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Sample records for total paleoseismological evidence

  1. Paleoseismology: evidence of earth activity

    Czech Academy of Sciences Publication Activity Database

    Nováková, Lucie

    2016-01-01

    Roč. 105, č. 5 (2016), 1467-1469 ISSN 1437-3254 Institutional support: RVO:67985891 Keywords : Paleoseismology * Colluvial wedge * White Creek Fault _ * Greendale Fault * San Andreas Fault * Paganica Fault Subject RIV: DC - Siesmology, Volcanology, Earth Structure Impact factor: 2.283, year: 2016

  2. Paleoseismology

    Science.gov (United States)

    Serva, Leonello

    About 20 years ago, when I was a newly graduated student of geology, neotectonics in the Mediterranean area was just emerging as a popular argument and a special project was begun in Italy. At that time, nobody on the old continent dared to conceive that the clear evidence of late Quaternary faulting could be directly linked to earthquakes. In fact, earthquakes were considered to be deep, hidden processes that essentially occurred in the crystalline basement beneath the sedimentary cover, such as in the fold and thrust belt of the Apennines, therefore accessible only to geophysicists. Only secondary earthquake effects were thought to leave evidence above the basement.

  3. Submarine paleoseismology based on turbidite records.

    Science.gov (United States)

    Goldfinger, Chris

    2011-01-01

    Many of the largest earthquakes are generated at subduction zones or other plate boundary fault systems near enough to the coast that marine environments may record evidence of them. During and shortly after large earthquakes in the coastal and marine environments, a spectrum of evidence may be left behind, mirroring onshore paleoseismic evidence. Shaking or displacement of the seafloor can trigger processes such as turbidity currents, submarine landslides, tsunami (which may be recorded both onshore and offshore), and soft-sediment deformation. Marine sites may also share evidence of fault scarps, colluvial wedges, offset features, and liquefaction or fluid expulsion with their onshore counterparts. This article reviews the use of submarine turbidite deposits for paleoseismology, focuses on the dating and correlation techniques used to establish stratigraphic continuity of marine deposits, and outlines criteria for distinguishing earthquake deposits and the strategies used to acquire suitable samples and data for marine paleoseismology.

  4. Latest Quaternary paleoseismology and evidence of distributed dextral shear along the Mohawk Valley fault zone, northern Walker Lane, California

    Science.gov (United States)

    Gold, Ryan D.; Briggs, Richard; Personius, Stephen; Crone, Anthony J.; Mahan, Shannon; Angster, Stephen

    2014-01-01

    The dextral-slip Mohawk Valley fault zone (MVFZ) strikes northwestward along the eastern margin of the Sierra Nevada in the northern Walker Lane. Geodetic block modeling indicates that the MVFZ may accommodate ~3 mm/yr of regional dextral strain, implying that it is the highest slip-rate strike-slip fault in the region; however, only limited geologic data are available to constrain the system’s slip rate and earthquake history. We mapped the MVFZ using airborne lidar data and field observations and identified a site near Sulphur Creek for paleoseismic investigation. At this site, oblique dextral-normal faulting on the steep valley margin has created a closed depression that floods annually during spring snowmelt to form an ephemeral pond. We excavated three fault-perpendicular trenches at the site and exposed pond sediment that interfingers with multiple colluvial packages eroded from the scarp that bounds the eastern side of the pond. We documented evidence for four surface-rupturing earthquakes on this strand of the MVFZ. OxCal modeling of radiocarbon and luminescence ages indicates that these earthquakes occurred at 14.0 ka, 12.8 ka, 5.7 ka, and 1.9 ka. The mean ~4 kyr recurrence interval is inconsistent with slip rates of ~3 mm/yr; these rates imply surface ruptures of more than 10 m per event, which is geologically implausible for the subdued geomorphic expression and 60 km length of the MVFZ. We propose that unidentified structures not yet incorporated into geodetic models may accommodate significant dextral shear across the northern Walker Lane, highlighting the role of distributed deformation in this region.

  5. Tsunami geology in paleoseismology

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    Yuichi Nishimura,; Jaffe, Bruce E.

    2015-01-01

    The 2004 Indian Ocean and 2011 Tohoku-oki disasters dramatically demonstrated the destructiveness and deadliness of tsunamis. For the assessment of future risk posed by tsunamis it is necessary to understand past tsunami events. Recent work on tsunami deposits has provided new information on paleotsunami events, including their recurrence interval and the size of the tsunamis (e.g. [187–189]). Tsunamis are observed not only on the margin of oceans but also in lakes. The majority of tsunamis are generated by earthquakes, but other events that displace water such as landslides and volcanic eruptions can also generate tsunamis. These non-earthquake tsunamis occur less frequently than earthquake tsunamis; it is, therefore, very important to find and study geologic evidence for past eruption and submarine landslide triggered tsunami events, as their rare occurrence may lead to risks being underestimated. Geologic investigations of tsunamis have historically relied on earthquake geology. Geophysicists estimate the parameters of vertical coseismic displacement that tsunami modelers use as a tsunami's initial condition. The modelers then let the simulated tsunami run ashore. This approach suffers from the relationship between the earthquake and seafloor displacement, the pertinent parameter in tsunami generation, being equivocal. In recent years, geologic investigations of tsunamis have added sedimentology and micropaleontology, which focus on identifying and interpreting depositional and erosional features of tsunamis. For example, coastal sediment may contain deposits that provide important information on past tsunami events [190, 191]. In some cases, a tsunami is recorded by a single sand layer. Elsewhere, tsunami deposits can consist of complex layers of mud, sand, and boulders, containing abundant stratigraphic evidence for sediment reworking and redeposition. These onshore sediments are geologic evidence for tsunamis and are called ‘tsunami deposits’ (Figs. 26

  6. Total Evidence, Uncertainty and A Priori Beliefs

    NARCIS (Netherlands)

    Bewersdorf, Benjamin; Felline, Laura; Ledda, Antonio; Paoli, Francesco; Rossanese, Emanuele

    2016-01-01

    Defining the rational belief state of an agent in terms of her initial or a priori belief state as well as her total evidence can help to address a number of important philosophical problems. In this paper, I discuss how this strategy can be applied to cases in which evidence is uncertain. I argue

  7. Paleoseismological study on stone cultural sites in Gyeongju, SE Korea

    Science.gov (United States)

    Lee, M.; Jin, K.; Kim, Y.

    2008-12-01

    The Korean peninsular, located within the Eurasian intracontinental region, is presently considered to be tectonically safe compared with neighboring countries such as Japan and Taiwan. However, historical records for the Gyeongju area, which is an old capital city with many ancient stone buildings, demonstrate that seismic events have significantly affected lives and properties in this town. For example, one reported earthquake in 779 AD had an inferred magnitude of M=6.7 and resulted in the deaths of over a hundred people and the destruction of many buildings. This study examines the affects of paleoseismological events recorded by stone constructions in Gyeongju. The study area contains mostly granite and is located near the junction between the Yangsan and Ulsan faults, which represent two of the major faults in SE Korea. In May of 2007, a statue of Buddha that was previously attached to and carved from a vertical granite cliff was discovered resting on the 45° slope of the Yeolam valley. Based on the artistic style of the granite statue, it was estimated to be during the late 8th century; it has a weight of about 70 tons and dimensions of 250x190x620 cm. Four main joint directions exist in the statue and in granite exposed in the cliff at its original location. These joint sets match if the statue were rotated 15° clockwise back from present position. Another evidence for damages also occurs at ChumSungDae astronomical observatory. One possible cause for these destructions and damages is paleoseismicity in this area.

  8. Macroseismological And Paleoseismological Studies In The Active Segments Of The Morelia Acambay Fault System, Mexico

    Science.gov (United States)

    Garduño-Monroy, V. H.; Rodriguez-Pascua, M. A.; Israde-Alcantara, I.; Hernandez-Madrigal, V. M.

    2007-05-01

    Paleoseismological studies along several faults of the Morelia-Acambay system show clear evidence of its seismicity. In the Acambay region, four seismic events were identified during the Pliocene Pleistocene; two linked to large sub aquatic landslides, and two to liquefaction processes. The two seismic events associated to slumps were also recognized in the Ixtlahuaca, Mexico, region; meaning these were relevant seismic events at a regional level. Their magnitudes were above 5 degrees. Because these latter events are located in the same column, they could be of aid in knowing recurrence periods. In the southern portion of the Lake of Patzcuaro region a collapse was identified generating a rock avalanche nearly 29,000 years ago. This collapse is associated to an earthquake of magnitude above 7 degrees, which decreased the lake's extension and resulted in morphology of small hummocks. The Purhepecha term Jaracuaro means "place that emerges" and is the name of a former island where Pre Hispanic settlements occurred. The island is exclusively made up of lacustrine sequences that rose above 50m in height, georadar and vertical electrical signal (VES) studies do not reveal intrusive bodies associated to this deformation. Isosists of the 1845 and 1858 seismic events were reconstructed in the modified Mercalli scale through several historical studies in a number of municipalities in the State of Michoacan. The results indicate isosistes of IX degrees in Patzcuaro, where the earthquake caused the collapse of the basilica. During the 1858 earthquake the water level in the southern portion of the Lake of Patzcuaro raised over 2m and the destruction of 120 adobe houses is related to the generation of a tsunami. This seismic event is being characterized in wells and ditches dugs around Patzcuaro Lake. The region of Patzcuaro has experienced a number of magmatic and tectonic events that undoubtedly modified the conditions of the lake regarding its sedimentology and anthropogenic

  9. Late Quaternary paleoseismology of the Milin fault: Implications for active tectonics along the Yarlung Zangbo Suture, Southeastern Tibet Plateau

    Science.gov (United States)

    Li, Kang; Xu, Xiwei; Kirby, Eric; Tang, Fangtou; Kang, Wenjun

    2018-04-01

    How the eastward motion of crust in the central Tibetan Plateau is accommodated in the remote regions of the eastern Himalayan syntaxis remains uncertain. Although the Yarlung Zangbo suture (YZS) forms a striking lineament in the topography of the region, evidence for recent faulting along this zone has been equivocal. To understand whether faults along the YZS are active, we performed a geological investigation along the eastern segments of the YZS. Geomorphic observations suggest the presence of active faulting along several segments of the YZS, which we collectively refer to as the "Milin fault". Paleoseismologic data from trenches reveal evidence for one faulting event, which is constrained to occur between 5620 and 1945 a BP. The latest faulting event displaced alluvial surface T2 by 7 m. The offset on this earthquake place the minimum value on the vertical slip rate of 0.3 mm/yr. Empirical relationships between surface rupture length, displacement and magnitude, suggest that magnitude of the latest event could have been Mw 7.3-7.7. On the basis of this slip rate and the elapsed time since the last event, it is estimated that a seismic moment equivalent to Mw 7.0 has been accumulated on the Milin fault. It is pose a threat to the surrounding region. Our results suggest that shortening occurs in the vicinity of the eastern Himalayan syntaxis, and part of eastward motion of crust from the central Tibetan Plateau is absorbed by uplift of the eastern Himalayan syntaxis.

  10. Paleoseismology and tectonic geomorphology of the Pallatanga fault (Central Ecuador), a major structure of the South-American crust

    Science.gov (United States)

    Baize, Stéphane; Audin, Laurence; Winter, Thierry; Alvarado, Alexandra; Pilatasig Moreno, Luis; Taipe, Mercedes; Reyes, Pedro; Kauffmann, Paul; Yepes, Hugo

    2015-05-01

    The Pallatanga fault (PF) is a prominent NNE-SSW strike-slip fault crossing Central Ecuador. This structure is suspected to have hosted large earthquakes, including the 1797 Riobamba event which caused severe destructions to buildings and a heavy death toll (more than 12,000 people), as well as widespread secondary effects like landsliding, liquefaction and surface cracking. The scope of this study is to evaluate the seismic history of the fault through a paleoseismological approach. This work also aims at improving the seismotectonic map of this part of the Andes through a new mapping campaign and, finally, aims at improving the seismic hazard assessment. We show that the PF continues to the north of the previously mapped fault portion in the Western Cordillera (Rumipamba-Pallatanga portion) into the Inter-Andean Valley (Riobamba basin). Field evidences of faulting are numerous, ranging from a clear geomorphological signature to fault plane outcrops. Along the western side of the Riobamba basin, the strike-slip component seems predominant along several fault portions, with a typical landscape assemblage (dextral offsets of valleys, fluvial terrace risers and generation of linear pressure ridges). In the core of the inter-Andean valley, the main fault portion exhibits a vertical component along the c. 100 m-high cumulative scarp. The presence of such an active fault bounding the western suburbs of Riobamba drastically increases the seismic risk for this densely inhabited and vulnerable city. To the east (Peltetec Massif, Cordillera Real), the continuation of the Pallatanga fault is suspected, but not definitely proved yet. Based on the analysis of three trenches, we state that the Rumipamba-Pallatanga section of the PF experienced 4 (maybe 5) Holocene to Historical strong events (Mw > 7). The coseismic behavior of the fault is deduced from the occurrence of several colluvial wedges and layers associated with the fault activity and interbedded within the organic

  11. Eumalacostracan phylogeny and total evidence: limitations of the usual suspects

    Directory of Open Access Journals (Sweden)

    Ferla Matteo P

    2009-01-01

    Full Text Available Abstract Background The phylogeny of Eumalacostraca (Crustacea remains elusive, despite over a century of interest. Recent morphological and molecular phylogenies appear highly incongruent, but this has not been assessed quantitatively. Moreover, 18S rRNA trees show striking branch length differences between species, accompanied by a conspicuous clustering of taxa with similar branch lengths. Surprisingly, previous research found no rate heterogeneity. Hitherto, no phylogenetic analysis of all major eumalacostracan taxa (orders has either combined evidence from multiple loci, or combined molecular and morphological evidence. Results We combined evidence from four nuclear ribosomal and mitochondrial loci (18S rRNA, 28S rRNA, 16S rRNA, and cytochrome c oxidase subunit I with a newly synthesized morphological dataset. We tested the homogeneity of data partitions, both in terms of character congruence and the topological congruence of inferred trees. We also performed Bayesian and parsimony analyses on separate and combined partitions, and tested the contribution of each partition. We tested for potential long-branch attraction (LBA using taxon deletion experiments, and with relative rate tests. Additionally we searched for molecular polytomies (spurious clades. Lastly, we investigated the phylogenetic stability of taxa, and assessed their impact on inferred relationships over the whole tree. We detected significant conflict between data partitions, especially between morphology and molecules. We found significant rate heterogeneity between species for both the 18S rRNA and combined datasets, introducing the possibility of LBA. As a test case, we showed that LBA probably affected the position of Spelaeogriphacea in the combined molecular evidence analysis. We also demonstrated that several clades, including the previously reported and surprising clade of Amphipoda plus Spelaeogriphacea, are 'supported' by zero length branches. Furthermore we showed

  12. Paleoseismology of Sinistral-Slip Fault System, Focusing on the Mae Chan Fault, on the Shan Plateau, SE Asia.

    Science.gov (United States)

    Curtiss, E. R.; Weldon, R. J.; Wiwegwin, W.; Weldon, E. M.

    2017-12-01

    The Shan Plateau, which includes portions of Myanmar, China, Thailand, Laos, and Vietnam lies between the dextral NS-trending Sagaing and SE-trending Red River faults and contains 14 active E-W sinistral-slip faults, including the Mae Chan Fault (MCF) in northern Thailand. The last ground-rupturing earthquake to occur on the broader sinistral fault system was the M6.8 Tarlay earthquake in Myanmar in March 2011 on the Nam Ma fault immediately north of the MCF the last earthquake to occur on the MCF was a M4.0 in the 5th century that destroyed the entire city of Wiang Yonok (Morley et al., 2011). We report on a trenching study of the MCF, which is part of a broader study to create a regional seismic hazard map of the entire Shan Plateau. By studying the MCF, which appears to be representative of the sinistral faults, and easy to work on, we hope to characterize both it and the other unstudied faults in the system. As part of a paleoseismology training course we dug two trenches at the Pa Tueng site on the MCF, within an offset river channel and the trenches exposed young sediment with abundant charcoal (in process of dating), cultural artifacts, and evidence for the last two (or three) ground-rupturing earthquakes on the fault. We hope to use the data from this site to narrow the recurrence interval, which is currently to be 2,000-4,000 years and the slip rate of 1-2 mm/year, being developed at other sites on the fault. By extrapolating the data of the MCF to the other faults we will have a better understanding of the whole fault system. Once we have characterized the MCF, we plan to use geomorphic offsets and strain rates from regional GPS to relatively estimate the activity of the other faults in this sinistral system.

  13. Rethinking turbidite paleoseismology along the Cascadia subduction zone

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    Atwater, Brian F.; Carson, Bobb; Griggs, Gary B.; Johnson, H. Paul; Salmi, Marie

    2014-01-01

    A stratigraphic synthesis of dozens of deep-sea cores, most of them overlooked in recent decades, provides new insights into deep-sea turbidites as guides to earthquake and tsunami hazards along the Cascadia subduction zone, which extends 1100 km along the Pacific coast of North America. The synthesis shows greater variability in Holocene stratigraphy and facies off the Washington coast than was recognized a quarter century ago in a confluence test for seismic triggering of sediment gravity flows. That test compared counts of Holocene turbidites upstream and downstream of a deep-sea channel junction. Similarity in the turbidite counts among seven core sites provided evidence that turbidity currents from different submarine canyons usually reached the junction around the same time, as expected of widespread seismic triggering. The fuller synthesis, however, shows distinct differences between tributaries, and these differences suggest sediment routing for which the confluence test was not designed. The synthesis also bears on recent estimates of Cascadia earthquake magnitudes and recurrence intervals. The magnitude estimates hinge on stratigraphic correlations that discount variability in turbidite facies. The recurrence estimates require turbidites to represent megathrust earthquakes more dependably than they do along a flow path where turbidite frequency appears limited less by seismic shaking than by sediment supply. These concerns underscore the complexity of extracting earthquake history from deep-sea turbidites at Cascadia.

  14. Paleoseismology of the Chelungpu Fault During the Past 1900 Years

    Science.gov (United States)

    Chen, W.; Lee, K.; Lee, L.; Yang, C. B.; Chen, Y.; Chang, H.

    2003-12-01

    The 1999 earthquake brought about 80-km-long surface ruptures along the Shihkang, Chelungpu, and Tajienshan Faults, central Taiwan. Several trenches have been excavated across the Chelungpu Fault of the middle segment. The surface ruptures display clear scarps ranging from 0.2 m to 4 m high, showing a complex geomorphic pattern due to coseismic faulting and folding. In the study, measurement of the vertical offset or structural relief was taken with reference to the hanging wall beyond the trishear deformation zone. Therefore we suggest that, for the measurement of offset, we should leave out the trishear zone, and that structural relief on the hanging wall should be represented as a real vertical offset. The net slip is then calculated from the structural relief and dip angle of the thrust on a vertical plane along the slip direction. By the excavation of the pineapple field across the Chelungpu Fault, we are able to first provide evidence of at least four earthquake events for the past about 1900 years, including the 1999 earthquake. Furthermore, based on the radiocarbon dates and historical record, the timing of the penultimate event is bracketed to be between 430 and 150 years ago, and the average recurrence interval smaller than 700 years. These data indicate that the average slip rate is about 8.7 mm/yr for the past 1900 years.

  15. Identification of the seismogenic source of the 1875 Cucuta earthquake on the basis of a combination of neotectonic, paleoseismologic and historic seismicity studies

    Science.gov (United States)

    Rodríguez, Luz; Diederix, Hans; Torres, Eliana; Audemard, Franck; Hernández, Catalina; Singer, André; Bohórquez, Olga; Yepez, Santiago

    2018-03-01

    An interesting variety of field evidence that collectively cover the three branches of Earthquake Geology: Neotectonics, Paleoseismology and Historical seismicity, has been collected in the border area between Venezuela and Colombia, near the town of San José de Cúcuta, as part of a study aimed at establishing the seismic source of the great Cucuta Earthquake, that occurred on May 18th, 1875, and that caused heavy losses of life and destruction on both sides of the border, between the Department of Norte de Santander in Colombia and Táchira state in Venezuela. This region is affected by the activity of several cross-border fault systems that converge in the zone of the so-called Pamplona Indenter. Among these seismic sources, the potential candidates of this destructive seismic event in 1875 are those related to the Boconó Fault System, of the northwestern foothills of the Mérida Andes and in particular it's most northwestern expression, the Aguas Calientes Fault System, as suggested by previous research carried out by FUNVISIS for the Venezuelan oil industry in the late 80s. In order to confirm whether this was the responsible system for the earthquake or not, the following studies were carried out: 1) In Neotectonics, a detailed binational surface mapping of the active faults of this system was carried out. This system consists of three branches referred to in this paper as: the North, Central and South branch respectively; 2) In Paleoseismology, two trenches were excavated. The first trench was excavated across the South branch and the second one across the North branch, which confirmed fault activity during the Holocene epoch; 3) In historical seismicity the direct coseismic surface effects that occurred in the epicentral area of the earthquake were assessed. All evidence collected and integrated in these three lines of research, made it possible to conclude that the Central branch of the Aguas Calientes fault system is the most likely candidate to have

  16. Paleoseismology under sea: First evidence for irregular seismic cycles during Holocene off Algeria from turbidites

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    Ratzov, Gueorgui; Cattaneo, Antonio; Babonneau, Nathalie; Déverchere, Jacques; Yelles, Karim; Bracene, Rabah

    2013-04-01

    According to simple models, stress build-up along a given fault is proportional to the time elapsed since the previous earthquake. Although the resulting « seismic gap » hypothesis suits well for moderate magnitude earthquake (Mw 4-5), large events (Mw>6) are hardly predictable and show great variation in recurrence intervals. Thus, models based on stress transfer and interactions between faults suggest that an earthquake may haste or delay the occurrence of next earthquake on adjacent fault by increasing or lowering the level of static stress. Here, we show that meaningful information of large earthquakes recurrence intervals over several seismic cycles may be obtained using turbidite record offshore the Algerian margin (Mediterranean Sea), an area prone to relatively large (M~7) earthquakes in historical times. Indeed, as evidenced on the Cascadia subduction zone, synchroneous turbidites over a large area and originated from independent sources, are most likely triggered by an earthquake. To test the method on this slowly convergent margin, we analysed turbidites in 3 sediment cores collected off the area shaken by the 1980 Ms 7.3 El Asnam and 1954 M6.7 Orléansville earthquakes. We used X-ray radioscopy, XRF major elements counter, magnetic susceptibility, and grain-size distribution to accurately discriminate turbidites (~instantaneous deposit) from hemipelagites (continuous background sedimentation). We dated turbidites by calculating hemipelagic sedimentation rates obtained with AMS radiocarbon ages, and applied the rates between turbidites. Finally, the age of events was compared to the only paleoseismic investigation available onland. We found that 10 to 25 turbidites deposited as single or multiple pulses over the last ~8ka. Once correlated from site to site, they support 14 seismic events. Most events are correlated with the paleoseismic record of the El Asnam fault, but uncorrelated events support that other faults were active. Only the first of the two major events of 1954 and 1980 triggered a turbidity current, implying that the sediment buffer on the continental shelf could not be reloaded in 26 years thus giving information on the minimum time resolution of our method. The new paleoseismic catalog shows a recurrence interval of 300-700 years for most events, but also a great interval of >1200 years without any major earthquake. This result suggest that the level of static stress may have drastically dropped as a result of three main events occurring within the 800 years prior the quiescence period. The quiescent period also supports a stress transfer and interaction between neighbouring faults.

  17. Paleoseismological evidence for historical surface faulting in São Miguel island (Azores

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    Rita Carmo

    2014-02-01

    Full Text Available The Azores archipelago is located at the triple junction between the Eurasian, Nubian and North American lithospheric plates, whose boundaries are the Mid-Atlantic Ridge and the Azores-Gibraltar Fault Zone. São Miguel is the largest island of the archipelago and is located on the eastern part of the western segment of the Azores-Gibraltar Fault Zone. The Achada das Furnas plateau, located in the central part of the island, between Fogo and Furnas central volcanoes, is dominated by several WNW-ESE and E-W trending alignments of basaltic cinder cones. Two E-W trending scarps were identified by aerial photo interpretation. Transect trenches exposed two active normal faults-the Altiprado Faults – confirming the tectonic nature of the scarps. Several paleoearthquakes were deduced, most of which in historical times, producing 1.38 m and 0.48 m of cumulative displacement. Maximum expected magnitudes (MW determined from slip per event range from 5.7 to 6.7. One of the events probably corresponds to the historical earthquake of October 22nd, 1522, the deadliest in the archipelago. Radiocarbon ages are in agreement with this interpretation.

  18. Paleoseismology and slip rate of the Conway Segment of the Hope Faultat Greenburn Stream, South Island, New Zealand

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    B. Estrada

    2003-06-01

    Full Text Available The Conway Segment of the dextral-slip Hope Fault is one of the fastest slipping fault segments along New Zealand s plate boundary, but has not ruptured co-seismically in the historic period and little paleoseismic data exist to constrain its large earthquake record. Two paleoseismic trenches were opened adjacent to Greenburn Stream near Kaikoura for the 2001 ILP Paleoseismology Conference. Both trenches were excavated into deposits ponded against an uphill-facing shutter scarp. Trench 1, dug through a cobbly soil and surface deposit was dominated by a thick fan/fluvial sequence that was radiocarbon dated at 4409 ± 60 C14 years BP (4844-5288 cal years BP at the base of the trench. This trench exhibited evidence of complex deformation from many paleoseismic events. The most recent earthquakes are difficult to constrain due to a lack of cover stratigraphy on the fan deposits. However, the modern soil appears to be faulted and is covered by cobbles with a weathering rind-derived age of 220 ± 60 years. Trench 2, dug ?? 50 m to the west has an expanded sequence of the younger cover deposits. Paleoseismic event horizons have been recognised from the combined evidence of upwardterminating faults, offset and mismatched units, a sandblow deposit, and abrupt landscape change shown by the burial of paleosol surfaces that form the event horizons. Two paleosols underlying the modern soil are clearly faulted by two separate rupture events. A dome of sand interpreted as a liquefaction sandblow deposit overlies the lower paleosol (event horizon. Both paleosols are overlain by metre-thick debris deposits, interpreted as earthquake-induced rock avalanches that cascaded off the hillslope following Mw 7 + events. Four radiocarbon dates place some constraints on the timing of the three recent surface-rupturing events. The youngest and lowest date is 548 ± 60 C14 years BP (504-656 cal years BP and occurs below the lower paleosol. It constrains the

  19. Total-Evidence Dating under the Fossilized Birth-Death Process.

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    Zhang, Chi; Stadler, Tanja; Klopfstein, Seraina; Heath, Tracy A; Ronquist, Fredrik

    2016-03-01

    Bayesian total-evidence dating involves the simultaneous analysis of morphological data from the fossil record and morphological and sequence data from recent organisms, and it accommodates the uncertainty in the placement of fossils while dating the phylogenetic tree. Due to the flexibility of the Bayesian approach, total-evidence dating can also incorporate additional sources of information. Here, we take advantage of this and expand the analysis to include information about fossilization and sampling processes. Our work is based on the recently described fossilized birth-death (FBD) process, which has been used to model speciation, extinction, and fossilization rates that can vary over time in a piecewise manner. So far, sampling of extant and fossil taxa has been assumed to be either complete or uniformly at random, an assumption which is only valid for a minority of data sets. We therefore extend the FBD process to accommodate diversified sampling of extant taxa, which is standard practice in studies of higher-level taxa. We verify the implementation using simulations and apply it to the early radiation of Hymenoptera (wasps, ants, and bees). Previous total-evidence dating analyses of this data set were based on a simple uniform tree prior and dated the initial radiation of extant Hymenoptera to the late Carboniferous (309 Ma). The analyses using the FBD prior under diversified sampling, however, date the radiation to the Triassic and Permian (252 Ma), slightly older than the age of the oldest hymenopteran fossils. By exploring a variety of FBD model assumptions, we show that it is mainly the accommodation of diversified sampling that causes the push toward more recent divergence times. Accounting for diversified sampling thus has the potential to close the long-discussed gap between rocks and clocks. We conclude that the explicit modeling of fossilization and sampling processes can improve divergence time estimates, but only if all important model aspects

  20. Physiotherapy rehabilitation after total knee or hip replacement: an evidence-based analysis.

    Science.gov (United States)

    2005-01-01

    physiotherapy. Inpatient physiotherapy is delivered in a rehabilitation hospital or specialized hospital unit. Outpatient physiotherapy is done either in an outpatient clinic (clinic-based) or in the person's home (home-based). Home-based physiotherapy may include practising an exercise program at home with or without supplemental support from a physiotherapist. Finally, physiotherapy rehabilitation may be administered at several points after surgery, including immediately postoperatively (within the first 5 days) and in the early recovery period (within the first 3 months) after discharge. There is a growing interest in whether physiotherapy should start before surgery. A variety of practises exist, and evidence regarding the optimal pre- and post-acute course of rehabilitation to obtain the best outcomes is needed. The Medical Advisory Secretariat used its standard search strategy, which included searching the databases of Ovid MEDLINE, CINHAL, EMBASE, Cochrane Database of Systematic Reviews, and PEDro from 1995 to 2005. English-language articles including systematic reviews, randomized controlled trials (RCTs), non-RCTs, and studies with a sample size of greater than 10 patients were included. Studies had to include patients undergoing primary total hip or total knee replacement, aged 18 years of age or older, and they had to have investigated one of the following comparisons: inpatient rehabilitation versus outpatient (clinic- or home-based therapy) rehabilitation, land-based post-acute care physiotherapy delivered by a physiotherapist compared with patient self-administered exercise and a land-based exercise program before surgery. The primary outcome was postoperative physical functioning. Secondary outcomes included the patient's assessment of therapeutic effect (overall improvement), perceived pain intensity, health services utilization, treatment side effects, and adverse events The quality of the methods of the included studies was assessed using the criteria outlined

  1. Total evidence phylogeny and the evolution of adult bioluminescence in fireflies (Coleoptera: Lampyridae).

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    Martin, Gavin J; Branham, Marc A; Whiting, Michael F; Bybee, Seth M

    2017-02-01

    Fireflies are some of the most captivating organisms on the planet. They have a rich history as subjects of scientific study, especially in relation to their bioluminescent behavior. Yet, the phylogenetic relationships of fireflies are still poorly understood. Here, we present the first total evidence approach to reconstruct lampyrid phylogeny using both a molecular matrix from six loci and an extensive morphological matrix. Using this phylogeny we test the hypothesis that adult bioluminescence evolved after the origin of the firefly clade. The ancestral state of adult bioluminescence is recovered as non-bioluminescent with one to six gains and five to ten subsequent losses. The monophyly of the family, as well as the subfamilies is also tested. Ototretinae, Cyphonocerinae, Luciolinae (incl. Pristolycus), Amydetinae, "cheguevarinae" sensu Jeng 2008, and Photurinae are highly supported as monophyletic. With the exception of four taxa, Lampyrinae is also recovered as monophyletic with high support. Based on phylogenetic and morphological data Lamprohiza, Phausis, and Lamprigera are transferred to Lampyridae incertae sedis. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Technical Note: Does Core Inflation Help Forecast Total Inflation? Evidence from Colombia

    OpenAIRE

    John Thornton

    1998-01-01

    In Colombia core and total inflation are both (1) series, and core inflation is cointegrated with total inflation. Granger causality tests using error correction methodology indicate that divergence of total inflation from core inflation is quickly revers

  3. Transanal total mesorectal excision: a systematic review of the experimental and clinical evidence.

    Science.gov (United States)

    Araujo, S E; Crawshaw, B; Mendes, C R; Delaney, C P

    2015-02-01

    Achieving a clear distal or circumferential resection margins with laparoscopic total mesorectal excision (TME) may be laborious, especially in obese males and when operating on advanced distal rectal tumors with a poor response to neoadjuvant treatment. Transanal (TaTME) is a new natural orifice translumenal endoscopic surgery modality in which the rectum is mobilized transanally using endoscopic techniques with or without laparoscopic assistance. We conducted a comprehensive systematic review of publications on this new technique in PubMed and Embase databases from January, 2008, to July, 2014. Experimental and clinical studies written in English were included. Experimental research with TaTME was done on pigs with and without survival models and on human cadavers. In these studies, laparoscopic or transgastric assistance was frequently used resulting in an easier upper rectal dissection and in a longer rectal specimen. To date, 150 patients in 16 clinical studies have undergone TaTME. In all but 15 cases, transabdominal assistance was used. A rigid transanal endoscopic operations/transanal endoscopic microsurgery (TEO/TEM) platform was used in 37 patients. Rectal adenocarcinoma was the indication in all except for nine cases of benign diseases. Operative times ranged from 90 to 460 min. TME quality was deemed intact, satisfactory, or complete. Involvement in circumferential resection margins was detected in 16 (11.8 %) patients. The mean lymph node harvest was equal or greater than 12 in all studies. Regarding morbidity, pneumoretroperitoneum, damage to the urethra, and air embolism were reported intraoperatively. Mean hospital stay varied from 4 to 14 days. Postoperative complications occurred in 34 (22.7 %) patients. TaTME with TEM is feasible in selected cases. Oncologic safety parameters seem to be adequate although the evidence relies on small retrospective series conducted by highly trained surgeons. Further studies are expected.

  4. Identification of tsunami deposits and liquefaction features in the Gargano area (Italy: paleoseismological implication

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    L. Graziani

    2003-06-01

    Full Text Available The Gargano region (Southeastern Italy was hit by a M = 6.8 earthquake and inundated by a subsequent tsunami in 1627. To better define the hazard in the region, we searched for evidence of this and prior earthquakes in the geologic record. We identified potential earthquake-related liquefaction features and tsunami deposits in the stratigraphic sequences of the marsh areas both north and south of the Gargano promontory. We recognized clear liquefaction features and possible tsunamigenic sands that can be related to the 1627 seismic event in irrigation ditch exposures and gouge cores along the Northern Gargano coast. In total, six potential tsunami sand deposits have been recognized in two areas located close to the northern and southern coasts of the Gargano promontory. However, ambiguous evidence comes from the paleontological analysis of these sands. Although fragments of marine shells have been found in the coarser portion of the sand samples, foraminifera and ostracods assemblages are typical of brackish water condition. Radiocarbon dating of three of these deposits from the Northern Gargano coast, near the town of Lesina, suggests an average recurrence interval of 1700 years for tsunami events in this area. Assuming that all the paleotsunamis are related to the same seismogenic source responsible for the 1627 earthquake, this average recurrence interval may be typical for that source. Radiocarbon dating of three sand layers observed on the southern coast, close to the city of Manfredonia, suggests that the average recurrence time for violent sea inundation there is about 1200 years.

  5. Metal-on-Metal Total Hip Resurfacing Arthroplasty: An Evidence-Based Analysis.

    Science.gov (United States)

    2006-01-01

    The objective of this review was to assess the safety and effectiveness of metal on metal (MOM) hip resurfacing arthroplasty for young patients compared with that of total hip replacement (THR) in the same population. Total hip replacement has proved to be very effective for late middle-aged and elderly patients with severe degenerative diseases of the hips. As indications for THR began to include younger patients and those with a more active life style, the longevity of the implant became a concern. Evidence suggests that these patients experience relatively higher rates of early implant failure and the need for revision. The Swedish hip registry, for example, has demonstrated a survival rate in excess of 80% at 20 years for those aged over 65 years, whereas this figure was 33% by 16 years in those aged under 55 years. Hip resurfacing arthroplasty is a bone-conserving alternative to THR that restores normal joint biomechanics and load transfer. The technique has been used around the world for more than 10 years, specifically in the United Kingdom and other European countries. Metal-on-metal hip resurfacing arthroplasty is an alternative procedure to conventional THR in younger patients. Hip resurfacing arthroplasty is less invasive than THR and addresses the problem of preserving femoral bone stock at the initial operation. This means that future hip revisions are possible with THR if the initial MOM arthroplasty becomes less effective with time in these younger patients. The procedure involves the removal and replacement of the surface of the femoral head with a hollow metal hemisphere, which fits into a metal acetabular cup. Hip resurfacing arthroplasty is a technically more demanding procedure than is conventional THR. In hip resurfacing, the femoral head is retained, which makes it much more difficult to access the acetabular cup. However, hip resurfacing arthroplasty has several advantages over a conventional THR with a small (28 mm) ball. First, the large

  6. A Phylogenetic Synthesis for Oceanic Dolphins: Total Evidence, Cytonuclear Discordance, and Possible Introgressive Hybridization

    OpenAIRE

    Haisten, David

    2016-01-01

    Introgressive hybridization is increasingly being detected in vertebrate taxa but was thought to be rare in mammals. Recent evidence suggests that this view might not correct and cetaceans may be pre-disposed for the capacity to hybridize. Numerous instances of cetacean (dolphins, whales, and porpoises) hybridization have been reported both in captivity and in the wild, many of which occurred in oceanic dolphins: family Delphinidae. The rapid radiation of Delphinidae commenced during the Mio...

  7. A Total Economic Valuation of Wetland Ecosystem Services: An Evidence from Jagadishpur Ramsar Site, Nepal

    Directory of Open Access Journals (Sweden)

    Sony Baral

    2016-01-01

    Full Text Available Wetlands are the most productive ecosystem and provide wide arrays of wetland ecosystems (goods and services to the local communities in particular and global communities in general. However, management of the wetland often does not remain priority and recognized as the unproductive waste land mainly due to poor realization of the economic value of the wetlands. Taking this into account, the study estimated the total economic value of the Jagadishpur Reservoir taking into account direct, indirect, and nonuse value. The study prioritized six major values of the reservoir which include wetland goods consumption, tourism, irrigation, carbon sequestration, biodiversity conservation, and conservation for future use (existence and option value. The study used market and nonmarket based valuation techniques to estimate total economic value of the reservoir. Household survey, focus group discussions, and interaction with the tourism entrepreneurs and district stakeholders were carried out to collect information. The study estimated the total annual economic value of the reservoir as NRs 94.5 million, where option/existence value remains main contributor followed by direct use value such as wetland goods and tourism and indirect use value, for example, carbon sequestration, biodiversity conservation, and irrigation. The study reveals that the local communities gave high importance to the future use value and are willing to make investment for conservation and restoration of reservoir given its conservation significance.

  8. A Total Economic Valuation of Wetland Ecosystem Services: An Evidence from Jagadishpur Ramsar Site, Nepal.

    Science.gov (United States)

    Baral, Sony; Basnyat, Bijendra; Khanal, Rajendra; Gauli, Kalyan

    Wetlands are the most productive ecosystem and provide wide arrays of wetland ecosystems (goods and services) to the local communities in particular and global communities in general. However, management of the wetland often does not remain priority and recognized as the unproductive waste land mainly due to poor realization of the economic value of the wetlands. Taking this into account, the study estimated the total economic value of the Jagadishpur Reservoir taking into account direct, indirect, and nonuse value. The study prioritized six major values of the reservoir which include wetland goods consumption, tourism, irrigation, carbon sequestration, biodiversity conservation, and conservation for future use (existence and option value). The study used market and nonmarket based valuation techniques to estimate total economic value of the reservoir. Household survey, focus group discussions, and interaction with the tourism entrepreneurs and district stakeholders were carried out to collect information. The study estimated the total annual economic value of the reservoir as NRs 94.5 million, where option/existence value remains main contributor followed by direct use value such as wetland goods and tourism and indirect use value, for example, carbon sequestration, biodiversity conservation, and irrigation. The study reveals that the local communities gave high importance to the future use value and are willing to make investment for conservation and restoration of reservoir given its conservation significance.

  9. A mathematical model of weight loss under total starvation: evidence against the thrifty-gene hypothesis

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    John R. Speakman

    2013-01-01

    The thrifty-gene hypothesis (TGH posits that the modern genetic predisposition to obesity stems from a historical past where famine selected for genes that promote efficient fat deposition. It has been previously argued that such a scenario is unfeasible because under such strong selection any gene favouring fat deposition would rapidly move to fixation. Hence, we should all be predisposed to obesity: which we are not. The genetic architecture of obesity that has been revealed by genome-wide association studies (GWAS, however, calls into question such an argument. Obesity is caused by mutations in many hundreds (maybe thousands of genes, each with a very minor, independent and additive impact. Selection on such genes would probably be very weak because the individual advantages they would confer would be very small. Hence, the genetic architecture of the epidemic may indeed be compatible with, and hence support, the TGH. To evaluate whether this is correct, it is necessary to know the likely effects of the identified GWAS alleles on survival during starvation. This would allow definition of their advantage in famine conditions, and hence the likely selection pressure for such alleles to have spread over the time course of human evolution. We constructed a mathematical model of weight loss under total starvation using the established principles of energy balance. Using the model, we found that fatter individuals would indeed survive longer and, at a given body weight, females would survive longer than males, when totally starved. An allele causing deposition of an extra 80 g of fat would result in an extension of life under total starvation by about 1.1–1.6% in an individual with 10 kg of fat and by 0.25–0.27% in an individual carrying 32 kg of fat. A mutation causing a per allele effect of 0.25% would become completely fixed in a population with an effective size of 5 million individuals in 6000 selection events. Because there have probably been about 24

  10. A Total-Evidence Approach to Dating with Fossils, Applied to the Early Radiation of the Hymenoptera

    Science.gov (United States)

    Ronquist, Fredrik; Klopfstein, Seraina; Vilhelmsen, Lars; Schulmeister, Susanne; Murray, Debra L.; Rasnitsyn, Alexandr P.

    2012-01-01

    Abstract Phylogenies are usually dated by calibrating interior nodes against the fossil record. This relies on indirect methods that, in the worst case, misrepresent the fossil information. Here, we contrast such node dating with an approach that includes fossils along with the extant taxa in a Bayesian total-evidence analysis. As a test case, we focus on the early radiation of the Hymenoptera, mostly documented by poorly preserved impression fossils that are difficult to place phylogenetically. Specifically, we compare node dating using nine calibration points derived from the fossil record with total-evidence dating based on 343 morphological characters scored for 45 fossil (4--20 complete) and 68 extant taxa. In both cases we use molecular data from seven markers (∼5 kb) for the extant taxa. Because it is difficult to model speciation, extinction, sampling, and fossil preservation realistically, we develop a simple uniform prior for clock trees with fossils, and we use relaxed clock models to accommodate rate variation across the tree. Despite considerable uncertainty in the placement of most fossils, we find that they contribute significantly to the estimation of divergence times in the total-evidence analysis. In particular, the posterior distributions on divergence times are less sensitive to prior assumptions and tend to be more precise than in node dating. The total-evidence analysis also shows that four of the seven Hymenoptera calibration points used in node dating are likely to be based on erroneous or doubtful assumptions about the fossil placement. With respect to the early radiation of Hymenoptera, our results suggest that the crown group dates back to the Carboniferous, ∼309 Ma (95% interval: 291--347 Ma), and diversified into major extant lineages much earlier than previously thought, well before the Triassic. [Bayesian inference; fossil dating; morphological evolution; relaxed clock; statistical phylogenetics.] PMID:22723471

  11. Observational evidence for turbulent effects on total suspended matter within the Pearl River plume

    Science.gov (United States)

    Chunhua, Qiu; Danyi, Su; Huabin, Mao; Jiaxue, Wu; Yongsheng, Cui; Dongxiao, Wang

    2017-12-01

    We observed the structure of the Pearl River plume and its turbulent characteristics, and investigated the turbulent effect on total suspended matter (TSM) within its ;far-field; region, based on in situ and satellite data collected in June 2015. A significant northeastward plume was created under southern monsoonal conditions. The in situ data provided the width, depth, and velocity of the plume, as inferred by salinity. Weaker turbulence occurred at the front surface position than in the plume zone. Stronger turbulence induced greater turbidity in the bottom boundary layer; however, the surface mixed layer differed. By estimating the turbidity budget, we found the lateral fluxes term was the largest term in the plume, turbulent fluxes comprised the second largest term, and the settling terms comprised the smallest term. We quantified the turbulent mechanisms and found that stronger river discharge induced greater TSM turbidity. Tidal and buoyancy fluxes had minor regulatory effects on TSM. Our observations suggest that TSM in the ;far field; region originated from the Pearl River and the coastal region.

  12. IN QUEST OF TOTAL QUALITY MANAGEMENT PRINCIPLES IN ARCHITECTURAL DESIGN SERVICES: EVIDENCE FROM TURKEY

    Directory of Open Access Journals (Sweden)

    Umut Durmus

    2010-12-01

    Full Text Available Proposal: Architectural design companies increasingly recognize that time spent on management is not at the expense of their production and there are always better ways to organize business. Although architects have long placed a traditional emphasis on quality, quality management is still a new concept for the majority of architectural design companies, which have to organize relatively more complicated operations nowadays to meet their clients’ expectations. This study aims to understand how architectural design companies define quality and explores the extent to which Total Quality Management (TQM principles like continual improvement, employee involvement, customer satisfaction and others can be pertinent in these companies. Adopting a qualitative research strategy, the authors interviewed with the owner-managers of 10 widely-recognized architectural design companies of different size in Istanbul. The results from the content analysis of semi-structured interview data suggest that i TQM principles cannot be directly applied in architectural design companies without an appropriate translation; ii special characteristics of design services are important to explain quality-related perceptions of owner-managers; iii the owner-managers feel the pressure from the changing internal and external environmental conditions, however few of them adopt a systematic and documented approach to quality management. Architectural design offices which aim to establish a quality management system can benefit from this study to understand potential problem areas on their road.

  13. Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence

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    Tanja Kongerslev Thorning

    2016-11-01

    Full Text Available Background: There is scepticism about health effects of dairy products in the public, which is reflected in an increasing intake of plant-based drinks, for example, from soy, rice, almond, or oat. Objective: This review aimed to assess the scientific evidence mainly from meta-analyses of observational studies and randomised controlled trials, on dairy intake and risk of obesity, type 2 diabetes, cardiovascular disease, osteoporosis, cancer, and all-cause mortality. Results: The most recent evidence suggested that intake of milk and dairy products was associated with reduced risk of childhood obesity. In adults, intake of dairy products was shown to improve body composition and facilitate weight loss during energy restriction. In addition, intake of milk and dairy products was associated with a neutral or reduced risk of type 2 diabetes and a reduced risk of cardiovascular disease, particularly stroke. Furthermore, the evidence suggested a beneficial effect of milk and dairy intake on bone mineral density but no association with risk of bone fracture. Among cancers, milk and dairy intake was inversely associated with colorectal cancer, bladder cancer, gastric cancer, and breast cancer, and not associated with risk of pancreatic cancer, ovarian cancer, or lung cancer, while the evidence for prostate cancer risk was inconsistent. Finally, consumption of milk and dairy products was not associated with all-cause mortality. Calcium-fortified plant-based drinks have been included as an alternative to dairy products in the nutrition recommendations in several countries. However, nutritionally, cow's milk and plant-based drinks are completely different foods, and an evidence-based conclusion on the health value of the plant-based drinks requires more studies in humans. Conclusion: The totality of available scientific evidence supports that intake of milk and dairy products contribute to meet nutrient recommendations, and may protect against the most

  14. Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence.

    Science.gov (United States)

    Thorning, Tanja Kongerslev; Raben, Anne; Tholstrup, Tine; Soedamah-Muthu, Sabita S; Givens, Ian; Astrup, Arne

    2016-01-01

    There is scepticism about health effects of dairy products in the public, which is reflected in an increasing intake of plant-based drinks, for example, from soy, rice, almond, or oat. This review aimed to assess the scientific evidence mainly from meta-analyses of observational studies and randomised controlled trials, on dairy intake and risk of obesity, type 2 diabetes, cardiovascular disease, osteoporosis, cancer, and all-cause mortality. The most recent evidence suggested that intake of milk and dairy products was associated with reduced risk of childhood obesity. In adults, intake of dairy products was shown to improve body composition and facilitate weight loss during energy restriction. In addition, intake of milk and dairy products was associated with a neutral or reduced risk of type 2 diabetes and a reduced risk of cardiovascular disease, particularly stroke. Furthermore, the evidence suggested a beneficial effect of milk and dairy intake on bone mineral density but no association with risk of bone fracture. Among cancers, milk and dairy intake was inversely associated with colorectal cancer, bladder cancer, gastric cancer, and breast cancer, and not associated with risk of pancreatic cancer, ovarian cancer, or lung cancer, while the evidence for prostate cancer risk was inconsistent. Finally, consumption of milk and dairy products was not associated with all-cause mortality. Calcium-fortified plant-based drinks have been included as an alternative to dairy products in the nutrition recommendations in several countries. However, nutritionally, cow's milk and plant-based drinks are completely different foods, and an evidence-based conclusion on the health value of the plant-based drinks requires more studies in humans. The totality of available scientific evidence supports that intake of milk and dairy products contribute to meet nutrient recommendations, and may protect against the most prevalent chronic diseases, whereas very few adverse effects have

  15. Late Pleistocene and Holocene paleoseismology of an intraplate seismic zone in a large alluvial valley, the New Madrid seismic zone, Central USA

    Science.gov (United States)

    Guccione, Margaret J.

    2005-10-01

    The New Madrid seismic zone (NMSZ) is an intraplate right-lateral strike-slip and thrust fault system contained mostly within the Mississippi Alluvial Valley. The most recent earthquake sequence in the zone occurred in 1811 1812 and had estimated moment magnitudes of 7 8 (e.g., [Johnston, A.C., 1996. Seismic moment assessment of stable continental earthquakes, Part 3: 1811 1812 New Madrid, 1886 Charleston, and 1755 Lisbon. Geophysical Journal International 126, 314 344; Johnston, A.C., Schweig III, E.S, 1996. The enigma of the New Madrid earthquakes of 1811 1812. Annual Reviews of Earth and Planetary Sciences 24, 339 384; Hough, S.E., Armbruster, J.G., Seeber, L., Hough, J.F., 2000. On the modified Mercalli intensities and magnitudes of the New Madrid earthquakes. Journal of Geophysical Research 105 (B10), 23,839 23,864; Tuttle, M.P., 2001. The use of liquefaction features in paleoseismology: Lessons learned in the New Madrid seismic zone, central United States. Journal of Seismology 5, 361 380]). Four earlier prehistoric earthquakes or earthquake sequences have been dated A.D. 1450 ± 150, 900 ± 100, 300 ± 200, and 2350 B.C. ± 200 years using paleoliquefaction features, particularly those associated with native American artifacts, and in some cases surface deformation ([Craven, J. A. 1995. Paleoseismology study in the New Madrid seismic zone using geological and archeological features to constrain ages of liquefaction deposits. M.S thesis, University of Memphis, Memphis, TN, U.S.A.; Tuttle, M.P., Lafferty III, R.H., Guccione, M.J., Schweig III, E.S., Lopinot, N., Cande, R., Dyer-Williams, K., Haynes, M., 1996. Use of archaeology to date liquefaction features and seismic events in the New Madrid seismic zone, central United States. Geoarchaeology 11, 451 480; Guccione, M.J., Mueller, K., Champion, J., Shepherd, S., Odhiambo, B., 2002b. Stream response to repeated co-seismic folding, Tiptonville dome, western Tennessee. Geomorphology 43(2002), 313 349; Tuttle, M

  16. Integration of historical, archaeoseismic and paleoseismological data for the reconstruction of the early seismic history in Messina Strait (south Italy: the 1st and 4th centuries AD earthquakes

    Directory of Open Access Journals (Sweden)

    Maria Serafina Barbano

    2014-03-01

    Full Text Available Historical accounts, archaeoseismic and paleoseismological evidence allowed us to reappraise two earthquakes affecting northeastern Sicily and southern Calabria in the 1st (probably between 14 and 37 and 4th (likely between 361 and 363 centuries AD, to obtain a better reconstruction of their effects and to reconsider their sources.The 1st century event damaged the area from Oppido (Calabria to Tindari (Sicily, roughly that of the February 6, 1783 Calabria earthquake. The similitude of these earthquakes is further stressed by the fact that they generated tsunamis, as recorded by historical data and by the tsunami deposits found at Capo Peloro, the oldest dated 0-125 AD, the youngest linked to the 1783 event. These earthquakes could be related to the same Calabria seismic source: the Scilla fault. Northeastern Sicily and southern Calabria were also damaged by one or more earthquakes in the 4th century AD and several towns were rebuilt/restored at that time. The hit area roughly coincides with that of the Messina 1908 earthquake suggesting similar seismic sources for the events. However, because close in time, historical descriptions of the 4th century Sicilian earthquake were mixed with those of the 365 Crete earthquake that generated a basin-wide tsunami most likely reaching also the Sicilian coasts. Reevaluating location, size, damage area and tsunamigenic potential of these two earthquakes of the 1st and 4th centuries AD is relevant for reassessing the seismogenic and tsunamigenic potential of the faults around the Messina Strait and the seismic hazard of the affected areas.

