Entrepreneurship, Calvinist Ethic and Regional Development

Directory of Open Access Journals (Sweden)

Alejandra Elizabeth Urbiola Solís

2012-11-01

Full Text Available The objective of this paper is to analyze the relation between a Calvinist religion orientation and the economic impact in Los Altos, Chiapas. The religious diversity is the result of the anticlerical fight in the XIX century and the decision to abandon the state religion. The opening in the religious market is also due to socioeconomicl factors and education, size and location of the town, and ethnicity. The economic practices of the Presbyterian groups are related to the Calvinist ideas about work. The Presbyterians promote entrepreneurship and leadership, as well as a comprehensive overview between the material and spiritual; Presbyterians have enhanced the principles of solidarity and support a system of risk management within each church, which allows the economic development in the long term. The study uses a phenomenological qualitative methodology court, in order to understand the relationship between beliefs and economic actions,   as well as to understand   perception that individuals built about the predestination phenomena and the way that this construction is related with the entrepreneurship and the leadership. This study was carried out in Chiapas and Queretaro states during 2011.

Fusion Genes Predict Prostate Cancer Recurrence

Science.gov (United States)

2017-10-01

Stanford University. The UPMC cohort includes up to 1900 well-annotated and -followed radical prostatectomy samples. University of Wisconsin will provide...probes, animal models); • clinical interventions; • new business creation; and • other. 7. PARTICIPANTS & OTHER COLLABORATING

Journal of Astrophysics and Astronomy | Indian Academy of Sciences

Indian Academy of Sciences (India)

Faculty of Humanities and Social Sciences, University of Rijeka, 51000 Rijeka, Croatia. Astronomical Observatory, Volgina 7, 11060 Belgrade, Serbia. LERMA, Observatoire de Paris, PSL Research University, CNRS, Sorbonne Universities, UPMC Univ. Paris 06, 5 Place Jules Janssen, 92195 Meudon Cedex, France.

Collaborative Radiological Response Planning

Science.gov (United States)

2013-12-01

DOE and EPA national laboratories .55 Additionally, the GAO conducted a survey of emergency management officials in cities, states and federal...for Biosecurity of UPMC, (2012). After fukushima: Managing the consequences of a radiological release. Retrieved from : http://issuu.com

Decompression tables for inside chamber attendants working at altitude.

Science.gov (United States)

Bell, James; Thombs, Paul A; Davison, William J; Weaver, Lindell K

2014-01-01

Hyperbaric oxygen (HBO2) multiplace chamber inside attendants (IAs) are at risk for decompression sickness (DCS). Standard decompression tables are formulated for sea-level use, not for use at altitude. At Presbyterian/St. Luke's Medical Center (Denver, Colorado, 5,924 feet above sea level) and Intermountain Medical Center (Murray, Utah, 4,500 feet), the decompression obligation for IAs is managed with U.S. Navy Standard Air Tables corrected for altitude, Bühlmann Tables, and the Nobendem© calculator. IAs also breathe supplemental oxygen while compressed. Presbyterian/St. Luke's (0.83 atmospheres absolute/atm abs) uses gauge pressure, uncorrected for altitude, at 45 feet of sea water (fsw) (2.2 atm abs) for routine wound care HBO2 and 66 fsw (2.8 atm abs) for carbon monoxide/cyanide poisoning. Presbyterian/St. Luke's provides oxygen breathing for the IAs at 2.2 atm abs. At Intermountain (0.86 atm abs), HBO2 is provided at 2.0 atm abs for routine treatments and 3.0 atm abs for carbon monoxide poisoning. Intermountain IAs breathe intermittent 50% nitrogen/50% oxygen at 3.0 atm abs and 100% oxygen at 2.0 atm abs. The chamber profiles include a safety stop. From 1990-2013, Presbyterian/St. Luke's had 26,900 total IA exposures: 25,991 at 45 fsw (2.2 atm abs) and 646 at 66 fsw (2.8 atm abs); there have been four cases of IA DCS. From 2008-2013, Intermountain had 1,847 IA exposures: 1,832 at 2 atm abs and 15 at 3 atm abs, with one case of IA DCS. At both facilities, DCS incidents occurred soon after the chambers were placed into service. Based on these results, chamber inside attendant risk for DCS at increased altitude is low when the inside attendants breathe supplemental oxygen.

Fulltext PDF

Indian Academy of Sciences (India)

1Faculty of Humanities and Social Sciences, University of Rijeka, 51000 Rijeka, Croatia. 2Astronomical Observatory, Volgina 7, 11060 Belgrade, Serbia. 3LERMA, Observatoire de Paris, PSL Research University, CNRS, Sorbonne Universities,. UPMC Univ. Paris 06, 5 Place Jules Janssen, 92195 Meudon Cedex, France.

A proposal for ethical research conduct in Madagascar

African Journals Online (AJOL)

Forest Management and Development, Department of Environmental Sciences, Swiss Federal Institute of Technology Zurich, 8092 Zurich, Switzerland. III ... Muséum national d'Histoire naturelle, Sorbonne Universités, Institut de Systématique, Evolution, Biodiversité (ISYEB), UMR7205-CNRS, MNHN, UPMC, EPHE,. CP 53 ...

Assessment of seasonal and year-to-year surface salinity signals retrieved from SMOS and Aquarius missions in the Bay of Bengal

Digital Repository Service at National Institute of Oceanography (India)

Akhil, V.P.; Lengaigne, M.; Durand, F.; Vialard, J.; Chaitanya, A.V.S.; Keerthi, M.G.; Gopalakrishna, V.V.; Boutin, J.; de Boyer, M.C.

, Sorbonne Universités (UPMC, Univ Paris 06)-CNRS-IRD-MNHN, Paris, France; dNIO, Goa, India; eLOS, IFREMER, Plouzané, France ABSTRACT The Bay of Bengal (BoB) exhibits a wide range of sea surface salinity (SSS), with very fresh water induced by heavy monsoonal...

Journal of Astrophysics and Astronomy | Indian Academy of Sciences

Indian Academy of Sciences (India)

2016-01-27

Jan 27, 2016 ... Department of Physics and Astronomy, College of Science, King Saud University, P. O. Box 2455, Riyadh 11451, Saudi Arabia. LERMA, Observatoire de Paris, PSL Research University, CNRS, Sorbonne Universités, UPMC Univ. Paris 06, 5 Place Jules Janssen, 92195 Meudon Cedex, France.

The early Korean Protestant Churches' impact on Korea's ...

African Journals Online (AJOL)

2014-06-20

Jun 20, 2014 ... general and the Korean Presbyterian Church in particular on the early phases of .... The missionary first asks for religious liberty, and then proclaims ..... which was historically founded in 1907, in Pyongyang, North Korea.

Untitled

African Journals Online (AJOL)

MAK

its enabling capacity to fulfil personal and social aspirations (Ahmed, 1979: 109). ... Methodist, Baptist, Presbyterian, and Qua Iboe, elementary schools were ... radio media in education which started in the early 1940s and mid1950s. The.

COMMUNITY STRESS, DEMORALIZATION AND BODY MASS INDEX: EVIDENCE FOR SOCIAL SIGNAL TRANSDUCTION. (R827027)

Science.gov (United States)

Quantification of the relationship between community-level chronic stress from neighborhood conditions and individual morale has rarely been reported. In this work, pregnant women were recruited at the prenatal clinics of Harlem Hospital and Columbia Presbyterian Medical Cente...

baat as bio-etiek sonder grense: 'n gereformeerd- etiese ...

African Journals Online (AJOL)

the universal moral obligations to do good for, and avoid harm to, other humans. .... one among a number of prima facie principles, and it does not determine the overall ...... Jersey: Presbyterian and Reformed Publishing Company. Fung. r.y.K..

Blunt Head Trauma and Headache

Directory of Open Access Journals (Sweden)

Ana B Chelse

2015-04-01

Full Text Available Investigators from New York Presbyterian Morgan Stanley Children’s Hospital examined whether having an isolated headache following minor blunt head trauma was suggestive of traumatic brain injury (TBI among a large cohort of children 2-18 years of age.

Prevalence of soil transmitted helminths and impact of Albendazole ...

African Journals Online (AJOL)

ELO

greatest number of STH infections occur in Sub Saharan. Africa where 89.9 millions of ..... combined approach with appropriate sanitation education. ACKNOWLEDGEMENTS. We thank the headmasters and teachers of Presbyterian ... human helminth infections in urban and rural environments in Brazil. Int. J. Parasitol.

FILOSOFIA THEORETICA FORMATED Vol 2 No. 2. Final 2docx

African Journals Online (AJOL)

JONATHAN

The development of this theory of “refl-action” becomes the focus of this scintillating paper. Students and African philosophers generally will find this work a useful intellectual resource. From Essien Ukpabio Presbyterian Theological College,. Ogbonnaya sets out to juxtapose Sartre's ontology with Asouzu's ontology.

International telepathology consultation: Three years of experience between the University of Pittsburgh Medical Center and KingMed Diagnostics in China

Directory of Open Access Journals (Sweden)

Chengquan Zhao

2015-01-01

Full Text Available Background: Telepathology is increasingly being employed to support diagnostic consultation services. Prior publications have addressed technology aspects for telepathology, whereas this paper will address the clinical telepathology experience of KingMed Diagnostics, the largest independent pathology medical laboratory in China. Beginning in 2012 the University of Pittsburgh Medical Center (UPMC and KingMed Diagnostics partnered to establish an international telepathology consultation service. Materials and Methods: This is a retrospective study that summarizes the telepathology experience and diagnostic consultation results between UPMC and KingMed over a period of 3 years from January 2012 to December 2014. Results: A total of 1561 cases were submitted for telepathology consultation including 144 cases in 2012, 614 cases in 2013, and 803 in 2014. Most of the cases (61.4% submitted were referred by pathologists, 36.9% by clinicians, and 1.7% by patients in China. Hematopathology received the most cases (23.7%, followed by bone/soft tissue (21.0% and gynecologic/breast (20.2% subspecialties. Average turnaround time (TAT per case was 5.4 days, which decreased from 6.8 days in 2012 to 5.0 days in 2014. Immunostains were required for most of the cases. For some difficult cases, more than one round of immunostains was needed, which extended the TAT. Among 855 cases (54.7% where a primary diagnosis or impression was provided by the referring local hospitals in China, the final diagnoses rendered by UPMC pathologists were identical in 25.6% of cases and significantly modified (treatment plan altered in 50.8% of cases. Conclusion: These results indicate that international telepathology consultation can significantly improve patient care by facilitating access to pathology expertise. The success of this international digital consultation service was dependent on strong commitment and support from leadership, information technology expertise, and

77 FR 44268 - National Register of Historic Places; Notification of Pending Nominations and Related Actions

Science.gov (United States)

2012-07-27

... Presbyterian Church of Peoria, 10236 N. 83rd Ave., Peoria, 12000493 CALIFORNIA Mariposa County Half Dome Cables and Trail, P.O. Box 577, Yosemite, 12000494 COLORADO Jefferson County Baugh, James H., House, 11361 W... Dome Observation Tower, Terminus of Clingmans Dome Rd., Bryson City, 12000515 SOUTH DAKOTA Lawrence...

Post-Mao China: Educational Services for Exceptional Individuals

Science.gov (United States)

Ding, Yi; Yang, Ling-Yan; Xiao, Fei; Van Dyke, Don C.

2008-01-01

When William Moore, a Scottish Presbyterian pastor, established the first special school in China in 1874, the country began her long and circuitous journey toward establishing formal educational services for individuals with special needs. Special education in China developed slowly on the infertile soil of continual wars, political instability,…

ORIGINAL ARTICLE

African Journals Online (AJOL)

User

Presbyterian Hospital, Asante Akim, 3School of Veterinary Medicine, University of Ghana, Accra, 4Department of ... ticipants and had a statistically significant association with the severity of the anaemia (p=0.0028). ..... where there is a low intake of animal source food, ... veys done in Latin America, estimates that approxi-.

Primary hypertension and special aspects of hypertension in older children and adolescents

OpenAIRE

Ellis, Demetrius; Miyashita, Yosuke

2011-01-01

Demetrius Ellis, Yosuke MiyashitaChildren’s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, PA, USAAbstract: The prevalence of hypertension has increased at an accelerated rate in older children and adolescents. This has raised great concern about premature development of cardiovascular disease, which has major long-term health and financial implications. While obesity and sedentary habits largely explain this phenomenon, there are other social and cultu...

Acta Theologica 2005: 1 RESENSIES/REVIEWS Trouble in the ...

African Journals Online (AJOL)

Bridges,. Presbyterian Leaders in 19th Century Australia, Melbourne 1993, p.19.) In .... last words. Added ..... But the author calls our attention to the shift from the old con- fessional ... A broad theme such as 2000 years of Christianity requires a selective approach ..... Such fees may be recouped from earnings on research.

Women Religious Leaders and Stress.

Science.gov (United States)

Rayburn, Carole A.; And Others

This study examined stress, strain, and coping mechanisms in women religious leaders. Subjects were nuns (N=51), Reform women rabbis (N=45), Episcopal women priests (N=32), United Methodist clergywomen (N=45) and Presbyterian clergywomen (N=45), matched for age and years on the job and pulpit assignments. All subjects were given the Osipow and…

Super Refractory Status Epilepticus

African Journals Online (AJOL)

user

et al did retrospective cohort study from 1 January st. 1994 to 31 March 1998 at Presbyterian Medical. Centre in Columbia, to determine the frequency, risk factors and impact on the outcome of RSE. They found out that 69% of seizures recurred after. Key Words: Super refractory status epilepticus, Zambia. Medical Journal of ...

Frontier Justice versus the Rule of Law: Two Cases of Intolerance in Mid-19th Century America Illustrate the Role of the Bill of Rights.

Science.gov (United States)

Kopecky, Frank

1992-01-01

Presents an essay dealing with two nineteenth-century incidents of religious intolerance. Recounts the story of Joseph Smith, the founder of the Mormon Church, who was murdered by opponents of the new religion. Explains how the writings of Presbyterian minister and newspaper publisher, Elijah Lovejoy, set off a response that led to his death. (SG)

ATF4, A Novel Mediator of the Anabolic Actions of PTH on Bone

Science.gov (United States)

2012-01-01

poster) A5. Xiao G. Critical role of activating transcription factor 4 in parathyroid hormone-mediated bone formation. Military Health Research...C, Pittsburgh, Pennsylvania 15240. E-mail: xiaog@upmc.edu. This work was supported by National Institutes of Health Grants DK072230 (to G.X.) and...Ahn JD, Takeda S, Starbuck M, Yang X, Liu X, Kondo H, Richards WG, Bannon TW, Noda M, Clement K, Vaisse C, Karsenty G 2005 Leptin regulation of bone

Enzyme Triggered Drug Delivery for Graft Targeted Immunosupression and Neuroregeneration after VCA

Science.gov (United States)

2016-05-11

Banz,6 Mihal A. Constant lnescu,1•2 Jeffrey M. Karp,4 t Praveen Kumar Vemula1 3 t Robert Rieben, 2t Esthe r Vogelin 1’ 2 Curre ntly, syst·emic... Praveen Vemula NAMRU, San Antonio Ms Carrie Crane Ms Candice Angueira i11Stern I) UPMC L𔃻mer.i t ~ uf 1󈧏 1,Jmr~h .\\l r<l1c.1l < c111er ’

Christianity, Western Education and Development in Akwa Ibom ...

African Journals Online (AJOL)

1846-04-10

The beginnings of that relationship go back to the 15th century, when the Portuguese Catholic Missionaries got to Benin and Warri, but it was rather sporadic until the 19th century with the arrival of the Presbyterian Church at Calabar on April 10, 1846 led by the Rev. Hope Masterton Waddell. Other missionaries were to ...

New Focus, Same Mission

Science.gov (United States)

Stuart, Reginald

2010-01-01

Bloomfield College, started in the mid-1800s by the Presbyterian Church as a school for German ministers immigrating to the United States, today proudly stands among the nation's predominantly Black colleges. It is a status the small private college did not seek and only fully embraced after a painful evolution marked by racial demographic changes…

Long-Term Outcome of Gilles De La Tourette Syndrome

Directory of Open Access Journals (Sweden)

J Gordon Millichap

2003-11-01

Full Text Available Videotapes recorded 1978 through 1991 of 56 children (ages 8 to 14 with Gilles de la Tourette syndrome (GTS were reviewed and 31 of the patients (28 men and 3 women, age>20 years were recruited for a second videotape and in-person assessment at Rush-Presbyterian-St Luke’s Movement Disorder Center, Chicago, IL.

Safe use of NSAIDs and RAS-inhibitors at Agogo Presbyterian ...

African Journals Online (AJOL)

2016-03-01

Mar 1, 2016 ... converting-enzyme inhibitor benazepril on the pro- gression of chronic renal insufficiency. The Angio- tensin-Converting-Enzyme Inhibition in Progres- sive Renal Insufficiency Study Group. N Engl J. Med. 1996;334(15):939-45. 26. Howard RL, Avery AJ, Slavenburg S, Royal S,. Pipe G, Lucassen P, et al.

Hervormde voetspore op die Tukkie-kampus: ’n Kroniek van die eerste 50 jaar

Directory of Open Access Journals (Sweden)

André G. Ungerer

2017-07-01

Full Text Available In 2017 the Nederduitsch Hervormde Kerk van Afrika (NHKA celebrates its centenary of theological education at the University of Pretoria (UP. In this article the focus is on the build-up to setting up the first 50 years 1917– 1967 at UP. From as early as 1909 there was a yearning for our own theological seminary; however, some of the church leaders expressed their desire for theological education at a university. At the dawn of 1916 everything was in place for the NHKA and the Presbyterian Church of South Africa, as the first two partners, to start a faculty of theology at the Transvaal University College (TUC. On 01 April 1917 the Faculty of Theology commenced its work with prof. J.H.J.A. Greyvenstein of the NHKA and prof. E. MacMillan from the Presbyterian Church. The Presbyterian link with the faculty was broken in 1933. From 1938 the Nederduitse Gereformeerde Kerk (NGK joined the NHKA and two independent sections were established: Section A for the NHKA and Section B for the NGK. There was a steady growth in the number of students and professors and on 13 June 1967 the NHKA filled its sixth professorship in the person of prof. I.J. de Wet. This era was also characterised by a lot of political tension in the heyday of the policy of apartheid. The NHKA was known for Article III in its constitution that propagates that church membership was for whites only. The NHKA support of the policy of apartheid was the cause of a dispute between the Church and prof. A.S. Geyser. In the end the matter was settled in favour of Geyser. There was also a dispute between professors A.G. Geyser and A.D. Pont that ended up in court in 1967. Pont was accused of defamation against Geyser. The court ruled against Pont and Geyser was granted the largest amount of compensation up till then.

Characterization of the Helderberg Group as a geologic seal for CO 2 sequestration

Science.gov (United States)

Lewis, J.E.; McDowell, R.R.; Avary, K.L.; Carter, K.M.

2009-01-01

The Midwest Regional Carbon Sequestration Partnership recognizes that both the Devonian Oriskany Sandstone and the Silurian Salina Group offer potential for subsurface carbon dioxide storage in northern West Virginia. The Silurian-Devonian Helderberg Group lies stratigraphically between these two units, and consequendy, its potential as a geologic seal must be evaluated. Predominantly a carbonate interval with minor interbedded siliciclastics and chert, the Helderberg Group was deposited in an ancient epeiric sea. Although most previous investigations of this unit have concentrated on outcrops in eastern West Virginia, new information is available from an injection well drilled along the Ohio River at First Energy's R. E. Burger electric power plant near Shadyside, Ohio. Geophysical, seismic, and core data from this well have been combined with existing outcrop information to evaluate the Helderberg Group's potential as a seal. The data collected suggest that only secondary porosity remains, and permeability, if it exists, most likely occurs along faults or within fractures. ?? 2009. The American Association of Petroleum Geologists/Division of Environmental Geosciences. All rights reserved.

Fire Service Emergency Management Handbook

Science.gov (United States)

1985-01-01

Adapted from Formulating Public Policy in Emergency Management Course Book and ResourceMRanual for Public OTTicials, ILMA Emergency Management Institute...659-2447 (202) 785-2757 Christian Reformed World Relief Presbyterian Church in U.S. Committee General Assemby Mission Board C. Neil Molenaar 341 Ponce...Healer, Mind as Slayer. New York: Delta Books , 1977. 86B:6 B-45 4) Mitchell, J.T., & Resnik, HLP: Emergency Response to Crisis: A Crisis Intervention

Between Christianity and secularity: counselling and psychotherapy provision in Scotland

OpenAIRE

Bondi, Liz

2013-01-01

Counselling and psychotherapy services have become increasingly prominent within modern urban welfare. Although often perceived to be intrinsically secular, since psychoanalytic thinking and practice arrived in Scotland it has been shaped by the Christian culture it encountered. Early Scottish-born contributors to psychoanalytic theory, including Ian Suttie and W.R.D. Fairbairn, reframed Freud’s ideas in ways that incorporated Scottish Presbyterian understandings of what it is to be human. A ...

Contribution of mesoscale processes to nutrient budgets in the Arabian Sea

Digital Repository Service at National Institute of Oceanography (India)

Resplandy, L; Levy, M.; Madec, G.; Pous, S.; Aumont, O.; DileepKumar, M.

Contribution of mesoscale processes to nutrient1 budgets in the Arabian Sea2 L. Resplandy, 1 M. L´evy, 1 G. Madec, 1,2 S. Pous, 1 O. Aumont, 3 D. Kumar 4 L. Resplandy, LOCEAN, UPMC, BC100, 4 place Jussieu, F-75252 Paris cedex 05, France. (lrlod... is constant and set to 122/16 [Takahashi et al., 1985]. To ensure positive values, biogeo-141 chemical tracers are advected with the positive Monotone Upstream-centered Schemes for142 Conservation Laws [Van Leer, 1979; L´evy et al., 2001] and dissipated along...

Critical appraisal of belatacept for prophylaxis of rejection in kidney transplant patients

OpenAIRE

Chandraker, Anil; Gabardi,Steven; Martin,Spencer; Tsapepas,

2011-01-01

Spencer T Martin1, Demetra Tsapepas1, Steven Gabardi2–5, Anil Chandraker2,31Department of Pharmacy, New York-Presbyterian Hospital, New York City, NY, USA; 2Harvard Medical School, Boston, MA, USA; 3Renal Division, 4Department of Pharmacy Services, 5Department of Transplant Surgery, Brigham and Women's Hospital, Boston, MA, USAAbstract: Belatacept (LEA29Y) is an intravenous biologic for long-term maintenance immunosuppressive therapy in renal transplant recipients. It is cur...

Development of an evidence-based decision pathway for vestibular schwannoma treatment options.

Science.gov (United States)

Linkov, Faina; Valappil, Benita; McAfee, Jacob; Goughnour, Sharon L; Hildrew, Douglas M; McCall, Andrew A; Linkov, Igor; Hirsch, Barry; Snyderman, Carl

To integrate multiple sources of clinical information with patient feedback to build evidence-based decision support model to facilitate treatment selection for patients suffering from vestibular schwannomas (VS). This was a mixed methods study utilizing focus group and survey methodology to solicit feedback on factors important for making treatment decisions among patients. Two 90-minute focus groups were conducted by an experienced facilitator. Previously diagnosed VS patients were recruited by clinical investigators at the University of Pittsburgh Medical Center (UPMC). Classical content analysis was used for focus group data analysis. Providers were recruited from practices within the UPMC system and were surveyed using Delphi methods. This information can provide a basis for multi-criteria decision analysis (MCDA) framework to develop a treatment decision support system for patients with VS. Eight themes were derived from these data (focus group + surveys): doctor/health care system, side effects, effectiveness of treatment, anxiety, mortality, family/other people, quality of life, and post-operative symptoms. These data, as well as feedback from physicians were utilized in building a multi-criteria decision model. The study illustrated steps involved in the development of a decision support model that integrates evidence-based data and patient values to select treatment alternatives. Studies focusing on the actual development of the decision support technology for this group of patients are needed, as decisions are highly multifactorial. Such tools have the potential to improve decision making for complex medical problems with alternate treatment pathways. Copyright © 2016 Elsevier Inc. All rights reserved.

A Heat Vulnerability Index and Adaptation Solutions for Pittsburgh, Pennsylvania.

Science.gov (United States)

Bradford, Kathryn; Abrahams, Leslie; Hegglin, Miriam; Klima, Kelly

2015-10-06

With increasing evidence of global warming, many cities have focused attention on response plans to address their populations' vulnerabilities. Despite expected increased frequency and intensity of heat waves, the health impacts of such events in urban areas can be minimized with careful policy and economic investments. We focus on Pittsburgh, Pennsylvania and ask two questions. First, what are the top factors contributing to heat vulnerability and how do these characteristics manifest geospatially throughout Pittsburgh? Second, assuming the City wishes to deploy additional cooling centers, what placement will optimally address the vulnerability of the at risk populations? We use national census data, ArcGIS geospatial modeling, and statistical analysis to determine a range of heat vulnerability indices and optimal cooling center placement. We find that while different studies use different data and statistical calculations, all methods tested locate additional cooling centers at the confluence of the three rivers (Downtown), the northeast side of Pittsburgh (Shadyside/Highland Park), and the southeast side of Pittsburgh (Squirrel Hill). This suggests that for Pittsburgh, a researcher could apply the same factor analysis procedure to compare data sets for different locations and times; factor analyses for heat vulnerability are more robust than previously thought.

Shielding requirements on-site loading and acceptance testing on the Leksell gamma knife

International Nuclear Information System (INIS)

Maitz, A.H.; Lunsford, L.D.; Wu, A.; Lindner, G.; Flickinger, J.C.

1990-01-01

On August 14, 1987, the first stereotactic radiosurgical procedure using the gamma knife was performed in North America. Located in a self-contained radiosurgical suite in the basement of Presbyterian-University Hospital in Pittsburgh, Pennsylvania. This device uses 201 highly focused beams 60Co for the single-treatment closed-skull irradiation of brain lesions localized by stereotactic techniques (radiosurgery). One hundred and fifty-two patients with intracranial arteriovenous malformations or brain tumors were treated in the first year of operation. The Presbyterian University Hospital of Pittsburgh gamma knife is the first such unit in which the 60Co sources were loaded on-site. This effort required us to solve some difficult and unusual problems encountered during site preparation, delivery, and loading of the unit in a busy hospital setting. The solutions developed enabled installation and use of the gamma knife with minimal disruption of hospital activities while maintaining acceptable levels of exposure to radiation. Environmental surveys performed during the loading of the 201 radioactive sources (total, 219 TBq) confirmed that on-site loading is possible and practical. Our experience in the design, construction, and implementation of the first North American gamma knife supports the practicality and safety of on-site loading and may be of value in the planning and development of future gamma knife installations

Autoinmunidad tiroidea: Recuerdos personales (1957-1959

Directory of Open Access Journals (Sweden)

Efraim Otero Ruiz

2011-07-01

Full Text Available

He creído importante transcribir estas reminiscencias, pues hacen parte del sudor y esfuerzo que muchos colombianos hemos brindado para contribuir con nuestro grano de arena a investigaciones que, en la segunda mitad del siglo XX, transformaron y dieron nueva luz al pensamiento inmunológico.

Puede decirse que en la segunda mitad de la década de los años 5Os se vivió una de las épocas más excitantes en el Departamento de Medicina del Columbia- Presbyterian Medical Center (Presbyterian Hospital o PH en la calle 168 de la ciudad de Nueva York. El Director (Chairman del Departamento era el Profesor Robert F. Loeb, uno de los internistas más prestigiosos del mundo, coautor del texto de Medicina Interna de Cecil Loeb, la biblia médica para los no iniciados. Alrededor de él se congregaba -como podía observarse los martes en las Clínicas Endocrinas Combinadas, celebradas en el enorme torreón o anfiteatro que databa de comienzos del siglo- la élite del conocimiento médico y científico, personas que sacaban tiempo de sus investigaciones para dictar las diversas cátedras: Severo Ochoa -el Premio Nobel español, tan adusto como su nombre- en genética, -proveniente del New York Hospital que compartía con Presbyterian y con Bellevue el triunvirato de la medicina interna y las clínicas combinadas-; Sydney Werner y Ken Sterling (tiroides, Dana Atchley (electrolitos, cetoacidosis diabética y Seymour Lieberman (suprarrenales en endocrinología; Franklin Hanger en Hepatología; Beatrice Seegal en inmunología y transplantes; y, por supuesto, como profesores visitantes, Salomón Berson y Rosalyn Yalow (diabetes procedentes del Hospital de Veteranos del Bronx, sin contar con los innumerables profesores asistentes o visitantes, más jóvenes, que después brillarían con luz propia. Se asistía no sólo a la primera infancia de la nueva genética (nacida con la doble hélice de Watson y Crick en 1953 sino del atrevido concepto

Safe use of NSAIDs and RAS-inhibitors at Agogo Presbyterian Hospital, Ghana

NARCIS (Netherlands)

Meulendijks, L.G.; Adomako, E.A.; Appiah, E.B.; Kramers, C.

2016-01-01

BACKGROUND: Preventable adverse events of medication are an important cause of hospital admissions in the developed world, in which non-steroidal anti-inflammatory drugs (NSAIDs) and renin-angiotensin system (RAS-) inhibitors are frequently involved. NSAIDs and RAS-inhibitors are also often used in

Identification of hidden relationships from the coupling of hydrophobic cluster analysis and domain architecture information.

Science.gov (United States)

Faure, Guilhem; Callebaut, Isabelle

2013-07-15

Describing domain architecture is a critical step in the functional characterization of proteins. However, some orphan domains do not match any profile stored in dedicated domain databases and are thereby difficult to analyze. We present here an original novel approach, called TREMOLO-HCA, for the analysis of orphan domain sequences and inspired from our experience in the use of Hydrophobic Cluster Analysis (HCA). Hidden relationships between protein sequences can be more easily identified from the PSI-BLAST results, using information on domain architecture, HCA plots and the conservation degree of amino acids that may participate in the protein core. This can lead to reveal remote relationships with known families of domains, as illustrated here with the identification of a hidden Tudor tandem in the human BAHCC1 protein and a hidden ET domain in the Saccharomyces cerevisiae Taf14p and human AF9 proteins. The results obtained in such a way are consistent with those provided by HHPRED, based on pairwise comparisons of HHMs. Our approach can, however, be applied even in absence of domain profiles or known 3D structures for the identification of novel families of domains. It can also be used in a reverse way for refining domain profiles, by starting from known protein domain families and identifying highly divergent members, hitherto considered as orphan. We provide a possible integration of this approach in an open TREMOLO-HCA package, which is fully implemented in python v2.7 and is available on request. Instructions are available at http://www.impmc.upmc.fr/∼callebau/tremolohca.html. isabelle.callebaut@impmc.upmc.fr Supplementary Data are available at Bioinformatics online.

Architectural design of a data warehouse to support operational and analytical queries across disparate clinical databases.

Science.gov (United States)

Chelico, John D; Wilcox, Adam; Wajngurt, David

2007-10-11

As the clinical data warehouse of the New York Presbyterian Hospital has evolved innovative methods of integrating new data sources and providing more effective and efficient data reporting and analysis need to be explored. We designed and implemented a new clinical data warehouse architecture to handle the integration of disparate clinical databases in the institution. By examining the way downstream systems are populated and streamlining the way data is stored we create a virtual clinical data warehouse that is adaptable to future needs of the organization.

Etiology of Congenital Dislocation of the Hip

OpenAIRE

Brand, Richard A.

2008-01-01

Dr. Carl E. Badgley was born in 1893, the son of a Presbyterian minister [2]. He received his medical degree at the University of Michigan in 1919, and became interested in orthopaedic surgery owing to Drs. Hugh Cabot and LeRoy Abbott. He was appointed as an instructor of surgery in 1920 and was appointed professor and head of the Section of Orthopaedic Surgery in 1932, an appointment he retained until 1963 when he retired. Dr. Badgley, devoted to his home state, was active in organizing inst...

Basin-wide seasonal evolution of the Indian Ocean's phytoplankton blooms

Digital Repository Service at National Institute of Oceanography (India)

Levy, M.; Shankar, D.; Andre, J.M.; Shenoi, S.S.C.; Durand, F.; De

OF GEOPHYSICAL RESEARCH, VOL. ???, XXXX, DOI:10.1029/, Basin-wide seasonal evolution of the Indian Ocean’s1 phytoplankton blooms2 M. L´evy 1,2 ,D.Shankar 2 , J.-M. Andr´e 1,2 , S. S. C. Shenoi 2 ,F.Durand 2,3 and C. de Boyer Mont´egut 4 M. L´evy, LOCEAN....2. The physical model We used outputs from the NEMO OGCM in its global configuration ORCA0595 (http://www.locean-ipsl.upmc.fr/NEMO). The model run that we used is an updated96 version of the simulation validated by de Boyer Mont´egut et al. (in press) over...

Telemedicine and its transformation of emergency care: a case study of one of the largest US integrated healthcare delivery systems.

Science.gov (United States)

Sharma, Rahul; Fleischut, Peter; Barchi, Daniel

2017-12-01

Innovative methods for delivering healthcare via the use of technology are rapidly growing. Despite the passage of the Affordable Care Act, emergency department visits have continued to rise nationally. Healthcare systems must devise solutions to face these increasing volumes and also deliver high quality care. In response to the changing healthcare landscape, New York Presbyterian Hospital has implemented a comprehensive enterprise wide digital health portfolio which includes the first mobile stroke treatment unit on the east coast and the first emergency department-based digital emergency care program in New York City.

'The repression and the return of bad objects': W. R. D. Fairbairn and the historical roots of theory.

Science.gov (United States)

Beattie, Hilary J

2003-10-01

One of the seminal, if solitary, figures of the British Object Relations School was the Scotsman W. R. D. Fairbairn. In this paper the author relates some of the distinctive features of Fairbairn's thinking to traumatic aspects of his country's history, especially the harsh, repressive traditions of Scottish Presbyterianism, which were magnified in confusing ways by his sexually puritanical parents. The two World Wars are shown to have played an important role in liberating Fairbairn from these constraints, influencing both his choice of career and, notably, the evolution of his ideas.

Characteristics and Associated Comorbidities of Pediatric Dental Patients Treated under General Anesthesia.

Science.gov (United States)

Delfiner, Alexandra; Myers, Aaron; Lumsden, Christie; Chussid, Steve; Yoon, Richard

To describe characteristics and identify common comorbidities of children receiving dental treatment under general anesthesia at Children's Hospital of New York-Presbyterian. Electronic medical records of all children that received dental treatment under general anesthesia through the Division of Pediatric Dentistry from 2012-2014 were reviewed. Data describing patient characteristics (age, sex, race/ethnicity, insurance carrier, and American Society of Anesthesiologists physical status classification system), medical history, and justification for treatment were collected. Descriptive statistics, including frequencies, percentages and t-tests, were calculated. A total of 298 electronic medical records were reviewed, of which 50 records were excluded due to missing information. Of the 248 electronic medical records included, the average age was 5-years-old and 58% were male. The most common reason for dental treatment under general anesthesia was extent and severity of dental disease (53%), followed by significant medical history (47%) and behavior/pre-cooperative age (39%). Those who were ASA III or IV were older (6.6-years) (p<.001). Common medical comorbidities appear evenly distributed: autism (12%), cardiac anomalies (14%), developmental delay (14%), genetic syndromes/chromosomal disorders (13%), and neurological disorders (12%). Younger age groups (1 to 2 years and 3 to 5 years) had a high percentage of hospitalizations due to the extent and severity of the dental disease (83%) and behavior (77%) (p<0.001). No single comorbidity was seen more often than others in this patient population. The range of medical conditions in this population may be a reflection of the range of pediatric specialty services at Children's Hospital of NewYork-Presbyterian.

Identification, prevalence, and treatment of painful diabetic neuropathy in patients from a rural area in South Carolina

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Pruitt III J

2017-04-01

Full Text Available Jimmy Pruitt III,1 Carolina Moracho-Vilrriales,1,2 Tiffaney Threatt,3 Sarah Wagner,3 Jun Wu,1 E Alfonso Romero-Sandoval1 1Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, SC, USA; 2Department of Biochemistry and Biotechnology, University of Alcalá de Henares, Madrid, Spain; 3Department of Pharmacy Practice, Presbyterian College School of Pharmacy, Clinton, SC, USA Abstract: Diabetic peripheral neuropathy (DPN represents significant burdens to many patients and the public health-care system. Patients with diabetes in rural areas have higher risk of developing complications and having less access to proper treatment. We studied a rural population of patients with diabetes who attended a pharmacist-led free clinic for a diabetic education program. Our objectives were to 1 determine the prevalence of DPN and painful diabetic neuropathy (p-DN in patients with type 2 diabetes; 2 assess the proportion of patients with DPN and p-DN left undocumented upon physician referral to a pharmacist-led free clinic; and 3 determine the appropriateness of pain medication regimen. We performed a retrospective analysis of clinical records of patients from the Presbyterian College School of Pharmacy (PCSP Wellness Center located in Clinton, SC. Diagnoses of DPN and/or p-DN were obtained from referral notes in the clinical records and compared with results from foot examinations performed in the free clinic and clinical features. Medication regimens were also obtained and compared using American Academy of Neurology (AAN treatment guidelines. Within our study population (n=111, the prevalence of DPN was 62.2% (national average of 28%–45% and that of p-DN was 23.4% (national average of 11%–24%. In p-DN patients (n=26, 53.8% (n=14 had a documented diagnosis of p-DN by the referring physician, and 46.2% (n=12 were identified by the pharmacists. A total of 95% (19 of 20 of the patients treated for p

An exploratory study of host polymorphisms in genes that clinically characterize breast cancer tumors and pretreatment cognitive performance in breast cancer survivors

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Koleck TA

2017-03-01

Full Text Available Theresa A Koleck,1,2 Catherine M Bender,1 Beth Z Clark,3,4 Christopher M Ryan,5,6 Puja Ghotkar,1 Adam Brufsky,4,7,8 Priscilla F McAuliffe,4,8,9 Priya Rastogi,4,7 Susan M Sereika,1,10,11 Yvette P Conley,1,12 1School of Nursing, University of Pittsburgh, Pittsburgh, PA, 2School of Nursing, Columbia University, New York, NY, 3Division of Gynecologic Pathology, Magee-Womens Hospital of University of Pittsburgh Medical Center (UPMC, 4School of Medicine, 5Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 6Department of Psychiatry, University of California San Francisco, San Francisco, CA, 7Division of Hematology/Oncology, Magee-Womens Hospital of UPMC, 8University of Pittsburgh Cancer Institute, 9Division of Breast Surgical Oncology, Magee-Womens Hospital of UPMC, 10Department of Biostatistics, 11Department of Epidemiology, 12Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA Purpose: Inspired by the hypothesis that heterogeneity in the biology of breast cancers at the cellular level may account for cognitive dysfunction symptom variability in survivors, the current study explored relationships between host single-nucleotide polymorphisms (SNPs in 25 breast cancer-related candidate genes (AURKA, BAG1, BCL2, BIRC5, CCNB1, CD68, CENPA, CMC2, CTSL2, DIAPH3, ERBB2, ESR1, GRB7, GSTM1, MELK, MKI67, MMP11, MYBL2, NDC80, ORC6, PGR, RACGAP1, RFC4, RRM2, and SCUBE2, identified from clinically relevant prognostic multigene-expression profiles for breast cancer, and pretreatment cognitive performance.Patients and methods: The sample (n=220 was comprised of 138 postmenopausal women newly diagnosed with early stage breast cancer and 82 postmenopausal age- and education-matched healthy controls without breast cancer. Cognitive performance was assessed after primary surgery but prior to initiation of adjuvant chemotherapy and/or hormonal therapy using a comprehensive battery of

UPMC Prescription for Wellness: A Quality Improvement Case Study for Supporting Patient Engagement and Health Behavior Change.

