Pilot Study of a Parent Guided Website Access Package for Early Intervention Decision-Making for Autism Spectrum Disorder

Science.gov (United States)

Carlon, Sarah; Carter, Mark; Stephenson, Jennifer

2017-01-01

A pilot study of the effectiveness of guided access to websites that provide information on intervention options for children with autism spectrum disorder (ASD) was conducted with 12 parents of preschool aged children with ASD. Guided access to reliable websites that included information about the effcacy of interventions for ASD (Raising…

Evaluation of ultrasound-guided vascular access in dogs.

Science.gov (United States)

Chamberlin, Scott C; Sullivan, Lauren A; Morley, Paul S; Boscan, Pedro

2013-01-01

To describe the technique and determine the feasibility, success rate, perceived difficulty, and time to vascular access using ultrasound guidance for jugular vein catheterization in a cardiac arrest dog model. Prospective descriptive study. University teaching hospital. Nine Walker hounds. A total of 27 jugular catheterizations were performed postcardiac arrest using ultrasound guidance. Catheterizations were recorded based on the order in which they were performed and presence/absence of a hematoma around the vein. Time (minutes) until successful vascular access and perceived difficulty in achieving vascular access (scale of 1 = easy to 10 = difficult) were recorded for each catheterization. Mean time to vascular access was 1.9 minutes (95% confidence interval, 1.1-3.4 min) for catheterizations without hematoma, versus 4.3 minutes (1.8-10.1 min) for catheterizations with hematoma (P = 0.1). Median perceived difficulty was 2 of 10 (range 1-7) for catheterizations without hematoma, versus 2 of 10 (range 1-8) for catheterizations with hematoma (P = 0.3). A learning curve was evaluated by comparing mean time to vascular access and perceived difficulty in initial versus subsequent catheterizations. Mean time to vascular access was 2.5 minutes (1.0-6.4 min) in the initial 13 catheterizations versus 3.3 minutes (1.5-7.5 min) in the subsequent 14 catheterizations (P = 0.6). Median perceived difficulty in the first 13 catheterizations (3, range 1-8) was significantly greater (P = 0.049) than median perceived difficulty in the subsequent 14 catheterizations (2, range 1-6). Ultrasound-guided jugular catheterization is associated with a learning curve but is successful in obtaining rapid vascular access in dogs. Further prospective studies are warranted to confirm the utility of this technique in a clinical setting. © Veterinary Emergency and Critical Care Society 2013.

A Nurse's Survival Guide to the Ward - Third edition Richards Ann Edwards Sharon A Nurse's Survival Guide to the Ward - Third edition 500pp £19.99 Elsevier 978 0 7020 4603 2 0702046035 [Formula: see text].

Science.gov (United States)

2013-05-08

This guide is a useful 'friend and companion' to keep close at hand. It is an essential reference for nurses, not only on the ward but in every field of practice where patient care is given. In fact, it makes an accessible guide for all healthcare practitioners.

75 FR 56903 - Pacific Halibut Fisheries; Limited Access for Guided Sport Charter Vessels in Alaska

Science.gov (United States)

2010-09-17

.... 100503209-0430-02] RIN 0648-AY85 Pacific Halibut Fisheries; Limited Access for Guided Sport Charter Vessels... program for charter vessels in the guided sport fishery for Pacific halibut in the waters of International... necessary to achieve the halibut fishery management goals of the North Pacific Fishery Management Council...

Algebra Survival Guide A Conversational Handbook for the Thoroughly Befuddled

CERN Document Server

Rappaport, Josh

2011-01-01

If you think algebra has to be boring, confusing and unrelated to anything in the real world, think again! Written in a humorous, conversational style, this book gently nudges students toward success in pre-algebra and Algebra I. With its engaging question/answer format and helpful practice problems, glossary and index, it is ideal for homeschoolers, tutors and students striving for classroom excellence. It features funky icons and lively cartoons by award-winning Santa Fe artist Sally BlakemoreThe Algebra Survival Guide is the winner of a Paretns' Choice award, and it meets the Standards 2000

Post-General Anesthesia Ultrasound-Guided Venous Mapping Increases Autogenous Access Placement Rates.

Science.gov (United States)

Png, C Y Maximilian; Korayem, Adam; Finlay, David J

2018-04-18

This study investigates the impact of introducing a post-general anesthesia ultrasound mapping (PAUS) on the type of vascular access chosen for hemodialysis in patients without previous accesses. 203 of 297 consecutive patients met inclusion criteria and were reviewed. Within-subjects analysis was performed on patients with both an outpatient ultrasound-guided vein mapping and a PAUS using sign tests and Wilcoxon signed ranked tests. Further, a between-subjects analysis added patients with only the outpatient vein mapping; demographic and comorbidity data were analyzed using t-tests and chi-squared tests. An ordinal logit regression was run for the type of access placed, while a bivariate logit regression was used to compare rates of autogenous access maturation. 165 (81%) patients received both a standard outpatient vein mapping and a PAUS. At the outpatient vein mapping, 130 (79%) patients had suitable veins for an autogenous access while 35 (21%) patients did not have suitable veins for an autogenous access and were planned for a prosthetic access. During PAUS, all 165 (100%) patients were found to have suitable veins for autogenous access formation (P<0.001). When comparing specific autogenous access configurations, Wilcoxon signed rank testing showed significantly more preferable access configurations in the PAUS group compared to the outpatient mapping (P<0.001); Outpatient mapping resulted in 81 (47%) radiocephalic accesses, 10 (6%) radiobasilic accesses, 20 (12%) brachiocephalic accesses, 19 (12%) brachiobasilic accesses and 35 (21%) prosthetic accesses planned, in contrast to 149 (90%) radiocephalic accesses, 3 (2%) radiobasilic accesses, 10 (6%) brachiocephalic accesses, 3 (2%) brachiobasilic accesses and 0 prosthetic accesses when the same patients were analyzed using PAUS. With the analysis expanded to include the 38 (19%) patients with only the outpatient vein mapping (without-PAUS), the Wilcoxon-Mann-Whitney test showed no significant differences

Survivability of Existing Peripheral Intravenous Access Following Blood Sampling in a Pediatric Population.

Science.gov (United States)

O'Neil, Sheree W; Friesen, Mary Ann; Stanger, Debra; Trickey, Amber Williams

2018-03-07

Although pediatric patients report venipuncture as their most feared experience during hospitalization, blood sampling from peripheral intravenous accesses (PIVs) is not standard of care. Blood sampling from PIVs has long been considered by healthcare personnel to harm the access. In an effort to minimize painful procedures, pediatric nursing staff conducted a prospective, observational study to determine if blood sampling using existing PIVs resulted in the loss of the access. The ability to obtain the sample from the PIV was measured along with patient and PIV characteristics. Specimen collection using 100 existing PIVs was attempted on pediatric inpatients. Each PIV was observed for functionality, infiltration, occlusion, and dislodgement following collection and again in 4h. Frequencies of PIV loss and successful blood sampling were calculated. Patient age, PIV gauge, access site, and PIV age were evaluated for associations with successful sampling using chi-square tests, Fisher's exact tests, and logistic regression. PIV survivability was reported at 99%. The ability to obtain a complete specimen was reported at 76% and found to be significantly related to PIV age and site. Size of PIV and patient's age were not significantly related to successful sampling. Encouraging rates of PIV survivability and collectability suggest blood sampling from PIVs to be a valuable technique to minimize painful and distressful procedures. Nursing practice was changed in this pediatric department. Patients and families are saved the pain and distress of venipuncture. Nurses reported saving time and personal distress by avoiding the venipuncture procedure. Copyright © 2018 Elsevier Inc. All rights reserved.

High-volume ovarian cancer care: survival impact and disparities in access for advanced-stage disease.

Science.gov (United States)

Bristow, Robert E; Chang, Jenny; Ziogas, Argyrios; Randall, Leslie M; Anton-Culver, Hoda

2014-02-01

To characterize the impact of hospital and physician ovarian cancer case volume on survival for advanced-stage disease and investigate socio-demographic variables associated with access to high-volume providers. Consecutive patients with stage IIIC/IV epithelial ovarian cancer (1/1/96-12/31/06) were identified from the California Cancer Registry. Disease-specific survival analysis was performed using Cox-proportional hazards model. Multivariate logistic regression analyses were used to evaluate for differences in access to high-volume hospitals (HVH) (≥20 cases/year), high-volume physicians (HVP) (≥10 cases/year), and cross-tabulations of high- or low-volume hospital (LVH) and physician (LVP) according to socio-demographic variables. A total of 11,865 patients were identified. The median ovarian cancer-specific survival for all patients was 28.2 months, and on multivariate analysis the HVH/HVP provider combination (HR = 1.00) was associated with superior ovarian cancer-specific survival compared to LVH/LVP (HR = 1.31, 95%CI = 1.16-1.49). Overall, 2119 patients (17.9%) were cared for at HVHs, and 1791 patients (15.1%) were treated by HVPs. Only 4.3% of patients received care from HVH/HVP, while 53.1% of patients were treated by LVH/LVP. Both race and socio-demographic characteristics were independently associated with an increased likelihood of being cared for by the LVH/LVP combination and included: Hispanic race (OR = 1.72, 95%CI = 1.22-2.42), Asian/Pacific Islander race (OR = 1.57, 95%CI = 1.07-2.32), Medicaid insurance (OR = 2.51, 95%CI = 1.46-4.30), and low socioeconomic status (OR = 2.84, 95%CI = 1.90-4.23). Among patients with advanced-stage ovarian cancer, the provider combination of HVH/HVP is an independent predictor of improved disease-specific survival. Access to high-volume ovarian cancer providers is limited, and barriers are more pronounced for patients with low socioeconomic status, Medicaid insurance, and racial minorities. Copyright © 2013

The learning curve for access creation in solo ultrasonography-guided percutaneous nephrolithotomy and the associated skills.

Science.gov (United States)

Yu, Weimin; Rao, Ting; Li, Xing; Ruan, Yuan; Yuan, Run; Li, Chenglong; Li, Haoyong; Cheng, Fan

2017-03-01

The aim of the current trial was to evaluate the learning curve of access creation through solo ultrasonography (US)-guided percutaneous nephrolithotomy (PCNL), and clarify the technical details of the procedure. We evaluated the first 240 solo US-guided PCNLs performed by one surgeon at our institution. The data including the puncture procedure, access characteristics, access-related complications and stone-free rates were assessed in four sequential groups. The puncture duration and number of times decreased from a mean of 4.4 min and 2.1 times for the first 60 patients to 1.3 min and 1.2 times for the last 60 patients. There was a significant decrease from 3.7 min and 1.8 times for the 61th-120th patients to 1.5 min and 1.3 times for the 121th-180th patients. All of the access-related severe bleeding appeared in the first 120 patients, while perforations only occurred in the first 60 patients. The stone-free rates were 68.3, 83.3, 90.0, and 93.3% for the four sequential groups. The increase in experience lead to an improvement in the puncture duration and times, which accompany with better stone-free rates and lower complications. We propose that 60 operations are sufficient to gain competency, and a cutoff point of 120 operations will allow the surgeon to achieve excellence in the solo US-guided PCNL.

Publications desktop survival guide

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-06-01

Purpose of this guide is to document and simplify the writing, reviewing, and production process for the Uranium Mill Tailings Remedial Action (UMTRA) Project Technical Assistance Contractor (TAC) staff and to provide specific answers concerning the content, style, and format of UMTRA Project documents. Goal of the UMTRA Project document preparation process is to deliver to the US DOE high-quality documents that meet requirements (meets expressed client needs; accurate and consistent technical content; clear writing; well organized document; consistent style). A document review process has been established to ensure that TAC documents are accurate, consistent, and well organized. The editing process applies standard rules for style and format, spelling, grammar, punctuation, and sentence structure to make the document consistent and easier to read. This guide sets forth the rules to be applied to UMTRA Project documents.

How to achieve ultrasound-guided femoral venous access: the new standard of care in the electrophysiology laboratory.

Science.gov (United States)

Wiles, Benedict M; Child, Nicholas; Roberts, Paul R

2017-06-01

Bedside vascular ultrasound machines are increasingly available. They are used to facilitate safer vascular access across a number of different specialties. In the electrophysiology laboratory however, where patients are frequently anticoagulated and require the insertion of multiple venous sheaths, anatomical landmark techniques predominate. Despite the high number of vascular complications associated with electrophysiological procedures and the increasing evidence to support its use in electrophysiology, ultrasound remains underutilised. A new standard of care is required. A comprehensive technical report, providing a detailed explanation of this important technique, will provide other electrophysiology centres with the knowledge and justification for adopting ultrasound guidance as their standard practice. We review the increasing body of evidence which demonstrates that routine ultrasound usage can substantially improve the safety of femoral venous access in the electrophysiology laboratory. We offer a comprehensive technical report to guide operators through the process of ultrasound-guided venous access, with a specific focus on the electrophysiology laboratory. Additionally, we detail a novel technique which utilises real-time colour Doppler ultrasound to accurately identify needle tip location during venous puncture. The use of vascular ultrasound to guide femoral venous cannulation is rapid, inexpensive and easily learnt. Ultrasound is readily available and offers the potential to significantly reduce vascular complications in the unique setting of the electrophysiology laboratory. Ultrasound guidance to achieve femoral venous access should be the new standard of care in electrophysiology.

Data Access Based on a Guide Map of the Underwater Wireless Sensor Network.

Science.gov (United States)

Wei, Zhengxian; Song, Min; Yin, Guisheng; Song, Houbing; Wang, Hongbin; Ma, Xuefei; Cheng, Albert M K

2017-10-17

Underwater wireless sensor networks (UWSNs) represent an area of increasing research interest, as data storage, discovery, and query of UWSNs are always challenging issues. In this paper, a data access based on a guide map (DAGM) method is proposed for UWSNs. In DAGM, the metadata describes the abstracts of data content and the storage location. The center ring is composed of nodes according to the shortest average data query path in the network in order to store the metadata, and the data guide map organizes, diffuses and synchronizes the metadata in the center ring, providing the most time-saving and energy-efficient data query service for the user. For this method, firstly the data is stored in the UWSN. The storage node is determined, the data is transmitted from the sensor node (data generation source) to the storage node, and the metadata is generated for it. Then, the metadata is sent to the center ring node that is the nearest to the storage node and the data guide map organizes the metadata, diffusing and synchronizing it to the other center ring nodes. Finally, when there is query data in any user node, the data guide map will select a center ring node nearest to the user to process the query sentence, and based on the shortest transmission delay and lowest energy consumption, data transmission routing is generated according to the storage location abstract in the metadata. Hence, specific application data transmission from the storage node to the user is completed. The simulation results demonstrate that DAGM has advantages with respect to data access time and network energy consumption.

75 FR 554 - Pacific Halibut Fisheries; Limited Access for Guided Sport Charter Vessels in Alaska

Science.gov (United States)

2010-01-05

... time. The Council recommended this limited access system to provide stability for the guided sport... IPHC regulations at section 25 of the annual management measures specify the legal gear for sport... IPHC regulations at section 28 of the annual management measures establish sport fishing rules specific...

Endoscopic ultrasonography-guided pancreatic duct access: techniques and literature review of pancreatography, transmural drainage and rendezvous techniques.

Science.gov (United States)

Itoi, Takao; Kasuya, Kazuhiko; Sofuni, Atsushi; Itokawa, Fumihide; Kurihara, Toshio; Yasuda, Ichiro; Nakai, Yousuke; Isayama, Hiroyuki; Moriyasu, Fuminori

2013-05-01

Endoscopic ultrasonography-guided (EUS)-guided pancreatic interventions have gained increasing attention. Here we review EUS-guided pancreatic duct (PD) access techniques and outcomes. EUS-guided PD intervention is divided into two types, antegrade and rendezvous techniques, following EUS-guided pancreatography. In the antegrade technique, pancreaticoenterostomy is carried out by stent placement between the PD and the stomach, duodenum, or jejunum. Transenteric antegrade PD stenting is conducted by stent placement, advancing anteriorly into the PD through the pancreatic tract. The rendezvous technique is carried out by using a guidewire through the papilla or anastomotic site for retrograde stent insertion. In terms of EUS-guided PD stenting, 11 case reports totaling 75 patients (35 normal anatomy, 40 altered anatomy) have been published. The technical success rate was greater than 70%. Early adverse events, including severe hematoma and severe pancreatitis,occurred in seven (63.6%) of 11 reports. Regarding the rendezvous technique, 12 case reports totaling 52 patients (22 normal anatomy, 30 altered anatomy) have been published. The technical success rate ranged from 25% to 100%. It was 48% in one report that involved more than 20 cases. Once stents were placed, all patients became free of symptoms. Early mild adverse events occurred in four (36.4%) of 11 reports. In conclusion, although it can be risky because of possible serious or even fatal adverse events, including pancreatic juice leakage, perforation and severe acute pancreatitis, EUS-PD access seems to be promising for treating symptomatic pancreatic diseases caused by PD stricture and pancreaticoenterostomy stricture. © 2013 The Authors. Digestive Endoscopy © 2013 Japan Gastroenterological Endoscopy Society.

Ultrasound-guided central venous access using Google Glass.

Science.gov (United States)

Wu, Teresa S; Dameff, Christian J; Tully, Jeffrey L

2014-12-01

The use of ultrasound during invasive bedside procedures is quickly becoming the standard of care. Ultrasound machine placement during procedures often requires the practitioner to turn their head during the procedure to view the screen. Such turning has been implicated in unintentional hand movements in novices. Google Glass is a head-mounted computer with a specialized screen capable of projecting images and video into the view of the wearer. Such technology may help decrease unintentional hand movements. Our aim was to evaluate whether or not medical practitioners at various levels of training could use Google Glass to perform an ultrasound-guided procedure, and to explore potential advantages of this technology. Forty participants of varying training levels were randomized into two groups. One group used Google Glass to perform an ultrasound-guided central line. The other group used traditional ultrasound during the procedure. Video recordings of eye and hand movements were analyzed. All participants from both groups were able to complete the procedure without difficulty. Google Glass wearers took longer to perform the procedure at all training levels (medical student year 1 [MS1]: 193 s vs. 77 s, p > 0.5; MS4: 197s vs. 91s, p ≤ 0.05; postgraduate year 1 [PGY1]: 288s vs. 125 s, p > 0.5; PGY3: 151 s vs. 52 s, p ≤ 0.05), and required more needle redirections (MS1: 4.4 vs. 2.0, p > 0.5; MS4: 4.8 vs. 2.8, p > 0.5; PGY1: 4.4 vs. 2.8, p > 0.5; PGY3: 2.0 vs. 1.0, p > 0.5). In this study, it was possible to perform ultrasound-guided procedures with Google Glass. Google Glass wearers, on average, took longer to gain access, and had more needle redirections, but less head movements were noted. Copyright © 2014 Elsevier Inc. All rights reserved.

Ultrasound-guided antegrade access during laparoscopic pyeloplasty in infants less than one year of age: A point of technique

Directory of Open Access Journals (Sweden)

Arvind Ganpule

2012-01-01

Full Text Available Background: Access to urethras and ureters of infants may be hazardous and injurious through an endoscopic route. Placement and removal of stents in infants requires anaesthesia and access through these small caliber urethras. We describe our technique of placing antegrade splint during a laparoscopic pyeloplasty in these infants. Materials and Methods: An ultrasound-guided percutaneous renal access is obtained. Telescopic metal two part needle is passed into the kidney over a guide wire. A second guide wire is passed through the telescopic metal two part needle. The tract is dilated with 14 Fr screw dilator. Over one guide wire, a 5 Fr ureteric catheter is passed and coiled in the renal pelvis. Over the other wire, a 14 Fr malecot catheter is placed as nephrostomy. Laparoscopic pyeloplasty is then done. During pyelotomy, the ureteric catheter is pulled and advanced through the ureter before the pyeloplasty is completed. The ureteric catheter thus acts as a splint across the anastomosis. Ureteric catheter is removed on the 3 rd post operative day and nephrostomy is clamped. Nephrostomy is removed on 4 th post operative day if child is asymptomatic. The modified technique was successfully done in five patients aged less than one year old. All patients tolerated the procedure well. Post operative period was uneventful in all. Conclusion: Ultrasound-guided ante grade nephroureteral ureteral splint for infant laparoscopic pyeloplasty is safe. It avoids the need for urethral instrumentation for insertion and removal of stents in these small patients.

Digitisation and public accessibility of old Polish guides on self-treatment and quality-of-life improvement

Directory of Open Access Journals (Sweden)

Joanna Nowak

2017-06-01

Full Text Available This letter to the Editor can prove useful as a mini-guide. Interest in health and quality of life is continuing to grow in the second decade of the 21st century, both among professionals actively involved in giving advice to others and among diverse social groups, as well as individually, among those sick and those healthy. Along with recent novelties, traditional Old Polish methods also feature prominently in discussions, but those interested know relatively little about how to access source materials. This letter therefore describes the possibilities for open access to Polish-language health guides from the Renaissance and Baroque era, whose authors included medical doctors and which focused on describing food and herbs used in self-treatment and promoting the healthy life style of the period. The works of Andrzej from Kobylin, Zawacki, Śleszkowski, Olszowski and Haur are briefly described and information is given about their availability in full-text on-line data bases.

Access 2010 Programmer's Reference

CERN Document Server

Hennig, Teresa; Griffith, Geoffrey L

2010-01-01

A comprehensive guide to programming for Access 2010 and 2007. Millions of people use the Access database applications, and hundreds of thousands of developers work with Access daily. Access 2010 brings better integration with SQL Server and enhanced XML support; this Wrox guide shows developers how to take advantage of these and other improvements. With in-depth coverage of VBA, macros, and other programming methods for building Access applications, this book also provides real-world code examples to demonstrate each topic.: Access is the leading database that is used worldwide; While VBA rem

End-Tidal CO2-Guided Chest Compression Delivery Improves Survival in a Neonatal Asphyxial Cardiac Arrest Model.

Science.gov (United States)

Hamrick, Justin T; Hamrick, Jennifer L; Bhalala, Utpal; Armstrong, Jillian S; Lee, Jeong-Hoo; Kulikowicz, Ewa; Lee, Jennifer K; Kudchadkar, Sapna R; Koehler, Raymond C; Hunt, Elizabeth A; Shaffner, Donald H

2017-11-01

To determine whether end-tidal CO2-guided chest compression delivery improves survival over standard cardiopulmonary resuscitation after prolonged asphyxial arrest. Preclinical randomized controlled study. University animal research laboratory. 1-2-week-old swine. After undergoing a 20-minute asphyxial arrest, animals received either standard or end-tidal CO2-guided cardiopulmonary resuscitation. In the standard group, chest compression delivery was optimized by video and verbal feedback to maintain the rate, depth, and release within published guidelines. In the end-tidal CO2-guided group, chest compression rate and depth were adjusted to obtain a maximal end-tidal CO2 level without other feedback. Cardiopulmonary resuscitation included 10 minutes of basic life support followed by advanced life support for 10 minutes or until return of spontaneous circulation. Mean end-tidal CO2 at 10 minutes of cardiopulmonary resuscitation was 34 ± 8 torr in the end-tidal CO2 group (n = 14) and 19 ± 9 torr in the standard group (n = 14; p = 0.0001). The return of spontaneous circulation rate was 7 of 14 (50%) in the end-tidal CO2 group and 2 of 14 (14%) in the standard group (p = 0.04). The chest compression rate averaged 143 ± 10/min in the end-tidal CO2 group and 102 ± 2/min in the standard group (p tidal CO2-guided chest compression delivery. The response of the relaxation arterial pressure and cerebral perfusion pressure to the initial epinephrine administration was greater in the end-tidal CO2 group than in the standard group (p = 0.01 and p = 0.03, respectively). The prevalence of resuscitation-related injuries was similar between groups. End-tidal CO2-guided chest compression delivery is an effective resuscitation method that improves early survival after prolonged asphyxial arrest in this neonatal piglet model. Optimizing end-tidal CO2 levels during cardiopulmonary resuscitation required that chest compression delivery rate exceed current guidelines

Ultrasound-Guided Angioplasty of Dysfunctional Vascular Access for Haemodialysis. The Pros and Cons

Energy Technology Data Exchange (ETDEWEB)

García-Medina, J., E-mail: josegmedina57@gmail.com [“Reina Sofia” University Hospital, Vascular and Interventional Radiology Unit, Department of Radiology (Spain); García-Alfonso, J. J., E-mail: juanjozarandieta@gmail.com [University of Murcia, Faculty of Medicine (Spain)

2017-05-15

PurposeTo describe the benefits and the disadvantages of angioplasty in dialysis fistulas using only ultrasound guidance.Materials and MethodsThis is a prospective study in 132 failing or non-maturing arteriovenous accesses that underwent 189 ultrasound-guided balloon angioplasties. The technical success was defined as non-use of X-ray fluoroscopy during the procedure.Results127 procedures (67%) were successfully completed without fluoroscopy. Most failures were due to difficulty to traverse aneurismal segments, as well as anastomotic stenoses. Including initial failures, the primary patency rates at 6, 12 months and 2 years were 75 ± 3, 41 ± 3 and 14 ± 2%, respectively.ConclusionEndovascular repair of the dysfunctional vascular access for haemodialysis under ultrasound guidance is feasible and safe in roughly two-thirds of cases.

CT-guided transgluteal biopsy for systematic sampling of the prostate in patients without rectal access: a 13-year single-center experience.

Science.gov (United States)

Olson, Michael C; Atwell, Thomas D; Mynderse, Lance A; King, Bernard F; Welch, Timothy; Goenka, Ajit H

2017-08-01

The purpose of our study was to examine the safety and diagnostic utility of transgluteal CT-guided prostate biopsy for prostate sampling in patients without rectal access. Seventy-three biopsies were performed in 65 patients over a 13-year period (2002-2015). Mean prostate-specific antigen (PSA) at biopsy was 7.8 ng/mL (range 0.37-31.5). Electronic medical records were reviewed for procedural details and complications. Mean PSA and number of cores in malignant and benign cohorts were compared with Student's t test. Technical success rate was 97.3% (71/73; mean cores 8, range 3-28). Of these, 43.6% (31/71) yielded malignancy (mean Gleason score 7, range 6-10) and 56.3% (40/71) yielded benign tissue. The only complication was an asymptomatic periprostatic hematoma (1/73; 1.4%). In 14 patients who underwent surgery, Gleason scores were concordant in 71.4% (10/14) and discordant in 28.6% (4/14; Gleason 6 on biopsy but Gleason 7 on surgical specimen). Mean effective radiation dose was 18.5 mSv (median 15.0, range 4.4-86.2). There was no significant difference in either mean PSA (p = 0.06) or number of core specimens (p = 0.33) between malignant and benign cohorts. CT-guided transgluteal prostate biopsy is highly safe and reliable for the detection of prostate cancer in men without rectal access. • Prostate cancer detection in men without rectal access is challenging. • CT-guided transgluteal prostate biopsy is safe and effective in these patients. • CT-guided biopsy may be particularly effective in diagnosing high-grade prostate cancer. • Unilateral CT-guided biopsy may be effective in patients with focal lesions. • The radiation exposure with this technique is acceptable.

Access 2010 for dummies

CERN Document Server

Ulrich Fuller, Laurie

2010-01-01

A friendly, step-by-step guide to the Microsoft Office database application Access may be the least understood and most challenging application in the Microsoft Office suite. This guide is designed to help anyone who lacks experience in creating and managing a database learn to use Access 2010 quickly and easily. In the classic For Dummies tradition, the book provides an education in Access, the interface, and the architecture of a database. It explains the process of building a database, linking information, sharing data, generating reports, and much more.As the Micr

Comparison of EUS-guided rendezvous and precut papillotomy techniques for biliary access (with videos).

Science.gov (United States)

Dhir, Vinay; Bhandari, Suryaprakash; Bapat, Mukta; Maydeo, Amit

2012-02-01

.4% vs 6.9%, P = .27). Retrospective nonrandomized study design; highly selective patient cohort. In this study, the EUS-guided rendezvous technique was found to be superior to precut papillotomy for single-session biliary access. Prospective randomized trials are needed to confirm these preliminary but promising findings. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Guided Endodontic Access in Maxillary Molars Using Cone-beam Computed Tomography and Computer-aided Design/Computer-aided Manufacturing System: A Case Report.

Science.gov (United States)

Lara-Mendes, Sônia T de O; Barbosa, Camila de Freitas M; Santa-Rosa, Caroline C; Machado, Vinícius C

2018-05-01

The aim of this study was to describe a guided endodontic technique that facilitates access to root canals of molars presenting with pulp calcifications. A 61-year-old woman presented to our service with pain in the upper left molar region. The second and third left molars showed signs of apical periodontitis confirmed by the cone-beam computed tomographic (CBCT) scans brought to us by the patient at the initial appointment. Conventional endodontic treatment was discontinued given the difficulty in locating the root canals. Intraoral scanning and the CBCT scans were used to plan the access to the calcified canals by means of implant planning software. Guides were fabricated through rapid prototyping and allowed for the correct orientation of a cylindrical drill used to provide access through the calcifications. Second to that, the root canals were prepared with reciprocating endodontic instruments and rested for 2 weeks with intracanal medication. Subsequently, canals were packed with gutta-percha cones using the hydraulic compression technique. Permanent restorations of the access cavities were performed. By comparing the tomographic images, the authors observed a drastic reduction of the periapical lesions as well as the absence of pain symptoms after 3 months. This condition was maintained at the 1-year follow-up. The guided endodontic technique in maxillary molars was shown to be a fast, safe, and predictable therapy and can be regarded as an excellent option for the location of calcified root canals, avoiding failures in complex cases. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Urate levels predict survival in amyotrophic lateral sclerosis: Analysis of the expanded Pooled Resource Open-Access ALS clinical trials database.

Science.gov (United States)

Paganoni, Sabrina; Nicholson, Katharine; Chan, James; Shui, Amy; Schoenfeld, David; Sherman, Alexander; Berry, James; Cudkowicz, Merit; Atassi, Nazem

2018-03-01

Urate has been identified as a predictor of amyotrophic lateral sclerosis (ALS) survival in some but not all studies. Here we leverage the recent expansion of the Pooled Resource Open-Access ALS Clinical Trials (PRO-ACT) database to study the association between urate levels and ALS survival. Pooled data of 1,736 ALS participants from the PRO-ACT database were analyzed. Cox proportional hazards regression models were used to evaluate associations between urate levels at trial entry and survival. After adjustment for potential confounders (i.e., creatinine and body mass index), there was an 11% reduction in risk of reaching a survival endpoint during the study with each 1-mg/dL increase in uric acid levels (adjusted hazard ratio 0.89, 95% confidence interval 0.82-0.97, P ALS and confirms the utility of the PRO-ACT database as a powerful resource for ALS epidemiological research. Muscle Nerve 57: 430-434, 2018. © 2017 Wiley Periodicals, Inc.

Accessibility observations of visually impaired users using the South African National Accessibility Portal

CSIR Research Space (South Africa)

Coetzee, L

2008-05-01

Full Text Available . Improving web site accessibility has proven to be a challenging task with a myriad of standards, accessibility testing tools and few technical guides for implementation. This paper presents the South African National Accessibility Portal (NAP), which is used...

Microsoft DirectAccess best practices and troubleshooting

CERN Document Server

Krause, Jordan

2013-01-01

This book covers best practices and acts as a complete guide to DirectAccess and automatic remote access.Microsoft DirectAccess Best Practices and Troubleshooting is an ideal guide for any existing or future DirectAccess administrator and system administrators who are working on Windows Server 2012. This book will also be beneficial for someone with a basic knowledge of networking and deployment of Microsoft operating systems and software who wants to learn the intricacies of DirectAccess and its interfaces.

CT-Guided Transgluteal Biopsy for Systematic Random Sampling of the Prostate in Patients Without Rectal Access.

Science.gov (United States)

Goenka, Ajit H; Remer, Erick M; Veniero, Joseph C; Thupili, Chakradhar R; Klein, Eric A

2015-09-01

The objective of our study was to review our experience with CT-guided transgluteal prostate biopsy in patients without rectal access. Twenty-one CT-guided transgluteal prostate biopsy procedures were performed in 16 men (mean age, 68 years; age range, 60-78 years) who were under conscious sedation. The mean prostate-specific antigen (PSA) value was 11.4 ng/mL (range, 2.3-39.4 ng/mL). Six had seven prior unsuccessful transperineal or transurethral biopsies. Biopsy results, complications, sedation time, and radiation dose were recorded. The mean PSA values and number of core specimens were compared between patients with malignant results and patients with nonmalignant results using the Student t test. The average procedural sedation time was 50.6 minutes (range, 15-90 minutes) (n = 20), and the mean effective radiation dose was 8.2 mSv (median, 6.6 mSv; range 3.6-19.3 mSv) (n = 13). Twenty of the 21 (95%) procedures were technically successful. The only complication was a single episode of gross hematuria and penile pain in one patient, which resolved spontaneously. Of 20 successful biopsies, 8 (40%) yielded adenocarcinoma (Gleason score: mean, 8; range, 7-9). Twelve biopsies yielded nonmalignant results (60%): high-grade prostatic intraepithelial neoplasia (n = 3) or benign prostatic tissue with or without inflammation (n = 9). Three patients had carcinoma diagnosed on subsequent biopsies (second biopsy, n = 2 patients; third biopsy, n = 1 patient). A malignant biopsy result was not significantly associated with the number of core specimens (p = 0.3) or the mean PSA value (p = 0.1). CT-guided transgluteal prostate biopsy is a safe and reliable technique for the systematic random sampling of the prostate in patients without a rectal access. In patients with initial negative biopsy results, repeat biopsy should be considered if there is a persistent rise in the PSA value.

Access Structures in a Standard Translation Dictionary | Louw ...

African Journals Online (AJOL)

The access structure is the primary guide structure in the central texts of any standard translation dictionary. The metalexicographical term "guide structures" refers to the set of structures that provides a framework within which the accessibility and availability of information types in the dictionary can be evaluated. The access ...

Conditional survival of patients with diffuse large B-cell lymphoma

DEFF Research Database (Denmark)

Møller, Michael Boe; Pedersen, Niels Tinggaard; Christensen, Bjarne E

2006-01-01

BACKGROUND: Prognosis of lymphoma patients is usually estimated at the time of diagnosis and the estimates are guided by the International Prognostic Index (IPI). However, conditional survival estimates are more informative clinically, as they consider those patients only who have already survive...... survival probability provides more accurate prognostic information than the conventional survival rate estimated from the time of diagnosis.......BACKGROUND: Prognosis of lymphoma patients is usually estimated at the time of diagnosis and the estimates are guided by the International Prognostic Index (IPI). However, conditional survival estimates are more informative clinically, as they consider those patients only who have already survived...... a period of time after treatment. Conditional survival data have not been reported for lymphoma patients. METHODS: Conditional survival was estimated for 1209 patients with diffuse large B-cell lymphoma (DLBCL) from the population-based LYFO registry of the Danish Lymphoma Group. The Kaplan-Meier method...

Introductory Guide to European Corporate Law

DEFF Research Database (Denmark)

Fomcenco, Alex

Introductory Guide to European Corporate Law presents in an easily comprehensible and accessible way the main features and principles that govern European corporate law.......Introductory Guide to European Corporate Law presents in an easily comprehensible and accessible way the main features and principles that govern European corporate law....

Introducing a Fresh Cadaver Model for Ultrasound-guided Central Venous Access Training in Undergraduate Medical Education.

Science.gov (United States)

Miller, Ryan; Ho, Hang; Ng, Vivienne; Tran, Melissa; Rappaport, Douglas; Rappaport, William J A; Dandorf, Stewart J; Dunleavy, James; Viscusi, Rebecca; Amini, Richard

2016-05-01

Over the past decade, medical students have witnessed a decline in the opportunities to perform technical skills during their clinical years. Ultrasound-guided central venous access (USG-CVA) is a critical procedure commonly performed by emergency medicine, anesthesia, and general surgery residents, often during their first month of residency. However, the acquisition of skills required to safely perform this procedure is often deficient upon graduation from medical school. To ameliorate this lack of technical proficiency, ultrasound simulation models have been introduced into undergraduate medical education to train venous access skills. Criticisms of simulation models are the innate lack of realistic tactile qualities, as well as the lack of anatomical variances when compared to living patients. The purpose of our investigation was to design and evaluate a life-like and reproducible training model for USG-CVA using a fresh cadaver. This was a cross-sectional study at an urban academic medical center. An 18-point procedural knowledge tool and an 18-point procedural skill evaluation tool were administered during a cadaver lab at the beginning and end of the surgical clerkship. During the fresh cadaver lab, procedure naïve third-year medical students were trained on how to perform ultrasound-guided central venous access of the femoral and internal jugular vessels. Preparation of the fresh cadaver model involved placement of a thin-walled latex tubing in the anatomic location of the femoral and internal jugular vein respectively. Fifty-six third-year medical students participated in this study during their surgical clerkship. The fresh cadaver model provided high quality and lifelike ultrasound images despite numerous cannulation attempts. Technical skill scores improved from an average score of 3 to 12 (pcadaver model prevented extravasation of fluid, maintained ultrasound-imaging quality, and proved to be an effective educational model allowing third-year medical

Security guide for subcontractors

Energy Technology Data Exchange (ETDEWEB)

Adams, R.C.

1991-01-01

This security guide of the Department of Energy covers contractor and subcontractor access to DOE and Mound facilities. The topics of the security guide include responsibilities, physical barriers, personnel identification system, personnel and vehicular access controls, classified document control, protecting classified matter in use, storing classified matter repository combinations, violations, security education clearance terminations, security infractions, classified information nondisclosure agreement, personnel security clearances, visitor control, travel to communist-controlled or sensitive countries, shipment security, and surreptitious listening devices.

Aircraft Crash Survival Design Guide. Volume 5. Aircraft Postcrash Survival

Science.gov (United States)

1980-01-01

neck Access door toprille capm enrFuel tank Figue 3. Fangblefiler eckinsalgbelati n. A-j L)n wal Aircraft skin Frangible filler neck Failure plane...This is because a number of major assumptions must be made in the extrapolation: the smoke generated is uniformly distri- buted and is independent

78 FR 42071 - Updates to Protective Action Guides Manual: Protective Action Guides (PAGs) and Planning Guidance...

Science.gov (United States)

2013-07-15

... Guides Manual: Protective Action Guides (PAGs) and Planning Guidance for Radiological Incidents AGENCY... guidance ``PAG Manual: Protective Action Guides (PAGs) and Planning Guidance for Radiological Incidents... ``anonymous access'' system, which means the EPA will not know your identity or contact information unless you...

Ex-vivo sensitivity profiling to guide clinical decision making in acute myeloid leukemia: A pilot study.

Science.gov (United States)

Swords, Ronan T; Azzam, Diana; Al-Ali, Hassan; Lohse, Ines; Volmar, Claude-Henry; Watts, Justin M; Perez, Aymee; Rodriguez, Ana; Vargas, Fernando; Elias, Roy; Vega, Francisco; Zelent, Arthur; Brothers, Shaun P; Abbasi, Taher; Trent, Jonathan; Rangwala, Shaukat; Deutsch, Yehuda; Conneally, Eibhlin; Drusbosky, Leylah; Cogle, Christopher R; Wahlestedt, Claes

2018-01-01

A precision medicine approach is appealing for use in AML due to ease of access to tumor samples and the significant variability in the patients' response to treatment. Attempts to establish a precision medicine platform for AML, however, have been unsuccessful, at least in part due to the use of small compound panels and having relatively slow turn over rates, which restricts the scope of treatment and delays its onset. For this pilot study, we evaluated a cohort of 12 patients with refractory AML using an ex vivo drug sensitivity testing (DST) platform. Purified AML blasts were screened with a panel of 215 FDA-approved compounds and treatment response was evaluated after 72h of exposure. Drug sensitivity scoring was reported to the treating physician, and patients were then treated with either DST- or non-DST guided therapy. We observed survival benefit of DST-guided therapy as compared to the survival of patients treated according to physician recommendation. Three out of four DST-treated patients displayed treatment response, while all of the non-DST-guided patients progressed during treatment. DST rapidly and effectively provides personalized treatment recommendations for patients with refractory AML. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Ultrahigh-resolution ultrasound characterization of access site trauma and intimal hyperplasia following use of a 7F sheathless guide versus 6F sheath/guide combination for transradial artery PCI: Results of the PRAGMATIC trial.

Science.gov (United States)

Batchelor, Wayne; Dahya, Vishal; McGee, Dan; Katopodis, John; Dixon, William; Campbell, James; Meredith, Ashley; Knap, Patty; Parkin, Mathew; Noel, Thomas

2018-04-01

There exist limited data on the relative degree of acute injury and late healing of the radial artery after transradial artery (TRA) percutaneous coronary intervention (PCI) with a 7F sheathless guide catheter compared with a 6F sheath/guide combination. We used ultrahigh-resolution (55 MHz) vascular ultrasound to compare intimal-medial thickening (IMT) and early and late radial artery (RA) injury resulting from a sheathless 7F guide catheter versus a 6F sheath/guide combination for TRA-PCI. Forty-one consecutive consenting patients undergoing elective nonemergent TRA-PCI at a single institution from June 2016 to December 2016 were included. Patients were randomized (stratified by sex) to undergo TRA-PCI using a 7F sheathless guide catheter versus a 6F sheath/6F guide combination. Ultrahigh-resolution vascular ultrasound (55MHz) of the RA access site was performed at 24hours and 90days post-TRA-PCI. The primary outcome of the study was a noninferiority comparison of radial artery IMT thickness at 90days. PCI success rates, fluoroscopy times, number of guides used, and crossover rates to a femoral approach were also compared. Baseline characteristics were similar between groups. Radial arterial IMT (mm) was similar between the 7F sheathless and 6F sheath/guide groups at 24hours (0.27 vs 0.29, respectively; P=.43) and at 90days (0.35 vs 0.34, respectively; P=.96). The P value for the noninferiority testing of a 0.07-mm limit was .002. Limited access site intimal tears were relatively common in both groups at 24hours (4 vs 5, P=.53) but often healed by 90days. Radial artery occlusion was infrequent at 90days (2 vs 1, P=.10), and no frank dissections were noted. PCI success rates (100% vs 95%, P=.59), fluoroscopy times (16 vs 12minutes, P=.17), number of guides used (1.1 vs 1.2, P=.48), and femoral crossover rates (0% vs 0%) were similar between the 2 respective groups. A 7F sheathless approach to TRA-PCI results in no more IMT and early or late RA trauma than a

In vitro chemo-sensitivity assay guided chemotherapy is associated with prolonged overall survival in cancer patients.

Science.gov (United States)

Udelnow, Andrej; Schönfęlder, Manfred; Würl, Peter; Halloul, Zuhir; Meyer, Frank; Lippert, Hans; Mroczkowski, Paweł

2013-06-01

The overall survival (OS) of patients suffering From various tumour entities was correlated with the results of in vitro-chemosensitivity assay (CSA) of the in vivo applied drugs. Tumour specimen (n=611) were dissected in 514 patients and incubated for primary tumour cell culture. The histocytological regression assay was performed 5 days after adding chemotherapeutic substances to the cell cultures. n=329 patients undergoing chemotherapy were included in the in vitro/in vivo associations. OS was assessed and in vitro response groups compared using survival analysis. Furthermore Cox-regression analysis was performed on OS including CSA, age, TNM classification and treatment course. The growth rate of the primary was 73-96% depending on tumour entity. The in-vitro response rate varied with histology and drugs (e.g. 8-18% for methotrexate and 33-83% for epirubicine). OS was significantly prolonged for patients treated with in vitro effective drugs compared to empiric therapy (log-rank-test, p=0.0435). Cox-regression revealed that application of in vitro effective drugs, residual tumour and postoperative radiotherapy determined the death risk independently. When patients were treated with drugs effective in our CSA, OS was significantly prolonged compared to empiric therapy. CSA guided chemotherapy should be compared to empiric treatment by a prospective randomized trial.

Corrosion monitoring using high-frequency guided waves

Science.gov (United States)

Fromme, P.

2016-04-01

Corrosion can develop due to adverse environmental conditions during the life cycle of a range of industrial structures, e.g., offshore oil platforms, ships, and desalination plants. Generalized corrosion leading to wall thickness loss can cause the reduction of the strength and thus degradation of the structural integrity. The monitoring of corrosion damage in difficult to access areas can be achieved using high frequency guided waves propagating along the structure from accessible areas. Using standard ultrasonic wedge transducers with single sided access to the structure, guided wave modes were selectively generated that penetrate through the complete thickness of the structure. The wave propagation and interference of the different guided wave modes depends on the thickness of the structure. Laboratory experiments were conducted for wall thickness reduction due to milling of the steel structure. From the measured signal changes due to the wave mode interference the reduced wall thickness was monitored. Good agreement with theoretical predictions was achieved. The high frequency guided waves have the potential for corrosion damage monitoring at critical and difficult to access locations from a stand-off distance.

The Effects of Public Access Defibrillation on Survival After Out-of-Hospital Cardiac Arrest: A Systematic Review of Observational Studies.

Science.gov (United States)

Bækgaard, Josefine S; Viereck, Søren; Møller, Thea Palsgaard; Ersbøll, Annette Kjær; Lippert, Freddy; Folke, Fredrik

2017-09-05

Despite recent advances, the average survival after out-of-hospital cardiac arrest (OHCA) remains 50%. Accordingly, placement of automated external defibrillators in the community as part of a public access defibrillation program (PAD) is recommended by international guidelines. However, different strategies have been proposed on how exactly to increase and make use of publicly available automated external defibrillators. This systematic review aimed to evaluate the effect of PAD and the different PAD strategies on survival after OHCA. PubMed, Embase, and the Cochrane Library were systematically searched on August 31, 2015 for observational studies reporting survival to hospital discharge in OHCA patients where an automated external defibrillator had been used by nonemergency medical services. PAD was divided into 3 groups according to who applied the defibrillator: nondispatched lay first responders, professional first responders (firefighters/police) dispatched by the Emergency Medical Dispatch Center (EMDC), or lay first responders dispatched by the EMDC. A total of 41 studies were included; 18 reported PAD by nondispatched lay first responders, 20 reported PAD by EMDC-dispatched professional first responders (firefighters/police), and 3 reported both. We identified no qualified studies reporting survival after PAD by EMDC-dispatched lay first responders. The overall survival to hospital discharge after OHCA treated with PAD showed a median survival of 40.0% (range, 9.1-83.3). Defibrillation by nondispatched lay first responders was associated with the highest survival with a median survival of 53.0% (range, 26.0-72.0), whereas defibrillation by EMDC-dispatched professional first responders (firefighters/police) was associated with a median survival of 28.6% (range, 9.0-76.0). A meta-analysis of the different survival outcomes could not be performed because of the large heterogeneity of the included studies. This systematic review showed a median overall

A Straight-Talk Survival Guide for Colleges

Science.gov (United States)

Facione, Peter A.

2009-01-01

Times are very tough. The great majority of colleges are looking at 2009 and 2010 and beyond, in anticipation of the deepest budget cuts in more than a generation. But as bad as the financial situation may be, colleges can survive if they take swift and strong emergency action. It is time for some straight talk, starting with the realization that…

Access 2013 for dummies

CERN Document Server

Ulrich Fuller, Laurie

2013-01-01

The easy guide to Microsoft Access returns with updates on the latest version! Microsoft Access allows you to store, organize, view, analyze, and share data; the new Access 2013 release enables you to build even more powerful, custom database solutions that integrate with the web and enterprise data sources. Access 2013 For Dummies covers all the new features of the latest version of Accessand serves as an ideal reference, combining the latest Access features with the basics of building usable databases. You'll learn how to create an app from the Welcome screen, get support

Mini access guide to simplify calyceal access during percutaneous nephrolithotomy: A novel device

Directory of Open Access Journals (Sweden)

Puskar Shyam Chowdhury

2017-01-01

Conclusion: The MAG is a simple, portable, cheap, and novel assistant to achieve successful PCNL puncture. It would be of great help for novices to establish access during their learning phase of PCNL. It would also be an asset toward significantly decreasing the radiation dose during PCNL access.

Equity and child-survival strategies.

Science.gov (United States)

Mulholland, Ek; Smith, L; Carneiro, I; Becher, H; Lehmann, D

2008-05-01

Recent advances in child survival have often been at the expense of increasing inequity. Successive interventions are applied to the same population sectors, while the same children in other sectors consistently miss out, leading to a trend towards increasing inequity in child survival. This is particularly important in the case of pneumonia, the leading cause of child death, which is closely linked to poverty and malnutrition, and for which effective community-based case management is more difficult to achieve than for other causes of child death. The key strategies for the prevention of childhood pneumonia are case management, mainly through Integrated Management of Childhood Illness (IMCI), and immunization, particularly the newer vaccines against Haemophilus influenzae type b (Hib) and pneumococcus. There is a tendency to introduce both interventions into communities that already have access to basic health care and preventive services, thereby increasing the relative disadvantage experienced by those children without such access. Both strategies can be implemented in such a way as to decrease rather than increase inequity. It is important to monitor equity when introducing child-survival interventions. Economic poverty, as measured by analyses based on wealth quintiles, is an important determinant of inequity in health outcomes but in some settings other factors may be of greater importance. Geography and ethnicity can both lead to failed access to health care, and therefore inequity in child survival. Poorly functioning health facilities are also of major importance. Countries need to be aware of the main determinants of inequity in their communities so that measures can be taken to ensure that IMCI, new vaccine implementation and other child-survival strategies are introduced in an equitable manner.

Promoting, Guiding, and Surviving Change in School Districts.

Science.gov (United States)

Deal, Terrence E.; Nutt, Samuel C.

Compiled for school administrators who must initiate or respond to external mandate for change, this guide draws on the experiences of 10 rural school districts that participated in the federally funded Experimental Schools (ES) program for perspectives that can be used in the successful management of change efforts in school districts. Organized…

Causes and Effects of Begging Style Involving Children as Guides in Dodoma Municipality, Tanzania: Liability in Basic Education Access

Directory of Open Access Journals (Sweden)

Abdallah Jacob Seni

2017-01-01

Full Text Available This paper explores the causes and effects of a unique begging style involving children as guides in Dodoma Municipality, Tanzania. The rationale for Dodoma Municipality to be the study location is that the begging phenomenon using children as guides is rampant. The study sample involved 40 respondents, of whom 6 were young carers of visually impaired adult beggars, 6 visually impaired adult beggars, 6 young carers of visually impaired adult beggars’ family members and 22 influential community members. Purposeful sampling technique was used to obtain these respondents. Data collection methods entailed interviews and observations. Artifacts were also used to portray issues under investigation more vividly. The data were analyzed using content analysis in which themes and sub-themes were determined by organization, reduction and interpretation of the information collected.   The study discovered that lack of education, sympathy attraction, lack of proper orientation, laziness and poverty were the major causes for the existence of begging involving children as guides. The study revealed that minor causes include parents’ negligence and alcoholism, Single Parenthood as well as drought and hunger. The begging style using children as guides resulted into notable limited basic education access among these vulnerable children hence a liability and not asset. The study recommends that young carers of visually impaired adult beggars should be enrolled to basic education and revitalize education for self-reliance.

Usability Testing, User-Centered Design, and LibGuides Subject Guides: A Case Study

Science.gov (United States)

Sonsteby, Alec; DeJonghe, Jennifer

2013-01-01

Usability testing has become a routine way for many libraries to ensure that their Web presence is user-friendly and accessible. At the same time, popular subject guide creation systems, such as LibGuides, decentralize Web content creation and put authorship into the hands of librarians who may not be trained in user-centered design principles. At…

Combined CT-guided radiofrequency ablation with systemic chemotherapy improves the survival for nasopharyngeal carcinoma with oligometastasis in liver: Propensity score matching analysis.

Science.gov (United States)

Li, Wang; Bai, Yutong; Wu, Ming; Shen, Lujun; Shi, Feng; Sun, Xuqi; Lin, Caijin; Chang, Boyang; Pan, Changchuan; Li, Zhiwen; Wu, Peihong

2017-08-08

The aim of this study was to retrospectively compare the treatment efficacy of systemic chemotherapy combined with sequential CT-guided radiofrequency ablation (Chemo-RFA) to chemotherapy alone (Chemo-only) in the management of nasopharyngeal carcinoma (NPC) with liver metastasis. Between 2003 and 2011, 328 NPC patients diagnosed with liver metastasis at Sun Yat-sen University Cancer Center were enrolled. One-to-one matched pairs between Chemo-RFA group with the Chemo-only group were generated using propensity score matching. The associations of treatment modality with overall survival (OS) and progression-free survival (PFS) were determined by Cox regression. Of the patients enrolled, 37 patients (11.8 %) received combined treatment, 291 (82.2) received chemotherapy alone. The patients in Chemo-RFA group were more frequently classified as lower number (≤3) of liver metastatic lesions (Poligometastasis in liver, and should be considered if the ablation is technically feasible.

Randomized trial of tourniquet vs blood pressure cuff for target vein dilation in ultrasound-guided peripheral intravenous access.

Science.gov (United States)

Nelson, Drew; Jeanmonod, Rebecca; Jeanmonod, Donald

2014-07-01

Ten percent of the time, peripheral intravenous access (PIV) is not obtained in 2 attempts in the emergency department. Typically, a tourniquet is used to dilate the target vein; but recent research showed that a blood pressure (BP) cuff improves dilation, which may translate to increased PIV success. We sought to determine if there is improved success in obtaining ultrasound-guided PIV using a BP cuff vs a tourniquet in "difficult stick" patients. This is a prospective, randomized, single-blinded trial. Adult patients requiring PIV with at least 2 prior failed attempts were enrolled. Patients were assigned to tourniquet or BP cuff for target vein dilation randomly. Nurses prepared the patient for PIV attempt by either placing a BP cuff inflated to 150 mm Hg or placing a tourniquet on the chosen extremity. The extremity was draped to blind the physician to assignment. Physicians then attempted ultrasound-guided PIV. Failures were defined as IVs requiring greater than 3 ultrasound-guided attempts or 30 minutes, or patient intolerance. If failure occurred, the physician was unblinded; and the patient could be crossed over and reattempted. Thirty-eight patients were enrolled. The success rate for the tourniquet group (n = 17) and BP cuff group (n = 21) was 82.4% and 47.6%, respectively (P = .04). There were no differences between groups for vessel depth, diameter, or procedure time. Six in the BP cuff group were crossed over and had successful PIV obtained with tourniquet. Tourniquet is superior to BP cuff for target vein dilation in ultrasound-guided PIV. Copyright © 2014 Elsevier Inc. All rights reserved.

Corrosion monitoring using high-frequency guided ultrasonic waves

Science.gov (United States)

Fromme, Paul

2014-02-01

Corrosion develops due to adverse environmental conditions during the life cycle of a range of industrial structures, e.g., offshore oil platforms, ships, and desalination plants. Both pitting corrosion and generalized corrosion leading to wall thickness loss can cause the degradation of the structural integrity. The nondestructive detection and monitoring of corrosion damage in difficult to access areas can be achieved using high frequency guided waves propagating along the structure from accessible areas. Using standard ultrasonic transducers with single sided access to the structure, guided wave modes were generated that penetrate through the complete thickness of the structure. The wave propagation and interference of the different guided wave modes depends on the thickness of the structure. Laboratory experiments were conducted and the wall thickness reduced by consecutive milling of the steel structure. Further measurements were conducted using accelerated corrosion in a salt water bath and the damage severity monitored. From the measured signal change due to the wave mode interference the wall thickness reduction was monitored. The high frequency guided waves have the potential for corrosion damage monitoring at critical and difficult to access locations from a stand-off distance.

Strand V: Education for Survival. First Aid and Survival Education. Health Curriculum Materials Grades 10-12.

Science.gov (United States)

New York State Education Dept., Albany. Bureau of Secondary Curriculum Development.

GRADES OR AGES: Grades 10-12. SUBJECT MATTER: First aid and survival education. ORGANIZATION AND PHYSICAL APPEARANCE: The guide is divided into six sections: transportation of the injured, automobile accidents, conditions resulting from nuclear explosion, chemical warfare, natural catastrophes, and psychological first aid. The publication format…

GuideLiner™ as guide catheter extension for the unreachable mammary bypass graft.

Science.gov (United States)

Vishnevsky, Alec; Savage, Michael P; Fischman, David L

2018-03-09

Percutaneous coronary intervention (PCI) of mammary artery bypass grafts through a trans-radial (TR) approach can present unique challenges, including coaxial vessel engagement of the guiding catheter, adequate visualization of the target lesion, sufficient backup support for equipment delivery, and the ability to reach very distal lesions. The GuideLiner catheter, a rapid exchange monorail mother-in-daughter system, facilitates successful interventions in such challenging anatomy. We present a case of a patient undergoing PCI of a right internal mammary artery (RIMA) graft via TR access in whom the graft could not be engaged with any guiding catheter. Using a balloon tracking technique over a guidewire, a GuideLiner was placed as an extension of the guiding catheter and facilitated TR-PCI by overcoming technical challenges associated with difficult anatomy. © 2018 Wiley Periodicals, Inc.

A new model with an anatomically accurate human renal collecting system for training in fluoroscopy-guided percutaneous nephrolithotomy access.

