well as the link-fault model. We also present a mechanical verification of the algorithm focusing on verifying the correctness of a bounded model of the algorithm as well as confirming claims of determinism.

  3. Albuquerque/Middle Rio Grande Urban Waters Viewer

    Science.gov (United States)

    These data have been compiled in support of the Middle Rio Grande/Albuquerque Urban Waters Partnership for the region including Albuquerque, New Mexico.The Middle Rio Grande/Albuquerque Urban Waters Federal Partnership is co-chaired by the U.S. Dept. of Housing and Urban Development and the U.S. Environmental Protection Agency. There are also a number of other federal agencies engaged in projects with Tribal, State, and local officials, and community stakeholders. Like many western river ecosystems, the Middle Rio Grande faces numerous challenges in balancing competing needs within a finite water supply and other resource constrains. Historical practices by our ancestors and immigrants to the Middle Rio Grande have established the conditions that we have inherited. Long-term drought exacerbated by climate change is changing conditions that affect natural and human communities as we strive to improve our precious Rio Grande.The Middle Rio Grande/Albuquerque Urban Waters Federal Partnership will reconnect our urban communities, particularly those that are overburdened or economically distressed, with the waterway by improving coordination among federal agencies and collaborating with community-led revitalization efforts. Our projects will improve our community water systems and promote their economic, environmental and social benefits. Specifically, the Middle Rio Grande/Albuquerque Urban Waters Federal Partnership will support the development of the Valle de Oro

  4. Grand Fir Nutrient Management in the Inland Northwestern USA

    Directory of Open Access Journals (Sweden)

    Dennis R. Parent

    2016-11-01

    Full Text Available Grand fir (Abies grandis (Douglas ex D. Don Lindley is widely distributed in the moist forests of the Inland Northwest. It has high potential productivity, its growth being nearly equal to western white pine, the most productive species in the region. There are large standing volumes of grand fir in the region. Nutritionally, the species has higher foliage cation concentrations than associated conifers, especially potassium (K and calcium (Ca. In contrast, it has lower nitrogen (N foliage concentrations, which creates favorable nutrient balance on N-limited sites. Despite concentration differences, grand fir stores proportionally more nutrients per tree than associated species because of greater crown biomass. Although few fertilization trials have examined grand fir specifically, its response is inferred from its occurrence in many monitored mixed conifer stands. Fertilization trials including grand fir either as a major or minor component show that it has a strong diameter and height growth response ranging from 15% to 50% depending in part on site moisture availability and soil geology. Grand fir tends to have a longer response duration than other inland conifers. When executed concurrently with thinning, fertilization often increases the total response. Late rotation application of N provides solid investment returns in carefully selected stands. Although there are still challenges with the post-fertilization effects on tree mortality, grand fir will continue to be an important species with good economic values and beneficial responses to fertilization and nutrient management.

  5. The value of case-based teaching vignettes in clinical microbiology rounds.

    Science.gov (United States)

    Spicer, Jennifer O; Kraft, Colleen S; Burd, Eileen M; Armstrong, Wendy S; Guarner, Jeannette

    2014-03-01

    To describe the implementation and evaluation of a case-based microbiology curriculum during daily microbiology rounds. Vignettes consist of short cases with images and questions that facilitate discussion among microbiologists, pathologists, infectious disease physicians, and trainees (residents and fellows). We performed a survey to assess the value of these vignettes to trainees. Motivation to come to rounds on time increased from 60% to 100%. Trainees attending rounds after implementation of the vignettes perceived the value of microbiology rounds to be significantly higher compared with those who attended rounds before implementation (P = .04). Pathology residents found that vignettes were helpful for retaining knowledge (8.3 of 10 points). The vignettes have enhanced the value of microbiology rounds by serving as a formalized curriculum exposing trainees from multiple specialties to various microbiology topics. Emphasis on interdisciplinary interactions between clinical and laboratory personnel was highlighted with this case-based curriculum.

  6. The Doha Round: "death-defying agenda" or "don't do it again"?

    OpenAIRE

    Harbinson, Stuart

    2009-01-01

    Almost eight years after the launch of the Doha Round, the WTO negotiations remain mired in a swamp of detail, with many participants unwilling or unable to make the hard decisions which would bring the Round to a conclusion. Meanwhile, the world has changed dramatically with the onset of a global economic crisis of proportions seldom, if ever, seen before. This has radically changed the context within which the Round is placed and may lead to fundamental rethinking of its future. This paper ...

  7. Reprogramming of round spermatids by the germinal vesicle cytoplasm in mice.

    Directory of Open Access Journals (Sweden)

    Peng-Cheng Kong

    Full Text Available The birthrate following round spermatid injection (ROSI remains low in current and evidence suggests that factors in the germinal vesicle (GV cytoplasm and certain substances in the GV such as the nucleolus might be responsible for genomic reprogramming and embryonic development. However, little is known whether the reprogramming factors in GV oocyte cytoplasm and/or nucleolus in GV are beneficial to the reprogramming of round spermatids and development of ROSI embryos. Here, round spermatids were treated with GV cytolysates and injected this round spermatid alone or co-injected with GV oocyte nucleolus into mature metaphase II oocytes. Subsequent embryonic development was assessed morphologically and by Oct4 expression in blastocysts. There was no significant difference between experimental groups at the zygote to four-cell development stages. Blastocysts derived from oocytes which were injected with cytolysate treated-round spermatid alone or co-injected with nucleoli injection yielded 63.6% and 70.3% high quality embryos, respectively; comparable to blastocysts derived by intracytoplasmic sperm injection (ICSI, but higher than these oocytes which were co-injected with lysis buffer-treated round spermatids and nucleoli or injected with the lysis buffer-treated round spermatids alone. Furthermore, the proportion of live offspring resulting from oocytes which were co-injected with cytolysate treated-round spermatids and nucleoli or injected with cytolysate treated-round spermatids alone was higher than those were injected with lysis buffer treated-round spermaids, but comparable with the ICSI group. Our results demonstrate that factors from the GV cytoplasm improve round spermatid reprogramming, and while injection of the extra nucleolus does not obviously improve reprogramming its potential contribution, although which cannot be definitively excluded. Thus, some reprogramming factors are evidently present in GV oocyte cytoplasm and could

  8. IMPACTS OF DOHA ROUND ON THE AGRIBUSINESS OF BRAZIL, CHINA AND INDIA

    OpenAIRE

    Pereira, Matheus Wemerson Gomes; Teixeira, Erly Cardoso; Razap-Skorbiansky, Sharon

    2008-01-01

    The central themes to be addressed during the Doha Round of world trade negotiations are the reduction of the agricultural production and export subsidies, and improved market access for agricultural and non-agricultural goods. The G-20 group wields enough power to press negotiations at the Doha Round toward lower agricultural trade barriers and production and exports subsidies. The objective of this study is to determine the impacts of four possible Doha Round scenarios on the economies of B...

  9. Proton decay: Numerical simulations confront grand unification

    International Nuclear Information System (INIS)

    Brower, R.C.; Maturana, G.; Giles, R.C.; Moriarty, K.J.M.; Samuel, S.

    1985-01-01

    The Grand Unified Theories of the electromagnetic, weak and strong interactions constitute a far reaching attempt to synthesize our knowledge of theoretical particle physics into a consistent and compelling whole. Unfortunately, many quantitative predictions of such unified theories are sensitive to the analytically intractible effects of the strong subnuclear theory (Quantum Chromodynamics or QCD). The consequence is that even ambitious experimental programs exploring weak and super-weak interaction effects often fail to give definitive theoretical tests. This paper describes large-scale calculations on a supercomputer which can help to overcome this gap between theoretical predictions and experimental results. Our focus here is on proton decay, though the methods described are useful for many weak processes. The basic algorithms for the numerical simulation of QCD are well known. We will discuss the advantages and challenges of applying these methods to weak transitions. The algorithms require a very large data base with regular data flow and are natural candidates for vectorization. Also, 32-bit floating point arithmetic is adequate. Thus they are most naturally approached using a supercomputer alone or in combination with a dedicated special purpose processor. (orig.)

  10. Coordinating the Atlantis Grand Opening Event

    Science.gov (United States)

    Smith, Abigail Allaine

    2013-01-01

    While working as the marketing intern for Kennedy Space Center's (KSC) Center Planning and Development Directorate (CPD), I was given the opportunity not only to learn new skills and expand my work experience under the powerful influence of NASA, but I also was given the opportunity to prove that I am an individual capable of contributing to the KSC team. My main responsibility while working in CPD was to organize and run a booth that represented the entire directorate at the Grand Opening of the Shuttle Atlantis exhibit during the weekend of June 28-30. This event was important for CPD because as a Directorate that markets KSC's facilities, technical capabilities and technologies to potential partners, it is important to attend all events and use them to gain an understanding of our audience. Although we catered mostly to the general public during this event, it was still important to reach out to the larger space enthusiast community and let them know about KSC's future plans to become a multi-user spaceport and that teclmology is still being developed.

  11. The grand descent has begun for CMS

    CERN Multimedia

    2006-01-01

    Until recently, the CMS experimental cavern looked relatively empty; its detector was assembled entirely at ground level, to be lowered underground in 15 sections. On 2 November, the first hadronic forward calorimeter led the way with a grand descent. The first section of the CMS detector (centre of photo) arriving from the vertical shaft, viewed from the cavern floor. There is something unusual about the construction of the CMS detector. Instead of being built in the experimental cavern, like all the other detectors in the LHC experiments, it was constructed at ground level. This was to allow for easy access during the assembly of the detector and to minimise the size of the excavated cavern. The slightly nerve-wracking task of lowering it safely into the cavern in separate sections came after the complete detector was successfully tested with a magnetic field at ground level. In the early morning of 2 November, the first section of the CMS detector began its eagerly awaited descent into the underground ca...

  12. Local grand unification in the heterotic landscape

    International Nuclear Information System (INIS)

    Schmidt, Jonas

    2009-06-01

    We consider the possibility that the unification of the electroweak interactions and the strong force arises from string theory, at energies significantly lower than the string scale. As a tool, an effective grand unified field theory in six dimensions is derived from an anisotropic orbifold compactification of the heterotic string. It is explicitly shown that all anomalies cancel in the model, though anomalous Abelian gauge symmetries are present locally at the boundary singularities. In the supersymmetric vacuum additional interactions arise from higher-dimensional operators. We develop methods that relate the couplings of the effective theory to the location of the vacuum, and find that unbroken discrete symmetries play an important role for the phenomenology of orbifold models. An efficient algorithm for the calculation of the superpotential to arbitrary order is developed, based on symmetry arguments. We furthermore present a correspondence between bulk fields of the orbifold model in six dimensions, and the moduli fields that arise from compactifying four internal dimensions on a manifold with non-trivial gauge background. (orig.)

  13. Gauge hierarchy problem in grand unified theories

    International Nuclear Information System (INIS)

    Alhendi, H.A.A.

    1982-01-01

    In grand unification schemes, several mass scales are to be introduced, with some of them much larger than all the others, to cope with experimental observations, in which elementary particles of higher masses require higher energy to observe them than elementary particles of lower masses. There have been controversial arguments in the literature on such hierarchical scale structure, when radiative corrections are taken into account. It has been asserted that the gauge hierarchy depends on the choice of the subtraction point (in the classical field space), of the four-point function at zero external momentum. It also has been asserted that the gauge hierarchy problem whenever it is possible to be maintained in one sector of particles, it also is possible to be maintained in the other sectors. These two problems have been studied in a prototype model, namely an 0(3)-model with two triplets of real scalar Higgs fields. Our analysis shows that, within ordinary perturbation theory, none of these two problems is quite correct

  14. Grand unification in the projective plane

    International Nuclear Information System (INIS)

    Hebecker, A.