Science.gov (United States)

Maners, Rebecca J; Bakow, Eric; Parkinson, Michael D; Fischer, Gary S; Camp, Geoffrey R

Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system. Building on the national Agency for Healthcare Research and Quality and Robert Wood Johnson Foundation-funded Prescription for Health multisite demonstration, this QI case study provides important lessons for transforming patient-physician-practice support systems to better address lifestyle and care management challenges critical to producing better outcomes.

Tiyo Soga (1829–1871 at the intersection of ‘universes in collision’

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Graham A. Duncan

2018-03-01

Full Text Available Tiyo Soga, the first black minister ordained in Scotland by the United Presbyterian Church of Scotland in 1856, was, by any standards, a conflicted character. He stood both in and between two worlds and suffered from the vulnerability that emerged from his dual allegiances. Yet he made a significant contribution to the mission history of South Africa, particularly through his early influence on the development of black consciousness and black nationalism, which were to make significant contributions to black thinking in the 20th century. Soga’s life and ministry are set in the context of Michael Ashley’s concept of ‘universes in collision’.

Fluorescence excitation analysis by two-photon confocal laser scanning microscopy: a new method to identify fluorescent nanoparticles on histological tissue sections

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Kahn E

2012-10-01

Full Text Available Edmond Kahn,1 Nicolas Tissot,3 Perrine Frere,3 Aurélien Dauphin,3 Mohamed Boumhras,2,4 Claude-Marie Bachelet,3 Frédérique Frouin,1 Gérard Lizard21Institut National de la Santé et de la Recherche Médicale (INSERM U678/UMR-S UPMC, CHU Pitié-Salpêtrière, Paris, France; 2Equipe Biochimie du Peroxysome, Inflammation et Métabolisme Lipidique EA7270, Faculté des Sciences Gabriel, Université de Bourgogne-INSERM Dijon, France; 3Plateforme d'Imagerie cellulaire, UPMC, Paris, France; 4Laboratory of Biochemistry and Neuroscience, Applied Toxicology Group, Faculty of Science and Technology, Settat, MoroccoAbstract: In the present study, we make use of the ability of two-photon confocal laser scanning microscopes (CLSMs equipped with tunable lasers to produce spectral excitation image sequences. Furthermore, unmixing, which is usually performed on emission image sequences, is performed on these excitation image sequences. We use factor analysis of medical image sequences (FAMIS, which produces factor images, to unmix spectral image sequences of stained structures in tissue sections to provide images of characterized stained cellular structures. This new approach is applied to histological tissue sections of mouse aorta containing labeled iron nanoparticles stained with Texas Red and counterstained with SYTO13, to obtain visual information about the accumulation of these nanoparticles in the arterial wall. The possible presence of Texas Red is determined using a two-photon CLSM associated with FAMIS via the excitation spectra. Texas Red and SYTO13 are thus differentiated, and corresponding factor images specify their possible presence and cellular localization. In conclusion, the designed protocol shows that sequences of images obtained by excitation in a two-photon CLSM enables characterization of Texas Red-stained nanoparticles and other markers. This methodology offers an alternative and complementary solution to the conventional use of emission

“Trickster” and “Republican”: Robert Harley’s Political Career in the 1690s

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Kiselev Aleksandr

2014-12-01

Full Text Available Despite the fact that Robert Harley is known as Tory politician, he began his career as a Whig politician. His grandfather and father were Presbyterians, and Robert Harley himself was a Presbyterian during his entire life. Harley’s family supported the Glorious Revolution of 1688. In 1689 Robert Harley was first elected to the House of Commons as a representative of the Whig party. Thanks to his wife’s Foley family, Robert Harley was elected as a commissioner of public accounts in the House of Commons. In 1689 Britain entered the “war of King William” which was a burden for many gentry (Whigs or Tories. Robert Harley became famous in the parliament as a critic of the war and corruption in the army. In 1693 the Whig leaders headed the ministry and continued the war. Their policy divided the Whigs party in two factions: “Court Whigs” and “Country Whigs”. Robert Harley and his supporters became “Country Whigs”, and they criticized the “Court Whigs”. By 1700 Robert Harley joined the Tory party. The article also describes the evolution of historiography of Harley‘s policy. Victorian historians have called the Prime Minister a “stupid person”. The same opinion was repeated by Russian historians of the 19th century. But in the 20th century the assessment of Robert Harley’s activity was changed by the works of K. Feiling, G. Holmes, B.W. Hill and other historians. Soviet historians (for example M.A. Barg also called R.Harley a “mediocre politician”, but modern Russian historians (L.I. Ivonina, T.L. Labutina and others consider him a “clever statesman” and a “master of political intrigues and parliamentary diplomacy”.

Intranet technology in hospital information systems.

Science.gov (United States)

Cimino, J J

1997-01-01

The clinical information system architecture at the Columbia-Presbyterian Medical Center in New York is being incorporated into an intranet using Internet and World Wide Web protocols. The result is an Enterprise-Wide Web which provides more flexibility for access to specific patient information and general medical knowledge. Critical aspects of the architecture include a central data repository and a vocabulary server. The new architecture provides ways of displaying patient information in summary, graphical, and multimedia forms. Using customized links called Infobuttons, we provide access to on-line information resources available on the World Wide Web. Our experience to date has raised a number of interesting issues about the use of this technology for health care systems.

Devereux Jarratt’s spiritual search: an example of autobiography in colonial and revolutionary Virginia

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Vostrikov Pavel Vyacheslavovich

2017-12-01

Full Text Available This article is about the life story of Devereux Jarratt (1733-1801, an Anglican clergyman from colonial and revolutionary Virginia. His autobiography reflects the colonists’ views on many features of social and cultural life. The progress of his life was quite unusual for that period as he was able to overcome social barriers separating simple yeomen from the ruling elite, and he became a man of book culture. Jarratt was an enthusiastic preacher in the times of Great Awakening (1740-1790, a protestant of revival movement; in his writings he preserved memories of many important events and tendencies in the state of Anglican Church as well as activities of Presbyterians, Baptists and Methodists.

Measuring large aspherics using a commercially available 3D-coordinate measuring machine

Science.gov (United States)

Otto, Wolfgang; Matthes, Axel; Schiehle, Heinz

2000-07-01

A CNC-controlled precision measuring machine is a very powerful tool in the optical shop not only to determine the surface figure, but also to qualify the radius of curvature and conic constant of aspherics. We used a commercially available 3D-coordinate measuring machine (CMM, ZEISS UPMC 850 CARAT S-ACC) to measure the shape of the GEMINI 1-m convex secondary mirrors at different lapping and polishing stages. To determine the measuring accuracy we compared the mechanical measurements with the results achieved by means of an interferometrical test setup. The data obtained in an early stage of polishing were evaluated in Zernike polynomials which show a very good agreement. The deviation concerning long wave rotational symmetrical errors was 20 nm rms, whereas the accuracy measuring of mid spatial frequency deviations was limited to about 100 nm rms.

A lean Six Sigma team increases hand hygiene compliance and reduces hospital-acquired MRSA infections by 51%.

Science.gov (United States)

Carboneau, Clark; Benge, Eddie; Jaco, Mary T; Robinson, Mary

2010-01-01

A low hand hygiene compliance rate by healthcare workers increases hospital-acquired infections to patients. At Presbyterian Healthcare Services in Albuquerque, New Mexico a Lean Six Sigma team identified the reasons for noncompliance were multifaceted. The team followed the DMAIC process and completed the methodology in 12 months. They implemented multiple solutions in the three areas: Education, Culture, and Environment. Based on methicillin-resistant Staphylococcus aureus (MRSA) mortality research the team's results included an estimated 2.5 lives saved by reducing MRSA infections by 51%. Subsequently this 51% decrease in MRSA saved the hospital US$276,500. For those readers tasked with increasing hand hygiene compliance this article will provide the knowledge and insight needed to overcome multifaceted barriers to noncompliance.

Terrorism, post-traumatic stress, coping strategies, and spiritual outcomes.

Science.gov (United States)

Meisenhelder, Janice Bell; Marcum, John P

2009-03-01

This mail survey measured post-traumatic stress symptoms, spiritual and non-spiritual coping strategies, and positive spiritual outcomes following the tragedies of 9/11/01 in a national, random sample of 1,056 Presbyterians. Respondents reported mild to moderate degrees of re-experiencing and hyper-arousal symptoms of post-traumatic stress, unrelated to location or knowing someone involved. People experiencing high stress used greater frequency and variety of both spiritual and non-spiritual types of coping strategies. Positive spiritual outcomes were remarkably related to positive spiritual coping strategies, in contrast to no association with negative coping. This study illustrates the significant degree of post-traumatic stress experienced with vicarious exposure and a wide spectrum of coping strategies used following the major terrorist attacks.

‘Quis custodiet ipsos custodes?’ (Juvenal Satires:§345 (Who guards [nurtures] the guardians?: Developing a constructivist approach to learning about ministerial and spiritual formation

Directory of Open Access Journals (Sweden)

Graham A. Duncan

2012-09-01

Full Text Available The main purpose of this exercise was to develop an improved model of ministerial and spiritual formation in the training of ministers in the Uniting Presbyterian Church in Southern Africa at the University of Pretoria. This is a perennial problem in many churches where there is a general dissatisfaction with the products, (i.e. ministers not only in terms of personal spirituality but in their inability to minister effectively in the many diverse situations to which they are called or appointed. The exercise of power becomes an issue in a vocation which is premised on servant ministry and so Juvenal’s quotation is apt as it is expressed as ‘Who can be trusted with authority/power?’.

A case-mix in-service education program.

Science.gov (United States)

Arons, R R

1985-01-01

The new case-mix in-service education program at the Presbyterian Hospital in the City of New York is a fine example of physicians and administration working together to achieve success under the new prospective pricing system. The hospital's office of Case-Mix Studies has developed an accurate computer-based information system with historical, clinical, and demographic data for patients discharged from the hospital over the past five years. Reports regarding the cases, diagnoses, finances, and characteristics are shared in meetings with the hospital administration and directors of sixteen clinical departments, their staff, attending physicians, and house officers in training. The informative case-mix reports provide revealing sociodemographic summaries and have proven to be an invaluable tool for planning, marketing, and program evaluation.

Juvenile nasopharyngeal angiofibroma staging: An overview.

Science.gov (United States)

Alshaikh, Nada Ali; Eleftheriadou, Anna

2015-06-01

Staging of tumors is very important in treatment and surgical decision making, as well as in predicting disease recurrence and prognosis. This review focuses on the different available classifications of juvenile nasopharyngeal angiofibroma (JNA) and their impact on the evaluation, management, and prognosis of JNA. The literature was reviewed, and publications on JNA staging were examined. Our MEDLINE search of the entire English-language literature found no review article on the current available staging systems for JNA. In this article, we review the common JNA classification systems that have been published, and we discuss some of their advantages and disadvantages. The most commonly used staging systems for JNA are the Radkowski and the Andrews-Fisch staging systems. However, some newer staging systems that are based on advances in technology and surgical approaches-the Onerci, INCan, and UPMC systems-have shown promising utility, and they will probably gain popularity in the future.

INTERSECTIONAL EMPOWERMENT: A CASE STUDY OF WOMEN IN LOCAL GOVERNANCE AND THE EVANGELICAL PRESBYTERIAN CHURCH, GHANA

OpenAIRE

Lolo, Dzifa Kweku

2015-01-01

This study explores the factors affecting the participation and representation of Anlo Ewe women in local-level politics in the Keta Municipality of Ghana. Generally, the low representation and participation of women in politics and public life can be considered a global issue; however, its impacts are more pronounced in Africa. Ghana is no exception, despite joining international conventions and treaties and the constitutional arrangements that women should be fairly represented in politics ...

Pilot study of participant-collected nasal swabs for acute respiratory infections in a low-income, urban population

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Vargas CY

2016-01-01

Full Text Available Celibell Y Vargas,1 Liqun Wang,1 Yaritza Castellanos de Belliard,1 Maria Morban,1 Hilbania Diaz,1 Elaine L Larson,2,3 Philip LaRussa,1 Lisa Saiman,1,4 Melissa S Stockwell1,5,6 1Department of Pediatrics, 2School of Nursing, 3Department of Epidemiology, Mailman School of Public Health, Columbia University, 4Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, 5Department of Population and Family Health, Mailman School of Public Health, Columbia University, 6NewYork-Presbyterian Hospital, New York, NY, USA Objective: To assess the feasibility and validity of unsupervised participant-collected nasal swabs to detect respiratory pathogens in a low-income, urban minority population. Methods: This project was conducted as part of an ongoing community-based surveillance study in New York City to identify viral etiologies of acute respiratory infection. In January 2014, following sample collection by trained research assistants, participants with acute respiratory infection from 30 households subsequently collected and returned a self-collected/parent-collected nasal swab via mail. Self/parental swabs corresponding with positive reverse transcription polymerase chain reaction primary research samples were analyzed. Results: Nearly all (96.8%, n=30/31 households agreed to participate; 100% reported returning the sample and 29 were received (median time: 8 days. Most (18; 62.1% of the primary research samples were positive. For eight influenza-positive research samples, seven (87.5% self-swabs were also positive. For ten other respiratory pathogen-positive research samples, eight (80.0% self-swabs were positive. Sensitivity of self-swabs for any respiratory pathogen was 83.3% and 87.5% for influenza, and specificity for both was 100%. There was no relationship between level of education and concordance of results between positive research samples and their matching participant swab. Conclusion: In this pilot study, self

Religion and politics in conflict: Paul Stuart Wright and the 1964 coup

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Márcio Ananias Ferreira Vilela

2016-06-01

Full Text Available In this article, we seek to understand the implications of Paulo Stuart Wright´s political and religious action. Beginning with the civil and military coup of 1964, it suffered a strong reaction from majority sectors in the Presbyterian Church of Brazil that started to perceive him as a threat to the religious community and to society itself. The following period was marked by an intense political conflict in Brazil. This contributed for the person in question to be expelled from the Church, have his mandate as a state representative for Santa Catarina impeached, be exiled, live in clandestinity and, later on in the 1970s, be murdered by the organs of repression. Thus, his trajectory bears many similarities to those of others who marked the recent history of Brazil.

Chest radiographic findings and complications of the temporary implantation of the Jarvik-7 artificial heart while awaiting orthotopic heart transplantation: Experience with five cases

International Nuclear Information System (INIS)

Sadler, L.R.; Fuhrman, C.R.; Hardesty, R.A.; Griffith, B.P.

1986-01-01

The Jarvik-7 artificial heart was originally introduced as a therapeutic alternative to cardiac transplantation in patients with endstage refractory cardiac disease. Its use has been expanded to those patients awaiting cardiac transplantation in whom death is impending and for whom a suitable donor match is unavailable. At Presbyterian-University Hospital of Pittsburgh five patients have had Jarvik-7 hearts implanted as a temporary measure while awaiting compatible donors for cardiac transplantation. The authors believe this is the largest patient group to undergo this procedure at a single institution. They present a brief description of the Jarvik-7 heart, the clinical factors affecting patient selection, and the radiographic appearance of a normally functioning Jarvik-7 heart, and review the chest radiographic complications seen in the patient group, along with eventual patient outcome

Resource based view of the firm: measures of reputation among health service-sector businesses.

Science.gov (United States)

Smith, Alan D

2008-01-01

Application of the strategic leverage of Resource Based View of the Firm (RBV) directly advocates that a company's competitive advantage is derived from its ability to assemble and exploit an appropriate combination of resources (both tangible and intangible assets). The three companies that were selected were Pittsburgh-based companies that were within relatively easy access, representing healthcare service-related industries, and can be reviewed for the principles of the RBV. The particular firms represented a variety of establishments and included Baptist Homes (a long-term care facility), University of Pittsburgh Medical Center (UPMC)(a provider of hospital and other health services), and GlaxoSmithKline, Consumer Healthcare, North America (GSK-CHNA)(a global provider of healthcare products and services). Through the case studies, it was found that not all intangible assets are strategic, and by extension, not all measures of reputation are strategic either. For an intangible asset to be considered strategic, in this case reputation, it must be valuable, rare, imperfectly imitable, and non-substitutable.

Herbert Rackow and Ernest Salanitre: the emergence of pediatric anesthesia as a specialty in the United States.

Science.gov (United States)

Friesen, Robert H

2015-07-01

Herbert Rackow and Ernest Salanitre were pediatric anesthesiologists at Babies Hospital at the Columbia-Presbyterian Medical Center in New York whose work spanned three decades beginning in the early 1950s. Their pioneering research included studies of the uptake and elimination of inhalational anesthetics and of the risk of cardiac arrest in infants and children. They were actively involved in the development of pediatric anesthesia as a specialty, and their efforts contributed to inter-disciplinary collaboration and to the formation of the Section on Anesthesiology of the American Academy of Pediatrics. Their 1969 review article, 'Modern Concepts in Pediatric Anesthesiology', provides a fascinating view of pediatric anesthesia 50 years ago. In 1990, they were jointly awarded the Robert M. Smith award by the Section on Anesthesiology of the American Academy of Pediatrics. © 2015 John Wiley & Sons Ltd.

Retreatment with bevacizumab in patients with gynecologic malignancy is associated with clinical response and does not increase morbidity

Directory of Open Access Journals (Sweden)

Laskey RA

2014-03-01

Full Text Available Robin A Laskey,1 Scott D Richard,2 Ashlee L Smith,1 Jeff F Lin,1 Tiffany L Beck,3 Jamie L Lesnock,1 Joseph L Kelley 3rd,1 Alexander B Olawaiye,1 Paniti Sukumvanich,1 Thomas C Krivak4 1Division of Gynecologic Oncology, Magee-Womens Hospital of UPMC, Pittsburgh, 2Division of Gynecologic Oncology, Drexel University College of Medicine/Hahnemann University Hospital, Philadelphia, 3Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital of UPMC, Pittsburgh, 4Division of Gynecologic Oncology, Western Pennsylvania Hospital, Pittsburgh, PA, USA Purpose: Bevacizumab (Bev is associated with improved progression-free survival in advanced epithelial ovarian cancer. The use of Bev in patients with gynecologic malignancy is increasing; however, little is known about cumulative toxicity and response in patients retreated with Bev. Our goal was to determine cumulative side effects and response in patients retreated with Bev. Patients and methods: Women with recurrent gynecologic malignancy treated with Bev between January 2007 and March 2012 at a single institution were identified, including a subset who received Bev in a subsequent regimen. The primary outcome was Bev-associated toxicity, and the secondary outcome was response. Results: Of 83 patients that received Bev for recurrent disease, 23 were retreated with Bev and four received Bev maintenance. Three patients (13% developed grade 3 or 4 hypertension; all had a history of chronic hypertension. One (4.3% patient developed grade 3 proteinuria, and one (4.3% developed an enterovaginal fistula. Four patients discontinued Bev secondary to toxicity. Toxicity was not related to the cumulative number of cycles. Twenty-six percent of patients responded to Bev retreatment. On univariate analysis, there was a significant (P=0.003 overall survival advantage when the Bev-free interval was >9 months (95% confidence interval [CI] 4.9–43.7 compared to ≤9 months (95% CI 2.1–11.5, 24

Designing a Clinical Data Warehouse Architecture to Support Quality Improvement Initiatives.

Science.gov (United States)

Chelico, John D; Wilcox, Adam B; Vawdrey, David K; Kuperman, Gilad J

2016-01-01

Clinical data warehouses, initially directed towards clinical research or financial analyses, are evolving to support quality improvement efforts, and must now address the quality improvement life cycle. In addition, data that are needed for quality improvement often do not reside in a single database, requiring easier methods to query data across multiple disparate sources. We created a virtual data warehouse at NewYork Presbyterian Hospital that allowed us to bring together data from several source systems throughout the organization. We also created a framework to match the maturity of a data request in the quality improvement life cycle to proper tools needed for each request. As projects progress in the Define, Measure, Analyze, Improve, Control stages of quality improvement, there is a proper matching of resources the data needs at each step. We describe the analysis and design creating a robust model for applying clinical data warehousing to quality improvement.

Ten years after the IOM report: Engaging residents in quality and patient safety by creating a House Staff Quality Council.

Science.gov (United States)

Fleischut, Peter M; Evans, Adam S; Nugent, William C; Faggiani, Susan L; Lazar, Eliot J; Liebowitz, Richard S; Forese, Laura L; Kerr, Gregory E

2011-01-01

Ten years after the 1999 Institute of Medicine report, it is clear that despite significant progress, much remains to be done to improve quality and patient safety (QPS). Recognizing the critical role of postgraduate trainees, an innovative approach was developed at New York-Presbyterian Hospital, Weill Cornell Medical Center to engage residents in QPS by creating a Housestaff Quality Council (HQC). HQC leaders and representatives from each clinical department communicate and partner regularly with hospital administration and other key departments to address interdisciplinary quality improvement (QI). In support of the mission to improve patient care and safety, QI initiatives included attaining greater than 90% compliance with medication reconciliation and reduction in the use of paper laboratory orders by more than 70%. A patient safety awareness campaign is expected to evolve into a transparent environment where house staff can openly discuss patient safety issues to improve the quality of care.

Driving improvement in patient care: lessons from Toyota.

Science.gov (United States)

Thompson, Debra N; Wolf, Gail A; Spear, Steven J

2003-11-01

Nurses today are attempting to do more with less while grappling with faulty error-prone systems that do not focus on patients at the point of care. This struggle occurs against a backdrop of rising national concern over the incidence of medical errors in healthcare. In an effort to create greater value with scarce resources and fix broken systems that compromise quality care, UPMC Health System is beginning to master and implement the Toyota Production System (TPS)--a method of managing people engaged in work that emphasizes frequent rapid problem solving and work redesign that has become the global archetype for productivity and performance. The authors discuss the rationale for applying TPS to healthcare and implementation of the system through the development of "learning unit" model lines and initial outcomes, such as dramatic reductions in the number of missing medications and thousands of hours and dollars saved as a result of TPS-driven changes. Tracking data further suggest that TPS, with sufficient staff preparation and involvement, has the potential for continuous, lasting, and accelerated improvement in patient care.

Nuclear and high-energy physics laboratory - LPNHE. Activity report 2006-2007

International Nuclear Information System (INIS)

Debu, Pascal; Ben-Haim, Eli; Hardin, Delphine; Laporte, Didier; Maurin, David; Cossin, Isabelle; Mathy, Jean-Yves

2008-01-01

The LPNHE is a joint research unit (UMR 7585) of the National Institute of Nuclear Physics and Particle Physics (IN2P3), Institute of the National Centre for Scientific Research (CNRS), UPMC and Paris Diderot Paris 7. It hosts several research teams and technical services (computers, electronics, mechanical), and two support services (administration, logistics). The laboratory is engaged in several major experimental programs pursued in the framework of international collaborations with very large research facilities around the world, centers of particle accelerators and observatories. The research programs cover current issues in particle physics, astro-particle and cosmology. This report presents the activities of the laboratory during the years 2006-2007: 1 - Forewords; 2 - Scientific activities: Physics with accelerators (LHC, Tevatron, CP Violation, ILC, Neutrino Physics); Physics without accelerators (Cosmology, high-energy gamma astronomy, extreme energy cosmic radiation, theoretical physics, physics-biology interface); 3 - Technical and administrative activities (electronics, computers, mechanics departments, Administration and general services); 4 - Laboratory life (Teaching, training, internships and PhDs); 5 - Internal activities (seminars, meetings..); 6 - External activities (Public information, relations with the industry, valorisation..)

SLC summer 2010 university - The ocean in the climate-energy problem, urban policies. Proceedings

International Nuclear Information System (INIS)

2010-09-01

This document brings together the available presentations given at the summer 2010 university of the SLC (save the climate) organization on the topics of the ocean in the climate-energy problem, and of the urban policies. Nine presentations (slides) are compiled in this document and deal with: 1 - Biofuels made from micro-algae: stakes and challenges (Olivier Bernard, Comore - INRIA /CNRS/UPMC); 2 - The energy of waves (Alain Clement, Ecole Centrale de Nantes); 3 - The sea, new source of renewable energies? (J.J. Herou, EDF CIH); 4 - Oceans acidification: the other CO 2 problem (James Orr, Pierre Simon Laplace Institute - IPSL, Laboratory of climate and environmental Sciences - LSCE, CEA-CNRS-UVSQ); 5 - Oceans and carbon cycle (Laurent Bopp, IPSL/LSCE); 6 - Renewable marine energies (Yann-Herve De Roeck, France Energies Marines); 7 - Energy renovation of buildings (Jean-Claude Terrier, Mesac Europe); 8 - Modevur research project - Modeling of urban development, sketch of a development typology of chinese cities (Clement-Noel Douady); 9 - Urban areas in the fight against climate change: stakes, knowledge and controversies (Francois Menard, PUCA)

Assessing Career Outcomes of a Resident Academic Administrator, Clinician Educator Track: A Seven-Year Follow-up.

Science.gov (United States)

Penner, Anne E; Lundblad, Wynne; Azzam, Pierre N; Gopalan, Priya; Jacobson, Sansea L; Travis, Michael J

2017-04-01

This study reports the academic outcomes, including scholarly productivity, of the graduates of one residency training track for future clinician educators and academic administrators. Since its implementation in 2008, the Academic Administrator, Clinician Educator (AACE) track at Western Psychiatric Institute and Clinic - UPMC has grown in popularity with reports of participants achieving post-graduate academic success; however, there has been no prior assessment of outcomes. In 2015 all graduates of the track were surveyed using an anonymous, web-based survey. Twenty-nine total graduates were surveyed RESULTS: Twenty-four graduates responded to the survey (83% response rate). The graduates are very active in academic psychiatry with 23 (96%) holding an academic appointment with different administrative roles, medical director (50%) and training director (17%) being the most frequent. Participants have also been active in pursuing scholarship with 80% presenting their scholarly projects at local and national conferences and producing post-graduate, peer-reviewed articles (50%). This study underscores the benefits of a clinician educator track and suggests areas for future growth.

SLC summer 2010 university - The ocean in the climate-energy problem, urban policies. Proceedings; Universite d'ete 2010 SLC - L'Ocean dans la problematique Climat-Energie, politiques urbaines. Recueil des presentations

Energy Technology Data Exchange (ETDEWEB)

NONE

2010-09-15

This document brings together the available presentations given at the summer 2010 university of the SLC (save the climate) organization on the topics of the ocean in the climate-energy problem, and of the urban policies. Nine presentations (slides) are compiled in this document and deal with: 1 - Biofuels made from micro-algae: stakes and challenges (Olivier Bernard, Comore - INRIA /CNRS/UPMC); 2 - The energy of waves (Alain Clement, Ecole Centrale de Nantes); 3 - The sea, new source of renewable energies? (J.J. Herou, EDF CIH); 4 - Oceans acidification: the other CO{sub 2} problem (James Orr, Pierre Simon Laplace Institute - IPSL, Laboratory of climate and environmental Sciences - LSCE, CEA-CNRS-UVSQ); 5 - Oceans and carbon cycle (Laurent Bopp, IPSL/LSCE); 6 - Renewable marine energies (Yann-Herve De Roeck, France Energies Marines); 7 - Energy renovation of buildings (Jean-Claude Terrier, Mesac Europe); 8 - Modevur research project - Modeling of urban development, sketch of a development typology of chinese cities (Clement-Noel Douady); 9 - Urban areas in the fight against climate change: stakes, knowledge and controversies (Francois Menard, PUCA)

SOx-NOx-Rox Box{trademark} flue gas clean-up demonstration. Final report

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-09-01

Babcock and Wilcox`s (B and W) SOx-NOx-Rox Box{trademark} process effectively removes SOx, NOx and particulate (Rox) from flue gas generated from coal-fired boilers in a single unit operation, a high temperature baghouse. The SNRB technology utilizes dry sorbent injection upstream of the baghouse for removal of SOx and ammonia injection upstream of a zeolitic selective catalytic reduction (SCR) catalyst incorporated in the baghouse to reduce NOx emissions. Because the SOx and NOx removal processes require operation at elevated gas temperatures (800--900 F) for high removal efficiency, high-temperature fabric filter bags are used in the baghouse. The SNRB technology evolved from the bench and laboratory pilot scale to be successfully demonstrated at the 5-MWe field scale. This report represents the completion of Milestone M14 as specified in the Work Plan. B and W tested the SNRB pollution control system at a 5-MWe demonstration facility at Ohio Edison`s R.E. Burger Plant located near Shadyside, Ohio. The design and operation were influenced by the results from laboratory pilot testing at B and W`s Alliance Research Center. The intent was to demonstrate the commercial feasibility of the SNRB process. The SNRB facility treated a 30,000 ACFM flue gas slipstream from Boiler No. 8. Operation of the facility began in May 1992 and was completed in May 1993. About 2,300 hours of high-temperature operation were achieved. The main emissions control performance goals of: greater than 70% SO{sub 2} removal using a calcium-based sorbent; greater than 90% NOx removal with minimal ammonia slip; and particulate emissions in compliance with the New Source Performance Standards (NSPS) of 0.03 lb/million Btu were exceeded simultaneously in the demonstration program when the facility was operated at optimal conditions. Testing also showed significant reductions in emissions of some hazardous air pollutants.

SOx-NOx-Rox Box{trademark} flue gas clean-up demonstration. Final report

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-09-01

The SNRB{trademark} Flue Gas Cleanup Demonstration Project was cooperatively funded by the U.S. Department of Energy (DOE), the Ohio Coal Development Office (OCDO), B&W, the Electric Power Research Institute (EPRI), Ohio Edison, Norton Chemical Process Products Company and the 3M Company. The SNRB{trademark} technology evolved from the bench and laboratory pilot scale to be successfully demonstrated at the 5-MWe field scale. Development of the SNRB{trademark} process at B&W began with pilot testing of high-temperature dry sorbent injection for SO{sub 2} removal in the 1960`s. Integration of NO{sub x} reduction was evaluated in the 1970`s. Pilot work in the 1980`s focused on evaluation of various NO{sub x} reduction catalysts, SO{sub 2} sorbents and integration of the catalyst with the baghouse. This early development work led to the issuance of two US process patents to B&W - No. 4,309,386 and No. 4,793,981. An additional patent application for improvements to the process is pending. The OCDO was instrumental in working with B&W to develop the process to the point where a larger scale demonstration of the technology was feasible. This report represents the completion of Milestone M14 as specified in the Work Plan. B&W tested the SNRB{trademark} pollution control system at a 5-MWe demonstration facility at Ohio Edison`s R. E. Burger Plant located near Shadyside, Ohio. The design and operation were influenced by the results from laboratory pilot testing at B&W`s Alliance Research Center. The intent was to demonstrate the commercial feasibility of the SNRB{trademark} process. The SNRB{trademark} facility treated a 30,000 ACFM flue gas slipstream from Boiler No. 8. Operation of the facility began in May 1992 and was completed in May 1993.

Integration of nursing assessment concepts into the medical entities dictionary using the LOINC semantic structure as a terminology model.

Science.gov (United States)

Cieslowski, B J; Wajngurt, D; Cimino, J J; Bakken, S

2001-01-01

Recent investigations have tested the applicability of various terminology models for the representing nursing concepts including those related to nursing diagnoses, nursing interventions, and standardized nursing assessments as a prerequisite for building a reference terminology that supports the nursing domain. We used the semantic structure of Clinical LOINC (Logical Observations, Identifiers, Names, and Codes) as a reference terminology model to support the integration of standardized assessment terms from two nursing terminologies into the Medical Entities Dictionary (MED), the concept-oriented, metadata dictionary at New York Presbyterian Hospital. Although the LOINC semantic structure was used previously to represent laboratory terms in the MED, selected hierarchies and semantic slots required revisions in order to incorporate the nursing assessment concepts. This project was an initial step in integrating nursing assessment concepts into the MED in a manner consistent with evolving standards for reference terminology models. Moreover, the revisions provide the foundation for adding other types of standardized assessments to the MED.

Using IT to improve quality at NewYork-Presybterian Hospital: a requirements-driven strategic planning process.

Science.gov (United States)

Kuperman, Gilad J; Boyer, Aurelia; Cole, Curt; Forman, Bruce; Stetson, Peter D; Cooper, Mary

2006-01-01

At NewYork-Presbyterian Hospital, we are committed to the delivery of high quality care. We have implemented a strategic planning process to determine the information technology initiatives that will best help us improve quality. The process began with the creation of a Clinical Quality and IT Committee. The Committee identified 2 high priority goals that would enable demonstrably high quality care: 1) excellence at data warehousing, and 2) optimal use of automated clinical documentation to capture encounter-related quality and safety data. For each high priority goal, a working group was created to develop specific recommendations. The Data Warehousing subgroup has recommended the implementation of an architecture management process and an improved ability for users to get access to aggregate data. The Structured Documentation subgroup is establishing recommendations for a documentation template creation process. The strategic planning process at times is slow, but assures that the organization is focusing on the information technology activities most likely to lead to improved quality.

Nuclear and high-energy physics laboratory - LPNHE. Activity report 2012-2014

International Nuclear Information System (INIS)

Balland, Christophe; Cossin, Isabelle; Giganti, Claudio; Hardin, Delphine; Lavergne, Laurence; Le Dortz, Olivier; Lenain, Jean-Philippe; Marchiori, Giovanni; Regnault, Nicolas; Varanda De-Sa, Vera; Daigremont, Jean-Jacques

2015-01-01

The LPNHE is a joint research unit (UMR 7585) of the National Institute of Nuclear Physics and Particle Physics (IN2P3), Institute of the National Centre for Scientific Research (CNRS), UPMC and Paris Diderot Paris 7. It hosts several research teams and technical services (computers, electronics, mechanical), and two support services (administration, logistics). The laboratory is engaged in several major experimental programs pursued in the framework of international collaborations with very large research facilities around the world, centers of particle accelerators and observatories. The research programs cover current issues in particle physics, astro-particle and cosmology. This report presents the activities of the laboratory during the years 2012-2014: 1 - Forewords; 2 - Highlights; 3 - Research: Masses and FUNDAMENTAL INTERACTIONS; Matter-antimatter asymmetry; Dark matter and dark energy; Cosmic radiation nature and origin; Publications, communications; 2 - Teaching, training, internships and PhDs; 3 - Competences and technical realisations (electronics and instrumentation, computers, mechanics, expertise, calculation and technical departments); 4 - Laboratory operation (organisation, partnerships, financial and human resources, permanent training, communication and library, health and safety, radiation protection, general services, staff); 5 - Scientific life and communication (seminars, meetings..)

Nuclear and high-energy physics laboratory - LPNHE. Activity report 2008-2009

International Nuclear Information System (INIS)

Pain, Reynald; Guy, Julien; Toussenel, Francois; Laforge, Bertrand; Levy, Jean-Michel; Cossin, Isabelle; Cardot, Violaine

2011-01-01

The LPNHE is a joint research unit (UMR 7585) of the National Institute of Nuclear Physics and Particle Physics (IN2P3), Institute of the National Centre for Scientific Research (CNRS), UPMC and Paris Diderot Paris 7. It hosts several research teams and technical services (computers, electronics, mechanical), and two support services (administration, logistics). The laboratory is engaged in several major experimental programs pursued in the framework of international collaborations with very large research facilities around the world, centers of particle accelerators and observatories. The research programs cover current issues in particle physics, astro-particle and cosmology. This report presents the activities of the laboratory during the years 2008-2009: 1 - Forewords; 2 - Highlights; 3 - Research: Masses and FUNDAMENTAL INTERACTIONS; Matter-antimatter asymmetry; Dark matter and dark energy; Cosmic radiation nature and origin; Interdisciplinary activities; Publications, communications; Partnerships; 2 - Teaching, training, internships and PhDs; 3 - Competences and technical realisations (electronics and instrumentation, computers, mechanics departments, test facilities); 4 - Laboratory operation (organisation, financial and human resources, permanent training, communication and library, health and safety, general services, staff); 5 - Scientific life and communication (seminars, meetings..)

Nuclear and high-energy physics laboratory - LPNHE. Activity report 2010-2012

International Nuclear Information System (INIS)

Pain, Reynald; Ghia, Piera L.; Lacour, Didier; Lavergne, Laurence; Billoir, Pierre; Cossin, Isabelle; Cardot, Violaine

2012-01-01

The LPNHE is a joint research unit (UMR 7585) of the National Institute of Nuclear Physics and Particle Physics (IN2P3), Institute of the National Centre for Scientific Research (CNRS), UPMC and Paris Diderot Paris 7. It hosts several research teams and technical services (computers, electronics, mechanical), and two support services (administration, logistics). The laboratory is engaged in several major experimental programs pursued in the framework of international collaborations with very large research facilities around the world, centers of particle accelerators and observatories. The research programs cover current issues in particle physics, astro-particle and cosmology. This report presents the activities of the laboratory during the years 2010-2012: 1 - Forewords; 2 - Highlights; 3 - Research: Masses and FUNDAMENTAL INTERACTIONS; Matter-antimatter asymmetry; Dark matter and dark energy; Cosmic radiation nature and origin; Publications, communications; 2 - Teaching, training, internships and PhDs; 3 - Competences and technical realisations (electronics and instrumentation, computers, mechanics departments, expertise and valorisation, conference participation, responsibilities); 4 - Laboratory operation (organisation, partnerships, financial and human resources, permanent training, communication and library, health and safety, radiation protection, general services, staff); 5 - Scientific life and communication (seminars, meetings..)