Science.gov (United States)

Turney, Benjamin W

2014-03-01

Obtaining renal access is one of the most important and complex steps in learning percutaneous nephrolithotomy (PCNL). Ideally, this skill should be practiced outside the operating room. There is a need for anatomically accurate and cheap models for simulated training. The objective was to develop a cost-effective, anatomically accurate, nonbiologic training model for simulated PCNL access under fluoroscopic guidance. Collecting systems from routine computed tomography urograms were extracted and reformatted using specialized software. These images were printed in a water-soluble plastic on a three-dimensional (3D) printer to create biomodels. These models were embedded in silicone and then the models were dissolved in water to leave a hollow collecting system within a silicone model. These PCNL models were filled with contrast medium and sealed. A layer of dense foam acted as a spacer to replicate the tissues between skin and kidney. 3D printed models of human collecting systems are a useful adjunct in planning PCNL access. The PCNL access training model is relatively low cost and reproduces the anatomy of the renal collecting system faithfully. A range of models reflecting the variety and complexity of human collecting systems can be reproduced. The fluoroscopic triangulation process needed to target the calix of choice can be practiced successfully in this model. This silicone PCNL training model accurately replicates the anatomic architecture and orientation of the human renal collecting system. It provides a safe, clean, and effective model for training in accurate fluoroscopy-guided PCNL access.

Users guide for the ANL IBM SPx

Energy Technology Data Exchange (ETDEWEB)

Gropp, W.; Lusk, E.

1994-12-01

This guide presents the features of the IBM SPx installed in the Mathematics and Computer Science Division at Argonne National Laboratory. The guide describes the available hardware and software, access policies, and hints for using the system productively.

IV access in dental practice.

LENUS (Irish Health Repository)

Fitzpatrick, J J

2009-04-01

Intravenous (IV) access is a valuable skill for dental practitioners in emergency situations and in IV sedation. However, many people feel some apprehension about performing this procedure. This article explains the basic principles behind IV access, and the relevant anatomy and physiology, as well as giving a step-by-step guide to placing an IV cannula.

Evaluating Expected Costs and Benefits of Granting Access to New Treatments on the Basis of Progression-Free Survival in Non-Small-Cell Lung Cancer.

Science.gov (United States)

Lakdawalla, Darius N; Chou, Jacquelyn W; Linthicum, Mark T; MacEwan, Joanna P; Zhang, Jie; Goldman, Dana P

2015-05-01

Surrogate end points may be used as proxy for more robust clinical end points. One prominent example is the use of progression-free survival (PFS) as a surrogate for overall survival (OS) in trials for oncologic treatments. Decisions based on surrogate end points may expedite regulatory approval but may not accurately reflect drug efficacy. Payers and clinicians must balance the potential benefits of earlier treatment access based on surrogate end points against the risks of clinical uncertainty. To present a framework for evaluating the expected net benefit or cost of providing early access to new treatments on the basis of evidence of PFS benefits before OS results are available, using non-small-cell lung cancer (NSCLC) as an example. A probabilistic decision model was used to estimate expected incremental social value of the decision to grant access to a new treatment on the basis of PFS evidence. The model analyzed a hypothetical population of patients with NSCLC who could be treated during the period between PFS and OS evidence publication. Estimates for delay in publication of OS evidence following publication of PFS evidence, expected OS benefit given PFS benefit, incremental cost of new treatment, and other parameters were drawn from the literature on treatment of NSCLC. Incremental social value of early access for each additional patient per month (in 2014 US dollars). For "medium-value" model parameters, early reimbursement of drugs with any PFS benefit yields an incremental social cost of more than $170,000 per newly treated patient per month. In contrast, granting early access on the basis of PFS benefit between 1 and 3.5 months produces more than $73,000 in incremental social value. Across the full range of model parameter values, granting access for drugs with PFS benefit between 3 and 3.5 months is robustly beneficial, generating incremental social value ranging from $38,000 to more than $1 million per newly treated patient per month, whereas access

Firms Started As Franchises Have Lower Survival Rates Than Independent Small Business Startups

OpenAIRE

Timothy Bates

1994-01-01

Aspiring entrepreneurs choosing to become franchisees certainly expect to improve their chances of survival during the turbulent early years of business startup and operation. Alignment with a franchiser parent company offers the franchisee managerial assistance, access to financial capital, and access to markets via the right to utilize the parent company trademark. This study examines survival patterns among franchise and nonfranchise small firms started between 1984 and 1987: survival thro...

EUS-guided biliary rendezvous using a short hydrophilic guidewire.

Science.gov (United States)

Dhir, Vinay; Kwek, Boon Eu Andrew; Bhandari, Suryaprakash; Bapat, Mukta; Maydeo, Amit

2011-10-01

BACKGROUND AND STUDY AIMS: EUS-guided rendezvous technique for biliary access requires expert manipulation of the guidewire across the downstream stricture or papilla. Published literature reports usage of the long-wire system to prevent loss of wire during scope exchange. We studied the efficacy of using a short hydrophilic guidewire in EUS-guided rendezvous. PATIENTS AND METHODS: This is a retrospective study conducted in a tertiary care referral centre. 15 patients underwent EUS-guided biliary rendezvous with short wire. EUS-guided transduodenal/transgastric puncture of the biliary system was performed, followed by anterograde placement of a hydrophilic short-wire (260 cm) across the downstream stricture and/or papilla. Retrograde access was then achieved by retrieving the trans-papillary wire, followed by standard ERCP intervention. Main outcome measurements were rates of procedural success and complications. RESULTS: EUS-guided biliary rendezvous was successful in 14 patients (93.3%). Failure was seen in one patient due to a tight malignant biliary stricture. One patient had peri-choledochal bile tracking which did not require any specific treatment. CONCLUSIONS: Short-wire system in EUS-guided biliary rendezvous is highly effective and safe. It is a useful salvage procedure for biliary cannulation in patients with accessible papilla.

Guided acoustic wave inspection system

Science.gov (United States)

Chinn, Diane J.

2004-10-05

A system for inspecting a conduit for undesirable characteristics. A transducer system induces guided acoustic waves onto said conduit. The transducer system detects the undesirable characteristics of the conduit by receiving guided acoustic waves that contain information about the undesirable characteristics. The conduit has at least two sides and the transducer system utilizes flexural modes of propagation to provide inspection using access from only the one side of the conduit. Cracking is detected with pulse-echo testing using one transducer to both send and receive the guided acoustic waves. Thinning is detected in through-transmission testing where one transducer sends and another transducer receives the guided acoustic waves.

Mastering IDEAScript the definitive guide

CERN Document Server

Mueller, John Paul

2011-01-01

With approximately 44,000 users in the U.S. and Canada, as well as 42,000 in Europe, IDEA software has become a leading provider of data analysis software for use by auditors and accountants. Written to provide users with a quick access guide for optimal use of IDEAScript, Mastering IDEAScript: The Definitive Guide is IDEA's official guide to mastering IDEAScript, covering essential topics such as Introducing IDEAScript, Understanding the Basics of IDEAScript Editor, Designing Structured Applications, Understanding IDEA Databases and much more. For auditors, accountants and controllers.

46 CFR 28.125 - Stowage of survival craft.

Science.gov (United States)

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Stowage of survival craft. 28.125 Section 28.125... FISHING INDUSTRY VESSELS Requirements for All Vessels § 28.125 Stowage of survival craft. (a) Each..., inflatable buoyant apparatus, and any auxiliary craft used in their place, must be kept readily accessible...

Guided Note Taking and Student Achievement in a Media Law Course

Science.gov (United States)

Blom, Robin

2017-01-01

In a quasi-experimental setting, a group of U.S. college students in an introductory media law course had higher test scores when the instructor provided access to guided worksheets than a group of students without access to guided worksheets. It also allows educators in journalism and mass communication to cover more materials during courses…

Comparative study of LDR (Manchester system) and HDR image-guided conformal brachytherapy of cervical cancer: patterns of failure, late complications, and survival.

Science.gov (United States)

Narayan, Kailash; van Dyk, Sylvia; Bernshaw, David; Rajasooriyar, Chrishanthi; Kondalsamy-Chennakesavan, Srinivas

2009-08-01

To compare patterns of failure, late toxicities, and survival in locally advanced cervical cancer patients treated by either low-dose-rate (LDR) or conformal high-dose-rate (HDRc) brachytherapy as a part of curative radiotherapy. A retrospective comparative study of 217 advanced cervix cancer patients was conducted; 90 of these patients received LDR and 127 received HDRc brachytherapy. All patients were staged using International Federation of Gynecology and Obstetrics (FIGO) rules, had pretreatment magnetic resonance imaging (MRI), and were treated with concurrent cisplatin chemoradiotherapy. Both groups matched for FIGO stage, MRI tumor volume, and uterine invasion status. Local and pelvic failures were similar 12-13% and 14% both in both groups. Abdominal and systemic failures in LDR group were 21% and 24%, whereas corresponding failures in HDRc group were 20% and 24%. Sixty-eight percent (87/127) of patients treated by HDRc remained asymptomatic, whereas 42% (38/90) of patients were asymptomatic from the bowel and bladder symptoms after treatment with LDR. The 5-year OS rate was 60% (SE = 4%). The 5-year failure-free survival rate was 55% (SE = 3%). There was no significant difference between the groups. Image-guided HDRc planning led to a large decrease in late radiation effects in patients treated by HDRc. Patterns of failure and survival were similar in patients treated either by LDR or HDRc.

Comparative Study of LDR (Manchester System) and HDR Image-guided Conformal Brachytherapy of Cervical Cancer: Patterns of Failure, Late Complications, and Survival

International Nuclear Information System (INIS)

Narayan, Kailash; Dyk, Sylvia van; Bernshaw, David; Rajasooriyar, Chrishanthi; Kondalsamy-Chennakesavan, Srinivas

2009-01-01

Purpose: To compare patterns of failure, late toxicities, and survival in locally advanced cervical cancer patients treated by either low-dose-rate (LDR) or conformal high-dose-rate (HDRc) brachytherapy as a part of curative radiotherapy. Materials and Methods: A retrospective comparative study of 217 advanced cervix cancer patients was conducted; 90 of these patients received LDR and 127 received HDRc brachytherapy. All patients were staged using International Federation of Gynecology and Obstetrics (FIGO) rules, had pretreatment magnetic resonance imaging (MRI), and were treated with concurrent cisplatin chemoradiotherapy. Both groups matched for FIGO stage, MRI tumor volume, and uterine invasion status. Results: Local and pelvic failures were similar 12-13% and 14% both in both groups. Abdominal and systemic failures in LDR group were 21% and 24%, whereas corresponding failures in HDRc group were 20% and 24%. Sixty-eight percent (87/127) of patients treated by HDRc remained asymptomatic, whereas 42% (38/90) of patients were asymptomatic from the bowel and bladder symptoms after treatment with LDR. The 5-year OS rate was 60% (SE = 4%). The 5-year failure-free survival rate was 55% (SE = 3%). There was no significant difference between the groups. Conclusions: Image-guided HDRc planning led to a large decrease in late radiation effects in patients treated by HDRc. Patterns of failure and survival were similar in patients treated either by LDR or HDRc.

Peripheral Insertion of a Central Venous Access Device Under Fluoroscopic Guidance Using a Peripherally Accessed System (PAS) Port in the Forearm

International Nuclear Information System (INIS)

Hata, Yasuhiro; Morita, Sojiro; Morita, Yoshitaka; Awatani, Toshihide; Takasaki, Motohiro; Horimi, Tadashi; Ozawa, Zen

1998-01-01

Purpose: We describe the technique, efficacy, and complications of fluoroscopy-guided implantation of a central venous access device using a peripherally accessed system (PAS) port via the forearm. Methods: Beginning in July 1994, 105 central venous access devices were implanted in 104 patients for the long-term infusion of antibiotics or antineoplasmic agents, blood products, or parenteral nutrition. The devices was inserted under fluoroscopic guidance with real-time venography from a peripheral route. Results: All ports were successfully implanted. There were no procedure-related complications. No thrombosis or local infection was observed; however, in six patients catheter-related phlebitis occurred. Conclusion: Fluoroscopy-guided implantation of a central venous access device using a PAS port via the forearm is safe and efficacious, and injection of contrast medium through a peripheral IV catheter before introduction of the catheter helps to avoid catheter-related phlebitis

Attributing death to cancer: cause-specific survival estimation.

Directory of Open Access Journals (Sweden)

Mathew A

2002-10-01

Full Text Available Cancer survival estimation is an important part of assessing the overall strength of cancer care in a region. Generally, the death of a patient is taken as the end point in estimation of overall survival. When calculating the overall survival, the cause of death is not taken into account. With increasing demand for better survival of cancer patients it is important for clinicians and researchers to know about survival statistics due to disease of interest, i.e. net survival. It is also important to choose the best method for estimating net survival. Increase in the use of computer programmes has made it possible to carry out statistical analysis without guidance from a bio-statistician. This is of prime importance in third- world countries as there are a few trained bio-statisticians to guide clinicians and researchers. The present communication describes current methods used to estimate net survival such as cause-specific survival and relative survival. The limitation of estimation of cause-specific survival particularly in India and the usefulness of relative survival are discussed. The various sources for estimating cancer survival are also discussed. As survival-estimates are to be projected on to the population at large, it becomes important to measure the variation of the estimates, and thus confidence intervals are used. Rothman′s confidence interval gives the most satisfactory result for survival estimate.

Impact of Focused Ultrasound-enhanced Drug Delivery on Survival in Rats with Glioma

Science.gov (United States)

Treat, Lisa Hsu; Zhang, Yongzhi; McDannold, Nathan; Hynynen, Kullervo

2009-04-01

Malignancies of the brain remain difficult to treat with chemotherapy because the selective permeability of the blood-brain barrier (BBB) blocks many potent agents from reaching their target. Previous studies have illustrated the feasibility of drug and antibody delivery across the BBB using MRI-guided focused ultrasound. In this study, we investigated the impact of focused ultrasound-enhanced delivery of doxorubicin on survival in rats with aggressive glioma. Sprague-Dawley rats were implanted with 9 L gliosarcoma cells in the brain. Eight days after implantation, each rat received one of the following: (1) no treatment (control), (2) a single treatment with microbubble-enhanced MRI-guided focused ultrasound (FUS only), (3) a single treatment with i.v. liposomal doxorubicin (DOX only), or (4) a single treatment with microbubble-enhanced MRI-guided focused ultrasound and concurrent i.v. injections of liposomal doxorubicin (FUS+DOX). The survival time from implantation to death or euthanasia was recorded. We observed a modest but significant increase in median survival time in rats treated with combined MRI-guided focused ultrasound chemotherapy, compared to chemotherapy alone (p0.10). Our study demonstrates for the first time a therapeutic benefit achieved with ultrasound-enhanced drug delivery across the blood-brain barrier. This confirmation of efficacy in an in vivo tumor model indicates that targeted drug delivery using MRI-guided focused ultrasound has the potential to have a major impact on the treatment of patients with brain tumors and other neurological disorders.

CT-guided transgluteal biopsy for systematic sampling of the prostate in patients without rectal access: a 13-year single-center experience

Energy Technology Data Exchange (ETDEWEB)

Olson, Michael C.; Atwell, Thomas D.; King, Bernard F.; Welch, Timothy; Goenka, Ajit H. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Mynderse, Lance A. [Mayo Clinic, Department of Urology, Rochester, MN (United States)

2017-08-15

The purpose of our study was to examine the safety and diagnostic utility of transgluteal CT-guided prostate biopsy for prostate sampling in patients without rectal access. Seventy-three biopsies were performed in 65 patients over a 13-year period (2002-2015). Mean prostate-specific antigen (PSA) at biopsy was 7.8 ng/mL (range 0.37-31.5). Electronic medical records were reviewed for procedural details and complications. Mean PSA and number of cores in malignant and benign cohorts were compared with Student's t test. Technical success rate was 97.3% (71/73; mean cores 8, range 3-28). Of these, 43.6% (31/71) yielded malignancy (mean Gleason score 7, range 6-10) and 56.3% (40/71) yielded benign tissue. The only complication was an asymptomatic periprostatic hematoma (1/73; 1.4%). In 14 patients who underwent surgery, Gleason scores were concordant in 71.4% (10/14) and discordant in 28.6% (4/14; Gleason 6 on biopsy but Gleason 7 on surgical specimen). Mean effective radiation dose was 18.5 mSv (median 15.0, range 4.4-86.2). There was no significant difference in either mean PSA (p = 0.06) or number of core specimens (p = 0.33) between malignant and benign cohorts. CT-guided transgluteal prostate biopsy is highly safe and reliable for the detection of prostate cancer in men without rectal access. (orig.)

The DEDUCE Guided Query tool: providing simplified access to clinical data for research and quality improvement.

Science.gov (United States)

Horvath, Monica M; Winfield, Stephanie; Evans, Steve; Slopek, Steve; Shang, Howard; Ferranti, Jeffrey

2011-04-01

In many healthcare organizations, comparative effectiveness research and quality improvement (QI) investigations are hampered by a lack of access to data created as a byproduct of patient care. Data collection often hinges upon either manual chart review or ad hoc requests to technical experts who support legacy clinical systems. In order to facilitate this needed capacity for data exploration at our institution (Duke University Health System), we have designed and deployed a robust Web application for cohort identification and data extraction--the Duke Enterprise Data Unified Content Explorer (DEDUCE). DEDUCE is envisioned as a simple, web-based environment that allows investigators access to administrative, financial, and clinical information generated during patient care. By using business intelligence tools to create a view into Duke Medicine's enterprise data warehouse, DEDUCE provides a Guided Query functionality using a wizard-like interface that lets users filter through millions of clinical records, explore aggregate reports, and, export extracts. Researchers and QI specialists can obtain detailed patient- and observation-level extracts without needing to understand structured query language or the underlying database model. Developers designing such tools must devote sufficient training and develop application safeguards to ensure that patient-centered clinical researchers understand when observation-level extracts should be used. This may mitigate the risk of data being misunderstood and consequently used in an improper fashion. Copyright © 2010 Elsevier Inc. All rights reserved.

A New Navigation System of Renal Puncture for Endoscopic Combined Intrarenal Surgery: Real-time Virtual Sonography-guided Renal Access.

Science.gov (United States)

Hamamoto, Shuzo; Unno, Rei; Taguchi, Kazumi; Ando, Ryosuke; Hamakawa, Takashi; Naiki, Taku; Okada, Shinsuke; Inoue, Takaaki; Okada, Atsushi; Kohri, Kenjiro; Yasui, Takahiro

2017-11-01

To evaluate the clinical utility of a new navigation technique for percutaneous renal puncture using real-time virtual sonography (RVS) during endoscopic combined intrarenal surgery. Thirty consecutive patients who underwent endoscopic combined intrarenal surgery for renal calculi, between April 2014 and July 2015, were divided into the RVS-guided puncture (RVS; n = 15) group and the ultrasonography-guided puncture (US; n = 15) group. In the RVS group, renal puncture was repeated until precise piercing of a papilla was achieved under direct endoscopic vision, using the RVS system to synchronize the real-time US image with the preoperative computed tomography image. In the US group, renal puncture was performed under US guidance only. In both groups, 2 urologists worked simultaneously to fragment the renal calculi after inserting the miniature percutaneous tract. The mean sizes of the renal calculi in the RVS and the US group were 33.5 and 30.5 mm, respectively. A lower mean number of puncture attempts until renal access through the calyx was needed for the RVS compared with the US group (1.6 vs 3.4 times, respectively; P = .001). The RVS group had a lower mean postoperative hemoglobin decrease (0.93 vs 1.39 g/dL, respectively; P = .04), but with no between-group differences with regard to operative time, tubeless rate, and stone-free rate. None of the patients in the RVS group experienced postoperative complications of a Clavien score ≥2, with 3 patients experiencing such complications in the US group. RVS-guided renal puncture was effective, with a lower incidence of bleeding-related complications compared with US-guided puncture. Copyright © 2017 Elsevier Inc. All rights reserved.

A Kleptocrat's Survival Guide : Autocratic Longevity in the Face of Civil Conflict

OpenAIRE

Milante, Gary

2007-01-01

Autocratic regimes are quite often short-lived kleptocracies formed and maintained through force and used to appropriate wealth from subjects. Some of these autocracies collapse after only a year or two of plundering while others manage to survive for 15 or 20 years. This paper asks why some autocratic regimes survive while others fail. A database of political regimes from 1960 to 2003 is ...

Practical considerations to guide development of access controls and decision support for genetic information in electronic medical records

Directory of Open Access Journals (Sweden)

Darcy Diana C

2011-11-01

Full Text Available Abstract Background Genetic testing is increasingly used as a tool throughout the health care system. In 2011 the number of clinically available genetic tests is approaching 2,000, and wide variation exists between these tests in their sensitivity, specificity, and clinical implications, as well as the potential for discrimination based on the results. Discussion As health care systems increasingly implement electronic medical record systems (EMRs they must carefully consider how to use information from this wide spectrum of genetic tests, with whom to share information, and how to provide decision support for clinicians to properly interpret the information. Although some characteristics of genetic tests overlap with other medical test results, there are reasons to make genetic test results widely available to health care providers and counterbalancing reasons to restrict access to these test results to honor patient preferences, and avoid distracting or confusing clinicians with irrelevant but complex information. Electronic medical records can facilitate and provide reasonable restrictions on access to genetic test results and deliver education and decision support tools to guide appropriate interpretation and use. Summary This paper will serve to review some of the key characteristics of genetic tests as they relate to design of access control and decision support of genetic test information in the EMR, emphasizing the clear need for health information technology (HIT to be part of optimal implementation of genetic medicine, and the importance of understanding key characteristics of genetic tests when designing HIT applications.

Practical considerations to guide development of access controls and decision support for genetic information in electronic medical records.

Science.gov (United States)

Darcy, Diana C; Lewis, Eleanor T; Ormond, Kelly E; Clark, David J; Trafton, Jodie A

2011-11-02

Genetic testing is increasingly used as a tool throughout the health care system. In 2011 the number of clinically available genetic tests is approaching 2,000, and wide variation exists between these tests in their sensitivity, specificity, and clinical implications, as well as the potential for discrimination based on the results. As health care systems increasingly implement electronic medical record systems (EMRs) they must carefully consider how to use information from this wide spectrum of genetic tests, with whom to share information, and how to provide decision support for clinicians to properly interpret the information. Although some characteristics of genetic tests overlap with other medical test results, there are reasons to make genetic test results widely available to health care providers and counterbalancing reasons to restrict access to these test results to honor patient preferences, and avoid distracting or confusing clinicians with irrelevant but complex information. Electronic medical records can facilitate and provide reasonable restrictions on access to genetic test results and deliver education and decision support tools to guide appropriate interpretation and use. This paper will serve to review some of the key characteristics of genetic tests as they relate to design of access control and decision support of genetic test information in the EMR, emphasizing the clear need for health information technology (HIT) to be part of optimal implementation of genetic medicine, and the importance of understanding key characteristics of genetic tests when designing HIT applications.

Launch of the new CERN Admin e-guide

CERN Multimedia

Laëtitia Pedroso

2010-01-01

The CERN Admin e-guide is a new guide to the Organization's administrative procedures, which has been drawn up for the benefit of members of the personnel and the various administrative services alike and replaces the old "Administrative Procedures Manual". All the different procedures currently available on separate department sites will henceforth be accessible at a single website.   Home page of the new CERN Admin e-guide. The goal of creating a compendium of CERN's administrative procedures, available at a single website and accessible with a simple click of the mouse, has now been realised.  "It had become difficult to know where to find the relevant up-to-date information on administrative procedures", says Yaël Grange-Lavigne of the HR-SPS-OP Section (Organisation and Procedures), coordinator of the working group that compiled the e-guide. The team, which comprised members of the HR Department, observers from other department...

Feasibility of Retrograde Ureteral Contrast Injection to Guide Ultrasonographic Percutaneous Renal Access in the Nondilated Collecting System.

Science.gov (United States)

Usawachintachit, Manint; Tzou, David T; Mongan, John; Taguchi, Kazumi; Weinstein, Stefanie; Chi, Thomas

2017-02-01

Ultrasound-guided percutaneous nephrolithotomy (PCNL) has become increasingly utilized. Patients with nondilated collecting systems represent a challenge: the target calix is often difficult to visualize. Here we report pilot study results for retrograde ultrasound contrast injection to aid in percutaneous renal access during ultrasound-guided PCNL. From April to July 2016, consecutive patients over the age of 18 years with nondilated collecting systems on preoperative imaging who presented for PCNL were enrolled. B-mode ultrasound imaging was compared with contrast-enhanced mode with simultaneous retrograde injection of Optison™ via an ipsilateral ureteral catheter. Five patients (four males and one female) with renal stones underwent PCNL with retrograde ultrasound contrast injection during the study period. Mean body mass index was 28.3 ± 5.6 kg/m 2 and mean stone size was 24.5 ± 12.0 mm. Under B-mode ultrasound, all patients demonstrated nondilated renal collecting systems that appeared as hyperechoic areas, where it was difficult to identify a target calix for puncture. Retrograde contrast injection facilitated delineation of all renal calices initially difficult to visualize under B-mode ultrasound. Renal puncture was then performed effectively in all cases with a mean puncture time of 55.4 ± 44.8 seconds. All PCNL procedures were completed without intraoperative complications and no adverse events related to ultrasound contrast injection occurred. Retrograde ultrasound contrast injection as an aide for renal puncture during PCNL is a feasible technique. By improving visualization of the collecting system, it facilitates needle placement in challenging patients without hydronephrosis. Future larger scale studies comparing its use to standard ultrasound-guided technique will be required to validate this concept.

Improving guide dog team play with accessible dog toys

NARCIS (Netherlands)

Hauser, S.; Wakkary, R.L.; Neustaedter, C.

2014-01-01

People with vision impairment have been a longstanding well-recognized user group addressed in HCI. Despite the recent interest in studying sighted dog owners and their pets in HCI, there is a noticeable gap in the field with regards to research on visually impaired owners and their dogs (guide dog

Virtualization A Manager's Guide

CERN Document Server

Kusnetzky, Dan

2011-01-01

What exactly is virtualization? As this concise book explains, virtualization is a smorgasbord of technologies that offer organizations many advantages, whether you're managing extremely large stores of rapidly changing data, scaling out an application, or harnessing huge amounts of computational power. With this guide, you get an overview of the five main types of virtualization technology, along with information on security, management, and modern use cases. Topics include: Access virtualization-Allows access to any application from any deviceApplication virtualization-Enables applications

When Nothing Matters Anymore: A Survival Guide for Depressed Teens.

Science.gov (United States)

Cobain, Bev

This guide provides adolescents with information on depression. An introduction discusses symptoms of depression and lists famous people who were known to be depressed. Part 1, "What's Wrong," explores how it feels to be depressed, the causes and types of depression, and the connections between depression, suicide, and drug and alcohol abuse. A…

Charter Halibut Limited Access Program

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This limited access system limits the number of charter vessels that may participate in the guided sport fishery for halibut in area 2C and 3A. NMFS issues a charter...

Davids Still Exist among Goliaths: A Story of Modest Self-Access Centre Establishment and Survival in Times of Economic Decline

Directory of Open Access Journals (Sweden)

Salomi Papadima-Sophocleous

2013-12-01

Full Text Available In a university setting, self-access language learning centres (SALLCs are generally created out of the need to support students and other members of the university and extra-mural community to explore and expand their language learning horizons. The nature of SALLCs depends on the needs of each institution and its community. They range from fully self-directed to semi-guided, from virtual online-self-access centres (OSACs to real centres, with traditional print, and more contemporary electronic and digital materials. While much of the research so far has dealt with different aspects of SALLCs, particularly of prominent ones, this article reports on the case of a small-scale SALLC, which was designed and developed, and which has operated, during difficult circumstances. This report describes how despite the administrative and financial constraints faced during the establishment of the host university and language centre, current theories and practices in SALLC were still taken into account. Also, despite these difficulties and the economic constraints being endured by the country as a whole, a number of strategies were implemented enabling the SALLC to be accessible to all students, with a view to promoting both autonomy and lifelong learning. The data used consisted of field notes collected during the period of operation as well as results from an evaluation of the use of different learning pathways on offer. Finally, the challenges still being faced as the SALLC enters a new period in its development are outlined.

Pediatric vascular access

International Nuclear Information System (INIS)

Donaldson, James S.

2006-01-01

Pediatric interventional radiologists are ideally suited to provide vascular access services to children because of inherent safety advantages and higher success from using image-guided techniques. The performance of vascular access procedures has become routine at many adult interventional radiology practices, but this service is not as widely developed at pediatric institutions. Although interventional radiologists at some children's hospitals offer full-service vascular access, there is little or none at others. Developing and maintaining a pediatric vascular access service is a challenge. Interventionalists skilled in performing such procedures are limited at pediatric institutions, and institutional support from clerical staff, nursing staff, and technologists might not be sufficiently available to fulfill the needs of such a service. There must also be a strong commitment by all members of the team to support such a demanding service. There is a slippery slope of expected services that becomes steeper and steeper as the vascular access service grows. This review is intended primarily as general education for pediatric radiologists learning vascular access techniques. Additionally, the pediatric or adult interventional radiologist seeking to expand services might find helpful tips. The article also provides education for the diagnostic radiologist who routinely interprets radiographs containing vascular access devices. (orig.)

Accessing Programs for Infants, Toddlers, and Preschoolers with Disabilities: A Parent's Guide = Programas para Infantes y Ninos Pre-escolares con Discapacidades: Guia para Padres de Familia. Update.

Science.gov (United States)

Kupper, Lisa, Ed.

This parent's guide (presented in both English and Spanish) is intended to help families access services for young children with special needs. It is presented in the form of questions and answers arranged in three parts. Part I presents 12 questions and answers about early intervention services for infants and toddlers (ages birth through 2…

Workshop AccessibleTV "Accessible User Interfaces for Future TV Applications"

Science.gov (United States)

Hahn, Volker; Hamisu, Pascal; Jung, Christopher; Heinrich, Gregor; Duarte, Carlos; Langdon, Pat

Approximately half of the elderly people over 55 suffer from some type of typically mild visual, auditory, motor or cognitive impairment. For them interaction, especially with PCs and other complex devices is sometimes challenging, although accessible ICT applications could make much of a difference for their living quality. Basically they have the potential to enable or simplify participation and inclusion in their surrounding private and professional communities. However, the availability of accessible user interfaces being capable to adapt to the specific needs and requirements of users with individual impairments is very limited. Although there are a number of APIs [1, 2, 3, 4] available for various platforms that allow developers to provide accessibility features within their applications, today none of them provides features for the automatic adaptation of multimodal interfaces being capable to automatically fit the individual requirements of users with different kinds of impairments. Moreover, the provision of accessible user interfaces is still expensive and risky for application developers, as they need special experience and effort for user tests. Today many implementations simply neglect the needs of elderly people, thus locking out a large portion of their potential users. The workshop is organized as part of the dissemination activity for the European-funded project GUIDE "Gentle user interfaces for elderly people", which aims to address this situation with a comprehensive approach for the realization of multimodal user interfaces being capable to adapt to the needs of users with different kinds of mild impairments. As application platform, GUIDE will mainly target TVs and Set-Top Boxes, such as the emerging Connected-TV or WebTV platforms, as they have the potential to address the needs of the elderly users with applications such as for home automation, communication or continuing education.

Awareness and Use of Open Access Scholarly Publications by ...

African Journals Online (AJOL)

The study investigated the awareness and use of Open Access scholarly publications by postgraduate students of Faculty of Science in Ahmadu Bello University Zaria (ABU), Kaduna State, Nigeria. The study was guided by four research objectives namely to determine the channels of awareness of Open Access ...

Monitoring of corrosion damage using high-frequency guided ultrasonic waves

Science.gov (United States)

Chew, D.; Fromme, P.

2015-03-01

Due to adverse environmental conditions corrosion can develop during the life cycle of industrial structures, e.g., offshore oil platforms, ships, and desalination plants. Both pitting corrosion and generalized corrosion leading to wall thickness loss can cause the degradation of the integrity and load bearing capacity of the structure. Structural health monitoring of corrosion damage in difficult to access areas can in principle be achieved using high frequency guided waves propagating along the structure from accessible areas. Using standard ultrasonic transducers with single sided access to the structure, high frequency guided wave modes were generated that penetrate through the complete thickness of the structure. Wall thickness reduction was induced using accelerated corrosion in a salt water bath. The corrosion damage was monitored based on the effect on the wave propagation and interference of the different modes. The change in the wave interference was quantified based on an analysis in the frequency domain (Fourier transform) and was found to match well with theoretical predictions for the wall thickness loss. High frequency guided waves have the potential for corrosion damage monitoring at critical and difficult to access locations from a stand-off distance.

Digitization and digital archiving a practical guide for librarians

CERN Document Server

Leggett, Elizabeth R

2014-01-01

Modern library patrons are embracing the ease with which information can be accessed digitally, and so many librarians are currently working toward making information available electronically. Digitization and Digital Archiving: A Practical Guide for Librarians is a comprehensive guide with step-by-step instructions for forming digital archives.

75 FR 33853 - Draft Regulatory Guide: Issuance, Availability

Science.gov (United States)

2010-06-15

.... Introduction The U.S. Nuclear Regulatory Commission (NRC) is issuing for public comment a draft guide in the... provides text and image files of NRC's public documents. If you do not have access to ADAMS or if there are... ADAMS Accession Number ML100760364. The regulatory analysis is available electronically under ADAMS...

The Educator's Guide to the Americans with Disabilities Act.

Science.gov (United States)

Morrissey, Patricia A.

This guide was written to acquaint educators with their legal responsibility in providing all individuals with disabilities--whether they be students, job applicants, employees, parents, or members of the community--with the same access and opportunities that are available to others. The guide explains legal requirements under the Americans with…

Expanding Library Services and Instruction Through LibGuides.

Science.gov (United States)

Ream, Tim; Parker-Kelly, Darlene

2016-01-01

Beginning in 2012, the Charles R. Drew University (CDU) Health Sciences Library used LibGuides in a number of innovative ways. Librarians constructed e-book databases, in-depth tutorials on technology-related topics, and web pages highlighting special events. To assess similar LibGuides innovation, CDU librarians developed an eight-question survey distributed to health sciences and hospital libraries throughout Southern California and Arizona. Results showed that libraries used LibGuides primarily to deliver access to online resources and to provide supplementary materials supporting instruction. Responses also revealed that many libraries had not yet adopted LibGuides. These findings were analyzed and compared to past and current LibGuides design at CDU.

Floral nectar guide patterns discourage nectar robbing by bumble bees.

Directory of Open Access Journals (Sweden)

Anne S Leonard

Full Text Available Floral displays are under selection to both attract pollinators and deter antagonists. Here we show that a common floral trait, a nectar guide pattern, alters the behavior of bees that can act opportunistically as both pollinators and as antagonists. Generally, bees access nectar via the floral limb, transporting pollen through contact with the plant's reproductive structures; however bees sometimes extract nectar from a hole in the side of the flower that they or other floral visitors create. This behavior is called "nectar robbing" because bees may acquire the nectar without transporting pollen. We asked whether the presence of a symmetric floral nectar guide pattern on artificial flowers affected bumble bees' (Bombus impatiens propensity to rob or access nectar "legitimately." We discovered that nectar guides made legitimate visits more efficient for bees than robbing, and increased the relative frequency of legitimate visits, compared to flowers lacking nectar guides. This study is the first to show that beyond speeding nectar discovery, a nectar guide pattern can influence bees' flower handling in a way that could benefit the plant.

Floral Nectar Guide Patterns Discourage Nectar Robbing by Bumble Bees

Science.gov (United States)

Leonard, Anne S.; Brent, Joshua; Papaj, Daniel R.; Dornhaus, Anna

2013-01-01

Floral displays are under selection to both attract pollinators and deter antagonists. Here we show that a common floral trait, a nectar guide pattern, alters the behavior of bees that can act opportunistically as both pollinators and as antagonists. Generally, bees access nectar via the floral limb, transporting pollen through contact with the plant’s reproductive structures; however bees sometimes extract nectar from a hole in the side of the flower that they or other floral visitors create. This behavior is called “nectar robbing” because bees may acquire the nectar without transporting pollen. We asked whether the presence of a symmetric floral nectar guide pattern on artificial flowers affected bumble bees’ (Bombus impatiens) propensity to rob or access nectar “legitimately.” We discovered that nectar guides made legitimate visits more efficient for bees than robbing, and increased the relative frequency of legitimate visits, compared to flowers lacking nectar guides. This study is the first to show that beyond speeding nectar discovery, a nectar guide pattern can influence bees’ flower handling in a way that could benefit the plant. PMID:23418475

Ultrasound-guided genitourinary interventions: principles and techniques

Directory of Open Access Journals (Sweden)

Byung Kwan Park

2017-10-01

Full Text Available Ultrasound (US is often used to guide various interventional procedures in the genitourinary (GU tract because it can provide real-time imaging without any radiation hazard. Moreover, US can clearly visualize the pathway of an aspiration or biopsy needle to ensure the safety of the intervention. US guidance also helps clinicians to access lesions via the transabdominal, transhepatic, transvaginal, transrectal, and transperineal routes. Hence, US-guided procedures are useful for radiologists who wish to perform GU interventions. However, US-guided procedures and interventions are difficult for beginners because they involve a steep initial learning curve. The purpose of this review is to describe the basic principles and techniques of US-guided GU interventions.

Ultrasound-guided genitourinary interventions: principles and techniques

Energy Technology Data Exchange (ETDEWEB)

Park, Byung Kwan [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2017-10-15

Ultrasound (US) is often used to guide various interventional procedures in the genitourinary (GU) tract because it can provide real-time imaging without any radiation hazard. Moreover, US can clearly visualize the pathway of an aspiration or biopsy needle to ensure the safety of the intervention. US guidance also helps clinicians to access lesions via the transabdominal, transhepatic, transvaginal, transrectal, and transperineal routes. Hence, US-guided procedures are useful for radiologists who wish to perform GU interventions. However, US-guided procedures and interventions are difficult for beginners because they involve a steep initial learning curve. The purpose of this review is to describe the basic principles and techniques of US-guided GU interventions.

PET-CT–Guided Surveillance of Head and Neck Cancers

Science.gov (United States)

Patients with advanced squamous cell carcinoma of the head and neck who underwent PET-CT–guided surveillance had fewer operations but similar overall survival rates to those of patients who underwent planned neck dissection.

Guide to a Strategic Procurement Planning Approach on Regulated Commodity Markets

Science.gov (United States)

Seifert, Marcus; Wüst, Thorsten

The access of Virtual Organizations to raw materials normally requires external resources. In many cases, the market for raw materials is regulated and the VO principles of trust, customer orientation etc. are not applicable. In consequence, the VO needs to provide reliable solutions for the customer while being dependent on the access to the required raw materials. The objective of the proposed paper is to present a guide to a strategic procurement planning for the manufacturing industry on regulated commodity markets. This guide can be used to evaluate specific sourcing options. The main goal of this guide is to identify the negative effects of market regulation at an early stage and reduce them by developing strategic alternatives. The successful application of this guide is demonstrated by the practical example of the refractory industry and one of their commodities, refractory grade bauxite.

Exploring Accessibility Scenarios for 2020 in Relation with Future ICT Trends on Assistive Technology and Accessibility

Directory of Open Access Journals (Sweden)

Adamantios Koumpis

2012-01-01

Full Text Available In this paper we are going to present a set of 5 future scenarios that were developed within the eAccessibility2020 study. The study aims to explore and analyse the referred relationships between the emerging ICT landscape, in the societal and economic context and the development and provision of assistive technologies (AT and e-Accessibility, within a perspective of 10 years. The scenarios were developed after an initial trend analysis that the study team conducted based on data gathering. The scenarios were developed based on a methodology which defined a set of guides for scenario development and a set of visions for the future of eAccessibility.

Accessing Your Health Information: How can I access my health information and medical records?

Science.gov (United States)

... from the doctor’s office. Visit the Guide to Getting & Using Your Health Records for practical tips to help you access, review, and make the most of your health records. Open Survey Content last reviewed on April 4, 2018 Was this page helpful? Yes No Form Approved OMB# 0990-0379 Exp. Date ...

75 FR 48382 - Draft Regulatory Guide: Issuance, Availability

Science.gov (United States)

2010-08-10

.... Introduction The U.S. Nuclear Regulatory Commission (NRC) is issuing for public comment a draft guide in the... provides text and image files of NRC's public documents. If you do not have access to ADAMS or if there are... analysis may be found in ADAMS under Accession No. ML101740327. Federal Rulemaking Web site: Public...

Enabling innovations in energy access: An African perspective

International Nuclear Information System (INIS)

Agbemabiese, Lawrence; Nkomo, Jabavu; Sokona, Youba

2012-01-01

Conventional energy technologies and deployment approaches cannot be relied upon to eliminate energy poverty in Africa. Innovations in energy access are necessary. Previous attempts at introducing and scaling up innovative solutions do not sufficiently address dynamic and structural determinants of success. This limits their actual performance as scalable drivers of innovations in technology, policy and institutions. Using technological innovation systems theory, we demonstrate a practical approach to assess the sustainability of innovations in energy access, and develop a framework to guide energy policy makers, clean energy entrepreneurs and energy-development researchers. - Highlights: ► Innovative technologies and policies are needed to expand energy access. ► TIS approach can guide the formulation and deployment of sustainable energy innovations. ► Learning by exploring and doing are the keys to entrepreneurial success. ► Lack of infrastructure and institutional frameworks are major barriers to innovations. ► Government intervention is needed to eliminate barriers to innovations.

A user's manual to the PMBOK guide

CERN Document Server

Stackpole Snyder, Cynthia

2013-01-01

The must-have manual to understand and use the latest edition of the Fifth Edition The professional standard in the field of project management, A Guide to the Project Management Body of Knowledge (PMBOK® Guide-Fifth Edition) published by the Project Management Institute (PMI) serves as the ultimate resource for professionals and as a valuable studying and training device for students taking the PMP® Exam. A User''s Manual to the PMBOK® Guide takes the next logical step to act as a true user''s manual. With an accessible format and easy-to-understand language, it helps to not only distill es

Single-operator EUS-guided cholangiopancreatography for difficult pancreaticobiliary access (with video).

Science.gov (United States)

Brauer, Brian C; Chen, Yang K; Fukami, Norio; Shah, Raj J

2009-09-01

When conventional ERCP methods fail because of periampullary or ductal obstruction, EUS-guided cholangiopancreatography (EUS-CP) may aid in pancreaticobiliary access. To report our experience when using single-operator EUS-CP. An academic tertiary-referral center. Consecutive patients undergoing EUS-CP were prospectively identified. These patients had undergone failed attempt(s) at therapeutic ERCP. A data sheet was used to record indications, reasons for failed ERCP, EUS-CP visualization of the duct of interest, transpapillary or transenteric intervention, clinical follow-up, and complications. Technical success was decompression of the duct of interest. Clinical success was resolution of jaundice or a > or = 50% reduction in pain or narcotics, as applicable. Between February 2003 and June 2007, EUS-CP was attempted in 20 patients (11 men, 9 women; mean [SD] age 58 +/- 14.9 years). Indications included jaundice (n = 8), biliary stones (n = 3), chronic pancreatitis (n = 6), acute pancreatitis (n = 2), and papillary stenosis (n = 1). Reasons for failed ERCP included periampullary mass (n = 8), intradiverticular papillae (n = 4), and pancreatic duct (PD) stricture (n = 7) or stone (n = 1). Technical success was achieved in 18 of 20 patients (90%). Biliary decompression was obtained in 11 of 12 patients (92%) (7 transpapillary and 4 transenteric-transcholedochal). Pancreatic decompression was obtained in 7 of 8 patients (88%) (3 transpapillary, 4 transgastric). On follow-up, clinical improvement was noted in 15 of 20 patients (70%). For treatment of pain associated with chronic pancreatitis, pain scores decreased by a mean of 1.75 (P = .18). Complications (in 2 of 20 [10%]) included perforation (n = 1) and respiratory failure (n = 1). A single-center nonrandomized observational study with a small patient population. At our academic referral center, single-operator EUS-CP provided decompression of obstructed ducts and may be performed after a failed attempt at

Cancer survival among Alaska Native people.

Science.gov (United States)

Nash, Sarah H; Meisner, Angela L W; Zimpelman, Garrett L; Barry, Marc; Wiggins, Charles L

2018-03-26

Recent cancer survival trends among American Indian and Alaska Native (AN) people are not well understood; survival has not been reported among AN people since 2001. This study examined cause-specific survival among AN cancer patients for lung, colorectal, female breast, prostate, and kidney cancers. It evaluated whether survival differed between cancers diagnosed in 1992-2002 (the earlier period) and cancers diagnosed in 2003-2013 (the later period) and by the age at diagnosis (<65 vs ≥65 years), stage at diagnosis (local or regional/distant/unknown), and sex. Kaplan-Meier and Cox proportional hazards models were used to estimate univariate and multivariate-adjusted cause-specific survival for each cancer. An improvement was observed in 5-year survival over time from lung cancer (hazard ratio [HR] for the later period vs the earlier period, 0.83; 95% confidence interval [CI], 0.72-0.97), and a marginally nonsignificant improvement was observed for colorectal cancer (HR, 0.81; 95% CI, 0.66-1.01). Site-specific differences in survival were observed by age and stage at diagnosis. This study presents the first data on cancer survival among AN people in almost 2 decades. During this time, AN people have experienced improvements in survival from lung and colorectal cancers. The reasons for these improvements may include increased access to care (including screening) as well as improvements in treatment. Improving cancer survival should be a priority for reducing the burden of cancer among AN people and eliminating cancer disparities. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

Support Services for Remote Users of Online Public Access Catalogs.

Science.gov (United States)

Kalin, Sally W.

1991-01-01

Discusses the needs of remote users of online public access catalogs (OPACs). User expectations are discussed; problems encountered by remote-access users are examined, including technical problems and searching problems; support services are described, including instruction, print guides, and online help; and differences from the needs of…

Survival of enteric pathogens in common beverages: an in vitro study.

Science.gov (United States)

Sheth, N K; Wisniewski, T R; Franson, T R

1988-06-01

This in vitro study was undertaken to determine the potential for survival of enteric pathogens in common drinking beverages. Three carbonated soft drinks, two alcoholic beverages, skim milk, and water were inoculated with Salmonella, Shigella, and enterotoxigenic Escherichia coli, and quantitative counts were performed over 2 days. Our studies showed poorest survival of all three organisms in wine, and greatest growth in milk and water. Beer and cola allowed survival of small numbers of Salmonella and E. coli at 48 h, whereas sour mix and diet cola were sterile by 48 h. Survival features may correlate with pH of the beverages. These observations may be useful in guiding travellers for appropriate beverage consumption while visiting areas endemic for "traveller's diarrhea."

Survival after Radiofrequency Ablation in 122 Patients with Inoperable Colorectal Lung Metastases

Energy Technology Data Exchange (ETDEWEB)

Gillams, Alice, E-mail: alliesorting@gmail.com [The London Clinic, Radiology Department (United Kingdom); Khan, Zahid [Countess of Chester Hospital (United Kingdom); Osborn, Peter [Queen Alexandra Hospital (United Kingdom); Lees, William [University College London Medical School (United Kingdom)

2013-06-15

Purpose. To analyze the factors associated with favorable survival in patients with inoperable colorectal lung metastases treated with percutaneous image-guided radiofrequency ablation. Methods. Between 2002 and 2011, a total of 398 metastases were ablated in 122 patients (87 male, median age 68 years, range 29-90 years) at 256 procedures. Percutaneous CT-guided cool-tip radiofrequency ablation was performed under sedation/general anesthesia. Maximum tumor size, number of tumors ablated, number of procedures, concurrent/prior liver ablation, previous liver or lung resection, systemic chemotherapy, disease-free interval from primary resection to lung metastasis, and survival from first ablation were recorded prospectively. Kaplan-Meier analysis was performed, and factors were compared by log rank test. Results. The initial number of metastases ablated was 2.3 (range 1-8); the total number was 3.3 (range 1-15). The maximum tumor diameter was 1.7 (range 0.5-4) cm, and the number of procedures was 2 (range 1-10). The major complication rate was 3.9 %. Overall median and 3-year survival rate were 41 months and 57 %. Survival was better in patients with smaller tumors-a median of 51 months, with 3-year survival of 64 % for tumors 2 cm or smaller versus 31 months and 44 % for tumors 2.1-4 cm (p = 0.08). The number of metastases ablated and whether the tumors were unilateral or bilateral did not affect survival. The presence of treated liver metastases, systemic chemotherapy, or prior lung resection did not affect survival. Conclusion. Three-year survival of 57 % in patients with inoperable colorectal lung metastases is better than would be expected with chemotherapy alone. Patients with inoperable but small-volume colorectal lung metastases should be referred for ablation.

EUA's Open Access Checklist for Universities: A Practical Guide on Implementation

Science.gov (United States)

Morais, Rita; Lourenço, Joana; Smith, John H.; Borrell-Damian, Lidia

2015-01-01

Open Access (OA) to research publications has received increased attention from the academic community, scientific publishers, research funding agencies and governments. This movement has been growing exponentially in recent years, both in terms of the increasing number of Open Access journals and the proliferation of policies on this topic. The…

Recent Ultrasonic Guided Wave Inspection Development Efforts

International Nuclear Information System (INIS)

Rose, Joseph L.; Tittmann, Bernhard R.

2001-01-01

The recognition of such natural wave guides as plates, rods, hollow cylinders, multi-layer structures or simply an interface between two materials combined with an increased understanding of the physics and wave mechanics of guided wave propagation has led to a significant increase in the number of guided wave inspection applications being developed each year. Of primary attention Is the ability to inspect partially hidden structures, hard to access areas, and treated or insulated structures. An introduction to some physical consideration of guided waves followed by some sample problem descriptions in pipe, ice detection, fouling detection in the foods industry, aircraft, tar coated structures and acoustic microscopy is presented in this paper. A sample problem in Boundary Element Modeling is also presented to illustrate the move in guided wave analysis beyond detection and location analysis to quantification

DOE interpretations Guide to OSH standards. Update to the Guide

Energy Technology Data Exchange (ETDEWEB)

1994-03-31

Reflecting Secretary O`Leary`s focus on occupational safety and health, the Office of Occupational Safety is pleased to provide you with the latest update to the DOE Interpretations Guide to OSH Standards. This Guide was developed in cooperation with the Occupational Safety and Health Administration, which continued it`s support during this last revision by facilitating access to the interpretations found on the OSHA Computerized Information System (OCIS). This March 31, 1994 update contains 123 formal in letter written by OSHA. As a result of the unique requests received by the 1-800 Response Line, this update also contains 38 interpretations developed by DOE. This new occupational safety and health information adds still more important guidance to the four volume reference set that you presently have in your possession.

DOE interpretations Guide to OSH standards. Update to the Guide

Energy Technology Data Exchange (ETDEWEB)

1994-03-31

Reflecting Secretary O`Leary`s focus on occupational safety and health, the Office of Occupational Safety is pleased to provide you with the latest update to the DOE Interpretations Guide to OSH Standards. This Guide was developed in cooperation with the Occupational Safety and Health Administration, which continued its support during this last revision by facilitating access to the interpretations found on the OSHA Computerized Information System (OCIS). This March 31, 1994 update contains 123 formal interpretation letters written by OSHA. As a result of the unique requests received by the 1-800 Response Line, this update also contains 38 interpretations developed by DOE. This new occupational safety and health information adds still more important guidance to the four volume reference set that you presently have in your possession.

DOE interpretations Guide to OSH standards. Update to the Guide

Energy Technology Data Exchange (ETDEWEB)

1994-03-31

Reflecting Secretary O`Leary`s focus on occupational safety and health, the Office of Occupational Safety is pleased to provide you with the latest update to the DOE Interpretations Guide to OSH Standards. This Guide was developed in cooperation with the Occupational Safety and Health Administration, which continued its support during this last revision by facilitating access to the interpretations found on the OSHA Computerized Information System (OCIS). This March 31, 1994 update contains 123 formal interpretation letters written OSHA. As a result of the unique requests received by the 1-800 Response Line, this update also contains 38 interpretations developed by DOE. This new occupational safety and health information adds still more important guidance to the four volume reference set that you presently have in your possession.

Subarachnoid and basal cistern navigation through the sacral hiatus with guide wire assistance.

Science.gov (United States)

Layer, Lauren; Riascos, Roy; Firouzbakht, Farhood; Amole, Adewumi; Von Ritschl, Rudiger; Dipatre, Pier; Cuellar, Hugo

2011-07-01

Intraspinal navigation with catheters and fiberscopes has shown feasible results for diagnosis and treatment of intraspinal and intracranial lesions. The most common approach, lumbar puncture, has allowed access to the spinal cord, however, coming with the difficulties of fiberscope damage and decreased torque for guidance. Our objective in this study is to allow an alternate access, the sacral hiatus, with guide wire assistance into the subarachnoid and intracranial structures, while easing the angle of entry and increasing torque. We advanced catheters with guide wire and fluoroscopy assistance into the sacral hiatus of three cadavers. After entry, the thecal sac was punctured and the catheter with guide wire was advanced rostrally until positioned in the basal cisterns of the brain. We confirmed catheter placement with contrast injection, autopsy, and dissection. In our study, the sacral hiatus was easily accessed, but resistance was found when attempting to puncture the thecal sac. The advancement of the catheter with guide wire assistance glided easily rostrally until some mild resistance was discovered at entry into the foramen magnum. With redirection, all catheters passed with ease into the basal cisterns. Positioning was confirmed with contrast injection with fluoroscopy evidence, autopsy, and dissection. There was no macroscopic or microscopic evidence of damage to the spinal roots, spinal cord, or cranial nerves. The sacral hiatus with guide wire assistance is an accessible conduit for uncomplicated entry into the subarachnoid and basal cistern space without damaging surrounding structures.

The INCA trial (Impact of NOD2 genotype-guided antibiotic prevention on survival in patients with liver Cirrhosis and Ascites): study protocol for a randomized controlled trial.

Science.gov (United States)

Casper, Markus; Mengel, Martin; Fuhrmann, Christine; Herrmann, Eva; Appenrodt, Beate; Schiedermaier, Peter; Reichert, Matthias; Bruns, Tony; Engelmann, Cornelius; Grünhage, Frank; Lammert, Frank

2015-03-08

Patients with liver cirrhosis have a highly elevated risk of developing bacterial infections that significantly decrease survival rates. One of the most relevant infections is spontaneous bacterial peritonitis (SBP). Recently, NOD2 germline variants were found to be potential predictors of the development of infectious complications and mortality in patients with cirrhosis. The aim of the INCA (Impact of NOD2 genotype-guided antibiotic prevention on survival in patients with liver Cirrhosis and Ascites) trial is to investigate whether survival of this genetically defined high-risk group of patients with cirrhosis defined by the presence of NOD2 variants is improved by primary antibiotic prophylaxis of SBP. The INCA trial is a double-blind, placebo-controlled clinical trial with two parallel treatment arms (arm 1: norfloxacin 400 mg once daily; arm 2: placebo once daily; 12-month treatment and observational period). Balanced randomization of 186 eligible patients with stratification for the protein content of the ascites (INCA trial is first in the field of hepatology aimed at rapidly transferring and validating information on individual genetic risk into clinical decision algorithms. German Clinical Trials Register DRKS00005616 . Registered 22 January 2014. EU Clinical Trials Register EudraCT 2013-001626-26 . Registered 26 January 2015.

National Audubon Society Specials. Teacher's Guide I.

Science.gov (United States)

WETA - TV, Washington, DC.

Since no civilization can survive without a healthy environment, people must learn to live in harmony with their natural ecosystems and build for future generations. This guide describes six award-winning programs on the condor, black-footed ferret, panthers and cheetahs, ducks, farming and wildlife, and the Galapagos Islands. Although each…

Influenza pandemic planning guide

Energy Technology Data Exchange (ETDEWEB)

NONE

2006-11-15

An influenza pandemic will have serious economic impacts on the natural gas industry due to absenteeism as well as downstream effects due to supply disruption.This guide was prepared to assist gas distribution companies in planning for an influenza epidemic. The guide aimed to minimize the risks that an influenza pandemic might pose to the health and safety of employees and the continuity of business operations. The guide discussed 5 critical aspects of emergency planning: (1) prevention and threat mitigation; (2) preparedness; (3) response; (4) business continuity; and (5) communication. The legal context of the emergency plans were discussed. The plans were also discussed to other essential infrastructure emergency response plans. Recommendations were presented for infection control, decentralization and access restriction. Outlines for pandemic response planning teams and training and exercise programs were provided. Issues related to alert, mobilization, and response procedures were also discussed. 10 refs., 3 tabs., 1 fig.

A Comparative Study on Java Technologies for Focus and Cursor Handling in Accessible Dynamic Interactions.

Science.gov (United States)

Jitngernmadan, Prajaks; Miesenberger, Klaus

2015-01-01

For an interactive application, supporting and guiding the user in fulfilling tasks is most important. The behavior of the application that will guide users through the procedures until they finish the task has to be designed intuitively and well guiding, especially if the users has only restricted or no access to the visual and spatial arrangement on the screen. Therefore, the focus/cursor management plays an important role for orientation and navigating through the interaction. In the frame of ongoing research on a software tool supporting blind people in more efficiently doing mathematical calculations, we researched how Java technologies support implementing an accessible Graphical User Interface (GUI) with an additional focus on usable accessibility in terms of guiding blind users through the process of solving mathematical calculations. We used Java Swing [1] and Eclipse SWT [2] APIs for creating a series of prototypes. We tested a) accessibility and usability of the prototypes for blind people when using screen reader software and refreshable Braille display and b) the implementation support to developers provided by both technologies. It turned out that Eclipse SWT API delivered best results under Windows operating system.

Magnesium 1993 Maternal-Fetal Toxicology. A Clinician's Guide ...