    2004-01-01

    A 6-dimensional grand unified theory with the compact space having the topology of a real projective plane, i.e., a 2-sphere with opposite points identified, is considered. The space is locally flat except for two conical singularities where the curvature is concentrated. One supersymmetry is preserved in the effective 4d theory. The unified gauge symmetry, for example SU(5), is broken only by the non-trivial global topology. In contrast to the Hosotani mechanism, no adjoint Wilson-line modulus associated with this breaking appears. Since, locally, SU(5) remains a good symmetry everywhere, no UV-sensitive threshold corrections arise and SU(5)-violating local operators are forbidden. Doublet-triplet splitting can be addressed in the context of a 6d N=2 super Yang-Mills theory with gauge group SU(6). If this symmetry is first broken to SU(5) at a fixed point and then further reduced to the standard model group in the above non-local way, the two light Higgs doublets of the MSSM are predicted by the group-theoretical and geometrical structure of the model. (author)

  15. y las grandes ciudades: 1970-2004

    Directory of Open Access Journals (Sweden)

    Adrián de León Arias

    2008-01-01

    Full Text Available El cambio regional en las manufacturas mexicanas a partir de la década de 1980 se ha caracterizado por el rápido crecimiento del empleo y la producción en la frontera norte del país y la pérdida de participación de ellos en las grandes ciudades. En este artículo se analiza y evalúa este cambio regional en términos de la dinámica de la productividad laboral y factorial total para ambas configuraciones espaciales, presentando cálculos de productividad para éstas de 1970 a 2004, estimados a partir de la información censal. Los resultados sugieren que mientras el empleo ha crecido en magnitud mucho más rápido en la frontera norte, esta dinámica se ha generado con bajos niveles en crecimiento de la productividad, al menos hasta fechas recientes, por lo que el cambio regional estimulado por la apertura comercial hasta 2004 no parece haber facilitado un crecimiento económico más acelerado para México

  16. Local grand unification in the heterotic landscape

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, Jonas

    2009-07-15

    We consider the possibility that the unification of the electroweak interactions and the strong force arises from string theory, at energies significantly lower than the string scale. As a tool, an effective grand unified field theory in six dimensions is derived from an anisotropic orbifold compactification of the heterotic string. It is explicitly shown that all anomalies cancel in the model, though anomalous Abelian gauge symmetries are present locally at the boundary singularities. In the supersymmetric vacuum additional interactions arise from higher-dimensional operators. We develop methods that relate the couplings of the effective theory to the location of the vacuum, and find that unbroken discrete symmetries play an important role for the phenomenology of orbifold models. An efficient algorithm for the calculation of the superpotential to arbitrary order is developed, based on symmetry arguments. We furthermore present a correspondence between bulk fields of the orbifold model in six dimensions, and the moduli fields that arise from compactifying four internal dimensions on a manifold with non-trivial gauge background. (orig.)

  17. Constraints on grand unified superstring theories

    International Nuclear Information System (INIS)

    Ellis, J.; Lopez, J.L.; Nanopoulos, D.V.; Houston Advanced Research Center

    1990-01-01

    We evaluate some constraints on the construction of grand unified superstring theories (GUSTs) using higher level Kac-Moody algebras on the world-sheet. In the most general formulation of the heterotic string in four dimensions, an analysis of the basic GUST model-building constraints, including a realistic hidden gauge group, reveals that there are no E 6 models and any SO(10) models can only exist at level-5. Also, any such SU(5) models can exist only for levels 4≤k≤19. These SO(10) and SU(5) models risk having many large, massless, phenomenologically troublesome representations. We also show that with a suitable hidden sector gauge group, it is possible to avoid free light fractionally charged particles, which are endemic to string derived models. We list all such groups and their representations for the flipped SU(5)xU(1) model. We conclude that a sufficiently binding hidden sector gauge group becomes a basic model-building constraint. (orig.)

  18. A unified grand tour of theoretical physics

    CERN Document Server

    Griffiths, J

    2002-01-01

    Anyone offering a grand tour is faced with several options. Should they concentrate on what may be considered to be essential features, or should they attempt to present a brief glimpse of almost everything? The present offering is a compromise between these two extremes. The area considered - theoretical physics - is now such a vast subject that some kind of compromise is essential. Indeed, the field is now so wide that few could even attempt to review it in a single-authored work. My task here is to assess how well this book has succeeded in its main aim of providing a unified (though introductory) tour of this subject. Constrained within a single volume, this is clearly not an updated Landau-Lifschitz. It cannot be expected to take any particular topic to the level of recent research. Nevertheless, it does seem to cover the broad range of essential topics which now constitute the subject. It starts (most appropriately in my opinion) with geometry. It then covers classical physics, general relativity and qu...

  19. The impact of a lean rounding process in a pediatric intensive care unit.

    Science.gov (United States)

    Vats, Atul; Goin, Kristin H; Villarreal, Monica C; Yilmaz, Tuba; Fortenberry, James D; Keskinocak, Pinar

    2012-02-01

    Poor workflow associated with physician rounding can produce inefficiencies that decrease time for essential activities, delay clinical decisions, and reduce staff and patient satisfaction. Workflow and provider resources were not optimized when a pediatric intensive care unit increased by 22,000 square feet (to 33,000) and by nine beds (to 30). Lean methods (focusing on essential processes) and scenario analysis were used to develop and implement a patient-centric standardized rounding process, which we hypothesize would lead to improved rounding efficiency, decrease required physician resources, improve satisfaction, and enhance throughput. Human factors techniques and statistical tools were used to collect and analyze observational data for 11 rounding events before and 12 rounding events after process redesign. Actions included: 1) recording rounding events, times, and patient interactions and classifying them as essential, nonessential, or nonvalue added; 2) comparing rounding duration and time per patient to determine the impact on efficiency; 3) analyzing discharge orders for timeliness; 4) conducting staff surveys to assess improvements in communication and care coordination; and 5) analyzing customer satisfaction data to evaluate impact on patient experience. Thirty-bed pediatric intensive care unit in a children's hospital with academic affiliation. Eight attending pediatric intensivists and their physician rounding teams. Eight attending physician-led teams were observed for 11 rounding events before and 12 rounding events after implementation of a standardized lean rounding process focusing on essential processes. Total rounding time decreased significantly (157 ± 35 mins before vs. 121 ± 20 mins after), through a reduction in time spent on nonessential (53 ± 30 vs. 9 ± 6 mins) activities. The previous process required three attending physicians for an average of 157 mins (7.55 attending physician man-hours), while the new process required two

  20. From Twin Towers to Fawlty Towers: The story of the Doha Round

    OpenAIRE

    Erixon, Fredrik

    2008-01-01

    The Doha Round has yet again collapsed. The July 2008 attempt to negotiate a broad headline deal between the main member countries of the WTO failed. The Round is already way beyond bedtime and members now need to ask themselves: Is it at all meaningful to continue the Round - or should it be put at sleep permanently? This paper aims at examining the structural problems of the Doha Round and, by extension, the WTO and its current institutional setup. It offers a broad stock take of the curren...

  1. Medical Student Self-Efficacy with Family-Centered Care during Bedside Rounds

    Science.gov (United States)

    Young, Henry N.; Schumacher, Jayna B.; Moreno, Megan A.; Brown, Roger L.; Sigrest, Ted D.; McIntosh, Gwen K.; Schumacher, Daniel J.; Kelly, Michelle M.; Cox, Elizabeth D.

    2012-01-01

    Purpose Factors that support self-efficacy must be understood in order to foster family-centered care (FCC) during rounds. Based on social cognitive theory, this study examined (1) how 3 supportive experiences (observing role models, having mastery experiences, and receiving feedback) influence self-efficacy with FCC during rounds and (2) whether the influence of these supportive experiences was mediated by self-efficacy with 3 key FCC tasks (relationship building, exchanging information, and decision making). Method Researchers surveyed 184 students during pediatric clerkship rotations during the 2008–2011 academic years. Surveys assessed supportive experiences and students’ self-efficacy with FCC during rounds and with key FCC tasks. Measurement models were constructed via exploratory and confirmatory factor analyses. Composite indicator structural equation (CISE) models evaluated whether supportive experiences influenced self-efficacy with FCC during rounds and whether self-efficacy with key FCC tasks mediated any such influences. Results Researchers obtained surveys from 172 eligible students who were 76% (130) White and 53% (91) female. Observing role models and having mastery experiences supported self-efficacy with FCC during rounds (each pFCC tasks, relationship building and decision making (each p FCC during rounds. Conclusions Observing role models and having mastery experiences foster students’ self-efficacy with FCC during rounds, operating through self-efficacy with key FCC tasks. Results suggest the importance of helping students gain self-efficacy in key FCC tasks before the rounds experience and helping educators implement supportive experiences during rounds. PMID:22534602

  2. Surgical management of hyperthyroidism.

    Science.gov (United States)

    Quérat, C; Germain, N; Dumollard, J-M; Estour, B; Peoc'h, M; Prades, J-M

    2015-04-01

    Hyperthyroidism includes several clinical and histopathological situations. Surgery is commonly indicated after failure of medical treatment. The aim of this study was to analyze the indications and complications of surgery as well as endocrine results. Patients operated on for hyperthyroidism between 2004 and 2012 were included in a retrospective study. Total thyroidectomy was performed for Graves' disease, toxic multinodular goiter and amiodarone-associated thyrotoxicosis; patients with toxic nodule underwent hemithyroidectomy. Pathologic analysis assessed surgical specimens; postoperative complications and resolution of hyperthyroidism were noted. Two hundred patients from 15 to 83 years old were included. One hundred and eighty-eight underwent primary surgery and 12 were re-operated for recurrent goiter (6 with subtotal thyroidectomy for multinodular goiter 25 years previously; 6 with hemithyroidectomy for solitary nodule 15 years previously). Eighty-two patients suffered from toxic multinodular goiter, 78 from Graves' disease, 35 from solitary toxic nodules and 5 from amiodarone-associated thyrotoxicosis. Fourteen papillary carcinomas (including 11 papillary microcarcinomas) and 34 healthy parathyroid glands (17%) were identified in the pathological specimens. Postoperative complications comprised 4% permanent recurrent laryngeal nerve palsy (1 year follow-up), 9% hematoma requiring surgical revision, and 3% definitive hypocalcemia. Normalization of thyroid hormone levels was observed in 198 patients. Two recurrences occurred due to incomplete resection (1 case of Graves' disease and 1 intrathoracic toxic goiter that occurred respectively 18 and 5 months after resection). Postoperative complications were more frequent in multinodular goiter (23%) than in Graves' disease (13%) (ns: P>0.05). Surgical management of hyperthyroidism enables good endocrinal control if surgery is complete. Patients need to be fully informed of all possible postoperative complications

  3. [Duane vertical surgical treatment].

    Science.gov (United States)

    Merino, M L; Gómez de Liaño, P; Merino, P; Franco, G

    2014-04-01

    We report 3 cases with a vertical incomitance in upgaze, narrowing of palpebral fissure, and pseudo-overaction of both inferior oblique muscles. Surgery consisted of an elevation of both lateral rectus muscles with an asymmetrical weakening. A satisfactory result was achieved in 2 cases, whereas a Lambda syndrome appeared in the other case. The surgical technique of upper-insertion with a recession of both lateral rectus muscles improved vertical incomitance in 2 of the 3 patients; however, a residual deviation remains in the majority of cases. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  4. VT Built Up Lands in Grand Isle County - 1986

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) NRCS mapped historical and current-day built-up lands for Grand Isle County, VT using several vintages of aerial photography: 1941, 1962, 1974,...

  5. VT Built Up Lands in Grand Isle County - 1941

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) NRCS mapped historical and current-day built-up lands for Grand Isle County, VT using several vintages of aerial photography: 1941, 1962, 1974,...

  6. Constructing 5d orbifold grand unified theories from heterotic strings

    International Nuclear Information System (INIS)

    Kobayashi, Tatsuo; Raby, Stuart; Zhang Renjie

    2004-01-01

    A three-generation Pati-Salam model is constructed by compactifying the heterotic string on a particular T 6 /Z 6 Abelian symmetric orbifold with two discrete Wilson lines. The compactified space is taken to be the Lie algebra lattice G 2 -bar SU(3)-bar SO(4). When one dimension of the SO(4) lattice is large compared to the string scale, this model reproduces many features of a 5d SO(10) grand unified theory compactified on an S 1 /Z 2 orbifold. (Of course, with two large extra dimensions we can obtain a 6d SO(10) grand unified theory.) We identify the orbifold parities and other ingredients of the orbifold grand unified theories in the string model. Our construction provides a UV completion of orbifold grand unified theories, and gives new insights into both field theoretical and string theoretical constructions

  7. 27 CFR 9.119 - Middle Rio Grande Valley.

    Science.gov (United States)

    2010-04-01

    ... Middle Rio Grande Valley. (a) Name. The name of the viticultural area described in this section is... 1979. (24) Veguita, N. Mex. (1952), revised 1979. (25) Wind Mesa, N. Mex. (1952), revised 1967. (c...