  17. Paleoseismology of the Denali fault system at the Schist Creek site, central Alaska

    Science.gov (United States)

    Personius, Stephen F.; Crone, Anthony J.; Burns, Patricia A.C.; Rozell, Ned

    2016-01-06

    Two hand-dug trenches at the Schist Creek site on the Denali fault system in central Alaska exposed evidence of four surface-rupturing earthquakes on the basis of upward terminations of fault strands and at least one buried, scarp-derived colluvial wedge. Limited radiocarbon ages provide some constraints on times of the ruptures. The youngest rupture (PE1) likely occurred about 200–400 years ago, the penultimate rupture (PE2) is younger than 1,200 years old, the third event back (PE3) occurred between 1,200 and 2,700 years ago, and the oldest rupture (PE4) occurred more than 2,700 and less than 17,000 years ago. Evidence for a possible additional rupture (PE4?) is equivocal and probably is related to earthquake PE4. On the basis of a nearby measured slip rate of 9.4 ± 1.6 millimeters per year and the long interevent times between our documented ruptures, we believe that our paleoseismic record at this site is incomplete. We suspect one undocumented earthquake between PE1 and PE2 and one or perhaps two more earthquakes between PE2 and PE3. We found stratigraphic evidence in the trenches for only four or possibly five (PE4?) earthquakes, but the addition of two or three inferred earthquakes yields a record of eight possible surface ruptures at the Schist Creek site. Our interpretation of the paleoseismic history at the site is consistent with recurrence intervals of several hundred years on this section of the Denali fault system.

  18. Clinical evidence of traditional vs fast track recovery methodologies after total arthroplasty for osteoarthritic knee treatment. A retrospective observational study

    Science.gov (United States)

    Castorina, Sergio; Guglielmino, Claudia; Castrogiovanni, Paola; Szychlinska, Marta Anna; Ioppolo, Francesco; Massimino, Paolo; Leonardi, Pietro; Maci, Christian; Iannuzzi, Maurizio; Di Giunta, Angelo; Musumeci, Giuseppe

    2017-01-01

    Summary Background During the last years, programs to enhance postoperative recovery and decrease morbidity after total knee arthroplasty, have been developed across a variety of surgical procedures and referred to as “Fast-Track Surgery”. In this study we aimed to find some answers in the management of osteoarthritic patients subjected to total knee arthroplasty, by using the Fast-Track methodology. To this purpose we evaluated parameters such as early mobilization of patients, better pain management, bleeding, possible complications, reduced hospitalization time, an overall improved recovery and patient satisfaction. Methods 132 patients were selected, of which, 95 treated with “Fast Track” method and 37 treated with traditional method (control group). All the patients were hospitalized and underwent the same rehabilitation program for the first three days after surgery. Results In both groups, the parameters of pain and deformity demonstrated the most rapid improvement, while those of function and movement were normalized as gradual and progressive improvement over the next 2 months. The different functional test used (Barthel, MRC, VAS) showed that the mean values were significantly greater in Fast Track group when compared to the control. Conclusion The results of the study confirm that the application of the Fast Track protocol in orthopaedics after total knee replacement results in rapid post-surgery recovery. Level of evidence IV. Case series, low-quality cohort or case-control studies. PMID:29387645

  19. Active faults, paleoseismology, and historical fault rupture in northern Wairarapa, North Island, New Zealand

    International Nuclear Information System (INIS)

    Schermer, E.R.; Van Dissen, R.; Berryman, K.R.; Kelsey, H.M.; Cashman, S.M.

    2004-01-01

    Active faulting in the upper plate of the Hikurangi subduction zone, North Island, New Zealand, represents a significant seismic hazard that is not yet well understood. In northern Wairarapa, the geometry and kinematics of active faults, and the Quaternary and historical surface-rupture record, have not previously been studied in detail. We present the results of mapping and paleoseismicity studies on faults in the northern Wairarapa region to document the characteristics of active faults and the timing of earthquakes. We focus on evidence for surface rupture in the 1855 Wairarapa (M w 8.2) and 1934 Pahiatua (M w 7.4) earthquakes, two of New Zealand's largest historical earthquakes. The Dreyers Rock, Alfredton, Saunders Road, Waitawhiti, and Waipukaka faults form a northeast-trending, east-stepping array of faults. Detailed mapping of offset geomorphic features shows the rupture lengths vary from c. 7 to 20 km and single-event displacements range from 3 to 7 m, suggesting the faults are capable of generating M >7 earthquakes. Trenching results show that two earthquakes have occurred on the Alfredton Fault since c. 2900 cal. BP. The most recent event probably occurred during the 1855 Wairarapa earthquake as slip propagated northward from the Wairarapa Fault and across a 6 km wide step. Waipukaka Fault trenches show that at least three surface-rupturing earthquakes have occurred since 8290-7880 cal. BP. Analysis of stratigraphic and historical evidence suggests the most recent rupture occurred during the 1934 Pahiatua earthquake. Estimates of slip rates provided by these data suggest that a larger component of strike slip than previously suspected is occurring within the upper plate and that the faults accommodate a significant proportion of the dextral component of oblique subduction. Assessment of seismic hazard is difficult because the known fault scarp lengths appear too short to have accommodated the estimated single-event displacements. Faults in the region are

  20. Leveraging Real-World Evidence in Disease-Management Decision-Making with a Total Cost of Care Estimator.

    Science.gov (United States)

    Nguyen, Thanh-Nghia; Trocio, Jeffrey; Kowal, Stacey; Ferrufino, Cheryl P; Munakata, Julie; South, Dell

    2016-12-01

    Health management is becoming increasingly complex, given a range of care options and the need to balance costs and quality. The ability to measure and understand drivers of costs is critical for healthcare organizations to effectively manage their patient populations. Healthcare decision makers can leverage real-world evidence to explore the value of disease-management interventions in shifting total cost trends. To develop a real-world, evidence-based estimator that examines the impact of disease-management interventions on the total cost of care (TCoC) for a patient population with nonvalvular atrial fibrillation (NVAF). Data were collected from a patient-level real-world evidence data set that uses the IMS PharMetrics Health Plan Claims Database. Pharmacy and medical claims for patients meeting the inclusion or exclusion criteria were combined in longitudinal cohorts with a 180-day preindex and 360-day follow-up period. Descriptive statistics, such as mean and median patient costs and event rates, were derived from a real-world evidence analysis and were used to populate the base-case estimates within the TCoC estimator, an exploratory economic model that was designed to estimate the potential impact of several disease-management activities on the TCoC for a patient population with NVAF. Using Microsoft Excel, the estimator is designed to compare current direct costs of medical care to projected costs by varying assumptions on the impact of disease-management activities and applying the associated changes in cost trends to the affected populations. Disease-management levers are derived from literature-based concepts affecting costs along the NVAF disease continuum. The use of the estimator supports analyses across 4 US geographic regions, age, cost types, and care settings during 1 year. All patients included in the study were continuously enrolled in their health plan (within the IMS PharMetrics Health Plan Claims Database) between July 1, 2010, and June 30

  1. Novel Approaches for Phylogenetic Inference from Morphological Data and Total-Evidence Dating in Squamate Reptiles (Lizards, Snakes, and Amphisbaenians).

    Science.gov (United States)

    Pyron, R Alexander

    2017-01-01

    Here, I combine previously underutilized models and priors to perform more biologically realistic phylogenetic inference from morphological data, with an example from squamate reptiles. When coding morphological characters, it is often possible to denote ordered states with explicit reference to observed or hypothetical ancestral conditions. Using this logic, we can integrate across character-state labels and estimate meaningful rates of forward and backward transitions from plesiomorphy to apomorphy. I refer to this approach as MkA, for “asymmetric.” The MkA model incorporates the biological reality of limited reversal for many phylogenetically informative characters, and significantly increases likelihoods in the empirical data sets. Despite this, the phylogeny of Squamata remains contentious. Total-evidence analyses using combined morphological and molecular data and the MkA approach tend toward recent consensus estimates supporting a nested Iguania. However, support for this topology is not unambiguous across data sets or analyses, and no mechanism has been proposed to explain the widespread incongruence between partitions, or the hidden support for various topologies in those partitions. Furthermore, different morphological data sets produced by different authors contain both different characters and different states for the same or similar characters, resulting in drastically different placements for many important fossil lineages. Effort is needed to standardize ontology for morphology, resolve incongruence, and estimate a robust phylogeny. The MkA approach provides a preliminary avenue for investigating morphological evolution while accounting for temporal evidence and asymmetry in character-state changes.

  2. Paleoseismology of the Xorxol Segment of the Central Altyn Tagh Fault, Xinjiang, China

    Directory of Open Access Journals (Sweden)

    Z. Y. Qiao

    2003-06-01

    Full Text Available Although the Altyn Tagh Fault (ATF is thought to play a key role in accommodating India-Eurasian convergence, little is known about its earthquake history. Studies of this strike-slip fault are important for interpretation of the role of faulting versus distributed deformation in the accommodation of the India- Eurasia collision. In addition, the > 1200 km long fault represents one of the most important and exemplary intracontinental strike-slip faults in the world. We mapped fault trace geometry and interpreted paleoseismic trench exposures to characterize the seismogenic behavior of the ATF. We identified 2 geometric segment boundaries in a 270 km long reach of the central ATF. These boundaries define the westernmost Wuzhunxiao, the Central Pingding, and the easternmost Xorxol (also written as Suekuli or Suo erkuli segments. In this paper, we present the results from the Camel paleoseismic site along the Xorxol Segment at 91.759°E, 38.919°N. There evidence for the last two earthquakes is clear and 14C dates from layers exposed in the excavation bracket their ages. The most recent earthquake occurred between 1456 and 1775 cal A.D. and the penultimate event was between 60 and 980 cal A.D. Combining the Camel interpretations with our published results for the central ATF, we conclude that multiple earthquakes with shorter rupture lengths (?? 50 km rather than complete rupture of the Xorxol Segment better explain the paleoseismic data. We found 2-3 earthquakes in the last 2-3 kyr. When coupled with typical amounts of slip per event (5-10 m, the recurrence times are tentatively consistent with 1-2 cm/yr slip rates. This result favors models that consider the broader distribution of collisional deformation, rather than those with northward motion of India into Asia absorbed along a few faults bounding rigid blocks.

  3. Paleoseismology of a possible fault scarp in Wenas Valley, central Washington

    Science.gov (United States)

    Sherrod, Brian L.; Barnett, Elizabeth A.; Knepprath, Nichole; Foit, Franklin F.

    2013-01-01

    In October 2009, two trenches excavated across an 11-kilometer-long scarp at Wenas Valley in central Washington exposed evidence for late Quaternary deformation. Lidar imagery of the Wenas Valley illuminated the west-northwest-trending, 2- to 8-meter-high scarp as it bisected alluvial fans developed at the mouths of canyons along the south side of Umtanum Ridge. The alignment of the scarp and aeromagnetic lineaments suggested that the scarp may be a product of and controlled by the same tectonic structure that produced the magnetic lineaments. Several large landslides mapped in the area demonstrated the potential for large mass-wasting events in the area. In order to test whether the scarp was the result of an earthquake-generated surface rupture or a landslide, trenches were excavated at Hessler Flats and McCabe Place. The profiles of bedrock and soil stratigraphy that underlie the scarp in each trench were photographed, mapped, and described, and a sequence of depositional and deformational events established for each trench. The McCabe Place trench exposed a sequence of volcaniclastic deposits overlain by soils and alluvial deposits separated by three unconformities. Six normal faults and two possible reverse faults deformed the exposed strata. Crosscutting relations indicated that up to five earthquakes occurred on a blind reverse fault, and a microprobe analysis of lapilli suggested that the earliest faulting occurred after 47,000 years before present. The Hessler Flat trench exposure revealed weathered bedrock that abuts loess and colluvium deposits and is overlain by soil, an upper sequence of loess, and colluvium. The latter two units bury a distinctive paloesol.

  4. Sedimentation influx and volcanic interactions in the Fuji Five Lakes: implications for paleoseismological records

    Science.gov (United States)

    Lamair, Laura; Hubert-Ferrari, Aurélia; Yamamoto, Shinya; El Ouahabi, Meriam; Garrett, Ed; Shishikura, Masanobu; Schmidt, Sabine; Boes, Evelien; Obrochta, Stephen; Nakamura, Atsunori; Miyairi, Yosuke; Yokoyama, Yusuke; De Batist, Marc; Heyvaert, Vanessa M. A.

    2017-04-01

    The Fuji Fives Lakes are located at the foot of Mount Fuji volcano close to the triple junction, where the North American Plate, the Eurasian plate and the Philippine Sea Plate meet. These lakes are ideally situated to study Mount Fuji volcanism and the interaction between volcanism, changes in lake sedimentation rates and the ability of lakes to record paleoearthquakes. Here, we present newly acquired geological data of Lake Yamanaka and Lake Motosu, including seismic reflection profiles, gravity and piston cores. These two lakes and their respective watersheds were affected by several eruptions of Mount Fuji. Lake Yamanaka, a very shallow lake (max. depth 14 m), was heavily impacted by the scoria fall-out of the A.D. 1707 Hoei eruption of Mount Fuji. A detailed investigation of the effect of the Hoei eruption was conducted on short gravity cores, using high resolution XRD, C/N and 210Pb/137Cs analyses. The preliminary results suggest that the sedimentation rate of Lake Yamanaka drastically reduced after the Hoei eruption, followed by an increase until the present day. Similarly, lacustrine sedimentation in Lake Motosu (max. depth 122 m) was disturbed by Mount Fuji volcanism at a larger scale. The watershed of Lake Motosu was impacted by several lava flows and scoria cones. For example, the Omuro scoria cone reduced the catchment size of Lake Motosu and modified its physiography. The related scoria fall out covered an extensive part of the lake catchment and reduced terrigenous sedimentary influx to Lake Motosu. Within the deep basin of Lake Motosu, seismic reflection data shows two different periods that are distinguished by a major change in the dominant sedimentary processes. During the first period, sublacustrine landslides and turbidity currents were the dominant sedimentation processes. During the second one, the seismic stratigraphy evidences only deposition of numerous turbidites interrupting the hemipelagic sedimentation. Changes in sedimentary processes

  5. Earthquake geology and paleoseismology of major strands of the San Andreas fault system: Chapter 38

    Science.gov (United States)

    Rockwell, Thomas; Scharer, Katherine M.; Dawson, Timothy E.

    2016-01-01

    The San Andreas fault system in California is one of the best-studied faults in the world, both in terms of the long-term geologic history and paleoseismic study of past surface ruptures. In this paper, we focus on the Quaternary to historic data that have been collected from the major strands of the San Andreas fault system, both on the San Andreas Fault itself, and the major subparallel strands that comprise the plate boundary, including the Calaveras-Hayward- Rogers Creek-Maacama fault zone and the Concord-Green Valley-Bartlett Springs fault zone in northern California, and the San Jacinto and Elsinore faults in southern California. The majority of the relative motion between the Pacific and North American lithospheric plates is accommodated by these faults, with the San Andreas slipping at about 34 mm/yr in central California, decreasing to about 20 mm/yr in northern California north of its juncture with the Calaveras and Concord faults. The Calaveras-Hayward-Rogers Creek-Maacama fault zone exhibits a slip rate of 10-15 mm/yr, whereas the rate along the Concord-Green Valley-Bartlett Springs fault zone is lower at about 5 mm/yr. In southern California, the San Andreas exhibits a slip rate of about 35 mm/yr along the Mojave section, decreasing to as low as 10-15 mm/yr along its juncture with the San Jacinto fault, and about 20 mm/yr in the Coachella Valley. The San Jacinto and Elsinore fault zones exhibit rates of about 15 and 5 mm/yr, respectively. The average recurrence interval for surface-rupturing earthquakes along individual elements of the San Andreas fault system range from 100-500 years and is consistent with slip rate at those sites: higher slip rates produce more frequent or larger earthquakes. There is also evidence of short-term variations in strain release (slip rate) along various fault sections, as expressed as “flurries” or clusters of earthquakes as well as periods of relatively fewer surface ruptures in these relatively short records. This

  6. The true costs of participatory sanitation: Evidence from community-led total sanitation studies in Ghana and Ethiopia.

    Science.gov (United States)

    Crocker, Jonny; Saywell, Darren; Shields, Katherine F; Kolsky, Pete; Bartram, Jamie

    2017-12-01

    Evidence on sanitation and hygiene program costs is used for many purposes. The few studies that report costs use top-down costing methods that are inaccurate and inappropriate. Community-led total sanitation (CLTS) is a participatory behavior-change approach that presents difficulties for cost analysis. We used implementation tracking and bottom-up, activity-based costing to assess the process, program costs, and local investments for four CLTS interventions in Ghana and Ethiopia. Data collection included implementation checklists, surveys, and financial records review. Financial costs and value-of-time spent on CLTS by different actors were assessed. Results are disaggregated by intervention, cost category, actor, geographic area, and project month. The average household size was 4.0 people in Ghana, and 5.8 people in Ethiopia. The program cost of CLTS was $30.34-$81.56 per household targeted in Ghana, and $14.15-$19.21 in Ethiopia. Most program costs were from training for three of four interventions. Local investments ranged from $7.93-$22.36 per household targeted in Ghana, and $2.35-$3.41 in Ethiopia. This is the first study to present comprehensive, disaggregated costs of a sanitation and hygiene behavior-change intervention. The findings can be used to inform policy and finance decisions, plan program scale-up, perform cost-effectiveness and benefit studies, and compare different interventions. The costing method is applicable to other public health behavior-change programs. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  7. Evident?

    DEFF Research Database (Denmark)

    Plant, Peter

    2012-01-01

    Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind......Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind...

  8. Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence

    DEFF Research Database (Denmark)

    Thorning, Tanja Kongerslev; Raben, Anne; Tholstrup, Tine

    2016-01-01

    , particularly stroke. Furthermore, the evidence suggested a beneficial effect of milk and dairy intake on bone mineral density but no association with risk of bone fracture. Among cancers, milk and dairy intake was inversely associated with colorectal cancer, bladder cancer, gastric cancer, and breast cancer...... of available scientific evidence supports that intake of milk and dairy products contribute to meet nutrient recommendations, and may protect against the most prevalent chronic diseases, whereas very few adverse effects have been reported.......BACKGROUND: There is scepticism about health effects of dairy products in the public, which is reflected in an increasing intake of plant-based drinks, for example, from soy, rice, almond, or oat. OBJECTIVE: This review aimed to assess the scientific evidence mainly from meta...

  9. Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence

    NARCIS (Netherlands)

    Thorning, Tanja Kongerslev; Raben, Anne; Tholstrup, Tine; Soedamah-muthu, Sabita S.; Givens, Ian; Astrup, Arne

    2016-01-01

    Background: There is scepticism about health effects of dairy products in the public, which is reflected in an increasing intake of plant-based drinks, for example, from soy, rice, almond, or oat.
    Objective: This review aimed to assess the scientific evidence mainly from meta-analyses of

  10. Testing for causality between the foreign direct investment, current account deficit, GDP and total credit: Evidence from G7

    Directory of Open Access Journals (Sweden)

    Akbas Yusuf Ekrem

    2013-01-01

    Full Text Available In this study, countries were analyzed between 1990 and 2011 in order to determine whether a causal relationship exists among current account deficit, GDP, foreign direct investment, and total credits of G7. Analysis took into account the cross-sectional dependence and was applied to test the causality among the variables form the panel. Firstly, panel unit root tests were used for determining stationary of variables. As a result of the panel unit root tests, it was found that GDP and foreign direct investment have a stationary structure and that total credits and current account deficit contain unit root. In order to see whether there is a long-term relationship among the variables or not, the panel co-integration test was used. As a result of the test, it was concluded that there is a co-integration relationship among the series. The possibility of a causal relationship was analyzed among the variables using the causality test developed by Elena Ivona Dumitrescu and Christophe Hurlin (2012. Results of the analysis showed a unidirectional causal relationship from current account deficit and foreign direct investment to GDP. Bidirectional causality was found between current account deficit and total credits. Finally, a unidirectional relationship was found from foreign direct investment to current account deficit and total credits.

  11. Do Work-Life Balance Policies Increase a Firm's Total Factor Productivity?: Evidence from panel data of Japanese firms (Japanese)

    OpenAIRE

    YAMAMOTO Isamu; MATSUURA Toshiyuki

    2011-01-01

    This paper examines how firms' policies for workers' work-life balance (WLB) affect total factor productivity (TFP) in the long run, by using panel data of Japanese firms from the 1990s. Although we observed a positive correlation between firms' WLB policies and their TFP, once controlling for unobserved firm heterogeneity, we found no causal relationship where WLB policies increase a firm's TFP in the long run. Under the following conditions, however, WLB policies would likely improve a firm...

  12. Assessment and Decomposition of Total Factor Energy Efficiency: An Evidence Based on Energy Shadow Price in China

    Directory of Open Access Journals (Sweden)

    Peihao Lai

    2016-04-01

    Full Text Available By adopting an energy-input based directional distance function, we calculated the shadow price of four types of energy (i.e., coal, oil, gas and electricity among 30 areas in China from 1998 to 2012. Moreover, a macro-energy efficiency index in China was estimated and divided into intra-provincial technical efficiency, allocation efficiency of energy input structure and inter-provincial energy allocation efficiency. It shows that total energy efficiency has decreased in recent years, where intra-provincial energy technical efficiency drops markedly and extensive mode of energy consumption rises. However, energy structure and allocation improves slowly. Meanwhile, lacking an integrated energy market leads to the loss of energy efficiency. Further improvement of market allocation and structure adjustment play a pivotal role in the increase of energy efficiency.

  13. Influence of Organisational Culture on Total Quality Management Implementation and Firm Performance: Evidence from the Vietnamese Construction Industry

    Directory of Open Access Journals (Sweden)

    Panuwatwanich Kriengsak

    2017-03-01

    Full Text Available The main purpose of this study is to examine the relationship between organisational culture (OC and Total Quality Management (TQM, and the influence of TQM implementation on organisational performance improvement within the context of the Vietnamese construction industry. A survey was conducted with 104 respondents from Vietnamese construction firms, using validated survey instruments developed in past research. Analysis techniques include cluster analysis and Structural Equation Modelling. Findings showed that Vietnamese construction firms are dominated by clan and hierarchy cultures rather than adhocracy and market cultures according to Competing Value Framework (CVF of OC classification. Furthermore, it was found that organisations dominated by either clan or adhocracy cultures could provide a favourable environment for successful TQM implementation, whereas this is not the case for those dominated by both market and hierarchy cultures. This study also confirmed the significant and positive relationship between TQM implementation and organisational performance improvement.

  14. Biomaterial Hypersensitivity: Is It Real? Supportive Evidence and Approach Considerations for Metal Allergic Patients following Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Andrew J. Mitchelson

    2015-01-01

    Full Text Available The prospect of biomaterial hypersensitivity developing in response to joint implant materials was first presented more than 30 years ago. Many studies have established probable causation between first-generation metal-on-metal hip implants and hypersensitivity reactions. In a limited patient population, implant failure may ultimately be related to metal hypersensitivity. The examination of hypersensitivity reactions in current-generation metal-on-metal knee implants is comparatively limited. The purpose of this study is to summarize all available literature regarding biomaterial hypersensitivity after total knee arthroplasty, elucidate overall trends about this topic in the current literature, and provide a foundation for clinical approach considerations when biomaterial hypersensitivity is suspected.

  15. Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery

    Science.gov (United States)

    Siletz, Anaar E.; Singer, Emily S.; Faltermeier, Claire; Hu, Q. Lina; Ko, Clifford Y.; Golladay, Gregory J.; Kates, Stephen L.; Wick, Elizabeth C.; Maggard-Gibbons, Melinda

    2018-01-01

    Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery—a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). Study Design: This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Results: Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. Conclusion: This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving

  16. Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.

    Science.gov (United States)

    Childers, Christopher P; Siletz, Anaar E; Singer, Emily S; Faltermeier, Claire; Hu, Q Lina; Ko, Clifford Y; Golladay, Gregory J; Kates, Stephen L; Wick, Elizabeth C; Maggard-Gibbons, Melinda

    2018-01-01

    Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/ Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving Surgical Care and Recovery aims to guide hospitals and

  17. Introduction to Special Section: Paleoseismology

    Science.gov (United States)

    Yeats, Robert S.; Prentice, Carol S.

    1996-03-01

    A proverb of Confucius states "Study the past if you would divine the future." If we could learn about the past history of earthquakes on a specific fault, then we could serve society well by better forecasting the future earthquake behavior of that fault. For most of the world, the period of historical records is short: about 200 years in California and less than that in New Zealand, Oregon, and other parts of the world. And even where the historical record is thousands of years long, such as in north central China or the eastern Mediterranean region, it is commonly difficult to correlate a major historical earthquake with a specific active fault. Even if this correlation could be made without ambiguity, the recurrence intervals for many faults are longer than even a historical record of several thousand years. For these reasons, the history of large earthquakes on faults must, for the most part, be learned from the geological record.

  18. A nutraceutical approach (Armolipid Plus) to reduce total and LDL cholesterol in individuals with mild to moderate dyslipidemia: Review of the clinical evidence.

    Science.gov (United States)

    Barrios, Vivencio; Escobar, Carlos; Cicero, Arrigo Francesco Giuseppe; Burke, David; Fasching, Peter; Banach, Maciej; Bruckert, Eric

    2017-02-01

    Compelling evidence supports the effectiveness of the reduction of total and LDL cholesterol (TC and LDL-C) in primarily preventing cardiovascular events, within the framework of life-long prevention programs mainly consisting in lifestyle changes. Pharmacological treatment should be introduced when lifestyle changes, including use of nutraceuticals, have failed. ESC/EAS guidelines list a number of nutraceutical compounds and functional foods which have been individually studied in randomized, controlled clinical trials (RCTs). To date only a proprietary formulation of three naturally occurring substances with putative complementary lipid-lowering properties - red yeast rice, policosanol and berberine - combined with folic acid, astaxanthin, and coenzyme Q10 (Armolipid Plus ® ) has been extensively investigated in several RCTs, 7 of which were placebo-controlled, 2 were ezetimibe comparators and 4 were "real life" studies comparing diet and Armolipid Plus to diet alone. The trials included mostly patients with mild to moderate dyslipidemia, treated for 6-48 weeks. The trials also included special populations and patients in whom statins were contraindicated or who could not tolerate them. Armolipid Plus has proved to be able to achieve significant reductions in TC (11-21%) and in LDL-C (15-31%) levels, which is equivalent to expectations from low dose statins. In patients intolerant to statins, who do not achieve their therapeutic target with ezetimibe, Armolipid Plus can achieve a further 10% improvement in TC and LDL-C. The safety and tolerability of Armolipid Plus were excellent, thought likely due to the intentional combination of low doses of its active ingredients: low enough not to be associated with untoward effects, but high enough to exert therapeutic effects in combination with other complementary substances. Consequently, in the event of intolerance to statins, Armolipid Plus offers an effective alternative, which is devoid of the safety risks

  19. A nutraceutical approach (Armolipid Plus) to reduce total and LDL cholesterol in individuals with mild to moderate dyslipidemia: Review of the clinical evidence.

    LENUS (Irish Health Repository)

    Barrios, Vivencio

    2017-02-01

    Compelling evidence supports the effectiveness of the reduction of total and LDL cholesterol (TC and LDL-C) in primarily preventing cardiovascular events, within the framework of life-long prevention programs mainly consisting in lifestyle changes. Pharmacological treatment should be introduced when lifestyle changes, including use of nutraceuticals, have failed. ESC\\/EAS guidelines list a number of nutraceutical compounds and functional foods which have been individually studied in randomized, controlled clinical trials (RCTs). To date only a proprietary formulation of three naturally occurring substances with putative complementary lipid-lowering properties - red yeast rice, policosanol and berberine - combined with folic acid, astaxanthin, and coenzyme Q10 (Armolipid Plus(®)) has been extensively investigated in several RCTs, 7 of which were placebo-controlled, 2 were ezetimibe comparators and 4 were "real life" studies comparing diet and Armolipid Plus to diet alone. The trials included mostly patients with mild to moderate dyslipidemia, treated for 6-48 weeks. The trials also included special populations and patients in whom statins were contraindicated or who could not tolerate them. Armolipid Plus has proved to be able to achieve significant reductions in TC (11-21%) and in LDL-C (15-31%) levels, which is equivalent to expectations from low dose statins. In patients intolerant to statins, who do not achieve their therapeutic target with ezetimibe, Armolipid Plus can achieve a further 10% improvement in TC and LDL-C. The safety and tolerability of Armolipid Plus were excellent, thought likely due to the intentional combination of low doses of its active ingredients: low enough not to be associated with untoward effects, but high enough to exert therapeutic effects in combination with other complementary substances. Consequently, in the event of intolerance to statins, Armolipid Plus offers an effective alternative, which is devoid of the safety risks

  20. Total protein

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

  1. Combined effect of blood pressure and total cholesterol levels on long-term risks of subtypes of cardiovascular death: Evidence for Cardiovascular Prevention from Observational Cohorts in Japan.

    Science.gov (United States)

    Satoh, Michihiro; Ohkubo, Takayoshi; Asayama, Kei; Murakami, Yoshitaka; Sakurai, Masaru; Nakagawa, Hideaki; Iso, Hiroyasu; Okayama, Akira; Miura, Katsuyuki; Imai, Yutaka; Ueshima, Hirotsugu; Okamura, Tomonori

    2015-03-01

    No large-scale, longitudinal studies have examined the combined effects of blood pressure (BP) and total cholesterol levels on long-term risks for subtypes of cardiovascular death in an Asian population. To investigate these relationships, a meta-analysis of individual participant data, which included 73 916 Japanese subjects (age, 57.7 years; men, 41.1%) from 11 cohorts, was conducted. During a mean follow-up of 15.0 years, deaths from coronary heart disease, ischemic stroke, and intraparenchymal hemorrhage occurred in 770, 724, and 345 cases, respectively. Cohort-stratified Cox proportional hazard models were used. After stratifying the participants by 4 systolic BP ×4 total cholesterol categories, the group with systolic BP ≥160 mm Hg with total cholesterol ≥5.7 mmol/L had the greatest risk for coronary heart disease death (adjusted hazard ratio, 4.39; Pdeath, and total cholesterol was inversely associated with intraparenchymal hemorrhage, but no significant interactions between BP and total cholesterol were observed for stroke. High BP and high total cholesterol can synergistically increase the risk for coronary heart disease death but not for stroke in the Asian population. © 2015 American Heart Association, Inc.

  2. Total algorithms

    NARCIS (Netherlands)

    Tel, G.

    We define the notion of total algorithms for networks of processes. A total algorithm enforces that a "decision" is taken by a subset of the processes, and that participation of all processes is required to reach this decision. Total algorithms are an important building block in the design of

  3. Effect of thyroxine on cellular oxygen-consumption and glucose uptake: evidence of an effect of total T4 and not "free T4"

    DEFF Research Database (Denmark)

    Kvetny, J; Matzen, L E

    1990-01-01

    Recent studies of cellular T4 and T3 uptake have indicated active transport of the hormones into the cell rather than passive diffusion of the non-protein bound fraction. In order to study the significance of the extracellular environment, oxygen consumption and glucose uptake were examined...... in human mononuclear blood cells. Cells were incubated in protein free medium and in human serum totally depleted of thyroid hormones by resin treatment and fixed amounts of T4 (total T4 = 0-50-100-5000 nmol/l; free T4 = 0-5-11-5600 pmol/l) were added. Thyroxine stimulated glucose uptake and oxygen......-consumption in a dose dependent manner but the T4 stimulation was dependent on the total concentration of T4 and did not differ between serum incubation or non-protein containing medium. Addition of ANS (100 mg/l) which inhibits binding of T4 to TBG, did not increase T4 effect in serum. Inhibition of the Na...

  4. Contribution of aerobic anoxygenic phototrophic bacteria to total organic carbon pool in aquatic system of subtropical karst catchments, Southwest China: evidence from hydrochemical and microbiological study.

    Science.gov (United States)

    Li, Qiang; Song, Ang; Peng, Wenjie; Jin, Zhenjiang; Müller, Werner E G; Wang, Xiaohong

    2017-06-01

    Aerobic anoxygenic phototrophic bacteria may play a particular role in carbon cycling of aquatic systems. However, little is known about the interaction between aerobic anoxygenic phototrophic bacteria and hydrochemistry in groundwater-surface water exchange systems of subtropical karst catchments. We carried out a detailed study on the abundance of aerobic anoxygenic phototrophic bacteria and bacterioplankton, hydrochemistry and taxonomy of bacterioplankton in the Maocun watershed, Southwest China, an area with karst geological background. Our results revealed that bacteria are the important contributors to total organic carbon source/sequestration in the groundwater-surface water of this area. The aerobic anoxygenic phototrophic bacteria, including β-Proteobacteria, also appear in the studied water system. In addition to that, the genus Polynucleobacter of the phototropic β-Proteobacteria shows a close link with those sampling sites by presenting bacterial origin organic carbon on CCA biplot and is found to be positively correlated with total nitrogen, dissolved oxygen and pH (r = 0.860, 0.747 and 0.813, respectively) in the Maocun watershed. The results suggest that Polynucleobacter might be involved in the production of organic carbon and might act as the negative feedback on global warming. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Totally James

    Science.gov (United States)

    Owens, Tom

    2006-01-01

    This article presents an interview with James Howe, author of "The Misfits" and "Totally Joe". In this interview, Howe discusses tolerance, diversity and the parallels between his own life and his literature. Howe's four books in addition to "The Misfits" and "Totally Joe" and his list of recommended books with lesbian, gay, bisexual, transgender,…

  6. Evidence for mouse Th1- and Th2-like helper T cells in vivo. Selective reduction of Th1-like cells after total lymphoid irradiation

    International Nuclear Information System (INIS)

    Bass, H.; Mosmann, T.; Strober, S.

    1989-01-01

    Purified CD4+ BALB/c spleen T cells obtained 4-6 wk after total lymphoid irradiation (TLI) helped normal syngeneic B cells to produce a vigorous antibody response to TNP keyhole limpet hemocyanin in adoptive cell transfer experiments. However, the same cells failed to transfer delayed-type hypersensitivity to the adoptive hosts as measured by a foot pad swelling assay. In addition, purified CD4+ cells from TLI-treated mice were unable to induce graft vs. host disease in lethally irradiated allogeneic C57BL/Ka recipient mice. In response to mitogen stimulation, unfractionated spleen cells obtained from TLI mice secreted normal levels of IL-4 and IL-5, but markedly reduced levels of IL-2 and INF-gamma. A total of 229 CD4+ clones from spleen cells of both normal and TLI-treated mice were established, and the cytokine secretion pattern from each clone was analyzed. The results demonstrate that the ratio of Th1- and Th2-like clones in the spleens of normal BALB/c mice is 1:0.6, whereas the ratio in TLI mice is approximately 1:7. These results suggest that Th2-like cells recover rapidly (at approximately 4-6 wk) after TLI treatment and account for the early return of antibody helper activity and secretion of IL-4 and IL-5, but Th1-like cells recover more slowly (in approximately 3 mo) after irradiation, and this accounts for the deficit in cell-mediated immunity and the reduced amount of IL-2 and IFN-gamma secretion

  7. Total Laparoscopic Hysterectomy: Evaluation of an Evidence-Based Educational Strategy Using a Novel Simulated Suture and Knot-Tying Challenge, the “Holiotomy”

    Directory of Open Access Journals (Sweden)

    Katherine A. O'Hanlan

    2012-01-01

    Full Text Available Objective. The purpose of this study was to evaluate perceptions of skills and practice patterns of gynecologists attending a course on total laparoscopic hysterectomy (TLH. This course employed extensive use of pelvic trainer boxes to accomplish the Holiotomy Challenge. The “Holiotomy Challenge” entailed suturing two plastic pieces with six figure-of-N sutures tied with four square knots each. Methods. A survey was administered before the course and 3 months later. Data were analyzed by paired t-tests, McNemar’s Chi Squares, and ANCOVAs with significance set P<.05. Results. At baseline, 216 surgeons and at 3 months 102 surgeons returned the survey. Surgeons’ self-perceptions of their skills significantly increased from 6.24 to 7.28. Their reports of their surgical practice at home revealed significantly increased rates of minimally invasive procedures, from 42% to 54%. Significantly more surgeons reported having the ability to close the vagina, or a small cystotomy or enterotomy. Participation in the cadaver lab and presence of their practice partner did not impact these rates. Conclusions. A comprehensive course employing laparoscopic surgical simulation focused on basic surgical skills essential to TLH has a positive impact on attendees' self-rated skill level and rate of laparoscopic approaches. Many had begun performing TLH after the course.

  8. Lack of Association Between the Use of Nerve Blockade and the Risk of Postoperative Chronic Opioid Use Among Patients Undergoing Total Knee Arthroplasty: Evidence From the Marketscan Database.

    Science.gov (United States)

    Sun, Eric C; Bateman, Brian T; Memtsoudis, Stavros G; Neuman, Mark D; Mariano, Edward R; Baker, Laurence C

    2017-09-01

    Total knee arthroplasty (TKA) is associated with high rates of prolonged opioid use after surgery (10%-34%). By decreasing opioid use in the immediate postoperative period, perioperative nerve blockade has been hypothesized to decrease the risk of persistent opioid use. Using health care utilization data, we constructed a sample of 120,080 patients undergoing TKA between 2002 and 2012 and used billing data to identify the utilization of peripheral or neuraxial blockade. We then used a multivariable logistic regression to estimate the association between nerve blockade and the risk of chronic opioid use, defined as having filled ≥10 prescriptions or ≥120 days' supply for an opioid in the first postsurgical year. Our analyses were adjusted for an extensive set of potential confounding variables, including medical comorbidities, previous opioid use, and previous use of other medications. We did not find an association between nerve blockade and the risk of postsurgical chronic opioid use across any of these 3 groups: adjusted relative risk (ARR) 0.984 for patients opioid-naïve in the year before surgery (98.3% confidence interval [CI], 0.870-1.12, P = .794), ARR 1.02 for intermittent opioid users (98.3% CI, 0.948-1.09, P = .617), and ARR 0.986 (98.3% CI, 0.963-1.01, P = .257) for chronic opioid users. Similar results held for alternative measures of postsurgical opioid use. Although the use of perioperative nerve blockade for TKA may improve short-term outcomes, the analyzed types of blocks do not appear to decrease the risk of persistent opioid use in the longer term.

  9. Evidence for a single stem cell to reconstitute nearly one half of the total blood T cells in two A-bomb survivors

    International Nuclear Information System (INIS)

    Kodama, Y.; Nakano, M.; Itho, M.; Ohtaki, K.; Kusunoki, Y.; Nakamura, N.

    2003-01-01

    Full text: Recently, we have encountered two A-bomb survivors who had identical chromosome aberrations in their lymphocytes with very high frequencies; one survivor bore the same translocations in 40% of blood lymphocytes (case 1, estimated dose= 1.06 Sv) and the other had identical inversions and deletions in 30% of the lymphocytes (case 2, estimated dose 3.54 Sv). In case 1, the same abnormality was frequently observed in CD4 T cells, CD8 T cells, and EBV-transformed B cells as well, suggesting the origin in a bone marrow stem cell. Although it is generally thought that the clonal aberrations observed in A-bomb survivors were induced by A-bomb radiation, the results did not allow us to distinguish if the clone preexisted (i.e., as a mosaic individual) or was induced following radiation exposure. To discriminate these two possibilities, we applied 24-color FISH to detect additional non-clonal aberrations among the clonal cells. As these survivors bore various non-clonal translocations in about 30% (case 1) or 50% (case 2) of the lymphocytes that do not carry the clonal aberration, the rational is straightforward; if the clonal cells preexisted, we expected 30% or 50% of additional but non-clonal aberrations among the clonal cells. By contrast, if the clone emerged following the A-bomb radiation exposure, we expected a minimum frequency of additional aberrations among the clonal cells (i.e., close to the background aberration frequency observed in non-exposed people). The results showed that the frequency of additional translocations among the clonal cells was only 3% (3/101 cells) in case 1 and 1% (1/100) in case 2. Thus, the results clearly demonstrated that the clonal cells did not preexist and were produced as a result of extensive proliferation of a single stem cell following radiation exposure, which gave rise to comprise nearly one half of the total lymphocytes

  10. Hyaluronic Acid Injections Are Associated with Delay of Total Knee Replacement Surgery in Patients with Knee Osteoarthritis: Evidence from a Large U.S. Health Claims Database.

    Directory of Open Access Journals (Sweden)

    Roy Altman

    Full Text Available The growing prevalence of osteoarthritis (OA and the medical costs associated with total knee replacement (TKR surgery for end-stage OA motivate a search for agents that can delay OA progression. We test a hypothesis that hyaluronic acid (HA injection is associated with delay of TKR in a dose-dependent manner.We retrospectively evaluated records in an administrative claims database of ~79 million patients, to identify all patients with knee OA who received TKR during a 6-year period. Only patients with continuous plan enrollment from diagnosis until TKR were included, so that complete medical records were available. OA diagnosis was the index event and we evaluated time-to-TKR as a function of the number of HA injections. The database included 182,022 patients with knee OA who had TKR; 50,349 (27.7% of these patients were classified as HA Users, receiving ≥1 courses of HA prior to TKR, while 131,673 patients (72.3% were HA Non-users prior to TKR, receiving no HA. Cox proportional hazards modelling shows that TKR risk decreases as a function of the number of HA injection courses, if patient age, gender, and disease comorbidity are used as background covariates. Multiple HA injections are therefore associated with delay of TKR (all, P < 0.0001. Half of HA Non-users had a TKR by 114 days post-diagnosis of knee OA, whereas half of HA Users had a TKR by 484 days post-diagnosis (χ2 = 19,769; p < 0.0001. Patients who received no HA had a mean time-to-TKR of 0.7 years; with one course of HA, the mean time to TKR was 1.4 years (χ2 = 13,725; p < 0.0001; patients who received ≥5 courses delayed TKR by 3.6 years (χ2 = 19,935; p < 0.0001.HA injection in patients with knee OA is associated with a dose-dependent increase in time-to-TKR.

  11. Total Thyroidectomy

    Directory of Open Access Journals (Sweden)

    Lopez Moris E

    2016-06-01

    Full Text Available Total thyroidectomy is a surgery that removes all the thyroid tissue from the patient. The suspect of cancer in a thyroid nodule is the most frequent indication and it is presume when previous fine needle puncture is positive or a goiter has significant volume increase or symptomes. Less frequent indications are hyperthyroidism when it is refractory to treatment with Iodine 131 or it is contraindicated, and in cases of symptomatic thyroiditis. The thyroid gland has an important anatomic relation whith the inferior laryngeal nerve and the parathyroid glands, for this reason it is imperative to perform extremely meticulous dissection to recognize each one of these elements and ensure their preservation. It is also essential to maintain strict hemostasis, in order to avoid any postoperative bleeding that could lead to a suffocating neck hematoma, feared complication that represents a surgical emergency and endangers the patient’s life.It is essential to run a formal technique, without skipping steps, and maintain prudence and patience that should rule any surgical act.

  12. Female married illiteracy as the most important continual determinant of total fertility rate among districts of Empowered Action Group States of India: Evidence from Annual Health Survey 2011–12

    OpenAIRE

    Rajesh Kumar; Vishal Dogra; Khushbu Rani; Kanti Sahu

    2017-01-01

    Background: District level determinants of total fertility rate in Empowered Action Group states of India can help in ongoing population stabilization programs in India. Objective: Present study intends to assess the role of district level determinants in predicting total fertility rate among districts of the Empowered Action Group states of India. Material and Methods: Data from Annual Health Survey (2011-12) was analysed using STATA and R software packages. Multiple linear regression models...

  13. Female married illiteracy as the most important continual determinant of total fertility rate among districts of Empowered Action Group States of India: Evidence from Annual Health Survey 2011–12

    Directory of Open Access Journals (Sweden)

    Rajesh Kumar

    2017-01-01

    Full Text Available Background: District level determinants of total fertility rate in Empowered Action Group states of India can help in ongoing population stabilization programs in India. Objective: Present study intends to assess the role of district level determinants in predicting total fertility rate among districts of the Empowered Action Group states of India. Material and Methods: Data from Annual Health Survey (2011-12 was analysed using STATA and R software packages. Multiple linear regression models were built and evaluated using Akaike Information Criterion. For further understanding, recursive partitioning was used to prepare a regression tree. Results: Female married illiteracy positively associated with total fertility rate and explained more than half (53% of variance. Under multiple linear regression model, married illiteracy, infant mortality rate, Ante natal care registration, household size, median age of live birth and sex ratio explained 70% of total variance in total fertility rate. In regression tree, female married illiteracy was the root node and splits at 42% determined TFR = 2.7. The next left side branch was again married illiteracy with splits at 23% to determine TFR = 2.1. Conclusion: We conclude that female married illiteracy is one of the most important determinants explaining total fertility rate among the districts of an Empowered Action Group states. Focus on female literacy is required to stabilize the population growth in long run.

  14. Female married illiteracy as the most important continual determinant of total fertility rate among districts of Empowered Action Group States of India: Evidence from Annual Health Survey 2011-12.

    Science.gov (United States)

    Kumar, Rajesh; Dogra, Vishal; Rani, Khushbu; Sahu, Kanti

    2017-01-01

    District level determinants of total fertility rate in Empowered Action Group states of India can help in ongoing population stabilization programs in India. Present study intends to assess the role of district level determinants in predicting total fertility rate among districts of the Empowered Action Group states of India. Data from Annual Health Survey (2011-12) was analysed using STATA and R software packages. Multiple linear regression models were built and evaluated using Akaike Information Criterion. For further understanding, recursive partitioning was used to prepare a regression tree. Female married illiteracy positively associated with total fertility rate and explained more than half (53%) of variance. Under multiple linear regression model, married illiteracy, infant mortality rate, Ante natal care registration, household size, median age of live birth and sex ratio explained 70% of total variance in total fertility rate. In regression tree, female married illiteracy was the root node and splits at 42% determined TFR illiteracy with splits at 23% to determine TFR illiteracy is one of the most important determinants explaining total fertility rate among the districts of an Empowered Action Group states. Focus on female literacy is required to stabilize the population growth in long run.

  15. Female married illiteracy as the most important continual determinant of total fertility rate among districts of Empowered Action Group States of India: Evidence from Annual Health Survey 2011–12

    Science.gov (United States)

    Kumar, Rajesh; Dogra, Vishal; Rani, Khushbu; Sahu, Kanti

    2017-01-01

    Background: District level determinants of total fertility rate in Empowered Action Group states of India can help in ongoing population stabilization programs in India. Objective: Present study intends to assess the role of district level determinants in predicting total fertility rate among districts of the Empowered Action Group states of India. Material and Methods: Data from Annual Health Survey (2011-12) was analysed using STATA and R software packages. Multiple linear regression models were built and evaluated using Akaike Information Criterion. For further understanding, recursive partitioning was used to prepare a regression tree. Results: Female married illiteracy positively associated with total fertility rate and explained more than half (53%) of variance. Under multiple linear regression model, married illiteracy, infant mortality rate, Ante natal care registration, household size, median age of live birth and sex ratio explained 70% of total variance in total fertility rate. In regression tree, female married illiteracy was the root node and splits at 42% determined TFR illiteracy with splits at 23% to determine TFR illiteracy is one of the most important determinants explaining total fertility rate among the districts of an Empowered Action Group states. Focus on female literacy is required to stabilize the population growth in long run. PMID:29416999

  16. LA CERTIFICACIÓN ISO 9000 EN EL SECTOR INDUSTRIAL DEL MUEBLE: EVIDENCIAS SOBRE LA CULTURA DE CALIDAD TOTAL Y LAS VENTAJAS QUE LA CARACTERIZAN / ISO 9000 ACCREDITATION IN FURNITURE INDUSTRY: EVIDENCES ON TOTAL QUALITY CULTURE AND BUSINESS PERFORMANCE WHICH DESCRIBE THIS STANDARD

    OpenAIRE

    Marín Vinuesa, L.M; Gimeno Zuera, J.

    2010-01-01

    Este estudio analiza si el nivel de implantación de prácticas de gestión de la calidad total, y el nivel de resultados empresariales, son factores que caracterizan a las empresas certificadas con la norma ISO 9000 en la industria nacional del mueble. Asimismo, se comprueba la posible relación de determinados aspectos TQM con la mejora de los resultados empresariales. Los resultados del análisis realizado sobre una muestra de empresas del citado sector muestran que las empresas certificadas co...

  17. Total parenteral nutrition - infants

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  18. Total parenteral nutrition

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000177.htm Total parenteral nutrition To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  19. Technique of total thyroidectomy

    International Nuclear Information System (INIS)

    Rao, R.S.

    1999-01-01

    It is essential to define the various surgical procedures that are carried out for carcinoma of the thyroid gland. They are thyroid gland, subtotal lobectomy, total thyroidectomy and near total thyroidectomy

  20. Total iron binding capacity

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003489.htm Total iron binding capacity To use the sharing features on this page, please enable JavaScript. Total iron binding capacity (TIBC) is a blood test to ...

  1. Total well dominated trees

    DEFF Research Database (Denmark)

    Finbow, Arthur; Frendrup, Allan; Vestergaard, Preben D.

    cardinality then G is a total well dominated graph. In this paper we study composition and decomposition of total well dominated trees. By a reversible process we prove that any total well dominated tree can both be reduced to and constructed from a family of three small trees....

  2. Fasting decreases apolipoprotein B mRNA editing and the secretion of small molecular weight apoB by rat hepatocytes: Evidence that the total amount of apoB secreted is regulated post-transcriptionally

    International Nuclear Information System (INIS)

    Leighton, J.K.; Joyner, J.; Zamarripa, J.; Deines, M.; Davis, R.A.

    1990-01-01

    Two different molecular weight forms of apoB are produced from a common initial transcript via editing of a Gln codon (CAA) to a stop codon (UAA), leading to a truncated translation product (apo BS) that consists of the amino terminal half of the larger form (apoBL). Previous studies have shown that fasting coordinately decreases lipogenesis and the secretion of very low density lipoprotein (VLDL) lipids and apoBS. Secretion of the apoBL is unaffected by fasting. We studied whether editing of apoB RNA is repressed by fasting, thus accounting for the selective decreased secretion of apoBS. Column chromatography of [35S]methionine-labeled lipoproteins secreted by hepatocytes from fed rats showed that essentially all of apoBL is secreted in the VLDL fraction, whereas a significant amount (15%) of apoBS is secreted associated as lipoproteins eluting in the HDL fractions. Fasting decreased the relative amount of apoBS that eluted in the VLDL fractions and increased the amount secreted in the HDL fractions. Consistent with previous results, hepatocytes from fasted rats show a selective twofold decrease in apoBS secretion. Fasting did not affect the relative abundance of apoB RNA, determined by slot blot hybridization assays using two different 32P-labeled cDNA probes coding either for both molecular weight forms or for only the large molecular weight form. However, quantitative of the editing of apoB RNA showed that fasting caused a 60% decrease in the amount of apoB RNA possessing the stop codon. These data show that the editing of apoB RNA is sensitive to metabolic state (i.e., fasting) resulting in a selective decrease in the secretion of apoBS. However, since the total secretion of apoB was decreased by fasting, while apoB mRNA levels remained constant, additional (post-transcriptional) mechanisms play a role in regulating apoB secretion

  3. Sedimentary evidence of historical and prehistorical earthquakes along the Venta de Bravo Fault System, Acambay Graben (Central Mexico)

    Science.gov (United States)

    Lacan, Pierre; Ortuño, María; Audin, Laurence; Perea, Hector; Baize, Stephane; Aguirre-Díaz, Gerardo; Zúñiga, F. Ramón

    2018-03-01

    The Venta de Bravo normal fault is one of the longest structures in the intra-arc fault system of the Trans-Mexican Volcanic Belt. It defines, together with the Pastores Fault, the 80 km long southern margin of the Acambay Graben. We focus on the westernmost segment of the Venta de Bravo Fault and provide new paleoseismological information, evaluate its earthquake history, and assess the related seismic hazard. We analyzed five trenches, distributed at three different sites, in which Holocene surface faulting offsets interbedded volcanoclastic, fluvio-lacustrine and colluvial deposits. Despite the lack of known historical destructive earthquakes along this fault, we found evidence of at least eight earthquakes during the late Quaternary. Our results indicate that this is one of the major seismic sources of the Acambay Graben, capable of producing by itself earthquakes with magnitudes (MW) up to 6.9, with a slip rate of 0.22-0.24 mm yr- 1 and a recurrence interval between 1940 and 2390 years. In addition, a possible multi-fault rupture of the Venta de Bravo Fault together with other faults of the Acambay Graben could result in a MW > 7 earthquake. These new slip rates, earthquake recurrence rates, and estimation of slips per event help advance our understanding of the seismic hazard posed by the Venta de Bravo Fault and provide new parameters for further hazard assessment.

  4. Total Quality Leadership

    Science.gov (United States)

    1991-01-01

    More than 750 NASA, government, contractor, and academic representatives attended the Seventh Annual NASA/Contractors Conference on Quality and Productivity. The panel presentations and Keynote speeches revolving around the theme of total quality leadership provided a solid base of understanding of the importance, benefits, and principles of total quality management (TQM). The presentations from the conference are summarized.