Nuclear and high-energy physics laboratory - LPNHE. Activity report 2004-2005

International Nuclear Information System (INIS)

Debu, Pascal; Bassler, Ursula; Boratav, Murat; Lacour, Didier; Lebbolo, Herve; Cossin, Isabelle; Mathy, Jean-Yves

2006-01-01

The LPNHE is a joint research unit (UMR 7585) of the National Institute of Nuclear Physics and Particle Physics (IN2P3), Institute of the National Centre for Scientific Research (CNRS), UPMC and Paris Diderot Paris 7. It hosts several research teams and technical services (computers, electronics, mechanical), and two support services (administration, logistics). The laboratory is engaged in several major experimental programs pursued in the framework of international collaborations with very large research facilities around the world, centers of particle accelerators and observatories. The research programs cover current issues in particle physics, astro-particle and cosmology. This report presents the activities of the laboratory during the years 2004-2005: 1 - Forewords; 2 - Scientific activities: Physics with accelerators (LHC, Tevatron, CP Violation, future linear electron collider, Neutrino beams); Physics without accelerators (Cosmology and supernovae, high-energy gamma astronomy, extreme energy cosmic radiation, theoretical physics, physics-biology interface); 3 - Technical and administrative activities (electronics, computers, mechanics departments, Administration, health and safety, radiation protection); 4 - Laboratory life (Teaching, training, internships and PhDs); 5 - Internal activities (seminars, meetings..); 6 - External activities (Public information, relations with the industry, valorisation..); 7 - List of publications; 8 - Appendixes: organigram, staff

Nuclear and high-energy physics laboratory - LPNHE. Activity report 2000-2001

International Nuclear Information System (INIS)

Astier, Pierre; Bassler, Ursula; Levy, Jean-Michel; Cossin, Isabelle; Mathy, Jean-Yves

2002-01-01

The LPNHE is a joint research unit (UMR 7585) of the National Institute of Nuclear Physics and Particle Physics (IN2P3), Institute of the National Centre for Scientific Research (CNRS), UPMC and Paris Diderot Paris 7. It hosts several research teams and technical services (computers, electronics, mechanical), and two support services (administration, logistics). The laboratory is engaged in several major experimental programs pursued in the framework of international collaborations with very large research facilities around the world, centers of particle accelerators and observatories. The research programs cover current issues in particle physics, astro-particle and cosmology. This report presents the activities of the laboratory during the years 2000-2001: 1 - Forewords; 2 - Scientific and technical activities of the laboratory: Physics with accelerators (CP Violation, hadronic physics, proton-antiproton physics, Neutrino beams, LEP, LHC, future linear electron collider); Physics without accelerators (extreme energy cosmic radiation, Cosmology and supernovae, high-energy gamma astronomy); theoretical physics (QCD, phenomenological approaches); 3 - Technical and administrative activities (electronics, computers, mechanics departments, Administration and general services); 4 - Laboratory life (Teaching, training, Internal activities); 5 - Dissemination of scientific information; 6 - List of publications; 7 - staff

Nuclear and high-energy physics laboratory - LPNHE. Activity report 1998-1999

International Nuclear Information System (INIS)

Vaissiere, Christian de la; Banner, Marcel; Faivre, Maria; Moine, Marguerite; Dumas, Jean-Marc; Jos, Jeanne

2000-01-01

The LPNHE is a joint research unit (UMR 7585) of the National Institute of Nuclear Physics and Particle Physics (IN2P3), Institute of the National Centre for Scientific Research (CNRS), UPMC and Paris Diderot Paris 7. It hosts several research teams and technical services (computers, electronics, mechanical), and two support services (administration, logistics). The laboratory is engaged in several major experimental programs pursued in the framework of international collaborations with very large research facilities around the world, centers of particle accelerators and observatories. The research programs cover current issues in particle physics, astro-particle and cosmology. This report presents the activities of the laboratory during the years 1998-1999: 1 - Forewords; 2 - Physics experiments: LHC Physics with ATLAS, search for new physics at LEP, DIRAC experiment, Neutrinos oscillation with NOMAD, TONIC and HERA-H1 experiments, CP Violation (BaBar), DΦ experiment at Tevatron, high-energy gamma astronomy, Supernovae, Pierre Auger Laboratory); 3 - Technical activities and means (electronics, computers, mechanics departments); 4 - Laboratory life (Teaching, Administration and general services, Internal and external activities); 5 - Dissemination of scientific information; 6 - List of publications; 7 - staff

Nuclear and high-energy physics laboratory - LPNHE. Activity report 2002-2003

International Nuclear Information System (INIS)

Dagoret-Campagne, Sylvie; Roos, Lydia; Schwemling, Philippe; Cossin, Isabelle; Mathy, Jean-Yves

2004-01-01

The LPNHE is a joint research unit (UMR 7585) of the National Institute of Nuclear Physics and Particle Physics (IN2P3), Institute of the National Centre for Scientific Research (CNRS), UPMC and Paris Diderot Paris 7. It hosts several research teams and technical services (computers, electronics, mechanical), and two support services (administration, logistics). The laboratory is engaged in several major experimental programs pursued in the framework of international collaborations with very large research facilities around the world, centers of particle accelerators and observatories. The research programs cover current issues in particle physics, astro-particle and cosmology. This report presents the activities of the laboratory during the years 2002-2003: 1 - Forewords; 2 - Scientific and technical activities of the laboratory: Physics with accelerators (CP Violation, proton-antiproton physics, LHC, Neutrino beams, LEP, future linear electron collider); Physics without accelerators (extreme energy cosmic radiation, Cosmology and supernovae, high-energy gamma astronomy); theoretical physics (QCD, phenomenological approaches); 3 - Technical and administrative activities (electronics, computers, mechanics departments, Administration and general services); 4 - Laboratory life (Teaching, training, Internal activities); 5 - Dissemination of scientific information; 6 - List of publications; 7 - Appendix: staff

Nuclear and high-energy physics laboratory - LPNHE. Activity report 1996-1997

International Nuclear Information System (INIS)

Vaissiere, Christian de la; Boniface, Nicole; Dumas, Jean-Marc; Jos, Jeanne

1998-01-01

The LPNHE is a joint research unit (UMR 7585) of the National Institute of Nuclear Physics and Particle Physics (IN2P3), Institute of the National Centre for Scientific Research (CNRS), UPMC and Paris Diderot Paris 7. It hosts several research teams and technical services (computers, electronics, mechanical), and two support services (administration, logistics). The laboratory is engaged in several major experimental programs pursued in the framework of international collaborations with very large research facilities around the world, centers of particle accelerators and observatories. The research programs cover current issues in particle physics, astro-particle and cosmology. This report presents the activities of the laboratory during the years 1996-1997: 1 - Forewords; 2 - Physics experiments: LHC Physics with ATLAS, search for new physics at LEP (DELPHI), Neutrinos oscillation DIRAC experiment, Neutrinos oscillation (NOMAD, TONIC), HERA-H1 experiment, CP Violation (BaBar), DΦ experiment at Tevatron, study of gamma radiation sources (CAT), Supernovae, Auger Laboratory project; 3 - Technical activities and means (electronics, computers, mechanics departments); 4 - Laboratory life (Teaching, Administration and general services, Internal and external activities); 5 - Dissemination of scientific information; 6 - List of publications; 7 - staff

Practical experience with the maintenance and auditing of a large medical ontology.

Science.gov (United States)

Baorto, David; Li, Li; Cimino, James J

2009-06-01

The Medical Entities Dictionary (MED) has served as a unified terminology at New York Presbyterian Hospital and Columbia University for more than 20 years. It was initially created to allow the clinical data from the disparate information systems (e.g., radiology, pharmacy, and multiple laboratories, etc.) to be uniquely codified for storage in a single data repository, and functions as a real time terminology server for clinical applications and decision support tools. Being conceived as a knowledge base, the MED incorporates relationships among local terms, between local terms and external standards, and additional knowledge about terms in a semantic network structure. Over the past two decades, we have sought to develop methods to maintain, audit and improve the content of the MED, such that it remains true to its original design goals. This has resulted in a complex, multi-faceted process, with both manual and automated components. In this paper, we describe this process, with examples of its effectiveness. We believe that our process provides lessons for others who seek to maintain complex, concept-oriented controlled terminologies.

Pachychoroid neovasculopathy in extramacular choroidal neovascularization

Directory of Open Access Journals (Sweden)

Gupta MP

2016-07-01

Full Text Available Mrinali Patel Gupta, Irene Rusu, Carly Seidman, Anton Orlin, Donald J D’Amico, Szilard Kiss Department of Ophthalmology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA Purpose: To review a series of extramacular choroidal neovascular membranes (CNVMs in the context of their choroidal features, as determined by optical coherence tomography (OCT.Methods: Patients with extramacular CNVMs were identified from a tertiary care center through a review of records. The charts and cases were reviewed using multimodal imaging including fundus photography, OCT, fluorescein angiography (FA, and indocyanine angio­graphy (ICG.Results: Of six patients with extramacular CNVMs evaluated in this series, four patients (66.7% exhibited pachychoroidopathy on OCT imaging under or adjacent to the extramacular CNVM. All four of these patients also exhibited pachychoroidopathy in the macular OCT distant from the CNVM.Conclusion: Pachychoroidopathy is implicated in some cases of extramacular CNVMs. This represents the first report, to our knowledge, of pachychoroidopathy in extramacular CNVM. Keywords: choroidal neovascularization, pachychoroidopathy, pachychoroid neovasculopathy, peripheral disciform lesions, extramacular choroidal neovascularization, polypoidal choroidal vasculopathy

Case study: how to apply data mining techniques in a healthcare data warehouse.

Science.gov (United States)

Silver, M; Sakata, T; Su, H C; Herman, C; Dolins, S B; O'Shea, M J

2001-01-01

Healthcare provider organizations are faced with a rising number of financial pressures. Both administrators and physicians need help analyzing large numbers of clinical and financial data when making decisions. To assist them, Rush-Presbyterian-St. Luke's Medical Center and Hitachi America, Ltd. (HAL), Inc., have partnered to build an enterprise data warehouse and perform a series of case study analyses. This article focuses on one analysis, which was performed by a team of physicians and computer science researchers, using a commercially available on-line analytical processing (OLAP) tool in conjunction with proprietary data mining techniques developed by HAL researchers. The initial objective of the analysis was to discover how to use data mining techniques to make business decisions that can influence cost, revenue, and operational efficiency while maintaining a high level of care. Another objective was to understand how to apply these techniques appropriately and to find a repeatable method for analyzing data and finding business insights. The process used to identify opportunities and effect changes is described.

An African hermeneutic reading of Luke 9:18–22 in relation to conflict and leadership in pastoral ministry: The Cameroonian context

Directory of Open Access Journals (Sweden)

Mbengu D. Nyiawung

2013-03-01

Full Text Available The practice of ministry is an intricate issue which involves the combination of individual efforts from diverse backgrounds. This diversity has been a breeding ground for conflict between the clergy and all the stakeholders involved in parish administration. This article attempted to highlight some of these conflicts, using the Presbyterian Church in Cameroon as a case study. The approach employed is an African hermeneutic reading of Luke 9:18–22 in which the clergy’s leadership has been likened to that of Jesus. The presence of many distracting agents did not perturb Jesus’ ministry instead, he remained focused. Conclusively, it is observed that the clergy often face conflict within the ministry because they ignore the fact that (1 they are expected to know their mission better than anyone else; (2 the diverse backgrounds of their followers are potential causes of conflict; and (3 there are several distracting agents within the ministry. In short, Jesus’ model of conflict management is recommended to the clergy for an effective pastoral ministry.

Importance of Motivational Factors among Future Business Persons: Further Evidence from Ghana

Directory of Open Access Journals (Sweden)

Peter Kwame Kuutol

2013-07-01

Full Text Available Businesses design motivation systems to persuade employees to perform in the most effective way but also to attract potential candidates. The key to create the efficient motivation system is an answer to the question what actually motivate employees. The rationale of this paper is to find which of the motivation factors are seen as the most important by students considered as future business persons either by gender or job possession as set out in the questionnaire. The study was based on the questionnaire distributed to the sample of 462 respondents from Presbyterian University college of Ghana. Respondents were asked to rank thirteen motivation factors in the order of their importance. The findings showed that Good wages and job security were the most important factors for all students as well as good working conditions.   The research recommended the creation of motivation systems for freshly graduated potential employees and freshly graduated employees to me their expectations as well as for planning recruitment strategies focused on future job seekers.

How can we improve Science, Technology, Engineering, and Math education to encourage careers in Biomedical and Pathology Informatics?

Science.gov (United States)

Uppal, Rahul; Mandava, Gunasheil; Romagnoli, Katrina M; King, Andrew J; Draper, Amie J; Handen, Adam L; Fisher, Arielle M; Becich, Michael J; Dutta-Moscato, Joyeeta

2016-01-01

The Computer Science, Biology, and Biomedical Informatics (CoSBBI) program was initiated in 2011 to expose the critical role of informatics in biomedicine to talented high school students.[1] By involving them in Science, Technology, Engineering, and Math (STEM) training at the high school level and providing mentorship and research opportunities throughout the formative years of their education, CoSBBI creates a research infrastructure designed to develop young informaticians. Our central premise is that the trajectory necessary to be an expert in the emerging fields of biomedical informatics and pathology informatics requires accelerated learning at an early age.In our 4(th) year of CoSBBI as a part of the University of Pittsburgh Cancer Institute (UPCI) Academy (http://www.upci.upmc.edu/summeracademy/), and our 2nd year of CoSBBI as an independent informatics-based academy, we enhanced our classroom curriculum, added hands-on computer science instruction, and expanded research projects to include clinical informatics. We also conducted a qualitative evaluation of the program to identify areas that need improvement in order to achieve our goal of creating a pipeline of exceptionally well-trained applicants for both the disciplines of pathology informatics and biomedical informatics in the era of big data and personalized medicine.

How can we improve Science, Technology, Engineering, and Math education to encourage careers in Biomedical and Pathology Informatics?

Directory of Open Access Journals (Sweden)

Rahul Uppal

2016-01-01

Full Text Available The Computer Science, Biology, and Biomedical Informatics (CoSBBI program was initiated in 2011 to expose the critical role of informatics in biomedicine to talented high school students.[1] By involving them in Science, Technology, Engineering, and Math (STEM training at the high school level and providing mentorship and research opportunities throughout the formative years of their education, CoSBBI creates a research infrastructure designed to develop young informaticians. Our central premise is that the trajectory necessary to be an expert in the emerging fields of biomedical informatics and pathology informatics requires accelerated learning at an early age.In our 4th year of CoSBBI as a part of the University of Pittsburgh Cancer Institute (UPCI Academy (http://www.upci.upmc.edu/summeracademy/, and our 2nd year of CoSBBI as an independent informatics-based academy, we enhanced our classroom curriculum, added hands-on computer science instruction, and expanded research projects to include clinical informatics. We also conducted a qualitative evaluation of the program to identify areas that need improvement in order to achieve our goal of creating a pipeline of exceptionally well-trained applicants for both the disciplines of pathology informatics and biomedical informatics in the era of big data and personalized medicine.

Genetic options for improving fodder yield and quality in forage sorghum

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C. Aruna

2015-01-01

Full Text Available Improving yield and quality of fodder from forage sorghum is important, especially in the semi-arid tropics, where sorghum is a major source of fodder. The aim of this work was to understand the genetic basis of fodder yield and quality traits, and character associations, and to estimate combining ability of the parents. The experiment was carried out during 2 successive rainy seasons using 10 parents crossed in a half-diallel design. Significant differences among the genotypes for fodder yield, quality and cell wall constituents were observed. Important quality traits, crude protein and digestibility (IVOMD, were not correlated with fodder yield, indicating the potential to improve yield and quality simultaneously in forage sorghum. General combining ability and specific combining ability variances showed that, for almost all characters, both additive and non-additive gene effects were important, with a predominance of non-additive effects. Parental lines SEVS4, HC308 and UPMC503 were good general combiners for yield and quality. The brown midrib lines, EC582508 and EC582510, were good general combiners for low lignin and high IVOMD. Strategies for improving forage sorghum to suit animal and biofuel industries are discussed.Keywords: Digestibility, crude protein, ADL, diallel analysis, gene effects.DOI: 10.17138/TGFT(349-58

Prototype Web-based continuing medical education using FlashPix images.

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Landman, A; Yagi, Y; Gilbertson, J; Dawson, R; Marchevsky, A; Becich, M J

2000-01-01

Continuing Medical Education (CME) is a requirement among practicing physicians to promote continuous enhancement of clinical knowledge to reflect new developments in medical care. Previous research has harnessed the Web to disseminate complete pathology CME case studies including history, images, diagnoses, and discussions to the medical community. Users submit real-time diagnoses and receive instantaneous feedback, eliminating the need for hard copies of case material and case evaluation forms. This project extends the Web-based CME paradigm with the incorporation of multi-resolution FlashPix images and an intuitive, interactive user interface. The FlashPix file format combines a high-resolution version of an image with a hierarchy of several lower resolution copies, providing real-time magnification via a single image file. The Web interface was designed specifically to simulate microscopic analysis, using the latest Javascript, Java and Common Gateway Interface tools. As the project progresses to the evaluation stage, it is hoped that this active learning format will provide a practical and efficacious environment for continuing medical education with additional application potential in classroom demonstrations, proficiency testing, and telepathology. Using Microsoft Internet Explorer 4.0 and above, the working prototype Web-based CME environment is accessible at http://telepathology.upmc.edu/WebInterface/NewInterface/welcome.html.

Primary hypertension and special aspects of hypertension in older children and adolescents

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Ellis D

2011-07-01

Full Text Available Demetrius Ellis, Yosuke MiyashitaChildren’s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, PA, USAAbstract: The prevalence of hypertension has increased at an accelerated rate in older children and adolescents. This has raised great concern about premature development of cardiovascular disease, which has major long-term health and financial implications. While obesity and sedentary habits largely explain this phenomenon, there are other social and cultural influences that may unmask genetic susceptibility to hypertension in the pediatric population. While it is essential to exclude numerous causes of secondary hypertension in every child, these disorders are not discussed in this review. Rather, the aim of this review is to familiarize pediatricians with casual and ambulatory blood pressure measurement, epidemiology, pathophysiology, and management of several common conditions that play a role in the development of hypertension in children and adolescents. Besides primary hypertension and obesity-related hypertension, emphasis is given to epidemiology, measurement of blood pressure, including ambulatory blood pressure monitoring, hypertension associated with drug use, teenage pregnancy, and video and computer games. Lastly, because pediatricians are increasingly confronted with special issues concerning the management of the hypertensive athlete, this topic is also addressed.Keywords: hypertension, adolescents, obesity, drugs, pregnancy, athletes

Leadership Training Program for Shared Leadership Based on Super Leadership at Cheo-Eum Korean Presbyterian Church: A Study of Christian Leadership

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Youn, Houng Jin

2013-01-01

The purpose of this dissertation was to launch a leadership training program for shared leadership based on "super leadership." The constructs of the study were designed to study Bible leaders in shared leadership, leadership paradigm and types, transformational leadership, and, super leadership and shared leadership theory that are all…

Proton pump inhibitors for the treatment of patients with erosive esophagitis and gastroesophageal reflux disease: current evidence and safety of dexlansoprazole

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Mermelstein J

2016-07-01

Full Text Available Joseph Mermelstein,1 Alanna Chait Mermelstein,2 Maxwell M Chait,3 1Department of Medicine, Mount Sinai Beth Israel/Icahn School of Medicine, 2Department of Psychiatry, New York Presbyterian Hospital/Weill Cornell Medicine, 3Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA Abstract: Gastroesophageal reflux disease is the most common upper gastroenterology disorder in the US. It is associated with a variety of complications and significantly impacts quality of life. Proton pump inhibitors are the most effective treatment. Dexlansoprazole modified release (MR is a proton pump inhibitor that employs a novel release formulation that prolongs its absorption and allows for more flexibility in dosing. Dexlansoprazole MR can be dosed without regard to food intake or time of day, and once-daily dosing may replace twice-daily dosing of other agents. Dexlansoprazole MR is effective for healing and maintenance of erosive esophagitis, and for the treatment of nonerosive disease, including nocturnal gastroesophageal reflux disease. Dexlansoprazole MR is safe and well tolerated, and can improve quality of life. Keywords: dexlansoprazole, proton pump inhibitors, gastroesophageal reflux disease, erosive esophagitis

From Data to Knowledge through Concept-oriented Terminologies

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Cimino, James J.

2000-01-01

Knowledge representation involves enumeration of conceptual symbols and arrangement of these symbols into some meaningful structure. Medical knowledge representation has traditionally focused more on the structure than the symbols. Several significant efforts are under way, at local, national, and international levels, to address the representation of the symbols though the creation of high-quality terminologies that are themselves knowledge based. This paper reviews these efforts, including the Medical Entities Dictionary (MED) in use at Columbia University and the New York Presbyterian Hospital. A decade's experience with the MED is summarized to serve as a proof-of-concept that knowledge-based terminologies can support the use of coded patient data for a variety of knowledge-based activities, including the improved understanding of patient data, the access of information sources relevant to specific patient care problems, the application of expert systems directly to the care of patients, and the discovery of new medical knowledge. The terminological knowledge in the MED has also been used successfully to support clinical application development and maintenance, including that of the MED itself. On the basis of this experience, current efforts to create standard knowledge-based terminologies appear to be justified. PMID:10833166

From data to knowledge through concept-oriented terminologies: experience with the Medical Entities Dictionary.

Science.gov (United States)

Cimino, J J

2000-01-01

Knowledge representation involves enumeration of conceptual symbols and arrangement of these symbols into some meaningful structure. Medical knowledge representation has traditionally focused more on the structure than the symbols. Several significant efforts are under way, at local, national, and international levels, to address the representation of the symbols though the creation of high-quality terminologies that are themselves knowledge based. This paper reviews these efforts, including the Medical Entities Dictionary (MED) in use at Columbia University and the New York Presbyterian Hospital. A decade's experience with the MED is summarized to serve as a proof-of-concept that knowledge-based terminologies can support the use of coded patient data for a variety of knowledge-based activities, including the improved understanding of patient data, the access of information sources relevant to specific patient care problems, the application of expert systems directly to the care of patients, and the discovery of new medical knowledge. The terminological knowledge in the MED has also been used successfully to support clinical application development and maintenance, including that of the MED itself. On the basis of this experience, current efforts to create standard knowledge-based terminologies appear to be justified.

Terminology tools: state of the art and practical lessons.

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Cimino, J J

2001-01-01

As controlled medical terminologies evolve from simple code-name-hierarchy arrangements, into rich, knowledge-based ontologies of medical concepts, increased demands are placed on both the developers and users of the terminologies. In response, researchers have begun developing tools to address their needs. The aims of this article are to review previous work done to develop these tools and then to describe work done at Columbia University and New York Presbyterian Hospital (NYPH). Researchers working with the Systematized Nomenclature of Medicine (SNOMED), the Unified Medical Language System (UMLS), and NYPH's Medical Entities Dictionary (MED) have created a wide variety of terminology browsers, editors and servers to facilitate creation, maintenance and use of these terminologies. Although much work has been done, no generally available tools have yet emerged. Consensus on requirement for tool functions, especially terminology servers is emerging. Tools at NYPH have been used successfully to support the integration of clinical applications and the merger of health care institutions. Significant advancement has occurred over the past fifteen years in the development of sophisticated controlled terminologies and the tools to support them. The tool set at NYPH provides a case study to demonstrate one feasible architecture.

Physics of gamma knife approach on convergent beams in stereotactic radiosurgery

International Nuclear Information System (INIS)

Wu, A.; Lindner, G.; Maitz, A.H.; Kalend, A.M.; Lunsford, L.D.; Flickinger, J.C.; Bloomer, W.D.

1990-01-01

The Presbyterian-University Hospital of Pittsburgh installed the first clinically designated Leksell gamma knife in the U.S. in August 1987. Gamma knife radiosurgery involves stereotactic target localization with the Leksell frame and subsequent closed-skull single-treatment session irradiation of a lesion with multiple highly focused gamma ray beams produced from 60Co sources. The hemispherical array of sources, the large number of small-diameter beams, and the steep dose gradients surrounding a targeted lesion make physical characterization of the radiation field complex. This paper describes the physical features and the operation of the gamma knife as well as the calibration procedures of the very small, well-collimated beams. The results of studies using in-phantom ion chamber, diode, film, and lithium fluoride thermoluminescent dosimetry were all in close agreement. Both single-beam and multiple-beam dose profiles were measured and reported for the interchangeable helmets, which have 4-, 8-, 14-, and 18-mm-diameter collimators. We also describe the dose calculation and treatment planning algorithm in the treatment planning system. Measurements of the accuracy of mechanical and radiation alignment are also performed and discussed

[The beginnings and the development of heart surgery in Debrecen; the consequence of Professor József Schnitzler's initiative].

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Péterffy, Arpád

2009-10-04

In the early 1960s, cardiac surgery was founded in Debrecen in the department of thoracic surgery, on Professor József Schnitzler's initiative with the cooperation of the head surgeon Arpád Eisert from Nyíregyháza. During the first 5 years, between 1963-1968, 44 closed cardiac surgical procedures were performed (closure of patent ductus arteriosus, pulmonal and mitral stenosis, pericardectomy). The first open heart surgery was performed by Gábor Kovács visiting professor from Szeged in 1968, after the Pemco heart-lung machine, a donation by Béla Köteles and the Presbyterian Church in Cleveland had arrived. The cardiac surgical activity was led by Professor András Gömöry (1972-1983). During the first 20 years 310 open, 220 closed cardiac surgical, and 612 pacemaker operations were performed. After Professor Schnitzler's retirement in 1983, Arpád Péterffy was appointed the head of the entire department (general and cardio-thoracic surgery). In the last 25 years, 18,000 open, 1500 closed and 8500 pacemaker procedures altogether 32,000 were performed. In 2008 associate professor Tamás Szerafin became the head of the department of cardiac surgery.

Teaching Cases in Management - Afinal, Quantas Empresas tem esta Cidade?

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Rosane Rivera Torres

2010-05-01

Full Text Available Barueri is a small country town, located to the west of São Paulo City. The town offers tax exemptions to companies that set up business there, becoming an important industrial area and cluster. As a consequence, Barueri has filled up with paper companies, that is, companies that exist only for formal burocratic purposes, but which do not really conduct their operations there. The task of identifying which companies really conduct their operations in the town is difficult. Frequently, a contact with a company with headquarters in Barueri results in dealing with a professional accounting office professional which represents it, with the organization effectively being located outside the town. The Presbyterian Mackenzie University intended to establish relationships with companies of the region, considering the plans of development for the Tamboré Campus, located in Barueri. Consequently, it was essential to define a universe and a sample of companies whose operations occurred in the surrounding area of the Campus in order to establish partnership programs. It was therefore faced with the challenge of finding which companies were effectively located in Barueri, since paper companies have no interest in the development of the campus. How to find them?

Radiological evaluation of spontaneous pneumoperitoneum

International Nuclear Information System (INIS)

Kim, H. S.; Kim, J. D.; Rhee, H. S.

1982-01-01

112 cases of spontaneous penumoperitoneum, the causes of which were confirmed by clinical and surgical procedure at Presbyterian Medical Center from January, 1977 to July, 1981 were reviewed radiologically. The results were as follows: 1. Perforation of duodenal ulcer (46/112: 41.1%), stomach ulcer (22/112: 19.6%), and stomach cancer (11/112: 9.8%) were the three most common causes of spontaneous penumoperitoneum. These were 70.5% of all causes. 2. The most common site of free gas was both subdiaphragmatic areas (46: 41.1%). Others were Rt. subdiaphragmatic only (31: 27.7%), both subdiaphragmatic with subhepatic (16: 14.3%), Rt. subdiaphragmatic with subhepatic (7: 6.2%), Rt. subdiaphragmatic only (5: 4.4%), diffuse in abdomen (4: 3.6%), and subhepatic only (3: 2.7%). So 92.0% (103/112) were located in RUQ. 3. The radiological shape of free gas was classified: crescent (52: 46.4%) of small amount; half-moon (21: 18.8%) of moderate amount; large or diffuse (39: 34.8%) of large amount.4. The age between 31 and 60 occupied 69.1% (77/112), and male was predominant (5.2 times). 5. The patient's position showing free air most frequently was erect

Ultra-fast bright field and fluorescence imaging of the dynamics of micrometer-sized objects

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Chen, Xucai; Wang, Jianjun; Versluis, Michel; de Jong, Nico; Villanueva, Flordeliza S.

2013-06-01

High speed imaging has application in a wide area of industry and scientific research. In medical research, high speed imaging has the potential to reveal insight into mechanisms of action of various therapeutic interventions. Examples include ultrasound assisted thrombolysis, drug delivery, and gene therapy. Visual observation of the ultrasound, microbubble, and biological cell interaction may help the understanding of the dynamic behavior of microbubbles and may eventually lead to better design of such delivery systems. We present the development of a high speed bright field and fluorescence imaging system that incorporates external mechanical waves such as ultrasound. Through collaborative design and contract manufacturing, a high speed imaging system has been successfully developed at the University of Pittsburgh Medical Center. We named the system "UPMC Cam," to refer to the integrated imaging system that includes the multi-frame camera and its unique software control, the customized modular microscope, the customized laser delivery system, its auxiliary ultrasound generator, and the combined ultrasound and optical imaging chamber for in vitro and in vivo observations. This system is capable of imaging microscopic bright field and fluorescence movies at 25 × 106 frames per second for 128 frames, with a frame size of 920 × 616 pixels. Example images of microbubble under ultrasound are shown to demonstrate the potential application of the system.

Does e-pain plan improve management of sickle cell disease associated vaso-occlusive pain crisis? a mixed methods evaluation.

Science.gov (United States)

Kato-Lin, Yi-Chin; Krishnamurti, Lakshmanan; Padman, Rema; Seltman, Howard J

2014-11-01

There is limited application and evaluation of health information systems in the management of vaso-occlusive pain crises in sickle cell disease (SCD) patients. This study evaluates the impact of digitization of paper-based individualized pain plans on process efficiency and care quality by examining both objective patient data and subjective clinician insights. Retrospective, before and after, mixed methods evaluation of digitization of paper documents in Children's Hospital of Pittsburgh of UPMC. Subjective perceptions are analyzed using surveys completed by 115 clinicians in emergency department (ED) and inpatient units (IP). Objective effects are evaluated using mixed models with data on 1089 ED visits collected via electronic chart review 28 months before and 22 months after the digitization. Surveys indicate that all clinicians perceived the digitization to improve the efficiency and quality of pain management. Physicians overwhelmingly preferred using the digitized plans, but only 44% of the nurses had the same response. Analysis of patient records indicates that adjusted time from analgesic order to administration was significantly reduced from 35.50 to 26.77 min (pmanagement. This study highlights the important role of health information technology (HIT) on vaso-occlusive pain management for pediatric patients with sickle cell disease and the critical challenges in accommodating human factor considerations in implementing and evaluating HIT effects. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Prognostic stratification of acute pulmonary embolism: Focus on clinical aspects, imaging, and biomarkers

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Luca Masotti

2009-07-01

Full Text Available Luca Masotti1, Marc Righini2, Nicolas Vuilleumier3, Fabio Antonelli4, Giancarlo Landini5, Roberto Cappelli6, Patrick Ray71Internal Medicine, 4Clinical Chemistry, Cecina Hospital, Cecina, Italy; 2Division of Angiology and Haemostasis, Department of Internal Medicine, Geneva University Hospital, Switzerland; 3Division of Laboratory Medicine, Department of Genetics and Laboratory Medicine, Geneva University Hospitals and University of Geneva, Switzerland; 5Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy; 6Thrombosis Center, University of Siena, Siena, Italy; 7Department of Emergency Medicine, Centre Hospitalo-Universitaire Pitié-Salpêtrière, UPMC Paris 6, Paris, FranceAbstract: Pulmonary embolism (PE represents a common disease in emergency medicine and guidelines for diagnosis and treatment have had wide diffusion. However, PE morbidity and mortality remain high, especially when associated to hemodynamic instability or right ventricular dysfunction. Prognostic stratification to identify high risk patients needing to receive more aggressive pharmacological and closer monitoring is of utmost importance. Modern guidelines for management of acute PE are based on risk stratification using either clinical, radiological, or laboratory findings. This article reviews the modern treatment of acute PE, which is customized upon patient prognosis. Accordingly the current risk stratification tools described in the literature such as clinical scores, echocardiography, helical computer tomography, and biomarkers will be reviewed.Keywords: pulmonary embolism, prognosis, troponin, BNP, NT-proBNP, echocardiography, computer tomography

Reconfiguration of a flexible fiber immersed in a 2D dense granular flow close to the jamming transition

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Kolb, Evelyne; Algarra, Nicolas; Vandembroucq, Damien; Lazarus, Arnaud

2015-11-01

We propose a new fluid/structure interaction in the unusual case of a dense granular medium flowing against an elastic fibre acting as a flexible intruder. We experimentally studied the deflection of a mylar flexible beam clamped at one side, the other free side facing a 2D granular flow in a horizontal cell moving at a constant velocity. We investigated the reconfiguration of the fibre as a function of the fibre's rigidity and of the granular packing fraction close but below the jamming in 2D. Imposing the fibre geometry like its length or thickness sets the critical buckling force the fibre is able to resist if it was not supported by lateral grains, while increasing the granular packing fraction might laterally consolidate the fibre and prevent it from buckling. But on the other side, the approach to jamming transition by increasing the granular packing fraction will be characterized by a dramatically increasing size of the cluster of connected grains forming a solid block acting against the fibre, which might promote the fibre's deflection. Thus, we investigated the granular flow fields, the fibre's deflexion as well as the forces experienced by the fibre and compared them with theoretical predictions from elastica for different loadings along the fibre. PMMH, CNRS UMR 7636, UPMC, ESPCI-ParisTech, 10 rue Vauquelin, 75231 Paris Cedex 05, France.

Discovering disease associations by integrating electronic clinical data and medical literature.

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Antony B Holmes

Full Text Available Electronic health record (EHR systems offer an exceptional opportunity for studying many diseases and their associated medical conditions within a population. The increasing number of clinical record entries that have become available electronically provides access to rich, large sets of patients' longitudinal medical information. By integrating and comparing relations found in the EHRs with those already reported in the literature, we are able to verify existing and to identify rare or novel associations. Of particular interest is the identification of rare disease co-morbidities, where the small numbers of diagnosed patients make robust statistical analysis difficult. Here, we introduce ADAMS, an Application for Discovering Disease Associations using Multiple Sources, which contains various statistical and language processing operations. We apply ADAMS to the New York-Presbyterian Hospital's EHR to combine the information from the relational diagnosis tables and textual discharge summaries with those from PubMed and Wikipedia in order to investigate the co-morbidities of the rare diseases Kaposi sarcoma, toxoplasmosis, and Kawasaki disease. In addition to finding well-known characteristics of diseases, ADAMS can identify rare or previously unreported associations. In particular, we report a statistically significant association between Kawasaki disease and diagnosis of autistic disorder.

The Truth and Reconciliation Commission of Canada: Insights into the Goal of Transformative Education

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Karina Czyzewski

2011-08-01

Full Text Available In 2006, the Government of Canada announced the approval of a final Residential Schools Settlement Agreement with the collaboration of the four churches responsible (United, Anglican, Presbyterian, Catholic, the federal government and residential school survivors. Schedule "N" of the Agreement lists the mandate of the TRC; therein, the TRC states one of its goals as: (d to promote awareness and public education of Canadians about the system and its impacts. Can education - as the TRC hopes to engender - truly be transformative, renewing relationships and promoting healing in the process of forging these new relationships? The literature reviewed and the conferences attended highlighted that generating empathy maybe a necessary ingredient for the instigation of social change, but is insufficient. Transformation through education, or reconciliation through truth-telling, testimonial reading and responsible listening would mean claiming a genuine, supportive responsibility for the colonial past. Educational policy and media initiatives are fundamental to creating awareness, developing public interest and support of the TRC's recommendations. However, authors also stress the importance of critical pedagogy in the whole process of truth andreconciliation, and that real reconciliation would require confronting the racism that initiated these institutions and allowed for a decontextualization of their impacts.

An update on the management of peripheral T-cell lymphoma and emerging treatment options

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Phillips AA

2011-09-01

Full Text Available Adrienne A Phillips1, Colette Owens2, Sangmin Lee1, Govind Bhagat31Division of Medical Oncology, Department of Medicine, 2Division of General Medicine, Department of Medicine, 3Department of Pathology and Cell Biology, Columbia University Medical Center and New York Presbyterian Hospital, Columbia University, New York, NY, USAAbstract: Peripheral T-cell lymphomas (PTCLs comprise a rare and heterogeneous subset of non-Hodgkin’s lymphomas (NHLs that arise from post-thymic T-cells or natural killer (NK-cells at nodal or extranodal sites. Worldwide, PTCLs represent approximately 12% of all NHLs and the 2008 World Health Organization (WHO classification includes over 20 biologically and clinically distinct T/NK-cell neoplasms that differ significantly in presentation, pathology, and response to therapy. Because of the rarity and heterogeneity of these diseases, large clinical trials have not been conducted and optimal therapy is not well defined. Most subtypes are treated with similar combination chemotherapy regimens as used for aggressive B-cell NHL, but with poorer outcomes. New treatment combinations and novel agents are currently being explored for PTCLs and this review highlights a number of options that appear promising.Keywords: treatment, non-Hodgkin’s lymphoma, novel therapy, natural-killer cells

Inhibition of aflatoxin biosynthesis in Aspergillus flavus by phenolic compounds extracted of Piper betle L.

