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Sample records for term breech presentation

  1. The relation of breech presentation at term to cerebral palsy

    DEFF Research Database (Denmark)

    Krebs, L; Topp, M; Langhoff-Roos, J

    1999-01-01

    OBJECTIVE: To examine the relation between breech delivery and cerebral palsy, considering the influence of intrauterine growth, low Apgar score at birth, and mode of delivery. DESIGN: Register-based, case-control study. POPULATION: A cohort of infants with cerebral palsy born between 1979 and 1986...... in East Denmark, identified by linkage of the cerebral palsy register with the national birth register. Discharge letters from births of breech infants with cerebral palsy were reviewed. MAIN OUTCOME MEASURES: Presentation, mode of delivery, gestational age, birthweight, Apgar score, type of cerebral...... palsy, severity of handicap. RESULTS: Breech presentation at term was associated with a borderline significantly higher risk of cerebral palsy than vertex presentation (OR 1.56; 95% CI 0.9-2.4). Breech presentation infants more often had a lower Apgar score (

  2. Term pregnancy in breech presentation in a unicornuate uterus: a ...

    African Journals Online (AJOL)

    Mullerian anomalies are rare and are associated with poor reproductive outcomes such as pregnancy wastage, preterm birth and malpresentation. This is a case report of an eighteen-year-old woman who presented at 38 weeks gestation in labour with the fetus in breech presentation. A caesarean section was performed, ...

  3. Long-term follow-up of cognitive outcome after breech presentation at birth

    DEFF Research Database (Denmark)

    Sørensen, Henrik Toft; Steffensen, Flemming Hald; Olsen, Jørn

    1999-01-01

    Studies of long-term consequences of birth in breech presentation are sparse. Therefore, we conducted a cohort study linking birth registry data with data collected during evaluation for military service in 4,298 conscripts born between 1973 and 1976. The cognitive functions were measured...

  4. Vaginal delivery of breech presentation.

    Science.gov (United States)

    Kotaska, Andrew; Menticoglou, Savas; Gagnon, Robert

    2009-06-01

    To review the physiology of breech birth; to discern the risks and benefits of a trial of labour versus planned Caesarean section; and to recommend to obstetricians, family physicians, midwives, obstetrical nurses, anaesthesiologists, pediatricians, and other health care providers selection criteria, intrapartum management parameters, and delivery techniques for a trial of vaginal breech birth. Trial of labour in an appropriate setting or delivery by pre-emptive Caesarean section for women with a singleton breech fetus at term. Reduced perinatal mortality, short-term neonatal morbidity, long-term infant morbidity, and short- and long-term maternal morbidity and mortality. Medline was searched for randomized trials, prospective cohort studies, and selected retrospective cohort studies comparing planned Caesarean section with a planned trial of labour; selected epidemiological studies comparing delivery by Caesarean section with vaginal breech delivery; and studies comparing long-term outcomes in breech infants born vaginally or by Caesarean section. Additional articles were identified through bibliography tracing up to June 1, 2008. The evidence collected was reviewed by the Maternal Fetal Medicine Committee of the Society of Obstetricians and Gynaecologists of Canada (SOGC) and quantified using the criteria and classifications of the Canadian Task Force on Preventive Health Care. This guideline was compared with the 2006 American College of Obstetrician's Committee Opinion on the mode of term singleton breech delivery and with the 2006 Royal College of Obstetrician and Gynaecologists Green Top Guideline: The Management of Breech Presentation. The document was reviewed by Canadian and International clinicians with particular expertise in breech vaginal delivery. The Society of Obstetricians and Gynaecologists of Canada. SUMMARY STATEMENTS: 1. Vaginal breech birth can be associated with a higher risk of perinatal mortality and short-term neonatal morbidity than

  5. Uptake of external cephalic version for term breech presentation: an Australian population study, 2002-2012.

    Science.gov (United States)

    Bin, Yu Sun; Roberts, Christine L; Nicholl, Michael C; Ford, Jane B

    2017-07-26

    The safety, efficacy, and cost-effectiveness of external cephalic version (ECV) for term breech presentation has been demonstrated. Clinical guidelines recommend ECV for all eligible women, but the uptake of this procedure in the Australian healthcare setting is unknown. This study aimed to describe ECV uptake in New South Wales, the most populous state of Australia, during 2002 to 2012. Data from routine hospital and birth records were used to identify ECVs conducted at ≥36 weeks' gestation. Women with ECV were compared to women who were potentially eligible for but did not have ECV. Eligibility for ECV was based on clinical guidelines. For those with ECV, birth outcomes following successful and unsuccessful procedures were examined. In N = 32,321 singleton breech pregnancies, 10.5% had ECV, 22.3% were ineligible, and 67.2% were potentially eligible but did not undergo ECV. Compared to women who were eligible but who did not attempt ECV, those who had ECV were more likely to be older, multiparous, overseas-born, public patients at delivery, and to deliver in tertiary hospitals in urban areas (p ECV smoked during pregnancy, fewer were morbidly obese, and fewer had a hypertensive disorder of pregnancy, compared to those who were eligible. Caesarean section occurred in 25.9% of successful compared to 95.6% of unsuccessful ECVs. Infant outcomes did not differ by ECV success. The majority of women with a breech presentation did not receive ECV. It is unclear whether this is attributable to issues with service provision or low acceptability among women. Policies to improve access to and information about ECV appear necessary to improve uptake among women with term breech presentation. Improved data collection around the diagnosis of breech presentation, ECV attempts, and outcomes may help to identify specific barriers to ECV uptake.

  6. Factors associated with the success of external cephalic version (ECV) of breech presentation at term.

    Science.gov (United States)

    Obeidat, N; Lataifeh, I; Al-Khateeb, M; Zayed, F; Khriesat, W; Amarin, Z

    2011-01-01

    To evaluate the predictors of success of ECV for breech presentation at term. A retrospective study was conducted over a 3-year period from 2005-2007, where 101 patients who had singleton breech presentation at term were undergoing external cephalic version (ECV) after 37 weeks of gestation at two major teaching hospitals in the North of Jordan. Comparative analysis was made between the successful ECV and unsuccessful ECV groups. The collected data were analysed by using statistical analysis Sudent's t-test and Mann-Whitney test as appropriate and on discrete results chi square or Fisher's exact test when appropriate. The differences were considered significant at a p value of ECV success rate was 72.3%. Favourable factors for success were multiparity (95.5% vs 4.1%, p = 0.0001), flexed breeches (74% vs 26%, p = 0.002), posterior placenta (38.6% vs 16.4%, p = 0.0001) and anterior fetal back (53.4% vs 34.8%, p = 0.03). Once turned the babies remained cephalic until delivery. All the 28 cases who had failed ECV had caesarean section. Among those who had a successful external cephalic version, the incidence of intrapartum caesarean section was only 8.2% which was lower than that of the average of both units caesarean rate (28%). There were no complications related to the ECV procedure in the study. Multiparity, flexed breech, posterior placenta, and anterior foetal back were the most favourable factors for successful ECV in our study. Moreover, with careful evaluation of individual predictors patient selection and success rates can be optimised.

  7. Cost-effectiveness of external cephalic version for term breech presentation

    Directory of Open Access Journals (Sweden)

    Carvalho Brendan

    2010-01-01

    Full Text Available Abstract Background External cephalic version (ECV is recommended by the American College of Obstetricians and Gynecologists to convert a breech fetus to vertex position and reduce the need for cesarean delivery. The goal of this study was to determine the incremental cost-effectiveness ratio, from society's perspective, of ECV compared to scheduled cesarean for term breech presentation. Methods A computer-based decision model (TreeAge Pro 2008, Tree Age Software, Inc. was developed for a hypothetical base case parturient presenting with a term singleton breech fetus with no contraindications for vaginal delivery. The model incorporated actual hospital costs (e.g., $8,023 for cesarean and $5,581 for vaginal delivery, utilities to quantify health-related quality of life, and probabilities based on analysis of published literature of successful ECV trial, spontaneous reversion, mode of delivery, and need for unanticipated emergency cesarean delivery. The primary endpoint was the incremental cost-effectiveness ratio in dollars per quality-adjusted year of life gained. A threshold of $50,000 per quality-adjusted life-years (QALY was used to determine cost-effectiveness. Results The incremental cost-effectiveness of ECV, assuming a baseline 58% success rate, equaled $7,900/QALY. If the estimated probability of successful ECV is less than 32%, then ECV costs more to society and has poorer QALYs for the patient. However, as the probability of successful ECV was between 32% and 63%, ECV cost more than cesarean delivery but with greater associated QALY such that the cost-effectiveness ratio was less than $50,000/QALY. If the probability of successful ECV was greater than 63%, the computer modeling indicated that a trial of ECV is less costly and with better QALYs than a scheduled cesarean. The cost-effectiveness of a trial of ECV is most sensitive to its probability of success, and not to the probabilities of a cesarean after ECV, spontaneous reversion

  8. Fear for external cephalic version and depression : Predictors of successful external cephalic version for breech presentation at term?

    NARCIS (Netherlands)

    Ciliacus, Emily; van der Zalm, Marieke; Truijens, Sophie E.; Hasaart, Tom H.; Pop, Victor J.; Kuppens, Simone M.

    2014-01-01

    Background Objective was to determine whether fear for external cephalic version (ECV) and depression are associated with the success rate of ECV in women with a breech presentation at term. Methods Prospective study conducted in the Catharina Hospital Eindhoven between October 2007 and May 2012.

  9. Patients' and professionals' barriers and facilitators to external cephalic version for breech presentation at term, a qualitative analysis in the Netherlands

    NARCIS (Netherlands)

    Rosman, A.N.; Vlemmix, F.; Fleuren, M.A.H.; Rijnders, M.E.; Beuckens, A.; Opmeer, B.C.; Mol, B.W.J.; Zwieten, M.C.B. van; Kok, M.

    2014-01-01

    Objective: external cephalic version (ECV) is a relatively simple and safe manoeuvre and a proven effective approach in the reduction of breech presentation at term. There is professional consensus that ECV should be offered to all women with a fetus in breech presentation, but only up to 70% of

  10. Fear for external cephalic version and depression: predictors of successful external cephalic version for breech presentation at term?

    Science.gov (United States)

    2014-01-01

    Background Objective was to determine whether fear for external cephalic version (ECV) and depression are associated with the success rate of ECV in women with a breech presentation at term. Methods Prospective study conducted in the Catharina Hospital Eindhoven between October 2007 and May 2012. Participants fulfilled The Edinburgh Depression Scale (EDS) questionnaire and expressed their degree of fear on a visual analogue scale from one to ten before ECV. Obstetric factors were evaluated as well. Primary outcome was the relation between psychological factors (fear for ECV and depression EDS scores) and ECV success rate. Secondary outcome was a possible relation between fear for ECV and increased abdominal muscle tension. Results The overall success rate was 55% and was significantly lower (p ECV and depression EDS-scores were not related with ECV success rate. Parity, placental location, BMI and engagement of the fetal breech were obstetric factors associated with ECV outcome. There was no relation between fear for ECV and abdominal muscle tone. Conclusion Fear for ECV and depression were not related with ECV success rate in this study. Engagement of the fetal breech was the most important factor associated with a successful ECV. Trial registration EBIS: The Eindhoven Breech Intervention Study, NCT00516555. PMID:24620740

  11. Fear for external cephalic version and depression: predictors of successful external cephalic version for breech presentation at term?

    Science.gov (United States)

    Ciliacus, Emily; van der Zalm, Marieke; Truijens, Sophie E; Hasaart, Tom H; Pop, Victor J; Kuppens, Simone M

    2014-03-12

    Objective was to determine whether fear for external cephalic version (ECV) and depression are associated with the success rate of ECV in women with a breech presentation at term. Prospective study conducted in the Catharina Hospital Eindhoven between October 2007 and May 2012. Participants fulfilled The Edinburgh Depression Scale (EDS) questionnaire and expressed their degree of fear on a visual analogue scale from one to ten before ECV. Obstetric factors were evaluated as well. Primary outcome was the relation between psychological factors (fear for ECV and depression EDS scores) and ECV success rate. Secondary outcome was a possible relation between fear for ECV and increased abdominal muscle tension. The overall success rate was 55% and was significantly lower (p Fear for ECV and depression EDS-scores were not related with ECV success rate. Parity, placental location, BMI and engagement of the fetal breech were obstetric factors associated with ECV outcome. There was no relation between fear for ECV and abdominal muscle tone. Fear for ECV and depression were not related with ECV success rate in this study. Engagement of the fetal breech was the most important factor associated with a successful ECV. The Eindhoven Breech Intervention Study, NCT00516555.

  12. Time trend in the risk of delivery-related perinatal and neonatal death associated with breech presentation at term.

    Science.gov (United States)

    Pasupathy, Dharmintra; Wood, Angela M; Pell, Jill P; Fleming, Michael; Smith, Gordon C S

    2009-04-01

    To determine the factors associated with the risk of delivery-related perinatal and neonatal death among term infants presenting by the breech and the effect of changes in the mode of delivery on the overall rates of perinatal and neonatal mortality associated with breech presentation. We studied 32,776 singleton term infants presenting breech excluding anomalous and antepartum losses in Scotland between 1985 and 2004, using linked Scottish national registries of pregnancy outcome data and perinatal death data. The event was delivery-related perinatal and neonatal death (i.e. intrauterine fetal death during labour or death of infant in the first 4 weeks of life), subdivided according to intrapartum anoxia or mechanical cause of death. Analysis was by multivariate logistic regression. During the study period, the risk of delivery-related perinatal and neonatal death decreased by 72% (95% CI -1% to 93%), due to a 90% (95% CI 33-99%) reduction in anoxic or mechanical deaths. Both intrapartum (OR 0.16, 95% CI 0.02-0.75) and planned (OR 0.01, 95% CI 0.00-0.09) caesarean delivery were protective against anoxic or mechanical deaths and increased use of planned caesarean delivery accounted for 16% of the decline in anoxic and mechanical deaths over the study period. Increased use of planned caesarean delivery only partly explains the decline in delivery-related perinatal and neonatal death between 1985 and 2004 in Scotland.

  13. The relation of breech presentation at term to epilepsy in childhood

    DEFF Research Database (Denmark)

    Krebs, Lone; Langhoff-Roos, Jens

    2006-01-01

    for epilepsy (OR: 1.2 [95% CI: 1.1, 1.3]). Breech infants with epilepsy were more often small for gestational age (9.7%) than breech infants without epilepsy (4.7%). Vaginal delivery was associated with low Apgar score, but mode of delivery and low Apgar score were not related to epilepsy. CONCLUSION...

  14. Persistent Breech Presentation in a Bicornuate Uterus: A Case Report

    African Journals Online (AJOL)

    We report a case of persistent breech presentation in a primigravida with bicornuate uterus that was initially diagnosed by early ultrasound scan. Persistent breech presentation later in the pregnancy necessitated an elective caesarean section at term. The diagnosis was confirmed intraoperatively by exteriorizing the uterus.

  15. A novel and dedicated multidisciplinary service to manage breech presentation at term; 3 years of experience in a tertiary care maternity unit.

    Science.gov (United States)

    Hickland, Patrick; Gargan, Phyl; Simpson, Jacquie; McCabe, Niamh; Costa, Janitha

    2017-08-09

    In order to provide uniform and unbiased multidisciplinary counselling on the options available, including vaginal breech delivery (VBD) and external cephalic version (ECV), the latter of which could then be performed, a weekly Breech Clinic was introduced to a tertiary care maternity unit in Northern Ireland in June 2013, replacing the traditional ECV Clinic introduced in June 2012. Retrospective data collection was undertaken using clinic proformas, Northern Ireland Maternity System data and case notes of women who attended the clinics (ECV and Breech) from June 2012 to May 2015. There were 434 referrals to the clinic over the 3-year period; 356 women attended. The proportion of women attending increased from 69% to 85% since the introduction of the Breech Clinic. Two hundred and thirty-two were deemed eligible and 179 of these underwent ECV after counselling. Although the proportion of women undergoing ECV decreased from 69% to 46%, 11 women opted for and achieved VBD during the 2 years of the Breech Clinic, compared with one woman in the year of the ECV Clinic. Seventy-one of the attempted ECVs were successful, with 61 women having a normal vaginal delivery. Notably, the success rate of ECV increased from 33% to 42%. The number of caesarean sections performed solely for breech at term decreased from 199 in the 12 months before the introduction of ECV clinic, to 188 during the ECV clinic, and 154 in the final 12 months of Breech Clinic. A dedicated service to counsel women on the management of breech presentation can decrease caesarean sections for breech presentation through increased uptake and success of ECV, and encouraging suitable women to opt for VBD when ECV is unsuccessful, contraindicated or declined.

  16. Consequences of the term breech trial in Denmark

    DEFF Research Database (Denmark)

    Hartnack Tharin, J.E.; Krebs, L.; Rasmussen, S.

    2011-01-01

    Objective. To analyze the consequences of the handling of breech presentation in Denmark after publication of the Term Breech Trial (TBT). Design. Population-based retrospective cohort study. Settings. Data from the National Birth Registry and discharge letters from cases with perinatal death...

  17. Facilitators and barriers to external cephalic version for breech presentation at term among health care providers in the Netherlands: A quantitative analysis

    NARCIS (Netherlands)

    Rosman, A.N.; Vlemmix, F.; Beuckens, A.; Rijnders, M.E.; Opmeer, B.C.; Mol, B.W.J.; Kok, M.; Fleuren, M.A.H.

    2014-01-01

    OBJECTIVE: guidelines recommend that external cephalic version (ECV) should be offered to all women with a fetus in breech presentation at term. However, only 50-60% of the women receive an ECV attempt. We explored the determinants (barriers and facilitators) affecting the uptake of the guidelines

  18. Improving external cephalic version for foetal breech presentation

    Science.gov (United States)

    Zandstra, H.; Mertens, H.J.M.M.

    2013-01-01

    Objectives: If success rate of external cephalic version (ECV) increases, the rate of primary caesarean sections declines. The aims of this retrospective cohort study were to evaluate the ECV and to identify factors associated with the success rate of ECV for breech presentation at term. The second aim of this study was to analyse the outcome of labour of all patients with a foetus in breech near term. Methods: All women with a foetus in breech near or at term were included. Logistic regression analyses were performed to identify the association between patient characteristics and success rate of ECV. Results: The overall rate of successful ECV’s was 19%. Foetal and maternal complications after ECV were negligible. BMI, type of breech and amount of amniotic fluid were significantly correlated with a successful ECV. The rate of primary caesarean sections for the group of patients who underwent an ECV was lower than the rate in the group who did not (52.9% vs. 79.6%). The rate of spontaneous deliveries was increased after ECV (36% versus 12%). After successful ECV the rate of spontaneous deliveries was 75%; after unsuccessful ECV 26.8%. Conclusion: The overall rate of successful ECV was low (19%). BMI, type of breech and amount of amniotic fluid were significantly correlated with a successful ECV. The rate of primary caesarean sections was significantly lower in patients with ECV (52.9% versus 79.6%). The rate of spontaneous deliveries was significantly higher (36% versus 12%). PMID:24753933

  19. Review: Breech presentation: The controversy continues | Cluver ...

    African Journals Online (AJOL)

    For women with a baby with flexed thighs who progress appropriately in labour with descent and spontaneous birth of the breech, the likelihood of difficulty with the delivery is very small. If progress is not good, even at full cervical dilation, recourse to CS is a safer option than attempts at breech extraction. Training videos are ...

  20. Breech presentation at term: morbidity and mortality according to the type of delivery at Port Royal Maternity hospital from 1993 through 1999.

    Science.gov (United States)

    Kayem, Gilles; Goffinet, François; Clément, Denis; Hessabi, Madieh; Cabrol, Dominique

    2002-05-10

    To compare neonatal morbidity and mortality at Port Royal Maternity between 1993 and 1999 for infants with a singleton breech presentation born after 37 weeks, according to planned mode of delivery. Retrospective study of 501 patients of whom vaginal delivery was planned in 322 (64%) or/and cesarean in 179 (36%). Severe neonatal morbidity was similar in the two groups (13/322, 4.0% versus 8/179, 4.5%; P=0.82); severe trauma morbidity was not significantly higher in the "planned vaginal delivery" group (3/322, 0.9% versus 1/179, 0.06%; P=0.16); there were no long-term sequelae. Mortality was not higher when vaginal delivery was planned. We have not found in this series any excess of morbidity or mortality attributable to vaginal delivery of breech presentations. This work does not indicate that we should change our obstetrical practice in the light of other recently-published studies.

  1. Breech presentation at a district level hospital in South Africa

    African Journals Online (AJOL)

    2009-03-05

    Mar 5, 2009 ... Conclusion: In a district hospital in South Africa, the mode of delivery for breech presentations is usually a planned Caesarean section. ..... Van Iddekinge B. Risk management: Planned vaginal breech delivery – should this be the mode of choice? The Obstetrician and Gynaecologist 2007;9:171–6. 6.

  2. Neonatal Outcome of Term Breech Births: A 15-Year Review at the ...

    African Journals Online (AJOL)

    was associated with significantly increased risk of perinatal death and neonatal morbidity. Keywords breech birth; vaginal delivery; cesarean section; perinatal mortality; Cameroon. 1 Introduction. Breech presentation occurs in about 3% of all term singleton pregnancies [5]. Compared with a fetus with cephalic pre- sentation ...

  3. Breech at term--mode of delivery?

    DEFF Research Database (Denmark)

    Krebs, L; Langhoff-Roos, J; Weber, T

    1995-01-01

    : Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death. RESULTS: A total...... of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores...... that vaginal delivery is associated with increased mortality and morbidity. However, validation of data and additional information from the medical records are needed before a recommendation of whether selection of parturients, structure of perinatal care or professional skills need to be improved, or all...

  4. Facilitators and barriers to external cephalic version for breech presentation at term among health care providers in the Netherlands: a quantitative analysis.

    Science.gov (United States)

    Rosman, Ageeth N; Vlemmix, Floortje; Beuckens, Antje; Rijnders, Marlies E; Opmeer, Brent C; Mol, Ben Willem J; Kok, Marjolein; Fleuren, Margot A H

    2014-03-01

    guidelines recommend that external cephalic version (ECV) should be offered to all women with a fetus in breech presentation at term. However, only 50-60% of the women receive an ECV attempt. We explored the determinants (barriers and facilitators) affecting the uptake of the guidelines among gynaecologists and midwives in the Netherlands. national online survey. the Netherlands. gynaecologists and midwives. in the online survey, we identified the determinants that positively or negatively influenced the professionals׳ adherence to three key recommendations in the guidelines: (a) counselling, (b) advising for ECV, (c) arranging an ECV. Determinants were identified in a previously performed qualitative study and were categorised into five underlying constructs; attitude towards ECV, professional obligation, outcome expectations, self-efficacy and preconditions for successful ECV. We performed a multivariate analysis to assess the importance of the different constructs for adherence to the guideline. 364 professionals responded to the survey. Adherence varied: 84% counselled, 73% advised, and 82% arranged an ECV for (almost) all their clients. Although 90% of respondents considered ECV to be an effective treatment for preventing caesarean childbirths, only 30% agreed that 'every client should undergo ECV'. Self-efficacy (perceived skills) was the most important determinant influencing adherence. self-efficacy appears to be the most significant determinant for counselling, advising and arranging an ECV. to improve adherence to the guidelines on ECV we must improve self-efficacy. Copyright © 2014. Published by Elsevier Ltd.

  5. Breech presentation and the cornual-fundal location of the placenta

    Science.gov (United States)

    Sekulić, Slobodan; Ilinčić, Marko; Radeka, Gordana; Novakov-Mikić, Aleksandra; Simić, Svetlana; Podgorac, Jelena; Keković, Goran

    2013-01-01

    Aim To investigate the association of cornual-fundal location of the placenta and breech presentation at term delivery. Methods This study was conducted at the Department of Obstetrics and Gynecology, Novi Sad, in 2011. The inclusion criteria were delivery at ≥37 weeks of gestation, singleton gestation, and cornual-fundal location of the placenta determined by ultrasonography at ≥37 weeks of gestation when 3/4 or more of the placenta was in the cornual-fundal region. Results Out of 2750 ultrasound examinations performed, 143 showed cornual-fundal location of the placenta (frequency 5.2%). Eighty six cases had cephalic presentation (60.14%) and 57 (39.86%) had breech presentation. Of the remaining cases with non- cornual-fundal location, 2585 had cephalic presentation and 22 (0.84%) had breech presentation. The difference in the frequency of breech presentation between the cornual-fundal and non-cornual-fundal groups was significant (χ2 = 77.78, P < 0.001). Conclusion Cornual-fundal location of the placenta may be an important clue in resolving the etiology of a number of cases of breech presentation at term delivery. PMID:23630148

  6. Neonatal outcomes of preterm infants in breech presentation according to mode of birth in Canadian NICUs.

    Science.gov (United States)

    Lodha, Abhay; Zhu, Qiaohao; Lee, Shoo K; Shah, Prakesh S

    2011-03-01

    Many medical practitioners have adopted the practice of caesarean section for preterm infants in breech presentation based on term infant data. Some studies have highlighted deleterious effects on survival, such as intraventricular haemorrhage and periventricular leucomalacia, while others have reported no difference from the outcomes after vaginal delivery. To compare outcomes of preterm infants of ≤32 weeks' gestational age who were in breech position at the time of birth according to mode of birth in Canadian neonatal intensive care units (NICUs). 29 Canadian NICUs. Neonates admitted to participating NICUs in the Canadian Neonatal Network between 2003 and 2007 were included in this retrospective study. Infants who were in breech position at the time of birth were divided into two groups: vaginal birth (VB) and caesarean section (CS). Data on common neonatal outcomes were compared using univariate and multivariate logistic regression. Neonatal mortality and other neonatal morbidities. Of 3552 preterm infants in breech position at birth, 2937 (83%) were delivered by CS and 615 (17%) by VB. Multivariate regression analysis with adjustment for perinatal risk factors indicated that VB was associated with an increased risk of death (OR 1.7; 95% CI 1.3 to 2.3), chronic lung disease (OR 1.5; 95% CI 1.1 to 1.9) and severe retinopathy of prematurity (OR 1.6; 95% CI 1.1 to 2.3). Vaginal birth for preterm infants in breech presentation is possibly associated with a higher risk of adverse neonatal outcomes compared with caesarean birth in Canadian NICUs. It is not clear whether adverse outcomes are due to the mode of delivery or whether breech birth is associated with other risk factors, an issue that can only be resolved by a randomised controlled trial.

  7. Vaginal delivery versus cesarean section for term breech delivery

    Directory of Open Access Journals (Sweden)

    Babović Ivana

    2010-01-01

    Full Text Available Background/Aim. The optimal method of delivery for breech presentation at term still remains a matter of controversy. This is probably due to the fact that the skills of vaginal breech delivery are being lost. The aim of this study was to examine risk factors: mother's age, parity, labor's duration, estimated neonatal birth weight for the mode of breech presentation delivery at term as well as the influence of the delivery mode on neonatal outcome. Methods. A retrospective study of 401 terms (more than 37 week's gestation breech deliveries at the Institute of Gynecology and Obstetrics, Belgrade, from 2007 to 2008 was made. The following groups with respect to mode of delivery were included: the group I - vaginal delivery (VD in 139 patients; the group II - urgent cesarean section (UCS in 128 patients; and the group III - elective cesarean section (ECS in 134 patients. Mother's age, parity, duration of VD, neonatal birth weight (BW, the Apgar score at 5th minute, and duration of stay in a neonatal intensive care unit (NICU vere determined. Neonatal mortality and major neonatal morbidity were compared according to the route of delivery. Fetuses and neonates with hemolytic disease and fetal and neonatal anomalies were excluded from the study. For statistical analyses we performed Student's t test, χ2 likelihood ratio, Kruskall-Wallis test, Mann Whitney test, and ANOVA. Results. The mean age of patients in the group I was 28.29 ± 4.97 years, in the group II 29.68 ± 5.92 years and in the group III 30.06 ± 5.41 years. Difference in mother's age between the group I and III was significant (p = 0.022. In the group III there were 73.9% nuliparous similarly to the gropu II (73.4%. We performed ECS in 54.6% of the nuliparous older than 35 years, and 54.4% multiparous younger than 35 years were delivered by VD. The use of oxytocin for stimulation of vaginal labor was not associated with its duration (p = 0.706. Lowset maneuver was performed in 88.5% of

  8. Comparing the Educational Readiness in Children with Breech Presentation Versus Cephalic Presentation

    Directory of Open Access Journals (Sweden)

    Batool Teimoori

    2013-02-01

    Full Text Available Background: Considering the fact that breech presentation is the most common abnormal presentation, the present paper compares the preparation of those people who had been born with breech and cephalic presentation. Materials and Methods: In this cross-sectional study we examines 1847 children in primary schools in Zahedan who had been born in 1994-1999; they were selected randomly from three elementary schools in Zahedan. Questionnaires were used to collect information and information about educational preparation of students were gathered using the standard and approved questionnaires by the Education Department of Iran archived in the patients’ profiles. To analyze the data, t-test and χ2 test had been used and p<0.05 was considered significant.Results: Out of the 1847 examined children , 1446 children (3.78% were male and 401 ones (7/21% were female. 1738 patients (94% had cephalic presentation (evident group and 109 (6% had breech presentation (cases. There was a significant statistical difference among the age averages of the mothers with the fetus presentation (p=0.001 and also among the average marks of the educational preparation of students and the fetus presentation (p=0.017 and children born with the breech presentation had higher scores in preparation. There was no significant difference between the mean score of the educational preparation and child delivery method (p=0.13.Conclusion: This study showed that school preparation scores, regardless of the mode of delivery, in breech presentation are higher than that in cephalic presentation.

  9. Cesarean Section and Right Femur Fracture: A Rare but Possible Complication for Breech Presentation

    Directory of Open Access Journals (Sweden)

    Giampiero Capobianco

    2013-01-01

    Full Text Available Background. The breech extraction of the fetus through the vagina has a greater risk of hip fracture compared with the extraction by abdominal route. Case. A 2390 g female infant was delivered at 39 weeks by elective cesarean section for breech presentation. The newborn sustained a fracture of the right femur. A simple immobilization of the limb in extension led to a complete healing of the fracture without sequelae. Conclusion. Caesarean delivery reduces the risk of causing a traumatic injury of the newborn compared to vaginal delivery, especially with breech presentation but does not eliminate this possible accidental complication.

  10. Changes in vaginal breech delivery rates in a single large metropolitan area.

    LENUS (Irish Health Repository)

    Hehir, Mark P

    2012-06-01

    Vaginal breech delivery rates have been accepted widely to be in decline and the Term Breech Trial (TBT) has recommended delivery of a breech-presenting infant by elective cesarean section delivery. Our aim was to examine the rate of vaginal delivery of term breech pregnancies in the 8 years before and after the publication of the TBT.

  11. Pregnancy outcome in singleton term breeches from a referral ...

    African Journals Online (AJOL)

    There were no statistically significant differences in the perinatal mortality rates, congenital malformation rates and Apgar score of less than 7 at 5 minutes in babies born by AVBD and CS, (p>0.05). There was statistically significant difference in birth trauma (p<0.00001). Conclusion: Vaginal breech delivery is strongly ...

  12. Pregnancy outcome in singleton term breeches from a referral ...

    African Journals Online (AJOL)

    mortality rates, congenital malformation rates and Apgar score of less than 7 at 5 minutes in babies born by AVBD and CS, (p>0.05). There was statistically significant difference in birth trauma (p<0.00001). Conclusion: Vaginal breech delivery is strongly associated with birth trauma in our community. It is recommended.

  13. Are intrapartum and neonatal deaths in breech delivery at term potentially avoidable?--a blinded controlled audit

    DEFF Research Database (Denmark)

    Krebs, Lone; Langhoff-Roos, Jens; Bødker, Birgit

    2002-01-01

    The aim of the study was to investigate whether deaths in term breech deliveries could have been avoided with improved care during pregnancy and delivery. All cases of intrapartum/early neonatal death of nonmalformed infants in breech presentation delivered at term in Denmark in the period 1982......-92 were studied. For each of the 12 deaths two controls matched by presentation and planned mode of delivery were selected. Eleven obstetricians assessed the care through narratives that ended when the infant was delivered to umbilicus and stated if the infant died, and whether the "possible death......" was potentially avoidable. The majority thought that 42% of cases and 9% of the controls had died. Antenatal and intrapartum care was suboptimal respectively in 17% and 25% of cases and 4% and 26% of controls. The assumed death was found to have been potentially avoidable in 58% of cases and 17% of controls. Care...

  14. Breech at term--mode of delivery? A register-based study

    DEFF Research Database (Denmark)

    Krebs, L; Langhoff-Roos, J; Weber, Tom

    1995-01-01

    . Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death. RESULTS. A total...... of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores......) when compared to those delivered by elective cesarean section. In vaginal deliveries, parity was not correlated with outcome, but infants with a birth weight above 4000 grams had significantly higher rates of low Apgar scores. CONCLUSIONS. Register data on singleton term breech deliveries imply...

  15. Brief report: a cost analysis of neuraxial anesthesia to facilitate external cephalic version for breech fetal presentation.

    Science.gov (United States)

    Carvalho, Brendan; Tan, Jonathan M; Macario, Alex; El-Sayed, Yasser Y; Sultan, Pervez

    2013-07-01

    In this study, we sought to determine whether neuraxial anesthesia to facilitate external cephalic version (ECV) increased delivery costs for breech fetal presentation. Using a computer cost model, which considers possible outcomes and probability uncertainties at the same time, we estimated total expected delivery costs for breech presentation managed by a trial of ECV with and without neuraxial anesthesia. From published studies, the average probability of successful ECV with neuraxial anesthesia was 60% (with individual studies ranging from 44% to 87%) compared with 38% (with individual studies ranging from 31% to 58%) without neuraxial anesthesia. The mean expected total delivery costs, including the cost of attempting/performing ECV with anesthesia, equaled $8931 (2.5th-97.5th percentile prediction interval $8541-$9252). The cost was $9207 (2.5th-97.5th percentile prediction interval $8896-$9419) if ECV was attempted/performed without anesthesia. The expected mean incremental difference between the total cost of delivery that includes ECV with anesthesia and ECV without anesthesia was $-276 (2.5th-97.5th percentile prediction interval $-720 to $112). The total cost of delivery in women with breech presentation may be decreased (up to $720) or increased (up to $112) if ECV is attempted/performed with neuraxial anesthesia compared with ECV without neuraxial anesthesia. Increased ECV success with neuraxial anesthesia and the subsequent reduction in breech cesarean delivery rate offset the costs of providing anesthesia to facilitate ECV.

  16. Contraindications for external cephalic version in breech position at term: a systematic review.

    Science.gov (United States)

    Rosman, Ageeth N; Guijt, Aline; Vlemmix, Floortje; Rijnders, Marlies; Mol, Ben W J; Kok, Marjolein

    2013-02-01

    External cephalic version (ECV) is a safe and effective intervention that can prevent breech delivery, thus reducing the need for cesarean delivery. It is recommended in national guidelines. These guidelines also mention contraindications for ECV, and thereby restrict the application of ECV. We assessed whether the formulation of these contraindications in guidelines are based on empiric data. Systematic review. Pregnant women with a singleton breech presentation from 34 weeks. We searched the National Guideline Clearinghouse, the Cochrane Central Register of Controlled Trials, MEDLINE (1953-2009), EMBASE (1980-2009), TRIP database (until 2011), NHS (National Health Services, until 2011), Diseases database (until 2011) and NICE guidelines (until 2011) for existing guidelines on ECV and studied the reproducibility of the contraindications stated in the guidelines. Furthermore, we systematically reviewed the literature for contraindications and evidence on these contraindications. Contraindications of ECV. We found five guidelines mentioning 18 contraindications, varying from five to 13 per guideline. The contraindications were not reproducible between the guidelines with oligohydramnios as the only contraindication mentioned in all guidelines. The literature search yielded 60 studies reporting on 39 different contraindications, of which we could only assess evidence of six of them. The present study shows that there is no general consensus on the eligibility of patients for ECV. Therefore we propose to limit contraindications for ECV to clear empirical evidence or to those with a clear pathophysiological relevance. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  17. Breech at term--mode of delivery? A register-based study

    DEFF Research Database (Denmark)

    Krebs, L; Langhoff-Roos, J; Weber, Tom

    1995-01-01

    . Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death. RESULTS. A total...... of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores...... that vaginal delivery is associated with increased mortality and morbidity. However, validation of data and additional information from the medical records are needed before a recommendation of whether selection of parturients, structure of perinatal care or professional skills need to be improved, or all...

  18. A randomized trial of remifentanil for analgesia in external cephalic version for breech presentation.

    Science.gov (United States)

    Liu, Xiaohua; Xue, Aiqin

    2016-12-01

    Although external cephalic version (ECV) can be effective for correcting the fetus in a cephalic presentation, it may be painful for the mother. This study aimed to evaluate the efficacy and safety of remifentanil for pain relief during ECV in China. In all, 152 Chinese parturients with singleton breech presentation were randomly divided into 2 groups, each with 76 patients. All 152 patients were assigned to receive either remifentanil (infused at 0.1 μg/kg/min and demand boluses of 0.1 μg/kg) or saline placebo. The study was performed between January 2012 and December 2015. Outcome measurements included the Numerical Rating Pain Scale score (0-10) after ECV, success rate for ECV, and maternal satisfaction after ECV. Adverse events were also evaluated. The study was completed by 146 patients. Remifentanil showed greater efficacy than placebo in decreasing the pain score immediately after ECV (remifentanil 4.6 ± 2.6 vs placebo 6.5 ± 2.7; P ECV showed a significant difference between the 2 groups (remifentanil 56.5% vs placebo 39.5%; P = 0.04). Maternal satisfaction also showed a significant difference between the 2 groups (remifentanil 9.6 ± 1.4 vs placebo 6.4 ± 3.7; P ECV, and increasing maternal satisfaction during ECV, and is generally well-tolerated without additional adverse effects.

  19. Comparison of Apgar scores in breech presentations between vaginal and cesarean delivery.

    Science.gov (United States)

    Fajar, Jonny Karunia; Andalas, Mohd; Harapan, Harapan

    2017-01-01

    The mode of delivery in breech presentation (BP) is controversial. Several studies have reported the advantages and disadvantages of delivery mode in BP. The aim of this study was to compare the Apgar scores in BPs between vaginal and cesarean delivery. A retrospective study was conducted at Dr. Zainoel Abidin General Hospital from January 2010 to December 2012. Data on the mode of delivery and Apgar scores at 1 and 5 min for infants with a BP were extracted from the medical records. Logistic regression was employed to assess the correlation between mode of delivery and Apgar scores. In addition, a meta-analysis was conducted to summarize findings from other regions. A total of 205 (3.9%) BPs among 5252 deliveries between January 2010 and December 2012 were analyzed for this study. There were 26% (52 cases) vaginal and 74% (153 cases) cesarean deliveries. The mode of delivery for BP had a significant association with Apgar score at 1 min (odds ratio [OR] 95% confidence interval [CI] = 6.462 [2.476-16.870], P = 0.0001) and 5 min (OR 95% CI = 7.727 [1.416-42.175], P = 0.018). Our meta-analysis showed that the delivery mode had a significant association with Apgar score in BP (OR: 3.69; 95% CI: 2.18-6.26, P = 0.0001). There was a significant association between Apgar scores in BPs and mode of delivery. Our results suggest better outcomes for cesarean than vaginal delivery in BPs.

  20. Comparison of Apgar scores in breech presentations between vaginal and cesarean delivery

    Science.gov (United States)

    Fajar, Jonny Karunia; Andalas, Mohd; Harapan, Harapan

    2017-01-01

    Objective: The mode of delivery in breech presentation (BP) is controversial. Several studies have reported the advantages and disadvantages of delivery mode in BP. The aim of this study was to compare the Apgar scores in BPs between vaginal and cesarean delivery. Materials and Methods: A retrospective study was conducted at Dr. Zainoel Abidin General Hospital from January 2010 to December 2012. Data on the mode of delivery and Apgar scores at 1 and 5 min for infants with a BP were extracted from the medical records. Logistic regression was employed to assess the correlation between mode of delivery and Apgar scores. In addition, a meta-analysis was conducted to summarize findings from other regions. Results: A total of 205 (3.9%) BPs among 5252 deliveries between January 2010 and December 2012 were analyzed for this study. There were 26% (52 cases) vaginal and 74% (153 cases) cesarean deliveries. The mode of delivery for BP had a significant association with Apgar score at 1 min (odds ratio [OR] 95% confidence interval [CI] = 6.462 [2.476–16.870], P = 0.0001) and 5 min (OR 95% CI = 7.727 [1.416–42.175], P = 0.018). Our meta-analysis showed that the delivery mode had a significant association with Apgar score in BP (OR: 3.69; 95% CI: 2.18–6.26, P = 0.0001). Conclusions: There was a significant association between Apgar scores in BPs and mode of delivery. Our results suggest better outcomes for cesarean than vaginal delivery in BPs. PMID:28757760

  1. Educational outcomes following breech delivery: a record-linkage study of 456947 children.

    Science.gov (United States)

    Mackay, Daniel F; Wood, Rachael; King, Albert; Clark, David N; Cooper, Sally-Ann; Smith, Gordon C S; Pell, Jill P

    2015-02-01

    Obstetric management of term breech infants changed dramatically following the Term Breech Trial which suggested increased serious neonatal morbidity following trial of labour. Short-term morbidity is a poor proxy of long-term neurological sequelae. We determined whether vaginal breech delivery was associated with educational outcomes. We linked three Scotland-wide administrative databases at an individual level: the ScotXed school census; Scottish Qualifications Authority (SQA) examination results; and Scottish Morbidity Record (SMR02) maternity database. The linkage provided information on singleton children, born at term, attending Scottish schools between 2006 and 2011. Of the 456 947 eligible children, 1574 (0.3%) had vaginal breech deliveries, 12 489 (2.7%) planned caesarean section for breech presentation and 442 090 (96.9%) vaginal cephalic deliveries. The percentage of term breech infants delivered vaginally fell from 23% to 7% among children who started school in 2006 and 2011, respectively. Of children born by vaginal breech delivery, 1.5% had a low 5-min Apgar score (≤3) compared with only 0.4% of those born by either breech caesarean section [adjusted odds ratio (OR) 6.16, 95% confidence interval (CI) 4.44-8.54, p<0.001] or cephalic vaginal delivery (adjusted OR 3.84, 95% CI 2.99-4.93, p<0.001). Children born by vaginal breech delivery had lower examination attainment than those born by either planned caesarean section for breech presentation (adjusted OR 1.16, 95% CI 1.02-1.32, p=0.020) or vaginal cephalic delivery (adjusted OR 1.14, 95% CI 1.01-1.28, p=0.029). Vaginal delivery of term breech infants was associated with lower examination attainment, as well as poorer Apgar scores, suggesting that the adverse effects are not just short-term. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

  2. Fracture of the Femur of A Newborn after Cesarean Section for Breech Presentation and Fibroid Uterus :A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Ibrahima Farikou

    2014-01-01

    Full Text Available Introduction: The practice of cesarean section is known to decrease the occurrence of long bone fractures. We present here an unusual diaphyseal fracture of the femur of a newborn after cesarean section, the only case observed in our 14 years of practice. Case Report: The patient was a 3.4-kg female child born at 38 weeks of gestation. The mother was a primipara and aged 39 years. Ultrasound examination at 20th week revealed intrauterine fibroids with a breech presentation. Therefore, elective cesarean section was indicated. There was no apparent bone disorder that could predispose to sustain femur fracture. The fracture was treated successfully with a bilateral spica cast. The cesarean section was indicated in an aged primipara, bearer of uterine fibroids, and breech presentation. She had a good general health status, but her bone density was unknown since this examination is not routinely performed in our clinical settings in Africa. Conclusion: Elderly age, primipara status, presence of uterine fibroids, and breech presentation are usual indications for cesarean section. However, there are not many reports on femur fracture after cesarean section. Our present case suggests that despite the latest advances in delivery techniques, cesarean section for breech presentation predisposes the neonate to femoral fractures. Keywords: Femur fracture; Cesarean section; Fibroid; Breech presentation; Africa.

  3. Contraindications for external cephalic version in breech position at term: A systematic review

    NARCIS (Netherlands)

    Rosman, A.N.; Guijt, A.; Vlemmix, F.; Rijnders, M.; Mol, B.W.J.; Kok, M.

    2013-01-01

    Objective. External cephalic version (ECV) is a safe and effective intervention that can prevent breech delivery, thus reducing the need for cesarean delivery. It is recommended in national guidelines. These guidelines also mention contraindications for ECV, and thereby restrict the application of

  4. Development and validation of an objective structured assessment of technical skill tool for the practice of breech presentation delivery.

    Science.gov (United States)

    Jordan, Alexis; Antomarchi, Julie; Bongain, André; Tran, Antoine; Delotte, Jérome

    2016-08-01

    To develop and test the validity of an Objective Structured Assessment of Technical Skills (OSATS) tool for breech presentation delivery. Monocentric prospective study conducted in the Department of Gynecology, Obstetrics, Fetal Medicine and Reproductive Medicine at the University Hospital of Nice. The study consisted of two parts, the development of the OSATS scoring system and its objective validation. Several experts in obstetrics from university hospital centers and private French hospitals were invited to participate in the development phase of the scoring system. For the validation phase, we formed a group of 20 novices and a group of 20 experts, who had to perform a breech presentation delivery on a simulator, according to a standardized scenario. Each participant was filmed and two experts would then evaluate their performance by viewing anonymized videos and using the OSATS score. The scores obtained by the expert group were significantly higher than those of the novice group, with a total score of 21.73/25 versus 6.95/25 (p skills using a simulator.

  5. Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version

    NARCIS (Netherlands)

    Vlemmix, F.; Rosman, A.N.; Fleuren, M.A.H.; Rijnders, M.E.B.; Beuckens, A.; Haak, M.C.; Akerboom, B.M.C.; Bais, J.M.J.; Kuppens, S.M.I.; Papatsonis, D.N.; Opmeer, B.C.; Post, J.A.M. van der; Mol, B.W.J.; Kok, M.

    2010-01-01

    Background: Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch Society for

  6. Implementation of the external cephalic version in breech delivery Dutch national implementation study of external cephalic version

    NARCIS (Netherlands)

    Vlemmix, Floortje; Rosman, Ageeth N.; Fleuren, Margot A. H.; Rijnders, Marlies E. B.; Beuckens, Antje; Haak, Monique C.; Akerboom, Bettina M. C.; Bais, Joke M. J.; Kuppens, Simone M. I.; Papatsonis, Dimitri N.; Opmeer, Brent C.; van der Post, Joris A. M.; Mol, Ben Willem J.; Kok, Marjolein

    2010-01-01

    ABSTRACT: BACKGROUND: Breech presentation occurs in 3 to 4 % of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch

  7. Reducing the cesarean delivery rates for breech presentations: administration of spinal anesthesia facilitates manipulation to cephalic presentation, but is it cost saving?

    Science.gov (United States)

    2014-01-01

    Background External cephalic version (ECV) is infrequently performed and 98% of breech presenting fetuses are delivered surgically. Neuraxial analgesia can increase the success rate of ECV significantly, potentially reducing cesarean delivery rates for breech presentation. The current study aims to determine whether the additional cost to the hospital of spinal anesthesia for ECV is offset by cost savings generated by reduced cesarean delivery. Methods In our tertiary hospital, three variables manpower, disposables, and fixed costs were calculated for ECV, ECV plus anesthetic doses of spinal block, vaginal delivery and cesarean delivery. Total procedure costs were compared for possible delivery pathways. Manpower data were obtained from management payroll, fixed costs by calculating cost/lifetime usage rate and disposables were micro-costed in 2008, expressed in 2013 NIS. Results Cesarean delivery is the most expensive option, 11670.54 NIS and vaginal delivery following successful ECV under spinal block costs 5497.2 NIS. ECV alone costs 960.21 NIS, ECV plus spinal anesthesia costs 1386.97 NIS. The highest individual cost items for vaginal, cesarean delivery and ECV were for manpower. Expensive fixed costs for cesarean delivery included operating room trays and postnatal hospitalization (minimum 3 days). ECV with spinal block is cheaper due to lower expected cesarean delivery rate and its lower associated costs. Conclusions The additional cost of the spinal anesthesia is offset by increased success rates for the ECV procedure resulting in reduction in the cesarean delivery rate. PMID:24564984

  8. Breech delivery at a University Hospital in Tanzania

    OpenAIRE

    H?gberg, Ulf; Claeson, Catrin; Krebs, Lone; Svanberg, Agneta Skoog; Kidanto, Hussein

    2016-01-01

    Background: There is a global increase in rates of Cesarean delivery (CD). A minor factor in this increase is a shift towards CD for breech presentation. The aim of this study was to analyze breech births by mode of delivery and investigate short-term fetal and maternal outcomes in a low-income setting. Methods: The study design was cross-sectional and the setting was Muhimbili National Hospital (MNH), Dar-es-Salaam, Tanzania. Subjects were drawn from a clinical database (1999-2010) using the...

  9. Vaginal breech births in a hospital where caesarean section is ...

    African Journals Online (AJOL)

    SCIENTIFIC LETTER. Objectives. Caesarean section has become the preferred delivery method for breech presentation at Chris Hani Baragwanath Academic ... This study has shown that vaginal breech births continue to occur as unexpected events. ... descriptive study was to understand why and how vaginal breech.

  10. Comparison of Fetomaternal Outcome between 47 Deliveries Following Successful External Cephalic Version for Breech Presentation and 7456 Deliveries Following Spontaneous Cephalic Presentation.

    Science.gov (United States)

    de Gregorio, Nikolaus; Friedl, Thomas; Schramm, Amelie; Reister, Frank; Janni, Wolfgang; Ebner, Florian

    2017-08-25

    Achieving a cephalic position after a successful external cephalic version (ECV) is desired to result in delivery and fetal outcomes that are similar to those of deliveries following spontaneous cephalic presentation. We performed a retrospective cohort study including patients with successful ECV following fetal breech position (ECV cohort, n = 47) or with a singleton spontaneous cephalic pregnancy at ≥37 weeks of gestational age (control group, n = 7,456) attempting a vaginal delivery between 2010 and 2013 at the University Hospital Ulm. The mode of delivery and fetal outcome parameters were compared between these 2 groups using nonparametric statistics. ECV cohort and control group did not differ with respect to maternal age, parity, gestational age at birth, and fetal gender. There were no significant differences between the 2 groups with regard to all parameters indicating fetal outcome. However, the rate of cesarean sections was higher after successful ECV compared to spontaneous cephalic presentation (27.7 vs. 12.8%, OR 2.615). While vaginal delivery is less likely to happen after a successful ECV compared to spontaneous cephalic singleton pregnancies, fetal outcome parameters showed no difference between the 2 groups. Physicians should be counseling and encouraging women to attempt ECV, as it is a safe and effective procedure. © 2017 S. Karger AG, Basel.

  11. The Impact of an ECV Service is Limited by Antenatal Breech Detection: A Retrospective Cohort Study.

    Science.gov (United States)

    Hemelaar, Joris; Lim, Lee N; Impey, Lawrence W

    2015-06-01

    External cephalic version (ECV) reduces the chance of breech presentation at term birth and lowers the chance of a cesarean delivery. ECV services are now in place in many units in the United Kingdom but their effectiveness is unknown. The aim of this study was to investigate the reasons for breech presentation at term birth. We performed a retrospective cohort study of 394 consecutive babies who were in breech presentation at term birth in a large United Kingdom maternity unit that offers ECV. The cohort was analyzed over two time periods 10 years apart: 1998-1999 and 2008-2009. Only 33.8 percent of women had undergone a (failed) ECV attempt. This low proportion was mainly because breech presentation was not diagnosed antenatally (27.9%). Other contributing factors were: ECV not offered by clinicians (12.2%), ECV declined by women (14%), and contraindications to ECV (10.7%). Over the 10-year period, the proportion of breech presentations that were not diagnosed antenatally increased from 23.2 to 32.5 percent (p = 0.04), which constituted 52.8 percent of women who had not undergone an ECV attempt in 2008-2009. Failure of clinicians to offer ECV reduced from 21.6 to 3.0 percent (p = 0.0001) and the proportion of women declining ECV decreased from 19.1 to 9.0 percent (p = 0.005). Overall, ECV attempts increased from 28.9 to 38.5 percent (p = 0.05). Although ECV counseling, referral, and attempt rates have increased, failure to detect breech presentation antenatally is the principal barrier to successful ECV. Improved breech detection would have a greater impact than methods to increase ECV success rates. © 2015 Wiley Periodicals, Inc.

  12. The influence of counseling on the mode of breech birth: A single-center observational prospective study in The Netherlands.

    Science.gov (United States)

    Abdessalami, Souhailla; Rota, Hanneke; Pereira, Gabriella Dias; Roest, Jan; Rosman, Ageeth N

    2017-12-01

    women in the Netherlands, with a fetus in breech presentation, are thoroughly counseled to make an informed choice for the mode of delivery. The aim of this study was to assess the influence of counseling techniques on women's choices for the mode of delivery and subsequently to compare fetal and maternal outcomes of vaginal breech birth versus planned caesarean section. we performed an observational prospective study. Data on breech deliveries were prospectively collected. We used ANOVA to identify variables influencing women's choice for the mode of delivery. the obstetric department of the Red Cross Hospital in Beverwijk, the Netherlands. women with a singleton gestation (>37 + 0 weeks) and a fetus in breech presentation were included. between January 2007 and December 2015 364 women were included. Counseling technique (p =mode of delivery. Of all included women 33% (N = 119) opted for a vaginal breech delivery and 52% (N = 190) opted for a planned cesarean section. 15% (N = 55) were unexpected breeches. Of the planned vaginal delivery group 66% (N = 79) delivered vaginal, whereas 99.5% (N = 189) of the women in the planned cesarean section group underwent a planned cesarean section. There were no significant differences in maternal and neonatal outcomes. women's choice on the mode of delivery and the eventual modus partus of fetuses in breech presentation is strongly influenced by the counseling technique. Vaginal breech birth in low-risk women is a safe option without long term morbidity in neonates. counselors should be aware of their influence on women's choice for mode of delivery in breech presentation. Counseling should be done using evidence based information. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Bilateral Humerus and Right Femur Fracture in a Newborn after Cesarean Section for Breech Presentation in a Twin Pregnancy: A Very Rare Case Report

    Science.gov (United States)

    Rahul, P; Grover, Amit Rakesh; Ajoy, S M

    2017-01-01

    Introduction: The most common fractures during vaginal delivery occur in the clavicle, humerus, and femur. Cesarean section reduces the chances of a child having a birth injury. However, in some difficult extractions, long bone fractures may occur. Cesarean section further reduces the incidence of birth injuries, especially in a breech delivery. Maneuvers employed during cesarean section, energetic traction, improper uterine incisions, and contracted uterus may cause these injuries. In the medical literature, there are few articles highlighting the occurrence of long bone fractures during cesarean section. There has been no case reported with a combined bilateral humerus and femur fracture in the medical literature. Case Report: A 2-day-old neonate born after cesarean section for breech presentation in a twin pregnancy presented with restricted movements of both his arms and right leg. Infantogram revealed bilateral humerus and right femur fracture. Biochemical tests were normal, and there were no other findings on clinical examination. There was no evidence of child abuse or any positive family history. Child was splinted for 3 weeks. X-rays suggested good callus at the fracture site of the right femur and bilateral humerus fracture were united. Conclusion: To conclude, we would like to emphasize that long bone fractures can happen with cesarean section also. To prevent such untoward complications, during delivery of the baby the surgeon should be very careful, avoid energetic traction and should plan his incisions. Appropriate relaxation of the uterus must be achieved. Clavicles and other long bones should be palpated after a difficult delivery. However, it is important to note that long bone fractures in children heal rapidly without the need for any major intervention. PMID:28630830

  14. Is routine caesarean section necessary for breech-breech and ...

    African Journals Online (AJOL)

    Objective: To determine if perinatal outcome is affected by the route of delivery in breech-breech and breech-transverse twin gestations. Design: Prospective observational study. Setting: Umtala General Hospital, a referral hospital for approximately 32 rural hospitals throughout the former Transkei. Subjects: Twin gestations ...

  15. Maternal and neonatal outcomes of vaginal breech delivery for singleton term pregnancies in a carefully selected Cameroonian population: a cohort study.