African Journals Online (AJOL)

I S I G I 0 I M I. Maternal-Fetal Toxicology. A Clinician's. Guide. 2nd edition. Ed. by Gideon Koren. Pp. 824 ... analysis is presented, and survival curve ideas for effects over time. Final chapters ... SPSS-PC+, SAS and Nanostat. Several important.

Open Access to essential health care information

Directory of Open Access Journals (Sweden)

Pandey Manoj

2004-12-01

Full Text Available Abstract Open Access publishing is a valuable resource for the synthesis and distribution of essential health care information. This article discusses the potential benefits of Open Access, specifically in terms of Low and Middle Income (LAMI countries in which there is currently a lack of informed health care providers – mainly a consequence of poor availability to information. We propose that without copyright restrictions, Open Access facilitates distribution of the most relevant research and health care information. Furthermore, we suggest that the technology and infrastructure that has been put in place for Open Access could be used to publish download-able manuals, guides or basic handbooks created by healthcare providers in LAMI countries.

Virtual Library: Providing Accessible Online Resources.

Science.gov (United States)

Kelly, Rob

2001-01-01

Describes e-global library, a virtual library based on the Jones International University's library that organizes Internet resources to make them more accessible to students at all skill levels. Highlights include online tutorials; research guides; financial aid and career development information; and possible partnerships with other digital…

Endoscopic Ultrasound Guided Rendezvous Drainage of Biliary Obstruction Using a New Flexible 19-Gauge Fine Needle Aspiration Needle.

Science.gov (United States)

Tang, Zhouwen; Igbinomwanhia, Efehi; Elhanafi, Sherif; Othman, Mohamed O

2016-01-01

Background and Aim. A successful endoscopic ultrasound guided rendezvous (EUS-RV) biliary drainage is dependent on accurate puncture of the bile duct and precise guide wire manipulation across the ampulla of Vater. We aim to study the feasibility of using a flexible 19-gauge fine aspiration needle in the performance of EUS-RV biliary drainage. Method. This is a retrospective case series of EUS-RV biliary drainage procedures at a single center. Patients who failed ERCP during the same session for benign or malignant biliary obstruction underwent EUS-RV using a flexible, nitinol covered, 19-gauge needle for biliary access and guide wire manipulation. Result. 24 patients underwent EUS-RV biliary drainage via extrahepatic access while 1 attempt was via intrahepatic access. The technical success rate was 80%, including 83.3% of cases via extrahepatic access. There was no significant difference in success rate of inpatient and outpatient procedures, benign or malignant indications, or type of guide wire used. Adverse events included mild pancreatitis (3 patients) and cholangitis (1 patient). Conclusion. A flexible 19-gauge needle for biliary access can be safe and effective when used to perform EUS-RV biliary drainage. Direct comparison between the nitinol needle and conventional metal needles in the performance of EUS guided biliary drainage is needed.

User's guide for remote access of the Performance Assessment Center

International Nuclear Information System (INIS)

Peterson, C.R.; Kostelnik, K.M.

1991-03-01

The Performance Assessment Center (PAC) was established by the Department of Energy's National Low-Level Waste Management Program to provide technical assistance to support the development of low-level radioactive waste disposal facilities. This user's manual provides guidance to remote users of the PAC. Information is presented on how remote users may most effectively access and use the systems available at the Performance Assessment Center in Idaho Falls, Idaho. Access requirements and operating procedures are presented to assist the first-time PAC user. This manual also provides brief descriptions of each code available on the system

Ultrasonic guided waves in eccentric annular pipes

International Nuclear Information System (INIS)

Pattanayak, Roson Kumar; Balasubramaniam, Krishnan; Rajagopal, Prabhu

2014-01-01

This paper studies the feasibility of using ultrasonic guided waves to rapidly inspect tubes and pipes for possible eccentricity. While guided waves are well established in the long range inspection of structures such as pipes and plates, studies for more complex cross sections are limited and analytical solutions are often difficult to obtain. Recent developments have made the Semi Analytical Finite Element (SAFE) method widely accessible for researchers to study guided wave properties in complex structures. Here the SAFE method is used to study the effect of eccentricity on the modal structures and velocities of lower order guided wave modes in thin pipes of diameters typically of interest to the industry. Results are validated using experiments. The paper demonstrates that even a small eccentricity in the pipe can strongly affect guided wave mode structures and velocities and hence shows potential for pipe eccentricity inspection

A Guide to Help Consumers Choose Apps and Avoid App Overload

Science.gov (United States)

Schuster, Ellen; Zimmerman, Lynda

2014-01-01

Mobile technology has transformed the way consumers access and use information. The exponential growth of mobile apps makes finding suitable, easy-to-use nutrition and health-related apps challenging. A guide for consumers helps them ask important questions before downloading apps. The guide can be adapted for other Extension disciplines.

Violence Prevention, Access to Justice, and Economic ...

International Development Research Centre (IDRC) Digital Library (Canada)

Solutions to empower women, reduce violence Researchers will identify and analyze interventions in Colombia, Guatemala, Mexico, and Peru. They will assess the impact of efforts on: -preventing violence against women -reducing victimization -improving women's access to justice The results will guide governments, civil ...

SPORTS (version 1) user's guide

International Nuclear Information System (INIS)

Chatoorgoon, V.; Thibeault, P.R.

1985-06-01

SPORTS is a transient one-dimensional thermalhydraulic code formulated from the non-linear time dependent conservation equations and designed to investigate two-phase flow stability. The SPORTS Users' Guide contains some features of the code, a brief description of the program environment and access, and a description of the input data complete with a sample problem

Procedures can be learned on the Web: a randomized study of ultrasound-guided vascular access training.

Science.gov (United States)

Chenkin, Jordan; Lee, Shirley; Huynh, Thien; Bandiera, Glen

2008-10-01

Web-based learning has several potential advantages over lectures, such as anytime-anywhere access, rich multimedia, and nonlinear navigation. While known to be an effective method for learning facts, few studies have examined the effectiveness of Web-based formats for learning procedural skills. The authors sought to determine whether a Web-based tutorial is at least as effective as a didactic lecture for learning ultrasound-guided vascular access (UGVA). Participating staff emergency physicians (EPs) and junior emergency medicine (EM) residents with no UGVA experience completed a precourse test and were randomized to either a Web-based or a didactic group. The Web-based group was instructed to use an online tutorial and the didactic group attended a lecture. Participants then practiced on simulators and live models without any further instruction. Following a rest period, participants completed a four-station objective structured clinical examination (OSCE), a written examination, and a postcourse questionnaire. Examination results were compared using a noninferiority data analysis with a 10% margin of difference. Twenty-one residents and EPs participated in the study. There were no significant differences in mean OSCE scores (absolute difference = -2.8%; 95% confidence interval [CI] = -9.3% to 3.8%) or written test scores (absolute difference = -1.4%; 95% CI = -7.8% to 5.0%) between the Web group and the didactic group. Both groups demonstrated similar improvements in written test scores (26.1% vs. 25.8%; p = 0.95). Ninety-one percent (10/11) of the Web group and 80% (8/10) of the didactic group participants found the teaching format to be effective (p = 0.59). Our Web-based tutorial was at least as effective as a traditional didactic lecture for teaching the knowledge and skills essential for UGVA. Participants expressed high satisfaction with this teaching technology. Web-based teaching may be a useful alternative to didactic teaching for learning procedural

PET/CT scanning guided intensity-modulated radiotherapy in treatment of recurrent ovarian cancer

Energy Technology Data Exchange (ETDEWEB)

Du, Xue-lian, E-mail: duxuelian23800@yahoo.com.cn [Department of Gynecologic Oncology, Shandong Cancer Hospital, Jinan 250117 (China); Shandong Academy of Medical Science, Jinan 250012 (China); Jiang, Tao, E-mail: melody23800@yahoo.com.cn [Department of Gynecologic Oncology, Shandong Cancer Hospital, Jinan 250117 (China); Shandong Academy of Medical Science, Jinan 250012 (China); Sheng, Xiu-gui, E-mail: jnsd2000@yahoo.cn [Department of Gynecologic Oncology, Shandong Cancer Hospital, Jinan 250117 (China); Shandong Academy of Medical Science, Jinan 250012 (China); Li, Qing-shui, E-mail: lqs1966@126.com [Department of Gynecologic Oncology, Shandong Cancer Hospital, Jinan 250117 (China); Shandong Academy of Medical Science, Jinan 250012 (China); Wang, Cong, E-mail: jnwc1981@hotmail.com [Department of Gynecologic Oncology, Shandong Cancer Hospital, Jinan 250117 (China); Shandong Academy of Medical Science, Jinan 250012 (China); Yu, Hao, E-mail: jnyh2200@sina.com [Department of Gynecologic Oncology, Shandong Cancer Hospital, Jinan 250117 (China); Shandong Academy of Medical Science, Jinan 250012 (China)

2012-11-15

Objective: This study was undertaken to evaluate the clinical contribution of positron emission tomography using {sup 18}F-fluorodeoxyglucose and integrated computer tomography (FDG-PET/CT) guided intensity-modulated radiotherapy (IMRT) for treatment of recurrent ovarian cancer. Materials and methods: Fifty-eight patients with recurrent ovarian cancer from 2003 to 2008 were retrospectively studied. In these patients, 28 received PET/CT guided IMRT (PET/CT-IMRT group), and 30 received CT guided IMRT (CT-IMRT group). Treatment plans, tumor response, toxicities and survival were evaluated. Results: Changes in GTV delineation were found in 10 (35.7%) patients based on PET-CT information compared with CT data, due to the incorporation of additional lymph node metastases and extension of the metastasis tumor. PET/CT guided IMRT improved tumor response compared to CT-IMRT group (CR: 64.3% vs. 46.7%, P = 0.021; PR: 25.0% vs. 13.3%, P = 0.036). The 3-year overall survival was significantly higher in the PET-CT/IMRT group than control (34.1% vs. 13.2%, P = 0.014). Conclusions: PET/CT guided IMRT in recurrent ovarian cancer patients improved the delineation of GTV and reduce the likelihood of geographic misses and therefore improve the clinical outcome.

Starting a Second Chance Home: A Guide for Policymakers and Practitioners.

Science.gov (United States)

Reich, Kathy; Kelly, Lisa M.

This guide outlines 10 basic steps for policymakers and practitioners interested in creating Second Chance Homes in their areas. Second Chance Homes provide stable, nurturing environments for teen families with access to child care, education, job training, counseling, and advice on parenting and life skills. The guide is based on interviews with…

Cancer survival for Aboriginal and Torres Strait Islander Australians: a national study of survival rates and excess mortality.

Science.gov (United States)

Condon, John R; Zhang, Xiaohua; Baade, Peter; Griffiths, Kalinda; Cunningham, Joan; Roder, David M; Coory, Michael; Jelfs, Paul L; Threlfall, Tim

2014-01-31

National cancer survival statistics are available for the total Australian population but not Indigenous Australians, although their cancer mortality rates are known to be higher than those of other Australians. We aimed to validate analysis methods and report cancer survival rates for Indigenous Australians as the basis for regular national reporting. We used national cancer registrations data to calculate all-cancer and site-specific relative survival for Indigenous Australians (compared with non-Indigenous Australians) diagnosed in 2001-2005. Because of limited availability of Indigenous life tables, we validated and used cause-specific survival (rather than relative survival) for proportional hazards regression to analyze time trends and regional variation in all-cancer survival between 1991 and 2005. Survival was lower for Indigenous than non-Indigenous Australians for all cancers combined and for many cancer sites. The excess mortality of Indigenous people with cancer was restricted to the first three years after diagnosis, and greatest in the first year. Survival was lower for rural and remote than urban residents; this disparity was much greater for Indigenous people. Survival improved between 1991 and 2005 for non-Indigenous people (mortality decreased by 28%), but to a much lesser extent for Indigenous people (11%) and only for those in remote areas; cancer survival did not improve for urban Indigenous residents. Cancer survival is lower for Indigenous than other Australians, for all cancers combined and many individual cancer sites, although more accurate recording of Indigenous status by cancer registers is required before the extent of this disadvantage can be known with certainty. Cancer care for Indigenous Australians needs to be considerably improved; cancer diagnosis, treatment, and support services need to be redesigned specifically to be accessible and acceptable to Indigenous people.

[Fistulae or catheter for elderly who start hemodialysis without permanent vascular access?].

Science.gov (United States)

García Cortés, Ma J; Viedma, G; Sánchez Perales, M C; Borrego, F J; Borrego, J; Pérez del Barrio, P; Gil Cunquero, J M; Liébana, A; Pérez Bañasco, V

2005-01-01

Autologous access is the best vascular access for dialysis also in older patients and it should be mature when patient needs hemodialysis. It is not always possible. Surgeon availability and demographic characteristics of patients (age, diabetes, vascular disease...) are factors that determine primary vascular access. To analyse outcome and vascular access complications in elderly who start hemodialysis without vascular access. All patients older than 75 years who initiated hemodialysis without vascular access between January 2000 and June 2002 were included, They were divided en two groups depending on primary vascular access. GI: arterio-venous fistulae. GIIl: Tunnelled cuffed catheter. Epidemiological and analytical data, vascular access complications related, as well as patient and first permanent vascular access survival from their inclusion in dialysis up to December 2002 were analysed and compared in both groups. 32 patients were studied. GI: n = 17 (4 men) and GIIl: n =1 5 (8 men), age: 79.9 +/- 3.8 and 81.7 +/- 4 years respectively (ns). There were no differences in sex and comorbidity (diabetes, ischemic heart disease, peripheral vascular disease and hypertension). It took GI 3 months to get a permanent vascular access suitable for using, while it took GIIl 1.3 months (p catheters was higher in GI (3.35 vs 1.87 p central venous thrombosis happen in GI (I: 25 CVT/100 patients-year) vs 30% in GIIl (I = 14.4/100 patients-year) (ns). No significant differences neither in bleeding (66.7% vs 33.3%) nor ischemia (75% vs 25%) were found. Dialysis dose (Kt/V) as well as anaemia degree were similar in both groups. Permanent vascular access survival after 2 years was 45.8% in GI and 24% in GII (ns). Patient survival was similar in GI and GII (72% vs 51% ns). Elderly who start hemodialysis without vascular access took longer to get a suitable permanent vascular access when arterio-venous fistulae is placed than with a tunnelled cuffed hemodialysis catheter. As a

Estimates for the probability of survival of electrons in passing through a radiator

International Nuclear Information System (INIS)

Loos, J.

1977-01-01

Some calculations on the survival of electrons passing through various radiator thicknesses are tabulated. The results of these calculations should serve as a guide for expected attenuation of electrons in the beam when various Pb radiators are inserted

Comptia Network+ review guide exam N10-006

CERN Document Server

Ferguson, Bill

2015-01-01

Be prepared for the Network+ exam CompTIA Network+ Review Guide is your ideal study companion for preparing for the CompTIA Network+ exam (N10-006). This concise review is the perfect companion to the CompTIA Network+ Study Guide and the CompTIA Network+ Deluxe Study Guide, with full exam coverage organized by objective for quick review and reinforcement of key topics. Each of the book's five parts is devoted to a specific domain area of the exam, providing a focused review to bolster areas of weak understanding. You get access to the Sybex test engine, which includes two bonus practice tests

Modifying the Heysham 2 and Torness guide tubes

International Nuclear Information System (INIS)

Salter, I.D.

1988-01-01

In 1986 the National Nuclear Corporation carried out the unfuelled engineering run on Torness Reactor One. Subsequent inspection revealed wear on the reactor control rods, following severe spinning caused by gas cross flow swirls at the guide tube castellated ring. The adopted solution was to machine 32 radial holes through the guide tube wall and blank off the existing castellated slots, however, man access to the guide tubes is extremely difficult. This paper describes how Taylor Hitec produced, in only 12 weeks, three remote drilling machines, together with associated debris collection systems, cleaning equipment and remote video/CCTV inspection systems, and then carried out the modifications to the reactors. (author)

Analysis of survival data with dependent censoring copula-based approaches

CERN Document Server

Emura, Takeshi

2018-01-01

This book introduces readers to copula-based statistical methods for analyzing survival data involving dependent censoring. Primarily focusing on likelihood-based methods performed under copula models, it is the first book solely devoted to the problem of dependent censoring. The book demonstrates the advantages of the copula-based methods in the context of medical research, especially with regard to cancer patients’ survival data. Needless to say, the statistical methods presented here can also be applied to many other branches of science, especially in reliability, where survival analysis plays an important role. The book can be used as a textbook for graduate coursework or a short course aimed at (bio-) statisticians. To deepen readers’ understanding of copula-based approaches, the book provides an accessible introduction to basic survival analysis and explains the mathematical foundations of copula-based survival models.

Association of Distance From a Transplant Center With Access to Waitlist Placement, Receipt of Liver Transplantation, and Survival Among US Veterans

Science.gov (United States)

Goldberg, David S.; French, Benjamin; Forde, Kimberly A.; Groeneveld, Peter W.; Bittermann, Therese; Backus, Lisa; Halpern, Scott D.; Kaplan, David E.

2015-01-01

IMPORTANCE Centralization of specialized health care services such as organ transplantation and bariatric surgery is advocated to improve quality, increase efficiency, and reduce cost. The effect of increased travel on access and outcomes from these services is not fully understood. OBJECTIVE To evaluate the association between distance from a Veterans Affairs (VA) transplant center (VATC) and access to being waitlisted for liver transplantation, actually having a liver transplant, and mortality. DESIGN, SETTING, AND PARTICIPANTS Retrospective study of veterans meeting liver transplantation eligibility criteria from January 1, 2003, until December 31, 2010, using data from the Veterans Health Administration’s integrated, national, electronic medical record linked to Organ Procurement and Transplantation Network data. MAIN OUTCOMES AND MEASURES The primary outcome was being waitlisted for transplantation at a VATC. Secondary outcomes included being waitlisted at any transplant center, undergoing a transplantation, and survival. RESULTS From 2003–2010, 50 637 veterans were classified as potentially eligible for transplant; 2895 (6%) were waitlisted and 1418 of those were waitlisted (49%) at 1 of the 5 VATCs. Of 3417 veterans receiving care at a VA hospital located within 100 miles from a VATC, 244 (7.1%) were waitlisted at a VATC and 372 (10.9%) at any transplant center (VATC and non-VATCs). Of 47 219 veterans receiving care at a VA hospital located more than 100 miles from a VATC, 1174 (2.5%) were waitlisted at a VATC and 2523 (5.3%) at any transplant center (VATC and non-VATCs). In multivariable models, increasing distance to closest VATC was associated with significantly lower odds of being waitlisted at a VATC (odds ratio [OR], 0.91 [95% CI, 0.89–0.93] for each doubling in distance) or any transplant center (OR, 0.94 [95% CI, 0.92–0.96] for each doubling in distance). For example, a veteran living 25 miles from a VATC would have a 7.4% (95% CI, 6.6%–8

Users' guide to system dynamics model describing Coho salmon survival in Olema Creek, Point Reyes National Seashore, Marin County, California

Science.gov (United States)

Woodward, Andrea; Torregrosa, Alicia; Madej, Mary Ann; Reichmuth, Michael; Fong, Darren

2014-01-01

The system dynamics model described in this report is the result of a collaboration between U.S. Geological Survey (USGS) scientists and National Park Service (NPS) San Francisco Bay Area Network (SFAN) staff, whose goal was to develop a methodology to integrate inventory and monitoring data to better understand ecosystem dynamics and trends using salmon in Olema Creek, Marin County, California, as an example case. The SFAN began monitoring multiple life stages of coho salmon (Oncorhynchus kisutch) in Olema Creek during 2003 (Carlisle and others, 2013), building on previous monitoring of spawning fish and redds. They initiated water-quality and habitat monitoring, and had access to flow and weather data from other sources. This system dynamics model of the freshwater portion of the coho salmon life cycle in Olema Creek integrated 8 years of existing monitoring data, literature values, and expert opinion to investigate potential factors limiting survival and production, identify data gaps, and improve monitoring and restoration prescriptions. A system dynamics model is particularly effective when (1) data are insufficient in time series length and/or measured parameters for a statistical or mechanistic model, and (2) the model must be easily accessible by users who are not modelers. These characteristics helped us meet the following overarching goals for this model: Summarize and synthesize NPS monitoring data with data and information from other sources to describe factors and processes affecting freshwater survival of coho salmon in Olema Creek. Provide a model that can be easily manipulated to experiment with alternative values of model parameters and novel scenarios of environmental drivers. Although the model describes the ecological dynamics of Olema Creek, these dynamics are structurally similar to numerous other coastal streams along the California coast that also contain anadromous fish populations. The model developed for Olema can be used, at least as a

Access to the Superficial Femoral Artery in the Presence of a 'Hostile Groin': A Prospective Study

International Nuclear Information System (INIS)

Marcus, Adrian J.; Lotzof, Kevin; Howard, Adam

2007-01-01

Purpose. Lower limb angioplasty is commonly performed via antegrade common femoral artery (CFA) puncture, followed by selective superficial femoral artery (SFA) catheterization. Arterial access can be complicated by a 'hostile groin' (scarring, obesity, or previous failed CFA puncture). We prospectively investigated color duplex ultrasound (CDU)-guided SFA access for radiological interventions. Methods. Antegrade CDU-guided CFA and SFA puncture were compared in 30 patients requiring intervention for severe leg ischemia who had hostile groins. Demographics, screen time, radiation dose, intervention, and complications were prospectively recorded. Results. Treatment in 30 patients involved 44 angioplasties (40 transluminal, 4 subintimal) and 2 diagnostic angiograms. Fifteen of these patients had CDU-guided CFA punctures; in 8 of these patients CDU-guided CFA puncture 'failed' (i.e., there was failure to pass a guidewire or catheter into the CFA or SFA), necessitating immediate direct CDU-guided SFA puncture. Overall, the mean screen time and radiation dosage, via direct CDU-guided SFA puncture in 30 patients, was 4.8 min and 464 Gy cm 2 respectively. With CDU-guided CFA puncture, mean screen time (10 min), radiation dose (2023 Gy cm 2 ), and complications (13%) were greater when compared with the SFA puncture results overall and in the same patients at subsequent similar procedures (2.7 min, 379 Gy cm 2 (p < 0.05), no complications in this subgroup). Five complications occurred: 2 each at CFA and SFA entry sites, and 1 angioplasty embolus. Conclusions. The CDU-guided SFA puncture technique was both more effective than CDU-guided CFA access in patients with scarred groins, obesity, or failed CFA punctures and safer, with reduced screen times, radiation doses, and complications

Effect of image-guided hypofractionated stereotactic radiotherapy on peripheral non-small-cell lung cancer

Directory of Open Access Journals (Sweden)

Wang SW

2016-08-01

Full Text Available Shu-wen Wang,1 Juan Ren,1 Yan-li Yan,2 Chao-fan Xue,2 Li Tan,2 Xiao-wei Ma2 1Department of Radiotherapy, First Affiliated Hospital of Xian Jiaotong University, 2Medical School of Xian Jiaotong University, Xi’an, Shaanxi, People’s Republic of China Abstract: The objective of this study was to compare the effects of image-guided hypofractionated radiotherapy and conventional fractionated radiotherapy on non-small-cell lung cancer (NSCLC. Fifty stage- and age-matched cases with NSCLC were randomly divided into two groups (A and B. There were 23 cases in group A and 27 cases in group B. Image-guided radiotherapy (IGRT and stereotactic radiotherapy were conjugately applied to the patients in group A. Group A patients underwent hypofractionated radiotherapy (6–8 Gy/time three times per week, with a total dose of 64–66 Gy; group B received conventional fractionated radiotherapy, with a total dose of 68–70 Gy five times per week. In group A, 1-year and 2-year local failure survival rate and 1-year local failure-free survival rate were significantly higher than in group B (P<0.05. The local failure rate (P<0.05 and distant metastasis rate (P>0.05 were lower in group A than in group B. The overall survival rate of group A was significantly higher than that of group B (P=0.03, and the survival rate at 1 year was 87% vs 63%, (P<0.05. The median survival time of group A was longer than that of group B. There was no significant difference in the incidence of complications between the two groups (P>0.05. Compared with conventional fractionated radiation therapy, image-guided hypofractionated stereotactic radiotherapy in NSCLC received better treatment efficacy and showed good tolerability. Keywords: non-small-cell lung cancer, hypofractionated radiotherapy, stereotactic radiotherapy, segmentation, intensity-modulated radiotherapy, image-guided radiation therapy technology

Immune phenotypes predict survival in patients with glioblastoma multiforme

Directory of Open Access Journals (Sweden)

Haouraa Mostafa

2016-09-01

Full Text Available Abstract Background Glioblastoma multiforme (GBM, a common primary malignant brain tumor, rarely disseminates beyond the central nervous system and has a very bad prognosis. The current study aimed at the analysis of immunological control in individual patients with GBM. Methods Immune phenotypes and plasma biomarkers of GBM patients were determined at the time of diagnosis using flow cytometry and ELISA, respectively. Results Using descriptive statistics, we found that immune anomalies were distinct in individual patients. Defined marker profiles proved highly relevant for survival. A remarkable relation between activated NK cells and improved survival in GBM patients was in contrast to increased CD39 and IL-10 in patients with a detrimental course and very short survival. Recursive partitioning analysis (RPA and Cox proportional hazards models substantiated the relevance of absolute numbers of CD8 cells and low numbers of CD39 cells for better survival. Conclusions Defined alterations of the immune system may guide the course of disease in patients with GBM and may be prognostically valuable for longitudinal studies or can be applied for immune intervention.

Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data

Science.gov (United States)

2009-01-01

Background During the last part of the 1990s the chance of surviving breast cancer increased. Changes in survival functions reflect a mixture of effects. Both, the introduction of adjuvant treatments and early screening with mammography played a role in the decline in mortality. Evaluating the contribution of these interventions using mathematical models requires survival functions before and after their introduction. Furthermore, required survival functions may be different by age groups and are related to disease stage at diagnosis. Sometimes detailed information is not available, as was the case for the region of Catalonia (Spain). Then one may derive the functions using information from other geographical areas. This work presents the methodology used to estimate age- and stage-specific Catalan breast cancer survival functions from scarce Catalan survival data by adapting the age- and stage-specific US functions. Methods Cubic splines were used to smooth data and obtain continuous hazard rate functions. After, we fitted a Poisson model to derive hazard ratios. The model included time as a covariate. Then the hazard ratios were applied to US survival functions detailed by age and stage to obtain Catalan estimations. Results We started estimating the hazard ratios for Catalonia versus the USA before and after the introduction of screening. The hazard ratios were then multiplied by the age- and stage-specific breast cancer hazard rates from the USA to obtain the Catalan hazard rates. We also compared breast cancer survival in Catalonia and the USA in two time periods, before cancer control interventions (USA 1975–79, Catalonia 1980–89) and after (USA and Catalonia 1990–2001). Survival in Catalonia in the 1980–89 period was worse than in the USA during 1975–79, but the differences disappeared in 1990–2001. Conclusion Our results suggest that access to better treatments and quality of care contributed to large improvements in survival in Catalonia. On

Improved resection and prolonged overall survival with PD-1-IRDye800CW fluorescence probe-guided surgery and PD-1 adjuvant immunotherapy in 4T1 mouse model

Directory of Open Access Journals (Sweden)

Du Y

2017-11-01

Full Text Available Yang Du,1,2,* Ting Sun,3,* Xiaolong Liang,4,* Yuan Li,3 Zhengyu Jin,3 Huadan Xue,3 Yihong Wan,5 Jie Tian1,2 1CAS Key Laboratory of Molecular Imaging, 2The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, 3Department of Radiology, Peking Union Medical College Hospital, 4Department of Ultrasound, Peking University Third Hospital, Beijing, China; 5Department of Pharmacology, University of Texas Southwestern Medical Center, Dallas, TX, USA *These authors contributed equally to this work Abstract: An intraoperative technique to accurately identify microscopic tumor residuals could decrease the risk of positive surgical margins. Several lines of evidence support the expression and immunotherapeutic effect of PD-1 in breast cancer. Here, we sought to develop a fluorescence-labeled PD-1 probe for in vivo breast tumor imaging and image-guided surgery. The efficacy of PD-1 monoclonal antibody (PD-1 mAb as adjuvant immunotherapy after surgery was also assessed. PD-1-IRDye800CW was developed and examined for its application in tumor imaging and image-guided tumor resection in an immunocompetent 4T1 mouse tumor model. Fluorescence molecular imaging was performed to monitor probe biodistribution and intraoperative imaging. Bioluminescence imaging was performed to monitor tumor growth and evaluate postsurgical tumor residuals, recurrences, and metastases. The PD-1-IRDye800CW exhibited a specific signal at the tumor region compared with the IgG control. Furthermore, PD-1-IRDye800CW-guided surgery combined with PD-1 adjuvant immunotherapy inhibited tumor regrowth and microtumor metastases and thus improved survival rate. Our study demonstrates the feasibility of using PD-1-IRDye800CW for breast tumor imaging and image-guided tumor resection. Moreover, PD-1 mAb adjuvant immunotherapy reduces cancer recurrences and metastases emanating from tumor residuals. Keywords: PD-1, programmed cell

The ComSoc guide to managing telecommunications projects

CERN Document Server

Desmond, Celia

2010-01-01

"This pocket guide provides an overview of the telecommunications environment as it has evolved over the past few years, illustrating the need for project management, the significance of project success to the companies, and the application of key project management processes within the telecom environment. Topics covered include: scope management, time management, cost management, procurement management, risk management, communications, quality, human resources, and Integration. It offers professionals a brief and accessible guide to managing telecommunication projects in the 21st century"--

A Tourism e-Guide System Using Mobile Integration

OpenAIRE

Emad M. Abuelrub; Hanan M. Solaiman

2010-01-01

This paper presents a tourism e-guide system via mobile integration using offloading while enjoying mobility. A user can search for new mobile services available on the website to use either remotely on the server where the services resides, or locally after downloading them to his/her mobile device and work offline without a mobile connection. Jordan Tourism e-Guide System (JTeGS) aims to help the user/tourist accessing the tourism information directly from his/her smart device, anytime and ...

Grey Guide: A Community Driven Open Resource Project in Grey Literature

OpenAIRE

Biagioni, Stefania; Giannini, Silvia

2017-01-01

In December 2013, the GreyGuide Project was formerly launched as an online forum and repository of good practice in grey literature. The GreyGuide manages Open Source Repositories and provides a unique resource in the field of grey literature that is long awaited and which responds to the information needs of a diverse, international grey literature community. As GreyNet's web access Portal, the GreyGuide now provides a wealth of content that was previously either confined to web pages or was...

Role of contact force-guided radiofrequency catheter ablation for treatment of atrial fibrillation: A systematic review and meta-analysis.

Science.gov (United States)

Lin, Hui; Chen, Yi-He; Hou, Jian-Wen; Lu, Zhao-Yang; Xiang, Yin; Li, Yi-Gang

2017-09-01

CF-sensing catheter emerged as a novel ablation technology and was increasingly used in clinical practice. Nonetheless, available evidence of efficacy and safety comparison between CF-guided RF catheter ablation and non-CF-guided ablation for treatment of AF was still lacking. Twenty-two eligible studies were included after systematic review through the MEDLINE, Google Scholar, the Cochrane Library and PubMed databases. AF/atrial tachycardia-free survival was markedly improved in CF-guided catheter ablation compared with non-CF-guided ablation at a median 12-month follow-up (RR: 1.12, 95% CI: 1.06-1.19, P = 0.000, fixed). Notably, CF-guided catheter ablation presented a robust survival benefit for treatment of paroxysmal AF (RR: 1.10, 95% CI: 1.03-1.18, P = 0.005, fixed), but not persistent AF (RR: 1.07, 95% CI: 0.89-1.28, P = 0.466, fixed). Moreover, procedure time (WMD: -23.87, 95% CI: -33.83 to -13.91, P = 0.000, random), fluoroscopy time (WMD: -7.78, 95% CI: -13.93 to -1.63, P = 0.013, random) and RF time (WMD: -3.98, 95% CI: -7.78 to -0.17, P = 0.040, random) were significantly reduced in CF-guided catheter ablation. The incidence of procedure-related complications did not differ between these two technologies (RR: 0.83, 95% CI: 0.59 to 1.16, P = 0.271, fixed). CF-guided RF catheter ablation was associated with a significant AF/atrial tachycardia-free survival benefit compared with non-CF-guided ablation in patients with paroxysmal AF rather than persistent AF. In addition, CF-guided ablation strategy also reduced the procedure time, fluoroscopy time, as well as RF time despite no distinct effect on the alleviation of procedure-related complications. © 2017 Wiley Periodicals, Inc.

Success rate and complications of internal jugular vein catheterization with and without ultrasonography guide.

Science.gov (United States)

Karimi-Sari, Hamidreza; Faraji, Mehrdad; Mohazzab Torabi, Saman; Asjodi, Gholamreza

2014-12-01

Central venous catheterization (CVC) is an important procedure in emergency departments (EDs). Despite existence of ultrasonography (US) devices in every ED, CVC is done using anatomical landmarks in many EDs in Iran. This study aimed to compare the traditional landmark method vs. US-guided method of CVC placement in terms of complications and success rate. In this randomized controlled trial, patients who were candidate for internal jugular vein catheterization, and referred to Baqiyatallah Hospital ED were randomly allocated into US-guided CVC and anatomical landmarks guided CVC groups. Central vein access time, number of attempts, success rate, and complications in each group were evaluated. Mann-Whitney U, chi-square and Fisher exact tests along with Pearson and Spearman correlation coefficients were used to analyze the data. Out of 100 patients, 56 were male and 44 were female. No significant differences were found between the US-guided and traditional landmark methods of CVC insertion in terms of age, gender, BMI, and site of catheter insertion. The mean access time was significantly lower in the US-guided group (37.12 ± 17.33 s vs. 63.42 ± 35.19 s, P < 0.001). The mean number of attempts was also significantly lower in the US-guided group (1.12 ± 0.3 vs. 1.58 ± 0.64 times, P < 0.001). Eighty-eight percent of patients in the US-guided group were catheterized in the first attempt, while 50% of patients in the traditional landmark group were catheterized in the second or more attempts (P < 0.001). The success rate was 100% in the US-guided group, while it was 88% in the landmark group (P = 0.013). Moreover, the rate of complications was significantly lower in the US-guided group (4% vs. 24%, P = 0.004). The US-guided method for CVC placement was superior to the traditional landmark method in terms of access time, number of attempts, success rate, and fewer complications.

SPSS survival manual a step by step guide to data analysis using SPSS

CERN Document Server

Pallant, Julie

2010-01-01

In this thoroughly revised edition of her bestselling text, now covering up to version 18 of the SPSS software, Julie Pallant guides you through the entire research process, helping you choose the right data analysis technique for your project.

Child survival and changing fertility patterns in Pakistan.

Science.gov (United States)

Sathar, Z A

1992-01-01

Pakistan is a country with high fertility and high infant and child mortality, and declines in total mortality and substantial development initiatives. The discussion considers whether fertility patterns in Pakistan can be related to changes in child mortality, and whether current and future changes in fertility influence child survival favorably. Omran's study linked large family size to child survival. Resources, which are divided, become more important deficits in households below the poverty line: a situation common in Pakistan. High fertility is associated with short birth intervals, which are related to higher infant and child mortality. In Pakistan, the spacing and mortality link was found among both poverty and higher socioeconomic households. There is some support for the notion that it is birth weight and general health that are linked to survival rather than competition for resources. Other studies link the maternal age at birth and birth order with child mortality (Alam and Cleland). Trussel argues for limiting births in high risk ages of under 20 years and over 35 years. The exact casual link is not well documented. Institutional and community factors are also considered important in influencing child survival: sanitation, potable water, access to roads, electricity, health and family planning services, and sewage. Young infants are more vulnerable to these factors. Bangladesh and some Indian states have shown that population programs and raising per captia incomes are necessary to fertility decline. In India, female autonomy, access to education, and more equal income distribution were considered more important than economic development to child survival. In Pakistan, Sathar and Kazi have linked at least 2 years of elementary, maternal education with reductions in child mortality. The pervasiveness of female illiteracy hinders the chances of child survival. Sex preferences also impact on female children. The probably impacts of declines in breast

Choice Behavior Guided by Learned, But Not Innate, Taste Aversion Recruits the Orbitofrontal Cortex.

Science.gov (United States)

Ramírez-Lugo, Leticia; Peñas-Rincón, Ana; Ángeles-Durán, Sandybel; Sotres-Bayon, Francisco

2016-10-12

The ability to select an appropriate behavioral response guided by previous emotional experiences is critical for survival. Although much is known about brain mechanisms underlying emotional associations, little is known about how these associations guide behavior when several choices are available. To address this, we performed local pharmacological inactivations of several cortical regions before retrieval of an aversive memory in choice-based versus no-choice-based conditioned taste aversion (CTA) tasks in rats. Interestingly, we found that inactivation of the orbitofrontal cortex (OFC), but not the dorsal or ventral medial prefrontal cortices, blocked retrieval of choice CTA. However, OFC inactivation left retrieval of no-choice CTA intact, suggesting its role in guiding choice, but not in retrieval of CTA memory. Consistently, OFC activity increased in the choice condition compared with no-choice, as measured with c-Fos immunolabeling. Notably, OFC inactivation did not affect choice behavior when it was guided by innate taste aversion. Consistent with an anterior insular cortex (AIC) involvement in storing taste memories, we found that AIC inactivation impaired retrieval of both choice and no-choice CTA. Therefore, this study provides evidence for OFC's role in guiding choice behavior and shows that this is dissociable from AIC-dependent taste aversion memory. Together, our results suggest that OFC is required and recruited to guide choice selection between options of taste associations relayed from AIC. Survival and mental health depend on being able to choose stimuli not associated with danger. This is particularly important when danger is associated with stimuli that we ingest. Although much is known about the brain mechanisms that underlie associations with dangerous taste stimuli, very little is known about how these stored emotional associations guide behavior when it involves choice. By combining pharmacological and immunohistochemistry tools with taste-guided

Venous access: options, approaches and issues

International Nuclear Information System (INIS)

Asch, M.R.

2001-01-01

Venous access is an essential part of medical practice. It is needed to obtain blood samples to make the diagnosis and to administer fluids or medicines as part of treatment. Although relatively new in the history of medicine, the placement and maintenance of the various venous access devices now occupies a significant portion of many vascular and interventional radiology practices. Thus, it is important to have a thorough understanding of these devices and their uses. The first long-term venous access devices were used in 1973. These were placed via a surgical cut-down on the subclavian vein. In 1982, the first subcutaneous implantable ports were described. These procedures were initially performed by surgeons, but over the last 5-10 years, both the insertion and management of these devices has shifted to interventional radiologists. Peripherally inserted central catheter (PICC) lines have almost completely supplanted the use of standard central lines (Fig. 1). A number of factors have facilitated this - namely, ready and less expensive room access, outpatient procedure and radiologists' accessibility and familiarity with image-guidance procedures and catheters and guide wires. (author)

Demographic population model for American shad: will access to additional habitat upstream of dams increase population sizes?

Science.gov (United States)

Harris, Julianne E.; Hightower, Joseph E.

2012-01-01

American shad Alosa sapidissima are in decline in their native range, and modeling possible management scenarios could help guide their restoration. We developed a density-dependent, deterministic, stage-based matrix model to predict the population-level results of transporting American shad to suitable spawning habitat upstream of dams on the Roanoke River, North Carolina and Virginia. We used data on sonic-tagged adult American shad and oxytetracycline-marked American shad fry both above and below dams on the Roanoke River with information from other systems to estimate a starting population size and vital rates. We modeled the adult female population over 30 years under plausible scenarios of adult transport, effective fecundity (egg production), and survival of adults (i.e., to return to spawn the next year) and juveniles (from spawned egg to age 1). We also evaluated the potential effects of increased survival for adults and juveniles. The adult female population size in the Roanoke River was estimated to be 5,224. With no transport, the model predicted a slow population increase over the next 30 years. Predicted population increases were highest when survival was improved during the first year of life. Transport was predicted to benefit the population only if high rates of effective fecundity and juvenile survival could be achieved. Currently, transported adults and young are less likely to successfully out-migrate than individuals below the dams, and the estimated adult population size is much smaller than either of two assumed values of carrying capacity for the lower river; therefore, transport is not predicted to help restore the stock under present conditions. Research on survival rates, density-dependent processes, and the impacts of structures to increase out-migration success would improve evaluation of the potential benefits of access to additional spawning habitat for American shad.

Interior Design 1992 Buyers Guide issue.

Science.gov (United States)

1992-01-30

The Interior Design Magazine Buyers Guide is compiled with you, the designer, in mind. So it's packed with the most comprehensive collection of sources available anyplace--arranged for fast, easy access. First, the Keyword Index presents all the Buyers Guide product categories alphabetically (see the first tab divider). Refer to the page number indicated in the Product Index (second tab divider) to view various manufacturers of products under each category heading. Addresses, phone and fax numbers, regional and international showroom/representatives are located in the A-Z Index (third tab divider) in alphabetical order. Consult the table of contents for trade associations, lighting consultants, marts, and other useful sections.

Resource Guide for Persons with Learning Impairments.

Science.gov (United States)

IBM, Atlanta, GA. National Support Center for Persons with Disabilities.

The resource guide identifies products which assist learning disabled and mentally retarded individuals in accessing IBM (International Business Machine) Personal Computers or the IBM Personal System/2 family of products. An introduction provides a general overview of ways computers can help learning disabled or retarded persons. The document then…

Automatic classification of EpCAM+, Cytokeratin+ objects versus survival in castration resistant prostate cancer

NARCIS (Netherlands)

Ligthart, Sjoerd T.; Coumans, Frank A.W.; Attard, Gert; de Bono, Johann S.; Terstappen, Leon W.M.M.

2010-01-01

Introduction: Circulating tumor cells (CTC) in patients with metastatic carcinomas are associated with poor survival and may guide therapy. CTC are morphologically heterogeneous and many research groups apply different morphological definitions. Manual assignment of CTC is therefore subjective. We

Respecting the right to access to medicines: Implications of the UN Guiding Principles on Business and Human Rights for the pharmaceutical industry.

Science.gov (United States)

Moon, Suerie

2013-06-14

What are the human rights responsibilities of pharmaceutical companies with regard to access to medicines? The state-based international human rights framework has long struggled with the issue of the human rights obligations of non-state actors, a question sharpened by economic globalization and the concomitant growing power of private for-profit actors ("business"). In 2011, after a six-year development process, the UN Human Rights Council unanimously endorsed the Guiding Principles advanced by the UN Secretary General's Special Representative on Business and Human Rights, John Ruggie. The Ruggie Principles sought to clarify and differentiate the responsibilities of states and non-state actors-in this case, "business" -with respect to human rights. The framework centered on "three core principles: the state duty to protect against human rights abuses by third parties, including business; the corporate responsibility to respect human rights; and the need for more effective access to remedies." The "Protect, Respect, and Remedy" Framework emerged from a review of many industrial sectors operating from local to global scales, in many regions of the world, and involving multiple stakeholder consultations. However, their implications for the pharmaceutical industry regarding access to medicines remain unclear. This article analyzes the 2008 Human Rights Guidelines for Pharmaceutical Companies in relation to Access to Medicines advanced by then-UN Special Rapporteur on the Right to Health, Paul Hunt, in light of the Ruggie Principles. It concludes that some guidelines relate directly to the industry's responsibility to respect the right to access to medicines, and form a normative baseline to which firms should be held accountable. It also finds that responsibility for other guidelines may better be ascribed to states than to private actors, based on conceptual and practical considerations. While not discouraging the pharmaceutical industry from making additional

Release of Waste Tire Comprehensive Utilization Industry Access Conditions

Institute of Scientific and Technical Information of China (English)

2012-01-01

On July 31, 2012, the Ministry of Industry and Information Technology released the Tire Retread- ing lndustry Access Conditions and Waste Tire Comprehensive Utilization Industry Access Condi- tions with the No. 32 announcement of 2012. The state will lay a foundation for realizing the green, safe, efficient, eco-friendly and energy saving tar- gets in the "12th Five-year Plan" of the industry by raising access conditions, regulating industrial development order, strengthening environmental protection, promoting corporate optimizing and up- grading, improving resources comprehensive utiliza- tion technology and management level and guiding the "harmless recycling and eco-friendly utiliza- tion" of the industry.

Survival of a wild ring-tailed lemur ( Lemur catta ) with abdominal ...

African Journals Online (AJOL)

Survival of a wild ring-tailed lemur ( Lemur catta ) with abdominal trauma in an anthropogenically ... PROMOTING ACCESS TO AFRICAN RESEARCH ... for 13 months until her remains, which showed evidence of dog predation, were found.

Making Partner: A Mentor's Guide to the Psychological Journey.

Science.gov (United States)

Ibarra, Herminia

2000-01-01

In this era of talent wars, partnerships at professional firms can no longer afford to have a "survival of the fittest" mindset toward the consultants, investment bankers, and junior accountants aspiring to join their ranks. Instead, they must understand--and guide--the complex emotional transformation that every "partner hopeful" must go through.…

Teacher Pay and Career Paths in an Opportunity Culture: A Practical Policy Guide

Science.gov (United States)

Hassel, Emily Ayscue; Holly, Christen; Locke, Gillian

2014-01-01

To help all students reach their potential, district leaders must ensure that every student has consistent access to excellent teaching. Opportunity Culture compensation and career path structures help make that possible, and this guide shows how. "Teacher Pay and Career Paths in an Opportunity Culture: A Practical Policy Guide" shows…

Intermediate-term results of image-guided brachytherapy and high-technology external beam radiotherapy in cervical cancer: Chiang Mai University experience.

Science.gov (United States)

Tharavichitkul, Ekkasit; Chakrabandhu, Somvilai; Wanwilairat, Somsak; Tippanya, Damrongsak; Nobnop, Wannapha; Pukanhaphan, Nantaka; Galalae, Razvan M; Chitapanarux, Imjai

2013-07-01

To evaluate the outcomes of image-guided brachytherapy combined with 3D conformal or intensity modulated external beam radiotherapy (3D CRT/IMRT) in cervical cancer at Chiang Mai University. From 2008 to 2011, forty-seven patients with locally advanced cervical cancer were enrolled in this study. All patients received high-technology (3D CRT/IMRT) whole pelvic radiotherapy with a total dose of 45-46 Gy plus image-guided High-Dose-Rate intracavitary brachytherapy 6.5-7 Gy × 4 fractions to a High-Risk Clinical Target Volume (HR-CTV) according to GEC-ESTRO recommendations. The dose parameters of the HR-CTV for bladder, rectum and sigmoid colon were recorded, as well as toxicity profiles. In addition, the endpoints for local control, disease-free, metastasis-free survival and overall survival were calculated. At the median follow-up time of 26 months, the local control, disease-free survival, and overall survival rates were 97.9%, 85.1%, and 93.6%, respectively. The mean dose of HR-CTV, bladder, rectum and sigmoid were 93.1, 88.2, 69.6, and 72 Gy, respectively. In terms of late toxicity, the incidence of grade 3-4 bladder and rectum morbidity was 2.1% and 2.1%, respectively. A combination of image-guided brachytherapy and IMRT/3D CRT showed very promising results of local control, disease-free survival, metastasis-free survival and overall survival rates. It also caused a low incidence of grade 3-4 toxicity in treated study patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Ergonomics and accessibility for people with visual impairment in hotels.

Science.gov (United States)

Dos Santos, Larissa Nascimento; de Carvalho, Ricardo José Matos

2012-01-01

This article presents a diagnosis of luxury or superior hotels in the city of Natal, located in the state of Rio Grande do Norte, in northeastern Brazil, in what concerns accessibility to the visually impaired. The main objective is to present the guiding principles to design actions and interventions that must be considered in the preparation or revision of technical standards and manuals of good practice in accessibility related to people with visual impairments who are hotel users. The survey showed that the hotels do not meet the normative indications of accessibility, their facilities are in-accessible (have prevented access) or of reduced accessibility and its employees are not prepared to provide adequate hospital services for people with visual impairment. It was concluded that some of the accessibility problems faced by people with visual impairments are also faced by people in general.

Joint survival probability via truncated invariant copula

International Nuclear Information System (INIS)

Kim, Jeong-Hoon; Ma, Yong-Ki; Park, Chan Yeol

2016-01-01

Highlights: • We have studied an issue of dependence structure between default intensities. • We use a multivariate shot noise intensity process, where jumps occur simultaneously and their sizes are correlated. • We obtain the joint survival probability of the integrated intensities by using a copula. • We apply our theoretical result to pricing basket default swap spread. - Abstract: Given an intensity-based credit risk model, this paper studies dependence structure between default intensities. To model this structure, we use a multivariate shot noise intensity process, where jumps occur simultaneously and their sizes are correlated. Through very lengthy algebra, we obtain explicitly the joint survival probability of the integrated intensities by using the truncated invariant Farlie–Gumbel–Morgenstern copula with exponential marginal distributions. We also apply our theoretical result to pricing basket default swap spreads. This result can provide a useful guide for credit risk management.

The SPAN cookbook: A practical guide to accessing SPAN

Science.gov (United States)

Mason, Stephanie; Tencati, Ronald D.; Stern, David M.; Capps, Kimberly D.; Dorman, Gary; Peters, David J.

1990-01-01

This is a manual for remote users who wish to send electronic mail messages from the Space Physics Analysis Network (SPAN) to scientific colleagues on other computer networks and vice versa. In several instances more than one gateway has been included for the same network. Users are provided with an introduction to each network listed with helpful details about accessing the system and mail syntax examples. Also included is information on file transfers, remote logins, and help telephone numbers.

CEH certified ethical hacker : version 8 : study guide

CERN Document Server

Oriyano, Sean-Philip

2014-01-01

Prepare for the new Certified Ethical Hacker version 8 exam with this Sybex guide Security professionals remain in high demand. The Certified Ethical Hacker is a one-of-a-kind certification designed to give the candidate a look inside the mind of a hacker. This study guide provides a concise, easy-to-follow approach that covers all of the exam objectives and includes numerous examples and hands-on exercises. Coverage includes cryptography, footprinting and reconnaissance, scanning networks, enumeration of services, gaining access to a system, Trojans, viruses, worms, covert channels, and muc

CCENT study guide exam 100-101 (ICND1)

CERN Document Server

Lammle, Todd

2013-01-01

The latest offering from Cisco Expert Todd Lammle for the New CCENT Certification Written by industry expert and Cisco networking guru, Todd Lammle, CCENT Study Guide improves on the popular Sybex Study Guide approach by providing 100 percent coverage of the ICND1 (#100-101) exam objectives. The book contains detailed information and examples on crucial Cisco networking topics, and provides practical examples and insights drawn from Todd's almost 30 years of real-world experience. You'll also have access to dozens of hands-on labs to get the necessary experience needed to pass

Hydraulics and pneumatics a technician's and engineer's guide

CERN Document Server

Parr, Andrew

2011-01-01

Nearly all industrial processes require objects to be moved, manipulated or subjected to some sort of force. Such movements and manipulations are frequently accomplished by means of devices driven by liquids (hydraulics) or air (pneumatics), the subject of this book. Hydraulics and Pneumatics is written by a practicing process control engineer as a guide to the successful operation of hydraulic and pneumatic systems for all engineers and technicians working with them. Keeping mathematics and theory to a minimum, this practical guide is thorough but accessible to technicians without a

Accessibility Considerations for e-Learning in Ghana

Science.gov (United States)

Boateng, John Kwame

2016-01-01

This paper reports on a study that explored the best ways to design e-learning in order to provide better access for adult learners with disabilities. Two districts from the Central Region of Ghana were selected and two major research questions guided the study. The five-point Likert scale was employed between May and August of 2014. The two…

Malariotherapy at Mont Park: the earliest surviving movie of psychiatric treatment in Australia.

Science.gov (United States)

Kaplan, Robert M

2013-02-01

A movie on malariotherapy for neurosyphilis made at Mont Park and filmed by Reg Ellery in 1926 is believed to be the oldest surviving movie of psychiatric treatment in Australia. The objective is to review the movie and discuss the background and context of the film, which shows the conditions of patients in a psychiatric hospital in the 1920s. Movie film is a guide to a psychiatric past that is rapidly being forgotten. The Ellery movie is an incentive to collect surviving footage before it is too late.

Guide Structures in CD-ROM Dictionaries, with Specific Reference to the EWED and the ELHAT

Directory of Open Access Journals (Sweden)

Philip Louw

2011-10-01

Full Text Available

macro- and microstructural information. In order to evaluate the methods which lexicographers employ to improve dictionary accessibility, the concept of guide structures was introduced by Hausmann and Wiegand (1989. Since the appearance of that article, various academics have written articles and read papers on guide structures in print dictionaries, but few studies have focussed on the tremendous potential of guide structures in electronic dictionaries. In this article it will be shown that electronic dictionaries add dimensions to the implementation of guide structures not possible in print versions. The role of two of the guide structures in the transfer of infonnation in CD-ROM dictionaries will be discussed. The access and mediostructures of the Microsoft Encarta World English Dictionary and the Elektroniese Handwoordeboek van die Afrikaanse Taal will be analysed and critically evaluated to illustrate the advantages of electronic dictionaries over print dictionaries and the urgent need for metalexicographical discussion of this publication medium.

Keywords: ACCESS STRUCTURE; ACTIVE CROSS-REFERENCES; CD-ROM DICTIONARY; DICTIONARY ACCESSIBILITY; ENCYCLOPAEDIC DICTIONARY; GUIDE STRUCTURES; INNER ACCESS STRUCTURE; INNER SEARCH PATH; INTERNET; MEDIOSTRUCTURE; MULTIMEDIA; OUTER ACCESS STRUCTURE; OUTER SEARCH PATH; PASSIVE CROSSREFERENCING; USER-FRIENDLINESS

Opsomming: Gidsstrukture in CD-ROM-woordeboeke, met spesifieke verwysingna EWED en ELHA T. Die sukses van modeme woordeboeke hang grootliles af vandie toeganklikheid van hulle makro- en mikrostrukturele inligting. Hausmann en Wiegand (1989het die konsep van gidsstrukture ingevoer om die metodes te evalueer wat leksikograwe gebruikom woordeboektoeganklikheid Ie verbeter. Sedert hierdie artikel verskyn het, het verskeie akademic:i artikels gepubliseer en referate gelewer oor gidsstrukture in gedrukte woordeboeke, maarmin studies het gefokus op die geweldige potensiaal van

Entrapment of Guide Wire in an Inferior Vena Cava Filter: A Technique for Removal

International Nuclear Information System (INIS)

Abdel-Aal, Ahmed Kamel; Saddekni, Souheil; Hamed, Maysoon Farouk; Fitzpatrick, Farley

2013-01-01

Entrapment of a central venous catheter (CVC) guide wire in an inferior vena cava (IVC) filter is a rare, but reported complication during CVC placement. With the increasing use of vena cava filters (VCFs), this number will most likely continue to grow. The consequences of this complication can be serious, as continued traction upon the guide wire may result in filter dislodgement and migration, filter fracture, or injury to the IVC. We describe a case in which a J-tipped guide wire introduced through a left subclavian access without fluoroscopic guidance during CVC placement was entrapped at the apex of an IVC filter. We describe a technique that we used successfully in removing the entrapped wire through the left subclavian access site. We also present simple useful recommendations to prevent this complication.

Use and benefits of public access defibrillation in a nation-wide network

DEFF Research Database (Denmark)

Nielsen, Anne Møller; Folke, Fredrik; Lippert, Freddy Knudsen

2013-01-01

BACKGROUND: Automated External Defibrillators (AEDs) are known to increase survival after out-of-hospital cardiac arrest (OHCA). The aim of this study was to examine the use and benefit of public-access defibrillation (PAD) in a nation-wide network. We primarily sought to assess survival at 1 month...... to exercise (42% vs. 0%), and with improved 30-day survival (69% vs. 15%, p=0.001). Among those presenting with a shockable rhythm, 20 (65%) had Return of Spontaneous Circulation upon arrival of EMS and 8 (26%) were conscious, which emphasizes the diagnostic value of ECG downloads from AEDs. Survival could...

A qualitative examination of psychology graduate students' experiences with guided Internet-delivered cognitive behaviour therapy

Directory of Open Access Journals (Sweden)

Lindsay N. Friesen

2014-04-01

Full Text Available Guided Internet-delivered cognitive behaviour therapy (ICBT is efficacious for the treatment of a variety of clinical disorders (Spek et al., 2007, yet minimal research has investigated training students in guided ICBT. To contribute to the training literature, through qualitative interviews, this study explored how ICBT was perceived by student therapists (n = 12 trained in guided ICBT. Additionally, facilitators and challenges encountered by students learning guided ICBT were examined. Qualitative analysis revealed that students perceived training to enhance their professional skills in guided ICBT such as how to gain informed consent, address emergencies, and facilitate communication over the Internet. Students described guided ICBT as beneficial for novice therapists learning cognitive behavior therapy as asynchronous communication allowed them to reflect on their clinical emails and seek supervision. Further, students perceived guided ICBT as an important skill for future practice and an avenue to improve patient access to mental health care. Specific facilitators of learning guided ICBT included having access to formal and peer supervision as well as technical assistance, ICBT modules, a functional web application, and detailed policies and procedures for the practice of guided ICBT. Challenges in delivering guided ICBT were also identified by participants such as finding time to learn the approach given other academic commitments, working with non-responsive clients, addressing multiple complex topics over email, and communicating through asynchronous emails. Based on the feedback collected from participants, recommendations for training in guided ICBT are offered along with future research directions.