Science.gov (United States)

Yazdani, Darab; Mior Ahmad, Zainal Abidin; Yee How, Tan; Jaganath, Indu Bala; Shahnazi, Sahar

2013-12-01

Food contamination by aflatoxins is an important food safety concern for agricultural products. In order to identify and develop novel antifungal agents, several plant extracts and isolated compounds have been evaluated for their bioactivities. Anti-infectious activity of Piper betle used in traditional medicine of Malaysia has been reported previously. Crude methanol extract from P. betel powdered leaves was partitioned between chloroform and water. The fractions were tested against A. flavus UPMC 89, a strong aflatoxin producing strain. Inhibition of mycelial growth and aflatoxin biosynthesis were tested by disk diffusion and macrodillution techniques, respectively. The presence of aflatoxin was determined by thin-layer chromatography (TLC) and fluorescence spectroscopy techniques using AFB1 standard. The chloroform soluble compounds were identified using HPLC-Tandem mass spectrometry technique. The results, evaluated by measuring the mycelial growth and quantification of aflatoxin B1(AFLB1) production in broth medium revealed that chloroform soluble compounds extract from P. betle dried leaves was able to block the aflatoxin biosynthesis pathway at concentration of 500μg/ml without a significant effect on mycelium growth. In analyzing of this effective fractions using HPLC-MS(2) with ESI ionization technique, 11 phenolic compounds were identified. The results showed that the certain phenolic compounds are able to decline the aflatoxin production in A. flavus with no significant effect on the fungus mycelia growth. The result also suggested P. betle could be used as potential antitoxin product.

Neural correlates of eating disorders: translational potential

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McAdams CJ

2015-09-01

Full Text Available Carrie J McAdams,1,2 Whitney Smith1 1University of Texas at Southwestern Medical Center, 2Department of Psychiatry, Texas Health Presbyterian Hospital of Dallas, Dallas, TX, USA Abstract: Eating disorders are complex and serious psychiatric illnesses whose etiology includes psychological, biological, and social factors. Treatment of eating disorders is challenging as there are few evidence-based treatments and limited understanding of the mechanisms that result in sustained recovery. In the last 20 years, we have begun to identify neural pathways that are altered in eating disorders. Consideration of how these pathways may contribute to an eating disorder can provide an understanding of expected responses to treatments. Eating disorder behaviors include restrictive eating, compulsive overeating, and purging behaviors after eating. Eating disorders are associated with changes in many neural systems. In this targeted review, we focus on three cognitive processes associated with neurocircuitry differences in subjects with eating disorders such as reward, decision-making, and social behavior. We briefly examine how each of these systems function in healthy people, using Neurosynth meta-analysis to identify key regions commonly implicated in these circuits. We review the evidence for disruptions of these regions and systems in eating disorders. Finally, we describe psychiatric and psychological treatments that are likely to function by impacting these regions. Keywords: anorexia nervosa, bulimia nervosa, social cognition, reward processing, decision-making

Electronic health record innovations: Helping physicians - One less click at a time.

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Guo, Uta; Chen, Lu; Mehta, Parag H

2017-09-01

Physician burnout is becoming an epidemic, due to the pressures of being productive, an imperfect electronic health record (EHR) system, and limited face-to-face time with patients. Poor usability in EHR-user interface can force users to go through more steps (i.e. more clicks on the computer) in accomplishing a task. This increased 'click burden' is a source of frustration for physicians. In the light of increased click burden and time due to meaningful use requirements, there is a need to improve the physician's experience by creating innovations in EHR. This case study describes an attempt by physicians at NewYork-Presbyterian Brooklyn Methodist Hospital to enhance the EHR experience with more efficient methods of documentation, chart review, ordering and patient safety. The EHR innovations trialled in this study were: a mobile documentation application; abnormal test results auto-populated into an EHR patient summary; physician alerts to reduce inappropriate test ordering; and a system of safety alerts on a dashboard. These innovations led to decreased click burden and allowed physicians to spend less time on the computer and more time with patients. Physician-driven changes to EHR systems have the potential to streamline virtual workflows and the management of health information and to improve patient safety, reduce physician burnout and increase physician job satisfaction.

Moral transgression, disease and holistic health in the Livingstonia Mission in late nineteenth and early twenttieth-century Malawi

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Hokkanen, Markku

2009-06-01

Full Text Available This article examines ideas of morality and health, and connections between moral transgression and disease in both Scottish missionary and Central African thought in the context of the Livingstonia Mission of the Presbyterian Free Church of Scotland in Malawi during the late nineteenth and early twentieth centuries.2 By concentrating on debates, conflicts and co-operation between missionaries and Africans over the key issues of beer drinking and sexual morality, this article explores the emergence of a new ‘moral hygiene’ among African Christian communities in Northern Malawi.

Este artículo analiza las ideas sobre moralidad y salud, así como las relaciones entre transgresión moral y enfermedad, tanto en el pensamiento misionero escocés como en el pensamiento del África central, en el contexto de la Misión de Livingstonia de la Iglesia Libre Presbiteriana de Escocia en Malawi entre finales del siglo XIX y principios del XX. Centrándose en las conversaciones, los conflictos y la colaboración entre los misioneros y los africanos sobre cuestiones clave como el consumo de cerveza y la moralidad sexual, este artículo estudia la aparición de una nueva «higiene moral» entre las comunidades cristianas africanas en Malawi del norte.

The Efficacy of Lavender Aromatherapy in Reducing Preoperative Anxiety in Ambulatory Surgery Patients Undergoing Procedures in General Otolaryngology

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Wotman, Michael; Levinger, Joshua; Leung, Lillian; Kallush, Aron; Mauer, Elizabeth

2017-01-01

Background Preoperative anxiety is a common problem in hospitals and other health care centers. This emotional state has been shown to negatively impact patient satisfaction and outcomes. Aromatherapy, the therapeutic use of essential oils extracted from aromatic plants, may offer a simple, low‐risk and cost‐effective method of managing preoperative anxiety. The purpose of this study was to evaluate the efficacy of lavender aromatherapy in reducing preoperative anxiety in ambulatory surgery patients undergoing procedures in general otolaryngology. Methods A prospective and controlled pilot study was conducted with 100 patients who were admitted to New York‐Presbyterian/Weill Cornell Medical Center for ambulatory surgery from January of 2015 to August of 2015. The subjects were allocated to two groups; the experimental group received inhalation lavender aromatherapy in the preoperative waiting area while the control group received standard nursing care. Both groups reported their anxiety with a visual analog scale (VAS) upon arriving to the preoperative waiting area and upon departure to the operating room. Results According to a Welch's two sample t‐test, the mean reduction in anxiety was statistically greater in the experimental group than the control group (p = 0.001). Conclusion Lavender aromatherapy reduced preoperative anxiety in ambulatory surgery patients. This effect was modest and possibly statistically significant. Future research is needed to confirm the clinical efficacy of lavender aromatherapy. Level of Evidence 2b PMID:29299520

Vitamin D deficiency intensifies deterioration of risk factors, such as male sex and absence of vision, leading to increased postural body sway.

Science.gov (United States)

Krause, Matthias; Anschütz, Wilma; Vettorazzi, Eik; Breer, Stefan; Amling, Michael; Barvencik, Florian

2014-01-01

Due to inconsistent findings, the influence of vitamin D on postural body sway (PBS) is currently under debate. This study evaluated the impact of vitamin D on PBS with regards to different foot positions and eye opening states in community-dwelling older individuals. In a cross-sectional study, we assessed PBS in 342 older individuals (264 females [average age (± SD): 68.3 ± 9.0 years], 78 males [65.7 ± 9.6 years]). A detailed medical history and vitamin D level were obtained for each individual. Fall risk was evaluated using the New York-Presbyterian Fall Risk Assessment Tool (NY PFRA). PBS parameters (area, distance, velocity, frequency) were evaluated on a pressure plate with feet in closed stance (CS) or hip-width stance (HWS), open eyes and closed eyes. Statistical analysis included logarithmic mixed models for repeated measures with the MIXED model procedure to test the influence of vitamin D (categorized in 30 μg/l), foot position, eye opening state, age, sex and frequency of physical activity on PBS. Vitamin D was not an independent risk factor for falls experienced in the last 12 months. Nonetheless, PBS was higher in patients with vitamin D deficiency (risk factors for increased PBS like male sex and absence of vision are additionally compromised by vitamin D deficiency. Copyright © 2013 Elsevier B.V. All rights reserved.

Percutaneous transhepatic cholangiographic evaluation of obstructive jaundice

International Nuclear Information System (INIS)

Kang, Hee Tae; Kim, Hong Soo; Kim, Jong Deok; Rhee, Hak Song

1983-01-01

PTC is the single most valuable diagnostic method available to evaluate the size, shape and site of the causes of obstructive jaundice among various radiological procedures. The authors reviewed and radiologically classified the PTC films of 203 cases of obstructive jaundice from July, 1977 to June, 1983 at Presbyterian Medical Center, Jeonju confirmed clinically, operatively and pathologically. The results are as follows; 1. The most common cause of obstructive jaundice was bile duct stone (64/203: 31.53%) and the other causes were bile duct cancer (43/203: 21.18%), pancreas cancer (41/203: 20.19%), biliary ascariasis and/or clonorchiasis (20/203: 9.8%), ampulla and duodenal cancer (7/203: 3.45%), fibrotic stenosis of sphincter of Oddi (6/203: 2.96%) etc. in the order. Of these primary involvement with cancer was more frequent (91/203: 44.33%) than stone. 3. The average maximal diameter of extrahepatic bile duct just proximal to the site of obstruction or stenosis by stones or by cancers was nearly equal (2.36 cm : 2.38 cm). 4. Cancers caused complete bile duct obstruction in about 75% (68/91) of cases and also were associated with intrahepatic duct dilatation about 92% (84/91) of cases. But in contrast biliary calculi showed good drainage of contrast medium in 75% (48/64) of cases and 92% (59/64) showed normal diameter

Performance characteristics of SCC radioimmunoassay and clinical significance serum SCC Ag assay in patients with malignancy

International Nuclear Information System (INIS)

Kim, Dong Youn

1986-01-01

To evaluate the performance characteristics of SCC RIV and the clinical significance of serum SCC Ag assay in patients with malignancy, serum SCC Ag levels were measured by SCC RIV kit in 40 normal controls and 35 percents with various untreated malignancy, who visited Chonju Presbyterian Medical Center. The results were as follows; 1. The SCC RIA was simple to perform and can be completed in two workday. And the standard curve and reproducibility were both good. 2. The mean serum SCC Ag level in normal controls was 1.64 ± 0.93 ng/mL and normal upper limit of serum SCC Ag was defined as 2.6 ng/mL. 3 out of 40 (7.5%) normal controls showed elevated SCC Ag levels above the normal upper limit. 3. In 35 patients with various untreated malignancy, 18 patients (51.4%) showed elevated serum SCC Ag levels, 59.1% of 22 patients with cervical cancer, 80% of 5 patients with lung cancer, 33% of 3 patients with esophageal cancer, 0% of 2 patients with rectal cancer and 0% of 3 patients with breast cancer showed elevated serum SCC Ag levels. Above results represent that SCC RIV is simple method to perform followed by good standard curve and reproducibility, and may be a useful indicator reflecting diagnostic data of patients with cervical cancer and lung cancer

SU-G-TeP4-05: An Evaluation of a Low Dose Rate (LDR) Prostate Brachytherapy Procedure Using a Failure Modes and Effects Analysis (FMEA)

International Nuclear Information System (INIS)

Cheong, S-K; Kim, J

2016-01-01

Purpose: The aim of the study is the application of a Failure Modes and Effects Analysis (FMEA) to access the risks for patients undergoing a Low Dose Rate (LDR) Prostate Brachytherapy Treatment. Methods: FMEA was applied to identify all the sub processes involved in the stages of identifying patient, source handling, treatment preparation, treatment delivery, and post treatment. These processes characterize the radiation treatment associated with LDR Prostate Brachytherapy. The potential failure modes together with their causes and effects were identified and ranked in order of their importance. Three indexes were assigned for each failure mode: the occurrence rating (O), the severity rating (S), and the detection rating (D). A ten-point scale was used to score each category, ten being the number indicating most severe, most frequent, and least detectable failure mode, respectively. The risk probability number (RPN) was calculated as a product of the three attributes: RPN = O X S x D. The analysis was carried out by a working group (WG) at UPMC. Results: The total of 56 failure modes were identified including 32 modes before the treatment, 13 modes during the treatment, and 11 modes after the treatment. In addition to the protocols already adopted in the clinical practice, the prioritized risk management will be implanted to the high risk procedures on the basis of RPN score. Conclusion: The effectiveness of the FMEA method was established. The FMEA methodology provides a structured and detailed assessment method for the risk analysis of the LDR Prostate Brachytherapy Procedure and can be applied to other radiation treatment modes.

Does a Weekly Didactic Conference Improve Resident Performance on the Pediatric Domain of the Orthopaedic In-Training Examination?

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Franklin, Corinna C; Bosch, Patrick P; Grudziak, Jan S; Dede, Ozgur; Ramirez, Rey N; Mendelson, Steven A; Ward, W Timothy; Brooks, Maria; Kenkre, Tanya; Lubahn, John D; Deeney, Vincent F; Roach, James W

2017-03-01

Performance on the Orthopaedic In-training Examination (OITE) has been correlated with performance on the written portion of the American Board of Orthopaedic Surgery examination. Herein we sought to discover whether adding a regular pediatric didactic lecture improved residents' performance on the OITE's pediatric domain. In 2012, a didactic lecture series was started in the University of Pittsburgh Medical Center (UPMC) Hamot Orthopaedic Residency Program (Hamot). This includes all topics in pediatric orthopaedic surgery and has teaching faculty present, and occurs weekly with all residents attending. A neighboring program [UMPC Pittsburgh (Pitt)] shares in these conferences, but only during their pediatric rotation. We sought to determine the effectiveness of the conference by comparing the historic scores from each program on the pediatric domain of the OITE examination to scores after the institution of the conference, and by comparing the 2 programs' scores. Both programs demonstrated improvement in OITE scores. In 2008, the mean examination score was 19.6±4.3 (11.0 to 30.0), and the mean percentile was 57.7±12.6 (32.0 to 88.0); in 2014, the mean examination score was 23.5±4.2 (14.0 to 33.0) and the mean percentile was 67.1±12.1 (40.0 to 94.0). OITE scores and percentiles improved with post graduate year (Pdidactic pediatric lecture improved residents' scores on the OITE and indirectly suggests that more frequent attendance is associated with better scores. Level III-retrospective case-control study.

SU-G-TeP4-05: An Evaluation of a Low Dose Rate (LDR) Prostate Brachytherapy Procedure Using a Failure Modes and Effects Analysis (FMEA)

Energy Technology Data Exchange (ETDEWEB)

Cheong, S-K; Kim, J [University of Pittsburgh Medical Center, Pittsburgh, PA (United States)

2016-06-15

Purpose: The aim of the study is the application of a Failure Modes and Effects Analysis (FMEA) to access the risks for patients undergoing a Low Dose Rate (LDR) Prostate Brachytherapy Treatment. Methods: FMEA was applied to identify all the sub processes involved in the stages of identifying patient, source handling, treatment preparation, treatment delivery, and post treatment. These processes characterize the radiation treatment associated with LDR Prostate Brachytherapy. The potential failure modes together with their causes and effects were identified and ranked in order of their importance. Three indexes were assigned for each failure mode: the occurrence rating (O), the severity rating (S), and the detection rating (D). A ten-point scale was used to score each category, ten being the number indicating most severe, most frequent, and least detectable failure mode, respectively. The risk probability number (RPN) was calculated as a product of the three attributes: RPN = O X S x D. The analysis was carried out by a working group (WG) at UPMC. Results: The total of 56 failure modes were identified including 32 modes before the treatment, 13 modes during the treatment, and 11 modes after the treatment. In addition to the protocols already adopted in the clinical practice, the prioritized risk management will be implanted to the high risk procedures on the basis of RPN score. Conclusion: The effectiveness of the FMEA method was established. The FMEA methodology provides a structured and detailed assessment method for the risk analysis of the LDR Prostate Brachytherapy Procedure and can be applied to other radiation treatment modes.

Navigating the storm: report and recommendations from the Atlantic Storm exercise.

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Smith, Bradley T; Inglesby, Thomas V; Brimmer, Esther; Borio, Luciana; Franco, Crystal; Gronvall, Gigi Kwik; Kramer, Bradley; Maldin, Beth; Nuzzo, Jennifer B; Schuler, Ari; Stern, Scott; Henderson, Donald A; Larsen, Randall J; Hamilton, Daniel S; O'Toole, Tara

2005-01-01

Atlantic Storm was a tabletop exercise simulating a series of bioterrorism attacks on the transatlantic community. The exercise occurred on January 14, 2005, in Washington, DC, and was organized and convened by the Center for Biosecurity of UPMC, the Center for Transatlantic Relations of Johns Hopkins University, and the Transatlantic Biosecurity Network. Atlantic Storm portrayed a summit meeting of presidents, prime ministers, and other international leaders from both sides of the Atlantic Ocean in which they responded to a campaign of bioterrorist attacks in several countries. The summit principals, who were all current or former senior government leaders, were challenged to address issues such as attaining situational awareness in the wake of a bioattack, coping with scarcity of critical medical resources such as vaccine, deciding how to manage the movement of people across borders, and communicating with their publics. Atlantic Storm illustrated that much might be done in advance to minimize the illness and death, as well as the social, economic, and political disruption, that could be caused by an international epidemic, be it natural or the result of a bioterrorist attack. These lessons are especially timely given the growing concerns over the possibility of an avian influenza pandemic that would require an international response. However, international leaders cannot create the necessary response systems in the midst of a crisis. Medical, public health, and diplomatic response systems and critical medical resources (e.g., medicines and vaccines) must be in place before a bioattack occurs or a pandemic emerges.

Presbyterian Patriots: The Historical Context of the Shared History and Prevalent Ideologies of Delaware’s Ulster-Scots who took up Arms in the American Revolution

Science.gov (United States)

2009-05-01

including Francis Bacon, Descartes, Grotius, Marcus Aurelius , and 71 The Newark Academy is the...34In fine I believe in the divinity of L. S. (Lord Shaftesbury) the saintship of Marcus Antoninus, the perspicuity and sublimity of Aristotle, and

Using Telemedicine to Address Crowding in the ED.

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Guss, Benjamin; Mishkin, David; Sharma, Rahul

2016-11-01

Some health systems are piloting telemedicine solutions in the ED to address crowding and decrease patient wait times. One new program, implemented at the Lisa Perry Emergency Center at New York Presbyterian (NYP) Weill Cornell Medical Center in New York, involves offering low-acuity patients the option of visiting an off-site physician via telemedicine hookup. Administrators note that the approach can get patients in and out of the ED within 30 minutes, and patients have thus far been highly satisfied with the approach. However, an earlier telemedicine program piloted at the University of San Diego Health System’s (UCSD) Hillcrest Hospital in 2013 got bogged down due to administrative and insurance reimbursement hurdles, although the approach showed enough promise that there is interest in restarting the program. In the NYP program, patients are identified as appropriate candidates for the program at triage. They can opt to be seen remotely or through traditional means in the ED’s fast-track section. Administrators note that patients with complex problems requiring extensive workups are not suitable for the telemedicine approach. The most challenging aspect of implementing a successful telemedicine program in the ED is getting the workflows right, according to administrators. An earlier ED-based telemedicine program piloted at UCSD ran into difficulties because the model required the involvement of two physicians, and some insurers did not want to pay for the telemedicine visits. However, patients were receptive.

Can Future Academic Surgeons be Identified in the Residency Ranking Process?

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Beninato, Toni; Kleiman, David A; Zarnegar, Rasa; Fahey, Thomas J

2016-01-01

The goal of surgical residency training programs is to train competent surgeons. Academic surgical training programs also have as a mission training future academicians-surgical scientists, teachers, and leaders. However, selection of surgical residents is dependent on a relatively unscientific process. Here we sought to determine how well the residency selection process is able to identify future academicians in surgery. Rank lists from an academic surgical residency program from 1992 to 1997 were examined. All ranked candidates׳ career paths after residency were reviewed to determine whether they stayed in academics, were university affiliated, or in private practice. The study was performed at New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY. A total of 663 applicants for general surgery residency participated in this study. In total 6 rank lists were evaluated, which included 663 candidates. Overall 76% remained in a general surgery subspecialty. Of those who remained in general surgery, 49% were in private practice, 20% were university affiliated, and 31% had academic careers. Approximately 47% of candidates that were ranked in the top 20 had ≥20 publications, with decreasing percentages as rank number increased. There was a strong correlation between the candidates׳ rank position and pursuing an academic career (p career. The residency selection process can identify candidates likely to be future academicians. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Computerized tomographic evaluation of primary brain tumors

Energy Technology Data Exchange (ETDEWEB)

Choi, Jin Ok; Lee, Jong Soon; Jeon, Doo Sung; Kim, Hong Soo; Rhee, Hak Song [Presbyterian Mediacal center, Cheonju (Korea, Republic of); Kim, Jong Deok [Inje Medical College, Paik Hospital, Pusan (Korea, Republic of)

1985-10-15

In a study of primary brain tumors 104 cases having satisfactory clinical, operative and histological proofs were analyzed by computerized tomography at Presbyterian Medical Center from May, 1982 to April 1985. The results were as follows: 1. The male to female ratio of primary brain tumor was 54 : 46. 2. The 2nd decade group (26%) was the most prevalent age group, followed by the 5th decade (16.3%), 1st decade (14.4%) , 3rd decade (12.5%), 4th decade (11.5%), 6th decade (10.6%), 7th decade (8.7%) in that order. 3. The incidence of primary brain tumors was found to be: glioma 64 cases (61.6%) among the GM, the most frequent 17 cases (16.3%), followed by meningioma 12 cases (11.5%), pituitary adenoma 10 cases (9.6%), craniopharyngioma 6 cases (5.8%), pinealoma and germinoma 3 cases (2.9%) respectively, and dermoid cyst 2 cases (1.9%) in that order. 4. The location of the primary brain tumors were as follows: cb. hemisphere (49%) of these 24.5% in parietal region, 11.9% in temporal region, 9.7% in frontal region, 3.0% in occipital region: juxtasella area (16.3%), cerebellar hemisphere (8.7%), parapineal and intraventricle (7.7%) respectively, cerebello-pontine angle area (5.8%), vermis and 4th ventricular region (4.8%). 5. There were no remarkable differences in the findings of pre- and post-contrast CT scanning of primary brain tumors computed with others.

A importância político-cultural do Levante das Estátuas nas Homilias sobre as Estátuas de João Crisóstomo The politico-cultural importance of the Revolt of the Statues in the Homilies about the Statues by John Chrysostom

Directory of Open Access Journals (Sweden)

Érica Cristhyane Morais da Silva

2009-01-01

Full Text Available A sociedade romana produziu estátuas abundantemente, como argumenta Stewart (2003:118. As suas funções eram diversas e vários os seus propósitos. Neste artigo, buscaremos apresentar a importância político-cultural das estátuas imperiais na sociedade romana do século IV d.C. a partir da compreensão da gravidade dos acontecimentos ocorridos durante a deflagração de um levante que ficou conhecido, na historiografia, como Levante das Estátuas. Neste levante, estátuas imperiais foram destruídas. Para tanto, utilizaremos a documentação legada por um presbítero, João Crisóstomo, que pronunciou, tradicionalmente, 21 homilias que a historiografia vinculou ao Levante das Estátuas.Roman society abundantly produced statues as discussed by Stewart (2003:118. Their functions were diverse and purposes innumerous. In this article, we seek to present the politico-cultural importance of the imperial statues in Roman society in the 4th century AD from our understanding of the seriousness of the events that occurred during the outburst of an insurrection that was better known in historiography as the Revolt of the Statues, where imperial statues were mutilated and destroyed. We therefore used documents linked to a Presbyterian, John Chrysostom, who preached traditionally 21 homilies that the historiography linked to the Revolt of the Statues.

Fear of falling: efficacy of virtual reality associated with serious games in elderly people

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Levy F

2016-04-01

Full Text Available Fanny Levy,1 Pierre Leboucher,2 Gilles Rautureau,2 Odile Komano,2 Bruno Millet,1 Roland Jouvent1 1Department of Adults Psychiatry, 2PRISME-Virtual Reality, ICM-A- IHU, UPMC UMR_S 975, Inserm U 1127, CNRS UMR 7225, GH Pitié-Salpêtrière, Paris, France Objective: Fear of falling is defined as an ongoing concern about falling that is not explained by physical examination. Focusing on the psychological dimension of this pathology (phobic reaction to walking, we looked at how virtual reality associated with serious games can be used to treat this pathology.Methods: Participants with fear of falling were randomly assigned to either a treatment group or a waiting list. The therapy consisted of 12 weekly sessions of virtual reality exposure therapy associated with serious games.Results: Sixteen participants were included. The mean age of the treatment group was 72 years and that of the control group was 69 years. Participants’ scores on the fear of falling measure improved after treatment with virtual reality associated with serious games, leading to a significant difference between the two groups.Conclusion: Virtual reality exposure therapy associated with serious games can be used in the treatment of fear of falling. The two techniques are complementary (top-down and bottom-up processes. To our knowledge, this is the first time that a combination of the two has been assessed. There was a specific effect of this therapy on the phobic reaction. Further studies are needed to confirm its efficacy and identify its underlying mechanism. Keywords: fear of falling, virtual reality exposure therapy, serious games, phobia, anxiety disorders

Good practices in health care "management experimentation models": insights from an international public-private partnership on transplantation and advanced specialized therapies.

Science.gov (United States)

Longo, Maria Cristina

2015-01-01

The research analyzes good practices in health care "management experimentation models," which fall within the broader range of the integrative public-private partnerships (PPPs). Introduced by the Italian National Healthcare System in 1991, the "management experimentation models" are based on a public governance system mixed with a private management approach, a patient-centric orientation, a shared financial risk, and payment mechanisms correlated with clinical outcomes, quality, and cost-savings. This model makes public hospitals more competitive and efficient without affecting the principles of universal coverage, solidarity, and equity of access, but requires higher financial responsibility for managers and more flexibility in operations. In Italy the experience of such experimental models is limited but successful. The study adopts the case study methodology and refers to the international collaboration started in 1997 between two Italian hospitals and the University of Pittsburgh Medical Center (UPMC - Pennsylvania, USA) in the field of organ transplants and biomedical advanced therapies. The research allows identifying what constitutes good management practices and factors associated with higher clinical performance. Thus, it allows to understand whether and how the management experimentation model can be implemented on a broader basis, both nationwide and internationally. However, the implementation of integrative PPPs requires strategic, cultural, and managerial changes in the way in which a hospital operates; these transformations are not always sustainable. The recognition of ISMETT's good management practices is useful for competitive benchmarking among hospitals specialized in organ transplants and for its insights on the strategies concerning the governance reorganization in the hospital setting. Findings can be used in the future for analyzing the cross-country differences in productivity among well-managed public hospitals.

Pocket pathologist: A mobile application for rapid diagnostic surgical pathology consultation

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Douglas J Hartman

2014-01-01

Full Text Available Introduction: Telepathology allows the digital transmission of images for rapid access to pathology experts. Recent technologic advances in smartphones have allowed them to be used to acquire and transmit digital images of the glass slide, representing cost savings and efficiency gains over traditional forms of telepathology. We report our experience with developing an iPhone application (App - Pocket Pathologist to facilitate rapid diagnostic pathology teleconsultation utilizing a smartphone. Materials and Methods: A secure, web-based portal (http://pathconsult.upmc.com/ was created to facilitate remote transmission of digital images for teleconsultation. The App augments functionality of the web-based portal and allows the user to quickly and easily upload digital images for teleconsultation. Image quality of smartphone cameras was evaluated by capturing images using different adapters that directly attach phones to a microscope ocular lens. Results: The App was launched in August 2013. The App facilitated easy submission of cases for teleconsultation by limiting the number of data entry fields for users and enabling uploading of images from their smartphone′s gallery wirelessly. Smartphone cameras properly attached to a microscope create static digital images of similar quality to a commercial digital microscope camera. Conclusion: Smartphones have great potential to support telepathology because they are portable, provide ubiquitous internet connectivity, contain excellent digital cameras, and can be easily attached to a microscope. The Pocket Pathologist App represents a significant reduction in the cost of creating digital images and submitting them for teleconsultation. The iPhone App provides an easy solution for global users to submit digital pathology images to pathology experts for consultation.

Nutritional advice for prevention of acute pancreatitis: review of current opinion

Directory of Open Access Journals (Sweden)

Lowe ME

2012-12-01

Full Text Available Mark E Lowe, Wednesday A SevillaDivision of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USAAbstract: Pancreatitis is inflammation of the pancreas that can be acute and self-limiting or, in a small percentage of patients, recurrent. Patients with recurrent episodes of acute pancreatitis (RAP often progress to chronic pancreatitis. Pancreatitis in all forms causes significant economic and social burdens. Prevention of RAP may decrease those burdens and halt progression to chronic disease. Unfortunately, no therapy has proven effective at altering the course of RAP. While enteral nutritional therapy plays an important role in the treatment of acute pancreatitis during episodes, nutritional advice provided to patients in an attempt to prevent recurrent episodes has not proven effective in most cases. Discontinuing alcohol consumption and treating dyslipidemia with diet and medication can help patients with these issues. In patients whose pancreatitis is associated with celiac disease or eosinophilic gastroenteritis, a gluten-free diet and avoidance of food allergens can be effective in stopping RAP. Advice to take pancreatic enzyme replacement therapy, lose weight, control diabetes, decrease dietary sucrose, decrease dietary fat or avoid monosodium glutamate has little to no evidence of efficacy. Some studies suggest that an antioxidant cocktail may decrease the frequency of RAP and the intensity of chronic pain, but the evidence is weak. Nutritional therapy may have a role in the treatment of patients with RAP. At present, there are no clear guidelines for nutritional advice to give these patients. More studies are needed to identify nutritional interventions that will benefit patients with RAP.Keywords: pancreatitis, nutrition, pancreatic enzyme replacement therapy, antioxidants, herbal supplements

Ixabepilone: a new chemotherapeutic option for refractory metastatic breast cancer

Directory of Open Access Journals (Sweden)

Shannon Puhalla

2008-09-01

Full Text Available Shannon Puhalla, Adam BrufskyUPMC Magee-Womens Cancer Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USAAbstract: Taxane therapy is commonly used in the treatment of metastatic breast cancer. However, most patients will eventually become refractory to these agents. Ixabepilone is a newly approved chemotherapeutic agent for the treatment of metastatic breast cancer. Although it targets microtubules similarly to docetaxel and paclitaxel, ixabepilone has activity in patients that are refractory to taxanes. This review summarizes the pharmacology of ixapebilone and clinical trials with the drug both as a single agent and in combination. Data were obtained using searches of PubMed and abstracts of the annual meetings of the American Society of Clinical Oncology and the San Antonio Breast Cancer Symposium from 1995 to 2008. Ixapebilone is a semi-synthetic analog of epothilone B that acts to induce apoptosis of cancer cells via the stabilization of microtubules. Phase I clinical trials have employed various dosing schedules ranging from daily to weekly to 3-weekly. Dose-limiting toxicites included neuropathy and neutropenia. Responses were seen in a variety of tumor types. Phase II studies verified activity in taxane-refractory metastatic breast cancer. The FDA has approved ixabepilone for use as monotherapy and in combination with capecitabine for the treatment of metastatic breast cancer. Ixabepilone is an efficacious option for patients with refractory metastatic breast cancer. The safety profile is similar to that of taxanes, with neuropathy and neutropenia being dose-limiting. Studies are ongoing with the use of both iv and oral formulations and in combination with other chemotherapeutic and biologic agents.Keywords: ixabepilone, epothilone, metastatic breast cancer, taxane-refractory

Poor planning, communication lead to missteps in care of Ebola patient.

Science.gov (United States)

2015-11-01

A panel of experts examining the diagnosis and care of Thomas Eric Duncan, a patient diagnosed with Ebola Virus Disease (EVD) in the United States in 2014, and the cases of two nurses who contracted EVD while caring for Duncan, has unveiled its findings along with recommendations to prevent many of the missteps that occurred during the crisis. While the independent panel was convened at the direction of Texas Health Resources, the parent company of Texas Health Presbyterian Hospital in Dallas, observers and the panel itself note that the findings should help hospitals, EDs, and communities across the country prepare for the next infectious disease event. The expert panel noted that ED personnel relied too heavily on the electronic medical record (EMR) to communicate with other members of the care team, and that important information, such as the patient's travel history, was not prioritized or highlighted in the EMR. Patient satisfaction and other operational objectives took precedence over patient safety during Duncan's ED visit, according to the expert panel's findings. The clinical team failed to pick up on changes in the patient's clinical status, missing an opportunity to re-evaluate Duncan and properly diagnosis him with EVD during his first visit to the ED. Confusion over the roles and responsibilities of local and federal health authorities, and inadequate preparation for an infectious disease event led to missteps. The expert panel suggests conducting practice drills that include all participating organizations, and hospital leaders should consider infectious disease threats as well as other types of disasters.

2011 John M. Eisenberg Patient Safety and Quality Awards. The effect of a novel Housestaff Quality Council on quality and patient safety. Innovation in patient safety and quality at the local level.

Science.gov (United States)

Fleischut, Peter M; Faggiani, Susan L; Evans, Adam S; Brenner, Samantha; Liebowitz, Richard S; Forese, Laura; Kerr, Gregory E; Lazar, Eliot J

2012-07-01

In 2008 New York-Presbyterian Hospital (NYP)/Weill Cornell Medical Center, New York City, the largest not-for-profit, nonsectarian hospital in the United States, created and implemented a novel approach--the Housestaff Quality Council (HQC)--to engaging house-staff in quality and patient safety activities. The HQC represented an innovative collaboration between the housestaff, the Department of Anesthesiology, the Division of Quality and Patient Safety, the Office of Graduate Medical Education, and senior leadership. As key managers of patient care, the housestaff sought to become involved in the quality and patient safety decision- and policy-making processes at the hospital. Its members were determined to decrease or minimize adverse events by facilitating multimodal communication, ensuring smart work flow, and measuring outcomes to determine best practices. The HQC, which also included frontline hospital staff or managers from areas such as nursing, pharmacy, and information technology, aligned its initiatives with those of the division of quality and patient safety and embarked on two projects--medication reconciliation and use of the electronic medical record. More than three years later, the resulting improvements have been sustained and three new projects--hand hygiene, central line-associated bloodstream infections, and patient handoffs--have been initiated. The HQC model is highly replicable at other teaching institutions as a complementary approach to their other quality and patient safety initiatives. However, the ability to sustain positive momentum is dependent on the ability of residents to invest time and effort in the face of a demanding residency training schedule and focus on specialty-specific clinical and research activities.

Hepatitis B and C viral infections among blood donors from rural Ghana.

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Nkrumah, B; Owusu, M; Frempong, H O; Averu, P

2011-09-01

To investigate the prevalence of Hepatitis B and C infections and co-infections among blood donors in a rural community of Ghana. A retrospective study. Samples of blood donated between January 2007 and December 2008 were screen for Hepatitis B and C viruses at the Agogo Presbyterian Hospital. The prevalence of Hepatitis B viral (HBV) infection was highest in females 21.4% (95% CI: 11.6-34.4) in 2006 than males in the same year 13.2% (95% CI: 10.8-15.9). Hepatitis C viral (HCV) infection was highest among males at 11.6% (95% CI: 9.5-13.8) in 2007. HBV and HCV co-infection was higher in males 2.6% (95% CI: 1.6-3.8) than females 1.3% (95% CI: 0-7.0) in 2007. The overall prevalence of HBV and HCV was 13.8% (95% CI: 11.4-16.4) and 9.4% (95% CI: 7.4-11.6) respectively in 2006. The rate of co-infection of HBV and HCV however increased from 1.6% (95% CI: 0.8-2.7) in 2006 to 2.2% (95% CI: 1.3-3.2) in 2008 in males and from 0% (95% CI: 0-6.4) in 2006 to 1.2% (95% CI: 0-6.5) in 2008 in females. The single infections of HBV and HCV reduced but co-infection of these transfusion transmitted infections (TTI) increased. Measures such as more sensitive techniques and education must be employed in these areas.

[One hundred years history of surgery in Korea].

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Chun, S I; Yeh, B

1999-01-01

Introduction of western surgery into Korea is closely related to the introduction of western medicine itself into Korea. In December 4th, 1884 Allen, who came to Korea as a Missionary Doctor of North Presbyterian Church of America, had a chance to treat a patient with severe stab wounds. The patient was a nephew of Queen Myungsung. The patient, Min Young Ik was recovered completely. These happenings led to the establishment of 'Kwangheywon (renamed to Jejoongwon 2 weeks later)', the first westernized hospital in Korea. With the great financial aids from Severance family, Jejoongwon developed into Severance Hospital and Medical School in 1904, and greatly contributed to education of Surgery for Korean medical students. Meanwhile Korean Government established the Medical School and Hospital to train Korean Doctors in 1899. But the original intentions became to be impaired by occupation of Korea by Japan in 1910. As a colony, many Japanese Surgeons came to Korea as professors of Kyungsung Medical College, and gave only few chances for Koreans to become a professor. On the contrary, several surgeons became professors in the private, missionary 'Severance Union Medical College'. After liberation from Japanese occupation in 1945, American medical system was introduced into Korea, and many surgeons had a chance to be trained in America. There was great advancements in the field of surgery, especially of neurosurgery, during a tragic Korean War. With the restoration of economy after the 1960s, surgery in Korea continued to develop toward an independent and consolidated fields of medicine.

Effect of donor age on long-term survival following cardiac transplantation.