    Science.gov (United States)

    Dohbit, Julius Sama; Foumane, Pascal; Tochie, Joel Noutakdie; Mamoudou, Fadimatou; Temgoua, Mazou N; Tankeu, Ronni; Aletum, Veronica; Mboudou, Emile

    2017-11-22

    Vaginal breech delivery (VBD) is known to be associated with more perinatal and maternal complications. Very few studies on the subject have been carried out in poor-resource settings. The aim of this study was to determine maternal and neonatal outcomes in carefully selected cases of VBD for singleton term pregnancies in a tertiary centre in Cameroon. A retrospective cohort study. A tertiary hospital in Yaounde, Cameroon. Cases of VBD of newborns weighing 2500-3500 g were matched in a ratio of 1:4 to consecutive vaginal cephalic deliveries (VCDs) of newborns weighing 2500-3500 g over a 5-year period. Both groups were matched for maternal age and parity. We excluded cases of multiple gestations, footling breech, clinically inadequate maternal pelvis, preterm delivery, post-term pregnancies, fetal demise prior to the onset of labour, placenta praevia and fetal anomaly incompatible with vaginal delivery. Neonatal and maternal adverse outcomes of VBD observed till 6 weeks after delivery analysed using Bonferroni correction. Fifty-three (53) VBDs were matched against 212 VCD. Unlike women who had VCD, those who underwent VBD were more likely to have prolonged labour (OR 8.05; 95% CI 3.00 to 11.47; P<0.001), and their newborns were more likely to suffer from birth asphyxia (OR 10.24; 95% CI 4.92 to 21.31; P<0.001). The study infers a strong association between VBD of singleton term pregnancies and maternofetal morbidity when specific protocols are applied. This, however, failed to translate into higher differences in perinatal mortality. This finding does not discount the role of VBD in low-income countries, but we emphasise the need for specific precautions like close monitoring of labour and adequate anticipation for neonatal resuscitation in order to reduce these complications. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly

  16. Breech repositioning unresponsive to Webster technique: coexistence of oligohydramnios.

    Science.gov (United States)

    Roecker, Christopher B

    2013-06-01

    The purpose of this report is to describe the results of a pregnant woman demonstrating breech fetal presentation who was managed with Webster technique in the presence of oligohydramnios. A 23-year-old primigravida woman sought chiropractic care for the management of breech presentation and bilateral sacroiliac arthralgia at 34 weeks' gestation. Sacral manipulation and abdominal effleurage (Webster Technique) was used to address breech presentation and sacroiliac arthralgia for a total of 7 treatments over a 3 1/2-week duration. The patient's sacroiliac pain reduced from 8/10 to 3/10. However, breech presentation was unchanged at each treatment. At a scheduled prenatal surveillance during the 37th week of gestation, the midwife detected vaginal bleeding and reduced fundal height, which resulted in hospitalization, diagnosis of oligohydramnios, and an emergency cesarean delivery. For this particular patient, the breech presentation was not corrected using the Webster technique. Clinicians who use the Webster technique to manage breech fetal presentation should be aware of undiagnosed comorbidities as a complicating factor in clinical presentation. Screening for previously undiagnosed comorbidities, such as oligohydramnios, must be considered.

  17. Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version

    Directory of Open Access Journals (Sweden)

    Papatsonis Dimitri N

    2010-05-01

    Full Text Available Abstract Background Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV and the Dutch Society for Obstetrics and Gynaecology (NVOG. Implementation of ECV does not exceed 50 to 60% and probably less. We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling. Method/design The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV. The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured. Discussion This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term. Trial

  18. Breech delivery at a University Hospital in Tanzania

    DEFF Research Database (Denmark)

    Högberg, Ulf; Claeson, Catrin; Krebs, Lone

    2016-01-01

    death (stillbirths + in-hospital neonatal deaths) and moderate asphyxia. Maternal outcomes, such as death, hemorrhage, and length of hospital stay, were also described. Results: The CD rate for breech presentation increased from 28 % in 1999 to 78 % in 2010. Perinatal deaths were associated with vaginal...... sound at admission, and absence of pregnancy-related complication as indication for CD. Of 2,765 mothers who had a breech delivery, 1,655 met the inclusion criteria. Analyses were stratified by mode of delivery, taking into account also other birth characteristics. The outcome measures were perinatal...... delivery (VD) (adjusted odds ratio (aOR) 6.2; 95 % confidence interval (CI) 3.0-12.6) and referral (aOR 2.1; 95 % CI 1.1-3.9), but not with parity, birth weight, or delivery year. Overall perinatal mortality was 5.8 % and this did not decline, due to an increase in stillbirths among vaginal breech...

  19. Breech preterm infants are at risk of developmental dysplasia of the hip.

    Science.gov (United States)

    Quan, Teddy; Kent, Alison L; Carlisle, Hazel

    2013-08-01

    There is uncertainty about the risk of developmental dysplasia of the hip (DDH) in breech preterm infants and therefore uncertainty about the benefits of using ultrasound screening in this population. The aim of this study was to determine if preterm infants born in the breech position are at risk of DDH. A retrospective audit of preterm and term infants born in the breech position was performed to determine the incidence of DDH. Group 1 included breech preterm infants (positive or negative for DDH. Three out of 129 (2.3%) preterm infants screened had DDH. For term infants, 3 out of 163 (1.8%) infants screened had DDH. The odds ratio for DDH in breech preterm infants compared with breech term infants was 1.27 (95% confidence interval 0.25 to 6.40). Preterm infants born in the breech position appear to have a similar incidence of DDH to term infants and thus require similar screening guidelines. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  20. The fact and the fiction: A prospective study of internet forum discussions on vaginal breech birth.

    Science.gov (United States)

    Petrovska, Karolina; Sheehan, Athena; Homer, Caroline S E

    2017-04-01

    Women with a breech baby late in pregnancy may use the internet to gather information to assist in decision-making for birth. The aim of this study was to examine how women use English language internet discussion forums to find out information about vaginal breech birth and to increase understanding of how vaginal breech birth is perceived among women. A descriptive qualitative study of internet discussion forums was undertaken. Google alerts were created with the search terms "breech birth" and "breech". Alerts were collected for a one-year period (January 2013-December 2013). The content of forum discussions was analysed using thematic analysis. A total of 50 forum discussions containing 382 comments were collected. Themes that arose from the data were: Testing the waters-which way should I go?; Losing hope for the chance of a normal birth; Seeking support for options-who will listen to me?; Considering vaginal breech birth-a risky choice?; Staying on the 'safe side'-caesarean section as a guarantee; Exploring the positive potential for vaginal breech birth. Women search online for information about vaginal breech birth in an attempt to come to a place in their decision-making where they feel comfortable with their birth plan. This study highlights the need for clinicians to provide comprehensive, unbiased information on the risks and benefits of all options for breech birth to facilitate informed decision-making for the woman. This will contribute to improving the woman's confidence in distinguishing between "the fact and the fiction" of breech birth discussions online. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  1. To what extent do the presentation of fetus, amniotic fluid index and fetal weight at term affect the cardiac axis?

    Science.gov (United States)

    Gultekin, Ismail Burak; Altınboga, Orhan; Karahanoglu, Ertugrul; Dogan, Nihan Guneri; Icer, Bilal; Alkan, Afra; Kucukozkan, Tuncay

    2016-01-01

    To analyse the change in cardiac axis with advancing gestational age and the factors that may affect it. 45 healthy pregnant women in 20th weeks of gestation were enrolled to the study. The cardiac axis was noted for each participant. The same group was once more assessed at term and the change in cardiac axis was calculated with the difference of cardiac axis at term and the 20th gestational weeks. Change in cardiac axis with advancing gestational weeks and factors that may affect it such as amniotic fluid index (AFI), estimated fetal weight (EFW) at term, actual birth weight and presentation of the fetus at term were evaluated. The median of ages was 28.0 (IQR=12.0)years within a range of 18-39years. The median of change in cardiac axis was 11.0 (IQR=9.0) degrees within a range of 3.0-47.0 degrees. The change in cardiac axis in regard to the fetal presenting part was 11.0 (IQR=8.0) degrees in vertex presentation and 23.50 (IQR=21.0) degrees in breech presentation. 81.1% of the variation in change in cardiac axis was found to be due to the actual birth weight and fetal presentation, with each 100g increase in actual birth weight leads to an increase of 0.375 degrees in cardiac axis. EFW at term, presentation of the fetus and the actual birth weight were all found to be significant in predicting the change in cardiac axis, but not AFI. These findings may have future potential value in evaluating electrocardiogram (ECG), especially of pregnants with extremes of left axis deviation (polyhydramnios, large fetus or breech presentation). Clinicians should be cautious during the interpretation of the ECG in pregnants, especially in those with extremes of left axis deviation because of either polyhydramnios, large fetus or breech presentation. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. A Rare Complication of a Vaginal Breech Delivery

    Directory of Open Access Journals (Sweden)

    H. C. Vergers-Spooren

    2011-01-01

    Full Text Available Rectal lesions without anal sphincter trauma in childbirth are only sporadically described in literature. We describe the case of a 29-year-old primigravida who delivered a child in frank breech presentation. During the second stage of labour a foot presented transanally through a rectal laceration with intact anal sphincters. The laceration was repaired immediately after delivery in theatre. Follow-up visits showed a properly cured laceration and no complaints of incontinence or foul discharge.

  3. Hypopituitarism in two brothers born by breech delivery.

    Science.gov (United States)

    del Rincón, J P; Lerman, I; Vázquez-Lamadrid, J; Gómez-Pérez, F J; Granados, J; Morales, J J; Mutchinick, O

    1999-01-01

    To describe two brothers with hypopituitarism who had been born by breech delivery and to discuss whether this condition corresponds to a familial form or to a pituitary stalk section as a result of the breech delivery. We present the clinical, biochemical, and magnetic resonance imaging (MRI) characteristics of two Mexican brothers, 19 and 21 years old, with hypopituitarism and a history of breech delivery. Physical examination of both patients showed short stature with normal body proportions, an obviously younger appearance than that expected for their chronologic age, high-pitched voice, irregularly positioned teeth, no axillary or pubic hair, and prepubertal genitalia. Biochemical testing showed low thyroxine and free thyroxine values with inadequate or normal thyrotropin, low basal testosterone, and mildly increased serum prolactin levels. Stimulation tests showed a normal and a delayed thyrotropin response to thyrotropin-releasing hormone, subnormal serum cortisol, considerably blunted growth hormone (GH) response to insulin-induced hypoglycemia, and absence of GH response to GH-releasing hormone in both cases. MRI showed an ectopic neuropituitary gland. In case 1, a caudal portion of a very thin pituitary stalk was observed, suggesting the preservation of a vascular component of the stalk. Because both parents of these brothers shared the major histocompatibility complex haplotype HLA-A*2301, B*3501, DRB1*0407, DQA1*03, DQB1*0201, consanguinity was suggested. The phenotype of these patients differs from that described in families with POU1F1 (Pit-1) and PROP1 mutations. These cases are most likely related to an autosomal recessive gene mutation that warrants further research. To our knowledge, this is the first report of hypopituitarism in two brothers born by breech delivery.

  4. ANAMNESTIC AND POPULATION CHARACTERISTICS OF THE BREECH DELIVERIES IN SUMADIJA REGION

    Directory of Open Access Journals (Sweden)

    Bozidar Jovanovic

    2008-04-01

    Full Text Available Breech presentation implies vertical position of the fetus, accounting for 3-4% of all monofetal deliveries. Perinatal morbidity and mortality are significantly higher in breech deliveries than in head presentation deliveries.The aim of the investigation was to examine the association between the anamnestic and population characteristics of the breech deliveries and the same characteristics in the head deliveries.Study group included 282 mothers who had breech deliveries and 282 mothers in control group who had head presentation deliveries. All the babies were delivered at the Clinic of Obstetrics and Gyneclogy Kragujevac.The population sample - the subject of the study encompassed mothers from Sumadija region with the center in Kragujevac as the capital and biggest city in the region.Distribution of probabilities according to profession or education of mothers was similar in both groups. The mean age of the mothers in both groups was 26.8 years. Significantly, the largest number of mothers from both groups was between 20 and 29 years of age, e.g. 70 %.With significantly high probability, the pregnancy progression in both groups was positive (85%, without maintaining pregnancy. The presence of associated disease was significantly higher, especially hypertension and diabetes in mothers who had breech deliveries compared to mothers who had head presentation deliveries.

  5. Elective cesarean delivery for term breech

    DEFF Research Database (Denmark)

    Krebs, Lone; Langhoff-Roos, Jens

    2003-01-01

    and anemia (RR 0.91; 95% CI 0.84, 0.97), and operations for wound infection (RR 0.69; 95% CI 0.57, 0.83) than emergency cesarean delivery. There was a higher rate of puerperal fever and pelvic infection (RR 1.20; 95% CI 1.11, 1.25) than for vaginal delivery. Thromboembolic disease occurred in 0.1% of women...... with cesarean delivery, and anal sphincter rupture occurred in 1.7% of women with vaginal delivery. Elective cesarean delivery was not associated with subsequent ectopic pregnancy, miscarriage, placental complications, uterine rupture, or adverse neonatal outcome. Women with elective cesarean delivery were more...... often delivered by elective cesarean in their second pregnancy, compared with women delivered vaginally (RR 1.25; 95% CI 1.21, 1.29). Elective cesarean delivery was associated with a lower rate of a subsequent delivery during the study period and a longer mean delivery interval than for vaginal delivery...

  6. Supporting Women Planning a Vaginal Breech Birth: An International Survey.

    Science.gov (United States)

    Petrovska, Karolina; Watts, Nicole P; Catling, Christine; Bisits, Andrew; Homer, Caroline S E

    2016-12-01

    The aim of this study was to explore the experiences of women who planned a vaginal breech birth. An online survey was developed consisting of questions regarding women's experiences surrounding planned vaginal breech birth. The survey was distributed between April 2014 and January 2015 to closed membership Facebook groups that had a consumer focus on vaginal breech birth. In total, 204 unique responses to the survey were obtained from women who had sought the option of a vaginal breech birth in a previous pregnancy. Most women (80.8%) stated that they were happy with the birth choices they made, and a significant proportion (89.4%) would attempt a vaginal breech birth in subsequent pregnancies. Less than half of women were formally referred to a clinician skilled in vaginal breech birth when their baby was diagnosed breech (41.8%), while the remainder sourced a clinician themselves. Half of the women felt supported by their care provider (56.7%) and less than half (42.3%) felt supported by family and friends. The women who responded to this international survey sought the option of a vaginal breech birth, were subsequently happy with this decision, and would attempt a vaginal breech birth in their next pregnancy. Access to vaginal breech birth is important for some women; however, this choice may be challenging to achieve. Consistent information and support from clinicians is important to assist decision-making. © 2016 Wiley Periodicals, Inc.

  7. Delivery presentations

    Science.gov (United States)

    ... is delivered under the pubic bone. After the shoulder, the rest of the body is usually delivered without a problem. Alternative Names Shoulder presentation; Malpresentations; Breech birth; Cephalic presentation; Fetal lie; ...

  8. Revisiting the mode of delivery and outcome of singleton breech ...

    African Journals Online (AJOL)

    Assisted vaginal breech delivery was associated wilh high rate of low Apgar score (score <7) at the 5th minute when compared 10 elective caesarean section (p = 0,000088). There was an increased rate of special care baby unit admission in the group that had assisted vaginal breech delivery than in those that had elective ...

  9. The Effect of Variable Composition Equilibrium Thermochemistry in Constant Breech Pressure (CBP) Gun Simulations

    Science.gov (United States)

    2014-01-01

    The Effect of Variable Composition Equilibrium Thermochemistry in Constant Breech Pressure (CBP) Gun Simulations by Anthony J. Kotlar...Effect of Variable Composition Equilibrium Thermochemistry in Constant Breech Pressure (CBP) Gun Simulations Anthony J. Kotlar Weapons and...May 1995 4. TITLE AND SUBTITLE The Effect of Variable Composition Equilibrium Thermochemistry in Constant Breech Pressure (CBP) Gun Simulations 5a

  10. The effects of the term breech trial on vaginal breech delivery 8 years on

    LENUS (Irish Health Repository)

    Hehir, MP

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2011

  11. [Neonatal outcome after a planned vaginal breech birth: no association with parity or birth weight, but more birth injuries than in planned cesarean section].

    Science.gov (United States)

    Brouwer, W K; Veenstra van Nieuwenhoven, A L; Santema, J G

    2001-08-11

    To investigate if in a planned vaginal breech delivery parity or birthweight is associated with neonatal outcome. Retrospective analysis of local data from the National Obstetric Registration of the Netherlands. The study concerned outcomes of 516 births of singletons with breech presentation after pregnancies > 37 weeks in the period 1 January 1995 to 31 December 1999 at the Medical Centre Leeuwarden, the Netherlands; there were 448 planned vaginal breech deliveries. Nulliparous and multiparous were separately studied in four birthweight groups ( or = 4000 g). None of the neonates born by primary caesarean experienced birth trauma. In the group with planned vaginal breech delivery 2% of the neonates of nulliparous and 3% of multiparous mothers experienced neonatal morbidity. There was one case of perinatal mortality due to birth trauma (0.2%). The total perinatal morbidity was 6% with no differences between nulliparae and multiparae and between the birthweight groups. In nulliparous, the percentage of emergency caesarean sections rose from 20% in the or = 4000 g birthweight group. Following a planned vaginal breech delivery, no differences were observed in neonatal outcome between nulliparous and multiparous women and between the four birthweight groups. The extent to which the figures were influenced by the selection for primary caesarean section is not clear.

  12. caesarean section in the management of singleton breech delivery ...

    African Journals Online (AJOL)

    J. Udoma, **A. D. Ekanem. Department 0f*()hstetrics andGynaecology, University ofUyo Teaching Hospital, UyoAkwa Ibom State w University afCalabar Teaching Hospital, Calabar, Nigeria . ABSTRACT,. Objective: To establish the role of Caesarean section in reducing perinatal mortality following singleton breech delivery ...

  13. Outcome of Singleton Breech Delivery in Wesley Guild Hospital ...

    African Journals Online (AJOL)

    Context: Singleton breech delivery in many developing countries is often associated with poor reproductive outcome largely because of increased perinatal morbidity and mortality. Objective: The aim of this study is to evaluate the impact of antenatal care and delivery in a specialist care unit on fetal outcome in singleton ...

  14. Delivery mode and neonatal outcome after a trial of external cephalic version (ECV): a prospective trial of vaginal breech versus cephalic delivery.

    Science.gov (United States)

    Reinhard, Joscha; Sänger, Nicole; Hanker, Lars; Reichenbach, Lena; Yuan, Juping; Herrmann, Eva; Louwen, Frank

    2013-04-01

    To examine the delivery mode and neonatal outcome after a trial of external cephalic version (ECV) procedures. This is an interim analysis of an ongoing larger prospective off-centre randomised trial, which compares a clinical hypnosis intervention against neuro-linguistic programming (NLP) of women with a singleton breech foetus at or after 37(0/7) (259 days) weeks of gestation and normal amniotic fluid index. Main outcome measures were delivery mode and neonatal outcome. On the same day after the ECV procedure two patients (2 %), who had unsuccessful ECVs, had Caesarean sections (one due to vaginal bleeding and one due to pathological CTG). After the ECV procedure 40.4 % of women had cephalic presentation (n = 38) and 58.5 % (n = 55) remained breech presentation. One patient remained transverse presentation (n = 1; 1.1 %). Vaginal delivery was observed by 73.7 % of cephalic presentation (n = 28), whereas 26.3 % (n = 10) had in-labour Caesarean sections. Of those, who selected a trial of vaginal breech delivery, 42.4 % (n = 14) delivered vaginally and 57.6 % (n = 19) delivered via Caesarean section. There is a statistically significant difference between the rate of vaginal birth between cephalic presentation and trial of vaginal breech delivery (p = 0.009), however, no difference in neonatal outcome was observed. ECV is a safe procedure and can reduce not only the rate of elective Caesarean sections due to breech presentation but also the rate of in-labour Caesarean sections even if a trial of vaginal breech delivery is attempted.

  15. Morbidity and mortality associated with mode of delivery for breech periviable deliveries.

    Science.gov (United States)

    Tucker Edmonds, Brownsyne; McKenzie, Fatima; Macheras, Michelle; Srinivas, Sindhu K; Lorch, Scott A

    2015-07-01

    The purpose of this study was to estimate the odds of morbidity and death that are associated with cesarean delivery, compared with vaginal delivery, for breech fetuses who are delivered from 23-24 6/7 weeks' gestational age. We conducted a retrospective cohort study of state-level maternal and infant hospital discharge data that were linked to vital statistics for breech deliveries that occurred from 23-24 6/7 weeks' gestation in California, Missouri, and Pennsylvania from 2000-2009 (N = 1854). Analyses were stratified by gestational age (23-23 6/7 vs 24-24 6/7 weeks' gestation). Cesarean delivery was performed for 46% (335 fetuses) and 77% (856 fetuses) of 23- and 24-week breech fetuses. In multivariable analyses, overall survival was greater for cesarean-born neonates (adjusted odds ratio [AOR], 3.98; 95% confidence interval [CI], 2.24-7.06; AOR, 2.91; 95% CI, 1.76-4.81, respectively). When delivered for nonemergent indications, cesarean-born survivors were more than twice as likely to experience major morbidity (intraventricular hemorrhage, bronchopulmonary dysplasia, necrotizing enterocolitis, asphyxia composite; AOR, 2.83; 95% CI, 1.37-5.84; AOR, 2.07; 95% CI, 1.11-3.86 at 23 and 24 weeks' gestation, respectively). Among intubated neonates, despite a short-term survival advantage, there was no difference in survival to >6-month corrected age (AOR, 1.77; 95% CI, 0.83-3.74; AOR, 1.50; 95% CI, 0.81-2.76, respectively). There was no difference in survival for intubated 23-week neonates who were delivered by cesarean for nonemergent indications or cesarean-born neonates who weighed morbidity for breech periviable neonates. However, among intubated neonates, despite a short-term survival advantage, there was no difference in 6-month survival. Also, cesarean delivery did not increase survival for neonates who weighed morbidity, maternal morbidity, and implications for future pregnancies. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Retention of Vaginal Breech Delivery Skills Taught in Simulation.

    Science.gov (United States)

    Stone, Heather; Crane, Joan; Johnston, Kathy; Craig, Catherine

    2018-02-01

    The optimal frequency of conducting simulation training for high-acuity, low-frequency events in obstetrics and gynaecology residency programs is unknown. This study evaluated retention over time of vaginal breech delivery skills taught in simulation, by comparing junior and senior residents. In addition, the residents' subjective comfort level to perform this skill clinically was assessed. This prospective cohort study included 22 obstetrics and gynaecology residents in a Canadian residency training program. Digital recordings were completed for pre-training, immediate post-training, and delayed (10-26 weeks later) post-training intervals of a vaginal breech delivery simulation, with skill assessment by a blinded observer using a binary checklist. Residents also completed questionnaires to assess their subjective comfort level at each interval. Junior and senior residents had significant improvements in vaginal breech delivery skills from the pre-training assessment to both the immediate post-training assessment (junior, P simulation 10-26 weeks later, although a decline in skills occurred over this time period. Comfort level was positively affected and retained. These results will aid in determining the frequency of simulation teaching for high-acuity, low-frequency events in a residency simulation curriculum. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  17. 16 CFR 303.18 - Terms implying fibers not present.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Terms implying fibers not present. 303.18... RULES AND REGULATIONS UNDER THE TEXTILE FIBER PRODUCTS IDENTIFICATION ACT § 303.18 Terms implying fibers... designation of a fiber which is not present in the product, (b) which are phonetically similar to the name or...

  18. Breech delivery at term in Denmark, 1982-92

    DEFF Research Database (Denmark)

    Krebs, L; Langhoff-Roos, J

    1999-01-01

    ,476) in Denmark, 1982-92, a review of medical records of all (n = 218) cases with Apgar score deaths and 412 controls, was performed. Planned vaginal delivery was associated with a 15 times greater risk of low Apgar score than elective Caesarean section...

  19. Breech deliveries in Usmanu Danfodiyo University Teaching Hospital Sokoto, Northwestern Nigeria: A 10-year review

    Directory of Open Access Journals (Sweden)

    Karima Tunau

    2013-01-01

    Full Text Available Background: Breech delivery is a major issue in obstetric practice mainly because of the high perinatal morbidity and mortality associated with it. The aims of the study are to determine the prevalence management and perinatal outcome of singleton breech deliveries in our center. Materials and Methods: A retrospective study involving 395 singleton breech deliveries out of 24,160 deliveries conducted at the Usmanu Danfodiyo University Teaching Hospital Sokoto, Sokoto, over a 10-year (2001-2010 period. Results: The prevalence rate of singleton breech delivery was 1.7%. Breech deliveries occurred more in the primigravidae. Most babies (69.1% had vaginal delivery. There was a high caesarean section (CS rate of 30.9%. Babies delivered by CS had better Apgar scores than those delivered through the vagina (P < 0.05. The perinatal mortality rate in breech deliveries (410/1000 was significantly higher than that (101.5/10000 in their cephalic counterparts (P < 0.05. Similarly, perinatal deaths were more common in unbooked than in booked patients (P < 0.05. Conclusion: Breech delivery was frequent in the study population. Singleton breech delivered by CS had better outcome than those who were delivered through the vagina.

  20. Traumatic Distal Femoral Periostitis of the Newborn: A Breech Delivery Birth Injury

    Science.gov (United States)

    Rutherford, Yvonne; Fomufod, Antoine K.; Gopalakrishnan, Lalapet J.; Beeks, Earl C.

    1983-01-01

    Traumatic femoral epiphyseal periostitis is a rare complication of breech delivery by cesarean section. The clinical course and management of a case of distal femoral periostitis recently encountered by the authors is discussed. ImagesFigure 1 PMID:6644835

  1. Deliberate acquisition of competence in physiological breech birth: A grounded theory study.

    Science.gov (United States)

    Walker, Shawn; Scamell, Mandie; Parker, Pam

    2017-09-29

    Research suggests that the skill and experience of the attendant significantly affect the outcomes of vaginal breech births, yet practitioner experience levels are minimal within many contemporary maternity care systems. Due to minimal experience and cultural resistance, few practitioners offer vaginal breech birth, and many practice guidelines and training programmes recommend delivery techniques requiring supine maternal position. Fewer practitioners have skills to support physiological breech birth, involving active maternal movement and choice of birthing position, including upright postures such as kneeling, standing, squatting, or on a birth stool. How professionals learn complex skills contrary to those taught in their local practice settings is unclear. How do professionals develop competence and expertise in physiological breech birth? Nine midwives and five obstetricians with experience facilitating upright physiological breech births participated in semi-structured interviews. Data were analysed iteratively using constructivist grounded theory methods to develop an empirical theory of physiological breech skill acquisition. Among the participants in this research, the deliberate acquisition of competence in physiological breech birth included stages of affinity with physiological birth, critical awareness, intention, identity and responsibility. Expert practitioners operating across local and national boundaries guided less experienced practitioners. The results depict a specialist learning model which could be formalised in sympathetic training programmes, and evaluated. It may also be relevant to developing competence in other specialist/expert roles and innovative practices. Deliberate development of local communities of practice may support professionals to acquire elusive breech skills in a sustainable way. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  2. Objective Evaluation of Subclass Characteristics on Breech Face Marks.

    Science.gov (United States)

    Riva, Fabiano; Hermsen, Rob; Mattijssen, Erwin; Pieper, Pascal; Champod, Christophe

    2017-03-01

    Subclass characteristics can be found on the breech face marks left on spent cartridge cases. Even if they are assumed to be rare and their reported number is small, they can potentially lead to false associations. Subclass characteristics have been studied empirically allowing examiners to recognize them and to understand in which conditions they are produced. Until now, however, their influence on the identification process has not been studied from a probabilistic point of view. In this study, we aim at measuring the effect of these features on the strength of association derived from examinations involving subclass characteristics. The study takes advantage of a 3D automatic comparison system allowing the calculation of likelihood ratios (LRs). The similarities between cartridge case specimens fired by thirteen S&W .40S&W Sigma pistols are quantified, and their respective LRs are computed. The results show that the influence of subclass characteristics on the LRs is limited, even when these features are prevalent among the potential sources considered in a case. We show that the proportion of firearms sharing subclass characteristics should be larger than 40% of the pool of potential firearms for the effect to be significant. © 2016 American Academy of Forensic Sciences.

  3. Acute mastoiditis in children: presentation and long term consequences.

    LENUS (Irish Health Repository)

    Glynn, F

    2008-03-01

    Acute mastoiditis, a destructive bacterial infection of the mastoid bone and air cell system, is relatively uncommon today but remains a potentially serious condition. There is a lack of information in the literature regarding the long term otological problems that children may face following an episode of this condition.

  4. The effect of intra-uterine breech position on postnatal motor functions of the lower limbs

    NARCIS (Netherlands)

    Sival, D A; Prechtl, H F; Sonder, G H; Touwen, B C

    The effect of intra-uterine movement restriction on the development of motor functions was studied longitudinally by comparing infants born after uncomplicated breech position (n = 13) with control infants (vertex position, n = 5-10). Before birth, fetal leg posture was studied at regular intervals

  5. Genetic relationships between dagginess, breech bareness, and wool traits in New Zealand dual-purpose sheep.

    Science.gov (United States)

    Pickering, N K; Blair, H T; Hickson, R E; Dodds, K G; Johnson, P L; McEwan, J C

    2013-10-01

    Genetic and phenotypic parameters were estimated for dagginess, breech, wool, and fiber traits from approximately 29,500 progeny born in 2009 and 2010 in New Zealand dual-purpose ram breeding sheep flocks. Dagginess is adherence of fecal matter to the wool, and this study investigates the genetic and phenotypic correlations between dagginess and breech and wool traits. Estimates for heritability were moderate (0.21 to 0.44) for the following traits: dag score at 3 and 8 mo (DAG3, DAG8), breech bareness, wool length, wool bulk (BULK), mean fiber diameter, mean fiber diameter SD, mean fiber diameter CV, curvature (CURV), weaning weight at 3 mo, and autumn BW. Heritability estimates for fleece weight at 12 mo and proportion of medullated fibers were high (0.49 and 0.53, respectively). Dag score at 3 mo and DAG8 had low genetic and phenotypic correlations with all traits. Breech bareness had positive genetic and phenotypic correlations with CURV and BULK and mostly negative genetic correlations with all other wool traits. In summary the quantity and attributes of wool were not primary causative factors in fecal accumulation, leaving fecal consistency and composition as the major factors.

  6. Ultrasound Examination for Infants Born Breech by Elective Cesarean Section With a Normal Hip Exam for Instability.

    Science.gov (United States)

    Pacana, Matthew J; Hennrikus, William L; Slough, Jennifer; Curtin, William

    2017-01-01

    Because of the risk of developmental dysplasia of the hip in infants born breech-despite a normal physical exam-the American Academy of Pediatrics (AAP) guidelines recommend ultrasound (US) hip imaging at 6 weeks of age for breech females and optional imaging for breech males. The purpose of this study is to report US results and follow-up of infants born breech with a normal physical exam. The electronic medical record for children born at 1 hospital from 2008 to 2011 was reviewed. Data were analyzed for sex, birth weight, breech position, birth order, ethnicity, US and x-ray results, follow-up, and cost. A total of 237 infants were born breech with a normal physical examination, all delivered by cesarean section. Of the infants, 55% were male and 45% female. About 151 breech infants (64%) with a normal Barlow and Ortolani exam had a precautionary hip US as recommended by the AAP performed at an average of 7 weeks of age. Eighty-six breech infants (35%) did not have an US and were followed clinically. Of the 151 infants that had an US, 140 (93%) were read as normal. None had a dislocated hip. Two patients had a normal physical exam but laxity on US. These 2 patients were the only infants treated in a Pavlik harness. A pediatric orthopaedic surgeon followed those with subtle US findings and no laxity until normal. The decision by the AAP to recommend US screening at 6 weeks of age for infants with a normal physical exam but breech position was based on an extensive literature review and expert opinion. Not all pediatricians are following the AAP guidelines. The decision to perform an US should be done on a case-by-case basis by the examining physician. A more practical, cost-effective strategy would be to skip the US if the physical exam is normal and simply obtain an AP pelvis x-ray at 4 months. Level III-this is a case-control study investigating the outcomes of infants on data drawn from the electronic medical record.

  7. Effects of age, gender, and stimulus presentation period on visual short-term memory.

    Science.gov (United States)

    Kunimi, Mitsunobu

    2016-01-01

    This study focused on age-related changes in visual short-term memory using visual stimuli that did not allow verbal encoding. Experiment 1 examined the effects of age and the length of the stimulus presentation period on visual short-term memory function. Experiment 2 examined the effects of age, gender, and the length of the stimulus presentation period on visual short-term memory function. The worst memory performance and the largest performance difference between the age groups were observed in the shortest stimulus presentation period conditions. The performance difference between the age groups became smaller as the stimulus presentation period became longer; however, it did not completely disappear. Although gender did not have a significant effect on d' regardless of the presentation period in the young group, a significant gender-based difference was observed for stimulus presentation periods of 500 ms and 1,000 ms in the older group. This study indicates that the decline in visual short-term memory observed in the older group is due to the interaction of several factors.

  8. Short term memory bowing effect is consistent with presentation rate dependent decay.

    Science.gov (United States)

    Tarnow, Eugen

    2010-12-01

    I reanalyze the free recall data of Murdock, J Exp Psychol 64(5):482-488 (1962) and Murdock and Okada, J Verbal Learn and Verbal Behav 86:263-267 (1970) which show the famous bowing effect in which initial and recent items are recalled better than intermediate items (primacy and recency effects). Recent item recall probabilities follow a logarithmic decay with time of recall consistent with the tagging/retagging theory. The slope of the decay increases with increasing presentation rate. The initial items, with an effectively low presentation rate, decay with the slowest logarithmic slope, explaining the primacy effect. The finding that presentation rate limits the duration of short term memory suggests a basis for memory loss in busy adults, for the importance of slow music practice, for long term memory deficiencies for people with attention deficits who may be artificially increasing the presentation rates of their surroundings. A well-defined, quantitative measure of the primacy effect is introduced.

  9. Compound presentation in labour: highlighting the importance of ...

    African Journals Online (AJOL)

    Objective: To describe the occurrence of compound presentation in labour, as an obstetric emergency. Background: Compound presentation is a rare obstetric event, defined as the presentation of the hand or foot alongside the head or breech. It places both mother and baby at severe risk. The presence of skilled attendants ...

  10. Lipoprotein lipase deficiency due to long-term heparinization presenting as severe hypertriglyceridaemia in pregnancy.

    OpenAIRE

    Watts, G F; Cameron, J; Henderson, A; Richmond, W.

    1991-01-01

    A case of severe hypertriglyceridaemia presenting in the third trimester of pregnancy in a woman on long-term heparin prophylaxis is described. The hypertriglyceridaemia was attributed to impaired clearance of triglyceride-rich lipoprotein particles secondary to heparin-induced reduction in the activity of the lipolytic enzyme, lipoprotein lipase.

  11. Political Youth Education in Germany. Presenting a Qualitative Study on Its Biographically Long-Term Effects

    Science.gov (United States)

    Balzter, Nadine; Ristau, Yan; Schröder, Achim

    2017-01-01

    Purpose: There is an impact analysis presented, which explores the long-term effect of extra-curricular political youth education from the perspective of participants. Methods: The former participants retell their own education and life stories about five years later. Life stories were then interpreted in the course of research workshops and…

  12. Presentation

    Directory of Open Access Journals (Sweden)

    Eduardo Vicente

    2013-06-01

    Full Text Available In the present edition of Significação – Scientific Journal for Audiovisual Culture and in the others to follow something new is brought: the presence of thematic dossiers which are to be organized by invited scholars. The appointed subject for the very first one of them was Radio and the invited scholar, Eduardo Vicente, professor at the Graduate Course in Audiovisual and at the Postgraduate Program in Audiovisual Media and Processes of the School of Communication and Arts of the University of São Paulo (ECA-USP. Entitled Radio Beyond Borders the dossier gathers six articles and the intention of reuniting works on the perspectives of usage of such media as much as on the new possibilities of aesthetical experimenting being build up for it, especially considering the new digital technologies and technological convergences. It also intends to present works with original theoretical approach and original reflections able to reset the way we look at what is today already a centennial media. Having broadened the meaning of “beyond borders”, four foreign authors were invited to join the dossier. This is the first time they are being published in this country and so, in all cases, the articles where either written or translated into Portuguese.The dossier begins with “Radio is dead…Long live to the sound”, which is the transcription of a thought provoking lecture given by Armand Balsebre (Autonomous University of Barcelona – one of the most influential authors in the world on the Radio study field. It addresses the challenges such media is to face so that it can become “a new sound media, in the context of a new soundscape or sound-sphere, for the new listeners”. Andrew Dubber (Birmingham City University regarding the challenges posed by a Digital Era argues for a theoretical approach in radio studies which can consider a Media Ecology. The author understands the form and discourse of radio as a negotiation of affordances and

  13. Reverse breech extraction versus the standard approach of pushing the impacted fetal head up through the vagina in caesarean section for obstructed labour: A randomised controlled trial.

    Science.gov (United States)

    Nooh, Ahmed Mohamed; Abdeldayem, Hussein Mohammed; Ben-Affan, Othman

    2017-05-01

    The objective of this study was to assess effectiveness and safety of the reverse breech extraction approach in Caesarean section for obstructed labour, and compare it with the standard approach of pushing the fetal head up through the vagina. This randomised controlled trial included 192 women. In 96, the baby was delivered by the 'reverse breech extraction approach', and in the remaining 96, by the 'standard approach'. Extension of uterine incision occurred in 18 participants (18.8%) in the reverse breech extraction approach group, and 46 (47.9%) in the standard approach group (p = .0003). Two women (2.1%) in the reverse breech extraction approach group needed blood transfusion and 11 (11.5%) in the standard approach group (p = .012). Pyrexia developed in 3 participants (3.1%) in the reverse breech extraction approach group, and 19 (19.8%) in the standard approach group (p = .0006). Wound infection occurred in 2 women (2.1%) in the reverse breech extraction approach group, and 12 (12.5%) in the standard approach group (p = .007). Apgar score vagina.

  14. Term pregnancy with choriocarcinoma presenting as severe fetal anemia and postpartum hemorrhage.

    Science.gov (United States)

    Peng, Hsiu-Huei; Ng, Zooi-Ping; Tang, Yun-Hsin; Chua, Angelica Anne A; Huang, Kuan-Gen

    2016-06-01

    Term pregnancy with choriocarcinoma is a rare condition that can be a serious health threat to both the mother and the fetus. We present a rare case of term pregnancy with choriocarcinoma presenting as severe fetal anemia and postpartum hemorrhage. A 34-year-old woman, gravida 3 para 2, was admitted for profuse vaginal bleeding 2 weeks after cesarean delivery of a full-term anemic baby. Transvaginal sonography revealed a 4.7-cm×10.6-cm heterogenous lesion in the endometrial cavity. Dilatation and curettage was done and a pathologic report revealed choriocarcinoma. Metastatic workup showed lung metastasis. The patient achieved remission after eight cycles of chemotherapy in the form of etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine. There was no evidence of recurrence in the subsequent 3 years of regular follow up. Although fetomaternal hemorrhage is a rare form of presentation of choriocarcinoma, its presence should alert the physician to investigate the cause further. This chemotherapy regimen was effective in our case and the patient needed to be followed up carefully. Copyright © 2016. Published by Elsevier B.V.

  15. Predictors of success of external cephalic version and cephalic presentation at birth among 1253 women with non-cephalic presentation using logistic regression and classification tree analyses.

    Science.gov (United States)

    Hutton, Eileen K; Simioni, Julia C; Thabane, Lehana

    2017-08-01

    Among women with a fetus with a non-cephalic presentation, external cephalic version (ECV) has been shown to reduce the rate of breech presentation at birth and cesarean birth. Compared with ECV at term, beginning ECV prior to 37 weeks' gestation decreases the number of infants in a non-cephalic presentation at birth. The purpose of this secondary analysis was to investigate factors associated with a successful ECV procedure and to present this in a clinically useful format. Data were collected as part of the Early ECV Pilot and Early ECV2 Trials, which randomized 1776 women with a fetus in breech presentation to either early ECV (34-36 weeks' gestation) or delayed ECV (at or after 37 weeks). The outcome of interest was successful ECV, defined as the fetus being in a cephalic presentation immediately following the procedure, as well as at the time of birth. The importance of several factors in predicting successful ECV was investigated using two statistical methods: logistic regression and classification and regression tree (CART) analyses. Among nulliparas, non-engagement of the presenting part and an easily palpable fetal head were independently associated with success. Among multiparas, non-engagement of the presenting part, gestation less than 37 weeks and an easily palpable fetal head were found to be independent predictors of success. These findings were consistent with results of the CART analyses. Regardless of parity, descent of the presenting part was the most discriminating factor in predicting successful ECV and cephalic presentation at birth. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  16. Long-term marriage patterns in the United States from colonial times to the present.

    Science.gov (United States)

    Haines, M R

    1996-01-01

    The author presents an overview of long-term trends in U.S. nuptiality. "Marriage in colonial North America was notable for being early (for women) and marked by low percentages never marrying.... Between 1800 and the present there have been long cycles in nuptiality. Since about 1800, female age at first marriage rose from relatively low levels to a peak around 1900. Thereupon a gradual decline commenced with a trough being reached about 1960 at the height of the baby boom. There then began another, and rapid, upswing in female marriage age. Proportions never married at ages 45-54 replicated these cycles with a lag of about 20-30 years. Since 1880 (when comprehensive census data became available), male nuptiality patterns have generally paralleled those of women. Male marriage ages were higher than those of females with proportions never marrying also usually higher." excerpt

  17. Long-Term Cardiovascular Outcomes In Patients With Angina Pectoris Presenting With Bundle Branch Block

    Science.gov (United States)

    Bansilal, Sameer; Aneja, Ashish; Mathew, Verghese; Reeder, Guy S.; Smars, Peter A.; Lennon, Ryan J.; Wiste, Heather J.; Traverse, Kay; Farkouh, Michael E.

    2011-01-01

    The long-term outcomes of unselected patients with angina pectoris and a bundle branch block (BBB) on the initial electrocardiogram are not well established. The Olmsted County Chest Pain Study is a community-based cohort of 2271 consecutive patients presenting to three Olmsted County emergency departments with angina from 1985 to 1992. Patients were followed for major adverse cardiovascular events (MACE) including death, myocardial infarction, stroke and revascularization at 30 days and over a median follow-up period of 7.3 years and for mortality only through a median of 16.6 years. Cox models were used to estimate the associations between bundle branch block and cardiovascular outcomes. The mean age of the cohort on presentation was 63 years, with 58% men. MACE at 30 days occurred in 11% with RBBB, 8.8 % with LBBB and 6.4 % in patients without BBB (p=0.17). Over a median follow-up of 7.3 years, patients with BBB were at higher risk for MACE (RBBB HR 1.85, 95% CI 1.44–2.38; p<0.001 and LBBB HR 2.04, 95% CI 1.62–2.56; p<0.001) compared to those without BBB. Over a median of 16.6 years, both BBB groups had lower survival rates than patients without BBB (RBBB HR 2.19, 95% CI 1.73–2.78; p<0.001 and LBBB HR 3.32, 95% CI 2.67–4.13; p ≤ 0.001), but after adjustment for multiple risk factors, an increased risk of mortality for LBBB remained significant. In conclusion, the appearance of LBBB or RBBB in patients presenting with angina predicts adverse long-term cardiovascular outcomes compared to patients without BBB. PMID:21439535

  18. Cardiac paraganglioma: clinical presentation, diagnostic approach and factors affecting short and long-term outcomes.

    Science.gov (United States)

    Khan, Muhammad Fahad; Datta, Subhajit; Chisti, Mohammad Muhsin; Movahed, Mohammad Reza

    2013-06-20

    We describe our experience of the case of a young female who presented with chest pain and was found to have an intra-pericardial mass that was later confirmed to be a paraganglioma. Although preoperative magnetic resonance imaging (MRI) did not show any left atrial invasion, the patient died in the peri-operative period due to irreparable damage of the cardiac structures from extensive neoplastic invasion. We then performed a retrospective analysis of the available literature to find the factors associated with adverse surgical and long-term outcomes in patients with cardiac paraganglioma. We found 93 case reports of cardiac and/or pericardial paragangliomas in the literature. After exclusions, 82 cases were included in the final analysis. The patients were divided into two groups based on the outcome of surgical management. Univariate analysis was performed using SPSS software (Chicago, IL version 18), and the statistical significance was defined as a p-valueparameters between the deceased and the surviving patients revealed that only the intra-cardiac location (p-value=0.021) and the development of metastases (p-valuestructures does not appear to affect short-or long-term survival in these patients. The Kaplan-Meier survival curve showed excellent long-term prognosis for patients with a complete surgical removal of the neoplasm. Based on our experience, we also suggest preoperative imaging with a three dimensional cardiac CT and evaluation for cardiac transplantation before embarking on the surgical resection of these tumors. Published by Elsevier Ireland Ltd.

  19. Endemic Burkitt Lymphoma: Long-term Outcome in 87 Patients Who Presented With Paraplegia in Cameroon.

    Science.gov (United States)

    Hesseling, P B; Mbah, G; Kouya, F; Kimbi, C; Nfor, P; Kaah, J; Kuruvilla, R; Best, A; Wharin, P

    2015-01-01

    The reported long-term outcome of endemic Burkitt lymphoma (eBL) patients who present with paraplegia is largely unknown. Records of BL patients treated with comparable short-interval cyclophosphamide chemotherapy schedules between 2004 and 2014 at three Baptist mission hospitals in Cameroon were reviewed. Survivors were followed up and examined at home or in hospital. Eighty-seven of 948 (9.2%) patients had paraplegia at diagnosis. The survival rate in eBL patients with paraplegia at diagnosis was 33% (n = 29) after follow-up of between 2 and 96 (median 40) months. Seven patients (24%) had neurological sequelae and needed rehabilitation. There was no relationship between the duration of symptoms (4 weeks) and the survival rate or the risk to have neurological sequelae. The survival rate and risk for sequelae were similar in patients with confirmed St. Jude stage III and IV diseases.

  20. Parotid small cell carcinoma presenting with long-term survival after surgery alone: a case report

    Directory of Open Access Journals (Sweden)

    Kanazawa Takeharu

    2012-12-01

    Full Text Available Abstract Introduction Primary involvement of the salivary glands in small cell carcinoma is rare, and has one of the worst prognoses of salivary gland neoplasms. However, it has been reported that some cases have a favorable outcome, although the prognostic factors are still under consideration. Multidisciplinary therapy was usually required to achieve long-term survival. Recently, a resemblance of some small cell carcinomas of the salivary gland to cutaneous Merkel cell carcinoma was suggested; the latter have the potential for spontaneous regression, which is related to a favorable clinical outcome. Case presentation We present a locoregional advanced parotid small cell carcinoma with multiple lymph node metastases in an 87-year-old Asian woman. The tumor was controlled by surgery alone, and nine-year disease-free survival was achieved without any adjunctive therapy. To the best of our knowledge, this is the longest reported follow-up of head and neck small cell carcinoma. Conclusion We believe this to be the first case of small cell carcinoma with involvement of the salivary glands reported in the literature with a good outcome after surgery alone without any adjunctive therapy.

  1. Characteristics and Long-Term Prognosis of Holocaust Survivors Presenting with Acute Myocardial Infarction.

    Science.gov (United States)

    Shiyovich, Arthur; Plakht, Ygal; Belinski, Katya; Gilutz, Harel

    2016-05-01

    Catastrophic life events are associated with the occurrence of cardiovascular incidents and worsening of the clinical course followirg-such events. To evaluate the characteristics and long-term prognosis of Holocaust survivors presenting with acute myocardial infarction (AMI) compared to non-Holocaust survivors. Israeli Jews who were born before 1941 and had been admitted to a tertiary medical center due to AMI during the period 2002-2012 were studied. Holocaust survivors were compared with non-Holocaust survivor controls using individual age matching. Overall 305 age-matched pairs were followed for up to 10 years after AMI. We found a higher prevalence of depression (5.9% vs. 3.3%, P = 0.045) yet a similar rate of cardiovascular risk factors, non-cardiovascular co-morbidity, severity of coronary artery disease, and in-hospital complications in survivors compared to controls. Throughout the follow-up period, similar mortality rates (62.95% vs. 63.9%, P = 0.801) and reduced cumulative mortality (0.9 vs. 0.96, HR = 0.780, 95% CI 0.636-0.956, P = 0.016) were found among survivors compared to age-matched controls, respectively. However, in a multivariate analysis survival was not found to be an independent predictor of mortality, although some tendency towards reduced mortality was seen (AdjHR = 0.84, 95% CI 0.68-1.03, P = 0.094). Depression disorder was associated with a 77.9% increase in the risk for mortality. Holocaust survivors presenting with AMI were older and had a higher prevalence of depression than controls. No. excessive, and possibly even mildly improved, risk of mortality.was observed in survivors compared with controls presenting with AMI. Possibly, specific traits that are associated with surviving catastrophic events counter the excess risk of such events following AMI.

  2. Long-term outcome in term breech infants with low Apgar score--a population-based follow-up

    DEFF Research Database (Denmark)

    Krebs, L; Langhoff-Roos, J; Thorngren-Jerneck, K

    2001-01-01

    and 218 controls. RESULTS: Four cases (4.6%) and one control (0.5%) had cerebral palsy. In infants without cerebral palsy, speech/language problems were more frequent than controls (10.6 versus 3.2%) (P=0.02). There were no differences in rates of deficits in attention, motor control and perception (DAMP...

  3. Persistent muscle fiber regeneration in long term denervation. Past, present, future

    Directory of Open Access Journals (Sweden)

    Ugo Carraro

    2015-03-01

    Full Text Available Despite the ravages of long term denervation there is structural and ultrastructural evidence for survival of muscle fibers in mammals, with some fibers surviving at least ten months in rodents and 3-6 years in humans. Further, in rodents there is evidence that muscle fibers may regenerate even after repeated damage in the absence of the nerve, and that this potential is maintained for several months after denervation. While in animal models permanently denervated muscle sooner or later loses the ability to contract, the muscles may maintain their size and ability to function if electrically stimulated soon after denervation. Whether in mammals, humans included, this is a result of persistent de novo formation of muscle fibers is an open issue we would like to explore in this review. During the past decade, we have studied muscle biopsies from the quadriceps muscle of Spinal Cord Injury (SCI patients suffering with Conus and Cauda Equina syndrome, a condition that fully and irreversibly disconnects skeletal muscle fibers from their damaged innervating motor neurons. We have demonstrated that human denervated muscle fibers survive years of denervation and can be rescued from severe atrophy by home-based Functional Electrical Stimulation (h-bFES. Using immunohistochemistry with both non-stimulated and the h-bFES stimulated human muscle biopsies, we have observed the persistent presence of muscle fibers which are positive to labeling by an antibody which specifically recognizes the embryonic myosin heavy chain (MHCemb. Relative to the total number of fibers present, only a small percentage of these MHCemb positive fibers are detected, suggesting that they are regenerating muscle fibers and not pre-existing myofibers re-expressing embryonic isoforms. Although embryonic isoforms of acetylcholine receptors are known to be re-expressed and to spread from the end-plate to the sarcolemma of muscle fibers in early phases of muscle denervation, we suggest

  4. Fission Product Appearance Rate Coefficients in Design Basis Source Term Determinations – Past and Present

    OpenAIRE

    Perez Pedro B.; Hamawi John N.

    2017-01-01

    Nuclear power plant radiation protection design features are based on radionuclide source terms derived from conservative assumptions that envelope expected operating experience. Two parameters that significantly affect the radionuclide concentrations in the source term are failed fuel fraction and effective fission product appearance rate coefficients. Failed fuel fraction may be a regulatory based assumption such as in the U.S. Appearance rate coefficients are not specified in regulatory re...

  5. Fission Product Appearance Rate Coefficients in Design Basis Source Term Determinations – Past and Present

    Directory of Open Access Journals (Sweden)

    Perez Pedro B.

    2017-01-01

    Full Text Available Nuclear power plant radiation protection design features are based on radionuclide source terms derived from conservative assumptions that envelope expected operating experience. Two parameters that significantly affect the radionuclide concentrations in the source term are failed fuel fraction and effective fission product appearance rate coefficients. Failed fuel fraction may be a regulatory based assumption such as in the U.S. Appearance rate coefficients are not specified in regulatory requirements, but have been referenced to experimental data that is over 50 years old. No doubt the source terms are conservative as demonstrated by operating experience that has included failed fuel, but it may be too conservative leading to over-designed shielding for normal operations as an example. Design basis source term methodologies for normal operations had not advanced until EPRI published in 2015 an updated ANSI/ANS 18.1 source term basis document. Our paper revisits the fission product appearance rate coefficients as applied in the derivation source terms following the original U.S. NRC NUREG-0017 methodology. New coefficients have been calculated based on recent EPRI results which demonstrate the conservatism in nuclear power plant shielding design.

  6. Context effects in short-term memory : Confirmatory evidence from recall of visually presented lists

    NARCIS (Netherlands)

    Bunt, A.A.

    1976-01-01

    Thirty-two subjects had tests of serial recall of visually presented nine-digit lists which were either presented in a single block of trials (constant context) or in between lists of much longer length (variable context). Other variables were vocalization-during-presentation versus silent

  7. Present and long-term composition of MSW landfill leachate: A review

    DEFF Research Database (Denmark)

    Kjeldsen, Peter; Barlaz, M.A.; Rooker, A.P.

    2002-01-01

    The major potential environmental impacts related to landfill leachate are pollution of groundwater and surface waters. Landfill leachate contains pollutants that can be categorized into four groups (dissolved organic matter, inorganic macrocomponents, heavy metals, and xenobiotic organic compounds...... are observed. In contrast, the concentration of ammonia does not decrease, and often constitutes a major long-term pollutant in leachate. A broad range of xenobiotic organic compounds is observed in landfill leachate. The long-term behavior of landfills with respect to changes in oxidation-reduction status...... is discussed based on theory and model simulations. It seems that the somewhere postulated enhanced release of accumulated heavy metals would not take place within the time frames of thousands of years. This is supported by a few laboratory investigations. The existing data and model evaluations indicate...

  8. Photovoltaic System Pricing Trends: Historical, Recent, and Near-Term Projections 2013 Edition (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Feldman, D.; Margolis, R.; James, T.; Goodrich, A.; Barbose, G.; Dargouth, N.; Weaver, S.; Wiser, R.

    2013-09-01

    This briefing provides a high-level overview of historical, recent, and projected near-term PV system pricing trends in the United States, drawing on several ongoing research activities from the Lawrence Berkeley National Laboratory and the National Renewable Energy Laboratory. It also discusses the different methodologies and factors that impact the estimated price of a PV system, such as system size, location, technology, and reporting methods. These factors, including timing, can have a significant impact on system pricing.

  9. Direct current induced short-term modulation of the left dorsolateral prefrontal cortex while learning auditory presented nouns

    Directory of Open Access Journals (Sweden)

    Meyer Martin

    2009-07-01

    Full Text Available Abstract Background Little is known about the contribution of transcranial direct current stimulation (tDCS to the exploration of memory functions. The aim of the present study was to examine the behavioural effects of right or left-hemisphere frontal direct current delivery while committing to memory auditory presented nouns on short-term learning and subsequent long-term retrieval. Methods Twenty subjects, divided into two groups, performed an episodic verbal memory task during anodal, cathodal and sham current application on the right or left dorsolateral prefrontal cortex (DLPFC. Results Our results imply that only cathodal tDCS elicits behavioural effects on verbal memory performance. In particular, left-sided application of cathodal tDCS impaired short-term verbal learning when compared to the baseline. We did not observe tDCS effects on long-term retrieval. Conclusion Our results imply that the left DLPFC is a crucial area involved in short-term verbal learning mechanisms. However, we found further support that direct current delivery with an intensity of 1.5 mA to the DLPFC during short-term learning does not disrupt longer lasting consolidation processes that are mainly known to be related to mesial temporal lobe areas. In the present study, we have shown that the tDCS technique has the potential to modulate short-term verbal learning mechanism.