  8. A GRAND PLAN FOR EARTH LOVE EDUCATION IN SOUTHERN ...

    African Journals Online (AJOL)

    cognition. From this doubtful synthesis, the researcher appears to have constructed a grand theory of how the world without ... problem here is that all of the students (English. Xhosa and ..... accompanying 'earthy music' will contrihute to.

  9. Casa Grande Ruins National Monument acoustical monitoring 2010

    Science.gov (United States)

    2014-11-01

    During September 2010, The Volpe Center collected baseline acoustical data at Casa Grande National Monument (CAGR), at one site for 28 days. The baseline data collected during this period will help park managers and planners estimate the effects of f...

  10. Flocculent and grand design spiral arm structure in cluster galaxies

    International Nuclear Information System (INIS)

    Elmegreen, D.M.

    1982-01-01

    A total of 829 spiral galaxies in 22 clusters having redshifts between z = 0.02 and 0.06 were classified according to the appearance of their spiral arm structures. The fraction of galaxies that have a grand design spiral structure was found to be higher among barred galaxies than among non-barred galaxies (at z = 0.02, 95 per cent of strongly barred galaxies have a grand design, compared with 67 per cent of non-barred or weakly barred galaxies). Cluster galaxies and distant non-cluster galaxies have the same fraction of grand design galaxies when resolution effects are considered. The grand design fraction among cluster galaxies is also similar to the fraction observed among nearby galaxies in binary systems and in groups. (author)

  11. Albuquerque/Middle Rio Grande Urban Waters Viewer

    Data.gov (United States)

    U.S. Environmental Protection Agency — These data have been compiled in support of the Middle Rio Grande/Albuquerque Urban Waters Partnership for the region including Albuquerque, New Mexico.The Middle...

  12. Rounds Today: A Qualitative Study of Internal Medicine and Pediatrics Resident Perceptions.

    Science.gov (United States)

    Rabinowitz, Raphael; Farnan, Jeanne; Hulland, Oliver; Kearns, Lisa; Long, Michele; Monash, Bradley; Bhansali, Priti; Fromme, H Barrett

    2016-10-01

    Attending rounds is a key component of patient care and education at teaching hospitals, yet there is an absence of studies addressing trainees' perceptions of rounds. To determine perceptions of pediatrics and internal medicine residents about the current and ideal purposes of inpatient rounds on hospitalist services. In this multi-institutional qualitative study, the authors conducted focus groups with a purposive sample of internal medicine and pediatrics residents at 4 teaching hospitals. The constant comparative method was used to identify themes and codes. The study identified 4 themes: patient care, clinical education, patient/family involvement, and evaluation. Patient care included references to activities on rounds that forwarded care of the patient. Clinical education pertained to teaching/learning on rounds. Patient/family involvement encompassed comments about incorporating patients and families on rounds. Evaluation described residents demonstrating skill for attendings. Resident perceptions of the purposes of rounds aligned with rounding activities described by prior observational studies of rounds. The influence of time pressures and the divergent needs of participants on today's rounds placed these identified purposes in tension, and led to resident dissatisfaction in the achievement of all of them. Suboptimal congruency exists between perceived resident clinical education and specialty-specific milestones. These findings suggest a need for education of multiple stakeholders by (1) enhancing faculty teaching strategies to maximize clinical education while minimizing inefficiencies; (2) informing residents about the value of patient interactions and family-centered rounds; and (3) educating program directors in proper alignment of inpatient rotational objectives to the milestones.

  13. Nalisis Kinerja Keuangan pada PT. Grand Victoria Hotel di Samarinda

    OpenAIRE

    -, Atmajaya -

    2013-01-01

    Based on the results of analysis show that the performance of PT. Hotel Grand Victorian is measured using liquidity ratios and profitability ratios decreased from 2010-2012. Performance PT. Grand Victorian is measured using the liquidity ratio has decreased from year 2010-2012 consists of current ratio has decreased, and this is because the total current assets has increased and decreased. Meanwhile, the cash ratio from year 2010-2012 has increased, this is because the total cash and cash equ...

  14. Simulations of Precipitation Variability over the Upper Rio Grande Basin

    International Nuclear Information System (INIS)

    Costigan, Keeley R.; Bossert, James E.; Langley, David L.

    1997-10-01

    In this research, we study Albuquerque's water and how it may be affected by changes in the regional climate, as manifested by variations in Rio Grande water levels. To do this, we rely on the use of coupled atmospheric, runoff, and ground water models. Preliminary work on the project has focused on uncoupled simulations of the aquifer beneath Albuquerque and winter precipitation simulations of the upper Rio Grande Basin. The latter is discussed in this paper

  15. Restrictions on SU(5) as a grand unified theory

    International Nuclear Information System (INIS)

    Shellard, R.C.

    1984-01-01

    Some restrictions imposed upon Grand Unified Theories by dynamical symetry breakdown are examined. They are shown that, in particular, theories SU(5) as symmetry group, with 3 or more fermion families undergo dynamical symmetry breakdown, and some of the fermions will acquire mass at the Grand Unified scale. On the other hand, the SO(10) group, with 3 families is free from this problem. (Author) [pt

  16. [Surgical treatment of gynecomastia].

    Science.gov (United States)

    Târcoveanu, E; Lupaşcu, C; Vasilescu, A; Moldovanu, R; Ichim, Mihaela; Georgescu, St; Niculescu, D; Dănilă, N; Dimofte, G; Anton, Raluca; Crumpei, Felicia; Florea, Niculina; Ungureanu, Cristina

    2008-01-01

    Gynecomastia describes a benign increase of the mammary gland in men. When medical treatment fails, the surgical procedure is the treatment of choice. There are two main surgical procedures: subdermal mastectomy and liposuction. To evaluate the results after surgical treatment (mastectomy) performed in a general surgery unit. We performed a retrospective study; all the patients operated for gynecomastia were reviewed. The clinical, imaging, biological, intraoperative and histological data were included into a MS Access database and statistical analyzed. From 1990-2007, 114 patients were admitted in the First Surgical Clinic Iaşi for gynecomastia. Only 12.6% from the patients were with bilateral gynecomastia. The mean age was 40.54 +/- 1.83 years old (range 12-84). Mean body mass was 26.72 +/- 0.46 kg/m2 (range 18.5-41), and about 20% from the patients had a BMI of over 30 kg/m2. We also noted that 46.5% were smokers. Simon classification was used for preoperative staging: 2.6% from the cases (N = 3) were included in stage I, 16.7% (N = 19) in stage IIa, 50% (N = 57) in stage IIb and 30.7% in stage III. The patients included in stages IIa and I are younger then the patients included in stage III (p = 0.024). Mastodynia was noted in 46 cases (40.4%). Ultrasound exam was performed in all the cases, and the larger diameter of the nodule measured was 3.75 +/- 0.18 cm (range 0.5-9.7). Only three cases were preoperatively treated with tamoxifen. Most of the cases were operated using general anesthesia (53.5%). Mastectomy was performed by peri-areolar (70.2%), elliptical (28.9%) or radial (0.9%) incisions. The subdermal mastectomy using peri-areolar approach was performed especially for the cases included in stages I, IIa and IIb--p gynecomastia in 6 cases; the other cases presented dilated ducts. We also noted intraductal papillary hyperplasia in 87 cases and chronic inflammation in 35 cases. The histological exam also revealed intraductal papilloma--9 cases, fibro

  17. Tres grandes plataformas marinas Mar del Norte

    Directory of Open Access Journals (Sweden)

    Soulas, R.

    1978-03-01

    Full Text Available This article analyzes the different building stages of three large sea platforms. After studying the structure's main characteristics, preparing scale models and calculating ail the elements, platform construction was carried out in three stages: — Dry-dock construction of the hull base. — Installation in the water and finishing the structure. — Immersion and bridge installation. Finally, the necessary operations to move the platform to its definite location were carried out. The structures are formed by a parallelepiped hull of reinforced concrete, divided into compartments by means of vertical orthogonals panels on top of which 2 or 4 piles are placed to support the bridge.

    En este artículo se analizan las diversas etapas en la realización de tres grandes plataformas marinas. Después de un estudio de las características principales de la estructura, ensayos en modelo reducido y cálculo de todos los elementos, se procede a la construcción de las plataformas en tres fases: — Construcción en seco de la base del casco. — Colocación en el agua y acabado de la estructura. — Inmersión y colocación del puente. Por último, se realizan las operaciones necesarias para llevar la plataforma a su ubicación definitiva. Las estructuras están formadas por un casco paralelepipédico de hormigón armado, dividido en compartimientos mediante tabiques verticales ortogonales y sobre el que se han colocado 2 ó 4 pilas que soportan el puente.

  18. Surgical Instrument Sets for Special Operations Expeditionary Surgical Teams.

    Science.gov (United States)

    Hale, Diane F; Sexton, Justin C; Benavides, Linda C; Benavides, Jerry M; Lundy, Jonathan B

    The deployment of surgical assets has been driven by mission demands throughout years of military operations in Iraq and Afghanistan. The transition to the highly expeditious Golden Hour Offset Surgical Transport Team (GHOST- T) now offers highly mobile surgical assets in nontraditional operating rooms; the content of the surgical instrument sets has also transformed to accommodate this change. The 102nd Forward Surgical Team (FST) was attached to Special Operations assigned to southern Afghanistan from June 2015 to March 2016. The focus was to decrease overall size and weight of FST instrument sets without decreasing surgical capability of the GHOST-T. Each instrument set was evaluated and modified to include essential instruments to perform damage control surgery. The overall number of main instrument sets was decreased from eight to four; simplified augmentation sets have been added, which expand the capabilities of any main set. The overall size was decreased by 40% and overall weight decreased by 58%. The cardiothoracic, thoracotomy, and emergency thoracotomy trays were condensed to thoracic set. The orthopedic and amputation sets were replaced with an augmentation set of a prepackaged orthopedic external fixator set). An augmentation set to the major or minor basic sets, specifically for vascular injuries, was created. Through the reorganization of conventional FST surgical instrument sets to maintain damage control capabilities and mobility, the 102nd GHOST-T reduced surgical equipment volume and weight, providing a lesson learned for future surgical teams operating in austere environments. 2017.

  19. Economic grand rounds: the price is right? Changes in the quantity of services used and prices paid in response to parity.

    Science.gov (United States)

    Goldman, Howard H; Barry, Colleen L; Normand, Sharon-Lise T; Azzone, Vanessa; Busch, Alisa B; Huskamp, Haiden A

    2012-02-01

    The impact of parity coverage on the quantity of behavioral health services used by enrollees and on the prices of these services was examined in a set of Federal Employees Health Benefit (FEHB) Program plans. After parity implementation, the quantity of services used in the FEHB plans declined in five service categories, compared with plans that did not have parity coverage. The decline was significant for all service types except inpatient care. Because a previous study of the FEHB Program found that total spending on behavioral health services did not increase after parity implementation, it can be inferred that average prices must have increased over the period. The finding of a decline in service use and increase in prices provides an empirical window on what might be expected after implementation of the federal parity law and the parity requirement under the health care reform law.