Science.gov (United States)

Topkara, Veli K; Cheema, Faisal H; Kesavaramanujam, Satish; Mercando, Michelle L; Forster, Catherine S; Argenziano, Michael; Esrig, Barry C; Oz, Mehmet C; Naka, Yoshifumi

2006-01-01

The current shortage of donor hearts has forced the criteria of organ procurement to be extended, leading to increased use of older donor hearts to bridge the gap between demand and availability. Our objective was to analyze the effect of donor age on outcomes after cardiac transplantation. We retrospectively studied 864 patients who underwent cardiac transplantation at New York Presbyterian Hospital - Columbia University between 1992 and 2002. Patients were divided into two groups; donor age or =40 years (Group B, n = 264). Characteristics including gender, body mass index, and cytomegalovirus (CMV) status were significantly different between the two donor age groups. Race, CMV status, toxoplasmosis status, left ventricular assist device prior to transplant, diabetes mellitus, and retransplantation were similar in both the recipient groups, while age, gender, and BMI were different. Early mortality was lower in Group A, 5%, versus 9.5% in Group B. Multivariate analysis revealed recipient female gender (odd ratio (OR) = 1.71), retransplantation (OR = 1.63), and increased donor age (OR = 1.02) as significant predictors of poor survival in the recipient population. Actuarial survival at 1 year (86.7% vs 81%), 5 years (75% vs 65%), and 10 years (56% vs 42%) was significantly different as well with a log rank p = 0.002. These findings suggest that increased donor age is an independent predictor of long-term survival. However, the shortage of organs makes it difficult to follow strict guidelines when placing hearts; therefore, decisions need to be made on a relative basis.

Clarithromycin (Biaxin)-lenalidomide-low-dose dexamethasone (BiRd) versus lenalidomide-low-dose dexamethasone (Rd) for newly diagnosed myeloma.

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Gay, Francesca; Rajkumar, S Vincent; Coleman, Morton; Kumar, Shaji; Mark, Tomer; Dispenzieri, Angela; Pearse, Roger; Gertz, Morie A; Leonard, John; Lacy, Martha Q; Chen-Kiang, Selina; Roy, Vivek; Jayabalan, David S; Lust, John A; Witzig, Thomas E; Fonseca, Rafael; Kyle, Robert A; Greipp, Philip R; Stewart, A Keith; Niesvizky, Ruben

2010-09-01

The objective of this case-matched study was to compare the efficacy and toxicity of the addition of clarithromycin (Biaxin) to lenalidomide/low-dose dexamethasone (BiRd) vs. lenalidomide/low-dose dexamethasone (Rd) for newly diagnosed myeloma. Data from 72 patients treated at the New York Presbyterian Hospital-Cornell Medical Center were retrospectively compared with an equal number of matched pair mates selected among patients seen at the Mayo Clinic who received Rd. Case matching was blinded and was performed according to age, gender, and transplant status. On intention-to-treat analysis, complete response (45.8% vs. 13.9%, P < 0.001) and very-good-partial-response or better (73.6% vs. 33.3%, P < 0.001) were significantly higher with BiRd. Time-to-progression (median 48.3 vs. 27.5 months, P = 0.071), and progression-free survival (median 48.3 vs. 27.5 months, P = 0.044) were higher with BiRd. There was a trend toward better OS with BiRd (3-year OS: 89.7% vs. 73.0%, P = 0.170). Main grade 3-4 toxicities of BiRd were hematological, in particular thrombocytopenia (23.6% vs. 8.3%, P = 0.012). Infections (16.7% vs. 9.7%, P = 0.218) and dermatological toxicity (12.5% vs. 4.2%, P = 0.129) were higher with Rd. Results of this case-matched analysis suggest that there is significant additive value when clarithromycin is added to Rd. Randomized phase III trials are needed to confirm these results. © 2010 Wiley-Liss, Inc.

CO Seasonal Variability and Trend over Paris Megacity Using Ground-Based QualAir FTS and Satellite IASI-MetOp Measurements

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Te, Yao; Jeseck, Pascal; Hadji-Lazaro, Juliette

2012-11-01

In a growing world with more than 7 billion inhabitants and big emerging countries such as China, Brazil and India, emissions of anthropogenic pollutants are increasing continuously. Monitoring and control of atmospheric pollutants in megacities have become a major challenge for scientists and public health authorities in environmental research area. The QualAir platform at University Pierre et Marie Curie (UPMC), is an innovating experimental research platform dedicated to survey urban atmospheric pollution and air quality. A Bruker Optics IFS 125HR Fourier transform spectrometer belonged to the Laboratoire de Physique Moléculaire pour l'Atmosphère et l'Astrophysique (LPMAA), was adapted for ground-based atmospheric measurements. As one of the major instruments of the QualAir platform, this ground-based Fourier transform spectrometer (QualAir FTS) analyses the composition of the urban atmosphere of Paris, which is the third largest European megacity. The continuous monitoring of atmospheric pollutants is essential to improve the understanding of urban air pollution processes. Associated with a sun-tracker, the QualAir remote sensing FTS operates in solar infrared absorption and enables to monitor many trace gases, and to follow up their variability in the Ile-de-France region. Concentrations of atmospheric pollutants are retrieved by the radiative transfer model PROFFIT. These ground-based remote sensing measurements are compared to ground in-situ measurements and to satellite data from IASI-MetOp (Infrared Atmospheric Sounding Interferometer). The remote sensing total column of the carbon monoxide (CO) obtained from January 2009 to June 2012, has a seasonal variability with a maximum in April and a minimum in October. While, after 2008, the mean CO level is quite stable (no significant decrease as before 2008).

Remote sensing of GHG over Paris megacity and Orléans forest using ground-based QualAir FTS and TCCON-Orléans

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Te, Y.; Jeseck, P.; Da Costa, J.; Deutscher, N. M.; Warneke, T.; Notholt, J.

2012-04-01

In a growing world with more than 7 billion inhabitants and big emerging countries such as China, Brazil and India, emissions of anthropogenic pollutants are increasing continuously. Monitoring and control of atmospheric pollutants in megacities have become a major challenge for scientists and public health authorities in environmental research area. The QualAir platform at University Pierre et Marie Curie (UPMC), is an innovating experimental research platform dedicated to survey greenhouse gases (GHGs) and urban air quality. As one of the major instruments of the QualAir platform, the ground-based Fourier transform spectrometer (QualAir FTS, IFS 125HR model) analyses the composition of the urban atmosphere of Paris, which is the third European megacity. The continuous monitoring of atmospheric pollutants is essential to improve the understanding of urban air pollution processes. Associated with a sun-tracker, the QualAir remote sensing FTS operates in solar infrared absorption and enables to monitor many trace gases, and to follow up their variability in the Ile-de-France region. A description of the QualAir FTS will be given. Concentrations of atmospheric GHG, especially CO2 and CH4, are retrieved by the radiative transfer model PROFFIT. Located in the centre of Paris, the QualAir FTS can provide new and complementary urban measurements as compared to unpolluted ground-based stations of existing networks (NDACC and TCCON). The work made by LPMAA to join the TCCON network will also be presented. TCCON-Orléans is a ground-based FTS of the TCCON network located in the forest of Orléans (100 km south of Paris). Preliminary comparisons of GHGs measurements from both sites will be shown. Such ground-based information will help to better characterize regional GHGs, especially regarding anthropogenic emissions and trends.

Allium compounds, dipropyl and dimethyl thiosulfinates as antiproliferative and differentiating agents of human acute myeloid leukemia cell lines

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Faten Merhi

2008-08-01

Full Text Available Faten Merhi1, Jacques Auger2, Francine Rendu1, Brigitte Bauvois11UMR 7131 UPMC Paris Universitas/CNRS, Groupe Hospitalier Broussais-HEGP, Paris, France; 2University F. Rabelais, IRBI, UPRESA CNRS 6035, Tours, FranceAbstract: Epidemiologic studies support the premise that Allium vegetables may lower the risk of cancers. The beneficial effects appear related to the organosulfur products generated upon processing of Allium. Leukemia cells from patients with acute myeloid leukemia (AML display high proliferative capacity and have a reduced capacity of undergoing apoptosis and maturation. Whether the sulfur-containing molecules thiosulfinates (TS, diallyl TS (All2TS, dipropyl TS (Pr2TS and dimethyl TS (Me2TS, are able to exert chemopreventative activity against AML is presently unknown. The present study was an evaluation of proliferation, cytotoxicity, differentiation and secretion of AML cell lines (U937, NB4, HL-60, MonoMac-6 in response to treatment with these TS and their related sulfides (diallylsulfide, diallyl disulfide, dipropyl disulfide, dimethyl disulfide. As assessed by flow cytometry, ELISA, gelatin zymogaphy and RT-PCR, we showed that Pr2TS and Me2TS, but not All2TS and sulfides, 1 inhibited cell proliferation in dose- and time-dependent manner and this process was neither due to cytotoxicity nor apoptosis, 2 induced macrophage maturation, and 3 inhibited the levels of secreted MMP-9 (protein and activity and TNF-α protein, without altering mRNA levels. By establishing for the first time that Pr2TS and Me2TS affect proliferation, differentiation and secretion of leukemic cell lines, this study provides the opportunity to explore the potential efficiency of these molecules in AML.Keywords: acute myeloid leukemia, thiosulfinate, proliferation, differentiation, matrix metalloproteinase-9

Remarkable effects of disorder on superconductivity of single atomic layers of lead on silicon

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Brun, Christophe

2015-03-01

It is well known that conventional superconductivity is very robust against non-magnetic disorder. Nevertheless for thin and ultrathin films the structural properties play a major role in determining the superconducting properties, through a subtle interplay between disorder and Coulomb interactions. Unexpectedly, in 2010 superconductivity was discovered in single atomic layers of lead and indium grown on silicon substrate using scanning tunneling spectroscopy and confirmed later on by macroscopic transport measurements. Such well-controlled and tunable crystalline monolayers are ideal systems for studying the influence of various kinds of structural defects on the superconducting properties at the atomic and mesoscopic scale. In particular, Pb monolayers offer the opportunity of probing new effects of disorder because not only superconductivity is 2D but also the electronic wave functions are 2D. Our study of two Pb monolayers of different crystal structures by very-low temperature STM (300 mK) under magnetic field reveals unexpected results involving new spatial spectroscopic variations. Our results show that although the sheet resistance of the Pb monolayers is much below the resistance quantum, strong non-BCS corrections appear leading to peak heights fluctuations in the dI/dV tunneling spectra at a spatial scale much smaller than the superconducting coherence length. Furthermore, strong local evidence of the signature of Rashba effect on the superconductivity of the Pb/Si(111) monolayer is revealed through filling of in gap states and local spatial variations of this filling. Finally the nature of vortices in a monolayer is found to be very sensitive to the properties of step edges areas. This work was supported by University Pierre et Marie Curie UPMC `Emergence' project, French ANR Project `ElectroVortex,' ANR-QuDec and Templeton Foundation (40381), ARO (W911NF-13-1-0431) and CNRS PICS funds. Partial funding by US-DOE Grant DE-AC02-07CH1.

A study of the transferability of influenza case detection systems between two large healthcare systems.

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Ye Ye

Full Text Available This study evaluates the accuracy and transferability of Bayesian case detection systems (BCD that use clinical notes from emergency department (ED to detect influenza cases.A BCD uses natural language processing (NLP to infer the presence or absence of clinical findings from ED notes, which are fed into a Bayesain network classifier (BN to infer patients' diagnoses. We developed BCDs at the University of Pittsburgh Medical Center (BCDUPMC and Intermountain Healthcare in Utah (BCDIH. At each site, we manually built a rule-based NLP and trained a Bayesain network classifier from over 40,000 ED encounters between Jan. 2008 and May. 2010 using feature selection, machine learning, and expert debiasing approach. Transferability of a BCD in this study may be impacted by seven factors: development (source institution, development parser, application (target institution, application parser, NLP transfer, BN transfer, and classification task. We employed an ANOVA analysis to study their impacts on BCD performance.Both BCDs discriminated well between influenza and non-influenza on local test cases (AUCs > 0.92. When tested for transferability using the other institution's cases, BCDUPMC discriminations declined minimally (AUC decreased from 0.95 to 0.94, p<0.01, and BCDIH discriminations declined more (from 0.93 to 0.87, p<0.0001. We attributed the BCDIH decline to the lower recall of the IH parser on UPMC notes. The ANOVA analysis showed five significant factors: development parser, application institution, application parser, BN transfer, and classification task.We demonstrated high influenza case detection performance in two large healthcare systems in two geographically separated regions, providing evidentiary support for the use of automated case detection from routinely collected electronic clinical notes in national influenza surveillance. The transferability could be improved by training Bayesian network classifier locally and increasing the

Development and use of a genitourinary pathology digital teaching set for trainee education

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Li Li

2010-01-01

Full Text Available Background : Automated, high-speed, high-resolution whole slide imaging (WSI robots are becoming increasingly robust and capable. This technology has started to have a significant impact on pathology practice in various aspects including resident education. To be sufficient and adequate, training in pathology requires gaining broad exposure to various diagnostic patterns through teaching sets, which are traditionally composed of glass slides. Methods: A teaching set of over 295 glass slides has been used for resident training at the Division of Genitourinary Pathology, Department of Pathology, University of Pittsburgh Medical Center. Whole slide images were prepared from these slides using an Aperio ScanScope CS scanner. These images and case-related information were uploaded on a web-based digital teaching model. Results: The web site is available at: https://www.secure.opi.upmc.edu/genitourinary/index.cfm. Once logged in, users can view the list of cases, or search cases with or without diagnoses shown. Each case can be accessed through an option button, where the clinical history, gross findings are initially shown. Whole slide images can be accessed through the links on the page, which allows users to make diagnoses on their own. More information including final diagnosis will display when the diagnosis-button is clicked. Conclusion: The web-based digital study set provides additional educational benefits to using glass slides. Residents or other users can remotely access whole slide images and related information at their convenience. Searching and sorting functions and self-testing mode allow a more targeted study. It would also prepare residents with competence to work with whole slide images. Further, the model can be expanded to include pre-rotation and post-rotation exams, and/or a virtual rotation system, which may potentially make standardization of pathology resident training possible in the future.

Low Response Rate and Other Factors Render Academic Health Science Library System Study Ungeneralizable. A Review of: Folb, B. L., Wessel, C. B., & Czechowski, L. J. (2011. Clinical and academic use of electronic and print books: The Health Sciences Library System e-book study at the University of Pittsburgh. Journal of the Medical Library Association, 99(3, 218-228. doi:10.3163/1536-5050.99.3.009

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Maria Melssen

2012-06-01

Full Text Available Objective – To determine the factors, barriersand facilitators, preference, and intended useof e-book compared to print book usage by allpatrons in a health science library system,which serves a university with health sciencedegree programs and a hospital system.Design – Two online surveys.Setting – University of Pittsburgh HealthSciences Library System, which includes theUniversity of Pittsburgh’s six schools of healthsciences (medicine, dental medicine, nursing,pharmacy, public health, and rehabilitationand the University of Pittsburgh MedicalCenter hospitals and programs.Subjects – All health sciences library systemusrers, including faculty, researchers, clinicians,residents, fellows, employees, and students.Methods – Two versions of the survey weredeployed in 2009 using Opinio. There were 46questions for the University of PittsburghMedical Center (UPMC survey and 47questions for the University of Pittsburgh (Pittsurvey. The surveys were pilot tested byHealth Sciences Library System (HSLSlibrarians and graduate students in a surveymethods class. The survey was edited based onthe feedback provided and receivedinstitutional review board approval as anexempt study.A total of 5,292 email addresses wererandomly selected by SPSS from a pool of 9,472 UPMC and Pitt patrons registered with a HSLS remote access password; 2,684 patrons from UPMC and 2,608 patrons from Pitt were selected. HSLS librarians were excluded from the survey. Participants were emailed a link to the survey in March of 2009. Three email reminders were sent at five day intervals. Data was collected for 22 days and exported from Opinio to SPSS statistics software. Survey results were analyzed using basic descriptive statistics and cross-tabulations.Main Results – Of the 5,292 emails sent, 979 surveys were submitted and 871 were completed fully. The 108 partially completed the surveys were analyzed using pair wise deletion. All HSLS user groups were represented and all

EFRAÍM OTERO RUIZ: UNA VIDA SÚMMUM DEL HUMANISMO. MÉDICO, INVESTIGADOR, HISTORIADOR, EDUCADOR, ETICISTA, POETA

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José Félix Patiño Restrepo

2014-10-01

Full Text Available Un hombre bueno, médico, investigador científico, historiador, educador, eticista, poeta. Ciertamente el súmmum del humanismo. Dueño de una excepcional inteligencia y una vasta cultura, Efraím Otero Ruiz fue el hombre de quien uno puede decir con total seguridad que es paradigma de la excelencia humana. De profundas -y muy orgullosas- raíces santandereanas, Efraím estudió siempre con los jesuitas: bachiller del Colegio de San Bartolomé La Merced y médico con grado cum laude de la Universidad Javeriana. Para su formación de posgrado viajó a los Estados Unidos a especializarse en endocrinología y medicina nuclear. Su portentoso talento, su inquietud intelectual y esa permanente búsqueda del saber lo llevó a los mejores centros de la época: el Instituto de Estudios Nucleares de Oak Ridge, Tennessee, por entonces el lugar de concentración de los más grandes físicos; la Universidad de California con su campus en Berkeley; el Presbyterian Hospital de la Universidad de Columbia en Nueva York. Eran centros donde, como él mismo me dijo una vez, "pululaban los premios Nobel". Y fue con ellos, codo a codo, que Efraím maduró el altísimo nivel académico y científico que caracterizó su vida profesional. Elegante y refinado escritor, Otero Ruiz tradujo los poetas ingleses y norteamericanos, y quienes hayan leído tales traducciones, estarán de acuerdo conmigo en que ¡son mejores que los textos originales!

Investigation of a Potential Protective Mechanism Against Heparin-Induced Thrombocytopenia in Patients on Chronic Intermittent Hemodialysis

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Tanhehco, Yvette C.; Cuker, Adam; Rudnick, Michael; Sachais, Bruce S.

2015-01-01

BACKGROUND Heparin-induced thrombocytopenia (HIT) develops as a result of platelet (PLT) activation by anti-platelet factor 4 (PF4)/heparin complex antibodies. Despite repeated exposure to heparin, patients undergoing chronic intermittent hemodialysis (HD) rarely develop HIT. We investigated the possibility that HD decreases/removes PF4 from PLT surfaces and/or plasma, thereby disfavoring immune complex formation as a mechanism of protection against HIT. MATERIALS AND METHODS We enrolled 20 patients undergoing chronic HD at the Penn Presbyterian Medical Center. Blood samples were drawn before, during and after treatment in the presence and absence of heparin. PF4, PF4/heparin antibody, heparin, and P-selectin levels were measured. RESULTS No patients demonstrated clinical symptoms of HIT. PLT surface PF4 levels decreased and plasma PF4 levels increased concurrently with increase in plasma heparin concentration. In the absence of heparin, PLT surface and plasma PF4 levels were unchanged. Anti-PF4/heparin antibodies, which were non-functional by the serotonin release assay, were detectable in 8 patients. PLT surface P-selectin levels did not change during treatment. CONCLUSIONS Removal of PLT surface and/or plasma PF4 as a mechanism of protection against HIT in patients undergoing HD is not supported by the results of our study, although the transient decrease in PLT surface PF4 in the presence of large amounts of heparin remains a candidate mechanism. The small sample size, single type of dialyzer membrane, and early sampling time points may have led to the inability to detect changes in PF4 levels. Future studies should explore other potential protective mechanisms. PMID:23305841

Greater Proptosis Is Not Associated With Improved Compressive Optic Neuropathy in Thyroid Eye Disease.

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Nanda, Tavish; Dunbar, Kristen E; Campbell, Ashley A; Bathras, Ryan M; Kazim, Michael

2018-05-18

Despite the paucity of supporting data, it has generally been held that proptosis in thyroid eye disease (TED) may provide relative protection from compressive optic neuropathy (CON) by producing spontaneous decompression. The objective of this study was to investigate this phenomenon in patients with bilateral TED-CON. We retrospectively reviewed the charts of 67 patients (134 orbits) with bilateral TED-CON at Columbia-Presbyterian Medical Center. Significant asymmetric proptosis (Hertel) was defined as ≥ 2 mm. Significant asymmetric CON was defined first, as the presence of an relative afferent pupillary defect. Those without an relative afferent pupillary defect were evaluated according to the TED-CON formula y = -0.69 - 0.31 × (motility) - 0.2 × (mean deviation) - 0.02 × (color vision) as previously established for the diagnosis of TED-CON. A difference in the formula result ≥ 1.0 between eyes was considered significant. Patients were then divided into 4 groups. Forty-one of 67 patients demonstrated asymmetric CON (29 by relative afferent pupillary defect, 12 by formula). Twenty-one of 67 patients demonstrated asymmetric proptosis. Only 5 of 12 (41.6%) of the patients who had both asymmetric proptosis and asymmetric CON (group 1) showed greater proptosis in the eye with less CON. Twenty-nine patients (group 2) showed that asymmetric CON occurred despite symmetrical proptosis. Seventeen patients (group 3), showed the inverse, that asymmetric differences in proptosis occurred with symmetrical CON. Despite commonly held assumptions, our results suggest that greater proptosis is not associated with improved TED-CON. Combining groups 1 to 3-all of which demonstrated asymmetry of either proptosis, CON, or both-91.4% of patients did not show a relationship between greater proptosis and improved CON.

Clinical Research Careers: Reports from a NHLBI Pediatric Heart Network Clinical Research Skills Development Conference

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Lai, Wyman W.; Richmond, Marc; Li, Jennifer S.; Saul, J. Philip; Mital, Seema; Colan, Steven D.; Newburger, Jane W.; Sleeper, Lynn A.; McCrindle, Brain W.; Minich, L. LuAnn; Goldmuntz, Elizabeth; Marino, Bradley S.; Williams, Ismee A.; Pearson, Gail D.; Evans, Frank; Scott, Jane D.; Cohen, Meryl S.

2013-01-01

Background Wyman W. Lai, MD, MPH, and Victoria L. Vetter, MD, MPH. The Pediatric Heart Network (PHN), funded under the U.S. National Institutes of Health-National Heart, Lung, and Blood Institute (NIH–NHLBI), includes two Clinical Research Skills Development (CRSD) Cores, which were awarded to The Children's Hospital of Philadelphia and to the Morgan Stanley Children's Hospital of New York–Presbyterian. To provide information on how to develop a clinical research career to a larger number of potential young investigators in pediatric cardiology, the directors of these two CRSD Cores jointly organized a one-day seminar for fellows and junior faculty from all of the PHN Core sites. The participants included faculty members from the PHN and the NHLBI. The day-long seminar was held on April 29, 2009, at the NHLBI site, immediately preceding the PHN Steering Committee meeting in Bethesda, MD. Methods The goals of the seminar were 1) to provide fellows and early investigators with basic skills in clinical research 2) to provide a forum for discussion of important research career choices 3) to introduce attendees to each other and to established clinical researchers in pediatric cardiology, and 4) to publish a commentary on the future of clinical research in pediatric cardiology. Results The following chapters are compilations of the talks given at the 2009 PHN Clinical Research Skills Development Seminar, published to share the information provided with a broader audience of those interested in learning how to develop a clinical research career in pediatric cardiology. The discussions of types of clinical research, research skills, career development strategies, funding, and career management are applicable to research careers in other areas of clinical medicine as well. Conclusions The aim of this compilation is to stimulate those who might be interested in the research career options available to investigators. PMID:21167335

Hypersensitivity myocarditis associated with ephedra use.

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Zaacks, S M; Klein, L; Tan, C D; Rodriguez, E R; Leikin, J B

1999-01-01

Ephedrine has previously been described as a causative factor of vasculitis but myocarditis has not yet been associated with either ephedrine or its plant derivative ephedra. A 39-year-old African American male with hypertension presented to Rush Presbyterian St. Luke's Medical Center with a 1-month history of progressive dyspnea on exertion, orthopnea, and dependent edema. He was taking Ma Huang (Herbalife) 1-3 tablets twice daily for 3 months along with other vitamin supplements, pravastatin, and furosemide. Physical examination revealed a male in mild respiratory distress. The lung fields had rales at both bases without audible wheezes. Internal jugular venous pulsations were 5 cm above the sternal notch. Medical therapy with intravenous furosemide and oral enalapril was initiated upon admission. Cardiac catheterization with coronary angiography revealed normal coronary arteries, a dilated left ventricle, moderate pulmonary hypertension, and a pulmonary capillary wedge pressure of 34 mm Hg. The patient had right ventricular biopsy performed demonstrating mild myocyte hypertrophy and an infiltrate consisting predominantly of lymphocytes with eosinophils present in significantly increased numbers. Treatment for myocarditis was initiated with azothioprine 200 mg daily and prednisone 60 mg per day with a tapering course over 6 months. Anticoagulation with warfarin and diuretics was initiated and angiotensin-converting enzyme inhibition was continued. Hydralazine was added later. One month into therapy, an echocardiogram demonstrated improved left ventricular function with only mild global hypokinesis. A repeat right ventricular biopsy 2 months after the first admission showed no evidence of myocarditis. At 6 months, left ventricular ejection fraction was normal (EFN 50%) and the patient asymptomatic. Ephedra (Ma Huang) is the suspected cause of hypersensitivity myocarditis in this patient due to the temporal course of disease and its propensity to induce vasculitis.

Nasal Carriage of Staphylococcus aureus among Children in the Ashanti Region of Ghana.

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Daniel Eibach

Full Text Available Nasal carriage with Staphylococcus aureus is a common risk factor for invasive infections, indicating the necessity to monitor prevalent strains, particularly in the vulnerable paediatric population. This surveillance study aims to identify carriage rates, subtypes, antimicrobial susceptibilities and virulence markers of nasal S. aureus isolates collected from children living in the Ashanti region of Ghana.Nasal swabs were obtained from children < 15 years of age on admission to the Agogo Presbyterian Hospital between April 2014 and January 2015. S. aureus isolates were characterized by their antimicrobial susceptibility, the presence of genes encoding for Panton-Valentine leukocidin (PVL and toxic shock syndrome toxin-1 (TSST-1 and further differentiated by spa-typing and multi-locus-sequence-typing.Out of 544 children 120 (22.1% were colonized with S. aureus, with highest carriage rates during the rainy seasons (27.2%; p = 0.007, in females aged 6-8 years (43.7% and males aged 8-10 years (35.2%. The 123 isolates belonged to 35 different spa-types and 19 sequence types (ST with the three most prevalent spa-types being t355 (n = 25, t84 (n = 18, t939 (n = 13, corresponding to ST152, ST15 and ST45. Two (2% isolates were methicillin-resistant S. aureus (MRSA, classified as t1096 (ST152 and t4454 (ST45, and 16 (13% were resistant to three or more different antimicrobial classes. PVL and TSST-1 were detected in 71 (58% and 17 (14% isolates respectively.S. aureus carriage among Ghanaian children seems to depend on age, sex and seasonality. While MRSA rates are low, the high prevalence of PVL is of serious concern as these strains might serve not only as a source for severe invasive infections but may also transfer genes, leading to highly virulent MRSA clones.

O discurso acadêmico de Rubem Alves sobre "protestantismo" e "repressão": algumas observações 30 anos depois

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Leonildo Silveira Campos

2008-01-01

Full Text Available Em 1979 foi publicado um dos primeiros ensaios críticos do protestantismo brasileiro. Seu autor, Rubem Alves, então teólogo presbiteriano, professor de filosofia e psicanalista, usando a linguagem da filosofia política, apresentou um livro que viria a se tornar um texto clássico no estudo do protestantismo brasileiro: Protestantismo e Repressão. Para isso criou um tipo ideal: "Protestantismo da Reta Doutrina" e desenvolveu uma metodologia própria, de inspiração fenomenológica e weberiana. Hoje, quase 30 anos depois, uma segunda edição surge com o nome "Religião e Repressão". Este artigo, partindo de sugestões da Sociologia do Conhecimento e das propostas de Pierre Bourdieu, procura descrever o campo religioso brasileiro em que esse texto surgiu, o contexto intelectual e político, discutindo a epistemologia e a metodologia empregada por Alves na confecção de sua obra.In 1979, there was published one of the first pieces of critic writings about Brazilian Protestantism. Its author was Rubem Alves, then a Presbyterian theologian, a professor of philosophy, and a psychoanalyst. Using the language of political philosophy, he presented a text that would become a classic in the study of Brazilian Protestantism: "Protestantism and Repression." To do this he created an ideal type, "right doctrine Protestantism," and developed his own methodology, inspired by phenomenology. Today, almost 30 years later, a second edition has appeared with the title "Religion and Repression." The present article, taking as its point of departure the Sociology of Knowledge and the proposals of Pierre Bourdieu, seeks to describe the Brazilian religious situation in which this book arose and the political and intellectual context, discussing the epistemology and the methodology employed by Alves in putting together his work.

A multi-center prospective cohort study to evaluate the effect of differential pricing and health systems strengthening on access to medicines and management of hypertension and diabetes in Ghana: A study protocol.

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Mobula, Linda Meta; Sarfo, Stephen; Arthur, Lynda; Burnham, Gilbert; Plange-Rhule, Jacob; Ansong, Daniel; Gavor, Edith; Ofori-Adjei, David

2018-02-07

Background: There is evidence to suggest that the prevalence of non-communicable diseases (NCDs), in particular cardiovascular diseases and diabetes, are being recognized as forming a substantial proportion of the burden of disease among populations in Low- and Middle-Income Countries (LMICs).  Access to treatment is likely a key barrier to the control and prevention of NCD outcomes.  Differential pricing, an approach used to price drugs based on the purchasing power of patients in different socioeconomic segments, has been shown to be beneficial and leads to improved access and affordability. Methods: This is a quasi-experimental study, with a pragmatic trial design, to be conducted over the course of three years. A mixed methods design will be used to evaluate the effects of health systems strengthening and differential pricing on the management of diabetes, hypertension and selected cancers in Ghana. A public private partnership was established between all sites that will receive multi-level interventions, including health systems strengthening  and access to medicines interventions. Study populations and sites: Study participants will include individuals with new or recently diagnosed hypertension and diabetes (n=3,300), who present to two major referral hospitals, Komfo Anokye Teaching Hospital and Tamale Teaching Hospital, as well as three district hospitals, namely Kings Medical Centre, Agogo Presbyterian District Hospital, and Atua Government Hospital. Discussion: The objective of this study aims to test approaches intended to improve access to drugs for the treatment of hypertension and diabetes, and improve disease control. Patients with these conditions will benefit from health systems strengthening interventions (education, counseling, improved management of disease), and increased access to innovative medicines via differential pricing. Pilot programs also will facilitate health system strengthening at the participating institutions, which includes

Late Abortion: A Comprehensive Review

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Sheng Chiang

2005-12-01

Full Text Available Late termination of pregnancy (LTOP is defined as an abortion carried out beyond 24 gestational weeks, when the fetus has arguably attained viability. In Taiwan, the current abortion law, bearing a eugenic title, allows LTOP on certain medical grounds. However, the fetal and maternal conditions that constitute medical grounds are not clarified and remain legally untested. Professional debate on the abortion issue is also lacking in academia in Taiwan, despite societal concerns. With the advent of technology to detect fetal abnormalities, obstetricians are now confronted more frequently with acute dilemmas regarding LTOP. Quite often, they sail in an uncharted sea with no clinical guidelines from their professional societies or affiliated hospitals. Recently, LTOP at 35 gestational weeks for a fetus with Down syndrome, complicated with polyhydramnios and tetralogy of Fallot, triggered media scrutiny and aroused much public attention. Although the clinical decision making for pregnancies with fetal abnormalities entails increasingly balanced information and consideration in terms of the medical, ethical, legal, psychologic, and societal aspects, society at large is unaware of the complexity and intertwined nature of various abortion issues, especially LTOP. Obstetricians are now in a vulnerable position in Taiwanese society, where litigations relevant to the practice of early abortions are not rare. Therefore, a global and in-depth look into abortion issues from legal and ethical dimensions is indispensable for modern obstetric practice. This review considers the core issues in LTOP, including what conditions constitute a “serious” fetal abnormality to justify LTOP, the incidence of LTOP, legislation regarding LTOP in Western countries, and recent research on ambivalent fetal pain. It will also present procedures, some under the auspices of the ethical committee of a Presbyterian hospital in Taiwan, for clinical decision making, particularly

Schooling of girls in pre-partition Punjab.

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Chanana, K

1997-01-01

This study examines female school enrollment during 1920-47 in the Punjab, India, prepartition. Data were obtained from reports, such as the Progress of Education in the Punjab. This period includes an active social reform movement. Punjabi Hindu men changed their attitudes toward purdah and seclusion and the education of women. Educated wives were in demand. Educational institutions were initially religiously affiliated. Schools for girls were set up by British missionaries and American Presbyterians in the late 1800s. The most active missionary societies were the Zenana Bible and Medical Mission and its precursor, the Indian Female Normal School and Instruction Society. Education was expanded by private organizations. The 1916-17 Report on Education in the Punjab indicates substantial public support for girls' education. The demand for education was strongest initially in urban areas. Government secondary schools for girls were set up in each district of the Punjab by 1931-32. By 1936-37 there was one girl school for every 46.3 sq. miles. Throughout the 1930s and 1940s the government established high or middle schools in smaller towns. Almost all large cities had colleges for women. Demand for girls' education rose at the same time as constraints neutralized the attitude changes. Constraints included a lack of trained women teachers, shortages of resources, poor infrastructural facilities, irrelevant curricula, and prejudice against women becoming teachers. Two measures encouraged the advancement of education. The growth of middle and high schools did not keep pace with the growth of primary schools. Female enrollments increased from 62,571 to 237,446 during 1921-45. Primary and middle coeducational school enrollment of girls declined during the 1940s. Muslim and Sikh enrollments increased. High-caste Hindu enrollments declined, but still represented half of all girls in colleges and universities.

Radiologic evaluation of colorectal cancer

International Nuclear Information System (INIS)

Lee, Young Joong; Kang, Hee Tae; Kim, Jong Deok; Rhee, Hak Song

1984-01-01

The incidence of colorectal cancer of Korea is much lower than that of Western countries, but has shown a tendency to a slight increase recently. Barium enema is the most valuable, noninvasive and inexpensive method available to evaluate the size, shape and site of colorectal cancer. The authors reviewed and radiologically classified barium enema studies of 232 cases of colorectal cancer from Aug. 1967 to July 1982 at Presbyterian Medical Center, Jeonju, Confirmed clinically, operatively and pathologically. The results were as follows; 1. The ratio of male and female was 1.3:1, and youngest was 13 year-old and the oldest 86 year-old. 2. The peak incidence occurred from 5th to 7th decades, accounting for 78% of all cases (181/232), and there was a relatively high incidence of the disease in patients below 30 years of age at 7.8% (18/232). 3. Rectum and rectosigmoid region are the most frequently involved regions (127/232:54.8%). 4. The positivity of barium enema examination was 4.0% (232/5807), and its accuracy was 96.5% (224/232). 5. The radiologic findings were classified into 4 groups, and they were annular encircling 62.9% (146/232). polypoid fungating 26.8% (62/232), infiltrating 8.6% (20/232), and primary ulcerating 1.7% (4/232) in order of frequency. 6. The linear length of the cancer ranged from 1.5 Cm to 15 Cm, and the average length was 5.5 Cm. 7. There was no statistical correlation between the length of lesion, the site, and the radiologic findings, and stages of the lesion (P:0.750-0.250). 8. The majority of colorectal cancers was adenocarcinoma (217/232:93.6%)

Association between assisted reproductive technology and advanced retinopathy of prematurity

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RV Paul Chan

2010-11-01

Full Text Available RV Paul Chan1, Yoshihiro Yonekawa1, Margaux A Morrison2,3, Grace Sun1, Ryan K Wong1, Jeffrey M Perlman4, Michael F Chiang5,6, Thomas C Lee7, M Elizabeth Hartnett3, Margaret M DeAngelis2,31Department of Ophthalmology, Weill Cornell Medical College, New York; 2Ocular Molecular Genetics Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts; 3University of Utah School of Medicine, Moran Eye Center, Salt Lake City, Utah; 4Department of Pediatrics, Weill Cornell Medical College, New York; Departments of 5Ophthalmology and 6Biomedical Informatics, Columbia University College of Physicians and Surgeons, New York; 7The Vision Center, Children’s Hospital Los Angeles, California, USAPurpose: To investigate the associations between assisted reproductive technology (ART and severe retinopathy of prematurity (ROP requiring treatment. Methods: Retrospective analyses of inborn preterm infants screened for severe ROP at the Weill Cornell Medical Center Neonatal Intensive Care Unit at the New York-Presbyterian Hospital by single factor logistic regression and multifactor models.Results: Of 399 ethnically diverse infants, 253 were conceived naturally and 146 by ART. Eight (3.16% patients conceived naturally, and 11 (7.53% with ART required laser treatment. In multifactor analyses, significant risks for severe ROP requiring treatment included both gestational age (odds ratio [OR] 0.34; 95% confidence interval [CI] 0.23–0.52; P< 0.001 and ART ([OR] 4.70; [CI], 1.52–4.57; P = 0.007.Conclusions: ART is associated with severe ROP requiring treatment in this cohort. This is the first report that demonstrates a statistically significant association between ART and severe ROP requiring treatment in infants in the US.Keywords: retinopathy of prematurity, low birth rate, blindness, assisted reproductive technology

Multi-Institutional Validation of an OSATS for the Assessment of Cystoscopic and Ureteroscopic Skills.