A design guide for energy-efficient research laboratories

Energy Technology Data Exchange (ETDEWEB)

Wishner, N.; Chen, A.; Cook, L. [eds.; Bell, G.C.; Mills, E.; Sartor, D.; Avery, D.; Siminovitch, M.; Piette, M.A.

1996-09-24

This document--A Design Guide for Energy-Efficient Research Laboratories--provides a detailed and holistic framework to assist designers and energy managers in identifying and applying advanced energy-efficiency features in laboratory-type environments. The Guide fills an important void in the general literature and compliments existing in-depth technical manuals. Considerable information is available pertaining to overall laboratory design issues, but no single document focuses comprehensively on energy issues in these highly specialized environments. Furthermore, practitioners may utilize many antiquated rules of thumb, which often inadvertently cause energy inefficiency. The Guide helps its user to: introduce energy decision-making into the earliest phases of the design process, access the literature of pertinent issues, and become aware of debates and issues on related topics. The Guide does focus on individual technologies, as well as control systems, and important operational factors such as building commissioning. However, most importantly, the Guide is intended to foster a systems perspective (e.g. right sizing) and to present current leading-edge, energy-efficient design practices and principles.

Optical Access Networks

Science.gov (United States)

Zheng, Jun; Ansari, Nirwan

2005-06-01

are now underway this hot area. The purpose of this feature issue is to expose the networking community to the latest research breakthroughs and progresses in the area of optical access networks. This feature issue aims to present a collection of papers that focus on the state-of-the-art research in various networking aspects of optical access networks. Original papers are solicited from all researchers involved in area of optical access networks. Topics of interest include but not limited to: Optical access network architectures and protocols Passive optical networks (BPON, EPON, GPON, etc.) Active optical networks Multiple access control Multiservices and QoS provisioning Network survivability Field trials and standards Performance modeling and analysis

The Use of Ultrasound to Improve Axillary Vein Access and Minimize Complications during Pacemaker Implantation.

Science.gov (United States)

Esmaiel, Abdullah; Hassan, Jeremy; Blenkhorn, Fay; Mardigyan, Vartan

2016-05-01

The Agency for Healthcare Research and Quality in the United States recommends the use of ultrasound (US) for central venous access to improve patient outcomes. However, in a recent publication, US is still underutilized for axillary vein access during pacemaker implantation. We sought to describe a technique for US-guided axillary vein access during pacemaker implantation and to report complication rates and success rate. Retrospective data collection included success rate and complications on all pacemaker implants by one operator since implementing the systematic use of US at our institution, from November 2012 to January 2015. For the last 59 cases, data were collected prospectively to include time of venous access and number of attempts. A total of 403 consecutive patients were included in the analysis. Two leads were implanted in 255 cases and one lead was implanted in 148 cases. The rate of successful US-guided access was 99.25%. There were no access-related complications. The average number of venipuncture attempts was 1.18 per patient. The average time to obtain venous access was 2.24 minutes including the time to apply the sterile US sleeve. The described technique has the potential to improve the success rate of axillary vein access and minimize complications during pacemaker implantation. ©2016 Wiley Periodicals, Inc.

Teacher Pay and Career Paths in an Opportunity Culture: A Practical Policy Guide--Summary

Science.gov (United States)

Hassel, Emily Ayscue; Holly, Christen; Locke, Gillian

2014-01-01

To help all students reach their potential, district leaders must ensure that every student has consistent access to excellent teaching. Opportunity Culture compensation and career path structures help make that possible, and this guide shows how. "Teacher Pay and Career Paths in an Opportunity Culture: A Practical Policy Guide" shows…

Access control within military C4ISR systems

Science.gov (United States)

Maschino, Mike

2003-07-01

Command, Control, Communications, Computers, Intelligence, Surveillance and Reconnaissance (C4ISR) tactical battlefield systems must provide the right information and resources to the right individuals at the right time. At the same time, the C4ISR system must enforce access controls to prevent the wrong individuals from obtaining sensitive information, or consuming scarce resources. Because lives, missions and property depend upon them, these access control mechanisms must be effective, reliable, efficient and flexible. The mechanisms employed must suit the nature of the items that are to be protected, as well as the varieties of access policies that must be enforced, and the types of access that will be made to these items. Some access control technologies are inherently centralized, while others are suitable for distributed implementation. The C4ISR architect must select from among the available technologies a combination of mechanisms that eases the burden of policy administration, but is inherently survivable, accurate, resource efficient, and which provides low latency. This paper explores various alternative access enforcement mechanisms, and assesses their effectiveness in managing policy-driven access control within the battlespace.

Field trip guide to the Hanford Site

International Nuclear Information System (INIS)

Reidel, S.P.; Lindsey, K.A.; Fecht, K.R.

1992-11-01

This report is designed to provide a guide to the key geologic and hydrologic features of the US Department of Energy's Hanford Site located in south-central Washington. The guide is divided into two parts. The first part is a general introduction to the geology of the Hanford Site and its relation to the regional framework of south-central Washington. The second part is a road log that provides directions to important geologic features on the Hanford Site and descriptions of the locality. The exposures described were chosen for their accessibility and importance to the geologic history of the Hanford Site and to understanding the geohydrology of the Site

A PhD is not enough! a guide to survival in science

CERN Document Server

Feibelman, Peter J

2011-01-01

A Ph. D. Is Not Enough! is required reading for anyone thinking of applying to graduate school or entering the science job market. Focusing on critical survival skills, it offers sound advice on selecting a thesis or postdoctoral adviser; choosing among research jobs in academia, government laboratories, and industry; and defining a research program. This new edition features updates throughout and a new chapter reflecting todays rapidly changing world.

An Assessment of Iranian Journals guide for authors

Directory of Open Access Journals (Sweden)

Javad abbaspour

2016-06-01

Full Text Available One indicator to assess the journals in international studies is the quality of guide for authors. The aim of this study is to determine the quality of guide for authors in Iranian journals.The population consisted of 755 Persian journals approved by Ministry of Science, Research and Technology in March 2013. Using a checklist, authors reviewed separately the content of guide for authors of 501 journals that provided access to their guide for authors through the web.according to the results, a total of 40% of the observed items were met. In addition, of the four studied sections, including generalities, legal and ethical issues, article structure and appearance, legal and ethical issues (18% and appearance (56% had the worst and best status respectively. In terms of the severity of problems, "violation of individuals or group rights"," how to write abbreviations and acronyms", "accepting journal requirements and laws", and "writing manuals used by authors" had the highest severity rankings.

Design for Survivability: An Approach to Assured Autonomy

Science.gov (United States)

Alexandrov, Natalia M.; Ozoroski, Thomas A.

2016-01-01

Rapidly expanding unmanned air traffic includes and will continue to include non-cooperative participants. Non-cooperative behavior may be due to technical failure, a lack of appropriate equipment, a careless or malicious operator. Regardless of the cause, the outcome remains: growing density of non-cooperative traffic will increase the risk of collision between unmanned vehicles and aircraft carrying humans. As a result, the degraded safety of airspace may limit access to airspace, with adverse consequences for the traveling public and the economy. Because encounters with small non-cooperative objects, such as birds or wayward drones, can happen too rapidly for an external control system to mitigate them, it is imperative that the aircraft that carry humans survive encounters with non-cooperative vehicles. To-date, design for survivability has been practiced explicitly in the military domain. Survivability against collisions in civil aviation has been limited to tolerances against bird strikes; and these tolerances have proved inadequate on occasion. The growing risk of collision with unmanned vehicles now requires the development of survivability discipline for civilian transport aircraft. The new discipline must be infused into multidisciplinary design methods, on par with traditional disciplines. In this paper, we report on a preliminary study of survivability considerations for the civil aviation domain.

Guiding Questions for Data Analysis, by Reports

Science.gov (United States)

Wake County Public School System, 2015

2015-01-01

This document, which is provided by the Data and Accountability Department staff at Wake County Public School System (WCPSS), is to be used as a resource to help guide the review of student data. This document provides examples of questions to consider when reviewing frequently accessed reports located in Case21, Quickr, EVAAS®, mClass®, or…

Short-term outcomes and safety of computed tomography-guided percutaneous microwave ablation of solitary adrenal metastasis from lung cancer: A multi-center retrospective study

Energy Technology Data Exchange (ETDEWEB)

Men, Min; Ye, Xin; Yang, Xia; Zheng, Aimin; Huang, Guang Hui; Wei, Zhigang [Dept. of Oncology, Shandong Provincial Hospital Affiliated with Shandong University, Jinan (China); Fan, Wei Jun [Imaging and Interventional Center, Sun Yat-sen University Cancer Center, Guangzhou (China); Zhang, Kaixian [Dept. of Oncology, Teng Zhou Central People' s Hospital Affiliated with Jining Medical College, Tengzhou (China); Bi, Jing Wang [Dept. of Oncology, Jinan Military General Hospital of Chinese People' s Liberation Army, Jinan (China)

2016-11-15

To retrospectively evaluate the short-term outcomes and safety of computed tomography (CT)-guided percutaneous microwave ablation (MWA) of solitary adrenal metastasis from lung cancer. From May 2010 to April 2014, 31 patients with unilateral adrenal metastasis from lung cancer who were treated with CT-guided percutaneous MWA were enrolled. This study was conducted with approval from local Institutional Review Board. Clinical outcomes and complications of MWA were assessed. Their tumors ranged from 1.5 to 5.4 cm in diameter. After a median follow-up period of 11.1 months, primary efficacy rate was 90.3% (28/31). Local tumor progression was detected in 7 (22.6%) of 31 cases. Their median overall survival time was 12 months. The 1-year overall survival rate was 44.3%. Median local tumor progression-free survival time was 9 months. Local tumor progression-free survival rate was 77.4%. Of 36 MWA sessions, two (5.6%) had major complications (hypertensive crisis). CT-guided percutaneous MWA may be fairly safe and effective for treating solitary adrenal metastasis from lung cancer.

The Evolution of Teachers' Instructional Beliefs and Practices in High-Access-to-Technology Classrooms.

Science.gov (United States)

Dwyer, David C.; And Others

Beginning in 1985, Apple Computer, Inc., and several school districts began a collaboration to examine the impact of computer saturation on instruction and learning in K-12 classrooms. The initial guiding question was simply put: What happens when teachers and students have constant access to technology? To provide "constant access,"…

Access 2007 forms and reports for dummies

CERN Document Server

Underdahl, Brian

2013-01-01

Do you have tons and tons of data on your computer but you're not quite sure how to make heads or tails of them-or even organize them? Are you using Access as spreadsheet rather than what it was really meant for? If you have trouble finding meaning in your data, then Access 2007 Forms & Reports for Dummies let you discover the wonders of this highly useful program. This no-nonsense guide gets right down to business by showing you the easy way to use this powerful tool. It gets you started with selective, targeted queries; forms that improve efficiency; and reports that communicate-while sparin

Disparities in cervical cancer survival among Asian American women

Science.gov (United States)

Nghiem, Van T.; Davies, Kalatu R.; Chan, Wenyaw; Mulla, Zuber D.; Cantor, Scott B.

2015-01-01

Purpose We compared overall survival and influencing factors between Asian American women as a whole and by subgroup with white women with cervical cancer. Methods Cervical cancer data were from the Surveillance, Epidemiology, and End Results registry; socioeconomic information was from the Area Health Resource File. We used standard tests to compare characteristics between groups; the Kaplan-Meier method with log-rank test to assess overall survival and compare it between groups; and Cox proportional hazards models to determine the effect of race and other covariates on overall survival (with/without age-stratification). Results Being 3.3 years older than white women at diagnosis (pAsian American women were more likely to be in a spousal relationship, had more progressive disease, and were better off socioeconomically. Women of Filipino, Japanese, and Korean origin had similar clinical characteristics compared with white women. Asian American women had higher 36- and 60-month survival rates (p=0.004 and p=0.013, respectively), higher overall survival rates (p=0.049), and longer overall survival durations after adjusting for age and other covariates (hazard ratio=0.77, 95% confidence interval: 0.68–0.86). Overall survival differed across age strata between the two racial groups. With the exception of women of Japanese or Korean origin, Asian American women grouped by geographic origin had better overall survival than white women. Conclusions Although Asian American women, except those of Japanese or Korean origin, had better overall survival than white women, their older age at cervical cancer diagnosis suggests that they have less access to screening programs. PMID:26552330

Disparities in cervical cancer survival among Asian-American women.

Science.gov (United States)

Nghiem, Van T; Davies, Kalatu R; Chan, Wenyaw; Mulla, Zuber D; Cantor, Scott B

2016-01-01

We compared overall survival and influencing factors between Asian-American women as a whole and by subgroup with white women with cervical cancer. Cervical cancer data were from the Surveillance, Epidemiology, and End Results registry; socioeconomic information was from the Area Health Resource File. We used standard tests to compare characteristics between groups; the Kaplan-Meier method with log-rank test to assess overall survival and compare it between groups; and Cox proportional hazards models to determine the effect of race and other covariates on overall survival (with and/or without age stratification). Being 3.3 years older than white women at diagnosis (P Asian-American women were more likely to be in a spousal relationship, had more progressive disease, and were better off socioeconomically. Women of Filipino, Japanese, and Korean origin had similar clinical characteristics compared to white women. Asian-American women had higher 36- and 60-month survival rates (P = .004 and P = .013, respectively), higher overall survival rates (P = .049), and longer overall survival durations after adjusting for age and other covariates (hazard ratio = 0.77, 95% confidence interval: 0.68-0.86). Overall survival differed across age strata between the two racial groups. With the exception of women of Japanese or Korean origin, Asian-American women grouped by geographic origin had better overall survival than white women. Although Asian-American women, except those of Japanese or Korean origin, had better overall survival than white women, their older age at cervical cancer diagnosis suggests that they have less access to screening programs. Copyright © 2016 Elsevier Inc. All rights reserved.

Predictors of survival among HIV-positive children on ART in ...

African Journals Online (AJOL)

... 16(4): 335–343. Open Access article distributed in terms of the Creative Commons Attribution License ... and adjusted hazard ratios respectively. The results reveal ... Children who were initiated early on ART had higher survival probability over time (HR: 0.35 [95% ..... workers they will have desirable clinical outcomes.

76 FR 11288 - Draft Regulatory Guide: Issuance, Availability

Science.gov (United States)

2011-03-01

..., telephone: 301-492- 3303 or e-mail; [email protected] . SUPPLEMENTARY INFORMATION: I. Introduction The U..., the public can gain entry into ADAMS, which provides text and image files of NRC's public documents... analysis may be found in ADAMS under Accession No. ML102350573. Regulatory guides are not copyrighted, and...

Exploring location influences on firm survival rates using parametric duration models

NARCIS (Netherlands)

Manzato, G.G.; Arentze, T.A.; Timmermans, H.J.P.; Ettema, D.F.; Timmermans, H.J.P.; Vries, de B.

2010-01-01

Using parametric duration models applied to an office firm dataset, we carried out an exploratory study about the location influences on firm survival rates. Amongst the variables included, we found that accessibility to infrastructure supply, regional effects, demographic and economic aspects, and

Exploring location influences on firm survival rates using parametric duration models

NARCIS (Netherlands)

Manzato, G.G.; Arentze, T.A.; Timmermans, H.J.P.; Ettema, D.F.

2011-01-01

Using parametric duration models applied to an office firm dataset, we carried out an exploratory study about the location influences on firm survival rates. Amongst the variables included, we found that accessibility to infrastructure supply, regional effects, demographic and economic aspects, and

A comparison of individualized treatment guided by VeriStrat with standard of care treatment strategies in patients receiving second-line treatment for advanced non-small cell lung cancer: A cost-utility analysis.

Science.gov (United States)

Nelson, Richard E; Stenehjem, David; Akerley, Wallace

2013-12-01

Two therapies are appropriate as 2nd-line treatment of non-small cell lung cancer (NSCLC) patients: chemotherapy and epidermal growth factor receptor (EGFR) inhibitor therapy. VeriStrat, a serum proteomic test, can be used to guide treatment decisions for NSCLC patients. The test classifies patients as likely to benefit from either of these two treatment options. The objective of this research was to model the anticipated survival and cost-effectiveness of four different treatment strategies: chemotherapy for all patients (C-all), EGFR inhibitor for all (E-all), a performance status guided selection strategy (PS-guided), and a strategy guided by VeriStrat test results (V-guided). We developed a Markov model with the perspective of the U.S. health care system. Model inputs were taken from published literature for the base-case analysis. One-way and probabilistic sensitivity analyses were performed. The C-all treatment strategy showed the best overall survival outcome (10.1 months), followed by V-guided (9.6 months), PS-guided (9.2 months), and E-all (8.2 months) strategies. The incremental cost-effectiveness ratio (ICER) of a V-guided treatment strategy was $91,111 (vs. E-all) and $8462 (vs. PS-guided) per quality-adjusted life year (QALY). The ICER for C-all compared to V-guided was $105,616. This cost-utility analysis indicates that a treatment strategy guided by the VeriStrat test in patients receiving second-line therapy for NSCLC may experience an overall survival benefit at an incremental cost-effectiveness ratio that is reasonable when compared with other practices, including cancer treatments, generally covered in the U.S. health care system. However, treating all patients with chemotherapy yielded the greatest expected survival. Copyright © 2013. Published by Elsevier Ireland Ltd.

Double Guided Surgery in All-on-4® Concept: When Ostectomy Is Needed

Directory of Open Access Journals (Sweden)

Gabriele Tonellini

2018-01-01

Full Text Available Background. The rehabilitation of edentulous jaws with guided and flapless surgery applied to the All-on-4 concepts is a predictable treatment with a high implant and prosthetic survival rates, but there are several contraindications for this technique like when bone reduction is needed due to a high smile line in the maxilla or when there is an irregular or thin bone crest. Purpose. To report a technique with double guided surgery for bone reduction and implant placement with the All-on-4 concept. Materials and Methods. 7 patients were included in the study. Guided implant planning was performed using CBCT, and the virtual templates were created with three dedicated software. Custom surgical templates were made for the ostectomy and for implants positioning. Results. 28 implants were placed using a double bone-supported surgical guide. The mean angular errors between the preoperative-planned implant and the postoperative-placed implant were 2.155° ± 2.03°; the mean distance errors between the planned and the placed implants were 0.763 mm ± 0.55 mm on the shoulder implant and 0.570 mm ± 0.40 mm on the apex implant. Conclusions. The results of our study indicate that this treatment is predictable with an excellent survival rate allowing excellent results even when bone reduction is mandatory.

CompTIA network+ study guide exam N10-006

CERN Document Server

Lammle, Todd

2015-01-01

All-star N10-006 prep, fully updated for the new exam The CompTIA Network+ Study Guide is your one-stop comprehensive resource in preparing for exam N10-006 Bestselling author and networking Guru Todd Lammle guides you through 100% of all exam objectives detailing the fundamental concepts you will need to know to prepare for the exam. Coverage includes network technologies, installation and configuration, media and topologies, security, and much more, plus practical examples drawn from real-world situations. You also gain access to practice exams and electronic flashcards that facilitate info

Manual for Accessibility: [Conference, Meeting, and Lodging Facilities]. Revised.

Science.gov (United States)

National Rehabilitation Association, Alexandria, VA.

This illustrated manual and survey forms are designed to be used by organizations, hotel and restaurant associations, interested individuals and others as a guide for selecting accessible conference, meeting, and lodging facilities. The guidelines can also be used with existing facilities to identify specific modifications and accommodations. The…

Survival in systemic lupus erythematosus, 1995-2010

DEFF Research Database (Denmark)

Voss, A; Laustrup, H; Hjelmborg, J

2013-01-01

ObjectiveThe objective of this paper is to investigate survival and causes of death in a Danish lupus population.MethodsTwo hundred and fifteen SLE patients (94% Caucasians) were followed prospectively for up to 16 years. Thirty-eight patients died. Survival rate and causes of death were analysed......%) and malignancies (13%). Deaths due to infections and active SLE were rare and predominated within the first seven years after diagnosis and before age 40, while cardiovascular deaths prevailed after 20 years' follow-up.ConclusionThis study shows that despite progress in lupus management, including direct access...... to specialized hospital care and increased use of hydroxychloroquine, mortality in lupus patients is still increased. Main causes of death were active disease and infections among the young and newly diagnosed, while cardiovascular deaths prevailed in longstanding disease....

The Latinas' Guide to the Information Superhighway: A Bilingual Guide for Latinas by Latinas = Guia para Mujeres Latinas sobre la Supercarretera de la Informacion: Una Guia Bilingue para Latinas por medio de Latinas.

Science.gov (United States)

MANA, A National Latina Organization, Washington, DC.

This guide to the Internet is designed to give Latinas basic information on computers and the information superhighway. Written in both Spanish and English, the guide begins by defining the Internet and making some suggestions about acquiring access to a computer. Among the topics discussed are how to choose an Internet service provider, how to…

75 FR 52996 - Draft Regulatory Guide: Issuance, Availability

Science.gov (United States)

2010-08-30

.... Introduction The U.S. Nuclear Regulatory Commission (NRC) is issuing for public comment a draft guide in the... entry into ADAMS, which provides text and image files of NRC's public documents. If you do not have.../ . The regulatory analysis may be found in ADAMS under Accession No. ML102310331. Federal Rulemaking Web...

Advanced Online Survival Analysis Tool for Predictive Modelling in Clinical Data Science.

Science.gov (United States)

Montes-Torres, Julio; Subirats, José Luis; Ribelles, Nuria; Urda, Daniel; Franco, Leonardo; Alba, Emilio; Jerez, José Manuel

2016-01-01

One of the prevailing applications of machine learning is the use of predictive modelling in clinical survival analysis. In this work, we present our view of the current situation of computer tools for survival analysis, stressing the need of transferring the latest results in the field of machine learning to biomedical researchers. We propose a web based software for survival analysis called OSA (Online Survival Analysis), which has been developed as an open access and user friendly option to obtain discrete time, predictive survival models at individual level using machine learning techniques, and to perform standard survival analysis. OSA employs an Artificial Neural Network (ANN) based method to produce the predictive survival models. Additionally, the software can easily generate survival and hazard curves with multiple options to personalise the plots, obtain contingency tables from the uploaded data to perform different tests, and fit a Cox regression model from a number of predictor variables. In the Materials and Methods section, we depict the general architecture of the application and introduce the mathematical background of each of the implemented methods. The study concludes with examples of use showing the results obtained with public datasets.

Ultrasonic Guided Insertion of Central Venous Catheter in Infants ...

African Journals Online (AJOL)

Background/Purpose: ultrasound is licensed for application of regional blocks and insertion of vascular access. We aimed to compare ultrasonic guided (USG) and anatomical landmark technique (ALT) for insertion of central venous catheter (CVC) as regard success rate and rate of complications in infants and children.

Application of a New Guiding System in Percutaneous Biopsies

International Nuclear Information System (INIS)

Petsas, Theodore; Tsota, Irene; Kalogeropoulou, Christina P.; Liatsikos, Evangelos N.

2007-01-01

We herein describe the application of a new guiding system designed for percutaneous biopsies. The guiding system set is composed of a 0.41 mm (27G) stainless steel guide stylet and a 22G Chiba needle. Following the initial insertion of the Chiba needle, the stylet is advanced via the needle toward the lesion. The stylet serves either as a guide for the Chiba needle or as an exchange wire for the introduction of larger or cutting biopsy needles. The stylet can also be curved prior to its insertion to facilitate access to lesions which require needle redirection. The technique was applied to 117 cases (54 thoracic, 31 abdominal, 21 pelvic, and 11 vertebral lesions.) The main advantage of the stylet is its small diameter, rendering it atraumatic and permitting multiple punctures for the successful final targeting of the lesion. With this guiding set we achieved targeting of difficult lesions. Furthermore, larger needles were more easily introduced in locations that posed technical difficulties. No major complications were observed. The complication rate was comparable to that of the conventional biopsy technique. The technique using the guide stylet was easily performed and could be applied to almost all organs

Do stage of disease, comorbidity or access to treatment explain socioeconomic differences in survival after ovarian cancer?

DEFF Research Database (Denmark)

Ibfelt, Else Helene; Dalton, Susanne Oksbjerg; Høgdall, Claus

2015-01-01

educated women. After adjustment for comorbid conditions, cancer stage, tumour histology, operation status and lifestyle factors, socioeconomic differences in survival persisted. CONCLUSIONS: Socioeconomic disparities in survival after ovarian cancer were to some extent, but not fully explained...... we retrieved information on prognostic factors, treatment information and lifestyle factors. Age, vital status, comorbidity, education, income and cohabitation status were ascertained from nationwide administrative registers. Associations were analyzed with logistic regression and Cox regression...... models. RESULTS: Educational level was weakly associated with cancer stage. Short education, lower income and living without a partner were related to poorer survival after ovarian cancer. Among women with early cancer stage, HR (95% CI) for death was 1.75 (1.20-2.54) in shorter compared to longer...

OpenCL programming guide

CERN Document Server

Munshi, Aaftab; Mattson, Timothy G; Fung, James; Ginsburg, Dan

2011-01-01

Using the new OpenCL (Open Computing Language) standard, you can write applications that access all available programming resources: CPUs, GPUs, and other processors such as DSPs and the Cell/B.E. processor. Already implemented by Apple, AMD, Intel, IBM, NVIDIA, and other leaders, OpenCL has outstanding potential for PCs, servers, handheld/embedded devices, high performance computing, and even cloud systems. This is the first comprehensive, authoritative, and practical guide to OpenCL 1.1 specifically for working developers and software architects. Written by five leading OpenCL authorities, OpenCL Programming Guide covers the entire specification. It reviews key use cases, shows how OpenCL can express a wide range of parallel algorithms, and offers complete reference material on both the API and OpenCL C programming language. Through complete case studies and downloadable code examples, the authors show how to write complex parallel programs that decompose workloads across many different devices. They...

Security guide for subcontractors

Energy Technology Data Exchange (ETDEWEB)

Adams, R.C.

1993-06-01

This guide is provided to aid in the achievement of security objectives in the Department of Energy (DOE) contractor/subcontractor program. The objectives of security are to protect information that, if released, would endanger the common defense and security of the nation and to safeguard plants and installations of the DOE and its contractors to prevent the interruption of research and production programs. The security objective and means of achieving the objective are described. Specific security measures discussed in this guide include physical barriers, personnel identification systems, personnel and vehicular access control, classified document control, protection of classified matter in use, storing classified matter, and repository combinations. Means of dealing with security violations and security infractions are described. Maintenance of a security education program is discussed. Also discussed are methods of handling clearance terminations, visitor control, travel to sensitive countries, and shipment security. The Technical Surveillance Countermeasures Program (TSCM), the Computer Security Program, and the Operations Security Plan (OPSEC) are examined.

Designing User Manuals for the Online Public Access Catalog.

Science.gov (United States)

Seiden, Peggy; Sullivan, Patricia

1986-01-01

Describes the process of developing and revising a brochure to guide library patrons in conducting an author search on an online public access catalog in order to demonstrate the application of four steps in production of a functional document--analysis; planning; development; evaluation, testing, and revision. Three sources are given. (EJS)

Hanford site: A guide to record series supporting epidemiologic studies conducted for the Department of Energy

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-07-06

The primary purpose of this guide is to describe each series of records which pertains to studies of worker health and mortality funded by the U.S. Department of Energy (DOE) at the Hanford site. Additionally, the guide provides information on the location and classification of the records and how they may be accessed. History Associates Incorporated (HAI) prepared this guide as part of its work as the support services contractor for DOE`s Epidemiologic Records Inventory Project. This introduction briefly describes the Epidemiologic Records Inventory Project, HAI`s role in the project, the history of the DOE and the Hanford site, and Hanford`s organizational structure. It provides information on the methodology used to inventory and describe pertinent records stored in various onsite offices, in Hanford`s Records Holding Area (RHA), and at the Seattle Federal Records Center (SFRC). Other topics include the methodology used to produce the guide, the arrangement of the record Series descrimations, and information on accessing records repositories.

U.S. Department of Energy Solar Decathlon Visitors Guide 2015

Energy Technology Data Exchange (ETDEWEB)

2015-09-03

The U.S. Department of Energy 2015 Visitors Guide is a free, hard-copy publication distributed free to those attending the Solar Decathlon event. The publications' objectives are to serve as the primary information resource for those in attendance, and to deliver a compelling message about the Solar Decathlon's success as a proven workforce development program and its role in educating students and the public about clean energy products and design solutions. The U.S. Department of Energy 2015 Visitors Guide SD15 Visitors Guide goals are to guide attendees through the Solar Decathlon village; List and explain the 10 contests; educate attendees about the participating teams and their competition houses; provide access to more information on the Solar Decathlon website through the use of QR codes; and acknowledge the support of all event sponsors.

Rural/Urban Differences in Child Growth and Survival in Bolivia.

Science.gov (United States)

Heaton, Tim B.; Forste, Renata

2003-01-01

In Bolivia, a third of rural children are stunted, and rural infants are twice as likely to die before age 2 than urban infants. National survey data indicate child survival and development are related to maternal education and literacy, community sanitation practices, access to health care, and socioeconomic status. Parental knowledge about…

Neonicotinoid pesticides and nutritional stress synergistically reduce survival in honey bees.

Science.gov (United States)

Tosi, Simone; Nieh, James C; Sgolastra, Fabio; Cabbri, Riccardo; Medrzycki, Piotr

2017-12-20

The honey bee is a major pollinator whose health is of global concern. Declines in bee health are related to multiple factors, including resource quality and pesticide contamination. Intensive agricultural areas with crop monocultures potentially reduce the quality and quantity of available nutrients and expose bee foragers to pesticides. However, there is, to date, no evidence for synergistic effects between pesticides and nutritional stress in animals. The neonicotinoids clothianidin (CLO) and thiamethoxam (TMX) are common systemic pesticides that are used worldwide and found in nectar and pollen. We therefore tested if nutritional stress (limited access to nectar and access to nectar with low-sugar concentrations) and sublethal, field-realistic acute exposures to two neonicotinoids (CLO and TMX at 1/5 and 1/25 of LD 50 ) could alter bee survival, food consumption and haemolymph sugar levels. Bee survival was synergistically reduced by the combination of poor nutrition and pesticide exposure (-50%). Nutritional and pesticide stressors reduced also food consumption (-48%) and haemolymph levels of glucose (-60%) and trehalose (-27%). Our results provide the first demonstration that field-realistic nutritional stress and pesticide exposure can synergistically interact and cause significant harm to animal survival. These findings have implications for current pesticide risk assessment and pollinator protection. © 2017 The Author(s).

Nuclear war survival skills

International Nuclear Information System (INIS)

Kearney, C.H.

1979-09-01

This book includes chapters on psychological preparations, warning and communications, and evacuation. It describes the building of expedient shelters, their ventilation and cooling, the purification and storage of adequate water, the processing and cooking of whole grains and legumes, fallout meters, protection against fires and carbon monoxide, and expedient furnishings for shelters. Other chapters cover sanitation and preventive medicine, medical advice for nuclear survivors lacking the help of doctors, improvised footwear and clothing, and advice on minimum preparations that can be made at low cost and should be made before a crisis arises. One appendix of the handbook gives detailed, field-tested instructions for building six types of earth-covered expedient fallout shelters, with criteria to guide the choice of which shelter to build. Others contain instructions for making an efficient shelter-ventilating pump and a homemade fallout meter that is accurate and dependable with inexpensive materials found in most households. This report is primarily a compilation and summary of civil defense measures and inventions developed at ORNL over the past 14 years and field-tested in six states, from Florida to Utah. It is the first comprehensive handbook of survival information for use by untrained citizens who want to improve their chances of surviving a possible nuclear attack. Sections may be easily excerpted and reproduced for mass distribution through news media

Statistical modelling of survival data with random effects h-likelihood approach

CERN Document Server

Ha, Il Do; Lee, Youngjo

2017-01-01

This book provides a groundbreaking introduction to the likelihood inference for correlated survival data via the hierarchical (or h-) likelihood in order to obtain the (marginal) likelihood and to address the computational difficulties in inferences and extensions. The approach presented in the book overcomes shortcomings in the traditional likelihood-based methods for clustered survival data such as intractable integration. The text includes technical materials such as derivations and proofs in each chapter, as well as recently developed software programs in R (“frailtyHL”), while the real-world data examples together with an R package, “frailtyHL” in CRAN, provide readers with useful hands-on tools. Reviewing new developments since the introduction of the h-likelihood to survival analysis (methods for interval estimation of the individual frailty and for variable selection of the fixed effects in the general class of frailty models) and guiding future directions, the book is of interest to research...

A Prospective Randomized Study of Brain Tissue Oxygen Pressure-Guided Management in Moderate and Severe Traumatic Brain Injury Patients

Directory of Open Access Journals (Sweden)

Chien-Min Lin

2015-01-01

Full Text Available The purpose of this study was to compare the effect of PbtO2-guided therapy with traditional intracranial pressure- (ICP- guided treatment on the management of cerebral variables, therapeutic interventions, survival rates, and neurological outcomes of moderate and severe traumatic brain injury (TBI patients. From 2009 to 2010, TBI patients with a Glasgow coma scale 20 mmHg, and 27 patients were treated with ICP-guided therapy (ICP 60 mmHg in the neurosurgical intensive care unit (NICU; demographic characteristics were similar across groups. The survival rate in the PbtO2-guided group was also significantly increased at 3 and 6 months after injury. Moreover, there was a significant correlation between the PbtO2 signal and Glasgow outcome scale-extended in patients from 1 to 6 months after injury. This finding demonstrates that therapy directed by PbtO2 monitoring is valuable for the treatment of patients with moderate and severe TBI and that increasing PaO2 to 150 mmHg may be efficacious for preventing cerebral hypoxic events after brain trauma.

Leading an Inclusive School: Access and Success for ALL Students

Science.gov (United States)

Villa, Richard A., Ed.; Thousand, Jacqueline S., Ed.

2016-01-01

This book provides an in-depth, research-based guide for ensuring that your school provides the federally guaranteed "least restrictive environment" for students no matter the severity of the challenges they face. "Leading an Inclusive School: Access and Success for ALL Students" offers administrators, teachers, and other…

The challenges and possibilities of public access defibrillation.

Science.gov (United States)

Ringh, M; Hollenberg, J; Palsgaard-Moeller, T; Svensson, L; Rosenqvist, M; Lippert, F K; Wissenberg, M; Malta Hansen, C; Claesson, A; Viereck, S; Zijlstra, J A; Koster, R W; Herlitz, J; Blom, M T; Kramer-Johansen, J; Tan, H L; Beesems, S G; Hulleman, M; Olasveengen, T M; Folke, F

2018-03-01

Out-of-hospital cardiac arrest (OHCA) is a major health problem that affects approximately four hundred and thousand patients annually in the United States alone. It is a major challenge for the emergency medical system as decreased survival rates are directly proportional to the time delay from collapse to defibrillation. Historically, defibrillation has only been performed by physicians and in-hospital. With the development of automated external defibrillators (AEDs), rapid defibrillation by nonmedical professionals and subsequently by trained or untrained lay bystanders has become possible. Much hope has been put to the concept of Public Access Defibrillation with a massive dissemination of public available AEDs throughout most Western countries. Accordingly, current guidelines recommend that AEDs should be deployed in places with a high likelihood of OHCA. Despite these efforts, AED use is in most settings anecdotal with little effect on overall OHCA survival. The major reasons for low use of public AEDs are that most OHCAs take place outside high incidence sites of cardiac arrest and that most OHCAs take place in residential settings, currently defined as not suitable for Public Access Defibrillation. However, the use of new technology for identification and recruitment of lay bystanders and nearby AEDs to the scene of the cardiac arrest as well as new methods for strategic AED placement redefines and challenges the current concept and definitions of Public Access Defibrillation. Existing evidence of Public Access Defibrillation and knowledge gaps and future directions to improve outcomes for OHCA are discussed. In addition, a new definition of the different levels of Public Access Defibrillation is offered as well as new strategies for increasing AED use in the society. © 2018 The Association for the Publication of the Journal of Internal Medicine.

The Effect of Haemodialysis Access Types on Cardiac Performance and Morbidities in Patients with Symptomatic Heart Disease.

Science.gov (United States)

Chuang, Min-Kai; Chang, Chin-Hao; Chan, Chih-Yang

2016-01-01

Little is known about whether the arteriovenous type haemodialysis access affects cardiac function and whether it is still advantageous to the uremic patient with symptomatic heart disease. We conducted a retrospective comparative study. Patients with heart disease and end-stage renal disease that had a new chronic access created between January 2007 and December 2008 and met the inclusion criteria were assessed. The endpoint was major adverse event (MAE)-free survivals of arteriovenous access (AVA) and tunneled cuffed double-lumen central venous catheter (CVC) groups. Whether accesses worsened heart failure was also evaluated. There were 43 CVC patients and 60 AVA patients. The median follow-up time from access creation was 27.6 months (IQR 34.7, 10.9~45.6). Although CVC patients were older than AVA patients (median age 78.0, IQR 14.0 vs. 67.5, IQR 16.0, respectively, p = .009), they manifested non-inferior MAE-free survival (mean 17.1, 95% CI 10.3~24.0 vs. 12.9, 95% CI 8.5~17.4 months in CVC and AVA patients, respectively, p = .290). During follow-up, more patients in the AVA group than in the CVC group deteriorated in heart failure status (35 of 57 vs. 10 of 42, respectively, odds ratio 5.1, p heart disease and end stage renal disease (ESRD), CVC patients showed non-inferior MAE-free survival in comparison to those in the AVA group. AV type access could deteriorate heart failure. Accordingly, uremic patients with symptomatic heart disease are not ideal candidates for AV type access creation.

Transthoracic versus transhiatal esophagectomy – influence on patient survival

Directory of Open Access Journals (Sweden)

Mariusz Łochowski

2016-12-01

Full Text Available Aim: To evaluate the survival of patients after surgery of the esophagus/cardia using the transthoracic and transhiatal methods. Material and methods : In the years 2007–2011, 102 patients were radically treated for cancer of the esophagus/cardia: 24 women and 78 men at the average age of 59.5. There were 38 transthoracic procedures and 64 transhiatal procedures. All patients had a conduit made from the stomach, led through lodges in the esophagus and combined with the stump of the esophagus in the neck following the Collard method. Two-pole lymphadenectomies were performed in all patients. Results: Patients after transthoracic procedures had statistically more (p < 0.05 lymph nodes removed than patients after transhiatal procedures. The 5-year survival rates in transhiatal and transthoracic procedures did not statistically differ, being 8% and 0% respectively. The length of patient survival was influenced by metastases in the nearby lymph nodes (p < 0.0001 and the presence of adenocarcinoma. Conclusions : Surgical access (transhiatal and transthoracic surgery does not affect the 5-year survival rates. Transhiatal surgery allows a greater number of lymph nodes to be removed. The main factor influencing the 5-year survival rate is the presence of metastases in the nearby lymph nodes.

Improved survival in rats with glioma using MRI-guided focused ultrasound and microbubbles to disrupt the blood-brain barrier and deliver Doxil

Science.gov (United States)

Aryal, Muna; Zhi Zhang, Yong; Vykhodtseva, Natalia; Park, Juyoung; Power, Chanikarn; McDannold, Nathan

2012-02-01

Blood-brain-barrier (BBB) limits the transportation of most neuropeptides, proteins (enzymes, antibodies), chemotherapeutic agents, and genes that have therapeutic potential for the treatment of brain diseases. Different methods have been used to overcome this limitation, but they are invasive, non-targeted, or require the development of new drugs. We have developed a method that uses MRI-guided focused ultrasound (FUS) combined with circulating microbubbles to temporarily open BBB in and around brain tumors to deliver chemotherapy agents. Here, we tested whether this noninvasive technique could enhance the effectiveness of a chemotherapy agent (Doxil). Using 690 kHz FUS transducer and microbubble (Definity), we induced BBB disruption in intracranially-implanted 9L glioma tumors in rat's brain in three weekly sessions. Animals who received BBB disruption and Doxil had a median survival time of 34.5 days, which was significantly longer than that found in control animals which is 16, 18.5, 21 days who received no treatment, BBB disruption only and Doxil only respectively This work demonstrates that FUS technique has promise in overcoming barriers to drug delivery, which are particularly stark in the brain due to the BBB.

A Tourism e-Guide System Using Mobile Integration

Directory of Open Access Journals (Sweden)

Emad M. Abuelrub

2010-04-01

Full Text Available This paper presents a tourism e-guide system via mobile integration using offloading while enjoying mobility. A user can search for new mobile services available on the website to use either remotely on the server where the services resides, or locally after downloading them to his/her mobile device and work offline without a mobile connection. Jordan Tourism e-Guide System (JTeGS aims to help the user/tourist accessing the tourism information directly from his/her smart device, anytime and anywhere using offloading. JTeGS is a web-based electronic guide that provides the user with appropriate tourism information about Jordan and guides him/her to find the best places to party, eat out, and enjoy culture events. The system architecture and the main components of the proposed services were presented and discussed. The system has been prototyped and validated in a real-time mobile internet application scenario. The system also has been evaluated through simulations in mobile network environment. Both experimental and simulation results demonstrated the effectiveness and efficiency of the proposed system.

The AAS Working Group on Accessibility and Disability (WGAD)

Science.gov (United States)

Monkiewicz, Jacqueline A.; Shanahan, J.; Murphy, Nicholas Arnold; Gilbert, Lauren

2016-06-01

The Working Group on Accessibility and Disability (WGAD) was formed by the Council of the American Astronomical Society in late 2015 in order to monitor and addresses issues of inclusivity in the astronomical community related to disability. WGAD promotes of the principles of universal accessibility and disability justice in both professional astronomy and astronomy education. The short term goals of WGAD for the next two years include producing a set of guidelines for a wide range of activities including supporting improved access to journals, data, and conferences. We will provide information and training regarding universal design as a guiding principle. The longer term goals of WGAD include integrating universal design as primary design strategy across the board in our many aspects of daily work life.

CompTIA Network+ Review Guide Exam N10-005

CERN Document Server

Ferguson, Bill

2012-01-01

Fast, focused review for the latest CompTIA Network+ Exam N10-005 CompTIA's Network+ certification is the leading non-vendor networking certification in the world and has become the standard certification for networking professionals. Make sure you're ready for CompTIA's new Network+ certification (exam N10-005) with this new edition of Sybex's CompTIA Network+ Review Guide. This concise guide is efficiently organized by exam objectives and covers all five exam domains. The book also includes 50 chapter review questions, as well as access to two online practice exams, and much more. It's the p

Self-guided internet-based and mobile-based stress management for employees

DEFF Research Database (Denmark)

Ebert, D. D.; Heber, E.; Berking, M.

2016-01-01

Objective This randomised controlled trial (RCT) aimed to evaluate the efficacy of a self-guided internet-based stress management intervention (iSMI) for employees compared to a 6-month wait-list control group (WLC) with full access for both groups to treatment as usual. M e t h o d A sample of 264...... of stressed employees. Internet-based self-guided interventions could be an acceptable, effective and potentially costeffective approach to reduce the negative consequences associated with work-related stress....

Facilitating access to the web of data a guide for librarians

CERN Document Server

Stuart, David

2011-01-01

Offers an introduction to the web of data and the semantic web, exploring technologies including APIs, microformats and linked data. This title includes topical commentary and practical examples that explore how information professionals can harness the power of this phenomenon to inform strategy and become facilitators of access to data.

Access to Archives at the National Archives of Namibia ...

African Journals Online (AJOL)

This article is based on findings of a study of the National Archives of Namibia conducted in 2015. The study investigated the terms and conditions that guide access at the National Archives of Namibia. The study also investigated how the National Archives of Namibia has conformed to the ICA Code of Ethics and The ...

Field Guide to Plant Model Systems

OpenAIRE

Chang, Caren; Bowman, John L.; Meyerowitz, Elliot M.

2016-01-01

For the past several decades, advances in plant development, physiology, cell biology, and genetics have relied heavily on the model (or reference) plant Arabidopsis thaliana. Arabidopsis resembles other plants, including crop plants, in many but by no means all respects. Study of Arabidopsis alone provides little information on the evolutionary history of plants, evolutionary differences between species, plants that survive in different environments, or plants that access nutrients and photo...

Feasibility and acceptability of patient partnership to improve access to primary care for the physical health of patients with severe mental illnesses: an interactive guide.

Science.gov (United States)

Pelletier, Jean-François; Lesage, Alain; Boisvert, Christine; Denis, Frédéric; Bonin, Jean-Pierre; Kisely, Steve

2015-09-14

Even in countries with universal healthcare systems, excess mortality rates due to physical chronic diseases in patients also suffering from serious mental illness like schizophrenia is such that their life expectancy could be lessened by up to 20 years. The possible explanations for this disparity include: unhealthy habits (i.e. smoking; lack of exercise); side-effects of psychotropic medication; delays in the detection or initial presentation leading to a more advanced disease at diagnosis; and inequity of access to services. The main objective of this paper is to explore the feasibility and acceptability of patient partnership for developing an interactive guide to improve access to primary care providers for chronic diseases management and health promotion among patients with severe mental illnesses. A participatory action research design was used to engage patients with mental illness as full research partners for a strategy for patient-oriented research in primary care for persons with schizophrenia who also have chronic physical illnesses. This strategy was also developed in partnership with a health and social services centre responsible for the health of the population of a territory with about 100,000 inhabitants in East-end Montreal, Canada. A new interactive guide was developed by patient research partners and used by 146 participating patients with serious mental illness who live on this territory, for them to be better prepared for their medical appointment with a General Practitioner by becoming more aware of their own physical condition. Patient research partners produced a series of 33 short videos depicting signs and symptoms of common chronic diseases and risk factors for the leading causes of mortality and study participants were able to complete the corresponding 33-item questionnaire on an electronic touch screen tablet. What proved to be most relevant in terms of interactivity was the dynamic that has developed among the study participants

Access to the Palais des Nations

CERN Multimedia

Relations with the Host States Service

2004-01-01

The United Nations Office at Geneva (UNOG) has informed CERN of very strict rules concerning access to the Palais des Nations that have recently come into effect in the framework of tightened security measures. Access is henceforth restricted to persons visiting the Palais on official business or for a guided tour. The presentation of a CERN card is no longer sufficient for such purposes. Those concerned must go either to the reception area at the Pregny entrance in the case of one-off visits or to the villa "Les Feuillantines" to be issued with an identity badge. UNOG wishes to thank the members of the CERN personnel and the beneficiaries of the Pension Fund for their understanding. Relations with the Host States Service http://www.cern.ch/relations/ Tel. 72848

Microfinance Institutions’ Social Intermediation and Micro and Small Enterprises Survival in Thika Town, Kenya

Directory of Open Access Journals (Sweden)

ZabronChege Wairimu

2017-05-01

Full Text Available The continuous rapid growth of microfinance institutions in Kenya seems not to offer enough solution to the micro and small enterprises survival challenges with more than a one-third of MSEs start-ups collapsing within the first three years. It is the high rate of collapse and low rate of survival of MSEs that motivated this research to fill the existing gap on the missing linkage between MFIs and MSEs survival. This study looked at the role of the social intermediation services offered by MFIs on survival of MSEs in Thika Town which is both an industrial town and a business hub. A descriptive study design was adopted. Stratified and purposive sampling methods were used to select a sample 272 MSEs. Findings indicated that; regular microfinance participation help reduce loan application and payment bureaucracy while keeping entrepreneur updated on available opportunities. Training equips MSEs owners with necessary managerial skills on financial management, book keeping, and business operations. Group liability eliminates the need for collateral security when accessing loan while it increases the amount of loan accessed. Networking increases business link widening goods and services markets and allows for formation of business clubs. Finally, it was found that training was the most sought service followed by group liability, microfinance participation, and networking. From the study findings, the researcher recommends that MSEs continue seeking for social intermediation services and especially networking to improve their competitiveness and create a competitive advantage over their competitors boosting their survival.

REPOSITORY RADIATION SHIELDING DESIGN GUIDE

International Nuclear Information System (INIS)

M. Haas; E.M. Fortsch

1997-01-01

The scope of this document includes radiation safety considerations used in the design of facilities for the Yucca Mountain Site Characterization Project (YMP). The purpose of the Repository Radiation Shielding Design Guide is to document the approach used in the radiological design of the Mined Geologic Disposal System (MGDS) surface and subsurface facilities for the protection of workers, the public, and the environment. This document is intended to ensure that a common methodology is used by all groups that may be involved with Radiological Design. This document will also assist in ensuring the long term survivability of the information basis used for radiological safety design and will assist in satisfying the documentation requirements of the licensing body, the Nuclear Regulatory Commission (NRC). This design guide provides referenceable information that is current and maintained under the YMP Quality Assurance (QA) Program. Furthermore, this approach is consistent with maintaining continuity in spite of a changing design environment. This approach also serves to ensure common inter-disciplinary interpretation and application of data

REPOSITORY RADIATION SHIELDING DESIGN GUIDE

Energy Technology Data Exchange (ETDEWEB)

M. Haas; E.M. Fortsch

1997-09-12

The scope of this document includes radiation safety considerations used in the design of facilities for the Yucca Mountain Site Characterization Project (YMP). The purpose of the Repository Radiation Shielding Design Guide is to document the approach used in the radiological design of the Mined Geologic Disposal System (MGDS) surface and subsurface facilities for the protection of workers, the public, and the environment. This document is intended to ensure that a common methodology is used by all groups that may be involved with Radiological Design. This document will also assist in ensuring the long term survivability of the information basis used for radiological safety design and will assist in satisfying the documentation requirements of the licensing body, the Nuclear Regulatory Commission (NRC). This design guide provides referenceable information that is current and maintained under the YMP Quality Assurance (QA) Program. Furthermore, this approach is consistent with maintaining continuity in spite of a changing design environment. This approach also serves to ensure common inter-disciplinary interpretation and application of data.

Exploration of location influences on firm survival rates using parametric duration models

NARCIS (Netherlands)

Manzato, G.G.; Arentze, T.A.; Timmermans, H.J.P.; Ettema, D.F.

2011-01-01

This study explored the influences of location on business firm survival rates with the use of parametric duration models applied to a data set. Of the variables included, those found to be the most significant were accessibility to infrastructure supply, regional effects, demographic and economic

Optical Access Networks

Science.gov (United States)

Zheng, Jun; Ansari, Nirwan

2005-01-01

have been receiving tremendous attention from both academia and industry. A large number of research activities have been carried out or are now underway this hot area. The purpose of this feature issue is to expose the networking community to the latest research breakthroughs and progresses in the area of optical access networks. Scope of Contributions This feature issue aims to present a collection of papers that focus on the state-of-the-art research in various networking aspects of optical access networks. Original papers are solicited from all researchers involved in area of optical access networks. Topics of interest include but not limited to: Optical access network architectures and protocols Passive optical networks (BPON, EPON, GPON, etc.) Active optical networks Multiple access control Multiservices and QoS provisioning Network survivability Field trials and standards Performance modeling and analysis Manuscript Submission To submit to this special issue, follow the normal procedure for submission to JON, indicating ``Optical Access Networks feature' in the ``Comments' field of the online submission form. For all other questions relating to this feature issue, please send an e-mail to jon@osa.org, subject line ``Optical Access Networks' Additional information can be found on the JON website: http://www.osa-jon.org/submission/. Submission Deadline: 1 June 2005

Effects of highly active antiretroviral therapy on the survival of HIV ...

African Journals Online (AJOL)

Recent improvements in access to Anti-Retroviral Therapy (ART) have radically reduced hospitalizations and deaths associated with HIV infection in both developed countries and sub-Saharan Africa. Not much is known about survival of patients on ART in slums. The objective of this study was to identify factors associated ...

BRAZILIAN EDUCATION AND SURVIVAL STRATEGIES OF CAPITALISM

Directory of Open Access Journals (Sweden)

Adriana Almeida Sales de Melo

2012-06-01

Full Text Available In discussing the theme Imperialism, Crisis and education, the essay points out aspects of our historical totality in relation to recent crises through which it passed capitalism, and its relationship to changes in Brazilian educational policies. Education remains at the heart of development projects, as a producer of knowledge, as well as guiding the processes of social conformation. They also discussed the aftermath of the crisis: the rise of social inequality and the increase of labor exploitation. Make clear our project of society and education, as resistance movements to the survival of capitalism is a necessity in building movements of counter-hegemony.

Scholarly communication : the role of oai in the context of open access

Directory of Open Access Journals (Sweden)

Ana Alice Baptista

2007-12-01

Full Text Available This paper discusses Open Access to scientific knowledge and its impacts on research. It overviews some of the major issues regarding the use of information technologies in scholarly communication activities, highlighting recent issues such as repository selfarchiving (green road and Open Access journals (golden road. Such issues are focused both as a reaction of researchers to the current business models of commercial scholarly publishers and as an awareness of the increasingly impact of documents available in Open Access. It adds to this discussion information about the necessary policies to fully implement Open Access. Authors describe the main technology facilities that support Open Access, such as OAI compliant Repositories and Journal Management systems. Moreover, future perspectives that should guide academic and government policies, decisions and actions that can assure Open Access, particularly in Portuguese Speaking Countries, are discussed.

Guided-wave tomography imaging plate defects by laser-based ultrasonic techniques

Energy Technology Data Exchange (ETDEWEB)

Park, Jun Pil; Lim, Ju Young; Cho, Youn Ho [School of Mechanical Engineering, Pusan National University, Pusan (Korea, Republic of)

2014-12-15

Contact-guided-wave tests are impractical for investigating specimens with limited accessibility and rough surfaces or complex geometric features. A non-contact setup with a laser-ultrasonic transmitter and receiver is quite attractive for guided-wave inspection. In the present work, we developed a non-contact guided-wave tomography technique using the laser-ultrasonic technique in a plate. A method for Lamb-wave generation and detection in an aluminum plate with a pulsed laser-ultrasonic transmitter and Michelson-interferometer receiver was developed. The defect shape and area in the images obtained using laser scanning, showed good agreement with the actual defect. The proposed approach can be used as a non-contact online inspection and monitoring technique.

MCSA Windows Server 2012 R2 configuring advanced services study guide exam 70-412

CERN Document Server

Panek, William

2015-01-01

The bestselling MCSA study guide, with expert instruction andhands-on practice MCSA Windows Server 2012 R2 Configuring Advanced ServicesStudy Guide provides focused preparation for exam 70-412 and isfully updated to align with the latest Windows Server 2012 R2objectives. This comprehensive guide covers 100 percent of all examobjective domains, and includes hundreds of practice questions andanswers. You get access to video demonstrations, electronicflashcards, and practice exams, and hands-on exercises based onreal-world scenarios allow you to apply your skills to everydaytasks. Organized by o

Role of ultrasonography in percutaneous renal access in patients with renal anatomic abnormalities.

Science.gov (United States)

Penbegul, Necmettin; Hatipoglu, Namik Kemal; Bodakci, Mehmet Nuri; Atar, Murat; Bozkurt, Yasar; Sancaktutar, Ahmet Ali; Tepeler, Abdulkadir

2013-05-01

To present our experience regarding the feasibility, safety, and efficacy of ultrasound (US)-guided percutaneous nephrolithotomy in anatomically abnormal kidneys. We performed US-guided percutaneous nephrolithotomy in 15 patients with anatomically abnormal kidneys and renal calculi. Of the 15 patients, 5 had horseshoe kidneys, 5 had rotation anomalies, 2 had kyphoscoliosis, and 3 had scoliosis. The stone size, number of access tracts, operative time, hospitalization duration, rate of stone clearance, and complication rate were recorded. Percutaneous access was achieved with US guidance in the operating room by the urologist. Successful renal access was obtained by the surgeon using US guidance in all patients, and a single access was obtained in all cases. Of the 15 patients, 8 were females, and 7 were males; 8 patients had solitary stones, and 7 had multiple calculi. The renal calculi were on the right in 7 patients and on the left in 8. Three patients had previously undergone unsuccessful shock wave lithotripsy. Complete stone clearance was achieved in 13 patients. The mean operative time was 54.2 minutes. No patient required a blood transfusion because of bleeding. Urinary tract infections occurred in 2 patients, who were treated with antibiotics. A double-J catheter was not inserted in any patient; however, a ureteral catheter was used in 3 patients for 1 day. None of the patients had any major complications during the postoperative period. The stone-free rate was 87%, and 2 patients had clinically insignificant residual fragments. Our results have demonstrated that US-guided percutaneous nephrolithotomy can be performed feasibly, safely, and effectively in anatomically abnormal kidneys. Copyright © 2013 Elsevier Inc. All rights reserved.

Introduction to SURPH.1 analysis of release-recapture data for survival studies

International Nuclear Information System (INIS)

Smith, S.G.; Skalski, J.R.; Schlechte, J.W.; Hoffmann, A.; Cassen, V.

1994-12-01

Program SURPH is the culmination of several years of research to develop a comprehensive computer program to analyze survival studies of fish and wildlife populations. Development of this software was motivated by the advent of the PIT-tag (Passive Integrated Transponder) technology that permits the detection of salmonid smolt as they pass through hydroelectric facilities on the Snake and Columbia Rivers in the Pacific Northwest. Repeated detections of individually tagged smolt and analysis of their capture-histories permits estimates of downriver survival probabilities. Eventual installation of detection facilities at adult fish ladders will also permit estimation of ocean survival and upstream survival of returning salmon using the statistical methods incorporated in SURPH.1. However, the utility of SURPH.1 far exceeds solely the analysis of salmonid tagging studies. Release-recapture and radiotelemetry studies from a wide range of terrestrial and aquatic species have been analyzed using SURPH.1 to estimate discrete time survival probabilities and investigate survival relationships. The interactive computing environment of SURPH.1 was specifically developed to allow researchers to investigate the relationship between survival and capture processes and environmental, experimental and individual-based covariates. Program SURPH.1 represents a significant advancement in the ability of ecologists to investigate the interplay between morphologic, genetic, environmental and anthropogenic factors on the survival of wild species. It is hoped that this better understanding of risk factors affecting survival will lead to greater appreciation of the intricacies of nature and to improvements in the management of wild resources. This technical report is an introduction to SURPH.1 and provides a user guide for both the UNIX and MS-Windows reg-sign applications of the SURPH software

Open access part II: the structure, resources, and implications for nurses.