  20. Cluster Server IPTV dengan Penjadwalan Algoritma Round Robin

    Directory of Open Access Journals (Sweden)

    Didik Aribowo

    2016-03-01

    Full Text Available Perkembangan teknologi informasi yang pesat, otomatis seiring juga dengan meningkatnya para pengguna yang terhubung pada jaringan internet. Berawal dari sebuah single server yang selalu mendapatkan request dari banyak user, perlahan tapi pasti akan terjadi overload dan crash sehingga berdampak pada request yang tidak dapat dilayani oleh single server. Desain arsitektur cluster dapat dibangun dengan menggunakan konsep network load balancing yang memungkinkan proses pengolahan data di share ke dalam beberapa komputer. Dalam penelitian ini menggunakan algoritma penjadwalan round robin sebagai solusi alternatif mengatasi permasalah overload data pada server yang dapat mempengaruhi kinerja sistem IPTV. Untuk  jumlah request yang digunakan dalam penelitian ini adalah 5000, 15000, 25000, dan 50000 request. Dengan metode tersebut, maka performansi algoritma penjawalan dapat diamati dengan menekankan pada parameter sebagai berikut, yaitu throughput, respon time, reply connection, dan error connection sehingga didapatkan algoritma penjadwalan terbaik dalam rangka optimalisasi cluster server IPTV. Secara otomatis dalam proses load balancing mampu mengurangi beban kerja setiap server sehingga tidak ada server yang overload dan memungkinkan server  menggunakan bandwidth  yang tersedia secara lebih efektif serta menyediakan akses yang cepat ke web browser yang dihosting. Implementasi webserver cluster dengan skema load balancing dapat memberikan alvalaibilitas sistem yang tetap terjaga dan skalabilitas yang cukup untuk dapat tetap melayani setiap request dari pengguna

  1. Evolution in the use of antidumping mechanism after Uruguay round

    Directory of Open Access Journals (Sweden)

    Vinícius de Azevedo Couto Firme

    2015-09-01

    Full Text Available This paper analyzed how the main economies have used the antidumping measures (AD after the Uruguay round, between 1995 and 2012. Therefore, some techniques were employed in order to reveal the main AD users and the trend, of using this instrument, associated to each one of them. We also tested the hypothesis that countries could converge in terms of the number of AD cases and if spatial effects could be involved in this process. Finally, a criterion was established and a model was estimated in order to identify countries that usually favor the most competitive sectors through AD practice. The results revealed that Brazil was the only heavy AD user that was counter to the general downward trend verified on the AD cases. Meanwhile, China was not only the main target of this mechanism but the cases against this country showed a growth trend also. Furthermore, we found that the number of AD cases opened by traditional and nontraditional users is converging. Finally, both the index and the estimated model have indicated that Turkey and the EU seem to be favoring the most competitive industries through the AD practice.

  2. Wind Turbine Gearbox Condition Monitoring Round Robin Study - Vibration Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Sheng, S.

    2012-07-01

    The Gearbox Reliability Collaborative (GRC) at the National Wind Technology Center (NWTC) tested two identical gearboxes. One was tested on the NWTCs 2.5 MW dynamometer and the other was field tested in a turbine in a nearby wind plant. In the field, the test gearbox experienced two oil loss events that resulted in damage to its internal bearings and gears. Since the damage was not severe, the test gearbox was removed from the field and retested in the NWTCs dynamometer before it was disassembled. During the dynamometer retest, some vibration data along with testing condition information were collected. These data enabled NREL to launch a Wind Turbine Gearbox Condition Monitoring Round Robin project, as described in this report. The main objective of this project was to evaluate different vibration analysis algorithms used in wind turbine condition monitoring (CM) and find out whether the typical practices are effective. With involvement of both academic researchers and industrial partners, the project sets an example on providing cutting edge research results back to industry.

  3. Feasibility of Round Window Stimulation by a Novel Electromagnetic Microactuator

    Directory of Open Access Journals (Sweden)

    Wouter Johannes van Drunen

    2017-01-01

    Full Text Available Introduction. Most implantable hearing aids currently available were developed to compensate the sensorineural hearing loss by driving middle ear structures (e.g., the ossicles. These devices are successfully used in round window (RW stimulation clinically, although this was initially not the intended use. Here, a novel microactuator, specifically designed for RW stimulation, was tested in human temporal bones to determine actuator performance and applicability. Methods. Stapes footplate response to RW stimulation was determined experimentally in human temporal bones and the obtained sound pressure output level was estimated. Results. The actuator had a flat displacement response between 0.125 and 4 kHz, a resonance between 4 and 7 kHz, and a roll-off above. At increasing contact force, the stapes footplate displacement decreased by 5–10 dB re μm for forces ≥ 2 mN. The equivalent sound pressure level between 0.125 and 4 kHz amounted to 87–97 eq dB SPL and increased to 117 eq dB SPL for frequencies of 4–7 kHz. The total harmonic distortion (THD of the actuator ranged within 15–40% for static forces of 5 mN. Conclusion. The feasibility of an electromagnetic actuator that may be placed into the RW niche was demonstrated but requires further optimization in terms of THD and static force sensitivity.

  4. Analysis of a yearly multi-round, multi-period, multi-product transmission rights auction

    International Nuclear Information System (INIS)

    Ziogos, N.P.; Bakirtzis, A.G.

    2008-01-01

    A yearly multi-round, multi-period, multi-product transmission rights (TR) auction issuing both point-to-point Financial Transmission Rights (FTRs) and Flow-Gate Rights (FGRs) is studied in this paper. In each round the TR market participants (buyers or sellers) submit their bid or offer prices based on past energy market performance. A Locational Marginal Pricing (LMP) based energy market is assumed. The TR market participants' bid or offer prices reflect their expectation of the average annual LMP differences between withdrawal and injections points for FTRs and of the transmission link capacity prices for FGRs. The TR auction is performed in four rounds; in each round 25% of the entire system capability is awarded. TRs that are awarded in one round are modeled as fixed injections in subsequent rounds. Market participants that have acquired TRs in one round can sell them in subsequent rounds. A market participant can submit bids or offers for on-peak, off-peak or 24-h TRs. A three-area, nine-bus test system with six TR market participants is used for the analysis of the TR auction. (author)

  5. The use of laser technology to investigate the effect of railway ballast roundness on shear strength

    CSIR Research Space (South Africa)

    Mvelase, GM

    2017-06-01

    Full Text Available of roundness. Triaxial tests were conducted to determine the effect of the roundness on the shear strength properties of the materials. A Mohr-Coulomb failure model was successfully developed from the results to represent individual materials tested...

  6. Administrative Problems in the Single-Track Year-Round High Schools: Research Findings and Guidelines.

    Science.gov (United States)

    Holt, Laura L.; Karr-Kidwell, PJ

    An analysis of the problems pertaining to the adoption of a year-round calendar for high schools, along with the advantages of year-round education (YRE), are examined. It provides a literary review (including historical contexts), types of calendars, benefits, administrative problems, and societal benefits. For the study, 28 schools responded to…

  7. Pay for Performance Proposals in Race to the Top Round II Applications. Briefing Memo

    Science.gov (United States)

    Rose, Stephanie

    2010-01-01

    The Education Commission of the States reviewed all 36 Race to the Top (RttT) round II applications. Each of the 36 states that applied for round II funding referenced pay for performance under the heading of "Improving teacher and principal effectiveness based on performance." The majority of states outlined pay for performance…

  8. Tympanotomy and sealing of the round window for treatment of sudden deafness

    DEFF Research Database (Denmark)

    Ul-Mulk, Jamshaid; Friis, Søren; Hahn, Christoffer Holst

    2011-01-01

    The objective of this study was to evaluate the effectiveness of explorative tympanotomy and sealing of the round window in patients diagnosed with sudden deafness.......The objective of this study was to evaluate the effectiveness of explorative tympanotomy and sealing of the round window in patients diagnosed with sudden deafness....

  9. Round robin test for zirconium alloys in 400 deg C steam: results from EDF

    International Nuclear Information System (INIS)

    Blat, M.

    1994-01-01

    The EDF Material Studies Branch has participated in the Round Robin program of uniform corrosion on zirconium alloys. The objectives of these Round Robin corrosion tests are to generate new uniform corrosion weight gain date utilizing modern zirconium alloy products and to improve the International and ASTM standards. (author). 2 tabs., 7 appendix., 2 refs

  10. VLSI IMPLEMENTATION OF NOVEL ROUND KEYS GENERATION SCHEME FOR CRYPTOGRAPHY APPLICATIONS BY ERROR CONTROL ALGORITHM

    Directory of Open Access Journals (Sweden)

    B. SENTHILKUMAR

    2015-05-01

    Full Text Available A novel implementation of code based cryptography (Cryptocoding technique for multi-layer key distribution scheme is presented. VLSI chip is designed for storing information on generation of round keys. New algorithm is developed for reduced key size with optimal performance. Error Control Algorithm is employed for both generation of round keys and diffusion of non-linearity among them. Two new functions for bit inversion and its reversal are developed for cryptocoding. Probability of retrieving original key from any other round keys is reduced by diffusing nonlinear selective bit inversions on round keys. Randomized selective bit inversions are done on equal length of key bits by Round Constant Feedback Shift Register within the error correction limits of chosen code. Complexity of retrieving the original key from any other round keys is increased by optimal hardware usage. Proposed design is simulated and synthesized using VHDL coding for Spartan3E FPGA and results are shown. Comparative analysis is done between 128 bit Advanced Encryption Standard round keys and proposed round keys for showing security strength of proposed algorithm. This paper concludes that chip based multi-layer key distribution of proposed algorithm is an enhanced solution to the existing threats on cryptography algorithms.

  11. Improved meet-in-the-middle attacks on reduced-round Piccolo

    DEFF Research Database (Denmark)

    Liu, Ya; Cheng, Liang; Liu, Zhiqiang

    2018-01-01

    Piccolo is a lightweight block cipher that adopts a generalized Feistel network structure with 4 branches, each of which is 16 bit long. The key length is 80 or 128 bit, denoted by Piccolo-80 and Piccolo-128, respectively. In this paper, we mounted meet-in-the-middle attacks on 14-round Piccolo-80...... and at the end, respectively. Based on this structure, we mounted an attack on 14-round Piccolo-80 from the 5th round to the 18th round. The data, time, and memory complexities were 252 chosen plaintexts, 267.44 encryptions, and 264.91 blocks, respectively. For Piccolo-128, we built a 7-round distinguisher...... to attack 18-round Piccolo-128 from the 4th round to the 21st round. The data, time, and memory complexities were 252 chosen plaintexts, 2126.63 encryptions, and 2125.29 blocks, respectively. If not considering results on biclique cryptanalysis, these are currently the best public results on this reduced...

  12. Quiet please! Drug round tabards: are they effective and accepted? A mixed method study

    NARCIS (Netherlands)

    Verweij, Lotte; Smeulers, Marian; Maaskant, Jolanda M.; Vermeulen, Hester

    2014-01-01

    The use of drug round tabards is a widespread intervention that is implemented to reduce the number of interruptions and medication administration errors (MAEs) by nurses; however, evidence for their effectiveness is scarce. Evaluation of the effect of drug round tabards on the frequency and type of

  13. Effects of Year-Round Education on Texas Middle School Student Performance

    Science.gov (United States)

    Coopersmith, Michael

    2011-01-01

    This study was designed to investigate the effects of the year-round calendar on student performance in Texas middle schools as measured by achievement on the Texas Assessment of Knowledge and Skills (TAKS) test. In the State of Texas, 15 schools served students in grades six through eight using the year-round calendar in 2009-2010. The 15…

  14. Attempting to Predict Success in the Qualifying Round of the International Chemistry Olympiad

    Science.gov (United States)

    Urhahne, Detlef; Ho, Lok Hang; Parchmann, Ilka; Nick, Sabine

    2012-01-01

    The aim of this study was trying to predict success in the qualifying round for the International Chemistry Olympiad (IChO) on the basis of the expectancy-value model of achievement motivation by Eccles et al. The investigation with 52 participants, including 14 females, was conducted during the third of four qualifying rounds of the IChO in…

  15. Global curriculum in surgical oncology.

    Science.gov (United States)

    Are, C; Berman, R S; Wyld, L; Cummings, C; Lecoq, C; Audisio, R A

    2016-06-01

    The significant global variations in surgical oncology training paradigms can have a detrimental effect on tackling the rising global cancer burden. While some variations in training are essential to account for the differences in types of cancer and biology, the fundamental principles of providing care to a cancer patient remain the same. The development of a global curriculum in surgical oncology with incorporated essential standards could be very useful in building an adequately trained surgical oncology workforce, which in turn could help in tackling the rising global cancer burden. The leaders of the Society of Surgical Oncology and European Society of Surgical Oncology convened a global curriculum committee to develop a global curriculum in surgical oncology. A global curriculum in surgical oncology was developed to incorporate the required domains considered to be essential in training a surgical oncologist. The curriculum was constructed in a modular fashion to permit flexibility to suit the needs of the different regions of the world. Similarly, recognizing the various sociocultural, financial and cultural influences across the world, the proposed curriculum is aspirational and not mandatory in intent. A global curriculum was developed which may be considered as a foundational scaffolding for training surgical oncologists worldwide. It is envisioned that this initial global curriculum will provide a flexible and modular scaffolding that can be tailored by individual countries or regions to train surgical oncologists in a way that is appropriate for practice in their local environment. Copyright © 2016 Society of Surgical Oncology, European Society of Surgical Oncology. Published by Elsevier Ltd.. All rights reserved.