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Argun, Omer Burak; Chrouser, Kristin; Chauhan, Sanket; Monga, Manoj; Knudsen, Bodo; Box, Geoffrey N; Lee, David I; Gettman, Matthew T; Poniatowski, Lauren H; Wang, Qi; Reihsen, Troy E; Sweet, Robert M

2015-10-01

We evaluated the internal and construct validity of an assessment tool for cystoscopic and ureteroscopic cognitive and psychomotor skills at a multi-institutional level. Subjects included a total of 30 urology residents at Ohio State University, Columbus, Ohio; Penn Presbyterian Medical Center, Philadelphia, Pennsylvania; and Mayo Clinic, Rochester, Minnesota. A single external blinded reviewer evaluated cognitive and psychomotor skills associated with cystoscopic and ureteroscopic surgery using high fidelity bench models. Exercises included navigation, basketing and relocation; holmium laser lithotripsy; and cystoscope assembly. Each resident received a total cognitive score, checklist score and global psychomotor skills score. Construct validity was assessed by calculating correlations between training year and performance scores (both cognitive and psychomotor). Internal validity was confirmed by calculating correlations between test components. The median total cognitive score was 91 (IQR 86.25, 97). For psychomotor performance residents had a median total checklist score of 7 (IQR 5, 8) and a median global psychomotor skills score of 21 (IQR 18, 24.5). Construct validity was supported by the positive and statistically significant correlations between training year and total cognitive score (r = 0.66, 95% CI 0.39-0.82, p = 0.01), checklist scores (r = 0.66, 95% CI 0.35-0.84, p = 0.32) and global psychomotor skills score (r = 0.76, 95% CI 0.55-0.88, p = 0.002). The internal validity of OSATS was supported since total cognitive and checklist scores correlated with the global psychomotor skills score. In this multi-institutional study we successfully demonstrated the construct and internal validity of an objective assessment of cystoscopic and ureteroscopic cognitive and technical skills, including laser lithotripsy. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

The Biblicism of the Korean Protestant churches: Its origin and early development

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Jae-Buhm Hwang

2016-09-01

Full Text Available The purpose of this article is to clarify the origin and early stages of the Biblicism of the Korean Protestant churches in general, and of the Presbyterian Church of Korea (PCK in particular. The Biblicism is very important for Korean Protestant churches, because it is believed to be a main cause of their unusual growth on the one hand, and on the other hand, of their Fundamentalism and many schisms in the post-liberation era. The article, in the beginning part, investigates the four crucial elements of Korean Biblicism and then examines how the four elements worked together to form a resilient Biblicism whose two distinctive theological forms were practical on the one hand, and dogmatic (fundamentalist, on the other. Among the four basic Biblicist elements, the first was the firm Biblicist theology of the early North American missionaries in Korea who tried to follow and flower their original, puritanical and Old Princeton theology in Korea. The second was Korean Protestants’ original, Neo-Confucian biblicism, which facilitated them to readily accept the missionaries’ Biblicist teachings of the Bible. The third element was the so-called Nevius [Mission] Methods, which emphasised simplistic Biblicist Bible studies, and offered both opportunities of learning and ways to become meaningful leaders in their communities. The fourth and last element was the Biblicist creed of PCK, which became the fundamentalist weapon against its modernist or liberalist wing. To sum up, Korean Biblicism has been the result of those four Biblicist elements working together. The Korean Biblicism was developed into two more or less different positions; the one being practical, exemplified by Rev. Samuel A. Moffett; and the other, dogmatic and fundamentalist, represented by Rev. Dr W.D. Reynolds.

The Biblicism of the Korean Protestant churches: Its origin and early development

Directory of Open Access Journals (Sweden)

Jae-Buhm Hwang

2016-04-01

Full Text Available The purpose of this article is to clarify the origin and early stages of the Biblicism of the Korean Protestant churches in general, and of the Presbyterian Church of Korea (PCK in particular. The Biblicism is very important for Korean Protestant churches, because it is believed to be a main cause of their unusual growth on the one hand, and on the other hand, of their Fundamentalism and many schisms in the post-liberation era. The article, in the beginning part, investigates the four crucial elements of Korean Biblicism and then examines how the four elements worked together to form a resilient Biblicism whose two distinctive theological forms were practical on the one hand, and dogmatic (fundamentalist, on the other. Among the four basic Biblicist elements, the first was the firm Biblicist theology of the early North American missionaries in Korea who tried to follow and flower their original, puritanical and Old Princeton theology in Korea. The second was Korean Protestants’ original, Neo-Confucian biblicism, which facilitated them to readily accept the missionaries’ Biblicist teachings of the Bible. The third element was the so-called Nevius [Mission] Methods, which emphasised simplistic Biblicist Bible studies, and offered both opportunities of learning and ways to become meaningful leaders in their communities. The fourth and last element was the Biblicist creed of PCK, which became the fundamentalist weapon against its modernist or liberalist wing. To sum up, Korean Biblicism has been the result of those four Biblicist elements working together. The Korean Biblicism was developed into two more or less different positions; the one being practical, exemplified by Rev. Samuel A. Moffett; and the other, dogmatic and fundamentalist, represented by Rev. Dr W.D. Reynolds.

Creating a pipeline of talent for informatics: STEM initiative for high school students in computer science, biology, and biomedical informatics

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Joyeeta Dutta-Moscato

2014-01-01

Full Text Available This editorial provides insights into how informatics can attract highly trained students by involving them in science, technology, engineering, and math (STEM training at the high school level and continuing to provide mentorship and research opportunities through the formative years of their education. Our central premise is that the trajectory necessary to be expert in the emergent fields in front of them requires acceleration at an early time point. Both pathology (and biomedical informatics are new disciplines which would benefit from involvement by students at an early stage of their education. In 2009, Michael T Lotze MD, Kirsten Livesey (then a medical student, now a medical resident at University of Pittsburgh Medical Center (UPMC, Richard Hersheberger, PhD (Currently, Dean at Roswell Park, and Megan Seippel, MS (the administrator launched the University of Pittsburgh Cancer Institute (UPCI Summer Academy to bring high school students for an 8 week summer academy focused on Cancer Biology. Initially, pathology and biomedical informatics were involved only in the classroom component of the UPCI Summer Academy. In 2011, due to popular interest, an informatics track called Computer Science, Biology and Biomedical Informatics (CoSBBI was launched. CoSBBI currently acts as a feeder program for the undergraduate degree program in bioinformatics at the University of Pittsburgh, which is a joint degree offered by the Departments of Biology and Computer Science. We believe training in bioinformatics is the best foundation for students interested in future careers in pathology informatics or biomedical informatics. We describe our approach to the recruitment, training and research mentoring of high school students to create a pipeline of exceptionally well-trained applicants for both the disciplines of pathology informatics and biomedical informatics. We emphasize here how mentoring of high school students in pathology informatics and biomedical

Spotlight on crizotinib in the first-line treatment of ALK-positive advanced non-small-cell lung cancer: patients selection and perspectives

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Giroux Leprieur E

2016-06-01

Full Text Available Etienne Giroux Leprieur,1,2 Vincent Fallet,3,4 Jacques Cadranel,3,4 Marie Wislez3,4 1Respiratory Diseases and Thoracic Oncology Department, APHP-Ambroise Paré Hospital, Boulogne-Billancourt, France; 2EA4340 Laboratory, UVSQ, Paris-Saclay University, France; 3Respiratory Diseases Department, APHP – Tenon Hospital, Paris, France; 4Sorbonne University, GRC 04, UPMC Univ Paris 06, France Abstract: Around 4% of advanced non-small-cell lung cancers (NSCLCs have an ALK rearrangement at the time of diagnosis. This molecular feature is more frequent in young patients, with no/light smoking habit and with adenocarcinoma pathological subtype. Crizotinib is a tyrosine kinase inhibitor, targeting ALK, ROS1, RON, and MET. The preclinical efficacy results led to a fast-track clinical development. The US Food and Drug Administration (FDA approval was achieved after the Phase I clinical trial in 2011 in ALK-rearranged advanced NSCLC progressing after a first-line treatment. In 2013, the randomized Phase III trial PROFILE-1007 confirmed the efficacy of crizotinib in ALK-rearranged NSCLC, compared to cytotoxic chemotherapy, in second-line setting or more. In 2014, the PROFILE-1014 trial showed the superiority of crizotinib in the first-line setting compared to the pemetrexed platinum doublet chemotherapy. The response rate was 74%, and the progression-free survival was 10.9 months with crizotinib. Based on these results, crizotinib received approval from the FDA and European Medicines Agency for first-line treatment of ALK-rearranged NSCLC. The various molecular mechanisms at the time of the progression (ALK mutations or amplification, ALK-independent mechanisms encourage performing re-biopsy at the time of progression under crizotinib. The best treatment strategy at the progression (crizotinib continuation beyond progression, switch to second-generation tyrosine kinase inhibitors, or cytotoxic chemotherapy depends on the phenotype of the progression, the

Improvement in Protein Domain Identification Is Reached by Breaking Consensus, with the Agreement of Many Profiles and Domain Co-occurrence.

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Juliana Bernardes

2016-07-01

ancient domain duplications, the reconstruction of the history of protein architectures, and the estimation of protein domain age. Website and software: http://www.lcqb.upmc.fr/CLADE.

Creating a pipeline of talent for informatics: STEM initiative for high school students in computer science, biology, and biomedical informatics.

Science.gov (United States)

Dutta-Moscato, Joyeeta; Gopalakrishnan, Vanathi; Lotze, Michael T; Becich, Michael J

2014-01-01

This editorial provides insights into how informatics can attract highly trained students by involving them in science, technology, engineering, and math (STEM) training at the high school level and continuing to provide mentorship and research opportunities through the formative years of their education. Our central premise is that the trajectory necessary to be expert in the emergent fields in front of them requires acceleration at an early time point. Both pathology (and biomedical) informatics are new disciplines which would benefit from involvement by students at an early stage of their education. In 2009, Michael T Lotze MD, Kirsten Livesey (then a medical student, now a medical resident at University of Pittsburgh Medical Center (UPMC)), Richard Hersheberger, PhD (Currently, Dean at Roswell Park), and Megan Seippel, MS (the administrator) launched the University of Pittsburgh Cancer Institute (UPCI) Summer Academy to bring high school students for an 8 week summer academy focused on Cancer Biology. Initially, pathology and biomedical informatics were involved only in the classroom component of the UPCI Summer Academy. In 2011, due to popular interest, an informatics track called Computer Science, Biology and Biomedical Informatics (CoSBBI) was launched. CoSBBI currently acts as a feeder program for the undergraduate degree program in bioinformatics at the University of Pittsburgh, which is a joint degree offered by the Departments of Biology and Computer Science. We believe training in bioinformatics is the best foundation for students interested in future careers in pathology informatics or biomedical informatics. We describe our approach to the recruitment, training and research mentoring of high school students to create a pipeline of exceptionally well-trained applicants for both the disciplines of pathology informatics and biomedical informatics. We emphasize here how mentoring of high school students in pathology informatics and biomedical informatics

The brain signature of paracetamol in healthy volunteers: a double-blind randomized trial

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Pickering G

2015-07-01

Full Text Available Gisèle Pickering,1–3 Adrian Kastler,4 Nicolas Macian,1,2 Bruno Pereira,5 Romain Valabrègue,6 Stéphane Lehericy,6 Louis Boyer,4,7 Claude Dubray,1–3 Betty Jean4 1CHU Clermont-Ferrand, Centre de Pharmacologie Clinique, 2Centre d’Investigation Clinique – Inserm 1405, 3Clermont Université, Laboratoire de Pharmacologie, Faculté de médecine, 4CHU Gabriel Montpied, Clermont-Ferrand, Service d’Imagerie Ostéo-articulaire thoracique et neurologique, 5CHU Clermont-Ferrand, Délégation Recherche Clinique et à l’Innovation, Clermont-Ferrand, France; 6Institut du Cerveau et de la Moelle epiniere – ICM, Centre de NeuroImagerie de Recherche CENIR, Inserm U1127, CNRS UMR 7225, Sorbonne Universités, UPMC University Paris, Paris, France, Department of Neuroradiology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; 7UMR CNRS UdA 6284, Clemont-Ferrand, France Background: Paracetamol’s (APAP mechanism of action suggests the implication of supraspinal structures but no neuroimaging study has been performed in humans.Methods and results: This randomized, double-blind, crossover, placebo-controlled trial in 17 healthy volunteers (NCT01562704 aimed to evaluate how APAP modulates pain-evoked functional magnetic resonance imaging signals. We used behavioral measures and functional magnetic resonance imaging to investigate the response to experimental thermal stimuli with APAP or placebo administration. Region-of-interest analysis revealed that activity in response to noxious stimulation diminished with APAP compared to placebo in prefrontal cortices, insula, thalami, anterior cingulate cortex, and periaqueductal gray matter.Conclusion: These findings suggest an inhibitory effect of APAP on spinothalamic tracts leading to a decreased activation of higher structures, and a top-down influence on descending inhibition. Further binding and connectivity studies are needed to evaluate how APAP modulates pain, especially in the context of repeated

Clinical Information Systems Integration in New York City's First Mobile Stroke Unit.

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Kummer, Benjamin R; Lerario, Michael P; Navi, Babak B; Ganzman, Adam C; Ribaudo, Daniel; Mir, Saad A; Pishanidar, Sammy; Lekic, Tim; Williams, Olajide; Kamel, Hooman; Marshall, Randolph S; Hripcsak, George; Elkind, Mitchell S V; Fink, Matthew E

2018-01-01

Mobile stroke units (MSUs) reduce time to thrombolytic therapy in acute ischemic stroke. These units are widely used, but the clinical information systems underlying MSU operations are understudied. The first MSU on the East Coast of the United States was established at New York Presbyterian Hospital (NYP) in October 2016. We describe our program's 7-month pilot, focusing on the integration of our hospital's clinical information systems into our MSU to support patient care and research efforts. NYP's MSU was staffed by two paramedics, one radiology technologist, and a vascular neurologist. The unit was equipped with four laptop computers and networking infrastructure enabling all staff to access the hospital intranet and clinical applications during operating hours. A telephone-based registration procedure registered patients from the field into our admit/discharge/transfer system, which interfaced with the institutional electronic health record (EHR). We developed and implemented a computerized physician order entry set in our EHR with prefilled values to permit quick ordering of medications, imaging, and laboratory testing. We also developed and implemented a structured clinician note to facilitate care documentation and clinical data extraction. Our MSU began operating on October 3, 2016. As of April 27, 2017, the MSU transported 49 patients, of whom 16 received tissue plasminogen activator (t-PA). Zero technical problems impacting patient care were reported around registration, order entry, or intranet access. Two onboard network failures occurred, resulting in computed tomography scanner malfunctions, although no patients became ineligible for time-sensitive treatment as a result. Thirteen (26.5%) clinical notes contained at least one incomplete time field. The main technical challenges encountered during the integration of our hospital's clinical information systems into our MSU were onboard network failures and incomplete clinical documentation. Future

Clinical indicators for bacterial co-infection in Ghanaian children with P. falciparum infection.

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Maja Verena Nielsen

Full Text Available Differentiation of infectious causes in severely ill children is essential but challenging in sub- Saharan Africa. The aim of the study was to determine clinical indicators that are able to identify bacterial co-infections in P. falciparum infected children in rural Ghana. In total, 1,915 severely ill children below the age of 15 years were recruited at Agogo Presbyterian Hospital in Ghana between May 2007 and February 2011. In 771 (40% of the children malaria parasites were detected. This group was analyzed for indicators of bacterial co-infections using bivariate and multivariate regression analyses with 24 socio-economic variables, 16 terms describing medical history and anthropometrical information and 68 variables describing clinical symptoms. The variables were tested for sensitivity, specificity, positive predictive value and negative predictive value. In 46 (6.0% of the children with malaria infection, bacterial co-infection was detected. The most frequent pathogens were non-typhoid salmonellae (45.7%, followed by Streptococcus spp. (13.0%. Coughing, dehydration, splenomegaly, severe anemia and leukocytosis were positively associated with bacteremia. Domestic hygiene and exclusive breastfeeding is negatively associated with bacteremia. In cases of high parasitemia (>10,000/μl, a significant association with bacteremia was found for splenomegaly (OR 8.8; CI 1.6-48.9, dehydration (OR 18.2; CI 2.0-166.0 and coughing (OR 9.0; CI 0.7-118.6. In children with low parasitemia, associations with bacteremia were found for vomiting (OR 4.7; CI 1.4-15.8, severe anemia (OR 3.3; CI 1.0-11.1 and leukocytosis (OR 6.8 CI 1.9-24.2. Clinical signs of impaired microcirculation were negatively associated with bacteremia. Ceftriaxone achieved best coverage of isolated pathogens. The results demonstrate the limitation of clinical symptoms to determine bacterial co-infections in P. falciparum infected children. Best clinical indicators are dependent on the

Hepatitis B and C viral infections among blood donors. A retrospective study from a rural community of Ghana.

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Nkrumah, Bernard; Owusu, Michael; Averu, Paul

2011-12-12

Infection by Hepatitis B virus (HBV) and Hepatitis C virus (HCV) cause serious mortality, morbidity and financial burden and are thus a major global health problem. The study was conducted to investigate the prevalence of Hepatitis B and C infections and co-infections among blood donors in a rural community of Ghana.This was a retrospective study conducted at the Agogo Presbyterian Hospital in the Asanti Akim North District of Ghana to investigate the prevalence of these infections over a three year period among 2773 blood donors. Males constituted a larger proportion of the study population (92.2%). Majority of the study population (43.9%) were within 26-35 age group. The disease prevalence was calculated at a 95% confidence interval. The prevalence of Hepatitis B viral (HBV) infection was highest in females- 21.4% (95% CI: 11.6-34.4) in 2006 than males in the same year- 13.2% (95% CI: 10.8-15.9). Hepatitis C viral (HCV) infection was highest among males- 11.6% (95% CI: 9.5-13.8) in 2007. HBV and HCV co-infection was higher in males- 2.6% (95% CI: 1.6-3.8) than females- 1.3% (95% CI: 0-7.0) in 2007. The overall prevalence of HBV and HCV was 13.8% (95% CI: 11.4- 16.4) and 9.4% (95% CI: 7.4-11.6) respectively in 2006. The rate of co-infection of HBV and HCV however increased from 1.6% (95% CI: 0.8-2.7) in 2006 to 2.2% (95% CI: 1.3-3.2) in 2008 in males and from 0% (95% CI: 0-6.4) in 2006 to 1.2% (95% CI: 0-6.5) in 2008 in females. The single infections of HBV and HCV reduced but co-infection of these transfusion transmitted infections increased. Measures such as more sensitive techniques for effective diagnosis and sanitary education to enlighten the population must be implemented.

Perceptions of Burnout, Its Prevention, and Its Effect on Patient Care as Described by Oncology Nurses in the Hospital Setting
.

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Russell, Kimberly

2016-01-01

To identify overall perceptions of burnout within the inpatient oncology nursing population, how they perceived that burnout affected the care they provided, and how they perceived that burnout could be decreased.
. A quantitative descriptive study using questionnaires to describe perceptions of burnout.
. A university-affiliated hospital using inpatient oncology nurses from three nursing units at University of Pittsburgh Medical Center Presbyterian in Pennsylvania.
. A convenience sample of 61 nurses. 
. Two instruments were used to investigate various aspects about perceptions of burnout among inpatient oncology nurses. Nurses participated on an anonymous voluntary basis by completing these instruments. 
. Perceived burnout, perception of how burnout affects care provided to patients, and strategies to relieve burnout.
. Inpatient oncology nurses report a moderate level of perceived burnout. In addition, this nursing population perceived that this burnout had a negative impact on the care they provided. Nurses believed they experienced burnout because of increased nurse-patient ratios and skipped or shortened lunches or breaks. However, they perceived that burnout could be prevented when adequate resources, collaboration, teamwork, and the support of family and friends existed. 
. As a result of the level of care needed by inpatients with cancer, the association between burnout experienced by nurses and how it can affect care is important to recognize. One such association identified was that a relationship existed between the nurses' interactions with patients' family, friends, or visitors and increased perceptions of burnout and depersonalization. As a result, nurses can experience increased burnout and act in a manner that lacks compassion because of emotional detachment.
. With extremely ill inpatients with cancer, nurses need to be able to manage high levels of demands from patients and their family members to provide quality and

Low prevalence of Pneumocystis pneumonia in hospitalized patients with systemic lupus erythematosus: review of a clinical data warehouse.

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Kapoor, T M; Mahadeshwar, P; Nguyen, S; Li, J; Kapoor, S; Bathon, J; Giles, J; Askanase, A

2017-12-01

Objective In the era of powerful immunosuppression, opportunistic infections are an increasing concern in systemic lupus erythematosus. One of the best-studied opportunistic infections is Pneumocystis pneumonia; however, the prevalence of Pneumocystis pneumonia in systemic lupus erythematosus is not clearly defined. This study evaluates the prevalence of Pneumocystis pneumonia in hospitalized systemic lupus erythematosus patients, with a focus on validating the Pneumocystis pneumonia and systemic lupus erythematosus diagnoses with clinical information. Methods This retrospective cohort study evaluates the prevalence of Pneumocystis pneumonia in all systemic lupus erythematosus patients treated at Columbia University Medical Center-New York Presbyterian Hospital between January 2000 and September 2014, using electronic medical record data. Patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and patients with renal transplants (including both early and late post-transplant patients) represented immunocompromised control groups. Patients with systemic lupus erythematosus, Pneumocystis pneumonia, HIV/AIDS, or renal transplant were identified using diagnostic codes from the International Classification of Diseases, Ninth Revision (ICD-9). Results Out of 2013 hospitalized systemic lupus erythematosus patients, nine had presumed Pneumocystis pneumonia, yielding a low prevalence of Pneumocystis pneumonia in systemic lupus erythematosus of 0.45%. Three of the nine Pneumocystis pneumonia cases were patients with concomitant systemic lupus erythematosus and HIV/AIDS. Only one of these nine cases was histologically confirmed as Pneumocystis pneumonia, in a patient with concomitant systemic lupus erythematosus and HIV/AIDS and a CD4 count of 13 cells/mm 3 . The prevalence of Pneumocystis pneumonia in renal transplant patients and HIV/AIDS patients was 0.61% and 5.98%, respectively. Conclusion Given the reported high rate of adverse effects

The Apgar score has survived the test of time.

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Finster, Mieczyslaw; Wood, Margaret

2005-04-01

In 1953, Virginia Apgar, M.D. published her proposal for a new method of evaluation of the newborn infant. The avowed purpose of this paper was to establish a simple and clear classification of newborn infants which can be used to compare the results of obstetric practices, types of maternal pain relief and the results of resuscitation. Having considered several objective signs pertaining to the condition of the infant at birth she selected five that could be evaluated and taught to the delivery room personnel without difficulty. These signs were heart rate, respiratory effort, reflex irritability, muscle tone and color. Sixty seconds after the complete birth of the baby a rating of zero, one or two was given to each sign, depending on whether it was absent or present. Virginia Apgar reviewed anesthesia records of 1025 infants born alive at Columbia Presbyterian Medical Center during the period of this report. All had been rated by her method. Infants in poor condition scored 0-2, infants in fair condition scored 3-7, while scores 8-10 were achieved by infants in good condition. The most favorable score 1 min after birth was obtained by infants delivered vaginally with the occiput the presenting part (average 8.4). Newborns delivered by version and breech extraction had the lowest score (average 6.3). Infants delivered by cesarean section were more vigorous (average score 8.0) when spinal was the method of anesthesia versus an average score of 5.0 when general anesthesia was used. Correlating the 60 s score with neonatal mortality, Virginia found that mature infants receiving 0, 1 or 2 scores had a neonatal death rate of 14%; those scoring 3, 4, 5, 6 or 7 had a death rate of 1.1%; and those in the 8-10 score group had a death rate of 0.13%. She concluded that the prognosis of an infant is excellent if he receives one of the upper three scores, and poor if one of the lowest three scores.

Pars plana vitrectomy compared with pars plana vitrectomy combined with scleral buckle in the primary management of noncomplex rhegmatogenous retinal detachment.

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Orlin, Anton; Hewing, Nina J; Nissen, Michael; Lee, Sangwoo; Kiss, Szilard; DʼAmico, Donald J; Chan, R V Paul

2014-06-01

To compare pars plana vitrectomy (PPV) with PPV combined with scleral buckle (PPV/SB) in the treatment of primary, noncomplex rhegmatogenous retinal detachment in an academic setting. Retrospective review of 74 consecutive cases that underwent either PPV or PPV/SB for primary rhegmatogenous retinal detachment at New York Presbyterian Hospital, Weill Cornell Medical College. Fifty-two eyes underwent PPV alone while 22 eyes had PPV combined with SB. All eyes had a minimum of 2 months of follow-up. The main outcome measure was single surgery anatomical success. Patients in the PPV/SB group were less likely to be phakic (P = 0.05) and more likely to have an inferior retinal break (P = 0.001) when compared with the PPV group. Between groups, there was no difference in eyes with peripheral retinal lattice degeneration (P = 0.929), multiple breaks (P = 0.801), breaks seen preoperatively (P = 0.095), or those presenting with the macula off retinal detachment (P = 0.548). The majority of patients in both groups underwent small-gauge surgery (23 G or 25 G) (P = 0.65). Attachment of the retina was obtained in 100% of the patients in both groups at most recent follow-up. Single surgery anatomical success was similar between groups (83% PPV vs. 86% PPV/SB; P = 0.695). Mean best-corrected Snellen visual acuity improved in both groups (P = 0.75), with a final best-corrected Snellen visual acuity of 0.418 logMAR in the PPV group and 0.479 logMAR in the PPV/SB group (P = 0.61). When comparing PPV with PPV/SB, no difference in single surgery anatomical success existed after evaluating eyes with inferior breaks (P = 0.68), pseudophakia (P = 0.75), or when small-gauge surgery was performed (P = 0.76). We did not find significant differences in single surgery anatomical success, final anatomical success, or change in visual acuity when comparing PPV with PPV/SB in the repair of primary noncomplex rhegmatogenous retinal detachment in an academic setting where vitreoretinal fellows

A missiological exploration of Australian missionary James Noble Mackenzie�s ministry to lepers in South Korea

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Sang Pil Son

2017-01-01

Full Text Available The history of Australian Presbyterian Mission in Korea (APM is not comprehensive, nor the study of missiology that addresses the marginalised. This study of the ministry of APM missionary, J.N. Mackenzie, to lepers in Japanese-occupied Korea, adds significantly to both these areas. An understanding of the role and methods of Mackenzie�s missionary activities among the marginalised in Korea can encourage today�s Church to effectively restore the marginalised in society, moving from Church doctrine to practical reproduction of the example of Jesus recorded in Mark�s gospel. Using original and published sources, the study examines the social conditions in which Mackenzie found Korean lepers, their historic treatment and government policies and the growth of his holistic mission, with its methods and fruits. Mackenzie�s work is documented with recorded data included to demonstrate its Christ-like effectiveness both spiritually and physically. By tracing Mackenzie�s work with lepers, it is clear that holistic mission can helpfully impact the situation of the most marginalised. Mackenzie�s work expanded dramatically, churches were formed and it even created cured evangelists, making it a useful model for mission work among the marginalised. Mackenzie�s work played a significant part in the Church and National history of Korea and presented a new path in the mission work of APM. It has the potential to influence modern mission in being �as Christ� to the marginalised and thus to impact the society. This study has given a unique perspective on the history and theology of mission to the poor and traditionally powerless in society.Intradisciplinary and/or interdisciplinary implications: Traditional views of history, theology and missiology have focussed on the ruling classes and urban societies. A perspective of the marginalised encourages a shift in these as it can be seen that the rural poor responded to holistic ministry and affected

Incidence and characteristics of bacteremia among children in rural Ghana.

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Maja Verena Nielsen

Full Text Available The objective of the study was to describe systemic bacterial infections occurring in acutely ill and hospitalized children in a rural region in Ghana, regarding frequency, incidence, antimicrobial susceptibility patterns and associations with anthropometrical data.Blood cultures were performed in all children below the age of five years, who were admitted to Agogo Presbyterian Hospital (APH, Asante Region, Ghana, between September 2007 and July 2009. Medical history and anthropometrical data were assessed using a standardized questionnaire at admission. Incidences were calculated after considering the coverage population adjusted for village-dependent health-seeking behavior.Among 1,196 hospitalized children, 19.9% (n = 238 were blood culture positive. The four most frequent isolated pathogens were nontyphoidal salmonellae (NTS (53.3%; n = 129, Staphylococcus aureus (13.2%; n = 32, Streptococcus pneumoniae (9.1%; n = 22 and Salmonella ser. Typhi (7.0%; n = 17. Yearly cumulative incidence of bacteremia was 46.6 cases/1,000 (CI 40.9-52.2. Yearly cumulative incidences per 1,000 of the four most frequent isolates were 25.2 (CI 21.1-29.4 for NTS, 6.3 (CI 4.1-8.4 for S. aureus, 4.3 (CI 2.5-6.1 for S. pneumoniae and 3.3 (CI 1.8-4.9 for Salmonella ser. Typhi. Wasting was positively associated with bacteremia and systemic NTS bloodstream infection. Children older than three months had more often NTS bacteremia than younger children. Ninety-eight percent of NTS and 100% of Salmonella ser. Typhi isolates were susceptible to ciprofloxacin, whereas both tested 100% susceptible to ceftriaxone. Seventy-seven percent of NTS and 65% of Salmonella ser. Typhi isolates were multi-drug resistant (MDR. Systemic bacterial infections in nearly 20% of hospitalized children underline the need for microbiological diagnostics, to guide targeted antimicrobial treatment and prevention of bacteremia. If microbiological diagnostics are lacking, calculated antimicrobial

3D Cloud Tomography, Followed by Mean Optical and Microphysical Properties, with Multi-Angle/Multi-Pixel Data

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Davis, A. B.; von Allmen, P. A.; Marshak, A.; Bal, G.

2010-12-01

-type model is used where the cloud surface "emits" either reflected (sunny-side) or transmitted (shady-side) light at different levels. As it turns out, the reflected/transmitted light ratio yields an approximate cloud optical thickness. Another approach is to invoke tomography techniques to define the volume occupied by the cloud using, as it were, cloud masks for each direction of observation. In the shape and opacity refinement phase, initial guesses along with solar and viewing geometry information are used to predict radiance in each pixel using a fast diffusion model for the 3D RT in MISR's non-absorbing red channel (275 m resolution). Refinement is constrained and stopped when optimal resolution is reached. Finally, multi-pixel/mono-angle MODIS data for the same cloud (at comparable 250 m resolution) reveals the desired droplet size information, hence the volume-averaged LWC. This is an ambitious remote sensing science project drawing on cross-disciplinary expertise gained in medical imaging using both X-ray and near-IR sources and detectors. It is high risk but with potentially high returns not only for the cloud modeling community but also aerosol and surface characterization in the presence of broken 3D clouds.

Iron nanoparticles increase 7-ketocholesterol-induced cell death, inflammation, and oxidation on murine cardiac HL1-NB cells

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Edmond Kahn

2010-03-01

Full Text Available Edmond Kahn1, Mauhamad Baarine2, Sophie Pelloux3, Jean-Marc Riedinger4, Frédérique Frouin1, Yves Tourneur3, Gérard Lizard21INSE RM U678/UMR – S UPMC, IFR 14, CH U Pitié-Salpêtrière, 75634 Paris Cedex 13, France; 2Centre de Recherche INSE RM U866, Equipe Biochimie Métabolique et Nutritionnelle – Université de Bourgogne, Faculté des Sciences Gabriel, 6 Bd Gabriel, 21000 Dijon, France; 3Centre Commun de Quantimétrie, Université Lyon 1; Université de Lyon, Lyon, France; 4Département de Biologie et de Pathologie des Tumeurs, Centre Georges François-Leclerc, 21000 Dijon, FranceObjective: To evaluate the cytotoxicity of iron nanoparticles on cardiac cells and to determine whether they can modulate the biological activity of 7-ketocholesterol (7KC involved in the development of cardiovascular diseases. Nanoparticles of iron labeled with Texas Red are introduced in cultures of nonbeating mouse cardiac cells (HL1-NB with or without 7-ketocholesterol 7KC, and their ability to induce cell death, pro-inflammatory and oxidative effects are analyzed simultaneously.Study design: Flow cytometry (FCM, confocal laser scanning microscopy (CLSM, and subsequent factor analysis image processing (FAMIS are used to characterize the action of iron nanoparticles and to define their cytotoxicity which is evaluated by enhanced permeability to SYTOX Green, and release of lactate deshydrogenase (LDH. Pro-inflammatory effects are estimated by ELISA in order to quantify IL-8 and MCP-1 secretions. Pro-oxidative effects are measured with hydroethydine (HE.Results: Iron Texas Red nanoparticles accumulate at the cytoplasmic membrane level. They induce a slight LDH release, and have no inflammatory or oxidative effects. However, they enhance the cytotoxic, pro-inflammatory and oxidative effects of 7KC. The accumulation dynamics of SYTOX Green in cells is measured by CLSM to characterize the toxicity of nanoparticles. The emission spectra of SYTOX Green and

Klebsiella pneumoniae necrotizing fasciitis of the leg in an elderly French woman

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Monié M

2014-07-01

Full Text Available Marguerite Monié,1 Laurence Drieux,2–4 Bernadette Nzili,1 Michèle Dicko,5 Catherine Goursot,1 Sandrine Greffard,6 Dominique Decré,3,4,7 Anthony Mézière1 1Assistance Publique-Hôpitaux de Paris (AP-HP, GHU Pitié Salpêtrière-Charles Foix, site Charles Foix, Service de Soins de Suite et Réadaptation orthogériatrique et polyvalent, Fondation d’Heur et Chemin Delatour, Ivry s/Seine, 2Assistance Publique-Hôpitaux de Paris, Hôpital Charles-Foix, Bactériologie-Hygiène, Paris, 3Sorbonne Universités, UPMC Univ Paris 06, CR7, Centre d’Immunologie et des Maladies Infectieuses, CIMI, team E13 (Bacteriology, Paris, 4INSERM, U1135, Centre d’Immunologie et des Maladies Infectieuses, CIMI, team E13 (Bacteriology, Paris, 5AP-HP, GHU Henri Mondor, Département de Médecine Interne et Gériatrie, Créteil, 6AP-HP, GHU Pitié Salpêtrière-Charles Foix, site Pitié Salpêtrière, Service de Médecine Gériatrique, Paris, 7AP-HP, Hôpital Saint-Antoine, Bactériologie-Hygiène, Paris, France Abstract: Klebsiella pneumoniae necrotizing fasciitis is a rare infection in regions outside of Asia. Here, we present a case of necrotizing fasciitis of the leg caused by K. pneumoniae in a 92-year-old French woman hospitalized in a geriatric rehabilitation unit. The patient initially presented with dermohypodermitis of the leg that developed from a dirty wound following a fall. A few hours later, this painful injury extended to the entire lower limb, with purplish discoloration of the skin, bullae, and necrosis. Septic shock rapidly appeared and the patient died 9 hours after the onset of symptoms. The patient was Caucasian, with no history of travel to Asia or any underlying disease. Computed tomography revealed no infectious metastatic loci. Blood cultures showed growth of capsular serotype K2 K. pneumoniae strains with virulence factors RmpA, yersiniabactin and aerobactin. This rare and fatal case of necrotizing fasciitis caused by a virulent strain

Virtual socialization in adults with spina bifida.

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Chan, Wendy M; Dicianno, Brad E

2011-03-01

To use spina bifida (SB) as a model of chronic physical disability to study the associations of virtual socialization, friendships, and quality of life (QOL) in adults. Cross-sectional survey. Subjects were recruited from residential living facilities, outpatient clinics, and the University of Pittsburgh Medical Center (UPMC) research registry. Inclusion criteria were age between 18 and 80 years and clinical diagnoses of SB cystica (myelomeningocele) and hydrocephalus. The exclusion criterion was the diagnosis of SB occulta. Sixty-three eligible adults were enrolled, and all completed the study. The survey via questionnaire was performed in person or over the telephone. Data collected included the World Health Organization's Medical Outcomes Study 26-item Short Form, Economic Self-Sufficiency from the Craig Handicap Assessment and Reporting Technique Short Form, virtual socializing habits, and number of friends. Three linear regression models were performed, each with a unique dependent variable: number of friends, psychological QOL, or social QOL. The following independent variables were included in all models: age, gender, ethnicity, economic self-sufficiency, marital status, education level, lesion level, health status, user group, collection method, and time spent virtually socializing. In addition, each regression model included the dependent variables from the other 2 models in its independent variables. Increased degree of virtual socialization (VS) was associated with a greater number of friends (P = .003, r = .684). Mean (standard deviation) numbers of friends by VS groups were the following: users, n = 4.9 ± 2.7; semi-users, n = 3.8 ± 2.7; and nonusers, n = 2.1 ± 2.3, which represent a 2.3 times greater number of friends between the users and nonusers. The effect of virtual socialization on QOL was also positive, however, not statistically significant. People with chronic physical disabilities, such as SB, are at high risk for peer rejection and long

Serum cytokine levels related to exposure to volatile organic compounds and PM2.5 in dwellings and workplaces in French farmers – a mechanism to explain nonsmoking COPD

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Audi C

2017-05-01

Full Text Available Christelle Audi,1,* Nour Baïz,1,* Cara N Maesano,1 Ollivier Ramousse,2 Damien Reboulleau,3 Antoine Magnan,3 Denis Caillaud,4 Isabella Annesi-Maesano1 1Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, UMRS 1136, Epidemiology of Allergic and Respiratory Diseases Department, Medical School Saint-Antoine, Paris, 2Mutualité Sociale Agricole, Clermont-Ferrand, Auvergne, 3Centre du Thorax de Nantes INSERM, UMR1087, Institut du thorax, Nantes, 4Respiratory Diseases Department, CHU Clermont-Ferrand, Clermont-Ferrand, Auvergne, France *These authors contributed equally to this work Abstract: Although French farmers smoke less on average than individuals from the general population, they suffer more from COPD. Exposure to biological and chemical air pollutants in the farm may be the cause of these higher COPD rates. This study investigates the role of biocontaminants, including the relationship of exposure to volatile organic compounds (VOCs and fine particulate matter (of diameter of 2.5 µm [PM2.5] objectively measured in the farm settings (dwellings and workplaces to serum cytokines involved in COPD, in a sample of 72 farmers from 50 farms in the Auvergne region, France. Mean concentrations of VOCs were highest inside the home, while levels of PM2.5 were highest in workplaces (stables and granaries. After adjusting for confounders, high exposure to PM2.5 was significantly associated with a decreased level of serum cytokines (among others, IL13: β: –0.94, CI: –1.5 to –0.2, P-value =0.004; IL8: β: –0.82, CI: –1.4 to –0.2, P-value =0.005 and high exposure to VOCs according to a VOC global score with a decreased IL13 level (β: –0.5, CI: –0.9 to –0.1, P-value =0.01. Moreover, respiratory symptoms and diseases, including COPD, were associated with a decreased level of serum cytokines significantly in the case of IL5. An alteration of immune response balance in terms of

Spectral-domain optical coherence tomography staging and autofluorescence imaging in achromatopsia.