  5. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...

  6. Laparoscopic total pancreatectomy

    Science.gov (United States)

    Wang, Xin; Li, Yongbin; Cai, Yunqiang; Liu, Xubao; Peng, Bing

    2017-01-01

    Abstract Rationale: Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy. Patients and Methods: Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien–Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition. Diagnosis and Outcomes: The indications for laparoscopic total pancreatectomy were intraductal papillary mucinous neoplasm (IPMN) (n = 2) and pancreatic neuroendocrine tumor (PNET) (n = 1). All patients underwent laparoscopic pylorus and spleen-preserving total pancreatectomy, the mean operative time was 490 minutes (range 450–540 minutes), the mean estimated blood loss was 266 mL (range 100–400 minutes); 2 patients suffered from postoperative complication. All the patients recovered uneventfully with conservative treatment and discharged with a mean hospital stay 18 days (range 8–24 days). The short-term (from 108 to 600 days) follow up demonstrated 3 patients had normal and consistent glycated hemoglobin (HbA1c) level with acceptable quality of life. Lessons: Laparoscopic total pancreatectomy is feasible and safe in selected patients and pylorus and spleen preserving technique should be considered. Further prospective randomized studies are needed to obtain a comprehensive understanding the role of laparoscopic technique in total pancreatectomy. PMID:28099344

  7. Estonian total ozone climatology

    Directory of Open Access Journals (Sweden)

    K. Eerme

    Full Text Available The climatological characteristics of total ozone over Estonia based on the Total Ozone Mapping Spectrometer (TOMS data are discussed. The mean annual cycle during 1979–2000 for the site at 58.3° N and 26.5° E is compiled. The available ground-level data interpolated before TOMS, have been used for trend detection. During the last two decades, the quasi-biennial oscillation (QBO corrected systematic decrease of total ozone from February–April was 3 ± 2.6% per decade. Before 1980, a spring decrease was not detectable. No decreasing trend was found in either the late autumn ozone minimum or in the summer total ozone. The QBO related signal in the spring total ozone has an amplitude of ± 20 DU and phase lag of 20 months. Between 1987–1992, the lagged covariance between the Singapore wind and the studied total ozone was weak. The spring (April–May and summer (June–August total ozone have the best correlation (coefficient 0.7 in the yearly cycle. The correlation between the May and August total ozone is higher than the one between the other summer months. Seasonal power spectra of the total ozone variance show preferred periods with an over 95% significance level. Since 1986, during the winter/spring, the contribution period of 32 days prevails instead of the earlier dominating 26 days. The spectral densities of the periods from 4 days to 2 weeks exhibit high interannual variability.

    Key words. Atmospheric composition and structure (middle atmosphere – composition and chemistry; volcanic effects – Meteorology and atmospheric dynamics (climatology

  8. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-06-01

    The present discussion is limited to a presentation of the most recent total photonuclear absorption experiments performed with real photons at intermediate energy, and more precisely in the region of nucleon resonances. The main sources of real photons are briefly reviewed and the experimental procedures used for total photonuclear absorption cross section measurements. The main results obtained below 140 MeV photon energy as well as above 2 GeV are recalled. The experimental study of total photonuclear absorption in the nuclear resonance region (140 MeV< E<2 GeV) is still at its beginning and some results are presented

  9. [Total artificial heart].

    Science.gov (United States)

    Antretter, H; Dumfarth, J; Höfer, D

    2015-09-01

    To date the CardioWest™ total artificial heart is the only clinically available implantable biventricular mechanical replacement for irreversible cardiac failure. This article presents the indications, contraindications, implantation procedere and postoperative treatment. In addition to a overview of the applications of the total artificial heart this article gives a brief presentation of the two patients treated in our department with the CardioWest™. The clinical course, postoperative rehabilitation, device-related complications and control mechanisms are presented. The total artificial heart is a reliable implant for treating critically ill patients with irreversible cardiogenic shock. A bridge to transplantation is feasible with excellent results.

  10. Total 2004 results

    International Nuclear Information System (INIS)

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  11. Total synthesis of ciguatoxin.

    Science.gov (United States)

    Hamajima, Akinari; Isobe, Minoru

    2009-01-01

    Something fishy: Ciguatoxin (see structure) is one of the principal toxins involved in ciguatera poisoning and the target of a total synthesis involving the coupling of three segments. The key transformations in this synthesis feature acetylene-dicobalthexacarbonyl complexation.

  12. Total 2004 results

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  13. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty....

  14. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty. Udgivelsesdato: 2009-Feb-23...

  15. Supravaginal eller total hysterektomi?

    DEFF Research Database (Denmark)

    Edvardsen, L; Madsen, E M

    1994-01-01

    There has been a decline in the rate of hysterectomies in Denmark in general over the last thirteen years, together with a rise in the number of supravaginal operations over the last two years. The literature concerning the relative merits of the supravaginal and the total abdominal operation is ...... indicate a reduced frequency of orgasm after the total hysterectomy compared with the supravaginal operation. When there are technical problems peroperatively with an increased urologic risk the supravaginal operation is recommended....

  16. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Sutherland, D.E.; Ferguson, R.M.; Simmons, R.L.; Kim, T.H.; Slavin, S.; Najarian, J.S.

    1983-01-01

    Total lymphoid irradiation by itself can produce sufficient immunosuppression to prolong the survival of a variety of organ allografts in experimental animals. The degree of prolongation is dose-dependent and is limited by the toxicity that occurs with higher doses. Total lymphoid irradiation is more effective before transplantation than after, but when used after transplantation can be combined with pharmacologic immunosuppression to achieve a positive effect. In some animal models, total lymphoid irradiation induces an environment in which fully allogeneic bone marrow will engraft and induce permanent chimerism in the recipients who are then tolerant to organ allografts from the donor strain. If total lymphoid irradiation is ever to have clinical applicability on a large scale, it would seem that it would have to be under circumstances in which tolerance can be induced. However, in some animal models graft-versus-host disease occurs following bone marrow transplantation, and methods to obviate its occurrence probably will be needed if this approach is to be applied clinically. In recent years, patient and graft survival rates in renal allograft recipients treated with conventional immunosuppression have improved considerably, and thus the impetus to utilize total lymphoid irradiation for its immunosuppressive effect alone is less compelling. The future of total lymphoid irradiation probably lies in devising protocols in which maintenance immunosuppression can be eliminated, or nearly eliminated, altogether. Such protocols are effective in rodents. Whether they can be applied to clinical transplantation remains to be seen

  17. Totally optimal decision rules

    KAUST Repository

    Amin, Talha

    2017-11-22

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  18. Totally optimal decision rules

    KAUST Repository

    Amin, Talha M.; Moshkov, Mikhail

    2017-01-01

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  19. Total volume versus bouts

    DEFF Research Database (Denmark)

    Chinapaw, Mai; Klakk, Heidi; Møller, Niels Christian

    2018-01-01

    BACKGROUND/OBJECTIVES: Examine the prospective relationship of total volume versus bouts of sedentary behaviour (SB) and moderate-to-vigorous physical activity (MVPA) with cardiometabolic risk in children. In addition, the moderating effects of weight status and MVPA were explored. SUBJECTS....../METHODS: Longitudinal study including 454 primary school children (mean age 10.3 years). Total volume and bouts (i.e. ≥10 min consecutive minutes) of MVPA and SB were assessed by accelerometry in Nov 2009/Jan 2010 (T1) and Aug/Oct 2010 (T2). Triglycerides, total cholesterol/HDL cholesterol ratio (TC:HDLC ratio......, with or without mutual adjustments between MVPA and SB. The moderating effects of weight status and MVPA (for SB only) were examined by adding interaction terms. RESULTS: Children engaged daily in about 60 min of total MVPA and 0-15 min/week in MVPA bouts. Mean total sedentary time was around 7 h/day with over 3...

  20. Total versus subtotal hysterectomy

    DEFF Research Database (Denmark)

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Anna Birthe

    2005-01-01

    The aim of this study was to compare total and subtotal abdominal hysterectomy for benign indications, with regard to urinary incontinence, postoperative complications, quality of life (SF-36), constipation, prolapse, satisfaction with sexual life, and pelvic pain at 1-year postoperative. Eighty...... women chose total and 105 women chose subtotal abdominal hysterectomy. No significant differences were found between the 2 operation methods in any of the outcome measures at 12 months. Fourteen women (15%) from the subtotal abdominal hysterectomy group experienced vaginal bleeding and three women had...

  1. Qualità totale e mobilità totale Total Quality and Total Mobility

    Directory of Open Access Journals (Sweden)

    Giuseppe Trieste

    2010-05-01

    Full Text Available FIABA ONLUS (Italian Fund for Elimination of Architectural Barriers was founded in 2000 with the aim of promoting a culture of equal opportunities and, above all, it has as its main goal to involve public and private institutions to create a really accessible and usable environment for everyone. Total accessibility, Total usability and Total mobility are key indicators to define quality of life within cities. A supportive environment that is free of architectural, cultural and psychological barriers allows everyone to live with ease and universality. In fact, people who access to goods and services in the urban context can use to their advantage time and space, so they can do their activities and can maintain relationships that are deemed significant for their social life. The main aim of urban accessibility is to raise the comfort of space for citizens, eliminating all barriers that discriminate people, and prevent from an equality of opportunity. “FIABA FUND - City of ... for the removal of architectural barriers” is an idea of FIABA that has already affected many regions of Italy as Lazio, Lombardy, Campania, Abruzzi and Calabria. It is a National project which provides for opening a bank account in the cities of referring, in which for the first time, all together, individuals and private and public institutions can make a donation to fund initiatives for the removal of architectural barriers within its own territory for a real and effective total accessibility. Last February the fund was launched in Rome with the aim of achieving a Capital without barriers and a Town European model of accessibility and usability. Urban mobility is a prerequisite to access to goods and services, and to organize activities related to daily life. FIABA promotes the concept of sustainable mobility for all, supported by the European Commission’s White Paper. We need a cultural change in management and organization of public means, which might focus on

  2. Superradiance or total reflection?

    CERN Document Server

    László, András

    2014-01-01

    Numerical evolution of massless scalar fields on Kerr background is studied. The initial data specifications are chosen to have compact support separated from the ergoregion and to yield nearly monochromatic incident wave packets. The initial data is also tuned to maximize the effect of superradiance. Evidences are shown indicating that instead of the anticipated energy extraction from black hole the incident radiation fail to reach the ergoregion rather it suffers a nearly perfect reflection.

  3. CSF total protein

    Science.gov (United States)

    CSF total protein is a test to determine the amount of protein in your spinal fluid, also called cerebrospinal fluid (CSF). ... The normal protein range varies from lab to lab, but is typically about 15 to 60 milligrams per deciliter (mg/dL) ...

  4. Total body irradiation

    International Nuclear Information System (INIS)

    Novack, D.H.; Kiley, J.P.

    1987-01-01

    The multitude of papers and conferences in recent years on the use of very large megavoltage radiation fields indicates an increased interest in total body, hemibody, and total nodal radiotherapy for various clinical situations. These include high dose total body irradiation (TBI) to destroy the bone marrow and leukemic cells and provide immunosuppression prior to a bone marrow transplant, high dose total lymphoid irradiation (TLI) prior to bone marrow transplantation in severe aplastic anemia, low dose TBI in the treatment of lymphocytic leukemias or lymphomas, and hemibody irradiation (HBI) in the treatment of advanced multiple myeloma. Although accurate provision of a specific dose and the desired degree of dose homogeneity are two of the physicist's major considerations for all radiotherapy techniques, these tasks are even more demanding for large field radiotherapy. Because most large field radiotherapy is done at an extended distance for complex patient geometries, basic dosimetry data measured at the standard distance (isocenter) must be verified or supplemented. This paper discusses some of the special dosimetric problems of large field radiotherapy, with specific examples given of the dosimetry of the TBI program for bone marrow transplant at the authors' hospital

  5. Total design of participation

    DEFF Research Database (Denmark)

    Munch, Anders V.

    2016-01-01

    The idea of design as an art made not only for the people, but also by the people is an old dream going back at least to William Morris. It is, however, reappearing vigoriously in many kinds of design activism and grows out of the visions of a Total Design of society. The ideas of participation b...

  6. Total Quality Management Simplified.

    Science.gov (United States)

    Arias, Pam

    1995-01-01

    Maintains that Total Quality Management (TQM) is one method that helps to monitor and improve the quality of child care. Lists four steps for a child-care center to design and implement its own TQM program. Suggests that quality assurance in child-care settings is an ongoing process, and that TQM programs help in providing consistent, high-quality…

  7. Total Quality Management Seminar.

    Science.gov (United States)

    Massachusetts Career Development Inst., Springfield.

    This booklet is one of six texts from a workplace literacy curriculum designed to assist learners in facing the increased demands of the workplace. The booklet contains seven sections that cover the following topics: (1) meaning of total quality management (TQM); (2) the customer; (3) the organization's culture; (4) comparison of management…

  8. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-01-01

    Experimental methods using real photon beams for measurements of total photonuclear absorption cross section σ(Tot : E/sub γ/) are recalled. Most recent σ(Tot : E/sub γ/)results for complex nuclei and in the nucleon resonance region are presented

  9. Total 2004 annual report

    International Nuclear Information System (INIS)

    2004-01-01

    This annual report of the Group Total brings information and economic data on the following topics, for the year 2004: the corporate governance, the corporate social responsibility, the shareholder notebook, the management report, the activities, the upstream (exploration and production) and downstream (refining and marketing) operating, chemicals and other matters. (A.L.B.)

  10. Total Water Management - Report

    Science.gov (United States)

    There is a growing need for urban water managers to take a more holistic view of their water resource systems as population growth, urbanization, and current operations put different stresses on the environment and urban infrastructure. Total Water Management (TWM) is an approac...

  11. Total 2003 Results

    International Nuclear Information System (INIS)

    2003-01-01

    This document presents the 2003 results of Total Group: consolidated account, special items, number of shares, market environment, 4. quarter 2003 results, full year 2003 results, upstream (key figures, proved reserves), downstream key figures, chemicals key figures, parent company accounts and proposed dividends, 2004 sensitivities, summary and outlook, operating information by segment for the 4. quarter and full year 2003: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refinery throughput by region, refined product sales by region, chemicals), impact of allocating contribution of Cepsa to net operating income by business segment: equity in income (loss) and affiliates and other items, Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  12. TOTAL PERFORMANCE SCORECARD

    Directory of Open Access Journals (Sweden)

    Anca ȘERBAN

    2013-06-01

    Full Text Available The purpose of this paper is to present the evolution of the Balanced Scorecard from a measurement instrument to a strategic performance management tool and to highlight the advantages of implementing the Total Performance Scorecard, especially for Human Resource Management. The study has been accomplished using the methodology of bibliographic study and various secondary sources. Implementing the classical Balanced Scorecard indicated over the years, repeatedly failure. It can be indicated that the crucial level is determined by the learning and growth perspective. It has been developed from a human perspective, which focused on staff satisfaction, innovation perspective with focus on future developments. Integrating the Total Performance Scorecard in an overall framework assures the company’s success, by keeping track of the individual goals, the company’s objectives and strategic directions. Like this, individual identity can be linked to corporate brand, individual aspirations to business goals and individual learning objectives to needed organizational capabilities.

  13. Totally parallel multilevel algorithms

    Science.gov (United States)

    Frederickson, Paul O.

    1988-01-01

    Four totally parallel algorithms for the solution of a sparse linear system have common characteristics which become quite apparent when they are implemented on a highly parallel hypercube such as the CM2. These four algorithms are Parallel Superconvergent Multigrid (PSMG) of Frederickson and McBryan, Robust Multigrid (RMG) of Hackbusch, the FFT based Spectral Algorithm, and Parallel Cyclic Reduction. In fact, all four can be formulated as particular cases of the same totally parallel multilevel algorithm, which are referred to as TPMA. In certain cases the spectral radius of TPMA is zero, and it is recognized to be a direct algorithm. In many other cases the spectral radius, although not zero, is small enough that a single iteration per timestep keeps the local error within the required tolerance.

  14. Total space in resolution

    Czech Academy of Sciences Publication Activity Database

    Bonacina, I.; Galesi, N.; Thapen, Neil

    2016-01-01

    Roč. 45, č. 5 (2016), s. 1894-1909 ISSN 0097-5397 R&D Projects: GA ČR GBP202/12/G061 EU Projects: European Commission(XE) 339691 - FEALORA Institutional support: RVO:67985840 Keywords : total space * resolution random CNFs * proof complexity Subject RIV: BA - General Mathematics Impact factor: 1.433, year: 2016 http://epubs.siam.org/doi/10.1137/15M1023269

  15. MFTF TOTAL benchmark

    International Nuclear Information System (INIS)

    Choy, J.H.

    1979-06-01

    A benchmark of the TOTAL data base management system as applied to the Mirror Fusion Test Facility (MFTF) data base was implemented and run in February and March of 1979. The benchmark was run on an Interdata 8/32 and involved the following tasks: (1) data base design, (2) data base generation, (3) data base load, and (4) develop and implement programs to simulate MFTF usage of the data base

  16. Total - annual report 2005

    International Nuclear Information System (INIS)

    2006-01-01

    This annual report presents the activities and results of TOTAL S.A., french society on oil and gas. It deals with statistics, the managers, key information on financial data and risk factors, information on the Company, unresolved Staff Comments, employees, major Shareholders, consolidated statements, markets, security, financial risks, defaults dividend arrearages and delinquencies, controls and procedures, code of ethics and financial statements. (A.L.B.)

  17. Total Absorption Spectroscopy

    International Nuclear Information System (INIS)

    Rubio, B.; Gelletly, W.

    2007-01-01

    The problem of determining the distribution of beta decay strength (B(GT)) as a function of excitation energy in the daughter nucleus is discussed. Total Absorption Spectroscopy is shown to provide a way of determining the B(GT) precisely. A brief history of such measurements and a discussion of the advantages and disadvantages of this technique, is followed by examples of two recent studies using the technique. (authors)

  18. Sobredentadura total superior implantosoportada

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.

  19. Postoperative pain treatment after total knee arthroplasty

    DEFF Research Database (Denmark)

    Karlsen, Anders Peder Højer; Wetterslev, Mik; Hansen, Signe Elisa

    2017-01-01

    INTRODUCTION: The aim of this systematic review was to document efficacy, safety and quality of evidence of analgesic interventions after total knee arthroplasty (TKA). METHODS: This PRISMA-compliant and PROSPERO-registered review includes all-language randomized controlled trials of medication......), to 19 mm (CI: 8, 31; single FNB), and at 24 hours from 3 mm (CI: -2, 8; gabapentinoids), to 16 mm (CI: 8, 23; continuous FNB). GRADE-rated quality of evidence was generally low. CONCLUSION: A low quality of evidence, small sample sizes and heterogeneity of trial designs prohibit designation...

  20. Total Synthesis of Hyperforin.

    Science.gov (United States)

    Ting, Chi P; Maimone, Thomas J

    2015-08-26

    A 10-step total synthesis of the polycyclic polyprenylated acylphloroglucinol (PPAP) natural product hyperforin from 2-methylcyclopent-2-en-1-one is reported. This route was enabled by a diketene annulation reaction and an oxidative ring expansion strategy designed to complement the presumed biosynthesis of this complex meroterpene. The described work enables the preparation of a highly substituted bicyclo[3.3.1]nonane-1,3,5-trione motif in only six steps and thus serves as a platform for the construction of easily synthesized, highly diverse PPAPs modifiable at every position.

  1. Total quality is people

    International Nuclear Information System (INIS)

    Vogel, C.E.

    1991-01-01

    Confronted by changing market conditions and increased global competition, in 1983 the Commercial Nuclear Fuel Division (CNFD) of Westinghouse Electric embarked on an ambitious plan to make total quality the centerpiece of its long-term business strategy. Five years later, the division's efforts in making continuous quality improvement a way of life among its more than 2,000 employees gained national recognition when it was named a charter recipient of the Malcolm Baldridge National Quality Award. What CNFD achieved during the 1980s was a cultural transformation, characterized by an empowered work force committed to a common vision. The company's quality program development strategy is described

  2. Total quality accounting

    Directory of Open Access Journals (Sweden)

    Andrijašević Maja

    2008-01-01

    Full Text Available The focus of competitive "battle" shifted from the price towards non-price instruments, above all, towards quality that became the key variable for profitability increase and achievement of better comparative position of a company. Under such conditions, management of a company, which, according to the established and certified system of total quality, strives towards achieving of a better market position, faces the problem of quality cost measurement and determination. Management, above all, cost accounting can help in solving of this problem, but the question is how much of its potential is being used for that purpose.

  3. Total_Aktion

    DEFF Research Database (Denmark)

    Søndergaard, Morten

    2008-01-01

    digitale medier er registreringen og muligheden for at opbevare og håndtere digital data uden begrænsninger. Oplevelse, registrering og bevaring knyttes sammen i en ny museal virkelighed, hvor samlingens særlige dokumentariske karakter og fokus, som er unikt for Museet for Samtidskunst, er i centrum...... at mikse deres personlige drinks. TOTAL_AKTION viser Hørbar#3, som er en videreudvikling af den første version. METASYN af Carl Emil Carlsen: Metadata er centralt for Carl Emil Carlsens projekt, der betragter museets samling som et ”univers” af værker (analoge og digitale), beskrivelser og relationer. I...

  4. Total Logistic Plant Solutions

    Directory of Open Access Journals (Sweden)

    Dusan Dorcak

    2016-02-01

    Full Text Available The Total Logistics Plant Solutions, plant logistics system - TLPS, based on the philosophy of advanced control processes enables complex coordination of business processes and flows and the management and scheduling of production in the appropriate production plans and planning periods. Main attributes of TLPS is to create a comprehensive, multi-level, enterprise logistics information system, with a certain degree of intelligence, which accepts the latest science and research results in the field of production technology and logistics. Logistic model of company understands as a system of mutually transforming flows of materials, energy, information, finance, which is realized by chain activities and operations

  5. Total Factbook 2003

    International Nuclear Information System (INIS)

    2003-01-01

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2003. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  6. Total 2004 fact book

    International Nuclear Information System (INIS)

    2004-01-01

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2004. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  7. TOTAL annual report 2003

    International Nuclear Information System (INIS)

    2004-01-01

    This 2003 annual report of the Group Total provides economical results and information of the society on the following topics: keys data, the corporate governance (Directors charter, board of directors, audit committee, nomination and remuneration committee, internal control procedures, compensation of directors and executive officers), the corporate social responsibility (environmental stewardship, the future of energy management, the safety enhancement, the human resources, ethics and local development), the investor relations, the management report, the upstream exploration and production, the downstream refining, marketing, trading and shipping, the chemicals and financial and legal information. (A.L.B.)

  8. Total knee arthroplasty

    DEFF Research Database (Denmark)

    Schrøder, Henrik M.; Petersen, Michael M.

    2016-01-01

    Total knee arthroplasty (TKA) is a successful treatment of the osteoarthritic knee, which has increased dramatically over the last 30 years. The indication is a painful osteoarthritic knee with relevant radiographic findings and failure of conservative measures like painkillers and exercise...... surgeon seems to positively influence the rate of surgical complications and implant survival. The painful TKA knee should be thoroughly evaluated, but not revised except if a relevant indication can be established. The most frequent indications for revision are: aseptic loosening, instability, infection...

  9. TOTAL user manual

    Science.gov (United States)

    Johnson, Sally C.; Boerschlein, David P.

    1994-01-01

    Semi-Markov models can be used to analyze the reliability of virtually any fault-tolerant system. However, the process of delineating all of the states and transitions in the model of a complex system can be devastatingly tedious and error-prone. Even with tools such as the Abstract Semi-Markov Specification Interface to the SURE Tool (ASSIST), the user must describe a system by specifying the rules governing the behavior of the system in order to generate the model. With the Table Oriented Translator to the ASSIST Language (TOTAL), the user can specify the components of a typical system and their attributes in the form of a table. The conditions that lead to system failure are also listed in a tabular form. The user can also abstractly specify dependencies with causes and effects. The level of information required is appropriate for system designers with little or no background in the details of reliability calculations. A menu-driven interface guides the user through the system description process, and the program updates the tables as new information is entered. The TOTAL program automatically generates an ASSIST input description to match the system description.

  10. Total process surveillance: (TOPS)

    International Nuclear Information System (INIS)

    Millar, J.H.P.

    1992-01-01

    A Total Process Surveillance system is under development which can provide, in real-time, additional process information from a limited number of raw measurement signals. This is achieved by using a robust model based observer to generate estimates of the process' internal states. The observer utilises the analytical reduncancy among a diverse range of transducers and can thus accommodate off-normal conditions which lead to transducer loss or damage. The modular hierarchical structure of the system enables the maximum amount of information to be assimilated from the available instrument signals no matter how diverse. This structure also constitutes a data reduction path thus reducing operator cognitive overload from a large number of varying, and possibly contradictory, raw plant signals. (orig.)

  11. Total and EDF invest

    International Nuclear Information System (INIS)

    Signoret, St.

    2008-01-01

    So as to prepare the future of their industrial sector,the Total company plans to invest (14 billion Euros in 2008) to increase its production capacities and strengthen in of other activities as the liquefied natural gas and the renewable energies; EDF plans to inject 35 billion Euros over three years to multiply the new projects of power plants (wind turbines, coal in Germany, gas in Great Britain and nuclear power in Flamanville). EDF wants to exploit its knowledge of leader to run more than ten E.P.R.(European pressurized water reactor) in the world before 2020, projects are in examination with China, Great Britain, South Africa and United States. (N.C.)

  12. Total quality at source

    International Nuclear Information System (INIS)

    Chiandone, A.C.

    1990-01-01

    The Total Quality at Source philosophy is based on optimizing the effectiveness of people in achieving ZERO-DEFECT results. In this paper a philosophy of what, I have come to perceive, it takes to get people to perform to the very best of their abilities and thereby achieve the best results they can, is presented. In the examples I shall describe I have played an instrumental role since it has become my belief that any job can always be done better provided that the people doing it can themselves become convinced that they can do better. Clearly there are many ideas on how to do this. The philosophy that I am presenting in this paper is based on my own experience, where I have both participated and observed it being applied; its effectiveness may be judged by the results. (author)

  13. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications. 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/

  14. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    An outline review notes recent work on total lymphoid irradiation (TLI) as a means of preparing patients for grafts and particularly for bone-marrow transplantation. T.L.I. has proved immunosuppressive in rats, mice, dogs, monkeys and baboons; when given before bone-marrow transplantation, engraftment took place without, or with delayed rejection or graft-versus-host disease. Work with mice has indicated that the thymus needs to be included within the irradiation field, since screening of the thymus reduced skin-graft survival from 50 to 18 days, though irradiation of the thymus alone has proved ineffective. A more lasting tolerance has been observed when T.L.I. is followed by an injection of donor bone marrow. 50% of mice treated in this way accepted allogenic skin grafts for more than 100 days, the animals proving to be stable chimeras with 50% of their peripheral blood lymphocytes being of donor origin. Experiments of a similar nature with dogs and baboons were not so successful. (U.K.)

  15. The total artificial heart.

    Science.gov (United States)

    Cook, Jason A; Shah, Keyur B; Quader, Mohammed A; Cooke, Richard H; Kasirajan, Vigneshwar; Rao, Kris K; Smallfield, Melissa C; Tchoukina, Inna; Tang, Daniel G

    2015-12-01

    The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.

  16. Incapacidad laboral total

    Directory of Open Access Journals (Sweden)

    Orlando Díaz Tabares

    1997-04-01

    Full Text Available Se realizó un estudio longitudinal, descriptivo y retrospectivo con el objetivo de conocer el comportamiento de la incapacidad permanente para el trabajo en el municipio "San Cristóbal" durante el decenio 1982-1991, y se aplicó el método de encuesta por el que se recogieron datos que fueron extraídos del modelo oficial de peritaje médico laboral y de la entrevista con el peritado. Los resultados fueron plasmados en tablas de contingencias donde se relacionan las variables por cada año estudiado, y se aplicó la prueba estadística de chi cuadrado. El número de individuos dictaminados con incapacidad laboral total fue de 693; predominó en reportes el año 1988 con 114 casos y muy discretamente el sexo femenino sobre el masculino, el grupo etáreo de 45 a 54 años con 360 casos y la artrosis como entidad valorada por ortopedia, con análisis estadísticos significativos. No resultó estadísticamente significativo, el predominio de la hipertensión arterial sistémica entre las entidades valoradas por la especialidad de medicina interna como causas de incapacidad laboral. Fue muy significativa la variación del número de dictaminados por la comisión en cada uno de los años estudiados y que el porcentaje de ellos que se encontraban realizando trabajos que demandan esfuerzo físico de moderado a intenso al momento de aplicar la encuesta, ascendió al 64,9.A longitudinal, descriptive and retrospective study was conducted in order to know the behavior of permanent labor disability at the municipality of San Cristóbal during 1982-1991. A survey was done to collect data taken from the official model of medical inspections and from the interview with the disabled worker. The results were shown in contingency tables where the variables are related by every year studied. The chi square statistical test was applied. The number of individuals with labor disability was 693. As for reports, the year 1988 predominated with 114. There was a discreet

  17. Evidence logics with relational evidence

    DEFF Research Database (Denmark)

    Baltag, Alexandru; Occhipinti, Andrés

    2017-01-01

    We introduce a family of logics for reasoning about relational evidence: evidence that involves an ordering of states in terms of their relative plausibility. We provide sound and complete axiomatizations for the logics. We also present several evidential actions and prove soundness...

  18. Digital evidence

    Directory of Open Access Journals (Sweden)

    Lukić Tatjana

    2012-01-01

    Full Text Available Although computer makes human activities faster and easier, innovating and creating new forms of work and other kinds of activities, it also influenced the criminal activity. The development of information technology directly affects the development of computer forensics without which, it can not even imagine the discovering and proving the computer offences and apprehending the perpetrator. Information technology and computer forensic allows us to detect and prove the crimes committed by computer and capture the perpetrators. Computer forensics is a type of forensics which can be defined as a process of collecting, preserving, analyzing and presenting digital evidence in court proceedings. Bearing in mind, that combat against crime, in which computers appear as an asset or object of the offense, requires knowledge of digital evidence as well as specific rules and procedures, the author in this article specifically addresses the issues of digital evidence, forensic (computer investigation, specific rules and procedures for detecting, fixing and collecting digital evidence and use of this type of evidence in criminal proceedings. The author also delas with international standards regarding digital evidence and cyber-space investigation.

  19. Impact Of Total Quality Management (TQM), Activity Based Costing ...

    African Journals Online (AJOL)

    Time (JIT), and Total Quality Management (TQM) as strategic initiatives lead to improved financial performance in the Turkish textile industry. Strong evidence emerged that there is a strong positive association between using ABC, JIT or TQM ...

  20. Total lymphoid irradiation of intractable rheumatoid arthritis

    International Nuclear Information System (INIS)

    Herbst, M.; Fritz, H.; Sauer, R.

    1986-01-01

    Eleven patients with intractable rheumatoid arthritis were treated with fractionated total lymphoid irradiation, (total dose 20 Gy). Lasting improvement in clinical symptoms was found in four patients during treatment and the remaining patients experienced similar benefit within 2 months of irradiation. There was marked reduction in exacerbations and number of joints involved. Morning stiffness, joint swelling and tenderness decreased. Complications included severe fatigue during treatment and acute bacterial arthritis in multiple joints in one patient. Four patients have since died, one of renal failure, another of cardiogenic shock following surgery 3 and 24 months after total lymphoid irradiation. Both had generalised amyloidosis. The third patient developed joint empyema and died of toxic cardiac failure. The fourth died 3 months after resection of a Kaposi's sarcoma complicated by wound infection which responded to treatment. Immunologically, total lymphoid irradiation resulted in suppression of the absolute lymphocyte count and reduction in T-helper cells, the number of T-suppressor cells remaining unchanged. These data provide evidence of T-cell involvement in the pathogenesis of rheumatoid arthritis. Total lymphoid irradiation can induce sustained improvement in clinical disease activity, but severe, possibly fatal, side-effects cannot be ignored. (author)

  1. Total lymphoid irradiation of intractable rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Herbst, M.; Fritz, H.; Sauer, R.

    1986-12-01

    Eleven patients with intractable rheumatoid arthritis were treated with fractionated total lymphoid irradiation, (total dose 20 Gy). Lasting improvement in clinical symptoms was found in four patients during treatment and the remaining patients experienced similar benefit within 2 months of irradiation. There was marked reduction in exacerbations and number of joints involved. Morning stiffness, joint swelling and tenderness decreased. Complications included severe fatigue during treatment and acute bacterial arthritis in multiple joints in one patient. Four patients have since died, one of renal failure, another of cardiogenic shock following surgery 3 and 24 months after total lymphoid irradiation. Both had generalised amyloidosis. The third patient developed joint empyema and died of toxic cardiac failure. The fourth died 3 months after resection of a Kaposi's sarcoma complicated by wound infection which responded to treatment. Immunologically, total lymphoid irradiation resulted in suppression of the absolute lymphocyte count and reduction in T-helper cells, the number of T-suppressor cells remaining unchanged. These data provide evidence of T-cell involvement in the pathogenesis of rheumatoid arthritis. Total lymphoid irradiation can induce sustained improvement in clinical disease activity, but severe, possibly fatal, side-effects cannot be ignored.

  2. Comparison of Serum Concentrations of Total Cholesterol and Total ...

    African Journals Online (AJOL)

    Tuberculosis (TB) is one of the most dangerous tropical diseases that complicates HIV infection in Nigeria to date. Over two million Nigerians are known to be infected with TB and many more are at risk of the infection. Serum concentrations of total cholesterol and total lipid of 117 female TB patients attending chest clinic at ...

  3. Changes in total and differential white cell counts, total lymphocyte ...

    African Journals Online (AJOL)

    Background: Published reports on the possible changes in the various immune cell populations, especially the total lymphocyte and CD4 cell counts, during the menstrual cycle in Nigerian female subjects are relatively scarce. Aim: To determine possible changes in the total and differential white blood cell [WBC] counts, ...

  4. Postoperative pain treatment after total hip arthroplasty

    DEFF Research Database (Denmark)

    Højer Karlsen, Anders Peder; Geisler, Anja; Petersen, Pernille Lykke

    2015-01-01

    Treatment of postoperative pain should rely on results from randomized controlled trials and meta-analyses of high scientific quality. The efficacy of a particular intervention may depend on the type of surgical procedure, which supports the reporting of "procedure-specific" interventions. The aim...... of this systematic review was to document the procedure-specific evidence for analgesic interventions after total hip arthroplasty (THA). This PRISMA-compliant and PROSPERO-registered review includes randomized placebo-controlled trials (RCTs) of medication-based analgesic interventions after THA. Endpoints were......, and lumbar plexus block reduced nausea and pruritus. The GRADE-rated quality of evidence ranged from low to very low throughout the analyses. This review demonstrated, that some analgesic interventions may have the capacity to reduce mean opioid requirements and/or mean pain intensity compared with controls...

  5. Total hip arthroplasty in Denmark

    DEFF Research Database (Denmark)

    Pedersen, Alma Becic; Johnsen, Søren Paaske; Overgaard, Søren

    2005-01-01

    The annual number of total hip arthroplasties (THA) has increased in Denmark over the past 15 years. There is, however, limited detailed data available on the incidence of THAs.......The annual number of total hip arthroplasties (THA) has increased in Denmark over the past 15 years. There is, however, limited detailed data available on the incidence of THAs....

  6. Congruences of totally geodesic surfaces

    International Nuclear Information System (INIS)

    Plebanski, J.F.; Rozga, K.

    1989-01-01

    A general theory of congruences of totally geodesic surfaces is presented. In particular their classification, based on the properties of induced affine connections, is provided. In the four-dimensional case canonical forms of the metric tensor admitting congruences of two-dimensional totally geodesic surfaces of rank one are given. Finally, congruences of two-dimensional extremal surfaces are studied. (author)

  7. Periprosthetic osteolysis after total wrist arthroplasty

    DEFF Research Database (Denmark)

    Boeckstyns, Michel E H; Herzberg, Guillaume

    2014-01-01

    Background and Literature Review Periprosthetic osteolysis (PPO) after second- or third-generation total wrist arthroplasty (TWA), with or without evident loosening of the implant components, has previously been reported in the literature, but rarely in a systematic way. Purpose The purpose...... of this study was to analyze the prevalence, location, and natural history of PPO following a TWA and to determine whether this was associated with prosthetic loosening. Patients and Methods We analyzed 44 consecutive cases in which a RE-MOTION TWA (Small Bone Innovations Inc., Morrisville, PA, USA) had been...

  8. Totality eclipses of the Sun

    CERN Document Server

    Littmann, Mark; Willcox, Ken

    2008-01-01

    A total eclipse of the Sun is the most awesome sight in the heavens. Totality: Eclipses of the Sun takes you to eclipses of the past, present, and future, and lets you see - and feel - why people travel to the ends of the Earth to observe them. - ;A total eclipse of the Sun is the most awesome sight in the heavens. Totality: Eclipses of the Sun takes you to eclipses of the past, present, and future, and lets you see - and feel - why people travel to the ends of the Earth to observe them. Totality: Eclipses of the Sun is the best guide and reference book on solar eclipses ever written. It explains: how to observe them; how to photograph and videotape them; why they occur; their history and mythology; and future eclipses - when and where to see them. Totality also tells the remarkable story of how eclipses shocked scientists, revealed the workings of the Sun, and made Einstein famous. And the book shares the experiences and advice of many veteran eclipse observers. Totality: Eclipses of the Sun is profusely ill...

  9. Total Product Life Cycle (TPLC)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Total Product Life Cycle (TPLC) database integrates premarket and postmarket data about medical devices. It includes information pulled from CDRH databases...

  10. Nutritional management after total laryngectomy

    African Journals Online (AJOL)

    28 September 2010 with a known diagnosis of cancer of the larynx. The patient, who underwent a total laryngectomy on 13 October, had a tracheostomy inserted .... status, leading to improved quality of life and better response to treatment.4.

  11. Transmandibular approach to total maxillectomy

    OpenAIRE

    Tiwari, R. M.

    2001-01-01

    Total Maxillectomy through transfacial approach has been practiced in the treatment of Cancer for more than a decade. Its role in T3 - T4 tumors extending posteriorly through gthe bony wall is questionable, since an oncological radical procedure is often not possible. Recurrences in the infratemporal fossa are common. Despite the addition of radiotherapy five year survivals have not significantly improved. Transmandibular approach to Total Maxillectomy overcomes this shortcoming by including ...

  12. Leadership and Total Quality Management

    Science.gov (United States)

    1992-04-15

    leadership and management skills yields increased productivity. This paper will focus on the skills required of senior level leaders (leaders at the...publication until it has been cleared by the appropriate mii..-, service or government agency. Leadership and Total Quality Management An Individual Study...llty Codes fAvti1 and/or DltISpecial Abstract AUTHOR: Harry D. Gatanas, LTC, USA TITLE: Leadership and Total Quality Management FORMAT- Individual

  13. Total body water and total body potassium in anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Dempsey, D.T.; Crosby, L.O.; Lusk, E.; Oberlander, J.L.; Pertschuk, M.J.; Mullen, J.L.

    1984-08-01

    In the ill hospitalized patient with clinically relevant malnutrition, there is a measurable decrease in the ratio of the total body potassium to total body water (TBK/TBW) and a detectable increase in the ratio of total exchangeable sodium to total exchangeable potassium (Nae/Ke). To evaluate body composition analyses in anorexia nervosa patients with chronic uncomplicated semistarvation, TBK and TBW were measured by whole body K40 counting and deuterium oxide dilution in 10 females with stable anorexia nervosa and 10 age-matched female controls. The ratio of TBK/TBW was significantly (p less than 0.05) higher in anorexia nervosa patients than controls. The close inverse correlation found in published studies between TBK/TBW and Nae/Ke together with our results suggest that in anorexia nervosa, Nae/Ke may be low or normal. A decreased TBK/TBW is not a good indicator of malnutrition in the anorexia nervosa patient. The use of a decreased TBK/TBW ratio or an elevated Nae/Ke ratio as a definition of malnutrition may result in inappropriate nutritional management in the patient with severe nonstressed chronic semistarvation.

  14. Total body water and total body potassium in anorexia nervosa

    International Nuclear Information System (INIS)

    Dempsey, D.T.; Crosby, L.O.; Lusk, E.; Oberlander, J.L.; Pertschuk, M.J.; Mullen, J.L.

    1984-01-01

    In the ill hospitalized patient with clinically relevant malnutrition, there is a measurable decrease in the ratio of the total body potassium to total body water (TBK/TBW) and a detectable increase in the ratio of total exchangeable sodium to total exchangeable potassium (Nae/Ke). To evaluate body composition analyses in anorexia nervosa patients with chronic uncomplicated semistarvation, TBK and TBW were measured by whole body K40 counting and deuterium oxide dilution in 10 females with stable anorexia nervosa and 10 age-matched female controls. The ratio of TBK/TBW was significantly (p less than 0.05) higher in anorexia nervosa patients than controls. The close inverse correlation found in published studies between TBK/TBW and Nae/Ke together with our results suggest that in anorexia nervosa, Nae/Ke may be low or normal. A decreased TBK/TBW is not a good indicator of malnutrition in the anorexia nervosa patient. The use of a decreased TBK/TBW ratio or an elevated Nae/Ke ratio as a definition of malnutrition may result in inappropriate nutritional management in the patient with severe nonstressed chronic semistarvation

  15. Total 2004 annual report; TOTAL 2004 rapport annuel

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    This annual report of the Group Total brings information and economic data on the following topics, for the year 2004: the corporate governance, the corporate social responsibility, the shareholder notebook, the management report, the activities, the upstream (exploration and production) and downstream (refining and marketing) operating, chemicals and other matters. (A.L.B.)

  16. Calidad total en el ICESI

    OpenAIRE

    González Zamora, José Hipólito

    2010-01-01

    En primer lugar deseo dar la bienvenida esta reunión al ingeniero Francisco Gensini, director ejecutivo de INCOLDA, quien ha sido fuente constante de inspiración para el trabajo relacionado con Control Total de Calidad (C.T.C.) que se ha venido desarrollando en el ICESI. El ingeniero Gensini ha logrado aglutinar alrededor de INCOLDA al grupo de seis empresas de la región, líderes en el estudio y aplicación de los principios del Control Total de Calidad , es decir Rica Rondo S.A., Banco de Oc...

  17. Sobredentadura total superior implantosoportada Superior total overdenture on implants

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.This is the case of a total maxilla edentulous patient seen in consultation of the "Pedro Ortíz" Clinic Implant of Habana del Este municipality in 2009 and con rehabilitation by prosthesis over osteointegration implants added to stomatology practice in Cuba as an alternative to conventional treatment in patients totally edentulous. We follow a protocol including a surgery or surgical phase, technique without or with flap creation and early or immediate load. This is a male patient aged 56 came to our multidisciplinary consultation worried because he had three prostheses in last two years and any fulfilled the requirements of retention to feel safe and comfortable with prostheses. The final result was the total satisfaction of rehabilitated patient improving its aesthetic and functional quality.

  18. Total phenolics and total flavonoids in selected Indian medicinal plants.

    Science.gov (United States)

    Sulaiman, C T; Balachandran, Indira

    2012-05-01

    Plant phenolics and flavonoids have a powerful biological activity, which outlines the necessity of their determination. The phenolics and flavonoids content of 20 medicinal plants were determined in the present investigation. The phenolic content was determined by using Folin-Ciocalteu assay. The total flavonoids were measured spectrophotometrically by using the aluminium chloride colorimetric assay. The results showed that the family Mimosaceae is the richest source of phenolics, (Acacia nilotica: 80.63 mg gallic acid equivalents, Acacia catechu 78.12 mg gallic acid equivalents, Albizia lebbeck 66.23 mg gallic acid equivalents). The highest total flavonoid content was revealed in Senna tora which belongs to the family Caesalpiniaceae. The present study also shows the ratio of flavonoids to the phenolics in each sample for their specificity.

  19. Total Synthesis of Adunctin B.

    Science.gov (United States)

    Dethe, Dattatraya H; Dherange, Balu D

    2018-03-16

    Total synthesis of (±)-adunctin B, a natural product isolated from Piper aduncum (Piperaceae), has been achieved using two different strategies, in seven and three steps. The efficient approach features highly atom economical and diastereoselective Friedel-Crafts acylation, alkylation reaction and palladium catalyzed Wacker type oxidative cyclization.

  20. Edge colouring by total labellings

    DEFF Research Database (Denmark)

    Brandt, Stephan; Rautenbach, D.; Stiebitz, M.

    2010-01-01

    We introduce the concept of an edge-colouring total k-labelling. This is a labelling of the vertices and the edges of a graph G with labels 1, 2, ..., k such that the weights of the edges define a proper edge colouring of G. Here the weight of an edge is the sum of its label and the labels of its...

  1. What is Total Quality Management?

    Science.gov (United States)

    Bryan, William A.

    1996-01-01

    Provides a general overview of Total Quality Management (TQM) and explains why there is pressure for change in higher education institutions. Defines TQM and the various themes, tools, and beliefs that make it different from other management approaches. Presents 14 principles and how they might be applied to student affairs. (RJM)

  2. A totally diverting loop colostomy.

    Science.gov (United States)

    Merrett, N. D.; Gartell, P. C.

    1993-01-01

    A technique is described where the distal limb of a loop colostomy is tied with nylon or polydioxanone. This ensures total faecal diversion and dispenses with the supporting rod, enabling early application of stoma appliances. The technique does not interfere with the traditional transverse closure of a loop colostomy. PMID:8379632

  3. A generalization of total graphs

    Indian Academy of Sciences (India)

    M Afkhami

    2018-04-12

    Apr 12, 2018 ... product of any lower triangular matrix with the transpose of any element of U belongs to U. The ... total graph of R, which is denoted by T( (R)), is a simple graph with all elements of R as vertices, and ...... [9] Badawi A, On dot-product graph of a commutative ring, Communications in Algebra 43 (2015). 43–50.

  4. Total synthesis of nepetoidin B

    Science.gov (United States)

    The total synthesis of nepetoidin B (the 2-(3,4-dihydroxyphenyl)ethenyl ester of 3-(3,4-dihydroxy¬phenyl)-2-propenoic acid) has been achieved in two steps from commercially available 1,5-bis(3,4-dimethoxyphenyl)-1,4-pentadien-3-one. Tetramethylated nepetoidin B was prepared directly by Baeyer-Villig...

  5. The "Total Immersion" Meeting Environment.

    Science.gov (United States)

    Finkel, Coleman

    1980-01-01

    The designing of intelligently planned meeting facilities can aid management communication and learning. The author examines the psychology of meeting attendance; architectural considerations (lighting, windows, color, etc.); design elements and learning modes (furniture, walls, audiovisuals, materials); and the idea of "total immersion meeting…

  6. First total synthesis of Boehmenan

    Indian Academy of Sciences (India)

    The first total synthesis of dilignan Boehmenan has been achieved. A biomimetic oxidative coupling of the ferulic acid methyl ester in the presence of silver oxide is the crucial step in the synthesis sequence, generating the dihydrobenzofuran skeleton. Hydroxyl group was protected with DHP and reducted with LiAlH4 to ...

  7. MODIFIED TECHNIQUE OF TOTAL LARYNGECTOMY

    Directory of Open Access Journals (Sweden)

    Predrag Spirić

    2010-12-01

    Full Text Available Surgical technique of total laryngectomy is well presented in many surgical textbooks. Essentially, it has remained the same since Gluck an Soerensen in 1922 described all its details. Generally, it stresses the U shape skin incision with releasing laryngeal structures and removing larynx from up to down. Further, pharyngeal reconstruction is performed with different kinds of sutures in two or more layers and is finished with skin suture and suction drainage. One of worst complications following this surgery is pharyngocutaneous fistula (PF. Modifications proposed in this this article suggests vertical skin incision with larynx removal from below upwards. In pharyngeal reconstruction we used the running locked suture in submucosal plan with „tobacco sac“ at the end on the tongue base instead of traditional T shaped suture. Suction drains were not used.The aim of study was to present the modified surgical technique of total laryingectomy and its impact on hospital stay duration and pharyngocutanous fistula formation. In this randomized study we analyzed 49 patients operated with modified surgical technique compared to 49 patient operated with traditional surgical technique of total laryngectomy. The modified technique of total laryngectomy was presented. Using modified technique we managed to decrease the PF percentage from previous 20,41% to acceptable 8,16% (p=0,0334. Also, the average hospital stay was shortened from 14,96 to 10,63 days (t =-2.9850; p=0.0358.The modified technique of total laryngectomy is safe, short and efficient surgical intervention which decreases the number of pharyngocutaneos fistulas and shortens the hospital stay.

  8. New Insights into Fully-Depleted SOI Transistor Response During Total Dose Irradiation

    International Nuclear Information System (INIS)

    Burns, J.A.; Dodd, P.E.; Keast, C.L.; Schwank, J.R.; Shaneyfelt, M.R.; Wyatt, P.W.

    1999-01-01

    Worst-case bias configuration for total-dose testing fully-depleted SOI transistors was found to be process dependent. No evidence was found for total-dose induced snap back. These results have implications for hardness assurance testing

  9. Subtotal versus total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Ottesen, Bent; Alling Møller, Lars Mikael

    2015-01-01

    OBJECTIVE: The objective of the study was to compare long-term results of subtotal vs total abdominal hysterectomy for benign uterine diseases 14 years after hysterectomy, with urinary incontinence as the primary outcome measure. STUDY DESIGN: This was a long-term follow-up of a multicenter......, randomized clinical trial without blinding. Eleven gynecological departments in Denmark contributed participants to the trial. Women referred for benign uterine diseases who did not have contraindications to subtotal abdominal hysterectomy were randomized to subtotal (n = 161) vs total (n = 158) abdominal...... from discharge summaries from all public hospitals in Denmark. The results were analyzed as intention to treat and per protocol. Possible bias caused by missing data was handled by multiple imputation. The primary outcome was urinary incontinence; the secondary outcomes were pelvic organ prolapse...

  10. Institutional total energy case studies

    Energy Technology Data Exchange (ETDEWEB)

    Wulfinghoff, D.

    1979-07-01

    Profiles of three total energy systems in institutional settings are provided in this report. The plants are those of Franciscan Hospital, a 384-bed facility in Rock Island, Illinois; Franklin Foundation Hospital, a 100-bed hospital in Franklin, Louisiana; and the North American Air Defense Command Cheyenne Mountain Complex, a military installation near Colorado Springs, Colorado. The case studies include descriptions of plant components and configurations, operation and maintenance procedures, reliability, relationships to public utilities, staffing, economic efficiency, and factors contributing to success.

  11. Total synthesis of (-)- and (+)-tedanalactam

    Digital Repository Service at National Institute of Oceanography (India)

    Majik, M.S.; Parameswaran, P.S.; Tilve, S.G.

    : The Journal of Organic Chemistry, vol.74(16); 6378-6381 1 Total Synthesis of (-) and (+)-Tedanalactam Mahesh S. Majik, † Peruninakulath S. Parameswaran, ‡ and Santosh G. Tilve* ,† Department of Chemistry, Goa University, Taleigao Plateau, Goa 403..., displaying a wide range of biological activities. 1 Piperidones are key synthetic intermediates 2 for the synthesis of piperidine ring due to the presence of keto function which allows the introduction of other groups. Piperidones are also known...

  12. Intrathoracic Hernia after Total Gastrectomy

    Directory of Open Access Journals (Sweden)

    Yoshihiko Tashiro

    2016-05-01

    Full Text Available Intrathoracic hernias after total gastrectomy are rare. We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointestinal endoscopy. We initially performed endoscopic submucosal dissection, but the vertical margin was positive in a pathological result. We performed total gastrectomy with antecolic Roux-Y reconstruction by laparotomy. For adhesion of the esophageal hiatus, the left chest was connected with the abdominal cavity. A pleural defect was not repaired. Two days after the operation, the patient was suspected of having intrathoracic hernia by chest X-rays. Computed tomography showed that the transverse colon and Roux limb were incarcerated in the left thoracic cavity. He was diagnosed with intrathoracic hernia, and emergency reduction and repair were performed. Operative findings showed that the Roux limb and transverse colon were incarcerated in the thoracic cavity. After reduction, the orifice of the hernia was closed by suturing the crus of the diaphragm with the ligament of the jejunum and omentum. After the second operation, he experienced anastomotic leakage and left pyothorax. Anastomotic leakage was improved with conservative therapy and he was discharged 76 days after the second operation.

  13. NIF total neutron yield diagnostic

    International Nuclear Information System (INIS)

    Cooper, Gary W.; Ruiz, Carlos L.