  16. VEIL Surgical Steps.

    Science.gov (United States)

    Raghunath, S K; Nagaraja, H; Srivatsa, N

    2017-03-01

    Inguinal lymphadenectomy remains the standard of care for metastatic nodal disease in cases of penile, urethral, vulval and vaginal cancers. Outcomes, including cure rates and overall and progression-free survivals, have progressively improved in these diseases with extending criteria to offer inguinal lymph node dissection for patients 'at-risk' for metastasis or loco-regional recurrence. Hence, despite declining incidence of advanced stages of these cancers, many patients will still need to undergo lymphadenectomy for optimal oncological outcomes. Inguinal node dissection is a morbid procedure with operative morbidity noted in almost two third of the patients. Video endoscopic inguinal lymphadenectomy (VEIL) was described and currently practiced with proven equivalent oncological outcomes. We describe our technique of VEIL using laparoscopic and robotic access as well as various new surgical strategies.

  17. The corner rounding modeling technique in SPICE simulations for deeply scaled MOSFETs

    International Nuclear Information System (INIS)

    Sun Wei; Yang Dake

    2013-01-01

    This paper presents a novel poly (PC) and active (RX) corner rounding modeling approach to SPICE simulations. A set of specially designed structures was used for measurement data collection. PC and RX corner rounding equations have been derived based on an assumption that the corner rounding area is a fragment of a circle. The equations were modified to reflect the gouging effect of physical silicon wafers. The modified general equations were implemented in the SPICE model to enable the model to describe the corner rounding effect. The good fittings between the SPICE model simulation results and the silicon data demonstrated in this paper proved that the designed corner rounding model is practical and accurate. (semiconductor devices)

  18. Internal differential collision attacks on the reduced-round Grøstl-0 hash function

    DEFF Research Database (Denmark)

    Ideguchi, Kota; Tischhauser, Elmar Wolfgang; Preneel, Bart

    2014-01-01

    . This results in collision attacks and semi-free-start collision attacks on the Grøstl-0 hash function and compression function with reduced rounds. Specifically, we show collision attacks on the Grøstl-0-256 hash function reduced to 5 and 6 out of 10 rounds with time complexities 248 and 2112 and on the Grøstl......-0-512 hash function reduced to 6 out of 14 rounds with time complexity 2183. Furthermore, we demonstrate semi-free-start collision attacks on the Grøstl-0-256 compression function reduced to 8 rounds and the Grøstl-0-512 compression function reduced to 9 rounds. Finally, we show improved...

  19. Aggressive surgical management of craniopharyngiomas

    Directory of Open Access Journals (Sweden)

    Manmohan Singh

    2013-01-01

    Full Text Available Surgical treatment of craniopharyngiomas is challenging and despite advancements it continues to pose a challenge. Proponents of subtotal resection in conjunction with radiotherapy argue that this less aggressive approach can yield appropriate results with the lower morbidity. On the contrary, other argument is that gross total resection is superior. Though surgical management of craniopharyngioma is challenging due to its location and important surrounding neurovascular structures, optimal surgical results can be expected following radical surgical excision. Radical excision of craniopharyngiomas is associated with excellent long-term recurrence free survival. Radiation induced long-term complications can be altogether avoided by excising these tumors completely.

  20. Surgical treatment of parastomal hernia

    International Nuclear Information System (INIS)

    Basti, Z.; Mayer, A.

    2013-01-01

    Stoma construction is among standard surgical skills and is performed for many indications. Every stoma means huge impact on quality of life for patients even with great improvement in surgical technique and ostomy devices. All patients are very sensitive to complication of stoma and the most frequent complication is parastomal hernia. Incidence reported in literature is very high and unacceptable, it is 30-70%. Surgical approach is very demanding on technical equipment and experiences of surgeon. Authors focus on each surgical approach for treating this complication weather it´s using mesh or laparoscopic or open approach. (author)

  1. Enterotoxemia em caprinos no Rio Grande do Sul Caprine enterotoxaemia in Rio Grande do Sul, Brazil

    Directory of Open Access Journals (Sweden)

    Edson M. Colodel

    2003-12-01

    Full Text Available São descritos surtos de enterotoxemia em caprinos em cinco propriedades no Estado do Rio Grande do Sul. Os animais afetados eram, normalmente, encontrados mortos ou apresentavam evolução aguda de 2 a 3 horas com acentuada depressão, cólicas abdominais e diarréia profusa com fibrina. Em duas propriedades relataram-se casos com a evolução de até 12 horas. Em treze animais necropsiados observaram-se aumento de líquidos nas cavidades abdominal, torácica e pericárdica, congestão e hiperemia da serosa e mucosa do intestino, conteúdo do cólon líquido com fibrina além de hemorragias de serosa e fibrina. Em um animal constatou-se microangiopatia cerebral caracterizada por acúmulo de material homogêneo e eosinofílico no espaço perivascular. No conteúdo intestinal, colônias com bastonetes morfológica e bioquimicamente sugestivos de Clostridium perfringens foram caracterizadas no estudo bacteriológico. A soroneutralização em camundongos com conteúdo intestinal dos animais afetados, revelou a presença da toxina épsilon. Estes achados evidenciam a enterotoxemia como doença de importância para criação de caprinos no Rio Grande do Sul.Five outbreaks of caprine enterotoxaemia in Rio Grande do Sul, Brazil, were studied. The animals were found dead or had a clinical course that usually lasted 2-3 hours. From two farms a clinical manifestation period of 12 hours was reported. Clinical signs were characterized by depression, marked abdominal discomfort, profuse watery diarrhea with fibrin clots, and death. Thirteen necropsies were performed and hydropericardium, hydrothorax and hydroperitoneum were commonly found. The mucosa and serosa of the colon were congested, and its contents was watery with multiple fibrin clots. Serosal hemorrhages and fibrin clots in the gallbladder were also seen. Fibrinous colitis and thyphilitis were the most frequent histological changes. Cerebral microangiopathy was observed in one case, which was

  2. 3D View of Grand Canyon, Arizona

    Science.gov (United States)

    2000-01-01

    The Grand Canyon is one of North America's most spectacular geologic features. Carved primarily by the Colorado River over the past six million years, the canyon sports vertical drops of 5,000 feet and spans a 445-kilometer-long stretch of Arizona desert. The strata along the steep walls of the canyon form a record of geologic time from the Paleozoic Era (250 million years ago) to the Precambrian (1.7 billion years ago).The above view was acquired by the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) instrument aboard the Terra spacecraft. Visible and near infrared data were combined to form an image that simulates the natural colors of water and vegetation. Rock colors, however, are not accurate. The image data were combined with elevation data to produce this perspective view, with no vertical exaggeration, looking from above the South Rim up Bright Angel Canyon towards the North Rim. The light lines on the plateau at lower right are the roads around the Canyon View Information Plaza. The Bright Angel Trail, which reaches the Colorado in 11.3 kilometers, can be seen dropping into the canyon over Plateau Point at bottom center. The blue and black areas on the North Rim indicate a forest fire that was smoldering as the data were acquired on May 12, 2000.Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra satellite. The instrument was built by Japan's Ministry of International Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products. Dr. Anne Kahle at NASA's Jet Propulsion Laboratory, Pasadena, Calif., is the U.S. Science team leader; Moshe Pniel of JPL is the project manager. ASTER is the only high resolution imaging sensor on Terra. The primary goal of the ASTER mission is to obtain high-resolution image data in 14 channels over the entire land surface, as

  3. Quality improvement of interdisciplinary rounds by leadership training based on essential quality indicators of the Interdisciplinary Rounds Assessment Scale.

    Science.gov (United States)

    Ten Have, Elsbeth C M; Nap, Raoul E; Tulleken, Jaap E

    2013-10-01

    The implementation of interdisciplinary teams in the intensive care unit (ICU) has focused attention on leadership behavior. Daily interdisciplinary rounds (IDRs) in ICUs integrate leadership behavior and interdisciplinary teamwork. The purpose of this intervention study was to measure the effect of leadership training on the quality of IDRs in the ICU. A nonrandomized intervention study was conducted in four ICUs for adults. The intervention was a 1-day training session in a simulation environment and workplace-based feedback sessions. Measurement included 28 videotaped IDRs (total, 297 patient presentations) that were assessed with 10 essential quality indicators of the validated IDR Assessment Scale. Participants were 19 intensivists who previously had no formal training in leading IDRs. They were subdivided by cluster sampling into a control group (ten experienced intensivists) and intervention group (nine intensive care fellows). Mann-Whitney U test was used to compare results between control and intervention groups. Baseline measurements of control and intervention groups revealed two indicators that differed significantly. The frequency of yes ratings for the intervention group significantly increased for seven of the ten indicators from before to after intervention. The frequency of yes ratings after training was significantly greater in the intervention than control groups for eight of the ten essential quality indicators. The leadership training improved the quality of the IDRs performed in the ICUs. This may improve quality and safety of patient care.

  4. NUFACT11 Round Table Discussion — Questions and Answers

    International Nuclear Information System (INIS)

    Blondel, A; Efthymiopoulos, I

    2013-01-01

    This presents the response to questions formulated by a round table discussion panel to the NUFACT11 participants. The main points made were as follows. Neutrino mass is physics beyond the Standard Model; it presents a very deep puzzle to solve, with the answers to several fundamental questions as potential reward. Precision measurement of oscillation parameters is one essential way to access information needed to solve this puzzle and there is a relatively clear (but not easy) way forward. Large θ 13 makes the appearance signals larger, but does not allow to relax the requirements on high beam intensity and large detector masses; it creates a difficult challenge on systematic errors, which will require dedicated ancillary experiments. Of particular interest is a low intensity muon storage ring for required cross-section measurements. There exist already extended bottom-up international collaboration in both physics and R and D experiments. All three main regions have plans for upgraded super-beams and associated detectors, with a variety of (mostly) complementary baselines, proceeding in an incremental way. The ultimate precision and verification of the neutrino mixing picture requires new types of neutrino beams based on storage rings. For low energy neutrinos, the beta-beam is a possible (but substantial) intermediate step. The Neutrino Factory offers the best precision and best sensitivity to deviations from the standard picture. Coordinated international R and D is pursued. International collaboration at the top level would be beneficial in acknowledging the process, so as make sure that intermediate steps are effectively building up in complementary fashion towards the ultimate goals.

  5. Homogenous BSCCO-2212 Round Wires for Very High Field Magnets

    International Nuclear Information System (INIS)

    Campbell, Scott; Holesinger, Terry; Huang, Ybing

    2012-01-01

    The performance demands on modern particle accelerators generate a relentless push towards higher field magnets. In turn, advanced high field magnet development places increased demands on superconducting materials. Nb3Sn conductors have been used to achieve 16 T in a prototype dipole magnet and are thought to have the capability for ∼18 T for accelerator magnets (primarily dipoles but also higher order multipole magnets). However there have been suggestions and proposals for such magnets higher than 20 T. The High Energy Physics Community (HEP) has identified important new physics opportunities that are enabled by extremely high field magnets: 20 to 50 T solenoids for muon cooling in a muon collider (impact: understanding of neutrinos and dark matter); and 20+ T dipoles and quadrupoles for high energy hadron colliders (impact: discovery reach far beyond present). This proposal addresses the latest SBIR solicitation that calls for grant applications that seek to develop new or improved superconducting wire technologies for magnets that operate at a minimum of 12 Tesla (T) field, with increases up to 15 to 20 T sought in the near future (three to five years). The long-term development of accelerator magnets with fields greater than 20 T will require superconducting wires having significantly better high-field properties than those possessed by current Nb 3 Sn or other A15 based wires. Given the existing materials science base for Bi-2212 wire processing, we believe that Bi 2 Sr 2 CaCu 2 O y (Bi-2212) round wires can be produced in km-long piece lengths with properties suitable to meet both the near term and long term needs of the HEP community. The key advance will be the translation of this materials science base into a robust, high-yield wire technology. While the processing and application of A15 materials have advanced to a much higher level than those of the copper oxide-based, high T c (HTS) counterparts, the HTS materials have the very significant advantage

  6. Access to Specialized Surgical Care

    African Journals Online (AJOL)

    The ANNALS of AFRICAN SURGERY. January 2016 Volume 13 Issue 1 1. EDITORIAL. Access to Specialized Surgical Care. Saidi H. University of Nairobi. Correspondence to: Prof Hassan Saidi, P.O Box 30196-00100, Nairobi. Email: hsaid2ke@yahoo.com. Ann Afr Surg. 2016;13(1):1-2. The narrative of surgical disease in ...