  10. Impact of Substance Use Disorder on Presentation and Short-Term Course of Schizophrenia

    Directory of Open Access Journals (Sweden)

    Rudraprosad Chakraborty

    2014-01-01

    Full Text Available The aim of the present study was to compare a cohort of schizophrenia patients with substance use disorder (SUD with a similar cohort of schizophrenia patients without SUD with regard to sociodemographic variables, clinical variables, psychopathology, anxiety symptoms, depressive symptoms, treatment outcome, and side effect profile of drugs. A total of 143 consecutive inpatients with ICD-10 DCR diagnosis of schizophrenia were included after obtaining informed consent. Patients were evaluated by a semistructured data sheet and Maudsley Addiction Profile. They were then rated by Positive and Negative Symptoms Scale, Calgary Depression Scale, Hamilton Anxiety Rating Scale, and Brief Psychiatric Rating Scale at presentation, three weeks, and six weeks. At three weeks and six weeks, they were also evaluated by UKU Side Effect Rating Scale. Substance abuse was detected in 63.6% schizophrenia patients. Nicotine was the commonest substance followed by cannabis and alcohol. Substance users had longer untreated illness and more depressive symptoms at presentation and six-week follow-up. Dual diagnosis patients had difficulty in abstraction at three and six weeks but not at presentation. Schizophrenia patients with SUD had more depressive symptoms. SUD appeared to mask abstraction difficulties at presentation. Schizophrenia patients with SUD should be carefully assessed for presence of depression.

  11. Presenting symptoms and long-term survival in head and neck cancer.

    Science.gov (United States)

    Douglas, C M; Ingarfield, K; McMahon, A D; Savage, S A; Conway, D I; MacKenzie, K

    2017-12-15

    To assess how type and number of symptoms are related to survival in patients with head and neck cancer. Patients were followed up for over 10 years from the Scottish Audit of Head and Neck Cancer (national cohort of head and neck cancer patients in Scotland 1999-2001). September 2013, cohort was linked to national mortality data. First, second and third presenting symptoms were recorded at diagnosis. National prospective audit-Scotland. A subset of 1589 patients, from the original cohort of 1895, who had cancer arising from one of the four main subsites; larynx, oropharynx, oral cavity and hypopharynx. Median survival in relation to patients' presenting symptoms. A total of 1146 (72%) males and 443 (28%) females, mean age at diagnosis 64 years (13-95). There was a significant difference in survival in relation to the number of the patient's presenting symptoms; one symptom had a median survival of 5.3 years compared with 1.1 years for three symptoms. Patients who presented with weight loss had a median survival of 0.8 years, compared to 4.2 years if they did not (P survival of 5.9 years compared to 2.6 years without (P survival for patients who presented with an ulcer, compared to those that did not (P = .105). This study highlights the importance of patients' presenting symptoms, giving valuable information in highlighting appropriate "red flag" symptoms and subsequent treatment planning and prognosis. © 2017 John Wiley & Sons Ltd.

  12. Monitoring Actuarial Present Values of Term Life Insurance By a Statistical Process Control Chart

    Science.gov (United States)

    Hafidz Omar, M.

    2015-06-01

    Tracking performance of life insurance or similar insurance policy using standard statistical process control chart is complex because of many factors. In this work, we present the difficulty in doing so. However, with some modifications of the SPC charting framework, the difficulty can be manageable to the actuaries. So, we propose monitoring a simpler but natural actuarial quantity that is typically found in recursion formulas of reserves, profit testing, as well as present values. We shared some simulation results for the monitoring process. Additionally, some advantages of doing so is discussed.

  13. How to reduce long-term drift in present-day and deep-time simulations?

    Science.gov (United States)

    Brunetti, Maura; Vérard, Christian

    2017-09-01

    Climate models are often affected by long-term drift that is revealed by the evolution of global variables such as the ocean temperature or the surface air temperature. This spurious trend reduces the fidelity to initial conditions and has a great influence on the equilibrium climate after long simulation times. Useful insight on the nature of the climate drift can be obtained using two global metrics, i.e. the energy imbalance at the top of the atmosphere and at the ocean surface. The former is an indicator of the limitations within a given climate model, at the level of both numerical implementation and physical parameterisations, while the latter is an indicator of the goodness of the tuning procedure. Using the MIT general circulation model, we construct different configurations with various degree of complexity (i.e. different parameterisations for the bulk cloud albedo, inclusion or not of friction heating, different bathymetry configurations) to which we apply the same tuning procedure in order to obtain control runs for fixed external forcing where the climate drift is minimised. We find that the interplay between tuning procedure and different configurations of the same climate model provides crucial information on the stability of the control runs and on the goodness of a given parameterisation. This approach is particularly relevant for constructing good-quality control runs of the geological past where huge uncertainties are found in both initial and boundary conditions. We will focus on robust results that can be generally applied to other climate models.

  14. Microcalcification-Associated Breast Cancer: Presentation, Successful First Excision, Long-Term Recurrence and Survival Rate.

    Science.gov (United States)

    Rominger, Marga B; Steinmetz, Carolin; Westerman, Ronny; Ramaswamy, Annette; Albert, Ute-Susann

    2015-12-01

    In this study we evaluated mammographic, histological and immunohistochemical findings for microcalcification-associated breast cancer with regards to breast-conserving therapy, recurrence and survival rate. We retrospectively analyzed 99 consecutive, non-palpable and microcalcification-associated breast cancers (94 women) that were treated surgically between January 2002 and December 2003 at a national academic breast cancer center. Calcifications were classified according to the Breast Imaging Reporting and Data System (BI-RADS). Descriptors, surgical outcome and histological findings were assessed. Recurrences and survival rates were evaluated based on medical records, standardized patient questionnaires and/or contacting the physician. 42 of the 99 lesions (42.4%) were invasive carcinomas, 57 (57.6%) were pure ductal carcinoma in situ (DCIS). 6 out of 99 (6.1%) lesions were triple negative, and 29 (29.3%) were HER2/neu positive. Successful first excision rate was 76/99 lesions (76.8%). Breast conservation was achieved in 73.7% (73/99). 10 women showed local recurrences without negatively impacting survival. The recurrences included round/punctate, amorphous, fine pleomorphic, and fine linear or fine-linear branching descriptors. The breast cancer-specific long-term survival rate was 91/94 (96.8%) for a mean follow-up of 81.4 months. The 3 patients who died due to breast carcinoma showed fine pleomorphic calcifications, and had nodal-positive invasive carcinoma at diagnosis. Microcalcification-associated breast cancers are frequently treated with breast-conserving therapy. Continuous clinical and mammographic follow-up is recommended for all descriptors.

  15. Isolated acute non-cystic white matter injury in term infants presenting with neonatal encephalopathy.

    LENUS (Irish Health Repository)

    Barrett, Michael Joseph

    2013-03-01

    We discuss possible aetiological factors, MRI evolution of injury and neuro-developmental outcomes of neonatal encephalopathy (NE). Thirty-six consecutive infants diagnosed with NE were included. In this cohort, four infants (11%) were identified with injury predominantly in the deep white matter on MRI who were significantly of younger gestation, lower birthweight with higher Apgars at one and five minutes compared to controls. Placental high grade villitis of unknown aetiology (VUA) was identified in all four of these infants. Our hypothesis states VUA may induce white matter injury by causing a local inflammatory response and\\/or oxidative stress during the perinatal period. We underline the importance of continued close and systematic evaluation of all cases of NE, including examination of the placenta, in order to come to a better understanding of the clinical presentation, the patterns of brain injury and the underlying pathophysiological processes.

  16. GENDER INFLUENCES THE CLINICAL PRESENTATION AND LONG-TERM OUTCOME OF GRAVES DISEASE.

    Science.gov (United States)

    Magri, Flavia; Zerbini, Francesca; Gaiti, Margherita; Capelli, Valentina; Ragni, Alberto; Rotondi, Mario; Chiovato, Luca

    2016-11-01

    The outcome of antithyroid drug (ATD) treatment for Graves disease (GD) is difficult to predict. In this study, we investigated whether male gender, besides other factors usually associated with a poor outcome of ATD treatment, may affect disease presentation and predict the response to medical treatment in subjects with GD. We studied 294 patients with a first diagnosis of GD. In all patients, ATD treatment was started. Clinical features, thyroid volume, and eye involvement were recorded at baseline. Serum levels of free thyroxine (FT4), free triiodothyronine (FT3), thyroid-stimulating hormone (TSH), and TSH-receptor antibodies (TRAb) were measured at baseline and during the follow-up. Treatment outcome (FT4, FT3, and TSH serum levels and further treatments for GD after ATD withdrawal) was evaluated. When compared to women, men showed a significantly larger thyroid volume and a higher family positivity for autoimmune diseases. During ATD, the mean serum levels of TSH, FT4, FT3, and TRAb did not differ between groups. Within 1 year after ATD discontinuation, relapse of hyperthyroidism was significantly more frequent in men than in women. Within the 5-year follow-up period, the prevalence of men suffering a late relapse was higher compared with that of women. The outcome at the end of the 5-year follow-up period was significantly associated with gender and TRAb levels at disease onset. Male patients with GD have a poorer prognosis when submitted to medical treatment with ATDs. A larger goiter at presentation and a stronger genetic autoimmune background might explain this gender difference in patients with GD. ATD = antithyroid drug FT3 = free triiodothyronine FT4 = free thyroxine GD = Graves disease GO = Graves orbitopathy RAI = radioiodine TRAb = thyroid-stimulating hormone-receptor antibody TSH = thyroid-stimulating hormone.

  17. Saudi Arabia

    African Journals Online (AJOL)

    Summary. Objective: To compare the pregnancy outcome in women with singleton breech presentation at term delivered by caesarean section (CS) and vaginal breech delivery. Design: A retrospective study. Setting: Abha Maternity hospital, Saudi Arabia. Material and Methods: 573 women with singleton breech.

  18. Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study

    DEFF Research Database (Denmark)

    Hansen, Anne Kirkeby; Wisborg, Kirsten; Uldbjerg, Niels

    2007-01-01

    of the newborn, respiratory distress syndrome, persistent pulmonary hypertension of the newborn) and serious respiratory morbidity (oxygen therapy for more than two days, nasal continuous positive airway pressure, or need for mechanical ventilation). RESULTS: 2687 infants were delivered by elective caesarean...... section. Compared with newborns intended for vaginal delivery, an increased risk of respiratory morbidity was found for infants delivered by elective caesarean section at 37 weeks' gestation (odds ratio 3.9, 95% confidence interval 2.4 to 6.5), 38 weeks' gestation (3.0, 2.1 to 4.3), and 39 weeks......-eclampsia, and intrauterine growth retardation, or by breech presentation. CONCLUSION: Compared with newborns delivered vaginally or by emergency caesarean sections, those delivered by elective caesarean section around term have an increased risk of overall and serious respiratory morbidity. The relative risk increased...

  19. Pathophysiology and long-term outcome of reversible tumor-like lesions induced by presenting status epilepticus.

    Science.gov (United States)

    Canas, Nuno; Soares, Pedro; Calado, Sofia; Pestana, Ricardo; Ribeiro, Constança; Vale, José

    2010-04-01

    Within the spectrum of reversible neuroimaging abnormalities induced by status epilepticus (SE) tumor-like lesions (TLL) have been rarely described. Their etiology, pathophysiology, and long-term outcome remain uncertain. These issues could be clarified by long-term magnetic resonance imaging (MRI) studies in TLL induced by presenting SE. Prospective multi-sequence MRI and clinical and electroencephalographic long-term (18 to 60 months) follow-up studies were performed in 3 patients with reversible TLL induced by presenting SE. In the peri-ictal MRI, TLL are hypointense in T1-weighted, hyperintense in T2-weighted, and fluid-attenuated inversion recovery images with a marked subcortical component and sulci effacement. The diffusion and MR-spectroscopy studies disclosed intermixed areas of increased/decreased diffusivity associated with a lactate peak and a decreased N-acetylaspartate. At long-term follow-up, none of the patients had seizure recurrence or electroencephalographic epileptiform abnormalities; MRI showed residual focal atrophy and gliosis associated with neuronal loss/dysfunction. SE per se may induce TLL. MRI multi-sequence studies disclosed that they are mainly formed by focal vasogenic and cytotoxic edema resulting from the hypermetabolism associated with seizure activity. In spite of a clinical favorable long-term outcome, the demonstration of irreversible brain damage argues in favor of immediate treatment of SE.

  20. Cavernous malformations of the brain after treatment for acute lymphocytic leukemia: presentation and long-term follow-up.

    Science.gov (United States)

    Singla, Amit; Brace O'Neill, Jill E; Smith, Edward; Scott, R Michael

    2013-02-01

    The authors undertook this study to determine the clinical course and long-term outcomes in pediatric patients who developed cavernous malformations of the brain following treatment for acute lymphocytic leukemia (ALL). They reviewed the senior author's database of surgically treated cavernous malformations of the brain to identify those patients whose cavernous malformations developed after cranial radiation during treatment for ALL. The medical records of these patients were reviewed to determine their clinical presentation, radiological findings, and outcome at long-term follow-up. Five patients fulfilled the specified criteria over a 23-year period. At the time of ALL diagnosis, they were all 4-5 years old. The cerebral cavernous malformations developed 2-8 years after cranial radiation, and 4 of the 5 patients presented with neurological symptoms, which ranged from focal deficits to seizures. Two patients required a second craniotomy, one from lesion recurrence possibly due to incomplete resection, and another for a second cavernous malformation, which developed at another site 6 years after the initial malformation was excised. Long-term follow-up of 2, 10, 11, 11, and 17 years has revealed no additional lesion development or recurrence. Symptomatic cavernous malformations of the brain may develop several years after chemotherapy and cranial radiation treatment for ALL, and the clinical course of these cavernous malformations may be more aggressive than that of the typical post-radiation lesions seen in other conditions. Long-term clinical and imaging monitoring is recommended for children who have undergone treatment for ALL. Craniotomy for excision of the malformations appears to convey long-term protection from repeat hemorrhage and accumulating neurological deficits.

  1. Understanding of Statistical Terms Routinely Used in Presentations: A Survey among Residents who participate at a Summer School

    Directory of Open Access Journals (Sweden)

    Cosmina-Ioana BONDOR

    2014-12-01

    Full Text Available Aim: The aim of our study was to investigate the understanding of statistical terms commonly used in lectures presented at summer schools for residents and young specialists. Material and Method: A survey was distributed to all the participants at the “Diabetic neuropathy from theory to practice” Summer School, 2014. The program was addressed to residents or young specialists in diabetes, neurology, surgery, and orthopedic from Romania. The survey consists of 6 multiple-choice questions and the first four questions evaluate the understanding of statistical terms. Results: There were 51 (42.5% participants who completed the questionnaires. From 204 total questions 81 (39.7% had correct answers. At the question 1, where relative risk was evaluated, only 3 (5.9% respondents answered correctly while at the question 2 (number need to treat about 78.4% (40 of answers were correct. At the question 3 (sensitivity, 22 (43.1% respondents answer correct while at the question 4 (Receiver Operating Characteristic curves only 16 (31.4% respondents provided a correct answer. The overall mean score of correct answers was 1.56±0.91. Conclusion: Our study showed that young specialists who participated to the survey were not familiarized with simple statistical terms commonly used in presentations.

  2. Clinical presentation, diagnostic findings and long-term survival in large breed dogs with meningoencephalitis of unknown aetiology.

    Science.gov (United States)

    Cornelis, I; Volk, H A; De Decker, S

    2016-08-06

    Although several studies indicate that meningoencephalitis of unknown aetiology (MUA) might affect every dog breed at every age, little is known about clinical presentation, diagnostic findings and long-term survival in large breed dogs. The aim of this study was therefore to compare the clinical presentation, diagnostic findings and long-term survival between large and small/medium breed dogs diagnosed with MUA. One hundred and eleven dogs met the inclusion criteria. 28 (25 per cent) dogs were considered large breed dogs compared with 83 (75 per cent) small/medium breed dogs. Large breed dogs presented significantly more often with a decreased mentation. Age, gender, duration of clinical signs prior to diagnosis, presence of seizures or cluster seizures, variables on complete blood count and cerebrospinal fluid analysis, and all variables on MRI were not significantly different between small/medium and large breed dogs. Median survival time was 281 and 106 days for the large and small/medium breed dogs, respectively, with no significant difference in survival curves for both groups. Although considered not typically affected by MUA, 25 per cent of dogs included in this study were considered large breed dogs. Therefore, MUA should be included in the differential diagnosis for large breed dogs presenting with intracranial neurological signs. If diagnosed with MUA, large breed dogs also carried a guarded prognosis. British Veterinary Association.

  3. The Early External Cephalic Version (ECV) 2 Trial: an international multicentre randomised controlled trial of timing of ECV for breech pregnancies.

    Science.gov (United States)

    Hutton, E K; Hannah, M E; Ross, S J; Delisle, M-F; Carson, G D; Windrim, R; Ohlsson, A; Willan, A R; Gafni, A; Sylvestre, G; Natale, R; Barrett, Y; Pollard, J K; Dunn, M S; Turtle, P

    2011-04-01

    To investigate whether initiating external cephalic version (ECV) earlier in pregnancy might increase the rate of successful ECV procedures, and be more effective in decreasing the rate of non-cephalic presentation at birth and of caesarean section. An unblinded multicentred randomised controlled trial. A total of 1543 women were randomised from 68 centres in 21 countries. Women with a singleton breech fetus at a gestational age of 33(0/7) weeks (231 days) to 35(6/7) weeks (251 days) of gestation were included. Participants were randomly assigned to having a first ECV procedure between the gestational ages of 34(0/7) (238 days) and 35(6/7) weeks of gestation (early ECV group) or at or after 37(0/7) (259 days) weeks of gestation (delayed ECV group). The primary outcome was the rate of caesarean section; the secondary outcome was the rate of preterm birth. Fewer fetuses were in a non-cephalic presentation at birth in the early ECV group (314/765 [41.1%] versus 377/768 [49.1%] in the delayed ECV group; relative risk [RR] 0.84, 95% CI 0.75, 0.94, P=0.002). There were no differences in rates of caesarean section (398/765 [52.0%] versus 430/768 [56.0%]; RR 0.93, 95% CI 0.85, 1.02, P=0.12) or in risk of preterm birth (50/765 [6.5%] versus 34/768 [4.4%]; RR 1.48, 95% CI 0.97, 2.26, P=0.07) between groups. External cephalic version at 34-35 weeks versus 37 or more weeks of gestation increases the likelihood of cephalic presentation at birth but does not reduce the rate of caesarean section and may increase the rate of preterm birth. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

  4. Pattern of Presentation and Outcome of Short-term Treatment for Idiopathic Clubfoot / CTEV with Ponseti Method

    Directory of Open Access Journals (Sweden)

    Gunalan R

    2016-11-01

    Full Text Available Introduction: Congenital Talipes Equinovarus (CTEV is a common congenital foot deformity that is associated with long term disability. Treatment with Ponseti method has been successful especially for children who present early. We conducted this study to investigate the age of presentation of children and report the early outcome. Materials: This is a retrospective study from a single institution. We included 31 patients with 45 idiopathic clubfeet and investigated problems and success rate at the end of serial casting. Results: Mean age at presentation was 4.9 months. The mean number of casting was 6 and mean duration of casting was 2.7 months. The initial success rate of 91.1%, with four feet (8.8% diagnosed as resistant clubfoot and eventually required soft tissue surgery. With mean follow up of 14.1 months, four other feet (8.8% developed relapse but were treated with repeat Ponseti method. Conclusion: Many CTEV patients present late for treatment. However, the Ponseti method remained effective with high initial success rate of 91.1%. Relapsed CTEV can still be treated successfully with repeat casting using the Ponseti method.

  5. Audit of Organic Acidurias from a Single Centre: Clinical and Metabolic Profile at Presentation with Long Term Outcome

    Science.gov (United States)

    Sindgikar, Seema Pavaman; Shenoy, Krithika Damodar; Kamath, Nutan

    2017-01-01

    Introduction Organic Acidurias (OA) accounts between 10% and 40% of confirmed Inborn Errors of Metabolism (IEM) in India. With prompt recognition and management, better survival but adverse neurodevelopmental outcome is reported. Aim To study the clinical and metabolic presentation, management with immediate and long term outcome of symptomatic children with confirmed OA. Materials and Methods Hospital based study of symptomatic children diagnosed to have OA between 2003 and 2009 and the survivors followed up over next five years. Diagnosis was based on clinical and metabolic presentation and confirmed by spectrometry analyses of urine and blood. Management, immediate outcome, compliance to treatment and recurrence of crises were documented. Neurodevelopmental outcome was assessed in follow up. Mean with Standard Error (Mean ± SE) and frequencies with percentages were calculated. Results Of 72 cases suspected to have IEM, 38 (52.8%) were confirmed of (IEM), and out of which 15 (39.5%) had OA. Methyl malonic acidemia, multiple carboxylase deficiency and Propionic Acidemia (PA) constituted the largest proportion. Neurodevelopmental issues (73.3%) and metabolic crisis (53.3%) were common presenting features. Mean ± SE of ammonia was 639.0±424.1 μg/dl and lactate was 33.6±4.9 mg/dl. Mean pH, bicarbonate, and anion gap was 7.27±0.07, 14.1±2.3 and 17.9±2.3 respectively. Management was protocol based. Death was reported in two cases of PA; other morbidities were seen in five. Recurrent crisis (46.7%) complicated the follow up in survivors. Spasticity, extrapyramidal movement disorder, intellectual subnormality, autism spectrum, attention deficit hyperactivity disorder and sensory neural deafness were seen amongst survivors, in spite of compliance to therapy. Conclusion OA is part of differential diagnosis in sick children and treatment needs to be prompt and specific. Prognosis is guarded even with long term cofactor supplementation in the symptomatic. PMID

  6. Long-term entrenchment and consequences in present flood hazard in Garona River (Val d'Aran, central Pyrenees)

    Science.gov (United States)

    Victoriano-Lamariano, Ane; Garcia-Silvestre, Marta; Furdada-Bellavista, Gloria

    2015-04-01

    Flood risk is one of the most dangerous natural disasters in mountainous areas. Risk management and mitigation have to be based on exhaustive risk evaluation. Moreover, hazard analysis requires a multidisciplinary approach to achieve a complete understanding of the dynamics of the phenomena. The Val d'Aran valley is located in the axial part of the Pyrenees and is drained by the Garona River. Flooding events are relatively frequent there. The last extraordinary episode occurred in June 2013. Considering both the main effects of this flooding and the geomorphology, the long-term dynamics of the Garona River was studied in two different areas (Arties-Vielha and Era Bordeta-Les), which are representative of the whole length along the Val d'Aran. In fact, present short-term processes can be partly explained as a result of the long-term fluvial tendency. During the analysis of the 2013 flood effects, several entrenchment and incision indicators were found. Under the hypothesis that the fluvial network tends to incise, an entrenchment indicator analysis was carried out. Firstly, we considered the geomorphologic features, such as two generations of alluvial fans, two generations of alluvial terraces and, incisions on geomorphologic features and in Paleozoic bedrock. Secondly, we found out that erosion dominated over overflow and deposition during the 2013 flooding. Finally, great erosion was identified in engineering structures, for instance, in bridges, channelization dikes, gauging stations and dams. The geomorphologic analysis and the entrenchment indicators are essential to perform a post-glacial evolution interpretation. During the last Pleistocene glacial retreat, a fluvio-torrential network was developed at the bottom of the ancient glacial valley. An early post-glacial phase with a high sediment transport lead to the formation of first generation alluvial fans and alluvial terraces (nowadays located ≈15m above the channel). As sediment transport decreased

  7. Multiple sclerosis and acute disseminated encephalomyelitis diagnosed in children after long-term follow-up: comparison of presenting features

    Science.gov (United States)

    Alper, Gulay; Heyman, Rock; Wang, Li

    2008-01-01

    The aim of this study was to compare the characteristics of the first demyelinating event between acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS). Children with acute demyelinating disease of the central nervous system and an abnormal brain magnetic resonance image (MRI) were studied. Patients were assigned a final diagnosis after long-term follow-up. Comparisons were made between the MS and ADEM groups. Proposed definitions by the Pediatric MS Study Group were applied to our cohort in retrospect and are discussed. Fifty-two children and adolescents with a documented abnormal brain MRI were identified (24 females, 28 males; mean age 10y 11mo [SD 5y 4mo] range 1y 10mo–19y 7mo). To date, 26 children have been diagnosed with MS, and 24 with ADEM. One child has relapsing neuromyelitis optica and one child has clinically isolated optic neuritis. Follow-up duration was 6 years 8 months in monophasic patients, and 5 years 6 months in relapsing patients. None of the patients with MS had encephalopathy while encephalopathy was present in 42% of patients with ADEM. Cerebrospinal fluid oligoclonal bands, an elevated immunoglobulin G index, and the periventricular perpendicular ovoid lesions correlated with MS outcome. Several clinical characteristics differ between ADEM and MS at first presentation; encephalopathy, when present, strongly suggests the diagnosis of ADEM. PMID:19018840

  8. Mars atmospheric loss to space: Observations of present-day loss and implications for long-term volatile evolution

    Science.gov (United States)

    Jakosky, Bruce; Brain, David; Luhmann, Janet; Grebowsky, Joe

    2017-04-01

    MAVEN completed its first Mars year of science mapping in October 2016. Results show loss of gas to space by multiple processes, including solar-wind pick-up, sputtering, photochemical loss, and thermal escape, along with their responses to changing solar and solar-wind boundary conditions and to discrete solar events. By understanding the current loss rates and the processes controlling them, we are able to examine the long-term loss to space, including the effects of different solar conditions early in history; in addition, we are able to use stable-isotope ratios to derive the integrated loss to space through time. Preliminary results suggest that loss to space was a dominant, if not the dominant, mechanism that drove the changing climate through time. We will present a framework for analyzing and interpreting the results, along with preliminary results on the extrapolation to long timescales.

  9. Ganzfeld perceptual field and gender effects on short-term memory as a function of rate of digit presentation.

    Science.gov (United States)

    Vitulli, W F; Laconsay, K L; Shepard, H A

    1996-06-01

    Efforts to enhance short term memory for digit span (in serial recall) included the Ganzfeld perceptual field and variation in the rate (interstimulus interval: 1 sec., 2 sec., 3 sec.) of 25 auditorily presented computer-generated random numbers (1 to 5). Undergraduate volunteers (52 men and 91 women) wore goggles consisting of halves of translucent ping-pong balls while viewing a red lamp and listening to 60 decibels of white noise. Control subjects wore goggles with clear plastic lenses. Participants were instructed to recall 25 random digits in the correct series (vocalized sequentially through headphones worn by the subjects) immediately after their presentations. A mixed 2 x 2 x 3 split plot analysis of variance yielded a significant effect for digit rates, and post hoc Scheffe tests of multiple comparisons showed differences in recall between interstimulus intervals of 1 and 2 sec., 1 and 3 sec., and 2 and 3 sec. Other Scheffe comparisons showed that men scored higher than women with the 3-sec. interstimulus interval and with the "clear" perceptual field. Ganzfeld may have reduced distractibility for women as compared with recall following the "clear" perceptual field. Serial-position effects favored "primacy," yet the "recency effect" was seen within the last 5 serial positions.

  10. Atypical clinical presentation and long-term survival in a patient with optic nerve medulloepithelioma: a case report

    Directory of Open Access Journals (Sweden)

    Pastora-Salvador Natalia

    2012-05-01

    Full Text Available Abstract Introduction Medulloepithelioma is a rare congenital tumor of the primitive medullary neuroepithelium. A significant proportion of patients with medulloepithelioma arising from the optic nerve die from intracranial spread or cerebral metastasis. Because it has no known distinct clinical features and because of its low frequency, this tumor presents within the first two to six years of life and is usually misdiagnosed clinically as a different type of optic nerve tumor. Here, we describe a new and atypical case of medulloepithelioma of the optic nerve in a 12-year-old boy. To the best of our knowledge, he is the oldest reported patient to present with this disease and, now as an adult, has the longest documented period of disease-free survival. Case presentation A 12-year-old Caucasian boy with headache and unilateral amaurosis was referred for a presumed optic nerve glioma to our hospital. A computed tomography scan showed optic nerve enlargement, and fundoscopy showed a whitish mass at the optic disc. Our patient had been followed at his local hospital for four years for an 'optic disc cyst' with no change or progression. He experienced mild progressive visual impairment during that period. He was admitted for resection, and a histopathological analysis revealed a medulloepithelioma of the optic nerve. Supplemental orbital radiotherapy was performed. He remained disease-free for 25 years. Conclusions Medulloepithelioma of the optic nerve can clinically mimic more common pediatric tumors, such as optic glioma, meningioma, or retinoblastoma. Thus, medulloepithelioma should be included in the differential diagnoses of pediatric optic nerve lesions. Fundoscopy in these patients may provide relevant information for diagnosis. Anterior optic nerve medulloepitheliomas may behave differently from and have a better prognosis than medulloepitheliomas that have a more posterior location. Our case report illustrates that long-term survival can be

  11. [Low Apgar score in term newborn infants and delivery pattern].

    Science.gov (United States)

    Atanasova, V; Slavkova, N; Yonov, M; Valkova, A

    2012-01-01

    Examine the influence of delivery pattern over neonatal condition in the first minutes of life. We have studied 3624 term newborns of single pregnancies for period of 2 years in the city of Pleven. The patients were divided in 4 groups by the delivery pattern: vaginal delivery with head presentation (2497 infants), vaginal delivery with instrumental assist (45 infants), per vias naturales in breech presentation (44 infants), delivery via Caesarean section (1038 infants). According to our results the Apgar score differs itself from the pathology of a given newborn. Neonatal deaths are significantly higher in the newborns with low Apgar score than deaths in the general population. From all cases of low Apgar score without other clinical problems the highest is the percentage in the infants delivered via Caesarean section. The goal of the Apgar score is to focus attention on the infant's condition in the first few minutes of its life and the need of resuscitation. Low Apgar score is an important predictor of the newborn morbidity and death rate. The Apgar score alone is not a proof for intrapartal asphyxia and is not associated with long-term neurological damage.

  12. Long-term Measurements of Solar Proton Fluxes (1963-present) and the Subsequent Impact on Stratospheric Constituents

    Science.gov (United States)

    Jackman, Charles H.; Fleming, Eric L.

    2005-01-01

    The fluxes of solar protons have been measured by satellites for over forty years (1963-present). Eight Interplanetary Monitoring Platform (IMP) satellites measured solar proton fluxes from 1963-1993 and five NOAA Geostationary Operational Environmental Satellites (GOES) were used for the period 1994present. These high energy solar protons precipitate on the Earth's polar atmosphere sporadically, especially during solar proton events (SPEs), which typically last a few days. Solar protons with energies greater than 30 MeV are capable of reaching the stratosphere and causing increases in odd hydrogen (HOx) and odd nitrogen (NOy) constituents at polar latitudes (greater than 60 degrees geomagnetic). The enhanced HOx leads to short-lived ozone depletion (-days) due to the short lifetime of HOx constituents. The enhanced NOy leads to long-lived ozone changes because of the long lifetime of the NOy family in the stratosphere. Several very large SPEs (August 1972, August and October 1989, July and November 2000, September and November 2001, and October 2003) over the 1963-2004 time period were simulated in the GSFC two-dimensional chemistry and transport model and were predicted to cause significant polar upper stratospheric ozone depletion greater than 10%, which lasted for several weeks past the events. Several satellite instruments (BUV, SBUV, SBW/2, SAGE II, HALOE, etc.) have shown constituent changes as a result of SPEs. Long-term (greater than 40 year) model simulations of the influence of the solar protons and satellite measurements during and after some of the very large SPEs will be shown.

  13. In Terms of the Logarithmic Mean Annual Seismicity Rate and Its Standard Deviation to Present the Gutenberg-Richter Relation

    Science.gov (United States)

    Chen, K. P.; Chang, W. Y.; Tsai, Y. B.

    2016-12-01

    The main purpose of this study is to apply an innovative approach to assess the median annual seismicity rates and their dispersions for Taiwan earthquakes in different depth ranges. This approach explicitly represents the Gutenberg-Richter (G-R) relation in terms of both the logarithmic mean annual seismicity rate and its standard deviation, instead of just the arithmetic mean. We use the high-quality seismicity data obtained by the Institute of Earth Sciences (IES) and the Central Weather Bureau (CWB) in an earthquake catalog with homogenized moment magnitudes from 1975 to 2014 for our study. The selected data set is shown to be complete for Mw>3.0. We first use it to illustrate the merits of our new approach for dampening the influence of spuriously large or small event numbers in individual years on the determination of median annual seismicity rate and its standard deviation. We further show that the logarithmic annual seismicity rates indeed possess a well-behaved lognormal distribution. The final results are summarized as follows: log10N=5.75-0.90Mw+/-(0.245-0.01Mw) for focal depth 0 300 km; log10N=5.78-0.94Mw+/-(0.195+0.01Mw) for focal depth 0-35 km; log10N=4.72-0.89Mw+/-(-0.075+0.075Mw) for focal depth 35-70 km; and log10N=4.69-0.88Mw+/-(-0.47+0.16Mw) for focal depth 70-300 km. Above results show distinctly different values for the parameters a and b in the G-R relations for Taiwan earthquakes in different depth ranges. These analytical equations can be readily used for comprehensive probabilistic seismic hazard assessment. Furthermore, a numerical table on the corresponding median annual seismicity rates and their upper and lower bounds at median +/- one standard deviation levels, as calculated from above analytical equations, is presented at the end. This table offers an overall glance of the estimated median annual seismicity rates and their dispersions for Taiwan earthquakes of various magnitudes and focal depths. It is interesting to point out that

  14. The Present, Mid-Term, and Long-Term Supply Curves for Tellurium; and Updates in the Results from NREL's CdTe PV Module Manufacturing Cost Model (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Woodhouse, M.; Goodrich, A.; Redlinger, M.; Lokanc, M.; Eggert, R.

    2013-09-01

    For those PV technologies that rely upon Te, In, and Ga, first-order observations and calculations hint that there may be resource constraints that could inhibit their successful deployment at a SunShot level. These are only first-order approximations, however, and the possibility for an expansion in global Te, In, and Ga supplies needs to be considered in the event that there are upward revisions in their demand and prices.In this study, we examine the current, mid-term, and long-term prospects of Tellurium (Te) for use in PV. We find that the current global supply base of Te would support <10 GW of annual traditional CdTe PV manufacturing production. But as for the possibility that the supply base for Te might be expanded, after compiling several preliminary cumulative availability curves we find that there may be significant upside potential in the supply base for this element - principally vis a vis increasing demand and higher prices. Primarily by reducing the Tellurium intensity in manufacturing and by increasing the recovery efficiency of Te in Cu refining processes, we calculate that it may prove affordable to PV manufacturers to expand the supply base for Te such that 100 GW, or greater, of annual CdTe PV production is possible in the 2030 - 2050 timeframe.

  15. Repairing the breech

    Directory of Open Access Journals (Sweden)

    Harry C. Boyte

    2012-04-01

    Full Text Available The main obstacle to genuine and productive partnerships between institutions of higher education and the professionals they prepare, on the one side, and communities, on the other, is a “knowledge war,” full of invisible hierarchies and exclusions, producing a hypercompetitive achievement culture. This knowledge war dramatically limits communities’ and citizens’ ability to act on the problems they face today. It also sharply erodes the power of higher education, professionals, and civic leaders to help shape the culture in democratic ways.We have to get beyond arrogant experts and aggrieved communities if we want to develop communities’ capacities to solve problems and also to generate a larger vision of a good society. Community is the living context for evaluating expert knowledge. But without engagement with other ways of knowing appeal to community knowledge can easily produce a Know-Nothing reaction to the larger world.If we are to build communities’ civic agency – capacities to work across differences to meet our common challenges – we need to democratize the politics of knowledge and end the knowledge war. This requires learning from effective community organizing the idea of “schools for public life,” where ordinary people develop skills, habits, and confidence of citizenship. It also means creating what might be called middle spaces, not owned by academics or professionals, but open to academic and scientific knowledge, where different ways of knowing and acting intermingle in creative ways. Middle spaces put science and academic knowledge in the mix, “on tap, not on top.” They also recognize the power and the limits of communal knowledge.Keywordscivic agency, cultural organizing, knowledge war

  16. Plug-in HEVs: A Near-Term Option to Reduce Petroleum Consumption from FY05 Milestone Report (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Markel, T.; O' Keefe, M.; Simpson, A.; Gonder, J.; Brooker, A.

    2006-01-19

    Presented to DOE management staff on September 14, 2005 at the DOE headquarters in Washington DC. Content was updated January 19, 2006 for publication. This presentation addresses plug-in hybrid electric vehicle (PHEV) market and technology issues for research and development efforts.

  17. Discharge of a Pistol Out a Car Window with the Breech Within the Interior of the Car: Analysis of Gunshot Residue on a Car's Interior Surfaces.

    Science.gov (United States)

    Burnett, Bryan R; Lebiedzik, Jozef

    2017-05-01

    The defendant, the driver of the questioned car, allegedly extended his right arm over the passenger seat and fired a single shot from a 380 pistol out the passenger window with the pistol's breech within the car. A simulation of this shooting scenario using the same model car, but different year, was conducted to quantitate gunshot residue (GSR) contamination of interior surfaces within the car. The test car's dash and headliner/window frame above the pistol had the heaviest GSR contamination. The dash GSR from airborne deposition documents a firearm discharge within the vehicle. Transfer from GSR-contaminated hands or clothing to the dash is unlikely. The heavy GSR contamination of the headliner/window frame above the pistol likely documents the window from which the pistol was fired, but additional experiments are needed to verify. © 2016 American Academy of Forensic Sciences.

  18. Advanced Uropathy in a Child With Underactive Bladder: Unusual Presentation, Treatment, and Long-term Follow Up

    Directory of Open Access Journals (Sweden)

    Rami S. Alazab

    2015-03-01

    Full Text Available Underactive bladder in children is characterized by low voiding frequency; straining, hypotonic high capacity bladder, and significant residual urine. The usual presentation is recurrent urinary tract infections. Accurate evidence-based diagnosis and treatment is crucial. Subjective and objective improvement and regain of normal voiding can be achieved in response to bladder rehabilitation program and correction of serious complications.

  19. The effect of post-learning presentation of music on long-term word-list retention.

    Science.gov (United States)

    Judde, Sarah; Rickard, Nikki

    2010-07-01

    Memory consolidation processes occur slowly over time, allowing recently formed memories to be altered soon after acquisition. Although post-learning arousal treatments have been found to modulate memory consolidation, examination of the temporal parameters of these effects in humans has been limited. In the current study, 127 participants learned a neutral word list and were exposed to either a positively or negatively arousing musical piece following delays of 0, 20 or 45min. One-week later, participants completed a long-term memory recognition test, followed by Carver and White's (1994) approach/avoidance personality scales. Retention was significantly enhanced, regardless of valence, when the emotion manipulation occurred at 20min, but not immediately or 45min, post-learning. Further, the 20min interval effect was found to be moderated by high 'drive' approach sensitivity. The selective facilitatory conditions of music identified in the current study (timing and personality) offer valuable insights for future development of more specified memory intervention strategies.

  20. Evaluation of Presenting Symptoms and Long-Term Outcomes of Patients Requiring Excision of a Transobturator Tape (TOT).

    Science.gov (United States)

    Forde, J C; Davis, N F; Creagh, T A

    2015-10-01

    The transobturator tape (TOT) is an effective treatment for stress urinary incontinence (SUI). Erosion of TOT mesh is a recognised complication requiring excision. A retrospective analysis of 228 females undergoing a TOT procedure over 4 years identified 16 patients (7%) that underwent excision of eroded mesh. Mean age of patients requiring excision was 48.8 years and mean weight was 72.7kg. Mean time to re-presentation was 14.5 months. Presenting symptoms included dyspareunia in 9 patients (56.2%), dysuria in 3 (18.7%), persistent incontinence in 3 (18.7%) and groin pain in one patient. Ten patients (62.5%) had a prior urogynecological procedure. After excision of eroded tape-mesh, 7 (43.7%) required a rectus fascial sling and 4 (25%) underwent repeat TOT for recurrence of SUI. Five patients (31.2%) required no further surgery. At present 10 patients (62.5%) report resolution of SUI, 4 (25%) report mild SUI and 2 (12.5%) patients have moderate/severe SUI. Resolution of symptoms occurred in the majority of patients after excision of eroded mesh and an additional anti-incontinence procedure.

  1. Sex differences in the characteristics and short-term prognosis of patients presenting with acute symptomatic pulmonary embolism

    Science.gov (United States)

    Barrios, Deisy; Morillo, Raquel; Guerassimova, Ina; Barbero, Esther; Escobar-Morreale, Héctor; Cohen, Alexander T.; Becattini, Cecilia; Tapson, Victor; Yusen, Roger

    2017-01-01

    Background We sought to examine sex-related differences in the characteristics and outcome in patients presenting with acute symptomatic pulmonary embolism (PE). Methods We conducted a retrospective cohort study of 2,096 patients diagnosed with acute PE. The characteristics were recorded at presentation. Treatment was at the discretion of patients’ physicians. The primary study outcome, all-cause mortality, and the secondary outcomes of PE-specific mortality, recurrent venous thromboembolism, and major bleeding were assessed during the first month of follow-up after PE diagnosis. Results Overall, the women were older than the men and had significantly higher rates of immobilization. They had significantly lower rates of chronic obstructive pulmonary disease and cancer. Women had a higher prevalence of syncope and elevated brain natriuretic peptide levels. Thirty-day all-cause mortality was similar between women and men (7.1% versus 6.2%; P = 0.38). Male gender was not independently significantly associated with PE-related death (adjusted odds ratio [OR] 1.02; 95% CI, 0.50 to 2.07; P = 0.96). Restricting the analyses to haemodynamically stable patients (n = 2,021), female gender was an independent predictor of all-cause (adjusted OR 1.56; 95% CI, 1.07 to 2.28; P = 0.02) and PE-specific mortality (adjusted OR 1.85; 95% CI, 1.02 to 3.33; P = 0.04). Compared with men, women were 2.05 times more likely to experience a major bleed. Conclusions Women and men with PE had different clinical characteristics, presentation, and outcomes. Women receiving anticoagulation have a significantly higher risk of major bleeding, suggesting the need for careful monitoring of anticoagulant intensity in women. PMID:29107971

  2. Long Term Manipulations of Intact Microbial Mat Communities in a Greenhouse Collaboratory: Simulating Earth's Present and Past Field Environments

    Science.gov (United States)

    Bebout, Brad; DesMarais, David J.; Discipulo, Mykell; Embaye, Tsegereda; Garcia-Pichel, Ferran; Hogan, Mary; Jahnke, Linda L.; Keller, Richard M.; Miller, Scott R.; Prufert-Bebout, Leslie E.; hide

    2002-01-01

    Photosynthetic microbial mat communities were obtained from marine hypersaline saltern ponds, maintained in a greenhouse facility, and examined for the effects of salinity variations. Because these microbial mats are considered to be useful analogs of equivalent ancient marine communities, they offer insights about evolutionary events during the greater than 3 billion year time interval wherein mats co-evolved with Earth's geosphere and atmosphere. Although photosynthetic mats can be highly dynamic and exhibit extremely high activity, the mats in the present study have been maintained for more than one year with relatively minor changes. The major groups of microorganisms, as assayed using microscopic, genetic, and biomarker methodologies, are essentially the same as those in the original field samples. Field and greenhouse mats were similar with respect to rates of exchange of oxygen and dissolved inorganic carbon across the mat-water interface, both during the day and at night. Field and greenhouse mats exhibited similar rates of efflux of methane and hydrogen. Manipulations of salinity in the water overlying the mats produced changes in the community that strongly resemble those observed in the field. A collaboratory testbed and an array of automated features are being developed to support remote scientific experimentation with the assistance of intelligent software agents. This facility will permit teams of investigators to explore ancient environmental conditions that are rare or absent today but might have influenced the early evolution of these photosynthetic ecosystems.

  3. Download this PDF file

    African Journals Online (AJOL)

    Krebs L., Langhoft-Ross J, Weber T. Breech at term-mode of delivery? A register based study. Acta ObstetGynae Scan. 1995; 74; 702-706. Keily JL. Mode of delivery and neonatal death in 17,587 infants presenting by the breech. Brit J. ObstetGynaecol. 1991; 98: 898-90-4. Hofmeyr GJ, External cephalic version at term.

  4. Association of external cephalic version before term with late preterm birth.

    Science.gov (United States)

    Poole, Kristie L; McDonald, Sarah D; Griffith, Lauren E; Hutton, Eileen K

    2017-08-01

    While evidence suggests that beginning an external cephalic version (ECV) before term (34(0/7) to 36(6/7) weeks) compared with after term may be associated with an increase in late preterm birth (34(0/7) to 36(6/7) weeks), it remains unknown what might account for this risk. The objective of the present study is to further investigate the association between ECV before term and late preterm birth. Secondary analysis of data collected from the international, multicenter Early ECV trials. We evaluated the relation between ECV exposure and late preterm birth (34(0/7) to 36(6/7) weeks), as well as whether additional risk factors for preterm birth (such as maternal age, height, body mass index, parity, placental location, and perinatal mortality rate) moderated this relation. Generalized linear mixed methods were used to account for center effect and adjust for covariates. Among 1765 women with breech pregnancies and without a prior preterm birth, 749 (42.4%) received at least one ECV before term. Exposure to an ECV before term was not associated significantly independently with odds of preterm birth. However, placenta location moderated the association between early ECV exposure and late preterm birth. The odds of preterm birth in women who were exposed to an ECV before term and who also had an anterior placenta were doubled (OR 2.05; 95% CI 1.12-3.71; p = 0.02). In a large cohort of women without known risks for preterm birth, those with an anterior placenta who undergo an ECV before term constitute a subgroup at particular risk for late preterm birth. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  5. Late presentation of an anomalous left coronary artery from the pulmonary artery treated with conservative surgical management with long-term cardiac magnetic resonance imaging follow-up

    Directory of Open Access Journals (Sweden)

    Pishoy Gouda

    2017-02-01

    Full Text Available Anomalous origin of the left coronary artery from the pulmonary artery is rare congenital abnormality that most commonly presents in childhood and is associated with a high mortality. In the elderly, patients may present acutely with arrhythmias or signs of ischemia or with vague chronic presentations of shortness of breath and fatigue. In the high-risk elderly population, it is unclear as to whether conservative surgical management by means of suture ligation of the left coronary artery is associated with positive long-term outcomes. We present a case of a 69-year-old patient diagnosed with anomalous origin of the left coronary artery from the pulmonary artery, which was treated with conservative surgical management and followed up for 15 years with cardiovascular magnetic resonance imaging, with positive outcomes.

  6. Longitudinal changes in seizure outcomes after resection of cerebral cavernous malformations in patients presenting with seizures: a long-term follow-up of 46 patients.

    Science.gov (United States)

    Kim, Jiha; Kim, Chi Heon; Chung, Chun Kee

    2014-08-01

    Seizure is the most common presentation in patients with cerebral cavernous malformations (CCMs). Although many articles have documented seizure outcomes after resection of CCM, few have conducted long-term follow-ups; thus, the fluctuating seizure outcomes have been neglected. The purpose of this study is to describe long-term postoperative seizure outcomes in patients with CCM and to compare seizure outcomes between patients with sporadic seizures and those with chronic seizures. Forty-six patients with CCM presenting with seizures underwent surgery. The male-to-female ratio was 1:1, and the average age at initial seizure onset was 27.6 years. The mean preoperative seizure duration was 42.7 months. Patients were divided into two groups: a chronic group (N = 20) and a sporadic group (N = 26) according to seizure frequency and duration. The mean postoperative follow-up duration was 96.3 months, and the postoperative seizure outcomes were checked annually based upon Engel's classification. After the first year of follow-up, 80.8 % of the sporadic group and 75.0 % of the chronic group were evaluated as Engel class I. These rates increased to 100.0 % and 90.0 %, respectively, at the eighth year of follow-up. Overall, 29 (63.0 %) of the 46 patients experienced changes in seizure outcomes over the follow-up period. Despite their delayed improvements, the chronic group showed less favorable outcomes throughout follow-up (p = 0.025). Long-term follow-up is indispensable for accurately assessing postoperative seizure outcomes because these outcomes change continuously. We recommend earlier surgery to achieve seizure-free status in patients with CCM. However, even in the chronic group, surgery is recommended, considering the overall delayed improvement.

  7. A qualitative interview study exploring pregnant women’s and health professionals’ attitudes to external cephalic version

    Science.gov (United States)

    2013-01-01

    Background Women who have a breech presentation at term have to decide whether to attempt external cephalic version (ECV) and how they want to give birth if the baby remains breech, either by planned caesarean section (CS) or vaginal breech birth. The aim of this study was to explore the attitudes of women with a breech presentation and health professionals who manage breech presentation to ECV. Methods We carried out semi-structured interviews with pregnant women with a breech presentation (n=11) and health professionals who manage breech presentation (n=11) recruited from two hospitals in North East England. We used purposive sampling to include women who chose ECV and women who chose planned CS. We analysed data using thematic analysis, comparing between individuals and seeking out disconfirming cases. Results Four main themes emerged from the data collected during interviews with pregnant women with a breech presentation: ECV as a means of enabling natural birth; concerns about ECV; lay and professional accounts of ECV; and breech presentation as a means of choosing planned CS. Some women’s attitudes to ECV were affected by their preferences for how to give birth. Other women chose CS because ECV was not acceptable to them. Two main themes emerged from the interview data about health professionals’ attitudes towards ECV: directive counselling and attitudes towards lay beliefs about ECV and breech presentation. Conclusions Women had a range of attitudes to ECV informed by their preferences for how to give birth; the acceptability of ECV to them; and lay accounts of ECV, which were frequently negative. Most professionals described having a preference for ECV and reported directively counselling women to choose it. Some professionals were dismissive of lay beliefs about ECV. Some key challenges for shared decision making about breech presentation were identified: health professionals counselling women directively about ECV and the differences between evidence

  8. A qualitative interview study exploring pregnant women’s and health professionals’ attitudes to external cephalic version

    Directory of Open Access Journals (Sweden)

    Say Rebecca

    2013-01-01

    Full Text Available Abstract Background Women who have a breech presentation at term have to decide whether to attempt external cephalic version (ECV and how they want to give birth if the baby remains breech, either by planned caesarean section (CS or vaginal breech birth. The aim of this study was to explore the attitudes of women with a breech presentation and health professionals who manage breech presentation to ECV. Methods We carried out semi-structured interviews with pregnant women with a breech presentation (n=11 and health professionals who manage breech presentation (n=11 recruited from two hospitals in North East England. We used purposive sampling to include women who chose ECV and women who chose planned CS. We analysed data using thematic analysis, comparing between individuals and seeking out disconfirming cases. Results Four main themes emerged from the data collected during interviews with pregnant women with a breech presentation: ECV as a means of enabling natural birth; concerns about ECV; lay and professional accounts of ECV; and breech presentation as a means of choosing planned CS. Some women’s attitudes to ECV were affected by their preferences for how to give birth. Other women chose CS because ECV was not acceptable to them. Two main themes emerged from the interview data about health professionals’ attitudes towards ECV: directive counselling and attitudes towards lay beliefs about ECV and breech presentation. Conclusions Women had a range of attitudes to ECV informed by their preferences for how to give birth; the acceptability of ECV to them; and lay accounts of ECV, which were frequently negative. Most professionals described having a preference for ECV and reported directively counselling women to choose it. Some professionals were dismissive of lay beliefs about ECV. Some key challenges for shared decision making about breech presentation were identified: health professionals counselling women directively about ECV and the

  9. What Risk Factors and Characteristics Are Associated With Late-presenting Dislocations of the Hip in Infants?

    Science.gov (United States)

    Mulpuri, Kishore; Schaeffer, Emily K; Andrade, Janice; Sankar, Wudbhav N; Williams, Nicole; Matheney, Travis H; Mubarak, Scott J; Cundy, Peter J; Price, Charles T

    2016-05-01

    Most infants with developmental dysplasia of the hip (DDH) are diagnosed within the first 3 months of life. However, late-presenting DDH (defined as a diagnosis after 3 months of age) does occur and often results in more complex treatment and increased long-term complications. Specific risk factors involved in late-presenting DDH are poorly understood, and clearly defining an associated set of factors will aid in screening, detection, and prevention of this condition. Using a multicenter database of patients with DDH, we sought to determine whether there were differences in (1) risk factors or (2) the nature of the dislocation (laterality and joint laxity) when comparing patients with early versus late presentation. A retrospective review of prospectively collected data from a multicenter database of patients with dislocated hips was conducted from 2010 to 2014. Baseline demographics for fetal presentation (cephalic/breech), birth presentation (vaginal/cesarean), birth weight, maternal age, maternal parity, gestational age, family history, and swaddling history of patients were compared among nine different sites for patients who were enrolled at age younger than 3 months and those enrolled between 3 and 18 months of age. A total of 392 patients were enrolled at baseline between 0 and 18 months of age with at least one dislocated hip. Of that group, 259 patients were younger than 3 months of age and 133 were 3 to 18 months of age. The proportion of patients with DDH who were enrolled and followed at the nine participating centers was 98%. A univariate/multivariate analysis was performed comparing key baseline demographics between early- and late-presenting patients. After controlling for relevant confounding variables, two variables were identified as risk factors for late-presenting DDH as compared with early-presenting: cephalic presentation at birth and swaddling history. Late-presenting patients were more likely to have had a cephalic presentation than early-presenting

  10. Impact of late presentation of HIV infection on short-, mid- and long-term mortality and causes of death in a multicenter national cohort: 2004-2013.

    Science.gov (United States)

    Sobrino-Vegas, Paz; Moreno, Santiago; Rubio, Rafael; Viciana, Pompeyo; Bernardino, José Ignacio; Blanco, José Ramón; Bernal, Enrique; Asensi, Víctor; Pulido, Federico; del Amo, Julia; Hernando, Victoria

    2016-05-01

    To analyze the impact of late presentation (LP) on overall mortality and causes of death and describe LP trends and risk factors (2004-2013). Cox models and logistic regression were used to analyze data from a nation-wide cohort in Spain. LP is defined as being diagnosed when CD4 HIV diagnoses, 46.9% (CI95%:45.7-48.0) were LP, 240 patients died. First-year mortality was the highest (aHRLP.vs.nLP = 10.3[CI95%:5.5-19.3]); between 1 and 4 years post-diagnosis, aHRLP.vs.nLP = 1.9(1.2-3.0); and >4 years, aHRLP.vs.nLP = 1.5(0.7-3.1). First-year's main cause of death was HIV/AIDS (73%); and malignancies among those surviving >4 years (32%). HIV/AIDS-related deaths were more likely in LP (59.2% vs. 25.0%; p 50.vs.HIV/AIDS-related mortality. Mid-term-, but not long-term mortality, remained also higher in LP than nLP. LP decreased in MSM and heterosexual men, not in heterosexual women. The groups most affected by LP are low educated, non-Spanish and heterosexual women. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Cholesterol-crystal embolism presenting with delayed graft function and impaired long-term function in renal transplant recipients: two case reports

    Directory of Open Access Journals (Sweden)

    Pliquett Rainer U

    2009-03-01

    Full Text Available Abstract Introduction Impaired renal function and/or pre-existing atherosclerosis in the deceased donor increase the risk of delayed graft function and impaired long-term renal function in kidney transplant recipients. Case presentation We report delayed graft function occurring simultaneously in two kidney transplant recipients, aged 57-years-old and 39-years-old, who received renal allografts from the same deceased donor. The 62-year-old donor died of cardiac arrest during an asthmatic state. Renal-allograft biopsies performed in both kidney recipients because of delayed graft function revealed cholesterol-crystal embolism. An empiric statin therapy in addition to low-dose acetylsalicylic acid was initiated. After 10 and 6 hemodialysis sessions every 48 hours, respectively, both renal allografts started to function. Glomerular filtration rates at discharge were 26 ml/min/1.73m2 and 23.9 ml/min/1.73m2, and remained stable in follow-up examinations. Possible donor and surgical procedure-dependent causes for cholesterol-crystal embolism are discussed. Conclusion Cholesterol-crystal embolism should be considered as a cause for delayed graft function and long-term impaired renal allograft function, especially in the older donor population.

  12. Normal prehospital electrocardiography is linked to long-term survival in patients presenting to the emergency department with symptoms of acute coronary syndrome.

    Science.gov (United States)

    Zègre-Hemsey, Jessica K; Sommargren, Claire E; Asafu-Adjei, Josephine K; Drew, Barbara J

    2015-01-01

    We studied 735 patients who activated "911" for chest pain and/or anginal equivalent symptoms and received 12-lead ECG monitoring with specialized ischemia monitoring software in the ambulance. Prehospital electrocardiograms (PH ECG) were analyzed to determine the proportion of patients who present with completely normal PH ECG findings (absence of ischemia/infarction, arrhythmia, or any other abnormality) and to compare outcomes among patients with and without any PH ECG abnormality. Of 735 patients (mean age 70.5, 52.4% male), 68 (9.3%) patients had completely normal PH ECG findings. They experienced significantly less adverse hospital outcomes (12% vs 37%), length of stay (1.19 vs 3.86 days), and long-term mortality (9% vs 28%) than those with any PH ECG abnormality (p<.05). Normal PH ECG findings are associated with better short and long-term outcomes in ambulance patients with ischemic symptoms. These findings may enhance early triage and risk stratification in emergency cardiac care. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Competent antigen-presenting cells are generated from the long-term culture of splenocytes with granulocyte-macrophage colony-stimulating factor.