    2001-01-01

    We have designed a total neutron yield diagnostic for the National Ignition Facility (NIF) which is based on the activation of In and Cu samples. The particular approach that we have chosen is one in which we calibrate the entire counting system and which we call the ''F factor'' method. In this method, In and/or Cu samples are exposed to known sources of DD and DT neutrons. The activated samples are then counted with an appropriate system: a high purity Ge detector for In and a NaI coincidence system for Cu. We can then calculate a calibration factor, which relates measured activity to total neutron yield. The advantage of this approach is that specific knowledge of such quantities as cross sections and detector efficiencies is not needed. Unless the actual scattering environment of the NIF can be mocked up in the calibration experiment, the F factor will have to be modified using the results of a numerical simulation of the NIF scattering environment. In this article, the calibration factor methodology will be discussed and experimental results for the calibration factors will be presented. Total NIF neutron yields of 10 9 --10 19 can be measured with this method assuming a 50 cm stand-off distance can be employed for the lower yields

  14. Neck after total laryngectomy: CT study

    International Nuclear Information System (INIS)

    DiSantis, D.J.; Balfe, D.M.; Hayden, R.E.; Sagel, S.S.; Sessions, D.; Lee, J.K.T.

    1984-01-01

    Computed tomographic scans in 23 patients who had undergone total laryngectomy were analyzed retrospectively to determine normal postoperative appearance and to evaluate the role of CT in assessing recurrent neoplasm. Nine patients without clinical evidence of recurrence illustrated the normal postoperative changes: a round or ovoid neopharynx connecting the base of the tongue with the cervical esophagus and intact fat planes surrounding the neopharynx, neurovascular bundles, and sternocleidomastoid muscles. In the 12 patients with recurrent neoplasm, the CT manifestations included masses involving the internal jugular lymph node chain, tracheostomy site, or paratracheal region. CT supplemented physical examination and indirect mirror examination, providing data regarding presence and extent of recurrent tumor and aiding in planning the mode and scope of therapy

  15. Granulomatous pseudotumors in total joint replacement

    International Nuclear Information System (INIS)

    Griffiths, H.J.; Burke, J.; Bonfiglio, T.A.

    1987-01-01

    Fourteen patients (15 joints) developed a foreign body reaction to methylmethacrylate, polyethylene, or metal adjacent to a total joint implant, a condition we would like to term granulomatous pseudotumors. There were eight male and six female patients. Their average age was 61 years. The hip was involved in 14 joints (femoral component 11 times, acetabulum 7, and greater trochanter once). One patient presented with granulomatous pseudotumors of the knee. The principal findings included increasing pain and radiographic evidence of loosening occurring on average 2.7 years following the implant. This was followed by a characteristic and gradually developing radiographic pattern of discrete rounded lucencies. These developed into large ovoid lytic areas, destroying both methylmethacrylate and bone. Histologically, the appearances were characterized by histiocytic infiltration and the presence of multiple foreign body giant cells. Foreign material was identified in 9 of 11 cases. The pathogenesis is unknown but appears related to micromovement or loosening of the implant. (orig.)

  16. Multiple Lines of Evidence

    Energy Technology Data Exchange (ETDEWEB)

    Amidan, Brett G. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Venzin, Alexander M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Bramer, Lisa M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-06-03

    This paper discusses the process of identifying factors that influence the contamination level of a given decision area and then determining the likelihood that the area remains unacceptable. This process is referred to as lines of evidence. These lines of evidence then serve as inputs for the stratified compliance sampling (SCS) method, which requires a decision area to be divided into strata based upon contamination expectations. This is done in order to focus sampling efforts more within stratum where contamination is more likely and to use the domain knowledge about these likelihoods of the stratum remaining unacceptable to buy down the number of samples necessary, if possible. Two different building scenarios were considered as an example (see Table 3.1). SME expertise was elicited concerning four lines of evidence factors (see Table 3.2): 1) amount of contamination that was seen before decontamination, 2) post-decontamination air sampling information, 3) the applied decontaminant information, and 4) the surface material. Statistical experimental design and logistic regression modelling were used to help determine the likelihood that example stratum remained unacceptable for a given example scenario. The number of samples necessary for clearance was calculated by applying the SCS method to the example scenario, using the estimated likelihood of each stratum remaining unacceptable as was determined using the lines of evidence approach. The commonly used simple random sampling (SRS) method was also used to calculate the number of samples necessary for clearance for comparison purposes. The lines of evidence with SCS approach resulted in a 19% to 43% reduction in total number of samples necessary for clearance (see Table 3.6). The reduction depended upon the building scenario, as well as the level of percent clean criteria. A sensitivity analysis was also performed showing how changing the estimated likelihoods of stratum remaining unacceptable affect the number

  17. Total eclipses of the sun

    CERN Document Server

    Zirker, Jack B

    2014-01-01

    Eclipses have captured attention and sparked curiosity about the cosmos since the first appearance of humankind. Having been blamed for everything from natural disasters to the fall of kings, they are now invaluable tools for understanding many celestial as well as terrestrial phenomena. This clear, easy-to-understand guide explains what causes total eclipses and how they can be used in experiments to examine everything from the dust between the planets to general relativity. A new chapter has been added on the eclipse of July 11, 1991 (the great Hawaiian eclipse). Originally published in 19

  18. Reverse hybrid total hip arthroplasty

    DEFF Research Database (Denmark)

    Wangen, Helge; Havelin, Leif I.; Fenstad, Anne M

    2017-01-01

    Background and purpose - The use of a cemented cup together with an uncemented stem in total hip arthroplasty (THA) has become popular in Norway and Sweden during the last decade. The results of this prosthetic concept, reverse hybrid THA, have been sparsely described. The Nordic Arthroplasty....... Patients and methods - From the NARA, we extracted data on reverse hybrid THAs from January 1, 2000 until December 31, 2013. 38,415 such hips were studied and compared with cemented THAs. The Kaplan-Meier method and Cox regression analyses were used to estimate the prosthesis survival and the relative risk...

  19. Total knee arthroplasty in ochronosis

    Directory of Open Access Journals (Sweden)

    Vaibhav G. Patel, MBBS

    2015-09-01

    Full Text Available Alkaptonuria is disorder of tyrosine metabolism due to deficiency of homogentisic oxidase characterized by excretion of homogentisic acid in urine, deposition of oxidized homogensitate pigments in connective tissues and articular cartilages (ochronosis. The result is dark pigmentation and weakening of the tissues resulting in chronic inflammation and osteoarthritis. Management of alkaptonuric ochronic osteoarthritis is usually symptomatic and replacements have comparable outcomes to osteoarthritis in patients without ochronosis. I report a case of a patient with ochronosis of knee treated with total knee replacement and report operative pearls for surgery in this rare disorder.

  20. Total filmless digital radiology service

    International Nuclear Information System (INIS)

    Mun, S.K.; Goeringer, F.; Benson, H.; Horii, S.C.

    1989-01-01

    The completion of a comprehensive picture archiving and communication system (PACS) at Georgetown University Hospital has allowed us to identify a number of technical, administrative, personnel, and operational issues that will affect a total digital radiology service. With a hospital-wide digital imaging network system, computer simulation of communications and storage options, and economic modeling, we have developed a feasibility study and implementation strategy for the smooth transition to a nearly filmless radiology service over the next several years. This paper describes the technical and operational requirements for various database operations, workstations (used in diagnosis, review, and education), and communications. Site and installation planning, personnel training, and transition operations are discussed

  1. Qualidade total: Um novo paradigma?

    Directory of Open Access Journals (Sweden)

    Suzana da Rosa Tolfo

    1999-01-01

    Full Text Available Nos últimos anos, o movimento para a implantação da Gestão da Qualidade Total vem crescendo ao redor do mundo. Em razão disso, há uma diversidade de ações realizadas com o nome de "Qualidade Total'. Uma revisão da teoria é complexa, porque existem muitos autores que tratam da questão. Eles escolhem diferentes perspectivas de análises (teóricas e empíricas e há dificuldades em se identificar um corpo conceitual. Há uma ampla difusão de modelos, ferramentas, técnicas, mercado e consultores. Essa popularidade, muitas vezes, faz com que determinadas organizações adotem essa forma de gestão do trabalho sem o conhecimento necessário das implicações que um modelo dessa ordem representa; especialmente no caso brasileiro, suscetível a proposições importadas. O presente artigo propõe um exame daquilo que os fundadores têm articulado sobre TQM, as principais críticas nesta direção e a avaliação de como vem sendo aplicadono nosso país.

  2. Testing EDM of Total Stations

    Directory of Open Access Journals (Sweden)

    Cirbus Ján

    2001-03-01

    Full Text Available The paper is devoted to testing electrooptical distance measuring devices (EDM built in total stations, than can be used for various tasks in the contemporary geodetic works. A rich market offer and availability of these universal measuring systems with satisfying distance range, excellent accuracy and other parameters, make total stations as dominant terrestrial geodetic instruments.For succesfully applying these instruments, above all for relliable distance measurements, the stability of the modulation frequency is the most important pre-condition. In the article, therefore, there are given some methods to verify the modulation frequency stability. In addition, some ways for determining the EDM distance constant and periodical corrections of the phase measuring unit are introduced for 4 types of EDM : LEICA 1700L, TOPCON GTS6A, TOPCON GTS2, C.ZEISS ELTA50. It were also investigated their possibilities for precise distance survey. Values of the determined constants and periodical corrections are presented in Tab. 2.Based on the investigation results of the 4 EDM types and using the values m obtained for different distances S, equations of the a posteriori standard deviations in form : m = (a+b.S were derived too.

  3. Total Value of Phosphorus Recovery.

    Science.gov (United States)

    Mayer, Brooke K; Baker, Lawrence A; Boyer, Treavor H; Drechsel, Pay; Gifford, Mac; Hanjra, Munir A; Parameswaran, Prathap; Stoltzfus, Jared; Westerhoff, Paul; Rittmann, Bruce E

    2016-07-05

    Phosphorus (P) is a critical, geographically concentrated, nonrenewable resource necessary to support global food production. In excess (e.g., due to runoff or wastewater discharges), P is also a primary cause of eutrophication. To reconcile the simultaneous shortage and overabundance of P, lost P flows must be recovered and reused, alongside improvements in P-use efficiency. While this motivation is increasingly being recognized, little P recovery is practiced today, as recovered P generally cannot compete with the relatively low cost of mined P. Therefore, P is often captured to prevent its release into the environment without beneficial recovery and reuse. However, additional incentives for P recovery emerge when accounting for the total value of P recovery. This article provides a comprehensive overview of the range of benefits of recovering P from waste streams, i.e., the total value of recovering P. This approach accounts for P products, as well as other assets that are associated with P and can be recovered in parallel, such as energy, nitrogen, metals and minerals, and water. Additionally, P recovery provides valuable services to society and the environment by protecting and improving environmental quality, enhancing efficiency of waste treatment facilities, and improving food security and social equity. The needs to make P recovery a reality are also discussed, including business models, bottlenecks, and policy and education strategies.

  4. Mesh Excision: Is Total Mesh Excision Necessary?

    Science.gov (United States)

    Wolff, Gillian F; Winters, J Christian; Krlin, Ryan M

    2016-04-01

    Nearly 29% of women will undergo a secondary, repeat operation for pelvic organ prolapse (POP) symptom recurrence following a primary repair, as reported by Abbott et al. (Am J Obstet Gynecol 210:163.e1-163.e1, 2014). In efforts to decrease the rates of failure, graft materials have been utilized to augment transvaginal repairs. Following the success of using polypropylene mesh (PPM) for stress urinary incontinence (SUI), the use of PPM in the transvaginal repair of POP increased. However, in recent years, significant concerns have been raised about the safety of PPM mesh. Complications, some specific to mesh, such as exposures, erosion, dyspareunia, and pelvic pain, have been reported with increased frequency. In the current literature, there is not substantive evidence to suggest that PPM has intrinsic properties that warrant total mesh removal in the absence of complications. There are a number of complications that can occur after transvaginal mesh placement that do warrant surgical intervention after failure of conservative therapy. In aggregate, there are no high-quality controlled studies that clearly demonstrate that total mesh removal is consistently more likely to achieve pain reduction. In the cases of obstruction and erosion, it seems clear that definitive removal of the offending mesh is associated with resolution of symptoms in the majority of cases and reasonable practice. There are a number of complications that can occur with removal of mesh, and patients should be informed of this as they formulate a choice of treatment. We will review these considerations as we examine the clinical question of whether total versus partial removal of mesh is necessary for the resolution of complications following transvaginal mesh placement.

  5. Total employment effect of biofuels

    International Nuclear Information System (INIS)

    Stridsberg, S.

    1998-08-01

    The study examined the total employment effect of both direct production of biofuel and energy conversion to heat and electricity, as well as the indirect employment effect arising from investments and other activities in conjunction with the production organization. A secondary effect depending on the increased capital flow is also included in the final result. The scenarios are based on two periods, 1993-2005 and 2005-2020. In the present study, the different fuels and the different applications have been analyzed individually with regard to direct and indirect employment within each separate sector. The greatest employment effect in the production chain is shown for logging residues with 290 full-time jobs/TWh, whereas other biofuels range between 80 and 280 full-time jobs/TWh. In the processing chain, the corresponding range is 200-300 full-time jobs per each additional TWh. Additionally and finally, there are secondary effects that give a total of 650 full-time jobs/TWh. Together with the predicted increase, this suggests that unprocessed fuel will provide an additional 16 000 annual full-time jobs, and that fuel processing will contribute with a further 5 000 full-time jobs. The energy production from the fuels will provide an additional 13 000 full-time jobs. The total figure of 34 000 annual full-time jobs must then be reduced by about 4000 on account of lost jobs, mainly in the oil sector and to some extent in imports of biofuel. In addition, the anticipated increase in capital turnover that occurs within the biofuel sector, will increase full-time jobs up to year 2020. Finally, a discussion is given of the accomplishment of the programmes anticipated by the scenario, where it is noted that processing of biofuel to wafers, pellets or powder places major demands on access to raw material of good quality and that agrarian fuels must be given priority if they are to enter the system sufficiently fast. Straw is already a resource but is still not accepted by

  6. Errors in the Total Testing Process in the Clinical Chemistry ...

    African Journals Online (AJOL)

    2018-03-01

    Mar 1, 2018 ... Analytical errors related to internal and external quality control exceeding the target range, (14.4%) ... indicators to assess errors in the total testing process. The. University ... Evidence showed that the risk of .... Data management and quality control: Pre-test ..... indicators and specifications for key processes.

  7. TotalFina+Elf, how to fight against the evidence?; TotalFina+Elf, comment lutter contre l'evidence?

    Energy Technology Data Exchange (ETDEWEB)

    Marion, G. [Ecole Nationale Superieure des Mines, 69 - Lyon (France)

    2000-09-01

    TotaIFina's successful bid for taking over Elf represents the victory of a certain type of 'discourse'. The strategist's ability to market his views resembles the marketer's ability to promote a product through packaging and advertising. Analyzing the publicity war between these two firms during the summer of 1999 sheds light on the strategist's ability to 'make strategy with words'. Out of the variety of explanatory factors and arguments for the success of such a takeover bid. 'managerial discourse' is not to be overlooked as a means for 'enacting' a strategy. (author)

  8. Conversion total hip arthroplasty: Primary or revision total hip arthroplasty

    Science.gov (United States)

    Schwarzkopf, Ran; Baghoolizadeh, Mahta

    2015-01-01

    Total hip arthroplasty (THA) is an increasingly common procedure among elderly individuals. Although conversion THA is currently bundled in a diagnosis related group (DRG) with primary THA, there is a lack of literature supporting this classification and it has yet to be identified whether conversion THA better resembles primary or revision THA. This editorial analyzed the intraoperative and postoperative factors and functional outcomes following conversion THA, primary THA, and revision THA to understand whether the characteristics of conversion THA resemble one procedure or the other, or are possibly somewhere in between. The analysis revealed that conversion THA requires more resources both intraoperatively and postoperatively than primary THA. Furthermore, patients undergoing conversion THA present with poorer functional outcomes in the long run. Patients undergoing conversion THA better resemble revision THA patients than primary THA patients. As such, patients undergoing conversion THA should not be likened to patients undergoing primary THA when determining risk stratification and reimbursement rates. Conversion THA procedures should be planned accordingly with proper anticipation of the greater needs both in the operating room, and for in-patient and follow-up care. We suggest that conversion THA be reclassified in the same DRG with revision THA as opposed to primary THA as a step towards better allocation of healthcare resources for conversion hip arthroplasties. PMID:26601055

  9. Instability after total hip arthroplasty

    Science.gov (United States)

    Werner, Brian C; Brown, Thomas E

    2012-01-01

    Instability following total hip arthroplasty (THA) is an unfortunately frequent and serious problem that requires thorough evaluation and preoperative planning before surgical intervention. Prevention through optimal index surgery is of great importance, as the management of an unstable THA is challenging even for an experienced joints surgeon. However, even after well-planned surgery, a significant incidence of recurrent instability still exists. Non-operative management is often successful if the components are well-fixed and correctly positioned in the absence of neurocognitive disorders. If conservative management fails, surgical options include revision of malpositioned components; exchange of modular components such as the femoral head and acetabular liner; bipolar arthroplasty; tripolar arthroplasty; use of a larger femoral head; use of a constrained liner; soft tissue reinforcement and advancement of the greater trochanter. PMID:22919568

  10. A total safety management model

    International Nuclear Information System (INIS)

    Obadia, I.J.; Vidal, M.C.R.; Melo, P.F.F.F.

    2002-01-01

    In nuclear organizations, quality and safety are inextricably linked. Therefore, the search for excellence means reaching excellence in nuclear safety. The International Atomic Energy Agency, IAEA, developed, after the Chernobyl accident, the organizational approach for improving nuclear safety based on the safety culture, which requires a framework necessary to provide modifications in personnel attitudes and behaviors in situations related to safety. This work presents a Total Safety Management Model, based on the Model of Excellence of the Brazilian Quality Award and on the safety culture approach, which represents an alternative to this framework. The Model is currently under validation at the Nuclear Engineering Institute, in Rio de Janeiro, Brazil, and the results of its initial safety culture self assessment are also presented and discussed. (author)

  11. Demand: a total nuclear disarmament

    International Nuclear Information System (INIS)

    Hessel, Stephane; Jacquard, Albert

    2012-01-01

    This bibliographical note presents a book, in which the authors make a plea for a total nuclear disarmament. They think that humanity cannot be found in competition, but in emulation, and examine how we can get rid of the nuclear bomb. They discuss the background of nuclear energy, state that nuclear weapons have always been useless and extremely dangerous, consider arms race as crazy and as a crime against humanity, recall that nuclear weapons already made numerous victims (Hiroshima, Nagasaki, nuclear tests), that they are a sword of Damocles over 7 billions human beings, that nuclear winter would be an apocalypse, that the Non Proliferation Treaty is a decoy. They discuss the political role of nuclear weapons, and outline that the only solution is their abolition. They discuss what has already been done and what is still to be done, and formulate a strategy for the future

  12. Total synthesis of mycalamide A.

    Science.gov (United States)

    Sohn, Jeong-Hun; Waizumi, Nobuaki; Zhong, H Marlon; Rawal, Viresh H

    2005-05-25

    This communication describes a concise and efficient total synthesis of mycalamide A by the convergent coupling of pederic acid unit with the mycalamine unit. The left-half, (+)-7-benzoylpederic acid, was synthesized from (2R,3R)-3-methylpent-4-en-2-ol in seven steps and 34.6% overall yield through a route that features a one-step Pd(II)-catalyzed tandem Wacker/Heck cyclization reaction to prepare the tetrahydropyran ring system. The right-half, the mycalamine unit, was synthesized in 21 steps and 10.5% overall yield from diethyl d-tartrate. Effective, stereoselective methods were developed for the assembly of the two parts to yield either mycalamide A or C(10)-epi-mycalamide A.

  13. Total quality management implementation guidelines

    Energy Technology Data Exchange (ETDEWEB)

    1993-12-01

    These Guidelines were designed by the Energy Quality Council to help managers and supervisors in the Department of Energy Complex bring Total Quality Management to their organizations. Because the Department is composed of a rich mixture of diverse organizations, each with its own distinctive culture and quality history, these Guidelines are intended to be adapted by users to meet the particular needs of their organizations. For example, for organizations that are well along on their quality journeys and may already have achieved quality results, these Guidelines will provide a consistent methodology and terminology reference to foster their alignment with the overall Energy quality initiative. For organizations that are just beginning their quality journeys, these Guidelines will serve as a startup manual on quality principles applied in the Energy context.

  14. Total quality management program planning

    Energy Technology Data Exchange (ETDEWEB)

    Thornton, P.T.; Spence, K.

    1994-05-01

    As government funding grows scarce, competition between the national laboratories is increasing dramatically. In this era of tougher competition, there is no for resistance to change. There must instead be a uniform commitment to improving the overall quality of our products (research and technology) and an increased focus on our customers` needs. There has been an ongoing effort to bring the principles of total quality management (TQM) to all Energy Systems employees to help them better prepare for future changes while responding to the pressures on federal budgets. The need exists for instituting a vigorous program of education and training to an understanding of the techniques needed to improve and initiate a change in organizational culture. The TQM facilitator is responsible for educating the work force on the benefits of self-managed work teams, designing a program of instruction for implementation, and thus getting TQM off the ground at the worker and first-line supervisory levels so that the benefits can flow back up. This program plan presents a conceptual model for TQM in the form of a hot air balloon. In this model, there are numerous factors which can individually and collectively impede the progress of TQM within the division and the Laboratory. When these factors are addressed and corrected, the benefits of TQM become more visible. As this occurs, it is hoped that workers and management alike will grasp the ``total quality`` concept as an acceptable agent for change and continual improvement. TQM can then rise to the occasion and take its rightful place as an integral and valid step in the Laboratory`s formula for survival.

  15. Instability following total knee arthroplasty.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos

    2011-10-01

    Background Knee prosthesis instability (KPI) is a frequent cause of failure of total knee arthroplasty. Moreover, the degree of constraint required to achieve immediate and long-term stability in total knee arthroplasty (TKA) is frequently debated. Questions This review aims to define the problem, analyze risk factors, and review strategies for prevention and treatment of KPI. Methods A PubMed (MEDLINE) search of the years 2000 to 2010 was performed using two key words: TKA and instability. One hundred and sixty-five initial articles were identified. The most important (17) articles as judged by the author were selected for this review. The main criteria for selection were that the articles addressed and provided solutions to the diagnosis and treatment of KPI. Results Patient-related risk factors predisposing to post-operative instability include deformity requiring a large surgical correction and aggressive ligament release, general or regional neuromuscular pathology, and hip or foot deformities. KPI can be prevented in most cases with appropriate selection of implants and good surgical technique. When ligament instability is anticipated post-operatively, the need for implants with a greater degree of constraint should be anticipated. In patients without significant varus or valgus malalignment and without significant flexion contracture, the posterior cruciate ligament (PCL) can be retained. However, the PCL should be sacrificed when deformity exists particularly in patients with rheumatoid arthritis, previous patellectomy, previous high tibial osteotomy or distal femoral osteotomy, and posttraumatic osteoarthritis with disruption of the PCL. In most cases, KPI requires revision surgery. Successful outcomes can only be obtained if the cause of KPI is identified and addressed. Conclusions Instability following TKA is a common cause of the need for revision. Typically, knees with deformity, rheumatoid arthritis, previous patellectomy or high tibial osteotomy, and

  16. Hazardous factories: Nigerian evidence.

    Science.gov (United States)

    Oloyede, Olajide

    2005-06-01

    The past 15 years have seen an increasing governmental and corporate concern for the environment worldwide. For governments, information about the environmental performance of the industrial sector is required to inform macro-level decisions about environmental targets such as those required to meet UN directives. However, in many African, Asian, and Latin American countries, researching and reporting company environmental performance is limited. This article serves as a contribution to filling the gap by presenting evidence of physical and chemical risk in Nigerian factories. One hundred and three factories with a total of 5,021 workers were studied. One hundred and twenty physical and chemical hazards were identified and the result shows a high number of workers exposed to such hazards. The study also reveals that workers' awareness level of chemical hazards was high. Yet the danger was perceived in behavioral terms, especially by manufacturing firms, which tend to see environmental investment in an increasingly global economy as detrimental to profitability.

  17. 20 CFR 410.240 - Evidence.

    Science.gov (United States)

    2010-04-01

    ... evidence may be submitted as part of a prescribed application form if the form provides for its inclusion... disability or death due to pneumoconiosis. For evidence requirements to support allegations of total disability or death due to pneumoconiosis; for the effect of the failure or refusal of an individual to...

  18. Total hip arthroplasty at the rothman institute.

    Science.gov (United States)

    Austin, Matthew S; Higuera, Carlos A; Rothman, Richard H

    2012-07-01

    Total hip arthroplasty (THA) is one of the most successful surgical interventions devised in modern times. Attempts to change the current THA procedure with unproven innovations bring the risk of increased failure rates while trying to improve the benefit of the surgery. This manuscript examines the evolution of THA at the Rothman Institute illustrating the key elements that lead the success of this procedure at this institution. These key elements include femoral stem design, use of highly crossed-linked polyethylene and use of pain and rehabilitation protocols. We attempted to describe the long-term results regarding safety, effectiveness, and durability of specific THA implant designs used at this institution drawing on reported evidence in the literature. The authors performed a review of peer-reviewed articles related to the Rothman Institute's experience with THA. Total hip arthroplasty is an efficient, safe, and durable procedure. It is a highly successful operation to restore function and improve pain. The survivorship of THA procedures at the Rothman Institute is higher than 99% at 10 years based on mechanical failure. The use of collarless, tapered wedge femoral stem, highly crossed-linked polyethylene, and improved pain rehabilitation protocols have contributed to this success. There is a well-documented long-term survivorship after THA. Future innovation in THA should address new challenges with younger and more demanding patients, rather than change current methods that have a proven good survivorship. This innovation depends mainly upon improvements in the bearing surfaces and advances in pain control and rehabilitation.

  19. The "July effect" in total shoulder arthroplasty.

    Science.gov (United States)

    Rao, Allison J; Bohl, Daniel D; Frank, Rachel M; Cvetanovich, Gregory L; Nicholson, Gregory P; Romeo, Anthony A

    2017-03-01

    New medical doctors enter their residency fields in July, a time in the hospital in which patient morbidity and mortality rates are perceived to be higher. It remains controversial whether a "July effect" exists in different areas of medicine and surgery, including in orthopedic surgery. The purpose of this study is to test for the July effect in patients undergoing primary total shoulder arthroplasty (TSA). Patients who underwent primary TSA from 2005-2012 were identified using the American College of Surgeons National Surgical Quality Improvement Program database. Cases were categorized as involving residents or fellows and as occurring during the first academic quarter. Rates of composite and any adverse event outcomes were compared between patient groups using multivariate logistic regression. A total of 1591 patients met the inclusion criteria. Of these cases, 711 (44.7%) had resident or fellow involvement and 390 (24.5%) were performed in the first academic quarter. There were few demographic and comorbidity differences between cases with and without residents or fellows or between cases performed during the first quarter and during the rest of the year. Overall, the rate of serious adverse events was 1.6% and the rate of any adverse events was 6.5%. Using one of the largest cohorts of primary TSA patients, this study could not provide evidence for a July effect. In the context of the recent growth in the volume of TSA procedures, these findings provide important reassurance to patients that it is safe to schedule their elective procedures at training institutions during the first part of the academic year. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  20. Total thyroidectomy as primary elective procedure in multinodular thyroid disease

    International Nuclear Information System (INIS)

    Sheikh, I.A.; Haider, I.Z.; Haroon, A.; Ashfaq, M.

    2009-01-01

    Multinodular goitre is one of the commonest thyroid diseases encountered in the practice of surgery. The most common surgery being performed for multinodular goitre is subtotal thyroidectomy. Total thyroidectomy is designed to remove all of the thyroid tissue. The objective of this study was to evaluate total thyroidectomy as a primary elective procedure for treatment of multinodular thyroid disease. This descriptive study was carried out at Combined Military Hospital Rawalpindi from June 2003 to September 2006. 88 patients of multinodular thyroid disease were included. Patients having evidence of recurrent laryngeal nerve damage, recurrent goitre, evidence of altered parathyroid functions or evidence of malignancy were excluded. All patients underwent total thyroidectomy by the same team of surgeons and the patients were closely followed up for postoperative complications especially in terms of recurrent laryngeal nerve damage and hypocalcaemic tetany. No major postoperative complication was noted. Only 1 patient (1.14%) developed unilateral recurrent laryngeal nerve damage and 2 patients (2.27%) developed transient hypocalcaemia that recovered quickly. Total thyroidectomy as a primary elective procedure in multinodular thyroid disease is a safe option and it removes the disease process completely, lowers local recurrence rates and avoids the substantial risks of re operative surgery. (author)

  1. The effects of probiotics on total cholesterol

    Science.gov (United States)

    Wang, Lang; Guo, Mao-Juan; Gao, Qing; Yang, Jin-Feng; Yang, Lin; Pang, Xiao-Li; Jiang, Xi-Juan

    2018-01-01

    Abstract Background: Probiotics supplements provide a new nonpharmacological alternative to reduce cardiovascular risk factors. The impact of probiotics on the reduction of total cholesterol (TC) remains controversial. We conducted a meta-analysis to showcase the most updated and comprehensive evaluation of the studies. Methods: Randomized controlled trials (RCTs) were searched from electronic databases, including PubMed, Embase, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang database dating from January 2007 to January 2017. The curative effects of probiotics on the reduction of TC were assessed using mean difference (MD), as well as their 95% confidence interval (CI). RevMan software (version 5.3) was used to carry out this meta-analysis. Results: Thirty-two RCTs including 1971 patients met the inclusion criteria. Results of this analysis showed that compared with the control group serum TC was significantly reduced in probiotics group [MD = −13.27, 95% CI (−16.74 to 9.80), P  6 weeks: [MD = −22.18, 95% CI (−28.73, −15.63), P probiotics forms and intervention duration might have a significant impact on the results. However, strains and doses of probiotics had no significant influence on curative effects. Conclusion: Available evidence indicates that probiotics supplements can significantly reduce serum TC. Furthermore, higher baseline TC, longer intervention time, and probiotics in capsules form might contribute to a better curative effect. PMID:29384846

  2. TREATMENT OF INFECTION AFTER TOTAL KNEE ARTHROPLASTY.

    Science.gov (United States)

    Cury, Ricardo de Paula Leite; Cinagawa, Eduardo Hitoshi Tsuge; Camargo, Osmar Pedro Arbix; Honda, Emerson Kiyoshi; Klautau, Giselle Burlamaqui; Salles, Mauro José Costa

    2015-01-01

    To identify and compare the rate of success of therapeutic modalities applied in surgeries for the treatment of infections associated with total knee arthroplasty (TKA), and to evaluate the functional outcome and pain in different therapeutic modalities by means of quality of life scores. We evaluated all patients who developed periprosthetic infection after TKA for primary or secondary osteoarthritis, in the period from January 1(st), 2008 to December 31(st), 2010. In the study period, 29 patients with TKA had infection, and 12 of these underwent debridement and retention of the prosthesis (D+R), seven received two-stage and six one-stage exchange arthroplasties, and four patients were treated with suppressive antibiotic therapy because they could not undergo another surgical procedure. The D+R, one-stage revision and two-stage revision success rates were 75%, 83.3%, and 100%, respectively. The best results of quality of life (QoL) and function occur in patients undergoing D+R. In contrast, the worst QoL and functional results were obtained in patients treated with two-stage revision arthroplasty. Level of Evidence II, Prognostic Studies - Investigating the Effect of a Patient Characteristic on the Outcome of Disease.

  3. Backside wear in modern total knee designs.

    Science.gov (United States)

    Jayabalan, Prakash; Furman, Bridgette D; Cottrell, Jocelyn M; Wright, Timothy M

    2007-02-01

    Although modularity affords various options to the orthopedic surgeon, these benefits come at a price. The unintended bearing surface between the back surface of the tibial insert and the metallic tray results in micromotion leading to polyethylene wear debris. The objective of this study was to examine the backside wear of tibial inserts from three modern total knee designs with very different locking mechanisms: Insall-Burstein II (IB II), Optetrak, and Advance. A random sample of 71 inserts were obtained from our institution's retrieval collection and examined to assess the extent of wear, depth of wear, and wear damage modes. Patient records were also obtained to determine patient age, body mass index, length of implantation, and reason for revision. Modes of wear damage (abrasion, burnishing, scratching, delamination, third body debris, surface deformation, and pitting) were then scored in each zone from 0 to 3 (0 = 0%, 1 = 0-10%, 2 = 10-50%, and 3 = >50%). The depth of wear was subjectively identified as removal of manufacturing identification markings stamped onto the inferior surface of the polyethylene. Both Advance and IB II polyethylene inserts showed significantly higher scores for backside wear than the Optetrak inserts. All IB II and Advance implants showed evidence of backside wear, whereas 17% (5 out of 30) of the retrieved Optetrak implants had no observable wear. There were no significant differences when comparing the depth of wear score between designs. The locking mechanism greatly affects the propensity for wear and should be considered when choosing a knee implant system.

  4. Total Petroleum Hydrocarbons (TPH): ToxFAQs

    Science.gov (United States)

    ... a state: This map displays locations where Total Petroleum Hydrocarbons (TPH) is known to be present. On ... I get more information? ToxFAQs TM for Total Petroleum Hydrocarbons (TPH) ( Hidrocarburos Totales de Petróleo (TPH) ) August ...

  5. Properties of solar gravity mode signals in total irradiance observations

    International Nuclear Information System (INIS)

    Kroll, R.J.; Chen, J.; Hill, H.A.

    1988-01-01

    Further evidence has been found that a significant fraction of the gravity mode power density in the total irradiance observations appears in sidebands of classified eigenfrequencies. These sidebands whose amplitudes vary from year to year are interpreted as harmonics of the rotational frequencies of the nonuniform solar surface. These findings are for non axisymmetric modes and corroborate the findings of Kroll, Hill and Chen for axisymmetric modes. It is demonstrated the the generation of the sidebands lifts the usual restriction on the parity of the eigenfunctions for modes detectable in total irradiance observations. 14 refs

  6. Patient Satisfaction Reporting After Total Hip Arthroplasty: A Systematic Review.

    Science.gov (United States)

    Kahlenberg, Cynthia A; Nwachukwu, Benedict U; Schairer, William W; Steinhaus, Michael E; Cross, Michael B

    2017-05-01

    This review evaluated the quality of patient satisfaction reporting after total hip arthroplasty. The initial search of the MEDLINE database yielded 755 studies. Twenty-four met the inclusion criteria. Most studies provided level III or IV evidence (n=15, 62.5%). The most common method used to assess satisfaction was the 10-point visual analog scale (7 studies, 29.2%), followed by an ordinal satisfaction scale (6 studies, 25.0%). The quality of evidence was poor, and the methods used to assess satisfaction were not standardized. Further research is needed to define the factors that affect patient satisfaction after total hip arthroplasty and how satisfaction is best measured. [Orthopedics. 2017; 40(3):e400-e404.]. Copyright 2017, SLACK Incorporated.

  7. Total lymphoid irradiation and total body irradiation for allogeneic bone marrow transplantation in aplastic anemia

    Energy Technology Data Exchange (ETDEWEB)

    Kurisu, Koichi; Hishikawa, Yoshio; Taniguchi, Midori; Kamikonya, Norihiko; Miura, Takashi; Kanamaru, Akihisa; Kakishita, Eizo; Kai, Shunro; Hara, Hiroshi (Hyogo Coll. of Medicine, Nishinomiya (Japan))

    Between April 1980 and June 1989, 15 patients with severe aplastic anemia (SAA) were treated at Hyogo College of Medicine with bone marrow transplantation (BMT) after preparation consisting of cyclophosphamide (CY) and total lymphoid irradiation (TLI) or total body irradiation (TBI) for the purpose of reducing the incidence of graft rejection. All patients had initial evidence of engraftment after the first transplantation except for one patient who died of heart failure due to CY on the third day after transplantation and could not be evaluated for engraftment. Rejection later occurred in four of these 14 patients, who then underwent successful regrafting. One of these four patients, who was conditioned with CY alone at the first grafting, underwent successful regrafting after a conditioning regimen of CY and TBI. In the other three patients, irradiation was performed twice as the conditioning regimen. Thus, 14 of 15 patients underwent successful BMT and are alive with restored hematopoietic function. From the above results, the combination of TLI or TBI and CY was considered to be very useful as a conditioning regimen for BMT in patients with SAA. (author).

  8. Use of antibiotic-loaded cement in total knee arthroplasty.

    OpenAIRE

    Hinarejos Gómez, Pedro Angel; Guirro Castellnou, Pau; Puig Verdié, Luís; Torres Claramunt, Raúl; Leal Blanquet, Joan; Sánchez Soler, JF.; Monllau García, Juan Carlos

    2015-01-01

    Bone cement has the capacity to release antibiotic molecules if any antibiotic is included in it, and these elution properties are improved as cement porosity is increased. In vitro studies have shown high local antibiotic concentration for many hours or few days after its use. Antibiotic loaded bone cement (ALBC) is helpful when treating an infection in total knee arthroplasty (TKA) revision surgery. The purpose of this paper was to review the evidence for the routine use of ALBC in TKA in t...

  9. Evidence and evidence gaps in tinnitus therapy

    Science.gov (United States)

    Hesse, Gerhard

    2016-01-01

    A nearly endless number of procedures has been tried and in particular sold for the treatment of tinnitus, unfortunately they have not been evaluated appropriately in an evidence-based way. A causal therapy, omitting the tinnitus still does not exist, actually it cannot exist because of the various mechanisms of its origin. However or perhaps because of that, medical interventions appear and reappear like fashion trends that can never be proven by stable and reliable treatment success. This contribution will discuss and acknowledge all current therapeutic procedures and the existing or non-existing evidence will be assessed. Beside external evidence, the term of evidence also encompasses the internal evidence, i.e. the experience of the treating physician and the patient’s needs shall be included. While there is no evidence for nearly all direct procedures that intend modulating or stimulating either the cochlea or specific cervical regions such as the auditory cortex, there are therapeutic procedures that are acknowledged in clinical practice and have achieved at least a certain degree of evidence and generate measurable effect sizes. Those are in particular habituation therapy and psychotherapeutic measures, especially if they are combined with concrete measures for improved audio perception (hearing aids, CI, hearing therapies). PMID:28025604

  10. Midflexion instability in primary total knee replacement: a review

    Directory of Open Access Journals (Sweden)

    Ramappa Manjunath

    2015-01-01

    Full Text Available Introduction: Midflexion instability in primary total knee replacement (TKR is an evolving concept. Successful treatment of instability requires an understanding of the different types of instability. Methods: A literature review was performed to identify information pertinent to midflexion instability in primary total knee replacement, utilising PRISMA guidelines. Databases searched included Embase, Medline, All of the Cochrane Library, PubMed and cross references. Results: Three factors, i.e., elevated joint line, multiradii femoral component and medial collateral ligament (MCL laxity, were identified to influence midflexion instability. Literature suggested mediolateral instability at 30–60° of flexion as diagnostic of midflexion instability. Literature search also revealed paucity in clinical studies analysing midflexion instability. Most of the evidence was obtained from cadaveric studies for elevated joint line and MCL laxity. Clinical studies on multiradii femoral component were limited by their small study size and early followup period. Conclusion: Elevated joint line, multiradii femoral component and MCL laxity have been suggested to cause midflexion laxity in primary TKR. Due to limitations in available evidence, this review was unable to raise the strength of overall evidence. Future well-designed clinical studies are essential to make definitive conclusions. This review serves as a baseline for future researchers and creates awareness for routine assessment of midflexion instability in primary total knee replacement.

  11. Global Drought Total Economic Loss Risk Deciles

    Data.gov (United States)

    National Aeronautics and Space Administration — Global Drought Total Economic Loss Risk Deciles is a 2.5 minute grid of global drought total economic loss risks. A process of spatially allocating Gross Domestic...

  12. Chinese National Strategy of Total War

    National Research Council Canada - National Science Library

    Good, Michael J

    2008-01-01

    ... concept of total warfare. This research seeks to determine if China is currently engaged in a total war with the United States across nontraditional forms of conflict including economic, political, information, financial...

  13. Totally optimal decision trees for Boolean functions

    KAUST Repository

    Chikalov, Igor; Hussain, Shahid; Moshkov, Mikhail

    2016-01-01

    We study decision trees which are totally optimal relative to different sets of complexity parameters for Boolean functions. A totally optimal tree is an optimal tree relative to each parameter from the set simultaneously. We consider the parameters

  14. Asymmetric total synthesis of cladosporin and isocladosporin.

    Science.gov (United States)

    Zheng, Huaiji; Zhao, Changgui; Fang, Bowen; Jing, Peng; Yang, Juan; Xie, Xingang; She, Xuegong

    2012-07-06

    The first asymmetric total syntheses of cladosporin and isocladosporin were accomplished in 8 steps with 8% overall yield and 10 steps with 26% overall yield, respectively. The relative configuration of isocladosporin was determined via this total synthesis.

  15. Global Landslide Total Economic Loss Risk Deciles

    Data.gov (United States)

    National Aeronautics and Space Administration — Global Landslide Total Economic Loss Risk Deciles is a 2.5 minute grid of global landslide total economic loss risks. A process of spatially allocating Gross...

  16. Evidence and evidence gaps - an introduction.

    Science.gov (United States)

    Dreier, Gabriele; Löhler, Jan

    2016-01-01

    Background: Medical treatment requires the implementation of existing evidence in the decision making process in order to be able to find the best possible diagnostic, therapeutic or prognostic measure for the individual patient based on the physician's own expertise. Clinical trials form the evidence base and ideally, their results are assembled, analyzed, summarized, and made available in systematic review articles. Beside planning, conducting, and evaluating clinical trials in conformity with GCP (good clinical practice), it is essential that all results of conducted studies are publicly available in order to avoid publication bias. This includes also the public registration of planned and cancelled trials. History: During the last 25 years, evidence-based medicine became increasingly important in medical care and research. It is closely associated with the names of Archibald Cochrane and David Sackett. About 15 years ago, the Deutsche Cochrane Zentrum (Cochrane Germany) and the Deutsche Netzwerk Evidenzbasierte Medizin e.V. (German Network for Evidence-based Medicine, DNEbM) were founded in Germany. In the International Cochrane Collaboration, clinicians and methodologists come together on an interdisciplinary level to further develop methods of evidence-based medicine and to discuss the topics of evidence generation and processing as well as knowledge transfer. Problem: Evidence is particularly important for physicians in the process of decision making, however, at the same time it is the base of a scientific proof of benefit for the patient and finally for the payers in health care. The closure of evidence gaps requires enormously high staff and financial resources, significant organizational efforts, and it is only successful when clinical and methodical expertise as well as specific knowledge in the field of clinical research are included. On the other hand, the knowledge has to be transferred into practice. For this purpose, practice guidelines, meetings

  17. [Evidence and Evidence Gaps - an Introduction].

    Science.gov (United States)

    Dreier, G; Löhler, J

    2016-04-01

    Treating patients requires the inclusion of existing evidence in any health care decision, to be able to choose the best diagnosis or treatment measure or to make valid prognosis statements for a particular patient in consideration of the physician's own expertise.The basis are clinical trials, the results of which are ideally gathered in systematic reviews, rated, summarized and published. In addition to the GCP (Good Clinical Practice)-compliant planning, conducting and analysis of clinical studies it is essential, that all study results are made publicly available, in order to avoid publication bias. This includes the public registration of planned and discontinued trials. In the last 25 years, the evidence-based medicine (EbM) has increasingly found its way into clinical practice and research. Here EbM is closely associated with the names Archibald Cochrane and David Sackett. In Germany, both the German Cochrane Centre (DCZ) and the network of evidence-based medicine (DNEbM) were established approximately 15 years ago. In the international Cochrane Collaboration clinicians and other scientists like statisticians interdisciplinary work side by side to develop the methods of evidence-based medicine and to address the topics of evidence generation and processing as well as the transfer of knowledge. Challenge: Existing evidence primarily serves doctors to support their decision-making, but is also the basis for providing scientific proof for a health care intervention's benefit to patients and ultimately payers/health insurances. The closure of existing evidence gaps requires substantial human and financial resources, a complex organizational structure and can only succeed with the involvement of clinical and methodological expertise and specific knowledge in the field of clinical research. In addition, the knowledge must be transferred into practice, using journals, guidelines, conferences, databases, information portals with processed evidence and not least the

  18. TUW at the First Total Recall Track

    Science.gov (United States)

    2015-11-20

    TUW AT THE FIRST TOTAL RECALL TRACK MIHAI LUPU Abstract. For the first participation in the TREC Total Recall track, we set out to try some basic...significantly and consistently outperformed it. 1. Introduction As the organizers point out, the focus of the Total Recall Track is to evaluate methods to...TUW AT THE FIRST TOTAL RECALL TRACK 3 The only change we made was at a higher level. The Sofia ML library provides 5 more ML algorithms. The following

  19. Phylogeny and systematics of Protodrilidae (Annelida) inferred with total evidence analyses

    DEFF Research Database (Denmark)

    Martinez Garcia, Alejandro; Di Domenico, Maikon; Rouse, Greg W.

    2015-01-01

    Protodrilidae is a group of small, superficially simple-looking annelids, lacking chaetae and appendages, except for two prostomial palps. Originally considered to be one of the primitive "archiannelid" families, its affinity within Annelida is still highly debated. Protodrilids are found worldwi...

  20. Effects of total fat intake on bodyweight in children.

    Science.gov (United States)

    Naude, Celeste E; Visser, Marianne E; Nguyen, Kim A; Durao, Solange; Schoonees, Anel

    2018-02-15

    analyses where data allowed. We included 24 studies comprising three parallel-group RCTs (n = 1054 randomised) and 21 prospective analytical cohort studies (about 25,059 children completed). Twenty-three were conducted in high-income countries. No meta-analyses were possible, since only one RCT reported the same outcome at each time point range for all outcomes, and cohort studies were too heterogeneous.For the RCTs, concerns about imprecision and poor reporting limited our confidence in our findings. In addition, the inclusion of hypercholesteraemic children in two trials raised concerns about applicability. Lower versus usual or modified total fat intake may have made little or no difference to weight over a six- to twelve month period (mean difference (MD) -0.50 kg, 95% confidence interval (CI) -1.78 to 0.78; 1 RCT; n = 620; low-quality evidence), nor a two- to five-year period (MD -0.60 kg, 95% CI -2.39 to 1.19; 1 RCT; n = 612; low-quality evidence). Compared to controls, lower total fat intake (30% or less TE) probably decreased BMI in children over a one- to two-year period (MD -1.5 kg/m 2 , 95% CI -2.45 to -0.55; 1 RCT; n = 191; moderate-quality evidence), with no other differences evident across the other time points (two to five years: MD 0.00 kg/m 2 , 95% CI -0.63 to 0.63; 1 RCT; n = 541; greater than five years; MD -0.10 kg/m 2 , 95% CI -0.75 to 0.55; 1 RCT; n = 576; low-quality evidence). Lower fat intake probably slightly reduced total cholesterol over six to 12 months compared to controls (MD -0.15 mmol/L, 95% CI -0.24 to -0.06; 1 RCT; n = 618; moderate-quality evidence), but may make little or no difference over longer time periods. Lower fat intake probably slightly decreased low-density lipoprotein (LDL) cholesterol over six to 12 months (MD -0.12 mmol/L, 95% CI -0.20 to -0.04; 1 RCT; n = 618, moderate-quality evidence) and over two to five years (MD -0.09, 95% CI -0.17 to -0.01; 1 RCT; n = 623; moderate-quality evidence), compared to controls. However

  1. Defense meteorological satellite measurements of total ozone

    International Nuclear Information System (INIS)

    Lovill, J.E.; Ellis, J.S.; Luther, F.M.; Sullivan, R.J.; Weichel, R.L.

    1992-01-01

    A multichannel filter radiometer (MFR) on Defense Meteorological Satellites (DMS) that measured total ozone on a global-scale from March 1977 - February 1980 is described. The total ozone data measured by the MFR were compared with total ozone data taken by surfaced-based Dobson spectrophotometers. When comparisons were made for five months, the Dobson spectrophotometer measured 2-5% more total ozone than the MFR. Comparisons between the Dobson spectrophotometer and the MFR showed a reduced RMS difference as the comparisons were made at closer proximity. A Northern Hemisphere total ozone distribution obtained from MFR data is presented

  2. Geological evidence of pre-2012 seismic events, Emilia-Romagna, Italy

    Directory of Open Access Journals (Sweden)

    Riccardo Caputo

    2012-10-01

    Full Text Available In May 2012, two moderate (-to-strong earthquakes that were associated with a noticeable aftershock sequence affected the eastern sector of the Po Plain, Italy, in correspondence with a buried portion of the Apennines thrust belt. The Provinces of Ferrara, Modena and Bologna (Emilia Romagna Region, Mantua (Lombardy Region, and Rovigo (Veneto Region were affected to different extents. The first shock (Ml 5.9 according to the Istituto Nazionale di Geofisica e Vulcanologia (INGV; National Institute of Geophysics and Volcanology, and Mw 6.1 according to the US Geological Service occurred on May 20, 2012, at 2:03 a.m. (GMT; this was the strongest of the sequence, and it was followed by several aftershocks (up to Ml 5.1. This first event produced secondary ground deformation effects, which were mainly associated with liquefaction phenomena that were spread across the broader epicentral region, and particularly in the western sector of the Ferrara Province [Papathanassiou et al. 2012, this volume]. A few weeks after the earthquake, a paleoseismological trench was excavated south of San Carlo village, where earthquake-induced effects were widely documented. This report presents the preliminary results of the paleoseismological investigation and documents the occurrence in the same area of paleo-events older than the May 2012 earthquakes. […

  3. Drug companies' evidence to justify advertising.

    Science.gov (United States)

    Wade, V A; Mansfield, P R; McDonald, P J

    1989-11-25

    Ten international pharmaceutical companies were asked by letter to supply their best evidence in support of marketing claims for seventeen products. Fifteen replies were received. Seven replies cited a total of 67 references: 31 contained relevant original data and only 13 were controlled trials, all of which had serious methodological flaws. There were four reports of changes in advertising claims and one company ceased marketing nikethamide in the third world. Standards of evidence used to justify advertising claims are inadequate.

  4. Assessment of conservation easements, total phosphorus, and total suspended solids in West Fork Beaver Creek, Minnesota, 1999-2012

    Science.gov (United States)

    Christensen, Victoria G.; Kieta, Kristen A.

    2014-01-01

    in 2009 were affected by outlier concentrations documented in March 2009. Agricultural land-retirement data only were available through 2008; therefore, it was not possible to compare total phosphorus and total suspended solids concentrations to agricultural land-retirement data for 2009–11. A downward trend in annual flow-weighted mean total-phosphorus concentrations was related significantly to annual land retirement for 1999–2008. The relation between annual flow-weighted mean total suspended solids concentration and annual land retirement was not statistically significant for 1999–2008. If land-retirement data had been available for 2009–11, it is possible that the relation between total phosphorus and land retirement would no longer be evident because of the marked increase in flow-weighted concentrations during 2009. Alternatively, the increase in annual flow-weighted mean total-phosphorus concentrations during 2009–11 may be because of other factors, including industrial discharges, increases in drain tile installation, changes in land use including decreases in agricultural land retirement after 2008, increases in erosion, increases in phosphorus applications to fields, or unknown causes. Inclusion of land-retirement effects in agency planning along with other factors adds perspective with regard to the broader picture of interdependent systems and allows agencies to make informed decisions on the benefits of perpetual easements compared to limited duration easements.