  7. Surgical residency: A tenant's view

    African Journals Online (AJOL)

    'To sleep: perchance to dream', is the frequent mantra of the surgical resident. However, unlike. Hamlet, there is no ensuing speculation as to what dreams may come as there are seldom any!! Surgical residency has been both vilified and immortalized, but the fact remains that it is one of the most challenging, provocative ...

  8. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated

  9. Acquiring minimally invasive surgical skills

    NARCIS (Netherlands)

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room.

  10. MYOMA OF THE ROUND LIGAMENT MIMICKING THE CLINICAL APPEARANCE OF THE INGUINAL HERNIA – A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Aleš Pišek

    2004-12-01

    Full Text Available Background. Myomas are the most frequent gynecological tumors. They first occur during puberty; however, they are most frequent among aged between 35 and 50. In this age group their incidence is 15–20%. They are rare after menopause. The majority of myomas arise in the uterus, but they may arise from other extrauterine sites such as the fallopian tubes, ovaries, round ligament, ligamentum latum, sacrouterine ligament, vagina and even the urethra. Most authors agree that there are numerous causes for the occurrence of myomas; however, they have not yet been clearly proven. They however agree that the myomas appear most frequently in the reproductive age, when the ovarian hormone levels are high and they diminish after menopause. They equally agree that the risk factors for the clinically significant myomas are nulliparity, obesity, a positive family history of myomas and African racial origin.Patients and methods. A 43-year-old patient was referred to our institution for operative treatment by her personal gynaecologist who clinically and sonografically verified a solid tumor situated to the right side of the uterus. The size of the tumor was that of a newborn’s head. The patient, however, had been observing a reponible inguinal hernia the size of a female fist for a period of four years. A solid tumor (22×6×7 cm arising from the right round ligament, was remowed during surgery. Half of its size was situated in the inguinal canal thus mimicking the clinical appearance of the inguinal hernia. After the tumor was removed the inner door of the inguinal canal closed by itself, no surgical repair was necessary. On histological examination the tumor was classified as a leiomyoma.Conclusions. Although the leiomyoma of the round ligament is the most frequent tumor of that region it is a rare gynecological tumor. The described case is especially interesting due to the unusual position of the tumor. It was situated partly intraabdominally and partly

  11. Perfluoroalkyl substances in waters along the Grand Canal, China.

    Science.gov (United States)

    Piao, H T; Jiao, X C; Gai, N; Chen, S; Lu, G H; Yin, X C; Yamazaki, E; Yamashita, N; Tan, K Y; Yang, Y L; Pan, J

    2017-07-01

    The Grand Canal, also known as the Beijing-Hangzhou Grand Canal, is a UNESCO World Heritage Site and the longest canal in the world. It is an important trunk line of the South-to-North Water Diversion Project in China. The contamination status and spatial distributions of perfluoroalky substances (PFASs) in waters of the Grand Canal were investigated. The total concentrations of PFASs (∑PFASs) range from 7.8 ng/L to 218.0 ng/L, with high ∑PFASs occurring in the southern part of the Grand Canal which is located in a highly urbanized and economically developed region. The dominance of PFOA showed a decreasing trend toward north while shorter chain homologue proportions increased in the northern part of the Canal which mainly traverses underdeveloped and rural areas in Eastern China. Positive correlations were observed between ∑PFASs and the population density as well as GDP per capita. Intersection with large rivers may affect the contamination levels and composition of PFASs in the water of the Grand Canal near the intersection sites. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Flocculent and grand design spiral galaxies in groups: time scales for the persistence of grand design spiral structures

    International Nuclear Information System (INIS)

    Elmegreen, B.G.; Elmegreen, D.M.

    1983-01-01

    Spiral arm classifications were made for 261 low-inclination galaxies in groups listed by Huchra and Geller. The fractional occurrence of grand design spiral structure in nonbarred galaxies was found to increase from approx.0.1 to approx.0.6 and then level off as the group crossing rate or galaxy collision rate in a group increases. A simple model is discussed where the random encounters between galaxies of any type and flocculent galaxies induce transient grand design spirals in the flocculent galaxies. If this grand-design stimulation occurs for binary collisions with impact parameters less than αR 25 , were R 25 is the galactic radius at 25 mag arcsec - 2 , and if the induced grand design spirals persist for an average time equal to #betta# galactic rotations, then the quantity α 2 #betta# equals approximately 3 x 10 4 . If binary collisions are responsible for grand design spirals, then this result implies either that the induced spirals last for many galactic rotations (#betta#>15), or that they can be stimulated by very remote encounters (α>45.) Alternatively, grand design spirals may be stimulated by multiple galaxy encounters, which would be the case for such large α, or by interactions with the potential well of the associated group, rather than by simple binary encounters. Weak correlations between the grand design fraction and the galaxy size, or between this fraction and the total number of galaxies in a group, were also found. Spiral structures of barred galaxies show no correlations with group environment

  13. Combined Surgical Treatment of Gynecomastia

    Directory of Open Access Journals (Sweden)

    Yordanov Y.

    2015-05-01

    Full Text Available Surgical treatment of gynecomastia could present unique challenges for the plastic surgeon. Achieving a good balance between effectiveness of the selected approach and the satisfactory aesthetic outcome often is a difficult endeavor. Optimal surgical treatment involves a combination of liposuction and direct excision. In the present study the charts of 11 patients treated with suction-assisted liposuction and direct surgical excision were retrospectively reviewed; a special emphasis is placed on the surgical technique. The mean follow-up period of the patients was 11.6 months. No infection, hematoma, nipple-areola complex necrosis and nipple retraction was encountered in this series. The combined surgical treatment of gynecomastia has shown to be a reliable technique in both small and moderate breast enlargement including those with skin excess.

  14. SO(10) - Grand unification and fermion masses

    International Nuclear Information System (INIS)

    Oezer, A.D.

    2005-01-01

    In this work, we study SO(10) grand unification in its full extent by using different explicit matrix representations which exhibit the structure of SO(10) in a very transparent way. Our approach consists mainly of two stages: We derive the explicit expressions of the mass-eigenvalues and mass-eigenstates of the physical gauge bosons from a mass squared-matrix that contains all the information about the mixing parameters among the gauge fields and the phases which are sources for CP violation. In the light of this analysis, we derive the explicit expressions for the interaction Lagrangians of the charged currents, the neutral currents and the charged and colored currents in SO(10). We present explicit expressions of the vector and axial-vector couplings of the two neutral currents in SO(10). We show how the baryon, lepton and baryon minus lepton number violating processes and their explicit CP violating phases are accommodated in the SO(10) theory. The Higgs potential that we use to implement in the Higgs mechanism is constructed in a most general fashion through a careful study of the Higgs fields of SO(10), where we give special emphasis on illustrating the explicit matrix representation of these Higgs fields. The potential part of the Higgs Lagrangian will give us the properties of the minimum of the vacuum, and the kinetic part will give us the mass-squared matrix of the gauge bosons via spontaneous symmetry breakdown. The same Higgs multiplets will be coupled to fermions through a democratic Yukawa matrix. Thereby, we derive explicit expressions for the fermion masses of the third family including Majorana and Dirac masses for neutrinos. We introduce a flavor-eigenbasis for neutrinos and find the mass-eigenstates and mass-eigenvalues of the neutrinos. Explicit expressions for CP violation in the neutrino sector are obtained. In the second stage of our work, we evaluate all the above mentioned quantities. In addition, we present the values of the physical

  15. Mechanical properties of two-way grid shells optimized considering roundness and elastic stiffness

    International Nuclear Information System (INIS)

    Ogawa, Toshiyuki; Yuta, Nishikawa; Rie, Tateishi; Ohsaki, Makoto

    2002-01-01

    A single-layer two-way grid shell defined by Bezier surface is optimized by coordinates of the control points as design variables. The purpose of this paper is to find optimal shapes considering roundness and elastic stiffness, and to investigate their mechanical properties. The distance of the center of curvature from the specified point is used for formulating the objective function for generating a round shape. Consider next a problem of minimizing the compliance as mechanical performance measure. The compliance is defined by the external work against the static loads applied to the nodes. The mechanically optimal shape is different from the round shape. Therefore, the multi objective optimization problem is formulated for optimizing the two objectives, which are roundness and the elastic stiffness defined by using the compliance. The constraint method is used for obtaining Pareto optimal solutions between the two objectives. We optimize single-layer two-way grid shells with square and rectangle plans. Mechanical properties of the optimal shapes are investigated by compliance and the distributions of axial force and bending moment. The round shape is significantly dominated by the bending moment and its compliance is large. The bending moment of the mechanically optimal shape is not very large, and the latticed shell has large stiffness through axial deformation. A trade-off shape is round enough, and the influence of the bending moment is smaller than that of the optimal round shape and the elastic stiffness is moderately large

  16. Reproductive biology of round sardinella (Sardinella aurita in north-eastern Mediterranean

    Directory of Open Access Journals (Sweden)

    Athanassios C. Tsikliras

    2006-06-01

    Full Text Available The reproductive biology of round sardinella, Sardinella aurita Valenciennes, 1847, was studied for the first time in the north-eastern Mediterranean Sea. Round sardinella has gained much attention lately because of its biomass increase, which might be the result of climatic changes occurring across the Mediterranean Sea. Monthly samples were collected on board commercial purse-seiners for two complete year cycles (September 2000 to August 2002. Round sardinella is a gonochoristic fish. The overall female to male ratio was not statistically different (P=0.34 from unity, although it varied monthly and with the length of the fish. The seasonal changes in the gonadosomatic index and the macroscopic characteristics of gonads showed that round sardinella in the northern Aegean spawns between May and July. Male round sardinella reach first sexual maturity at a smaller total length than females (155.0 and 168.3 mm respectively. Mean absolute fecundity (FA increased exponentially with body length (FA=0.0949xL4.22 and weight (FA=511.19xW1.02, with an average of ~21,000 oocytes produced per spawning female. Relative fecundity (FR ranged between 242 and 681 oocytes/g of body weight (average: 445 oocytes/g. The frequency distribution of oocytes showed that round sardinella produces a single batch of oocytes. In general, the reproductive characteristics of round sardinella in the north-eastern Mediterranean Sea differed when compared to stocks from other areas of its distribution.

  17. Palliative medicine Death Rounds: small group learning on a vital subject.

    Science.gov (United States)

    Kitzes, Judith A; Kalishman, Summers; Kingsley, Darra D; Mines, Jan; Lawrence, Elizabeth

    The medical student's experience with patients' dying and death has profound impact on personal and professional development. Death Rounds at the University of New Mexico School of Medicine is a small group educational model that promotes student self-reflection, metacognition, professional growth, and collegial support. To describe the implementation and evaluation activities of a third year clerkship Death Rounds which are a structured, institutionally supported resource for helping students to understand the clinical, ethical, legal, professional, cultural, and spiritual aspects of death. Medical students attend 2 to 3 small group palliative medicine Death Rounds sessions, facilitated by the attending clerkship director, chief residents, and a palliative care physician. The students' assessment of their palliative medicine knowledge and skills in 5 categories before and after participation in Death Rounds rated their skills after Death Rounds higher with effect sizes ranging from 0.9 to 1.9. Evidence from both the Death Rounds Questionnaire and Facilitators' Logs demonstrates that multiple issues and topics were addressed and all associated with the School of Medicine's 6 core competencies. Death Rounds minimally affect on clerkship time and faculty resources.

  18. Attacking 44 Rounds of the SHACAL-2 Block Cipher Using Related-Key Rectangle Cryptanalysis

    Science.gov (United States)

    Lu, Jiqiang; Kim, Jongsung

    SHACAL-2 is a 64-round block cipher with a 256-bit block size and a variable length key of up to 512 bits. It is a NESSIE selected block cipher algorithm. In this paper, we observe that, when checking whether a candidate quartet is useful in a (related-key) rectangle attack, we can check the two pairs from the quartet one after the other, instead of checking them simultaneously; if the first pair does not meet the expected conditions, we can discard the quartet immediately. We next exploit a 35-round related-key rectangle distinguisher with probability 2-460 for the first 35 rounds of SHACAL-2, which is built on an existing 24-round related-key differential and a new 10-round differential. Finally, taking advantage of the above observation, we use the distinguisher to mount a related-key rectangle attack on the first 44 rounds of SHACAL-2. The attack requires 2233 related-key chosen plaintexts, and has a time complexity of 2497.2 computations. This is better than any previously published cryptanalytic results on SHACAL-2 in terms of the numbers of attacked rounds.