    Science.gov (United States)

    Ryu, Seul Hye; Na, Hye Young; Sohn, Moah; Choi, Wanho; In, Hyunju; Shin, Hyun Soo; Choi, Jae-Hoon; Park, Chae Gyu

    2017-08-01

    Dendritic cells (DCs) are routinely produced from the culture of mouse bone marrow (BM) with granulocyte-macrophage colony-stimulating factor (GM-CSF) within a period of 10days. Although splenic extramedullary myelopoiesis was suggested to occur under the influence of GM-CSF, the hematopoietic outcome of splenic culture with GM-CSF has not been scrutinized. We have cultured mouse splenocytes with GM-CSF for an extended period of time, where we discovered that the CD11b⁺CD11c⁺ cells began to proliferate prominently after 10days and their number increased until the 4th week of the culture. In parallel experiments, FMS-like tyrosine kinase 3 (FLT3) and its ligand, FLT3L, were not found to influence the culture of splenocytes. Like DCs in the culture of BM with GM-CSF, a distinct population of CD11b⁺CD11c⁺MHC IIhi cells was readily identified as DCs in the long-term culture of splenocytes. After being isolated and plated overnight the CD11b⁺CD11c⁺MHC IIhi cells exhibited non-adherent dendritic morphology, while the other CD11b⁺CD11c⁺ cells became adherent. Besides, these CD11b⁺CD11c⁺MHC IIhi cells possessed relatively weak endocytic and phagocytic abilities but displayed strong antigen-presenting capacities, revealing DC-like characteristics; in contrast, the other CD11b⁺CD11c⁺ cells showed strong endocytosis and phagocytosis of antigens but were poor at antigen presentation, indicating macrophage-like traits. Therefore, we demonstrated that phenotypically as well as functionally genuine DCs are generated in the long-term culture of splenocytes with GM-CSF. Copyright © 2017 European Federation of Immunological Societies. Published by Elsevier B.V. All rights reserved.

  14. Poor Long-Term Outcome in a Survivor Presenting with the Twin Reversed Arterial Perfusion Sequence In Utero: A Case Report

    Directory of Open Access Journals (Sweden)

    Chih-Chen Chen

    2003-10-01

    Full Text Available The twin reversed arterial perfusion (TRAP sequence is a very rare complication of multiple gestations and is associated with a high mortality rate, reaching more than 50% in pump twins. The four common complications are preterm labor, polyhydramnios, fetal congestive heart failure, and fetal death of the pump twin in utero. Prenatal diagnosis during early pregnancy is possible using detailed ultrasonographic examination. Therapies, including conservative treatment and invasive procedures, are directed toward achieving optimal maintenance of pump twins based on clinical presentation. Risk factors for pump twin mortality include a high twin-to-twin weight ratio, acardiacus anceps, low umbilical artery pulsatility index, and a rapid growth rate in the acardiac twin. Herein, we present a case of TRAP sequence in a patient who underwent conservative treatment and had a poor neurologic outcome during long-term follow-up. Although the experience is still limited, early diagnosis of TRAP sequence and more aggressive treatment, instead of an expectant approach, might be a better option.

  15. An Experimental Investigation of Stresses in a Steel Model of an Overloaded Breech Ring by Means of Photoelastic Coating Technique

    Science.gov (United States)

    1980-08-01

    following the same law of yielding. The shape of the stress strain 4 curve is represented by a parameter in the Ramberg - Osgood equation. It is possible...becomes ^ Ramberg , W. and Osgood , W. R., "Description of Stress-Strain Curves by Three Parameters," NACA TN 902, 1943. ^Mesnager, M., "Sur la...34 to be presented at the International Conference on Reliability Stress Analysis and Failure Presentation, ASME, San Francisco, August 1980. 4. Ramberg

  16. Presenting features and long-term effects of growth hormone treatment of children with optic nerve hypoplasia/septo-optic dysplasia

    Directory of Open Access Journals (Sweden)

    Vedin Amy M

    2011-11-01

    Full Text Available Abstract Background Optic nerve hypoplasia (ONH with/or without septo-optic dysplasia (SOD is a known concomitant of congenital growth hormone deficiency (CGHD. Methods Demographic and longitudinal data from KIGS, the Pfizer International Growth Database, were compared between 395 subjects with ONH/SOD and CGHD and 158 controls with CGHD without midline pathology. Results ONH/SOD subjects had higher birth length/weight, and mid-parental height SDS. At GH start, height, weight, and BMI SDS were higher in the ONH/SOD group. After 1 year of GH, both groups showed similar changes in height SDS, while weight and BMI SDS remained higher in the ONH/SOD group. The initial height responses of the two groups were similar to those predicted using the KIGS-derived prediction model for children with idiopathic GHD. At near-adult height, ONH/SOD and controls had similar height, weight, and BMI SDS. Conclusions Compared to children with CGHD without midline defects, those with ONH/SOD presented with greater height, weight, and BMI SDS. These differences persisted at 1 year of GH therapy, but appeared to be overcome by long-term GH treatment.

  17. Effect of maternal intravenous fluid therapy on external cephalic version at term: a prospective cohort study.

    Science.gov (United States)

    Burgos, Jorge; Quintana, Eider; Cobos, Patricia; Osuna, Carmen; Centeno, María del Mar; Melchor, Juan Carlos

    2014-12-01

    We sought to analyze whether maternal intravenous fluid therapy prior to external cephalic version (ECV) increases the amount of amniotic fluid and the success rate of the procedure. This was a prospective single-center cohort study of 200 women with a consecutive cohort of 100 pregnant women with a breech presentation at term who were administered intravenous fluid therapy with 2 L of hypotonic saline before the version attempt, compared to a control cohort of 100 pregnant women not given hydration treatment. The mean increase in the amniotic fluid index (AFI) after intravenous maternal hydration was 3.75 ± 2.71 cm. The amount of fluid before hydration was the only variable found to be associated with increases in amniotic fluid levels, both in absolute and relative terms (odds ratio, -0.21; 95% confidence interval, -0.37 to -0.05 and odds ratio, -4.62; 95% confidence interval, -6.17 to -3.06; P intravenous fluid therapy. The ECV success rate was 43% in the study group compared to 47% in the control group (P = .67). The success rate was significantly lower the larger the relative increase in the AFI, although no correlation was found in absolute terms (χ(2) for linear trend = 0.03 and 0.34, respectively). Maternal intravenous fluid therapy with 2 L of hypotonic saline prior to ECV is an effective and safe technique for increasing the AFI. However, its use in ECV does not increase the success rate of the procedure. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. A long-term nearshore wave hindcast for Ireland: Atlantic and Irish Sea coasts (1979-2012). Present wave climate and energy resource assessment

    Science.gov (United States)

    Gallagher, Sarah; Tiron, Roxana; Dias, Frédéric

    2014-08-01

    The Northeast Atlantic possesses some of the highest wave energy levels in the world. The recent years have witnessed a renewed interest in harnessing this vast energy potential. Due to the complicated geomorphology of the Irish coast, there can be a significant variation in both the wave and wind climate. Long-term hindcasts with high spatial resolution, properly calibrated against available measurements, provide vital information for future deployments of ocean renewable energy installations. These can aid in the selection of adequate locations for potential deployment and for the planning and design of those marine operations. A 34-year (from 1979 to 2012), high-resolution wave hindcast was performed for Ireland including both the Atlantic and Irish Sea coasts, with a particular focus on the wave energy resource. The wave climate was estimated using the third-generation spectral wave model WAVEWATCH III®; version 4.11, the unstructured grid formulation. The wave model was forced with directional wave spectral data and 10-m winds from the European Centre for Medium Range Weather Forecasts (ECMWF) ERA-Interim reanalysis, which is available from 1979 to the present. The model was validated against available observed satellite altimeter and buoy data, particularly in the nearshore, and was found to be excellent. A strong spatial and seasonal variability was found for both significant wave heights, and the wave energy flux, particularly on the north and west coasts. A strong correlation between the North Atlantic Oscillation (NAO) teleconnection pattern and wave heights, wave periods, and peak direction in winter and also, to a lesser extent, in spring was identified.

  19. Recurrence risk of low Apgar score among term singletons: a population-based cohort study.

    Science.gov (United States)

    Ensing, Sabine; Schaaf, Jelle M; Abu-Hanna, Ameen; Mol, Ben W J; Ravelli, Anita C J

    2014-09-01

    To examine the risk of recurrence of low Apgar score in a subsequent term singleton pregnancy. Population-based cohort study. The Netherlands. A total of 190,725 women with two subsequent singleton term live births between 1999 and 2007. We calculated the recurrence risk of low Apgar score after adjustment for possible confounders. Women with an elective cesarean delivery, fetus in breech presentation or a fetus with congenital anomalies were excluded. Results were reported separately for women with a vaginal delivery or a cesarean delivery at first pregnancy. Prevalence of birth asphyxia, a 5-min Apgar score Apgar score of Apgar score in the subsequent pregnancy was 1.1% (odds ratio 2.1, 95% confidence interval 1.4-3.3). This recurrence risk was present in women with a previous vaginal delivery (odds ratio 2.1, 95% confidence interval 1.2-3.5) and in women with a previous cesarean delivery (odds ratio 3.8, 95% confidence interval 1.7-8.5). Among women with a small-for-gestational-age infant in the subsequent pregnancy and a previous vaginal delivery, the recurrence risk was 4.8% (adjusted odds ratio 5.8, 95% confidence interval 2.0-16.5). Women with birth asphyxia of the first born have twice the risk of renewed asphyxia at the next birth compared to women without birth asphyxia of the first born. This should be incorporated in the risk assessment of pregnant women. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

  20. Past and present of corneal refractive surgery: a retrospective study of long-term results after photorefractive keratectomy and a prospective study of refractive lenticule extraction.

    Science.gov (United States)

    Vestergaard, Anders Højslet

    2014-03-01

    Surgical correction of refractive errors is becoming increasingly popular. In the 1990s, the excimer laser revolutionized the field of corneal refractive surgery with PRK and LASIK, and lately refractive lenticule extraction (ReLEx) of intracorneal tissue, using only a femtosecond laser, has become possible. Two new procedures were developed, ReLEx flex (FLEX) and ReLEx smile (SMILE). Until this thesis, only a few long-term studies of PRK with a relatively limited number of patients had been published; therefore, this thesis intended to retrospectively evaluate long-term outcomes after PRK for all degrees of myopia for a large number of patients. Furthermore, a prospective contralateral eye study comparing FLEX and SMILE, when treating high to moderate degrees of myopia, had not been performed prior to this study. This was the second aim of this thesis. In the first study, results from 160 PRK patients (289 eyes) were presented. Preoperative spherical equivalent ranged from -1.25 to -20.25 D, with 78% having low myopia (corneas, etc.). The results also highlight that treatment of higher degrees of myopia with standard PRK should only be done today under special circumstances, due to low refractive predictability, and high risk of corneal haze. Technological advances since then should be taken into account when comparing these results with contemporary techniques. In the second study, 35 patients were randomized to receive FLEX in one eye and SMILE in the other. Preoperative spherical equivalent refraction ranged from -6 to -10 D with low degrees of astigmatism. A total of 34 patients completed the 6 month follow-up period. Refractive and visual outcomes were very similar for the two methods, as well as tear film measurements and changes in corneal biomechanics. Ninety-seven percent were within ± 1.00 D of target refraction, no eyes lost two lines or more of CDVA, and contrast sensitivity was unaffected after both procedures. The changes in higher-order aberrations

  1. The Long-term deformation of the Longmen Shan (Sichuan, China), a key to understand the present structure of the eastern Tibet

    Science.gov (United States)

    Airaghi, Laura; de Sigoyer, Julia; Guillot, Stéphane; Lanari, Pierre; Warren, Clare J.; Robert, Alexandra

    2017-04-01

    The Longmen Shan thrust belt, at the eastern border of Tibetan plateau, is a tectonically active region as demonstrated by the Mw 7.9 Wenchuan (2008) and Mw 6.6 Lushan (2013) earthquakes. The Moho discontinuity deepens across the Longmen Shan (below the along-strike Wenchuan fault) from ˜40 km beneath the Sichuan basin to more than 60 km beneath the Songpan-Ganze block. Such a thickness is not compatible with the only ˜35 km of shortening estimated at the front of the belt during the Cenozoic-Quaternary compressive reactivation. The geological inheritance may thus play a key role in the present structure of the Longmen Shan. However the long-term history of the belt is still poorly documented. The major Wenchuan fault separates medium-grade metamorphic rocks to the West (internal domain of the Longmen Shan) to the greenschist metamorphic rocks to the East (external domain). In the hanging and footwall of the fault the South China basement also crops out. Metamorphic rocks, exhumed from depth, offer the opportunity to investigate the deep processes occurred in the Longmen Shan. We have characterized and dated the metamorphism in the central part of the belt by combining structural and microstructural observations with high-resolution X-ray mapping and chemical analyses of metamorphic minerals related to the different stages of deformation. In situ 40Ar/39Ar dating on mica and in situ U-Pb/Th dating on allanite (REE-rich epidote) allowed the different phases of metamorphism and deformation to be dated. Our results show that the Longmen Shan underwent a complex Mesozoic tectono-metamorphic history, articulated in a succession of pulses of deformation (burial or uplifting) and periods of quiescence. A first phase of rapid thin-skinned deformation occurred about 200 Ma ago. Internal sedimentary units were strongly deformed and buried down to 11±1 kbar, 550±30˚ C. This phase was followed by a period of slow exhumation between 200 and 170 Ma. A second pulse of

  2. SINGLETON BREECH DELIVERIES IN IBADAN

    African Journals Online (AJOL)

    intrauterine deaths and congenital abnormalities, 524 of these cases were fully studied. Data was collected from the labour ward records, lying-in ward case records and in some cases, the. casefiles of those admitted to the Special Care Baby Unit (SCBU). For the purpose of this study a perinatal death is that of the fetus.

  3. Prevalence, presentation and prognosis of delirium in older people in the population, at home and in long term care : a review

    NARCIS (Netherlands)

    de Lange, E.; Verhaak, P. F. M.; van der Meer, K.

    Objective The aim of this study is to provide an overview of prevalence, symptoms, risk factors and prognosis of delirium in primary care and institutionalized long-term care. Design The method used in this study is a systematic PubMed search and literature review. Results The prevalence of delirium

  4. Prevalence, presentation and prognosis of delirium in older people in the population, at home and in long term care: a review.

    NARCIS (Netherlands)

    Lange, E. de; Verhaak, P.F.M.; Meer, K. van der

    2013-01-01

    Objective: The aim of this study is to provide an overview of prevalence, symptoms, risk factors and prognosis of delirium in primary care and institutionalized long-term care. Design: The method used in this study is a systematic PubMed search and literature review. Results: The prevalence of

  5. Non-obstructive coronary artery disease upon multi-detector computed tomography in patients presenting with acute chest pain--results of an intermediate term follow-up.

    Science.gov (United States)

    Segev, Amit; Beigel, Roy; Goitein, Orly; Brosh, Sella; Oiero, Dan; Konen, Eli; Hod, Hanoch; Matetzky, Shlomi

    2012-02-01

    Multi-detector computed tomography (MDCT) has emerged as an efficient tool for detection of obstructive coronary artery disease (CAD) and assessment of patients with acute chest pain. MDCT may detect premature, non-obstructive atherosclerotic lesions which otherwise would have not been detected upon functional cardiac imaging tests. Currently, there is scarce data regarding the clinical significance of these lesions. The purpose of this study was to prospectively analyse the intermediate term outcome of patients admitted to chest pain unit (CPU) with findings of non-obstructive CAD upon MDCT. Method and results The study comprised 444 patients admitted to the CPU at Sheba Medical Center and underwent evaluation by MDCT for complaints of acute chest pain. Studies were classified as: normal; non-obstructive CAD (defined as any narrowing Patients were followed up for a minimum of 1 year and outcomes were compared between the non-obstructive (n = 115) and the normal (n = 266) MDCT groups in regard to MACE [coronary revascularization, acute coronary syndrome (ACS), and death]. Comparing the groups, those with non-obstructive CAD were older, more likely to be males, and dyslipidaemic. During an intermediate term follow-up (2.5 ± 0.4 years) MACE was equally low between the two groups (1% for both groups; P = 0.9). Among patients evaluated by MDCT for acute chest pain, during an intermediate term follow-up, those with non-obstructive CAD had a benign clinical outcome compared with those with normal coronary arteries.

  6. Emergency Presentation and Short-Term Survival Among Patients With Colorectal Cancer Enrolled in the Government Health Plan of Puerto Rico.

    Science.gov (United States)

    Ortiz-Ortiz, Karen J; Ríos-Motta, Ruth; Marín-Centeno, Heriberto; Cruz-Correa, Marcia R; Ortiz, Ana P

    2016-01-01

    In this study, we examine factors associated with the use of the emergency room (ER) as an entry point into the health-care system to initiate a cancer diagnosis among Puerto Rico's Government Health Plan (GHP) patients and compare the 1-year survival of GHP patients that initiated cancer diagnosis in the emergency room (ER) presentation with those that initiated the diagnosis in a physician's office. Data for patients with colorectal cancer (CRC) aged 50 to 64 years and diagnosed in 2012 were obtained from the Puerto Rico Central Cancer Registry and linked to the Puerto Rico Health Insurance Administration database (n = 190). Crude odds ratio, adjusted odds ratio, and their 95% confidence intervals were reported. We used the Kaplan-Meier method to generate survival curves. Multivariate Cox regression analysis was performed to evaluate the association between ER presentation and 1-year cause-specific survival. We found that 37.37% of the study population had an ER presentation. Male patients had a higher occurrence of having an ER presentation (66.20%), while 76.06% of the patients with an ER presentation were diagnosed in late stage. Emergency room presentation was a highly predictive factor for cancer mortality in the year following the diagnosis. These patients had between 3.99 to 4.24 times higher mortality risk than non-ER presentation patients ( P < .05). Late presentation for CRC diagnosis through an ER visit is a significant concern that influences negatively on the patient's outcome. Efforts at increasing primary care visits and routine screening tests among GHP beneficiaries could improve survival.

  7. Emergency Presentation and Short-Term Survival Among Patients With Colorectal Cancer Enrolled in the Government Health Plan of Puerto Rico

    Directory of Open Access Journals (Sweden)

    Karen J. Ortiz-Ortiz

    2016-05-01

    Full Text Available Objective: In this study, we examine factors associated with the use of the emergency room (ER as an entry point into the health-care system to initiate a cancer diagnosis among Puerto Rico’s Government Health Plan (GHP patients and compare the 1-year survival of GHP patients that initiated cancer diagnosis in the emergency room (ER presentation with those that initiated the diagnosis in a physician’s office. Methods: Data for patients with colorectal cancer (CRC aged 50 to 64 years and diagnosed in 2012 were obtained from the Puerto Rico Central Cancer Registry and linked to the Puerto Rico Health Insurance Administration database (n = 190. Crude odds ratio, adjusted odds ratio, and their 95% confidence intervals were reported. We used the Kaplan-Meier method to generate survival curves. Multivariate Cox regression analysis was performed to evaluate the association between ER presentation and 1-year cause-specific survival. Results: We found that 37.37% of the study population had an ER presentation. Male patients had a higher occurrence of having an ER presentation (66.20%, while 76.06% of the patients with an ER presentation were diagnosed in late stage. Emergency room presentation was a highly predictive factor for cancer mortality in the year following the diagnosis. These patients had between 3.99 to 4.24 times higher mortality risk than non-ER presentation patients ( P < .05. Conclusion: Late presentation for CRC diagnosis through an ER visit is a significant concern that influences negatively on the patient’s outcome. Efforts at increasing primary care visits and routine screening tests among GHP beneficiaries could improve survival.

  8. Congenital Uterovaginal Prolapse Present at Birth

    African Journals Online (AJOL)

    common risk factor (85% of cases).[1-4] Occult spina bifida as occurred in the index patient is not common. Defective innervations of the pelvic floor muscle in meningomyelocele may lead to weakened support of the uterus and vagina. The rise in fetal intra-abdominal pressure during breech delivery stretches the pelvic floor.

  9. Fatty acids in formulae for term infants: compliance of present recommendations with the actual human milk fatty acid composition of geographically different populations.

    Science.gov (United States)

    Smit, E N; Martini, I A; Kemperman, R F J; Schaafsma, A; Muskiet, F A J; Boersma, E R

    2003-07-01

    Recommendations for formula fatty acids (FA) are largely based on the mature human milk FA composition. This study aimed to investigate whether current recommendations for formula FA for term infants comply with the actual breast-milk FA composition of geographically distinct populations and to provide more realistic grounds for future recommendations. 455 mature breast-milk samples were collected in different countries over 25 y. Recommendations of different organizations were projected on their FA data. FA interrelationships were calculated with Spearman's rank tests. FA compositions of 30 formulae were compared with those of breast milk. Many samples from non-Western communities did not meet the recommendations for formula 12:0, 14:0 and 18:2omega6, since these are mainly based on breast milk of mothers living in Western countries. Recommendations for 18:3omega3, 18:2omega6/18:3omega3, 20:4omega6 and 22:6omega3 were not met by many milk samples, which may point to the poorly developed recommendations for long-chain polyunsaturated FA. Most of the investigated breast-milk FA (12:0, 14:0, 16:0, 18:0, 18:3omega3, 22:6omega3, 18:2omega6, 20:4omega6, 18:1omega9) were either positively or negatively interrelated. Many formulae had FA compositions that were not consistent with the physiological interrelationships of FA in breast milk. Future recommendations, if based on human milk, should derive from its FA balance, as indicated by the FA interrelationships. A "humanized" formula FA composition would in this sense be any composition that cannot be distinguished from that of breast milk by techniques such as principal component analysis.

  10. The European General Practice Research Network presents a comprehensive definition of multimorbidity in family medicine and long term care, following a systematic review of relevant literature.

    Science.gov (United States)

    Le Reste, Jean Yves; Nabbe, Patrice; Manceau, Benedicte; Lygidakis, Charilaos; Doerr, Christa; Lingner, Heidrun; Czachowski, Slawomir; Munoz, Miguel; Argyriadou, Stella; Claveria, Ana; Le Floch, Bernard; Barais, Marie; Bower, Peter; Van Marwijk, Harm; Van Royen, Paul; Lietard, Claire

    2013-05-01

    Multimorbidity is a new concept encompassing all the medical conditions of an individual patient. The concept links into the European definition of family medicine and its core competencies. However, the definition of multimorbidity and its subsequent operationalization are still unclear. The European General Practice Research Network wanted to produce a comprehensive definition of multimorbidity. Systematic review of literature involving eight European General Practice Research Network national teams. The databases searched were PubMed, Embase, and Cochrane (1990-2010). Only articles containing descriptions of multimorbidity criteria were selected for inclusion. The multinational team undertook a methodic data extraction, according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The team identified 416 documents, selected 68 abstracts, included 54 articles, and found 132 definitions with 1631 different criteria. These criteria were aggregated into 11 themes that led to the following definition: Multimorbidity is defined as any combination of chronic disease with at least one other disease (acute or chronic) or biopsychosocial factor (associated or not) or somatic risk factor. Any biopsychosocial factor, any risk factor, the social network, the burden of diseases, the health care consumption, and the patient's coping strategies may function as modifiers (of the effects of multimorbidity). Multimorbidity may modify the health outcomes and lead to an increased disability or a decreased quality of life or frailty. This study has produced a comprehensive definition of multimorbidity. The resulting improvements in the management of multimorbidity, and its usefulness in long term care and in family medicine, will have to be assessed in future studies. Copyright © 2013 American Medical Directors Association, Inc. All rights reserved.

  11. Prefrontal blood flow and oxygenation measured by NIRS during long-term memory tasks are impaired by acute hyperglycemia (Conference Presentation)

    Science.gov (United States)

    Harris, R. Luke; Bell, Lindsay; Reimer, Andrea; Pettersen, Jacqueline A.; Siakaluk, Paul; Duffels, Brian

    2017-02-01

    Our goal was to use 2-channel frequency domain near-infrared spectroscopy (NIRS) to investigate the hemodynamic and metabolic mechanisms underlying hyperglycemia-associated long-term memory impairment. We hypothesized that prefrontal cortex (PFC) oxygen saturation (%Sat) and perfusion (tHb, i.e. total hemoglobin) would decrease due to hyperglycemia during learning, and then increase during recall. During learning, participants' blood glucose was manipulated with beverages containing either 47.4 mg saccharine control (CON, n = 10), or 50 g dextrose + 23.7 mg saccharine (GLC, n = 10). In the Symbol-Digit Modalities Test (SMDT) participants matched nine symbols to corresponding digits (1-9 inclusive), completing 105 learning and 15 testing trials on day 1 and 15 testing trials on day 2. From learning to recall, CON SMDT performance was unchanged, but GLC SMDT performance was decreased 11% (P = 0.0173). There were significant interactions (2-way ANOVA) between the CON-GLC treatment effects and the learning-recall effects for both PFC perfusion and oxygen saturation. Specifically, comparing learning to recall, CON exhibited no tHb differences but for GLC there was a large tHb decrease during learning with a partial recovery toward CON values during recall (P = 0.0012); and, comparing learning to recall, CON exhibited a large %Sat decrease but GLC exhibited a large %Sat increase (P = 0.021). We speculate that, during learning, after overnight fasting (CON) the PFC demands more hemodynamic and metabolic resources and "works" harder, but with readily available sugar (GLC) the PFC exhibits decreased "effort."

  12. Long-term trajectories of patients with neck pain and low back pain presenting to chiropractic care: A latent class growth analysis.

    Science.gov (United States)

    Ailliet, L; Rubinstein, S M; Hoekstra, T; van Tulder, M W; de Vet, H C W

    2018-01-01

    Information on the course of neck pain (NP) and low back pain (LBP) typically relies on data collected at few time intervals during a period of up to 1 year. In this prospective, multicentre practice-based cohort study, patients consulting a chiropractor responded weekly for 52 weeks to text messages on their cell phones. Data from 448 patients (153 NP, 295 LBP) who had returned at least one set of answers in the first 26 weeks were used. Outcome measures were pain intensity (VAS) and functional outcome, assessed using four different questions: pain intensity, limitation in activities of daily living (ADL), number of days with pain in the previous week and number of days limited in ADL. Distinct patterns of pain were analysed with quadratic latent class growth analysis. The final model was a 4-class model for NP and LBP. The 'recovering from mild baseline pain' is most common (76.3% of NP patients/58.3% of LBP patients) followed by the 'recovering from severe baseline pain' class (16.3% NP/29.8% LBP). They follow similar trajectories when considered over a period of 6 months. Pain at baseline, duration of complaints, functional status, limitations in ADL and the score on psychosocial scales were the variables that most contributed to distinguish between groups. Most patients with NP or LBP presenting in chiropractic care show a trajectory of symptoms characterized by persistent or fluctuating pain of low or medium intensity. Only a minority either experience a rapid complete recovery or develop chronic severe pain. Ninety percentage of patients with neck pain or low back pain presenting to chiropractors have a 30% improvement within 6 weeks and then show a trajectory of symptoms characterized by persistent or fluctuating pain of low or medium intensity. Only a minority either experience a rapid complete recovery or develop chronic severe pain. © 2017 European Pain Federation - EFIC®.

  13. Quantitative long term measurements of burns in a rat model using spatial frequency domain imaging and laser speckle imaging (Conference Presentation)

    Science.gov (United States)

    Ponticorvo, Adrien; Rowland, Rebecca A.; Baldado, Melissa L.; Kennedy, Gordon T.; Saager, Rolf B.; Choi, Bernard; Durkin, Anthony J.

    2016-04-01

    The ability to accurately assess burn wound severity in a timely manner is a critical component of wound management as it dictates the course of treatment. While full thickness and superficial burns can be easily diagnosed through visual inspection, burns that fall in between these categories are difficult to classify. Additionally, the ability to better quantify different stages of wound healing from a burn of any severity would be important for evaluating the efficacy of different treatment options. Here we present a longitudinal (28 day) study that employs spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI) as non-invasive technologies to characterize in-vivo burn wounds and healing in a murine model. Burn wounds were created using an established technique of a brass comb heated to a given temperature and applied for a set amount of time. They were imaged immediately after the initial injury and then at 2, 4, 7, 14, 21, and 28 days following the injury. Biopsies were taken on the day of the injury in order to verify the extent of the burn damage as well as at different time points after the injury in order to visualize different stages of inflammation and healing. The results of this study suggest that the reduced scattering coefficient measured using SFDI and blood flow as measured using LSI have the potential to provide useful metrics for quantifying the severity of burn injuries as well as track the different stages associated with wound healing progression.

  14. Conservative treatment of idiopathic scoliosis according to FITS concept: presentation of the method and preliminary, short term radiological and clinical results based on SOSORT and SRS criteria

    Science.gov (United States)

    2011-01-01

    Background Conservative scoliosis therapy according to the FITS Concept is applied as a unique treatment or in combination with corrective bracing. The aim of the study was to present author's method of diagnosis and therapy for idiopathic scoliosis FITS-Functional Individual Therapy of Scoliosis and to analyze the early results of FITS therapy in a series of consecutive patients. Methods The analysis comprised separately: (1) single structural thoracic, thoracolumbar or lumbar curves and (2) double structural scoliosis-thoracic and thoracolumbar or lumbar curves. The Cobb angle and Risser sign were analyzed at the initial stage and at the 2.8-year follow-up. The percentage of patients improved (defined as decrease of Cobb angle of more than 5 degrees), stable (+/- 5 degrees), and progressed (increase of Cobb angle of more than 5 degrees) was calculated. The clinical assessment comprised: the Angle of Trunk Rotation (ATR) initial and follow-up value, the plumb line imbalance, the scapulae level and the distance from the apical spinous process of the primary curve to the plumb line. Results In the Group A: (1) in single structural scoliosis 50,0% of patients improved, 46,2% were stable and 3,8% progressed, while (2) in double scoliosis 50,0% of patients improved, 30,8% were stable and 19,2% progressed. In the Group B: (1) in single scoliosis 20,0% of patients improved, 80,0% were stable, no patient progressed, while (2) in double scoliosis 28,1% of patients improved, 46,9% were stable and 25,0% progressed. Conclusion Best results were obtained in 10-25 degrees scoliosis which is a good indication to start therapy before more structural changes within the spine establish. PMID:22122964

  15. CATCHY PRESENTATIONS

    DEFF Research Database (Denmark)

    Eriksen, Kaare; Tollestrup, Christian; Ovesen, Nis

    2011-01-01

    and ideas in many areas and avoiding “Death by Powerpoint”. This paper discusses the need and tools for making short presentations and describes the result from a business development project where engineering graduate students in architecture and design used the Pecha Kucha format to present...

  16. Information Presentation

    Science.gov (United States)

    Holden, Kritina L.; Thompson, Shelby G.; Sandor, Aniko; McCann, Robert S.; Kaiser, Mary K.; Adelstein, Barnard D.; Begault, Durand R.; Beutter, Brent R.; Stone, Leland S.; Godfroy, Martine

    2009-01-01

    The goal of the Information Presentation Directed Research Project (DRP) is to address design questions related to the presentation of information to the crew. In addition to addressing display design issues associated with information formatting, style, layout, and interaction, the Information Presentation DRP is also working toward understanding the effects of extreme environments encountered in space travel on information processing. Work is also in progress to refine human factors-based design tools, such as human performance modeling, that will supplement traditional design techniques and help ensure that optimal information design is accomplished in the most cost-efficient manner. The major areas of work, or subtasks, within the Information Presentation DRP for FY10 are: 1) Displays, 2) Controls, 3) Procedures and Fault Management, and 4) Human Performance Modeling. The poster will highlight completed and planned work for each subtask.

  17. Poster Presentations

    National Research Council Canada - National Science Library

    2017-01-01

    [...]high index of suspicion was observed when other 4 patients presented with biopsy proven secondary membranous with history of intake of indigenous medications and all were shown to have increased urinary mercury levels...

  18. CERN presentations

    CERN Multimedia

    CERN. Geneva

    2011-01-01

    Presentation by CERN (10 minutes each) Rolf Landua - Education and Outreach Salvatore Mele - Open Access Jean-Yves Le Meur - Digital Library in Africa Francois Fluckiger - Open Source/Standards (tbc) Tim Smith - Open Data for Science Tullio Basiglia - tbc

  19. Analysis of long-term (median 10.5 years) outcomes in children presenting with traumatic brain injury and an initial Glasgow Coma Scale score of 3 or 4.

    Science.gov (United States)

    Fulkerson, Daniel H; White, Ian K; Rees, Jacqueline M; Baumanis, Maraya M; Smith, Jodi L; Ackerman, Laurie L; Boaz, Joel C; Luerssen, Thomas G

    2015-10-01

    Patients with traumatic brain injury (TBI) with low presenting Glasgow Coma Scale (GCS) scores have very high morbidity and mortality rates. Neurosurgeons may be faced with difficult decisions in managing the most severely injured (GCS scores of 3 or 4) patients. The situation may be considered hopeless, with little chance of a functional recovery. Long-term data are limited regarding the clinical outcome of children with severe head injury. The authors evaluate predictor variables and the clinical outcomes at discharge, 1 year, and long term (median 10.5 years) in a cohort of children with TBI presenting with postresuscitation GCS scores of 3 and 4. A review of a prospectively collected trauma database was performed. Patients treated at Riley Hospital for Children (Indianapolis, Indiana) from 1988 to 2004 were reviewed. All children with initial GCS (modified for pediatric patients) scores of 3 or 4 were identified. Patients with a GCS score of 3 were compared with those with a GCS score of 4. The outcomes of all patients at the time of death or discharge and at 1-year and long-term follow-up were measured with a modified Glasgow Outcome Scale (GOS) that included a "normal" outcome. Long-term outcomes were evaluated by contacting surviving patients. Statistical "classification trees" were formed for survival and outcome, based on predictor variables. Sixty-seven patients with a GCS score of 3 or 4 were identified in a database of 1636 patients (4.1%). Three of the presenting factors differed between the GCS 3 patients (n = 44) and the GCS 4 patients (n = 23): presence of hypoxia, single seizure, and open basilar cisterns on CT scan. The clinical outcomes were statistically similar between the 2 groups. In total, 48 (71.6%) of 67 patients died, remained vegetative, or were severely disabled by 1 year. Eight patients (11.9%) were normal at 1 year. Ten of the 22 patients with long-term follow-up were either normal or had a GOS score of 5. Multiple clinical

  20. Voting Present

    Directory of Open Access Journals (Sweden)

    James Lo

    2013-12-01

    Full Text Available During his time as a state senator in Illinois, Barack Obama voted “Present” 129 times, a deliberate act of nonvoting that subsequently became an important campaign issue during the 2008 presidential elections. In this article, I examine the use of Present votes in the Illinois state senate. I find evidence that Present votes can largely be characterized as protest votes used as a legislative tool by the minority party. Incorporating information from Present votes into a Bayesian polytomous item-response model, I find that this information increases the efficiency of ideal point estimates by approximately 35%. There is little evidence of significant moderation by Obama when Present votes are accounted for, though my results suggest that Obama’s voting record may have moderated significantly before his subsequent election to the U.S. Senate. My results also suggest that because legislative nonvoting may occur for a variety of reasons, naive inclusion of nonvoting behavior into vote choice models may lead to biased results.

  1. Technical presentation

    CERN Multimedia

    FI Department

    2008-01-01

    RADIOSPARES, the leading catalogue distributor of components (electronic, electrical, automation, etc.) and industrial supplies will be at CERN on Friday 3 October 2008 (Main Building, Room B, from 9.00 a.m. to 3.00 p.m.) to introduce its new 2008/2009 catalogue. This will be the opportunity for us to present our complete range of products in more detail: 400 000 part numbers available on our web site (Radiospares France, RS International, extended range of components from other manufacturers); our new services: quotations, search for products not included in the catalogue, SBP products (Small Batch Production: packaging in quantities adapted to customers’ requirements); partnership with our focus manufacturers; demonstration of the on-line purchasing tool implemented on our web site in conjunction with CERN. RADIOSPARES will be accompanied by representatives of FLUKE and TYCO ELECTRONICS, who will make presentations, demonstrate materials and answer any technical questio...

  2. Invasive micropapillary carcinoma of the breast has a better long-term survival than invasive ductal carcinoma of the breast in spite of its aggressive clinical presentations: a comparison based on large population database and case-control analysis.

    Science.gov (United States)

    Chen, Hongliang; Wu, Kejin; Wang, Maoli; Wang, Fuwen; Zhang, Mingdi; Zhang, Peng

    2017-12-01

    There are controversies in the comparison of overall survival between invasive micropapillary carcinoma of the breast (IMPC) and invasive ductal carcinoma (IDC). The objective of this study was to compare the long-term survival outcome between non-metastatic IMPC and IDC. The Surveillance, Epidemiology, and End Results database was searched to identify women with non-metastatic IMPC and IDC diagnosed between 2001 and 2013. Comparisons of patient and tumor characteristics were performed using Pearson's chi-square. The propensity score matching method was applied with each IMPC matched to one IDC. Breast cancer-specific survival (BCSS) and overall survival (OS) were estimated using the Kaplan-Meier product limit method and compared across groups using the log-rank statistic. Multivariate analysis was performed through Cox models. IMPC was presented with aggressive clinical presentations such as larger tumor, more positive lymph nodes, and more advanced stage compared with IDC. A higher rate of estrogen receptor (ER)/progesterone receptor (PR) positivity was also observed in IMPC. With a median follow-up of 64 months, IMPC had a better BCSS (P = 0.031) and OS (P = 0.012) compared with IDC. In a case-control analysis IMPC was still an independent favorable prognostic factor for BCSS (HR = 0.410, P analysis, IMPC always showed a better survival outcome compared with IDC except in AJCC stage I and histologic grade I disease. IMPC has a better long-term survival outcome compared with IDC in spite of its highly aggressive clinical presentation. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  3. A comparison of obstetrical outcomes with labor induction agents used at term.

    Science.gov (United States)

    Aghideh, Farnaz K; Mullin, Patrick M; Ingles, Sue; Ouzounian, Joseph G; Opper, Neisha; Wilson, Melissa L; Miller, David A; Lee, Richard H

    2014-04-01

    To compare the obstetrical outcomes of term pregnancies induced with one of four commonly used labor induction agents. This is a retrospective cohort study of induced deliveries between 1 August 1995 and 31 December 2007 occurring at the Los Angeles County + University of Southern California Medical Center. Viable, singleton, term pregnancies undergoing induction were identified. Exclusion criteria included gestational age less than 37 weeks, previous cesarean delivery, breech presentation, stillbirth, premature rupture of membranes, and fetal anomaly. Induction methods studied were oxytocin, misoprostol, dinoprostone and Foley catheter. Our primary outcome was cesarean delivery rate among the four induction agents. Secondary outcomes included rate of failed induction, obstetrical complications, and immediate neonatal complications. A total of 3707 women were included in the study (1486 nulliparous; 2221 multiparous). Outcomes were compared across induction methods using Chi-square Tests (Pearson or Fisher's, as appropriate). Among the nulliparous patients, there was no statistical difference among the four induction agents with regards to cesarean delivery rate (p = 0.51), frequency of failed inductions (p = 0.49), the cesarean delivery frequency for "fetal distress" (p = 0.82) and five minute Apgar score <7 (p = 0.24). Among parous patients, the cesarean delivery rate varied significantly by induction method (p < 0.001), being lowest among those receiving misoprostol (10%). Those receiving oxytocin and transcervical Foley catheter had cesarean rates of 22%, followed by dinoprostone at 18%. The rate of failed inductions was 2% among those receiving misoprostol, compared to 7-8% among those in the other groups (p < 0.01). Although cases of "fetal distress" between the four induction agents was not significantly different amongst multipara women, the cesarean delivery indication for "fetal distress" was higher among multipara receiving

  4. Impact of Multiple Complex Plaques on Short-and Long-Term Clinical in Patients Presenting with ST-Segment Elevation Myocardial Infarction (From the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction [HORIZONS-AMI] Trial)

    Science.gov (United States)

    Keeley, Ellen C.; Mehran, Roxana; Brener, Sorin J.; Witzenbichler, Bernhard; Guagliumi, Giulio; Dudek, Dariusz; Kornowski, Ran; Dressler, Ovidiu; Fahy, Martin; Xu, Ke; Grines, Cindy L.; Stone, Gregg W.

    2014-01-01

    It is not known whether the extent and severity of non-culprit coronary lesions correlate with outcomes in patients with STEMI referred for primary PCI. We sought to quantify complex plaques in ST-segment elevation myocardial infarction (STEMI) patients referred for primary percutaneous coronary intervention (PCI) and to determine their effect on short- and long-term clinical outcomes by examining the core laboratory database for plaque analysis from the HORIZONS-AMI study. Baseline demographic, angiographic, and procedural details were compared between patients with single vs. multiple complex plaques undergoing single vessel PCI. Multivariable analysis was performed for predictors of long-term major adverse cardiac events (MACE), a combined end point of death, reinfarction, ischemic target vessel revascularization, or stroke, and for death alone. Single vessel PCI was performed in 3,137 patients (87%): 2,174 (69%) had multiple complex plaques and 963 (31%) had a single complex plaque. Compared to those with a single complex plaque, patients with multiple complex plaques were older (p<0.0001) and had more comorbidities. The presence of multiple complex plaques was an independent predictor of 3-year MACE (hazard ratio [HR]: 1.58; 95% confidence interval [CI]: 1.26–1.98, p<0.0001), and death alone (HR: 1.68; 95% CI: 1.05–2.70, p=0.03). In conclusion, multiple complex plaques are present in the majority of STEMI patients undergoing primary PCI and their presence is an independent predictor of short- and long-term MACE, including death. (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction [HORIZONS-AMI]; NCT00433966) PMID:24703369

  5. Technical presentation

    CERN Multimedia

    FP Department

    2009-01-01

    07 April 2009 Technical presentation by Leuze Electronics: 14.00 – 15.00, Main Building, Room 61-1-017 (Room A) Photoelectric sensors, data identification and transmission systems, image processing systems. We at Leuze Electronics are "the sensor people": we have been specialising in optoelectronic sensors and safety technology for accident prevention for over 40 years. Our dedicated staff are all highly customer oriented. Customers of Leuze Electronics can always rely on one thing – on us! •\tFounded in 1963 •\t740 employees •\t115 MEUR turnover •\t20 subsidiaries •\t3 production facilities in southern Germany Product groups: •\tPhotoelectric sensors •\tIdentification and measurements •\tSafety devices

  6. Perinatal risk factors for low and moderate five-minute Apgar scores at term.

    Science.gov (United States)

    Lai, Shimona; Flatley, Christopher; Kumar, Sailesh

    2017-03-01

    To evaluate the specific maternal and perinatal variables associated with a low (≤3) or moderate (4-6) Apgar score, compared to a high (≥7) score. This was a retrospective, cohort study of 58429 term singleton babies born at the Mater Mother's Hospital in Brisbane, Australia in 2007-2013. Maternal demographics, socio-economic status using the Australian Socioeconomic Index for Areas (SEIFA) score, obstetric factors, and birth outcomes were compared for neonates grouped into three categories based on their five-minute Apgar: low (≤3), moderate (4-6) and high (≥7). The low- and moderate-score cohorts were individually compared to the high-score cohort using both univariate and multivariate analysis. Logistic regression analysis confirmed that of the variables analysed, only maternal public insurance status (OR 2.1, 95% CI 1.5-3.1), breech presentation (OR 2.4, 95% CI 1.1-4.6), other non-cephalic presentation (OR 9.5, 95% CI 2.2-25.4), intramuscular narcotic use (OR 2.3, 95% CI 1.5-3.5), and presence of meconium (OR 3.7, 95% CI 2.5-5.4) were significantly associated with low Apgar scores. Variables significantly associated with a moderate score were: SEIFA ≤50th centile (OR 1.6, 95% CI 1.2-2.0) and 61st to 70th centile (OR 1.31, 95% CI 0.9-1.8) categories, maternal public insurance status (OR 2.7, 95% CI 2.2-3.3), nulliparity (OR 2.0, 95% CI 1.7-2.5), emergency caesarean birth (OR 2.6, 95% CI 2.1-3.2), instrumental birth (OR 2.3, 95% CI 1.9-2.9), and presence of meconium (OR 2.6, 95% CI 2.1-3.2). Factors associated with low and moderate Apgar scores vary in type and degree of influence. Distinctions in the perinatal background can help predict newborn compromise and accelerate delivery of care. Copyright © 2017. Published by Elsevier B.V.

  7. Influence of advancing age on clinical presentation, treatment efficacy and safety, and long-term outcome of inducible paroxysmal supraventricular tachycardia without pre-excitation syndromes: A cohort study of 1960 patients included over 25 years

    Science.gov (United States)

    Brembilla-Perrot, Béatrice; Sellal, Jean Marc; Olivier, Arnaud; Villemin, Thibaut; Beurrier, Daniel; Vincent, Julie; Manenti, Vladimir; de Chillou, Christian; Bozec, Erwan

    2018-01-01

    Aim To investigate the influence of increasing age on clinical presentation, treatment and long-term outcome in patients with inducible paroxysmal supraventricular tachycardia (SVT) without pre-excitation syndromes. Methods Clinical and electrophysiological study (EPS) data, as well as long-term clinical outcome (mean follow-up 2.4±4.0 years) were collected in patients referred for regular tachycardia with inducible SVT during EPS without pre-excitation. Results Among 1960 referred patients, 301 patients (15.4%) were aged ≥70 (70–97). In this subset, anticoagulants were prescribed in 49 patients following an erroneous diagnosis of atrial tachycardia and 14 were previously erroneously diagnosed with ventricular tachycardia because of wide QRS. Ablation was performed more frequently in patients ≥70 despite more frequent failure and complications. During follow-up, higher risks of AF, stroke, pacemaker implantation and death were observed in patients ≥70 whereas SVT recurrences were similar in both age groups. In multivariable analysis, age ≥70 was independently associated with higher risks of SVT-related adverse events prior to ablation (OR = 1.93, 1.41–2.62, pSVT without pre-excitation syndromes are elderly. These patients exhibit higher risks of erroneous tachycardia diagnosis prior to EPS as well as failure and/or complication of ablation, but similar risk of SVT recurrence. These results support performing transesophageal EPS in most patients and intracardiac EPS in selected patients. EPS may furthermore prove useful in elderly patients with regular tachycardia, mainly by avoiding treatment based on an erroneous diagnosis. PMID:29304037

  8. Obstetrical Interventions for Term First Births in the United States

    Science.gov (United States)

    Ananth, Cande V.; Wilcox, Allen J.; Gyamfi-Bannerman, Cynthia

    2014-01-01

    Background Labour induction and caesarean are increasingly done without clinical indication. However, little is known about the prevalence of such interventions, or the characteristics of women who receive them. We used the 2003 revision of the US birth certificates to summarise recorded interventions and to characterise maternal profiles associated with such interventions. Methods We carried out a retrospective study of 2.35 million primiparous women delivering singleton live births at 37–44 weeks in the United States, 2005–08. We used the 2003 revision of the birth certificate to define delivery categories: “indicated” were those with induced labour or pre-labour caesarean for hypertension, diabetes, chorioamnionitis, failed cephalic version at ≥40 weeks, growth restriction (postterm (≥42 weeks); those with prelabour caesarean with breech at ≥39 weeks; or those with caesarean with labour lasting ≥12 hours, failed trial of labour, vacuum/forceps extraction, or fetal intolerance to labour. Remaining deliveries with induction/caesarean were classified as “non-indicated” and all other deliveries “spontaneous.” Results Half of all term first births (50%) were delivered after intervention, and half of interventions were non-indicated (26% of all deliveries.) Women with interventions were more likely to deliver on a weekday. Non-indicated interventions were more common among socially advantaged women. Conclusions Nearly a quarter of US term first deliveries had an indicated intervention, and another quarter received intervention without a recorded clinical indication. Both numbers are probably underestimates. PMID:23930780

  9. Investigación sobre manejo forestal a largo plazo en Patagonia Sur -Argentina: Lecciones del pasado, desafíos del presente Long-term forest management research in South Patagonia - Argentina: Lessons from the past, challenges from the present

    Directory of Open Access Journals (Sweden)

    GUILLERMO J MARTÍNEZ-PASTUR

    2010-03-01

    ón de tratamientos intermedios, (iii determinar líneas base y definir los impactos de distintos sistemas silvícolas, (iv proponer metodologías de monitoreo de amplio espectro y establecer áreas demostrativas de manejo, y (v proveer áreas y conocimientos para entrenar profesionales en prácticas de manejo forestal y conservación de la biodiversidad. Las parcelas permanentes ya establecidas en los bosques de Nothofagus de Patagonia Sur y las bases de datos obtenidas podrían servir como punto de partida para definir un núcleo regional que pueda participar en el International Long Term Ecological Research para asegurar el uso sustentable de los bosques nativos.Argentina has based its economy in agriculture and cattle production seeing forests as one of the main obstacles for future development. Forest harvesting in South Patagonia has been an activity based on colonization and exploitation of new areas. Harvesting is mainly carried out in old-growth forests without silviculture management after the first cuts. Beyond this mismanagement, scientific research defined the basis to conserve, protect and improve the present forest management for the South Patagonia native forests. The first long-term study permanent plots (1965-1966 monitored only economic and forest structure parameters, and near twenty plots were established in public forested lands of Tierra del Fuego. Most of these plots were destroyed or discontinued due to a lack of land use planning, scarce social interest for long-term researches, absence of commitment of institutions, and few contributions of forest companies. After this, a second group of nine long-term study permanent plots were established in South Patagonia (1993-2004 based in the collaboration between private companies and national research institutions. The objectives included economic as well as ecological parameters. The new plots were established on private lands based on several agreements and joint venture projects between national

  10. Analyzing in the present

    DEFF Research Database (Denmark)

    Revsbæk, Line; Tanggaard, Lene

    2015-01-01

    The article presents a notion of “analyzing in the present” as a source of inspiration in analyzing qualitative research materials. The term emerged from extensive listening to interview recordings during everyday commuting to university campus. Paying attention to the way different parts...... of various interviews conveyed diverse significance to the listening researcher at different times became a method of continuously opening up the empirical material in a reflexive, breakdown-oriented process of analysis. We argue that situating analysis in the present of analyzing emphasizes and acknowledges...

  11. [TANDEM (TAsk force oN long Duration unemployment of Elderly People and Mental health) implementation of a cross-institutional pilot project for elderly long-term unemployed persons - presentation of the project procedure and the utilisation].

    Science.gov (United States)

    Steil, C; Meiler, B; Wiesten, I; Wiltfang, J; Kis, B

    2013-08-01

    The aim of this study is to implement and examine the feasibility of a cross-institutional mental health intervention to comprehend and advance mental health of elderly long-term unemployed persons. Report on the procedure and on the observational study utilisation in a 14-month period. The structure and processes chosen could be implemented into practice successfully. Utilisation was high but 30% dropped out during the procedure. Of the unemployed persons surveyed, 96% received a psychiatric diagnosis. 85% were not having psychiatric treatment. The method chosen is feasible and was accepted by the target group. Project structure and processes proved to be applicable for the implementation of the project aims. The method chosen reaches an up to now "psychiatry-inexperienced" target group characterised by frequent incidence of mental disorders and low utilisation of psychiatric care. Thus, vocational reintegration programmes should be supported by psychiatric services. © Georg Thieme Verlag KG Stuttgart · New York.

  12. A decision analytical cost analysis of offering ECV in a UK district general hospital.

    Science.gov (United States)

    James, M; Hunt, K; Burr, R; Johanson, R

    2001-01-01

    To determine the care pathways and implications of offering mothers the choice of external cephalic version (ECV) at term for singleton babies who present with an uncomplicated breech pregnancy versus assisted breech delivery or elective caesarean. A prospective observational audit to construct a decision analysis of uncomplicated full term breech presentations. The North Staffordshire NHS Trust. All women (n = 176) who presented at full term with a breech baby without complications during July 1995 and June 1997. The study determined to compare the outcome in terms of the costs and cost consequences for the care pathways that resulted from whether a women chose to accept the offer of ECV or not. All the associated events were then mapped for the two possible pathways. The costs were considered only within the hospital setting, from the perspective of the health care provider up to the point of delivery. The additional costs for ECV, assisted breech delivery and elective caesarean over and above a normal birth were 186.70 pounds sterling, 425.36 pounds sterling and 1,955.22 pounds sterling respectively. The total expected cost of the respective care pathways for "ECV accepted" and "ECV not accepted" (including the probability of adverse events) were 1,452 pounds sterling and 1,828 pounds sterling respectively, that is the cost of delivery through the ECV care pathways is less costly than the non ECV delivery care pathway. Implementing an ECV service may yield cost savings in secondary care over and above the traditional delivery methods for breech birth of assisted delivery or caesarean section. The scale of these expected cost savings are in the range of 248 pounds sterling to 376 pounds sterling per patient. This converts to a total expected cost saving of between 43,616 pounds sterling and 44,544 pounds sterling for the patient cohort considered in this study.

  13. The Long-Term Benefits of Positive Self-Presentation via Profile Pictures, Number of Friends and the Initiation of Relationships on Facebook for Adolescents' Self-Esteem and the Initiation of Offline Relationships.

    Science.gov (United States)

    Metzler, Anna; Scheithauer, Herbert

    2017-01-01

    Social networking sites are a substantial part of adolescents' daily lives. By using a longitudinal approach the current study examined the impact of (a) positive self-presentation, (b) number of friends, and (c) the initiation of online relationships on Facebook on adolescents' self-esteem and their initiation of offline relationships, as well as the mediating role of positive feedback. Questionnaire data were obtained from 217 adolescents (68% girls, mean age 16.7 years) in two waves. Adolescents' positive self-presentation and number of friends were found to be related to a higher frequency of receiving positive feedback, which in turn was negatively associated with self-esteem. However, the number of Facebook friends had a positive impact on self-esteem, and the initiation of online relationships positively influenced the initiation of offline relationships over time, demonstrating that Facebook may be a training ground for increasing adolescents' social skills. Implications and suggestions for future research are provided.

  14. The Long-Term Benefits of Positive Self-Presentation via Profile Pictures, Number of Friends and the Initiation of Relationships on Facebook for Adolescents’ Self-Esteem and the Initiation of Offline Relationships

    Science.gov (United States)

    Metzler, Anna; Scheithauer, Herbert

    2017-01-01

    Social networking sites are a substantial part of adolescents’ daily lives. By using a longitudinal approach the current study examined the impact of (a) positive self-presentation, (b) number of friends, and (c) the initiation of online relationships on Facebook on adolescents’ self-esteem and their initiation of offline relationships, as well as the mediating role of positive feedback. Questionnaire data were obtained from 217 adolescents (68% girls, mean age 16.7 years) in two waves. Adolescents’ positive self-presentation and number of friends were found to be related to a higher frequency of receiving positive feedback, which in turn was negatively associated with self-esteem. However, the number of Facebook friends had a positive impact on self-esteem, and the initiation of online relationships positively influenced the initiation of offline relationships over time, demonstrating that Facebook may be a training ground for increasing adolescents’ social skills. Implications and suggestions for future research are provided. PMID:29187827

  15. The Long-Term Benefits of Positive Self-Presentation via Profile Pictures, Number of Friends and the Initiation of Relationships on Facebook for Adolescents’ Self-Esteem and the Initiation of Offline Relationships

    OpenAIRE

    Anna Metzler; Herbert Scheithauer

    2017-01-01

    Social networking sites are a substantial part of adolescents’ daily lives. By using a longitudinal approach the current study examined the impact of (a) positive self-presentation, (b) number of friends, and (c) the initiation of online relationships on Facebook on adolescents’ self-esteem and their initiation of offline relationships, as well as the mediating role of positive feedback. Questionnaire data were obtained from 217 adolescents (68% girls, mean age 16.7 years) in two waves. Adole...

  16. Term Context

    OpenAIRE

    Bancerek Grzegorz

    2015-01-01

    Two construction functors: simple term with a variable and compound term with an operation and argument terms and schemes of term induction are introduced. The degree of construction as a number of used operation symbols is defined. Next, the term context is investigated. An x-context is a term which includes a variable x once only. The compound term is x-context iff the argument terms include an x-context once only. The context induction is shown and used many times. As a key concept, the co...