  5. Systematic review: Do patient expectations influence treatment outcomes in total knee and total hip arthroplasty?

    Directory of Open Access Journals (Sweden)

    Haanstra Tsjitske M

    2012-12-01

    Full Text Available Abstract Objective This systematic review aims to summarise all the available evidence related to the association between pre-operative patient expectations (outcome expectations, process expectations and self efficacy expectations and 5 different treatment outcomes (overall improvement, pain, function, stiffness and satisfaction in patients with total knee or total hip arthroplasty at three different follow-op periods (>6 weeks; >6 weeks- ≤6 months; >6 months. Methods English and Dutch language articles were identified through PubMed, EMBASE.com, PsycINFO, CINAHL and The Cochrane Library from inception to September 2012. Articles assessing the association between pre-operative patient expectations and treatment outcomes for TKA/THA in either adjusted or unadjusted analysis were included. Two reviewers, working independently, determined eligibility, rated methodological quality and extracted data on study design, population, expectation measurements, outcome measurements and strength of the associations. Methodological quality was rated by the same reviewers on a 19 item scale. The scores on the quality assessment were taken into account when drawing final conclusions. Results The search strategy generated 2252 unique references, 18 articles met inclusion criteria. Scores on the methodological quality assessment ranged between 6% and 79%. Great variety was seen in definitions and measurement methods of expectations. No significant associations were found between patient expectations and overall improvement, satisfaction and stiffness. Both significant positive and non-significant associations were found for the association between expectations and pain and function. Conclusions There was no consistency in the association between patients’ pre-operative expectations and treatment outcomes for TKA and THA indentified in this systematic review. There exists a need for a sound theoretical framework underlying the construct of

  6. Evidence-based management - healthcare manager viewpoints.

    Science.gov (United States)

    Janati, Ali; Hasanpoor, Edris; Hajebrahimi, Sakineh; Sadeghi-Bazargani, Homayoun

    2018-06-11

    Purpose Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The purpose of this paper is to identify evidence-based management (EBMgt) components and challenges. Consequently, the authors provide an improving evidence-based decision-making framework. Design/methodology/approach A total of 45 semi-structured interviews were conducted in 2016. The authors also established three focus group discussions with health service managers. Data analysis followed deductive qualitative analysis guidelines. Findings Four basic themes emerged from the interviews, including EBMgt evidence sources (including sub-themes: scientific and research evidence, facts and information, political-social development plans, managers' professional expertise and ethical-moral evidence); predictors (sub-themes: stakeholder values and expectations, functional behavior, knowledge, key competencies and skill, evidence sources, evidence levels, uses and benefits and government programs); EBMgt barriers (sub-themes: managers' personal characteristics, decision-making environment, training and research system and organizational issues); and evidence-based hospital management processes (sub-themes: asking, acquiring, appraising, aggregating, applying and assessing). Originality/value Findings suggest that most participants have positive EBMgt attitudes. A full evidence-based hospital manager is a person who uses all evidence sources in a six-step decision-making process. EBMgt frameworks are a good tool to manage healthcare organizations. The authors found factors affecting hospital EBMgt and identified six evidence sources that healthcare managers can use in evidence-based decision-making processes.

  7. Total antioxidant capacity in children with acute appendicitis.

    Science.gov (United States)

    Kaya, M; Boleken, M E; Kanmaz, T; Erel, O; Yucesan, S

    2006-02-01

    This study aimed to investigate antioxidant capacity by using a novel automated method in children with acute appendicitis. Blood samples were obtained from consecutive patients with acute appendicitis (appendicitis group, n = 12) and acute abdominal pain due to non surgical disease (non-appendicitis group, n = 11), and from patients with inguinal hernia (healthy group, n = 12) as the control group. At admission, total antioxidant capacity (TAC) levels of plasma were evaluated in all patients by a method recently developed by Erel. Four other major individual plasma antioxidant components, the levels of total protein, albumin, uric acid and bilirubin, were also evaluated. Total antioxidant capacity in patients with acute appendicitis was statistically compared with the two other groups. While the TAC level in the appendicitis group was significantly greater than in the non-appendicitis group, no significant difference was found in healthy groups (p 0.05, 1.94 +/- 0.38, 1.40 +/- 0.36, and 1.99 +/- 0.35 respectively). Individual components of total antioxidant capacity, i.e. total protein, albumin, uric acid and bilirubin concentrations, were also higher in the patients with acute appendicitis than those of the other two control groups. Our data show that children with acute appendicitis do not have deficient blood plasma antioxidant capacity. These results provide evidence that acute appendicitis results in more induction of antioxidative response than non-surgical diseases.

  8. Evidence for Mental Health Occupational Therapy

    Directory of Open Access Journals (Sweden)

    Danielle Hitch

    2015-09-01

    Full Text Available This article reports on the evidence for mental health occupational therapy in peer-reviewed journals from 2000 to 2013. Descriptive and inductive methods were used to address this question, with evidence from CINAHL, OTDBase, PSYCInfo, SCOPUS, and Google Scholar® included. Many articles (n = 1,747 were found that met the inclusion and exclusion criteria. A total of 47 different methods were used to develop evidence for mental health occupational therapy, and evidence appeared in 300 separate peer-reviewed journals. It takes on average 7 months for an article to progress from submission to acceptance, and a further 7 months to progress from acceptance to publication. More than 95% of articles published between 2000 and 2002 were cited at least once in the following decade, and around 70% of these citations were recorded in non-occupational therapy journals. The current evidence base for mental health occupational therapy is both substantial and diverse.

  9. Total Productive Maintenance at Paccar INC

    Directory of Open Access Journals (Sweden)

    Ştefan Farkas

    2010-06-01

    Full Text Available This paper reports the application of total productive maintenance method at Paccar Inc. truck’s plant in Victoria, Australia. The total productive maintenance method and total productive maintenance house are presented. The global equipment effectiveness is computed and exemplified. The production structure and organising maintenance are presented. Resultas of the variation of global equipment effectiveness and autonomous maintenance in a two weeks period of time are reported.

  10. Total Productive Maintenance at Paccar INC

    OpenAIRE

    Ştefan Farkas

    2010-01-01

    This paper reports the application of total productive maintenance method at Paccar Inc. truck’s plant in Victoria, Australia. The total productive maintenance method and total productive maintenance house are presented. The global equipment effectiveness is computed and exemplified. The production structure and organising maintenance are presented. Resultas of the variation of global equipment effectiveness and autonomous maintenance in a two weeks period of time are reported.

  11. LTDNA evidence on trial

    OpenAIRE

    Roberts, Paul

    2016-01-01

    Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. The section titled Expert Evidence as Forensic Epistemic Warrant addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1) expert competence; (2) discip...

  12. Total pollution effect of urban surface runoff.

    Science.gov (United States)

    Luo, Hongbing; Luo, Lin; Huang, Gu; Liu, Ping; Li, Jingxian; Hu, Sheng; Wang, Fuxiang; Xu, Rui; Huang, Xiaoxue

    2009-01-01

    For pollution research with regard to urban surface runoff, most sampling strategies to date have focused on differences in land usage. With single land-use sampling, total surface runoff pollution effect cannot be evaluated unless every land usage spot is monitored. Through a new sampling strategy known as mixed stormwater sampling for a street community at discharge outlet adjacent to river, this study assessed the total urban surface runoff pollution effect caused by a variety of land uses and the pollutants washed off from the rain pipe system in the Futian River watershed in Shenzhen City of China. The water quality monitoring indices were COD (chemical oxygen demand), TSS (total suspend solid), TP (total phosphorus), TN (total nitrogen) and BOD (biochemical oxygen demand). The sums of total pollution loads discharged into the river for the four indices of COD, TSS, TN, and TP over all seven rainfall events were very different. The mathematical model for simulating total pollution loads was established from discharge outlet mixed stormwater sampling of total pollution loads on the basis of four parameters: rainfall intensity, total land area, impervious land area, and pervious land area. In order to treat surface runoff pollution, the values of MFF30 (mass first flush ratio) and FF30 (first 30% of runoff volume) can be considered as split-flow control criteria to obtain more effective and economical design of structural BMPs (best management practices) facilities.

  13. Operational resource theory of total quantum coherence

    Science.gov (United States)

    Yang, Si-ren; Yu, Chang-shui

    2018-01-01

    Quantum coherence is an essential feature of quantum mechanics and is an important physical resource in quantum information. Recently, the resource theory of quantum coherence has been established parallel with that of entanglement. In the resource theory, a resource can be well defined if given three ingredients: the free states, the resource, the (restricted) free operations. In this paper, we study the resource theory of coherence in a different light, that is, we consider the total coherence defined by the basis-free coherence maximized among all potential basis. We define the distillable total coherence and the total coherence cost and in both the asymptotic regime and the single-copy regime show the reversible transformation between a state with certain total coherence and the state with the unit reference total coherence. Extensively, we demonstrate that the total coherence can also be completely converted to the total correlation with the equal amount by the free operations. We also provide the alternative understanding of the total coherence, respectively, based on the entanglement and the total correlation in a different way.

  14. Total quality management in American industry.

    Science.gov (United States)

    Widtfeldt, A K; Widtfeldt, J R

    1992-07-01

    The definition of total quality management is conformance to customer requirements and specifications, fitness for use, buyer satisfaction, and value at an affordable price. The three individuals who have developed the total quality management concepts in the United States are W.E. Deming, J.M. Juran, and Philip Crosby. The universal principles of total quality management are (a) a customer focus, (b) management commitment, (c) training, (d) process capability and control, and (e) measurement through quality improvement tools. Results from the National Demonstration Project on Quality Improvement in Health Care showed the principles of total quality management could be applied to healthcare.

  15. 38 CFR 3.342 - Permanent and total disability ratings for pension purposes.

    Science.gov (United States)

    2010-07-01

    ... applied with other types of disabilities requiring hospitalization for indefinite periods. The need for... permanency of total disability contained in § 3.340, the following special considerations apply in pension... permanence of total disability will be established as of the earliest date consistent with the evidence in...

  16. A note on totally normal spaces

    International Nuclear Information System (INIS)

    Zougdani, H.K.

    1990-10-01

    In this note we give the necessary and sufficient condition for a topological space X such that the product space X x Y is totally normal for any (non discrete) metric space Y, and we show that a totally normal p-space need not be a perfectly normal in general, which makes Theorem 2 doubtful. (author). 6 refs

  17. Total cardiovascular disease risk assessment: a review.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2011-09-01

    The high risk strategy for the prevention of cardiovascular disease (CVD) requires an assessment of an individual\\'s total CVD risk so that the most intensive risk factor management can be directed towards those at highest risk. Here we review developments in the assessment and estimation of total CVD risk.

  18. Total cross section of highly excited strings

    International Nuclear Information System (INIS)

    Lizzi, F.; Senda, I.

    1990-01-01

    The unpolarized total cross section for the joining of two highly excited strings is calculated. The calculation is performed by taking the average overall states in the given excitation levels of the initial strings. We find that the total cross section grows with the energy and momentum of the initial states. (author). 8 refs, 1 fig

  19. Simultaneous and staged bilateral total hip arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Joergensen, Christoffer Calov; Husted, Henrik

    2013-01-01

    Bilateral total hip arthroplasty (BTHA) and bilateral simultaneous total hip arthroplasty (BSTHA) are done increasingly. Previous studies evaluating outcomes after bilateral procedures have found different results. The aim of this study was to investigate length of hospital stay (LOS), 30 days...

  20. Total internal reflection effect on gyrotropic interface

    Science.gov (United States)

    Glushchenko, Alexander G.; Glushchenko, Eugene P.; Zhukov, Sergey V.

    2018-02-01

    This article considers the physical features of total internal reflection at gyrotropic and isotropic interfaces for two cases: electrical gyrotropy (plasma) and magnetic gyrotropy (ferrite). It is shown that the plasma magnetization may lead to the formation of the total internal reflection effect, which does not occur in isotropic plasma. The threshold values of the magnetic field, which are necessary for the total internal reflection effect, are determined. The total internal reflection effect on a ferrite-dielectric interface for waves emanating from different angles is observed in various frequency ranges and magnetization fields. The study points out the possibility of changing the total internal reflection angle value in large limits due to a change in the external magnetic field magnitude. The calculation results of the total internal reflection angle dependence on the external magnetic field magnitude are presented. The formulas are elaborated for calculating the total internal reflection angles of different interfaces for gyrotropic and isotropic media. The generalized formulas are defined for calculating the Doppler effect in the gyrotropic media. The study demonstrates how the velocity of the media interface affects the limiting angle of total internal refection.

  1. Records Management in Organization and Total Quality

    Directory of Open Access Journals (Sweden)

    Fahrettin Özdemirci

    1999-06-01

    Full Text Available In this article the relationship between total quality management and records managemen t are examined. It has also been indicated that the records mana­gement has vita'ly important part for realizing the total quality management approach.

  2. Vibrational enhancement of total breakup cross sections

    International Nuclear Information System (INIS)

    Haftel, M.I.; Lim, T.K.

    1984-01-01

    This paper considers the role of multi-two-body bound states, namely vibrational excitations, on total three-body breakup cross-sections. Total cross-sections are usually easy to measure, and they play a fundamental role in chemical kinetics. (orig.)

  3. A Total Factor Productivity Toolbox for MATLAB

    NARCIS (Netherlands)

    B.M. Balk (Bert); J. Barbero (Javier); J.L. Zofío (José)

    2018-01-01

    textabstractTotal Factor Productivity Toolbox is a new package for MATLAB that includes functions to calculate the main Total Factor Productivity (TFP) indices and their decompositions, based on Shephard’s distance functions and using Data Envelopment Analysis (DEA) programming techniques. The

  4. Timing the total reflection of light

    International Nuclear Information System (INIS)

    Chauvat, Dominique; Bonnet, Christophe; Dunseath, Kevin; Emile, Olivier; Le Floch, Albert

    2005-01-01

    We have identified for the first time the absolute delay at total reflection, envisioned by Newton. We show that there are in fact two divergent Wigner delays, depending on the polarisation of the incident light. These measurements give a new insight on the passage from total reflection to refraction

  5. Sexuality after total vs. subtotal hysterectomy

    DEFF Research Database (Denmark)

    Zobbe, Vibeke Bahn; Gimbel, Helga Margrethe Elisabeth; Andersen, Birthe Margrethe

    2004-01-01

    The effect of hysterectomy on sexuality is not fully elucidated and until recently total and subtotal hysterectomies have only been compared in observational studies.......The effect of hysterectomy on sexuality is not fully elucidated and until recently total and subtotal hysterectomies have only been compared in observational studies....

  6. The total energy policy in Flanders

    International Nuclear Information System (INIS)

    Bouma, J.W.J.

    1994-01-01

    The policy of the Flemish region (Belgium) with regard to the total energy principle are presented. An overview of the main policy instruments to support energy saving and environmental-friendly investments as well as the development of new technologies is given. The total energy policy of the Flanders Region forms part of the general Flemish (energy) policy. (A.S.)

  7. Airway Complications of Total Artificial Heart.

    Science.gov (United States)

    Pathak, Vikas; Donovan, Colin; Malhotra, Rajiv

    2017-02-01

    The total artificial heart is the mechanical device which is used as a bridge to the heart transplant in patients with biventricular failure. Due to the mechanical nature of the device, patients receiving total artificial heart (TAH) require to be on anticoagulation therapy. Hemorrhage and coagulopathy are few of the known complications of TAH.

  8. Total Quality Management in Education. Second Edition.

    Science.gov (United States)

    Sallis, Edward

    Quality is at the top of most agendas, and improving quality is probably the most important task facing any institution. In addition, quality is difficult to define or measure. This book, the second edition of "Total Quality Management in Education," introduces the key concepts of Total Quality Management (TQM) and demonstrates how they…

  9. The Total Quality Movement in Education.

    Science.gov (United States)

    Leuenberger, John A.; Whitaker, Sheldon V., Jr.

    The total quality movement began as a result of the desire of W. Edwards Deming, an American statistician, to permit the economic system to maintain its edge in a growing global market. The 14 points Deming listed as essential to "total quality management" have recently been adapted to the field of education. The success of the total…

  10. Creating the Total Quality Effective School.

    Science.gov (United States)

    Lezotte, Lawrence W.

    This book shows how Deming's Total Quality Management (TQM) theory for organizational management can be integrated with the effective-schools literature. Part 1 compares the 14 principles of TQM with the tenets of effective-schools research. The second part develops a blueprint for creating the total quality effective school. The conceptual…

  11. Analysis of a retrieved delta III total shoulder prosthesis.

    Science.gov (United States)

    Nyffeler, R W; Werner, C M L; Simmen, B R; Gerber, C

    2004-11-01

    A reversed Delta III total shoulder prosthesis was retrieved post-mortem, eight months after implantation. A significant notch was evident at the inferior pole of the scapular neck which extended beyond the inferior fixation screw. This bone loss was associated with a corresponding, erosive defect of the polyethylene cup. Histological examination revealed a chronic foreign-body reaction in the joint capsule. There were, however, no histological signs of loosening of the glenoid base plate and the stability of the prosthetic articulation was only slightly reduced by the eroded rim of the cup.

  12. Trabecular metal acetabular components in primary total hip arthroplasty

    DEFF Research Database (Denmark)

    Laaksonen, Inari; Lorimer, Michelle; Gromov, Kirill

    2018-01-01

    Background and purpose - Trabecular metal (TM) cups have demonstrated favorable results in acetabular revision and their use in primary total hip arthroplasty (THA) is increasing. Some evidence show that TM cups might decrease periprosthetic infection (PPI) incidence. We compared the survivorship...... of TM cups with that of other uncemented cups in primary THA, and evaluated whether the use of TM cups is associated with a lower risk of PPI. Patients and methods - 10,113 primary THAs with TM cup and 85,596 THAs with other uncemented cups from 2 high-quality national arthroplasty registries were...

  13. Totally optimal decision trees for Boolean functions

    KAUST Repository

    Chikalov, Igor

    2016-07-28

    We study decision trees which are totally optimal relative to different sets of complexity parameters for Boolean functions. A totally optimal tree is an optimal tree relative to each parameter from the set simultaneously. We consider the parameters characterizing both time (in the worst- and average-case) and space complexity of decision trees, i.e., depth, total path length (average depth), and number of nodes. We have created tools based on extensions of dynamic programming to study totally optimal trees. These tools are applicable to both exact and approximate decision trees, and allow us to make multi-stage optimization of decision trees relative to different parameters and to count the number of optimal trees. Based on the experimental results we have formulated the following hypotheses (and subsequently proved): for almost all Boolean functions there exist totally optimal decision trees (i) relative to the depth and number of nodes, and (ii) relative to the depth and average depth.

  14. What is Evidence? (editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2011-06-01

    Full Text Available Lately, I have been pondering what we really mean when we say “evidence based practice”? In LIS, we all know the definitions that have been proposed (Booth 2000, Eldredge 2000, Crumley and Koufogiannakis 2002, and which have not ever really been challenged. But have we ever said explicitly what qualifies as evidence in this model? The underlying assumption seems to be that evidence is research, hence, we are really talking about research-based practice, but we don’t actually use that term.Higgs and Jones (2000 note that evidence is “knowledge derived from a variety of sources that has been subjected to testing and has found to be credible.” The Oxford English Dictionary states that evidence is “something serving as a proof” (OED, 2011. Neither of these definitions of evidence notes that evidence equals research; research is only one form of evidence. It certainly isn’t the only form of evidence – so what, then, constitutes evidence?Rycroff-Malone et al. (2004 state that that in order for evidence based practice to create a broader evidence base in nursing, “the external, scientific and the internal, intuitive” need to be brought together. The external, scientific is what evidence based practice has been focused on, in the form of scientific research, but Rycroff-Malone et al. note that other elements such as clinical experience, patient experience, and information from the local context also need to be considered.In library and information practice, what are the other forms of evidence we need to consider? I propose that while research evidence is of high importance to our profession and knowledge, LIS practitioners need to first of all consider local evidence. Local evidence is found in our working environment and specific to the context in which we carry out our work. It includes such things as our experiences with patrons in particular contexts, and what we observe to work in such situations, assessment of programs

  15. Principles of Antibiotic Prophylaxis in Total Joint Arthroplasty: Current Concepts.

    Science.gov (United States)

    Bosco, Joseph A; Bookman, Jared; Slover, James; Edusei, Emmanuel; Levine, Brett

    2015-08-01

    Infection is a rare, serious complication following total joint arthroplasty and constitutes a considerable emotional and financial burden for patients, surgeons, and healthcare systems. Prevention of surgical site and periprosthetic joint infections is crucial. This requires knowledge of the microorganisms that commonly cause these infections, including Staphylococcus species. Selection of the appropriate antibiotic regimen to treat infection remains controversial, but cefazolin and cefuroxime are the most commonly recommended antibiotics for prophylaxis. Appropriate timing of administration before surgery, with redosing performed as needed, can help to ensure optimal antibiotic concentration during surgery. Given the increasing evidence that S aureus colonization is a risk factor for periprosthetic joint infection, an exploration of the potential benefits of preoperative S aureus carrier screening and decolonization protocols is warranted. The use of antibiotic-loaded bone cement in primary total joint arthroplasty and antibiotic powder at wound closure are other controversial topics that require additional research. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

  16. Hermeneutics, evidence ad judgment

    Directory of Open Access Journals (Sweden)

    Michele Taruffo

    2018-03-01

    Full Text Available The text analyzes several topics of the judicial process from the point of view of the important contributions offered by the hermeneutical philosophy. It deals mainly with the construction of factual narratives, the presentation of evidence and the discovery of truth made by the judge in his final judgment based upon the evidence.

  17. The Evidence Movement

    DEFF Research Database (Denmark)

    Hansen, Hanne Foss; Rieper, Olaf

    2009-01-01

    The evidence movement and the idea of systematic reviews, defined as summaries of the results of already existing evaluation and research projects, have gained considerable support in recent years as many international as well as national evidence-producing organizations have been established...

  18. Teaching with Evidence

    Science.gov (United States)

    Crocco, Margaret; Halvorsen, Anne-Lise; Jacobsen, Rebecca; Segall, Avner

    2017-01-01

    In this age of real and fake news, students need to be able to assess the trustworthiness of evidence. The authors' current research examines students' use of evidence in secondary social studies classrooms as students deliberate contemporary public policy issues. The authors found that students shifted their evaluations of the trustworthiness of…

  19. Observational Evidence for Atoms.

    Science.gov (United States)

    Jones, Edwin R., Jr.; Childers, Richard L.

    1984-01-01

    Discusses the development of the concept of atomicity and some of the many which can be used to establish its validity. Chemical evidence, evidence from crystals, Faraday's law of electrolysis, and Avogadro's number are among the areas which show how the concept originally developed from a purely philosophical idea. (JN)

  20. Evidence-based radiography

    International Nuclear Information System (INIS)

    Hafslund, Bjorg; Clare, Judith; Graverholt, Birgitte; Wammen Nortvedt, Monica

    2008-01-01

    Evidence-based practice (EBP) offers the integration of the best research evidence with clinical knowledge and expertise and patient values. EBP is a well known term in health care. This paper discusses the implementation of EBP into radiography and introduces the term evidence-based radiography. Evidence-based radiography is radiography informed and based on the combination of clinical expertise and the best available research-based evidence, patient preferences and resources available. In Norway, EBP in radiography is being debated and radiographers are discussing the challenges of implementing EBP in both academic and clinical practice. This discussion paper explains why EBP needs to be a basis for a radiography curriculum and a part of radiographers' practice. We argue that Norwegian radiographers must increase participation in research and developing practice within their specific radiographic domain

  1. Does total hip replacement affect sexual quality of life?

    Science.gov (United States)

    Harmsen, Rita Th E; Haanstra, Tsjitske M; Sierevelt, Inger N; Jansma, Elise P; Nolte, Peter A; Nicolai, Melianthe P J; Wall, Peter D H; Van Royen, Barend J

    2016-05-04

    Total Hip Replacement (THR) is an effective treatment for end-stage hip osteoarthritis. Since the introduction of total joint replacement, the effect on the Sexual Quality of Life (SQoL) following THR has been addressed in scant studies. The aim of our study was to systematically review the literature, to summarise effects of THR on patients' SQoL. We searched PubMed, EMBASE and PsycINFO between January 1970 and February 9th, 2015 with search terms including Total Hip, Osteoarthritis, SQoL, and THR. Eligible studies were identified and two independent authors extracted data including details of SQoL, study quality and risk of bias. There were 12 eligible studies, which included a total of 2099 patients with an age range of 20-85 years. The methodological quality of ten studies was rated as low, and of two as moderate. Amongst the majority of patients, SQoL improved after surgery, both in terms of physical-functional and psychosocial well-being. However, changes between pre-operative and postoperative SQoL ranged extensively: for example, Sexual Dysfunction Δ 8-51% and Sexual Activity (SA) Δ 0-77%. Three studies reported that some patients never resumed SA again after surgery. In over 40 years of THR treatment, scant studies have examined the effect of THR on patients' SQoL. This review suggests that SQol improves after THR, although the magnitude of effects varies highly. However, the quality of the supporting evidence was rated as low to moderate. This suggests a need for more high quality evidence about the effects of THR on SQoL.

  2. Rehabilitation after total joint replacement: a scoping study.

    Science.gov (United States)

    L Snell, Deborah; Hipango, Julia; Sinnott, K Anne; Dunn, Jennifer A; Rothwell, Alastair; Hsieh, C Jean; DeJong, Gerben; Hooper, Gary

    2018-07-01

    The evidence supporting rehabilitation after joint replacement, while vast, is of variable quality making it difficult for clinicians to apply the best evidence to their practice. We aimed to map key issues for rehabilitation following joint replacement, highlighting potential avenues for new research. We conducted a scoping study including research published between January 2013 and December 2016, evaluating effectiveness of rehabilitation following hip and knee total joint replacement. We reviewed this work in the context of outcomes described from previously published research. Thirty individual studies and seven systematic reviews were included, with most research examining the effectiveness of physiotherapy-based exercise rehabilitation after total knee replacement using randomized control trial methods. Rehabilitation after hip and knee replacement whether carried out at the clinic or monitored at home, appears beneficial but type, intensity and duration of interventions were not consistently associated with outcomes. The burden of comorbidities rather than specific rehabilitation approach may better predict rehabilitation outcome. Monitoring of recovery and therapeutic attention appear important but little is known about optimal levels and methods required to maximize outcomes. More work exploring the role of comorbidities and key components of therapeutic attention and the therapy relationship, using a wider range of study methods may help to advance the field. Implications for Rehabilitation Physiotherapy-based exercise rehabilitation after total hip replacement and total knee replacement, whether carried out at the clinic or monitored at home, appears beneficial. Type, intensity, and duration of interventions do not appear consistently associated with outcomes. Monitoring a patient's recovery appears to be an important component. The available research provides limited guidance regarding optimal levels of monitoring needed to achieve gains following hip

  3. Total elbow arthroplasty for the treatment of distal humeral fractures.

    Science.gov (United States)

    Gallucci, G L; Larrondo Calderón, W; Boretto, J G; Castellaro Lantermo, J A; Terán, J; de Carli, P

    2016-01-01

    To report the clinical-functional outcomes of the treatment of humeral distal fractures with a total elbow prosthesis. This retrospective study was performed in two surgical centres. A total of 23patients were included, with a mean age of 79years, and of which 21 were women. The inclusion criteria were: patients with humeral distal fractures, operated on using a Coonrad-Morrey prosthesis, and with a follow-up of more than one year. According to AO classification, 15fractures were type C3, 7 C2 and 1 A2. All patients were operated on without de-insertion of the extensor mechanism. The mean follow-up was 40 months. Flexor-extension was 123-17°, with a total mobility arc of 106° (80% of the contralateral side). Pain, according to a visual analogue scale was 1. The Mayo Elbow Performance Index (MEPI) was 83 points. Excellent results were obtained in 8 patients, good in 13, medium in 1, and poor in 1. The mean DASH (disability) score was 24 points. Treatment of humeral distal fractures with total elbow arthroplasty could be a good treatment option, but indications must be limited to patients with complex fractures, poor bone quality, with osteoporosis and low functional demands. In younger patients, the use is limited to serious cases where there is no other treatment option. Level of Evidence IV. Copyright © 2016 SECOT. Published by Elsevier Espana. All rights reserved.

  4. Assessments of Total Lightning Data Utility in Weather Forecasting

    Science.gov (United States)

    Buechler, Dennis E.; Goodman, Steve; LaCasse, Katherine; Blakeslee, Richard; Darden, Chris

    2005-01-01

    National Weather Service forecasters in Huntsville, Alabama have had access to total lightning data from the North Alabama Lightning Mapping Array (LMA) since 2003. Forecasters can monitor real-time total lightning observations on their AWIPS (Advanced Weather Interactive Processing System (AWIPS) workstations. The lightning data is used to supplement other observations such as radar and satellite data. The lightning data is updated every 2 min, providing more timely evidence of storm growth or decay than is available from 5 min radar scans. Total lightning observations have been used to positively impact warning decisions in a number of instances. A number of approaches are being pursued to assess the usefulness of total lightning measurements to the operational forecasting community in the warning decision process. These approaches, which include both qualitative and quantitative assessment methods, will be discussed. submitted to the American Meteorological Society (AMS) Conference on Meteorological Applications of Lightning Data to be held in San Diego, CA January 9-13,2005. This will be a presentation and an extended abstract will be published on a CD available from the AMS.

  5. Total's LNG activities from Algeria to Yemen

    International Nuclear Information System (INIS)

    Vedrenne, J.P.

    1997-01-01

    In March 1995, further to an international tender, Total was awarded the leadership of the first LNG project in Yemen. On January 1997 Total announced the extension of the share-holding of the Yemen LNG Co. to include the companies with interests in the Marib area (Hunt-Exxon-Yukong). The Marib area will supply the gas to the future liquefaction plant. The ratification of these agreements confirms the role of Total as lead shareholder with 36% in the share-holding structure and guarantees gas supply from the Marib licence, operated by Hunt-Exxon. (author)

  6. Total dominator chromatic number of a graph

    Directory of Open Access Journals (Sweden)

    Adel P. Kazemi

    2015-06-01

    Full Text Available Given a graph $G$, the total dominator coloring problem seeks a proper coloring of $G$ with the additional property that every vertex in the graph is adjacent to all vertices of a color class. We seek to minimize the number of color classes. We initiate to study this problem on several classes of graphs, as well as finding general bounds and characterizations. We also compare the total dominator chromatic number of a graph with the chromatic number and the total domination number of it.

  7. Total neutron cross section of lead

    International Nuclear Information System (INIS)

    Kanda, K.; Aizawa, O.

    1976-01-01

    The total thermal-neutron cross section of natural lead under various physical conditions was measured by the transmission method. It became clear that the total cross section at room temperature previously reported is lower than the present data. The total cross section at 400, 500, and 600 0 C, above the melting point of lead, 327 0 C, was also measured, and the changes in the cross section as a function of temperature were examined, especially near and below the melting point. The data obtained for the randomly oriented polycrystalline state at room temperature were in reasonable agreement with the theoretical values calculated by the THRUSH and UNCLE-TOM codes

  8. Outcomes of an anatomic total shoulder arthroplasty with a contralateral reverse total shoulder arthroplasty.

    Science.gov (United States)

    Cox, Ryan M; Padegimas, Eric M; Abboud, Joseph A; Getz, Charles L; Lazarus, Mark D; Ramsey, Matthew L; Williams, Gerald R; Horneff, John G

    2018-06-01

    It is common for patients to require staged bilateral shoulder arthroplasties. There is a unique cohort of patients who require an anatomic total shoulder arthroplasty (TSA) and a contralateral reverse shoulder arthroplasty (RSA). This study compared the outcomes of patients with a TSA in 1 shoulder and an RSA in the contralateral shoulder. Our institutional database was queried to identify all patients with a TSA and a contralateral RSA. Data collection included patient demographics, preoperative and latest follow-up shoulder range of motion, radiographic analysis, and postoperative complications. Identified patients were assessed at follow-up visits or contacted by phone for functional outcome scores. Nineteen patients met our inclusion/exclusion criteria. There was statistically significant greater internal rotation in the TSA shoulder (P= .044) but no significant difference in forward elevation (P = .573) or external rotation (P= .368). There was no radiographic evidence of humeral or glenoid component loosening of any arthroplasty implants. There were no significant differences between TSA and RSA shoulders for the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment (P= .381), Simple Shoulder Test (P = .352), Single Assessment Numerical Evaluation (P = .709), and visual analog scale satisfaction (P= .448) or pain scores (P= .305). Thirteen patients (68.4%) preferred the RSA side, 1 patient (5.3%; z = 4.04, P < .001) patient preferred the TSA side, and 5 patients expressed no preference. Despite known limitations and differences between TSA and RSA designs, patients who have received both implants are highly satisfied with both. The only parameter in which the TSA had superior outcomes was internal rotation. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  9. The total plasmatic estriol on normal gestation

    International Nuclear Information System (INIS)

    Thiesen, A.L.

    1980-01-01

    The total plasmatic estriol in normal pregnants was determinated by radioimmunological method using estriol labelled with sup(125)I. The obtained results presented similar results in comparison with methods using sup(19)C and sup(3)H. (author)

  10. TOTAL REWARDS MODEL IN ROMANIAN COMPANIES

    Directory of Open Access Journals (Sweden)

    Elena-Sabina HODOR

    2014-04-01

    Full Text Available Total Rewards Management is a subject of major importance for companies, because, by using models for this, firms can achieve their objectives of high performance. In order to analyse a validated total rewards model in Romanian Accounting and Consulting Companies, it is used The WorldatWork Total Rewards Model, which depict what contributes to applicant attraction and employee motivation and retention. Thus, the methodology of the previous survey is adjusted to the local context. The conclusions for the methodological aspects illustrate that the present research involves three strategic steps in order to achieve the objectives presented: the analysis of organizational environment of the companies from the sample, checking if Total Rewards Model proposed in the previous research is applicable for the same romanian companies from the previous survey, the analysing of the differences between results, and, if necessary, the adaptation of the model for Romania.

  11. Pulmonary nodules secondary to total parenteral alimentation

    International Nuclear Information System (INIS)

    Landry, B.A.; Melhem, R.E.

    1989-01-01

    A seven-year-old male, who had a retroperitoneal alveolar rhabdomyosarcoma and was on total parenteral alimentation (TPN) developed muliple pulmonary nodules, indistinguishable from metastases. These proved to be multiple lipid emboli on open biopsy. (orig.)

  12. Definition of total bootstrap current in tokamaks

    International Nuclear Information System (INIS)

    Ross, D.W.

    1995-01-01

    Alternative definitions of the total bootstrap current are compared. An analogous comparison is given for the ohmic and auxiliary currents. It is argued that different definitions than those usually employed lead to simpler analyses of tokamak operating scenarios

  13. The First Total Synthesis of Isoliquiritin

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    A first total synthesis of isoliquiritin was accomplished starting from p-hydroxy- benzaldehyde and 2,4-dihydroxyacetylphenone. The key step is condensation reaction. In synthetic process need not protect the hydroxy group of reacting substance.

  14. Can You Depend Totally on Computers?

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 3; Issue 2. Can You Depend Totally on Computers? Computer Security, Availability and Correctness. H N Mahabala. General Article Volume 3 Issue 2 February 1998 pp 35-44 ...

  15. NESDIS Blended Total Precipitable Water (TPW) Products

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The blended Total Precipitable Water (TPW) product is derived from multiple sensors/satellites. The Percentage of TPW normal (PCT), or TPW anomaly, shows the...

  16. Establishing a total information management program

    International Nuclear Information System (INIS)

    Hegstrom, K.L.; Fisher, J.

    1982-01-01

    A total information management program manages documents for easy access and identifies data elements commonly found in all documents. The program thus links disparate documents by identifying information they share in common

  17. Safety Precautions for Total Release Foggers

    Science.gov (United States)

    Total release foggers, also known as bug bombs, are pesticide products containing aerosol propellants that release their contents at once to fumigate an area. They can pose a hazard if used incorrectly. Find safety information and videos on this page.

  18. Medicaid Financial Management Data – National Totals

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset reports summary state-by-state total expenditures by program for the Medicaid Program, Medicaid Administration and CHIP programs. These state...

  19. The 1995 total solar eclipse: an overview.

    Science.gov (United States)

    Singh, J.

    A number of experiments were conducted during the total solar eclipse of October 24, 1995. First time efforts were made to photograph the solar corona using IAF jet aircrafts and transport planes ad hot air balloons.

  20. US-Total Electron Content Product (USTEC)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The US Total Electron Content (US-TEC) product is designed to specify TEC over the Continental US (CONUS) in near real-time. The product uses a Kalman Filter data...

  1. Total Analysis System for Ship Structural Strength

    OpenAIRE

    Takuya, Yoneya; Hiroyuki, Kobayashi; Abdul M., Rahim; Yoshimichi, Sasaki; Masaki, Irisawa; Technical Investigation and Information Department, Research Center; Technical Investigation and Information Department, Research Center; Singapore Office; Technical Investigation and Information Department, Research Center; Technical Investigation and Information Department, Research Center

    2001-01-01

    This paper outlines a total analysis system for ship hull structures, which integrates a wide variety of analysis functions to realise practical applications of rational methods for assessing ship structural strength. It is based on direct calculation of wave-induced loads as well as three-dimensional structural analysis of an entire-ship or hold structure. Three major analysis functions of the total system are ship motion and wave load analysis, ship structural analysis and statistical analy...

  2. Total Quality Service and the Business College

    OpenAIRE

    James Perotti

    1995-01-01

    Moving a business college to commit to a total quality service approach is much more difficult than the literature suggests. The commitment to customer satisfaction is the essential focus of total quality service. It is unlikely to occur in business colleges. While small incremental change is readily possible, the values and culture of the faculty and administration prevent the requisite acceptance by the faculty of students as their customers, and acceptance of the faculty as customers of th...

  3. A strategic zone for Total's future

    International Nuclear Information System (INIS)

    Legros, E.J.

    1997-01-01

    In 1997, the Total company investments in the Middle East reached 1.2 billions of French Francs. This region is considered as a major growth zone by the French group. This paper summarizes the Total's participations in oil and gas activities and partnerships of Middle East countries (Abu Dhabi, Dubai, Oman, Qatar, Yemen): exploration, production, development, contracts, permits, technical assistance etc.. (J.S.)

  4. Studies towards a total synthesis of tagetitoxin

    OpenAIRE

    Mahoney, Brian

    2017-01-01

    Tagetitoxin was first isolated over thirty five years ago and a total synthesis has not been achieved to date. A vast amount of research has been carried out on the biological activity of tagetitoxin with hundreds of literature reports. However, very few papers have been published regarding the synthesis and within this thesis we will explore a number of synthetic pathways some towards tagetitoxin. The first chapter reviews previous developments regarding the total synthesis of...

  5. Expressions for the Total Yaw Angle

    Science.gov (United States)

    2016-09-01

    1. Introduction 1 2. Mathematical Notation 1 3. Total Yaw Expression Derivations 2 3.1 First Derivation 2 3.2 Second Derivation 4 3.3 Other...4 iv Approved for public release; distribution is unlimited. 1. Introduction The total yaw angle, γt , of a ballistic projectile is... elevation angles from spherical coordinates.∗ We again place point A at the end point of V. Now imagine a plane parallel to the y-z plane that includes

  6. Total energy system in the future

    International Nuclear Information System (INIS)

    Hijikata, K.

    1994-01-01

    The possibility of improving the thermal efficiency of energy systems from an exergy point of view is discussed. In total energy systems, we should employ multi-pass recycling consisting of thermal and chemical energies. The recycling system is supported by electrical energy, which is provided by a renewable energy source or by excess commercial electric power. This total energy system should be considered not only in one country, but all around the globe. (author). 6 figs., 4 tabs., 8 refs

  7. Evidence: Study Guide. Revision

    National Research Council Canada - National Science Library

    1997-01-01

    ...) correct application of principles of military rules of evidence. This study guide is also intended to be a convenient reference for use by Navy and Marine Corps judge advocates and Coast Guard law...

  8. Enriquillo–Plantain Garden fault zone in Jamaica: paleoseismology and seismic hazard

    Science.gov (United States)

    Koehler, R.D.; Mann, P.; Prentice, Carol S.; Brown, L.; Benford, B.; Grandison-Wiggins, M.

    2013-01-01

    The countries of Jamaica, Haiti, and the Dominican Republic all straddle the Enriquillo–Plantain Garden fault zone ( EPGFZ), a major left-lateral, strike-slip fault system bounding the Caribbean and North American plates. Past large earthquakes that destroyed the capital cities of Kingston, Jamaica (1692, 1907), and Port-au-Prince, Haiti (1751, 1770), as well as the 2010 Haiti earthquake that killed more than 50,000 people, have heightened awareness of seismic hazards in the northern Caribbean. We present here new geomorphic and paleoseismic information bearing on the location and relative activity of the EPGFZ, which marks the plate boundary in Jamaica. Documentation of a river bank exposure and several trenches indicate that this fault is active and has the potential to cause major destructive earthquakes in Jamaica. The results suggest that the fault has not ruptured the surface in at least 500 yr and possibly as long as 28 ka. The long period of quiescence and subdued geomorphic expression of the EPGFZ indicates that it may only accommodate part of the ∼7–9 mm=yr plate deformation rate measured geodetically and that slip may be partitioned on other undocumented faults. Large uncertainties related to the neotectonic framework of Jamaica remain and more detailed fault characterization studies are necessary to accurately assess seismic hazards.

  9. Structure of the Mina Deflection in Mono Lake, CA: Inferences from Paleoseismology

    Science.gov (United States)

    Sangani, Radhika Chandrakant

    Walker Lane, a zone of transcurrent faulting along the Sierran range front, is dominated by NNW trending normal faults. Within the Walker Lane, the Mina Deflection is a region of structural anomaly, where a significant component of regional displacement and seismicity is transferred from NNW-trending faults to ENE-trending faults of the Excelsior-Coledale domain. Geographically, the western boundary of the Mina Deflection lies along the western margin of Mono Basin. This is kinematically implied by the distributed tensional and shear stress in the NNW- and ENE- trending faults of the region. Transfer of strain from the NNW-trending, right-lateral oblique slip faults to the ENE-trending, primarily left-lateral faults is poorly understood. The nature of this transfer is complicated by the presence of the young volcanics of Mono Lake at the stepover bend. I undertook detailed study of the sub-km scale geometry and kinematics of the stepover bend, and its relation to nearby recent magmatic fluid flow within the Mono Lake. Fault orientations, slip rates and ages of most recent events allow for understanding strain transfer between faulting and volcanism. The results suggest that strain is transferred from the outer arc to the inner arc of the stepover bend. Within the inner arc, the magmatism on Paoha Island seems to have arisen from a sill-like intrusion. Furthermore, strain transfer is accomplished through sets of faults and fissures that variously act as large-scale Reidel shears and tension gashes allowing the migration of magmatic fluids from depth.

  10. Does paleoseismology forecast the historic rates of large earthquakes on the San Andreas fault system?

    Science.gov (United States)

    Biasi, Glenn; Scharer, Katherine M.; Weldon, Ray; Dawson, Timothy E.

    2016-01-01

    The 98-year open interval since the most recent ground-rupturing earthquake in the greater San Andreas boundary fault system would not be predicted by the quasi-periodic recurrence statistics from paleoseismic data. We examine whether the current hiatus could be explained by uncertainties in earthquake dating. Using seven independent paleoseismic records, 100 year intervals may have occurred circa 1150, 1400, and 1700 AD, but they occur in a third or less of sample records drawn at random. A second method sampling from dates conditioned on the existence of a gap of varying length suggests century-long gaps occur 3-10% of the time. A combined record with more sites would lead to lower probabilities. Systematic data over-interpretation is considered an unlikely explanation. Instead some form of non-stationary behaviour seems required, perhaps through long-range fault interaction. Earthquake occurrence since 1000 AD is not inconsistent with long-term cyclicity suggested from long runs of earthquake simulators.

  11. LTDNA Evidence on Trial

    OpenAIRE

    Paul Roberts; Paul Roberts; Paul Roberts

    2016-01-01

    Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. Section 1 addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1) expert competence; (2) disciplinary domain; (3) methodological validity; (4) materia...

  12. Cataract incidence after total-body irradiation

    International Nuclear Information System (INIS)

    Zierhut, D.; Lohr, F.; Schraube, P.; Huber, P.; Haas, R.; Hunstein, W.; Wannenmacher, M.

    1997-01-01

    Purpose: Aim of this retrospective study was to evaluate cataract incidence in a homogeneous group of patients after total-body irradiation followed by autologous bone marrow transplantation or peripheral blood stem cell transplantation. Method and Materials: Between 11/1982 and 6/1994 in total 260 patients received in our hospital total-body irradiation for treatment of haematological malignancy. In 1996-96 patients out of these 260 patients were still alive. 85 from these still living patients (52 men, 33 women) answered evaluable on a questionnaire and could be examined ophthalmologically. Median age of these patients was 38,5 years (15 - 59 years) at time of total-body irradiation. Radiotherapy was applied as hyperfractionated total-body irradiation with a median dose of 14,4 Gy in 12 fractions over 4 days. Minimum time between fractions was 4 hours, photons with a energy of 23 MeV were used, and the dose rate was 7 - 18 cGy/min. Results: Median follow-up is now 5,8 years (1,7 - 13 years). Cataract occurred in (28(85)) patients after a median time of 47 months (1 - 104 months). In 6 out of these 28 patients who developed a cataract, surgery of the cataract was performed. Whole-brain irradiation prior to total-body irradiation was more often in the group of patients developing a cataract (14,3%) vs. 10,7% in the group of patients without cataract. Conclusion: Cataract is a common side effect of total-body irradiation. Cataract incidence found in our patients is comparable to results of other centres using a fractionated regimen for total-body irradiation. The hyperfractionated regimen used in our hospital does obviously not result in a even lower cataract incidence. In contrast to acute and late toxicity in other organ/organsystems, hyperfractionation of total-body irradiation does not further reduce toxicity for the eye-lens. Dose rate may have more influence on cataract incidence

  13. A high performance totally ordered multicast protocol

    Science.gov (United States)

    Montgomery, Todd; Whetten, Brian; Kaplan, Simon

    1995-01-01

    This paper presents the Reliable Multicast Protocol (RMP). RMP provides a totally ordered, reliable, atomic multicast service on top of an unreliable multicast datagram service such as IP Multicasting. RMP is fully and symmetrically distributed so that no site bears un undue portion of the communication load. RMP provides a wide range of guarantees, from unreliable delivery to totally ordered delivery, to K-resilient, majority resilient, and totally resilient atomic delivery. These QoS guarantees are selectable on a per packet basis. RMP provides many communication options, including virtual synchrony, a publisher/subscriber model of message delivery, an implicit naming service, mutually exclusive handlers for messages, and mutually exclusive locks. It has commonly been held that a large performance penalty must be paid in order to implement total ordering -- RMP discounts this. On SparcStation 10's on a 1250 KB/sec Ethernet, RMP provides totally ordered packet delivery to one destination at 842 KB/sec throughput and with 3.1 ms packet latency. The performance stays roughly constant independent of the number of destinations. For two or more destinations on a LAN, RMP provides higher throughput than any protocol that does not use multicast or broadcast.

  14. Use of the total motile sperm count to predict total fertilization failure in in vitro fertilization

    NARCIS (Netherlands)

    Repping, Sjoerd; van Weert, Janne-Meije; Mol, Ben W. J.; de Vries, Jan W. A.; van der Veen, Fulco

    2002-01-01

    Objective: To evaluate the capacity of baseline characteristics and total motile sperm count (TMC) to predict total fertilization failure (TIFF) in patients undergoing IVF. Design: Retrospective cohort study. Setting: University hospital. Patient(s): Eight hundred ninety-two couples with a total of

  15. Evidence Based Practice: Valuable and Successful Examples from ...

    African Journals Online (AJOL)

    Keywords: evidence-based practice, nursing, midwifery, education, quality improvement, ... developed by Deming, the father of quality control. ... representative of the total population. .... and helped the management engage in key areas of.

  16. Chambolle's Projection Algorithm for Total Variation Denoising

    Directory of Open Access Journals (Sweden)

    Joan Duran

    2013-12-01

    Full Text Available Denoising is the problem of removing the inherent noise from an image. The standard noise model is additive white Gaussian noise, where the observed image f is related to the underlying true image u by the degradation model f=u+n, and n is supposed to be at each pixel independently and identically distributed as a zero-mean Gaussian random variable. Since this is an ill-posed problem, Rudin, Osher and Fatemi introduced the total variation as a regularizing term. It has proved to be quite efficient for regularizing images without smoothing the boundaries of the objects. This paper focuses on the simple description of the theory and on the implementation of Chambolle's projection algorithm for minimizing the total variation of a grayscale image. Furthermore, we adapt the algorithm to the vectorial total variation for color images. The implementation is described in detail and its parameters are analyzed and varied to come up with a reliable implementation.

  17. A method for total body irradiation

    International Nuclear Information System (INIS)

    Yasukochi, Hiroshi; Higashi, Shizuka; Okuhata, Yoshitaka; Lee, Keiichi; Ishioka, Kuniaki; Murakami, Koji; Nagai, Jun; Kuniyasu, Yoshio

    1988-01-01

    In these two years, we have treated four infant patients of acute leukemia by Cobalt-60 total body irradiation and bone marrow transplantation. During total body irradiation, thermoluminescence dosimeters were attached to the skin of patients. For four patients, nine dosimetries were performed. Reliability of this method was examined by phantom experiment. Every irradiation for the patient per fraction was 2.4 Gy, that is, 60 cGy for each four positions, right decubitus A-P and PA directions and left decubitus A-P and PA directions under aseptic circumstances. Radiation dose was uniform by this technique for each patient, and average determined dose for surface of the patients was between 87 % and 106 % compared with the air dose of the center of aseptic space (wagon). As the result, we suggest that this method is suitable for the total body irradiation of acute leukemia of infant. (author)

  18. Total reflection X-ray fluorescence analysis

    International Nuclear Information System (INIS)

    Michaelis, W.; Prange, A.

    1987-01-01

    In the past few years, total reflection X-ray flourescence analysis (TXRF) has found an increasing number of assignments and applications. Experience of trace element analysis using TXRF and examples of applications are already widespread. Therefore, users of TXRF had the opportunity of an intensive exchange of their experience at the 1st workshop on total reflection X-ray fluorescence analysis which took place on May 27th and 28th 1986 at the GKSS Research Centre at Geesthacht. In a series of lectures and discussions dealing with the analytical principle itself, sample preparation techniques and applications as well as comuter programs for spectrum evaluation, the present state of development and the range of applications were outlined. 3 studies out of a total of 14 were included separately in the INIS and ENERGY databases. With 61 figs., 12 tabs [de

  19. Assay development status report for total cyanide

    International Nuclear Information System (INIS)

    Simpson, B.C.; Jones, T.E.; Pool, K.H.

    1993-02-01

    A validated cyanide assay that is applicable to a variety of tank waste matrices is necessary to resolve certain waste tank safety issues and for purposes of overall waste characterization. The target for this effort is an assay with an applicable range of greater than 1,000 ppM (0.10 wt%) total cyanide and a confidence level greater than 80%. Figure 1 illustrates the operating regime of the proposed cyanide assay method. The Assay Development Status Report for Total Cyanide will summarize the past experience with cyanide analyses on-tank waste matrices and will rate the status of the analytical methods used to assay total cyanide (CN - ion) in the tank waste matrices as acceptable or unacceptable. This paper will also briefly describe the current efforts for improving analytical resolution of the assays and the attempts at speciation

  20. Total quality management in orthodontic practice.

    Science.gov (United States)

    Atta, A E

    1999-12-01

    Quality is the buzz word for the new Millennium. Patients demand it, and we must serve it. Yet one must identify it. Quality is not imaging or public relations; it is a business process. This short article presents quality as a balance of three critical notions: core clinical competence, perceived values that our patients seek and want, and the cost of quality. Customer satisfaction is a variable that must be identified for each practice. In my practice, patients perceive quality as communication and time, be it treatment or waiting time. Time is a value and cost that must be managed effectively. Total quality management is a business function; it involves diagnosis, design, implementation, and measurement of the process, the people, and the service. Kazien is a function that reduces value services, eliminates waste, and manages time and cost in the process. Total quality management is a total commitment for continuous improvement.

  1. Heterotopic bone formation following total shoulder arthroplasty

    DEFF Research Database (Denmark)

    Kjaersgaard-Andersen, P.; Frich, Lars Henrik; Sjøbjerg, J.O.

    1989-01-01

    The incidence and location of heterotopic bone formation following total shoulder arthroplasty were evaluated in 58 Neer Mark-II total shoulder replacements. One year after surgery, 45% had developed some ectopic ossification. In six shoulders (10%) the ossifications roentgenographically bridged...... the glenohumeral and/or the glenoacromial space. There was no correlation between shoulder pain and the development of ossification. Shoulders with grade III heterotopic bone formation had a limited range of active elevation compared with shoulders without or with only a milder lesion. Men and patients...... with osteoarthritis of the shoulder joint were significantly disposed to the development of heterotopic bone. Heterotopic bone formation following total shoulder arthroplasty is frequent, but disabling heterotopic ossifications seem to be rare....

  2. Severe Heterotopic Ossification following Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Alexander L. Dodds

    2014-01-01

    Full Text Available Although the incidence of minor heterotopic ossification is probably higher than what is usually expected, severe heterotopic ossification (HO is an extremely rare event following total knee replacement surgery. We present the case of a 66-year-old woman who initially had achieved an excellent range of motion following bilateral uncemented rotating platform total knee replacement, before presenting with pain and loss of range of motion at 2 months after surgery. Severe HO was diagnosed on X-rays. Treatment consisted of nonoperative measures only, including physiotherapy with hydrotherapy and anti-inflammatories. She eventually regained her range of motion when seen at 8 months after operation. This case illustrates that nonoperative treatment without the use of radiotherapy or surgery can be used to safely resolve stiffness caused by HO after total knee replacement.

  3. Mixed total screening for sulfur isotope

    International Nuclear Information System (INIS)

    Cui Bin; Zhao Lei; Zhan Zhaoyang; He Zhijun

    2003-01-01

    The research on modern economic geology indicates that most ore deposits formed with characters of multi-origin, multi-stage and multi-genesis. Quantificational research of Sulfur isotope origin is a difficult problem that puzzles Geochemists all along. So the formation process of an ore deposit can be taken as the mix or the superposition of multi totals, which can be described by the mathematics model of mixed total screening. In the study of mid-down Yangtze River and Dongpo ore field in Hunan province, the authors successfully applied the mathematics model of mixed total screening, quantificationally resolved the problem of Sulfur isotope origin and mineralizing matter origin, and found out the mineralizing mechanism. This is very valuable. (authors)

  4. LTDNA Evidence on Trial

    Science.gov (United States)

    Roberts, Paul

    2016-01-01

    Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. The section titled Expert Evidence as Forensic Epistemic Warrant addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1) expert competence; (2) disciplinary domain; (3) methodological validity; (4) materiality; and (5) legal admissibility. This generic model of expert authority, highlighting law's fundamentally normative character, applies to all modern forms of criminal adjudication, across Europe and farther afield. The section titled LTDNA Evidence in UK Criminal Trials then examines English and Northern Irish courts' attempts to get to grips with LTDNA evidence in recent cases. Better appreciating the ways in which UK courts have addressed the challenges of LTDNA evidence may offer some insights into parallel developments in other legal systems. Appellate court rulings follow a predictable judicial logic, which might usefully be studied and reflected upon by any forensic scientist or statistician seeking to operate effectively in criminal proceedings. Whilst each legal jurisdiction has its own unique blend of jurisprudence, institutions, cultures and historical traditions, there is considerable scope for comparative analysis and cross-jurisdictional borrowing and instruction. In the spirit of promoting more nuanced and sophisticated international interdisciplinary dialogue, this article examines UK judicial approaches to LTDNA evidence and begins to elucidate their underlying institutional logic. Legal argument and broader policy debates are not confined to considerations of scientific validity, contamination risks and evidential integrity, or associated judgments of legal admissibility or exclusion. They also crucially

  5. LTDNA Evidence on Trial.

    Science.gov (United States)

    Roberts, Paul

    2016-01-01

    Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. The section titled Expert Evidence as Forensic Epistemic Warrant addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1) expert competence; (2) disciplinary domain; (3) methodological validity; (4) materiality; and (5) legal admissibility. This generic model of expert authority, highlighting law's fundamentally normative character, applies to all modern forms of criminal adjudication, across Europe and farther afield. The section titled LTDNA Evidence in UK Criminal Trials then examines English and Northern Irish courts' attempts to get to grips with LTDNA evidence in recent cases. Better appreciating the ways in which UK courts have addressed the challenges of LTDNA evidence may offer some insights into parallel developments in other legal systems. Appellate court rulings follow a predictable judicial logic, which might usefully be studied and reflected upon by any forensic scientist or statistician seeking to operate effectively in criminal proceedings. Whilst each legal jurisdiction has its own unique blend of jurisprudence, institutions, cultures and historical traditions, there is considerable scope for comparative analysis and cross-jurisdictional borrowing and instruction. In the spirit of promoting more nuanced and sophisticated international interdisciplinary dialogue, this article examines UK judicial approaches to LTDNA evidence and begins to elucidate their underlying institutional logic. Legal argument and broader policy debates are not confined to considerations of scientific validity, contamination risks and evidential integrity, or associated judgments of legal admissibility or exclusion. They also crucially

  6. Correlations between corneal and total wavefront aberrations

    Science.gov (United States)

    Mrochen, Michael; Jankov, Mirko; Bueeler, Michael; Seiler, Theo

    2002-06-01

    Purpose: Corneal topography data expressed as corneal aberrations are frequently used to report corneal laser surgery results. However, the optical image quality at the retina depends on all optical elements of the eye such as the human lens. Thus, the aim of this study was to investigate the correlations between the corneal and total wavefront aberrations and to discuss the importance of corneal aberrations for representing corneal laser surgery results. Methods: Thirty three eyes of 22 myopic subjects were measured with a corneal topography system and a Tschernig-type wavefront analyzer after the pupils were dilated to at least 6 mm in diameter. All measurements were centered with respect to the line of sight. Corneal and total wavefront aberrations were calculated up to the 6th Zernike order in the same reference plane. Results: Statistically significant correlations (p the corneal and total wavefront aberrations were found for the astigmatism (C3,C5) and all 3rd Zernike order coefficients such as coma (C7,C8). No statistically significant correlations were found for all 4th to 6th order Zernike coefficients except for the 5th order horizontal coma C18 (p equals 0.003). On average, all Zernike coefficients for the corneal aberrations were found to be larger compared to Zernike coefficients for the total wavefront aberrations. Conclusions: Corneal aberrations are only of limited use for representing the optical quality of the human eye after corneal laser surgery. This is due to the lack of correlation between corneal and total wavefront aberrations in most of the higher order aberrations. Besides this, the data present in this study yield towards an aberration balancing between corneal aberrations and the optical elements within the eye that reduces the aberration from the cornea by a certain degree. Consequently, ideal customized ablations have to take both, corneal and total wavefront aberrations, into consideration.

  7. Imaging Total Stations - Modular and Integrated Concepts

    Science.gov (United States)

    Hauth, Stefan; Schlüter, Martin

    2010-05-01

    Keywords: 3D-Metrology, Engineering Geodesy, Digital Image Processing Initialized in 2009, the Institute for Spatial Information and Surveying Technology i3mainz, Mainz University of Applied Sciences, forces research towards modular concepts for imaging total stations. On the one hand, this research is driven by the successful setup of high precision imaging motor theodolites in the near past, on the other hand it is pushed by the actual introduction of integrated imaging total stations to the positioning market by the manufacturers Topcon and Trimble. Modular concepts for imaging total stations are manufacturer independent to a large extent and consist of a particular combination of accessory hardware, software and algorithmic procedures. The hardware part consists mainly of an interchangeable eyepiece adapter offering opportunities for digital imaging and motorized focus control. An easy assembly and disassembly in the field is possible allowing the user to switch between the classical and the imaging use of a robotic total station. The software part primarily has to ensure hardware control, but several level of algorithmic support might be added and have to be distinguished. Algorithmic procedures allow to reach several levels of calibration concerning the geometry of the external digital camera and the total station. We deliver insight in our recent developments and quality characteristics. Both the modular and the integrated approach seem to have its individual strengths and weaknesses. Therefore we expect that both approaches might point at different target applications. Our aim is a better understanding of appropriate applications for robotic imaging total stations. First results are presented. Stefan Hauth, Martin Schlüter i3mainz - Institut für Raumbezogene Informations- und Messtechnik FH Mainz University of Applied Sciences Lucy-Hillebrand-Straße 2, 55128 Mainz, Germany

  8. Failure of aseptic revision total knee arthroplasties.

    Science.gov (United States)

    Leta, Tesfaye H; Lygre, Stein Håkon L; Skredderstuen, Arne; Hallan, Geir; Furnes, Ove

    2015-02-01

    In Norway, the proportion of revision knee arthroplasties increased from 6.9% in 1994 to 8.5% in 2011. However, there is limited information on the epidemiology and causes of subsequent failure of revision knee arthroplasty. We therefore studied survival rate and determined the modes of failure of aseptic revision total knee arthroplasties. This study was based on 1,016 aseptic revision total knee arthroplasties reported to the Norwegian Arthroplasty Register between 1994 and 2011. Revisions done for infections were not included. Kaplan-Meier and Cox regression analyses were used to assess the survival rate and the relative risk of re-revision with all causes of re-revision as endpoint. 145 knees failed after revision total knee arthroplasty. Deep infection was the most frequent cause of re-revision (28%), followed by instability (26%), loose tibial component (17%), and pain (10%). The cumulative survival rate for revision total knee arthroplasties was 85% at 5 years, 78% at 10 years, and 71% at 15 years. Revision total knee arthroplasties with exchange of the femoral or tibial component exclusively had a higher risk of re-revision (RR = 1.7) than those with exchange of the whole prosthesis. The risk of re-revision was higher for men (RR = 2.0) and for patients aged less than 60 years (RR = 1.6). In terms of implant survival, revision of the whole implant was better than revision of 1 component only. Young age and male sex were risk factors for re-revision. Deep infection was the most frequent cause of failure of revision of aseptic total knee arthroplasties.

  9. Radiological evaluation of failed total hip replacement

    International Nuclear Information System (INIS)

    Raspa, V.; Aldrovandi, S.; Pompei, G.

    1988-01-01

    The retrospective study of 50 operated cases of cemented total hip replacement and a review of the literature enabled the authors to define the radiological features of the above-mentioned condition. These features include one or more of the following signs: calcar reabsorption, lacunar erosions, modified relatioships between the prosthesis components, sepsis and loosening, periarticular calcifications dislocation and fracture of prosthesis components. Careful evaluation of these radiological features is extremely important for both an early diagnosis of failed total hip replacement and the choice of an adequate surgical treatment

  10. ANALYSIS AND ACCOUNTING OF TOTAL CASH FLOW

    Directory of Open Access Journals (Sweden)

    MELANIA ELENA MICULEAC

    2012-01-01

    Full Text Available In order to reach the objective of supplying some relevant information regarding the liquidity inflows and outflows during a financial exercise, the total cash flow analysis must include the analysis of result cashable from operation, of payments and receipts related to the investment and of financing decisions of the last exercise, as well as the analysis of treasury variation (of cash items. The management of total cash flows ensures the correlation of current liquidness flows as consequence of receipts with the payments ’flows, in order to provide payment continuity of mature obligations.

  11. Employee benefits in a total rewards framework.

    Science.gov (United States)

    Kwon, Jane; Hein, Pam

    2013-01-01

    Benefits represent one of the largest investments a company makes in its talent. However, our tendency can be to design, deliver and communicate benefits programs independently, without fully considering how those programs fit within a bigger picture of total rewards. Sure, we need to manage and execute individual benefit programs--but not at the expense of getting a real return on our more significant investment in talent. This article provides employers with perspectives on the value of managing benefits within the broader framework of total rewards, why it works and, most importantly, how to make it work.

  12. TOTAL 2003 activities report in brief

    International Nuclear Information System (INIS)

    2004-01-01

    This activities report presents the activities of the petroleum industry Group Total for the year 2003. The following topics are detailed: the corporate social responsibility with the environment stewardship, the energy future management, the safety enhancing, the human resources and the ethics and local development; the shareholder information with the Total share and the share-holding structure; the activities with informations on the Group, the main events, the upstream exploration and production,, the downstream refining, marketing, trading and shipping, the chemicals with overview 2003, base chemical and polymers, performance and specialities. (A.L.B.)

  13. Total shoulder replacement in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Sneppen, O; Fruensgaard, S; Johannsen, Hans Viggo

    1996-01-01

    A prospective study of 62 Neer mark II total shoulder arthroplasties performed during the period from 1981 to 1990 on 51 patients with rheumatoid arthritis was undertaken to evaluate factors associated with component loosening and proximal humeral migration. Thirty-two (51%) showed proximal......, range of movement, abduction force, or function. The risk of clinical asymptomatic loosening is a relatively late complication that is eventually followed by pronounced bone destruction related to the loose component. Long-term radiographic control of total shoulders with rheumatoid arthritis...... is recommended. Hemiarthroplasty with a cemented humeral prosthesis may be a better treatment in the end stage of rheumatoid arthritis of the shoulder....

  14. Development of kits for total PSA monitoring

    International Nuclear Information System (INIS)

    Suprarop, P.

    1999-01-01

    The development of kits for Total PSA assay has shown promising results. All essential components of the assay were prepared with reproducibility and used to optimize the assay. By choosing two steps method, we could avoid the hook effect and obtain satisfactory Q.C. parameters of the standard curve i.e. blank = 0.8%, maximum binding = 65%. If reference material for calibration of the standard is agree upon, the validation could then be carried out with total confidence. Our final goal is to reduce the step of incubation to just one step with no interference from hook effect

  15. TOTAL FINA ELF. Annual report 2002

    International Nuclear Information System (INIS)

    2003-01-01

    This document is the annual report 2002 of Total-Fina-Elf society, great company on the hydrocarbons market. According to the company objective (set the standard not only with the financial performance, but also with stringent requirements in terms of social and environmental responsibility), it presents the Chairman message, the corporate governance, the social and environmental responsibility, the future of energy, the human resources policy, the investor relations, the overview of Total-Fina-Elf fiscal year with financial information and 2002 industrial events. (A.L.B.)

  16. Determination of total solutes in synfuel wastewaters

    Energy Technology Data Exchange (ETDEWEB)

    Wallace, J.R.; Bonomo, F.S.

    1984-03-01

    Efforts to investigate both lyophilization and the measurement of colligative properties as an indication of total solute content are described. The objective of the work described is to develop a method for measuring total dissolved material in retort wastewaters which is simple and rugged enough to be performed in a field laboratory in support of pollution control tests. The analysis should also be rapid enough to provide timely and pertinent data to the pollution control plant operator. To be of most value, the technique developed also should be applicable to other synfuel wastewaters, most of which contain similar major components as oil shale retort waters. 4 references, 1 table.

  17. Total antioxidant/oxidant status in meningism and meningitis.

    Science.gov (United States)

    Aycicek, Ali; Iscan, Akin; Erel, Ozcan; Akcali, Mustafa; Selek, Sahbettin

    2006-12-01

    The objective of this study was to investigate the antioxidant/oxidant status of serum and cerebrospinal fluid in children with meningismus and acute bacterial meningitis. Twenty-three children (age range, 0.75 to 9 years) with fever and meningeal signs that required analysis of the cerebrospinal fluid, but no cytologic or biochemical evidence of meningitis in their serum and cerebrospinal fluid, constituted the meningismus group. Thirty-one children (age range, 0.5 to 10 years) with acute bacterial meningitis constituted the meningitis group. Twenty-nine healthy children (age range, 0.5 to 11 years) were recruited as control subjects. Antioxidant status (ascorbic acid, albumin, thiol, uric acid, total bilirubin, total antioxidant capacity, catalase and ceruloplasmin concentrations) and oxidant status (lipid hydroperoxide and total oxidant status) were measured. The serum antioxidant status was lower, and oxidant status levels higher in both meningitis and meningismus subjects than in the control children (P antioxidant status was lower, and serum oxidant status was higher in children in the meningismus and meningitis groups, whereas cerebrospinal fluid oxidant status was higher in the meningismus group than in the meningitis group.

  18. Sonographic findings after total hip arthroplasty: normal and complications

    International Nuclear Information System (INIS)

    Lee, Kyoung Rok; Seon, Young Seok; Choi, Ji He; Kim, Sun Su; Kim, Se Jong; Park, Byong Lan; Kim, Byoung Geun

    2002-01-01

    The purpose of this study was to determine the efficacy of sonography in the evaluation of normal pseudocapsular morphology and the detection of complications after total hip arthroplasty. Between Janvary 1997 and June 2000, 47 patients (35 men and 12 women aged 24 to 84 (mean, 61) years) using real-time linear-array, convex US units with 3.5-MHz and 10-MHz transducers. Normal capsular morphology in 30 with total hip replacements, who had been asymptomatic for at least one year, was studied, and the prosthetic joint infection demonstrated in six of 17 who had experienced was confirmed at surgery or by US-guided aspiration. Sonograms indicated that a normal pseudocapsule lay straight over the neck of the prosthesis or was slightly convex toward the neck , and that the mean bone-to-pseudocapsule distance was 2.9 mm. However, in the 11 symptomatic patients in whom no evidence of infection was revealed by cultures, th mean distance was 4.7 mm; in the remaining six patients, whose joints were infected (a condition strongly suggested by the presence of extracapsular fluid), the mean distance was 5.5 mm, with no significant difference between the two groups. Sonography can be used to evaluate normal caspular morphology after total hip replacement and to diagnose infection around hip prostheses. In all patients in whom sonography revealed the presence of extra-articular fluid, infection had occurred

  19. Sonographic findings after total hip arthroplasty: normal and complications

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyoung Rok; Seon, Young Seok; Choi, Ji He; Kim, Sun Su; Kim, Se Jong; Park, Byong Lan; Kim, Byoung Geun [Kwangju Christian Hospital, Kwangju (Korea, Republic of)

    2002-04-01

    The purpose of this study was to determine the efficacy of sonography in the evaluation of normal pseudocapsular morphology and the detection of complications after total hip arthroplasty. Between Janvary 1997 and June 2000, 47 patients (35 men and 12 women aged 24 to 84 (mean, 61) years) using real-time linear-array, convex US units with 3.5-MHz and 10-MHz transducers. Normal capsular morphology in 30 with total hip replacements, who had been asymptomatic for at least one year, was studied, and the prosthetic joint infection demonstrated in six of 17 who had experienced was confirmed at surgery or by US-guided aspiration. Sonograms indicated that a normal pseudocapsule lay straight over the neck of the prosthesis or was slightly convex toward the neck , and that the mean bone-to-pseudocapsule distance was 2.9 mm. However, in the 11 symptomatic patients in whom no evidence of infection was revealed by cultures, th mean distance was 4.7 mm; in the remaining six patients, whose joints were infected (a condition strongly suggested by the presence of extracapsular fluid), the mean distance was 5.5 mm, with no significant difference between the two groups. Sonography can be used to evaluate normal caspular morphology after total hip replacement and to diagnose infection around hip prostheses. In all patients in whom sonography revealed the presence of extra-articular fluid, infection had occurred.

  20. Incidental Parathyroidectomy during Total Thyroidectomy: Risk Factors and Consequences

    Directory of Open Access Journals (Sweden)

    Dimitrios K. Manatakis

    2016-01-01

    Full Text Available Objective. To evaluate the incidence of accidental parathyroidectomy in our series of total thyroidectomies, to investigate its clinical and biochemical consequences, and to identify potential risk factors. Methods. Patients who underwent total thyroidectomy between January 2006 and December 2015 were retrospectively analyzed. Pathology reports were reviewed to identify those cases who had an incidental parathyroidectomy and these were compared to patients with no parathyroidectomy, in terms of clinical (age, sex, and symptoms of hypocalcemia, pathological (thyroid specimen weight, Hashimoto thyroiditis, and malignancy, and biochemical (serum calcium and phosphate levels factors. Results. 281 patients underwent total thyroidectomy during the study period. Incidental parathyroidectomy was noticed in 24.9% of cases, with 44.3% of parathyroid glands found in an intrathyroidal location. Evidence of postoperative biochemical hypocalcemia was noticed in 28.6% of patients with parathyroidectomy, compared with 13.3% in the no-parathyroidectomy group (p=0.003. Symptomatic hypocalcemia was observed in 5.7% and 3.8%, respectively (p=0.49. Age, sex, thyroid specimen weight, Hashimoto thyroiditis, and malignancy did not differ significantly between the two groups. Conclusions. Our study found an association of incidental parathyroidectomy with transient postoperative biochemical hypocalcemia, but not with clinically symptomatic disease. Age, sex, thyroid gland weight, Hashimoto thyroiditis, and malignancy were not identified as risk factors.

  1. OCCURRENCE OF EARLY KNEE ARTHROSIS FOLLOWING TOTAL MENISCECTOMIES IN YOUTH

    Directory of Open Access Journals (Sweden)

    Sasa Milenkovic

    2006-01-01

    Full Text Available The occurrence of early knee arthrosis following early total meniscectomy is a significant orthopedic, social and economical problem. Arthroscopic surgery shows the role and significance of the menisci for normal knee functioning. The outcome of 19 knee arthroscopies are presented; patients are of male sex, average age 39 (from 34 to 45. All patients underwent knee arthrotomy and total medial and lateral meniscectomy before the age of 25. All patients were active sportsmen. 12 arthroscopies of the right knee and 7 arthroscopies of the left one were done. In 13 patients, medial knee arthrosis following medial meniscectomy was found. One patient had lateral knee arthrosis and degeneration of the medial meniscus following lateral meniscectomy . The same patient had the total rupture of LCA. The remaining 5 patients had lateral knee arthrosis following lateral meniscectomy. One or more loose bodies of cartilaginous origin were found in 8 patients. All the operated patients had evident early signs of initial or progressive knee arthrosis confirmed or diagnosed arthroscopically. Knee arthroscopy in early arthroses following knee meniscectomies in youth can relieve the pain and slow down disease progression. A permanent solution to the problem is possible only with unicompartmental knee arthroplasty.

  2. Evidence-based dentistry.

    Science.gov (United States)

    Chambers, David W

    2010-01-01

    Both panegyric and criticism of evidence-based dentistry tend to be clumsy because the concept is poorly defined. This analysis identifies several contributions to the profession that have been made under the EBD banner. Although the concept of clinicians integrating clinical epidemiology, the wisdom of their practices, and patients' values is powerful, its implementation has been distorted by a too heavy emphasis of computerized searches for research findings that meet the standards of academics. Although EBD advocates enjoy sharing anecdotal accounts of mistakes others have made, faulting others is not proof that one's own position is correct. There is no systematic, high-quality evidence that EBD is effective. The metaphor of a three-legged stool (evidence, experience, values, and integration) is used as an organizing principle. "Best evidence" has become a preoccupation among EBD enthusiasts. That overlong but thinly developed leg of the stool is critiqued from the perspectives of the criteria for evidence, the difference between internal and external validity, the relationship between evidence and decision making, the ambiguous meaning of "best," and the role of reasonable doubt. The strongest leg of the stool is clinical experience. Although bias exists in all observations (including searches for evidence), there are simple procedures that can be employed in practice to increase useful and objective evidence there, and there are dangers in delegating policy regarding allowable treatments to external groups. Patient and practitioner values are the shortest leg of the stool. As they are so little recognized, their integration in EBD is problematic and ethical tensions exist where paternalism privileges science over patient's self-determined best interests. Four potential approaches to integration are suggested, recognizing that there is virtually no literature on how the "seat" of the three-legged stool works or should work. It is likely that most dentists

  3. Evidence-Based Toxicology.

    Science.gov (United States)

    Hoffmann, Sebastian; Hartung, Thomas; Stephens, Martin

    Evidence-based toxicology (EBT) was introduced independently by two groups in 2005, in the context of toxicological risk assessment and causation as well as based on parallels between the evaluation of test methods in toxicology and evidence-based assessment of diagnostics tests in medicine. The role model of evidence-based medicine (EBM) motivated both proposals and guided the evolution of EBT, whereas especially systematic reviews and evidence quality assessment attract considerable attention in toxicology.Regarding test assessment, in the search of solutions for various problems related to validation, such as the imperfectness of the reference standard or the challenge to comprehensively evaluate tests, the field of Diagnostic Test Assessment (DTA) was identified as a potential resource. DTA being an EBM discipline, test method assessment/validation therefore became one of the main drivers spurring the development of EBT.In the context of pathway-based toxicology, EBT approaches, given their objectivity, transparency and consistency, have been proposed to be used for carrying out a (retrospective) mechanistic validation.In summary, implementation of more evidence-based approaches may provide the tools necessary to adapt the assessment/validation of toxicological test methods and testing strategies to face the challenges of toxicology in the twenty first century.

  4. Management of hypocalcemia following total thyroidectomy

    International Nuclear Information System (INIS)

    Pahuja, D.N.; Patwardhan, U.N.; Samuel, A.M.

    1999-01-01

    A retrospective analysis of calcemic status of 500 randomly selected patients, who underwent total thyroidectomy (TTx) for differentiated thyroid carcinoma (DTC) was studied. These patients were followed up from a minimum of 2-3 years, to a maximum of 15-20 years, and calcemic status was ascertained at varying times following their surgery and radioiodine ( 131 ) therapy

  5. Predicting thyroxine requirements following total thyroidectomy.

    Science.gov (United States)

    Mistry, Dipan; Atkin, Stephen; Atkinson, Helen; Gunasekaran, Sinnappa; Sylvester, Deborah; Rigby, Alan S; England, R James

    2011-03-01

    Optimal thyroxine replacement following total thyroidectomy is critical to avoid symptoms of hypothyroidism. The aim of this study was to determine the best formula to determine the initiated replacement dose of levothyroxine immediately following total thyroidectomy. Prospective study. All patients were initiated on 100 μg levothyroxine and titrated to within the reference range for TSH and free T4. Correlations to height, weight, age, lean body mass (LBM), body surface area (BSA) and body mass index (BMI) were calculated. One hundred consecutive adult patients underwent total thyroidectomy for non-malignant disease. Comparison between three methods of levothyroxine dose prediction, aiming for a levothyroxine dose correct to within 25 μg of actual dose required. Correlations were seen between levothyroxine dose and patient age (r=-0.346, Pregression equation was calculated (predicted levothyroxine dose=[0·943 × bodyweight] + [-1.165 × age] + 125.8), simplified to (levothyroxine dose= bodyweight - age + 125) pragmatically. Initiating patients empirically on 100 μg post-operatively showed that 40% of patients achieved target within 25 μg of their required dose; this increased to 59% when using a weight-only dose calculation (1.6 μg/kg) and to 72% using the simplified regression equation. A simple calculated regression equation gives a more accurate prediction of initiated levothyroxine dose following total thyroidectomy, reducing the need for outpatient attendance for dose titration. © 2011 Blackwell Publishing Ltd.

  6. Total Quality Management in Libraries. ERIC Digest.

    Science.gov (United States)

    Masters, Denise G.

    Total Quality Management (TQM) is "a system of continuous improvement employing participative management and centered on the needs of customers." Key components of TQM are employee involvement and training, problem-solving teams, statistical methods, long-term goals and thinking, and recognition that the system, not people, produces…

  7. Total spectral distributions from Hawking radiation

    Energy Technology Data Exchange (ETDEWEB)

    Broda, Boguslaw [University of Lodz, Department of Theoretical Physics, Faculty of Physics and Applied Informatics, Lodz (Poland)

    2017-11-15

    Taking into account the time dependence of the Hawking temperature and finite evaporation time of the black hole, the total spectral distributions of the radiant energy and of the number of particles have been explicitly calculated and compared to their temporary (initial) blackbody counterparts (spectral exitances). (orig.)

  8. Accumulation pattern of total nonstructural carbohydrate in ...

    African Journals Online (AJOL)

    Umukoro

    1977-09-09

    Sep 9, 1977 ... 1Instituto Nacional de Tecnología Agropecuaria (INTA), EEA Famaillá, Argentina. 2Department of Plant Sciences, University of California Davis, CA, USA. Accepted 17 October, 2012. The pattern of total nonstructural carbohydrate (TNC) accumulation in strawberry (Fragaria ananassa. Duch.) nursery ...

  9. Concepts of total quality management in radiology

    International Nuclear Information System (INIS)

    Pratik Kumar

    2003-01-01

    Quality is one of the touch-stones to determine the competitive advantage for a service, product or company. Total Quality Management has a large ambit, which encompasses not only the quality of images and services producing these images, but also the customers satisfaction. In health care patients satisfaction is divided into three parts: patient quality, professional quality and management quality

  10. Total pressing Indonesian gas development, exports

    International Nuclear Information System (INIS)

    Anon.

    1994-01-01

    Total is on track to become Indonesia's leading gas exporter by the turn of the century. Total's aggressive development of its Mahakam Delta acreage in East Kalimantan is intended to keep pace with growing liquefied natural gas demand, mainly from Japan but also increasingly from South Korea and Taiwan. A frantic scramble is under way among natural gas suppliers in the Pacific Rim region, particularly those with current LNG export facilities, to accommodate projections of soaring natural gas demand in the region. Accordingly, Total's Indonesian gas production goal is the centerpiece of a larger strategy to become a major player in the Far East Asia gas scene. Its goals also fall in line with Indonesia's. Facing flat or declining oil production while domestic oil demand continues to soar along with a rapidly growing economy, Indonesia is heeding some studies that project the country could become a net oil importer by the turn of the century. The paper describes Total's Far East strategy, the Mahakam acreage which it operates, the shift to gas development, added discoveries, future development, project spending levels, and LNG export capacity

  11. Adapting Total Quality Management (TQM) to Government.

    Science.gov (United States)

    Swiss, James E.

    1992-01-01

    Total quality management will not work well in government agencies because of stress on products, not services; on well-defined consumer groups; on inputs/processes, not results; and on preoccupation with quality. An effective revised version emphasizes client feedback, performance monitoring, continuous improvement, and worker participation. (SK)

  12. Production Function Geometry with "Knightian" Total Product

    Science.gov (United States)

    Truett, Dale B.; Truett, Lila J.

    2007-01-01

    Authors of principles and price theory textbooks generally illustrate short-run production using a total product curve that displays first increasing and then diminishing marginal returns to employment of the variable input(s). Although it seems reasonable that a temporary range of increasing returns to variable inputs will likely occur as…

  13. Total hip reconstruction in acetabular dysplasia.

    NARCIS (Netherlands)

    Schller, H.M.; Dalstra, M.; Huiskes, R.; Marti, R.K.

    1993-01-01

    In acetabular dysplasia, fixation of the acetabular component of a cemented total hip prosthesis may be insecure and superolateral bone grafts are often used to augment the acetabular roof. We used finite element analysis to study the mechanical importance of the lateral acetabular roof and found

  14. Total Quality Management in Libraries: A Sourcebook.

    Science.gov (United States)

    O'Neil, Rosanna M., Comp.

    Total Quality Management (TQM) brings together the best aspects of organizational excellence by driving out fear, offering customer-driven products and services, doing it right the first time by eliminating error, and maintaining inventory control without waste. Libraries are service organizations which are constantly trying to improve service.…

  15. The Total Synthesis of Cephalosporin C

    Indian Academy of Sciences (India)

    IAS Admin

    The Total Synthesis of Cephalosporin C. Edited by Setty Mallikarjuna Babu and Subramania Ranganathan. Keywords. Cephalosporin C. The Nobel Prize in Chemistry for 1965 has been awarded for contributions to the art of chemical synthesis. It gives me much pleasure to record here my gratification with the citation, ...

  16. Total Body Opacification 'Technique Neonatal Adrenal Haemorrhage

    African Journals Online (AJOL)

    1971-12-11

    Dec 11, 1971 ... A case is reported illustrating the possible usefulness of total body opacification in the diagnosis of neonatal adrenal haemorrhage. To derive maximum benefit from this principle, the routine use of an early film coupled with high dosage is urged whenever an intravenous pyelogram is performed for ...

  17. [Contents of total flavonoids in Rhizoma Arisaematis].

    Science.gov (United States)

    Du, S S; Lin, H Y; Zhou, Y X; Wei, L X

    2001-06-01

    Comparing the contents of total flavonoides of Rhizoma Arisaematis, which collected in different time, regions, different varieties and processed. Determining the contents by ultraviolet spectro-photometry. The contents were found in the following sequence: 1. the end of July, the begin of July, August, September; 2. Beijing, Shanxi, Sichuan, Anhui; 3. Arisaema erubenscens, A. heterophyllum, A. amurense; 4. unprocessed product, processed product.

  18. Total cross section results for deuterium electrodisintegration

    International Nuclear Information System (INIS)

    Skopik, D.M.; Murphy, J.J. II; Shin, Y.M.

    1976-01-01

    Theoretical total cross sections for deuterium electrodisintegration are presented as a function of incident electron energy. The cross section has been calculated using virtual photon theory with Partovi's photodisintegration calculation for E/subx/ > 10 MeV and effective range theory for E/subx/ 2 H(e, n) reaction in Tokamak reactors

  19. Total hip arthroplasty for giant cell tumour.

    Directory of Open Access Journals (Sweden)

    Kulkarni S

    1996-07-01

    Full Text Available A 32 month follow up of an uncommon case of a Giant Cell Tumour affecting the proximal end of femur is presented. Following a wide excision, the hip was reconstructed using Charnley type of low friction total hip arthroplasty. At a 32 month review, there was no recurrence and the function was good.

  20. Coordinating Council. Ninth Meeting: Total Quality Management

    Science.gov (United States)

    1992-01-01

    This report summarizes the 9th meeting of the STI Coordinating Council. The council listened to the speakers' understanding of Total Quality Management (TQM) principles and heard stories of successful applications of these principles. Definitions of quality stated were focused on customer satisfaction. Reports presented by the speakers are also included.

  1. Revitalizing Space Operations through Total Quality Management

    Science.gov (United States)

    Baylis, William T.

    1995-01-01

    The purpose of this paper is to show the reader what total quality management (TQM) is and how to apply TQM in the space systems and management arena. TQM is easily understood, can be implemented in any type of business organization, and works.

  2. Application of Total Quality Management in Education

    Science.gov (United States)

    Farooq, M. S.; Akhtar, M. S.; Ullah, S. Zia; Memon, R. A.

    2007-01-01

    The purpose of the paper is to analyzing thoughts of the modern management paradigm "Total Quality Management" (TQM), and its application in the field of education. The basic theme of TQM is participatory approach to address the question(s) of quality in business aswell as in the field of education. Reviewing fresh literature from the internet …

  3. Diagnosing Total Quality Management. Part I

    NARCIS (Netherlands)

    Bossink, B.A.G.; Gieskes, J.F.B.; Pas, T.N.M.

    1992-01-01

    From extensive literature research a total quality management (TQM) model is developed. This model describes the basic elements of the concept of TQM. It also provides the way in which the basic elements can be made operational in practice. Based on this model a quality-diagnostical instrument is

  4. Diagnosing Total Quality Management - part 2

    NARCIS (Netherlands)

    Bossink, B.A.G.; Gieskes, J.F.B.; Pas, T.N.M.

    1993-01-01

    From extensive literature research a total quality management (TQM) model is developed. This model describes the basic elements of the concept of TQM. It also provides the way in which the basic elements can be made operational in practice. Based on this model a quality-diagnostical instrument is

  5. Accumulation pattern of total nonstructural carbohydrate in ...

    African Journals Online (AJOL)

    The pattern of total nonstructural carbohydrate (TNC) accumulation in strawberry (Fragaria ananassa Duch.) nursery runner plants, cv. eCamarosaf, was determined for three growing seasons. Plant growth and fruit production patterns were also evaluated. The experiments were carried out on plants propagated in high ...

  6. Total Synthesis of balanol, Part 2

    DEFF Research Database (Denmark)

    Tanner, David Ackland; Kelly, Nicholas; Tedenborg, Lars

    1997-01-01

    A convergent enantioselective total synthesis of the natural product (-)-balanol (1) is described. In addition to benzophenone fragment 8, key intermediates are chiral bicyclic aziridine 3 and the corresponding epoxide 4, both of which undergo highly regio- and stereoselective nucleophilic ring...

  7. Total synthesis of insect antifeedant drimane sesquiterpenes

    NARCIS (Netherlands)

    Jansen, B.J.M.

    1993-01-01

    The investigations described in this thesis deal with the total synthesis of sesquiterpenes of the drimane family, named for their widespread occurrence in the stem bark of South American Drimys species. These compounds contain the bicyclofarnesol nucleus

  8. Feasibility study of transanal total mesorectal excision

    NARCIS (Netherlands)

    Velthuis, S.; Boezem, P.B. van den; Peet, D.L. van der; Cuesta, M.A.; Sietses, C.

    2013-01-01

    BACKGROUND: Laparoscopic resection of colorectal cancers is a safe alternative to open surgery. The conversion rate to open surgery remains fairly constant but is associated with increased morbidity. A new approach to the surgical excision of rectal cancer is transanal total mesorectal excision

  9. TOTAL HIP REPLACEMENTS AT KIKUYU HOSPITAL, KENYA

    African Journals Online (AJOL)

    equipments, few trained personnel and the high cost of implants. It is mainly in the ..... function more affected than the sensory a day after. There was a foot drop. .... 60: Issue 2, 217-. 220. 13. NIH Consensus Development Panel on Total Hip.

  10. Total Survey Error for Longitudinal Surveys

    NARCIS (Netherlands)

    Lynn, Peter; Lugtig, P.J.

    2016-01-01

    This article describes the application of the total survey error paradigm to longitudinal surveys. Several aspects of survey error, and of the interactions between different types of error, are distinct in the longitudinal survey context. Furthermore, error trade-off decisions in survey design and

  11. Food safety and total quality management

    NARCIS (Netherlands)

    Barendsz, A.W.

    1998-01-01

    Food safety is a growing global concern not only because of its continuing importance for public health but also because of its impact on international trade. The application of total quality management (TQM) provides the best possible care by continuously improving products and services to meet or

  12. Total pancreatic lipomatosis with malabsorption syndrome

    Directory of Open Access Journals (Sweden)

    Rama Anand

    2011-01-01

    Full Text Available Total fat replacement of the pancreas is rare. Focal fatty replacement is the most common degenerative lesion of pancreas. Focal fatty deposits have no major clinical significance; however, extreme fat replacement is of pathologic significance, as it is associated with marked reduction in exocrine function of pancreas, resulting in malabsorption due to pancreatic enzyme insufficiency.

  13. Brutally Unfair Tactics Totally OK Now

    DEFF Research Database (Denmark)

    Wilson, Douglas

    2011-01-01

    In this paper, I use a party game that I co-designed, Brutally Unfair Tactics Totally OK Now (B.U.T.T.O.N.), as a case study to suggest some alternative possibilities for the design of digitally-mediated play and games. Specifically, I argue that that intentionally “broken” or otherwise incomplet...

  14. Total energy calculations and bonding at interfaces

    International Nuclear Information System (INIS)

    Louie, S.G.

    1984-08-01

    Some of the concepts and theoretical techniques employed in recent ab initio studies of the electronic and structural properties of surfaces and interfaces are discussed. Results of total energy calculations for the 2 x 1 reconstructed diamond (111) surface and for stacking faults in Si are reviewed. 30 refs., 8 figs

  15. Trying and the Arguments from Total Failure

    DEFF Research Database (Denmark)

    Grünbaum, Thor

    2008-01-01

    New Volitionalism is a name for certain widespread conception of the nature of intentional action. Some of the standard arguments for New Volitionalism, the so-called arguments from total failure, have even acquired the status of basic assumptions for many other kinds of philosophers. It is there...

  16. A formal model for total quality management

    NARCIS (Netherlands)

    S.C. van der Made-Potuijt; H.B. Bertsch (Boudewijn); L.P.J. Groenewegen

    1996-01-01

    textabstractTotal Quality Management (TQM) is a systematic approach to managing a company. TQM is systematic in the sense that it is uses facts through observation, analysis and measurable goals. There are theoretical descriptions of this management concept, but there is no formal model of it. A

  17. Multicultural Leadership, Sustainable Total School Environment

    Science.gov (United States)

    Yeung, See-Wai Alison; Lee, Yeung; Yue, K. W. Ryan

    2006-01-01

    Banks (2002) stated that to implement multicultural education successfully, we must think of the school as a social system. Therefore, if educational equity and excellence are to be provided to all students, a systemic Total School Environment [Banks (2001) "Cultural diversity and education: Foundations curriculum and teaching, 4th ed." Allyn and…

  18. Recurrent hemarthrosis after total knee arthroplasty

    NARCIS (Netherlands)

    Rukavina, A.; Kerkhoffs, G.M.M.J.; Schneider, P.; Kuster, M.S.

    2010-01-01

    This report describes a case of spontaneous recurrent hemarthrosis of the knee that presented 4 weeks after total knee arthroplasty. Femoral arteriography showed a false aneurysm of a branch of the inferior lateral geniculate artery. Therapeutic embolization of the arterial branch was performed

  19. An approach to total quality assurance

    International Nuclear Information System (INIS)

    Archer, L.G.

    1976-01-01

    Total Quality Assurance must be based on amalgamating three quality functions: effective quality control, competent inspection, and regularly audited Quality Assurance programmes. In applying these functions the fuel supplier must regard each of his sub-contractors as part of his own works and ensure a common policy of motivated Quality Assurance throughout his own works and those of his suppliers. (author)

  20. On total noncommutativity in quantum mechanics

    Science.gov (United States)

    Lahti, Pekka J.; Ylinen, Kari

    1987-11-01

    It is shown within the Hilbert space formulation of quantum mechanics that the total noncommutativity of any two physical quantities is necessary for their satisfying the uncertainty relation or for their being complementary. The importance of these results is illustrated with the canonically conjugate position and momentum of a free particle and of a particle closed in a box.

  1. Flavonoid, hesperidine, total phenolic contents and antioxidant ...

    African Journals Online (AJOL)

    Additionally, the antioxidant activities were also determined by ferric reducing antioxidant power (FRAP) and 1,1-diphenyl-2-picryl hydrazyl (DPPH) radical scavenging activity. C. hystrix had the highest flavonoid and total phenolic contents while C. aurantifolia had the highest hesperidine content. The antioxidant activity of ...

  2. Total dissolved carbohydrate in Mahi river estuary

    Digital Repository Service at National Institute of Oceanography (India)

    Bhosle, N.B.; Rokade, M.A.; Zingde, M.D.

    Total dissolved carbohydrate varied from 4.37-15 mg l-1 and 3.71-15.95 mg l-1 in the surface and bottom samples respectively. Highest concentration of carbohydrate was observed at station 1 which decreased downward upto Station 6 which showed...

  3. Total and the Algerian shale gas

    International Nuclear Information System (INIS)

    Chapelle, Sophie; Petitjean, Olivier; Maurin, Wilfried; Balvet, Jacqueline; Combes, Maxime; Geze, Francois; Hamouchene, Hamza; Hidouci, Ghazi; Malti, Hocine; Renaud, Juliette; Simon, Antoine; Titouche, Fateh

    2015-01-01

    This publication proposes a rather detailed and discussed overview of the movement of mobilisation of Algerian people (notably those living in the Sahara) against projects of exploration and exploitation of shale gases in Algeria by the Total group. The authors also recall and comment the long and heavy history of hydrocarbon management in Algeria, the role of international firms and of western interests (notably French interests) in this country, and the position of Total regarding the stake related to shale gases. The authors outline problems created by shale gas exploitation regarding water consumption and waste waters. They also notice that the safety of wells is at the centre of the protest. Problems raised by hydraulic fracturing are reviewed: seismic activity, chemical pollution, air pollution and greenhouse gases, landscape destruction. The attitude of the Algerian government is commented. Then, the authors try to identify and describe the action of Total in the Algerian shale gas sector, discuss the possible French influence, and outline the presence of Total all over the world in this sector

  4. LAMBDA p total cross-section measurement

    CERN Multimedia

    CERN PhotoLab

    1970-01-01

    A view of the apparatus used for the LAMBDA p total cross-section measurement at the time of its installation. The hyperons decaying into a proton and a pion in the conical tank in front were detected in the magnet spectrometer in the upper half of the picture. A novel detection technique using exclusively multiwire proportional chambers was employed.

  5. Extracorporeal total artificial heart as bailout surgery.

    Science.gov (United States)

    Perrodin, Stéphanie F; Muller, Olivier; Gronchi, Fabrizio; Liaudet, Lucas; Hullin, Roger; Kirsch, Matthias

    2017-03-01

    We report the use of a total extracorporeal heart for uncontrolled bleeding following a proximal left anterior descending artery perforation, using two centrifugal ventricular assist devices after heart explantation. The literature describing similar techniques and patient outcomes for this "bailout" technique are reviewed. © 2017 Wiley Periodicals, Inc.

  6. Benchmarking, Total Quality Management, and Libraries.

    Science.gov (United States)

    Shaughnessy, Thomas W.

    1993-01-01

    Discussion of the use of Total Quality Management (TQM) in higher education and academic libraries focuses on the identification, collection, and use of reliable data. Methods for measuring quality, including benchmarking, are described; performance measures are considered; and benchmarking techniques are examined. (11 references) (MES)

  7. Salinity: Electrical conductivity and total dissolved solids

    Science.gov (United States)

    The measurement of soil salinity is a quantification of the total salts present in the liquid portion of the soil. Soil salinity is important in agriculture because salinity reduces crop yields by reducing the osmotic potential making it more difficult for the plant to extract water, by causing spe...

  8. Total Quality Management: Implications for Educational Assessment.

    Science.gov (United States)

    Rankin, Stuart C.

    1992-01-01

    Deming's "System of Profound Knowledge" is even more fundamental than his 14-principle system transformation guide and is based on 4 elements: systems theory, statistical variation, a theory of knowledge, and psychology. Management should revamp total system processes so that quality of product is continually improved. Implications for…

  9. Total Quality Management. ERIC Digest, Number 73.

    Science.gov (United States)

    Weaver, Tyler

    The Japanese success story has made W. Edwards Deming's Total Quality Management (TQM) theory increasingly popular among American managers, from car manufacturers to educational leaders. TQM is based on two tenets: the primacy of customer satisfaction and the necessity of tapping nontraditional sources (especially employee ideas) to institute…

  10. Staff Development and Total Quality Management.

    Science.gov (United States)

    Norris, Gerald L.; Norris, Joye H.

    Professional development is an emerging view of faculty development that places teachers in charge of their own professional growth. The emergence of Total Quality Management (TQM) provides a vehicle for designing professional development to meet the needs of individuals and the organizations that employ them. The eight tenets of Deming's theory…

  11. Curriculum Transformation through Total Quality Management.

    Science.gov (United States)

    Edwards, Barbara; Algozzine, Bob

    1995-01-01

    Describes a massive cultural transformation project at two Charlotte, North Carolina, elementary schools that used Deming's total quality management principles to restructure curricula according to Boyer's eight commonalities of learning. Shows how the FADE (focus, analyze, develop, and execute) model was used to develop a well-coordinated,…

  12. Total Quality Management in Higher Education.

    Science.gov (United States)

    Sherr, Lawrence A.; Lozier, G. Gredgory

    1991-01-01

    Total Quality Management, based on theories of W. Edward Deming and others, is a style of management using continuous process improvement characterized by mission and customer focus, a systematic approach to operations, vigorous development of human resources, long-term thinking, and a commitment to ensuring quality. The values espoused by this…

  13. Perioperative management of endocrine insufficiency after total pancreatectomy for neoplasia.

    Science.gov (United States)

    Maker, Ajay V; Sheikh, Raashid; Bhagia, Vinita

    2017-09-01

    Indications for total pancreatectomy (TP) have increased, including for diffuse main duct intrapapillary mucinous neoplasms of the pancreas and malignancy; therefore, the need persists for surgeons to develop appropriate endocrine post-operative management strategies. The brittle diabetes after TP differs from type 1/2 diabetes in that patients have absolute deficiency of insulin and functional glucagon. This makes glucose management challenging, complicates recovery, and predisposes to hospital readmissions. This article aims to define the disease, describe the cause for its occurrence, review the anatomy of the endocrine pancreas, and explain how this condition differs from diabetes mellitus in the setting of post-operative management. The morbidity and mortality of post-TP endocrine insufficiency and practical treatment strategies are systematically reviewed from the literature. Finally, an evidence-based treatment algorithm is created for the practicing pancreatic surgeon and their care team of endocrinologists to aid in managing these complex patients. A PubMed, Science Citation Index/Social sciences Citation Index, and Cochrane Evidence-Based Medicine database search was undertaken along with extensive backward search of the references of published articles to identify studies evaluating endocrine morbidity and treatment after TP and to establish an evidence-based treatment strategy. Indications for TP and the etiology of pancreatogenic diabetes are reviewed. After TP, ~80% patients develop hypoglycemic episodes and 40% experience severe hypoglycemia, resulting in 0-8% mortality and 25-45% morbidity. Referral to a nutritionist and endocrinologist for patient education before surgery followed by surgical reevaluation to determine if the patient has the appropriate understanding, support, and resources preoperatively has significantly reduced morbidity and mortality. The use of modern recombinant long-acting insulin analogues, continuous subcutaneous insulin

  14. Evidence-Based Development

    DEFF Research Database (Denmark)

    Hertzum, Morten; Simonsen, Jesper

    2004-01-01

    Systems development is replete with projects that represent substantial resource investments but result in systems that fail to meet users’ needs. Evidence-based development is an emerging idea intended to provide means for managing customer-vendor relationships and working systematically toward...... meeting customer needs. We are suggesting that the effects of the use of a system should play a prominent role in the contractual definition of IT projects and that contract fulfilment should be determined on the basis of evidence of these effects. Based on two ongoing studies of home-care management...

  15. Laparoscopic versus open total mesorectal excision for rectal cancer.

    Science.gov (United States)

    Vennix, Sandra; Pelzers, Loeki; Bouvy, Nicole; Beets, Geerard L; Pierie, Jean-Pierre; Wiggers, Theo; Breukink, Stephanie

    2014-04-15

    Colorectal cancer including rectal cancer is the third most common cause of cancer deaths in the western world. For colon carcinoma, laparoscopic surgery is proven to result in faster postoperative recovery, fewer complications and better cosmetic results with equal oncologic results. These short-term benefits are expected to be similar for laparoscopic rectal cancer surgery. However, the oncological safety of laparoscopic surgery for rectal cancer remained controversial due to the lack of definitive long-term results. Thus, the expected short-term benefits can only be of interest when oncological results are at least equal. To evaluate the differences in short- and long-term results after elective laparoscopic total mesorectal excision (LTME) for the resection of rectal cancer compared with open total mesorectal excision (OTME). We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2013, Issue 2), MEDLINE (January 1990 to February 2013), EMBASE (January 1990 to February 2013), ClinicalTrials.gov (February 2013) and Current Controlled Trials (February 2013). We handsearched the reference lists of the included articles for missed studies. Only randomised controlled trials (RCTs) comparing LTME and OTME, reporting at least one of our outcome measures, was considered for inclusion. Two authors independently assessed study quality according to the CONSORT statement, and resolved disagreements by discussion. We rated the quality of the evidence using GRADE methods. We identified 45 references out of 953 search results, of which 14 studies met the inclusion criteria involving 3528 rectal cancer patients. We did not consider the risk of bias of the included studies to have impacted on the quality of the evidence. Data were analysed according to an intention-to-treat principle with a mean conversion rate of 14.5% (range 0% to 35%) in the laparoscopic group.There was moderate quality evidence that laparoscopic and open TME had similar

  16. Gait as evidence

    DEFF Research Database (Denmark)

    Lynnerup, Niels; Larsen, Peter Kastmand

    2014-01-01

    This study examines what in Denmark may constitute evidence based on forensic anthropological gait analyses, in the sense of pointing to a match (or not) between a perpetrator and a suspect, based on video and photographic imagery. Gait and anthropometric measures can be used when direct facial...

  17. Evidence-based policy

    DEFF Research Database (Denmark)

    Vohnsen, Nina Holm

    2013-01-01

    -makers and the research community (e.g. Boden & Epstein 2006; House of Commons 2006; Cartwright et al 2009; Rod 2010; Vohnsen 2011). This article intends to draw out some general pitfalls in the curious meeting of science and politics by focusing on a particular attempt to make evidence-based legislation in Denmark (for...

  18. Turning Evidence into Practice

    Science.gov (United States)

    CGH CRTA, Hillary Topazian, attended the National Cancer Institute’s 3rd Symposium on Global Cancer Research; a satellite meeting to the 6th Annual Consortium of Universities for Global Health (CUGH) Conference in Boston. The Symposium centered on the theme of implementation science, a field which studies the integration of research findings and evidence into healthcare policy and practice.

  19. Evidence of Absence software

    Science.gov (United States)

    Dalthorp, Daniel; Huso, Manuela M. P.; Dail, David; Kenyon, Jessica

    2014-01-01

    Evidence of Absence software (EoA) is a user-friendly application used for estimating bird and bat fatalities at wind farms and designing search protocols. The software is particularly useful in addressing whether the number of fatalities has exceeded a given threshold and what search parameters are needed to give assurance that thresholds were not exceeded. The software is applicable even when zero carcasses have been found in searches. Depending on the effectiveness of the searches, such an absence of evidence of mortality may or may not be strong evidence that few fatalities occurred. Under a search protocol in which carcasses are detected with nearly 100 percent certainty, finding zero carcasses would be convincing evidence that overall mortality rate was near zero. By contrast, with a less effective search protocol with low probability of detecting a carcass, finding zero carcasses does not rule out the possibility that large numbers of animals were killed but not detected in the searches. EoA uses information about the search process and scavenging rates to estimate detection probabilities to determine a maximum credible number of fatalities, even when zero or few carcasses are observed.

  20. Fossil wood evidences

    Indian Academy of Sciences (India)

    Climate has played a crucial role in assigning a different kind of topography to Rajasthan and Gujarat since the Cenozoic time. Evidently, three genera, namely, Dipterocarpus Gaert. f., Hopea Roxb. And Shorea Roxb. of the Dipterocarpaceae are described from the Neogene sediments of western India (Rajasthan and ...

  1. Nucleus-nucleus total reaction cross sections

    International Nuclear Information System (INIS)

    DeVries, R.M.; Peng, J.C.

    1980-01-01

    We compare sigma/sub R/(E) for nucleus-nucleus systems (obtained from existing direct measurements and derived from elastic scattering data) with nucleon-nucleon and nucleon-nucleus data. The energy dependence of sigma/sub R/(E) for nucleus-nucleus systems is found to be quite rapid; there appears to be no evidence for an energy independent, geometric sigma/sub R/. Simple parameter free microscopic calculations are able to quantitatively reproduce the data and thus, emphasize the dominance of nucleon-nucleon interactions in medium energy nucleus-nucleus collisions

  2. Inestabilidad de la Artroplastia Total de Cadera

    OpenAIRE

    Ezquerra Herrando, Laura; Albareda Albareda, Jorge; Seral García, Belén

    2014-01-01

    INTRODUCCIÓN La artroplastia total de cadera (ATC) es un procedimiento muy frecuente en los Servicios de Cirugía Ortopédica y Traumatología, y aunque su efectividad es muy elevada, no está exenta de complicaciones como son el aflojamiento aséptico, luxaciones, infección y fracturas periprotésicas. A pesar de los avances en las técnicas y modelos protésicos, la luxación sigue siendo la segunda complicación más frecuente después del aflojamiento aséptico en las artroplastias totales de cadera. ...

  3. A Modern Approach to Total Wellbeing

    Science.gov (United States)

    Hadzic, Maja; Chen, Meifania; Brouwer, Rick; Dillon, Tharam

    The events of the last decades have impacted our lives and our health significantly. We expected that the technology boom will improve our lives. While this may be true in a specific context, generally speaking our societies are suffering from moral decays, terrorism fears, wars, financial crisis and unpredictable acts of nature that are increasing in frequency and in intensity. The complex nature of the world we live is impacting our health and wellbeing considerably. Our health is not only determined by our physical health but is the end product of the interplay of the physical, mental, emotional, financial, relational and spiritual events of a lifetime. In this paper we develop a framework that will help us define and measure total wellbeing of individuals in our volatile societies. This framework will help us better understand the complex nature of total wellbeing and develop effective prevention and intervention strategies.

  4. Quality Indicators for the Total Testing Process.

    Science.gov (United States)

    Plebani, Mario; Sciacovelli, Laura; Aita, Ada

    2017-03-01

    ISO 15189:2012 requires the use of quality indicators (QIs) to monitor and evaluate all steps of the total testing process, but several difficulties dissuade laboratories from effective and continuous use of QIs in routine practice. An International Federation of Clinical Chemistry and Laboratory Medicine working group addressed this problem and implemented a project to develop a model of QIs to be used in clinical laboratories worldwide to monitor and evaluate all steps of the total testing process, and decrease error rates and improve patient services in laboratory testing. All laboratories are invited, at no cost, to enroll in the project and contribute to harmonized management at the international level. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Total gastrectomy for non-neoplastic diseases

    DEFF Research Database (Denmark)

    Bjorn, Niels; Ainsworth, Alan Patrick; Mortensen, Michael Bau

    2017-01-01

    Background: The aim of this study was to describe patients who had total gastrectomy for non-neoplastic diseases within a well-defined geographical area. Material and Methods: Retrospective study of patients who had gastrectomy for a non-neoplastic disease at the Department of Surgery, Odense...... University Hospital from 1 January 2005 to 31 December 2014. Results: A total of 268 gastrectomies were performed with the 10-year period. Of these, ten (4%) were done for non-neoplastic diseases. Two were men and eight women with a median age of 51 years (range 31 to 96 years). Six had emergency surgery...... of 10 and 2 of 10, respectively. Histology of the resected specimens showed: Oedema, inflammation and/or necrosis (n=6), Menetrier's disease (n=2) and perforation (n=2). Conclusions: Gastrectomy for non-neoplastic diseases accounts for less than 5% of all gastrectomies. The majority of these cases...

  6. Atomic resonances above the total ionization energy

    International Nuclear Information System (INIS)

    Doolen, G.

    1975-01-01

    A rigorous result obtained using the theory associated with dilatation analytic potentials is that by performing a complex coordinate rotation, r/subj/ → r/subj/e/subi//sup theta/, on a Hamiltonian whose potential involves only pairwise Coulombic interactions, one can show that when theta = π/2, no complex eigenvalues (resonances) appear whose energies have a real part greater than the total ionization energy of the atomic system. This appears to conflict with experimental results of Walton, Peart, and Dolder, who find resonance behavior above the total ionization energy of the H -- system and also the theoretical stabilization results of Taylor and Thomas for the same system. A possible resolution of this apparent conflict is discussed and a calculation to check its validity is proposed

  7. Total: overview of the 2002 financial year

    International Nuclear Information System (INIS)

    Anon.

    2003-01-01

    In a globally less favourable environment than 2001, Total company (the former 'TotalFinaElf') succeeded in limiting the decay of its results thanks to the increase of its hydrocarbons production which reached the record level of 10% and to the implementation of its synergy and productivity programs. The three activity sectors of the group are: the upstream (exploration, production of hydrocarbons, gas electric power and other energies), the downstream (refining, distribution of petroleum products, special products, trading and shipping of crudes and products), and the chemistry (basic chemistry and big polymers, intermediate and performance polymers, special products). This article details the 2002 results of the group for the three sectors: upstream (exploration and development, reserves, production, natural gas sales), gas and electric power integration (Europe, Americas, Asia), electric power and cogeneration. (J.S.)

  8. Asymptotic Behaviour of Total Generalised Variation

    KAUST Repository

    Papafitsoros, Konstantinos; Valkonen, Tuomo

    2015-01-01

    © Springer International Publishing Switzerland 2015. The recently introduced second order total generalised variation functional TGV2 β,α has been a successful regulariser for image processing purposes. Its definition involves two positive parameters α and β whose values determine the amount and the quality of the regularisation. In this paper we report on the behaviour of TGV2 β,α in the cases where the parameters α, β as well as their ratio β/α becomes very large or very small. Among others, we prove that for sufficiently symmetric two dimensional data and large ratio β/α, TGV2 β,α regularisation coincides with total variation (TV) regularization

  9. Total quality management of cobalt-60 sources

    International Nuclear Information System (INIS)

    Malkoske, G.R.

    1999-01-01

    Total Quality Management of Cobalt-60 sources by a supplier requires a life cycle approach to source management. This covers various aspects, including design, manufacturing, installation, field inspection, source surveillance and return of cobalt-60 sources at the end of their useful life. The Total Quality Management approach demonstrates a strong industry commitment to the beneficial use of gamma technology for industrial irradiation applications in both developed nations and in those nations who are developing their infrastructure and techniques for the beneficial use of this technology. MDS Nordion continues to demonstrate its support and commitment to the industry by developing and implementing state-of-the-art standards for the safe use of cobalt-60 sources

  10. Total variation-based neutron computed tomography

    Science.gov (United States)

    Barnard, Richard C.; Bilheux, Hassina; Toops, Todd; Nafziger, Eric; Finney, Charles; Splitter, Derek; Archibald, Rick

    2018-05-01

    We perform the neutron computed tomography reconstruction problem via an inverse problem formulation with a total variation penalty. In the case of highly under-resolved angular measurements, the total variation penalty suppresses high-frequency artifacts which appear in filtered back projections. In order to efficiently compute solutions for this problem, we implement a variation of the split Bregman algorithm; due to the error-forgetting nature of the algorithm, the computational cost of updating can be significantly reduced via very inexact approximate linear solvers. We present the effectiveness of the algorithm in the significantly low-angular sampling case using synthetic test problems as well as data obtained from a high flux neutron source. The algorithm removes artifacts and can even roughly capture small features when an extremely low number of angles are used.

  11. Increasing productivity through Total Reuse Management (TRM)

    Science.gov (United States)

    Schuler, M. P.

    1991-01-01

    Total Reuse Management (TRM) is a new concept currently being promoted by the NASA Langley Software Engineering and Ada Lab (SEAL). It uses concepts similar to those promoted in Total Quality Management (TQM). Both technical and management personnel are continually encouraged to think in terms of reuse. Reuse is not something that is aimed for after a product is completed, but rather it is built into the product from inception through development. Lowering software development costs, reducing risk, and increasing code reliability are the more prominent goals of TRM. Procedures and methods used to adopt and apply TRM are described. Reuse is frequently thought of as only being applicable to code. However, reuse can apply to all products and all phases of the software life cycle. These products include management and quality assurance plans, designs, and testing procedures. Specific examples of successfully reused products are given and future goals are discussed.

  12. An unusual case of total ophthalmoplegia

    Directory of Open Access Journals (Sweden)

    Chowdhury Ravindra

    2009-01-01

    Full Text Available An eight-year-old male child presented with drooping of the left eyelid with a history of penetrating injury of hard palate by an iron spoon seven days ago, which had already been removed by the neurosurgeon as the computed tomography scan revealed a spoon in the left posterior ethmoid and sphenoid bone penetrating into the middle cranial fossa. On examination, visual acuity was 20/20 in each eye and left eye showed total ophthalmoplegia. Oral cavity revealed a hole in the left lateral part of the hard palate. We managed the case with tapering dose of systemic prednisolone. The total ophthalmoplegia was markedly improved in one month. Cases of foreign bodies in the orbit with intracranial extension are not unusual, but the path this foreign body traveled through the hard palate without affecting the optic nerve, internal carotid artery or cavernous sinus makes an interesting variation.

  13. Implantation of total body irradiation in radiotherapy

    International Nuclear Information System (INIS)

    Habitzreuter, Angela Beatriz

    2010-01-01

    Before implementing a treatment technique, the characteristics of the beam under irradiation conditions must be well acknowledged and studied. Each one of the parameters used to calculate the dose has to be measured and validated before its utilization in clinical practice. This is particularly necessary when dealing with special techniques. In this work, all necessary parameters and measurements are described for the total body irradiation implementation in facilities designed for conventional treatments that make use of unconventional geometries to generate desired enlarged field sizes. Furthermore, this work presents commissioning data of this modality at Hospital das Clinicas of Sao Paulo using comparison of three detectors types for measurements of entrance dose during total body irradiation treatment. (author)

  14. Overview of Total Group financial year

    International Nuclear Information System (INIS)

    Anon.

    2003-01-01

    In 2004, the combination of very high crude oil prices with a strong rise of refining margins, and in the second half of 2004 of the start off again of the rise of petrochemical margins, has led Total Group to reach a record level of 9.04 billion euros for its net adjusted result, which represents a 23% rise with respect to 2003, and this despite a fall of the Dollar exchange rate. Total has also carried on its downstream strategy of natural gas production. This strategy aims at facilitating and optimizing the access to its present day and future productions and reserves, not only to traditional markets but also to markets opened to world competition. (J.S.)

  15. Total quality management in hotel industry

    OpenAIRE

    Mitreva, Elizabeta; Saneva, Dusica; Miteva, Natasa

    2017-01-01

    Total quality management (TQM) is a systematic management approach aiming at continuous increase of the value offered to consumers through improvement of service quality. In hotel industry, success is achieved through service quality, which stands as a key factor for sustainability in the twenty-first century. Nowadays, quality is the basic factor for survival on the market, better competition, and greater profitability. TQM is a process that starts and ends with the consumer. The aim of this...

  16. Total Quality Management. A Selected Bibliography

    Science.gov (United States)

    1994-03-01

    and Publow, Mark. "Understanding and Managing Authority Relationships : Guidelines for Supervisors and Sub- ordinates." QUALITY PROGRESS, Vol. 25...NEXT OPERATION AS CUSTOMER (NOAC): HOW TO IMPROVE QUALITY, COST AND CYCLE TIME IN SERVICE OPERATIONS. New York: American Management Association, 1991...Keith. HORIZONTAL MANAGEMENT : BEYOND TOTAL CUSTOMER SATISFACTION. New York: Lexington Books, 1991. 211pp. (HD66 D45 1991) Donnelly, James H., Jr. CLOSE

  17. Changing trends in total knee replacement

    OpenAIRE

    Goudie, Ewan; Robinson, Cal; Walmsley, Phil; Brenkel, Ivan

    2017-01-01

    Introduction:  This study evaluates a possible change in the demographics and surgical practice observed in a large cohort of patients undergoing total knee replacement (TKR). Patients and methods:  We performed a retrospective analysis of a prospectively collected data on two groups of consecutive patients undergoing primary TKR. Group one consisted of patients who underwent surgery between 1994 and 1998. Group two consisted of patients who had surgery between 2009 and 2012. Results:  The me...

  18. Total Quality Management (TQM): Group Dynamics Workshop

    Science.gov (United States)

    1990-05-15

    take for these changes to penetrate most OSD agencies. - The unique organizational culture, structure, and functioning of OSD (i.e., a gigantic size...Performing (group problem solving; Performing diagnosing and solving quality problems and sele2cting and implementing solutions). Total Quality Management...Stage, the quality improvement group diagnoses the quality problem/opportunity, gathers the right kind of quantitative data, and formulates, selects, and

  19. Total dissociation cross section of halo nuclei

    Energy Technology Data Exchange (ETDEWEB)

    Formanek, J. [Karlova Univ., Prague (Czech Republic). Fakulta Matematicko-Fyzikalni; Lombard, R.J. [Paris-11 Univ., 91 - Orsay (France). Inst. de Physique Nucleaire

    1996-10-01

    Calculations of the total dissociation cross section is performed in the impact parameter representation. The case of {sup 11}Be and {sup 11}Li loosing one and two neutron(s), respectively, by collision on a {sup 12}C target, which remains in its ground state are discussed. The results are found to depend essentially on the rms radius of the halo wave function. (author). 12 refs.

  20. The First Total Synthesis of Dragmacidin D

    OpenAIRE

    Garg, Neil K.; Sarpong, Richmond; Stoltz, Brian M.

    2002-01-01

    The first total synthesis of the biologically significant bis-indole alkaloid dragmacidin D (5) has been achieved. Thermal and electronic modulation provides the key for a series of palladium-catalyzed Suzuki cross-coupling reactions that furnished the core structure of the complex guanidine- and aminoimidazole-containing dragmacidins. Following this crucial sequence, a succession of meticulously controlled final events was developed leading to the completion of the natural product.

  1. Counterterrorism and cybersecurity total information awareness

    CERN Document Server

    Lee, Newton

    2013-01-01

    Provides a broad survey of the United States' counterterrorism history, the use of artificial intelligence in data mining, social media and privacy, cyber attacks and prevention, and longstanding issues of war and peace Closely examines how Total Information Awareness, a governmental data mining project focused on scanning public and private data, plays an integral role in cybersecurity Analyzes recent cyberattacks across the globe orchestrated by 'hacktivist' groups, such as Anonymous

  2. Heisenberg rise of total cross sections

    International Nuclear Information System (INIS)

    Ezhela, V.V.; Yushchenko, O.P.

    1988-01-01

    It is shown that on the basis of the original idea of Heisenberg on the quasiclassical picture of extended particle interactions one can construct a satisfactory description of the total cross sections, elastic cross sections, elastic diffractive slopes and mean charged multiplicities in the cm energy range from 5 to 900 GeV, and produce reasonable extrapolations up to several tens of TeV. 14 refs.; 7 figs.; 2 tabs

  3. Total elbow arthroplasty: a radiographic outcome study

    Energy Technology Data Exchange (ETDEWEB)

    Bai, Xue Susan [University of Washington, Department of Radiology, Box 357115, Seattle, WA (United States); Petscavage-Thomas, Jonelle M. [Penn State Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Ha, Alice S. [University of Washington, Department of Radiology, Box 354755, Seattle, WA (United States)

    2016-06-15

    Total elbow arthroplasty (TEA) is becoming a popular alternative to arthrodesis for patients with end-stage elbow arthrosis and comminuted distal humeral fractures. Prior outcome studies have primarily focused on surgical findings. Our purpose is to determine the radiographic outcome of TEA and to correlate with clinical symptoms such as pain. This is an IRB-approved retrospective review from 2005 to 2015 of all patients with semiconstrained TEA. All available elbow radiographs and clinical data were reviewed. Data analysis included descriptive statistics and Kaplan-Meier survival curves for radiographic and clinical survival. A total of 104 total elbow arthroplasties in 102 patients were reviewed; 75 % were in women and the mean patient age was 63.1 years. Mean radiographic follow-up was 826 days with average of four radiographs per patient. Seventy TEAs (67 %) developed radiographic complications, including heterotopic ossification (48 %), perihardware lucency (27 %), periprosthetic fracture (23 %), hardware subluxation/dislocation (7 %), polyethylene wear (3 %), and hardware fracture/dislodgement (3 %); 56 patients (55 %) developed symptoms of elbow pain or instability and 30 patients (30 %) underwent at least one reoperation. In patients with radiographic complications, 66 % developed elbow pain, compared to 19 % of patients with no radiologic complications (p = 0.001). Of the patients with radiographic complications, 39 % had at least one additional surgery compared to 0 % of patients without radiographic complications (p = 0.056). Radiographic complications are common in patients after total elbow arthroplasty. There is a strong positive association between post-operative radiographic findings and clinical outcome. Knowledge of common postoperative radiographic findings is important for the practicing radiologist. (orig.)

  4. NASA total quality management 1990 accomplishments report

    Science.gov (United States)

    1991-01-01

    NASA's efforts in Total Quality Management are based on continuous improvement and serve as a foundation for NASA's present and future endeavors. Given here are numerous examples of quality strategies that have proven effective and efficient in a time when cost reduction is critical. These accomplishment benefit our Agency and help to achieve our primary goal, keeping American in the forefront of the aerospace industry.

  5. Apparatus for measuring total flow in pipes

    International Nuclear Information System (INIS)

    Matthews, H.

    1986-01-01

    To obtain a sample representative of the total flow in a pipe over a given period a Pitot tube is located in the pipe and connected to a collector outside the pipe. The collector is pressurised to a pressure substantially equal to the static head of the flow in the pipe via a line. Liquid is discharged from a collector to a container which is vented to atmosphere. (author)

  6. Total evaporation in thermal ionization mass spectrometry

    International Nuclear Information System (INIS)

    Callis, E.L.; Cappis, J.H.

    1996-01-01

    Experiments were conducted to assess the effects of impurities on the total evaporation method for mass spectrometric measurement of the isotope ratio of uranium. Standard samples were spiked with Na, Ca, Fe, Zr and Ba. The results indicated that only Fe, and possible Na, displayed any interference, and then only at high concentrations. One problem limiting the accuracy of the method is the determination of the relative efficiency of the collectors in the multicollector system. 3 refs., 1 tab

  7. Total fact-book 2000-2005

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    TOTAL S.A., a French society incorporated in France on March 28, 1924, together with its subsidiaries and affiliates, is the fourth largest publicly-traded integrated oil and gas company in the world. This document provides statistical data and information on the corporate (highlights, statements), upstream (production, costs,main producing fields, drilling), upstream maps, downstream (refining, distillation, retail gasoline outlets) and chemicals (sales, specialities). (A.L.B.)

  8. Total fact-book 2000-2005

    International Nuclear Information System (INIS)

    2005-01-01

    TOTAL S.A., a French society incorporated in France on March 28, 1924, together with its subsidiaries and affiliates, is the fourth largest publicly-traded integrated oil and gas company in the world. This document provides statistical data and information on the corporate (highlights, statements), upstream (production, costs,main producing fields, drilling), upstream maps, downstream (refining, distillation, retail gasoline outlets) and chemicals (sales, specialities). (A.L.B.)

  9. Calidad total: fuente de ventaja competitiva

    OpenAIRE

    Tarí, Juan-José

    2000-01-01

    El objeto de este trabajo es analizar la dirección de la calidad estudiando sus pilares básicos como son, la planificación, organización y control por un lado y los aspectos humanos por otro, centrándonos en sus dos elementos clave para desarrollar la calidad total: el liderazgo y la involucración de todos los empleados.

  10. Total synthesis of (+)-antroquinonol and (+)-antroquinonol D.

    Science.gov (United States)

    Sulake, Rohidas S; Chen, Chinpiao

    2015-03-06

    The first total synthesis of (+)-antroquinonol and (+)-antroquinonol D, two structurally unique quinonols with a sesquiterpene side chain, is described. The route features an iridium-catalyzed olefin isomerization-Claisen rearrangement reaction (ICR), lactonization, and Grubbs olefin metathesis. The requisite α,β-unsaturation was achieved via the selenylation/oxidation protocol and elimination of β-methoxy group to provide two natural products from a common intermediate.

  11. Multi sensor reanalysis of total ozone

    Directory of Open Access Journals (Sweden)

    R. J. van der A

    2010-11-01

    Full Text Available A single coherent total ozone dataset, called the Multi Sensor Reanalysis (MSR, has been created from all available ozone column data measured by polar orbiting satellites in the near-ultraviolet Huggins band in the last thirty years. Fourteen total ozone satellite retrieval datasets from the instruments TOMS (on the satellites Nimbus-7 and Earth Probe, SBUV (Nimbus-7, NOAA-9, NOAA-11 and NOAA-16, GOME (ERS-2, SCIAMACHY (Envisat, OMI (EOS-Aura, and GOME-2 (Metop-A have been used in the MSR. As first step a bias correction scheme is applied to all satellite observations, based on independent ground-based total ozone data from the World Ozone and Ultraviolet Data Center. The correction is a function of solar zenith angle, viewing angle, time (trend, and effective ozone temperature. As second step data assimilation was applied to create a global dataset of total ozone analyses. The data assimilation method is a sub-optimal implementation of the Kalman filter technique, and is based on a chemical transport model driven by ECMWF meteorological fields. The chemical transport model provides a detailed description of (stratospheric transport and uses parameterisations for gas-phase and ozone hole chemistry. The MSR dataset results from a 30-year data assimilation run with the 14 corrected satellite datasets as input, and is available on a grid of 1× 1 1/2° with a sample frequency of 6 h for the complete time period (1978–2008. The Observation-minus-Analysis (OmA statistics show that the bias of the MSR analyses is less than 1% with an RMS standard deviation of about 2% as compared to the corrected satellite observations used.

  12. TOTAL QUALITY MANAGEMENT AND CONTEMPORARY HOTEL INDUSTRY

    OpenAIRE

    Ivica Batinić

    2013-01-01

    Strong competition in the market has caused the development of a new management approach known as Total Quality Management (TQM). Due to importance that quality plays in achieving competitive advantage, the hotel industry started to apply TQM. During the introduction of these systems, hotel companies may use different approaches to suit their own buseiness requirements. In doing so, 'TQM standards' can be used, or various international standards and models of business ...

  13. LTDNA Evidence on Trial

    Directory of Open Access Journals (Sweden)

    Paul Roberts

    2016-10-01

    Full Text Available Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. Section 1 addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1 expert competence; (2 disciplinary domain; (3 methodological validity; (4 materiality; and (5 legal admissibility. This generic model of expert authority, highlighting law’s fundamentally normative character, applies to all modern forms of criminal adjudication, across Europe and farther afield. Section 2 then examines English and Northern Irish courts’ attempts to get to grips with LTDNA evidence in recent cases. Better appreciating the ways in which UK courts have addressed the challenges of LTDNA evidence may offer some insights into parallel developments in other legal systems. Appellate court rulings follow a predictable judicial logic, which might usefully be studied and reflected upon by any forensic scientist or statistician seeking to operate effectively in criminal proceedings. Whilst each legal jurisdiction has its own unique blend of jurisprudence, institutions, cultures and historical traditions, there is considerable scope for comparative analysis and cross-jurisdictional borrowing and instruction. In the spirit of promoting more nuanced and sophisticated international interdisciplinary dialogue, this article examines UK judicial approaches to LTDNA evidence and begins to elucidate their underlying institutional logic. Legal argument and broader policy debates are not confined to considerations of scientific validity, contamination risks and evidential integrity, or associated judgments of legal admissibility or exclusion. They also crucially concern the manner in which LTDNA profiling results are presented and explained to

  14. Climate Change and Tropical Total Lightning

    Science.gov (United States)

    Albrecht, R.; Petersen, W.; Buechler, D.; Goodman, S.; Blakeslee, R.; Christian, H.

    2009-01-01

    While global warming is regarded as a fact by many in the scientific community, its future impact remains a challenge to be determined and measured. The International Panel on Climate Change (IPCC) assessment report (IPCC, 2007) shows inconclusive answers on global rainfall trends and general agreement on a future drier climate with increased global warming. The relationship between temperature, humidity and convection is not linear and is strongly dependent on regional scale features, such as topography and land cover. Furthermore, the relationship between convective lightning production (thunderstorms) and temperature is even more complicated, being subjected to the cloud dynamics and microphysics. Total lightning (intracloud and cloud-to-ground) monitoring is a relatively new field of observation. Global and tropical total lightning began to be more extensively measured by satellites in the mid 90s. In this scope, the Lightning Imaging Sensor (LIS) onboard of the Tropical Rainfall Measurement Mission (TRMM) has been operational for over 11 years. Here we address total lightning trends observed by LIS from 1998 to 2008 in different temporal (annual and seasonal) and spatial (large and regional) scales. The observed 11-year trends are then associate to different predicted/hypothesized climate change scenarios.

  15. Total generating costs: coal and nuclear plants

    International Nuclear Information System (INIS)

    1979-02-01

    The study was confined to single and multi-unit coal- and nuclear-fueled electric-generating stations. The stations are composed of 1200-MWe PWRs; 1200-MWe BWRs; 800-and 1200-MWe High-Sulfur Coal units, and 800- and 1200-MWe Low-Sulfur Coal units. The total generating cost estimates were developed for commercial operation dates of 1985 and 1990; for 5 and 8% escalation rates, for 10 and 12% discount rates; and, for capacity factors of 50, 60, 70, and 80%. The report describes the methodology for obtaining annualized capital costs, levelized coal and nuclear fuel costs, levelized operation and maintenance costs, and the resulting total generating costs for each type of station. The costs are applicable to a hypothetical Middletwon site in the Northeastern United States. Plant descriptions with general design parameters are included. The report also reprints for convenience, summaries of capital cost by account type developed in the previous commercial electric-power cost studies. Appropriate references are given for additional detailed information. Sufficient detail is given to allow the reader to develop total generating costs for other cases or conditions

  16. Total Variation Depth for Functional Data

    KAUST Repository

    Huang, Huang

    2016-11-15

    There has been extensive work on data depth-based methods for robust multivariate data analysis. Recent developments have moved to infinite-dimensional objects such as functional data. In this work, we propose a new notion of depth, the total variation depth, for functional data. As a measure of depth, its properties are studied theoretically, and the associated outlier detection performance is investigated through simulations. Compared to magnitude outliers, shape outliers are often masked among the rest of samples and harder to identify. We show that the proposed total variation depth has many desirable features and is well suited for outlier detection. In particular, we propose to decompose the total variation depth into two components that are associated with shape and magnitude outlyingness, respectively. This decomposition allows us to develop an effective procedure for outlier detection and useful visualization tools, while naturally accounting for the correlation in functional data. Finally, the proposed methodology is demonstrated using real datasets of curves, images, and video frames.

  17. Total quality in spent fuel pool reracking

    International Nuclear Information System (INIS)

    Cranston, J.S.; Bradbury, R.B.; Cacciapouti, R.J.

    1993-01-01

    The nuclear utility environment is one of strict cost control under prescriptive regulations and increasing public scrutiny. This paper presents the results of A Total Quality approach, by a dedicated team, that addresses the need for increased on-site spent fuel storage in this environment. Innovations to spent fuel pool reracking, driven by utilities' specific technical needs and shrinking budgets, have resulted in both product improvements and lower prices. A Total Quality approach to the entire turnkey project is taken, thereby creating synergism and process efficiency in each of the major phases of the project: design and analysis, licensing, fabrication, installation and disposal. Specific technical advances and the proven quality of the team members minimizes risk to the utility and its shareholders and provides a complete, cost effective service. Proper evaluation of spent fuel storage methods and vendors requires a full understanding of currently available customer driven initiatives that reduce cost while improving quality. In all phases of a spent fuel reracking project, from new rack design and analysis through old rack disposal, the integration of diverse experts, at all levels and throughout all phases of a reracking project, better serves utility needs. This Total Quality environment in conjunction with many technical improvements results in a higher quality product at a lower cost

  18. Liver failure in total artificial heart therapy.

    Science.gov (United States)

    Dimitriou, Alexandros Merkourios; Dapunt, Otto; Knez, Igor; Wasler, Andrae; Oberwalder, Peter; Koerfer, Reiner; Tenderich, Gero; Spiliopoulos, Sotirios

    2016-07-01

    Congestive hepatopathy (CH) and acute liver failure (ALF) are common among biventricular heart failure patients. We sought to evaluate the impact of total artificial heart (TAH) therapy on hepatic function and associated clinical outcomes. A total of 31 patients received a Syncardia Total Artificial Heart. Preoperatively 17 patients exhibited normal liver function or mild hepatic derangements that were clinically insignificant and did not qualify as acute or chronic liver failure, 5 patients exhibited ALF and 9 various hepatic derangements owing to CH. Liver associated mortality and postoperative course of liver values were prospectively documented and retrospectively analyzed. Liver associated mortality in normal liver function, ALF and CH cases was 0%, 20% (P=0.03) and 44.4% (P=0.0008) respectively. 1/17 (5.8%) patients with a normal liver function developed an ALF, 4/5 (80%) patients with an ALF experienced a markedly improvement of hepatic function and 6/9 (66.6%) patients with CH a significant deterioration. TAH therapy results in recovery of hepatic function in ALF cases. Patients with CH prior to surgery form a high risk group with increased liver associated mortality.

  19. The error in total error reduction.

    Science.gov (United States)

    Witnauer, James E; Urcelay, Gonzalo P; Miller, Ralph R

    2014-02-01

    Most models of human and animal learning assume that learning is proportional to the discrepancy between a delivered outcome and the outcome predicted by all cues present during that trial (i.e., total error across a stimulus compound). This total error reduction (TER) view has been implemented in connectionist and artificial neural network models to describe the conditions under which weights between units change. Electrophysiological work has revealed that the activity of dopamine neurons is correlated with the total error signal in models of reward learning. Similar neural mechanisms presumably support fear conditioning, human contingency learning, and other types of learning. Using a computational modeling approach, we compared several TER models of associative learning to an alternative model that rejects the TER assumption in favor of local error reduction (LER), which assumes that learning about each cue is proportional to the discrepancy between the delivered outcome and the outcome predicted by that specific cue on that trial. The LER model provided a better fit to the reviewed data than the TER models. Given the superiority of the LER model with the present data sets, acceptance of TER should be tempered. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Total neutron cross section for 181Ta

    Directory of Open Access Journals (Sweden)

    Schilling K.-D.

    2010-10-01

    Full Text Available The neutron time of flight facility nELBE, produces fast neutrons in the energy range from 0.1 MeV to 10 MeV by impinging a pulsed relativistic electron beam on a liquid lead circuit [1]. The short beam pulses (∼10 ps and a small radiator volume give an energy resolution better than 1% at 1 MeV using a short flight path of about 6 m, for neutron TOF measurements. The present neutron source provides 2 ⋅ 104  n/cm2s at the target position using an electron charge of 77 pC and 100 kHz pulse repetition rate. This neutron intensity enables to measure neutron total cross section with a 2%–5% statistical uncertainty within a few days. In February 2008, neutron radiator, plastic detector [2] and data acquisition system were tested by measurements of the neutron total cross section for 181Ta and 27Al. Measurement of 181Ta was chosen because lack of high quality data in an anergy region below 700 keV. The total neutron cross – section for 27Al was measured as a control target, since there exists data for 27Al with high resolution and low statistical error [3].

  1. [Total pollution features of urban runoff outlet for urban river].

    Science.gov (United States)

    Luo, Hong-Bing; Luo, Lin; Huang, Gu; He, Qiang; Liu, Ping

    2009-11-01

    The urban stormwater runoff discharged to urban river, especially to rainfall source river, cannot be ignored. In this study, the Futian River watershed in Shenzhen city in a typical southern city of China is taken as the research object. In order to guide the pollution control for urban river, the eighteen rainfall events were monitored, and the total pollution features of the urban runoff outlet for this urban river were analyzed and discussed by using the process of pollutographs, the identifying to first flush, event mean concentration (EMC), etc. Results show that the concentrations of COD, SS, TN, TP and BOD5 are ten times more than the grade V of the environmental quality standards for surface water during the runoff time; the pollution caused by heavy metals (Cr, Ge, Cu, Hg and As) in runoff at a typical rainfall event is serious; the average and range of pollutant concentration at this runoff outlet in study area are evidently higher than at Shapingba in Chongqing city of China and at Silerwood in Canada, but are lower than at Shilipu in Wuhan city of China. The first flushes of COD, SS, BOD5, especially COD and SS, are evident, but the TN and TP are not. The average EMC of COD, TN, TP and BOD5 are 224.14, 571.15, 5.223, 2.04, 143.5 mg/L, respectively. To some extent, the EMC of COD is about two times of the value of the near cities, Macao and Zhuhai. The EMC of TN and TP are obviously higher than Beijing, Guangzhou and Shanghai. To compared with foreign counties, the EMC of the study area in Shenzhen is obviously much higher than the cities of Korean, USA and Canada. So the total pollution caused by the urban surface runoff in study area is serious and necessary to be treated.

  2. Successful heart transplantation in patients with total artificial heart infections.

    Science.gov (United States)

    Taimur, Sarah; Sullivan, Timothy; Rana, Mennakshi; Patel, Gopi; Roldan, Julie; Ashley, Kimberly; Pinney, Sean; Anyanwu, Anelechi; Huprikar, Shirish

    2018-02-01

    Data are limited on clinical outcomes in patients awaiting heart transplant (HT) with total artificial heart (TAH) infections. We retrospectively reviewed all TAH recipients at our center. TAH infection was classified as definite if a microorganism was isolated in cultures from the exit site or deep tissues around the TAH; as probable in patients without surgical or microbiologic evidence of infection but no other explanation for persistent or recurrent bloodstream infection (BSI); or possible in patients with clinical suspicion and radiographic findings suggestive of TAH infection, but without surgical intervention or microbiologic evidence. From 2012 to 2015, a total of 13 patients received a TAH, with a median age at implantation of 52 years (range: 28-60). TAH infection occurred in nine patients (seven definite, one probable, one possible) a median of 41 days after implant (range: 17-475). The majority of TAH infections were caused by Staphylococcus species. Seven of nine patients underwent HT (four had pre-HT mediastinal washout, and five had positive HT operative cultures). Three patients had an active BSI caused by the same pathogen causing TAH infection at the time of HT, with one developing a post-HT BSI with the same bacteria. No patient developed post-HT surgical site infection caused by the TAH infection pathogen. No deaths among HT recipients were attributed to infection. TAH infection is frequently associated with BSI and mediastinitis and Staphylococcus was the most common pathogen. A multimodal approach of appropriate pre- and post-HT antimicrobial therapy, surgical drainage, and heart transplantation with radical mediastinal debridement was successful in curing infection. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Total body irradiation: current indications; L`irradiation corporelle totale: les indications actuelles

    Energy Technology Data Exchange (ETDEWEB)

    Giraud, P.; Danhier, S.; Dubray, B.; Cosset, J.M. [Institut Curie, 75 - Paris (France)

    1998-05-01

    The choice of dose and fractionation for total body irradiation is made difficult by the large number of considerations to be taken into account. The outcome of bone marrow transplantation after total body irradiation can be understood in terms of tumor cell killing, engraftment, and normal tissue damage, each of these endpoints being influenced by irradiation-, disease-, transplant-, and patient- related factors. Interpretation of clinical data is further hampered by the overwhelming influence of logistic constraints, the small numbers of randomized studies, and the concomitant variations in total dose and fraction size or dose rate. So far, three cautious conclusions can be drawn in order to tentatively adapt the total body irradiation schedule to clinically-relevant situations. Firstly, the organs at risk for normal tissue damage (lung, liver, lens, kidney) are protected by delivering small doses per fraction at low dose rate. This suggests that, when toxicity is at stake (e.g. in children), fractionated irradiation should be preferred, provided that inter-fraction intervals are long enough. Secondly, fractionated irradiation should be avoided in case of T-cell depleted transplant, given the high risk of graft rejection in this setting. An alternative would be to increase total (or fractional) dose of fractionated total body irradiation, but this approach is likely to induce more normal tissue toxicity. Thirdly, clinical data have shown higher relapse rates in chronic myeloid leukemia after fractionated or low dose rate total body irradiation, suggesting that fractionated irradiation should not be recommended, unless total (or fractional) dose is increased. Total body irradiation-containing regimens, primarily cyclophosphamide / total body irradiation, are either equivalent to or better than the chemotherapy-only regimens, primarily busulfan / cyclophosphamide. Busulfan / cyclophosphamide certainly represents a reasonable alternative, especially in patients who

  4. Higher Total Serum Cholesterol Levels Are Associated With Less Severe Strokes and Lower All-Cause Mortality

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Christensen, Rune Haubo Bojesen; Kammersgaard, Lars

    2007-01-01

    Background and Purpose - Evidence of a causal relation between serum cholesterol and stroke is inconsistent. We investigated the relation between total serum cholesterol and both stroke severity and poststroke mortality to test the hypothesis that hyperch....

  5. Outcome of total parathyroidectomy and autotransplantation as treatment of secondary and tertiary hyperparathyroidism in children and adults.

    NARCIS (Netherlands)

    Kievit, A.J.; Tinnemans, J.G.; Idu, M.M.; Groothoff, J.W.; Surachno, S.; Aronson, D.C.

    2010-01-01

    BACKGROUND: Treatment safety and effectiveness of total parathyroidectomy and autotransplantation for secondary and tertiary hyperparathyroidism have been extensively proven in adults; the evidence for children, however, is scarce. Children and adolescents cannot simply be seen as young adults in

  6. Child abduction murder: the impact of forensic evidence on solvability.

    Science.gov (United States)

    Brown, Katherine M; Keppel, Robert D

    2012-03-01

    This study examined 733 child abduction murders (CAMs) occurring from 1968 to 2002 to explore the influence of forensic evidence on case solvability in CAM investigations. It was hypothesized that the presence of forensic evidence connecting the offender to the crime would enhance case solvability in murder investigations of abducted children. This study examined the impact of CAM of different types of forensic evidence and the impact of the summed total of forensic evidence items on case solvability by controlling for victim age, victim race, victim gender, and victim-offender relationship. Time and distance theoretical predictors were also included. Binomial logistic regression models were used to determine whether forensic evidence was a critical solvability factor in murder investigations of abducted children. This research indicated that, while forensic evidence increased case solvability, the impact of forensic evidence on solvability was not as important as other solvability factors examined. © 2011 American Academy of Forensic Sciences.

  7. Fluorogenic membrane overlays to enumerate total coliforms, Escherichia coli, and total Vibrionaceae in shellfish and seawater

    Science.gov (United States)

    Three assays were developed to enumerate total coliforms, Escherichia coli, and total Vibrionaceae in shellfish and other foods and in seawater and other environmental samples. Assays involve membrane overlays of overnight colonies on non-selective agar plates to detect ß-glucuronidase and lysyl am...

  8. Total Radiosynthesis: Thinking outside "the box".

    Science.gov (United States)

    Liang, Steven H; Vasdev, Neil

    2015-09-01

    The logic of total synthesis transformed a stagnant state of medicinal and synthetic organic chemistry when there was a paucity of methods and reagents to synthesize drug molecules and/or natural products. Molecular imaging by positron emission tomography (PET) is now experiencing a renaissance in the way radiopharmaceuticals for molecular imaging are synthesized, however, a paradigm shift is desperately needed in the discovery pipeline to accelerate in vivo imaging studies. A significant challenge in radiochemistry is the limited choice of labeled reagents (or building blocks) available for the synthesis of novel radiopharmaceuticals with the most commonly used short-lived radionuclides carbon-11 ( 11 C; half-life ~20 minutes) and fluorine-18 ( 18 F; half-life ~2 hours). In fact, most drugs cannot be labeled with 11 C or 18 F due to a lack of efficient and diverse radiosynthetic methods. In general, routine radiopharmaceutical production relies on the incorporation of the isotope at the last or penultimate step of synthesis, ideally within one half-life of the radionuclide, to maximize radiochemical yields and specific activities thereby reducing losses due to radioactive decay. Reliance on radiochemistry conducted within the constraints of an automated synthesis unit ("box") has stifled the exploration of multi-step reactions with short-lived radionuclides. Radiopharmaceutical synthesis can be transformed by considering logic of total synthesis to develop novel approaches for 11 C- and 18 F-radiolabeling complex molecules via retrosynthetic analysis and multi-step reactions. As a result of such exploration, new methods, reagents and radiopharmaceuticals for in vivo imaging studies are discovered. A new avenue to develop radiotracers that were previously unattainable due to the lack of efficient radiosynthetic methods is necessary to work towards our ultimate, albeit impossible goal - the concept we term total radiosynthesis - to radiolabel virtually any molecule

  9. Total urogenital sinus mobilization for ambiguous genitalia.

    Science.gov (United States)

    Jesus, Vinicius Menezes; Buriti, Francisco; Lessa, Rodrigo; Toralles, Maria Betânia; Oliveira, Luciana Barros; Barroso, Ubirajara

    2018-04-01

    Genital ambiguity is a very common phenomenon in disorders of sex development (DSD). According to the Chicago Consensus 2006, feminizing genitoplasty, when indicated, should be performed in the most virilized cases (Prader III to V). Advances in the knowledge of genital anatomy in DSD have enabled the development and improvement of various surgical techniques. Mobilization of the urogenital sinus (MUS), first described by Peña, has become incorporated by most surgeons. However, the proximity of the urethral sphincter prompts concern over urinary incontinence, especially for full mobilization of the urogenital sinus. To retrospectively evaluate the short-term surgical results of feminizing genitoplasty with total mobilization of the urogenital sinus in patients with DSD. Review of medical records of all patients undergoing feminizing genitoplasty with mobilization of the urogenital sinus. We evaluated the rates of complications from surgery and of urinary incontinence, as well as cosmetic results, according to the opinion of the surgeon and the family. A total of 8 patients were included in the study. The mean age at surgery was 51months. Congenital adrenal hyperplasia (CAH) was diagnosed in six patients, and gonadal dysgenesis in the other two. The vagina was separated from the urethra, with suitable distance in all cases. No patient had urinary incontinence after surgery. The mean follow-up of patients was. 20months (3-56months). In all cases, surgeons recorded being satisfied with the aesthetic result of post-surgical genitalia. The family was recorded as satisfied with the aesthetic result of the genitalia after surgery. In every case, there was no need for a second surgical procedure. The total mobilization of the urogenital sinus is a feasible and safe technique. The technique permits good cosmetic results, and urinary incontinence is absent. Therapeutic study. Level III. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Assessment of total efficiency in adiabatic engines

    Science.gov (United States)

    Mitianiec, W.

    2016-09-01

    The paper presents influence of ceramic coating in all surfaces of the combustion chamber of SI four-stroke engine on working parameters mainly on heat balance and total efficiency. Three cases of engine were considered: standard without ceramic coating, fully adiabatic combustion chamber and engine with different thickness of ceramic coating. Consideration of adiabatic or semi-adiabatic engine was connected with mathematical modelling of heat transfer from the cylinder gas to the cooling medium. This model takes into account changeable convection coefficient based on the experimental formulas of Woschni, heat conductivity of multi-layer walls and also small effect of radiation in SI engines. The simulation model was elaborated with full heat transfer to the cooling medium and unsteady gas flow in the engine intake and exhaust systems. The computer program taking into account 0D model of engine processes in the cylinder and 1D model of gas flow was elaborated for determination of many basic engine thermodynamic parameters for Suzuki DR-Z400S 400 cc SI engine. The paper presents calculation results of influence of the ceramic coating thickness on indicated pressure, specific fuel consumption, cooling and exhaust heat losses. Next it were presented comparisons of effective power, heat losses in the cooling and exhaust systems, total efficiency in function of engine rotational speed and also comparison of temperature inside the cylinder for standard, semi-adiabatic and full adiabatic engine. On the basis of the achieved results it was found higher total efficiency of adiabatic engines at 2500 rpm from 27% for standard engine to 37% for full adiabatic engine.

  11. Evidence on acne therapy

    Directory of Open Access Journals (Sweden)

    Caroline Sousa Costa

    Full Text Available Among the current treatments available for acne vulgaris, many widely practiced options lack support from studies at the best level of scientific evidence. The aim of this narrative review was to present the very latest information on topical and systemic treatments for acne vulgaris. Information from systematic reviews and well-designed clinical trials, obtained through a systematic search of the major medical databases, is emphasized. There are important issues regarding the clinical management of acne that still lack consistent grounding in scientific evidence. Among these are the optimum dose and duration of treatment with oral antibiotics that can be given without inducing bacterial resistance, and the safety of oral isotretinoin.

  12. Total internal reflection tomography of small objects

    International Nuclear Information System (INIS)

    Chen Xudong

    2008-01-01

    The multiple signal classification (MUSIC) imaging method is applied to determine the locations of a collection of small anisotropic spherical scatterers in the framework of the total internal reflection tomography. Multiple scattering between scatterers is considered and the inverse scattering problem is nonlinear, which, however, is solved by the proposed fast analytical approach where no associated forward problem is iteratively evaluated. The paper also discusses the role of the polarization of incidence waves, the incidence angle, the separation of scatterers from the surface of the substrate, and the level of noise on the resolution of imaging.

  13. Qβ measurements with a total absorption detector

    International Nuclear Information System (INIS)

    Shibata, Michihiro; Kawade, Kiyoshi; Shindou, Terumasa; Kojima, Yasuaki; Taniguchi, Akihiro; Kawase, Yoichi; Ichikawa, Shin-ichi

    2003-01-01

    For Q β determination, we have developed a newly total absorption detector that can detect almost all radiation from the radioactive nuclei. The detector is composed of large volume and low background twin BGO scintillation detectors. The estimated efficiency is more than two orders of magnitude larger than those of Ge or Si detectors. The Q β s of some fission products of 235 U were successfully measured using an on-line mass separator for the first time (KUR-ISOL). We have proposed the possibility of determination Q β up to about 10 MeV using the detector without the knowledge of the decay scheme. (author)

  14. Nuclear war would cause total destruction

    International Nuclear Information System (INIS)

    Caldicott, H.

    1985-01-01

    In this paper, the author urges everyone to become better informed about the nuclear hazard humanity faces and challenges the reader to take action to ensure human survival on Earth. The author explains what would happen in the event of a nuclear war. Population centers would be smashed flat. Firestorms would rage over millions of acres. People near the center of the blast would die immediately. Those who survived would reenter a totally devastated world, lacking the life-support systems on which the human species depends. Epidemics would be rampant. Only if we abolish nuclear weapons and permanently halt the nuclear power industry can we hope to survive

  15. Total down to work for Chtokman's gas

    International Nuclear Information System (INIS)

    Labeyre, J.

    2008-01-01

    In the framework of the exploitation contract signed with Gazprom, Total group, partner of the project with StatoilHydro, has started the feasibility study for the huge Chtokman gas field in Russia (Barents sea). A definitive investment decision should be given within less a year. The pre-project phase started in summer 2008 but nothing has been decided yet. Russia has two big projects in competition: Chtokman and Kharasavey in Yamal province. Considering the extreme climate conditions and the technical challenges, Russia will need the experience of foreign partners. (J.S.)

  16. Total quality management (TQM) in diagnostic radiology

    International Nuclear Information System (INIS)

    Rehani, M.M.

    1995-01-01

    The branch of quality assurance is now taking a new direction towards total quality management (TQM). Being of industrial origin, the concepts and terminologies in TQM are alien to medical and paramedical professionals. However, the impetus it has already made in other areas of health sciences makes medical physicists left out when diagnostic radiology does not encompass TQM. The purpose of this paper is to introduce the terms used in TQM and some aspects of its application to diagnostic radiology. (author). 12 refs., 1 tab

  17. Total ankle arthroplasty: An imaging overview

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Da Rae; Choi, Yun Sun; Chun, Ka Young; Jung, Yoon Young; Kim, Jin Su; Young, Ki Won [Eulji Hospital, Eulji University, Seoul (Korea, Republic of); Potter, Hollis G.; Li, Angela E. [Dept. of Radiology and Imaging, Hospital for Special Surgery, New York (United States)

    2016-06-15

    With advances in implant technology, total ankle arthroplasty (TAA) has become an increasingly popular alternative to arthrodesis for the management of end-stage ankle arthritis. However, reports in the literature do not focus on the imaging features of TAA. Through a literature review, we demonstrate basic design features of the current ankle arthroplasty system, and the normal and abnormal postoperative imaging features associated with such devices. Pre- and postoperative evaluations of ankle arthroplasty mainly include radiography; in addition, computed tomography and magnetic resonance imaging provide further characterization of imaging abnormalities. Familiarization with multimodal imaging features of frequent procedural complications at various postoperative intervals is important in radiological practice.

  18. PENDEKATAN TOTAL QUALITY MANAGEMENT PRODUK BROILER TOLAKAN

    Directory of Open Access Journals (Sweden)

    Zeetpy Maisana

    2012-11-01

    Full Text Available ABSTRACTThe purpose of this study was to analyze rejected product in slaughterhouse division using total quality management approach. The secondary data were collected from the company archives and judgmental sampling was used to collect primary data from six experienced respondents. The analysis method used was total quality management, include stratification, Pareto diagrams, control charts, fishbone diagrams, and quality function deployment. The findings of this study showed that the use of line production system by the slaughterhouse to produce the product; where products’ redness/bruises, size uniformity, bloodless feature, incorrect delivery, delivery delay, and damaged package were the cause of product rejection. The strategies ordered based on the priority to improve the management quality are: tools repair and replacement, creating quality based projects, build an information system between the production lines, training and seminar. The managerial implications of the study suggested the slaughterhouse to replace or repair the plucker, scalder and automatic weighing machine. It also suggested the slaughterhouse to tighten the span of control in the chilling room to maintain product freshness.Keywords: rejected product analysis, TQM, QFD, chicken slaughterhouse, carcassABSTRAKPenelitian ini bertujuan menganalisis produk tolakan pada rumah potong ayam melalui pendekatan total quality management. Pengumpulan data sekunder penelitian diperoleh dari arsip perusahaan dan judgemental sampling digunakan terhadap enam responden ahli untuk memperoleh data primer penelitian. Metode analisis data yang digunakan total quality management, meliputi stratifikasi, diagram pareto, peta kendali, diagram tulang ikan, dan quality function deployment.  Hasil penelitian menunjukkan penggunaan sistem lini produksi pada proses produksi di perusahaan, dimana memar pada produk, keseragaman ukuran, kesegaran produk, pengiriman tidak sesuai pesanan

  19. THE TOTAL SOLAR IRRADIANCE CLIMATE DATA RECORD

    Energy Technology Data Exchange (ETDEWEB)

    Dewitte, Steven; Nevens, Stijn [Royal Meteorological Institute of Belgium, Ringlaan 3, B-1180 Brussels (Belgium)

    2016-10-10

    We present the composite measurements of total solar irradiance (TSI) as measured by an ensemble of space instruments. The measurements of the individual instruments are put on a common absolute scale, and their quality is assessed by intercomparison. The composite time series is the average of all available measurements. From 1984 April to the present the TSI shows a variation in phase with the 11 yr solar cycle and no significant changes of the quiet-Sun level in between the three covered solar minima.

  20. Hyperon magnetic moments and total cross sections

    International Nuclear Information System (INIS)

    Lipkin, H.J.

    1982-06-01

    The new data on both total cross sections and magnetic moments are simply described by beginning with the additive quark model in an SU(3) limit where all quarks behave like strange quarks and breaking both additivity and SU(3) simultaneously with an additional non-additive mechanism which affects only nonstrange quark contributions. The suggestion that strange quarks behave more simply than nonstrange may provide clues to underlying structure or dynamics. Small discrepancies in the moments are analyzed and shown to provide serious difficulties for most models if they are statistically significant. (author)

  1. Asymmetric Total Synthesis of Ieodomycin B

    Directory of Open Access Journals (Sweden)

    Shuangjie Lin

    2017-01-01

    Full Text Available Ieodomycin B, which shows in vitro antimicrobial activity, was isolated from a marine Bacillus species. A novel asymmetric total synthetic approach to ieodomycin B using commercially available geraniol was achieved. The approach involves the generation of 1,3-trans-dihydroxyl at C-3 and C-5 positions via a Crimmins-modified Evans aldol reaction and a chelation-controlled Mukaiyama aldol reaction of a p-methoxybenzyl-protected aldehyde, as well as the generation of a lactone ring in a deprotection–lactonization one-pot reaction.

  2. Contemporary pain management in total knee arthroplasty.

    Science.gov (United States)

    Khanasuk, Yutthana; Ngarmukos, Srihatach

    2012-10-01

    Pain management has become a very important part of postoperative care for total knee arthroplasty patients. Contemporary pain control has evolved from high-dose opioid in the past to state-of-the-art multimodal regimens. These include multiple non-opioid medication such as NSAIDs, COX-2 inhibitors, and gabapentinoid, and novel anesthetic techniques such as preemptive analgesia and ultrasound-guided peripheral nerve blocks. Another method which is gaining popularity is intraarticular injection of anesthetic cocktail during surgery. Pre-op education can also help patients cope with their pain better.

  3. Total synthesis and biological investigation of (-)-promysalin.

    Science.gov (United States)

    Steele, Andrew D; Knouse, Kyle W; Keohane, Colleen E; Wuest, William M

    2015-06-17

    Compounds that specifically target pathogenic bacteria are greatly needed, and identifying the method by which they act would provide new avenues of treatment. Herein we report the concise, high-yielding total synthesis (eight steps, 35% yield) of promysalin, a natural product that displays antivirulence phenotypes against pathogenic bacteria. Guided by bioinformatics, four diastereomers were synthesized, and the relative and absolute stereochemistries were confirmed by spectral and biological analysis. Finally, we show for the first time that promysalin displays two antivirulence phenotypes: the dispersion of mature biofilms and the inhibition of pyoverdine production, hinting at a unique pathogenic-specific mechanism of action.

  4. Transanal total mesorectal excision - a systematic review

    DEFF Research Database (Denmark)

    Bjørn, Maya Xania; Perdawood, Sharaf Karim

    2015-01-01

    of the dissection. We aimed to evaluate the literature on TaTME. METHODS: We performed a systematic search of the literature in the PubMed and Embase databases. Both authors assessed the studies. All publications on TaTME were included with the exception of review articles. RESULTS: A total of 29 studies (336...... the potential advantages seem to be related to a bulky mesorectum in the male pelvis. The preliminary results are encouraging and the most serious complication is urethral injury. The oncological results are acceptable, although the follow-up is short. CONCLUSION: TaTME is a feasible approach for mid and low...

  5. Efficient total synthesis of (S)-14-azacamptothecin.

    Science.gov (United States)

    Liu, Guan-Sai; Yao, Yuan-Shan; Xu, Peng; Wang, Shaozhong; Yao, Zhu-Jun

    2010-06-01

    An efficient total synthesis of (S)-14-azacamptothecin has been accomplished in 10 steps and 56% overall yield from 5H-pyrano[4,3-d]pyrimidine 8. A mild Hendrickson reagent-triggered intramolecular cascade cyclization, a highly enantioselective dihydroxylation, and an efficient palladium-catalyzed transformation of an O-allyl into N-allyl group are the key steps in the synthesis. This work provides a much higher overall yield than the previous achievement and shows sound flexibility for the further applications that will lead to new bioactive analogues.

  6. Quantum mechanics as total physical theory

    International Nuclear Information System (INIS)

    Slavnov, D.A.

    2002-01-01

    It is shown that the principles of the total physical theory and conclusions of the standard quantum mechanics are not at such an antagonistic variance as it is usually accepted. The axioms, which make it possible to plot the renewed mathematical scheme of the quantum mechanics are formulated within the frames of the algebraic approach. The above scheme includes the standard mathematical apparatus of the quantum mechanics. Simultaneously there exists the mathematical object, which adequately describes the individual experiment. The examples of applying the proposed scheme is presented [ru

  7. Total lymphoid irradiation in rhesus monkeys

    International Nuclear Information System (INIS)

    Vriesendorp, H.M.; Maat, B.; Hogeweg, B.

    Total lymphoid irradiation (TLI) consists of three contiguous fields, a mantle, an inverted Y and a spleen field. TLI induces a state of immunosuppression in patients with Hodgkin disease or in small rodents. Infusion of allogeneic bone marrow cells into mice after TLI led to the development split haemopoietic chimerism and indefinite survival of skin grafts from the bone marrow donor. A protocol for TLI was developed for rhesus monkeys to attempt to verify these interesting observations in a pre-clinical animal model. (Auth.)

  8. Total-variation regularization with bound constraints

    International Nuclear Information System (INIS)

    Chartrand, Rick; Wohlberg, Brendt

    2009-01-01

    We present a new algorithm for bound-constrained total-variation (TV) regularization that in comparison with its predecessors is simple, fast, and flexible. We use a splitting approach to decouple TV minimization from enforcing the constraints. Consequently, existing TV solvers can be employed with minimal alteration. This also makes the approach straightforward to generalize to any situation where TV can be applied. We consider deblurring of images with Gaussian or salt-and-pepper noise, as well as Abel inversion of radiographs with Poisson noise. We incorporate previous iterative reweighting algorithms to solve the TV portion.

  9. First total synthesis of (-)-AL-2.

    Science.gov (United States)

    Miyakoshi, Naoki; Mukai, Chisato

    2003-06-26

    Treatment of the 3,4-dioxygenated-9-hydroxy-1-nonyn-5-one derivative, derived from diethyl l-tartrate, with a palladium catalyst in methanol under a CO atmosphere effected an intramolecular acetalization and a stereoselective construction of the (E)-methoxycarbonylmethylidene functionality resulting in formation of the core framework of the diacetylenic spiroacetal enol ether natural products. Chemical transformations of the 1,6-dioxaspiro[4.5]decane derivative thus formed led to the first total synthesis of (-)-AL-2. [reaction: see text

  10. TOTAL QUALITY MANAGEMENT AND CONTEMPORARY HOTEL INDUSTRY

    Directory of Open Access Journals (Sweden)

    Ivica Batinić

    2013-04-01

    Full Text Available Strong competition in the market has caused the development of a new management approach known as Total Quality Management (TQM. Due to importance that quality plays in achieving competitive advantage, the hotel industry started to apply TQM. During the introduction of these systems, hotel companies may use different approaches to suit their own buseiness requirements. In doing so, 'TQM standards' can be used, or various international standards and models of business excellence Malcolm Balridge National Quality Award and European Quality Award.

  11. TotalFinaElf Factbook 2002

    International Nuclear Information System (INIS)

    2002-01-01

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2002. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  12. Total Hip Arthroplasty in Mucopolysaccharidosis Type IH

    Directory of Open Access Journals (Sweden)

    S. O'hEireamhoin

    2011-01-01

    Full Text Available Children affected by mucopolysaccharidosis (MPS type IH (Hurler Syndrome, an autosomal recessive metabolic disorder, are known to experience a range of musculoskeletal manifestations including spinal abnormalities, hand abnormalities, generalised joint stiffness, genu valgum, and hip dysplasia and avascular necrosis. Enzyme therapy, in the form of bone marrow transplantation, significantly increases life expectancy but does not prevent the development of the associated musculoskeletal disorders. We present the case of a 23-year-old woman with a diagnosis of Hurler syndrome with a satisfactory result following uncemented total hip arthroplasty.

  13. Lattice-Like Total Perfect Codes

    Directory of Open Access Journals (Sweden)

    Araujo Carlos

    2014-02-01

    Full Text Available A contribution is made to the classification of lattice-like total perfect codes in integer lattices Λn via pairs (G, Φ formed by abelian groups G and homomorphisms Φ: Zn → G. A conjecture is posed that the cited contribution covers all possible cases. A related conjecture on the unfinished work on open problems on lattice-like perfect dominating sets in Λn with induced components that are parallel paths of length > 1 is posed as well.

  14. Total synthesis of (±)-antroquinonol d.

    Science.gov (United States)

    Sulake, Rohidas S; Jiang, Yan-Feng; Lin, Hsiao-Han; Chen, Chinpiao

    2014-11-21

    Total synthesis of (±)-antroquinonol D, which is isolated from very expensive and rarely found Antrodia camphorata and which has potential anticancer properties, was achieved from 4-methoxyphenol. In addition, a Michael addition to dimethoxy cyclohexadienones was studied. The main step involved chelation and substrate-controlled diastereoselective reduction of cyclohexenone and lactonization. Lactone synthesis facilitated the diastereoselective reduction of ketone, which help control the desired stereochemistry at the crucial stereogenic center in the natural product. Other key reactions in the synthesis involved a Michael addition of dimethyl malonate on cyclohexadienone, dihydroxylation, and Wittig olefination. A sesquiterpene side chain was synthesized through coupling with geranyl phenyl sulfide and Bouveault-Blanc reduction.

  15. Observational evidence for mergers

    International Nuclear Information System (INIS)

    Schweizer, F.

    1983-01-01

    Theory has long suggested that dynamical friction between colliding galaxies must lead to mergers. The problem for observers has been to find which galaxies are mergers. The author first reviews the available evidence for mergers in various kinds of galaxies, then proposes a tentative classification scheme for mergers, and finally discusses mergers in giant ellipticals and their relation to the evolution and perhaps even the formation of ellipticals. (Auth.)

  16. Evidence informed decision making

    DEFF Research Database (Denmark)

    Sharma, Tarang; Choudhury, Moni; Kaur, Bindweep

    2015-01-01

    from the literature and a combined best practice checklist has been proposed. CONCLUSIONS: As decisions often need to be made in areas where there is a lack of published scientific evidence, CE is employed. Therefore to ensure its appropriateness the development of a validated CE data quality check......-list to assist decision makers is essential and further research in this area is a priority....

  17. Evidence-based management.

    Science.gov (United States)

    Pfeffer, Jeffrey; Sutton, Robert I

    2006-01-01

    For the most part, managers looking to cure their organizational ills rely on obsolete knowledge they picked up in school, long-standing but never proven traditions, patterns gleaned from experience, methods they happen to be skilled in applying, and information from vendors. They could learn a thing or two from practitioners of evidence-based medicine, a movement that has taken the medical establishment by storm over the past decade. A growing number of physicians are eschewing the usual, flawed resources and are instead identifying, disseminating, and applying research that is soundly conducted and clinically relevant. It's time for managers to do the same. The challenge is, quite simply, to ground decisions in the latest and best knowledge of what actually works. In some ways, that's more difficult to do in business than in medicine. The evidence is weaker in business; almost anyone can (and many people do) claim to be a management expert; and a motley crew of sources--Shakespeare, Billy Graham,Jack Welch, Attila the Hunare used to generate management advice. Still, it makes sense that when managers act on better logic and strong evidence, their companies will beat the competition. Like medicine, management is learned through practice and experience. Yet managers (like doctors) can practice their craft more effectively if they relentlessly seek new knowledge and insight, from both inside and outside their companies, so they can keep updating their assumptions, skills, and knowledge.

  18. EPR: Evidence and fallacy.

    Science.gov (United States)

    Nichols, Joseph W; Bae, You Han

    2014-09-28

    The enhanced permeability and retention (EPR) of nanoparticles in tumors has long stood as one of the fundamental principles of cancer drug delivery, holding the promise of safe, simple and effective therapy. By allowing particles preferential access to tumors by virtue of size and longevity in circulation, EPR provided a neat rationale for the trend toward nano-sized drug carriers. Following the discovery of the phenomenon by Maeda in the mid-1980s, this rationale appeared to be well justified by the flood of evidence from preclinical studies and by the clinical success of Doxil. Clinical outcomes from nano-sized drug delivery systems, however, have indicated that EPR is not as reliable as previously thought. Drug carriers generally fail to provide superior efficacy to free drug systems when tested in clinical trials. A closer look reveals that EPR-dependent drug delivery is complicated by high tumor interstitial fluid pressure (IFP), irregular vascular distribution, and poor blood flow inside tumors. Furthermore, the animal tumor models used to study EPR differ from clinical tumors in several key aspects that seem to make EPR more pronounced than in human patients. On the basis of this evidence, we believe that EPR should only be invoked on a case-by-case basis, when clinical evidence suggests the tumor type is susceptible. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Case histories as evidence.

    Science.gov (United States)

    Herxheimer, Andrew; Healy, David; Menkes, David B

    2012-01-01

    In courts case histories play a central part when a crime may have resulted from an effect of a prescribed drug; in civil cases where a person may have suffered damage from a drug; and in coroners' enquiries into the cause of unexplained deaths. The court must decide two important questions: 1. Can the suspected medication(s) cause this kind of effect? 2. Did it (or they) do so in this particular case? Many judges and coroners have not addressed these questions clearly and have not used expert witnesses consistently, on occasion disregarding scientific evidence. Courts need to appoint experts to explain and interpret the scientific evidence. Few judges are equipped to resolve contradictions between different experts. Brief accounts of five cases from four countries illustrate these points. The reluctance of legal processes to implicate drugs as a possible cause of violent behaviour leads to injustice. Courts must be required to obtain appropriate expert evidence, and be given independent data on which drugs can cause such behaviour.

  20. Evidence-based surgery

    Directory of Open Access Journals (Sweden)

    Miran Rems

    2007-04-01

    Full Text Available Background: Surgery is setting a new ground by the reign of evidence that was brought up by the Evidence Based Medicine (EBM. While experiences and opinion of an expert count the least by the principles of EBM, randomized controlled trials (RCT and other comparative studies have gained their importance. Recommendations that were included in guidelines represent a demanding shift in surgeon’s professional thinking. Their thinking and classical education have not yet been completely based on the results of such studies and are still very very much master-pupil centred. Assessment of someone’s own experiences is threatened by objectivity as negative experiences get recorded in deeper memory. Randomized studies and meta-analyses do appear also in surgery. However, they demand an extra knowledge about critical assessment.Conclusions: Setting a patient to the foreground brings a surgeon’s decision to the field of EBM. The process has already begun and cannot be avoided. Decision hierarchy moves from the experience field to the evidence territory but to a lesser extent when compared to the rest of medicine. There exist objective restrictions with approving a new paradigm. However, these should not stop the process of EBM implementation. Finally, there is an ethic issue to be considered. Too slow activities in research, education and critical assessment can bring the surgeon to the position when a well-informed patient loses his/her trust.

  1. Influence of urban morphology on total noise pollution: multifractal description.

    Science.gov (United States)

    Ariza-Villaverde, Ana B; Jiménez-Hornero, Francisco J; Gutiérrez De Ravé, Eduardo

    2014-02-15

    Exposure to ambient noise levels above 65 dB can cause public health problems. The spatial distribution of this kind of pollution is linked to various elements which make up the urban form, such as construction density, the existence of open spaces and the shape and physical position of buildings. Since urban morphology displays multifractal behaviour, the present research studies for the first time the relationship between total noise pollution and urban features, such as street width and building height by means of a joint multifractal spectrum in two neighbourhoods of the city of Cordoba (Andalusia, Spain). According to the results, the joint multifractal spectrum reveals a positive correlation between the total noise pollution and the street width to building height ratio, this being more evident when urban morphology is regular. The information provided by the multifractal analysis completes the description obtained by using urban indexes and landscape metrics and might be useful for urban planning once the linkage between both frameworks has been done. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Validating the Changes to Self-identity After Total Laryngectomy.

    Science.gov (United States)

    Bickford, Jane; Coveney, John; Baker, Janet; Hersh, Deborah

    2018-05-25

    A total laryngectomy often prolongs life but results in long-term disablement, disfigurement, and complex care needs. Current clinical practice addresses the surgical options, procedures, and immediate recovery. Less support is available longer-term despite significant changes to aspects of personhood and ongoing medical needs. The aim of this study was to explore the experience of living with and/or supporting individuals with a laryngectomy at least 1 year after surgery. Constructivist grounded theory methods and symbolic interactionism were used to guide collection and analysis of interview data from 28 participants (12 individuals with a laryngectomy, 9 primary supporters, and 7 health professionals). The phenomena of "validating the altered self after total laryngectomy" highlighted how individuals, postlaryngectomy, navigate and negotiate interactions due to the disruption of their self-expression, related competencies, and roles. Several reframing patterns representing validation of the self emerged from the narratives. They were as follows: destabilized, resigned, resolute, and transformed. The data describe the influence of the processes of developing competence and building resilience, combined with contextual factors, for example, timing and turning points; being supported; and personal factors on these reframing patterns. The findings further our understanding of the long-term subjective experience of identity change after laryngectomy and call attention to the persisting need for psychosocial support. This research provides important evidence for evaluating and strengthening the continuum of services (specialist to community) and supporting social participation, regardless of communication method, and for competency training for all involved to optimize person-centered practices.

  3. INADMISSIBLE EVIDENCE IN CIVIL PROCEDURE

    Directory of Open Access Journals (Sweden)

    Mihajlo Dika

    2016-01-01

    Full Text Available This paper examines the exclusion of specific means of evidence as instruments for determining the object of evidence, as well as the taking of evidence in the framework of the Croatian civil procedure law. The introduction lays the grounds for classifying and qualifying exclusion of evidence (general, special; absolute, relative; removable, irremovable; direct, indirect, after which greater attention is paid to the so called absolute and relative type; exclusionary evidence of the direct relative type pertaining to the establishing of facts, and evidence dismissals. With regard to the indirect relative type, the paper examines exclusionary evidence concerning the object of evidence. The remainder of the paper focuses on illegally obtained evidence, while outlining the constitutional, statutory, judicature and doctrinaire premises of bearing for such evidence. Subsequently, the question of evidence obtained in violation of the Constitutional guarantee of respect and legal protection of private and family life, dignity, reputation and honour, as well as evidence obtained by breach of the Constitutional guarantee of freedom and secrecy of correspondence and all other forms of communication, and in violation of the right to safety and privacy of personal data, are discussed too. In addition, the paper analyses the institutions of preclusion of evidence and the so called informative evidence. Concluding, the author points to a lacking regulation of inadmissible evidence within the Croatian civil procedure law, underlining the need to determine de lege ferenda legal requirements with a view to operationalizing inadmissible evidence within the Croatian civil procedure law.

  4. Imaging of total colonic Hirschsprung disease

    International Nuclear Information System (INIS)

    Stranzinger, Enno; DiPietro, Michael A.; Strouse, Peter J.; Teitelbaum, Daniel H.

    2008-01-01

    Hirschsprung disease (HD) is a functional obstruction of the bowel caused by the absence of intrinsic enteric ganglion cells. The diagnosis of total colonic HD (TCHD) based on contrast enemas is difficult in newborns because radiological findings vary. To evaluate the radiographic and contrast enema findings in patients with pathologically proven TCHD. From 1966 to 2007, 17 records from a total of 31 patients with TCHD were retrospectively evaluated for diameter and shape of the colon, diameter of the small bowel, bowel wall contour, ileal reflux, abdominal calcifications, pneumoperitoneum, filling defects, transitional zones and rectosigmoid index. Three colonic patterns of TCHD were found: microcolon, question-mark-shape colon and normal caliber colon. Additional findings included spasmodic colon, ileal reflux, delayed evacuation and abdominal calcifications. Colonic transitional zones were found in eight patients with TCHD. The diagnosis of TCHD is difficult to establish by contrast enema studies. The length of the aganglionic small bowel and the age of the patient can influence the radiological findings in TCHD. The transitional zone and the rectosigmoid index can be false-positive in TCHD. The colon can appear normal. Consider TCHD if the contrast enema study is normal but the patient remains symptomatic and other causes of distal bowel obstruction have been excluded. (orig.)

  5. Total body irradiation for children with malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Sanuki, Eiichi; Maeno, Toshio; Kamata, Rikisaburo; Tanaka, Yoshiaki; Mugishima, Hideo [Nihon Univ., Tokyo (Japan). School of Medicine

    1995-12-01

    Total body irradiation combined with high dose chemotherapy has been performed just before bone marrow transplantation in 35 children with advanced malignancies, with the object of achieving successful transplantation and improving the prognosis. Simulation was performed as follows: back scatter, flatness, dose accumulation using randophantom and dose distribution using a thermo-luminescence dosimeter and linac-graphy. The standard error of dose distribution was within 10%. In neuroblastoma, of which there were 14 cases in stage IV and one case in stage III, the 5-year survival rate was 55%. In leukemia, of which all cases were in the high-risk group (7 cases of acute lymphoblastic leukemia and 2 of acute myeloblastic leukemia) the 5-year survival rate was 55%. The 5 cases having first remission survived disease-free while the 4 cases having non-first remission died. In malignant lymphoma (6 cases in stage IV and one case in stage III, with bulky mass) the 5-year survival rate was 67%. Four cases with other diagnoses (severe aplastic anemia, and others) all survived. As yet no side effects resulting from total body irradiation have been recognized in our cases, but a longer follow-up period is necessary to observe possible late side effects. (author).

  6. EHV transmission maintenance. A total asset strategy

    International Nuclear Information System (INIS)

    Bronsdon, J.A.N.

    1996-01-01

    For countries whose economies are rapidly expanding, the demand for power, and in particular electricity, is resulting in rapid expansions of the generation, transmission and distribution of electricity. This means that a new plant is being installed which, apart from some minor post commissioning problems, will be free from major maintenance for several years to come. Consequently, in such cases, maintenance is confined to basic annual shutdown checks and routine online monitoring. As equipment and plant age it is important to commence planning for additional maintenance over and above these basic annual checks; to monitor performance; to monitor faults and defects and to use that information to engineer out design faults, to influence current maintenance techniques and to influence future procurement specifications. Also, provided that sufficient information is available, informed decisions can be taken as to when a power plant should be decommissioned or refurbished. This process can be described as a total asset management strategy covering all decisions from procurement through to commissioning, ongoing maintenance, refurbishment, decommissioning and reappraisal of specifications for future procurement. Based upon the author's experience within the United Kingdom Electricity Supply industry, a total asset strategy will be proposed for EHV transmission plant that will optimise current and future expenditure while maximizing reliability and minimising downtime. 1 ref., 5 figs

  7. TOTAL QUALITY MANAGEMENT IN ISLAMIC EDUCATION INSTITUTION

    Directory of Open Access Journals (Sweden)

    Indriyenni Indriyenni

    2018-04-01

    Full Text Available There have been five characteristics of a qualified school such as focusing on the customer, total engagement, measurement, commitment, and continuous improvement. Every educational institution including Islamic boarding school (IBS is required to provide the best services to its customers. In this way, IBS need to be supported by a good management system; the existence of a regular mindset (administrative thinking, the implementation of regular activities (administrative behavior, attitude to the task activities well (administrative attitude, and so forth. To answer the various problems that exist in the educational environment the management should have an Integrated or Total Quality Management (TQM. One of its goals is to transform a school institution into a sincere team, without conflict and internal competition to achieve a single goal of satisfying all customers. TQM will provide educators professional solutions to meet today’s challenges and the future. It is because TQM can be used to build alliance between education, business and government. TQM can also shape the community responsive to the changing demands of society in this era of globalization. Besides, TQM form a responsive school and is able to respond to changes that occur in the field of education in order to give satisfaction to stakeholder.

  8. Total quality drives nuclear plant improvements

    International Nuclear Information System (INIS)

    Richey, R.B.

    1991-01-01

    Total quality (TQ) at Carolina Power and Light (CP and L) is fulfilling a 1985 vision of Sherwood H. Smith, Jr., CP and L's chairman, president, and chief executive officer. The TQ concept has provided a way for employees to align their creative energies toward meeting the business needs of the company. Throughout CP and L, TQ has been recognized as the vehicle for reducing operating costs and improving customer satisfaction. Within the nuclear organization, application of the TQ process has helped to improve communications, resolve challenges, and provide more consistent work practices among CP and L's three nuclear plants. Total quality was introduced from the top down, with initial benefits coming from team interactions. Senior management at CP and L defined the corporate expectations and outlined the training requirements for implementing TQ. Management staffs at each organizational level became steering committees for TQ team activities within their departments. Teams of employees most knowledgeable about a given work area were empowered to solve problems or overcome obstacles related to that work area. Employees learned to become better team players and to appreciate the quality of decisions reached through group consensus. Now, formalized methods that started TQ are becoming part of the day-to-day work ethic

  9. METHODS FOR THE DETERMINATION OF TOTAL ORGANIC ...

    Science.gov (United States)

    Organic matter in soils and sediments is widely distributed over the earth's surface occurring in almost all terrestrial and aquatic environments (Schnitzer, 1978). Soils and sediments contain a large variety of organic materials ranging from simple sugars and carbohydrates to the more complex proteins, fats, waxes, and organic acids. Important characteristics of the organic matter include their ability to: form water-soluble and water- insoluble complexes with metal ions and hydrous oxides; interact with clay minerals and bind particles together; sorb and desorb both naturally-occurring and anthropogenically-introduced organic compounds; absorb and release plant nutrients; and hold water in the soil environment. As a result of these characteristics, the determination of total organic carbon (a measure of one of the chemical components of organic matter that is often used as an indicator of its presence in a soil or sediment) is an essential part of any site characterization since its presence or absence can markedly influence how chemicals will react in the soil or sediment. Soil and sediment total organic carbon (TOC) determinations are typically requested with contaminant analyses as part of an ecological risk assessment data package. TOC contents may be used qualitatively to assess the nature of the sampling location (e.g., was it a depositional area) or may be used to normalize portions of the analytical chemistry data set (e.g., equilibrium partitioning).

  10. Total Site Heat Integration Considering Pressure Drops

    Directory of Open Access Journals (Sweden)

    Kew Hong Chew

    2015-02-01

    Full Text Available Pressure drop is an important consideration in Total Site Heat Integration (TSHI. This is due to the typically large distances between the different plants and the flow across plant elevations and equipment, including heat exchangers. Failure to consider pressure drop during utility targeting and heat exchanger network (HEN synthesis may, at best, lead to optimistic energy targets, and at worst, an inoperable system if the pumps or compressors cannot overcome the actual pressure drop. Most studies have addressed the pressure drop factor in terms of pumping cost, forbidden matches or allowable pressure drop constraints in the optimisation of HEN. This study looks at the implication of pressure drop in the context of a Total Site. The graphical Pinch-based TSHI methodology is extended to consider the pressure drop factor during the minimum energy requirement (MER targeting stage. The improved methodology provides a more realistic estimation of the MER targets and valuable insights for the implementation of the TSHI design. In the case study, when pressure drop in the steam distribution networks is considered, the heating and cooling duties increase by 14.5% and 4.5%.

  11. SMED: El camino a la flexibilidad total

    Directory of Open Access Journals (Sweden)

    Cruz, J.

    2004-07-01

    Full Text Available Este artículo presentará la metodología de SMED (Cambio de dados en un dígito de minuto como una alternativa hacia la flexibilidad total, la cuál se propone como una herramienta vital de competencia ante las condiciones del mercado existentes. Se explicarán los pasos a seguir para implementar la herramienta y se presentará un caso de estudio en el cuál la herramienta fue aplicada exitosamente, identificándose como la decisión determinante en la reducción del tiempo de ciclo por cambios de modelo, incrementando así la eficiencia del sistema de manufactura. El mercado hoy en día, está caracterizado por elementos determinantes, tales como: la globalización, una desaceleración económica de nuestro vecino y socio comercial, los Estados Unidos de Norteamérica, y una industria Asiática emergente. Estos factores combinados, impactan de manera total la forma de operar de las empresas, debido a que las empresas requieren implementar diferentes estrategias, tales como: 1 disminuir costos de producción, 2 incrementar la calidad, e 3 incrementar la flexibilidad y tiempo de respuesta.

  12. Deformation analysis with Total Least Squares

    Directory of Open Access Journals (Sweden)

    M. Acar

    2006-01-01

    Full Text Available Deformation analysis is one of the main research fields in geodesy. Deformation analysis process comprises measurement and analysis phases. Measurements can be collected using several techniques. The output of the evaluation of the measurements is mainly point positions. In the deformation analysis phase, the coordinate changes in the point positions are investigated. Several models or approaches can be employed for the analysis. One approach is based on a Helmert or similarity coordinate transformation where the displacements and the respective covariance matrix are transformed into a unique datum. Traditionally a Least Squares (LS technique is used for the transformation procedure. Another approach that could be introduced as an alternative methodology is the Total Least Squares (TLS that is considerably a new approach in geodetic applications. In this study, in order to determine point displacements, 3-D coordinate transformations based on the Helmert transformation model were carried out individually by the Least Squares (LS and the Total Least Squares (TLS, respectively. The data used in this study was collected by GPS technique in a landslide area located nearby Istanbul. The results obtained from these two approaches have been compared.

  13. Chronic total coronary occlusion: treatment results.

    Science.gov (United States)

    Kirk Christensen, Martin; Freeman, Phillip Fischer; Rasmussen, Jeppe Groendal; Villadsen, Anton Boel; Raungaard, Bent; Eggert Jensen, Svend; Thuesen, Leif

    2017-08-01

    To describe the clinical and procedural coronary chronic total occlusion (CTO) treatment results in a Nordic PCI centre during the implementation of a CTO treatment program. In a retrospective registry study, we assessed; (1) indication for the procedure, (2) Canadian Cardiovascular Society angina pectoris score (CCS)/New York Heart Association (NYHA) heart failure score, (3) lesion complexity and (4) adverse events during hospital stay and three months following the index procedure. The study cohort included 503 patients (594 lesions). From 2010 to 2013 96% of procedures were performed with antegrade wire-escalation technique and 4% performed using retrograde techniques, from 2013-2016 the corresponding numbers were 83% and 17.0%. The procedural success rate was 69%, increasing from 64% before to 72% (p = .06) after routinely using the retrograde approach. No individual patient characteristic, lesion variable or score was strongly associated with procedural success or failure. There were 4% serious procedure related complications. In patients with PCI of a CTO lesion only, 87% were in CCS or NYHA functional class ≥2 before the index procedure vs. 22% at follow-up. Routine use of retrograde techniques tended to increase the procedural success rate. Clinical results after three months were acceptable, but the complication rate was higher than for non-CTO PCI. Individual patient and lesion characteristics had a low predictability for procedural success. Therefore, clinical symptoms, objective signs of myocardial ischemia and procedural risk should be focus points in coronary chronic total occlusion treatment strategies.

  14. Total performance measurement and management: TPM2

    Energy Technology Data Exchange (ETDEWEB)

    Sheather, G. [University of Technology, Sydney, NSW (Australia)

    1996-10-01

    As the rate of incremental improvement activities and business process re-engineering programs increase, product development times reduce, collaborative endeavours between OEMs and out-sourcing suppliers increase, as agile manufacturing responds to the demands of a global marketplace, the `virtual` organisation is becoming a reality. In this context, customers, partners, suppliers and manufacturers are increasingly separated by field geography, time zone, and availability, but linked by distributed information systems. Measuring and monitoring business performance in this environment requires a entirely different framework and set of key performance indicators (KPIs) usually associated with traditional financial accounting approaches. These approaches are critiqued, then the paper introduces a new concept `Total Performance Measurement Management` (TPM2), to distinguish it from the conventional TPM (Total Productive Management). A model for combining both financial and non-financial KPIs relevant to real-time performance measures stretching across strategic, business unit and operational levels, is presented. The results of the model confirm the hypothesis that it is feasible to develop a TPM2 framework for achieving enterprise wide strategic objectives. (author). 6 tabs., 18 figs., refs.

  15. Total body photography for skin cancer screening.

    Science.gov (United States)

    Dengel, Lynn T; Petroni, Gina R; Judge, Joshua; Chen, David; Acton, Scott T; Schroen, Anneke T; Slingluff, Craig L

    2015-11-01

    Total body photography may aid in melanoma screening but is not widely applied due to time and cost. We hypothesized that a near-simultaneous automated skin photo-acquisition system would be acceptable to patients and could rapidly obtain total body images that enable visualization of pigmented skin lesions. From February to May 2009, a study of 20 volunteers was performed at the University of Virginia to test a prototype 16-camera imaging booth built by the research team and to guide development of special purpose software. For each participant, images were obtained before and after marking 10 lesions (five "easy" and five "difficult"), and images were evaluated to estimate visualization rates. Imaging logistical challenges were scored by the operator, and participant opinion was assessed by questionnaire. Average time for image capture was three minutes (range 2-5). All 55 "easy" lesions were visualized (sensitivity 100%, 90% CI 95-100%), and 54/55 "difficult" lesions were visualized (sensitivity 98%, 90% CI 92-100%). Operators and patients graded the imaging process favorably, with challenges identified regarding lighting and positioning. Rapid-acquisition automated skin photography is feasible with a low-cost system, with excellent lesion visualization and participant acceptance. These data provide a basis for employing this method in clinical melanoma screening. © 2014 The International Society of Dermatology.

  16. Telerehabilitation Feasibility in Total Joint Replacement

    Directory of Open Access Journals (Sweden)

    Mark J. Nelson

    2017-11-01

    Full Text Available Despite documented benefits, many Total Joint Replacement (TJR patients find it difficult to access rehabilitation following discharge from hospital. One solution to improve access for TJR patients is telerehabilitation. This study aimed to assess the feasibility of introducing a telerehabilitation program for TJR patients.   TJR patients at QEII Jubilee Hospital were invited to complete a questionnaire regarding their access, feelings towards and preferences in using technology. Seventy-five patients were recruited. Most patients had computer access (72% and internet (69% at home. Sixty-five percent of participants were willing to participate in telerehabilitation. A significant difference was found between older and younger patients. Watching videos on an electronic device was the preferred method for a technology-based home exercise program and phone call the preferred method of communication.  Results indicate telerehabilitation in the TJR population is feasible from the perspective of access to, feelings toward, and preferences for technology. Keywords: Hip replacement, Knee replacement, Telerehabilitation, Telemedicine, Total joint replacement

  17. Renal function after elective total hip replacement

    DEFF Research Database (Denmark)

    Perregaard, Helene; Damholt, Mette B; Solgaard, Søren

    2016-01-01

    Background and purpose - Acute kidney injury (AKI) is associated with increased short-term and long-term mortality in intensive care populations and in several surgical specialties, but there are very few data concerning orthopedic populations. We have studied the incidence of AKI and the prevale......Background and purpose - Acute kidney injury (AKI) is associated with increased short-term and long-term mortality in intensive care populations and in several surgical specialties, but there are very few data concerning orthopedic populations. We have studied the incidence of AKI...... and the prevalence of chronic kidney disease (CKD) in an elective population of orthopedic patients undergoing primary total hip replacement, hypothesizing that chronic kidney disease predisposes to AKI. Patients and methods - This was a single-center, population-based, retrospective, registry-based cohort study...... involving all primary elective total hip replacements performed from January 2003 through December 2012. Patient demographics and creatinine values were registered. We evaluated the presence of CKD and AKI according to the international guidelines for kidney disease (KDIGO Acute Kidney Injury Workgroup 2013...

  18. Phytochemical screening, total phenolic, total flavonoids contents and antioxidant activity of cinchona ledgeriana leaves ethanol extract

    Science.gov (United States)

    Sundowo, Andini; Artanti, Nina; Hanafi, M.; Minarti, Primahana, Gian

    2017-11-01

    C ledgeriana is a medicinal plant that contains alkaloids, especially on the barks for commercial production of quinine as antimalarial. The main alkaloids in this plant are cinchonine, cinchonidine, quinine and quinidine. Besides for antiamalarial this plant is also commonly used to treat whooping cough, influenza and dysentery. Compare to other medicinal plants, nowadays only very few studies were conducted in Cinchona species. Our current study aims to determine the content of phytochemical, total phenol and total flavonoids from C. ledgeriana leaves 70% ethanol extract. The extraction was performed by maceration method using 70% ethanol solvent and then fractionated into hexane, ethylacetate and butanol. Phytochemical screening was performed to determine the content of alkaloids, flavonoids, terpenoids, tannins and saponins. Total phenol and flavonoid contents of the extract were determined by Folin-Ciocalteu and alumunium chloride colorimetric methods using gallic acid and quercetin as standards. The antioxidant activity was determined by using 2, 2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity. The results of phytochemical screening showed that the 70% ethanol extract of C. ledgeriana leaves contained alkaloids, flavonoids, terpenoids, tannins and saponins. The total phenol and total flavonoids analysis showed that ethyl acetate fraction had the highest total phenol (40.23%) and total flavonoids (65.34%).

  19. Total hemispherical emissivity of Inconel 718

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Benjamin P.; Nelson, Shawn E.; Walton, Kyle L.; Ghosh, Tushar K.; Tompson, Robert V.; Loyalka, Sudarshan K., E-mail: LoyalkaS@missouri.edu

    2015-06-15

    Highlights: • We have measured the total hemispherical emissivity for Inconel 718 from about 600–1250 K. • Oxidation in air at 1073 K resulted in an increase in emissivity. • Sandblasting of Inconel 718 was also observed to increase the emissivity. • Coating of graphite powder onto the ‘as-received’ Inconel 718 showed no increase in the emissivity. • Coating of graphite powder onto the 220 grit sandblasted Inconel 718 did show an increase in emissivity. - Abstract: Total hemispherical emissivity for Inconel 718 was measured in anticipation of its application in Very High Temperature Gas Reactors (VHTRs). A majority of current emissivity data for Inconel 718 is in the form of spectral measurements. The data presented here were obtained with an experimental apparatus based on the standard ASTM C835-06 for total hemispherical emittance. Measurements of Inconel 718 were made for four different surface types including: (i) ‘as-received’ from the manufacturer, (ii) oxidized in air and humidified helium, (iii) sandblasted with aluminum oxide powder, and (iv) with a thin coating of nuclear grade graphite powder (grade NGB-18). The emissivity for the ‘as-received’ sample ranged from 0.21 to 0.28 in the temperature interval from 760 K to 1275 K. Oxidation in air at 1073 K resulted in an increase in emissivity into the range from 0.2 at 650 K to 0.52 at 1200 K. There was no dependence on the oxidation times studied here. Oxidation with humidified helium at 1073 K produced less of an increase in emissivity than the oxidation in air but there was an increase up to the range from 0.2 at 600 K to 0.35 at 1200 K. Sandblasting of Inconel 718 was also observed to increase the emissivity up to the range from 0.43 at 780 K to 0.53 at 1270 K when 60 grit sized powder was used and up to the range from 0.45 at 683 K to 0.57 at 1267 K when 120 and 220 grit sized powders were used. Coating of graphite powder onto the ‘as-received’ Inconel 718 showed no increase

  20. GLUCOSE AND TOTAL PROTEIN LEVEL IN LABORATORY RATS UNDER CONDITIONS OF SHORT-TERM FASTING

    Directory of Open Access Journals (Sweden)

    Damir Suljević

    2013-09-01

    Full Text Available Glucose level (UV enzymatic method and total protein level (Biuret method were measured in the blood samples of the rats exposed to short-term starvation. We found a statistically significant increase in the glucose level in experimental animals during starvation, which is also evident in males and females in the experimental group (p <0.05, while decrease in the total protein level was not statistically significant. During starvation, more significant weight loss was observed in females compared to males.Key words: glucose, total protein, serum, Rattus

  1. Phytochemical screening, antioxidant activity, total phenolic and total flavonoid contents of seven local varieties of Rosa indica L.

    Science.gov (United States)

    Zahid, Kiran; Ahmed, Maqsood; Khan, Farah

    2018-05-01

    Rosa indica symbol of godness and beauty known for various healing power, has astringent, sedative, anti-inflammatory and antidepressant qualities. Standard methods were used for qualitative detection of phyto-compounds, and quantitative detection of antioxidants was done using DPPH radical scavenging assay, total phenolics and total flavonoids content were expressed in mg GAE/g dry weight and mg QE/g dry weight. Results revealed phyto-compounds presence in all varieties under study however maximum % inhibition was observed by R. indica var pink perfume (94 ± 0.6) with IC50 value 0.3376 ± 0.01 mg/mL. Highest phenolic and flavonoid content was observed in the leaves extract of R. indica var cardinal red, i.e. 3.3553 ± 0.11 (ethanol) mg of Gallic acid equivalents (GAE)/g dry weight and 3.736 ± 0.001(ethanol) mg of quercetin equivalents (QE)/g dry weight, respectively, at conc. 0.125 mg/mL. Our finding provides evidence that all varieties of rose contain medicinally important bioactive compounds and justifies their use for treatment of different diseases.

  2. Audit on the Efficient Use of Cross-Matched Blood in Elective Total Hip and Total Knee Replacement

    Science.gov (United States)

    Rogers, BA; Johnstone, DJ

    2006-01-01

    INTRODUCTION This prospective audit studies the use of cross-matched blood in 301 patients over a 1-year period undergoing total knee (TKR) and total hip replacement (THR) surgery in an orthopaedic unit. PATIENTS AND METHODS Analysis over the first 6 months revealed a high level of unnecessary cross-matched blood. The following interventions were introduced: (i) to cease routine cross-matching for THR; (ii) all patients to have a check full blood count on day 2 after surgery; and (iii) Hb < 8 g/dl to be considered as the trigger for transfusion in patients over 65 years and free from significant co-morbidity. These changes are in accordance with published national guidelines [Anon. Guidelines for the clinical use of red cell transfusions. Br J Haematol 2001; 113: 24–31]. RESULTS In the next 6 months, the number of units cross-matched but not transfused fell by 96% for THR, and the cross-match transfusion (C:T) ratio reduced from 3.21 to 1.62. Reductions were also observed for the TKR cohort. These results provide evidence of a substantial risk and cost benefit in the use of this limited resource. A telephone survey of 44 hospitals revealed that 20 hospitals routinely cross-matched blood for THR and 11 do so for TKR. CONCLUSIONS Changes can be made to the Maximum Surgical Blood Ordering Schedules (MSBOS) in other orthopaedic units according to national guidelines. PMID:16551419

  3. Functional exercise after total hip replacement (FEATHER): a randomised control trial.

    LENUS (Irish Health Repository)

    Monaghan, Brenda

    2012-11-01

    Prolonged physical impairments in range of movement, postural stability and walking speed are commonly reported following total hip replacement (THR). It is unclear from the current body of evidence what kind of exercises should be performed to maximize patient function and quality of life.

  4. Radiological evaluation of painful total hip replacement

    International Nuclear Information System (INIS)

    Tehranzadeh, J.; Schneider, R.; Freiberger, R.H.

    1981-01-01

    Ninety-four cases of clinically failed, cemented, total hip prostheses requiring surgery were reviewed to determine the accuracy of preoperative plain radiography, culture of aspirated fluid, arthrography, and bone scanning. When radiopaque cement had been used to embed the prosthesis, plain radiography was highly accurate in detecting a loose femoral component, less so in detecting a loose acetabular component. Culture of aspirated fluid was accurate in diagnosing infection. A positive arthrogram identified loosening with good accuracy; however, a negative arthrogram did not reliably exclude loosening. 99 mTc bone scans frequently differentiated loosening from loosening with infection. The suggested sequence of diagnostic tests is plain radiography followed by bone scanning. If the bone scan shows diffuse augmented uptake, culture of aspirated fluid followed by arthrography is indicated

  5. Tribology of total hip arthroplasty prostheses

    Science.gov (United States)

    Rieker, Claude B.

    2016-01-01

    Articulating components should minimise the generation of wear particles in order to optimize long-term survival of the prosthesis. A good understanding of tribological properties helps the orthopaedic surgeon to choose the most suitable bearing for each individual patient. Conventional and highly cross-linked polyethylene articulating either with metal or ceramic, ceramic-on-ceramic and metal-on-metal are the most commonly used bearing combinations. All combinations of bearing surface have their advantages and disadvantages. An appraisal of the individual patient’s objectives should be part of the assessment of the best bearing surface. Cite this article: Rieker CB. Tribology of total hip arthroplasty prostheses: what an orthopaedic surgeon should know. EFORT Open Rev 2016;1:52-57. DOI: 10.1302/2058-5241.1.000004. PMID:28461928

  6. Quality of life after total knee arthroplasty.

    Science.gov (United States)

    Canovas, F; Dagneaux, L

    2018-02-01

    Total knee arthroplasty (TKA) results in a high degree of patient satisfaction, as it provides patients with considerable medium- and long-term benefits in terms of quality of life, pain relief and function. Nevertheless, the literature reports that up to 30% of patients are dissatisfied. This dissatisfaction is directly related to the patients' quality of life, which they deem insufficient. Their quality of life depends on many physical, behavioural, social and psychological factors that are not taken into account by functional outcome scores. After describing the principles of quality of life evaluation after TKA, we will assess the effects of patient-related factors, the surgical technique and postoperative program through an exhaustive review of the literature. Patient expectations after TKA will then be outlined, particularly return to work and return to sports. Copyright © 2017. Published by Elsevier Masson SAS.

  7. Total quality management in the hospital setting.

    Science.gov (United States)

    Ernst, D F

    1994-01-01

    With the increasing demands on hospitals for improved quality and lower costs, hospitals have been forced to reevaluate their manner of operation and quality assurance (QA) programs. Hospitals have been faced with customer dissatisfaction with services, escalating costs, intense competition, and reduced reimbursement for services. As a result, many hospitals have incorporated total quality management (TQM), also known as continuous quality improvement (CQI) and quality improvement (QI), to improve quality care and decrease costs. This article examines the concept of TQM, its rationale, and how it can be implemented in a hospital. A comparison of TQM and QA is made. Examples of hospital implementation of TQM and problems and issues associated with TQM in the hospital setting are explored.

  8. Regularization by truncated total least squares

    DEFF Research Database (Denmark)

    Hansen, Per Christian; Fierro, R.D; Golub, G.H

    1997-01-01

    The total least squares (TLS) method is a successful method for noise reduction in linear least squares problems in a number of applications. The TLS method is suited to problems in which both the coefficient matrix and the right-hand side are not precisely known. This paper focuses on the use...... schemes for relativistic hydrodynamical equations. Such an approximate Riemann solver is presented in this paper which treats all waves emanating from an initial discontinuity as themselves discontinuous. Therefore, jump conditions for shocks are approximately used for rarefaction waves. The solver...... is easy to implement in a Godunov scheme and converges rapidly for relativistic hydrodynamics. The fast convergence of the solver indicates the potential of a higher performance of a Godunov scheme in which the solver is used....

  9. Segmental blood pressure after total hip replacement

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Henriksen, Jens Henrik Sahl

    1992-01-01

    Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significant...... drop was found in all pressures 1 week postoperatively. The decrease followed the systemic pressure and was restored to normal after 6 weeks. In a group of six patients with preoperatively decreased ankle pressure, a significant transient further decrease in the ankle-toe gradient pressure was found...... on the operated side. None of the patients had symptoms from the lowered pressure. We conclude that in patients without signs of ischemia, the postoperative segmental pressure decrease is reversible and therefore not dangerous....

  10. Comparative risk assessment of total energy systems

    International Nuclear Information System (INIS)

    Soerensen, B.

    1982-01-01

    The paper discusses a methodology for total impact assessment of energy systems, ideally evaluating all the impacts that a given energy system has on the society in which it is imbedded or into which its introduction is being considered. Impacts from the entire energy conversion chain ('fuel cycle' if the system is fuel-based), including energy storage, transport and transmission, as well as the institutions formed in order to manage the system, should be compared on the basis of the energy service provided. A number of impacts are considered, broadly classified as impacts on satisfaction of biological needs, on health, on environment, on social relations and on the structure of society. Further considerations include impacts related to cost and resilience, and, last but not least, impacts on global relations. The paper discusses a number of published energy studies in the light of the comparative impact assessment methodology outlined above. (author)

  11. Synchrotron radiation total reflection for rainwater analysis

    International Nuclear Information System (INIS)

    Simabuco, Silvana M.; Matsumoto, Edson

    1999-01-01

    Total reflection X-ray fluorescence analysis excited with synchrotron radiation (SR-TXRF) has been used for rainwater trace element analysis. The samples were collected in four different sites at Campinas City, SP. Standard solutions with gallium as internal standard were prepared for the calibration system. Rainwater samples of 10 μl were putted onto Perspex reflector disk, dried on vacuum and analyzed for 100 s measuring time. The detection limits obtained for K-shell varied from 29 ng.ml -1 for sulfur to 1.3 ng.ml -1 for zinc and copper, while for L-shell the values were 4.5 ng.ml -1 for mercury and 7.0 ng.ml -1 for lead. (author)

  12. Single-incision total laparoscopic hysterectomy

    Directory of Open Access Journals (Sweden)

    Sinha Rakesh

    2011-01-01

    Full Text Available Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. Ongoing refinement of the surgical technique and instrumentation is likely to expand its role in gynecologic surgery in the future. We perform single-incision total laparoscopic hysterectomy using three ports in the single transumbilical incision.

  13. Total is making petroleum rhyme with data

    International Nuclear Information System (INIS)

    Barbaux, Aurelie

    2017-01-01

    Total, the French oil and gas company, which possesses the most powerful industrial supercomputer in the world, is claiming to be 'digital native'. The company has launched a digital transformation plan, under the authority of Gilles Cochevelou as 'chief digital officer'. More than a simple management tool, the plan which is implemented in every branches of the company, is intended to increase safety and generate millions of dollars in savings through a better communication between operation or maintenance teams (with smart rooms in every site), the permanent exchange of data, an enhanced collaboration, etc. However, as G. Cochevelou points out, the main challenge is not to deploy the technologies and tools; it is to get the people to adopt and use them

  14. On the total character of finite groups

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Prajapati

    2014-09-01

    Full Text Available For a finite group $G$, we study the total character $tau_G$ afforded by the direct sum of all the non-isomorphic irreducible complex representations of $G$. We resolve for several classes of groups (the Camina $p$-groups, the generalized Camina $p$-groups, the groups which admit $(G,Z(G$ as a generalized Camina pair, the problem of existence of a polynomial $f(x in mathbb{Q}[x]$ such that $f(chi = tau_G$ for some irreducible character $chi$ of $G$. As a consequence, we completely determine the $p$-groups of order at most $p^5$ (with $p$ odd which admit such a polynomial. We deduce the characterization that these are the groups $G$ for which $Z(G$ is cyclic and $(G,Z(G$ is a generalized Camina pair and, we conjecture that this holds good for $p$-groups of any order.

  15. Total charge fluctuation in heavy ion collision

    International Nuclear Information System (INIS)

    Mishra, D.K.; Netrakanti, P.K.; Mohanty, A.K.; Garg, P.

    2014-01-01

    Event-by-event fluctuations of positive, negative, total and net charge produced in relativistic nuclear collisions have been of interest to explore phase transition and/or a critical end point (CEP) which is believed to exist somewhere between the hadronic phase and the quark-gluon phase of the QCD phase diagram. The entropy is closely related to the particle multiplicity, and it is expected to be approximately conserved during the evolution of the matter created at the early stage. The entropy fluctuations are not directly observed but can be inferred from the experimentally measured quantities. The final state mean multiplicity is proportional to the entropy of the initial state ( ∼ S). The particle multiplicity can be measured on an event-by-event basis, whereas the entropy is defined by averaging the particle multiplicities in the ensemble of events. Thus, the dynamical entropy fluctuations can be measured experimentally by measuring the fluctuations in the mean multiplicity

  16. NASA total quality management 1989 accomplishments report

    Science.gov (United States)

    Tai, Betty P. (Editor); Stewart, Lynne M. (Editor)

    1990-01-01

    NASA and contractor employees achieved many notable improvements in 1989. The highlights of those improvements, described in this seventh annual Accomplishments Report, demonstrate that the people who support NASA's activities are getting more involved in quality and continuous improvement efforts. Their gains solidly support NASA's and this Nation's goal to remain a leader in space exploration and in world-wide market competition, and, when communicated to others through avenues such as this report, foster improvement efforts across government and industry. The principles in practice which led to these process refinements are important cultural elements to any organization's productivity and quality efforts. The categories in this report reflect NASA principles set forth in the 1980's and are more commonly known today as Total Quality Management (TQM): top management leadership and support; strategic planning; focus on the customer; employee training and recognition; employee empowerment and teamwork; measurement and analysis; and quality assurance.

  17. Favorable results after total wrist arthroplasty

    DEFF Research Database (Denmark)

    Boeckstyns, Michel E. H.; Herzberg, G.; Merser, Søren

    2013-01-01

    survival was 0.9 at 5–9 years. Interpretation The clinical results in terms of pain, motion, strength, and function were similar to those in previous reports. The implant survival was 0.9 at 9 years, both in rheumatoid and non-rheumatoid cases, which is an important improvement compared to the earlier......Background and purpose During the past 40 years, several attempts have been made with total wrist arthroplasty to avoid fusion in severely destroyed wrists. The results have often been disappointing. There is only modest clinical documentation due to the small number of patients (especially non......-rheumatoid cases) and short follow-up times. Here we report a multicenter series using a third-generation implant with a minimum follow-up time of 5 years. Methods In 2012, data were retrieved from a registry of consecutive wrist operations at 7 centers with units specialized in hand surgery, between 2003 and 2007...

  18. Total Quality Management in Educational Organisations

    Directory of Open Access Journals (Sweden)

    Edvard Konrad

    2000-12-01

    Full Text Available Movement for Total Quality Management (TQM, which was initially successfully applied in the production of goods, has spread to the service domain including educational organisations. Many of principles and experiences known so far could be creatively transferred to educational situations. Additional research and specific innovations are necessary for successful application of existing knowledge. In this paper we discuss certain topics from the specific nature of the quality of education: the definition of the concept of a consumer, motivation of participants in educational processes, improvement of educational processes, quality of learning and leadership in educational organisations.

  19. TOTAL QUALITY MANAGEMENT IN HIGH EDUCATION

    Directory of Open Access Journals (Sweden)

    Hasan SERİN, Alper AYTEKİN

    2009-01-01

    Full Text Available The approach of Total Quality Management (TQM has been even more common and most recently its use in high education has been discussed. Likewise the enterprises producing various products, universities have also inputs, processes, and outputs. Due to conditions of competition, universities have to improve the qualities of these inputs, processes, and outputs, according to satisfaction, demands, and expectations of internal and external customers. If the TQM has been implemented in the universities with a manner that aims for customer satisfaction (students, lecturers, public and private establishments, and families, supports constant development, ensures participatory approach, and encourages working in groups, it will provide universities with effectiveness, efficiency, dynamics, and economics. In this study, common problems of universities, definitions of quality and TQM in high education, customer concept at universities, and factors affecting the quality of education have been explained. Besides, in order TQM approach to be successfully implemented in the universities, various suggestions have been presented.

  20. Material Science in Cervical Total Disc Replacement

    Science.gov (United States)

    Pham, Martin H.; Mehta, Vivek A.; Tuchman, Alexander; Hsieh, Patrick C.

    2015-01-01

    Current cervical total disc replacement (TDR) designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti), and cobalt-chrome (CoCr). These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation. PMID:26523281