Science.gov (United States)

Nick, Jan

2011-11-23

Electronic publishing has changed the landscape for broadcasting scholarly information. Now Open Access is globalizing scholarly work. Open Access facilitates lifelong learning habits; enhances dissemination and distribution of information; impacts the informatics curriculum; supports active learning; and provides areas for nursing informatics research. In the last 10 years the Open Access Movement has formalized into a distinct publishing paradigm. Many free, full-text resources are now available to guide nursing practice. This article describes the Open Access structure, and provides suggestions for using Open Access resources in classroom and practice settings. The nursing community is only beginning to accept and use Open Access. Yet all nurses should be aware of the unique opportunity to obtain free, current, and scholarly information through a variety of avenues and also to incorporate this information into their daily practice. The resources presented in this article can be used to increase nursing knowledge and support evidence-based practice.

Clinicopathologic Features and Survival of Breast Cancer Subtypes in Northeast Iran

Directory of Open Access Journals (Sweden)

Soodabeh Shahidsales

2018-01-01

Full Text Available Background: Breast cancer can be categorized into different histopathological subtypes based on gene expression profiles. This study aims to evaluate the clinicopathological features and overall survival of various subtypes of breast cancer to assist diagnosis and guide treatment. Methods: The clinicopathologic features of 1095 patients with breast cancer diagnosed over a 10–year period between 2001 and 2011 were analyzed. The Kaplan–Meier method was used to analyze disease-free survival and overall survival. Calculation of the hazard ratio was conducted by multivariate Cox regression. Results: According to the clinicopathologic characteristics of 1095 cases, there were 42% luminal A subtype, 19.2% luminal B, 23% triple negative, and 15% HER2+. The lowest (46.88±12.59 years and highest (50.54±12.32 years mean ages were in the triple negative and HER2+ groups, respectively. There was a significant correlation between histology subtype and age, BMI, lymph node, type of surgery, and stage of disease. There was significantly shorter overall survival and disease free survival in HER2+ breast cancer patients (P<0.001. Multivariate analysis showed that age had the highest hazard ratio of 2.481 (95% Confidence Interval: 1.375-4.477. Conclusion: The results of this study showed the importance of clinicopathological studies of molecular types which help early diagnosis and identification of the best strategy to treat breast cancer.

Pace-capture-guided ablation after contact-force-guided pulmonary vein isolation: results of the randomized controlled DRAGON trial.

Science.gov (United States)

Masuda, Masaharu; Fujita, Masashi; Iida, Osamu; Okamoto, Shin; Ishihara, Takayuki; Nanto, Kiyonori; Kanda, Takashi; Sunaga, Akihiro; Tsujimura, Takuya; Matsuda, Yasuhiro; Ohashi, Takuya; Uematsu, Masaaki

2017-11-17

Before the discovery of contact-force guidance, eliminating pacing capture along the pulmonary vein (PV) isolation line had been reported to improve PV isolation durability and rhythm outcomes. DRAGON (UMIN-CTR, UMIN000015332) aimed to elucidate the efficacy of pace-capture-guided ablation following contact-force-guided PV isolation ablation in paroxysmal atrial fibrillation (AF) patients. A total of 156 paroxysmal AF patients with AF-trigger ectopies from any of the four PVs induced by isoproterenol were randomly assigned to undergo pace-capture-guided ablation along a contact-force-guided isolation line around AF-trigger PVs (PC group, n = 76) or contact-force-guided PV isolation ablation alone (control group, n = 80). Follow-up of at least 1 year commenced with serial 24 h Holter and symptom-triggered ambulatory monitoring. There was no significant difference in acute PV reconnection rates during a 20 min waiting period after the last ablation or adenosine infusion testing between the PC and the control groups (per patient, 21% vs. 27%, P = 0.27; per AF-trigger PV, 5.9% vs. 7.3%, P = 0.70; and per non-AF-trigger PV, 7.1% vs. 7.4%, P = 0.92). Atrial tachyarrhythmia-free survival rates off antiarrhythmic drugs after the initial session were comparable at 19.3 ± 6.2 months between the two groups (82% vs. 80%, P = 0.80). Among 22 patients who required a second ablation procedure, there was no difference between the PC and the control groups in the PV reconnection rates at both previously AF-trigger (29% vs. 43%, P = 0.70) and non-AF-trigger PVs (18% vs. 19%, P = 0.88). Pace-capture-guided ablation performed after contact-force-guided PV isolation demonstrated no improvement in PV isolation durability or rhythm outcome. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

Lymphatic endothelial S1P promotes mitochondrial function and survival in naive T cells.

Science.gov (United States)

Mendoza, Alejandra; Fang, Victoria; Chen, Cynthia; Serasinghe, Madhavika; Verma, Akanksha; Muller, James; Chaluvadi, V Sai; Dustin, Michael L; Hla, Timothy; Elemento, Olivier; Chipuk, Jerry E; Schwab, Susan R

2017-06-01

Effective adaptive immune responses require a large repertoire of naive T cells that migrate throughout the body, rapidly identifying almost any foreign peptide. Because the production of T cells declines with age, naive T cells must be long-lived. However, it remains unclear how naive T cells survive for years while constantly travelling. The chemoattractant sphingosine 1-phosphate (S1P) guides T cell circulation among secondary lymphoid organs, including spleen, lymph nodes and Peyer's patches, where T cells search for antigens. The concentration of S1P is higher in circulatory fluids than in lymphoid organs, and the S1P 1 receptor (S1P 1 R) directs the exit of T cells from the spleen into blood, and from lymph nodes and Peyer's patches into lymph. Here we show that S1P is essential not only for the circulation of naive T cells, but also for their survival. Using transgenic mouse models, we demonstrate that lymphatic endothelial cells support the survival of T cells by secreting S1P via the transporter SPNS2, that this S1P signals through S1P 1 R on T cells, and that the requirement for S1P 1 R is independent of the established role of the receptor in guiding exit from lymph nodes. S1P signalling maintains the mitochondrial content of naive T cells, providing cells with the energy to continue their constant migration. The S1P signalling pathway is being targeted therapeutically to inhibit autoreactive T cell trafficking, and these findings suggest that it may be possible simultaneously to target autoreactive or malignant cell survival.

Treating anxiety and depression in young adults: A randomised controlled trial comparing clinician-guided versus self-guided Internet-delivered cognitive behavioural therapy.

Science.gov (United States)

Dear, Blake F; Fogliati, Vincent J; Fogliati, Rhiannon; Johnson, Bareena; Boyle, Olivia; Karin, Eyal; Gandy, Milena; Kayrouz, Rony; Staples, Lauren G; Titov, Nickolai

2017-10-01

Internet-delivered cognitive behaviour therapy may increase access by young adults to evidence-based treatments for anxiety and depression. The aim of this study was to compare the efficacy of an Internet-delivered cognitive behaviour therapy intervention designed for adults aged 18-24 years, when delivered in clinician-guided versus self-guided formats. The intervention, the Mood Mechanic Course, is a transdiagnostic treatment that simultaneously targets symptoms of anxiety and depression using cognitive and behavioural skills. The brief intervention comprised four lessons, delivered over 5 weeks. Following a brief telephone interview, young adults ( n = 191) with symptoms of anxiety and depression were randomly allocated to either (1) clinician-guided treatment ( n = 96) or (2) self-guided treatment ( n = 95). At post treatment, large reductions (average improvement; clinician guided vs self-guided) were observed in symptoms of anxiety (44% vs 35%) and depression (40% vs 31%) in both groups. Significant improvements were also observed in general psychological distress (33% vs 29%), satisfaction with life (18% vs 15%) and disability (36% vs 29%). No marked or consistent differences in clinical outcomes emerged between conditions at post-treatment, at 3-month or 12-month follow-up. Satisfaction was high with both treatment formats, but slightly higher for clinician-guided treatment. These results indicate the potential of carefully developed Internet-delivered cognitive behaviour therapy interventions for young adults with anxiety and depression provided in either self or therapist-guided format. Further large-scale research is required to determine the short- and long-term advantages and disadvantages of different models of support.

Mathematics for physicists and engineers fundamentals and interactive study guide

CERN Document Server

Weltner, Klaus; Weber, Wolfgang J; Schuster, Peter; Grosjean, Jean

2014-01-01

This textbook offers an accessible and highly approved approach which is characterized by the combination of the textbook with a detailed study guide available online at our repository extras.springer.com. This study guide divides the whole learning task into small units which the student is very likely to master successfully. Thus he or she is asked to read and study a limited section of the textbook and to return to the study guide afterwards. Working with the study guide his or her learning results are controlled, monitored and deepened by graded questions, exercises, repetitions and finally by problems and applications of the content studied. Since the degree of difficulties is slowly rising the students gain confidence and experience their own progress in mathematical competence thus fostering motivation. Furthermore in case of learning difficulties he or she is given supplementary explanations and in case of individual needs supplementary exercises and applications. So the sequence of the studies is ind...

Learning Survival Models with On-Line Simulation Activities in the Actuarial Science Degree

Directory of Open Access Journals (Sweden)

Antonio Fernandez-Morales

2011-03-01

Full Text Available The aim of this paper is to describe an on-line survival laboratory designed to enhance teaching and learning in the Statistics courses of the Actuarial Science Degree of the Uni-versity of Málaga. The objective of the on-line survival lab is to help students through a guided program of simulation activities with the understanding of the most important statistical concepts of the stochastic modeling of human survival, from an Actuarial point of view. The graphical interactive simulator is implemented as Java applets for the web version, and as a Javascript animation for a lite iPhone/iPod touch version. Finally, the results of a survey carried out at the end of the course are discussed to have a preliminary assessment of the students’ satisfaction with the resources, and their perception about the usefulness for their learning process.

Human rights responsibilities of pharmaceutical companies in relation to access to medicines.

Science.gov (United States)

Lee, Joo-Young; Hunt, Paul

2012-01-01

Although access to medicines is a vital feature of the right to the highest attainable standard of health ("right to health"), almost two billion people lack access to essential medicines, leading to immense avoidable suffering. While the human rights responsibility to provide access to medicines lies mainly with States, pharmaceutical companies also have human rights responsibilities in relation to access to medicines. This article provides an introduction to these responsibilities. It briefly outlines the new UN Guiding Principles on Business and Human Rights and places the human rights responsibilities of pharmaceutical companies in this context. The authors draw from the work of the first UN Special Rapporteur on the right to the highest attainable standard of health, in particular the Human Rights Guidelines for Pharmaceutical Companies in Relation to Access to Medicines that he presented to the UN General Assembly in 2008, and his UN report on GlaxoSmithKline (GSK). While the Guiding Principles on Business and Human Rights are general human rights standards applicable to all business entities, the Human Rights Guidelines for Pharmaceutical Companies consider the specific human rights responsibilities of one sector (pharmaceutical companies) in relation to one area of activity (access to medicines). The article signals the human rights responsibilities of all pharmaceutical companies, with particular attention to patent-holding pharmaceutical companies. Adopting a right-to-health "lens," the article discusses GSK and accountability. The authors argue that human rights should shape pharmaceutical companies' policies, and provide standards in relation to which pharmaceutical companies could, and should, be held accountable. They conclude that it is now crucial to devise independent, accessible, transparent, and effective mechanisms to monitor pharmaceutical companies and hold them publicly accountable for their human rights responsibilities. © 2012 American

The challenges and possibilities of public access defibrillation

DEFF Research Database (Denmark)

Ringh, Mattias; Hollenberg, Jacob; Palsgaard-Moeller, Thea

2018-01-01

. Much hope has been put to the concept of Public Access Defibrillation with a massive dissemination of public available AEDs throughout most western countries. Accordingly, current guidelines recommend that AEDs should be deployed in places with a high likelihood of OHCA. Despite these efforts, AED use...... is in most settings anecdotal with little effect on overall OHCA survival. The major reasons for low use of public AEDs are that most OHCA take place outside high incidence sites of cardiac arrest and that most OHCAs take place in residential settings, currently defined as not suitable for Public Access...... Defibrillation. However, the use of new technology for identification and recruitment of lay bystanders and nearby AEDs to the scene of the cardiac arrest as well as new methods for strategic AED placement redefines and challenges the current concept and definitions of Public Access Defibrillation. Existing...

Blogging business step-by-step startup guide

CERN Document Server

magazine, Entrepreneur

2014-01-01

This kit includes: Essential industry and business-specific startup steps with worksheets, calculators, checklists and more. Entrepreneur Editors' Start Your Own Business, a guide to starting any business and surviving the first three years. Downloadable, customizable business letters, sales letters, and other sample documents. Entrepreneur's Small Business Legal Toolkit. Blogs are still one of the internet's fastest-growing phenomena–and one of the best and easiest ways to make money online. Packed with the latest blog tools, tricks, and up-and-coming trends, this fully revised edition teache

Development and Evaluation of a Novel Curved Biopsy Device for CT-Guided Biopsy of Lesions Unreachable Using Standard Straight Needle Trajectories

Energy Technology Data Exchange (ETDEWEB)

Schulze-Hagen, Maximilian Franz, E-mail: mschulze@ukaachen.de; Pfeffer, Jochen; Zimmermann, Markus; Liebl, Martin [University Hospital RWTH Aachen, Department of Diagnostic and Interventional Radiology (Germany); Stillfried, Saskia Freifrau von [University Hospital RWTH Aachen, Department of Pathology (Germany); Kuhl, Christiane; Bruners, Philipp; Isfort, Peter [University Hospital RWTH Aachen, Department of Diagnostic and Interventional Radiology (Germany)

2017-06-15

PurposeTo evaluate the feasibility of a novel curved CT-guided biopsy needle prototype with shape memory to access otherwise not accessible biopsy targets.Methods and MaterialsA biopsy needle curved by 90° with specific radius was designed. It was manufactured using nitinol to acquire shape memory, encased in a straight guiding trocar to be driven out for access of otherwise inaccessible targets. Fifty CT-guided punctures were conducted in a biopsy phantom and 10 CT-guided punctures in a swine corpse. Biposies from porcine liver and muscle tissue were separately gained using the biopsy device, and histological examination was performed subsequently.ResultsMean time for placement of the trocar and deployment of the inner biopsy needle was ~205 ± 69 and ~93 ± 58 s, respectively, with a mean of ~4.5 ± 1.3 steps to reach adequate biopsy position. Mean distance from the tip of the needle to the target was ~0.7 ± 0.8 mm. CT-guided punctures in the swine corpse took relatively longer and required more biopsy steps (~574 ± 107 and ~380 ± 148 s, 8 ± 2.6 steps). Histology demonstrated appropriate tissue samples in nine out of ten cases (90%).ConclusionsTargets that were otherwise inaccessible via standard straight needle trajectories could be successfully reached with the curved biopsy needle prototype. Shape memory and preformed size with specific radius of the curved needle simplify the target accessibility with a low risk of injuring adjacent structures.

Presto 2.9 user's guide.

Energy Technology Data Exchange (ETDEWEB)

Jung, Joseph

2008-05-01

Presto is a Lagrangian, three-dimensional explicit, transient dynamics code that is used to analyze solids subjected to large, suddenly applied loads. The code is designed for a parallel computing environment and for problems with large deformations, nonlinear material behavior, and contact. Presto also has a versatile element library that incorporates both continuum elements and structural elements. This user's guide describes the input for Presto that gives users access to all the current functionality in the code. The environment in which Presto is built allows it to be coupled with other engineering analysis codes. Using a concept called scope, the input structure reflects the fact that Presto can be used in a coupled environment. The user's guide describes how scope is implemented from the outermost to the innermost scopes. Within a given scope, the descriptions of input commands are grouped based on functionality of the code. For example, all material input command lines are described in a chapter of the user's guide for all the material models that can be used in Presto.

Presto 4.18 user's guide.

Energy Technology Data Exchange (ETDEWEB)

Spencer, Benjamin Whiting

2010-09-01

Presto is a Lagrangian, three-dimensional explicit, transient dynamics code that is used to analyze solids subjected to large, suddenly applied loads. The code is designed for a parallel computing environment and for problems with large deformations, nonlinear material behavior, and contact. Presto also has a versatile element library that incorporates both continuum elements and structural elements. This user's guide describes the input for Presto that gives users access to all the current functionality in the code. The environment in which Presto is built allows it to be coupled with other engineering analysis codes. Using a concept called scope, the input structure reflects the fact that Presto can be used in a coupled environment. The user's guide describes how scope is implemented from the outermost to the innermost scopes. Within a given scope, the descriptions of input commands are grouped based on functionality of the code. For example, all material input command lines are described in a chapter of the user's guide for all the material models that can be used in Presto.

CT-guided lung biopsy: incidence of pneumothorax after instillation of NaCl into the biopsy track

International Nuclear Information System (INIS)

Billich, Christian; Brenner, Gerhard; Schmidt, Stefan A.; Brambs, Hans-Juergen; Pauls, Sandra; Muche, Rainer; Krueger, Stefan

2008-01-01

This study was conducted to evaluate whether instillation of NaCl 0.9% solution into the biopsy track reduces the incidence of pneumothoraces after CT-guided lung biopsy. A total of 140 consecutive patients with pulmonary lesions were included in this prospective study. All patients were alternatingly assigned to one of two groups: group A in whom the puncture access was sealed by instillation of NaCl 0.9% solution during extraction of the guide needle (n 70) or group B for whom no sealing was performed (n = 70). CT-guided biopsy was performed with a 18-G coaxial system. Localization of lesion (pleural, peripheral, central), lesion size, needle-pleural angle, rate of pneumothorax and alveolar hemorrhage were evaluated. In group A, the incidence of pneumothorax was lower compared to group B (8%, 6/70 patients vs. 34%, 24/70 patients; P < 0.001). All pneumothoraces occurred directly post punctionem after extraction of the guide needle. One patient in group A and eight patients in group B developed large pneumothoraces requiring chest tube placement (P 0.01). The frequency of pneumothorax was independent of other variables. After CT-guided biopsy, instillation of NaCl 0.9% solution into the puncture access during extraction of the needle significantly reduces the incidence of pneumothorax. (orig.)

CT-guided lung biopsy: incidence of pneumothorax after instillation of NaCl into the biopsy track

Energy Technology Data Exchange (ETDEWEB)

Billich, Christian; Brenner, Gerhard; Schmidt, Stefan A.; Brambs, Hans-Juergen; Pauls, Sandra [University of Ulm, Department of Diagnostic and Interventional Radiology, Ulm (Germany); Muche, Rainer [University of Ulm, Institute of Biometrics, Ulm (Germany); Krueger, Stefan [University of Ulm, Department of Internal Medicine, Ulm (Germany)

2008-06-15

This study was conducted to evaluate whether instillation of NaCl 0.9% solution into the biopsy track reduces the incidence of pneumothoraces after CT-guided lung biopsy. A total of 140 consecutive patients with pulmonary lesions were included in this prospective study. All patients were alternatingly assigned to one of two groups: group A in whom the puncture access was sealed by instillation of NaCl 0.9% solution during extraction of the guide needle (n = 70) or group B for whom no sealing was performed (n = 70). CT-guided biopsy was performed with a 18-G coaxial system. Localization of lesion (pleural, peripheral, central), lesion size, needle-pleural angle, rate of pneumothorax and alveolar hemorrhage were evaluated. In group A, the incidence of pneumothorax was lower compared to group B (8%, 6/70 patients vs. 34%, 24/70 patients; P < 0.001). All pneumothoraces occurred directly post punctionem after extraction of the guide needle. One patient in group A and eight patients in group B developed large pneumothoraces requiring chest tube placement (P = 0.01). The frequency of pneumothorax was independent of other variables. After CT-guided biopsy, instillation of NaCl 0.9% solution into the puncture access during extraction of the needle significantly reduces the incidence of pneumothorax. (orig.)

Totally Accessible MRI A User's Guide to Principles, Technology, and Applications

CERN Document Server

Lipton, Michael L

2008-01-01

This is a practical guide that offers a lucid introduction to the principles of MRI physics. The author, recognized in the imaging community for his exceptional teaching methods and lectures, has written an easy to understand text. Each chapter explains the "why" and "how" behind MRI physics. Readers will understand how altering MRI parameters will have many different consequences for image quality and the speed in which images are generated. Practical topics, selected for their value to clinical practice, include progressive changes in key MRI parameters, imaging time, and signal to noise ratio. A wealth of high quality illustrations, complemented by concise text, enables readers to gain a thorough understanding of the subject without requiring prior in-depth knowledge

Review of factors affecting the growth and survival of follicular grafts

Directory of Open Access Journals (Sweden)

William M Parsley

2010-01-01

Full Text Available Great strides have been made in hair restoration over the past 20 years. A better understanding of natural balding and non-balding patterns along with more respect for ageing has helped guide proper hairline design. Additionally, the use of smaller grafts has created a significantly improved natural appearance to the transplanted grafts. Inconsistent growth and survival of follicular grafts, however, has continued to be a problem that has perplexed hair restoration surgeons. This review attempts to explore the stresses affecting grafts during transplantation and some of the complexities involved in graft growth and survival. These authors reviewed the literature to determine the primary scope of aspects influencing growth and survival of follicular grafts. This scope includes patient selection, operating techniques, graft care, storage solutions and additives. The primary focus of the hair restoration surgeons should first be attention to the fundamentals of hair care, hydration, temperature, time out of body and gentle handling. Factors such as advanced storage solutions and additives can be helpful once the fundamentals have been addressed.

A quick guide to pipeline engineering

CERN Document Server

Alkazraji, D

2008-01-01

Pipeline engineering requires an understanding of a wide range of topics. Operators must take into account numerous pipeline codes and standards, calculation approaches, and reference materials in order to make accurate and informed decisions.A Quick Guide to Pipeline Engineering provides concise, easy-to-use, and accessible information on onshore and offshore pipeline engineering. Topics covered include: design; construction; testing; operation and maintenance; and decommissioning.Basic principles are discussed and clear guidance on regulations is provided, in a way that will

MRI-guided vacuum-assisted breast biopsy: comparison with stereotactically guided and ultrasound-guided techniques

Energy Technology Data Exchange (ETDEWEB)

Imschweiler, Thomas; Freiwald, Bianka; Kubik-Huch, Rahel A. [Kantonspital Baden AG, Institute for Radiology, Baden (Switzerland); Haueisen, Harald [Kantonspital Aarau AG, Institute for Radiology, Aarau (Switzerland); Kampmann, Gert [Clinica Sant' Anna, Lugano, Sorengo (Switzerland); Rageth, Luzi [Adjumed Services AG, Zurich (Switzerland); Seifert, Burkhardt [Institute for Social and Preventive Medicine, University of Zurich, Division of Biostatistics, Zuerich (Switzerland); Rageth, Christoph [Breast Centre, Zurich (Switzerland)

2014-01-15

To analyse the development of MRI-guided vacuum-assisted biopsy (VAB) in Switzerland and to compare the procedure with stereotactically guided and ultrasound-guided VAB. We performed a retrospective analysis of VABs between 2009 and 2011. A total of 9,113 VABs were performed. Of these, 557 were MRI guided. MRI-guided VAB showed the highest growth rate (97 %) of all three procedures. The technical success rates for MRI-guided, stereotactically guided and ultrasound-guided VAB were 98.4 % (548/557), 99.1 % (5,904/5,960) and 99.6 % (2,585/2,596), respectively. There were no significant differences (P = 0.12) between the MRI-guided and the stereotactically guided procedures. The technical success rate for ultrasound-guided VAB was significantly higher than that for MRI-guided VAB (P < 0.001). There were no complications using MRI-guided VAB requiring open surgery. The malignancy diagnosis rate for MRI-guided VAB was similar to that for stereotactically guided VAB (P = 0.35). MRI-guided VAB is a safe and accurate procedure that provides insight into clinical breast findings. (orig.)

Extra Luminal Entrapment of Guide Wire; A Rare Complication of Central Venous Catheter Placement in Right Internal Jugular Vein

OpenAIRE

Ansari, Md Abu Masud; Kumar, Naveen; Kumar, Shailesh; Kumari, Sarita

2016-01-01

Central venous Catheterization (CVC) is a commonly performed procedure for venous access. It is associated with several complications. We report a rare case of extra luminal entrapment of guide wire during CVC placement in right jugular vein. We report a case of 28 years old female patient presented in our emergency with history of entrapped guide wire in right side of neck during CVC. X-ray showed coiling of guide wire in neck. CT Angiography showed guide wire coursing in between common caro...

Downstream fish passage guide walls: A hydraulic scale model analysis

Science.gov (United States)

Mulligan, Kevin; Towler, Brett; Haro, Alexander J.; Ahlfeld, David P.

2018-01-01

Partial-depth guide walls are used to improve passage efficiency and reduce the delay of out-migrating anadromous fish species by guiding fish to a bypass route (i.e. weir, pipe, sluice gate) that circumvents the turbine intakes, where survival is usually lower. Evaluation and monitoring studies, however, indicate a high propensity for some fish to pass underneath, rather than along, the guide walls, compromising their effectiveness. In the present study we evaluated a range of guide wall structures to identify where/if the flow field shifts from sweeping (i.e. flow direction primarily along the wall and towards the bypass) to downward-dominant. Many migratory fish species, particularly juveniles, are known to drift with the flow and/or exhibit rheotactic behaviour during their migration. When these behaviours are present, fish follow the path of the flow field. Hence, maintaining a strong sweeping velocity in relation to the downward velocity along a guide wall is essential to successful fish guidance. Nine experiments were conducted to measure the three-dimensional velocity components upstream of a scale model guide wall set at a wide range of depths and angles to flow. Results demonstrated how each guide wall configuration affected the three-dimensional velocity components, and hence the downward and sweeping velocity, along the full length of the guide wall. In general, the velocities produced in the scale model were sweeping dominant near the water surface and either downward dominant or close to the transitional depth near the bottom of the guide wall. The primary exception to this shift from sweeping do downward flow was for the minimum guide wall angle tested in this study (15°). At 15° the flow pattern was fully sweeping dominant for every cross-section, indicating that a guide wall with a relatively small angle may be more likely to produce conditions favorable to efficient guidance. A critical next step is to evaluate the behaviour of migratory fish as

Teach yourself visually Access 2013

CERN Document Server

McFedries, Paul

2013-01-01

The easy, visual way to learn this popular database program Part of the Office 2013 productivity suite, Access enables you to organize, present, analyze, and share data on a network or over the web. With this Visual guide to show you how, you'll master the fundamentals of this robust database application in no time. Clear, step-by-step instructions are illustrated with full-color screen shots that show exactly what you should see on your screen. Learn to enter new records; create, edit, and design tables and forms; develop queries that generate specific reports; add smart tags to y

Guided-wave tomographic imaging of plate defects by laser-based ultrasonic techniques

Energy Technology Data Exchange (ETDEWEB)

Park, Junpil; Lim, Ju Young; Cho, Youn Ho [School of Mechanical Engineering, Pusan National University, Busan (Korea, Republic of)

2016-12-15

Contact-guided-wave tests are impractical for investigating specimens with limited accessibility and rough surfaces or complex geometric features. A non-contact setup with a laser-ultrasonic transmitter and receiver is quite attractive for guided-wave inspection. In the present work, we developed a non-contact guided-wave tomography technique using the laser-ultrasonic technique in a plate. A method for Lamb-wave generation and detection in an aluminum plate with a pulsed laser-ultrasonic transmitter and Michelson-interferometer receiver was developed. The defect shape and area in the images obtained using laser scanning, showed good agreement with the actual defect. The proposed approach can be used as a non-contact online inspection and monitoring technique.

A Novel Method for Intraoral Access to the Superior Head of the Human Lateral Pterygoid Muscle

Directory of Open Access Journals (Sweden)

Aleli Tôrres Oliveira

2014-01-01

Full Text Available Background. The uncoordinated activity of the superior and inferior parts of the lateral pterygoid muscle (LPM has been suggested to be one of the causes of temporomandibular joint (TMJ disc displacement. A therapy for this muscle disorder is the injection of botulinum toxin (BTX, of the LPM. However, there is a potential risk of side effects with the injection guide methods currently available. In addition, they do not permit appropriate differentiation between the two bellies of the muscle. Herein, a novel method is presented to provide intraoral access to the superior head of the human LPM with maximal control and minimal hazards. Methods. Computational tomography along with digital imaging software programs and rapid prototyping techniques were used to create a rapid prototyped guide to orient BTX injections in the superior LPM. Results. The method proved to be feasible and reliable. Furthermore, when tested in one volunteer it allowed precise access to the upper head of LPM, without producing side effects. Conclusions. The prototyped guide presented in this paper is a novel tool that provides intraoral access to the superior head of the LPM. Further studies will be necessary to test the efficacy and validate this method in a larger cohort of subjects.

Biophysical characterization of a relativistic proton beam for image-guided radiosurgery.

Science.gov (United States)

Yu, Zhan; Vanstalle, Marie; La Tessa, Chiara; Jiang, Guo-Liang; Durante, Marco

2012-07-01

We measured the physical and radiobiological characteristics of 1 GeV protons for possible applications in stereotactic radiosurgery (image-guided plateau-proton radiosurgery). A proton beam was accelerated at 1 GeV at the Brookhaven National Laboratory (Upton, NY) and a target in polymethyl methacrylate (PMMA) was used. Clonogenic survival was measured after exposures to 1-10 Gy in three mammalian cell lines. Measurements and simulations demonstrate that the lateral scattering of the beam is very small. The lateral dose profile was measured with or without the 20-cm plastic target, showing no significant differences up to 2 cm from the axis A large number of secondary swift protons are produced in the target and this leads to an increase of approximately 40% in the measured dose on the beam axis at 20 cm depth. The relative biological effectiveness at 10% survival level ranged between 1.0 and 1.2 on the beam axis, and was slightly higher off-axis. The very low lateral scattering of relativistic protons and the possibility of using online proton radiography during the treatment make them attractive for image-guided plateau (non-Bragg peak) stereotactic radiosurgery.

Biophysical characterization of a relativistic proton beam for image-guided radiosurgery

International Nuclear Information System (INIS)

Yu, Z.; Vanstalle, M.; La Tessa, C.; Durante, M.; Jiang Guoliang

2012-01-01

We measured the physical and radiobiological characteristics of 1 GeV protons for possible applications in stereotactic radiosurgery (image-guided plateau-proton radiosurgery). A proton beam was accelerated at 1 GeV at the Brookhaven National Laboratory (Upton, NY) and a target in polymethyl methacrylate (PMMA) was used. Clonogenic survival was measured after exposures to 1-10 Gy in three mammalian cell lines. Measurements and simulations demonstrate that the lateral scattering of the beam is very small. The lateral dose profile was measured with or without the 20-cm plastic target, showing no significant differences up to 2 cm from the axis A large number of secondary swift protons are produced in the target and this leads to an increase of approximately 40% in the measured dose on the beam axis at 20 cm depth. The relative biological effectiveness at 10% survival level ranged between 1.0 and 1.2 on the beam axis, and was slightly higher off-axis. The very low lateral scattering of relativistic protons and the possibility of using online proton radiography during the treatment make them attractive for image-guided plateau (non-Bragg peak) stereotactic radiosurgery. (author)

Seedling survival of Handroanthus impetiginosus (Mart ex DC Mattos in a semi-arid environment through modified germination speed and post-germination desiccation tolerance

Directory of Open Access Journals (Sweden)

J. R. Martins

Full Text Available Abstract Uniform rapid seed germination generally forms a great risk for the plant population if subsequent intermittent precipitation causes desiccation and seedling death. Handroanthus impetiginosus can be found commonly in a wide range of biomes within Brazil including those that are semi-arid. Germination and early growth was studied to understand how germinated seeds survive under these stringent conditions. Accessions were sampled from four seasonally dry biomes in Brazil. Precipitation at the start of the rainy season in the Caatinga, a semi-arid biome, is less predictable and the number of successive dry days per dry interval in the first four months of the rainy season was higher than in the other studied biomes. Plants from the Caatinga produced thicker seeds and this trait concurred with slow germination and stronger osmotic inhibition of germination across the accessions, forming a stress avoidance mechanism in the Caatinga. Post-germination desiccation tolerance was high in the Caatinga accession, could be re-induced in accessions from biomes with more regular precipitation (Cerrado and transition zone, but remained poor in the Cerradão accession; thus forming a stress tolerance mechanism. Production of adventitious roots ascertained survival of all tested individuals from all four locations, even if protruded radicles did not survive desiccation, forming an additional stress tolerance mechanism. A sequence of stress avoidance and stress tolerance mechanisms in seeds and germinated seeds was associated with precipitation patterns in different biomes. These mechanisms purportedly allow rapid seedling establishment when conditions are suitable and enable survival of the young seedling when conditions are adverse.

Factors of influence upon overall survival in the treatment of intracranial MPNSTs. Review of the literature and report of a case

International Nuclear Information System (INIS)

Gousias, Konstantinos; Boström, Jan; Kovacs, Attila; Niehusmann, Pitt; Wagner, Ingo; Kristof, Rudolf

2010-01-01

Intracranial malignant peripheral nerve sheath tumors are rare entities that carry a poor prognosis. To date, there are no established therapeutic strategies for these tumors. We review the present treatment modalities and present the current therapeutic dilemmas. We perform a statistical analysis to evaluate the prognostic factors for Overall Survival of these patients. Additionally, we present our experience with a 64-year-old man with a MPNST of the left cerebellopontine angle. To our best knowledge, forty three patients with intracranial MPNSTs, including our case, have been published in the international literature. Our analysis showed gross total resection, radiotherapy and female gender to be beneficial prognostic factors of survival in the univariate analysis. Gross total resection was recognized as the only independent predictor of prolonged Overall Survival. In our case, we performed a gross total resection followed for the first time by stereotactically guided radiotherapy. Considering the results of the statistical analysis and the known advantages of the stereotaxy, we suggest aggressive surgery followed by stereotactically guided radiotherapy as therapy of choice

OCA Oracle Database SQL exam guide (exam 1Z0-071) complete exam preparation

CERN Document Server

O'Hearn, Steve

2017-01-01

This thoroughly revised Oracle Press guide offers 100% coverage of all objectives on the latest version of the Oracle Database SQL Exam. Ideal both as a study guide and on-the-job reference, OCA Oracle Database SQL Exam Guide (Exam 1Z0-071) features detailed explanations, examples, practice questions, and chapter summaries. “Certification Objectives,” “Exam Watch,” and “On the Job” sections reinforce salient points throughout. You will gain access to two complete practice exams that match the tone, tenor, and format of the live test. Get complete coverage every topic on Exam 1Z0-071, including: • DDL and SQL SELECT statements • Manipulating, restricting, and sorting data • Single-row and group functions • Displaying data from multiple tables • Subqueries • Schema objects • Set operators • Grouping related data • Report creation • Data dictionary views • Large data sets • Hierarchical retrieval • Regular expression support • User access control The electronic includes: • Two full practi...

OCA Oracle Database SQL exam guide (exam 1Z0-071) : complete exam preparation

CERN Document Server

O'Hearn, Steve

2017-01-01

This thoroughly revised Oracle Press guide offers 100% coverage of all objectives on the latest version of the Oracle Database SQL Exam. Ideal both as a study guide and on-the-job reference, OCA Oracle Database SQL Exam Guide (Exam 1Z0-071) features detailed explanations, examples, practice questions, and chapter summaries. “Certification Objectives,” “Exam Watch,” and “On the Job” sections reinforce salient points throughout. You will gain access to two complete practice exams that match the tone, tenor, and format of the live test. Get complete coverage every topic on Exam 1Z0-071, including: • DDL and SQL SELECT statements • Manipulating, restricting, and sorting data • Single-row and group functions • Displaying data from multiple tables • Subqueries • Schema objects • Set operators • Grouping related data • Report creation • Data dictionary views • Large data sets • Hierarchical retrieval • Regular expression support • User access control The electronic includes: • Two full practi...

SYMPAL: utilities guide

International Nuclear Information System (INIS)

Simpson, J.A.; Sublet, J.-Ch.

1997-02-01

The processing code SYMPAL is used to perform the data treatment for creating a new version of the European Activation File (EAF). The entire process is handled by different modules of the code in a sequential and orderly manner. The modular code system accesses, translates and processes cross section data from a wide variety of libraries and calculations with nuclear model codes. Two major data bases are accessed and merged so as to create a new library version. The Master Data File (MDF) contains the original cross section data extracted, unmodified but reformatted, from numerous sources. The Master Parameter File (MPF) contains a compilation of all physical information necessary to renormalise, split and internally validate any particular type of cross section. The combination of these two files generates a new activation library in pointwise and various groupwise formats. The SYMPAL utilities guide describes a set of programs developed to handle certain aspects of the procedure done outside of the main processing tasks. These include counting, translating, selecting and plotting data streams. Special printing and plotting procedures have been written to handle the large amounts of information present in activation libraries. (author)

Remotely Piloted Aerial Systems Survivability: A Defense-in-Depth Approach

Science.gov (United States)

2012-09-01

The 2007 roadmap fails to account for the fact that survivability and interoperability cannot be divorced when dealing with a system of systems...School, Monterrey , CA, August 2004), http://www.nps.edu/Academics/Schools/GSEAS/Departments/SE/Documents/SE- Scholarship.doc, (accessed 13 December 2009...Statement on Systems Engineering Scholarship.” Naval Postgraduate School, Monterrey , CA, August 2004. http://www.nps.edu/Academics/Schools/GSEAS

Survival analysis of cancer risk reduction strategies for BRCA1/2 mutation carriers.

Science.gov (United States)

Kurian, Allison W; Sigal, Bronislava M; Plevritis, Sylvia K

2010-01-10

Women with BRCA1/2 mutations inherit high risks of breast and ovarian cancer; options to reduce cancer mortality include prophylactic surgery or breast screening, but their efficacy has never been empirically compared. We used decision analysis to simulate risk-reducing strategies in BRCA1/2 mutation carriers and to compare resulting survival probability and causes of death. We developed a Monte Carlo model of breast screening with annual mammography plus magnetic resonance imaging (MRI) from ages 25 to 69 years, prophylactic mastectomy (PM) at various ages, and/or prophylactic oophorectomy (PO) at ages 40 or 50 years in 25-year-old BRCA1/2 mutation carriers. With no intervention, survival probability by age 70 is 53% for BRCA1 and 71% for BRCA2 mutation carriers. The most effective single intervention for BRCA1 mutation carriers is PO at age 40, yielding a 15% absolute survival gain; for BRCA2 mutation carriers, the most effective single intervention is PM, yielding a 7% survival gain if performed at age 40 years. The combination of PM and PO at age 40 improves survival more than any single intervention, yielding 24% survival gain for BRCA1 and 11% for BRCA2 mutation carriers. PM at age 25 instead of age 40 offers minimal incremental benefit (1% to 2%); substituting screening for PM yields a similarly minimal decrement in survival (2% to 3%). Although PM at age 25 plus PO at age 40 years maximizes survival probability, substituting mammography plus MRI screening for PM seems to offer comparable survival. These results may guide women with BRCA1/2 mutations in their choices between prophylactic surgery and breast screening.

Self-taught axillary vein access without venography for pacemaker implantation: prospective randomized comparison with the cephalic vein access.

Science.gov (United States)

Squara, Fabien; Tomi, Julien; Scarlatti, Didier; Theodore, Guillaume; Moceri, Pamela; Ferrari, Emile

2017-12-01

Axillary vein access for pacemaker implantation is uncommon in many centres because of the lack of training in this technique. We assessed whether the introduction of the axillary vein technique was safe and efficient as compared with cephalic vein access, in a centre where no operators had any previous experience in axillary vein puncture. Patients undergoing pacemaker implantation were randomized to axillary or cephalic vein access. All three operators had no experience nor training in axillary vein puncture, and self-learned the technique by reading a published review. Axillary vein puncture was fluoroscopy-guided without contrast venography. Cephalic access was performed by dissection of delto-pectoral groove. Venous access success, venous access duration (from skin incision to guidewire or lead in superior vena cava), procedure duration, X-ray exposure, and peri-procedural (1 month) complications were recorded. results We randomized 74 consecutive patients to axillary (n = 37) or cephalic vein access (n = 37). Axillary vein was successfully accessed in 30/37 (81.1%) patients vs. 28/37 (75.7%) of cephalic veins (P = 0.57). Venous access time was shorter in axillary group than in cephalic group [5.7 (4.4-8.3) vs. 12.2 (10.5-14.8) min, P < 0.001], as well as procedure duration [34.8 (30.6-38.4) vs. 42.0 (39.1-46.6) min, P = 0.043]. X-ray exposure and peri-procedural overall complications were comparable in both groups. Axillary puncture was safe and faster than cephalic access even for the five first procedures performed by each operator. Self-taught axillary vein puncture for pacemaker implantation seems immediately safe and faster than cephalic vein access, when performed by electrophysiologists trained to pacemaker implantation but not to axillary vein puncture. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissions@oup.com.

Remaining missed opportunities of child survival in Peru: modelling mortality impact of universal and equitable coverage of proven interventions

OpenAIRE

Yvonne Tam; Luis Huicho; Carlos A. Huayanay-Espinoza; María Clara Restrepo-Méndez

2016-01-01

Background Peru has made great improvements in reducing stunting and child mortality in the past decade, and has reached the Millennium Development Goals 1 and 4. The remaining challenges or missed opportunities for child survival needs to be identified and quantified, in order to guide the next steps to further improve child survival in Peru. Methods We used the Lives Saved Tool (LiST) to project the mortality impact of proven interventions reaching every women and child in need, and the mor...

A New CT-Guided Modified Trocar Technique for Drainage of Difficult Locations Abscesses

Energy Technology Data Exchange (ETDEWEB)

Tyng, Chiang J., E-mail: chiangjengtyng@gmail.com; Amoedo, Maurício K.; Bohrer, Yves; Bitencourt, Almir G. V.; Barbosa, Paula N. V.; Almeida, Maria Fernanda A.; Zurstrassen, Charles E. [AC Camargo Cancer Center, Department of Imaging (Brazil); Coimbra, Felipe J. F.; Costa, Wilson L. da [AC Camargo Cancer Center, Department of Abdominal Surgery (Brazil); Chojniak, Rubens [AC Camargo Cancer Center, Department of Imaging (Brazil)

2017-05-15

PurposeComputed tomography (CT) is commonly used to guide drainage of deep-seated abdominal fluid collections. However, in some cases, these collections seem to be inaccessible due to surrounding organs or their being in difficult locations. The aim of this study is to describe a modified Trocar technique to drain collections in difficult locations, especially those in the subphrenic space, without passing through intervening organs.Materials and MethodsThis retrospective case series study describes seven inpatients who underwent CT-guided drainage using a modified Trocar technique for abscesses that are difficult to access percutaneously. All patients provided written informed consent prior to the procedure. After placement of a 12–14F catheter inside the peritoneum, the Trocar stylet was removed so that the tip of the catheter became blunt and flexible to avoid injury to organs and structures in the catheter route, and the catheter was slowly advanced towards the collection using CT guidance and tactile sensation. After reaching the target, the stylet was reintroduced to enter the abscess wall.ResultsAll procedures were performed using an anterior abdominal wall access with adequate catheter positioning and resulted in clinical status improvement in the days after the drainage. No complications related to the procedure were identified in any of the patients.ConclusionsThe modified Trocar technique for percutaneous CT-guided drainage of abdominal abscesses may be feasible for lesions that are difficult to access with conventional methods.

The evaluation of radiologic methods for access guidance in percutaneous nephrolithotomy: a systematic review of the literature.

Science.gov (United States)

Breda, Alberto; Territo, Angelo; Scoffone, Cesare; Seitz, Christian; Knoll, Thomas; Herrmann, Thomas; Brehmer, Mariannhe; Osther, Palle J S; Liatsikos, Evangelos

2017-11-12

Percutaneous nephrolithotomy (PNL) is the treatment of choice for larger and complex renal calculi. First step in performing PNL is to obtain access to the renal cavity using either fluoroscopy or ultrasound (US) guidance or a combination of both. Which guiding method to choose is controversial? A systematic review of the literature was performed comparing image guidance modalities for obtaining access in PNL. Evidence acquisition and synthesis: A PubMed, Scopus and Cochrane search for peer-reviewed studies was performed using the keywords "ultrasound" AND "fluoroscopy" AND "Percutaneous nephrolithotomy". Eligible articles were reviewed according to PRISMA criteria. Two hundred and forty records were identified using the keywords. Of these twelve studies were considered relevant. US guidance seems to be associated with a slightly lower complication rate, which may be related to fewer puncture attempts needed for obtaining access and to better peri-renal organ visualization. On the other hand, US-guidance alone needs the adjunct of fluoroscopy in a significant number of cases for achieving access. Stone free rate (SFR) was comparable between groups. Using US for renal access unequivocally reduces radiation exposure. Current evidence indicates that both fluoroscopy and US guidance may be successfully used for obtaining percutaneous renal access. Combining the image-guiding modalities - US and fluoroscopy - seems to increase outcome in PNL both with regard to success in achieving access and reducing complications. Furthermore, including US in the access strategy of PNL reduces radiation exposure to surgeon and staff as well as patients.

Prioritising Redundant Network Component for HOWBAN Survivability Using FMEA

Directory of Open Access Journals (Sweden)

Cheong Loong Chan

2017-01-01

Full Text Available Deploying redundant component is the ubiquitous approach to improve the reliability and survivability of a hybrid optical wireless broadband access network (HOWBAN. Much work has been done to study the cost and impact of deploying redundant component in the network but no formal tools have been used to enable the evaluation and decision to prioritise the deployment of redundant facilities in the network. In this paper we show how FMEA (Failure Mode Effect and Analysis technique can be adapted to identify the critical segment in the network and prioritise the redundant component to be deployed to ensure network survivability. Our result showed that priority must be given to redundancy to mitigate grid power outage particularly in less developed countries which is poised for rapid expansion in broadband services.

Unified Facilities Criteria (UFC) Design Guide. Army Reserve Facilities

Science.gov (United States)

2010-02-01

horticulturally appropriate to the site specific location in which they are planted. Consideration should be given to adjacent structures and improvements...impact FPI Federal Prison Industries FPM Feet per minute GFCI Government-furnished/contractor-installed or Ground-Fault Circuit Interrupter GFGI...Uniform Federal Accessibility Standards UFGs Unified Facility Guide Specifications UFGs Rst UFGS - Reserve Support Team UnICoR Federal Prison Industry

Southern forest inventory and analysis volume equation user’s guide

Science.gov (United States)

Christopher M. Oswalt; Roger C. Conner

2011-01-01

Reliable volume estimation procedures are fundamental to the mission of the Forest Inventory and Analysis (FIA) program. Moreover, public access to FIA program procedures is imperative. Here we present the volume estimation procedures used by the southern FIA program of the U.S. Department of Agriculture Forest Service Southern Research Station. The guide presented...

Hispanic Folk Arts and the Environment: An Interdisciplinary Curriculum Guide. A New Mexican Perspective.

Science.gov (United States)

Lopez, Alejandro

This interdisciplinary, bilingual curriculum resource, contains a 29-minute videotape program, 20 colorplate posters, and a curriculum guide. The resource presents an examination of the folklife and folklore expressions of the Hispanic people of New Mexico. The focus of the curriculum is the relationship of survival-based folk activities to the…

Influence of diet, exercise, and dietician’s on the incidence and survival of japanese dialysis patients

Directory of Open Access Journals (Sweden)

Satoshi Ogata

2012-06-01

Full Text Available It is known that there are distinct regional differences in the incidence and prevalence of dialysis, as well as the survival of dialysis patients in Japan. We investigated the relationship between diet, the level of exercise, and the incidence of dialysis due to diabetes mellitus (DM and chronic glomerulonephritis (CGN. We also investigated the influence of access to full-time and part-time dieticians at dialysis centers on survival. We used data for the 47 prefectures of Japan from the National Nutrition Survey 1995-99 (n=38,003 and the Japanese Society for Dialysis Therapy 2005-07 (n=45,033. The impact of each factor was assessed by univariate regression analysis. Univariate analysis showed that body mass index (BMI (r=0.296, p=0.022, intake of fish and shellfish (r=−0.254, p=0.043, and the intake of meat (r=0.275, p=0.031 were correlated with the incidence of new patients starting dialysis due to DM. In addition, the BMI (r=0.355, p=0.014, number of steps walked daily (r=−0.358, p=0.014, intake of green and yellow vegetables (r=−0.424, p=0.003, intake of fish and shellfish (r=−0.358, p=0.014, and intake of milk (r=−0.529, p<0.001 were correlated with the incidence of new patients starting dialysis due to CGN. Access to full-time dieticians was correlated with the 1-year survival of new dialysis patients (r=0.294, p=0.023, but not access to part-time dieticians. We conclude that nutritional advice might play an important role in survival in dialysis patients.

Socioeconomic disparity in survival after breast cancer in ireland: observational study.

Directory of Open Access Journals (Sweden)

Paul M Walsh

Full Text Available We evaluated the relationship between breast cancer survival and deprivation using data from the Irish National Cancer Registry. Cause-specific survival was compared between five area-based socioeconomic deprivation strata using Cox regression. Patient and tumour characteristics and treatment were compared using modified Poisson regression with robust variance estimation. Based on 21356 patients diagnosed 1999-2008, age-standardized five-year survival averaged 80% in the least deprived and 75% in the most deprived stratum. Age-adjusted mortality risk was 33% higher in the most deprived group (hazard ratio 1.33, 95% CI 1.21-1.45, P<0.001. The most deprived groups were more likely to present with advanced stage, high grade or hormone receptor-negative cancer, symptomatically, or with significant comorbidity, and to be smokers or unmarried, and less likely to have breast-conserving surgery. Cox modelling suggested that the available data on patient, tumour and treatment factors could account for only about half of the survival disparity (adjusted hazard ratio 1.18, 95% CI 0.97-1.43, P = 0.093. Survival disparity did not diminish over time, compared with the period 1994-1998. Persistent survival disparities among Irish breast cancer patients suggest unequal use of or access to services and highlight the need for further research to understand and remove the behavioural or other barriers involved.

Assessing the Impact of Internet Access on Household Income and Financial Performance of Small Farms

OpenAIRE

Khanal, Aditya R.; Mishra, Ashok K.

2013-01-01

With increased focus on survival strategies for small farm businesses, we investigate the impact of Internet access on income and farm expenses of small farm business and households. Using a nation-wide farm-level data in the U.S. and non-parametric matching estimators, the study finds a significant positive impact of Internet access on total household and off-farm income.

Using SPSS syntax: a beginner's guide Jacqueline Collier Using SPSS syntax: a beginner's guide Sage Pages: 216 £24.99 9781412922180 1412922186 [Formula: see text].

Science.gov (United States)

2011-01-21

As someone who is comfortable with analysing data in SAS using coding language, it is perplexing that I run from the use of syntax in SPSS. But, my apprehension has subsided with the Collier's guide. Syntax command can automate processes, increase reproducibility and give the user broader access to features otherwise unavailable in SPSS.

Magnetic resonance imaging guided reirradiation of recurrent and second primary head and neck cancer.

Science.gov (United States)

Chen, Allen M; Cao, Minsong; Hsu, Sophia; Lamb, James; Mikaeilian, Argin; Yang, Yingli; Agazaryan, Nzhde; Low, Daniel A; Steinberg, Michael L

2017-01-01

To report a single-institutional experience using magnetic resonance imaging (MRI) guided radiation therapy for the reirradiation of recurrent and second cancers of the head and neck. Between October 2014 and August 2016, 13 consecutive patients with recurrent or new primary cancers of the head and neck that occurred in a previously irradiated field were prospectively enrolled in an institutional registry trial to investigate the feasibility and efficacy of MRI guided radiation therapy using a 0.35-T MRI scanner with a cobalt-60 radiation therapy source called the ViewRay system (ViewRay Inc., Cleveland, OH). Eligibility criteria included biopsy-proven evidence of recurrent or new primary squamous cell carcinoma of the head and neck, measurable disease, and previous radiation to >60 Gy. MRI guided reirradiation was delivered either using intensity modulated radiation therapy with conventional fractionation to a median dose of 66 Gy or stereotactic body radiation therapy (SBRT) using 7 to 8 Gy fractions on nonconsecutive days to a median dose of 40 Gy. Two patients (17%) received concurrent chemotherapy. The 1- and 2-year estimates of in-field control were 72% and 72%, respectively. A total of 227 daily MRI scans were obtained to guide reirradiation. The 2-year estimates of overall survival and progression-free survival were 53% and 59%, respectively. There were no treatment-related fatalities or hospitalizations. Complications included skin desquamation, odynophagia, otitis externa, keratitis and/or conjunctivitis, and 1 case of aspiration pneumonia. Our preliminary findings show that reirradiation with MRI guided radiation therapy results in effective disease control with relatively low morbidity for patients with recurrent and second primary cancers of the head and neck. The superior soft tissue resolution of the MRI scans that were used for planning and delivery has the potential to improve the therapeutic ratio.

Basic survival needs and access to medicines--coming to grips with TRIPS: conversion + calculation.

Science.gov (United States)

Van Puymbroeck, Rudolf V

2010-01-01

"Access to medicines" is a broad concept. After a review of three authoritative frameworks that help to identify its constitutive components, this essay summarizes the actual situation on the ground in low- and middle-income countries on the basis of recent empirical work. An analysis of survey data from 36 countries concluded that developing countries should promote generic medicines as a key policy option for improving access to medicines. Taking an international perspective to that recommendation, this essay reviews the World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and, particularly, how this agreement has been applied in practice. As shown by the experience of Thailand, Brazil, and the Philippines, in order to deal effectively with international pressures for an excessive application of the TRIPS Agreement, some sort of conversion experience appears to be required, which then leads to a switch from a private enterprise, supply-driven approach to a public health vision that insists on universal and affordable access. But moral conviction is not sufficient. In order to muster and sustain the political will to face down international forces, civil society and government offices must be able and ready to show the costs and other adverse consequences of the TRIPS-based model for medicines. This calculation needs to reach beyond the health sector and calls for new alliances, nationally as well as internationally. © 2010 American Society of Law, Medicine & Ethics, Inc.

MCSA Windows Server 2012 R2 administration study guide exam 70-411

CERN Document Server

Panek, William

2015-01-01

Complete exam coverage, hands-on practice, and interactive studytools for the MCSA: Administering Windows Server 2012 R2 exam70-411 MCSA: Windows Server 2012 R2 Administration Study Guide: Exam70-411 provides comprehensive preparation for exam 70-411:Administering Windows Server 2012 R2. With full coverage of allexam domains, this guide contains everything you need to know to befully prepared on test day. Real-world scenarios illustrate thepractical applications of the lessons, and hands-on exercises allowyou to test yourself against everyday tasks. You get access to aninteractive practice te

Parental care improves offspring survival and growth in burying beetles

Science.gov (United States)

Eggert; Reinking; MULLER

1998-01-01

Burying beetles (genus Nicrophorus) provide elaborate parental care to their offspring. Parental beetles defend a small vertebrate carcass, which constitutes the sole food source for the larvae. They also manipulate the carcass in various ways and directly regurgitate pre-digested carrion to the young. The benefits of carcass manipulation and regurgitation have been the subject of a few small-scale studies that have yielded conflicting results. In this study, we investigated the benefits of these behaviours and tested for possible beneficial effects on larval survival rates and final body mass in N. vespilloides. In this species: (1) larval survival and mass were significantly higher in broods receiving parental care throughout larval development on the carcass than in broods developing in the absence of adults; (2) parental presence immediately subsequent to larval hatching greatly improved larval survival rates; (3) continued parental presence for several days further improved larval growth, leading to a greater final mass of individual larvae; (4) larval survival and growth were improved by parental preparation of carcasses and by an excision made in the integument of the carcass surface by the parents that allows the larvae ready access to their food; (5) positive effects of parental feeding on larval survival and growth were not mediated by the transfer of symbionts. Copyright 1998 The Association for the Study of Animal Behaviour.

Building College Access with Families in New Bedford, Massachusetts: A Case Study

Science.gov (United States)

Marks, Sue Anne

2012-01-01

This qualitative study was an investigation into improving college access through family engagement with minority and low-income students in an urban school district. Critical theory concepts of cultural capital, field, and habitus, as well as organizational communication theory, formed the theoretical framework that guided a literature review and…

Mathematics for physicists and engineers fundamentals and interactive study guide

CERN Document Server

Weltner, Klaus; Grosjean, Jean; Schuster, Peter

2009-01-01

Mathematics is the basic language in physics and engineering. It is an essential tool which first and second year students have to master as soon as possible. A lack of competence in mathematics is the main reason for failure and drop out in the beginning periods of study. This textbook offers an accessible and highly approved approach which is characterized by the combination of the textbook with a detailed study guide available online at extras.springer.com. This study guide divides the whole learning task into small units which the student is very likely to master successfully. Thus he or she is asked to read and study a limited section of the textbook and to return to the study guide afterwards. Working with the study guide his or her learning results are controlled, monitored and deepened by graded questions, exercises, repetitions and finally by problems and applications of the content studied. Since the degree of difficulties is slowly rising the students gain confidence and experience their own progre...