  17. Term Context

    Directory of Open Access Journals (Sweden)

    Bancerek Grzegorz

    2015-02-01

    Full Text Available Two construction functors: simple term with a variable and compound term with an operation and argument terms and schemes of term induction are introduced. The degree of construction as a number of used operation symbols is defined. Next, the term context is investigated. An x-context is a term which includes a variable x once only. The compound term is x-context iff the argument terms include an x-context once only. The context induction is shown and used many times. As a key concept, the context substitution is introduced. Finally, the translations and endomorphisms are expressed by context substitution.

  18. Long-term changes in the Northwestern Atlantic and Mediterranean SST from 1982 to 2016: A contribution of the Operational Oceanography to the determination of the present day Climate

    Science.gov (United States)

    Artale, Vincenzo; Buongiorno Nardelli, Bruno; Marullo, Salvatore; Pisano, Andrea; Santoleri, Rosalia; Tronconi, Cristina

    2017-04-01

    Estimating long-term SST changes is crucial to evaluate global warming impact at regional scales. Here, we analyze the Mediterranean (MED) and the Northwestern Atlantic Box (NWA) SST changes over the last 34 years (1982 - 2016) by combining reprocessed (REP) and near-real-time (NRT) data. Actually, the Italian National Research Council (CNR) has recently produced daily (nighttime), 4 km resolution REP MED level 4 datasets (REP L4), also covering the adjacent Atlantic region, based on the latest Pathfinder v5.2 AVHRR dataset (1982-2012). These data represent the longest satellite MED SST L4 time series and are freely distributed through the European Copernicus Marine Environment Monitoring Service (CMEMS). However, as Pathfinder has not yet released an update of its product, the REP data end in 2012. To fill in the gap between 2013 and 2016, we investigated the possibility to extend the time series by using the Mediterranean near real time (NRT), multi-sensor L4 SST data at Ultra-High spatial Resolution (UHR) produced by CNR, which are distributed through CMEMS and now mirrored at GHRSST. Since this product is available since 2008, the consistency with the REP has been assessed. Combining the REP L4 data (1982-2012) and a bias-corrected version of the NRT L4 data (2013-2016), we built the SST time series and provided updated estimates of the MED and NWA SST trends. The analysis shows that The Atlantic Box and The Mediterranean Sea have similar trend behavior until 2008. Afterward the Mediterranean Sea SST continued to increase while the Atlantic Box persisted in its warming pause.

  19. Breech Babies: What Can I Do If My Baby Is Breech?

    Science.gov (United States)

    ... Andrew S. Coco, M.D., M.S., and Stephanie D. Silverman, M.D.(American Family Physician 09/01/98) ... and ChildbirthUltrasound During PregnancyA fetal ultrasound is a test that uses sound waves to create an image ...

  20. The Long-Term Benefits of Positive Self-Presentation via Profile Pictures, Number of Friends and the Initiation of Relationships on Facebook for Adolescents’ Self-Esteem and the Initiation of Offline Relationships

    Directory of Open Access Journals (Sweden)

    Anna Metzler

    2017-11-01

    Full Text Available Social networking sites are a substantial part of adolescents’ daily lives. By using a longitudinal approach the current study examined the impact of (a positive self-presentation, (b number of friends, and (c the initiation of online relationships on Facebook on adolescents’ self-esteem and their initiation of offline relationships, as well as the mediating role of positive feedback. Questionnaire data were obtained from 217 adolescents (68% girls, mean age 16.7 years in two waves. Adolescents’ positive self-presentation and number of friends were found to be related to a higher frequency of receiving positive feedback, which in turn was negatively associated with self-esteem. However, the number of Facebook friends had a positive impact on self-esteem, and the initiation of online relationships positively influenced the initiation of offline relationships over time, demonstrating that Facebook may be a training ground for increasing adolescents’ social skills. Implications and suggestions for future research are provided.

  1. Virtual Presenters: Towards Interactive Virtual Presentations

    NARCIS (Netherlands)

    Nijholt, Antinus; Cappellini, V.; Hemsley, J.

    2005-01-01

    We discuss having virtual presenters in virtual environments that present information to visitors of these environments. Some current research is surveyed and we will look in particular to our research in the context of a virtual meeting room where a virtual presenter uses speech, gestures, pointing

  2. Presentation rubric: improving faculty professional presentations.

    Science.gov (United States)

    Hayne, Arlene N; McDaniel, Gretchen S

    2013-01-01

    This article describes the content of a presentation evaluation rubric for use in the development and improvement in faculty performance to enhance learning. Lectures or professional presentations require skills that can be learned through the use of evidence-based practices for all forms of public speaking. A core competency of nursing faculty is to serve as a role model in skilled oral communication. The use of an evaluation presentation rubric can increase faculty competency in this area. © 2013 Wiley Periodicals, Inc.

  3. Making your presentation fun: creative presentation techniques

    Energy Technology Data Exchange (ETDEWEB)

    KEENEN,MARTHA JANE

    2000-05-18

    What possesses someone to volunteer and go through hoops and red tape to make a presentation at a conference? For that matter, why does anyone ever present anything to anyone? Actually, presentations are a fact of life and there are many reasons for doing a presentation and doing it well. New and existing staff need training and orientation to the way things are done here. Handing all of them a manual and hoping they read it is pretty much a waste of paper. On the other hand, an effective, entertaining and upbeat presentation on the relevant topics is more likely to stick with those people. They will even have a name and face to remember and seek out when they have an issue on or with that topic. This can be a very effective beginning for networking with new peers. The presenter is seen as knowledgeable, as a source of information on company topics and possibly evaluated as a potential mentor or future manager. Project staff and/or peers benefit from clear, concise, presentations of topical knowledge. This is one way that a group working on various aspects of the same project or program can stay in touch and in step with each other. Most importantly, presentations may be the best or only door into the minds (and budgets) of management and customers. These presentations are a wonderful opportunity to address legal and compliance issues, budget, staffing, and services. Here is a chance, maybe the only one, to demonstrate and explain the wonderfulness of a program and the benefit they get by using the services offered most effectively. An interactive presentation on legal and compliance issues can be an effective tool in helping customers and/or management make good risk management decisions.

  4. Texts of presentation

    Energy Technology Data Exchange (ETDEWEB)

    Magnin, G.; Vidolov, K.; Dufour-Fallot, B.; Dewarrat, Th.; Rose, T.; Favatier, A.; Gazeley, D.; Pujol, T.; Worner, D.; Van de Wel, E.; Revaz, J.M.; Clerfayt, G.; Creedy, A.; Moisan, F.; Geissler, M.; Isbell, P.; Macaluso, M.; Litzka, V.; Gillis, W.; Jarvis, I.; Gorg, M.; Bebie, B.

    2004-07-01

    Implementing a sustainable local energy policy involves a long term reflection on the general interest, energy efficiency, distributed generation and environmental protection. Providing services on a market involves looking for activities that are profitable, if possible in the 'short-term'. The aim of this conference is to analyse the possibility of reconciling these apparently contradictory requirements and how this can be achieved. This conference brings together the best specialists from European municipalities as well as important partners for local authorities (energy agencies, service companies, institutions, etc.) in order to discuss the public-private partnerships concerning the various functions that municipalities may perform in the energy field as consumers and customers, planners and organizers of urban space and rousers as regards inhabitants and economic players of their areas. This document contains the summaries of the following presentations: 1 - Performance contracting: Bulgarian municipalities use private capital for energy efficiency improvement (K. VIDOLOV, Varna (BG)), Contracting experiences in Swiss municipalities: consistent energy policy thanks to the Energy-city label (B. DUFOUR-FALLOT and T. DEWARRAT (CH)), Experience of contracting in the domestic sector (T. ROSE (GB)); 2 - Public procurement: Multicolor electricity (A. FAVATIER (CH)), Tendering for new green electricity capacity (D. GAZELEY (GB)), The Barcelona solar thermal ordinance (T. PUJOL (ES)); 3 - Urban planning and schemes: Influencing energy issues through urban planning (D. WOERNER (DE)), Tendering for the supply of energy infrastructure (E. VAN DE WEL (NL)), Concessions and public utility warranty (J.M. REVAZ (CH)); 4 - Certificate schemes: the market of green certificates in Wallonia region in a liberalized power market (G. CLERFAYT (BE)), The Carbon Neutral{sup R} project: a voluntary certification scheme with opportunity for implementation in other European

  5. Vitality of optical vortices (Presentation)

    CSIR Research Space (South Africa)

    Roux, FS

    2014-02-01

    Full Text Available This presentation discusses the vitality of optical vortices to distinguish between vortex dipole creation and annihilation events. Vitality is expressed in terms of the transverse 1st and 2nd order derivatives of the optical field. It can be used...

  6. Slide Composition for Electronic Presentations

    Science.gov (United States)

    Larson, Ronald B.

    2004-01-01

    Instructors who use computer-generated graphics in their lectures have many options to consider when developing their presentations. Experts give different advice on which typefaces, background and letter colors, and background imagery improve communications. This study attempted to resolve these controversies by examining how short-term recall of…

  7. Diabetic Myonecrosis: An Atypical Presentation

    Directory of Open Access Journals (Sweden)

    José Hernán Martínez

    2013-01-01

    Full Text Available Diabetic myonecrosis is a frequently unrecognized complication of longstanding and poorly controlled diabetes mellitus. The clinical presentation is swelling, pain, and tenderness of the involved muscle, most commonly the thigh muscles. Management consists of conservative measures including analgesia and rest. Short-term prognosis is good, but long-term prognosis is poor with most patients dying within 5 years. Failure to properly identify this condition will expose the patient to aggressive measures that could result in increased morbidity. To our knowledge this is the first case reported in which there was involvement of multiple muscle groups including upper and lower limbs.

  8. Equational term graph rewriting

    NARCIS (Netherlands)

    Z.M. Ariola (Zena); J.W. Klop (Jan Willem)

    1995-01-01

    textabstractWe present an equational framework for term graph rewriting with cycles. The usual notion of homomorphism is phrased in terms of the notion of bisimulation, which is well-known in process algebra and concurrency theory. Specifically, a homomorphism is a functional bisimulation. We prove

  9. Toyotarity. Term, model, range

    Directory of Open Access Journals (Sweden)

    Stanisław Borkowski

    2013-04-01

    Full Text Available The Toyotarity and BOST term was presented in the chapter. The BOST method allows to define relations between material resources and human resources and between human resources and human resources (TOYOTARITY. This term was also invented by the Author (and is legally protected. The idea of methodology is an outcome of 12 years of work.

  10. Steganography: Past, Present, Future

    Energy Technology Data Exchange (ETDEWEB)

    Judge, J C

    2001-12-01

    Steganography (a rough Greek translation of the term Steganography is secret writing) has been used in various forms for 2500 years. It has found use in variously in military, diplomatic, personal and intellectual property applications. Briefly stated, steganography is the term applied to any number of processes that will hide a message within an object, where the hidden message will not be apparent to an observer. This paper will explore steganography from its earliest instances through potential future application.

  11. Eliminating the xy Term.

    Science.gov (United States)

    Roberti, Joseph V.

    1979-01-01

    A process for eliminating the xy term in a quadratic equation in two variables is presented. The author feels this process will be within the reach of more high school students than more commonly used methods. (MK)

  12. Develop your presentation skills

    CERN Document Server

    Theobald, Theo

    2016-01-01

    Going beyond handling nerves and presenting PowerPoint slides, the third edition of "Develop Your Presentation Skills "offers practical advice on developing a captivating presentation, constructing compelling content, and boosting self-confidence. The book includes three new chapters on delivering a "stripped down"presentation, using new media to engage with the audience, and handling being asked to present on short notice."

  13. Subpart AA Training Presentations

    Science.gov (United States)

    EPA has produced the following training presentation(s) for reporters subject to this subpart. Generally, these presentations explain how to use the reporting system e-GGRT to submit annual GHG reports to EPA.

  14. Subpart HH Training Presentations

    Science.gov (United States)

    EPA has produced the following training presentation(s) for reporters subject to this subpart. Generally, these presentations explain the rule or show how to use the reporting system e-GGRT to submit annual GHG reports to EPA.

  15. Subpart W Training Presentations

    Science.gov (United States)

    EPA has produced the following training presentation(s) for reporters subject to this subpart. Generally, these presentations explain the rule or show how to use the reporting system e-GGRT to submit annual GHG reports to EPA.

  16. Subpart DD Training Presentations

    Science.gov (United States)

    EPA has produced the following training presentation(s) for reporters subject to this subpart. Generally, these presentations explain the rule or show how to use the reporting system e-GGRT to submit annual GHG reports to EPA.

  17. Imagined futures, present lives

    DEFF Research Database (Denmark)

    Dalsgaard, Anne Line; Wildermuth, Norbert

    2006-01-01

    The article is focused thematically on the uses and meanings of media for (some) young people in Recife, a million-inhabitant city in the northeast of Brazil. The article brings together the perspective of Anne Line Dalsgaard, a long-term anthropological field researcher who is familiar with the ......The article is focused thematically on the uses and meanings of media for (some) young people in Recife, a million-inhabitant city in the northeast of Brazil. The article brings together the perspective of Anne Line Dalsgaard, a long-term anthropological field researcher who is familiar...

  18. The principal is present

    DEFF Research Database (Denmark)

    Staunæs, Dorthe; Juelskjær, Malou

    2016-01-01

    In the seminal book Discipline and Punish: The Birth of the Prison (1977) French philosopher Michel Foucault described how the psy-disciplines—his collective term for psychiatry, psychology, psycho-analysis and other psycho-therapies—became entangled in new forms of government. 18th and 19th...

  19. NITRD Presentation Library

    Data.gov (United States)

    Networking and Information Technology Research and Development, Executive Office of the President — This resource is a collection of presentations, reports, and webinars given by a broad range of presenters from academia, government, and private sectors at various...

  20. Presenting Food Science Effectively

    Science.gov (United States)

    Winter, Carl K.

    2016-01-01

    While the need to present food science information effectively is viewed as a critical competency for food scientists by the Institute of Food Technologists, most food scientists may not receive adequate training in this area. Effective presentations combine both scientific content and delivery mechanisms that demonstrate presenter enthusiasm for…

  1. Rotating Poster Presentations

    Science.gov (United States)

    Lagares, Manuel; Reisenleutner, Sandra

    2017-01-01

    Oral presentations are a common practice in foreign language classes, often used to assess students' speaking skills. Usually, the presentations are delivered by students in front of the class, often with PowerPoint slides or Prezi as support. However, frequently the audience does not engage with the presentation and thus, the benefits of this…

  2. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2012-08-01

    This presentation summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. This presentation was presented in a Wind Powering America webinar on August 15, 2012 and is now available through the Wind Powering America website.

  3. Innovative presentations for dummies

    CERN Document Server

    Anthony, Ray

    2014-01-01

    Be the speaker they follow with breakthrough innovative presentations Innovative Presentations For Dummies is a practical guide to engaging your audience with superior, creative, and ultra-compelling presentations. Using clear language and a concise style, this book goes way beyond PowerPoint to enable you to reimagine, reinvent, and remake your presentations. Learn how to stimulate, capture, and hold your audience in the palm of your hand with sound, sight, and touch, and get up to speed on the latest presentation design methods that make you a speaker who gets audiences committed and acting

  4. The Availability of Indium: The Present, Medium Term, and Long Term

    Energy Technology Data Exchange (ETDEWEB)

    Lokanc, Martin [Colorado School of Mines, Golden, CO (United States); Eggert, Roderick [Colorado School of Mines, Golden, CO (United States); Redlinger, Michael [Colorado School of Mines, Golden, CO (United States)

    2015-10-01

    Demand for indium is likely to increase if the growth in deployment of the copper-indium-gallium-selenide (CIGS) and III-V thin-film photovoltaic technologies accelerates. There are concerns about indium supply constraints since it is relatively rare element in the earth's crust and because it is produced exclusively as a byproduct.

  5. CERN Electronics Pool presentations

    CERN Multimedia

    2011-01-01

    The CERN Electronics Pool has organised a series of presentations in collaboration with oscilloscope manufacturers. The last one will take place according to the schedule below.   Time will be available at the end of the presentation to discuss your personal needs. The Agilent presentation had to be postponed and will be organised later. -     Lecroy: Thursday, 24 November 2011, in 530-R-030, 14:00 to 16:30.

  6. Hyponatraemia - presentations and management.

    Science.gov (United States)

    Dineen, Rosemary; Thompson, Christopher J; Sherlock, Mark

    2017-06-01

    Hyponatraemia is the most common electrolyte disturbance encountered in clinical practice. It is associated with -significant morbidity and mortality, thus appropriate investigation and treatment is essential. Hyponatraemia presents with a spectrum of clinical presentations ranging from no symptoms to life-threatening neurological sequelae. Hyponatraemia has multiple aetiologies and distinguishing the underlying aetiology facilitates appropriate treatment. This review provides an overview of the presentations and approaches to management of this common clinical condition. © Royal College of Physicians 2017. All rights reserved.

  7. Unusual presentation of entomophthoromycosis

    OpenAIRE

    Michael R; Michael J; Mathews M; Rupa V

    2009-01-01

    Rhinoentomophthoromycosis caused by Conidiobolus sp commonly presents as a chronic granulomatous lesion that affects the rhinofacial subcutaneous tissue. We present an 18-year-old girl who presented with progressive bilateral proptosis and loss of vision since 2 weeks. Biopsy and fungal cultures confirmed diagnosis of Conidiobolus sp infection of the paranasal sinuses bilaterally with orbital extension and blindness. The clinical picture was complicated by the presence of sputum-positive ...

  8. Presentation skills for nurses.

    Science.gov (United States)

    Foulkes, Mark

    2015-02-20

    This article emphasises the importance of effective presentation skills. Such skills allow nurses to share knowledge and expertise and to communicate clearly in a range of workplace scenarios. Nurses are increasingly being asked to present in formal and informal situations, such as conferences, poster presentations, job interviews, case reports and ward-based teaching. This article explores the principles underpinning the development of these skills, discusses the situations in which they could be applied and demonstrates how nurses might improve and develop as presenters.

  9. Presentation of celiac disease.

    Science.gov (United States)

    Reilly, Norelle Rizkalla; Fasano, Alessio; Green, Peter H R

    2012-10-01

    The mode of presentation of patients with celiac disease has changed dramatically over the recent decades, with diarrheal or classic presentations becoming less common. This trend is most markedly seen in children, whose main presentations include recurrent abdominal pain, growth issues, and screening groups at risk. Among adults, presentations include diarrhea, anemia, osteoporosis, and recognition at endoscopy performed for gastroesophageal reflux disease, as well as screening. The groups most commonly screened include family members of patients with celiac disease, Down syndrome, and autoimmune diseases. Copyright © 2012. Published by Elsevier Inc.

  10. Scientific papers and presentations

    National Research Council Canada - National Science Library

    Davis, Martha

    2005-01-01

    This book provides practical instruction for writing first drafts, reviewing and revising, communicating clearly and concisely, adhering to stylistic principles, presenting data in tables and figures...

  11. Fostering oral presentation performance

    OpenAIRE

    Ginkel, van, J.R.; Gulikers, Judith; Biemans, Harm; Mulder, Martin

    2017-01-01

    Previous research revealed significant differences in the effectiveness of various feedback sources for encouraging students’ oral presentation performance. While former studies emphasised the superiority of teacher feedback, it remains unclear whether the quality of feedback actually differs between commonly used sources in higher education. Therefore, this study examines feedback processes conducted directly after 95 undergraduate students’ presentations in the following conditions: teacher...

  12. Print advertising: Celebrity presenters

    National Research Council Canada - National Science Library

    Rossiter, John R; Smidts, Ale

    2012-01-01

    .... The theory's characteristics are visibility (widely well-known, necessary for celebrity presenters and creatable via advertising for “real people” presenters and animated characters), credibility (expertise and trustworthiness), attraction (likability and role-model identification), and power (for coercive persuasion that rarely applies ...

  13. Conjugando el presente

    Directory of Open Access Journals (Sweden)

    Héctor Rojas Herazo

    1968-06-01

    Full Text Available La añoranza suele ser, casi siempre, la línea critica de menor resistencia. El lema de que "todo tiempo pasado fue mejor" tiene un poco la culpa. En cualquier orden del conocimiento el pasado sigue el verdadero presente. Ese presente en que nos gusta respirar y vivir. Nada de compromiso circundante. Nada de inmediatez.

  14. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Hand, M. M.

    2012-08-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It was presented in a webinar given by the California Energy Commission.

  15. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2012-08-01

    This presentation summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It was presented in a Power Systems Engineering Research Center webinar on September 4, 2012.

  16. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Hand, M.; Mai, T.

    2012-08-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It was presented in an Union of Concerned Scientists webinar on June 12, 2012.

  17. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Hand, M.

    2012-10-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It is being presented at the Utility Variable-Generation Integration Group Fall Technical Workshop on October 24, 2012.

  18. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Hand, M. M.

    2012-09-01

    This presentation summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050.

  19. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2012-10-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050.

  20. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2012-11-01

    This presentation summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050.

  1. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2013-04-01

    This presentation summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050.

  2. UTM Weather Presentation

    Science.gov (United States)

    Chan, William N.; Kopardekar, Parimal H.; Carmichael, Bruce; Cornman, Larry

    2017-01-01

    Presentation highlighting how weather affected UAS operations during the UTM field tests. Research to develop UAS weather translation models with a description of current and future work for UTM weather.

  3. Atypical Presentation of Neurosyphilis

    Directory of Open Access Journals (Sweden)

    L C Anand

    1980-01-01

    Full Text Available Five cases of neurospyhilis with atypical manifestation have been reported. Of these four cases presented as acute neurological illness and showed variable recovery after antisyp′iiilitic therapy. One of these cases had parinaud sip which was unaffected by treatment One case presented as dementia and gave poor response to therapy. In only one of these five cases was reagin in CSF demonstrated. Lange′s colloidal gold test was negative in all. As such failure to demonstrate reagin in CSF does not rule out the diagnosis of neurosyphilis. In an antibiotic era patients may inadvertently receive some antibiotics prior to presentation to a clinician and therefore are unlikely to present with typical neurological and laboratory findings.

  4. Workshop Presentations: RSW Analysts

    Data.gov (United States)

    National Aeronautics and Space Administration — These slides were presented at the AePW, April 21-22, 2012. They detail the analytical results generated by each of the participating analysis teams for the...

  5. Workshop Presentations: HIRENASD Analysts

    Data.gov (United States)

    National Aeronautics and Space Administration — These slides were presented at the AePW, April 21-22, 2012. They detail the analytical results generated by each of the participating analysis teams for the HIRENASD.

  6. Workshop Presentations: BSCW Analysts

    Data.gov (United States)

    National Aeronautics and Space Administration — These slides were presented at the AePW, April 21-22, 2012. They detail the analytical results generated by each of the participating analysis teams for the...

  7. Fostering oral presentation performance

    NARCIS (Netherlands)

    Ginkel, van Stan; Gulikers, Judith; Biemans, Harm; Mulder, Martin

    2017-01-01

    Previous research revealed significant differences in the effectiveness of various feedback sources for encouraging students’ oral presentation performance. While former studies emphasised the superiority of teacher feedback, it remains unclear whether the quality of feedback actually differs

  8. Contents of Presentation

    Indian Academy of Sciences (India)

    First page Back Continue Last page Graphics. Contents of Presentation. Introduction on Power Quality (PQ). PQ Definitions. PQ Standards. Causes of PQ problems. PQ Mitigation Methods. Improved Power Quality Converters. Conclusion.

  9. PRESENT STATUS IN INDIA

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. PRESENT STATUS IN INDIA. FIXED LINES – 36 MILLION. MOBILE CONNECTIONS – 14 MILLION. TELEDENSITY APPROXIMATELY 5. INTERNET CONNECTIONS – 5 MILLION. INTERNET USERS NEARLY – 25 MILLION.

  10. Going beyond methodological presentism

    DEFF Research Database (Denmark)

    Schmidt, Garbi

    2017-01-01

    Denmark is an example of a country where the idea of historical ethnic homogeneity stands strong. This article challenges this historical presentism: the scholarly and societal tendency to understand social phenomena within a limited contemporary framework, neglecting possible effects and similar......Denmark is an example of a country where the idea of historical ethnic homogeneity stands strong. This article challenges this historical presentism: the scholarly and societal tendency to understand social phenomena within a limited contemporary framework, neglecting possible effects...

  11. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Hand, M. M.

    2012-08-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It was presented to the 2012 Western Conference of Public Service Commissioners, during their June, 2012, meeting. The Western Conference of Public Service Commissioners is a regional association within the National Association of Regulatory Utility Commissioners (NARUC).

  12. Stellar Presentations (Abstract)

    Science.gov (United States)

    Young, D.

    2015-12-01

    (Abstract only) The AAVSO is in the process of expanding its education, outreach and speakers bureau program. powerpoint presentations prepared for specific target audiences such as AAVSO members, educators, students, the general public, and Science Olympiad teams, coaches, event supervisors, and state directors will be available online for members to use. The presentations range from specific and general content relating to stellar evolution and variable stars to specific activities for a workshop environment. A presentation—even with a general topic—that works for high school students will not work for educators, Science Olympiad teams, or the general public. Each audience is unique and requires a different approach. The current environment necessitates presentations that are captivating for a younger generation that is embedded in a highly visual and sound-bite world of social media, twitter and U-Tube, and mobile devices. For educators, presentations and workshops for themselves and their students must support the Next Generation Science Standards (NGSS), the Common Core Content Standards, and the Science Technology, Engineering and Mathematics (STEM) initiative. Current best practices for developing relevant and engaging powerpoint presentations to deliver information to a variety of targeted audiences will be presented along with several examples.

  13. Session: Parabolic Troughs (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Kutscher, C.

    2008-04-01

    The project description is R and D activities at NREL and Sandia aimed at lowering the delivered energy cost of parabolic trough collector systems and FOA awards to support industry in trought development. The primary objectives are: (1) support development of near-term parabolic trought technology for central station power generation; (2) support development of next-generation trought fields; and (3) support expansion of US trough industry. The major FY08 activities were: (1) improving reflector optics; (2) reducing receiver heat loss (including improved receiver coating and mitigating hydrogen accumulation); (3) measuring collector optical efficiency; (4) optimizing plant performance and reducing cost; (5) reducing plant water consumption; and (6) directly supporting industry needs, including FOA support.

  14. Extratarsal presentation of chalazion.

    Science.gov (United States)

    Chang, Moohwan; Park, Jiwoong; Kyung, Sungeun E

    2017-12-01

    We report a case of atypical, extratarsal chalazion referred with a history of a chronic inflammatory mass found on the edge of the lower eyelid. A 3-year-old female developed a small mass on the medial side of the right lower lid in 4-month duration. She was seen by her ophthalmologist and the diagnosis of a chalazion was made. Over the ensuing one month with warm compression, the lesion subsided and the new lesion appeared away from the edge on the lateral eyelid 3 months ago. She underwent surgery and drainage was performed. We found a track, a proof of migration, on the lower tarsal conjunctiva in the medial side of the right eyelid during surgery. Long-term observation in chalazion may induce migration with tract and express as an atypical chalazion.

  15. The psychological present.

    Science.gov (United States)

    Hayes, L J

    1992-01-01

    The present paper compares behavior-analytic and cognitive treatments of the concept of psychological history with regard to its role in current action. Both treatments take the position that the past bears some responsibility for the present, and are thereby obligated to find a means of actualizing the past in the present. Both do so by arguing that the past is brought to bear in the present via the organism. Although the arguments of the two positions differ on this issue, neither provides a complete account. An unconventional treatment of psychological history is proposed, the logic of which is exemplified in anthropological, biological, and psychological perspectives. The unconventional treatment in psychological perspective holds that (a) the organism's interaction with its environment, not the organism itself, changes with experience; and (b) the past interactions of an organism exist as, and only as, the present interactions of that organism. This solution to the problem of psychological history provides obligations and opportunities for analysis that are not available when the more conventional positions of cognitivism and behavior analysis are adopted.

  16. Unusual presentation of entomophthoromycosis

    Directory of Open Access Journals (Sweden)

    Michael R

    2009-01-01

    Full Text Available Rhinoentomophthoromycosis caused by Conidiobolus sp commonly presents as a chronic granulomatous lesion that affects the rhinofacial subcutaneous tissue. We present an 18-year-old girl who presented with progressive bilateral proptosis and loss of vision since 2 weeks. Biopsy and fungal cultures confirmed diagnosis of Conidiobolus sp infection of the paranasal sinuses bilaterally with orbital extension and blindness. The clinical picture was complicated by the presence of sputum-positive cavitatory pulmonary tuberculosis, which was diagnosed at the same time. To our knowledge, this is the first such case to be reported from India. We also discuss the management of entomophthoromycosis. Despite many reports of success, there remains no consensus on the treatment of Conidiobolus infections of the nose and the paranasal sinuses with antifungal agents.

  17. Unusual presentation of entomophthoromycosis.

    Science.gov (United States)

    Michael, R C; Michael, J S; Mathews, M S; Rupa, V

    2009-01-01

    Rhinoentomophthoromycosis caused by Conidiobolus sp commonly presents as a chronic granulomatous lesion that affects the rhinofacial subcutaneous tissue. We present an 18-year-old girl who presented with progressive bilateral proptosis and loss of vision since 2 weeks. Biopsy and fungal cultures confirmed diagnosis of Conidiobolus sp infection of the paranasal sinuses bilaterally with orbital extension and blindness. The clinical picture was complicated by the presence of sputum-positive cavitatory pulmonary tuberculosis, which was diagnosed at the same time. To our knowledge, this is the first such case to be reported from India. We also discuss the management of entomophthoromycosis. Despite many reports of success, there remains no consensus on the treatment of Conidiobolus infections of the nose and the paranasal sinuses with antifungal agents.

  18. Melanoma: Clinical Presentations.

    Science.gov (United States)

    Kibbi, Nour; Kluger, Harriet; Choi, Jennifer Nam

    2016-01-01

    The malignant cell in melanoma is the melanocyte. Because melanocytes are located in the basal layer of the epidermis, melanoma is most commonly seen on the skin. However, melanoma can also arise on mucosal surfaces such as the oral cavity, the upper gastrointestinal mucosa, the genital mucosa, as well as the uveal tract of the eye and leptomeninges. Melanomas tend to be pigmented but can also present as pink or red lesions. They can mimic benign or other malignant skin lesions. This chapter presents the spectrum of typical and less typical presentations of melanoma, as well as patterns of spread. It is divided into (1) cutaneous lesions; (2) patterns of regional spread, (3) non-cutaneous lesions; and (4) distant metastases.

  19. Milk: Past and Present

    Science.gov (United States)

    Bulajić, S.; Đorđević, J.; Ledina, T.; Šarčević, D.; Baltić, M. Ž.

    2017-09-01

    Although milk/dairy consumption is part of many cultures and is recommended in most dietary guidelines around the world, its contribution to overall diet quality remains a matter of controversy, leading to a highly polarized debate within the scientific community, media and public sector. The present article, at first, describes the evolutionary roots of milk consumption, then reviews the milk-derived bioactive peptides as health-promoting components. The third part of the article, in general, presents the associations between milk nutrients, disease prevention, and health promotion.

  20. Book Presentation | 27 February

    CERN Multimedia

    The CERN Library

    2013-01-01

    "A caccia del bosone di Higgs. Magneti, governi, scienziati e particelle nell'impresa scientifica del secolo" by Luciano Maiani and Romeo Bassoli, published by Mondadori. On Wednesday 27 February Luciano Maiani will present the book "A caccia del bosone di Higgs. Magneti, governi, scienziati e particelle nell'impresa scientifica del secolo". More information here. The presentation will take place in the Council Chamber at 16.00 and will be followed by a debate and book signing. The book will be on sale. You are cordially invited.

  1. Hand dermatitis: uncommon presentations.

    Science.gov (United States)

    Bauer, Andrea

    2005-01-01

    Hand dermatitis is a common diagnosis seen in dermatologic and general practice. It can present with typical morphology, but uncommon manifestations are possible. This review reports on common and uncommon presentations of irritant and allergic hand dermatitis focusing on uncommon localizations, time course, and morphology such as follicular, pustular, bullous, ulcerous, exudative erythema multiforme-like, purpuric, lichenoid, pigmented, and depigmented skin lesions. Clinical diagnosis can be challenging. Even histopathology is not always very helpful. Thorough evaluation of the patient's history and investigation of clinical morphology are the cornerstones of diagnosis.

  2. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2012-08-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It was presented at the 2012 RE AMP Annual Meeting. RE-AMP is an active network of 144 nonprofits and foundations across eight Midwestern states working on climate change and energy policy with the goal of reducing global warming pollution economy-wide 80% by 2050.

  3. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    DeMeo, E.

    2012-08-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It was presented at Wind Powering America States Summit. The Summit, which follows the American Wind Energy Association's (AWEA's) annual WINDPOWER Conference and Exhibition, provides state Wind Working Groups, state energy officials, U.S. Energy Department and national laboratory representatives, and professional and institutional partners an opportunity to review successes, opportunities, and challenges for wind energy and plan future collaboration.

  4. Interactive Presentation of Content

    Science.gov (United States)

    Magdin, Martin; Turcáni, Milan; Vrábel, Marek

    2009-01-01

    In the paper we discus about design of universal environment for solution of creating effective multimedia applications with accent on the implementation of interactive elements with the possibility of using the adaptive systems (AS). We also discuss about possibilities of offline presentation of this interactive multimedia adaptive animations…

  5. PowerPoint Presentation

    Indian Academy of Sciences (India)

    Table of contents. PowerPoint Presentation · CHANDIPURA VIRUS · Slide 3 · Slide 4 · Slide 5 · VIRUSES · PROPERTIES OF VIRUSES · CLASSIFICATION OF VIRUSES · VIRUS FAMILIES · VIRUS FAMILIES – contd · General Classification · Slide 12 · Slide 13 · Slide 14 · Slide 15 · Slide 16 · Slide 17 · Slide 18 · Slide 19.

  6. Presentation of 2004 earnings

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-03-01

    This presentation offers financial information on the AREVA Group earnings for the year 2004. With manufacturing facilities in over 40 countries and a sales network in over 100, Areva offers customers technological solutions for nuclear power generation and electricity transmission and distribution. The Group also provides interconnect systems to the telecommunications, computer and automotive markets. (A.L.B.)

  7. Presentism and black holes

    NARCIS (Netherlands)

    Sengers, G. (Geurt)

    2017-01-01

    textabstractIn a recent publication in the European Journal for Philosophy of Science (Romero and Pérez, European Journal for Philosophy of Science, 4, 293–308, 2014), Romero and Pérez claim to reveal new trouble for the already difficult life of presentism in relativistic spacetimes. Their argument

  8. Generating Embodied Information Presentations

    NARCIS (Netherlands)

    Theune, Mariet; Heylen, Dirk K.J.; Nijholt, Antinus; Stock, O.; Zancanaro, M

    2005-01-01

    The output modalities available for information presentation by embodied, human-like agents include both language and various nonverbal cues such as pointing and gesturing. These human, nonverbal modalities can be used to emphasize, extend or even replace the language output produced by the agent.

  9. ORIGINAL RESEARCH PRESENTATIONS

    African Journals Online (AJOL)

    13. ORIGINAL RESEARCH PRESENTATIONS. ABSTRACT. Objectives. To determine factors contributing to home delivery in Kongwa District. Methods: A community-based cross-sectional study was conducted in September 2009 in which women of child-bearing age were interviewed. The variables mainly included:.

  10. Econophysics: Past and present

    Science.gov (United States)

    de Area Leão Pereira, Eder Johnson; da Silva, Marcus Fernandes; Pereira, H. B. B.

    2017-05-01

    This paper provides a brief historical review of the relationship between economics and physics, beginning with Adam Smith being influenced by Isaac Newton's ideas up to the present day including the new econophysics discipline and some of the tools applied to the economy. Thus, this work is expected to motivate new researchers who are interested in this new discipline.

  11. Assessing oral presentation performance

    NARCIS (Netherlands)

    Ginkel, van Stan; Laurentzen, Ramona; Mulder, Martin; Mononen, Asko; Kyttä, Janika; Kortelainen, Mika J.

    2017-01-01

    Purpose: The purpose of this paper is to design a rubric instrument for assessing oral presentation performance in higher education and to test its validity with an expert group. Design/methodology/approach: This study, using mixed methods, focusses on: designing a rubric by identifying

  12. PowerPoint Presentation

    Indian Academy of Sciences (India)

    Table of contents. PowerPoint Presentation · There are 5 Speakers- The Ultimate dream is to get the Road map for connectivity to NE · Witnessing the Revolution · Some History · Slide 5 · Itanium® Processor Family Roadmap ... Growth of Wireless & Internet- Source Motorola · Convergence · Internet Alone is Not Enough…

  13. El escenario del presente

    Directory of Open Access Journals (Sweden)

    Cruz, Manuel

    2008-12-01

    Full Text Available The disappearance of the idea of progress in post-Enlightenment thought constitutes one of the central tenets of the network of topics that make up contemporary social imagery. However, that tenet, which in a sense has been present from the origins of the Enlightment tradition, produces discursive effects of significant relevance, a particular kind of perverse effects related to thought, not always legitimized enough to certify that disappearance.

    La desaparición de la idea de progreso en el pensamiento postilustrado constituye uno de los convencimientos centrales del entramado de tópicos que forman el imaginario social contemporáneo. Pero dicho convencimiento, en cierto modo presente desde los orígenes de la propia tradición ilustrada, da lugar a efectos discursivos de considerable importancia, a una particular modalidad de efectos perversos en materia de pensamiento, no siempre suficientemente aquilatados al certificar dicha desaparición.

  14. [Metachromatic Leukodystrophy. Case Presentation].

    Science.gov (United States)

    Espejo, Lina María; de la Espriella, Ricardo; Hernández, José Fernando

    Metachromatic leukodystrophy (MLD) is a rare demyelinating disease (prevalence 1:40 000), also called arylsulfatase A deficiency (ARS-A), which may present with neurological and psychiatric symptoms. Clinical assessment may be difficult, due to unspecific signs and symptoms. A case is presented of a 16 year-old female patient seen in psychiatry due to behavioural changes, psychosis, and with impaired overall performance. She was initially diagnosed with schizophrenia, but the Nuclear Magnetic Resonance (NMR) scan and laboratory tests lead to the diagnosis of MLD. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  15. Presentation = Speech + Slides

    Directory of Open Access Journals (Sweden)

    Derik Badman

    2008-12-01

    Full Text Available Back in October, Aaron Schmidt posted “HOWTO give a good presentation” to his blog walking paper. His second bullet point of “thoughts” on good presentations is: Please don’t fill your slides with words. Find some relevant and pretty pictures to support what you’re saying. You can use the pictures to remind yourself what you’re going [...

  16. Generating Embodied Information Presentations

    OpenAIRE

    Theune, Mariet; Heylen, Dirk K. J.; Nijholt, Antinus; Stock, O.; Zancanaro, M

    2005-01-01

    The output modalities available for information presentation by embodied, human-like agents include both language and various nonverbal cues such as pointing and gesturing. These human, nonverbal modalities can be used to emphasize, extend or even replace the language output produced by the agent. To deal with the interdependence between language and nonverbal signals, their production processes should be integrated. In this chapter, we discuss the issues involved in extending a natural langu...

  17. Unusual presentation of phaeochromocytoma.

    Science.gov (United States)

    Hope, D C D; Palan, J M

    2016-05-10

    A 44-year-old woman, with a background of heart, lung and renal transplantation secondary to cystic fibrosis and type 1 diabetes, presented with tachycardia, hyperglycaemia, nausea and vomiting. She was initially managed for diabetic ketoacidosis with severe dehydration. However, persistent episodic hypertension and tachycardia led the investigating team to identify significantly raised urinary metanephrines and a left-sided adrenal mass; Iodine-123-meta-iodobenzylguanidine single photon emission computer tomography scan (MIBG SPECT/CT) showed avid uptake of tracer, confirming a left-sided phaeochromocytoma. She was started on medical management and is awaiting an elective laparoscopic procedure. This case describes the presentation of a unilateral phaeochromocytoma as ketoacidosis in a patient with type 1 diabetes with no other apparent precipitant. This highlights the metabolic counter-regulatory effect of excess catecholamines in addition to the inotropic/chronotropic effects that are associated with this adrenal tumour. Recognition of atypical signs and symptoms may point towards an atypical precipitant of diabetic ketoacidosis-a medical emergency presenting to front-line clinicians. 2016 BMJ Publishing Group Ltd.

  18. Bad (Re)Presentations

    CERN Multimedia

    Computer Security Team

    2013-01-01

    This time, we would like to address copyright violations (again) - but with a twist. While previous articles focussed on “Music, videos and the risk for CERN” or on software licences, the focus is now on using photos, music and images “found” on the Web for presentations, publications and web pages…   Just recently, a video produced for CERN and published on YouTube and Facebook used background music from a contemporary popular artist. However, the people responsible failed to obtain the appropriate permission to actually use that music. They thought that having bought it on iTunes was sufficient. But it was not: “buying” means you have the right to listen, but not the right for further distribution or re-publication. As a result, the videos were pulled from YouTube and Facebook. Similarly, how many of us integrate graphics and images “found” on the Web into our presentations?  How many of us...

  19. Determining the number of test fires needed to represent the variability present within 9mm Luger firearms.

    Science.gov (United States)

    Law, Eric F; Morris, Keith B; Jelsema, Casey M

    2017-07-01

    Many studies have been performed in recent years in the field of firearm examination with the goal of providing an objective method for comparisons of fired cartridge cases. No published research to support the number of test fires needed to represent the variability present within the impressions left on a cartridge case could be found. When a suspect firearm is submitted to a firearm examiner, typically two to four test fires are performed. The recovered cartridge cases are compared to each other to determine which characteristics from the firearm are reproducing, and then compared to any cartridge cases collected at a crime scene. The aim of this research was to determine the number of test fires examiners should perform when a suspect firearm is submitted to the lab to balance cartridge case acquisition time with performance accuracy. Each firearm in the IBIS(®) database at West Virginia University(®) is represented by approximately 100 fired cartridge case entries. Random samples of cartridge cases were taken separately from the breech face match score and firing pin match score lists. This subset was compared to the total match distribution of the firearm using a hybrid equivalence test to determine if the subset of similarity scores were statistically equivalent to the larger distribution of scores. For the sampled distribution to remain above 80% equivalent to the match distribution, a minimum of 15 cartridge cases should be used to model the match distribution, based on IBIS(®) scores. Thirty cartridge cases is a conservative estimate, allowing one to determine that the location and dispersion of the match and sampling distributions are equivalent with nearly 100% probability. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Understanding anatomical terms.

    Science.gov (United States)

    Mehta, L A; Natrajan, M; Kothari, M L

    1996-01-01

    Words are our masters and words are our slaves, all depending on how we use them. The whole of medical science owes its origin to Greco-Roman culture and is replete with terms whose high sound is not necessarily accompanied by sound meaning. This is even more the case in the initial, pre-clinical years. Anatomical terminology seems bewildering to the initiate; and maybe that is a reason why love of anatomy as a subject does not always spill over through later years. Employing certain classifications of the origin of the anatomical terms, we have prepared an anthology that we hope will ease the student's task and also heighten the student's appreciation of the new terms. This centers on revealing the Kiplingian "how, why, when, where, what, and who" of a given term. This presentation should empower students to independently formulate a wide network of correlations once they understand a particular term. The article thus hopes to stimulate students' analytic and synthetic faculties as well. A small effort can reap large rewards in terms of enjoyment of the study of anatomy and the related subjects of histology, embryology, and genetics. It is helpful to teachers and students alike. This exercise in semantics and etymology does not demand of the student or his teacher any background in linguistics, grammar, Greek, Latin, Sanskrit, anatomy, or medicine.

  1. Giving effective presentations.

    Science.gov (United States)

    Englehart, Nadine

    2004-03-01

    Apprehension about oral communication, or public speaking is rated as the number one fear among most individuals. Developing skill in, and comfort with, public speaking is important whether we are presenting oral reports and proposals, responding to questions, or training co-workers. Effective speakers are able to communicate information in a way that stimulates interest, helps the audience to understand and remember, and influences attitudes and behaviours. Many of us think that effective speakers are born rather than made. In truth most successful speakers work hard and invest a great deal of time and effort in to improving their speaking capabilities. Effective public speaking is a learned skill and activity that requires lots of practice. Like other learned skills, having a strategy with clear action steps can help you achieve your goal.

  2. Living in the Present

    Directory of Open Access Journals (Sweden)

    Angela Barns

    2015-12-01

    Full Text Available This article presents the findings from a qualitative research project exploring eight women’s experiences of living with rheumatoid arthritis (RA. Through semistructured interviews, the women provided insights into the physical, emotional, and social impacts of RA and the “work” involved in negotiating its influence in the everyday life. In narrating their experiences of adapting to RA, the women express a common desire for “normalcy,” to return to a time and space before the disruption of RA. The women’s accounts also emphasized the interrelatedness between bodily experience and constructions of self, highlighting the corporeal nature of RA and the constant shaping and reshaping of personal meanings and values.

  3. Presente continuo [Ressenya

    OpenAIRE

    Sánchez-Biosca, Vicente

    2002-01-01

    Albera, François (ed.): Eisenstein dans le texte, número monográfico de Cinémas, vol. 11-nº 2-3, primavera 2001 S.M. Eisenstein: Hacia una teoría del montaje, Barcelona, Paidós, 2001, dos volúmenes La presente reseña se ocupa de dos libros en torno a la vanguardia artística en su relación con el cine y la Teoría general del montaje de S.M. Eisenstein y reflexiona sobre las articulaciones que la obra de Eisenstein tuvo con la vanguardia francesa, alemana y, sobre todo, rusa de los años...

  4. Film Presentation: Die Urknallmaschine

    CERN Multimedia

    Carolyn Lee

    2010-01-01

    Die Urknallmaschine, an Austrian film by Gerd Baldauf, narrated by Norbert Frischauf (Alpha Österreich - ORF, 2009).  In CERN’s gigantic complex particles are accelerated to almost the speed of light, brought to collision and made to divide into even smaller particles. Public opinion of CERN’s research is also divided. Sceptics fear that black holes may be created. Might the goal to study the origin of the world lead to its destruction? The Austrian researcher Norbert Frischauf worked at CERN for many years. With his guidance it is possible to explore the world’s largest research centre, get a glimpse of the fascinating work the scientists do there and take a crash course in particle physics. Die Urknallmaschine will be presented on Friday, 25 June from 13:00 to 14:00 in the Main Auditorium. Language: German

  5. RESRAD model presentation

    Energy Technology Data Exchange (ETDEWEB)

    Yu, C.; Faillace, E.; Chen, S.Y. [Argonne National Lab., IL (United States); Wallo, A. III; Williams, W.A.; Peterson, H.; Domotor, S. [Dept. of Energy, Washington, DC (United States)

    1998-05-01

    RESRAD was one of the multimedia models selected by the US Nuclear Regulatory Commission (NRC) to include in its workshop on radiation dose modeling and demonstration of compliance with the radiological criteria for license termination. This paper is a summary of the presentation made at the workshop and focuses on the 10 questions the NRC distributed to all participants prior to the workshop. The code selection criteria, which were solicited by the NRC, for demonstrating compliance with the license termination rule are also included. Among the RESRAD family of codes, RESRAD and RESRAD-BUILD are designed for evaluating radiological contamination in soils and in buildings. Many documents have been published to support the use of these codes. This paper focuses on these two codes. The pathways considered, the databases and parameters used, quality control and quality assurance, benchmarking, verification and validation of these codes, and capabilities as well as limitations of these codes are discussed in detail.

  6. MSG RAO Presentation

    Science.gov (United States)

    Oriol-Pibernat, E.; Govaerts, Y.

    2004-11-01

    BACKGROUND The Meteosat Second Generation (MSG) Research Announcement of Opportunity (RAO) was released by ESA and EUMETSAT in 1999, after a first warning issued in September 1998. The RAO main objective is to promote the scientific use of the new MSG satellites outside the operational meteorological user community, also in synergy with ERS and Envisat data. The variety and quality of the selected proposals proved the usefulness of such joint initiative. 2. STATUS OF THE RAO A total of 43 proposals were selected in 1999. Following the delay in the MSG-1 launch (which operational name is Meteosat-8), the PIs were contacted in early 2003 in order to confirm the interest to continue with the project. There were 5 withdrawals due to various reasons. The PIs have been receiving news through a dedicated WEB site or by emails. Each PI has been assigned a correspondent from ESA or EUMETSAT to follow up the project through the site: http://eopi.esa.int/esa/esa where the papers presented at this Workshop will be included as the first report. 3. THE MSG RAO WORKSHOPS In the framework of the MSG RAO, a series of workshops are organised which goal is to establish a structured dialogue and interactions among the MSG Principal Investigators (PIs) and ESA/EUMETSAT, respectively. Each of these workshops is focusing on a specific aspect, in addition to the necessary exchange of information. 4. OBJECTIVES OF THE BOLOGNA WORKSHOP The focus of the first workshop (17-19 May 2000) was on the presentation of MSG features and of all selected RAO projects. It was a starting point for continued interaction within the MSG RAO community (selected PIs and their co-Investigators, Co-Is). The first MSG RAO workshop provided a forum for discussion among scientists, and ESA and EUMETSAT, leading to a continuous scientific co-operation. Requirements and possibilities with regard to data delivery were formulated and discussed at this workshop. In particular, PIs were asked to specify the minimal and

  7. Director general presentation to personnel

    CERN Multimedia

    2016-01-01

    Dear Colleagues, Many important discussions are scheduled for the upcoming Council Week (13-17 June) on topics including the Medium-Term Plan, the Pension Fund and other matters of great relevance to us.   I would therefore like to share the main outcome of the week with you and I invite you to join me and the Directors in the Main Auditorium at 10 a.m. on Thursday 23 June. The meeting will last about one hour and a webcast will also be available. Best regards, Fabiola Gianotti DG presentation to personnel Thursday 23 June at 10 am Main Auditorium Retransmission in Council Chamber, IT Auditorium, Kjell Jonhsen Auditorium, Prevessin 864-1-C02 Webcast on cern.ch/webcast More information on the event page.

  8. Presentation of Pydio

    CERN Multimedia

    CERN. Geneva

    2014-01-01

    **Pydio is an open-source platform for file sharing and synchronisation.** It is wildly used by enterprises and organizations worldwide, including major universities. Pydio comes with a rich web-based interface, native clients for both iOS and Android mobile devices, and lately a new sync client for desktop platforms. Pydio v6 is of great useability and introduces many new features that makes it the ultimate sharing machine. Its architecture makes it a perfect fit for either easily deploying an on-premise dropbox solution, or building more complicated solutions where the box feature is integrated as OEM. Storage-agnostic, Pydio is a simple layer that can be deployed on top of any storage backend, thus providing scalability and high-availability out-of-the-box. Charles du Jeu is the lead developer of the solution and will briefly present its feature and how it can fit for research and engineering purpose. See https://pyd.io/ for more information.

  9. Sarcoidosis: An unusual presentation.

    Science.gov (United States)

    Madureira, Pedro; Pimenta, Sofia; Cardoso, Hélder; Guimarães Cunha, Rui; Costa, Lúcia

    A 35-year-old man presented with a 3-year history of arthralgia and purple coloration of the skin of his fingers and feet. Hand and foot radiography showed cystic bone lesions on phalanges suggestive of sarcoidosis. Lab tests revealed increased liver enzymes. Liver MRI evidenced an enlarged liver and retroperitoneal lymphadenopathy. Histological analysis of the finger skin, lymph nodes and liver demonstrated the presence of granulomas, confirming the diagnosis of sarcoidosis. The patient started prednisolone with rapid improvement of the symptoms. Skin lesions are divided into two groups: specific for sarcoidosis (with granulomas, lupus pernio-like) and nonspecific (without granulomas, erythema nodosum-like). Specific cutaneous lesions usually cause no other symptoms beyond cosmetic changes. Lupus pernio stands out for having distinctive features but, to the best of our knowledge, the simultaneous involvement of both hands and feet has never been reported. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  10. The laryngocele; case presentation

    Directory of Open Access Journals (Sweden)

    Gabriel V. Berteșteanu

    2016-05-01

    Full Text Available Laryngocele is a rare pathology, but because of their clinical evolution and the symptoms they generate, they should always be considered as a differential diagnosis when investigating neck masses. A laryngocele is basically a herniation of the mucosa of the laryngeal ventricle (Morgagni's ventricle arising usually from the saccular region. This herniation may remain confined to the larynx - in which case the laryngocele is internal- or expand through the thyro-hyoid membrane into the structures of the neck - thus being called an external laryngocele. Usually the laryngocele has both an internal and external component thus being a mixed laryngocele. Diagnosis of laryngoceles still relies heavily on clinical signs such as tympanism, easily depressible neck mass, indirect laryngoscopy, but is now simplified by imagistic investigations (ultrasound, CT and MRI. However, the treatment of this condition is exclusively surgical and consists of total excision of the laryngocele, as well as proper identification of the point of origin from the saccule and also the final suture of the breach in order to prevent recurrence. Investigation of possible causes of obstruction of the laryngeal ventricle should always be performed (because of the possibility of an underlying malignancy as well as a follow-up protocol of the patient, given the risk of relapse. We present a recently diagnosed case of a 32 year old man with mixed laryngocele, which we have operated in our clinic.

  11. Endometriosis Presenting as Hydronephrosis

    Directory of Open Access Journals (Sweden)

    Ahmed Bakheet Zaharani

    2005-01-01

    Full Text Available The most serious urological complication of endometriosis is hydronephrotic renal atrophy secondary to ureteric involvement. As only half of these patients are symptomatic, it is commonly diagnosed late and more by the clinicians awareness and suspicion of this entity. We report a case of an unmarried young female who presented primarily with left loin pain of 2-year duration. She was found to have lower ureteric stricture by an IVU done by her referring doctor. Further workup at our center showed that she had pelvic endometriosis with hydronephrosis secondary to extrinsic ureteric endometriosis. She had a first-degree relative with the same disease. She had no menstrual problems. Diagnostic laparoscopy, biopsy of the lesion, ureteric dilatation with stenting, along with hormonal treatment was given to her as first line of treatment. There was no improvement of the ureteric obstruction even after 6 months of treatment. Finally, surgical excision of the endometrioma, left oophorectomy, along with resection of the ureteric stricture with uretero-ureterostomy was done. This case report includes details of her further management and outcome along with a brief review of literature.

  12. Pneumoperitoneum: An unusual presenting finding of perforated ...

    African Journals Online (AJOL)

    Pneumoperitoneum is rarely encountered as a radiographic finding in association with perforated appendicitis in children, and may lead to diagnostic errors. In this paper, we present pneumoperitoneum as a presenting finding of perforated appendicitis in a 2-year-old boy. The term pneumoperitoneum frequently indicates ...

  13. THE UPSIDE OF PRESENTISM

    Directory of Open Access Journals (Sweden)

    Lynn Fendler

    2009-01-01

    Full Text Available El presentismo es visto generalmente como un mal necesario en historiografía. Este artículo explora lo positivo de esta inevitabilidad. Aplicando un enfoque filosófico al análisis discursivo en la tradición de la nueva historia cultural, se distingue -de una parte-¿ entre un uso estratégico del presentismo, y -de otra- un enfoque racionalista en historia. El artículo concluye considerando algunas implicaciones políticas en historiografía de las explicaciones racionalistas y de las explicaciones estratégicamente presentistas. Los modos de comprensión racionalistas inscriben las expectativas del pasado en las visiones del futuro; asignando al historiador el papel de profeta; y perpetuando nociones de agentes ahistóricos. En contraste, las historias estratégicamente presentistas incorporan una orientación que deliberadamente emplea las lentes y perspectivas del presente en orden a tener en cuenta supuestos y perspectivas actuales. Cuando las asunciones son examinadas en relación a las perspectivas presentistas, dichos presupuestos sueltan su rienda en el pensamiento. Dado que el presentismo es inevitable, no debe ser desestimado por completo, sino que debe ser una cuestión sondeada y examinada críticamente. Con dicho foco, el presentismo estratégico en la historiografía debe posibilitar una reflexión sobre los límites de lo que es posible pensar.