Science.gov (United States)

Greenberg, Jonathan P; Sherman, Jerome; Zweifel, Sandrine A; Chen, Royce W S; Duncker, Tobias; Kohl, Susanne; Baumann, Britta; Wissinger, Bernd; Yannuzzi, Lawrence A; Tsang, Stephen H

2014-04-01

IMPORTANCE Evidence is mounting that achromatopsia is a progressive retinal degeneration, and treatments for this condition are on the horizon. OBJECTIVES To categorize achromatopsia into clinically identifiable stages using spectral-domain optical coherence tomography and to describe fundus autofluorescence imaging in this condition. DESIGN, SETTING, AND PARTICIPANTS A prospective observational study was performed between 2010 and 2012 at the Edward S. Harkness Eye Institute, New York-Presbyterian Hospital. Participants included 17 patients (aged 10-62 years) with full-field electroretinography-confirmed achromatopsia. MAIN OUTCOMES AND MEASURES Spectral-domain optical coherence tomography features and staging system, fundus autofluorescence and near-infrared reflectance features and their correlation to optical coherence tomography, and genetic mutations served as the outcomes and measures. RESULTS Achromatopsia was categorized into 5 stages on spectral-domain optical coherence tomography: stage 1 (2 patients [12%]), intact outer retina; stage 2 (2 patients [12%]), inner segment ellipsoid line disruption; stage 3 (5 patients [29%]), presence of an optically empty space; stage 4 (5 patients [29%]), optically empty space with partial retinal pigment epithelium disruption; and stage 5 (3 patients [18%]), complete retinal pigment epithelium disruption and/or loss of the outer nuclear layer. Stage 1 patients showed isolated hyperreflectivity of the external limiting membrane in the fovea, and the external limiting membrane was hyperreflective above each optically empty space. On near infrared reflectance imaging, the fovea was normal, hyporeflective, or showed both hyporeflective and hyperreflective features. All patients demonstrated autofluorescence abnormalities in the fovea and/or parafovea: 9 participants (53%) had reduced or absent autofluorescence surrounded by increased autofluorescence, 4 individuals (24%) showed only reduced or absent autofluorescence, 3

Granulocyte Colony-Stimulating Factor Use after Autologous Peripheral Blood Stem Cell Transplantation: Comparison of Two Practices.

Science.gov (United States)

Singh, Amrita D; Parmar, Sapna; Patel, Khilna; Shah, Shreya; Shore, Tsiporah; Gergis, Usama; Mayer, Sebastian; Phillips, Adrienne; Hsu, Jing-Mei; Niesvizky, Ruben; Mark, Tomer M; Pearse, Roger; Rossi, Adriana; van Besien, Koen

2018-02-01

Administration of granulocyte colony-stimulating factor (G-CSF) after autologous peripheral blood stem cell transplantation (PBSCT) is generally recommended to reduce the duration of severe neutropenia; however, data regarding the optimal timing of G-CSFs post-transplantation are limited and conflicting. This retrospective study was performed at NewYork-Presbyterian/Weill Cornell Medical Center between November 5, 2013, and August 9, 2016, of adult inpatient autologous PBSCT recipients who received G-CSF empirically starting on day +5 (early) versus on those who received G-CSF on day +12 only if absolute neutrophil count (ANC) was ANC-driven). G-CSF was dosed at 300 µg in patients weighing ANC-driven (n = 50) G-CSF regimen. Patient and transplantation characteristics were comparable in the 2 groups. In the ANC-driven group, 24% (n = 12) received G-CSF on day +12 and 60% (n = 30) started G-CSF earlier due to febrile neutropenia or at the physician's discretion, 6% (n = 3) started after day +12 at the physician's discretion, and 10% (n = 5) did not receive any G-CSF. The median start day of G-CSF therapy was day +10 in the ANC-driven group versus day +5 in the early group (P ANC-driven group (P = .07). There were no significant between-group differences in time to platelet engraftment, 1-year relapse rate, or 1-year overall survival. The incidence of febrile neutropenia was 74% in the early group versus 90% in the ANC-driven group (P = .04); however, there was no significant between-group difference in the incidence of positive bacterial cultures or transfer to the intensive care unit. The duration of G-CSF administration until neutrophil engraftment was 6 days in the early group versus 3 days in the ANC-driven group (P ANC-driven group (P = .28). Our data show that early initiation of G-CSF (on day +5) and ANC-driven initiation of G-CSF following autologous PBSCT were associated with a similar time to neutrophil engraftment

Real-time functional magnetic resonance imaging in obsessive-compulsive disorder

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Gonçalves ÓF

2017-07-01

Full Text Available Óscar F Gonçalves,1–3 Marcelo C Batistuzzo,4 João R Sato5 1Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal; 2Spaulding Neuromodulation Center, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 3Social and Cognitive Neuroscience Laboratory, Center for Health and Biological Sciences, Mackenzie Presbyterian University, 4Department and Institute of Psychiatry, University of São Paulo Medical School (FMUSP, 5Mathematics, Computing, and Cognition Center, Universidade Federal do ABC – UFABC, São Paulo, Brazil Abstract: The current literature provides substantial evidence of brain alterations associated with obsessive-compulsive disorder (OCD symptoms (eg, checking, cleaning/decontamination, counting compulsions; harm or sexual, symmetry/exactness obsessions, and emotional problems (eg, defensive/appetitive emotional imbalance, disgust, guilt, shame, and fear learning/extinction and cognitive impairments associated with this disorder (eg, inhibitory control, working memory, cognitive flexibility. Building on this evidence, new clinical trials can now target specific brain regions/networks. Real-time functional magnetic resonance imaging (rtfMRI was introduced as a new therapeutic tool for the self-regulation of brain–mind. In this review, we describe initial trials testing the use of rtfMRI to target brain regions associated with specific OCD symptoms (eg, contamination, and other mind–brain processes (eg, cognitive – working memory, inhibitory control, emotional – defensive, appetitive systems, fear reduction through counter-conditioning found impaired in OCD patients. While this is a novel topic of research, initial evidence shows the promise of using rtfMRI in training the self-regulation of brain regions and mental processes associated with OCD. Additionally, studies with

Gastrointestinal events and association with initiation of treatment for osteoporosis

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Modi A

2015-11-01

Full Text Available Ankita Modi,1 Ethel S Siris,2 Jackson Tang,3 Shiva Sajjan,1 Shuvayu S Sen1 1Center for Observational and Real-World Evidence, Merck & Co., Inc, Kenilworth, NJ, 2Toni Stabile Osteoporosis Center, Columbia University Medical Center, NY Presbyterian Hospital, New York, NY, 3Asclepius Analytics Ltd, Brooklyn, NY, USA Background: Preexisting gastrointestinal (GI events may deter the use of pharmacologic treatment in patients diagnosed with osteoporosis (OP. The objective of this study was to examine the association between preexisting GI events and OP pharmacotherapy initiation among women diagnosed with OP. Methods: The study utilized claims data from a large US managed care database to identify women aged ≥55 years with a diagnosis code for OP (index date during 2002–2009. Patients with a claim for pharmacologic OP treatment in the 12-month pre-index period (baseline were excluded. OP treatment initiation in the post-index period was defined as a claim for bisphosphonates (alendronate, ibandronate, risedronate, zoledronic acid, calcitonin, raloxifene, or teriparatide. During the post-index period (up to 12 months, GI events were identified before treatment initiation. A time-dependent Cox regression model was used to investigate the likelihood of initiating any OP treatment. Among patients initiating OP treatment, a discrete choice model was utilized to assess the relationship between post-index GI events and likelihood of initiating with a bisphosphonate versus a non-bisphosphonate. Results: In total, 65,344 patients (mean age 66 years were included; 23.7% had a GI event post diagnosis and before treatment initiation. Post-index GI events were associated with a 75% lower likelihood of any treatment initiation (hazard ratio 0.25; 95% confidence interval 0.24–0.26. Among treated patients (n=23,311, those with post-index GI events were 39% less likely to receive a bisphosphonate versus a non-bisphosphonate (odds ratio 0.61; 95% confidence

Comparative evaluation of two rapid field tests for malaria diagnosis: Partec Rapid Malaria Test® and Binax Now® Malaria Rapid Diagnostic Test.

Science.gov (United States)

Nkrumah, Bernard; Acquah, Samuel Ek; Ibrahim, Lukeman; May, Juergen; Brattig, Norbert; Tannich, Egbert; Nguah, Samuel Blay; Adu-Sarkodie, Yaw; Huenger, Frank

2011-05-23

About 90% of all malaria deaths in sub-Saharan Africa occur in children under five years. Fast and reliable diagnosis of malaria requires confirmation of the presence of malaria parasites in the blood of patients with fever or history suggestive of malaria; hence a prompt and accurate diagnosis of malaria is the key to effective disease management. Confirmation of malaria infection requires the availability of a rapid, sensitive, and specific testing at an affordable cost. We compared two recent methods (the novel Partec Rapid Malaria Test® (PT) and the Binax Now® Malaria Rapid Diagnostic Test (BN RDT) with the conventional Giemsa stain microscopy (GM) for the diagnosis of malaria among children in a clinical laboratory of a hospital in a rural endemic area of Ghana. Blood samples were collected from 263 children admitted with fever or a history of fever to the pediatric clinic of the Agogo Presbyterian Hospital. The three different test methods PT, BN RDT and GM were performed independently by well trained and competent laboratory staff to assess the presence of malaria parasites. Results were analyzed and compared using GM as the reference standard. In 107 (40.7%) of 263 study participants, Plasmodium sp. was detected by GM. PT and BN RDT showed positive results in 111 (42.2%) and 114 (43.4%), respectively. Compared to GM reference standard, the sensitivities of the PT and BN RDT were 100% (95% CI: 96.6-100) and 97.2% (95% CI: 92.0-99.4), respectively, specificities were 97.4% (95% CI: 93.6-99.3) and 93.6% (95% CI: 88.5-96.9), respectively. There was a strong agreement (kappa) between the applied test methods (GM vs PT: 0.97; p < 0.001 and GM vs BN RDT: 0.90; p < 0.001). The average turnaround time per tests was 17 minutes. In this study two rapid malaria tests, PT and BN RDT, demonstrated a good quality of their performance compared to conventional GM. Both methods require little training, have short turnaround times, are applicable as well as affordable and

Examination of the suitability of an implementation of the Jette localized heterogeneities fluence term L(1)(x,y,z) in an electron beam treatment planning algorithm

Science.gov (United States)

Rodebaugh, Raymond Francis, Jr.

2000-11-01

In this project we applied modifications of the Fermi- Eyges multiple scattering theory to attempt to achieve the goals of a fast, accurate electron dose calculation algorithm. The dose was first calculated for an ``average configuration'' based on the patient's anatomy using a modification of the Hogstrom algorithm. It was split into a measured central axis depth dose component based on the material between the source and the dose calculation point, and an off-axis component based on the physics of multiple coulomb scattering for the average configuration. The former provided the general depth dose characteristics along the beam fan lines, while the latter provided the effects of collimation. The Gaussian localized heterogeneities theory of Jette provided the lateral redistribution of the electron fluence by heterogeneities. Here we terminated Jette's infinite series of fluence redistribution terms after the second term. Experimental comparison data were collected for 1 cm thick x 1 cm diameter air and aluminum pillboxes using the Varian 2100C linear accelerator at Rush-Presbyterian- St. Luke's Medical Center. For an air pillbox, the algorithm results were in reasonable agreement with measured data at both 9 and 20 MeV. For the Aluminum pill box, there were significant discrepancies between the results of this algorithm and experiment. This was particularly apparent for the 9 MeV beam. Of course a one cm thick Aluminum heterogeneity is unlikely to be encountered in a clinical situation; the thickness, linear stopping power, and linear scattering power of Aluminum are all well above what would normally be encountered. We found that the algorithm is highly sensitive to the choice of the average configuration. This is an indication that the series of fluence redistribution terms does not converge fast enough to terminate after the second term. It also makes it difficult to apply the algorithm to cases where there are no a priori means of choosing the best average

GHG monitoring over Paris megacity and Orléans forest

Science.gov (United States)

Te, Y. V.; Jeseck, P.; Zanon, T.; Boursier, C.; Janssen, C.; Deutscher, N. M.; Warneke, T.; Notholt, J.; Lac, C.; Dieudonné, E.; Lopez, M.; Schmidt, M.; Xueref-remy, I. C.

2012-12-01

In a growing world with more than 7 billion inhabitants and big emerging countries such as China, Brazil and India, emissions of anthropogenic pollutants and greenhouse gases (GHGs) are increasing continuously. Their monitoring and control in megacities have become a major challenge for scientists and public health authorities in environmental research area. The ground-based Fourier transform spectrometer (QualAir FTS[a], model IFS 125HR) of the QualAir platform located in downtown Paris at University Pierre et Marie Curie (UPMC), is a scientific research instrument dedicated to the survey of greenhouse gases (GHGs) and urban air quality. Equipped with a sun-tracker, the remote sensing QualAir FTS relies on solar infrared absorption for monitoring trace gas concentrations and their variability in the Ile-de-France region[b]. Concentrations of atmospheric GHGs, especially CO2, CH4 and N2O, are retrieved by the radiative transfer model PROFFIT[c]. Because Paris is the third largest European megacity, the QualAir FTS can provide new and complementary measurements as compared to existing ground-based FTS network stations (NDACC and TCCON) located in unpolluted environments, such as the TCCON-Orléans station[d] situated in the forest of Orléans (100 km south of Paris). In the effort to integrate QualAir FTS into the TCCON network, simultaneous FTS measurements of GHGs at Paris and Orléans have been performed. We will emphasize on comparisons of CO2 from these two sites. Our comparison will be completed by high-resolved direct CO2 modeling outputs from the Meso-NH model, and ground in situ measurements at different sites (Orléans/Trainou, Paris/Jussieu, Paris/Eiffel Tower). Parts of the data were acquired in the framework of the French CO2-MEGAPARIS project[e, f], whose main goal is to quantify CO2 emissions from the Paris area. The present data intercomparison will help to reduce uncertainties in carbon cycle models and to better characterize regional GHG fluxes

Paleoclimate records at high latitude in Arctic during the Paleogene

Science.gov (United States)

Salpin, Marie; Schnyder, Johann; Baudin, François; Suan, Guillaume; Labrousse, Loïc; Popescu, Speranta; Suc, Jean-Pierre

2015-04-01

Paleoclimate records at high latitude in Arctic during the Paleogene SALPIN Marie1,2, SCHNYDER Johann1,2, BAUDIN François1,2, SUAN Guillaume3, LABROUSSE Loïc1,2, POPESCU Speranta4, SUC Jean-Pierre1,4 1: Sorbonne Universités, UPMC Univ Paris 06, UMR 7193, Institut des Sciences de la Terre Paris (iSTeP), F 75005, Paris, France 2: CNRS, UMR 7193, Institut des Sciences de la Terre Paris (iSTeP), F 75005 Paris, France 3: UCB Lyon 1, UMR 5276, LGLTPE, 69622 Villeurbanne Cedex, France 4: GEOBIOSTRATDATA.CONSULTING, 385 Route du Mas Rillier 69140 Rillieux la Pape, France The Paleogene is a period of important variations of the Earth climate system either in warming or cooling. The climatic optima of the Paleogene have been recognized both in continental and marine environment. This study focus on high latitudes of the northern hemisphere, in the Arctic Basin. The basin has had an influence on the Cenozoic global climate change according to its polar position. Is there a specific behaviour of the Arctic Basin with respect to global climatic stimuli? Are there possible mechanisms of coupling/decoupling of its dynamics with respect to the global ocean? To answer these questions a unique collection of sedimentary series of Paleogene age interval has been assembled from the Laurentian margin in Northern Yukon (Canada) and from the Siberian margin (New Siberian Islands). Selected continental successions of Paleocene-Eocene age were used to study the response of the Arctic system to known global events, e.g. the climatic optima of the Paleogene (the so-called PETM, ETM2 or the Azolla events). Two sections of Paleocene-Eocene age were sampled near the Mackenzie delta, the so-called Coal Mine (CoMi) and Caribou Hills (CaH) sections. The aim of the study is to precise the climatic fluctuations and to characterise the source rock potential of the basin, eventually linked to the warming events. This study is based on data of multi-proxy analyses: mineralogy on bulk and clay

Evaluating the Impact of Sample Medication on Subsequent Patient Adherence.

Science.gov (United States)

Pringle, Janice L; Aldridge, Arnie; Kearney, Shannon M; Grasso, Kim; Radack, John; Hogue, Susan; Manolis, Chronis

2016-11-01

.6% for controls, P filling their initial prescriptions and adhering to those medications. This program can affect health care costs, as evidenced by lower costs for the treatment group. Financial support for this study was provided by MedVantx. UMPC Health Plan reviewed and commented on the manuscript. Hogue is an employee of MedVantx and also reviewed the manuscript. Manolis is employed by UPMC Health Plan. The remaining authors report no other conflicts of interest. Study concept and design were contributed by Pringle. Aldridge took the lead in data collection, along with Kearney. Data interpretation was performed primarily by Radack, along with Kearney and Grasso. The manuscript was written by Kearney, Aldridge, and Radack and revised by Kearney, Manolis, Hogue, and Radack.

Accuracy of the ankle-brachial index using the SCVL®, an arm and ankle automated device with synchronized cuffs, in a population with increased cardiovascular risk

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Rosenbaum D

2012-04-01

Full Text Available David Rosenbaum1,2, Sandra Rodriguez-Carranza1,3, Patrick Laroche4, Eric Bruckert1,2, Philippe Giral1,2, Xavier Girerd1,21Unité de Prévention Cardiovasculaire, Service d'Endocrinologie-Métabolisme, Assistance Publique/Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière – Université Pierre et Marie Curie, 2Dyslipoproteinemia and Atherosclerosis Research Unit, National Institute for Health and Medical Research (INSERM and Pierre et Marie Curie University (UPMC – Paris VI, Paris, France; 3Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Departamento de Endocrinología y Metabolismo, Delegación Tlalpan, México Distrito Federal; 4STACTIS, Paris, FranceObjective: To evaluate the accuracy of the ankle brachial index (ABI measured with the SCVL® (“screening cardiovascular lab”; GenNov, Paris, France, an automated device with synchronized arm and ankle cuffs with an automatic ABI calculation.Methods: Patients were consecutively included in a cardiovascular prevention unit if they presented with at least two cardiovascular risk factors. ABI measurements were made using the SCVL, following a synchronized assessment of brachial and ankle systolic pressure. These values were compared to the ABI obtained with the usual Doppler-assisted method.Results: We included 157 patients. Mean age was 59.1 years, 56.8% had hypertension, 22.3% had diabetes mellitus, and 17.6% were current smokers. An abnormal ABI was observed in 17.2% with the SCVL and in 16.2% with the Doppler. The prevalence rates of an abnormal ABI by patient measured with each device, ie, 15.7% (confidence interval [CI] 0.95: [11.8; 20.4] or 14.3% (CI 0.95: [10.7; 18.9], did not differ. The coefficient of variation of Doppler and SCVL measures was 15.8% and 15.1%, respectively. The regression line between the two measurement methods was statistically significant. The value-to-value comparison also shows a difference of mean equal to 0.010 (CI 0.95: [–0

Radiation therapy rather than prior surgery reduces extent of resection during endonasal endoscopic reoperation for craniopharyngioma.

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Younus, Iyan; Forbes, Jonathan A; Ordóñez-Rubiano, Edgar G; Avendano-Pradel, Rafael; La Corte, Emanuele; Anand, Vijay K; Schwartz, Theodore H

2018-07-01

Radiation therapy is often advocated for residual or recurrent craniopharyngioma following surgical resection to prevent local recurrence. However, radiation therapy is not always effective and may render tumors more difficult to remove. If this is the case, patients may benefit more from reoperation if gross total resection can be achieved. Nevertheless, there is little data on the impact of radiation on reoperations for craniopharyngioma. In this study, we sought to analyze whether a history of previous radiation therapy (RT) affected extent of resection in patients with recurrent craniopharyngiomas subsequently treated with reoperation via endoscopic endonasal approach (EEA). The authors reviewed a prospectively acquired database of EEA reoperations of craniopharyngiomas over 13 years at Weill Cornell, NewYork-Presbyterian Hospital. All procedures were performed by the senior author. The operations were separated into two groups based on whether the patient had surgery alone (group A) or surgery and RT (group B) prior to recurrence. A total of 24 patients (16 male, 8 female) who underwent surgery for recurrent craniopharyngioma were identified. The average time to recurrence was 7.64 ± 4.34 months (range 3-16 months) for group A and 16.62 ± 12.1 months (range 6-45 months) for group B (p < 0.05). The average tumor size at recurrence was smaller in group A (1.85 ± 0.72 cm; range 0.5-3.2) than group B (2.59 ± 0.91 cm; range 1.5-4.6; p = 0.00017). Gross total resection (GTR) was achieved in 91% (10/11) of patients in group A and 54% (7/13) of patients in group B (p = 0.047). There was a near significant trend for higher average Karnofsky performance status (KPS) score at last follow-up for group A (83 ± 10.6) compared with group B (70 ± 16.3, p = 0.056). While RT for residual or recurrent craniopharyngioma may delay time to recurrence, ability to achieve GTR with additional surgery is reduced. In the case of

Secondary glaucoma in CAPN5-associated neovascular inflammatory vitreoretinopathy

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Cham A

2016-06-01

Full Text Available Abdourahman Cham,1,2 Mayank Bansal,3 Himanshu K Banda,4 Young Kwon,1 Paul S Tlucek,1 Alexander G Bassuk,5 Stephen H Tsang,6,7 Warren M Sobol,8 James C Folk,1 Steven Yeh,4 Vinit B Mahajan1,2 1Department of Ophthalmology and Visual Sciences, 2Omics Laboratory, University of Iowa, Iowa City, IA, USA; 3Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; 4Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, 5Department of Pediatrics, University of Iowa, Iowa City, IA, 6Barbara and Donald Jonas Laboratory of Stem Cells and Regenerative Medicine and Bernard and Shirlee Brown Glaucoma Laboratory, Department of Pathology and Cell Biology, Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, 7Edward S Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, 8Retina Physicians & Surgeons, Inc., Dayton, OH, USA Objective: The objective of this study was to review the treatment outcomes of patients with secondary glaucoma in cases of autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV, a hereditary autoimmune uveitis due to mutations in CAPN5. Patients and methods: A retrospective, observational case series was assembled from ADNIV patients with secondary glaucoma. The main outcome measures were intraocular pressure (IOP, visual acuity, use of antiglaucoma medications, ocular surgeries, and adverse outcomes. Perimetry and optic disk optical coherence tomography (OCT were also analyzed. Results: Nine eyes of five ADNIV patients with secondary glaucoma were reviewed. Each received a fluocinolone acetonide (FA implant for the management of posterior uveitis. Following implantation, no eyes developed neovascular glaucoma. Five eyes (in patients 1, 2, and 5 required Ahmed glaucoma valve surgery for the management of steroid-responsive glaucoma. Patient 2 also developed angle closure with iris bombe and underwent laser

16th International Conference on Micro and Nanotechnology for Power Generation and Energy Conversion Applications (PowerMEMS 2016)

International Nuclear Information System (INIS)

2016-01-01

, JAPAN Reza Ghodssi - University of Maryland Einar Halvorsen - Grenoble Alpes Université, FRANCE Hiroki Kuwano-Tohoku University, JAPAN Jeff Lang - Massachusetts Institute of Technology, USA Carol Livermore - Northeastern University, USA Ryutaro Maeda - National Institute of Advanced Industrial Science and Technology, JAPAN Kazusuke Maenaka - University of Hyogo, JAPAN Paul Mitcheson - Imperial College London, UK Yuji Suzuki - University of Tokyo, JAPAN Shuji Tanaka -Tohoku University, JAPAN Luis Velásquez-García - Massachusetts Institute of Technology, USA Peter Woias - University Freiburg-IMTEK, GERMANY Eric Yeatman - Imperial College London, UK Technical Program Committee Mahmoud Almasri, University of Missouri, USA David Arnold, University of Florida, USA Mustafa Beyaz, Antalya International University, TURKEY Danick Briand, EPFL, SWITZERLAND Stephen Burrow, Univesrity of Bristol, UK Francesco Cottone, University of Perugia, ITALY Alper Erturk, Georgia Institute of Technology, USA Luis Fonseca, IMB-CNM (CSIC)Micro-Nanosytems, SPAIN Takayuki Fujita, University of Hyogo, JAPAN Dimitri Galayko, UPMC-Sorbonne, FRANCE Tzeno Galchev, Analog Devices Inc., USA Gideon Gouws, Victoria University of Wellington, NEW ZEALAND Andrew Holmes, Imperial College London, UK Yoshihiro Kawahara, The University of Tokyo, JAPAN Sang-Woo Kim, Sungkyunkwan University, SOUTH KOREA Jeffrey Lang, Massachusetts Institute of Technology, USA Janet Ledesma-García, Universidad Autónoma de Querétaro, MEXICO Carol Livermore, Northeastern University, USA Yiannos Manoli, University of Freiburg, GERMANY Jianmin Miao, Nanyang Technological University, SINGAPORE Paul Mitcheson, Imperial College London, UK Koji Miyazaki, Kyushu Institute of Technology, JAPAN Jaeyeong Park, Kwangwoon University, KOREA Michael Renaud, Holst Centre-lmec NL, NETHERLANDS Paul Ronney, University of Southern California, USA Shad Roundy, University of Utah, USA Tomonori Seki, OMRON Corporation, JAPAN Yuji Suzuki, The

PLASMA-2013: International Conference on Research and Applications of Plasmas (Warsaw, Poland, 2-6 September 2013)

Science.gov (United States)

Sadowski, Marek J.

2014-05-01

, Otwock, Poland—Chairman Dimitri Batani, Universite Bordeaux, France Sergio Ciattaglia, ITER, Cadarache, France Michael Dudeck, UPMC, Paris, France Igor E Garkusha, NSC KIPT, Kharkov, Ukraine Zbigniew Kłos, CBK PAN, Warsaw Giorgio Maddaluno, ENEA Frascati, Italy Andrea Murari, EFDA JET, Culham, UK Józef Musielok, University of Opole, Poland Svetlana Ratynskaia, RIT, Stockholm, Sweden Karel Rohlena, IP CAS, Prague, Czech Republic Valentin Smirnov, Rosatom, Moscow, Russia Francisco Tabares, CIEMAT, Madrid, Spain Lorenzo Torrisi, University of Messina, Messina, Italy Jerzy Wołowski, IFPiLM, Warsaw, Poland Urszula Woźnicka, IFJ PAN, Cracow, Poland Local Organizing Committee Jerzy Wołowski—Chairman Paweł Gąsior—Secretary Zofia Kalinowska Ewa Kowalska-Strzęciwilk Monika Kubkowska Anita Pokorska Ryszard Panfil Joanna Dziak-Beme Conference website: http://plasma2013.ipplm.pl/

Topical ocular 0.1% cyclosporine A cationic emulsion in dry eye disease patients with severe keratitis: experience through the French early-access program

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Pisella P

2018-02-01

Full Text Available Pierre-Jean Pisella,1 Marc Labetoulle,2 Serge Doan,3 Beatrice Cochener-Lamard,4 Mourad Amrane,5 Dahlia Ismail,5 Catherine Creuzot-Garcher,6,7 Christophe Baudouin8–10 1Department of Ophthalmology, Tours University Hospital, University François Rabelais, Bretonneau Hospital, Tours, 2Department of Ophthalmology, Bicêtre Hospital, APHP, Paris-Sud University, Le Kremlin-Bicêtre, 3Department of Ophthalmology, Bichat Hospital and Fondation A de Rothschild, Paris, 4Brest University Medical School, Morvan Hospital, Brest, 5Santen SAS, Evry, 6Department of Ophthalmology, University Hospital, 7Department of Ophthalmology III, Eye and Nutrition Research Group, Burgundy, Dijon, 8Research Team S12, Quinze-Vingts National Ophthalmology Hospital, 9Department of Ophthalmology, Ambroise-Paré Hospital, APHP, UPMC University, Paris 6, Vision Institute, INSERM UMRS968, CNRS UMR7210, Paris, 10University of Versailles Saint-Quentin en Yvelines, Versailles, France Purpose: The objective of this study was to report the evaluation of efficacy and safety of cyclosporine A cationic emulsion (CsA CE 0.1% for the treatment of severe keratitis in adults with dry eye disease (DED in a French early-access program. Methods: Patients with DED and severe keratitis (corneal fluorescein staining [CFS] score of 3–5 on the Oxford scale and/or the presence of corneal lesions [filaments or ulcers] were enrolled in a compassionate use program (Authorization for Temporary Use [ATU] for once-daily CsA CE, which was approved by French health authorities prior to its registration. Efficacy and safety at 1, 3, 6, and 12-month follow-up visits were evaluated. Results: The ATU cohort (n=1,212; mean age =60.5 years; 79.5% female; 98.1% with severe keratitis; 74.5% with corneal lesions consisted of 601 CsA-naïve patients and 611 patients treated previously with other CsA formulations. The primary DED etiology was Sjögren’s syndrome (48.7%. Clinical benefit could be discerned among

Targeted polyethylene glycol gold nanoparticles for the treatment of pancreatic cancer: from synthesis to proof-of-concept in vitro studies

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Spadavecchia J

2016-02-01

Full Text Available Jolanda Spadavecchia,1,2,* Dania Movia,3,* Caroline Moore,3,4 Ciaran Manus Maguire,3,4 Hanane Moustaoui,2 Sandra Casale,1 Yuri Volkov,3,4 Adriele Prina-Mello3,4 1Laboratoire de Réactivité de Surface, Sorbonne Universités, UPMC Univ Paris VI, Paris, 2Centre National de la recherche française, UMR 7244, CSPBAT, Laboratory of Chemistry, Structures, and Properties of Biomaterials and Therapeutic Agents, Université Paris 13, Sorbonne Paris Cité, Bobigny, France; 3AMBER Centre, CRANN Institute, 4Department of Clinical Medicine, School of Medicine, Trinity College, Dublin, Ireland *These authors contributed equally to this work Abstract: The main objective of this study was to optimize and characterize a drug delivery carrier for doxorubicin, intended to be intravenously administered, capable of improving the therapeutic index of the chemotherapeutic agent itself, and aimed at the treatment of pancreatic cancer. In light of this goal, we report a robust one-step method for the synthesis of dicarboxylic acid-terminated polyethylene glycol (PEG-gold nanoparticles (AuNPs and doxorubicin-loaded PEG-AuNPs, and their further antibody targeting (anti-Kv11.1 polyclonal antibody [pAb]. In in vitro proof-of-concept studies, we evaluated the influence of the nanocarrier and of the active targeting functionality on the anti-tumor efficacy of doxorubicin, with respect to its half-maximal effective concentration (EC50 and drug-triggered changes in the cell cycle. Our results demonstrated that the therapeutic efficacy of doxorubicin was positively influenced not only by the active targeting exploited through anti-Kv11.1-pAb but also by the drug coupling with a nanometer-sized delivery system, which indeed resulted in a 30-fold decrease of doxorubicin EC50, cell cycle blockage, and drug localization in the cell nuclei. The cell internalization pathway was strongly influenced by the active targeting of the Kv11.1 subunit of the human Ether-à-go-go related gene

Anti-inflammatory and immunomodulatory effects of Aquaphilus dolomiae extract on in vitro models

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Aries MF

2016-11-01

Full Text Available Marie-Françoise Aries,1 Hélène Hernandez-Pigeon,1 Clémence Vaissière,1 Hélène Delga,1 Antony Caruana,1 Marguerite Lévêque,1 Muriel Bourrain,1,2 Katia Ravard Helffer,1 Bertrand Chol,3 Thien Nguyen,1 Sandrine Bessou-Touya,1 Nathalie Castex-Rizzi1 1Pierre Fabre Dermo-Cosmétique, Centre de Recherche & Développement Pierre Fabre, Toulouse, 2Sorbonne Universités, UPMC Univ Paris 06, CNRS, Laboratoire de Biodiversité et Biotechnologies Microbiennes (LBBM, Observatoire Océanologique, Banyuls/Mer, France; 3Centre d’Immunologie Pierre Fabre, Saint-Julien-en-Genevois, France Background: Atopic dermatitis (AD is a common skin disease characterized by recurrent pruritic inflammatory skin lesions resulting from structural and immune defects of the skin barrier. Previous studies have shown the clinical efficacy of Avène thermal spring water in AD, and a new microorganism, Aquaphilus dolomiae was suspected to contribute to these unique properties. The present study evaluated the anti-inflammatory, antipruritic, and immunomodulatory properties of ES0, an original biological extract of A. dolomiae, in immune and inflammatory cell models in order to assess its potential use in the treatment of AD.Materials and methods: An ES0 extract containing periplasmic and membrane proteins, peptides, lipopolysaccharides, and exopolysaccharides was obtained from A. dolomiae. The effects of the extract on pruritus and inflammatory mediators and immune mechanisms were evaluated by using various AD cell models and assays.Results: In a keratinocyte model, ES0 inhibited the expression of the inflammatory mediators, thymic stromal lymphopoietin, interleukin (IL-18, IL-4R, IL-8, monocyte chemoattractant protein-3, macrophage inflammatory protein-3α, and macrophage-derived chemokine and induced the expression of involucrin, which is involved in skin barrier keratinocyte terminal differentiation. In addition, ES0 inhibited protease-activated receptor-2 activation in

Dynamics of nanoparticules detected at 1 AU by S/WAVES onboard STEREO spacecraft

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Belheouane, Soraya; Issautier, Karine; Meyer-Vernet, Nicole; Le Chat, Gaétan; Czechowski, Andrzej; Zaslavsky, Arnaud; Zouganelis, Yannis; Mann, Ingrid

In order to interpret in detail the S/WAVES data on the interplanetary nanodust discovered by STEREO at 1 AU [Meyer-Vernet et al., 2009], we study the dynamics of nanoparticles in the inner interplanetary medium as well as the distribution of their velocities and directions of arrival, with a model based on [Czechowski and Mann, 2012]. We deduce the charges released by their impacts on the STEREO spacecraft at 1 AU and their dependence on the position of the spacecraft on their orbits. The model studies nanoparticles of size equal or smaller than about 70 nm, assumed to be created via collisional fragmentation of dust grains of larger size moving on keplerian orbits, and sublimation of dust, meteoroids and comets. The nanoparticles are released near the Sun with initial velocities close to keplerian, and mainly subjected to the Lorentz force calculated with a simple solar wind model. A part of the nanoparticles is accelerated to high speeds of the order of 300 km/s, thereby providing impact charges between 10(-14) and 10(-11) Cb [Belheouane, 2014] which enable them to be detected by S/WAVES, whereas another part is trapped within about 0.2 AU from the Sun. We discuss how the fluxes and direction of arrival at 1 AU are expected to change in function of the solar cycle. These results enable us to interpret in detail the STEREO/WAVES observations [Zaslavsky et al., 2012]; [Pantellini et al., 2013]; [Le Chat et al., 2013]. Belheouane, S. (2014). Nanoparticules dans le vent solaire, observations spatiales et theorie. PhD thesis, Pierre and Marie Curie University UPMC. Czechowski, A. and Mann, I. (2012). Nanodust Dynamics in Interplanetary Space, chapter Nanodust Dynamics in Interplanetary Space. Springer Berlin Heidelberg. Le Chat, G., Zaslavsky, A., Meyer-Vernet, N., Issautier, K., Belheouane, S., Pantellini, F., Maksimovic, M., Zouganelis, I., Bale, S., and Kasper, J. (2013). Interplanetary Nanodust Detection by the Solar Terrestrial Relations Observatory/WAVES Low

María Callas: La Divina

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Efraim Otero Ruiz

2000-12-01

Full Text Available

Podría decirse ingenuamente que mis más de 40 años de amistad ininterrumpida con José Félix Patiño casi que comienzan y terminan con María Callas.

Pero antes de causar alarma entre mis oyentes, quiero calificar mi afirmación diciendo que comienzan y terminan en un sentido más estrictamente histórico que afectivo. Veamos por qué.

A finales de 1958 era yo apenas un residente de medicina interna y endocrinología en el Columbia- Presbyterian Medical Center de Nueva York y José Félix había ya completado su grado y su postgrado en la Universidad de Yale.Como lo relata en su libro, él ya había tenido la oportunidad de oír y admirar a María Callas desde los asientos de galería del viejo Metropolitan de la calle 38.

En cambio yo, llegado a Nueva York desde Tennessee sólo a comienzos del año, y embebido 13 horas al día en mi trabajo de dosificación biológica de TSH, apenas si había tenido el tiempo y el dinero para visitar los museos, las galerías y tal cual concierto en Carnegie Hall compitiendo con los “musicals” de Broadway. Con una beca que apenas igualaba los menguados salarios de mis compañeros de residencia, debía contar y recontar los escasos dólares y -en compañía de amigas y amigos del laboratorio tratar de reservar y comprar la boletería con meses de anticipación para evitar los precios de estreno inmediato o de reventa que -aun para gallinero quedaban bien fuera de nuestro alcance.

Callas había electrizado al público neoyorquino desde su llegada en Octubre del 56 a Idlewild (como se llamaba en esa época el hoy Aeropuerto Kennedy con toda la fanfarria musical y propagandística que la acompañaba y con su debut en Norma (con la fenomenal Casta Diva.

Seguida luego por Tosca en Noviembre, destacando apartes de esta misma ópera en el show de Ed Sullivan en la televisión en blanco y negro y finalizando con las dos apoteósicas presentaciones de Lucia di Lammermoor en

Walter Rowe Courtenay, Jr. (1933–2014)

Science.gov (United States)

Benson, Amy J.

2016-01-01

WALTER R. COURTENAY, JR., ichthyologist and retired professor, Florida Atlantic University, Boca Raton, Florida, died in Gainesville, Florida, on 30 January 2014 at age 80. Walt was born in Neenah, Wisconsin, on 6 November 1933, son of Walter and Emily Courtenay. Walt's interest in fish began at a young age as evidenced by a childhood diary in which at 13 years of age he wrote about his first catch—a two-and-a-half pound “pike” from Lake Winnebago. When Walt turned ten, the family moved from Wisconsin to Nashville, Tennessee, the move precipitated by his father accepting a position as pastor of the First Presbyterian Church. During those early days in Nashville, Walt's father would take summers off and travel to Michigan to teach at Camp Miniwanca along the shore of Lake Michigan where father and son honed their angling skills. It was also at that time Walt's father had definite views on what his son should be doing in adult life—in Walt's case it was to become a medical doctor. However, his Woods Hole internship in marine biology and oceanography toward the end of his undergraduate years was a transformative experience for him so much so that he abandoned all ideas of becoming a medical doctor and instead specialized in ichthyology and oceanography. Apart from the inherent interest and opportunities Woods Hole opened to him, being back at the shore of a large body of water, in this case the Atlantic Ocean, was far more interesting than sitting in lectures on organic chemistry. With that, Walt completed his B.A. degree at Vanderbilt University in 1956. In 1960 while in graduate school in Miami, Walt met and married Francine Saporito, and over the next several years had two children, Walter III and Catherine. He went on to receive his M.S. in 1961 from The Rosenstiel School of Marine and Atmospheric Science at the University of Miami on the systematics of the genus Haemulon (grunts) and his Ph.D. degree in 1965 working under his advisor C. Richard �

A community kitchen in the Kamanves slum, India.