  19. Adaptation of a hospital electronic referral system for antimicrobial stewardship prospective audit and feedback rounds.

    Science.gov (United States)

    Rawlins, Matthew D M; Raby, Edward; Sanfilippo, Frank M; Douglass, Rae; Chambers, Jonathan; McLellan, Duncan; Dyer, John R

    2018-05-04

    To evaluate the impact of the adaptation of an existing electronic referral application for use in antimicrobial stewardship prospective audit and feedback rounds (antimicrobial rounds). Retrospective, single-centre observational study between March 2015 and February 2016. A new quaternary referral centre. Adults referred for antimicrobial rounds outside of the intensive care and haematology units. Adaptation of an electronic referral application used by medical and allied health staff. A questionnaire-style referral form was designed to capture patient clinical details using a combination of free text and dropdown menus. Clinical pharmacists were educated and granted access to the system. The proportion of completed electronic referrals of total round reviews by month for the 12 months after implementation. The time from request to completion of reviews. The impact on adherence to advice provided on rounds. The impact on the institutional usage of broad-spectrum antibiotics: glycopeptides, carbapenems, third and fourth generation cephalosporins, fluoroquinolones and piperacillin/tazobactam. Over the study period, the proportion of electronic referrals of completed antimicrobial round reviews increased from 59% to 88% (P < 0.001); 75.7% of accepted electronic referrals were seen within 48 h of request. The proportion of advice ignored fell from 18% to 8.5% (P < 0.001). Piperacillin/tazobactam, fluoroquinolone and glycopeptide usage decreased. The adaptation of an electronic referral application for antimicrobial rounds was associated with increased adherence to advice and reduction in use in target antibiotics. Our model is now used at other institutions.

  20. Output control of da Vinci surgical system's surgical graspers.

    Science.gov (United States)

    Johnson, Paul J; Schmidt, David E; Duvvuri, Umamaheswar

    2014-01-01

    The number of robot-assisted surgeries performed with the da Vinci surgical system has increased significantly over the past decade. The articulating movements of the robotic surgical grasper are controlled by grip controls at the master console. The user interface has been implicated as one contributing factor in surgical grasping errors. The goal of our study was to characterize and evaluate the user interface of the da Vinci surgical system in controlling surgical graspers. An angular manipulator with force sensors was used to increment the grip control angle as grasper output angles were measured. Input force at the grip control was simultaneously measured throughout the range of motion. Pressure film was used to assess the maximum grasping force achievable with the endoscopic grasping tool. The da Vinci robot's grip control angular input has a nonproportional relationship with the grasper instrument output. The grip control mechanism presents an intrinsic resistant force to the surgeon's fingertips and provides no haptic feedback. The da Vinci Maryland graspers are capable of applying up to 5.1 MPa of local pressure. The angular and force input at the grip control of the da Vinci robot's surgical graspers is nonproportional to the grasper instrument's output. Understanding the true relationship of the grip control input to grasper instrument output may help surgeons understand how to better control the surgical graspers and promote fewer grasping errors. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Smartphone use during inpatient attending rounds: prevalence, patterns and potential for distraction.

    Science.gov (United States)

    Katz-Sidlow, Rachel J; Ludwig, Allison; Miller, Scott; Sidlow, Robert

    2012-10-01

    While there are numerous benefits of smartphone use for physicians, little is known about the negative effects of using these devices in the context of patient care. To assess resident and faculty smartphone use during inpatient attending rounds and its potential as a source of distraction during transfer of clinical information. Cross-sectional survey. University-affiliated public teaching hospital. All housestaff and inpatient faculty in the departments of Medicine and Pediatrics. Participants were asked about smartphone ownership, usage patterns during attending rounds, and whether team members had ever missed important data during rounds due to distraction from smartphones. Attendings were asked whether policies should be established for smartphone use during rounds. The overall response rate was 73%. Device ownership was prevalent (89% residents, 98% faculty), as was use of smartphones during inpatient rounds (57% residents, 28% attendings). According to self-reports, smartphones were used during rounds for patient care (85% residents, 48% faculty), reading/responding to personal texts/e-mails (37% residents, 12% faculty), and other non-patient care uses (15% residents, 0% faculty). Nineteen percent of residents and 12% of attendings believed they had missed important information because of distraction from smartphones. Residents and faculty agreed that smartphones "can be a serious distraction during attending rounds," and nearly 80% of faculty believed that smartphone policies should be established. Smartphone use during attending rounds is prevalent and can distract users during important information transfer. Attendings strongly favored the institution of formal policies governing appropriate smartphone use during inpatient rounds. Copyright © 2012 Society of Hospital Medicine.

  2. Accuracy of Laboratory Data Communication on ICU Daily Rounds Using an Electronic Health Record.

    Science.gov (United States)

    Artis, Kathryn A; Dyer, Edward; Mohan, Vishnu; Gold, Jeffrey A

    2017-02-01

    Accurately communicating patient data during daily ICU rounds is critically important since data provide the basis for clinical decision making. Despite its importance, high fidelity data communication during interprofessional ICU rounds is assumed, yet unproven. We created a robust but simple methodology to measure the prevalence of inaccurately communicated (misrepresented) data and to characterize data communication failures by type. We also assessed how commonly the rounding team detected data misrepresentation and whether data communication was impacted by environmental, human, and workflow factors. Direct observation of verbalized laboratory data during daily ICU rounds compared with data within the electronic health record and on presenters' paper prerounding notes. Twenty-six-bed academic medical ICU with a well-established electronic health record. ICU rounds presenter (medical student or resident physician), interprofessional rounding team. None. During 301 observed patient presentations including 4,945 audited laboratory results, presenters used a paper prerounding tool for 94.3% of presentations but tools contained only 78% of available electronic health record laboratory data. Ninty-six percent of patient presentations included at least one laboratory misrepresentation (mean, 6.3 per patient) and 38.9% of all audited laboratory data were inaccurately communicated. Most misrepresentation events were omissions. Only 7.8% of all laboratory misrepresentations were detected. Despite a structured interprofessional rounding script and a well-established electronic health record, clinician laboratory data retrieval and communication during ICU rounds at our institution was poor, prone to omissions and inaccuracies, yet largely unrecognized by the rounding team. This highlights an important patient safety issue that is likely widely prevalent, yet underrecognized.

  3. When thinking is beneficial and when it is not : The effects of thin and round advertising models

    NARCIS (Netherlands)

    Häfner, M.; Trampe, D.

    2009-01-01

    This study addresses the advertising effectiveness of round and thin models. Integrating previous findings and theories, the authors predict and find that impulsive and reflective product evaluations as responses to thin and round advertisement models diverge. Specifically, four experiments indicate

  4. A proposed standard round compact specimen for plane strain fracture toughness testing

    Science.gov (United States)

    Underwood, J. H.; Newman, J. C., Jr.; Seeley, R. R.

    1980-01-01

    A round, disk-shaped specimen is proposed as a standard test specimen for addition to ASTM Test for Plane-Strain Fracture Toughness of Metallic Materials (E 399-78A). The specimen is diametrically cracked, and loaded in the same way as the existing standard compact specimen. Tests and analyses were performed to verify that the proposed round compact specimen and associated stress intensity factor K solution are appropriate for a standard plane strain fracture toughness test. The use of the round compact specimen for other fracture tests is described.

  5. Results from Second Round of Remediated Nitrate Salt Surrogate Formulation and Testing

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Geoffrey Wayne [Los Alamos National Laboratory; Leonard, Philip [Los Alamos National Laboratory; Hartline, Ernest Leon [Los Alamos National Laboratory; Tian, Hongzhao [Los Alamos National Laboratory

    2016-04-04

    High Explosives and Technology (M-7) completed the second round of formulation and testing of Remediated Nitrate Salt (RNS) surrogates on March 17, 2016. This report summarizes the results of the work and also includes additional documentation required under test plan PLAN-TA9-2443 Rev B, "Remediated Nitrate Salt (RNS) Surrogate Formulation and Testing Standard Procedure", released February 16, 2016. All formulation and testing was carried out according to PLAN-TA9-2443 Rev B. Results from the first round of formulation and testing were documented in memorandum M7-16-6042, "Results from First Round of Remediated Nitrate Salt Surrogate Formulation and Testing."

  6. Peer Observation of Rounds Leads to Collegial Discussion of Teaching.

    Science.gov (United States)

    Pierce, J Rush; Rendón, Patrick; Rao, Deepti

    2018-01-01

    Faculty in the Division of Hospital Medicine provide most of the clinical teaching for learners at our institution. The majority of these faculty are Assistant Professors with limited formal instruction in clinical teaching. Previous Divisional strategies to improve clinical teaching ability included discussion of effective teaching behaviors, developing written expectations for teaching faculty, and instituting seminars on effective clinical teaching. Heretofore, the Division had not utilized a direct observation exercise. We developed a direct observation exercise to encourage discussion of teaching techniques and contemplation of change. Using a social learning model, we developed a peer-to-peer observation followed by a nonevaluative discussion. We created a tool for describing teaching behaviors in 5 domains that were similar to or different from the usual behavior of the observing peer: learner presentations, team leadership, bedside teaching, professionalism, and other. After the observation, the observing and observed faculty met to discuss observed teaching behaviors. Both faculty members discussed and then recorded any teaching behaviors that they planned to adopt or change. We implemented this intervention in a 22-member Academic Division of Hospital Medicine at a tertiary care medical center in the United States. A high proportion were junior faculty and graduates of our residency program. We reviewed records of 28 of 31 observations that were completed during the initial 9-month period of implementation and later surveyed faculty. The exercise resulted in planned changes in teaching behaviors that included instituting new methods to improve teaching team leadership, triaging of patients seen on rounds, faculty behaviors during oral presentations, giving real-time feedback, use of technology and humor, demonstrating physical examination findings, and modeling professional behaviors. Faculty later reported adoption of new teaching behaviors that were

  7. The Mesaba Energy Project: Clean Coal Power Initiative, Round 2

    Energy Technology Data Exchange (ETDEWEB)

    Stone, Richard; Gray, Gordon; Evans, Robert

    2014-07-31

    The Mesaba Energy Project is a nominal 600 MW integrated gasification combine cycle power project located in Northeastern Minnesota. It was selected to receive financial assistance pursuant to code of federal regulations (?CFR?) 10 CFR 600 through a competitive solicitation under Round 2 of the Department of Energy?s Clean Coal Power Initiative, which had two stated goals: (1) to demonstrate advanced coal-based technologies that can be commercialized at electric utility scale, and (2) to accelerate the likelihood of deploying demonstrated technologies for widespread commercial use in the electric power sector. The Project was selected in 2004 to receive a total of $36 million. The DOE portion that was equally cost shared in Budget Period 1 amounted to about $22.5 million. Budget Period 1 activities focused on the Project Definition Phase and included: project development, preliminary engineering, environmental permitting, regulatory approvals and financing to reach financial close and start of construction. The Project is based on ConocoPhillips? E-Gas? Technology and is designed to be fuel flexible with the ability to process sub-bituminous coal, a blend of sub-bituminous coal and petroleum coke and Illinois # 6 bituminous coal. Major objectives include the establishment of a reference plant design for Integrated Gasification Combined Cycle (?IGCC?) technology featuring advanced full slurry quench, multiple train gasification, integration of the air separation unit, and the demonstration of 90% operational availability and improved thermal efficiency relative to previous demonstration projects. In addition, the Project would demonstrate substantial environmental benefits, as compared with conventional technology, through dramatically lower emissions of sulfur dioxide, nitrogen oxides, volatile organic compounds, carbon monoxide, particulate matter and mercury. Major milestones achieved in support of fulfilling the above goals include obtaining Site, High Voltage

  8. Biomechanical analysis technique choreographic movements (for example, "grand battman jete"

    Directory of Open Access Journals (Sweden)

    Batieieva N.P.

    2015-04-01

    Full Text Available Purpose : biomechanical analysis of the execution of choreographic movement "grand battman jete". Material : the study involved students (n = 7 of the department of classical choreography faculty of choreography. Results : biomechanical analysis of choreographic movement "grand battman jete" (classic exercise, obtained kinematic characteristics (path, velocity, acceleration, force of the center of mass (CM bio parts of the body artist (foot, shin, thigh. Built bio kinematic model (phase. The energy characteristics - mechanical work and kinetic energy units legs when performing choreographic movement "grand battman jete". Conclusions : It was found that the ability of an athlete and coach-choreographer analyze the biomechanics of movement has a positive effect on the improvement of choreographic training of qualified athletes in gymnastics (sport, art, figure skating and dance sports.

  9. Liberating methodological thinking in human sciences from grand theories

    DEFF Research Database (Denmark)

    Kharlamov, Nikita; Baldursson, Einar Baldvin

    2016-01-01

    focus on the necessity of a “grand unified theory” at the expense of any and all alternative perspectives. Properties of grand theories are discussed on the examples of Giddens and Bourdieu. It is argued that grand theories hamper a more productive focus on concrete phenomena. Robert Merton’s focus......Many humanistic and social disciplines are naturally inclined to seek for human-, person-, self- centered focus, and develop a holistic theory of such. Such disciplines continually engage with philosophical, metaphysical and meta-theoretical perspectives. This engagement often leads to a singular...... on “middle range” theories is revisited and its continuing relevance is highlighted. The level of abstraction characteristic of such theories, as well as the way they engage with the empirical social reality, are discussed. The article concludes by considering the paradoxical reductionism that can...

  10. Mesothelial cell proliferation in the scala tympani: a reaction to the rupture of the round window membrane.

    Science.gov (United States)

    Sone, M

    1998-10-01

    The inner layer of the round window membrane is composed of mesothelial cells and this mesothelial cell layer extends to the scala tympani. This study describes the histopathologic findings of temporal bone analysis from a patient with bilateral perilymphatic fistula of the round window membrane. The left ear showed proliferation of mesothelial cells in the scala tympani of the basal turn adjoining the round window membrane. This cell proliferation is thought to be a reaction to the rupture of the round window membrane.

  11. Environmental Audit of the Grand Junction Projects Office

    Energy Technology Data Exchange (ETDEWEB)

    1991-08-01

    The Grand Junction Projects Office (GJPO) is located in Mesa County, Colorado, immediately south and west of the Grand Junction city limits. The US Atomic Energy Commission (AEC) established the Colorado Raw Materials Office at the present-day Grand Junction Projects Office in 1947, to aid in the development of a viable domestic uranium industry. Activities at the site included sampling uranium concentrate; pilot-plant milling research, including testing and processing of uranium ores; and operation of a uranium mill pilot plant from 1954 to 1958. The last shipment of uranium concentrate was sent from GJPO in January, 1975. Since that time the site has been utilized to support various DOE programs, such as the former National Uranium Resource Evaluation (NURE) Program, the Uranium Mill Tailings Remedial Action Project (UMTRAP), the Surplus Facilities Management Program (SFMP), and the Technical Measurements Center (TMC). All known contamination at GJPO is believed to be the result of the past uranium milling, analyses, and storage activities. Hazards associated with the wastes impounded at GJPO include surface and ground-water contamination and potential radon and gamma-radiation exposure. This report documents the results of the Baseline Environmental Audit conducted at Grand Junction Projects Office (GJPO) located in Grand Junction, Colorado. The Grand Junction Baseline Environmental Audit was conducted from May 28 to June 12, 1991, by the Office of Environmental Audit (EH-24). This Audit evaluated environmental programs and activities at GJPO, as well as GJPO activities at the State-Owned Temporary Repository. 4 figs., 12 tabs.

  12. Saturn's Internal Magnetic Field Revealed by Cassini Grand Finale

    Science.gov (United States)

    Cao, H.; Dougherty, M. K.; Khurana, K. K.; Hunt, G. J.; Provan, G.; Kellock, S.; Burton, M. E.; Burk, T. A.

    2017-12-01

    Saturn's internal magnetic field has been puzzling since the first in-situ measurements during the Pioneer 11 Saturn flyby. Cassini magnetometer measurements prior to the Grand Finale phase established 1) the highly axisymmetric nature of Saturn's internal magnetic field with a dipole tilt smaller than 0.06 degrees, 2) at least an order of magnitude slower secular variation rate compared to that of the current geomagnetic field, and 3) expulsion of magnetic fluxes from the equatorial region towards high latitude. The highly axisymmetric nature of Saturn's intrinsic magnetic field not only challenges dynamo theory but also makes an accurate determination of the interior rotation rate of Saturn extremely difficult. The Cassini spacecraft entered the Grand Finale phase in April 2017, during which time the spacecraft dived through the gap between Saturn's atmosphere and the inner edge of the D-ring 22 times before descending into the deep atmosphere of Saturn. The unprecedented proximity to Saturn (reaching 2500 km above the cloud deck) and the highly inclined nature of the Grand Finale orbits provided an ideal opportunity to decode Saturn's internal magnetic field. The fluxgate magnetometer onboard Cassini made precise vector measurements during the Grand Finale phase. Magnetic signals from the interior of the planet, the magnetospheric ring current, the high-latitude field-aligned current (FAC) modulated by the 10.7 hour planetary period oscillation, and low-latitude FACs were observed during the Grand Finale phase. Here we report the magnetometer measurements during the Cassini Grand Finale phase, new features of Saturn's internal magnetic field revealed by these measurements (e.g., the high degree magnetic moments of Saturn, the level of axisymmetry beyond dipole), and implications for the deep interior of Saturn.

  13. Regional economic impacts of Grand Canyon river runners.

    Science.gov (United States)

    Hjerpe, Evan E; Kim, Yeon-Su

    2007-10-01

    Economic impact analysis (EIA) of outdoor recreation can provide critical social information concerning the utilization of natural resources. Outdoor recreation and other non-consumptive uses of resources are viewed as environmentally friendly alternatives to extractive-type industries. While outdoor recreation can be an appropriate use of resources, it generates both beneficial and adverse socioeconomic impacts on rural communities. The authors used EIA to assess the regional economic impacts of rafting in Grand Canyon National Park. The Grand Canyon region of northern Arizona represents a rural US economy that is highly dependent upon tourism and recreational expenditures. The purpose of this research is twofold. The first is to ascertain the previously unknown regional economic impacts of Grand Canyon river runners. The second purpose is to examine attributes of these economic impacts in terms of regional multipliers, leakage, and types of employment created. Most of the literature on economic impacts of outdoor recreation has focused strictly on the positive economic impacts, failing to illuminate the coinciding adverse and constraining economic impacts. Examining the attributes of economic impacts can highlight deficiencies and constraints that limit the economic benefits of recreation and tourism. Regional expenditure information was obtained by surveying non-commercial boaters and commercial outfitters. The authors used IMPLAN input-output modeling to assess direct, indirect, and induced effects of Grand Canyon river runners. Multipliers were calculated for output, employment, and income. Over 22,000 people rafted on the Colorado River through Grand Canyon National Park in 2001, resulting in an estimated $21,100,000 of regional expenditures to the greater Grand Canyon economy. However, over 50% of all rafting-related expenditures were not captured by the regional economy and many of the jobs created by the rafting industry are lower-wage and seasonal. Policy

  14. Environmental Audit of the Grand Junction Projects Office

    International Nuclear Information System (INIS)

    1991-08-01

    The Grand Junction Projects Office (GJPO) is located in Mesa County, Colorado, immediately south and west of the Grand Junction city limits. The US Atomic Energy Commission (AEC) established the Colorado Raw Materials Office at the present-day Grand Junction Projects Office in 1947, to aid in the development of a viable domestic uranium industry. Activities at the site included sampling uranium concentrate; pilot-plant milling research, including testing and processing of uranium ores; and operation of a uranium mill pilot plant from 1954 to 1958. The last shipment of uranium concentrate was sent from GJPO in January, 1975. Since that time the site has been utilized to support various DOE programs, such as the former National Uranium Resource Evaluation (NURE) Program, the Uranium Mill Tailings Remedial Action Project (UMTRAP), the Surplus Facilities Management Program (SFMP), and the Technical Measurements Center (TMC). All known contamination at GJPO is believed to be the result of the past uranium milling, analyses, and storage activities. Hazards associated with the wastes impounded at GJPO include surface and ground-water contamination and potential radon and gamma-radiation exposure. This report documents the results of the Baseline Environmental Audit conducted at Grand Junction Projects Office (GJPO) located in Grand Junction, Colorado. The Grand Junction Baseline Environmental Audit was conducted from May 28 to June 12, 1991, by the Office of Environmental Audit (EH-24). This Audit evaluated environmental programs and activities at GJPO, as well as GJPO activities at the State-Owned Temporary Repository. 4 figs., 12 tabs

  15. Pequena monografia sobre o Rio Grande do Sul

    Directory of Open Access Journals (Sweden)

    Ana Maria Pinho

    2014-05-01

    Full Text Available Pequena monografia desenvolvida por membros do Colégio Sevigne, que versa sobre diversos assuntos a respeito do Rio Grande do Sul, divididos em histórico, fronteiras, organização política administrativa, características geográficas, formação geomorfológica, economia, aspectos históricos e geográficos da capital do Estado, generalidades étnicas, e sobre o gaúcho em si. Grande quantidade de ilustrações e poemas enriquecem o artigo.

  16. Severe accident sequences simulated at the Grand Gulf Nuclear Station

    International Nuclear Information System (INIS)

    Carbajo, J.J.

    1999-01-01

    Different severe accident sequences employing the MELCOR code, version 1.8.4 QK, have been simulated at the Grand Gulf Nuclear Station (Grand Gulf). The postulated severe accidents simulated are two low-pressure, short-term, station blackouts; two unmitigated small-break (SB) loss-of-coolant accidents (LOCAs) (SBLOCAs); and one unmitigated large LOCA (LLOCA). The purpose of this study was to calculate best-estimate timings of events and source terms for a wide range of severe accidents and to compare the plant response to these accidents

  17. Grand Minima: Is The Sun Going To Sleep?

    Science.gov (United States)

    Mcintosh, S. W.; Leamon, R. J.

    2014-12-01

    We explore recent observational work which indicate that the energetics of the sun's outer atmosphere have been on a steady decline for the past decade and perhaps longer. Futher, we show that new investigations into evolution of the Sun's global magnetic activity appear to demonstrate a path through which the Sun can go into, and exit from, a grand activity minimum without great difficulty while retaining an activity cycle - only losing sunspots. Are we at the begining of a new grand(-ish) minimum? Naturally, only time will tell, but the observational evidence hint that one may not be far off to what impact on the Sun-Earth Connection.

  18. Falares: a oralidade como elemento construtor da grande-reportagem

    OpenAIRE

    Alex Criado

    2006-01-01

    Esta tese discute a incorporação da oralidade de falantes excluídos social e culturalmente na grande-reportagem. O foco desta pesquisa é refletir como a grande-reportagem no Brasil, em sua missão de desvendamento do real, tem lidado com a questão da oralidade. Discute os desafios para a incorporação dos registros orais de pessoas com baixa escolaridade, tendo em vista o preconceito que existe na sociedade em relação aos falantes que se utilizam de modalidades diferentes da língua padrão. Prop...

  19. Mitigation measures for the La Grande 1 hydroelectric development

    International Nuclear Information System (INIS)

    Faucher, O.; Gagnon, R.

    1992-01-01

    Measures to mitigate environmental impacts of the La Grande 1 hydroelectric development are described. An overview is presented of the La Grande 1 project, its surrounding environment, and the principle environmental repercussions of the reservoir, hydrological changes between the dam and river mouth, construction activities and permanent and temporary structures, and presence of workers. Mitigation measures including compensation, corrective measures (deforestation, selective cutting, fish populations, wildlife populations, land rehabilitation, access roads, fisheries, and erosion control), protective measures, enhancement measures, and contract and employment opportunities for the Cree population are described. 10 refs., 2 figs

  20. Guidebook to Rio Grande rift in New Mexico

    Science.gov (United States)

    Hawley, J.W.

    1978-01-01

    Discusses the details of geologic features along the rift zone. Included are short papers on topics relative to the overall region. These papers and the road logs are of special interest to any one pursuing further study of the rift. This book is a comprehensive guide to the middle and late Cenozoic geology of the Rio Grande region of Colorado and New Mexico. Though initially used on field trips for the International Symposium on Tectonics and Magmatism of the Rio Grande rift, the guidebook will be useful to anyone interested in the Cenozoic history of the 600-mi-long area extending from central Colorado to El Paso, Texas.