  14. Expected Term Structures

    DEFF Research Database (Denmark)

    Buraschi, Andrea; Piatti, Ilaria; Whelan, Paul

    hypothesis. Finally, we use ex-ante spanned subjective beliefs to evaluate several reduced-form and structural models. We find support for heterogeneous beliefs models and also uncover a number of statistically significant relationships in favour of alternative rational expectations models once the effect......This paper studies the properties of bond risk premia in the cross-section of subjective expectations. We exploit an extensive dataset of yield curve forecasts from financial institutions and document a number of novel findings. First, contrary to evidence presented for stock markets but consistent......-primary dealers. Third, we reject the null hypothesis that subjective expected bond returns are constant. When predicting long term rates, however, primary dealers have no information advantage. This suggests that a key source of variation in long-term bonds are risk premia and not short- term rate variation...

  15. WOODEN FLOORING – BETWEEN PRESENT AND FUTURE

    OpenAIRE

    Ivan CISMARU; Marius FILIPAȘCU; Olimpia-Minerva ȚURCAȘ (DIACONU); Adriana FOTIN

    2015-01-01

    The paper aims at presenting a systematization of the wood floors, both in terms of the areas of application, and in terms of the fastening solutions and structures in constructions. In this respect, an extensive bibliographic research was achieved, on the researchers’ preoccupations. Starting from the current situation and forecasting the future, from the point of view of the chances held by wooden flooring, in competition with other types of materials, we dare say the wooden flo...

  16. Evolução intra-hospitalar e seguimento pós-alta de pacientes idosos atendidos com insuficiência cardíaca congestiva na unidade de emergência Hospital outcome and short-term follow-up of predominatly elderly patients presenting to the emergency department with congestive heart failure

    Directory of Open Access Journals (Sweden)

    Humberto Villacorta

    1998-03-01

    Full Text Available OBJETIVO: Conhecer a evolução intra-hospitalar (IH e pós-alta (PA de uma população predominantemente idosa, com insuficiência cardíaca congestiva (ICC na unidade de emergência (UE. MÉTODOS: Durante 11 meses, foram selecionados 57 pacientes consecutivos com ICC, atendidos em EU, com idade média de 69+15 (27 a 94 anos, sendo 39 (68,4% homens. O diagnóstico de ICC baseou-se nos critérios de Boston. Avaliou-se a evolução IH e PA num período médio de 5,7+2,7 (1 a 12 meses, procurando-se identificar variáveis que se correlacionassem com a mortalidade e o mecanismo de morte, avaliado pelo sistema ACME . RESULTADOS: Oito (14% pacientes faleceram na fase IH, sendo 7 por falência circulatória (FC, e 1 em pós-operatório (PO. Durante o seguimento ocorreram 9 (18,4% óbitos, sendo 5 por FC, 2 mortes súbitas e 2 em PO (troca valvar mitral e ventriculectomia. A sobrevida dos pacientes que tiveram alta foi de 82% e 66%, aos 6 meses e 1 ano, respectivamente. Sódio sérico PURPOSE: To evaluate the in-hospital (IH outcome and the short-term follow-up of predominantly elderly patients presenting to an emergency room (ER with congestive heart failure (CHF. METHODS: In an 11 month period, 57 patients presenting to the ER with CHF were included. Mean age was 69+15 years (27 to 94 and 39 (68,4% were male. CHF diagnosis was based on the Boston criteria. We evaluated IH outcome and prognosis in a mean follow-up of 5,7+2,7 months (1 to 12. In addition, some mortality predictors and mechanisms of death according on the ACME system were identified. RESULTS: Eight patients (14% died in the IH period. Modes of death were circulatory failure (CF in 7, and peri-operative (PO in one (aortic valve replacement. During follow-up 9 deaths ocurred. Five were due to CF, 2 were sudden and 2 were PO (mitral valve replacement and ventriculectomy. Six-months and 1-year survival rates of the patients who were discharged were 82% and 66%, respectively. Sodium lower

  17. Random walk term weighting for information retrieval

    DEFF Research Database (Denmark)

    Blanco, R.; Lioma, Christina

    2007-01-01

    We present a way of estimating term weights for Information Retrieval (IR), using term co-occurrence as a measure of dependency between terms.We use the random walk graph-based ranking algorithm on a graph that encodes terms and co-occurrence dependencies in text, from which we derive term weights...... that represent a quantification of how a term contributes to its context. Evaluation on two TREC collections and 350 topics shows that the random walk-based term weights perform at least comparably to the traditional tf-idf term weighting, while they outperform it when the distance between co-occurring terms...

  18. Presentation

    Directory of Open Access Journals (Sweden)

    Andrea Cannas

    2015-07-01

    Full Text Available Della dimensione sonora si esaminano alcuni aspetti poco noti e trascurati, o anche meno percepiti, pur facendo parte del soundscape della vita quotidiana odierna. Sono oggetto di analisi, inoltre, musiche, voci e suoni osteggiati da forze e poteri oppure perduti col trascorrere del tempo. Infine un’attenzione particolare è riservata alla polisemia e alla dialettica dei silenzi.

  19. present

    African Journals Online (AJOL)

    for Malawi's language-in-education policies to be successfully implemented, there is need for the involvement of ... system and as a subject of study throughout Malawi's entire education system in the 1969/70 academic ...... Sibayan's (1999:42) comments on the Singapore experiences where similar assumptions led to the ...

  20. Presentation

    Directory of Open Access Journals (Sweden)

    Manuel ALCÁNTARA SÁEZ

    2010-10-01

    Full Text Available Argentina y Uruguay fueron los países más desarrollados de América Latina hasta comienzos de la década de 1970. Aunque muy diferentes en tamaño, atesoran una envidiable dotación en recursos agropecuarios, una frontera abierta desde su independencia hasta comienzos del XX, un fuerte flujo de inmigración europea que contribuyó a modelar sus sociedades, sistemas políticos y relaciones internacionales. Por su «europeísmo» y prosperidad, por el igualitarismo y tamaño de sus clases medias, hasta los años centrales del siglo pasado ambos países eran considerados excepcionales en el contexto latinoamericano.

  1. [ISRAEL NEONATOLOGY: PRESENT AND FUTURE].

    Science.gov (United States)

    Dollberg, Shaul

    2016-01-01

    The practice of neonatology in Israel debuted in the 1970s as local enterprises by individual hospitals that needed to provide sick and preterm newly born infants with up-to-date and effective care. Descriptions of research and advances in humane and gentle treatment during neonatal care for preterm infants and their families, as well as prevention of neonatal infections, follow-up of preterm infants and care of full-term infants are presented in this issue. The Israel National Very Low Birth Weight (VLBW) Infant database provides an excellent source of knowledge, which has led to multiple scientific publications. Recent international comparisons of the outcome of preterm VLBW infants, made possible by this unique database in Israel, has provided the neonatal community and the Ministry of Health with insights as to the differences in prognosis between Israel and other countries, especially among extremely low birth weight infants. At the border of viability, mortality in Israelis significantly higher than that reported in other countries and proactive steps undertaken to examine these differences and prompt correctional action should be pursued. The Israel Ministry of Health started positive initiatives and should ensure that their steps are implemented at the preterm infant's bedside.

  2. Nuclear Fuels: Present and Future

    Directory of Open Access Journals (Sweden)

    Donald R. Olander

    2009-02-01

    Full Text Available The important new developments in nuclear fuels and their problems are reviewed and compared with the status of present light-water reactor fuels. The limitations of these fuels and the reactors they power are reviewed with respect to important recent concerns, namely provision of outlet coolant temperatures high enough for use in H2 production, destruction of plutonium to eliminate proliferation concerns, and burning of the minor actinides to reduce the waste repository heat load and long-term radiation hazard. In addition to current oxide-based fuel-rod designs, the hydride fuel with liquid metal thermal bonding of the fuel-cladding gap is covered. Finally, two of the most promising Generation IV reactor concepts, the Very High Temperature Reactor and the Sodium Fast Reactor, and the accompanying reprocessing technologies, aqueous-based UREX and pyrometallurgical, are summarized. In all of the topics covered, the thermodynamics involved in the material's behavior under irradiation and in the reprocessing schemes are emphasized.

  3. Term Graph Rewriting and Parallel Term Rewriting

    Directory of Open Access Journals (Sweden)

    Andrea Corradini

    2011-02-01

    Full Text Available The relationship between Term Graph Rewriting and Term Rewriting is well understood: a single term graph reduction may correspond to several term reductions, due to sharing. It is also known that if term graphs are allowed to contain cycles, then one term graph reduction may correspond to infinitely many term reductions. We stress that this fact can be interpreted in two ways. According to the "sequential interpretation", a term graph reduction corresponds to an infinite sequence of term reductions, as formalized by Kennaway et.al. using strongly converging derivations over the complete metric space of infinite terms. Instead according to the "parallel interpretation" a term graph reduction corresponds to the parallel reduction of an infinite set of redexes in a rational term. We formalize the latter notion by exploiting the complete partial order of infinite and possibly partial terms, and we stress that this interpretation allows to explain the result of reducing circular redexes in several approaches to term graph rewriting.

  4. Enhancing the Recall of Presented Material

    Science.gov (United States)

    Larson, Ronald B.

    2009-01-01

    Many educators distribute either complete or incomplete handouts so students can follow along with their lectures. This research examines a teaching system that combines computer-generated graphics presentations and detailed outline handouts with blanks added. An experiment found that this system produced significantly higher short-term recall of…

  5. Subdural Empyema: Clinical Presentations and Management ...

    African Journals Online (AJOL)

    2018-02-07

    Feb 7, 2018 ... Subdural empyema: Clinical presentations and management options for an uncommon neurosurgical emergency in a developing country. Niger J Clin Pract 2017;20:1221-5. This is an open access article distributed under the terms of the Creative Commons. Attribution-Non Commercial-Share Alike 3.0 ...

  6. Chapter 2. Borderlands environment, past and present

    Science.gov (United States)

    Guadalupe Sanchez de Carpenter; A.C. MacWilliams

    2006-01-01

    The major mountain ranges in the study area today were produced by Middle Miocene and younger extensional faulting. Faulting continued into the late Pleistocene as evidenced by fault scarps along the margins of the Animas, Hachita, and Playas Valleys. These long-term geologic events resulted in the present basin and range physiography of the Malpai Borderlands, as...

  7. Food Service Technical Terms. English-Spanish Lexicon.

    Science.gov (United States)

    Shin, Masako T.

    This English-Spanish lexicon presents food service technical terms. The terms are divided into seven categories: basic food items, common baking terms, food cutting terms, general cooking terms, non-English culinary terms, and tools and equipment. Each English word or term is followed by its Spanish equivalent(s). (YLB)

  8. Gogny interactions with tensor terms

    Energy Technology Data Exchange (ETDEWEB)

    Anguiano, M.; Lallena, A.M.; Bernard, R.N. [Universidad de Granada, Departamento de Fisica Atomica, Molecular y Nuclear, Granada (Spain); Co' , G. [INFN, Lecce (Italy); De Donno, V. [Universita del Salento, Dipartimento di Matematica e Fisica ' ' E. De Giorgi' ' , Lecce (Italy); Grasso, M. [Universite Paris-Sud, Institut de Physique Nucleaire, IN2P3-CNRS, Orsay (France)

    2016-07-15

    We present a perturbative approach to include tensor terms in the Gogny interaction. We do not change the values of the usual parameterisations, with the only exception of the spin-orbit term, and we add tensor terms whose only free parameters are the strengths of the interactions. We identify observables sensitive to the presence of the tensor force in Hartree-Fock, Hartree-Fock-Bogoliubov and random phase approximation calculations. We show the need of including two tensor contributions, at least: a pure tensor term and a tensor-isospin term. We show results relevant for the inclusion of the tensor term for single-particle energies, charge-conserving magnetic excitations and Gamow-Teller excitations. (orig.)

  9. Interactive Proof Presentations with Cobra

    National Research Council Canada - National Science Library

    Ring, Martin; Lüth, Christoph

    2017-01-01

    We present Cobra, a modern proof presentation framework, leveraging cutting-edge presentation technology together with a state of the art interactive theorem prover to present formalized mathematics as active documents...

  10. Long term stability of power systems

    Energy Technology Data Exchange (ETDEWEB)

    Kundur, P.; Gao, B. [Powertech Labs. Inc., Surrey, BC (Canada)

    1994-12-31

    Power system long term stability is still a developing subject. In this paper we provide our perspectives and experiences related to long term stability. The paper begins with the description of the nature of the long term stability problem, followed by the discussion of issues related to the modeling and solution techniques of tools for long term stability analysis. Cases studies are presented to illustrate the voltage stability aspect and plant dynamics aspect of long term stability. (author) 20 refs., 11 figs.

  11. Primary Index Term Secondary Index Term Tertiary Index term ...

    Indian Academy of Sciences (India)

    chaubey

    Tertiary Index term. Geosciences. Solid earth. Tectonics. Structural Geology. Geodynamics. Seismology. Exploration geophysics. Seismic hazards. Geomagnetism. Mineralogy. Petrology. Metamorphic. Igneous. Sedimentary. Fossil fuels. Petroleum and coal. Isotope geology. Geochronology. Isotope geology. Landform and.

  12. Creating Presentations on ICT Classes

    Science.gov (United States)

    Marchis, Iuliana

    2010-01-01

    The article focuses on the creation of presentations on ICT classes. The first part highlights the most important steps when creating a presentation. The main idea is, that the computer presentation shouldn't consist only from the technological part, i.e. the editing of the presentation in a computer program. There are many steps before and after…

  13. Put Power into Your Presentations: Using Presentation Software Effectively

    Science.gov (United States)

    Safransky, Robert J.; Burmeister, Marsha L.

    2009-01-01

    Microsoft PowerPoint, Apple Keynote, and OpenOffice Impress are relatively common tools in the classroom and in the boardroom these days. What makes presentation software so popular? As the Chinese proverb declares, a picture is worth a thousand words. People like visual presentations. Presentation software can make even a dull subject come to…

  14. Infantile dystocia fibrosarcoma presentIng as shoulder

    African Journals Online (AJOL)

    fibrosarcoma. •. presentIng as shoulder. M. S. PUZEY, D. F. INNES, C. W. VAN DER ELST. Summary. Congenital (infantile) fibrosarcomas are soft-tissue tumours that usually present after birth. In the case described a large tumour of the right arm caused shoulder dystocia and death of the fetus. S Atr Med J 1989; 76: 73-74.

  15. Present Nightmares and Realizable Futures

    Science.gov (United States)

    Morris, Doug

    2010-01-01

    The article reflects on the work of Henry Giroux, focusing on his latest book "Youth in a Suspect Society". It attempts to capture the experience of reading Giroux and what Giroux's critical engagements across a wide array of cultural and pedagogical formations provide in terms of assisting us in articulating substantive criticisms of and insights…

  16. Dressed to Present: Ratings of Classroom Presentations Vary with Attire

    Science.gov (United States)

    Gurung, Regan A. R.; Kempen, Laura; Klemm, Kayla; Senn, Rebecca; Wysocki, Rosie

    2014-01-01

    This study investigates the effects of formality of dress on ratings of classroom presentations. Participants (N = 65, 66% women) from a Midwestern university in the United States rated three female students giving a presentation designed for a health psychology class in one of four outfits: casual, party, business casual, or business formal.…

  17. Power Electronics Thermal Control (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Narumanchi, S.

    2010-05-05

    Thermal management plays an important part in the cost of electric drives in terms of power electronics packaging. Very promising results have been obtained by using microporous coatings and skived surfaces in conjunction with single-phase and two-phase flows. Sintered materials and thermoplastics with embedded fibers show significant promise as thermal interface materials, or TIMs. Appropriate cooling technologies depend on the power electronics package application and reliability.

  18. Isolated Torticollis May Present as an Atypical Presentation of Meningitis

    Directory of Open Access Journals (Sweden)

    Roger Chirurgi

    2012-01-01

    Full Text Available Background. Bacterial meningitis is a life-threatening medical emergency that requires urgent diagnosis and treatment. Diagnosis is infrequently missed if the patient presents with the classic symptoms of fever, headache, rash, nuchal rigidity, or Kernig or Brudzinski sign. However, it may be less obvious in neonates, elderly, or immunocompromised patients. Meningitis which presents as isolated torticollis, without any other signs or symptoms, is exceedingly rare. Objective. To identify an abnormal presentation of meningitis in an adult immunocompromised patient. Case Report. We present a case of an adult diabetic male who presented multiple times to the ED with complaint of isolated torticollis, who ultimately was diagnosed with bacterial meningitis. Conclusion. We propose that in the absence of sufficient explanation for acute painful torticollis in an immunocompromised adult patient, further evaluation, possibly including a lumbar puncture may be warranted.

  19. Biography of biophenols: past, present and future

    Directory of Open Access Journals (Sweden)

    Hassan K. Obied

    2013-06-01

    Full Text Available ABSTRACTBackground: The term “biophenols” was first coined by Romeo and Uccella in 1996 to denote bioactive phenols in olives replacing the more common and less chemically accurate term “polyphenols”. “Biophenols” has started gaining popularity beyond olive chemistry and currently used by researchers to refer to plant phenols in general. Biophenols constitute the largest group of secondary plant metabolites with ubiquitous presence in plants and wide spectrum of biological activities. During the last three decades, biophenols have seized scientific attention, lured industry and attracted consumers’ interest due to their antioxidative potential in preservation of food and maintaining human health. For the first time, a definition for “biophenols” has been proposed to present a more precise and comprehensive umbrella term to encompass all phenolic compounds of botanical origin. In this article, the author is tracing the landmarks of the history of biophenol research; profiling contemporary research directions; highlighting research controversies and uncertainties; and presenting an outlook of the biophenols future research.Keywords: polyphenols, chemistry, pharmacology, biological activities, antioxidant

  20. Forløsningsmåde ved underkropspraesentation. Selektion ved røntgenologisk baekkenmåling

    DEFF Research Database (Denmark)

    Krebs, L; Nilas, L; Langhoff-Roos, J

    1997-01-01

    , pelvimetry was performed in 74 women, where pelvic dimensions too small for recommendation of vaginal breech delivery were found in 30 cases. The overall rate of caesarean section was 78%, among diagnosed patients it was 84% and 64% among undiagnosed breech presentations. Rates of morbidity (low Apgar score...

  1. Emphysematous pyelonephritis: a rare presentation.

    Directory of Open Access Journals (Sweden)

    Jain S

    2000-01-01

    Full Text Available Emphysematous pyelonephritis is a rare life threatening infection in diabetes characterised by suppurative infection of renal parenchyma and perirenal tissues. It usually presents with fever, nausea, vomiting, abdominal pain, shock, lethargy, and confusion. Diabetic ketoacidosis is an uncommon presentation. In the present case, an elderly female presented with abdominal pain, fever, vomiting, and altered sensorium. She was diagnosed to have diabetic ketoacidosis with metabolic encephalopathy with right emphysematous pyelonephritis. She had an excellent response to medical treatment alone and was later discharged on oral hypoglycaemic agents.

  2. Eigenvalues properties of terms correspondences matrix

    Science.gov (United States)

    Bondarchuk, Dmitry; Timofeeva, Galina

    2016-12-01

    Vector model representations of text documents are widely used in the intelligent search. In this approach a collection of documents is represented in the form of the term-document matrix, reflecting the frequency of terms. In the latent semantic analysis the dimension of the vector space is reduced by the singular value decomposition of the term-document matrix. Authors use a matrix of terms correspondences, reflecting the relationship between the terms, to allocate a semantic core and to obtain more simple presentation of the documents. With this approach, reducing the number of terms is based on the orthogonal decomposition of the matrix of terms correspondences. Properties of singular values of the term-document matrix and eigenvalues of the matrix of terms correspondences are studied in the case when documents differ substantially in length.

  3. Lyme arthritis: pathogenesis, clinical presentation, and management.

    Science.gov (United States)

    Puius, Yoram A; Kalish, Robert A

    2008-06-01

    Arthritis is one of the most prominent features of Lyme disease, the tick-borne illness caused by Borrelia burgdorferi. Although the pathogenesis of Lyme arthritis is complex and still under study, the clinical presentation and natural history have been established by long-term observation of untreated and treated patients. This review addresses the clinical presentation of Lyme arthritis as a mono- or oligoarticular relapsing/remitting arthritis primarily affecting the large joints and describes presentations in which arthralgias rather than arthritis are seen. Strategies for diagnosis and treatment are discussed, and methods are reviewed for addressing treatment-refractory Lyme arthritis and arthralgias that may occur after treatment of Lyme disease (sometimes as a component of what is known as the post-Lyme disease syndrome).

  4. Student Conceptions of Oral Presentations

    Science.gov (United States)

    Joughin, Gordon

    2007-01-01

    A phonographic study of students' experience of oral presentations in an open learning theology programme constituted three contrasting conceptions of oral presentations--as transmission of ideas; as a test of students' understanding of what they were studying; and as a position to be argued. Each of these conceptions represented a combination of…

  5. Presenting the discovery of W

    CERN Multimedia

    CERN PhotoLab

    1983-01-01

    The UA1 results were presented by Carlo Rubbia in the Main Auditorium on 20 January. The photo shows Alan Astbury from back talking to Carlo Rubbia (centre), Between them is Bernard Aubert. On the background, left, stands Peter Kalmus, and, right, massimo Placidi. The UA2 results were presented in the Main Auditorium by Luigi Di Lella on 21 January.

  6. Multiphasic presentation of Rasmussen's encephalitis

    NARCIS (Netherlands)

    Avbersek, A.; Miserocchi, A.; McEvoy, A.W.; Patel, A.V.; Aronica, E.; Blumcke, I.; Jacques, T.S.; Acheson, J.; Thom, M.; Sisodiya, S.M.

    2015-01-01

    Rasmussen's encephalitis is a rare, chronic inflammatory disorder of unknown cause, characterised by drug-resistant focal epilepsy that may rarely present in adolescence or adulthood. We present a case of Rasmussen's encephalitis with prominent recurrent fluctuation in symptoms and well-documented

  7. Task Group 9 Update (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Bosco, N.

    2014-04-01

    This presentation is a brief update of IEC TC82 QA Task Force, Group 9. Presented is an outline of the recently submitted New Work Item Proposal (NWIP) for a Comparative Thermal Cycling Test for CPV Modules to Differentiate Thermal Fatigue Durability.

  8. Unusual Presentation Of Dapsone Syndrome

    Directory of Open Access Journals (Sweden)

    Singh Prabhas Chandra

    2001-01-01

    Full Text Available A 15 year old girl presented with a rare association of generalized maculopapular rash with exfoliation, hepatic involvement, nephritis, arthralgia and repeated serum sickness type of reaction after taking depsone. The case is reported because of its unusual presentation.

  9. Present status of processing method

    Energy Technology Data Exchange (ETDEWEB)

    Kosako, Kazuaki [Sumitomo Atomic Energy Industries Ltd., Tokyo (Japan)

    1998-11-01

    Present status of processing method for a high-energy nuclear data file was examined. The NJOY94 code is the only one available to the processing. In Japan, present processing used NJOY94 is orienting toward the production of traditional cross section library, because a high-energy transport code using a high-energy cross section library is indistinct. (author)

  10. Case Presentation of Sagittal Balance.

    Science.gov (United States)

    Kim, Paul K

    2016-04-01

    Sagittal balance is an important concept in spinal coronal and kyphotic deformity correction. Sagittal alignment/lumbar lordosis is increasingly recognized and discussed in terms of surgical outcomes. Positive sagittal balance can lead to development of iatrogenic kyphosis, flatback syndrome, adjacent level degeneration, and junctional kyphosis. This concept is no longer associated only with deformity. Spine surgeons have learned that sagittal alignment/lumbar lordosis is very important even in 1-level or 2-level interbody fusion procedures, and that it can be attained, maintained, or lost during any procedure, resulting in complications.

  11. KINECTATION (Kinect for Presentation): Control Presentation with Interactive Board and Record Presentation with Live Capture Tools

    Science.gov (United States)

    Sutoyo, Rhio; Herriyandi; Fennia Lesmana, Tri; Susanto, Edy

    2017-01-01

    Presentation is one the most common activity performed in various fields of work (e.g. lecturer, employee, manager, etc.). The purpose of presentation is to demonstrate or introduce presenters’ idea to the attendees. Within the given time and specific place, presenters must transfer their knowledge and leave great impression for their audience. Generally, presenters use several handy tools such as mouse, presenter, and webcam to help them to navigate their slides. Nevertheless, some of these tools have several constraints and limitations such as not portable and does not support multimedia. In this research, we develop an application that assist presenters to control their presentation materials by using Microsoft KINECT. In this research, we manipulate colour image, image depth, and the skeleton of the presenters captured by the KINECT. Then, we show the post-process image results into the projector screen. The KINECT has more useful than other tools because it supports video and audio recording. Moreover, it also able to capture presenters’ movement that can be used as an input to interact and manipulate the content (i.e. by touching the projection wall). Not only this application provides an alternative in controlling presentation activity, but it also makes the presentation more efficient and attractive.

  12. Dexmedetomidine for an awake fiber-optic intubation of a parturient with Klippel-Feil syndrome, Type I Arnold Chiari malformation and status post released tethered spinal cord presenting for repeat cesarean section

    Directory of Open Access Journals (Sweden)

    Tanmay H. Shah

    2011-08-01

    Full Text Available Patients with Klippel-Feil Syndrome (KFS have congenital fusion of their cervical vertebrae due to a failure in the normal segmentation of the cervical vertebrae during the early weeks of gestation and also have myriad of other associated anomalies. Because of limited neck mobility, airway management in these patients can be a challenge for the anesthesiologist. We describe a unique case in which a dexmedetomidine infusion was used as sedation for an awake fiber-optic intubation in a parturient with Klippel-Feil Syndrome, who presented for elective cesarean delivery. A 36-yearold female, G2P1A0 with KFS (fusion of cervical vertebrae who had prior cesarean section for breech presentation with difficult airway management was scheduled for repeat cesarean delivery. After obtaining an informed consent, patient was taken in the operating room and non-invasive monitors were applied. Dexmedetomidine infusion was started and after adequate sedation, an awake fiberoptic intubation was performed. General anesthetic was administered after intubation and dexmedetomidine infusion was continued on maintenance dose until extubation. Klippel-Feil Syndrome (KFS is a rare congenital disorder for which the true incidence is unknown, which makes it even rare to see a parturient with this disease. Patients with KFS usually have other congenital abnormalities as well, sometimes including the whole thoraco-lumbar spine (Type III precluding the use of neuraxial anesthesia for these patients. Obstetric patients with KFS can present unique challenges in administering anesthesia and analgesia, primarily as it relates to the airway and dexmedetomidine infusion has shown promising result to manage the airway through awake fiberoptic intubation without any adverse effects on mother and fetus.

  13. An unusual presentation of sporotrichosis

    Directory of Open Access Journals (Sweden)

    S S Vaishampayan

    2013-01-01

    Full Text Available Sporotrichosis can mimic a few diseases. Sporotrichosis presenting as a hypoaesthetic plaque or plaque suggestive of leprosy has not been mentioned in literature. Herein we present a case of a 26 years old man who presented with hypoesthetic plaque on left ankle and was clinically diagnosed to have borderline tuberculoid leprosy who later developed few nodules in linear fashion on left leg, which ruptured to form non healing ulcers. Culture from ulcer grew Sporothrix schenckii. Patient was successfully treated with oral potassium iodide.

  14. Galactosemia presenting as recurrent sepsis.

    Science.gov (United States)

    Rathi, Narendra; Rathi, Akanksha

    2011-12-01

    Galactosemia is a treatable metabolic disorder caused by the deficiency of enzyme galactose-1-phosphate uridyl transferase (GALT) and inherited as an autosomal recessive trait. A case of neonate manifesting with recurrent Escherichia coli sepsis is presented here which turned out to be a classic galactosemia. No other common presenting features were observed in this infant except cataract on slit lamp examination. To the best of our knowledge, there is no case of galactosemia reported in literature which presented with recurrent neonatal sepsis without hepatomegaly, hyperbilirubinemia, bleeding disorder, vomiting, diarrhea, failure to thrive, hypoglycemia, coagulopathy, hemolysis or renal tubular acidosis.

  15. Urticarial vasculitis: a unique presentation.

    Science.gov (United States)

    Stigall, Landon E; Sigmon, Justin R; Leicht, Stuart S

    2009-05-01

    Urticarial vasculitis is a relatively rare diagnosis in a patient presenting with urticaria. The process is classically described as a generalized eruption, painful more so than pruritic, lasting longer than 24 hours. Two forms of urticarial vasculitis have been described: ahypocomplementemic form more commonly associated with systemic disease, and a normocomplementemic form that is generally limited to the skin. We report on a uniquely distributed vasculitic eruption restricted mainly to the anterior belt line area in a patient presenting with urticaria and intense pruritus. Urticarial vasculitis as a unique entity is reviewed along with its clinical and histopathologic presentation and the pharmacologic agents used for treatment.

  16. Gearbox Reliability Collaborative Update (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Sheng, S.; Keller, J.; Glinsky, C.

    2013-10-01

    This presentation was given at the Sandia Reliability Workshop in August 2013 and provides information on current statistics, a status update, next steps, and other reliability research and development activities related to the Gearbox Reliability Collaborative.

  17. Wind Technologies & Evolving Opportunities (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Robichaud, R.

    2014-07-01

    This presentation covers opportunities for wind technology; wind energy market trends; an overview of the National Wind Technology Center near Boulder, Colorado; wind energy price and cost trends; wind turbine technology improvements; and wind resource characterization improvements.

  18. Conference/workshop presentation materials.

    Science.gov (United States)

    2014-11-01

    Project No. 5-6005-01: Statewide Implementation of Total Pavement Acceptance Device : (TPAD) is coming to completion. During the operating period of the TPAD (January 1, : 2013 through August 31, 2014), the research team gave several presentations an...

  19. HYDROGEOLOGIC CASE STUDIES (DENVER PRESENTATION)

    Science.gov (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  20. Research Ethics Timeline (1932-Present)

    Science.gov (United States)

    ... the font size, or print this page. Research Ethics Timeline (1932-Present) by David B. Resnik, J. ... Report becomes a key document in human research ethics regulations in the U.S. 1980 Congress passes the ...

  1. Thyrotoxic crisis presenting with jaundice.

    Science.gov (United States)

    Wickramasinghe, R D S S; Luke, W A N V; Sebastiampillai, B S; Gunathilake, M P M L; Premaratna, R

    2016-06-23

    Thyrotoxic crisis is a medical emergency requiring early diagnosis and urgent management, which can be challenging due to its diverse clinical presentations. While common presentations include fever, sweating, palpitations, tremors and confusion, presence of jaundice is rare. We report a 35-year-old male who presented with jaundice due to cholestasis along with other features of thyrotoxic crisis due to Graves' disease. He had a good clinical recovery with resolution of cholestasis following treatment for thyrotoxic crisis. Jaundice can be a rare manifestation of thyrotoxic crisis, and should be considered in the differential diagnosis when other clinical features of thyrotoxic crisis are present. However secondary causes of jaundice should be looked into and excluded.

  2. BioFuels Atlas (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Moriarty, K.

    2011-02-01

    Presentation for biennial merit review of Biofuels Atlas, a first-pass visualization tool that allows users to explore the potential of biomass-to-biofuels conversions at various locations and scales.

  3. A centralized audio presentation manager

    Energy Technology Data Exchange (ETDEWEB)

    Papp, A.L. III; Blattner, M.M.

    1994-05-16

    The centralized audio presentation manager addresses the problems which occur when multiple programs running simultaneously attempt to use the audio output of a computer system. Time dependence of sound means that certain auditory messages must be scheduled simultaneously, which can lead to perceptual problems due to psychoacoustic phenomena. Furthermore, the combination of speech and nonspeech audio is examined; each presents its own problems of perceptibility in an acoustic environment composed of multiple auditory streams. The centralized audio presentation manager receives abstract parameterized message requests from the currently running programs, and attempts to create and present a sonic representation in the most perceptible manner through the use of a theoretically and empirically designed rule set.

  4. Extradural lipomatosis presenting with paraplegia.

    Directory of Open Access Journals (Sweden)

    Deogaonkar M

    1995-07-01

    Full Text Available An unusual case with spinal extradural lipomatosis in a non-obese and otherwise healthy man is reported. The patient presented with a history of weakness of legs which progressed to paraplegia over a 40 day period.

  5. An Atypical Presentation on Insulinoma

    Science.gov (United States)

    2017-06-16

    commercial entity or an entity seeking to do business with the government. then your presentation should have an ethics review. If your travel is being...need the date (month, day and year) along with the location of your presentation. It is important to update this information so that we can provide...route the request form to clinical investigations. S02 ISG/JAC ( Ethics Review) and Public Affairs (S9 MOW/PA) for review and then forward you a final

  6. Procrastination with variable present bias

    OpenAIRE

    Gravin, Nick; Immorlica, Nicole; Lucier, Brendan; Pountourakis, Emmanouil

    2016-01-01

    Individuals working towards a goal often exhibit time inconsistent behavior, making plans and then failing to follow through. One well-known model of such behavioral anomalies is present-bias discounting: individuals over-weight present costs by a bias factor. This model explains many time-inconsistent behaviors, but can make stark predictions in many settings: individuals either follow the most efficient plan for reaching their goal or procrastinate indefinitely. We propose a modification in...

  7. Adolescent violence prevention: a case presentation.

    Science.gov (United States)

    Omar, Hatim; Griffith, Joan

    2003-01-01

    Violence in adolescence has seen an increase since the 1990s with dramatic statistics on violent death and risk behaviors. School violence has been focused upon by a huge media coverage of especially violent cases that could have had some endemic consequences worldwide. We present a case of a 14 year old white male with change in school behavior, strategies for the case investigation, its results, and long term prevention. Other research has shown that preventive measures during pregnancy, infancy and childhood can prevent adolescent and adult delinquency.

  8. Retinoblastoma presenting with orbital cellulitis.

    Science.gov (United States)

    Walinjkar, Jaydeep; Krishnakumar, S; Gopal, Lingam; Ramesh, Anita; Khetan, Vikas

    2013-06-01

    To study the effectiveness of pre-enucleation steroids in reducing inflammation in patients with retinoblastoma presenting as orbital cellulitis. Medical records of consecutive retinoblastoma patients presenting at a single tertiary eye care center during a period of 3 years were retrospectively reviewed. For those who presented with orbital cellulitis, clinical, radiological, and histopathological variables were assessed. The effect of pre-enucleation steroids was noted in this group of patients. Of 260 retinoblastoma cases reviewed, 14 had retinoblastoma-associated cellulitis (5.39%). Of these 14 patients, 4 received neoadjuvant chemotherapy and were excluded from the series. Of the remaining 10 cases (mean age at presentation, 14.2 months; mean follow-up, 16.4 months), 9 presented with orbital cellulitis and were included in the study. Radiological imaging depicted intraocular tumors occupying 80% to 100% of the globe in each case. All patients underwent enucleation. Five children received pre-enucleation systemic steroids (mean, 5.4 days), which resulted in a prompt decrease in inflammation. Postenucleation chemotherapy was administered in 4 (6 cycles) and external beam radiation therapy in 1 patient with high-risk histopathological characteristics. Advanced necrotic retinoblastoma with anterior segment involvement may present as orbital cellulitis. Pre-enucleation systemic steroids can aid in the surgical management of these tumors. Copyright © 2013 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  9. [Neurologic presentation in haemolytic-uraemic syndrome].

    Science.gov (United States)

    Roche-Martínez, A; Póo, P; Maristany-Cucurella, M; Jiménez-Llort, A; Camacho, J A; Campistol, J

    Haemolytic-uraemic syndrome (HUS) is characterized by microangiopathic hemolytic anaemia, thrombopenia and multiorganic aggression, specially renal, gastrointestinal and central nervous system disturbances. Sporadic in Spain (2/1,500,000 inhabitants), its clinical onset includes acute renal failure, hypertension and central nervous system symptoms (irritability, drowsiness, convulsions, cortical blindness, hemiparesia or coma), due to metabolic distress, hypertension or central nervous system microangiopathy. Few long-term outcome studies have been published. A retrospective analysis of a series of 58 patients with HUS between 1981 and 2006, is reported. Clinical onset, laboratory, electrophysiology, neuroimaging tests, and prognosis factors are reviewed, together with long-term clinical outcome. 22 children presented neurologic symptoms, seven had some neurological test; one patient died; in five some neurological sequelae persisted (hemiparesia, cognitive deficit, visual-perception deficit), the other 16 remaining asymptomatic. Neurological morbility is high in HUS (27% of the children with neurological symptoms), with a 1.7% mortality. Seizure at onset was not a poor prognosis factor in our group. No positive correlation can be established between neuroimaging and long-term outcome.

  10. Optimistically Engaging in the Present

    Directory of Open Access Journals (Sweden)

    Eric A. Fenkl

    2014-07-01

    Full Text Available This study explores the experiences of aging among gay men to further explain the phenomenon of gay male aging in contemporary terms, to put those experiences into a historically relevant context, and to expand upon previous findings on aging within the gay male population. Nineteen self-identifying gay men from a metropolitan area in South Florida were interviewed. The data collected were analyzed using grounded theory method. Findings from the study indicated that a great deal of optimism was revealed by the participants of the study in spite of their past adversarial experiences related to their sexuality and current challenges related to gay male sexuality and aging. Based on these findings, professionals working with an older population should consider the supportive environments that can most benefit this population in the community and even consider partnering with lesbian, gay, bisexual, and transgender (LGBT oriented organizations to better serve the needs of their clients.

  11. Maternal characteristics and timing of presentation following pre ...

    African Journals Online (AJOL)

    Background: To examine the influence of maternal characteristics on timing of presentation for intervention following pre-labour rupture of membrane (PROM) at term. Materials and Methods: This was a descriptive study of cases of term PROM with singleton births at the University of Benin Teaching Hospital (UBTH) from ...

  12. Presentation of the ASTRAL software; Presentation du logiciel ASTRAL

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This report presents the ASTRAL software (ASTRAL means technical assistance in post-accidental radioprotection) which is aimed to be used as an aid-to-decision tool in the case of an important release of radionuclides in the environment by assessing radionuclide concentration in different environments and food products, determining the potential exposure to irradiation of concerned populations, foreseeing the evolution of the situation, and proposing different scenarios for the management of contaminated areas. The report describes the software general operation, presents the calculation module (main functionalities, concentration index calculation, dose calculation or radiological impact calculation, how countermeasures are taken into account), the data bases (contextual data, data for radio-ecological calculations and for radiological calculations), the software ergonomics (general principles, result selection and display, result printing and input data). Its briefly evokes the development quality assurance, and describes the software implementation architecture

  13. Auditory presentation of experimental data

    Science.gov (United States)

    Lunney, David; Morrison, Robert C.

    1990-08-01

    Our research group has been working for several years on the development of auditory alternatives to visual graphs, primarily in order to give blind science students and scientists access to instrumental measurements. In the course of this work we have tried several modes for auditory presentation of data: synthetic speech, tones of varying pitch, complex waveforms, electronic music, and various non-musical sounds. Our most successful translation of data into sound has been presentation of infrared spectra as musical patterns. We have found that if the stick spectra of two compounds are visibly different, their musical patterns will be audibly different. Other possibilities for auditory presentation of data are also described, among them listening to Fourier transforms of spectra, and encoding data in complex waveforms (including synthetic speech).

  14. Dexmedetomidine overdosage: An unusual presentation

    Directory of Open Access Journals (Sweden)

    Soumya S Nath

    2013-01-01

    Full Text Available We present a case of dexmedetomidine toxicity in a 3-year-old child. The case report describes the features and outlines the treatment strategy adopted. The child presented with bradypnoea, bradycardia, hypotension, deep hypnosis and miosis. He was successfully managed with oxygen, saline boluses and adrenaline infusion. He became haemodynamically stable with adrenaline infusion. He started responding to painful stimuli in 3 h and became oriented in 7 h. Dexmedetomidine, a selective α2 adrenoceptor agonist, is claimed to have a wide safety margin. This case report highlights the fact that dexmedetomidine administered in a toxic dose may be life-threatening may present with miosis and adrenaline infusion may be a useful supportive treatment.

  15. Neonatal hemophilia: a rare presentation

    Directory of Open Access Journals (Sweden)

    Nuno Ferreira

    2015-12-01

    Full Text Available Hemophilia A is a X-linked hereditary condition that lead to decreased factor VIII activity, occurs mainly in males. Decreased factor VIII activity leads to increased risk of bleeding events. During neonatal period, diagnosis is made after post-partum bleeding complication or unexpected bleeding after medical procedures. Subgaleal hemorrhage during neonatal period is a rare, severe extracranial bleeding with high mortality and usually related to traumatic labor or coagulation disorders. Subgaleal hemorrhage complications result from massive bleeding. We present a neonate with unremarkable family history and uneventful pregnancy with a vaginal delivery with no instrumentation, presenting with severe subgaleal bleeding at 52 hours of life. Aggressive support measures were implemented and bleeding managed. The unexpected bleeding lead to a coagulation study and the diagnosis of severe hemophilia A. There were no known sequelae. This case shows a rare hemophilia presentation reflecting the importance of coagulation studies when faced with unexplained severe bleeding.

  16. Thick Presentism and Newtonian Mechanics

    CERN Document Server

    Lubashevsky, Ihor

    2016-01-01

    In the present paper I argue that the formalism of Newtonian mechanics stems directly from the general principle to be called the principle of microlevel reducibility which physical systems obey in the realm of classical physics. This principle assumes, first, that all the properties of physical systems must be determined by their states at the current moment of time, in a slogan form it is "only the present matters to physics." Second, it postulates that any physical system is nothing but an ensemble of structureless particles arranged in some whose interaction obeys the superposition principle. I substantiate this statement and demonstrate directly how the formalism of differential equations, the notion of forces in Newtonian mechanics, the concept of phase space and initial conditions, the principle of least actions, etc. result from the principle of microlevel reducibility. The philosophical concept of thick presentism and the introduction of two dimensional time---physical time and meta-time that are mut...

  17. Comprehensible Presentation of Topological Information

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Gunther H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Beketayev, Kenes [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bremer, Peer-Timo [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hamann, Bernd [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Haranczyk, Maciej [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hlawitschka, Mario [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Pascucci, Valerio [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-03-05

    Topological information has proven very valuable in the analysis of scientific data. An important challenge that remains is presenting this highly abstract information in a way that it is comprehensible even if one does not have an in-depth background in topology. Furthermore, it is often desirable to combine the structural insight gained by topological analysis with complementary information, such as geometric information. We present an overview over methods that use metaphors to make topological information more accessible to non-expert users, and we demonstrate their applicability to a range of scientific data sets. With the increasingly complex output of exascale simulations, the importance of having effective means of providing a comprehensible, abstract overview over data will grow. The techniques that we present will serve as an important foundation for this purpose.

  18. CLL: Common Leukemia; Uncommon Presentations.

    Science.gov (United States)

    Lad, Deepesh; Malhotra, Pankaj; Varma, Neelam; Sachdeva, Manupdesh Singh; Das, Ashim; Srinivasan, Radhika; Bal, Amanjit; Khadwal, Alka; Prakash, Gaurav; Suri, Vikas; Kumari, Savita; Jain, Sanjay; Varma, Subhash

    2016-09-01

    We report here a series of ten patients with uncommon presentations and associations of chronic lymphocytic leukemia (CLL) not reported hitherto or occasionally reported in literature. The first two cases describe unusual causes of abdominal distension in CLL and unusual sites infiltration by CLL. The next two cases illustrate occurrence of CLL in association with other hematological malignancies. Cases five and six describe unusual infections and their impact on CLL. Cases seven and eight depict associations of rare non-hematological autoimmune conditions with CLL. The last two cases describe transformation at unusual sites. This series of ten cases illustrates how a common leukemia like CLL can present in different forms and how despite so much progress in understanding of this leukemia so little is known of such presentations.

  19. Granuloma faciale -- an unusual presentation.

    Science.gov (United States)

    Mashood, Asher Ahmed

    2006-04-01

    Granuloma faciale is a rare skin disorder, characterized by asymptomatic cutaneous nodules on the face without any systemic manifestations. The disorder mainly affects middle-aged Caucasian males. One such case occurring in a young unmarried lady of "Pathan" descent is presented here. The presentation was unusual due to the history of frequent swelling, redness and heat in her nodules without any known stimuli and spontaneous regression of the nodules to the original size in a few hours. The patient was treated with a combination of cryotherapy and intralesional corticosteroids with excellent results.

  20. Technical presentation: Next Generation Oscilloscopes

    CERN Multimedia

    PH Department

    2011-01-01

      Rohde & Schwarz "Next Generation Oscilloscopes" - Introduction and Presentation Agenda: Wednesday 23 March  -  09:30 to 11:30 (open end) Bldg. 13-2-005 Language: English 09.30 Presentation "Next Generation Oscilloscopes" from Rohde & Schwarz RTO / RTM in theory and practice Gerard Walker 10.15 Technical design details from R&D Dr. Markus Freidhof 10.45 Scope and Probe Roadmap (confidential) Guido Schulze 11.00 Open Discussion Feedback, first impression, wishes, needs and requirements from CERN All 11.30 Expert Talks, Hands on All Mr. Dr. Markus Freidhof, Head of R&D Oscilloscopes, Rohde & Schwarz, Germany; Mr. Guido Schulze, ...

  1. Somatic presentations of distress in China.

    Science.gov (United States)

    Zaroff, Charles M; Davis, J Mark; Chio, Pit Hoi; Madhavan, Deepak

    2012-11-01

    Somatic presentations of distress are common cross-culturally and are thought to predominate in Asian cultures such as that of China. From an etic perspective, researchers utilizing empirically validated standardized assessment measures find that somatic symptoms are no more common in individuals of Chinese descent than they are in individuals of European descent. In contrast, patient presentations are heavily influenced by culture and are associated with patterns of illness behavior. The objective of the current review is to determine the culture-specific factors contributing to somatic presentations and descriptions of distress in China. The current review was based on a literature search of PubMed and PsychInfo using the terms 'China,' 'Asia,' 'somatoform,' 'somatization,' and 'psychogenic.' Factors contributing to somatic presentations of distress in China include stigma and help-seeking behavior, and assessment approaches that ignore culture-specific patterns of symptom reporting, fail to incorporate somatic metaphor and Chinese conceptualizations of distress that emphasize bodily sensation, and ignore the role that culture-specific normative data and culture specific response patterns may produce on assessment results. From an emic perspective, there are numerous factors contributing to the appearance of a predominantly somatic presentation of distress in China. Implications for clinical practice are discussed.

  2. Unusual presentation of twisted ovarian cyst

    Directory of Open Access Journals (Sweden)

    Vineet V Mishra

    2016-01-01

    Full Text Available Ovarian torsion (also termed as adnexal torsion refers to partial or complete rotation of the ovary and a portion of fallopian tube along its supplying vascular pedicle. It occurs commonly in reproductive age group; more on the right side (60% and often presents with acute lower abdominal pain lasting for few hours and up to 24 h, accounting for 2.7% of acute gynecological conditions. It is one of the devastating conditions, hampering blood supply of ovary which may lead to total necrosis of ovarian tissue and complications, if not diagnosed and managed in time. Hence, we present a case on a twisted ovarian cyst in postmenopausal woman with unusual symptomatology leading to delayed diagnosis and loss of an ovary.

  3. Incentivizing Distributed Solar: Best Practices (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Bird, L.; Reger, A.

    2013-06-01

    The presentation discussed findings of a recent NREL technical report on best practices for designing and implementing incentives for small and mid-sized residential and commercial distributed solar energy projects. Topics covered included: factors to consider in setting and modifying incentive levels over time, differentiating incentives to encourage various market segments, and administrative issues such as providing equitable access to incentives and customer protection. In addition, the presentation explored how incentive programs can be designed to respond to changing market conditions while attempting to provide a longer-term and stable environment for the solar industry. The findings of the report were based on interviews with program administrators, regulators, and industry representatives as well as data from numerous incentive programs nationally, particularly the largest and longest-running programs.

  4. Hypervideos and interactive multimedia presentations

    NARCIS (Netherlands)

    B. Meixner (Britta)

    2017-01-01

    textabstractHypervideos and interactive multimedia presentations allow the creation of fully interactive and enriched video. It is possible to organize video scenes in a nonlinear way. Additional information can be added to the video ranging from short descriptions to images and more videos.

  5. Testing for PV Reliability (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Kurtz, S.; Bansal, S.

    2014-09-01

    The DOE SUNSHOT workshop is seeking input from the community about PV reliability and how the DOE might address gaps in understanding. This presentation describes the types of testing that are needed for PV reliability and introduces a discussion to identify gaps in our understanding of PV reliability testing.

  6. Tuberculosis presenting as posttraumatic panophthalmitis

    Directory of Open Access Journals (Sweden)

    Pankaj Gupta

    2016-01-01

    Full Text Available Panophthalmitis is one of rare manifestations of tuberculosis described in atypical situations such as children, immune compromised patients, or drug abuse. The present report describes the first case of tubercular panophthalmitis developing after trauma in an otherwise healthy adult patient. A 46-year-old female patient presented with corneal infiltrate and endophthalmitis that developed after an injury to right eye with wooden object. Corneal scrapings and vitreous tap were sterile. The patient did not improve with antibiotics and developed panophthalmitis. On evisceration of the painful blind eye, histopathology showed the presence of granulomatous inflammation and acid-fast bacilli. The patient had no other systemic focus of tubercular infection. The patient was managed with anti-tubercular therapy for 6 months. Atypical presentations of tuberculosis like panophthalmitis pose a difficult problem in diagnosis as well as treatment. Direct inoculation of bacilli during trauma is a rare source of infection. This case report presents unusual development of tubercular panophthalmitis following direct inoculation of bacilli during trauma. Ocular tuberculosis should be considered in differential diagnosis of posttraumatic endophthalmitis and panophthalmitis, especially in endemic regions like India.

  7. Rose breeding: past, present, prospects

    NARCIS (Netherlands)

    Vries, de D.P.; Dubois, L.A.M.

    1996-01-01

    In this review the PAST, PRESENT and PROSPECT will be considered as three separate periods in the history of the breeding and development of rose cultivars. The recurring theme is the genetic variation. This theme was chosen because there is justified doubt as to sufficient genetic variation

  8. Understanding Algorithms in Different Presentations

    Science.gov (United States)

    Csernoch, Mária; Biró, Piroska; Abari, Kálmán; Máth, János

    2015-01-01

    Within the framework of the Testing Algorithmic and Application Skills project we tested first year students of Informatics at the beginning of their tertiary education. We were focusing on the students' level of understanding in different programming environments. In the present paper we provide the results from the University of Debrecen, the…

  9. Water plants past and present

    DEFF Research Database (Denmark)

    Riis, T.; Sand-Jensen, K.

    2006-01-01

    How has the condition of the environment developed during the last 100 years? This is an important question because the conditions of the past infl uence those of the present, and knowledge about this development makes it possible to evaluate the causes of changes in species richness, species com...

  10. DOE Collegiate Wind Competition (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Jones, J.

    2014-02-01

    This presentation for the January Stakeholder Engagement and Outreach webinar outlines the expanded need for workers in the wind industry and provides an overview of the DOE Wind Competition (to be held in May 2014) and the guiding principles of the competition.

  11. Porphyria Presenting as Diffuse Encephalopathy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2005-05-01

    Full Text Available An 18-year-old female presenting with seizures, myalgias, abdominal pain, headache and vomiting had multiple large contrast-enhancing white matter lesions on MRI and was diagnosed with acute intermittent porphyria (AIP, in a report from the Department of Neurology, Mayo Clinic, Rochester, MN.

  12. Unusual presentation of gallbladder perforation

    Directory of Open Access Journals (Sweden)

    G. Jayasinghe

    2016-01-01

    Conclusions: Percutaneous abscesses arising from the gallbladder are a rare but potentially serious consequence of acute cholecystitis, and may present in a wide variety of locations. Therefore it is imperative to conduct a full body inspection in the septic patient, even when a source has been identified.

  13. Neonatal presentation of Caroli's disease

    Science.gov (United States)

    Keane, F; Wilkinson, M; Qureshi, S; Reid, C; Baker, A; Mieli-Vergani, G

    1997-01-01

    A neonatal presentation of Caroli's disease with severe cardiac and progressive renal pathology is described. The availability of small paediatric endoscopes ensured early diagnosis. Despite aggressive medical management, the baby died with severe bleeding complications before potentially life saving multiple organ transplantation could take place.

 Keywords: Caroli's disease; endoscopic retrograde cholangiopancreatography; pulmonary artery stenosis PMID:9377141

  14. Neonatal presentation of Caroli's disease

    OpenAIRE

    Keane, F.; Wilkinson, M.; Qureshi, S; Reid, C.; Baker, A.; Mieli-Vergani, G

    1997-01-01

    A neonatal presentation of Caroli's disease with severe cardiac and progressive renal pathology is described. The availability of small paediatric endoscopes ensured early diagnosis. Despite aggressive medical management, the baby died with severe bleeding complications before potentially life saving multiple organ transplantation could take place.

 Keywords: Caroli's disease; endoscopic retrograde cholangiopancreatography; pulmonary artery stenosis

  15. Unusual Presentation of Maydl's Hernia

    African Journals Online (AJOL)

    Maydl's hernia is an uncommon presentation of inguinal hernia whereby predominantly right sided afferent and efferent loops of bowel herniate into the sac with an intervening intra-abdominal loop of bowel that is prone to strangulation. This could be missed if hernia repair is performed with inguinal approach only.

  16. Pulmonary hyalinizing granuloma presenting with dysphagia: a rare presentation.

    Science.gov (United States)

    Khan, Fazal; Hamid, Arsalan; Fatima, Benish; Hashmi, Shiraz; Fatimi, Saulat

    2017-01-01

    A 25-year-old man presented with a 2-month history of dysphagia and past history of pulmonary and intestinal tuberculosis. A barium swallow showed a point of constriction 42 mm above the gastroesophageal junction. Computed tomography revealed large opacities in bilateral lung fields, encroaching more on the esophagus. The lesion progressively compressed the esophagus as it moved inferiorly. A right posterolateral thoracotomy was performed for sub-anatomical resection of the mass. A biopsy revealed homogenous whirling hyalinized collagen fibers, highly suggestive of pulmonary hyalinizing granuloma, with no evidence of malignancy. Pulmonary hyalinizing granuloma should be considered in the differential diagnosis of longstanding dysphagia.

  17. Blau syndrome presenting with ichthyosis.

    Science.gov (United States)

    Masel, Grant; Halbert, Anne

    2005-02-01

    A 12-year-old girl presented with uveitis, joint disease and ichthyosis resembling ichthyosis vulgaris. A biopsy taken from the affected lower leg demonstrated sarcoidal-type granulomas. Synovial biopsy from the knee also showed granulomas. There was a family history of similar clinical features in the patient's younger sister. There were no other systemic features present to suggest a diagnosis of sarcoidosis or other granulomatous disease such as Crohn's disease or tuberculosis. The familial nature of the condition also made these diagnoses less likely. A clinical diagnosis of Blau syndrome was made. Blau syndrome is an uncommon sarcoidosis-like multisystem autosomal-dominant granulomatous disorder caused by mutations in the CARD15 gene. This gene has also recently been found to be a factor in the development of psoriatic arthritis and Crohn's disease. Although many forms of skin involvement have been described in Blau syndrome, this is the first case described of ichthyosis as the primary skin manifestation.

  18. Pronunciation Teaching: Past and Present

    Directory of Open Access Journals (Sweden)

    Saeed Ketabi

    2015-09-01

    Full Text Available Pronunciation, despite being known as an important component of language learning, has not been awarded due attention within the field of language education. This article is a humble attempt to present an overview of the history of pronunciation teaching. Different approaches and methods of language teaching from the late nineteenth century into the new millennium are reviewed and discussed with regard to their stance in pronunciation instruction. Recent trends and issues of pronunciation teaching, e.g. intelligibility and Lingua Franca Core are also highlighted. Discussions like the present one might be beneficial in gaining a better understanding and evaluation of the status quo in order to improve and enhance the status of pronunciation instruction within language pedagogy.