Science.gov (United States)

Ram, E R; Holkar, V M

1978-01-01

The Kamanves slum in the town of Mijar (Maharashtra State) is an impoverished area of about 2500 people, most living in 1-room mud-walled houses. About 70% have either no or only nominal education, and more than half are only informally or temporarily employed. The average income amounts to less than $0.85 per day for an average family of 5. In 1974 a group of Kamanves residents formed a committee, backed by the Director of the Department of Community Health of the Miraj Medical Center, to try to alleviate some of the area's problems. Through community discussions, the 1st priority of the committee was held to be to provide for the nutritional needs of the children (about 35% of the population). The group tried to raise money internally, but when this was seen to be impossible, funds were sought from outside (Terre des Hommes in Germany, and the National Committee for People's Self Development of the United Presbyterian Church in the U.S.). Steps were taken to build an extension of the local school, and the local school board was used as the legal base for the organization of a public trust, with its own bank account and constitution (later revised to cover additional projects). The 1st projects were provision of a morning meal for some 150 children under 5, and an evening meal for older children, with special supplementary foods for those suffering from nutritional diseases. The meal includes rice and meat twice a week and fruit 3 times a week. Health care is provided through monitoring of weight, regular medical examinations, treatment of worms and minor ailments. Personal hygiene is taught. A very small fee is charged for each child weekly. Additional projects later included a communal meal for the very poorest adults and expansion of the kitchen (run on a rotating basis by community mothers under management of specially trained women) to help feed the poorer patients at the Miraj Medical Center (this project will undergo evaluation by the community to see if

Los cincuenta años del puntaje APGAR

Directory of Open Access Journals (Sweden)

Alfredo Jácome Roca

2003-08-01

Full Text Available

Perfil biográfico de una mujer extraordinaria.

Algún día del año 1949,un grupo de médicos y alumnos se encontraba tomando el desayuno en la cafetería del Hospital Columbia-Presbyterian en NuevaYork, cuando un estudiante (quien rotaba por anestesia comentó que hacía falta desarrollar un sistema de valoración del recién nacido.

La anestesióloga Virginia Apgar, quien se encontraba entre los concurrentes, respondió: “Eso es fácil, se puede hacer de la siguiente manera”; y acto seguido cogió de la mesa un pedazo de papel y escribió los cinco temas de lo que más adelante se convertiría en el famoso puntaje de evaluación del neonato que conocemos como el “Apgar”. Se levantó entonces y se fue al servicio de obstetricia para ensayar de inmediato la escala de valoración que acababa de ocurrírsele.

En 1952, hace cincuenta años, presentaría sus experiencias en un congreso internacional de anestesiología.

Esta anécdota fue contada en 1980 por el médico Richard Patterson, presente en el famoso desayuno; hace parte del material biogràfico de Selma Harrison Calmes, profesora de anestesiología en la Universidad de California en Los Ángeles (UCLA, sobre su colega Ginny Apgar. Calmes es la principal biógrafa de esta sobresaliente, valerosa y peculiar mujer.

Para entender la importancia de lo realizado por Apgar, es necesario ponerse en el contexto de aquella época. Nacida en 1909 en Westfield, Nueva Jersey, tuvo un padre aficionado a la electricidad, las ondas radiales y la astronomía, por lo que ella creció al lado de un telescopio y un laboratorio, instalados en el sótano. Estuvo entonces en temprano contacto con la ciencia y además con la práctica médica, pues un hermano murió a los tres años de tuberculosis y otro visitaba frecuentemente al médico por un eczema crónico, hechos que quizá influyeron en su determinación de seguir la carrera de medicina cuando

The multinational second Diabetes, Attitudes, Wishes and Needs study: results of the French survey

Directory of Open Access Journals (Sweden)

Reach G

2015-02-01

Full Text Available Gérard Reach,1,2 Silla M Consoli,3,4 Serge Halimi,5 Claude Colas,6 Martine Duclos,7–9 Pierre Fontaine,10 Caroline Martineau,11 Carole Avril,12 Catherine Tourette-Turgis,13 Sylvie Pucheu,4 Olivier Brunet14 1Department of Endocrinology, Diabetes and Metabolic Diseases, Avicenne Hospital, Bobigny, 2EA 3412, CRNH-IDF, Paris 13 University, Sorbonne Paris Cité, Bobigny, 3Paris Descartes University, Paris Sorbonne Cité, Faculty of Medicine, Paris, 4University Service of Adult and Elderly Psychiatry, European Georges-Pompidou Hospital, Paris, 5Department of Diabetology, Endocrinology and Nutrition, Joseph Fourier University and CHU Grenoble, Grenoble, 6Department of Diabetology, Hôtel-Dieu Hospital, Paris, 7Department of Sport Medicine and Functional Explorations, Montpied Hospital, Clermont-Ferrand, 8Department of Human Nutrition, Centre de Recherche en Nutrition Humaine, Institut National de la Recherche Agronomique, Clermont-Ferrand, 9Department of Human Nutrition, University of Auvergne, Clermont-Ferrand, 10Department of Endocrinology, Diabetes and Metabolic Diseases, Huriez Hospital, Lille 2 University, Lille, 11Department of Dietetics, Larrey Hospital, CHU Toulouse, 12French Diabetics Federation, Paris, 13UPMC-Sorbonne Universités, Paris, 14General practitioner, Seraincourt, France Aim: The second Diabetes, Attitudes, Wishes and Needs (DAWN2™ multinational cross-sectional study was aimed at generating insights to facilitate innovative efforts by people with diabetes (PWD, family members (FMs, and health care professionals (HCPs to improve self-management and psychosocial support in diabetes. Here, the French data from the DAWN2™ study are described.Methods: In France, 500 PWD (80 with type 1 diabetes [T1] and 420 with type 2 diabetes [T2], 120 FMs, and 288 HCPs were recruited. The questionnaires assessed the impact of diabetes on quality of life and mood, self-management, attitudes/beliefs, and care/support.Results: Diabetes

Comparative analysis of molecular signatures suggests the use of gabapentin for the management of endometriosis-associated pain

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Bellessort B

2018-04-01

Full Text Available Brice Bellessort,1 Anne Bachelot,1,2 Virginie Grouthier,2 Camille De Lombares,1 Nicolas Narboux-Neme,1 Paolo Garagnani,3,4 Chiara Pirazzini,3,4 Simonetta Astigiano,5 Luca Mastracci,6,7 Anastasia Fontaine,1 Gladys Alfama,1 Evelyne Duvernois-Berthet,1 Giovanni Levi1 1Evolution of Endocrine Regulations, Department AVIV, National Museum of Natural History, Paris, France; 2AP-HP, Department of Endocrinology and Reproductive Medicine, Reference Center for Rare Endocrine Diseases, Pitié-Salpêtrière Hospital, UPMC, Paris, France; 3Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy; 4Interdepartmental Center “L. Galvani”, University of Bologna, Bologna, Italy; 5Department of Integrated Oncological Therapies, San Martino Hospital, Genova, Italy; 6Department of Experimental Medicine and Center of Excellence for Biomedical Research, University of Genoa, Genova, Italy; 7Division of Anatomic Pathology, Department of Surgical Science and Integrated Diagnostics, University of Genoa, Genova, Italy Background: It has been repetitively shown that the transcription factors DLX5 and DLX6 are drastically downregulated in endometriotic lesions when compared with eutopic endometrium. These findings suggest that regulatory cascades involving DLX5/6 might be at the origin of endometriosis symptoms such as chronic pelvic pain (CPP. We have shown that inactivation of Dlx5 and Dlx5/6 in the mouse uterus results in an endometrial phenotype reminiscent of endometriosis. Methods: We focused on genes that present a similar deregulation in endometriosis and in Dlx5/6-null mice in search of new endometriosis targets. Results: We confirmed a strong reduction of DLX5 expression in endometriosis implants. We identified a signature of 30 genes similarly deregulated in human endometriosis implants and in Dlx5/6-null mouse uteri, reinforcing the notion that the downregulation of Dlx5/6 is an early event in

Mitogen-activated protein kinase phosphatase-3 (MKP-3 in the surgical wound is necessary for the resolution of postoperative pain in mice

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Skopelja-Gardner S

2017-03-01

Full Text Available Sladjana Skopelja-Gardner,1,* Madhurima Saha,1,* Perla Abigail Alvarado-Vazquez,2 Brenna S Liponis,1 Elena Martinez,1 E Alfonso Romero-Sandoval2 1Department of Anesthesiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, 2Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, SC, USA *These authors contributed equally to this work. Abstract: Mitogen-activated protein kinase (MAPK phosphatase-3 (MKP-3 and its substrates (extracellular signal-regulated kinase [ERK] and p38 play an important role in pathophysiological mechanisms of acute postoperative and chronic neuropathic pain in the spinal cord. This study aimed to understand the role of MKP-3 and its target MAPKs at the site of surgical incision in nociceptive behavior. Wild-type (WT and MKP-3 knockout (KO mice underwent unilateral plantar hind paw incision. Mechanical allodynia was assessed by using von Frey filaments. Peripheral ERK-1/2 and p38 phosphorylation were measured by Western blot. Cell infiltration was determined using hematoxylin and eosin histological staining. Peripheral phosphorylated ERK-1/2 (p-ERK-1/2 inhibition was performed in MKP-3 KO mice. In WT mice, mechanical hypersensitivity was observed on postoperative day 1 (0.69±0.17 g baseline vs 0.13±0.08 g day 1, which resolved normally by postoperative day 12 (0.46±0.08 g, N=6. In MKP-3 KO mice, this hypersensitivity persisted at least 12 days after surgery (0.19±0.06 g; N=6. KO mice displayed higher numbers of infiltrating cells (51.4±6 cells/0.1 mm2 than WT mice (8.7±1.2 cells/0.1 mm2 on postoperative day 1 (vs 5–6 cells/0.1 mm2 at baseline that returned to baseline 12 days after surgery (10–12 cells/0.1 mm2. In WT mice, peripheral p-p38 and p-ERK-1/2 expression increased (5- and 3-fold, respectively on postoperative days 1 and 5, and returned to basal levels 7–12 days after surgery (N=3 per group. Peripheral p-p38 levels in MKP-3 KO mice followed

Implementing SPRINTT [Student Polar Research with IPY National(and International)Teacher Training] in 5th Grade Science

Science.gov (United States)

Glass, D. S.

2009-12-01

I implemented the new NSF-funded SPRINTT (Student Polar Research with IPY National (and International) Teacher Training) curriculum with a 5th grade science class. SPRINTT, developed at U.S. Satellite Laboratory, Inc., is a 5-8 week science program teaching 5th through 10th graders to investigate climate change using polar data. The program includes perspectives of both Western scientists and the indigenous Northern population. The course contains three phases: Phase 1 includes content, data interpretation, and hands-on experiments to study Frozen Water, Frozen Land, and Food; Phase 2 (optional) includes further content on specific polar topics; and Phase 3 is a scaffolded research investigation. Before the course, teachers were trained via live webinars. This curriculum capitalizes on children’s innate fascination with our planet’s final frontier and combines it with the politically and scientifically relevant topic of climate change. In 2009, I used SPRINTT with 23 heterogeneous fifth grade students at National Presbyterian School in Washington DC for an environmental science unit. Overall, it was a success. The students met most of the learning objectives and showed enthusiasm for the material. I share my experiences to help other educators and curriculum developers. The Phase 1 course includes earth science (glaciers, sea ice, weather and climate, greenhouse gases, seasons, and human impacts on environments), life science (needs of living things, food and energy transfer, adaptations, and ecosystems and biomes) and physical science (phases of matter). Tailoring the program, I focused on Phase 1, the most accessible material and content, while deemphasizing the more cumbersome Phase 3 online research project. Pre-assessments documented the students’ misconceptions and informed instruction. The investigations were appropriately educational and interesting. For example, students enjoyed looking at environmental factors and their impact on the people in the

Non-Destructive Approaches for the Validation of Visually Observed Spatial Patterns of Decay

Science.gov (United States)

Johnston, Brian; McKinley, Jennifer; Warke, Patricia; Ruffell, Alastair

2017-04-01

Historical structures are regarded as a built legacy that is passed down through the generations and as such the conservation and restoration of these buildings is of great importance to governmental, religious and charitable organisations. As these groups play the role of custodians of this built heritage, they are therefore keen that the approaches employed in these studies of stone condition are non-destructive in nature. Determining sections of facades requiring repair work is often achieved through a visual conditional inspection of the stonework by a specialist. However, these reports focus upon the need to identify blocks requiring restorative action rather than the determination of spatial trends that lead to the identification of causes. This fixation on decay occurring at the block scale results in the spatial distribution of weathering present at the larger 'wall' scale appearing to have developed chaotically. Recent work has shown the importance of adopting a geomorphological focus when undertaking visual inspection of the facades of historical buildings to overcome this issue. Once trends have been ascertained, they can be used to bolster remedial strategies that target the sources of decay rather than just undertaking an aesthetic treatment of symptoms. Visual inspection of the study site, Fitzroy Presbyterian Church in Belfast, using the geomorphologically driven approach revealed three features suggestive of decay extending beyond the block scale. Firstly, the influence of architectural features on the susceptibility of blocks to decay. Secondly, the impact of the fluctuation in groundwater rise over the seasons and the influence of aspect upon this process. And finally, the interconnectivity of blocks, due to deteriorating mortar and poor repointing, providing conduits for the passage of moisture. Once these patterns were identified, it has proven necessary to validate the outcome of the visual inspection using other techniques. In this study

The plain film roentgenographic findings in diagnosis of intestinal volvulus

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Chung, Gyung Ho; Seo, Yeon Hee; Sohn, Myung Hee; Kim, Chong Soo; Choi, Ki Chul; Jeon, Doo Sung [Chunbuk National University College of Medicine, Chunju (Korea, Republic of)

1988-08-15

Intestinal volvulus indicates the twisting of a loop of bowel around the axis of its own mesentery and implies interference of the blood supply associated with the obstruction. It is the purpose of this communication to review the clinical and plain roentgen manifestation on the basis of which the diagnosis can be established. In this regard, the authors have reviewed 60 cases of intestinal volvulus which have been treated from Jan, 1976 to Dec, 1987 at Chunbuk National University and Chunju presbyterian Medical Center. The results were as follows: 1) The most frequent type of intestinal volvulus was volvulus of small intestine (50%), followed by sigmoid volvulus (40%), compound volvulus (5%), cecal volvulus (3.3%), and transverse colon volvulus (1.7%). 2) The sex distribution of intestinal vovulus assumed a male to female ratio of 2.9:1. The incidence ratio of male to female was 3.4:1 in the volvulus of small intestine, 1.67:1 in sigmoid volvulus. All patients with cecal volvulus, compound volvulus, and transverse volvulus were male. 3) Of the age distribution, the youngest case was an infant of 8 months, the oldest one in 79 years. There happened even age distribution in the volvulus of small intestine at any age group, and old age distribution in colon volvulus. 4) In 30 cases of small intestine, the predisposing factors were previous abdominal operation in 20 cases (66.7%), congenital band in 3 cases (10%), malrotation in 3 cases (10%), tumor in 1 case (3.3%), and Meckel's diverticulum in 1 case (3.3%). In 24 cases of sigmoid volvulus, the predisposing factors were redundant mobile bowel in 18 cases (75%), previous operation in 4 cases (16.7%), and pelvic inflammation and adhesion in 2 cases (8.4%). In 2 cases of cecal volulus, 1 case had the history of previous operation, and 1 case had long redundant cecal loop. In 3 cases of compound volvulus, 2 cases had redundant mobile sigmoid, and 1 case had previous operation. 5) In 30 cases of the volulus of small

The plain film roentgenographic findings in diagnosis of intestinal volvulus

International Nuclear Information System (INIS)

Chung, Gyung Ho; Seo, Yeon Hee; Sohn, Myung Hee; Kim, Chong Soo; Choi, Ki Chul; Jeon, Doo Sung

1988-01-01

Intestinal volvulus indicates the twisting of a loop of bowel around the axis of its own mesentery and implies interference of the blood supply associated with the obstruction. It is the purpose of this communication to review the clinical and plain roentgen manifestation on the basis of which the diagnosis can be established. In this regard, the authors have reviewed 60 cases of intestinal volvulus which have been treated from Jan, 1976 to Dec, 1987 at Chunbuk National University and Chunju presbyterian Medical Center. The results were as follows: 1) The most frequent type of intestinal volvulus was volvulus of small intestine (50%), followed by sigmoid volvulus (40%), compound volvulus (5%), cecal volvulus (3.3%), and transverse colon volvulus (1.7%). 2) The sex distribution of intestinal vovulus assumed a male to female ratio of 2.9:1. The incidence ratio of male to female was 3.4:1 in the volvulus of small intestine, 1.67:1 in sigmoid volvulus. All patients with cecal volvulus, compound volvulus, and transverse volvulus were male. 3) Of the age distribution, the youngest case was an infant of 8 months, the oldest one in 79 years. There happened even age distribution in the volvulus of small intestine at any age group, and old age distribution in colon volvulus. 4) In 30 cases of small intestine, the predisposing factors were previous abdominal operation in 20 cases (66.7%), congenital band in 3 cases (10%), malrotation in 3 cases (10%), tumor in 1 case (3.3%), and Meckel's diverticulum in 1 case (3.3%). In 24 cases of sigmoid volvulus, the predisposing factors were redundant mobile bowel in 18 cases (75%), previous operation in 4 cases (16.7%), and pelvic inflammation and adhesion in 2 cases (8.4%). In 2 cases of cecal volulus, 1 case had the history of previous operation, and 1 case had long redundant cecal loop. In 3 cases of compound volvulus, 2 cases had redundant mobile sigmoid, and 1 case had previous operation. 5) In 30 cases of the volulus of small

Mid-regional pro-adrenomedullin and copeptin to predict short-term prognosis of COPD exacerbations: a multicenter prospective blinded study

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Dres M

2017-03-01

Full Text Available Martin Dres,1,2 Pierre Hausfater,3,4 Frantz Foissac,5,6 Maguy Bernard,7 Luc-Marie Joly,8 Mustapha Sebbane,9 Anne-Laure Philippon,3,4 Cédric Gil-Jardiné,10 Jeannot Schmidt,11 Maxime Maignan,12 Jean-Marc Treluyer,13 Nicolas Roche14,15 On behalf of the UTAPE Study Investigators and Scientific Committee 1Pulmonary and Critical Care Department, Pitié-Salpêtrière Hospital, AP-HP, 2UMRS1158: Clinical and Experimental Respiratory Neurophysiology, Paris 6 University, 3Emergency Department, Hôpital Pitié-Salpêtrière, AP-HP, 4Sorbonne Universités UPMC Univ-Paris06, GRC-14 BIOSFAST, 5Clinical Research Department, Necker Cochin Hospital, AP-HP, 6EA 7323, Sorbonne Paris-Cité, 7Biochemistry Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, 8Emergency Department, Charles Nicolle Hospital, Rouen, 9Department of Emergency Medicine, Lapeyronie Hospital, Montpellier, 10Emergency Department, Pellegrin Hospital, Bordeaux, 11Emergency Department, Gabriel Montpied Hospital, Clermont-Ferrand, 12Emergency Department, Grenoble University Hospital, Grenoble, 13Clinical Research Department, Paris Descartes University, Hôpital Cochin, AP-HP, 14Pulmonary Department, Cochin Hospital, AP-HP, 15Paris Descartes University, Paris, France Background: Exacerbations of COPD (ECOPD are a frequent cause of emergency room (ER visits. Predictors of early outcome could help clinicians in orientation decisions. In the current study, we investigated whether mid-regional pro-adrenomedullin (MR-proADM and copeptin, in addition to clinical evaluation, could predict short-term outcomes.Patients and methods: This prospective blinded observational study was conducted in 20 French centers. Patients admitted to the ER for an ECOPD were considered for inclusion. A clinical risk score was calculated, and MR-proADM and copeptin levels were determined from a venous blood sample. The composite primary end point comprised 30-day death or transfer to the intensive care unit or a new ER

A Geomorphologically Driven Conditional Assessment for the Study of Urban Stone Decay

Science.gov (United States)

Johnston, Brian; McKinley, Jennifer; Warke, Patricia; Ruffell, Alastair

2017-04-01

into consideration these limitations by undertaking two conditional assessments, using differing techniques, of wall sections at Fitzroy Presbyterian Church in Belfast. These assessments will be undertaken using a classification system focusing upon percentage of surface alteration. Initially, an assessment was carried out focussing on classifying each block individually. This was then followed by observations in a regular grid of 10x10cm squares across the wall sections. Results suggest that decay features develop beyond the extents of a single stone when situated within a larger built structure, with mortar and blocks providing both interconnectivity and barriers that influence the spread of decay. The results suggest the presence of three wall scale processes; urban microclimatic influencing capillary rise of ground water, architectural features creating a barrier and the passage of moisture through deteriorating mortar. Probe permeametry, GPR and 3D modelling of the wall sections were used to provide support for these findings. For the conservationist, application of a gridded observation approach is time consuming and of little use when deciding upon the remediation of individual blocks. However, in geomorphologically focused studies it facilitates a greater understanding of processes that extend beyond a single block, particularly when considering sites where the development of decay appears to be spatially complex.

A 360 degrees evaluation of a night-float system for general surgery: a response to mandated work-hours reduction.

Science.gov (United States)

Goldstein, Michael J; Kim, Eugene; Widmann, Warren D; Hardy, Mark A

2004-01-01

New York State Code 405 and societal/political pressure have led the RRC and ACGME to mandate strict limitations on resident work hours. In an attempt to meet these limitations, we have switched from the previous Q3 call schedule to a specialized night float (NF) system, the continuity-care system (CCS). The purpose of this CCS is to maximize resident duty time spent on direct patient care, operative experience, and outpatient clinics, while reducing duty hours spent on performing routine tasks and call coverage. The implementation of the CCS is the fundamental step in the restructuring of our residency program. In addition to a change in the call system, we added physician assistants to aid in performing some service tasks. We performed a 360 degrees evaluation of this work in progress. In May 2002, the standard Q3 call system was abolished on the general surgery services at the New York Presbyterian Hospital, Columbia campus. Two dedicated teams were created to provide day and night coverage, a day continuity-care team (DCT) and a night continuity-care team (NCT). The DCTs, consisting of PGY1-5 residents, provide daily in-house coverage from 6 AM to 5 PM with no regular weekday night-call responsibilities. The DCT residents provide Friday night, Saturday, and daytime Sunday call coverage 3 to 4 days per month. The NCT, consisting of 5 PGY1-5 residents, provides nightly continuous care, 5 PM to 6 AM, Sunday through Thursday, with no other weekend call responsibilities. This system creates a schedule with less than 80 duty hours per week, on average, with one 24-hour period off a week, one complete weekend off per month, and no more than 24 hours of consecutive duty time. After 1 year of use, the system was evaluated by a 360 degrees method in which residents, residents' spouses, nurses, and faculty were surveyed using a Likert-type scale. Statistical significance was calculated using the Student t-test. Patient satisfaction was measured both by internal review of

The LIFE Cognition Study: design and baseline characteristics

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Sink KM

2014-08-01

Full Text Available Kaycee M Sink,1 Mark A Espeland,2 Julia Rushing,2 Cynthia M Castro,3 Timothy S Church,4 Ronald Cohen,5 Thomas M Gill,6 Leora Henkin,2 Janine M Jennings,7 Diana R Kerwin,8 Todd M Manini,5 Valerie Myers,9 Marco Pahor,5 Kieran F Reid,10 Nancy Woolard,1 Stephen R Rapp,11 Jeff D Williamson1 On behalf of LIFE Investigators 1Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC, USA; 2Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA; 3Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA; 4Pennington Biomedical, Louisiana State University, Baton Rouge, LA, USA; 5Institute on Aging and Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA; 6Yale School of Medicine, Department of Internal Medicine, New Haven, CT, USA; 7Department of Psychology, Wake Forest University, Winston-Salem, NC, USA; 8Texas Alzheimer’s and Memory Disorders, Texas Health Presbyterian Hospital Dallas, TX, USA; 9Klein Buendel, Inc., Golden, CO, USA; 10Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA; 11Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA Abstract: Observational studies have shown beneficial relationships between exercise and cognitive function. Some clinical trials have also demonstrated improvements in cognitive function in response to moderate–high intensity aerobic exercise; however, these have been limited by relatively small sample sizes and short durations. The Lifestyle Interventions and Independence for Elders (LIFE Study is the largest and longest randomized controlled clinical trial of physical activity with cognitive outcomes, in older sedentary

Obituary: Patrick L. Nolan (1952-2011)

Science.gov (United States)

Digel, Seth

2011-12-01

Patrick Lee Nolan died at his home in Palo Alto, California, on November 6, 2011, from complications related to a brain tumor, glioblastoma multiforme, which had been diagnosed less than five months earlier. He was born in Colusa, California, on November 18, 1952. Pat was the only child of John Henry Nolan and Carol Lee Harris Nolan. For most of his childhood they lived in Grass Valley, California, where his father was a butcher and his mother was a surgical nurse. Pat graduated from the California Institute of Technology in 1974 with a B.S. in Physics and completed a Ph.D. at the University of California at San Diego in 1982. His graduate and professional career was devoted to high-energy astronomy. His loss is being keenly felt by his friends and colleagues around the world, including the members of the Chancel Choir of the Menlo Park Presbyterian Church, of which he was a member for 25 years. At U. C. San Diego, Pat worked on construction of the Hard X-ray and Low Energy Gamma Ray Experiment for the first High Energy Astronomy Observatory mission, which was launched in 1977. His Ph.D. thesis, supervised by Prof. Laurence E. Peterson, was based on data from this instrument and addressed variability of the high-energy emission from Cygnus X-1 and other black hole binary systems in the Milky Way. After he completed his Ph.D., Pat took a National Research Council postdoctoral research position at the Naval Research Laboratory in Washington, D.C. He worked there from 1982-1984 developing spectral analysis software and studying gamma-ray bursts using the gamma-ray spectrometer on the Solar Maximum Mission satellite. A paper in Nature setting constraining limits on positron-electron annihilation radiation in the spectra of bursts marked the culmination of his efforts. Pat was hired by Prof. Robert Hofstadter at Stanford University in 1984 to work on the Energetic Gamma-Ray Experiment Telescope (EGRET). As a co-investigator for EGRET, Pat worked on its calorimeter

airGR: a suite of lumped hydrological models in an R-package

Science.gov (United States)

Coron, Laurent; Perrin, Charles; Delaigue, Olivier; Andréassian, Vazken; Thirel, Guillaume

2016-04-01

study application. References: - Le Moine, N. (2008), Le bassin versant de surface vu par le souterrain : une voie d'amélioration des performances et du réalisme des modèles pluie-débit ?, PhD thesis (in French), UPMC, Paris, France. - Mathevet, T. (2005), Quels modèles pluie-débit globaux pour le pas de temps horaire ? Développement empirique et comparaison de modèles sur un large échantillon de bassins versants, PhD thesis (in French), ENGREF - Cemagref (Antony), Paris, France. - Mouelhi S. (2003), Vers une chaîne cohérente de modèles pluie-débit conceptuels globaux aux pas de temps pluriannuel, annuel, mensuel et journalier, PhD thesis (in French), ENGREF - Cemagref Antony, Paris, France. - Mouelhi, S., C. Michel, C. Perrin and V. Andréassian (2006), Stepwise development of a two-parameter monthly water balance model, Journal of Hydrology, 318(1-4), 200-214, doi:10.1016/j.jhydrol.2005.06.014. - Perrin, C., C. Michel and V. Andréassian (2003), Improvement of a parsimonious model for streamflow simulation, Journal of Hydrology, 279(1-4), 275-289, doi:10.1016/S0022-1694(03)00225-7. - Pushpalatha, R., C. Perrin, N. Le Moine, T. Mathevet and V. Andréassian (2011), A downward structural sensitivity analysis of hydrological models to improve low-flow simulation, Journal of Hydrology, 411(1-2), 66-76, doi:10.1016/j.jhydrol.2011.09.034. - R Core Team (2015). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/ - Valéry, A., V. Andréassian and C. Perrin (2014), "As simple as possible but not simpler": What is useful in a temperature-based snow-accounting routine? Part 2 - Sensitivity analysis of the Cemaneige snow accounting routine on 380 catchments, Journal of Hydrology, doi:10.1016/j.jhydrol.2014.04.058.

La escuela de ciegos del Campo de la Leña, A Coruña: los inicios de la enseñanza especial en Galicia

Directory of Open Access Journals (Sweden)

Rodríguez Díaz, Ana

2014-12-01

Full Text Available The aim of this article is to show the relevance of the school for the blind opened in A Coruña by the Presbyterian José María Salgado, in 1895. This school was one of the few establishments in Spain that was dedicated, to the education these students, in the late 19th and early 20th century. It also constitutes a signficant contribution to the history of specialist education in Galicia. The Salgado School was the second institution for the blind of Galicia and the second in the city of A Coruña. This study approached Specialist Education from an historic, descriptive and comparative perspective, is based on concrete archived sources, along with the Galician press and other relevant current and historic publications. The literature review carried out to develop this work found very few monographic studies on these schools inaugurated at the end of the 19th century. There are large gaps in the information. Although they are often overlooked, some of these establishments represented a milestone in the beginnings of the institutionalisation of specialist education.Este artículo pretende mostrar la relevancia de la escuela de ciegos instaurada en la ciudad de A Coruña en el año 1895, por parte del presbítero José María Salgado. Esta escuela representa uno de los escasos establecimientos que, a finales del siglo XIX y principios del XX, se dedican en España a la educación de estos alumnos. Igualmente, constituye una contribución significativa en la historia de la enseñanza especial gallega. La escuela de Salgado figura como la segunda institución destinada a la instrucción de ciegos que se establece en Galicia y la primera que se establece en la ciudad de A Coruña. El presente estudio, abordado desde una perspectiva histórica, descriptiva y comparada, se ha fundamentado en fuentes archivísticas concretas, así como en la prensa histórica gallega y otras publicaciones históricas y actuales relativas a la educación especial. La

Obituary: Edward W. Burke, Jr. (1924-2011)

Science.gov (United States)

Bloomer, Raymond, Jr.

2011-12-01

Dr. Edward W. Burke Jr. passed away on June 15, 2011, after suffering a heart attack. Dr. Burke devoted his professional life to the research and teaching of physics and astronomy at King College in Bristol, Tennessee. Edward W. Burke, Jr., was born in Macon, Georgia, on September 16, 1924. He was a Navy veteran, having been commissioned as an ensign in 1944. He served in the Pacific near the end of World War II. He proceeded to complete his undergraduate degree in mathematics from Presbyterian College in 1947 and pursued the M.S. and Ph.D. in physics (1949 and 1954, respectively) at the University of Wisconsin. Under the direction of Professor Julian Mack, his thesis was titled "Isotope Shift in the Spectra of Boron." Although he did research in atomic spectra in the early part of his career, his interest in astronomy and variable stars in particular were his primary interests during his long academic career. Dr. Burke began his illustrious career at King College in 1949. He initiated the astronomy program there in 1950, included constructing a 12.5 inch Newtonian telescope, homemade as was most everything in those days. Many of his students learned about photometry at the Burke Observatory on the college campus. Burke was known for his trips to the Kitt Peak and Lowell observatories accompanied by undergraduate students on his trips, all of which were made by automobile which he preferred over flying. His initial interest in Ap stars later broadened into variable and especially eclipsing binary stars. His motivation was maintained by his desire to have his students experience basic research and to spark their interest in advanced degrees. Numerous students achieved advanced science and medical degrees because of Burke's encouragement and mentoring. In 1959, Dr. Burke was awarded a Fulbright professorship and traveled to Chile where he taught physics for a year in the Engineering School at the University of Chile in Santiago. He worked to establish a physics

Enhanced recovery after surgery and video-assisted thoracic surgery lobectomy: the Italian VATS Group**List of collaborators of the Italian ERAS Group: Jacopo Vannucci, MD (University of Perugia); Antonio D’Andrilli, MD (S. Andrea Hospital, Roma); Majed Refai, MD (Ospedali Riuniti, Ancona); Guendalina Graffigna, MD (Università Cattolica del Sacro Cuore, Milano); Stefano Lovadina, MD (Ospedali Riuniti, Trieste); Marzia Umari (Ospedali Riuniti, Trieste), Paolo Ferrari, MD (IRCCS ISMETT-UPMC, University of Pittsburgh, Palermo); Michele Zuliani, MD (Ospedali Riuniti, Trieste); Marco Taurchini, MD (Casa Sollievo della Sofferenza, San Giovanni Rotondo); Carlo Del Naja, MD (Casa Sollievo della Sofferenza, San Giovanni Rotondo); Domenico Massullo, MD (S. Andrea Hospital, Roma), Olha Putina, MD (ASST Mantova), Nicoletta Pia Ardò (University of Foggia). surgical protocol

Science.gov (United States)

Viggiano, Domenico; Voltolini, Luca; Bertani, Alessandro; Bertolaccini, Luca; Crisci, Roberto; Droghetti, Andrea

2018-01-01

Enhanced recovery after surgery (ERAS®) is a strategy that seeks to reduce patients’ perioperative stress response, thereby reducing potential complications, decreasing hospital length of stay and enabling patients to return more quickly to their baseline functional status. The concept was introduced in the late 1990s and was first adopted in patients undergoing open colorectal surgery. Since then, the concept of ERAS has been adopted by multiple surgical specialties. The diffusion of video-assisted thoracic surgery lobectomy (VATS-L) sets also the surgical treatment of lung cancer as a new area for ERAS development. In this paper, we present the Italian VATS Group (www.vatsgroup.org) surgical protocol as part of the ERAS clinical pathway belonging to the VATS-L national database. PMID:29629203

List of Participants

Science.gov (United States)

2008-11-01

Mohab Abou ZeidInstitut des Hautes Études Scientifiques, Bures-sur-Yvette Ido AdamMax-Planck-Institut für Gravitationsphysik (AEI), Potsdam Henrik AdorfLeibniz Universität Hannover Mohammad Ali-AkbariIPM, Tehran Antonio Amariti Università di Milano-Bicocca Nicola Ambrosetti Université de Neuchâtel Martin Ammon Max-Planck-Institut für Physik, München Christopher AndreyÉcole Polytechnique Fédérale de Lausanne (EPFL) Laura AndrianopoliPolitecnico di Torino David AndriotLPTHE, Université UPMC Paris VI Carlo Angelantonj Università di Torino Pantelis ApostolopoulosUniversitat de les Illes Balears, Palma Gleb ArutyunovInstitute for Theoretical Physics, Utrecht University Davide AstolfiUniversità di Perugia Spyros AvramisUniversité de Neuchâtel Mirela BabalicChalmers University, Göteborg Foday BahDigicom Ioannis Bakas University of Patras Igor BandosUniversidad de Valencia Jose L F BarbonIFTE UAM/CSIC Madrid Till BargheerMax-Planck-Institut für Gravitationsphysik (AEI), Potsdam Marco Baumgartl Eidgenössische Technische Hochschule (ETH), Zürich James BedfordImperial College London Raphael BenichouLaboratoire de Physique Théorique, École Normale Supérieure, Paris Francesco Benini SISSA, Trieste Eric Bergshoeff Centre for Theoretical Physics, University of Groningen Alice BernamontiVrije Universiteit, Brussel Julia BernardLaboratoire de Physique Théorique, École Normale Supérieure, Paris Adel Bilal Laboratoire de Physique Théorique, École Normale Supérieure, Paris Marco Billo' Università di Torino Matthias Blau Université de Neuchâtel Guillaume BossardAlbert-Einstein-Institut, Golm Leonardo BriziÉcole Polytechnique Fédérale de Lausanne (EPFL) Johannes BroedelLeibniz Universität Hannover (AEI) Tom BrownQueen Mary, University of London Ilka BrunnerEidgenössische Technische Hochschule (ETH), Zürich Erling BrynjolfssonUniversity of Iceland Dmitri BykovSteklov Institute, Moscow and Trinity College, Dublin Joan CampsUniversitat de Barcelona

From Editor vol 11, No.3

Directory of Open Access Journals (Sweden)

Ugur Demiray

2010-07-01

virtual CoP evolves and becomes embedded within this organization.The sixth article which is entitled as “Providing Information Communication Technology Support to Distance Education Students: A Case of the University of Ghana, Legon”, written by Beatrice K. AGYEMANG from Presbyterian College of Education and Perpetua DADZIE from Department of Information Studies, University of Ghana, Legon, GHANA. The purpose of their study is to investigate the current state of Information Communication Technology policy of the University of Ghana Distance Education (DE programme and the extent of awareness and use of ICTs in general by the DE learners was carried out. The survey methodology was adopted using questionnaire and interview instruments. Respondents were made up of 120 DE students, the coordinator of the DE programme, and 5 workers at the DE unit. The questionnaires were distributed to all the 120 students while the workers responded to a semi-structured interview. The data was analyzed using descriptive statistics.“Determining The Navigational Aids Use On The Internet: The Information Technologies Teacher Candidates’ Case”, send by Abdullah KUZU and Research Assistant Mehmet FIRAT, from Anadolu University, Eskisehir. TURKEY. In this survey research, Information Technologies Teacher Candidates’ use of navigational aids in Web sites and Web browsers, and the reasons for low use of navigational aids were investigated. The findings of the study revealed that the teacher candidates did not use bookmarks, Web maps, RSS and atom feeds sufficiently. Moreover, it was found out that the use of navigational aids by teacher candidates show variations according to the average Internet use is researched.The eight article is came from Malaysia. Titled article is on INFORMATION VISUALIZATION AND PROPOSING NEW INTERFACE FOR MOVIE RETRIEVAL SYSTEM (IMDB, written by Ronak ETEMADPOUR, Mona MASOOD and Bahari BELATON from Universiti Sains Malaysia. Their paper focuses on development