Magneticresonanceimaging-guided percutaneouscryoablationofhepatocellular carcinomainspecialregions

Institute of Scientific and Technical Information of China (English)

Bin Wu; Yue-Yong Xiao; Xiao Zhang; Ai-Lian Zhang; Hong-Jun Li; Deng-Fa Gao

2010-01-01

BACKGROUND:Local cryoablation guided by CT or ultrasound has been widely applied in the treatment of hepatocellular carcinoma. However, it is still dififcult to apply this technique in certain regions such as the diaphragm dome, the ifrst hepatic hilum, and regions adjacent to the gallbladder. This study aimed to evaluate the safety and efifcacy of using magnetic resonance imaging (MRI)-guided percutaneous cryoablation as well as the effect of using an open MRI system in guiding and monitoring the treatment of hepatocellular carcinoma in these regions. METHODS:Cryoablation, guided by an open 0.35T MRI scanner and with the assistance of an MRI-compatible optical navigation system, was performed on 32 patients with hepatocellular carcinoma at the diaphragm dome, the ifrst hepatic hilum, and regions adjacent to the gallbladder. Each patient had one or two tumors. The total number of tumors treated was 36. The tumor diameters ranged from 2.5 to 10.0 cm (mean 4.7±1.8 cm). The cryosurgical system was MRI-compatible and equipped with cryoprobes 1.47 mm in outside diameter. Under the guidance of MRI in combination with the optical navigation system, the cryoprobes were introduced percutaneously into a tumor at the planned targeting points while critical organs or tissues were avoided. Each cryoablation procedure included two freezing-thawing cycles, and MRI images were acquired dynamically to monitor the ablation of the tumor from time to time during the operation. In order to investigate the therapeutic effects of a cryoablation procedure, AFP measurements and liver-enhanced MRI or CT-enhanced scans were performed at regular times. RESULTS:MRI and optical navigation system-guided cryo-ablation procedures were successfully performed on all 32 patients (36 tumor sites) and no serious complications occurred. The follow-up period ranged from 5 to 12 months. The 6-and 12-month overall survival rates were 96.8%and 90.6%, respectively. According to the diagnosis of liver

Interventional radiology in the provision and maintenance of long-term central venous access

International Nuclear Information System (INIS)

Lyon, S.M.; Given, M.; Marshall, N.L.

2008-01-01

Establishing and maintaining venous access forms an increasing proportion of the workload in interventional radiology. Several patient groups require medium-term to long-term venous catheters for a variety of purposes, including chemotherapy, long-term antimicrobials, parenteral nutrition, short-term access for haemodialysis or exhausted haemodialysis. Often, these catheters are required for treatment and frequent blood testing, which can quickly exhaust the peripheral veins. Venous access devices include implantable catheters (ports), tunnelled catheters and peripherally inserted central catheters, which have different functions, advantages and limitations. Imaging-guided placement is the preferred method of insertion in many institutions because of higher success rates and radiologists are well suited to address catheter complications.

Green electricity buyer's guide

International Nuclear Information System (INIS)

Kelly, B.; Klein, S.; Olivastri, B.

2002-06-01

The electricity produced in whole or in large part from renewable energy sources like wind, small hydro electricity and solar energy, is generally referred to as green electricity. The authors designed this buyer's guide to assist customers in their understanding of green electricity, as the customers can now choose their electricity supplier. The considerations and steps involved in the purchasse of green electricity are identified, and advice is provided on ways to maximize the benefits from the purchase of green electricity. In Alberta and Ontario, customers have access to a competitive electricity market. The emphasis when developing this guide was placed firmly on the large buyers, as they can have enormous positive influence on the new market for green electricity. The first chapter of the document provides general information on green electricity. In chapter two, the authors explore the opportunity for environmental leadership. Chapter three reviews the basics of green electricity, which provides the link to chapter four dealing with the creation of a policy. Purchasing green electricity is dealt with in Chapter five, and maximizing the benefits of green electricity are examined in Chapter Six. 24 refs., 3 tabs

Guiding People to Interpret Their Experienced Difficulty as Importance Highlights Their Academic Possibilities and Improves Their Academic Performance

Science.gov (United States)

Oyserman, Daphna; Elmore, Kristen; Novin, Sheida; Fisher, Oliver; Smith, George C.

2018-01-01

Does experiencing difficulty bolster or undermine future self-images, strategies to get there and actual performance? We build on four insights from prior research to predict that accessible interpretation-of-experienced-difficulty mindset shapes identity and performance. First, people have two different interpretation-of-experienced-difficulty mindsets available in memory; their difficulty-as-impossibility mindset focuses attention on difficulty as implying low odds and their difficulty-as-importance mindset focuses attention on difficulty as implying high value. Second, people are sensitive to contextual cues as to which mindset to apply to understand their experienced difficulty. Third, people apply the mindset that comes to mind unless they have reason to question why it is “on-the-mind.” Fourth, social class can be thought of as a chronic context influencing how much people endorse each interpretation-of-experienced-difficulty mindset. We used subtle primes to guide participants’ attention toward either a difficulty-as-importance or a difficulty-as-impossibility mindset (N = 591). Participants guided toward a difficulty-as-importance mindset performed better on difficult academic tasks (Studies 1, 2) than participants guided toward a difficulty-as-impossibility mindset; whether they had more school-focused possible identities and linked strategies depended on sample (Studies 3, 4). For college students, the effect of guided interpretation-of-experienced-difficulty mindset was not moderated by how much participants agreed with that mindset (Studies 1, 3, 4). College students mostly disagreed with a difficulty-as-impossibility mindset, but making that mindset accessible undermined their performance and sometimes their possible identities anyway. In contrast, middle school students (a younger and lower social class sample) were more likely to agree with a difficulty-as-impossibility mindset. In this sample (Study 2), we found an effect of mindset

Practical guide to content delivery networks

CERN Document Server

Held, Gilbert

2005-01-01

With a practical and organized approach to learning and implementation, A Practical Guide to Content Delivery Networks presents a step-by-step process for building a highly available and highly scalable content delivery network (CDN). CDN refers to the infrastructure behind any service that provides utility or access to data to an end user. This book offers terminology, tactics, potential problems to avoid, and individual layers of design, providing clear understanding of the framework for CDNs using a structural and visual approach. The text emphasizes a best-of-breed strategy, allowing a tec

A New Regime of SME Finance in Emerging Asia: Enhancing Access to Growth Capital and Policy Implications

OpenAIRE

Shigehiro Shinozaki

2014-01-01

While finance is critical for small and medium-sized enterprises (SMEs) to survive and grow, most SMEs suffer from poor access to finance. Given the pronounced global financial uncertainty, stable access to appropriate funding sources has become even more difficult for SMEs to attain. Lessons from the global financial crisis have motivated many countries to consider SME access to finance beyond conventional bank credit and to diversify their domestic financial systems. This paper uses empiric...

Is progression-free survival a more relevant endpoint than overall survival in first-line HR+/HER2− metastatic breast cancer?

Directory of Open Access Journals (Sweden)

Forsythe A

2018-05-01

Full Text Available Anna Forsythe,1 David Chandiwana,2 Janina Barth,3 Marroon Thabane,4 Johan Baeck,5 Anastasiya Shor,1 Gabriel Tremblay6 1Health Technology Assessment Evidence, Purple Squirrel Economics, New York, NY, USA; 2Global Value and Access, Novartis Pharmaceutical Corporation, East Hanover, NJ, USA; 3German Market Access, Novartis Pharma GmbH, Nuremberg, Germany; 4Health Policy and Patient Access, Novartis Pharmaceuticals Incorporated, Dorval, QC, Canada; 5Global Medical Affairs (Oncology Business Unit, Novartis Pharmaceutical Corporation, East Hanover, NJ, USA; 6Health Economics, Purple Squirrel Economics, New York, NY, USA Background: Hormone receptor-positive (HR+, human epidermal growth factor receptor 2- negative (HER2−, metastatic breast cancer (MBC accounts for 73% of all MBCs. Endocrine therapy (ET is the basis of first-line (1L therapy for patients with HR+/HER2− MBC. Novel therapies have demonstrated improvements in progression-free survival (PFS compared to ET. The clinical relevance of PFS is being debated, as there is no proven direct correlation with overall survival (OS benefit to date. We reviewed studies of HR+/HER2− MBC to assess PFS and other factors that influence OS and treatment response, and health-related quality of life (HRQoL. Methods: The Embase®, Medline®, and Cochrane databases were systematically searched to identify studies in adult women with HR+/HER2− MBC, published between January 2006 and January 2017, and written in English. Phase II and III randomized controlled trials (RCTs, observational, and retrospective studies were included. Results: Seventy-nine RCTs were identified: 58 (73% in the 1L+ setting and 21 (27% in second-line or greater settings. PFS hazard ratios (HRs were reported in 61 (77% studies; 31 (39% reported significant PFS improvements. OS was reported in 44 (41% studies; 12 (15% reported significant OS improvements. Significant improvements in both PFS and OS were reported in only 6 (8% studies

Effect of Gas Fueling Location on H-mode Access in NSTX

International Nuclear Information System (INIS)

Maingi, R.; Bell, M.; Bell, R.; Biewer, T.; Bush, C.; Chang, C.S.; Gates, D.; Kaye, S.; Kugel, H.; LeBlanc, B.; Maqueda, R.; Menard, J.; Mueller, D.; Raman, R.; Sabbagh, S.; Soukhanovskii, V.

2003-01-01

The dependence of H-mode access on the poloidal location of the gas injection source has been investigated in the National Spherical Torus Experiment (NSTX). We find that gas fueling from the center stack midplane area produces the most reproducible H-mode access with generally the lowest L-H threshold power in lower single-null configuration. The edge toroidal rotation velocity is largest (in direction of the plasma current) just before the L-H transition with center stack midplane fueling, and then reverses direction after the L-H transition. Simulation of these results with a 2-D guiding-center Monte Carlo neoclassical transport code is qualitatively consistent with the trends in the measured velocities. Double-null discharges exhibit H-mode access with gas fueling from either the center stack midplane or center stack top locations, indicating a reduced sensitivity of H-mode access on fueling location in that shape

Kidnapping and abduction minimizing the threat and lessons in survival

CERN Document Server

Heard, Brian John

2014-01-01

Terrorist groups and organized crime cartels pose an increasing threat of kidnapping throughout many regions in the word. At the same time, international travel has become more commonplace for both business and leisure purposes. Kidnapping and Abduction: Minimizing the Threat and Lessons in Survival provides a practical guide on the precautions travelers can take to avoid being kidnapped or derail a kidnapping attempt in progress. In the event this cannot be avoided, the book supplies advice on how to ensure survival during captivity. Readers will learn: The basic elements of kidnapping and abduction The motivations and mechanisms of kidnappers The hotspots where kidnapping/hostage taking is prevalent Vehicles best suited for avoidance of kidnap threat and proposals for up-armoring an existing vehicle How to recognize immediate threats and precautions to be taken in assessing threat level The types of weapons most favored by kidnappers and their threat level Available bullet-resistant materials and their use ...

Forum Guide to Taking Action with Education Data. NFES 2013-801

Science.gov (United States)

National Forum on Education Statistics, 2012

2012-01-01

Education data are growing in quantity, quality, and value. When appropriately used to guide action, data can be a powerful tool for improving school operations, teaching, and learning. Education stakeholders who possess the knowledge, skills, and abilities to appropriately access, analyze, and interpret data will be able to use data to take…

Heavenly bodies the photographer's guide to astrophotography

CERN Document Server

Krages, Esq, Bert P

2003-01-01

Detailing the photographic equipment and astronomical instruments needed to capture celestial images, this guide shows how astrophotography can be accessible to all photographers. Included is a detailed introduction to basic astronomy with information on mapping the sky, locating celestial bodies, and planning an expedition to photograph astronomical phenomena. Photographers learn how to determine the color sensitivity of various films and achieve the best possible exposure, how to ensure a captivating composition, and how commercially processed prints can support their artistic vision. Whethe

MicroPRIS user's guide

International Nuclear Information System (INIS)

1991-01-01

MicroPRIS is a new service of the IAEA Power Reactor Information System (PRIS) for the Member States of IAEA. MicroPRIS makes the IAEA database on nuclear power plants and their operating experience available to Member States on computer diskettes in a form readily accessible by standard commercially available personal computer packages. The aim of this publication is to provide the users of the PC version of PRIS data with description of the subset of the full PRIS database contained in MicroPRIS (release 1990), description of files and file structures, field descriptions and definitions, extraction and selection guide and with the method of calculation of a number of important performance indicators used by the IAEA

An analysis of brachytherapy with computed tomography-guided permanent implantation of Iodine-125 seeds for recurrent nonkeratin nasopharyngeal carcinoma

Directory of Open Access Journals (Sweden)

Shen X

2015-05-01

Full Text Available Xinying Shen,1,2 Yong Li,2 Yanfang Zhang,2 Jian Kong,2 Yanhao Li1 1Department of Interventional Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, 2Department of Interventional Radiology, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, People’s Republic of China Background: 125I seed implantation is a new method in treatment of nasopharyngeal carcinoma (NPC, and it is worthwhile to evaluate its feasibility. In this study, we performed brachytherapy with computed tomography (CT-guided permanent implantation of 125I seeds in the treatment of patients with the recurrence of NPC.Methods: A total 30 patients (20 male and ten female at the median age of 55 (range 25–80 years were diagnosed with recurrent nonkeratin NPC, with a total 38 lesions and a short disease-free interval (median ~11 months after primary radiotherapy alone or combined with chemotherapy. Patients received CT scan, starting from 2 months after the treatment. Follow-up was conducted for ~2–38 months to observe the local control rate and overall survival rate. We also analyzed the possible correlation between survival periods and the status of recurrent tumors.Results: The local control rates at 6, 12, 24, 30, and 36 months after the procedure of 125I seed implantation were 86.8%, 73.7%, 26.3%, 15.8%, and 5.3%, respectively. The overall 1-, 2-, and 3-year survival rates were 80.0% (24/30, 30.0% (9/30, and 6.7% (2/30, respectively, with a median survival period of 18 months (17.6±8.6 months. Interestingly, the survival periods of the patients who had primary radiotherapy with or without chemotherapy were 15.8±7.9 and 24.3±7.9 months, respectively. Kaplan–Meier survival analysis demonstrated that χ2 (log rank was 7.555, with very significant difference (P<0.01. The survival periods of patients in tumor stages I, II, III, and IV were 25.4±8.7, 19.8±9.4, 16.1±4.5, and 12.8±7.8 months, respectively, with

Neuronavigator-guided percutaneous radiofrequency thermocoagulation in the treatment of intractable trigeminal neuralgia.

Science.gov (United States)

Xu, Shu-jun; Zhang, Wen-hua; Chen, Teng; Wu, Cheng-yuan; Zhou, Mao-de

2006-09-20

Percutaneous radiofrequency thermocoagulation of the trigeminal ganglion (PRTTG) is regarded as the first choice for most patients with trigeminal neuralgia (TN) because of its safety and feasibility. However, neuronavigator-guided PRTTG has been seldom reported. The purpose of this study was to assess the safety and efficacy of neuronavigator-guided PRTTG for the treatment of intractable TN. Between January 2000 and December 2004, 54 patients with intractable TN were enrolled into this study and were randomly divided into two groups. The patients in navigation group (n = 26) underwent PRTTG with frameless neuronavigation, and those in control group (n = 28) received PRTTG without neuronavigation. Three months after the operation, the efficacy, side effects, and complications of the surgery were recorded. The patients in the control group were followed up for 10 to 54 months (mean, 34 +/- 5), and those in the navigation group were followed up for 13 to 58 months (mean, 36 +/- 7). Kaplan-Meier analyses of the pain-free survival curves were used for the censored survival data, and the log-rank test was used to compare survival curves of the two groups. The immediate complete pain-relief rate of the navigation group was 100%, whereas it was 95% in the control. The proportion of sustained pain-relief rates at 12, 24 and 36 months after the procedure were 85%, 77%, and 62% in the navigation group, and 54%, 40%, and 35% in the control. Recurrences in the control group were more common than that in the navigation group. Annual recurrence rate in the first and second years were 15% and 23% in the navigation group, and 46%, 60% in the control group. No side-effect and complication was noted in the navigation group except minimal facial hypesthesia. Neuronavigator-guided PRTTG is a safe and promising method for treatment of intractable TN with better short- and long-term outcomes and lower complication rate than PRTTG without neuronavigation.

The TJ-II Relational Database Access Library: A User's Guide

International Nuclear Information System (INIS)

Sanchez, E.; Portas, A. B.; Vega, J.

2003-01-01

A relational database has been developed to store data representing physical values from TJ-II discharges. This new database complements the existing TJ-EI raw data database. This database resides in a host computer running Windows 2000 Server operating system and it is managed by SQL Server. A function library has been developed that permits remote access to these data from user programs running in computers connected to TJ-II local area networks via remote procedure cali. In this document a general description of the database and its organization are provided. Also given are a detailed description of the functions included in the library and examples of how to use these functions in computer programs written in the FORTRAN and C languages. (Author) 8 refs

Causes and Effects of Begging Style Involving Children as Guides in Dodoma Municipality, Tanzania: Liability in Basic Education Access

Science.gov (United States)

Seni, Abdallah Jacob

2017-01-01

This paper explores the causes and effects of a unique begging style involving children as guides in Dodoma Municipality, Tanzania. The rationale for Dodoma Municipality to be the study location is that the begging phenomenon using children as guides is rampant. The study sample involved 40 respondents, of whom 6 were young carers of visually…

Guide to the periodic inspection of nuclear reactor steel pressure vessels

International Nuclear Information System (INIS)

1969-01-01

This Guide is intended to provide general information and guidance to reactor owners or operators, inspection authorities, certifying authorities or regulatory bodies who are responsible for establishing inspection procedures for specific reactors or reactor types, and for the preparation of national codes or standards. The recommendations of the Guide apply primarily to water-cooled steel reactor vessels which are at a sufficiently early stage of design so that recommendations to provide accessibility for inspection can be incorporated into the early stages of design and inspection planning. However, much of the contents of the Guide are also applicable in part to vessels for other reactor types, such as gas-cooled, pressure-tube, or liquid-metal-cooled reactors, and also to some existing water-cooled reactors and reactors which are in advanced stage of design or construction. 46 refs, figs, 1 tab

Efficacy of self-guided internet based cognitive behavioral therapy in the treatment of depressive symptoms : A meta analysis of individual participant data

NARCIS (Netherlands)

Karyotaki, E.; Riper, Heleen; Twisk, Jos W. R.; Hoogendoorn, A.W.; Kleiboer, M.A.; Mira, Adriana; Mackinnon, A.; Meyer, B.; Botella, C.; Littlewood, Elizabeth; Andersson, G.; Christensen, H.; Klein, J.; Schröder, Johanna; Breton-Lopez, Juana; Scheider, Justin; Griffiths, J.; Farrer, L.; Huibers, M. J. H.; Phillips, Rachel; Gilbody, S.; Moritz, S.; Berger, T.; Pop, V.J.M.; Spek, V.R.M.; Cuijpers, P.

2017-01-01

Importance: Self-guided internet-based cognitive behavioral therapy (iCBT) has the potential to increase access and availability of evidence-based therapy and reduce the cost of depression treatment. Objectives: To estimate the effect of self-guided iCBT in treating adults with depressive symptoms

Fractional flow reserve guided percutaneous coronary intervention results in reduced ischemic myocardium and improved outcomes.

Science.gov (United States)

Sawant, Abhishek C; Bhardwaj, Aishwarya; Banerjee, Kinjal; Jobanputra, Yash; Kumar, Arnav; Parikh, Parth; Kandregula, Krishna C; Poddar, Kanhaiya; Ellis, Stephen G; Nair, Ravi; Corbelli, John; Kapadia, Samir

2018-02-06

To determine if fractional flow reserve guided percutaneous coronary intervention (FFR-guided PCI) is associated with reduced ischemic myocardium compared with angiography-guided PCI. Although FFR-guided PCI has been shown to improve outcomes, it remains unclear if it reduces the extent of ischemic myocardium at risk compared with angiography-guided PCI. We evaluated 380 patients (190 FFR-guided PCI cases and 190 propensity-matched controls) who underwent PCI from 2009 to 2014. Clinical, laboratory, angiographic, stress testing, and major adverse cardiac events [MACE] (all-cause mortality, recurrence of MI requiring PCI, stroke) data were collected. Mean age was 63 ± 11 years; the majority of patients were males (76%) and Caucasian (77%). Median duration of follow up was 3.4 [Range: 1.9, 5.0] years. Procedural complications including coronary dissection (2% vs. 0%, P = .12) and perforation (0% vs. 0%, P = 1.00) were similar between FFR-guided and angiography-guided PCI patients. FFR-guided PCI patients had lower unadjusted (14.7% vs. 23.2%, P = .04) and adjusted [OR = 0.58 (95% CI: 0.34-0.98)] risk of repeat revascularization at one year. FFR-guided PCI patients were less likely (23% vs. 32%, P = .02) to have ischemia and had lower (5.9% vs. 21.1%, P guided PCI, FFR-guided PCI results in less repeat revascularization and a lower incidence of post PCI ischemia translating into improved survival, without an increase in complications. © 2018 Wiley Periodicals, Inc.

Comparison of survival analysis and palliative care involvement in patients aged over 70 years choosing conservative management or renal replacement therapy in advanced chronic kidney disease.

Science.gov (United States)

Hussain, Jamilla A; Mooney, Andrew; Russon, Lynne

2013-10-01

There are limited data on the outcomes of elderly patients with chronic kidney disease undergoing renal replacement therapy or conservative management. We aimed to compare survival, hospital admissions and palliative care access of patients aged over 70 years with chronic kidney disease stage 5 according to whether they chose renal replacement therapy or conservative management. Retrospective observational study. Patients aged over 70 years attending pre-dialysis clinic. In total, 172 patients chose conservative management and 269 chose renal replacement therapy. The renal replacement therapy group survived for longer when survival was taken from the time estimated glomerular filtration rate management, in patients older than 80 years or with a World Health Organization performance score of 3 or more. There was also a significant reduction in the effect of renal replacement therapy on survival in patients with high Charlson's Comorbidity Index scores. The relative risk of an acute hospital admission (renal replacement therapy vs conservative management) was 1.6 (p management patients died in hospital, compared to 69% undergoing renal replacement therapy (Renal Registry data). Seventy-six percent of the conservative management group accessed community palliative care services compared to 0% of renal replacement therapy patients. For patients aged over 80 years, with a poor performance status or high co-morbidity scores, the survival advantage of renal replacement therapy over conservative management was lost at all levels of disease severity. Those accessing a conservative management pathway had greater access to palliative care services and were less likely to be admitted to or die in hospital.

Faculty staff-guided versus self-guided ultrasound training for internal medicine residents.

Science.gov (United States)

Alba, George A; Kelmenson, Daniel A; Noble, Vicki E; Murray, Alice F; Currier, Paul F

2013-11-01

Ultrasonography is of growing importance within internal medicine (IM), but the optimal method of training doctors to use it is uncertain. In this study, the authors provide the first objective comparison of two approaches to training IM residents in ultrasonography. In this randomised trial, a simulation-based ultrasound training curriculum was implemented during IM intern orientation at a tertiary care teaching hospital. All 72 incoming interns attended a lecture and were given access to online modules. Interns were then randomly assigned to a 4-hour faculty-guided (FG) or self-guided (SG) ultrasound training session in a simulation laboratory with both human and manikin models. Interns were asked to self-assess their competence in ultrasonography and underwent an objective structured clinical examination (OSCE) to assess their competence in basic and procedurally oriented ultrasound tasks. The primary outcome was the score on the OSCE. Faculty-guided training was superior to self-guided training based on the OSCE scores. Subjects in the FG training group achieved significantly higher OSCE scores on the two subsets of task completion (0.9-point difference, 95% confidence interval [CI] 0.27-1.54; p = 0.008) and ultrasound image quality (2.43-point difference, 95% CI 1.5-3.36; p training groups demonstrated an increase in self-assessed competence after their respective training sessions and there was little difference between the groups. Subjects rated the FG training group much more favourably than the SG training group. Both FG and SG ultrasound training curricula can improve the self-reported competence of IM interns in ultrasonography. However, FG training was superior to SG training in both skills acquisition and intern preference. Incorporating mandatory ultrasound training into IM residencies can address the perceived need for ultrasound training, improve confidence and procedural skills, and may enhance patient safety. However, the optimal training method

Witness response at acute onset of stroke: a qualitative theory-guided study.

Directory of Open Access Journals (Sweden)

Stephan U Dombrowski

Full Text Available Delay in calling emergency medical services following stroke limits access to early treatment that can reduce disability. Emergency medical services contact is mostly initiated by stroke witnesses (often relatives, rather than stroke patients. This study explored appraisal and behavioural factors that are potentially important in influencing witness behaviour in response to stroke.Semi-structured interviews with 26 stroke witnesses were transcribed and theory-guided content analysed was undertaken based on the Common Sense Self-Regulation Model (appraisal processes and Theory Domains Framework (behavioural determinants. Response behaviours were often influenced by heuristics-guided appraisal (i.e. mental rules of thumb. Some witnesses described their responses to the situation as 'automatic' and 'instinctive', rather than products of deliberation. Potential behavioural influences included: environmental context and resources (e.g. time of day, social influence (e.g. prompts from patients and beliefs about consequences (e.g. 999 accesses rapid help. Findings are based on retrospective accounts and need further verification in prospective studies.Witnesses play a key role in patient access to emergency medical services. Factors that potentially influence witnesses' responses to stroke were identified and could inform behavioural interventions and future research. Interventions might benefit from linking automatic/instinctive threat perceptions with deliberate appraisal of stroke symptoms, prompting action to call emergency medical services.

Sow preferences for farrowing under a cover with and without access to straw

DEFF Research Database (Denmark)

Damm, Birgitte Iversen; Heiskanen, Teresia; Pedersen, Lene Juul

2010-01-01

and thus piglet survival we investigated if access to a covered area and ad libitum access to straw would improve maternal behaviour of importance for piglet survival. We used forty-four primiparous sows housed in large individual pens from approximately 2 weeks prior to expected parturition. The sows were...... and the temporal pattern of sow position in relation to position of the cover (left or right side of the pen) was studied. Furthermore, postural and nest-building behaviours were observed, as well as situations where the piglets were either at risk of being crushed or were crushed. The results showed......In semi-natural environments sows often select a protected nest site at farrowing. Investigations of nest site selection under indoor conditions are scarce but suggest that sows prefer to nest and farrow under a covered area. Since feed-back from a functional nest may improve maternal behaviour...

Density-dependent intraspecific aggression regulates survival in northern Yellowstone wolves (Canis lupus).

Science.gov (United States)

Cubaynes, Sarah; MacNulty, Daniel R; Stahler, Daniel R; Quimby, Kira A; Smith, Douglas W; Coulson, Tim

2014-11-01

Understanding the population dynamics of top-predators is essential to assess their impact on ecosystems and to guide their management. Key to this understanding is identifying the mechanisms regulating vital rates. Determining the influence of density on survival is necessary to understand the extent to which human-caused mortality is compensatory or additive. In wolves (Canis lupus), empirical evidence for density-dependent survival is lacking. Dispersal is considered the principal way in which wolves adjust their numbers to prey supply or compensate for human exploitation. However, studies to date have primarily focused on exploited wolf populations, in which density-dependent mechanisms are likely weak due to artificially low wolf densities. Using 13 years of data on 280 collared wolves in Yellowstone National Park, we assessed the effect of wolf density, prey abundance and population structure, as well as winter severity, on age-specific survival in two areas (prey-rich vs. prey-poor) of the national park. We further analysed cause-specific mortality and explored the factors driving intraspecific aggression in the prey-rich northern area of the park. Overall, survival rates decreased during the study. In northern Yellowstone, density dependence regulated adult survival through an increase in intraspecific aggression, independent of prey availability. In the interior of the park, adult survival was less variable and density-independent, despite reduced prey availability. There was no effect of prey population structure in northern Yellowstone, or of winter severity in either area. Survival was similar among yearlings and adults, but lower for adults older than 6 years. Our results indicate that density-dependent intraspecific aggression is a major driver of adult wolf survival in northern Yellowstone, suggesting intrinsic density-dependent mechanisms have the potential to regulate wolf populations at high ungulate densities. When low prey availability or high

CompTIA A+ complete study guide exams 220-801 and 220-802

CERN Document Server

Docter, Quentin; Skandier, Toby

2012-01-01

CompTIA Authorized, fully updated Study Guide for the leading IT certification: CompTIA A+ CompTIA A+ is the de facto certification for IT technicians. Some vendors even require employees to achieve certification as part of their job training. This book prepares you for both required exams: 220-801 and 220-802. Totally updated to cover the 2012 exams, this popular prep guide covers all the exam objectives. Readers will also have access to additional study tools, including the Sybex Test Engine with bonus practice exams, electronic flashcards, and a glossary of important terms in searchable PD

Predatory Publishing: How to Safely Navigate the Waters of Open Access.

Science.gov (United States)

Power, Helen

2018-03-01

Open access publishing enables scholarship to be openly accessible to everyone, which has countless benefits. However, the open access movement has opened the door for "predatory publishers" to take advantage of researchers surviving in this publish or perish academic landscape. Predatory journals are becoming increasingly common. Nursing researchers, instructors, and students need to be made aware of the dangers of predatory journals, and they need to know how to identify them. While there are blacklists and whitelists that can be used to aid in decision-making, it is critical to note that these lists can never be entirely up to date. This article incorporates a literature review which provides insights into newer trends in predatory and unethical publishing, including "journal hijacking" and "bogus impact factors". Extensive criteria for assessing emerging or unknown journals is compiled to aid researchers, students, educators, and the public in evaluating open access publications.

Access safety systems - New concepts from the LHC experience

International Nuclear Information System (INIS)

Ladzinski, T.; Delamare, C.; Luca, S. di; Hakulinen, T.; Hammouti, L.; Havart, F.; Juget, J.F.; Ninin, P.; Nunes, R.; Riesco, T.; Sanchez-Corral Mena, E.; Valentini, F.

2012-01-01

The LHC Access Safety System has introduced a number of new concepts into the domain of personnel protection at CERN. These can be grouped into several categories: organisational, architectural and concerning the end-user experience. By anchoring the project on the solid foundations of the IEC 61508/61511 methodology, the CERN team and its contractors managed to design, develop, test and commission on time a SIL3 safety system. The system uses a successful combination of the latest Siemens redundant safety programmable logic controllers with a traditional relay logic hard wired loop. The external envelope barriers used in the LHC include personnel and material access devices, which are interlocked door-booths introducing increased automation of individual access control, thus removing the strain from the operators. These devices ensure the inviolability of the controlled zones by users not holding the required credentials. To this end they are equipped with personnel presence detectors and the access control includes a state of the art bio-metry check. Building on the LHC experience, new projects targeting the refurbishment of the existing access safety infrastructure in the injector chain have started. This paper summarises the new concepts introduced in the LHC access control and safety systems, discusses the return of experience and outlines the main guiding principles for the renewal stage of the personnel protection systems in the LHC injector chain in a homogeneous manner. (authors)

Against all odds: Tales of survival and growth of the Foundational Approaches in Science Teaching (FAST) project

Science.gov (United States)

Yamamoto, Karen Kina

This study examines the dynamics of survival and growth of curricular and instructional innovations. It focuses on the Foundational Approaches in Science Teaching (FAST) project, a long-term survivor of reform in science education. Key questions guiding this study include: (1) How did the FAST project survive over the past 30 years? (2) What elements are essential for long-term survival and growth of an innovative science program? (3) Why did the project continue to survive amidst several waves of educational reform? The core of my conceptual framework is that the odds of survival and growth of curricular and instructional innovations are increased by the extent to which resources, theory-based curriculum development processes, and professional development strategies are not only incorporated into but also interdependent within a project. With this framework as a guide, the main methods of data collection were document analysis, interviews, and observations. FAST, developed by the University of Hawaii's Curriculum Research and Development Group (CRDG), consists of a sequential and interdisciplinary middle and high school science program for students in grades 6-10. According to the results of this study, the project was able to survive by receiving constant organizational support from CRDG and a steady source of State funding through the university since 1966; it also retained a relatively small but stable staff of highly qualified project personnel. Formulated on a discipline-based theory that values development of students' intellectual capacities as the platform for curriculum research, design, and development, the FAST project translated this vision of science education into key elements of an innovative program that survived and thrived: (1) an interdisciplinary program consisting of physical, biological, and earth sciences; inquiry as content and process; history and philosophy of science; and links between and among sciences, technology, and society; and (2

Survival analysis

International Nuclear Information System (INIS)

Badwe, R.A.

1999-01-01

The primary endpoint in the majority of the studies has been either disease recurrence or death. This kind of analysis requires a special method since all patients in the study experience the endpoint. The standard method for estimating such survival distribution is Kaplan Meier method. The survival function is defined as the proportion of individuals who survive beyond certain time. Multi-variate comparison for survival has been carried out with Cox's proportional hazard model

The OpenAIRE Guide for Research Institutions

Directory of Open Access Journals (Sweden)

Gültekin Gürdal

2013-11-01

Full Text Available This text is transcript of OpenAIRE Guide which is prepared in order to help research institutions was released on 13.04.2011and translated with the cooperation of ANKOS Open Access and Institutional Repositories Grup members and OpenAIREplus project team of Turkey which is coordinated from Izmir Institute of Technology Library. OpenAIRE Project aims to support researchers in complying with the European Commission Seventh Framework Programme Open Access Pilot through a European Helpdesk System; support researchers in depositing their research publications in an institutional or disciplinary repository; build up an OpenAIRE portal and e-infrastructure for repository networks. The project will work in tadem with OpeanAIREplus Project which has the principal goal of creating a robust, participatory service for the cross-linking of peer-reviewed scientific publications and associated datasets.

Sky coverage modeling for the whole sky for laser guide star multiconjugate adaptive optics.

Science.gov (United States)

Wang, Lianqi; Andersen, David; Ellerbroek, Brent

2012-06-01

The scientific productivity of laser guide star adaptive optics systems strongly depends on the sky coverage, which describes the probability of finding natural guide stars for the tip/tilt wavefront sensor(s) to achieve a certain performance. Knowledge of the sky coverage is also important for astronomers planning their observations. In this paper, we present an efficient method to compute the sky coverage for the laser guide star multiconjugate adaptive optics system, the Narrow Field Infrared Adaptive Optics System (NFIRAOS), being designed for the Thirty Meter Telescope project. We show that NFIRAOS can achieve more than 70% sky coverage over most of the accessible sky with the requirement of 191 nm total rms wavefront.

COATING ALTERNATIVES GUIDE (CAGE) USER'S GUIDE

Science.gov (United States)

The guide provides instructions for using the Coating Alternatives GuidE (CAGE) software program, version 1.0. It assumes that the user is familiar with the fundamentals of operating an IBM-compatible personal computer (PC) under the Microsoft disk operating system (MS-DOS). CAGE...

TRENDS: A flight test relational database user's guide and reference manual

Science.gov (United States)

Bondi, M. J.; Bjorkman, W. S.; Cross, J. L.

1994-01-01

This report is designed to be a user's guide and reference manual for users intending to access rotocraft test data via TRENDS, the relational database system which was developed as a tool for the aeronautical engineer with no programming background. This report has been written to assist novice and experienced TRENDS users. TRENDS is a complete system for retrieving, searching, and analyzing both numerical and narrative data, and for displaying time history and statistical data in graphical and numerical formats. This manual provides a 'guided tour' and a 'user's guide' for the new and intermediate-skilled users. Examples for the use of each menu item within TRENDS is provided in the Menu Reference section of the manual, including full coverage for TIMEHIST, one of the key tools. This manual is written around the XV-15 Tilt Rotor database, but does include an appendix on the UH-60 Blackhawk database. This user's guide and reference manual establishes a referrable source for the research community and augments NASA TM-101025, TRENDS: The Aeronautical Post-Test, Database Management System, Jan. 1990, written by the same authors.

The Guide to Community Preventive Services and Disability Inclusion.

Science.gov (United States)

Hinton, Cynthia F; Kraus, Lewis E; Richards, T Anne; Fox, Michael H; Campbell, Vincent A

2017-12-01

Approximately 40 million people in the U.S. identify as having a serious disability, and people with disabilities experience many health disparities compared with the general population. The Guide to Community Preventive Services (The Community Guide) identifies evidence-based programs and policies recommended by the Community Preventive Services Task Force (Task Force) to promote health and prevent disease. The Community Guide was assessed to answer the questions: are Community Guide public health intervention recommendations applicable to people with disabilities, and are adaptations required? An assessment of 91 recommendations from The Community Guide was conducted for 15 health topics by qualitative analysis involving three data approaches: an integrative literature review (years 1980-2011), key informant interviews, and focus group discussion during 2011. Twenty-six recommended interventions would not need any adaptation to be of benefit to people with disabilities. Forty-one recommended interventions could benefit from adaptations in communication and technology; 33 could benefit from training adaptations; 31 from physical accessibility adaptations; and 16 could benefit from other adaptations, such as written policy changes and creation of peer support networks. Thirty-eight recommended interventions could benefit from one or more adaptations to enhance disability inclusion. As public health and healthcare systems implement Task Force recommendations, identifying and addressing barriers to full participation for people with disabilities is important so that interventions reach the entire population. With appropriate adaptations, implementation of recommendations from The Community Guide could be successfully expanded to address the needs of people with disabilities. Published by Elsevier Inc.

Acute myeloid leukemia: survival analysisof patients at a university hospital of Paraná

Directory of Open Access Journals (Sweden)

Sergio Lunardon Padilha

2015-02-01

Full Text Available Objective: The aim of this study was to analyze the prognostic factors correlated with survival of patients with acute myeloid leukemia at the Hospital de Clínicas, Universidade Federal do Paraná between 2003 and 2009, as well as to investigate the clinical and epidemiological profile. Methods: The overall survival and disease-free survival were statistically evaluated using the Kaplan-Meier method, the log-rank test and multivariate evaluation by Cox regression analysis. Results: The study population was predominantly younger than 60 years old (81,6%, had intermediate cytogenetic risk (40.8%, in first complete remission after induction chemotherapy (46.9%, with a white blood count at diagnosis of less than 30 × 109 /L (57.1% and de novo acute myeloid leukemia (62.2%. Survival curves showed that better prognosis was related to age below 60 years (median:12,4 months; p-value = 0,2227; Odds Ratio = 0,6676, good pro- gnostic cytogenetic markers (median: 97.7 months; p-value = 0.0037; Odds Ratio = 0.4239 and white blood cell count at diagnosis of less than 30 × 109 /L (median survival: 23.6 months; p- value = 0.0001; Odds Ratio = 0.3651. Regarding the French-American-British subgroups, the median overall survival was 23.5 months for M0, M1 and M2, 97.7 months for M3 and 7.4 months for M4, M5, M6, and M7 (p-value = 0.0288. Conclusion: Prognostic factors strongly influenced patient survival, as well as guided treat- ment. Moreover, these factors were consistent with the available literature adjusted for the population in question.

Biochemical disease-free survival following I-125 prostate implantation

International Nuclear Information System (INIS)

Beyer, David C.; Priestley, Joseph B.

1995-01-01

Purpose/Objective: To assess the five-year clinical and biochemical results of ultrasound-guided permanent I-125 brachytherapy in early prostate cancer. Biochemical disease-free survival (BDFS) is reported, using PSA follow-up and is compared to the surgical and radiation therapy literature. Materials and Methods: From 12/88 through 12/93, ultrasound-guided brachytherapy was preplanned with I-125 and delivered 16,000 cGy as the sole treatment in 499 patients. All were clinically staged as T1 or T2 - N0M0 adenocarcinoma of the prostate. Within the first year, 19 patients were lost to follow-up and have been excluded from further study. The remaining 480 patients form the basis of this report. Clinical status and PSA values were systematically recorded before and after treatment. Results: With a median follow-up of 35 months (3-70) the actuarial clinical local control is 83%. Both stage and grade are shown to predict for this endpoint. Actuarial BDFS is also correlated with stage, grade, and PSA at presentation. Biochemical disease-free survival at five years is 94% for T1, 70% for unilateral T2, and 34% for T2c tumors. Grade is also predictive, ranging from 85% in low-grade tumors to 30% in high-grade tumors. In a multivariate analysis, the pretreatment PSA is most highly correlated (p 10 had a BDFS of 40%. Complications have been few, with severe urinary urgency or dysuria in 4% and both incontinence and proctitis seen in 1%. Conclusion: While biochemical disease-free survival reports in the literature are immature and have short follow-up, our data compares favorably with studies following radical prostatectomy or radiation therapy. Further follow-up of this cohort is required. The complication rate is low and patient acceptance excellent. Permanent implantation of I-125 as the sole treatment for early prostate cancer is a viable alternative for patients with early stage and low- to moderate-grade cancers. The PSA provides significant prognostic information and

Biochemical disease-free survival following I-125 prostate implantation

Energy Technology Data Exchange (ETDEWEB)

Beyer, David C; Priestley, Joseph B

1995-07-01

Purpose/Objective: To assess the five-year clinical and biochemical results of ultrasound-guided permanent I-125 brachytherapy in early prostate cancer. Biochemical disease-free survival (BDFS) is reported, using PSA follow-up and is compared to the surgical and radiation therapy literature. Materials and Methods: From 12/88 through 12/93, ultrasound-guided brachytherapy was preplanned with I-125 and delivered 16,000 cGy as the sole treatment in 499 patients. All were clinically staged as T1 or T2 - N0M0 adenocarcinoma of the prostate. Within the first year, 19 patients were lost to follow-up and have been excluded from further study. The remaining 480 patients form the basis of this report. Clinical status and PSA values were systematically recorded before and after treatment. Results: With a median follow-up of 35 months (3-70) the actuarial clinical local control is 83%. Both stage and grade are shown to predict for this endpoint. Actuarial BDFS is also correlated with stage, grade, and PSA at presentation. Biochemical disease-free survival at five years is 94% for T1, 70% for unilateral T2, and 34% for T2c tumors. Grade is also predictive, ranging from 85% in low-grade tumors to 30% in high-grade tumors. In a multivariate analysis, the pretreatment PSA is most highly correlated (p < 0.0001). Patients with a normal pretreatment PSA enjoyed 93% BDFS, while those presenting with PSA > 10 had a BDFS of 40%. Complications have been few, with severe urinary urgency or dysuria in 4% and both incontinence and proctitis seen in 1%. Conclusion: While biochemical disease-free survival reports in the literature are immature and have short follow-up, our data compares favorably with studies following radical prostatectomy or radiation therapy. Further follow-up of this cohort is required. The complication rate is low and patient acceptance excellent. Permanent implantation of I-125 as the sole treatment for early prostate cancer is a viable alternative for patients with

Promotion Guide – A guide for career reviews

CERN Multimedia

Staff Association

2017-01-01

On 8 February, the Standing Concertation Committee (SCC) approved the Promotion Guide, subtitled “A guide for career reviews”. The English version is already published on the HR website. This Promotion Guide is not very different from the Career Path Guide which it replaces following the implementation of the new career structure with benchmark jobs and grades. Structure The guide is composed of three parts: Section I – Introduction revisits the reference documents: the Staff Rules and Regulations (S&R) and the Administrative Circular No. 26 (AC 26). In the Staff Rules and Regulations, the term promotion is defined as a change of grade1 and in Administrative Circular No. 26, the Promotion Guide is referenced under paragraph 452. The objective of the Promotion Guide is laid out in Section I: “The Promotion Guide defines the criteria to be used as a reference for career reviews with a view to a potential promotion”. However, this guide do...

The copyright book a practical guide

CERN Document Server

Strong, William S

2014-01-01

Through five editions since 1981, this book has offered the most comprehensive accessible guide available to all aspects of copyright law. Now, with the sixth edition, The Copyright Book has been thoroughly updated to cover copyright for the Internet age, discussing a range of developments in the law since 2000. The only book written for nonlawyers that covers the entire field of copyright law, it is essential reading for authors, artists, creative people in every medium, the companies that hire them, users of copyrighted material, and anyone with an interest in copyright law from a policy perspective. New material includes greatly expanded coverage of infringement and fair use, with detailed discussion of recent decisions, including the Grateful Dead, Google, and HathiTrust cases. The new edition considers such topics as open access, the defeat of the Stop Online Piracy Act (SOPA), file sharing, e-reserves, the status of "orphan works," and the latest developments under the Digital Millennium Copyright Act (...

Pilfering for survival: how health workers use access to drugs as a coping strategy

Directory of Open Access Journals (Sweden)

Fernandes Maria

2004-04-01

Full Text Available Abstract Background Coping strategies have, in some countries, become so prevalent that it has been widely assumed that the very notion of civil services ethos has completely – and possibly irreversibly – disappeared. This paper describes the importance and the nature of pilfering of drugs by health staff in Mozambique and Cape Verde, as perceived by health professionals from these countries. Their opinions provide pointers as to how to tackle these problems. Methods This study is based on a self-administered questionnaire addressed to a convenience sample of health workers in Mozambique and in Cape Verde. Results The study confirms that misuse of access to pharmaceuticals has become a key element in the coping strategies health personnel develop to deal with difficult living conditions. Different professional groups (misuse their privileged access in different ways, but doctors diversify most. The study identifies the reasons given for misusing access to drugs, shows how the problem is perceived by the health workers, and discusses the implications for finding solutions to the problem. Our findings reflect, from the health workers themselves, a conflict between their self image of what it means to be an honest civil servant who wants to do a decent job, and the brute facts of life that make them betray that image. The manifest unease that this provokes is an important observation as such. Conclusion Our findings suggest that, even in the difficult circumstances observed in many countries, behaviours that depart from traditional civil servant deontology have not been interiorised as a norm. This ambiguity indicates that interventions to mitigate the erosion of proper conduct would be welcome. The time to act is now, before small-scale individual coping grows into large-scale, well-organized crime.

SPECIAL REPORT - The KC EMPOWER Project: Designing More Accessible STEM Learning Activities

Directory of Open Access Journals (Sweden)

Bob Hirshon

2016-01-01

Full Text Available The overall purpose of the Kinetic City (KC Empower project was to examine how informal science activities can be made accessible for students with disabilities. The premise of this project was that all students, including those with disabilities, are interested in and capable of engaging in science learning experiences, if these experiences are accessible to them. Drawing on resources from Kinetic City, a large collection of science experiments, games, and projects developed by the American Association for the Advancement of Science (AAAS, the project researched and adapted five afterschool science activities guided by universal design for learning principles.

Radiation Safety of Gamma, Electron and X Ray Irradiation Facilities. Specific Safety Guide (Spanish Edition)

International Nuclear Information System (INIS)

2015-01-01

The objective of this Safety Guide is to provide recommendations on how to meet the requirements of the BSS with regard to irradiation facilities. This Safety Guide provides specific, practical recommendations on the safe design and operation of gamma, electron and X ray irradiators for use by operating organizations and the designers of these facilities, and by regulatory bodies. SCOPE. The facilities considered in this publication include five types of irradiator, whether operated on a commercial basis or for research and development purposes. This publication is concerned with radiation safety issues and not with the uses of irradiators, nor does it cover the irradiation of product or its quality management. The five types of irradiator are: - Panoramic dry source storage irradiators; - Underwater irradiators, in which both the source and the product being irradiated are under water; - Panoramic wet source storage irradiators; - Electron beam irradiation facilities, in which irradiation is performed in an area that is potentially accessible to personnel, but that is kept inaccessible during the irradiation process; - X ray irradiation facilities, in which irradiation is performed in an area that is potentially accessible to personnel, but that is kept inaccessible during the irradiation process. Consideration of non-radiation-related risks and of the benefits resulting from the operation of irradiators is outside the scope of this Safety Guide. The practices of radiotherapy and radiography are also outside the scope of this Safety Guide. Category I gamma irradiators (i.e. 'self-shielded' irradiators) are outside the scope of this Safety Guide

Guide to preparing SAND reports and other communication products.

Energy Technology Data Exchange (ETDEWEB)

2011-09-01

This guide describes the R&A process, Common Look and Feel requirements, and preparation and publishing procedures for communication products at Sandia National Laboratories. Samples of forms and examples of published communications products are provided. This guide takes advantage of the wealth of material now available on the Web as a resource. Therefore, it is best viewed as an electronic document. If some of the illustrations are too small to view comfortably, you can enlarge them on the screen as needed. The format of this document is considerably different than that usually expected of a SAND Report. It was selected to permit the large number of illustrations and examples to be placed closer to the text that references them. In the case of forms, covers, and other items that are included as examples, a link to the Web is provided so that you can access the items and download them for use. This guide details the processes for producing a variety of communication products at Sandia National Laboratories. Figure I-1 shows the general publication development process. Because extensive supplemental material is available from Sandia on the internal web or from external sources (Table I-1), the guide has been shortened to make it easy to find information that you need.

Endoscopic ultrasound rendezvous for bile duct access using a transduodenal approach: cumulative experience at a single center. A case series.

Science.gov (United States)

Kim, Y S; Gupta, K; Mallery, S; Li, R; Kinney, T; Freeman, M L

2010-06-01

Endoscopic ultrasound (EUS)-assisted biliary access is utilized when conventional endoscopic retrograde cholangiopancreatography (ERCP) fails. We report a 10-year experience utilizing a transduodenal EUS rendezvous via a transpapillary route without dilation of the transduodenal tract, followed by immediate ERCP access. Patients included all EUS-guided rendezvous procedures for biliary access that were performed following ERCP failure. EUS-assisted bile duct puncture was performed via a transduodenal approach and a guide wire was advanced through the papilla without any dilation or bougienage of the tract; ERCP was performed immediately afterwards. EUS-assisted biliary rendezvous was attempted in 15 patients (mean age 66 +/- 18.2 years; malignant = 10, benign = 5). Mean diameter of measured bile ducts was 14.3 +/- 5.17 mm (range 4-23 mm). The reasons for initial ERCP failure were tumor infiltration or edema (n = 9), intradiverticular papilla (n = 2), pre-existing duodenal stent (n = 1), and anatomic anomalies (n = 3). Successful EUS-guided bile duct puncture and wire passage were achieved in all 15 patients (100 %), with drainage being successful in 12 / 15 (80 %). Failures occurred in three patients due to inability to traverse the biliary stricture (n = 2) or dissection of a choledochocele with the guide wire (n = 1); all were subsequently drained via percutaneous methods. Stents placed were metallic in eight patients and plastic in four. Complications consisted of moderate pancreatitis after a difficult ERCP attempt in one patient, and bacteremia after percutaneous biliary drainage in another. There were no instances of perforation, extraluminal air or fluid collections. EUS-assisted biliary drainage utilizing a transduodenal rendezvous approach demonstated a high success rate without any complications directly attributable to the EUS access. Advantages over percutaneous biliary and other methods of EUS biliary access include performance under the same

Accent modulates access to word meaning: Evidence for a speaker-model account of spoken word recognition.

Science.gov (United States)

Cai, Zhenguang G; Gilbert, Rebecca A; Davis, Matthew H; Gaskell, M Gareth; Farrar, Lauren; Adler, Sarah; Rodd, Jennifer M

2017-11-01

Speech carries accent information relevant to determining the speaker's linguistic and social background. A series of web-based experiments demonstrate that accent cues can modulate access to word meaning. In Experiments 1-3, British participants were more likely to retrieve the American dominant meaning (e.g., hat meaning of "bonnet") in a word association task if they heard the words in an American than a British accent. In addition, results from a speeded semantic decision task (Experiment 4) and sentence comprehension task (Experiment 5) confirm that accent modulates on-line meaning retrieval such that comprehension of ambiguous words is easier when the relevant word meaning is dominant in the speaker's dialect. Critically, neutral-accent speech items, created by morphing British- and American-accented recordings, were interpreted in a similar way to accented words when embedded in a context of accented words (Experiment 2). This finding indicates that listeners do not use accent to guide meaning retrieval on a word-by-word basis; instead they use accent information to determine the dialectic identity of a speaker and then use their experience of that dialect to guide meaning access for all words spoken by that person. These results motivate a speaker-model account of spoken word recognition in which comprehenders determine key characteristics of their interlocutor and use this knowledge to guide word meaning access. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

No Experience Necessary: A Guide to Employment for the Female Liberal Arts Graduate.

Science.gov (United States)

Friedman, Sande; Schwartz, Lois C.

A guide for beginning employment for female liberal arts graduates (referred to as FLAGs), this book describes 14 fields found to be presently most accessible to FLAGs without advanced degrees: advertising, the art world, banking and finance, book publishing, computer programing, fashion (and beauty), films, Government, magazine and newspaper…

JCE Online: Equipment Buyers Guide

Science.gov (United States)

Holmes, Jon L.

1999-01-01

The Equipment Buyers Guide was edited by Jo Rita Jordan. The new Equipment Buyers Guide, bound into the back of this issue, is also a new resource of JCE Internet. This resource provides an online source for the information contained in the printed guide. Placing this information online allows us to regularly update it and to provide live links to the suppliers' WWW sites. The organization of the online version parallels that of the print version. There is an alphabetical list of suppliers and a categorical listing. Links to these lists are provided on every page in the left-hand navigation bar. To quickly find information about a particular supplier, you click Supplier List, click the letter that begins the supplier's name, and scroll through the list to find the supplier. To find which suppliers provide a particular type of instrument or equipment, use the Categories link; click the category of the equipment you are looking for and then click the link to a supplier. You will then be taken to an alphabetical supplier listing page where you can scroll until you find the particular supplier of the item for which you are looking. Once you have found a supplier, the online Equipment Buyers Guide gives you the traditional contact information. But in addition, you also get one-click access to the WWW sites of the suppliers that have them. Depending on the site, you should be able to find information about the items that you seek and may even be able to order the items online! We think that you will find the online version of the Equipment Buyers Guide useful. To make it more useful, please send your suggestions, any errors or omissions you find, and any additional categories to the editor at jjordan@world.std.com The online Equipment Buyers Guide can be found at JCE Online at http://JChemEd.chem.wisc.edu/JCEWWW/Resources/EBG/ JCE Online in '99 JCE Online is your online source of "all things JCE". In order to provide you with an even more useful online resource, JCE

Network survivability performance

Science.gov (United States)

1993-11-01

This technical report has been developed to address the survivability of telecommunications networks including services. It responds to the need for a common understanding of, and assessment techniques for network survivability, availability, integrity, and reliability. It provides a basis for designing and operating telecommunications networks to user expectations for network survivability and a foundation for continuing industry activities in the subject area. This report focuses on the survivability of both public and private networks and covers a wide range of users. Two frameworks are established for quantifying and categorizing service outages, and for classifying network survivability techniques and measures. The performance of the network survivability techniques is considered; however, recommended objectives are not established for network survivability performance.

Improving Maternal Healthcare Access and Neonatal Survival through a Birthing Home Model in Rural Haiti

Directory of Open Access Journals (Sweden)

Elizabeth Wickstrom

2007-10-01

Full Text Available High neonatal mortality in Haiti is sustained by limited access to essential maternity services, particularly for Haiti’s rural population. We investigated the feasibility of a rural birthing home model to provide basic prenatal, delivery, and neonatal services for women with uncomplicated pregnancies while simultaneously providing triage and transport of women with pregnancy related complications. The model included consideration of the local context, including women’s perceptions of barriers to healthcare access and available resources to implement change. Evaluation methods included the performance of a baseline community census and collection of pregnancy histories from 791 women living in a defined area of rural Haiti. These retrospective data were compared with pregnancy outcome for 668 women subsequently receiving services at the birthing home. Of 764 reported most recent pregnancies in the baseline survey, 663(87% occurred at home with no assistance from skilled health staff. Of 668 women followed after opening of the birthing home, 514 (77% subsequently gave birth at the birthing home, 94 (14% were referred to a regional hospital for delivery, and only 60 (9% delivered at home or on the way to the birthing home. Other measures of clinical volume and patient satisfaction also indicated positive changes in health care seeking. After introduction of the birthing home, fewer neonates died than predicted by historical information or national statistics. The present experience points out the feasibility of a rural birthing home model to increase access to essential maternity services.

SCHOOL, UNIVERSITY AND EDUCATIONAL ACCESSIBILITY: DISCUSSING EDUCATIONAL OPPORTUNITIES FOR STUDENTS WITH HIGH SKILLS/GIFTEDNESS

Directory of Open Access Journals (Sweden)

Renata Gomes Camargo

2013-12-01

Full Text Available Thinking about educational accessibility in academic research constitutes a necessity in view of the reality of education today and investigations unexplored, such as the relation between the high skills/giftedness -AH/SD-, researchin university and educational accessibility. This paper aims to discuss the dialogue between school and university research regarding the accessibility of students with AH/SD, seeking to highlight some actions related to a research project of theUniversidade Federal de Santa Maria/RS. The discussion in this article is guided in a qualitative perspective, is the main theoretical support studies of Manzini (2005 and Freitas and Pérez (2010. Among the main considerations, it follows that: shared responsibility between school and university, through action research projects, contributes significantly to the establishment of educational accessibility for students with AH/SD.

Guided wave testing for touch point corrosion

International Nuclear Information System (INIS)

Alleyne, David

2012-01-01

Guided wave testing (GWT) is established in the petrochemical and related industries, primarily for the detection of corrosion flaws. Touch point corrosion at support positions in pipe-work has become a significant problem within many operating gas, chemical and petro-chemical plants world-wide, particularly as a high proportion of these plants have been operational for many decades. This article demonstrates how GWT using guided waves sent axially along the pipe can be performed for the detection and accurate classification of touchpoint corrosion. The major advantage of GWT methods for the detection of touch point corrosion is its ability to examine several support positions from a single easy to access transducer position. The strategy is then to prioritize or rank the condition of the pipe at the supports by removing those with negligible wall loss from scheduling for further inspection. Guided waves are accurate at detecting and classifying corrosion patches at support positions, but deep pits within such patches are more difficult to accurately identify. Examples using data from routine inspection testing are used to support the development of the methods and testing approaches presented. Recent developments of the interpretation methods, testing procedures and calibration methods have significantly enhanced the capabilities of GWT for this important application.

Reporting combined outcomes with Trifecta and survival, continence, and potency (SCP) classification in 337 patients with prostate cancer treated with image-guided hypofractionated radiotherapy.

Science.gov (United States)

Jereczek-Fossa, Barbara A; Zerini, Dario; Fodor, Cristiana; Santoro, Luigi; Maucieri, Andrea; Gerardi, Marianna A; Vischioni, Barbara; Cambria, Raffaella; Garibaldi, Cristina; Cattani, Federica; Vavassori, Andrea; Matei, Deliu V; Musi, Gennaro; De Cobelli, Ottavio; Orecchia, Roberto

2014-12-01

To report the image-guided hypofractionated radiotherapy (hypo-IGRT) outcome for patients with localised prostate cancer according to the new outcome models Trifecta (cancer control, urinary continence, and sexual potency) and SCP (failure-free survival, continence and potency). Between August 2006 and January 2011, 337 patients with cT1-T2N0M0 prostate cancer (median age 73 years) were eligible for a prospective longitudinal study on hypo-IGRT (70.2 Gy/26 fractions) in our Department. Patients completed four questionnaires before treatment, and during follow-up: the International Index of Erectile Function-5 (IIEF-5), the International Prostate Symptom Score (IPSS), and the European Organization for Research and Treatment of Cancer prostate-cancer-specific Quality of Life Questionnaires (QLQ) QLQ-PR25 and QLQ-C30. Baseline and follow-up patient data were analysed according to the Trifecta and SCP outcome models. Cancer control, continence and potency were defined respectively as no evidence of disease, score 1 or 2 for item 36 of the QLQ-PR25 questionnaire, and total score of >16 on the IIEF-5 questionnaire. Patients receiving androgen-deprivation therapy (ADT) at any time were excluded. Trifecta criteria at baseline were met in 72 patients (42% of all ADT-free patients with completed questionnaires). Both at 12 and 24 months after hypo-IGRT, 57% of the Trifecta patients at baseline were still meeting the Trifecta criteria (both oncological and functional success according to the SCP model). The main reason for failing the Trifecta criteria during follow-up was erectile dysfunction: in 18 patients after 6 months follow-up, in 12 patients after 12 months follow-up, and in eight patients after 24 months. Actuarial 2-year Trifecta failure-free survival rate was 44% (95% confidence interval 27-60%). In multivariate analysis no predictors of Trifecta failure were identified. Missing questionnaires was the main limitation of the study. The Trifecta and SCP

Barriers and facilitators to intraosseous access in adult resuscitations when peripheral intravenous access is not achievable.

Science.gov (United States)

James Cheung, Warren; Rosenberg, Hans; Vaillancourt, Christian

2014-03-01

Studies suggest that intraosseous (IO) access is underutilized in adult resuscitations, despite recommendations from advanced trauma and cardiac life support guidelines. The objective was to determine factors associated with IO access use by physicians during adult resuscitations when intravenous (IV) access is not immediately achievable. This study was an online survey among physicians purposefully recruited from various clinical care areas at three teaching hospitals. Questions were generated from the qualitative results of 20 iterative interviews, verified for internal validity, and piloted. The interview guide was based on the constructs of the Theory of Planned Behavior (TPB), which elicits salient attitudes, social influences, and control beliefs that potentially influence intention to use IO access. Recruitment took place in September 2012 until reaching more than 100% of the required sample size (n = 200). Internal consistency was measured using Cronbach's alpha, and the effect of TPB constructs and specific beliefs were assessed with regression analyses. For the 205 respondents, the mean age was 35 years (range = 20 to 66 years), and 53.3% were male. Participants' departmental affiliations were 50.3% emergency medicine (EM), 16.9% internal medicine, 14.9% anesthesia, 10.8% general surgery, and 7.2% critical care. Residents comprised 60.7% of the sample, and 39.3% were attending physicians. Median intention to use IO access when IV is not immediately achievable was 4.67 (interquartile range [IQR] = 4 to 5) out of 5 (5 highest) and predicted by the following TPB constructs: attitudes (AdjCoefficients = 0.504; 95% confidence interval [CI] = 0.334 to 0.673), social influences (AdjCoefficients = 0.285; 95% CI = 0.172 to 0.398), and control beliefs (AdjCoefficients 0.217; 95% CI = 0.113 to 0.320). Physicians were more likely to use IO access if they believed that it provided rapid vascular access for delivering large volumes of fluids, could prevent delays in

Guia para Padres: Acceso a los Grupos de Padres (Accessing Parent Groups: A Parent's Guide).

Science.gov (United States)

Interstate Research Associates, McLean, VA.

This guide, in Spanish, notes the value of parent groups for parents of children with disabilities, as they offer parents a place and a means to share information, give and receive emotional support, and work as a team to address common concerns. Typical activities of a parent group are listed, and ways of identifying parent groups that exist…

Defense Strategy of Aircraft Confronted with IR Guided Missile

Directory of Open Access Journals (Sweden)

Hesong Huang

2017-01-01

Full Text Available Surface-type infrared (IR decoy can simulate the IR characteristics of the target aircraft, which is one of the most effective equipment to confront IR guided missile. In the air combat, the IR guided missile poses a serious threat to the aircraft when it comes from the front of target aircraft. In this paper, firstly, the model of aircraft and surface-type IR decoy is established. To ensure their authenticity, the aircraft maneuver and radiation models based on real data of flight and exhaust system radiation in the state of different heights and different speeds are established. Secondly, the most effective avoidance maneuver is simulated when the missile comes from the front of the target aircraft. Lastly, combining maneuver with decoys, the best defense strategy is analysed when the missile comes from the front of aircraft. The result of simulation, which is authentic, is propitious to avoid the missile and improve the survivability of aircraft.

Extra Luminal Entrapment of Guide Wire; A Rare Complication of Central Venous Catheter Placement in Right Internal Jugular Vein.

Science.gov (United States)

Ansari, Md Abu Masud; Kumar, Naveen; Kumar, Shailesh; Kumari, Sarita

2016-10-01

Central venous Catheterization (CVC) is a commonly performed procedure for venous access. It is associated with several complications. We report a rare case of extra luminal entrapment of guide wire during CVC placement in right jugular vein. We report a case of 28 years old female patient presented in our emergency with history of entrapped guide wire in right side of neck during CVC. X-ray showed coiling of guide wire in neck. CT Angiography showed guide wire coursing in between common carotid artery and internal jugular vein (IJV), closely abutting the wall of both vessels. The guide wire was coiled with end coursing behind the esophageal wall. Guide wire was removed under fluoroscopic guide manipulation under local anesthesia. We want to emphasize that even though CVC placement is common and simple procedure, serious complication can occur in hands of untrained operator. The procedure should be performed under supervision, if done by trainee. Force should never be applied to advance the guide wire if resistance is encountered.

Technical strategies and anatomic considerations for parapedicular access to thoracic and lumbar vertebral bodies

International Nuclear Information System (INIS)

Beall, Douglas P.; Martin, Hal D.; Stapp, Annette M.; Puckett, Timothy A.; Stechison, M.T.; Braswell, John J.

2007-01-01

To investigate and illustrate a variation on the traditional percutaneous access to the vertebral body via a parapedicular approach. An effective parapedicular access technique that could safely and reliably guide the needle tip into the center of the vertebral body was developed from cadaver dissection observations for the purpose of clinical use. A total of 102 vertebral compression fractures from T-4 to L-5 were treated via the parapedicular access at our institution between July 2005 and March 2006. There were 72 patients between the ages of 17 and 96 years (mean age: 68.2 years) who underwent treatment. The cadaver dissection revealed a relatively avascular and aneural portion of the vertebral body along the superior margin of the vertebral body-pedicle junction. A total 102 vertebral fractures were treated using the parapedicular access technique without any recognized clinical complications from the needle access or the instrumentation. The thoracic and lumbar vertebral bodies may be safely, reliably, and reproducibly accessed using a percutaneous parapedicular access technique. The technique presented represents a relatively avascular and aneural approach to vertebral body. (orig.)

BIOCHEMISTRYGUIDE: A GUIDE TO STUDY BIOCHEMISTRY IN THE PALM OF YOUR HAND

Directory of Open Access Journals (Sweden)

M. L.C. Zago

2015-08-01

Full Text Available The new generation has grown driven by the digital technologies. Nowadays, the access to information has extended to the mobile technologies, like cell phones and tablets, increasing the technological resources for use in education. Educational institutions are opening more and more space to technologies, which have a new teaching, and learning methodology. The internet is an inexhaustible source of knowledge. With so much available material, the student finds difficulties in choosing the best source to study. Develop a cell phone app that works as a biochemistry study guide, providing materials from safe source and easy access. The app was developed at the website "Factory of apps", for free, and available for all the operational systems (Android, IOS, windows, enabling the download in any device. Were inserted in it materials like: summaries of the main subjects dealt in the discipline with clear and objective language, scientific articles to complementary reading, video-classes and exercises. Offering fast and practical access to the material, facilitating the process of studying and learning. The student does not have to let his mobile phone in preference of studying and does not find difficulties to filter available information in the internet. After the app's use, was applied a questionnaire to the participating students for this tool's assessment, such as layout, quality of the available material, access facilities. All the participants have approved the listed aspects and have said that the use of the tool can help at the biochemistry study, by the reliable material and by being available in a mobile device providing quick and immediate access, at any time in the palm of the hand. The use of this tool can be applied in the classroom to help the professor in getting materials and to help the students by its practicality.Acknowledgements: CnpQ, Unipampa. Keywords: App, BiochemistryGuide, Biochemistry

DB2 9 for Linux, Unix, and Windows database administration certification study guide

CERN Document Server

Sanders, Roger E

2007-01-01

In DB2 9 for Linux, UNIX, and Windows Database Administration Certification Study Guide, Roger E. Sanders-one of the world's leading DB2 authors and an active participant in the development of IBM's DB2 certification exams-covers everything a reader needs to know to pass the DB2 9 UDB DBA Certification Test (731).This comprehensive study guide steps you through all of the topics that are covered on the test, including server management, data placement, database access, analyzing DB2 activity, DB2 utilities, high availability, security, and much more. Each chapter contains an extensive set of p

Adenosine triphosphate-based chemotherapy response assay (ATP-CRA)-guided platinum-based 2-drug chemotherapy for unresectable nonsmall-cell lung cancer.

Science.gov (United States)

Moon, Yong Wha; Choi, Sung Ho; Kim, Yong Tai; Sohn, Joo Hyuk; Chang, Joon; Kim, Se Kyu; Park, Moo Suk; Chung, Kyung Young; Lee, Hyoun Ju; Kim, Joo-Hang

2007-05-01

The study investigated correlations between adenosine triphosphate / chemotherapy response assay (ATP-CRA) and clinical outcomes after ATP-CRA-guided platinum-based chemotherapy for unresectable nonsmall-cell lung cancer (NSCLC). The authors performed an in vitro chemosensitivity test, ATP-CRA, to evaluate the chemosensitivities of anticancer drugs such as cisplatin, carboplatin, paclitaxel, docetaxel, gemcitabine, and vinorelbine for chemonaive, unresectable NSCLC. The cell death rate was determined by measuring the intracellular ATP levels of drug-exposed cells compared with untreated controls. A sensitive drug was defined as a drug producing 30% or more reduction in ATP compared with untreated controls. Assay-guided platinum-based 2-drug chemotherapy was given to patients with pathologically confirmed NSCLC. Thirty-four patients were enrolled. Thirty tumor specimens were obtained by bronchoscopic biopsies and 4 obtained surgically. The median age was 61 years and 27 patients had an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1. The response rate was 43.8%. At a median follow-up period of 16.9 months, the median progression-free and overall survivals were 3.6 and 11.2 months, respectively. Patients were dichotomized into the platinum-sensitive (S; 20 patients) and resistant (R; 14 patients) groups. The positive/negative predictive values were 61.1% and 78.6% with a predictive accuracy of 68.8%. Although without significant differences in pretreatment parameters, the S-group showed better clinical response (P=.036), longer progression-free survival (P=.060), and longer overall survival (P=.025). Despite using bronchoscopic biopsied specimens, ATP-CRA and clinical outcomes correlated well after assay-guided platinum-based 2-drug chemotherapy for unresectable NSCLC. There was a favorable response and survival in the platinum-sensitive vs resistant groups. Copyright (c) 2007 American Cancer Society

Effect of Message Format and Content on Attitude Accessibility Regarding Sexually Transmitted Infections.

Science.gov (United States)

Jain, Parul; Hoffman, Eric; Beam, Michael; Xu, Shan Susan

2017-11-01

Sexually transmitted infections (STIs) are widespread in the United States among people ages 15-24 years and cost almost $16 billion yearly. It is therefore important to understand message design strategies that could help reduce these numbers. Guided by exemplification theory and the extended parallel process model (EPPM), this study examines the influence of message format and the presence versus absence of a graphic image on recipients' accessibility of STI attitudes regarding safe sex. Results of the experiment indicate a significant effect from testimonial messages on increased attitude accessibility regarding STIs compared to statistical messages. Results also indicate a conditional indirect effect of testimonial messages on STI attitude accessibility, though threat is greater when a graphic image is included. Implications and directions for future research are discussed.

Effects of scale and efficiency of rural traffic calming on safety, accessibility and wildlife

NARCIS (Netherlands)

Jaarsma, C.F.; Langevelde, van F.

2011-01-01

This paper examines the effects of scale and efficiency of regional traffic calming on traffic safety, rural accessibility, and survival of wildlife. We distinguish by the scale of road networks affected and considered the efficiencies of various bundling of traffic flows on designated routes.

Expression of LDL receptor-related proteins (LRPs in common solid malignancies correlates with patient survival.

Directory of Open Access Journals (Sweden)

Steven L Gonias

Full Text Available LDL receptor-related proteins (LRPs are transmembrane receptors involved in endocytosis, cell-signaling, and trafficking of other cellular proteins. Considerable work has focused on LRPs in the fields of vascular biology and neurobiology. How these receptors affect cancer progression in humans remains largely unknown. Herein, we mined provisional databases in The Cancer Genome Atlas (TCGA to compare expression of thirteen LRPs in ten common solid malignancies in patients. Our first goal was to determine the abundance of LRP mRNAs in each type of cancer. Our second goal was to determine whether expression of LRPs is associated with improved or worsened patient survival. In total, data from 4,629 patients were mined. In nine of ten cancers studied, the most abundantly expressed LRP was LRP1; however, a correlation between LRP1 mRNA expression and patient survival was observed only in bladder urothelial carcinoma. In this malignancy, high levels of LRP1 mRNA were associated with worsened patient survival. High levels of LDL receptor (LDLR mRNA were associated with decreased patient survival in pancreatic adenocarcinoma. High levels of LRP10 mRNA were associated with decreased patient survival in hepatocellular carcinoma, lung adenocarcinoma, and pancreatic adenocarcinoma. LRP2 was the only LRP for which high levels of mRNA expression correlated with improved patient survival. This correlation was observed in renal clear cell carcinoma. Insights into LRP gene expression in human cancers and their effects on patient survival should guide future research.

Looking into the effect of Diabetes Mellitus on Vascular Access in Haemodialysis Patients

Directory of Open Access Journals (Sweden)

Stavroula Tsinikori

2017-03-01

Full Text Available Introduction: The creation and maintenance of a good vascular access is mandatory for a successful haemodialysis sessions and the survival of a Chronic Kidney Disease patient. Aim: The aim of the present cross-sectional study was to look into the vascular access complications in haemodialysed patients with or without Diabetes Mellitus (DM and to find any possible correlation of these complications with Diabetes Mellitus. Methods: For this cross-sectional study data from patients’ records of private Dialysis Unit (n=77 and a big General Hospital in a Northern Greece city (n=33 were studied. Demographics, data on medication therapy and vascular access (area, type, dialysis parameters and complications were recorded. Statistical analysis was performed with SPSS 20.0. Results: The sample was 66.7 (±12.5 years old, mainly male (58%, n=58 and on dialysis for 37.3 (±34.3 months. DM was the primary disease of 53% (n=53 of the patients and Hypertension for 13% (n=13,whereas the mean of comorbidities was 5,3 (±2,6. Thirty-seven patients (37% had more than one VA created or placed. On the total of the sample (n=100 156 VA were accessed with the 63% (n=63 of them with arteriovenous fistula (AVF, 35% (n=35 with central venous catheter (CVC and 2% (n=2 with arteriovenous graft (AVG. A statistical significance (U=2560,5, p=0,1 was found regarding the number of VA of the two group of patients (DM=2,2 VA, non DM=1,8. On survival analysis it was found that DM increases the relative risk of “death” of a VA with odds ratio of 1,7 (95% confidence interval 1,1-2,6. Conclusions: DM, as primary disease or co-morbidity, in haemodialysis patients affects negatively the VA survival. Effective blood glucose control, management and methods of puncturing VA play a crucial role in maintaining the VA in DM haemodialysis patients.

Wilmar Planning Tool, user guide

Energy Technology Data Exchange (ETDEWEB)

Larsen, Helge V.

2006-01-15

This is a short user guide to the Wilmar Planning Tool developed in the project Wind Power Integration in Liberalised Electricity Markets (WILMAR) supported by EU (Contract No. ENK5-CT-2002-00663). A User Shell implemented in an Excel workbook controls the Wilmar Planning Tool. All data are contained in Access databases that communicate with various sub-models through text files that are exported from or imported to the databases. In the User Shell various scenario variables and control parameters are set, and export of model data from the input database, activation of the models, as well as import of model results to the output database are triggered from the shell. (au)

Wilmar Planning Tool, user guide

International Nuclear Information System (INIS)

Larsen, Helge V.

2006-01-01

This is a short user guide to the Wilmar Planning Tool developed in the project Wind Power Integration in Liberalised Electricity Markets (WILMAR) supported by EU (Contract No. ENK5-CT-2002-00663). A User Shell implemented in an Excel workbook controls the Wilmar Planning Tool. All data are contained in Access databases that communicate with various sub-models through text files that are exported from or imported to the databases. In the User Shell various scenario variables and control parameters are set, and export of model data from the input database, activation of the models, as well as import of model results to the output database are triggered from the shell. (au)

Association of tRNA methyltransferase NSUN2/IGF-II molecular signature with ovarian cancer survival.

Science.gov (United States)

Yang, Jia-Cheng; Risch, Eric; Zhang, Meiqin; Huang, Chan; Huang, Huatian; Lu, Lingeng

2017-09-01

To investigate the association between NSUN2/IGF-II signature and ovarian cancer survival. Using a publicly accessible dataset of RNA sequencing and clinical follow-up data, we performed Classification and Regression Tree and survival analyses. Patients with NSUN2 high IGF-II low had significantly superior overall and disease progression-free survival, followed by NSUN2 low IGF-II low , NSUN2 high IGF-II high and NSUN2 low IGF-II high (p IGF-II signature with the risks of death and relapse remained significant in multivariate Cox regression models. Random-effects meta-analyses show the upregulated NSUN2 and IGF-II expression in ovarian cancer versus normal tissues. The NSUN2/IGF-II signature associates with heterogeneous outcome and may have clinical implications in managing ovarian cancer.

Population distribution, settlement patterns and accessibility across Africa in 2010.

Directory of Open Access Journals (Sweden)

Catherine Linard

Full Text Available The spatial distribution of populations and settlements across a country and their interconnectivity and accessibility from urban areas are important for delivering healthcare, distributing resources and economic development. However, existing spatially explicit population data across Africa are generally based on outdated, low resolution input demographic data, and provide insufficient detail to quantify rural settlement patterns and, thus, accurately measure population concentration and accessibility. Here we outline approaches to developing a new high resolution population distribution dataset for Africa and analyse rural accessibility to population centers. Contemporary population count data were combined with detailed satellite-derived settlement extents to map population distributions across Africa at a finer spatial resolution than ever before. Substantial heterogeneity in settlement patterns, population concentration and spatial accessibility to major population centres is exhibited across the continent. In Africa, 90% of the population is concentrated in less than 21% of the land surface and the average per-person travel time to settlements of more than 50,000 inhabitants is around 3.5 hours, with Central and East Africa displaying the longest average travel times. The analyses highlight large inequities in access, the isolation of many rural populations and the challenges that exist between countries and regions in providing access to services. The datasets presented are freely available as part of the AfriPop project, providing an evidence base for guiding strategic decisions.

Field Guide to Plant Model Systems.

Science.gov (United States)

Chang, Caren; Bowman, John L; Meyerowitz, Elliot M

2016-10-06

For the past several decades, advances in plant development, physiology, cell biology, and genetics have relied heavily on the model (or reference) plant Arabidopsis thaliana. Arabidopsis resembles other plants, including crop plants, in many but by no means all respects. Study of Arabidopsis alone provides little information on the evolutionary history of plants, evolutionary differences between species, plants that survive in different environments, or plants that access nutrients and photosynthesize differently. Empowered by the availability of large-scale sequencing and new technologies for investigating gene function, many new plant models are being proposed and studied. Copyright © 2016 Elsevier Inc. All rights reserved.

Survival of Patients with Stomach Cancer and its Determinants in Kurdistan.

Science.gov (United States)

Moradi, Ghobad; Karimi, Kohsar; Esmailnasab, Nader; Roshani, Daem

2016-01-01

Stomach cancer is the fourth most common cancer and the second leading cause of death from cancer in the world. In Iran, this type of cancer has high rates of incidence and mortality. This study aimed to assess the survival rate of patients with stomach cancer and its determinants in Kurdistan, a province with one of the highest incidence rates of stomach cancer in the country. We studied a total of 202 patients with stomach cancer who were admitted to Tohid Hospital in Sanandaj from 2009 to 2013. Using KaplanMeier nonparametric methods the survival rate of patients was calculated in terms of different levels of age at diagnosis, gender, education, residential area, occupation, underweight, and clinical variables including tumor histology, site of tumor, disease stage, and type of treatment. In addition, we compared the survival rates using the logrank test. Finally, Cox proportional hazards regression was applied using Stata 12 and R 3.1.0 software. The significance level was set at 0.05. The mean age at diagnosis was 64.7 ± 12.0 years. The survival rate of patients with stomach cancer was 43.9% and 7% at the first and the fifth year after diagnosis, respectively. The results of logrank test showed significant relationships between survival and age at diagnosis, education, disease stage, type of treatment, and degree of being underweight (P<0.05). Moreover, according to the results of Cox proportional hazards regression model, the variables of education, disease stage, and type of treatment were associated with patient survival (P<0.05). The survival rate of patients with stomach cancer is low and the prognosis is very poor. Given the poor prognosis of the patients, it is critical to find ways for early diagnosis and facilitating timely access to effective treatment methods.

Allelic database and divergence among Psidium accessions by using microsatellite markers.

Science.gov (United States)

da Costa, S R; Santos, C A F

2013-12-16

This study aimed to investigate the genetic variability among guava accessions and wild Psidium species of the Embrapa Semiárido germplasm collection by using microsatellite loci to guide genetic resources and breeding programs, emphasizing crosses between guava and other Psidium species. DNA was extracted using the 2X CTAB method, and polymerase chain reaction products were analyzed on 6% denatured polyacrylamide gels stained with silver nitrate. The unweighted pair-group method using arithmetic average dendrogram generated from the distance matrix of the Jaccard coefficient for 183 alleles of 13 microsatellite loci was used for visualization of genetic similarity. The number of base pairs was estimated using inverse mobility method based on the regression of known-size products. Analysis of molecular variance was performed using total decomposition between and within guava accessions. The accessions showed similarity from 0.75 to 1.00, with the dendrogram presenting cophenetic value of 0.85. Five groups were observed: the first included guava accessions; the second, P. guineense accessions; the third, one accession of P. friedrichsthalianum; and the last 2 groups, P. cattleianum. The genetic similarity among P. guineense and some guava accessions were above 80%, suggesting greater possibility to obtain interspecies hybrids between these 2 species. The genetic variability between the accessions was considered to be high (ΦST = 0.238), indicating that guava genetic variability is not uniformly distributed among the 9 Brazilian states from where the accession were obtained. Obtaining a greater number of accessions by Brazilian states is recommended in order to have greater diversity among the species.

Using Operational Analysis to Improve Access to Pulmonary Function Testing

Directory of Open Access Journals (Sweden)

Ada Ip

2016-01-01

Full Text Available Background. Timely pulmonary function testing is crucial to improving diagnosis and treatment of pulmonary diseases. Perceptions of poor access at an academic pulmonary function laboratory prompted analysis of system demand and capacity to identify factors contributing to poor access. Methods. Surveys and interviews identified stakeholder perspectives on operational processes and access challenges. Retrospective data on testing demand and resource capacity was analyzed to understand utilization of testing resources. Results. Qualitative analysis demonstrated that stakeholder groups had discrepant views on access and capacity in the laboratory. Mean daily resource utilization was 0.64 (SD 0.15, with monthly average utilization consistently less than 0.75. Reserved testing slots for subspecialty clinics were poorly utilized, leaving many testing slots unfilled. When subspecialty demand exceeded number of reserved slots, there was sufficient capacity in the pulmonary function schedule to accommodate added demand. Findings were shared with stakeholders and influenced scheduling process improvements. Conclusion. This study highlights the importance of operational data to identify causes of poor access, guide system decision-making, and determine effects of improvement initiatives in a variety of healthcare settings. Importantly, simple operational analysis can help to improve efficiency of health systems with little or no added financial investment.

Geographic Access to Cancer Care and Mortality Among Adolescents.

Science.gov (United States)

Tai, Eric; Hallisey, Elaine; Peipins, Lucy A; Flanagan, Barry; Lunsford, Natasha Buchanan; Wilt, Grete; Graham, Shannon

2018-02-01

Adolescents with cancer have had less improvement in survival than other populations in the United States. This may be due, in part, to adolescents not receiving treatment at Children's Oncology Group (COG) institutions, which have been shown to increase survival for some cancers. The objective of this ecologic study was to examine geographic distance to COG institutions and adolescent cancer mortality. We calculated cancer mortality among adolescents and sociodemographic and healthcare access factors in four geographic zones at selected distances surrounding COG facilities: Zone A (area within 10 miles of any COG institution), Zones B and C (concentric rings with distances from a COG institution of >10-25 miles and >25-50 miles, respectively), and Zone D (area outside of 50 miles). The adolescent cancer death rate was highest in Zone A at 3.21 deaths/100,000, followed by Zone B at 3.05 deaths/100,000, Zone C at 2.94 deaths/100,000, and Zone D at 2.88 deaths/100,000. The United States-wide death rate for whites without Hispanic ethnicity, blacks without Hispanic ethnicity, and persons with Hispanic ethnicity was 2.96 deaths/100,000, 3.10 deaths/100,000, and 3.26 deaths/100,000, respectively. Zone A had high levels of poverty (15%), no health insurance coverage (16%), and no vehicle access (16%). Geographic access to COG institutions, as measured by distance alone, played no evident role in death rate differences across zones. Among adolescents, socioeconomic factors, such as poverty and health insurance coverage, may have a greater impact on cancer mortality than geographic distance to COG institution.

Pre-End-Stage Renal Disease Care and Early Survival among Incident Dialysis Patients in the US Military Health System.

Science.gov (United States)

Nee, Robert; Fisher, Evan; Yuan, Christina M; Agodoa, Lawrence Y; Abbott, Kevin C

2017-01-01

Previous reports showed an increased early mortality after chronic dialysis initiation among the end-stage renal disease (ESRD) population. We hypothesized that ESRD patients in the Military Health System (MHS) would have greater access to pre-ESRD care and hence better survival rates during this early high-risk period. In this retrospective cohort study, using the US Renal Data System database, we identified 1,256,640 patients initiated on chronic dialysis from January 2, 2004 through December 31, 2014, from which a bootstrap sample of 3,984 non-MHS incident dialysis patients were compared with 996 MHS patients. We assessed care by a nephrologist and dietitian, erythropoietin administration, and vascular access use at dialysis initiation as well as all-cause mortality as outcome variables. MHS patients were significantly more likely to have had pre-ESRD nephrology care (adjusted OR [aOR] 2.9; 95% CI 2.3-3.7) and arteriovenous fistula used at dialysis initiation (aOR 2.2; 95% CI 1.7-2.7). Crude mortality rates peaked between the 4th and the 8th week for both cohorts but were reduced among MHS patients. The baseline adjusted Cox model showed significantly lower death rates among MHS vs. non-MHS patients at 6, 9, and 12 months. This survival advantage among MHS patients was attenuated after further adjustment for pre-ESRD nephrology care and dialysis vascular access. MHS patients had improved survival within the first 12 months compared to the general ESRD population, which may be explained in part by differences in pre-ESRD nephrology care and vascular access types. © 2017 S. Karger AG, Basel.

CompTIA Security+ Review Guide Sy0-201

CERN Document Server

Stewart, James M

2011-01-01

This review guide is broken into six parts, each one corresponding to one of the six domain areas of the Security+ exam: systems security, network infrastructure, access control, assessments and audits, cryptography, and organizational security. You'll find this book to be essential reading if you are studying for Security+ certification and want to get up to speed on the most recent security topics. The CD-ROM contains more than 120 review questions, two bonus exams, electronic flashcards, and a searchable key term database.

Auditing cloud computing a security and privacy guide

CERN Document Server

Halpert, Ben

2011-01-01

The auditor's guide to ensuring correct security and privacy practices in a cloud computing environment Many organizations are reporting or projecting a significant cost savings through the use of cloud computing-utilizing shared computing resources to provide ubiquitous access for organizations and end users. Just as many organizations, however, are expressing concern with security and privacy issues for their organization's data in the "cloud." Auditing Cloud Computing provides necessary guidance to build a proper audit to ensure operational integrity and customer data protection, among othe

Rural AIDS Diagnoses in Florida: Changing Demographics and Factors Associated With Survival

Science.gov (United States)

Trepka, Mary Jo; Niyonsenga, Theophile; Maddox, Lorene M.; Lieb, Spencer

2012-01-01

Purpose To compare demographic characteristics and predictors of survival of rural residents diagnosed with acquired immunodeficiency syndrome (AIDS) with those of urban residents. Methods Florida surveillance data for people diagnosed with AIDS during 1993–2007 were merged with 2000 Census data using ZIP code tabulation areas (ZCTA). Rural status was classified based on the ZCTA’s rural-urban commuting area classification. Survival rates were compared between rural and urban areas using survival curves and Cox proportional hazards models controlling for demographic, clinical, and area-level socioeconomic and health care access factors. Findings Of the 73,590 people diagnosed with AIDS, 1,991 (2.7%) resided in rural areas. People in the most recent rural cohorts were more likely than those in earlier cohorts to be female, non-Hispanic black, older, and have a reported transmission mode of heterosexual sex. There were no statistically significant differences in the 3-, 5-, or 10-year survival rates between rural and urban residents. Older age at the time of diagnosis, diagnosis during the 1993–1995 period, other/unknown transmission mode, and lower CD4 count/percent categories were associated with lower survival in both rural and urban areas. In urban areas only, being non-Hispanic black or Hispanic, being US born, more poverty, less community social support, and lower physician density were also associated with lower survival. Conclusions In rural Florida, the demographic characteristics of people diagnosed with AIDS have been changing, which may necessitate modifications in the delivery of AIDS-related services. Rural residents diagnosed with AIDS did not have a significant survival disadvantage relative to urban residents. PMID:23802929

Influence of socioeconomic factors on survival after breast cancer-A nationwide cohort study of women diagnosed with breast cancer in Denmark 1983-1999

DEFF Research Database (Denmark)

Dalton, Susanne Oksbjerg; Ross, Lone; During, M.

2007-01-01

The reasons for social inequality in breast cancer survival are far from established. Our study aims to study the importance of a range of socioeconomic factors and comorbid disorders on survival after breast cancer surgery in Denmark where the health care system is tax-funded and uniform. All 25...... for the social inequality in survival after breast cancer surgery in Denmark lies in the access to and/or compliance with management of comorbid conditions in poorer women. (c) 2007 Wiley-Liss, Inc....

Realtime ultrasound guided percutaneous tracheostomy in emergency setting: the glass ceiling has been broken.

Science.gov (United States)

Ravi, Parli Raghavan; Vijai, M N; Shouche, Sachin

2017-01-01

In recent years ultrasound guided percutaneous tracheostomy (USPCT) has become a routine practice in critical care units. Its safety and superiority over conventional percutaneous tracheostomy and bronchoscopic guided PCT is proven to be non-inferior in elective cases. However its role in emergency percutaneous tracheostomy has never been studied, since percutaneous tracheostomy itself remains an enigma in accessing emergency airway. There is no report of use of ultrasound guided percutaneous tracheostomy in emergency setting so far in the literature. We report our early experience with USPCT in emergency setting. Sixteen adult patients who required access to an emergency surgical airway after failure to accomplish emergency oro-tracheal intubation were the study population. Their airway was accessed by USPCT. Recorded data included clinical and demographic data including time taken to perform the procedure and complications. Short term and long term follow ups for a period of 2 years were done for the survivors. Twelve male and four female patients underwent the procedure and the average time of the procedure was 3.6 min with no failures nor conversions to surgical tracheostomy and no complications. The average oxygen saturation was 86% and average Glasgow coma scale was 8.4. This time period included the oxygen insufflation time. 10 patients were decannulated while six patients died due to the pathology of the disease itself. There were no complications in either short term or long term follow up. USPCT has a definitive role in emergency both in trauma and non-trauma setting. It is safe, feasible and faster in experienced hands. Use of USPCT in emergency setting has further narrowed the list of contraindications of percutaneous tracheostomy.

Security for small computer systems a practical guide for users

CERN Document Server

Saddington, Tricia

1988-01-01

Security for Small Computer Systems: A Practical Guide for Users is a guidebook for security concerns for small computers. The book provides security advice for the end-users of small computers in different aspects of computing security. Chapter 1 discusses the security and threats, and Chapter 2 covers the physical aspect of computer security. The text also talks about the protection of data, and then deals with the defenses against fraud. Survival planning and risk assessment are also encompassed. The last chapter tackles security management from an organizational perspective. The bo

[Gender, equality, and health services access: an empirical approximation].

Science.gov (United States)

Gómez Gómez, Elsa

2002-01-01

This piece describes the conceptual framework and the objectives that guided a research initiative in the Region of the Americas that was called "Gender, Equity, and Access to Health Services" and that was sponsored in 2001 by the Pan American Health Organization. The piece does not summarize the results of the six projects that were carried under the initiative, whose analyses have not all been completed. Instead, the piece discusses some of the foundations of the initiative and provides a general introduction to the country studies that were done. The six studies were done in Barbados/Jamaica, Brazil, Chile, Colombia, Ecuador, and Peru. The primary objective of the initiative was to stimulate the use of existing quantitative information in the countries, with the goal of starting a process of systematically documenting two things: 1) the unfair, unnecessary, and avoidable inequalities between men and women in their access to health care and 2) the linkages between those inequalities and other socioeconomic factors. The concept of gender equity that guided this examination of health care was not the usual one calling for the equal distribution of resources. Rather, it was the notion that resources should be allocated differentially, according to the particular needs of men and of women, and that persons should pay for health services according to their economic ability rather than their risk level. The starting point for the initiative was the premise that gender inequities in utilizing and paying for health care result from gender differences in the macroeconomic and microeconomic distribution of resources. The piece concludes that achieving equity in health care access will require a better understanding of the gender needs and gender barriers that are linked to social structures and health systems.

Making Astronomy Accessible

Science.gov (United States)

Grice, Noreen A.

2011-05-01

A new semester begins, and your students enter the classroom for the first time. You notice a student sitting in a wheelchair or walking with assistance from a cane. Maybe you see a student with a guide dog or carrying a Braille computer. Another student gestures "hello” but then continues hand motions, and you realize the person is actually signing. You wonder why another student is using an electronic device to speak. Think this can't happen in your class? According to the U.S. Census, one out of every five Americans has a disability. And some disabilities, such as autism, dyslexia and arthritis, are considered "invisible” disabilities. This means you have a high probability that one of your students will have a disability. As an astronomy instructor, you have the opportunity to reach a wide variety of learners by using creative teaching strategies. I will share some suggestions on how to make astronomy and your part of the universe more accessible for everyone.

Towards better territorial governance in Europe; a guide for practitioners, policy and decision makers based on contributions from the ESPON TANGO Project

NARCIS (Netherlands)

Janin Rivolin, U.; Santangelo, M.; Cotella, G.; Governa, F.; Caruso, N.; De Luca, A.; Schmitt, P.; Van Well, L.; Lange, S.; Reardon, M.; Stead, D.; Spaans, M.; Zonneveld, W.A.M.; Wandl, A.; Davoudi, S.; Cowie, P.; Madanipour, A.; Vigar, G.; Pálné Kovács, I.; Mezei, C.; Grünhut, Z.; Zavodnik Lamovsek, A.; Pichler-Milanovic, N.; Peterlin, M.; Simoneti, M.

2014-01-01

Guides help you do things. You turn to them when you need to find out how to solve a problem. They are a form of knowledge transfer, written by experts but in a way that is accessible and helpful to a wide group of users. This Guide was written by the researchers on the ESPON applied research study

Examination of accessibility for disabled people at metro stations

Directory of Open Access Journals (Sweden)

Evren Burak Enginöz

2016-07-01

enforcements, as well as insufficient user’s knowledge cause our cities inaccessible. Therefore, we have to increase the awareness of our community on accessible city life and transportation systems rather than make laws and hope for recovery. In this context, a case study is intended to examine the approaches on barrier-free design and level of accessibility at metro stations in Turkey. With the scope of this case study, current informative, stimulating and guiding regulations, vertical and horizontal implementations on circulation areas at metro stations are examined by an accessible design control list Accessible design control list consists of 28 questions that have been selected from Turkish Ministry of Family and Social Policies-People with Disabilities and Elderly General Service Accessibility check Lists and Turkish World Handicapped Foundation- Outdoors and Indoors Accessibility Check Lists. With the help of question we can examine the passengers’ expectations on the quality of informative, stimulating and guiding signboards at entrance, circulations and surroundings of metro stations; except the legislations related to the product sizes and constraints that designers or professionals have to obey The questions are answered by disabled passengers who use Kadıkoy Ayrılık Cesme main transmission metro station. Disabled passengers are divided into two subject groups. First subject group consist of 5 visually impaired and partially impaired people. The second subject group consist of 7 wheelchair users. Experimentally, asked all the subject groups to make a journey beginning from the entrance of metro station to the train platforms without getting any help. After they completed their journey, they were requested to answer the questions of control list and describe the positive and negative situations from their experiences. According to the result of examining the approaches on barrier-free design and the level of accessibility at Ayrılıkcesme main transmission

A study on laser-based ultrasonic technique by the use of guided wave tomographic imaging

Energy Technology Data Exchange (ETDEWEB)

Park, Junpil, E-mail: jpp@pusan.ac.kr; Lim, Juyoung, E-mail: jpp@pusan.ac.kr [Graduate school, School of Mechanical Engineering, Pusan National University (Korea, Republic of); Cho, Younho [School of Mechanical Engineering, Pusan National University (Korea, Republic of); Krishnaswamy, Sridhar [Center for Quality Engineering and Failure Prevention, Northwestern University, Evanston, IL (United States)

2015-03-31

Guided wave tests are impractical for investigating specimens with limited accessibility and coarse surfaces or geometrically complicated features. A non-contact setup with a laser ultrasonic transmitter and receiver is the classic attractive for guided wave inspection. The present work was done to develop a non-contact guided-wave tomography technique by laser ultrasonic technique in a plate-like structure. A method for Lam wave generation and detection in an aluminum plate with a pulse laser ultrasonic transmitter and a Michelson interferometer receiver has been developed. In the images obtained by laser scanning, the defect shape and area showed good agreement with the actual defect. The proposed approach can be used as a non-contact-based online inspection and monitoring technique.

Study of guided wave transmission through complex junction in sodium cooled reactor

International Nuclear Information System (INIS)

Elie, Q.; Le Bourdais, F.; Jezzine, K.; Baronian, V.

2015-01-01

Ultrasonic guided wave techniques are seen as suitable candidates for the inspection of welded structures within sodium cooled fast reactors (SFR), as the long range propagation of guided waves without amplitude attenuation can overcome the accessibility problem due to the liquid sodium. In the context of the development of the Advanced Sodium Test Reactor for Industrial Demonstration (ASTRID), the French Atomic Commission (CEA) investigates non-destructive testing techniques based on guided wave propagation. In this work, guided wave NDT methods are applied to control the integrity of welds located in a junction-type structure welded to the main vessel. The method presented in this paper is based on the analysis of scattering matrices peculiar to each expected defect, and takes advantage of the multi-modal and dispersive characteristics of guided wave generation. In a simulation study, an algorithm developed using the CIVA software is presented. It permits selecting appropriate incident modes to optimize detection and identification of expected flawed configurations. In the second part of this paper, experimental results corresponding to a first validation step of the simulation results are presented. The goal of the experiments is to estimate the effectiveness of the incident mode selection in plates. The results show good agreement between experience and simulation. (authors)

Image-guided surgery and therapy: current status and future directions

Science.gov (United States)

Peters, Terence M.

2001-05-01

Image-guided surgery and therapy is assuming an increasingly important role, particularly considering the current emphasis on minimally-invasive surgical procedures. Volumetric CT and MR images have been used now for some time in conjunction with stereotactic frames, to guide many neurosurgical procedures. With the development of systems that permit surgical instruments to be tracked in space, image-guided surgery now includes the use of frame-less procedures, and the application of the technology has spread beyond neurosurgery to include orthopedic applications and therapy of various soft-tissue organs such as the breast, prostate and heart. Since tracking systems allow image- guided surgery to be undertaken without frames, a great deal of effort has been spent on image-to-image and image-to- patient registration techniques, and upon the means of combining real-time intra-operative images with images acquired pre-operatively. As image-guided surgery systems have become increasingly sophisticated, the greatest challenges to their successful adoption in the operating room of the future relate to the interface between the user and the system. To date, little effort has been expended to ensure that the human factors issues relating to the use of such equipment in the operating room have been adequately addressed. Such systems will only be employed routinely in the OR when they are designed to be intuitive, unobtrusive, and provide simple access to the source of the images.

Migrations and swimming capabilities of endangered pallid sturgeon (Scaphirhynchus albus) to guide passage designs in the fragmented Yellowstone River

Science.gov (United States)

Braaten, P. J.; Elliott, Caroline M.; Rhoten, Jason C.; Fuller, D. B.; McElroy, Brandon J.

2015-01-01

Fragmentation of the Yellowstone River is hypothesized to preclude recruitment of endangered Scaphirhynchus albus (pallid sturgeon) by impeding upstream spawning migrations and access to upstream spawning areas, thereby limiting the length of free-flowing river required for survival of early life stages. Building on this hypothesis, the reach of the Yellowstone River affected by Intake Diversion Dam (IDD) is targeted for modification. Structures including a rock ramp and by-pass channel have been proposed as restoration alternatives to facilitate passage. Limited information on migrations and swimming capabilities of pallid sturgeon is available to guide engineering design specifications for the proposed structures. Migration behavior, pathways (channel routes used during migrations), and swimming capabilities of free-ranging wild adult pallid sturgeon were examined using radiotelemetry, and complemented with hydraulic data obtained along the migration pathways. Migrations of 12–26% of the telemetered pallid sturgeon population persisted to IDD, but upstream passage over the dam was not detected. Observed migration pathways occurred primarily through main channel habitats; however, migrations through side channels up to 3.9 km in length were documented. The majority of pallid sturgeon used depths of 2.2–3.4 m and mean water velocities of 0.89–1.83 m/s while migrating. Results provide inferences on depths, velocities, and habitat heterogeneity of reaches successfully negotiated by pallid sturgeon that may be used to guide designs for structures facilitating passage at IDD. Passage will provide connectivity to potential upstream spawning areas on the Yellowstone River, thereby increasing the likelihood of recruitment for this endangered species.

Monitoring of corrosion damage using high-frequency guided ultrasonic waves

OpenAIRE

Chew, D.; Fromme, P.

2014-01-01

Due to adverse environmental conditions corrosion can develop during the life cycle of industrial structures, e.g., offshore oil platforms, ships, and desalination plants. Both pitting corrosion and generalized corrosion leading to wall thickness loss can cause the degradation of the integrity and load bearing capacity of the structure. Structural health monitoring of corrosion damage in difficult to access areas can in principle be achieved using high frequency guided waves propagating along...

Radiological Control Technician: Phase 1, Site academic training study guides

International Nuclear Information System (INIS)

1992-10-01

This volume is a study guide for training Radiological Control Technicians. Provided herein are support materials for learning radiological documentation, communication systems, counting errors and statistics, dosimetry, contamination control, airborne sampling program methods, respiratory protection, radiological source control, environmental monitoring, access control and work area setup, radiological work coverage, shipment and receipt for radioactive material, radiological incidents and emergencies, personnel decontamination, first aid, radiation survey instrumentation, contamination monitoring, air sampling, and counting room equipment

Alaska: a guide to geothermal energy development

Energy Technology Data Exchange (ETDEWEB)

Basescu, N.; Bloomquist, R.G.; Higbee, C.; Justus, D.; Simpson, S.

1980-06-01

A brief overview is given of the geological characteristics of each region of the state as they relate to potential geothermal development. Those exploration methods which can lead to the siting of a deep exploration well are described. Requirements and techniques needed for drilling deeper higher temperature exploration and production wells are presented. Electrical generation, direct utilization, and indirect utilization are reviewed. Economic factors of direct use projects are presented. A general guide to the regulatory framework affecting geothermal energy development is provided. The general steps necessary to gain access to explore, develop, distribute, and use geothermal resources are outlined. (MHR)

Washington: a guide to geothermal energy development

Energy Technology Data Exchange (ETDEWEB)

Bloomquist, R.G.; Basescu, N.; Higbee, C.; Justus, D.; Simpson, S.

1980-01-01

A brief overview is given of the geological characteristics of each region of the state as they relate to potential geothermal development. Those exploration methods which can lead to the siting of a deep exploration well are described. Requirements and techniques needed for drilling deeper higher temperature exploration and production wells are presented. Electrical generation, direct utilization, and indirect utilization are reviewed. Economic factors of direct use projects are presented. A general guide to the regulatory framework affecting geothermal energy development is provided. The general steps necessary to gain access to explore, develop, distribute, and use geothermal resources are outlined. (MHR)

The definitive guide to HTML 5 video

CERN Document Server

Pfeiffer, Silvia

2010-01-01

Plugins will soon be a thing of the past. The Definitive Guide to HTML5 Video is the first authoritative book on HTML5 video, the new web standard that allows browsers to support audio and video elements natively. This makes it very easy for web developers to publish audio and video, integrating both within the general presentation of web pages. For example, media elements can be styled using CSS (style sheets), integrated into SVG (scalable vector graphics), and manipulated in a Canvas. The book offers techniques for providing accessibility to media elements, enabling consistent handling of a

A Practical Guide to Lightcurve Photometry and Analysis

CERN Document Server

Warner, Brian D

2006-01-01

A Practical Guide to Lightcurve Photometry and Analysis provides, for those with access to even a modest telescope and CCD camera, all the information needed to take part in the scientific study of asteroids and variable stars. Using commercially available equipment, amateur astronomers can determine the rotation rate, size, and shape of asteroids. Similarly, it is possible to discover the size, temperature, and orbits of stars in binary systems by using this powerful technique. A Practical Guide to Lightcurve Photometry and Analysis contains all the material needed for readers to understand the theory, and avoid the practical pitfalls of lightcurve photometry. Detailed examples are given for obtaining data, and of course for the exciting and rewarding task of analyzing the data to determine the physical properties of the object. Any college student or amateur astronomer who wants to go beyond mere imaging with a CCD camera and enter the challenging world of "real science" via the lightcurves of asteroids and...

A User Guide to the ION Work Group Server

CERN Document Server

Miotto, A; CERN. Geneva; Jones, R W L; Dodgson, M; Miotto, A

1999-01-01

This guide describes the computing ressources available to the member of the ALICE collaboration. It includes a description of: the general services such as PLUS, SHIFT and CSF; the services such as the ION and NA49 WGS (Work Group Servers) dedicated to the members of ALICE and of the other heavy ion experiments at CERN; some Unix tools such as AFS, shells, HEPiX X11 environment, LSF etc; the access to magnetic tapes. This document is also available in pdf format.

Security of Radioactive Sources. Implementing Guide (French Edition)

International Nuclear Information System (INIS)

2012-01-01

There are concerns that terrorist or criminal groups could gain access to high activity radioactive sources and use these sources maliciously. The IAEA is working with Member States to increase control, accounting and security of radioactive sources to prevent their malicious use and the associated potential consequences. Based on extensive input from technical and legal experts, this implementation guide sets forth guidance on the security of sources and will serve as a useful tool for legislators and regulators, physical protection specialists and facility and transport operators, as well as for law enforcement officers.

E-serials cataloging access to continuing and integrating resources via the catalog and the web

CERN Document Server

Cole, Jim

2014-01-01

This comprehensive guide examines the state of electronic serials cataloging with special attention paid to online capacities. E-Serials Cataloging: Access to Continuing and Integrating Resources via the Catalog and the Web presents a review of the e-serials cataloging methods of the 1990s and discusses the international standards (ISSN, ISBD[ER], AACR2) that are applicable. It puts the concept of online accessibility into historical perspective and offers a look at current applications to consider. Practicing librarians, catalogers and administrators of technical services, cataloging and serv

Adenosine triphosphate-based chemotherapy response assay (ATP-CRA)-guided versus empirical chemotherapy in unresectable non-small cell lung cancer.

Science.gov (United States)

Moon, Yong Wha; Sohn, Joo Hyuk; Kim, Yong Tai; Chang, Hyun; Jeong, Jae Heon; Lee, Young Joo; Chang, Joon; Kim, Se Kyu; Jung, Minkyu; Hong, Soojung; Choi, Sung Ho; Kim, Joo-Hang

2009-10-01

We retrospectively compared adenosine triphosphate-based chemotherapy response assay (ATP-CRA)-guided and empirical chemotherapies for unresectable non-small cell lung cancer (NSCLC) in this case-control study. Unresectable NSCLC patients receiving ATP-CRA-guided platinum-based doublets as first-line therapy were enrolled as cases (n=27; 14 platinum-sensitive and 13 platinum-resistant patients). Performance status, stage, and chemotherapeutic regimen-matched patients receiving empirical chemotherapy were selected from the retrospective database as controls (n=93) in a case to control ratio of approximately 1:3. Response rate and survival (progression-free; overall) in both groups were not significantly different. However, the platinum-sensitive subgroup by ATP-CRA showed a higher response rate than the empirical group (71 versus 38%; p=0.023) with a trend toward longer progression-free survival (8.7 versus 4.8 months for platinum-sensitive versus empirical; p=0.223) and overall survival (not reached versus 12.6 months for platinum-sensitive versus empirical for p=0.134). ATP-CRA may be helpful in selecting platinum-responsive patients in unresectable NSCLC. We consider that nonplatinum doublets in platinum-resistant patients by ATP-CRA may be a more adapted approach than platinum-based doublets in future clinical trials.

SAGE 2.1: SOLVENT ALTERNATIVES GUIDE: USER'S GUIDE

Science.gov (United States)

The guide provides instruction for using the SAGE (Solvent Alternatives GuidE) software system, version 2.1. SAGE recommends solvent replacements in cleaning and degreasing operations. It leads the user through a question-and-answer session. The user's responses allow the system ...

Data survivability vs. security in information systems

International Nuclear Information System (INIS)

Levitin, Gregory; Hausken, Kjell; Taboada, Heidi A.; Coit, David W.

2012-01-01

A multiple objective problem formulation and solution methodology is presented to select optimal information and data storage configurations considering both data survivability and data security, as well as cost. This paper considers a situation where the information is divided into several separately stored blocks in order to mitigate the risk of unauthorized access or theft. The information can be used only if all of the blocks are accessed. To impede the information theft, the defender prefers to maximize the number of blocks. On the other hand the destruction of any block destroys the integrity of information and makes it impossible to use. To impede the information destruction, the defender prefers to maximize the number of parallel (reserve) copies of each block, regardless how many blocks in series there are. Given the set of available information storage resources, the defender must consider a multi-objective optimization problem to determine how many blocks and their copies to create, and how to distribute them among available resources in order to minimize information vulnerability, insecurity, and storage cost. Non-dominated solutions to this problem are determined using a multiple objective genetic algorithm (MOGA). This methodology is demonstrated with two general examples.

DOE assessment guide for safeguards and security

International Nuclear Information System (INIS)

Bennett, C.A.; Christorpherson, W.E.; Clark, R.J.; Martin, F.; Hodges, Jr.

1978-04-01

DOE operations are periodically assessed to assure that special nuclear material, restricted data, and other classified information and DOE facilities are executed toward continuing the effectiveness of the International Atomic Energy Agency safeguards. A guide to describe the philosophy and mechanisms through which these assessments are conducted is presented. The assessment program is concerned with all contractor, field office, and Headquarters activities which are designed to assure that safeguards and security objectives are reached by contractors at DOE facilities and operations. The guide takes into account the interlocking relationship between many of the elements of an effective safeguards and security program. Personnel clearance programs are a part of protecting classified information as well as nuclear materials. Barriers that prevent or limit access may contribute to preventing theft of government property as well as protecting against sabotage. Procedures for control and surveillance need to be integrated with both information systems and procedures for mass balance accounting. Wherever possible, assessment procedures have been designed to perform integrated inspection, evaluation, and follow-up for the safeguards and security program

EUS-Guided Vascular Procedures: A Literature Review

Directory of Open Access Journals (Sweden)

Tomislav Bokun

2013-01-01

Full Text Available Endoscopic ultrasound (EUS is continuously stepping into the therapeutic arena, simultaneously evolving in different directions, such as the management of pancreatic and biliary diseases, celiac neurolysis, delivering local intratumoral therapy, and EUS-guided endosurgery. EUS-guided vascular procedures are also challenging, considering the variety of vascular pathology, proximity of the vascular structures to the GI tract wall, high resolution, and real-time guidance offering an attractive access route and precise delivery of the intervention. The literature on vascular therapeutic EUS demonstrates techniques for the management of upper GI variceal and nonvariceal bleeding, pseudoaneurysms, and coiling and embolization procedures, as well as the creation of intrahepatic portosystemic shunts. The paucity of studies, diversity of study designs, and the number of animal model studies hamper a systematic approach to the conclusion and decision making important to clinicians and healthcare policy makers. Nevertheless, theoretical benefits and findings up to date concerning technical feasibility, efficacy, and safety of the procedures drive further research and development in this rather young therapeutic arena.

Change Agent Survival Guide

Science.gov (United States)

Dunbar, Folwell L.

2011-01-01

Consulting is a rough racket. Only a tarantula hair above IRS agents, meter maids and used car sales people, the profession is a prickly burr for slings and arrows. Throw in education, focus on dysfunctional schools and call oneself a "change agent," and this bad rap all but disappears. Unfortunately, though, consulting/coaching/mentoring in…

Copyright: A Survival Guide

OpenAIRE

Hughes, Katie

2017-01-01

Presentation for HASS PhD students given on 24th October 2017. The presentation provides an overview about copyright, Fair Dealing, and how to seek permission for Third Party copyrighted material. The presentation does not include legal advice.

Efficacy evaluation of laparoscopy assisted ultrasound guided radiofrequency ablation in the treatment of hepatocellular carcinoma beneath the diaphragm

Directory of Open Access Journals (Sweden)

Song WANG

2017-06-01

Full Text Available Objective To explore the feasibility, safety and efficacy of laparoscopy assisted ultrasound guided radiofrequency ablation (RFA in the treatment of hepatocellular carcinoma (HCC beneath the diaphragm. Methods Twenty- three consecutive patients with solitary HCC beneath the diaphragm were treated by laparoscopy assisted ultrasound guided RFA in the Chinese PLA General Hospital from January 2013 to March 2016. We observed the perioperative complications and followed- up long-term effect. Results All the 23 patients successfully underwent laparoscopy assisted ultrasound guided radiofrequency ablation. No serious complications such as massive hemorrhage, biliary fistula and severe pleural effusion, hemopneumothorax occurred in the patients during perioperative period. CT examination 2-3 days after the operation revealed that the tumor was completely covered by the ablation area. Besides, the survival condition was satisfactory during follow-up period of 9-38 months. Conclusion Laparoscopy-assisted ultrasound-guided radiofrequency ablation is effective and safe for HCC beneath the diaphragm. DOI: 10.11855/j.issn.0577-7402.2017.05.16

SYMPAL: user guide

International Nuclear Information System (INIS)

Simpson, J.A.; Sublet, J.-Ch.; Nierop, D.

1997-02-01

The processing code SYMPAL is used to perform the data handling involved in creating a new version of the European Activation File (EAF). The process is handled by different modules of the code in a sequential and orderly manner. The modular code system accesses, translates and processes cross section data from a wide variety of libraries and calculations with nuclear model codes. Two major data bases are accessed and merged so as to create a new version of a library. The Master Data File (MDF) contains the original cross section data extracted, unmodified but reformatted, from numerous sources. A set of input (ASCII) tables, which form a compilation of all physical information necessary to renormalise, split into isomeric states and internally validate any particular type of cross section, are then read by SYMPAL and used to produce a second database: the Master Parameter File (MPF). The combination of these two files generates a new activation library in pointwise and various groupwise formats. This guide describes all aspects of the SYMPAL code, starting with the basic operating environment, compilation of the code and directory structure. Details of how to use SYMPAL to produce an activation library are then explained, along with instructions and examples of how to use each module of the code. Finally details of the MPF format, listings of some parts of the code and the input (ASCII) tables are provided. (author)

Point-of-Care Ultrasound-Guided Percutaneous Cannulation of Extracorporeal Membrane Oxygenation: Make it Simple.

Science.gov (United States)

Ahn, Hong Joon; Lee, Jun Wan; Joo, Ki Hyuk; You, Yeon Ho; Ryu, Seung; Lee, Jin Woong; Kim, Seung Whan

2017-12-30

Cannulation of the great vessels is required for extracorporeal membrane oxygenation (ECMO). Currently, there is no guideline for optimal imaging modalities during percutaneous cannulation of ECMO. The purpose of this study was to describe percutaneous cannulation guided by point-of-care ultrasound (POCUS) for ECMO and compare it with fluoroscopy and landmark guidance. Three groups (POCUS-, fluoroscopy-, and landmark-guided) of percutaneous cannulation for ECMO were analyzed retrospectively in a tertiary academic hospital. In the POCUS-guided group, visual confirmation of guidewire and cannula by ultrasound in both the access and return cannula were essential for successful cannulation. Fluoroscopy- and landmark-guided groups were cannulated with the conventional technique. A total of 128 patients were treated by ECMO during the study period, of which 94 (73.4%) cases were venoarterial ECMO. This included 56 cases of extracorporeal cardiopulmonary resuscitation. Also, there were 30 (23.4%) cases of venovenous ECMO and 4 (3.1%) cases of venoarteriovenous ECMO. A total of 71 (55.5%) patients were cannulated under POCUS guidance, and 43 (33.6%) patients were cannulated under fluoroscopy guidance and 14 (10.9%) patients were cannulated by landmark guidance. No surgical cut downs were required. Misplacement of cannula occurred in 3 (2.3%) cases. All three occurred in the landmark-guided group. POCUS-guided cannulation is comparable to fluoroscopy-guided cannulation in terms of avoiding cannula misplacement. In our experience, POCUS-guided cannulation is a useful strategy over fluoroscopy- and landmark-guided cannulation during peripheral ECMO. Copyright © 2017 Elsevier Inc. All rights reserved.

Characteristics of spent fuel, high-level waste, and other radioactive wastes which may require long-term isolation: Appendix 2B, User's guide to the LWR assemblies data base, Appendix 2C, User's guide to the LWR radiological data base, Appendix 2D, User's guide to the LWR quantities data base

International Nuclear Information System (INIS)

1987-12-01

This User's Guide for the LWR Assemblies data base system is part of the Characteristics Data Base being developed under the Waste Systems Data Development Program. The objective of the LWR Assemblies data base is to provide access at the personal computer level to information about fuel assemblies used in light-water reactors. The information available is physical descriptions of intact fuel assemblies and radiological descriptions of spent fuel disassembly hardware. The LWR Assemblies data base is a user-oriented menu driven system. Each menu is instructive about its use. Section 5 of this guide provides a sample session with the data base to assist the user

Pure natural orifice transluminal endoscopic surgery (NOTES) with ultrasonography-guided transgastric access and over-the-scope-clip closure

DEFF Research Database (Denmark)

Donatsky, Anders Meller; Andersen, Luise; Nielsen, Ole Lerberg

2012-01-01

Most natural orifice transluminal endoscopic surgery (NOTES) procedures to date rely on the hybrid technique with simultaneous laparoscopic access to protect against access-related complications and to achieve adequate triangulation for dissection. This is done at the cost of the potential benefi...

OAuth 2.0 identity and access management patterns

CERN Document Server

Spasovski, Martin

2013-01-01

This is a practical and fast-paced guide that gives you all the information you need to start implementing secure OAuth 2.0 implementations in your web applications.OAuth 2.0 Identity and Access Management Patterns is intended for software developers, software architects, and enthusiasts working with the OAuth 2.0 framework.In order to learn and understand the OAuth 2.0 grant flow, it is assumed that you have some basic knowledge of HTTP communication. For the practical examples, basic knowledge of HTML templating, programming languages, and executing commands in the command line terminal is a

Floral Nectar Guide Patterns Discourage Nectar Robbing by Bumble Bees

OpenAIRE

Leonard, Anne S.; Brent, Joshua; Papaj, Daniel R.; Dornhaus, Anna

2013-01-01

Floral displays are under selection to both attract pollinators and deter antagonists. Here we show that a common floral trait, a nectar guide pattern, alters the behavior of bees that can act opportunistically as both pollinators and as antagonists. Generally, bees access nectar via the floral limb, transporting pollen through contact with the plant's reproductive structures; however bees sometimes extract nectar from a hole in the side of the flower that they or other floral visitors create...

Modelling survival

DEFF Research Database (Denmark)

Ashauer, Roman; Albert, Carlo; Augustine, Starrlight

2016-01-01

The General Unified Threshold model for Survival (GUTS) integrates previously published toxicokinetic-toxicodynamic models and estimates survival with explicitly defined assumptions. Importantly, GUTS accounts for time-variable exposure to the stressor. We performed three studies to test...

COLLABORATIVE GUIDE: A REEF MANAGER'S GUIDE TO ...

Science.gov (United States)

Innovative strategies to conserve the world's coral reefs are included in a new guide released today by NOAA, and the Australian Great Barrier Reef Marine Park Authority, with author contributions from a variety of international partners from government agencies, non-governmental organizations, and academic institutions. Referred to as A Reef Manager's Guide to Coral Bleaching, the guide will provide coral reef managers with the latest scientific information on the causes of coral bleaching and new management strategies for responding to this significant threat to coral reef ecosystems. Innovative strategies to conserve the world's coral reefs are included in a new guide released today by NOAA, and the Australian Great Barrier Reef Marine Park Authority, with author contributions from a variety of international partners from government agencies, non-governmental organizations, and academic institutions. Dr. Jordan West, of the National Center for Environmental Assessment, was a major contributor to the guide. Referred to as

Energy Dissipation and Dynamics in Large Guide Field Turbulence Driven Reconnection at the Magnetopause

Science.gov (United States)

TenBarge, J. M.; Shay, M. A.; Sharma, P.; Juno, J.; Haggerty, C. C.; Drake, J. F.; Bhattacharjee, A.; Hakim, A.

2017-12-01

Turbulence and magnetic reconnection are the primary mechanisms responsible for the conversion of stored magnetic energy into particle energy in many space and astrophysical plasmas. The magnetospheric multiscale mission (MMS) has given us unprecedented access to high cadence particle and field data of turbulence and magnetic reconnection at earth's magnetopause. The observations include large guide field reconnection events generated within the turbulent magnetopause. Motivated by these observations, we present a study of large guide reconnection using the fully kinetic Eulerian Vlasov-Maxwell component of the Gkeyll simulation framework, and we also employ and compare with gyrokinetics to explore the asymptotically large guide field limit. In addition to studying the configuration space dynamics, we leverage the recently developed field-particle correlations to diagnose the dominant sources of dissipation and compare the results of the field-particle correlation to other energy dissipation measures.

GreyGuide, GreyNet’s web access portal and lobby for change in Grey Literature

OpenAIRE

Farace, Dominic J. (GreyNet); Frantzen, Jerry (GreyNet); Biagioni, Stefania (ISTI-CNR); Carlesi, Carlo (ISTI-CNR); Ponti, Roberto (ISTI-CNR); Stock, Christiane (Inist-CNRS); GreyNet, Grey Literature Network Service

2015-01-01

In December 2013, the GreyGuide was formerly launched as an online forum and repository of good practice in grey literature. The project partners then turned to the acquisition of both proposed and published good practices. During this same timeframe, GreyNet – one of the project partners – welcomed far reaching developments in its infrastructure. Three new committees were established alongside its Program Committee in line with GreyNet’s fourfold mission dedicated to research, publication, o...

HBR guides

CERN Document Server

Duarte, Nancy; Dillon, Karen

2015-01-01

Master your most pressing professional challenges with this seven-volume set that collects the smartest best practices from leading experts all in one place. "HBR Guide to Better Business Writing" and "HBR Guide to Persuasive Presentations" help you perfect your communication skills; "HBR Guide to Managing Up and Across" and "HBR Guide to Office Politics" show you how to build the best professional relationships; "HBR Guide to Finance Basics for Managers" is the one book you'll ever need to teach you about the numbers; "HBR Guide to Project Management" addresses tough questions such as how to manage stakeholder expectations and how to manage uncertainty in a complex project; and "HBR Guide to Getting the Right Work Done" goes beyond basic productivity tips to teach you how to prioritize and focus on your work. This specially priced set of the most popular books in the series makes a perfect gift for aspiring leaders looking for trusted advice. Arm yourself with the advice you need to succeed on the job, from ...

Magnetic resonance imaging guided transatrial electrophysiological studies in swine using active catheter tracking - experience with 14 cases

Energy Technology Data Exchange (ETDEWEB)

Grothoff, Matthias; Gutberlet, Matthias [University of Leipzig - Heart Center, Department of Radiology, Leipzig (Germany); Hindricks, Gerhard; Sommer, Philipp; Hilbert, Sebastian [University of Leipzig - Heart Center, Department of Electrophysiology, Leipzig (Germany); Fleiter, Christian [Helios Klinikum Berlin-Buch, Department of Orthopaedic Surgery, Berlin (Germany); Schnackenburg, Bernhard [Philips Healthcare, Hamburg (Germany); Weiss, Steffen; Krueger, Sascha [Philips Innovative Technologies, Hamburg (Germany); Piorkowski, Christopher; Gaspar, Thomas [University of Dresden - Heart Center, Department of Electrophysiology, Dresden (Germany); Wedan, Steve; Lloyd, Thomas [Imricor Medical Systems, Burnsville, MN (United States)

2017-05-15

To evaluate the feasibility of performing comprehensive Cardiac Magnetic resonance (CMR) guided electrophysiological (EP) interventions in a porcine model encompassing left atrial access. After introduction of two femoral sheaths 14 swine (41 ± 3.6 kg) were transferred to a 1.5 T MR scanner. A three-dimensional whole-heart sequence was acquired followed by segmentation and the visualization of all heart chambers using an image-guidance platform. Two MR conditional catheters were inserted. The interventional protocol consisted of intubation of the coronary sinus, activation mapping, transseptal left atrial access (n = 4), generation of ablation lesions and eventually ablation of the atrioventricular (AV) node. For visualization of the catheter tip active tracking was used. Catheter positions were confirmed by passive real-time imaging. Total procedure time was 169 ± 51 minutes. The protocol could be completed in 12 swine. Two swine died from AV-ablation induced ventricular fibrillation. Catheters could be visualized and navigated under active tracking almost exclusively. The position of the catheter tips as visualized by active tracking could reliably be confirmed with passive catheter imaging. Comprehensive CMR-guided EP interventions including left atrial access are feasible in swine using active catheter tracking. (orig.)

Scheduling language and algorithm development study. Volume 2, phase 2: Introduction to plans programming. [user guide

Science.gov (United States)

Cochran, D. R.; Ishikawa, M. K.; Paulson, R. E.; Ramsey, H. R.

1975-01-01

A user guide for the Programming Language for Allocation and Network Scheduling (PLANS) is presented. Information is included for the construction of PLANS programs. The basic philosophy of PLANS is discussed, and access and update reference techniques are described along with the use of tree structures.

Vascular access choice in incident hemodialysis patients: a decision analysis.

Science.gov (United States)

Drew, David A; Lok, Charmaine E; Cohen, Joshua T; Wagner, Martin; Tangri, Navdeep; Weiner, Daniel E

2015-01-01

Hemodialysis vascular access recommendations promote arteriovenous (AV) fistulas first; however, it may not be the best approach for all hemodialysis patients, because likelihood of successful fistula placement, procedure-related and subsequent costs, and patient survival modify the optimal access choice. We performed a decision analysis evaluating AV fistula, AV graft, and central venous catheter (CVC) strategies for patients initiating hemodialysis with a CVC, a scenario occurring in over 70% of United States dialysis patients. A decision tree model was constructed to reflect progression from hemodialysis initiation. Patients were classified into one of three vascular access choices: maintain CVC, attempt fistula, or attempt graft. We explicitly modeled probabilities of primary and secondary patency for each access type, with success modified by age, sex, and diabetes. Access-specific mortality was incorporated using preexisting cohort data, including terms for age, sex, and diabetes. Costs were ascertained from the 2010 USRDS report and Medicare for procedure costs. An AV fistula attempt strategy was found to be superior to AV grafts and CVCs in regard to mortality and cost for the majority of patient characteristic combinations, especially younger men without diabetes. Women with diabetes and elderly men with diabetes had similar outcomes, regardless of access type. Overall, the advantages of an AV fistula attempt strategy lessened considerably among older patients, particularly women with diabetes, reflecting the effect of lower AV fistula success rates and lower life expectancy. These results suggest that vascular access-related outcomes may be optimized by considering individual patient characteristics. Copyright © 2015 by the American Society of Nephrology.

Ultrasound-guided sacroiliac joint injection technique.

LENUS (Irish Health Repository)

Harmon, Dominic

2008-07-01

We describe a case report and technique for using a portable ultrasound scanner and a curvilinear transducer (4-5MHz) (SonoSite Micromaxx SonoSite, Inc. 21919 30th Drive SE Bothwell W. A.) to guide sacroiliac joint (SIJ) injection. A 42-year-old male presented with chronic lower back pain centered on his left SIJ. His pain averaged 7 out of 10 (numerical rating scale). For the ultrasound-guided SIJ injection the patient was placed in the prone position. The ultrasound transducer was oriented in a transverse orientation at the level of the sacral hiatus. Here the sacral cornuae were identified. Moving the transducer laterally from here, the lateral edge of the sacrum was identified. This bony edge was followed in a cephalad direction with the transducer maintained in a transverse orientation. A second bony contour, the ileum, was identified. The cleft between both bony contours represented the sacroiliac joint. This was found at 4.5 cm depth. Real-time imaging was used to direct a 22G spinal needle into the SIJ, where solution was injected under direct vision. The patient\\'s pain intensity decreased to a 2 out of 10 (numerical rating scale). Function improved and the patient was able to return to work. These improvements were maintained at 16 weeks. Ultrasound guidance does not expose patients and personnel to radiation and is readily accessible. Ultrasound-guided SIJ injections may have particular applications in the management of chronic lower back pain in certain clinical scenarios (e.g. pregnancy). Future studies to demonstrate efficacy and reproducibility are needed.

Survival outcome of intermediate risk neuroblastoma at Children Cancer Hospital Egypt.

Science.gov (United States)

Elzomor, Hossam; Ahmed, Gehad; Elmenawi, Salma; Elkinaai, Naglaa; Refaat, Amal; Soliman, Sonya; Abdelwahab, Mai Amr; Zaghloul, Mohamed Saad; Fawzy, Mohamed

2018-03-01

The study aims to evaluate survival outcome in newly diagnosed pediatric intermediate risk neuroblastoma patients treated at the Children Cancer Hospital - Egypt and their relation to various clinical and pathological factors. The study included stage 3 patients INSS) stage 4 disease, stage 4 children 1-1.5 years with favorable biology, and infants stage 4 s (with unfavorable biologic features). Patients received systemic chemotherapy, in the form of etoposide and carboplatin alternating with cyclophosphamide, doxorubicin and vincristine, administered at 3-week intervals, with a total of 6 or 8 cycles guided by reaching objective overall response (complete/very good partial/partial response). The study included 136 patients, 67 males and 69 females. 101 patients had abdominal primary tumors, 28 had mediastinal masss and 7 with masses in the neck; 68% were stage 3 and the remaining (n = 44) had metastatic disease. The three-year overall survival (OS) and event-free survival (EFS) estimates were 94% ± 2% and 90.9% ± 2.5%, respectively. OS and EFS by gender, age, pathology and INPC were all statistically not significantly different. Moreover, OS for patients having surgery versus no surgery (inoperable residual only) was statistically significant (98.4% ± 1.6% & 88.7% ± 5.3%, respectively, p = .034). A very high rate of survival is currently achievable in patients with intermediate risk neuroblastoma by chemotherapy or chemotherapy and surgery. In addition to response, our plan is to adopt biologically-based treatment to reduce treatment-induced complications among survivors. Copyright © 2018 National Cancer Institute, Cairo University. Production and hosting by Elsevier B.V. All rights reserved.

Precision oncology in advanced cancer patients improves overall survival with lower weekly healthcare costs

Science.gov (United States)

Haslem, Derrick S.; Chakravarty, Ingo; Fulde, Gail; Gilbert, Heather; Tudor, Brian P.; Lin, Karen; Ford, James M.; Nadauld, Lincoln D.

2018-01-01

The impact of precision oncology on guiding treatment decisions of late-stage cancer patients was previously studied in a retrospective analysis. However, the overall survival and costs were not previously evaluated. We report the overall survival and healthcare costs associated with precision oncology in these patients with advanced cancer. Building on a matched cohort study of 44 patients with metastatic cancer who received all of their care within a single institution, we evaluated the overall survival and healthcare costs for each patient. We analyzed the outcomes of 22 patients who received genomic testing and targeted therapy (precision oncology) between July 1, 2013 and January 31, 2015, and compared to 22 historically controlled patients (control) who received standard chemotherapy (N = 17) or best supportive care (N = 5). The median overall survival was 51.7 weeks for the targeted treatment group and 25.8 weeks for the control group (P = 0.008) when matching on age, gender, histological diagnosis and previous treatment lines. Average costs over the entire period were $2,720 per week for the targeted treatment group and $3,453 per week for the control group, (P = 0.036). A separate analysis of 1,814 patients with late-stage cancer diagnoses found that those who received a targeted cancer treatment (N = 93) had 6.9% lower costs in the last 3 months of life compared with those who did not. These findings suggest that precision oncology may improve overall survival for refractory cancer patients while lowering average per-week healthcare costs, resource utilization and end-of-life costs. PMID:29552312

Contribution of screening and survival differences to racial disparities in colorectal cancer rates

Science.gov (United States)

Lansdorp-Vogelaar, Iris; Kuntz, Karen M.; Knudsen, Amy B.; van Ballegooijen, Marjolein; Zauber, Ann G.; Jemal, Ahmedin

2012-01-01

Background Considerable disparities exist in colorectal cancer (CRC) incidence and mortality rates between blacks and whites in the US. We estimated how much of these disparities could be explained by differences in CRC screening and stage-specific relative CRC survival. Methods We used the MISCAN-Colon microsimulation model to estimate CRC incidence and mortality rates in blacks aged 50 years and older from 1975 to 2007 assuming they had: 1) the same trends in screening rates as whites instead of observed screening rates (incidence and mortality); and 2) the same trends in stage-specific relative CRC survival rates as whites instead of observed (mortality only); and 3) a combination of both. The racial disparities in CRC incidence and mortality rates attributable to differences in screening and/or stage-specific relative CRC survival were then calculated by comparing rates from these scenarios to the observed black rates. Results Differences in screening account for 42% of disparity in CRC incidence and 19% of disparity in CRC mortality between blacks and whites. 36% of the disparity in CRC mortality could be attributed to differences in stage-specific relative CRC survival. Together screening and survival explained a little over 50% of the disparity in CRC mortality between blacks and whites. Conclusion Differences in screening and relative CRC survival are responsible for a considerable proportion of the observed disparities in CRC incidence and mortality rates between blacks and whites. Impact Enabling blacks to achieve equal access to care as whites could substantially reduce the racial disparities in CRC burden. PMID:22514249

Polygenic hazard score to guide screening for aggressive prostate cancer

DEFF Research Database (Denmark)

Seibert, Tyler M; Fan, Chun Chieh; Wang, Yunpeng

2018-01-01

. These polymorphisms were incorporated into a survival analysis to estimate their effects on age at diagnosis of aggressive PCa (that is, not eligible for surveillance according to National Comprehensive Cancer Network guidelines; any of Gleason score ≥7, stage T3-T4, PSA (prostate specific antigen) concentration ≥10......OBJECTIVES: To develop and validate a genetic tool to predict age of onset of aggressive prostate cancer (PCa) and to guide decisions of who to screen and at what age. DESIGN: Analysis of genotype, PCa status, and age to select single nucleotide polymorphisms (SNPs) associated with diagnosis...

The Experience of Being a Guide Dog Puppy Raiser Volunteer: A Longitudinal Qualitative Collective Case Study

Directory of Open Access Journals (Sweden)

Anna Chur-Hansen

2014-12-01

Full Text Available There are no published studies that consider the experiences of guide dog puppy raisers. As these people are volunteers, their continued willingness to participate in the training of dogs for assisting the vision impaired and blind is essential for the viability of guide dog schools around the world. Using a qualitative, longitudinal methodology, data were collected from nine guide dog puppy raisers at four time points: before receiving the puppy, one week, then three months after the puppy arrived, and 13 months after the puppy arrived (at which time all puppies had left the raisers. Participants reported more challenges than benefits in raising the puppies. Volunteering to be a guide dog puppy raiser may not be the pleasant experience that is anticipated when community members first offer their services. Understanding what it is like to be a puppy raiser and working towards ways in which to address problems is essential, given that, without volunteers to train and care for puppies, vision impaired and blind people would not have access to guide dogs.

Stakeholder Involvement in Decision Making: A Short Guide to Issues, Approaches and Resources

International Nuclear Information System (INIS)

2015-01-01

Radioactive waste management is embedded in broader societal issues such as the environment, risk management, energy, health policy and sustainability. In all these fields, there is an increasing demand for public involvement and engagement. This 2015 update of Stakeholder Involvement Techniques: Short Guide and Annotated Bibliography, assists practitioners and non-specialists by outlining the steps and issues associated with stakeholder involvement in decision making and by facilitating access to useful online resources (handbooks, toolboxes and case studies). The updated guide has been considerably enriched with experiences since 2004 and includes extensive references to the literature. It is published alongside the release of an online annotated bibliography that will be updated regularly. (authors)

Compact instrument for fluorescence image-guided surgery

Science.gov (United States)

Wang, Xinghua; Bhaumik, Srabani; Li, Qing; Staudinger, V. Paul; Yazdanfar, Siavash

2010-03-01

Fluorescence image-guided surgery (FIGS) is an emerging technique in oncology, neurology, and cardiology. To adapt intraoperative imaging for various surgical applications, increasingly flexible and compact FIGS instruments are necessary. We present a compact, portable FIGS system and demonstrate its use in cardiovascular mapping in a preclinical model of myocardial ischemia. Our system uses fiber optic delivery of laser diode excitation, custom optics with high collection efficiency, and compact consumer-grade cameras as a low-cost and compact alternative to open surgical FIGS systems. Dramatic size and weight reduction increases flexibility and access, and allows for handheld use or unobtrusive positioning over the surgical field.

Exploratory Cost-Effectiveness Analysis of Response-Guided Neoadjuvant Chemotherapy for Hormone Positive Breast Cancer Patients.

Directory of Open Access Journals (Sweden)

Anna Miquel-Cases

Full Text Available Guiding response to neoadjuvant chemotherapy (guided-NACT allows for an adaptative treatment approach likely to improve breast cancer survival. In this study, our primary aim is to explore the expected cost-effectiveness of guided-NACT using as a case study the first randomized controlled trial that demonstrated effectiveness (GeparTrio trial.As effectiveness was shown in hormone-receptor positive (HR+ early breast cancers (EBC, our decision model compared the health-economic outcomes of treating a cohort of such women with guided-NACT to conventional-NACT using clinical input data from the GeparTrio trial. The expected cost-effectiveness and the uncertainty around this estimate were estimated via probabilistic cost-effectiveness analysis (CEA, from a Dutch societal perspective over a 5-year time-horizon.Our exploratory CEA predicted that guided-NACT as proposed by the GeparTrio, costs additional €110, but results in 0.014 QALYs gained per patient. This scenario of guided-NACT was considered cost-effective at any willingness to pay per additional QALY. At the prevailing Dutch willingness to pay threshold (€80.000/QALY cost-effectiveness was expected with 78% certainty.This exploratory CEA indicated that guided-NACT (as proposed by the GeparTrio trial is likely cost-effective in treating HR+ EBC women. While prospective validation of the GeparTrio findings is advisable from a clinical perspective, early CEAs can be used to prioritize further research from a broader health economic perspective, by identifying which parameters contribute most to current decision uncertainty. Furthermore, their use can be extended to explore the expected cost-effectiveness of alternative guided-NACT scenarios that combine the use of promising imaging techniques together with personalized treatments.

Challenges in the estimation of Net SURvival: The CENSUR working survival group.

Science.gov (United States)

Giorgi, R

2016-10-01

Net survival, the survival probability that would be observed, in a hypothetical world, where the cancer of interest would be the only possible cause of death, is a key indicator in population-based cancer studies. Accounting for mortality due to other causes, it allows cross-country comparisons or trends analysis and provides a useful indicator for public health decision-making. The objective of this study was to show how the creation and formalization of a network comprising established research teams, which already had substantial and complementary experience in both cancer survival analysis and methodological development, make it possible to meet challenges and thus provide more adequate tools, to improve the quality and the comparability of cancer survival data, and to promote methodological transfers in areas of emerging interest. The Challenges in the Estimation of Net SURvival (CENSUR) working survival group is composed of international researchers highly skilled in biostatistics, methodology, and epidemiology, from different research organizations in France, the United Kingdom, Italy, Slovenia, and Canada, and involved in French (FRANCIM) and European (EUROCARE) cancer registry networks. The expected advantages are an interdisciplinary, international, synergistic network capable of addressing problems in public health, for decision-makers at different levels; tools for those in charge of net survival analyses; a common methodology that makes unbiased cross-national comparisons of cancer survival feasible; transfer of methods for net survival estimations to other specific applications (clinical research, occupational epidemiology); and dissemination of results during an international training course. The formalization of the international CENSUR working survival group was motivated by a need felt by scientists conducting population-based cancer research to discuss, develop, and monitor implementation of a common methodology to analyze net survival in order

A Socio-Technical Analysis of Patient Accessible Electronic Health Records.

Science.gov (United States)

Hägglund, Maria; Scandurra, Isabella

2017-01-01

In Sweden, and internationally, there is a movement towards increased transparency in healthcare including giving patients online access to their electronic health records (EHR). The purpose of this paper is to analyze the Swedish patient accessible EHR (PAEHR) service using a socio-technical framework, to increase the understanding of factors that influence the design, implementation, adoption and use of the service. Using the Sitting and Singh socio-technical framework as a basis for analyzing the Swedish PAEHR system and its context indicated that there are many stakeholders engaged in these types of services, with different driving forces and incentives that may influence the adoption and usefulness of PAEHR services. The analysis was useful in highlighting important areas that need to be further explored in evaluations of PAEHR services, and can act as a guide when planning evaluations of any PAEHR service.

The importance of building construction materials relative to other factors affecting structure survival during wildfire

Science.gov (United States)

Syphard, Alexandra D.; Brennan, Teresa J.; Keeley, Jon E.

2017-01-01

Structure loss to wildfire is a serious problem in wildland-urban interface areas across the world. Laboratory experiments suggest that fire-resistant building construction and design could be important for reducing structure destruction, but these need to be evaluated under real wildfire conditions, especially relative to other factors. Using empirical data from destroyed and surviving structures from large wildfires in southern California, we evaluated the relative importance of building construction and structure age compared to other local and landscape-scale variables associated with structure survival. The local-scale analysis showed that window preparation was especially important but, in general, creating defensible space adjacent to the home was as important as building construction. At the landscape scale, structure density and structure age were the two most important factors affecting structure survival, but there was a significant interaction between them. That is, young structure age was most important in higher-density areas where structure survival overall was more likely. On the other hand, newer-construction structures were less likely to survive wildfires at lower density. Here, appropriate defensible space near the structure and accessibility to major roads were important factors. In conclusion, community safety is a multivariate problem that will require a comprehensive solution involving land use planning, fire-safe construction, and property maintenance.

[Ultrasound guided percutaneous nephrolithotripsy].

Science.gov (United States)

Guliev, B G

2014-01-01

The study was aimed to the evaluation of the effectiveness and results of ultrasound guided percutaneous nephrolithotripsy (PNL) for the treatment of patients with large stones in renal pelvis. The results of PNL in 138 patients who underwent surgery for kidney stones from 2011 to 2013 were analyzed. Seventy patients (Group 1) underwent surgery with combined ultrasound and radiological guidance, and 68 patients (Group 2)--only with ultrasound guidance. The study included patients with large renal pelvic stones larger than 2.2 cm, requiring the formation of a single laparoscopic approach. Using the comparative analysis, the timing of surgery, the number of intra- and postoperative complications, blood loss and length of stay were evaluated. Percutaneous access was successfully performed in all patients. Postoperative complications (exacerbation of chronic pyelonephritis, gross hematuria) were observed in 14.3% of patients in Group 1 and in 14.7% of patients in Group 2. Bleeding requiring blood transfusion, and injuries of adjacent organs were not registered. Efficacy of PNL in the Group 1 was 95.7%; 3 (4.3%) patients required additional interventions. In Group 2, the effectiveness of PNL was 94.1%, 4 (5.9%) patients additionally underwent extracorporeal lithotripsy. There were no significant differences in the effectiveness of PNL, the volume of blood loss and duration of hospitalization. Ultrasound guided PNL can be performed in large pelvic stones and sufficient expansion of renal cavities, thus reducing radiation exposure of patients and medical staff.

The Ecology of Human Fear: Survival Optimization and the Nervous System

Directory of Open Access Journals (Sweden)

Dean eMobbs

2015-03-01

Full Text Available We propose a Survival Optimization System (SOS to account for the strategies that humans and other animals use to defend against recurring and novel threats. The SOS attempts to merge ecological models that define a repertoire of contextually relevant threat induced survival behaviors with contemporary approaches to human affective science. We first propose that the goal of the nervous system is to reduce surprise and optimize actions by (i predicting the sensory landscape, through simulation of possible encounters with threat, selecting appropriate action by pre-encounter avoidance and (ii prevention strategies in which the organism manufactures safe environments. When a potential threat is encountered the (iii threat orienting system is engaged to determine whether the organism ignores the stimulus or switches into a process of (iv assessment, where the organism monitors the stimulus, weighs the threat value, predicts the actions of the threat, searches for safety, and guides behavioral actions crucial to directed escape. When under imminent attack, (v defensive systems evoke fast reflexive indirect escape behaviors (i.e. fight or flight. This cascade of responses to threat of increasing magnitude are underwritten by an interconnected neural architecture that extends from cortical and hippocampal circuits, to attention, action and threat systems including the amygdala, striatum, and hard-wired defensive systems in the midbrain. The SOS also includes a modulatory feature consisting of cognitive appraisal systems that flexibly guide perception, risk and action. Moreover, personal and vicarious threat encounters fine-tune avoidance behaviors via model-based learning, with higher organisms bridging data to reduce face-to-face encounters with predators. Our theory unifies the divergent field of human affective science, proposing the highly integrated, interconnected nervous systems are optimized to avoid ecological dangers.

AWS certified solutions architect official study guide associate exam

CERN Document Server

Baron, Joe; Bixler, Tim; Gaut, Biff; Kelly, Kevin E; Senior, Sean; Stamper, John

2017-01-01

This is your opportunity to take the next step in your career by expanding and validating your skills on the AWS cloud. AWS has been the frontrunner in cloud computing products and services, and the AWS Certified Solutions Architect Official Study Guide for the Associate exam will get you fully prepared through expert content, and real-world knowledge, key exam essentials, chapter review questions, access to Sybex's interactive online learning environment, and much more. This official study guide, written by AWS experts, covers exam concepts, and provides key review on exam topics, including: * Mapping Multi-Tier Architectures to AWS Services, such as web/app servers, firewalls, caches and load balancers * Understanding managed RDBMS through AWS RDS (MySQL, Oracle, SQL Server, Postgres, Aurora) * Understanding Loose Coupling and Stateless Systems * Comparing Different Consistency Models in AWS Services * Understanding how AWS CloudFront can make your application more cost efficient, faster and secure * Implem...

Gaze strategies during visually-guided versus memory-guided grasping.

Science.gov (United States)

Prime, Steven L; Marotta, Jonathan J

2013-03-01

Vision plays a crucial role in guiding motor actions. But sometimes we cannot use vision and must rely on our memory to guide action-e.g. remembering where we placed our eyeglasses on the bedside table when reaching for them with the lights off. Recent studies show subjects look towards the index finger grasp position during visually-guided precision grasping. But, where do people look during memory-guided grasping? Here, we explored the gaze behaviour of subjects as they grasped a centrally placed symmetrical block under open- and closed-loop conditions. In Experiment 1, subjects performed grasps in either a visually-guided task or memory-guided task. The results show that during visually-guided grasping, gaze was first directed towards the index finger's grasp point on the block, suggesting gaze targets future grasp points during the planning of the grasp. Gaze during memory-guided grasping was aimed closer to the blocks' centre of mass from block presentation to the completion of the grasp. In Experiment 2, subjects performed an 'immediate grasping' task in which vision of the block was removed immediately at the onset of the reach. Similar to the visually-guided results from Experiment 1, gaze was primarily directed towards the index finger location. These results support the 2-stream theory of vision in that motor planning with visual feedback at the onset of the movement is driven primarily by real-time visuomotor computations of the dorsal stream, whereas grasping remembered objects without visual feedback is driven primarily by the perceptual memory representations mediated by the ventral stream.

A Framework for Research in Gamified Mobile Guide Applications using Embodied Conversational Agents (ECAs

Directory of Open Access Journals (Sweden)

Ioannis Doumanis

2015-09-01

Full Text Available Mobile Guides are mobile applications that provide players with local and location-based services (LBS, such as navigation assistance, where and when they need them most. Advances in mobile technologies in recent years have enabled the gamification of these applications, opening up new opportunities to transfer education and culture through game play. However, adding traditional game elements such as PBLs (points, badges, and leaderboards alone cannot ensure that the intended learning outcomes will be met, as the player’s cognitive resources are shared between the application and the surrounding environment. This distribution of resources prevents players from easily immersing themselves into the educational scenario. Adding artificial conversational characters (ECAs that simulate the social norms found in real-life human-to-human guide scenarios has the potential to address this problem and improve the player’s experience and learning of cultural narratives [1]. Although significant progress has been made towards creating game-like mobile guides with ECAs ([2], [3], there is still a lack of a unified framework that enables researchers and practitioners to investigate the potential effects of such applications to players and how to approach the concepts of player experience, cognitive accessibility and usability in this context. This paper presents a theoretically-well supported research framework consisted of four key components: differences in players, different features of the gamified task, aspects of how the ECA looks, sound or behaves and different mobile environments. Furthermore, it provides based on this framework a working definition of what player experience, cognitive accessibility and usability are in the context of game-like mobile guide applications. Finally, a synthesis of the results of six empirical studies conducted within this research framework is discussed and a series of design guidelines for the effective gamification

Survival in common cancers defined by risk and survival of family members

Directory of Open Access Journals (Sweden)

Jianguang Ji

2011-10-01

Full Text Available Studies on survival between familial and sporadic cancers have been inconclusive and only recent data on a limited number of cancers are available on the concordance of survival between family members. In this review, we address these questions by evaluating the published and unpublished data from the nation-wide Swedish Family-Cancer Database and a total of 13 cancer sites were assessed. Using sporadic cancer as reference, HRs were close to 1.0 for most of the familial cancers in both the offspring and parental generations, which suggested that survival in patients with familial and sporadic cancers was equal, with an exception for ovarian cancer with a worse prognosis. Compared to offspring whose parents had a poor survival, those with a good parental survival had a decreased risk of death for most cancers and HR was significantly decreased for cancers in the breast, prostate, bladder, and kidney. For colorectal and nervous system cancers, favorable survival between the generations showed a borderline significance. These data are consistent in showing that both good and poor survival in certain cancers aggregate in families. Genetic factors are likely to contribute to the results. These observations call for intensified efforts to consider heritability in survival as one mechanism regulating prognosis in cancer patients.

In the presence of conflicting gaze cues, fearful expression and eye-size guide attention.

Science.gov (United States)

Carlson, Joshua M; Aday, Jacob

2017-10-19

Humans are social beings that often interact in multi-individual environments. As such, we are frequently confronted with nonverbal social signals, including eye-gaze direction, from multiple individuals. Yet, the factors that allow for the prioritisation of certain gaze cues over others are poorly understood. Using a modified conflicting gaze paradigm, we tested the hypothesis that fearful gaze would be favoured amongst competing gaze cues. We further hypothesised that this effect is related to the increased sclera exposure, which is characteristic of fearful expressions. Across three experiments, we found that fearful, but not happy, gaze guides observers' attention over competing non-emotional gaze. The guidance of attention by fearful gaze appears to be linked to increased sclera exposure. However, differences in sclera exposure do not prioritise competing gazes of other types. Thus, fearful gaze guides attention among competing cues and this effect is facilitated by increased sclera exposure - but increased sclera exposure per se does not guide attention. The prioritisation of fearful gaze over non-emotional gaze likely represents an adaptive means of selectively attending to survival-relevant spatial locations.

Guided access cavity preparation using cone-beam computed tomography and optical surface scans - an ex vivo study

DEFF Research Database (Denmark)

Buchgreitz, J; Buchgreitz, M; Mortensen, D

2016-01-01

AIM: To evaluate ex vivo, the accuracy of a preparation procedure planned for teeth with pulp canal obliteration (PCO) using a guide rail concept based on a cone-beam computed tomography (CBCT) scan merged with an optical surface scan. METHODOLOGY: A total of 48 teeth were mounted in acrylic bloc...

Rad Toolbox User's Guide

Energy Technology Data Exchange (ETDEWEB)

Eckerman, Keith F. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Sjoreen, Andrea L. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2013-05-01

The Radiological Toolbox software developed by Oak Ridge National Laboratory (ORNL) for U. S. Nuclear Regulatory Commission (NRC) is designed to provide electronic access to the vast and varied data that underlies the field of radiation protection. These data represent physical, chemical, anatomical, physiological, and mathematical parameters detailed in various handbooks which a health physicist might consult while in his office. The initial motivation for the software was to serve the needs of the health physicist away from his office and without access to his handbooks; e.g., NRC inspectors. The earlier releases of the software were widely used and accepted around the world by not only practicing health physicist but also those within educational programs. This release updates the software to accommodate changes in Windows operating systems and, in some aspects, radiation protection. This release has been tested on Windows 7 and 8 and on 32- and 64-bit machines. The nuclear decay data has been updated and thermal neutron capture cross sections and cancer risk coefficients have been included. This document and the software’s user’s guide provide further details and documentation of the information captured within the Radiological Toolbox.

Constraints and challenges in access to insulin: a global perspective.

Science.gov (United States)

Beran, David; Ewen, Margaret; Laing, Richard

2016-03-01

Substantial attention has been given to the issue of access to medicines for communicable diseases; however, access to essential medicines for diabetes, especially insulin, has had insufficient focus. Although insulin was discovered in 1921, the drug is unattainable to many globally, and this Review aims to highlight the range and complexity of factors that contribute to this unattainability. Manufacturers' selling prices of various insulin formulations and presentations, duties, taxes, mark-ups, and other supply chain costs affect the price of insulin and hence the drug's affordability to health systems and individuals. Unlike drugs for HIV and AIDS, the production of generic or biosimilar insulin has not had an effect on the overall market. Other factors contributing to poor availability of insulin include its quantification at the national level, in-country distribution, and determination of needs at lower levels of the health system. Although insulin is essential for the survival of people with type 1 diabetes and is needed for improved management of diabetes for some people with type 2 diabetes, very little has been done globally to address the issue of access, despite the UN's political commitment to address non-communicable diseases and ensure universal access to drugs for these disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

1D profiling using highly dispersive guided waves

International Nuclear Information System (INIS)

Volker, Arno; Zon, Tim van; Enthoven, Daniel; Verburg, Wesley

2015-01-01

Corrosion is one of the industries major issues regarding the integrity of assets. Currently inspections are conducted at regular intervals to ensure a sufficient integrity level of these assets. Cost reduction while maintaining a high level of reliability and safety of installations is a major challenge. There are many situations where the actual defect location is not accessible, e.g., a pipe support or a partially buried pipe. Guided wave tomography has been developed to reconstruct the wall thickness. In case of bottom of the line corrosion, i.e., a single corrosion pit, a simpler approach may be followed. Data is collected in a pit-catch configuration at the 12 o'clock position using highly dispersive guided waves. The phase spectrum is used to invert for a wall thickness profile in the circumferential direction, assuming a Gaussian defect profile. An EMAT sensor design has been made to measure at the 12 o'clock position of a pipe. The concept is evaluated on measured data, showing good sizing capabilities on a variety simple defect profiles

1-D profiling using highly dispersive guided waves

Science.gov (United States)

Volker, Arno; van Zon, Tim

2014-02-01

Corrosion is one of the industries major issues regarding the integrity of assets. Currently, inspections are conducted at regular intervals to ensure a sufficient integrity level of these assets. Cost reduction while maintaining a high level of reliability and safety of installations is a major challenge. There are many situations where the actual defect location is not accessible, e.g., a pipe support or a partially buried pipe. Guided wave tomography has been developed to reconstruct the wall thickness of steel pipes. In case of bottom of the line corrosion, i.e., a single corrosion pit, a simpler approach may be followed. Data is collected in a pitch-catch configuration at the 12 o'clock position using highly dispersive guided waves. After dispersion correction the data collapses to a short pulse, any residual dispersion indicates wall loss. The phase spectrum is used to invert for the wall thickness profile in the circumferential direction, assuming a Gaussian defect profile. The approach is evaluated on numerically simulated and on measured data. The method is intended for rapid, semi-quantitative screening of pipes.

1-D profiling using highly dispersive guided waves

International Nuclear Information System (INIS)

Volker, Arno; Zon, Tim van

2014-01-01

Corrosion is one of the industries major issues regarding the integrity of assets. Currently, inspections are conducted at regular intervals to ensure a sufficient integrity level of these assets. Cost reduction while maintaining a high level of reliability and safety of installations is a major challenge. There are many situations where the actual defect location is not accessible, e.g., a pipe support or a partially buried pipe. Guided wave tomography has been developed to reconstruct the wall thickness of steel pipes. In case of bottom of the line corrosion, i.e., a single corrosion pit, a simpler approach may be followed. Data is collected in a pitch-catch configuration at the 12 o'clock position using highly dispersive guided waves. After dispersion correction the data collapses to a short pulse, any residual dispersion indicates wall loss. The phase spectrum is used to invert for the wall thickness profile in the circumferential direction, assuming a Gaussian defect profile. The approach is evaluated on numerically simulated and on measured data. The method is intended for rapid, semi-quantitative screening of pipes

Design and application of model for training ultrasound-guided vascular cannulation in pediatric patients.

Science.gov (United States)

Pérez-Quevedo, O; López-Álvarez, J M; Limiñana-Cañal, J M; Loro-Ferrer, J F

2016-01-01

Central vascular cannulation is not a risk-free procedure, especially in pediatric patients. Newborn and infants are small and low-weighted, their vascular structures have high mobility because of tissue laxity and their vessels are superficial and with small diameter. These characteristics, together with the natural anatomical variability and poor collaboration of small children, make this technique more difficult to apply. Therefore, ultrasound imaging is increasingly being used to locate vessels and guide vascular access in this population. (a) To present a model that simulates the vascular system for training ultrasound-guided vascular access in pediatrics patients; (b) to ultrasound-guided vascular cannulation in the model. The model consisted of two components: (a) muscular component: avian muscle, (b) vascular component: elastic tube-like structure filled with fluid. 864 ecoguided punctures was realized in the model at different vessel depth and gauge measures were simulated, for two medical operators with different degree of experience. The average depth and diameter of vessel cannulated were 1.16 (0.42)cm and 0.43 (0.1)cm, respectively. The average number of attempts was of 1.22 (0.62). The percentage of visualization of the needle was 74%. The most frequent maneuver used for the correct location, was the modification of the angle of the needle and the relocation of the guidewire in 24% of the cases. The average time for the correct cannulations was 41 (35.8)s. The more frequent complications were the vascular perforation (11.9%) and the correct vascular puncture without possibility of introducing the guidewire (1.2%). The rate of success was 96%. The model simulates the anatomy (vascular and muscular structures) of a pediatric patient. It is cheap models, easily reproducible and a useful tool for training in ultrasound-guided puncture and cannulation. Copyright © 2015 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Coronary and peripheral stenting in aorto-ostial protruding stents: The balloon assisted access to protruding stent technique.

Science.gov (United States)

Helmy, Tarek A; Sanchez, Carlos E; Bailey, Steven R

2016-03-01

Treatment of aorto-ostial in-stent restenosis lesions represents a challenge for interventional cardiologists. Excessive protrusion of the stent into the aorta may lead to multiple technical problems, such as difficult catheter reengagement of the vessel ostium or inability to re-wire through the stent lumen in repeat interventions. We describe a balloon assisted access to protruding stent technique in cases where conventional coaxial engagement of an aorto-ostial protruding stent with the guide catheter or passage of the guide wire through the true lumen is not feasible. This technique is applicable both in coronary and peripheral arteries. © 2015 Wiley Periodicals, Inc.

A successful model to learn and implement ultrasound-guided venous catheterization in apheresis.

Science.gov (United States)

Gopalasingam, Nigopan; Thomsen, Anna-Marie Eller; Folkersen, Lars; Juhl-Olsen, Peter; Sloth, Erik

2017-12-01

Apheresis treatments can be performed with peripheral venous catheters (PVC), although central venous catheters (CVC) are inserted when PVCs fail or patient with history of difficult vascular access prior to the apheresis. Ultrasound guidance for PVC has shown promising results in other settings. To investigate if ultrasound guidance for PVC could be implemented among apheresis nurses. Second, how implementation of ultrasound guidance affected the number of CVCs used for apheresis per patient. Apheresis nurses completed a systematic training program for ultrasound-guided vascular access. All independent catheterizations were registered during the implementation stage. The number of CVCs in the pre- and postimplementation stages of the ultrasound guidance was compared. Six nurses completed the training program within a median of 48 days (range 38-83 days). In 77 patients, 485 independent ultrasound-guided PVC placements were performed during the implementation stage. All apheresis treatments (485/485) were accomplished using PVCs without requiring CVC as rescue. During the preimplementation stage, 125 of 273 (45.8%) procedures required a CVC for completion of apheresis procedures; during the postimplementation stage only 30 of 227 (13.2%) procedures required a CVC (p < 0.001). In the postimplementation stage, no CVCs were placed as rescue caused by failed PVCs but were only placed for patients where the ultrasound machine was unavailable. It indicates an effective success rate of 100% for ultrasound-guided PVC use. This study showed that ultrasound guidance could be implemented among apheresis nurses as a routine tool eliminating the need of CVC as a rescue. © 2017 Wiley Periodicals, Inc.

Internet-based guided self-help for posttraumatic stress disorder (PTSD): Randomized controlled trial.

Science.gov (United States)

Lewis, Catrin E; Farewell, Daniel; Groves, Vicky; Kitchiner, Neil J; Roberts, Neil P; Vick, Tracey; Bisson, Jonathan I

2017-06-01

There are numerous barriers that limit access to evidence-based treatment for posttraumatic stress disorder (PTSD). Internet-based guided self-help is a treatment option that may help widen access to effective intervention, but the approach has not been sufficiently explored for the treatment of PTSD. Forty two adults with DSM-5 PTSD of mild to moderate severity were randomly allocated to internet-based self-help with up to 3 h of therapist assistance, or to a delayed treatment control group. The internet-based program included eight modules that focused on psychoeducation, grounding, relaxation, behavioural activation, real-life and imaginal exposure, cognitive therapy, and relapse prevention. The primary outcome measure was reduction in clinician-rated traumatic stress symptoms using the clinician administered PTSD scale for DSM-V (CAPS-5). Secondary outcomes were self-reported PTSD symptoms, depression, anxiety, alcohol use, perceived social support, and functional impairment. Posttreatment, the internet-based guided self-help group had significantly lower clinician assessed PTSD symptoms than the delayed treatment control group (between-group effect size Cohen's d = 1.86). The difference was maintained at 1-month follow-up and dissipated once both groups had received treatment. Similar patterns of difference between the two groups were found for depression, anxiety, and functional impairment. The average contact with treating clinicians was 2½ h. Internet-based trauma-focused guided self-help for PTSD is a promising treatment option that requires far less therapist time than current first line face-to-face psychological therapy. © 2017 Wiley Periodicals, Inc.

Predicting survival time in noncurative patients with advanced cancer: a prospective study in China.

Science.gov (United States)

Cui, Jing; Zhou, Lingjun; Wee, B; Shen, Fengping; Ma, Xiuqiang; Zhao, Jijun

2014-05-01

Accurate prediction of prognosis for cancer patients is important for good clinical decision making in therapeutic and care strategies. The application of prognostic tools and indicators could improve prediction accuracy. This study aimed to develop a new prognostic scale to predict survival time of advanced cancer patients in China. We prospectively collected items that we anticipated might influence survival time of advanced cancer patients. Participants were recruited from 12 hospitals in Shanghai, China. We collected data including demographic information, clinical symptoms and signs, and biochemical test results. Log-rank tests, Cox regression, and linear regression were performed to develop a prognostic scale. Three hundred twenty patients with advanced cancer were recruited. Fourteen prognostic factors were included in the prognostic scale: Karnofsky Performance Scale (KPS) score, pain, ascites, hydrothorax, edema, delirium, cachexia, white blood cell (WBC) count, hemoglobin, sodium, total bilirubin, direct bilirubin, aspartate aminotransferase (AST), and alkaline phosphatase (ALP) values. The score was calculated by summing the partial scores, ranging from 0 to 30. When using the cutoff points of 7-day, 30-day, 90-day, and 180-day survival time, the scores were calculated as 12, 10, 8, and 6, respectively. We propose a new prognostic scale including KPS, pain, ascites, hydrothorax, edema, delirium, cachexia, WBC count, hemoglobin, sodium, total bilirubin, direct bilirubin, AST, and ALP values, which may help guide physicians in predicting the likely survival time of cancer patients more accurately. More studies are needed to validate this scale in the future.

Gelatin model for training ultrasound-guided puncture

Directory of Open Access Journals (Sweden)

Alexandre Campos Moraes Amato

2015-09-01

Full Text Available BACKGROUND: It is indispensable that members of the medical profession receive the technical training needed to enable them to rapidly obtain effective vascular access. Training procedures should be used judiciously to familiarize students with the technique. However, existing models are expensive or ineffective, and models need to be developed that are similar to what will be encountered in real patients.OBJECTIVES: To demonstrate creation and application of a gelatin model for training ultrasound-guided puncture.METHOS: The model was made using a mixture of colorless gelatin and water in a transparent plastic receptacle with two pairs of orifices of different diameters, through which two plastic tubes were inserted, to simulate blood vessels.RESULTS: The model was a close approximation to the real medical procedure in several aspects, since gelatin has a similar consistency to human tissues, providing a more faithful reproduction of the tactile sensation at the moment when the needle reaches the interior of a vessel and its contents are aspirated.CONCLUSIONS: The method proposed here can be used to easily construct a low-cost model using everyday materials that is suitable for large-scale training of ultrasound-guided puncture.

Automated Guided Vehicle For Phsically Handicapped People - A Cost Effective Approach

Science.gov (United States)

Kumar, G. Arun, Dr.; Sivasubramaniam, Mr. A.

2017-12-01

Automated Guided vehicle (AGV) is like a robot that can deliver the materials from the supply area to the technician automatically. This is faster and more efficient. The robot can be accessed wirelessly. A technician can directly control the robot to deliver the components rather than control it via a human operator (over phone, computer etc. who has to program the robot or ask a delivery person to make the delivery). The vehicle is automatically guided through its ways. To avoid collisions a proximity sensor is attached to the system. The sensor senses the signals of the obstacles and can stop the vehicle in the presence of obstacles. Thus vehicle can avoid accidents that can be very useful to the present industrial trend and material handling and equipment handling will be automated and easy time saving methodology.

Treatment outcome of high-dose image-guided intensity-modulated radiotherapy using intra-prostate fiducial markers for localized prostate cancer at a single institute in Japan

International Nuclear Information System (INIS)

Takeda, Ken; Shimizu, Eiji; Abe, Keiko; Shirata, Yuko; Ishikawa, Yohjiro

2012-01-01

Several studies have confirmed the advantages of delivering high doses of external beam radiotherapy to achieve optimal tumor-control outcomes in patients with localized prostate cancer. We evaluated the medium-term treatment outcome after high-dose, image-guided intensity-modulated radiotherapy (IMRT) using intra-prostate fiducial markers for clinically localized prostate cancer. In total, 141 patients with localized prostate cancer treated with image-guided IMRT (76 Gy in 13 patients and 80 Gy in 128 patients) between 2003 and 2008 were enrolled in this study. The patients were classified according to the National Comprehensive Cancer Network-defined risk groups. Thirty-six intermediate-risk patients and 105 high-risk patients were included. Androgen-deprivation therapy was performed in 124 patients (88%) for a median of 11 months (range: 2–88 months). Prostate-specific antigen (PSA) relapse was defined according to the Phoenix-definition (i.e., an absolute nadir plus 2 ng/ml dated at the call). The 5-year actuarial PSA relapse-free survival, the 5-year distant metastasis-free survival, the 5-year cause-specific survival (CSS), the 5-year overall survival (OS) outcomes and the acute and late toxicities were analyzed. The toxicity data were scored according to the Common Terminology Criteria for Adverse Events, version 4.0. The median follow-up was 60 months. The 5-year PSA relapse-free survival rates were 100% for the intermediate-risk patients and 82.2% for the high-risk patients; the 5-year actuarial distant metastasis-free survival rates were 100% and 95% for the intermediate- and high-risk patients, respectively; the 5-year CSS rates were 100% for both patient subsets; and the 5-year OS rates were 100% and 91.7% for the intermediate- and high-risk patients, respectively. The Gleason score (<8 vs. ≥8) was significant for the 5-year PSA relapse-free survival on multivariate analysis (p = 0.044). There was no grade 3 or 4 acute toxicity. The incidence of

Acceptable Use Policies in a Web 2.0 & Mobile Era: A Guide for School Districts

Science.gov (United States)

Consortium for School Networking (NJ1), 2011

2011-01-01

Web 2.0 applications and mobile Internet devices have added new issues to the safety/access situation for schools. The purpose of this guide is to assist school districts in developing, rethinking, or revising Internet policies as a consequence of the emergence of Web 2.0, and the growing pervasiveness of smart phone use. The Consortium for School…

Comparison of a novel real-time SonixGPS needle-tracking ultrasound technique with traditional ultrasound for vascular access in a phantom gel model.

Science.gov (United States)

Kopac, Daniel S; Chen, Jerry; Tang, Raymond; Sawka, Andrew; Vaghadia, Himat

2013-09-01

Ultrasound-guided percutaneous vascular access for endovascular procedures is well established in surgical practice. Despite this, rates of complications from venous and arterial access procedures remain a significant cause of morbidity. We hypothesized that the use of a new technique of vascular access using an ultrasound with a novel needle-guidance positioning system (GPS) would lead to improved success rates of vascular puncture for both in-plane and out-of-plane techniques compared with traditional ultrasound. A prospective, randomized crossover study of medical students from all years of medical school was conducted using a phantom gel model. Each medical student performed three ultrasound-guided punctures with each of the four modalities (in-plane no GPS, in-plane with GPS, out-of-plane no GPS, out-of-plane with GPS) for a total of 12 attempts. The success or failure was judged by the ability to aspirate a simulated blood solution from the model. The time to successful puncture was also recorded. A poststudy validated NASA Task Load Index workload questionnaire was conducted to assess the student's perceptions of the two different techniques. A total of 30 students completed the study. There was no significant difference seen in the mean times of vascular access for each of the modalities. Higher success rates for vascular access using the GPS for both the in-plane (94% vs 91%) and the out-of-plane (86% vs 70%) views were observed; however, this was not statistically significant. The students perceived the mental demand (median 12.0 vs 14.00; P = .035) and effort to be lower (mean 11.25 vs 14.00; P = .044) as well as the performance to be higher (mean 15.50 vs 14.00; P = .041) for the GPS vs the traditional ultrasound-guided technique. Students also perceived their ability to access vessels increased with the aid of the GPS (7.00 vs 6.50; P = .007). The majority of students expressed a preference for GPS (26/30, 87%) as opposed to the traditional counterpart

Can free open access resources strengthen knowledge-based emerging public health priorities, policies and programs in Africa?

Science.gov (United States)

Tambo, Ernest; Madjou, Ghislaine; Khayeka-Wandabwa, Christopher; Tekwu, Emmanuel N; Olalubi, Oluwasogo A; Midzi, Nicolas; Bengyella, Louis; Adedeji, Ahmed A; Ngogang, Jeanne Y

2016-01-01

Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost. Free Open Access (FOA) health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed. These are critical in establishing real time and effective knowledge or evidence-based translation, proven and validated approaches, strategies and tools to strengthen and revamp health systems.  As such, early and timely access to needed emerging public health information is meant to be instrumental and valuable for policy-makers, implementers, care providers, researchers, health-related institutions and stakeholders including populations when guiding health financing, and planning contextual programs.