  19. Congenital chloride diarrhea: late presentation

    Directory of Open Access Journals (Sweden)

    Al Bishi L

    2011-04-01

    Full Text Available Laila Al Bishi1, Mustafa Al Toonisi2Pediatric Department, North West Armed Forces Hospital, Tabuk, Kingdom of Saudi ArabiaAbstract: We report the case of a male infant who presented with diarrhea at 6 months of age. He was failing to thrive, and biochemical investigation revealed hypokalemic hypochloremic metabolic alkalosis. Diagnosis of congenital chloride diarrhea was suspected and confirmed by the stool chloride result. He was started on high-dose sodium chloride and potassium chloride to control the electrolyte imbalance. The disease was difficult to control for a year after diagnosis. Late presentation is associated with severe chronic electrolyte disturbances and high-dose replacement therapy.Keywords: congenital chloride diarrhea, hypokalemic hypochloremic metabolic alkalosis, high stool chloride

  20. Xanthoma Disseminatum Presenting with Hoarseness

    Directory of Open Access Journals (Sweden)

    Biswanath Behera

    2017-11-01

    Xanthoma disseminatum is a very rare form of non-Langerhans cell histiocytosis that classically presents with cutaneous xanthomas, mucosal xanthomas, and diabetes insipidus. Hoarseness of voice due to lesions involving the larynx is a rare symptom. Because the disease has punctated, numerous relapses and causes morbidity to the patient, its multisystem manifestations have to be known. Therefore, xanthoma disseminatum has to be kept in mind as a differential  diagnosis for hoarseness of voice.

  1. Syntomatic Tarlov Cyst. Case presentation

    OpenAIRE

    Jorge Luis Castillo López; María E. Jerves Crespo; Victoria E. Solís Espín; Juan C. Vargas Parra

    2017-01-01

    Tarlov or perineural cysts are pathologic deformations located in the space between the Perineurium and endoneurium of spinal roots close to the posterior root ganglion. It is an infrequent disease. Although its etiology is uncertain different theories have been postulated since its discovery. Regularly they are asymptomatic; they are discovered as incidental findings in imaging studies. A case is presented of a patient complaining of a lumbociatalgia of month evolution, without relation with...

  2. Fluorescent compounds present in food

    OpenAIRE

    Soto Serrano, Axel

    2014-01-01

    Póster The food industry demands fast, reliable, cheap and reproducible methods for quality and process control. This bibliographic review work investigates florescence spectroscopy, a method that couldn’t be used in food until the recent technological advances, concretely front-face fluorescence and chemometric tools. This technology presents advantages as compared to classical methods like HPLC or capillary electrophoresis, which require qualified staff, sample preparation and are time-c...

  3. Presentation of the Geocoder software

    OpenAIRE

    Töpel, Mats

    2013-01-01

    geocoder.py is a program written in Python that takes one file containing polygons, and one file with species locality data as input. The program then tests if a species have been recorded inside any of the polygons. The result is presented as a nexus file with "0" indicating absence, and "1" indicating presence of a species in a polygon.  

  4. Presentation : Spatial Analysis and GEOmatics

    OpenAIRE

    Didier Josselin; Thérèse Libourel

    2014-01-01

    SAGEO is the annual International Conference on Spatial Analysis and GEOmatics. It aims to:  present recent and high quality research in the field of Geomatics and Spatial Analysis, bring together researchers from various disciplines, provide an exchange platform on research and development in Geomatics, on a national and international level, for public or private bodies. SAGEO is a good opportunity for two complementary research networks to meet and to discuss their points of view on spatial...

  5. Congenital chloride diarrhea: late presentation

    OpenAIRE

    Al Bishi, Laila; Mustafa,

    2011-01-01

    Laila Al Bishi1, Mustafa Al Toonisi2Pediatric Department, North West Armed Forces Hospital, Tabuk, Kingdom of Saudi ArabiaAbstract: We report the case of a male infant who presented with diarrhea at 6 months of age. He was failing to thrive, and biochemical investigation revealed hypokalemic hypochloremic metabolic alkalosis. Diagnosis of congenital chloride diarrhea was suspected and confirmed by the stool chloride result. He was started on high-dose sodium chloride and potassium chloride to...

  6. Leadership: Past, present, and future

    OpenAIRE

    Antonakis, J.; Cianciolo, A. T.; Sternberg, R. J.

    2004-01-01

    In this introductory chapter, the editors of the present volume provide readers with the background necessary to understand the chapters that follow. They first acquaint readers with the concept of leadership and why leadership is necessary. Then, the editors briefly trace the history of leadership research and examine its major schools, most of which are reviewed in this book. Their historical overview is also necessary as an organizing framework because chapter authors frequently refer to e...

  7. Nocardial mycetoma: Diverse clinical presentations

    Directory of Open Access Journals (Sweden)

    Sharma Nand

    2008-01-01

    Full Text Available Nocardia spp are gram-positive, aerobic, acid-fast bacteria which exist as saprophytes in nature. Invasive disseminated infections are particularly common in immunocompromised or debilitated hosts. Superficial infections with Nocardia spp occur as a result of local trauma and contamination of the wound. Clinically, it presents as acute infection (abscesses or cellulitis, mycetoma, or sporotrichoid infection. Differential diagnosis includes eumycetoma, chromomycosis, blastomycosis, coccidioidomycosis, sporotrichosis, tuberculosis, botryomycosis, syphilis, yaws, and neoplasia. Its diagnosis is confirmed by demonstrating the causative organism in exudates (as granules, tissue specimens, or cultures. Early diagnosis will obviate need for drastic surgical measures as early institution of chemotherapy is effective in most patients. However, its diagnosis is often delayed due to diverse clinical presentations and for want of clinical suspicion, particularly in non-endemic areas. This paper presents 4 clinical forms of this not so uncommon disease, emphasizing the importance of high index of clinical suspicion, especially in non-endemic regions; and the significance of repeated examination of exudates for Nocardia granules for an early diagnosis.

  8. XPL the Extensible Presentation Language

    Directory of Open Access Journals (Sweden)

    A. Santangelo

    2009-01-01

    Full Text Available The last decade has witnessed a growing interest in the development of web interfaces enabling both multiple ways to access contents and, at the same time, fruition by multiple modalities of interaction (point-and-click, contents reading, voice commands, gestures, etc.. In this paper we describe a framework aimed at streamlining the design process of multi-channel, multimodal interfaces enabling full reuse of software components. This framework is called the eXtensible Presentation architecture and Language (XPL, a presentation language based on design pattern paradigm that keeps separated the presentation layer from the underlying programming logic. The language supplies a methodology to expedite multimodal interface development and to reduce the effort to implement interfaces for multiple access devices, by means of using the same code. This paper describes a methodology approach based on Visual Design Pattern (ViDP and Verbal Design Pattern (VeDP, offering examples of multimodal and multichannel interfaces created with the XPL Editor.

  9. Quantum technology past, present, future: quantum energetics (Conference Presentation)

    Science.gov (United States)

    Choi, Sang H.

    2017-04-01

    Since the development of quantum physics in the early part of the 1900s, this field of study has made remarkable contributions to our civilization. Some of these advances include lasers, light-emitting diodes (LED), sensors, spectroscopy, quantum dots, quantum gravity and quantum entanglements. In 1998, the NASA Langley Research Center established a quantum technology committee to monitor the progress in this area and initiated research to determine the potential of quantum technology for future NASA missions. The areas of interest in quantum technology at NASA included fundamental quantum-optics materials associated with quantum dots and quantum wells, device-oriented photonic crystals, smart optics, quantum conductors, quantum information and computing, teleportation theorem, and quantum energetics. A brief review of the work performed, the progress made in advancing these technologies, and the potential NASA applications of quantum technology will be presented.

  10. Lysinuric protein intolerance presenting with multiple fractures

    Directory of Open Access Journals (Sweden)

    Jennifer E. Posey

    2014-01-01

    Full Text Available Lysinuric protein intolerance (LPI is a rare autosomal recessive inborn error of metabolism caused by mutations in SLC7A7, which encodes a component of the dibasic amino acid transporter found in intestinal and renal tubular cells. Patients typically present with vomiting, diarrhea, irritability, failure to thrive, and symptomatic hyperammonemia after protein-rich meals. Long-term complications may include pulmonary alveolar proteinosis, renal disease, and osteoporosis. We present a 5-year-old male who was followed in our skeletal dysplasia clinic for 3 years for multiple fractures, idiopathic osteoporosis, and short stature in the absence of typical features of LPI. Whole exome sequencing performed to determine the etiology of the osteoporosis and speech delay identified a nonsense mutation in SLC7A7. Chromosome microarray analysis identified a deletion involving the second allele of the same gene, and biochemical analysis supported the diagnosis of LPI. Our patient's atypical presentation underscores the importance of maintaining a high index of suspicion for LPI in patients with unexplained fractures and idiopathic osteoporosis, even in the absence of clinical symptoms of hyperammonemia after protein rich meals or other systemic features of classical LPI. This case further demonstrates the utility of whole exome sequencing in diagnosis of unusual presentations of rare disorders for which early intervention may modify the clinical course.

  11. Recognition and Memory for Briefly Presented Scenes

    Science.gov (United States)

    Potter, Mary C.

    2012-01-01

    Three times per second, our eyes make a new fixation that generates a new bottom-up analysis in the visual system. How much is extracted from each glimpse? For how long and in what form is that information remembered? To answer these questions, investigators have mimicked the effect of continual shifts of fixation by using rapid serial visual presentation of sequences of unrelated pictures. Experiments in which viewers detect specified target pictures show that detection on the basis of meaning is possible at presentation durations as brief as 13 ms, suggesting that understanding may be based on feedforward processing, without feedback. In contrast, memory for what was just seen is poor unless the viewer has about 500 ms to think about the scene: the scene does not need to remain in view. Initial memory loss after brief presentations occurs over several seconds, suggesting that at least some of the information from the previous few fixations persists long enough to support a coherent representation of the current environment. In contrast to marked memory loss shortly after brief presentations, memory for pictures viewed for 1 s or more is excellent. Although some specific visual information persists, the form and content of the perceptual and memory representations of pictures over time indicate that conceptual information is extracted early and determines most of what remains in longer-term memory. PMID:22371707

  12. Dynamic term structure models

    DEFF Research Database (Denmark)

    Andreasen, Martin Møller; Meldrum, Andrew

    This paper studies whether dynamic term structure models for US nominal bond yields should enforce the zero lower bound by a quadratic policy rate or a shadow rate specification. We address the question by estimating quadratic term structure models (QTSMs) and shadow rate models with at most four...

  13. RxTerms

    Data.gov (United States)

    U.S. Department of Health & Human Services — RxTerms is a drug interface terminology derived from RxNorm for prescription writing or medication history recording (e.g. in e-prescribing systems, PHRs). RxTerms...

  14. Big Data: present and future

    Directory of Open Access Journals (Sweden)

    Mircea Raducu TRIFU

    2014-05-01

    Full Text Available The paper explains the importance of the Big Data concept, a concept that even now, after years of development, is for the most companies just a cool keyword. The paper also describes the level of the actual big data development and the things it can do, and also the things that can be done in the near future. The paper focuses on explaining to nontechnical and non-database related technical specialists what basically is big data, presents the three most important V's, as well as the new ones, the most important solutions used by companies like Google or Amazon, as well as some interesting perceptions based on this subject.

  15. Cartography past, present and future

    CERN Document Server

    Rhind, DW

    2013-01-01

    Making maps dates back at least four thousand years and it is widely recognised that many maps are of great historical value and present a skilled method of summarising the real world on a sheet of paper. Less well known is the judgement involved in the selection and simplification of features, the complex transformation of space and the exacting standards which are needed in cartography. This book is primarily a tribute to Professor F.J. Ormeling, former President and Secretary/Treasurer of the ICA and gives a wide ranging review of the current status of cartography, how this status was atta

  16. Tuberculosis presenting with abdominal lymphadenitis

    OpenAIRE

    Garcia, Rui; Velez, Jorge; Reis, Conceição; Porto, Armando

    2007-01-01

    A tuberculose é uma infecção bacteriana pleomórfica, podendo atingir qualquer tecido ou órgão. O caso clínico relata uma situação que implicou grandes dificuldades de diagnóstico diferencial, sobretudo pela diferente interpretação dos exames auxiliares de diagnóstico. Apesar disso, e após a determinação do diagnóstico certo, instituiu-se um esquema terapêutico segundo as normas aceites e recomendadas, encontrando-se o doente bem. Tuberculosis may target any organ or system and present a...

  17. Tuberculosis presenting as bronchoesophageal fistula

    Directory of Open Access Journals (Sweden)

    Santhosh Narayanan

    2017-01-01

    Full Text Available We report a case of bronchoesophageal fistula associated with tuberculosis. A 25 year old woman presented to us with 3 month history of cough worsening with deglutition. Radiological examination revealed mediastinal lymphadenopathy and bronchoscopy with esophagoscopy confirmed the presence of fistulous communication with features of endobronchial tuberculosis. Histological examination of bronchial biopsy specimen showed non necrotic granuloma with the PCR positive for Mycobacterium tuberculosis in her bronchial secretions. She was begun on antituberculous treatment and became asymptomatic after 2 months. Bronchoscopy done during follow up after 4 months showed normal bronchial lumen with disappearance of fistulous tract. Imaging showed resolution of lung lesions.

  18. Unusual presentations of accommodative esotropia.

    OpenAIRE

    Pollard, Z F; Greenberg, M F

    2000-01-01

    PURPOSE: Most patients with accommodative esotropia are first examined between the ages of 6 months and 2 years. This paper discusses unusual presentations of accommodative esotropia that occur outside of this age-group and/or have a precipitating event that triggered the esotropia. In a series of patients who were from 5 to 11 years of age, trauma was the precipitating event. In some of the patients under 6 months of age, high myopia, as well as a moderate to large amount of hyperopia, was t...

  19. Presentation at Innoventure Annual Competition

    Energy Technology Data Exchange (ETDEWEB)

    None

    2010-03-31

    This report documents the components of the workshop presented at the recent annual competition for the Innoventure program. The goal of the workshop was to focus on the delivery of science, technology, engineering, and math (STEM) concepts in a hands-on experiential learning format to increase interest in national security careers at NNSA, most of which are in the STEM fields. This work is a part of the National Security Preparedness Project (NSPP), being performed under a Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant.

  20. Neuromodulation: present and emerging methods

    Directory of Open Access Journals (Sweden)

    Song eLuan

    2014-07-01

    Full Text Available Neuromodulation has wide ranging potential applications in replacing impaired neural function (prosthetics, as a novel form of medical treatment (therapy, and as a tool for investigating neurons and neural function (research. Voltage and current controlled electrical neural stimulation (ENS are methods that have already been widely applied in both neuroscience and clinical practice for neuroprosthetics. However, there are numerous alternative methods of stimulating or inhibiting neurons. This paper reviews the state-of-the-art in ENS as well as alternative neuromodulation techniques - presenting the operational concepts, technical implementation and limitations - in order to inform system design choices.

  1. Neuromodulation: present and emerging methods.

    Science.gov (United States)

    Luan, Song; Williams, Ian; Nikolic, Konstantin; Constandinou, Timothy G

    2014-01-01

    Neuromodulation has wide ranging potential applications in replacing impaired neural function (prosthetics), as a novel form of medical treatment (therapy), and as a tool for investigating neurons and neural function (research). Voltage and current controlled electrical neural stimulation (ENS) are methods that have already been widely applied in both neuroscience and clinical practice for neuroprosthetics. However, there are numerous alternative methods of stimulating or inhibiting neurons. This paper reviews the state-of-the-art in ENS as well as alternative neuromodulation techniques-presenting the operational concepts, technical implementation and limitations-in order to inform system design choices.

  2. Cutaneous sporotrichosis: Unusual clinical presentations

    Directory of Open Access Journals (Sweden)

    Mahajan Vikram

    2010-01-01

    Full Text Available Three unusual clinical forms of sporotrichosis described in this paper will be a primer for the clinicians for an early diagnosis and treatment, especially in its unusual presentations. Case 1, a 52-year-old man, developed sporotrichosis over pre-existing facial nodulo-ulcerative basal cell carcinoma of seven-year duration, due to its contamination perhaps from topical herbal pastes and lymphocutaneous sporotrichosis over right hand/forearm from facial lesion/herbal paste. Case 2, a 25-year-old woman, presented with disseminated systemic-cutaneous, osteoarticular and possibly pleural (effusion sporotrichosis. There was no laboratory evidence of tuberculosis and treatment with anti-tuberculosis drugs (ATT did not benefit. Both these cases were diagnosed by histopathology/culture of S. schenckii from tissue specimens. Case 3, a 20-year-old girl, had multiple intensely pruritic, nodular lesions over/around left knee of two-year duration. She was diagnosed clinically as a case of prurigo nodularis and histologically as cutaneous tuberculosis, albeit, other laboratory investigations and treatment with ATT did not support the diagnosis. All the three patients responded well to saturated solution of potassium iodide (SSKI therapy. A high clinical suspicion is important in early diagnosis and treatment to prevent chronicity and morbidity in these patients. SSKI is fairly safe and effective when itraconazole is not affordable/ available.

  3. Subacute presentation of propionic acidemia.

    Science.gov (United States)

    Delgado, Carmen; Macías, Carlos; de la Sierra García-Valdecasas, Maria; Pérez, Manuel; del Portal, Luis Ruiz; Jiménez, Luis Manuel

    2007-12-01

    Propionic acidemia is a hereditary metabolic disease caused by a deficiency of enzyme propionyl-CoA carboxylase, which is involved in the catabolism of ramified amino acids, odd-chain fatty acids, and other metabolites; the deficiency of this enzyme leads to an accumulation of toxic substances in the body. There are various forms of clinical presentation (severe neonatal, chronic intermittent, or slow and gradual). The case presented in this study was of a slow and insidious evolution form that was diagnosed when the child was 9 months old. Intracranial magnetic resonance imaging showed a slight increase in the signal intensity in sequences measured in T2 in addition to a restriction of the diffusion at the level of both putamens, which, together with biochemical and genetic analyses, confirmed the diagnosis of propionic acidemia. After initiating treatment involving a diet that was low in proteins, carnitine, and biotin, and an open-formula diet of ramified amino acids, the patient made progress, showing signs of improved hypotonia and increased weight gain. His vomiting stopped, and ketoacidosis was corrected.

  4. STS-81 Post Flight Presentation

    Science.gov (United States)

    1997-01-01

    The flight crew of the STS-81 mission, Commander Michael A. Baker, Pilot Brent W. Jett Jr, and Mission Specialists John M. Grunsfeld, Marsha S. Ivins, Peter J.K. Wisoff, and Jerry M. Linenger present a video mission over-view of their space flight. Images include prelaunch activities such as eating the traditional breakfast, crew suit-up, and the ride out to the launch pad. Also included are various panoramic views of the shuttle on the pad. The crew can be seen being readied in the "white room" for their mission. After the closing of the hatch and arm retraction, launch activities are shown including countdown, engine ignition, launch, and the separation of the Solid Rocket Boosters. During the presentation the astronauts take turns discussing aspects of the mission including: the SPACEHAB a double module that provides additional middeck locker space for secondary experiments. During the five days of docked operations with Mir, the crews is seen transferring water and supplies from one spacecraft to the other.

  5. Atypical presentations of neuromyelitis optica

    Directory of Open Access Journals (Sweden)

    Douglas Sato

    2011-10-01

    Full Text Available Neuromyelitis optica (NMO is an inflammatory disease of central nervous system classically characterized by acute, severe episodes of optic neuritis and longitudinally extensive transverse myelitis, usually with a relapsing course. The identification of an autoantibody exclusively detected in NMO patients against aquaporin-4 (AQP-4 has allowed identification of cases beyond the classical phenotype. Brain lesions, once thought as infrequent, can be observed in NMO patients, but lesions have different characteristics from the ones seen in multiple sclerosis. Additionally, some AQP-4 antibody positive patients may present with a variety of symptoms not being restricted to optic neuritis and acute myelitis during the first attack or in a relapse. Examples are not limited to, but may include patients only with brain and/or brainstem lesions, narcolepsy with hypothalamic lesions or patients with intractable hiccups, nausea and vomiting. The prompt identification of NMO patients with atypical presentations may benefit these patients with institution of early treatment to reduce disability and prevent further attacks.

  6. Case presentation – thyroid lymphoma

    Directory of Open Access Journals (Sweden)

    Belkisa Izić

    2011-11-01

    Full Text Available Malignant tumors of the thyroid gland account for about 1% of thenewly diagnosed malignant tumors each year, and their incidence inwomen is twice the incidence in men. According to the WHO classification (2004 thyroid tumors are divided into: carcinoma of the thyroid, adenoma and similar tumors, and other thyroid tumors which include: teratomas, angiosarcomas, paragangliomas and others, as well as primary lymphomas and plasmacytomas. Primary thyroid lymphomasare defined as lymphomas which originate in the thyroid gland. This study presents the case of a 68-year-old patient with a thyroid lymphoma, which caused compression of the airways. In the patientpresented there was reduced activity of the thyroid gland. The dominant symptoms were: breathing difficulties, hoarse voice and the enlargement of the thyroid. An ultrasound examination was performedbefore surgery on the neck, which showed a multinodular thyroid,with compromised and compressed trachea to the right and rear. Anemergency surgical procedure was performed to reduce the tumor.Pathohistological diagnosis confirmed diffuse large B cell lymphoma.The aim of the study was to present a patient with a thyroid lymphoma, who had previously not had any immunological changes to the gland,that is, she had not had any chronic lymphocyte thyroiditis, but due to the compressive syndrome it was necessary to perform an emergencysurgical procedure to reduce the tumor.

  7. Self Presentation dalam Kehidupan Virtual

    Directory of Open Access Journals (Sweden)

    Ita Musfirowati Hanika

    2016-06-01

    Full Text Available Abstract: The Sims 4 is a life simulation digital game, wherein the player can create and manage their virtual world. This research aims to reveal the players’ ideas in constructing their virtual world in this game. It is a qualitative research, using indepth interview to collect the data. Based on Ervin Goffman’s dramaturgy theory, “The presentation of self in everyday life”, this research concludes that The Sims 4 is played like a “real” life to create the expected self-image in the real world. Abstrak: Permainan digital The Sims 4 merupakan permainan simulasi kehidupan yang memberi kesempatan pemainnya untuk menciptakan dan mengatur dunia virtualnya. Tujuan penelitian ini adalah untuk mengungkapkan gagasan yang mendasari pemain dalam mengonstruksi dunia mereka dalam permainan digital. Penelitian ini merupakan penelitian kualitatif dengan wawancara mendalam sebagai metode pengumpulan data. Menggunakan teori dramaturgi Ervin Goffman, “The presentation of self in everyday life”, penelitian ini menyimpulkan bahwa permainan The Sims 4 dijalankan layaknya kehidupan “real” untuk menciptakan citra diri yang diharapkan di dunia nyata.

  8. Leptospirosis presenting as honeymoon fever.

    Science.gov (United States)

    de Sainte Marie, B; Delord, M; Dubourg, G; Gautret, P; Parola, P; Brouqui, P; Lagier, J C

    2015-05-01

    An increasing number of travelers from western countries visit tropical regions, questioning western physicians on the prophylaxis, the diagnosis and the therapeutic management of patients with travel-associated infection. In July 2014, a French couple stayed for an adventure-travel in Columbia without malaria prophylaxis. A week after their return the woman presented with fever, myalgia, and retro-orbital pain. Three days later, her husband presented similar symptoms. In both patients, testing for malaria, arboviruses and blood cultures remained negative. An empirical treatment with doxycycline and ceftriaxone was initiated for both patients. Serum collected from the female patient yielded positive IgM for leptospirosis but was negative for her husband. Positive Real-Time PCR were observed in blood and urine from both patients, confirming leptospirosis. Three lessons are noteworthy from this case report. First, after exclusion of malaria, as enteric fever, leptospirosis and rickettsial infection are the most prevalent travel-associated infections, empirical treatment with doxycycline and third generation cephalosporin should be considered. In addition, the diagnosis of leptospirosis requires both serology and PCR performed in both urine and blood samples. Finally, prophylaxis using doxycycline, also effective against leptospirosis, rickettsial infections or travellers' diarrhea should be recommended for adventure travelers in malaria endemic areas. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Uncommon presentation of pulmonary aspergilloma

    Directory of Open Access Journals (Sweden)

    Baradkar V

    2009-01-01

    Full Text Available Cases of pulmonary aspergilloma without any predisposing factors are rarely reported. Clinical presentation varies from case to case. Here, we report a case of pulmonary aspergilloma in a 60-year-old male patient who was admitted to the Intensive Respiratory Care Unit with spontaneous pneumothorax. The patient had a history of dyspnea on exertion since 9 months and mild haemoptysis since the last 6 months. A computerised tomographic scan of the lungs showed a lesion in the left main bronchus along with obstructive emphysema of the right lung, moderate pneumothorax and mediastinal emphysema. Bronchoscopy was performed and the biopsy samples were processed for histopathological examination and culture on Sabouraud′s dextrose agar, which yielded growth of Aspergillus flavus. Repeat sputum samples also yielded the growth of A. flavus . The patient responded to intravenous liposomaamphotericin B and intercostal drainage.

  10. Unusual presentation of spinal lipomatosis

    Directory of Open Access Journals (Sweden)

    Stephenson W

    2014-09-01

    Full Text Available William Stephenson,1 Matthew J Kauflin2,3 1Primary Care, Huntington Veteran's Affairs Medical Center, Huntington, WV, USA; 2Department of Pharmacy, Grandview Medical Center, Dayton, Ohio, OH, USA; 3Ohio Northern University, Ada, Ohio, OH, USA Abstract: Spinal epidural lipomatosis (SEL is a rare condition characterized by overgrowth of normal adipose tissue in the extradural space within the spinal canal that can lead to significant spinal cord compression. It is most commonly reported in patients receiving chronic glucocorticoid therapy. Other causes can include obesity and hypercortisolism. Occasionally, idiopathic SEL will occur in patients with no known risk factors, but cases are more generally reported in obesity and males. We present the case of a 35 year-old non-obese woman found to have rapidly progressive SEL that was not associated with any of the common causes of the disorder. Keywords: lipomatosis, laminectomy, hypercortisolism

  11. An unusual presentation of hypothyroidism.

    Science.gov (United States)

    Soni, Sonia; Singh, Gundeep; Yasir, Subia; Hatipoglu, Betul

    2005-03-01

    We describe a case of a 42-year-old male, with a 5-year history of recurrent gum bleeding, easy bruising, and chronic fatigue who presented for management of possible bleeding complications prior to a planned dental procedure. After extensive work-up, the patient was diagnosed with acquired von Willebrand Disease and underlying hypothyroidism with a thyrotropin (TSH) of 321 mIU/L (0.35-5.5) and total thyroxine (T(4)) of less than 1 microg/dL (4.5-12.5). He was started on levothyroxine and therapy and when compliant with treatment, the mucosal bleeding and symptoms of hypothyroidism were resolved. A subsequent TSH and total T(4) samples were drawn and found to be 6.3 mIU/L and 4.1 microg/dL, respectively.

  12. Sarcoidosis Presenting with Cicatrizing Conjunctivitis.

    Science.gov (United States)

    O'Donnell, John J; Karakus, Sezen; Doroslovacki, Pavle; Akpek, Esen K

    2015-08-01

    To report two patients with sarcoidosis initially presenting with cicatrizing conjunctivitis. Both patients with chronic conjunctivitis were referred for further management. The first patient had conjunctival granulomas, subepithelial fibrosis, and forniceal foreshortening. The second patient had extensive upper and lower conjunctival scarring with forniceal foreshortening and symblepharon formation of both eyes. Conjunctival biopsy specimens revealed noncaseating granulomas. Immunofluorescein studies were negative for immunoreactant deposition in the basement membrane. Because of further diagnostic evaluations, sarcoidosis was determined to be the final cause of the cicatrizing conjunctivitis. Sarcoidosis should be included in the differential diagnosis of cicatrizing conjunctivitis. Recognition of the characteristic noncaseating granulomas in the conjunctival biopsy and initiation of the appropriate evaluations are essential in establishing the diagnosis and determining the extent of systemic involvement.

  13. Atypical presentations of celiac disease

    Directory of Open Access Journals (Sweden)

    Balasa Adriana Luminita

    2016-08-01

    Full Text Available In this study we evaluated the association of celiac disease in 81 children with autoimmune disease and genetic syndromes over a two years periods (January 2014 to July 2016 in Pediatric Clinic in Constanta. Because the extraintestinal symptoms are an atypical presentation of celiac disease we determined in these children the presence of celiac disease antibodies: Anti-tissue Transglutaminase Antibody IgA and IgA total serum level as a screening method followeds in selective cases by Anti-tissue Transglutaminase Antibody IgG, anti-endomysial antibodies, deamidated gliadin antibodies IgA and IgG and intestinal biopsia. In our study 8 patients had been diagnosed with celiac disease with extraintestinal symptoms, of which 4 with type 1 diabetes, 1 patient with ataxia, 2 patients with dermatitis herpetiformis and 1 patient with Down syndrome that associate also autoimmune thyroiditis, alopecia areata, enamel hypoplasia.

  14. Splenic abscess: a rare presentation

    Directory of Open Access Journals (Sweden)

    Mohit Bhatia

    2015-01-01

    Full Text Available Splenic abscess is a rare clinical entity with an incidence of 0.2-0.7% in autopsy-based studies. When untreated, splenic abscess is associated with nearly 100% mortality; in treated patients, the mortality rate is 16.6% during the first 90 days. It mostly occurs in patients with neoplasia, immunodeficiency, trauma, diabetes or splenic infarct. The incidence of splenic abscess is thought to be growing because of the increase in the number of immunocompromised patients who are particularly at risk for this disease and also because of the widespread use of diagnostic modalities. However, the optimal treatment for this remains unclear. We present a case of a 42-year-old man diagnosed with multiloculated splenic abscess and was subjected to splenectomy.

  15. Atmospheric neutrinos - present and future -

    Energy Technology Data Exchange (ETDEWEB)

    Kajita, Takaaki [Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, Univ. of Tokyo, Kashiwa-no-ha 5-1-5, Kashiwa, Chiba 277-8582 (Japan)

    2005-12-15

    Atmospheric neutrinos have been playing a major role in studying neutrino oscillations. The present data are consistent with pure 2 flavor {nu}{sub {mu}}->{nu}{sub {tau}} oscillations. The allowed {nu}{sub {mu}}->{nu}{sub {tau}} oscillation parameter region is sin{sup 2}2{theta}{sub 23}>0.92 and 1.5<{delta}m{sub 23}{sup 2}<3.4x10{sup -3}eV{sup 2} at 90%C.L. Recent data from an L/E analysis showed that the {nu}{sub {mu}} disappearance probability obeys the sinusoidal function as predicted by neutrino oscillations. Future atmospheric neutrino experiments are also discussed emphasizing the measurement of {theta}{sub 13} and the sign of {delta}m{sub 23}{sup 2}.

  16. Neurocysticercosis presenting as pseudobulbar palsy

    Directory of Open Access Journals (Sweden)

    Arinaganahalli Subbanna Praveen Kumar

    2014-01-01

    Full Text Available Neurocysticercosis (NCC is the most common helminthic infestation of the central nervous system (CNS and a leading cause of acquired epilepsy worldwide. The common manifestations of NCC are seizures and headache. The NCC as a cause of pseudobulbar palsy is very unusual and not reported yet in the literature. A pseudobulbar palsy can occur in any disorder that causes bilateral corticobulbar disease. The common etiologies of pseudobulbar palsy are vascular, demyelinative, or motor neuron disease. We report a 38-year-old female patient who presented with partial seizures and pseudobulbar palsy. The MRI brain showed multiple small cysts with scolex in both the cerebral hemispheres and a giant intraparenchymal cyst. Our patient responded well to standard treatment of neurocysticercosis and antiepileptics.

  17. Concurrent electrophysiology and TPM/OCT imaging of long-term implanted electrodes (Conference Presentation)

    Science.gov (United States)

    Hammer, Daniel X.; Gao, Yu-Rong; Ye, Meijun; Welle, Cristin G.

    2017-02-01

    Microelectrodes implanted in the brain cause mechanical damage to the tissue that mediate neuroinflammation and eventual encapsulation by microglia and astrocytes. Electrophysiological signals recorded from implants used in brain-computer interfaces (BCI) degrade over time, limiting their usefulness, but the precise causes and progression are not fully understood. We are investigating the dynamics of brain morphological changes and neuroinflammation with a multimodal approach to better understand the potential causes of implant failure. We performed weekly optical coherence tomography (OCT)-guided two-photon microscopy (TPM) in the region around microelectrodes inserted under a cranial window concurrent with electrophysiological recordings. Transgenic mouse cohorts studied include Thy1-YFP, Cx3cr1, and GFAP-GFP to image neurons, microglia, and astrocytes, respectively. Single-shank, 16-channel, Michigan-style microelectrodes were inserted under the window at a 15-20° angle with an insertion depth up to cortical layer 5. Single-unit and local field potential (LFP) recordings were collected for 15 minutes while the animals moved freely in their home cages. Cellular and vascular morphology were monitored using TPM and OCT at timepoints matched to the recordings. In preliminary data, we observed a decay of neural firing rates in most of the channels after implantation. The relationship between electrophysiological measures (e.g., neural firing rate, LFP power) and neural/vascular morphological measurements (e.g., cell density, glial migration, blood flow changes) will be quantified. The multimodal approach combining electrophysiology and optical imaging provides a broader picture of the multifactorial nature of the response to implanted electrodes. Understanding and accounting for the response may lead to better BCI designs and approaches.

  18. Dynamic Presentation of Long Term Upper Ocean Study (LOTUS) Data Using Videotape.

    Science.gov (United States)

    1986-09-01

    8217..,, Il OOM 14000M 7 5000M 40007 Figure 3. Schematic showing a surface and a near surface mooring typical of those used in LOTUS with instruments at...command files passed vari- ables to the command file that ran PROSPECT, and allowed many runs to be done together in one overnight batch job. Usually 10-20...of the time periods were done in one night. The command files were large and cumbersome to edit, but were worth the effort in run time saved. D

  19. The Concept Lens Diagram: A New Mechanism for Presenting Biochemistry Content in Terms of "Big Ideas"

    Science.gov (United States)

    Rowland, Susan L.; Smith, Christopher A.; Gillam, Elizabeth M. A.; Wright, Tony

    2011-01-01

    A strong, recent movement in tertiary education is the development of conceptual, or "big idea" teaching. The emphasis in course design is now on promoting key understandings, core competencies, and an understanding of connections between different fields. In biochemistry teaching, this radical shift from the content-based tradition is…

  20. Traceability of biologicals: present challenges in pharmacovigilance.

    Science.gov (United States)

    Vermeer, Niels S; Spierings, Irina; Mantel-Teeuwisse, Aukje K; Straus, Sabine M J M; Giezen, Thijs J; Leufkens, Hubert G M; Egberts, Toine C G; De Bruin, Marie L

    2015-01-01

    Traceability is important in the postmarketing surveillance of biologicals, since changes in the manufacturing process may give rise to product- or batch-specific risks. With the expected expansion of the biosimilar market, there have been concerns about the ability to trace individual products within pharmacovigilance databases. The authors discuss the present challenges in the traceability of biologicals in relation to pharmacovigilance, by exploring the processes involved in ensuring traceability. They explore both the existing systems that are in place for the recording of exposure information in clinical practice, as well as the critical steps involved in the transfer of exposure data to various pharmacovigilance databases. The existing systems ensure the traceability of biologicals down to the manufacturer within pharmacy records, but do not support the routine recording of batch information. Expected changes in supply chain standards provide opportunities to systematically record detailed exposure information. Spontaneous reporting systems are the most vulnerable link in ensuring traceability, due to the manual nature of data transfer. Efforts to improve the traceability should, in the short term, be focused toward encouraging health professionals and patients to systematically record and report detailed exposure information. Long-term solutions lie in expanding the accessibility to, and increasing the electronic exchange of exposure data.

  1. WOODEN FLOORING – BETWEEN PRESENT AND FUTURE

    Directory of Open Access Journals (Sweden)

    Ivan CISMARU

    2015-06-01

    Full Text Available The paper aims at presenting a systematization of the wood floors, both in terms of the areas of application, and in terms of the fastening solutions and structures in constructions. In this respect, an extensive bibliographic research was achieved, on the researchers’ preoccupations. Starting from the current situation and forecasting the future, from the point of view of the chances held by wooden flooring, in competition with other types of materials, we dare say the wooden flooring or the wood in combination with other materials are not likely to be eliminated from the “civil-engineering market”. The wood floors are likely to develop as an application, especially in the area of the “special floors”, specific to the indoor sports or social halls; and even for some industrial sectors, with strict operating conditions (elasticity, thermal insulation, soundproofing that cannot be provided by other types of materials or structures. Starting from this last observation, the paper also aims at submitting current opinions with respect to this type of floors, both in the light of the current databases and in the light of the future researches, to this end

  2. Celiac disease patients presenting with anemia have more severe disease than those presenting with diarrhea.

    Science.gov (United States)

    Abu Daya, Hussein; Lebwohl, Benjamin; Lewis, Suzanne K; Green, Peter H

    2013-11-01

    Anemia is considered to be an atypical or silent presentation of celiac disease, compared with the classic presentation with diarrhea. However, little information is available about how these groups compare in terms of disease severity. We compared the severity of celiac disease between patients who present with anemia vs those who present with diarrhea. The study cohort was selected from a database of patients with celiac disease who were evaluated at a tertiary referral center between 1990 and 2011. Severity of celiac disease was assessed by the degree of villous atrophy and clinical and serologic parameters. Patients were compared according to mode of presentation and sex. Multivariable analyses, adjusting for age and sex, were conducted to assess the association between the mode of celiac disease presentation and cholesterol level, bone density, severity of villous atrophy, erythrocyte sedimentation rate, and level of anti-tissue transglutaminase. Of 727 patients, 77% presented with diarrhea and 23% with anemia (92% iron deficient). On multiple regression analysis, presentation with anemia was associated with lower levels of total cholesterol (P = .02) and high-density lipoprotein (P = .002) and a higher erythrocyte sedimentation rate (P = .001) and level of anti-tissue transglutaminase (P = .01). Presentation with anemia was associated with lower level of cholesterol only in women. Anemic patients were more than 2-fold more likely to have severe villous atrophy and a low bone mass density at the time they were diagnosed with celiac disease than patients who presented with diarrhea. Celiac disease patients who present with anemia have more severe disease than those who present with diarrhea. There also appear to be sex-specific differences with regard to the association between anemia and the different features of celiac disease. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

  3. Space exploration - Present and future challenges

    CERN Multimedia

    CERN. Geneva

    2003-01-01

    Our future deep-space exploration faces many daunting challenges, but three of them loom high above the rest: physiological debilitation, radiation sickness and psychological stress. Many measures are presently being developed to reduce these difficulties. However, in the long run, two important new developments are required: abundant supply of power, and advanced space propulsion. The future looks bright, however. While the road is a long one, it is now well defined and many exciting explorations are within near-term reach.BiographyDr. Chang-Diaz graduated from MIT in the field of applied plasma physics and fusion research. He has been a NASA space shuttle astronaut on seven missions between 1986 and 2002. As director of the ASP Laboratory in Houston, he continues research on plasma rockets.For more details: see www.jsc.nasa.gov/Bios/htmlbios/chang.htmlNote: Tea and coffee will be served at 16:00 hrs.

  4. Submaxillary gland mucocele: presentation of a case.

    Science.gov (United States)

    Boneu-Bonet, Fernando; Vidal-Homs, Enric; Maizcurrana-Tornil, Aránzazu; González-Lagunas, Javier

    2005-01-01

    The term mucocele is referred to two concepts: the extravasation cysts resulting from salivary glandular duct rupture, with mucin leakage into the surrounding peri-glandular soft tissue, and the retention cysts, caused by a glandular duct obstruction and resulting in a decrease or even an absence of glandular secretion. Mucocele can not be considered as a true cyst because its wall lacks an epithelial lining. These lesions are very common in the minor salivary glands (particularly in the labial glands), but are very infrequent in the major salivary glands--including the submaxillary glands. The present study describes a clinical case of a right submaxillary gland mucocele resolved by surgical treatment and reviews the differential diagnosis with other clinical entities.

  5. Extreme Achalasia Presenting as Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    P. J. Goldsmith

    2012-01-01

    Full Text Available Background. Achalasia may lead to cachexia if not diagnosed in an early stage. Surgery in cachectic patients is hazardous and complications may result in a protracted recovery or even death. Different treatment options have been described. In this paper, we report a stepwise surgical laparoscopic approach which appears to be safe and effective. Methods. Over a one-year period, a patient with a body mass index (BMI below 17 being treated for anorexia nervosa was referred with dysphagia. Because of the extreme cachexia, a laparoscopic feeding jejunostomy (LFJ was fashioned to enable long-term home enteral feeding. The patient underwent a laparoscopic Heller myotomy (LHM when the BMI was normal. Results. The patient recovered well following this stepwise approach. Conclusion. Patients with advanced achalasia usually present with extreme weight loss. In this small group of patients, a period of home enteral nutrition (HEN via a laparoscopically placed feeding jejunostomy allows weight gain prior to safe definitive surgery.

  6. Pheochromocytoma Presenting as Partial HELLP Syndrome

    Directory of Open Access Journals (Sweden)

    Yazan Daaboul

    2015-01-01

    Full Text Available Diagnosis of pheochromocytoma in partial HELLP syndrome is extremely rare. We report a case of a 25-year-old multigravida woman at 30 weeks of gestation who presented with clinical features consistent with partial HELLP syndrome. Her symptoms were not controlled by pharmacologic therapy, and the patient underwent urgent cesarean section. The patient gave birth to a viable baby, but she sustained an episode of ventricular fibrillation intraoperatively that did not result in any long-term sequelae. The patient’s symptoms persisted postoperatively and work-up for secondary etiologies of hypertension demonstrated a right adrenal pheochromocytoma. Following resection, the patient’s signs and symptoms resolved, and her lab tests normalized.

  7. ABSTRACT PRESENTATION--PHARMACEUTICALS AS ...

    Science.gov (United States)

    Pharmaceuticals comprise a large and diverse array of contaminants that can occur in the environmentfrom the combined activities and actions of multitudes of individuals as well as from veterinary andagricultural use. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for med

  8. Neurologic presentation of celiac disease.

    Science.gov (United States)

    Bushara, Khalafalla O

    2005-04-01

    Celiac disease (CD) long has been associated with neurologic and psychiatric disorders including cerebellar ataxia, peripheral neuropathy, epilepsy, dementia, and depression. Earlier reports mainly have documented the involvement of the nervous system as a complication of prediagnosed CD. However, more recent studies have emphasized that a wider spectrum of neurologic syndromes may be the presenting extraintestinal manifestation of gluten sensitivity with or without intestinal pathology. These include migraine, encephalopathy, chorea, brain stem dysfunction, myelopathy, mononeuritis multiplex, Guillain-Barre-like syndrome, and neuropathy with positive antiganglioside antibodies. The association between most neurologic syndromes described and gluten sensitivity remains to be confirmed by larger epidemiologic studies. It further has been suggested that gluten sensitivity (as evidenced by high antigliadin antibodies) is a common cause of neurologic syndromes (notably cerebellar ataxia) of otherwise unknown cause. Additional studies showed high prevalence of gluten sensitivity in genetic neurodegenerative disorders such as hereditary spinocerebellar ataxia and Huntington's disease. It remains unclear whether gluten sensitivity contributes to the pathogenesis of these disorders or whether it represents an epiphenomenon. Studies of gluten-free diet in patients with gluten sensitivity and neurologic syndromes have shown variable results. Diet trials also have been inconclusive in autism and schizophrenia, 2 diseases in which sensitivity to dietary gluten has been implicated. Further studies clearly are needed to assess the efficacy of gluten-free diet and to address the underlying mechanisms of nervous system pathology in gluten sensitivity.

  9. Presentation Vol. 8 Issue 1

    Directory of Open Access Journals (Sweden)

    Sonia Natalia Cogollo-Ospina

    2017-01-01

    Full Text Available It is with great joy that we share with our readers the fact that our journal has been included in new databases of high prestige. Our journal can now be consulted online at Web of Science, Ulrich web, ERIH Plus, EBSCO, CLASE and we are also members of the Latin American Human Social Science Association of Academic journals. There is also the recognition of our Institution as Universidad Católica Luis Amigó given by the Ministry of Education, that came as a result of cooperative research work and publications. Our celebration is the result of hard work to provide high-quality services and products. We are pleased to present an issue that focuses on questions based on emerging situations that come about as a result of the imperative and domineering discourses of our time; which have become research objects. As usual, there are different topics from different disciplines. In honor of our multidisciplinary approach this issue includes contribution of research papers from the fields of law, psychology, sociology, anthropology, history and social geography, education, social work, political sciences and psychiatry.

  10. Augmented reality: past, present, future

    Science.gov (United States)

    Inzerillo, Laura

    2013-03-01

    A great opportunity has permitted to carry out a cultural, historical, architectural and social research with great impact factor on the international cultural interest. We are talking about the realization of a museum whose the main theme is the visit and the discovery of a monument of great prestige: the monumental building the "Steri" in Palermo. The museum is divided into sub themes including the one above all, that has aroused the international interest so much that it has been presented the instance to include the museum in the cultural heritage of UNESCO. It is the realization of a museum path that regards the cells of the Inquisition, which are located just inside of some buildings of the monumental building. The project, as a whole, is faced, in a total view, between the various competences implicated: historic, chemic, architectonic, topographic, drawing, representation, virtual communication, informatics. The birth of the museum will be a sum of the results of all these disciplines involved. Methodology, implementation, fruition, virtual museum, goals, 2D graphic restitution, effects on the cultural heritage and landscape environmental, augmented reality, Surveying 2D and 3D, hi-touch screen, Photogrammetric survey, Photographic survey, representation, drawing 3D and more than this has been dealt with this research.

  11. A cool present for LEIR

    CERN Multimedia

    2005-01-01

    LEIR (Low Energy Ion Ring), which will supply lead ions to the LHC experiments, has taken delivery of one of its key components, its electron cooling system. From left to right, Gérard Tranquille, Virginia Prieto and Roland Sautier, in charge of the electron cooling system for LEIR at CERN, and Christian Lacroix, in charge of installation for the LEIR machine. On 16 December, the day before CERN's annual closure, the LEIR teams received a rather impressive Christmas present. The "parcel" from Russia, measuring 7 metres in length and 4 metres in height, weighed no less than 20 tonnes! The component will, in fact, be one of the key elements of the future LEIR, namely its electron cooling system. LEIR is one of the links in the injector chain that will supply lead ions to the LHC experiments, in particular ALICE (see Bulletin No. 28/2004 of 5 July 2004), within the framework of the I-LHC Project. The electron cooling system is designed to reduce and standardise transverse ion velocity. This focuses the bea...

  12. [An unusual presentation of sarcoidosis].

    Science.gov (United States)

    Nakano, Y; Matsushita, H

    1997-02-01

    A 52-year-old man was admitted to our hospital with chief complaints of fever, general fatigue, and weight loss. A chest roentgenogram showed hyperinflation and many small nodular shadows in both lung fields. A chest CT scan showed centrilobular shadows distributed equally over all lung fields. Examination of a transbronchial lung biopsy specimen revealed a small non-caseating granuloma composed of a giant cell of Langhans type, epithelioid cells, and a few lymphocytes. There was a dark red eruption about 1 cm in diameter on the right forearm, which had been present for a few years, to the best of the patient's memory. Examination of a skin biopsy specimen revealed many non-caseating granulomas composed of epithelioid cells. Uveitis developed about 2 months after admission. Our diagnosis was sarcoidosis. Steroid therapy was started. The patient's symptoms rapidly disappeared and a chest roentgenogram showed remarkable improvement. We believe this was a very peculiar case of sarcoidosis: the patient had systemic symptoms only, and roentgenographic examinations showed hyperinflation and centrilobular shadows distributed over all lung fields.

  13. [Asbestos: past, present and future].

    Science.gov (United States)

    Seaton, A

    1995-03-11

    Owing to its particular properties asbestos has been widely used for the production of insulating material, for fire proofing, and for strengthening to other materials such as cements and plastics, and thus the story of this mineral was one of progressive commercial success until the middle of this century. However, serious health hazards were realized early: around the turn of the century a progressive form of diffuse fibrosis (asbestosis) in asbestos workers was observed and in 1950 an excess risk of lung cancer, while in 1960 the causal relationship between asbestos and mesothelioma were confirmed. In view of the known potential risks of asbestos and its widespread use in the building industry, more recently asbestos has caused considerable public concern and anxiety. Based on numerous experimental and epidemiological observations, present knowledge of the pathogenic effects of asbestos is sufficient for a number of broad conclusions to be drawn. (1) The amphibole types of asbestos are too dangerous for use as industrial material, and should be banned. (2) Chrysotile can probably be used safely if there is strict control of the workers' dust exposure. (3) It is very unlikely that the general public is at any measurable risk from asbestos in buildings. Exceptions are people working regularly on maintenance tasks involving removing or cutting of asbestos in buildings; such people are properly classified as asbestos workers and should be protected accordingly.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Unusual presentation of oral amyloidosis

    Directory of Open Access Journals (Sweden)

    William P.P Silva

    2015-01-01

    Full Text Available Amyloidosis is a rare disease of difficult diagnosis that occurs due accumulation of amyloid substance localized or systemic. The oral cavity is an unusual site and can be related to both localized and systemic forms and for that reason a full investigation is necessary to determine the extent of the disease. This study reports a case of a 58-year-old melanoderm male patient referred to the Department of Oral and Maxillofacial Surgery with white plaques on the tongue and multiple nodules in the region of the buccal mucosa and labial commissure, with 6 months of evolution and painful symptoms. An incisional biopsy was performed on both sites and histological examination indicated the presence of eosinophilic amorphous material within the connective tissue, positive for crystal violet staining, consistent with amyloidosis. At the present time, there is no consensus on the management of local amyloidosis. Surgical treatment of localized forms is indicated in some cases to reduce the functional prejudice. Moreover, follow-up is mandatory, both to manage recurrences and to monitor the possible evolution of the disease to the systemic form.

  15. STS-93 Post Flight Presentation

    Science.gov (United States)

    1999-01-01

    An overview of Flight STS-93 is presented. The primary objective of the STS-93 mission was to deploy the Advanced X-Ray Astrophysics Facility (AXAF), also known as the Chandra X-ray Observatory. The mission flew on the Columbia Shuttle, on July 22, 1999. This facility is the most sophisticated X-ray observatory ever built. Other payloads on STS-93 were: (1) the Midcourse Space Experiment (MSX), (2) Shuttle Ionospheric Modification with Pulsed Local Exhaust (SIMPLEX), (3) Southwest Ultraviolet Imaging System (SWUIS), (4) Gelation of Sols: Applied Microgravity Research (GOSAMR), Space Tissue Loss-B (STL-B), (5) Light Weight Flexible Solar Array Hinge (LFSAH), (6) Cell Culture Module (CCM), and (7) the Shuttle Amateur Radio Experiment-II (SAREX-II), (8) EarthKam, (9) Plant Growth Investigations in Microgravity (PGIM), (10) Commercial Generic Bioprocessing Apparatus (CGBA), (11) Micro-Electrical Mechanical System (MEMS), and (12) the Biological Research in Canisters (BRIC). The crew was: Eileen M. Collins, Mission Commander, the first female shuttle commander; Jeffrey S. Ashby, Pilot; Steven A. Hawley , Mission Specialist; Catherine G. Coleman, Mission Specialist; Michel Tognini (CNES), Mission Specialist. The video contains views of life aboard the space shuttle. This mission featured both a night launching and a night landing at the Kennedy Space Center.

  16. Historical ecology: past, present and future.

    Science.gov (United States)

    Szabó, Péter

    2015-11-01

    The term 'historical ecology' has been used with various meanings since the first half of the 20th century. Studies labelled as historical ecology have been produced in at least four academic disciplines: history, ecology, geography and anthropology. Although all those involved seem to agree that historical ecology concerns the historical interconnectedness of nature and human culture, this field of study has no unified methodology, specialized institutional background and common publication forums. Knowledge of the development of historical ecology is also limited. As a result, the current multitude of definitions of historical ecology is accompanied by divergent opinions as to where the origins of the field are to be sought. In this review, I follow the development of historical ecology from the 18th century to the present. In the first part, I briefly describe some early examples of historical ecological investigations, followed by a description of the various scientific strands in the 20th century that contributed to the formation of historical ecology. In the second part, I discuss the past five decades of historical ecological investigations in more detail, focusing mostly (but not exclusively) on works that their respective authors identified as historical ecology. I also examine the appearance and interconnectedness of the two main trends (ecological and anthropological) in historical ecological research. In the last part, I attempt to outline the future of historical ecology based on common features in existing research. It appears that at present historical ecology is at a crossroads. With rapidly growing interest in historical ecological research, it may move towards institutionalization or remain an umbrella term. © 2014 The Authors. Biological Reviews © 2014 Cambridge Philosophical Society.

  17. Historical ecology: past, present and future

    Science.gov (United States)

    Szabó, Péter

    2017-01-01

    The term ‘historical ecology’ has been used with various meanings since the first half of the 20th century. Studies labelled as historical ecology have been produced in at least four academic disciplines: history, ecology, geography and anthropology. Although all those involved seem to agree that historical ecology concerns the historical interconnectedness of nature and human culture, this field of study has no unified methodology, specialized institutional background and common publication forums. Knowledge of the development of historical ecology is also limited. As a result, the current multitude of definitions of historical ecology is accompanied by divergent opinions as to where the origins of the field are to be sought. In this review, I follow the development of historical ecology from the 18th century to the present. In the first part, I briefly describe some early examples of historical ecological investigations, followed by a description of the various scientific strands in the 20th century that contributed to the formation of historical ecology. In the second part, I discuss the past five decades of historical ecological investigations in more detail, focusing mostly (but not exclusively) on works that their respective authors identified as historical ecology. I also examine the appearance and interconnectedness of the two main trends (ecological and anthropological) in historical ecological research. In the last part, I attempt to outline the future of historical ecology based on common features in existing research. It appears that at present historical ecology is at the crossroads. With rapidly growing interest in historical ecological research, it may move towards institutionalization or remain an umbrella term. PMID:25174685

  18. Long-term collections

    CERN Multimedia

    Collectes à long terme

    2007-01-01

    The Committee of the Long Term Collections (CLT) asks for your attention for the following message from a young Peruvian scientist, following the earthquake which devastated part of her country a month ago.

  19. Hip osteoarthrosis: clinical presentation, diagnosis, approaches to treatment

    Directory of Open Access Journals (Sweden)

    Marina Stanislavovna Svetlova

    2013-01-01

    Full Text Available The paper characterizes the specific features of the anatomy and physiology of the hip joint, the clinical presentation of coxarthrosis and presents current methods for the diagnosis and treatment of the disease. It gives the results of a trial evaluating the impact of long-term (one-year theraflex therapy on the symptoms of hip osteoarthrosis.

  20. Medical informatics: past, present, future.

    Science.gov (United States)

    Haux, Reinhold

    2010-09-01

    To reflect about medical informatics as a discipline. To suggest significant future research directions with the purpose of stimulating further discussion. Exploring and discussing important developments in medical informatics from the past and in the present by way of examples. Reflecting on the role of IMIA, the International Medical Informatics Association, in influencing the discipline. Medical informatics as a discipline is still young. Today, as a cross-sectional discipline, it forms one of the bases for medicine and health care. As a consequence considerable responsibility rests on medical informatics for improving the health of people, through its contributions to high-quality, efficient health care and to innovative research in biomedicine and related health and computer sciences. Current major research fields can be grouped according to the organization, application, and evaluation of health information systems, to medical knowledge representation, and to the underlying signal and data analyses and interpretations. Yet, given the fluid nature of many of the driving forces behind progress in information processing methods and their technologies, progress in medicine and health care, and the rapidly changing needs, requirements and expectations of human societies, we can expect many changes in future medical informatics research. Future research fields might range from seamless interactivity with automated data capture and storage, via informatics diagnostics and therapeutics, to living labs with data analysis methodology, involving sensor-enhanced ambient environments. The role of IMIA, the International Medical Informatics Association, for building a cooperative, strongly connected, and research-driven medical informatics community worldwide can hardly be underestimated. Health care continuously changes as the underlying science and practice of health are in continuous transformation. Medical informatics as a discipline is strongly affected by these

  1. Presentation of adult mitochondrial epilepsy.

    Science.gov (United States)

    Finsterer, Josef; Mahjoub, Sinda Zarrouk

    2013-03-01

    Mitochondrial disorders (MIDs) frequently manifest phenotypically as epilepsy (mitochondrial epilepsy). Mitochondrial epilepsy occurs in early-onset as well as late-onset syndromic and non-syndromic MIDs. We were interested in the types of epilepsy, the prevalence of mitochondrial epilepsy, the type and effectiveness of treatment, and in the outcome of adult MID patients with epilepsy. We retrospectively evaluated adult patients with syndromic or non-syndromic MIDs and epilepsy. MIDs were classified according to the modified Walker criteria as definite, probable, and possible. Epilepsy in adult patients with a MID was classified as "structural/metabolic" in two-thirds of the cases and as "genetic" in one-third of the cases. Although all types of seizures may occur in mitochondrial epilepsy, adult patients most frequently presented with generalised tonic-clonic seizures, partial seizures, convulsive status epilepticus, or non-convulsive status epilepticus. Cerebral imaging was normal in one-third of the patients. Two-thirds of the adult patients with mitochondrial epilepsy who took antiepileptic drugs received monotherapy, one-third combination treatment. The antiepileptic drugs most frequently administered included levetiracetam, lamotrigine, valproic acid, and gabapentin. Antiepileptic drugs were usually well tolerated and the outcome favourable. Adult mitochondrial epilepsy appears to be less frequent than previously believed but the prevalence strongly depends on patient selection. Mitochondrial epilepsy is most frequently "structural/metabolic". AEDs recommended for mitochondrial epilepsy include levetiracetam, lamotrigine, gabapentin and lacosamide. The outcome of mitochondrial epilepsy may be more favourable if mitochondrion-toxic AEDs are avoided. Only if non-mitochondrion-toxic AEDs are ineffective, mitochondrion-toxic AEDs may be used. Copyright © 2012 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  2. Nocardia farcinica bacteraemia presenting as a prostate abscess

    Directory of Open Access Journals (Sweden)

    Hana Scorey

    2016-01-01

    Full Text Available Nocardia is characterised as a Gram positive filamentous rod and is found worldwide in soil, decaying vegetable matter and aquatic environments. Localised pulmonary infection is the most common clinical presentation. However, Nocardia can present in a wide variety of clinical manifestations, especially in the immunocompromised individual. We present the first case of a prostate abscess caused by Nocardia farcinica in a man with a history of severe psoriasis and psoriatic arthritis. He had been on long term immunosuppression for this with prednisolone and etanercept. His Nocardia was likely contracted through direct skin inoculation while gardening with haematological dissemination to the prostate. He responded well to long term sulfamethoxazole and trimethoprim.

  3. Short-term energy outlook

    Energy Technology Data Exchange (ETDEWEB)

    1990-11-07

    The Energy Information Administration (EIA) presents future scenarios of quarterly short-term energy supply, demand, and prices for publication in February, May, August, and November in the Short-Term Energy Outlook (Outlook). An annual supplement analyzes previous estimate errors, compares recent scenarios with those of other forecasting services, and discusses current topics of the short-term energy markets. (See Short-Term Energy Outlook: Annual Supplement, DOE/EIA-0202.) The principal users of the Outlook are managers and energy analysts in private industry and government. The scenario period for this issue of the Outlook extends from the fourth quarter of 1990 through the fourth quarter of 1991. Some data for the third quarter of 1990 are preliminary EIA estimates of actual data (for example, some petroleum estimates are based on statistics from the Weekly Petroleum Status Report) or are derived from internal model simulations using the latest exogenous information available (for example, some electricity demand estimates are based on recent weather data). 11 figs., 13 tabs.

  4. Long-term data archiving

    Energy Technology Data Exchange (ETDEWEB)

    Moore, David Steven [Los Alamos National Laboratory

    2009-01-01

    Long term data archiving has much value for chemists, not only to retain access to research and product development records, but also to enable new developments and new discoveries. There are some recent regulatory requirements (e.g., FDA 21 CFR Part 11), but good science and good business both benefit regardless. A particular example of the benefits of and need for long term data archiving is the management of data from spectroscopic laboratory instruments. The sheer amount of spectroscopic data is increasing at a scary rate, and the pressures to archive come from the expense to create the data (or recreate it if it is lost) as well as its high information content. The goal of long-term data archiving is to save and organize instrument data files as well as any needed meta data (such as sample ID, LIMS information, operator, date, time, instrument conditions, sample type, excitation details, environmental parameters, etc.). This editorial explores the issues involved in long-term data archiving using the example of Raman spectral databases. There are at present several such databases, including common data format libraries and proprietary libraries. However, such databases and libraries should ultimately satisfy stringent criteria for long term data archiving, including readability for long times into the future, robustness to changes in computer hardware and operating systems, and use of public domain data formats. The latter criterion implies the data format should be platform independent and the tools to create the data format should be easily and publicly obtainable or developable. Several examples of attempts at spectral libraries exist, such as the ASTM ANDI format, and the JCAMP-DX format. On the other hand, proprietary library spectra can be exchanged and manipulated using proprietary tools. As the above examples have deficiencies according to the three long term data archiving criteria, Extensible Markup Language (XML; a product of the World Wide Web

  5. Present and future hydropower scheduling in Statkraft

    Science.gov (United States)

    Bruland, O.

    2012-12-01

    Statkraft produces close to 40 TWH in an average year and is one of the largest hydropower producers in Europe. For hydropower producers the scheduling of electricity generation is the key to success and this depend on optimal use of the water resources. The hydrologist and his forecasts both on short and on long terms are crucial to this success. The hydrological forecasts in Statkraft and most hydropower companies in Scandinavia are based on lumped models and the HBV concept. But before the hydrological model there is a complex system for collecting, controlling and correcting data applied in the models and the production scheduling and, equally important, routines for surveillance of the processes and manual intervention. Prior to the forecasting the states in the hydrological models are updated based on observations. When snow is present in the catchments snow surveys are an important source for model updating. The meteorological forecast is another premise provider to the hydrological forecast and to get as precise meteorological forecast as possible Statkraft hires resources from the governmental forecasting center. Their task is to interpret the meteorological situation, describe the uncertainties and if necessary use their knowledge and experience to manually correct the forecast in the hydropower production regions. This is one of several forecast applied further in the scheduling process. Both to be able to compare and evaluate different forecast providers and to ensure that we get the best available forecast, forecasts from different sources are applied. Some of these forecasts have undergone statistical corrections to reduce biases. The uncertainties related to the meteorological forecast have for a long time been approached and described by ensemble forecasts. But also the observations used for updating the model have a related uncertainty. Both to the observations itself and to how well they represent the catchment. Though well known, these

  6. Subcutaneous leiomyosarcoma of scrotum presenting as an exophytic mass: An unusual presentation

    Directory of Open Access Journals (Sweden)

    Ashima Batra

    2015-01-01

    Full Text Available Paratesticular leiomyosarcoma originates from testicular tunica (48%, spermatic cord (48%, epididymis (2% and dartos muscle, as well as subcutaneous tissue of the scrotum (2%. Leiomyosarcomas of the scrotum, not involving the testis, epididymis or spermatic cord, are rare, and belong to the group of subcutaneous superficial leiomyosarcomas. To the knowledge of the authors, less than 10 cases of leiomyosarcoma of the scrotum have so far been reported from India. The tumor usually presents as a painless, slow-growing scrotal mass in middle-aged or elderly men. The current approach is wide local excision, often with adjuvant therapy. The prognosis is usually good following complete excision, though a local recurrence rate of 40% has been reported. Long term follow-up is, therefore, necessary to monitor for recurrence. Herein we present the case of 35-year-old male who presented with an exophytic scrotal mass. Histopathological and immunohistochemical findings of the mass were consistent with leiomyosarcoma.

  7. Past and present Aral Sea

    Science.gov (United States)

    Dukhovniy, Viktor; Stulina, Galina; Eshchanov, Odylbek

    2013-04-01

    The tragedy of disappearing of Aral Sea is well known to the World. Before and after collapse of Soviet Union, a huge quantity of scientific and popular editions described with grief the situation around the Aral Sea. After the NIS states became independent, World Bank, UNDP, UNEP in proper competition with each other had provided some assessment of the situation through presentation of some small and medium grants, but after 2000, the local population remained alone with own problems. Although on the eyes of the present generation a unique transformation of great water body into deserts took place, the global scientific community did not find forces and financing for real and detail investigation of the processes accompanying the Sea shrinking and land formation. We should acknowledge and give big respect to NATO, later to German Government that through GTZ (now GIZ) - German International Collaboration Agency - and GFZ (Potzdam) paid attention to this area of environment crisis and organized scientific and protective design in the so-called Priaralie - the territory around the drying Sea and delta of the two rivers - Amudarya and Syrdarya. Thank to this assistance, the local specialists in collaboration with limited a number of foreign scientists (N.Aladin, P.Zavialov, Joop de Schutter, Hans Wilps, Hedi Oberhansli) organized significant works for detail socioeconomic, ecological and hydrological assessment situation in Priaralie and on the Aral sea coast. On this base, Ministry of Agriculture and Water resources of Uzbekistan and State Committee of Water resources of Kazakhstan developed a plan of rehabilitation of Amudarya and Syrdarya deltas and started implementation of these projects. If Kazakh water authority moved ahead in wetland restoration faster, a forestation of delta and drying bed of Aral Sea got big success in Uzbek territory. 244 thousands hectares of saxsaul and tamarix were planted for protection of the Priaralie. By request of GTZ SIC, ICWC

  8. Como responder ao momento presente?

    Directory of Open Access Journals (Sweden)

    Maria Filomena Molder

    2013-12-01

    Full Text Available http://dx.doi.org/10.5007/1984-784X.2013v13n19p13 Foi com esta pergunta — já um efeito de um primeiro encontro entre Irene Pimentel e eu própria — que decidimos desafiar colegas, estudantes e funci­onários da nossa Faculdade, FCSH (Faculdade de Ciências Sociais e Huma­nas, de outras Faculdades da Universidade Nova de Lisboa, de outras Uni­versidades e todos os interessados em con­siderar e discutir em comum aquilo que se passava em Portugal e que no anúncio da Jornada de 6 de De­zembro de 2012 se descrevia como um “processo de desmantela­mento social, económico e cultural sem precedentes — pese embora tantas compara­ções, baseadas na premissa da ‘eterna repetição’ — e cujas consequências não param de exceder as previsões dos responsáveis por esse desmantelamento”. Acedendo com todo o empenho e gratidão ao convite que me foi dirigido por Humberto Brito para fazer uma resenha da Jornada a publicar no primeiro número de Forma de Vida (saúdo a revista e o título, decidi-me, no entanto, a pôr de lado a resenha, que sob a forma de “Editorial” será em breve publi­cada no blogue Responder ao Momento Presente, entre­tanto criado, conjuntamente com os textos escritos pelos nossos convidados, com as parti­cipações de pessoas que corresponderam ao nosso apelo e ainda com contri­bui­ções que se alargaram para lá da Jornada; a que se juntará uma gravação em video, também disponível no Youtube.   Texto publicado originalmente em Forma de Vida, Lisboa, n.1, fev. 2013. Agrade­cemos à autora por permitir a republicação neste número do Boletim. [N.E.

  9. Como responder ao momento presente?

    Directory of Open Access Journals (Sweden)

    Maria Filomena Molder

    2013-06-01

    Full Text Available Foi com esta pergunta — já um efeito de um primeiro encontro entre Irene Pimentel e eu própria — que decidimos desafiar colegas, estudantes e funci­onários da nossa Faculdade, FCSH (Faculdade de Ciências Sociais e Huma­nas, de outras Faculdades da Universidade Nova de Lisboa, de outras Uni­versidades e todos os interessados em con­siderar e discutir em comum aquilo que se passava em Portugal e que no anúncio da Jornada de 6 de De­zembro de 2012 se descrevia como um “processo de desmantela­mento social, económico e cultural sem precedentes — pese embora tantas compara­ções, baseadas na premissa da ‘eterna repetição’ — e cujas consequências não param de exceder as previsões dos responsáveis por esse desmantelamento”. Acedendo com todo o empenho e gratidão ao convite que me foi dirigido por Humberto Brito para fazer uma resenha da Jornada a publicar no primeiro número de Forma de Vida (saúdo a revista e o título, decidi-me, no entanto, a pôr de lado a resenha, que sob a forma de “Editorial” será em breve publi­cada no blogue Responder ao Momento Presente, entre­tanto criado, conjuntamente com os textos escritos pelos nossos convidados, com as parti­cipações de pessoas que corresponderam ao nosso apelo e ainda com contri­bui­ções que se alargaram para lá da Jornada; a que se juntará uma gravação em video, também disponível no Youtube. Texto publicado originalmente em Forma de Vida, Lisboa, n.1, fev. 2013. Agrade­cemos à autora por permitir a republicação neste número do Boletim. [N.E.

  10. HOME LONG-TERM CARE IN POLAND

    Directory of Open Access Journals (Sweden)

    Ewa Kułagowska

    2011-06-01

    Full Text Available The considerable proportion of the elderly, the chronically ill and the disabled in community is an economic and organizational challenge for the state social policy. It requires a large, steadily increasing financing from the public funds and creating an optional care model to fulfill the needs of citizens and guarantee high quality services. Development of the long-term care is one of the problems to be solved. This paper presents: – a long-term care forms, organization and tasks; – a role of long-term care but particularly home longterm care to protect health in Poland; – problems related with home long-term care functioning.

  11. Cutaneous presentation of Double Hit Lymphoma

    Directory of Open Access Journals (Sweden)

    Yousef Khelfa MD, FACP

    2016-04-01

    Full Text Available Diffuse large B-cell lymphoma (DLBCL is the most common type of non-Hodgkin lymphoma (NHL, representing approximately 25% of diagnosed NHL. DLBCL is heterogeneous disease both clinically and genetically. The 3 most common chromosomal translocations in DLBCL involve the oncogenes BCL2, BCL6, and MYC. Double hit (DH DLBCL is an aggressive form in which MYC rearrangement is associated with either BCL2 or BCL6 rearrangement. Patients typically present with a rapidly growing mass, often with B symptoms. Extranodal disease is often present. Though there is a paucity of prospective trials in this subtype, double hit lymphoma (DHL has been linked to very poor outcomes when patients are treated with standard R-CHOP. There is, therefore, a lack of consensus regarding the standard treatment for DHL. Several retrospective analyses have been conducted to help guide treatment of this disease. These suggest that DA EPOCH-R may be the most promising regimen and that achievement of complete resolution predicts better long-term outcomes.

  12. Molecularly Imprinted Polymers: Present and Future Prospective

    Science.gov (United States)

    Vasapollo, Giuseppe; Sole, Roberta Del; Mergola, Lucia; Lazzoi, Maria Rosaria; Scardino, Anna; Scorrano, Sonia; Mele, Giuseppe

    2011-01-01

    Molecular Imprinting Technology (MIT) is a technique to design artificial receptors with a predetermined selectivity and specificity for a given analyte, which can be used as ideal materials in various application fields. Molecularly Imprinted Polymers (MIPs), the polymeric matrices obtained using the imprinting technology, are robust molecular recognition elements able to mimic natural recognition entities, such as antibodies and biological receptors, useful to separate and analyze complicated samples such as biological fluids and environmental samples. The scope of this review is to provide a general overview on MIPs field discussing first general aspects in MIP preparation and then dealing with various application aspects. This review aims to outline the molecularly imprinted process and present a summary of principal application fields of molecularly imprinted polymers, focusing on chemical sensing, separation science, drug delivery and catalysis. Some significant aspects about preparation and application of the molecular imprinting polymers with examples taken from the recent literature will be discussed. Theoretical and experimental parameters for MIPs design in terms of the interaction between template and polymer functionalities will be considered and synthesis methods for the improvement of MIP recognition properties will also be presented. PMID:22016636

  13. Molecularly Imprinted Polymers: Present and Future Prospective

    Directory of Open Access Journals (Sweden)

    Giuseppe Vasapollo

    2011-09-01

    Full Text Available Molecular Imprinting Technology (MIT is a technique to design artificial receptors with a predetermined selectivity and specificity for a given analyte, which can be used as ideal materials in various application fields. Molecularly Imprinted Polymers (MIPs, the polymeric matrices obtained using the imprinting technology, are robust molecular recognition elements able to mimic natural recognition entities, such as antibodies and biological receptors, useful to separate and analyze complicated samples such as biological fluids and environmental samples. The scope of this review is to provide a general overview on MIPs field discussing first general aspects in MIP preparation and then dealing with various application aspects. This review aims to outline the molecularly imprinted process and present a summary of principal application fields of molecularly imprinted polymers, focusing on chemical sensing, separation science, drug delivery and catalysis. Some significant aspects about preparation and application of the molecular imprinting polymers with examples taken from the recent literature will be discussed. Theoretical and experimental parameters for MIPs design in terms of the interaction between template and polymer functionalities will be considered and synthesis methods for the improvement of MIP recognition properties will also be presented.

  14. Localization beyond the diffraction limit (Conference Presentation)

    Science.gov (United States)

    Petrov, Petar N.; Shechtman, Yoav; Moerner, William E.

    2017-02-01

    Point spread function (PSF) engineering has extended far-field localization microscopy into three dimensions by encoding the axial position of each emitter into the shape of its image on the detector. By fitting the observed PSF to a model function, one can extract position information with sub-diffraction precision. However, in practice this procedure is often complicated by optical aberrations present in the imaging system, which distort the shape of the observed PSF relative to the model function. The mismatch between the model and observed PSFs can limit the accuracy and precision achieved by the localization procedure. Here, we present a simple method to experimentally improve the model PSF by phase retrieval of the pupil function of the imaging system using a set of images of an isolated emitter at different displacements from the focal plane. The pupil function is estimated by adding a phase term consisting of a combination of Zernike modes to the theoretical electric field at the back focal plane of the microscope. The amplitudes of the Zernike modes are determined by maximizing the likelihood function over all pixels in the experimental data set. Importantly, since all data is taken with the phase mask in place, we account for any aberrations it introduces. Using the resulting pupil function, we generate a model PSF which is significantly improved over the theoretical model in both the accuracy and precision of experimental emitter localizations. We also provide a MATLAB package which performs the entire fitting procedure, from phase retrieval to single-emitter localization.

  15. Acute neck pain, an atypical presentation of subarachnoid haemorrhage

    OpenAIRE

    Ahmed, Julian; Blakeley, Chris; Sakar, Ramy; Aktar, Khalida; Hashemi, Kambiz

    2007-01-01

    Subarachnoid haemorrhage can be a massively debilitating condition with long‐term repercussions. The “classic” presentation of sudden‐onset severe headache normally raises suspicions. However, if the presentation is atypical, the diagnosis may be missed. We report on a 52‐year‐old man who presented with a 1‐day history of progressively worsening right‐sided neck pain spreading to the chest with associated symptoms of autonomic dysfunction. After initial stabilisation, the patient's Glasgow Co...

  16. Measurement of Driving Terms

    CERN Document Server

    Schmidt, F; Faus-Golfe, A

    2001-01-01

    In 2000 a series of MDs has been performed at the SPS to measure resonance driving terms. Theory predicts that these terms can be determined by harmonic analysis of BPM data recorded after applying single kicks at various amplitudes. Strong sextupoles were introduced to create a sizeable amount of nonlinearities. Experiments at injection energy (26 GeV) with single bunch as well as one experiment at 120 GeV with 84 bunches were carried out. The expected nonlinear content is compared to the experimenteal observation.

  17. Present status of iodine research at IPSN

    Energy Technology Data Exchange (ETDEWEB)

    Bardelay, J. [IPSN/DPEA/SEAC (France)

    1996-12-01

    Since several years, IPSN has conducted an effort in order to evaluate the release of radioactive iodine in case of hypothetical severe accident in a realistic manner. This source-term evaluation is performed with IODE code which is a module of the EXCADRE system of codes. This code is validated against: -analytical experiments: in these experiments, IPSN studies radiolytic effects and chemical processes in the sump, organic formation, mass transfer, effect of spray (CARAIDAS experiment), - the CAIMAN semi global experiment; this experiment will allow to study the phenomena linked to iodine behavior under representative containment geometry in the presence of painted surfaces and global irradiation, - the PHEBUS FP program. The paper consists to describe succinctly the current status of IODE and the various experiments for its validation. In case of hypothetical severe accident iodine can induce important perturbations of human organism. The effects are principally radiological, in particular on the thyroid. At short term, radioactive iodine is the most important contributor for the sanitary risk. It represents 55% of effective dose and 92% of thyroid dose at 10 km in case of controlled rejects with current assumptions. This is the reason why it must be actively studied. In France, the safety evaluations are performed with mechanistic codes or lumped parameter codes like EXCADRE which contains a module devoted to iodine studies: IODINE. The objective of the French experimental program on iodine is to understand and quantify important phenomena in order to put kinetic parameters in IODE module. The experiments can be classified in analytical experiments, the semi-global experiment CAIMAN which takes into account different phenomena studied in analytical experiments and the global experiment PHEBUS PF, not only devoted to iodine behavior study. In the following text we will present the needs of IODINE code and these different experiments. (author).

  18. Past and present floods in South Moravia

    Science.gov (United States)

    Brázdil, Rudolf; Chromá, Kateřina; Řezníčková, Ladislava; Valášek, Hubert; Dolák, Lukáš; Stachoň, Zdeněk; Soukalová, Eva; Dobrovolný, Petr

    2015-04-01

    Floods represent the most destructive natural phenomena in the Czech Republic, often causing great material damage or loss of human life. Systematic instrumental measurements of water levels in Moravia (the eastern part of the Czech Republic) started mainly in the 1880s-1890s, while for discharges it was in the 1910s-1920s. Different documentary evidence allows extension of our knowledge about floods prior the instrumental period. The paper presents long-term flood chronologies for four South Moravian rivers: the Jihlava, the Svratka, the Dyje and the Morava. Different documentary data are used to extract floods. Taxation records are of particular importance among them. Since the mid-17th century, damage to property and land (fields, meadows, pastures or gardens) entitled farmers and landowners to request a tax relief. Related documents of this administration process kept mainly in Moravian Land Archives in Brno allow to obtain detail information about floods and their impacts. Selection of floods in the instrumental period is based on calculation of N-year return period of peak water levels and/or peak discharges for selected hydrological stations of the corresponding rivers (with return period of two years and more). Final flood chronologies combine floods derived from both documentary data and hydrological measurements. Despite greater inter-decadal variability, periods of higher flood frequency are c. 1821-1850 and 1921-1950 for all four rivers; for the Dyje and Morava rivers also 1891-1900. Flood frequency fluctuations are further compared with other Central European rivers. Uncertainties in created chronologies with respect to data and methods used for compilation of long-term series and anthropogenic changes in river catchments are discussed. The study is a part of the research project "Hydrometeorological extremes in Southern Moravia derived from documentary evidence" supported by the Grant Agency of the Czech Republic, reg. no. 13-19831S.

  19. Long-Term Collections

    CERN Multimedia

    Comité des collectes à long terme

    2011-01-01

    It is the time of the year when our fireman colleagues go around the laboratory for their traditional calendars sale. A part of the money of the sales will be donated in favour of the long-term collections. We hope that you will welcome them warmly.

  20. Multicystic encephalomalacia in term infants.

    Science.gov (United States)

    Frigieri, G; Guidi, B; Costa Zaccarelli, S; Rossi, C; Muratori, G; Ferrari, F; Cavazzuti, G B

    1996-12-01

    The terms "multicystic encephalomalacia" and "subcortical leucomalacia" (SCL) are used to describe the presence of areas of necrosis that develop into cystic lesions inside the brain. These lesions are generally due to severe asphyxia and/or hypotension. The designation SCL can also be used to describe the extent and the seat of the lesion in the brain or to distinguish subcortical lesions from periventricular and/or combined ones. In this study we give an account of our experience with eight newborns admitted to our neonatal intensive care unit, who presented clinical-neurological alterations and encephalomalacic lesions whose presence was documented by ultrasonography.

  1. AN EXPERIMENTAL THESAURUS OF INDEX TERMS FOR DOCUMENTS IN MUSIC.

    Science.gov (United States)

    CADY, HENRY L.; SCHNEIDER, ERWIN H.

    A LISTING OF RETRIEVAL TERMS FOR DOCUMENTS IN MUSIC IS PRESENTED IN THIS EXPERIMENTAL THESAURUS. INCLUDED IN THE LISTING ARE "USE" ENTRIES WHICH DIRECT THE THESAURUS USER TO PREFERRED TERMS. (SEE ED 010 298.) (GC)

  2. A new five-term simple chaotic attractor

    Energy Technology Data Exchange (ETDEWEB)

    Munmuangsaen, Buncha [Sirindhorn International Institute of Technology, Thammasat University, 131 M.5, Tivanont Road, Bangkadi, Muang, Pathum-Thani, 12000 (Thailand); Srisuchinwong, Banlue, E-mail: banlue@siit.tu.ac.t [Sirindhorn International Institute of Technology, Thammasat University, 131 M.5, Tivanont Road, Bangkadi, Muang, Pathum-Thani, 12000 (Thailand)

    2009-10-26

    A new chaotic attractor is presented with only five terms in three simple differential equations having fewer terms and simpler than those of existing seven-term or six-term chaotic attractors. Basic dynamical properties of the new attractor are demonstrated in terms of equilibria, Jacobian matrices, non-generalized Lorenz systems, Lyapunov exponents, a dissipative system, a chaotic waveform in time domain, a continuous frequency spectrum, Poincare maps, bifurcations and forming mechanisms of its compound structures.

  3. Eponymous Terms of Architecture, Art and Building

    Directory of Open Access Journals (Sweden)

    Laimutė Kitkauskienė

    2011-06-01

    Full Text Available The article discusses the importance of terms in subject- matter conversation. The issue of architecture as being the crossing of science and art is reminded of. Eponymous terms are defined. The opinion is held that such a term which is a person’s name, the name of a city, village, of some other geographical place, of a country or nation, as well as of a tribe included in its structure, can be called an eponymous term. The Lithuanian terms of such a kind were not discussed till now, that’s why the article could give the start for discussions or for more thorough studies in this field. Logical – semantic links between the eponymous term and its original source (the proper name are examined. As one-word terms are loans, or borrowings, their original source is indicated. A lot of material is presented, and it could help to determine and identify the main ways of the formation of eponymous terms as well as their structural patterns. The given patterns could be successfully applied in forming the terms of other special fields.

  4. Weight management in obesity - past and present.

    Science.gov (United States)

    Haslam, D

    2016-03-01

    To describe the treatment of obesity from ancient times to present day. Articles reporting the development of anti-obesity therapies were identified through a search for 'anti-obesity' AND 'pharmacotherapy' AND 'development' within the title or abstract on PubMed and 'obesity' in ClinicalTrials.gov. Relevant articles and related literature were selected for inclusion. Stone-age miniature obese female statuettes indicate the existence and cultural significance of obesity as long as 30,000 years ago. Records from Ancient Egyptian and Biblical eras through Greco-Roman to Medieval times indicate that obesity was present throughout the major periods of history, although peoples of previous centuries would probably have experienced overweight and obesity as exceptional rather than normal. Health risks of obesity were noted by the Greek physician Hippocrates (460-377 BCE) when the earliest anti-obesity recommendations on diet, exercise, lifestyle and use of emetics and cathartics were born. These recommendations remained largely unchanged until the early 20th century, when spreading urbanisation, increasingly sedentary jobs and greater availability of processed foods produced a sharp rise in obesity. This led to the need for new, more effective, ways to lose weight, to address comorbidities associated with obesity, and to attain the current cultural ideal of slimness. Drug companies of the 1940s and 1950s produced a series of anti-obesity pharmacotherapies in short succession, based largely on amphetamines. Increased regulation of drug development in the 1960s and new efficacy requirements for weight-loss drugs led to rapid reduction in anti-obesity therapies available by the early 1990s. In the last two decades, several new and emerging therapies have been approved or are in development to provide safe, long-term pharmacological agents for the treatment of obesity. © 2016 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd.

  5. Congenital Diaphragmatic Hernia with Delayed Presentation

    Directory of Open Access Journals (Sweden)

    Alireza Malekzadegan

    2016-01-01

    Full Text Available Congenital diaphragmatic hernia (CDH is caused due to abnormal formation of the muscular parts of diaphragm. The incidence of CDH in common births ranges from 1/25000 to 1/30000. Pulmonary hypoplasia and pulmonary hypertension are factors that associate with the increase of mortality and morbidity due to CDH. We presented a 68-year-old Iranian woman with abdominal pain and tenderness in right upper quadrant who was diagnosed as having CDH. The disease was detected using chest X-ray and chest and abdomen sonography and confirmed with chest and abdomen CT scan with and without oral contrast. A defect was revealed in posterolateral right diaphragm with omentum and transverse colon herniated through it. Right posterolateral thoracotomy was performed to cure the disease. CT and CXR were the two useful methods in diagnosis of CDH in this patient, although CDH detection prior to surgery is too challenging because of rare cases and different types of CDH. In order to improve clinical cares in adult CDH patients, investigating more cases and long term follow-up are recommended.

  6. Laboratory dialysis--past, present and future.

    Science.gov (United States)

    Bansal, Parikshit; Ajay, Dara

    2012-04-01

    Laboratory dialysis, one of the most widely used techniques in biological research is truly a ' gateway technology' . The analogy is to that of a ' gate' of a building through which everybody has to pass, even though they may wish to go to different departments. Similarly, researchers may be working in altogether different areas but all may need to use laboratory dialysis at one stage or the other during the course of their research. Biochemists may use it to purify enzymes, an immunologist may use it to purify monoclonal antibodies from culture supernatants, a chemist may use it as a step in the crystallography process or for purification of ionic liquids, a biotechnologist may use it to study the effectiveness of enzyme immobilization and a drug discovery scientist may use it for determining drug-protein interaction. The present article reviews patents in the field of laboratory dialysis from inception till date, focusing on the various developmental and innovation related milestones during evolution of the technique. It captures the full panorama of a very interesting technique which continues to be as relevant today as it was in 1866 when the term ' dialysis' was first coined.

  7. [Bilateral ovarian Burkitt's lymphoma. A case presentation].

    Science.gov (United States)

    Briseño-Hernández, Andrés Alejandro; Quezada-López, Deissy Roxana; Castañeda-Chávez, Agar; Dassaejv Macías-Amezcua, Michel; Pintor-Belmontes, Julio Cesar

    2014-01-01

    Burkitt lymphoma, is described as an aggressive form of non-Hodgkin lymphoma of B cells which occurs most often in children and young adults, ovarian lymphoma can appear as a primary lesion or more commonly referred to as a metastasis. Primary ovarian lesions are rare manifestations corresponding to 0.5% of non-Hodgkin lymphoma and 1.5% of ovarian tumors. Clinic case: 31 years old female with general weakness, march incapacity, dyspnea, hyporexia, fever, diaphoresis, weight loss of 20 kg, flat abs with abdominal pain; Ca125 610 U/ml. Abdominal computed tomography shows a solid aspect tumor which affects the right pelvic cavity. Bilateral ovarian tumors were removed. Microscopically, both lesions show a "starry sky" pattern composed by a monotonous infiltration of lymphocytes mixed with large and clear macrophages, several atypical mitoses, and necrosis and hemorrhage areas. Immunohistochemistry was positive for CD10, CD20, and negative for CD3 and high Ki67 proliferation index. Bilateral ovarian Burkitt's lymphoma was diagnosed. Bilateral ovarian Burkitt's lymphoma is a rare entity, with a variability of presentations, the abdominal pain and abdominal tumors are the most frequent. The patient's prognosis at short term is poor, therefore it's necessary to know this entity and make an early diagnosis.

  8. Antireflux Endoluminal Therapies: Past and Present

    Directory of Open Access Journals (Sweden)

    Kuo Chao Yew

    2013-01-01

    Full Text Available The basic principle of antireflux procedures employing endoscopic intervention aims to create a mechanical barrier to prevent primary pathophysiology in gastroesophageal reflux disease (GERD. We review, highlight, and discuss the past and present status of endoluminal therapy. Currently, there are 3 commonly employed anti-reflux endoluminal procedures: fundoplication or suturing techniques (EndoCinch, NDO, and EsophyX, intramural injection or implant techniques (enhancing lower esophageal sphincter (LES volume and/or strengthening compliance of the LES-Enteryx and Gatekeeper, and radiofrequency ablation of LES and cardia. EndoCinch plication requires further study and modification of technique before it can be recommended because of durability issues. Esophynx, the transoral incisionless fundoplication, may reduce hiatal hernias and increase LES length. Preliminary studies have shown promising reduction in symptoms and medication use but evidence concerning safety and long-term durability is still pending. The safety issue with injection technique is the main concern as evident from the incidences of implant withdrawals after reported major adverse events. Future research with cautious monitoring is required before any new implant material can be recommended for commercial application. Radiofrequency ablation therapy is regaining popularity in treating refractory symptoms despite PPI use due to improved efficacy, durability, and safety after years of refinement of protocol.

  9. Half term report

    CERN Multimedia

    2011-01-01

    This week marks the mid-point of my mandate as Director General, so what better time to take stock of the last two and a half years and look forward to the next?    On the surface, the report is good. The LHC is performing well, Council has just approved our medium term plan, and the there seem to be few clouds on CERN’s long-term horizon. It’s precisely at times like this, however, that complacency would be most dangerous. The world is still in the grip of an economic crisis, and recovery in our Member States is slow. CERN is still in debt, as are our social security systems. We are working on this, but these factors need constant and careful attention. While we need to remain vigilant, I’d like to focus on the positives for my mid term message. Let’s start with the LHC. The machine’s performance this year has been fantastic. We achieved our target luminosity for the year in June, which augurs well for the summer conferences. I don&r...

  10. Rheumatoid arthritis phenotype at presentation differs depending on the number of autoantibodies present.

    Science.gov (United States)

    Derksen, V F A M; Ajeganova, S; Trouw, L A; van der Helm-van Mil, A H M; Hafström, I; Huizinga, T W J; Toes, R E M; Svensson, B; van der Woude, D

    2017-04-01

    In rheumatoid arthritis (RA), seropositive and seronegative disease may be two entities with different underlying pathophysiological mechanisms, long-term outcomes and disease presentations. However, the effect of the conjoint presence of multiple autoantibodies, as proxy for a more pronounced humoral autoimmune response, on clinical phenotype remains unclear. Therefore, this study investigates the association between the number of autoantibodies and initial clinical presentation in two independent cohorts of patients with early RA. Autoantibody status (rheumatoid factor, anticitrullinated protein antibodies and anticarbamylated protein antibodies) was determined at baseline in the Leiden Early Arthritis Cohort (n=828) and the Swedish BARFOT (Better Anti-Rheumatic Farmaco-Therapy, n=802) study. The association between the number of autoantibodies and baseline clinical characteristics was investigated using univariable and multivariable ordinal regression. In both cohorts, the following independent associations were found in multivariable analysis: patients with a higher number of RA-associated antibodies were younger, more often smokers, had a longer symptom duration and a higher erythrocyte sedimentation rate at presentation compared with patients with few autoantibodies. The number of autoantibodies, reflecting the breadth of the humoral autoimmune response, is associated with the clinical presentation of RA. Predisease pathophysiology is thus reflected by the initial clinical phenotype. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. Short-term and long-term deflection of reinforced hollow core ...

    African Journals Online (AJOL)

    This paper presents a study on different methods of analysis that are currently used by design codes to predict the short-term and long-term deflection of reinforced concrete slab systems and compares the predicted deflections with measured deflections. The experimental work to measure deflections involved the testing of ...

  12. IVF culture media: past, present and future.

    Science.gov (United States)

    Chronopoulou, Elpiniki; Harper, Joyce C

    2015-01-01

    The advances in the world of IVF during the last decades have been rapid and impressive and culture media play a major role in this success. Until the 1980s fertility centers made their media in house. Nowadays, there are numerous commercially available culture media that contain various components including nutrients, vitamins and growth factors. This review goes through the past, present and future of IVF culture media and explores their composition and quality assessment. A computerized search was performed in PubMed regarding IVF culture media including results from 1929 until March 2014. Information was gathered from the websites of companies who market culture media, advertising material, instructions for use and certificates of analysis. The regulation regarding IVF media mainly in the European Union (EU) but also in non-European countries was explored. The keyword 'IVF culture media' gave 923 results in PubMed and 'embryo culture media' 12 068 results dating from 1912 until March 2014, depicting the increased scientific activity in this field. The commercialization of IVF culture media has increased the standards bringing a great variety of options into clinical practice. However, it has led to reduced transparency and comparisons of brand names that do not facilitate the scientific dialogue. Furthermore, there is some evidence suggesting that suboptimal culture conditions could cause long-term reprogramming in the embryo as the periconception period is particularly susceptible to epigenetic alterations. IVF media are now classified as class III medical devices and only CE (Conformité Européene)-marked media should be used in the EU. The CE marking of IVF culture media is a significant development in the field. However, the quality and efficiency of culture media should be monitored closely. Well-designed randomized controlled trials, large epidemiological studies and full transparency should be the next steps. Reliable, standardized models assessing

  13. Single term off-line coins

    Science.gov (United States)

    Ferguson, Niels T.

    1993-03-01

    A construction for offline electronic coins that is both far more efficient and much simpler than previous systems is presented. Instead of using many terms, each for a single bit of the challenge, the system uses a single term for a large number of possible challenges. The withdrawal protocol does not use a cut and choose methodology as with earlier systems, but uses a direct construction.

  14. Pleuropulmonary blastoma presenting as a complicated pleural effusion.

    LENUS (Irish Health Repository)

    O'Brien, J

    2012-02-01

    Pleuropulmonary blastoma (PPB) is a rare tumour of mesenchymal cells. We present a case of PPB in a child, which presented to the emergency department with an extensive pleural effusion. We discuss the radiological features, pathology, classification and treatment of this condition. This case reiterates the importance of considering this diagnosis prior to surgical intervention, to improve the long term prognosis of this aggressive disease.

  15. Voriconazole-related periostitis presenting on magnetic resonance imaging.

    Science.gov (United States)

    Davis, Derik L

    2015-01-01

    Painful periostitis is a complication of long-term antifungal therapy with voriconazole. A high clinical suspicion coupled with imaging and laboratory assessment is useful to establish the diagnosis. Prompt discontinuance of voriconazole typically results in the resolution of symptoms and signs. This report describes the presentation of voriconazole-related periostitis on magnetic resonance imaging.

  16. Mood disorders and season of presentation: A preliminary study of ...

    African Journals Online (AJOL)

    The relationship between season and mood is complex. This study attempts to clarify one aspect of the relationship: the impact of season on mood in terms of the hypothesised seasonal variation in the presentation of mood disorders at Baragwanath Hospital. Although a preliminary study, the results show a statistically ...

  17. Word Spelling Assessment Using ICT: The Effect of Presentation Modality

    Science.gov (United States)

    Sarris, Menelaos; Panagiotakopoulos, Chris

    2010-01-01

    Up-to-date spelling process was assessed using typical spelling-to-dictation tasks, where children's performance was evaluated mainly in terms of spelling error scores. In the present work a simple graphical computer interface is reported, aiming to investigate the effects of input modality (e.g. visual and verbal) in word spelling. The software…

  18. Choroid Plexus A-V Malformation Presenting with IVH

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-12-01

    Full Text Available A term infant presenting on the second day with apnea and decerebrate posturing had an intraventricular hemorrhage (IVH, the result of an arteriovenous malformation of the choroid plexus demonstrated angiographically on the 3rd day and reported from Johns Hopkins Hospital.

  19. Nocardia liver abscess post liver transplantation-A rare presentation.

    Science.gov (United States)

    Hanchanale, Pavan; Jain, Mayank; Varghese, Joy; V, Jayanthi; Rela, Mohamed

    2017-04-01

    Nocardiosis is usually a disseminated disease seen in immunocompromised individuals. We herein present a rare case of isolated Nocardia liver abscess post liver transplantation. The patient responded well to treatment and is on long-term antibiotics for Nocardia infection. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. The Balloon Foot ; A Rare Presentation Of Congenital Constricting ...

    African Journals Online (AJOL)

    We present a case of a rare manifestation of congenital constricting annular band (CAB) in the lower extremity resulting in a severe excessive swelling of the foot which we have termed Balloon foot. The ballooned foot is caused by a progressive deepening of the circumferential constriction into the soft tissue of the lower ...

  1. Torsion of the Spermatic Cord: An Exemplary Early Presentation

    African Journals Online (AJOL)

    2017-10-26

    Oct 26, 2017 ... How to cite this article: Oluyemi OY. Torsion of the spermatic cord: an exemplary early presentation. Niger J Clin Pract 2017;XX;000-000. This is an open access article distributed under the terms of the Creative Commons. Attribution-Non Commercial-Share Alike 3.0 License, which allows others to remix,.

  2. Chronic myeloid leukaemia presenting with priapism as the only ...

    African Journals Online (AJOL)

    Objective: There have been few reports of priapism as complications of various haematological malignancies. Delays in establishing the cause and late institution of appropriate intervention in patients suffering from priapism could result in long-term complications, especially erectile dysfunction. We present here a case of ...

  3. Using electrophysiology to demonstrate that cueing affects long-term memory storage over the short term

    National Research Council Canada - National Science Library

    Maxcey, Ashleigh M; Fukuda, Keisuke; Song, Won S; Woodman, Geoffrey F

    2015-01-01

    .... We tested the hypothesis that cues presented during a stream of objects, followed by a short retention interval and immediate memory test, can change how information is handled by long-term memory...

  4. Neutrino oscillations: Present status and outlook

    Indian Academy of Sciences (India)

    more, an outlook on the measurement of the mixing angle θ13 in the near term future, as well as prospects to discover CP violation in neutrino oscillations and to determine the type of the neutrino mass ordering by long-baseline experiments in the long term future are given. Keyword. Neutrino oscillations. PACS Nos 14.60.

  5. Long-Term Collections

    CERN Multimedia

    Staff Association

    2016-01-01

    45 years helping in developing countries! CERN personnel have been helping the least fortunate people on the planet since 1971. How? With the Long-Term Collections! Dear Colleagues, The Staff Association’s Long-Term Collections (LTC) Committee is delighted to share this important milestone in the life of our Laboratory with you. Indeed, whilst the name of CERN is known worldwide for scientific discoveries, it also shines in the many humanitarian projects which have been supported by the LTC since 1971. Several schools and clinics, far and wide, carry its logo... Over the past 45 years, 74 projects have been supported (9 of which are still ongoing). This all came from a group of colleagues who wanted to share a little of what life offered them here at CERN, in this haven of mutual understanding, peace and security, with those who were less fortunate elsewhere. Thus, the LTC were born... Since then, we have worked as a team to maintain the dream of these visionaries, with the help of regular donat...

  6. Long-Term Collection

    CERN Multimedia

    Staff Association

    2016-01-01

    Dear Colleagues, As previously announced in Echo (No. 254), your delegates took action to draw attention to the projects of the Long-Term Collections (LTC), the humanitarian body of the CERN Staff Association. On Tuesday, 11 October, at noon, small Z-Cards were widely distributed at the entrances of CERN restaurants and we thank you all for your interest. We hope to have achieved an important part of our goal, which was to inform you, convince you and find new supporters among you. We will find out in the next few days! An exhibition of the LTC was also set up in the Main Building for the entire week. The Staff Association wants to celebrate the occasion of the Long-Term Collection’s 45th anniversary at CERN because, ever since 1971, CERN personnel have showed great support in helping the least fortunate people on the planet in a variety of ways according to their needs. On a regular basis, joint fundraising appeals are made with the Directorate to help the victims of natural disasters around th...

  7. Collectes à long terme

    CERN Multimedia

    Collectes à long terme

    2014-01-01

    En cette fin d’année 2014 qui approche à grands pas, le Comité des Collectes à Long Terme remercie chaleureusement ses fidèles donatrices et donateurs réguliers pour leurs contributions à nos actions en faveur des plus démunis de notre planète. C’est très important, pour notre Comité, de pouvoir compter sur l’appui assidu que vous nous apportez. Depuis plus de 40 ans maintenant, le modèle des CLT est basé principalement sur des actions à long terme (soit une aide pendant 4-5 ans par projet, mais plus parfois selon les circonstances), et sa planification demande une grande régularité de ses soutiens financiers. Grand MERCI à vous ! D’autres dons nous parviennent au cours de l’année, et ils sont aussi les bienvenus. En particulier, nous tenons à remercier...

  8. Hybrid codes: Past, present and future

    Science.gov (United States)

    Winske, D.; Yin, L.

    Hybrid codes, in which the ions are treated kinetically and the electrons are assumed to be a massless fluid, have been widely used in space physics over the past two decades. These codes are used to model phenomena that occur on ion inertia and gyroradius scales, which fall between longer scales obtained by magnetohydrodynamic simulations and shorter scales attainable by full particle simulations. In this tutorial, the assumptions and equations of the hybrid model are discussed along with some most commonly used numerical implementations. Examples of results of two-dimensional hybrid simulations are used to illustrate the method, to indicate some of the tradeoffs that need to be addressed in a realistic calculation, and to demonstrate the utility of the technique for problems of contemporary interest. Some speculation about the future direction of space physics research using hybrid codes is also provided. 1 Hybrid codes: Past Generally, the term "hybrid code" in plasma physics can refer to any simulation model in which one or more of the plasma species are treated as a single or multiple fluids, while the remaining species are treated kinetically as particles. The plasma can be coupled to the electromagnetic fields in a variety of ways: full Maxwell equations, low-frequency Darwin model, electrostatic only, etc. In this tutorial, we shall concentrate only on the most common type of hybrid code used in space plasmas: where all the ions are treated kinetically, the electrons are assumed to be an inertia-less and quasineutral fluid, and the electromagnetic fields are treated in the low-frequency approximation. Because this tutorial is being presented in the context of the International School for Space Simulation (ISSS), we will mostly restrict the discussion of "past" uses of hybrid methods in space physics to the articles published in the previous schools. Those articles give appropriate and timely

  9. Orbital Debris: Past, Present, and Future

    Science.gov (United States)

    Stansbery, Gene; Johnson, Nicholas

    2013-01-01

    In the early days of spaceflight, the gBig Sky h theory was the near universally accepted paradigm for dealing with collisions of orbiting objects. This theory was also used during the early years of the aviation industry. Just as it did in aviation, the gBig Sky h theory breaks down as more and more objects accumulate in the environment. Fortunately, by the late 1970 fs some visionaries in NASA and the US Department of Defense (DoD) realized that trends in the orbital environment would inevitably lead to increased risks to operational spacecraft from collisions with other orbiting objects. The NASA Orbital Debris Program was established at and has been conducted at Johnson Space Center since 1979. At the start of 1979, fewer than 5000 objects were being tracked by the US Space Surveillance Network and very few attempts had been made to sample the environment for smaller sizes. Today, the number of tracked objects has quadrupled. Ground ]based and in situ measurements have statistically sampled the LEO environment over most sizes and mitigation guidelines and requirements are common among most space faring nations. NASA has been a leader, not only in defining the debris environment, but in promoting awareness of the issues in the US and internationally, and in providing leadership in developing policies to address the issue. This paper will discuss in broad terms the evolution of the NASA debris program from its beginnings to its present broad range of debris related research. The paper will discuss in some detail current research topics and will attempt to predict future research trends.

  10. Clinical presentation and evaluation of dermatomyositis.

    Science.gov (United States)

    Marvi, Umaima; Chung, Lorinda; Fiorentino, David F

    2012-09-01

    Dermatomyositis (DM) is a chronic inflammatory disorder of the skin and muscles. Evidence supports that DM is an immune-mediated disease and 50-70% of patients have circulating myositis-specific auto-antibodies. Gene expression microarrays have demonstrated upregulation of interferon signaling in the muscle, blood, and skin of DM patients. Patients with classic DM typically present with symmetric, proximal muscle weakness, and skin lesions that demonstrate interface dermatitis on histopathology. Evaluation for muscle inflammation can include muscle enzymes, electromyogram, magnetic resonance imaging, and/or muscle biopsy. Classic skin manifestations of DM include the heliotrope rash, Gottron's papules, Gottron's sign, the V-sign, and shawl sign. Additional cutaneous lesions frequently observed in DM patients include periungual telangiectasias, cuticular overgrowth, "mechanic's hands", palmar papules overlying joint creases, poikiloderma, and calcinosis. Clinically amyopathic DM is a term used to describe patients who have classic cutaneous manifestations for more than 6 months, but no muscle weakness or elevation in muscle enzymes. Interstitial lung disease can affect 35-40% of patients with inflammatory myopathies and is often associated with the presence of an antisynthetase antibody. Other clinical manifestations that can occur in patients with DM include dysphagia, dysphonia, myalgias, Raynaud phenomenon, fevers, weight loss, fatigue, and a nonerosive inflammatory polyarthritis. Patients with DM have a three to eight times increased risk for developing an associated malignancy compared with the general population, and therefore all patients with DM should be evaluated at the time of diagnosis for the presence of an associated malignancy. This review summarizes the immunopathogenesis, clinical manifestations, and evaluation of patients with DM.

  11. Term rewriting with traversal functions

    NARCIS (Netherlands)

    J.J. Vinju (Jurgen); M.G.J. van den Brand (Mark); P. Klint (Paul)

    2003-01-01

    htmlabstractTerm rewriting is an appealing technique for performing program analysis and program transformation. Tree (term) traversal is frequently used but is not supported by standard term rewriting. We extend many-sorted, first-order term rewriting with traversal functions that automate tree

  12. Geological storage of CO2: long term security aspects

    National Research Council Canada - National Science Library

    Liebscher, A; Münch, U

    2015-01-01

    .... A collaborative work by scientists and industrial partners, this volume presents original research, it investigates several aspects of innovative technologies for medium-term use and it includes...

  13. An Ever Present Danger: A Concise History of British Military Operations on the North-West Frontier, 1849-1947 (Occasional Paper, Number 33)

    Science.gov (United States)

    2010-06-01

    scale with new breech-loading magazine-fed rifles, all of which used smokeless powder . For example, a British historian noted that; “Tribal made...enable a rifleman to fire over it standing and about two to three feet thick. Large stones were placed on the parapet at intervals, like almonds on a...tipsy- cake , and loopholes were constructed at ground 33 level. It was a tribal custom when attacking a piquet by day or night, to divide into a rifle

  14. TRANSITION IN TERMS OF GLOBALISATION

    Directory of Open Access Journals (Sweden)

    Miroslav Milutinović

    2014-10-01

    Full Text Available One of the essential constituents of the term transition, in Serbia as well as in other postsocialistic countries, refers to the transition from one development concept onto another one (extensive and mobilising, which is completely different (market-based and innovation-oriented. Market behaviour rules have changed to a great extent, as well as the increasingly present innovations in the field of technology, and introduced certain innovations in business orientation of companies. The struggle for market share is becoming more aggressive and dynamic enabling the survival of exclusively those companies which have implanted high flexibility and innovation levels into their business ambience. Globalisation is inherent in capitalism, it is its constituent logic. In future, new rules will have to be brought which would allow of the managment function to be performed within the complete business policy mutually agreed upon betwen the representatives of the capital owner and those of the personell. These regulations are necessary for long-term efficiency and profitability of private sector, as well as for the final success of economy.

  15. A Systematic Analysis of Term Reuse and Term Overlap across Biomedical Ontologies

    Science.gov (United States)

    Kamdar, Maulik R.; Tudorache, Tania; Musen, Mark A.

    2016-01-01

    Reusing ontologies and their terms is a principle and best practice that most ontology development methodologies strongly encourage. Reuse comes with the promise to support the semantic interoperability and to reduce engineering costs. In this paper, we present a descriptive study of the current extent of term reuse and overlap among biomedical ontologies. We use the corpus of biomedical ontologies stored in the BioPortal repository, and analyze different types of reuse and overlap constructs. While we find an approximate term overlap between 25–31%, the term reuse is only 90% semantic similarity, hinting that ontology developers tend to reuse terms that are sibling or parent–child nodes. We validate this finding by analysing the logs generated from a Protégé plugin that enables developers to reuse terms from BioPortal. We find most reuse constructs were 2-level subtrees on the higher levels of the class hierarchy. We developed a Web application that visualizes reuse dependencies and overlap among ontologies, and that proposes similar terms from BioPortal for a term of interest. We also identified a set of error patterns that indicate that ontology developers did intend to reuse terms from other ontologies, but that they were using different and sometimes incorrect representations. Our results stipulate the need for semi-automated tools that augment term reuse in the ontology engineering process through personalized recommendations. PMID:28819351

  16. Refining search terms for nanotechnology

    Energy Technology Data Exchange (ETDEWEB)

    Porter, Alan L. [Georgia Institute of Technology (United States); Youtie, Jan [Georgia Institute of Technology, Enterprise Innovation Institute (United States)], E-mail: jan.youtie@innovate.gatech.edu; Shapira, Philip [Georgia Institute of Technology (United States); Schoeneck, David J. [Search Technology, Inc. (United States)

    2008-05-15

    The ability to delineate the boundaries of an emerging technology is central to obtaining an understanding of the technology's research paths and commercialization prospects. Nowhere is this more relevant than in the case of nanotechnology (hereafter identified as 'nano') given its current rapid growth and multidisciplinary nature. (Under the rubric of nanotechnology, we also include nanoscience and nanoengineering.) Past efforts have utilized several strategies, including simple term search for the prefix nano, complex lexical and citation-based approaches, and bootstrapping techniques. This research introduces a modularized Boolean approach to defining nanotechnology which has been applied to several research and patenting databases. We explain our approach to downloading and cleaning data, and report initial results. Comparisons of this approach with other nanotechnology search formulations are presented. Implications for search strategy development and profiling of the nanotechnology field are discussed.

  17. Refining search terms for nanotechnology

    Science.gov (United States)

    Porter, Alan L.; Youtie, Jan; Shapira, Philip; Schoeneck, David J.

    2008-05-01

    The ability to delineate the boundaries of an emerging technology is central to obtaining an understanding of the technology's research paths and commercialization prospects. Nowhere is this more relevant than in the case of nanotechnology (hereafter identified as "nano") given its current rapid growth and multidisciplinary nature. (Under the rubric of nanotechnology, we also include nanoscience and nanoengineering.) Past efforts have utilized several strategies, including simple term search for the prefix nano, complex lexical and citation-based approaches, and bootstrapping techniques. This research introduces a modularized Boolean approach to defining nanotechnology which has been applied to several research and patenting databases. We explain our approach to downloading and cleaning data, and report initial results. Comparisons of this approach with other nanotechnology search formulations are presented. Implications for search strategy development and profiling of the nanotechnology field are discussed.

  18. Long-term benzodiazepine users in family practice: differences from short-term users in mental health, coping behaviour and psychological characteristics.

    NARCIS (Netherlands)

    Zandstra, S.M.; Rijswijk, E. van; Rijnders, C.A.T.; Lisdonk, E.H. van de; Bor, J.H.J.; Weel, C. van; Zitman, F.G.

    2004-01-01

    BACKGROUND: Contrary to short-term use, long-term benzodiazepine use is undesirable. Nevertheless, its prevalence is high. To prevent long-term use, it is important to know which short-term users are at risk of becoming long-term users. OBJECTIVES: The purpose of the present study was to identify

  19. Visual Considerations in the Presentation of Mathematical Proofs

    Directory of Open Access Journals (Sweden)

    Lara Alcock

    2010-11-01

    Full Text Available This article is about visual issues in the presentation of mathematics within teaching situations. It focuses particularly on the presentation of proofs to undergraduate students. We describe some of the decisions that a lecturer must make when presenting a written proof, from the layout of individual equations to the layout of a whole argument on the page. We consider the way in which these decisions are made explicit for lecturers who construct electronic learning resources termed e-Proofs, and conclude by discussing the constraints and affordances of this technology.

  20. Panic Disorder in Patients Presenting to the Emergency Department With Chest Pain: Prevalence and Presenting Symptoms.

    Science.gov (United States)

    Greenslade, Jaimi H; Hawkins, Tracey; Parsonage, William; Cullen, Louise

    2017-12-01

    Patients with panic disorder experience symptoms such as palpitations, chest pain, dizziness, and breathlessness. Consequently, they may attend the Emergency Department (ED) to be assessed for possible emergency medical conditions. Recognition of panic disorder within the ED is low. We sought to establish the prevalence of panic disorder in patients presenting for ED investigation of potential acute coronary syndrome. We also sought to characterise the cohort of patients with panic disorder in terms of presenting symptoms, risk factors, medical history and major adverse cardiac events (MACE). This was an observational study of 338 adult patients presenting to the Emergency Department of a tertiary hospital in Australia. Research nurses collected clinical data using a customised case report form. The outcome was panic disorder, assessed using the Mini International Neuropsychiatric Interview. The average age of participants was 50.2 years and 37.9% were female. Thirty-day MACE occurred in 7.7% of the cohort. The clinical diagnosis of panic disorder was made in 5.6% (95% CI: 3.4-8.6%) of patients. Compared to patients without panic disorder, patients with panic disorder were slightly more likely to report that their pain felt heavy (48.9% and 73.7% respectively, p=0.04). All other reported symptoms were similar in the two groups. The prevalence of panic disorder was low in patients presenting to an Australian ED with chest pain. Clinical signs or symptoms that are routinely collected as part of the chest pain workup cannot be used to distinguish patients with and without panic disorder. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved.